The price of all this crap

[D5CAV]

I am not saying this is not serious, but one can over react to serious things as well. There is a cost to what we are doing, a cost that was also include lives. Many of the things we are doing are good and worthwhile, while others have tremendous cost for marginal benefit. BTW, some of those costs will also end up in people being dead.

There is no reason to ever NOT do a cost/benefit analysis. The more serious the situation, the more important it is.

Also, keep in mind that point of all of this isolation is to "flatten the curve", but the area under the curve stays the same, in other words the same number of people will get it either way. There is value in doing that, but it is not infinitely valuable.

I work a lot with China. The CCP is not exactly a group that is sensitive to people's "feelings". CCP also downplayed the virus in it's early stages. I knew it was serious when I saw what China did over 2 months ago. They not only shut down the City of Wuhan, they shut down the entire Hubei province.

To put this in perspective, Wuhan is called "The Chicago of China". Hubei, together with Hunan, are the agricultural and industrial heartland of China and Wuhan is the biggest city in that heartland. Chinese provinces are much larger than US States. Think of the US shutting down Chicago along with the entirety of Illinois, Indiana, Michigan and Wisconsin.

I am certain someone in the CCP did a "cost/benefit" analysis with data that they were not sharing. The numbers that were being published did not match the "cost" that was being self-inflicted on China. This told me 2 months ago that COVID-19 is a lot more serious than the CCP was letting-on, and anyone in the western media was taking it. I told many of my friends to plan accordingly. Did anyone take my advice? Crickets...

Regarding "flatten the curve", a quick run through of the numbers:

1. R is about 4 to 6, and is communicable with asymptomatic carriers (one person infects 4 to 6 others)
2. Recovery time is about 4 weeks (not 3 days in hospital bed)
3. Mortality rate is probably going to be about 1% once all the data is in
4. Persistence on surfaces is about 4 days
5. May be airborne

For comparison:
1. R of regular flu is about 1, and requires symptoms (1 person infects 1 other person on average, doesn't spread as fast)
2. Recovery time is about 1 to 2 weeks
3. Mortality rate is less than 0.1%
4. Persistence on surfaces is less than 1 day
5. Airborne

This is not regular flu and not SARS and not MERS. SARS had a mortality rate of 10%, but was only communicable with symptomatic carriers, so had a much lower R number. MERS had a mortality rate of 30%, but you could only get it from camels, it wasn't human-to-human communicable (R was effectively 0 unless you ride camels).

Mortality rates of 2% to 4% are being thrown around based on data coming out of affected countries, however, I think this is due to under-counting of actual infected people. Countries like Korea which is testing everyone is coming up with many people who are infected, but have mild or no symptoms, so their infection rate looks higher and their mortality rate looks lower, about 1%. Many countries that are not testing are showing higher mortality rates because only those who show up with serious symptoms at hospital are tested.

However, this is the problem. US has fewer hospital beds per person than China, and China has fewer hospital beds per person than Korea. Korea was able to bring this under control with fewer restrictions because their medical system hasn't been overwhelmed. China had to shut down.

Yes, everyone will eventually get this. Maybe you will die (maybe as high as 1%). However, if we overwhelm the medical system, that mortality rate will be much higher - maybe 5%, maybe more. People who may have recovered with some medical care won't get it, and will die. If you can delay when you get this, maybe better.

Why is "flattening the curve" so important? To smooth the flow of patients into our hospital system. Imagine being taken to the medical tent on Omaha Beach on D-Day with a gunshot wound to the torso; some medic will put a tag on your toe, give you some morphine, and let you die. If you get a gunshot wound to the torso on a Saturday night in Chicago, you have a pretty good chance of survival because even in Chicago, only 3 or 4 gunshot wounds show up at a major hospital ER on a Saturday night. Yes, total number of people shot in Chicago over the past century probably adds up to Omaha Beach, but that was over a century vs. a day. That's what it means to "flatten the curve."

[Vonz90]

....Yes, everyone will eventually get this. Maybe you will die (maybe as high as 1%). However, if we overwhelm the medical system, that mortality rate will be much higher - maybe 5%, maybe more. People who may have recovered with some medical care won't get it, and will die. If you can delay when you get this, maybe better.

Why is "flattening the curve" so important? To smooth the flow of patients into our hospital system. Imagine being taken to the medical tent on Omaha Beach on D-Day with a gunshot wound to the torso; some medic will put a tag on your toe, give you some morphine, and let you die. If you get a gunshot wound to the torso on a Saturday night in Chicago, you have a pretty good chance of survival because even in Chicago, only 3 or 4 gunshot wounds show up at a major hospital ER on a Saturday night. Yes, total number of people shot in Chicago over the past century probably adds up to Omaha Beach, but that was over a century vs. a day. That's what it means to "flatten the curve."

D5CAV,

You do a nice job of laying out the worst case scenario, however, I think you miss a few points.

First off relative to China, we know that they went from hiding it, to going full to the hilt isolation, to backing way off and getting people back to work with modified restrictions. So, assuming that they are not being straight with answers and data, but judging by their actions; it suggests after initially reacting very strongly they decided that the restrictions were overboard and backed off. There may be another explanation, but that fits that data.

Secondly, you are assuming that the alternative course is to do nothing. While there are a couple people advocating that, I do not think too many people are taking them seriously. Many of the actions we are doing do make sense (social distancing, limiting travel, closing schools, working from home, eliminating mass groups) - but while there is a cost to them, none of them shut down the whole economy. They are certainly not business as usual, as we do not do any of these things for even an extraordinary flu season. I would add, we should doing extraordinary things for those who are most vulnerable in terms of isolating and taking care of them. The advantage of such a course is that it is maximizes the benefit for those who need it the most, and if in fact this goes on for months and months as some contend, it is sustainable. Shutting down the economy is very much not sustainable.

