6 ms·

I see a lot of rumbling in this thread about how we need to ask ourselves if the costs of a shutdown is worth it, or what happens after a shutdown? My question

I see a lot of rumbling in this thread about how we need to ask ourselves if the costs of a shutdown is worth it, or what happens after a shutdown? My question is this: what would you propose we do? If we don’t lock everything down, we’ll overwhelm the hospitals and the death rate will skyrocket. And then the deaths will be less skewed towards the elderly, because virtually all causes of mortality will shoot up when we no longer have a functioning medical system to treat anyone for anything except this. Are you really proposing we just let hundreds of millions of people all over the world die over the next 6-12 months? So we’ll all just go back to work and to restaurants and on vacation while 5% of the population is gasping their last breaths in a hospital somewhere? We’ll just say goodbye to a huge chunk of our parents and grandparents and aunts and uncles and coworkers? Because the economic cost is just too high? It’s easy to complain about this course of action. It sucks. But unless you can lay out a plausible alternative, this still seems like the best one to me.

whb07 7y ago
Because everyone keeps parroting what you're saying. We are effectively now in a fear bubble. So now everyone's mindset is "stop the world lets hunker down and cower in a corner for the impending doom. Nothing positive or new data can change my mind." In a couple weeks/months they'll start testing people to find out if they did have the virus. The tests right now only show if you currently have it. Once the real numbers come out I am confident it will be a massive over estimate for the CFR. The fear bubble is causing people to underlook the data in places like SK, SG, Japan, Germany and overlook the data in Italy, China, Iran. It could be quite possible that a mixture of smoking, age, over reporting causes, and bad healthcare (gasp not in Italy where socialized medicine is world beating) is being overlooked. So what we get now is stopping of society and the economy, millions of people will go through displacement and a host of negative things. People's savings will be depleted, not to mention teacher's/public servants/ pension and 401ks will take a MASSIVE hit. Oh and add to that more trillions of USD to the debt.
- clwg 7y ago
  The alternative to over reaction is under reaction. I'd rather take extreme precautions and deal with the economic fallout then under react and deal with the situation that italy is currently in. I think in this situation fear is good, it ensures urgency and assists with decisive action making, coupled with humility to change course when your wrong. Apathy is much scarier than fear in these situations.
- senordevnyc 7y ago
  You didn’t answer my question. What is your plan? It sounds like your plan to deal with an exponential outbreak is to wait a few weeks until you have better testing to see if this is really something to worry about, or if those disaster countries that came before you were just a fluke. Do you not see the problem here? No one is suggesting we don’t test. But the disease is rapidly spreading while we dither about, and if you’re wrong about the CFR, it’ll be way, way too late by the time we know that.
  - bsaul 7y ago
    The only country that has correctly dealt with the virus is SK, because the had the test infra ready to test enough people to actually do science. The others countries have all had debate on optimistic vs precautious solutions, buying time vs saving the economy, but the reality is that none are able to correctly assess the spread of the virus. They can’t do correct science.
    - whycombagator 7y ago
      HK/Singapore/Japan numbers also don't seem too bad either[0]. Seems their responses have been pretty good? SK's numbers are higher (last I checked), but I know they had the issue with those religous gatherings hampering their containment efforts. [0] https://www.worldometers.info/coronavirus/#countries https://www.worldometers.info/coronavirus/#countries
  - whb07 7y ago
    I’ll tell you what we do. We don’t shut down the country and destroy millions of lives and future generations. We definitely don’t do it if there’s already overwhelming evidence this impacts the 70+ year old crowd. We can talk dream scenarios if this actually impacted the youth. Because in that case then there’s actual risk to future societies. Have you seen an actuarial table for a 70 year old? Go ahead and tell me those numbers and how they compare to the sub 1% CFR seen in Germany, SG, South Korea and Japan.
    - senordevnyc 7y ago
- jmull 7y ago
  It’s hard to take you seriously when you just dodge the question. Also, the idea the economy will just keep rolling along somehow if we don’t do anything to slow the virus is wrong. When people are dying in the streets due to lack of health care capacity you’ll see what a real panic looks like. The economy is going to hard stop, probably including the food supply chain.
  - mardifoufs 7y ago
    The most comprehensive analysis of the disease puts the average age of death from COVID at about ~80 years. Almost all of victims had a pre-existing condition. Fully choking the economy now means that we are much more likely to choke the supply chains and the healthcare system since we are stopping even healthy, younger people who are usually the main contributors to economic output. Without that output, it will only get harder to help those most vulnerable to the disease. So the argument that stopping the economy now to help it later, eventually, even if we don't know how long we will need to keep it shut doesn't make any sense imo. We are jeopardizing our future ability to fight against the disease, big time
    - senordevnyc 7y ago
      You’re dancing around my question: what would you do right now with what you have available right now? Just let 5% of your population die and tell the rest to get back to work, restaurants, vacation?
      - mardifoufs 7y ago
