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I find myself reconsidering the original proposition by England to isolate the most vulnerable for a couple months and let the virus work its course through the
by daxfohl 7y ago
I find myself reconsidering the original proposition by England to isolate the most vulnerable for a couple months and let the virus work its course through the less vulnerable population.
If death rate is substantially lower among the under 50 crowd, this could work its way through with a fairly low death toll, and result in a herd immunity within a couple months. This slow burn approach we're doing however seems possibly to be the precise worst way to handle it, leaving the virus in the population for as long as possible, reducing the ability for our vulnerable population to avoid it.
Note I think the best possible solution is a complete lock down for a couple months until the virus is more or less eradicated, as Wuhan did. But I don't think it's a realistic option in our society.
- jdm2212 7y agoThe outcomes aren't just death and recovery. There's also the possibility of long-term heart, lung, and kidney damage. And the blood thinners used to prevent coronavirus blood clots can cause brain bleeding. Those happen in younger people, too. And realistically there's no way to isolate those over 50. They generally live with, work with, or are cared for by younger people.
- taeric 7y agoThis feels like fear talking. As more data comes in, we are seeing more people with no affects. Not just mild, but nigh non existent. It is agreed that something gives people severe cases. Severe includes death and recovered with damage. We don't seem to have data letting you know who or what would land there.
- eloff 7y agoI disagree, see my sister comment. Even without data on lingering deficiencies, we can speculate with confidence that it carries a cost.
- taeric 7y agoSpeculation is fine. But we need data to back it. Right now, we don't. Could hypothesize that many being found with damage surviving, had damage going in. Would neatly explain why it hit them so hard.
- eloff 7y agoI'm not speculating about the long term effects of covid19. I'm saying all sickness carries a cost as currently understood according to our theories of cellular senescence. You've missed my point entirely.
- taeric 7y agoAnd you are missing mine. Agreed there could be long term things. Yes, we should study that and watch for it. If that is the extent of your point, then my response is "yes, and?" Your framing, though, begs the question that mild cases have long term damage. We have zero evidence of that. Literally none.
- eloff 7y agoYou're still missing my point. I'm saying all sickness comes with a long term cost. It gives you a shove toward the grave. Covid19 falls into that category, regardless of how much or little we know about it. Now you could argue that sickness and aging don't work that way. I don't think you'd be right, but you can make that argument. Your argument about the long term effects of covid19 is not relevant to the point I made.
- taeric 7y agoYour point feels vacuous, then. Yes, getting sick can have long term impact. Do you have evidence that that is relevant to our current scenario? More so than it would be for any other sickness that is running rampant?
- DeonPenny 7y ago
- op00to 7y agoDo non-severe cases cause lung damage too? Is the lung damage heal able?
- taeric 7y agoThat is the point of my question. There has been no evidence of damage in non severe cases. Indeed, we are having to get complicated testing to find out many people had it at all.
- op00to 7y agoHow could we even tell? Biopsy? Lol no thanks.
- taeric 7y agoPresumably you could find some evidence. X-ray? Just listening to lungs?
- rootusrootus 7y agoThere have been a number of reports of folks who were diagnosed with otherwise asymptomatic COVID when they had a CT for an unrelated reason that showed their lungs with GGO. And in some cases they have shown no signs of recovery even weeks later.
- taeric 7y agoA link would be awesome. And we would still need to ascertain that they did not have this damage before getting covid. :(. CT scans have a troubled history of seeing damage that preexisted. (See back pains)
- proto-n 7y agoHow about this article [1] (translation at reddit [2]) about german divers who had "mild cases" (no hospitalization, recovered at home) and were found to have suffered permanent lung damage, so severe that they can't dive anymore. [1] https://www.rainews.it/tgr/tagesschau/articoli/2020/04/tag-Coronavirus-Lungeschaden-Forschung-Uniklinik-Innsbruck-6708e11e-28dc-4843-a760-e7f926ace61c.html https://www.rainews.it/tgr/tagesschau/articoli/2020/04/tag-C... [2] https://www.reddit.com/r/Coronavirus/comments/g3rv7h/permament_lung_damage_found_in_revovered_patients/fnt1p3e/ https://www.reddit.com/r/Coronavirus/comments/g3rv7h/permame...
