4 ms·

Among what age group, though? Using an average morbidity across the entire population is misleading. Everything I've read indicates that the morbidity scales

Among what age group, though? Using an average morbidity across the entire population is misleading. Everything I've read indicates that the morbidity scales very highly with age so that it would be something like (making this up here) 0.05% for people under 40, scaling up very quickly as you get to the elderly population. The question then becomes can we effectively quarantine at-risk groups instead of the entire population? I don't know the answer, but I do know that continuing to pursue current policies until some indefinite point in the future is untenable.

marcinzm 6y ago
>but I do know that continuing to pursue current policies until some indefinite point in the future is untenable. Go strawman, go! California and NY both have plans for slowly reopening in the comings weeks or months with various metrics guiding the timelines.
- mdorazio 6y ago
  Serious question: can you show me the metrics for california with concrete targets that will trigger reopening? The last plan I saw wasn't a plan at all, it was just guidelines.
  - marcinzm 6y ago
    I don't see the difference between plan and guidelines from any practical point of view. There is a statewide timeline and counties can open slower/faster. There's a list of criteria for counties to consider. This is a slide deck summarizing things at a state level, it notes a variety of metrics that are being looked at: https://www.gov.ca.gov/wp-content/uploads/2020/04/Update-on-California-Pandemic-Roadmap.pdf https://www.gov.ca.gov/wp-content/uploads/2020/04/Update-on-...
    - mdorazio 6y ago
      Here's a plan: when we get to X new cases per day, we will reopen. Here's a guideline: we'll reopen when we think it's safe. The former has concrete goals that you can measure against and take action on. The latter has no clarity whatsoever. If I presented a project plan the way California has presented its Covid reopening "plans" I would be fired.
      - marcinzm 6y ago
        Except "the population feeling safe" is the only metric that really matters. Everything else is a proxy. If the population doesn't feel safe then they will protest and not resume activities. The other metrics can be golden but if the population disagree you will have trouble in a democracy.
  - cozzyd 6y ago
    At least in Illinois, opening targets are based on agent-based simulations of disease spread. Specifically, the simulations predicted that if Illinois had reopened on May 1, we would have seen a larger peak than the initial one in June. You can read about it here: https://www.chicagobusiness.com/greg-hinz-politics/look-inside-one-models-city-hall-uses-track-how-fast-covid-19-spreads https://www.chicagobusiness.com/greg-hinz-politics/look-insi...
  - pm90 6y ago
    For California, see SF Chronicles' COVID Tracker page: https://projects.sfchronicle.com/2020/coronavirus-map/ https://projects.sfchronicle.com/2020/coronavirus-map/. It even has a checklist with the targets that must be met before a county can lift quarantine.
    - mdorazio 6y ago
