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> A lot of this is like Russian Roulette -- there's a huge amount about this virus which we don't know, and it could be super-bad or not-that-bad. I think at t

> A lot of this is like Russian Roulette -- there's a huge amount about this virus which we don't know, and it could be super-bad or not-that-bad. I think at this point we know enough to say: 1) For most of the population, the virus is not that serious 2) For a subset of the population the virus is seriously deadly. For example, ~20% of NY state coronavirus deaths were from nursing homes, ~37% are 80 or older. By contrast, there were 2 people under the age of 10 at the time of this post. [0] > I think the key problem here is failure to understand risk management I think another key problem is a failure to be frank about the cost-benefit of our actions. I have had to make stronger cases about changing the color of a button or optimizing a backend call than I've seen presented by authorities who are shutting down or reopening or anywhere in between. [0] https://covid19tracker.health.ny.gov/views/NYS-COVID19-Tracker/NYSDOHCOVID-19Tracker-Fatalities?%3Aembed=yes&%3Atoolbar=no&%3Atabs=n https://covid19tracker.health.ny.gov/views/NYS-COVID19-Track...

edmundsauto 6y ago
On 1), what do you consider "not that serious"? IE, what are your metrics of choice, and what are the acceptable values? Regarding the cost-benefit discussion, my perspective is that people only want to discuss the downsides from a reduced economy. Second order effects include reduced vehicle deaths, reduced deaths from pollution, etc. IE, my discussions has felt agenda driven because it considers first order effects only. If we're going to compare apples-to-apples, I'm willing to have that conversation. If the conversation is limited to "people die during recessions", it's a pretty clear signal that agenda is driving and would not be a productive use of my time.
- alexbanks 6y ago
  It seems kind of ridiculous to cite "reduced deaths from pollution" as an upside while people are also being forced into confinement, no?
  - edmundsauto 6y ago
    If the argument is that more people will die from economic recession, it's a necessary component. What's the rationale for excluding it? Without 2nd order effects, it doesn't seem like the correct comparison.
- sharken 6y ago
  We are quite a lot of people that fear the operation will be successful but the patient is dead with the Corona actions being taken. Case in point, 26.5 million americans have sought unemployment benefits (https://vastuullisuusuutiset.fi/en/weben/women-bear-brunt-of-u-s-job-losses-in-coronavirus-crisis/ https://vastuullisuusuutiset.fi/en/weben/women-bear-brunt-of...). The deaths in New York are quite telling for who is at risk, see https://www.statista.com/statistics/1109867/coronavirus-death-rates-by-age-new-york-city/ https://www.statista.com/statistics/1109867/coronavirus-deat.... Over 90% of the dead so far are old with comorbidites such as Hypertension and Diabetes, see https://www.bloomberg.com/news/articles/2020-03-25/most-nyc-covid-19-dead-had-other-health-problems-city-data-show https://www.bloomberg.com/news/articles/2020-03-25/most-nyc-.... So i agree that "not serious" is an accurate statement.
  - edmundsauto 6y ago
    Your argument supports the statement that coronavirus is not as dangerous for young people compared to old people. And that it's really serious for old people. There remains a required link to why this isn't serious for young people. And from there, an argument that this situation is better than the other scenarios (including 2nd order effects from other scenarios).
    - sharken 6y ago
      I think nobody has all the answers yet, but it looks like the state of your immune system along with age is a key factor. See https://www.statnews.com/2020/03/30/what-explains-coronavirus-lethality-for-elderly/ https://www.statnews.com/2020/03/30/what-explains-coronaviru... That could explain why Monaco and Japan have not seen a lot of deaths, while Italy and Spain for example have. In the US it would help immensely i think, if obesity and hypertension became a focus area when this crisis is over.
  - wegs 6y ago
    That's an accurate argument for why it'd be nice if COVID19 would be not serious. Wishful thinking doesn't make it not serious. Deaths are telling for who is dead, not for who is at risk of lung damage, compromised immune system, or other consequences.
- Zach_the_Lizard 6y ago
  >On 1), what do you consider "not that serious"? Death rates, hospitalization rates, etc. As mentioned before, 20% of NY deaths are nursing home patients. 37% are 80 or older. I'm on mobile and a bit lazy, but check out death rates for the flu in younger populations and compare them to this virus. The virus has a higher mortality rate but not enough to be worth worrying about in younger populations. >Regarding the cost-benefit discussion, my perspective is that people only want to discuss the downsides from a reduced economy. While keeping the benefits in mind is an important part of this analysis, the fact is the pre-quarantine deaths were already accepted as "worth it" given that there was no political will to reduce them. But yes, we should tally the reduction in deaths, pollution, etc.
