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In many ways, this was a worst case scenario for countries without a history of fighting respiratory diseases. It’s lethal enough to rack up a significant body

In many ways, this was a worst case scenario for countries without a history of fighting respiratory diseases. It’s lethal enough to rack up a significant body count, but “safe” enough for large portions of the population to disregard the risk and potentially transmit it. Oh, and it’s airborne and you’re infectious before you have symptoms. Ironically, a disease with a much higher case fatality rate probably would’ve killed fewer Americans, since we’d be more aligned on stopping it, and it would have a greater tendency to burn itself out.

soperj 6y ago
You've got over 18000 people a week dying in the US from Covid-19. How many more people do you need?
- ashtonkem 6y ago
  What a weirdly accusatory tone. For the record, I’m staying at home and I wear a mask. Save your accusations for those who actually advocate for behavior you disagree with. My point is entirely that the perception of risk has had a huge impact on compliance for social distancing and mask wearing. The fact that 99% of those infected survive (age dependent) has had a negative impact on compliance. If this had been a pandemic with a higher CFR, then compliance would have been even higher. I have an extremely hard time imagining there being an anti-lockdown movement for an outbreak of Ebola, for example.
  - soperj 6y ago
    1% is a huge amount of people dying. Death rate doesn't matter so much as the number of people getting it, why is why SARS with a much high death rate killed far fewer people than Covid-19.
    - ashtonkem 6y ago
      Read what I said more carefully before replying. You’re largely reiterating what I’ve already said. Yes, 1% CFR is a lot of deaths, which is why ~3k Americans are dying per day. But 1% of personal risk is perceived as a low risk thing, hence the low compliance. Transmissibility is also a factor, of course.
      - soperj 6y ago
        I don't think Americans would align more to stop it if it were deadlier is my point. There would be the same stupid outcry. Look at the history of the Spanish flu. It's the same crap.
        ashtonkem 6y ago
        Yeah, that’s fair. There were mask protests during the Spanish Flu, which had a much higher CFR.
        soperj 6y ago
        Sorry if I came off as a jerk.
davidw 6y ago
Yeah, this was something 'interesting' to learn about people's behavior. If it had been deadlier, more people would take it more seriously. It hits a "sweet spot" where it's lethal... but not quite enough to terrify everyone into staying home. So it keeps ebbing and flowing.
tialaramex 6y ago
> Ironically, a disease with a much higher case fatality rate probably would’ve killed fewer Americans, since we’d be more aligned on stopping it Not unless it was much higher, like 10% whole population fatality might do it but merely twice as much death wouldn't move the needle. It's because of one of the most literal examples of survivorship bias. No living people have ever died as a result of taking some particular obviously unsafe shortcut, so they can rationalise it as OK, even though intellectually they know it's a very bad idea. Each time this unsafe shortcut kills somebody, all the living people still have no experience of dying from that shortcut because the one person who experienced the other outcome is now dead. Close calls can help a little bit, gradually, but the effect is slow and unevenly distributed. > it would have a greater tendency to burn itself out. One reason I particularly point at elimination strategy (beyond the, in my opinion obviously related fact that it worked) is that zero cases has a categorically different impact than merely low numbers of cases that result from hoping a lower R-number will cause it to "burn itself out". You get to zero only one case at a time, tracking and tracing everything, getting right into the details, whereas these vague statistical approaches do not do that. Lots of countries or regions have tried to "flatten the curve" but that's not actually a way out, it's just to buy time. Now, in this case if you bought enough time (maybe 18-24 months) you get a vaccine. But not all diseases are like that, and we could not be confident this was one. Getting to zero is instead a (painful) permanent fix that allows you to really open up (within the country or region at zero). New Zealand's international tourist economy got a kick in the head, but its people are alive, much of everyday life is already how a lot of us in the North are hoping 2021 will be - its message this summer is "Make summer unstoppable" with small adjustments like wearing a mask on the plane, or tracking where you visited with QR code scanners - but otherwise a pretty normal vacation season, concerts, sports events and so on.
- WalterBright 6y ago
  I sometimes think about this in terms of warfare. Everyone who has memories of a war survived it, and this factors into deciding whether the next war is worth it or not. Nobody asks the people who died in the war if it was worth it.
  - 6y ago

soperj 6y ago

You've got over 18000 people a week dying in the US from Covid-19. How many more people do you need?

