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Is the goal FLATTEN THE CURVE or ELIMINATE COVID?


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1 hour ago, Mom2mthj said:

The “credible medical experts” were scaring us with predictions of 2.2 million deaths to get us to comply with stay at home orders until oops, sorry our model was wrong.

No one was lying, it wasn't a "scare tactic," it was an estimate based on the best data we had at the time. 

At the beginning of the pandemic, the numbers we were getting from countries that were hit first suggested a fatality rate of around 3.4%. If just 20% of the US population contracted the virus, and 3.4% of that 20% died, that's 2.2 million deaths. Now that we understand how many asymptomatic carriers there are, AND we have mitigation measures in place, the fatality rate appears to be closer to 1%.

However, even at 1%, if this virus was allowed to run through the population and 70% got it this year (i.e. developed herd immunity), 1% of that 70% still equals around 2.2 million deaths. And there is no doubt that the % would be higher without mitigation measures, because there would be hospital overwhelm in so many places. So it's not as if the early predictions caused more extreme mitigation measures than were necessary. The mitigation measures are part of what actually brought the fatality rate down.

 

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22 minutes ago, Corraleno said:

No one was lying, it wasn't a "scare tactic," it was an estimate based on the best data we had at the time. 

At the beginning of the pandemic, the numbers we were getting from countries that were hit first suggested a fatality rate of around 3.4%. If just 20% of the US population contracted the virus, and 3.4% of that 20% died, that's 2.2 million deaths. Now that we understand how many asymptomatic carriers there are, AND we have mitigation measures in place, the fatality rate appears to be closer to 1%.

However, even at 1%, if this virus was allowed to run through the population and 70% got it this year (i.e. developed herd immunity), 1% of that 70% still equals around 2.2 million deaths. And there is no doubt that the % would be higher without mitigation measures, because there would be hospital overwhelm in so many places. So it's not as if the early predictions caused more extreme mitigation measures than were necessary. The mitigation measures are part of what actually brought the fatality rate down.

 

Yup. Because things are working doesn't mean they were not a good idea. 

And expecting people to get things right all the time with nearly no information is crazy. Would people rather they err in the other direction, underplay it, and then if it was way worse those people wouldn't be pointing fingers about how they were not warned? Unlikely. 

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18 minutes ago, Corraleno said:

No one was lying, it wasn't a "scare tactic," it was an estimate based on the best data we had at the time. 

At the beginning of the pandemic, the numbers we were getting from countries that were hit first suggested a fatality rate of around 3.4%. If just 20% of the US population contracted the virus, and 3.4% of that 20% died, that's 2.2 million deaths. Now that we understand how many asymptomatic carriers there are, AND we have mitigation measures in place, the fatality rate appears to be closer to 1%.

However, even at 1%, if this virus was allowed to run through the population and 70% got it this year (i.e. developed herd immunity), 1% of that 70% still equals around 2.2 million deaths. And there is no doubt that the % would be higher without mitigation measures, because there would be hospital overwhelm in so many places. So it's not as if the early predictions caused more extreme mitigation measures than were necessary. The mitigation measures are part of what actually brought the fatality rate down.

 

The models also didn't take into account human behavior without mitigation. I know the focus has been on people who don't social distance voluntarily and parks being crowded, but a lot of people also went the other way and voluntarily removed themselves from crowds and close contact before the government ordered SIP. It's very, very difficult for models to predict that sort of thing.

Even if it wasn't a scare tactic, it does not help for future crises to publish stuff like that and then have to revise downward by such a huge factor without HUGE caveats. "The best data we had at the time" is a huge caveat in situations like this because most data we had was based on China, who was lying outright and very, very incomplete. In any case, it makes people less likely to take things seriously in the future. Most people, myself included, do not understand modeling or its limitations, especially for an emerging crisis.

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2 minutes ago, Ktgrok said:

Yup. Because things are working doesn't mean they were not a good idea. 

And expecting people to get things right all the time with nearly no information is crazy. Would people rather they err in the other direction, underplay it, and then if it was way worse those people wouldn't be pointing fingers about how they were not warned? Unlikely. 

No one should be trying to make far sweeping predictions based on nearly no information and putting that out to the general public without that caveat. No one who was putting those models on the news was telling people it was based on nearly no information. It the same as all these pre-print studies getting put out without peer review. A vast majority of them will likely turn out to be crap.

There are consequences to doing this. You see the same thing with hurricane prediction. Every hurricane is so hyped that people start rolling their eyes and not taking things seriously when they actually need to because they've heard worst case scenarios that never came to fruition so many times. It's human nature to become desensitized to threats, especially if they never turn out to be actually what they were made out to be. And to make it worse, the dude sitting at home watching TV who is listening to a prediction of 2 million deaths and says, "They are just trying to scare me!" gets to feel he was smugly correct, and he was, but maybe not for the right reasons, but he feels he can then ignore the next warning.

And, we don't even know if things are "working"! We don't even have the data to see that yet, if we ever will. We can't know what would have happened under any other measures, tighter or looser, because we can't see what never happened. Our models are crap for predicting how individuals will behave in any given circumstance.

In any case, no, it is not better for society to err on the side of crazy scary high numbers without the data being fully formed. There is a negative to doing that.

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2 hours ago, Mom2mthj said:

The “credible medical experts” were scaring us with predictions of 2.2 million deaths to get us to comply with stay at home orders until oops, sorry our model was wrong.

i agree that antibiotics have helped, but while a vaccine slowed measles spread, mortality from measles was declining before a vaccine.

A pretty good example of everything that is wrong today. You repeat propaganda that is intended to mislead people. The true measure of the benefits of the measles vaccine (or any vaccine) is the impact on the incidence rate not mortality rate. Modern medical interventions helped to reduce mortality rates. The incidence rate did not decline until the measles vaccine was widely available. 

And do you really believe that these medical experts showed the models to get people to comply with stay at home orders? Really? More propaganda. 

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16 minutes ago, EmseB said:


In any case, no, it is not better for society to err on the side of crazy scary high numbers without the data being fully formed. There is a negative to doing that.

But they weren't "crazy high scary numbers" — they were actually quite conservative based on a 3.4% fatality rate, assuming only 20% of the population catching it. Even with a 1% fatality rate, if we allowed it to run through the population until herd immunity was acquired — which many people are in fact advocating — 1% dead of 70% of the population is still 2.2 million people. 

What's really scary is that Trump seems to continue to rely on the extremely low IHME estimates, which are garbage because (1) they are based primarily on Chinese data, and (2) they assume a symmetrical curve and estimate a steep drop in deaths, with single digits in June and ZERO deaths after July 1st. That is not remotely realistic, yet that is what the administration is pushing — that CV19 will be gone this summer and won't be back. When the CDC Director was quoted in The Washington Post saying that things could be even worse in the fall, Trump insisted that Redfield had been misquoted and made him appear at the news briefing to walk it back. But when questioned by reporters, he admitted that he had been quoted accurately. After Redfield didn't back him up on that, he asked Birx "Don't you think it's likely that it's not coming back?" and she said "We just don't know." He said there might be "embers" in the fall but we can put them out quickly. He is convinced that this is almost over and CV19 will be gone by the end of the summer. THAT is scary, and it's a perfect illustration of why an unrealistically low estimate is far more dangerous than a plausible estimate that turns out to be too high.

