[flagged]
Absolutely wrong. And you are missing:
- lockdown reduction in suffering, due both to the acute phase of the disease and after effects
- No-lockdown-externalities, including damage to the economy if the disease is allowed to spread through the entire population
And perhaps most importantly:
- the risk that a huge reservoir of infected people will lead to repeat waves caused by mutations, and even worse that cross-species infection occurs (we already know cats and dogs can be infected - pigs and poultry could be next); then we risk flu-like antigenic shifts.
Put all this into the equation and I think the only thing we should be contemplating is how to eradicate the virus as soon as possible.
Do you think that eradication is actually a possibility? Or are you using it as a metaphor for "contain it super well"?
There are a number of reasons why eradication is completely infeasible. In short, COVID-19 is a highly infectious respiratory disease and it came from a zoonotic origin. We know there are animal reservoirs at this moment.
Therefore eradication is impossible. We've only ever eradicated two diseases in all of human history.
This seems like a very strange take. This is a utilitarian perspective, but with a floor of 20 million years of utility before we take any action. Why shouldn't we take action if the mortality reduction years > lockdown externalities? You're essentially saying "we should take no action to prevent a disease from costing us 20 million wellbeing-years", which seems odd.
> BTW I think once accounting for vector exhaustion (not everyone has the same risk of infection) and what I feel is a more realistic IFR, we'd be closer to 600,000 deaths in the "realistic" scenario IMO.
Are you accounting for the other side effects of Covid? Life long lung capacity loss due to pneumonia side effects, weird not well understood side effects like strokes in young people etc? Most of the people I see minimizing the risk and saying we should reopen seem to entirely ignore those dangers.
> Given that we must practice indefinite containment until we develop the "game-changer", we are executing a strategy which is based off a temporally unbounded future event. Therefore the potential drawbacks are unbounded given that the strategy involves waiting for a miraculous leap forward in COVID-19 vaccination or treatment.
This isn't at all true. Look at China, Taiwan, and South Korea, which have all begun reopening, but with infrastructure in place to track and keep outbreaks contained even as they reopen. Some parts of the US are on track to do the same relatively soon (weeks, not months or years).
> My proposal is an approach where we try to direct testing resources and governmental assistance to protecting the most at-risk members of society.
You realize that this is what's being done now, essentially, its just that tests are so severely limited that that isn't useful. We can't, for example, consistently test employees at nursing homes to make sure that they aren't infectious. Until we can do that, returning to normal is asking nursing home employees to shelter even more tightly than individuals are now, or it's sacrificing lives.
It feels like you haven't looked deeply into the criteria that many metro areas (NYC, WA, and the Bay to name a few) have to reopen. They're specific and clear, and backed by reasonable thought.
You're right, that was my mistake. I got a rough 20 million life-years by taking Ferguson's worst-case scenario and then applying the "COVID-19 takes average 10 years of lives" claim (which is a false claim). Thus arriving at the implied scenario that lockdown proponents say could happen but that I think is an impossible to reach number.
(For context I use Ferguson's 2.2 million as an upper bound, but that 2.2 million scenario involves an overwhelming portion of the deaths being people who were already at death's door. Thus I think 2.2 million is possible but highly unlikely due to the other factors I mentioned, whereas the 20 million life-years figure I view as basically impossible to hit because it implies that same worst-case scenario but with the wrong distribution of age)
At that point I thought to myself "wait, I forgot to account for the negative externalities". But as you indicated, that logic was wrong.
So, allow me to retroactively change my answer to just 20 million life-years period.
Thanks for pointing that out.
> It feels like you haven't looked deeply into the criteria that many metro areas (NYC, WA, and the Bay to name a few) have to reopen. They're specific and clear, and backed by reasonable thought.
No, I understand their criteria but fundamentally disagree with the entire approach of containment, as I explained in the GP comment you replied to.
> This isn't at all true. Look at China, Taiwan, and South Korea, which have all begun reopening, but with infrastructure in place to track and keep outbreaks contained even as they reopen. Some parts of the US are on track to do the same relatively soon (weeks, not months or years).
I don't believe that the US can use the same strategy that China, South Korea, or Taiwan has been using. They have much better control of their borders and are a much more homogenous and compliant population.
I don't think this is correct. Every day that passes by, we learn a little bit more about this virus and get a little better at treating it. For example, in the past few weeks doctors have discovered better ventilator protocols [1] and potential benefits of anticoagulants [2] in treating Covid-19 patients.
None of these are "game-changers" but they incrementally improve patient outcomes and that's a good thing. The more time we buy to make discoveries like these, the better off we will be.
Put another way: would you rather have been of the first few patients in Wuhan when doctors had no idea what this virus was or how to treat it, or would you rather have it now? What about a few months from now?