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NYC did not particularly flatten their curve, and they did not see excess deaths due to lack of available care.

I'm pretty sure all the family members of the people who died would regard their loved ones as "excess deaths". Your technocratic language ascribes no value to the lives lost, in which case of course the actions seem excessive. For people who don't value the lives of others, it would be hard to understand all the fuss.

This isn’t a disease for which “flattening the curve” makes particular sense. That would require there actually be an effective treatment.

This is a self-contradictory statement. The whole point of flattening the curve is to buy time to develop exactly those effective treatments. It is also possible to flatten the curve to an extent that there are fewer deaths under it, and based on the continual downward revision of the IHME model fatality estimates, that appears to be exactly what is happening.

So the most charitable interpretation of my comment is to convince yourself I’m a sociopath?

Excess deaths is a term of art to describe a number of deaths over a baseline. It can be used in general, or specifically, as I was using it, to describe the repercussions of an overloaded health care system. Here, for example, is a Sky News story from today using the term in its headline. [1]

I think you owe me an apology, but I won’t hold my breathe.

“Flattening the curve” is absolutely not intended to buy time to develop a cure or vaccine. The timeline over which the economic devastation of flattening the curve can be sustained is measured in weeks not 12-18 months.

The purpose of flattening the curve is to be sure there are the necessary number of hospital beds and ICU beds to provide effective treatment. If effective treatment can not be provided it leads to “excess deaths”.

Bad projections based on a 10% hospitalization rate and based on assumptions that ICU ventilators wouldn’t kill 80% of patients, have led to disastrously bad public policy which is causing untold suffering throughout the country. This suffering, which many people seem to be blind to, is notably self-imposed rather than natural, and through logical and reasonable interpretation of factual data we can stop this suffering.

This is very much unlike the suffering caused by people who are dying from COVID, for which unfortunately we have no effective cure or treatment, and for which it is not reasonable to assume we will develop one in the timeline of this current pandemic.

This is the key takeaway from “flattening the curve”. It cannot and will not decrease the total number of people who are ultimately exposed at this stage of the pandemic. Once the health system capacity is high enough to handle the number of cases coming in with effective care, continuing social distancing causes extraordinary damage without any benefit.

Since effective care at this point has proven to be both simple and extremely scalable (non-invasive ventilation, antibiotics, and frequent repositioning) the resource curves for effective care are extremely larger than projected, back when they were based on availability of ventilators.

Simply put, the data has changed, and it’s time to update the policy. It’s extremely incompassionate to do otherwise.

[1] - https://news.sky.com/story/amp/coronavirus-englands-excess-d...

However you choose to define the term "excess deaths", the fact remains that there are tens of thousands of people alive today who would be dead if we all took your advice and ignored the notion of social distancing. Does that make you a sociopath? No, it simply makes you wrong, policy-wise, if you value human life. Unless you really are a sociopath, and advocate the policy precisely because you don't value those lives. I can either give you the benefit of the doubt morally, or intellectually. Which do you prefer?

You are correct that social distancing and flattening the curve protects the health care system from overloading. That doesn't mean that it is the only purpose, or effect. If we took a poll among health care policymakers about the benefits of flattening the curve, I'd be happy to bet any amount you'd like to wager that "buying time to develop effective treatments or a vaccine" would be on their list.

This is the key takeaway from “flattening the curve”. It cannot and will not decrease the total number of people who are ultimately exposed at this stage of the pandemic.

This is just mathematically untrue. There is clearly a point where the curve is so flattened that the number of deaths under it is less than a baseline "no action" scenario. If we could somehow get everyone in the US to truly isolate for three weeks, the virus would die out entirely. So clearly there is a spectrum of actions and their corresponding outcomes. The number of infected (and dead) is not a fixed number with only the duration of the outbreak changing.

If your premise were simply that the current measures are unsustainable, I couldn't agree more. Fortunately, those measures have bought us the time to take more focused, informed action based on the latest data. In a crisis this fast-moving, every day is time to update the policy.

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