"Millions of people across England have been banned from meeting friends and family indoors over the festive season as they enter a new tier-four level of Covid restrictions, while indoor mixing has been restricted to Christmas Day alone for the rest of the country."
Perhaps someone in the comments could show me evidence that London was "loosening the lockdown for Christmas"?
Also I live in London (and did during Christmas, where I cancelled my plans because of said lockdown), and am British.
yep, I literally got married on the 18th and tier 4 was brought in on the 19th. Much of the rest of the country was in tier 3 and the xmas days were rolled back from 5 to 1 with only xmas day itself permitted, only in lower tier areas and with more restrictions.
Little weird to be getting to -1 downvotes for something that's a google away...
London and the SE is where the new highly infectious strain originated from and was more or less entirely locked down. Big chunk of population here too...
"London saw wild scenes of a weekend mass exodus before the start of a Christmas lockdown and travel ban sparked by a new, more infectious mutation of COVID-19."
We are probably living in two different worlds. There is reality and there is the world you live in.
In real world it is not the restrictions that save lives, it is people following them. If people ignore restrictions it doesn't matter whether they were or were not tightened.
Actually, if people were sane we would not need restrictions. Everybody would wash their hands, avoid touching their face, wear their mask properly (ie. not faking wearing the mask) and avoid physical contact with other people unless necessary. And all research suggests that would be enough to deal with the virus.
The fact is that Christmas in almost every country resulted in mass movement of people that just have to go and meet their families. And it doesn't matter for what reason it happened, it is just a fact.
So, regardless of whether there were or were not tightened restrictions, there is going to be an inevitable increase in cases.
The point is that it's absolutely irrelevant if the lockdown was loosened or tightened, if UK entered tier 4, 5 or 127. The indisputable fact is that millions of people travelled on Christmas day to visit friends and families, allowing the virus to spread. For a large number of those, such a visit was simply not possible just a day before because they were already in Tier 3 where meeting people inside was not allowed. So yes, Christmas day was a significant "loosening" of restrictions for those people.
Following your nonsensical logic there would be no difference in covid cases between states or nations. Obviously this is not true.
It is absolutely the government’s job to enact policy to slow the spread of deadly disease. It is also the job of governing leaders to encourage and educate citizens on how and why they should comply with these policies. This is where the USA is failing miserably.
We could discuss the tradeoffs and the details, that’s fair, but it’s totally irresponsible of you to say that this massive spike in cases was ‘inevitable’.
Every nation spends their Christmas differently. And the rise in cases will also heavily depend on what was done by the government before the Christmas, so no, not every country will see exact same increase in cases.
No he could be right: the covid is better handled in places were people are more careful, which explains the difference between countries. In fact there is less deaths in countries with less or no restrictions (Taiwan, South Korea, Japan) than the ones who heavily locked down their population (Europe) which tends to prove the point.
The specific argument was that people didn't change their behaviour enough. The inevitable consequence being more cases. Inevitable as in "can't change it anymore, the cases are rolling in."
Nope, December was pretty free and easy (comparatively speaking) and Christmas Day was not a lockdown. Boxing Day was (sort of) but I know plenty of people breached that and travelled home after Boxing Day.
Source: am British also (and stayed home and saw no one at all over Christmas and new year, just sayin)
I am British and living in London. From the article:
"London saw wild scenes of a weekend mass exodus before the start of a Christmas lockdown and travel ban sparked by a new, more infectious mutation of COVID-19."
I saw plenty of pictures shared by families meeting in London on Christmas Day so perhaps the OP should have put “this is a consequence of people breaking the restrictions on Christmas Day” caused by wilfully ignoring the rules or confusion.
Where I live in North London, there was a testing centre for people that were not showing any symptoms. Before Christmas (and after the Tier 4 restrictions were introduced) there was a huge queue of people without symptoms that were very interested in finding out whether they had Coronavirus.
I found it quite strange, since if you were staying at home and had zero symptoms, why would they need a test? However, somebody let slip that they were getting tested in order to get confidence travelling home to visit their family... Therefore, while people were locked-down, I think many worked around this.
I live in London but I went back to Paris where I'm from for Christmas. Here in Paris it was the norm: everyone got tested before driving to their families for Christmas. The days before Christmas there were white tents every couple of blocks where you could get tested without an appointment. You're probably right that's what lots of people in London did as well.
I think I've figured out what happened; Boris spent ages trailing "looser restrictions for Christmas" and then changed them on the 20th. However that still included "the Christmas rules allowing up to three households to meet will now be limited to Christmas Day only".
Updated: I’m an idiot and forgot the article was London focussed.
You’re inadvertently doing the London thing that Londoners do where you conflate a comment about the whole country to just be about London. London may have had increased restrictions (which I doubt had the level of observance they should have but hey ho) but the rest of the country didn’t. The parent comment didn’t specify London, they were talking generally and, generally, restrictions were loosened for Christmas.
Just wait for results of year's end parties. While during Christmas the virus is shared within families, the year end is an occasion to do this with a bunch of strangers!
And it is also ideal delay from Christmas to Dec 31st for most of the people that got infected over Christmas to start spreading the virus but not yet show symptoms.
No it will be worse. The original post implied we’d seen the effect of the Christmas idiocy. The cases caught on Christmas Day would be ided about Dec 29 and hospitalised maybe about now and into this weekend
The cases caught from Christmas Day and passed on multiplied to the school return on Monday. That political decision will have killed hundreds needlessly, maybe thousands, just because he didn’t want to back down.
How much of that is the new strain, how much is Christmas, and how much is government decisions (reopening universities, encouraging office workers to work in person, allowing foreign holidays, announcing an end date for the second lockdown before it had even started...) is hard to say.
If a mutant strain of COVID-19 becomes twice as deadly, this "merely" doubles the pressure on hospitals. A constant factor like this can be dealt with.
However, an increased rate of spread (R factor) is a change in the parameter of the exponential curve, and cannot be dealt with by any sub-exponential response. The only thing that could possibly work is to change the factor. Rapid vaccination or lockdown. It's impossible to vaccinate the population of London in two weeks, which means a full lockdown is the only option now.
YC News is mostly a forum for software developers, which means that these notions ought to be familiar to most people here. When talking about software algorithms, we all learned about big-O notation. We all learned that Exponential time algorithms are (nearly) the worst case, and will always be worse for large data sets than a linear-time or quadratic algorithm, irrespective of the constant factor.
Essentially the new mutant strain changes the "R" term in Θ(a×exp(R×𝑡)), whereas increasing the lethality is a change in the "a" term.
People are concerned about the lethality getting worse, but they shouldn't be. This change in the infection rate is more scary.
Good analysis but small nitpick: the use of "Θ" in Θ(a×exp(R×𝑡)) is slightly inaccurate (or is it the use of "a"?) because the set of functions Θ(a×exp(R×𝑡)) is the same for all positive a.
I agree, but I think there is now a non-trivial group who are either a) in total denial about the virus or believe it's a conspiracy, b) overwhelmed by news of it and unable/unwilling to process anything new, or c) believe in herd immunity and might even welcome a faster spread on that basis.
Arguments about exponentials mean nothing to anyone in any of these buckets— they'll be flaunting a lockdown up until and perhaps beyond the point where it is administered by force.
I don't know how to deal with this reality, but it feels like the greatest threat at this point.
Extremely good coordination with vaccine invention, extremely bad with all other aspects.
Humanity is irrational, most people believe crazy, inconsistent things, and are easily manipulated.
The average citizen is stupid, the government is vulnerable to sentiment from the average citizen (and partisan media orgs that seek to influence those citizens for their own power or money).
It's a bad situation.
It's basically like Asimov said, "The saddest aspect of life right now is that science gathers knowledge faster than society gathers wisdom."
I'm taking it very seriously. This is a meta-discussion about reasons other people may not be, and how to address that both personally and at a policy level.
I don't know. I would say I'm d) believe that the West cannot and should not enforce a lockdown the same way authoritarian China or Singapore can, and therefore it is doomed to fail.