        That's a ridiculous false choice fallacy. First of all, the 5% doesn't make sense and is demonstrably false. You are cherry picking the data that fits you and assuming everyone infected got tested. Also, if you go by your logic, why do you think killing 5% of the population better than killing even more people by completely wrecking the supply chains that allow us to treat enough people? Also, you've literally ignored all of my argument that addressed what would be better and why it would be better. You also shifted back to a rhetorical question to avoid talking about whatever you said about dead people in the streets. It's absurd to move the goalposts like this. But even if you are clearly being dishonest here, I'll say it again. The best option would be to not lock down the vast majority of the population because it will only mean less resources to help the sick and fight against the disease itself. It will also only lead to a breaking point where people will simply not be able to afford to stay on lockdown no matter how bad it gets. That will make the whole thing much more deadly because people will simply not follow any measure if they are hungry or completely broke.
taeric 7y ago
Nobody is proposing we just let people die. At least, nobody credibly that I have seen. There are some questions on if there was really going to be a curve to flatten. Such that, if we flatten it now, was it the social distancing we did, or was it going to flatten anyway? These are not reasons to abandon caution. They do seem valid questions, though. Especially considering the costs of the actions we have taken.
- int_19h 7y ago
  Can you cite some references on "there was really going to be a curve"? I haven't seen any models that expect it to die out on its own without infecting a significant proportion of the population first - all of them assume exponential spread, just different rates of it (which is exactly what social distancing lowers).
  - taeric 7y ago
    Your question is part of my complaint. There have to be models that this didn't spread exponentially in the severe cases. Where are they, and what were their odds?
    - Rexxar 7y ago
      > There have to be models that this didn't spread exponentially in the severe cases Why ? Model have to fit what we observe. And we always observe exponential.
      - taeric 7y ago
        But we haven't observed much, yet. This is akin to the xkcd about how married you will be for days after your wedding. We are way too early to know what the later curve looks like.
        jiggawatts 7y ago
        The more accurate curve is a Logistic Curve. You have to factor in that eventually people become immune or die, and there's a total population ceiling. Obviously, the number of confirmed cases cannot exceed this limit! There are other fudge-factors as well. There is evidence that the very early stages are not exponential, but possibly quadratic or some other curve, but this doesn't matter very much in the grand scope of things. If you want to be really pedantic, you have to do Monte Carlo simulations using census and geospatial data for each area, factoring in things like school days, work hours, mass transit usage, and tourism. However, it turns out that after all that effort you end up pretty much with a logistic curve, the first half of which is barely distinguishable from an exponential curve. All previous pandemics and plagues have followed curves like this. There is no magic math formula that will dispel this plague. Sorry.
DesiLurker 7y ago
My thinking stems from the conclusion that at this point there is no containing this virus, because this whole thing started with a single infection and transmission is asymptomatic so unless we test all humans & quarantine till we get vaccine this going to spread. If you accept that premise, then the only solution is to manage hospital capacity. So I propose that we use hospital overload as a high watermark for quarantining the local communities. so basically you initiate quarantine when hospitals are say at 50% of their capacity (because they will peak after quarantine begin). Wait & once they fall below say 10% release the quarantine. Repeat the process until you get herd immunity or vaccine.
- yiyus 7y ago
  Your numbers are totally unrealistic. Assuming the growth rate is similar as in Europe (and afaik there is no reason to think it is any different), if you start the quarantine with hospitals at 50%, they will be at 100% capacity in 3 days, and the cases that require hospitalization will keep doubling every 3 days for at least 2-3 weeks. A quarantine won't magically reduce it to 10%.
  - DesiLurker 7y ago
    thats a valid criticism, but I didn't mean the thresholds as prescriptive. they would depend upon a few things but actual values can be calculated based on infection rate & also be learnt from past cycles after you have gone through it once. the idea is that quarantine will slow down R0 enough to give hospitals a breather & work through the cases. also it will buy enough time to manufacture more ventilators. Lastly once we go through a couple of these on-off cycles it will help establish that the virus is a know quantity to the larger economy so we can plan around this. which is way better than current 'OMG we are headed for depression' style panic.
hydroreadsstuff 7y ago
The obvious answer is to test aggressively and quarantine the infected and direct contacts. Then the rest can be out and about.
- senordevnyc 7y ago
  It may be a good option, we’ll see how SK and Singapore and Taiwan continue to fare. Regardless, we obviously can’t execute on it, for reasons of incompetency, culture, faith in government, etc. And even if we could, it would take months to scale to where we’re testing millions per day like we’d need for that strategy. Millions would die by then. So given where we are today, and the resources we have today, what would you do?
- systemvoltage 7y ago
  Coronavirus has an incubation period of avg 5 days, and it gets contagious on the 2nd day. So, no, that will not work unless we have billions of tests and we test every citizen 3 times a week. Given that we don't have tests, and we cannot test every citizen with force; this is not gonna work.

