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Not everyone who needs medical help for Covid-19 needs a ventilator. Some just need supplemental oxygen. And people go to hospital with other conditions. If h

Not everyone who needs medical help for Covid-19 needs a ventilator. Some just need supplemental oxygen. And people go to hospital with other conditions. If hospitals are 100% overwhelmed with Covid-19 cases, then they may struggle to treat strokes, heart attacks, car crash victims, cancer patients, etc... Flattening the curve will save lives.

twblalock 6y ago
> Flattening the curve will save lives. Yes, but how many lives will it save? The answer is unclear but it seems to be lower than what most people would expect. The basic assumptions were not well supported when the decisions were made. All the models we had were based on a very, very low level of testing and unreliable information from other countries.
- paradoja 6y ago
  What is your source on this? This opinion seems to be against what experts continue saying.
- jhowell 6y ago
  What's an acceptable death rate look like for you? Anecdotally does that number change if we're talking about your life, or the lives of people you are responsible for?
  - twblalock 6y ago
    How many jobs lost per lives saved is worth it to you? 100? 1000? And how long are the lives saved being prolonged? In California it looks like more than 200 jobs could have been lost per life saved and that's a lot of human suffering. https://marginalrevolution.com/marginalrevolution/2020/04/california-estimate-of-the-day.html https://marginalrevolution.com/marginalrevolution/2020/04/ca...
    - evgen 6y ago
      Jobs come back. Dead people do not.
      - yellowapple 6y ago
        A lack of jobs can create dead people, whether through crime or through an inability to afford healthcare or shelter or food. I'm not convinced that such deaths outweigh the lives saved through these measures, but they're still worth mentioning if we want a full picture of the impact.
      - KKPMW 6y ago
        This might sound good as a sound bite but offers no thought behind it. One thing that is clear is that we cannot go to extremes on either end. On one side - we cannot stop the economy to contain the virus, because that would turn into every person having to grow their own food and carry their own water with a bucket from the river. Many many people would also die. On the other side - we also cannot ignore the pandemic and carry as if nothing is happening because that would over-burden the hospitals to the point that they will not be able to treat people with other issues. Many many people would die as well. So there indeed has to be a balance. And the question "what price are we willing to pay for saving a life" seems to be on point.
      - twblalock 6y ago
        A lot of the jobs that were lost won't come back for years. It's not like we can flip a switch and all the businesses that closed will be open again. The small business economy has been destroyed.
    - typon 6y ago
      Have you accounted for the human suffering caused by the loss of those lives on the survivors? How many jobs is that worth?
    - tluyben2 6y ago
      True, but that outlook depends a lot on age, life experience and other factors; a lot of people will agree with you unless it's their own life/family. Also; por qué no los dos? The USA has enough money and resources (and billionaires) to save the lives + not have the suffering (basic income/welfare). That they choose not to might not be the concern of the people who voted for those things but got Trump; they don't want their lives or loved ones to be chosen over 'jobs/economy' just because the people in power are overly greedy and short-sighted.
  - yodsanklai 6y ago
    > What's an acceptable death rate look like for you? We make arbitrage like this when setting pollution laws, or speed limits. The issue here is that we don't know the cost of flattening the curve. We know that GDP is strongly correlated with life expectancy, and the loss of GDP worldwide will have important sanitary impact, but it's hard to quantify this. That being said, I'm not saying we shouldn't try to flatten the curve. Considering we don't have the data to make the right decision, we use a greedy algorithm. But I'm quite convinced that we'll be worse off in the long term. Incidentally, we choosing to save old people over poor people.
    - rat87 6y ago
      Most economists say we should listen to health professionals and not re-open to early. And that if we do re-open too early its likely to cause more long term damage to the economy http://www.igmchicago.org/surveys/policy-for-the-covid-19-crisis/ http://www.igmchicago.org/surveys/policy-for-the-covid-19-cr...
      - leereeves 6y ago
        That's from a month ago.
      - thedudeabides5 6y ago
        Most economists have stayed as far as humanely possible from evaluating lives vs GDP. Which is a shame. It’s like the one example where some back of the envelope yet informed numbers might improve public policy vs the status quo..blind panic and a livelihood crippling total lockdown.
