We should end the general lock-downs. Now

The Quarantine Zone
61

OP, you asked how great a risk each risk factor, such as obesity, is. The answer so far is “pretty great.” A study published last month which divided subjects into under-60 and over-60 found

Compared to normo- and over-weight groups, the rate of hospitalization increased 2.0 (1.6–2.6; p < 0.0001) and 2.2 (1.7–2.9; p < 0.0001) times in younger patient group with obesity grade I and II, respectively. Moreover, younger group patients with obesity grade I and II had an increased likelihood to receive critical care 1.8 (1.2–2.7; p < 0.006) and 3.6 (2.5–5.3; p < 0.0001) times respectively, compared to normoweight and overweight groups.

Bolding mine. Level I is a BMI of 30-34, Level II is a BMI of 35-39.

I can’t find statistics for how many people between ages 18 and 60 have obesity, but overall, over 33% of US adults are considered obese.

Every study I’ve seen indicates that obesity, even without associated health disorders like diabetes, increases the likelihood of requiring ventilation by around 7 times.

We want to have lots of precise data right now, but with a pandemic this new and with an incredible range of symptoms, severity, and risk factors, conclusive data just isn’t there yet, and we can’t afford to wait until it is.

62

When someone says “Modest Proposal,” you can assume everything that follows is reductio ad absurdum. It’s a reference to an essay Jonathan Swift wrote 1729 about using Irish children as a food source.

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We aren’t saying “Fuck masks.” I am pointing out the attitude of the vocal contingency that demanded we open up earlier than we likely should have. I am mocking that group, not amongst them.

I am this guy.

64

Meanwhile, as the OP bleats for opening up, states that did that are already shutting back down or facing hard choices to do so:

After reopening, restaurants again shutting their doors as coronavirus flares
Summer setback: Cities put brakes on reopening as virus spikes again
Gov. Greg Abbott orders Texas bars to close again and restaurants to reduce to 50% occupancy as coronavirus spreads
Is Ohio close to another shutdown? Local and state leaders weigh in
California urges hard-hit Imperial County to resume shutdown

But really, it’s definitely time to reopen. :roll_eyes:

65

I know. I didn’t mean for it to sound like I was stomping on you. Not completely down with the replying and showing whom you’re replying to. Sorry. :no_mouth:

66

It’s fine. Allowed me to post that hilarious video. :grinning:

67

The annoying thing is that we can probably reopen most of the economy just fine, so long as people keep doing social distancing, wearing masks, and avoiding large gatherings.

Unfortunately, people refuse to wear masks, want to be right on top of eachother, and want to go to big shindigs with lots of people. I would say that it is the fault of these people that we have to slow or even potentially roll back the opening.

I really think that if we had stopped large gatherings and recommended masks and social distancing from January on, we wouldn’t have had to have had any of the more extreme shutdown policies.

I have acted responsibly in my interactions with others not only to help to save lives, but because I don’t want another shutdown. I am still digging my way out of the last one, and another at this time would be catastrophic.

68

The average age of farmers in the USA is over 57 years old.

That’s the average. Quite a lot of us are older than that. Quite a lot of us also have at least one additional risk factor, as do (as others have pointed out) quite a lot of the population of the country.

Yes, we can do a lot of our work from home. No, we can’t do all of it. And quite a lot of us have to work with people who come onto the farm from elsewhere.

Wanna get anything to eat? Locking up all us Old Folks ain’t gonna get you there. And there is, as others have said, a whole lot of other essential work being done by people over 50 with additional risk factors, some even by people over 70; and a great deal more being done by people who live with such a person.

Want to protect me, 69 with three other risk factors, there at my farmers’ market stall, or at the farm supply store replacing a broken tractor part? Put a damn mask on.

And while you’re at it, you’ll be protecting quite a lot of younger people who no, are not invulnerable, either from death or from long-term residual health effects.

And, actually, almost nobody in the USA was ever “locked down”; though I’ll admit to accidentally using the term myself. People still went to the grocery, and the big box stores under the guise of their groceries were still selling everything else. People in the USA who wanted to go outside could go outside – those who had back yards or front yards or acreage more easily than others. Some places in the world had actual lockdowns. Almost nowhere in the USA was among them.

