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> Why shouldn't we remove the lockdown if we can manage to do so without overwhelming hospitals?

That's a big if. The last stats I saw showed Sweden experiencing 4x deaths per capita compared to its neighbors, which is a clue that eschewing lockdown does make a difference. Every country is different. How do you know that Sweden's approach used in a different country wouldn't overwhelm hospitals? Once you let the pandemic get more widespread in a population, it gets hard to stop. Think very carefully about irreversible decisions.

They have more deaths because they're paying up front. The bet is that over time deaths will be roughly the same, lockdown or not. Considering that we're far off from a vaccine and world economy can't be left on life support for years, I'm inclined to believe them.

> The bet is that over time deaths will be roughly the same, lockdown or not

The total number of infections will be the same up until a vaccine is developed, but the death rate can be lowered by delaying widespread infection until treatments are developed, tested, and deployed, and by keeping the infection rate at a level the medical system can handle.

Can that be a personal decision, for example:

Person #1) I'm at risk and there are no good treatments, so I will self-isolate, waiting for vaccines, better treatment, and/or this to go away.

Person #2) I'm young, my risk is negligable, hospitals are not overwhelmed, and I have to support my family, my kids need to go to school, etc.

Why does person #1 get to tell person #2 what to do?

Unfortunately, if Person #2 chooses to get sick sooner, it increases the probability that Person #1 will get sick sooner. All precautions are multiplicative factors. See https://www.linkedin.com/pulse/saving-your-health-one-mask-t...

>Unfortunately, if Person #2 chooses to get sick sooner, it increases the probability that Person #1 will get sick

How does person #1 catch something if they are self isolating and don't interact with person #2?

You mentioned the probability of this, an increased risk for person #1 even if they are self isolating. I can grant that there is some risk associated with this But how does that compare to the impact that these lockdowns are having on tens of millions of people.

What if there won't be a vaccine soon enough, and herd immunity amongst the young is our best defense, and lockdowns just prolonged the economic misery and didn't save lives in the end? Still a possible outcome at this point.

> How does person #1 catch something if they are self isolating and don't interact with person #2?

Person #1 can't be 100% isolated. Person #2 can breathe on produce at the grocery store that supplies Person #1. Person #2 can infect Person #3 with whom Person #1 can't completely avoid interaction.

I can't answer the other questions. I just think we have to proceed with caution because ending the lockdown could cause irreversible spread of the virus.

It may work out that way. But I don't think that was Sweden's intent. Just yesterday I read that the guy who devised their pandemic response was surprised by the deaths. (Sorry, I don't recall the source...)

> They have more deaths because they're paying up front.

ISTM that with equal justification, you could argue that the lockdown countries have (possibly) more economic damage because they paid up front. But one side is paying in treasure, the other in blood.

And it's not even clear that Sweden is reaping economic benefits. Some parts of their economy suffered just as much damage as other countries. And now, many of the lockdown countries are experimenting with loosened restrictions, while Sweden's infection and death rates remain stubbornly high.

It could also be the case where lockdown countries are paying up front in economic damage AND will also pay later in deaths because there won't be a vaccine in time to stop this from spreading to everyone anyways.

> The last stats I saw showed Sweden experiencing 4x deaths per capita compared to its neighbors, which is a clue that eschewing lockdown does make a difference.

The reason why some countries have significantly higher death rates from coronavirus: it permeating nursing homes.

The countries that put in strict controls overall and maximally protected people in nursing homes have the lowest death rates.

Of course, the death rates worldwide are under-reported, and overall, worldwide, on average, the death rate is expected to be double of what is reported. To get an idea of what the true death rate from coronavirus, you would also need to compare previous death rates in previous years--at the same time of year. There is more work to do on that, because you would ideally have projections for if an epidemic never happened this year.

Correlation does not equal causation. I could spin the data to point out that Sweden has a fraction of the deaths as NYC and a higher antibody rate, proving that lockdowns don't work.

I don't think data is the reason why people feel strongly one way or the other about this. Maybe risk assessment is the difference.

We both look at the same data and come up with different conclusions. We might even both agree that this is most likely to peter-out from this point, but that it could get worse. We disagree on how to hedge/address both possible outcomes.

> I could spin the data to point out that Sweden has a fraction of the deaths as NYC and a higher antibody rate, proving that lockdowns don't work.

Could you? My impression is you have too much integrity to do that. Ignoring the obvious difference between a largely rural Nordic country and one of the world's most densely populated trade centers might be hard for you.

>We both look at the same data and come up with different conclusions

I have yet to draw a conclusion. If you read my comment carefully, it's cautioning you against coming to a conclusion too soon.

