I am sick of this tone of superiority so often used here. It's so elitist and so out of touch.
So let me ask: on what basis did you arrive at your opinion?
[Edit: HN comment from 10 months ago: https://news.ycombinator.com/item?id=22578742]
In Scotland, the mean COVID death age was higher than the average lifetime expectancy[1], which indicates that on average those people would probably live <10 years had they not contracted the disease. The expected remaining lifetime of the average individual in Scotland (if it remains unchanged) is ~37 years, which would reduce the lifetime adjusted death toll by at least 3.7.
There have been a significant amount of excess deaths that are not attributable to COVID [2]. I suspect that such deaths have a lower average age (e.g. due to suicides), than COVID deaths, further reducing the average life years saved due to the lockdowns.
I'm not proposing that we should optimise for life years saved, but I do think that the death of a 86 year old is less tragic than that of a 38 year old, and that we perhaps shouldn't evaluate lockdown vs no lockdown purely based on the percentage of the population which died.
[1] https://www.bbc.com/news/uk-scotland-54433305 [2] https://www.newswise.com/factcheck/are-a-third-of-the-excess...
I of course agree with that. Just stating lives lost in isolation is misleading. It simply much easier to use for back-of-envelope math, and generally back of the envelope math indicating a course of action would lead to millions of excess deaths is enough to conclude that probably it won't be a great idea.
> which indicates that on average those people would probably live <10 years
This is plausible, but it may not be much less than 10 years either. The life expectancy of someone who reaches average UK life expectancy is close to another 10 years. And we'd probably both prefer neither ourselves nor any elderly relatives or friends to suffocate 10 years before their or our time.
> There have been a significant amount of excess deaths that are not attributable to COVID [2].
So this sounds initially plausible (lockdown stress/economic hardship leading to an increase in suicides) but I believe it's bullshit and that these deaths are in fact due to covid. Since we were talking about the UK, let's go back to look at that: the baseline figure of suicides is pretty low (~6k in the UK for 2019, which is 1e-4 per individual per year). The number of excess deaths in 2020 is at least 12 times higher than that. So the suicide rate would have had to at least double to account for a significant part of that. And nationwide suicide rates are quite stable, year-on-year, including, crucially, during times of severe economic hardship.
I will answer this, although more than likely my comment will get killed soon:
I believe that the high-risk people (elderly, immuno-compromised, people with diseases that put them at risk) should go into voluntary quarantine if they wish, together with a government package to support them. Anyone who wishes to undergo lockdown can also do so, although with no package beyond what they would normally get. The rest can do as they please.
This will not stop the ICU beds from filling up obviously, which is why they should be triaged to high-risk patients, frontline staff, and people who underwent quarantine and lockdown. When capacity allows, other people too. The people who chose not to lockdown deal with it, or die.
This is probably unimplementable in the real world. That said, it would mean the lowest amount of economic stress (which kills silently) for the following years. On some level, it also appeals to the human need for cause: those people that died of corona and didn't get treatment "did it to themselves". The high-risk people do not get sacrificed.
What about all the nurses who die in the line of duty treating all these new infections? Should they be allowed to opt-out of infection risk?
I understand the desire to keep things going, but so long as there is community spread the lockdown can never end, and the virus would never go away.
What's being done about them now? How is this better? They're losing everything they own, their house, and getting $600 from the government? Many would take a chance of corona over that.
> What about all the nurses who die in the line of duty treating all these new infections? Should they be allowed to opt-out of infection risk?
Nurses (along with all healthcare personnel) should always receive priviledged treatment. One nurse dying is not a person dying, it is many people dying.
> but so long as there is community spread the lockdown can never end, and the virus would never go away.
Vaccines will hopefully change that.
.. all good points though, and I thought of them too as I was writing out my thoughts. I'm not fully satisfied with these answers, but I do not believe the direction we're headed in right now is much better.
I agree the economic issues are problematic and painful. Sadly, I don’t see a way around a lot of financial pain for everyone over coming months regardless of the status of a lockdown. Depending on your job and industry, there simply isn’t any work to be done while there’s a real risk of death (tourism comes to mind).
I think one big sticking point for me around arguments to reopen boil down to our medical care workers—doctors, nurses, and everyone who supports them. I’m not comfortable telling _anyone_ that they need to die to keep the economy going, especially when our medical workers don’t have a say in the matter.
What makes you think so? Did you look at the life-expectancy impact of severe economic downturns and compare them to likely excess fatality figures due to your proposed policy? I suspect not, because last I looked for it I didn't seem to find much evidence for silently killing economic stress.
> This will not stop the ICU beds from filling up obviously,
That's a bit of a problem, because those ICU beds are also known to be useful for people suffering from urgent non-covid related problems. Even if you managed to turn away all the non-lockdowners (how would you even check? Police patrols tattooing people spotted on the street during voluntary lockdown?), you might still find that just the "legitimate" cases are enough to really mess up urgent health care for a lot of other people.