We need financial assistance, obviously, for those out of jobs because they work at places that shouldn’t be open; as well as for those out of jobs or short of hours because the places where they work can’t handle as many customers while providing distancing. We know how to do financial assistance. (The current government may well be unwilling to provide it. That’s a different problem than not knowing how.) We don’t know how to cure covid-19. We know, at this point, only one way to prevent it: which is to keep people from breathing on each other. And you appear to be saying we shouldn’t use that way.

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The numbers for obesity and severe obesity by age group can be found here, table 2. Yes, lots of Americans under 60 are obese. From a low of 33% for males 20 to 39, to peaks of 45% for women 40 to 59.

Unfortunately though the article you linked to does not seem to divide into those over and under 60: the included studies were only for those under 60. Overall we know that those under 60 are as a group at substantially lower risk of severe COVID-19 those over 60 despite a third to nearly a half of them being obese, slightly more of an obesity rate than those over 60.

What I can’t tell from the article, or from any other source I can find, is how big the risk is for an obese younger adult compared to a non-obese healthy older adult. Given that there is more than an order of magnitude difference in fatality rates reported for those under 50 compared to those over 60 (despite if anything more obesity in the younger cohort) one suspects that the best interpretation is less how huge of a risk an obese under 50 year old adult is at, but how extremely small of a risk a normal weight adult that age is at compared to other groups of adults.

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Here is a question. I am convinced that masks, moderate social distancing, limiting indoor crowds and stopping mass gatherings would be enough. Would certainly have been enough if we’d all started that March 1st.

But does that apply places where the hospital system is close to being overwhelmed? Because I am in Dallas, and it’s starting to look pr÷tty fucking scary right now. When the hospitals start to get full, should we go to a more draconian lock down?

Also, to @Deeg, if mask compliance is never going to be better than 50%, do you feel the same way?

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I managed to get three of my neighbors with lost jobs employed at the store I work at. I can’t afford to pay anyone else’s rent, but I can help them into a situation where they can pay their own. I’m afraid that’s about all I can do.

I’ve also been upping my usual monthly donation to my local food pantry. Again, there’s not much more I can do, but I do what I can.

Basically, there is no one good answer for everyone. That’s the nature of a pandemic. It causes pain and suffering on a world-wide scale.

No, we can’t do a full lockdown long term. But opening up to broadly and too soon is also a bad thing. We have to chart a course down the middle somehow.

72

I think it is a mistake to look at just fatality rates. Yes, the young who become seriously ill are not dying at the same rate as the elderly but many are being left with lingering health problems and might have long-term permanent organ damage (we’ll see, as time goes by).

So, yay, a 25 year old might not die, but having long term organ damage is not a desirable outcome, either. We don’t know how much these people are going to be impaired over time, and/or how much they might or might not recover. I think it’s important to look at those figures, too - if you can find them.

73

Yup. I did that in January when my mother broke her hip. I do use sick time to take care of her a few times a month, and burn my own sick leave, but at least they know I’m not slacking off just using sick time. Also I’m a lucky one. Looks like my department has proved that that we work from home just fine. This may be forever for me.

74

Cities that have hospital systems near capacity should have imposed more draconian measures like 7-10 days ago. What you’re seeing now is reflecting infections and spread that occurred in the past. Today’s draconian measures will result in numbers going down 7-14 days from now.

Assuming we absolutely must reopen, if everyone or nearly everyone (let’s say 80-90% of people) were wearing masks, you’d see numbers stabilize in these areas. Making work as remote as possible would also help. We could still probably keep the economy somewhat open if we would really improve in these areas.

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And let’s not forget the costs of treatment. Think about how many people are either uninsured or under-insured, especially now.

Does anyone here have $50,000 to 100,000 they feel comfortable throwing away?

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I am well aware. But here we are. So I am curious if the “let her rip” position is taking places like Texas and Flordia into account.

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To be fair the op is not a “let ‘er rip” suggestion. And per capita new hospitalization rates are not yet rising very high in Texas or Arizona (even if such is reasonably expected to occur following increased case rates in the next week or so).

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Meanwhile, in Texas:

Google Photos

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…this is simply a failure of imagination.

Let’s start from the beginning.

What was the purpose of the general lock-downs?

The purpose was to “flatten the curve.”

