8 ms·

>It's good to see a piece that shows how complex the science behind COVID is, in the middle of so many contradictory or over-simplified news. It's rather unfor

by schemy 6y ago

>It's good to see a piece that shows how complex the science behind COVID is, in the middle of so many contradictory or over-simplified news. It's rather unfortunate how politicized the whole issue is. I got banned from reddit for pointing out that without knowing what the r0 was for asymptomatic patients any type of lock down tells you more about the psychology of the person for or against it than about its effectiveness.

enkid 6y ago
I mean, all you really have to know is that the r0 for asymptomatic patients is > 1 or that symptomatic patients aren't going to be perfect and are going to be going out when they are sick (or most likely a combination of the two). I think we've had enough evidence of that for a while now. The way you write your comment seems rather condescending and anti-lockdown when what we've seen is that "shutdowns" have saved lives.
- schemy 6y ago
  The sheer hubris of your post is the problem I'm talking about. Banning cars saves lives. Forcing everyone to wear a helmet when walking saves lives. Banning sugar saves lives. The issue is how many lives and at what cost? I'll wait to see how many millions end up homeless before I say that the lock downs saved lives anywhere where they were implemented.
  - nickthemagicman 6y ago
    This so much. The economy IS lives! People putting food on the table. I feel like it's that train track problem where you have a train barreling at three people and we just pulled the lever and had it kill 40 people instead.
    - schemy 6y ago
      You are far too optimistic with how wrong things can go. The economy running smoothly is what keeps revolutions and wars from happening. The last time the wheels fell off as badly as they did over the last three months we had WWII happen within a decade. We are lucky that it is a sharp shock and it is probably recoverable, but the longer we keep this up the slower the recovery will be. And given how popular extremist ideas were even before a 25% unemployment wall it is not something I want to play with.
      - nickthemagicman 6y ago
        Have had those same exact thoughts that poverty leads to war and other terrible stuff. The people supporting these extreme coronavirus measures have good intentions but don't seem to understand the law of unintended consequences.
        ghthor 6y ago
        Yeah, it's a mess out there. One thing I've noticed is just how narrow people viewpoints are, if they could just take a step back and look at the whole picture they might start finding some common ground. The government is overstepping its responsibility rig but now, and far too many people are cheering it on, it's dangerous.
    - bildung 6y ago
      Or just help those 40 people with federal funds, which is what every other rich country did, and _which worked_? The problem isn't the lockdown (the US didn't even have a proper lockdown, compared to European countries), the problem is lack of federal help to compensate the losses. The US GDP shrinkage in Q2 2020 was three times larger than that of e.g. Germany and France, despite these countries having harder lockdowns. Now those countries are mostly done with Covid, while the US still has over 1000 deaths a day _plus_ the economical costs of Covid.
      - makomk 6y ago
        The US GDP shrinkage in Q2 2020 was smaller than Germany, France and even the average of the entire Eurozone. You've been caught out by the fact that the widely-quoted US quarterly figure is annualized by multiplying the actual change in GDP during that quarter by four, whereas the figures for European countries are how much GDP actually shrunk by in that quarter. (Some widely-trusted organisations which should know better even quoted both figures side-by-side in the same article with no warning explaining they weren't comparable. I'm looking at you, BBC.) If they were actually comparable rather than the US having less of a decrease in GDP, the US figure would be four times the European one rather than three due to that annualization.
        bildung 6y ago
        I stand corrected, annualized the quarterly shrinkage of US and Germany are about the same. This sadly doesn't change the main point, though: Most of the hardships of employees and small businesses are specific results of the lack of proper relief in the US, without the US economy having gained an advantage out of this.
  - gfxgirl 6y ago
    your post has just as much hubris. you seem to be suggesting the no lockdowns would have no impact on the economy. There are plenty of knowledgable people that believe the impact on the economy would be even worse without lockdowns. I'm not saying they are right, just pointing out you seem to be implying there's only 2 possibilities 1. we lockdown and the economy goes to bad which kills people because of lack of income 2. we don't lockdown and the economy magically stays strong. There's other possibilities. 3. we don't lockdown, the pandemic kills millions, the economy goes down more than if we had locked down. 4. ??
    - schemy 6y ago
      >you seem to be suggesting the no lockdowns would have no impact on the economy. No. I'm suggesting that acknowledging the cost of lockdowns is something that is not allowed to be discussed in liberal circles. 4: World war 3 caused by the economic collapse and radicalization of the population. You know, like the last time there was mass sustained unemployment.
      - adrianN 6y ago
        You are currently discussing the cost of lockdowns in fairly liberal circles.
        coldtea 6y ago
        And getting downvoted to death, so he does have some point...
        schemy 6y ago
        It's kind of funny honestly. Ah well, the mob wants it pound of flesh. Who are we to deny them?
      - ghthor 6y ago
