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It's been very hard for me to understand this line of thinking. As I see it, there are so few cases in California because of the measures that have been taken.

It's been very hard for me to understand this line of thinking. As I see it, there are so few cases in California because of the measures that have been taken. Do you think California would not have many more cases if the measures were relaxed? Or do you think that the cases would not be all that bad? Or do you think that they would only affect people that you aren't personally concerned about? I'm asking honestly for an explanation here, because you're certainly not alone in this view, but I haven't heard a rational justification for it yet, and I haven't been able to come up with one myself.

istorical 7y ago
I think there are open questions about how much our current actions are preventing deaths vs delaying them, what the difference is in terms of number of deaths caused by stay-at-home order vs more mild social distancing, and what downstream effects and deaths will result from a new global depression (especially in the developing world).
- deleted 7y ago
  [deleted]
- yibg 7y ago
  Are there any examples of milder social distancing without extensive testing and contact tracing that has been effective? There are certainly a lot of examples of delayed or poorly enforced / adhered social distancing that has proved to be ineffective.
  - option 7y ago
    Sweden. Also look how different states/counties are affected in US
    - therealdrag0 7y ago
      Sweden has one of the highest deaths/million.
      - CydeWeys 7y ago
        Yup, it's worse than the United States even. They're not a model of success at all.
        temp20160423 7y ago
        It's not worse than US: http://91-divoc.com/pages/covid-visualization/ http://91-divoc.com/pages/covid-visualization/ (third plot on page)
        CydeWeys 7y ago
        Wrong data. You're looking at confirmed cases, which Sweden is massively falling behind on because they're under-testing so badly, as you can see from their absolutely incredible (as in unbelievable) reported case fatality rate of 9%. It's not that 9% of their population is dying from this, it's that they're not even catching 1 out of every 50 people that even have it. Their stats look low because they're so severely under-reported. The correct figures to be comparing here are per capita deaths. Sweden is currently sitting at 1,014 deaths per 10M people while the United States is at 789. Ergo, Sweden's outbreak is roughly a third worse than the US so far, and growing worse.
christophilus 7y ago
> there are so few cases in California because of the measures that have been taken This is probably true, but other countries haven't locked down hard and aren't seeing a big spread. Our options aren't binary. It's not as if the only choice is "Nuke everything" or "Surrender". The US is not a very densely populated country, and density seems to have the biggest impact on the spread of this thing. We probably could do something like this: - Dense city? Quarantine. - Moderately dense? High risk individuals quarantine, everyone else social distances, but works. - etc Across the board, if your business is the sort that can WFH (such as software companies), then you do work from home. If not, then you're open, but with precautions. Restaurants are open, but pickup only, etc. The point is, we've used a nuke, and it's not at all clear to me that that was the right decision.
- CydeWeys 7y ago
  > This is probably true, but other countries haven't locked down hard and aren't seeing a big spread. Which countries might that be? If you're referring to South Korea, they're ahead of the game enough on testing for this to be workable (unlike us). If you're referring to anyone else, they're simply not at that point yet in the curve, but will arrive there.
  - christophilus 7y ago
    Various European countries. Sweden comes to mind.
    - CydeWeys 7y ago
      Sweden has more deaths per capita from coronavirus than the US, has an exponentially increasing death rate (i.e. they haven't turned the corner yet), and a very high case fatality rate of 9.4% indicating that they're severely under-testing. This is not what a successful disease prevention strategy looks like.
      - malandrew 7y ago
        Sweden's deaths per capita is neck and neck with the United States and following approximately the same trajectory with no lockdown. It's neither appreciably better nor appreciably worse. http://91-divoc.com/pages/covid-visualization/ http://91-divoc.com/pages/covid-visualization/
tempsy 7y ago
Not all cities issued a shelter in place in California at the same time. Bay Area was early, and then the state issued one a week later. You think you’d see a hot spot somewhere in the state but doesn’t appear to be the case. Unclear to me that SIP is the main reason why we have few cases vs if we just required face masks and social distancing while keeping more businesses open.
- thaumaturgy 7y ago
  Yeah, fwiw I would not argue with someone that claimed that nobody has a complete picture of all of the factors in the virus's infection rate. There has been a lot of conflicting and incomplete information and it's been difficult to stay up-to-date. It might be that there's some sort of difference between California and New York or northern Italy that would make California far less susceptible. Maybe environmental, or demographic, who knows. The problem though is that we don't know that California would somehow turn out differently, and because of this thing's damnable asymptomatic incubation period and rates of spread, by the time you realize you haven't taken it seriously enough, it's going to be very bad. So imagine you're sitting at the table with the governor and CalOES. They're asking you to make a decision today: tank the economy, or not. In two weeks you get to see how it turned out: either you saved the economy and only several hundred people died, or several thousand people have died and your healthcare system is on the verge of collapse and the economy tanked anyway because sick and dead people don't do a lot of shopping.
