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  #51  
Old 03-14-2020, 07:50 PM
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Originally Posted by monstro View Post
It is estimated that 20-somethings who have been infected by COVID-19 have a 0.2% risk of dying (assuming they have access to adequate healthcare).

This doesn't seem like a big risk when we're talking about low numbers.

But let's say 30% of Americans ages 20-39 get infected by the end of the year. That's a little over 12 million people. 0.2% of that number is 24,000.

That's just 20-somethings.

And of course, that 0.2% is based on statistics from China, where people were literally welded into their homes for a month to keep this thing contained. China built extra hospitals and mobilized an army of doctors and nurses so that people of all ages would be treated. Needless to say, we aren't doing this here.
Here are the numbers from South Korea:
https://www.businessinsider.com/coro...-to-flu-2020-3

0.0% under 30
0.09% 40-49

up to the highest at 8.23% above age 80

Much more deadly than the seasonal flu, but nowhere near your numbers. And if we have a bunch of people who never even go to the hospital because they think they just have a bad cold, then those numbers are vastly overstated.

France and Spain have closed all businesses except grocery stores and pharmacies. What more would/could they do if this was the actual Black Death of the 1300s, or Captain Tripps from The Stand?

I'm not saying that we are overreacting. I don't know enough to say that. But it would seem to a layperson that we are.
  #52  
Old 03-14-2020, 08:02 PM
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How are you not a layperson here?
  #53  
Old 03-14-2020, 08:19 PM
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Originally Posted by UltraVires View Post
Here are the numbers from South Korea:
https://www.businessinsider.com/coro...-to-flu-2020-3

0.0% under 30
0.09% 40-49

up to the highest at 8.23% above age 80

Much more deadly than the seasonal flu, but nowhere near your numbers. And if we have a bunch of people who never even go to the hospital because they think they just have a bad cold, then those numbers are vastly overstated.

France and Spain have closed all businesses except grocery stores and pharmacies. What more would/could they do if this was the actual Black Death of the 1300s, or Captain Tripps from The Stand?

I'm not saying that we are overreacting. I don't know enough to say that. But it would seem to a layperson that we are.
The layperson is often wrong about stuff.

Of course there's a lot we don't know. We do know that we aren't testing at the same rate that SK is, though. We don't have the kind of healthcare system that SK has (SK has four times the number of hospital beds the US has, per capita). So we shouldn't use SK's outcomes to inform us of our risk. We seem to be following more of the path of Italy, which chose to take a wait-and-see approach until shit got too real. Since we don't have the political will to do what SK has done with testing and we can clearly see that Italy's approach has been disastorous, then it makes perfect sense to be as proactive as we can without literally welding people into their homes. Our strategy my not end up being a good one either, but what is the alternative? No one is saying what we're doing is the best way.


So I guess I don't know what point you're trying to make.
  #54  
Old 03-14-2020, 08:30 PM
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The layperson is often wrong about stuff.

Of course there's a lot we don't know. We do know that we aren't testing at the same rate that SK is, though. We don't have the kind of healthcare system that SK has (SK has four times the number of hospital beds the US has, per capita). So we shouldn't use SK's outcomes to inform us of our risk. We seem to be following more of the path of Italy, which chose to take a wait-and-see approach until shit got too real. Since we don't have the political will to do what SK has done with testing and we can clearly see that Italy's approach has been disastorous, then it makes perfect sense to be as proactive as we can without literally welding people into their homes. Our strategy my not end up being a good one either, but what is the alternative? No one is saying what we're doing is the best way.


So I guess I don't know what point you're trying to make.
I guess the short, short version of my point is that we are taking an awfully goddamn drastic approach to something that we don't know very much about. Panicking people and trashing the economy and people's lives: marriages canceled, vacations canceled, sports cancelled, high school seniors no prom or graduation ceremonies, unemployment, businesses going to close, lost opportunities, social distancing, and the like. All for "we don't know."

ETA: And from being around town, bars, strip clubs and tattoo parlors are still running as usual, but not schools.

Last edited by UltraVires; 03-14-2020 at 08:31 PM.
  #55  
Old 03-14-2020, 08:30 PM
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I'm not saying that we are overreacting. I don't know enough to say that. But it would seem to a layperson that we are.
Maybe Newt Gingrich can convince you... NEWT GINGRICH: I AM IN ITALY AMID THE CORONAVIRUS CRISIS. AMERICA MUST ACT NOW—AND ACT BIG | OPINION.

