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Comment by gms7777 | Hacker News Reader

It's a real world example of a trolley problem. They're choosing to let a large group risk severe disease or death through inaction, rather than pulling the lever and have a small group be at risk due to their actions.

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I think that's exactly it. There is a tradeoff to be made here with likely deaths on both sides, and the government is choosing much higher numbers of deaths because it looks better for them politically. That's immoral and cowardly.

I don't see any way to justify the decision they've made logically.

This pandemic is basically this entire story. COVID deaths are much more visible than the missed cancers, the depression and drug abuse caused by lockdowns, so basically it’s an easy choice for governments, lockdowns are better politically.

That argument doesn't make a lot of sense to me.

It assumes that the numbers caused by the lock-downs are bigger than the numbers caused by Covid.

It assumes that there is not positives to the lock-downs (maybe some people is less depressed at home than at their work, not deaths by flu, etc..) and, most important, it assumes that not lock-downs would not increase deaths by other causes (intensive care overworked).

The number of deaths due to missed TB vaccinations alone will be a very substantial percentage of number of COVID deaths.

Maybe, maybe not. TB should be readily stopped by masking and distancing measures; we might get something of a respite from it. I'm not aware of any numbers in either direction yet.

Confidently stated, but the impact of lockdowns is likely more complex in reality. It may require years of research to tease out all the components; lockdown vs general pandemic stress, differences in implementation, etc. For example:

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...

> Rate ratios (RRs) and 95% CIs based on the observed versus expected numbers of suicides showed no evidence of a significant increase in risk of suicide since the pandemic began in any country or area. There was statistical evidence of a decrease in suicide compared with the expected number in 12 countries or areas.

Less human contact, less stress, less suicide.

Less school, less stress, less suicide.

That is a narrative that misses the point of the thread and is generally not compatible with hard data. For example, the amount of suicides in US during 2020 went down.

Parent was talking about missed cancers and drug abuse, not suicides. Alcohol sales were up ~20% [1]—that too is hard data.

[1]: https://wineindustryadvisor.com/2020/11/16/nielsen-covid-bev...

Off-premises alcohol sales were up; the article indicates it's a shift from on-premises to off-premises, which... shouldn't be surprising, given a lot of those premises are shut.

And the number of deaths due to seasonal flues is practically 0. I actually do not think any of these statistics matter, because data driven decisions are not timely by definition. What mattered is that the entire western world failed to react in time.

CDC only tracks actual suicides, not attempts. Attempts and suicidal thoughts are up: https://www.aappublications.org/news/2020/12/16/pediatricssu...

Also, on the CDC stats, deaths by "unintentional injuries" is up by way more than suicides are down.

Has anyone not had suicidal thoughts since the lockdown?

But people will also miss cancer screenings, get depressed and so on when they stay at home because of an unmitigated pandemic running wild. It wouldn't be 2019 again without government intervention.

(PS: also, why would they miss a cancer screening when it's literally the only pastime that isn't shut down?)

> (PS: also, why would they miss a cancer screening when it's literally the only pastime that isn't shut down?)

I was literally looking forward to an expensive and unpleasant dentist appointment (dental implant). At least, some change in the routine.

> PS: also, why would they miss a cancer screening when it's literally the only pastime that isn't shut down.

Fear to go anywhere near a medical environment. Long delays and cancelled procedures and appointments because medical professionals had other priorities.

Wouldn’t both of those situations be vastly worse if there were fewer or less strict lockdowns?

Sorry I missed the context for your PS. Yes they'd be worse without lockdowns. OP's argument is actually an argument for the side.

The story with lockdown is a lot muddier. There's a good argument to be made on both sides, and weighing which decision is best with partial data is difficult.

I completely understand the initial lockdowns when we had no data. I would have done that too, although I would have acted sooner because I saw this threat clearly in January - why our governments were less competent across the board than some rando programmer is something I haven't forgiven.

What I don't understand is now that we have data, we're still doing lockdowns with no attempt to publicly weigh the pluses and minuses and justify three decision logically. I mean maybe it's the right thing to do, but I want to see them put some real thought into the decision, and not do it because it's what they're before, or what's politically viable.

There should be a clear logical argument being made, weighing the harms on both sides and choosing the lesser evil.

The point of the trolley problem is that it’s hard to make the right decision. Yet apparently anyone who doesn’t make a decision based on the move naive application of utilitarianism is a coward.

At a government level you have to be able to weigh bodies. Because there are often deaths or serious harm on both sides of a decision. Just because it's a hard decision doesn't mean there isn't a right choice that minimizes harm. This is also true of the trolley problem.

In this case one side is clearly tipping the scales by multiple orders of magnitude more. To choose that side for political reasons is cowardice and unethical.

I don't know if "weighing bodies" is the right approach to government, but even if it is people who "weigh bodies" are not likely to remain in power very long. There aren't a lot of humans who would support harvesting the organs of a healthy patient to save 5 sick ones, for example.

I put it crudely to be dramatic, but it is the core function of a government to choose between competing harms and benefits for different segments of the population (including populations outside their borders when it comes to foreign policy.)

> There aren't a lot of humans who would support harvesting the organs of a healthy patient to save 5 sick ones, for example.

That's a strawman. I'm not taking the position that the right decision is always choosing the least number of bodies. Maybe that is true, there are debates to be had there, but I'm not arguing that, and that's not comparable to the decision here with the AstraZenica vaccine.

