Neither of these is a final or accurate number: many of the current cases will progress to death, and many who have been (or are) infected have not been tested (e.g. because they were asymptomatic or had only minor symptoms).
Here’s a more careful attempt to determine the numbers for Wuhan (published today) which results in numbers substantially lower (though still scary) than those suggested by the WHO previously https://www.nature.com/articles/s41591-020-0822-7
Source: https://www.wsj.com/articles/italys-virus-death-toll-on-the-...
For the record, on the Diamond Princess (with everybody tested) the number of asymptomatic case was 60% with more than 1% death rate with Japanese healthcare (not overloaded). You can't generalize on these figures either for many reasons but thats's still a strong warning.
# Italian deaths / Italian cases = percentage dead [1]
2_978 / 35_713 = 0.0833870019
# USA population * percentage dead = USA death scenario [2]
329_414_824 * 0.0833870019 = 27_468_914
It's prob not gonna get that bad, but Italy didn't see a scenario where people would die at a rate over 8%. So there's a scenario. Don't panic, but also don't dismiss scenarios you'd rather not believe. Americans who get laid off lose access to cheap healthcare, and many as already don't have it. Lack of healthcare doesn't sound like a great a situation.
[1] Source: Coronavirus disease (COVID-2019) situation reports # 59 for March 19
No need to make already awful numbers into lies by multiplying by 7.
Stats from Italy are going to be heavily skewed towards fatalities for a number of reasons that have been documented by epidemiologists.
And regardless, it would be very, very bad. If it's only 5M people instead of 15M, that's still catastrophic. Also while the hospitals are completely overwhelmed with COVID-19, people will die of other things that would normally be survivable.
And finally, we have an alternative: keep employing distancing and, where necessary, lockdown measures while scaling up testing. These lockdowns will get the cases under control, but they would flare back up as soon as they're ended. However, with the expanded testing, we can instead perform sufficient testing across the entire population to catch outbreaks before they start. With sufficient testing, things can go back to normal while remaining confident that we're not spreading the virus undetected and seeding a new outbreak. It needs to be orders of magnitude more than we have now, but it's entirely possible.
Wealthy people have power.
It takes time to accrue wealth, most wealthy people are old.
Coronavirus kills 10% of 80+, and 5% of all 65+.
Old people vote.
If the hospital systems are overwhelmed because we don't flatten the curve, those percentages likely double or triple.
Look at how much we've learned about treating this virus in the 3-ish months we've been paying it the attention it deserves. If we slow it for another month, maybe these percentages could be cut in half.
You should find the actuarial tables and life expectancies for an 80 year old. It ain’t sunshine and rainbows.
Every year nearly 3 million people die in the US already.
https://www.cdc.gov/nchs/fastats/deaths.htm
Are you saying we experience the worst catastrophe year in and year out?
The hyperbole and exaggerated fearmongering over coronavirus is something to keep an eye out for. Also, if everyone gets infected, it likely means that the virus is far less deadly than you assume and the death rate is far lower than 1%. Think about it rather than cherrypicking data to push an agenda.
People who are elderly or have health conditions that put them at high risk could isolate themselves for the next several months while the virus makes its way through the population. When enough people get it, herd immunity will develop and then those people will be protected. High risk individuals have a personal responsibility to isolate and protect themselves.
I don't know if this is just my community, but I went to the store (out of necessity) twice during the past week or so... and both times it was filled with elderly individuals. It very much made me feel like we were all sacrificing so that the elderly didn't have to.
It seems like their current plan is to do what everyone else is doing, after wasting a lot of time.
What people don't seem to get is that this was best-practice even before COVID-19. Influenza also disproportionately affects people with high-risk health profiles and there are millions of cases in the US every year, already, with thousands to tens of thousands of deaths.
For teachers in OECD countries I found this chart: https://4cdn.hu/kraken/image/upload/s--n8f4dn-h--/c_limit,w_...
For GPs in Hungary I found this: https://4cdn.hu/kraken/image/upload/s--HqWJo4dH--/7Qfxe7y7fM...
In the UK and Colombia (and maybe elsewhere) there are mandatory quarantines only for the elderly. I can see this being tried in other Western nations if blanket quarantines go on too long.
What if we all shelter in place but hospitals end up overwhelmed anyway? That seems like a real possibility and it kind of makes the argument irrelevant.
If we didn’t “flatten the curve” enough to get the imaginary hump below the imaginary dotted line, then the benefits of “shelter in place” are going to end up being a lot less valuable.
There aren't just two modes: Hospitals OK and Hospitals Overwhelmed. The idea behind flattening the curve is to reduce the burden on the hospitals to whatever degree is possible. How is it "irrelevant" if a hospital is 200% over capacity versus 500% over capacity? The people who would die in the worst-case scenario but not in the "flattened" scenario would probably think it is extremely relevant.
Otherwise, what on earth is the strategy? Flatten the curve only to have an explosion later?
