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Old 03-25-2020, 11:58 AM
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Economic impact of "let 'er rip" vs shutting down


The impact of the current move toward more and more restrictions is relatively easy to see:
- Immediate lost jobs
- Drain on unemployment funds
- Decrease in all sort of retail spending
- Cascading impacts such as landlords not getting rent, banks not getting mortgage payments
- Increased household debt
- Loss of wealth due to the stock market and use of emergency funds to keep afloat
- Less income = less tax revenue for the government
etc etc etc.

I have not seen any estimates of the costs here, but it seems like the consensus is the damage is roughly somewhere between "Oh shit" and "We're screwed for the next 50 years" (not sure what that is in decimal notation).

What I have NOT seen any real discussion of is the impact if we just said "Screw it, go out to the nearest COVID party and get it over with".

- Lost time from work when you do get sick
- Lost income if you don't have paid sick leave
- Lost productivity from work while you're sick - and possibly longer if you are disabled as a result
- Drain on disablity funds
- Larger medical bills overall (assumption: the same number of people will get sick overall, but they will get sicker and require more care)
- Larger disaability figures overall (same assumption, so more people will have long-term issues)
- Larger medical infrastructure spending: temporary hospitals, more ventilators (let's assume sufficient numbers can be acquired)
- Some loss in retail / rent / mortgage though hopefully less than in the shutdown.
  #2  
Old 03-25-2020, 12:14 PM
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I have no idea why anyone is assuming option 2 will cause less economic damage. I think it's pretty clear that if millions get seriously ill at once, tens of thousands at a minimum die, and who knows how many are crippled -- that this will devastate our economy.
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Old 03-25-2020, 02:17 PM
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I have no idea why anyone is assuming option 2 will cause less economic damage. I think it's pretty clear that if millions get seriously ill at once, tens of thousands at a minimum die, and who knows how many are crippled -- that this will devastate our economy.
Well yeah, that's my point.

There are innumerable articles from the right-wing side bemoaning the economic devastation caused by the shutdown. And they're not wrong - but it's half the picture. NOBODY seems to be discussing the impact of the "kill Granny to save the economy" approach.
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Old 03-25-2020, 03:51 PM
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The Federalist, the tighty-righty magazine that fancies itself the voice for the intellectual conservative movement, has come out in favor of proactive infections. A twitter under its name...

Quote:
A tweet by conservative online magazine The Federalist, which suggested people should deliberately infect themselves with the coronavirus strain COVID-19, has been pulled after it “violated” Twitter’s rules.

The infringing tweet, posted on Wednesday morning, said: “It is time to think outside the box and seriously consider a somewhat unconventional approach to COVID-19: controlled voluntary infection.”....
Dumb da dumb dumb. Dumb da dumb dumb dumb!
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Old 03-25-2020, 04:31 PM
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You don't have "death" on the 2nd list, which is also an economic downer.
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Old 03-25-2020, 04:33 PM
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Well yeah, that's my point.

There are innumerable articles from the right-wing side bemoaning the economic devastation caused by the shutdown. And they're not wrong - but it's half the picture. NOBODY seems to be discussing the impact of the "kill Granny to save the economy" approach.
All of these theories seem to revolve around the certainty that it will be SOMEONE ELSE'S granny that will die, or maybe just a bunch of poor people I don't know.
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Old 03-25-2020, 04:34 PM
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Well yeah, that's my point.

There are innumerable articles from the right-wing side bemoaning the economic devastation caused by the shutdown. And they're not wrong - but it's half the picture. NOBODY seems to be discussing the impact of the "kill Granny to save the economy" approach.
You are assuming that those articles are written by people with the country's best interests at heart.
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Old 03-25-2020, 04:47 PM
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Well I know it sounds strange but lets say a healthy person under age 40 could go to some "center". There they would be first screened for issues and if given the green light, be exposed to the virus.

I'm thinking some type of dorm style place with rows of beds where they would be closely monitored and as they get sick, they get treated. Most, about 80%, it wouldnt be no worse than an ordinary flu. Ones who are the most severe would get sent to a different wing for treatment.

Once they recover and are through with symptoms and certified clear, they then can go home and back to work. Probably immune now. Sort of a new version of chicken pox or measles parties they used to do.

