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It's pretty clear that the current policies are misguided, IMO. The vast majority of those dying are the elderly and people with pre-existing conditions, most o

by m0zg 7y ago

It's pretty clear that the current policies are misguided, IMO. The vast majority of those dying are the elderly and people with pre-existing conditions, most of the time, both. THOSE people should be locked down tight and they should receive testing and resources if we are to minimize the death toll. We're also fortunate in the sense that only 16% of US population is over 65 years old. Germany and especially Italy are nowhere near this lucky. Instead, we're spreading limited resources super thin, and fucking up the economy in the process for everyone. Seems like offering these vulnerable populations temporary shelter and supported isolation for a month would do a heck of a lot better job than locking down everything _and not providing any support to the elderly and those with pre-existing conditions_. And you could easily offer such isolation: millions of hotel rooms are currently empty, and hoteliers are hurting for cash, which bodes well for getting those rooms (and room service to go with it) at cost. Case in point: as of March 17, only 17 people of those who died in Italy were under the age of 50. That's out of something like 2800. And the median age of those dying was 80.5 years. Same stats on the ship: all of the deaths were among 70-80 year olds. This shows you who's really at risk in a Western-style medical system in a developed country.

troydavis 7y ago
> The vast majority of those dying are the elderly and people with pre-existing conditions. That’s true of deaths but not hospitalizations: https://www.nytimes.com/2020/03/18/health/coronavirus-young-people.html https://www.nytimes.com/2020/03/18/health/coronavirus-young-... The hospitalization rate is believed to be 10-20% and much less specific to people over 65 or even 50.
jpmattia 7y ago
> Case in point: as of March 17, only 17 people of those who died in Italy were under the age of 50. Worth pointing out that the available life-saving equipment is being given to young people there, which complicates the simple statistic.
gnicholas 7y ago
My understanding is that in Italy they are triaging patients and allocating scarce resources to those who are younger and therefore more likely to recover. Apparently they are literally turning away some who are 80 on the grounds that the likelihood of saving them is too low (and they need to use the resources for people who are younger and therefore more savable). If this is true, it would artificially inflate the percentage of older folks who die, and do the opposite for the stats on younger people. I learned this from someone who has been heavily researching the COVID situation for months, and whose opinion I trust.
calf 7y ago
It's a creative idea to use hotel space to isolate elderly and other vulnerable groups, but have you gone over how it might fail? Do you have citations or know of experts who recommend this different solution?
logicchains 7y ago
>It's pretty clear that the current policies are misguided, IMO. The vast majority of those dying are the elderly and people with pre-existing conditions, most of the time, both. THOSE people should be locked down tight and they should receive testing and resources if we are to minimize the death toll. This seems to be what Sweden is doing, and so far it's working okay. Nice to see a country that's trying to minimise violation of its citizens' right to free movement by only imposing restrictions that have the most "bang for their buck". Also Korea. From https://www.sciencemag.org/news/2020/03/mass-testing-school-closings-lockdowns-countries-pick-tactics-war-against-coronavirus https://www.sciencemag.org/news/2020/03/mass-testing-school-...: "“South Korea is a democratic republic; we feel a lockdown is not a reasonable choice,” says Kim Woo-Joo, an infectious disease specialist at Korea University. Instead, the key to success has been a large, well-organized testing program, combined with extensive efforts to isolate infected people and trace and quarantine their contacts. "
jkachmar 7y ago
Please see the Imperial College London report, recently released, for a model that contradicts what you’re suggesting [0]. In particular, see Figure 3 for a direct refutation of the idea that simply applying suppression techniques to the infected or primarily-at-risk groups is adequate. Anything other than immediate and severe suppression techniques puts us over ICU capacity in the next few months, and the estimated number of deaths skyrockets into the millions. [0] 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...
- m0zg 7y ago
  I might be misreading this, but see graph on page 8 of the report. What I'm proposing is the blue curve.
  - jkachmar 7y ago
    Yes, I’m saying that the figures on page 10 imply that the blue curve (on its own) is not effective enough to avoid critically overwhelming the hospital system in the UK in the short term. The guidance towards the measures you see now (nonessential workplace closures, social distancing, restrictions on movement and activity) are what seem to be recommended throughout the rest of the report to suppress the catastrophically high death tolls. If you read further to Figure 4 (page 12) you’ll see a model for “adaptive triggering” of suppressive techniques (basically staggering to allow a resumption of activity before starting again) which would need to be in place until a vaccine has been successfully verified as safe and inoculation has started. EDIT: “Perhaps our most significant conclusion is that _mitigation is unlikely to be feasible_ without emergency surge capacity limits of the UK and US healthcare systems being exceeded many times over. [...] In addition, even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US. [...] We therefore conclude that _epidemic suppression is the only viable strategy_ at the current time.” Emphasis mine.