0x8BADF00D 7y ago
Sweden has far fewer cases and death rate without a massive lockdown. If this disease is really so deadly, why isn’t their country being massively depopulated? Same for states in the US that haven’t implemented any lockdown measures.
- yazboo 7y ago
  Sweden has the highest death rate per capita of all developed nations.
  - rileymat2 7y ago
    Where is that stat? The sources I have seen do not show that.
    - CydeWeys 7y ago
      The stat that they're specifically referring to is the case fatality rate, but that has a lot more to do with the denominator (Sweden's utter failure to test) than the numerator (actual number of deaths).
  - viceroyalbean 7y ago
    While current Swedish strategy carries a high risk of bringing it to that point, that statement is absolutely false right now. Swedish deaths per 1 million are currently 102, significantly lower than Spain (397), Italy (348), France (241), Belgium (383), etc. Source: https://www.worldometers.info/coronavirus/#countries https://www.worldometers.info/coronavirus/#countries
  - dx034 7y ago
    I'd like to believe that Belgium, Italy, France and others in Europe are also developed.
- StavrosK 7y ago
  Sweden: https://imperialcollegelondon.github.io/covid19estimates/#/details/Sweden https://imperialcollegelondon.github.io/covid19estimates/#/d... Greece: https://imperialcollegelondon.github.io/covid19estimates/#/details/Greece https://imperialcollegelondon.github.io/covid19estimates/#/d... Where would you rather be?
fullshark 7y ago
I personally think something should have been done, but it's an open question if we went too far or not far enough and am willing to listen to the argument that we went too far. It's unlikely what was done was the absolute perfect policy prescription given all the trade offs involved. Personally I'm looking to Sweden's data, a country that instituted some social distancing measures (no crowds above 50) but not all (Restaurant dine in still open) for some clarity. Their numbers are worse than Denmark's right now but not absurdly so (2x deaths per capita).
- CydeWeys 7y ago
  Give it time. They're still in full exponential growth, whereas every place that enacted social distancing rules a couple weeks ago or more is now plateauing.
  - fullshark 7y ago
    Possibly, their numbers the last 4 days are bizarre, potentially due to holiday effects. My guess is what's going to happen is they will see more deaths, but not an unreasonable number and both sides of the debate will declare victory as they move the goal posts sufficiently.
    - CydeWeys 7y ago
      My guess is that they'll end up having to do more stringent social distancing measures anyway, but that a lot of people will end up having unnecessarily died because they waited so long relative to other countries. Because currently they are on track for an unreasonable number of deaths, and it would reasonable to change the course of action so that that doesn't happen. I'm not seeing a lot of subtlety in these outcomes, nor possibility of both sides (credibly) claiming that they were right. We'll know soon enough either way.
  - williamstein 7y ago
    Sweden's number of confirmed cases is not in full exponential growth right now. https://www.worldometers.info/coronavirus/country/sweden/ https://www.worldometers.info/coronavirus/country/sweden/
vondur 7y ago
I totally believe that the coronavirus has been in California since December and peaked in February. I’m sure if we look back we can find evidence of people getting sick and recovering. Those who died were listed as death from pneumonia or something else.
- CydeWeys 7y ago
  If COVID-19 had been spreading uncontrolled in California for four months prior to containment measures being enacted, the number of deaths by now would be truly mind-boggling. It's simply not possible for this to have been the case, because it would have been obvious sheerly looking at the all-cause death rate in the state increasing by many times its normal value months ago. This didn't happen, ergo COVID-19 was not spreading uncontained in California for that long.
- thaumaturgy 7y ago
  The main snag with this model is hospitalizations. Even if we grant that there was no testing available, and that early deaths of covid19 would have been attributed to cardiac disease or pneumonia, and that there may have been some kind of less lethal early strain or some other voodoo, the hospitalization rate would still be expected to be constant, and it hasn't been. Health care workers have broadly been reporting pretty typical case loads up until early to mid March. For some corroborating data, there's a "smart thermometer" company [1] that uses the aggregated data from their thermometers to maintain health "weather" metrics for the US [2]. Right on their health weather page, you can see a chart showing typical rates for seasonal infections across the US, up until March 1st. And if you're concerned that New York is tilting the results, then you can even zoom in to the San Francisco area [3] and see the same behavior. Kinsa's CEO has published a writeup on medium [4] that compares a couple of different areas with different responses and timelines, and he says that the data he's seeing suggests that stay-at-home orders are making a big difference in infection rates. They have more stuff like this on their Twitter account [5]. I would think that if this were the same disease all the way back in December, the data would look very different. There'd be no explanation for the fall-off of fever rates all the way up to March 1, when it suddenly started climbing. [1]: https://www.kinsahealth.co/ https://www.kinsahealth.co/ [2]: https://healthweather.us/?mode=Atypical https://healthweather.us/?mode=Atypical [3]: https://healthweather.us/?regionId=06075&mode=Atypical https://healthweather.us/?regionId=06075&mode=Atypical [4]: https://medium.com/@inders/your-sacrifices-are-saving-lives-3c80d88cea39 https://medium.com/@inders/your-sacrifices-are-saving-lives-... [5]: https://twitter.com/kinsa https://twitter.com/kinsa