I mean when you think about it many of us already have had it but didnt know it. This way we would know for sure and probably be safe for use in high risk areas like hospitals.
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Old 03-25-2020, 05:03 PM
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You don't have "death" on the 2nd list, which is also an economic downer.
All these 'let's just get it over with and everyone get sick at once' arguments leave out crucial elements, such as the effect on the economy of millions of deaths.

A lot of those deaths would be of health-care workers: doctors, nurses, and all the others in the medical field. Losing a generation of doctors and nurses would not be so easy for the economy to shrug off, as some are assuming.

The arguments all contain some assumptions of Magic Occurring, as in the first quote (below) about ventilators, and in the second quote about acquired immunity. A sufficient quantity of ventilators is NOT going to miraculously appear. And we have NO IDEA if a majority of those who get COVID-19 have any sort of immunity at all.


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... more ventilators (let's assume sufficient numbers can be acquired)...
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Originally Posted by Urbanredneck View Post
Well I know it sounds strange but lets say a healthy person under age 40 could go to some "center". There they would be first screened for issues and if given the green light, be exposed to the virus.

...Once they recover and are through with symptoms and certified clear, they then can go home and back to work. Probably immune now. ...
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Old 03-25-2020, 05:20 PM
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What we would need to make the (cold-hearted) estimation would be a comparison of death rates among young productive folks who get the more serious version of the illness either a) with or b) without medical care.

I mean, we currently have a with-medical-care expectation that only .04% of 40-49-year-olds (for instance) die from the virus. What's that number with no medical care? Since the 'let-her-rip' school pretty much guarantees that only a small proportion of serious cases get actual medical care.

Also I feel the economic calculations aren't adding in any factor for the probability of mobs of grieving survivors with pitchforks marching on Washington after you've all been thrown to the wolves...
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Old 03-25-2020, 06:41 PM
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...
The arguments all contain some assumptions of Magic Occurring, as in the first quote (below) about ventilators, and in the second quote about acquired immunity. A sufficient quantity of ventilators is NOT going to miraculously appear. And we have NO IDEA if a majority of those who get COVID-19 have any sort of immunity at all.
To be fair, I did think about "death = bad for the economy", simply forgot to list it - and the "let's assume we can get the ventilators" I should have caveatted with "let's assume that somehow some magic happens and they are available".

Someone would also have to factor in the effect of all these deaths on the Social Security fund. Since older people are likelier to die, all of a sudden that frees up their income - though the tradeoff of younger people who survive but are permanently disabled would likely wipe that out.
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Old 03-25-2020, 07:09 PM
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Someone would also have to factor in the effect of all these deaths on the Social Security fund. Since older people are likelier to die, all of a sudden that frees up their income - though the tradeoff of younger people who survive but are permanently disabled would likely wipe that out.
I really haven't heard much about permanent disabilities among younger people. What have you read?
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Old 03-26-2020, 01:38 AM
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The Federalist, the tighty-righty magazine that fancies itself the voice for the intellectual conservative movement, has come out in favor of proactive infections. A twitter under its name...

Dumb da dumb dumb. Dumb da dumb dumb dumb!
Before Jenner did the smallpox vaccine, this was how it was done. People, like American Revolutionary soldiers, were infected with smallpox. Lots died (I think it might have been 5%) but the rest were immune. But they were pretty sure to get it, because of conditions in camp, and Washington (who pushed for this) thought it was better for them to be sick in camp than during a battle.
So if were were in a war where a lot of soldiers had to be crammed in together, maybe. Maybe the Federalist people think we are, given Trump's spouting about being a war-time president.
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Old 03-26-2020, 01:43 AM
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Yet another problem with letting it rip is the assumption by those who think this would improve the economy that everyone is stupid. If you know that going to a restaurant means you might be infected, you don't go. Restaurants were losing customers before the shutdown.

My daughter's asshat company was forcing people to go in until the governor shut it down and pretty much forced everyone to work from home. Most of the people spent their time worrying and finding out how many in their building had been affected. She is twice as productive at home. That doesn't work for manufacturing, but a line can't run if a lot of people are out.
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Old 03-26-2020, 03:38 AM
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The most likely outcome is a mix of the two.

* Stuff like concerts, conventions, sports events, cinema, etc are closed indefinitely. Bad news for the industry, but manageable in for the economy as a whole.

* School year gets canceled till September.

* Businesses open with heavy restriction and regulation. Masks and gloves for all. Sanitation staff clean offices surfaces, especially handles, fixtures and fitting with disinfectant regularly.

