
SARS-CoV-2-specific immunity in Covid-19 and SARS cases, and uninfected controls - guscost
https://www.nature.com/articles/s41586-020-2550-z
======
jhayward
Derek Lowe's latest commentary on SARS-COV-2 immunity and this paper
specifically:

[https://blogs.sciencemag.org/pipeline/archives/2020/07/15/ne...](https://blogs.sciencemag.org/pipeline/archives/2020/07/15/new-
data-on-t-cells-and-the-coronavirus)

------
notatoad
I know that as somebody who isn't a scientist, i'm not the intended audience
for pre-print articles in scientific journals.

would anybody mind providing a summary of conclusions for the general audience
here?

~~~
guscost
Derek Lowe's blog (linked by jhayward, thanks) has a good rundown of the
recent T Cell research and what it means in general:
[https://blogs.sciencemag.org/pipeline/archives/2020/07/15/ne...](https://blogs.sciencemag.org/pipeline/archives/2020/07/15/new-
data-on-t-cells-and-the-coronavirus)

But, he (and the paper authors!) seem to skim right over what might be the
most important conclusion:

> Recognition of the nsp7 and nsp13 proteins is prominent, _~as well as the N
> protein~_. And when they looked at that nsp7 response, it turns out that the
> T cells are recognizing particular protein regions that have low homology to
> those found in the “common cold” coronaviruses – but do have very high
> homology to various animal coronaviruses.

This "NP" or "nucleocapsid protein" has high homology to "common cold" _human_
betacoronaviruses (OC43 and HKU1), so this basically means that previous
exposure to these colds should confer some degree of immunity to SARS-CoV-2.
The novel result that everyone seems to be dwelling on is interesting too, it
raises the possibility that coronaviruses are transmitted from animals to
humans more often than had been previously thought.

------
solinent
I remember at the start of this an infectious diseases professor commented how
if you had the antibodies already against CoV you'd be fine, but if you had
only _half_ , you were at a _significantly_ higher risk of death.

I guess the immune system can misidentify as well--I bet we haven't
taxonomized everything fully yet so eventually we'll have a new name for what
immunity is required.

~~~
EGreg
Sorry can you rephrase?

What do you mean by half?

~~~
solinent
I have no clue! I just heard this a while back on some random video three
months ago from an infectious diseases professor. My knowledge of biology is
very low, I really shouldn't be speculating publically, I thought it was less
controversial knowledge. I've probably just phrased it badly or remembered it
in too simple of a manner due to my lack of background here.

I think half is a simplification, it must mean that if you have the wrong type
or quantity or some combination thereof, but again I'm guessing and not an
expert or even a professional.

~~~
__blockcipher__
The closest thing I can think of is [https://en.wikipedia.org/wiki/Antibody-
dependent_enhancement...](https://en.wikipedia.org/wiki/Antibody-
dependent_enhancement#Potential_linkage_between_pathophysiology_of_COVID-19_and_ADE).

There's no way in which having real antibodies, but a reduced amount of them,
would be worse than not having antibodies, but the following is very possible:

> It is likely that in older people the production of antibodies is slower and
> by the time the antibodies are developed in the titer that is sufficient to
> neutralize the virus, the virus changes its antigenic determinants. In this
> case, immuno-dominant neutralizing antibodies might start forming unstable
> complexes with the new form of the virus and start to infect
> monocytes/macrophages causing ADE. This process can trigger generalized
> infection of immune cells in multiple organs and cytokine storm

~~~
solinent
It's possibly by type and not mass, ie, one of each type of antibody versus
various strains of COVID. I think that would make the most sense to me given
the conclusion--if you don't have the right antibodies but have some you may
be more susceptible to some strains and less susceptible to other strains. I
will see if I get the time to find the original source.