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These steps are not an overreaction. The coronavirus is out of control of in Northern Italy. As of 6 p.m. local/1 p.m. EST on March 10, there were 15,113 total cases in Italy, with 12,839 active cases, 1,016 deaths and 1,258 recoveries. And there were 162 total cases here in Rome.
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Because the demand for respirators and intensive care has been beyond any previous planning, doctors have been forced into the kind of triage thinking developed for intense battlefield casualty situations. There are reports that emergency room doctors are allotting respirators to those with higher life expectancy due to the limited equipment in the hardest hit areas of the province. If you are older or have other illnesses, you may simply not be eligible for treatment.
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The lesson of Italy is that the sooner you act, the fewer lives you will lose and the less damage you will do to your economy.
  #56  
Old 03-14-2020, 08:35 PM
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Newt is part of the Deep State now.
  #57  
Old 03-14-2020, 08:40 PM
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So now Newt Gingrich is the authoritative cite for the SDMB??? The world really is going to end.
  #58  
Old 03-14-2020, 08:43 PM
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Originally Posted by UltraVires View Post
I guess the short, short version of my point is that we are taking an awfully goddamn drastic approach to something that we don't know very much about. Panicking people and trashing the economy and people's lives: marriages canceled, vacations canceled, sports cancelled, high school seniors no prom or graduation ceremonies, unemployment, businesses going to close, lost opportunities, social distancing, and the like. All for "we don't know."
But we do know what's happening in Italy. We'd be fools to not use what's happening in Italy (and now Spain) to motivate us to take an awfully goddamn drastic approach.

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ETA: And from being around town, bars, strip clubs and tattoo parlors are still running as usual, but not schools.
Because bars, strip clubs, and tattoo parlors are run by people who won't be held accountable if a public health disaster happens.
  #59  
Old 03-14-2020, 08:48 PM
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An analysis that looked at the decisions by the lens of economics is very hard to do with the information we have UltraVires, but it would include what is called "Quality Adjusted Life Years" (QALY). QALY's monetary value is not applied consistently but seems to generally range between $50 to 150K at full health value. So yes economic analysis values a healthy 30something with 50 years of presumed life ahead as worth much more than an 81 year old with significant disability. In 2008-2009 the H1N1 pandemic had a significant impact on QALY because it impacted younger people more commonly than the old and infirm.

The analysis would have to know how many QALYs are likely to be preserved at what net cost.

I'm gathering that most have accepted the concept that the goal now is "flattening the curve" and understand that the concept assumes the same number of total cases in each age cohort but in one case more occurring in a circumstance in which the system is over its capacity threshold, and in another the threshold is never breached. So applying the economic analysis lens would have to be able to estimate how many more of which age groups (and thereby how many QAYs) would die as a result of the threshold being breeched that could be avoided by investing in these costs today? And then add in the other economic costs (lost productivity, so on) and/or (cold this) savings of those lost lives.

Anyone doing such a modeling exercise could use a variety of hypothetical assumptions, of different fractions getting infected in each demographic and different true mortality rate, and different impacts of avoiding the threshold being breeched, and even different odds of the investment having that avoiding breeching capacity payoff to different degrees.

Doing such might offend some people, making decisions on its basis likely third rail, but it would still be an interesting and important analysis.

Last edited by DSeid; 03-14-2020 at 08:50 PM.
  #60  
Old 03-14-2020, 09:03 PM
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A little Google finds this not too dissimilar take!
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We could use a metric like QALYs (quality-adjusted life years) to aggregate the burden of COVID-19. Then, in assessing public policy interventions, such as closing schools and limiting travel, we could at least informally perform some sort of cost-benefit analysis, assessing the economic cost of an intervention and comparing it with the benefit in reduced deaths and illness.

Yet the QALY does not seem to enter into discussions of COVID-19. We see a great deal of discussion of mortality rates among those infected by the novel coronavirus, including reports of how those rates vary by age band. The question, though, is not just the age of those who have died, but how much longer they would have lived. I have not seen any systematic attempt to convert these mortality rates into a QALY number, let alone any formal cost-benefit analyses assessing how different interventions might save QALYs. ...

... I have no idea which steps to slow the spread of COVID-19 are cost-justified and which steps are not. My own ignorance doesn't matter, but I worry that health organizations and governments may not even be trying to compare costs and benefits in any systematic fashion. Overreaction in the form of an availability cascade is especially likely at the beginning of a crisis, yet there is also a danger of complacency. There may be some good reasons not to base policy decisions solely on comparisons of QALYs and costs, but production of at least back-of-the-envelope estimates could be useful in anchoring serious policy discussion, even in or maybe especially in times of crisis.
  #61  
Old 03-14-2020, 09:10 PM
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So now Newt Gingrich is the authoritative cite for the SDMB??? The world really is going to end.
No. Newt Gingrich, as always, can go fuck himself.

I did, however, think you might find him persuasive.
  #62  
Old 03-14-2020, 09:15 PM
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Anyone doing such a modeling exercise could use a variety of hypothetical assumptions, of different fractions getting infected in each demographic and different true mortality rate, and different impacts of avoiding the threshold being breeched, and even different odds of the investment having that avoiding breeching capacity payoff to different degrees.
One non-hypothetical: People are social animals. Social distancing can only last a couple weeks before cabin fever will out. Click to see an Ikea in Singapore today:

https://www.straitstimes.com/sites/d...nes_140320.jpg

"I can't avoid going to certain places like malls, I need to do grocery shopping... It comes to a point where you can't stay at home. Kids get cabin fever."