  - edmundsauto 6y ago
    So 13k deaths in NY (so far) are under 80 years old. That sounds pretty dangerous to me. Comparison to the flu could indicate that we underindex on all these other causes of death. It doesn't make those death numbers some magical line where now it's worth it, because Coronavirus deaths in 2 months equal annual flu deaths.
    - alexbanks 6y ago
      How many under 65? (I know the answer, I'm obviously asking very intentionally/rhetorically)
  - wegs 6y ago
    If you're adding everything up, please don't omit the costs of long-term disability from COVID19-related lung damage. That swings the numbers completely. If it were just 3.6% of the US population dying, I would understand the economic versus public health argument. It comes down to values at that point: how much is a human life worth? But that changes completely when you consider how many people we'll either need to support for decades, or who will have lower economic output. Those costs get astronomical, and at least by my ballpark estimates, align public health with economic outcomes completely.
fzeroracer 6y ago
A question for you: If you're so sure about the severity of the virus, then I'd like you to tell me what you know about the long term rammifcations of the virus on people that exhibit symptoms. If you can't, then perhaps it might be a good idea to reconsider advocating for reopening the economy. Because for all we know, this could end up being another Chickenpox situation leading to something similar to Shingles. We don't know enough about the virus to make reckless remarks such as yours.
- SpicyLemonZest 6y ago
  Is it your thesis that the economy must never reopen until we know the long-term ramifications of the virus?
  - fzeroracer 6y ago
    Generally speaking? it's probably a good idea to delay opening things back up until we know the full extent of the virus, yes. If the antibodies only confer short-term protection and people could get reinfected again (as some indications have shown), it MIGHT be a bad idea to reopen the economy and pave the way for a second wave of the virus, you know? Just throwing that out there. If you think things are bad now, do you honestly think things would get better if we had to go through this again because we decided to stop early? Though given you seem to be peddling the idea that this is all a conspiracy by activists to keep us at home forever, I'm willing to bet you're not going to engage this point with any sort of good faith.
    - SpicyLemonZest 6y ago
      You say it's a conspiracy theory, but you agree we should stay at home until the "full extent of the virus" is known, and long-term effects by definition aren't going to be visible any time soon. Do you have a plan for how we could discover such things faster than a year or two?
      - fzeroracer 6y ago
wegs 6y ago
We don't know the virus is not serious for most of the population. We know most of the population won't die of it in 2-3 months. We have evidence of lung damage, increased risk of stroke, and a slew of other things which /are/ serious, and may impact a broader segment of the population. We've redefined "serious" to mean in an ICU, on a ventilator, within a few weeks of catching it (or in some cases, we've defined "serious" to mean dead within a few weeks). By that definition, AIDS isn't serious for most of the population. There is a distinct lack of ROI calculations, but my ROI calculations lean towards a much stricter shutdown than we have in place right now, together with thoughtful actions to protect the economy.
XorNot 6y ago
Unless your plan to deal with mortality in at-risk populations is to simply deny them medical care, then any plan which involves ignoring these populations and their use of extremely limited (in terms of the total population) medical resources is going to kill far more then the number implied by current COVID-19 mortality rates. The estimate of 1% mortality is with medical intervention. The estimate of hospitalization rates ranges from 5% to 15% (sometimes higher). If you get a disease serious enough to require hospitalization, and there are no hospital beds/nurses/ventilators etc. available, then it is very likely you will die. But of course it's worse then that: because hospital resources are generally somewhat fungible - at least for ICU/surgical treatment. So not only does your mortality shoot up to ~5% at least, literally every other treatable but potentially life endangering condition (say appendicitis - which occurs at a rate 1.1 per 1000 people per year, or an estimate of 300,000ish cases yearly in the US) has now become, quite likely, untreatable - and thus lethal (appendicitis will definitely kill you, untreated). Lots of people seem really latched onto that 1% number or whatever they imagine it to be, without any actual consideration of the context of what that figure is actually all about, or you know, an explanation things are "not that bad" yet hospitals can't get PPE, and ventilator triage is in progress, and local morgue capacity has been overwhelmed.