Not the point I was making. I do not know which option will lead to less death, neither do you, neither do really the scientists (although they have a better idea). However, a full lockdown will lead to more economic loss at least in the short term than a voluntary lockdown. Long-term, as I said, I don't think any of us can say.
> you might still find that just the "legitimate" cases are enough to really mess up urgent health care for a lot of other people.
Like is currently happening? Yes, my solution wouldn't stop all bad effects. There will be much death regardless, the hope is that the people who are left to die as they chose no protection will "help out" with the number of ICU beds needed in general.
> how would you even check ?
You are in lockdown until you fill in some sort of form with the government, waiving your rights to hospital care in the case of catching Corona. This list is used to make decisions. This part at least is implementable.
What point were you making then? And yes, I think I do know which option will lead to less death, because I actually took the time to do some minimal research and the relevant information wasn't hard to find or terribly ambiguous. It's fine to have a contrarian opinion, based on some effort to ascertain facts and reason about them and we could then have a productive discussion on why our conclusions differ but from everything you said so far my current impression is that you made no such effort whatsoever.
> However, a full lockdown will lead to more economic loss at least in the short term than a voluntary lockdown. Long-term, as I said, I don't think any of us can say.
For some farcial definition of "short term" and "can't say" maybe, but for anything a sane person would care about (quarters or longer) we can just try to compare economic stats.
I mean to me it seems like the herd-immunity/corona-is-a-hoax/hands-off-response countries weren't doing that hot economically either:
https://tradingeconomics.com/sweden/gdp
https://tradingeconomics.com/united-kingdom/gdp
https://tradingeconomics.com/brazil/gdp
vs
https://tradingeconomics.com/new-zealand/gdp
https://tradingeconomics.com/south-korea/gdp
https://tradingeconomics.com/taiwan/gdp
https://tradingeconomics.com/china/gdp
> You are in lockdown until you fill in some sort of form with the government, waiving your rights to hospital care in the case of catching Corona. This list is used to make decisions. This part at least is implementable.
Why would anyone in their right mind sign such a form, no matter whether they intend to flout lockdown or not? Not without massive penalities. How would you enforce them?
What’s more, do you have any reasonable figures to suggest why letting a percentage or more of the population die unnecessarily, consigning even larger numbers to long-term health problems and so forth is somehow a good choice?
If you ask people to cite statistics for their claims, you should also do so for your claims such as this one.
It is an axiom of healthcare that outcomes suffer in an overburdened healthcare system, and readily apparent why that is the case. That said, for those too lazy to look, here’s literally the top result for me when googling terms related to this: https://www.kabc.com/news/covid-19-mortality-rates-rise-as-h...
If I squint my eyes a bit. Reduce the burden on the pension system?
Long-term disabled or ill people who are unable to work will effectively take early retirement (in some cases they can draw on their actual pension early too), and depend on state support from then on whether it's called pension or something else. The duration of payouts will be longer than for ordinary retirement age.
It's not just miserable for those survivors, it's expensive for the state.
Long-term health problems are also likely to cost more in healthcare later.
I’d guess so, based on what I read so far, but not sure.
Have you considered that of 100 friends, family and acquaintances you’d see two die and 10 would have a painful and difficult future?
We don't know how many people have ... whatever you are proposing we compare that against.
So faced with the options of "prevent the deaths of over a million people" and "matz1 doesn't like lockdown but doesn't want to talk about or quantify it" I think the choice is pretty clear. Unless you want to elaborate further?
What you have said is that people will suffer under lockdown - but you haven’t really tried to quantify that. You’ve decided that’s a lost cause and have moved onto “lockdown causes death” ! Amazing.
Likewise If you get covid, doesn't mean you will die from covid. vast majority of people will be fine.
>If you lockdown, you don’t get covid. It’s a simplification but it’s a start
Maybe you don't get covid but if you lockdown, you may suffer/die from starving/mental health issue instead.
>What you have said is that people will suffer under lockdown - but you haven’t really tried to quantify that
Is it really hard to think that lockdown would cause at least some unemployment, some bankruptcy, some mental health issue ?
>“lockdown causes death”
Unemployment has long been associated with a significantly increased risk of death.
I don't have the precise number but how are you sure that the damage from virus is greater than damage from lockdown ?
