4 ms·

A very important thing is that % is concentrated among old and people with preexisting health conditions. Not every death is the same - a 80 year old with weak

A very important thing is that % is concentrated among old and people with preexisting health conditions. Not every death is the same - a 80 year old with weak immune system could have lived 5 years longer without corona, but a healthy 20 year-old dying from cytokine storm caused by influenza has lost potentially 60 years of healthy life - the loss is much worse.

pbhjpbhj 6y ago
How does that compare, with other high IFR diseases, didn't they also have deaths skewed towards older people?
- newacct583 6y ago
  To be perfectly fair (and for the record I'm very much not among the "sacrifice the old and weak" set!): not as much as covid. The elderly and immunocompromised obviously die more to almost every illness. But the effect is really pronounced with covid. And most other viral infections tend to kill children at higher rates too, and covid very notably does not. It's definitely an interesting aspect of the disease, though it's produce a kind of horrifying calculus among a lot of the right wing in the US.
- rootusrootus 6y ago
  The 1918 flu was notable for having a high fatality rate for young children. That does not seem to be the case for flu in general.
newacct583 6y ago
> Not every death is the same OK, so how many "influenza death equivalents" are we looking at? What's your metric for how bad this is? I mean, I think that's a little ghoulish, obviously, but if people really want to make this argument I'd really like to see the kinds of well-founded numbers that the experts are producing. Medical ethics is hardly a new field, after all. You'd think someone would have pulled some analysis off the shelf. Instead, the people pushing "these people would have died anyway" seem to be almost exclusively political actors (or their proxies on social media sites like this one) with a goal of either defending the inaction of the current administration or pushing a policy goal that necessarily sets the virus loose on the public. But if you really want to make a numerate case for not trying to save the old and sick, I'd genuinely and carefully read it.
- rubber_duck 6y ago
  I think there are already such calculations for approving drugs on public health programs - cost of treatment vs years of quality life provided. So you would need to estimate the number of years lost vs the economic damage. This is impossible to get right on both sides but at least it gives you a framework.
Symmetry 6y ago
I agree we should consider years of life lost but the figures are a bit higher than they ones you're using. 14 years on average for men and 12 for women. Not 60 years but more than 5. https://wellcomeopenresearch.org/articles/5-75 https://wellcomeopenresearch.org/articles/5-75
- rubber_duck 6y ago
  Thank you for this link - this is the reason I come here :) Seeing those numbers makes me more supportive of the isolation measures.
joe_the_user 6y ago
Not every death is the same - a 80 year old with weak immune system could have lived 5 years longer without corona, but a healthy 20 year-old dying from cytokine storm caused by influenza has lost potentially 60 years of healthy life - the loss is much worse. In a triage situation, where you have to decide between different people dying, such choices are unavoidable or necessary. But I want highlight that you are talking about this stuff to say that it's OK to plan for the death of "a 80 year old with weak immune system could have lived 5 years longer" versus no death at all. And that's not OK.
- rubber_duck 6y ago
  But those discussions happen all the time. If there is a drug that can extend the life of this person for 5 years but it costs X - should it be covered by society ? At what X does it become unacceptable ? The highest numbers I've seen argued are in the 200k/year but realistically it's much lower depending on the country.
  - joe_the_user 6y ago
    Well, there are two kinds of choices that are generally considered radically different. One choice is providing some opportunity for further life beyond what's expected. That's generally considered something society likes but isn't obligated to provide. Society doesn't obligate it's member to spend money developing some miracle-extend that gives someone five more years. The other choice is taking life that would normally be expected. That is something that society very much frowns on. If you could protect someone and you don't do it 'cause it would cost you money, you may wind-up in jail for murder. Very quantitatively oriented people seem to have a hard time grasping why there's a difference here. But I think it's very rational in an evolutionary game-theoretic compact kind of way. Everyone is a member of society and values everyone else's life highly, more highly than immediate material things though maybe not more highly than other people's lives. This gives member of society basic security - you are thinking my insulin might worth just stealing and selling on the open market, me murdering you first might be my best strategy. You can see where things break down? The "social contract" is kind of the way around this.
wonnage 6y ago
Roughly 25% of males in the US 35-44 had hypertension in 2010, and this grows to over 50% by 55-64, an age I don't think anyone would consider especially old: https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_319587.pdf https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd... Basically everyone who dies from this has a preexisting condition, but basically everyone in the US will develop at least one of the big three (hypertension, diabetes, or obesity) at some point.
- nradov 6y ago
  Fortunately those conditions are preventable in the majority of cases.
  - kitotik 6y ago
    You are correct, it is possible to prevent some of those conditions in some (but not all) future cases. Kinda sucks if you have any of those conditions right now though.
    - whb07 6y ago
      We don’t cry about the millions of heart attacks that are easily prevented. We definitely don’t Give a damn about some person dying of cancer when they are smokers. Why are we drawing a distinction here? You chose to eat X and not exercise for years/decades. A middle class American has enough education and purchasing power to know and behave accordingly. Does it suck? Yes, but i find it incredibly unfair and hypocritical towards the rest of the world by ruining their lives based on the extremely old and or fat/unhealthy population.
greedo 6y ago
You do realize that at least in the US, 30% of the population has comorbidities? And your comment comes across as extremely crass and insensitive.