edmundsauto 6y ago

On 1), what do you consider "not that serious"? IE, what are your metrics of choice, and what are the acceptable values? Regarding the cost-benefit discussion, my perspective is that people only want to discuss the downsides from a reduced economy. Second order effects include reduced vehicle deaths, reduced deaths from pollution, etc. IE, my discussions has felt agenda driven because it considers first order effects only. If we're going to compare apples-to-apples, I'm willing to have that conversation. If the conversation is limited to "people die during recessions", it's a pretty clear signal that agenda is driving and would not be a productive use of my time.

alexbanks 6y ago
It seems kind of ridiculous to cite "reduced deaths from pollution" as an upside while people are also being forced into confinement, no?
- edmundsauto 6y ago
  If the argument is that more people will die from economic recession, it's a necessary component. What's the rationale for excluding it? Without 2nd order effects, it doesn't seem like the correct comparison.
sharken 6y ago
We are quite a lot of people that fear the operation will be successful but the patient is dead with the Corona actions being taken. Case in point, 26.5 million americans have sought unemployment benefits (https://vastuullisuusuutiset.fi/en/weben/women-bear-brunt-of-u-s-job-losses-in-coronavirus-crisis/ https://vastuullisuusuutiset.fi/en/weben/women-bear-brunt-of...). The deaths in New York are quite telling for who is at risk, see https://www.statista.com/statistics/1109867/coronavirus-death-rates-by-age-new-york-city/ https://www.statista.com/statistics/1109867/coronavirus-deat.... Over 90% of the dead so far are old with comorbidites such as Hypertension and Diabetes, see https://www.bloomberg.com/news/articles/2020-03-25/most-nyc-covid-19-dead-had-other-health-problems-city-data-show https://www.bloomberg.com/news/articles/2020-03-25/most-nyc-.... So i agree that "not serious" is an accurate statement.
- edmundsauto 6y ago
  Your argument supports the statement that coronavirus is not as dangerous for young people compared to old people. And that it's really serious for old people. There remains a required link to why this isn't serious for young people. And from there, an argument that this situation is better than the other scenarios (including 2nd order effects from other scenarios).
  - sharken 6y ago
    I think nobody has all the answers yet, but it looks like the state of your immune system along with age is a key factor. See https://www.statnews.com/2020/03/30/what-explains-coronavirus-lethality-for-elderly/ https://www.statnews.com/2020/03/30/what-explains-coronaviru... That could explain why Monaco and Japan have not seen a lot of deaths, while Italy and Spain for example have. In the US it would help immensely i think, if obesity and hypertension became a focus area when this crisis is over.
- wegs 6y ago
  That's an accurate argument for why it'd be nice if COVID19 would be not serious. Wishful thinking doesn't make it not serious. Deaths are telling for who is dead, not for who is at risk of lung damage, compromised immune system, or other consequences.
Zach_the_Lizard 6y ago
>On 1), what do you consider "not that serious"? Death rates, hospitalization rates, etc. As mentioned before, 20% of NY deaths are nursing home patients. 37% are 80 or older. I'm on mobile and a bit lazy, but check out death rates for the flu in younger populations and compare them to this virus. The virus has a higher mortality rate but not enough to be worth worrying about in younger populations. >Regarding the cost-benefit discussion, my perspective is that people only want to discuss the downsides from a reduced economy. While keeping the benefits in mind is an important part of this analysis, the fact is the pre-quarantine deaths were already accepted as "worth it" given that there was no political will to reduce them. But yes, we should tally the reduction in deaths, pollution, etc.
- edmundsauto 6y ago
  So 13k deaths in NY (so far) are under 80 years old. That sounds pretty dangerous to me. Comparison to the flu could indicate that we underindex on all these other causes of death. It doesn't make those death numbers some magical line where now it's worth it, because Coronavirus deaths in 2 months equal annual flu deaths.
  - alexbanks 6y ago
    How many under 65? (I know the answer, I'm obviously asking very intentionally/rhetorically)
- wegs 6y ago
  If you're adding everything up, please don't omit the costs of long-term disability from COVID19-related lung damage. That swings the numbers completely. If it were just 3.6% of the US population dying, I would understand the economic versus public health argument. It comes down to values at that point: how much is a human life worth? But that changes completely when you consider how many people we'll either need to support for decades, or who will have lower economic output. Those costs get astronomical, and at least by my ballpark estimates, align public health with economic outcomes completely.

