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Comment by qeternity | Hacker News Reader

History books will not be kind to our past and present handling of covid-19.

Incurring incredible economic and social damage without fully understanding the threat. It’s been very clear for some time that covid is not nearly as lethal as once feared AND even more clear that we over quarantined.

In the UK we have hospitals built specifically for covid that are completely unused. This isn’t flattening the curve, it’s choking it. A vaccine isn’t happening anytime soon and the only way forward is herd immunity. This means we need new infections.

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You are aware that despite the world very best efforts, almost 500.000 people have already died, and in many parts of the world, its actually not slowing down, but speeding up?

These numbers would be much more useful if they were in pairs; (#people, #avg_years_lost).

https://abcnews.go.com/Health/swine-flu-h1n1-pandemic-deaths...

"Though the virus was deadly, the swine flu pandemic is still considered to have been a fairly mild one. The CDC calculates that up to 575,000 people may have died from H1N1 in 2009. The WHO estimates that the seasonal flu kills up to 500,000 people each year. Both pale in comparison to the flu pandemic of 1918, which killed an estimated 50 million people worldwide."

Sure... and then consider that, unlike swine flu or seasonal flu, COVID-19 has already killed hundreds of thousands of people even with near-total lockdowns to the point of dystopic absurdity in many countries†, has done so over the course of only a few months, and due to lackluster government response in some countries is still increasing exponentially in some places.

† See China's brief use of 'only specific designated people per apartment building are allowed to leave the building for specific designated shopping trips, under the threat of military force' policies at the worst of the peak in its cities.

You can't deduce the gravity of a threat from the state's response to it. Just consider the ~0 killed by terrorism each year in western countries vs the security theater at airports.

Terrorism isn't an infectious disease.

Your point?

That your analogy doesn't hold. We do know that infectious diseases with a median R0 of 5.7 will spread exponentially, as was the case with covid-19 in the January-March timeframe.

https://wwwnc.cdc.gov/eid/article/26/7/20-0282_article

And that means that you can deduce something about the danger of something from the reaction to it because...?

500.000 and counting WITH 'excessive' quarantine measures.

So covid-19 got to 500k, the high end of those other diseases, in 1/3rd the time and despite extreme measures to contain.

The final total for deaths due to Coronavirus is likely to be in the millions globally now, as it is spreading out of control and most countries have given up on lockdowns. Had it occurred in the conditions of 1918, it's likely millions would be dead already, but luckily we haven't just come out of a world war and healthcare is more advanced.

The one bright spot in this otherwise gloomy picture is that we don't fully understand immunity - NYC for example is seeing very low cases, despite being surrounded by plenty of infection in surrounding states and no travel lockdown - that seems to indicate heavily infected areas might escape a second wave, perhaps due to T-Cell immunity and a much higher infection rate than antibody tests would indicate. It's hard to explain the massive and continued drop in NYC otherwise after very high infection/death rates.

https://old.reddit.com/r/COVID19/comments/hdxwf5/intrafamili...

You're counting covid-19 and flu death differently.

For covid-19 you're using numbers of people who were confirmed with a test to have had covid; for flu you're looking at complex statistical modelling.

So far the best data we have shows that for people in their 60s covid-19 is killing them about ten years early.

See eg this from Economist: https://www.economist.com/graphic-detail/2020/05/02/would-mo...

https://www.gla.ac.uk/news/headline_720672_en.html

> “As most people dying with COVID-19 are older with underlying chronic conditions, some have speculated that the impact of the condition may have been overstated, and that the actual number of years of life lost as a result of COVID-19 are relatively low,” said Dr McAllister.

> “This new analysis found that death from COVID-19 results in over 10 years of life lost per person, even after taking account of the typical number and type of chronic conditions found in people dying of COVID-19. Among people dying of COVID-19, the number of years of life lost PER PERSON appear similar to diseases such as coronary heart disease. Information such as this is important to ensure governments and the public do not wrongly underestimate the effects of COVID-19 on individuals,” he added.

https://wellcomeopenresearch.org/articles/5-75

> Results: Using the standard WHO life tables, YLL per COVID-19 death was 14 for men and 12 for women. After adjustment for number and type of LTCs, the mean YLL was slightly lower, but remained high (13 and 11 years for men and women, respectively). The number and type of LTCs led to wide variability in the estimated YLL at a given age (e.g. at ≥80 years, YLL was >10 years for people with 0 LTCs, and <3 years for people with ≥6).

> Conclusions: Deaths from COVID-19 represent a substantial burden in terms of per-person YLL, more than a decade, even after adjusting for the typical number and type of LTCs found in people dying of COVID-19. The extent of multimorbidity heavily influences the estimated YLL at a given age. More comprehensive and standardised collection of data on LTCs is needed to better understand and quantify the global burden of COVID-19 and to guide policy-making and interventions.

So what this says, basically, that if comparing to the deaths and other effects from lockdowns on general population, given its age, covid deaths are to be divided by 5 or so, before even adjusting for age (I'd assume most would rather lose their 80ies than their 30ies).

