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I think you've misunderstood what the experts are attempting to do. They're not trying to get 0 covid deaths at the expense of all else. COVID can easily overw

I think you've misunderstood what the experts are attempting to do. They're not trying to get 0 covid deaths at the expense of all else. COVID can easily overwhelm the hospital system all by itself. We saw that in Italy and China... and hospital systems in several parts of the US are already near capacity. Once they're overwhelmed, there will be no room left in the hospitals, and they'll have to do one of two things: Start sending covid patients home, which will increase the covid death rate and/or start refusing patients with other injuries/diseases.. which will increase the deaths in those cases. The restrictions are all about preventing the hospitals from being overwhelmed, and causing more people to die than currently. It just seems like they're so focused on covid, because it spreads so rapidly that it can overwhelm hospitals in a very short period of time. Unfortunately with the numbers in Texas, Florida, and elsewhere... and with how long it takes for restrictions to have an effect... it's very likely we'll see what an overwhelmed hospital system looks like very soon.

umvi 6y ago
> COVID can easily overwhelm the hospital system all by itself. 1. Is there anything a hospital can actually do to save someone with a serious case of covid-19? As far as I know, ventilators are ineffective (and may even make things worse?). If 100 people with serious covid-19 are taking up ICU beds, how many will live due to direct hospital intervention? If it's a very low %, it seems like a no-brainer to turn away covid-19 cases in favor or other, more treatable diseases. Otherwise it's like letting people with prion disease use up all the ICU beds despite their condition being pretty much untreatable. 2. Anti-covid measures can do the inverse. Remember back in March/April/May when all the hospitals in the USA were empty due to SIP? Most hospitals ended up dismantling their temporary covid-19 field hospitals due to lack of use.
- deleted 6y ago
  [deleted]
- rgbrenner 6y ago
  1. Ventilators are likely effective: https://www.npr.org/sections/health-shots/2020/05/15/856768020/new-evidence-suggests-covid-19-patients-on-ventilators-usually-survive https://www.npr.org/sections/health-shots/2020/05/15/8567680... New treatments are being developed every day, so those numbers may get better. 2. IMO, dismantling the field hospitals was a terrible idea. They built them early, locked down, then saw the decline and people started thinking we were going to eradicate it like in New Zealand. It was never going to happen.
- chki 6y ago
  Ventilators are definitely not ineffective. Obviously it's not a treatment but a measure to keep the patient alive and prolong the time for the patients own immune response to fight the virus. Studies show a 30% mortality rate among ICU patients. Without ventilation this would be closer to 100% because patients without ventilation would suffocate.
- lmilcin 6y ago
  If you look at statistics, death rates skyrocket in places and at the time when hospitals are overwhelmed. Also remember, doctors and nurses are people, too. Who is going to save your ass if all staff is sick?
  - umvi 6y ago
    If all the staff is sick, then 2 weeks later all the staff will be immune. So just... Don't get sick during the window when all staff is simultaneously sick.
- pessimizer 6y ago
  > it seems like a no-brainer to turn away covid-19 cases in favor or other, more treatable diseases. A hospital wouldn't be turning them away, they'd be throwing them out. Any likely fatal case of covid is already in the hospital. That's death panels on steroids. What survival percentage should get people ejected? 10%? What would be the social consequences of turning people away from a hospital who would live 10% of the time? Should they also start turning down people in serious car accidents or who have had serious heart attacks? Where would these triaged be sent? Would there be some sort of lightly manned hospice warehouse where suffering people wait to die, or would it be more merciful to give them an injection? If you don't give them an injection, but 1-2% of the time they still end up recovering on their own, how would we answer them when they start loudly and publicly asking questions about our priorities? These probably aren't questions that you would personally have to answer, because your role in this hypothetical is just to not be on lockdown and to be free to do whatever you want when you want, but other people are going to be required to physically carry this stuff out. > Most hospitals ended up dismantling their temporary covid-19 field hospitals due to lack of use. This is good news, not bad news.
