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supernova87a

Human beings (or maybe America right now) are good, or used to be good, at attacking threats that are:

-- large and concentrated

-- sudden

-- unusual, uncommon

-- gruesome

Not so good at threats that are:

-- everyday, slow

-- small, but distributed

-- mundane, familiar

I guess COVID found our Achilles heel.

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I just don't think this is true as a generalization. It may be true of American culture today, but it doesn't follow from even the past 50 years of broader human innovation against death. Consider the number of lives saved from:

- antibiotics

- seatbelts and other automotive innovations

- CFC rules

- anti smoking legislation

- etc...

A reciprocal view is that all sci/tech advances which led to those saved lives has also led to urbanization (=> vastly accrued need for antibiotics), automobile (=> need for seatbelts and other automotive innovations)...

We may (or may not) be "more something" (for example "more happy", "more self-accomplished"...) thanks to all those advances.

> ...urbanization (=> vastly accrued need for antibiotics)...

Historically, bacterial infections were major killers in pre-industrial, predominantly rural societies globally.

Nowadays cancer, diabetes, obesity, depression/addiction, mental illness(...) are major killers.

A lot of that is because people are living long enough to have those types of issues pop up.

Maybe not as much as we think, as AFAIK diabetes, obesity, depression/addiction and mental illness (for example) are also hitting hard among youngsters.

I will get beat up for speaking up on this topic, but you are right and its related to food based on my researching this topic in nih.gov. First world countries are experiencing the highest mortality rates because of eating garbage. Insulin resistance being at the root of most of your mentioned down-stream problems. There are also a lot more chemicals in foods now. Pesticides, fungicides, etc. leading to auto-immune problems, allergies, chronic low-grade inflammation, higher triglycerides, higher small dense particles in the LDL cholesterol. To find some of the studies backing this, use google and put in queries like "site:nih.gov insulin resistance" and other similar terms. Some of the studies contain graphs by country. The most fascinating studies are the ones that include cultures that are still hunter-gatherers. Most of them have no traces of cardio vascular disease, mental illness, obesity and certainly no diabetes.

> its related to food

GIGO (Garbage In, Garbage Out) rules. Add sleep (of dubious quality) deprivation, 'bad stress' (no real motivation, extreme noise and light, near-constant state of haste...), lack of exercise... feedback-boosting the destructive process we now see nearly everywhere in full swing.

Automotive deaths are another example of a failure, not success. Something like 40,000 deaths a year still. Add guns to the list as well. Covid isn’t the first mass killer we just kind of learn to live with and ignore.

This is a VERY American perspective. Neither Covid nor gun deaths have been significant in NZ this year.

The US is arguably a bit of an outlier on automotive deaths. In most highly developed countries these peaked in the 70s or so and fell sharply since (due to seatbelts, better car design, harsh anti-drink-driving rules, etc). The UK peaked at 8k per year in the late 60s, for instance, and fell to reliably under 2k by the last decade. The US peaked around the same time at 55k, but fell much more modestly to 38k.

Gun deaths, of course, are a very US thing; they don’t really register in most developed countries.

I think a lot of the problem is that it isn't familiar. People use intuitive reasoning, they don't see disease and death, it must not be a problem. But it spreads so fast that it's dangerous long before you see it (because it quickly gets to the point of being uncontrollable).

This too. Or just people's perceptions of "overwhelmed." I know people who don't think hospitals are having issues because "nobody is spilling out the door, so they still have room in hallways."

They went to a local hospital and looked through the window to make this judgement, as if the resource constraint was physical space in the building.

What threat? There is zero context to this "increase"; Did population stay the same, grow or shrink for this year? That gives entirely different context to this raw number.

*some humans

The majority of developed countries run by half competent leaders is taking this threat very seriously.

It has a name:

https://en.m.wikipedia.org/wiki/Availability_heuristic

Or just anything that is not an equal opportunity killer. Everyone can be killed by a terrorist. Plenty of people believe COVID is no threat to them.

