Coronavirus

Quoting boethius

When I was arguing for competent containment it was to avoid this as a worst case scenario of shutting down the major economies all at once

If people would learn from past mistakes, this (competent containment) would likely happen after this pandemic. People would be ready for the next one and likely contain it before the pandemic phase.

Earlier the US would have created a great effective system to stop pandemics and both parties would take it as seriously as stopping Al Qaeda. The US would be a leader that others would follow. Now when I think of it, I'm not so sure about that. That was the US of the past.

You see, it's not Eisenhower's era anymore where a Republican administration would invest in huge infrastructure projects like the Interstate Highway System or start a large vaccination program against polio. This isn't just about Trump ineptness, it's more about how broken the system is and how people distrust the government. You think that all people are willing to take a corona vaccination when it comes around let's say in 2021-2022? Will they want to upload the apps now worked on to track the pandemic? I don't think so. It's big brother with it's sinister plans scheming behind the innocent sounding agenda of "stopping the pandemic".

And then there's the economic recession (depression). Putting then money anywhere else than something that the people can immediately benefit from won't be popular. That will severely hinder the future responses and likely, at least after a decade, the guard will be down again.

Reply to boethius
I'm not a Republican.

Reply to ssu
As usual, you're one of the few sane voices.

Real question here, not a politically motivated one, but Fauci reports that had the US implemented more social distancing measures earlier, it would have saved lives:

https://www.cnn.com/2020/04/12/politics/anthony-fauci-pushback-coronavirus-measures-cnntv/index.html

My understanding of the social distancing concept is that it is to level out the curve of infections so as to be sure there is adequate healthcare (especially with regard to there being sufficient ventilators) to treat the curable.

I've not heard however that there have actually been a lack of ventilators and that people are dying who could have been treated. While many thought it would get that bad, it never actually did. What I'm hearing is:

https://newyork.cbslocal.com/2020/04/08/coronavirus-update-nyc-has-enough-ventilators-to-get-through-the-week-positive-covid-first-responders-returning-to-work/

Social distancing obviously will slow the spread of the disease, but I really don't think we can expect it to reduce the overall occurrence given sufficient time unless you're committed to removing the most vulnerable from the population long enough to find a vaccine (a year?).

The US numbers also don't appear drastically different in infections and deaths per million than what we're seeing in Europe (some nations higher, some lower), so it seems everyone's approach was fairly similar, with similar results (except for the interesting Swedish experiment).

Quoting frank

As usual, you're one of the few sane voices.

Now that's a slap in the face.

Quoting frank

I'm not a Republican.

You don't need to be a Republican to drink and parrot the Republican coolaid.

The fountain of lies quenches the thirst of all who seek it.

Quoting ssu

If people would learn from past mistakes, this would likely happen after this pandemic. People would be ready for the next one and likely contain it before the pandemic phase.

Ah yes, foresight is some sort of mystical quality that can't be expected.

It does make a certain kind of sense though. The right spends their time denying science and then when science based predictions come true: Magic! Demons!

Yet, you live in Finland, enjoying the fruits of foresight based politics and institutional design, quite comfortable during this crisis without any fear of social dysfunction, and instead of explaining how and why these institutions work, based on ideas worth considering, you prefer to coddle American conservatives (with whom you share only a couple of policy concerns) and help lull them back to sleep and protect them from too many terrifying facts at once.

Quoting ssu

Earlier the US would have created a great effective system to stop pandemics and both parties would take it as seriously as stopping Al Qaeda. The US would be a leader that others would follow. Now when I think of it, I'm not so sure about that.

The US had such a team! This has been one of the main subjects of debate. Ok, maybe the pandemic team wouldn't have prevented completely the pandemic, but there's just no reasonable argument to make that they wouldn't have been more effective.

But you misunderstand my argument. The US elite were previously concerned about pandemics, not because it's a threat to the American citizens, but because it's a threat to themselves and their "government can't help you, only money for army" ideology.

Quoting ssu

You see, it's not Eisenhower's era anymore where a Republican administration would invest in huge infrastructure projects like the Interstate Highway System or start a large vaccination program against polio. This isn't just about Trump ineptness, it's more about how broken the system is and how people distrust the government.

Yes, it is about Trump ineptness. It's also about the general corrupting trend, but obviously that trend resulting in the stupendous Trumpian ineptness is completely relevant.

Also, pandemic prevention is not a huge infrastructure, it's a small investment that has massive cost-benefits, as we're witnessing in real time.

"The system is corrupt and inept ... but don't look at the leader as exemplifying these qualities," is a terrible argument.

Quoting ssu

You think that all people are willing to take a corona vaccination when it comes in 2021-2022? Will they want to upload the apps now worked on to track the pandemic? I don't think so. It's big brother with it's sinister plans scheming behind the innocent sounding agenda of "stopping the pandemic".

Is this point relating to my position in some way?

Is it the big bad leftist big brother coming for them from the heart of Trump's white house, pushing the limits of double think. Or are you saying these people are going to be criticizing Trump and Republicans for big brother policies?

Quoting ssu

And then there's the economic recession (depression). Putting then money anywhere else than something that the people can immediately benefit from won't be popular. That will severely hinder the future responses and likely, at least after a decade, the guard will be down again.

So you agree that the American elite have lost the thread, are incapable now of making reasonable decisions even to protect the Empire and their own class interests, and we are witnessing the free fall of the American Empire?

Or will they somehow succeed despite such incompetence?

A Republican and great sage:

Quoting Hanover

A Republican and great sage:

Oh Dubbaya! He was genius compared to Trump.

Quoting Hanover

I've nor heard however that there have actually been a lack of ventilators and that people are dying who could have been treated. While many thought it would get that bad, it never actually did. What I'm hearing is:

Ventilators is only one of many issues.

It's been a focus only because it's a simple metric, and more importantly something that can be acted upon.

The far bigger issue so far has been lack of masks and protection for health-care workers.

Overwhelming the system is also not simply an equipment issue in any case. Most severe cases have other medical problems, doctors need to continue to treat these problems as well as the virus, which takes knowledge and trained staff. So, killing doctors and nurses due to a lack of protection and lowering moral generally doesn't help, and there's simply a limit to how many patients doctors and nurses can treat concurrently.

The lack of equipment is more emblematic of how terrible the preparedness is and how the denial was really total; not even trying to stock up and organize logistics before there are shortages. If a doctor or nurse doesn't have the right equipment today and gets sick, that equipment showing up eventually doesn't help him or her.

Delaying outbreaks as much as possible through containment as well as preventing the outbreaks entirely in some regions, in this first phase at least, has massive equipment preparedness, human resource implications, and logistical optimization implications.

Quoting Hanover

I've nor heard however that there have actually been a lack of ventilators and that people are dying who could have been treated. While many thought it would get that bad, it never actually did. What I'm hearing is:

Although there's a lot to discuss here, even assuming it's true, the reason it's true is because of acute lock downs.

The major benefit for pro-active management is mostly economic.

For instance, had containment been pursued to radically slow and prevent where possible the spread of the virus around the globe due to plane travel (i.e. a flying freeze and serious quarantine and testing of all plane travelers) then most of the globe can continue mostly as normal at any given time. The current experiment of "what if we shutdown most economic activity on the planet at the same time" doesn't need to be run; the problem moves around, we learn what outbreaks look like and how best to deal with it, it's a problem but essentially just a nuisance compared to this scenario.

However, once hospitals start to be overwhelmed then governments do "whatever it takes" to slow the virus down, so those worst case scenarios of unmitigated spread don't happen. However, getting to that overwhelmed point and then doing "whatever it takes" is insanely disruptive. Pursuing containment since November (when US intelligence first identified this virus as potentially cataclysmic) would have mostly been an economic benefit (disproportionately to the US ruling elite, but normal citizens around the globe too in this case).

Waiting, and then doing a hard and sudden social distancing is not orders of magnitude worse than containment, preparing, having well thought out plan at each step, in terms of lives. You can make up for lost time by having everyone stay at home and shutting down the economy. Foresight and a well thought out plan is mostly a difference in economic and general social disruption. Waiting for things to go out of control is still incredibly harsh on medical systems and does quantitatively result in more deaths and injuries, but the emergency break on all of society does work, so the difference is in factors and not orders of magnitude.

However, looking at the unemployment numbers, we do see order of magnitude difference compared to a scenario only affecting certain regions at certain times and policies being put in place and logistical problems solved to avoid the emergency social stop. This is what South Korea did, restaurants are still open for instance.

Quoting Hanover

Real question here, not a politically motivated one, but Fauci reports that had the US implemented more social distancing measures earlier, it would have saved lives:

Maybe he'll explain what he meant later on.

Reply to 180 Proof Thank you for your being here. :flower:

Quoting frank

Is there CV in that blood? If course!

No.

Quoting frank

here I am covered in plastic, thank God I remembered my anti-fogger spray, turn the vent off, pull the ETT, cover head in plastic, prepare for the long journey of cleaning this vent up for the next person.

What's so weird is that when I usually withdraw support, the whole family is in the room. It's only with homeless people that the RN and I do this alone. But now everybody dies alone. I haven't gotten to know any of these people.

Frank, you are someone to whom I am trying to reach about the mental stress you are enduring. I'm sorry you are having to go through this with such a Stoic approach at the same time it comforts me to know that someone like you IS with the spirit of the person when they pass.
Angels surround you :sparkle:

Quoting Benkei

No

Yes.

Quoting Benkei

No.

From the quick look up that I could see suggests the jury is still out on a difinitive answer.

It can be spread by fecal matter so why it would not be shed in blood as well is something that doesn't add up.

Reply to ArguingWAristotleTiff I'm kind of used to it. I think you'd be a good one to work with. Going to RN school?

Quoting frank

I'm kind of used to it. I think you'd be a good one to work with. Going to RN school?

Social Worker with chemical dependency is my first destination and then I would like to work for Hospice.
Mom was a nurse starting with Trauma Level 1, Cardiac ICU and ending at Hospice of the Valley. I would like to volunteer as an 11th hour Hospice Social Worker but in time, and with some pushing, I would like to be a death dula that helps people cease living at home, at the time of their choosing with those they wish to have with them. I think it can be a beautiful journey when kept home. :heart:

It is not really surprising that there is a lack of face masks. The simple truth is the culture in western hospitals is not to wear masks. If any of you have visited a hospital in the far east you might have noticed that doctors and nurses wear face masks all the time - it is common practice, hence they have amply supplies (not to mention, you can buy face masks in many convenience stores too).

I imagine such equipment will become more common place in all hospitals now.

"In France, as in Europe, we don't have the tradition of wearing the mask. There is a tradition in Asia."

https://www.thelocal.com/20200405/coronavirus-and-face-masks-how-countries-have-changed-their-advice

Reply to ArguingWAristotleTiff There's a crowd of drug addicts waiting for you. I think you'll be great.

They say that when Kierkegaard died his smile lit up the whole room. :cool:

How large a gathering is too large during the coronavirus pandemic?
The math of social networks can create a roadmap to a group size that still curbs spread

https://www.sciencenews.org/article/coronavirus-covid19-social-gathering-size-math-pandemic?fbclid=IwAR3s-IrVETEIq6mBHCSXJJyO1OLg5FrZtHj_1rfmXLa1Wm8KBxnH5qeSjC8

Reply to boethius I really don't see how this answers my question, which is specifically how the delay in social distancing has resulting in a measurable loss of life, unless you can show that the treatment received under the current conditions has limited the healthcare received and that limitation can be specifically shown to matter. I get that healthcare workers are stressed and volume is high, and it would make sense that these added pressures might result in poorer outcomes for patients, but you can't make an empirical statement without supporting data (which is precisely the complaint made about Trump and the anti-malaria drugs). Sure, it sucks to not have enough masks and an ongoing worry that there will be insufficient ventilators, and we worry about the stress levels to healthcare workers and how we might be exposing them to risk, but if you're going to say it has cost X number of lives, you need to specify your predicted range of X and you need to offer your support for it.

Keep in mind, this is the same guy that said masks offered no defense against the spread of the virus.. That never made any sense, and we later learn it was politically motivated in the hopes it would allow healthcare providers greater access to masks. I'm just not making sense of these new comments, other than reading it as an expression of a growing rift between him and Trump. Fauci's comment that he got continual pushback from the White House with regard to instituting social distancing earlier is of no relevance from a scientific perspective, but it casts dispersion upon the White House. Maybe he's correct in assertions, and maybe the public has the right to know what sort of leaders we have, but Fauci has now jumped into the political fray with this comment and he needs to provide his basis for his assertions and he needs to explain why he feels it's his role in the middle of the crisis to publicly report on errors of his team.

Quoting frank

Oh Dubbaya! He was genius compared to Trump.

They blamed him for the levies breaking during Katrina. Anyway, I don't think Trump has mishandled this. It wasn't a perfect response, but I doubt the US numbers are going to look a whole lot different per capita from the rest of the Western world once this is all said and done.

It's funny too how GW sort of has this simple, happy go lucky persona when he basically set fire to the entire Middle East. Trump's just a blow hard, but has been incredibly dovish, and, if anyone has been watching, he just passed through a massive bipartisan social security program that has protected the average American worker. Scary times, sure, but we won't remember these days like they were the Great Depression or the Black Plague.

Quoting Hanover

I really don't see how this answers my question, which is specifically how the delay in social distancing has resulting in a measurable loss of life, unless you can show that the treatment received under the current conditions has limited the healthcare received and that limitation can be specifically shown to matter.

Mechanisms are pretty simple.

Without adequate protection not only to health care workers get sick at the peak, when they are needed most, but they also receive higher viral loads which are associated with worse outcomes.

As hospitals are overwhelmed people get less good care in several steps. It's not binary. First, doctors and nurses that aren't respiratory specialists find themselves caring for respiratory illness, this isn't optimum care. Second phase is that doctors and nurses simply have too many patients to adequately care for everyone. Third phase is triage where patients over a certain age, or certain prognosis, or have dementia and "no quality years left", aren't cared for at all. Fourth phase is that patients who need care, of varying degrees, for other things can't go to the hospital or don't get good care for above reasons even if they do. Fifth phase is health care system collapse.

The other reason for loss of life is that delaying the outbreak also allows more learning and treatments options explored about the illness. Maybe there is some straight-up cure, so this has a sort of "net-present-value" of the consequence of some probability spectrum of treatment improvements over time that buying more time provides. Treatment isn't static; as more experience and science accumulates, treatment gets better.

The virus isn't static either. Slowing the outbreak slows the rate of mutation (there are simply less viruses around to mutate).

These are all measurable affects. I didn't focus on them in my previous response because they aren't the biggest difference since "stop society" is a very effective measure that is not radically different than a "Stop, Think, Observe, Plan" preemptive approach, in terms of overall health outcomes. It's not like other disasters where there can be a point-of-no return that then locks in the worst outcome (discounting trying to actively make an even worse outcome, like dropping bombs on flood survivors or something).

The economic difference is much larger comparing these scenarios, and "exactly how many died due to inaction" is difficult to prove in the risk-analysis-is-taboo framework of modern discourse; whereas the economic consequences are larger and more obvious.

Reply to Hanover I was talking to this 86 year old woman, she said that nothing like this has ever happened in her lifetime. So it's all new. First time through any process reveals short comings.

I don't hold Trump responsible, I just wish he'd be less of a nuisance if he can't help by unifying us in the face of a mess.

True about GW Bush. Obama also managed to initiate the Syrian meltdown at a terrible cost. Trump has caused less bloodshed and I would expect Biden to start some shit somewhere.

It's a tough choice come November.

Quoting boethius

Yet, you live in Finland, enjoying the fruits of foresight based politics and institutional design, quite comfortable during this crisis without any fear of social dysfunction, and instead of explaining how and why these institutions work, based on ideas worth considering, you prefer to coddle American conservatives (with whom you share only a couple of policy concerns) and help lull them back to sleep and protect them from too many terrifying facts at once.

:smile: Well, that's not my intention. But I have noticed that for quite some a time now it has been difficult especially for Americans to take of those politically tinted glasses off and look at all things without the juxtaposition between pinko-liberal-democrats agenda and the libertarian-right wing-Trumpist-republicans agenda.

Just to recap, policy responses to this pandemic do not follow the line of American politics. Sweden, which also has a population quite devoted to follow it's official line, is run by social democrats. My country is ruled by good looking young women in their 30's, a leftist-centrist administration dubbed to be the "lipstick-administration" here, which actually agreed to the demands of the opposition, which in turn made up of conservatives and the so-called right-wing populists, to choose the lock-down option immediately. And to the administrations amazement, the opposition was happy and has mainly pulled the same line. Furthermore, Germany, UK and France have right wing governments. To find an inherently [i]political/i] divide in the response, with at one side being the right neo-liberals thinking about money and in the left the progressives thinking of the common good isn't what reality is like.

Quoting boethius

Also, pandemic prevention is not a huge infrastructure, it's a small investment that has massive cost-benefits, as we're witnessing in real time.

This is true. And in hindsight, it is an effort quite easy to make. It wouldn't be difficult for an US administration to understand that however well it otherwise performs, a lousy response to a huge earthquake, a large hurricane or a pandemic might cost it the next election. And for the government to prepare for those natural disasters before they happen would be beneficial. Armed Forces have always operational plans for war (OPPLANs) guiding their training and peace-time preparations, so in order for other authorities to take similar plans seriously would be easy. You would avoid the part of states bidding against each other to get PPEs and an overall sense of confusion.

Quoting boethius

Is it the big bad leftist big brother coming for them from the heart of Trump's white house, pushing the limits of double think. Or are you saying these people are going to be criticizing Trump and Republicans for big brother policies?

In general Americans have a distrust about the government, especially when the administration running isn't the party they voted for. It's so simple. The unfortunate thing is that this kind of thinking is closer to people in the Third World than those in the First World.

Quoting boethius

So you agree that the American elite have lost the thread, are incapable now of making reasonable decisions even to protect the Empire and their own class interests, and we are witnessing the free fall of the American Empire?

More like that the elite doesn't even think it's their job anymore. They are responsible only to their shareholders, their constituents or themselves and nobody else. Besides, who does anymore think that the "American Empire" is important? Who in the Trump-era thinks that the US is the leader of the Free World? I would say the invasion of Iraq was a real watershed moment, but the downfall has been the Trump presidency, when it should be obvious to everyone that the US doesn't want to lead anymore. And Trump's followers are happy with this. The change in the attitude towards the government is obvious too.

Ages ago even Disney had a character called "Colonel Doberman", an Air Force officer working for the government, that Mickey Mouse helped in his adventures. Not so anymore. Now such unabashed militarism would be frowned upon. The government is the problem, both for the right and for the left (when it's the right in power, that is).

A lot of criticism in this thread is aimed at the US, for whatever reason, even though everyone can clearly see the virus was brought to the continent by European and Chinese travellers. Despite the failed efforts of globalist institutions—the WHO, the UN, the EU (just add up the death rate there)—whom we can all blame, criticism begins and ends at the American border. Why is that? Is it the need of a whipping boy?

Quoting NOS4A2

A lot of criticism in this thread is aimed at the US, for whatever reason, even though everyone can clearly see the virus was brought to the continent by European and Chinese travellers. Despite the failed efforts of globalist institutions—the WHO, the UN, the EU (just add up the death rate there)—whom we can all blame, criticism begins and ends at the American border. Why is that? Is it the need of a whipping boy?

Because the United States is responsible for how the United States deals with infections in the United States? Nobody is criticizing civilians for bringing the infection into the country or spreading it (unless they're breaking social distancing rules and whatnot); they're criticizing how the Government is responding to the virus. So saying that the virus was brought into the country by European and Chinese travellers is a red herring.

Reply to ArguingWAristotleTiff The answer is no. Although blood can have a viral load and therefore a Covid patient shouldn't be donating blood, it is in such low concentration and bound to the blood that for you to inhale it and get an infection requires you to snort it.

Quoting Echarmion

It's weird how often people forget that the world is larger than the US, and the CDC can therefore not fabricate numbers across the globe.

Oh, of course, it's just absurd to think other states than the US would deceive and disinform its public. Yes, it's absolutely impossible.

Reply to Michael

Blame the pangolins!.

Here's a story from the UK, which is not in the US.

https://www.bbc.co.uk/news/uk-england-tyne-52268841

So 13 people have died out of 72 old folks in this one care home.

I would invite you to consider the possibilities and give an opinion. It looks to me that either:--

!. The stories that these people have had great treatment with adequate PPE and everything that could be done has been done are false.

2. The virus is rather more dangerous than at least the optimists here think.

or

3. You are going to give a plausible explanation for an 18% death rate.

And when I say 18% I mean 18% already, so far. It isn't over yet.

Quoting Merkwurdichliebe

Oh, of course, it's just absurd to think other states than the US would deceive and disinform its public. Yes, it's absolutely impossible.

Ah yes, the classic "they're all in on it" argument. Turning contrary evidence into supporting evidence with just one small leap of irrationality.

Reply to Michael

I wasn’t dismissing the criticism. I was merely asking why the criticism is US-centric, why other governments, international institutions, and those we pay vast sums of cash to warn us of such threats, are given a pass.

Reply to unenlightened

There is a horrific case in Quebec, Canada, where 31 care home residents have died, only 5 of which were attributed to covid-19. It is possible the rest died due to gross negligence. The stories coming out of there are horrific.

https://globalnews.ca/news/6810089/quebec-coroner-to-investigate-31-deaths-at-seniors-home-in-montreal/

Quoting Echarmion

Oh, of course, it's just absurd to think other states than the US would deceive and disinform its public. Yes, it's absolutely impossible.
— Merkwurdichliebe

Ah yes, the classic "they're all in on it" argument. Turning contrary evidence into supporting evidence with just one small leap of irrationality.

What are you blabbering about? Who's all in on it?
Are you referring to the moronic rabble gobbling up the hype? They are definitely "all in on it".

Reply to unenlightened

"We are completely devastated that this many residents have lost their lives to what we believe to be Covid-19."

So, they didn't even test them?

Except for:

"One resident who tested positive for the virus is in hospital."

Sorry, but what??

Reply to Baden I thought I had already mentioned this.

1. Most people in are homes are not being taken to hospital with suspected CV because it is "not in their interest".

2. People who do not go to hospital are not being tested for CV.

3. People who have not been tested are not counted as 'confirmed cases, or as deaths from CV.

Therefore:

4. The cases and deaths published daily are underestimates by at a very rough guess 50% to 150%.

I know I did mention that this government is being accused by me of deliberate genocide.

Quoting unenlightened

Most people in care homes are not being taken to hospital with suspected CV because it is "not in their interest".

That was the bit I missed. Sick.

Reply to unenlightened

This report mentions the underreporting of Coronavirus-linked deaths:

Quoting Merkwurdichliebe

What are you blabbering about? Who's all in on it?

So let me put this in simple terms:

You make a claim "the CDC is fabricating numbers to induce a panic", and provide some evidence in support.

Then I say "what about all the other countries?". This is evidence that contradicts your initial claim. You need to deal with this contrary evidence somehow, or else your claim is weakend.

You say "well they're all doing the same". Instead of updating your view based on the contrary evidence, you simply incorporate into your view. You updated your claim from a US conspiracy to a world conspiracy, without supplying further evidence. Logically, your new claim would need much more and much stronger evidence, since it's so much broader. But since you simply took my objection and turned it around, you have no such need. That's the small leap of irrationality that leads to a big dumb conspiracy theory.

Quoting Echarmion

Then I say "what about all the other countries?". This is evidence that contradicts your initial claim.

Evidence? Evidence of what? Obviously evidence that you don't understand what constitutes evidence.

Quoting Echarmion

Instead of updating your view based on the contrary evidence, you simply incorporate into your view.

How cute, you want me to think like your kind. I'm not flattered, and no thanks.

Quoting Echarmion

big dumb conspiracy theory.

It is no conspiracy that the idiotic public has gone mad over a load of inconclusive and suspect information backed independently by sovereign states across the globe. And it's no conspiracy that the idiotic public is willing to invent any reason in order to justify its mass stupidity...
although I admit, it's much too easy to follow the crowd, especially when one is cowardly.

Reply to Evil Thanks for that. What a lot of people there are making it all up, and exaggerating.

Reply to Evil Yes, Channel 4 News is breaking the story. The chief medical officer said that as of today 13.5% of care homes in England have a confirmed case. In Scotland it's 33%. The England figures are likely an underestimate due to lack of testing.

None of them are in any way equipped to deal with it and hospitals aren't accepting the patients.

Quoting Merkwurdichliebe

although I admit, it's much too easy to follow the crowd, especially when one is cowardly.

Cute :wink:
Have fun in your little corner.

Reply to Evil That's odd. If they aren't reporting nursing facility COVID-19 deaths, then why is the UK's death total so high? There was this.

Did the UK just decide not to ramp up to meet the demand? That would explain the death total, but, I mean, that would be crazy.

Or maybe they had no options because of Brexit. Woops!

Quoting Echarmion

Cute :wink:
Have fun in your little corner.

social distancing, right? :lol:

As we now know, the IHME model used by the US government to set policy was wildly inaccurate.

An international group of statisticians from CTDS, Northwestern University and the University of Texas have released a paper (pdf, 2.5MB) investigating the predictive performance of the model developed by Institute for Health Metrics and Evaluation (IHME). The IHME model is is used to predict ventilator use, hospital bed requirements and other resourcing for US states response to COVID-19.

The key findings are:

In excess of 70% of US states had actual death rates falling outside the 95% prediction interval for that state, (see Figure 1)

The ability of the model to make accurate predictions decreases with increasing amount of data. (figure 2)

Improved predictive modelling needed for adequate provision of ventilators, PPE, medical staff at a local level

https://www.sydney.edu.au/data-science/home.html

Reply to frank

That's odd. If they aren't reporting nursing facility COVID-19 deaths, then why is the UK's death total so high? There was this.

Did the UK just decide not to ramp up to meet the demand? That would explain the death total, but, I mean, that would be crazy.

They are only reporting deaths in hospital of patients tested positive for Covid19. There are more accurate figures published by the ONS every two weeks, we will get the updated figures tomorrow. It is generally accepted that the actual death rate is about twice the reported figure.

The UK has ramped up for the surge, they have around 6,000 extra beds available in temporary hospitals set up in exhibition halls. Although they are way short of ventilators.

Also If you've been reading my posts and Unenlightened's comments, you would know that in the UK, there is an unspoken policy of letting Covid19 run through the care homes unhindered, relieving the government of a social care crisis in the future. It's all part of their herd immunity policy.

Although I suspect that Johnson has had a Damascene conversion following his own infection.

Reply to Punshhh Their data probably just needs to be updated. As it is, it doesn't make much sense. Too many deaths.

Reply to frank I didn't see the figures you're referencing, but the figure of the number of people infected is not accurate because it is a function of the number of tests being carried out and the policy is that if you have symptoms to stay at home and only contact the health service if you begin to have difficulty breathing while at rest. The assumption is that there are large numbers infected, with no attempt to test them.

Reply to Punshhh Yep. Sorry about the nursing home deaths.

Quoting Punshhh

Although I suspect that Johnson has had a Damascene conversion following his own infection.

Any reason for your uncharacteristic optimism?

People in care homes are amongst the most vulnerable in society, not to mention the loneliest and most neglected. Excluding them from COVID testing and treatment is despicable. I don't have the words.

Here's an old Danish poster from 1918 (attached), so just over a century ago. Let me try translating:

Precautions against spread of the flu

1. observe the best possible cleanliness
2. cover your mouth with your hand when coughing or sneezing
3. watch for anyone coughing, sneezing or speaking to you in close proximity to your face
4. keep the phone clean, in particular if used by many
5. vent rooms well
6. keep the healthy away from the sick as best possible
7. avoid unnecessary visits to the sick
8. do not get up too early after recovery
9. avoid places with many people
10. postpone larger meetings and assemblies
11. don't take the tram more than necessary
12. ensure the children get fresh air

The health board, 17th Oct 1918

More or less the same advice today. Old news. Common sense.

Quoting jorndoe

More or less the same advice today. Old news. Common sense.

Everything except mandated mask wearing. This generation is pitiful.

Quoting NOS4A2

I wasn’t dismissing the criticism. I was merely asking why the criticism is US-centric, why other governments, international institutions, and those we pay vast sums of cash to warn us of such threats, are given a pass.

People are usually critical of their country's responses. I've been positive but also critical about my country's response. There has been a lot of debate about the policies implemented by Sweden, many of it critical, hence not all is US-centric.

Quoting Baden

People in care homes are amongst the most vulnerable in society, not to mention the loneliest and most neglected. Excluding them from COVID testing and treatment is despicable. I don't have the words.

If only the UK had universal public healthcare we wouldn't be seeing such things.

Quoting jorndoe

More or less the same advice today. Old news. Common sense.

If they cared about saving lives back then they wouldn't have written it in gibberish.

Quoting ssu

People are usually critical of their country's responses. I've been positive but also critical about my country's response. There has been a lot of debate about the policies implemented by Sweden, many of it critical, hence not all is US-centric.

It's true, but I think it's hard for many not to use this crisis to call into question Trump, capitalism, autonomy, and other Americanisms to show it's somehow a failed system.

But in true American form, Americans really don't care what the world thinks about them.

Quoting Hanover

I really don't see how this answers my question, which is specifically how the delay in social distancing has resulting in a measurable loss of life, unless you can show that the treatment received under the current conditions has limited the healthcare received and that limitation can be specifically shown to matter.

Even if you don't consider the healthcare angle, delays in implementing quarantine measures do that.

(1) How quickly a disease spreads controls the growth rate of infected cases.
(2) The growth rate of a disease in a population is controlled by how infectious it is in the circumstances it may transmit.
(3) The more likely the circumstances it may transmit are to occur, the more quickly it spreads.
(4) The more quickly it spreads, the higher its growth rate.
(5) More growth rate increases over time yield higher proportions of infected people.

(3) combined with (4-5) lets you consider counterfactuals; if intervention X was taken at time t, what would the growth rate have been? Growth rate calculations let you predict disease effects. You compare the counterfactual situation of doing whatever intervention vs not doing it, and if the only thing that was changed [hide=*](or, more precisely and generally, you also include knock on effects of the intervention) (Considering that the knock on effects of delayed intervention include healthcare overload, they are also implicated in the delay, like COPD risks are implicated in smoking risks)[/hide] was the intervention (like social distancing), the discrepancy between the two scenarios in whatever statistic you like is attributable to the intervention (or lack of it).

It's exactly the same logic as in this scenario: if you've been gross enough at some point in your life to have a pan go mouldy, and you choose not to wash it on a given day, the next day's extra mould is attributable to your lack of washing the blooming thing, just as washing the blooming thing makes the mould goes away.

Or the same logic as vaccinations; if we agree they are responsible for saving lives, administrative responses to pandemics can be responsible for killing people.

Quoting Hanover

But in true American form, Americans really don't care what the world thinks about them.

Very true...very.

Quoting Hanover

It's true, but I think it's hard for many not to use this crisis to call into question Trump, capitalism, autonomy, and other Americanisms to show it's somehow a failed system.

No one is throwing all the deaths at capitalism's feet, anticapitalist; specifically anti-austerity; criticism which has been going on (in Europe too, even in countries with universal healthcare) is all just saying that the kind of welfare system investment strategy that diminishes access as compared to effective universal healthcare amplifies the knock on effects of the virus by reducing how prepared hospitals could be, and how short sighted postponing quarantine measures (among other things, like too little testing) was by the administrations that chose to take that route.

The anticapitalist generalisation is just that this is business as usual when organising investment based on return on investment than the public good, and favouring the short term concerns of the economy versus longer term concerns and the public good.

Quoting unenlightened

So 13 people have died out of 72 old folks in this one care home.

26 out of 65 here:

https://www.rcinet.ca/en/2020/04/07/pinecrest-nursing-home-the-logistics-involved-in-horror-are-revealed/

Quoting unenlightened

You are going to give a plausible explanation for an 18% death rate.

I can give you the centrist/conservative line on this if you like.

Well no investment strategy in healthcare could possibly have provided for everyone in every old person's home. The 18% death rate is much higher than the one observed under effective treatment because resources were rightly prioritised to hospitals to deal with the worst cases. It's unfair to think of this as some grand conspiracy to kill people simply because we didn't know enough about the disease in time and we didn't know it was coming. A pandemic is impossible to plan for, the healthcare system will always be overloaded in those circumstances.

It's so easy to start thinking with my gut and be sane.

Quoting Metaphysician Undercover

So 13 people have died out of 72 old folks in this one care home.
— unenlightened

26 out of 65 here:

we know the overwhelming majority of COVID-19 deaths occur in patients that are already suffering from a number of other conditions. In Italy, for example, data shows 99 percent of COVID-19 deaths occurred in patients who had at least one other condition. More than 48 percent had three other conditions. Similar cases in the US are now likely to be routinely reported simply as COVID-19 cases.

https://mises.org/wire/march-us-deaths-covid-19-totaled-less-2-percent-all-deaths

Makes sense to me.

Quoting Hanover

But in true American form, Americans really don't care what the world thinks about them.

And in true non-American form, we don't care that you don't care what we think about you. We're going to tell you anyway.

Ok, your turn.

Quoting fdrake

No one is throwing all the deaths at capitalism's feet, anticapitalist; specifically anti-austerity; criticism which has been going on (in Europe too, even in countries with universal healthcare) is all just saying that the kind of welfare system investment strategy that diminishes access as compared to effective universal healthcare amplifies the knock on effects of the virus by reducing how prepared hospitals could be, and how short sighted postponing quarantine measures (among other things, like too little testing) was by the administrations that chose to take that route.

The anticapitalist generalisation is just that this is business as usual when organising investment based on return on investment than the public good, and favouring the short term concerns of the economy versus longer term concerns and the public good

I just don't see that this has much to do the economic system or health care system as much as it has to do with individual leadership style and decisions made by certain personalities.

The UK appears to be overlooking their most vulnerable despite having nationalized healthcare. The Swedes seem to think laissez faire is the way to go despite being staunchly socialist. GW Bush is credited for creating a national response program to pandemics despite being whatever the hell be was.

Whatever problems the US may have, I don't think they were exposed or made more evident by this crisis. The US numbers are better than many and fared pretty well comparatively. I don't give it a pass for any errors, but it's reponse hardly gives concern that anything systemic needs changing other than a laying out a specific protocol that should be followed for future similar events.

Quoting Merkwurdichliebe

Makes sense to me.

It might make sense to you, but for that virus to spread through a nursing home and kill more than a third of the residents in just two weeks time, is quite incredible no matter how you choose to look at it.

Quoting Baden

And in true non-American form, we don't care that you don't care what we think about you. We're going to tell you anyway.

Ok, your turn.

But you do care, else there'd be far less discussion of Trump and far more discussion of the Irish leader whoever that is.

Your turn.

Reply to Hanover

Quoting Hanover

If only the UK had universal public healthcare we wouldn't be seeing such things.

Bug. Not feature. Want to know who the bugs are?

Quoting Hanover

Whatever problems the US may have, I don't think they were exposed or made more evident by this crisis.

Have you looked?

Seriously, "test, isolate, treat" is the maxim for dealing with a pandemic. Having a healthcare system which makes people avoid those measures on pain of bankruptcy or being unable to eat for a week is absolutely insane, and I have no idea how you could think of this as anything but a catastrophic design problem; read, a systemic issue.

Edit: even staunch proponents of this incredibly stupid state of affairs realised it was stupid and instituted Medicaid for all (effectively) to address the problem. Let's hope it stays that way.

lost my job completely today because financial aid for my employer didn’t materialize in time.

Inconclusive facts half truths are very dangerous to an uninformed and under educated populous. If there is any lesson to be learned from this forged crisis is not to jump to conclusions about what the media is presenting you as so called facts... This society has lost all faith and wisdom. We have faced countless pathogens bacteria and viruses in the past. Never have ive seen such ignorance and panic in all of my 39 years of being on this planet...

Quoting Metaphysician Undercover

It might make sense to you, but for that virus to spread through a nursing home and kill more than a third of the residents in just two weeks time, is quite incredible no matter how you choose to look at it.

I agree. It is incredible. There is a lot of incredible fuckery going on in the world right now.

Quoting BeastdarityBarbarianProphet

Never have [I] seen such ignorance and panic in all of my 39 years of being on this planet...

Well, you're still relatively young, give it time.

Reply to Pfhorrest

I’m sorry to hear, friend. Times are bleak, many are in the same boat. I know that’s no consolation but you are not alone. Godspeed.

Reply to NOS4A2 Thanks.

I think I’ll post this again. Clearly some people missed it the first time around:

https://m.youtube.com/watch?v=gxAaO2rsdIs

Note: Pay attention to the section that gets infected and the section that doesn’t get infected. Slowly the spread brings the virus to a halt. I think what some people are asking above is how low the number infected can be kept - last I heard Fauci said between 50-75% infected (which is better than 100%). Clearly the sooner preventative measures are put in place the less people get infected. ALSO if you watch the video all the way through you’ll see the chaotic nature of this and the risk of lifting measures too soon - which would basically make most of the lockdown measures a complete waste of time. It’s playing roulette to some degree, the best preventative measures are no guarantee when dealing with chaotic systems. The difficulty is in deciding where to draw the line given the huge margins of error involved (if anyone ‘gets it right’ it will be due, in part, to pure luck).

Here’s something else tangental to consider: https://smallcaps.com.au/coronavirus-could-speed-up-introduction-cashless-society/

Quoting Hanover

Whatever problems the US may have, I don't think they were exposed or made more evident by this crisis. The US numbers are better than many and fared pretty well comparatively. I don't give it a pass for any errors, but it's reponse hardly gives concern that anything systemic needs changing other than a laying out a specific protocol that should be followed for future similar events.

It really is too early to tell how countries did because policy who to test carry rather wildly. The Netherlands only tests severe cases, healthcare workers and people who died. Our deaths is a very accurate figure, but our infected isn't. The latter is probably similar to Germany's.

The only country I suspect has really accurate data is South Korea.