chiefalchemist 6y ago
Yes, mitigate the possibility of overwhelming the hospitals. However, there are unintended consequences to that mindset. From domestic violence to substance abuse to the economic fallout [1], these "side effects" are real. Yet somehow completely unaddressed. How do we know the cure isn't going to be worse? [1] There's plenty of data on economy vs health from the circa 2008 economic implosion. We could start with that, but we haven't. That's risky, for some fatal.
- vharuck 6y ago
  It'd be hard to determine the difference between extra deaths and economic damage because of government actions versus what we would have seen with different or no action. I think, if there had been no government action, people still would've reacted to the pandemic on their own, causing economic damage and a spike in suicides. The difficult part is finding a good model to estimate the difference in effect. But by the time we saw cases on the West and East coasts in the US, there were no "good" options. We'd also need to account for a drop in deaths from fewer car and workplace accidents.
  - claudeganon 6y ago
    Yes, people keep mixing up cause and effect when talking about this. It’s true that bad government responses can exacerbate things (as the US seems intent on proving), but the pandemic was going to inflict serious economic damage anywhere it reached the uncontrolled state like now exists in the US. The only way to have prevented that was to act early and competently, which many countries have successfully done. But once you’ve crossed that threshold, demanding people risk serious illness and death for the sake of the economy isn’t going to get you very far in correcting things.
    - chiefalchemist 6y ago
      The point is, how much suffering and how many deaths are "collateral damage" from "the war"? Why are we assuming? What if the path we're on is worse? Do we really expect the elected officials to admit the error? Will the media ask? It's wrong to assume. If nothing else it devalues the lives lost and damaged from the side effects. Either we're all in this together or we're not.
colordrops 6y ago
The point of the original post is exactly what you are saying. They are only thinking about what it takes to avoid overwhelming the hospital system without thinking at all about collateral damage and other externalities. There was a recent UN study that estimates that 50 million children will go into poverty due to current measures. There is another NIH study showing several thousands non-covid deaths a day above the average, at least toward the start of the pandemic. I personally know two people that died because they didn't get the medical care they needed at the beginning of the quarantine. Suicides are up significantly. Overdoses are up almost 50%. Depression is rampant due to isolation and financial distress. Domestic violence went up drastically at the start of quarantine. Violent offenders were released from prison due to worries about covid infection due to overcrowding. It's not clear AT ALL whether we are net positive overall due to the current particular quarantine measures. That is not to say that we shouldn't take measures. What it's saying is that the measures in place are not doing well at accounting for all impacts, which is certainly a difficult problem.
- rgbrenner 6y ago
  That's a good point.. But also keep in mind that the number we need to compare those deaths to isn't the current covid death rate.. it's the death rate that occurs once the hospital system is overwhelmed... since that would be the result if all of the restrictions (that cause the effects you listed) were lifted.
  - elmo2you 6y ago