        You're not alone, it's hard to have these conversations mostly because they devolve into libel attacks that people opposed to lockdowns or wearing masks dont care about other people.
  - GavinMcG 6y ago
    The difference is that a lockdown can predictably drop r0 below 1 over a relatively finite amount of time. It doesn't need to be ongoing, as in your examples. Also, the U.S. did not conduct a lockdown. By all means, look to the countries that did, and see how many new homeless that created.
    - schemy 6y ago
      Australia is looking at up to 40% of all households with mortgages to be foreclosed on within the next 3 years: https://www.abc.net.au/news/2020-06-04/covid-recession-mortgage-stress-default-home-loans-jobkeeper/12318274 https://www.abc.net.au/news/2020-06-04/covid-recession-mortg...
      - lkrubner 6y ago
        The Australian government does not have the power to bring the dead to life but it does have the power to bail-out home owners, and everyone else badly effected by the economic crisis. Given that the economic problems can be offset with enough economic stimulus, but dead people can not be brought back to life, it seems obvious which course should be taken.
      - morsch 6y ago
        I guess you are referring to the "mortgage stress" number from the article (37.5%). That sounds high, but it was 32.7% already in December 2019[1]. And you are throwing statistics out there without bothering to make an argument. Being in mortgage stress certainly isn't the same as being homeless now or in the future. https://www.savings.com.au/home-loans/1-1-million-households-now-under-mortgage-stress https://www.savings.com.au/home-loans/1-1-million-households...
      - doctor_eval 6y ago
        Also, after the first Victorian attempt to control CV19 through lockdown succeeded and lockdown was raised, there was a significant quarantine breach, after which infections ran out of control. This evidence completely invalidates the premise of your first point regarding r0. Had people actually observed the restrictions, the Victorian economy would be fully open, like New Zealand is now.
  - zuminator 6y ago
    Let's assume for now that you are correct, economy-first is best. Then, has the Federal government pursued the optimal course of action to make economy-first practical and successful? If not, then why not? And also, if not, then is it possible that given the lack of a solid comprehensive plan from the Feds, the r-flattening strategy has been left as unfortunately the most reasonable course of action? On the other hand, if the Federal government has properly laid out the optimal pro economy-first course of action, or close enough to it, then how is it that we are not implementing it, at least in parts of the country? The US has 50 states, many which are dominated by conservatives who like the President, are not broadly in favor of lockdowns. Why haven't those states insisted upon going full steam ahead with economy first, and proving the efficacy of that choice? Why do even conservative, business-friendly, Trump-loyal states keep backtracking and implementing partial lockdowns if they are such a ruinously counterproductive idea? My own opinion is that the Feds have failed at every level, leaving the states with no choice but to flounder through this pandemic with only bad options. Had we taken comprehensive nationwide steps to stop the spread of the virus, especially at the early stages, shutdowns may have been unnecessary or greatly lessened in severity. And had we taken more wholehearted steps to mitigate the economic effects of the shutdowns, we would be in a much healthier position overall to ride out temporary drops of economic activity without the irreversible effects we are currently facing. But I'm curious as to what you think the best economy- and lifesaving strategy would've been.
GlennS 6y ago
At this point (and for a few of months now), surely you don't need to know the R0 value? Why not just look at other countries, see which have had the best outcomes, and copy them?
- schemy 6y ago
  >Why not just look at other countries, see which have had the best outcomes, and copy them? Because if the R0 value for asymptomatic cases is high enough you will need 2 week quarantine for all travelers and fortress boarders until the virus is eradicated everywhere. Something New Zealand is currently doing after implementing the most draconian nation wide lock-down. Do you support a barb wire wall around both the Canadian and Mexican border with lethal force counter measures if anyone tries to pass and forced isolation of all travelers?
  - GlennS 6y ago
    If you think New Zealand's approach is infeasible, perhaps instead take inspiration from some of the countries with land borders that are doing well?
    - nradov 6y ago
      After some initial problems, Sweden appears to be doing well for the past several weeks.
      - bildung 6y ago
        I wouldn't say so. The economical costs are very similar to its neighbors Denmark and Norway (around -6% GDP growth projected for 2020), but the death rate is 10x higher in Sweden.
      - dmitriid 6y ago
        > doing well for the past several weeks. How convenient of you to ignore all the weeks prior to "the past several" as in: significantly higher mortality rates than any of its neighbours. And the end result? Worst recession since WWII.
doliveira 6y ago
"No one knows everything" is much different from "No one knows anything so anyone can make anything up". We already know that it is bigger than 1. And you're mistaken if you think your comment has no political connotation.
- schemy 6y ago
  >We already know that it is bigger than 1. Do we? Do you have a study?
  - doliveira 6y ago
    There are quite a few studies showing that asymptomatic carry just as much viral load, and pre-symptomatic transmission is a thing as well. But I don't think you want to be convinced. Like you said, it has become politicized.
    - schemy 6y ago
      Please provide the doi.
      - doliveira 6y ago
