8 ms·

Coronavirus pandemic takes hold, we are making decisions without reliable data

80 points by cyrksoft 7y ago

zw123456 7y ago
Are we sure that the economic damage of the shutdown of the world economy out weighs the heath risks of the virus. Are we in group think here? A major recession/depression means a lot of people go hungry, lose access to medical care etc. Does anyone know of studies or research that looks at the health impacts of a shutdown vs. the health risk of the virus ? Just asking questions. I keep asking this question and I get no response from anyone. This smells like group think. Are we not able to discuss such questions ?
- vondur 7y ago
  It does seem that we have blindly followed the Chinese's government's response to the outbreak without any real data. I'm guessing there may be large numbers of people who are affected who aren't really showing any symptoms other than typical cold/flu symptoms.
  - steve_adams_86 7y ago
    > without any real data The trouble is we can only get "real data" by testing more people. If we test more people we will almost certainly discover the numbers are worse than they appear now. All that is to say that the situation can only be worse than we already know. I'm not sure more data would lead us to isolate less at all. You might be right that there could be large numbers of people with the virus who are doing just fine right now, but we know from nearly 200,000 cases (that's plenty) that a non-trivial portion of cases require hospitalization. That's the whole problem, right there. So we know hospitals can be overwhelmed and a LOT of people die for it. Healthcare workers included. We know the situation is probably worse than it looks, but we won't know how much worse for weeks yet. So without real data, it seems to err on the side of caution is absolutely essential. This can bring countries to their knees within weeks, and it has. What would you propose we do without real data?
    - parineum 7y ago
      >You might be right that there could be large numbers of people with the virus who are doing just fine right now, but we know from nearly 200,000 cases (that's plenty) that a non-trivial portion of cases require hospitalization. That's the whole problem, right there. You're not applying the logic all the way through. If a great number of people are already infected and do not require hospitalization it grossly affects the math on the potential for overwhelming our medical system. Those infected people unnoticeable to minor symptoms have the potential to be the herd immunity we'd want from a vaccine. > All that is to say that the situation can only be worse than we already know. I'm not sure more data would lead us to isolate less at all. More infected people who are unnoticed because they don't show severe symptoms and require hospitalization actually makes the situation better. It would lower the hospitalization rate and alter the projections drastically in the direction of less epidemic. We are being cautious right now. That, by definition, means we're likely overreacting.
      - travisporter 7y ago
        I was wondering if there’s an efficient way to screen a large population with low prevalence with limited tests. I’m thinking of the 1000 prisoner wine riddle with one drop of poison if that rings a bell
      - steve_adams_86 7y ago
        I thought that, but then how do you explain situations like Italy? Such a tremendous number of people are suffering.
    - oldgradstudent 7y ago
      > The trouble is we can only get "real data" by testing more people. We get "real data" by properly testing, not necessarily by testing more people. Currently we are mainly testing people arriving with symptoms. This results in underestimate of the number of infected and an overestimate of mortality and morbidity rates.
  - oefrha 7y ago
    “It won’t happen here.” “It could happen here, but it’s not a big concern.” “It’s happening here, and it’s a big concern, but we don’t have reliable data so let’s do nothing.” “We have reliable data now, but it’s too late to do anything.”
    - teh_infallible 7y ago
      Are you quoting people from an actual conversation, or setting up a straw man to justify draconian actions based on limited data?
      - travisporter 7y ago
        While data is limited, the basic premise of viral spread and quarantine is nothing new or ineffective. There is no doubt there is exponential growth, and limiting that would be effective sooner than later health and economy wise.
        spookthesunset 7y ago
        Is the growth of testing also exponential? Cause if it is, than it follows the confirmed infected will also look exponential even if the underlying actual growth number is totally different. You can make anything fit an exponential curve if you try hard enough.
        sershe 7y ago
        There is no data as far as the latter is concerned. The current data (Fed actions, pronouncements of 18mo shutdowns, recession worse than 2008, etc.) is to the contrary. What, really, is the economic impact of virus deaths after exponential growth quickly bumps into population size and lots of mostly non-working people die? Nobody even tries to answer this.
    - PeterisP 7y ago
      Are you suggesting the four stage strategy? https://www.youtube.com/watch?v=nSXIetP5iak https://www.youtube.com/watch?v=nSXIetP5iak
  - dragonwriter 7y ago
    That is incorrect. The US, UK, and others were taking a mitigation strategy until the last couple of days; the change wasn't driven by delayed blind copying of China, but by this analysis, which was shared with governments as a WIP before being published: https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf https://www.imperial.ac.uk/media/imperial-college/medicine/s... There may be legitimate criticism of the broad policy approach, but “blindly following China” isn't one of them.
