4 ms·

Not to take sides, but that was the basis of the whole flatten the curve thing — or how it was presented to most people atleast.

ddingus 6y ago
The basis for it was reducing impact on health care systems, and to limit second, and future wave impact. Doing the first saved a lot of people because treatment was available. Secondary saves were non covid patients who could get service because capacity remained more available. Had we had better safety compliance, we would have reduced even more than we did and may have normalized things such that the wave upon us now would be much less. Death rates are dead/recovered and that is driven by infections. Lower infections means fewer entering the death equation. More health care available means more recovered and all of that means far fewer dead people.
- thu2111 6y ago
  It actually didn't save anyone because there was never any risk of hospital overload when panic didn't set in: Sweden has one of the lowest ICU capacities in Europe and never saw hospital overload. A few places did, but that's because they over-reacted and quarantined lots of their medical staff. That's the reaction not the virus.
  - pvaldes 6y ago
    It does not matter so much if you die in the hospital or in your home, in the end you are still dead. Deterring people to go to the hospitals, that are destined to save lifes, so they die at home instead, is not brilliant advice. They can (and will) sell it as a success, but Swedden still had much more people killed than their twin country Norway. The fact that those hospital rooms where not occupied despite having some elders in need of specialized care, is a failure, not a success. > was never any risk of hospital overload I think that many physicians in the planet would tell a very different history.
    - nickthemagicman 6y ago
      This is an arbitrary distinction to compare Sweden to Norway(who also had no mask mandate), cherry picked to fit your narrative. Sweden had deaths on par with the average of all of European countries less than Italy, Spain, the UK, etc.
      - pvaldes 6y ago
        Take in mind that the family structure is different in South and North Europe. Southern Europe homes are often multigenerational. Having gransons and grandpas living together increases the risk. Many granpas live alone in Swedden. Their results would be even worse if we remove this structural difference. If we can't compare Swedden With Norway, maybe you would prefer Denmark? 645 danish killed versus 5875 Sweddish. Even if we correct the difference in population, is still much lower (around 1290 versus 5875). They are not much different populations genetically. Do you have any hypothesis that would explain the difference?
        nickthemagicman 6y ago
        Wheres your evidence that Italy has more multigenerational households than Sweden? Do you have a citation? That's scientifically unsubstantiated and almost like you made it up on the spot based on anecdotal information. Also, you're cherry picking again to suit your narrative. Sweden is part of Europe and should be compared as such. It's disingenuous to keep promoting this demon-ization of Sweden narrative with unsubstantiated, and cherry picked comments. Sweden did the right thing. Other countries did not. It's that simple.
        pvaldes 6y ago
        You can find easily those data in Eurostat of course, that is the official channel for those things in EU. Mean age of youngsters leaving parental home to live in their own home. Data from 2019: - Italy: 30.1 Years old. - European Union: 26.2 Years old - Swedden: 17.8 Years old. So... Yes, definitely I would say that they are very different societies. This, most probably, saved Swedden several deaths. > Sweden is part of Europe and should be compared as such. For your information, Czechia is an European country, same as Denmark
  - Retric 6y ago
