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Comment by qeternity | Hacker News Reader

In the UK, 95% of the deaths are people over 60. There are more deaths for people over 90 than under 70.

When are we going to start putting all these efforts and resources into focusing on the vulnerable populations and not painting with a broad brush.

We know that lockdowns are too blunt an instrument which is why most of Europe is having to engage in ever more draconian measures. We are mortgaging our future here, without questioning the cost.

We don't need more of the same. It's not a question of willpower. It's a question of approach, and currently nobody is asking the hard questions.

EDIT It seems downvote brigade has arrived to ensure that any contrarian opinion is snuffed out. No rebuttal with data, just downvotes.

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Everybody is asking the hard questions and the hard answer is that it is downright impossible to isolate the most vulnerable from the general population. Tried and attempted in multiple places; turns out you only need one nurse, one doctor, one caretaker, one young kid in a large household to infect those people.

Maybe, just maybe, the experts (and I mean the people who have spent their lifetimes studying the transmission of respiratory diseases) have already weighed in, their answers don't look that different from when things started, and their assessments turned out to be mostly correct?

> Tried and attempted in multiple places

Really? Where was this tried at scale? Where did we spend a fraction of the cost that we incur locking down an entire population. This just isn't true.

> Maybe, just maybe, the experts (and I mean the people who have spent their lifetimes studying the transmission of respiratory diseases) have already weighed in, their answers don't look that different from when things started, and their assessments turned out to be mostly correct?

The hardest question is whether or not this is worth it, and nobody is asking that because politicians want to get reelected.

You are missing the point entirely. Virology experts are not the people who should be making these decisions. It's not as if covid response is free, but they aren't tasked with consdering the costs. They aren't tasked with finding out what the right amount of death is. That's the unfortunate reality and this is what the great leaders throughout history have all understood: there are no good decisions in times like this, merely least worst decisions.

I'm always surspised that we're still arguing about this.

Look at the excess mortality in Belgium:

https://ourworldindata.org/grapher/excess-mortality-raw-deat...

Supposedly, that's with the percentage of Covid cases still in the single digits. It seems obvious that if you do not get a handle on this, your healthcare system will be overwhelmed eventually. No sane person wants to see that happen, hence the drastic measures...

> I'm always surspised that we're still arguing about this.

Ignoring the fact that Belgium is one of the worst affected countries, I'm not even sure what you're arguing? Yes, covid is bad and yes it kills people. Did people in Belgium die who otherwise wouldn't have? Yes. Can we move on to the real issue?

> If you do not get a handle on this, your healthcare system will be overwhelmed eventually, and no sane person wants to see that happen.

Ignoring this ridiculous strawman attack (if I disagree, I'm insane) I'm very unclear where I suggested we shouldn't get a handle on it. Did I suggest that I want out healthcare to be overwhelmed? What is this? You're just throwing up charts an screaming about how bad covid is. We already know this.

Ignoring the fact that Belgium is one of the worst affected countries, I'm not even sure what you're arguing?

Belgium is the prototype for what would happen elsewhere if you're just a bit less successful at getting a handle on the pandemic.

Did I suggest that I want out healthcare to be overwhelmed?

Correct me if I'm wrong, but you seem to be arguing for a lessening of restrictions for the general public, right now. Here in Germany, there already are a few regions where some hospitals are close to capacity, and modelling suggests that without continued restictions, the health care system might get overwhelmed by March.

Ignoring this ridiculous strawman attack (if I disagree, I'm insane)

I realize this might come close to violating (or even cross the line of) HN guidelines, but that's how I see it.

> Correct me if I'm wrong

...

> I realize this might come close to violating (or even cross the line of) HN guidelines, but that's how I see it.

Ok, you're wrong. And worst of all, you've decided that anyone who doesn't share your exact opinion is insane. No wonder you've got it so wrong, you've cut yourself off from any real discussion.

What I argued was that lockdowns don't work. We have done serious lockdowns across the world, and in the best case all the do is buy a little time. In the worst case, they do nothing. The US printed $4T in 2020...do you really not believe that with that money, we could have a devised a better approach that put tremendous resources into isolating the vulnerable population and accepting the stunningly low risk to the rest of the population?

It's amazing to me that people on HN, a site dedicated to the constant advancement of the human condition, looks at a failed strategy concocted during panic and says "yeah, that's as good as it gets and can't be improved".

Jesus, when it comes to covid all I hear are people asking for faster horses.

What I argued was that lockdowns don't work.

