Let it burn

[Why Me]

This article makes the point I was thinking given that most (80%, 90%?) who get C-19 suffer no to mild symptoms: identify and protect the vulnerable (old/ill/...), but let others live and work normally, letting their immune systems deal with it. Some will catch it, maybe work on, maybe call in sick for a few days and recover. In the process vital herd immunity develops as well.

 

This way healthcare can be concentrated on those at risk without getting overwhelmed with millions clamoring for drugs and care who don't need it. And the whole country doesn't have to come to a grinding stop. Politically infeasible maybe ("How dare you propose allowing people to get sick?") but makes sense.

 

https://www.nytimes.com/2020/03/20/opinion/coronavirus-pandemic-social-distancing.html?action=click&module=Opinion&pgtype=Homepage

Edited March 22, 2020 by Why Me

[Lacessit]

The problem is hospitals being overwhelmed by the percentage of really sick people with life-threatening symptoms. Delaying the spread of the virus, also called flattening the curve, helps hospitals to cope. But if you want to be one of the people turned away from a hospital because they have run out of medical facilities to treat you, be my guest.

[donnacha]

What you describe is by far the smartest way to handle this sort of pandemic but, sadly, no democratically elected government can risk it. As the UK government learned very rapidly when they tried to introduce such a plan, a panicked population have no appetite for counterintuitive nuance, and the press will distort your intentions and keep bludgeoning your reputation until you give up and go do what every other country is doing.

Locking down the entire population is pure theatre. It is a big, expensive action designed to give the impression that something is being done. Very similar to the ridiculous restrictions introduced to air travel after 9/11, very few were about actually improving safety.

The calculus for any politician who wants to get re-elected is this:

"If I try a nuanced approach, and focus resources on protecting the vulnerable while allowing the economy to be going, my enemies will blame them for any deaths that do occur."

"On the other hand, if I shut everything down, and send the army onto the streets, I will be able to say I did all I could ... even if far more people die, and even if we keeping having to stop the economy every winter and Spring for years to come."

[donnacha]

If I was running Thailand, I would seize all unoccupied condos and use them to house anyone over 60 or with an underlying condition, or any couple with at least one such person, who currently share their home with younger members of their family. I would make it clear that, for six months, they could not go out or receive in-person visits. Only Facetime calls and free food deliveries. We would treat them as if contact with the outside world during that six month period could kill them. Which it could.

For that six month period, everyone else would continue to work or go to school, flights from anywhere would be allowed to keep coming. Most people would catch the virus, hopefully developing immunity, a very small number would require hospitalization, very few would die (average age of the death so far has been 79.9 years).

At the end of that six months, when the outbreak has burned itself out, everyone is reunited, the economy is still functioning, and we don't have to keep dealing with the same problem every year.

I would refuse to accept flights or trade from China until they close down the wet markets, to prevent the next epidemic. I would also send mercy squads of Thai cooks to teach the Chinese how to make tasty meals without bats and pangolins. 

 

Edited March 22, 2020 by donnacha

[HighPriority]

1 hour ago, Lacessit said:

The problem is hospitals being overwhelmed by the percentage of really sick people with life-threatening symptoms. Delaying the spread of the virus, also called flattening the curve, helps hospitals to cope. But if you want to be one of the people turned away from a hospital because they have run out of medical facilities to treat you, be my guest.

Yep, if everyone gets it at once we don’t have the medical resources to treat the old and vulnerable.

Surely it’s not that hard to sit reasonably still for a couple of weeks ?

[DannyCarlton]

4 minutes ago, donnacha said:

If I was running Thailand, I would seize all unoccupied condos and use them to house anyone over 60 or with an underlying condition, or any couple with at least one such person, who currently share their home with younger members of their family. I would make it clear that, for six months, they could not go out or receive in-person visits. Only Facetime calls and free food deliveries. We would treat them as if contact with the outside world during that six month period could kill them. Which it could.

For that six month period, everyone else would continue to work or go to school. Most people would catch the virus, hopefully developing immunity. At the end of that six months, when the outbreak has burned itself out, everyone is reunited, the economy is still functioning, and we don't have to keep dealing with the same problem every year.

I would also refuse to accept flights or trade from China until they close down the wet markets. 