* Parks closed or restricted. Coffee shops only take away.Resturamts banned from seating more than 2/3 per table.

* Regular temperature checks by police of people.

I don't think "normal" will be back for years.
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Old 03-26-2020, 05:55 AM
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No way are restrictions lasting years.
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Old 03-26-2020, 10:41 AM
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There are insufficient inputs to be able to answer the op but there are those in the academic community who have the skill sets to give results across a variety of hypothetical assumptions of those inputs. They routinely do a bit of it just for seasonal influenza.
Quote:
Every year in the US, influenza viruses pose remarkable impacts on socio-economy, such as costs of medical care, loss of productivity, and deaths [1]. Since economic considerations are essential for influenza control, decision makers often need to examine following questions for health interventions. How much will an influenza season cost the US? Which states or counties bear high costs? Where to distribute vaccines to achieve the maximum returns? To date, only a small number of studies have estimated the economic impacts of influenza in the US. The Office of Technology Assessment reported that the influenza accounts for $1 ~ 3 billion per year in medical costs [2]. Meltzer, et al. argued that the annual economic burden of pandemic influenza could range from $71.3 ~ 166.5 billion [3]. The latest estimation by Molinari et al. indicated that the short-term costs and long-term burden of seasonal influenza can be amounted to $26.8 ~ $87.1 billion a year [4]. These studies have established systematic methods to analyze influenza economics and offered valuable guidance for interventions.
That article actually drills down and is able to conclude:
Quote:
The results indicate that the annual economic costs of influenza varied from $13.9 thousand to $957.5 million across US counties, with a median of $2.47 million. Prioritizing vaccines to counties with high influenza attack rates produces the lowest influenza cases and highest net returns.
The other tactic for high ROI with influenza is prioritizing the immunization of children, not because they are a large direct source of influenza morbidity and mortality but because they both spread it the most and respond better to immunization (stronger immune response) than the more high risk population.

Once they have filled in the inputs to the models estimating the cost of disease itself is something this group of academics have good experience with. The costs of the different social distancing interventions, not just economic but in adverse health outcomes inclusive of deaths both directly and indirectly, is something I think they have less of a sold footing with.

Anecdotally I've already heard of a child who has been waiting for an organ transplant (I don't know the name but still feel I should not even state which organ other than that life depends on it) who had one come available but who could not get the transplant because there is not enough matched blood available in the bank right now to do the operation.

The number of deaths and morbidities eventually caused by the food/housing insecurities to outright homelessness, even just from the impacts of social isolation itself, produced by the interventions are harder, I think, to calculate. They will however be very large.

It should be an extremely high priority item to fill in the blanks of needed inputs into the models, and to work out the other side of the equation as best as is possible by those wit the best training and information to do so. Actually answering the question of the OP, not just in a binary manner but with various levels and types of interventions less disruptive to the entire world economy is of critical importance. Anyone who at this point states they know the answer is frankly full of shit.
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Old 03-26-2020, 11:04 AM
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It is pretty annoying that it seems the real purpose of this thread seems to be "lets all just talk about how wrong they are" and everyone throwing around conjecture. I don't see a single "$" in the thread before DSeid's post.

The indisputable fact is, we ain't shutting everything down. We aren't quarantining everybody. The level of shutdown we have right now is not acceptable to the public for more than a month or so. This disease will continue to spread at some level for a while. We will have to find a middle ground.
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Old 03-26-2020, 03:04 PM
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I don't understand people who think this just kills old or sick people. The first person in St. Louis to die, this week or last, was 31 and had no health problems. She had a slight cough and the next week she was dead. In New York, people are already dying while waiting for a bed. That sort of thing doesn't inspire people to go out and buy Levi's jeans, Big Macs and Chevy trucks. The economy is fucked whether the government ever shut anything down or not. The question is, do we have a another Great Depression and millions dead, or another Great Recession and tens of thousands dead? Anybody who thinks we can avoid a recession if we just let people die in hospital parking lots isn't thinking with their head on straight.
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Old 03-26-2020, 03:11 PM
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. That sort of thing doesn't inspire people to go out and buy Levi's jeans, Big Macs and Chevy trucks. The economy is fucked whether the government ever shut anything down or not. The question is, do we have a another Great Depression and millions dead, or another Great Recession and tens of thousands dead? Anybody who thinks we can avoid a recession if we just let people die in hospital parking lots isn't thinking with their head on straight.
This ignores reality, I'm afraid. Yes, people are scared and will buy less (in person) but they are shutting stuff down for a reason. People are still going shopping/tanning/drinking/eating until they've made it against the law.
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Old 03-26-2020, 03:29 PM
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It is pretty annoying that it seems the real purpose of this thread seems to be "lets all just talk about how wrong they are" and everyone throwing around conjecture. I don't see a single "$" in the thread before DSeid's post.

