
Do Covid-19 death rates by age suggest a path to staying open in a second wave? - rafaelc
https://docs.google.com/document/d/1hbnDIwW8MPE5X5bMwEMGD-DiR-HLEGpqzZKiNi2dkc8/edit
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tekdude
Possibly yes, but society will probably need to figure out and take some
additional steps if it wants to protect the vulnerable groups. There will need
to be both environmental and legal changes.

Environmental: More researched and standardized procedures for interacting
with those at risk. For example, we should determine if/how items need to be
sanitized when an at-risk person receives them (such a grocery/food
deliveries, etc...). Environmental changes could also include physical
requirements, such as meeting such persons through plexiglass panels or
mandating protective gear.

Legal: Labor and welfare/disability laws need to adapt to the situation so
those at risk are not forced to re-enter society in order to support
themselves and their families. Not everyone at risk is elderly and already in
retirement; many people in their prime working years have underlying
conditions that affect their health, but were still able to work with few or
no limitations (until COVID-19). Not every job can be completed at home, and
not everyone has savings to stay home indefinitely. Without support from the
government or their employers, they'll be between a proverbial rock and hard
place.

Another issue is low-risk people who live with high-risk people. Should a low-
risk partner stay home if the other is high-risk? How will society support
those situations?

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entangledqubit
While I've had thoughts along these lines as the "pragmatic" thing to do -
given that the population level health effects of a busted economy and the
fact that we're probably not changing the system anytime soon - we should
still acknowledge that there's a lot we don't know about covid and that this
would be a huge experiment. There are follow on health effects from both
chicken pox (shingles) and polio viruses, for example, that often happen
decades after their first onset - so we could have a "bonus" surprise from
covid down the line. This would be to gain an immunity that is not assured as
of yet - because we still don't know enough.

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pjkundert
Yes. The Navy experience (60%+ asymptomatic) and others (almost completely
asymptomatic homeless shelter with large percentage positive tests) indicate
we have been given hugely false or misleading stats about this virus.

Once we can beat proper stats out of the government with large-scale testing,
it may become clear that we are already well on our way to herd immunity, and
that the vast majority of healthy people without serious secondary issues will
be fine (perhaps unhappy and hurting, but will survive).

Of course, encourage any fearful or ill people to continue segregation.

But, this segregation of otherwise healthy low risk population just has to
stop. It is nuts.

~~~
walterbell
There's also the Stanford study of Santa Clara residents which shows
asymptomatic infection/recovery 50-85 times the official numbers.

~~~
donjigweed
I think Andrew Gelman raised some serious concerns with that study.

[https://statmodeling.stat.columbia.edu/2020/04/19/fatal-
flaw...](https://statmodeling.stat.columbia.edu/2020/04/19/fatal-flaws-in-
stanford-study-of-coronavirus-prevalence/)

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brandon272
We don't give vaccines to people without subjecting them to comprehensive and
time-consuming clinical trials. So why would we willingly subject half the
population to a virus that we seem to know very little about? Are there long
term health effects to an "otherwise healthy" person being infected with
COVID-19? Are there potential long-term lung issues, even in a person who is
symptomatic but does not require hospitalization?

I worry about these things based simply on reading the anecdotes of many
younger, healthy people who have dealt with this virus. It's extremely clear
in those anecdotes that this virus is nothing like the common cold or the flu.
Yet so much of the rhetoric seems to make that assumption.

I'd hate to take the "this is silly, let's open things up for the healthy"
approach only to be in a situation 20 years from now where we are dealing with
the misery of mass-scale respiratory disease that gets linked back to these
infections.

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walterbell
To author: please include a date and changelog in this document, assuming it
will be updated to reflect new data and comments on the doc.

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Ozzie_osman
My guess is a lot of the assumptions and conclusions are wrong but that the
high-level takeaway is correct: we should be looking for solutions to safely
(yes, safely, don't ignore that word please if you're going to reply and
disagree) reopen the economy, rather than just do the "social distancing until
we have a vaccine" thing.

edit to try and preempt the downvotes: I am supportive of social distancing
and I'm observing it pretty strictly. But I also know a lot of people who are
going to be in a lot of trouble if we're in this state for too long. We should
be aggressively trying to get data that helps us get back to as normal a life
as we can, safely.

~~~
DennisP
What I've seen epidemiologists recommend: lock down long enough to build up
testing and tracing and reduce infections to a point where tracing is
practical, then you can open back up and isolate individual cases.

Trouble is, we haven't ramped up testing enough and we're heading toward
opening prematurely. According to Harvard we need about three times as much
daily testing to open safely:
[https://www.nytimes.com/interactive/2020/04/17/us/coronaviru...](https://www.nytimes.com/interactive/2020/04/17/us/coronavirus-
testing-states.html)

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aiscapehumanity
Filled with bullshit jobs and a lagging technological scene, we've set our
economy up for vulnerability and i hope even if it opens we dont go back to
bullshit as usual.

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sjg007
No. We assume immunity which is not guaranteed and may be transient. We need
to break transmission chains by physical distancing.

~~~
steveeq1
Physical distancing is a costly measure. It would be economically cheaper for
the young and healthy to self-infect and then self-quarantine. Their chances
of dying or even hospitalization is basically a rounding error in that
demographic. That way, they can't spread it to other people. Herd immunity
should be accelerated, not decelerated.

The evidence so far seems to show that there is immunity to it after recovery
(as well as the rest of the corona viruses). Immunity is not permanent, it
last 6-18 months from what I understand.

Physical distancing is another alternative but is enormously expensive to the
economy.

~~~
stuaxo
Young people do die though and will with this.

Herd immunity without a vaccine is condemning thousands of people to die.

~~~
SeeTheTruth
Some on this site seem to be ruthlessly selfish. They do not care about those
who are at risk - and would rather rush back to the way things were.

It's ethically vile, and deserves nothing but spit.

That anyone will die should be reason enough to slow down and do the right
thing. Covid-19 has revealed how thin some margins are for businesses we need
to survive. Condemning the sick to die and going back to normal isn't just
cruel and evil - it's shortsighted and foolish.

We need to change.

~~~
steveeq1
But some economic tradeoffs are viable. For instance, 35,000 people will die
every year as tradeoff for the convenience for driving.

~~~
Gibbon1
You first dude.