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51 minutes ago, EmseB said:

No one should be trying to make far sweeping predictions based on nearly no information and putting that out to the general public without that caveat. No one who was putting those models on the news was telling people it was based on nearly no information. It the same as all these pre-print studies getting put out without peer review. A vast majority of them will likely turn out to be crap.

There are consequences to doing this. You see the same thing with hurricane prediction. Every hurricane is so hyped that people start rolling their eyes and not taking things seriously when they actually need to because they've heard worst case scenarios that never came to fruition so many times. It's human nature to become desensitized to threats, especially if they never turn out to be actually what they were made out to be. And to make it worse, the dude sitting at home watching TV who is listening to a prediction of 2 million deaths and says, "They are just trying to scare me!" gets to feel he was smugly correct, and he was, but maybe not for the right reasons, but he feels he can then ignore the next warning.

And, we don't even know if things are "working"! We don't even have the data to see that yet, if we ever will. We can't know what would have happened under any other measures, tighter or looser, because we can't see what never happened. Our models are crap for predicting how individuals will behave in any given circumstance.

In any case, no, it is not better for society to err on the side of crazy scary high numbers without the data being fully formed. There is a negative to doing that.

That might be human nature, but you know what, you can't fix dumb. 

I live in Florida, always have, for over 40 years. I've been though many hurricanes. I've had a relative's house demolished, with a tree crushing it only feet from where they were hiding. I've watched my unemotional, nothing upsets him Dad totally shell shocked after seeing what his home town looked like - he said that had he not lived their for 20 years he never would have even found the house. (my uncles were living in their childhood home). And if the media stopped giving us the scary info, and downplayed the risk of the next storm, and people died because of it, THAT would be a tragedy. 

Yes, sure, you can overhype things. But you give people the worst case scenario because if you don't, and it happens, that's on you. That people don't listen, and don't get that just because they said there was a 50% chance of a direct hit, and you didn't get it, it doesn't mean they were wrong, or that next time you shouldn't listen...I can't fix that. And it doesn't mean that the meteorologists shouldn't warn us again the next time. They do their best, they say the storm could go anywhere in the "cone", but people don't listen, don't believe them, don't get it. I can't fix that. Stupid people are going to be stupid I guess. But I certainly want that warning, and that cone, so that I can prepare. And if it doesn't hit me I'll have the sense to be grateful I was spared, not angry I "wasted" time preparing. 

The media said all along that there COULD be that many deaths, not that there WOULD be that many deaths. And there could have been. Still could be. 

what were they supposed to do? Just shrug and say, "meh, maybe it will be fine, who the hell knows. Everyone figure it out yourself?" And then sit and watch as people die?

Edited by Ktgrok
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29 minutes ago, Corraleno said:

But they weren't "crazy high scary numbers" — they were actually quite conservative based on a 3.4% fatality rate, assuming only 20% of the population catching it. Even with a 1% fatality rate, if we allowed it to run through the population until herd immunity was acquired — which many people are in fact advocating — 1% dead of 70% of the population is still 2.2 million people. 

What's really scary is that Trump seems to continue to rely on the extremely low IHME estimates, which are garbage because (1) they are based primarily on Chinese data, and (2) they assume a symmetrical curve and estimate a steep drop in deaths, with single digits in June and ZERO deaths after July 1st. That is not remotely realistic, yet that is what the administration is pushing — that CV19 will be gone this summer and won't be back. When the CDC Director was quoted in The Washington Post saying that things could be even worse in the fall, Trump insisted that Redfield had been misquoted and made him appear at the news briefing to walk it back. But when questioned by reporters, he admitted that he had been quoted accurately. After Redfield didn't back him up on that, he asked Birx "Don't you think it's likely that it's not coming back?" and she said "We just don't know." He said there might be "embers" in the fall but we can put them out quickly. He is convinced that this is almost over and CV19 will be gone by the end of the summer. THAT is scary, and it's a perfect illustration of why an unrealistically low estimate is far more dangerous than a plausible estimate that turns out to be too high.

I don't think either one is good, regardless of which politician is in office. I think being honest with people, telling them that this is bad, we don't know exactly how bad...is far better than predicting a worst case scenario that promotes future complacency because, "It wasn't that bad. They were just trying to scare me to get me to do what they say."

We shouldn't be giving numbers of any kind based off of crap. Rightly or wrongly, the people you're trying to persuade feel duped and less likely to listen in the future. 

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2 minutes ago, EmseB said:

I don't think either one is good, regardless of which politician is in office. I think being honest with people, telling them that this is bad, we don't know exactly how bad...is far better than predicting a worst case scenario that promotes future complacency because, "It wasn't that bad. They were just trying to scare me to get me to do what they say."

We shouldn't be giving numbers of any kind based off of crap. Rightly or wrongly, the people you're trying to persuade feel duped and less likely to listen in the future. 

No numbers, no range, nothing? Just "this could be bad" and let people think what they will?

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19 minutes ago, Ktgrok said:

 

what were they supposed to do? Just shrug and say, "meh, maybe it will be fine, who the hell knows. Everyone figure it out yourself?" And then sit and watch as people die?

Oh my goodness. This forum is so frustrating. It doesn't have to be either extreme. No, you don't have to breathlessly report worst case scenarios if you know your models are based on incomplete and false Chinese data. You also don't have to "sit and watch people die." Good grief.

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14 minutes ago, EmseB said:

Oh my goodness. This forum is so frustrating. It doesn't have to be either extreme. No, you don't have to breathlessly report worst case scenarios if you know your models are based on incomplete and false Chinese data. You also don't have to "sit and watch people die." Good grief.

You specifically said, "no numbers of any kind" which is what I was responding to. 

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7 minutes ago, Ktgrok said:

No numbers, no range, nothing? Just "this could be bad" and let people think what they will?

Report the numbers we have. Report the data we have. If you know your model is based on incomplete data or as @Corraleno put it "with nearly no information", tell people that's what you have. Tell them we don't know what to expect because China is lying and our population and healthcare system is different than Europe.. Everyone on this forum acknowledges the garbage in, garbage out reality of all of these models.

Your comment in a pp wrt people not taking officials seriously the next time (or even going forward right now!) as a simple "you can't fix dumb", along with being just plain arrogant, is really shortsighted, especially when it comes to public health. In general, people may not be as smart as you are. They may not be as well read on the topic or as scientifically literate as you are, or understand modeling as well as you do, but if you tell them they have to give up their livelihoods to save millions or thousands of lives, they will do it. If you act like they are stupid rubes because your worst case didn't come to pass and they are skeptical going forward, I guarantee compliance such as it is will be harder to come by in the future. At least have a little sympathy instead of just writing them off as dumb.

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12 minutes ago, EmseB said:

Report the numbers we have. Report the data we have. If you know your model is based on incomplete data or as @Corraleno put it "with nearly no information", tell people that's what you have. Tell them we don't know what to expect because China is lying and our population and healthcare system is different than Europe.. Everyone on this forum acknowledges the garbage in, garbage out reality of all of these models.

Your comment in a pp wrt people not taking officials seriously the next time (or even going forward right now!) as a simple "you can't fix dumb", along with being just plain arrogant, is really shortsighted, especially when it comes to public health. In general, people may not be as smart as you are. They may not be as well read on the topic or as scientifically literate as you are, or understand modeling as well as you do, but if you tell them they have to give up their livelihoods to save millions or thousands of lives, they will do it. If you act like they are stupid rubes because your worst case didn't come to pass and they are skeptical going forward, I guarantee compliance such as it is will be harder to come by in the future. At least have a little sympathy instead of just writing them off as dumb.

