5 ms·

Imperial College report on Covid-19 that led to the extreme measures in US

53 points by jimktrains2 7y ago

im3w1l 7y ago
Here's a scenario I'm curious about. Chickenpox parties for young and healthy people who are then isolated. Use heavy suppression to make sure there are ventilators available for them should they be needed. My gut feeling is that this could create herd immunity at small cost.
- zaksoup 7y ago
  1/500 dead for all 20-40yo even with medical intervention is not a small cost...
  - tonyedgecombe 7y ago
    Exclude the vunerable in that age range and it would be much lower.
    - onion2k 7y ago
      "If you ignore some of the deaths then the number is lower" is an odd response. Why would you exclude vulnerable people?
      - johncolanduoni 7y ago
        Assuming they know they’re vulnerable they presumably wouldn’t go to these parties. However that’s quite an assumption, particularly among young people.
        im3w1l 7y ago
        You could have screenings beforehand.
      - odkamkfn 7y ago
        Because shutting down the economy will kill people, too. It will also decrease quality of life for everyone, and disrupt families, communities, cities and countries. I don't even know what the best course of action is, but there are trade-offs that a lot of people here seem to be ignoring.
    - serpix 7y ago
      Exclude the [non-people] in that age range and it would be much lower. We are all humans. All life is sacred.
      - ramblerman 7y ago
        I'm pretty sure OP meant, exclude them from going to the party. Not exclude the statistic
- sveme 7y ago
  Basing pandemic interventions on the gut feeling of a random internet guy sounds foolproof to me.
  - im3w1l 7y ago
    I'm putting the idea out there so we can discuss it first obviously.
- leereeves 7y ago
  I see a possible problem with the idea: > Chickenpox parties for young and healthy people who are then isolated. Sign here to be given coronavirus and locked away for a month...
  - guscost 7y ago
    People are already volunteering in other ways, I guess...
  - im3w1l 7y ago
    If you don't sign you are to practice social distancing for a year meaning you will be excluded from most of society. How's that for an incentive? You see that is what the article proposes everyone should do.
- anarticle 7y ago
  Stick to software.
- pjc50 7y ago
  This was roughly the UK strategy until the message that it would result in about 250k dead finally got through. Natural spread is already outpacing likely ventilation requirements; we'll find out in a couple of weeks how badly.
  - im3w1l 7y ago
    Natural spread is way inferior to artificial spread. By doing it artificially you can control exactly who gets it, can monitor them more easily, and can prevent the vulnerable from getting it. And you can very precisely control the rate of spread.
    - Jedd 7y ago
      This only works if people do what they're told, and re-infection rates are low & slow - and we suspect they neither is the case.
    - pjc50 7y ago
      .. but meanwhile the natural spread is going on? It's a bit like saying a controlled burn can stop a forest fire - it's true, but it can easily get lost in the scale when you have an Australian or Californian situation and half the state is on fire.
      - im3w1l 7y ago
        In either case you need to put a quarantine in place. But with artificial spread, it's needed for a much shorter duration.
- amanaplanacanal 7y ago
  How do you keep the people who went to the party from infecting the people who didn't go?
Leary 7y ago
Landmark report not because it's likely to be accurate, but it scared the UK (and perhaps the US) into action from the high mortality figures based on the latest Italian data. However, let's look at how the report underestimates the effectiveness of interventions: Case isolation in the home: Reduces non-household contacts by 75% and assumes 70% of households comply : so only reduces non-household contacts by 52% Voluntary home quarantine: Reduces community contacts by 75% but assumes only 50% of household complies. Social Distancing: "Reduce contacts by 50% in workplaces, increase household contacts by 25% and reduce other contacts by 75%. Assume 75% compliance with policy." Social distancing of entire population: "All households reduce contact outside household, school or workplace by 75%. School contact rates unchanged, workplace contact rates reduced by 25%. Household contact rates assumed to increase by 25%." Closure of schools and universities: "Closure of all schools, 25% of universities remain open. Household contact rates for student families increase by 50% during closure. Contacts in the community increase by 25% during closure. " 25%, 50%, 75%... Where did they come up with these figures??
- andbberger 7y ago
  Unfortunately I don't think that undermines the essential conclusion of the report.
- 1996 7y ago
  > 25%, 50%, 75%... Where did they come up with these figures?? When numbers are too round, the good old "finger in the air"
- hnzix 7y ago
  > School contact rates unchanged I'm in a country with mandatory social distancing, and parents are still having school cricket and soccer matches in the local park. The parents are all clustered together watching. They think their children are "immune".
