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I understand why this was downvoted, but I am a bit annoyed at the downvotes because _we can do both_. We can do more to control the virus, and we can do more for people dealing with the fallout of mental health issues exacerbated by the pandemic. That these two very related things are seen as mutually exclusive is the real bummer of this whole scenario. The number one priority is not controlling the virus or helping people with mental health or addiction issues. The "number one priority" is helping people who are struggling, pandemic-related or not, period.

I struggled to find, but the JAMA podcast (https://www.stitcher.com/show/jama-author-interviews) had a good semi-recent interview of authors on an article on the covid bereavement major depression wave

If I remember right, the authors estimated the scenario as:

* Project 500K-750K excess deaths in the US until mass vaccine availability based on current public health practices (conservative/linear, ignoring exponentials involved)

* Someone dying generally has ~10 people close to them => half will experience ~depression for 1mo, 1 quarter for 2mo

* Something like 10-20% will have severe forms (major/ptsd/..)

* So something like 3 million people across all of above

That's a lot. Not quite as high as # of addicts in the US afaict, but up there. I could have easily got parts wrong, so worth going to the interview+article if you're truly interested.

They also have some articles on depression in elderly and other groups being especially impacted right now. Pretty real.

I don't think the grief of losing someone to the virus is any greater or less than losing someone to an overdose or suicide. A death is a death and always tragic. I'm sure the mother grieving her sons suicide is just as sad as the person grieving the death of an elderly parent. (Of course in reality people care less about addiction deaths because many still mistakenly see it as a moral failing rather than a disease). The focus needs to be on controlling the disease while also limiting the collateral damage as much as possible. Don't forget: most of us are likely to get this disease at some point anyway, even with a vaccine it will mutate. The important point has always been to slow the spread. Preventing it completely is near impossible without very extreme measures.

> most of us are likely to get this disease at some point anyway

If you live someplace like South Dakota with grossly irresponsible leaders at every level of government, this is probably true.

If you live somewhere with decisive and responsible leadership like South Korea, New Zealand, Finland (among many successful countries around the world, rich and poor), or Vermont, then probably not.

Notice that multiple effective vaccines are here. We just need to hold out through this winter, so that production can spin up enough to start getting a substantial proportion of the population vaccinated.

The flu also has a vaccine and yet we have never managed to eradicate it, and this is even more contagious.

It will be quite hard to “eradicate” Covid around the world, but with luck vaccines will provide lasting immunity, enough to end the pandemic, return life to more or less normal, and prevent tens of millions of deaths.

Empirically, SARS-CoV-2 mutates much more slowly than influenza viruses, and if a new strain eventually pops up that the vaccine and people’s antibodies do not work on, the current vaccines should be faster to modify than to recreate from scratch.

I'm not sure if you genuinely believe the extreme hyperbole in the second paragraph of your post or if you're just trying to counteract the people who act like the virus is nothing at all.

If it's the former, you should probably find some more reliable information sources. If it's the latter, truth and accuracy are a better counterpoint than taking the opposite extreme of misinformation.

What do you think is the hyperbolic part? That millions of people have died and millions more were extremely sick is a simple statement of fact. As far as I can tell there is nothing even slightly controversial in what I wrote.

Your response is a weird combination of vague and rude/patronizing. I’m not sure what your point is.

Well, just for starters, millions of people haven't died of the virus. At last count, the death toll so far is just over 1.5 million. A terrible number, to be sure, but if you claim to not be engaging in hyperbole or misstatement of facts, it would be good to back that by not making your very first statement completely non-factual.

There have been 1.5 million confirmed Covid deaths, but the total number of people who have died from Covid is far higher than that, I would guess at least 1 million more, but possibly higher. Even wealthy countries with developed healthcare/government infrastructure are missing a significant fraction of deaths (in the USA alone, we have probably missed about 100k Covid deaths from the confirmed count). In many less developed countries, a majority (in some cases an overwhelming majority) of Covid deaths are never counted as such.

It will be hard to get a total estimate until at least a year or two after the pandemic is over, because even in developed countries death reporting can lag by up to a year (that’s leaving aside cause-of-death attribution). If you check back in a year or two WHO, CDC, etc. will have much better estimates for the total death toll in 2020, with (possibly wide) error bars you can largely trust.

Beyond that, this is weak pedantry about the definition of “millions”. People commonly use this plural to mean >1 million; we’re talking about the order of magnitude here, not the precise count.

If you want to play number games like that, then you should also acknowledge that many who died were on the brink of dead already without Covid. You should only count excess deaths, not who was tested or not.

Show me the 3 million excess deaths, before you continue with the alarmism.

Eh, you probably should count what actually killed them, though you can make some arguments.

If you have let’s say two years left to life and COVID ends up finishing you off, that’s a death due to COVID.

Just show me the excess deaths.

And what if somebody has only one month to live, and dies with Covid, also a death from Covid? Maybe yes, but really worthy of hyperbole then?

My grandmother died from the flu, at 99 years old. I never felt I should blame her death on the flu pandemic, though.