The indisputable fact is, we ain't shutting everything down. We aren't quarantining everybody. The level of shutdown we have right now is not acceptable to the public for more than a month or so. This disease will continue to spread at some level for a while. We will have to find a middle ground.
One thing I will mention again is that large swaths of the economy arenít shut down and canít be shut down.

Health care and everything related to health care, including the factories that make medical supplies and the warehouse operations that sell them. Anything related to food that isnít a sit down restaurant. Farms, factories distributors. Gas stations and fuel distribution. Companies that make packaging and shipping materials for essential industries. Someone still has to print and label all the food packaging.

The construction industry, to some extent - although they may have been partially shut down in areas under mandatory lockdown. But you have to let enough plumbers and electricians stick around for repair work and make enough supplies for repairs. Law enforcement, first responders and the industries that supply them.

The areas of the economy that have shut down are the most visible, but much industry is still up and running. And if those workers get sick en masse, we are all screwed.

Thatís why those of us in those highly visible non-essential businesses need to stay home as much as possible, we need to keep the essential workers healthy.
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Old 03-26-2020, 03:30 PM
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This ignores reality, I'm afraid. Yes, people are scared and will buy less (in person) but they are shutting stuff down for a reason. People are still going shopping/tanning/drinking/eating until they've made it against the law.
That's now. Or a couple weeks ago. I'm talking about the entirety of the pandemic. Millions dead in a few months or a year, even if they're all "old and unproductive" is devastating to an economy. And that's before you account for how significantly the survivors will alter their consumption and work patterns.
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Old 03-26-2020, 04:07 PM
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If you know that going to a restaurant means you might be infected, you don't go.
But if you have already been infected, recovered, and now know for sure that you have immunity,then you will go to a restaurant. And keep the economy functioning.

I'm not saying that we should do this today--because we still have a chance to control the virus.We can still count the number of cases accurately, and we know precisely how many deaths.
But in just a few more weeks, there's a good chance that we will learn that we failed to control it. The infected will no longer be countable ( millions, not thousands), and even the numbers of dead bodies will be only approximate estimates (tens of thousands).

At that point, yes, it will make sense economically to end the shutdown and let the disease run full speed, till herd immunity builds up in the population.
Then go back to normal and rebuild, like the Marshall plan after WWII.

Quote:
Millions dead in a few months or a year, is devastating to an economy.
And millions of unemployed is also devastating.

So we are playing a numbers game, in which nobody knows what the numbers will be.

Some hard questions are going to be answered withing the next 3-4 weeks.
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Old 03-26-2020, 04:13 PM
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In effect its a decision by children to sacrifice their own (and everyone else's) parents for their own long-term benefit either in some notional societal good or specifically to release assets and their value for their own use.

I'm sure their own children will be seeing the worthiness of the measure and wondering how quickly they can euthenize their own unproductive older generation in turn.
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Old 03-26-2020, 04:17 PM
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As I mentioned in another thread, for all of Trump's blustering about wanting to open the country back up, it's not like he or anybody else can just flip a switch and have everything go back to normal.

Disney World isn't going to open back up just because Trump says everything is fine. Schools aren't going to let students back in. I doubt many people are making vacation plans for the near future.

The best anyone can hope for is to contain the damage that's already been done.
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Old 03-26-2020, 04:27 PM
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And millions of unemployed is also devastating.
Much easier to recover from unemployment than from death.
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Old 03-26-2020, 05:03 PM
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Much easier to recover from unemployment than from death.
I'm going to have remember this one. Thanks.
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Old 03-26-2020, 08:40 PM
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I don't understand people who think this just kills old or sick people. The first person in St. Louis to die, this week or last, was 31 and had no health problems. ... Anybody who thinks we can avoid a recession if we just let people die in hospital parking lots isn't thinking with their head on straight.
No, they are definitely not thinking with their head on straight. ALL the 'let 'er rip' arguments depend upon assumptions that have no evidentiary support:

***"Only old people die of this" (as mentioned in your post). Already disproved by numerous cases of young, previously-healthy people dying.