        They're a Google search away. Are you aware that you're the one with the extraordinary claim?
        doliveira 6y ago
        But anyway, I do regret entering this discussion. I hope I was not disrespectful.
        roenxi 6y ago
        https://apps.who.int/iris/bitstream/handle/10665/332293/WHO-2019-nCov-IPC_Masks-2020.4-eng.pdf?sequence=1&isAllowed=yed=y https://apps.who.int/iris/bitstream/handle/10665/332293/WHO-... > Comprehensive studies on transmission from asymptomatic individuals are difficult to conduct, but the available evidence from contact tracing reported by Member States suggests that asymptomatically-infected individuals are much less likely to transmit the virus than those who develop symptoms. > The available data, to date, on onward infection from cases without symptoms comes from a limited number of studies with small samples that are subject to possible recall bias and for which fomite transmission cannot be ruled out. Go looking for evidence on the internet I suspect anything can be supported. I stopped trying to keep up with the evidence a few months ago; but certainly as of May I was infuriated by how little actual knowledge seemed to be disseminating about how, in detail, this thing spreads. There is a lot of 'common sense' out there that appears to be unsupported by attempts to gather and work to evidence. I havn't seen anything so far to suggest that asymptotic transmission is the problem. My theory is that people are ignoring quarantines if they have mild symptoms - but again, no evidence.
monkeydreams 6y ago
> I got banned from reddit for pointing out You got banned from reddit. As in the whole site? For merely pointing this out? I see a lot of users stake out similar positions all the time without ramification. Perhaps you were banned from a subreddit, or perhaps this isn't the full story. > without knowing what the r0 was for asymptomatic patients any type of lock down tells you more about the psychology of the person for or against it than about its effectiveness. Aaah, the old "I don't know 100% that this blotch on your face is a melanoma because I'm not an oncologist, therefore don't do anything about it" line of thinking. A few points: 1. We have a good history of containing pandemics, using simple processes and practices. We begin by following these. 2. We have a good handle on how to reduce and control the outbreak of COVID-19. This has demonstrated that total eradication of the disease is possible within certain populations (i.e. island populations, areas with strong border controls). This has also demonstrated that flattening the curve only works if you do not ease up on the curve-flattening practices (i.e. Japan, Korea, Singapore, Australia). 3. The impact on areas of high infection is not linear - due to the effectiveness of medical intervention when such intervention is not overwhelmed, flattening the curve significantly reduces overall deaths and allows for control of the disease even after it has reached relatively high saturation within the population. 4. Conversely, when medical capability is overwhelmed or absent, the death rate climbs significantly. (The US, UK and Iran demonstrate this). This is the "bulldozer mortuary" and "death panel triage" point in the pandemic. 5. The economic impact is not solely driven by lockdown. The US has limited lockdown, and they are being impacted severely because of lack of demand (people don't want goods at the price of their health). The government people seem to think the only driver of impact is Supply-side (i.e. shut down shops and the economy dies), and have completely underestimated people's willingness to sacrifice their health for the economy. 6. The biggest questions we don't know are the long term impacts of the virus on sufferers and the potential range of this impact does not extend into the positive. It appears to cause long-term damage to the cardiovascular system, and potentially the brain and other organs as well. We are seeing upswings in strokes, heart disease, and general mortality in sufferers and those who have recovered. To top it off, the potential lower end of this range appears extremely negative - with drastically lowered life expectancy in older patients and the potential for things such as a rise in dementia and significant cv illness as those who have recovered grow older. With all of this answers that we have, and identifying the questions yet to answer, the path is very fucking clear. Countries which do something appear to end up much better off. Those who do not, fare far worse. Pointing to an economic impact now, as people are doing with Sweden, is only part of the answer and is an indication of the best picture of Swedish public health - there is nothing which will improve and the picture will only grow worse as time passes. Whereas for NZ, Australia, etc, they have borne or are bearing the impact, and will have a healthier, fitter and less traumatised population to revive demand again when things improve.
snowwrestler 6y ago
R0 is an observed metric, not an inherent metric. That is, the R0 for asymptomatic patients depends on how those patients interact with other humans, not just on how the disease works. Reducing human interactions will reduce R0 for every communicable disease including COVID-19. This is highlighted on the Wikipedia page, for example: > R_{0} is not a biological constant for a pathogen as it is also affected by other factors such as environmental conditions and the behaviour of the infected population. https://en.wikipedia.org/wiki/Basic_reproduction_number https://en.wikipedia.org/wiki/Basic_reproduction_number We don't need to know the R0 to know that COVID-19 causes abnormal impacts on society like increased hospitalizations and deaths; those abnormal impacts are how we discovered the disease in the first place. Those are the reason that affected societies are changing how they work temporarily to mitigate the impact of the disease.