guscost 7y ago
I’m not qualified to properly challenge any of this, but it looks like all of these models use one estimate of the IFR (“mortality rate”). This paper is the basis for their 0.9% number: https://www.medrxiv.org/content/10.1101/2020.03.09.20033357v1 https://www.medrxiv.org/content/10.1101/2020.03.09.20033357v... If that estimate is wrong, all of the numbers in the models would be wrong too. Strange that they tried a range of numbers for infectiousness but only one basically educated guess for IFR.
- th0ma5 7y ago
  Could be just what they had. I thought we all thought the IFR was higher, in which case the Central point of it all being urgent is perhaps understated you think?
  - guscost 7y ago
    I definitely do not think that the true IFR is higher. But again, I’m not a doctor and this is not medical advice.
    - imustbeevil 7y ago
      Based on the data here: https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/ The current death rate of closed cases is 9%. I guess the expectation is that it falls once we develop a vaccine?
      - odkamkfn 7y ago
        Most infections never turn into "cases", which is why the IFR (Infection Fatality Rate) is a lot lower than the CFR (Case Fatality Rate). How much lower is very, very hard to say. Also note that there's no strict definition for how to calculate the CFR, so you'll see conflicting numbers even for the same area/country.
bitL 7y ago
I am wondering - coronavirus (the usual one) is associated with common cold; we don't have any vaccine against it nor do we actually understand the common cold itself; moreover, COVID-19 has a similar genomic packing as HIV/Ebola, two diseases we don't have vaccines for either. I am wondering if it is just wishful thinking we get a COVID-19 vaccine anytime soon (i.e. in the next decade). Are there any reasons to be optimistic? Also, regarding herd immunity - we aren't immune against flu, is there any reason to think we could develop (long-term) immunity to COVID-19?
- nikhilsimha 7y ago
  > we aren't immune against flu, is there any reason to think we could develop (long-term) immunity to COVID-19? Spanish flu became less lethal in subsequent generations[1]. Helps with the survivability of the virus if it doesn't kill the host. So, the strains with less lethality win out. We don't need to be immune for the situation to resolve. Simply co-evolving with the virus is sufficient [1] https://demystifyingscience.com/blog/2020/3/4/patriarch-of-pandemics https://demystifyingscience.com/blog/2020/3/4/patriarch-of-p...
  - bitL 7y ago
    > So, the strains with less lethality win out. Which is the case for COVID-19 vs original SARS (much more lethal). So we already have a "mild" version of SARS and it doesn't look good.
  - sliken 7y ago
    Flu's evolve and there's feedback from the behavior of the humans they infect. So if they make you feel like crap you are less likely to spread the infection. So that results in a less aggressive infection out competing a similar but more aggressive infection, doubly so since the immune system will like cross react between the two. However with COVID19 the infection seems quite adept at spreading before the symptoms show, so there's going to be less of a feedback loop. Might even be the opposite since a serious infection means visiting the doctors office, in many cases more than once, and finally escalating to the emergency room. COVID19 seems especially adept at infecting nurses, doctors, ambulance drivers, and EMTs.
LatteLazy 7y ago
"extreme measures" - the term used before the pandemic. "insufficient measures" - the term used after the pandemic.
deleted 7y ago
[deleted]
ramblerman 7y ago
In the pdf report there is a nice table at the bottom of page 5. Not only is the CFR lower than I had anticipated, but it made me realize that a hospital trip doesn't immediately imply intensive care. For instance a 35 year old has 3.2% chance of going to hospital, and then 5% chance of ending up in the ICU when going to hospital. Can I multiply these together to get 0.16% chance of ending up in the ICU once infected, or is that too simplistic :)
- jbc1 7y ago
  That seems way less dangerous to young people than I'm otherwise seeing reported, and this is the report that's apparently so extreme it got the UK and US to finally do something. What with all the people who are obese, smoke heavily, have asthma, immune compromised, etc I would have assumed 0.16% of people find themselves in the ICU if they get a cold.
  - 8fingerlouie 7y ago
    Italy reported today that 99% of the COVID-19 deaths in Italy had a preexisting condition. If you're healthy you (probably) don't have anything to worry about, but if you're diabetic, smoking, have hypertension or other normally manageable conditions, you're (maybe) at risk. And to all the healthy people who seems to think they're immune. You probably won't die from it, but someone in your close family may very well die because you didn't take it seriously.
- 8fingerlouie 7y ago
