This is an important observation. In the Netherlands, where I live, I've had a number of people look at me with great surprise and mistrust when I mentioned that the Dutch have done a terrible job with this epidemic. The Guardian plots show that the Netherlands is one of the worst when it comes to under-reporting.
This is not to say however that the Swedes have done a good job. While their numbers are credible, their magnitude is still unacceptably large: 0.5/1000 Swedes have so far died of the corona virus.
Considering COVID has closed many of life's fun things, there will be an entire generation of people who have effectively "lost" a year of the things they hoped they would do in their lifetime. By stating open, Sweden might decrease life expectancy in years, but increase it in terms of 'things achieved in a lifetime'
Yes, people die. That's true of all countries and all times. What we might call civilized societies have however strived to reduce those numbers as much as possible. This was done by trying to avoid violence, improving lifestyles and developing better medical techniques in order to prevent or repair diseases and injuries.
Containing and minimizing the effects of a pandemic is just one aspect of what we might call a civilized attitude towards human life. Conversely, not doing so is uncivilized and I might add immoral and irresponsible.
> there will be an entire generation of people who have effectively "lost" a year of the things they hoped they would do in their lifetime
This almost doesn't merit a reply. A few months of not going to festivals and the cinema is by no measure a catastrophe. It's not fun, but suggesting that your right to fun should trump others' right to life is, again, uncivilized, immoral and irresponsible.
> Containing and minimizing the effects of a pandemic is just one aspect of what we might call a civilized attitude towards human life. Conversely, not doing so is uncivilized and I might add immoral and irresponsible.
The reality is that everyone is prepared to allow others to die for their own convenience. I intentionally phrased that harshly, but it is indisputably true. In the US, 70,000 people died from the influenza season of 2018-2019. We could have sharply reduced that through quarantine measures. But no one wants to do that.
Once you accept that everyone is prepared to allow others to die preventable deaths for their own convenience, then all you are talking about is a matter of degree. It can't be immoral to believe 1 death is okay, but 2 is wrong. That's just an opinion. The only difference between believing 70,000 is okay, and 700,000 is not is a gut feeling about how much preventable death is worth it to maintain our living standards.
It has much less to do with people dying directly from Covid and more to do with the sheer number of severe Covid cases overloading healthcare systems to the point that patients with other serious conditions can't receive medical treatment.
This occurred in Italy, New York City, etc., and is now being seen in some cities in Texas and Florida. This condition is what incentivizes societies to lock down, not just the mere occurrence of a new disease.
If a society's healthcare system can handle a severe influx of serious Covid cases, then you typically have seen that government's restrictions lift.
>This occurred in Italy, New York City, etc., and is now being seen in some cities in Texas and Florida.
Not Florida. An article from yesterday (https://www.news4jax.com/news/local/2020/06/18/florida-has-l...) ominously claims that "less than 25%" of ICU beds are available in the state, but actually read it and see that 90% occupancy rates are normal, and only a few of those in the ICU are COVID19 cases.
Texas? Let's look at Houston, where for a month it's been "we'll be running out of ICU beds in two weeks" every week.
Italian and New York hospitals were overwhelmed because a) both places put sick elderly into old age homes. b) Like elsewhere early on, doctors put everyone serious onto ventilators in a mistaken belief that they should treat patients like they do ARDS cases based on blood oxygen levels. This damaged healthy lung sacs and caused long-term dependence on mechanical respiration that doctors found almost impossible to wean patients from, and other side effects like deep vein thrombosis; Nick Cordero is a recent example. This article from three months ago (https://www.statnews.com/2020/04/08/doctors-say-ventilators-...) was completely vindicated in retrospect.
(And even NYC being overwhelmed was thankfully temporary. That's why the military hospital ship sent there was not used.)
56 Florida ICUs are at capacity, with a further 35 are above 90%[0]. Five days ago the largest hospital operator in Houston, TMC announced that they were at 102% [1]. There’s a little bit of flexibility there; TMC can get that down to 72% by converting every possible bed to an ICU space[2], but they are now operating above official capacity.
I agree that there’s a lot to criticize in how NYC handled their hospitals, and that in a pinch hospitals in Texas and Florida can scrounge up extra beds. But those hospitals are filling up.
As I said, a 90% ICU load is normal; hospitals routinely transfer patients elsewhere to maximize utilization across as many facilities as possible. Again, only a small portion of ICU patients are there for COVID19, and a good chunk of the remainder are people who postponed procedures during the lockdown.
Let me clarify. By "normal" I meant that 90% is not an unusual or undesirable situation. To some extent, an ICU bed is not being used is going to waste; from a hospital administrator's perspective, the ideal situation is 100% utilization at all times with every excess patient smoothly being transferred elsewhere. This of course is unrealistic—you want to leave some surge capacity (thus my 90% figure) if possible—but, generally speaking, a hospital will transfer excess patients elsewhere (either within the same system, or to others in the region), and accept others' excess patients to fill up its own empty beds.
COVID19 patients are not making up a large percentage of ICU patients at the moment; see, for example, the hospital in the aforementioned article with 100 ICU beds. Yes, the 100 beds are full at that moment, but only seven are COVID19 patients; no doubt some other fraction are patients who put off procedures during the lockdown. That hospital is sending new patients it can't handle elsewhere, and will also move some existing patients elsewhere when practical/safe. This is possible because there is no overcapacity on a regional or statewide level.
Thanks for this response, its a good counterpoint with solid evidence, but the main point still stands - societies aren't merely shutting down because of a virus - it's because of a fear of healthcare systems being overwhelmed.
Not sure where you get 70,000. On average it's 16,000 - 40,000 per year, there was a really bad flu on 2017-2018, which killed about 61,000 people, but on 2018-2019 it killed 34,000[1].
Anyway, your point stands, but there are people who think covid deaths are no higher than a bad flu, and your numbers seem to mislead in that direction.
I am leaning towards the lock down skepticism. It's not that I think that Covid is not worse than a flu, it is worse, but there response is unparalleled. We have had a strict lockdown and lots of deaths anyway. The initial predictions about the virus turned out to be way off, it seems to be more infectious and less dangerous than we were initially told
Initially lockdown was to "flatten the curve", stop the hospitals an in particular the ICU beds from getting overwhelmed. That worked, and while it got close to breaking point here in Spain we made it through.
I noticed as new data emerged from Sweden - they hadn't spiralled out of control as many, including myself, predicted. Flatten the curve seemed to be forgotten about, and it turned into a pointless competition of who has the least cases, least excess deaths - pointless because this is far from over.
Or maybe we are past the worst of it already - the Diamond Princess cruise ship showed only 20% of the passengers infected - so maybe covid only affects 20% of the population.
You calling that a strict lockdown? When I go to a park and see tons of people there, half of them not wearing any masks. We aren't even fining people for not wearing them.
Someone here mentioned how Vietnam handled it, they reacted quickly and had steep fines (for their income) and achieved 0 deaths and now it's 80 days since last infection was reported.
There are other countries that handled it really well: Australia, New Zealand, Taiwan, South Korea, Finland.
Assuming you're talking about USA. The USA is probably an outlier since it essentially had no lockdown, no enforced mask usage, and very weakly enforced business closures. All the states had were half-assed "Stay At Home suggestions" that people pretty much ignored (and still ignore).
I wouldn't look at any state in the USA for evidence of whether lockdown works or not, because it pretty much wasn't done here.
> Can you explain why the estimates on this page are different from previously published and reported estimates for 2017-2018? (For example, total flu-related deaths during 2017-2018 was previously estimated to be 79,000, but the current estimate is 61,000)?
> The estimates on this page have been updated from an earlier report published in December 2018 based on more recently available information. There is a trade-off between timeliness and accuracy of the burden estimates. To provide timely burden estimates to the public, clinicians, and public health decision-makers, we use preliminary data that may lead to over- or under-estimates of the true burden. However, each season’s estimates will be finalized when data on testing practices and deaths for that season are available.
All preventable deaths should be prevented - this is the gold standard. In reality, of course, things don't work out that way. The analogy with a flu season is deeply misleading. The coronavirus has, in half a year, killed more people than the worst flu seasons, with extraordinary measures in place all over the world. It's completely reasonable to assume that without lockdowns we would have had millions of deaths already.
