We should end the general lock-downs. Now

I’m going to take a lot of heat for this from Dopers but I think it’s a rational, reasonable position. Until recently I have moderately supported the various lockdowns but that changed when I saw this data on COVID-19 deaths in Massachusetts as reported by the Boston Globe: https://www.boston.com/news/coronavirus/2020/04/27/massachusetts-covid-19-deaths (note: the article was originally from May but it’s updated frequently). I consider the Boston Globe to be a reputable source but if you have a good site that contradicts it I’d love to see it.

Before I give my rationale, lets start with two tragic, incontrovertible facts:

  • Nearly 130k people have died of COVID. This is grandmothers and fathers, siblings, friends, and coworkers. More will continue to die. This sucks.
  • The lockdowns have caused tens of millions of people to lose their jobs, mostly lower-wage and working class; if the lockdowns continue the losses may become permanent. Schools at all levels have been closed, delaying or retarding the education of 50+ millions more. Millennials and Zoomers will be paying taxes on the relief packages for years. This sucks.

Outside of a vaccine, I don’t know of any plan or policy that can reduce both of these catastrophes. Anything that reduces one by a non-trivial amount will raise the other. If we had reacted sooner we might have been able to isolate the infections but we didn’t and nothing will change that now.

Back to the Boston Globe article, there are two stats that stick out to me:

Average age of death: 81
Percentage of deaths with underlying conditions: 98%

There are some caveats (which I’ll get to later) but this data seems to indicate that we can target lockdowns/quarantines to an easily identifiable population, especially with regards to underlying conditions: 98%! So,

  • If you are over 70, stay the fuck home.
  • If you are 50+ with an underlying condition, stay the fuck home.
  • If you live with or work closely with someone in the above two groups, stay the fuck home.
  • If you are not in the above groups, go about your life with moderate precautions: wash your hands, work from home if you can, and wear a fucking mask.

If we aggressively quarantine just those with the highest risk factors we can save jobs and education while largely protecting lives. It’s not perfect and it will probably end up with more deaths than a general lockdown. I think it’s worth it.

Now for the caveats in the data, and there are two:

  • It doesn’t go into details about what are the underlying conditions. If, say, 80% of Americans have an underlying condition then it’s largely a worthless stat.
  • The data is known for roughly half the deaths. It’s possible that the number of deaths without underlying conditions is much higher.

There are still plenty of things to work out, like what to do with students who live with at-risk parents or teachers who are at-risk. In the end, however, I think it’s reasonable to limit the lockdowns to just a smaller population.

No, it it not possible to separate out the at risk population without sending them off to live on an isolated island or something. Epidemiology and populations do not work that way.

< modest proposal>

If it’s simply a matter of economics, then it’s clear that the older population is a net drain on the economy. They add very little, if anything to the GDP of the country. After a certain age, they are not productive. Even before COVID, they used up valuable medical resources that would be more sensibly spent on younger, productive workers.

Really, there should be a measure of how much an older person is productive to the economy of the country, relative to how much it costs to keep them alive. Those that enter negative territory should have all government supports removed. Or if that is too cruel, then they can be offered a quick, painless way out.

For the good of the economy.

</Modest proposal>

That’s pretty much the gist of what this is about; The economy is supreme, and some will have to be sacrificed.

I think there is also the point about controlling the number of people who simultaneously need intensive care. If you can ease lockdown without spread of the virus getting out of control then you can make an argument for doing it. But the reproduction rate (r) is clearly not easily controllable and there is limited hospital capacity for treating patients with covid.

So if you reopen everything you better make sure that you’re not going to let r get much over 1. If it’s over 1 then you’ve got a problem. It hard to achieve this whilst reopening. In most of Western Europe and lots of the US, r is probably between 0.7 and 0.9. In some US states however, such as Florida, r has clearly been allowed to creep back over 1. And very soon the hospitals will be unable to cope and then people start dying in larger numbers.

However shielding particular groups as you suggest is probably one way to help.

