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PiemanLK  





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PostPosted: Mon May 04, 2020 5:22 pm    Post subject: Reply with quote

Cabanon wrote:
38 millions sure looks like a big number but how many of those 38 millions would have die anyway either of old age or illness ? How many die each year and how many newborn comes to life ? pretty sure the ratio 1:1. it's all good questions but I'm pretty sure we'll never know the answers for.


Since when has our public health policy been, "well you were gonna die anyways and someone will probably replace you so, best of luck!" ?
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raynebc  





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PostPosted: Mon May 04, 2020 8:10 pm    Post subject: Reply with quote

Most people who died of COVID-19 were already old and/or had significant preexisting conditions. You can't stop people from dying, especially if they are already old or sick. Bringing on a great depression (which also causes suffering and death) can only do so much good for the amount of bad that comes along with it.
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TheLonging  





Joined: 07 Apr 2008
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PostPosted: Tue May 05, 2020 3:01 pm    Post subject: Reply with quote

Cabanon wrote:
38 millions sure looks like a big number but how many of those 38 millions would have die anyway either of old age or illness ? How many die each year and how many newborn comes to life ? pretty sure the ratio 1:1. it's all good questions but I'm pretty sure we'll never know the answers for.


raynebc wrote:
Most people who died of COVID-19 were already old and/or had significant preexisting conditions. You can't stop people from dying, especially if they are already old or sick. Bringing on a great depression (which also causes suffering and death) can only do so much good for the amount of bad that comes along with it.


You really cannot just look at cold numbers for this though, is my point. The actual death toll for COVID is higher than what's being reported for various reasons; this explains why. That combined with no firm data points for mortality rate by age (as again, there's still more to COVID we don't know about and we're still learning about) makes it hard to discuss something like reopening the economy in good faith, considering the amount of human lives that would be lost in order to enable an early opening when we haven't even flattened the curve and are nowhere near the point of doing so yet, a point where we shouldn't be thinking about reopening.

The 38 million figure is a best-of case, taking the world population from last year (and not this year) and using the percentage given in this thread. The reality is that it'd be a lot rougher, and would not negatively impact just us and global perception of the United States, but also negatively impact the rest of the world having to deal with the aggressive spread of the virus globally that reopening here would do. It's hard to get the true fatality rate, but even if you generously assume it's 1% (which is below the number that experts are touting), that's 70 million people, and if you ask me, it's insane to forcibly restart our economy. If you want to solely go by the number touted in NPR for the United States instead of a global fatality rate, that's 18.7 million people; very much not an insignificant number of the population no matter how you look at it.

Yeah, a depression would suck, but so would running the trolly over 19/70 million people just to make an attempt to save the economy, and I'd rather avoid a genocide than live not even comfortably in a running country if it meant killing all those people. Thinking about reopening seems like a capitalist prospect that favors the value of money over the value of human lives, and I'm certainly not about that. One way to look at it if nothing else really convinces you; would you be okay being one of those 19/70 million if it meant reopening? If you value that over your own life, that's your decision I guess.
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PiemanLK  





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PostPosted: Tue May 05, 2020 4:44 pm    Post subject: Reply with quote

raynebc wrote:
Most people who died of COVID-19 were already old and/or had significant preexisting conditions. You can't stop people from dying


Of course you can't stop people from dying, everyone dies eventually, but we do generally make every attempt to stop people from dying right up until the moment they do in fact die (unless they have a DNR of course). Humans didn't survive this long by saying "eh, fuck it, 50 million people gone no big deal, let em die, who needs a smallpox vaccine anyways?"

raynebc wrote:
Bringing on a great depression (which also causes suffering and death) can only do so much good for the amount of bad that comes along with it.