So:
* lockdowns are guaranteed not going to eradicate the virus the way it has in China.
* lockdowns are guaranteed to crush small businesses and restaurants, creating an L-shaped economic recovery and putting the West at a disadvantage in future geopolitical conflicts.
* the vaccine works but will take a year to rollout to everyone and it is unimaginable that the public will tolerate a lockdown for more than a month
* herd immunity might work
I truly welcome any debate on this as I'd love to be wrong about my critique of my country's (Canada) approach to all this. We seem to be not having our cake and not eating it too.
Waterloo Region here. Up until the end of August, I was pretty happy with the response where I am, at all three levels of government— it seemed like the policies were basically working and the spread was contained, with new flare-ups presumably being seeded from elsewhere (Toronto, the US probably) and quickly dying out.
And then cases started spiking in September, I suppose due to some combination of back-to-school, lockdown fatigue, increased indoor gatherings, etc. At that point I became extremely unhappy as it became apparent how little the Provincial gov't in particular had taken advantage of the long summer of low cases to build up test and hospital bed capacity, and to make plans for vaccine distribution. The second wave hit and it felt like basically just rewinding to March. This was apparent to everyone and I think it probably became a positive feedback loop as more and more people gave up and had in-person Thanksgiving and Christmas gatherings.
> People are concerned about the lethality getting worse, but they shouldn't be
They should. Lockdowns deal with the exponential phase, but in the long term the process is not exponential. The virus is probably going to infect half of population anyway. There simply aren't ten times more people it could infect. On the other hand, there are ten times more people it could kill or cripple.
Percentage wise the total population infection rate even in the US and UK isn't actually high, something like 9-11 percent at the moment after a full year of the virus spreading.
Even with this faster spreading strain, it's possible that the vaccination efforts will win out and halt the spread before it reaches 50% of the population.
Nothing in nature grows exponentially. If it did it would overwhelm the universe.
YC News is mostly a forum for software developers, which means most of us have a tendency to want to keep things simple. That's fine for simple thinks like operating systems or proving all problems in NP are also in P. But nature is on a completely different level.
The projected natural end of this pandemic would come within a year when the majority of the population got infected. As a society we've decided to not let this happen. Which is why the numbers diverge from your simplistic formula.
> A fast spreading variant could overall reduce deaths over the next 5 years.
Assume being infected from this variant grants some protection to future variants. If everyone was infected (or vaccinated) and protected then it would be difficult for the virus to spread and mutate.
A slower spreading virus would produce more mutations over time and its possible one of those mutations could be catastrophic (though unlikely). Not only do you have more mutations but you also have fewer people protected.
> A slower spreading virus would produce more mutations over time
Mutation is not primarily a function of time but of infections. So mutation is higher when there are more hosts. Letting the virus infect people leads to more mutations.
Now we're probably not talking about the same thing when we say mutations. I mean the sum-total of mutations. You mean successful mutations. But here comes the connection: The virus is more likely to evolve into infecting vaccinated people when it is more widespread. Because there are more mutations and consequently more chances for one of them to evade the immune response of vaccinated people.
Coronavirus will grow exponentially IF you let it!
That's why we're all wearing face masks, limiting social interaction and even put whole countries in a full lockdown. WE all do this to LOWER the spread of the virus.
From the article "These would be complemented by 1,000 “step down beds”, some of the supplied by the opening of the capital’s Nightingale hospital," so sounds like it's not in use yet.
The big problem with the nightingale hospitals is that there were no staff to run them, and hospitals are understaffed as it is with people of sick or isolating due to the governments approach of vaccinating their voters first ahead of medical staff.
Even if they were used in the first wave it was in the expectation that any hospitals sending patients there would also send staff to look after them, which was never realistic.
You can hire a hall and stick a bed in it, but if there’s no one to look after the sick person in it they don’t have much of a chance.
They are unfit for use as hospitals and you're right, there's no staff, hospitals around the country alone are struggling. There's no adequate places to even wash your hands due to toilets located sparsely in unsuitable places.
I've worked in Nightingale (London) and am on standby for Nightingale North West if needed. Luckily I didn't have to deal with any patients there and I hope we don't again.
I can't find that data. I did find daily statistics for "Total beds - occupied by confirmed COVID-19 patients (as at 08:00)"[0], which from the 1st to 6th of January is the following sequence:
I think the important difference is that the situation is expected to get worse. While this may seem normal, it is a peak as the cause will have stopped by now and the lead time is short. In this case, the fallout from Christmas and New Years is just starting to hit.
Is there any context to that number? I’d be very interested in seeing how many beds were free this day in 2019, 2018, etc. It’s not a secret that hospitals are designed to run at or near capacity at all times, I don’t know where the notion that hospitals run at 40% capacity at all times in order to account for the random once-in-a-century pandemic comes from.
There's a link in a sibling comment pointing to data from 2019 January where 151 out of 1033 adult critical care beds in London were free (14.6%), and in January 2020 146 out of 1034 were free
Even now ICU utilization nationwide in the United States is only ~63% [1]. Regardless of country, ICUs are not supposed to be run at capacity as a matter of practice - the staffing level in ICUs is on the order of one to three people per patient and it's not a resource that can be scaled up or down quickly.
For a large metro area like London, you might have some hospitals at high utilization because they're very close to other ICUs and can redirect incoming patients. It's not supposed to be at high utilization regionally, otherwise a single minor disaster can cause the system to tailspin.
Comparisons to previous years don't really make sense. ICU capacity should have somewhat increased and in previous years they weren't anticipating such a massive influx of new patients.
~1700 people per day die of heart disease in America and have done so for decades. I think we should shut down the economy until we can get everyone's heart healthy.
Sometimes COVID gets compared to flu. Thing is, most people underestimate what flu is like (I suspect this is because of the tendency to say “XYZ got the flu” when they had a common cold).
This is what COVID is like — First roll two D4: If you rolled a 1 in the first, you now have a liver injury; If you rolled a 1 on the other, you lose your sense of smell.
Now roll a D20:
• 1-4: asymptotic but still infectious
• 5-16: somewhere up to “mild pneumonia”
• 17-19: severe symptoms (dyspnea, hypoxia, etc)
• 20: critical symptoms (respiratory failure, shock, or multiorgan dysfunction)
And that’s with treatment. All that “flattening the curve” talk early last year was about making sure people could still get treatment — if you exceed the capacity of the healthcare system, you don’t get to save all the people whose conditions would have been well within your capacity in a non-overloaded system.
About 2%, currently. Meaning if you walk into a room, spend time in it with 100 other people, 2 of them are likely to die.
The odds are low for an individual. Sadly, 2% is a bigger deal when you get on a bus, walk through an airport, use an elevator, go to a public restroom, or walk down a crowded sidewalk.
This isn’t an issue of your health or my health. It’s an issue if everyone’s health.
And provide avenues for testing, and educate people to instill a culture in which people engaging in frequent sexual activity get routinely tested, and that's expected by their would-be partners.
We do ask them to put a "mask" on their penis if they are having sex though, and most do. Yet still there are people that can't put a mask on their face.
Can't believe after 12 months this argument is still being made.
You say shutting down the economy so casually, as if it has no impact on an infectious disease spreading during a pandemic.
If there hadn't been any shutdown, it would lead to a tenfold increase in infections and an even higher than tenfold increase in death as hospitals will be completely overwhelmed and unable to provide normal healthcare.
But if you think a 20x death rate from the nr 1 cause of death (heart disease), preventable by a lockdown for a few more months as a vaccine is rolled out, is no big deal, then there really is no arguing with you.
My point is more like, 10x the number of people could be dying of COVID per day than are dying right now, and I would care about 10x more than I care about all those people who are dying of heart disease, which would still be an indescribably small amount of care, even with the multiplier.
I am not making the argument that it's "just a flu", but I will make the argument that it's "just death". Death is. Only a sheltered person is emotionally distraught because of this; and in turn, only a person who cannot handle this perspective would deem it logical to permanently damage society in order to reduce this number.