      Thanks, it's really confusing because there are multiple conflicting sources with different guidelines and the governor's statements have indicated Phase 2 is still case-by-case and phases 3 and 4 are "sometime soonish". In addition to the metrics that SF Chronicle page is tracking for Bay Area counties, there's also [1], [2], and [3] in addition to the original governor's slides a few weeks ago. I can't find any concrete goals from official sources for completely reopening the state (phase 4). [1] https://www.sfchronicle.com/politics/article/Here-s-a-checklist-of-what-California-counties-15254787.php https://www.sfchronicle.com/politics/article/Here-s-a-checkl... [2] https://apnews.com/2c69fe294f73a1120c2dad4a738966e3 https://apnews.com/2c69fe294f73a1120c2dad4a738966e3 [3] https://www.gov.ca.gov/wp-content/uploads/2020/05/5.4-Report-Card-on-California-Resilience-Roadmap.pdf https://www.gov.ca.gov/wp-content/uploads/2020/05/5.4-Report...
  - joshuamorton 6y ago
    Targets for early reopening (ie before the state at large): - 1.5 tests per 1000 people per day - No deaths in the past 14 days - Some max number of cases per day that's really low - Stockpile of PPE (I forget the exact numbers) - A minimum number of contact tracers (I think also 1.5 per 1000 people, although it may be an order of magnitude lower) The bay area has a more stringent set of guidelines (minus the number of deaths that another person linked to).
m_ke 6y ago
https://www.nytimes.com/2020/05/09/health/mysterious-coronavirus-illness-claims-3-children-in-new-york.html https://www.nytimes.com/2020/05/09/health/mysterious-coronav...
mushbino 6y ago
Do you have any research or data showing that the lives of the elderly and immunocompromised are less valuable than those considered more safe?
- sokoloff 6y ago
  I have shared this opinion before (in person) and it went poorly, but I’ll try again here. If one of my 75 year old parents (whom I love dearly) dies from COVID-19, that is less of a tragedy than if a random teenager in my city does. My parent would have lost fewer years or “years of quality life” than the teen. For the same reason, IMO, if there was only 1 kidney available, an 18 year old should get it before a 50 year old who should get it before an 82 year old, if all else is equal. In that limited way, I do think the lives of the young have more value than those of middle age or the elderly.
  - mushbino 6y ago
    Is age the only measure? What about the contribution or potential contributions to society? Is the life of an 18 year old unmotivated ne'er do well worth more than a 50 year old with children or a 6o yr old who has made great contributions to society and wants to enjoy their last 30-40 years? There's just no way we can assume that age is the great qualifier.
digi59404 6y ago
Yes, the death rates scale with age. However, the permanent damage persists even in younger folks. It’s not as cut and dry as “x number are asymptomatic, and that mean 1 million will die. But those are mainly older folks so we act accordingly.” The problem is: 1. The virus causes permanent damage in people. Even if they live and survive they’ll be dealing with the damage for a long period of time. Some lung damage can take months to heal. 2. The virus immunity exists in the short term immunity of the body. Which means depending on the person in 6 months to a year - Surprise theyre reinfected. We haven’t seen reinfections yet, but we have proven immunity is short term and not life long. 3. This effectively means the risk of this virus becoming a yearly thing is exceptionally high. Not to mention herd immunity isn’t as useful. Due to the fact we’ll always have people losing immunity and becoming sick. What this essentially means is that 0.5% number (which I think is wrong, but I digress) is a yearly number and will compound over time. And yes - After a few cycles the percentage (should) drop due to our older folks dying off. However, we’re also going to see people with organ damage 6 months on being reinfected which could result in a higher mortality in itself.

