Am I missing something here? (re: reopening of bars, etc... now)

[Banquet_Bear]

@Trom

I wish I had your confidence.

…I am 100% confident that nearly every single epidemiologist in the world would agree with me that the United States has fucked up their response to Covid-19.

@Trom

I don’t see the point of a useless playbook, then. We need other approaches.

The playbook that worked? Lockdown hard and early, ramp up testing and contact tracing, social distancing, masks, and isolation of those with Covid? What other approach do you suggest?

@Trom

I think you’re fighting the hypothetical.

I wasn’t aware I was addressing a hypothetical. In the real world New Zealand is going to have options. The United States doesn’t have options. Nothing is going to change until (potentially) the administration changes next year. If continuity is maintained then the only way out for the United States is a vaccine.

@Trom

What does New Zealand plan to do if, a year from now, there is no vaccine and COVID-19 is endemic in the rest of the world. Continue to isolate from the rest of the world indefinitely?

We will do what we need to do. If that means continuing to isolate? Then yes. Does that exclude the possibility of setting up bubbles with other Covid-free nations? No it does not. We will figure it out. New Zealander overwhelmingly support our present course. Jacinda Arden’s Labour government just got re-elected and they smashed the opposition. I would stop worrying about what is happening here.

What does the United States do if in one years time there isn’t a vaccine? The economy still won’t be able to properly open up, hospitals will still be in danger of being overwhelmed, hundreds of thousands of people will still be dying, many more will be left with life long debilitating illness. I’m much happier being in my non-hypothetical situation than not thank you very much for you asking again.

@Trom

I was responding to your claim that all that had to be done was a lockdown.

Except this wasn’t my claim, this was never my claim, and I really don’t know what you are going on about now. The lockdowns buy time to ramp up testing and the ability to contact trace. It allows the medical system time and space to reinforce PPE, and if you do the lockdown hard enough and for just long enough it gives the country enough time to (epidemiologically) eliminate the virus. I’ve never argued that a lockdown was all you needed.

@Trom

During what other pandemic has the world responded this way?

China and South Korea and many other Asian countries, much of Africa have all responded this way to flus, Sars, ebola, and those countries are doing much better than the ones that haven’t followed the playbook.

@Trom

Again, simply pointing out there isn’t precedent for a worldwide lockdown. Where does the claim that this is the “standard playbook” come from?

You seem to be missing the point. You are lumping in lockdowns with global lockdowns with this being what the “standard playbook” is and I’m not saying that at all.
What I’m actually talking about the measures I’ve talked about a couple of times to you already: early hard lockdowns followed by ramping up testing and contact tracing, social distancing, isolation and masks.

@Trom

I guess I interpreted you as saying once the pandemic hit, there was no choice but to pursue the policies that have since been enacted, implying any adverse effects of policies are the direct result of the pandemic.

If I had intended to say this I would have said it. All I actually said was that the pandemic was the disrupting event. That’s it.

[Voyager]

@tofor

Yes, the economy, society, the big picture. Sure, it would be affected if 2-4% of the folks in the world died, but especially how skewed the effects are toward the elderly if we all just gave a collective meh and went on with our business then I think most of the worldwide economy would be fine. As the pandemic spread, local medical facilities would be overwhelmed temporarily, some people would die, and the survivors could move on.

The problem with this is that if 2 - 4% of the population is dying, none of us knows if we are in this percentage or not. While it is true that the elderly are most at risk, they are hardly the only ones at risk. Way more than 2 - 4% of the population will refrain from putting themselves at risk, which is where the impact on the economy comes from.
And let’s not try to anchor the death rate low. You’re talking 150 million to 300 million dead. Sounds a bit worse that way, doesn’t it?
One thing the US did right (past tense) was the relief package which kept us from medical and economic catastrophe.
I live in the Bay Area, and we have not yet had an uptick. Good weather helps, but both the government and the people are behind protective measures. I’ve yet to see even one person in the supermarket I go to without a mask. We’ve got social pressure working the right way.

[Shalmanese]

@Trom

No, we don’t yet. It’s too early to say over the long term.

There was a study done in New York’s largest hospital system

Patients in the study had a 25.6% chance of dying at the start of the pandemic; they now have a 7.6% chance.

Even when adjusted for age and co-morbidities, these effects still persisted:

Risk adjustment partially attenuated the mortality decline, but adjusted mortality rates in the second-to-last two weeks remained outside the control limits (Figure, Table). The O/E risk of mortality decreased from 1.07 (0.64-1.67) in the first two weeks to 0.39 (0.08-1.12) in the last two weeks.

We’re not going to suddenly forget everything we’ve learned about treating COVID. Even if you take the most pessimistic view of how everyone is doomed to get it eventually, we can already calculate the lives saved by simply shifting the cases from early in the pandemic to late.

