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AntonStratiev

-18 karma · joined March 19, 2020

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AntonStratiev··on 'Pandemic ventilator' could offer solution in potential 'worst case' scenario
And the survival rate is only 3% to 20% for COVID-19 specifically, based on data from Wuhan, following patients for a month. Long-term mortality will be even less.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Plus you need nurses and doctors to intubate the patient and setup and monitor the actual ventilator. The machine itself is a small part of the equation.

I think the focus on ventilators is somewhat misleading. If you need mechanical ventilation, you're a goner anyway, and your bed and healthcare staff could be better used on someone else. The 'lack' of a machine is just a very visible component.

AntonStratiev··on Covid-19’s stop-gap solution until vaccines and antivirals are ready
https://twitter.com/NAChristakis/status/1240689935557865472

Details a study on a different Coronavirus in 1990. There is definitely some immunity, but its complicated.

AntonStratiev··on Venezuela to Close Pumps as Gas Runs Short, Viral Outbreak Grows
We can take the age profile of Venezuela[1] and the estimated hospital rates and general virus profile from the Imperial College report[2].

Assume 80% infection, and assuming that 100% of people who would have needed hospitalization die.

This is 720,000 people, or 2.5% of the population. However, if we just take the working-age population (65 and lower), and assume 50% survival rate instead of 0%, the deaths are just 0.79% of the total population.

So decimation is absolutely inaccurate and the higher-up poster is correct. Developing countries like Venezuela cannot afford to and should not shutdown their economies or societies.

[1] https://www.populationpyramid.net/venezuela-bolivarian-repub...

[2] https://www.imperial.ac.uk/media/imperial-college/medicine/s...

AntonStratiev··on Risky hack could double access to ventilators
Based on data from China, 97% of the people who need ventilators will die anyway:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

The Ventilator just keeps them alive for a few days, but there are other bodily systems failing and causing death.

AntonStratiev··on Risky hack could double access to ventilators
The people who are going to die are already in very poor health. The median age of deaths in Italy is 80 from yesterday's data. [1]

Previously it has been communicated that 99% of deaths are to people with existing health problems.

https://www.reuters.com/article/us-health-coronavirus-italy-...

There are two people in my life I expect to die of the virus: my sister who is in her late 20s, with a lifetime history of Anorexia/Bulimia, who is currently in stage 5 kidney failure. Secondly my Aunt, a lifetime smoker, who currently has terminal lung cancer.

Both of these people, speaking personally, are going to die sometime this year. Will their deaths be accounted against the Coronavirus death toll or to their underlying conditions?

Is there any point to shutting down everything for 18+ months so that they can live another few months, doing so under lockdown conditions and general panic, with nobody able to visit them? And at the end of it all, many of the people who care for them will be unemployed.

AntonStratiev··on Risky hack could double access to ventilators
We should be building palliative care centres across the country, not pop-up hospitals.

Pay everyone who contracts Coronavirus in the next 4 months and is refused ICU care, $100,000. If they die, the amount is divided between their surviving immediate family members or previously registered carer.

The current panic seems to be driven by the guilt of not being able to treat everyone. This payment should alleviate that guilt and allow us to continue with life.

AntonStratiev··on Effect of economic crisis on America’s small businesses [slides]
There is no need to imagine, we have the forecasts from the Imperial College report:

https://www.imperial.ac.uk/media/imperial-college/medicine/s...

There are 40 million 40-somethings in the USA, you're proposing that 100% of them will have lung damage.

Let's imagine that 80% of the population is infected, that 80% of cases are symptomatic, and that 80% of the 4.90% of hospitalised cases (this 4.90 is direct from the report) get damaged lungs. This is one million 40-somethings, not the entire population.

1 million sounds like a lot, but its only 2.5% of the population at that age range, and assume worst-case.

You know what causes reduced lung functionality in adults? Asthma, driven by air pollution from vehicles and coal power plants. 7.7% of adults have Asthma. Where is the war-scale drive to eliminate fossil-fueled vehicles and power generation?

AntonStratiev··on How to explain the events of 2019/2020 to the next generation – a handy guide
I meant to say 'fatal cases' and have corrected the text. Thanks for pointing it out.
AntonStratiev··on How to explain the events of 2019/2020 to the next generation – a handy guide
Its simpler than that, if we're brutally honest and scientific: the developed world had accumulated, through extensive use of modern medicine and redistributive welfare schemes, a large population of people who were kept alive solely by modern medicine and the support (forced or otherwise) of their fellow citizens.