Harvesting 5 organs from 1 healthy patient to save 5 sick patients is a variation of the trolley problem, not just a random straw man I picked. The fact that people who are surveyed are fine pulling a lever to kill 1 person to save 5 people from a runaway trolley but don't want to harvest the organs of 1 healthy person to save 5 sick people shows that these ethical problems are "difficult" as one person said up-thread.

This is the slippery slope of analogies. I'm not here to argue about trolley problems or organ harvesting.

I'm here to say that there's a clear right decision to be made here that will cause the fewest number of deaths by multiple orders of magnitude - and the Danes are making the wrong choice because they left the decision to their medical professionals who are biased to first do no harm. It is the role of government to make these kinds of hard decisions, and they need to step up to the plate and do the right thing. This oversimplifies the problem because the deaths from Covid-19 tend to be older people and the deaths from blood clots, tend to be younger. But then there's still a clear right choice to be made by just using the AstraZenica vaccine in older people. This is the sensible decision most countries have taken so far.

What do we do in cases where it's murky like the trolley problem or the organ problem? The government still has to choose, and not choosing is still a decision. In that case if there's no clear answer then maybe the decision doesn't matter that much - both paths are similar.

The trolley problem and the organ problem have been argued about ad nauseaum. I don't expect to add anything new to that. They're different problems. The trolley problem you should pick the 1 to die - it might end up being the worst choice still, but it's the one most likely to do the least harm, so the choice is obvious - IMHO. If I recall correctly, that 1 person is not innocent, they put themselves in this situation, but the 5 on the trolley are and didn't make a bad judgment call. That seems to matter to the ethics of the thing.

With the organ harvesting - all the people are equally innocent. You can't take the life of an innocent person to save the lives of 5 others, even though the math makes sense. That's crossing a line.

Again, they're hard problems, not everyone will agree. But it's the job of the government to choose in hard situations, and choosing nothing is a choice too.

For me, the difference is that people can handle the idea of getting sick and dying. It happens to everyone eventually and there's nobody to blame. People are much less happy about deaths that are directly tracable to someone's decision (e.g. continuing to use a vaccine that will kill some small number of people).

That could be part of it for sure. I think the first do no harm mentality is a very strong bias in the medical community in general. And as pointed out elsewhere, it was the Danish medical authorities that made this call. They're the wrong people to do that.

I think there were broadly 3 strategies:

1. Do very little intervention, but perhaps isolate the vulnerable. This was the "Sweden strategy".

2. Do big interventions if cases rise, but only so far as is required to prevent hospitals being over-whelmed. This was the strategy in most of Europe, and in particular the UK.

3. Do big interventions with the intention of reaching "covid zero", including restrictions on international travel. This was the strategy of Australia, New Zealand, Taiwan and perhaps China (hard to get the full story).

Having spent the past year under (2) I wish I was living under (3). Sure it's painful in the short term, but compared to rolling lock-downs for over 12 months?

> but compared to rolling lock-downs for over 12 months?

So far. Add 6, 12 or 24 months.

So why not choose (1)?

This seems to have been the strategy in the past with similar risks. And it avoids the costs of freedom and live at the same time. What am I missing?

That it doesn't work. Sweden had to go back on it, and in many countries trying to do (1) ended up with hospitals full - like France. Everything was done to avoid a third lockdown this spring, but hospitals are at 150% capacity and here we are again. Are you aware of some magic trick that negates that?

Sweden did not "go back on it". They remain with significantly lighter restrictions than ~all of continental Europe:

https://www.folkhalsomyndigheten.se/the-public-health-agency...

As far as I can tell, their most stringent restrictions are limits on group gatherings to 8, and closing bars at 8pm:

https://www.bloomberg.com/news/articles/2021-03-30/swedish-h...

Contrast to France, Italy, the UK, Belgium, etc., where people have been forcibly restricted to their homes for a significant portion of the last year.

And Sweden has the worst infection and death rates per capita compared to all of Scandinavia:

https://www.statista.com/statistics/1113834/cumulative-coron...

https://journals.sagepub.com/doi/full/10.1177/14034948209802...

https://ourworldindata.org/coronavirus/country/sweden

But they faired much better than e.g. Spain and Belgium.

https://www.aljazeera.com/news/2021/3/24/swedens-2020-death-...

Which are incomparable due to a vast amount of variables ( culture, population density, population spread in housing, temperatures, weather, etc.)

That's patently false.

Everyone compares countries all the time.

You literally just did it a few posts up by comparing it to other Scandinavian countries which are all different from Sweden.

Covid zealots compare other countries to New Zealand when it's convenient.

All with different cultures climate population density etc.

If what you're saying is true then you can't make any claims about any country's success rate because they're all unique.

You're just selecting Sweden as incomparable because it doesn't fit your narrative.

Scandinavian countries have similar cultures, population densities, climates, customs ( e.g. people don't kiss on the cheek when they meet, which is what French people used to do pre-pandemic). They're more comparable between themselves than with Spain, with an entirely different climate, people living much closer together, etc.

New Zealand are isolated by water from everyone, lockdown is drastically easier in that case.

Swedes are European and share as much in common with Europeans as they do with other Scandinavian countries. Comparing Sweden to other European countries is a perfectly valid comparison.

You're cherry picking and choosing cultural aspects and labeling it as 'unquestionable fact' with no scientific evidence.