No. I am just not having sympathy for people who for whatever reason, refuse to even listen. With hurricanes, they say EVERY forecast that they can't predict with certainty. that the storm could go anywhere in the cone. They say it over and over and over again .And it is printed on every forecast image. And yet, people REFUSE to believe that, and focus on the center of the cone, and then when it hits somewhere else say the predictions were wrong, when the storm DID hit within the cone. Just not in the center. So when they then refuse to prepare next time, that's not because they were misled, or whatever. It is because they don't care what anyone says, or the experts say, they are going to believe what they want to believe. I can't fix that. 

Same here. We had to share that our best predictions were there COULD be UP TO that many deaths. Not that there WOULD be. If people refuse to listen to the "could be" part, and then say they were lied to when we don't (yet) hit the very worst case,  how do you fix that? We made the best estimates we could based on the numbers we had, and it would have been irresponsible NOT to share that information, along with the caveat that this was a possibility, not written in stone. 

You think I'm arrogant and writing people off, but do you really think people are not intelligent enough to understand "possible worst case scenario" doesn't mean "this absolutely will happen"? Or are they just looking for something to be mad about?

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1 minute ago, Ktgrok said:

 

You specifically said, "no numbers of any kind" which is what I was responding to. 

finish the sentence you quoted: no numbers of any kind based off of crap. Which we know and knew the Chinese data was. We also knew our population is vastly different than what we were seeing out of Italy so much so we could not model based of of their data either. We also knew testing everywhere was severely limited. It's not as if the IC didn't know all these things when writing that first paper. Anyway, this seems to be rather fruitless because once again there is no middle ground.

My only point is that from a public health measures compliance perspective, which you really want from the general public (dumb though you may find them to be), there absolutely is a downside to playing up worst case scenarios that are not able to be accurately modeled. But we can actually view this happening in real time. A lot of people didn't and don't take this seriously precisely because of previous hype surrounding H1N1, ebola, sars, etc., which were plenty bad on their own. A lot of people were inoculated against taking this thing seriously because they thought they had seen this before and it didn't turn out as bad as initially predicted. 

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1 minute ago, EmseB said:

finish the sentence you quoted: no numbers of any kind based off of crap. Which we know and knew the Chinese data was. We also knew our population is vastly different than what we were seeing out of Italy so much so we could not model based of of their data either. We also knew testing everywhere was severely limited. It's not as if the IC didn't know all these things when writing that first paper. Anyway, this seems to be rather fruitless because once again there is no middle ground.

My only point is that from a public health measures compliance perspective, which you really want from the general public (dumb though you may find them to be), there absolutely is a downside to playing up worst case scenarios that are not able to be accurately modeled. But we can actually view this happening in real time. A lot of people didn't and don't take this seriously precisely because of previous hype surrounding H1N1, ebola, sars, etc., which were plenty bad on their own. A lot of people were inoculated against taking this thing seriously because they thought they had seen this before and it didn't turn out as bad as initially predicted. 

So what numbers do you share? How would you have preferred they warn the public?

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35 minutes ago, EmseB said:

Oh my goodness. This forum is so frustrating. It doesn't have to be either extreme. 

That is what I was hoping with starting this thread....that we could talk about a sensible, reasonable middle ground.  Just because I do feel that some more workers can cautiously go back to work does NOT mean that I don't care or am ignorant, etc.   I just know that there are long term repercussions of staying closed long term.....AND there are long term repercussions of opening up too much too soon. 

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5 minutes ago, Ktgrok said:

No. I am just not having sympathy for people who for whatever reason, refuse to even listen. With hurricanes, they say EVERY forecast that they can't predict with certainty. that the storm could go anywhere in the cone. They say it over and over and over again .And it is printed on every forecast image. And yet, people REFUSE to believe that, and focus on the center of the cone, and then when it hits somewhere else say the predictions were wrong, when the storm DID hit within the cone. Just not in the center. So when they then refuse to prepare next time, that's not because they were misled, or whatever. It is because they don't care what anyone says, or the experts say, they are going to believe what they want to believe. I can't fix that. 

Same here. We had to share that our best predictions were there COULD be UP TO that many deaths. Not that there WOULD be. If people refuse to listen to the "could be" part, and then say they were lied to when we don't (yet) hit the very worst case,  how do you fix that? We made the best estimates we could based on the numbers we had, and it would have been irresponsible NOT to share that information, along with the caveat that this was a possibility, not written in stone. 

You think I'm arrogant and writing people off, but do you really think people are not intelligent enough to understand "possible worst case scenario" doesn't mean "this absolutely will happen"? Or are they just looking for something to be mad about?

I think if we want people to listen to experts, experts have to be more measured and acknowledging of their own limitations.

 

Or people who disagree with you are probably just looking for something to be mad about. Can't fix dumb, right?

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23 hours ago, Lady Florida. said:

As a new teacher I was taught, all new teachers were taught, that it's easier to start out with strict classroom policies and loosen them up later. If you don't have a good handle on the behavior of your students from the start it will be hard to ever get it. I hate to say it but many governors acted like new teachers who didn't heed that lesson and many people are acting like their students, i.e. children.

The problem is that citizens of a republic are not children in a classroom. This is just really frightening. And explains so much, actually. If this is your (general) view of the government's relationship to it's citizens I feel like basic American civics is out the window. Pandemic or no...governors are not enforcing some kind of detention of children.

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I think there are a few things going on with this.

I'm in Canada, and I have a few family members in health care who are part of the management for covid in our province, so I have some pretty clear sense of what the medical people are thinking. It is to flatten the curve and keep it at a sustainable level until there is herd immunity.  They aren't sure that there is immunity, but they have some reason to think there is.  The idea of preventing spread totally is not part of their thinking, and they aren't counting on a vaccine ever becoming available either. Their assumption is up to 90% of the poulation will get it eventually. They are also concerned to reach that point as quickly as possible without overwhelming resources.

 

However - many many people are not understanding that and believe that they will be able to avoid getting it if they follow the restrictions.  I think there are a few things behind this - fear mainly, not understanding the science, and a lot is down to the messaging from the government. I am convinced that the premier and medical officer who do a press conference every day have little or no idea how people are taking the things they say. Some confusions also seems to come from people hearing about places like New Zealand, or where reported deaths seem low, and not understanding that their situation has substantial differences, or that we actually don't know that their strategy is successful because it is too soon.

 

I've become fairly concerned about people's well being. Not so much the economy as such though production of essential items is a concern. But people are becoming very judgemental about things that are not risky. Parks etc have been closed although there is little risk from them and our local government doesn't seem to have much intent to open them up. People and kids are struggling. Domestic abuse it up including two deaths, plus there was a mass shooting here for the first time ever, the largest in Canadian history, and it seems to have begun as a domestic incident too.  People like my MIL are not getting care for their cancer which is stressful and possibly dangerous. My aunt died and no one but her son could be with her in hospital.

 

I worry about public pressure to keep things locked down, and that they will not accept that most people will become ill and many will die before a vaccine becomes available, or they don't understand that may not happen at all.

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17 minutes ago, Ktgrok said:

So what numbers do you share? How would you have preferred they warn the public?

