Plan for 5 Years of Lockdown
boffinism.com
boffinism.com
My own mother still needs urgent dental surgery. It’s going on two months now.
You hear the trite content free version of this tradeoff in people whining “you just want to protect your 401(k)”. Imagine after five years, all 401(k)s are wiped out, most hospitals are bankrupt for lack of running any profitable procedures, and the US is throwing together some emergency single-payer system ... but it is struggling with recruitment because there’s not enough tax revenue to get the budget to pay enough doctors. (You want to sell bonds? Who has money to buy bonds?) How many die in this scenario?
I really think I would agree with you in normal circumstances. But there is so much political pressure from groups who are downplaying the virus altogether, to just ignore the virus and go back to business as usual, that I suspect a lot of less-than-ethical ulterior motives are at work. So I feel a very real “allergic reaction” to anyone who says we need to just reopen things.
Maybe it’s because politicians in the US have turned the whole question into a wedge issue to oversimplify things and get voters on their sides, I dunno. But the question on when/whether we can return to normal is a very serious one that needs to be something we all understand and agree on, and I’m worried that’ll never happen. Our priorities are simply too far out of alignment.
I think there is a middle ground. We cannot be on lockdown for a year, lets be realistic. Even if the virus persists, the world or even a single country just could not sustain that. And on the opposite side, we cannot open up too quickly. I know China's data is not accurate but we can at least communicate with people inside of the country and we know life is getting more back to normal there. So we can see that we also have to stay closed enough that the first large wave does not devastate the system.
It is just a shame though that we can not have dialogue about the science and data behind this. And instead it becomes an extreme from both sides.
From outside the USA watching these protests -- it's possible more weight is being given to certain (less favourable / sensible) aspects of the message they're trying to send, but we're seeing things like 'If you're sick - come along to the protest' and 'We don't want people wearing masks'.
That doesn't explain the prevalence of "I WANT A HAIRCUT!" and "I WANT TO GOLF!" signs. The protests seem to mostly be "I want people to work for me", rather than "I want to work".
> Earning a living is essential
> I want my job back
Or [2]:
> Free people make their own risk assessments
Shame we have to look to the Indian press for fair coverage of these protests in the US.
1: https://c.ndtvimg.com/2020-04/b70u23q_us-protest650_625x300_...
2: http://www.dailyaddaa.com/world-news/us-covid-19-live-free-o...
But from the earliest lockdowns, all the forecasts have been that about 60% of the world population ultimately gets infected anyway. The lockdowns are about making that happen in a more orderly way, one that doesn’t absolutely crush our hospitals, ICUs, ventilator capacity, and our stocks of PPE. That’s what we’re buying with the lockdowns. That’s where the lives are being saved.
That makes sense, for a while. That doesn’t make sense for five years. The question is where the line goes in between, and I really don’t know exactly where. We may have passed it or it may be months ahead.
Just remember that even if we are right to call for a much longer lockdown, we shouldn’t go all William Bligh about it, condescending to abuse people who are stubborn and wrong for their stupidity on the matter. Such an approach is anti-leadership; it gets you senseless mutinies instead of buy-in.
(See also: Bill de Blasio enjoying the amenities of the Park Slope YMCA mere moments before shutting down all the gyms. Not a great way to build solidarity.)
What part of the world are you in, and what part do you speak for?
There was mention of 401k's (something I believe is peculiar to <5% of the world's population). The claim that emergency surgery was impossible during any kind of lockdown (not true, in my understanding). The claim that hospitals would be bankrupt without profitable procedures (something that simply doesn't make sense outside of the USA).
The GP is entirely speculative, and claims to speak for an audience that doesn't necessarily agree with them.
My question - in response to the claim that the world agrees with them - is what part of the world they are in, and what part do they claim to speak for. I don't understand what there is to understand with this question.
The equation evidently (according to OC):
take the death count ... versus ... mass unemployment, no basic medical services and cancer screenings
Part of the RHS was also most hospitals are bankrupt, and the weird claim that tax revenues are the only way to fund essential services. (I'd suggest cutting costs in other areas - defence, for example - is one way to rediscover funds for essential services.)
Anyway, I expect that where you are right now, what you're seeing going on around (aka the level of incompetence exhibited by your leaders / government) along with the usual way your society and economy work, is going to significantly affect which way you lean on that equation.
Also if you run the stats and conclude you personally are not likely to be part of the death count, but you would be inconvenienced by a cautious approach, you're probably going to lean towards the '[other] people dying ain't so bad' camp.
> "In the end, I suspect the only way out of lockdown in anything like the short or medium term is if we can assert something new:
A5) The social and economic damage caused by lockdown is going to cause more unnecessary deaths than those caused by ending it."That's a very American problem due to having private hospitals...
What happens to the European hospitals when tax income falls way below what the government needs to operate?