adventured 7y ago
> As I see it, there are so few cases in California because of the measures that have been taken. California has been spared because it's not in the Covid Belt. That's a term I've come up with to describe the ideal climate that SARS-CoV-2 thrives in. All hard hit regions exist in the Covid climate belt. Not all the least hit areas (eg South Korea) exist outside of the Covid Belt. You can also limit its spread with other aggressive measures. Climate provides a substantial natural impediment, although it doesn't entirely stop the spread either. It's why Texas, New Mexico, Arizona look like they do right now versus Michigan and New York. It's not because Texas has had amazing testing and tracing and quarantine measures. It's why Tehran was hammered by the virus but Baghdad was not. It wasn't luck, it wasn't testing, it wasn't tracing, it wasn't lockdown measures. Baghdad is a hotter climate than Tehran during the December > May time frame. It's why Athens & Greece is largely spared but Milan is not. It's not because Greece implemented South Korea-style measures early on and they have a far better healthcare system than Britain. It's why Southern Italy is not hit like Northern Italy. They have different climates. It's why Madrid is hit so hard but Barcelona and Lisbon are not. They have different climates. It's why NYC is hit hard but San Francisco and Los Angeles and San Diego are not. The entire San Diego County has 53 deaths. It's why Texas is largely spared but Massachusetts and Michigan are not. It's why Detroit was hit but Phoenix was not. It's why Belgium and the Netherlands were hit but Mexico wasn't. It's why Wuhan was hit but Hawaii and Jakarta and Singapore were not. It's why Algiers (7.8m people in their metro, just south of Spain) isn't drowning in Covid cases and hasn't been hit like Madrid. It's also why India and Pakistan have been largely spared bad outbreaks. Defying all predictions thus far to the contrary. It's why Lagos Nigeria isn't being hit hard and the Netherlands and Britain were. It's why Cairo isn't buried in dead bodies right now. The Cairo metro has 20 million people. Check out the temps in Cairo during the Nov > May time frame. Look at the climates. Nearly all of the hardest hit areas exist in a sweet spot on temperature range. Milan: https://weather-and-climate.com/uploads/average-temperature-italy-milan-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Wuhan: https://weather-and-climate.com/uploads/average-temperature-china-wuhan-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... NYC: https://weather-and-climate.com/uploads/average-temperature-united-states-of-america-new-york-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Tehran: https://weather-and-climate.com/uploads/average-temperature-iran-tehran-ir-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... London: https://weather-and-climate.com/uploads/average-temperature-united-kingdom-london-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Boston: https://weather-and-climate.com/uploads/average-temperature-united-states-of-america-boston-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Chicago: https://weather-and-climate.com/uploads/average-temperature-united-states-of-america-chicago-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Now compare to Baghdad: https://weather-and-climate.com/uploads/average-temperature-iraq-baghd-d-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Cairo: https://weather-and-climate.com/uploads/average-temperature-egypt-cairo-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Los Angeles: https://weather-and-climate.com/uploads/average-temperature-united-states-of-america-los-angeles-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Algiers: https://weather-and-climate.com/uploads/average-temperature-algeria-algiers-dz-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Lagos: https://weather-and-climate.com/uploads/average-temperature-nigeria-lagos-ng-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Houston: https://weather-and-climate.com/uploads/average-temperature-united-states-of-america-houston-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Phoenix: https://weather-and-climate.com/uploads/average-temperature-united-states-of-america-phoenix-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Singapore: https://weather-and-climate.com/uploads/average-temperature-singapore-singapore-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Las Vegas: https://weather-and-climate.com/uploads/average-temperature-united-states-of-america-las-vegas-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... San Diego: https://weather-and-climate.com/uploads/average-temperature-united-states-of-america-san-diego-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Athens: https://weather-and-climate.com/uploads/average-temperature-greece-athens-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... --- Compare Barcelona: https://weather-and-climate.com/uploads/average-temperature-spain-barcelona-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... To Madrid: https://weather-and-climate.com/uploads/average-temperature-spain-madrid-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Compare Milan again:https://weather-and-climate.com/uploads/average-temperature-italy-milan-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... To Rome: https://weather-and-climate.com/uploads/average-temperature-italy-rome-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... See those higher highs through the flu season? That 8-10 degrees of higher temps throughout Winter is the difference. Getting as close to the ~55-60 F or higher temp zone at the highs as possible during Winter is where you want to be. The regions that are, have seen dramatically fewer cases. This spans all variations of circumstances between nations (rich vs poor, good testing vs weak testing etc). At 64 degrees F and above, we know that influenza, for example, is heavily impeded by the heat. This is why so many experts have been predicting a big downturn in the virus as Spring & Summer temperatures roll in. This has already been shown by several studies. We already know why. 90-95% of all cases of transmission have occurred in the Covid Belt areas that have ideal climates for the transmission of the virus (otherwise Africa would be drowning in Covid deaths right now).
