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Comment by fastball | Hacker News Reader

My question is mostly just "how do we draw the line in the sand?"

The fact is that if mask-wearing and lockdowns prevent the spread of this virus, they'll work for the flu too. If there is a moral imperative to use these methods for COVID, why would there not also be a moral imperative to use them for the flu?

Where do you draw the line?

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False equivalency. Hospitals don't overflow with flu patients every winter. Meanwhile just in Italy and NY, hospitals were overflowing with Covid patients with only a fraction of people exposed to it compared to the billions exposed to the flu every year.

Same with the number of deaths. 65,000 in a really bad flu season in the US with hundreds of millions exposed to it, and Covid already has exceed that with only about 20% exposed to the virus.

It's not a false equivalency because I'm not saying the two diseases are equivalent.

I'm asking where we draw the line. Yes the flu is less severe than COVID-19. The question is not which is worse. It is how many lives do we need to save with these measures in order to make it "worth it"? Who determines that? How do we determine that?

We apparently decided it is worth it for COVID-19. Ok, but then why not for the flu. It kills people too, just not as many. What about something in between the flu in COVID in terms of lethality?

I don’t know what to tell you, we should have probably banned tobacco a long time ago. You’re arguing against a kafkacracy, not scientists.

> Ok, but then why not for the flu. It kills people too, just not as many.

Literally because of "just not as many" part. Yes, real world policies do some cold calculations about "how many people die" and have arbitrary lines. Arbitrary lines are actually ok. Better then arbitrary line on either "never ever" or "totally all the time" extreme. Also, we literally close schools when flu get out of control in some area - for a week or so and that is enough for flu to get under control. There is also huge push for flu vaccines each year. It is not true that no flu management is done, there is a lot of flu management going on.

Like, I dont know whether it is consequences of two party system, but the whole "we either lock everything for every reason or never nothing at all" and "we cant possibly think in probabilities and death rates and nuance" is frankly, idiotic.

Like your parent said, the difference is the tendency for COVID-19 to eat up all health care capacity.

Appendicitis? Stroke? Car accident? Sorry, the hospital is full of COVID patients, we can't take you in. Go home, lie down, see if it gets better.

This is the scenario we're trying to avoid. If the flu would do that, we'd have lockdowns for it too.

Yes they do:

https://www.upi.com/Top_News/US/2018/01/24/Hospitals-overwhe...

https://www.latimes.com/local/lanow/la-me-ln-flu-demand-2018...

https://www.dispatchhealth.com/blog/ers-are-overwhelmed-with...

https://www.cbsnews.com/news/overwhelmed-by-flu-cases-some-e...

https://edition.cnn.com/2018/01/12/health/flu-surveillance-c...

In Italy and Spain, aged care centres were abandoned by Eastern European workers fleeing the country before border closure, leaving residents ill cared for.

In New York, symptomatic patients were ordered back into aged care homes to free up hospital space.

These conditions would not have occurred without hysteria and excessive fear.

COVID in Sweden is about as deadly as the 2009 flu wave: https://swprs.org/wp-content/uploads/2020/10/sweden-monthly-...

Sweden is on track for an annual number of deaths in 2020 mostly the same as prior years: https://www.statista.com/statistics/525353/sweden-number-of-...

I’ll just point out the last one, because it’s terribly wrong, and how wrong it was pointed out in HN over the last couple of days itself.

Sweden, through early November, has as many deaths as it has had in its worst entire years before. And Swedens death numbers increase beyond the current year, as they attribute more deaths towards the previous year in the beginning of a year.

Sweden is on track to have 10-20% more deaths than normal.

There are no excess deaths apparent in October or November for Sweden: https://www.euromomo.eu/graphs-and-maps#z-scores-by-country

>Hospitals don't overflow with flu patients every winter.

They do it just isn't covered as much as anything covid related.

https://time.com/5107984/hospitals-handling-burden-flu-patie...

In the US, 40,000 deaths per year for typical flu. Currently, we have 275,0000 deaths from covid over 9 months even with social interventions. And, that’s not considering the under-reporting of deaths. And, before March 2021, we’ll see another 200k deaths.

Where do we draw the line? As with most complex things, it requires a careful balance of trade-offs. And, when there’s a lot of uncertainty and risk, it’s good to be cautious at first.

Do lockdowns help? A lot of countries with hard lockdowns had really bad curves. A slow fire maybe sometimes burns better. A place where everybody gets infected can maybe be more dangerous for visitors when you increase the time the infection is going on?!

Do masks help? Do they reduce immunity by eliminating some light contacts? Do they allow to transfer the virus without being infected? For sure you wouldn't like to have doctors (treating e.g. Ebola patients) go shopping and exhaling through their contaminated masks.

Is there any epidemiological evidence that masks helped? Data using "reporting date" often shows trend changes around mask measures. Taking a look at "date of death" data those trend changes usually are gone. Why is so little "date of death" data available?

If you have the flu you should wear a mask. We are enforcing mask-wearing and doing lockdowns because of COVID asymptomatic infections, these methods don't make much sense for the flu.

Many influenza cases are asymptomatic, and they can transmit the virus.

https://www.centerforhealthsecurity.org/cbn/2005/cbnreport_1...

> We are enforcing mask-wearing and doing lockdowns because of COVID asymptomatic infections,

We are doing these so that politicians can be seen to be "doing something". Not because there is any evidence that they work or are effective

It would be reasonable to conclude that countries where mask wearing is common (South Korea, Japan) would have lower rates of deaths from flu. It doesn't appear to be the case.

The line has been drawn, historically, at somewhere between a "normal" flu and the Spanish Flu of 1918. And that matters, because it sets the default on what people are inclined to accept.

The line is drawn based on hospital capacity. We have enough capacity for flu, because of immunity and vaccinations. We don't have enough for Covid.

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