  The problem with the CFR is that it assumes that everybody can get the care they need. If the health system gets swamped by 50% of a country's population, then you basically have the same situation as they have in Italy. We're just at the very beginning here in Denmark, the number of hospitalized people has roughly doubled every day for the past 3-4 days, and already hospitals are running out of masks and other essential equipment. Since the world is in lockdown, and everybody is fighting this, basic supplies are in short demand everywhere.
- saber6 7y ago
thedudeabides5 7y ago
Tyler Cowen had a great take calling out the tradeoff implied by this paper, raising the question of if a 18m total lockdown (the upper bound of the recommendation in this paper) is even a reasonable thing from a society/utilitarian perspective. https://marginalrevolution.com/marginalrevolution/2020/03/herd-immunity-time-consistency-and-the-epidemic-yoyo.html https://marginalrevolution.com/marginalrevolution/2020/03/he... Alternatively, let’s say we start off being really strict with shutdowns, quarantines, and social distancing. Super-strict, everything closed. For how long can we tolerate the bankruptcies, the unemployment, and the cabin fever? At what point do the small businesspeople, one way or another, violate the orders and resume some form of commercial activity? What about “mitigation fatigue“? Again, I fear we might switch course and, again, end up with the worst of both worlds. We would take a big hit to gdp but not really stop the spread of the virus. I also can imagine that we keep switching back and forth. The epidemic yoyo. Because in fact we find none of the scenarios tolerable. Because they are not.
- TYPE_FASTER 7y ago
  I've been thinking about it two ways: 1. We could forecast a projected cost to the global markets, vs. the number of lives saved, and put a price to each life saved. Every healthcare conversation has avoided doing this, so maybe this pandemic will force the conversation. 2. We shelter in place, take the hit to the market, and use the opportunity to learn a lot about our impact on the environment, ourselves, and how we can possibly change as societies to make things better for everybody.
HSO 7y ago
I really wonder what future historians will say about this hysteria and the economic damage it causes. 1) 80% of Americans would get the disease That sounds scary (big number!!). But I'm getting tired of the constant reporting of each and every infection. What is really relevant is infections of at-risk groups. Most infections, nothing happens! 2) 8-15% of all Americans over 70 would die. Newsflash: Old people tend to die more often than young people. What is the all-cause i.e. normal mortality rate of the elderly. One number I saw cited: all-cause mortality of 83/84 yo's in the US ~7 percent. Case mortality rate i.e. with infection in Korea among 80+ yo's: 7.4 percent. What am I missing here? Are the reported covid mortality rates all normalized by all-cause mortality and they report only real "excess" deaths or are they lumping everything together? This would be so mind-numbingly stupid, I really hope I'm wrong about this! 3) 0.9% of them would die. That's the unconditional number, all age cohorts aggregated. Split them up and the number is clearly skewed by the large number of the elderly (and see 2 above). Now factor in that testing outside Korea, Taiwan etc. is really bad and focused on symptomatic cases. Common estimate of how high are the true numbers of infected is around one order of magnitude. Let's assume the official stats are off by a factor of ten. Let's further assume that young people (say, below 65) are "more social" or mobile than elderly and thus likelier to get infected. That means a) the undercount is dominated by younger people and b) the mortality rates are off by more than ten. At what point are we getting to mortality rates of common influenza? 4) There are basically two ways to die from the virus: a) immune system overwhelmed by virus or b) immune system overreacts. Younger, healthy people ( < 65 yo) seem to die more from b. Now look into who are the victims in this cohort and it turns out mostly medical professionals. Due to lack of preparation and equipment, those medical professionals are exposed to disproportionately higher or even extreme quantities of the virus. This seems consistent with b. Also, it means that the mortality rates of younger, healthy people is skewed by counting medical- and non-medical people together. In sum, I think this is a total overreaction and panic that causes huge economic damage (which has a big human cost, in terms of lives lost, as well make no mistake) for what may turn out to be basically nothing. What am I missing? [EDIT: I'd prefer we focus on the at-risk groups (elderly and pre-existing conditions like obesity, cardiovascular diseases, diabetes, etc) instead of just blanket-everybody. Isolate the at-risk groups until vaccine and/or medication are developed and let everyone else basically develop herd immunity until then. Increase testing. And basically use this as a call for more general health measures, not just virus panic. The immune system depends on sleep, nutrition, mental health/hormone balance, etc. With the panic and the economic crash induced by it, all these factors are becoming negative instead of positive factors for most people now.]