watertom 7y ago
I’ve participated in Homeland Security pandemic exercises. One in particular had a R0 of about 2, and a death rate of 1.3%, with a hospitalization rate of 10%, and and acute care rate of 3%. All numbers lower than CoVID-19. What happened in the exercise was that all hospitals got over run, very quickly, it took months for the infection rates to flatten. Nobody could get into a hospital and get any proper care, entire families started dying, the death rate jumped up to almost 12%. Remember the calculated death rate is based on proper care. Police, Fire, EMS, got hit hard and they all walked off the job. Nursing homes, assisted living facilities had death rates of almost 75%, (we’re starting to see 50% now). Hospital workers started walking off the job. The economy didn’t slow down the economy flew into the ground at 500mph and exploded in billions of tiny pieces. The country went into immediate shortages of everything, which didn’t really matter because basically everyone stopped going to work. When you might get sick and you know you can’t get care and without care you have a 12 in 100 chance of dying you can’t get people to leave their house, for any reason. People start dying home alone. The death rate gets even higher because of food shortages, prescription drug shortages, and underlying health conditions fuel the fire. Power disruptions, water, sewage issue because no one is working. Crime becomes a problem, because a) the police aren’t working and b) people get desperate. Once things start to unravel you can’t simply re-ravel things. In a normal flu season about 40 Million people get infected, with 30-67K dead a year spread out over 6 months. If we respond to COVID-19 like we do with the flu, we could see 150-200 million infected because it spreads more easily, those numbers would overwhelm the country, maybe have 20-35 Million dead, the economy might stop for a year or two, or three or four. We don’t know if infection confers immunity, what happens if it doesn’t? What if getting it makes you more susceptible to a second and worse infection? What if we can’t develop a vaccine? You’ll be gambling with a lot of lives.
- CydeWeys 7y ago
  I agree with your point in general, but this claim is overblown: > If we respond to COVID-19 like we do with the flu, we could see 150-200 million infected because it spreads more easily, those numbers would overwhelm the country, maybe have 20-35 Million dead Even without any medical treatment at all, the death rate from COVID-19 is much lower than 13%. It might even be below 1%, once you factor in all the asymptomatic cases that we're only just starting to discover from blood antibody testing. So we're still talking about millions of deaths, which would be absolutely horrible enough in its own right, but we're not looking at double digit death numbers. COVID-19 fortunately isn't that deadly. Other diseases are though ... so in a way, as bad as this seems, we did still get somewhat lucky.
nickthemagicman 7y ago
> As I see it, there are so few cases in California because of the measures that have been taken How do you know though? The flat curver movement has set themselves up so there's no accountability, no reliance on data, no proof that it's working or not working. Just repeating what other people have said and patting themselves on the back that it's working. Sweden has less per capita infections than many other countries and they have no full quarantine just basic social distancing and hand washing.
thu2111 7y ago
It's rational, you just haven't seen the data causing people to ask these questions. Perhaps because aforementioned newspaper outlets aren't showing you. Here is some. Graphical comparison of UK (hard lock down) with Sweden (not much lockdown e.g. restaurants and shops still open) http://www.theblogmire.com/a-comparison-of-lockdown-uk-with-non-lockdown-sweden/ http://www.theblogmire.com/a-comparison-of-lockdown-uk-with-... There's basically no difference. Switzerland's proportion of positive tests as a fraction of all tests (i.e. is it spreading) shows no epidemic and no effect from lockdown, again, presented visually here in the tweet that's a reply to the first: https://twitter.com/FScholkmann/status/1249703752904425478 https://twitter.com/FScholkmann/status/1249703752904425478 In Switzerland the apparent reproduction number started to fall before lockdown began (see the shaded graph): https://medicalxpress.com/news/2020-04-lockdown-impact-covid-.html https://medicalxpress.com/news/2020-04-lockdown-impact-covid... https://www.tagesanzeiger.ch/ansteckungsraten-flachten-bereits-vor-dem-lockdown-ab-809893127675 https://www.tagesanzeiger.ch/ansteckungsraten-flachten-berei... (you can delete the paywall to see the headline and summary) There are other reasons to be skeptical. Epidemics naturally come and go very quickly. The "lockdown" concept comes from epidemiologists. These people have a history of proposing extreme measures that turn out to have had no effect when compared to control groups, or when people simply realise that the epidemic entered decline before the recommended measures were implemented. If the lockdown ends up having no effect it'd be counter-intuitive but entirely predictable from how things worked out in the past. For instance, look at the history of foot-and-mouth disease in the UK.