- naner 7y ago
  The problem is not so much the health risk but the overwhelming of healthcare systems and lack of supplies. This isn't a theory, we already know the outcome of not slowing down infection rates fast enough (China, Italy, etc).
  - mokarma 7y ago
    So why aren't we scrambling to build more hospitals?
    - NhanH 7y ago
      Doctors and nurses is the big cap alongside equipments and rooms.
    - jsight 7y ago
      And why aren't we scrambling to get our factories making masks and other basic supplies?
  - sershe 7y ago
    That doesn't answer the question though. Ioannidis addresses the worst case scenario. Lack of supplies, also, is made much worse by closing factories and tanking economy in general, as well as e.g. cancelling blood drives (a real case from King County), none of which are caused by the virus.
- reilly3000 7y ago
  I think the economic damage will be so remarkable that nobody will go hungry. We are seeing unprecedented pro-social behavior and legislation. Social safety nets are born out of crises.
  - nostromo 7y ago
    I see panic hoarding and empty grocery stores and laid off people worried about rent. And it’s been two weeks.
    - cvlasdkv 7y ago
      Forcing the government to act as our economic and political structure reveals itself inadequate in the face of a national crisis _is_ what will spur legislation. Hopefully smart forward-thinking legislation.
- cma 7y ago
  I think it outweighs the economic damage. But aside from that, we need the capability to hit the pause button on the economy during similar future events. What if for example a more extreme one in the future threatened to kill 10% of the population and required a significantly longer lockdown. By having a dry-run (in comparison) now, we might be much more prepared.
- secretsatan 7y ago
  How many people dying is acceptable to you?
  - teh_infallible 7y ago
    Do you mean as a result of the virus, or as a result of losing their livelihood and being plunged into poverty?
  - mns 7y ago
    I'm afraid that on the long term, the social unrest and the economic consequences will far outweigh the damage done by the virus. There is no plan on how long you can shut down whole countries. Europe, for example is not like China, you are just locking down everything, you don't have any other regions to support you. Sure, some people can work from home now, but by having the economy run at minimum level, work will go down, there will be no more projects even for IT people. How many people are losing their jobs already, what will happen if we need to quarantine ourselves for another 6 months to flatten the curve, if jobs are cut after just 2 weeks? I might have enough saved to be able to live not working for a couple of years, but I don't think that will help me if the entire social order is collapsing.
    - thda 7y ago
      > I'm afraid that on the long term, the social unrest and the economic consequences will far outweigh the damage done by the virus. I'm french. I have italian friends. I don't care about the economy. It will be back up. As long as there are humans they will need goods. > there will be no more projects even for IT people. Sure. But let's put it in balance for France: - less work for IT people - 350K deaths I vote for number one. I can't believe I'm reading that on this forum, where people are supposed to be educated. This is insane.
      - sershe 7y ago
        "I don't care about economy" I didn't know I'd ever say this, hate these words, but this is privilege talking. Look at life expectancy chart for Russia in the 90ies. This was mere economic mismanagement, and it's far worse than the worst case virus scenario. In some countries, unemployment and economic mismanagement leads to civil wars, revolutions and dictatorships. Sure, techies in democratic/democratic-socialist first world countries will be probably fine in bad economy, if my experience in the great recession is any indication. A chance to buy cheaper stocks, too! However, even in a mild recession hundreds of millions (at least) will suffer. I'd choose 350k deaths. EDIT: Come think of it, if you could completely mitigate one historical event in Europe, would you go for Spanish flu (millions of deaths!) or Great Depression (mere economy, of no consequence)?
- lowdose 7y ago
  I second this it seems more and more like massa hysteria. 8.000 people died on 7.7 billion people. Its crazy to pull the handbrake on the economy. 99% of the people that died were going to be death in a year or 2 anyway. Have you heard about that school class full of 6 years old kids in Italy that died last a week? Didn't happen but when it happens we do not have this options anymore. Old people die and thats life.
  - hatenberg 7y ago
    This talk at the start of an exponential curve is exactly the problem
    - spookthesunset 7y ago
      I wonder how many people are fitting the “how many people are tested” to the same exponential curve? If there is exponential growth in the number of tests given, it follows there would be an exponential growth in number of cases detected.
      - jsight 7y ago
        That is absolutely true, which is one of the reasons that it is surprising that the curve isn't any higher than it is.
  - ornornor 7y ago