    You might want to give that line of reasoning some additional critical thinking. Because there appears to be a big assumption in that statement. One that might sound all but certain to you, but might not be. What I can tell you is this: I happen to have first hand experience from a country that initially took some of the most draconian of measures when the virus surfaced. All with the usual explanations as for why all that was absolutely necessary. Then, after some time, the local ruler needed to secure a reelection he had already planned before the virus spread. All of a sudden, it was like there was no virus anymore. Of course there was, but the topic was practically taboo while the elections where going on. Now that the elections are over, and said ruler has galvanized his position for the foreseeable future, the virus has returned and the number of infections grown. No surprise that stronger measures came back too. But that's not the interesting part. What is interesting, is that during the elections none of the doom scenarios that almost every country around the globe has used to justify/explain their measures (whatever those might be), happened. There is a good chance that a lot of bad news was suppressed and covered up. If only to ensure the election would not be forcefully shut down. But there are only so many mysteriously dead people and failing hospitals that even a government with absolute power and no accountability can cover up. The point here is this: that despite all the rhetoric about why all those draconian measure were so much necessary, when they were (practically all) temporarily lifted for political reasons, the world did not stop turning and neither did any systems collapse. In fact, in many/most aspects the country managed to temporarily recover more/faster than other countries in the region. That was, of course, until the election was over, and the virus "returned". I am not saying that any of the measures are wrong or that they didn't help prevent deaths. But what I am saying is that maybe the "reasoning" regarding what will happen without them isn't as much established fact as many people like to believe.
argonaut 6y ago
No no no, this is a major misunderstanding, and it has contributed to a lot of public mistrust of public health authorities. Even though flatten the curve was largely believed by the media and the public in March to mean "mitigate Covid to prevent health system collapse," many experts are insisting that what they meant all along was trying to reduce Covid deaths as much as possible. And this intention becomes clear when you see an expert oppose reopening even in areas where hospitals are mostly empty (like parts of California a month ago). Some good tweet threads on this major point of contention: https://twitter.com/mattyglesias/status/1277236932121157632 https://twitter.com/mattyglesias/status/1277236932121157632 (Carl Bergstrom, in the replies, is one public health figure who insists he originally meant essentially flatten as much as possible). Nate Silver insists most people understood flatten the curve in March to mean mitigation: https://twitter.com/NateSilver538/status/1277347535061946372 https://twitter.com/NateSilver538/status/1277347535061946372 One of the few nations to actually follow the "mitigate Covid to prevent health care system collapse" is Sweden. The fact that the media/experts roundly criticize Sweden for having too many deaths (despite their health system not collapsing) is another piece of evidence that they really mean "flatten as much as possible."
- graeme 6y ago
  Yeah I think the language itself was ill chosen. “Flatten the curve” helped convince people that drastic measures were needed, but it also gave the idea the curve would continue. Coronavirus has two bad effects: 1. It kills people and causes long run harm to many survivors 2. It can also overwhelm health systems, which leads to more deaths than otherwise and prevents the treatment of normal medical problems You obviously want to avoid #2. But it also makes sense to avoid #1. “Flatten the curve” makes it seem like #1 is not so bad. I said flatten the curve myself. I meant eliminate both though. It’s not that much more effort, as many countries have shown. In fact with a head start it was much less effort. We have a harder road ahead now though in places where it is not eliminated. But I am not sure anyone can find a credible expert who said “flatten the curve and keep letting it run through till a vaccine”.
- umanwizard 6y ago
  How is it even possible to avoid the same number of people getting it, regardless of lockdowns? Lockdowns will have to be lifted eventually, almost certainly before a vaccine is widely distributed, and then won’t the outbreaks just start again, assuming there’s still at least one case anywhere in the world?