~~~
__blockcipher__
Yeah that still doesn't make sense haha. It's not really a different strains
thing. But if you read about ADE you'll see that, I don't understand it
perfectly but more or less you have a partial match which seems to make the
immune system turn on itself. (I butchered that but it's been a long day...)

~~~
solinent
Well it could be based on ADE--certain strains of coronavirus antibodies will
help other strains replicate. In any case, I do remember quite clearly "half"
but it was towards a very lay audience.

------
gridlockd
Unfortunately, it doesn't go into detail where exactly these samples come
from.

It's seems plausible that animal coronaviruses induce an immune response in
humans that can later help against SARS-CoV-2. If so, there should be a
correlation between animal contact and COVID-19 severity.

~~~
__blockcipher__
No need to bring in animals to explain this. There are a handful of human
coronaviruses - I think 4 that are not SARS-related, but I’m on mobile so will
have to dig up the study later.

Besides, once a virus jumps from an animal it either becomes a human virus
(capable of spreading), or somehow is a one-off virus that can jump from
animal->human but not subsequently to another human. If the latter, that
effect is so negligible it would not explain 20-50% of SARS-CoV-2-naive
individuals having t cell reactivity.

—-

While I’m at it, just a reminder to all that SARS-2 _overall_ is a fairly mild
virus, and the level of hysteria and death-inducing counterproductive response
(lockdown, suspension of elective surgeries like Newsom did for a month here
in California) is completely divorced from the fundamentals of this virus.

Also a reminder that unlike flu, SARS-2 primarily kills the very old / very
unhealthy, whereas flu kills the very young and the very old. Thus when you
run the math on population dynamics / herd immunity, the recurring yearly
deaths will be vanishingly low (unlike flu) and thus amortized across years,
SARS-2 is even leas deadly than the current numbers imply.

This is because once it has passed through the population, the set of SARS-
CoV-2 naive individuals becomes dominated by new entrants to the world
(babies/toddlers) who essentially have 0 risk of dying from COVID (it’s
basically a rounding error). Thus while SARS-CoV-2 is and will remain endemic
(circulating in the population), it will barely kill anyone once the current
world population is largely exposed to it.

—

Finally, a reminder that mentioning stuff like the above tends to result in
censorship from social media platforms, which combined with the incredible
bias of “news” organizations like CNN etc, means that those who are plugged
into the matrix will never encounter real information about this threat. And
surprisingly (although in retrospect it shouldn’t have been surprising to me),
there are a lot of people on HN that have dranken that very kool-aid and thus
will reactively downvote or even flag commenters who present their beliefs
(however founded or unfounded) about the true danger of this virus versus its
purported impact.

Also, since I’m already ranting, I just want to throw out that the narrative
around “long-term damage” (often stated to be lifelong) is completely
unfounded and contradicted by the research we already have about SARS-1, which
is SARS-2’s much more deadly yet much less popular older brother.

~~~
tln
Regarding the "long-term damage"... here's a post that goes into that aspect.
There are sources. Saying it's unfounded shows who is pushing a "narrative".

[https://www.quora.com/How-can-a-disease-with-1-mortality-
shu...](https://www.quora.com/How-can-a-disease-with-1-mortality-shut-down-
the-United-States/answer/Franklin-Veaux)

These numbers and the permanence of the effects may be off, but hardly
unfounded.

The issue I have with pushing the idea that it's a mild virus, despite loads
of evidence it's far more dangerous than the seasonal flu, is that it results
in less societal countermeasures.. prolonging this for all of us, and
endangering those at-risk or with at-risk family members.

Keep in mind that going to the hospital can be financially ruinous.

Please wear a mask, don't throw parties, and consider your fellow members of
society.

PS. quoting sources is a good way to share real information, outside of "the
matrix".

~~~
__blockcipher__
I am happy to provide sources; as I explained elsewhere, I've had a crazily
high number of encounters where I provide a bunch of sources and then get
flagged or downvoted etc, which is very demoralizing so I've gotten into the
habit of waiting until people bite to pull out sources.

Let me start by out-lining my beliefs about long-term damage or the other
classic complications of blood clotting, stroke, or pediatric multi-
inflammatory syndrome:

(1) Any time the body enters a state of pathological cytokine release
syndrome, basically any runaway inflammatory cascade, a lot of really bad shit
happens. Blood clotting, strokes, etc. What's important to understand is that
(a) this is not at all unique to COVID, we see it with flu and any of the
other dozen classes of virus that can make you sick, and (b) statistically,
they happen in incredibly small numbers.

