Comment by ryankemper | Hacker News Reader

Comment by ryankemper | Hacker News Reader

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It really is highly ironic that by instituting a national lockdown and telling citizens to avoid the hospital across-the-board (instead of specifying high-impacted areas like New York), we destroyed tons of jobs in the medical industry.

I dislike citing news articles, I'd prefer to cite real research, but here's a crappy source: https://www.usatoday.com/story/news/health/2020/04/02/corona...

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When I first started hearing about the Coronavirus and figuring out the situation, my initial reaction was that we need to foster herd immunity, and avoiding exposure is near-impossible over the long run therefore we should just "get it over with" - not going out of our way to get infected but also not hiding.

Then as we heard about Italy, France, etc, my view shifted, and I viewed the lockdown as a necessary evil.

I've now swung back the other way. Time will tell, but I really think that subsequent research we'll show that we took a huge problem - a covid pandemic - and turned it into two huge problems - a pandemic along with significant swaths of our economy getting destroyed.

The argument to flatten the curve, beyond preventing exceeding hospital capacity, which is absolutely a critical goal, was also that those of us who are not at serious risk could spread to those who _are_ at risk, and therefore everyone needs to act in lockstep. Well, if you take a systems-level view, absolutely the best thing a non-at-risk person can do is get exposed to covid, fully quarantine themselves, and then return to daily life. Having a huge swath of the population with immunity is the best way to protect our at risk population. (In a perfect world, we could culture sars-cov-2 and voluntarily expose ourselves - basically a vaccine except you're exposing yourself to the real deal and not a virus rendered inert)

Also, back on the "exceeding hospital capacity" point, it is precisely those at-risk who are filling up hospitals and needing intubation or ventilation. So we can have a huge portion of the population who is not at risk still living their lives (with some adjustments), and the effect on hospitalizations would really not be that bad as a result.

I'll be closely following Sweden's data over the next months. I'm very curious how their strategy pans out.

> if you take a systems-level view, absolutely the best thing a non-at-risk person can do is get exposed to covid, fully quarantine themselves, and then return to daily life

The problem with this kind of "systems-level view" is that individual humans are not cogs in a system. What you propose here is asking every non-at-risk person to take an unknown, but possibly as high as a percent or two, risk of dying. I doubt many people will take you up on that. I certainly won't.

I think the best you're going to get along these lines is to find out, once widespread antibody testing is available, how many people have already been exposed to the virus without knowing it. If that number of people turns out to be large enough, it will be a lot easier to get things back to something approaching normal.

> What you propose here is asking every non-at-risk person to take an unknown, but possibly as high as a percent or two, risk of dying. I doubt many people will take you up on that. I certainly won't.

This is a complete farce. 1-2% of dying in not-at-risk individuals? We know that the diamond princess, the cruise where we tested everybody, had around a 1% mortality rate, and that was with a bunch of at-risk individuals (the elderly, in this case). That basically gives us an upper bound IFR, and other data coming out from places like Germany is putting us closer to .2-.6% IFR.

But yes, if someone has extreme anxiety that they are going to die from covid, even despite evidence to the contrary, they should absolutely stay at home. No one should be forced to go outside, but unfortunately in many parts of the world people are being forbidden from going outside practically at all.

The important thing here is the individual needs to be empowered to make an informed decision based off their personal risk tolerance. If someone decides that the unknowns are too overwhelming and they want to remain at home until a hypothetical future vaccine is hypothetically released, that's totally fine. But critically, I don't want to be living in a society that is forcing me to stay inside for reasons that are not based on evidence-based public health policy. And unfortunately so much of what we've seen (e.g. closing public parks, banning jogging, disallowing drive-thru church meetings until the decision was overturned) is not grounded in sane policy, but instead in panic-driven reactionism.

> This is a complete farce.

This seems like a highly disproportionate response.

> other data coming out from places like Germany is putting us closer to .2-.6% IFR.

Which is not that different from 1% if you're talking about people deliberately exposing themselves to the virus. If I'm not going to do that at 1%, I'm not going to do it at .2% either. So the term "complete farce" seems way over the top. To me, if you seriously think a significant number of people are going to be willing to deliberately infect themselves and take a .2% risk of dying, or even a considerably lower risk than that, that seems like a farce.

> The important thing here is the individual needs to be empowered to make an informed decision based off their personal risk tolerance.

I'm generally in favor of the idea that people should be given the best available information and then should make their own decisions. In this particular case, I just think you are way, way off as far as your apparent estimate of the average person's risk tolerance when it comes to deliberately infecting themselves with a virus.

Also, if we're going to talk about evidence-based public policy, we need to look at the evidence regarding how well people make decisions when they are empowered to do so. I think the evidence of the last couple of months shows that many people are very bad at that; a lot of public places continued to be crowded with people well after the point where there was plenty of public information telling everyone that close contact with other people in crowded places would spread this virus.

Further, our current public policy regime holds public officials responsible when things go bad, regardless of whether it was actually their fault. That creates a huge incentive for public officials to impose restrictions on people, whether or not they actually make a difference. If we really want to be empowered to make our own choices, we need to stop expecting our public officials to automatically protect us from bad things happening, and take the responsibility for protecting ourselves.

FWIW: .2% would be the IFR for the general population. Given you stated you are not at risk, your actual chance of death would be something like .007%, or 7 deaths in 10,000

> Given you stated you are not at risk, your actual chance of death would be something like .007%, or 7 deaths in 10,000

Where is this number coming from?

(Also, .007% is 7 per 100,000.)

Sorry for the delayed response. And thanks for catching my math fail.

Those numbers came from https://esb.nu/blog/20059695/we-kunnen-nu-gaan-rekenen-aan-c..., but given it's in dutch it's probably easier to use this table that a redditor compiled:

https://old.reddit.com/r/COVID19/comments/g4tqvk/dutch_antib...

My bad on not including the source originally; I was on mobile and couldn't track it down (and therefore probably should have just not commented)

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