Can someone explain to me why what we are doing isn't overreacting

The Quarantine Zone
1

I’m sure I’ll get a lot of hostility for this but hear me out.

Back when the death rate was considered to be 2-4%, that is a pretty high number. We’re looking at worst case scenario, 60-70% of the human race gets the infection and 2-4% die, that means up to 200 million dead.

A huge number and sheltering in place makes a lot of sense.

But isn’t newer research showing the death rate is closer to 0.5%, possibly even lower? If so, then global death rates would be closer to 25 million. Still a huge number, but about 60 million die each year and most of those 25 million are people who are not far from death anyway.

I think this point is serious because some diseases main and harm young people for life. The spanish flu killed people in their primes due to a cytokine storm. Other infections like smallpox or malaria infect children and either end their lives, or disable them for life. But the coronavirus seems to mostly kill people who have lived their productive years.

Obviously, there are good reasons to take all these precautions. Governments all over the world of a wide range of government types and ideologies are taking this virus seriously and listening to educated experts who say to shelter in place, reduce contact, etc. So obviously, its a very serious issue.

I guess I’m starting to get confused as to why a virus with a 0.5% mortality rating is this big of a deal that we are looking at endless trillions in economic damage and a global depression. The major strain of smallpox had a 30% mortality rate, and I don’t believe they shut society down when they were vaccinating against that disease. a case fatality rate of 0.5% is about on par with malaria, and societies with that don’t shut down. To my knowledge the spanish flu didn’t lead to large scale lockdowns, endless trillions in global debt spending and initiative a global depression and it had a higher death rate.

I know about bending the curve and trying to buy time so we can invent drug regimens, research vaccines, manufacture more PPE, etc. And I know that even though the virus is just starting (it’ll be much much worse in April and May), hospitals are already overrun and running out of PPE.

Again, obviously this is all being done for a good reason because people far more educated than me are calling for it to happen. I’m just confused as to what exactly that reason is if the death rate is far lower than we thought.

TL;DR - why is a disease with a 0.5% or possibly lower mortality rating where most of the deaths are among people who are going to die soon anyway serious enough to warrant all these precautions and shutdowns? Do societies shut down like this over smallpox (before vaccines) or malaria? We could be looking at endless trillions in spending globally on sheltering in place as well as a global depression after this is all over. Obviously people way smarter than me think this is a good idea, I’m just curious if someone can explain it to me in a way that makes sense to me.

2

The death rate isn’t a magic property of the disease. It varies city to city. 0.5% is a best case estimate, if we flatten the curve. Right now in italy it’s more like 10%.

3

Maybe you could share where you are getting your 0.5% figure? Even South Korea is above 1.0% now. I have not heard 0.5% anywhere. If you have something, please post it.

As far as sheltering in place goes, here are some statistics:
March 10 - San Francisco 17 cases, NYC 32
March 24 - San Francisco 152 cases, NYC 14,776

Now NYC has more people in SF, may be denser, but that’s still a wildly different outcome. We are getting wildly different outcomes from locale to locale and it DOES matter how things are handled.

4

Part of your assumptions are possibly incorrect: the mortality rate among younger people may be higher than you suspect.
But I think the answer to your question is: it’s who is dying, and how.
The people dying will be people we know. And some will die because someone chose for someone else to get the last ventilator. This is difficult to accept in our society.
We don’t tend to do straight math on death anyway. We will spend money on digging a kid out of a well which could save a multiple of kids in a famine area.

5

We’re not:

When I used to teach CPR, first aid, and emergency medicine, I always emphasized the reality. I always taught worst-case scenarios, in addition to the standard stuff. I wanted my students know they may break bones during CPR, the victim might vomit into your face, a bad hand position on a female victim could send the wire in her underwire bra go through your hand (or into her!), etc.

The point was to always be prepared for the worst, but hope for the best. But the critical issue was you had a greater chance performing CPR on someone you care about, someone you love, than on a stranger. In order to save a life you have to fall back on your training, A-B-C, 1-2-3, etc., and not allow your emotions to cloud your life-savings.

Because it’s only after the EMTs or paramedics arrive and take over that you realize it was your mother, or your father, or your newborn baby’s life you just saved. Then you can go into a corner, allow your emotions to surface and cry your eyes out. Been there, done that. They all survived.

None of this half-hearted shit on COVID-19. Full-court press. Damn the torpedoes, full speed ahead. Anything less will be a disaster none of us have ever experienced.

6

An ADDITIONAL 25 million deaths isn’t a big deal? That’s more people than were killed in WWI.

7

Well again, how I see it is that resources are finite.

Lets say that in between the deficit spending and global depression, the world loses 100 trillion over the next decade. Hopefully it won’t be nearly that large. Many of those 25 million who die will be past their productive years and will be dead fairly soon anyway.

That has to come from somewhere. Part of it will come from reducing education, or childhood nutrition programs, or renewable energy investments, or R&D and infrastructure spending to build a better world for the next generation. So possibly we are extracting tons of wealth to save the elderly that we could’ve used to raise the next generation of children.

In the UK they use the NICE program to determine if a medical intervention is cost effective. I think its about $50,000 per quality adjusted life year. So if there is a medication that’ll extend your lifespan by 3 months but costs $200,000, the NHS won’t cover it. You can cover a lot of medical care for 200k and the NHS decides its better to spend it on medical care for the young and middle aged and early seniors than to spend it on slightly extending lifespans of terminal patients and the very old.

If this lockdown saves 25 million lives, but it costs 100 trillion dollars, that is 4 million per life saved. Since many of those saved are going to be people past their productive years.

8

You keep making this point about “people past their productive years.” Because fuck them, right? Nothing more than withered husks, those people. I mean, I could see throwing six, maybe seven hundred bucks toward keeping Grandpa upright out of sentimental value, but $4 million??? That’s a full .0001% of the annual U.S. federal budget!!!