pbhjpbhj 6y ago

How does that compare, with other high IFR diseases, didn't they also have deaths skewed towards older people?

newacct583 6y ago
To be perfectly fair (and for the record I'm very much not among the "sacrifice the old and weak" set!): not as much as covid. The elderly and immunocompromised obviously die more to almost every illness. But the effect is really pronounced with covid. And most other viral infections tend to kill children at higher rates too, and covid very notably does not. It's definitely an interesting aspect of the disease, though it's produce a kind of horrifying calculus among a lot of the right wing in the US.
rootusrootus 6y ago
The 1918 flu was notable for having a high fatality rate for young children. That does not seem to be the case for flu in general.

newacct583 6y ago

> Not every death is the same OK, so how many "influenza death equivalents" are we looking at? What's your metric for how bad this is? I mean, I think that's a little ghoulish, obviously, but if people really want to make this argument I'd really like to see the kinds of well-founded numbers that the experts are producing. Medical ethics is hardly a new field, after all. You'd think someone would have pulled some analysis off the shelf. Instead, the people pushing "these people would have died anyway" seem to be almost exclusively political actors (or their proxies on social media sites like this one) with a goal of either defending the inaction of the current administration or pushing a policy goal that necessarily sets the virus loose on the public. But if you really want to make a numerate case for not trying to save the old and sick, I'd genuinely and carefully read it.

rubber_duck 6y ago
I think there are already such calculations for approving drugs on public health programs - cost of treatment vs years of quality life provided. So you would need to estimate the number of years lost vs the economic damage. This is impossible to get right on both sides but at least it gives you a framework.

Symmetry 6y ago

I agree we should consider years of life lost but the figures are a bit higher than they ones you're using. 14 years on average for men and 12 for women. Not 60 years but more than 5. https://wellcomeopenresearch.org/articles/5-75 https://wellcomeopenresearch.org/articles/5-75

rubber_duck 6y ago
Thank you for this link - this is the reason I come here :) Seeing those numbers makes me more supportive of the isolation measures.

joe_the_user 6y ago

Not every death is the same - a 80 year old with weak immune system could have lived 5 years longer without corona, but a healthy 20 year-old dying from cytokine storm caused by influenza has lost potentially 60 years of healthy life - the loss is much worse. In a triage situation, where you have to decide between different people dying, such choices are unavoidable or necessary. But I want highlight that you are talking about this stuff to say that it's OK to plan for the death of "a 80 year old with weak immune system could have lived 5 years longer" versus no death at all. And that's not OK.

rubber_duck 6y ago
But those discussions happen all the time. If there is a drug that can extend the life of this person for 5 years but it costs X - should it be covered by society ? At what X does it become unacceptable ? The highest numbers I've seen argued are in the 200k/year but realistically it's much lower depending on the country.
- joe_the_user 6y ago
  Well, there are two kinds of choices that are generally considered radically different. One choice is providing some opportunity for further life beyond what's expected. That's generally considered something society likes but isn't obligated to provide. Society doesn't obligate it's member to spend money developing some miracle-extend that gives someone five more years. The other choice is taking life that would normally be expected. That is something that society very much frowns on. If you could protect someone and you don't do it 'cause it would cost you money, you may wind-up in jail for murder. Very quantitatively oriented people seem to have a hard time grasping why there's a difference here. But I think it's very rational in an evolutionary game-theoretic compact kind of way. Everyone is a member of society and values everyone else's life highly, more highly than immediate material things though maybe not more highly than other people's lives. This gives member of society basic security - you are thinking my insulin might worth just stealing and selling on the open market, me murdering you first might be my best strategy. You can see where things break down? The "social contract" is kind of the way around this.

wonnage 6y ago

Roughly 25% of males in the US 35-44 had hypertension in 2010, and this grows to over 50% by 55-64, an age I don't think anyone would consider especially old: https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_319587.pdf https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd... Basically everyone who dies from this has a preexisting condition, but basically everyone in the US will develop at least one of the big three (hypertension, diabetes, or obesity) at some point.

nradov 6y ago
Fortunately those conditions are preventable in the majority of cases.
- kitotik 6y ago
  You are correct, it is possible to prevent some of those conditions in some (but not all) future cases. Kinda sucks if you have any of those conditions right now though.
  - whb07 6y ago
    We don’t cry about the millions of heart attacks that are easily prevented. We definitely don’t Give a damn about some person dying of cancer when they are smokers. Why are we drawing a distinction here? You chose to eat X and not exercise for years/decades. A middle class American has enough education and purchasing power to know and behave accordingly. Does it suck? Yes, but i find it incredibly unfair and hypocritical towards the rest of the world by ruining their lives based on the extremely old and or fat/unhealthy population.

greedo 6y ago

You do realize that at least in the US, 30% of the population has comorbidities? And your comment comes across as extremely crass and insensitive.