  - baddox 6y ago
    I’m not sure if it’s possible to have an earnest conversation about that when one party can easily claim the moral high ground by expressing outrage that the other party might not be willing to go to literally all costs to save a single life.
    - Tostino 6y ago
      I do see some of that argument being made, however, I see a lot more false information coming from one side, as well as ignoring the advice of experts, and actively quieting people in the government who dare to publicly disagree with the president's statements. So, yeah it is pretty hard to have an unbiased discussion on this. I obviously have my own biases here :).
    - leereeves 6y ago
      > the other party might not be willing to go to literally all costs to save a single life. That's an easy thing to say if the cost you pay is working from home and not going out on the town. Not so easy when the cost is the end of a small business you worked years to build.
  - thinkharderdev 6y ago
    To be clear, I fully support Strict social distancing and think the idea of their being a trade-off between government policy on the matter and economic performance is off-base. People will social distance whether the government tells them to or not, and if the pandemic worsens substantially then the economic impact will be even worse. That is to say that the best thing to do from both a lives saved AND an economic perspective is to contain the pandemic to a manageable level. </br> All that throat clearing out of the way... this is a silly argument and one that is not applied in any other domain. Should we ban cars? How can you possibly say that the many thousands of people who die in automobile accidents each year are an acceptable loss of life?
    - gpderetta 6y ago
      > Should we ban cars? From cities? You'll find that many will agree with that. I do agree with your general point though.
    - overlordalex 6y ago
      > Should we ban cars? To put it in perspective, approximately 37,000 people die per YEAR from automobile accidents in the USA With all the measures already in place, and strong possibilities of under counting COVID19 has already killed more than 50,000 people in less than 4 months. A better argument would be banning obesity. ~300,000 people die from obesity related diseases every year
      - nradov 6y ago
        Obesity is actually the top chronic condition risk factor for COVID-19.
    - rurban 6y ago
      We definitely need to ban all cars, airplanes, busses. But more importantly close all factories and borders. Forbid sodas. We need to safe every single life. Bonkers.
  - austhrow743 6y ago
    You can save the life of a child for like $3k so the life of a diseased old person should probably be worth either that or lower.
- yomly 6y ago
  I read the study and nowhere does it mention when or how ventilators were applied. If ventilators are a scarce resource/bottleneck and ventilation is applied by prioritisation then I could see the mortality rate skewing up as a function of treatment being applied too late. It is worth bearing in mind the mortality rate of non-swamped health care systems. For every NYC/Paris/Lombardy/Wuhan there is a South Korea/Taiwan/Hong Kong with very different data profiles. I would love to see the mortality rate for ventilation support in these countries/cities...
slavik81 6y ago
Can we expand the capacity of the healthcare system for those treatments? Oxygen is not without danger, but it can be safely handled by non-professionals, and it's relatively easy to manufacture. I've never actually heard anybody discuss any treatments besides ventilators, so I have no idea what's feasible.
- pas 6y ago
  Remdesivir seems promising, also variolation, also plasma therapy (IVIG). Currently the lockdown makes sense for one reason, to get something that at least makes it seasonal flu-deadly (about 5-10 times less than currently).
  - DanBC 6y ago
    Accidental release of data for remdesivir showed no benefit. https://www.statnews.com/2020/04/23/data-on-gileads-remdesivir-released-by-accident-show-no-benefit-for-coronavirus-patients/ https://www.statnews.com/2020/04/23/data-on-gileads-remdesiv... Maybe the data wasn't ready for release, and the final version will show some benefit, but it's likely that remdesivir has little benefit. (Genuinely confused about why this got downvotes.)
    - deleted 6y ago
      [deleted]
    - op00to 6y ago
      People don’t like bad news.
    - pas 6y ago
      Thanks! Too bad :/ Last week it seemed promising... (I have no idea who would downvote your comment.)
  - VieEnCode 6y ago
    Remdesivir seems far less promising now, unfortunately: https://www.bbc.co.uk/news/world-52406261 https://www.bbc.co.uk/news/world-52406261
AlexTWithBeard 6y ago
But could oxygen be given outside of hospital environment?
- Amezarak 6y ago
  Oxygen is very regularly given outside of the hospital for a range of ailments. There is a thriving industry selling home and portable oxygen delivery units.