by schemy 6y ago

enkid 6y ago

I mean, all you really have to know is that the r0 for asymptomatic patients is > 1 or that symptomatic patients aren't going to be perfect and are going to be going out when they are sick (or most likely a combination of the two). I think we've had enough evidence of that for a while now. The way you write your comment seems rather condescending and anti-lockdown when what we've seen is that "shutdowns" have saved lives.

schemy 6y ago
The sheer hubris of your post is the problem I'm talking about. Banning cars saves lives. Forcing everyone to wear a helmet when walking saves lives. Banning sugar saves lives. The issue is how many lives and at what cost? I'll wait to see how many millions end up homeless before I say that the lock downs saved lives anywhere where they were implemented.
- nickthemagicman 6y ago
  This so much. The economy IS lives! People putting food on the table. I feel like it's that train track problem where you have a train barreling at three people and we just pulled the lever and had it kill 40 people instead.
  - schemy 6y ago
    You are far too optimistic with how wrong things can go. The economy running smoothly is what keeps revolutions and wars from happening. The last time the wheels fell off as badly as they did over the last three months we had WWII happen within a decade. We are lucky that it is a sharp shock and it is probably recoverable, but the longer we keep this up the slower the recovery will be. And given how popular extremist ideas were even before a 25% unemployment wall it is not something I want to play with.
    - nickthemagicman 6y ago
      Have had those same exact thoughts that poverty leads to war and other terrible stuff. The people supporting these extreme coronavirus measures have good intentions but don't seem to understand the law of unintended consequences.
      - ghthor 6y ago
        Yeah, it's a mess out there. One thing I've noticed is just how narrow people viewpoints are, if they could just take a step back and look at the whole picture they might start finding some common ground. The government is overstepping its responsibility rig but now, and far too many people are cheering it on, it's dangerous.
  - bildung 6y ago
    Or just help those 40 people with federal funds, which is what every other rich country did, and _which worked_? The problem isn't the lockdown (the US didn't even have a proper lockdown, compared to European countries), the problem is lack of federal help to compensate the losses. The US GDP shrinkage in Q2 2020 was three times larger than that of e.g. Germany and France, despite these countries having harder lockdowns. Now those countries are mostly done with Covid, while the US still has over 1000 deaths a day _plus_ the economical costs of Covid.
    - makomk 6y ago
      The US GDP shrinkage in Q2 2020 was smaller than Germany, France and even the average of the entire Eurozone. You've been caught out by the fact that the widely-quoted US quarterly figure is annualized by multiplying the actual change in GDP during that quarter by four, whereas the figures for European countries are how much GDP actually shrunk by in that quarter. (Some widely-trusted organisations which should know better even quoted both figures side-by-side in the same article with no warning explaining they weren't comparable. I'm looking at you, BBC.) If they were actually comparable rather than the US having less of a decrease in GDP, the US figure would be four times the European one rather than three due to that annualization.
      - bildung 6y ago
        I stand corrected, annualized the quarterly shrinkage of US and Germany are about the same. This sadly doesn't change the main point, though: Most of the hardships of employees and small businesses are specific results of the lack of proper relief in the US, without the US economy having gained an advantage out of this.
- gfxgirl 6y ago
  your post has just as much hubris. you seem to be suggesting the no lockdowns would have no impact on the economy. There are plenty of knowledgable people that believe the impact on the economy would be even worse without lockdowns. I'm not saying they are right, just pointing out you seem to be implying there's only 2 possibilities 1. we lockdown and the economy goes to bad which kills people because of lack of income 2. we don't lockdown and the economy magically stays strong. There's other possibilities. 3. we don't lockdown, the pandemic kills millions, the economy goes down more than if we had locked down. 4. ??