Reply to Benkei What about Vietnam?

https://www.scmp.com/news/asia/southeast-asia/article/3079598/coronavirus-whats-behind-vietnams-containment-success?fbclid=IwAR2irzKkJaJkaLgOSi9VU6UQ1nVajeyozkxtiHN5qf2GyfClHDAfENbXxY4

Quoting Hanover

My understanding of the social distancing concept is that it is to level out the curve of infections so as to be sure there is adequate healthcare (especially with regard to there being sufficient ventilators) to treat the curable.

That's one goal, but not the only one...

Quoting Hanover

Social distancing obviously will slow the spread of the disease, but I really don't think we can expect it to reduce the overall occurrence given sufficient time unless you're committed to removing the most vulnerable from the population long enough to find a vaccine (a year?).

With the suppression (or hammer) strategy, the goal is to get the epidemic under control as quickly as possible. That is, for the number of new cases to be reduced to close to zero and for comprehensive testing and contact tracing to be in place to isolate those cases. Then people can essentially return to life as normal with just some measures retained such as border control checks and limits on large gatherings. See, for example, China and South Korea (albeit tentatively - we'll see how it goes). Australia and New Zealand, among other countries, may soon be there as well.

Consider an analogy with forest fires. As long as there are proper safeguards and monitoring in place for small local fires, large uncontrolled fires need not break out. Of course if they do break out, then suppression is needed again.

Reply to unenlightened

"Although I suspect that Johnson has had a Damascene conversion following his own infection."
— Punshhh

Any reason for your uncharacteristic optimism?

If you listen to Johnson's speeches after he returned from hospital he sounds different, there could be a decent fellow inside, which has come to the surface while he stared death in the face. He accepts that his life was in the hands of some immigrant nurses and he has seen the good work the NHS does from the inside. I might be wrong, let's see what he does when he returns to the fray. He really should kick out Raab and Patel, who are actively hostile to the NHS ( and a lot else besides). If he goes back to business as usual, he really will cement his reputation for being a hypocrite.

Quoting Hanover

It's true, but I think it's hard for many not to use this crisis to call into question Trump, capitalism, autonomy, and other Americanisms to show it's somehow a failed system.

People can question government policies, outsourcing, just-on-time logistics and the absence strategic reserves or the health care policies without them referring to the American discourse. As the problems and the discussion is the same as in the States, you might think otherwise. But of course now as the US is at the present epicenter of the pandemic, it's no wonder that the discussion is focused on you.

Quoting Hanover

But in true American form, Americans really don't care what the world thinks about them.

You just assume foreigners hate the US, I guess. In true American form, can there be any other discourse than the American one?

Reply to Pfhorrest Hang on in there, the economy should bounce back once the virus is under control.

Reply to Punshhh Thanks. Provided the extended unemployment benefits actually come through, I can basically treat the time from now through the end of July as an extended "summer staycation" financially, and barely lose anything. Hopefully by then things will be back to normal, and my job will re-materialize. The boss definitely wants me back, so much that he's letting me hang on to my work computer (I telecommute anyway).

Some hard figures (update coming today too) about the underlying causes of death for ALL deaths this year in the UK up to April 3:

https://www.ons.gov.uk/file?uri=%2fpeoplepopulationandcommunity%2fbirthsdeathsandmarriages%2fdeaths%2fdatasets%2fweeklyprovisionalfiguresondeathsregisteredinenglandandwales%2f2020/referencetablesweek14202013042020165839.xlsx

Note: They’ve been careful to note death where Covid was mentioned AND where Covid corresponds to respiratory failure resulting in death (there is no attempt to exaggerate the figures).

Quoting fdrake

Have you looked?

Seriously, "test, isolate, treat" is the maxim for dealing with a pandemic. Having a healthcare system which makes people avoid those measures on pain of bankruptcy or being unable to eat for a week is absolutely insane, and I have no idea how you could think of this as anything but a catastrophic design problem; read, a systemic issue.

I have looked. The death tolls in France, Italy, Spain, and the UK are much higher per capita than the US, despite them having the healthcare systems you believe will result in lower death tolls. Americans requiring healthcare cannot be denied healthcare. It's the law. You simply don't have any data to support that the American situation has been caused by or is aggravated by its brand of healthcare.

Reply to Hanover

I dunno what to tell you. If you don't deny that "test, isolate, treat" when consistently applied has demonstrably lead to bankruptcy in the US and not other countries, or that the healthcare system required a policy hotfix towards something much closer to free (at least more affordable) universal healthcare to address the issue by your administration. The US administration acknowledged the systemic issue and took a measure to rectify it. Let's hope it does not get repealed.

Quoting ssu

But of course now as the US is at the present epicenter of the pandemic, it's no wonder that the discussion is focused on you.

The epicenter remains the path from Spain, France, and Italy, with numbers far worse than what the US is reporting. In fact, the US pandemic is largely limited to a few areas, primarily New York and some surrounding areas. I'm in Atlanta, and saying that I'm at the epicenter is a bit of a stretch, considering my experience is dramatically different from Manhattan. As I watched Italian reports, it seems that country is truly in a state of devastation, but that's really not the experience where I am. Maybe New York can be said to be a hotspot right now, but whether that's going to spread like wildfire across the US seems unlikely.

Quoting Baden

Bug. Not feature. Want to know who the bugs are?

You speak a broken English and you speak in riddles, but, yes, answer that question for me, although I'm not sure what it is.

Reply to Hanover

You have such a poor track record saying true things about the virus and the effectiveness and necessity of policy interventions it's difficult to take what you're saying seriously. You've downplayed the spread of coronavirus and its seriousness at every opportunity. Except the one where you said you shouldn't do it any more, and then continued to. You keep flip flopping without ever losing any of the passion in your arguments!

Quoting Hanover

My prediction is that no one here will die or lose a close family member to the virus.

[hide=More stuff]
Quoting Hanover

It sounds like unsound government policy got the Italians where they are.

Showing that you believe policy can actually impact the disease a lot.

Quoting Hanover

I put all my hope in a scientific solution, not in a policy one. My trust isn't in some politician of any party of any country to figure out how to fix this.

Contradicting the above.

Quoting Hanover

My proposal is not just to let nature take it's course, but instead to invest the trillions we intend to to prop up the economy on ventilators, hospital beds, and better treatment in an effort to drive down the deaths from the infections, as opposed to the futile battle to control the infection rate, which will just further damage all sorts of lives in the process.

Defending not social distancing or quarantine measures (despite blaming Italy's admin for not adhering to them well enough).

Quoting Hanover

Currently .02% of the world is infected with the coronavirus (169,387 / 7,771,074,926). The percentage of worldwide deaths rounds to 0.00% (6,513), but if you take it out enough decimal points you will eventually see some evidence of it.

Quoting Hanover

The US is at 41. That's 41/50ths a person per state we've lost. Do you know what it's like to lose just over 80% of a person? It's not pretty I tell you.

And other people already corrected your calculations[/hide]

Quoting fdrake

I dunno what to tell you. If you don't deny that "test, isolate, treat" when consistently applied has demonstrably lead to bankruptcy, or that the healthcare system required a policy hotfix towards something much closer to free (at least more affordable) universal healthcare to address the issue by your administration. The US administration acknowledged the systemic issue and took a measure to rectify it. Let's hope it does not get repealed.

It's always been the case that emergency care (as defined by the patient) cannot be denied regardless of ability to pay. That rule has led to those without health insurance using emergency rooms to treat for minor illnesses. Inner city hospitals routinely make no effort to collect those fees, and that care has been provided at government expense for some time. That is a shortcoming of the American system, and it contributes to the high dollar expenditure by the government for healthcare.

But, if what you're trying to say is that there are people dying of treatable illness in the US, including of coranavirus, due to inability to pay, or that that has been the case in the past, that is not true. It's also not true that those nations with public healthcare systems in place has fared better than the US in this crisis. If your point is that the US has deployed government resources in response to a health care crisis in a way that goes far beyond how it provides social security in normal times, I agree with that. I don't follow, though, why what we do in an emergency should be expected in normal times. I think I can be expected to provide for myself more in normal times than I do in a state of emergency, just as I can expect to be left alone most days to fend for myself, but I fully expect a county owned firetruck to roll up when my house is on fire.

Quoting fdrake

Showing that you believe policy can actually impact the disease a lot.

I do think that. That's obvious. Quoting fdrake

I put all my hope in a scientific solution, not in a policy one. My trust isn't in some politician of any party of any country to figure out how to fix this.
— Hanover

Contradicting the above.

That's not a contradiction.

I trust scientists more than politicians, even though I accept that government decisions can impact the result.
[/Quoting fdrake

My proposal is not just to let nature take it's course, but instead to invest the trillions we intend to to prop up the economy on ventilators, hospital beds, and better treatment in an effort to drive down the deaths from the infections, as opposed to the futile battle to control the infection rate, which will just further damage all sorts of lives in the process.
— Hanover

Defending not social distancing or quarantine measures (despite blaming Italy's admin for not adhering to them well enough).

I still think that the logic of the social distancing is based upon keeping the serious cases low enough not to overwhelm medical care available. The solution then can arise is two ways, either (1) decrease the number of serious cases at any given time through social distances, or (2) increasing the amount of available healthcare (including ventilators). That's true as far as i can see it.Quoting fdrake

Currently .02% of the world is infected with the coronavirus (169,387 / 7,771,074,926). The percentage of worldwide deaths rounds to 0.00% (6,513), but if you take it out enough decimal points you will eventually see some evidence of it.
— Hanover

The US is at 41. That's 41/50ths a person per state we've lost. Do you know what it's like to lose just over 80% of a person? It's not pretty I tell you.
— Hanover

And other people already corrected your calculations

My numbers are generally correct. If I missed the decimal space one or two spots nothwithstanding, it's very much the case that the raw percentages of people worldwide contracting the disease and dying from disease is very very low. That's just true. But don't spin that into me saying that death is no big deal just because someone died of a rare disease.

Quoting Hanover

. As I watched Italian reports, it seems that country is truly in a state of devastation

I don't think so. Numbers are declining there. Here no news is good news. And in Italy the worst hit regions have been in the North, not the South. Single glimpse at the maps below and you can see why not much has been reported from Rome, the biggest city in the country.

(number of cases)


How the pandemic spread in Italy and how the lockdowns were implemented:

Reply to Hanover

Quoting Hanover

I do think that. That's obvious.

It seems you think that now that policy interventions have been implemented in the US, and were extremely skeptical of it beforehand. You demonstrably were not convinced they were necessary, even after the first confirmed cases in the US by date; that includes social distancing. You've passionately argued about the necessity of keeping things going, and... what was it... Keeping everything going as normal when the old people are safely locked away?

Maybe you changed your mind! Maybe you didn't notice. Maybe your past positions are defined by your current declarations, who can say? We all do that to some extent.

Quoting Hanover

My numbers are generally correct.

You quoted the right numbers, up to some decimal error. But you interpreted them completely wrongly. You used them rhetorically to downplay the virus without checking you had interpreted them correctly, when you could've looked up how epidemiologists were interpreting the spread, and supported what scientific policy interventions they were recommending. Rather than predicting that no one would die from the disease in the US (presumably from the context because you believed it would not reach the US ( when there were already confirmed US cases and the information was publicly available.

An old physics teacher of mine forgot to multiply Plank's constant by 10^-34, instead multiplying it by 10^34, when calculating a photon's momentum, he ran with it, and said "As you can all see, a single photon has a massive amount of energy". Our class later calculated that with that understanding, a normal bit of light has equivalent energy to over 100 Hiroshima nukes. He defended it adamantly when later questioned, and eventually switched to the correct interpretation quietly over the course of months.

It wasn't that you made typographical errors, it's that you've yet to actually demonstrate any predictive understanding of the numbers you're quoting, or shown any skill in interpreting or contextualising their consequences, or shown willingness to actually look up what you're writing about the virus before you post it.

I'm definitely a partisan hack when it comes to their interpretation; though the view that austerity programs creating healthcare access problems, or healthcare access programs more generally, have exacerbated the effects is probably true; but I make sure I get my facts interpreted right when posting.

Quoting Hanover

I still think that the logic of the social distancing is based upon keeping the serious cases low enough not to overwhelm medical care available. The solution then can arise is two ways, either (1) decrease the number of serious cases at any given time through social distances, or (2) increasing the amount of available healthcare (including ventilators). That's true as far as i can see it.

It isn't a choice between them, we need quarantines to decrease the load on healthcare resources; unmitigated growth of the disease would almost certainly quickly overwhelm any immediate investment strategy (the beds and buildings and respirators take time to construct and arrive). The best option is to do both, and focus on testing and isolation, while doing whatever can be done to ensure that serious cases get the resources they need despite the huge load increase from the pandemic (which, as was known beforehand, should be mitigated by quarantine measures).

Despite it being commonplace that people in the US avoid healthcare treatment due to its prohibitive cost being well established before the virus, the cost of a mere coronavirus test was 100 dollars; a debilitating chunk of, if not more than a week's minimum wage after tax + rent; which until the emergency bill to fix that glaring problem was coming out of wage earner's pockets. They certainly could not have afforded any further treatment (costing in the 1000s of dollars) if they tested positive! Countries which do not offload the costs of dealing with a pandemic into their poorest' citizens wage packets (which have also not been inflation adjusted for years and years and years...) did not need to hotfix their healthcare system to deal with a pandemic in this way. It exposes a devastating error in healthcare access in the US that even the supporters of this devastating error had to acknowledge and address when it poured gasoline all over and started nonchalantly smoking inside of that lethal dumpster fire you passionately defend as a healthcare system.

Quoting Hanover

The solution then can arise is two ways, either (1) decrease the number of serious cases at any given time through social distances, or (2) increasing the amount of available healthcare (including ventilators). That's true as far as i can see it.

False dichotomy. Please reprogram your brain with logic and understanding. Thank you.

Both France and the UK have oddly high mortality rates, but the UK's is substantially worse. I look forward to some downstream analysis of how each country managed.

Specifically, was the UK's result a matter if demographics, treatment strategy, or what? I guess we're too close to it now to make an assessment.

Quoting frank

Specifically, was the UK's result a matter if demographics, treatment strategy, or what? I guess we're too close to it now to make an assessment.

My guess is that the UK's is high because testing isn't commonplace. That means that the majority of confirmed cases are serious ones, it's a data selection bias. Lack of testing can also increase mortality out of sample. There are probably demographic factors at work; like our problem with actually intervening in infected nursing homes, we're hesitant to do that. The exact weighting of them will be unknown for some time, or forever.

My bet is that it's largely attributable to the testing though, as the selection bias based on extreme cases has a multiplicative effect (edit: analogy, like the effect of switching between age categories or comorbidity presence/absence on the (log) odds scale in a risk model) on the estimated mortality risk that applies over all demographics. Norway's tested enough to get the observed death rate of tested cases to be very close to the predicted population risk.

Reply to fdrake Yes, but both countries seem to have lower serious-critical numbers with a high death total. That suggests that instead of lingering toward recovery, they're just dying.

Genetics could also be a factor.

Quoting frank

Genetics could also be a factor.

Heredity is unlikely to multiply the death rate within countries by a factor of 6 compared to the predicted population risk when genetic effects are constant over effected populations.

Quoting Baden

The solution then can arise is two ways, either (1) decrease the number of serious cases at any given time through social distances, or (2) increasing the amount of available healthcare (including ventilators). That's true as far as i can see it.
— Hanover

False dichotomy. Please reprogram your brain with logic and understanding. Thank you.

It's a false dichotomy only if I presented it as a dichotomy. Purely hypothetically, you might say that if I support Trump, I'm either (1) a mindless Republican, or (2) drunk. There's nothing in that sentence that says I can't be both.

You can't read ordinary conversation like a syllogism, but, for the sake of clarity, please do insert the words "or both" somewhere in my sentence so that I can avoid my embarrassing logical fallacy. Thank you.

Quoting fdrake

Heredity is unlikely to multiply a country's death rate within countries by a factor of 6 compared to the predicted population risk when genetic effects are constant over effected populations.

True. I'd be happy to explain how genetics could be a factor.

Oh wait, no I wouldn't. :joke:

Quoting frank

Oh wait, no I wouldn't. :joke:

Give me a link then.

Reply to fdrake I don't have a link. Are you actually interested in how genetics affects the robustness of pulmonary tissue?

Reply to frank

Ah. Yeah, I read about that. Attributing the observed risk inflation between countries to something which is constant over those populations is strange. I was hoping for a link that shows, say, Norwegians are way, way more likely to have good heart tissue genetics vs UK people. To my understanding, it's a good tool for explaining the weird what appears to be post recovery heart failure, but explaining such a large inflation of observed risk (on the population level) by something that each population has in approximately the same degree does not make sense.

I have been reading along but my song stopped when I realized that maybe this item was not as well published around America.

I have a father with many commodities and has his DNR card updated monthly and well placed on him and the refrigerator at home. IF something were to happen to him at this point in time, nothing would be attempted per his desire. HOWEVER my MOM would only get one shot if she were to flat line. She with an Afib is taking care of him at home. How the F* is that fair? He is 100% paced with a pacemaker and no desire to live and she has the desire to live long past him.

See where things tend to get 'sticky' when trying to save lives via policy?

And I realize this is RT but it has another view of what is happening, There is a point system as to whom to "save" and as crude as it is, where people's baseline health is plugged into an equation that takes into consideration what the chances are that the person will survive: ie: commodities and what 'value' the person has to the future ie: their profession. It's raw but it happens and I would like to think that our society didn't use such a grading system but it happens.

Reply to fdrake I'd need access to a keyboard to talk about it more. It would be genetics in combination with other factors, not genetics alone.

Quoting frank

I'd need access to a keyboard to talk about it more. It would be genetics in combination with other factors, not genetics alone.

Aye, it would have to be.

Quoting frank

Genetics could also be a factor.

It's much, much more likely to be a matter of how data is collected, what counts as serious or critical, and so on. There is no established methodology for estimating the prevalence in the population, no international agreement as to what symptoms are counted as serious and no consistency about the circumstances that warrant tests. At the moment in the UK, the advice is that if your life is not in immediate danger because you have breathing difficulties, you should not even contact the health service, just go online and read the advice (take some paracetamol and take it easy). Other cultures may cry 'emergency' if they sneeze, but we are tough. That and pollution levels, demographics of population age, economic factors, diet, and fuck knows what else.

Reply to Hanover

I would never accuse you of being a drunk!

Reply to unenlightened :up:

I hadn't read any articles on it until just now. I was just looking at the raw data.

Reply to Baden Is Hanover drunk?

Reply to frank

Nah, he's just a Republican.

Quoting Hanover

It's a false dichotomy only if I presented it as a dichotomy. Purely hypothetically, you might say that if I support Trump, I'm either (1) a mindless Republican, or (2) drunk. There's nothing in that sentence that says I can't be both.

The "either" in "either ... or ..." means that it can't be both. You Americans need to learn English.

Reply to Michael

He can either choose to accept that or reject it, so he'll probably do both.

Speaking of drunks, I've either started drinking at work or I haven't.

If Trump doesn't have the power to reopen schools, businesses, state and local govt. offices, etc. then did he really have the power to close them down? If it is the power of the governors to reopen their states, then wasn't it their responsibility to close them? If so, then why are people blaming Trump for not closing things down sooner?

Politics.

Reply to Harry Hindu I assume that state governors don’t have access to the intelligence resources that the White House has, for one thing. Also, the criticism isn’t just about not closing things down.

Quoting praxis

I assume that state governors don’t have access to the intelligence resources that the White House has, for one thing.

Its a pandemic not a drone bombing. :lol:

Reply to frank I assume wrongly then?

Reply to praxis I was just being a smart ass.

Brief report on the situation in India: https://m.youtube.com/watch?v=JIhNKZOHJ74

2 days ago:

Quoting boethius

You're forgetting the key elements that the left is to blame for the shutdown (somehow the left is in charge and setting policy in the white house), that Trump has had essentially no agency through the entire ordeal, poor thing

Today:

Quoting Harry Hindu

If Trump doesn't have the power to reopen schools, businesses, state and local govt. offices, etc. then did he really have the power to close them down? If it is the power of the governors to reopen their states, then wasn't it their responsibility to close them? If so, then why are people blaming Trump for not closing things down sooner?

Amazing.

Quoting Baden

He can either choose to accept that or reject it, so he'll probably do both.

There's a difference between asking someone to choose either A or B versus A or not A. The former permits both choices, the latter only one, but not because of the "either," but because of the contradiction in choosing both to be and not to be.

As to the question, do I want bourbon or vodka, the answer is yes.

As more info is revealed, it is becoming increasingly difficult to discount the idea that the pandemic is the result of a lab accident in Wuhan, and the subsequent CCP coverup. This could be China’s Chernobyl. There is more circumstantial evidence for this than there is for the conventional wisdom that it began in a wet market.

State Department cables warned of safety issues at Wuhan lab studying bat coronaviruses

In January 2018, the U.S. Embassy in Beijing took the unusual step of repeatedly sending U.S. science diplomats to the Wuhan Institute of Virology (WIV), which had in 2015 become China’s first laboratory to achieve the highest level of international bioresearch safety (known as BSL-4). WIV issued a news release in English about the last of these visits, which occurred on March 27, 2018. The U.S. delegation was led by Jamison Fouss, the consul general in Wuhan, and Rick Switzer, the embassy’s counselor of environment, science, technology and health. Last week, WIV erased that statement from its website, though it remains archived on the Internet.

What the U.S. officials learned during their visits concerned them so much that they dispatched two diplomatic cables categorized as Sensitive But Unclassified back to Washington. The cables warned about safety and management weaknesses at the WIV lab and proposed more attention and help. The first cable, which I obtained, also warns that the lab’s work on bat coronaviruses and their potential human transmission represented a risk of a new SARS-like pandemic.

https://www.washingtonpost.com/opinions/2020/04/14/state-department-cables-warned-safety-issues-wuhan-lab-studying-bat-coronaviruses/

Quoting Harry Hindu

If Trump doesn't have the power to reopen schools, businesses, state and local govt. offices, etc. then did he really have the power to close them down? If it is the power of the governors to reopen their states, then wasn't it their responsibility to close them? If so, then why are people blaming Trump for not closing things down sooner?

Different states have imposed different restrictions. Where I live, the first thing to happen was the county closed the local schools. The city where I lived then closed down restaurants. A number of other cities within my county began doing the same thing. Then the county closed everything down, but it did it by joint resolution of all the cities within the county. Then other counties did the same. Finally the governor shut everything down throughout the state. Interestingly, the state preempted the cities and the state reopened the beaches, which pissed off the mayors along the coast who wanted them closed.

Trump can close down the interstate travel, but I saw in Florida (and other places), they're not letting people cross state lines without good reason. I doubt that's Constitutional, but whatever.

I suspect that Trump could take full charge and declare a national emergency where he would have the right to close the schools and all the stores and issue a complete lock down. The truth is that that Americans really aren't that rebellious of a group and if the President issued a decree that everything close, it's very doubtful some local government would open up for business and Johnny would board the school bus and go off to school.

But, as to your question, if I hold a beer fest in the park with 500 of my friends, I will be charged with a state crime. I will not be charged with a federal offense. The states are the ones imposing these restrictions. But Trump could have closed the country down by just saying it must be done, as he has that level of influence, regardless of whether his decree was made enforceable by federal marshals.

Quoting frank

I was just being a smart ass.

Bungling a drone strike could cost a handful of lives. Bungling the National response to a pandemic could costs tens of thousands.

Reply to praxis Feeding 12 chickens one bucket of food per day will give you a dozen small eggs.

Feeding the same amount to an ostrich will give you one giant egg.

Reply to frank

Tens of thousands of American lives is like chicken feed to you?! What a monster. :scream:

Reply to praxis Are you saying that ostriches don't make giant eggs?

According to this study, "the key metric for the success of social distancing is whether critical care capacities are exceeded", and in order to avoid this, "prolonged or intermittent social distancing may be necessary into 2022". Assuming their models are accurate, and assuming the economy will suffer under such conditions, without a vaccine or "herd immunity" the lockdown approach appears to be unsustainable.

Abstract
It is urgent to understand the future of severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) transmission. We used estimates of seasonality, immunity, and cross-immunity for betacoronaviruses OC43 and HKU1 from time series data from the USA to inform a model of SARS-CoV-2 transmission. We projected that recurrent wintertime outbreaks of SARS-CoV-2 will probably occur after the initial, most severe pandemic wave. Absent other interventions, a key metric for the success of social distancing is whether critical care capacities are exceeded. To avoid this, prolonged or intermittent social distancing may be necessary into 2022. Additional interventions, including expanded critical care capacity and an effective therapeutic, would improve the success of intermittent distancing and hasten the acquisition of herd immunity. Longitudinal serological studies are urgently needed to determine the extent and duration of immunity to SARS-CoV-2. Even in the event of apparent elimination, SARS-CoV-2 surveillance should be maintained since a resurgence in contagion could be possible as late as 2024.

https://science.sciencemag.org/content/early/2020/04/14/science.abb5793

Reply to NOS4A2

We're going to have to social distance until we get a vaccine. The virus is not going to put up the white flag and leave us alone. That shouldn't be news to anyone at this point. Lockdowns are just one form of enforced social distancing and they'll be ending well before social distancing does. I don't think anyone is arguing we should continue those indefinitely. Mandatory mask-wearing orders are being introduced already and I expect that's the way we'll go: https://foxbaltimore.com/news/coronavirus/mandatory-face-mask-order-to-go-into-effect-in-prince-georges-county

Reply to Baden

Where I live proper masks are difficult to come by, but I think the efficacy of masks and even goggles is obvious at this point. But also, as the study suggests, we need innovation, therapeutics, and any way to help our flailing healthcare systems. I just worry the lockdown can only stifle such efforts.

Quoting Baden

. Mandatory mask-wearing orders are being introduced already and I expect that's the way we'll go

They are actually starting to advise putting plastic bags over your head where I live. I'd strongly encourage you to get ahead of the curve where you live and start doing that so that you're not caught with your pants down again.

The surest way to kill the parasite is to kill the host. Don't overthink that, just go get yourself a head bag. Maybe even double bag it.

Quoting Hanover

They are actually starting to advise putting plastic bags over your head where I live

In your case, you may have misheard "paper bag".

Though I guarantee if you marketed MAGA plastic bags, you could solve most of your country's problems in a few short minutes per user. :flower:

Quoting Hanover

go get yourself a head bag

0:18

Quoting frank

Are you saying that ostriches don't make giant eggs?

No. We should probably verify this with your mom though.

I was dating this girl who thought my lackadaisical attitude during this coronavirus thing was irresponsible and evidence of incompatibility. I told her I found her judgmental and harsh, and that I'd stay with her even if she robbed a liquor store, which was something I found worse than a failure to take the coronavirus thing more seriously. While I thought that persuasive in showing how my commitment would hypothetically exceed hers, she apparently did not. So, after some discussion, we stopped discussing, and now I've got to go through this quarantine alone, which is not at all what I think I should expect during a quarantine.

My point here is that there all sorts of lesser but real casualties that this thing has brought about. I can't help but to feel sad for her, now having to be without me.

Quoting praxis

No. We should probably verify this with your mom though.

Are you saying that @frank's mom is an ostrich? Frank, is that true?

Quoting praxis

No. We should probably verify this with your mom though.

Okay we are officially off course here with your Momma jokes :joke:
Having said that: you don't necessarily get 12 eggs from 12 chickens. Lots of chickens will lay lots of eggs and others are just as content to lay on golf balls. True story.
Another take on eggs and chickens: do to odd circumstances we had to clean out a barn and there were lots of eggs but some were old. We tossed out the eggs in a wheel barrow of horse muck and when we emptied the barrow a couple days later, we found a couple of dead chics. The heat outside and the shade of the compost was the perfect incubator. I just wish we would have known. :broken: After that any unknown eggs were fed to the pigs and chickens, and yes chickens eat their eggs if you break them.
One last total distracted fact but relevant all the same: an dozen chicken eggs is about the same quantity as what you get out of an Ostrich or Emu egg. The Gold Gilded Egg that is so valuable is the size of an Ostrich egg.

Quoting Hanover

My point here is that there all sorts of lesser but real casualties that this thing has brought about. I can't help but to feel sad for her, now having to be without me.

I'm saddened to hear such of such intolerance but I'm not surprised. Having been at home for the last 23 yrs raising the family and now in virtual school has created a work day that is 28/9/366 with my partner.

We have space but I feel an undercurrent that is unsettling. I know that divorce rates are up, suicide is up, spousal and domestic abuse is up as is the use of any vice in the extreme whether that is good, drugs, sex or the loss of any of the three.

Touch deprevation is a real thing and something to be aware of. Virtual hugs to you

Quoting Hanover

It's a false dichotomy only if I presented it as a dichotomy. Purely hypothetically, you might say that if I support Trump, I'm either (1) a mindless Republican, or (2) drunk. There's nothing in that sentence that says I can't be both.

Quoting Hanover

I'd stay with her even if she robbed a liquor store

Quoting Hanover

I hold a beer fest in the park with 500 of my friends

Quoting Hanover

As to the question, do I want bourbon or vodka, the answer is yes.

Are you trying to to tell is that you're an alcoholic?

Quoting ArguingWAristotleTiff

Touch deprevation is a real thing and something to be aware of. Virtual hugs to you

Doing a collection now for @Hanover's paper bag. Might help his love life. Please give generously. :pray:

Quoting ArguingWAristotleTiff

One last total distracted fact but relevant all the same: an dozen chicken eggs is about the same quantity as what you get out of an Ostrich or Emu egg.

Google says two dozen. No Ostriches on the ranch, I take it?

Trump has announced that he will withhold funding for WHO, because they're to blame for the pandemic's spread to the US.

I have no doubt that WHO's processes could have been better - maybe much better. But the appropriate thing to do is to learn from the mistakes, and develop processes to avoid repeating them. Every government entity in the US (federal, state, and local) and in the world should do the same thing.

This user has been deleted and all their posts removed.

Quoting Michael

Speaking of drunks, I've either started drinking at work or I haven't.

Drinking at work, working at home, what's the difference?

Reply to tim wood There are other places where you can partake in serious discourse. This site certainly shouldn’t be your first choice.

Reply to I like sushi Got any recommendations?

Reply to Baden

Doing a collection now for @Hanover's paper bag. Might help his love life. Please give generously.

A bottle of bourbon would be a good start.

A copy of How to win friends and influence people, might be useful.

Reply to Metaphysician Undercover

Drinking at work, working at home, what's the difference?

I think the point is he's working from home.

Reply to Pfhorrest Breitbart's comments section.

Reply to frank

Max Richter, The Consolations of Philosophy

Nice track.

I just wanted to say that I offer you my philosophical and moral support for the work you are doing in this time of existential uncertainty. I think many are thinking of the difficulties being faced now by health workers and how they are now in the front line of a struggle for our world, our way of life. A life which many of us were questioning, before this happened, but which I expect they would take back in a heartbeat, in the newly dawning knowledge of our vulnerabilities. But to then do things differently.

Is this our wake up call?

Reply to I like sushi
There are already news reports appearing about violence and riots around food distribution in undeveloped countries. Countries where many millions of people are at risk of starvation imminently.

Going back to your thoughts, I have sympathy with your sentiment, but as I said before I don't think the developed countries would come to the assistance of these undeveloped countries now due to their own existential crises, even if they had somehow averted the worst effects of the lockdowns and managed to maintain some semblance of normality in their economies. The international community responded in a remarkable way to the last Ebola outbreak. But this was only possible in a normal world, disrupt that and such a response is quickly lost. This crisis is global and catastrophic to our way of life globally, we are struggling to offer assistance to ourselves, let alone anyone else.

Quoting tim wood

Being serious about any topic seems to me to require at least three deliberate actions or stances to take wrt to the topic.

1) To learn about it, or be receptive to competent opinion that in itself seems reasonable and knowledgeable.

2) To act in accord with that knowledge, or what seems knowledgeable, wrt & etc.

3) To treat the topic with appropriate respect.

Corollary: To avoid ignorance and applied ignorance (i.e., stupidity), and to try not to be either.

The problem is that it now days everything becomes political and too many people see a political / ideological agenda in everything. This is one of the most unfortunate issues as the situation is new for us. Yes, we have had corona-viruses a long time. But we have not responded to anything as we have done now since perhaps the Spanish flu. And this situation is totally different. The "Asian flu" or the "Hong Kong flu" pandemics were not tackled like this. Yes, a big part of it is the present media environment which instantly reports everything. We are also very intolerant to deaths from pandemics. We don't accept that many people die of infectious diseases, when we could avoid them.

The inflamed political environment also makes even the scientific discourse difficult. We know that scientist don't always agree on things and those minority views don't have to be trolls or paid to promote disinformation. Because what to do in the pandemic isn't so evident. The "herd immunity" policy isn't totally crazy and we cannot now just brush aside the path that Sweden has opted with it's chief epidemiologist Anders Tegnell as utterly wrong. Countries cannot stay up to 18 months in lock down and really how it goes when countries ease those lock down measures is the real question. In my view it's likely that countries having "flattened the curve" will opt for the Sweden-lite option. But this we will see only when that time comes. In my view perhaps the best policy is first containment, the lockdown once the containment isn't possible before the first deaths and then once the 'curve is flattened', the Sweden option. But of course I could be wrong.

Here's one those 'contrarian' views, professor Knut Wittkowski, who explains herd immunity and isn't a great from of the mainstream policies against the pandemic. Interview done April 1st and 2nd.



And to give another perspective, here's the more conventional view from Dr John Ioannidis.



To say that one is "right" and the other "wrong" is itself the wrong way to look at it.

Anyone who doesn't see these issues as immediately political is a dupe, and all the more a victim and willing participant of shitty politics for it.

Quoting ssu

es, a big part of it is the present media environment which instantly reports everything. We are also very intolerant to deaths from pandemics. We don't accept that many people die of infectious diseases, when we could avoid them.

I'm sure you already know this, but regardless of media reporting, healthcare systems would have been way more likely to fail, and even more people would have died, if their intake wasn't controlled through quarantine measures.

Quoting ssu

The "herd immunity" policy isn't totally crazy and we cannot now just brush aside the path that Sweden has opted with it's chief epidemiologist Anders Tegnell as utterly wrong.

Eventually people will recover or die. The reason "herd immunity" was wrong wasn't because eventually the majority of the population (albeit an ageing one) will adapt and what's the point, it's because people advocating herd immunity explicitly did not want the economic risks of quarantine measures, despite the massive death toll and healthcare system failure that recklessness would have caused.

Quoting ssu

The problem is that it now days everything becomes political and too many people see a political / ideological agenda in everything.

The reasons people resisted quarantine measures were purely ideological, it isn't just the discourse, it's, unsuprisingly, policy being politically/ideologically motivated rather than just looking to the epidemiologists and scientists for cues on how best to manage the pandemic. The delays and resistance from our politicians to implementing quarantine measures were ideologically motivated, later they conformed because they realised they must.

So it is absolutely bonkers to claim that the issue isn't a political one, when the management of a pandemic is an economic, scientific and political project.

You would not be saying "it's all so difficult now that politics is in the mix" if your reference points were Indian police beating the shit out of Muslims breaking quarantine for worship, or the use of a state of emergency for Orban to seize power indefinitely. How it's managed and responded to is political from the get go, unless somehow the world lives inside an epidemiology journal or WHO bulletin.

Quoting fdrake

The reasons people resisted quarantine measures were purely ideological, it isn't just the discourse, it's, unsuprisingly, policy being politically/ideologically motivated rather than just looking to the epidemiologists and scientists for cues on how best to manage the pandemic

It goes beyond this even - a pandemic like this is immediately political not only because of politically and ideologically motivated responses - responses ought to be politically and ideologically motivated - but because the virus's effects are immediately deferentially socially distributed along class and even racial lines. Aside from the fact that - in the US at least - CV has killed disproportionately more black people than others (because less likely to have access to good healthcare, because more likely to work in so-called 'essential jobs', because less able to have the privilege of self-isolating) the virus kills the poorest of the population at incredibly high rates:

"The coronavirus has taken a particularly vicious toll on paraprofessionals, who represent just 19% of the workforce but more than 44% of deaths. The statistics mirror a stark reality across the city: that the virus has fallen disproportionately hard on low-income communities of color... Paraprofessionals, who often work intimately alongside students with disabilities, earn salaries starting around $26,000."

Anyone who says that this virus 'hasn't exposed the cracks in American society' is either not looking, or a deliberate hack. As Jodi Dean says aporpos 'opening up' again:

The various discussions of return and re-opening are misleading. They proceed as if the primary differences that matter are in terms of region, geographical location. But this prevents us from seeing the class character of re-opening: who is returning to what and under what conditions?

If we think about the 50 deaths in the NYC public school system, does return mean increasing the exposure of teachers' aides, teachers, cafeteria workers, janitors? Does it mean increasing the risks to children who will then take the virus back to their families living in close quarters? Are the decision-makers thinking about the over-crowded and under-served public schools?

I expect that the goal is letting the top 10 percent live good lives while continuing to sacrifice the warehouse workers, delivery personnel, grocers, food processing workers, farm workers, etc. Already the food supply is taking hits as large scale food processing plants are closing down (rather than take appropriate precautions to make the factories safe, provide the workers adequate space and PPE, and pay them overtime and health benefits). Already agricultural workers are being infected, transmitting the virus to each other, and then ultimately being left to die. Return to normal is the name for legitimating this condition.

Re-opening the economy appears to be focused on the privileged. If the economy is opening the workers continue to die, while high income people can go on like before. The media and the politicians will move on, talk about the stock market, and let a death rate of 500 or so per day in New York state be the new normal. The more the focus is on re-opening, the less visible will be the necessity of a rent, mortgage, and debt jubilee, the violence and cruelty of employer based health insurance.

Normal = class war.

This event is political all the way down. It is not the crust on some perfectly apolitical cake. Anyone who doesn't see it, or denies it, is complicit with the way in which the politics of this is current, actually, playing out.