@Trom

What’s the end game though? Endless whack-a-mole of open/lockdown?

The “endless whack-a-mole” characterization elides that New Zealand was able to go 101 days without community transmission before their second wave. Vietnam went 99 days, Thailand went 100 days. String a couple of 100 days together, pretty soon, you’re talking about real substantial periods of time before the “endgame”.

Plus, we have real empirical examples of how the impact of each subsequent outbreak can be lessened. China’s gone through so many new outbreaks now that they barely shrug at it. The standard response is to just test everyone in the city, quarantine only those who were close contacts and let everyone else go on with their lives. The most recent two outbreaks both happened in Qingdao, one because two seafood workers got infected by imported frozen food, one because a patient used a CT scanner that had been improperly sanitized after a hotel quarantine case had used it the previous day. The former was caught because food importers are tested on a biweekly schedule and both men were caught while still in the asymptomatic phase and 250K+ testing revealed they didn’t spread it to anyone else. The latter was caught because everyone entering into a hospital has to have a COVID test now and they tested all 9M people in Qingdao to figure out it had spread to 12 other people before they clamped it down.

Once you have the infrastructure in place, this is an eminently manageable public health issue. On July 24th, Australia had 532 new COVID cases, France had 514. On July 30th, Australia had 723 cases and the UK had 763. Australia locked down the state of Victoria and now Australia had 1 new case across the entire country today and Europe is descending into a hellish winter because they refused to believe you could put the infrastructure in place to bring this down to zero.

[SayTwo]

@Voyager

The problem with this is that if 2 - 4% of the population is dying, none of us knows if we are in this percentage or not. While it is true that the elderly are most at risk, they are hardly the only ones at risk. Way more than 2 - 4% of the population will refrain from putting themselves at risk, which is where the impact on the economy comes from.
And let’s not try to anchor the death rate low. You’re talking 150 million to 300 million dead. Sounds a bit worse that way, doesn’t it?

Not necessarily to come down on one side of this or the other, but if I’m not mistaken, deaths from the virus amount to about 10% of deaths from other causes over the same time span. I feel pretty certain that we would largely be unaware, as a population, if each other singular cause of death went up ten percent in a year.

[SayTwo]

@Shalmanese

Once you have the infrastructure in place, this is an eminently manageable public health issue. On July 24th, Australia had 532 new COVID cases, France had 514. On July 30th, Australia had 723 cases and the UK had 763. Australia locked down the state of Victoria and now Australia had 1 new case across the entire country today and Europe is descending into a hellish winter because they refused to believe you could put the infrastructure in place to bring this down to zero.

Trouble is that we are long, long past the point, in most places, where ‘having the infrastructure in place’ is anything more than pie in the sky. It is wonderful, the situations that largely unscathed countries find themselves in. Just as it is horrible, the situations for most of the rest of the world. Australia, as I’m sure you would say, was apparently seeded with a mere fraction of the virus that continental European countries were. And even then, what the state of Victoria suffered through to get their case count where it is now is not something I’d ever to think to call ‘eminently manageable’. The end was evidently achievable, yes, but I dare say that you’d see protests like we’ve not seen in a long while were those same measures to be tried many places else.

[tofor]

@Voyager

Way more than 2 - 4% of the population will refrain from putting themselves at risk, which is where the impact on the economy comes from.

You seem to think you’re disagreeing with me, but this is exactly what I’m trying to say. The economic impact comes almost entirely from our reaction to the virus, not the virus itself or the people it directly affects.

@Voyager

And let’s not try to anchor the death rate low. You’re talking 150 million to 300 million dead. Sounds a bit worse that way, doesn’t it?

Do you think I’m arguing that “everybody ignore the virus” is an approach I’m in favor of? Because I’ve very clearly stated repeatedly that I am not.

@Banquet_Bear

…I think by removing the rock and the road and and the entire circumstances of your death you’ve completely forgotten the point of the original analogy.

I was responding to your new analogy that did not involve a rock.

[MandaJo]

@tofor

You seem to think you’re disagreeing with me, but this is exactly what I’m trying to say. The economic impact comes almost entirely from our reaction to the virus, not the virus itself or the people it directly affects.

Are you proposing we force people to shop? Have massive PR campaigns telling people they are overreacting and it’s just a bad cold? Shut down remote learning options and vigorously prosecute people who don’t send their kids to school?

[tofor]

@MandaJo

Are you proposing we force people to shop? Have massive PR campaigns telling people they are overreacting and it’s just a bad cold? Shut down remote learning options and vigorously prosecute people who don’t send their kids to school?

I’m not proposing or advocating anything. If people choose not to shop, that’s a reaction to the virus causing an economic downturn. All I am saying is that the virus can ONLY cause people to get sick and die. Nearly all the other effects you see are caused by how we react to that sickness and death.