Early contact tracing with forced quarantine for those positive seems to be working pretty well in flattening the curve in Singapore. But measures like trying to keep children isolated IMHO displays a lack of common sense. In two weeks they'll be crawling over each other at the playgrounds.

Trying to isolate different countries, which may have not-radically-different infection rates, from each other, also makes no sense to me.

Last edited by PhillyGuy; 03-14-2020 at 09:18 PM.
  #63  
Old 03-14-2020, 09:39 PM
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Delaying infections by two weeks is a HUGE improvement over what we have now.
  #64  
Old 03-14-2020, 10:46 PM
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I guess the short, short version of my point is that we are taking an awfully goddamn drastic approach to something that we don't know very much about. Panicking people and trashing the economy and people's lives: marriages canceled, vacations canceled, sports cancelled, high school seniors no prom or graduation ceremonies, unemployment, businesses going to close, lost opportunities, social distancing, and the like. All for "we don't know".
I would rather act with an abundance of caution and flatten the curve while we can than to be too late to act and have a catastrophe like Italy on our hands. YMMV.
  #65  
Old 03-14-2020, 11:30 PM
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Originally Posted by PhillyGuy View Post
One non-hypothetical: People are social animals. Social distancing can only last a couple weeks before cabin fever will out. Click to see an Ikea in Singapore today:

https://www.straitstimes.com/sites/d...nes_140320.jpg

"I can't avoid going to certain places like malls, I need to do grocery shopping... It comes to a point where you can't stay at home. Kids get cabin fever."

Early contact tracing with forced quarantine for those positive seems to be working pretty well in flattening the curve in Singapore. But measures like trying to keep children isolated IMHO displays a lack of common sense. In two weeks they'll be crawling over each other at the playgrounds.

Trying to isolate different countries, which may have not-radically-different infection rates, from each other, also makes no sense to me.
They can afford to relax a bit in Singapore because they clamped on air travel early, tested maniacally (by this time many of the ones in that article are aware that they have no symptoms or tested negative) and thanks to a government-run universal healthcare system with a significant private healthcare sector they had the capability to do so.

https://time.com/5802293/coronavirus...g-kong-taiwan/
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Rigorous detection and strict quarantine

When the virus began crossing China’s borders in January, Singapore appeared fated for a large-scale outbreak. The tiny city-state was the third country to report cases of COVID-19, and by mid-February, had recorded over 80 infections, the highest outside the Chinese mainland.

But the tally indicated more about the thorough testing conducted on the island of 5.7 million. A study by Harvard University’s Center for Communicable Disease Dynamics estimates Singapore detects almost three times more cases than the global average due to its strong disease surveillance and fastidious contact tracing.

In order to uncover COVID-19 infections that may have otherwise evaded detection, Singapore’s health authorities decided early on to test all influenza-like and pneumonia cases. They have also spared no pains in hunting down every possible contact of those infected. The process, which operates 24/7, starts with patient interviews, and has also involved police, flight manifests and a locally developed a test for antibodies, which linger even after an infection clears.

As of Mar. 13, the city-state had 178 cases and zero deaths.

Singapore is “leaving no stone unturned,” said Tedros Adhanom Ghebreyesus, director-general of the WHO.

Government advertisements carried on the front page of Singapore’s largest daily newspaper urge readers with even mild symptoms to see a doctor and refrain from going to school or work. And no Singaporean has to fear affording treatment. Testing is free, and the government foots the hospital bills for Singaporean residents who have suspected or confirmed cases.
We are not testing much yet, and we were very late in the response in the USA, thanks to the delays in testing and generally dealing with unknown rates of contagion, the efforts to limit contagion by advising about or closing public venues makes sense... until we get more testing and access to care.
  #66  
Old 03-15-2020, 12:07 AM
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Looking at the CDC site right now, they have 5833 deaths and 73968 recovered. With SARS-Cov-2, once you get sick, you seem to stay sick for weeks. People often start OK but get worse. To me, it seems to make the most sense to look at the "resolved" cases and that shows a mortality of 7%.
  #67  
Old 03-15-2020, 03:34 AM
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To me, it seems to make the most sense to look at the "resolved" cases and that shows a mortality of 7%.
That's misleading because it doesn't include people who had no symptoms or mild symptoms. They were never tested and never visited a doctor or hospital, so they aren't included in the statistics at all.

The number of mild and asymptomatic cases must be large, but it's unknown, so we can't yet tell the true mortality rate.
  #68  
Old 03-15-2020, 08:30 AM
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I have to admit when someone posts over and over and over again on Facebook that the Flu kills 12,000-61,000 people a year and this COVID-19 thing is overblown by the media and we are all needlessly panicking, I have trouble disagreeing with those numbers. Often the argument is coupled with the "media is trying to discredit Trump" charge which makes my back bristle even more.

