3 ms·
> The fact that we're peaking now, way under universal infection, proves this wrong. Please define "peaking". Really what you mean is that the curve of new inf
by ryankemper 6y ago
> The fact that we're peaking now, way under universal infection, proves this wrong.
Please define "peaking". Really what you mean is that the curve of new infections is starting to flatten, but by definition, we are going to hit a new, higher peak if we lift the lockdown, because we haven't exposed enough of our population yet.
It is very important that we either agree on the 3 postulates I provided, or can convincingly explain to each other why we disagree on point (3). The vast majority of the globe will be exposed to this.
> We didn't all get Ebola or HIV, which were similarly novel. The world never acquired universal herd immunity to polio either.
Hmm. This is just incredibly wrong. It's not the "novelness" that determines whether the majority of the globe will be exposed. You have to look at how the disease is spread and how fast/easily it spreads. HIV is not a respiratory infection. So it's a total red herring. Same thing with polio. It should be really obvious that a disease where you need to be exposed to semen/blood/other fluids of someone infected (HIV), or exposed to fecal matter entering your mouth (polio), is going to behave differently than a disease that spreads via respiratory droplets (covid).
Look, the entire world agrees we cannot eradicate influenza, and we also agree that the majority of the world has some level of immunity to these diseases. Whereas with a completely novel virus, we do not have widespread immunity.
Any infection that spreads easily enough (which tends to exclusively be respiratory infections since they spread the most) is impossible to eradicate, doubly so if there are natural animal reservoirs as their are with H1N1 and sars-cov-2.
> So it maybe made sense to let one spread where we want to contain the other.
We cannot contain either of these diseases. It is infeasible. This is another point we really need to agree on to be able to have a productive discussion. Tell me, is there any respected health organization that is advocating a policy of _containment_ towards covid? I am asserting that there is not.
Containment has virtually nothing to do with lethality of the disease, except insofar as a disease with a 50% mortality rate will tend to burn itself out. It's all about the transmission rate.
I agree that details matter. Which is why I think when the facts of how this virus operates are examined, it is extremely clear that we will neither contain nor eradicate the disease.
The approach you are advocating for will lead to the so-called "second wave" that will crush us, and we'll have to close our economy down again to avoid widespread infection, except (a) we won't be able to because we already damaged it too much to have that headroom, and (b) as I believe this "first wave" will show us, economic shutdown is just a bad policy across the board except in areas where we are near peak hospital capacity.
Not sure if you're interested, but my thoughts on a "second wave" are that it's an indication that a society totally mishandled the initial outbreak. We need to try to maintain a steady rate of new infections, such that we are near our capacity but not exceeding it. Now, due to how exponents work, it is really easy to mess up that balance. But we have to work towards herd immunity. (BTW, it's not something that you have to "work" towards, it's really a natural process that we can only interfere with by trying to foolishly contain rather than practicing targeted mitigation.
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> Do you have a specific policy you're trying to advocate for?
Yeah, I'll give you one to chew on. All at-risk individuals are encouraged to voluntarily self isolate, and hunker down until we have a possible vaccine. Those who are not at risk live life as normal, minus some large gatherings. While those at-risk quarantine, everyone else is developing herd immunity. BTW, it saddens me that "herd immunity" has been turned into a dirty word. It is a natural consequence of the way immunity works in a population, and so the idea that building herd immunity is "callous" or ineffective is just a total disregard of reality.
We need to build immunity in as much of the population as possible. That's the only way, and it's what we've done for every Influenza outbreak, because herd immunity isn't even something you can avoid developing without containment. But what we can do via misguided lockdowns is needlessly delay the formation of herd immunity while also destroying our economy (I am using strong language but if you look at the jobless claims, medical workers being furloughed, etc, you realize we are truly _destroying_ tremendous sources of value).
This is sort of the pareto principle. We get 80% of the benefits of a mass lockdown, with only a small increase in costs. In fact, I would go one further and say that any policies that prevent the development of herd immunity are actively causing harm since we're postponing the reconciliation into the future while damaging our economy in the present
Oh, and just to be clear, I advocate total lockdown in any areas that are nearing medical capacity. New York is the quintessential example here.
BTW, New York will be a great example of herd immunity. Their death toll is staggering right now, because massive quantities of people have been exposed. It's hard to know how many, particularly given that the death figures are a little untrustworthy, but I would assume that every death has something like 200 corresponding infections (somewhere around a .5% IFR). Give it another month, and we will see a dramatic dropoff in infection, even if we lift the lockdown, because there won't be many vectors left for covid to spread through.
Last thing I'll say is, it's very telling that you have not made any references to the economic impacts of lockdown. A rational decision requires comparing the benefits of lockdown with the costs to our economy, and by not even mentioning the latter, it seems to imply that you're not performing a rational cost/benefit analysis here, but rather are relying on very dubious reasoning.
- maxerickson 6y agoThe current daily case rate in South Korea has the whole population getting it after about 100 years (the post I saw said 141, I'm rounding). We should probably look for mitigations that are not economically harmful and keep them in place. Mask wearing seems to be one of them. Then we can use the time that gives us to look for treatments and maybe even a vaccine. I wonder if you are giving any consideration of the economic consequences of the virus? Those are going to happen regardless of imposed lockdowns. There's a tweet about reservations at restaurants in Seattle declining 60% prior to the lockdown. That's plenty. BTW, New York is nowhere near herd immunity. If you assume 1000 cases per death, they would have ~1 million people that have been infected. For a virus this contagious, you want 50-60% for herd immunity, not ~12%.
- ryankemper 6y ago> We should probably look for mitigations that are not economically harmful and keep them in place. Mask wearing seems to be one of them. Then we can use the time that gives us to look for treatments and maybe even a vaccine. Absolutely. > I wonder if you are giving any consideration of the economic consequences of the virus? Those are going to happen regardless of imposed lockdowns. There's a tweet about reservations at restaurants in Seattle declining 60% prior to the lockdown. That's plenty. Yes, I have given consideration to that, and I think your point is an important one. Basically, I draw a distinction between unavoidable economic impact due to covid itself (your example with restaurant reservations) versus self-inflicted economic damage (forcing closures rather than letting businesses decide for themselves, discouraging elective surgery in areas without a huge outbreak which has led to incredible job loss/furloughs in the medical sector) > BTW, New York is nowhere near herd immunity. If you assume 1000 cases per death, they would have ~1 million people that have been infected. For a virus this contagious, you want 50-60% for herd immunity, not ~12%. Right, hitting the "herd immunity" threshold is great, but the important point is that any marginal increase in recovered cases leads to reduced transmission, even if it does not lead to containment the way "full" herd immunity does. Per your point, if we stick with that 1000:1 estimate (which honestly I think is within an order of magnitude of the true number), that implies we're only 2, maybe 3 "doublings" away from herd immunity in New York. (Let me know if you see an issue with that logic). By comparison, in my home state of California, we currently have 1000 deaths which we would expand to 1 million cases using that same 1000:1 ratio, whereas our population is about 40 million, so we have an implied 2.5% herd immunity