Classic Covid zealot move.

As a matter of fact, we're all human beings that like to congregate together and eat out and go to bars and coffee shops and see live music, and our biological drives have way more significance than anything cultural .

It's extremely disingenuous.

You have never visited any of those places, have you?

I don't know what "Covid zealot" is supposed to mean, but i think you need a reality check.

So, let's be clear: you make claims that aren't true (Sweden hasn't done what you originally claimed; they have significantly fewer restrictions than most of Europe, even today), and then when people point out the factual inaccuracies in your statements, you retreat to arguing about the wisdom of Sweden's choices.

Reasonable people can disagree about policy choices, but misrepresenting facts as a starting point does not make you look reasonable.

My claims are true, Sweden has significantly tightened restrictions. And to add insult to injury, their death rate is appalling, so their policy was indeed wrong on top of not working.

You said:

> Sweden had to go back on it

They did not. If your standard for "going back on it" is "adding some restrictions", then you are erecting a straw man argument. By this standard, every country in Europe "had to go back on it", as all of them changed their tactics over time.

Also, not incidentally: I'm aware of no legitimate source for the claim that Sweden's hospitals were "full" (which is a non-specific claim). Most sources I've read emphasized that hospitals were under stress -- like in most parts of the Europe -- with some hospitals closer than others to capacity, and resources being shifted around the nation to manage:

https://www.thelocal.se/20201211/is-the-second-wave-overload...

Again, you could take this article and put it in Paris, Berlin, London, Brussels or other major cities in Europe in December of 2020. Details matter, and vague claims that "hospitals are full" are meaningless.

When their policy is "let's avoid any restrictions and just ask people to stay away from each other", and then they add light ( compared to other countries) restrictions, how is that not "going back [on their initial policy]"? No other European country persisted with the "no restrictions" policy post-spring 2020.

And i never said the Swedish hospital system was "full", just that their death toll compared to their neighbours was appalling, and said neighbors had to add restrictions on movement from Sweden.

My understanding is that these restrictions were only imposed in December of last year (and are in force until at least 30 June), so I would tend to agree with the parent that they definitely changed directions.

They added some restrictions, certainly, but it's completely inaccurate to suggest that they've somehow reversed course -- the OP is erecting an ideologically rigid, straw-man argument that Sweden can never do anything differently at all, or they are somehow "going back on" their initial approach.

Overall, Sweden has taken a light touch with the pandemic, and continues to do so, even though, yes, they've adapted over time.

Of course they went back on their initial approach, same as the UK. If you say "no need to restrict anything, it will go away", your death toll is significantly hire than comparable countries, and then you enact restrictions, what is that? Yes, the situation and our knowledge of the virus and the pandemic is highly evolving and the UK took barely a few months before making a U-turn, while Sweden persisted for many months with their strategy, in spite of the death toll, and some research saying that the economic impact is still significant.

The secret to not having hospitals overwhelmed is to have enough capacity in the first place, but also to avoid superspreader events. Sweden did ban some gatherings and they did close down schools briefly.

Most other lockdown measures are questionable at best, including mandatory mask usage. They are clearly symbolic tools for the political class to signal that something is being done, but the data to support them is not very strong considering that there is not much of a control group.

> The secret to not having hospitals overwhelmed is to have enough capacity in the first place

Enough for what? Hospital capacity was wildly sufficient for regular times, but the pandemic turned that around. Even Germany, which has multiple times the capacity per capita than France, is struggling in that regard. What is "enough"?

> but also to avoid superspreader events

Lol. Events with more than 2000 people outside ( at the best of times, usually it has been flat out forbidden), and 6-100 inside have been forbidden in France since last year. That obviously didn't help.

> Most other lockdown measures are questionable at best, including mandatory mask usage. They are clearly symbolic tools for the political class to signal that something is being done, but the data to support them is not very strong considering that there is not much of a control group.

There is, check the US and Brazil.

> Enough for what? Hospital capacity was wildly sufficient for regular times, but the pandemic turned that around.

Indeed, "enough" for normal times is not the same as "enough" for pandemic times.

> Even Germany, which has multiple times the capacity per capita than France, is struggling in that regard. What is "enough"?

Of course it's a "struggle" to suddenly work at capacity, but Germany wasn't in the situation of having to turn down patients. To the contrary, Germany was able to pick up patients from neighboring countries. That's "enough".

> Events with more than 2000 people outside ( at the best of times, usually it has been flat out forbidden), and 6-100 inside have been forbidden in France since last year. That obviously didn't help.

How do you know that it didn't help? We know from epidemiological studies that superspreader events were responsible for causing a surge of cases in a short amount of time.

> There is, check the US and Brazil.

There really isn't, we have countries with strong lockdowns doing poorly and countries with weak lockdowns doing relatively well, and everything in between. Lockdown measures are also difficult to compare, as are populations, as is testing and reporting.

For example, Brazil with minimal lockdowns is doing just as poorly as Peru, with heavy lockdowns. Florida is doing better than many other US states with heavier restrictions. Japan is supposedly doing well with few restrictions, but also performs little testing.

There are lots of variables and unknowns here and one can always cherrypick data to argue for or against lockdowns in various forms.

That was during the first lockdown. More recently, they're closer to capacity:

https://www.dw.com/en/coronavirus-digest-germany-icu-capacit...