> The reality is that everyone is prepared to allow others to die for their own convenience.
It may be so. Those people are morally wrong however. This is a deep point that I have insisted on in other comments as well. Casually weighing human life against economic cost is not acceptable in what we might call a civilized society.
> The only difference between believing 70,000 is okay, and 700,000 is not is a gut feeling about how much preventable death is worth it to maintain our living standards.
That is not true. Deaths caused by the regular flu are deeply regrettable and should be prevented as much as possible. If you dig into the data however, you will see that the coronavirus not only kills many more people than the flu, but it also kills people who would otherwise have many more years left to live. Diabetes, a heart condition or age > 65 yrs. shouldn't be death sentences in a modern civilized society.
> Casually weighing human life against economic cost is not acceptable in what we might call a civilized society.
The reality is quite different. We accept a risk of death to ourselves and others in everything we do. You do it, too. Everything. You even risk death by doing nothing.
You could say "if it cost $1b to save this life, we should do it". But how many lives could be saved at $1b each before we run out of money? Then what? And what about the lives that could have been saved at $1m apiece?
If someone not willing to give up all of his assets to save someone else's life, is he uncivilized and morally wrong?
> You could say "if it cost $1b to save this life, we should do it".
This a common, yet unrealistic, hypothetical. In reality, of course, death is inevitable regardless of the economic costs. Past a certain point everybody, so far, has died. The amount of things that we can do in order to prevent any given death doesn't scale with the economic cost, past a certain (quite low) point. Spending 1B on a person won't get you 1000 times better 'medical stuff' than spending 1 million; therefore, a trade-off of e.g. one life for 1B vs 1000 lives for 1m is illusory.
In practice all societies have limited resources. My position is, however, that those limited resources, in the case of an acute health crisis, should be focused as much as possible on mitigating that crisis, without having primary concern for the economic costs.
> All preventable deaths should be prevented - this is the gold standard.
It absolutely isn't; it is complete nonsense.
Firstly, it directly conflicts with right to die; it asserts that if we can intervene in any suicide, then we should. How can stepping on the right to die be elevated to a gold standard?
Some people take risks, and those risks are fatal. Deaths in dangerous sports and other activities are easily preventable: just forcibly take away the right to engage in them. Closing off Mt. Everest to climbers will certainly prevent deaths. By your gold standard, that must be what should be done.
Preventing some deaths may even require lives to to be imperiled; someone has to be asked to risk their own life to save others.
No, no, no; live and let die is the gold standard.
People should be sometimes left to the consequences of their actions and circumstances and that includes dying. Obviously not always, and not as a rule, but sometimes. Often enough that "all preventable deaths should be prevented" is utterly preposterous.
There is no right to die in most countries in the world. Got horrible painfull and untreatable disease, but a few years left on the clock? In most places you are doomed to suffer through it. The only exception i am aware of is netherlands.
Secondly, most of your post conflates me engangering myself my choice ( i choose a dangerous sport and suffer) vs someone else endangering me (unsafe building collapses on my head).
Note that, normally, a writer can't conflate A and B, if they don't make even the slightest reference to B. That said, I've pulled off "the impossible" before.
It may be so. Those people are morally wrong however.
I'm willing to bet that you have taken many unnecessary car trips in your life. By doing so you have increased the risk to other drivers, cyclists, and pedestrians of suffering a fatal accident. Sure, it's a very small increase, but surely that outweighs your selfish desire to visit your friends or go to a movie.
Casually weighing human life against economic cost is not acceptable in what we might call a civilized society.
It's not only acceptable, it's essential in order to make reasonable decisions.
Deaths caused by the regular flu are deeply regrettable and should be prevented as much as possible.
Flu vaccine reduces risk of death. Coronavirus has no vaccine yet. I do think we take the flu too lightly. Urgent care and hospitals definitely need to be more risk averse even after this pandemic is over, and I hope we learn that lesson in this pandemic.
To my knowledge all modern nation states have some sort of stat like that; it’s either relevant for healthcare expense planning, or disability/life insurance schemes. I believe the US rates it down to the value of each limb for the latter; and my private AD&D insurance does the same.
The response to the coronavirus has been many orders of magnitude more strict than the response to the flu. All this while be less than an order of magnitude as deadly, probably 3X-4X. This is why I think it is perfectly valid to compare it to the flu.
The collective response has been outsized to the actual risk of death, and I believe this is due to fear rather than sensible policymaking.
If it really was about reducing all cause mortality, most governments could do so much to reduce the primary causes of death, like heart disease and cancer, by banning things like cigarettes and enforcing healthier diets among the populace.
Imagine what banning sugar alone would do to the rates of obesity and type 2 diabetes in the US. But no one wants to do that.
> All preventable deaths should be prevented - this is the gold standard. In reality, of course, things don't work out that way.
Yes, in reality a lot of people die driving cars all around the world no matter the amount of on board safety devices and yet cars are legal everywhere. There are countless similar examples.
Preventable is what people agree or tolerate to prevent.
Really? Here in Norway children would only be vaccinated against influenza if they already have other severe conditions such as diabetes, chronic heart or lung disease, etc.
First, economy was never a consideration for the Swedish Corona strategi.
Secondly, the flue has quite reason, like year 2000, taken more lifes in Sweden then what Corona has taken this year. And I would be surprised if that would be exceptional to Sweden.
That not even consider there are more people living in Sweden today then 20 years ago. A couple of years earlier, the death rate per 100 000 was higher then Corona this spring.
And yes, there are some strong indications that there was Corona in Sweden in December, in Svärdsjö, Dalecarlia. A woman that has not been outside of the region got Corona signs on X rays of her lungs.
And that I guess isn't exceptional either. So, we probably hade Covid-19 a lot earlier than we has thought. Which could explain the explosion of the spread.
> Casually weighing human life against economic cost is not acceptable in what we might call a civilized society.
Human life and economic cost are not separate things. The economy is a comprehensive (if incomplete) description human life. When we shut down the economy we cause millions to lose jobs, to lose incomes, to lose structure, to lose community, to lose activities that give their lives purpose and joy.
The economic shut down is killing people. It's also reducing quality of life and length of life. That's not to say it's not worth it. The effects of lockdown are hard to measure and no one can be sure if it's worth it or not. But this framing of economic cost vs human life as if it's just a little money is wildly inaccurate and damaging.
> It's completely reasonable to assume that without lockdowns we would have had millions of deaths already.
I agree that it's a reasonable assumption. Ivor Cummings dives into some statistics a bit more, and it isn't so clear that the lockdown had the effect, rather that it might be do to with seasonality and the way the virus spreads. I am interested if anyone has any decent criticism of the numbers he bring up in that video, as they seemed reasonable to me?
> The coronavirus has, in half a year, killed more people than the worst flu seasons
That's not true. The flu seasons in 1968, 1957, 1918, and 1889 each killed over a million people worldwide, twice as many as COVID-19 in roughly the same timespan, and that out of a lower total population, and despite lockdowns and quarantines.
(Who is downvoting this simple truth? How is anyone going to discuss this issue if we can't even talk about basic facts?)
You are referring, I think, to years with pandemics that were not caused by what can be called the 'regular' flu. It's especially comical that you have included the 1918 flu pandemic among your counter-examples.
At least for Sweden, it is still true that the worst flus have killed more people than corona on a per capita basis. And we don't have to go back very far at all to find cases of this. 1993 and 2000 where particularly bad and topped corona.
But that is corona with social distancing and very widespread working from home, so it isn't really an apples to apples comparison.
What is "regular" flu? There are many strains in circulation, including those that caused past pandemics. We have vaccines and acquired immunity, so it's been some time since the last truly deadly flu epidemic, but the flu should not be dismissed so lightly.
And why wouldn't I include 1918 in a list of flu pandemics that killed over a million people?
Is it? I see it acknowledged, and often paired with the observation that the worst flus have not been mitigated by extreme social distancing as we have now.