Of course, that's not to say that ideological responses ought to be discounted. They should be put front and centre too. Like the fact that the bailout tax benfits will overhwelmingly be geared towards helping millionaires - i.e. "80 percent of the benefits of a tax change tucked into the coronavirus relief package Congress passed last month will go to those who earn more than $1 million annually,"

https://www.washingtonpost.com/business/2020/04/14/coronavirus-law-congress-tax-change/

Quoting StreetlightX

It goes beyond this even - a pandemic like this is immediately political not only because of politically and ideologically motivated responses - responses ought to be politically and ideologically motivated - but because the virus's effects are immediately socially socially distributed along class and even racial lines. Aside from the fact that - in the US at least - CV has killed disproportionately more black people than others (because less likely to have access to good healthcare, because more likely to work in so-called 'essential jobs', because less able to have the privilege of self-isolating) the virus kills the poorest of the population at incredibly high rates:

:up:

Anyone who wants to keep responses to this 'apolitical' is doing nothing but endorsing the hyper-politicised situation that exists on the ground at it stands. It's as stupid as those liberal fucks who say "I don't see color" while vast racial injustice bleeds out of every corner of the world. It's not by avoiding politics that one sees reality for what it is; it's by avoiding the reality of politics that one avoids reality entirely. It's wilful, harmful ignorance.

I watched a programme about Bergen Belsen las night. film of the bodies being buried by the thousand in mass graves when it was liberated, and the place being burned to the ground to disinfect it. Over 14,000 inmates died after the liberation.

I also heard that UK policy has been to send recovering CV patients to care homes and hospices. You know, those care homes and hospices that were being shielded and so didn't need PPE or tests. It's odious to make any comparison.

I am odious.

Today there is a new policy to test in care homes. But there are still not enough tests for the hospitals, so they might as well have a policy to send the virus to the moon. or shoot it on sight, like that chap in the Philippines.

I have a sore throat and a cough, so I am using a non-touch screen and wearing gloves to post. You should probably still cover your eyes before reading this - duct tape is good.

Reply to Punshhh I don’t agree. The world can act together. The quicker the developed countries get sorted out the sooner they can ship supplies and equipment to help out.

The whole reason I am posting anything anywhere is to keep this in the minds of those who are focused on what is happening in their own doorstep. The point being, once the restrictions start lifting and cases go down, there needs to be a public voice pushing to put a plan in place to help other countries.
That voice is already getting louder.

Quoting praxis

I assume that state governors don’t have access to the intelligence resources that the White House has, for one thing. Also, the criticism isn’t just about not closing things down.

:roll:
This doesn't answer my question. If the governors don't have access to the intelligence resources that the WH has, then why are they saying that they have the power (which would include the resources) to re-open their own states, and not the WH?

If they have the power bestowed by the Constitution, then it would imply that they would have set resources in place for them to carry out their powers. If not, then shame on all the governors for not being prepared to take on the responsibilities dictated by the Constitution since the founding.

Quoting boethius

Amazing.

Not the term I would choose to describe the inconsistency of political partisans - those who see life through the prism of politics. The term I would use is, "pathetic".

Quoting Hanover

But, as to your question, if I hold a beer fest in the park with 500 of my friends, I will be charged with a state crime. I will not be charged with a federal offense. The states are the ones imposing these restrictions. But Trump could have closed the country down by just saying it must be done, as he has that level of influence, regardless of whether his decree was made enforceable by federal marshals.

Blasio tried to shut down NYC schools for the rest of the school year but was blunted by the NY governor. The governor has control of the school system, the local police force, state and local government offices. They don't have control over the national borders or even their own borders. The president only has the power to close down the national and state borders.

Quoting Hanover

I suspect that Trump could take full charge and declare a national emergency

This only gives the president power to provide federal funds to the states to handle their emergencies, not the power to tell them when to close things down and reopen them.

Trump yesterday:

“Today I’m instructing my administration to stop funding of the WHO while a review is conducted to assess the WHO’s role in severely mismanaging and covering up the spread of the Coronavirus”.

There should be an investigation. The failures are unforgivable.

Quoting fdrake

The reason "herd immunity" was wrong wasn't because eventually the majority of the population (albeit an ageing one) will adapt and what's the point, it's because people advocating herd immunity explicitly did not want the economic risks of quarantine measures, despite the massive death toll and healthcare system failure that recklessness would have caused.

I acknowledge that there is the crowd that put basically the economy before anything, but I don't the chief epidemiologist Tegnell in Sweden had (and has) that in mind. Or Wittkowski above. Even my little country, which now has emergency laws and has quarantined the whole Capital region from the rest of the country doesn't have a curfew in place. To argue that people should stay inside their homes and not venture out is dismissed as humbug by doctors here. You can choose something between a) doing nothing and b) having a curfew.

And should be remarked here that people aren't against quarantining those that have the disease, it's simply how drastic quarantine measure of everybody are you talking about.

Quoting fdrake

The reasons people resisted quarantine measures were purely ideological, it isn't just the discourse, it's, unsuprisingly, policy being politically/ideologically motivated rather than just looking to the epidemiologists and scientists for cues on how best to manage the pandemic.

My old father, who's a professor of viriology, said to me that we'll find out after summer or so if Sweden's option was better or not. Herd immunity isn't a fabrication or nonsense, on the contrary.

There are those who do indeed think from purely ideological stance about this, even in this forum, NOT from an epidemiological view point at all. This I do admit. My only point is that there really is the medical/health policy discourse on the subject, something that you seem to deny.

Quoting fdrake

The delays and resistance from our politicians to implementing quarantine measures were ideologically motivated, later they conformed because they realised they must.

It wasn't that. It wasn't about implementing quarantine measures, but any kind of response to the pandemic. Basically it was about denying there to be any serious pandemic at all. That's a huge difference.

Quoting fdrake

So it is absolutely bonkers to claim that the issue isn't a political one, when the management of a pandemic is an economic, scientific and political project.

I'm not saying that the decision wouldn't be political, because it naturally inherently is political. What I'm just arguing is that it is bonkers to think uttering something about herd immunity or that a severe "lock down" wouldn't perhaps be best course of action is just based on ideological stance of a person. That's my point. But for you it seems so when you say: "The reasons people resisted quarantine measures were purely ideological".

So what's the "purely ideological" reason for Swedish social democrats to choose the more lax measures?

Quoting StreetlightX

Anyone who says that this virus 'hasn't exposed the cracks in American society' is either not looking, or a deliberate hack. As Jodi Dean says aporpos 'opening up' again:

It hasn't. Even should I assume your assessment is correct, it's not like I've not heard it before, meaning nothing new has been exposed. I disregard your concerns because they're agenda based, and it's an agenda I don't agree with, which is that the impoverished you identify are not benefited better under the current system more than they would be in whatever alternative you're envisioning.

And I do find this all sidetracking and politicizing, which serves no purpose other than to hijack this crisis to promote your political agenda. The predictable result will be that those opposed to your agenda will fight you every step of the way, even when some of the healthcare measures proposed might be objectively valid. That is what is happening, by the way.

You've sort of taken on this idea that anything less than a vitriolic diatribe is cowardly, like the time for rebellion is NOW! It's entertaining, but I can't imagine it moves your opponents any closer to your position. Maybe your objective isn't to persuade, but just to rally the troops. I really haven't figured it out.

Quoting Hanover

I disregard your concerns because they're agenda based, and it's an agenda I don't agree with, which is that the impoverished you identify are not benefited better under the current system more than they would be in whatever alternative you're envisioning.

What could this possibly mean as a response to the fact that the poor and the non-white are being infected and killed off at higher rates? Does reality have an agenda? Is reality an agenda for you? If you disregard reality, then so much the worse for you, not reality.

I dunno, the death of the poor and the marginal doesn't seem like a sidetrack. It makes me wonder how it could seem that way to anyone. Actually scratch that. They've always been ignored - dismissed, 'disregarded', in your words, as a sidetrack - precisely by people like you.

This user has been deleted and all their posts removed.

Quoting Hanover

and it's an agenda I don't agree with, which is that the impoverished you identify are not benefited better under the current system more than they would be in whatever alternative you're envisioning.

Poor people wouldn't be better off if you gave them free healthcare and raised the minimum wage? That's not going to fly. You might argue that the country as a whole wouldn't be better off, and that is the usual argument, but you can't argue that certain sectors would not be better off when you redistribute money their way. Just like you can't argue that the rich are not better off when you give them tax cuts. It's literally nonsense.

Reply to Baden The response is basically: there is no better world than the one we currently inhabit, and any effort to make it better will end in disaster. This, even as disaster is all around. Instead, what is happening right now - the death of the poor and the black and the old - is the best possible outcome. The most just deserts have been meted out by the best possible world, which just happens to be this one. It's perverse in a way that words don't quite do justice to.

Quoting ssu

I acknowledge that there is the crowd that put basically the economy before anything, but I don't the chief epidemiologist Tegnell in Sweden had (and has) that in mind. Or Wittkowski above. Even my little country, which now has emergency laws and has quarantined the whole Capital region from the rest of the country doesn't have a curfew in place. To argue that people should stay inside their homes and not venture out is dismissed as humbug by doctors here. You can choose something between a) doing nothing and b) having a curfew.

You're right, there were multiple ways of impeding the spread of the virus. The less socially intrusive ways were less effective. The European countries that I'm aware of (except Italy and Hungary) have taken to politely requesting people to adhere to social distancing and increased hygiene, mandating businesses to close to remove central hubs etc.

I am not disagreeing that there were multiple ways of responding to the virus; corresponding to a trade off between social intrusion/impediment and decreasing growth rate.

Quoting ssu

It wasn't that. It wasn't about implementing quarantine measures, but any kind of response to the pandemic. Basically it was about denying there to be any serious pandemic at all. That's a huge difference.

This is precisely what the use of "herd immunity" by politicians was for. It was not used as a statement of the uncontroversial fact that eventually populations will immunise. The fact was used rhetorically as a stalling tactic. Eventually all countries effected which used the rhetoric have responded somehow, because they needed to.

Quoting ssu

My only point is that there really is the medical/health policy discourse on the subject, something that you seem to deny.

Nah. I've helped a couple of doctors I know understand their epidemiology bulletins due to the virus and have been studying the global case records personally occasionally, also keeping somewhat up to date with stats papers on it. I'm sure that fellow statisticians will be working on the data set for years to come. The discourse within epidemiology (as far as I am aware) is not about the plain fact that decreasing social connectivity decreases growth rate. It's about using the data to quantify the hows and whys and to track and predict spread.

I'm not of the opinion that curfews and using the military to keep people in their homes is particularly desirable, even though it would obviously make the transmission rate go down. (Edit2: even if middle road measures need not decrease the total number of infected long term, it will decrease the mortality by not overloading the bandwidth of healthcare systems by even more)

The use of "herd immunity" by politicians was a stalling tactic against every response. Any stalling is well understood to lead to inflated death tolls; it's killed people who would not have died otherwise, and that number is increasing with time due to how the growth works. It took catastrophic economic circumstances to be likely, like global economic collapse, to get these people's heads in gear and actually take the situation seriously.

I'll put this numerically; politicians advocated a strategy (non-response) that their intelligence networks and consultants must have informed them would yield up to 2% of their populations dying. Because they did not want to risk a big recession that would come from curtailing the loss of life. If at the end of the pandemic, you piled all the bodies that would have come from the advocated non-response strategy, that number would have been bigger than political north troop deaths in Afghanistan (using just UK figures, that would have already been passed a while ago). That was seen, at the time, as an acceptable risk to prevent a recession.

To make matters worse; right news media in the US and UK has reported to support this interpretation; portraying it as patriotic to die to save the country from a recession; there are internal memos from the UK Tory party being nonchalant about killing off all the old people.

Until the global economy started shuddering, all of the above were acceptable risks.

Edit:{

The pandemic would have been forecasted to overload the healthcare system by so much it would increase the death rate beyond that, especially for risk groups (if schmucks like me could see it coming, I'm sure people who know more than a university course dealing with some epidemiology models and related private study would have done so and passed it on) and cause untold more losses if responses were not taken to mitigate the risks. This was seen as an acceptable risk.

When it actually started happening, they finally responded "Oh no! All the things we were obviously told beforehand in intelligence briefings confidently by consultants are actually coming true, let's start doing something about it!"

So consider; what made the politicians more afraid of a predicted recession than more predicted deaths of their own citizens than your average war?

}

Quoting ssu

So what's the "purely ideological" reason for Swedish social democrats to choose the more lax measures?

I can understand attributing a view to me I don't actually hold in these circumstances.

Quoting StreetlightX

It's perverse in a way that words don't quite do justice to.

So I've been looking for a song, and I think this is a near as I can get to it, from, appropriately, Planet Waves.

Quoting Harry Hindu

If the governors don't have access to the intelligence resources that the WH has, then why are they saying that they have the power (which would include the resources) to re-open their own states, and not the WH?

They do have the power, regardless of der Führer’s claim of “absolute” power in the matter. The framework they’ve outlined is based on “principles that residents' health comes first, health outcomes and science dictate decisions and states need to work with local and community leaders.” Would it make more sense for the White House to dictate how and when restrictions are rolled back in each state?

Quoting Baden

Poor people wouldn't be better off if you gave them free healthcare and raised the minimum wage? That's not going to fly. You might argue that the country as a whole wouldn't be better off, and that is the usual argument, but you can't argue that certain sectors would not be better off when you redistribute money their way. Just like you can't argue that the rich are not better off when you give them tax cuts. It's literally nonsense.

If you raise minimum wage, you reduce minimum wage jobs, so, whether the whole sector benefits isn't obviously so. Medicaid is free healthcare for the poor. They already have that. The rich keep more money if you pass a law that they keep more money. That I agree with.

The coronavirus has absolutely nothing to do with this discussion. If we ought to increase minimum wage or whether all sorts of government benefits ought be increased or decreased is no more or less evident or obvious due to this pandemic. Whether you're a right wing libertarian or a totalitarian Marxist, this pandemic is not cause for you to lose your religion, and that is the gist of my (recent) objection to this meandering conversation. This whole "let's take advantage of every crisis in order to advance our political agenda" thing is what I'm objecting to.

Reply to Hanover

I think there is a political discussion to be had here. For example, the much touted healthcare systems of Europe, often held against the American system as far superior, are not fairing much better when put to the test in this crisis. The notion that we must risk our livelihoods and put ourselves on lockdown to keep them from collapsing is damning, in my opinion.

The principles underlying our systems of government are being put to the test, and I think the political implications are severe.

Reply to I like sushi

I don’t agree. The world can act together. The quicker the developed countries get sorted out the sooner they can ship supplies and equipment to help out.

I hope you're right, although even if it does go the way you lay out. It will be to late. The help is needed now and the West is nowhere near coming out the other side of the first peak yet. The help wouldn't start to be sent out for a few months at the earliest and there are to many countries crying out for help now. Just imagine if that Ebola outbreak had been in multiple countries at the same time, it would have been a struggle to get it under control even with our own countries not infected.

Quoting NOS4A2

think there is a political discussion to be had here. For example, the much touted healthcare systems of Europe, often held against the American system as far superior, are not fairing much better when put to the test in this crisis. The notion that we must risk our livelihoods and put ourselves on lockdown to keep them from collapsing is damning, in my opinion.

This strikes me as two points: (1) those nations with public healthcare are not faring any better than the US, and (2) we shouldn't allow for a lockdown because it risks our livelihoods.

I agree with #1 because it's true. I disagree with #2 because it's dependent upon what the greater good is. That is, if there were a nationwide pandemic of Ebola, I think we'd all agree everyone would have to do their share to be sure we didn't all start dying in the streets, regardless of the risk to our livelihood. I suspect you distinguish the coronavirus from ebola in that you believe the danger posed by the former has been hyped up and you don't believe it's that dangerous. If that's the case, that's a debate over the empirical evidence showing its dangerousnes, not a debate over the general question of whether we have a duty to society not to infect our neighbors with deadly diseases.

Quoting Punshhh

Just imagine if that Ebola outbreak had been in multiple countries at the same time, it would have been a struggle to get it under control even with our own countries not infected.

Ebola isn't as easily spread as the coronavirus because the infected person becomes symptomatic quickly and then dies fairly quickly, making it easier to detect and the person doesn't have as much time to spread it.

Reply to ssu

Sweden just recorded it’s highest daily death count since the 6th of April after a slow weekend. This will surely ignite pressure for more draconian measures and put their choices under more scrutiny. I’m still hoping for them because I believe the lives vs. livelihoods approach is a false dichotomy, and that a sustainable balance would be preferable and more sustainable. But if I’m being honest it’s not looking good.

As countries open up I suspect the lives vs. livelihoods approach will loosen—governments cannot task itself with saving lives forever—and a better balance will be sought.

Reply to NOS4A2

As countries open up I suspect the lives vs. livelihoods approach will loosen—governments cannot task itself with saving lives forever—and a better balance will be sought.

At this stage of the pandemic, it is not a simple choice between lives and livelihoods. There is the chaos resulting from what would happen without lockdown measures. It would not only be a medical crisis and an economic one, but a food and civil disobedience crisis as well. This was already pointed out at the beginning of the thread, but ought to be considered here.

Reply to Hanover

I personally would deviate from your point because I do not believe in any notion of a greater good, but I certainly do agree we should all do our share during a time of pandemic for the obvious reasons. It’s just I disagree with the manner in which they are enforced or implemented.

I don’t believe the danger of a pandemic, no matter which virus, can be hyped up given the history.

Reply to Punshhh

At this stage of the pandemic, it is not a simple choice between lives and livelihoods. There is the chaos resulting from what would happen with out lockdown measures. It would not only be a medical crisis and an economic one, but a food and disobedience crisis as well. This was already pointed out at the beginning of the thread, but ought to be considered here.

That’s a good point. The line-ups outside the barbershop alone will cause chaos.

Reply to NOS4A2 It's good to see you so unforgiving about failures. Oh wait. :rofl:

The hypocrisy is just too funny since you lack any ability at introspection to see how utterly ludicrous it is coming from you.

Quoting Hanover

If you raise minimum wage, you reduce minimum wage jobs

Not true. We have raised the minimum wage in Ireland consistently (at above inflation rates, you know, to reflect economic growth and actually give everyone a share of it) over the past 30 years and also consistently increased employment. And, besides, reducing minimum wage jobs as a proportion of overall jobs would be great for obvious reasons as long as overall employment levels remained steady.

Quoting Hanover

Whether you're a right wing libertarian or a totalitarian Marxist, this pandemic is not cause for you to lose your religion, and that is the gist of my (recent) objection to this meandering conversation. This whole "let's take advantage of every crisis in order to advance our political agenda" thing is what I'm objecting to.

You can't disentangle the crisis from politics. The fuck ups we're in are political fuck ups. The bailout was political. Different solutions have different political implications. Your characterisation that some here are "taking advantage" of the crisis is also political. It could easily be interpreted as "don't look now while the cover's blown on the good thing my lot have going". Even if you don't agree with that, how can you talk about the way the crisis is being dealt with in the US, for example, without discussing the bailout? And how do you discuss that without being "political"? Every one of us has an "agenda", only from each of our perspectives, the agenda boils down to nothing more than advocating for what we see as the right thing to do, both in the short and long term, and that requires generalisation from the specific problem to the underlying factors exacerbating it. And their context is social and political. So, unless, you can explain what a politics-free conversation would look like here, I don't see much substance to the objection.

Who's the totalitarian Marxist by the way? I want to meet that guy. We need the gulag back in fashion.

Reply to praxis It's obviously difficult to see my point with your politically partisan glasses on.

Quoting NOS4A2

For example, the much touted healthcare systems of Europe, often held against the American system as far superior, are not fairing much better when put to the test in this crisis. The notion that we must risk our livelihoods and put ourselves on lockdown to keep them from collapsing is damning, in my opinion.

More stupidity. The quality of healthcare doesn't affect outcomes where it concerns a virus we don't have an effective treatment for. Universal healthcare is always better for a simple reason: risk mutualisation is cheaper. So whatever quality you're paying for, you'll be paying less than any option that isn't universal.

By any measure the US healthcare system underperforms: life expectancy, infant mortality, unmanaged asthma, unmanaged diabetes, heart attack mortality, hospital admittance for preventable diseases etc. etc.

How a country fares depends on the policies enacted and how fast. Since it spreads at the same rate regardless of which country we're talking about, the country with the most infections and most deaths will have done the worst. At this time, due to all the variation in testing capacity, methodology and qualification of deaths, any comparison is nearly impossible to make. We can be pretty sure that for modern Western countries the USA, France, Italy, UK and Spain fucked up in greater or lesser extent. Although I'd be willing to forgive the Italians since they were hit early when very little data was available. The fact it was that terrible there probably has saved a lot of lives in other European countries as it was a wake up call for them.

Reply to Benkei

I’m no statistician but I suspect deaths per million is a more adequate measure to determine who faired better or worse. In that respect, some countries, the Netherlands included, have done worse.

More bad news:

https://www.washingtonpost.com/health/coronavirus-destroys-lungs-but-doctors-are-finding-its-damage-in-kidneys-hearts-and-elsewhere/2020/04/14/7ff71ee0-7db1-11ea-a3ee-13e1ae0a3571_story.html?tid=pm_pop&itid=pm_pop

And (!):

https://www.independent.co.uk/news/world/asia/coronavirus-china-mcdonalds-black-people-home-evictions-a9465776.html

To be honest I could've ranted on at you @ssu for a very long time, but I wanted to add one more thing that's important to notice; the delays didn't just exacerbate the deaths, they will exacerbate the long term economic damage too.

Care minister literally laughing when being told that 4,000 people have died in care homes. Just in case anyone thought un was being paranoid. Horrible human being.

Quoting Baden

Not true. We have raised the minimum wage in Ireland consistently (at above inflation rates, you know, to reflect economic growth and actually give everyone a share of it) over the past 30 years and also consistently increased employment. And, besides, reducing minimum wage jobs as a proportion of overall jobs would be great for obvious reasons as long as overall employment levels remained steady.

The US has increased its minimum wage as well and there's obviously a breaking point, as I understand some areas, like Seattle, have priced some employees out of jobs. Whether Ireland is the best historical example of a thriving economy I don't know.

Quoting Baden

So, unless, you can explain what a politics-free conversation would look like here, I don't see much substance to the objection.

We have a bit of a tautology here, considering a decision maker by definition is a politician. So, sure, we can't take the politics out of decision making. My objection is to using this crisis to bring about permanent structural change that could not be achieved during normal times. That is, I don't see this crisis as evidence that we've been doing things all wrong and we need non-crisis times to be different now. If we need to change things, then we can do that, but this isn't the needed catalyst for that change.

Reply to NOS4A2

@Punshhh
At this stage of the pandemic, it is not a simple choice between lives and livelihoods. There is the chaos resulting from what would happen with out lockdown measures. It would not only be a medical crisis and an economic one, but a food and disobedience crisis as well. This was already pointed out at the beginning of the thread, but ought to be considered here.

@NOS4A2

That’s a good point. The line-ups outside the barbershop alone will cause chaos.

Good to see that you are prepared to debate the crisis with the seriousness it deserves. Just like Trump who showered himself with glory lastnight, by withholding funds to the WHO the only international authority trying to help countries around the world save lives. But vanity comes before lives of course.

Quoting Hanover

That is, I don't [want to] see this crisis as evidence that we've been doing things all wrong and we need non-crisis times to be different now

There, fixed it for you.

Quoting Hanover

That is, I don't [want to opportunistically pretend] [s]see[/s] this crisis [s]as[/s] [is] evidence that we've been doing things all wrong and we need non-crisis times to be different now

Fixed it.

Quoting fdrake

This is precisely what the use of "herd immunity" by politicians was for. It was not used as a statement of the uncontroversial fact that eventually populations will immunise. The fact was used rhetorically as a stalling tactic. Eventually all countries effected which used the rhetoric have responded somehow, because they needed to. - The use of "herd immunity" by politicians was a stalling tactic against every response.

I agree with this.

With some politicians. I'm not so sure about Swedish politicians (or the Dutch). When there were two cases in Sweden in the end of February Swedish prime minister Löfven convened a Crisis Management Council that previously had met only in 2018. And right from the start Löfven has consistently followed what the health authorities have purposed and (at least to my knowledge) the prime minister has not given any demeaning or dismissive statements about the corona virus or it's outbreak in China. Trump and I-shake-hands-with-corona-patients Johnson were different.

But I don't agree on that "herd immunity" wouldn't be real and wouldn't be important. And I assume that this isn't your intention.

The best example of this is when you had the greatest "long quarantine" opened in human history: when humans in one continent had been separate from others and hadn't trade with other continents for ages and what happened when you then mixed the people for the first time starting from 1492 onwards. And yes, it was especially those zoonotic diseases from animals that hadn't existed in the continent that were the culprits.

But I think we understand each others points here...

Reply to Baden Those hard Brexiters in government must be sh****g themselves, now they are having to deal with something serious, just when they were revelling in getting Brexit done. It's all a world of sh*t now and they are going to have to pull us through.

Quoting Hanover

As I understand some areas, like Seattle, have priced some employees out of jobs.

The unemployment rate (until the crisis) in Seattle was 3.3%. That's what's known as full employment.

In Mississippi, on the other hand, the figure is 5.4%. Guess what? Mississippi has the joint-lowest state minimum wage in the country. You can repeat that for Pennsylvania, Louisiana etc.

Your argument is just without foundation. A higher minimum wage does not lead to more unemployment. Period. Part of the reason it doesn't is because more people have more money to spend on shit. And when you're on minimum wage, you spend what you have. Which is good for business.

https://www.google.com/search?q=seattle+unemployment+rate&rlz=1C1CHBF_enIE831IE831&oq=seattle+unemployment+rate&aqs=chrome..69i57j0l7.4326j1j8&sourceid=chrome&ie=UTF-8

https://www.google.com/search?q=pennsylvania+unemployment+rate&rlz=1C1CHBF_enIE831IE831&oq=pennsylvania+unemployment+rate&aqs=chrome..69i57j0l7.5901j1j8&sourceid=chrome&ie=UTF-8

Quoting Hanover

That is, I don't [want to opportunistically pretend] see this crisis as [is] evidence that we've been doing things all wrong and we need non-crisis times to be different now

Hey, do something original dude. What am I, your guru?

Quoting NOS4A2

Sweden just recorded it’s highest daily death count since the 6th of April after a slow weekend. This will surely ignite pressure for more draconian measures and put their choices under more scrutiny. I’m still hoping for them because I believe the lives vs. livelihoods approach is a false dichotomy, and that a sustainable balance would be preferable and more sustainable. But if I’m being honest it’s not looking good.

As countries open up I suspect the lives vs. livelihoods approach will loosen—governments cannot task itself with saving lives forever—and a better balance will be sought.

Well, let's remember what the definition is of an epidemic:

the occurrence of more cases of disease, injury, or other health condition than expected in a given area or among a specific group of persons during a particular period.

So if still in 2030 this corona virus still kills people, but it's the expected rate, then it's not an epidemic.

But I'm not so sure just what your reasoning is here lives vs livelihoods is here. If we would pretend that the pandemic isn't real we'd not have an economic depression or? :brow: You don't think the health sector collapsing, those mass graves dug and freezer trucks next to hospitals wouldn't make people alter lifestyles or what?

If this hasn't already been shown, it has to be shown here now (again)...

Reply to Punshhh

I think the WHO needs to be accountable for its errors, namely spreading Chinese misinformation, declaring a pandemic too late, opposing travel restrictions, all of which arguably contributed to the spread of the virus across the globe. This is one instance where the WHO might have been useful. But it wasn’t.

Reply to NOS4A2 Is the middle of a pandemic really the best time to withhold funds from the world health organization?

Reply to NOS4A2 So we'll withdraw funding during a pandemic, which will surely lead to many more deaths in vulnerable populations? (such a stable genius).

Admit that this is Trump trying to pass blame to anyone he can, rather than take responsibility for his actions.

It can only be a vanity project, by an egomaniac, anyone else would realise that everyone objective will see through it. This is his death nail, he can only be grasping at any semblance at credibility as he falls from grace, to reduce the fallout.

Quoting Hanover

This whole "let's take advantage of every crisis in order to advance our political agenda" thing is what I'm objecting to.

Let's also not forget that those using the crisis to further their own ends are more than likely to be the very same ones hyping it up and blowing it out of proportion...and they got all the suckers to take a bite. Unfortunately, this is not the first time.

Here's an idea: stop whining and do something to help someone. Some person who lives near you.

It doesnt have to be dramatic like the guy who delivered tablets to hospitalized people so they could communicate with loved ones who aren't allowed to visit.

Remember, its not just covid people who are cut off from family and friends, its everybody in the hospital.

Quoting Harry Hindu

It's obviously difficult to see my point with your politically partisan glasses on.

I’ll admit your point is foggy. State government decided when to impose restrictions so if they did it too late for an optimal outcome that’s their fault, although perhaps not entirely.

The criticisms directed at the White House regarding corona span a variety of issues, many of which aren’t really comparable to state government.

Quoting frank

Here's an idea: stop whining and do something to help someone. Some person who lives near you.

My wife is making masks. I’m making stupid paintings (surely unhelpful). What are you doing?

Reply to Punshhh

It’s the other way about. It appears Trump has become the scapegoat once again, as has been the case from everything to climate change to mistrust of the media. Yet the fact is that President Trump has utilized all power and assets of the federal government—too much in my opinion—to support the states during this emergency. FEMA, the military, the CDC, and even much of the private sector have been mobilized to tackle the crisis. The sheer amount of proclamations and executive orders for this purpose have been astounding.

So which actions exactly should he be responsible for?

Secondly, I think it’s time critics should say what they would have done differently. What would you have done differently?

^ Anti government nutjob licks balls of head of government.

Reply to VagabondSpectre

Yes. It’s in our best interest to have a properly functioning health authority, especially during a pandemic.

Can't wait to go to a restaurant

Oh look, an offended commie.

You mispelt entertained, bootlicker.

Reply to StreetlightX

Your mispelt entertained, bootlicker.

Lol quick to edit that one, weren’t you?

Yes, I care about getting things right :)

But do go on about how much the state sucks while you fellate the head of state...

If Trump bottled his farts NOS4A2 would buy a jar and smell it 100%

Quoting NOS4A2

Yes. It’s in our best interest to have a properly functioning health authority, especially during a pandemic.

How is de-funding them going to make them function any more properly in the short term? You're advocating market solutions to a non-market problem.

Reply to VagabondSpectre

How is de-funding them going to make them function any more properly in the short term? You're advocating market solutions to a non-market problem.

They are not being defunded. The US is withholding its funding pending an investigation.

Reply to NOS4A2 How does withholding its funding pending an investigation during a pandemic make it function more properly in the short term?

Reply to VagabondSpectre

The investigation can help recognize structural and perhaps even political failures. I see no reason to continue funding until that process is complete. How does continuing to fund it resolve any of those issues?

Why the rhetorical questions Vega? Blaming the WHO is meant to deflect attention to the total failure of Trump's leadership and give fodder to his servile peons - like NOS - to spew out instead.

The usual litigious American blame game begins (or more accurately: continues)...

https://www.msn.com/en-ca/news/world/opinions-china-should-be-legally-liable-for-the-pandemic-damage-it-has-done/ar-BB12oS9V

Reply to Janus It's not the worst idea. Only it ought to be coupled with repayments from the US for the damage done for their imperial endeavours in the last 100 years too. Say, 30% of GDP to Iraq, an additional 30% to Afganistan, and maybe another 300% or so to central and south America. American interventions being more directly attributible to American agency than a non-human entity. The UK can probably join in as well for all the evil it wrought on its colonies.

Quoting NOS4A2

How does continuing to fund it resolve any of those issues?

It doesn't resolve any of those issues, but you're not answering my question.

I am insinuating that withholding funding may comprise their ability to function in the short term.

Do you think that withholding funding from the WHO will not affect its ability to function in the short term?

Would you withhold funding from a fire-department during a period of extreme fire hazard in order incentivize them to work harder?

Here are some tangents for you to bounce off instead of answering the above:

What do structural and political failures have to do with anything? Are you advocating for a random fishing expedition? What's with the timing here? I thought witch hunts were bad? Why are investigations good when Republicans suggest them and bad when Democrats suggest them? Why can't we let COVID wash over the nation?

Reply to StreetlightX Perhaps it's boredom, but there's something oddly satisfying about the contorted responses that must follow...

Like watching raw pasta extruded through a narrow and misshapen orifice...

Mostly I just want clear responses though, so that I have something solid to throw back when Donald inexorably flip-flops.

Reply to StreetlightX Ah, but why should accountability go both ways?

Reply to VagabondSpectre

If the fire-Department was actively covering for the arsonist, then yes, withholding funding would be prudent as would an investigation. Yes, withholding funds would affect its ability to function in the short term.

I understand the push back, but it’s not about getting them to work harder. It’s about holding the leadership accountable for their dereliction of duty .

Reply to NOS4A2

So, is Trump the helpless victim of China and the WHO here or is he the strong leader with total authority? It seems you're just going to keep playing whichever card suits your spin. I mean, I just don't know why you would think that's convincing.

Reply to Baden

So, is Trump the helpless victim of China and the WHO here or is he the strong leader with total authority? It seems you're just going to keep playing whichever card suits your spin. I mean, I just don't know why you would think that's convincing.

I never said Trump was a victim. I never said he has total authority. I’m not sure why one would try to lie about that but I’m sure spin has something to do with it.

Reply to NOS4A2 Arsonist?

China is an arsonist in this analogy?

Quoting NOS4A2

Yes, withholding funds would affect its ability to function in the short term.

Can't we have an investigation while also continuing to fund them? If you want the leadership to be held accountable, then hold them accountable; withholding funding from the organization does not hold leadership accountable.

In keeping with the fire analogy, you would shut down a component of the fire department, mid-blaze, on principle, figuring that accountability is more important than putting out the fire.

This seems to speak volumes about your ideology. Saving Trump's face is worth more than human lives?

Reply to VagabondSpectre

I think the difference in my “ideology” is that I’m not into applying utilitarian principles. But if I were to do so I would say your assumption that funding an ineffectual fire-Department to protect us from fire is also dangerous.

When you go out for a run or fast-paced walk or whatever try to avoid being in the slipstream of other runners/walkers

Quoting NOS4A2

I think the difference in my “ideology” is that I’m not into applying utilitarian principles.

Utilitarianism is more palatable than virtue ethics run amok though, wouldn't you say? Why must the slaves be buried alongside the failed lords?

You could accuse any argument that appeals to saving lives as being utilitarian, but it's not a very persuasive counter-appeal (you might as well accuse the WHO of being too socialist). When we're dealing with broad, general, and hard to answer issues, utilitarianism often wins out even our legal system. No matter, after-all, holding people accountable and all that is much more important than putting our existing fires, right? (they're the arsonists who keep intentionally setting the fires, right?).

BUT WAIT! Wait just one stock-pickin' minute...

How do you know the WHO is corrupt, ineffectual, or derrelicted their duty before an investigation has been carried out?

Wouldn't we be rather stupid to compromise one of our defenses to an existing attack, even if it is not perfectly effectual?

If we withhold funding from the WHO, conduct the investigation, and then find that the WHO was actually acting responsibly and effectually, and that the funding cuts resulted in decreased performance, would we then be allowed to hold Trump accountable?

got my stimulus check & bought a cot. Now I'm primarily living in the walk-in closet off my main bedroom (does have a window, at least, I'm not crazy enough to forego that yet.) I don't know why, but it feels more synced up with my mood and the general mood. Provisional and simple?

Quoting Evil

When you go out for a run or fast-paced walk or whatever try to avoid being in the slipstream of other runners/walkers

I heard the same advice after 9-11

My humblest apologies for NOT wishing to focus my attention on party-based political wrangling.

I’m just some duped nobody :)

Another brief report on the situation and struggles in India:

https://m.youtube.com/watch?v=tpST8TNcAKI

Reply to Merkwurdichliebe

What does your name mean? I can't be bothered to go to Google translate

Quoting I like sushi

My humblest apologies for wishing to focus my attention on party-based political wrangling

What are we actually supposed to talk about here

Reply to Evil

It's the German name of Dr. Strangelove (from the movie). I also misspelled it, I think its supposed to be "Merkwuerdigichliebe".

Quoting I like sushi

Another brief report on the situation and struggles in India:

https://m.youtube.com/watch?v=tpST8TNcAKI

Fuck yeah!!! Good for them. I hope social unrest sweeps the globe. I hope it sweeps the globe faster than the irrational panic over coronavirus.

Reply to Evil I missed out the ‘NOT’. Have edited that post.

I believe the subject matter of the thread is in the OP. I’m suggesting government policies don’t matter, only that the actual short and long term effects are of more importance on a global scale rather than a national one.

To repeat, my concern is with developing nations and how developed countries can help once they are able to.

Reply to Merkwurdichliebe Nice trolling! Have fun :)

Reply to NOS4A2 If I have a virus with spread 2.4 per week and in one country there are 2 million people and in another 10 million. Where doing nothing is the worst you can do both don't do anything and have a patient zero at the same time. They both have 2.4 infected after a week, 5.76 after 2 and 13.8 after 3 etc. Etc.

They are both doing as badly but deaths per million are totally different. Capice?

So the US is doing an order of magnitude worse than the Netherlands. Thanks to Trump not doing shit despite being advised to do so by Fauci.

Is this a good time to post an ad for your friend?

Reply to NOS4A2 And yet the weight of evidence is still that it was a natural cause.

I also fail to see the relevance really. As if having a lab and animal testing are illegal. The subsequent cover up by China would be an issue but totally expected - like any country they don't air their mistakes publicly.

"Indian poor cannot afford a lock down" - heading off today's online newspaper in the Netherlands.

I guess that will be another abject lesson soon about the extent of democracy in a country still living its caste system (and I really mean abject not object in this case).

Reply to VagabondSpectre

This seems to speak volumes about your ideology. Saving Trump's face is worth more than human lives?

Yes, this is what I was pointing out too. NOS will even dance on the graves of these lives rather than save his credibility on the forum, to save face.

But the faces are becoming more and more contorted, sooner or later they will disappear in a puff of smoke.

Reply to NOS4A2

It’s the other way about. It appears Trump has become the scapegoat once again, as has been the case from everything to climate change to mistrust of the media.

