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I'm not sure how to feel about this simulation... I basically did nothing and burned through COVID within 3 months and things went back to normal by mid-summer.

I'm not sure how to feel about this simulation... I basically did nothing and burned through COVID within 3 months and things went back to normal by mid-summer. By the end of the year, despite mid-summer government confidence being terrible, I was told "The people trust the government" with a 70% approval. I mean I killed what 10% of the country, but hey... the people have short memories! What is this supposed to be teaching exactly? If the model is correct then I think a lot of people would say we should have just let the disease burn out and deal with the deaths. I'm not sure that's what the designers intended.

dng88 5y ago
Stop the virus from the source. Lab … q wuhan and stop those index case flying out of wuhan … vaccination until 70-80%. For the 10% dead … how about mutation … if they did it is not going to be heed imm. It would be another 10%? It may stabilise or it may not.
notananthem 5y ago
Yeah I killed 111k people immediately and then it flatlined, I was a little surprised. Then again, I killed 111k people.. my second time I did what I thought we (the US) should do with a full lockdown and killed like 50 total.
- setr 5y ago
  Depends when you do it. Obviously if you go full Madagascar at the first sign of trouble, you’ll crush it, but it’d pretty absurd behavior (every false flag would trigger lockdown). I waited a little by accident and then went full lockdown and got a total of 130k deaths
H8crilA 5y ago
Well, letting the thing burn is actually the fastest way to end the pandemic. The only thing faster than that would be additional intentional spreading (covid parties?) and/or vaccinations going on at the same time. This applies to any pandemic really, as long as the disease leaves some immunity. It's epidemiology 101, for example the SIR model flatlines when the R gets to the herd immunity level. But do you want the other [than pandemic ending] consequences? Like in your game-based example, 10% of the population dead?
- epgui 5y ago
  Biochemist here. No it is not, and that's not epi-101. By letting it rip you're not just maximizing your fatalities, but you're also maximizing the rate at which the thing mutates, which maximizes the probability that your "recovered" pool becomes vulnerable again.
  - carlmr 5y ago
    >but you're also maximizing the rate at which the thing mutates No country is a closed system. We see now that a previous immune response is better than nothing against the Delta variant. I'm wondering what will happen to the island nations that kept the virus at bay while not having a high vaccination rate, won't they have many more deaths now with the more infectious and more deadly version that other countries that "let it rip" like Sweden have at least partial widespread immunity to?
  - H8crilA 5y ago
    True. But suppose you had no vaccines, then roughly the same mutations will play out whether the epidemic lasts a week or a year. (Also, what the sibling wrote)
- graeme 5y ago
  Is it? Places with little forced mitigation like Brazil are still having waves. Some portion of the populace will be cautious and take precautions, and transient herd immunity within networks of people out and about will prevent some less cautious people from getting it during a given wave. To truly burn it out in real world conditions you’d need to actively infect people.
- Robotbeat 5y ago
  If you have healthy, low-risk people intentionally get the disease (from a single variant which you keep in good stock) and then strictly isolate/quarantine until they get better, that'd be a potential strategy. It's probably the best way to get overall immunity high enough that COVID would burn out... ...of course, this is basically the same as a super crappy vaccine. Vaccination would be way better. But back when people were poo-pooing the possibility of a fast vaccine development, it almost felt tempting to just do this and get it over with. Because the virus wouldn't be spreading beyond the host that got it, the risk of mutation would be small. (IMHO, we should've just massively accelerated vaccine development... even just a couple months would've saved lots of lives. If you're willing to try the strategy in my post, then accelerating vaccine approval would probably be no worse morally and probably a lot better.)
tapland 5y ago
I'm not sure it wouldn't have worked. Sweden had something like 80% support to only have event limits at 500 and no other restrictions, with people arguing in public forums that those dying deserved it and that it was worth it. I had a doctor outright scold me for wearing a mask to the hospital here (checkup for crohns disease which I take immunosupressants for) and didnt see a single other mask in the hospital until December 2020. o.O. Smaller countries with limited access to the wider discussions in English can turn very weird.
- gus_massa 5y ago
  >> I was told "The people trust the government" with a 70% approval. I mean I killed what 10% of the country, but hey... the people have short memories! > Sweden had something like 80% support to only have event limits at 500 and no other restrictions But even now Sweden has 0.15% of the population killed by covid-19, that is like 100 times smaller than the 10% that the GP got in the simulation.
  - henrikschroder 5y ago
    Also note that as of right now, Sweden has half the number of deaths/capita compared to Czechia, and is below the EU average, despite having had the least restrictive policy. This game perpetuates the gigantic fallacy that government intervention is the biggest factor determining spread and outcome, when in reality it's geography, structural differences, and enormous amounts of luck.