(2) Medium-term damage in the sense of your lungs taking a month or rarely,
even longer, to recover absolutely can happen, we see it with SARS-1. But at
the 1 year mark, for example, people's lungs look totally normal. I tend to
use SARS-1 infections as a model for what _severe_ COVID-19 (caused by SARS-2
just as a reminder) looks like. So I think SARS-1 gives us a great upper
bound.

There is a narrative specifically that people who don't have bad symptoms will
have hidden long term damage, that's just complete bullshit and there isn't
much for me to debunk. As far as the real severe COVID-19 cases that do have
some type of complication, again they might have damage for a few months,
certainly not beyond the 1 year mark.

Let's talk about strokes. The "strokes in young people narrative" (which I
can't resist mentioning was heavily pushed by CNN, who as you can tell I have
an incredible disgust for, because until this year I truly didn't realize how
far they had fallen) AFAICT stems entirely from this series of case studies:

["Large-Vessel Stroke as a Presenting Feature of Covid-19 in the
Young"]([https://www.nejm.org/doi/full/10.1056/NEJMc2009787](https://www.nejm.org/doi/full/10.1056/NEJMc2009787))
- April 28, 2020

Normally with scientific stuff, what happens is that news orgs take the study,
misrepresent/oversimplify the conclusions and twist its meaning. Well, that
did happen to an extent here, but actually the actual title of the article
ends with "in the Young". Now, maybe there's some medical definition of young
that I am not aware of, but this study does not look at young people, it looks
at _non-elderly_ people. So, in my opinion, there are a lot of scientists that
are basically editorializating their own work. In other words, there is a
large faction of people so incredibly concerned about COVID-19 that their bias
is seeping into their scientific work. Anyway, I actually love this paper,
because of the buried lede about lockdown/hysteria actually making things
worse, which the authors seemingly tried to not draw attention to.

* "Social distancing, isolation, and reluctance to present to the hospital may contribute to poor outcomes. Two patients in our series delayed calling an ambulance because they were concerned about going to a hospital during the pandemic."

* (for those concerned about stroke in the young, note the occurrence is rare in those without comorbidities. And "young" here means "not old" [youngest was 33, oldest was 49, 3/5 had serious risk factors])

My commentary: So, the first irony is that people who _actually had COVID-19_
, and had it severely enough that they _literally ended up developing strokes_
, were afraid to seek medical attention for quite some time, _because they
didn 't want to catch COVID-19_. My interpretation is that the media hysteria,
etc has/had hit such a point, that even though they were probably feeling sick
and like total garbage, they thought to themselves "well, this is bad, but not
as bad as COVID-19 is from what I've heard". (Yes, this is me reading WAY
between the lines so feel free to disagree, but I just had to point out the
delicious irony).

The second irony is that, as they say, social distancing and isolation may
have contributed to poor outcomes. Personally I believe this is self-evident,
but take it as you will.

Finally, the title says "young" but the youngest was 33 and oldest was 49. I
would think young would at the most mean people in their 20's.

\--

Before I go back to long-term damage, since the prior study touched (however
briefly) upon possible externalities of lockdown, I also wanted to point out
the obvious impact on mental health:

["Patients with mental health disorders in the COVID-19
epidemic"]([https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...](https://www.thelancet.com/journals/lanpsy/article/PIIS2215-03662030090-0/fulltext))
- Published April 01 2020:

* "Third, the COVID-19 epidemic has caused a parallel epidemic of fear, anxiety, and depression. People with mental health conditions could be more substantially influenced by the emotional responses brought on by the COVID-19 epidemic, resulting in relapses or worsening of an already existing mental health condition because of high susceptibility to stress compared with the general population."

* "Finally, many people with mental health disorders attend regular outpatient visits for evaluations and prescriptions. However, nationwide regulations on travel and quarantine have resulted in these regular visits becoming more difficult and impractical to attend."

I'll let those bullets speak for itself.