What are they escaping? This is twisted paranoia. Trump brings it on himself by his inane tweeting and bullshiting press conferences.

So which actions exactly should he be responsible for?

Well there are a few, like threatening the stability of NATO, pulling out of the Paris accord on climate change, withholding funds to the WHO during a pandemic, a lack of credible leadership.

But in reality he doesn't need to do all this blaming, it's a weakness in his vanity, he fears being held accountable, so it's not in reference to anything in particular when he does it. He just doesn't have the attributes of a good President.

Secondly, I think it’s time critics should say what they would have done differently. What would you have done differently?

I would have taken the threat of Covid19 seriously from the beginning of January. Indeed I did, but I am not in a position of power, so there was little I could do. Trumps bans of flights was a good move, but it was to little to late. The whole global airline industry should have been closed down at the beginning of January to contain the virus, all the Western powers where guilty of this one.

Reply to StreetlightX I agree with you thoughts on how things should change politically, but I don't think it will change yet, but rather a slower realisation which will take a generation (about 25 years). Because there are to many people who have benefited from the affluence of the last 40 years still in positions of control, or holding onto the wealth. The young are not in this position and are ready for change, as they begin to take hold of the reigns as the older generations die off, things will change.

Reply to frank All I can do is to stay home and limit interaction with people outside my household. When I do go out, I wear a mask, gloves and do the best I can to prevent the spread. Washing hands etc on my return. Also urge people I know to do the same.

I have asked some vulnerable people to tell me if there is anything I can do to help, but so far they have all been coping ok.

If we hadn't had the lockdown this situation would have been much worse.

Reply to VagabondSpectre

It’s not an accusation, I’m just contrasting it to my own ethics, which are more deontological. I’m suggesting this is where we might differ.

The China response is well reported and recorded, filled with the typical communist censorship of its own people, the disappearing of critics, and the suppression evidence. The WHO, on the other hand, helped to spread this misinformation. It was late in declaring a public health emergency—after the virus had already spread to 18 countries—and spoke in glowing, servile terms about China’s response while doing so. It is so far up China’s ass that it embarrassingly dodged questions from Hong Kong reporters about excluding Taiwan.

It might not be the WHO itself that is to blame. It could very well be just the leadership. But one thing is for certain, our taxpayer dollars are funding this and this is not what we pay for. A holding on funds and an investigation is warranted. None of this would be necessary if the WHO didn’t launder China’s image at the expense of its own credibility.

Reply to Punshhh

I would have taken the threat of Covid19 seriously from the beginning of January. Indeed I did, but I am not in a position of power, so there was little I could do. Trumps bans of flights was a good move, but it was to little to late. The whole global airline industry should have been closed down at the beginning of January to contain the virus, all the Western powers where guilty of this one.

No western country could have known enough that early.

Here’s a decent timeline of events.

https://en.wikipedia.org/wiki/Timeline_of_the_2019–20_coronavirus_pandemic_from_November_2019_to_January_2020

Reply to csalisbury I like your lamp, I hope you don't get cabin fever in there and get out regularly.

This is where I self isolate,


Perhaps if folk post an image of where they isolate, it would be interesting to see how our experiences differ?

Reply to NOS4A2 This is false. They just didn’t take the risk seriously due to the previous scares of SARS and such - which were taken seriously in the East.

The only use in discussing this is to set up better systems to prevent this from happening again. And to repeat, this is a global issue not an east versus west issue. The better it is dealt with everywhere the better for everyone.

Note: Germany, China and other countries are providing assistance to other countries. The sooner developed countries get past the worst of this the sooner they can assist others and prevent a needlessly fatal cycle.

Latest news from the Netherlands is that an expected 3% of the population has antibodies against the coronavirus. That meas about 500.000 people in the Netherlands. If that's true it would be a mortality rate of .64%, which is in line with earlier estimates from the Lancet study I shared before.

It also appears some people who have been infected with Covid-19 are not immune afterwards.

Reply to Benkei There is some information in here explaining the difference between ‘relapse’ and ‘reinfection’ (from leading expert in South Korea):

https://m.youtube.com/watch?v=QwoNP9QWr4Y

It’s about 45 mins long, but hopefully people here aren’t looking for soundbites.

Quoting Punshhh

All I can do is to stay home and limit interaction with people outside my household. When I do go out, I wear a mask, gloves and do the best I can to prevent the spread. Washing hands etc on my return. Also urge people I know to do the same.

I have asked some vulnerable people to tell me if there is anything I can do to help, but so far they have all been coping ok.

That's a lot! And it's awesome.

Some might find they have a capacity to help local pet fostering organizations. In some places food banks are running short. A person with internet prowess could start a go-fund-me for local waiters and waitresses. Just make somebody laugh with a sign in your yard.

I was just saying that people who have extra angst could direct that energy more locally.

Reply to Benkei @frank

I just wanted to provide some info about the things that make death statistics fluctuate a lot, based on (what I assume is) the same Lancet paper.

(1) Testing. If you want see how many people have died with coronavirus, they need to have tested positive for coronavirus. If you test certain groups of people, but not others, this makes the death rate calculated from the tested group depend upon the group's demography.
(2) Group demography effects in testing; tested people are more likely to be severe cases; whatever factors contribute to the severity of the case will be more present in the tested population, this is a positive bias to the death rate.
(3) Severe infection demography. If the virus is more likely to inflict a severe case dependent upon a demographic factor, people in those demographics are more likely to be tested due to the things stated above.

Correcting for these things requires weighting the observed statistics by the demographic factors then calculating for the population at large based upon the correction. It is especially hard to correct for people outside of the tested population; which includes the mild and asymptomatic cases disproportionately, and those demographic categories which are not as likely to be tested due to having those milder cases; so observed death rates in hospitals and in the spreadsheets derived from there are likely to be over-estimates of the overall population death risk, the latter means the case where demography and case severity are no longer making the tested population non-representative of the infected population at large.

However, it should always be stressed that the effects of the disease when considered in some circumstance need not reflect the population death rate. EG: If 1 in 50 infected individuals die, thinking about it that way it wouldn't be surprising not to know anyone who died. But part of that 1 in 50 is the people aged over 60, in which 1 in 8 are expected to die. You maybe don't know anyone who's died personally, but it's way more likely for there to be someone you care about who's lost their grandparents or parents to the disease and is grieving.

Quoting frank

I was just saying that people who have extra angst could direct that energy more locally.

I disinfect the cleaning station at my supermarket when I go. Ironically it doesn't seem to be cleaned often.

Reply to fdrake

I don't want to step on your obviously far more qualified toes, but I think you missed a few (while we're making a list), please do correct me if I'm wrong.

(4) If you're using the death statistic to compare to like diseases, you cannot discount overlap. Most groups of people who die have an average of 2 viruses present at the time of death, sometimes as many as 5. Only one of these is going to be recorded as the cause, and right now, it's going to be Covid-19. The bias here will increase as the pandemic takes hold. About 10,000 people die every week (in the UK), an increasing proportion of these are going to have Covid-19 in their system at the time of death.

(5) Similar to (4), someone who dies of Covid-19 is not then available to form part of the pool of people who are going to die of something else. So this will affect net deaths, but also proportional death (when comparing causes).

(6) The peak of a curve and the extent both contribute to the total. We're presumably concerned both with the raw number of deaths and the rate of increase. I've seen a lot of reporting which confuses the two. A high rate of increase does not necessarily mean more deaths (it depends on duration), and likewise the other way around.

(7) The deaths reported are crude numbers so they don't represent the actual changes in death rate (they're lagged by a few day from the rate for actual cases). This means that the proportion of deaths to cases will artificially a bit low as the pandemic progresses, but likewise artificially a bit high as it subsides.

Quoting Isaac

but I think you missed a few

I did! Thank you.

Reply to Isaac points (4) and (7). There stats are out for deaths in UK up until April 3rd - they are not crude estimates.

The death rate clearly spiked in the last reported week. I guess it could be argued that this is due to other causes but they’ve clearly marked respiratory problems and Covid.

https://www.ons.gov.uk/file?uri=%2fpeoplepopulationandcommunity%2fbirthsdeathsandmarriages%2fdeaths%2fdatasets%2fweeklyprovisionalfiguresondeathsregisteredinenglandandwales%2f2020/referencetablesweek142020.xlsx

6000 deaths above usual rate PLUS above average deaths due to respiratory disease being the ‘underlying cause’. When the next set of figures are out the picture should be much clearer.

I am curious about how air quality plays into this. Not really spent much time looking into that. Anyone found info in that area?

Quoting fdrake

I disinfect the cleaning station at my supermarket when I go. Ironically it doesn't seem to be cleaned often.

An overlooked super spreader. Cool.

Reply to Isaac
Anecdotally, I look at respiratory viral panels all the time and it's rare to see more than one virus at a time. I think it's partly because an immune defense for viruses is a chemical called interferon, which coats cells to make them resistant to viral invasion.

Quoting frank

An overlooked super spreader. Cool.

Why?

Reply to frank Quoting I like sushi

The death rate clearly spiked in the last reported week. I guess it could be argued that this is due to other causes but they’ve clearly marked respiratory problems and Covid.

So

1) A spike in the death rate is only a snapshot at a particular moment. The 6000 extra people who died last week are not now available to form the pool of people who will die next week. This would be irrelevant if Covid-19 did not preferentially target those with underlying problems, but it does.

2) 'crude' here doesn't mean estimated, it means that the actual people forming the deaths are not the same actual people forming the cases in the same week. So saying 'x deaths from y cases this week' is a crude figure. The x deaths came from the amount of cases there were last week (assuming it takes people a week to die).

3) 2000 cases from respiratory conditions is not far off normal. It's the amount of cases with underlying health problems being pushed over the edge that is the real problem here. The key thing there being that we don't know how many of them would have died anyway, nor will we until the year's figures are out.

Quoting frank

Anecdotally, I look at respiratory viral panels all the time and it's rare to see more than one virus at a time.

Interesting. I'll dig out the paper I got my figures from when I get home. I may have misunderstood it.

Reply to Isaac (1) No idea what that means or how it counters anything I said? The figures give are for week ending April 3. Clearly there is a spike in deaths.

(2) I know what ‘crude’ means. Look back several pages where I mentioned this. The figures for deaths (ALL deaths) are not ‘crude’. The deaths for last week ARE crude - meaning they are not official figures because it takes time to account for all deaths.

(3) No, it’s not. I said that we’ll have a better picture soon enough. An extra 500 cases is a significant rise though.

The data is there is black and white: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/weeklyprovisionalfiguresondeathsregisteredinenglandandwales

Maybe you’re comparing April to Dec and Jan. That is faulty because the death toll during the winter months in the UK is always significantly higher - there is certainly room to question the event of respiratory illness being particularly worse in April for some reason? Perhaps hay fever plays a role in this? Honestly, I’ve no idea. It seems like a reasonable thought to assume that people suffering with respiratory problems may be effected more in hay fever season (I guess looking up the pollen count would clear that up quickly enough - the season falls from March to May, so there may have been a spike in the pollen count that week?)

Quoting Isaac

3) 2000 cases from respiratory conditions is not far off normal. It's the amount of cases with underlying health problems being pushed over the edge that is the real problem here. The key thing there being that we don't know how many of them would have died anyway, nor will we until the year's figures are out.

The statistical analysis of this general issue I've seen so far, is that getting the virus doubles your chances of death of the year compared to your risk group. Young healthy people have a low risk of yearly death, so absolute numbers are low but there are still young people dying.

The affect your talking about, if I understand you correctly, also only really kicks in with large numbers and even then the effect is low.

For instance, if there is a risk group with 10% chance of respiratory death this year, and getting the virus increases those chances by double, then there is a of collision between Covid deaths and other respiratory deaths. But if those diseases are distributed randomly the collision is not much. E.i. if this group is 100 people, then the odds that the 10 people expected to die from Covid would happen to be the 10 people expected to die from influenza, is extremely low.

So, even though people dying of Covid are in high-risk groups, it is a mistake to assume "they would likely, individually, go onto to die from respiratory illness anyways, or even any other illness".

It is only true of people in risk categories such as "80% chance of dying next week" who get Covid and die this week; but these risk categories are very small in absolute numbers.

Of course, if Covid deaths are kept low due to extreme social distancing, then the deaths (in this first phase) are mostly sensitive to when the measures are put in place. If the virus is replicating along a pathway of a doubling time every 3 days, then a week delay in required measures will have dramatic effect; 2 week delay and the results are no longer really comparable.

(This is why Trump supporters are not angry about the delays and inventing excuses; they do not understand the basic math, as I'm sure you'd agree).

I'm not sure you're even arguing / implying something against what I emphasize above, or are just compiling all the statistical minutia of relations to consider.

In terms of adding to the list, a big one that can not only nullify the affect of high-risk groups decreasing in absolute size (due to dying), but actually reverse that tendency, is that the virus may cause long term lung damage.

So, if every 70 year old got the disease, all else being equal, we may expect that demographic cohort to have less deaths post-pandemic, simply due to their numbers being smaller or perhaps particularly weak breathers being culled from the heard. However, if long term injury increases the risk-of-death factor for survivors of Covid, then you may end up with more deaths in absolute terms next year due to lung injuries or other long term Covid treatment complications. (likewise for every other demographic cohort)

Long story short, some Covid deaths would have died anyways, but expected overlap is small (extreme bias towards this group getting Covid would be needed for a significant overlap), and long-term injury may compensate, even significantly over-compensate, this overlap by increasing the risk-of-death factor for these risk groups (indeed all risk groups).

Quoting I like sushi

(1) No idea what that means or how it counters anything I said? The figures give are for week ending April 3. Clearly there is a spike in deaths.

Yes, my reading of these numbers is the same as yours, there's clearly a large increase in respiratory deaths. Of course, lot's of caveats can tweak things one way or another; I'm not sure Isaac is saying effects he's pointing too are significant or not.

What is clear, however, is that we have a phenomenon that can quickly overwhelm a heath system with (in any remotely plausible analysis) only a small fraction of people being affected by that phenomenon.

There are now 2 million official cases world-wide, and an economic depression has been triggered due to lock-downs needed to keep things remotely within health care capacity. We're 7 billion. So a short back of the envelope calculation of getting to heard immunity with current health capacity is easily dozens of months (even with super-duper high assumptions of asymptomatic; i.e. even if real cases right now are 200 million, is still months and months to process severe cases at that rate). This is what people are currently not understanding ... but they will soon.

Quoting frank

An overlooked super spreader. Cool.

Ok. I asked a doctor. They said I'm not increasing the transmission risk by washing the sink how I wash it. Absent a good justification, I'm gonna take their word over yours.

Edit: Ok, that's 2 doctors who agree that it's good to wash the sink how I wash it.

Reply to fdrake He meant the cleaning station is the super spreader, not you. This is evidenced by his use of the word "cool", if he were accusing you of that he would not be cool about it.

Reply to Punshhh

I hope so. I don't think I've ever seen @frank use the word cool when it wasn't sarcastically insulting someone though.

Quoting Baden

We're going to have to social distance until we get a vaccine. The virus is not going to put up the white flag and leave us alone. That shouldn't be news to anyone at this point. Lockdowns are just one form of enforced social distancing and they'll be ending well before social distancing does. I don't think anyone is arguing we should continue those indefinitely.

Though I agree with your points about social distancing going to be with us for a while, that "We're going to have to social distance until we get a vaccine" is not a certainty.

Vaccine science and technology is pretty bad in terms of rapidly developing and deploying a new vaccine as well as efficacy in general.

Certain diseases have had no successful vaccines despite decades of work and motivation on them, while other vaccines have really poor efficacy.

True, a lot of effort is going into vaccine for Coronavirus in a short period of time, but the sequential limitations to research and development is generally a trustworthy truism (the "a manager is one who believes nine pregnant women can produce a baby in one month" adage).

There is also serious concerns in the evolutionary community about vaccines with low efficacy. If the vaccine works for some, but simply doesn't work for others and the majority just get a mild form of the disease then (even with 100% compliance) a huge amount of people still get the disease as normal.

What can be much worse, is that a large group getting a milder form of the disease can apply evolutionary pressure to the virus to be "better replicator" and so then cause more severe disease in the people for whom the vaccine simply didn't work at all.

So, with an "imperfect vaccine" (the technical term) it may look good on paper but not actually change anything; it could result in 70% having a milder disease but 30% of people having a much worse disease. It is not a resolved issue of how good an imperfect vaccine needs to be to be worth it.

So, a magic bullet vaccine or magic bullet treatment is possible, but it is not guaranteed on a time frame relevant to us. Some diseases resist magic bullet solutions, some don't, and it's impossible to to know ahead of time.

The alternative to a magic bullet is simply muddling through (more-or-less chaotic social distancing) over about 1-3 years depending on the true infection-fatality-rate.

Reply to fdrake I meant that if no one cleans the station then one person could potentially infect a bunch of people. So you're helping people stay healthy.

Reply to frank

Ah good. I'm glad.

It's generally agreed that power corrupts, and historically we have fought the tyranny of religious institutions and governments by placing strict limitations on their power. In the US, we have decreed certain limitations on government power and described them as inalienable rights endowed by no less than the Creator.

What limitations do we place on the power of the medical community in dictating how the average citizen is to live? Are we really that comfortable in saying that that community is above the political fray and that its only agenda is the altruistic protection of society and that it cannot be bought off, swayed, or led by those with less than pure motive?

All these final decisions are being made by our executive branches (President, governors, and mayors) without legislative act and so far with no judicial oversight. On this board, we sort through various websites and largely agree (with some exceptions) that our executives are considering reliable material and are making proper decisions. This strikes me as wrong, if for no other reason than I think everyone is biased one way or the other (malicious or not), and we have no checks or balances on anything. In fact, anyone who disputes the official line is shouted down as a idiot and murderer.

Quoting Hanover

In the US, we have decreed certain limitations on government power and described them as inalienable rights endowed by no less than the Creator.

The rest of your argument falls flat on anyone who doesn't believe in this Creator if that's how you intend to justify it.

Quoting Hanover

All these final decisions are being made by our executive branches (President, governors, and mayors) without legislative act and so far with no judicial oversight

You aren't objecting to the way NY arrived at its decisions are you? Just smaller communities where the lockdown is presently causing hardship?

Quoting boethius

For instance, if there is a risk group with 10% chance of respiratory death this year, and getting the virus increases those chances by double, then there is a of collision between Covid deaths and other respiratory deaths. But if those diseases are distributed randomly the collision is not much. E.i. if this group is 100 people, then the odds that the 10 people expected to die from Covid would happen to be the 10 people expected to die from influenza, is extremely low.

The latter odds of the two coinciding likely depend on comorbidity to begin with though. I think if you stratified based on comorbidity the reasoning holds though.

P(person dies of flu | confirmed comorbidity presence, risk group) is much higher than P(person dies of flu| risk group).
P(person dies of coronavirus | confirmed comorbidity, risk group) is much higher than P(person dies of coronavirus | risk group)

So long as the confirmed comorbidities are comparatively rare on the population level or within the risk group anyway (so if your idea of "risk group" includes accounting for comorbidity explicitly, that would be fine too).

It's like flipping two coins which can result in heads or tails (heads = death, tails = not death) with loads of blu-tack on tails (blu tack on not death), they'll coincide on heads (death) a lot even if the flipping mechanisms (joint infection probability of coronavirus with another disease, given comorbidity and risk group) are unrelated (P(i have flu, i have coronavirus| comorbidity, risk group). = P(i have flu| comorbidity, risk group)*P(i have coronavirus|comorbidity, risk group))

Edit: also notice the transition between discussing death probability and infection probability, P(infection | comorbidity, risk group) might behave much differently than P(death | comorbidity, risk group), so the causal colliders in one need not transfer to the other, or death might have colliders that infection does not.

Quoting Michael

The rest of your argument falls flat on anyone who doesn't believe in this Creator if that's how you intend to justify it.

That's not how I intend to justify it. I justify it by referencing the Constitution. My reference to the Creator is only to point out how fundamental of rights these are considered. The foundation of the laws is the Constitution. It's not really significant for these purposes upon what foundation the Constitution rests.

Quoting fdrake

The latter odds of the two coinciding likely depend on comorbidity to begin with though. I think if you stratified based on comorbidity the reasoning holds though.

Yes, the reasoning is based on the empirical data that the virus seems to simply double your chances of death this year, whatever your risk group; that this is the best predictor for most people.

If the virus only tended to kill people about to die of a heart-attack, or who have late stage cancer, then the overlap with "people who are likely to die anyways" would be more significant.

I think "comorbidities" has given a lot of people on the internet the impression that most people who die from Covid are essentially on deaths doorstep and the virus was a, perhaps even in their minds a merciful, coup de grace. However, these underlying conditions that increase the probability of death are very large, fairly banal groups; people with heart disease, diabetics and cancer survivors that have relatively long life expectancies. Large groups where there's no reason to believe those that would die of some respiratory disease anyways, not to mention just any cause of death, are significantly more likely to get Covid fist.

Quoting fdrake

Edit: also notice the transition between discussing death probability and infection probability.

What do you mean by this?

If you reference my term "infection-fatality-rate", it is simply reference to the unknowns on asymptomatics. More asympotomatics makes the disease harder to control, but faster to process the whole population -- whether in a controlled or uncontrolled way.

Right now we only really have "okish" data on the cases, infections that manifest to the tracking system in some way. The factor of asymptomatics can be played with to radically decrease the true infection-fatality-rate. But from what I understand, based on the spread pattern it's not very plausible to postulate numbers much more than double symptomatic cases. Double is a lot, but it isn't so high as to be able to process the entire population anytime soon, and lot's of asymptotics is a double edge sword as they require more extreme social distancing to control the spread.

Not that I know or even have a better guess than the professional to any of these factors. But my point was subtle things like Isaac's point can be illusory, especially at these small number of cases and relatively small odds and the disease affects seeming to be well mixed in the population; and, we can also think of subtle factors that might go in the opposite direction of the effect, such as lung injury -- which then might be the confounding "comorbity" creating a new risk group of Covid survivors that keep the general risk-profile of society the same post-pandemic, or potentially even higher.

So many unknowns. Why not investing in containment such a crazy idea.

Quoting frank

You aren't objecting to the way NY arrived at its decisions are you? Just smaller communities where the lockdown is presently causing hardship?

I was purposefully vague enough not to specify what I was objecting to, but more concerned with the lack of oversight and what appears to be a naive assumption that these experts wouldn't steer us wrong because they are somehow the world's only neutral, objective people, devoid of any political gain in the situation.

Reply to Hanover

You have a king now. You don't need a constitution.

Quoting Hanover

I was purposefully vague enough not to specify what I was objecting to, but more concerned with the lack of oversight and what appears to be a naive assumption that these experts wouldn't steer us wrong because they are somehow the world's only neutral, objective people, devoid of any political gain in the situation.

That was way too vague to be an accusation of anti-Republican bias favoring blowing the economy up prior to a presidential election. But that would probably make a good movie. Could we also add in an alien that has no structure of its own but rather absorbs and displays the structures of other lifeforms and then explore what happens when that alien plants itself on earth and starts absorbing and displaying the human psyche in combination with fungi and combinations of plant and animal life? I'm reading that book right now.

Reply to Hanover

Exactly right. This is why I never listen to my doctor and instead get my medical advice from Judge Judy. That's to say, don't make the perfect the enemy of the good. The medical and scientific community have made some mistakes, but you can safely presume politicians and pundits are more likely to intentionally mislead us than eggheads dragged from their labs and papers to deal with real life.

Quoting boethius

I think "comorbidities" has given a lot of people on the internet the impression that most people who die from Covid are essentially on deaths doorstep and the virus was a, perhaps even in their minds a merciful, coup de grace. However, these underlying conditions that increase the probability of death are very large, fairly banal groups; people with heart disease, diabetics and cancer survivors that have relatively long life expectancies. Large groups where there's no reason to believe those that would die of some respiratory disease anyways, not to mention just any cause of death, are significantly more likely to get Covid fist.

That wasn't my intention.

I was just talking about whether partitioning the data based upon risk group removes the collider bias you mentioned, and giving some justifying statements that comorbidity complicates the attribution of the deaths to coronavirus, seeing as it also contributes to deaths from influenza.

This applies especially if we're analysing only people who have died, will die, or would die, that group's going to have corona virus presence collided with other virus presence because it's already known that health outcome severity is influenced by comorbidity presence and severity. Anything regarding population infection rates at large isn't going to remove it (at least, I don't see an easy way to control, the randomisation introduced by infection risk won't touch the death risk given infection and its influences; we're already conditioning on infection for one of the considered groups!)

The relevant scenario to consider is whether a person with a given comorbidity is more likely to die (or other health outcome, or increased prevalence of larger values of negative health outcome) from coronavirus than from influenza, rather than considering the population at large based on risk groups that do not track comorbidity while still being influenced by it (through the dependence introduced by subsampling based on death)

Quoting fdrake

That wasn't my intention.

Sorry, should have clarified I wasn't attributing this to you; was really talking about lot's of people on the internet. The word comorbidity seems "really bad" if you don't know the definition, so a lot of people seemed to take it to mean on deaths door step.

Quoting fdrake

I was just talking about whether partitioning the data based upon risk group removes the collider bias you mentioned, and giving some justifying statements that comorbidity complicates the attribution of the deaths to coronavirus, seeing as it also contributes to deaths from influenza.

From what I understand, there's no other way to do it, as there's no way to "know" who really will die absent Covid. We can only put people into risk groups and then calculate the probability of death from Covid of people in their respective risk group.

Lot's of people at risk of respiratory disease, or death from any other cause, this year, of course won't actually

Quoting fdrake

This applies especially if we're analysing only people who have died, will die, or would die, that group's going to have corona virus presence collided with other virus presence because it's already known that health outcome severity is influenced by comorbidity presence and severity.

Yes, we're in agreement that disentangling is not clear-cut.

My point about overlap is perhaps best summarized as overlap is only significant, or potentially significant:

1. Early days with low numbers and cause and effect is not clear, the disease could be simply correlated with the other comorbities but not causal.
2. A disease that has enormous bias towards killing the terminally ill, but essentially no one else -- such as a hospital disease.
3. A super high mortality rate and completely out of control epidemic that has large overlaps with other "would be causes of death" simply due to killing so many people. For instance, many people dying in an Ebola outbreak are genuinely people who would have died anyways in the short term; so there's lot's of overlap but the effect is now small because total deaths are so high anyways -- doesn't do much for lowering attribution of death to the disease.

If a disease is in the Covid range where we now know it's not a correlation mixup, know it's not highly specific to terminally ill, and know it's not crazy high mortality, then expected overlap is low: most people dying of Covid are not people who would have died anyways; there is simply a large number of additional deaths from Covid and the risk profiles going forward remain constant, as far as we can expect at this time; it could be lower or it could be higher.

However, this expectation is not taking into affect social distancing. With social distancing deaths may go down due to people staying at home and relaxing; less air pollution, etc.. Apparently there are less deaths during a recession / depression. So these second order effects of our response to Covid can also add a layer of complication, and could swing the death count back the other way ... or world war III breaks out and we revise these estimates.

I think we're in agreement on all this -- and I'm not even sure I'm in disagreement with Isaac's original comment I was responding to, as if it's just "one effect" among many, and we'll see with time, then I have no qualms -- but I've rewritten this point for benefit of others or in case we do in fact disagree somewhere.

Basically, my purpose is to emphasize your point that these data sets will be analyzed for years and decades to come, we can only really speculate about subtler relations beyond "it bad" at this point.

Quoting frank

it's rare to see more than one virus at a time.

Can't find the exact article I remembered so I'll defer to your greater expertise and presume I either remembered it wrong or misunderstood it in the first place. I had a brief look online and it is certainly common to be infected with more than one virus at a time, but the only similar figures to the ones I quoted were for HRV so that might be where I've gone wrong.

Quoting I like sushi

No idea what that means or how it counters anything I said? The figures give are for week ending April 3. Clearly there is a spike in deaths.

Yes, but people can't die twice. 10,000 people die every week, different proportions for different cohorts, but with elderly and those with underlying health conditions, the proportions are obviously higher. So if, rather than 10,000, 16,000 dies one week, that's 6,000 fewer people who can die next week (they're already dead). No-one's increased the entry to that cohort (the birth rate wasn't raised in advance 80 years ago), so the effect will be seen in the following week. More so by a year.

The chances of and 85+ person dying are about 1 in 6 annually. So in any given year, one in every six of that cohort are going to die. That's about 280,000. If 20,000 die from Covid-19, the other diseases aren't going to 'seek out' their usual number of victims, they haven't got a quota to fill. There are simply going to be fewer people in that cohort so the percentage of them dying of the same diseases is going to lead to smaller number. If a disease preferentially causes fatality in those with underlying health condition, then that is the cohort against which it's impact should be measured in this sense. Obviously that cohort is not going to be added to at an increased rate, but it is going to be removed from at an increased rate so there will be a much smaller pool for the remaining illnesses to draw their mortality from.

Quoting I like sushi

The figures for deaths (ALL deaths) are not ‘crude’. The deaths for last week ARE crude - meaning they are not official figures because it takes time to account for all deaths.

No, still not what I'm getting at. The cohort for whom the deaths in one week are related are not the cohort for whom the case numbers are given. Any in that cohort who are going to die are going to be reflected in the next fortnight's figures.

Quoting I like sushi

An extra 500 cases is a significant rise though.

Fair enough. It's pointless quibbling over what 'significant' means, so I won't.

Quoting I like sushi

Maybe you’re comparing April to Dec and Jan. That is faulty because the death toll during the winter months in the UK is always significantly higher

No it isn't faulty. The deaths are higher in winter because of flu. So, given that we now have a new flu-like illness (but one not yet clearly seasonal), comparing it to it's most similar condition is entirely appropriate, I think. No-one's saying there's no deaths being caused by Covid -19, the issue (for risk analysis) is how many compared to other diseases we've dealt with. The most obvious comparison if flu at it's worst. That's something we've dealt with before. 2000 deaths a week is not much different from flu at it's worst, so we can use that for response planning.

Quoting boethius

From what I understand, there's no other way to do it, as there's no way to "know" who really will die absent Covid. We can only put people into risk groups and then calculate the probability of death from Covid of people in their respective risk group.

Aye. When someone is usually tested based on severity the data's going to have things which will come from colliders, they'll tend to inflate sample correlation between whatever's collided; but it's extremely unlikely that the correlation observed between severity/mortality and comorbidity is explained entirely by the collider bias induced by the testing.

Quoting boethius

there is simply a large number of additional deaths from Covid and the risk profiles going forward remain constant

From what I know, I'd agree with that; the disease doesn't seem to have changed nature, and if it already had changed we'd probably be talking about it, though the risk profiles can increase through exogenous stuff like healthcare system failures; if the infection risk goes way up within hospitals due to resource shortages (not sure how likely this is), that increased risk can partially be attributed to COVID presence, but also on the broader stuff that lead to the shortage.

The people with comorbidities are more likely to die if they're in the "we have covid" group than in the "we do not have covid" group. Covid's an extra influence, and its knock on effects can be (partially) attributed to it; quantifying the effect of it on health outcomes should also include its knock on effects on other outcomes. It's like uh.... Hitting someone in the head with a clawhammer, I'm responsible for the brain damage, even though it's an effect of the impact rather than my intention to hit someone on the head with a clawhammer.

Quoting boethius

The statistical analysis of this general issue I've seen so far, is that getting the virus doubles your chances of death of the year compared to your risk group.

Where's this? Just on the face of it if this were true then we'd expect to see a doubling of the death rate in all age groups, yet we see absolutely no impact whatsoever in age groups below about 65 (decreasing in statistical significance of course, rather than a single cut-off point).

The rest of your post seems based on this so we'd better sort out what support you have for that assertion first.

Quoting boethius

I think "comorbidities" has given a lot of people on the internet the impression that most people who die from Covid are essentially on deaths doorstep and the virus was a, perhaps even in their minds a merciful, coup de grace. However, these underlying conditions that increase the probability of death are very large, fairly banal groups; people with heart disease, diabetics and cancer survivors that have relatively long life expectancies. Large groups where there's no reason to believe those that would die of some respiratory disease anyways,

500,000 people die every year - from which group do you think these deaths are drawn? If these groups do not form the ones who would have "died anyway", then from which group are the 500,000 people who do "die anyway" drawn? Are you suggesting that chance of death is essentially random and not related to underlying health conditions?

Quoting Isaac

Where's this? Just on the face of it if this were true then we'd expect to see a doubling of the death rate in all age groups, yet we see absolutely no impact whatsoever in age groups below about 65 (decreasing in statistical significance of course, rather than a single cut-off point).

I will track the source down. However, it's not really a premise to my argument concluding that collisions will be low; it just seemed the best predictor I have seen so far. There can be lot's of variations from one risk group to another, such as men and women (men being already in their own higher-risk group, so compatible with the predictor "doubles your risk of death compared to your risk group"). But I'll get back to this when I have the time.

As to, assuming it is true, doubling death rate to result in double the deaths, for that to happen based on the premise, everyone would need to get the disease, which hasn't happened yet.

Quoting Isaac

500,000 people die every year - from which group do you think these deaths are drawn? If these groups do not form the ones who would have "died anyway", then from which group are the 500,000 people who do "die anyway" drawn? Are you suggesting that chance of death is essentially random and not related to underlying health conditions?

Yes, there are risk groups along single metrics: age, diabetes, cancer stage, etc. and of course risk groups combining them. What is random is which individuals will create these patterns, but the patterns are nor random.

Introducing a new pattern that has no causal mechanism to significantly overlap (and thus displace) an existing pattern simply results in more deaths and no first-order reason to believe deaths will be lower when that pattern goes away.

I used the term "terminally ill" in my above analysis to refer to people we are "extremely sure will die in the short term".

If you look at risk groups such as "diabetes" this isn't a terminally ill disease where we'd expect death this year. Likewise, most people at risk of respiratory illness will also not die this year nor people suffering from heart disease. There's no reason to assume the Covid will overlap with the other causal mechanisms that make these risk groups what they are. People will continue to die of hear attacks for instance; there's no reason that Covid is killing people who really would die of a heart attack this year compared to people simply at risk of dying of a heart attack; since Covid doesn't kill enough people to change this risk group significantly in absolute terms, we should expect just as many heart attacks going forward. Likewise for respiratory illness, diabetes, cancer stages or survivor status.

In some cases there may very well be less deaths in the risk group, but this is due to our response to Covid (lowering pollution) changing the underlying causal mechanism impacting that risk group, not because Covid deaths overlapped with "expected deaths". And, as I mention, maybe other second-order effects increase causal death mechanism, such as lung injury.

Reply to Isaac I guess I don’t understand your point. Either way the next set of figures will give a clearer picture.

https://nypost.com/2020/04/14/coronavirus-cases-skyrocket-in-south-dakota/

"South Dakota’s coronavirus cases have begun to soar after its governor steadfastly refused to mandate a quarantine.

The number of confirmed cases in the state has risen from 129 to 988 since April 1 — when Gov. Kristi Noem criticized the “draconian measures” of social distancing to stop the spread of the virus in her state.

Noem had criticized the quarantine idea as “herd mentality, not leadership” during a news conference, adding, “South Dakota is not New York.”"

Yall need to bring back public hanging of public officials.

As I was saying, this is the way we'll be going.

"Poland’s borders will remain closed until at least May 3, Prime Minister Mateusz Morawiecki said on Thursday.
Morawiecki said Poland would start easing some coronavirus restrictions from April 20.
Poles will also have to cover their noses and mouths in public until a coronavirus vaccine is found, health minister Lukasz Szumowski announced."

https://www.theguardian.com/world/live/2020/apr/16/coronavirus-live-news-cases-worldwide-top-2-million-trump-doubts-china-death-toll?page=with:block-5e98b0658f0895d83068f7ca#block-5e98b0658f0895d83068f7ca

Quoting StreetlightX

"South Dakota’s coronavirus cases have begun to soar after its governor steadfastly refused to mandate a quarantine.

The number of confirmed cases in the state has risen from 129 to 988 since April 1 — when Gov. Kristi Noem criticized the “draconian measures” of social distancing to stop the spread of the virus in her state.

Noem had criticized the quarantine idea as “herd mentality, not leadership” during a news conference, adding, “South Dakota is not New York.”"

Yall need to bring back public hanging of public officials.

And their deaths per million is now 8, 2nd lowest in the nation. South Dakota isn't New York. There are 10.7 people per square mile in SD, compared to 411.2 in NY (70,826 per square mile in Manhattan). This is to say that South Dakotans practice more social distancing on an average day than a New Yorker practices on total lock down. It's not a one size fits all, which is why the individual governors are given the ability to decide the best course of action.

Quoting Baden

The medical and scientific community have made some mistakes, but you can safely presume politicians and pundits are more likely to intentionally mislead us than eggheads dragged from their labs and papers to deal with real life.

Mengele.

Reply to Hanover

Was a sadist and would therefore be voting to end the lockdown now so he could enjoy the additional deaths that would cause. What's the right wing of the Repub party's excuse?

Quoting Baden

What's the right wing of the Repub party's excuse?

Can't say. My excuse is is that I don't interact with the elderlies, so I can't do any harm, so set me free. I'm also running out of room from all this toilet paper I've got.

I'm gonna go get an MD or something so I can control the damn world. Dr. Hanover will be an emancipator, not a regulator. He won't be spittin no viruses, just rhymes.

Reply to fdrake If fairly extensive random testing were carried out, would that not give a reasonably accurate picture of just how much Covid-19 infection is in the community?

My company just laid off a bunch of people. Luckily, I still have my job. The CEO took a 20% paycut. However, after reading a few articles, found this passage. It went uncommented on, in the comment sections, so maybe I just don't have the finance/business background to adequately contextualize it, but it seems shady af to me. Anyone have any insight to this, and whether it's as bad a thing as it looks?

[quote=Portland Press Herald]On Feb. 18, when Wex stock was trading above $220 per share, company President and CEO Melissa Smith exercised an option to buy 8,056 shares of Wex stock at a discounted price of $77.20, then immediately sold 15,556 shares at $223.19 per share for a total cash-out of just under $3.5 million, according to a filing with the U.S. Securities and Exchange Commission.[/quote]

Reply to Punshhh That's gorgeous! What country/region are you in?

