4 ms·

The things that generally kill Americans (heart disease, cancer, car crashes, diabetes, etc) aren’t contagious, so this is a bad analogy.

marcell 6y ago
No analogy is perfect, but people need context to understand fatality rates, and see what risk is acceptable. Society doesn't have a goal of 0% death rates. We all accept some risk of death as a cost of continued existence. New data is showing that the fatality rate from covid-19 is more like existing risk we were all previously exposed to in the course of our existence, and not like a second version of smallpox.
- johnnyo 6y ago
  As you said, you gotta die of something. If the covid rate equals the regular rate, then the US death rate would effectively double if we simply did nothing. That’s assuming no second order effects like a shortage of medical care making things worse.
  - beagle3 6y ago
    > If the covid rate equals the regular rate, then the US death rate would effectively double if we simply did nothing. For one year (or however long it takes to reach herd immunity -- and if longer, then death rates wouldn't double but increase much less). Assuming recovery confers significantly long lasting immunity, which I agree is not a trivial assumption (and one we don't know yet how reasonable). Definitely not trivial, but -- in context -- means a reduction of life expectancy by less than one year. The US already lags Japan by 6; there's a lot that can be done to improve it by a year, with costs much lower than those currently spent to avoid reducing it by a year.
- scott_s 6y ago
  Correct, Covid-19 is not as bad as smallpox. But it's still bad. Focusing on fatality rates misses the infection rate. Two diseases with the same case fatality rate can kill widely different number of people if one is more infectious than the other. We have learned that SARS-CoV-2 is way more infectious than the flu, meaning that way more people are getting it. With way more cases, we have way more deaths. (And, of course, way more strain on the medical system.)
- dekhn 6y ago
  This more or less sums up my position. Thank you for stating it. I think the news media played a big role in amplifying the risk in a very uncertain early period that made people treat this differently from other risks that affect us and many of the arguments right now are happening because some poeple believe the goal of society is to reach 0% death rates. An important thing to recognize is that the disease itself is not an existential threat (even smallpox wasn't; even the plague wasn't!), but our response to it skirts creating one.
- evross 6y ago
  The graphs on this page shows the situation for NY. It is clear that the risk can't be compared with 2009's H1N1. It's sobering. https://www.nytimes.com/interactive/2020/04/10/upshot/coronavirus-deaths-new-york-city.html https://www.nytimes.com/interactive/2020/04/10/upshot/corona... We need to give the scientists and medical professionals and industry more time to figure out how best to prevent this. There are many reports of 40-50 day illnesses in young people due to not clearing the virus. And the poorly named 'mild' case can be rough. It's (badly imo) defined as when a patient doesn't require hospital. It should be called moderate I think. [1] [1] https://www.businessinsider.com/what-coronavirus-mild-symptoms-are-fever-2020-3?op=1&r=US&IR=T https://www.businessinsider.com/what-coronavirus-mild-sympto...
gus_massa 6y ago
The numbers from Wikipedia are very different, many death are due to contagious illness https://en.wikipedia.org/wiki/List_of_causes_of_death_by_rate https://en.wikipedia.org/wiki/List_of_causes_of_death_by_rat... Cardiovascular diseases 29.34% Infectious and parasitic diseases 23.04% Malignant neoplasms (cancers) 12.49% Respiratory diseases 6.49% Unintentional injuries * 6.23% Perinatal conditions 4.32% Digestive diseases 3.45% Intentional injuries + 2.84% Neuropsychiatric disorders 1.95% Diabetes mellitus 1.73% Diseases of the genitourinary system 1.49% * includes car accidents + suicide, violence, war, etc.
- johnnyo 6y ago
  Those are world rates, not US rates. In the US, it’s largely the things I listed.
beagle3 6y ago
This is not an analogy. It's just math - the risk of dying from COVID19 if you got it is comparable to the risk of dying this year all things other than COVID19 considered. (approx 0.1% in your twenties, approx 15% in your eighties). If getting it confers lifelong immunity (a question that does not yet have a definite answer), that means getting it means you compressed the overall risks of two years into one[0], or reduced your life expectancy by one year. Now, one year is a lot. But the difference in life expectancy between the US (78) and Japan (84) is already six times as much, so the lockdown in that context is about 6 times more expensive (per day, per person) than moving to Japan[1] would have been before COVID19, and no one would have preached the latter. Here's a conundrum: you can (a) lock yourself at home for 6 months, likely losing your job, potentially keeping in touch through the internet; then come back to "normal" life. (b) give up 6 months of your life expectancy, but go back to your normal life tomorrow. That is, w.r.t life expectancy, you can pause for 6 months and keep those 6 months; or fast forward those 6 months (and thus lose them). Almost everyone I know would pick (b) if there aren't any exception circumstances such as terminal disease. But the western world at large chose (a). [0] That's not exactly true - depending on some other model parameters; reduction of life expectancy by 6-9 months is more accurate. [1] It's not guaranteed that moving to Japan would grant you Japanese life expectancy. It is also not guaranteed that the lockdown as practiced really buys you more than a year either.