Also, it is going to be hard to correlate fatality rates between countries because the variance is huge anyway (the .1% number you give is typical for the US for the normal flu, but some countries have fatality rates over 10% for the annual flu.) Like the epidemiologist from Stanford that I linked above pointed out, the current data set could support a fatality rate anywhere between .05% to 2% because it is so small. Country to country for COVID-19 shows from .3% (Germany) to well over 10% (Iran); so how competent a country's medical system is makes a difference and there are most likely cultural and possibly genetic factors too.

The only way a maximum shutdown makes sense is if it is to buy time for additional data and adjustments in action plans (again, not the path I would go, but there is an argument). It is not encouraging that most anyone mentioning this in the media is being attacked.

Oh well, interesting times.

[HTRN]

Also, it is going to be hard to correlate fatality rates between countries because the variance is huge anyway (the .1% number you give is typical for the US for the normal flu, but some countries have fatality rates over 10% for the annual flu.) Like the epidemiologist from Stanford that I linked above pointed out, the current data set could support a fatality rate anywhere between .05% to 2% because it is so small. Country to country for COVID-19 shows from .3% (Germany) to well over 10% (Iran); so how competent a country's medical system is makes a difference and there are most likely cultural and possibly genetic factors too.

Germany is rising. You might want to note that boyh the UK and France have higher fatality rates than either the US or Canada, but then the virus started their earlier. Italy and San Marino now have the highest fatality rates.

https://www.cebm.net/global-covid-19-ca ... ity-rates/

And the US deathcount is now 508, correction, 512.

[scipioafricanus]

I forget who said it, but the reaction by the leaders that are the main target group for this might have a bias.

[toad]

If it is a worst case serious , what are we going to do with all the widows and orphans ?

[Vonz90]

If it is a worst case serious , what are we going to do with all the widows and orphans ?

Since the major demographic of those dying is over 70, probably not a huge problem, or at least not more than it is typically.

[toad]

I just turned 76 and I have stents in my heart , high blood pressure , Sleep Apnea, and a shitty attitude. The apartment management is delivering a fever thermometer to me. ....If only the good die young I'll probably go on for another 10 years.

[D5CAV]

D5CAV,

You do a nice job of laying out the worst case scenario, however, I think you miss a few points.

Not my worst case scenario.

1% fatalities over the next 24 months, if we manage to "flatten the curve", is less than the 1918 influenza pandemic.

I'm not at a high enough pay-grade to have access to information beyond what is being talked on sites like this, so I can't say if what is being done is too much or not enough

Frankly, even if I was on Trump's, Xi's or Putin's cabinet with access to all the classified intel, I'm not sure I could definitively say what is too much or not enough.

For sure these are interesting times. I think what comes out of Washington, DC, Beijing, Brussels, and Moscow over the next few months will prove to be more dangerous to our long-term survival than a virus. Those guys might be good for more than a couple % fatalities. Be prepared to see "common sense" restrictions on more Amendments than just the 2nd.

Remember the quote from the former Mayor of Chicago "Never let a crisis go to waste." For sure there are many well-intentioned and bad-intentioned legislators who are eager to use this crisis to "get things done for our good" and "Temporary" legislation never goes away.

Keep your tomahawk sharp, your musket well oiled and your powder dry.

[Precision]

Also, it is going to be hard to correlate fatality rates between countries because the variance is huge anyway (the .1% number you give is typical for the US for the normal flu, but some countries have fatality rates over 10% for the annual flu.) Like the epidemiologist from Stanford that I linked above pointed out, the current data set could support a fatality rate anywhere between .05% to 2% because it is so small. Country to country for COVID-19 shows from .3% (Germany) to well over 10% (Iran); so how competent a country's medical system is makes a difference and there are most likely cultural and possibly genetic factors too.

Germany is rising. You might want to note that boyh the UK and France have higher fatality rates than either the US or Canada, but then the virus started their earlier. Italy and San Marino now have the highest fatality rates.

https://www.cebm.net/global-covid-19-ca ... ity-rates/

And the US deathcount is now 508, correction, 512.

Italy is counting all people infected with Covid-19 that die as being Covid deaths, when in fact most already had n stage pnuemonia, terminal cancer, COPD or many other things. 12% of those reported likely would not have died without Covid, The rest were just waiting for a gentle breeze to push them over the edge.

No offense to those amount the 512 and their families, but Diahreah has killed more than that this year in the US. Communitistic policies enacted, depression from isolation, money woes and a host of other things caused by the overe reaction will kill more than Covid. And that is before I discuss CIVIL RIGHTS violations and semi permanent losses, due to not wasting a mostly manufactured crisis.

[Vonz90]

D5CAV,

You do a nice job of laying out the worst case scenario, however, I think you miss a few points.

Not my worst case scenario.

1% fatalities over the next 24 months, if we manage to "flatten the curve", is less than the 1918 influenza pandemic.

I'm not at a high enough pay-grade to have access to information beyond what is being talked on sites like this, so I can't say if what is being done is too much or not enough

Frankly, even if I was on Trump's, Xi's or Putin's cabinet with access to all the classified intel, I'm not sure I could definitively say what is too much or not enough.

A common error of expertise is that they can extrapolate from known data and predict the future. They actually are not any better at that than anyone else.

Even the simulation (which can be very accurate in some situations) can be way off depending on biases involved setting them up.

The numbers say what they say, with a very wide range. The numbers you are using are on the extreme edge of that. It could happen, and I could win PB, but it is not the way to bet.