50% of those hospitalised/seriously ill are under 50. The 2 doctors who died in Wuhan were in their 30's. The notion that only those over 70 and/or with pre existing conditions are in danger ia a dangerous fallicy.

[Skallywag]

Yes this CV virus is 3 times more contagious than the swine flus and avian flus we have been getting sick with for the last 25 years.  

Other parts of the world are experiencing "exponential" rises in infections.  But not Thailand.  

The prediction that every country will get an exponential increase in infections or deaths is always possible, but has not been shown as a reality at this time. 

We need to shelter in place and keep our hands clean and stay away from other people as much as possible. 

Why is that so difficult to understand? 

 

[donnacha]

37 minutes ago, DannyCarlton said:

50% of those hospitalised/seriously ill are under 50 ... or with pre existing conditions

Pre-existing is the wrong term in this context, that mainly applies to insurance, underlying is the usual term in a medical context.

Those with underlying conditions or other potential vulnerabilities (such as pregnancy) would, of course, include many people under the age of 60 and, sadly, people do not always know what conditions they have until they suddenly become a problem.

Even so, and despite the sad cases of medical workers who have died, the average age of those who die is around 80 - some are younger, some are older, around 80 is the mathematical average.

My understanding, and I could well be wrong, is that the over 60s are massively overrepresented in the ~20% who require hospitalization, and even more so in the roughly one tenth of those critical care patients who die.

If that is true, there is a solid argument for focusing most resources on protecting those who we know will be most vulnerable, old and young, while allowing the economy to continue.

What I am seeing in most Western countries is that it is apparently not possible to get the entire population to comply with a broad lockdown. My own sister is off out at house parties every night, indirectly exposing my elderly father. Just a few days in, some people are acting as if they have been locked up for months. I fear that, as a society, we are about to discover that a lockdown without strict enforcement is pretty much useless, even for just slowing down the outbreak. As a family, I fear we may learn our own deeply tragic lesson over the coming months. 




 

Edited March 22, 2020 by donnacha

[DannyCarlton]

9 minutes ago, Skallywag said:

Yes this CV virus is 3 times more contagious than the swine flus and avian flus we have been getting sick with for the last 25 years.  

Other parts of the world are experiencing "exponential" rises in infections.  But not Thailand.  

The prediction that every country will get an exponential increase in infections or deaths is always possible, but has not been shown as a reality at this time. 

We need to shelter in place and keep our hands clean and stay away from other people as much as possible. 

Why is that so difficult to understand? 

 

You have made an almost identical post in another thread expounding the same nonsense, so I'll give you the same reply.

 

https://www.aljazeera.com/news/2020/03/thailand-sees-biggest-jump-coronavirus-cases-200321135412582.html

 

"In Asia, Thailand reported 89 new cases - the biggest daily jump in the number of infections so far, taking its total to 411."

 

It is rising exponentially in Thailand, this is just the start of it.

 

Why is that so difficult to understand?

[baansgr]

55 minutes ago, donnacha said:

What you describe is by far the smartest way to handle this sort of pandemic but, sadly, no democratically elected government can risk it. As the UK government learned very rapidly when they tried to introduce such a plan, a panicked population have no appetite for counterintuitive nuance, and the press will distort your intentions and keep bludgeoning your reputation until you give up and go do what every other country is doing.

Locking down the entire population is pure theatre. It is a big, expensive action designed to give the impression that something is being done. Very similar to the ridiculous restrictions introduced to air travel after 9/11, very few were about actually improving safety.

The calculus for any politician who wants to get re-elected is this:

"If I try a nuanced approach, and focus resources on protecting the vulnerable while allowing the economy to be going, my enemies will blame them for any deaths that do occur."

"On the other hand, if I shut everything down, and send the army onto the streets, I will be able to say I did all I could ... even if far more people die, and even if we keeping having to stop the economy every winter and Spring for years to come."

Just let everybody get it with a mortality rate of 3%...so for the sake of not being able to have a beer or go clubbing, 2million UK citizens will die....unbelievable

[DannyCarlton]

4 minutes ago, donnacha said:

Pre-existing is the wrong term in this context, that mainly applies to insurance, underlying is the usual term in a medical context.