I am all for protecting older folks, even at great expense. We should have isolated every old folks' home and done everything possible to keep them COVID-free and well stocked with everything they need. These folks have served their time in society and deserve to be cared for with a higher standard than others. It's highly unfortunate that the exact opposite thing happened; I hope that we learn a lesson from this.
However, when we're talking about the non-elderly, it seems that the vast majority of people who are dying are simply in bad shape / vitamin deficient / etc. Sorry, I don't see any reason I should care about their death any more than I would care about it if they died from heart disease, which is almost certainly going to get most of the people in that demographic eventually anyway, if they don't get hit by a car first. It's sad for their families, and for us it's just a warning to get some sunshine and exercise ever so often, which is literally all it takes to put yourself in the group of people who have a massively high survival rate. In fact, we've all had a whole year with literally nothing else to do for amusement to have gotten in good shape during. At this point, anyone who is still ignoring that has made their choice.
It's about putting things in perspective. 50-100k people die from the flu every year in America for the past decade and nobody cared before and nobody will care about that 10 years from now either unless it's a really slow news day.
> there really is no arguing with you
There's plenty of arguing with me. Convince me why I should care about people who die of one disease when I already didn't care about all the people dying of a different one. That's fundamentally what this comes down to: blowing that level of care out of proportion while denying people the right to make their own decisions about what level of personal risk they are comfortable with.
The problem with airborne infectious diseases is that in order to protect that "minority" that has a high risk of death you have to ensure the spread doesn't use the "majority" that doesn't have the high risk to reach the high risk people. You do that by limiting contact between people, social distancing, wearing masks, etc. The end game here for the high risk individuals is to buy enough time for us to vaccinate a large enough amount of the population so that then there's no need for a lockdown as the virus just can't spread in a largely immune population.
But lockdown and the other measures aren't just meant to protect the high risk individuals. We still don't understand how the virus affects many lower risk individuals long term because it's a very new virus. Strictly looking at the "death rate" may make us miss that significantly large portions of recovered individuals (from the lower death risk segment) develop long term health issues that may significantly reduce their lifetime expectation.
And yet another reason for lockdown and the other measures is to keep the health system afloat for the other, much higher death risk, health conditions. If our entire ICU capacity is occupied with COVID patients we won't be able to offer the same quality treatment to much higher risk situations like in emergencies (accidents of every kind) not to mention the COVID death rate itself may spike a lot higher if we can't provide the same quality of health care that we've been able to so far.
I understand you're saying that we wouldn't be in this situation if we didn't let the old getting infected. How do you suppose we could've "isolated every old folks' home" if everybody else had gotten infected?
But wait now, while you're deciding for them how they should live you're not accepting that they could also ask you to live differently during this pandemic. So when they take personal risk, like going grocery-shopping, and get infected, does that mean they have a lesser claim to a hospital bed than you, who wants to "make their own decision" about the risk of spreading the virus? Or do you accept the fact that an old fat guy might just block the ICU you could happen to need tomorrow?
> My point is more like, 10x the number of people could be dying of COVID per day than are dying right now, and I would care about 10x more than I care about all those people who are dying of heart disease, which would still be an indescribably small amount of care, even with the multiplier. I am not making the argument that it's "just a flu", but I will make the argument that it's "just death". Death is. Only a sheltered person is emotionally distraught because of this; and in turn, only a person who cannot handle this perspective would deem it logical to permanently damage society in order to reduce this number.
What are you talking about? 3500 died in a single day, that's a 9/11. Multiply it by tenfold like you said, and do it for a year, you're looking at 12.7 million Americans dying alone. Is that a death rate you don't care about? For comparison, the 1st world war, second world war, vietnam war, korean war, war in afghanistan, war in iraq, combined, gets you to about 0.45m casualties.
And that's in one year and one country. On a global scale it'd be insane, and again, just one year. A year in which a vaccine is rolled-out and can end the lockdown. Ending that lockdown now without having rolled-out the vaccine makes no sense.
On principle you're right - and hopefully you, and others who share your line of thought, will continue to fight for this after this period is over so that we can focus on spending money to alleviate problems affecting those in relative-poverty that we - as a society - have happily ignored thus far
If heart disease was an airborne infectious diseases for which we have vaccines already being deployed, then by all means let's shutdown everything! (since the death rate like you pointed out is even bigger there)
>The NHS England presentation, seen by HSJ (see slides below story), showed that even if the number of covid patients grew at the lowest rate considered likely
Covid rates have consistently grown at the lowest rate considered likely.
Well even at the most conservative readings of recent statistics the growth rate has been 3.5% daily, so you might have 2 and a half weeks if you are really lucky.
This article is confusing. It starts off by saying this is an analysis of "best" and "worst" case scenarios for continued growth in cases, but later it says:
> HSJ understands that the briefing was part of an attempt to get senior clinical leaders to focus on what they would have to do, if current growth trends were not surpressed by the tighter lockdown.
So, er, what if the growth trends are suppressed by the tighter lockdown, as seems likely? Will things then be better than the "best" case scenario?
It sounds like there's a bit of misreporting going on here. The leaked document forecasts demand based on pre-lockdown trends, to highlight the significant risks. But the article is reporting it as if running of beds is totally guaranteed in all circumstances, which doesn't appear to be the case, if the lockdown works.
The hospitalisation curve for the next fortnight is largely locked in by what was happening before lockdown started. If lockdown has a positive effect, it'll be visible in the hospitalisation stats after 12 days or so.
> So, er, what if the growth trends are suppressed by the tighter lockdown, as seems likely? Will things then be better than the "best" case scenario?
There's two lag factors to consider. The first is the lag between restrictions and cases dropping, this takes a couple of weeks and cases and the growth isn't likely to even slow for 1 week. The second is the lag between infections and people getting seriously sick and needing hospitalization, that takes 3-4 weeks. There's also the serious possibility that the restrictions arn't strict enough to make a big difference.
This scenario is basically baked in, avoiding it required action weeks earlier.
Nobody is in charge of people's perspectives. The UK has really gone all in on psychosocial nudge tactics in this pandemic, and it has massively failed so far. Arguably, they've done so because they knew the population were so belligerent and arrogantly ignorant that a more direct approach would definitely fail. They have leveraged the 'new variant' to implement at the last moment the measures that were being recommended for months by all their expert committees. People here don't want to be told what to do and there are very well organised efforts to encourage people to feel empowered in their ignorance and irresponsibility. The 'people in charge' aren't the only ones to blame for that.
I would expect that if growth trends are suppressed by the tighter lockdown, that would be the best case scenario. That’s not the most likely scenario though, and you need to prepare for the worst case scenario. So that’s what clinical leaders need to focus on, right?
I agree that the "best case" scenario should probably involve some impact from the lockdown (after a delay), but given the experience in California (which was that the lockdown didn't slow things down much, if at all), it seems at least plausible to look at what happens if the same is true in the U.K.
Big lockdowns last year definitely made an impact in England and Italy. I expect it will be the same now. What failed here in UK was the regional approach, the continuous attempts at unfounded optimism, and the attitude that covid-related rules were just another game to play and cheat at (like a minster saying that a scotch egg is “a substantial meal” which can justify going to the pub...).
The population doesn’t take the message seriously unless the gravity of the situation is stressed and the necessary plans are clear, simple, consistent throughout, and ruthlessly enforced. When most of that happened, lockdowns worked.
The critical issue is to ensure the health system is not overwhelmed, and that was achieved. Prolonging the agony is actually a result of unwillingness to extend hard lockdowns for 4+ straight months over whole countries - we keep lowering restrictions as soon as possible.
But sure, things might have definitely been faster if only we just let more people die.
It's not immediately obvious from any reporting but the "rules" in London haven't actually changed significantly since the 20th December (schools did not reopen as planned but they'd been closed since before then anyway for the Christmas break).
The only meaningful change in the past couple of days is the "takeaway pint" ban (which is unlikely to make any difference and is purely symbolic).
> When did we switch the emphasis from tracking deaths, to tracking infections?