  - schemy 6y ago
    >you seem to be suggesting the no lockdowns would have no impact on the economy. No. I'm suggesting that acknowledging the cost of lockdowns is something that is not allowed to be discussed in liberal circles. 4: World war 3 caused by the economic collapse and radicalization of the population. You know, like the last time there was mass sustained unemployment.
    - adrianN 6y ago
      You are currently discussing the cost of lockdowns in fairly liberal circles.
      - coldtea 6y ago
        And getting downvoted to death, so he does have some point...
        schemy 6y ago
        It's kind of funny honestly. Ah well, the mob wants it pound of flesh. Who are we to deny them?
    - ghthor 6y ago
      You're not alone, it's hard to have these conversations mostly because they devolve into libel attacks that people opposed to lockdowns or wearing masks dont care about other people.
- GavinMcG 6y ago
  The difference is that a lockdown can predictably drop r0 below 1 over a relatively finite amount of time. It doesn't need to be ongoing, as in your examples. Also, the U.S. did not conduct a lockdown. By all means, look to the countries that did, and see how many new homeless that created.
  - schemy 6y ago
    Australia is looking at up to 40% of all households with mortgages to be foreclosed on within the next 3 years: https://www.abc.net.au/news/2020-06-04/covid-recession-mortgage-stress-default-home-loans-jobkeeper/12318274 https://www.abc.net.au/news/2020-06-04/covid-recession-mortg...
    - lkrubner 6y ago
      The Australian government does not have the power to bring the dead to life but it does have the power to bail-out home owners, and everyone else badly effected by the economic crisis. Given that the economic problems can be offset with enough economic stimulus, but dead people can not be brought back to life, it seems obvious which course should be taken.
    - morsch 6y ago
      I guess you are referring to the "mortgage stress" number from the article (37.5%). That sounds high, but it was 32.7% already in December 2019[1]. And you are throwing statistics out there without bothering to make an argument. Being in mortgage stress certainly isn't the same as being homeless now or in the future. https://www.savings.com.au/home-loans/1-1-million-households-now-under-mortgage-stress https://www.savings.com.au/home-loans/1-1-million-households...
    - doctor_eval 6y ago
      Also, after the first Victorian attempt to control CV19 through lockdown succeeded and lockdown was raised, there was a significant quarantine breach, after which infections ran out of control. This evidence completely invalidates the premise of your first point regarding r0. Had people actually observed the restrictions, the Victorian economy would be fully open, like New Zealand is now.
- zuminator 6y ago
  Let's assume for now that you are correct, economy-first is best. Then, has the Federal government pursued the optimal course of action to make economy-first practical and successful? If not, then why not? And also, if not, then is it possible that given the lack of a solid comprehensive plan from the Feds, the r-flattening strategy has been left as unfortunately the most reasonable course of action? On the other hand, if the Federal government has properly laid out the optimal pro economy-first course of action, or close enough to it, then how is it that we are not implementing it, at least in parts of the country? The US has 50 states, many which are dominated by conservatives who like the President, are not broadly in favor of lockdowns. Why haven't those states insisted upon going full steam ahead with economy first, and proving the efficacy of that choice? Why do even conservative, business-friendly, Trump-loyal states keep backtracking and implementing partial lockdowns if they are such a ruinously counterproductive idea? My own opinion is that the Feds have failed at every level, leaving the states with no choice but to flounder through this pandemic with only bad options. Had we taken comprehensive nationwide steps to stop the spread of the virus, especially at the early stages, shutdowns may have been unnecessary or greatly lessened in severity. And had we taken more wholehearted steps to mitigate the economic effects of the shutdowns, we would be in a much healthier position overall to ride out temporary drops of economic activity without the irreversible effects we are currently facing. But I'm curious as to what you think the best economy- and lifesaving strategy would've been.