whb07 7y ago

Because everyone keeps parroting what you're saying. We are effectively now in a fear bubble. So now everyone's mindset is "stop the world lets hunker down and cower in a corner for the impending doom. Nothing positive or new data can change my mind." In a couple weeks/months they'll start testing people to find out if they did have the virus. The tests right now only show if you currently have it. Once the real numbers come out I am confident it will be a massive over estimate for the CFR. The fear bubble is causing people to underlook the data in places like SK, SG, Japan, Germany and overlook the data in Italy, China, Iran. It could be quite possible that a mixture of smoking, age, over reporting causes, and bad healthcare (gasp not in Italy where socialized medicine is world beating) is being overlooked. So what we get now is stopping of society and the economy, millions of people will go through displacement and a host of negative things. People's savings will be depleted, not to mention teacher's/public servants/ pension and 401ks will take a MASSIVE hit. Oh and add to that more trillions of USD to the debt.

clwg 7y ago
The alternative to over reaction is under reaction. I'd rather take extreme precautions and deal with the economic fallout then under react and deal with the situation that italy is currently in. I think in this situation fear is good, it ensures urgency and assists with decisive action making, coupled with humility to change course when your wrong. Apathy is much scarier than fear in these situations.
senordevnyc 7y ago
You didn’t answer my question. What is your plan? It sounds like your plan to deal with an exponential outbreak is to wait a few weeks until you have better testing to see if this is really something to worry about, or if those disaster countries that came before you were just a fluke. Do you not see the problem here? No one is suggesting we don’t test. But the disease is rapidly spreading while we dither about, and if you’re wrong about the CFR, it’ll be way, way too late by the time we know that.
- bsaul 7y ago
  The only country that has correctly dealt with the virus is SK, because the had the test infra ready to test enough people to actually do science. The others countries have all had debate on optimistic vs precautious solutions, buying time vs saving the economy, but the reality is that none are able to correctly assess the spread of the virus. They can’t do correct science.
  - whycombagator 7y ago
    HK/Singapore/Japan numbers also don't seem too bad either[0]. Seems their responses have been pretty good? SK's numbers are higher (last I checked), but I know they had the issue with those religous gatherings hampering their containment efforts. [0] https://www.worldometers.info/coronavirus/#countries https://www.worldometers.info/coronavirus/#countries
- whb07 7y ago
  I’ll tell you what we do. We don’t shut down the country and destroy millions of lives and future generations. We definitely don’t do it if there’s already overwhelming evidence this impacts the 70+ year old crowd. We can talk dream scenarios if this actually impacted the youth. Because in that case then there’s actual risk to future societies. Have you seen an actuarial table for a 70 year old? Go ahead and tell me those numbers and how they compare to the sub 1% CFR seen in Germany, SG, South Korea and Japan.
  - senordevnyc 7y ago
jmull 7y ago
It’s hard to take you seriously when you just dodge the question. Also, the idea the economy will just keep rolling along somehow if we don’t do anything to slow the virus is wrong. When people are dying in the streets due to lack of health care capacity you’ll see what a real panic looks like. The economy is going to hard stop, probably including the food supply chain.
- mardifoufs 7y ago
  The most comprehensive analysis of the disease puts the average age of death from COVID at about ~80 years. Almost all of victims had a pre-existing condition. Fully choking the economy now means that we are much more likely to choke the supply chains and the healthcare system since we are stopping even healthy, younger people who are usually the main contributors to economic output. Without that output, it will only get harder to help those most vulnerable to the disease. So the argument that stopping the economy now to help it later, eventually, even if we don't know how long we will need to keep it shut doesn't make any sense imo. We are jeopardizing our future ability to fight against the disease, big time
  - senordevnyc 7y ago
    You’re dancing around my question: what would you do right now with what you have available right now? Just let 5% of your population die and tell the rest to get back to work, restaurants, vacation?
    - mardifoufs 7y ago
      That's a ridiculous false choice fallacy. First of all, the 5% doesn't make sense and is demonstrably false. You are cherry picking the data that fits you and assuming everyone infected got tested. Also, if you go by your logic, why do you think killing 5% of the population better than killing even more people by completely wrecking the supply chains that allow us to treat enough people? Also, you've literally ignored all of my argument that addressed what would be better and why it would be better. You also shifted back to a rhetorical question to avoid talking about whatever you said about dead people in the streets. It's absurd to move the goalposts like this. But even if you are clearly being dishonest here, I'll say it again. The best option would be to not lock down the vast majority of the population because it will only mean less resources to help the sick and fight against the disease itself. It will also only lead to a breaking point where people will simply not be able to afford to stay on lockdown no matter how bad it gets. That will make the whole thing much more deadly because people will simply not follow any measure if they are hungry or completely broke.