umvi 6y ago

> COVID can easily overwhelm the hospital system all by itself. 1. Is there anything a hospital can actually do to save someone with a serious case of covid-19? As far as I know, ventilators are ineffective (and may even make things worse?). If 100 people with serious covid-19 are taking up ICU beds, how many will live due to direct hospital intervention? If it's a very low %, it seems like a no-brainer to turn away covid-19 cases in favor or other, more treatable diseases. Otherwise it's like letting people with prion disease use up all the ICU beds despite their condition being pretty much untreatable. 2. Anti-covid measures can do the inverse. Remember back in March/April/May when all the hospitals in the USA were empty due to SIP? Most hospitals ended up dismantling their temporary covid-19 field hospitals due to lack of use.

deleted 6y ago
[deleted]
rgbrenner 6y ago
1. Ventilators are likely effective: https://www.npr.org/sections/health-shots/2020/05/15/856768020/new-evidence-suggests-covid-19-patients-on-ventilators-usually-survive https://www.npr.org/sections/health-shots/2020/05/15/8567680... New treatments are being developed every day, so those numbers may get better. 2. IMO, dismantling the field hospitals was a terrible idea. They built them early, locked down, then saw the decline and people started thinking we were going to eradicate it like in New Zealand. It was never going to happen.
chki 6y ago
Ventilators are definitely not ineffective. Obviously it's not a treatment but a measure to keep the patient alive and prolong the time for the patients own immune response to fight the virus. Studies show a 30% mortality rate among ICU patients. Without ventilation this would be closer to 100% because patients without ventilation would suffocate.
lmilcin 6y ago
If you look at statistics, death rates skyrocket in places and at the time when hospitals are overwhelmed. Also remember, doctors and nurses are people, too. Who is going to save your ass if all staff is sick?
- umvi 6y ago
  If all the staff is sick, then 2 weeks later all the staff will be immune. So just... Don't get sick during the window when all staff is simultaneously sick.
pessimizer 6y ago
> it seems like a no-brainer to turn away covid-19 cases in favor or other, more treatable diseases. A hospital wouldn't be turning them away, they'd be throwing them out. Any likely fatal case of covid is already in the hospital. That's death panels on steroids. What survival percentage should get people ejected? 10%? What would be the social consequences of turning people away from a hospital who would live 10% of the time? Should they also start turning down people in serious car accidents or who have had serious heart attacks? Where would these triaged be sent? Would there be some sort of lightly manned hospice warehouse where suffering people wait to die, or would it be more merciful to give them an injection? If you don't give them an injection, but 1-2% of the time they still end up recovering on their own, how would we answer them when they start loudly and publicly asking questions about our priorities? These probably aren't questions that you would personally have to answer, because your role in this hypothetical is just to not be on lockdown and to be free to do whatever you want when you want, but other people are going to be required to physically carry this stuff out. > Most hospitals ended up dismantling their temporary covid-19 field hospitals due to lack of use. This is good news, not bad news.

chiefalchemist 6y ago

Yes, mitigate the possibility of overwhelming the hospitals. However, there are unintended consequences to that mindset. From domestic violence to substance abuse to the economic fallout [1], these "side effects" are real. Yet somehow completely unaddressed. How do we know the cure isn't going to be worse? [1] There's plenty of data on economy vs health from the circa 2008 economic implosion. We could start with that, but we haven't. That's risky, for some fatal.

vharuck 6y ago
It'd be hard to determine the difference between extra deaths and economic damage because of government actions versus what we would have seen with different or no action. I think, if there had been no government action, people still would've reacted to the pandemic on their own, causing economic damage and a spike in suicides. The difficult part is finding a good model to estimate the difference in effect. But by the time we saw cases on the West and East coasts in the US, there were no "good" options. We'd also need to account for a drop in deaths from fewer car and workplace accidents.
- claudeganon 6y ago
  Yes, people keep mixing up cause and effect when talking about this. It’s true that bad government responses can exacerbate things (as the US seems intent on proving), but the pandemic was going to inflict serious economic damage anywhere it reached the uncontrolled state like now exists in the US. The only way to have prevented that was to act early and competently, which many countries have successfully done. But once you’ve crossed that threshold, demanding people risk serious illness and death for the sake of the economy isn’t going to get you very far in correcting things.
  - chiefalchemist 6y ago
    The point is, how much suffering and how many deaths are "collateral damage" from "the war"? Why are we assuming? What if the path we're on is worse? Do we really expect the elected officials to admit the error? Will the media ask? It's wrong to assume. If nothing else it devalues the lives lost and damaged from the side effects. Either we're all in this together or we're not.

colordrops 6y ago

The point of the original post is exactly what you are saying. They are only thinking about what it takes to avoid overwhelming the hospital system without thinking at all about collateral damage and other externalities. There was a recent UN study that estimates that 50 million children will go into poverty due to current measures. There is another NIH study showing several thousands non-covid deaths a day above the average, at least toward the start of the pandemic. I personally know two people that died because they didn't get the medical care they needed at the beginning of the quarantine. Suicides are up significantly. Overdoses are up almost 50%. Depression is rampant due to isolation and financial distress. Domestic violence went up drastically at the start of quarantine. Violent offenders were released from prison due to worries about covid infection due to overcrowding. It's not clear AT ALL whether we are net positive overall due to the current particular quarantine measures. That is not to say that we shouldn't take measures. What it's saying is that the measures in place are not doing well at accounting for all impacts, which is certainly a difficult problem.