Depends on which studies you trust. I've read a few, and my conclusion back then was that they do work. However, I've not kept up with the debate once I came to that conclusion, so maybe I shouldn't have phrased things quite as strongly as I did. If you have a recommendation for a single study that makes a particularly strong case against lockdowns, feel free to link it.

Looking for more recent results just now, I found [1], analyzing the differences in response of US states. It seems to suggests that as a general rule, the stronger the restrictions, the smaller the case growth, which would have been my null hypothesis anyway. Cf. https://i.imgur.com/kLfSs6W.png

I do agree that we do not yet know the effectiveness of any particular measure. It would be nice if we knew better, but experimenting with extinguishing agents while your house is on fire is too risky for my taste.

[1] https://www.bsg.ox.ac.uk/sites/default/files/2020-12/BSG-WP-...

Everyone must lockdown because medical professionals are infecting the vulnerable? Perhaps those that are doing the infecting should be quarantined?

That’s probably because the moment someone looks at it objectively someone posts a headline along the lines of ”8 year old dies of covid” or ”Tory MP says N is an acceptable death count”. Both are useless headlines as quoted but the entire political system is a shit media popularity contest and literally the only objective is to come out looking less bad than thy neighbour.

So the hard questions are never asked for which we sacrifice a good chunk of our population to dwindling cancer care, mental health issues and economic decline. Those scandals can be written off statistically by the next lot.

And yes I’ve had it. And yes I’ve lost three relatives to it. And quite frankly they were all circling the drain already.

It's unclear how cancer and mental health patients would be any better off with less sacrifices, that would lead to the health care system being more overwhelmed, not less.

I think you need to look at the future not just now. The overall side effects of burning care now may have a higher body count than covid. Case in point if you look at the austerity policy attributed deaths as a reference.

I know someone who just got handed a guaranteed poor cancer outcome because her preventative surgery will only be done when it’s an emergency later on.

These will be easy to write off as incidental deaths and poor health outcomes which is why they aren’t prioritised as high as covid outcomes. Honestly, staff have complained about this too, but when it comes to triage do you stick a 90 year old on a ventilator or do you reserve the ICU capacity for 10 cancer patients waiting for preventative surgery with a better outcome? That’s the hard decisions being burned for political capital.

The real travesty is we have to choose and that is down to our politicians and the slow wind down of NHS funding and political tennis for the last 30 years.

If hospitals are full, then cancel paitents won't be diagnosed.

Had we locked down 2 weeks ago when SAGE said "Lock down now or else!" we'd have fewer people in hospital and more beds for preventative cancer surgery.

Sure, you could go round with a flamethrower burning anyone over the age of 70 for using precious resources just so you could have the pub open for a few more days. Is that your solution?

All of that is bad, but I don't think avoiding lockdown or other measures would help with it. The images in the media of people dying in the street outside hospitals would just lead to more social/political pressure to deprioritise those cancer patients.

Translated it’d make the politicians look bad for all those cuts.

What cuts, the NHS has an extra £350m a week as of last Friday.

(/s)

Hahaha perfect snark there :)

If you get a bad dose and you can’t get a respirator you’re in big trouble. Guess what happens when there are so many sick that respirators run out. What happens when hospitals are overrun with patients with ‘mild’ symptoms? We’ve been talking about this for nine months and you’re still at the marginal deaths stage of reasoning. Do you need a picture drawn for you or something?

> Do you need a picture drawn for you or something?

And Reddit clapped.

Lockdowns trade away the life, health, mental health, education, and social development of children and young people for the safety of less than 1% of the population that are either aged or unhealthy as it is, and who can be protected in other ways.

And even mentioning this cost, which is becoming quite extreme (look at youth suicidality numbers, and childhood depression rates), causes you to be accused of not caring about elderly people.

The devastation that Covid lockdowns have caused will last far longer than the disease itself.

Considering the vast number of excess deaths of old but healthy people and the human cost of the people who continue to show symptoms months after initial infection, I would say your calculations are just wrong.

Excess deaths globally for 2020 will end up being about 2.5%

Is that vast?

It's 13% higher in England, which yes, I would characterize as vast.

I'm not sure you understand how excess mortality works. Excess mortality right now during the winter period is higher...it always is. And 13% is not panic numbers.

Would you be surprised to learn that the 17/18 flu season resulted in more excess deaths than we are having right now? Surely you must have been freaking out then as well advocating for national lockdowns...right?

No, it was 13% higher overall in England during 2020 compared to the 5-year average.

Your comparison with the '17 flu season is, honestly, stupid, and demonstrates your lack of reasoning on this. C'mon: there _wasn't_ a lockdown, and here despite a tremendous lockdown and a long way to go before herd immunity the situation is dire.