Let's look at British Columbia, Canada where we have managed to stabilize at ~10 cases a day. How long before we get the same number of deaths with our population of 5 million people. Hmm, 5 million divided by 10 divided by 365 is 1369 years. Even if we consider 10 cases for every one detected case that's ~137 years! Longer than a human life span. Ignoring things like improved treatment options, vaccines, and other things that are going to change in our understanding.
So I think this proves the argument wrong.
If you consider the other costs you're avoiding, long term issues for sick people, the cost of treating all these people in hospital, the potential for people to get sick with this multiple times (we don't know if you get any immunity by getting sick) then it's even clearer.
They have only stabilized at that level if you are willing to permanently keep things the way they are. Are you comfortable with the restrictions currently in place being permanent?
I think we can keep things where they are. The current restrictions aren't great but they are sustainable:
- Virtually no travel in and out of the country (goods still flow though).
- No gatherings > 50 people.
- Keep 2m away from others (except for "bubbles").
- Wash your hands.
- Masks in certain situations (not mandatory for most).
- Various limitations in place as to how businesses operate, e.g. distance between tables in restaurants, physical barriers, cleaning, one way aisles in stores etc etc.
Since I'm not the type or age who goes partying out in crowded bars or to packed concerts that stuff doesn't really bother me personally. Sure, it's no fun, but the alternative seems like a lot less fun. In my (global) company we all switched to wfh when this started and I'm fine with that.
Wow. All I can say is that you have very different priorities than most others. Most are ok with those changes temporarily. Almost nobody is willing to make that sacrifice permanently.
Permanently != until there's a vaccine or effective treatment.
There's lot of room for optimization/improvements. Travel might be ok to locations that have this under control, for example. We might find better solutions for keeping the transmission low. We could decide to clamp down harder and eradicate the virus locally so that we can trade off local restrictions vs. travel restrictions.
It's just between all the bad options here this seems to be the least bad. 2 years of the disease raging through the community until (maybe) there's herd immunity sounds so much worse. I'm pretty sure the Americans who think this is the way to go will change their minds come this fall assuming the current trend continues. Maybe I'm wrong... Let's catch up in December ;)
> Youre are going to have the same number of deaths sooner or later as long as the hospitals aren't overwhelmed.
Even assuming there's never a vaccine or effective cure, this is not true: temporarily reducing the R number (lockdowns, distancing, masks) reduces the overshoot in the total number of people who get the disease (some proportion of which will die). It's the difference between scenario 0 and scenario 1 in the excellent https://ncase.me/covid-19/ playable models.
Quoting the site: "This reduces total cases! Even if you don't get R < 1, reducing R still saves lives, by reducing the 'overshoot' above herd immunity. Lots of folks think "Flatten The Curve" spreads out cases without reducing the total. This is impossible in any Epidemiology 101 model. But because the news reported "80%+ will be infected" as inevitable, folks thought total cases will be the same no matter what. Sigh."
What I said: "temporarily reducing the R number (lockdowns, distancing, masks) reduces the overshoot in the total number of people who get the disease (some proportion of which will die)."
The R is reduced while any effective measures are active. The playable sim for Scenario 1 has them active while there's blue shading over the graph, deactivating them once herd immunity is reached in that sim. In that case, compared to scenario 0 (do nothing), fewer people have been exposed so fewer people die. So it is not true to say, as you did, that "Youre are going to have the same number of deaths sooner or later as long as the hospitals aren't overwhelmed."
> There's no avoiding society returning to normal as people need jobs to pay rent and buy food.
You've moved the goalposts, but even so, the later sims suggest other things that can be done with less invasive measures like test and trace, wearing masks and social distancing. These don't prevent people doing jobs. They do decrease the number of people who die.
What's a preventable death? Everybody dies eventually, there's no such thing as a preventable death. There's delaying death, but everyone dies. Period.
I feel that in this thread people are quite stubborn about interpreting things literally, or misinterpreting them all together.
I will give it my best shot at clarifying:
Preventable refers to what a given society can be expected to manage given its limited resources and given other moral constraints, such as not impinging on people's freedoms unnecessarily. A number of the terms I have used have vague meanings that can't be clarified (not by me at least) within the scope of an HN comment. A good faith interpretation of my statement would be that a society should hold saving lives as its highest priority, as long as this does not cause catastrophic costs or dystopian levels of population control. Some temporary economic costs and some temporary restrictions on certain freedoms should be accepted, I think.
> in this thread people are quite stubborn about interpreting things literally, or misinterpreting them all together.
My complaint is a bit different. I'd say "preventable deaths should be prevented" and people will interpret that as if it said "all". I reply that if I meant "all" I would have said "all".
Your case is a bit different, because you said "all" but did not mean "all".
Cancer is a rather big problem. It taxes society quite a bit, costs a lot of money and in general inconveniences quite a lot of people that need to support or help cancer patients.
Would you agree then that perhaps it's a better idea to let cancer patients die rather than try and find cures or reduce the chances of dying? Why or why not? If you had cancer but of the curable kind, would you accept the state killing you because it inconveniences others?
My point is not that society should take no effort to reduce preventable deaths. Society should do whatever we collectively want to do.
Rather, my point was that it's hypocritical to argue that anyone that does not want to continue major disruptions is either immoral, uncivilized, or an absolute monster.
Everyone attaches some value X to human life, and some value Z to normal functioning. Not everyone values these things the same. But everyone certainly has a value, and almost everyone is okay with allowing many tens of thousands annually to die a preventable death in order to avoid disruptions to life. That being true, let's stop the moralizing arguments, and focus instead on why coronavirus is worse than other illnesses, and why it's worth it to continue our efforts to disrupt it.
In other words, my argument is really about language and rhetoric, not the coronavirus itself.
I think your argument is nonsense and pedantic to be completely honest.
For example, being against the treatment of the Uighurs in China would be an example of moralizing if we took your argument to the extreme. The government in China simply places lesser value on their lives and since we all attach different values to human lives it's hypocritical to criticize their treatment.
You're avoiding the actual argument at hand in favor of nitpicking the rhetoric. Basically, tone policing. And I don't think tone arguments solve anything over than diversion.
> It's not fun, but suggesting that your right to fun should trump others' right to life is, again, uncivilized, immoral and irresponsible.
That's not the argument he was making. And as a society we have to accept some negative externalities and weigh up the benefits, otherwise things like (recreational) road-trips would be banned.
I'm not exactly sure what OP's argument was, but it sounded like "Think of all the fun activities people sacrificed while we tried to handle a deadly worldwide pandemic!" I don't think this is really convincing to a lot of people and frankly it sounds borderline disgusting to me.
In the past, generations have willingly sacrificed their lives at war, ostensibly fighting for the common good, yet today we can't even stomach a year without pedicures and dining out? That's pretty sad and gross.
>What we might call civilized societies have however strived to reduce those numbers as much as possible
Unless you're claiming that no civilised society exists, that's not true at all. A civilisation built around minimising death as much as possible would look very differently to any that currently exists.
Resources are always a trade off. People working at those festivals and cinemas could have went in to medical care pre corona virus. People building festival stages and cinemas could have been building hospitals. If festivals and cinemas didn't exist then that would be less driving and less road deaths.
At some level festivals and cinemas existing is putting some peoples fun over others right to life, corona virus or no.
What's reasonable is exactly what's up for debate though and they didn't say "civilisation is 5000 fun utils to 1 QALY saved ratio but doing nothing about corona virus actually costs you 3 QALY for every 5000 fun utils so that's disgusting, what they said was
>It's not fun, but suggesting that your right to fun should trump others' right to life is, again, uncivilized, immoral and irresponsible.
I really don't understand what you're trying to accomplish here: are you seriously asserting "unless you can assign objectively quantifiable values to 'right to fun' and 'right to life' and prove the latter is larger than the former, your argument is invalid?"
The argument was made that "avoiding unnecessary death > fun/comfort things to do". The counter argument was "if that was true, we'd ban lots of things" and that it's more of a question of how many deaths vs how much fun/comfort.
One death a year vs permanent lockdown? We won't lock down. 99% of society dying vs washing your hands once a day? We'll make hand-washing mandatory. The deaths from Covid-19 and the responses to it are somewhere between those extremes.