I had no idea they had audited the age of the bankers who caused that mess. Only one I'm aware of was https://en.wikipedia.org/wiki/Nick_Leeson who brought down an entire bank at the age of 25.
As for your darwinistic-eugenics as an old person, sure I'm happy with that, but the question is - would you be happy with that when your older and somebody else's kids suggests the same thing. Not that easy to answer.
But whatever age people are, the penchant to begrudge the age groups above them to varying degrees and reasons tends to be strong, at least until they reach their 40's. At least that is what I have observed from many years of experience of many age ranges.
> In an ideal world we would not need to make choices like this, but the choice is real and we can't fumble it.
I suspect the film Logan's Run would be worth a watch if you have not seen it. https://www.imdb.com/title/tt0074812/
Oh I'd also add, we have not seen results of sterility post infection - that data might change your perspective if we end up finding out that the chances of becoming sterile due to infection of this are high. Which is still an unknown and not to be ruled out.
Still, once you put a price upon a life, you find yourself more open to other equations in which you have that variable and then you start reducing the value of that variable. It's a slippery slope.
The decisions we make now will affect everyone, not just those who die.
My point is that we can't avoid the trade-offs. We cannot pretend that saving the lives of sick people does not affect other lives.
Our society is not having that discussion, but is focused on saving as many lives as possible. Not enough attention is being paid to the other side of that trade-off.
What is an economy, the generation and circulation of money. Then offset with humans and they reproduce and circulate.
However, whilst not all economic aspects are equal, human life is. Hence you will see essential aspects of the economy maintained and less essential will either ride it out, evolve or expire - including what may well be, older businesses as well as young ones.
let us not forget, some businesses are very dynamic and volatile at the best of times, restaurants being the classic example. Casualties of human life and economic are inevitable and with that, each country has a different plan, though mostly stimulus and loans.
However, fear has and will do more damage to the economy than this virus and if you do not have shutdowns, that fear will only rise - so yes it is a fine balance with much minutia.
Save the lives! Deal with the paperwork later.
Generally speaking: health insurers will prefer to pay for procedures for those who will get the most benefit from them.
Health insurers are hugely part of the problem in America and should not be looked up to, as an example for how to behave in a crisis.
Other countries have figured it out how to take care of each other as a decent society.
Ultimately, there is a trade-off to be made between how much we use to save a life vs improving the quality of everyone else's life.
The EPA puts the cost of a life at $10 million [0]. Juries put it at $2.2 million, apparently [0].
But, of course, not all lives are (statistically) as valuable. A 65 year old might have 20 years of life left. A newborn has 80+ years. An 80 year old has a 4% (and rapidly increasing) chance of dying per year. [1]
Should we spend more to save an infant than an old person? I'd say we should because we're saving more units of life-years.
So to save 1 million people, we should spend how much, exactly?
If we go by the EPA, $10 trillion. If we go by juries, $2.2 trillion.
US GDP is $21.44 trillion to give a sense of the magnitude of the cost. The EPA estimate would entail asking the US to spend the equivalent of half its output or 12.5% of the entire world's output.
If it's 1 million 65 year olds, and life expectancy is 80 years, how much should we spend? A 65-year old has lived 80% of their life. Should we spend only 20%, then?
That'd be $2 trillion under the EPA estimate.$444 billion if we go by juries.
I have no idea if we should provide that sort of discount, honestly, but it's definitely worth thinking about in an era of intense economic impact to (primarily, but not exclusively) save members of that demographic.
The stimulus packages the US government is considering are within striking distance of these discounted numbers at $1.5 trillion or so depending on what passes.
And that stimulus doesn't come close to covering the full impact, either.
The S&P 500 market cap, only a portion of the immediately measurable economic impact, has dropped by ~$2.2 trillion over the last month. [2]
That plus the stimulus is putting us at $3.7 trillion, well over the discounted value of saving a million 65 year olds.
We have other measurements to consult, and we're not even getting started.
The total US stock market cap is 109% of GDP. It was 158% a month ago. [3]
That's a $10 trillion drop. I think the market was overheated, but coronavirus is a huge portion of that drop.
[0] https://www.bloomberg.com/graphics/2017-value-of-life/
[1] https://www.irs.gov/pub/irs-drop/n-19-26.pdf
[2] https://ycharts.com/indicators/sp_500_market_cap
[3] https://ycharts.com/indicators/us_total_market_capitalizatio...
This isn't about numbers for me.
Distinguish between wealth and paperwork. As Bucky Fuller pointed out, if all the paperwork disappeared overnight we would have a hellofa fight over who owns what, but no one would (necessarily) starve. If the wealth itself disappeared: the factories, the distribution networks, and so on, we would be screwed.
In the situation today the physical basis of wealth is not under attack, the "human capital" is.
Nevermind the Goddamned paperwork. Save the lives.
Economic downturns lead to deaths of despair - long-term unemployment causes spikes in suicides, drug overdoses, even domestic terrorism brought on by a potent mixture of sheer nihilism and depression. Just because it's more difficult to count those future lives (more likely to be young) against a current model - who are you to discount them?