The healthcare budget is a rather small part of the total government budget, a small increase is probably too small to register on the radar. But if it does, one might assume that the government would rather keep healthcare running, especially given the circumstances, and cut money anywhere else.
To make a comparison for US readers. Healthcare in Europe is like freedom of speech in the US. It's deeply ingrained in each citizen and cannot be taken away.
According to the commonwealth fund[1], Germany spends over 10% of its GDP on providing health insurance. This insurance is funded by a tax on income.
If GDP contracts, and there are less income earners, this can become a very large part of the budget which would require cutting other programs. Obviously healthcare would be a priority. But in a country where people rely heavily on their government, cutting out social programs will really hurt.
> Tax income is already way below spending. Countries are going deeper and deeper in debt every year.
This is what I am concerned about. Governments fund their debt by selling bonds. In the USA, roughly 70% of the federal debt is in the form of bonds held by the public. If people stop buying bonds (because their returns are awful right now, or because people have much less income to be investing), then the governments of the world cannot continue to operate the way they have been.
[1] https://international.commonwealthfund.org/countries/germany...
Besides, publicly funded hospitals and healthcare systems in general need money, too. If there's hardly any tax income anymore because there's hardly any taxable income anymore funds for publicly funded hospitals will dry up, too.
> Title has nothing to do with the content
You might be misparsing the title in the same way that I originally did. It's not "[this is the] plan for 5 years of lockdown", but "[you should] plan for 5 years of lockdown" which is a correct summary of the position argued by the article.
Lockdown has very real costs. We are seeing crazy unemployment, a huge spike in calls to suicide hotlines, and very likely an increase in all-cause mortality as people are unable to get regular preventative care. Someone who would have had that weird lump checked out last year isn't going to right now.
We are already seeing protests pop up all over the place. And as most places have seen daily new cases start to fall, lockdown will become unenforceable as people get too restless.
So letting the virus run its course is not as simple as people would like to believe. If we do let the virus infect 60 to 70% of the population, we vastly increase the risk of a much worse pandemic.
Personally I think that the people who want to re-open the most are rich people who realize that they stand to lose a lot of money both by not getting the income from an active economy and secondly by higher taxes and asset nationalization from governments who are going to have to support lost income and social services.
My final thought is that many people now perceive the virus as mainly targeting elderly, poor, frail, drug addicted and ethnic communities; which sadly many people consider to be acceptable losses.
The are currently > 30 known mutations: https://nypost.com/2020/04/21/coronavirus-has-mutated-into-a...
But a lot of deadliest viruses kill fast and are less viral, so only way to spread is become less lethal.
This virus has the luxury of being both deadly AND extremely viral (because it takes it's time killing people).
Even if you don't die, nobody knows the long term effects of the virus on lungs, kidneys, heart, etc...
So, while a lot of diseases do mutate to be less severe, that doesn't need to be the case with Sars-cov-2.
I'm laying odds that the USA will be an exporter of COVID cases around the world. Assuming the rest of the world will accept travelers from the USA without mandatory quarantine.
There's no way a lockdown like this will go on for more than a year even if it means more people die.
There are good reasons to be sceptical about locking down a complete economy, but everybody is afraid to speak out, because they know they will be destroyed by the moralists!
The communists believed in altruism... they thought they were right and people around them evil. The human mind is corrupt. Some people simply live in a fantasy world. The christians, communists and fascists had 1 thing in common... they thought they were right and used the truths as a weapon against other people.
Speaking about other people as "evil", is sometimes projection or an egoic illusion.
The supply chain will just disintegrate otherwise.
I tried to buy a part for my dryer two weeks ago and it was going to take >2 months. I ended up then trying to buy a dryer and the only one I could purchase was already in store. If I tried to order one again it was >2 months (on an unknown timeline).
China is having massive production issues, there are import fees/inspections and now a 2 week quarantine on incoming goods.
It’s all kinds of messed up and now there’s a good reason to change production location.
I expect, though, that these sorts of things will get sorted out. For one, no government is going to be keen on letting people who are confined to home and dependent on computers and the Internet to keep their little corner of the economy going go without power for long just because it's suddenly next-to-impossible to get some special precision bracket from the overseas factory that got the contract to make it back in 2005, while at the same time the domestic economy has hordes of ex-machinists who aren't quite ready to retire yet yet, and would be more than happy to quit their jobs as greeters at the local big box store in order to return to a job that pays more and reduces their risk of exposure to SARS-CoV-2.
Worst case scenario, perhaps we won't return to the "easily availability of basically everything so everything's basically disposable because the global supply chain is so fluid that it's easier to buy new broken crap than replace old broken crap" that we enjoyed so far this millennium. But I doubt it'll get much worse than the level of availability that developed economies enjoyed when I was a kid. Which is still pretty good. It would take a bit longer to rejigger the design of consumer products so that they return to using more standardized parts that can easily be stocked locally instead of all this fragile, disposable, special snowflake industrial design. But I could see that shifting fairly quickly, too, if things are still looking bad in 5 years.