Never, infections have always been a foucs of tracking because infections lead hospitalizations lead deaths (and hospitalizations have second-order impacts on mortality from other causes when they reach a critical level, even beyond direct COVID deaths.)
If you only focus on deaths, you are weeks behind the curve in reacting.
Back in April we weren’t able to test anyone outside of hospitals. In march we were likely up in the 100k infections a day just before lockdown, around what we are now come to think of it.
That’s based on taking the IFR and working backwards from reported deaths at different ages.
Not sure what you mean since tracking infections, hospitalizations, and deaths are all useful. However, there are reporting delays for infections and deaths during weekends and holidays.
Infections happen earlier than hospitalizations and deaths but the count depends on people getting tested.
With the masses sedate at their screens, the bureaucracy has no cognitive experience or expectations for anything different.
Decades of headlines being fed to Main Street going on about growing inequality did not really motivate Main Street to do much but shuffle back into the office.
Relativity pervades all experience. Reading about history in books is not exactly experiencing history.
Or maybe these people will keep believing the lie, even after they die from COVID, like the Calormen at the end of CS Lewis’ The Last Battle. Everyone else will be in Heaven, and they’ll be all like, “Let me out of the hospital, corona is a lie!”
People die from all sorts of diseases. Someone dying from Corona doesn't prove that he died from a pandemic level disease. (I'm not saying it is not a pandemic, just that that kind of logic is bullshit).
Even the nurse reports about "patients being in disbelief about dying". I would imagine lots of people who are about to die are in disbelief.
A friend of my mother died from the flu. He called her shortly before that. I think he probably also was in disbelief.
Unfortounately it is more complicated than that, Odds are 1000:1 that when when they get it the symtoms will be "just a flu" and they will tell their famly and friemds their experience
Just to flesh this out, the NHS could use more money, but it's worth saying that it's the only European healthcare system I'm aware of so fragile. If you ask a lot of British people they seem to think that the only alternative is the wild west found in the US, rather than the other healthcare systems in Europe.
There was a good piece in the private eye a few years ago listing headlines saying the NHS is doomed tomorrow going back to before Blair.
>Just to flesh this out, the NHS could use more money, but it's worth saying that it's the only European healthcare system I'm aware of so fragile.
You've fallen for the very "NHS is more fragile than systems in other countries" mantra that the Private Eye piece mocks. COVID19 has overwhelmed the French, Belgian, and Italian systems too.
>If you ask a lot of British people they seem to think that the only alternative is the wild west found in the US, rather than the other healthcare systems in Europe.
The NHS is unique in being so unified. I'm not sure there's another European country in which one government entity runs insurance, billing, and delivery. Because the UK is the foreign country Americans are most exposed to (Canada doesn't count), this results in both Americans and Britons thinking that all healthcare plans outside the US are like the NHS, when actually the norm is something closer to that of France, Germany, or the Netherlands.
Government running every aspect of healthcare means that every aspect of healthcare is a political issue. The consequent level of weaponization of the NHS in British political rhetoric is flabbergasting. It's said that Social Security (the US version of UK National Insurance) is the "third rail" of American politics—any politician that touches it gets electrocuted—but there is no comparison. I, for one, have no desire whatsoever to ever experience the US equivalent of how in the UK the NHS is always, Always, ALWAYS the #1 or #2 topic of every single election, with every candidate competing to outdo the others in promising that the NHS will "always be free" and that he is the only candidate who can make sure that the local GP's surgery hours will widen and that the A&E will no longer be "the worst in England" or "the second-worst in Yorkshire". The Private Eye piece is the result of the above.
(Canada, also with a single-payer system, sensibly divorces billing from providers. As in the US private entities deliver most healthcare, and in both countries if one's doctor has inconvenient hours or if the local hospital has substandard care, one simply goes to another as opposed to having this being something politicians are expected to fix.)
I said fragile but I would've mentioned efficacy - it's past midnight. The NHS isn't even that good, but it's hard to bring it up because it's the sacred cow.
I think Denmark apparently has the most comparable system in Europe, but I've not read much about it (just heard it in passing).
>I said fragile but I would've mentioned efficacy - it's past midnight. The NHS isn't even that good, but it's hard to bring it up because it's the sacred cow.
NHS does well in the Commonfund healthcare comparisons (https://www.commonwealthfund.org/publications/other-publicat...), especially given how small a share of UK GDP healthcare spending is. That's certain an argument for its unitary, top-down structure. That same integration, however, makes it vulnerable to the sort of political grandstanding that Private Eye satirized.
I think it's not just Britain. Having hospitals with lots of empty beds, i.e. capacity, is just too costly.
So when the capacity is needed as it is now, then you can't really do much.
But every year we have excess mortality caused by cuts to service. That's literally people dying because of poor funding choices. What do you expect to see? Ambos on fire?
The NHS delays operations every year. This year, you'll go to A&E, need a ventilator and be told they're out and to ring a relative to give you cpr or die quietly in a corner please.
A colleague made the point that we need more pictures of overflowing morgues and ICUs and (like is happening in LA) people waiting in an ambulance for 7-8 hours (and some of those people dying because of it).
Just like the US government banned (discouraged?) pictures of caskets coming back from war.
These images need to be on the news and on news websites 24/7.
Modern conspiracy has nothing to do with facts, but entirely to do with the shape, rate and self forming nature of modern human communication networks.
I'll argue, strongly, that right now - everything regarding Social Media misinformation is an epiphenomena of those factors.
People assign truth value based on heuristics, one of which is how many times information is repeated. If you self select a network of people who believe the same things and repeat it, with slight modifications - you can ensure people will believe conspriacies.
With the ability to self select nodes/people who tend to be conspiracy inclined you will easily cross the number of people needed to make an idea seem socially valid.
The pace and size of our information networks naturally supports the evolution of highly viral content - not truthful content.
At the beginning of this pandemic, I watched a 2-3 min video of a Turin hospital (back when Italy was the epicenter in the west) of people silently choking to death in their ventilators. It was absolutely fucking eerie and insane and every time I think of doing something risky, I think about the sound in that video.
Unfortunately in this context, it is illegal to film people in a hospital. I think that's a fair rule but I really would like to have a few videos floating around with no voiceover and no commentary just to scare the shit out of people. I think it would work.
If the person gives their consent to be filmed I don't think it's morally wrong. If I ended up in intensive care due to the covid I'd agree to be filmed for prevention
Obvious panic doesn't help much, but I was sort of advocating a "Do you want to execute grandma?"-style advert for people who think it's a bit of a laugh.
There should be more awareness about what is going on in hospitals all year round. Media hype can make everything extreme.
And there are many theories to explain, for example NY morgues may have been overflowing because morgue owners were afraid to accept people who died from Covid.
Is there actual evidence that people died because they couldn't receive care? Even in Italy I have not seen the evidence, just YouTube videos of some alleged doctors making such claims.
Serious question. I would love to see evidence of people dying because they couldn't receive care (in the Western world).
So you won't accept video evidence given by named doctors at specific hospitals, thus easily checked by the media or anyone who has anything to do with the hospital.
Named doctors would be a start. Media doing some checking would also be a start. Some person looking like a doctor making claims on YouTube is not sufficient.
None of those reports citing the alleged doctor actually checked with the hospitals.
Maybe that should be the minimum: actually checking the situation, rather than repeating some random claims.
There is a comment not far away above from HN user who doesn't feel safe on a street without mask with other people closer than 25 feet. Imagine what those TV pictures of yours gonna make with people like that.
What "normie" people think "crazy conspiracy people" believe: "COIVD isn't real!"
What we actually believe, "Governments have proven they cannot effectively contain this, so if the choice is between security theater or freedom, obviously take freedom."
Go back to guzzling down the mainstream media propaganda that's "informing" you.