"Died with Covid", not "died from Covid".

Regular old respiratory infections are a frequent indirect cause of strokes and heart attacks, but we've never claimed before that common colds cause "millions" of deaths.

No the common cold, but the flu.

The official death toll in Germany from the 2017/2018 flu season is still higher than deaths from COVID-19 so far. And I suspect that if we used the same method for COVID-19 deaths that was used for the flu (indirect measurement), the flu of 2017/18 would surpass COVID-19 by far.

Across every age group (except children) Covid is roughly 5x to 10x deadlier than the seasonal flu. It also spreads faster (higher reproductive number), is much more often spread by asymptomatic/presymptomatic people, and nobody has any apparent pre-existing immunity. (And the seasonal flu is a serious deadly disease which stresses hospital systems every year, not some joke. Even if Covid were only as bad as the flu, it would still be a real threat.)

The method used to estimate flu deaths every year is far more expansive than the method used for confirmed Covid deaths.

One interesting thing to see is that the social reactions vs. Covid have radically reduced the amount of flu spread this year vs. previous years.

> Across every age group (except children) Covid is roughly 5x to 10x deadlier than the flu.

Two points:

a) 'Flu' is a different disease than respiratory viral diseases. (A.k.a. "common colds".) Covid is a kind of respiratory viral disease.

b) "Common colds" are also deadly and cause a huge number of deaths each year. They just get classified as deaths from stroke or heart attack, not the common cold: https://www.google.com/search?hl=en&q=does%20the%20common%20...

So counting mortality rates is not a simple issue and depends a lot on cultural factors, political incentives, etc.

I love how the assumption is always that confirmed covid death that were actually unrelated to covid are more frequent then covid death that were not confirmed.

But, chances are that latter are more frequent. Covid tests are not done on all deaths precisely in places where situation is worst.

I think in the first world the former is more likely. I personally know someone whose grandma died of entirely unrelated causes and the hospital offered to pay for the funeral if they agreed to report her as a COVID death. Our governments are setting perverse incentives.

> I love how the assumption is always that confirmed covid death that were actually unrelated to covid are more frequent then covid death that were not confirmed.

There is no such assumption. Read my post again: millions and millions of people died from the common cold before 2020. The media never reported those deaths as 'common cold deaths', though, even though it would have made just as much sense as reporting 'Covid deaths' does.

> There have been 1.5 million confirmed Covid deaths

It'd really be halpful to frame with some kind of context. TB kills that many annually. To make matters worse, it's a curable disease, so these deaths are entirely unnecessary, but when was the last time you heard a peep about that? It's been raging for decades, and WHO is targeting 2030 as the end of it.

Speaking of necessary context - in 2019 the US saw several hundred people die of TB, vs ~250,000 of covid so far this year. For better or worse, it's been possible to control the spread of TB so that it is no longer a great threat in the west, and that is what controls the amount of American money and public interest spent on it.

But, the way this control has been achieved is that the US and many other rich countries require anyone applying to immigrate (and many people not applying to immigrate, if they are from a risky country) to be screened for TB and be treated successfully before they are allowed to enter the country (with some waivers where treatment is unlikely to be available where they are). On top of all these border controls, at least $100 million is spent specifically on TB just inside the US every year, in order to keep the number of annual cases down somewhere around 10,000. Until 2019 healthcare professionals in the USA were required to be screened for TB every year. People in America who do contract active TB disease are required to take medication daily, personally supervised by a healthcare professional, for six months - to make sure they do it correctly.

And all this is only possible because TB takes a pretty significant amount of contact to spread, and there's a detectable latent stage (sometimes lasting an entire lifetime) of infection before it becomes contagious - neither of which is true with covid.

You're ignoring the fact that this is despite huge restrictions around the world to limit its spread, if approached the same way as TB it would do insanely more harm.

The best current estimate of the IFR of Covid is something like 0.5% with good medical care, or much higher without. If populations take no action whatsoever to curb spread, somewhere between 1/3 and 2/3 of people will likely be infected. If we multiply that by the population of the world, we get something on the order of 15–50 million people dead. Not as bad as the 1918 flu, but worse than any pandemic since, roughly comparable to the entire death toll of AIDS over the past 40 years.

Thankfully all around the world people have taken significant steps to slow the virus down, and so hopefully the vaccine will arrive in time to save tens of millions.

I am happy to agree with you that humanity could do a whole lot more to prevent deaths from infectious diseases, including tuberculosis.

Truly, where do you keep pulling the most alarmist numbers you think you can plausibly get away with from? COVID IFR at 0.5% with exceptional treatment? No, none of the wider more recent data backs this up, and please, don't just take my word for it. The CDC's more recent overview results don't at all back up your claim even though they do state that IFR can vary by region due to demographic and other factors. https://www.cdc.gov/library/covid19/112420_covidupdate.html

First, off the bat: why are you so aggressively hostile and abusive?