    The problem is that so many people are ill or die within a very very short window instead of being spread out as it is before the epidemic. From a purely selfish point of view, assuming the disease will be a minor inconvenience to you because you’re young and healthy, there are other things to consider: - what happens to your (presumably much older) parents when they get sick? Death is a very real outcome there - what happens when you have a car crash and need intensive care but all hospital beds are full and there are also younger patients than you to treat with a better outcome? You’re triaged lower priority and may not get the care you’d normally get or survive at all For perspective, there really aren’t that many ICU hospital beds altogether because the usual number of people who need intensive care at any given point in a city of millions is in the hundreds (maybe low thousand?) Once the exponential nature of the epidemics hits and there are thousands of people who need care right now on top of the usual load, then it’s like in Italy where some are left to die just because choices must be made and there are either healthier victims with better prognosis.
- unionpivo 7y ago
  Because the answer is, we wont know for sure until it's over. But you can lessen the impact on economy help with bring it back, western countries produce more than enough food to make sure nobody starves (if they want) If you leave covid 19 unchecked it will overwhelm your medical system anyway so even more people would loose access to medical care. So the choice comes down to, hope that worst case (italy++) wont happen and carry on, or try to do something. And you cant get away with bulshit pretending that you are doing something when you are not, because people suddenly listen to scientist and doctors, when their ass is on the line. Unsurprisingly we choose to do something. Additionally given that in west most politicians are elected, and that most reliable voters and donors for political campaigns are from age group most affected by this virus, decision is even more obvious.
- aaron695 7y ago
  What is the value of a human life in the West? My figure is $2 million. Then a billion $ is 500 lives. A trillion $ is 500,000 lives. This is how I rate it. What is your figure on a life? And how would you relate loss and gain of $ to buying / destroying lives? The discussion changes when you leave the West, so start there.
  - csharptwdec19 7y ago
    I remember that the author of XKCD dug up that the EPA puts a human life around 8.4mil.
    - aaron695 7y ago
      https://what-if.xkcd.com/96/ https://what-if.xkcd.com/96/ Sounds ok. I think it's less, but it's the same for this calculation. Do people even get trained in napkin math anymore? Wiki is very limited on the topic- https://en.wikipedia.org/wiki/Back-of-the-envelope_calculation https://en.wikipedia.org/wiki/Back-of-the-envelope_calculati...
  - sershe 7y ago
    Don't forget about the age of deaths here. Divide the above by life expectancy at birth, then multiply by life expectancy at death from the virus. And possibly weigh by decade, I'd probably trade another decade of my 20ies over e.g. 80ies (not that I've been there). AFAIK /the average/ age in Italy is pushing 70.
- currymj 7y ago
  it seems like this is the response from most people everywhere about until their region hits the knee of the exponential curve. this pattern played out in Italy, Spain, France, and now the US. the Imperial College paper estimates 2 million dead in the US with no response and ~1 million dead with a limited response that doesn’t involve a full shutdown. That paper explicitly doesn’t consider the very severe economic impacts but it’s hard to imagine that deaths on that scale aren’t worse than whatever they might be.
  - beatgammit 7y ago
    ~1 million is the current annual death rate in the US (~0.8% last I checked), and the disease kills older people much more than younger people. How many of those 2 million would have died anyway in the next couple of years? How many would have contributed to the economy over the next few years? How many of those who will die from a recession would have contributed to the economy? These are tough questions, but I think they're worth answering so we know what we're really gaining by shutting down the economy. I know we want to save as many lives as possible, but we should also know the cost too.
    - jjeaff 7y ago
      Another thing to note is that the virus will overwhelm emergency rooms world wide and deprive many other patients of adequate care that will cause some unnecessary death. So it isn't just virus deaths you have to factor in.
  - spookthesunset 7y ago
    Those estimates are based on constantly changing data. And “exponential curve” means a lot of things. We are just now starting very limited testing in the US... what do you want to bet the number of tests given follow an exponential pattern just by nature of how they are deployed? If your test deployment is exponential your infections is gonna look exponential even if the underlying data isn’t... at least for a little while. You can curve fit anything if you forget about the bias in your data.
  - oldgradstudent 7y ago
- antman 7y ago
  It has mostly hit Europe and Asia where people don't lose their medical care. And in general we don't expect them to leave their people hungry. Also there is no econonic model of millions of people dying in a few months so governments opt for the safer choices. Most governments at least.
- jsight 7y ago
  Yeah, when I ask that question I get responses "how many people do you want to kill, because of course health comes first!" I haven't seen much of what I consider to be reasonable analysis. I suspect this will be analyzed for years to come.
Waterluvian 7y ago
Acting without reliable data reminds me of war. And that got me thinking: is this the closest exposure to "Total War" that any living generation (except the greatest generation) has experienced? It's not like recent wars that can be ignored by shutting off the TV. This captivates all of us and is becoming impossible to ignore.
- deleted 7y ago
  [deleted]
- redis_mlc 7y ago
  No, as I wrote another day, polio, the Cold War, the meth/crack epidemic in the USA and the vodka epidemic in Russia were/are pretty scary. (A lot of apartment blocks in Russia became 100% female after all the men either died in the Afghanistan war or destroyed their livers with vodka/wood alcohol.) SARS (Corona-1) in 2002/2003 was bad too, but mostly affected Asia, with isolated incidents in North America.
