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Most people should be behaving normally with some added protections (like washing their hands), and those who are at high-risk should be protected. You would t
by btilly 7y ago
Most people should be behaving normally with some added protections (like washing their hands), and those who are at high-risk should be protected.
You would think, but you would be wrong.
Here is the fundamental math. There is a number called https://en.wikipedia.org/wiki/Basic_reproduction_number https://en.wikipedia.org/wiki/Basic_reproduction_number which is how many people the average infected person infects in turn. If that figure is above 1, the epidemic spreads and some nontrivial fraction of the total population will get sick. The exact number who catch it is impossible to calculate since the relationship between the basic reproduction number and how many people eventually get the disease is chaotic.
But if that figure can be reduced below 1, the disease dies out on its own. It took draconian measures, but this is already happening in China.
Public health officials have a variety of strategies available depending on the situation. But the choices from most desirable to least is as follows.
1. If possible, get the basic reproduction number below 1.
2. If not possible, encourage at risk groups to get extra protection so that as the disease sweeps through, as many as possible don't get it.
3. Be overwhelmed.
The current strategy is focused on the first option. As noted, the basic reproduction rate is already below 1 in China and the disease is dying out there. If it escapes, the second option will be tried. But an epidemic that hospitalizes 20% of victims and kills 3% will, if we accept #2, leave us quickly at #3.
And as much as a temporary slowdown of the economy loses us all, figuring out how to some up with a reasonable substitute for hospitalizing 20% of the country when we don't have medical staff (knowing that a failure to figure it out will result in much higher casualty rates) will have much greater economic impacts.
It turns out that we can quantify it. Based on https://www.theglobalist.com/the-cost-of-a-human-life-statistically-speaking/ https://www.theglobalist.com/the-cost-of-a-human-life-statis... it is reasonable to say that we value a human life at about $8 million. If half of 327 million Americans get sick and (as current rates have it, 3.7% of them die, the economic impact is about $48.4 trillion. That is about the same as the US economy for 2 years. If losing 1/4 of our economy for 6 months, and then suffer similar economic damage on the path to recovery, gives us even odds of preventing this, we absolutely should panic.
And, as China demonstrates, it IS still possible to prevent this outcome. It will take heroics. But it is possible.
- nostromo 7y agoThe current fatality rate is not 3.7%. The New England Journal of Medicine suggests it may end up being much less than 1%. https://www.nejm.org/doi/full/10.1056/NEJMe2002387 https://www.nejm.org/doi/full/10.1056/NEJMe2002387 > it is reasonable to say that we value a human life at about $8 million We're talking about the very elderly dying a bit earlier than they would have otherwise. Before you accuse me of being heartless, I agree that that is indeed sad and worth mourning. But, no, it is not the same economically as a working-age person or younger dying in large quantities. And keep in mind it's March, and flu season will naturally be on the decline this month.
- btilly 7y ago3.7% is the measured rate in China. Which has the best available data set. Which is why I used it. The CDC has consistently concluded that the real rate will be somewhere in the 2-4% range. There are admittedly researchers who think that cases are severely underreported. However data from other countries has been in line with the Chinese experience. If dramatically more get it, those dramatically more seem to also be less infectious. Given this, it is better to act on the higher end of evidence based estimates and to have possibly overestimated than it is to believe on the low end and find that a higher figure was appropriate. But even if you disagree with that reasoning, dropping all of my figures by a factor of 4 still comes up with figures that justify truly shocking disruptions to our lives. And the basic facts about epidemiology that I gave are still worth understanding.
- nostromo 7y agoYou are wrong, that is one of the worst data sets to use, because of so many unidentified cases. Again, see the NEJM: https://www.nejm.org/doi/full/10.1056/NEJMe2002387 https://www.nejm.org/doi/full/10.1056/NEJMe2002387 Or any of the better data sets: On the Princess Cruise, a naturally controlled study, the death rate was less than 1%, with a cruise full of old people. Non-Wuhan death rate in China, where more mild cases were identified, ended up being 0.7%. https://www.livescience.com/is-coronavirus-deadly.html https://www.livescience.com/is-coronavirus-deadly.html Goodness, there are so many chicken littles on HN nowadays.