If a teacher dies from COVID-19, her students don’t have a teacher because of COVID-19. If a teacher chooses to retire early due to fear of COVID-19, her students don’t have a teacher because of a reaction to COVID-19. I think this is an important distinction and all I’ve tried to do is point out the difference, and suggest that the vast majority of the effects we see are of the second kind.

[I_Love_Me_Vol.I]

@tofor

The point is we chose the situation as it is, individually and collectively. The only thing the virus can do is make people sick and kill a small number of them (<5%). Everything else is a result of our response. If we had acted differently the current situation could be different. Humans made choices, and we are living with the consequences. It is not helpful to pretend otherwise.

There was never any real choice with regards to expending medical resources to treat people with COVID. In our society when people are injured, sick, and suffering we help them and try to make them well again. Doctors take an oath that would make it, ISTM, all but impossible to ignore people gasping for breath and suffocating in the ER.

I can’t imagine that ever happening outside of a thought-experiment or a dark, dystopian sci-fi novel:

“Faced with a devastating pandemic, the World Council decides to simply ignore the problem and let people die. No effort to mitigate the situation would be made and anyone caught giving aid or comfort to a pandemic victim would be summarily executed.”

[tofor]

@I_Love_Me_Vol.I

I can’t imagine that ever happening outside of a thought-experiment or a dark, dystopian sci-fi novel

Neither can I. I said in my very first post on the subject that the actions causing the disruptions were

@tofor

largely the right actions

but that doesn’t change the fact that it’s those very actions which caused disruptions. I think we need to own up to the costs of our actions where we can, and not hand-wave them away as “caused by the pandemic”. Only when we acknowledge the costs of our actions (even the negative costs of right actions) can we properly evaluate our choices.

[Monocracy]

@Trom

The 1957 and 1968 flus caused deaths on the same order of magnitude as COVID-19 and the world hardly blinked. The Baby Boomers partied through it, and undoubtedly passed disease on to grandmas.

Your second sentence destroys the point you make in the first sentence. The U.S. “partied” through the 1958 flu and only 100,000 Americans died. The U.S. locked down and made reams of social changes for COVID and over 200,000 Americans died. And COVID isn’t over yet, the numbers are still climbing.

If we had “partied” through COVID, the U.S. likely would have seen 2.2 million deaths. There is your order of magnitude.

[Trom]

@Banquet_Bear

…I am 100% confident that nearly every single epidemiologist in the world would agree with me that the United States has fucked up their response to Covid-19.

Yep, so would I. Though, I still can’t agree with your assertion that we objectively know the correct way to deal with this pandemic. It’s literally impossible to know at this point. Yes, we know measures to take that slow the spread of the virus, but we’re at halftime of the game, at best. The costs vs. benefits of various strategies will be the subject of PhD dissertations for the next 20 years+.

@Banquet_Bear

The playbook that worked? Lockdown hard and early, ramp up testing and contact tracing, social distancing, masks, and isolation of those with Covid? What other approach do you suggest?

I’m not denying it worked in some places, like New Zealand. However, “lockdown hard and early” hasn’t worked in a place like Peru. I don’t know what the correct approach should be.

@Banquet_Bear

We will do what we need to do. If that means continuing to isolate? Then yes.

Fair enough. Hole up and wait for the vaccine. Hopefully it works.

@Banquet_Bear

China and South Korea and many other Asian countries, much of Africa have all responded this way to flus, Sars, ebola, and those countries are doing much better than the ones that haven’t followed the playbook.

I guess it’s a matter of degrees, but from my perspective none of those diseases prompted anything like the lockdown response we’ve seen during COVID-19.

@Banquet_Bear

You seem to be missing the point. You are lumping in lockdowns with global lockdowns with this being what the “standard playbook” is and I’m not saying that at all.

Well, that’s simple enough. That’s what I was objecting to.

@Banquet_Bear

If I had intended to say this I would have said it. All I actually said was that the pandemic was the disrupting event. That’s it.

As I said, happy to drop it.

[Trom]

@Monocracy

Your second sentence destroys the point you make in the first sentence. The U.S. “partied” through the 1958 flu and only 100,000 Americans died. The U.S. locked down and made reams of social changes for COVID and over 200,000 Americans died. And COVID isn’t over yet, the numbers are still climbing.

If we had “partied” through COVID, the U.S. likely would have seen 2.2 million deaths. There is your order of magnitude.

Huh? My point was that previous pandemics didn’t elicit the same global lockdown response. I was stating a historical fact. I’m not arguing we should party through COVID-19.

