It's 5% if you do nothing, because your health care system gets overwhelmed and people who would have lived if they got a bed / ventilator / nurse etc all die.

Right, and to be clear, it's not just COVID patients, but other patients with treatable diseases. Notably, critically ill COVID patients require more resources: they use a bed and ventilator for longer and require more frequent assistance from nurses and other staff while they're occupying those resources. As an anecdote, my 60-year-old aunt was in the ICU for 6 weeks before a collapsed lung finally killed her.

Oh I didn't mean to suggest that a complete lockdown is not draconian. It is. Look at San Francisco: yes, stay-at-home orders were clearly effective there, but what once was a bustling city now has boarded up storefronts everywhere, it's depressing.

And for what it is worth, taking the opposite stance and being lax in the name of freedom or whatever can also be devastating, e.g. read anything about covid ravaging the US mid-west in the past few months.

As for the statistics, I think they are great for a 10,000 miles view, but at the same time, they can really support whatever narrative we want. 0.5% may seem like nothing, but if we instead point out there are 80 million people dead worldwide, it now sounds pretty darn scary. Regardless, there's all sorts of trickle down effects that are easy to gloss over when just looking at numbers: frontline doctors will probably have some very strong opinions about freedom SJWs, and likewise I'm sure jobless people facing imminent eviction will have strong opinions about their governments' response to covid.

Covid is an extreme example. But I think the trade-offs that people are willing to make have changed. The health of myself, friends and family is critically important to me. In a world where most of our needs are already met health is the biggest existential threat we face.

This kind of threat could be exploited by bad actors. But the ultimate goal of keeping people alive and healthy is a legitimate one. I think more of the economy will be devoted to healthcare, fitness, and even "wellbeing". Covid was just a massive acceleration of that.

and yet its a leading death reason in US, and we are on a way to 2m dead mark.

So, yes! The trade-off in China worked out great for them.

In US and EU they did not. Since its all varying degrees of half-assed approaches. That end up delaying the virus not stop it. That is probably the worse approach, since economy suffers and people are still end up infected.

The one thing you also forget is the serious long term complications including brain damage in around 2% of infected.

2% is enough to make me take it serious, there are account of marathon runners unable to run a mile months after recovering.

"If you truly believe that that trade-off is worth it, "

???

Whuan/Australia clamped down and then they were relatively COVID free and their economies are expanding. The US is still in upside down mode with business flailing people dying.

.5% death rate is meaningless if 1) it expands rapidly enough to overwhelm the health system 2) even at that rate we're talking millions of dead Americans and therefore must be dealt with.

I'd 100% have rather taken the path of Wuhan, Australia or Taiwan who have effectively dealt with this issue while the rest of us flail in the wind.

This is exactly my problem. The United States is structurally terrible at responding to a pandemic. We have a slow moving, federal republic with (ostensibly) a weak executive. We have open borders between states that is (arguably) constitutionally protected. We have a patchwork of local authorities with differing skills and abilities.

The federal republic is an incredible system of government for many things. The balance that it has (in theory) restricts it from doing anything quickly, including responding to a pandemic.

Yes, the pandemic caught us with our pants down, so to speak. But I would not trade for authoritarian control for protection against a once-in-a-century pandemic.

(I know Aus is not an authoritarian country and is quite like the US culturally. But it is an island. The only non-island nations that have curtailed this are strong authoritarian states)

The same structure has responded to nationwide events with more competency in the past. It's only the structure in that the structure allows for such incompetence to inhabit key offices.

Look at it in terms of total number of deaths, not the rate.

It's killed a LOT of people. Like 360,000 people in the US according to the CDC.

https://covid.cdc.gov/covid-data-tracker/#cases_casesper100k...

If you believe the numbers are cooked or something, then consider excess all-cause mortality there are clearly a LOT more dead people this year.

https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

I mean, you can just eyeball the weekly deaths graph between 2018 and now, and go 'oh, this isn't good.' There's no end in sight. LA ICUs are now nightmarish.

"At Los Angeles County-USC Medical Center, the breaking point came Sunday night.

There was not one available bed for at least 30 patients who needed intensive or intermediate levels of care, and the hospital had to shut its doors to all ambulance traffic for 12 hours. Some patients, including the very sick who required intensive oxygen, experienced wait times as long as 18 hours to get into the intensive care unit.

The front entrance of Community Hospital of Huntington Park was closed to the public Monday; the back of the building saw a steady stream of ambulances over the weekend, with one security guard saying the vehicles arrived as frequently as every half hour.

And Memorial Hospital of Gardena on Monday was running at 140% capacity, forcing officials to ask for a four-hour suspension of new ambulance calls so it could move patients. The hospital is struggling to keep enough oxygen and supplies on hand amid the crunch of COVID-19 patients who need it."

...

"The crisis at Los Angeles County hospitals hit new levels as patients continued to stream in during the holiday weekend, and the medical system is bracing for a new wave of coronavirus spread arising from Christmas travel and gatherings. L.A. County’s cumulative COVID-19 death toll is expected to climb past 10,000 this week."

https://www.latimes.com/california/story/2020-12-29/l-a-coun...