marcell 6y ago

No analogy is perfect, but people need context to understand fatality rates, and see what risk is acceptable. Society doesn't have a goal of 0% death rates. We all accept some risk of death as a cost of continued existence. New data is showing that the fatality rate from covid-19 is more like existing risk we were all previously exposed to in the course of our existence, and not like a second version of smallpox.

johnnyo 6y ago
As you said, you gotta die of something. If the covid rate equals the regular rate, then the US death rate would effectively double if we simply did nothing. That’s assuming no second order effects like a shortage of medical care making things worse.
- beagle3 6y ago
  > If the covid rate equals the regular rate, then the US death rate would effectively double if we simply did nothing. For one year (or however long it takes to reach herd immunity -- and if longer, then death rates wouldn't double but increase much less). Assuming recovery confers significantly long lasting immunity, which I agree is not a trivial assumption (and one we don't know yet how reasonable). Definitely not trivial, but -- in context -- means a reduction of life expectancy by less than one year. The US already lags Japan by 6; there's a lot that can be done to improve it by a year, with costs much lower than those currently spent to avoid reducing it by a year.
scott_s 6y ago
Correct, Covid-19 is not as bad as smallpox. But it's still bad. Focusing on fatality rates misses the infection rate. Two diseases with the same case fatality rate can kill widely different number of people if one is more infectious than the other. We have learned that SARS-CoV-2 is way more infectious than the flu, meaning that way more people are getting it. With way more cases, we have way more deaths. (And, of course, way more strain on the medical system.)
dekhn 6y ago
This more or less sums up my position. Thank you for stating it. I think the news media played a big role in amplifying the risk in a very uncertain early period that made people treat this differently from other risks that affect us and many of the arguments right now are happening because some poeple believe the goal of society is to reach 0% death rates. An important thing to recognize is that the disease itself is not an existential threat (even smallpox wasn't; even the plague wasn't!), but our response to it skirts creating one.
evross 6y ago
The graphs on this page shows the situation for NY. It is clear that the risk can't be compared with 2009's H1N1. It's sobering. https://www.nytimes.com/interactive/2020/04/10/upshot/coronavirus-deaths-new-york-city.html https://www.nytimes.com/interactive/2020/04/10/upshot/corona... We need to give the scientists and medical professionals and industry more time to figure out how best to prevent this. There are many reports of 40-50 day illnesses in young people due to not clearing the virus. And the poorly named 'mild' case can be rough. It's (badly imo) defined as when a patient doesn't require hospital. It should be called moderate I think. [1] [1] https://www.businessinsider.com/what-coronavirus-mild-symptoms-are-fever-2020-3?op=1&r=US&IR=T https://www.businessinsider.com/what-coronavirus-mild-sympto...

gus_massa 6y ago

The numbers from Wikipedia are very different, many death are due to contagious illness https://en.wikipedia.org/wiki/List_of_causes_of_death_by_rate https://en.wikipedia.org/wiki/List_of_causes_of_death_by_rat... Cardiovascular diseases 29.34% Infectious and parasitic diseases 23.04% Malignant neoplasms (cancers) 12.49% Respiratory diseases 6.49% Unintentional injuries * 6.23% Perinatal conditions 4.32% Digestive diseases 3.45% Intentional injuries + 2.84% Neuropsychiatric disorders 1.95% Diabetes mellitus 1.73% Diseases of the genitourinary system 1.49% * includes car accidents + suicide, violence, war, etc.

johnnyo 6y ago
Those are world rates, not US rates. In the US, it’s largely the things I listed.

beagle3 6y ago

This is not an analogy. It's just math - the risk of dying from COVID19 if you got it is comparable to the risk of dying this year all things other than COVID19 considered. (approx 0.1% in your twenties, approx 15% in your eighties). If getting it confers lifelong immunity (a question that does not yet have a definite answer), that means getting it means you compressed the overall risks of two years into one[0], or reduced your life expectancy by one year. Now, one year is a lot. But the difference in life expectancy between the US (78) and Japan (84) is already six times as much, so the lockdown in that context is about 6 times more expensive (per day, per person) than moving to Japan[1] would have been before COVID19, and no one would have preached the latter. Here's a conundrum: you can (a) lock yourself at home for 6 months, likely losing your job, potentially keeping in touch through the internet; then come back to "normal" life. (b) give up 6 months of your life expectancy, but go back to your normal life tomorrow. That is, w.r.t life expectancy, you can pause for 6 months and keep those 6 months; or fast forward those 6 months (and thus lose them). Almost everyone I know would pick (b) if there aren't any exception circumstances such as terminal disease. But the western world at large chose (a). [0] That's not exactly true - depending on some other model parameters; reduction of life expectancy by 6-9 months is more accurate. [1] It's not guaranteed that moving to Japan would grant you Japanese life expectancy. It is also not guaranteed that the lockdown as practiced really buys you more than a year either.