With the appearance of a new type of virus, mostly harmless to the majority of the population, but lethal to those at the medical fringes (eg. 99% of fatal cases in Italy have existing health problems, average age 79), we overreacted and in the process destroyed our economy and society, unwilling to face our own mortality.

AntonStratiev··on Effect of economic crisis on America’s small businesses [slides]
Focusing on positive or negative is the wrong focus, we need to test for immunity. Those who are immune can contract the virus again in a year, but will do so without symptoms, according to older studies for similar viruses.

And most importantly, those with immunity can go on to lead a normal life and participate in the economy.

https://twitter.com/NAChristakis/status/1240689935557865472

AntonStratiev··on UK government to pay up to 80% of wages for employees not working
Vaccine estimate is 18 months according to the Imperial College:

https://www.imperial.ac.uk/media/imperial-college/medicine/s...

Vaccines in human trials in the US now need to go through a 14 month observation period to understand effectiveness and side effects.

Influenza vaccines, if they are any guide, are only 50-70% effective and need to be renewed annually.

Ask people if they are willing to sacrifice 18 months of their life so that someone with an average age of 79 and existing health complications can live another couple of years and you will start to deal with the problem honestly.

By my calculations for every 1 year of saved life (average age 79) we are paying for it with 10 years of lockdown life (average age 35-40).

AntonStratiev··on UK government to pay up to 80% of wages for employees not working
500,000 people with an average age of 79, the vast majority of whom are in poor health with existing conditions. This is what the data from Italy shows.

Coronavirus is just the last nail in the coffin - it brings forward the deaths that would have occurred over the next 1-2 years into the present. The panic is irrational.

AntonStratiev··on UK government to pay up to 80% of wages for employees not working
What does a pound or a dollar even represent anymore? They are being printed and given out with little consideration to the impact.

I think we are going to see hyperinflation at some point, particularly if this is dragged on for the 18 months necessary for a vaccine.

Why would I go in to work and stack shelves when the Government will just give me money to sit at home? Why would I even go into the hospital to operate a Ventilator?

The point is that the UK (and many other countries) are essentially 100% oriented around COVID-19, to the extent that the entire resources of the country and its people are dedicated or impacted by it.

Lets reiterate the death rates, from Imperial College's own report:

0-9: 1 in 50,000

10-19: 1 in 16,667

20-29: 1 in 3,333

30-39: 1 in 1,250

40-49: 1 in 667

50-59: 1 in 167

60-69: 1 in 45

70-79: 1 in 20

80+: 1 in 11

The above is slightly less than the risk of death from any cause.

AntonStratiev··on UK government to pay up to 80% of wages for employees not working
Has anyone calculated the value of life that we are saving here?

The Imperial College report had 510,000 dying in the UK under a no-action scenario. Average age lets say 79 as the virus progresses.

510,000 * (82.5-79) * GBP 30,000 (QALY for the NHS) = 53.5 billion pounds based on the funding methodology used for the NHS.

Instead the Uk seems to be willing to throw its entire GDP at this problem, 3 trillion pounds. This seems... completely unjustified.

How can we justify this sort of effort for Coronavirus, but not Climate Change, Obesity, Air Pollution, which will kill many more than COVID-19? Is it just because Coronavirus does it spectacularly in 3 months and all of those other things take decades?

AntonStratiev··on New York Gov. Cuomo Orders All Nonessential Workers in State to Stay Home
Our national priority needs to be on testing for people who have developed an immunity:

https://twitter.com/NAChristakis/status/1240689935557865472

Who can then go on and socialise and operate the economy as usual.

We need to take advantage of the fact that this virus is so mild for the vast majority of the working-age population.

Combine that with isolation of the elderly, and we could reopen the schools, at least for the youngest children, so that more people can go to work.

Alternative (and yes this is a bit tongue-in-cheek) transfer the entire elderly population of the USA to Florida, and completely isolate the state. Flood it with ventilators and healthcare professionals. Let the rest of the country operate as usual and treat the unlucky few who need hospitalisation.

We need some big, bold, active national measures instead of just taking the easy road of printing money for banks and forcing all businesses into closure and all workers into home unemployment.