Here are the arguments I have made so far, is there a better one?

-The infection rate appears to be higher
-So far the death rate is higher
-Its possible way more than 40,000 people will die

I have a feeling there is a better argument out there that these people are missing. Is there one?
I would go with the first argument. From what I've read, one person with the flu usually infects 1.3 people, whereas COVID 2019 infects 2 to 3 people. Until I read that statistic I didn't take it seriously, since I believed it was less contagious (though deadlier) than the flu.

Now I think it will infect almost everyone (although, fortunately, the death rate isn't spectacularly high). Social distancing, etc, will act to slow down the rate of infection.
  #69  
Old 03-15-2020, 09:28 AM
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That's misleading because it doesn't include people who had no symptoms or mild symptoms. They were never tested and never visited a doctor or hospital, so they aren't included in the statistics at all.

The number of mild and asymptomatic cases must be large, but it's unknown, so we can't yet tell the true mortality rate.
It's also misleading because the "recovered" number will lag far behind all the others. If you want to take that approach you have to look at regions where almost who have had it have recovered, and where the local system was able to test more than virtually only the very sickest (still likely to way undercount the numbers infected). Guangdong China fits. 1357 cases, 1303 recovered, 8 deaths, 46 still recovering v "not dead yet". Deaths/those with a known outcome = 0.6%

Adding up all of China outside of Hubei I get for of known outcome so far of those with confirmed infections 118 deaths/12299 recovered = 0.9%.

Interpret how you want.
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Old 03-15-2020, 09:35 AM
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Delaying infections by two weeks is a HUGE improvement over what we have now.
Can you explain what the HUGE improvement delaying infections by 2 weeks is? Do you interpret a 2 week delay of the spike as flattening the curve?
  #71  
Old 03-15-2020, 09:53 AM
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Here are the numbers from South Korea:
https://www.businessinsider.com/coro...-to-flu-2020-3

0.0% under 30
0.09% 40-49

up to the highest at 8.23% above age 80 ...

I'm not saying that we are overreacting. I don't know enough to say that. But it would seem to a layperson that we are.
I'm curious. Do you actually let the stats decide your opinion on the appropriateness of the reaction level? Is there a fatality rate at which you'll conclude the US is not "overreacting"? Is there a total number of cases? Rate of contagiousness?

I agree, we don't have great idea of the actual stats in the US yet (probably because testing has been fucked up). So I'm wondering if your opinion on whether the US is "over-reacting" is based on those stats, or something else. If the death rate is 2%, is that enough? 2.5% Is a million cases overall enough? 10 million? 100 million? IS a 1.5% infection rate too high? 2.5%?

Where is your line drawn?

Last edited by Hamlet; 03-15-2020 at 09:54 AM.
  #72  
Old 03-15-2020, 11:45 AM
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Hamlet, UltraVires very clearly states "I'm not saying that we are overreacting. I don't know enough to say that." Not expressing an opinion that the US is.

I'm curious - do you think that some form of economic analysis, using QALY, based on various levels of assumptions of true infection mortality rate and assumptions of differences in outcomes with different societal actions, both positive and negative, would be of value or offensive?
  #73  
Old 03-15-2020, 03:40 PM
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An analysis that looked at the decisions by the lens of economics is very hard to do with the information we have UltraVires, but it would include what is called "Quality Adjusted Life Years" (QALY). QALY's monetary value is not applied consistently but seems to generally range between $50 to 150K at full health value. So yes economic analysis values a healthy 30something with 50 years of presumed life ahead as worth much more than an 81 year old with significant disability. In 2008-2009 the H1N1 pandemic had a significant impact on QALY because it impacted younger people more commonly than the old and infirm.

The analysis would have to know how many QALYs are likely to be preserved at what net cost.

I'm gathering that most have accepted the concept that the goal now is "flattening the curve" and understand that the concept assumes the same number of total cases in each age cohort but in one case more occurring in a circumstance in which the system is over its capacity threshold, and in another the threshold is never breached. So applying the economic analysis lens would have to be able to estimate how many more of which age groups (and thereby how many QAYs) would die as a result of the threshold being breeched that could be avoided by investing in these costs today? And then add in the other economic costs (lost productivity, so on) and/or (cold this) savings of those lost lives.

Anyone doing such a modeling exercise could use a variety of hypothetical assumptions, of different fractions getting infected in each demographic and different true mortality rate, and different impacts of avoiding the threshold being breeched, and even different odds of the investment having that avoiding breeching capacity payoff to different degrees.

Doing such might offend some people, making decisions on its basis likely third rail, but it would still be an interesting and important analysis.
I don't think it is offensive at all. We make tradeoffs all of the time based on things. For example, 30,000 people die per year so that we can drive cars. We have made a decision that the economic and personal benefits of automobiles outweigh 30,000 deaths per year.