I feel like I spent a couple posts going into that already? What a middle ground might look like?

What would you have said of anyone who was skeptical of the 2 million figure when it first came out? Let's say a smart, rational, intelligent person you know suggested that number might be too high given any number of factors (demographics, variations in human behavior models can't predict, bad input, etc.). What would you have told them at the time? What are models for?

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10 hours ago, SKL said:

There is also frustration because the restrictions got more strict even as the disease predictions got much less scary.  So initially they were saying that even if we all hid in our bunkers for x weeks, the hospitals would still be overwhelmed and they were scouting hotels, dorms, etc. for extra space for when that happened.  Now, as we all know, the actual hospitalizations in most places are so low that hospitals are actually underutilized.  Yay!  So the government response is to take more things away for longer.  How do you expect people to react to that?

I'm not talking about going to the beach.  People still aren't allowed to have funerals for the deceased.  People aren't able to get preventative health services.  And on and on.  This is what we get for obeying the orders and flattening the curve.

The fact that nobody knows what to believe and nobody can make plans - with or without a current income/bank balance - is incredibly stressful for many people.

The phrase, "No good deed goes unpunished" must have come from somewhere.

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re feeling overwhelmed/ pessimistic

3 hours ago, Ordinary Shoes said:

This scares the hell out of me. I think I've been naively counting on a vaccine. 

Those things you say we need to do - we aren't going to do them. I hate to be pessimistic but that kind of effort requires something that we don't have in the US today. 

Definitely agree that people don't see the real threat. I've been so disappointed by the responses of some people but it has become obvious that they see it through a filter. The "other side" believes X about this virus so Y must be correct. 

We live in a society of tremendous inequality which leads to resentment of the other. Many are conditioned to doubt "mainstream" science and medicine. I'm know people who believe this is all a hoax and that the vaccine is a plot by Bill Gates to take over the world. They will never change their minds because they have so much invested in being 'contrary' to the mainstream. We've been trained over the last 50 or so years to doubt the capability of government to help. You hear people say all of the time that the government can't do anything right. Most Americans have no idea how much they personally benefit, on a daily basis, from actions of "the government." 

I'm very pessimistic about this and think that we will be on on our own feeding into the anti-communitarian world-view which makes this harder. Some states and local governments are more functional and might be able to do some good. 

I read something that stuck with me. I can't remember where I read it so don't have the cite. It contrasted two kinds of people; those who insist that nothing changes because they don't want things to change and people who can conceptualize significant changes. (I'm not wording this well.) Basically, the first group is usually right because things rarely change all of that much but are catastrophically wrong when things do change. The second group is wrong most of the time but right when those once in a lifetime changes occur. 

I don't think that we will do the right things. There will be coverups of the deaths and the long term complications. This will be easier because the effects of COVID seem to fall more on the people we hardly notice anyway. I think the next step will be a denial of the difference of the 'current' to the 'before,' i.e. "this is the way it's always been." Tinfoil hat time but I sometimes tell my daughter to remember things if people ever try to tell her otherwise in the future. For example, I've told her to remember that the fires we see every fall are worse than they've ever been before. This isn't normal. This isn't how it always was. I think I'll need to have a similar discussion with her about this subject. 

I am sorry.

I don't mean to leave you or anyone else without hope. It is very hard to keep on carrying on without hope, and (whatever our worldview, whatever lens through which we're viewing this plague) we really don't have any option but to keep on carrying on.

FWIW, I am not, myself, without hope. I believe we will find a way to manage this plague, either through a vaccine (the better case) or through adaptations on how we live (the less good case). Either will take a long time, either will be disruptive, either will entail very significant costs in lives, money, health, and lifestyle.  Perhaps -- at this point it seems likely -- our nation will bear higher per capita costs than other nations, in lives and money and health and lifestyle, because this plague is filtering into fissures of social safety net and polarization and suspicion of government action / collective good / science generally and vaccines specifically / sense of consumer entitlement / resentment about supporting the needs of Others that are more extreme here than elsewhere. Perhaps.  

But I believe change will be thrust upon us whether we choose it or not.  Isn't that true of much of the important changes throughout history? Even the visionaries who, as you put it, are able to conceptualize significant change... face enormous obstacles in effecting it... 

 

Anyway. Over on another thread that @Quill started earlier today, I wrote about how during Passover I participated in a session whose leader offered a frame for us as we endured this time. Every year at this time, we retell a story, which starts with fear and uncertainty, punctuated by hope, and ends in a better place. Right now we are living inside a story.  But we do not know how this story ends. We're experiencing the fear and uncertainty but it's hard to feel the hope, because from where we are we cannot glimpse the ending.

I keep returning to this frame. It's actually helped me a LOT to empathize with the kvetching and complaining amongst the Israelites, their total turnaround on their leader as soon as he was out of sight, their lapses of faith in their God, the quickness with which they turned on one another. It feels really REAL in a way it never had before.

None of us asked to live in this globally unprecedented story. We don't know the end of this story. That is unnerving. It is valid to acknowledge how unnerving, and also irritating, is this position we've been thrust into.

And then figure out what our role is within the story. Really there is no other option.

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2 hours ago, Ordinary Shoes said:

A pretty good example of everything that is wrong today. You repeat propaganda that is intended to mislead people. The true measure of the benefits of the measles vaccine (or any vaccine) is the impact on the incidence rate not mortality rate. Modern medical interventions helped to reduce mortality rates. The incidence rate did not decline until the measles vaccine was widely available. 

And do you really believe that these medical experts showed the models to get people to comply with stay at home orders? Really? More propaganda

Glad to know that you think I am an example of everything that is wrong in the world today.   That is pretty brash.  I could think of a few bigger things, but I am sure that wouldn’t fit into your worldview where you are the only one that has things all figured out.  If you look back at your own post that I quoted you will notice that you are following credible experts who are CONSISTENT.  I believe they have been very far from consistent.  You also state that we are GENERATIONS away from having to worry about dying from measles.  I agree, but since the first vaccine for measles wasn’t approved until 1963 it can’t be the vaccine that got us to that point.  Since you said “die from measles” , death =mortality in case that big word want clear to you.  I actually said that the vaccine reduced the spread or the incidence rate.  Try reading what I wrote before declaring me an example of everything wrong with the world.

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5 minutes ago, StellaM said:

 

OMG what people get for flattening the curve is that their health system isn't overwhelmed. That's the reward. 

Oh, and lots of people got to live. 

It's not some kind of flipping punishment.

Context Stella, I was replying to another post.. Context.

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7 hours ago, Pam in CT said:

re is it feasible to get to 5 million daily tests (to start phased reopening by early June) to 20 million daily tests (to fully re-mobilize the economy, ideally by end-July) as per the Harvard Roadmap

I don't know.  It will entail a massive mobilization as well as associated massive cost.  

(We have not yet touched at all on this thread, or much on other threads I've loosely followed, on the COST side of either what "orderly  management of the Dance" or the ad hoc distribution of medical expenses of let-er-rip-Open-Everything-Up.  Even mild cases entailing days rather than weeks of ICU rather than ventilators, will take a whole lot of even-insured households past their financial capacity. We have not discussed personal bankruptcy due to medical costs, hospital bankruptcy due to unpaid bills, the second stage of triage for the "routine mild cases" based on who's insured how.  There are no good options, looking at this issue from a cost vantage point. But that is another thread.)