To assuage any fears about my well-being, I do get out most days. Lucky enough to live near a tranquil park w/ altitude which overlooks Southern Maine as it stretches north til the foothills, and past that to the mountains. And a slow 2.5 hour walk will let me circle the city and stop at the park on the other end, which looks out onto the ocean. However, it's not isolated; at either park, there are usually a fair number of others around. An old cemetery nearby works for outdoors isolation, but, of course, its a cemetery. Which I'm ok with, but you can't really ignore the fact there's a bunch of civil war vets a few feet down.

So the Paycheck Protection Program ran out of money this morning. My semi-former employer was counting on that to keep his business afloat, and I was counting on that in turn to have a job to come back to before my enhanced unemployment runs out.

It sounds like a bill to re-fund it is already in the works, but the new funds are expected to run out just as quickly, and apparently Democrats are holding up the bill (!?), though I can’t find any good information on why.

ETA: It appears Democrats want more hospital funding and better access to the money for small lenders, and Trump sounds pretty okay with that, it’s just senate Republicans who want to leave that out.

Matterhorn

:cool:

Reply to Hanover Yet the point is that a great deal of those infections - and correponding deaths - were likely preventable. They need not have happened.

Quoting csalisbury

What country/region are you in?

From what I can ascertain: West Anglia.

Reply to Evil i need to get me one of those west anglia tranquil-spots.

Reply to csalisbury I'm sure it was done legally but I don't see how yet. Prima facie it seems to be a breach of the holding period as described here: https://www.sec.gov/reportspubs/investor-publications/investorpubsrule144htm.html

Reply to I like sushi Thanks. I actually started with the one before that. Looking into getting a kf94 mask now, which unfortunately may not be exported from Korea or Taiwan unless you're Korean or Taiwanese and live abroad.

Sucks monkey balls.

Quoting boethius

Introducing a new pattern that has no causal mechanism to significantly overlap (and thus displace) an existing pattern simply results in more deaths and no first-order reason to believe deaths will be lower when that pattern goes away.

But it's not a pattern which has no causal mechanism to significantly overlap an existing pattern. Why do you think the government has sent out specific advice to vulnerable people? What biological mechanism do you think takes place to account for variation in disease course if not the ability of the immune system to respond? Viral load is certainly one factor, but it's unsure at this stage whether that's even a significant factor (one study says it could be, two other say it isn't, but those have yet to be peer reviewed).

So as things stand we're left with immune system response as being the only mechanism that has been reliably demonstrated to account for the variability in outcome. Meaning that literally everyone who experiences a poor outcome does so on account of a compromised immune response (except as I said, if the Lancet paper is right then very hight loads such as healthcare professionals are exposed to could be a factor too, but not for the general population).

So how do immune responses become compromised other than by underlying health conditions?

Quoting boethius

Likewise, most people at risk of respiratory illness will also not die this year nor people suffering from heart disease.

No, and most people who get Covid-19 won't die this year either. That's not the point. The point is that of those people who will die, a disproportionate amount will be drawn from that small group of people who were going to die from respiratory illness or heart disease. We're talking about quite small proportions in either case, so it's no good saying that only a very small proportion of those with underlying health conditions were going to die this year anyway. We know with great precision how many of those people were going to die this year anyway, its about 300,000 (the death rate minus deaths from accidents). So until the death rate from Covid-19 exceeds 300,000 you can't possibly say that the victims were not going to die anyway, simply on the basis of the numbers, you additionally need data on the overlap - or you need to wait for deaths occurring over a longer timescale - say a year, or you need a plausible mechanism of fatality which does no coincide with underlying health conditions.

Quoting boethius

People will continue to die of hear attacks for instance; there's no reason that Covid is killing people who really would die of a heart attack this year compared to people simply at risk of dying of a heart attack

Again, not to labour the point, but there absolutely is such a reason. People who are going to die from heart disease this year will disproportionately be in worse general health (specifically cardiovascular health) than those (from the same cohort) who were going to last more than a year. Death does not harvest randomly. Those who were ill enough to be likely to die this year from heart disease are more likely to die from Covid-19. That is why we see a disproportionate number of deaths in these categories.

Quoting boethius

maybe other second-order effects increase causal death mechanism, such as lung injury.

Again, not comparing like with like. If you're including (in your risk analysis) for Covid-19 potentially related deaths, then when comparing it to risks we know already, you have to do the same. Many illnesses have related tissue damage which causes morbidity later on, we don't include it in the death statistics for that condition - so why would we change our statistical approach for this particular condition?

Covid-19 may well be with us for some years, and if not this, then the next one. We have to manage it (and more importantly learn to cope with it psychologically) in a sustainable and consistent manner. I understand the impetus, but artificially making it sound more terrifying than it already is does not get people to act in the rational manner needed at times like these, nor is it healthy for the population in the long-run (not that the mental health of the population in the long run isn't already a lost cause - one might as well be holding back floodwater with a sieve)

Quoting Janus

If fairly extensive random testing were carried out, would that not give a reasonably accurate picture of just how much Covid-19 infection is in the community?

I think it would.

Quoting csalisbury

Anyone have any insight to this, and whether it's as bad a thing as it looks?

You have two interpretations: a) Melissa wanted the cash from the options immediately. Many who get into the options program don't have any incentive to actually hold on to the stock, but treat it just a bonus like cash. Of course, the other way is to think that b) Melissa knew that the company was totally lost and verge of collapse and has absolutely no faith in the company.

Reply to Janus Reply to fdrake

Iceland has, to my knowledge, done the most extensive testing so far. Their (preliminary) results are here

The other respected dataset is Estonia which is here, but you'll have to translate the page.

Quoting Punshhh

Perhaps if folk post an image of where they isolate, it would be interesting to see how our experiences differ?

Right now I long for a garden like that. England?



Isolation Station, Moscow. Pretty much the same as before to be honest, although now my wife is working from home as well, and we can't go out except for essentials. Out the window I can see for many miles across the city, places I cannot go.

Earlier this week, or maybe last week, the Moscow authorities introduced a pass system for travel. If you want to go anywhere in a car or by public transport, you need to get a special QR code from the local government web site. If the police catch you without one they'll fine you 5000 rubles.

Locals are generally derisive about this system, partly because it's been introduced in a rush and quite incompetently and chaotically. The web site crashed several times and the mayor immediately blamed foreign hackers--which I think convinced exactly nobody--and the police don't have scanning devices to check the QR codes, so they have to call back to base to confirm the code's validity. This has caused long queues at the metro stations, leading one journalist to caption a photo with "Stations of the Moscow metro are experiencing unprecedented DDoS attacks organized from abroad". I'm getting to like the Russian sense of humour.

EDIT: I really should clean up.

Quoting Benkei

Sucks monkey balls

Per Cuomo 80% of the people who were intubated died. That means we have a really expensive supportive technology that mostly fails for this virus.

Quoting Isaac

But it's not a pattern which has no causal mechanism to significantly overlap an existing pattern.

No, there's no causal mechanism that will cause significant overlap, unless by significant you mean measurable.

I've repeatedly said I have no problem with your claim we'd see an effect of people dying in the "otherwise would have died" category, but it's not a big effect.

Most of the risk categories, including respiratory, will continue to suffer from whatever they are at risk of.

What would make a significant overlap with people who really would have otherwise died I have outlined:

Quoting boethius

1. Early days with low numbers and cause and effect is not clear, the disease could be simply correlated with the other comorbities but not causal.
2. A disease that has enormous bias towards killing the terminally ill, but essentially no one else -- such as a hospital disease.
3. A super high mortality rate and completely out of control epidemic that has large overlaps with other "would be causes of death" simply due to killing so many people. For instance, many people dying in an Ebola outbreak are genuinely people who would have died anyways in the short term; so there's lot's of overlap but the effect is now small because total deaths are so high anyways -- doesn't do much for lowering attribution of death to the disease.

Being in an at-risk group increases your risk of dying if you get Covid, but the progression of Covid, in itself, does not significantly alter the nature of those risk groups going forward, such as culling the people that would actually die soon, without some mechanism -- a mechanism which is simply not there. Risk groups of Covid are very large groups we'd expect to be vulnerable, such as elderly, obese, diabetics, smokers, and so on.

I am not arguing with the fact there are groups more likely to die of Covid if they get infected. I am arguing with the idea that there will be a significant decrease in smokers dying because Covid preemptively removed smokers that would have otherwise died soon.

Quoting Isaac

No, and most people who get Covid-19 won't die this year either. That's not the point. The point is that of those people who will die, a disproportionate amount will be drawn from that small group of people who were going to die from respiratory illness or heart disease.

Exactly where we disagree.

Yes, the people who would otherwise die of respiratory disease are a small group.

But no, people dying from Covid are not drawn from this small group, but very large risk groups of which this group of people who actually die, or would have actually died, this year is a small subset.

Smoking, obesity, being old, are very large groups. Covid killing some people in those groups is just as random as other causal mechanisms that make these risk groups exist. Since the probability of death due to being a smoker is fairly small for the average smoker and the probability of death of Covid is fairly small, then we can essentially ignore intersection of "smokers dying of general risks of smoking" and "smokers dying of Covid".

If Covid killed all smokers, then yes there would be complete intersection and we could look forward to having less deaths relating to smoking; this would be the ebola example.

If Covid only targeted smokers in the terminally ill phase of lung cancer then again there's an intersection; the hospital disease case.

Likewise, if Covid was not a cause of disease but something everyone already had just scientists didn't know it, then it could easily be a false alarm that there's a new terrible disease; this would be the corollary-causation mixup.

But we know we can rule these things out.

Quoting Isaac

Again, not comparing like with like. If you're including (in your risk analysis) for Covid-19 potentially related deaths, then when comparing it to risks we know already, you have to do the same.

That's why I clearly make the distinction of respiratory illness decreasing after Covid because those people were culled from risk groups, and respiratory illness going down after Covid due to less pollution or other second order affects of Covid.

Our response to Covid is a massive systematic causal change to all sorts of things. So, it is definitely true we might see less respiratory deaths because of massive systemic changes to society; but it's a mistake to attribute that decrease to "people who would have otherwise died, but Covid got to them first and so they were not available to die in the existing death patterns we see".

However, we also know that the disease can cause long term lung damage, so it could be that we see this effect dominating the less pollution effect.

Point being, we cannot assume anything about these second order effects on face value. We can list effects, but we can't conclude which trend we will see nor conclude that our list of effects is exhaustive without some detailed model justification -- i.e. the opposite of face value.

We can be confident less pollution is good for lungs, and more lung damage is bad, but we can't know which will be the bigger effect, especially in a scenario where we don't find any effective treatment and everyone gets the disease.

We should also not confuse second order effects with primary effects of changing the makeup of risk groups in absolute terms as direct consequence of the disease killing some people.

As an aside, I did a lot of looking for the source of the "roughly double your existing annual risk", and found it in a search engine cache, so I didn't dream it. It's from a BBC article posting a graph from Imperial College analysis, but seems to be removed from the original article, I imagine because it give the impression that the risk of death for all age groups is completely unchanged by the pandemic, rather than it simply overlaying risk of death from Covid, if you become a case, onto of your existing risk in relation to the single risk dimension of age. Anyways, I'll upload it as it's an interesting pattern, but it's not needed for my above arguments to work.

Video of a guy giving food to the homeless during the pandemic (but making sure to film it to get that praise and YouTube views/money).

Quoting boethius

No, there's no causal mechanism that will cause significant overlap, unless by significant you mean measurable.

Covid-19 kills people either by the lungs filling with fluid as a result of a failure of the immune system (sometimes from comorbid bacterial infection) or by exacerbating the effects of other conditions, particularly heart disease. Every single one of those mechanisms relies on an underlying health problem. If you know of some way Covid-19 applies a random element to the selection of fatalities, I'd be interested to hear it. As it stands, if you lined up 1000 people in order of healthiness and gave them all Covid-19, the one who will die will be drawn from the least healthy end. Likewise if you lined up all 70 million people in the country in order of healthiness, the 300,000 who are going to die this year (from disease) will be drawn from the least healthy end. It's the same cohort.

I don't know how else to explain this. There are 300,000 people who are so ill that they're going to die this year. You're suggesting that when these people get a Covid-19 infection, they're not significantly more likely to die from it then anyone else, that the deaths won't be drawn with any significant bias from this group.

Quoting boethius

Being in an at-risk group increases your risk of dying if you get Covid, but the progression of Covid, in itself, does not significantly alter the nature of those risk groups going forward, such as culling the people that would actually die soon

Of course it significantly alters the nature of the risk groups. So far 98% of Covid-19 deaths are from these risk groups, so if Covid-19 kills 20,000 people, then these risk groups will be 19,600 people smaller than they were beforehand. They are not like an exclusive club, they don't have a waiting list. If 19,600 people suddenly get removed from these groups, there's not a reserve cohort waiting to take their place. The 300,000 deaths are also drawn mainly from these cohorts. Again 300,000 is not a quota to be filled. If Death finds fewer people in his preferred selection group than normal he's not going to go looking elsewhere to bump up the numbers.

Quoting boethius

Smoking, obesity, being old, are very large groups. Covid killing some people in those groups is just as random as other causal mechanisms that make these risk groups exist.

No it isn't. Even within a risk group, the least healthy members of that risk group are more likely to die than the most healthy. There's no dice in our bodies that a virus gets to roll to see if it's going to kill us or not. It's a direct and unmediated consequence of the response of the immune system and the function of supporting organs. There's no roulette wheel involved.

Quoting Isaac

Covid-19 kills people either by the lungs filling with fluid as a result of a failure of the immune system (sometimes from comorbid bacterial infection) or by exacerbating the effects of other conditions, particularly heart disease. Every single one of those mechanisms relies on an underlying health problem.

Nothing I have said contradicts this.

Quoting boethius

Nothing I have said contradicts this.

Then where is the random mechanism? If you agree that it is failure of the immune response and supporting organs which leads to death, then it directly follows that those with the weakest immune systems and supporting organs will almost exclusively be the group from which fatalities will be drawn.

If you want to claim fatalities are drawn randomly from that group you need to describe the random mechanisms, so far all we have agreed on are non-random mechanisms directly related to health.

Quoting Isaac

No it isn't. Even within a risk group, the least healthy members of that risk group are more likely to die than the most healthy.

This is not true.

For this to be true, the "less healthy members" within a risk group need to somehow be far more likely to get infected to begin with. That is certainly not the case so far.

Furthermore, it would need to be the case that being particularly at risk of Covid within a risk group, means being particularly at risk of whatever makes up your risk group. It could be random genetic differences that make a person in a risk group, such as smoking, particularly at risk of Covid.

In other words, one could be a on the "healthy side" of a risk group, but particularly vulnerable to Covid due to some genetic difference that has no bearing on one's underlying condition.

Quoting Isaac

Then where is the random mechanism?

The random mechanism is that we don't know who within a risk group is actually going to die this year, so taking people out of the group by another mechanism, such as Covid, doesn't change significantly the expected pattern of death from the existing risk. The randomness is due to a lack of knowledge at this stage; but there's no reason to expect Covid targets "the particularly unhealthy members of a risk group".

Quoting boethius

For this to be true, the "less healthy members" within a risk group need to somehow be far more likely to get infected to begin with.

No they don't, because if everyone is equally likely to be infected then the liklihood of infection can be removed from the equation. It's only relevant if it biases fatality in the opposite direction. We're looking at whether fatalities are going to be significantly disproportionately drawn from certain groups. If 10% of all groups become infected, then we're dealing with 10% of the healthy cohort vs 10% of the least healthy cohort.

Quoting boethius

It could be random genetic differences that make a person in a risk group, such as smoking, particularly at risk of Covid.

Unless you're suggesting that there's some gene specific to the defense against Covid-19, then the only genetic component which might be relevant is one which affects the immune system in general. Such as defect would put you in the cohort from which the 300,000 yearly deaths are drawn.

Quoting boethius

The random mechanism is that we don't know who within a risk group is actually going to die this year,

Yes we do. It will (disproportionately) be the least healthy. Same as those most likely to die from Covid-19.

It might be different in a country whose disease-related deaths were mostly infections (like some developing countries) but not in the Western world. Our deaths are drawn overwhelmingly from heart disease and cancer. The exact same groups from which Covid-19 is drawing most of it's fatalities (with cancers being mostly the immune suppressing effects of treatment).

Quoting Isaac

No they don't, because if everyone is equally likely to be infected then the liklihood of infection can be removed from the equation.

No it can't, if you're trying to support the idea that Covid kills the "particularly unhealthy". Lot's of "particularly unhealthy" simply don't get the disease, so there will remain lot's of these "particularly unhealthy" around since they didn't get infected.

Quoting Isaac

Unless you're suggesting that there's some gene specific to the defense against Covid-19, then the only genetic component which might be relevant is one which affects the immune system in general. Such as defect would put you in the cohort from which the 300,000 yearly deaths are drawn.

I'm saying there's no reason to assume the variation of death and survival within a risk group is due to being "particularly unhealthy" within that group. It could be some other mechanism such as otherwise benign genetic differences, or then simply random variation such as where exactly the virus begins replicating in the body, that then dominates chances of death within a risk group.

Quoting Isaac

Yes we do. It will (disproportionately) be the least healthy. Same as those most likely to die from Covid-19.

As I've explained above, this is not a given assumption.

We cannot assume those that die from Covid are "least healthy" within their risk group.

Quoting boethius

We cannot assume those that die from Covid are "least healthy" within their risk group.

It isn't necessary that those within a risk group that are "least healthy" will die, it's just more likely. If you found any factor or variable which contributed to risk, and it wasn't aliased with [hide=*](or otherwise providing redundant information/variables given the assumptions)[/hide] the risk group already, those in the sub group of that risk group that have the extra risk are more likely to die than those in the base risk group. If you condition on death, you're already pre-selecting for demography and other characteristics which make death more likely; as in, within the group of those who have died from COVID (or any other thing), the characteristics that make death more likely will be more prevalent than they are in the general population (on average). It's the same mechanism that makes the more severe cases of COVID be more likely to be tested for COVID, but in a different form.

To be super clear about this; if your sample is those who have died while having COVID, that sample is more likely to contain a higher number of people on average who fall into the groups that amplify risk. Like... those who have died from COVID are more likely to have comorbidities and be older.

Quoting fdrake

It isn't necessary that those within a risk group that at "least healthy" will die, it's just more likely. If you found any factor or variable which contributed to risk, and it wasn't aliased with * the risk group already, those in the sub group of that risk group that have the extra risk are more likely to die.

This is simply not true, as I've explained above.

First of all, at this stage with a small percentage of the population that has gotten Covid, it just doesn't matter because 90-99% of these "least healthy" are still out there and will continue to die due to whatever they are at risk of.

Second of all, even of the people that die within a risk group, the factors determining death compared to one's peers could be otherwise benign. A particularly unhealthy smoker may survive Covid due to some completely benign genetic difference, such as exact shape of proteins on cells etc.

An example, it seems blood type O is particularly resistant to Covid, but blood type O does not provide a similar resistance to smoking. So O blood type's who smoke and survive Covid due to this genetic advantage, there's no reason to assume that they were a "particularly healthy" smoker.

It's an over simplistic assumption to postulate Covid deaths is selecting for "least healthy" within a risk group. It seems intuitively correct, but is not correct.

As I've also mentioned previously, the survivors of Covid, but with long term lung damage or treatment complications, may then replenish the "least healthy" category even if there was such a selector for "least healthy" to begin with.

Reply to csalisbury Good to hear, I live 20 miles south west of Norfolk England. We bought a house where you can buy property with land at a reasonable price, we are surrounded by farmland. But the peace and quiet is worth it. There are a few redneck farms around, I get on ok with them though, a small price to pay.

Reply to jamalrob Sorry to hear how the authorities treat you in Moscow. Aren't you allowed to go out to exercise? Don't worry about the mess, my house would be messy if my wife didn't make me remind me to tidy up and do the housework regularly.

Reply to Evil I'm near Diss, West Anglia isn't talked about, it's called the fens in these parts, I couldn't live there.

Quoting boethius

No it can't, if you're trying to support the idea that Covid kills the "particularly unhealthy". Lot's of "particularly unhealthy" simply don't get the disease, so there will remain lot's of these "particularly unhealthy" around since they didn't get infected.

I'm not suggesting none of the "particularly unhealthy" will remain. Only that they constitue both the cohort from which Covid-19 draws most of its fatalities and also the group from which the general death rate draws most of it's fatalities.

Being the same group means that if one draw reduces the numbers, the other will have proportionately fewer to draw from.

Quoting boethius

I'm saying there's no reason to assume the variation of death and survival within a risk group is due to being "particularly unhealthy" within that group. It could be some other mechanism such as otherwise benign genetic differences, or then simply random variation such as where exactly the virus begins replicating in the body, that then dominates chances of death within a risk group.

Well then support that theory with evidence from the literature. Otherwise it's just idle speculation and you're using it to fuel serious fear and panic so it had better be damn good evidence.

Quoting boethius

It's an over simplistic assumption to postulate Covid deaths is selecting for "least healthy" within a risk group. It seems intuitively correct, but is not correct.

It selects for COVID-19 resistant. Still, a COPD patient who has it has a poor prognosis.

Quoting Punshhh

Aren't you allowed to go out to exercise?

Since March 30, officially no:

[quote=US embassy]According to the published decree, leaving one’s place of residence is permitted only for the following: seeking emergency medical care or other direct threats to life and health; traveling to and from work if required to do so; shopping at the nearest existing store or pharmacy; walking pets at a distance not to exceed 100 meters from one’s residence; taking out household garbage.[/quote]

But so far it's not as strict as Spain. Unlike there, I haven't encountered any police checking what I buy at the supermarket. In fact I haven't seen any police in this neighbourhood at all.

Quoting Punshhh

Don't worry about the mess, my house would be messy if my wife didn't make me remind me to tidy up and do the housework regularly

Unfortunately my wife is as bad as me.

Tomorrow, I'll definitely do it tomorrow.

Quoting boethius

It's an over simplistic assumption to postulate Covid deaths is selecting for "least healthy" within a risk group. It seems intuitively correct, but is not correct.

Whether it's a random sample with no causal mechanism or not depends on the model. Some models are better.

The question is: who are those people who are most likely to die of COVID? That's people who are elderly and have comorbidities.

If the question is: how many deaths are attributable to COVID? That's a bit different. If the question is restricted to: how many deaths of those in a given comorbidity + age risk group are attributable to COVID? It revolves around the counterfactual: If you gave someone with those characteristics COVID, how much more likely are they to die than if they did not have COVID? This is much harder to answer, requires an explicit model of how COVID interacts with the comorbidities, and can't be immediately read off the risk of death of those people who have those characteristics (comorbidity + age) who have confirmed cases and died in hospital (that group selects for comorbidity severity already!)

Edit: if you have a link to a study which is doing this kind of calculation, or something similar, already (trying to quantify EXTRA deaths from covid within risk categories), I'd like to see it!

Some “seroprevalence” studies are beginning to come out. This one is not peer-reviewed, but it’s conclusions are profound.

Under the three scenarios for test performance characteristics, the population prevalence of COVID-19 in Santa Clara ranged from 2.49% (95CI 1.80-3.17%) to 4.16% (2.58-5.70%). These prevalence estimates represent a range between 48,000 and 81,000 people infected in Santa Clara County by early April, 50-85-fold more than the number of confirmed cases. Conclusions The population prevalence of SARS-CoV-2 antibodies in Santa Clara County implies that the infection is much more widespread than indicated by the number of confirmed cases.

https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1

Quoting boethius

An example, it seems blood type O is particularly resistant to Covid, but blood type O does not provide a similar resistance to smoking

This is trivial compared to the disproportionate risk having heart disease, lung conditions or undergoing treatment for cancer has on your risk from dying of Covid-19. Those are overwhelmingly the main risk factors. They are also overwhelmingly the main risk factors for death in general. Minor variations in genetic make up (which do not also affect things like infection, heart disease and cancer) are just that... Minor.

Quoting Isaac

This is trivial compared to the disproportionate risk having heart disease, lung conditions or undergoing treatment for cancer has on your risk from dying of Covid-19.

But these are the large groups I've been talking about.

Yes, heart disease is a big predictor of Covid outcome, but it's a large group and there's simply no reason to assume deaths from Covid overlap with some unknown "particularly unhealthy" sub-group of heart disease.

There are definitely known subgroups such as those already experience heart failure, or have had a heart transplant which is being rejected, which I would assume Covid is an even bigger risk. But there is no evidence that Covid is only affecting this known extreme risk subgroup.

Your argument is that we can assume Covid selects for the "particularly unhealthy" within these groups, but there is no reason to assume that is the case. We cannot expect heart attacks to lesson substantially after Covid because the "particular bad cases of heart disease" were culled from the heart disease risk group.

Now, maybe heart attacks do decrease due to systemic effects such as people de-stressing in lockdown, but this is totally different than a "cull effect".

And, even if there was a substantial cull effect, many survivors may have long term injury that simply replenishes the "particularly unhealthy" end of their risk group.

Quoting fdrake

The question is: who are those people who are most likely to die of COVID? That's people who are elderly and have comorbidities.

I'm not disagreeing that people with comobidities are more likely to die from Covid.

My argument is a counter-argument to the idea that Covid is shaving off a population from these risk groups that can be in some sense said to "about to die anyways"; I've been using a year as a baseline time frame for the meaning of "about to die".

Covid doesn't kill enough people to have an obvious and noticeable statistical effect of this kind, such as non-respiratory disease going forward making up for, or nearly making up for, Covid deaths and arriving at some equilibrium.

If Covid killed everyone who smoked, everyone with heart disease, and every cancer patient and all the old people, then it would have such a very noticeable effect, but the disease doesn't behave in this way and we cannot assume that "particularly unhealthy anyways" dominates in determining who in these risk groups actually dies from Covid; other factors could dominate the death selection process within these groups.

Now, maybe this effect of less respiratory disease deaths does actually happen, since the lockdowns we can easily expect to have a significant change to peoples relationship to pollution, to stress, and to influenza and other infections -- that we can assume are also depressed by the lockdowns. But these effects are due to the lockdowns, not due to Covid culling the "otherwise would have died anyway" group in a big way.

Quoting boethius

there's simply no reason to assume deaths from Covid overlap with some unknown "particularly unhealthy" sub-group of heart disease.

Firstly, yes there is a reason. Those most likely to die in the "heart disease" group are those with the weakest hearts (for various reasons), those are the same people who, within that group, are more likely to die from Covid-19. It is the inability of the heart to support recovery which causes the fatality, not some dice-rolling random factor. The exact same factor.

Secondly, even if the studies relating heart disease to Covid-19 deaths turned out to be wrong about the mechanism, there are still no studies showing the opposite (as you are claiming) a lack of overlap in mechanism.

As I said, if you're going to spread hysteria, you'd better have damn good evidence backing it up, not a bit of guesswork and a lack of contrary evidence.

Quoting Isaac

Those most likely to die in the "heart disease" group are those with the weakest hearts (for various reasons), those are the same people who, within that group, are more likely to die from Covid-19. It is the inability of the heart to support recovery which causes the fatality, not some dice-rolling random factor. The exact same factor.

No, this simply isn't true. You are taking a truism too far.

Also, note that you also have to deal with the fact that right now it's a small group of people who have been infected, and so the effect you describe would not be noticeable much anyways simply because the vast majority of "those with the weakest heart" have not yet gotten the disease. And even if you deal with that, you still have to deal with the fact that long term lung injury or treatment complications may simply replenish this supply of "those with the weakest heart".

However, even the middle part of assuming Covid kills "those with the weakest heart" within the heart disease group is not a sound argument. Other factors can easily dominate in selecting for death within the heart disease group.

Furthermore, a big determining factor for surviving a heart attack is time and place, and this is a completely independent variable to Covid; likewise, people may improve or deteriorate their lifestyle moving from this "weakest" category to "ok" or vice versa, or a really stressful life event has an acute impact on heart disease likelihood; failing to seek timely treatment etc.

Point being, even simply considering these future events that determine heart disease deaths, in other words make your "weakest heart" category not static but a dynamically changing group, significantly enlarges the category of "weakest heart"; i.e. Covid may kill someone who is in the "weakest" category now, but would otherwise have gone on to make life changing decisions and moved out of the weakest category, and so would not have appeared as a heart disease death in the short term.

So, you also have to deal with the dynamic nature of your "weakest" category, in addition to deal with the fact "weakest" is not a given and other factors may dominate who dies and who doesn't of Covid with a risk category. After solving these, there is the fact not enough people have gotten Covid for such an effect to be large, and the fact that if that does happen, Covid does kill off the "weakest", that those that survive may now have long term comorbidity effects due to Covid, thus replenishing this "weakest" group.

Quoting Isaac

The exact same factor.

Yes, there is the same factor.

But having a factor of risk does not mean you will die within a short period of time, it is just a factor.

You are making a completely unfounded addition to the risk group observation that Covid somehow selects to the weakest members of those risk groups -- essentially the terminally ill but we don't know it. There's no reason to assume such a thing. If Covid was a disease of the terminally ill, such as a hospital disease that kills only those with essentially failed immune systems, we would know it by now. There's no reason to assume that there's some hidden group of "true terminally ill people" that make up "actual expected deaths within a year" that we don't know about but will discover because Covid kills them and then they do not live to be killed of their other risk factor. Furthermore, I don't think any doctor would agree such a "hidden terminally ill" group exists, but would say there's a large element of chance within these large risk groups, such as heart disease or smoking or cancer.

Therefore, the only way to have a culling effect is if a disease killed a large proportion of such people, otherwise, with a small amount of killing that Covid does, small in the sense of seeing such an overlap between "Covid deaths" and "people who are about to die anyways", the same "elements of chance" continue to operate in determining who has a turn for the worse, who responds well to treatment and who doesn't, who encounters deteriorating life conditions, develops an addictions, has an accident or some other complicating factor, with respect to Covid as well as whatever other conditions such people continue to have.

In other words, there is not some well ordered spectrum from "good to worse" of heart disease, or lung disease, and that people simply move progressively towards "worse" and then fall off the edge and die. There is a large element of intrinsic randomness and re-ordering due to contingent events, which is why these groups are large and not already separated in a finely grained way with excellent predictors of who in particular is going to die in a given time frame. It's an extremely small group of people who doctors are "certain" will die in any relatively short time frame, such as a year.

Just wait 3 more days and look at the official figures:

https://www.ons.gov.uk/file?uri=%2fpeoplepopulationandcommunity%2fbirthsdeathsandmarriages%2fdeaths%2fdatasets%2fweeklyprovisionalfiguresondeathsregisteredinenglandandwales%2f2020/referencetablesweek142020.xlsx

The last official figures show that there were 6000 deaths registered above average. That is around 50% above average so hard to ignore without a damn good explanation.

Quoting fdrake

requires an explicit model of how COVID interacts with the comorbidities, and can't be immediately read off the risk of death of those people who have those characteristics (comorbidity + age) who have confirmed cases and died in hospital (that group selects for comorbidity severity already!)

Yes, this is my point. If the comorbidity groups are large, we can't simply assume Covid is killing off some unknown sub-group who are very likely to die in some agreed short term anyway; and once such comorbidity groups are large it is implausible such a subgroup even exists that explains many, much less all, deaths in that group: Some people in the risk group die due to simply being in the risk group, without some hidden mechanism that explains why they in particular died, and even if there are hidden subgroups there's no reason to expect they overlap with the subgroup of people more likely to die of Covid -- some otherwise benign genetic difference may dominate here, exactly why species store up diversity in case some otherwise benign difference is no longer benign given new conditions.

If you take out the entire risk group, then it's a different story, but Covid is not remotely lethal enough; therefore, there's no reason to expect Covid deaths intersect with "would die anyways from underlying conditions in the short term". In a refutable form; Covid discovering for us there are such hidden "weakest, about to die" subgroups in otherwise large risk-groups with little success so far in a finer grained differentiation, would be the greatest medical discovery of all time.

@Hanover
For some reason the models say your state's peak deaths is two week away while my state's is already passed.

But they're going to open Texas! Woo hoo!

Quoting boethius

we can't simply assume Covid is killing off some unknown sub-group who are very likely to die;

I mean, COVID is more likely to kill people who are more likely to die anyway. This complicates whatever attribution of death to COVID you do.

Even if the infection risk is constant across the factors that increase the likelihood of death. If COVID infection initiates the causal chain that leads to their death, even if it's the knock on effects (like it interacting with comorbidities) that ultimately kill people, that's going to make the number of deaths attributable to COVID much higher than it would otherwise be - IE, if COVID's the thing that's making people in the underlying risk groups die, and they wouldn't've died now without COVID, then it's COVID's fault they died now.

It can still be that COVID infection is what killed them, even if the majority of people end up dying from heart failure or kidney failure, or other complications (rooted in comorbidity or not).

Reply to frank If I were you I’d be saying ‘Oh no!’

Quoting fdrake

I mean, COVID is more likely to kill people who are more likely to die anyway. This complicates whatever attribution of death to COVID you do.

I don't disagree here. Where I disagree is this effect will be big in terms of reducing deaths from these risk factors going forward.

The original claim I have contention with, is that respiratory deaths may go so low after Covid as to balance Covid deaths. So a incredibly large effect.

There is definitely some overlap, but my contention is it is small; small in the sense that it could be completely ignored in calculating likely deaths in these risk groups (though there can be other causes of big changes, such as the lock-downs). I.e. if you calculate the people who die of Covid that are at risk of heart disease in likely scenario of your choosing, and then calculate the people who will die of heart disease, you can essentially ignore the the fact some people died of Covid in this category other than there simply being slightly less people. That there is not a big culling effect.

It's not big now because most people haven't gotten the disease yet.

It may never be a big effect because likely Covid simply doesn't kill those who are about to die in the short term. I've defined short term as a year and explained all the reasons why we wouldn't expect there to be an overlap with "people who would otherwise die this year" and there's no reason to assume such a category even exists now in a predictive sense.

It may be an effect that that is not only not big but is dominated by something that goes in the other direction, such as a large amount of long term lung injury that replenishes the at risk categories, or even increases them.

Quoting I like sushi

I were you I’d be saying ‘Oh no!’

I always alternate woo hoo' s and oh no's.

Reply to frank Woohoos and d'ohs for me.

Reply to Benkei
:razz:

Quoting boethius

The original claim I have contention with, is that respiratory deaths may go so low after Covid as to balance Covid deaths.

If COVID kills the majority of people that would've otherwise died from these issues (pulmonary, heart, cancer patients). and there isn't a corresponding increase of intake in those risk groups over the relevant time period, the number of people that could die from those issues after this year (in the relevant short time period) is going to be lower. It isn't so much that this will cancel out the deaths attributable to COVID, it's that it'll constrain the number of people that could die from other causes in that group (irrelevant of what they are); since the dead people won't be in that group any more, and certainly can't die from other causes if they're already dead from COVID. (@Isaac 's use of the word "cohort" in his responses probably is used to emphasise this time moving property when fixing a group to study over time, cohorts have a fixed initial size that depletes through death/over time)

Quoting boethius

Other factors can easily dominate in selecting for death within the heart disease group.

What are these factors then (presumably ones which don't also overlap with factors making death from Covid-19 more likely)?

Quoting boethius

Furthermore, a big determining factor for surviving a heart attack is time and place, and this is a completely independent variable to Covid

Really? In what way? Presumably proximity to medical services is the key variable in time and place (those more remote will have more difficulty). How is that different with Covid-19?

Quoting boethius

people may improve or deteriorate their lifestyle moving from this "weakest" category to "ok" or vice versa, or a really stressful life event has an acute impact on heart disease likelihood; failing to seek timely treatment etc.

Again, how do these categories differ from those which relate to vulnerability to Covid-19 fatality? Stress, for example, suppresses immune response.

Quoting frank

For some reason the models say your state's peak deaths is two week away while my state's is already passed.

But they're going to open Texas! Woo hoo!

I don't know what we'll do here. Georgia's governor is really pretty stupid. You'd think from the governors we elect that we really talk this slow.


I do like the dancing guy with the beard in the back left. Not sure what he's listening to, but he's way into it.

Fox is reporting that it was a research project that escaped from a Wuhan lab...

Quoting I like sushi

The last official figures show that there were 6000 deaths registered above average. That is around 50% above average so hard to ignore without a damn good explanation.

Have you seen people ignoring it? Last time I looked the world was practically hysterical about it. There's certainly a considerable disagreement as to how best to proceed, but I think everybody's way beyond ignoring it.

Reply to Hanover I learned from watching the Texas broadcast that sign language for "viral test kit" is the motion of sticking a q-tip in your nose and swirling it around. You might need that.

Quoting frank

Per Cuomo 80% of the people who were intubated died. That means we have a really expensive supportive technology that mostly fails for this virus.

That or they're dying of intubation. During the Civil War (spoiler alert, South lost), soldiers did whatever they could to avoid being treated because the treatment usually killed them.

The best way to avoid serious consequences during this crisis is not to be old.

Quoting frank

I learned from watching the Texas broadcast that sign language for "viral test kit" is the motion of sticking a q-tip in your nose and swirling it around. You might need that.

Makes sense. The sign for "you've contracted the virus and have a pre-existing immune system problem" is where the sign language guy bends over the Governor and simulates impregnating him. It's weird that there's a sign for such a specific thing, and it's often hard to find a Governor to complete the sign, but it's a good to know what it means so that you don't misinterpret it.

Quoting Shawn

Fox is reporting that it was a research project that escaped from a Wuhan lab...

That's always been one of the theories, but it seems to be gaining more steam lately. The Chinese government's information is completely unreliable, so I don't think we'll ever have a clear answer of how it really got started.

Reply to Isaac Clearly you don’t know what I’m talking about given that the figures I’m referring to were only released a couple of days ago. Prior to that the number of deaths (all deaths from all causes) were nothing out if the ordinary. My point in posting this was to reveal the now official numbers rather than focus on rough estimates without any clear comparison.