***"COVID-19 is just like the flu." In fact, what it's like is double pneumonia for which there is no treatment. Many patients need to be on a ventilator---receiving round-the-clock care from a number of health professionals---for 20 to 30 days, before their immune systems kick in. Before this virus, 3 to 4 days on a ventilator was the norm.*

***"Once you get it you're immune." This is the biggest and least-supported assumption. Several indications cast doubt on this unfounded assumption; to name one: the idea of using plasma from people who appear to have recovered is limited by the fact that the antibodies in their blood are effective for only a limited time. As the New York Times pointed out:

Quote:
The antibodies generated in response to infection with some viruses — polio or measles, for example — bestow a lifetime of immunity. But antibodies to the coronaviruses that cause the common cold persist for just one to three years — and that may be true of their new cousin as well.
https://www.nytimes.com/2020/03/25/h...ntibodies.html

Again: there is no lifelong immunity to the common cold, is there? None whatsoever. And the novel coronavirus may well turn out to behave the same way. We have no evidence-based reason to believe otherwise.


Those who are arguing for 'infect everyone and get it over with' are ignoring important facts. For common topics of dispute on message boards, that lack of rational, evidence-based reasoning doesn't matter a great deal.

But for the topic of 'let's all get infected at once,' the stupid will have deadly consequences---for many more than just the person making the bad argument.



* https://www.cnbc.com/2020/03/26/new-...ntilators.html

Last edited by Sherrerd; 03-26-2020 at 08:41 PM.
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Old 03-26-2020, 09:36 PM
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"Let-er rip" is a Russian meme. Note which interests are served with America pandemicized.

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Disney World isn't going to open back up just because Trump says everything is fine. Schools aren't going to let students back in. I doubt many people are making vacation plans for the near future.
Have Tramp golf courses, resorts, and Mar-a-Lago shut down? Will they be open upon presidential command?
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Old 03-26-2020, 09:49 PM
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All I can think about regarding the OP's question is: are we ready and willing to do mass graves? It's not like funeral people are exempt from catching this virus. Hospital morgues will fill fast and so will temp. freezer trucks. No one knows AFAIK how long a dead body is infectious and/or if chilling them down to stop the rotting will render them safe.

Grisly thoughts but I read a lot of pandemic/zombie/all kinds of apocalypse stories.
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Old 03-26-2020, 10:06 PM
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All I can think about regarding the OP's question is: are we ready and willing to do mass graves? It's not like funeral people are exempt from catching this virus. Hospital morgues will fill fast and so will temp. freezer trucks. No one knows AFAIK how long a dead body is infectious and/or if chilling them down to stop the rotting will render them safe.

Grisly thoughts but I read a lot of pandemic/zombie/all kinds of apocalypse stories.
Funeral services have already been banned or severely restricted in many places. I have lost all of my immediate family but I still have close family members and friends. I can't imagine not being able to grieve in the manner to which I have been accustomed. It's already mind boggling.
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Old 03-26-2020, 10:55 PM
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Much easier to recover from unemployment than from death.
Plus unemployment insurance helps the unemployed. Life insurance doesn't do much for the corpse.
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Old 03-26-2020, 10:59 PM
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But if you have already been infected, recovered, and now know for sure that you have immunity,then you will go to a restaurant. And keep the economy functioning.

I'm not saying that we should do this today--because we still have a chance to control the virus.We can still count the number of cases accurately, and we know precisely how many deaths.
But in just a few more weeks, there's a good chance that we will learn that we failed to control it. The infected will no longer be countable ( millions, not thousands), and even the numbers of dead bodies will be only approximate estimates (tens of thousands).
Yeah, after everyone is either dead or recovered we can open things up again. But that is not going to happen by Easter. And definitely when we have a vaccine we can open things up.
Most of the estimates I've seen show the same area under both curves. If we flatten it, we can open up when we reach the end of the flattened curve. Which is longer from now then the tail of the nonflattened curve - but with a lot fewer deaths.
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Old 03-27-2020, 04:21 PM
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***"Once you get it you're immune." This is the biggest and least-supported assumption. Several indications cast doubt on this unfounded assumption;

Again: there is no lifelong immunity to the common cold, is there? None whatsoever. And the novel coronavirus may well turn out to behave the same way. We have no evidence-based reason to believe otherwise.
Any chance to discuss this point without being shouted at? I'll try.