Oxford is doing a very good data roundup and visualization comparing different nations' testing, positive cases, and fatality numbers (though there are, inevitably, data issues as different nations' CDC equivalents track different metrics).  One of their indicators is a rolling 3-day average of "tests per 1,000 people" (which is, I think, the best way to render apples(ish) to apples(ish) to correct for the relative size of economies, medical/research sectors, and manufacturing capacity; and population -- both the capacity to produce tests and the need to deploy them).

The Harvard Roadmap's 5M to 20M daily tests in the US would amount to about 1.3 tests per thousand (to begin phased commencement of The Dance) to 5.3 (fully re-mobilize the economy based on widespread public trust that The Dance is working).  Right now, two months in, Italy and Estonia are approaching the bottom end of that range -- suggesting that yes, at least this level is within the range of plausibility.  The US is still testing well less than 1/2 person per thousand per day.

But it will COST. To the extent that test deployment is fully dependent upon for-profit market actors to develop/manufacture/deploy tests based on their independent profitability calculations, it will cost considerably MORE.  And I don't know if the will is there.

We want to re-open, but we also want to do so on the cheap.  Those two (legitimate, understandable) desires are in tension with one another.

 

re COVID's looking more, or less, alarming now than it did back in February:

I'm also far more acutely aware now, than then, about the invisibility of transmission -- that folks who have it, transmit before they have any symptoms; and even more that folks who never have symptoms, transmit it unwittingly. Back then (when we were *panicked* about transmission to my FIL, who was in a rehab center in NYC for wholly unrelated issues), I was paranoid about anyone with a hint of a cough; I now appreciate that literally anyone who walked into his room could have been shedding it.

I also assumed, then, that it was only a matter of time before a vaccine was developed (a lengthy time, to be sure) and that in the interim folks who'd had it, would be protected and could resume normal activities.  My husband and I presumed, eventually, that this would be us.  I assumed that immunity would hold, and that ultimately control of it, via either vaccine and/or prevalence was possible. I am seriously concerned by the indications of relapse among patients who've had it, recovered, and then fallen ill again.

 

 

More than anything else, though, I'm alarmed that we seem unable, as a society, to perceive this virus on its own terms. 

It's like we're so primed to receive anything BAD in terms of our usual blame categories that we are literally unable to see it clearly. This is a disease, is of a scale and transmission ease and -- thus, in combination -- lethality that literally no one alive has seen. It has already crossed all national and state borders. We do not understand very much about it. It has already incurred tremendous cost in lives, health, money and disruption. We have not begun to contain it and we don't have the information we need to be able to contain it.

It is a VIRUS. It is not an ideology.

I feel like we're so used to blaming the Other Party that we can't adjust to the REALITY that we are facing down an amorphous enemy that truly DOES NOT CARE about our partisanship problems or other societal fractures. Sure, I think this Administration made errors early on.  Sure, the Chinese government did as well.  OK.

But King Solomon himself would not have been able to see the outlines of this beast.  Such a beast has never before prowled this earth.

Whether we like it or not -- absolutely no one likes it -- we are facing a war.  Like all wars, it came on so abruptly that the mind has trouble adjusting. Like all wars, there is tremendous uncertainty on how it will unfold going forward. Like all wars, no government can promise when it will be over or on what terms. Like all wars, there will shortages, hardships, long periods of boredom punctuated by moments of heart-dropping panic. Like all wars, it will bring out the best and worst in us as individuals and as a society.

We haven't endured a war that imposed real hardship across all segments of society since people my mother's age were children.  Even then the war was Over There, not here.

And unlike other wars, this enemy is invisible, moving within us, here.  That is a very different front line.  Its ultimate defeat, if we manage to defeat it, will be a matter of science and collective action; and many of us distrust one or both of those.  And -- like all wars -- developing and deploying the tools to defeat it will be immensely costly.

But it is what it is.  It's a VIRUS, not an ideology.  We really seem to be struggling with that reality.

Remember who the real enemy is.

 

 

 

 

This. I was shocked it took as long as it did for things to turn partisan. Didn't let me down though!

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1 minute ago, StellaM said:

 

Ugh, sorry. 

I just honestly can't handle it when people don't give a d*mn about what it's like to be one of the people protected under lock down, and whine, really, about something that's only gone on for such a short time.

And as that's my problem, I'll take myself off line for a time.

Sorry if I misunderstood you.

💕 I'm so sorry this is such a hard time. I really hate that you are suffering.

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Quote

As someone with a risk factor for severe illness and disability from coronavirus, I can almost get to the point of accepting the 'price is too high' demand, if people took the eugenics out of it and started seriously thinking about ways to ensure those at-risk are protected as best as possible, and not thrown on the scrap heap of 'death happens'.

 

I don't think that's what I am getting at. Nothing to do with sacrificing anyone or a too high price, just the way a virus behaves. It's a virus, it will do what it will do which is infect people. Barring an early vaccine which is unlikely, the best option for those who are high risk is for them to strictly observe quarantine until there is herd immunity, and to have that happen as soon as possible so that they aren't quarantined for inhumane/unsustainable amounts of time.

If people are imagining some scenario where we can all keep social distancing and testing to the point that we halt the virus, that is going to involve much longer and more significant restrictions, all the while the high risk people have to observe even more restrictions.  And this would happen in waves in most places because there will never been enough immunity in the population to prevent it, and you can't stop it moving around the globe.

Now, it seems like Australia and NZ maybe slightly different in hoping they can actually reduce the virus and prevent new infection from coming in through strict control and testing and preventing travel internationally. Personally I am pretty doubtful that can work, but maybe it could work long enough - I don't know how long people will accept things like not being able to travel without quarantining for two weeks, or what it might mean for trade.  But in many places that simply isn't an option, the ability to prevent the virus moving from other places is not geographically or politically possible.

Many people where I live think the government strategy is to stop the spread. That's just not true, and if they are very surprised when they realise that I am concerned about what their response is going to be.

Edited by Bluegoat
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20 minutes ago, Pam in CT said:

re feeling overwhelmed/ pessimistic

I am sorry.

I don't mean to leave you or anyone else without hope. It is very hard to keep on carrying on without hope, and (whatever our worldview, whatever lens through which we're viewing this plague) we really don't have any option but to keep on carrying on.

FWIW, I am not, myself, without hope. I believe we will find a way to manage this plague, either through a vaccine (the better case) or through adaptations on how we live (the less good case). Either will take a long time, either will be disruptive, either will entail very significant costs in lives, money, health, and lifestyle.  Perhaps -- at this point it seems likely -- our nation will bear higher per capita costs than other nations, in lives and money and health and lifestyle, because this plague is filtering into fissures of social safety net and polarization and suspicion of government action / collective good / science generally and vaccines specifically / sense of consumer entitlement / resentment about supporting the needs of Others that are more extreme here than elsewhere. Perhaps.  

But I believe change will be thrust upon us whether we choose it or not.  Isn't that true of much of the important changes throughout history? Even the visionaries who, as you put it, are able to conceptualize significant change... face enormous obstacles in effecting it... 

 

Anyway. Over on another thread that @Quill started earlier today, I wrote about how during Passover I participated in a session whose leader offered a frame for us as we endured this time. Every year at this time, we retell a story, which starts with fear and uncertainty, punctuated by hope, and ends in a better place. Right now we are living inside a story.  But we do not know how this story ends. We're experiencing the fear and uncertainty but it's hard to feel the hope, because from where we are we cannot glimpse the ending.