Agreed. It would be prudent to ease out of lockdowns with the capability to return to them if hospitals are becoming overwhelmed. The county I live in is taking a phased approach to opening businesses based on the risk of exposure for workers and customers. They haven't started yet. I question some of their targets, but am glad that they have measurable targets.

You are getting down voted, and I'm not sure why. I've grown the opinion that you cannot have any discussion around any measured approach related to COVID.

It seems some people view COVID as guaranteed death and any questioning of lock downs ending means that you are or are about to be a mass murderer.

One reason could be that GP seems to assume that spread to herd immunity is inevitable, ignoring the countries that have had great success in containing the virus.

What countries are you thinking of?

New Zealand has been able to pretty much eradicate the virus through lockdowns and contact tracing, but they only had 1000 cases.

There is no precedent for doing that in a country with millions of cases, like the U.S. It may be too late for that.

So is the purpose of continued lockdowns in the U.S. to eradicate the virus? That is what I am skeptical about, I don't see the evidence that such a thing is possible.

For the 'hard lockdown' crowd, how long can we put time on hold? A week? A month? A year? A decade?

It is an elementary fact that life rides on the derivative. Stop work and no wealth gets created. No meat, no veggies, no crops, no gas, no electricity, no metal, no lumber, no stone, no plastic, no industrials, no dentists, no medical services, no schools, no nothing. Modern people cannot live subsistence lives off the chickens in their backyard and a plot of land within walking distance. Our stockpiles will last for a while, but not forever.

At a second degree, the social connections that enable the amazing collaboration underpinning modern society break down. The longer we are locked down, the harder will be to come back and figure out our place in the grand social puzzle.

It is a terrible situation. Most people are going to get infected, and a non-negligible fraction of them [1%] are going to die. Everywhere where the virus got endemic. Perhaps a handful of East Asian countries will manage 100% border shutdowns and 100% contact tracing for years on end. More power to them, the rest of the world lacks the social cohesion to pull off something like that.

Worse, the impact is going to be unequal. Some social strata will have more options to stay isolated for longer. It will appear, for a while, that they are somehow performing better than everybody else. Rest assured, there will be very few that can avoid the disease for long enough (~18 months) to be on the upside of a hypothetical vaccine. All we can hope is that, eventually, this disease goes the way of the common cold.

Toughen up. This is not Man's making. Nature send a Russian Roulette our way, we have no choice but to play.

In the meantime, try to avoid media that does it's best to paint this disease as the second coming of the Black Death. One of the technique is to cherry pick. Say 'one of my co-workers died', implying that they are next. Instead of '1 out of 73,348 of my colleagues' died. It is unavoidable tragedy that there may be anywhere between 73 and 733 of their colleagues that are going to die before we see the end of this.

Sure, we cant shutdown forever, but I dont understand the rush to sacrifice.

Covid will be with us forever now, and in just a few months we already understand a lot more about it than we did at the start.

The longer we can delay mass infection, the more effective our treatment of the disease will be, and the more likely we will have vaccines.

Lets delay for a while, figure out the best treatment methods, and then let it through.

2 months is too early. Can you name a date when we should open? Can you even name a date that is obviously too late?

I've struggled with the same questions. I noticed that no matter which date I picked, 'let's delay longer' was always the preferred choice. We've got to wean ourselves from the lockdown.

We're in NZ, its feeling likely at the moment that the date will be wednesday.

OTOH we have been incredibly lucky with both our leadership and our island status.

the US is a huge state, with porous borders so the right choice might be different, but the more controlled the spread is, the fewer lives will be lost and the more likely time will help us understand the best treatment.

>The longer we can delay mass infection, the more effective our treatment of the disease will be

You can stay in your house until the treatments get better, which is also a smart thing for vulnerable people to do.

Why not let other people off lockdown if they wish as long as the hospitals are not overflowed? A lot of people face a negligable risk from this.

What difference would it be to you? And look at the cost to them, tens of millions of people's livelihoods thrown up in the air.

Having said the above, I do see the value of lockdowns that prevented hospitals from being overwhelmed. That is different. But it looks to me like we can look at moving past that threat. What do we do next?

Its not about me.

The benefit comes when the community as a whole does it, there is literally no point to anyone doing it alone, unless they are vulnerable.

"What do we do next?"

Figure out the best way to treat covid, and talk about the best time to end the lockdown.

Im in NZ btw, NZ locked down hard and early. Its been six weeks and so far we have 20 deaths from covid.

"What next?" is exactly the question, and I dont think anyone knows the best answer yet.

We are likely to be mostly ending our lockdown on this wednesday. We are entering "level 2" which I believe is all businesses open and running, just some rules around congregation.