taeric 7y ago

Nobody is proposing we just let people die. At least, nobody credibly that I have seen. There are some questions on if there was really going to be a curve to flatten. Such that, if we flatten it now, was it the social distancing we did, or was it going to flatten anyway? These are not reasons to abandon caution. They do seem valid questions, though. Especially considering the costs of the actions we have taken.

int_19h 7y ago
Can you cite some references on "there was really going to be a curve"? I haven't seen any models that expect it to die out on its own without infecting a significant proportion of the population first - all of them assume exponential spread, just different rates of it (which is exactly what social distancing lowers).
- taeric 7y ago
  Your question is part of my complaint. There have to be models that this didn't spread exponentially in the severe cases. Where are they, and what were their odds?
  - Rexxar 7y ago
    > There have to be models that this didn't spread exponentially in the severe cases Why ? Model have to fit what we observe. And we always observe exponential.
    - taeric 7y ago
      But we haven't observed much, yet. This is akin to the xkcd about how married you will be for days after your wedding. We are way too early to know what the later curve looks like.
      - jiggawatts 7y ago
        The more accurate curve is a Logistic Curve. You have to factor in that eventually people become immune or die, and there's a total population ceiling. Obviously, the number of confirmed cases cannot exceed this limit! There are other fudge-factors as well. There is evidence that the very early stages are not exponential, but possibly quadratic or some other curve, but this doesn't matter very much in the grand scope of things. If you want to be really pedantic, you have to do Monte Carlo simulations using census and geospatial data for each area, factoring in things like school days, work hours, mass transit usage, and tourism. However, it turns out that after all that effort you end up pretty much with a logistic curve, the first half of which is barely distinguishable from an exponential curve. All previous pandemics and plagues have followed curves like this. There is no magic math formula that will dispel this plague. Sorry.

DesiLurker 7y ago

My thinking stems from the conclusion that at this point there is no containing this virus, because this whole thing started with a single infection and transmission is asymptomatic so unless we test all humans & quarantine till we get vaccine this going to spread. If you accept that premise, then the only solution is to manage hospital capacity. So I propose that we use hospital overload as a high watermark for quarantining the local communities. so basically you initiate quarantine when hospitals are say at 50% of their capacity (because they will peak after quarantine begin). Wait & once they fall below say 10% release the quarantine. Repeat the process until you get herd immunity or vaccine.

yiyus 7y ago
Your numbers are totally unrealistic. Assuming the growth rate is similar as in Europe (and afaik there is no reason to think it is any different), if you start the quarantine with hospitals at 50%, they will be at 100% capacity in 3 days, and the cases that require hospitalization will keep doubling every 3 days for at least 2-3 weeks. A quarantine won't magically reduce it to 10%.
- DesiLurker 7y ago
  thats a valid criticism, but I didn't mean the thresholds as prescriptive. they would depend upon a few things but actual values can be calculated based on infection rate & also be learnt from past cycles after you have gone through it once. the idea is that quarantine will slow down R0 enough to give hospitals a breather & work through the cases. also it will buy enough time to manufacture more ventilators. Lastly once we go through a couple of these on-off cycles it will help establish that the virus is a know quantity to the larger economy so we can plan around this. which is way better than current 'OMG we are headed for depression' style panic.

hydroreadsstuff 7y ago

The obvious answer is to test aggressively and quarantine the infected and direct contacts. Then the rest can be out and about.

senordevnyc 7y ago
It may be a good option, we’ll see how SK and Singapore and Taiwan continue to fare. Regardless, we obviously can’t execute on it, for reasons of incompetency, culture, faith in government, etc. And even if we could, it would take months to scale to where we’re testing millions per day like we’d need for that strategy. Millions would die by then. So given where we are today, and the resources we have today, what would you do?
systemvoltage 7y ago
Coronavirus has an incubation period of avg 5 days, and it gets contagious on the 2nd day. So, no, that will not work unless we have billions of tests and we test every citizen 3 times a week. Given that we don't have tests, and we cannot test every citizen with force; this is not gonna work.