  - mntmoss 7y ago
    A distinctive feature of a pandemic event is that it really is a global thing. Even the world wars could claim to have quiet fronts... and that matters as a global society. Normally - since the modern era began - we're in a default state of national competition and every country is under some obligation to work itself to the bone and exploit what it can to get ahead of the others. Hence the default response to crises has long been "keep a strong international image, maintain business as usual". The crisis harms a select group somewhere and everyone else ignores it. But we did periodically have pandemics, and each one changed the character of things going forward. And it's clear why that is the case; you can't really get ahead if you don't take care of the disease. The as-usual response fails because it affects everyone. Even AIDS, which was approached so, so reluctantly, eventually got an organized response. And this response is more likely to be humane than most crisis management because there is so little room to evade the issue and try to fit it into the usual powermongering circus.
Ancalagon 7y ago
This article fails to make a single mention of Italy's case-load and its effect on Italy's healthcare system.
- hummo56 7y ago
  That was exactly my thoughts. The article makes valid points but this does not fit.
- mokarma 7y ago
  Italy seems to be an outlier. They're hit significantly harder then any other country.
  - thda 7y ago
    Not true. France is hit, eastern France's hospitals are at full capacity. Doctors are starting to consider letting people over 70 die without access to an ICU. Also, it's kind of strange that on this forum people do not get the notion of exponential increase. It's twice worst every 72 hours. Time runs out really fast.
    - sershe 7y ago
      People totally get exponential increase. I agree it's really bad given that we have infinite population! Oh wait, we don't. The exponential increase will go on for 3-4 weeks after which there will be no more people to infect; the time in ICU is 2-3 week, there's overlap, so in say a month we will be done. Recessions last years; in case of Great Depression, a decade. Remember how Great Depression ended in Europe?
- giardini 7y ago
  FWIW Italy has a very active anti-vax movement: https://bppj.berkeley.edu/2018/10/25/the-anti-vaccination-movement-breaks-out-in-italy-and-beyond/ https://bppj.berkeley.edu/2018/10/25/the-anti-vaccination-mo... Effect on Italian measles outbreak: https://www.huffpost.com/entry/italy-vaccines-anti-vaxxer-populism_n_5b8ee98de4b0cf7b003a661a?guccounter=1&guce_referrer_us=aHR0cHM6Ly9kdWNrZHVja2dvLmNvbS8&guce_referrer_cs=Zgd-WwgTHeH1dpGChu6V-g https://www.huffpost.com/entry/italy-vaccines-anti-vaxxer-po... Anti-vaxxers are unlikely to get annual flu shots and are, as a consequence, subject to both the annual flu strains and to covid-19.
neurocline 7y ago
I’m sure it wasn’t the author’s intention, but the article has a lot of the patterns and phrasing I see in denialist literature (global warming, for example). I agree with the author that we need more data. But he nerfed the urgency of his plea by using wording that downplays the problem, and seems to only be talking about the situation in the U.S. and U.K. No mention of the data points collected at great cost by China and Italy, not to mention Iran (which seems to be digging mass graves). I’m confused. What does the author expect from publishing this piece?
- bsaul 7y ago
  about your last point : it mentions doing random sampling periodically to get a better assessment of the spread, in order to be able to cut lockdowns when the epidemic is already touching 99% of the population ( and not wait weeks until we see the numbers drop in hospitals). also, that we take south korea as an example for future policies and not china.
- oldgradstudent 7y ago
  > I’m confused. What does the author expect from publishing this piece? The gathering of reliable data by random testing of the general population. I thought he made it quite clear.
fsh 7y ago
I think that Ioannidis makes a valid point about the need for accurate data. But isn't the (pretty decent) italian healthcare system getting completely overwhelmed a strong argument against the possibility that the corona outbreak could get "buried within the noise" of seasonal influenza? I also don't understand how shutting down non-essential businesses for a few weeks is supposed to cause large damage.
ailideex 7y ago
Sanction and fine the Chinese communist party and their officers for the catastrophe they inflicted on the world. Never again.
- simion314 7y ago
  This is not a solution for the present, also to prevent this happening in the future I would strongly suggest not focusing only on China but maybe have a program setup for this kind of emergencies that were predicted already and for some reason governments were not prepared, this will happen again and it might originate in a different place, it might affect the young and it might be more infectious. Blaming China is good political strategy to shift the blame and responsibility though, so use that if you are a politician responsible of inaction maybe you get re-elected, you could blame the immigrants and people working over the borders ... fuck political thinking...
anotheryou 7y ago
At what point do randomly sampled tests make sense? I guess now you'd test too many negative and would need too many tests to get reliable results. (you need to have a decent sample of sick people for statistical significance). Than again the infections also cluster locally a lot, so you can't extrapolate for a country well..