Quoting fdrake

since the dead people won't be in that group any more, and certainly can't die from other causes if they're already dead from COVID

This is my position, which I have been very clear about since the beginning.

I also gave Isaac the same benefit of the doubt, as I wasn't sure if he meant "significant" in the sense of "big" or in the sense of some measurable statistically significant effect (which can be very small, but still measurable). Why I have stressed I'm talking about some short term observation, such as within a year.

But if you read Isaac's recent comments, he has clarified that he means Covid kills some hidden subgroup of for instance the "weakest heart" within the relatively large "heart disease" risk group. An effect larger than simply reducing these groups by whoever dies of Covid, but that they otherwise continue to have the same risk profile going forward.

I believe we agree that's not the case; that there is some effect of culling the terminally ill (whether known or unknown) but it's not a large effect.



Quoting Isaac

What are these factors then (presumably ones which don't also overlap with factors making death from Covid-19 more likely)?

I say "can be easily be other factors", I mention otherwise benign genetic differences (that benign differences can have a significant outcome difference given some new threat, is exactly why we have evolved to have such differences; epidemic is the classic case for why evolution goes this way), but there's also initial inoculation viral load that is highly expected to have a big effect on outcome, and of course timeliness and quality of care, but even with similar care there is variation in response to treatment.

Quoting Isaac

Really? In what way? Presumably proximity to medical services is the key variable in time and place (those more remote will have more difficulty). How is that different with Covid-19?

I am talking about the variable of proximity to medical services when one has a heart attack (or ability to get service before said heart attack). This is in the future and totally independent of Covid. These future contingent events that have an effect on heart disease outcome mean that the "weakest hearts" is an oversimplification of who exactly dies of heart disease in a given time; "weakest heart" maybe a subgroup, but there's also a large group that then get's filtered (in the future relative Covid) by proximity to medical care.

If you want to talk about the subgroup of people far from medical care as a constant risk factor; it's not symmetric as a heart attack is much more acute.

Quoting Isaac

Again, how do these categories differ from those which relate to vulnerability to Covid-19 fatality? Stress, for example, suppresses immune response.

Again, some future stressful event is a filtering mechanism that is independent of getting Covid today. The person that has heart disease but not the "weakest heart" today, may live to encounter some future event, such as acute stress, that puts them at acute risk of heart attack.

These future events that filter for who actually dies in the risk category is simply the strongest example of why "Covid kills the weakest in these categories" is not sound reasoning.

Quoting boethius

I believe we agree that's not the case; that there is some effect of culling the terminally ill (whether known or unknown) but it's not a large effect.

But it does kill people now who are likely to die soon that aren't likely to die now otherwise, right?

Quoting fdrake

But it does kill people now who are likely to die soon that aren't likely to die now otherwise, right?

Agreed, but this is a small group of both the known terminally ill risk groups and postulated hidden terminally ill groups, and within this group not all have gotten infected at this point (and the initial conversation was about UK numbers essentially next week or a few weeks from now). So the effect is small because these groups are small.

Covid definitely is a disease likely to kill the terminally ill, but it also kills people in very large risk groups that have an average life expectancy far beyond a year. Covid kills a small percentage of these people, again they need to get the disease first also, and so the effect is small on reducing future deaths because not many die and they continue to have the same risks as before.

We know that Covid is not killing only people that doctors expect to die shortly anyways, and it's implausible that there is some hidden extreme-risk sub-group within larger risk groups that Covid happens to kill (and implausible such a sub-group even exists that explains all, or even most, deaths in those risk groups).

Quoting boethius

I mention otherwise benign genetic differences (that benign differences can have a significant outcome difference given some new threat

You keep talking in vague generalities and obscure factors. To support your position you have to demonstrate that the vast majority of factors defining the most vulnerable people in the group suffering from heart disease, lung conditions, cancer etc are not the same as the factors defining the most vulnerable people in the group of Covid-19 sufferers.

Not just one or two areas in which they might differ.

So common factors like weakness of the heart, suppressed immune system, overworked supporting organs, stress, comorbid infections, lack of exercise.... All these common factors.... You've got to come up with a list of uncommon factors which is bigger and has a net larger influence on fatality in each group.

Quoting Isaac

To support your position you have to demonstrate that the vast majority of factors defining the most vulnerable people in the group suffering from heart disease, lung conditions, cancer etc are not the same as the factors defining the most vulnerable people in the group of Covid-19 sufferers.

First, I've already explained why those factors can't be the same as some of those factors are in the future. So I guess deal with those first.

Second, I've already explained why it's highly unlikely for those factors to be the same even in the present; for instance, inoculant load is a factor highly suspect to be a big factor in outcomes for Covid but cannot be a factor in any other underlying health condition as it's Covid specific.

The more the factors don't overlap, the smaller the effect of "Covid killing those that would die soon anyway" becomes; though, to be clear, no where have I stated it disappears, it just becomes small.

Smoking, obesity, even age, are risk groups where people can still be expected to live decades, but die from Covid despite such odds.

Professor Anthony Costello, former director of the Institute for Global Health, has said today that the UK is on course to have the highest death toll in Europe, in excess of 40,000 in the initial peak. Due to an only partial lockdown, which was implemented to late.

Even now, as pointed out by Evett Cooper in parliamentary select Committee today, that there are even now many thousands of people flying into the UK from all over the world without any checks, tests, or even requests for self isolation.

Now Sweden's death rate is spiking.

Reply to Shawn

Fox is reporting that it was a research project that escaped from a Wuhan lab...

A new Cold War, and the're commies to boot.

How pathetic.

Quoting NOS4A2

It’s not an accusation, I’m just contrasting it to my own ethics, which are more deontological. I’m suggesting this is where we might differ.

I think that a retreat to framework appeal is a red herring in this case (though I did initiate meta-commentary by contrasting your willingness to accept increased death in the name of punitive justice, so don't take this as hypocrisy; I was actually making a rhetorical emotional appeal of my own). At one point we were debating withholding funding in terms of pragmatism... To cede the point that withholding funding will negatively affect the WHO, and that a negatively affected WHO can be reasonably expected to negatively affect health and safety (in the context of the current pandemic), is ostensibly to say that doling out punishment is more important than mitigating the present disaster.

Surely there is room in your deontological stack for a rule or principle that says "don't hamstring an emergency support service to conduct investigations and dole out punishments during the middle of an emergency"...

But in the end what difference would it make? If our moral frameworks can be haphazardly thrusted at others as sufficient argument and justification for our beliefs or actions, what's the point? Deontological frameworks and virtue ethics set out to achieve consistency and rational grounding, but ironically they just wind up creating a zoo of poorly and diversely justified cherries that can be randomly and hypocritically picked at any time. I mean... You didn't even bother to cite a rule, reason, or even rhyme that rationalizes your position, you basically just alleged that your convictions are different from my own.

Quoting NOS4A2

The China response is well reported and recorded, filled with the typical communist censorship of its own people, the disappearing of critics, and the suppression evidence. The WHO, on the other hand, helped to spread this misinformation. It was late in declaring a public health emergency—after the virus had already spread to 18 countries—and spoke in glowing, servile terms about China’s response while doing so. It is so far up China’s ass that it embarrassingly dodged questions from Hong Kong reporters about excluding Taiwan.

It might not be the WHO itself that is to blame. It could very well be just the leadership. But one thing is for certain, our taxpayer dollars are funding this and this is not what we pay for. A holding on funds and an investigation is warranted. None of this would be necessary if the WHO didn’t launder China’s image at the expense of its own credibility.

The WHO is an internationally funded organization that does not directly serve the USA's political interests. It is not the propaganda mouthpiece of either China or the USA. If the Chinese government officially reports the "results" of their investigation, then it is arguably the duty of the WHO to report them rather than to play political guessing games about state liars. The tweet you quoted merely reported relevant information, which included clearly stating the source.The WHO had no way of confirming or disconfirming the results of the investigation in any reasonable amount of time, so they just relayed the information.

But again, all of this is merely to say "WHO BAD, WHO BAD!". They're not perfect, and I'm sure they've made countless mistakes since the start of this pandemic, but we're not debating the WHO's performance, we're debating whether withholding funding is a sane thing to do in the middle of a pandemic.

Can you show that the WHO is causing more harm than good? If not, why should we trust Trump's gut instinct that the WHO should be fired?

Quoting boethius

First, I've already explained why those factors can't be the same as some of those factors are in the future. So I guess deal with those first.

I'm just repeating myself, and so are you, so this is getting pointless. You're pointing out that the factors do not entirely overlap. I'm saying that they oveap in the vast majority. If all you're going to do is provide instances where they don't overlap we're not going to get anywhere. I'm not arguing that there are no such instances.

Here's some basic resources on risk factors for heart disease (as an example).

https://www.who.int/cardiovascular_diseases/en/cvd_atlas_03_risk_factors.pdf

https://www.nhs.uk/conditions/coronary-heart-disease/causes/

Here's the preliminary findings on risk factors for Covid-19 mortality.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fulltext

https://www.bmj.com/content/368/bmj.m1198

Note the repeat of hypertension, CVD, diabetes...

Note the complete lack in either case of mention of locality, blood type, luck, or some as yet unidentified genetic factor or in fact any of your obscure factors.

is there a better thread I should post in to talk about the economics of this crisis more than the medicine?

I texted my boss today to let him know i am financially secure through at least july thanks to enhanced unemployment and i’d be happy to do a trivial amount of work for him for postponed pay if it helps him qualify for PPP loans since those require that you don’t lay anyone off.

he replied that they are restructuring due to covid19 and i shouldn’t count on his company at this time, but he will refer some friends at other companies that are doing better to me. now i’m having a panic attack because the only thing keeping me from having one before was the expectation that this job would recover and be required to hire me back.

Quoting Isaac

Note the repeat of hypertension, CVD, diabetes...

This data supports my point not yours. Hypertension, diabetes, etc. are very large risk groups from which my analysis follows.

If risk groups are large, then the "people who we would expect to die this year from the existing pattern" are unlikely to intersect "people who actually die from Covid". There is some intersection, but it is small; there is also a small change in simply the absolute numbers that makeup the group due to people dying from Covid. But both these small effects would only be relevant with a large portion of people actually getting infected, and in such a scenario it is a very real the possibility that long term lung damage or other treatment complications replenishes the risk groups (this maybe a small amount too, but the effects under consideration are also small).

Furthermore, you've simply ignored the other reasons we shouldn't expect Covid deaths to be displacing near-future-otherwise-deaths even if there was unknown "weakest heart" kind of groups within these groups, such as diabetes, hypertension etc. such as the simple fact we're early in the outbreak.

Yes, people dying tend to have underlying conditions. But no, people dying are not "going to die soon anyway" in any meaningful sense. Covid does not select for "going to die anyway" nor "the weakest part of the spectrum within these groups" (and such a spectrum does not exist in well ordered nor static sense; a lot of chance is at work).

The reason I argue this point, is because it is a widespread misunderstanding that Covid is "culling the weakest". It lines up with certain political ideologies that want laissez faire survival of the fittest, which I understand you don't empathize with; nevertheless, not emphathizing with a political bias does not automatically protect oneself from misgivings propagated or that happen to line up with such a bias (indeed sometimes we can be so concerned of our own biases that we jump on inconvenient impressions to convince ourselves we are managing our biases).

So, I have no problem continuing to argue the point.

Quoting Pfhorrest

is there a better thread I should post in to talk about the economics of this crisis more than the medicine?

Well, someone started a Corona and Stockmarkets... thread, but that may seem far too narrow.

I think this is just fine. Just like the Trump thread jumps here and there just like the old man himself in scope.

But of course, the huge number of unemployed do have an effect on the economy. And at least initially (before the central banks intervened) the stock market was actually responding to the actual economy, surprisingly.

Quoting boethius

I say "can be easily be other factors",

Like all viral infections, stress in general, plays a very important role in the severity of the infection. The type of stress that an individual might have varies enormously.

Quoting VagabondSpectre

But again, all of this is merely to say "WHO BAD, WHO BAD!". They're not perfect, and I'm sure they've made countless mistakes since the start of this pandemic, but we're not debating the WHO's performance, we're debating whether withholding funding is a sane thing to do in the middle of a pandemic.

To be fair, insofar as Trump downplayed the effects of the virus to a far greater - and more deadly - extent than the WHO, it'd only be consistent if Trump suspended his own presidency while a People's Commission investigated his own handling of CV. Suspended from a bridge, preferably.

Reply to StreetlightX Oh, WHEN will the people gather in front of the White House for his afternoon Covid-19 press conference/mini-campaign rally and chant loudly and long, LOCK HIM UP

Reply to VagabondSpectre

You said my reasoning “speaks volumes about my ideology”, without telling me what volumes they speak of. So I told you that it wasn’t about any ideology, that you and I probably differ on ethical grounds. I believe it is right to withhold funds pending an investigation into said failures, especially when decades of funding just proved useless precisely the time we needed it.

Besides laundering the CCP’s image, spreading their misinformation to its members and the world, the WHO advised against travel bans between China because it would create “stigma”, and other PC piffle. That turned out to be dead wrong. When the WHO declared a public health crisis of international concern, the director spent most of it obsequiously applauding the CCP’s efforts, which as we now know was rife with the typical communist censorship and narrative-building, and we get another lesson in the eternal efforts to disguise a failed and bloody political ideology.

Quoting NOS4A2

Besides laundering the CCP’s image, spreading their misinformation ... we get another lesson in the eternal efforts to disguise a failed and bloody political ideology.

Yes but enough about Trump, what about the WHO?

This user has been deleted and all their posts removed.

Sunlight may kill the virus quite quickly.

Preliminary results from government lab experiments show that the coronavirus does not survive long in high temperatures and high humidity, and is quickly destroyed by sunlight, providing evidence from controlled tests of what scientists believed — but had not yet proved — to be true.

A briefing on the preliminary results, marked for official use only and obtained by Yahoo News, offers hope that summertime may offer conditions less hospitable for the virus, though experts caution it will by no means eliminate, or even necessarily decrease, new cases of COVID-19, the disease caused by the coronavirus. The results, however, do add an important piece of knowledge that the White House’s science advisers have been seeking as they scramble to respond to the spreading pandemic.

The study found that the risk of “transmission from surfaces outdoors is lower during daylight” and under higher temperature and humidity conditions. “Sunlight destroys the virus quickly,” reads the briefing.

While that may provide some good news about the outlook for outdoor activities, the Department of Homeland Security briefing on the results cautions that enclosed areas with low humidity, such as airplane cabins, “may require additional care to minimize risk of transmission.”

https://news.yahoo.com/sunlight-destroys-coronavirus-very-quickly-new-government-tests-find-but-experts-say-pandemic-could-still-last-through-summer-200745675.html

Reply to NOS4A2

Those dreaded sunbathers of the UK were right all along...

Covid-19....what a concept!

I received this important email about the current pandemic...it drags on a bit too long in my opinion:

Arnis Frost:Here are the official Coronavirus guidelines:

1. Basically, you can't leave the house for any reason, but if you have to, then you can.

2. Masks are useless, but maybe you have to wear one, it can save you, it is useless, but maybe it is mandatory as well.

3. Stores are closed, except those that are open.

4. You should not go to hospitals unless you have to go there. Same applies to doctors, you should only go there in case of emergency, provided you are not too sick.

5. This virus is deadly but still not too scary, except that sometimes it actually leads to a global disaster.

6. Gloves won't help, but they can still help.

7. Everyone needs to stay HOME, but it's important to GO OUT.

8. There is no shortage of groceries in the supermarket, but there are many things missing when you go there in the evening, but not in the morning. Sometimes.

9. The virus has no affect on children except those it affects.

10. Animals are not affected, but there is still a cat that tested positive in Belgium in February when no one had been tested, plus a few tigers here and there…

11. You will have many symptoms when you are sick, but you can also get sick without symptoms, have symptoms without being sick, or be contagious without having symptoms. Oh, my..

12. In order not to get sick, you have to eat well and exercise, but eat whatever you have on hand and it's better not to go out, well, but no…

13. It's better to get some fresh air, but you get looked at very wrong when you get some fresh air, and most importantly, you don't go to parks or walk. But don’t sit down, except that you can do that now if you are old, but not for too long or if you are pregnant (but not too old).

14. You can't go to retirement homes, but you have to take care of the elderly and bring food and medication.

15. If you are sick, you can't go out, but you can go to the pharmacy.

16. You can get restaurant food delivered to the house, which may have been prepared by people who didn't wear masks or gloves. But you have to have your groceries decontaminated outside for 3 hours. Pizza too?

17. Every disturbing article or disturbing interview starts with " I don't want to trigger panic, but…"

18. You can't see your older mother or grandmother, but you can take a taxi and meet an older taxi driver.

19. You can walk around with a friend but not with your family if they don't live under the same roof.

20. You are safe if you maintain the appropriate social distance, but you can’t go out with friends or strangers at the safe social distance.

21. The virus remains active on different surfaces for two hours, no, four, no, six, no, we didn't say hours, maybe days? But it takes a damp environment. Oh no, not necessarily.

22. The virus stays in the air - well no, or yes, maybe, especially in a closed room, in one hour a sick person can infect ten, so if it falls, all our children were already infected at school before it was closed. But remember, if you stay at the recommended social distance, however in certain circumstances you should maintain a greater distance, which, studies show, the virus can travel further, maybe.

23. We count the number of deaths but we don't know how many people are infected as we have only tested so far those who were "almost dead" to find out if that's what they will die of…

24. We have no treatment, except that there may be one that apparently is not dangerous unless you take too much (which is the case with all medications).

25. We should stay locked up until the virus disappears, but it will only disappear if we achieve collective immunity, so when it circulates… but we must no longer be locked up for that?

Reply to Merkwurdichliebe It missed out the most important guideline, you mustn't smile, especially outside, although you can laugh in your own home. Lol

You are not allowed to be happy at anytime, only miserable and worried.

Quoting boethius

This data supports my point not yours. Hypertension, diabetes, etc. are very large risk groups from which my analysis follows.

Just repeating that your analysis is right doesn't make it right. Them being large risk groups does not in itself mean that they are not graduated along the same factors as constituted membership.

Quoting boethius

If risk groups are large, then the "people who we would expect to die this year from the existing pattern" are unlikely to intersect "people who actually die from Covid".

There is no reason at all why this follows from the risk groups being large. they would also have to be unsorted (by the same factors) but you've not shown any evidence that this is the case.

Quoting boethius

Furthermore, you've simply ignored the other reasons we shouldn't expect Covid deaths to be displacing near-future-otherwise-deaths even if there was unknown "weakest heart" kind of groups within these groups, such as diabetes, hypertension etc. such as the simple fact we're early in the outbreak.

No, the fact that the group membership is dynamic only affects the risk estimates if the group is changing (growing or shrinking). The risk group for heart disease, diabetes, cancer, etc is not growing or shrinking. It is remaining roughly the same size. The rate at which people's risk factors reach the threshold to cause them to join it is roughly the same as the rate at which people leave it (whether by death of by getting better). If more people leave it by death then the group will get smaller by exactly that number. the fact that some people also leave by getting better doesn't make any difference to that effect. again, all these factors are the same, and the articles I linked show this. Even if you focus on the people who leave the group by getting better, they are still more likely to be the people with lower scores in the key factor than those with higher scores. Exactly the same factors determining likelihood of fatality from Covid-19.

I've yet to see you present a single piece of evidence showing that factors other then those we mentioned (hypertension, diabetes, suppressed immune system, failing supporting organs, lung damage...) are not the main factors determining fatalities from either the covid-19 group, or the {heart disease, cancer, lung condition} group.

It's pretty simple - so long as they are the main factors determining fatality in both groups, then covid-19 fatalities will be overwhelmingly drawn from the same pool as heart disease, cancer and lung condition fatalities.

So rather than just repeat that you're right, again, or point out that other obscure factors do come into play, again... why don't you link to some scientific papers showing that the factors listed are not the main factors determining fatality in either group. Otherwise I've nothing further to say on the matter.

(Oh and if you try and play the "you've been duped by ideology whereas I remain coldly rational and unaffected by such weaknesses" card again I will not respond - let's presume we're all intelligent, relatively equal people until proven otherwise shall we?)

Quoting Punshhh

You are not allowed to be happy at anytime, only miserable and worried.

:rofl: :groan:

[tweet]https://twitter.com/ryanstruyk/status/1251275775627669512[/tweet]

Liberate!! ... Souls from bodies or something.

Just in case anyone else has jumped to the conclusion that because I mentioned the statistical implications of overlap in mortality cohorts I'm obviously either a heartless fascist or duped by one...

The reasons I think overlap in mortality cohorts is important are;

1. High overlap undermines certain arguments against social distancing measures because there should be little net excess in treatment requirement, focusing the main problem even more in the height of the spike of cases. Without overlap there is an argument that flattening the curve will not help because it pulls staff from other vulnerable cases in the long term so providing no net gain. In other words, with overlap we only need to re-assign resources (which everyone agrees is doable), without overlap we need to produce a net increase in resources (which many think is not doable, so why bother >> herd immunity bullshit).

2. Perpetuating the idea of no overlap in order to procure these additional resources (and likewise avoid providing an excuse to those who don't want to pay for them) may well work in the short-term, but a) it's hardly a long-term strategy for procuring more investment in health care, and b) it undermines the credibility of socialist arguments if the threat does not then materialise. We shouldn't pin arguments about investment in healthcare to the severity of rare pandemics when there are perfectly sound arguments for it which are already demonstrable.

3. Using fear to bring about policy change is a dangerous strategy as the very institutions and cultural practices which are necessary to make it a success do not in themselves act as filters for the sensibleness, humanity or practicality of the policy being thus advocated. Fear can be useful politically, but it does not have a good long-term track record of maintaining positive change.

4. The extent and nature of any short-term change in demand on healthcare systems is crucially important to the management of those systems. We can bemoan the shortfall in net funding all we like, but somone still has to make ten bandages fix twelve broken arms, so to speak. They need to know what the future calls on their insufficient funds are likely to be. This is less relevant to public discussion, but public mood does filter into policymaker's discussions, they're only people after all.

5. We will have to come out of lockdown soon (partially) and continued promotion of the idea that Covid-19 is some random reaper stalking the land takes resources away from those who really need them as the hysterical-selfish (by far the largest population group) panic-buy themselves their ppe/food parcel combo (Disney-themed, Bluetooth-enabled version, only £9.99 on Amazon), while doctors make do with paper towels and some sellotape.

Edit - I forgot to add that I just don't like it if something seems wrong, so even if none of the above were true I'd still be arguing about the statistical implications of an overlap in mortality cohorts just because I think there is one, and I'd rather hope to be discussing things with people intelligent enough to know the difference between a fact which is unhelpful and one which is wrong.

It's amazing why it's now reported, as if it's news, that UV light is a virucide. No shit.

Let's recall MERS for a second and realise that the summer isn't going to solve this for us.

I think this above describes aptly seriousness of the the coronavirus into perspective.



What I'm totally surprised from the chart above is the how low the 1957-1958 Asian flu pandemic is here. That killed at least 1 million people in the World and 116 000 in the US. And the "Asian flu" has been said to have infected as many people as the Spanish flu, but a vaccine, improved health care, and the invention of antibiotics contributed to a lower mortality rate.

The source I previously mentioned.

Reply to ssu

The number of people recorded as having died 'of' a particular condition is heavily dependent on the manner in which the death certificate is recorded and examined in data harvesting. The CDC figures for ILI from 17-18 is recorded in the same way as Covid-19 (listed as a contributory factor on the death certificate), so it should be comparable, but we've no idea how doctors and coroners were instructed to list flu in 1958, so the figures are not accurately comparable.

Death certificates are notoriously difficult to extract good data from, especially across medical paradigm changes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808686/

Reply to Isaac

No one is debating these facts, but once numbers get large the ambiguities get small, as a large amount of people dying of pneumonia in a region during respiratory epidemic is very likely.

The graph I just posted (if true or close to true) demonstrates the basic problem, as it would mean (if everyone got the disease) about double total deaths in the year (there is less infants that die, but there's some excess in the 60s range) happening in a short period of time would be a total disaster.

Furthermore, many people that recover still needed hospitalization and care not just at an alarming rate, but also for a long duration of time (2-3 weeks).

There's simply no way statistical coincidence with other causes of death explain the phenomena of overloaded health systems, nor any reason to expect we'd have some large effect of abatement of those other causes of death after the initial overload.

If you really want me to go into the calculations that explain my position, I can do so.

Quoting Isaac

I'd rather hope to be discussing things with people intelligent enough to know the difference between a fact which is unhelpful and one which is wrong.

If you think this applies to me in this discussion, please argue the point. I said maybe you are affected by attempting to overcompensate your bias; maybe not. Either way, you are still wrong about believing the real overlap that really does exist could be big enough to result in effects you think are possible.

Reply to boethius

Here's David Spiegelhalter explaining what he means by those figures. He's very good at explaining these things (it is, afterall his job).

So, if the factors which cause fatality from Covid-19 are largely different to the factors which cause fatality in general, how do you explain the fact that fatality risk from Covid-19 tracks fatality risk in general almost exactly?

Why would a 70 year old face exactly the same increase in risk from Covid-19, compared to a 19 year old, that they do from all diseases combined without a majority of significant overlapping factors?

Say mortality from Covid-19 is determined largely by a factor-A, and mortality from heart disease is largely determined by unrelated factor-B. Your risk would be related to the prevelance of the related factor. Unless both of these factors, despite being unrelated, coincidentally increased at almost exactly the same rate with age, then the match in increase of risk with age would have to be a massive coincidence.

The fact that the risk from Covid-19 tracks almost exactly the risk in general shows that the factors causing risk in Covid-19 are likely to be the same as the ones causing risk from disease in general.

Quoting boethius

The graph I just posted (if true or close to true) demonstrates the basic problem, as it would mean (if everyone got the disease) about double total deaths in the year

No it doesn't because it is comparing the estimated risk from Covid-19 compared to the normal risk for a year taken ftom years in which Covid-19 was absent. It doesn't tell us anything about the relative risk from other diseases in a year where Covid-19 is present.

Hardly any ancient farmers died of cancer. It's not because they were super-healthy, it's mostly because they died of something else first. It's the same with these figures. The risks for a year in which Covid-19 is not present to kill you first are not going to be the same as for a year in which it is.

Quoting boethius

If you really want me to go into the calculations that explain my position, I can do so.

Yes, that's what I've been repeatedly asking you to do.

Quoting Isaac

In other words, with overlap we only need to re-assign resources (which everyone agrees is doable), without overlap we need to produce a net increase in resources (which many think is not doable, so why bother >> herd immunity bullshit).

For instance, if you want to debate your arguments even assuming your premise, the above simply doesn't hold. Even if there's overlap, I've been mostly talking about overlap of a temporal nature (people dying now that would die in the near future, such as within a year), and there's no way to re-assign resources from the future to the present. Furthermore, lot's of health-care resources simply don't apply to respiratory infection, and therefore can't be reassigned; therefore, for both reasons, even if your overlap theory is true, there needs to be "net increase in resources".

True, it is not doable to scale in parallel to a unmitigated pandemic; yes, the fascists say "why bother, let's keep the economy humming and the dividends flowing". But this is a false dichotomy. We can lower infection rate by social distancing to something that is below health care capacity (such as many countries have demonstrated) or then at least not so far beyond capacity to reach a total health system collapse (every country late to the game is doing). We can at the same time scale resources as best we can.

Quoting Isaac

5. We will have to come out of lockdown soon (partially) and continued promotion of the idea that Covid-19 is some random reaper stalking the land takes resources away from those who really need them as the hysterical-selfish (by far the largest population group) panic-buy themselves their ppe/food parcel combo (Disney-themed, Bluetooth-enabled version, only £9.99 on Amazon),

Again, nor I, nor anyone else has here has claimed it's a "random reaper", just "random within risk groups that are large enough and existing risks low enough that Covid deaths do not coincide with 'weakest heart' deaths type hypothesis". Furthermore, people aren't panic buying due to such a fear in any case, most young people and even a lot of elderly people don't fear getting the virus, but people are panic buying because they think other people are panic buying or then not even panic but in the hopes of price gauging, because of the lock-downs not the virus itself.

Quoting Isaac

while doctors make do with paper towels and some sellotape.

Both the panic buying in itself and doctors going without due to panic and hoarding are false dichotomies. Government can easily solve such a problem through rationing, and many governments have. In the US this would be socialism and "a republican" administration doesn't want to set precedents that socialism can help on some issues (except giving corporations as well as 2 week old companies created by sycophants money).

Quoting boethius

there's no way to re-assign resources from the future to the present.

There is. Loans, postponing leave, postponing retirement, postponing investment plans. There's all sorts of ways of borrowing from the future.

Quoting boethius

In the US this would be socialism and "a republican" administration doesn't want to set precedents that socialism can help on some issues

Right. So you're wrong when you say that governments can deal with these problems through rationing then aren't you? Governments are elected by (Influential sectors of) populations, populations which at the moment are increasingly right wing, so government can't help in the way you suggest. It's no good planning a response strategy based on a pipe dream of what we'd like the world to be. "The first thing we need to do invent a time machine and ensure we get a more socialist government elected", is that your plan?

Quoting Isaac

Yes, that's what I've been repeatedly asking you to do.

You have not been repeatedly asking me to do this, and I have not volunteered as calculations don't actually solve the disagreement.

Your claim is that within these risk groups such as heart disease, there is a hidden risk group of "weakest heart" and these are those dying of Covid and are subsequently culled from the heard and don't die / burden the health system later.

Demonstrating how my point about these groups being large makes the overlap small using calculations doesn't solve the above difference. And, it seemed you accepted that my point about large groups held, so there was not need for me to demonstrate it.

I gave lot's of reasons why there is no such subgroup of "weakest heart" as lot's of factors affecting real death from heart disease are in the future and therefore Covid cannot select for.

My whole position is based on a well known statistical fact that as selection from a group becomes a small, the chance of colliding with some other small selector is small. If we are both picking 1 out of a hundred hats at random, it's unlikely we'll pick the same hat. Now, it's not random given the whole population, there are risk groups, but if these risk groups are large (such as heart disease or obesity) then collision remain small (1 out of a thousand instead of 1 out of million). The set we're selecting from needs to become very small or then the number of selection very big of one or both selectors for there to be collisions.

However, for your benefit I will bring out all the theorems and things we "certainly" (highly, highly likely) know about the pandemic so far, to demonstrate why overlap will be very small of all kinds; both confounding causes of death and overlap with "would die soon anyways".

Quoting Isaac

There is. Loans, postponing leave, postponing retirement, postponing investment plans. There's all sorts of ways of borrowing from the future.

Not physical resources. A loan doesn't help a doctor today treat a Covid patient, only real material and human resources (which cannot come from the future).

Quoting Isaac

Right. So you're wrong when you say that governments can deal with these problems through rationing then aren't you?

Government have already implemented rationing successfully, even some chains voluntarily implemented rationing.

For instance, in Japan there is a limit to masks you can buy and a large fine for buying more (because rationing obviously works to prevent perverse distribution of resources in an emergency).

Quoting boethius

I gave lot's of reasons why there is no such subgroup of "weakest heart" as lot's of factors affecting real death from heart disease are in the future and therefore Covid cannot select for.

No, you gave a small number of minor factors without any citations to back them up and nothing to counter the cited evidence I provided of the major factors which do overlap.

Quoting boethius

My whole position is based on a well known statistical fact that as selection from a group becomes a small, the chance of colliding with some other small selector is small

Yes, and you've yet to demonstrate, with evidence, that the selection is small (relative to the group {at most risk}, nor that there is 'some other' selector rather than exactly the same one.

Quoting boethius

A loan doesn't help a doctor today treat a Covid patient, only real material and human resources (which cannot come from the future)

It's a start. A start which is more likely to be made if people are not overduely concerned about preserving resources for some future apocalypse.

Quoting boethius

Government have already implemented rationing successfully, even some chains voluntarily implemented rationing.

So your complaint about the US government in this regard was about what?

Quoting boethius

if you want to debate your arguments even assuming your premise, the above simply doesn't hold.

Actually, please just ignore the last two paragraphs of my last post. I don't really want to discuss that. I just wanted to explain some of the reasons I thought it was important that we don't avoid the possibility of an overlap. It really makes no difference at all if I'm wrong about all of them (presuming we're not deciding what's right on the basis of what it would be convenient to be right).

I don't want to hold two discussions at once (one is hard enough to keep up with). There's enough to discuss just on whether there is an overlap without adding whether it would be beneficial to publicise that fact (a completely unrelated question).

Quoting Isaac

No, you gave a small number of minor factors without any citations to back them up and nothing to counter the cited evidence I provided of the major factors which do overlap.

You didn't disagree with future contingencies affecting heart disease outcome; therefore, I need not cite it as you seem to agree and I used common knowledge examples.

So, if you don't point and say "I'd need proof to assume stressful events that might happen in the future could impact heart outcomes" then I can't know you don't also accept this common wisdom.

Instead, you cited evidence that supports my view, that risk factors are very large groups such as heart disease, obesity, etc. not evidence that it is only the "severe risk subgroups doctors say will likely die anyways soon" nor any evidence that such groups exist despite doctors not knowing about them.

If you provide citations that support my point, why do I need to do anything?

And again, no where have I said factors don't overlap, the point at issue is whether these overlapping factors are coming from large groups that have small factors (many with a small chance of death in both sets; i.e. risk of death from both selectors) or small groups with big factors (few with a large chance of death from each).

Quoting Isaac

Yes, and you've yet to demonstrate, with evidence, that the selection is small (relative to the group {at most risk}, nor that there is 'some other' selector rather than exactly the same one.

This is your hypothesis, and there's no evidence for it, therefore "there is no reason to assume it", therefore it's not a reasonable risk to take.

Furthermore, it wold overturn the prevailing view in medicine that most deaths in a given year are fundamentally unpredictable (there are very, very small groups in "90% risk of death this year" but there are very, very large groups with "10%, 5%, 1%, 0.5%, 0.1%" and and most deaths come from these groups in a given year because although probabilities are small membership is large).

But if you are not aware just how sensitive "selector collisions" are to the summed probabilities of selectors being small, then it's difficult to intuit these large number statistical theorems (which are clearly at play with the evolution of Covid, otherwise nearly every country wouldn't be experiencing the same simultaneously, just managing better or worse, as there would be dominating small number variations that result in very different outcomes due to pure chance).

So I will explain these theorems and why chances of the overlap you are talking about become so small as risk groups become large and chances of death from both Covid and underlying conditions are small that the broad facts about the pandemic support my position without the need for laborious analysis taking into consideration all sorts of subtleties.

There is a clear dominating driver of events which is Covid, once containment fails, kills enough people in a short period of time as to overwhelm health systems; society (relatively rich societies anyway) simply can't function without a health system and so, even the most "initially downplayed to the max" governments take social distancing action and try to ramp up resources to deal with the situation (with the exception of Brasil, so a convenient, although tragic, control case for this analysis).

Quoting Hanover

That or they're dying of intubation. During the Civil War (spoiler alert, South lost), soldiers did whatever they could to avoid being treated because the treatment usually killed them.

Actually there is a theory that mechanical ventilation, which is potentially dangerous for any set of lungs, is particularly hard on COVID-19 lungs. We were intubating early, but we stopped that. We've started waiting as long as we can.

Quoting Hanover

Makes sense. The sign for "you've contracted the virus and have a pre-existing immune system problem" is where the sign language guy bends over the Governor and simulates impregnating him.

So when the sign language person is female?

Reply to boethius

Why don't you just take it up with the experts, they both have blogs. I can't be bothered with this condescending "I'll teach you where you've gone wrong" crap.

Prof Sir David Spiegelhalter {Professor of Mathematical Statistics at Cambridge), - "there will be a substantial overlap, Many people who die of Covid [the disease caused by coronavirus] would have died anyway within a short period," - he can be argued with at https://mobile.twitter.com/d_spiegel

Prof Neil Ferguson, the lead modeller at Imperial College London, has suggested it [the deaths of those who would have died anyway] "might be as much as half or two thirds of the deaths we see, because these are people at the end of their lives or who have underlying conditions.". - he can be contacted at https://www.imperial.ac.uk/people/neil.ferguson

When both Professer Spiegelhalter and Professer Ferguson have agreed that they're wrong and you're right, perhaps you'll have the authority to 'teach' the rest of us where we've gone wrong.

Reply to Pfhorrest

Being freshly laid-off and in the midst of a pandemic/recession is worrisome, to say the least. We can't help but worry. From the stoic point of view, it's all out of our control so there's no point in worrying. What we do have control of is doing the best we can under the circumstances. You've got valuable skills, good credentials, and work in a field that can be done online (with social distancing), so you're actually in a position with a lot of potential for employment, freelance work, or entrepreneurial endeavors. We can worry and see opportunities and move forward.

Reply to Pfhorrest And to tie you over until you find something relevant to your skills and experience, you might consider delivery work.

Edit: sorry, typical "here's a solution" reply.

It sucks for sure and I can imagine this causes a serious amount of stress. Do you have someone close to really talk about it?

Quoting Isaac

Why don't you just take it up with the experts, they both have blogs. I can't be bothered with this condescending "I'll teach you where you've gone wrong" crap.

You just stated in your previous comment that you've been asking for the basic statistics all this time.

But yes, explaining a position requires explaining it. If you don't want to debate, probably a debate forum isn't a good place to be.

Quoting Isaac

Prof Sir David Spiegelhalter {Professor of Mathematical Statistics at Cambridge), - "there will be a substantial overlap, Many people who die of Covid [the disease caused by coronavirus] would have died anyway within a short period,"

This statement depends on what he means by "substantive". Most people might think it to be "a lot", but in this context it is just some measurable effect.

Quoting BBC

That does not mean there will be no extra deaths - but, Sir David says, there will be "a substantial overlap".

"Many people who die of Covid [the disease caused by coronavirus] would have died anyway within a short period," he says.

Knowing exactly how many is impossible to tell at this stage.

This is the context. The statement here does not support the idea that this effect is large, just that we will see it.

If he thought it was the majority or "nearly all" he would have said so.