twblalock 6y ago

> Flattening the curve will save lives. Yes, but how many lives will it save? The answer is unclear but it seems to be lower than what most people would expect. The basic assumptions were not well supported when the decisions were made. All the models we had were based on a very, very low level of testing and unreliable information from other countries.

paradoja 6y ago
What is your source on this? This opinion seems to be against what experts continue saying.
jhowell 6y ago
What's an acceptable death rate look like for you? Anecdotally does that number change if we're talking about your life, or the lives of people you are responsible for?
- twblalock 6y ago
  How many jobs lost per lives saved is worth it to you? 100? 1000? And how long are the lives saved being prolonged? In California it looks like more than 200 jobs could have been lost per life saved and that's a lot of human suffering. https://marginalrevolution.com/marginalrevolution/2020/04/california-estimate-of-the-day.html https://marginalrevolution.com/marginalrevolution/2020/04/ca...
  - evgen 6y ago
    Jobs come back. Dead people do not.
    - yellowapple 6y ago
      A lack of jobs can create dead people, whether through crime or through an inability to afford healthcare or shelter or food. I'm not convinced that such deaths outweigh the lives saved through these measures, but they're still worth mentioning if we want a full picture of the impact.
    - KKPMW 6y ago
      This might sound good as a sound bite but offers no thought behind it. One thing that is clear is that we cannot go to extremes on either end. On one side - we cannot stop the economy to contain the virus, because that would turn into every person having to grow their own food and carry their own water with a bucket from the river. Many many people would also die. On the other side - we also cannot ignore the pandemic and carry as if nothing is happening because that would over-burden the hospitals to the point that they will not be able to treat people with other issues. Many many people would die as well. So there indeed has to be a balance. And the question "what price are we willing to pay for saving a life" seems to be on point.
    - twblalock 6y ago
      A lot of the jobs that were lost won't come back for years. It's not like we can flip a switch and all the businesses that closed will be open again. The small business economy has been destroyed.
  - typon 6y ago
    Have you accounted for the human suffering caused by the loss of those lives on the survivors? How many jobs is that worth?
  - tluyben2 6y ago
    True, but that outlook depends a lot on age, life experience and other factors; a lot of people will agree with you unless it's their own life/family. Also; por qué no los dos? The USA has enough money and resources (and billionaires) to save the lives + not have the suffering (basic income/welfare). That they choose not to might not be the concern of the people who voted for those things but got Trump; they don't want their lives or loved ones to be chosen over 'jobs/economy' just because the people in power are overly greedy and short-sighted.
- yodsanklai 6y ago
  > What's an acceptable death rate look like for you? We make arbitrage like this when setting pollution laws, or speed limits. The issue here is that we don't know the cost of flattening the curve. We know that GDP is strongly correlated with life expectancy, and the loss of GDP worldwide will have important sanitary impact, but it's hard to quantify this. That being said, I'm not saying we shouldn't try to flatten the curve. Considering we don't have the data to make the right decision, we use a greedy algorithm. But I'm quite convinced that we'll be worse off in the long term. Incidentally, we choosing to save old people over poor people.
  - rat87 6y ago
    Most economists say we should listen to health professionals and not re-open to early. And that if we do re-open too early its likely to cause more long term damage to the economy http://www.igmchicago.org/surveys/policy-for-the-covid-19-crisis/ http://www.igmchicago.org/surveys/policy-for-the-covid-19-cr...
    - leereeves 6y ago
      That's from a month ago.
    - thedudeabides5 6y ago
      Most economists have stayed as far as humanely possible from evaluating lives vs GDP. Which is a shame. It’s like the one example where some back of the envelope yet informed numbers might improve public policy vs the status quo..blind panic and a livelihood crippling total lockdown.
- baddox 6y ago
  I’m not sure if it’s possible to have an earnest conversation about that when one party can easily claim the moral high ground by expressing outrage that the other party might not be willing to go to literally all costs to save a single life.
  - Tostino 6y ago
    I do see some of that argument being made, however, I see a lot more false information coming from one side, as well as ignoring the advice of experts, and actively quieting people in the government who dare to publicly disagree with the president's statements. So, yeah it is pretty hard to have an unbiased discussion on this. I obviously have my own biases here :).
  - leereeves 6y ago
    > the other party might not be willing to go to literally all costs to save a single life. That's an easy thing to say if the cost you pay is working from home and not going out on the town. Not so easy when the cost is the end of a small business you worked years to build.
- thinkharderdev 6y ago
  To be clear, I fully support Strict social distancing and think the idea of their being a trade-off between government policy on the matter and economic performance is off-base. People will social distance whether the government tells them to or not, and if the pandemic worsens substantially then the economic impact will be even worse. That is to say that the best thing to do from both a lives saved AND an economic perspective is to contain the pandemic to a manageable level. </br> All that throat clearing out of the way... this is a silly argument and one that is not applied in any other domain. Should we ban cars? How can you possibly say that the many thousands of people who die in automobile accidents each year are an acceptable loss of life?
  - gpderetta 6y ago
    > Should we ban cars? From cities? You'll find that many will agree with that. I do agree with your general point though.
  - overlordalex 6y ago
    > Should we ban cars? To put it in perspective, approximately 37,000 people die per YEAR from automobile accidents in the USA With all the measures already in place, and strong possibilities of under counting COVID19 has already killed more than 50,000 people in less than 4 months. A better argument would be banning obesity. ~300,000 people die from obesity related diseases every year
    - nradov 6y ago
      Obesity is actually the top chronic condition risk factor for COVID-19.
  - rurban 6y ago
    We definitely need to ban all cars, airplanes, busses. But more importantly close all factories and borders. Forbid sodas. We need to safe every single life. Bonkers.
- austhrow743 6y ago
  You can save the life of a child for like $3k so the life of a diseased old person should probably be worth either that or lower.
yomly 6y ago
I read the study and nowhere does it mention when or how ventilators were applied. If ventilators are a scarce resource/bottleneck and ventilation is applied by prioritisation then I could see the mortality rate skewing up as a function of treatment being applied too late. It is worth bearing in mind the mortality rate of non-swamped health care systems. For every NYC/Paris/Lombardy/Wuhan there is a South Korea/Taiwan/Hong Kong with very different data profiles. I would love to see the mortality rate for ventilation support in these countries/cities...