Perhaps the solution is: Save as many people as you can today then, and when there is an economic downturn we should do a better job helping people get off drugs by talking to them and treating them, helping develop new markets, reaching out to young poor communities.
I feel like half of your problems listed are solved by hiring more therapists and psychiatrists. It sounds more like America has a lack of caring for it's people rather than anything else.
I think this is a really callous way of putting it, and it's only valid if you accede to the empathetic framing. The point of my original comment is to show that there is an econometric argument against the empathetic framing, even for one intended to allow empathy to dictate their opinion.
> I feel like half of your problems listed are solved by hiring more therapists and psychiatrists.
Part of any rational decision process asks about the costs of the different options. The cost of this economic recession will be high; the cost of improving mental health infrastructure would have been much lower.
> Perhaps the solution is: Save as many people as you can today then, and when there is an economic downturn we should do a better job helping people get off drugs by talking to them and treating them, helping develop new markets, reaching out to young poor communities.
Why decide to pay both costs when only one needed to be paid?
Parents? Grandparents? Who needs them! They’re just a strain on the economy.
/s
Edit: I should add that ramping up testing may take longer than that. I'm not an expert; just going by what I've read. Even so though, we should definitely aim to scale up testing as much as possible; the better our testing, the less restrictive and long-lasting isolation measures will need to be.
Two months of this is going to be the beginning of the next depression.
If we don’t, what happens to the rather large percentage of young people who require hospitalization? It’s no stretch to assume that many would die. Let alone the fact that mortality for young people is already many times higher than the flu. Break the healthcare system and that goes up dramatically.
On top of that, break the healthcare system and what happens to all the normal, baseline, hospitalization needs? They’re not going to suddenly disappear. Survivable medical events become fatal.
How do you recover as a society from that, without an economic depression like none we’ve seen in our lifetime?
We desperately want to prevent an economic depression, and for good reason! But the chessboard is what it is. We don’t have a whole lot of moves.
That “flatten the curve” graph people are sharing is just a visual aid. It’s not based on real data. How could it be? Hospital capacity varies by region but everyone in the country is passing around the same graph.
It’s nice to flatten the curve, but if the flattened curve isn’t low enough then we will overload our health care system anyway, and we will add an economic shutdown on top of that.
We are lucky this is not a super deadly virus, because I don’t think we would have handled it any better.
Based on last week’s numbers, unemployment claims are up almost 10x compared to the normal level. That is one indicator of the damage to the economy.
We need to consider that the human suffering caused by the economic shutdown will outweigh the human suffering caused by deaths, and it will last longer too.
Only when everyone panics and people fight over live saving toilet paper, instead of keeping the power running, then the economy will shut down for good.
So I am not really scared of the virus, but rather panicked mobs.
Nonetheless I also think that they do factor this in. If your health system breaks down around the world it might become very catastrophic.
And in Italy there have been enough not only old people dying.
At $10M/life, 1M deaths in the US is a $10 trillion cost. That's 50% of GDP - I fail to see how it can't be cheaper to "shut down the economy" (a term I find quite hyperbolic anyway) for a month.
It's possible that a massive global economic slowdown could help solve the collective action problems there a bit, right? Maybe the spirit of cooperation necessary to achieve "war time" resistance to the pandemic can seamlessly transition into building a new economy that's more sustainable?
And when we get kicked into the man made depression two weeks from now, anyone that doesn’t already have savings and wealths, their lives are ruined.
And that’s gonna be much more than 1 or even 5 percent of the population
However, if hospitals are completely overrun with uncontrolled spread, along with virus related deaths (1% to whatever), normal hospital cases of heart attacks, strokes, cancer, accidents etc will result in straight death too. Health services were already struggling to cope with those cases alone before the virus hit. Total death toll would be an almost guaranteed disaster. Any economic downturn of lockdown will seem a barely perceptible blip atop that body count. Lockdown naysayers need to get a grip on reality.
I'm here stressing about finding toilet paper. I'd hate to be worried about affording toilet paper.
Keeping in mind that most young people who get the virus will survive, this is a massive generational sacrifice by the same people who left college around the time of the 2008 crash to protect older people. Anyone who thinks this is only going to last 3 weeks is just not being realistic.
Of course nobody wants to callously stand by while older Americans die of the virus. My own parents are at risk. I myself have asthma and I don't really know what my chances would be. However, the worst-case scenario in 20 years is that the older people we saved by sheltering in place will be gone, but the consequences of shutting down the economy will still haunt everyone living.
There are long-term trade-offs to consider here, particularly ruining the lives of the young in order to save the old, and I don't think they are being considered properly.
In an ideal world we would not need to make choices like this, but the choice is real and we can't fumble it.
I feel like a bit of a dick for posting this, but after reflection I do think it's a valid point and we cannot escape the trade-offs I described.