    - carlmr 5y ago
      I would also say it's cultural. Swedes keep a distance without you telling them, Spaniards do not.
      - disgruntledphd2 5y ago
        The biggest difference between Sweden an Spain is the presence of multi generational households in the latter.
parksy 5y ago
If the two metrics used are loss of life vs cost of pandemic, the cost of a life needs to be included in the final score I think. In Australia, it appears some early models predicted between 50k to 150k lives lost assuming no response. A statistical life is valued at over $4m, meaning a cost of $200bn to $600bn. Also, with 60% of the population infected, that would mean over 12 million people infected - we still don't have a good idea what the long-term issues will be - but one study in Australia found ~5% of people experiencing "long covid" symptoms, which would mean at least 600,000 people with long-term complications - which in our hypothetical Harkonnen society we'd likely just shove them into a hole somewhere and forget about them, otherwise we'd have to deal with their social welfare (yuck!) and strain on the health system. No doubt the cost, responses, short and long term impacts, etc, will be something economists and sociologists will debate for decades to come. https://www.smh.com.au/politics/federal/thousands-of-predicted-covid-19-deaths-never-eventuated-was-it-poor-modelling-or-our-response-20200527-p54wsn.html https://www.smh.com.au/politics/federal/thousands-of-predict... https://en.wikipedia.org/wiki/Value_of_life#Australia https://en.wikipedia.org/wiki/Value_of_life#Australia https://www.abc.net.au/news/2021-06-24/long-covid-nsw-research-five-per-cent-of-patients-slow-recovery/100241420 https://www.abc.net.au/news/2021-06-24/long-covid-nsw-resear... Edit: On thinking about it, I think the value of life is based on insurance / compensation purposes, perhaps the value of a life in terms of total GDP contribution would be different? Anyway, a subject more for the actuaries and economists I think. Interesting to consider nonetheless, which I think may be the overall point of this game.
- logicchains 5y ago
  >In Australia, it appears some early models predicted between 50k to 150k lives lost assuming no response. A statistical life is valued at over $4m, meaning a cost of $200bn to $600bn. That is the value of an "average" life. But the average age of death from covid is over 75, so the actual economic cost would be much less (which is accounted for when using https://en.wikipedia.org/wiki/Quality-adjusted_life_year https://en.wikipedia.org/wiki/Quality-adjusted_life_year, the standard way of measuring these things).
  - parksy 5y ago
jkey 5y ago
I doubt this - it is impossible to kill 10% of the population in the game. As anyone can see on the final screen, max number of deaths in the game is about 150000, which is 1.5% (Czechia population is approximately 10M)
nradov 5y ago
Even in a worst case scenario it would be impossible to kill 10% of the country. The worldwide infection fatality rate is under 1%. That would rise a little of the healthcare system was overwhelmed but getting to 10% isn't remotely plausible.
- TylerE 5y ago
  It would rise a LOT if health care gets overwhelmed, as we saw in Italy. And it’s not just COVID… if the hospitals are overrun many other things will have much higher mortality, like trauma cases.
  - deleted 5y ago
    [deleted]
  - nradov 5y ago
    None of that gets you even close to 10% mortality. In any given year only a tiny fraction of the population needs advanced hospital care to survive trauma or other diseases.
    - zibzab 5y ago
      IIRC Lombardy death rate reached 17% once hospitals were overwhelmed. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30099-2/fulltext https://www.thelancet.com/journals/lanpub/article/PIIS2468-2...
      - nradov 5y ago
        You do not recall correctly. You have confused case fatality rate with infection fatality rate. There are a large number of infections which are never officially counted as cases due to limited testing and minimal symptoms.
        zibzab 5y ago
        Well, with that line of reasoning we cannot trust any corona statistics, can we? Anyway, the effect of failing to "fallten the curve" in Lombardy are well documented. And this happened in December 2019 before we had a global pandemic.
pmontra 5y ago
I played the game by restricting everything except a full lockdown and by doing nothing. The first time I had less than 200 deaths, the second time almost 150 k. The government survived in both cases, actually a little better in the latter. I'm not surprised because I don't remember a single government having to resign because of covid, even where the pandemic hit hard. Somebody had lost elections but it's difficult to assess the impact of covid mismanagement of the outcome of any election.
collyw 5y ago
Well if you manged to kill 10% of the country then it is completely inaccurate. The maximum CSF I have seen estimated for coronavirus is 3% and I have a feeling that is quite an overestimation.
daeglin 5y ago
[game author here] Worst case scenario in the game is ~1.5% of the population. The estimated fatality rate is 0.5%. This number is increased to 1% if the hospitals are overwhelmed (note that there was a strong consensus in the country that this needs to be avoided). Note that only 1/4 of the infections get detected in the game the game so the ratio deaths/detected infections will be 4% (the deaths/actual infections is 1%) - likely too optimistic in the scenario of overwhelmed testing capacity. If you do nothing in the game, you kill 1% of the population during the first wave and you kill another ~0.5% in winter after the natural immunity of some people expires. Again, the real country was simply not willing to go that far.

