
Deconfinement: The Price of Human Life - evo_9
https://mondaynote.com/deconfinement-the-price-of-human-life-ebeae82edafd
======
Lazare
Some good points, although I'd toss another thought into the mix. The
confinements and shutdowns and shelter in place orders _also_ cost lives.

We know that recessions cost lives. One study (published in The Lancet, so
worth taking a second look at) suggested 500k excess cancer deaths from the
global financial crisis[1], and another study (published in the BMJ) suggested
that excess suicides in 2009 alone across the US and 53 other countries
totalled some 5k[2]. I don't know of a single comprehensive effort, but we
know recessions reduce the resources available at the margins for food,
medicine and shelter, and increase the suicide rate. The net effect for
something like the GFC seems likely to be on the order of tens of thousands of
deaths (and perhaps significantly higher), and the recession caused in part by
Covid-19 and in part by our reaction _to_ Covid-19 seems to be within an order
of magnitude of the GFC.

Thus, it seems fairly obvious that at least _some_ responses to Covid-19 would
cost more lives than they saved. If you're evaluating a measure that, let's
say, would save X lives from Covid-19, _but_ would cause the resulting
recession to go from, Y% as bad as the GFC to Z% as bad as the GFC, there are
absolutely values for X, Y and Z which would make the measure net negative on
lives.

I'd be happier if that tradeoff got acknowledged a bit more often, even in a
perfunctory "well, we're clearly MILES away from the break even point, so
let's ignore it" sort of way. If you pretend that tradeoffs don't exist,
you're unlikely to reach an optimal decision.

[1]: [https://www.telegraph.co.uk/news/2016/05/25/financial-
crisis...](https://www.telegraph.co.uk/news/2016/05/25/financial-crisis-
caused-500000-extra-cancer-death-according-to-l/)

[2]:
[https://www.bmj.com/content/347/bmj.f5239](https://www.bmj.com/content/347/bmj.f5239)

~~~
drapred7
If the movement restrictions cost lives, why are total fatalities down? (even
including SARS deaths)

~~~
elcomet
Also, movement restrictions cause deaths in longer terms than the virus.

~~~
drapred7
How?

~~~
elcomet
Movement restrictions causes financial difficulties for companies, which cause
job losses, which can cause depression. All this can take time.

------
boomboomsubban
>The Hong Kong Flu caused more deaths than are projected for this current
pandemic and yet, at the time, no one thought of bringing entire economies to
a halt.

The other way to look at it, even with the quarentine this pandemic will kill
a similar number of people.

If the reports were true that "half the workers were in bed," that would mean
there were millions of cases, yet only ~50k deaths. Compare that to the
current pandemic, where France has 25k deaths in ~150k cases.

~~~
sigotirandolas
There have been many, many more cases than the official confirmed (=medically
tested/diagnosed positive) cases. For example data in Spain points to 5%
prevalence (~2M infected) with ~25k deaths (official number, may be higher due
to unverified and side cases).

~~~
lbeltrame
Do you know if the serological data in Spain has also per-city estimates? I
doubt the 5% is evenly distributed across the population, I'm expecting higher
percentages in Madrid, for example.

~~~
sigotirandolas
If I remember correctly the data from Spain is also available itemized by
region (autonomous community), and indeed the most population-dense regions
have a higher prevalence. I believe the data isn't broken down by city, but it
should be obvious that they're going to have a higher prevalence as well.

------
ekianjo
> In the end, these determinations all place an unspoken price on human life

We are already doing this by letting people drive with personal vehicles every
year even they cost dozens of thousands of lives. There is no zero risk, but
we decide (we, as in, the society at large, not individuals) what level of
harm is "acceptable".

~~~
thescriptkiddie
The line between _deciding_ that a particular level of harm is acceptable, and
accepting it by default, is blurry. And yet allowing, through inaction, a
human being to come to harm is not functionally or morally different than
deliberately harming them. And so we wash our hands of responsibility by
telling ourselves _we_ didn't do anything. But who are we fooling?

~~~
drapred7
If that definition were taken, and people were moral, you could infinitely
blackmail moral people by threatening harm.

------
Normal_gaussian
Something that seems not to be considered by many observers is that if a
disease is not eliminated, it will continuously either claim lives or reduce
efficiency (which claims lives).

~~~
luckylion
Is there reasonable hope for a virus like this to be completely eliminated? I
figure if it's in that sweet spot of contagiousness, incubation time and
mortality, it's hard to eradicate completely. And unless it's eradicated
completely, we'll absolutely have to live with reduced efficiency in hyper-
alert testing of anyone with symptoms, unless we find that it ceases to be a
serious problem once humans have had contact with it.

~~~
leereeves
It probably depends on how long acquired immunity lasts, which we don't know
yet. People remain immune to some diseases, like measles, for a lifetime after
surviving the disease or being vaccinated. Immunity to other diseases, like
influenza, disappears quickly (even immunity to the same strain lasts less
than a year).[1]

If COVID-19 is in the latter category, it will be difficult to control and
we'll probably have to learn to live with it, as we have learned to live with
the flu causing hundreds of thousands of deaths each year worldwide.

1: [https://www.sciencemag.org/news/2019/04/how-long-do-
vaccines...](https://www.sciencemag.org/news/2019/04/how-long-do-vaccines-
last-surprising-answers-may-help-protect-people-longer#)

~~~
drapred7
That likely depends on how effective we are at eliminating it in the coming
months. I doubt it will become endemic in Korea or Singapore.