Huh, this is the first I hear of such a thing. Is this in the US? I thought the scientific consensus was that even under the most favorable circumstances the virus isn't viable on any surface after two or three days. And typically much shorter and very unlikely to be sufficiently concentrated in the first place, e.g., the person manufacturing your dryer in China won't be sneezing into it constantly. So locking things up for two weeks seems surprising.
Personally I'd much rather a slightly longer lockdown now than a long painful cycle of repeated lockdowns.
It's already surprising how much of the activity turned out to be "non-essential". And we can have oil at half-price to do the essential. :D
Worldwide, that's not to be taken for granted. Here in Russia, the police is sometimes stopping agricultural workers from planting their crops because of the lockdowns. (Source in Russian: https://www.kommersant.ru/doc/4311038)
Could you explain what kind of lockdown model you are thinking of that would prohibit production or distribution of food?
As an intentionally pessimistic estimate, to counteract all the over-optimistic estimates, I think it makes sense.
Would you prefer it as “5 years until a return to normality”?
So the headline and thesis have been successful in getting us discussing the situation, but the content is weak with no evidence from a source with zero credibility.
For me personally, just saying “prepare for a much longer lockdown” wouldn’t be better; without a concrete number it makes much less of an impact.
With a concrete number in there, even if it’s very clearly just a guesstimate with huge error bars, it makes you think about what the effects might be in the real world, which I think is helpful (in fact it’s the very point of the whole post).
How long before we realise its not going away? At the 3 year mark when no successful vaccine is found???
> I know. I know. No one wants to hear this.
> But, but… vaccine?
Would this kind of antagonism really convince anyone?
God ("nature"?) is punishing us, because we have sinned.
There are so many variables in play right now, which we don't know about.
Things that could help us are:
* unrecognised infections make the mortality compute to flu levels
* we find a vaccine timely
* we find treatment timely
* we find specifics about transmission and can avoid it with low-impact responses instead of lockdown
* there are explanations for why it's so regionally different (NYC/Italy vs. Singapore/Germany)
* some sort of seasonality
* we find more specific risk factors which can be remidiated (air pollution?)
Probably more.
Why point out it could all go bad? That seriously can't count for an intelligent assessment of the situation. It's an expression of fear. Why don't you read the optimistic reading more often? It's almost like people think fear was virtuous.
Being pessimistic is not the same thing as being afraid. Being cautious is not the same thing as being afraid. Acting on negative prediction does not mean one is acting out of fear.
Being cautious is emotionally neutral, we should strive for it, for sure.
Acting only on negative predictions without weighing in positive predictions or the uncertainty of the original prediction is stupid and unscientific, and likely the result of fear. That you see all the time right now.
Where do people discuss the postponed cancer operations and their casualties, what is the cost of livelihoods destroyed, like yoga studios and hair dresser small businesses? How do you even measure it? Who's stating their opinion on coronavirus lockdown, while also adding the disclaimer about their steady and safe monthly salary as a conflict of interest? People who want to reopen don't care about the "money," they care about economical survival, most probably in most cases.
My point was about optimistic bias you get when you frame every discussion about negative aspects of something as fear. Which is exactly what you was doing there. This rhetorical trick:
> Why point out it could all go bad? That seriously can't count for an intelligent assessment of the situation. It's an expression of fear. Why don't you read the optimistic reading more often? It's almost like people think fear was virtuous.
Buying this, there is no way to rationally point out that things could be bad. You just ruled out arguments of the people you disagree with without engaging with them. Only optimistic prediction or information is allowed in rational discussion.
> Where do people discuss the postponed cancer operations and their casualties, what is the cost of livelihoods destroyed, like yoga studios and hair dresser small businesses? How do you even measure it?
I distinctively remember those being discussed. You can discuss them. I am not saying that these should not be discussed.
But they are not optimistic. They are pessimistic and if I wanted to frame them as "fear", I could. And it would be equally dishonest rhetorical trick.
I'm arguing for balanced assessment of risk and opportunities.
Because that's what is meant with "why point out it all go bad" part. The lack of counter arguments. You created the "only good" bit in your mind.
I'd challenge you to perceive opposing views not as bad faith, deceptive or dishonest. The world has far less of those types than current media and political climate makes you think.
I think this is a very important point, and I have some hopes that we will. Austria reopened smaller shops (below a certain number of square meters; supermarkets and other "essential" stores were open all the time) eight days ago, with a limit on how many customers may be admitted at a time, and a requirement to wear masks. If this were dangerous, we should have started to see a rise in new cases per day, but they have mostly been sinking over this period. Further businesses will follow in the coming weeks, with the numbers being monitored. I think that over the next few months we should get pretty good data on what seems to work and what doesn't.
The solution will not be limited to "wash your hands, don't touch your face" like we thought in early March, but neither is this virus impossible to keep in check using some hygienic and distancing measures.