Because it would result in hundreds of thousands dying, complete overcapacity of hospitals increasing the death rate of covid and all other injuries and illnesses, and cause even more damage to the economy as a result than lockdown
Speaking only for myself, I think your opinion is idiotic based on some simple back of the envelope math I did many months ago (when the UK announced its herd immunity plan), relating to hospital capacity, likely peak case numbers, proportion of cases that would need hospital treatment or die and some simple minded guesses about knock-on effects for the rest of the health system. I have not bothered to redo these calculations in the light of current evidence (some things have gotten better, others have gotten worse), but I remain sceptical that anyone numerate who spent one or two hours trying to work out the likely results of your advocated policy would arrive at similar conclusion as to the best course of action as you did.
So let me ask: on what basis did you arrive at your opinion?
if we let the virus lives its life, maximum 2% of pop will die, 90 more % will live normally and a few percent will have covid related health issues. so we sacrifice a few percent of population for the future of the others
This is obviously not true, since allowing the virus to spread freely massively increases the rate of fatalities and long-term illness once healthcare becomes overwhelmed.
Care to cite any stats supporting your assertion that a maximum of 2% of the population would die? During periods where the healthcare system has been overloaded the mortality rates have been many multiples of that during times when healthcare is provided at an appropriate level.
What’s more, do you have any reasonable figures to suggest why letting a percentage or more of the population die unnecessarily, consigning even larger numbers to long-term health problems and so forth is somehow a good choice?
> What’s more, do you have any reasonable figures to suggest why letting a percentage or more of the population die unnecessarily, consigning even larger numbers to long-term health problems and so forth is somehow a good choice?
If I squint my eyes a bit. Reduce the burden on the pension system?
If I squint my eyes, I don't think it would even reduce the burden on the state pension system when you take into account the benefit system it is part of.
Long-term disabled or ill people who are unable to work will effectively take early retirement (in some cases they can draw on their actual pension early too), and depend on state support from then on whether it's called pension or something else. The duration of payouts will be longer than for ordinary retirement age.
It's not just miserable for those survivors, it's expensive for the state.
Long-term health problems are also likely to cost more in healthcare later.
> During periods where the healthcare system has been overloaded the mortality rates have been many multiples of that during times when healthcare is provided at an appropriate level.
If you ask people to cite statistics for their claims, you should also do so for your claims such as this one.
I think it’s appropriate to ask for stats for suggestions that run counter to accepted wisdom. That doesn’t put the onus on me to provide evidence of generally accepted facts. Suggesting that we should let the virus run wild through the population is contrary to guidance from the WHO, any number of national health organisations, etc. So no, I don’t feel the need to cite statistics for my position, as it’s not the novel one.
It is an axiom of healthcare that outcomes suffer in an overburdened healthcare system, and readily apparent why that is the case. That said, for those too lazy to look, here’s literally the top result for me when googling terms related to this: https://www.kabc.com/news/covid-19-mortality-rates-rise-as-h...
... or you can lock down, eradicate it and go back to normal (except for international travel). It passed that point in many places now unfortunately. I’m in Auckland, NZ and it’s a normal summer. We have also learned that NZs terrible road toll is unrelated to tourists, who we previously blamed.
Have you considered that of 100 friends, family and acquaintances you’d see two die and 10 would have a painful and difficult future?
Really not sure how to perform that comparison. How do we equate one death vs one "suffer", and how do we count the "suffers" of people who take ill of covid in the free-for-all scenario? I think the ball is in your court on this one but, frankly, good luck
Well we actually have a very good idea of how many people would die of Covid if the entire population of the UK got Covid.
We don't know how many people have ... whatever you are proposing we compare that against.
So faced with the options of "prevent the deaths of over a million people" and "matz1 doesn't like lockdown but doesn't want to talk about or quantify it" I think the choice is pretty clear. Unless you want to elaborate further?
This is coming from the figures the other anti-lockdown guy gave for the number of deaths they expect - 2% deaths of the UK population is ~1.32 million people. If you don’t get covid, you don’t die of covid. If you lockdown, you don’t get covid. It’s a simplification but it’s a start.
What you have said is that people will suffer under lockdown - but you haven’t really tried to quantify that. You’ve decided that’s a lost cause and have moved onto “lockdown causes death” ! Amazing.
To add to that, there would also be a large number of people suffering from long-term complications who may not be able to work and will need ongoing medical care.
Indeed there would. The naive estimate of deaths is bad enough, the knock on impact is a bit harder to wrap our heads around in terms of magnitude, but would still be severe.
Basically - this is not nothing, it’s being treated like a Big Deal because it legitimately is. There’s a lot of talk from the “treatment is worse than the disease” crowd, scant few of whom are experts. And like climate change and evolution deniers many of the arguments seem to boil down to conspiracy theories or the It’s Always Sunny In Philadelphia argument - “science is a liar ... sometimes”: https://youtu.be/Zgk8UdV7GQ0
There are already multiple working vaccines. Why on earth would you even contemplate killing or permanently damaging over a million people, just in the UK alone? Do you really think that 90% of the remaining population will be cool with that and continue to lead a normal life amidst all of this? Even a good fraction of other people in the bottom decile for empathy might waver in their commitment to lead a normal and maximally economically productive life if they are (understandably) worried about the risks this brings to their own well-being.
[ EDIT: the number I originally used for "requiring hospitalization" were way off. I've edited to reflect data from September provided by the CDC. The 20% -> ICU figure comes from the NYC experience in May, but seems roughly correct from other global hotspots ]
Roughly 0.4% of those who catch COVID19 will require hospitalization. Of those, 20% will require ICU treatment.
In the end, the entire human race will be exposed to SARS-COV-2. If that happens all on the same day, or week, or month or probably even year, no health care system in the world can possibly deal with the case load.
Some of those who might have survived COVID19 with hospital care will die.
But (and this is the important part) those with other medical conditions that timely and effective health care could have treated will also die. Trauma (e.g. car or tool accidents). Infectious disease. Cancer. Chronic health conditions.
And in killing all these people, you've made nothing better for those who survive, because if you think the economy has gone to hell under current attempts to deal with it, you clearly cannot imagine it as the entire health care system melts down.
COVID19 is not a personal health crisis. Most people will not die of it (even though hundreds of thousands will, which is not going to be much comfort to their families, friends, colleagues and neighbors. It is a public health crisis that threatens to overwhelm our health care systems and thus have far worse effects than just the disease itself.
> Roughly 20% of those who catch COVID19 will require hospitalization.
Where do you get this from? I do think, of those requiring hospitalization, there is somewhere around a <20% mortality rate (it seems to vary by region).
> Roughly 20% of those who catch COVID19 will require hospitalization. Of those, 20% will require ICU treatment.
Where do you get these numbers from? California has about 50k new cases per day, with probably another 50k cases that were not tested. According to your stats 20k people will require hospitalization and 5k will require an ICU bed per day.
> In the end, the entire human race will be exposed to SARS-COV-2.
This statement is false.
(With regard to any reasonable definition of exposure to the current virulent strains and assuming the vaccines do their job.)
One major purpose of the vaccines is to cause R < 1 and the virus to fade out, so that most humans will not be exposed to the virus ever in their lives. The other major purpose is for those humans who are exposed to it, to significantly reduce the chance of the virus causing harm.
Like putting out a fire before it spreads everywhere. Some things are burned but not everything is even touched by the flame, if it's put out.
The epidemiology I saw near the beginning of the pandemic was fairly clear that even when R0 drops substantially below 1, the virus will be endemic to human existence.
Sure, it's certainly up for debate (and the future) whether or not the rate will drop low enough that most humans escape exposure. That will depend on more than just R0 - we still don't know if the vaccines (any of them) prevent transference, and the emergence of new variants with higher R0 values but identical infection mechanisms (which most people would agree is the same virus) may also complicate this quite a bit.
So sure, maybe I should have dialed it back to "it's entirely possible that the entire human race will be exposed to SARS-COV-2, though if we are lucky that probably won't happen".
I don't think that changes my fundamental point that the crisis for a pandemic like this is not in personal health - "Am I going to die?" - but in the public health - "can my society's health care systems still function?"
I read that too, when the epidemiologists were saying it could become endemic, but if it does, it's unlikely to be the current virulence, which is what counts when discussing deaths etc.