I think your point is that life and health are being traded is not the case - since these measures are to keep people alive and healthy. I agree there is some cost but let's not get hyperbolic.

Gyms and organized sports are closed. Most people are living sedentary lives. Activities that young children rely on for physical development and exercise are non existent. Many children haven't socialized with someone their age in almost a year. Children are unable to focus on school and are being under-educated. Depression rates amongst school age children have skyrocketed.

It is not hyperbolic to say that health and mental health is being traded away.

My family's experience is the exact opposite of what you describe. I've never been healthier because most of last year I had time to go for daily exercise instead of sitting in a car commuting. I took my young daughter out with me a lot of the time. My wife also took advantage of the daily outings. Our mental health is probably better than it has ever been because we get to spend more time with each other rather than with a bunch of guys in the office.

Education wise, my wife has used the opportunity to dip her toes into teaching - which is something she always wanted to try. I realise not everyone wants to be a teacher, but you never know.

The situation is what you make of it.

My experience is the exact opposite of what you describe. I've experienced depression and anxiety for the first time in my life, due to most fun things in my life disappearing overnight (due to mainly involving socialization). The future is bleak. I've gotten pretty decent at guitar though. That doesn't replace seeing friends though unfortunately.

I'm very sorry to hear that - I'm not sure I can offer much in the way of improving your outlook. I'm just focusing on the vaccine and the hope that provides.

To change the subject slightly: Would you describe yourself as an extrovert or introvert?

As an introvert I suppose I thrive on my own / with few people around me. I wonder if extroverts suffer more mental anquish when forced into isolation?

“nobody is asking the hard questions.”

Maybe they have asked these questions and concluded that this is the best path? Seems most countries are following similar paths.

This [1] is a useful summary of statistics comparing the current situation to that of Spring and earlier years. It’s interesting to see that the total number of hospitalised people and deaths are broadly in line with previous years, but the portion tagged as COVID is increasing. There’s lots of discussion around the issues with PCR testing (e.g. picking up old virus fragments & false positives). Difficult to know what to believe but there seems to be a lack of studies/data to back up the accuracy, and the NHS have recently switched to using Lateral Flow devices for regular staff testing due to the volume of asymptomatic staff being require to isolate.

[1] https://drive.google.com/file/d/1S7cUVU6o28QeIil__fQyqntQcYK...

Hospitals are quickly filling up, young people need hospitals as much as anyone. What's your suggestion, allow elderly covid patients to die at home?

Overflow hospitals in the UK have never been used:

https://www.standard.co.uk/news/uk/covid-patients-england-ni...

The UK Government is arresting people who film empty hospitals:

https://www.thesun.co.uk/news/13619752/moment-anti-covid-loc...

Meanwhile less than 400 people under age 50 have died with/of COVID in the UK.

The fundamental driver of this pandemic is the ill-health of the population - driven by sugar (obesity), coal and oil (air pollution), as well as Vitamin (D) deficiencies - but these factors receive no attention.

Meanwhile in Sweden - without hard lockdown - deaths are up only 3.2% above 2018, and even then explained by mortality shifting from 2019 and 2021.

Even Ukraine without hard lockdown over Winter has had far fewer deaths per Capita than the UK and has a much more rudimentary healthcare system.

Lockdown seems to drive deaths, at huge social and economic cost, rather than prevent them.

That 400 number seems off to me. Without more information on where you've pulled that number, what I can find is that there's ~74.7k deaths where COVID-19 was mentioned on the death cert in England and Whales since January last year. They didn't seem to really start counting that until March, until that point they were just classified as respiratory diseases.

Current statistics show that there's around 1'400 deaths of those under 50 with COVID-19 listed on their death registration, ( https://www.ons.gov.uk/peoplepopulationandcommunity/birthsde... ).

Where's your data from?

> Lockdown seems to drive deaths, at huge social and economic cost, rather than prevent them.

This could easily be a reversed causality, that deaths drive lockdowns... which, on the surface seems to make sense as high deaths seem to force politicians to lockdown (either for reality or perception).

> The UK Government is arresting people who film empty hospitals:

The police arrested one person who walked, mask-less, though quiet public areas of a busy hospital (and was abusive when challenged by hospital workers). The vital need to spread conspiracy theories on Facebook isn't one of the "reasonable excuses" for leaving your house.

> The fundamental driver of this pandemic is the ill-health of the population - driven by sugar (obesity), coal and oil (air pollution), as well as Vitamin (D) deficiencies - but these factors receive no attention

I was saying this at the start of the pandemic. The UK is approaching US -levels of obesity, but now we have "fat shaming" whereby any mention of overweight people being unhealthy is socially unacceptable; and showing skinny people in adverts on the London Undergound causes "offence". I wonder if this particular world-view will reverse in the coming years?