80 points by cyrksoft 7y ago

Are we sure that the economic damage of the shutdown of the world economy out weighs the heath risks of the virus. Are we in group think here? A major recession/depression means a lot of people go hungry, lose access to medical care etc. Does anyone know of studies or research that looks at the health impacts of a shutdown vs. the health risk of the virus ? Just asking questions. I keep asking this question and I get no response from anyone. This smells like group think. Are we not able to discuss such questions ?

vondur 7y ago
It does seem that we have blindly followed the Chinese's government's response to the outbreak without any real data. I'm guessing there may be large numbers of people who are affected who aren't really showing any symptoms other than typical cold/flu symptoms.
- steve_adams_86 7y ago
  > without any real data The trouble is we can only get "real data" by testing more people. If we test more people we will almost certainly discover the numbers are worse than they appear now. All that is to say that the situation can only be worse than we already know. I'm not sure more data would lead us to isolate less at all. You might be right that there could be large numbers of people with the virus who are doing just fine right now, but we know from nearly 200,000 cases (that's plenty) that a non-trivial portion of cases require hospitalization. That's the whole problem, right there. So we know hospitals can be overwhelmed and a LOT of people die for it. Healthcare workers included. We know the situation is probably worse than it looks, but we won't know how much worse for weeks yet. So without real data, it seems to err on the side of caution is absolutely essential. This can bring countries to their knees within weeks, and it has. What would you propose we do without real data?
  - parineum 7y ago
    >You might be right that there could be large numbers of people with the virus who are doing just fine right now, but we know from nearly 200,000 cases (that's plenty) that a non-trivial portion of cases require hospitalization. That's the whole problem, right there. You're not applying the logic all the way through. If a great number of people are already infected and do not require hospitalization it grossly affects the math on the potential for overwhelming our medical system. Those infected people unnoticeable to minor symptoms have the potential to be the herd immunity we'd want from a vaccine. > All that is to say that the situation can only be worse than we already know. I'm not sure more data would lead us to isolate less at all. More infected people who are unnoticed because they don't show severe symptoms and require hospitalization actually makes the situation better. It would lower the hospitalization rate and alter the projections drastically in the direction of less epidemic. We are being cautious right now. That, by definition, means we're likely overreacting.
    - travisporter 7y ago
      I was wondering if there’s an efficient way to screen a large population with low prevalence with limited tests. I’m thinking of the 1000 prisoner wine riddle with one drop of poison if that rings a bell
    - steve_adams_86 7y ago
      I thought that, but then how do you explain situations like Italy? Such a tremendous number of people are suffering.
  - oldgradstudent 7y ago
    > The trouble is we can only get "real data" by testing more people. We get "real data" by properly testing, not necessarily by testing more people. Currently we are mainly testing people arriving with symptoms. This results in underestimate of the number of infected and an overestimate of mortality and morbidity rates.
- oefrha 7y ago
  “It won’t happen here.” “It could happen here, but it’s not a big concern.” “It’s happening here, and it’s a big concern, but we don’t have reliable data so let’s do nothing.” “We have reliable data now, but it’s too late to do anything.”
  - teh_infallible 7y ago
    Are you quoting people from an actual conversation, or setting up a straw man to justify draconian actions based on limited data?
    - travisporter 7y ago
      While data is limited, the basic premise of viral spread and quarantine is nothing new or ineffective. There is no doubt there is exponential growth, and limiting that would be effective sooner than later health and economy wise.
      - spookthesunset 7y ago
        Is the growth of testing also exponential? Cause if it is, than it follows the confirmed infected will also look exponential even if the underlying actual growth number is totally different. You can make anything fit an exponential curve if you try hard enough.
      - sershe 7y ago
        There is no data as far as the latter is concerned. The current data (Fed actions, pronouncements of 18mo shutdowns, recession worse than 2008, etc.) is to the contrary. What, really, is the economic impact of virus deaths after exponential growth quickly bumps into population size and lots of mostly non-working people die? Nobody even tries to answer this.
  - PeterisP 7y ago
    Are you suggesting the four stage strategy? https://www.youtube.com/watch?v=nSXIetP5iak https://www.youtube.com/watch?v=nSXIetP5iak
- dragonwriter 7y ago
  That is incorrect. The US, UK, and others were taking a mitigation strategy until the last couple of days; the change wasn't driven by delayed blind copying of China, but by this analysis, which was shared with governments as a WIP before being published: https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf https://www.imperial.ac.uk/media/imperial-college/medicine/s... There may be legitimate criticism of the broad policy approach, but “blindly following China” isn't one of them.