istorical 7y ago

I think there are open questions about how much our current actions are preventing deaths vs delaying them, what the difference is in terms of number of deaths caused by stay-at-home order vs more mild social distancing, and what downstream effects and deaths will result from a new global depression (especially in the developing world).

deleted 7y ago
[deleted]
yibg 7y ago
Are there any examples of milder social distancing without extensive testing and contact tracing that has been effective? There are certainly a lot of examples of delayed or poorly enforced / adhered social distancing that has proved to be ineffective.
- option 7y ago
  Sweden. Also look how different states/counties are affected in US
  - therealdrag0 7y ago
    Sweden has one of the highest deaths/million.
    - CydeWeys 7y ago
      Yup, it's worse than the United States even. They're not a model of success at all.
      - temp20160423 7y ago
        It's not worse than US: http://91-divoc.com/pages/covid-visualization/ http://91-divoc.com/pages/covid-visualization/ (third plot on page)
        CydeWeys 7y ago
        Wrong data. You're looking at confirmed cases, which Sweden is massively falling behind on because they're under-testing so badly, as you can see from their absolutely incredible (as in unbelievable) reported case fatality rate of 9%. It's not that 9% of their population is dying from this, it's that they're not even catching 1 out of every 50 people that even have it. Their stats look low because they're so severely under-reported. The correct figures to be comparing here are per capita deaths. Sweden is currently sitting at 1,014 deaths per 10M people while the United States is at 789. Ergo, Sweden's outbreak is roughly a third worse than the US so far, and growing worse.

christophilus 7y ago

> there are so few cases in California because of the measures that have been taken This is probably true, but other countries haven't locked down hard and aren't seeing a big spread. Our options aren't binary. It's not as if the only choice is "Nuke everything" or "Surrender". The US is not a very densely populated country, and density seems to have the biggest impact on the spread of this thing. We probably could do something like this: - Dense city? Quarantine. - Moderately dense? High risk individuals quarantine, everyone else social distances, but works. - etc Across the board, if your business is the sort that can WFH (such as software companies), then you do work from home. If not, then you're open, but with precautions. Restaurants are open, but pickup only, etc. The point is, we've used a nuke, and it's not at all clear to me that that was the right decision.

CydeWeys 7y ago
> This is probably true, but other countries haven't locked down hard and aren't seeing a big spread. Which countries might that be? If you're referring to South Korea, they're ahead of the game enough on testing for this to be workable (unlike us). If you're referring to anyone else, they're simply not at that point yet in the curve, but will arrive there.
- christophilus 7y ago
  Various European countries. Sweden comes to mind.
  - CydeWeys 7y ago
    Sweden has more deaths per capita from coronavirus than the US, has an exponentially increasing death rate (i.e. they haven't turned the corner yet), and a very high case fatality rate of 9.4% indicating that they're severely under-testing. This is not what a successful disease prevention strategy looks like.
    - malandrew 7y ago
      Sweden's deaths per capita is neck and neck with the United States and following approximately the same trajectory with no lockdown. It's neither appreciably better nor appreciably worse. http://91-divoc.com/pages/covid-visualization/ http://91-divoc.com/pages/covid-visualization/

tempsy 7y ago

Not all cities issued a shelter in place in California at the same time. Bay Area was early, and then the state issued one a week later. You think you’d see a hot spot somewhere in the state but doesn’t appear to be the case. Unclear to me that SIP is the main reason why we have few cases vs if we just required face masks and social distancing while keeping more businesses open.

thaumaturgy 7y ago
Yeah, fwiw I would not argue with someone that claimed that nobody has a complete picture of all of the factors in the virus's infection rate. There has been a lot of conflicting and incomplete information and it's been difficult to stay up-to-date. It might be that there's some sort of difference between California and New York or northern Italy that would make California far less susceptible. Maybe environmental, or demographic, who knows. The problem though is that we don't know that California would somehow turn out differently, and because of this thing's damnable asymptomatic incubation period and rates of spread, by the time you realize you haven't taken it seriously enough, it's going to be very bad. So imagine you're sitting at the table with the governor and CalOES. They're asking you to make a decision today: tank the economy, or not. In two weeks you get to see how it turned out: either you saved the economy and only several hundred people died, or several thousand people have died and your healthcare system is on the verge of collapse and the economy tanked anyway because sick and dead people don't do a lot of shopping.