The important point here is: it's not a matter of moral principles, it's a matter of where on those scales you put the deaths/counter measures. Pretending that it's a moral argument (as in "you're immoral if you accept any amount of unnecessary deaths for non-essential things like going to festivals or having pineapple delivered to your door") is simply not working unless you (demand to) ban plenty of things.
They're not even trying to say that one is larger than the former without objectively quantifying it! That would be a start.
I would like a argument. Any. Instead there's just a bunch of people treating corona virus as this exception where you're sociopath to consider any other facet of life when deciding how to respond to it.
> Containing and minimizing the effects of a pandemic is just one aspect of what we might call a civilized attitude towards human life. Conversely, not doing so is uncivilized and I might add immoral and irresponsible.
This is acting under the assumption that something can be done, that the thing done is effective, or for that matter, isn't harmful. There were, of course, many things done. Were all of them effective? Were some of them harmful?
Doing something harmful, like for example forcefully depriving many of a livelihood during a pandemic, can be considered immoral and irresponsible.
There are many ways of mitigating the harmful effects of the lock down. State aid targeted directly towards individuals (and not corporations) is a good idea, I think. The same goes for a freeze on mortgage payments, rents, evictions etc.
These are all measures that a modern state can take to prevent people from suffering economically.
Depends. If you give someone a furlough handout, they can keep buying food, paying rent, paying for services (keeping other people's jobs viable, basically).
If you let someone go bankrupt, lose their job, house, etc. they are suddenly not contributing to the economy and other people start losing their jobs. And that person then needs welfare payments anyway to avoid starving to death etc.
In the former case the government might borrow to pay for that, but if you borrow money, you have to borrow it off someone. Someone has to buy those bonds; e.g. pension funds.
"The young" will be not will be worse off overall; it has to balance out overall. Some of them will be creditors. The balance won't be evenly distributed, but future governments can decide by how much with tax strategies.
Compare to climate change, a problem we are very definitely kicking down the road to future generations.
This was already the case long before COVID, different problem, requiring an entirely different solution. Look to fix political systems in order to address these issues.
> There are many ways of mitigating the harmful effects of the lock down. State aid targeted directly towards individuals (and not corporations) is a good idea, I think. The same goes for a freeze on mortgage payments, rents, evictions etc.
I think it's a bad idea to have people with little understanding of economics, but a high sense of moral superiority, fix the problems they create through their incompetence. Politicians are the last people you want doing this.
Freeze evictions? Landlords go bust. Freeze mortgages? Mortgage servicers go bust. Now what? Mortgages when created are aggregated into securities with guaranteed contractual payments. No payments? What happens to the securities and the organizations that own them? Banks, pensions, retirement accounts, etc? What happens to the mortgage market and the young family who needs to buy their first home?
Actions have consequences. It's nice to have ideas over the internet, but reality is a bit more complicated.
> I think it's a bad idea to have people with little understanding of economics, but a high sense of moral superiority, fix the problems they create through their incompetence.
Not sure who you're referring to here.
> Freeze evictions? Landlords go bust. Freeze mortgages? Mortgage servicers go bust.
Corporations are legal fictions that do not have a right to life. Let them go bust and save the individuals working for those corporations. Once the crisis passes, they will re-create the legal fictions and continue their work.
> Mortgages when created are aggregated into securities with guaranteed contractual payments.
This should probably not have been allowed to happen in the first place.
In general valid replies to your comments are easily available. Your condescension is, however, tiresome, so I will not pursue this thread any further.
It's easy to dodge the questions and act morally superior when you don't personally have to make the hard decisions or accept responsibility for the consequences. Others don't have that luxury.
These are all problems caused by the economic system.
If an economic system can't cope with a relatively minor external stressor - and Covid is not nearly as dangerous or destructive as some stressors - then the problem is with the economic system.
Actions do indeed have consequences - and trying to use the wrong tool for the job because you can't imagine a better tool is possible is not a wise action.
> These are all problems caused by the economic system.
What problems? There are no major structural problems yet. There will be major structural problems if OP's ideas are implemented because they're not sound. That's not related to the economic system, that's related to OP's ideas.
Yeah, we've heard all of that. However, is it really true?
How many lifes could be saved if we directed 50% of world wide military budget towards ending hunger?
Let that sink for a while, and let me know if you still think the "we are just protecting you" narrative is really honest.
In my country less than 80 people have died because of the COVID-19. One can argue that many more have died because of lack of access to the medical help. Not because the health care system was overwhelmed—far from it. But the access was very limited for the sake of "preparation" to deal with COVID.
That's not a number we will know for decades. Saw an article in Sweden saying cancer detections are down 30% since the start, those undetected cancers are still developing. Unless they somehow can be caught a couple of years down the line they will sadly show up in the stats.
> A few months of not going to festivals and the cinema is by no measure a catastrophe.
Do you have any data to support that? For many people their mental health has a great effect on their physical health, and in a country like Sweden where a lot of people have mental issues already (including stress, loneliness, various forms of depression etc.), yes you could make a case that making people even more isolated by sitting at home would increase their stress and loneliness which has an effect on the health.
Young people aren't just losing a few months of festivals. A generation of kids are losing a year (possibly more!) of schooling. Young adults are graduating into career-crippling unemployment which may haunt their lives for decades. People are getting laid off, burning through their meager life savings, losing businesses that they've worked themselves half to death to establish. Suicide rates are up. We're just beginning to see the economic and geopolitical consequences... the last great depression precipitated a world war that killed 3% of the world population.
All so that 75 year olds can have an extra month or two of average life expectancy?
I have octogenarian parents who I love deeply and would prefer to see live forever. I also have a young son. I would grind up my parents and feed them to my child if that's what it took for him to thrive. And I would expect my child to do the same for his children.
Stop moralizing, this isn't "right vs wrong". It's basically picking which demographic bears the brunt of an extremely unfortunate but naturally occurring phenomenon. I'm not at all sure we picked the right one.
It's potentially a lot more if you let the virus get out of control. The hospitalisation rate is difficult to pin down, but could be something like 4% for people in their 40s. That proportion starts to get closer to the overall death rate if your health system is overwhelmed.
That study estimates years of life lost for people that died, not the infected population:
Among patients dying of COVID-19, there appears to be a considerable burden in terms of years of life lost
I don't think you are deliberately misusing statistics here, but this common confusion massively overstates the risk of infection in the same way that the early focus on Case Fatality Rates did. To be meaningful, those Years Of Life Lost numbers need to be multiplied by the Infection Fatality Rate.
I can't find an IFR for 75+, but the CDC currently has 1.3% for age 65+. The average 65yo has 19.1 years of life remaining (2010 stats, also from the CDC).
1.3% * 19.1 years = ~0.25 years, or about 4 months.
This is probably a conservative estimate - older people have fewer years remaining.
Look, if covid-19 actually reduced the average lifespan of the population by a decade, I'd be in a panic too. Thankfully, it doesn't.
I'm don't think I'm deliberately or accidentally misusing statistics. I think it's useful to look at it from both points of view.
You said "All so that 75 year olds can have an extra month or two of average life expectancy", which gives the impression that the virus is only taking people a couple of months ahead of their natural death; this is not the case if you look at the average. People are dying with years of useful life left.
You might also like to do that calculation for the worst-case scenario of hospitals being overwhelmed, to see the much more serious situation we're trying to avoid.
> All so that 75 year olds can have an extra month or two of average life expectancy?
In a "More or less" episode the insurance industry debunked that "an extra month or two": it's more like 5 years on average in a first world country.
That's some significant grand-parenting time.
Also, "flattening the curve" was not only about trying to save those old people but to not overwhelm hospitals and cemetaries. The system cannot handle so many excess deaths in so little time.
Your argument sounds like we should have let the virus go rampant and in 6 months:
1. let health workers go grazy
2. wipe out all 75+ people from the planet
Maybe the grand-children could give kisses of death to grandparents and problem is solved?
Newsflash: the world isn't steady state. What we think is 'normal' today can change, and by adapting to change we ensure our continued success and survival as a species. Entitlement as to what you feel your life should be like is a good way to be frustrated and rather than to see that a generation of kids lost a year of schooling (which isn't actually the case, most countries had only a few months interruption the bulk of which got caught by remote schooling) think about it this way: we don't get all that worked up about those countries where there are very few or poor levels of school to start with and even in the rich West 200 years ago (an eyeblink on the scale of human history) there was hardly any schooling to begin with.