GlennS 6y ago

At this point (and for a few of months now), surely you don't need to know the R0 value? Why not just look at other countries, see which have had the best outcomes, and copy them?

schemy 6y ago
>Why not just look at other countries, see which have had the best outcomes, and copy them? Because if the R0 value for asymptomatic cases is high enough you will need 2 week quarantine for all travelers and fortress boarders until the virus is eradicated everywhere. Something New Zealand is currently doing after implementing the most draconian nation wide lock-down. Do you support a barb wire wall around both the Canadian and Mexican border with lethal force counter measures if anyone tries to pass and forced isolation of all travelers?
- GlennS 6y ago
  If you think New Zealand's approach is infeasible, perhaps instead take inspiration from some of the countries with land borders that are doing well?
  - nradov 6y ago
    After some initial problems, Sweden appears to be doing well for the past several weeks.
    - bildung 6y ago
      I wouldn't say so. The economical costs are very similar to its neighbors Denmark and Norway (around -6% GDP growth projected for 2020), but the death rate is 10x higher in Sweden.
    - dmitriid 6y ago
      > doing well for the past several weeks. How convenient of you to ignore all the weeks prior to "the past several" as in: significantly higher mortality rates than any of its neighbours. And the end result? Worst recession since WWII.

doliveira 6y ago

"No one knows everything" is much different from "No one knows anything so anyone can make anything up". We already know that it is bigger than 1. And you're mistaken if you think your comment has no political connotation.

schemy 6y ago
>We already know that it is bigger than 1. Do we? Do you have a study?
- doliveira 6y ago
  There are quite a few studies showing that asymptomatic carry just as much viral load, and pre-symptomatic transmission is a thing as well. But I don't think you want to be convinced. Like you said, it has become politicized.
  - schemy 6y ago
    Please provide the doi.
    - doliveira 6y ago
      They're a Google search away. Are you aware that you're the one with the extraordinary claim?
      - doliveira 6y ago
        But anyway, I do regret entering this discussion. I hope I was not disrespectful.
      - roenxi 6y ago
        https://apps.who.int/iris/bitstream/handle/10665/332293/WHO-2019-nCov-IPC_Masks-2020.4-eng.pdf?sequence=1&isAllowed=yed=y https://apps.who.int/iris/bitstream/handle/10665/332293/WHO-... > Comprehensive studies on transmission from asymptomatic individuals are difficult to conduct, but the available evidence from contact tracing reported by Member States suggests that asymptomatically-infected individuals are much less likely to transmit the virus than those who develop symptoms. > The available data, to date, on onward infection from cases without symptoms comes from a limited number of studies with small samples that are subject to possible recall bias and for which fomite transmission cannot be ruled out. Go looking for evidence on the internet I suspect anything can be supported. I stopped trying to keep up with the evidence a few months ago; but certainly as of May I was infuriated by how little actual knowledge seemed to be disseminating about how, in detail, this thing spreads. There is a lot of 'common sense' out there that appears to be unsupported by attempts to gather and work to evidence. I havn't seen anything so far to suggest that asymptotic transmission is the problem. My theory is that people are ignoring quarantines if they have mild symptoms - but again, no evidence.