Those with underlying conditions or other potential vulnerabilities (such as pregnancy) would, of course, include many people under the age of 60 and, sadly, people do not always know what conditions they have until they suddenly become a problem.

Even so, and despite the sad cases of medical workers who have died, the average age of those who die is around 80 - some are younger, some are older, around 80 is the mathematical average.

My understanding, and I could well be wrong, is that the over 60s are massively overrepresented in the ~20% who require hospitalization, and even more so in the roughly one tenth of those critical care patients who die.

If that is true, there is a solid argument for focusing most resources on protecting those who we know will be most vulnerable, old and young, while allowing the economy to continue.

What I am seeing in most Western countries is that it is apparently not possible to get the entire population to comply with a broad lockdown. My own sister is off out at house parties every night, indirectly exposing my elderly father. I fear that, as a society, we are about to discover that a lockdown without strict enforcement is pretty much useless, even for just slowing down the outbreak. As a family, I fear we may learn our own deeply tragic lesson over the coming months. 

 

 

[donnacha]

25 minutes ago, DannyCarlton said:

 

You may have fallen for a well-intentioned cherry-picking of the facts. The plainly stated purpose of that interview was to persuade young folks to observe safety measures, if not to protect the vulnerable, at least to protect themselves. This is part of the "nudge" approach that characterizes modern political messaging.

He did not state which outbreak that particular figure came from, but I suspect it was Korea where, because that mainly spread within a religious cult, the age profile of the infected was far younger than China or Italy but, by the same token, had far lower mortality.

Each country is different, perhaps the spread in Thailand will more closely reflect Korea than China, but that is why you cannot take numbers seriously unless they are attached to specifics. For that, written papers remain a cleaner source of information than talking heads pushing that day's agenda on TV.

 

[donnacha]

1 hour ago, DannyCarlton said:

50% of those hospitalised/seriously ill are under 50. The 2 doctors who died in Wuhan were in their 30's. The notion that only those over 70 and/or with pre existing conditions are in danger ia a dangerous fallicy.

These are the most complete death figures I could find based on a combination of all outbreaks in a countries so far:

https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/

 

As you can see, it really takes off after 70. For each decade there, we can assume that the majority of each percentage figure is clustered towards the older years in that decade.

I am suggesting 60 as the cut-off point, because that decade has 3.6% mortality, whereas those between 50 and 59 only have 1.3% mortality.

All the other decades have less that one percent mortality, and that is likely to be people who are otherwise compromised: diabetes, heart conditions, smokers / exposed to high levels of air pollution etc.

Again, I am not saying your figures are wrong, it is possible they were correct at one stage in one of the many outbreaks, but they do not tally with the overall world experience so far.


 

Edited March 22, 2020 by donnacha

[DannyCarlton]

1 minute ago, donnacha said:

These are the most complete death figures I could find based on a combination of all outbreaks in a countries so far:

https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/

 

As you can see, it really takes off after 70. For each decade there, we can assume that the majority of each percentage figure is clustered towards the older years in that decade.

I am suggesting 60 as the cut-off point, because that decade has 3.6% mortality, whereas those between 50 and 59 only have 1.3% mortality.

All the other decades have less that one percent mortality, and that is likely to be people who are otherwise compromised: diabetes, heart conditions, smokers / exposed to high levels of air pollution etc.

Again, I am not saying your figures are wrong, it is possible they were correct at one stage in one of the many outbreaks, but they do not tally with the overall world experience so far.


 

That's the mortality rate. Not the same for "admitted to hospital", "admitted to ICU". Also mortality rate isn't zero for those under 50.

[donnacha]

1 minute ago, DannyCarlton said:

That's the mortality rate. Not the same for "admitted to hospital", "admitted to ICU".

Yeah, you're right about that, I realized as I was writing but could not find the age-of-admission stats I'd seen earlier.

So, I cannot prove, right now, that the elderly and otherwise vulnerable make up the vast majority of admissions for critical care.

By the same token, however, you must admit that what you are claiming - that, of the 20% of the infected bad enough to require critical care, half of them are under 50 - seems statistically unlikely if they represent just 1% of all deaths.