The big difference this time around is that the rich West is confronted with some of their organizational and political failures.
Grinding up your parents if that's what it took for your son to thrive is a false choice, your son will thrive regardless of whether or not your grind up your parents because it isn't the end of the world to lose a year of schooling. Just work a bit harder the next year and you'll be fine.
I've watched an 8-year-old do "remote schooling". It is nonsense. We might have better luck with mature high school or university students, but the only young kids in my general vicinity receiving education are the ones whose parents can afford to hire private teachers.
It's not clear yet whether the schools here will be opened this fall. A lot of it depends on the outcome of discussions like these - and the "save lives at all costs" crowd is pushing strongly for "no". It really doesn't help to throw around terms like "survival of our species" - there is no plausible scenario where the survival of our species is threatened by Covid-19.
Well, one of my kids is an 8 year old and did 'remote schooling' and managed to keep up with the regular curriculum just fine. The big difference is in the schools, not in the kids.
> All so that 75 year olds can have an extra month or two of average life expectancy?
Extra years. There's plenty of elderly with additional risk conditions who could manage and live with them for years w/o the extra strain of a poorly understood high-impact novel infectious agent.
But the idea that vulnerability is confined to the retired is wrong. Excess death stats are also up in the 45-65 range. And I'm personally acquainted with cases 45 & under people are already looking at severe lasting health effects and have been informed of COVID attributable deaths in that age range a degree or two out from my circle. This is unsurprising at a certain breadth of infection no matter the relative difference in risks for younger demographics. Very small numbers across very large populations = large absolute impacts. Let it burn through the population without suppression measures and it's not going to look prettier.
And that includes the economic effects. They're bad. But the idea that we could have chosen not to have them is false. Once contact takes on additional risks, some large portion of people stay away from contact underlying many economic activities whether there's civil direction or not, because all transactions are still cost/benefit. The only way to stop that would have been to totally suppress knowledge of the pandemic or have crushed the disease itself from the start. Distancing measures and other civil restrictions we're left with are basically a question of how coordinated activity is, not a difference in the order of the impacts. That kind of reduction happens when people are confident they're safe and they don't present a risk to those they care about.
Also, while everyone whose career has crossed the last crash or two knows it sucks, it isn't clear the impacts move beyond economic:
And while we're considering quality of life issues -- are we really saying that a year of public education is worth the tradeoff of having a parent or grandparent relationship? I think it's interesting that some of the societies that are doing much better than the West seem to have a culture of respect for the contributions elders make to their families and societies in general. I wonder if there's a connection.
And as for whether people should be moralizing: these are moral issues, which usually makes it a good time to do so. Apparently you agree, given that your own comment does. Which might even be appropriate if your moral case were the stronger one.
The problem is, covid has tons of indirect negative consequences on people's health. Folks overall stopped moving around and exercising so much. Tons of people with all kinds of medical complications stayed at home rather than receiving checks and treatment in hospitals. Imagine finding some lump on your body, but staying at home. Or missing regular health check.
Probably impossible to estimate how many people died because of this, and how many will have their lives shorter because they didn't get treatment earlier. Here at local cantonal hospital, this has been recognized as a big failure of general directions given to the population, and is a huge problem for old people.
Its far from the trivialization you make out of it about some kids missing some festivals and parties.
> A few months of not going to festivals and the cinema is by no measure a catastrophe. It's not fun, but suggesting that your right to fun should trump others' right to life is, again, uncivilized, immoral and irresponsible.
What are your thoughts on a state of permanent lockdown in order to eliminate the tens of thousands of worldwide deaths that occur every single year due to the common flu?
Perhaps life to most of the world involves balancing several factors, one of which is risk to personal health.
> What are your thoughts on a state of permanent lockdown in order to eliminate the tens of thousands of worldwide deaths that occur every single year due to the common flu?
Total lock-downs might not be necessary. From what I can tell, the working from home-thing pretty much stopped this year's flu epidemic; one of my customers talked about sick-leave being down by over two thirds since the pandemic hit. They've already changed their policies so that anyone with cold or flu symptoms are required to work from home from now on.
> Perhaps life to most of the world involves balancing several factors, one of which is risk to personal health.
No doubt about it. However, this pandemic has shown us that there are plenty of measures that can be taken without major disruptions.
Personally, I'm all for telling people with a sore throat and fever that they should stay the fk away from things like sports events, even if it's just a flu in that specific case. The only reason the flu does go around like it does is because we let it. We don't have to.
Keep in mind that years of life lost by dying sooner are actually a complete loss, while a year in quarantine is still partially lived. It varies a lot from person to person. If it was all about yourself, what do you think would be a reasonable exchange rate?
Economists and medical ethicists calculate that exchange rate as the quality-adjusted life year (QALY) metric. It was originally designed to provide guidance on medical interventions but the same calculation can be applied to public health measures.
It's not possible to calculate that exchange rate, because you don't have access to the counterfactual. You're not taking the ratio of lockdown years to years lost to deaths, right? Both of those belong in the expenses side...
Sweden didn't lock down, that is the typical worst case you would get. So lives saved is the deaths per pop in Sweden compared to deaths per pop where you are.
The picture you’re painting doesn’t represent reality — there were definitely lock downs (mostly related to elderly care, but also to varying degrees for the general public). People have worked from home since February.
You, as so many other, are ignorant about Sweden.
We have had rules about social distancing, visit band in elderly homes, social distancing and washing hands. And if possible, work from home.
Schools from age 16 are distance nu teaching, so are universitets.
All gatherings över 50 persons are forbiden and we are to told to not travel IF not needed.
We still uphold laws, so the government bor riksdag can force lockdown om People. But can close Stores and restaurants that doesn't follow rules.
And about Corona deaths, we are probably have more correct reports of deaths than many countries, like UK. Which probably are under reporting.
That based on all deaths reporter. The exccess deaths compared to previous five years are about the same as the reporter Covid-19 deaths.
And the över deaths in Sweden are in pair with Denmark, higher then Norway but lower that Finland and Scotland (yes, part of UK).
And Finland has Hard lockdown, so Scotland and Denmark.
Even IF you compare Copenhagen area with Skåne area (South part of Sweden) with about same population, the death rate reporter of Covid-19 is higher in Copenhagen. There are areas in Sweden that have lower death rates then Finland, on pair with Finland.
So No, you are basically ignorant of the death rates of Sweden.
And yes, death rates of Covid-19 in Sweden are still lower than some bad influenza years, like in 2000. Even through the population in Sweden was smaller then, total number of deaths in flue was Word. And letting children go to school was a good Choice, as Corona isn't pushed by children, many are better going to school then forced to be at home. And they are not loosing important time in school with their friends and some normalities.
And the all deaths are now down to under normal years. Most thanks to the changed in behaviour has almost erased the flue in Sweden.
Comparing total deaths data, without different rules to define IF deaths are Covid-19 or not, shows that the lockdown in UK, Denmark and Finland did not do much difference. Not compared to Sweden, with moderate and mostly informed population about how to defeat the spread of the Corona virus.
But, that isn't interesting to wrote about, I guess. As it could show that the lockdown is the only solution, that it also cost life and sufferings.
No, Sweden has an exceptionally low population density. You cannot just grab a country and take it as a model for any other country. The same measures as in Sweden would lead to a catastrophe in many other countries.
This is what happens is democratic societies with a demographic pyramid that's upside down: lots of old and relatively few young. Politicians want to get re-elected and cater to the largest, most influential voter group (old people) and disregard younger voters agendas.
> lots of old and relatively few young. Politicians want to get re-elected and cater to the largest, most influential voter group (old people) and disregard younger voters agendas.
I really don't follow your argument. Do you believe young voters are totally indifferent to the idea of seeing their parents and grandparents die?
It is not about old people, they don't want this either. If anything old people are a lot more conservative and libertarian. Once you are 82 you sure made piece with dying after all most people you grew up with have long passed.
It is more about catering to the sort of voter that is easily scared, exposed for the first time to the fact that life is indeed fragile and limited, a voter that looks at someone to protect them.