> How do you know that it didn't help? We know from epidemiological studies that superspreader events were responsible for causing a surge of cases in a short amount of time.

It didn't help in the sense that hospitals are overcapacity and new cases, hospitalisation and death rates were still exploding until the recent pseudo-lockdown.

"An intensive care doctor has warned that only five to 10% of intensive care beds are still available in parts of Germany."

In most countries, running at 90% ICU capacity is the normal state of affairs, Germany being an exception.

Of course you can always warn that the health care system is just about to collapse.

In 2015:

https://www.theguardian.com/society/2015/sep/19/nhs-collapse...

In 2016:

https://www.theguardian.com/society/2016/sep/10/hospitals-on...

In 2017:

https://www.theguardian.com/society/2017/feb/20/nhs-at-break...

In 2018:

https://www.theguardian.com/commentisfree/2018/apr/06/nhs-fa...

In 2019:

https://www.theguardian.com/society/2019/dec/02/nhs-winter-c...

In 2020:

https://www.theguardian.com/world/2020/mar/21/doctors-warn-c...

In 2021:

https://www.theguardian.com/world/2021/jan/09/nhs-counts-the...

Spoiler: The NHS did not collapse. Working right at the brink of collapse is normal.

> It didn't help in the sense that hospitals are overcapacity and new cases, hospitalisation and death rates were still exploding until the recent pseudo-lockdown.

According to your own source, hospitals are not over capacity. If you had a few super spreader events, that could obviously change rather quickly. Whether a "pseudo-lockdown" meaningfully slows spread is not so obvious.

It’s absolutely true that ICU capacity generally runs at 90% utilisation - ICU beds are bloody expensive (staffing etc). In NSW, Australia, where I live and work (and have worked in ICU) there is a statewide ICU service so if you need a bed and you’re on the other end of the state you can end up getting transferred 1500 km to be in one.

Having said that about utilisation, what pandemic beds requirements meant in the rest of the world and would have meant here is that no elective surgeries could be performed; leukaemia/cancer patient stem cell/marrow transplants couldn’t go ahead and trauma victims risked not being able to be cared for. This was absolutely the case in the UK during the height of things (friends are ortho/trauma surgeons over there and ended up working as assistants in nursing for 3-4 weeks in January).

So, with increase in ICU bed availability through adding new beds and with stopping any potential procedures that would electively require an ICU bed for recovery countries were able to basically meet demands (although many of my emergency colleagues in the UK reported having to determine who was going to be for ICU or not - ie top level care was not offered to some people during the height due to lack of resources) - there is now a massive backlog of patients requiring their baseline care to be fulfilled.

For example, another of my colleague’s mothers is a (retired) dermatologist in London. She was pulled back into work because there are now people presenting eith melanomas that were missed because no one was going for their regular care early in the year. And now they’ve spread and now people are dying because of this; not to mention the backup.

There’s no silver lining here.

You moved the goal post to encompass elective surgeries and other things.

The argument was: Did the hospitals overflow from Covid?

And they did not overflow anywhere in the world.

From the CBC: The latest on the coronavirus outbreak for April 20 [1]

> New Toronto field hospital prepares to accept patients as ICUs overflow

> Greater Toronto Area hospitals are so overwhelmed due to record COVID-19 admissions that some patients are being transferred to health-care centres outside the region.

[1] https://www.cbc.ca/news/canada/coronavirus-newsletter-april-...

Covid zealots say #believeTheSciene but the use the news media as scientific sources.

Post an actual link to ICU numbers if you truly '#believeTheScience'

Here I did it for you.

https://www.arcgis.com/apps/MapSeries/index.html?appid=078a3...

Do your own data analysis and see ICU admissions are only up 15% or so.

Also, according to other media outlets, ICUs in Toronto haven't filled up, they're 'NEAR capacity'.....which has been the story for over a year everywhere.

The media drums things up to make money and should not be used as evidence for your argument.

The media also said San Diego ICUs and Houston ICUs were overflowing but it didn't happen.

For example, this sensation article never happened:

https://www.google.com/amp/s/www.nbcsandiego.com/news/local/...

Do you have anything supporting your argument of hospital overflow with substance?

Or do you get all of your 'science' from the news media?

I'm not posting to try to convince you, as you're clearly beyond reason. I just find some aspects of your comments here interesting, and worth laying out for any third party who might read them.

First you attacked a comment (above), claiming they'd moved goalposts in their arguments, and then you claimed hospitals had not overflowed. Subsequently, you responded to a comment providing a citation saying they did, by demanding a different source - which is moving the goalposts, the very thing you criticized in someone else.

Here, look at this, another article showing Indian hospitals have overflowed, this time from Reuters:

> Indian hospitals turn away patients in COVID-19 ‘tsunami’ [1]

This is relevant because you yourself consider Reuters a citable source, at least when you like what it is saying [2].

That comment you cited Reuters in reminded me of another of your comments [3] (I actually did mark your words, as requested):

> Mark my words America is heading towards herd immunity as long as we stay this course, and this will be all over by the end of the year. (you, eight months ago)

How's that herd immunity coming along? Was it all over by the end of the year?

[1] https://www.reuters.com/world/india/indias-daily-coronavirus...

[2] https://news.ycombinator.com/item?id=26732877

[3] https://news.ycombinator.com/item?id=24277509

I'm glad you marked my words.