So, I'll play. The average age of death in Italy is 81. What are the statistical chances of a person age 81 dying before reaching age 82? Any mortality rate of this virus should be subtracted by that, no?
  #74  
Old 03-15-2020, 03:58 PM
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I don't think it is offensive at all. We make tradeoffs all of the time based on things. For example, 30,000 people die per year so that we can drive cars. We have made a decision that the economic and personal benefits of automobiles outweigh 30,000 deaths per year.

So, I'll play. The average age of death in Italy is 81. What are the statistical chances of a person age 81 dying before reaching age 82? Any mortality rate of this virus should be subtracted by that, no?
Sorry, found it:

https://www.ssa.gov/oact/STATS/table4c6.html

If I am reading this right, an 81 year old has a 6% chance of dying before reaching age 82. At age 85 you have a 10% chance of dying before age 86.

Obviously, having the virus increases you chances of dying, but as the less healthy are the ones that would die anyways, could you say that many of those 8% who would die from the virus would likely be part, likely a large part, of the 6% who would die anyways?

Again, and I mean it, all life is precious and old people matter. But I think it is important to take these things into consideration. 81 years old is 23 years more than my father lived and 10 years longer than my grandfather lived. Is it worth billions, probably trillions of dollars to give people maybe a couple of extra years?

ETA: And can my posts have the disclaimer that I don't support throwing the elderly to the wolves, nor do I think we shouldn't care for them.

Last edited by UltraVires; 03-15-2020 at 04:00 PM.
  #75  
Old 03-15-2020, 04:11 PM
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Oh sure, but when OBAMA proposed death panels, conservatives hated the idea.

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  #76  
Old 03-15-2020, 04:17 PM
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Oh sure, but when OBAMA proposed death panels, conservatives hated the idea.
Oh for fuck's sake. This is a discussion board, right? Can we discuss the fucking topic instead of everything going back to politics? I'm trying to understand exactly what we are accomplishing here. And once again, as you seem to be unable to comprehend what I wrote, I AM NOT SAYING THAT WE ARE OVERREACTING.

I don't know enough to say that, but it seems to me that we are if we are spending a bajillion dollars to save people who were very likely to die anyways.
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Old 03-15-2020, 04:28 PM
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Oh for fuck's sake. This is a discussion board, right? Can we discuss the fucking topic instead of everything going back to politics? I'm trying to understand exactly what we are accomplishing here. And once again, as you seem to be unable to comprehend what I wrote, I AM NOT SAYING THAT WE ARE OVERREACTING.

I don't know enough to say that, but it seems to me that we are if we are spending a bajillion dollars to save people who were very likely to die anyways.
It's not just the death rate that we need to be concerned with; this virus also has a fairly high rate of hospitalization, which can be prohibitively expensive.

Also, don't be so sure that the illness limits its fatilities to the elderly; for reasons that are not yet clear, the fatality rate (and rates of emergency medical care) in Italy is considerably higher than it was even in Wuhan, where the Chinese bungled the response for several weeks before finally flying into action. It could be that Italians smoke, but there's at least one underlying factor that makes Americans of any age at risk of dying, and that's obesity. About 1/3 or more of the country is seriously obese and well on their way to diabetes.

Beyond the risk of death and medical bankruptcy, this disease wreaks havoc on the lungs. It can potentially reduce pulmonary capacity forever, making individuals susceptible to respiratory failure in the future.

There's also the fact that if we don't freak out at least a little, the volume of incidence will overwhelm the healthcare system, putting both healthcare workers and patients, who have everything from heart attacks and strokes to traumatic injuries, at risk.
  #78  
Old 03-15-2020, 04:29 PM
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Sorry, found it:

https://www.ssa.gov/oact/STATS/table4c6.html

If I am reading this right, an 81 year old has a 6% chance of dying before reaching age 82. At age 85 you have a 10% chance of dying before age 86.

Obviously, having the virus increases you chances of dying, but as the less healthy are the ones that would die anyways, could you say that many of those 8% who would die from the virus would likely be part, likely a large part, of the 6% who would die anyways?

Again, and I mean it, all life is precious and old people matter. But I think it is important to take these things into consideration. 81 years old is 23 years more than my father lived and 10 years longer than my grandfather lived. Is it worth billions, probably trillions of dollars to give people maybe a couple of extra years?

ETA: And can my posts have the disclaimer that I don't support throwing the elderly to the wolves, nor do I think we shouldn't care for them.
You are overly fixated on the mortality directly caused by COVID-19. Experts who are pushing for draconian measures are focused more on hospital bed capacity since the indirect effects of COVID-19 are far scarier.

Let's say you, the individual who isn't at a high risk of dying from COVID-19, gets into a serious car accident in the next two weeks. Under normal circumstances, you'd be able to receive good medical treatment and make a full recovery. But under a rampant COVID-19 scenario, you aren't going to get good medical treatment. It may take an extra 30 minutes for an ambulance to get you to an ER, since EMT's are too busy transporting COVID-19 victims. If you need a ventilator once you get to the ER, well, good luck with that! The care you will receive will be subpar and you may end up dying, but you won't be counted in the COVID-19 statistics.