slavik81 6y ago

Can we expand the capacity of the healthcare system for those treatments? Oxygen is not without danger, but it can be safely handled by non-professionals, and it's relatively easy to manufacture. I've never actually heard anybody discuss any treatments besides ventilators, so I have no idea what's feasible.

pas 6y ago
Remdesivir seems promising, also variolation, also plasma therapy (IVIG). Currently the lockdown makes sense for one reason, to get something that at least makes it seasonal flu-deadly (about 5-10 times less than currently).
- DanBC 6y ago
  Accidental release of data for remdesivir showed no benefit. https://www.statnews.com/2020/04/23/data-on-gileads-remdesivir-released-by-accident-show-no-benefit-for-coronavirus-patients/ https://www.statnews.com/2020/04/23/data-on-gileads-remdesiv... Maybe the data wasn't ready for release, and the final version will show some benefit, but it's likely that remdesivir has little benefit. (Genuinely confused about why this got downvotes.)
  - deleted 6y ago
    [deleted]
  - op00to 6y ago
    People don’t like bad news.
  - pas 6y ago
    Thanks! Too bad :/ Last week it seemed promising... (I have no idea who would downvote your comment.)
- VieEnCode 6y ago
  Remdesivir seems far less promising now, unfortunately: https://www.bbc.co.uk/news/world-52406261 https://www.bbc.co.uk/news/world-52406261

AlexTWithBeard 6y ago

But could oxygen be given outside of hospital environment?

Amezarak 6y ago
Oxygen is very regularly given outside of the hospital for a range of ailments. There is a thriving industry selling home and portable oxygen delivery units.