Texas had 40,000 people at a football game, has no covid restrictions, and is at record lows for Covid.

With the exception of Michigan almost every single state has reached record lows of Covid.

It's not an exact science but we have reached herd immunity in almost all of America within a few months of what I predicted.

All with only 25 to 40 percent vaccination number. So it's clearly not vaccination or restrictions providing the full herd immunity.

As for India sure I'll give you that. I should amend my statement to mean 'First world' countries with adequate ICU capacity had no ICU overflow.

You have to quote a third world country with the average personal income of 2000 dollars a month to support your argument because the hundreds and hundreds of other worldwide first and second world countries didn't have any hospital overflows. This is not surprising or unexpected and disingenuous of you to discredit hundreds of other countries in favor of a single country to support your argument.

However, the rest of the first world outside of India has had no hospital overflow.

Asking for a legitimate source this is not the news media.... is not 'moving the goal posts'.

You 'beleiveInScience' Covid zealots think the news media is science. I hate to break it to you but the news media is not a reliable scientific source. You should try to learn what science is before you #believe in it.

I'm not sure what you Covid zealots require to feel safe again.

I legitimately feel sorry for you.

You're in a permanent prison of fear.

I have to say, you never disappoint: you've moved the goalpost again.

You're implicitly conceding that contrary to your earlier assertions, there have been hospital overflows, but now are further restricting your claims to only apply to first and second world countries.

You're also ignoring the fact that I chose this particular article not because I couldn't find first world examples (I already did, see above), but because this one was from a source (Reuters) you've already endorsed by citing articles from it yourself.

Now you're writing a rambling attack to distract from the fact that you have nothing to support your claims, and can only try to evade the evidence against them.

Sure Ill concede that out of hundreds of countries, one third world country of India has had hospital overflows.

Any person with good faith and an honest mindset would agree that India is the exception not the rule.

Covid zealots are not known for honesty though.

I don't know what the f your problem is, but you're wrong. France is today, even past the worst of the current wave, still at more than 100% original capacity of ICU beds. (118% for France, 152% for the Ile de France region with Paris)

Official sources and raw data: https://www.france24.com/en/europe/20210310-paris-hospitals-... https://bonjour.tousanticovid.gouv.fr/app.html#chiffres

Are you going to shift the goalposts again and redefine to "Anglosphere first world countries"? Or are you going to admit you don't know what the hell you're talking about?

"Covid zealots" is a peculiar term, i'll give that. Makes little sense of course, but nothing you say does.

The first article that you linked was a news article and said "Near capacity" not "Over capacity" and the second link you posted didn't have ICU numbers that I could see.

ICU's run "near capacity" all the time, so the news source you linked is simply stating a normal situation in a sensational context.

See here: https://www.beckershospitalreview.com/patient-flow/2-healthc....

What I mean by Covid zealot is people who believe things that aren't real about Covid based on poor critical thinking and/or poor understanding of the data or some other reason that I don't understand.

The second link includes ICU numbers in the "rea" ( for reanimation, the French term for ICU). Pre-pandemic capacity is readily available online.

ICUs in France had their capacity doubled over last summer, and since the beginning of the year everything elective has been postponed to make place for Covid patients.

> What I mean by Covid zealot is people who believe things that aren't real about Covid based on poor critical thinking and/or poor understanding of the data or some other reason that I don't understand

So denialists that still fail to grasp the gravity of the situation, like yourself?

Unless, I'm missing something about that link you posted, it's just simply showing REA numbers increasing and not the total capacity of ICU.

Patient numbers are still NOT ICU capacity. Numbers can go up and still not be at capacity.

If I'm indeed not missing something that is either poor reasoning or a disengenuous citation.

If you get all of your information from the news media there's 'gravity to the situation' but if you look at statistics...

Covid is mostly over in the states and either over or on the downswing around the world, with the exception of a few third world countries.

You should look at statistics and not the news media.

In the U.S., States are at record lows of new infections and almost every state has lifted most of it's restrictions and we're not even at 40% vaccination rate.

Even New Zealand has opened it's borders to Austrailia and their vaccination rate is in the mid teens.

Covid's fatality rate in the states was around 0.00125 and I'm assuming other places as well.

Trying to understand the gravity of the situation that you claim exists.

It's like The 3 billion people who believe in God. Despite all evidence to the contrary the zealots will cling to their narrative.

> Covid's fatality rate in the states was around 0.00125 and I'm assuming other places as well.

Totally wrong. Johns Hopkins says the case fatality rate in the states is 1.8% [1]. Many others are worse, like Canada at 2.0% and 2.9% for the United Kingdom.

[1] https://coronavirus.jhu.edu/data/mortality

500,000 dead / 400 million people.

You can do the math.

Hell only 33 million in the states tested positive for contracting Corona.

33 million / 400 million

Which is infection rate of .0825

Even if you double it to account for non tested cases that .16% JUST CASES.

Even if you double that you're not even at 1% yet.

The experts err to the EXTREME side of safety.

These are the same experts that say only eat steak if it's well done and not to drink more than 2/3 cup of wine in an evening.

The divisor for case fatality is number of infections, not total population.

You can look up the definition.

so 572,674 / 32,124,869 = 1.8%

As I already said, and as you can look up yourself, in the link I gave.

No that's the chance of death if you're already infected.

The fatality chance for a healthy person in the general population is the measure of risk for the average person. Using the same measure of population that the R value uses to calculate infectiousness.