Old people are the pawns and "protecting" them is the spectacle of demonstrating competence in governing.
There's a standard way of looking at this, and in the US the answer is yes, the life of everyone is worth the same, and that's how other economic decisions are made in the US (e.g. safety regulations need to meet this same standard). Suddenly changing the way you value lives to suit a particular outcome for a particular decision doesn't seem right. If you are going to look into the economics you should consider not only deaths but costs of all other hospitalizations, long term effects and various other second order effects. (check out the recent Planet Money episode about the value of lives in the US and their discussion of whether or not the US should lock down, tl;dr economically yes by orders of magnitude).
Stuff like highway safety is done with a single cost per human life saved. That's fine there, since the cause of death isn't terribly sensitive to age (and to the extent that it is, there are effects in both directions--young people drive more and more dangerously, but are more likely to survive a given accident, so it partially nets out).
But like many diseases, the coronavirus is far more sensitive--the IFR for a 75-year-old is >100x that of a 25-year-old[1]. That's the reason why health care spending is near-universally assessed by cost per quality-adjusted life-year (QALY) saved. To do otherwise would yield absurd results, paying the same to restore a dying child to perfect health as to extend a centenarian's life by another month of agony. Around the usual ~$100k per QALY saved and counting both the deaths and loss of quality in severe but non-fatal cases, I believe that masks, social distancing, remote working where possible, and closure of the highest-risk businesses (theaters, nightclubs, etc.) until a vaccine is available are likely cost-effective, but facility closures beyond that are not (except to any extent required to stop the medical system from getting overrun).
If it kept my loved ones and other random people from dying, sure. Everyone optimizing for their own benefit only is bowing down to the altar of Moloch.
If you look at your argument without the "I bias", there is (or at least I'd argue there is strong empirical evidence for) a tradeoff between "lives saved [from Covid]" and "decrease in the quality of life" which IMHO is the argument of the OC.
No, considering that the past 6 months also mean my parents and grandparents stayed safe, which I actually care about a little bit. Not to mention my God-parents, uncles, and the well-being of my friends' relatives.
We live in a society, and Covid19 is not just a question of personal choices.
Not to mention, people who have defied quarantine orders and have spread this to their loved ones can become depressed and suicidal, so quality of life for many who would spread this disease will become abysmal.
That is the estimated risk of death, not the risk of becoming a carrier of the disease, possibly an asymptomatic one, who spreads it to others.
This is what's really frustrating about this whole "trade-off" argument: it's fine to make trade-offs for yourself, but you do not have the right to implicitly force your choice on others. If you sit within six feet of me not wearing a mask, my risk of falling off a mountain does not increase by any measurable amount. If you have Covid-19 and don't know it yet, the same cannot be said.
A grandparent might accept a 20% chance of dying, if it means regularly taking their grandchild to the park in the last few good years of life they have left. Most of the people at great risk of CORVID only have a few good years left.
Or, look at things like obesity or smoking or drinking (all of which might be getting worse - will people develop bad habits in quarantine?). People are willing to take risks (and overburden the health system) over lots of things, and we accept that the government shouldn't make it illegal.
Actually, why don't we just create quarantine safe old people's homes, and force them all into it? Then we can protect old people in quarantine, and let young people risk CORVID to build up herd immunity, then plunge the country into a brief elimination lockdown. It would be kinda inhumane to the old people we would be locking up (though people seem willing to take extreme measures anyway) but at least it would be quick.
Now tell this to the people dying painful deaths after a horrible battle on a respirator. Your death will not be in vain, because we prevented people from "losing" a year of getting frequent haircuts and going to events!
Human wellbeing is not fungible. It is not acceptable to let a significant portion of people suffer to prevent a moderate inconvenience to a larger group of people.
It's an argument you have to accept on some level, unless you propose to make more radical changes to society. How many thousands of people could we have saved from car accidents in 2019 by banning nonessential driving?
> unless you propose to make more radical changes to society. How many thousands of people could we have saved from car accidents in 2019 by banning nonessential driving?
I'm pretty sure that mandating driver's license to be able to drive, and passing laws and regulations to enforce the use and adoption of safety systems such as seat belts, air bags, and helmets, not to mention criminalizing wreck less driving, is a pretty radical change to society.
With covid19 all people is asked to do is wear a mask and practice social distancing.
No, in Scotland for weeks I couldnt visit friends, and still cant drive more than 5 miles for social reasons.
We could make those things permenant, it would really reduce road traffic deaths if noone could socially drive more than 5 miles, or drive to visit friends.
The official stay at home order where I live forbids me from visting my family. I'm ignoring that part of it - everyone I know is, at this point - but it's a much more severe imposition than the phrase "practice social distancing" makes it sound.
You do agree that a temporary emergency measure that is expected to take between a few weeks and a couple of months doesn't come close to compare with all the driving regulation, don't you agree?
I mean, Spain had to endure a couple of months of isolation and we don't see Spaniards complaining that it's the end of the world.
At a fundamental level, yes. By degree of magnitude not even in the same galaxy. If you take a 200 million mile road trip you might contribute to one death, vs. going to a party and risk contracting and spreading a pandemic that has has already claimed hundreds of thousands of lives.
Remember, the game plan that virologists came up with for COVID acknowledged that most people will get it eventually. The point of the lockdowns was not to eliminate spread, which is impossible, but to not overwhelm the system.
And also to provide time for treatments to appear, with the eventual prospect of a vaccine.
And also to avoid panic and shortages of essentials caused by mass avoidable deaths and work absenteeism, both of which would have been the inevitable and predictable outcome of attempting to carry on as normal.
IMO the argument is already over. In fact there shouldn't have been an argument at all. There was never a rational case for trying to avoid lockdown, or failing to test/trace, or setting up other basic mitigation measures - either on humanitarian or on economic grounds.
> In fact there shouldn't have been an argument at all.
This is an awful way of thinking.
> There was never a rational case for trying to avoid lockdown
This is untrue. Many virologists and epidemiologists made rational cases against lockdowns. Sweden followed the strategy of Anders Tegnell, who is a renowned epidemiologist. The case for or against lockdowns was ultimately decided by the perception of public opinion, with politicians trading off the risk of "having done too little" versus "having done too much".
The New York times is spinning a narrative that Sweden, because of no lockdown whatsoever, had a really bad outcome. It's just not true. The amount of deaths controlled for population is lower than in Spain, France or the UK, all of which had a total lockdown. Their current fatality cases are near zero. Their economic contraction is half that of the rest of the EU.
First of all no, not lower than France's, but it was much lower for a while. Secondly, their economic contraction might be somewhat less, yet the death toll compared to Norway much higher, which did not suffer much worse economically. The question boils down was it worth for a modest economical benefit allow 5000 people to die or not. Some people think it is okay, most do not.
> Secondly, their economic contraction might be somewhat less, yet the death toll compared to Norway much higher, which did not suffer much worse economically.
This is cherry-picking. You can always tell if somebody is making a bad argument when they pick Norway - a sparsely populated oil-rich welfare state - for a comparison.
> The question boils down was it worth for a modest economical benefit allow 5000 people to die or not. Some people think it is okay, most do not.
No, that's an oversimplification. You are assuming that the lockdowns could've prevented these deaths, yet we have other countries that had strict lockdowns and that had similar death rates.
You also have countries like Germany and Netherlands with modest lockdowns and lower death rates.
There are a lot of factors at play here and the numbers are all over the place, but there is no evidence that lockdowns actually do better in the long run. Part of the problem is that most countries did do some form of lockdown, so Sweden is one of few in the control group.
No, comparisons with Norway are just a pet peeve of mine.
It doesn't really matter anyway, I already admitted that countries like Germany and Netherlands did have fewer deaths with modest lockdowns. These are samples in favor of a lockdown.
However, there are also countries like France, Spain and UK that had the strictest lockdown, yet they had higher death rates. Those hint at strict lockdowns being no more effective than modest lockdowns when compared against Germany, or even being completely inneffective when compared against Sweden.
There is no clear correlation between having a lockdown and having fewer deaths, so you can't claim that Sweden would've had a far different result with a lockdown. That's just an unknown, there are many more factors at play.