The basic math he uses is "Nearly 10% of people aged over 80 will die in the next year, Prof Sir David Spiegelhalter at the University of Cambridge points out, and the risk of them dying if infected with coronavirus is almost exactly the same".

I'm not sure he's trying to mislead lay people on purpose, as many will interpret that statement to mean your risk of dying this year is the same with or without Covid. Rather, coincidentally, risk of death of Covid happens to be similar to your yearly risk of death. The missing key element he or the reporter leave out is that based on this information the risks are commutative. So, with an unmitigated spread where all ~80 year olds get Covid, 10% of them die, but then another 10% of those remaining go onto die within the year; so 19% total deaths this year.

Now, if we include other risk factors, yes, we could expect less due to this; but unless the disease somehow targets those 10% that would normally die (10% of 80 year olds die and then significantly fewer die for a whole year), the the change is small.

Furthermore, it's simply irresponsible to not mention that maybe surviving Covid increases the risk profile in these groups, so you get more deaths due to long term lung damage instead of less deaths due to overlap.

In otherwords, this expert does not support your position but has made an ambiguous easily misunderstood statement about a lack of knowledge.

It seems the journalist paraphrased a longer rambling explanation of the details with "knowing exactly how many is impossible to tell at this stage". So, it's clearly not a prediction in any case.

Quoting Isaac

Prof Neil Ferguson, the lead modeller at Imperial College London, has suggested it [the deaths of those who would have died anyway] "might be as much as half or two thirds of the deaths we see, because these are people at the end of their lives or who have underlying conditions.

I read the article where this citation comes up. I'm going to give the benefit of the doubt for Prof Ferguson that he was temporarily hallucinating about statistics at the time, as he himself was recovering from Covid. And again, it's a "who knows" kind of statement.

But if you read his modelling paper Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand then you see an unmitigated death toll from Covid of 2.2 million in the United States from May to July.

Total US deaths in 2018 was 2.8 million. There's simply no way Prof Ferguson is saying you could have 2.2 million deaths in 3 months and then going less half to a third of otherwise expected deaths happening for the rest of the year.

Likewise, if you read the paper of the expert you're citing, you'll see a massive overburdening of the health care system in unmitigated spread as well as the problem of it happening again and again and again each time a lockdown is lifted.

When he talks about "half to two thirds would have died anyways" he seems to be talking about a situation where social distancing is done really, really well and the disease is limited to being like a hospital disease that kills terminally ill people since they cluster around hospitals.

And again, without mentioning that the effects of Covid could replenish these risk groups that would likely die within the year, it is simply a mistake on the part of this expert. Experts can still make these kinds of errors in interviews, which is why citations of published papers are usually preferred supporting evidence.

I don't know if he's specifically revised this statement, but 2 days ago he was interviewed and said:

[quote=independent reporting a BBC 4 interview;https://www.independent.co.uk/news/uk/politics/coronavirus-vaccine-uk-lockdown-social-distancing-news-covid-19-latest-a9467891.html]“What we really need is the ability to put something in their place. If we want to reopen schools, let people get back to work, then we need to keep transmission down in another manner.

“And I should say, it’s not going to be going back to normal. We will have to maintain some level of social distancing – a significant level of social distancing – probably indefinitely until we have a vaccine available.”

He said that despite the “billions of pounds per day” cost to the economy – by putting in place infrastructure to tackle the virus – it was a “small price to pay” to tackle the outbreak of the virus.

Pressed on whether the government was moving towards an exit strategy, Prof Ferguson went on: “I’m not completely sure. I would like to see action accelerated. I don’t have a deep insight into what’s going on in government but decisions certainly need to be accelerated and real progress made.[/quote]

This doesn't seem the position of someone who thinks up to two thirds of people dying of Covid are those that would have died within the year.

Reply to Isaac I agree. Especially when there is a understandable desire to keep the numbers of deaths low. Hence what sometimes happens are these sudden upticks in the figures with later studies.

Quoting boethius

In otherwords, this expert does not support your position but has made an ambiguous easily misunderstood statement about a lack of knowledge.

Spiegelhalter clarifies his statements (as a result of their misunderstanding) on twitter:

"I fully admit the graph doesn’t tell the story: it just shows that short-term Covid risks are numerically similar to annual risks (on average). So getting Covid might roughly double the risk of dying this year. That’s it. Some would have died anyway, but that’s not the main point"

https://twitter.com/d_spiegel/status/1248971466357555205?s=20

https://twitter.com/d_spiegel/status/1248966611400364032?s=20

Reply to ssu Note the difference between flu and flu & pneumonia. Something I found out several weeks ago was that in the West deaths from flu and death from flu & pneumonia were counted as flu deaths, whilst in the East many countries ONLY counted flu deaths as flu deaths and pneumonia deaths as pneumonia deaths.

Quoting Andrew M

I fully admit the graph doesn’t tell the story: it just shows that short-term Covid risks are numerically similar to annual risks (on average). So getting Covid might roughly double the risk of dying this year. That’s it.

Interesting. From the statistics I've seen, the global death totals as projected annually for this year do not mark an anomaly.

The brutal fact is: when it's your time to go, it's your time to get going.

Reply to boethius Given that the figures that they are working with are the official figures (officially registered deaths), and that the data is old, it still doesn’t say much other than to make the problem look better than it is - because most people have no idea how to interpret statistical mathematics!

Quoting Merkwurdichliebe

Interesting. From the statistics I've seen, the global death totals as projected annually for this year do not mark an anomaly.

Because, depending on where you are, the deaths haven’t happened yet and/or haven’t been officially registered. I did post the official figures from the UK government on the previous pages to highlight this - the official figures in the UK only run up to April 3, the next update (which will show the real effect) will be in a few days.

Go back a few weeks and people in the US were saying ‘no problem here!’ Because once you’re infected you don’t drop dead on the spot. There is a substantial lag between infection and death in most cases - we’re talking in excess of a month in some cases.

It never ceases to amaze me the lengths people will go to to maintain their chosen narrative.

Apparently when Spiegelhalter uses the words 'many' and 'substantial', he means 'hardly any'.

Professor Ferguson, despite giving a cogent speech, was suddenly overtaken by an hallucination when he mentions a two thirds overlap.

Professor Spiegelhalter (a professor of mathematical statistics) apparently doesn't understand mathematical statistics.

Him saying the overlap 'is not the point' of the graph has somehow become him saying that there is no substantial overlap (oh, sorry I forgot 'substantial' now means 'very small' - I will have to get the hang of this newspeak)

I should never have started trying to have a reasonable discussion again.

Anyone else actually get the 'rona? :party:

Quoting I like sushi

Go back a few weeks and people in the US were saying ‘no problem here!’ Because once you’re infected you don’t drop dead on the spot. There is a substantial lag between infection and death in most cases - we’re talking in excess of a month in some cases.

And those deaths are very complicated. An overabundance of cases involve preexisting conditions that are exacerbated by covid infection. So, it becomes very difficult to separate the true covid fatalities from the compounded cases. At this point, from the vantage points of bystanders like you and I, until one of us is dead, it is all speculation. I'm unnaturally averse to hype, forgive me, I was heavily impacted by Bush and the Iraq War.

Quoting Isaac

It never ceases to amaze me the lengths people will go to to maintain their chosen narrative.

You must be easily amazed.

Quoting Isaac

I should never have started trying to have a reasonable discussion again.

That you attempted it amazes me, and I thank you for that.

Reply to Merkwurdichliebe Regardless, an above average number of deaths registered in the last official figures in the UK (50% above average) requires some kind of explanation. I imagine some of those deaths were due to people scared of visiting a hospital, but 6000 seems far too many for that to be the only reason.

The problem is the politicking. The science is consistent but the models, because they’re models, are never ever 100% accurate and the very same computer model ran twice will never give out the same result.

The general population’s mistrust of scientists, and politician’s lack of scientific understanding, are the main factors. The Iraq War wasn’t anything to do with science on the scale the pandemic does. People just want to be told when, why and how and certainly don’t like the honest scientific opinion of ‘we can only give you rough estimates, so we err on the side of caution or millions could die’.

Reply to Isaac Reply to boethius

[quote=Spiegelharter]It is crucially important that the NHS is not overwhelmed, but if COVID deaths can be kept in the order of say 20,000 by stringent suppression measures, as is now being suggested, there may end up being a minimal impact on overall mortality for 2020 (although background mortality could increase due to pressures on the health services and the side-effects of isolation). [/quote]

That reads to me as if he doesn't know one way or the other but that we shouldn't be surprised if the yearly deaths for 2020 despite covid-19 remains stable. That really depends, I think, what types of comorbities are in play and whether those world result in deaths this year or much later (like diabetis and overweight).

What you’ll find is at the end of the year more people will have died from the common flu (hopefully). This will lead some people to imagine there was never a problem in the first place. The very same people would likely have been those dead without the restrictions being put in place.

When a plan is put into place and works, those opposed to it can always turn around and say it wouldn’t have mattered if no plan was used.

Peter Hitchens is one of these. He is worth listening to just to get an idea of how well articulated someone can be without any actual expertise in the field - by making comparisons with hie he was right about the Iraq War (which is mere rhetoric as that had no real scientific basis whatsoever).

Quoting I like sushi

an above average number of deaths registered in the last official figures in the UK (50% above average) requires some kind of explanation

Only the British can make US bullshit smell like Rose's. :kiss:

Quoting I like sushi

The general population’s mistrust of scientists, and politician’s lack of scientific understanding, are the main factors.

Scientist are more full-of-shit than all the politicians and lawyers combined 8-fold. This pandemic has proven that medical science has no clue whatsoever. Otherwise, it would be written... and not a bunch of speculative hype, which you and I are currently guilty of. But I have a good time working out these ideas, and I appreciate you for assisting me in this quest. I hope it is reciprocal.

I like sushi :The Iraq War wasn’t anything to do with science on the scale the pandemic does. People just want to be told when, why and how and certainly don’t like the honest scientific opinion of ‘we can only give you rough estimates, so we err on the side of caution or millions could die’.

"so we err on the side of caution or millions could die"

That's exactly what they said about "weapons of mass destruction"...wmd's mf'er!!!...yellow cake from Nigeria MF'er!!! We all gonna die from the terrorists in the sky.

Reply to Merkwurdichliebe I can only assume you’ve not looked at the links I’ve provided.

Here they are:

https://m.youtube.com/watch?v=gxAaO2rsdIs

https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/weeklyprovisionalfiguresondeathsregisteredinenglandandwales

If you still don’t understand the nature of mathematical modeling I cannot take your comments seriously. If you refuse to believe the governments statistics regarding the number of registered deaths (for all causes) that just makes me think you’re part of the tinfoil hat brigade or here purely to troll, and therefore cannot take your comments seriously.

Reply to Noble Dust

Anyone else actually get the 'rona?

Do you have it? I hope your symptoms are not to bad.

Reply to Benkei

Yes. It depends entirely on the type and effect of comorbidities. The fact is that the overlap is unknown and will remain unknown until the end of the year (possibly even the following year, which I think is what Professor Spiegelhalter is referring to there).

My argument with @boethius is mainly about his ridiculous assertion that the overlap will definitely be small because there's no significant overlap in factors. This despite the fact the the only recorded factors affecting prognosis thus far are exactly the same as the factors affecting prognosis in other conditions, as the four articles I cited demonstrate.

I should add we already know a considerable amount about the effect of comorbidities from the death certificates. 91% in the UK and 98% in Italy. It should be stressed here as I think this has lead to some confusion these are not figures for "other things the patient had" which seems to be the prevailing opinion here. When we say comorbidity in this context we're not saying "Oh and he happend to have heart disease also, but that's irrelevant".

As the ONS specify "we analyse deaths involving COVID-19 by the main pre-existing condition. This is defined as the one pre-existing condition that is, on average, mostly likely to be the underlying cause of death for a person of that age and sex had they not died from COVID-19."

We're not talking about "and they also had..." we're talking about a condition that actually listed on the death certificate as a contributory cause of death and I stress - mostly likely to be the underlying cause of death for a person of that age and sex had they not died from COVID-19

I just don't know what more I can say to get this across.

Reply to Isaac

It never ceases to amaze me the lengths people will go to to maintain their chosen narrative.

I should never have started trying to have a reasonable discussion again.

Please do stick around to discuss this, your contributions are valued. I think you unfortunately chose to dig a little deeper with the wrong interlocutor. Boethius is quite argumentative, he seems to enjoy it. But this might result in a failure to reach consensus.

There are others following this crisis who will be more agreeable.

I apologise for not following your comments, I have limited time for this at the moment. I think you will find that the various folk following the thread have their own position, or take on this crisis, which they have presented, the rest of us can then take what we want from it. I am not sure what your position is?

Mine is that the health consequences are not the primary concern, that we won't have accurate statistical analysis at this point, but there is a substantial overlap, along with a significant number of healthy younger fatalities and a worrying mortality among vulnerable groups. Those who are immunosuppresed for medical reasons, for example, they are a significant constituency. But more importantly there is the economic, political and social consequences, these are the areas of interest for many. Because the consequences may, or may not be profound.

Quoting I like sushi

When a plan is put into place and works, those opposed to it can always turn around and say it wouldn’t have mattered if no plan was used.

This is a non-sequitur. When a plan is put into place and the threat it was intended to avoid does not materialise we can say it was the plan, or we can say the plan was not needed. Neither is true or false out of the box. It depends entirely on the posterior analysis.

Quoting Punshhh

Please do stick around to discuss this, your contributions are valued.

Thank you. That's kind of you to say so.

Quoting Punshhh

I am not sure what you position is?

Not too far from you it seems. My main concern is the psychological impact in two major ways.

1. We needed to have responded to this crisis much quicker and with more decisiveness - let's be absolutely clear, despite my efforts to explain the overlap in deaths from other conditions, even if the overlap was 100%, having a year's worth of deaths in the space of a few weeks is an absolute disaster and would undoubtedly have caused thousands (if not tens of thousands) of unnecessary deaths due to the overloading of the healthcare systems. We needed to have instigated social distancing, testing and tracing straight away and the fact that we didn't is bordering on criminal. The problem, psychologically, is that the more the threat is hyped up, the more people panic about it, the less rationally they respond and that is the opposite of what we need. It may be tempting to think that presenting the worst case scenario fires people into action, but the literature just does not support that position. People become either hyper or hypo aroused to the threat meaning that they will either see it everywhere (and so not focus on where it really is) or they will just 'block it out' because it's too big to handle. Both of these effects are well-documented (it's not just guesswork) and both of them could be disastrous for the next time something like this happens.

2. I'm extremely concerned about the effect the media has been able to exert on the general psyche. Culture has always been able to generate collective affect, but it's becoming worryingly uniform the more social media grows (I won't derail the thread by going into it here, but imagine starlings murmuring - one or two and it's just a mess going every which way, thousands and it suddenly looks like a choreographed dance, but all it is is just thousands of birds all trying to respond to each other and making tiny errors in copying which then get magnified)

It would be political suicide now for any government to act in a way which contradicted the media view (because it is so uniform) and any government which did want to lead (they're supposed to represent the population - not blindly follow it) simply don't have the means to spread information in the same way. It's not about political ideology anymore, it's about market-ready groups who can have focussed advertising delivered to them. Ideology has been subsumed into these groupings.

2,195 children every day die from Diarrhoea, 88% of which is avoidable by supplying clean drinking water and washing facilities. A relatively cheap intervention which doesn't even impact on issues like economic independence as other development aid might. The money to solve that problem is easily available, ready to hand and it really should have been sorted decades ago. any rational assessment of spending priorities would have focussed on it. But we don't get rational assessments of spending priorities when we jump from one media-instigated panic to the next.

Reply to Isaac Of course? That was the point.

I saw the protests against lockdown in the US and Trump announcing premature opening up of lockdowns. Looks like it's going to get fruity over there.

Reply to I like sushi

You said...

Quoting I like sushi

This will lead some people to imagine there was never a problem in the first place.

You can't say that they'd be imagining it without having done the analysis. Presuming here we're talking somewhat rhetorically. If you literally mean people imagining there was no problem - zero problem - then of course they're wrong already, but if that's what you mean, then you're straw-manning. No one is claiming there's no problem, even the worst right-wing rats are admitting that a problem exists.

Reply to Merkwurdichliebe I understood what you meant the first time. It’s like me saying “I told you it’d rain today!” and trying to say because I was right about this I am therefore right about which horse will win the Grand National - there is a slight connection between the two given that the weather will determine the running, but neither hold any weight if we haven’t examined the facts.

Clearly you haven’t examined the facts because you don’t understand how mathematical modeling works and use this as an excuse to dismiss the science behind the modeling (which is your uninformed choice). Dismissing the science because it is inconclusive is to dismiss science completely. It’s ridiculous.

As fro WMD very few people believed the government. In the UK public opinion was against the war and parliament debated the point too.

My agenda here has been announced several times! I am concerned about how this plays out in developing countries and whether or not lockdowns helps or hinders them in the long run.

I’ve steered well clear of politicizing this or pointing to any particular leader/government to blame. Nature is worse than any government in terms of death counts.

Reply to Isaac You appear to want me to be saying something you’re not saying to disagree with me and start a pointless argument. Find someone else to spit your dummy at because you’ve done this too many times to me already.

No more replies from me so go at it and get it off your chest (whatever it is?)

Quoting Isaac

My argument with boethius is mainly about his ridiculous assertion that the overlap will definitely be small because there's no significant overlap in factors. This despite the fact the the only recorded factors affecting prognosis thus far are exactly the same as the factors affecting prognosis in other conditions, as the four articles I cited demonstrate.

The overlap is 100% given a long enough time period. I think we don't really know yet in the short term but I think there are some educated guesses.

We have a number of old people who would've died this year anyways and a number who would've died later. Given sufficient infections we will see a statistically significant rise in deaths in the older age groups, where a lot of deaths will occur now instead of later due to a reduced immune system and no effective treatment at this time.

Then there's the group of comorbidities. I don't know what the prevalence is of comorbidities resulting in deaths this year but since this apparently includes obesity and diabetis, here too I suspect a staristically significant increase in deaths this year from people who would've died much later under other circumstances.

To what extent these will be practically significant increases depends on the infection rate and therefore the efficacy of policies.

What is practically significant isn't precise and is a matter of opinion. It appears to me you and boethius might be discussing opinions at this point which is why you aren't reaching agreement.

Quoting Benkei

What is practically significant isn't precise and is a matter of opinion. It appears to me you and boethius might be discussing opinions at this point which is why you aren't reaching agreement.

You're right, and of course, the timescale matters. Thinking about overlap with deaths this year is a fairly arbitrary cut off point (why not the next two years or five). This is a problem with risk analysis in general and why people like Prof. Spiegelhalter tend to talk about Days of Life Lost rather than raw deaths, it's not because he doesn't care about the elderly and ill, it's just that there's no other way to account for effect of interventions statistically without skewing the results.

The overlap in factors affecting prognosis, however, is not just opinion (or rather it's the opinion of virtually every expert who's written on the subject). This overlap does affect the predictions in ways which are then beyond mere opinion. In order for the overlap to be statistically small, for example, we would have to have a lack of overlap in factors affecting prognosis to a greater extent than there is overlap. In order to sustain such a position one would have to assume that factors as yet undiscovered turn out to be so significant that they outweigh the overlapping factors already discovered. That seems quite a stretch.

What we know is that the vast majority of fatalities (over 90%) had other comorbidities which were "mostly likely to be the underlying cause of death for a person of that age and sex had they not died from COVID-19". so this is referring to cause of death at the time of death. Not cause of death eventually, or some time in the distant future if they're unlucky enough. It is the other factor which the doctor or coroner thought serious enough to contribute to the actual death at the time ie without Covid-19 they would quite likely have died from that condition alone.

I agree that the complicating factors of system overloading and long-term lung damage make the figures difficult to say with certainty, but there is not any evidential support for the position that the overlap with those who would have died anyway will be statistically very small. As Professor Ferguson says, this is primarily a condition which causes death in those who are already very ill.

Quoting Benkei

since this apparently includes obesity and diabetis

Just noticed this. The risk group (those who are significantly more at risk than average) include the overweight and those with diabetes. The comorbidities registered on death certificates (where the overlap comes from) do not include any such vague categories. They are actual causes of death. They're far less vague and use either ICD-10 or WHO cause of death categories.

Quoting Isaac

You're right, and of course, the timescale matters. Thinking about overlap with deaths this year is a fairly arbitrary cut off point (why not the next two years or five).

If you think we've been talking about some vague timeline and therefore, your position is correct given more time, you are wrong.

Quoting Isaac

3) 2000 cases from respiratory conditions is not far off normal. It's the amount of cases with underlying health problems being pushed over the edge that is the real problem here. The key thing there being that we don't know how many of them would have died anyway, nor will we until the year's figures are out.

Quoting boethius

Yes, the reasoning is based on the empirical data that the virus seems to simply double your chances of death this year, whatever your risk group; that this is the best predictor for most people.

Quoting boethius

However, if long term injury increases the risk-of-death factor for survivors of Covid, then you may end up with more deaths in absolute terms next year due to lung injuries or other long term Covid treatment complications. (likewise for every other demographic cohort)

Quoting Isaac

We know with great precision how many of those people were going to die this year anyway, its about 300,000 (the death rate minus deaths from accidents). So until the death rate from Covid-19 exceeds 300,000 you can't possibly say that the victims were not going to die anyway, simply on the basis of the numbers, you additionally need data on the overlap - or you need to wait for deaths occurring over a longer timescale - say a year, or you need a plausible mechanism of fatality which does no coincide with underlying health conditions.

Quoting boethius

My argument is a counter-argument to the idea that Covid is shaving off a population from these risk groups that can be in some sense said to "about to die anyways"; I've been using a year as a baseline time frame for the meaning of "about to die".

Covid doesn't kill enough people to have an obvious and noticeable statistical effect of this kind, such as non-respiratory disease going forward making up for, or nearly making up for, Covid deaths and arriving at some equilibrium.

We've been talking about a year.

Obviously, if you make "die anyways" to mean any length of time then the overlap is 100 percent as @Benkei mentions. Since that's obvious it's necessary to discuss some specific time frame.

We've been discussing the time frame of a year.

Quoting boethius

We've been discussing the time frame of a year.

I'm aware of that. I was simply making the point that what might be a 60% overlap in a year could be a 90% overlap in two years. Picking one year is quite arbitrary (although it does cover seasonal variations, so it's pretty much the minimum time scale it makes any sense to compare over). Professor Ferguson and Professor Spiegelhalter are referring to the yearly mortality in their comments, as have I been.

Quoting Isaac

My argument with boethius is mainly about his ridiculous assertion that the overlap will definitely be small because there's no significant overlap in factors. This despite the fact the the only recorded factors affecting prognosis thus far are exactly the same as the factors affecting prognosis in other conditions, as the four articles I cited demonstrate.

By small, I have been clear that the effect is there, the effect is measurable, but the effect is not so large as to essentially balance out deaths over the year, or come anywhere close to that.

Yes, people have problems that will likely kill them with time. We've been talking about a 1 year time frame. No where have you presented any evidence that most people dying of Covid would die within 1 year.

Quoting Isaac

Him saying the overlap 'is not the point' of the graph has somehow become him saying that there is no substantial overlap (oh, sorry I forgot 'substantial' now means 'very small' - I will have to get the hang of this newspeak)

Substantial for a statistician can easily mean "a small but statistically significant effect".

I have said the overlap is small in the context of your initial assertion that Covid deaths and "otherwise deaths" may completely balance out to have no, or hardly, and net increase in deaths. That's a big effect.

I've been arguing that the effect is small, because we have enough information to know it's killing people in large risk groups. And furthermore, I've been arguing that the overlap maybe not only small but not as big as long term injury replenishing those risk groups.

Quoting Isaac

I agree that the complicating factors of system overloading and long-term lung damage make the figures difficult to say with certainty, but there is not any evidential support for the position that the overlap with those who would have died anyway will be statistically very small. As Professor Ferguson says, this is primarily a condition which causes death in those who are already very ill.

You complain about me being a dishonest debater, and yet you don't mention that this has been one of my major points, that I said from the beginning.

And now you say "very small" is what you've been disagreeing with, to give room for you to have the small v very small part of the debate. I never used there term very small.

Yes, we know people that die of Covid are usually ill, maybe very ill, we've been discussing the overlap with people "who would otherwise die this year", not the overlap with "ill people".

If you want to discuss 10 year, 20 year time frame, then I would agreeing with you. But we've been talking about a year.

You've basically changed your position to my position, but you're so cranky about being wrong and citing evidence that supports my position, that you want to pretend my position was your position all along based on substituting meaning of words. But that ambiguity isn't there.

Quoting Isaac

1) A spike in the death rate is only a snapshot at a particular moment. The 6000 extra people who died last week are not now available to form the pool of people who will die next week. This would be irrelevant if Covid-19 did not preferentially target those with underlying problems, but it does.

This is your initial position in your disagreement with @I like sushi. I like sushi and I have been saying such an effect, is there, but is not big.

You've been arguing that Covid targets "the weakest" hearts and so on, to support your position that the effect is large, or at least likely large. So large as to change policy response or create narrative risks on the left of some sort.

Quoting Isaac

Professor Ferguson and Professor Spiegelhalter are referring to the yearly mortality in their comments, as have I been.

Ok, so we're talking about a year.

What evidence is there that the effect of overlap with people "who would otherwise die this year" is a big effect as opposed to a small effect?

I.e. big enough to support the idea that:

Quoting Isaac

1. High overlap undermines certain arguments against social distancing measures because there should be little net excess in treatment requirement, focusing the main problem even more in the height of the spike of cases. Without overlap there is an argument that flattening the curve will not help because it pulls staff from other vulnerable cases in the long term so providing no net gain. In other words, with overlap we only need to re-assign resources (which everyone agrees is doable), without overlap we need to produce a net increase in resources (which many think is not doable, so why bother >> herd immunity bullshit).

Quoting boethius

the effect is not so large as to essentially balance out deaths over the year, or come anywhere close to that.

As I've said, take it up with the professionals who disagree with you, or present some counter-citations. Your personal 'rekon' that it won't be large doesn't amount to much on its own when contrasted with two experts who both think it will be between 50 and 100%.

Quoting boethius

No where have you presented any evidence that most people dying of Covid would die within 1 year.

Right. And nowhere have you presented any evidence that they wouldn't. Hence my point to @Benkei that a year was a bit arbitrary. Professor Ferguson talks about people at "the end of their lives" and Professor Spiegelhalter talks about a "very short time". If you want to interpret those expression as meaning much more than a year, you can, but I'll not join you. Someone with 5 or more years left being described as at "the end of their lives" is ridiculous.

Quoting boethius

Substantial for a statistician can easily mean "a small but statistically significant effect".

What about "many", does that now mean 'few'? Plus his recent comment is much clearer that he expects "there may end up being a minimal impact on overall mortality for 2020". Or does "minimal now mean 'massive'?

Quoting boethius

What evidence is there that the effect of overlap with people "who would otherwise die this year" is a big effect as opposed to a small effect?

Over 90% of people who have died of Covid-19 had comorbid conditions that were "mostly likely to be the underlying cause of death for a person of that age and sex had they not died from Covid-19". These were not the assignation of broad risk groups. These are the additional conditions the doctors considered life-threatening enough to be listed as a cause of death.

Prognosis for Covid-19 fatality is significantly worse for key factors which are identical to factors which also affect prognosis for the comorbid conditions listed. There are no non- overlapping factors listed in any of the studies.

Quoting Punshhh

Please do stick around to discuss this, your contributions are valued. I think you unfortunately chose to dig a little deeper with the wrong interlocutor. Boethius is quite argumentative, he seems to enjoy it. But this might result in a failure to reach consensus.

Poor, poor @Isaac, comes to a debate forum, engages in a debate, get's served with a debate.

None of the points I have made is motivated simply to disagree with Isaac.

I genuinely believe the effect of overlap of deaths of Covid this year with "otherwise would have actually died" group this year is small and can be defended with reasoning. By small I mean the effect is there, but not big enough to change policy response.

If you agree with my position, which you seem to, then why would it be unreasonable to defend a position you view as correct? If you disagree, then join the debate -- maybe I'm wrong and you can explain where and why -- instead of complaining about others debating on a debate forum.

Reply to Isaac

3 days ago, I made my position very clear:

Quoting boethius

I'm not sure you're even arguing / implying something against what I emphasize above, or are just compiling all the statistical minutia of relations to consider.

In terms of adding to the list, a big one that can not only nullify the affect of high-risk groups decreasing in absolute size (due to dying), but actually reverse that tendency, is that the virus may cause long term lung damage.

So, if every 70 year old got the disease, all else being equal, we may expect that demographic cohort to have less deaths post-pandemic, simply due to their numbers being smaller or perhaps particularly weak breathers being culled from the heard. However, if long term injury increases the risk-of-death factor for survivors of Covid, then you may end up with more deaths in absolute terms next year due to lung injuries or other long term Covid treatment complications. (likewise for every other demographic cohort)

Long story short, some Covid deaths would have died anyways, but expected overlap is small (extreme bias towards this group getting Covid would be needed for a significant overlap), and long-term injury may compensate, even significantly over-compensate, this overlap by increasing the risk-of-death factor for these risk groups (indeed all risk groups).

I gave you the benefit of the doubt that you were saying the same thing.

If you're saying the same thing now, you've wasted your time and made yourself look like a fool. Though you haven't wasted my time fortunately, for it is true, as @Punshhh suggests, that I enjoy debating on a debate forum, which is why I come to a debate forum to debate.

For instance if you mean by:

Quoting Isaac

What we know is that the vast majority of fatalities (over 90%) had other comorbidities which were "mostly likely to be the underlying cause of death for a person of that age and sex had they not died from COVID-19". so this is referring to cause of death at the time of death.

That 90 percent of Covid deaths had comobidities, but that does not mean 90 percent will die within 1 year. Then you agree with my original position!

If by:

Quoting Isaac

I agree that the complicating factors of system overloading and long-term lung damage make the figures difficult to say with certainty,

You mean that regardless of overlap, long term lung damage may simply replenished those "at risk of dying within 1 year" then you agree with my original position!

Maybe you aren't here to debate, which sometimes means recognizing a change in position and simply saying so. Maybe you just want to have Reply to Merkwurdichliebe pat you on the back all day. That can be done in private, why bother us about it?

Quoting Isaac

2. I'm extremely concerned about the effect the media has been able to exert on the general psyche. Culture has always been able to generate collective affect, but it's becoming worryingly uniform the more social media grows (I won't derail the thread by going into it here, but imagine starlings murmuring - one or two and it's just a mess going every which way, thousands and it suddenly looks like a choreographed dance, but all it is is just thousands of birds all trying to respond to each other and making tiny errors in copying which then get magnified)

This is not at all an accurate representation of herd mentality.

Quoting Isaac

What we know is that the vast majority of fatalities (over 90%) had other comorbidities which were "mostly likely to be the underlying cause of death for a person of that age and sex had they not died from COVID-19". so this is referring to cause of death at the time of death.

I see this statement as blatant deception. The vast majority of covid-19 related deaths are pneumonia related, pneumonia caused by the virus. the cause of death is the virus.

This seems to be the premise that you are trying to support, that something other than the virus causes these deaths, but it's not the case. And it's completely false to argue that the people would have died at that time anyway, because they already have an "underlying cause of death". Clearly they were still alive and could not have had a cause of death already. From your logic we might as well say that every living person has an underlying cause of death because we're all going to die. Life is an underlying cause of death. It's simply a nonsensical argument which you've been putting forth.

Quoting Isaac

Hardly any ancient farmers died of cancer. It's not because they were super-healthy, it's mostly because they died of something else first.

Look at this analogy. It's pure nonsense. Ancient farmers ate produce directly from the farm, not highly processed food (a significant factor in some cancers) that today's city dwellers eat. Your entire argument, that people haven't died from A,B,C,D, or a bunch of other different conditions, because they died of X first, but we still ought to talk about all these conditions as is they are causes of death for these people, or even potential causes of death for these people, is complete nonsense. They have an actual cause of death, which is X.

Quoting boethius

That 90 percent of Covid deaths had comobidities, but that does not mean 90 percent will die within 1 year. Then you agree with my original position!

No. A comorbidity sufficient to be be mentioned on a death certificate is extremely likely to to cause death within the year. Doctors do not fill in death certificates with a list of "other stuff they also had", these are very serious conditions which are "mostly likely to be the underlying cause of death for a person of that age and sex had they not died from Covid-19". That is why Professor Ferguson described victims as being mostly "at the end of their lives"

So I am not saying that it doesn't mean these people will most likely die within a year. It absolutely does mean that. Having a comorbidity listed on the death certificate as a cause of death is very serious and anyone in that condition is very likely to die within the year. That is why, again, both the experts who have spoken on this matter have reached the same conclusion, and why you've not managed to produce a single expert saying anything to the contrary.

300,000 people die each year (from disease). These deaths are drawn, in the overwhelming majority, from the exact group of people who would have the comorbidities listed in the ONS figures as having a 90% overlap with Covid-19 fatality. I've supported that assertion for heart disease and cancer by providing studies of risk factors and prognosis.

For your claim to be true, there would have to be little overlap with this group.

We already know there is a massive overlap with Covid-19 fatality and these comorbidities (over 90%). We already know that there is a massive overlap in prognostic factors (I've cited the studies for you). So you'd have to present an argument which shows how, despite an overlap in prognostic factors, the 300,000 deaths this year are not largely drawn from the group of people ill enough with these comorbidities to have them recorded as a potential cause of death. This is, on the face of it, a ridiculous assertion for which you've yet to provide a shred of evidence.

Quoting boethius

You mean that regardless of overlap, long term lung damage may simply replenished those "at risk of dying within 1 year" then you agree with my original position!

No. "Complicate the figures" is not anywhere near "replenish the entire cohort". Again, there is no evidence that lung damage will cause future deaths in these numbers. This is just your speculation and needs evidence to support it.

Reply to Isaac The reason you aren't seeing higher mortality among younger people with no underlying health issues is the availability of oxygen, the ability to resuscitate with saline, antibiotics, pressor drugs, and so on. So death is just one aspect of this pandemic, and in developing countries where the poor receive none of the help I just mentioned, death will be a more significant aspect than it is in core nations.

I know you aren't disagreeing with that, I'm just saying that I think the cause of death listed on official documents probably isn't a big deal?

I'm not going to allow @Merkwurdichliebe to troll here anymore and am deleting his posts. Replying to him is therefore probably a waste of time. Unless he comes up with a sincere contribution, which is unlikely.

Quoting Isaac

300,000 people die each year (from disease). These deaths are drawn, in the overwhelming majority, from the exact group of people who would have the comorbidities listed in the ONS figures as having a 90% overlap with Covid-19 fatality. I've supported that assertion for heart disease and cancer by providing studies of risk factors and prognosis.

This is the error in your analysis I've pointed out like 5 times already.

We're talking about deaths within 1 year, so talking about overlap with comorbidity in larger groups than "likely to die within 1 year" supports my position.

The "heart disease" risk group is larger than "people going to die of heart disease within one year from heart disease".

Quoting Isaac

For your claim to be true, there would have to be little overlap with this group.

No, my claim is completely compatible with these facts.

Lot's of deaths (most deaths) each year are not predictable at the individual level.

At the start of the year, we cannot predict with any degree of certainly in the sense of individual identification who will be dead by the end of the year.

Most deaths within 1 year do not come from groups with 90% chance of death this year. There are such groups, but they are small and so even 90% of such people dying within the year is not a big number.

Lot's of effort has gone into this, as doctors and life insurers would like to know, but they don't know. What we know is that everyone has a chance of dying, that chance varies and can be statistically investigated, our understanding always improved, but the pure element of chance (relative our knowledge at the start of year as well as just the nature of reality) is also at work.

If statisticians put someone in a group of 1% risk of death due to heart disease this year, they are not saying that they were just too lazy to analyse further and see which of these people with heart disease have actually quite strong hearts (and so many 0.1% of dying) and which have "the weakest heart" (and so 90% of dying); they are saying "of 100 people in this group we expect 1 to be dead by the end of the year, but we don't know which one". Further analysis can make some progress, but does not fundamentally change the fact that most deaths are from groups with small chance of death within the year, but they are large groups and so result in lot's of deaths.

Statisticians of these sorts of things are constantly doing analysis to see if there are other predictors, and sometimes new predictors are found and new risk-groups created, but things are no where close to predicting "who's going to die within 1 year".

That's why your argument depends (depended) on some hidden variable we do not know, such as assuming the people who would die from heart disease this year have "the weakest heart" and the people with heart disease who die from Covid too have "the weakest heart". This is not what statisticians believe. Certainly, such a hidden variable is there that might be uncovered by better medical tools or perhaps is fundamentally hidden for ever, but there is also a large amount of random chance that goes into who dies or doesn't within a year of heart disease.

Quoting Isaac

No. "Complicate the figures" is not anywhere near "replenish the entire cohort". Again, there is no evidence that lung damage will cause future deaths in these numbers. This is just your speculation and needs evidence to support it.

You have not bothered to understand my argument.

It's you that has been claiming that the overlap is big, so big that Covid maybe just a problem of reallocating resources and does not require new net-resources.

I have been arguing that the overlap is small with "people who would die this year anyways"; small in the sense that Covid is not just a resource allocation problem even if you could reallocate without friction from other health resources that having nothing to do with respiratory disease (which you can't), and even if you could reallocate from the future to the present (which you can't, even with loans).

I have also mentioned, that even if you are right about overlap, the risk group might be replenished due to long term lung injury.

No where have I said it's guaranteed or I know it to be true. It is, however, a risk, a big risk, and therefore no reason to change policy even if your overlap hypothesis was true (which it isn't).

Furthermore, the effect of replenishing the risk group can be very small but still result in replenishing the risk group (a small thing that affects a large amount of people). If a risk group is 1% risk of death of heart disease and 1% risk of death of Covid (if infected with Covid), and they all get Covid and 1 person dies of Covid, then there's a decrease in expected deaths in absolute terms within the year based only this, due to that 1 person no longer in the group, so now there's 1% risk of death for 99 people, so 0.9 expected deaths from this group within the year.