Here’s some data on how many people have underlying conditions. Their estimate is 41M in the U.S. between 18-64 years of age, although this doesn’t include cancer patients (for some reason that doesn’t make sense to me).

Among the many flaws in the proposal: as Euphonious_Polemic points out, you can’t just tell those at risk to stay home. People have some level of exposure to the outside world through hospital or elder care, shopping, and other errands that can’t be postponed for a year or two. We can reduce the risk to these people if they are less likely to encounter sick people. But if we let everyone else get exposed, these at-risk people will get sick barring complete (i.e., impossible) isolation.

Second, this idea that the economy would be fine if we weren’t shut down is ludicrous. Restaurants are back open in my area at limited capacity, but I won’t sit down for a dinner inside. I’m not going to jump on a plane for some vacation even if the destination is open. Sure, some people will, but the economy is taking a massive hit even if everything is allowed to remain open.

You know what we need? Some of these “recommendations” to have the actual force of law. My state is in the process opening back up, but the official recommendation is still for anyone who can work from home to do so. Meanwhile, I am asthmatic and over 50, and am married to someone who can work from home quite easily. His employer has informed everyone that they should expect to be working in the office half-time as of July 1, although they have made some pretty half-assed attempts to reduce transmission. As in “nobody will be allowed to use the water cooler, and use of the fridge and microwave will be strongly discouraged.”

When employees inquired what they were supposed to do about food and water, answers were not forthcoming. When employees asked about coordinating use of the very limited number of parking spaces so that people don’t have to take public transportation to the office (at least those employees who have access to cars at all), they were basically told to figure it out among themselves. Luckily we live close enough that Tom Scud can bike to work, weather permitting, but this is Chicago and weather won’t always permit.

My husband’s request to continue working from home, citing my asthma, was met with an ADA accommodation request form, which of course doesn’t apply because a) he is not the one with the medical issue, and b) my medical issue doesn’t affect his ability to perform his job duties at all; he just needs to change where he performs them. (He even offered to pop in if he needs printed materials that aren’t available in electronic form.)

So of course we will jump through the requested hoops, but we shouldn’t have to. And how many other people in similar situations are not going to be able to manage to jump through the hoops? It’s completely stupid to put people at risk for absolutely zero benefit. And the accommodation costs his employer nothing; the only reason it’s even necessary is because management of his employer has a completely outmoded notion of the importance of ass-in-chair. And drives to work every day and has an assigned parking space.

To be fair, this is what the UK has been doing. I’m in the shielding group due to an underlying health condition. The government has offered me free food deliveries and other support should I need it (I don’t so I’m not using it). The government also gave the list of shielding people to supermarkets so they could prioritise those people for deliveries. The set of instructions that I should follow are entirely different to the rest of the country. The government has sent me letters and called me up to check I’m doing okay. Our hospitals here have not been overwhelmed thankfully and I think this policy has helped (though I don’t want to give the government too much credit, they’ve dropped many other balls during this crisis). Shielding vulnerable groups is possible with enough care and thought.

AIUI, if we just forced everyone - and truly, everyone - to wear masks, lockdowns and shutdowns wouldn’t even be needed. We’d successfully cut the infection spread rate down to a tiny fraction of what it is now. And there is no economic loss associated with wearing a facemask.

But for 1/3 of Americans, that regulation (wearing a mask) is somehow anathema.

The CDC says 60% of Americans have an underlying medical condition. That’s about 197 million Americans. I’ve included children because the CDC says kids with underlying health conditions are at higher risk than other kids. Note that some conditions–obesity, kidney, disease, COPD, etc.–DO put people at higher risk and some (pregnancy, smoking, asthma, hypertension, etc.) MAY put people at higher risk. We just don’t have all the numbers yet.

Question: Since the health of a state’s economy is strongly connected to a governor’s chances of reelection, why do you suppose the governors of 43 states ordered lockdowns if it weren’t absolutely necessary?

Out of curiosity, what instructions is the government giving you?