Also, the costs aren't just economic. Lockdowns are a severe restriction of civil rights. There's a great deal of suffering caused by lockdowns. They can destroy livelihoods. They limit medical care. There's more domestic violence, more suicides, more depression.
Unknown, but highly probable. It is like saying, yea it is unknown if you press the light switch and the light would turn on. Unknown yes, highly probable - yes. Lockdowns have been since medeival times and always turned out to be a working soluction.
"Everyone gets COVID" is not an unavoidable eventuality. The spread of the virus can be attenuated enough so that it a decreasing amount of people, and eventually a vaccine can be developed.
The plan is/was also to understand it, find effective protocols for managing it, etc.
(And we also have pretty good chances of coming up with a vaccine in about 1 year.) It's not "just the same amount of death, but slower, so the crematoriums don't get overwhelmed".
...pretty good chances of coming up with a vaccine in about 1 year.
This is just wishful thinking. We've never had effective vaccines for this sort of virus. (The yearly flu vaccine is like 30% effective.) Sure lots of research groups are working on vaccines, but many of them are academics who have no particular duty to work on research likely to have an immediate payoff. The researchers who do have such a duty, i.e. those who work for private drug firms, are mostly developing treatments like the antiviral remdesivir. Effective treatments of various sorts are closer than any vaccine, for COVID-19. IMHO, the most likely eventual winner will be a scaled-up version of the convalescent plasma therapy, which unlike the current version will be able to produce effective antibodies without drawing blood from humans.
At least one phase 3 clinical trial is about to start this month. I too am surprised that the one year estimate is not complete nonsense, but it seems it's not. (Of course the mRNA vector might simply not pan out, but there are still others currently undergoing phase 2.)
Efficacy is always a question, sure, yet it seems the spike protein is stable (conserved across mutations).
If the mRNA stuff works well then it'll likely work for the flu too. (It be easy to pack one shot full if flu strains.)
My understanding is that the spike protein already mutated in the human population, some time in January or early February. Researchers who started work on earlier samples had to start over because the later spike protein version has such superior fitness that it has largely replaced the earlier version in the wild.
So, stability over e.g. a month doesn't guarantee stability over longer terms.
> Covid (any vaccine based treatment really) is even more difficult as you need to wait for six months to assess transmission.
Technically, you don't. There are volunteers ready to get infected with SARS-CoV2 and I wouldn't put my money on "ethics" standing in the way in this case.
It also completely ignores the knock on effect of increased poor health due to COVID. Organ damage leads to reduced quality of life and economic output.
Studies like this show that this is a false choice, there is no real option to 'choose the economy' for example. As we saw from studies of the Spanish Flu, cities with late and light lockdowns actually suffered more economically than cities that locked down earlier and tighter because the effects of an un checked (or less well managed) outbreak that lasted longer were so devastating. More people sick and dying is a huge drag on activity, including all the people that have to look after them, and people self-isolate anyway out of fear. Pandemics like this are a juggernaut, there's no real option to ignore and carry on.
can we get past the deaths anyway, like 20% of people are going to have weeks if not months of below average capabilities plus some unknown percentage of lung damage.
Everyone keeps forgetting this is a NOVEL virus, between rare severe impacts to children, there have been neurological any circulatory issues so saying it only matters to the people who die I think is ludicrously naive.
Where did the virus come from? How did it arise? Is it deadlier than we realize? Will it remain what we see now? Does it target specific populations? Do children have unexpected long terms side effects of having it? Will it wipe out the entirety of the elderly if we allow it to circulate? Will people get reinfected by it after a short time or long time? How rapidly will it mutate to become deadlier? How rapidly less so? How many will die in the meantime?
There too much unknown to dismiss what this disease can do.
New Zealand hasn't even begun dealing with Covid-19 yet, unless their plan is to keep the borders closed permanently, or at least until the development of the first vaccine in history for any coronavirus.
They are probably the farthest away from reaching herd immunity of any developed country.
Their plan is to require a strict quarantine for all arrivals from overseas. That will be permanent, at least until an effective vaccine is available. It may work, at the cost of their tourism industry.
At age 65 (or any age) I'd evaluate my risk and modify my own activities. I wouldn't even dream of asking others to give up their work or school or favorite activities because of my own frailty.
Not sending kids to school is about keeping the teachers, administrators, and their dependents and contacts safe. It's about grandparents who care for the children and would be at risk. I don't think it's about your mom.
You asked a wrong question. You should have asked if it is ok if all her friends, all the neighbors in 60s and 70s, all the sick people of younger age, all the doctors in emergency rooms, all the people who need a surgery, but cannot get because ERs are full are under the risk, just because some 20 y.old dude wants to go to the beach.
People smoke, drink alcohol and do drugs. Those are much much worse than covid for your health. Sweden will still have much higher life expectancy than Denmark and Finland this year even though they got higher covid deaths since Sweden is much better at policing those drugs.
In 2000 the overall total deaths was actually higher then Corona this year.
That even though the population was smaller back then. And a few years earlier it also was a be ad flue year.
Actually the current death rate are lower for last month then the mean value of previous 5 years same month.
But I guess that doesn't fit the common view of how it should be in Sweden.
Nor that the total death rate are in pair with Denmark and lower then Finland, with much harder lockdown.
The Dutch think of their healthcare as the Brits think of their NHS. It's more faith than fact.
I find it impossible to have a reasonable discussion on the subject, even people in healthcare (I worked in a famous Dutch hospital). People are dug in, evidence-based medicine is a tool to improve statistics first, patient care second, and nobody knows what anything actually costs, despite the national DBC-accounting system which was invented for insurers. Hint: not even the Dutch statistics bureau can tell you what the total cost of Dutch healthcare is. I've heard this is very politicized issue, all behind the scenes of course.
I think the NHS was at one point very good, especially in terms of price/performance ratio. What you see now is the result of over a decade of governments that have a fundamental antipathy towards any kind of public service, and who consider the NHS as an obstacle that must be torn down before a more private system can be established. The difference in quality of care is visible, and the policies the system must work under essentially amount to sabotage.
You cannot know that until after the pandemic is over.
The Swedes are betting that nobody in the world will be spared from COVID and therefore the delta in deaths is temporary. They are front-loading it while attempting to keep the economic impacts as low as possible. They anticipate the rest of the world will be contending with shutdowns, re-openings, shutdowns, re-openings, and when all is said and done, the death rate per capita will be the same the world over.
So far, they the Swedes have bet one way, much of the rest of the world has bet the other way. Time will tell, but it is much too soon to make that judgment today.
They haven't seen any benefit to their economy compared to other nordic countries at all.
Partly because they are export dependant and nobody's buying & partly because enough swedes are staying home (not going to pubs etc.) for the economy to tank but not enough to avoid 10 times as many deaths as their neighbours.
So, yes, time will tell. But for now they are getting the worst of both:
Sweden hasnt any had any hospitals overwhelmed. they're just front loading the deaths that every single other country is going to have but is just delaying.
A vaccine in the next couple years is not unthinkable I'd say.
If you have a look at the current infection rate in a lot of European (and others) countries, even reaching 50% of the population infected would take decades.
So yes, I believe that delaying is not the only possibility.
I've posted elsewhere but my wife (40yo and in great health) has been suffering from a range of issues since her infection over 100 days ago. She cant climb stairs without getting out of breath. Her covid symptoms for the first two weeks was relatively mild. She is in a Slack group with over 7000 others. Predominantly women over 40 or men 2o to 50. All with serious long term issues after getting covid. It is a small number, but not small enough to wave away.
Yep but to be fair that isn’t a younger age group. Broadly speaking under-20s are pretty much unaffected. 20-40 aren’t particularly affected either if in good health and without comorbidities. 40+ can be quite seriously affected and over 65s it’s a double digit risk of death. It’s super non-linear.
It seems speculatively like this is due to age-linked expression of ACE2.
Two young people I know here in Stockholm have had complications: my team lead (who is in his mid-thirties) had an embolism in his lung after covid. He now has to inject blood-thinning medication twice a day. We’ll see how this works out for him.
I would argue a decent metric is human hours. For example, if a safety protocol costs n people x hours in return for saving y lives, then we can strike a balance. In general I'd argue that n * x ~= y * (human life expectancy in hours).