    Sweden’s compliance and low population density looks very different from most countries. Social distancing[edit] On 16 March 2020, the agency recommended that people over 70 should limit close contact with other people, and avoid crowded areas such as stores, public transport and public spaces.[112] At the end of March, 93% of those older than 70 said that they were following the recommendations from the health service to some extent, with the majority having decreased their contacts with friends and family.[113] In May, the agency looked at easening the recommendations for the 'young elderly' of good health, but ultimately decided against it. The US might be keeping school systems closed, but movie theaters for example are open across most of the country. Mask compliance for example tracks closely with where areas that are currently experiencing outbreaks in the US. That likely says more about overall compliance than the effectiveness of masks. PS: It’s random mixing between groups that really spreads diseases. Individual classrooms where people see the same people every day may have outbreaks, but that’s all local transmission.
  - pvaldes 6y ago
    To add context, If Swedden would have the same population as Spain, the number of killed people at the current ratio would be 26907. In Czechia (a country with a similar population that Swedden) would be 2489 instead. Less than ten times lower. Swedden has not such stellar results as they are trying to sell.
  - ddingus 6y ago
    Reevaluate that for the US.
eesmith 6y ago
In this demonstration of a simple infection model (the SIR model) you can see this worked out at https://www.youtube.com/watch?v=k6nLfCbAzgo&feature=youtu.be&t=920 https://www.youtube.com/watch?v=k6nLfCbAzgo&feature=youtu.be... that "not only do you flatten the curve, you also stop everyone from getting the disease in the long run." A bit later they point out that flattening the curve increases the chance of getting to a vaccine or viable treatment; which is another way to reduce the total number of infections.
- sigotirandolas 6y ago
  The problem with that is that in real life transmissibility is not a fixed parameter you can keep down forever. People eventually get lockdown fatigue and/or realize the opportunity cost is not worth it for them. So the area under the curve is roughly the same in the long run. That is, unless we can get a vaccine or effective treatment fast enough.
  - eesmith 6y ago
    Like I said, "simple infection model (the SIR model)". Which more rigorous models have the area under the curve as roughly the same, as you describe it? I believe any model which has herd immunity, where personal immunity comes after a period of infection, must have the possibility of overshooting the minimum heard immunity density when the infection rate is high enough. As in the SIR model. Lower the infection rate and there's lower overshoot.
    - sigotirandolas 6y ago
      My point is that that the argument you made - i.e. that lower transmissibility aka. "flatten the curve" lowers total mortality in the SIR model - doesn't hold unless you assume that you can keep transmissibility down forever (and unless a vaccine or treatment comes out fast enough). That is, I'm not presenting a new argument, merely refuting your argument, over the SIR model you used, adding the assumption that transmissibility can't be kept down indefinitely - which I believe is very reasonable given what we are observing. I believe it's the burden of the proof is on you to present a new, more rigorous model if you want to argue that slowing down transmission significantly lowers overall mortality - as the null hypothesis is that they are not associated. On the last point, I am aware that under the SIR model, there's the possibility of overshoot, i.e. exceeding the minimum herd immunity threshold. My understanding is that this isn't a significant effect unless you have uncontrolled, explosive expansion, so that most people get infected simultaneously before others develop immunity and can therefore act as a barrier for herd immunity. I don't believe this is the situation right now given the numbers we are seeing. That said, I believe that the more realistic future is that a vaccine or an effective treatment will be developed in the next months, and that will be the thing that will have made temporarily lowering transmissibility worth it. What I don't believe, because I haven't found any evidence for it that holds basic scrutiny, is that if no vaccine or effective treatment can be developed in a reasonable timeframe, then keeping the measures to slow down transmission as long as possible will have any significant effect on lower overall mortality. EDIT: To make it clear so people do not misunderstand me, what I believe has no evidence is that without a timely vaccine or effective treatment, slowing down transmission beyond what is necessary to keep the health system from overloading is associated with lower overall mortality.