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

Have you been using 1.8% chance of death as your chance of dying? I would be scared too.

For a healthy person to become infected is a very small number to begin with and highly biased towards the elderly or people with co morbidities.

You can legitimately lighten up. Your risk from this is infinitesimally small if you're under 55 and healthy.

If not it's still unbelievably small.

This is right from the Johns Hopkins page linked to above:

> fatality ratios (the number of deaths divided by the number of confirmed cases)

So you’re wrong. Again.

fatalities / infected = fatality rate of those infected.

It's literally the definitions of those words.

It's fine continue to be scared. I legit feel bad for you.

My state just lifted the mask mandate recently and were not even at 30% vaccination rate yet.

Feels good.

You're ignoring the reality, which is that people died preventable death and suffered preventable harm because hospitals were overwhelemed.

There are thousands of English HCPs talking about this. Here's one: https://twitter.com/seahorse4000/status/1386263023900319745?...

(That comment about staff is for their particular NHS trust, not the NHS as a whole)

We rationed oxygen

We shut the hospital

I was managing icu pts on amu

We stopped elective surgery

We had over 400 staff off with covid

I had 9 pts die on a single shift

Using twitter and the mainstream media are the new scientific sources.

interesting that you don't level the same at parent poster.

Parent poster was using links to mock the news media and evidence how unreliable and hypocritical they are.

You are using an anecdotal Tweet as an actual epidemiological citation.

It's very interesting to me how low the bar is for the Covid zealots scientific sources!

(2) leads to fewer deaths overall than (1). (1) gives better quality of life to the healthy than (2). (3) leads to fewer deaths than (1) or (2), but it requires political will. If you can pull it off, (3) is what you want. That's a big "if" though.

As a healthy person, I personally would have been better off under (1). However, I think the economic and emotional damage of that number of deaths would have been too much for society as a whole.

I'm not certain the emotional damage around the deaths would be worse than the emotional damage around the restrictions. Same with the economic damage, I'm entirely certain the the economic damaged caused by the death of a large amount of largely economically inactive persons would have been way less than the economic damage caused by forcibly shutting down large chunks of the economy.

The whole 1 vs 2 thing is just a matter of how much must the whole suffer for the benefit of the few?

Living in 2 i'm not sure 3 would have worked where i am ( France) to get to zero, especially considering Schengen and the fact that even if by some magic you get to zero cases, it can easily spillover by even a few people from neighboring countries or tourists. And i sincerely doubt it could have gotten to zero cases - every lockdown since the first one has been ignored by a non-negligeable amount of the population.

To be in (3) though you have to isolate your country right at the beginning before the action can be politically justified.

I'm quite surprised that China was able to pull it off, because they're a major trade economy and must have millions of people coming and going. Of course it helps to have a government that can take any action without regard for rights or political consequences.

This is impossible I think for a country like the US with vital land borders and constant trade across them. I think it's also very hard for democratic counties where people have rights.

The lock-downs imposed in (2) countries were very effective and given a bit more time (and political will) they could have transitioned to strategy (3).

Australia and China managed to do this.

If I look at the center of Amsterdam, in the past year there have been losts of tourists from all over Europe even when bars and restaurants are closed. So this means that any strict lock down would have to be coordinated at least within the EU.

In the past, EU countries did not want to delegate health care to the EU (except for approving medicine). So this would require lots of individual countries (including Sweden and, until this year, the UK) to suddenly agree on a single strict lockdown. Very unlikely to happen.

The lockdowns imposed in countries that only used them to prevent the hospital system being overwhelmed were very effective on average, but that's not enough. In order to reach Covid Zero you need lockdowns to be very effective everywhere. Take for example the UK - there were apparently some areas where cases kept growing even during the strictest lockdowns, and that's enough to ensure you'll never reach zero cases.

All the countries where this worked seem to have the advantage of being geographically and geopolitically distant from Italy, which meant they could take action against their outbreaks at a relatively early stage before they got deeply embedded in society. (Early on, cases were more or less a gradient radiating out from Italy, probably because they had a major outbreak which went completely undetected as in literally reporting zero cases country-wide despite having an awful lot more than that.)

You don't have the right to even smoke in a restaurant now, what's the right issue when talking about a health issue here. It needs the same reason as quarantine requirements being imposed on people. So many 'we are different' refuse to stay at home and wear masks.

The real tragedy is that most of countries are following UK and US as their model because most of their government policy makers are trained in US and US, and they don't have the capacity and courage to set out their own plans.

China actually had a bit of advantage here, as other countries started shutting out Chinese nationals, preventing their citizens from going abroad and reintroducing the virus. Also it seems like as the first hard hit place its citizens started to become wary of traveling abroad earlier.

I would have preferred a strategy of using financial incentives. Big fines for companies that refused to switch to remote work where it was feasible. An additional tax on indoor dining and shopping, to make curbside pickup more attractive. Fines and additional tax would go directly to lockdown financial relief.

>I wish I was living under (3). Sure it's painful in the short term, but compared to rolling lock-downs for over 12 months?

Having spent the last year under (3), I dream of 1 or 2.

That said, it very much dependent on the country. I live somewhere that is 20 x 20 miles in size (Hong Kong). The strictness of the border control (3 weeks in a hotel room if you leave and come back) make leaving pretty much impossible.