You could apply this to things like airport security and check how the sum of all the time passenger spend in line compares to the lives saved. My guess is especially in the airport example the lines have taken more human life than terrorists.
That isn't really how terrorism works though is it? 'they' want the population to be fearful doing normal things - it isn't just the life lost but the changes in behaviour people have to make.
Similarly if I died of covid now, it isn't just the 40ish years of life ahead I lose, but the impact on my wife, children and wider family. I've seen friends lose 72 yo grandfathers - who could have provided years ahead of fun and good memories with their grandkids.
Any death is unacceptable. This is, of course, unattainable in practice, so I would suggest looking at Eastern European or East Asian societies for a rule of thumb (e.g. Czechia, Slovakia, Greece, Taiwan, South Korea, Vietnam etc.).
This is not how society works. We could drastically curtail the number of deaths by outlawing cars, alcohol, and social interaction indefinitely, regardless of covid, but we don't. Refusing to understand that tradeoffs are involved is not helpful.
Also leads to undesireable conclusions. If the metric is minimize death, best way to achieve this is kill everyone alive today, or at least sterilize them. Everyone alive today will die someday, guaranteed. If they do not have any kids, there will be consequently be no further deaths. Same outcome for all sentient life. If minimizing suffering is the ultimate meteric, then the optimal solution is elimination of all sentient life.
While not explicitly specified, my comment was referring to deaths caused by the coronavirus. If you read past the first sentence you will also notice that I explicitly said that this is an unattainable standard and I have provided a number of countries that can be taken as reference for what an acceptable death rate might be.
Some deaths are caused not by the coronavirus itself, but by the lockdown. Suicides, as well as consequences of foregone or delayed diagnostic tests and other medical appointments, for example. In the US, where unemployment often means no health insurance, many thousands of lives are lost per percentage point of unemployment. I'm the third world, you've got future deaths due to foregone immunizations. So the goal is not minimizing Covid deaths at all. The goal is minimizing deaths, and it's not at all clear that going into max lockdown mode in fact minimizes the sum total of deaths.
Also, how many elderly people have died due to flatten the curve procedures that sent positive cases back to nursing homes to free up hospital beds for younger patients? An enormous percentage of the US deaths were nursing home occupants. It is precisely the lockdown procedures that have resulted in such high death rates. This is the huge uncovered scandal of the pandemic response.
from an high level/abstract point of view, all deaths (I am now specifically referring to the coronavirus, but this works for deaths in general) should be avoided. This is obviously not possible in practice, hence some deaths have to be accepted. What can be considered acceptable is relative, but it helps to look at the countries that have managed to keep their deaths low and take their numbers as a yardstick for other societies.
I think it was the wording. You said not acceptable and acceptable for the same exact thing. In this last post it was all deaths should be avoided, but that some deaths are acceptable. I think everyone can agree that all deaths _should_ be avoided, and probably those same people would agree that it would be impossible to attain that goal... specifically for Covid.
The inclusion of Vietnam on these lists always surprises me. There is no excess mortality data for Vietnam, nor any data on infections (e.g. from random population sampling). All we have is their self-reported number of cases (i.e. confirmed infections) and deaths (zero!), which come from triumphant news releases from the Communist Party (usually paired with reminders about how great this success will be for their economy in the post-COVID world), repeated with zero critical thought by overseas media.
- Nobody knows if there was some excess mortality here, because there's no monitoring.
- There were thousands of "suspected cases" in the official reports, which remained suspected cases and never progressed to a confirmed case or a confirmed non-case (as they would if they were tested) until they stopped reporting numbers.
- People with confirmed close contact with known cases were told to isolate and were only tested if they showed symptoms (this is also normal practice in many/most Western countries).
- The supposed "large" number of tests carried out in Vietnam represents only 0.2% of the population.
- A significant portion of those tests are of people who had to be tested anyway, rather than community testing (e.g. overseas Vietnamese arriving home; the large number of charter flights that were allowed as exceptions from Korea and other countries, for employees of large firms with factories in Vietnam - e.g. LG - who did not stop during the lockdown).
- The lockdown was largely not enforced, and while streets were much quieter than usual, there were many people outside throughout. Smaller bars and restaurants only closed for a few weeks, and of course nobody wore a mask inside them. Many informal businesses (e.g. street food) never closed.
I think Vietnam's "success" is largely down to some environmental factor (average temperature/humidity, sunlight exposure, the general "outdoor" way most people socialise) keeping the number of infections or the severity of those infections down, and I think the chances that COVID caused exactly zero deaths are almost zero.
> if you fail to self isolate, you go to a gov’t camp
There are a few instances of this, which of course the govt made sure were widely reported. It's very unlikely in general that they would know, though.
> all int’l flight have been stopped; only repatriation flights are happening
This is completely false, as you can verify on any public flight tracker website. The number of flights is greatly reduced, but they never stopped. Also, extra charter flights were put on for (at least) Samsung and LG employees to come from Korea, regularly, even in the middle of the lockdown. The "all international flights stopped" line was repeated many times in the local media, and most people here believe it, despite it being untrue.
> for those foreigners who made it in before the flights stopped, they all went to gov't facilities
Not true at all, I know many people who did not have to.
> if someone tests positive, they will lock down all the people around them for 24hr, disinfect common areas and test
They notify the people around them and tell them to self-isolate. They spray some bleach around. They do not test unless symptoms are shown.
Maybe there is a bit of variation across Vietnam? I’m just sharing what my in-laws observed where they live.
When I say “all international flights” stopped, I mean, you can’t just hoop on the next flight to Vietnam. Yes, there are still repatriation flights happening and flight for certain purposes, but “normal” air travel has stopped, no?
So regardless, would you agree that Vietnam is going far beyond a lot of countries in trying to control the spread?
> Maybe there is a bit of variation across Vietnam? I’m just sharing what my in-laws observed where they live.
Perhaps. My experience was with HCMC and Hanoi.
> When I say “all international flights” stopped, I mean, you can’t just hop on the next flight to Vietnam. Yes, there are still repatriation flights happening and flight for certain purposes, but “normal” air travel has stopped, no?
Actually, there were normal, scheduled flights throughout the lockdown. There are right now, there were last week, and there were every week before that. You can trivially confirm this on a flight-tracking website (one of the ones that goes on the ADS-B data, so you see actual aircraft tracks, rather than just a flight schedule website which may show you flights that didn't actually operate). Visa waiver, visa-on-arrival, e-visa and visa issuance for tourists completely stopped, so in practice a tourist can't board a flight to Vietnam, but a small number of flights have continued running throughout, indicating sufficient demand from people who are able to fly here (Vietnamese citizens, people with residence permits, people who were able to get issued non-tourist visas in their home country, ...)
> So regardless, would you agree that Vietnam is going far beyond a lot of countries in trying to control the spread?
I'd say they're pretty much on par with any of the places that aren't a massive failure. But I also think the question of which country did it better or worse is not very interesting, and mostly a pointless political distraction from useful questions like which control measures have a meaningful effect and which don't.
Agreed that it certainly can feel "fluked" or random which areas are overwhelmed and which recover, but I have to disagree with the idea that Vietnam didn't take it particularly seriously.
I was there in February, for around a month.
As a foreigner, I was regularly receiving SMS updates about covid infections. There was a website which detailed exactly when and where people were testing positive. Hotels and guest houses, if allowed to remain open, were being closed for deep-cleaning.
Buses and trains were stopped and my temperature checked, towns and islands were quarantined where someone tested positive, contact tracing appeared to be in full force and foreigners were requested to register their movements and check in daily(iirc) to a web portal.
Again, this was in mid-February.
Luck and climate seem to be factors, but Vietnam acted when they had a low caseload and handled outbreaks sufficiently well to keep R below 1. It wouldn't be all that surprising to me if there really were no covid deaths there.
I was curious. Not very convincing data. Mortality has gone down in Sweden in the long term so covid is not actually a big deal? I don’t see the connection
This is not to say however that the Swedes have done a good job. While their numbers are credible, their magnitude is still unacceptably large: 0.5/1000 Swedes have so far died of the corona virus.