I wonder if even influenza could be erraticated in the coming years with mass
testing and contact tracing. The lockdowns ended flu season early this year.

~~~
leereeves
We'd have to eliminate it worldwide, or it would travel from country to
country like the flu does.

In particular, from Mexico. There's too much travel between the US and Mexico
to prevent it from crossing the border, and there are 50,000 confirmed cases
in Mexico already, with roughly 2000 more being found every day.

~~~
rswail
Given the relative number of cases, Mexico should be stopping travel _from_
the US, not the other way around.

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pmiller2
Regarding sending people to the moon, I don't believe we've changed how we
calculate the value of human life in this scenario at all. Remember,
astronauts _volunteer_ to strap themselves to gigantic tanks of explosives,
all for the chance to experience the universe personally in a way very few
humans ever have.

Rather, I think the issues here are:

* America literally watched 14 people die on national TV.

* At the time of the Columbia disaster in 2003, the Space Shuttle was already a 30 year old vehicle (Columbia itself was 22 years old when it was lost), based on 40 year old designs.

* We realized we just don't need humans on the moon. Compared with robots, we're terribly fragile, inefficient, and largely superfluous on the surface of the Moon in a lunar exploration mission.

~~~
WalterBright
> We realized we just don't need humans on the moon. Compared with robots,
> we're terribly fragile, inefficient, and largely superfluous on the surface
> of the Moon in a lunar exploration mission.

Robots are inflexible. There's nothing like human eyes and hands.

~~~
pmiller2
Even if I agreed with you in this context (I don't -- hands inside space suits
are clumsy, and eyes limited in what they can perceive compared to
instruments), we can keep the people here on Earth operating the robots with
~1 second latency, and it will be fine. We even operate rovers on Mars with
~20 minute latency, and they've worked out well.

~~~
WalterBright
They've worked out well considering the extremely limited scope of what they
can do. They can't, for example, brush the dust off their solar panels. Or
even the simplest repair. Or dig a hole with a pickaxe.

------
Fradow
I am under the impression the author is missing the point of the lockdown. The
main point is not about "saving lives" / "avoiding deaths".

Lockdown is about (1) keeping hospitals under capacity and (2) hopefully
slowing the virus to the point it's not an epidemic anymore.

If you don't keep hospitals under capacity, people who can be cured have to be
either moved somewhere else at great cost (this happened, there have been
people moved from France to Germany) or left to die because they cannot be
taken care of (I am pretty sure this happened too). Please note people who
have another issue than the Coronavirus are also affected. That's what
everyone REALLY wants to avoid. Needless to say, letting the virus run its
course and overwhelm hospitals would have an order of magnitude more deaths.

The hard issue is about how to re-open without letting the virus rampage
again. It's a lot of difficult decisions, and no one have conclusive data on
what works and what does not. It's going to be a lot of trial and error, as
shown by the fact that no 2 countries have the same rules to reopen.

------
wrnr
C2 are really fun to drive if you are at the wheel, but the back seat is like
a big beach chair. The ones with a piece of cloth suspended on a frame. Do you
think in a world of autonomous driving cars, we can make the cars lighter
again? I suspect that in the future, around 2100, there will probably be a
lucrative industry around turning old-timers into self driving vehicle. Once a
technology is commoditised it needs to be commercialised in another way. Maybe
then driving will be fun again, like a big theme park.

~~~
tonyedgecombe
A friend of mine had one which went up in flames. There was a lot of paper
ducting around the engine that eventually got soaked in oil with inevitable
results.

It was interesting to drive, mostly I remember it would lean a long way over
going round bends.

------
js8
I find the complaint that it is harder to do something today, for safety
reasons, a bit odd. Isn't the attempt to eliminate more and more human
suffering a sign of moral progress?

It seems to me that inevitably, if you attempt to save marginally more lives,
the technology to do so will become more complex.

But conversely, why have all the associated complexity of technology, if the
human suffering is not reduced? What is the goal then?

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Animats
The "Get and keep America open" plan is really a "keep dying" plan, but this
is something few want to admit. Someone else pointed out how deceptive the
"flattening the curve" charts were. Most showed a symmetrical rise and fall.
In reality, that plan just keeps the hospitalization rate and death rate down
to what the medical system can handle. Both stay high for many months until
either saturation ("herd immunity") is approached, or there's a vaccine. The
"flat" part is probably a year long, somewhere around the current death rate,
which is in the 1000-2000 deaths per day range. (That may be underestimated.
See this Financial Times article, which is looking at "excess mortality", or
the change in deaths from all causes.)[1]

"Herd immunity" is a long way off.[2] That only happens when 70% or so of the
population has had this virus. While there's not much data yet about how many
people have cleared the virus and acquired antibodies, most figures are around
5% of the population, except a few cities, primarily New York, where it may be
somewhere above 20%. So the dying is maybe 6-10% done, nationally.

The CDC is now avoiding death forecasts beyond mid-June.[3] Previous longer-
term projections have been so far off as to be useless.[4]

Don't bunch up, and wear a real mask that protects you, not others.

[1]
[https://www.ft.com/content/6bd88b7d-3386-4543-b2e9-0d5c6fac8...](https://www.ft.com/content/6bd88b7d-3386-4543-b2e9-0d5c6fac846c)
[2] [https://www.msn.com/en-us/health/medical/no-place-on-
earth-i...](https://www.msn.com/en-us/health/medical/no-place-on-earth-is-
anywhere-close-to-herd-immunity-for-the-coronavirus/ar-BB1466DN) [3]
[https://www.cdc.gov/coronavirus/2019-ncov/covid-
data/forecas...](https://www.cdc.gov/coronavirus/2019-ncov/covid-
data/forecasting-us.html) [4] [https://www.foxnews.com/politics/coronavirus-
model-estimates...](https://www.foxnews.com/politics/coronavirus-model-
estimates-us-deaths-down)