rgbrenner 6y ago
That's a good point.. But also keep in mind that the number we need to compare those deaths to isn't the current covid death rate.. it's the death rate that occurs once the hospital system is overwhelmed... since that would be the result if all of the restrictions (that cause the effects you listed) were lifted.
- elmo2you 6y ago
  You might want to give that line of reasoning some additional critical thinking. Because there appears to be a big assumption in that statement. One that might sound all but certain to you, but might not be. What I can tell you is this: I happen to have first hand experience from a country that initially took some of the most draconian of measures when the virus surfaced. All with the usual explanations as for why all that was absolutely necessary. Then, after some time, the local ruler needed to secure a reelection he had already planned before the virus spread. All of a sudden, it was like there was no virus anymore. Of course there was, but the topic was practically taboo while the elections where going on. Now that the elections are over, and said ruler has galvanized his position for the foreseeable future, the virus has returned and the number of infections grown. No surprise that stronger measures came back too. But that's not the interesting part. What is interesting, is that during the elections none of the doom scenarios that almost every country around the globe has used to justify/explain their measures (whatever those might be), happened. There is a good chance that a lot of bad news was suppressed and covered up. If only to ensure the election would not be forcefully shut down. But there are only so many mysteriously dead people and failing hospitals that even a government with absolute power and no accountability can cover up. The point here is this: that despite all the rhetoric about why all those draconian measure were so much necessary, when they were (practically all) temporarily lifted for political reasons, the world did not stop turning and neither did any systems collapse. In fact, in many/most aspects the country managed to temporarily recover more/faster than other countries in the region. That was, of course, until the election was over, and the virus "returned". I am not saying that any of the measures are wrong or that they didn't help prevent deaths. But what I am saying is that maybe the "reasoning" regarding what will happen without them isn't as much established fact as many people like to believe.

argonaut 6y ago

No no no, this is a major misunderstanding, and it has contributed to a lot of public mistrust of public health authorities. Even though flatten the curve was largely believed by the media and the public in March to mean "mitigate Covid to prevent health system collapse," many experts are insisting that what they meant all along was trying to reduce Covid deaths as much as possible. And this intention becomes clear when you see an expert oppose reopening even in areas where hospitals are mostly empty (like parts of California a month ago). Some good tweet threads on this major point of contention: https://twitter.com/mattyglesias/status/1277236932121157632 https://twitter.com/mattyglesias/status/1277236932121157632 (Carl Bergstrom, in the replies, is one public health figure who insists he originally meant essentially flatten as much as possible). Nate Silver insists most people understood flatten the curve in March to mean mitigation: https://twitter.com/NateSilver538/status/1277347535061946372 https://twitter.com/NateSilver538/status/1277347535061946372 One of the few nations to actually follow the "mitigate Covid to prevent health care system collapse" is Sweden. The fact that the media/experts roundly criticize Sweden for having too many deaths (despite their health system not collapsing) is another piece of evidence that they really mean "flatten as much as possible."

graeme 6y ago
Yeah I think the language itself was ill chosen. “Flatten the curve” helped convince people that drastic measures were needed, but it also gave the idea the curve would continue. Coronavirus has two bad effects: 1. It kills people and causes long run harm to many survivors 2. It can also overwhelm health systems, which leads to more deaths than otherwise and prevents the treatment of normal medical problems You obviously want to avoid #2. But it also makes sense to avoid #1. “Flatten the curve” makes it seem like #1 is not so bad. I said flatten the curve myself. I meant eliminate both though. It’s not that much more effort, as many countries have shown. In fact with a head start it was much less effort. We have a harder road ahead now though in places where it is not eliminated. But I am not sure anyone can find a credible expert who said “flatten the curve and keep letting it run through till a vaccine”.
umanwizard 6y ago
How is it even possible to avoid the same number of people getting it, regardless of lockdowns? Lockdowns will have to be lifted eventually, almost certainly before a vaccine is widely distributed, and then won’t the outbreaks just start again, assuming there’s still at least one case anywhere in the world?