That's with the biggest state in the country (CA) jumping on the grenade and staying in lockdown. Imagine if CA behaved like North Dakota.

Meanwhile, China is back to normal, with only minimal contact tracing required for the occasional outbreak here and there. They couldn't even run clinical trials for their vaccines in-country because not enough people have the virus anymore. There's a certain freedom in that. Hard to be free if you're dead.

I do not think the numbers are cooked. I think you are interpreting them incorrectly, or disingenuously.

We have had 399,857 deaths over the average expectation, and 328k over the upper bound. Are you saying that every single one of those excess deaths are from COVID infections? How many of those are from deaths of despair, lack of preventative healthcare due to closures, abuse, murders, aggravation of Alzheimer's etc.

The simple fact, that I would love to hear a reasonable refutation of, is that a majority of the people who have died from COVID would have died this year from another cause. However, those who have died from the impact of our response would NOT have died this year.

All in all, we reduced the number of life years due to our response. That is the problem.

Edit: Lets look at state data.

Florida has been widely criticized for their lax restrictions, while California has been widely celebrated for their lockdown. So which performed better?

Florida has 18,000 excess deaths and a population of 21.48 million.

California has had 37,000 excess deaths and a population of 39 millions.

So about the fucking same. Notice also that a lot of the excess deaths in California came throughout the Summer, where there wasn't as big a spike as there is now.

How do the many countries with more severe, briefer lockdowns and far lower excess fatality rates than the USA figure into your analysis?

Also, doesn't the conclusion in your edit (strong vs weak lockdowns are "the fucking same") refute your original claim ("those who have died from the impact of our response would NOT have died this year")?

Also, do you believe that lockdown in general induces severe long-term health complications in survivors on par with the effects of COVID?

Also, do you reject the idea that the effects of COVID scale superlinearly with concurrent infections, due to exhaustion of medical resources (i.e. do you think "flattening the curve" is a myth)?

I believe that we don't know the effects of a long term lockdown because we've never done it before. I do believe the number of people impacted by poverty, food insecurity and job loss is far higher than the number of people impacted by COVID long term.

I do not believe flattening the curve is a myth. I believe that without an exit strategy flattening the curve is unsustainable. I believe that keeping ICUs from being full is a very good goal. I also believe we generally locked down out of panic way before ICU capacity was at risk (See SFO in March) and thus consumed the will, resources etc to withstand flattening the curve. Now we have ICU issues but we've lost the will .

How do you explain countries that have had stricter, longer lockdowns than the USA having a hire mortality rate? It is almost as if lockdowns do fuckall

Which countries would those be?

Belgium, Italy, UK, Slovenia

https://www.worldometers.info/coronavirus/

Take a look at the "daily new deaths" graphs for each of those countries on the site you linked. All four of those countries fall to near zero over the summer. Their first-wave lockdowns worked, eventually. The USA's did not; people just kept getting infected all summer long.

The second wave has hit hard, but deaths in Slovenia, Belgium, and Italy are at this point all trending back downward. USA's are not. Extend those graphs out and we'll be well ahead in deaths before long. The UK isn't trending down either, but their leadership is suffering from a lot of the same problems as the USA's with not taking this seriously.

Also note that all four of those countries are reporting fewer infections than the USA - their deaths per capita come from higher case fatality rates. This suggests that the death rate has more to do with their hospital systems being worse-positioned to handle the influx of patients than how the spread was managed.

Hospital beds are full. ICU beds are full. They are full of covid patients.

That's the simplest I can put it. You're arguing against reality.

ICUs are always full. Literally. ICUs and ERs are on divert more often than not. At least in the USA, hospitals have a fiduciary responsibility to keep beds filled. We will just take the sicker ones now.

They absolutely are not. Our typical occupancy this time of year would be around 50% (of pre-covid capacity) which is high because it's flu season. It's currently 140% which we can only accommodate because we've expanded the capacity specifically for covid.

You don't know what you're talking about.

I can only speak for my home state. Maybe we have shit hospitals

Where did you hear that ICUs are always full? I keep hearing that from people, and I don't know if it's bullshit or not.

Do you have any sort of a source that ICUs and ERs are on divert more often than not?

You can't evaluate the counterfactual without a controlled experiment.

And we don't have that.

We have a year of guesswork, and learning, and trying to stop thousands and thousands of loved ones and neighbors from dying.

Perhaps so many lives were saved due to decreases in traffic accidents, that it totally outweighed the lives lost to murder and suicide? Nobody knows right now.

We're just doing the best we can to leg it out until people can get the vaccine. There has been no cohesive federal anything, so the states are hanging in there as best they can.

Be patient. We've made it a year. We're in the home stretch.

Edit: Compare the size of the largest city in California with the largest city in Florida. It's a whole different ballgame. 900k vs 4 million. Florida's playing little-league compared to CA. They're not working with LA sprawl and urban density.