I think most who are discussing the "let er rip" strategy aren't suggesting you would develop lifelong immunity, which seems to be what you claim the argument is. I would hope not, at least. I'm not in the "let er rip" category, but I am in the category of strategically exposing people (not Trump's plan, I promise) and my understanding is that people who survive this will have immunity for at least a short while, perhaps years. There is evidence of that.
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Old 03-27-2020, 06:05 PM
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Any chance to discuss this point without being shouted at? I'll try.

I think most who are discussing the "let er rip" strategy aren't suggesting you would develop lifelong immunity, which seems to be what you claim the argument is. I would hope not, at least. I'm not in the "let er rip" category, but I am in the category of strategically exposing people (not Trump's plan, I promise) and my understanding is that people who survive this will have immunity for at least a short while, perhaps years. There is evidence of that.
Short-term immunity can be used as a foundation for resumption of economic activity ONLY if reliable testing is freely available---because no one will know when their short-term immunity will expire. A year? Three months? The difference is crucial.

We need lots of tests, and we need them to be free (obviously--people can't be shelling out thousands, repeatedly), and most of all, we need them to be fast-and-reliable. A society dealing with virulently contagious + dangerous viral outbreaks* can carry on economic activity: you need buildings constructed with 'airlocks' and plenty of qualified, trained people to administer tests. You pass the test, you go inside and work. You don't, you go home. (Variations on this plan can be developed for all those who work somewhere other than inside a building, too; they will be more complex.)

But all of this is pie in the sky at the moment. We don't have the fast, reliable, plentiful tests. We don't have the trained personnel, nor the protective equipment they'd need. We don't have a system set up to fund all this, and it won't work if the financial burden is placed on the workers.

I realize that people need to be able to at least picture a resumption of "normal life." There is a way that can happen, but it's a long way off.


*And this particular novel coronavirus is highly unlikely to be the last challenge humanity faces. Even if no one on the planet ever again operates a market in which live animals and humans mingle, there are going to be more nasty microbes evolving and attacking us.
  #36  
Old 03-27-2020, 06:24 PM
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Originally Posted by Sherrerd View Post
Short-term immunity can be used as a foundation for resumption of economic activity ONLY if reliable testing is freely available---because no one will know when their short-term immunity will expire. A year? Three months? The difference is crucial.
Yes, three months is a lot different than a year. I don't disagree.

You wrote a nice post that argues against some of the rationale people are putting forward for "let er rip." I think you overstated what some of the arguments are, but the immunity one was particularly sensitive to me because I think it grossly mischaracterizes that particularly rationale.

I think we need to try to discuss this honestly and not grossly exaggerate what is being argued or discussed. If we do that, maybe we can come to an agreement on a best path forward.

The rest... I'll leave to discuss later. Suffice it to say, please take care when characterizing counter arguments.
  #37  
Old 03-27-2020, 06:35 PM
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I am sure that complete "let er rip" proponents exist somewhere, but I've not seen any in the wild. Not even Trump.

OTOH I see quite a bit of reasoned discussion that considers a range of social distancing options between near shut down of society (barring activities defined as "essential") and doing nothing.

Let's address the shouted claims about assumptions with no evidentiary support.

No one is claiming that only old people die of this. Those over 70 in particular and/or with chronic health problems are at much greater risk per individual. In Italy, for example, over 85% of the deaths have been among those 70 and over. What is the true infection mortality rate among non-elderly without major comorbidities? No one really knows as identified case is clearly an underestimate of the true infection rate. One estimate is that 85% of all infections have been undocumented and uncounted. If so, then the age specific crude case fatality rates used by the Imperial College study are minimally 85% over-estimates. Still large n will be a real and a significant number in an absolute sense - whenever they get it.