I keep returning to this frame. It's actually helped me a LOT to empathize with the kvetching and complaining amongst the Israelites, their total turnaround on their leader as soon as he was out of sight, their lapses of faith in their God, the quickness with which they turned on one another. It feels really REAL in a way it never had before.

None of us asked to live in this globally unprecedented story. We don't know the end of this story. That is unnerving. It is valid to acknowledge how unnerving, and also irritating, is this position we've been thrust into.

And then figure out what our role is within the story. Really there is no other option.

I'm pessimistic but not hopeless. 

Oddly enough I see some positives. I think many Americans are finally waking up to how messed up things are. I hear more people say that the government *should* and *can* provide help. This is after 50 years of propaganda about how the government can't do anything to make things better for us. 

I'm hopeful that the quasi-homeschooling happening in every family leads to some changes in our schools. All American kids were excused from standardized tests this year. That's good all by itself even if came about because of this crisis. More bringing the truth to light...

Maybe this struggle for a vaccine, even if unsuccessful, will lead to more understanding of the benefits of vaccines. Or at least end the passive don't ask/don't tell because we don't want to rock the boat tolerance have for people who don't vaccinate. 

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4 minutes ago, Bluegoat said:

 

I don't think that's what I am getting at. Nothing to do with sacrificing anyone or a too high price, just the way a virus behaves. It's a virus, it will do what it will do which is infect people. Barring an early vaccine which is unlikely, the best option for those who are high risk is for them to strictly observe quarantine until there is herd immunity, and to have that happen as soon as possible so that they aren't quarantined for inhumane/unsustainable amounts of time.

If people are imagining some scenario where we can all keep social distancing and testing to the point that we halt the virus, that is going to involve much longer and more significant restrictions, all the while the high risk people have to observe even more restrictions.  And this would happen in waves in most places because there will never been enough immunity in the population to prevent it, and you can't stop it moving around the globe.

Now, it seems like Australia and NZ maybe slightly different in hoping they can actually reduce the virus and prevent new infection from coming in through strict control and testing and preventing travel internationally. Personally I am pretty doubtful that can work, but maybe it could work long enough - I don't know how long people will accept things like not being able to travel without quarantining for two weeks, or what it might mean for trade.  But in many places that simply isn't an option, the ability to prevent the virus moving from other places is not geographically or politically possible.

Many people where I live think the government strategy is to stop the spread. That's just not true, and if they are very surprised when they realise that I am concerned about what their response is going to be.

How do you get to herd immunity in a reasonably safe way? How do you protect the "high risk" when so many people are high risk? We know high blood pressure is one the primary risk factors and almost half of all American adults have high blood pressure. (I believe there is some controversy about how high blood pressure is defined.)

And what if there is no long term immunity? There is a risk associated with getting a population to herd immunity. Is that risk worth if immunity does not hold? 

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Just now, Ordinary Shoes said:

How do you get to herd immunity in a reasonably safe way? How do you protect the "high risk" when so many people are high risk? We know high blood pressure is one the primary risk factors and almost half of all American adults have high blood pressure. (I believe there is some controversy about how high blood pressure is defined.)

And what if there is no long term immunity? There is a risk associated with getting a population to herd immunity. Is that risk worth if immunity does not hold? 

 

Well, safe is the point of flattening the curve - so people who become ill have access to proper care.  I'm not sure what you mean by safe beyond that - it's like the flu, it's not safe.

Not everyone is at equal risk, but not all risk factors make people high risk.  People who are immunosuppressed for example, the very elderly in care homes,, they are the high risk people who need to think about strict quarantine. That doesn't mean they necessarily have to do so, btw - but that is a risk they choose (Though if you are in an institution then you will likely have less choice.)

If there is no herd immunity, that is unfortunate, but doesn't really suggest an easy option. Permanent shut down of services and social distancing isn't likely to be something people would accept even if it were possible. At that point I think the scenario would be life as per normal with outbreaks where people stay home and probably some quarantining too, but mainly people would have to get used to a yearly round of infection as they do wth the flu and medical services would have to remain beefed up to reflect that.

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20 minutes ago, Terabith said:

Just for the record, the numbers weren't based solely on the much maligned Chinese numbers.  They were also based off the numbers from the Diamond Princess and numbers coming out of Italy.  

Yes, exactly. Both older populations. One set of people unable to avoid contact or exposure to the infected even if they wanted to. I don't know that much about modeling, but I dont even know how you would begin to tweak a model to go from the DP to apply to...regular life anywhere else really. I think DP data is usual for a lot of reasons, but not for predicting spread anywhere but on a quarantined cruise ship.

Note, I'm not saying those people don't matter. I'm saying they are not useful for modeling disease spread in Canada or the US because demographics and living situations are so different.

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5 minutes ago, StellaM said:

 

Otherwise known as the 'lock 'em up and forget about 'em' strategy. 

 

 

How so? The whole effort is directed to getting them out as soon as possible. And if they are in their own homes they don't have to quarantine, but no one can stop them being high risk if they don't.

The other option is try and keep cases as low as possible and then they have to remain segregated much longer.

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2 hours ago, EmseB said:

Report the numbers we have. Report the data we have. If you know your model is based on incomplete data or as @Corraleno put it "with nearly no information", tell people that's what you have. Tell them we don't know what to expect because China is lying and our population and healthcare system is different than Europe.. Everyone on this forum acknowledges the garbage in, garbage out reality of all of these models.

Your comment in a pp wrt people not taking officials seriously the next time (or even going forward right now!) as a simple "you can't fix dumb", along with being just plain arrogant, is really shortsighted, especially when it comes to public health. In general, people may not be as smart as you are. They may not be as well read on the topic or as scientifically literate as you are, or understand modeling as well as you do, but if you tell them they have to give up their livelihoods to save millions or thousands of lives, they will do it. If you act like they are stupid rubes because your worst case didn't come to pass and they are skeptical going forward, I guarantee compliance such as it is will be harder to come by in the future. At least have a little sympathy instead of just writing them off as dumb.

I never used the phrase "with nearly no information." I said the ICL model that predicted up to 2.2 million deaths was based on "the best data we had at the time," and that the current IHME model, which is predicting only 67K deaths in total, is based on garbage data. The ICL specifically said:

"in an unmitigated epidemic, we would predict approximately 510,000 deaths in GB and 2.2 million in the US"

In other words, IF WE DID NOTHING, we could have up to 2.2 million deaths. That is not a crazy number they pulled out of a hat — even with the better data we have now, that is still a very likely outcome if we did nothing.

And it's widely agreed that it was specifically those numbers that finally got Trump to stop telling the public not to worry because "it's going to go away." Without that report, we'd likely be in MUCH worse shape right now. The full ICL report is available online and has been since it was released. Anyone who wanted to see what the numbers were based on could go read the report. 

I don't understand all these posts claiming "people aren't stupid" and yet expecting that all information should be provided with elementary-level explanations attached, because people can't possibly understand what a "model" is, or be expected to look anything up on their own, or actually read an article instead of just skimming a headline.