So as you're crunching numbers to find out the value of an average COVID-19 fatality, crunch the numbers for all the people who die indirectly because of COVID-19. And also crunch the numbers for all the people who end up with lifelong complications that could have been avoided if their medical care hadn't been impacted by COVID-19.

The two of us have wrangled over this topic in the past, back when you had a different username. Do you still believe that dead people represent savings rather than costs on society, as you did back then? Let me remind you that a lot of those dead people are providing valuable, tangible services to others. Letting them die is wasteful. This is true even if they are 81.

Quite a few of the guys calling the shots right now in this country are damn-near close to 81.
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Old 03-15-2020, 05:13 PM
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Hamlet, UltraVires very clearly states "I'm not saying that we are overreacting. I don't know enough to say that." Not expressing an opinion that the US is.
And I didn't say differently. I asked if and how the stats would actually influence that determination. And he hasn't answered.

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I'm curious - do you think that some form of economic analysis, using QALY, based on various levels of assumptions of true infection mortality rate and assumptions of differences in outcomes with different societal actions, both positive and negative, would be of value or offensive?
I'm not a fan of QALY and in no way should it be the only thing used in these determinations. But it does have some value and is not, on its face, "offensive" to me.

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Old 03-16-2020, 12:25 AM
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My concern is that Trump--in his usual ham-fisted childish way--has turned the response to coronavirus from a health/medical situation into a political one. Liberals now have a politically vested interest in making it look as bad as possible and conservatives have a vested interest in trivializing it. We can't possibly let the other side win because we all know they're made up completely of idiots and morons.

Personally I think we're going overboard. Massachusetts just closed down bars/restaurants starting Tuesday and schools are going to be closed for a month. A non-trivial number of people are going to go through hardship because of this.
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Old 03-16-2020, 12:37 AM
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As a liberal, I'd be delighted if this blew over quickly and with little of the predicted illness and death.
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Old 03-16-2020, 04:42 AM
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I've wondered before if there is a name for this fallacy. The fallacy of, If you don't prevent it, you're incompetent - and if you do act to prevent it, and it is prevented, then it was unnecessary.
Luckily we have a control group this time, as the UK has decided to do nothing and allow "normal herd immunity" to develop, even if it kills tens or hundreds of thousands. So we will know what happens if you do nothing. We will remember them fondly, thanks you very much, Boris.
Perhaps the Darwin Award will we awarded to a colletive this time. They can have my thoughts, my prayers and a toast to their brave sacrifice. For science, whodda thunk!
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Old 03-16-2020, 07:38 AM
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Personally I think we're going overboard. Massachusetts just closed down bars/restaurants starting Tuesday and schools are going to be closed for a month. A non-trivial number of people are going to go through hardship because of this.
This is certainly the oddest situation like this in my lifetime. I mean, this sort of utter panic didn't happen with SARS, which is of course another coronavirus that was capable of killing people with alarming efficiency.

The case of Italy suggests that this is not some overreaction; the numbers would suggest that the pandemic is going to kill a LOT of people there. Conversely, it seems under control in some places, like South Korea and Japan.

What is certain is this; this thing is going to hurt people one way or another. however bad the virus gets, the world's economy, which has been riding high for ten years, is going to go into a severe recession. The reasons for that are many, and that story is yet to be fully told, but it's happening, and that worries me as much as the virus does.
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Old 03-16-2020, 08:33 AM
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Luckily we have a control group this time, as the UK has decided to do nothing and allow "normal herd immunity" to develop, even if it kills tens or hundreds of thousands. So we will know what happens if you do nothing. We will remember them fondly, thanks you very much, Boris.
Perhaps the Darwin Award will we awarded to a colletive this time. They can have my thoughts, my prayers and a toast to their brave sacrifice. For science, whodda thunk!
Coronavirus: Man in Japan tests positive again after recovering from illness

Goodbye herd immunity...
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Old 03-16-2020, 09:11 AM
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I have to admit when someone posts over and over and over again on Facebook that the Flu kills 12,000-61,000 people a year and this COVID-19 thing is overblown by the media and we are all needlessly panicking, I have trouble disagreeing with those numbers. Often the argument is coupled with the "media is trying to discredit Trump" charge which makes my back bristle even more.

Here are the arguments I have made so far, is there a better one?

-The infection rate appears to be higher
-So far the death rate is higher
-Its possible way more than 40,000 people will die

I have a feeling there is a better argument out there that these people are missing. Is there one?
While I am a Trump supporter, for many reasons which I won't go into.

Covid-19 overall death rate is currently at 2.3 percent while the flu has a death rate of .01 percent. Meaning for every 10,000 people infected with the flu you can expect 1 death with Covid-19 with the same 10,000 people infected you can expect 230 deaths. So with the flu assuming EVERYONE in the US get infected all 330 million you'd expect about 33,000 deaths with the Covid-19 you'd expect 7,590,000 deaths.