And they’d be right:

Someone over 70 is 270x as likely to die of COVID as someone under 50. For anyone under 50 without co-morbidity, then this is just a yearly flu — and destroying your economic future over the flu doesn’t make sense.

Having a blanket policy that ignores those differences is unrealistic.

IFR numbers are from the CDC’s best estimate:

https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...

So... now we are having a conversation about why one group of 400K people is more worthy of saving than another?

I think, clearly, that there is a debate to be had about the value of lives that are nearly at an end no matter what, and lives that are just hitting their prime.

Someone who is 60 or even 70 is not necessarily “nearly at an end”. Just ask either of your presidents.

That conversation has been going on since long before COVID-19. For example age is one factor in allocating scarce transplant organs. Other countries with socialized healthcare systems sometimes explicitly use Quality Adjusted Life Years (QALY) in deciding whether to pay for expensive treatments for elderly patients.

We are talking about a whole percent of the US population here, not just the tiny fraction that requires organ transplants.

So is he. QALY analysis is used to allocate all treatment in places like the UK, realistically in other places too. Basically a very expensive treatment that is only expected to increase your lifespan by a few months if you're already very elderly may not get funded if there are other interventions with better cost/benefit ratios available in the queue. This obviously affects nearly 100% of the population in the sense that most people will make it to old age, and even the non-elderly are affected by getting treatment they otherwise might not have done.

Not saying that those 400K doesn't deserve to be saved, they are absolutely deserve the care but if you are doing it at the huge expense for other people then conversation is unavoidable.

doing it at the huge expense for other people

Begs the question.

You build in the assumption that policy responses to a pandemic will harm the economy, and then don't do any work to establish that policy responses in this pandemic have prioritized lives over the economy, or to demonstrate that policy responses that weren't used would have been similar, etc.

Hey, good news. We have pretty strong evidence that our policy choices have been geared towards letting the elderly die.

(I'm talking about all the elderly that died if it isn't clear what evidence I'm referring to)

Of course, the awful thing is that controlling the virus in May (I mean actually doing it, not just having a pause) would have been better for the economy. But we are too stupid for that.

>Plenty of people believe COVID is no threat to them

That is true, if you are under 70 and reasonably healthy, the chance of seriously sick from covid is very very low.

The personal risk of getting seriously sick is very low. The risk of spreading it to others is very high. And the hospitals are overwhelmed.

Sometimes your personal risk is not the end of the story.

And once hospitals are overwhelmed, your risk of dying of any cause increases regardless of your age, location or health.

Is that a major concern? Around me, the hospitals are at capacity for covid patients, but have reserved space for accidents, pregnancies, and other expected needs.

At some point you run out of caregivers.

https://www.npr.org/sections/health-shots/2020/12/22/9489081...

Probably because they are lying worker/refuse to hire more:

https://www.beckershospitalreview.com/finance/financial-fall...

The cited reason: 'Lower patient volumes, canceled elective procedures and higher expenses tied to the pandemic have created a cash crunch for hospitals'

I wonder if the lockdown/stay at home order has something to do with it...

With the highest cost of idle hospital beds being in the intensive care (ICU), people talk as if whole sections of hospitals sit empty waiting for the day when they are needed. Occupancy in ICUs typically are close to full. If they are not the hospital closes more beds so that they remain near capacity.

>The risk of spreading it to others is very high

So? The risk of that other person become seriously sick remain the same.

>And the hospitals are overwhelmed

If the hospital are overwhelmed, keep in mind that most hospital are not overwhelmed, then yes it need to be fixed, nobody said to do nothing, some that can be done:

- increase capacity

- redistribute patient to less busy hospital

- better treatment method

- don't test everyone for covid

- don't admit people with mild symptom

- etc

I believe all those things are already being done. Increasing capacity is the hard one, making new doctors and nurses takes several years.

Well you would think so but lot of hospital freeze hiring/laying of worker during this pandemic.

I'm not taking about making new doctor/nurses, I'm talking about hiring more.