naner 7y ago
The problem is not so much the health risk but the overwhelming of healthcare systems and lack of supplies. This isn't a theory, we already know the outcome of not slowing down infection rates fast enough (China, Italy, etc).
- mokarma 7y ago
  So why aren't we scrambling to build more hospitals?
  - NhanH 7y ago
    Doctors and nurses is the big cap alongside equipments and rooms.
  - jsight 7y ago
    And why aren't we scrambling to get our factories making masks and other basic supplies?
- sershe 7y ago
  That doesn't answer the question though. Ioannidis addresses the worst case scenario. Lack of supplies, also, is made much worse by closing factories and tanking economy in general, as well as e.g. cancelling blood drives (a real case from King County), none of which are caused by the virus.
reilly3000 7y ago
I think the economic damage will be so remarkable that nobody will go hungry. We are seeing unprecedented pro-social behavior and legislation. Social safety nets are born out of crises.
- nostromo 7y ago
  I see panic hoarding and empty grocery stores and laid off people worried about rent. And it’s been two weeks.
  - cvlasdkv 7y ago
    Forcing the government to act as our economic and political structure reveals itself inadequate in the face of a national crisis _is_ what will spur legislation. Hopefully smart forward-thinking legislation.
cma 7y ago
I think it outweighs the economic damage. But aside from that, we need the capability to hit the pause button on the economy during similar future events. What if for example a more extreme one in the future threatened to kill 10% of the population and required a significantly longer lockdown. By having a dry-run (in comparison) now, we might be much more prepared.
secretsatan 7y ago
How many people dying is acceptable to you?
- teh_infallible 7y ago
  Do you mean as a result of the virus, or as a result of losing their livelihood and being plunged into poverty?
- mns 7y ago
  I'm afraid that on the long term, the social unrest and the economic consequences will far outweigh the damage done by the virus. There is no plan on how long you can shut down whole countries. Europe, for example is not like China, you are just locking down everything, you don't have any other regions to support you. Sure, some people can work from home now, but by having the economy run at minimum level, work will go down, there will be no more projects even for IT people. How many people are losing their jobs already, what will happen if we need to quarantine ourselves for another 6 months to flatten the curve, if jobs are cut after just 2 weeks? I might have enough saved to be able to live not working for a couple of years, but I don't think that will help me if the entire social order is collapsing.
  - thda 7y ago
    > I'm afraid that on the long term, the social unrest and the economic consequences will far outweigh the damage done by the virus. I'm french. I have italian friends. I don't care about the economy. It will be back up. As long as there are humans they will need goods. > there will be no more projects even for IT people. Sure. But let's put it in balance for France: - less work for IT people - 350K deaths I vote for number one. I can't believe I'm reading that on this forum, where people are supposed to be educated. This is insane.
    - sershe 7y ago
      "I don't care about economy" I didn't know I'd ever say this, hate these words, but this is privilege talking. Look at life expectancy chart for Russia in the 90ies. This was mere economic mismanagement, and it's far worse than the worst case virus scenario. In some countries, unemployment and economic mismanagement leads to civil wars, revolutions and dictatorships. Sure, techies in democratic/democratic-socialist first world countries will be probably fine in bad economy, if my experience in the great recession is any indication. A chance to buy cheaper stocks, too! However, even in a mild recession hundreds of millions (at least) will suffer. I'd choose 350k deaths. EDIT: Come think of it, if you could completely mitigate one historical event in Europe, would you go for Spanish flu (millions of deaths!) or Great Depression (mere economy, of no consequence)?
lowdose 7y ago
I second this it seems more and more like massa hysteria. 8.000 people died on 7.7 billion people. Its crazy to pull the handbrake on the economy. 99% of the people that died were going to be death in a year or 2 anyway. Have you heard about that school class full of 6 years old kids in Italy that died last a week? Didn't happen but when it happens we do not have this options anymore. Old people die and thats life.
- hatenberg 7y ago
  This talk at the start of an exponential curve is exactly the problem
  - spookthesunset 7y ago
    I wonder how many people are fitting the “how many people are tested” to the same exponential curve? If there is exponential growth in the number of tests given, it follows there would be an exponential growth in number of cases detected.
    - jsight 7y ago
      That is absolutely true, which is one of the reasons that it is surprising that the curve isn't any higher than it is.
- ornornor 7y ago
