The more granular we can get with risk assessment the better obviously, but meaningful population based decisions can, in fact will always, be made without such being so certain. Broad categories of relative risk is the best that can ever be hoped for, with the best efforts possible made to make them a bit less broad as more is known. Certain? Certainly not.
Let’s go with the idea of “limiting public gatherings and contact” … you I am sure appreciate that that is not a yes/no thing. Which sorts of gatherings by which populations of what size, and what sort of contacts are riskiest? Which ones least risky? Which ones restricted in which ways cause the most harms by limiting and which ones fairly little?
Start at one end - adequate PPE with adequate training and oversight for HCWs in nursing homes, frequent testing of those providers, and other high attention to protecting that population in ways that allow for some safe social contacts, is relatively low cost and big pay-off. Providing strict guidance for known super spreader event type activities (crowded social circumstances inclusive of funerals, weddings, bars, religious services) … a significant spiritual and maybe to some degree quality of life cost but not as huge of an economic cost and a big benefit to reducing spread.
Go to the other - prohibiting small group daycare with a consistent set of children and providers, preventing in person education for elementary students also in cohorted (limited exposure) classes, are both a big cost, to the children, to their parents, and to the economy, with risk reduction avoided not demonstrated to be bigger than a regular winter infectious disease season entails. Stores and manufacturing open with rules on social distancing and capacity as the risks of the space require - huge benefit to opening up with relatively low risk. Perhaps more frequent targeted testing of front facing staff?
Surveillance in general sufficient to identify increases if rates before they show up as hospital rates increasing dramatically. Again, exact parameters to be decided but keeping well below capacity for hospital and ICU beds, enough that regular hospital business can be done and still have room to flex for a surge, but accepting that the zero is not the goal.
There’s a simple test for this. Do we shut the country down every year for the flu season? The answer is no. Just wave goodbye to 60,000 people who died needlessly because we didn’t shelter in place at the expense of other people’s livelihood.
Readers of this thread, and particularly the Original Poster, might find this articleinteresting -
It looks at the cost-benefit calculations for the pandemic. Its based on Australia, so not sure exactly how it would scale up for the US, but the broad structure of the cost-benefit calculation should be directly applicable between a hard lock-down versus a vague herd immunity approach.
As presented, it calculates the cost of the shut down to Australia, which went relatively early and hard as about AU$90 Billion nett costs. Like other places we are starting to emerge from lock-down but are, I suspect, in a much better place with a solid testing and contact tracing system operating and only 98 deaths to date, than many other countries which seem to be doing a Trumpian ‘maybe it will just go away’ and hope for the best response.
The cost of not having done this, and hoping that herd immunity would develop through broad infection, as an alternative was calculated at AU$1.1 Trillion, mainly composed of the cost of deaths within the population.
One thing to note is that its based on an actuarial cost per life as AU$4.9M (this is roughly U$3.15M). The figure used in the US is three times as much [US$10M], and an explanatory link is provided for info on that.
While this is a comparison between actual hard-early response and a do nothing much alternative, I think the cost progression is not linear and even. Once you miss or dilute the early lock-down, the costs rapidly rise towards the full amount, while also having the financial subsidy and lost production component included. If you lived somewhere like Michigan, you’d have to add a component for reduced economic activity due to continued uncertainty and risk of flare-ups because the virus was not properly suppressed (you may ask why socialismophobic armed morons seem happy to socialise the costs of their stupidity among the community).
I took a university class in mathematical modelling years ago. Some of the variables can be fuzzy - limited to a defined range. But if there are a lot of fuzzy variables, the model is not worth much.
There are lots of ways to look at life, and I was going to discuss QALYs and insurance statistics. But this does not solve the problem of bad data. The estimates of problems by age cohort may not apply to future pandemics - they are different. And it isn’t clear that things for the same bug will remain the same, or be the same in different countries or places. So well you could come up with a system, it may be less useful than you think.
What makes you think “Most of the outbreaks once past a base level for herd immunity will likely take place in children whop show little ill effects from it”? Do you have a cite for that? If not, please explain the scientific basis for this assumption.
As for our limited resources, we’re all aware of that. What I’m not sure you grasp is that the inescapably horrible economic consequences are WORSE if we open too early.
TL;DR: You want to limit the economic devastation? DON’T push for reopening so soon.
A minor comment nelliebly - no one is out there arguing to open up things “too soon.” It is a question of who is convinced what is “too soon” (and/or “too much”) and a pushback against the mindset in some quarters that anything other than all standing completely still is too soon coupled with an apparent denial of the global harms (many deaths included) caused by going “too slow”.
Of course the problem is that no one knows what the Goldilockian “just right” is, and there is not even broad agreement over what it would look like. There was broad consensus regarding “flatten the curve” with even some understanding by many what that meant (not eradication but stretching the curve out over time so that systems were not overwhelmed). The consensus breaks down when the goal becomes eradication or bust coupled with no appreciation of what that “bust” really means.
So agreed by all: each state and locality should open up “just right.”