Very very few are claiming that COVID-19 is just like the flu. But neither is having COVID-19 always a double pneumonia. It is like the flu in certain ways. Those who get sickest get Acute Respiratory Distress Syndrome (ARDS) which is often fatal and includes a long vent course. And some don't get very sick at all. Again, how many? We still don't really know. Studies to be in progress, finally, checking for "the extent of infection, as determined by seropositivity in the general population, in any country in which COVID-19 virus infection has been reported"

Lifelong immunity is not required. We do not yet know how long immunity having had COVID-19 will last. As noted common cold coronaviruses tend to last in the one to three year range (although re-infection tends to be milder disease). But immunity to SARS seems to last 8 to 10 years. There is some confidence that immunity to SARS-CoV-2 will last a minimum of one to two years, and possibly much longer. By one to two years a vaccine would be more likely available. It is also true that it won't just suddenly disappear for all, all at once. Even as it fades there would be a population more fully protected which would slow a new epidemic's surge.


Given that we blew the chance to apply the same approach as in South Korea and in Singapore (neither of which required the level of society shut down we are now doing) what are the graded options between let er rip "infect everyone", and suppression level measures for the likely 18 months that it would take to develop a vaccine and prove its safety/efficacy?

At some point we will see solid evidence of flattening the curve - most lagging a decrease in daily death rates within a region, less lagging a decrease in ICU admissions attributable to COVID-19. Hopefully the first signs within two weeks. What then?

Rationally those who are immune come out first (however many that is and it could in certain regions be a large number, we don't yet know), and those at lowest risk for getting sickest second, so on. Monitor rates of new disease (at that point having enough test kits) and ICU admissions attributable to COVID-19 and if rates stay below some predetermined threshold release the next lowest risk cohort into the workforce, rinse repeat, aiming to have it spread out over as long as five to six months, but done before influenza hits. There are interventions that likely have the lowest ROI (in long term total morbidity and mortality balance each side) and ones that have the highest. Undo the first group and if we stay within the threshold for a couple of weeks consider the timing of releasing the next. Along the way build more capacity and collect the missing key data inputs.
  #38  
Old 03-27-2020, 07:29 PM
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Much easier to recover from unemployment than from death.
But not impossible. I have a tab open in Chrome showing the worldometer pandemic counters. When it refreshed at 00:16 the death toll declined to 27,250 from the 27,251 at 23:51 GMT. One lucky guy.
  #39  
Old 03-27-2020, 09:02 PM
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I'd have thought it obvious that my post did not attempt to claim that all cases of COVID-19 resemble double-pneumonia, nor that anything short of life-long immunity rendered economic recovery impossible, nor that Let 'er Rip advocates claimed that only old people would die.

For most readers, I'd guess, it was clear that I was responding to "get it over with" arguments such as the one we have in this thread's opening post:

Quote:
Originally Posted by Mama Zappa View Post
...
What I have NOT seen any real discussion of is the impact if we just said "Screw it, go out to the nearest COVID party and get it over with".

- Lost time from work when you do get sick
- Lost income if you don't have paid sick leave
- Lost productivity from work while you're sick - and possibly longer if you are disabled as a result
- Drain on disablity funds
- Larger medical bills overall (assumption: the same number of people will get sick overall, but they will get sicker and require more care)
- Larger disaability figures overall (same assumption, so more people will have long-term issues)
- Larger medical infrastructure spending: temporary hospitals, more ventilators (let's assume sufficient numbers can be acquired)
- Some loss in retail / rent / mortgage though hopefully less than in the shutdown.
Implicit or actually explicit, here and in other 'let 'er rip' arguments, is that most people will "get over" COVID-19, and that the process of getting over it might cause some expense in terms of "temporary hospitals," but that's about it. No particular stress on healthcare professionals; no particularly long stays in intensive care---just the need to buy a few more ventilators, really.

To counter such views it seemed reasonable to point out that for many people around the globe so far, COVID-19 has been a lot more like double-pneumonia than the rosy picture in the OP assumes. That's not the same thing as saying that COVID-19 is like double pneumonia for everyone who is infected. Again, I'd have thought that would go without saying (and I suspect it did, for most readers).

The OP didn't discuss immunity, but of course many arguing the "let's get it over with" case do:

Quote:
Letís say we expose lots of people to the virus rather quickly, to build up herd immunity. Furthermore, we would let commerce and gdp continue to thrive.
https://marginalrevolution.com/margi...emic-yoyo.html

The writer does go on to note issues with the argument. But unsupported assumptions---here, that commerce and GDP would "continue to thrive"---abound.