That, combined with extremely conservative local restrictions (not to mention the political situation) takes a significant toll after a while.

Most people in positions 1 and 2 can’t really leave their countries either, and depending on how strict 2 is you may not have been able to travel far within your country either.

This is mostly an artefact of the fact that HK is so small. At least you’re not in Macau, which is 30 sq km?

>At least you’re not in Macau, which is 30 sq km?

Macau has quarantine free travel with the Mainland, so that's >9 million sq km ;)

(3) only really works in isolated communities and islands such as those mentioned.

I would choose a mix of (1) and (2), but no matter what we say here it won't change the past.

Going forward we can either choose the goal of no masks, no vaccine pass and no restrictions this year. Follow Texas for more on how that works.

Or we can go on with restrictions and random shutdowns when infections rise above an arbitrary level.

I know i would choose the first option.

Canada, specifically Quebec has been in full on curfew for a long time now. It hasn't helped and cases keep rising with now being the highest.

[1] should have been the best strategy.

Indeed, having your freedom taken away like that is an overreaction.

Until recently nobody in the US had the idea of removing restrictions and allowing 40.000 to gather for sport events.

That was until Texas did it and they are doing just as well as those with restrictions.

https://fee.org/articles/texas-has-fewer-covid-cases-than-mi...

Except it's not the government, or any politicians for that matter. It is the decision of medical professionals, basically the danish version of FDA decided to stop using Astra Zeneca vaccine. They have that level of power here in Denmark.

That's the problem. They're strongly biased towards the do no harm side of the balance - even when inaction causes much greater harm. It's simply a blind spot for them.

They're the wrong group to make the call here, and the politicians should overrule them.

Politicians don't make that determination right now. Self driving cars are a pretty good example. There's evidence right now showing that most systems are safer than human drivers. Yet still they are not permitted for use despite the fact that it will almost certainly result in fewer deaths.

Doctors are supposed to do no harm.

And erroring on the side of caution is what tends to happen in democracies. An authoritarian government is much more suited to taking bold and controversial action. I’ll personally stick with the overly cautious government.

No! There are NOT likely deaths on both sides. That’s the insanity!

There are certain deaths on one side (no vaccine) and virtually certain absence of any deaths on the other side.

It is cowardice and self importance triumphing over reason and morality. Imo

The blood clots have already caused deaths, unless I'm mistaken. At any rate it's not "virtually certain absence of any deaths". I agree with your conclusion, but the premise has some issues.

A few deaths out of 6 million defies any confident statistical pronouncements. It is rounding error. That we are so cautious as to halt rollout because of rounding error only speaks to how very cautious and rigorous we’re being with the rollout. People without the background to understand what 6/6,000,000 means in a medical research context will hear these fud statements and opt not to get the vaccine. Some of the people will die because they read smart peoples comments in web forums and thought they would be safer not getting vaccinated. You are throwing the switch in the trolley problem if you are telling people to ignore the scientific consensus and spreading anti vax fud. People need to accept the responsibility that entails.

> You are throwing the switch in the trolley problem if you are telling people to ignore the scientific consensus and spreading anti vax fud.

I'm not spreading any FUD. I'm as far from an anti-vaxer as you can get. I think you didn't read my comments.

> A few deaths out of 6 million defies any confident statistical pronouncements. It is rounding error.

But it does suggest there is a problem there. I took issue with your no deaths on the pro vaccine side. That's not true, as you admit.

> People without the background to understand what 6/6,000,000 means in a medical research context will hear these fud statements and opt not to get the vaccine.

This is sadly true. That's the same odds as dying from lightning in a given year. People suck at evaluating risk. I had many arguments with my parents about the risks from the vaccine, when it's literally lower than the risk of getting out of bed in the morning. People are irrational and it makes me sad. I'm also irrational, and I don't always catch it.

I disagree with “it does suggest there is a problem there.”

Without statistical evidence we cannot make that claim. There may be a problem, but there is so far no statistical evidence to suggest so. There are anecdotal findings but there are anecdotes about space aliens and we don’t craft policy around that (that the public is aware of.)

Despite having 1 dose of AZ already in my arm, it would give me great peace of mind to find some logical basis for this decision. Until then, I'll continue to suspect politics.

  Country after country appears to have taken a turn doubting the vaccine.  It would be normal for one or two outliers to behave this way, but for so many to defy logic - appearing to take turns falling in line with the EU message - it starts to smell a bit funny.

I've written this before, but if Britain (having left the Union) pulls this off and Europe continues to flounder, it is potentially catastrophic for the Union.

Slowely I'm getting the impression that a lot of decisions around AZ are politically driven. In Germany, the new recommendation is now to use Biontech for the second shot after AZ. In that recommendation, it is also stated that there are no studies nor data supporting that.

Quite funny, because there is, to my understanding, a study taking place in the Uk for that. It is expected to be done by end of April. Someone has to explain to me why that recommendation couldn't wait until there is data.

I guess that a decision needed to be made in a timely manner to provide guidelines for those who get their second dose before end of April?

Which would mean mixing vaccines without any trials done on the effects of this. As compared to using a second AZ shot, which has been analyzed and approved. Seems risky to my untrained eye.

And it wouldn't be hte first AZ related recommendation that changes every other week. We had so far:

- not for people over 65 because of underrepresentation in the trials

- not for people under 60 because of blood clots before any studies were finished

- Nobody wants AZ, so we will give it to everyone who is willing to take it

I don't see a strigent strategy here.