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37 minutes ago, Bluegoat said:

I don't think that's what I am getting at. Nothing to do with sacrificing anyone or a too high price, just the way a virus behaves. It's a virus, it will do what it will do which is infect people. Barring an early vaccine which is unlikely, the best option for those who are high risk is for them to strictly observe quarantine until there is herd immunity, and to have that happen as soon as possible so that they aren't quarantined for inhumane/unsustainable amounts of time.

Have you done the math on what "herd immunity" would mean in a population of 330 million, where something like 40% have an underlying condition that puts them at higher risk? Because unless this virus mutates very quickly into something much less severe, that is going to be at least a million deaths, and quite likely twice that.

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10 minutes ago, Bluegoat said:

 

Well, safe is the point of flattening the curve - so people who become ill have access to proper care.  I'm not sure what you mean by safe beyond that - it's like the flu, it's not safe.

Not everyone is at equal risk, but not all risk factors make people high risk.  People who are immunosuppressed for example, the very elderly in care homes,, they are the high risk people who need to think about strict quarantine. That doesn't mean they necessarily have to do so, btw - but that is a risk they choose (Though if you are in an institution then you will likely have less choice.)

If there is no herd immunity, that is unfortunate, but doesn't really suggest an easy option. Permanent shut down of services and social distancing isn't likely to be something people would accept even if it were possible. At that point I think the scenario would be life as per normal with outbreaks where people stay home and probably some quarantining too, but mainly people would have to get used to a yearly round of infection as they do wth the flu and medical services would have to remain beefed up to reflect that.

I'm not sure what I mean by "safe" either. Although deliberately exposing people to the virus to promote herd immunity is not safe. On second thought, perhaps it could be safe but it is unethical. 

Can you have normal life with random outbreaks and periods of quarantine? People above have complained about not being able to make plans. How do you make plans when your life could be upended at any time? 

How would companies plan for staffing if outbreaks could happen at any time? 

To be clear, I know this is the way that humans lived their lives until we had vaccines and antibiotics. 

I shudder to think how capitalism would address this risk. People who are more at risk would be too risky to be employed. Definitely too risky to include in an employer health plan. 

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Just now, StellaM said:

 

Not 'them'. 

'Us'.

The whole effort isn't directed to preserving the lives of the most vulnerable.

It's directed to not over-whelming the health care system, and then getting everyone else 'back to normal' as soon as possible (sooner than that), and individualising cost to at-risk individuals by making their safety a matter of their own personal choice.

 

Lacking a vaccine, the only protection people who are high risk will have is protection through herd immunity. Which means allowing those at less risk to get it as quickly as possible without it being so fast lack of medical care causes deaths. This is why it's important to try not to allow all these measures to go on longer than necessary - it just means people in high risk situations and locked down in care homes have to wait longer.

Back to normal is inevitable. The major thing that slows transmission are people staying home and self isolating, lack of travel, reducing people in supermarkets, no large public gatherings. That is not sustainable in the long term. Hand-washing and a lot more cleaning are also significant and could likely be continued. Masks are gloves are fairly minor and also need to be used with care and attention.

The reason at risk individuals need to be allowed to choose, if at all possible, whether to quarantine or not is because they are adults and you can't tell them they aren't allowed to go out, sleep with their spouse, and so on.  

I'm really not sure what you are envisioning people doing.  

 

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6 minutes ago, Corraleno said:

Have you done the math on what "herd immunity" would mean in a population of 330 million, where something like 40% have an underlying condition that puts them at higher risk? Because unless this virus mutates very quickly into something much less severe, that is going to be at least a million deaths, and quite likely twice that.

 

This is what I think the OP was talking about. No health professionals are talking about stopping this virus permanently. They are all talking about flattening the curve with an end-point of herd immunity. Not because they are jerks, but because it is the only possible endpoint .  

 

 

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8 minutes ago, Ordinary Shoes said:

I'm not sure what I mean by "safe" either. Although deliberately exposing people to the virus to promote herd immunity is not safe. On second thought, perhaps it could be safe but it is unethical. 

Can you have normal life with random outbreaks and periods of quarantine? People above have complained about not being able to make plans. How do you make plans when your life could be upended at any time? 

How would companies plan for staffing if outbreaks could happen at any time? 

To be clear, I know this is the way that humans lived their lives until we had vaccines and antibiotics. 

I shudder to think how capitalism would address this risk. People who are more at risk would be too risky to be employed. Definitely too risky to include in an employer health plan. 

 

But no one is talking about deliberately exposing people, any more than we deliberately expose people to colds.  People will be exposed going about their lives. I am in zero doubt that I will get it in the next year, probably the next six months. Health care workers will almost certainly get it sooner.  That's just going to happen.

In the long term, if you have something like a virus that means regular outbreaks, I think it would look a lot like it did in the past. Probably it would be somewhat cyclical, and we'd have to institute regular testing of people coming in with relevant symptoms. When it started to appear you'd have infected individuals in strict isolation, contact tracing, and ramping back other activities until it dies down. I daresay it would be ball games and concerts closed down but not shops and schools if was a yearly thing, but mostly people would choose to be careful.  Capitalism would cope though the US would need to think seriously about their social services.  And people would get used COVID being on a lot of death certificates along with the other big killers.

I don't know - there's never been a reason to think that we won't again have diseases like that as we had in the past.  That's always a possibility.

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12 minutes ago, Bluegoat said:

 

This is what I think the OP was talking about. No health professionals are talking about stopping this virus permanently. They are all talking about flattening the curve with an end-point of herd immunity. Not because they are jerks, but because it is the only possible endpoint .  

 

 

There is a difference between advocating that everyone get it ASAP to get to herd immunity as soon as possible and advocating for flattening/stretching the curve while we come to understand this virus much better, have a better understanding of who is higher risk and why and how to mitigate that, have much more effective and targeted treatments, possibly have a milder virus to deal with thanks to mutation, and possibly have a vaccine.

I think the idea that we need everyone who isn't high risk to get it as quickly as possible ignores those possibilities, ignores the difficulties in quarantining huge numbers of "high risk" people, and ignores the social, economic, and psychological impact of having more than a million people die in a short period of time. 

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1 hour ago, StellaM said:

 

Ugh, sorry. 

I just honestly can't handle it when people don't give a d*mn about what it's like to be one of the people protected under lock down, and whine, really, about something that's only gone on for such a short time.

And as that's my problem, I'll take myself off line for a time.

 

The thing is, I am protected under lockdown! But I am locking myself and my kids down. Even now, unless I call the police, I can't control what my neighbors do. They assume less risk,, i guess, because they are all hanging out together. The governor's order is nice because it means I'm not a total outcast for keeping all of us to ourselves, but ultimately I can't control other people and even doing this for such a short time has huge impacts on food supply and other chains that literally sustain life. I can't afford to get sick with this bug so we stay to ourselves as much as I can. I don't know what you consider to be a short time for this to continue, but I know here city governments that rely on travel or tourism are already laying people off after 1 month. And not just a few people, but like over 100 in the first month. That isn't just about people not being able to go on flights of fancy and go back to normal, it's about the government not being able to provide assistance to at risk populations because there's no revenue coming in. 

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14 minutes ago, Corraleno said:

There is a difference between advocating that everyone get it ASAP to get to herd immunity as soon as possible and advocating for flattening/stretching the curve while we come to understand this virus much better, have a better understanding of who is higher risk and why and how to mitigate that, have much more effective and targeted treatments, possibly have a milder virus to deal with thanks to mutation, and possibly have a vaccine.

