5 ms·

That is what I said in the second half of my comment. These two statements are not contradictory. To be precise, the cost of lockdown is 1/3 of the cost of unm

That is what I said in the second half of my comment. These two statements are not contradictory. To be precise, the cost of lockdown is 1/3 of the cost of unmitigated covid. The cost of lockdown is mostly borne by the young and healthy while the cost of non-lockdown is mostly borne by the vulnerable. It is a trolley problem.

onethought 6y ago
But the cost borne is very different. One the cost is death. The other the cost is hardship... how can you compare the two?
- jyBKJpc2P6 6y ago
  ONS compares QALY costs in both cases. In essence QALY is a measure of how much people value their life relative to suffering from some condition. The weighting for QALY calculations is based on asking relevant questions such as whether a patient would rather live with their condition or undergo an intervention that may either kill or cure them.
  - onethought 6y ago
    So I’m a perfectly healthy 65 year old, and there is a perfectly healthy 25 year old.* Could you explain how to use QALY to decide whether lockdowns are worth the (very treatable) risk of mental health deterioration vs not locking down and facing the very untreatable risk of death? *(Actually there are 10,000s of each)
    - jozvolskyef 6y ago
      The report I'm quoting[1] estimates the lockdown scenario to cost 182k QALYs in mental disorders, 190k QALYs in musculoskeletal disorders, and 157k QALYs in cardiovascular disorders.[1] Note that if your only risk factor is being 65 years old, implying you are female, it isn't necessarily the case that covid impacts you worse than lockdown. [1]: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/907616/s0650-direct-indirect-impacts-covid-19-excess-deaths-morbidity-sage-48.pdf https://assets.publishing.service.gov.uk/government/uploads/...
- criddell 6y ago
  Isn't this actually a fairly routine calculation?
- scatters 6y ago
  Everyone dies eventually. So a premature death means months or years of life lost, which can be compared against months or years of less full life due to hardship.
TheOtherHobbes 6y ago
The cost of non-lockdown would also be borne by the young and healthy, because there would be second order effects - including job losses, business failures, panic buying and food shortages, possible civil unrest, collapse of existing health systems, and loss of essential skilled people at all levels. Among others. There is no trite healthy vs vulnerable tradeoff here, and it's simply a fantasy to believe that everyone under 40 would be able to get on with life without consequences while the over-55s were dying off quietly. The reality is far more complicated. Letting Covid run wild would have been far more damaging than mitigation in a huge number of ways - economic, psychological, political, medical, and more. The one area of valid debate is whether good mitigation strategies were chosen and implemented wisely. Often they weren't. Test and trace, masking, and PPE provision should have been central, allowing more limited lockdowns. In the most badly hit countries none of that happened, and without them full-spectrum lockdowns were the only (blunt) tool that was left.
- filmgirlcw 6y ago
  > The one area of valid debate is whether good mitigation strategies were chosen and implemented wisely. Often they weren't. Test and trace, masking, and PPE provision should have been central, allowing more limited lockdowns. > In the most badly hit countries none of that happened, and without them full-spectrum lockdowns were the only (blunt) tool that was left. This exactly. I get really frustrated with the simplistic argument over whether lockdown measures have been better or worse than doing nothing, because it misses that these were not the only two options. Not even close. When you look at how countries that reacted quickly to the virus and implemented, masking, testing, PPE provisions and sensible social-distancing requirements, it is clear that those countries were able to recover, both economically and socially. In areas, like the United States, that waited until it was too late to do anything, and then were forced to implement lockdowns, the outcome is far worse and the aggregate human toll — irrespective of death count due to the virus — much greater. As a strong supporter of civil liberties, I’m in a difficult position, when I try to balance some of the more draconian state-run actions of places like Singapore, Taiwan, and South Korea, with the effects we see in the United States. For all of the many negatives of that kind of government/militaristic control, I can’t help but think that if the US had done that, the global economy, not to mention all of the industries that have evaporated in the US, would have recovered much more strongly by now. This is absolutely not a trolley problem. This didn’t have to be a choice between two negative outcomes. There were ways to mitigate exposure that could have saved people from dying from the coronavirus, while also limiting the debilitating impact of lockdown. The world's biggest superpower just didn’t do that.