The evolution of viruses like this is they tend to mutate into milder strains as they become endemic. At that point the milder version may still cause excess deaths (like flu does, and unfortunately it would be in addition to flu deaths), but not at the same virulence.
But an endemic virus does not necessarily mean every human will be exposed to it. There are diseases which are almost but not quite eradicated by widespread vaccination, and keep going in clusters, surviving in pockets here and there.
> so we sacrifice a few percent of population for the future of the others
No, you sacrifice an uncertain percentage of the population (but probably larger than you suggest because healthcare systems would be quickly overwhelmed by a massive spike in cases) to both death and long-term sickness and disability, but for what? Lockdown causes people to lose their jobs, children to miss school, and others to suffer problems with mental health (although to use your phrasing, this would just be "a few percent" of the population) but it saves people's lives and health.
I'm also really disappointed that people don't get the idea that people dying and having long-term health issues doesn't screw the economy too.
I suppose you are free to decide that 1.32 million people in the UK should die an avoidable death, so that others have an easier life for a few months. Yes it's a value judgement. But it's a particularly awful value to hold:
- Advocating for the death of a million people when it's avoidable is abhorrent
- It would be more than that, due to the collapse of health services, causing people who would currently survive to die instead
- It would be more again due to the increased likelihood of viral mutations when left to run rampant
- Also due to the collapse of health services, most deaths would be outside hospitals, i.e. at home, slowly suffocating to death
- Some would survive with brain damage due to lack of oxygen at home
- While dying, people at home would know if they could get a hospital place they'd probably survive, and avoid brain damage, but they can't get one
- It wouldn't even boost the economy, because a million deaths is actually quite a drag on the economy, especially when most of them are dying at home with their families staying at home to look after them due to collapse of the health services
- It would be horrendously traumatic; a lot of people would struggle to work afterwards after watching their family members, friends, neighbours and people they know die at home slowly from an avoidable cause
- It would cause tremendous social division, as many of the traumatised people having watched their family members (& friends, etc) die, avoidably, would know it was caused by the actions of their own neighbours & local community, along with national decision-making to "sacrifice" those million
- That's just deaths; survivors with long Covid would also be a large drag on the economy, struggling or unable to work, requiring support, and potentially expensive for the healthcare services and their familiies in later life if it's long-term organ damage as some fear. The numbers with long Covid would exceed the current number of official unemployed
- Advocating for serious life-long disability for another several million people when it's avoidable is abhorrent too
> So let me ask: on what basis did you arrive at your opinion?
I will answer this, although more than likely my comment will get killed soon:
I believe that the high-risk people (elderly, immuno-compromised, people with diseases that put them at risk) should go into voluntary quarantine if they wish, together with a government package to support them. Anyone who wishes to undergo lockdown can also do so, although with no package beyond what they would normally get. The rest can do as they please.
This will not stop the ICU beds from filling up obviously, which is why they should be triaged to high-risk patients, frontline staff, and people who underwent quarantine and lockdown. When capacity allows, other people too. The people who chose not to lockdown deal with it, or die.
This is probably unimplementable in the real world. That said, it would mean the lowest amount of economic stress (which kills silently) for the following years. On some level, it also appeals to the human need for cause: those people that died of corona and didn't get treatment "did it to themselves". The high-risk people do not get sacrificed.
> That said, it would mean the lowest amount of economic stress (which kills silently) for the following years
What makes you think so? Did you look at the life-expectancy impact of severe economic downturns and compare them to likely excess fatality figures due to your proposed policy? I suspect not, because last I looked for it I didn't seem to find much evidence for silently killing economic stress.
> This will not stop the ICU beds from filling up obviously,
That's a bit of a problem, because those ICU beds are also known to be useful for people suffering from urgent non-covid related problems. Even if you managed to turn away all the non-lockdowners (how would you even check? Police patrols tattooing people spotted on the street during voluntary lockdown?), you might still find that just the "legitimate" cases are enough to really mess up urgent health care for a lot of other people.
> What makes you think so? Did you look at the life-expectancy impact of severe economic downturns and compare them to likely excess fatality figures due to your proposed policy? I suspect not, because last I looked it didn't seem to find much evidence for silently killing economic stress.
Not the point I was making. I do not know which option will lead to less death, neither do you, neither do really the scientists (although they have a better idea). However, a full lockdown will lead to more economic loss at least in the short term than a voluntary lockdown. Long-term, as I said, I don't think any of us can say.
> you might still find that just the "legitimate" cases are enough to really mess up urgent health care for a lot of other people.
Like is currently happening? Yes, my solution wouldn't stop all bad effects. There will be much death regardless, the hope is that the people who are left to die as they chose no protection will "help out" with the number of ICU beds needed in general.
> how would you even check ?
You are in lockdown until you fill in some sort of form with the government, waiving your rights to hospital care in the case of catching Corona. This list is used to make decisions. This part at least is implementable.
> Not the point I was making. I do not know which option will lead to less death, neither do you,
What point were you making then? And yes, I think I do know which option will lead to less death, because I actually took the time to do some minimal research and the relevant information wasn't hard to find or terribly ambiguous. It's fine to have a contrarian opinion, based on some effort to ascertain facts and reason about them and we could then have a productive discussion on why our conclusions differ but from everything you said so far my current impression is that you made no such effort whatsoever.
> However, a full lockdown will lead to more economic loss at least in the short term than a voluntary lockdown. Long-term, as I said, I don't think any of us can say.
For some farcial definition of "short term" and "can't say" maybe, but for anything a sane person would care about (quarters or longer) we can just try to compare economic stats.
I mean to me it seems like the herd-immunity/corona-is-a-hoax/hands-off-response countries weren't doing that hot economically either:
> You are in lockdown until you fill in some sort of form with the government, waiving your rights to hospital care in the case of catching Corona. This list is used to make decisions. This part at least is implementable.
Why would anyone in their right mind sign such a form, no matter whether they intend to flout lockdown or not? Not without massive penalities. How would you enforce them?
What do you do about folks who don’t have the luxury to choose to isolate? The majority of US citizens don’t have the funds to stop working for more than a week or so.
What about all the nurses who die in the line of duty treating all these new infections? Should they be allowed to opt-out of infection risk?
I understand the desire to keep things going, but so long as there is community spread the lockdown can never end, and the virus would never go away.
> What do you do about folks who don’t have the luxury to choose to isolate?
What's being done about them now? How is this better? They're losing everything they own, their house, and getting $600 from the government? Many would take a chance of corona over that.
> What about all the nurses who die in the line of duty treating all these new infections? Should they be allowed to opt-out of infection risk?
Nurses (along with all healthcare personnel) should always receive priviledged treatment. One nurse dying is not a person dying, it is many people dying.
> but so long as there is community spread the lockdown can never end, and the virus would never go away.
Vaccines will hopefully change that.
.. all good points though, and I thought of them too as I was writing out my thoughts. I'm not fully satisfied with these answers, but I do not believe the direction we're headed in right now is much better.
I agree the economic issues are problematic and painful. Sadly, I don’t see a way around a lot of financial pain for everyone over coming months regardless of the status of a lockdown. Depending on your job and industry, there simply isn’t any work to be done while there’s a real risk of death (tourism comes to mind).
I think one big sticking point for me around arguments to reopen boil down to our medical care workers—doctors, nurses, and everyone who supports them. I’m not comfortable telling _anyone_ that they need to die to keep the economy going, especially when our medical workers don’t have a say in the matter.
I think the conclusion of a death toll estimation exercise may shift if you adjust for expected remaining lifetime.
In Scotland, the mean COVID death age was higher than the average lifetime expectancy[1], which indicates that on average those people would probably live <10 years had they not contracted the disease. The expected remaining lifetime of the average individual in Scotland (if it remains unchanged) is ~37 years, which would reduce the lifetime adjusted death toll by at least 3.7.
There have been a significant amount of excess deaths that are not attributable to COVID [2]. I suspect that such deaths have a lower average age (e.g. due to suicides), than COVID deaths, further reducing the average life years saved due to the lockdowns.