0x8BADF00D 7y ago

Sweden has far fewer cases and death rate without a massive lockdown. If this disease is really so deadly, why isn’t their country being massively depopulated? Same for states in the US that haven’t implemented any lockdown measures.

yazboo 7y ago
Sweden has the highest death rate per capita of all developed nations.
- rileymat2 7y ago
  Where is that stat? The sources I have seen do not show that.
  - CydeWeys 7y ago
    The stat that they're specifically referring to is the case fatality rate, but that has a lot more to do with the denominator (Sweden's utter failure to test) than the numerator (actual number of deaths).
- viceroyalbean 7y ago
  While current Swedish strategy carries a high risk of bringing it to that point, that statement is absolutely false right now. Swedish deaths per 1 million are currently 102, significantly lower than Spain (397), Italy (348), France (241), Belgium (383), etc. Source: https://www.worldometers.info/coronavirus/#countries https://www.worldometers.info/coronavirus/#countries
- dx034 7y ago
  I'd like to believe that Belgium, Italy, France and others in Europe are also developed.
StavrosK 7y ago
Sweden: https://imperialcollegelondon.github.io/covid19estimates/#/details/Sweden https://imperialcollegelondon.github.io/covid19estimates/#/d... Greece: https://imperialcollegelondon.github.io/covid19estimates/#/details/Greece https://imperialcollegelondon.github.io/covid19estimates/#/d... Where would you rather be?

fullshark 7y ago

I personally think something should have been done, but it's an open question if we went too far or not far enough and am willing to listen to the argument that we went too far. It's unlikely what was done was the absolute perfect policy prescription given all the trade offs involved. Personally I'm looking to Sweden's data, a country that instituted some social distancing measures (no crowds above 50) but not all (Restaurant dine in still open) for some clarity. Their numbers are worse than Denmark's right now but not absurdly so (2x deaths per capita).

CydeWeys 7y ago
Give it time. They're still in full exponential growth, whereas every place that enacted social distancing rules a couple weeks ago or more is now plateauing.
- fullshark 7y ago
  Possibly, their numbers the last 4 days are bizarre, potentially due to holiday effects. My guess is what's going to happen is they will see more deaths, but not an unreasonable number and both sides of the debate will declare victory as they move the goal posts sufficiently.
  - CydeWeys 7y ago
    My guess is that they'll end up having to do more stringent social distancing measures anyway, but that a lot of people will end up having unnecessarily died because they waited so long relative to other countries. Because currently they are on track for an unreasonable number of deaths, and it would reasonable to change the course of action so that that doesn't happen. I'm not seeing a lot of subtlety in these outcomes, nor possibility of both sides (credibly) claiming that they were right. We'll know soon enough either way.
- williamstein 7y ago
  Sweden's number of confirmed cases is not in full exponential growth right now. https://www.worldometers.info/coronavirus/country/sweden/ https://www.worldometers.info/coronavirus/country/sweden/

vondur 7y ago

I totally believe that the coronavirus has been in California since December and peaked in February. I’m sure if we look back we can find evidence of people getting sick and recovering. Those who died were listed as death from pneumonia or something else.

CydeWeys 7y ago
If COVID-19 had been spreading uncontrolled in California for four months prior to containment measures being enacted, the number of deaths by now would be truly mind-boggling. It's simply not possible for this to have been the case, because it would have been obvious sheerly looking at the all-cause death rate in the state increasing by many times its normal value months ago. This didn't happen, ergo COVID-19 was not spreading uncontained in California for that long.
thaumaturgy 7y ago
The main snag with this model is hospitalizations. Even if we grant that there was no testing available, and that early deaths of covid19 would have been attributed to cardiac disease or pneumonia, and that there may have been some kind of less lethal early strain or some other voodoo, the hospitalization rate would still be expected to be constant, and it hasn't been. Health care workers have broadly been reporting pretty typical case loads up until early to mid March. For some corroborating data, there's a "smart thermometer" company [1] that uses the aggregated data from their thermometers to maintain health "weather" metrics for the US [2]. Right on their health weather page, you can see a chart showing typical rates for seasonal infections across the US, up until March 1st. And if you're concerned that New York is tilting the results, then you can even zoom in to the San Francisco area [3] and see the same behavior. Kinsa's CEO has published a writeup on medium [4] that compares a couple of different areas with different responses and timelines, and he says that the data he's seeing suggests that stay-at-home orders are making a big difference in infection rates. They have more stuff like this on their Twitter account [5]. I would think that if this were the same disease all the way back in December, the data would look very different. There'd be no explanation for the fall-off of fever rates all the way up to March 1, when it suddenly started climbing. [1]: https://www.kinsahealth.co/ https://www.kinsahealth.co/ [2]: https://healthweather.us/?mode=Atypical https://healthweather.us/?mode=Atypical [3]: https://healthweather.us/?regionId=06075&mode=Atypical https://healthweather.us/?regionId=06075&mode=Atypical [4]: https://medium.com/@inders/your-sacrifices-are-saving-lives-3c80d88cea39 https://medium.com/@inders/your-sacrifices-are-saving-lives-... [5]: https://twitter.com/kinsa https://twitter.com/kinsa

