COVID19 Factors We Should Consider/Current Events

[Mark Rippetoe]

For what it’s worth, I practice intensive care medicine in an epicenter. It is a very scary disease in that it can kill people very quickly and there is relatively little that can be done to stop the severe cases. I have seen it first hand and it is by far the scariest shit I have ever seen, and I have seen bad stuff. That said, my current feeling is that if you have it bad you die with a very high likelihood. And if there is a ventilator, you just die with a ventilator. I am not sure torching our economy was worth it. And we will be in a depression regardless.

Here's an adult question, Bbinck: If 2 million people actually die of a disease, but in an attempt to reduce that number to 1 million we destroy the ability of all the other people who are not paid with government printed money to eat, pay their rent, electric bills, hospital bills, be diagnosed with melanoma, not commit suicide, etc., is it worth it? Adult question, and our version isn't that stark.

I talked to a guy today who told me that his banker was projecting a 50% default rate in the bank's portfolio.

[lazygun37]

We're having a different conversation now. If you'd like to participate, go ahead.

So the conversation is about things like mortality statistics, until somebody shows that they're pretty bad. At which point, it's all about the economy....

And then the conversation is about the economy, until somebody asks how you propose to avoid a crash in the midst of a really bad epidemic. At which point, it's all about the mortality statistics...

All points of view. This is why Bruno "Hippocrates" Lawrence gets to post here.

This is your response? You post a link to something that's just demonstrably false, and when it's shown to be false you say, whatever, it's just a "point of view"?

It's one thing to have different opinions/interpretations, but it's quite another to pretend facts don't exist.

All sarcasm aside: can we at least agree to acknowledge when we clearly fuck something up? Everybody fucks up -- I do it all the time. But if partisanship is at the point where we'd rather defend obvious untruths than concede a point -- no matter how small -- then what the hell are we all doing?

[wiigelec]

I said no such thing. Clearly the virus was spreading for some time before lockdowns. Reducing contacts with those infected reduces spread of the virus before and after lockdowns. And reducing contacts with the infected limits viral spread and therefore will affect graphs of those affected and death rates.

Yes my apologies I misread your post.

The point I'm getting at is that the egregiously large numbers were based on the assumption that fewer people had been exposed undetected. We are learning more and more each day that this is likely not true, that the virus has likely been spreading undetected for a length of time significantly longer than assumed in the initial models which is in my opinion why the projections are dropping quickly, because herd immunity is already in play. Your contention is that the lock downs and associated limitations of the spread are the reason the numbers are dropping. Assuming a decent antibody testing protocol is initiated and followed through we should have more data to indicate which of the two may be the more likely reason for the lower than initially modeled absolute mortality...

[Mark Rippetoe]

So the conversation is about things like mortality statistics, until somebody shows that they're pretty bad. At which point, it's all about the economy....

And then the conversation is about the economy, until somebody asks how you propose to avoid a crash in the midst of a really bad epidemic. At which point, it's all about the mortality statistics...

Here are some statistics that you have not addressed: COVID19 Factors We Should Consider

This is going to be a blow, so get ready: Not everybody lives in NYC, and not everybody cares about NYC they way they care about where they live -- that seems wrong to you, doesn't it? And since you've been gone, we've been dealing with the inadequacies in the data over several pages, and yet I have to read about how I evade the issue of the piled-up bodies in New York City.

And still you're not being deleted, even though I thirst for your blood.

[lazygun37]

Here's an adult question, Bbinck: If 2 million people actually die of a disease, but in an attempt to reduce that number to 1 million we destroy the ability of all the other people who are not paid with government printed money to eat, pay their rent, electric bills, hospital bills, be diagnosed with melanoma, not commit suicide, etc., is it worth it? Adult question, and our version isn't that stark.

Since people here seem to assume that I value the life of every 105-year-old at approximately 6 trillion dollars, let me give you my answer to this:

If we knew that, without the attempt to reduce the number of deaths, the economy would not crash, and if we had good enough data on the mortality stats, there is, in principle, a perfectly rational way to optimize our response. After all, health care is *always* rationed, in every country. Every health care system assigns a dollar value to what's usually called a QUALY -- a quality-adjusted life year. So if I knew how many *net* life-years I could save with a given intervention (i.e. discounting excess suicides etc), and if I also knew how much tanking the economy would cost, I could try to design an optimal response strategy. In practice, mortality data during a new epidemic is always going to be tricky, but the basic principle holds even then. (For epidemics that have a non-negligible chance of being truly disastrous, the precautionary principle needs to be considered as well, obviously.)