I think the idea that we need everyone who isn't high risk to get it as quickly as possible ignores those possibilities, ignores the difficulties in quarantining huge numbers of "high risk" people, and ignores the social, economic, and psychological impact of having more than a million people die in a short period of time. 

 

Sure, you could attempt to stretch it out longer in order to achieve some of those things, though it's a bit of a crap-shoot for most of them.  

That's not without balancing considerations however. While you are doing that people in care homes or prisons or in hospitals are unable to see their families, or leave their institutions. Kids or wives in neglectful or abusive households are struggling, people living in poverty are struggling, people like my aunt who is an addict and at high risk has mental health issues are struggling, health care workers are having to isolate themselves from their kids and spouses, and even forgetting about "the economy" as such which I don't really give a fig for, we have to figure out how to get enough food grown for everyone (should we conscript locals to live in close quarters or ship in foreign workes as usual and risk their health?) and oh, world starvation is looking to double.

I'm really finding this implication that those of us who are suggesting a entirely reasonable view held by many epidemiologist are just asshats who don't care about people with hypertension really, really grating. 

Edited by Bluegoat
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2 hours ago, kand said:

 

I think the original source matters. If someone shares an article from a reputable news organization, that’s different than if they share something from some wackadoodle‘s blog, or someone’s random Twitter feed.

 

YES! We need a more accurate term for that, because there certainly is some crazy stuff floating around.

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18 minutes ago, Bluegoat said:

 

Sure, you could attempt to stretch it out longer in order to achieve some of those things, though it's a bit of a crap-shoot for most of them.  

That's not without balancing considerations however. While you are doing that people in care homes or prisons or in hospitals are unable to see their families, or leave their institutions. Kids or wives in neglectful or abusive households are struggling, people living in poverty are struggling, people like my aunt who is an addict and at high risk has mental health issues are struggling, health care workers are having to isolate themselves from their kids and spouses, and even forgetting about "the economy" as such which I don't really give a fig for, we have to figure out how to get enough food grown for everyone (should we conscript locals to live in close quarters or ship in foreign workes as usual and risk their health?) and oh, world starvation is looking to double.

I'm really finding this implication that those of us who are suggesting a entirely reasonable view held by many epidemiologist are just asshats who don't care about people with hypertension really, really grating. 

No one is suggesting that full stay-at-home orders should last 2 years, or even 1 year. But you said the best option is to achieve herd immunity as quickly as possible. This assumes that you can remove all restrictions on the "low risk" people so as many as possible get infected quickly, while still somehow protecting those at high risk.

My question is how do you protect the "high risk" people in a population where 70 million adults are obese, 68 million have high blood pressure, 34 million are diabetic, and 69 million are over the age of 60? How do you decide which high-risk people deserve "protection" (which is basically going to mean financial subsidies) and which are just going to have to take their chances for the greater good? I have read lots of blogs and editorials and op-eds saying the solution is to protect those at high-risk and let everyone else get back to business as usual, but no one ever explains how they would do that. It sounds like a simple, common sense solution, as long as the "high risk" population you imagine protecting is basically little old grandparents who are retired and sitting home anyway. When you look at just how large a percentage of the population is actually high risk, it becomes much more problematic, and I fear we are going to get into a situation where "protection" is limited to those who are considered most "deserving" and the rest — who are likely to be disproportionately poor and brown and employed in low-wage jobs — will be the canon fodder.

I think a gradual reopening, with continued social distancing (bans on large gatherings, limits on the number of people in stores and businesses at one time, continued reliance on working from home and home delivery as much as possible, required mask wearing, etc.) to keep the curve as flat as possible as long as possible, is the best policy in order to protect as many people as possible, not just a small percentage of high-risk people deemed "worthy" of protection. That will not achieve herd immunity ASAP,  but it should lead to fewer deaths overall as we develop more effective treatments, get much better at testing and tracing, and work towards a vaccine.

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53 minutes ago, StellaM said:

I month is pretty short.

Not sure how it is where you are, but we're not talking about 1 month in many places.  It'll be 7 weeks that my household has been essentially locked down when the current order ends (not including school which is out for the year), and I suspect it will be extended for who knows how much longer.  As Bluegoat says, this is delaying the inevitable since the virus is gonna do what it's gonna do, sooner or later.

This discussion is doomed since one side is dead set on the idea that anyone who disagrees just doesn't care who gets hurt.  Bluegoat explained why it is likely a loosening (to promote natural herd immunity) could save lives in the long run.  That is also what I believe. 

It is a lot easier to prevent the spread to vulnerable people in the short term than if you drag it out for many months or even years.  Folks need to come out of isolation sooner or later.  My folks have many medical issues that should not be allowed to go untreated for months and months.  They have people bringing them food and other items that always have some risk of contamination.  They have little chance of getting exercise or seeing the people who would lift their spirits.  And these are true of folks in everyone else's family too.  The sooner the virus runs its course, the better for all of these people.  This opinion is the opposite of the "lock 'em up and forget 'em" label you have suggested.

Edited by SKL
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13 minutes ago, Corraleno said:

No one is suggesting that full stay-at-home orders should last 2 years, or even 1 year. But you said the best option is to achieve herd immunity as quickly as possible. This assumes that you can remove all restrictions on the "low risk" people so as many as possible get infected quickly, while still somehow protecting those at high risk.

My question is how do you protect the "high risk" people in a population where 70 million adults are obese, 68 million have high blood pressure, 34 million are diabetic, and 69 million are over the age of 60? How do you decide which high-risk people deserve "protection" (which is basically going to mean financial subsidies) and which are just going to have to take their chances for the greater good? I have read lots of blogs and editorials and op-eds saying the solution is to protect those at high-risk and let everyone else get back to business as usual, but no one ever explains how they would do that. It sounds like a simple, common sense solution, as long as the "high risk" population you imagine protecting is basically little old grandparents who are retired and sitting home anyway. When you look at just how large a percentage of the population is actually high risk, it becomes much more problematic, and I fear we are going to get into a situation where "protection" is limited to those who are considered most "deserving" and the rest — who are likely to be disproportionately poor and brown and employed in low-wage jobs — will be the canon fodder.

I think a gradual reopening, with continued social distancing (bans on large gatherings, limits on the number of people in stores and businesses at one time, continued reliance on working from home and home delivery as much as possible, required mask wearing, etc.) to keep the curve as flat as possible as long as possible, is the best policy in order to protect as many people as possible, not just a small percentage of high-risk people deemed "worthy" of protection. That will not achieve herd immunity ASAP,  but it should lead to fewer deaths overall as we develop more effective treatments, get much better at testing and tracing, and work towards a vaccine.

There has absolutely been mention of until there is a vaccine. Absolutely.

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WRT trying to achieve herd immunity as quickly as possible - how does that work if a significant part of the population refuses to expose themselves? 

I've read that because COVID is highly contagious, we need a very high percentage of immunity in the population. (I'm sorry for not using the proper terminology. I don't know much about this.) If a significant portion of the population takes extreme measures to avoid exposure, how do you get to that high level of immunity in the population? 

Besides, if herd immunity isn't going to hold, what is the benefit to letting the virus run its course? If herd immunity is impossible then everyone should be motivated to avoid exposure. With no herd immunity, people will be exposed over and over again. The less times you are exposed, the stronger you will be and longer you will live. 

 

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