 

[DannyCarlton]

1 minute ago, donnacha said:

Yeah, you're right about that, I realized as I was writing but could not find the age-of-admission stats I'd seen earlier.

So, I cannot prove, right now, that the elderly and otherwise vulnerable make up the vast majority of admissions for critical care.

By the same token, however, you must admit that what you are claiming - that, of the 20% of the infected bad enough to require critical care, half of them are under 50 - seems statistically unlikely if they represent just 1% of all deaths.


 

See my post #12. And that's just the US. I've seen higher percentages quoted for other countries.

[donnacha]

58 minutes ago, baansgr said:

Just let everybody get it with a mortality rate of 3%...so for the sake of not being able to have a beer or go clubbing, 2million UK citizens will die....unbelievable

Yeah, this statement is a solid example of why more people than necessary will die. No politician is able to focus resources where they are most needed because people get hysterical and are unable to understand more sophisticated and potentially more effective strategies.

Again, no one wants 1% of people under 50 to die, but that is peanuts compared to how many will die from an overstretched, impossible attempt to stop everything and keep everyone at home for six months. The cracks are already showing.  Don't forget, the economic damage of stopping for six months every year will also cause plenty of misery and death.

[donnacha]

5 minutes ago, DannyCarlton said:

See my post #12. And that's just the US. I've seen higher percentages quoted for other countries.

 
Post #12 is the TV interview, right?

I listened to it but did not hear him attach that 40% figure to any particular outbreak, and it seems quite early to be extrapolating anything from the relatively new and scattered US outbreaks.

I'm pretty sure that, as a political appointee, his marching orders for that interview, in the wake of those spring break covid videos, were to press the idea that young people should worry too, and to cherrypick whatever figures he needed to advance that argument.

While I love YouTube, for analysis like this TV clips are just too propagandized to be useful. Written sources are alway better.

 

[Jingthing]

People are being incredibly naïve if they think these lockdowns are only for a few weeks.

More like on and off for 18 months.

There is a price to pay for such lockdowns and not only in money.

Yes use your imagination on how continuing lockdowns can cause health problems and deaths having nothing to do with the virus.

There are no good choices where lots of people won't be dying as a result of policy decisions that are made. 

No, I have no answers. Just suggesting that people wake up to how bad this is if they haven't already.

 

Remember 9/11? If you're old enough you do.

Well, this likely has the impact of TEN 9/11s or even a hundred. I really wish it wasn't so but I'm pretty sure it is so

Edited March 22, 2020 by Jingthing

[DannyCarlton]

15 minutes ago, donnacha said:

Yeah, you're right about that, I realized as I was writing but could not find the age-of-admission stats I'd seen earlier.

So, I cannot prove, right now, that the elderly and otherwise vulnerable make up the vast majority of admissions for critical care.

By the same token, however, you must admit that what you are claiming - that, of the 20% of the infected bad enough to require critical care, half of them are under 50 - seems statistically unlikely if they represent just 1% of all deaths.


 

At the beginning of the video the reporter clearly stated that more than 40% of Covid-19 sufferers that are hospitalised are under 55 according to a CDC report. Then discussed with the doctor.

 

If you want to argue that black is white, do it with someone else. I'm done.

[donnacha]

29 minutes ago, DannyCarlton said:

At the beginning of the video the reporter clearly stated that more than 40% of Covid-19 sufferers that are hospitalised are under 55 according to a CDC report.

This is why you should consider finding better sources of information than TV clips. Your arguments are simply meaningless if you base them on figures without knowing which outbreak they refer to. That the figure allegedly appeared in "a CDC report" is irrelevant. They operate worldwide and produce hundreds of reports every month. There is a reason why that political appointee was being vague: he was giving that interview to  push a particular agenda
 

29 minutes ago, DannyCarlton said:

If you want to argue that black is white, do it with someone else. I'm done.

Well, again, you would find debates less frustrating if your central argument was not "Here are some figures, with no actual context, that some guy on TV said"

By the way, you have now changed the figure from 50% to 40% and the age from 50 to 55, so, you know, you definitely have room to improve your debating game a bit.

Never mind about me. You are clearly passionate about being right. For your own sake, then, consider using better sources than TV. There are sites that will make it easy for you find real figures. Books are also well worth trying.