\--

> despite loads of evidence it's far more dangerous than the seasonal flu

Can you give me some ballpark numbers here? My estimates are that the IFR is
maybe 3x the flu, although I think it would be lower if we weren't cooking the
books as far as deaths go (note: my argument does not hinge upon the
assumption that deaths are overstated/misclassified, indeed I believe if
deaths were 5x as high relatively speaking as they currently are, that
lockdown/etc would still be horribly counterproductive)

As I stated in my parent comment, though, once you amortize across multiple
years, even with a 3x IFR of the flu, COVID-19 will kill _far_ less than any
individual strain of Influenza.

Also, briefly:

> [https://www.quora.com/How-can-a-disease-with-1-mortality-
> shu...](https://www.quora.com/How-can-a-disease-with-1-mortality-shu..).

The question says 1% mortality, "mortality" is vague but note that the IFR is
much likelier to be .3%. And the IFR actually makes it sound worse because we
have evidence now that many people basically can't get infected or are highly
resistant to it without ever having been exposed (see the submission we're
discussing).

> is that it results in less societal countermeasures.. prolonging this for
> all of us, and endangering those at-risk or with at-risk family members.

Actually, the societal countermeasures you are referring to, insofar as they
actually work, _are_ the source of this thing being prolonged. The way to not
prolong it is not to artificially interfere with the spread of SARS-2 in the
general population, which is the position I advocate for full-stop. (I used to
be a bit more like "okay well maybe banning large gatherings makes sense", but
the more evidence stacks up the more I'm convinced that we should not accept
_any_ mandatory countermeasures, period)

> Keep in mind that going to the hospital can be financially ruinous.

Of course it can be. I also urge you to keep in mind that the vast majority of
people will never go to a hospital for COVID-19. And indeed that many
hospitals around the country have been nearly empty due to a combination of
fear of going to the hospital (which has been huge) and suspension of elective
surgeries, leading to an unprecedented scale _down_ of our medical capacity
via furloughs.

\---

Back to the quora link - sorry for jumping around like a maniac here BTW - it
just links to a lot of scientific-sounding news articles. It doesn't actually
link to real papers, and the reason for that is because when you look at the
actual statistics we have, it becomes pretty apparent that these are just what
happens with "cytokine storm" (a better term for this is "pathological
cytokine release syndrome" and thus I use that term), etc. It happens very
rarely, but it does happen. There's nothing super unique about it with
COVID-19, as far as I can tell thus far.