adventured 7y ago

> As I see it, there are so few cases in California because of the measures that have been taken. California has been spared because it's not in the Covid Belt. That's a term I've come up with to describe the ideal climate that SARS-CoV-2 thrives in. All hard hit regions exist in the Covid climate belt. Not all the least hit areas (eg South Korea) exist outside of the Covid Belt. You can also limit its spread with other aggressive measures. Climate provides a substantial natural impediment, although it doesn't entirely stop the spread either. It's why Texas, New Mexico, Arizona look like they do right now versus Michigan and New York. It's not because Texas has had amazing testing and tracing and quarantine measures. It's why Tehran was hammered by the virus but Baghdad was not. It wasn't luck, it wasn't testing, it wasn't tracing, it wasn't lockdown measures. Baghdad is a hotter climate than Tehran during the December > May time frame. It's why Athens & Greece is largely spared but Milan is not. It's not because Greece implemented South Korea-style measures early on and they have a far better healthcare system than Britain. It's why Southern Italy is not hit like Northern Italy. They have different climates. It's why Madrid is hit so hard but Barcelona and Lisbon are not. They have different climates. It's why NYC is hit hard but San Francisco and Los Angeles and San Diego are not. The entire San Diego County has 53 deaths. It's why Texas is largely spared but Massachusetts and Michigan are not. It's why Detroit was hit but Phoenix was not. It's why Belgium and the Netherlands were hit but Mexico wasn't. It's why Wuhan was hit but Hawaii and Jakarta and Singapore were not. It's why Algiers (7.8m people in their metro, just south of Spain) isn't drowning in Covid cases and hasn't been hit like Madrid. It's also why India and Pakistan have been largely spared bad outbreaks. Defying all predictions thus far to the contrary. It's why Lagos Nigeria isn't being hit hard and the Netherlands and Britain were. It's why Cairo isn't buried in dead bodies right now. The Cairo metro has 20 million people. Check out the temps in Cairo during the Nov > May time frame. Look at the climates. Nearly all of the hardest hit areas exist in a sweet spot on temperature range. Milan: https://weather-and-climate.com/uploads/average-temperature-italy-milan-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Wuhan: https://weather-and-climate.com/uploads/average-temperature-china-wuhan-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... NYC: https://weather-and-climate.com/uploads/average-temperature-united-states-of-america-new-york-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Tehran: https://weather-and-climate.com/uploads/average-temperature-iran-tehran-ir-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... London: https://weather-and-climate.com/uploads/average-temperature-united-kingdom-london-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Boston: https://weather-and-climate.com/uploads/average-temperature-united-states-of-america-boston-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Chicago: https://weather-and-climate.com/uploads/average-temperature-united-states-of-america-chicago-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Now compare to Baghdad: https://weather-and-climate.com/uploads/average-temperature-iraq-baghd-d-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Cairo: https://weather-and-climate.com/uploads/average-temperature-egypt-cairo-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Los Angeles: https://weather-and-climate.com/uploads/average-temperature-united-states-of-america-los-angeles-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Algiers: https://weather-and-climate.com/uploads/average-temperature-algeria-algiers-dz-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Lagos: https://weather-and-climate.com/uploads/average-temperature-nigeria-lagos-ng-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Houston: https://weather-and-climate.com/uploads/average-temperature-united-states-of-america-houston-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Phoenix: https://weather-and-climate.com/uploads/average-temperature-united-states-of-america-phoenix-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Singapore: https://weather-and-climate.com/uploads/average-temperature-singapore-singapore-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Las Vegas: https://weather-and-climate.com/uploads/average-temperature-united-states-of-america-las-vegas-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... San Diego: https://weather-and-climate.com/uploads/average-temperature-united-states-of-america-san-diego-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Athens: https://weather-and-climate.com/uploads/average-temperature-greece-athens-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... --- Compare Barcelona: https://weather-and-climate.com/uploads/average-temperature-spain-barcelona-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... To Madrid: https://weather-and-climate.com/uploads/average-temperature-spain-madrid-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... Compare Milan again:https://weather-and-climate.com/uploads/average-temperature-italy-milan-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... To Rome: https://weather-and-climate.com/uploads/average-temperature-italy-rome-fahrenheit.png https://weather-and-climate.com/uploads/average-temperature-... See those higher highs through the flu season? That 8-10 degrees of higher temps throughout Winter is the difference. Getting as close to the ~55-60 F or higher temp zone at the highs as possible during Winter is where you want to be. The regions that are, have seen dramatically fewer cases. This spans all variations of circumstances between nations (rich vs poor, good testing vs weak testing etc). At 64 degrees F and above, we know that influenza, for example, is heavily impeded by the heat. This is why so many experts have been predicting a big downturn in the virus as Spring & Summer temperatures roll in. This has already been shown by several studies. We already know why. 90-95% of all cases of transmission have occurred in the Covid Belt areas that have ideal climates for the transmission of the virus (otherwise Africa would be drowning in Covid deaths right now).