Then you can consider even trivial DALY adjustments for e.g. starvation (at some point, it was expected to affect 130 million extra people, by some relevant UN body), unemployment, lack of "non essential" medical care (see estimates for excess cancer deaths from the last financial crisis due to lack of care), etc., and multiply by numbers affected.

What is speeding up, exactly? Our ability to detect marginal cases, certainly. Not the death rate.

Do you realize how many of those people would have perished this year anyway? Do you realize how many hundreds of millions of people die every year and that covid barely registers as a blip? Do you realize the enormous human cost of quarantine has to be weighed against this?

We have pretty good ideas of what normal death rates are like, and we see huge numbers of excess mortality.

> that covid barely registers as a blip?

What figures are you looking at for all cause mortality please?

This year, some 60m people will die of non-covid causes. Let's double the current 500k death toll AND presume that none of those fatalities would have occurred anyway. With covid: 61m deaths...out of 7b people.

Ha! That kinda flies in the face of facts. The UK and the US did NOT "over-quarantine" and this is precisely the problem.

Nations, even some bad-old-authoritarian ones, that didn't dilly-dally and turn the question of lockdown into a political issue, but took it as a public health issue, those are the nations that are re-opening now with low enough numbers to claim to be over the first wave.

The Tory's and GOP's treatment of a pandemia as a political football, instead of a public health menace, led to spotty lockdown actualities that precisely resulted in MORE spreading of the virus. I.E. The Wisconsin Supreme Courts decision and the immediate opening of the bars and no masks, no social distancing, etc. These are FAILED policies and the ideology behind them is incorrect.

What you are spouting might have been debatable several months ago, but I'm going to have to rub your nose in the reality that your entire set of talking points are demonstrably rubbish.

It seems to me that the Tories and GOP correctly understood that it was a political football, and their friends across the aisle would start organizing mass gatherings the instant it was politically convenient for them to do so. I certainly think there's something to be said for nations that were willing to reliably comply with pandemic control measures, and I'm very glad I live in a region of the US that did comply (even in our gun stores everyone's wearing masks!), but I don't think you can lay this at the feet of some particular political parties.

I'll just lay it at the feet of the people who stole ppe, shut down testing sites, encouraged people to drink bleach, refused to lockdown the nation, didn't implement contract tracing, didn't shut down the borders (only pretended to), didn't quarantine arrivals, and said that less testing will lead to less deaths. Interestingly all those assholes belong to the same political party.

Maybe. New Zealand took a different path and managed the problem with far fewer deaths.

America needs to secede from North America and close all airports and seaports...

For now. They will have second/third waves. We’re not going to cure this before we reach herd immunity. New Zealand just delayed the inevitable (which is what flattening the curve is all about: delay infections enough so that we can reasonably treat)

And there might not be a second/third wave. Some countries observe the virus weakening. People who would've died two months ago if they caught it are now showing milder symptoms. We have 80 year olds now who would need a ventilator two months ago recovering completely as per some doctors from Europe (Italy, Serbia).

And probably a better economic outcome.

> History books will not be kind to our past and present handling of covid-19.

History has not been approving of the casual disregard for human life and probably won’t be in this case either.

For the US, I think history will judge us harshly for our overall lack of response. (We’re scaling back pretty much every response for short-sighted political reasons even as cases are starting to spike again.)

> History has not been approving of the casual disregard for human life and probably won’t be in this case either.

This is not disregard for human life. This is nature.

> we have hospitals built specifically for covid that are completely unused.

Only the London nightingale went "unused", and that's because government is pursuing herd immunity by discharging older people to care and nursing homes, not to the Nightingale.

It wasn't "completely" unused.

And the other Nightingales were pretty full.

They were only full to keep other hospitals free and less contaminated. The overall additional capacity was hardly used.

I’m also saying something different: we should have quarantined to the lowest possible degree that kept the hospitals reasonably utilized. We need infections. We just don’t want to overload NHS. I’m glad we built new capacity. I’m frustrated we didn’t use it...and now a big second wave is likely.

You really need to cite sources to backup your claim regarding the other Nightingales being pretty full. I am struggling to find sources to prove they were used at all.

However, you do have an extremely valid point about what was going on with the care homes. The hospitals were vacated of 'bed blockers' at the same time as the Nightingale facilities were being built, so the old people were sent to their care homes and not to a Nightingale.

Exeter Nightingale going to open soon:

https://www.devonlive.com/news/devon-news/exeters-nightingal...

So that one has not been pretty full. It has been absolutely empty.

Bristol:

https://www.bristolpost.co.uk/news/bristol-news/bristols-nig...

Pretty Full?

Nope, just opened, no patients yet.

Moving to Wales:

https://www.bbc.co.uk/news/uk-wales-53082404

They had 17 field hospitals open up. A health economist from Swansea University said that, in hindsight, spending £166m on 46 patients was "not a good use of limited resources".

Although not technically 'Nightingale' you get the idea.

Northern Ireland?

https://www.bbc.co.uk/news/uk-northern-ireland-52651725

The Nightingale in Belfast peaked with 30 patients, before being mothballed.

I suspect that every Nightingale has a similar story.

HSJ has an article about use of the nightingales. I'm struggling to find it.

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