I owe you a few studies about these effects occurring in Influenza and other
illnesses as well, I know I have them buried in my clipboard history or a
stray sublime tab, so I'll try to circle back here in a bit with those. But
hopefully I gave you enough to chew on / fight back on for now.

~~~
tln
> I owe you a few studies

As do I. It's been a day at work, I'll see if I can dig into this soon.

In the meantime, thanks for the thoughtful response.

------
__blockcipher__
First of all, here's the full text in-case anyone isn't aware:

[https://www.nature.com/articles/s41586-020-2550-z_reference....](https://www.nature.com/articles/s41586-020-2550-z_reference.pdf)

Before the actual paper, some review.

REVIEW SECTION 1

Coronavirus is a family of viruses, viruses being basically pieces of genetic
material that swim around, inject their DNA into other cells, which makes the
cells produce more copies of themselves until thousands of baby viruses
explode out of the cell, killing it and moving on to the next cell.

COVID-19 is the condition that results from infection with SARS-CoV-2, which
is a novel coronavirus that almost certainly emerged sometime in 2019. Think
HIV/AIDS: HIV is the virus, AIDS is the disease, same with SARS-2 vs COVID-19.

SARS-CoV-2 while technically novel, is incredibly close related to what we now
call SARS-CoV-1, which we used to just call "SARS". SARS-1 was incredibly
deadly, but the pandemic fizzled out, presumably because it is quite
deadly/quite symptomatic and AFAIK there isn't pre-symptomatic transmission.

SARS-CoV-2 structurally is very similar, sharing the same characteristic spike
protein, and targetting the same ACE2 receptor which is expressed
differentially in different tissue types. But SARS-CoV-2 is like a refined
version of SARS-1, it "learned" from SARS-1's mistakes. So, it appears to be
adapted to spread quite well, possibly because of cool things it does with
interferon-mediated early course immunosuppression, which lets it spread for a
few days before you show symptoms. It's also _much_ less deadly than SARS-1.

Now, to craft the "optimal" pandemic virus, you want something that spreads
easily, has a long incubation time, and isn't too deadly (otherwise it fizzles
out by killing its hosts before they spread sufficiently). So in that sense,
SARS-2 is perfectly crafted to kill a bunch of people. But please don't fall
into fear-mongering, it doesn't kill nearly as many people as most have been
led to believe. In my opinion it's really quite a mild virus _overall_ , but
some people can have severe COVID-19 which presents very similarly to a more
run-of-the-mill SARS-1 infection (remember the original SARS is very deadly,
so run-of-the-mill != no-big-deal).

REVIEW SECTION 2

We've talked about SARS-1 and SARS-2, but let me briefly butcher the immune
system (I can already hear the immunologists stampeding towards me in the
distance).

Your immune system's job is to distinguish self from non-self, (or more
accurately, "non-self that is actually a threat" since you can have
bacteria/etc that are not pathogenic/pathological). When it identifies a
target, it has a lot of cool ways to kill it, but the specifics of neutrophils
and antibodies, etc are out of scope.

For now, take it as given that your immune system can detect and kill
pathogens.

Once it has fought off an infection, you will likely have antibodies, which
are little heat-seeker-missiles that are primed to detect and neutralize the
pathogen in question. (Note there's also T-Cell immunity which operates
perhaps orthogonally to antibody immunity. This paper talks about T-Cell
immunity).

Assuming you produced antibodies, eventually your active circulating
antibodies will fade. This takes several weeks-a few months for SARS-1, and
seems to hold for SARS-2, although I believe antibody prevalence is correlated
with disease severity.

So eventually you have no more circulating antibodies. Contrary to what
doomers will tell you, that's not a bad thing, it's inefficient to perpetually
maintain antibodies. So instead your body maintains a living library of the
pathogens it has previously encountered.

I'd encourage anyone to read about
[https://en.wikipedia.org/wiki/Immunological_memory](https://en.wikipedia.org/wiki/Immunological_memory).
I'll summarize briefly.

(1) After infection, even when antibodies fade, you still have circulating
Memory B Cells which persist across _decades_ , waiting for exposure to the
previously-fought-off pathogen at which they ramp up antibody production,
leading to a faster, more strong response that results in lower peak viral
load, presumably lower transmissibility/symptoms/etc. So, eventually it's
possible to get reinfected as far as antibody immunity is concerned, but it
takes quite awhile and when it does happen it's not nearly as bad.

(2) There's also memory T Cells, which are similar except instead of relying
on antibodies, they work with T cells, with basically directly kill pathogens
rather than indirectly produce the antibodies with neutralize the pathogen.

Okay, now it's time for

THE ACTUAL PAPER

The first finding is not surprising at all to anyone who has been reading
research, but probably surprising to everyone else (read: almost everybody):
if you've been previously exposed to SARS-1, you have memory T cells which
persist long-term and will happily attack SARS-2.

Remember when I said SARS-CoV-2 was a novel virus? Well, it was, but it was
also incredibly similar to SARS-CoV-1. So, technically it's novel but in real
terms it's only a little bit novel, so previous SARS-1 infection is
protective.

Well, that's cool, but most of us have never been exposed to SARS-1. But many
of us have been exposed to one of the handful of other _human coronaviruses_
that we know about.

The somewhat shocking (maybe not shocking to those who have been reading about
immunology for years) revelation in this paper is this:

> Surprisingly, we also frequently detected SARS-CoV-2 specific T cells in
> individuals with no history of SARS, COVID-19 or contact with SARS/COVID-19
> patients (n=37).

In other words, people never exposed to either of the two SARS viruses showed
immune activation against SARS-2, meaning that they are either completely or
partially immune to SARS-2.

Why? Because they've almost certainly been exposed to some of the other human
coronaviruses, which basically cause common colds. (Side note: For almost
everybody SARS-2 is not any different from the common cold. It's quite rare to
have severe SARS-2, but those that do get it experience very bad effects,
since their immune system is basically ravaging their entire body)

\---

So the TL;DR: any model that has assumed that everyone can get infected is
completely wrong and will massively overestimate the ultimate death of letting
SARS-2 rip through the population.

Many people will never be able to get SARS-2 because they've already fought
off similar-enough human coronaviruses. (BTW, coronaviruses are very
distinctive in structure so that is likely why our immune systems exhibit this
cross-reactivity)

Implications: (Warning: Strong opinion) As a result any cost/benefit tradeoffs
of, say, lockdown, based off those models was off by a huge factor. The good
news is, that even with the assumption that everyone was susceptible (capable
of being infected), it was still really obvious to anyone with the capacity
for rational thinking that containment/lockdown was a terrible idea, so these
findings don't really change too much on that front, it just makes it even
more overwhelmingly obvious that we collectively lost our shit and chopped off
a limb in response to a papercut. So, instead of us (meaning, everywhere
except Sweden) being super duper wrong, we now have good evidence that we were
actually unimaginably, insanely wrong, to a degree that will be studied by
subsequent scientists for decades as an example of where social contagion,
groupthink and censorship led to one of the most damaging events in modern
human history. Woot!