Your link estimates the Covid IFR in the USA to be about 0.6%, compared to e.g. 0.4% for China where the population skews younger or 0.8–1.1% for several European countries and Japan where the population skews older.

https://www.cdc.gov/library/covid19/images/november2020/1124...

I’m somewhat suspicious about the numbers for lower-income countries though. In Mexico for example Covid deaths have been grossly undercounted. These kind of high-level estimates are hard to do reliably when they are built on poor-quality low-level data.

I don’t know why you are pretending that “good medical care” (by which I mean, the average in a typical developed country with a well funded medical system that has not yet been completely overwhelmed; as compared to the “poor” level of care available in many developing countries or in places where hospitals are collapsing) is equivalent to “exceptional treatment”. I don’t know what you mean by “exceptional treatment”, but your link says nothing about it.

There have been a large number of estimates of IFR, and they consistently range from about 0.4% to about 1.5%, mostly toward the middle of that range. Judging by the best current science, the 0.5% number I used is probably a slight underestimate, but it is at at any rate in the right ballpark.

If you e.g. guess the actual number of deaths in absence of any countermeasures would be more like 10–20 million instead of the range I gave of 15–50 million, that seems plausible enough (though I stand by my estimate). It’s a counterfactual in any case, since in practice extreme countermeasures were adopted in many parts of the world.

Children don't generally die from Covid19. Your numbers are exaggerated, Covid is not the only cause of death around the world.

The load of sick people is also not exceptionally high, at least not in the intensive wards (don't have data for normal hospitalizations).

Here in Germany we have daily updates on the number of ICUs in use. It shows Covid is only a fraction of the patients, even now only 10% despite of soaring infection numbers.

https://www.intensivregister.de/#/aktuelle-lage/zeitreihen

Of course there is an exceptional number of ICU patients. Many hospitals in Germany already are running at capacity and can't admit any more ICU patients. And that's despite every postponable operation being postponed.

I have posted the official chart of ICU occupation in Germany. How can you argue with that? Covid patients are only a small fraction of the occupied beds.

In general it makes sense to use existing ICU beds at capacity (or slightly below), to, you know, make use of them.

Surely you could also still adjust by delaying surgical procedures that are not urgent, if things would get worse.

You said it yourself, you want to run ICUs close to capacity, so you can't just add another 10% (or 27% like in Berlin right now) for COVID patients without calling it exceptional load. Procedures are already being delayed to free up extra capacity, and nurses are working overtime. The system is fairly close to collapse and we're lucky that the current measures stopped the growth of new infections, albeit at a very high level. We couldn't handle another doubling.

Only 20% of patients are in ICU because of Covid, so it is simply incorrect to claim that because of Covid the system is close to collapse. It is not. And if you call more than 80% use (which we don't even have) "exceptional load", it still isn't the same as "close to collapse". Have you even looked at the charts? If you count the emergency reserve, there is still capacity for 15000 more beds. A "doubling of cases" would put 4000 more people into ICU, so it wouldn't break the system at all. https://www.intensivregister.de/#/aktuelle-lage/zeitreihen

As for nurses working overtime, do you have any data for that? Quoting some individual hospital managers warning of "possible collapse" is not really evidence. They can also be politically motivated ("see, we really need more money for our ICU section"). You can also find individual hospital managers saying everything is fine.

The offical numbers say that German's hoslitals are not running at their limits. In average roughly 20% of intensive care beds are not occupied.

https://www.intensivregister.de/#/aktuelle-lage/kartenansich...

The regional differences are pretty high, and beds are in many cases not the limiting factor. It's ICU nurses.

If you can read German here is a source for Berlin: https://www.tagesspiegel.de/berlin/zu-viele-corona-patienten...

TLDR is only 85% of the beds are full, but there aren't enough nurses, so the emergency room will be closed. Several other hospitals in Berlin already stopped admitting new ICU patients.

As other said, it is not that unusual that individual units are full. As for staff, if things would become dire, surely more capacity could be mustered (people working overtime and so on).

And if it is really such a limiting factor, the statistics should be adjusted accordingly.

I think it is just a wildcard argument without any specific numbers. You can imagine whatever you like. How many nurses are available? How many are sick, specifically?

Also, sick nurses tend to be well again after two weeks (if they have Covid).

Yes, I read German. But this is not a singular event that has never happened before. Here is a report from 2017 that sounds familiar:

https://www.welt.de/regionales/bayern/article161869919/Klini...

Yes of course, there are other occasions where this happens, but I consider in very good evidence against the claim that there is no exceptional ICU load right now.

Yes, situation is bad, but we will make it. Prof. Kluge does not sound too pessimistic. If you have time, take a look at his report about the flu season 2017/18. Pretty grim stuff, more than 40% of intensive care patients died.

https://www.researchgate.net/publication/333785335_Managemen...

You never run ICUs at 100% because where would you put the people who have car crashes etc?

Optimal rate depends on the country, but about 75% is typical.

Sure, but that is exactly the case in Germany, only 80% are in use, as would be expected in normal times. Presumably they can adjust by delaying surgical procedures that are not urgent.