I'm not proposing that we should optimise for life years saved, but I do think that the death of a 86 year old is less tragic than that of a 38 year old, and that we perhaps shouldn't evaluate lockdown vs no lockdown purely based on the percentage of the population which died.
> I'm not proposing that we should optimise for life years saved, but I do think that the death of a 86 year old is less tragic than that of a 38 year old, and that we perhaps shouldn't evaluate lockdown vs no lockdown purely based on the percentage of the population which died.
I of course agree with that. Just stating lives lost in isolation is misleading. It simply much easier to use for back-of-envelope math, and generally back of the envelope math indicating a course of action would lead to millions of excess deaths is enough to conclude that probably it won't be a great idea.
> which indicates that on average those people would probably live <10 years
This is plausible, but it may not be much less than 10 years either. The life expectancy of someone who reaches average UK life expectancy is close to another 10 years. And we'd probably both prefer neither ourselves nor any elderly relatives or friends to suffocate 10 years before their or our time.
> There have been a significant amount of excess deaths that are not attributable to COVID [2].
So this sounds initially plausible (lockdown stress/economic hardship leading to an increase in suicides) but I believe it's bullshit and that these deaths are in fact due to covid. Since we were talking about the UK, let's go back to look at that: the baseline figure of suicides is pretty low (~6k in the UK for 2019, which is 1e-4 per individual per year). The number of excess deaths in 2020 is at least 12 times higher than that. So the suicide rate would have had to at least double to account for a significant part of that. And nationwide suicide rates are quite stable, year-on-year, including, crucially, during times of severe economic hardship.
Because it's a value judgement and one at least worth considering so it's not idiotic.
I mean maybe the decision to lockdown for many many months is better but we are least need to try to estimate how many lives it saves in comparison to just letting it run and hope big the economic cost is.
Yeah and it's still a value call with significant part of the population on both sides.
It's easy to be for lockdowns when you're in privileged position in the society but if you talk to people not so fortunate when it comes to income, education and perspectives in life you will see why they are so often for letting the pandemic run it course. It's because lockdowns take the very little they had in their life be it work or ways to escape loneliness for just a while.
I am sick of this tone of superiority so often used here. It's so elitist and so out of touch.
You complained that people need to "at least look at the cost", and now you're mad that people have looked at it and found the answers to be wildly in favor of lockdowns. It is an unbelievable "tone of superiority" to keep ranting about everyone else not having thought as deeply as you, and imagining yourself as the only person who knows any low income people.
So now the number of free icu beds in hospital and number of death are the only kpi we look at to make decisions?
It is crazy how people opinion like mine is fully ignored in Europe. today we tolerate flu deaths so that people can live freely, why shouldn't we tolerate covid deaths to live freely?
One reason of many: flu deaths don't overwhelm hospital capacity. If someone dies from flu, it's generally not because of lack of available care. When hospital capacity is overwhelmed, people die that wouldn't otherwise die. If covid overwhelms hospital capacity, then people will die because of lack of available care. And so therefore, people dying from lack of available care is valued as "worse" than people dying with sufficient medical care.
And so if you equate the two, a lot of people think that is crazy.
You will tolerate deaths until it becomes a loved one or yourself. At that point you'll realise that all you need to do is stop being an idiot and understand that with some restrictions we can significantly reduce deaths and at some point in the near future resume "free life".
"It's crazy" how much people are willing to risk just because they can't be patient.
> You will tolerate deaths until it becomes a loved one or yourself.
Couldn't you argue that a loved one may die because of the consequences of the lockdown? Undiagnosed cancer, depression, suicide, aftermath of the ruined economy? Is anyone keeping this tally?
Hard to get a diagnosis when the hospital is overrun with people dying in line, friend.
To the other points: yes, things will be hard. We can quantify how hard each approach will be.
In the case of a lockdown, there will be orders of magnitude fewer deaths.
A tally is being kept—all the numbers were run before a lockdown was even considered. The only reason this debate continues is because so many ignore the hard work medical administrations, public health departments, virologists, economists, and policy makers have already done.
Because it's not possible to 'tolerate' them - left unchecked it would overwhelm our health service, destroy the economy, and cripple society.
Your proposal is a fantasy; it sounds as if you're wishing this was similar in effect and scope to the flu (and I'm sure we all wish that) but clearly that seems not to be the case
Because the standard of care that people receive in a regular flu season is with a health service that can say that it gave someone the intensive care they needed, but unfortunately it didn't work out.
With covid left unchecked, the intensive care isn't intensive at all because the health care resources are spread more thinly.
Over a large enough population, this will lead to many more deaths that would not have happened had those people not been in a healthcare system that was overwhelmed.
So as a society we'd be saying that "these people died because our health service was overwhelmed, we knew that this would happen if we didn't lock down, and we chose to not lock down anyway".
>It is crazy how people opinion like mine is fully ignored in Europe.
I don't believe it's crazy that your opinion is ignored. I think it's rational and moral to do the opposite of your opinion.
I just happen to think your opinion is selfish and deliberately and unproductively obtuse.
The people that have serious cases of the flu don't overwhelm the hospitals because a good part of the vulnerable population get vaccinated. The herd immunity also plays a role because this kind of virus has been around for a long time.
We could decide that lockdowns / restrictions are not good but then we also have to be okay with letting lot of people die gasping for air and drowning in their own lungs at home / in the hospital corridors. As much as I hate not being able to socialize how I like I still prefer that and it seem to also be the case for most of the population.
I have no idea if we'll ever be able to eradicate the Covid but if we don't it might become just an other flu when enough people are vaccinated or had it.
We don't tolerate flu deaths. We actually work hard every single year to prevent them - providing inoculations for the sick and vulnerable for one thing. People die in spite of all the efforts we put into preventing them from doing so.
You can think what you like as long as you wear a mask, work from home if able etc. Seriously, you have an absolute right to your opinion. But too many people think that stretches to taking their mask off in public places or having parties.
You're allowed to think any way you want. And you're even allowed to explain that you do think that and why. But most people will probably think that's plainly a bad plan and point out that lots of people will die because of it, so be prepared to feel embarrassed often.
It's really not that uncommon of a belief, those who hold it just get shamed a lot by the crowd that parrots the media narrative all the time and keep it amongst ourselves, instead of talking to you about it.
Maybe most people do believe what you do, but majority opinion isn't automatically right opinion. You know what else will kill people? Economic shock.
It's so arrogant to act like an opinion like yours is completely obviously right, and to tell someone to "prepare to feel embarrassed often". You should feel embarrassed.
I guess it seems like a surprising view to have (to think that the government should let it run its course)?
I mean, the evidence is pretty clear by now isn't it?
Countries that responded to the pandemic with swift strong action, especially restrictions on movement, have had the best outcomes for both health and the economy.
Countries that tried to protect the economy / their nation's finances by enacting watered down measures have fared very much worse.
It's interesting to me how far views in different places have diverged on where the balance point is for this. Australia's recently been having a debate about whether or not 20 cases a day is enough to justify a full lockdown of a city (the NSW premier decided no) and border closures (most states decided yes). Meanwhile, in the UK...
I don't think the evidence is clear. There are countries that were unsuccessful with their lockdowns, and countries were numbers were decreasing (because of lockdown or other reasons is unclear).
Then there is China, whose numbers can't be trusted. And some remote island states seem to have done well. Most interesting case perhaps Taiwan (which incidentally also belongs to China).
> I mean, the evidence is pretty clear by now isn't it?
I think the evidence is clear that it's endemic to the world (like Tuberculosis still is, with most ppl carrying a latent infection). Things are deadly in the world. As far as pandemics go, this one is about as bad as the modern world can handle...ok, some govts can handle. If economies/governments fall apart, it will run it's course as well. The bet that the entire world will lock down their borders and get vaccines every 6 mo for the rest of our lifetimes, is silly. Will corona basically be gone this year? Next year? The year after that?