~~~
archagon
The rest of your comments aside, which I don't have evidence to address, "it
was still really obvious to anyone with the capacity for rational thinking
that containment/lockdown was a terrible idea" is just absolutely, patently
untrue (if taken at face value and not just as a snipe). In fact, I'd say that
_most_ people I know with the "capacity for rational thinking" — including
scientists, doctors, and amateur COVID researchers who dig through the
scientific literature every day — would strongly agree with some form of
lockdown.

I am immediately suspicious of "everyone has gone mad except me" arguments,
and I'd posit that "worldwide hysteria" just isn't a thing that happens
without good reason.

~~~
__blockcipher__
> I'd posit that "worldwide hysteria" just isn't a thing that happens.

Well, we have well-understood cases of more localized hysteria, like
[https://en.wikipedia.org/wiki/Tulip_mania](https://en.wikipedia.org/wiki/Tulip_mania).

Worldwide mania is just an extension of that. Since I believe that literally
social media / the internet / other aspects of modern technology have allowed
the propagation of mind-viruses to a degree never seen before, I truly believe
that it is simply a state of mass collective delusion.

> "it was still really obvious to anyone with the capacity for rational
> thinking that containment/lockdown was a terrible idea" is just absolutely,
> patently untrue (if taken at face value and not just as a snipe).

Okay, you are right and I let my frustration be visible there, I agree that it
is not a fair characterization. More accurately, I feel that people who came
down on the pro-lockdown side _have the capacity_ for rational thinking and
yet _were /are not using that capacity_ insofar as COVID-19 is concerned.

> I am immediately suspicious of "everyone has gone mad except me" arguments

You should know that I am too. I spent quite some time trying to figure out
what obvious thing I was missing.

Well, I think enough evidence is in at this point, if you're willing to look
at it. The truth is that otherwise intelligent and knowledgeable people can
very easily fall into states of delusion. It's no secret that as humans we are
endowed with an incredible set of cognitive distortions, that presumably had
adaptive value at one point, but now hamper efforts towards rationality.

If you've ever taken the time to synthesize a body of research into a coherent
whole - not necessarily writing an actual paper etc, but just trying to
iterate and construct a really good mental model - then you know what an
enormous amount of careful thought, effort, and intelligence it requires. It's
simply not easy to do, thus I think that the majority of doctors really just
regurgitate the things they learned in med school, the majority of scientists
do their version of that, the majority of software engineers just make
whatever hacky change they need to get their feature out without thinking
about the whole system (often because the system is crushingly complex, etc).

So when I look at what our "leaders" and public health officials have done, I
see a total failure to take that mentality, a total failure to see what was
really there in front of them. And I don't necessarily blame them; it's well
known that an environment of sleep deprivation and stress cripples the
capacity for cognitive flexibility.

Anyway, to conclude, you are right that my characterization was unfair. I do
stand by the notion that they behaved irrationally, but not because of some
fundamental lack of ability to be rational, but simply because truly being
rational takes an incredible amount of careful attention. (And obviously, none
of us, myself included, are truly rational, but what I mean is, are you near
that asymptote or are you off in the woods somewhere ranting about how it's
too unsafe to open up our schools, etc)

~~~
atomi
You might find this interesting:

> IFR takes into account both symptomatic and asymptomatic cases and may
> therefore be a more directly measurable parameter for disease severity for
> COVID-19.