ashtonkem 6y ago
What a weirdly accusatory tone. For the record, I’m staying at home and I wear a mask. Save your accusations for those who actually advocate for behavior you disagree with. My point is entirely that the perception of risk has had a huge impact on compliance for social distancing and mask wearing. The fact that 99% of those infected survive (age dependent) has had a negative impact on compliance. If this had been a pandemic with a higher CFR, then compliance would have been even higher. I have an extremely hard time imagining there being an anti-lockdown movement for an outbreak of Ebola, for example.
- soperj 6y ago
  1% is a huge amount of people dying. Death rate doesn't matter so much as the number of people getting it, why is why SARS with a much high death rate killed far fewer people than Covid-19.
  - ashtonkem 6y ago
    Read what I said more carefully before replying. You’re largely reiterating what I’ve already said. Yes, 1% CFR is a lot of deaths, which is why ~3k Americans are dying per day. But 1% of personal risk is perceived as a low risk thing, hence the low compliance. Transmissibility is also a factor, of course.
    - soperj 6y ago
      I don't think Americans would align more to stop it if it were deadlier is my point. There would be the same stupid outcry. Look at the history of the Spanish flu. It's the same crap.
      - ashtonkem 6y ago
        Yeah, that’s fair. There were mask protests during the Spanish Flu, which had a much higher CFR.
        soperj 6y ago
        Sorry if I came off as a jerk.

davidw 6y ago

Yeah, this was something 'interesting' to learn about people's behavior. If it had been deadlier, more people would take it more seriously. It hits a "sweet spot" where it's lethal... but not quite enough to terrify everyone into staying home. So it keeps ebbing and flowing.

tialaramex 6y ago

> Ironically, a disease with a much higher case fatality rate probably would’ve killed fewer Americans, since we’d be more aligned on stopping it Not unless it was much higher, like 10% whole population fatality might do it but merely twice as much death wouldn't move the needle. It's because of one of the most literal examples of survivorship bias. No living people have ever died as a result of taking some particular obviously unsafe shortcut, so they can rationalise it as OK, even though intellectually they know it's a very bad idea. Each time this unsafe shortcut kills somebody, all the living people still have no experience of dying from that shortcut because the one person who experienced the other outcome is now dead. Close calls can help a little bit, gradually, but the effect is slow and unevenly distributed. > it would have a greater tendency to burn itself out. One reason I particularly point at elimination strategy (beyond the, in my opinion obviously related fact that it worked) is that zero cases has a categorically different impact than merely low numbers of cases that result from hoping a lower R-number will cause it to "burn itself out". You get to zero only one case at a time, tracking and tracing everything, getting right into the details, whereas these vague statistical approaches do not do that. Lots of countries or regions have tried to "flatten the curve" but that's not actually a way out, it's just to buy time. Now, in this case if you bought enough time (maybe 18-24 months) you get a vaccine. But not all diseases are like that, and we could not be confident this was one. Getting to zero is instead a (painful) permanent fix that allows you to really open up (within the country or region at zero). New Zealand's international tourist economy got a kick in the head, but its people are alive, much of everyday life is already how a lot of us in the North are hoping 2021 will be - its message this summer is "Make summer unstoppable" with small adjustments like wearing a mask on the plane, or tracking where you visited with QR code scanners - but otherwise a pretty normal vacation season, concerts, sports events and so on.

WalterBright 6y ago
I sometimes think about this in terms of warfare. Everyone who has memories of a war survived it, and this factors into deciding whether the next war is worth it or not. Nobody asks the people who died in the war if it was worth it.
- 6y ago