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Comment by stupidcar | Hacker News Reader

What about the situation in northern Italy? In the absence of a lockdown, the healthcare system did collapse, or came very close to doing so and this was only averted when the government implemented draconian quarantine policies.

The article claims that the survival of the healthcare system in places that implemented a lockdown has nothing to do with the lockdown, but then gives no evidence at all to back up that assertion.

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I also just have to point out that Sweden, the country that didn't implement lockdown, has 6 times higher amount of COVID-19 cases than other Scandinavian countries when adjusted.

https://www.nationalreview.com/corner/coronavirus-fatality-r...

Sweden has much larger nursing homes than, for example, Norway, and most deaths in Sweden are from nursing homes. The time integral of the curve over 1 year will tell the real story.

So are you arguing those numbers are acceptable because of the size of nursing homes in Sweden? Or am I missing something in your 2 sentences?

I think they're saying that Norway would also have the same number of deaths as Sweden if they had the same number of nursing homes.

Come on. He's pointing out both an explanatory factor, i.e. larger groups of vulnerable clustered together, and also saying that the total deaths may end up being very similar between countries and that it is too early to tell. Without a vaccine or effective treatment, there's no long term alternative to something akin to the Swedish strategy.

Most deaths in most countries are in nursing homes. Do we not care if older people die?

We care, but we care less than if people with their whole life ahead of them die.

That's the whole point of YPLL and other age adjusted metric that the scientist and academics who study disease, pollution, etc. use.

UK also shut down fairly hard and that still didn't stop the spread in nursing homes. So lockdown does not automatically seem to stop the contagion from coming into nursing homes.

Makes sense really. Maybe a focused effort should be made to protect nursing homes.

The UK did not shut down very hard nor early, New Zealands recently "relaxed" lockdown is basically the same has what the UK has been under

The UK shut down too late. People at the time of the Cheltenham Festival (10-13 March) were saying it shouldn't have happened, and now: https://www.theguardian.com/sport/2020/apr/29/racing-ireland...

I think the point was that the total death count at this time is related with the size of nursing homes. Norway has numerous very small nursing home. Sweden has very big nursing home. All over the world we see that big nursing homes are impossible to protect. Belgium locked down harder than Sweden but has the worst stats in Europe. The nursing home death are often 80% to 90% of all death.

COVID-19 is bad, but if you exclude the nursing homes from the stats it doesnt justify the lockdown damage. Is there a realistic plan to isolate big nursing homes somewhere?

Given that basically nobody wants to end up in a nursing home, but do, often to face neglect and abuse, I'd say that no, we don't really care what happens to old people in nursing homes. Out of sight, out of mind. Yeah, sure, people with a lot of moral indignation will gnash their teeth at such a claim, but I just can't see how they're actually good places to be, and how if we really cared we'd structure our society in a way that makes them necessary.

You don't have to do a full lockdown if you just want to protect nursing homes; isolation of just the nursing homes/other high-risk concentrated populations would have the same effect on those inside

And their staff. And all family members of their staff. It's not "impossible", but I don't think any countries have attempted such a nursing-home-only lockdown.

Do you have a source on that?

That seems to be a point frequently cited in the media, but it seems quite random to compare Sweden to two selected countries, and it makes it look like you are trying to twist facts to prove a point.

Besides, the circumstances of the deaths are vastly different: deaths at retirement homes vs deaths in general population. Indeed, merely locking down Swedish retirement homes would have made your pro-lockdown argument meaningless.

The missing variable in this is what happens when you lift lockdown in the absence of a treatment or vaccine.

Comparisons with eg Sweden at this point have always seemed strange to me because the whole point of a herd immunity approach is to increase exposure initially, which will necessarily involve deaths being less spread out. The real question is, after a year, what's the total excess mortality including non-COVID cases due to delayed treatments due to lockdown etc. (which are never included in the models, which focus on one disease, and would take time to manifest) ?

I'm not opposed to shelter in place but the endgame logic has always been unclear, and as such, classist. The right way to do it, for example, is to pay people to stay home.

Alternatively - Sweden's per-capita covid19 mortality rates are about 125% those of the US, and bellow those of UK,France,Italy,Spain,Netherlands,Belgium all of which are locked down.

For some reason I feel compelled to point out that a blog post is not an "article," and in this case it's just one random techie's extremely stupid and ill-informed opinion. It's shameful that this garbage made it to the front page of HN.

The current policy post immediate emergency was criticized by a top scientist in Italy just today (obligatory disclaimer: he is the head of the institute I work in, but the views and opinions I express here are my own), and in fact he said that the government is not thinking forward with regards to preparing the health system to better handle this pandemic.

As an addition, not all the measures were correct to "fight" the pandemic in Northern Italy, where I am located. Glaring errors were made in putting patients within nursing homes, with "guarantees" of separation. Well, these guarantees did not hold, and death counts flared up there. To be fair, this also happened in all nursing homes in the country.

Also some regions were more efficient than others, some even started implementing contact tracing in absence of a position from the government (still not clear as of today).

I believe that a more directed lockdown (or avoiding errors like in Alzano Lombardo, near Bergamo, where basically a hospital turned into an "infection center") would've worked miles better than the current situation, where regions with almost no new infections are locked up as much as those with significant counts.

Northern Italy's health system also collapsed in 2018 (and probably other years, too) from the flu:

https://translate.google.com/translate?sl=it&tl=en&u=https%3...

The term "collapse" isn't used correctly there. The accurate title would have been "somewhat strained locally".

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