53 points by jimktrains2 7y ago

Here's a scenario I'm curious about. Chickenpox parties for young and healthy people who are then isolated. Use heavy suppression to make sure there are ventilators available for them should they be needed. My gut feeling is that this could create herd immunity at small cost.

zaksoup 7y ago
1/500 dead for all 20-40yo even with medical intervention is not a small cost...
- tonyedgecombe 7y ago
  Exclude the vunerable in that age range and it would be much lower.
  - onion2k 7y ago
    "If you ignore some of the deaths then the number is lower" is an odd response. Why would you exclude vulnerable people?
    - johncolanduoni 7y ago
      Assuming they know they’re vulnerable they presumably wouldn’t go to these parties. However that’s quite an assumption, particularly among young people.
      - im3w1l 7y ago
        You could have screenings beforehand.
    - odkamkfn 7y ago
      Because shutting down the economy will kill people, too. It will also decrease quality of life for everyone, and disrupt families, communities, cities and countries. I don't even know what the best course of action is, but there are trade-offs that a lot of people here seem to be ignoring.
  - serpix 7y ago
    Exclude the [non-people] in that age range and it would be much lower. We are all humans. All life is sacred.
    - ramblerman 7y ago
      I'm pretty sure OP meant, exclude them from going to the party. Not exclude the statistic
sveme 7y ago
Basing pandemic interventions on the gut feeling of a random internet guy sounds foolproof to me.
- im3w1l 7y ago
  I'm putting the idea out there so we can discuss it first obviously.
leereeves 7y ago
I see a possible problem with the idea: > Chickenpox parties for young and healthy people who are then isolated. Sign here to be given coronavirus and locked away for a month...
- guscost 7y ago
  People are already volunteering in other ways, I guess...
- im3w1l 7y ago
  If you don't sign you are to practice social distancing for a year meaning you will be excluded from most of society. How's that for an incentive? You see that is what the article proposes everyone should do.
anarticle 7y ago
Stick to software.
pjc50 7y ago
This was roughly the UK strategy until the message that it would result in about 250k dead finally got through. Natural spread is already outpacing likely ventilation requirements; we'll find out in a couple of weeks how badly.
- im3w1l 7y ago
  Natural spread is way inferior to artificial spread. By doing it artificially you can control exactly who gets it, can monitor them more easily, and can prevent the vulnerable from getting it. And you can very precisely control the rate of spread.
  - Jedd 7y ago
    This only works if people do what they're told, and re-infection rates are low & slow - and we suspect they neither is the case.
  - pjc50 7y ago
    .. but meanwhile the natural spread is going on? It's a bit like saying a controlled burn can stop a forest fire - it's true, but it can easily get lost in the scale when you have an Australian or Californian situation and half the state is on fire.
    - im3w1l 7y ago
      In either case you need to put a quarantine in place. But with artificial spread, it's needed for a much shorter duration.
amanaplanacanal 7y ago
How do you keep the people who went to the party from infecting the people who didn't go?

Leary 7y ago

Landmark report not because it's likely to be accurate, but it scared the UK (and perhaps the US) into action from the high mortality figures based on the latest Italian data. However, let's look at how the report underestimates the effectiveness of interventions: Case isolation in the home: Reduces non-household contacts by 75% and assumes 70% of households comply : so only reduces non-household contacts by 52% Voluntary home quarantine: Reduces community contacts by 75% but assumes only 50% of household complies. Social Distancing: "Reduce contacts by 50% in workplaces, increase household contacts by 25% and reduce other contacts by 75%. Assume 75% compliance with policy." Social distancing of entire population: "All households reduce contact outside household, school or workplace by 75%. School contact rates unchanged, workplace contact rates reduced by 25%. Household contact rates assumed to increase by 25%." Closure of schools and universities: "Closure of all schools, 25% of universities remain open. Household contact rates for student families increase by 50% during closure. Contacts in the community increase by 25% during closure. " 25%, 50%, 75%... Where did they come up with these figures??

andbberger 7y ago
Unfortunately I don't think that undermines the essential conclusion of the report.
1996 7y ago
> 25%, 50%, 75%... Where did they come up with these figures?? When numbers are too round, the good old "finger in the air"
hnzix 7y ago
> School contact rates unchanged I'm in a country with mandatory social distancing, and parents are still having school cricket and soccer matches in the local park. The parents are all clustered together watching. They think their children are "immune".