And "herd immunity" itself is a precarious concept when it comes to a virus that may mutate in unpredictable ways. From the marginalrevolution page:

Quote:
Hubei deletes a report claming COVID-19 damages male fertility.
In other words, herd immunity = herd infertility.
"The infection could result in ďimpairment of immune homeostasis in the testesĒ, which could cause orchitis Ė an inflammation of the testicles Ė which in turn could reduce a manís sperm count and possibly lead to infertility, it said."
https://www.scmp.com/news/china/soci...iming-covid-19
and

Quote:
Lord Action March 18, 2020 at 8:17 am
... we're talking about a virus that has already mutated in a large way effecting its aggressiveness once already. Are we so certain that the next mutation won't make it kill 20% of children? Or increase r0? Or that it already has long-term health effects in mild cases that we haven't had time to see, like shingles for chicken pox?

In my view, we don't have enough information to bet everybody on the long-term effects of billions of cases being benign (even if they're 80% non-hospitalizing in the short-term). Especially when the downside is trading a 1% fatality rate for a crowded hospital 5% fatality rate.
My point (in the original post) was that "let 'er' rip" arguments depend upon completely unwarranted assumptions about immunity. It did not deny the potential utility of limited-time immunity.



Quote:
Originally Posted by DSeid View Post
I am sure that complete "let er rip" proponents exist somewhere, but I've not seen any in the wild. Not even Trump.
Two* in the news recently:

***Rick Santelli: https://www.msn.com/en-us/money/mark...my/ar-BB10OhgN

***Robin Hanson: https://www.wonkette.com/economist-s...th-coronavirus

Hanson was previously known for his advocacy of free sex for incels.

*Unless you are going for some definition of "complete" which requires arguments to have no qualifications whatsoever, which would be rather shameless of you.



Quote:
Originally Posted by DSeid View Post
No one is claiming that only old people die of this.
If you want to carp about "only" you distort the 'let 'er 'rip' argument. The point is that virtually all people making that argument, claim that one of its virtues is that most of those who die will be useless old burdens on society---even though most of them avoid being quite that candid. But the message is clear. Here's a typical example (it's from the marginalrevolution page linked above).

Quote:
The current mortality in the United States is something like three million people each year. Most of the leading causes of death are, or would be, co-morbid with this virus, not least of which is "natural causes", i.e., old age. I'm not trying to downplay these deaths but it would be more helpful to look at the effects on average life expectancy ...
https://marginalrevolution.com/margi...emic-yoyo.html

In other words, 'They're Going To Die, Anyway!' is a crucial part of the argument. My post pointed this out. It did not claim that every advocate of 'let 'er rip' had stated that "only" old people would die.




Quote:
Originally Posted by DSeid View Post
...At some point we will see solid evidence of flattening the curve - most lagging a decrease in daily death rates within a region, less lagging a decrease in ICU admissions attributable to COVID-19. Hopefully the first signs within two weeks. What then?

Rationally those who are immune come out first (however many that is and it could in certain regions be a large number, we don't yet know), and those at lowest risk for getting sickest second, so on. Monitor rates of new disease (at that point having enough test kits) and ICU admissions attributable to COVID-19 and if rates stay below some predetermined threshold release the next lowest risk cohort into the workforce, rinse repeat, aiming to have it spread out over as long as five to six months, but done before influenza hits. There are interventions that likely have the lowest ROI (in long term total morbidity and mortality balance each side) and ones that have the highest. Undo the first group and if we stay within the threshold for a couple of weeks consider the timing of releasing the next. Along the way build more capacity and collect the missing key data inputs.
You're going to need to add a massive apparatus for re-training to that program. If, say, an automotive fuel-filter factory had a workforce of 68 and that was the minimum for effective operation, but only 14 of those employees qualified to be in a "released" cohort, then you're going to have to train 54 other newly-"released" people, who had been doing some other kind of work before, to do the fuel-filter-factory jobs.

Multiply this throughout the economy and you have a major need for re-education and training. Not all jobs are skilled, of course. But enough are, to be an important factor.
  #40  
Old 03-27-2020, 11:18 PM
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Originally Posted by don't ask View Post
But not impossible. I have a tab open in Chrome showing the worldometer pandemic counters. When it refreshed at 00:16 the death toll declined to 27,250 from the 27,251 at 23:51 GMT. One lucky guy.
The search is on! Whomever is found to have resurrected will doubtless be drained of plasma for the good of mankind. Same with all those listed as "recovered". Antibodies! Immunity! I'd hate to be one.
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