  The problem is that so many people are ill or die within a very very short window instead of being spread out as it is before the epidemic. From a purely selfish point of view, assuming the disease will be a minor inconvenience to you because you’re young and healthy, there are other things to consider: - what happens to your (presumably much older) parents when they get sick? Death is a very real outcome there - what happens when you have a car crash and need intensive care but all hospital beds are full and there are also younger patients than you to treat with a better outcome? You’re triaged lower priority and may not get the care you’d normally get or survive at all For perspective, there really aren’t that many ICU hospital beds altogether because the usual number of people who need intensive care at any given point in a city of millions is in the hundreds (maybe low thousand?) Once the exponential nature of the epidemics hits and there are thousands of people who need care right now on top of the usual load, then it’s like in Italy where some are left to die just because choices must be made and there are either healthier victims with better prognosis.
unionpivo 7y ago
Because the answer is, we wont know for sure until it's over. But you can lessen the impact on economy help with bring it back, western countries produce more than enough food to make sure nobody starves (if they want) If you leave covid 19 unchecked it will overwhelm your medical system anyway so even more people would loose access to medical care. So the choice comes down to, hope that worst case (italy++) wont happen and carry on, or try to do something. And you cant get away with bulshit pretending that you are doing something when you are not, because people suddenly listen to scientist and doctors, when their ass is on the line. Unsurprisingly we choose to do something. Additionally given that in west most politicians are elected, and that most reliable voters and donors for political campaigns are from age group most affected by this virus, decision is even more obvious.
aaron695 7y ago
What is the value of a human life in the West? My figure is $2 million. Then a billion $ is 500 lives. A trillion $ is 500,000 lives. This is how I rate it. What is your figure on a life? And how would you relate loss and gain of $ to buying / destroying lives? The discussion changes when you leave the West, so start there.
- csharptwdec19 7y ago
  I remember that the author of XKCD dug up that the EPA puts a human life around 8.4mil.
  - aaron695 7y ago
    https://what-if.xkcd.com/96/ https://what-if.xkcd.com/96/ Sounds ok. I think it's less, but it's the same for this calculation. Do people even get trained in napkin math anymore? Wiki is very limited on the topic- https://en.wikipedia.org/wiki/Back-of-the-envelope_calculation https://en.wikipedia.org/wiki/Back-of-the-envelope_calculati...
- sershe 7y ago
  Don't forget about the age of deaths here. Divide the above by life expectancy at birth, then multiply by life expectancy at death from the virus. And possibly weigh by decade, I'd probably trade another decade of my 20ies over e.g. 80ies (not that I've been there). AFAIK /the average/ age in Italy is pushing 70.
currymj 7y ago
it seems like this is the response from most people everywhere about until their region hits the knee of the exponential curve. this pattern played out in Italy, Spain, France, and now the US. the Imperial College paper estimates 2 million dead in the US with no response and ~1 million dead with a limited response that doesn’t involve a full shutdown. That paper explicitly doesn’t consider the very severe economic impacts but it’s hard to imagine that deaths on that scale aren’t worse than whatever they might be.
- beatgammit 7y ago
  ~1 million is the current annual death rate in the US (~0.8% last I checked), and the disease kills older people much more than younger people. How many of those 2 million would have died anyway in the next couple of years? How many would have contributed to the economy over the next few years? How many of those who will die from a recession would have contributed to the economy? These are tough questions, but I think they're worth answering so we know what we're really gaining by shutting down the economy. I know we want to save as many lives as possible, but we should also know the cost too.
  - jjeaff 7y ago
    Another thing to note is that the virus will overwhelm emergency rooms world wide and deprive many other patients of adequate care that will cause some unnecessary death. So it isn't just virus deaths you have to factor in.
- spookthesunset 7y ago
  Those estimates are based on constantly changing data. And “exponential curve” means a lot of things. We are just now starting very limited testing in the US... what do you want to bet the number of tests given follow an exponential pattern just by nature of how they are deployed? If your test deployment is exponential your infections is gonna look exponential even if the underlying data isn’t... at least for a little while. You can curve fit anything if you forget about the bias in your data.
- oldgradstudent 7y ago
antman 7y ago
It has mostly hit Europe and Asia where people don't lose their medical care. And in general we don't expect them to leave their people hungry. Also there is no econonic model of millions of people dying in a few months so governments opt for the safer choices. Most governments at least.
jsight 7y ago
Yeah, when I ask that question I get responses "how many people do you want to kill, because of course health comes first!" I haven't seen much of what I consider to be reasonable analysis. I suspect this will be analyzed for years to come.