guscost 7y ago

I’m not qualified to properly challenge any of this, but it looks like all of these models use one estimate of the IFR (“mortality rate”). This paper is the basis for their 0.9% number: https://www.medrxiv.org/content/10.1101/2020.03.09.20033357v1 https://www.medrxiv.org/content/10.1101/2020.03.09.20033357v... If that estimate is wrong, all of the numbers in the models would be wrong too. Strange that they tried a range of numbers for infectiousness but only one basically educated guess for IFR.

th0ma5 7y ago
Could be just what they had. I thought we all thought the IFR was higher, in which case the Central point of it all being urgent is perhaps understated you think?
- guscost 7y ago
  I definitely do not think that the true IFR is higher. But again, I’m not a doctor and this is not medical advice.
  - imustbeevil 7y ago
    Based on the data here: https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/ The current death rate of closed cases is 9%. I guess the expectation is that it falls once we develop a vaccine?
    - odkamkfn 7y ago
      Most infections never turn into "cases", which is why the IFR (Infection Fatality Rate) is a lot lower than the CFR (Case Fatality Rate). How much lower is very, very hard to say. Also note that there's no strict definition for how to calculate the CFR, so you'll see conflicting numbers even for the same area/country.

bitL 7y ago

I am wondering - coronavirus (the usual one) is associated with common cold; we don't have any vaccine against it nor do we actually understand the common cold itself; moreover, COVID-19 has a similar genomic packing as HIV/Ebola, two diseases we don't have vaccines for either. I am wondering if it is just wishful thinking we get a COVID-19 vaccine anytime soon (i.e. in the next decade). Are there any reasons to be optimistic? Also, regarding herd immunity - we aren't immune against flu, is there any reason to think we could develop (long-term) immunity to COVID-19?

nikhilsimha 7y ago
> we aren't immune against flu, is there any reason to think we could develop (long-term) immunity to COVID-19? Spanish flu became less lethal in subsequent generations[1]. Helps with the survivability of the virus if it doesn't kill the host. So, the strains with less lethality win out. We don't need to be immune for the situation to resolve. Simply co-evolving with the virus is sufficient [1] https://demystifyingscience.com/blog/2020/3/4/patriarch-of-pandemics https://demystifyingscience.com/blog/2020/3/4/patriarch-of-p...
- bitL 7y ago
  > So, the strains with less lethality win out. Which is the case for COVID-19 vs original SARS (much more lethal). So we already have a "mild" version of SARS and it doesn't look good.
- sliken 7y ago
  Flu's evolve and there's feedback from the behavior of the humans they infect. So if they make you feel like crap you are less likely to spread the infection. So that results in a less aggressive infection out competing a similar but more aggressive infection, doubly so since the immune system will like cross react between the two. However with COVID19 the infection seems quite adept at spreading before the symptoms show, so there's going to be less of a feedback loop. Might even be the opposite since a serious infection means visiting the doctors office, in many cases more than once, and finally escalating to the emergency room. COVID19 seems especially adept at infecting nurses, doctors, ambulance drivers, and EMTs.

LatteLazy 7y ago

"extreme measures" - the term used before the pandemic. "insufficient measures" - the term used after the pandemic.

deleted 7y ago

[deleted]

ramblerman 7y ago

In the pdf report there is a nice table at the bottom of page 5. Not only is the CFR lower than I had anticipated, but it made me realize that a hospital trip doesn't immediately imply intensive care. For instance a 35 year old has 3.2% chance of going to hospital, and then 5% chance of ending up in the ICU when going to hospital. Can I multiply these together to get 0.16% chance of ending up in the ICU once infected, or is that too simplistic :)

jbc1 7y ago
That seems way less dangerous to young people than I'm otherwise seeing reported, and this is the report that's apparently so extreme it got the UK and US to finally do something. What with all the people who are obese, smoke heavily, have asthma, immune compromised, etc I would have assumed 0.16% of people find themselves in the ICU if they get a cold.
- 8fingerlouie 7y ago
  Italy reported today that 99% of the COVID-19 deaths in Italy had a preexisting condition. If you're healthy you (probably) don't have anything to worry about, but if you're diabetic, smoking, have hypertension or other normally manageable conditions, you're (maybe) at risk. And to all the healthy people who seems to think they're immune. You probably won't die from it, but someone in your close family may very well die because you didn't take it seriously.
8fingerlouie 7y ago
The problem with the CFR is that it assumes that everybody can get the care they need. If the health system gets swamped by 50% of a country's population, then you basically have the same situation as they have in Italy. We're just at the very beginning here in Denmark, the number of hospitalized people has roughly doubled every day for the past 3-4 days, and already hospitals are running out of masks and other essential equipment. Since the world is in lockdown, and everybody is fighting this, basic supplies are in short demand everywhere.
saber6 7y ago