This isn't a choice between "save economy" or "kill economy"; this is a choice between "hurt economy some" or "hurt economy way more" because in case you haven't noticed, millions of dead people are REALLY bad for business. Economic depressions are artificial causes of suffering and death anyways. They are not inevitable, we could prevent them but we choose to let them happen. There's plenty of resources but our choices about how to distribute them are based on participation in an arbitrary system we impose upon ourselves rather than actual need. Imagine being in a restaurant on fire but you still have to pay your check before you can leave. That's the insanity of this situation.
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raynebc  





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PostPosted: Tue May 05, 2020 6:16 pm    Post subject: Reply with quote

The US did flatten the curve, hence States are deciding for themselves whether to ease up on the harsh lock downs. That was the point of the emergency quarantine procedures, not isolating everybody until there was a vaccine. Food supply chains are starting to buckle, and there are many people who depend on food assistance. Things will get much worse if the public can't reliably get food anymore.

Find a better straw man, Pieman. Jobs are real. Peoples' livelihoods are real. The investment of one's life savings in a small business is real. Entire industries are real. Crippling everybody to save the few isn't automatically the best answer.
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inv4der  





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PostPosted: Wed May 06, 2020 3:57 am    Post subject: Reply with quote

maybe this thread is the real disease
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LlamaYip  





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PostPosted: Wed May 06, 2020 3:42 pm    Post subject: Reply with quote

As not exactly a scientist, but rather a teacher of future scientists, I offer my thoughts here in hopes of criticism, conversation and revision. Feel free to dissect any of the ideas here because I feel only somewhat educated with the information, but have had little opportunity to broadcast my thoughts in media aside from the echo chamber of my own head.

TL;DR: there is so much more complexity to the issue then almost anyone is giving credit for and there are hard, necessary decisions approaching that have to be discussed critically.

The national discussion regarding the virus response, like this thread's conversation, lacks necessary nuance in my mind and it is frustrating to see this topic become polarized just as most issues have in this country in the last ten years. I had a fleeting hope that the virus, like terrorism, might be a common enemy and therefore become unifying. However there are too many people, including the president's base and well as his opposition's base, entrenched in their existing schemas of the world which are not reconcilable. The intent of my post is not to make specific comments about either the left or the right (although I am wholly unsatisfied with Trump's leadership and decision making prior to, and during, the pandemic. And I am generally more privy to giving Trump benefit of the doubt than the average SH poster I would imagine).

What I do intend to though, is establish that dichotomizing the response as 'either economy or life' is extremely unhelpful, especially as we go forward later in time. The discussions regarding interpretation of data also lack critical evaluation as well, and I have not seen many approaches to the data aside from 'disregard all the data' or 'this data clearly states this particular conclusion'.

Firstly--I think many of the reopenings happening right now are premature. Reopening businesses, schools and the economy need to have at least multiple non-arbitrary criteria in the testing and positive case areas (I'll talk a little more about that) and careful evaluation about the how well the data suggests those criteria are met. However, I think most (not all) of the reopenings so far are emotional decisions, more 'It's about time' or 'We are sick of this' instead of 'We have judged this re-opening to be prudent because [insert reason here].' Even having a less valid, evidence-based reason for reopening is better than the 'It's time to get back to work' because determining when 'It's time' is completely subjective and blind to what the current risk is. While I substantively agree with the sentiments in this thread that the economy and livelihoods of people are important considerations for re-opening, I do not agree with the framing of most of these sentiments--that the economic needs of the many surpass the lives of the few.

Similarly, though, I agree with the 'caution over ambition' approach in re-opening. The potential mass death that many models currently show is still likely in the case of mass re-opening at this time, has to be avoided. I don't think we can make any re-opening decisions with a clean conscience if there is a significant statistical likelihood of massive outbreak. But to me, when people point this out, the implication most of the time is "Lives always > livelihood" or "staying closed is always the right decision" or "Don't mention economy to me" etc. Even if you internally acknowledge that we have to open eventually, coming to the table by saying something like this full-stop ignores a number of aboslutely essential realities that have to be considered.

Some of the realities that I wish were discussed more are as follows.

1. As time with the economy frozen progresses, livelihood transforms into lives.

I was watching The Big Short and thought about this point when the Brad Pitt character chastises the two young investors for celebrating their option purchase, and states "Don't you guys know that for every 1% rise in unemployment, 40,000 people die? So stop celebrating." And then they get quiet, lol.