Can't argue with that. Everything about the AZ vaccine in politics and the media has been a shitshow so far. AZ themselves probably were caught off guard by the initial bad reporting and the wave of negative public reactions. They don't normally have to play the mass media game in their business.

It means getting a shot of AZ and two of Pfizer/biontech then. Seems reasonable, and this type of mixing is done all the time.

Complete nonsense. Do you honestly think the Danish medical authority gives a shit about the squabbling between the UK and Germany over AZ? To the point where they would even condemn people to death and put their careers at risk? I do not find that plausible at all. What I found plausible is that you are too gullible and do not realize that your "impression" was fed to you by the media, who definitely have a political agenda, one way or the other.

There are more poliical angles around AZ than just Brexit. Germany has a bunch of elections this year, for example. A lot of our screwed up Covid measures can be traced to a inner-party conflict about the Chancelor candidate for conservative party, Angela Merkel's government party at the moment. The same party that is up to the neck in a corruption sandal over mask contracts, and quite likely contracts for testing its as well.

No idea how the situation in Denmark is, so. Just one example how vaccines are used for political purposes in Germany, the Bavarian Prime Minister, Söder, and one of the two likely candidates for the chancelor candidacy, just placed a pre order for Russia's Sputnik V. The plan is to produce 2.5 millon doses in a plant in Bavaira by June or so. Never mention that Sputnik V has no EU approval, no study was submitted (what was that again with "faulty" AZ data?) and by June Germany will get up to 260 million doses the EU contracts.

EDIT: I read the 260 million in an article. Numbers from Statista don't back that up. And the EU isn't publishing any schedules. The supply chain guy in me is crying for a year now, first masks, now vaccines. Really frustrating. I really have to get a new job, right I have too much time on my hand it seems...

I was getting the impression that pretty much any government decision around COVID-19 was politically driven, not just AZ.

Actually that does not even sound very surprising.

Yeah, sounds about right. Having elections only seems to make these things worse.

I’ll tell you one thing that’s even worse than elections - no elections

Absolutely! But having elections in 2021 makes every Covid-related decision by definition political. And that doesn't help.

I should have made clear that the problem with elections is the timing, not elections in general. Governments should be focused on getting the population vaccinated as fast as possible now, and not worry about their / (re-)election chances.

As soon as you justify canceling elections for one crisis, you can cancel them for any crisis. You'll manufacture a crisis if necessary.

I never said we should cancel elections, quite the opposite. I just certain problems with conflicting incentives in the period before an election. Like weighing decision not just based on data and facts, but on public perception, media coverage and the impact on election chances. Covid had a shitty timing with that.

> But having elections in 2021 makes every Covid-related decision by definition political

Every COVID-related (or other) decision by or about government is political, by definition, independent of election timing.

Election timing may effect the degree to which the people of a democratic state have effectively direct input on an issue whose existence and political salience would not be regularly forseeable, but that’s a very different issue than whether decisions about that issue are “political”.

People often mean “partisan” when they say political. The parties of course control our definition of politics but that’s done with the consensus of party line voters, unfortunately the overwhelming majority of our electorate.

This much was clear in January 2020.

> a lot of decisions around AZ are politically driven.

Well, in the end "everything is politics" I guess. But one must also see it practically. In places where AZ is a small part of the vaccine strategy, skipping it just means a small delay. It's not a huge or risky decision to either stop using it or use it only in older groups.

In places where AZ forms the backbone of the vaccination strategy such as the UK, it's a much harder decision. The delay imposed by stopping general use of AZ means more deaths because it's a longer delay.

So different countries reaching different conclusions is natural.

> Slowely I'm getting the impression that a lot of decisions around ~AZ~ the pandemic are politically driven

This would be correct if Covid was very widespread in Denmark, most of the at-risk >65 population wasn't vaccinated already and there weren't alternatives available very shortly. But none of these are true, so the overall ethical decision becomes more complicated than that.

It's fallacious to describe this as an instance of the trolley problem, as there's also the public's trust in vaccines to consider. You'll see that the rest of Europe have arrived at a different conclusion, largely due to the fact that Covid is much more widespread there.

Decsions like that undermine trust. Now scepical people can point at Denmark and say: "See, it is dangerous, I don't take it" Because nobody will take time to understand how and why Denmark came to that conclusion. Not in a time where people are happy only reading half of a headline.

You mean people outside of Denmark. Inside of Denmark people will look at the next vaccine the government decides to go with and feel more willing to trust it precisely because their government withdrew support of the one causing clots

Correct. But to me it seems that pulling the lever to kill a few would be considered more culpable from legal perspective rather than not doing so (and let more people die). IANAL - I am curious to know how law perceives it.

Don't the COVID vaccine companies enjoy blanket immunity?

https://www.reuters.com/article/us-astrazeneca-results-vacci...

> They're choosing to let a large group risk severe disease or death through inaction, rather than pulling the lever and have a small group be at risk due to their actions.

I think your interpretation of the relative risks is wrong, but I’m open to seeing the calculations by which you come to this conclusion.

I mean the 65+ group is also most at risk of dying of Covid. I don’t see the moral hazard here. I understand that you can argue against vaccinations of younger people whose Covid risk might be eclipsed by the thrombosis risk. But for old people it seems simply stupid.

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