AntonStratiev··on New research shows social distancing a must to beat Covid-19
Introducing social distancing for the entire population comes at huge economic and social cost.

It is more effective to follow these three simple measures:

1. Symptomatic cases stay at home for 7 days

2. All household members of symptomatic cases stay at home for 14 days

3. Social distancing for the over 70 population only

https://www.imperial.ac.uk/media/imperial-college/medicine/s...

Social distancing of the entire population also slows the acquisition of immunity with zero and low risk age groups, which drags the whole situation out months longer.

It might even be logical with the above 3 steps in place for zero/low risk group to deliberately seek out the virus. This grants immunity quicker, and if they become sick, they can receive treatment whilst hospitals are still underwhelmed.

Speaking personally I would happily accept a strain of the virus considered to be low risk, then go into 14 day quarantine, if it meant I could afterwards work and socialise without any lockdown or restriction.

AntonStratiev··on U.S. suspending visa services worldwide due to coronavirus
There is no indication that 5% of the population will die.

The Imperial College report finds that in a complete do-nothing scenario, 4 million Americans will die, which is only 1.2% of the population.

With some mitigation (isolation of the elderly, isolation of suspect cases and their families) that number is reduced to 2 million, only 0.6% of the total population. This is the approach we need to be pursuing, and it means reopening all schools and businesses right now, and directing and supporting the elderly to self-isolate. Massively ramping up our healthcare infrastructure and preparing for massive triage is also a good idea.

The alternative of complete suppression requires total shutdown for an estimated period of 18 months, until a vaccine is available. However, its worth nothing that vaccines for influenza (for reference) are only partially (50-70%) effective, and need to be renewed annually. So its likely that even in this total shutdown scenario, we are still looking at 1 million deaths - with immense and unprecedented economic and social impacts.

Keep in mind, that 2.8 million Americans die annually from all causes - 0.8%. Coronavirus might mean for example that a critically ill patient dies from cancer a week earlier than otherwise.

AntonStratiev··on U.S. suspending visa services worldwide due to coronavirus
That would only be the case for 3 months, after which those who were most vulnerable to the virus would have perished.

2.8m Americans die annually, basically we are just seeing 1-2 years of deaths brought forward into a 3 month window. It will be harrowing to triage those patients but it can be managed.

I would prefer that situation to living through a great depression. Healthcare is irrelevant without a job or any income whatsoever, with huge sections of the economy closed and extensive restrictions on what individuals can and can't do.

I have parents in their late 60s who are looking at their entire retirement portfolio evaporating.

I have a terminally ill sister and aunt who are faced with spending their final weeks/months in lockdown, with people unable to visit them or attend their funerals. They are struggling to access regular supplies due to hoarding.

AntonStratiev··on U.S. suspending visa services worldwide due to coronavirus
No but I am in the tens of millions of Americans who will lose their job and go bankrupt if things continue this way. I could sell my possessions and move back with my elderly parents (ironically exposing them even more to the virus). Suicide is another option if the situation does not improve.

At least during a regular economic downturn, you can go to a bar, drink out your sorrows, join a construction crew. Now, during Coronavirus panic, which of these options even remain? It is completely unprecedented to have everything shut.

Those who will perish already have existing health conditions, and would have died at some point anyway:

https://www.bloomberg.com/news/articles/2020-03-18/99-of-tho...

AntonStratiev··on U.S. suspending visa services worldwide due to coronavirus
The Imperial College report:

https://www.imperial.ac.uk/media/imperial-college/medicine/s...

Full suppression will require total shutdown for ~18 months.

Mitigation, specifically requiring the sick and elderly to self-isolate and quarantinging COIVD-19 cases and their families, will result in 2-4 million dead (depending on its effectiveness), with the situation over in 3 months.

AntonStratiev··on U.S. suspending visa services worldwide due to coronavirus
We need to just accept 2-4 million sick and elderly Americans dying. That outcome cannot be any worse than complete economic and social destruction that we seem to be pursuing in the name of virus suppression.

Edit: I am specifically referring to the Imperial College report which outlines this scenario. Here is the original report: https://www.imperial.ac.uk/media/imperial-college/medicine/s...

And here is a summary: https://twitter.com/jeremycyoung/status/1239975682643357696