by m0zg 7y ago

troydavis 7y ago

> The vast majority of those dying are the elderly and people with pre-existing conditions. That’s true of deaths but not hospitalizations: https://www.nytimes.com/2020/03/18/health/coronavirus-young-people.html https://www.nytimes.com/2020/03/18/health/coronavirus-young-... The hospitalization rate is believed to be 10-20% and much less specific to people over 65 or even 50.

jpmattia 7y ago

> Case in point: as of March 17, only 17 people of those who died in Italy were under the age of 50. Worth pointing out that the available life-saving equipment is being given to young people there, which complicates the simple statistic.

gnicholas 7y ago

My understanding is that in Italy they are triaging patients and allocating scarce resources to those who are younger and therefore more likely to recover. Apparently they are literally turning away some who are 80 on the grounds that the likelihood of saving them is too low (and they need to use the resources for people who are younger and therefore more savable). If this is true, it would artificially inflate the percentage of older folks who die, and do the opposite for the stats on younger people. I learned this from someone who has been heavily researching the COVID situation for months, and whose opinion I trust.

calf 7y ago

It's a creative idea to use hotel space to isolate elderly and other vulnerable groups, but have you gone over how it might fail? Do you have citations or know of experts who recommend this different solution?

logicchains 7y ago

>It's pretty clear that the current policies are misguided, IMO. The vast majority of those dying are the elderly and people with pre-existing conditions, most of the time, both. THOSE people should be locked down tight and they should receive testing and resources if we are to minimize the death toll. This seems to be what Sweden is doing, and so far it's working okay. Nice to see a country that's trying to minimise violation of its citizens' right to free movement by only imposing restrictions that have the most "bang for their buck". Also Korea. From https://www.sciencemag.org/news/2020/03/mass-testing-school-closings-lockdowns-countries-pick-tactics-war-against-coronavirus https://www.sciencemag.org/news/2020/03/mass-testing-school-...: "“South Korea is a democratic republic; we feel a lockdown is not a reasonable choice,” says Kim Woo-Joo, an infectious disease specialist at Korea University. Instead, the key to success has been a large, well-organized testing program, combined with extensive efforts to isolate infected people and trace and quarantine their contacts. "

jkachmar 7y ago

Please see the Imperial College London report, recently released, for a model that contradicts what you’re suggesting [0]. In particular, see Figure 3 for a direct refutation of the idea that simply applying suppression techniques to the infected or primarily-at-risk groups is adequate. Anything other than immediate and severe suppression techniques puts us over ICU capacity in the next few months, and the estimated number of deaths skyrockets into the millions. [0] 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...

m0zg 7y ago
I might be misreading this, but see graph on page 8 of the report. What I'm proposing is the blue curve.
- jkachmar 7y ago
  Yes, I’m saying that the figures on page 10 imply that the blue curve (on its own) is not effective enough to avoid critically overwhelming the hospital system in the UK in the short term. The guidance towards the measures you see now (nonessential workplace closures, social distancing, restrictions on movement and activity) are what seem to be recommended throughout the rest of the report to suppress the catastrophically high death tolls. If you read further to Figure 4 (page 12) you’ll see a model for “adaptive triggering” of suppressive techniques (basically staggering to allow a resumption of activity before starting again) which would need to be in place until a vaccine has been successfully verified as safe and inoculation has started. EDIT: “Perhaps our most significant conclusion is that _mitigation is unlikely to be feasible_ without emergency surge capacity limits of the UK and US healthcare systems being exceeded many times over. [...] In addition, even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US. [...] We therefore conclude that _epidemic suppression is the only viable strategy_ at the current time.” Emphasis mine.