The latest CDC estimates an IFR of 0.65%

[https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-
scena...](https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-
scenarios.html)

I'll let you do the math on how many are estimated to die without mitigation.

And for a lot of those who don't succumb to COVID-19, here are the extra-
pulmonary effects:

[https://www.nature.com/articles/s41591-020-0968-3/figures/2](https://www.nature.com/articles/s41591-020-0968-3/figures/2)

Spreading the idea that shutting down was unwise is incredibly irresponsible.

~~~
__blockcipher__
> Spreading the idea that shutting down was unwise is incredibly
> irresponsible.

Nonsense. I would argue that spreading the idea that shutting down was a good
thing is and was incredibly irresponsible, but the difference is I don't
believe in suppressing other peoples' ideas. But pro-lockdowners seem to love
it. For the same reason they like the lockdown: it's a mentality that stems
from a love of compulsion and control, and a sharp anxiety about living a full
life.

> I'll let you do the math on how many are estimated to die without
> mitigation.

I don't advocate against mitigation (nursing homes, etc), but I advocate
against containment full-stop.

Anyway, I have done the math. In fact, I've done the math with an IFR of .9%
and assuming 82% of the population got infected (see Ferguson's paper).

2.2 million deaths. That's what the worst case scenario was.

And on balance, it was worth it.

What do I think the actual number is? Well, I'd use a new upper bound of maybe
600,000 - which BTW is around the number of cardiac deaths per year in the US.
Amortized across 5 years, it becomes even less shocking.

These are upper bounds, btw. I think the actual number could be lower, but I
don't bank on it. Unfortunately, given the way we classify deaths, it will be
very difficult to find out what the "real" death toll was looking back.

~~~
atomi
Without shutting down it wouldn't be amortized.

You'd effectively have millions of additional deaths from lack of hospital
capacity, more than doubling the yearly death rate. And additionally you'd
have millions of more people with debilitating complications from all causes.

That's absolute insanity. You're devaluing life. Stop it. It's frankly scary
to think you're out there.

~~~
__blockcipher__
> Without shutting down it wouldn't be amortized.

Huh? No it wouldn't. Read my other comments in the thread, the point is that
after it works its way through the population, the set of SARS-CoV-2-naive
individuals becomes dominated by new entrants to the world (babies/toddlers),
who don't die from COVID-19.

So over a period of 5 years, the average yearly death will be this year's
deaths / 5\. That doesn't hold in the same way for the Flu since it does kill
babies.

> You'd effectively have millions of additional deaths from lack of hospital
> capacity

This is just false. I can't really debunk it because you didn't make an actual
argument, so let's leave it at that.

> And additionally you'd have millions of more people with debilitating
> complications from all causes.

Huh? Are you saying complications from COVID-19 itself, or are you saying non-
covid reasons which would get neglected due to lack of medical care?

> That's absolute insanity. You're devaluing life. Stop it. It's frankly scary
> to think you're out there.

No, I actually value life, which is why I understand how precious it is, and
what a cruel thing it is to do to subject an entire planet to a regime of
isolation and fear. As I've said elsewhere in this thread, I also believe that
lockdown leads to more mortality than doing nothing, so even if you don't care
about wellbeing and just want to myopically look at lives saved, I'm arguing
that lockdown is worse on both counts.

~~~
atomi
You cannot argue that there wouldn't be more infections if we hadn't shut
down.

That is, if we hadn't shut down, we'd have exponentially more infections right
now.

There are deleterious effects to shutting down. But your theory that shutting
down has lead to more deaths is absurd.