No they aren't. NHS occupancy in 2020 was lower than in 2019. We are currently 50% below our peak ventilator usage in April and the 7 day trend is very flat.

This is just not true. Go look at the data instead of parroting headlines.

EDIT Lol again downvotes but no replies. Does anyone want to bother educating me on this topic and showing me where hospitals are filling up? I would love to see it, because the NHS figures certainly don't show it.

Go look at the data instead of parroting headlines.

Or, even better, talk to anyone who works in a front-line NHS role, particularly in areas like A&E/intensive care. People who understand the context of the statistics and how they translate to real standards of patient care do not think everything is OK right now.

As it happens, I've spent some time over the past few days travelling to and from various medical facilities. Every single one of them had heavy precautions in place. And on the radio in the car this afternoon, there was a whole series of medical and public health professionals talking about not only the current situation with the virus but also how damaging it is when people do exactly what you're doing right now.

Remember, if you can keep your head when all about you are losing theirs, they probably know something you don't.

> Or, even better, talk to anyone who works in a front-line NHS role, particularly in areas like A&E/intensive care. People who understand the context of the statistics and how they translate to real standards of patient care do not think everything is OK right now.

Yeah I know that, my best mates girlfriend is a doctor. But that's not at all proof of anything. There is a reason that wars aren't planned and architected by the foot soldier in the trench. They don't have perspective and the task at hand detracts from the bigger picture. I have the utmost respect for our NHS heroes but front line personnel are the last people you should ask. They have been put through hell over the past year and if I were in their shoes I would be ready to keel over. And that's exactly why these individuals shouldn't be calling the shots...they're just seeing one part of the puzzle.

But that's not at all proof of anything.

Do you realise that in two successive comments, you have literally just claimed that hospitals are not really filling up, then claimed that reports from front-line staff working in those hospitals don't prove anything?

There is a reason that wars aren't planned and architected by the foot soldier in the trench. They don't have perspective and the task at hand detracts from the bigger picture.

A curious metaphor. There is a reason for the saying that an army is run by its sergeants. All the plans made by generals aren't worth squat if you don't have boots on the ground who know what they're doing to implement those plans.

> Do you realise that in two successive comments, you have literally just claimed that hospitals are not really filling up, then claimed that reports from front-line staff working in those hospitals don't prove anything?

Um, what? That's exactly right. Hospitals are not filling up. The NHS own data shows this. The fact that doctors think the hospitals are filling up is irrelevant. People's estimates of things are notoriously incorrect, especially when they are under pressure. I'm not sure what you've taken issue with.

Are you disputing the NHS data that hospitals are not filling up?

> There is a reason for the saying that an army is run by its sergeants. All the plans made by generals aren't worth squat if you don't have boots on the ground who know what they're doing to implement those plans.

Right, Sergents run the implementation, not the planning. What we are talking about is the planning. But the bigger issue with this logic is that this isn't a medical plan. It's a social one. The people who should develop a strategy around a global pandemic are not the same people who intubate the casualties of said pandemic. It's like asking a car mechanic how we should build safer roads...they're just not the same thing.

https://www.bbc.co.uk/news/uk-england-55430397

https://www.independent.co.uk/news/uk/home-news/coronavirus-...

Etc.

Same story happen in 2016,2017,2018,2019. This just show that the system need to be better managed, not lockdown.

Lockdown is just cop out and not only it doesn't help it creates tons of additional problem.

It's easy to say something is bad. It's more difficult to say what, specifically, would be better.

What exactly would "better managed" look like, in your opinion, and what evidence do you have that your version of events would result in better outcomes than the lockdown measures that have been used?

You posted link about ambulance delays. This is issue is not caused by covid, because it happened as well in the past where there was not covid.

By implementing lockdown, now you have 2 issue : Ambulance delay and the damage from lockdown.

I'm not sure your conclusion logically follows from the evidence, but even if it did, you still haven't answered the big questions your position raises. If you think what they're doing at the moment is wrong, what specifically do you think they should be doing instead and why do you think your alternative strategy would have better outcomes?

Specifically: no lockdown.

Why it has better outcome?

From the data we know that for vast majority of people who get infected it will be either asymptomatic or only have mild symptoms and the serious case/death is skewed towards the elderly.

Lockdown cause harm. The virus cause harm.

More people suffer from lockdown than the virus.