ddingus 6y ago

The basis for it was reducing impact on health care systems, and to limit second, and future wave impact. Doing the first saved a lot of people because treatment was available. Secondary saves were non covid patients who could get service because capacity remained more available. Had we had better safety compliance, we would have reduced even more than we did and may have normalized things such that the wave upon us now would be much less. Death rates are dead/recovered and that is driven by infections. Lower infections means fewer entering the death equation. More health care available means more recovered and all of that means far fewer dead people.

thu2111 6y ago
It actually didn't save anyone because there was never any risk of hospital overload when panic didn't set in: Sweden has one of the lowest ICU capacities in Europe and never saw hospital overload. A few places did, but that's because they over-reacted and quarantined lots of their medical staff. That's the reaction not the virus.
- pvaldes 6y ago
  It does not matter so much if you die in the hospital or in your home, in the end you are still dead. Deterring people to go to the hospitals, that are destined to save lifes, so they die at home instead, is not brilliant advice. They can (and will) sell it as a success, but Swedden still had much more people killed than their twin country Norway. The fact that those hospital rooms where not occupied despite having some elders in need of specialized care, is a failure, not a success. > was never any risk of hospital overload I think that many physicians in the planet would tell a very different history.
  - nickthemagicman 6y ago
    This is an arbitrary distinction to compare Sweden to Norway(who also had no mask mandate), cherry picked to fit your narrative. Sweden had deaths on par with the average of all of European countries less than Italy, Spain, the UK, etc.
    - pvaldes 6y ago
      Take in mind that the family structure is different in South and North Europe. Southern Europe homes are often multigenerational. Having gransons and grandpas living together increases the risk. Many granpas live alone in Swedden. Their results would be even worse if we remove this structural difference. If we can't compare Swedden With Norway, maybe you would prefer Denmark? 645 danish killed versus 5875 Sweddish. Even if we correct the difference in population, is still much lower (around 1290 versus 5875). They are not much different populations genetically. Do you have any hypothesis that would explain the difference?
      - nickthemagicman 6y ago
        Wheres your evidence that Italy has more multigenerational households than Sweden? Do you have a citation? That's scientifically unsubstantiated and almost like you made it up on the spot based on anecdotal information. Also, you're cherry picking again to suit your narrative. Sweden is part of Europe and should be compared as such. It's disingenuous to keep promoting this demon-ization of Sweden narrative with unsubstantiated, and cherry picked comments. Sweden did the right thing. Other countries did not. It's that simple.
        pvaldes 6y ago
        You can find easily those data in Eurostat of course, that is the official channel for those things in EU. Mean age of youngsters leaving parental home to live in their own home. Data from 2019: - Italy: 30.1 Years old. - European Union: 26.2 Years old - Swedden: 17.8 Years old. So... Yes, definitely I would say that they are very different societies. This, most probably, saved Swedden several deaths. > Sweden is part of Europe and should be compared as such. For your information, Czechia is an European country, same as Denmark
- Retric 6y ago
  Sweden’s compliance and low population density looks very different from most countries. Social distancing[edit] On 16 March 2020, the agency recommended that people over 70 should limit close contact with other people, and avoid crowded areas such as stores, public transport and public spaces.[112] At the end of March, 93% of those older than 70 said that they were following the recommendations from the health service to some extent, with the majority having decreased their contacts with friends and family.[113] In May, the agency looked at easening the recommendations for the 'young elderly' of good health, but ultimately decided against it. The US might be keeping school systems closed, but movie theaters for example are open across most of the country. Mask compliance for example tracks closely with where areas that are currently experiencing outbreaks in the US. That likely says more about overall compliance than the effectiveness of masks. PS: It’s random mixing between groups that really spreads diseases. Individual classrooms where people see the same people every day may have outbreaks, but that’s all local transmission.
- pvaldes 6y ago
  To add context, If Swedden would have the same population as Spain, the number of killed people at the current ratio would be 26907. In Czechia (a country with a similar population that Swedden) would be 2489 instead. Less than ten times lower. Swedden has not such stellar results as they are trying to sell.
- ddingus 6y ago
  Reevaluate that for the US.

eesmith 6y ago

In this demonstration of a simple infection model (the SIR model) you can see this worked out at https://www.youtube.com/watch?v=k6nLfCbAzgo&feature=youtu.be&t=920 https://www.youtube.com/watch?v=k6nLfCbAzgo&feature=youtu.be... that "not only do you flatten the curve, you also stop everyone from getting the disease in the long run." A bit later they point out that flattening the curve increases the chance of getting to a vaccine or viable treatment; which is another way to reduce the total number of infections.

sigotirandolas 6y ago
The problem with that is that in real life transmissibility is not a fixed parameter you can keep down forever. People eventually get lockdown fatigue and/or realize the opportunity cost is not worth it for them. So the area under the curve is roughly the same in the long run. That is, unless we can get a vaccine or effective treatment fast enough.
- eesmith 6y ago
  Like I said, "simple infection model (the SIR model)". Which more rigorous models have the area under the curve as roughly the same, as you describe it? I believe any model which has herd immunity, where personal immunity comes after a period of infection, must have the possibility of overshooting the minimum heard immunity density when the infection rate is high enough. As in the SIR model. Lower the infection rate and there's lower overshoot.
  - sigotirandolas 6y ago
    My point is that that the argument you made - i.e. that lower transmissibility aka. "flatten the curve" lowers total mortality in the SIR model - doesn't hold unless you assume that you can keep transmissibility down forever (and unless a vaccine or treatment comes out fast enough). That is, I'm not presenting a new argument, merely refuting your argument, over the SIR model you used, adding the assumption that transmissibility can't be kept down indefinitely - which I believe is very reasonable given what we are observing. I believe it's the burden of the proof is on you to present a new, more rigorous model if you want to argue that slowing down transmission significantly lowers overall mortality - as the null hypothesis is that they are not associated. On the last point, I am aware that under the SIR model, there's the possibility of overshoot, i.e. exceeding the minimum herd immunity threshold. My understanding is that this isn't a significant effect unless you have uncontrolled, explosive expansion, so that most people get infected simultaneously before others develop immunity and can therefore act as a barrier for herd immunity. I don't believe this is the situation right now given the numbers we are seeing. That said, I believe that the more realistic future is that a vaccine or an effective treatment will be developed in the next months, and that will be the thing that will have made temporarily lowering transmissibility worth it. What I don't believe, because I haven't found any evidence for it that holds basic scrutiny, is that if no vaccine or effective treatment can be developed in a reasonable timeframe, then keeping the measures to slow down transmission as long as possible will have any significant effect on lower overall mortality. EDIT: To make it clear so people do not misunderstand me, what I believe has no evidence is that without a timely vaccine or effective treatment, slowing down transmission beyond what is necessary to keep the health system from overloading is associated with lower overall mortality.