Basically - this is not nothing, it’s being treated like a Big Deal because it legitimately is. There’s a lot of talk from the “treatment is worse than the disease” crowd, scant few of whom are experts. And like climate change and evolution deniers many of the arguments seem to boil down to conspiracy theories or the It’s Always Sunny In Philadelphia argument - “science is a liar ... sometimes”: https://youtu.be/Zgk8UdV7GQ0
No, you sacrifice an uncertain percentage of the population (but probably larger than you suggest because healthcare systems would be quickly overwhelmed by a massive spike in cases) to both death and long-term sickness and disability, but for what? Lockdown causes people to lose their jobs, children to miss school, and others to suffer problems with mental health (although to use your phrasing, this would just be "a few percent" of the population) but it saves people's lives and health.
I'm also really disappointed that people don't get the idea that people dying and having long-term health issues doesn't screw the economy too.
- Advocating for the death of a million people when it's avoidable is abhorrent
- It would be more than that, due to the collapse of health services, causing people who would currently survive to die instead
- It would be more again due to the increased likelihood of viral mutations when left to run rampant
- Also due to the collapse of health services, most deaths would be outside hospitals, i.e. at home, slowly suffocating to death
- Some would survive with brain damage due to lack of oxygen at home
- While dying, people at home would know if they could get a hospital place they'd probably survive, and avoid brain damage, but they can't get one
- It wouldn't even boost the economy, because a million deaths is actually quite a drag on the economy, especially when most of them are dying at home with their families staying at home to look after them due to collapse of the health services
- It would be horrendously traumatic; a lot of people would struggle to work afterwards after watching their family members, friends, neighbours and people they know die at home slowly from an avoidable cause
- It would cause tremendous social division, as many of the traumatised people having watched their family members (& friends, etc) die, avoidably, would know it was caused by the actions of their own neighbours & local community, along with national decision-making to "sacrifice" those million
- That's just deaths; survivors with long Covid would also be a large drag on the economy, struggling or unable to work, requiring support, and potentially expensive for the healthcare services and their familiies in later life if it's long-term organ damage as some fear. The numbers with long Covid would exceed the current number of official unemployed
- Advocating for serious life-long disability for another several million people when it's avoidable is abhorrent too
[ EDIT: the number I originally used for "requiring hospitalization" were way off. I've edited to reflect data from September provided by the CDC. The 20% -> ICU figure comes from the NYC experience in May, but seems roughly correct from other global hotspots ]
Roughly 0.4% of those who catch COVID19 will require hospitalization. Of those, 20% will require ICU treatment.
In the end, the entire human race will be exposed to SARS-COV-2. If that happens all on the same day, or week, or month or probably even year, no health care system in the world can possibly deal with the case load.
Some of those who might have survived COVID19 with hospital care will die.
But (and this is the important part) those with other medical conditions that timely and effective health care could have treated will also die. Trauma (e.g. car or tool accidents). Infectious disease. Cancer. Chronic health conditions.
And in killing all these people, you've made nothing better for those who survive, because if you think the economy has gone to hell under current attempts to deal with it, you clearly cannot imagine it as the entire health care system melts down.
COVID19 is not a personal health crisis. Most people will not die of it (even though hundreds of thousands will, which is not going to be much comfort to their families, friends, colleagues and neighbors. It is a public health crisis that threatens to overwhelm our health care systems and thus have far worse effects than just the disease itself.
Where do you get these numbers from? California has about 50k new cases per day, with probably another 50k cases that were not tested. According to your stats 20k people will require hospitalization and 5k will require an ICU bed per day.
Where do you get this from? I do think, of those requiring hospitalization, there is somewhere around a <20% mortality rate (it seems to vary by region).
This statement is false.
(With regard to any reasonable definition of exposure to the current virulent strains and assuming the vaccines do their job.)
One major purpose of the vaccines is to cause R < 1 and the virus to fade out, so that most humans will not be exposed to the virus ever in their lives. The other major purpose is for those humans who are exposed to it, to significantly reduce the chance of the virus causing harm.
Like putting out a fire before it spreads everywhere. Some things are burned but not everything is even touched by the flame, if it's put out.
Sure, it's certainly up for debate (and the future) whether or not the rate will drop low enough that most humans escape exposure. That will depend on more than just R0 - we still don't know if the vaccines (any of them) prevent transference, and the emergence of new variants with higher R0 values but identical infection mechanisms (which most people would agree is the same virus) may also complicate this quite a bit.
So sure, maybe I should have dialed it back to "it's entirely possible that the entire human race will be exposed to SARS-COV-2, though if we are lucky that probably won't happen".
I don't think that changes my fundamental point that the crisis for a pandemic like this is not in personal health - "Am I going to die?" - but in the public health - "can my society's health care systems still function?"
The evolution of viruses like this is they tend to mutate into milder strains as they become endemic. At that point the milder version may still cause excess deaths (like flu does, and unfortunately it would be in addition to flu deaths), but not at the same virulence.
But an endemic virus does not necessarily mean every human will be exposed to it. There are diseases which are almost but not quite eradicated by widespread vaccination, and keep going in clusters, surviving in pockets here and there.