But this is all based on the assumption that, without the attempt to reduce the number of deaths, the economy would not crash. What I want to know -- and have asked you several times now: do you honestly think that in the midst of this sort of epidemic, the economy will not crash entirely on its own? By your own assumption, you are talking about an epidemic that will kill 2 million people and therefore hospitalize several times more than that (i.e. a significant fraction of the population), all in the space of a few months. Let's not even worry about overload on hospitals and how that will cause higher mortality rates. Just based on those numbers alone, you think people will just go on with their lives, i.e. go to work, eat in restaurants, go to the gym?

[MatthewG]

Disturbing news report about a UK residential care home...


Care home asked to take COVID-19 NHS patient despite govt advice
YouTube

On a darker note, I believe isolation + lockdown + financial hardship + state pensions / life insurances + "suspected" or actual COVID19 is a recipe for the predatory approach of some individuals / organizations to commit foul play. Hopefully doctors and detectives don't feel pressurized to buying into the hysteria like the majority of the public.

[Bbinck1]

Here's an adult question, Bbinck: If 2 million people actually die of a disease, but in an attempt to reduce that number to 1 million we destroy the ability of all the other people who are not paid with government printed money to eat, pay their rent, electric bills, hospital bills, be diagnosed with melanoma, not commit suicide, etc., is it worth it? Adult question, and our version isn't that stark.

I talked to a guy today who told me that his banker was projecting a 50% default rate in the bank's portfolio.

Exactly the question. Look. I am literally waiting to see if I get sick because a person was not diagnosed correctly 5 days ago. I am careful but no one is 100% sure what is “good enough” not to get infected. So I am not a pussy that has no skin in the game. But the hard cold fact is 90% survive and are you willing to destroy the economy so that 10% get the chance at 25% survival. Meaning 2.5 % that would have died maybe survive. While I watch all my neighbors that own restaurants and small businesses etc go bankrupt. I am not sure it is worth that. And there are countless health care providers getting infected to save that 2.5%. We do that because it’s our job, but it is a high price to pay. Devastated economy and ruined health care system. That is the price. Make no mistake about it. It is real.

[Shiva Kaul]

And just because the CDC has a document, that doesn't mean that people are following the guidelines.

I linked to the official ICD-10-CM guidelines, which are mandated by law under HIPAA.

[chrisza]

Reports are now coming out implying California may have been hit first and has experienced " herd immunity " just as professor Wittowski explained. Stanford Medicine California Herd Immunity Coronavirus | THE NEW ALT 105.3

[Mark Rippetoe]

But this is all based on the assumption that, without the attempt to reduce the number of deaths, the economy would not crash. What I want to know -- and have asked you several times now: do you honestly think that in the midst of this sort of epidemic, the economy will not crash entirely on its own? By your own assumption, you are talking about an epidemic that will kill 2 million people and therefore hospitalize several times more than that (i.e. a significant fraction of the population), all in the space of a few months. Let's not even worry about overload on hospitals and how that will cause higher mortality rates. Just based on those numbers alone, you think people will just go on with their lives, i.e. go to work, eat in restaurants, go to the gym?

The economy will not crash entirely on its own. No. And you know this because it did not crash in 2009, when this occurred:

CDC illness and death estimates from April 2009 to April 2010, in the US are as follows:

between 43 million and 89 million cases of 2009 H1N1 occurred between April 2009 and 10 April 2010. The mid-level in this range is about 61 million people infected with 2009 H1N1.
between about 195,000 and 403,000 H1N1-related hospitalizations occurred between April 2009 and 10 April 2010. The mid-level in this range is about 274,000 2009 H1N1-related hospitalizations.
between about 8,870 and 18,300 2009 H1N1-related deaths occurred between April 2009 and 10 April 2010. The mid-level in this range is about 12,470 2009 H1N1-related deaths.[192][193][194]

and we didn't close the "non-essential" businesses, lock everybody inside, and use the media to make everybody afraid to talk to each other. And now it's crashed because we did. Current US deaths are 14668. The IMHE model gets revised down every day, and the 2 million number I cited was a rhetorical device, as you surely know. I've posted all the links, and you either haven't read them or you don't care to do so.

This week is supposed to be a "rough week" with the death count "soaring" and the hospitals finally overwhelmed. Let's say the death count is 60,000 in two weeks: was the destruction of the economy worth it? People will do what they want to do if you let them. If they want to stay at home because they're afraid, they will. But your petty local tyrants have decreed that we Shall Not Pass, and things will not look the same on the other side of this particular disease.

And what happens next time we have a new bug? You haven't answered that question, although I remember asking it. If this response is the new normal protocol, what does the next 20 years look like?

I linked to the official ICD-10-CM guidelines, which are mandated by law under HIPAA.

Right. It's the law. Remember back when there were illegal drugs and murders, and then we passed laws, and they all went away?