[MandaJo]

But a lot of those actions really aren’t under the control of the policy makers: they have some influence, but not total control. Government action isn’t what is keeping people from economic activity: fear–arguably rational fear–is. You said:

@tofor

Yes, the economy, society, the big picture. Sure, it would be affected if 2-4% of the folks in the world died, but especially how skewed the effects are toward the elderly if we all just gave a collective meh and went on with our business then I think most of the worldwide economy would be fine. As the pandemic spread, local medical facilities would be overwhelmed temporarily, some people would die, and the survivors could move on.

But people don’t like those odds. We aren’t going to give a collective “meh”, because most people aren’t cool with losing 1-2% of the people they care about. So they aren’t going to just ignore the virus and go about their lives. So even in some “hard choices” fantasy where some government decided that was the best thing to do, it wouldn’t work, because people would look around them at hospitals overflowing, funerals adding up, and say “fuck this, I am staying home”. And the economic downturn would come. Saying “Well, that’s not the virus, it’s people being more cautious than I want them to be” is a distinction without a difference.

I mean, to some degree this is like the paradox of thrift: the total damage to the economy might, theoretically, be worse from shutting down than from letting the virus rip through the population. But the damage the virus would cause would not be evenly distributed: a smaller percentage will have devastating loss–either their own life or a loved one–and others will not be personally affected at all. But the benefit, a sounder economy, would be spread across everyone. In that sort of situation (which I am not even convinced this is), a rational individual will err on the side of extreme caution: let someone else take the hit. The cumulative effect of that action is that you never get “herd immunity”, or it takes much much longer, and the economic hit is felt by everyone.

[tofor]

@MandaJo

But a lot of those actions really aren’t under the control of the policy makers

I never suggested that I was talking only about governments or policy makers. I explicitly used the phrase “individually and collectively” when referring to choices and actions which have caused most of the fallout from the pandemic.

Again, I am not advocating any specific change in policy or human behavior.

Nearly every outcome that gets attributed to the pandemic that is not a sick or dead person could have been different if a person or people behaved differently. That is all I am saying.

[MandaJo]

Nearly every action that is a sick or a dead person could have been different if a person or people behaved differently, as well.

I don’t see the value of this distinction.

[tofor]

@MandaJo

I don’t see the value of this distinction.

Because when you say, “The pandemic caused economic shutdowns around the world” you are suggesting that it was inevitable, and that how we react to it is irrelevant. @BanquetBear said

@Banquet_Bear

We haven’t disrupted the system. The pandemic has disrupted the system.

This is not right. We chose individually and collectively to disrupt the system as a reaction to the pandemic. In most cases, that was probably the best option we had, but if we had better options and had taken advantage of them perhaps we could have dealt with the pandemic without “disrupting the system”. Blaming “The Pandemic” allows us to ignore how the choices we made lead to the outcomes we see, and so avoid rationally evaluating those choices.

[Joey_P]

@SayTwo

Well, health officials these days believe a lot of things, and most of the time they turn out to be wrong. Most college campuses are far closer to a ‘vacuum’ than it’s being made out. It’s not like every student stays infectious all semester long. How many people outside of the ‘bubble’ will an average student interact with while he’s infectious? How often do people believe these kids are traveling back home, or to the next town? It’s not how typical college kids spend their typical college days.

Maybe my college experience was different than yours. When I was in college (in Wisconsin), the dorms were a ghost town over the weekends, especially the first few months. Plus, we were constantly going out to eat, going to Walmart/Target, going a few towns over because there was something to do there and we were bored. Then, look at a place like Madison, that entire town is like one giant campus. Students are everywhere, a lot (most? nearly all?) of the houses in the area are rented out to students or owned by teachers. Plus, Madison is just a stones throw from Milwaukee and only a, what, 3 hour drive to either Chicago or the Twin Cities, so a lot of students will head to Milwaukee or Chicago when they have time.

Now, even if every student in the dorms never left the campus, there’s still all the teachers and the other half of the students that don’t live on campus.

[DMC]

@tofor

Nearly every outcome that gets attributed to the pandemic that is not a sick or dead person could have been different if a person or people behaved differently.

Do you think there is a single person in this thread that doesn’t realize that the actual virus itself is not literally stripping grocery stores of toilet paper nor calling people into its office and letting them go because it’s feeling mean today?

We all know that. The language that you seem to have a problem with is fully understood by all parties, apparently even you. If you wish to have a grammatical conversation, there are plenty of categories to choose from. You also said that you aren’t advocating any change in policy or behavior.

So, I have no idea what you’d like for us to take away from your posts in this thread. Would you care to share?

[SayTwo]

I meant that Madison would be the bubble. Or Austin. Or Oxford or Athens. When you guys went out and around, you did so together, right? And - how many days is someone thought to be infectious? And how many of…home to do laundry, next town over 'cause we’re bored, big city on the weekend, and so on can one do on those days? On top of class and work and dates and parties around campus and all the other things they’re busy with most days.