Great! Now we’ve flattened the curve, the hospitals didn’t get overwhelmed, now what do we do?

:: silence ::

The lockdowns did their job. The curve (in America) did get flattened. But there have been no specific objectives outside of flattening the curve. So if the objective has been reached, what do you do next?

Open up. Which is where we are now.

Pivoting to a plan to aggressively quarantine just those with the highest risk factors isn’t going to work because it works against the original objective which was to flatten the curve. Covid-19 is already in widespread community spread, aggressively quarantining those with the highest risk factors won’t stop the hospitals getting overwhelmed, it won’t stop doctors and nurses getting sick and getting taken out of action.

I’m a small business owner. About a couple of weeks before we went into lockdown (here in NZ) I had all of my work for the next six months cancel. About a week into lockdown our government announced plans to support small business and sole traders. To apply for (monetary) support all I had to do was fill out a form online. There were five questions. One of them asked for my IRD number. Another question asked for my bank account number, the last question was a statutory declaration that everything I said was true (and it was).

The money was in my bank account a full day before I got the notification that my application had been approved. It was that quick. The government had moved swiftly to remove obstacles for people to apply for benefits and support, it provided wage subsidies to small and large businesses so that they could continue payroll.

This article is paywalled but it is worth the $2.50 it if you want to see the full behind-the-scenes story about how the New Zealand government reacted to Covid-19. (Its part of the series, so read the whole thing if you can)

When we locked down we only had enough supplies for six days of testing. The Prime Minister took a gamble to ramp up testing instead of rationing. Its decisions like this that helped eliminate Covid-19 from NZ and restrict it to our borders. The heroes of this story are the supermarket workers, the cleaners, the hospital workers, the people that stayed home. The low-level civil servant, who normally worked 9-5 Monday to Friday having to effectively reinvent the way that the country worked overnight.

(CONT)

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(CONT)

And that’s the fundamental disconnect that’s going on here. Flattening the curve was always only the first problem to be solved. We bought in the “bubble system” with the goal of locking down for incubation periods. The Level System was literally invented by the Prime Minister in a brainwave, it was passed onto the civil services and the advisors and they figured it out from there, inventing something out-of-nothing in days. The system got rolled out immediately and they quickly moved us through the alert system so that when we hit Level 4 (objectively the toughest lockdown in OECD countries) almost nobody had cause to complain.

But the economy wasn’t ignored. They have been pumping millions of dollars into the system to keep business open, to keep people employed. Not every business was going to survive. But the cash injection gave many a fighting chance.

Social distancing flattened the curve. It starved Covid-19 of new hosts. But the objective then turned to saving lives, and then the possibility of elimination. So testing and tracing got ramped up. We set up a system that wasn’t reliant on an app or any one thing. We did about 10,000 tests yesterday. Thats double what we were doing during lockdown. We have zero cases in community transmission and we are doing that amount of testing.All the cases that we do have are New Zealanders returning home and being quarantined at the borders.

So here’s the fundamental problem with how America is handling this (ignoring the colossal failure and abdication of duty by the Federal Government for just a second.)

You just don’t want to do the work.

You can’t just lockdown for a bit and then hope that Covid-19 is going to go away.

Masks are important: but masks alone aren’t going to be enough.

You can’t prioritise the economy at the expense of peoples lives.

You can’t expect people to lockdown if they can’t afford to live, if they can’t get medical care.

You can’t rely on a “miracle cure”. There isn’t one just around the corner.

And you can’t just aggressively quarantine those with the highest risk factors when that means you also have to aggressive quarantine those that look after them, those that support those that look after them, and ignore the fact the Covid-19 is still in massive community spread.

I can’t believe what I’m hearing coming out from America. I can’t believe that the Federal government only has paid out $1200 to qualifying people, that they actually mailed out cheques and those cheques took weeks or longer to arrive. I can’t believe that the Federal government paid out billions of dollars to businesses, they won’t declare who those businesses are, and everybody has forgotten about that already. They need to be pumping billions of dollars into the economy to help people stay home which will allow States time to ramp up testing/tracing/quarantining to not only “flatten the curve” but to start to stamp out community spread. It isn’t about only doing “one thing.” You’ve got to be doing many different things, and quickly.

(CONT)