My numbers differ from TroutMan’s.

The CDC site I used, which is current, says this:

“These changes increase the number of people who fall into higher risk groups. An estimated 60 percent of American adults have at least one chronic medical condition. Obesity is one of the most common underlying conditions that increases one’s risk for severe illness – with about 40 percent of U.S. adults having obesity.”

Yeah, my cite was from April, so I’m sure they’ve added more risk conditions as they’ve learned more. Also, the 41M I quoted excludes those 65 and older, since the OP was already classifying them all as at-risk.

It is worth noting that death is not the only thing that can happen to you. There are too many reports of permanent organ damage – not just lungs but apparently virtually any organ, including the brain, in survivors, to make this a non-negligible risk. Many originally perfectly healthy young people.

The old and sick may die, but the young and hearty might just live with their bodies irreparably damaged.

I said this in another thread, but we’re a long way off from herd immunity.

Nationwide I’d wager (at best) that 10% of the population are walking around with Covid antibodies. Boston specifically was harder hit than a lot of places, and in mid-may they were at 10%.

If the majority of people need to get covid to reach herd immunity (say 60%+ as some experts suggest), then we’re talking about what we’ve already gone through… 5 more times. That’s a possible 500,000 more people lost to covid (if we don’t suffer hospital overruns that make it worse).

Until we reach herd immunity, any sort of “old and unhealthy people only” lockdown is futile given the fact that symptoms don’t present while you’re initially contagious. Hell, we can’t even get people to go out while wearing masks.

If we can’t figure out how to support each other through a failing pandemic economy and instead need to sacrifice half a million people… then I think we’ve utterly failed at the general concept of society.

My first letter was four pages long but the key bits were as follows:

The safest course of action is for you to stay at home at all times and avoid all face-to-face contact until the end of June, except from carers and healthcare workers who must see you as part of your medical care

If you are in touch with friends, family or a support network in your community who can support you to get food and medicine follow the advice in this letter. If you do not… [gives contact details]

It ends with advice on looking after my mental health.

Last week I got a new letter telling me the advice will change from 6th July:

  • you may, if you wish, meet in a group of up to 6 people outdoors, including people from different households, while maintaining strict social distancing;

  • you no longer need to observe social distancing with other members of your household;

  • in line with the wider guidance for single adult households in the general population, you may from this date, if you wish, also form a ‘support bubble’ with one other household. All those in a support bubble will be able to spend time together inside each other’s homes, including overnight, without needing to socially distance.

Then there’s further advice that says from 1 August you can go back to work if you cannot work from home and the business of COVID-safe. You can shop, go toplaces of worship and exercise whilst maintaining social distancing. And to remain cautious.

Have your husband apply for FMLA.

~VOW

Since I’m one of the old, useless folks, you want me to hurry up and die.

That’s quite “immodest” to me. I don’t want to die now.

Throughout my productive, working years, part of my paycheck went for retirement and Social Security. That is MY money. I want to live out my Golden Years enjoying my friends, my family, my home and my money.

Go find someone else to sacrifice on your altar of modest proposal.

~VOW

First we are going to jump through the hoops of providing the letter from my doctor that arrived today, advising that I (and by extension he) self-isolate. Hopefully that will work. I am not working right now either (for totally unrelated health reasons), so it would be nice not to blow through all our savings even faster than we already are. His paycheck basically covers the mortgage and adding me to his health insurance (his employer doesn’t subsidize dependents at all, so it’s pretty damn expensive), but that’s about it.

I think you misunderstood. His “modest proposal” is a satire based on Jonathan Swift’s satire whereby it’s recommended that we eat people. Read what he wrote AFTER the modest proposal. (At least that’s how I interpreted it.)

FMLA is like a big, stretchy rubberband. It can be used for many things! The fact that YOU must self-quarantine means that your husband has to do the shopping and errand-running. And that falls under FMLA!

~VOW

I think wearing a mask is a good idea, but I don’t think it’s as effective as this post implies.