monkeydreams 6y ago

> I got banned from reddit for pointing out You got banned from reddit. As in the whole site? For merely pointing this out? I see a lot of users stake out similar positions all the time without ramification. Perhaps you were banned from a subreddit, or perhaps this isn't the full story. > without knowing what the r0 was for asymptomatic patients any type of lock down tells you more about the psychology of the person for or against it than about its effectiveness. Aaah, the old "I don't know 100% that this blotch on your face is a melanoma because I'm not an oncologist, therefore don't do anything about it" line of thinking. A few points: 1. We have a good history of containing pandemics, using simple processes and practices. We begin by following these. 2. We have a good handle on how to reduce and control the outbreak of COVID-19. This has demonstrated that total eradication of the disease is possible within certain populations (i.e. island populations, areas with strong border controls). This has also demonstrated that flattening the curve only works if you do not ease up on the curve-flattening practices (i.e. Japan, Korea, Singapore, Australia). 3. The impact on areas of high infection is not linear - due to the effectiveness of medical intervention when such intervention is not overwhelmed, flattening the curve significantly reduces overall deaths and allows for control of the disease even after it has reached relatively high saturation within the population. 4. Conversely, when medical capability is overwhelmed or absent, the death rate climbs significantly. (The US, UK and Iran demonstrate this). This is the "bulldozer mortuary" and "death panel triage" point in the pandemic. 5. The economic impact is not solely driven by lockdown. The US has limited lockdown, and they are being impacted severely because of lack of demand (people don't want goods at the price of their health). The government people seem to think the only driver of impact is Supply-side (i.e. shut down shops and the economy dies), and have completely underestimated people's willingness to sacrifice their health for the economy. 6. The biggest questions we don't know are the long term impacts of the virus on sufferers and the potential range of this impact does not extend into the positive. It appears to cause long-term damage to the cardiovascular system, and potentially the brain and other organs as well. We are seeing upswings in strokes, heart disease, and general mortality in sufferers and those who have recovered. To top it off, the potential lower end of this range appears extremely negative - with drastically lowered life expectancy in older patients and the potential for things such as a rise in dementia and significant cv illness as those who have recovered grow older. With all of this answers that we have, and identifying the questions yet to answer, the path is very fucking clear. Countries which do something appear to end up much better off. Those who do not, fare far worse. Pointing to an economic impact now, as people are doing with Sweden, is only part of the answer and is an indication of the best picture of Swedish public health - there is nothing which will improve and the picture will only grow worse as time passes. Whereas for NZ, Australia, etc, they have borne or are bearing the impact, and will have a healthier, fitter and less traumatised population to revive demand again when things improve.

snowwrestler 6y ago

R0 is an observed metric, not an inherent metric. That is, the R0 for asymptomatic patients depends on how those patients interact with other humans, not just on how the disease works. Reducing human interactions will reduce R0 for every communicable disease including COVID-19. This is highlighted on the Wikipedia page, for example: > R_{0} is not a biological constant for a pathogen as it is also affected by other factors such as environmental conditions and the behaviour of the infected population. https://en.wikipedia.org/wiki/Basic_reproduction_number https://en.wikipedia.org/wiki/Basic_reproduction_number We don't need to know the R0 to know that COVID-19 causes abnormal impacts on society like increased hospitalizations and deaths; those abnormal impacts are how we discovered the disease in the first place. Those are the reason that affected societies are changing how they work temporarily to mitigate the impact of the disease.