dng88 5y ago

Stop the virus from the source. Lab … q wuhan and stop those index case flying out of wuhan … vaccination until 70-80%. For the 10% dead … how about mutation … if they did it is not going to be heed imm. It would be another 10%? It may stabilise or it may not.

notananthem 5y ago

Yeah I killed 111k people immediately and then it flatlined, I was a little surprised. Then again, I killed 111k people.. my second time I did what I thought we (the US) should do with a full lockdown and killed like 50 total.

setr 5y ago
Depends when you do it. Obviously if you go full Madagascar at the first sign of trouble, you’ll crush it, but it’d pretty absurd behavior (every false flag would trigger lockdown). I waited a little by accident and then went full lockdown and got a total of 130k deaths

H8crilA 5y ago

Well, letting the thing burn is actually the fastest way to end the pandemic. The only thing faster than that would be additional intentional spreading (covid parties?) and/or vaccinations going on at the same time. This applies to any pandemic really, as long as the disease leaves some immunity. It's epidemiology 101, for example the SIR model flatlines when the R gets to the herd immunity level. But do you want the other [than pandemic ending] consequences? Like in your game-based example, 10% of the population dead?

epgui 5y ago
Biochemist here. No it is not, and that's not epi-101. By letting it rip you're not just maximizing your fatalities, but you're also maximizing the rate at which the thing mutates, which maximizes the probability that your "recovered" pool becomes vulnerable again.
- carlmr 5y ago
  >but you're also maximizing the rate at which the thing mutates No country is a closed system. We see now that a previous immune response is better than nothing against the Delta variant. I'm wondering what will happen to the island nations that kept the virus at bay while not having a high vaccination rate, won't they have many more deaths now with the more infectious and more deadly version that other countries that "let it rip" like Sweden have at least partial widespread immunity to?
- H8crilA 5y ago
  True. But suppose you had no vaccines, then roughly the same mutations will play out whether the epidemic lasts a week or a year. (Also, what the sibling wrote)
graeme 5y ago
Is it? Places with little forced mitigation like Brazil are still having waves. Some portion of the populace will be cautious and take precautions, and transient herd immunity within networks of people out and about will prevent some less cautious people from getting it during a given wave. To truly burn it out in real world conditions you’d need to actively infect people.
Robotbeat 5y ago
If you have healthy, low-risk people intentionally get the disease (from a single variant which you keep in good stock) and then strictly isolate/quarantine until they get better, that'd be a potential strategy. It's probably the best way to get overall immunity high enough that COVID would burn out... ...of course, this is basically the same as a super crappy vaccine. Vaccination would be way better. But back when people were poo-pooing the possibility of a fast vaccine development, it almost felt tempting to just do this and get it over with. Because the virus wouldn't be spreading beyond the host that got it, the risk of mutation would be small. (IMHO, we should've just massively accelerated vaccine development... even just a couple months would've saved lots of lives. If you're willing to try the strategy in my post, then accelerating vaccine approval would probably be no worse morally and probably a lot better.)

tapland 5y ago

I'm not sure it wouldn't have worked. Sweden had something like 80% support to only have event limits at 500 and no other restrictions, with people arguing in public forums that those dying deserved it and that it was worth it. I had a doctor outright scold me for wearing a mask to the hospital here (checkup for crohns disease which I take immunosupressants for) and didnt see a single other mask in the hospital until December 2020. o.O. Smaller countries with limited access to the wider discussions in English can turn very weird.

gus_massa 5y ago
>> I was told "The people trust the government" with a 70% approval. I mean I killed what 10% of the country, but hey... the people have short memories! > Sweden had something like 80% support to only have event limits at 500 and no other restrictions But even now Sweden has 0.15% of the population killed by covid-19, that is like 100 times smaller than the 10% that the GP got in the simulation.
- henrikschroder 5y ago
  Also note that as of right now, Sweden has half the number of deaths/capita compared to Czechia, and is below the EU average, despite having had the least restrictive policy. This game perpetuates the gigantic fallacy that government intervention is the biggest factor determining spread and outcome, when in reality it's geography, structural differences, and enormous amounts of luck.
  - carlmr 5y ago
    I would also say it's cultural. Swedes keep a distance without you telling them, Spaniards do not.
    - disgruntledphd2 5y ago
      The biggest difference between Sweden an Spain is the presence of multi generational households in the latter.