"People Thought Covid-19 Was Relatively Harmless for Younger Adults. They Were Wrong."[1]

"New research shows that July may have been the deadliest month for young adults in modern American history."

The latest episode of This Week in Virology[2] covered this article and the Journal of the American Medial Association (JAMA) article it was based on.

"From March to July a total of 76,088 all-cause deaths occured in the US in adults from 25 to 44 years of age, which is about 12,000 more than you would expected (the expected number would be about 64,000) so 12,000 excess deaths. Among this age group there were 4,500 COVID-19 deaths recorded. That's 38% of the excess mortality. The idea is that that is due to COVID-19, and they go in to that further and say, yeah, that is probably what it was."

"The point is, as we're learning, anyone who says this group doesn't get infected, that group doesn't get sick, they're just wrong... the data shows that if you're between 25 and 44 you can die of COVID-19..."

"And that's only the deaths. There are a lot of people who got sick with this and still aren't quite well.. and that's not good either... you can get a mild infection and still get long-term COVID.. even if it's not mild or long-term, you could could still have a relatively short-term illness that puts you in the hospital, you don't die - you're really sick. And 4,500 people, that's more than we lost on 9/11. Just a little perspective. Just the deaths is still a huge number of people. And those are just the confirmed COVID deaths... that's 38% of the excess, and the article is basically - what's the rest of the excess? Because you don't expect that many people to die, and a significant portion of those are certainly going to be people who just didn't get a confirmed diagnosis of COVID-19 before they died."

Then they quote from the NYT article:

"In fact, July appears to have been the deadliest month among this age group in modern American history. Over the past 20 years, an average of 11,000 young American adults died each July. This year that number swelled to over 16,000."

"I don't think you can argue to us that that's not COVID-related. What else is going on? Nor can you say that "oh, it must be harmless in this age group", this is really having an effect."

"And this is not political, folks. This is the truth. This is science. This is the data. This is what we see."

[1] - https://www.nytimes.com/2020/12/16/opinion/covid-deaths-youn...

[2] - starting around 4'50" in episode 696: https://www.microbe.tv/twiv/twiv-696/

https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...

the estimate for ifr :

0-19 years: 0.00003

20-49 years: 0.0002

50-69 years: 0.005

70+ years: 0.054

And if you factor in co-morbid conditions, it will be very clear how much that matters to IFR.

These numbers do not add up with CDC statistics, which show that about 7000 people in that age group died from COVID over the whole year.

One mistake I see is to take the average of twenty years of deaths in that age group as baseline. The number of deaths from drug overdoses has steadily risen from 20,000 per year in 2000 to over 80,000 last year - with a sharp spike at the beginning of this year.

Edit: The paper that is cited in the introduction acknowledges that an increase opiate overdoses may be the underlying factor here. They only had data from 2018 to estimate its impact.

Every death is a tragedy, but the vast majority of those younger COVID-19 patients who died had at least one serious co-morbid condition, such as obesity. For those under 50 with no co-morbid conditions the risk of death is extremely low.

Exactly this, US is famous for obesity and should actively pursue doing something about it.

Hopefully Biden will take this up when he is president.

What do you propose be done? It’s not like people have been unaware of this issue for decades now.

Maybe cap sugar content in foods. Maybe try and reverse what the sugar industry did with it's "Fat is the enemy" campaigns. Fact is sugar is what leads to obesity, diabetes, etc. It causes people to overeat.

Or maybe just ban lobbying at all in congress and via PACs and Super Pacs, so that gov't can fix issues that matter based on real needs assessment not one cherry picked for them by special interests groups with lots of money to throw around.

More like -

Everyone can be killed by COVID, everyone can be killed by terrorists.

However it is unlikely your dunkin donuts in farmville, North Dakota is going to be the target of the latest ISIS attack.

Likewise your likelihood of dying of COVID is not equal to others. If you believe it is - you have been duped.

Grammer seems to be another Achilles heel.

Grammer and speling.

Whew! He's only got two heels, so we're in the clear now!

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