fzeroracer 6y ago

A question for you: If you're so sure about the severity of the virus, then I'd like you to tell me what you know about the long term rammifcations of the virus on people that exhibit symptoms. If you can't, then perhaps it might be a good idea to reconsider advocating for reopening the economy. Because for all we know, this could end up being another Chickenpox situation leading to something similar to Shingles. We don't know enough about the virus to make reckless remarks such as yours.

SpicyLemonZest 6y ago
Is it your thesis that the economy must never reopen until we know the long-term ramifications of the virus?
- fzeroracer 6y ago
  Generally speaking? it's probably a good idea to delay opening things back up until we know the full extent of the virus, yes. If the antibodies only confer short-term protection and people could get reinfected again (as some indications have shown), it MIGHT be a bad idea to reopen the economy and pave the way for a second wave of the virus, you know? Just throwing that out there. If you think things are bad now, do you honestly think things would get better if we had to go through this again because we decided to stop early? Though given you seem to be peddling the idea that this is all a conspiracy by activists to keep us at home forever, I'm willing to bet you're not going to engage this point with any sort of good faith.
  - SpicyLemonZest 6y ago
    You say it's a conspiracy theory, but you agree we should stay at home until the "full extent of the virus" is known, and long-term effects by definition aren't going to be visible any time soon. Do you have a plan for how we could discover such things faster than a year or two?
    - fzeroracer 6y ago

wegs 6y ago

We don't know the virus is not serious for most of the population. We know most of the population won't die of it in 2-3 months. We have evidence of lung damage, increased risk of stroke, and a slew of other things which /are/ serious, and may impact a broader segment of the population. We've redefined "serious" to mean in an ICU, on a ventilator, within a few weeks of catching it (or in some cases, we've defined "serious" to mean dead within a few weeks). By that definition, AIDS isn't serious for most of the population. There is a distinct lack of ROI calculations, but my ROI calculations lean towards a much stricter shutdown than we have in place right now, together with thoughtful actions to protect the economy.

XorNot 6y ago

Unless your plan to deal with mortality in at-risk populations is to simply deny them medical care, then any plan which involves ignoring these populations and their use of extremely limited (in terms of the total population) medical resources is going to kill far more then the number implied by current COVID-19 mortality rates. The estimate of 1% mortality is with medical intervention. The estimate of hospitalization rates ranges from 5% to 15% (sometimes higher). If you get a disease serious enough to require hospitalization, and there are no hospital beds/nurses/ventilators etc. available, then it is very likely you will die. But of course it's worse then that: because hospital resources are generally somewhat fungible - at least for ICU/surgical treatment. So not only does your mortality shoot up to ~5% at least, literally every other treatable but potentially life endangering condition (say appendicitis - which occurs at a rate 1.1 per 1000 people per year, or an estimate of 300,000ish cases yearly in the US) has now become, quite likely, untreatable - and thus lethal (appendicitis will definitely kill you, untreated). Lots of people seem really latched onto that 1% number or whatever they imagine it to be, without any actual consideration of the context of what that figure is actually all about, or you know, an explanation things are "not that bad" yet hospitals can't get PPE, and ventilator triage is in progress, and local morgue capacity has been overwhelmed.