Also without precautions it could take as little as 2 MONTHS for Covid-19 to infect the entire world. Really we're trying to buy time, First we don't want to overwhelm our medical facilities having Covid-19 take a year or two to infect everyone is far better than it taking 2 months. 2. It give us time to make a vaccine, the first one should in testing in human test by April.

But we need time and that's what we're trying to buy, time.

So WASH YOU STUPID HANDS PEOPLE. If you get sick STAY HOME. And please stop buy all the toilet paper, it makes you look dumb.

Last edited by postpic200; 03-16-2020 at 09:13 AM.
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Old 03-16-2020, 10:22 AM
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You are overly fixated on the mortality directly caused by COVID-19. Experts who are pushing for draconian measures are focused more on hospital bed capacity since the indirect effects of COVID-19 are far scarier.

Let's say you, the individual who isn't at a high risk of dying from COVID-19, gets into a serious car accident in the next two weeks. Under normal circumstances, you'd be able to receive good medical treatment and make a full recovery. But under a rampant COVID-19 scenario, you aren't going to get good medical treatment. It may take an extra 30 minutes for an ambulance to get you to an ER, since EMT's are too busy transporting COVID-19 victims. If you need a ventilator once you get to the ER, well, good luck with that! The care you will receive will be subpar and you may end up dying, but you won't be counted in the COVID-19 statistics.

So as you're crunching numbers to find out the value of an average COVID-19 fatality, crunch the numbers for all the people who die indirectly because of COVID-19. And also crunch the numbers for all the people who end up with lifelong complications that could have been avoided if their medical care hadn't been impacted by COVID-19.

The two of us have wrangled over this topic in the past, back when you had a different username. Do you still believe that dead people represent savings rather than costs on society, as you did back then? Let me remind you that a lot of those dead people are providing valuable, tangible services to others. Letting them die is wasteful. This is true even if they are 81.

Quite a few of the guys calling the shots right now in this country are damn-near close to 81.
Again, and I feel I must keep placing the disclaimer, I am all for people living long lives and enjoying their retirement, but your argument is absurd. Elderly people largely do not contribute and are a drain on society's resources.

If there is a conflict, say a 22 year old who was just in a car accident, versus a 89 year old on a ventilator because of Covid-19, and there was no other way to resolve it, I treat the 22 year old in a heartbeat and give the 89 year old palliative care. Yes, they are valuable and deserve respect, made in the image of God and whatnot.

We make these choices all of the time. 89 year olds are not put on a heart transplant list, whether or not we have UHC.

Again, what steps would we take if we had the Black Death of the 1300s facing us? If this progresses, in a couple of weeks, people will be without food. Society will start to break down. We should take fewer steps IF, and I state IF, this is largely only hastening elderly people's natural demise.
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Old 03-16-2020, 10:26 AM
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Re-infection is something that can happen with other diseases too, especially (but not exclusively) among the elderly and people with compromised immune systems.
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Old 03-16-2020, 10:46 AM
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Again, and I feel I must keep placing the disclaimer, I am all for people living long lives and enjoying their retirement, but your argument is absurd. Elderly people largely do not contribute and are a drain on society's resources.



If there is a conflict, say a 22 year old who was just in a car accident, versus a 89 year old on a ventilator because of Covid-19, and there was no other way to resolve it, I treat the 22 year old in a heartbeat and give the 89 year old palliative care. Yes, they are valuable and deserve respect, made in the image of God and whatnot.



We make these choices all of the time. 89 year olds are not put on a heart transplant list, whether or not we have UHC.



Again, what steps would we take if we had the Black Death of the 1300s facing us? If this progresses, in a couple of weeks, people will be without food. Society will start to break down. We should take fewer steps IF, and I state IF, this is largely only hastening elderly people's natural demise.
For the last time:

It isn't just elderly people who are dying from this. And the costs of this thing go beyond simple mortality.

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Old 03-16-2020, 10:48 AM
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If there is a conflict, say a 22 year old who was just in a car accident, versus a 89 year old on a ventilator because of Covid-19, and there was no other way to resolve it, I treat the 22 year old in a heartbeat and give the 89 year old palliative care. Yes, they are valuable and deserve respect, made in the image of God and whatnot.
That's a strawman. The choices won't be that stark. It'll be a 22 year old who is so beat up he probably won't survive, anyway, and a 72 year old woman who still walks 5 miles a day, does Yoga, and watches her grandchildren so that her daughter, a doctor, can save lives. Or a 45 year old alcoholic smoker who is currently unemployed but has a college degree vs a 63 year old who plans to retire at 65 and is in good health. And people are going to be making these decisions in seconds, with no way to assess anything but basic demographics. Even IF there was a way to perfectly calculate the worth of each life, they won't have the information and will probably make the wrong call as often as the right one.

