
San Francisco emerged from a lockdown too soon during the 1918 Spanish flu - vinnyglennon
https://www.businessinsider.com/what-san-francisco-can-learn-spanish-flu-pandemic-coronavirus-1918
======
goalieca
The spanish flu killed working age people. The case fatality rate for Italian
health care workers (frequently tested so should be a good proxy for IFR) is
sitting around 0,35%. When you adjust for age (those under 60) you end up with
<0.1%. When you look at data based on cfr, serology, etc it all paints a
picture of stratified risks based on age. The best gift my age group can give
is build herd immunity.

Given most deaths in Canada are in long term care homes (up to 80% in Quebec),
this gives us a clear target to improve.

~~~
coolvision
It's strange that engineers are giving in to this biased and non-rational
mental model, treating this situation as linear and robust.

It is non-linear and non-robust system. The main problem is that mortality
rate even among young people would become much higher as soon as hospitals
become overwhelmed.

So you can not make any predictive conclusions based on current stats. Please
look at any of the numerous models available online which account for all
factors, and you will see how badly herd immunity idea would end for all age
groups.

~~~
grawprog
>is that mortality rate even among young people would become much higher as
soon as hospitals become overwhelmed.

I don't see how this follows. The point the parent was making is that young
people don't seem to need hospital care. Why would they suddenly start dying
just because 'hospitals are overwhelmed'? They still won't need them...

~~~
DanBC
> The point the parent was making is that young people don't seem to need
> hospital care.

Low risk doesn't mean no risk, and we see plenty of younger people in
hospital, and in intensive care, because of covid-19.

ICNARC has a report that they update over time using data from UK intensive
care units. [https://www.icnarc.org/Our-
Audit/Audits/Cmp/Reports](https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports)

[https://www.icnarc.org/DataServices/Attachments/Download/c5a...](https://www.icnarc.org/DataServices/Attachments/Download/c5a62b13-6486-ea11-9125-00505601089b)

Age at admission (years), number of people discharged alive (%), number of
people died (%)

    
    
      16-39     240 (78.4)     66 (21.6)
      40-49     350 (73.2)    128 (26.8)
      50-59     568 (57.0)    429 (43.0)
      60-69     503 (41.8)    701 (58.2)
      70-79     293 (32.2)    617 (67.8)
         80+     57 (31.3)    125 (68.7)
    
    

Once admitted to ICU people aged 16-39 have a 21.6% chance of dying vs a 78.4%
chance of being discharged alive.

~~~
techslave
bad use of statistics. if gp is to be believed, once in ICU you are _already_
in the 0.x %. the question then is, are you in the 0.1 or 99.9.

------
coldcode
50M people died worldwide from "Spanish" Flu, in a world much different than
today, yet within a couple years the world had mostly recovered. So far we are
still a long way from that number. The problem is you won't know if you are to
be in the dead or gravely ill category, or the mild or perfectly fine
category, irrespective of age, until it happens.

What we could have had today is the ability to identify, isolate, and thus
properly quarantine those who are ill or spreading, but we did not as a
society deem it valuable to invest in (outside of places like S Korea). It's a
classic pay me now or pay me later situation; now we are reaping the lack of
investment in the past (even before the current ineptitude).

I always thought the lack of a comprehensive nation healthcare system or at
least a plan that covered everyone in some way in the US would bite us if
there ever was a pandemic. We as a society decided that long term planning was
not economically viable or even desirable. But we did not even do a minimum.
Now we have to hope for the best.

As a nation having everyone (not just some people) healthy and when not have
access to affordable healthcare is a benefit to the nation as a whole and the
economy, something that the new German nation back in the late 1800's figured
out. How we get there in the US in the future I don't know, I just hope we
come to the same realization and do something.

~~~
ranDOMscripts
Very few people want to spend $40 on a fire extinguisher every few years until
the moment when their kitchen is actually on fire.*

*That is, unless, history repeats itself and we lose ~1-2% of the world population[0] this Fall. That might provide sufficient motivation. [0][https://en.wikipedia.org/wiki/Spanish_flu](https://en.wikipedia.org/wiki/Spanish_flu)

~~~
pravda
>spend $40 on a fire extinguisher every few years

Gosh, I hope they last longer then that!

I have a (genuine) Halon fire extinguisher hanging on the wall. According to
the internets, Halon was banned in 1994!

The pressure dial on it is still in the green.

~~~
ranDOMscripts
"Stored pressure ABC extinguishers are very common, and they often require
internal maintenance every 6 years and hydrostatic testing every 12 years.
Other types of extinguishers may vary in their internal examination and
testing intervals." -[https://www.cintas.com/fire-protection-services/fire-
extingu...](https://www.cintas.com/fire-protection-services/fire-
extinguishers.aspx)

------
Ididntdothis
I am starting to wonder if there is any good way for dealing with this. If you
lock down preventatively, you are at risk of hurting the economy, losing a ton
of jobs and looking silly if things turn out to be not as bad. If you wait,
you are at risk of killing people. It seems only in hindsight there is a clear
path that balances all factors. I definitely wouldn’t want to have to make
decisions right now. You can pretty much only fail in one way or the other.

I think what we should learn is that we need to put much more effort into
vaccines even if they are not profitable immediately but the cost of a
pandemic is just so high that it’s worth being on top of things.

In a way we are lucky that this didn’t happen some decades earlier when remote
work was much less of an option. When I look at my company there are
definitely problems from not being able to access equipment at the office that
keep accumulating but overall things are moving along pretty well. Without a
100 megabit connection I would not be able to do much.

~~~
GekkePrutser
It's a lot more than just 'looking silly'. The lockdown kills many jobs
leading to people losing hope and triggering a recession worse than 2007's.
That will have its death toll too.

~~~
throwaway-2020
Does anyone have figures for the increase in deaths during the last great
recession?

I'm tired of the cure cannot be worse than the disease rhetoric. Economies
will recover. The dead won't.

~~~
GekkePrutser
But this situation will also lead to deaths. I already hear the mental
hospitals are overflowing.

And really, if we would do everything possible to prevent deaths, we would
have tackled traffic, alcohol, poverty, pollution etc. In some countries even
poor healthcare overall (Trump is still fighting 'Obamacare').

It's not as black and white as this; the virus isn't the only problem in our
society.

~~~
jamesmontalvo3
Approximately 36k deaths per year in the US are from traffic [1]. About 88k
from alcohol [2]. Poverty and pollution is harder to pin down with a quick web
search. According to [3], deaths-per-day from COVID-19 flattened at about 2000
deaths about three weeks ago. So in that time ~40k deaths from COVID. That’s
with the curve flattened...with the curve flattened it was approximately equal
to traffic deaths. If exponential growth had continued what would it be? I
think deaths-per-day would doubled about 4 times. So 32k per day. Each day
we’d be in the ballpark of traffic deaths. Wait a few days and it would have
eclipsed alcohol-related deaths.

[1]
[https://en.m.wikipedia.org/wiki/Motor_vehicle_fatality_rate_...](https://en.m.wikipedia.org/wiki/Motor_vehicle_fatality_rate_in_U.S._by_year)

[2] [https://www.niaaa.nih.gov/publications/brochures-and-fact-
sh...](https://www.niaaa.nih.gov/publications/brochures-and-fact-
sheets/alcohol-facts-and-statistics)

[3]
[https://coronavirus.1point3acres.com/en](https://coronavirus.1point3acres.com/en)