9

The higher mortality rates tend to be in places where the medical system is overwhelmed. In order to achieve the 0.5% or even 1%, we would need a scenario where there are only a few people at a time getting sick. When you start having large numbers of ill, including nurses and doctors getting sick, the mortality number seems more like 5 to 10% rather than the 0.5% you mention.

10

Worldwide as of today, we have about 471,000 confirmed cases with 21,200 deaths. That’s a global mortality rate of 4.5% - nine times higher than your estimate. In that worst case scenario, we’re looking at 175 million deaths - I.e, 2% of the entire human race or one in every fifty human beings. In raw numbers, it’s nearly twice the total death count of WWII.

That’s not an acceptable loss.

11

Op, you look for money (in numbers that you make up), to “come from somewhere”. Much, likely most, is just money that just isn’t made when it could’ve been.

12

You’re not alone in asking this question. And you’re also not alone in making the basic mistake of not looking at the costs of not doing anything.

When the entire hospital system has collapsed from sheer numbers and you wind up getting seriously ill from something other than coronavirus will you still be asking this question? What do you think the economic reality will be then? Are you looking forward to an economy with no health care? What’s the price of that? What’s the long-term effect?

Others have recognized that your made-up numbers are silly and totally unrealistic, so I’ll just wonder about something else you said. You talk about the UK and its choices in normal-time. Have you also noticed that the UK has turned totally around and is locking down the country? Why aren’t you asking them what the price of individual lives are? Could it be that something significant has changed since times were normal?

13

This was the point I was going to make as well. With hospitals overwhelmed for a long time, regular health care and emergencies and operations are all going to take a back seat to coronavirus. Break a bone? Appendix acting up? Kid has an ear infection? Elective surgery? Rotten tooth? Heart attack? Stroke? Colonoscopy? Forget about it - the system is fully engaged in keeping coronavirus people alive - you may have to wait or take a back seat or go somewhere else.

14

If all you care about is the money, have you happened to think about what is going to happen to Granny’s savings? Instead of dying peacefully in her sleep, everything she might have left to folks will be spent on her health care. Kids and grandkids who might have enjoyed getting a windfall will just end up with a handful of medical bills to deal with.

Some of those old, unproductive folks are the volunteers who do a whole bunch of scut work that nobody ever notices. The local Lion’s clubs I have known recycle paper to pay for eye care for the poor. I don’t know if you think that having folks help that way is productive, but I do.

Libraries usually have volunteers who accept donations, have book sales and raise money to buy needed books which improves the community. Yeah, I’m sure you think those folks aren’t very productive either.

Hospitals out here and begging for volunteers because all of their very unproductive old folks volunteers are afraid of getting sick so they need other volunteers. Many of the worthless layabouts are sewing masks for their hospital, but are certainly not productive enough to be worth caring about.

Parks, shelters, food banks and more all depend of those unproductive old people.

I know that the coming depression will raise my taxes, but if all of those unproductive old folks die off, my taxes won’t cover the loss of services those worthless old people allow me to enjoy.

15

  1. We don’t know what the mortality rate is. But it seems to be a lot lower in places that took sensible precautions and physical distancing earlier.

  2. Most countries have very limited surge capacity in their emergency rooms and critical care units. This includes staff, equipment, beds and ventilators.

  3. The economic cost is not “endless trillions”. I don’t think it is wrong to ask what the cost is, but it is disingenuous, since the economic costs of ignoring a pandemic are also exceedingly high independent of lives lost. Events would still be cancelled and more would be affected.

  4. One has a choice between overreacting and underreacting. Overreacting is safer, builds system capacity for future problems, promotes research and likely saves lives. But countries like Mexico have not reacted much. So we will see what happens. Things look quite scary in some countries.

  5. The disturbing thing about this is the high contagion rate and the fact healthy men age 30-50 can be severely affected. The comparison to malaria is not apt.

  6. Much remains unknown about this and it is easy to fear the unknown. Is a vaccine possible? Will it come in waves? Can you be reinfected?

16

What kind of person talks of other people as tho they were inanimate objects who’s only purpose is to serve?

17

None of the arguments I’ve read about sacrificing COVID patients to the economic altars take into account that the stock market was really overdue for a correction. Trump may have otherwise artificially kept it going until the November elections - but at some point it was going to down-cycle like it always has. The COVID crisis has likely made it happen sooner, sharper and worse - but from a historical standpoint it was already overdue for a bear market. How much worse COVID will have made it we’ll never really know - but it should be recognized that COVID isn’t the sole contributing factor to the unemployment, retirement fund losses and other financial issues that people will soon be suffering through.
The good news is if people and their governments don’t let 2-5% of the people die - the economy will likely rebound ‘bigly’ within a few years.

18

The confirmed cases is an underestimate of the true number of cases. The only question is whether the true number is only a few times higher, or considerably more than that.

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19

One epidemiologist explained it this way: With a 2% death rate, *everyone *in the US will know someone who died from Covid-19. A grandparent, a colleague, a work buddy, a buddy.

20

I gotta say I think the social distancing and quarantine we did was a good thing but it can’t keep on much longer and maybe it already served its purpose by staggering the amount of people in the hospital or on ventilators hitting the system at once.

But I don’t get the big emergency either the number as of writing this of global deaths is over 21,000 and that’s not anything to sniff at but even if that number doubles, triples, quintuples or more it’s still essentially a drop in the bucket.

In 2018 worldwide something like 140,000 died of measles, over a million deaths from auto accidents, then other accidental deaths, influenza deaths, but those deaths are just static in the background and nobody really freaks out about it. Why is this any different?