At the minimum doing nothing different than the government already done in the past would lead better outcome than what we currently have.

If you want to do something, then there are many ways that are not lockdown, that can be done such as:

- increasing healthcare capacity/funding when needed

- accelerate development of better treatment

- accelerate vaccine development

- do not test everyone, so much wasted resource spent on this.

- media campaign to educate people about the actual risk of covid

- increase campaign on exercise, healthy diet, outdoor activities.

That's pretty much what I would do if I'm in power.

So you're proposing a natural selection strategy that would, on the evidence so far, probably kill around 1 million people in this country alone and possibly cause long-term health consequences that we don't fully understand yet for millions more who get the virus but don't die of it?

And that's still making the implicit assumption that the greater number of people getting the virus and therefore greater number of opportunities for new mutations to develop don't make things any worse, for example by evolving a mutation that severely affects other demographics in the same way that the current known variations of the virus affect elderly or otherwise vulnerable groups and/or that can withstand the treatments and vaccines we have available so far.

And it's also making the obviously false assumption that the NHS has the resources to offer the best possible care to everyone who does get the virus in your scenario, and that care for others with serious conditions is not compromised causing further suffering and loss of life.

I don't think most people would agree that such a strategy is either ethical or likely to be more effective at controlling the virus than the lockdown measures, under the present circumstances.

>So you're proposing a natural selection strategy that would

I didn't say that, I listed multiple measure that can be taken.

What I'm saying is, if for some reason the government refuse/unable to do those, at the minimum no lockdown is better.

>on the evidence so far, probably kill around 1 million people

1 million out of how many ? How many million people who going to suffer from lockdown?

>that we don't fully understand yet

Right, its not fully understood yet, so its not a justification to implement a measure that is harmful for million of people such as lockdown.

>or example by evolving a mutation that severely affects other demographics in the same way that the current known variations of the virus affect elderly or otherwise vulnerable groups and/or that can withstand the treatments and vaccines we have available so far

New mutation generally evolve into something that spread more easily but less deadly.

>And it's also making the obviously false assumption that the NHS has the resources to offer the best possible care to everyone

I never made assumption that the NHS has the resources to offer the best possible care to everyone.

>I don't think most people would agree that such a strategy is either ethical or likely to be more effective at controlling the virus than the lockdown measures, under the present circumstances.

I acknowledge that everybody has their own preference, if you like to live in the place with lockdown then to each their own. I'm just trying my best to everybody people I know. If I can choose I would much much prefer to live where the government handling this without lockdown. I ready to move to place with less lockdown, if the government in my place decided to increase the lockdown.

That being said I think each of us lives in their own preferable place is probably only thing that going to work for both of us.

So if the foot soldier in the trench keeps complaining that they don't have enough bullets, and saying that without bullets they can't fight and will loose the battle, they shouldn't be listened to?

I think they are exactly the ones we should be listening to.

No, you give them more bullets. If the NHS says they need more supplies, then give it to them.

But you don't listen to the foot soldier when they tell you how you should position your troops. And that's exactly what you're suggesting.

Except they are not, vast majority of people infected with covid do not require hospitalization.

If the hospital can't handle this virus then the health care system must be really bad in the first place. The solution is to fix and improve it, not lockdown.

Lockdown measures is just cop out.

If the hospital can't handle this virus then the health care system must be really bad in the first place.

Any health system has finite resources available: facilities, equipment, trained staff, the money to pay for all of it, etc.

If the NHS had already been set up to handle this once-in-a-century black swan event better, it would have been less effective at handling other conditions that have affected patients in the more than a century since the last outbreak of similar severity.

I haven't been impressed by how our national government has handled this situation, but if you stop and think about what's happened in the past year or so, it's actually pretty amazing how quickly and effectively our NHS staff, scientific community and others playing supporting roles in our society have adapted. They are fixing and improving our healthcare system, and they're doing it right before our eyes in real time.

You've made a lot of comments and mentioned many numbers and statistics, but I've yet to see any sources linked. Could you add them?

And please don't say something like "do your own research," that doesn't help the conversation at all.

> When are we going to start putting all these efforts and resources into focusing on the vulnerable populations and not painting with a broad brush.

We have been. That's why the vaccine is going out to them first.

We have too many people in hospital. Even if all spreading stopped right this second, the number of people going into hospital will continue to increase for another 2 weeks. This is the busiest time of year for hospitals, and we already have more covid paitents than we did in April.

If my child needs an ICU bed, I want one available, I don't want it filled with 80 year old covid patients.

Consider the age group(s) for most of the world's politicians.

Why is ageism so widely parroted on HN?

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