onethought 6y ago

But the cost borne is very different. One the cost is death. The other the cost is hardship... how can you compare the two?

jyBKJpc2P6 6y ago
ONS compares QALY costs in both cases. In essence QALY is a measure of how much people value their life relative to suffering from some condition. The weighting for QALY calculations is based on asking relevant questions such as whether a patient would rather live with their condition or undergo an intervention that may either kill or cure them.
- onethought 6y ago
  So I’m a perfectly healthy 65 year old, and there is a perfectly healthy 25 year old.* Could you explain how to use QALY to decide whether lockdowns are worth the (very treatable) risk of mental health deterioration vs not locking down and facing the very untreatable risk of death? *(Actually there are 10,000s of each)
  - jozvolskyef 6y ago
    The report I'm quoting[1] estimates the lockdown scenario to cost 182k QALYs in mental disorders, 190k QALYs in musculoskeletal disorders, and 157k QALYs in cardiovascular disorders.[1] Note that if your only risk factor is being 65 years old, implying you are female, it isn't necessarily the case that covid impacts you worse than lockdown. [1]: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/907616/s0650-direct-indirect-impacts-covid-19-excess-deaths-morbidity-sage-48.pdf https://assets.publishing.service.gov.uk/government/uploads/...
criddell 6y ago
Isn't this actually a fairly routine calculation?
scatters 6y ago
Everyone dies eventually. So a premature death means months or years of life lost, which can be compared against months or years of less full life due to hardship.

TheOtherHobbes 6y ago

The cost of non-lockdown would also be borne by the young and healthy, because there would be second order effects - including job losses, business failures, panic buying and food shortages, possible civil unrest, collapse of existing health systems, and loss of essential skilled people at all levels. Among others. There is no trite healthy vs vulnerable tradeoff here, and it's simply a fantasy to believe that everyone under 40 would be able to get on with life without consequences while the over-55s were dying off quietly. The reality is far more complicated. Letting Covid run wild would have been far more damaging than mitigation in a huge number of ways - economic, psychological, political, medical, and more. The one area of valid debate is whether good mitigation strategies were chosen and implemented wisely. Often they weren't. Test and trace, masking, and PPE provision should have been central, allowing more limited lockdowns. In the most badly hit countries none of that happened, and without them full-spectrum lockdowns were the only (blunt) tool that was left.

filmgirlcw 6y ago
> The one area of valid debate is whether good mitigation strategies were chosen and implemented wisely. Often they weren't. Test and trace, masking, and PPE provision should have been central, allowing more limited lockdowns. > In the most badly hit countries none of that happened, and without them full-spectrum lockdowns were the only (blunt) tool that was left. This exactly. I get really frustrated with the simplistic argument over whether lockdown measures have been better or worse than doing nothing, because it misses that these were not the only two options. Not even close. When you look at how countries that reacted quickly to the virus and implemented, masking, testing, PPE provisions and sensible social-distancing requirements, it is clear that those countries were able to recover, both economically and socially. In areas, like the United States, that waited until it was too late to do anything, and then were forced to implement lockdowns, the outcome is far worse and the aggregate human toll — irrespective of death count due to the virus — much greater. As a strong supporter of civil liberties, I’m in a difficult position, when I try to balance some of the more draconian state-run actions of places like Singapore, Taiwan, and South Korea, with the effects we see in the United States. For all of the many negatives of that kind of government/militaristic control, I can’t help but think that if the US had done that, the global economy, not to mention all of the industries that have evaporated in the US, would have recovered much more strongly by now. This is absolutely not a trolley problem. This didn’t have to be a choice between two negative outcomes. There were ways to mitigate exposure that could have saved people from dying from the coronavirus, while also limiting the debilitating impact of lockdown. The world's biggest superpower just didn’t do that.