Long term lung injury only has to increase the risk of death in this group by ~0.1% to replenish the risk group back to resulting in 1 expected death within the year; so 2 deaths within the year (1 from Covid and one from the other risk, such as heart disease) instead of 1.9 deaths due to the slight culling effect Covid had on this group.

This is why overlap has to be with small groups that have super high chance of death to not only see a culling effect but also for the long-term injury effect to also need to be very large. 0.1% increase of death in a group that has 90% chance of death within the year changes little in absolute terms.

If everyone, or most people, gets Covid, and most deaths arise within large risk-groups, then a very slight increase in chances of death due to surviving Covid can easily replenish all the risk groups to result in the same amount of deaths in absolute terms within the year.

You've been basically wrong at every level of your argument, and now that you're beginning to realize this, you are trying re-interpret things to arrive at my position.

Welcome to my position.

Quoting Punshhh

Do you have it? I hope your symptoms are not to bad.

No reply. Hmm :chin:

Quoting frank

The reason you aren't seeing higher mortality among younger people with no underlying health issues is the availability of oxygen, the ability to resuscitate with saline, antibiotics, pressor drugs, and so on.

I'm not sure, though. I get how that would not be reflected in the comorbidities from the death certificates, but I don't see how that gets around the overlap in prognostic factors. Those, presumably, cover all age groups, and those affect severity as well as death (it's not like death is predicted by a different range of factors to severity). So the number of people getting to a point where they need critical medical care will still be influenced most strongly by the same factors influencing mortality.

If this is the case, then the numbers in critical care will still be heavily drawn from the numbers who would have ended up in critical care any that year due to the overlapping factors. Obviously much less so than with fatality. The critical care group will have a much greater flux than the "end of life" group. Plus complicating factors will have a greater impact because of that. I'd be interested if anyone has heard any modelling of the critical care group.

I'm not sure how it makes the cause of death not a big deal though (is that what you meant?). The fact that there's a 90% overlap with comorbidities serious enough to be listed as a cause of death is hugely significant for risk assessment.

Quoting boethius

We're talking about deaths within 1 year, so talking about overlap with comorbidity in larger groups than "likely to die within 1 year" supports my position.

They are not comorbidity groups larger than "likely to die within a year". They are exactly comorbidity groups that are likely to die within a year. That's why the experts responsible are talking about overlap within that time scale.

Listing a comorbidity on a death certificate is not the equivalent of assigning a broad risk category. It's saying that the person was likely to have died from that condition had they not had Covid-19. That is literally the wording the ONS use.

Just to be abundantly clear about this the MCCD guidance states that a main listed cause of death must go "back through the sequence of events or conditions that led to death on subsequent lines, until you reach the one that started the fatal sequence. If the certificate has been completed properly, the condition on the lowest completed line of part I will have caused all of the conditions on the lines above it. This initiating condition, on the lowest line of part I will usually be selected as the underlying cause of death, following the ICD coding rules. WHO defines the underlying cause of death as “a) the disease or injury which initiated the train of morbid events leading directly to death"

And clearer still...

"The conditions mentioned in part two [not even the part we're talking about, a lesser subsidiary of it] must be known or suspected to have contributed to the death, not merely be other conditions which were present at the time."

Comorbidity on a death certificate is not the assignment into a broad risk category. It is the declaration of a very serious condition directly responsible (albeit sometimes in part) for the chain of events leading to death.

Quoting boethius

Most deaths within 1 year do not come from groups with 90% chance of death this year.

What? How does that even happen mathematically?

Quoting boethius

If statisticians put someone in a group of 1% risk of death due to heart disease this year, they are not saying that they were just too lazy to analyse further and see which of these people with heart disease have actually quite strong hearts (and so many 0.1% of dying) and which have "the weakest heart" (and so 90% of dying); they are saying "of 100 people in this group we expect 1 to be dead by the end of the year, but we don't know which one"

Evidence.

Quoting boethius

most deaths are from groups with small chance of death within the year, but they are large groups and so result in lot's of deaths.

Evidence, again.

Quoting boethius

things are no where close to predicting "who's going to die within 1 year".

Nor do they need to be. It is sufficient to see overlapping cohorts.

Quoting boethius

assuming the people who would die from heart disease this year have "the weakest heart" and the people with heart disease who die from Covid too have "the weakest heart". This is not what statisticians believe.

I've literally posted studies showing exactly that. Did you read any of them. They provide prognostic factors for deaths within broad groups (such as hypertension within the heart disease group) which accurately predict likelihood of death within that group. The same factors (in this case hypertension) are associated with a higher chance of death within the Covid-19 group. D-dimer count (18 fold increase) and SOFA scores (5 fold increase) are two more such factors.

Quoting boethius

If everyone, or most people, gets Covid, and most deaths arise within large risk-groups, then a very slight increase in chances of death due to surviving Covid can easily replenish all the risk groups to result in the same amount of deaths in absolute terms within the year.

Yes, but your premise is not true. Having a comorbidity of sufficient severity to class as a cause of death is not a "large risk-group" it is, as the country's leading expert in the field has said "people at the end of their lives".

Quoting Isaac

I don't see how that gets around the overlap in prognostic factors. Those, presumably, cover all age groups, and those affect severity as well as death

Those factors are also tied to a certain social setting. People will die in Honduras who wouldn't have died in the US. They'll die from dehydration, hypoxia, and septic shock. They could be in their 30s with no underlying health problems.

Quoting Isaac

The fact that there's a 90% overlap with comorbidities serious enough to be listed as a cause of death is hugely significant for risk assessment.

True. It's interesting to me to step back and look at what we did, though. Across the world, societies, by going into lockdown, collectively shouldered a burden. I don't think that's how the average person thought of it, but that's what we did. We reduced the mortality rate of a pandemic by collective action.

Quoting frank

Those factors are also tied to a certain social setting. People will die in Honduras who wouldn't have died in the US. They'll die from dehydration, hypoxia, and septic shock. They could be in their 30s with no underlying health problems.

Yeah, absolutely. I think I did mention it somewhere, but it should be made even more clear. All this only applies to the developed world. The overlapping comorbidities have a completely different cohort size in developing countries (and presumably within small, very poor groups in developed countries, I don't know). I'm still not sure about "no underlying health conditions". I'd need to see the data on that. Some people work from a default position that disease is random until some factor is proven. I tend to work from the position that it is caused until the random factor is demonstrated. It's just a different axiom, I suppose.

Quoting frank

We reduced the mortality rate of a pandemic by collective action.

Well, that's a very positive way to look at it. Not saying that's a bad thing. Personally, I'm more of a governments-too-concerned-about-public-image-to-act-in-a-calm-reassuring-and-timely-manner-could-well-have-killed-thousands kind of guy, but each to their own.

Quoting Isaac

Some people work from a default position that disease is random until some factor is proven. I tend to work from the position that it is caused until the random factor is demonstrated. It's just a different axiom, I suppose.

Maybe you could flesh out how you're using "random" and "caused." Random stuff is usually understood to be caused.

Quoting Isaac

Personally, I'm more of a governments-too-concerned-about-public-image-to-act-in-a-calm-reassuring-and-timely-manner-could-well-have-killed-thousands kind of guy, but each to their own.

Things would have been worse if this happened 100 years ago. Things would have been worse without the lockdowns. In some places it was overkill, but that's no one's fault.

Quoting frank

Maybe you could flesh out how you're using "random" and "caused." Random stuff is usually understood to be caused.

Yeah, fair enough. I'm using random in the sense of not possible to control for. As in, some as yet hidden factor, some non-measurable element of chance (such as replication error in cellular growth), or some ubiquitous factor.

Quoting frank

Things would have been worse if this happened 100 years ago.

Interesting thought. Severely limited travel might have kept it in one place, lower population of elderly with comorbidities too. But lack of medical care on the other hand. Thing is, medical intervention is only saving a proportion of sufferers. Using the JAMA figures (which I know are preliminary) 14% went into care and 2.5% died. So presuming those that died went into care first, that care saved at most 85% (some survivors would have survived anyway). The first two factors only need to lower the total infected by, say, 80% or so and total number of deaths would have been lower even without modern medical care. Since the over 70 population has doubled in some countries in the last 100 years, plus most people lived and worked in one town/village...

Quoting frank

Things would have been worse without the lockdowns. In some places it was overkill, but that's no one's fault.

Yes, I think that's unarguable. They should have been sooner and accompanied by testing and tracing. We've known about the possibility of something like this for decades. It's shameful we weren't better prepared.

Quoting Isaac

Yes, but your premise is not true. Having a comorbidity of sufficient severity to class as a cause of death is not a "large risk-group" it is, as the country's leading expert in the field has said "people at the end of their lives".

"End of their lives" as in over 60?

Or, "end of their lives" as in will die within 1 year?

You can't just substitute meanings all over the place to pretend your position has been my position all along.

All my arguments have been about this 1 year time frame.

So, please show where this expert clarified their meaning of "end of their lives" as to mean "would have died within 1 year". Otherwise, again, you are citing evidence that supports my position, not yours.

Quoting boethius

"End of their lives" as in over 60?

No! Who the hell thinks people over 60 are at the end of their lives. I bloody hope not.

Quoting boethius

Or, "end of their lives" as in will die within 1 year?

Yes. In the context (and supported by David Spiegelhalter, who specifically referred to 2020). I'm quite confident "end of their lives" meant they they were close enough to death to fit mostly in the year's mortality. Coupled with the severity of a comorbidity appearing as a cause of death. If someone had lung cancer recorded as the cause of death, but then (imaginary doctor incompetence) it turned out they weren't dead after all, just unconscious, do you really think their not very much less likely than other lung cancer patients to make it through the year? "It was nothing, just a little lung failure severe enough to be listed as a cause of death... I got better"

Quoting boethius

show where this expert clarified their meaning of "end of their lives" as to mean "would have died within 1 year". Otherwise, again, you are citing evidence that supports my position, not yours.

What? If I can't cite evidence he meant within exactly one year then that somehow counts as evidence supporting your position? How on earth does that work? If I can't cite such evidence (notwithstanding my other supporting evidence) then at best that means we don't know. Under no circumstances does it mean that this cohort are definitely not expected to die anyway within the year. How does it support your position?

Second thoughts just don't bother answering. I've had enough of this.

Quoting Isaac

As in, some as yet hidden factor, some non-measurable element of chance (

Some people become infected or colonized by this coronavirus and have no symptoms. Some become ill enough to die. I think there is a hidden factor involved.

Quoting Isaac

They should have been sooner and accompanied by testing and tracing.

I dont worry much about "should haves" unless there's a clear path to doing things differently in the future and there isn't here.

Quoting Isaac

No! Who the hell thinks people over 60 are at the end of their lives. I bloody hope not.

The point is, you don't know.

It's completely reasonable to say people at 60 are closer to the end of their lives than people at 20, more so people above 70 or 80.

It's entirely possible to talk about people "at the end of their lives" without meaning "people that will be dead within 1 year", just meaning that old people, by definition, are usually closer to the end of their lives than anyone else.

For a technical expert, it's entirely accurate to talk about old people as "close to the end of their lives".

Quoting Isaac

Yes. In the context (and supported by David Spiegelhalter, who specifically referred to 2020). I'm quite confident "end of their lives" meant they they were close enough to death to fit mostly in the year's mortality.

Quite confident based on nothing.

Read his papers, if he had statistical evidence for this, he would have included it in his model, as his model papers are all about health care capacity based on his best use of the statistics available to him.

For instance, he discusses the possibility that there's a very large amount of asymptomatic infected, and explains why (despite a large potential variation in this factor) it can't possibly be high enough to change the main conclusions of his paper and the requirement of social distancing to keep within health care capacity for a significant amount of time.

If he thought a large portion of people who were dying would have otherwise been dead within the year, that's very significant, and he would have included a model or at least some discussion of what that would mean.

The statement you're referring to is also clearly in the context of social distancing working to keep deaths below 20 000 for the whole UK; so, we can understand it to be a feature of that specific scenario, not a feature of Covid if left to proliferate uncontrollably (which his model of a unmitigated spread cannot possibly be interpreted to kill everyone who otherwise would have died within 1 year anyway, not even close). He also just says "maybe" in the sense that it hasn't been completely excluded yet, an upper bound without any reason to assume things will be anywhere close to that upper bound in reality.

So, he is not lending support to your position, just didn't completely exclude it yet within the context of a social distancing scenario that the UK has already passed.

You can't take one statement (not even in a paper but an interview) of an expert, out of the context of where they said it, interpret it wrong (confuse pre-modelling guesses of upper bounds and "likelihood"), not consider their published papers on the same subject, and call it evidence supporting your position (well you can say it is, as you've been doing, it just isn't actual evidence).

Quoting Isaac

What? If I can't cite evidence he meant within exactly one year then that somehow counts as evidence supporting your position?

The evidence you cited is that 90% of cases have comorbidities, that is not evidence that 90% (or anywhere close to that) "would have died within 1 year". You've cited risk factors for large groups.

The larger the risk-group Covid is affecting (where both the preexisting condition risk and Covid risk of death is low), the smaller the overlap between people who die from Covid and those that would have died anyway. You are citing evidence that supports my position.

You do not have the technical ability to understand your mistake. You don't want to be taught by me; fine, but your unwillingness to learn doesn't impact my willingness to defend my position.

Quoting frank

Some people become infected or colonized by this coronavirus and have no symptoms. Some become ill enough to die. I think there is a hidden factor involved.

I believe in that sense, comorbidity presence and severity explain a lot of the variation between those cases (they are the common factor). In general, the closer something gets to being a mysterious hidden factor (patternless unstructured variation), the closer it gets to being noise (unstructured individual level variation). Signals tend to announce themselves.

Quoting fdrake

I believe in that sense, comorbidity presence and severity explain a lot of the variation between those cases (they are the common factor). In general, the closer something gets to being a mysterious hidden factor (patternless unstructured variation), the closer it gets to being noise (unstructured individual level variation). Signals tend to announce themselves.

We simply don't know yet why some people go through infection without any symptoms. I agree that the descent to death is more likely in a patient with an underlying health problem. That's true of flu, motor vehicle accident, cocaine use, etc.

I think I'm on the border of not knowing what we're talking about. :razz: I just wanted a reason to drop in my comment about collective action and how amazing it is. Internet and whatnot.

Quoting frank

I think I'm on the border of not knowing what we're talking about. :razz: I just wanted a reason to drop in my comment about collective action and how amazing it is. Internet and whatnot.

:up:

Reply to frank

Some people become infected or colonized by this coronavirus and have no symptoms. Some become ill enough to die. I think there is a hidden factor involved.

Yes, there are some geneticists looking into a genetic disposition. It makes sense to me, but I'm no expert.

Reply to Punshhh I've heard from 1/3 to 1/2 exposed show no symptoms. And then others, yes sometimes young with no medical history, come close to death. It's strange.

Reply to boethius if we look at a group in the population who are ill with one of the comorbidity diseases who would be destined to die in 2020. Some of those will die prematurely due to a Covid infection. I would find it hard to believe that many of these patients would survive Covid, only to die later in the year, so the overlap will be large, say around 95% ( of those who become infected with Covid)

There is a second group who are ill with the same illnesses, but who are not destined to die in 2020. A proportion of thes patients will die in 2020 after contracting Covid. I would expect the overlap here to remain high, but not as high, say 60%.(of those infected with Covid)

There is a third group who were destined to die of a disease in 2020, but who presented as quite well, but who will die unexpectedly in 2020. Of this group there may, or may not be an overlap, if there is I expect it is quite low, say 10, or 20%.( of those infected with Covid)

Presumably it requires statistical analysis to arrive at an overall overlap across the three groups. I expect we don't have sufficient data to come to anything near accurate.

Reply to frank

I've heard from 1/3 to 1/2 exposed show no symptoms. And then others, yes sometimes young with no medical history, come close to death. It's strange.

From what I remember from the article I heard, some people might have a genetic predisposition which causes cells to repell, or become slippy to Covid.

Also I expect (although this is speculation) that some people have a genetic predisposition which makes their immune system somehow vulnerable to, or deadly for Covid.

Reply to I like sushi

It’s starting to look more and more like the infection fatality rate of covid-19 is in the ballpark of the seasonal flu, at least according to this study.

https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1

Here is the lowdown:



This is good new, if true.

Quoting Punshhh

if we look at a group in the population who are ill with one of the comorbidity diseases who would be destined to die in 2020. Some of those will die prematurely due to a Covid infection. I would find it hard to believe that many of these patients would survive Covid, only to die later in the year, so the overlap will be large, say around 95% ( of those who become infected with Covid)

I agree if you are destined to die in 2020 you are "even more" destined to die in 2020 if you get Covid.

This group I have been calling "would otherwise die within 1 year" or "terminally ill" interchangeably.

The first problem is that not all terminally ill people will get Covid. For instance, if only 15% of people have Covid so far, then there's 85% of these terminally ill people out there, absent a selector that makes these terminally ill vastly more likely to get Covid. If we look simply at the fact Covid progresses geographically then we already know the selector to get Covid of a "well mixed" sub-population is weak, because they are not all clustered geographically; yes, they may cluster around hospitals within their individual regions, but the disease still progresses geographically.

Furthermore, we know who the at risk populations are and we take additional measures, so this also weakens the selector.

Therefore, if 85% of terminally ill people are still out there, they will still die in 2020.

And that's an upper-bound of total infected. The lower bounds is as low as 1% infected (confirmed Covid infections) in which case 99% of terminally ill are still out there and will still die in 2020.

So, although we can assume terminally ill people who get Covid will more likely die even sooner than Covid somehow having the opposite effect and curing them of their underlying condition, for this to create a big effect of simply moving deaths around within the year then we need to have reason to believe this entire population gets Covid with extreme bias (and there's solid reason to not assume that's no so).

Quoting Punshhh

There is a second group who are ill with the same illnesses, but who are not destined to die in 2020. A proportion of thes patients will die in 2020 after contracting Covid. I would expect the overlap here to remain high, but not as high, say 60%.(of those infected with Covid)

I read this to mean that 60% of total Covid deaths are from ill people, just not ill enough to die in 2020.

Although I agree most people who die of Covid have underlying conditions, the reason to believe most Covid deaths are not from people who "would have otherwise died" within 1 year, is because the vast majority of deaths each year are not from people who doctors are certain will die within the year.

Lot's of people who have 1% chance of dying from a heart attack have just that, a 1% chance. At the start of the year you can test them however you want, but you couldn't have done any test to determine a greater than 1% chance. The reason is that random things (from the perspective of the start of the year) happen: stressful life events, poor response to treatment due to genetic variation or "bad batch" of pharmaceuticals (quality control exists because processes aren't perfect, including quality control), taking up drinking, unlucky torque on an artery, immune system "learning something" by a lucky stochastic result.

If someone with a 1% chance of death has a prognosis of 1% chance of death from Covid if they contract Covid (what the evidence Isaac cited broadly indicates), then this is the "large risk" group situation I have been talking about and overlap with "who would otherwise die within 1 year" is small if Covid proliferates in these risk groups.

If you look at the risk groups people are in, they are these very large risk groups with around 1% dying per year (increasing with age and severity / number of conditions).

Very, very few people are in a risk group of 90% chance of dying this year. So if everyone got Covid, yes, all these people would die, but there are few deaths because it's a small group.

Very, very large amounts of people are in groups with < 1%, 1%, 2% up to about 10% (with decreasing total numbers). Most deaths per year are due to a very large number of people having a small chance to die, resulting in still a large number. Nearly all these people are above 60, but the are still in large groups that are not otherwise expected to die within 1 year.

The prevailing theory of medicine and actuary science is not that there are hidden variables within the body that actually explain who dies and who doesn't, but rather that variations in environment, disease progression, immune response, life choices, doctor actions, timing of intervention and dosage, etc. that determine who lives and who dies without any ability to predict these things much better than we currently do on a 1 year time frame.

Isaac's position relies not only on these hidden variables, but furthermore that these hidden variables are the same between determining "who actually die from Covid" and "who actually dies from underlying condition like heart disease".

It makes sense on the surface that "the weakest" would die in each case, but this is exactly the opposite idea actuary science is premised on; it's not true that the "weakest hearts" die each year (lot's of other factors involved), and even if it was true (which is isn't) it can easily be something else that drives Covid deaths within risk-groups, such as an otherwise benign genetic variation (subtle protein differences that don't have any difference until now, but Covid exploits that difference particularly well) that helps the virus proliferate faster (epidemic resistance is a classic reason to explain why genetic variation is a good thing). A genetic sub-group particularly susceptibility to Covid explains very well why we still see deaths even in seemingly healthy people.

Quoting Punshhh

There is a third group who were destined to die of a disease in 2020, but who presented as quite well, but who will die unexpectedly in 2020. Of this group there may, or may not be an overlap, if there is I expect it is quite low, say 10, or 20%.( of those infected with Covid)

This is statistically impossible to reach 10 - 20%; that would be a huge overlap for a group of people who's "otherwise death in 2020" shares no causal mechanism at all to their Covid death (as they were simply not expected to die).

For instance, I think we could agree that dying of Covid won't somehow preferentially select for people who would otherwise die in a car crash.

This is simply the "base case": let's say a person has 0.5% chance of dying from Covid and 0.5% chance of dying from something else had they lived (so the people that do die from this group represent "unexpected" deaths), so it's a simple "choose 1 out of 200, choose another out of 200, what are the chances the choice is the same item?" which is simply 1 out of 200, a small effect of Covid deaths overlapping "would have otherwise died deaths" in this case (and an effect easily compensated for by increase in death probabilities due to lung damage from Covid, interruption of quality care for many risk groups while the medical system deals with Covid, or other things that can have a small forcing on large groups; decrease in pollution and changes to stress patterns may push things the other way).

Of course, the probabilities don't need to be the same (but they remarkably line up pretty well with chance-of-death by year by age group), but if they are small then overlap is very small. If they are probabilities that apply to large groups, "like all 60 year old's that seem healthy and not expected to die this year" then you still have large numbers because these are large groups.

Furthermore, if Covid deaths would be happening in a short period of time, instead of over a year, then even groups that have low probabilities of dying from Covid, they would still overload the health system as they arrive in a short period of time (why the idea of trying to protect over-70s and letting everyone else live normally made no numerical sense).

Reply to NOS4A2 I’m waiting for number of registered deaths in next UK report (in a few days).

If there are still 50% more deaths a week than usual then I’m inclined to disagree - judging by the UK governments latest statements I imagine the rough estimates are that the number of deaths (covid or otherwise) hasn’t eased off at all.

The hysteria does bother me, but that’s just human nature. From what little I’ve managed to glean I wouldn’t be at all surprised if the figure is below 1%, but don’t think it’ll be any lower than 0.5% - which are both significantly worse than the flu. Maybe the professor deems that ‘in the ballpark’, but it’s highly suspicious to say that rather than put an actual figure to his estimate.

Reply to frank it also depends on viral load

Reply to I like sushi The latest peer reviewed estimate in the Lancet was .6%.

Also, I've looked into the Chinese and WHO handling and the more I look into it, the more appalled I'm getting. I can get the misinformation from the local Chinese government as that's to be expected in a "shoot the messenger" culture. After that though, 10 january China fails to communicate an almost certain person-to-person transmission to the WHO and instead feeds it the famous 14 january line that "no clear evidence" exists fo person-to-person transmission. While that might have been technically true, it appears to be purposefully misleading given the available anecdotal evidence at the time.

It's fine to say you haven't conclusively established it but if you're sure as shit looking into it because of the anecdotal evidence, China should've said so.

Let's remember 10th of january is the same day the WHO does not advise to test people flying from Wuhan.

And sure the WHO is a political body but the level at which it is, is rather worrying. There really does seem too much subservience towards China that has endangered a lot of people across the world as a result.

Notwithstanding all the aid now flowing from China this really needs to be taken seriously as it's really problematic if they fail to appropriately inform others of new diseases.

Reply to boethius
There are a large number of factors resulting in deaths in this pandemic, so I want to focus on this point you are making about the overlap.

So you are happy with there being a group (1), which is a small group, who are destined to die in 2020 due to another medical condition, comorbidity. With an overlap of 95% or more, who have contracted Covid, dying due to Covid.

You are happy with a group (2), who have an underlying medical condition, comorbidity, but who are not destined to die in 2020, they may die in 1, 2, or 10 years of these conditions. That this is a large group, and that a large proportion of these patients will die in 2020 if they contract Covid. I estimated that 60% of these who contract Covid will die.

You are happy with another group (3) who are destined to die in 2020, but who don't present as very ill when they contract Covid. I accept for now that the overlap here may be smaller say 1-5% who contract Covid will die.

It's important that we don't complicate this with discussing the percentage of the population who has currently been exposed to the virus, because this figure is changing throughout the year and the degree of this change is determined by many factors other than morbidity.


So you are proposing that (1) is very small, so insignificant. That (2) is very large, and presumably (3) is small. Meaning that the majority of the comorbidity deaths are in group 2 amongst people who may have an underlying health condition which is not going to kill them for many years in most cases, but who have a high mortality if they contract Covid.

So your main point is to highlight the large number of deaths in group 2. So how do you conclude that the overall comorbidity overlap is small? ( is (2) a small percentage of the population?).

Reply to Punshhh

I'm trying to follow your line of argument here (or rather your request for clarification), but your terminology is a little confusing in places. It may just be that you're attempting to reflect boethius's terminology, but I may also have just misunderstood what you're saying, so...

If you're accepting that there could be a "large number of deaths in group 2", then group 1 cannot possibly be "small". Experts predict about 20,000 deaths total from Covid-19. Group 1 has at least 300,000 in it. Or is that the point you were trying to make and I missed it?

Quoting Punshhh

So you are happy with there being a group (1), which is a small group, who are destined to die in 2020 due to another medical condition, comorbidity. With an overlap of 95% or more, who have contracted Covid, dying due to Covid.

No, because not everyone in this group gets Covid.

It works in reverse, 95% of people in this group who get Covid we might reasonably expect they die of Covid, and certainly all of them within 2020 (as we don't expect Covid to somehow cure them).

But, the whole group doesn't get Covid. So far estimates are 1 - 15% of the population actually has Covid ... or exposure to Covid, even in hotspot areas (exposure, even if real and not a false positive, may or may not provide good immunity). So, even with the upper bound of 15% got Covid, 85% of people in this group don't die of Covid and do die of something else, so their burden on the medical system remains 85% (and they are a small group to begin with).

As more people get Covid, more of this group also get Covid, but more people in other groups get Covid too. The ratio remains more or less the same (for decision making purposes about projecting health care burden) absent an extreme bias for this group to get Covid (for which there is no plausible mechanism, considering geographic constraints alone).

Quoting Punshhh

You are happy with a group (2), who have an underlying medical condition, comorbidity, but who are not destined to die in 2020, they may die in 1, 2, or 10 years of these conditions. That this is a large group, and that a large proportion of these patients will die in 2020 if they contract Covid. I estimated that 60% of these who contract Covid will die.

This is not justified by what we know so far.

The basic pattern is Covid doubles your risk of death this year. Most people who have a risk of death "within 10 years" don't have 30% risk of death this year and therefore 60% risk of death with Covid this year (which is still not 60% chance of death from Covid). If a person of high risk of death with in 10 years has 5% risk of death this year, then their risk of death of Covid seems to be also 5% (therefore 10% within the year).

Why we see Covid deaths overwhelming medical system is that large numbers of people have a low risk of sever complication of Covid.

Most individual deaths within a year are not well predicted individually at the start of the year. Being in a risk group of 10% chance of death this year is a very high risk group.

Actuary science and medical science places a large importance on random variation of environmental factors, internal factors, life choices, life events, medical intervention, accidents, family support, etc. in causal determination of who will actually die within a year time span. In short, there are large groups of which a small portion of them will get "unlucky" within a year time-frame (with a fundamental inability to make a better prediction at the start of the year regardless of amount of tests, measurement, modelling, crystal balls or any other predictive device).

Definitely, these groups from which deaths happen "randomly" are heavily weighted towards being old and / or having underlying conditions, but these groups are still very large for our statistical purposes here of estimating overlap between the set of Covid deaths and the set of "otherwise would have died this year".

The reason that the group of people we are pretty certain will die this year is small, is because (for most people in wealthy society not at war) to get to ~90% chance of death this year (such as 90 year old with dementia and failing heart) meant having a ~80% chance of death last year (due to slightly less sever dementia and failing heart), and ~70% chance of death the year before that, and so on (though these numbers will depend on disease, there is not a large group that had 0.1% chance of dying last year but 90% chance of dying this year). So most people "getting old", the group they are a part of was already reduced significantly each year prior to getting to 90% and in a accumulative way: starting at about 5% chance of death this year, these risk-groups thin out very rapidly in a 10 year time span (each year they lose members and the chance of death of remaining members increases); during this time span most deaths are not well predicted individually (of 20 people, one of them dies the first year; maybe in a way that makes sense in hindsight, but there was no way to predict which individual would die at the start of the year).

This is why from 60 to 100 years of age the demographic chart is nearly a straight line to almost 0 population at 100, but it's a fat bar until 60 (variations in birth rates and immigration can dominate death rates below 60).

Also, why I keep coming back to the fact the discussion is about a year time frame.

If we were talking about dying within a 20 year time frame, the overlap can easily start approaching 90% for the exact same reasons (relatively high-risk groups rapidly thin out on decade time scales; just not 1 year time scales). Overlap between dying of Covid or "otherwise would die within 20 years", which is not to say people who will die within 20 years are "very likely to die of Covid".

In a 1 year time frame -- which is relevant for estimating health care resource needs and other policy choices -- overlap is low if a disease affects large risk groups (such as people in their 60s with hypertension). If a random (otherwise benign) genetic difference is also a good predictor of death from Covid, then the overlap is even less strong as Covid doesn't tend to select for "worst heart" within these risk groups but it's random genetics that dominates chance of death from Covid between risk category peers, leaving survivors to be just as likely to die of heart failure as before (perhaps more so due to long term lung injury), and also explains why Covid can kill completely healthy people, as perhaps they just have bad genetic luck (maybe Covid exploits particularly well 3 uncommon gene variation; then it could be if you have all 3 genes you have a 90% chance of death even if healthy, and it's quite rare to have them all, but happens) so is consistent with "gene variations matter hypothesis" and this hypothesis is consistent with the dominant medical theory.

Unless there is a very clear pattern that would be obvious by now (you only die of Covid if you not only have hypertension but have already had a heart-attack, or if you are on immune suppression therapy or otherwise severely immuno-compromised); absent such patterns, "risk-factors and genetics" is the go-to explanation for why some populations survive a selective pressure and some don't, without good individual predictors available at the start: it's how evolution usually works, so no reason to assume it's not happening with Covid; i.e. it obviously doesn't help to be obese or have hyper-tension or smoke or be old and frail, but the virus maybe only particularly lethal with certain particular kinds of proteins on cells; i.e. certain genes or particular epigenetic gene expression or specific immune system history (such as getting or not getting some particular common cold in the past by random chance).

Therefore, it's more reasonable to assume there is large random variation determining individual deaths from Covid from among large risk groups (as this is the pattern we actually see) and subsequently assume that deaths from other causes will continue, perhaps even increase (for the purposes of decision making), than to assume actuary and medical science is wrong (foundationally, not just some specific issue) and there are some hidden variables that dominate the real determination of both individual death each year, for instance not just heart disease but having "the weakest heart" (but in a way we can't measure), and individual death from Covid (and these hidden variables would need to be the same in both cases to boot; the hypothesis is implausible, and even if true, it's still implausible) resulting in Covid deaths tending to lighten the burden on the health system from other causes of death (as those deaths are now dead from Covid, no longer available to die of something else).

Of course, there can be second order effects that actually do reduce deaths (people drive less and therefore there are less accidents) but this has nothing to do with the statistical overlap discussed here but a consequence of our response to Covid (it's entirely reasonable for modelers to estimate less traffic due to lock-downs, and therefore less accidents and therefore position less traffic accident resources; this was an obvious lock-down health-care hypothesis that has already been proven true; but another hypothesis that people who need care for other things don't get care and therefore die at a higher rate also seems to be proven true).

Reply to Isaac I was not trying to make a point, I was trying to work out what Boethius's point is.

For me the confusion seems to be in dividing group 1 from group 2. So I phrased it in terms of those who are, or are not destined (absent the Covid epidemic) to die during 2020. Thus confining members of each group to their group, eliminating overlap between the groups.

So when we include Covid the size of each group is unchanged with no overlap. But in this case a percentage of group 2 does die in 2020, solely due to contracting Covid.

The idea being to tease out what Boethius is trying to say.

Reply to boethius I was asking about those who do catch Covid, I even put it in bold.

So it looks like you're saying that not many in group 1 die in 2020 because only a small amount of them will become infected?
Unfortunately we don't know how many will become infected by 31st of December.
Also that just as many by percentage of fit and healthy people get it to( perhaps the size of the group 1 by percentage is important here).

Regarding group 2 your wall of text suggests to me that you disagree with my 60% of those infected? Where would you estimate the figure? Or do you think it can't be estimated for the reasons you give?

Quoting Punshhh

So it looks like you're saying that not many in group 1 die in 2020 because only a small amount of them will become infected?

Well, I'm relating this group to my discussion with Isaac.

If this group was very large and most deaths from Covid came from this group, then Covid deaths displace near-future deaths.

If this this group is small and people are dying of Covid outside this group then this effect is small. If, for our purposes of decision making now, this group has not even gotten Covid much, then the effect so far is even smaller and so even less likely this group is displacing near-future deaths.

However, if your question is simply if we can be 95% sure people who are destined to die in 2020 would die of Covid if they get it, then no we can't make that assumption. It doesn't really matter what we assume, as they are going to burden the health care system either way, but we'd have to know more about these people; maybe they have some terminal disease that doesn't affect their resistance to Covid (they experience Covid as just a cold and go onto die from a heart attack this year anyways).

Reply to Punshhh

Thanks, that ties in with what I thought you were doing, but I wasn't sure.

So it might help to put some numbers in?

Group 1 - those who are going to die this year is about 500,000, but when we're talking about overlap of comorbidities, we're only really interested in a sub-group {those who are going to die this year from underlying health issues}. That's about 300,000 - taking away accident and intentional self-harm.

Group 2 - comorbidities which will not lead to death this year. About 2.5 million for cancer, 7.4 million for heart disease. Other risk groups are much smaller, so we could say about 11 million.

Group 3 - some proportion of the remainder (about 59 million) who will, despite a lack of comorbidity die from coronavirus. We know from the studies that this group is somewhere between 0 and 9 % of all coronavirus deaths, so taking Prof Ferguson's latest estimate of 20,000, and a mid-range estimate, this group would be about 1,000 people.

So the question is how the remaining 19,000 estimated deaths will be distributed between groups 1 and 2.

We know that this group (the 19,000) will have comorbidities serious enough to be listed as a cause of death. So we can re-label this group, group A {those with comorbidities serious enough to appear as a cause of death}

As you can see, the size of groups 1 and 2 is irrelevant right now. The question is solely about the nature of group A. Is group A drawn mostly from group 1 or mostly from group 2? Group 2 being bigger only makes a difference if group A is being drawn from the pooled group 1+2 at a bias that is significantly less than the 3 in 100 ratio between the group sizes (boethius's contention).

Disputing even the lower of the estimates for overlap (50%), we'd need to argue that fewer than 49% of those in group A are drawn from group 1. Ie we'd have to say that the group of people so ill with a condition that it is listed as a cause of death is not even majoratatively drawn from a group of people so ill with that same condition that they are going to die of it later this year.

To me, such a contrary contention would require a substantial amount medical evidence demonstrating its veracity and the mechanism by which it acts. (not to mention the reason why the country's leading expert on pandemics has somehow missed this fact in his training thus far)

Quoting Punshhh

Regarding group 2 your wall of text suggests to me that you disagree with my 60% of those infected? Where would you estimate the figure? Or do you think it can't be estimated for the reasons you give?

Yes, I realized I didn't directly answer your question after posting, but have already fixed that:

Quoting boethius

The basic pattern is Covid doubles your risk of death this year. Most people who have a risk of death "within 10 years" don't have 30% risk of death this year and therefore 60% risk of death with Covid this year (which is still not 60% chance of death from Covid). If a person of high risk of death with in 10 years has 5% risk of death this year, then their risk of death of Covid seems to be also 5% (therefore 10% within the year).

(The wall of text has all the critical elements to understand the statistical situation. Statistical reasoning is hard precisely because there are usually no short answers for any real world situation.)

Quoting Isaac

such a contrary contention would require a substantial amount medical evidence demonstrating its veracity and the mechanism by which it acts.

I should also add to this that I'm speaking hypothetically. This work has already been done and disputes the claim.

From the BMJ:Independent predictors of mortality were diabetes mellitus, a history of renal dysfunction (or higher creatinine), New York Heart Association (NYHA) functional class III or IV, lower weight or body mass index, lower blood pressure, ankle oedema, and higher scores on a disease specific quality of life questionnaire...A prognostic model produced on the basis of easily obtainable information from medical history and physical examination can adequately stratify heart failure patients according to their short term risk of death. (my bolding)

It is not a mystery what factors are linked to mortality in people with serious conditions, there are entire libraries filled with papers about prognosis of mortality from various conditions.

@Punshhh - should have tagged you in to the post above

Reply to Punshhh

Looking at a demographics chart can be really useful to get a sense of what's going on:



Yes, 80-90 year old's have a higher likelihood of dying of Covid (if they get Covid), but they are a small group. They are also not only a small group, but most not "going to die within 1 year" (an even smaller group within the +80 group). They mostly have 10-20% chance of death this year.

Further ordering by risk -- you can visualize as taking very sick people out of younger cohorts and placing them with people in the +80 cohort -- doesn't significantly alter the picture, no where close enough people would be moving around cohorts to turn this sort by age into sort by risk, to arrive at "people who would die of Covid" and "people who would die in 2020" overlapping significantly (more than a numerically small amount), unless Covid was a disease of the terminally ill (which we would know by now; such diseases simply cannot bring medical systems to their knees, they can clear out hospitals of critical patients, which is unfortunate, but the outbreak then ends).