First, there has been recent debate about what kind of correlation there is between unemployment and mortality. Recently, there has been literature that suggest that an expansion of economy actually increases mortality, therefore insinuating that joblessness actually decreases mortality. Other literature, however, criticizes this conclusions and uses more micro-analysis to affirm the more traditional view that for every rise in unemployment, there is a correlating expected increase in all-cause mortality for the same population. In my mind, the latter conclusion is a better indicator of what we should expect as time progresses, and most recent number also suggest that minorities are disproportionately affected during times of recession or unemployment from a mortality standpoint.

So there is a delicate balance here. If the viral risk could result in 2,000,000 million deaths in the United States, the second link there suggests that would be a 9% rise** in unemployment sustained over a full year would result in a similar death toll. Now, in my view, this is a massive overestimation, because I think that rate would regress as the percentage increases, and I didn't get too much into the weeds of workforce that is currently working. But.... I just think it is worth illustrating that the sustained effects of suppressing livelihood, eventually, does become life-endangering. We have to be sensitive to this fact and be careful not to allow the cost of solution not to exceed the cost.

How do we go about evaluating this decision? Heck if I know. But I don't see that conversation being had. Also--I am not a fan of quantifying mass amounts of life, and just trying to make a decision based on how many people would die (well, option A we predict 800,000 people would die and option B 760,000 would die so let's go with B for that reason). So I am not advocating for making this a sole criterion. But the economy is not 'just' the economy, and saying 'money is fake but people are real' is kind of reductionist and unhelpful.

2. Regardless of whenever we re-open, a re-spike in positive cases and deaths is inevitable because of the nature of re-opening.

I suppose I would point to data from previous flu epidemics, as well as anecdotal knowledge, to support this particular claim. In my mind there are only to assumptions that have to be true that there would be a re-spike in all re-opening cases.

a. The virus is still present in the population.
b. Re-opening would introduce people to the virus that would not be exposed otherwise.

We could re-open 10 years from now, and both of these statements will be true. So, I think this means that if we decide not to re-opening if there is a re-spike risk, then we would never open because it is GOING to happen. That means the conversation has to shift to, what elements of prudent re-opening procedure need to be introduced to mitigate the re-spike? Also, what time of the year will mitigate re-spike? etc.

3. We lack the data to determine where there is higher risk, and what behaviors have been leading to more positive cases and more deaths.

An anecdotal statement I see on social media frequently from family members of those who have died from coronavirus say something like this. "Wear your mask, practicing social distancing. This virus is NO joke." I have also read sensationalist headlines where, if there is an increase in case or death count in an area where a congregation has occurred or there is a looser shutdown policy, the immediate conclusion is that these two are linked. Here, the thought is that 'These individual cases or big picture cases are directly related to people violating suggestions or looser policies'. However, we do not possess the data to make these conclusions because we do not possess comprehensive demographic data on who is testing positive. How many of these people are violators of SD? How many are essential workers? Are they contracting the virus at home? On public transit? Do these people live in single family homes or are they in apartments? Where is the real risk? When we are able to collect this information, it will be easier for us to identify and attack the areas where the disease is truly spreading, especially in large cities (I live in Chicago and there are so many nuances to the risk presence in this area).

One example of a high-risk area that we know about is nursing homes. I feel confident saying that nursing homes are extremely more risky than say, going for a run without a mask (which I do frequently) but this is only because the death rate has been so incredibly high that we have been forced to turn our attention to nursing homes.

4. A re-spike during flu season is quasi-inevitable.

Relating to #2, and again I will just point to quotations from people like Dr. Fauci. This detail is important to me because I think it affects the timing of our re-opening. Many thing such as colleges project to re-open at the onset of flu season and I wonder if earlier or later re-openings sensitive to the season would be more prudent.

5. A successful vaccine is not guaranteed.

Sobering reality but is a reality. Fauci has dedicated his life's work to eradicating HIV, and great work has been done in this area but there has never been a universally successful vaccine developed. This is to say that, if our criteria for re-opening is to wait for a successful vaccine, then that may never come.

And a few things that are my opinion...