Waterluvian 7y ago

Acting without reliable data reminds me of war. And that got me thinking: is this the closest exposure to "Total War" that any living generation (except the greatest generation) has experienced? It's not like recent wars that can be ignored by shutting off the TV. This captivates all of us and is becoming impossible to ignore.

deleted 7y ago
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redis_mlc 7y ago
No, as I wrote another day, polio, the Cold War, the meth/crack epidemic in the USA and the vodka epidemic in Russia were/are pretty scary. (A lot of apartment blocks in Russia became 100% female after all the men either died in the Afghanistan war or destroyed their livers with vodka/wood alcohol.) SARS (Corona-1) in 2002/2003 was bad too, but mostly affected Asia, with isolated incidents in North America.
- mntmoss 7y ago
  A distinctive feature of a pandemic event is that it really is a global thing. Even the world wars could claim to have quiet fronts... and that matters as a global society. Normally - since the modern era began - we're in a default state of national competition and every country is under some obligation to work itself to the bone and exploit what it can to get ahead of the others. Hence the default response to crises has long been "keep a strong international image, maintain business as usual". The crisis harms a select group somewhere and everyone else ignores it. But we did periodically have pandemics, and each one changed the character of things going forward. And it's clear why that is the case; you can't really get ahead if you don't take care of the disease. The as-usual response fails because it affects everyone. Even AIDS, which was approached so, so reluctantly, eventually got an organized response. And this response is more likely to be humane than most crisis management because there is so little room to evade the issue and try to fit it into the usual powermongering circus.

Ancalagon 7y ago

This article fails to make a single mention of Italy's case-load and its effect on Italy's healthcare system.

hummo56 7y ago
That was exactly my thoughts. The article makes valid points but this does not fit.
mokarma 7y ago
Italy seems to be an outlier. They're hit significantly harder then any other country.
- thda 7y ago
  Not true. France is hit, eastern France's hospitals are at full capacity. Doctors are starting to consider letting people over 70 die without access to an ICU. Also, it's kind of strange that on this forum people do not get the notion of exponential increase. It's twice worst every 72 hours. Time runs out really fast.
  - sershe 7y ago
    People totally get exponential increase. I agree it's really bad given that we have infinite population! Oh wait, we don't. The exponential increase will go on for 3-4 weeks after which there will be no more people to infect; the time in ICU is 2-3 week, there's overlap, so in say a month we will be done. Recessions last years; in case of Great Depression, a decade. Remember how Great Depression ended in Europe?
giardini 7y ago
FWIW Italy has a very active anti-vax movement: https://bppj.berkeley.edu/2018/10/25/the-anti-vaccination-movement-breaks-out-in-italy-and-beyond/ https://bppj.berkeley.edu/2018/10/25/the-anti-vaccination-mo... Effect on Italian measles outbreak: https://www.huffpost.com/entry/italy-vaccines-anti-vaxxer-populism_n_5b8ee98de4b0cf7b003a661a?guccounter=1&guce_referrer_us=aHR0cHM6Ly9kdWNrZHVja2dvLmNvbS8&guce_referrer_cs=Zgd-WwgTHeH1dpGChu6V-g https://www.huffpost.com/entry/italy-vaccines-anti-vaxxer-po... Anti-vaxxers are unlikely to get annual flu shots and are, as a consequence, subject to both the annual flu strains and to covid-19.

neurocline 7y ago

I’m sure it wasn’t the author’s intention, but the article has a lot of the patterns and phrasing I see in denialist literature (global warming, for example). I agree with the author that we need more data. But he nerfed the urgency of his plea by using wording that downplays the problem, and seems to only be talking about the situation in the U.S. and U.K. No mention of the data points collected at great cost by China and Italy, not to mention Iran (which seems to be digging mass graves). I’m confused. What does the author expect from publishing this piece?

bsaul 7y ago
about your last point : it mentions doing random sampling periodically to get a better assessment of the spread, in order to be able to cut lockdowns when the epidemic is already touching 99% of the population ( and not wait weeks until we see the numbers drop in hospitals). also, that we take south korea as an example for future policies and not china.
oldgradstudent 7y ago
> I’m confused. What does the author expect from publishing this piece? The gathering of reliable data by random testing of the general population. I thought he made it quite clear.

fsh 7y ago

I think that Ioannidis makes a valid point about the need for accurate data. But isn't the (pretty decent) italian healthcare system getting completely overwhelmed a strong argument against the possibility that the corona outbreak could get "buried within the noise" of seasonal influenza? I also don't understand how shutting down non-essential businesses for a few weeks is supposed to cause large damage.

ailideex 7y ago

Sanction and fine the Chinese communist party and their officers for the catastrophe they inflicted on the world. Never again.

simion314 7y ago
This is not a solution for the present, also to prevent this happening in the future I would strongly suggest not focusing only on China but maybe have a program setup for this kind of emergencies that were predicted already and for some reason governments were not prepared, this will happen again and it might originate in a different place, it might affect the young and it might be more infectious. Blaming China is good political strategy to shift the blame and responsibility though, so use that if you are a politician responsible of inaction maybe you get re-elected, you could blame the immigrants and people working over the borders ... fuck political thinking...

anotheryou 7y ago

At what point do randomly sampled tests make sense? I guess now you'd test too many negative and would need too many tests to get reliable results. (you need to have a decent sample of sick people for statistical significance). Than again the infections also cluster locally a lot, so you can't extrapolate for a country well..