COVID19 Factors We Should Consider/Current Events

[Mark Rippetoe]

We go back to "normal", and achieve rapid herd immunity. Assuming an infection CFR of 0.5 percent, this will mean about 35 million deaths worldwide, and about 1.5 million deaths in the United States.

This would be catastrophic, to be sure, and may damage our society in ways more horrific than we can imagine.

Who is still talking about 1.5 million deaths in the US?

If true.. super frustrating.

Gov. Andrew Cuomo Has Not Yet Accepted Remington's Offer to Help With PPE, Ventilators

Of course he can't. It would taint his Democrat presidential candidacy.

[spacediver]

Who is still talking about 1.5 million deaths in the US?

The data coming out of Germany indicate an infection CFR of about half a percent. If strategy B is employed, how many deaths in the U.S., if not tens of millions, would you predict?

Keep in mind that strategy B is business as usual. Selective sheltering in place (i.e. for elderly/vulnerable) would imply a different strategy (e.g. it may fall under strategy D).

[Mark Rippetoe]

What is the IFR? You have that data? Haven't we already discussed this? What leads you to believe that this shit is 25 times worse than the worst flu season in the past 100 years?

[RKC]

Of course he can't. It would taint his Democrat presidential candidacy.

Yeah, of course he can’t. Because it’s not about the sick and dying... it’s about the political agenda. (Regardless of what the truth is about the virus)

[spacediver]

What is the IFR? You have that data? Haven't we already discussed this? What leads you to believe that this shit is 25 times worse than the worst flu season in the past 100 years?

There's a municipality in Germany where 80% of the population had an antibody test. Based on that data, which if I'm not mistaken is some of the highest quality data we have about this virus's lethality, an IFR of 0.4% was estimated.

That's about 4 times as lethal as the flu in terms of IFR.

But that doesn't mean 4 times as many deaths as the flu (one of the reasons for this is that herd immunity slows flu transmission down).

SARS CoV 2 is a novel pathogen, and has a very different playing field than that of seasonal influenza.

[franklie]

Regarding our current situation, here are the options I can make out.

A

We heavily prioritize minimization of total deaths. This involves keeping transmission at essentially a screeching halt until anti-virals and/or vaccine are ready.

This is likely to be at least a year, and quite possibly years (I may update my thinking on this once I learn more about vaccines).

Our society will be damaged beyond belief if this strategy is taken, and it will only be effective if everyone plays the same game.


B

We go back to "normal", and achieve rapid herd immunity. Assuming an infection CFR of 0.5 percent, this will mean about 35 million deaths worldwide, and about 1.5 million deaths in the United States.

This would be catastrophic, to be sure, and may damage our society in ways more horrific than we can imagine.


C

We contract and expand periodically, essentially allowing for periodic "blood letting". We eventually reach herd immunity. Even if anti-virals and vaccines aren't developed, less people die in total compared to B, because herd immunity protects those who haven't achieved immunity. I think you need ~70 percent of population to be immune for herd immunity, but I haven't yet gone down that rabbit hole. And the slower timescale of this strategy compared to B allows for more time for antivirals/vaccine development.


D

We find a stable middle ground where transmission is allowed, but at a smaller rate. This means that peak demand on healthcare system is not "overwhelming", but deaths will still occur, both in the obviously vulnerable, and in the smaller cohort of young healthy adults that this virus seems to capriciously target. As in C, herd immunity is eventually achieved, and more time is granted for antivirals/vaccine development.


The best strategy may differ from community to community, and here's the bitter twist:

The more information we have (about the virus, or about how many people are currently infected/already recovered), the more optimal our decision making will be. But we need time for more information, which increases the damage of what we are currently doing.

This is an optimization problem, to be sure, and it may not be an easy one.

Are there any options I've missed? Does anyone disagree with any of the premises?

E those who get sick get treated with malaria medicine and antibiotics (azithrimicin) for a reduction in sick time and a chance for their own bodies to build up the antibodies and everyone goes back to work.

[Luke Cook]

I'm going to piggy back your and Jovan's line of dialogue and put a plug in for thelasypsychiatrist.com. He hasn't updated his blog in years, but if you read through some of his later posts (e.g. Hipsters on Foodstamps) he's got some very interesting analyses of how modern society operates.

The Last Psychiatrist

Just read “The Maintenance Of Certification Exam As Fetish”.

This blog is gold. I now have my Easter Monday reading sorted. Thank you!

[Johnsonville]

E those who get sick get treated with malaria medicine and antibiotics (azithrimicin) for a reduction in sick time and a chance for their own bodies to build up the antibodies and everyone goes back to work.

I am genuinely baffled at the reluctance some people have towards this treatment, and also the seemingly conflicting reports towards it. I understand the media going against it because Trump, but why isn’t every doctor giving this to patients who are dying? Is there truly that much of a potential shortage and if so, why aren’t they calling for companies to manufacture this instead of ventilators?

[Mark Rippetoe]

There's a municipality in Germany where 80% of the population had an antibody test. Based on that data, which if I'm not mistaken is some of the highest quality data we have about this virus's lethality, an IFR of 0.4% was estimated.

That's about 4 times as lethal as the flu in terms of IFR.

But that doesn't mean 4 times as many deaths as the flu (one of the reasons for this is that herd immunity slows flu transmission down).

SARS CoV 2 is a novel pathogen, and has a very different playing field than that of seasonal influenza.

Yes, it does. It's playing field has been expanded to all the governments -- local, state, federal -- of the entire world, in terms of totalitarian policies and economic interventions, the extent of which have never been experienced before. For 4 times as many deaths as the flu, is this a reasonable response? Adult question, once again.

I am genuinely baffled at the reluctance some people have towards this treatment, and also the seemingly conflicting reports towards it. I understand the media going against it because Trump, but why isn’t every doctor giving this to patients who are dying? Is there truly that much of a potential shortage and if so, why aren’t they calling for companies to manufacture this instead of ventilators?

"Doctor, I want the treatment President Trump talked about, hydroxychloroquin and azithromycin."

"I can't prescribe it. It hasn't been approved by the FDA for COVID-19. It might not work. And there's no evidence that it's safe."

"Might not work?? Safe??? I'm dying, you fucking imbecile! I'm not very safe right now anyway!"

"There, there, sweetie. You just rest easy. Nurse, more Haldol, stat."

[Jovan Dragisic]

Go East young man.

North. Those motherfuckers got the best weather.