A. The 1918 Spanish Flu pandemic is not analogous to the 2020 coronavirus pandemic.

There were too many externalities affecting the transmission of the virus at this time in the world so I don't think the mega-spike that we saw of the Spanish Flu is as cautionary of a tale as people have cited it to be. The two largest factors are that this was wartime, and hordes of soliders were returning to the country while the virus as in a dormant state. Secondly, data suggests that this virus was especially deadly to that exact demographic (healthy males in their 20's) which is a bizarre detail that is not true of coronavirus (yet). Now, there are smaller-scale stories of re-opening (see: St. Louis, Philadelphia) that are broad cautionary tales which are worth thinking about.

B. The mainstream American media has been unreliable during this time.

Another anecdotal point. Leading stories are rarely reports and usual subjective analyses of the situation from non-doctors and non-scientists. I think that most outlets have cited the CDC only when the prospects have been more pessimistic than usual (CNN, NBC, etc.) or more optimistic than usual or just plain misinterpreted (FOX). The choices for reporting on specific cases clearly are chosen to fit particular narratives about the virus and provide commentary on re-opening. I think broad criticisms of the media are usually unfounded and uninformed but I am making one right now anyways. I have only been able to best depend on information I gather from my friends who are in medicine and my own independent research and number-crunching (I've done a little, and my models aren't too in-depth lol).

C. Individual states have to be allowed to function as individual states because the virus situation is not homogeneous throughout America.

Although this is becoming less true each day, you almost have to consider the epidemic in NYC to be separate from that in the rest of the country because the devastation was on just another order of magnitude from what anything else saw. I have lived in both the North and the South, and my family is from the North while in-laws are from the South. I see people in urban or north areas extremely judgmental of the behavior of people in less affected areas because they perceive this behavior as indifferent to the devastation and risk of the virus. I see people in less affected areas judgmental of the restrictive orders and over-caution of Northerners or urban areas because they look around and don't see much of effect at all. This is one of those situations where both views can be rational, because data suggests that even for areas of similar population density and activity, the death rates vary significantly by region (Florida, Texas, California, Minnesota, compared with Louisiana, Michigan, Illinois, etc.).

D. The U.S. failure to respond to the virus, especially compared to other countries (citing our bulk numbers ) is overstated.

Maybe this opinion is a little more shaky. But I have seen so many people take the position that the U.S. has been the absolute worst in the world, that every step of the way our response as been inadequate, that our numbers prove that people don't take social distancing seriously and we are all to blame. The U.S. is an intentional travel hub in ways that possibly no other country in the world is (we received more inbound flights from Wuhan in late winter than Beijing did, I think) and we were susceptible to the disease as a population coming from multiple hotspots that no other country was. I believe the NYC epidemic was clearly related to travel from Italy. Futhermore, even with all of the testing that we still lack, the country's allocation of testing towards high risk individuals has given us much larger yields of positive tests and frankly I trust our death totals more than other countries (maybe I'm being selective).

Now I'll nuance my idea with this: I still think the response was inadequate. We lacked testing in early phases and the White House's dismissal of important health officials preceding and during the rise of the virus in China and Italy to be alarming and damaging. I just think we shouldn't conclude that America and its citizens collectively are the worst when it comes to the response.[/b]

___________________________

Llama, you're criticizing everyone a lot but do you actually have anything to offer?

Well, for our decision to reopen, I think there are two major criteria that need to be met.

1. A sustained period of time with statistically significant declines of positive cases (not deaths). As far as how long that time is, this needs to be determine by municipality. But a number has to be chosen. 3 weeks maybe? idk .

2. Testing has to be available to large amounts of the population, and there has to be infrastructure in place to perform reliable contact tracing. How much of the population? Again this should be determined by careful analysis.
a. In my opinion, I would add that the testing can be prorated with the level of re-opening at each stage. I won't get too into that right now but I'll come up with some specific ideas.

Lastly.......

Let's talk about specifically HOW to re-open. What to we re-open and what norms do we establish during re-opening? How do we redesign schooling and what criteria should we establish for returning schooling to a previous state? Which business do we categorize as essential and how can we evaluate the needs to re-open on individual bases? Lastly, what is our action plan in response to inevitable re-spikes?

Okay I'm done and my fingers are tired. And I have to write a quiz for my classes this afternoon.