 

Edited March 22, 2020 by donnacha

[DannyCarlton]

2 hours ago, DannyCarlton said:

Other parts of the world are experiencing "exponential" rises in infections.  But not Thailand.  

More evidence of exponential rise in Thailand.

 

 

[Lacessit]

4 hours ago, HighPriority said:

Yep, if everyone gets it at once we don’t have the medical resources to treat the old and vulnerable.

Surely it’s not that hard to sit reasonably still for a couple of weeks ?

I agree with you, and that is why I am 1/  Not socialising 2/ Playing golf by myself, and using the swimming pool when no-one is there 3/ Wearing a mask outside my room 4/ Air purifier running 24/7 in my room. 5/ Regular hands Hygiene.

[rabas]

duplicate

Edited March 22, 2020 by rabas

[rabas]

2 hours ago, DannyCarlton said:

See my post #12. And that's just the US. I've seen higher percentages quoted for other countries.

Italian doctors who manage Italy's ICU facilities have warned the EU in writing about what they are seeing. You might want to review this, you can start here. The picture that is evolving suggests there is no common set of experiences.

 

In an alarming development, Dr Nattino said younger patients were being affected, saying the ages of patients ranged from 46 to 83 with only a small number having important underlying conditions.

 

They said Italian hospitals had seen “a very high” number of intensive care patients who were admitted “almost entirely” for severe lung failure caused by the virus and needing ventilators to help them breathe."

 

My guess from covid-19 evolutionary charts is that Italy and the EU were hit with the more aggressive subtype L from Wuhan. Japan, South Korea, and some of the US west coast show more of the less aggressive subtype S. Subtype S spread through much of China ex-Wuhan.

 

FWIW

[Why Me]

Is Our Fight Against Coronavirus Worse Than the Disease?

The headline from the NYT piece of 20/3 I linked in the OP is above. Trump's tweet from late 22/3 is below.

 

WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF ...

 

Ya think maybe he's been talking to Dr. Katz? Btw, here's an interesting video from BBC Israel if you haven't seen it yet:

 

https://www.bbc.com/news/av/world-middle-east-51981861/israel-s-coronavirus-patient-74-talks-about-her-experience

 

She gets her throat swabbed through a hole in wall by a medic in a hazmat suit and then off she goes with her fellow C-19 patients to sit around a table and play cards, for crying out aloud!  Seriously, can we get some rational perspective on this thing?

 

I don't particularly like Trump but if he has the guts to say, "All you old and infirm stay isolated. The rest get back to the way you were. Sure some of you'll get sick but this ain't ebola and the best darned medical system in the world has your back. Oh, and by the way, in case you get it C-19 treatment is on the house and we'll make sure you get paid every sick day." then he has my vote on 11/3.

 

[RJRS1301]

On 3/22/2020 at 2:38 PM, donnacha said:

Pre-existing is the wrong term in this context, that mainly applies to insurance, underlying is the usual term in a medical context.

Comorbidity

In medicine, comorbidity is the presence of one or more additional conditions co-occurring with a primary condition; in the countable sense of the term, a comorbidity is each additional condition. The additional condition may also be a behavioral or mental disorder.

 

 

[AlexRich]

A better way would be to quarantine people deemed vulnerable and organising a support group to make sure they get food, medicines and provisions, together with a period when they can get out and take some exercise, like a curfew period that “the rest” observe.

 

Business and retail can go on as usual and the intensive care units will be able to deal with the younger people unlucky enough to have a bad experience. After a few months we should have established herd immunity and some kind of therapeutic treatments ... and a little later we get the vaccine. 
 

it would take a bit of organising but it’s doable.

[Why Me]

7 hours ago, AlexRich said:

A better way would be to quarantine people deemed vulnerable and organising a support group to make sure they get food, medicines and provisions, together with a period when they can get out and take some exercise, like a curfew period that “the rest” observe.

 

Business and retail can go on as usual and the intensive care units will be able to deal with the younger people unlucky enough to have a bad experience. After a few months we should have established herd immunity and some kind of therapeutic treatments ... and a little later we get the vaccine. 
 

it would take a bit of organising but it’s doable.

Political will is what it'll take. Let's see who has the guts.