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"The only reliable metric of severity remains the number of deaths" Completely agree. "until that gets into tens of thousands (i.e. exceeds that of flu), any

"The only reliable metric of severity remains the number of deaths" Completely agree. "until that gets into tens of thousands (i.e. exceeds that of flu), any panic is premature" I completely and totally disagree with this statement. By the time you get to >10s of thousands of deaths (e.g., about 20 days ahead of the actual infection rate) before you implement severe social distancing and Wuhan-style lockdown, you are set up for a guaranteed million deaths by the time it's over. 10's of thousands of deaths is too damn late. The time to act was a month ago. We are already chasing the dragon, and a number of miracles will need to happen to get this thing under control without 100,000 deaths.

m0zg 7y ago
You're ignoring the economic damage. That has non-zero fatality rate as well. As cynical as that sounds, you have to balance the two. You can't shut down the economy for more than a few weeks before supply chains fall apart and you start running out of food and necessities, not to mention anything more complicated. Any given widget typically relies on hundreds, if not thousands of suppliers upstream, to manufacture, and if you shut down some of those suppliers, you lose the ability to make the widget, or at least do so quickly. That "global economy" everyone was so proud of a few months back? It got a swift kick to the nuts in all this. Moreover, Europe will have to restart production also, for the same reasons, within no more than a month. Also, you're making decisions based on pure panic in the absence of reliable information, and you're making them country-wide even though the country is not uniformly affected. The reality on the ground is some parts of the country need to remain more operational than others for us to pull through this, and aiming for sub-flu levels of fatalities is an unrealistic goal, no matter how much fear mongering you see from the press. It's simply not going to happen, even if COVID19 is cured entirely, if for no other reason that we can't cure the flu. 60K people die every winter, nobody gives a shit. 1K people die of coronavirus - everyone loses their mind. Now granted, it could get much worse very fast, but that's why we're ramping up testing so massively: to be able to offer a more adaptive, more localized response that doesn't shut everything down.
- hcknwscommenter 7y ago
  "You're ignoring the economic damage." No i am not. "You can't shut down the economy for more than a few weeks before supply chains fall apart and you start running out of food and necessities, not to mention anything more complicated. " The California shut down has no affect on food and consumer necessity supply chains. "Also, you're making decisions based on pure panic in the absence of reliable information" This is not pure panic and there is information, and we know EXACTLY how to model in the uncertainties and confidence intervals surrounding best estimates of CFR, R0, etc. We have very good numbers from S. Korea. We have very good numbers from Diamond Princess and we can stratify based on age and prior health status and cross-check with Korea. WE are not in a blind panic. The press is not fear mongering. We are running out/ have run out of ventilators in NY. It has already TODAY gotten much worse very fast, and it should be no surprise to anyone who was paying attention to Italy two weeks ago. 1K deaths today, following an exponential growth pattern makes the numbers VERY scary in two weeks and that's assuming our healthcare system is not overwhelmed. "but that's why we're ramping up testing so massively" Are we? Not yet? And why not? Because Trump didn't want his numbers to look bad so he ordered the CDC to insist all tests were run through them. Now our country is scrambling to catch up. We will ramp up testing, I am sure. It is in the works, but we still haven't actually done it on the scale we really need. NY is getting sort of close, but not really. Even they have to at least double. EVERYWHERE else in the U.S. is laughably behind.
  - m0zg 7y ago
    > The California shut down has no affect on food and consumer necessity supply chains. Citation needed. If it has "no effect" then we should just get rid of whatever they shut down, since it's clearly not necessary. > We have very good numbers from Diamond Princess We don't. All the people who died there were in their 70s and 80s and had pre-existing conditions as well. And it was a single digit number. One would have to be totally statistically illiterate to extrapolate that to a country the size of United States. > 1K deaths today Yes, the slope can get pretty scary in the middle of a sigmoid. But there weren't "1K deaths today", and they are seeing gradual reduction in the number of daily new cases. This is especially encouraging given that they're doing a ton of tests now. > Are we? Yes: https://www.politico.com/interactives/2020/coronavirus-testing-by-state-chart-of-new-cases/ https://www.politico.com/interactives/2020/coronavirus-testi.... With half a million tests given so far, best I can tell we have the highest testing throughput in the world, and it keeps on increasing. It's very impressive actually. I wish we didn't fumble it so badly out of the gate, NY could be much better now if they had more reliable info earlier. What we need is serologic test to determine approximately how many people had asymptomatic COVID19. Some studies suggest there could be a ton of those, which would explain why Wuhan did not experience a second round of epidemic after lifting most of the restrictions and putting people back to work. Assuming, of course, we're not getting fake news from there.