________________________________________________

**EDIT:

How did I calculate 9% employment would predict, with that model, 2,000,000 additional deaths?

The model estimates a 6% increase in mortality for every 1% increase in unemployment. In 2019, there were 2,800,000 deaths in the United States for all reasons, so I just used that figure assumed a compounded 6% rate.

2,800,000 ^ 1.06*n = 4,800,000, when n = about 9.

However, this assumes that 1. the rate compounds, which it might not, it might just be an additive rate (more likely), and 2. I think the 6% increase in mortality refers only to a portion of that 2,800,000 deaths. I'll give an alternative estimate taking that first assumption into question and probably get a more reasonable answer.

6% of 2,800,000 is 168,000

2,000,000 / 168,000 = 12

Therefore, a more reasonable estimate may be that a 12% rise in unemployment, which is astronomical, would be more likely to correspond to an estimated increased mortality of 2 million people in the United States.
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Last edited by LlamaYip on Wed May 06, 2020 5:34 pm; edited 1 time in total
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PiemanLK  





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PostPosted: Wed May 06, 2020 3:51 pm    Post subject: Reply with quote

inv4der wrote:
maybe this thread is the real disease


^
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[quote=''Otend'']Id come up with a long post, but Pieman said what we are all thinking, as usual[/quote]
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Chrisssss  





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PostPosted: Sat May 09, 2020 11:17 pm    Post subject: Reply with quote

I find it weird when I drive around in the UK and see other drivers wearing masks in their cars. Are they protecting themselves from themselves? lol

Also... am I the only one that hates anti-bac? I swear whenever I use a public one way too much comes out and my hands are like a swimming pool.
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raynebc  





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PostPosted: Sun May 10, 2020 10:13 am    Post subject: Reply with quote

If you're driving to multiple places, it's probably easiest to leave the mask on. Every time you handle it you're supposed to sanitize your hands, aren't you?
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blingdomepiece  





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PostPosted: Sun May 10, 2020 1:00 pm    Post subject: Reply with quote

raynebc wrote:
If you're driving to multiple places, it's probably easiest to leave the mask on. Every time you handle it you're supposed to sanitize your hands, aren't you?


Yeah, I think easiest is to just wear the mask for your trip, then take care of cleaning everything up when you get home.
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PiemanLK  





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PostPosted: Sun May 10, 2020 4:30 pm    Post subject: Reply with quote

Chrisssss wrote:
I find it weird when I drive around in the UK and see other drivers wearing masks in their cars. Are they protecting themselves from themselves? lol


If I'm being honest it's really just laziness, I can't be bothered to take it on and off all day
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[quote=''Otend'']Id come up with a long post, but Pieman said what we are all thinking, as usual[/quote]
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LlamaYip  





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PostPosted: Thu May 28, 2020 5:28 pm    Post subject: Reply with quote

The United States just hit 100,000 deaths due to COVID-19. Seeing how much higher it will get is a difficult projection because the rate of new cases is so different in different parts of the country. In Illinois, where I live, we have been seeing about 150 deaths a day for over 6 weeks now, whereas in Oklahoma where my wedding will be, there have only been 300 deaths total. Even adjusted for population is a massive difference in presence of the disease.
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bdawg95  





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PostPosted: Wed Jul 22, 2020 7:35 pm    Post subject: Reply with quote

this thread is full of some atrocious takes, wow. also hi everyone. this pandemic forced me to move out of my apartment in DC and back home to atlanta for four months, which have been nothing short of hellacious in basically every possible sense of that word. but wear your masks and socially distance cause this shit is serious and also if you want to fucking economy to start again we have to control the virus, you dildos
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PiemanLK  





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PostPosted: Thu Jul 23, 2020 4:26 pm    Post subject: Reply with quote

bdawg95 wrote:
this thread is full of some atrocious takes, wow. also hi everyone. this pandemic forced me to move out of my apartment in DC and back home to atlanta for four months, which have been nothing short of hellacious in basically every possible sense of that word. but wear your masks and socially distance cause this shit is serious and also if you want to fucking economy to start again we have to control the virus, you dildos

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