watertom 7y ago

I’ve participated in Homeland Security pandemic exercises. One in particular had a R0 of about 2, and a death rate of 1.3%, with a hospitalization rate of 10%, and and acute care rate of 3%. All numbers lower than CoVID-19. What happened in the exercise was that all hospitals got over run, very quickly, it took months for the infection rates to flatten. Nobody could get into a hospital and get any proper care, entire families started dying, the death rate jumped up to almost 12%. Remember the calculated death rate is based on proper care. Police, Fire, EMS, got hit hard and they all walked off the job. Nursing homes, assisted living facilities had death rates of almost 75%, (we’re starting to see 50% now). Hospital workers started walking off the job. The economy didn’t slow down the economy flew into the ground at 500mph and exploded in billions of tiny pieces. The country went into immediate shortages of everything, which didn’t really matter because basically everyone stopped going to work. When you might get sick and you know you can’t get care and without care you have a 12 in 100 chance of dying you can’t get people to leave their house, for any reason. People start dying home alone. The death rate gets even higher because of food shortages, prescription drug shortages, and underlying health conditions fuel the fire. Power disruptions, water, sewage issue because no one is working. Crime becomes a problem, because a) the police aren’t working and b) people get desperate. Once things start to unravel you can’t simply re-ravel things. In a normal flu season about 40 Million people get infected, with 30-67K dead a year spread out over 6 months. If we respond to COVID-19 like we do with the flu, we could see 150-200 million infected because it spreads more easily, those numbers would overwhelm the country, maybe have 20-35 Million dead, the economy might stop for a year or two, or three or four. We don’t know if infection confers immunity, what happens if it doesn’t? What if getting it makes you more susceptible to a second and worse infection? What if we can’t develop a vaccine? You’ll be gambling with a lot of lives.

CydeWeys 7y ago
I agree with your point in general, but this claim is overblown: > If we respond to COVID-19 like we do with the flu, we could see 150-200 million infected because it spreads more easily, those numbers would overwhelm the country, maybe have 20-35 Million dead Even without any medical treatment at all, the death rate from COVID-19 is much lower than 13%. It might even be below 1%, once you factor in all the asymptomatic cases that we're only just starting to discover from blood antibody testing. So we're still talking about millions of deaths, which would be absolutely horrible enough in its own right, but we're not looking at double digit death numbers. COVID-19 fortunately isn't that deadly. Other diseases are though ... so in a way, as bad as this seems, we did still get somewhat lucky.

nickthemagicman 7y ago

> As I see it, there are so few cases in California because of the measures that have been taken How do you know though? The flat curver movement has set themselves up so there's no accountability, no reliance on data, no proof that it's working or not working. Just repeating what other people have said and patting themselves on the back that it's working. Sweden has less per capita infections than many other countries and they have no full quarantine just basic social distancing and hand washing.

thu2111 7y ago

It's rational, you just haven't seen the data causing people to ask these questions. Perhaps because aforementioned newspaper outlets aren't showing you. Here is some. Graphical comparison of UK (hard lock down) with Sweden (not much lockdown e.g. restaurants and shops still open) http://www.theblogmire.com/a-comparison-of-lockdown-uk-with-non-lockdown-sweden/ http://www.theblogmire.com/a-comparison-of-lockdown-uk-with-... There's basically no difference. Switzerland's proportion of positive tests as a fraction of all tests (i.e. is it spreading) shows no epidemic and no effect from lockdown, again, presented visually here in the tweet that's a reply to the first: https://twitter.com/FScholkmann/status/1249703752904425478 https://twitter.com/FScholkmann/status/1249703752904425478 In Switzerland the apparent reproduction number started to fall before lockdown began (see the shaded graph): https://medicalxpress.com/news/2020-04-lockdown-impact-covid-.html https://medicalxpress.com/news/2020-04-lockdown-impact-covid... https://www.tagesanzeiger.ch/ansteckungsraten-flachten-bereits-vor-dem-lockdown-ab-809893127675 https://www.tagesanzeiger.ch/ansteckungsraten-flachten-berei... (you can delete the paywall to see the headline and summary) There are other reasons to be skeptical. Epidemics naturally come and go very quickly. The "lockdown" concept comes from epidemiologists. These people have a history of proposing extreme measures that turn out to have had no effect when compared to control groups, or when people simply realise that the epidemic entered decline before the recommended measures were implemented. If the lockdown ends up having no effect it'd be counter-intuitive but entirely predictable from how things worked out in the past. For instance, look at the history of foot-and-mouth disease in the UK.