marcinzm 6y ago

>but I do know that continuing to pursue current policies until some indefinite point in the future is untenable. Go strawman, go! California and NY both have plans for slowly reopening in the comings weeks or months with various metrics guiding the timelines.

mdorazio 6y ago
Serious question: can you show me the metrics for california with concrete targets that will trigger reopening? The last plan I saw wasn't a plan at all, it was just guidelines.
- marcinzm 6y ago
  I don't see the difference between plan and guidelines from any practical point of view. There is a statewide timeline and counties can open slower/faster. There's a list of criteria for counties to consider. This is a slide deck summarizing things at a state level, it notes a variety of metrics that are being looked at: https://www.gov.ca.gov/wp-content/uploads/2020/04/Update-on-California-Pandemic-Roadmap.pdf https://www.gov.ca.gov/wp-content/uploads/2020/04/Update-on-...
  - mdorazio 6y ago
    Here's a plan: when we get to X new cases per day, we will reopen. Here's a guideline: we'll reopen when we think it's safe. The former has concrete goals that you can measure against and take action on. The latter has no clarity whatsoever. If I presented a project plan the way California has presented its Covid reopening "plans" I would be fired.
    - marcinzm 6y ago
      Except "the population feeling safe" is the only metric that really matters. Everything else is a proxy. If the population doesn't feel safe then they will protest and not resume activities. The other metrics can be golden but if the population disagree you will have trouble in a democracy.
- cozzyd 6y ago
  At least in Illinois, opening targets are based on agent-based simulations of disease spread. Specifically, the simulations predicted that if Illinois had reopened on May 1, we would have seen a larger peak than the initial one in June. You can read about it here: https://www.chicagobusiness.com/greg-hinz-politics/look-inside-one-models-city-hall-uses-track-how-fast-covid-19-spreads https://www.chicagobusiness.com/greg-hinz-politics/look-insi...
- pm90 6y ago
  For California, see SF Chronicles' COVID Tracker page: https://projects.sfchronicle.com/2020/coronavirus-map/ https://projects.sfchronicle.com/2020/coronavirus-map/. It even has a checklist with the targets that must be met before a county can lift quarantine.
  - mdorazio 6y ago
    Thanks, it's really confusing because there are multiple conflicting sources with different guidelines and the governor's statements have indicated Phase 2 is still case-by-case and phases 3 and 4 are "sometime soonish". In addition to the metrics that SF Chronicle page is tracking for Bay Area counties, there's also [1], [2], and [3] in addition to the original governor's slides a few weeks ago. I can't find any concrete goals from official sources for completely reopening the state (phase 4). [1] https://www.sfchronicle.com/politics/article/Here-s-a-checklist-of-what-California-counties-15254787.php https://www.sfchronicle.com/politics/article/Here-s-a-checkl... [2] https://apnews.com/2c69fe294f73a1120c2dad4a738966e3 https://apnews.com/2c69fe294f73a1120c2dad4a738966e3 [3] https://www.gov.ca.gov/wp-content/uploads/2020/05/5.4-Report-Card-on-California-Resilience-Roadmap.pdf https://www.gov.ca.gov/wp-content/uploads/2020/05/5.4-Report...
- joshuamorton 6y ago
  Targets for early reopening (ie before the state at large): - 1.5 tests per 1000 people per day - No deaths in the past 14 days - Some max number of cases per day that's really low - Stockpile of PPE (I forget the exact numbers) - A minimum number of contact tracers (I think also 1.5 per 1000 people, although it may be an order of magnitude lower) The bay area has a more stringent set of guidelines (minus the number of deaths that another person linked to).

m_ke 6y ago

https://www.nytimes.com/2020/05/09/health/mysterious-coronavirus-illness-claims-3-children-in-new-york.html https://www.nytimes.com/2020/05/09/health/mysterious-coronav...

mushbino 6y ago

Do you have any research or data showing that the lives of the elderly and immunocompromised are less valuable than those considered more safe?

sokoloff 6y ago
I have shared this opinion before (in person) and it went poorly, but I’ll try again here. If one of my 75 year old parents (whom I love dearly) dies from COVID-19, that is less of a tragedy than if a random teenager in my city does. My parent would have lost fewer years or “years of quality life” than the teen. For the same reason, IMO, if there was only 1 kidney available, an 18 year old should get it before a 50 year old who should get it before an 82 year old, if all else is equal. In that limited way, I do think the lives of the young have more value than those of middle age or the elderly.
- mushbino 6y ago
  Is age the only measure? What about the contribution or potential contributions to society? Is the life of an 18 year old unmotivated ne'er do well worth more than a 50 year old with children or a 6o yr old who has made great contributions to society and wants to enjoy their last 30-40 years? There's just no way we can assume that age is the great qualifier.

digi59404 6y ago

Yes, the death rates scale with age. However, the permanent damage persists even in younger folks. It’s not as cut and dry as “x number are asymptomatic, and that mean 1 million will die. But those are mainly older folks so we act accordingly.” The problem is: 1. The virus causes permanent damage in people. Even if they live and survive they’ll be dealing with the damage for a long period of time. Some lung damage can take months to heal. 2. The virus immunity exists in the short term immunity of the body. Which means depending on the person in 6 months to a year - Surprise theyre reinfected. We haven’t seen reinfections yet, but we have proven immunity is short term and not life long. 3. This effectively means the risk of this virus becoming a yearly thing is exceptionally high. Not to mention herd immunity isn’t as useful. Due to the fact we’ll always have people losing immunity and becoming sick. What this essentially means is that 0.5% number (which I think is wrong, but I digress) is a yearly number and will compound over time. And yes - After a few cycles the percentage (should) drop due to our older folks dying off. However, we’re also going to see people with organ damage 6 months on being reinfected which could result in a higher mortality in itself.