m0zg 7y ago

You're ignoring the economic damage. That has non-zero fatality rate as well. As cynical as that sounds, you have to balance the two. You can't shut down the economy for more than a few weeks before supply chains fall apart and you start running out of food and necessities, not to mention anything more complicated. Any given widget typically relies on hundreds, if not thousands of suppliers upstream, to manufacture, and if you shut down some of those suppliers, you lose the ability to make the widget, or at least do so quickly. That "global economy" everyone was so proud of a few months back? It got a swift kick to the nuts in all this. Moreover, Europe will have to restart production also, for the same reasons, within no more than a month. Also, you're making decisions based on pure panic in the absence of reliable information, and you're making them country-wide even though the country is not uniformly affected. The reality on the ground is some parts of the country need to remain more operational than others for us to pull through this, and aiming for sub-flu levels of fatalities is an unrealistic goal, no matter how much fear mongering you see from the press. It's simply not going to happen, even if COVID19 is cured entirely, if for no other reason that we can't cure the flu. 60K people die every winter, nobody gives a shit. 1K people die of coronavirus - everyone loses their mind. Now granted, it could get much worse very fast, but that's why we're ramping up testing so massively: to be able to offer a more adaptive, more localized response that doesn't shut everything down.

hcknwscommenter 7y ago
"You're ignoring the economic damage." No i am not. "You can't shut down the economy for more than a few weeks before supply chains fall apart and you start running out of food and necessities, not to mention anything more complicated. " The California shut down has no affect on food and consumer necessity supply chains. "Also, you're making decisions based on pure panic in the absence of reliable information" This is not pure panic and there is information, and we know EXACTLY how to model in the uncertainties and confidence intervals surrounding best estimates of CFR, R0, etc. We have very good numbers from S. Korea. We have very good numbers from Diamond Princess and we can stratify based on age and prior health status and cross-check with Korea. WE are not in a blind panic. The press is not fear mongering. We are running out/ have run out of ventilators in NY. It has already TODAY gotten much worse very fast, and it should be no surprise to anyone who was paying attention to Italy two weeks ago. 1K deaths today, following an exponential growth pattern makes the numbers VERY scary in two weeks and that's assuming our healthcare system is not overwhelmed. "but that's why we're ramping up testing so massively" Are we? Not yet? And why not? Because Trump didn't want his numbers to look bad so he ordered the CDC to insist all tests were run through them. Now our country is scrambling to catch up. We will ramp up testing, I am sure. It is in the works, but we still haven't actually done it on the scale we really need. NY is getting sort of close, but not really. Even they have to at least double. EVERYWHERE else in the U.S. is laughably behind.
- m0zg 7y ago
  > The California shut down has no affect on food and consumer necessity supply chains. Citation needed. If it has "no effect" then we should just get rid of whatever they shut down, since it's clearly not necessary. > We have very good numbers from Diamond Princess We don't. All the people who died there were in their 70s and 80s and had pre-existing conditions as well. And it was a single digit number. One would have to be totally statistically illiterate to extrapolate that to a country the size of United States. > 1K deaths today Yes, the slope can get pretty scary in the middle of a sigmoid. But there weren't "1K deaths today", and they are seeing gradual reduction in the number of daily new cases. This is especially encouraging given that they're doing a ton of tests now. > Are we? Yes: https://www.politico.com/interactives/2020/coronavirus-testing-by-state-chart-of-new-cases/ https://www.politico.com/interactives/2020/coronavirus-testi.... With half a million tests given so far, best I can tell we have the highest testing throughput in the world, and it keeps on increasing. It's very impressive actually. I wish we didn't fumble it so badly out of the gate, NY could be much better now if they had more reliable info earlier. What we need is serologic test to determine approximately how many people had asymptomatic COVID19. Some studies suggest there could be a ton of those, which would explain why Wuhan did not experience a second round of epidemic after lifting most of the restrictions and putting people back to work. Assuming, of course, we're not getting fake news from there.