thedudeabides5 7y ago

Tyler Cowen had a great take calling out the tradeoff implied by this paper, raising the question of if a 18m total lockdown (the upper bound of the recommendation in this paper) is even a reasonable thing from a society/utilitarian perspective. https://marginalrevolution.com/marginalrevolution/2020/03/herd-immunity-time-consistency-and-the-epidemic-yoyo.html https://marginalrevolution.com/marginalrevolution/2020/03/he... Alternatively, let’s say we start off being really strict with shutdowns, quarantines, and social distancing. Super-strict, everything closed. For how long can we tolerate the bankruptcies, the unemployment, and the cabin fever? At what point do the small businesspeople, one way or another, violate the orders and resume some form of commercial activity? What about “mitigation fatigue“? Again, I fear we might switch course and, again, end up with the worst of both worlds. We would take a big hit to gdp but not really stop the spread of the virus. I also can imagine that we keep switching back and forth. The epidemic yoyo. Because in fact we find none of the scenarios tolerable. Because they are not.

TYPE_FASTER 7y ago
I've been thinking about it two ways: 1. We could forecast a projected cost to the global markets, vs. the number of lives saved, and put a price to each life saved. Every healthcare conversation has avoided doing this, so maybe this pandemic will force the conversation. 2. We shelter in place, take the hit to the market, and use the opportunity to learn a lot about our impact on the environment, ourselves, and how we can possibly change as societies to make things better for everybody.

HSO 7y ago

I really wonder what future historians will say about this hysteria and the economic damage it causes. 1) 80% of Americans would get the disease That sounds scary (big number!!). But I'm getting tired of the constant reporting of each and every infection. What is really relevant is infections of at-risk groups. Most infections, nothing happens! 2) 8-15% of all Americans over 70 would die. Newsflash: Old people tend to die more often than young people. What is the all-cause i.e. normal mortality rate of the elderly. One number I saw cited: all-cause mortality of 83/84 yo's in the US ~7 percent. Case mortality rate i.e. with infection in Korea among 80+ yo's: 7.4 percent. What am I missing here? Are the reported covid mortality rates all normalized by all-cause mortality and they report only real "excess" deaths or are they lumping everything together? This would be so mind-numbingly stupid, I really hope I'm wrong about this! 3) 0.9% of them would die. That's the unconditional number, all age cohorts aggregated. Split them up and the number is clearly skewed by the large number of the elderly (and see 2 above). Now factor in that testing outside Korea, Taiwan etc. is really bad and focused on symptomatic cases. Common estimate of how high are the true numbers of infected is around one order of magnitude. Let's assume the official stats are off by a factor of ten. Let's further assume that young people (say, below 65) are "more social" or mobile than elderly and thus likelier to get infected. That means a) the undercount is dominated by younger people and b) the mortality rates are off by more than ten. At what point are we getting to mortality rates of common influenza? 4) There are basically two ways to die from the virus: a) immune system overwhelmed by virus or b) immune system overreacts. Younger, healthy people ( < 65 yo) seem to die more from b. Now look into who are the victims in this cohort and it turns out mostly medical professionals. Due to lack of preparation and equipment, those medical professionals are exposed to disproportionately higher or even extreme quantities of the virus. This seems consistent with b. Also, it means that the mortality rates of younger, healthy people is skewed by counting medical- and non-medical people together. In sum, I think this is a total overreaction and panic that causes huge economic damage (which has a big human cost, in terms of lives lost, as well make no mistake) for what may turn out to be basically nothing. What am I missing? [EDIT: I'd prefer we focus on the at-risk groups (elderly and pre-existing conditions like obesity, cardiovascular diseases, diabetes, etc) instead of just blanket-everybody. Isolate the at-risk groups until vaccine and/or medication are developed and let everyone else basically develop herd immunity until then. Increase testing. And basically use this as a call for more general health measures, not just virus panic. The immune system depends on sleep, nutrition, mental health/hormone balance, etc. With the panic and the economic crash induced by it, all these factors are becoming negative instead of positive factors for most people now.]