- cryoshon 7y agowe have absolutely no clue regarding the long-term impacts of exposure to this virus for asymptomatic people or otherwise. we cannot gamble with our future so carelessly on the basis of preliminary data. here is a vignette to explain why. once someone is infected with HIV, most people experience flu-like symptoms for a week or two which then resolve either with or without treatment. in some people, the virus is cleared so effectively after the initial infection that they will test negative for HIV. then, over the span of months and years, their immune system is silently and entirely asymptomatically destroyed, leaving them none the wiser until they progress to AIDS and get extremely sick. COVID hasn't given us any indication of similar activity. but we know so very little that we can't take the risk, especially not with millions and millions of people. i will also note that we are unlikely to rule out these kinds of hypothetical risks anytime soon. so caution is our only defense against disaster.
- djrogers 7y ago> COVID hasn't given us any indication of similar activity. but we know so very little that we can't take the risk We take that risk with other viruses and bacteria literally all the time. If hypothetical but unlikely risks become thejustification for destroying people's livelihoods and the world ecomony, we're all dead anyway.
- cryoshon 7y agoas a former immunologist, i can assure you that with common viruses and bacteria, we have years and years of knowledge about how they perform, thereby making the risks of exposure calculable. it is this body of knowledge which allows our society to normally function even during a typical flu season. we understand the upper and lower boundaries of the consequences, and we can make an informed judgment about what we should do to navigate the environment accordingly. the idea of throwing open the gates to allow everyone to get infected is a dangerous fantasy. at best, it's taking a leap of faith with other people's health without knowing whether there is a long way down or not.
- taeric 7y ago
- eloff 7y agoYes, recovery is not binary. Even if you recover fully you've expended some percent of your finite lifetime capacity to heal your organs. It may well have taken years off your life. That's true for other illnesses to. The flu doesn't just cost you a week of productivity.
- ver_ture 7y agoI think I'll try to get back into running again.
- DeonPenny 7y agoWouldnt that mean quartine would never work because it make sense that those younger people going outside would make those 60 olds sick regardless of the quarantine.
- jdm2212 7y agoThe SK/Taiwan/Chinese/Singapore approach to quarantine has been to isolate people away from their families if they're thought to be sick (i.e., in a hotel or military barracks). That's how you make quarantine actually work.
- DeonPenny 7y agoThat seems like a much cheaper solution. Aside from china who were welding people regardless of there sick status and had millions of faulty tests. Everyone else on that list has lower death numbers and a economy not going into the toilet.
- daxfohl 7y agoBut that's going to happen anyway because people will catch it until we hit herd immunity. Unless a vaccine comes out before we get there, which seems pretty iffy at this point. I do think we can plan for the isolation of that population for a couple of months if we have some strong leadership. Unfortunately that seems to be lacking right now.
- cycrutchfield 7y ago>But that's going to happen anyway because people will catch it until we hit herd immunity It's about managing the hospitalization rate so that the medical system doesn't get overwhelmed.
- daxfohl 7y agoI was responding to the contents of the parent comment. I agree with you (see a separate branch of the comment tree), but that's not part of what the parent comment was talking about.
- eloff 7y agoAll things equal, it would be better to get it out of the way sooner. However, what it doesn't account for is: 1) can we flatten the curve enough that some people never get it because we get a vaccine? 2) can we flatten it until we find an effective treatment protocol, saving lives? 3) if we did nothing would the hospitals be overwhelmed leading to additional loss of life and a higher death rate? The first two are speculative, but the last one is pretty much certain looking at Italy and NYC. Without lockdown it could have been so much worse.
- luckylion 7y agoIf we prolong it a lot with all the associated cost and 1 and 2 never happen, we've lost not just a large part of the economy, but also lives without anything to show for it.