I simply do not understand the chorus of calls to end lockdown (or simply never start it) in countries where absolutely nothing is under control.

It will cause incredibly loss of life, and people are doing in a rush.

Im really struggling, on a personal level, to understand the rush in some countries to sacrifice people and not economies.

Surely the economy is there to serve us?

NZ did a great job of jumping on this early. Last week when I looked they something like 1000-2000 confirmed cases? NZ has been able to effectively eradicate the disease there with their early lockdown. It will be interesting to see how things go there over time (second wave? etc)

That is quite a different scenario than in the U.S., where there were hundreds of thousands of infections (millions?), not enough tests to go after eradication at this point, etc.

Were you thinking that the U.S. would be able to maintain a lockdown until eradication, perhaps with contact tracing? Is there evidence that such a plan could work?

I understand your struggle to see my point of view. Ditto! I read a book that posited that people are born with personality differences, and value some things more than others. For example, I feel very strongly about individualism and anti-authority, while others may be more communitarian and authoritarian. The world ultimately benefits from both.

Having said that, I wonder what practical benefits a person who chooses to self-isolate in any of a number of countries where this is endemic gains by forcing other to lockdown against their will when the hospitals are not overflowing. Why should the many young and healthy who face a negligible risk to continue in what is sometimes very difficult circumstances? What is really gained at this point?

Anyways, that was all meant to be a peek into my thinking.

yeah, we got lucky with our leadership and with our island status.

", where there were hundreds of thousands of infections"

well, EVENTUALLY, there were hundreds of thousands of infections. at one point there were, famously, 15...

"Were you thinking that the U.S. would be able to maintain a lockdown until eradication, perhaps with contact tracing? Is there evidence that such a plan could work?"

No, I dont think that would be a long term solution for the US, I dont have any source for my beliefs, but I suspect with the size of the US, the nature of its people and the incredibly porous border it has that a lockdown until eradication would be doomed to failure.

" I feel very strongly about individualism and anti-authority, while others may be more communitarian and authoritarian"

yess....the world does need both. Im not sure where that comes into the decision to lockdown or not, and for how long. I feel like there needs to be a more sciency approach taken there rather than some vague handwavy stuff about personalities.

"Why should the many young and healthy who face a negligible risk to continue in what is sometimes very difficult circumstances?"

I dont know. I dont have much use for the word 'should'.

I think that two things are true, first the young and healthy are at risk from this disease themselves - the stats prove that, and second its almost certainly true that the young and healthy have loved ones who are young and unhealthy, or old and healthy, or old and unhealthy, and....maybe....the young and healthy dont want to catch covid and then infect the people they love.

All I was saying with my comment above, is I dont understand the rush to sacrifice those people who are vulnerable to this disease.

Even here in NZ where we have been very lucky so far it is obvious that eventually we will have to reopen the borders and let the rest of the world in, and at that point infections will start again, but by then we have the best possible chance of understanding how to treat the disease most effectively.

I dont believe "lockdown for eradication" in the US is a viable choice, but I do think "lockdown to slowdown" is a sensible option for a while yet, to give every one of your citizens the best possible chance of survival.

The economy will recover, it always does. It reflects the nature of people, and for that reason is endlessly resilient.

>well, EVENTUALLY, there were hundreds of thousands of infections. at one point there were, famously, 15...

Maybe there were 15 case last October! :-) I'm thinking we could have had thousands of cases in the U.S. before we started testing. But that's water under the bridge at this point. I wasn't arguing that lockdowns were useless, or that they weren't justified a month ago. But given the additional data I wonder about them now.

>I think that two things are true, first the young and healthy are at risk from this disease themselves - the stats prove that

I end up looking at NYC stats a lot... Last week they were seeing 20-25% of sample population with antibodies. I found found April 14 NYC numbers showing 4.5% of covid deaths there were people under 45, and a bit over 14k deaths in NYC as of yesterday. Extrapolating from these numbers I calculate 2500 people under 45 will die before reaching 80% herd immunity. That's 2500 in a city of 8 million. 2016 numbers showed 4.9 million people under age 45. Which works out to just under 1 in 2000 young people dying.

It's interesting for me to think about that number. Is it significant? I looked at some actuarial tables and see that a 45 year old has a 1 in 300 chance of dying in any given year. 1 in 1000 for 20 year old.

I'm betting a lot of unemployed young people want to get on with their lives and wouldn't be worries about taking their chance with a 1 in 2000 risk.

>and second its almost certainly true that the young and healthy have loved ones who are young and unhealthy, or old and healthy, or old and unhealthy, and....maybe....the young and healthy dont want to catch covid and then infect the people they love.