parksy 5y ago

If the two metrics used are loss of life vs cost of pandemic, the cost of a life needs to be included in the final score I think. In Australia, it appears some early models predicted between 50k to 150k lives lost assuming no response. A statistical life is valued at over $4m, meaning a cost of $200bn to $600bn. Also, with 60% of the population infected, that would mean over 12 million people infected - we still don't have a good idea what the long-term issues will be - but one study in Australia found ~5% of people experiencing "long covid" symptoms, which would mean at least 600,000 people with long-term complications - which in our hypothetical Harkonnen society we'd likely just shove them into a hole somewhere and forget about them, otherwise we'd have to deal with their social welfare (yuck!) and strain on the health system. No doubt the cost, responses, short and long term impacts, etc, will be something economists and sociologists will debate for decades to come. https://www.smh.com.au/politics/federal/thousands-of-predicted-covid-19-deaths-never-eventuated-was-it-poor-modelling-or-our-response-20200527-p54wsn.html https://www.smh.com.au/politics/federal/thousands-of-predict... https://en.wikipedia.org/wiki/Value_of_life#Australia https://en.wikipedia.org/wiki/Value_of_life#Australia https://www.abc.net.au/news/2021-06-24/long-covid-nsw-research-five-per-cent-of-patients-slow-recovery/100241420 https://www.abc.net.au/news/2021-06-24/long-covid-nsw-resear... Edit: On thinking about it, I think the value of life is based on insurance / compensation purposes, perhaps the value of a life in terms of total GDP contribution would be different? Anyway, a subject more for the actuaries and economists I think. Interesting to consider nonetheless, which I think may be the overall point of this game.

logicchains 5y ago
>In Australia, it appears some early models predicted between 50k to 150k lives lost assuming no response. A statistical life is valued at over $4m, meaning a cost of $200bn to $600bn. That is the value of an "average" life. But the average age of death from covid is over 75, so the actual economic cost would be much less (which is accounted for when using https://en.wikipedia.org/wiki/Quality-adjusted_life_year https://en.wikipedia.org/wiki/Quality-adjusted_life_year, the standard way of measuring these things).
- parksy 5y ago

jkey 5y ago

I doubt this - it is impossible to kill 10% of the population in the game. As anyone can see on the final screen, max number of deaths in the game is about 150000, which is 1.5% (Czechia population is approximately 10M)

nradov 5y ago

Even in a worst case scenario it would be impossible to kill 10% of the country. The worldwide infection fatality rate is under 1%. That would rise a little of the healthcare system was overwhelmed but getting to 10% isn't remotely plausible.

TylerE 5y ago
It would rise a LOT if health care gets overwhelmed, as we saw in Italy. And it’s not just COVID… if the hospitals are overrun many other things will have much higher mortality, like trauma cases.
- deleted 5y ago
  [deleted]
- nradov 5y ago
  None of that gets you even close to 10% mortality. In any given year only a tiny fraction of the population needs advanced hospital care to survive trauma or other diseases.
  - zibzab 5y ago
    IIRC Lombardy death rate reached 17% once hospitals were overwhelmed. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30099-2/fulltext https://www.thelancet.com/journals/lanpub/article/PIIS2468-2...
    - nradov 5y ago
      You do not recall correctly. You have confused case fatality rate with infection fatality rate. There are a large number of infections which are never officially counted as cases due to limited testing and minimal symptoms.
      - zibzab 5y ago
        Well, with that line of reasoning we cannot trust any corona statistics, can we? Anyway, the effect of failing to "fallten the curve" in Lombardy are well documented. And this happened in December 2019 before we had a global pandemic.

pmontra 5y ago

I played the game by restricting everything except a full lockdown and by doing nothing. The first time I had less than 200 deaths, the second time almost 150 k. The government survived in both cases, actually a little better in the latter. I'm not surprised because I don't remember a single government having to resign because of covid, even where the pandemic hit hard. Somebody had lost elections but it's difficult to assess the impact of covid mismanagement of the outcome of any election.

collyw 5y ago

Well if you manged to kill 10% of the country then it is completely inaccurate. The maximum CSF I have seen estimated for coronavirus is 3% and I have a feeling that is quite an overestimation.

daeglin 5y ago

[game author here] Worst case scenario in the game is ~1.5% of the population. The estimated fatality rate is 0.5%. This number is increased to 1% if the hospitals are overwhelmed (note that there was a strong consensus in the country that this needs to be avoided). Note that only 1/4 of the infections get detected in the game the game so the ratio deaths/detected infections will be 4% (the deaths/actual infections is 1%) - likely too optimistic in the scenario of overwhelmed testing capacity. If you do nothing in the game, you kill 1% of the population during the first wave and you kill another ~0.5% in winter after the natural immunity of some people expires. Again, the real country was simply not willing to go that far.