- cycrutchfield 7y agoI don't think you quite understand what happens to the fatality rate once hospitals become overwhelmed. That 1% IFR will quickly become 3-5% IFR.
- luckylion 7y agoThat's a different argument. I'm saying that "lockdown until we have a vaccine or great treatment" might mean "lockdown until 2030". We already see heavy economic damages, civil unrest and riots after 4-8 weeks. Make that 40, 80 or 200 weeks and the world will be very different.
- cycrutchfield 7y agoA handful of peabrained astroturf protestors does not equal "civil unrest and riots". Also nobody is arguing for "lockdown until we have a vaccine", that is a strawman. The strategy has always been to buy time for testing capacity to get high enough to support less restrictive mitigation efforts. Along the way we will likely pick up additional things like antibody testing to identify the immunized and treatment options that work (clinical trials still in progress).
- Reedx 7y agoSweden didn't lockdown and might have herd immunity in weeks, according to their chief epidemiologist. It'll be interesting to see how this plays out in the long run. “In major parts of Sweden, around Stockholm, we have reached a plateau (in new cases) and we’re already seeing the effect of herd immunity and in a few weeks’ time we’ll see even more of the effects of that. And in the rest of the country, the situation is stable,” Dr. Anders Tegnell, chief epidemiologist at Sweden’s Public Health Agency Tegnell said sampling and modeling data indicated that 20% of Stockholm’s population is already immune to the virus, and that “in a few weeks’ time we might reach herd immunity and we believe that is why we’re seeing a slow decline in cases, in spite of sampling (testing for the coronavirus) more and more.” https://www.cnbc.com/2020/04/22/no-lockdown-in-sweden-but-stockholm-could-see-herd-immunity-in-weeks.html https://www.cnbc.com/2020/04/22/no-lockdown-in-sweden-but-st...
- cm2187 7y agoIt might be herd immunity. If might also be that this disease is seasonal. Either way it is an interesting metric.
- m4rtink 7y agoI would not really call the Swedish model successful - Czech Republic and Sweden have both about 10 million inhabitants. Things moved pretty quickly to pretty comprehensive lockdown here in Czech Republic, including mandatory mask wearing. So far this seem to be effective, with combined death toll currently at 210. In comparison Sweden has almost 10x as much, 2010 dead. Looks like if more has been done less people could have died, not to mention the alarming news about organ damage, virus resurgence and questionable long term immunity.
- klmadfejno 7y agoI've been making many posts arguing against the efficacy of lockdowns (and been getting shat on by points I find mostly naive). I think something like this is probably the best approach because it minimizes economic harm while also trying to minimize hospitalization rates among the elderly. But even if we pretend we could implement a perfect bubble for everyone over 50, they're not especially safe when the lockdown is lifted for them. The virus will still exist, and people over 50 tend to spend time with people over 50 (see: homophily). Once it enters the social network, herd immunity doesn't exist because your local community of old people are both super vulnerable to acquiring the disease and few of them have immunity from past exposure because of the lockdown. Locking down the country until the virus is eradicated is not a realistic option and its incorrect to think Wuhan has "done" this
- formercoder 7y agoAny time I try and make counterpoints to lockdowns or even logical evaluations of them online the downvotes and hate start flowing. There is a huge bias among those in our circles towards locking down as long as possible, because all of us can work from home and aren’t worried about feeding our families.
- TheCowboy 7y agoArguing it's a matter of bias sidesteps the reasoning for lockdowns. This is like when someone dismisses someone for possessing a political bias---that's not an argument. And framing it as lockdown vs. being able to feed your family is a false dichotomy. It seems like a waste to even get into the finer details if this is where you're coming from, but keep calling it hate while ignoring the criticism.
- SpicyLemonZest 7y agoNo, it's a very real dichotomy. People won't literally starve in the US, but waiting in a bread line for hours is very different than feeding your family through your own money and effort.