I'm not saying that everyone has to go out and mingle. Everyone is free to self-isolate.

I grant that some people could be put in a difficult position, feeling like they have to go to work when they don't want to, living with someone who won't self-isolate, etc.

Maybe there's away to ease the lockdown and provide assistance to those left in a bind. These would be good problems to talk about, and will probably come up no matter when we ease the lockdown.

Everyone wants to get on with their lives, but at what cost? thats what it comes down to. We will either pay in economic damage, lost lives or (looking likely) both.

Again, I dont understand the rush to throw so many lives under the bus with so little care, its bewildering.

Those people, our vulnerable, can be sacrificed at anytime, but they can only be sacrificed once.

Lets try something else for a few months first, and see how it works.

If nothing else works out, we can always fall back to the "let everyone in society who has an underlying condition of some kind die" plan afterwards.

On a different note, I will say it is massively interesting to me that someone who claims to be anti-authoritarian is recommending everyone in society return to work in an orderly fashion to save the economy.

Which side do of that argument do you believe holds authority at the moment?

Hard Authoritarianism: Do what I say or else I send armed thugs to enforce it.

Soft Authoritarianism: Do what I say or else I convince everyone else you should be treaded like a pariah. See exile, excommunication, cancel culture.

Liberalism: This is the right thing to do, I pray you join me in doing it.

I might be thinking of the word anti-authority different in this context. I was talking about people who could protect themselves by self-isolation forcing others to self-isolate. I don't believe that is as justified as it was when this started.

GP brought out the tired "Give people who aren't afraid the freedom to choose" argument, which misses the point: The Stay at Home order is not about those freedom people. It is about the people those people will infect.

> Why shouldn't we remove the lockdown if we can manage to do so without overwhelming hospitals?

The premise of the question is false. The states making aggressive reopening moves are largely on upward trends of cases and show no sign of being able to avoid overwhelming their health systems if they reopen (some are on track to so so with their, often already too lenient, “lockdowns”), and even the states doing more measured reopenings that seem to have the caseload situation more in hand (like California) don't have the surveillance in place to detect a new surge in time to effectively respond. The latter approach is risky but arguably responsible given the context of the grossly negligent federal economic response, but the former is just flatly indefensible.

I would agree with your concern about the possibility of hospitals being overwhelmed with no lockdown. But then again that has not happened in Sweden.

You mentioned being concerned with the caseload in states that are doing graduated openings. I was thinking of this mostly in terms of hospitals being overwhelmed.

Are you thinking we can eradicate this in the U.S. with a long term lockdown? I don't think that's possible anymore.

It’s also to slow the rate of infection in order to buy time until we figure out more effective treatments and potentially a vaccine, and also to improve detection and isolation practices. The goal isn't “spread 1,000,000 deaths out over a longer period of time.” It’s also to reduce the number of deaths and infections altogether. Unfortunately, in the US we haven’t used our lockdown time in a useful way. We’ve kept hospitals (mostly) from being overwhelmed for now, but none of the infra that supports an effective test/trace/isolation regime was deployed. Hospitals still can’t get sufficient PPE. Etc.

The purpose of the lockdowns initialy was to keep the hospitals from being overwhelmed, i.e. Flatten the Curve.

Are there other useful ways to use a lockdown at this point, when there are already millions of infected?

There's no precendent/evidence that anything else can be done at this point, there's too many cases.

Are you thinking that we should change the goal of the lockdown, to be eradication? Is that possible?

This thing is still spreading, even during the current lockdowns.

The purpose of TTI isn’t necessarily to eradicate the virus altogether, which does seem unlikely. It’s the alternative to lockdowns. Like lockdown, it reduces the new infection rate. Unlike lockdown, society is more able to carry on with something resembling regular economic activity and mobility liberties. In the US we have squandered our lockdown time in a way that will make TTI more difficult, more expensive, and less effective because, the outbreak is more widespread. But even with those marks against it, it would be better (in terms of economics, health outcomes, and personal liberty) than extending lockdown indefinitely or “opening up” the economy to what will quickly result in resuming exponential growth of infections and, consequently, deaths.

> Why shouldn't we remove the lockdown if we can manage to do so without overwhelming hospitals?

Because until we have an effective vaccine or treatment, that'd mean something about 2% mortality rate across the infected population, which, without any containment, would be close to 100% as this thing is crazy contagious. That's 6 million dead people.

And keep in mind that 2% is a very optimistic number. Germany has twice as many. In the US about 6% of the confirmed cases are already dead, with only about half recovered. From that 6%, it'd be 22 million dead people.