Look, "especially dangerous to thsoe over 60, and those with certain conditions" does NOT mean "only kills 89-year old grannies that were half way out the door anyway".
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Old 03-16-2020, 11:43 AM
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I have been able to get people thinking by asking them why they think China and Italy have chosen to cripple their own economies and imprison their own people. What insane leader would go to such extremes just to discredit Trump? It makes no sense.

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I heard Glenn Beck (!) trying to get people to take it seriously on the radio this morning using similar logic. "If you think this is an anti-Trump hoax, why are other countries shutting down? You think they care who the President is?"
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Old 03-16-2020, 11:46 AM
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That's a strawman. The choices won't be that stark. It'll be a 22 year old who is so beat up he probably won't survive, anyway, and a 72 year old woman who still walks 5 miles a day, does Yoga, and watches her grandchildren so that her daughter, a doctor, can save lives. Or a 45 year old alcoholic smoker who is currently unemployed but has a college degree vs a 63 year old who plans to retire at 65 and is in good health. And people are going to be making these decisions in seconds, with no way to assess anything but basic demographics. Even IF there was a way to perfectly calculate the worth of each life, they won't have the information and will probably make the wrong call as often as the right one.



Look, "especially dangerous to thsoe over 60, and those with certain conditions" does NOT mean "only kills 89-year old grannies that were half way out the door anyway".
Thank you.

I am in my 40s, but I am pretty sick of hearing people let out a sigh of relief that "only" old people are dying. My boss is one of these "old" people. I have several coworkers who are "old". My closest friend is 82. All of these people are still net contributers to society.


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Old 03-16-2020, 12:06 PM
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It's clear than many of us on SDMB are older, and most are working, babysitting grandkids, helping an even older relative, subsidizing younger adults' education and housing, and other actions. It's also the case that many of us paid into the social and economic services futures for decades. Society is welcome to give me that money back right now if it doesn't wish to take care of me. I'll take a lump sum, with the interest earned.
  #93  
Old 03-16-2020, 12:31 PM
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I think the UK is making an epic mistake, not necessarily in assuming that there will be heard immunity but in its assumption that its national health system can withstand what, in all likelihood, will be a tidal wave of patients rushing to the hospitals. FFS, Italy's approach was essentially a 'herd immunity' response, even if that's not necessarily what Italians were thinking when they were initially so nonchalant about the epidemic. We've seen what happens to a national health system with that approach - it gets overwhelmed.
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Old 03-16-2020, 12:37 PM
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Re-infection is something that can happen with other diseases too, especially (but not exclusively) among the elderly and people with compromised immune systems.
It's about the viral load, which can seem small enough to make people (and even tests) think that the virus is gone. Someone might have a small viral load, but still have the virus. If they're immuno-compromised, the small viral load gradually comes back. Older people generally have weaker immune systems.
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Old 03-16-2020, 01:32 PM
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That's a strawman. The choices won't be that stark. It'll be a 22 year old who is so beat up he probably won't survive, anyway, and a 72 year old woman who still walks 5 miles a day, does Yoga, and watches her grandchildren so that her daughter, a doctor, can save lives. Or a 45 year old alcoholic smoker who is currently unemployed but has a college degree vs a 63 year old who plans to retire at 65 and is in good health. And people are going to be making these decisions in seconds, with no way to assess anything but basic demographics. Even IF there was a way to perfectly calculate the worth of each life, they won't have the information and will probably make the wrong call as often as the right one.

Look, "especially dangerous to thsoe over 60, and those with certain conditions" does NOT mean "only kills 89-year old grannies that were half way out the door anyway".
Of course. I was speaking in generalities. But by all means, let's do this to "contain" the panic:

https://www.youtube.com/watch?v=8ivD...qVzZkTFM3Mu6O0
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Old 03-16-2020, 01:34 PM
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Oh, and yes, I know that my post was from The Stand, but this shit is going down that road if we don't stop pretending that this is like the Black Death.
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Old 03-16-2020, 02:08 PM
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Well at least you let us know how serious you are about having a conversation about this.
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Old 03-16-2020, 02:14 PM
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You know what will make people panic?

Watching what is happening in Italy, Spanish, and Iran while your own country does nothing but talk about herd immunity and acceptable losses. That is what is happening in the UK right now, and people are understandably freaking out.

People have eyes and ears. They have access to all the information in the world right now. So they are going to panic. So you don't set policy around keeping people from panicking. Policy should be based on what works now and into the foreseeable future, not on what feels good in this singular moment in time.

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Old 03-16-2020, 02:36 PM
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Well at least you let us know how serious you are about having a conversation about this.
Exactly right. He, once again, won't answer questions or attempt to refute opposing arguments. But linking to poor quality YouTube videos. That he can do.

Last edited by Hamlet; 03-16-2020 at 02:37 PM.
  #100  
Old 03-16-2020, 03:56 PM
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Oh, and yes, I know that my post was from The Stand, but this shit is going down that road if we don't stop pretending that this is like the Black Death.
I'm not being cute, but I never click on YouTube links and I have never seen nor read the Stand.
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