It's all hand wringing theater at this point. I think there's plenty of evidence that govts are taking advantage of the situation, but that's not the same as it being a grand conspiracy to release a virus for transhumanistic purposes (to get ppl used to getting govt injection). That's also nonsense.
Isn't is plausible, if not expected, that countries with different industries and economic structures would do differently with the exact same kind of lockdown plan?
That is, a country that has a large WFH-capable population would feel less economic pain than another otherwise similar country?
And thus, maybe a swift and harsh lockdown is the best move for one country, but the cons for another would outweigh the pros? That is another country would enter an economic decline that overall costs more lives than would have been saved?
We don't know the answers to these questions, but I think we shouldn't dismiss these considerations.
That isn’t the full statement though, you omitted the part about it being just like the flu. I think if you believe that it should be allowed to run its course understanding what it entails then you’re either woefully ignorant or something of a sociopath (but that’s addressed in other comments below). However, believing it should run its course because it’s no worse than the rule is not just an opinion, it clearly ignores all evidence to the contrary and is roughly equivalent to the others in terms of bring completely detached from fact or empirical evidence.
I’d love to know why this is being downvoted. As other people have observed, there exist right now multiple, highly effective vaccines. To advocate for letting it run through the population, knowing it will likely kill at least 1% of the population, cause long term health care problems for countless more, and likely devastate the economy... the best option here is that you are ignorant of these facts.
No doubt the NHS in London is close to capacity, perhaps even more so than it usually is this time of year. It's hard to know for sure.
It doesn't help, however, when activist NHS nurses lie on (and abetted by) national media; imagining bed occupancy and oxygen supply levels out of thin air, implying the mutant strain is more virulent among children etc. causing panic, confusion, and supplying fuel to the very people you're trying to lampoon.
In every society since the dawn of man, certain things carried a social cost. In our society, advocating idiotic conspiracies should carry, IMHO, a social cost of feeling embarrassed and stupid. Frankly.
At this point I'm not sure they're capable of feeling embarrassed or stupid. They get all riled up and start acting out, but it doesn't look like insulting and embarrassing them is working...
Surprise surprise, amplifying division just further amplifies division.
We're hearing this:
A: "I'm dying inside because of lockdown. I can't work and I'm this close to the end of my rope."
Should the response be this?
B: "People are dying outside because of COVID. I don't care about your pain. You are an idiot."
A: [storms capitol]
Or this?
B: "This sucks all around for sure. Your pain is real, and I feel it too. The tradeoffs made by society as a whole based on available data are X Y and Z, but here's a list of things you can do for now to help make ends meet and keep it together...."
A: "Thanks, I'm glad we're able to help one another out."
Of course, some people can't be reasoned with and others will just go off the handle because they're crazy. There's no point in being nice to those, but people forget about all the others that are not far gone and we could help them to understand. That's never going to happen if we start every sentence by calling them idiots right off the bat.
Even the unreasonable and the crazy are likely to have better outcomes if treated with some dignity rather than open rudeness. I'm not saying I'm great at it, but "I think you're wrong, here's why, maybe we can find the root of our disagreement in either differing values or differing/incomplete data" probably works better than "you are an idiot" or "your views are idiotic".
While valid, this argument can only apply in a different information reality than our current world.
The pace of interaction and information has simply overwhelmed the ability of human one on one interaction. Most of our actions are with a mobile phone near us, meaning that the social sphere is directly with us and only a twitter/FB/Reddit/HN glance away.
Doesn't even help that the sites are designed to be competitively addictive on top of it.
IF that is the case - no matter how much you listen to someone, a few seconds after they return to their phone they are part of the new outrage cycle.
Do note that the whole thing above is doable with cable television as well. IF your uncle goes back home to listen to X TV channel day in and day out, your one on one interaction is going to only have a tiny impact.
The saddest part of what tech has created is a faster pace of communication that is orienting itself inimically to slower one on one human interaction.
Even this para above is built with the idea that parts of it will be broken off by people who read it and then reused later on. It's not a conversation with just the person I am responding to, but to everyone else reading it.
This misses an important fact: not everyone is acting in good faith and what should have been a discussion on public health policy has been turned into a political football.
Good on you if you can help people who are struggling, but recognize that when people push back against the lockdown there are often ideological factors in play.
The supposed goal of a malicious government is to make everyone entirely dependent on it, for everything, even the basics. Small business represents independence to a large degree. Destroying small business means everyone turns to the government to survive. Having everyone dependent on you means you can enact any law with little resistence.
I believe we should have let covid run its course whatever the cost. Not because I think it's a hoax but because the alternative violates the non aggression principle. Is freedom more important to me than 1% of the population dead? Sure.
I don't necessarily think the government is doing it on purpose and colluding with big businesses that are profiting from the situation, I think it's more likely that politicians are just incompetent (they need to save face with people who are pro and against a lockdown) and that big companies are better positioned and can push the government a bit to get what they want. As usual.
If you fear for you life isolate yourself. If you can't afford to isolate ask for charitable donations (even if the more preferred approach has been to just give taxpayers money, taken with force from everyone).
I isolated myself and my family 2 weeks before the government forced a lockdown on us, because there was no data and I was scared of the mortality rate. After seeing the mortality rate and the age range, I stopped caring but I started keeping a distance from old people.
I still led a pretty isolated life for personal reasons - and wore my mask to avoid fines and to respect my social contract with society, which took this decision against my will.
I'm genuinely curious to see if the doomsday is going to arrive or not in 2-4 weeks time.
If it does, I hope it will crash the economy and that I'll make a profit or that house prices will go down (assuming I don't die, given my kids go to nursery and are probably spreading all kind of viruses).
If it doesn't, your argument won't look very good and you'll regret calling idiots those with a different opinion. And I guess there is still a chance of an economy crash, given the lockdown.
Funny, I didn't see anyone calling to shutter the economy when my dad was dying of cancer. Similarly, I didn't see any great outrage this summer when my uncle died of a heart attack.
Death is tragic, but it's also a fact of life.
A lot of people have fallen into the trap of making fear a virtue this year.
If "cancer" was this new disease that appeared in 2020 and it was highly contagious I'm pretty sure similar measures would have been taken. Or in other words, lockdown doesn't help combat the spread of cancer but it helps against airborne diseases. On the other hand, we haven't ignored cancer, AFAIK is one of the family of diseases that has most of the research funding going into (at least pre-2020) and it shows, the treatment efficiency for many types of cancer in 2020 is much better than it was 50 years ago.
I was fully on board with lockdowns, etc. in the spring. We are long past the "novel and unknown" stage for Coronavirus.
Our schools opened in the fall and have been able to stay open. Everything I've heard about "remote learning" points to that being a huge blessing for the families in our state.
I am thankful every day that our state and local government has had the backbone to let people live their lives.
> Funny, I didn't see anyone calling to shutter the economy when my dad was dying of cancer. Similarly, I didn't see any great outrage this summer when my uncle died of a heart attack.
Don't be obtuse. Neither of those things are contagious.
> Death is tragic, but it's also a fact of life.
Death is a fact of life. But nobody wants you around if you have a contagious deadly disease.
> A lot of people have fallen into the trap of making fear a virtue this year.
The opposite is true. Those who've made fear a virtue have survived and helped keep the elders in their family alive.
It's the brave idiots who don't wear masks who're killing the old people. I guess without your dad and uncle, you have nobody old left that you care about.
> I guess without your dad and uncle, you have nobody old left that you care about.
My 98 year old grandma was the first person in my family to catch the coronavirus. Since then I've an aunt and uncle both catch it. All three have recovered just fine, as have my five or six neighbors who also caught it, and nearly everyone in my broader community who has caught it.
But yes, me and my cold dead heart killing old people. I'd personally much rather that than the reality of my grandma being locked in her nursing home without visitors for the past nine months and the whole place still caught the virus. Maybe now with the vaccine coming out she can finally have some comfort in her life instead of sobbing and threatening to run away every day.
> My 98 year old grandma was the first person in my family to catch the coronavirus. Since then I've an aunt and uncle both catch it. All three have recovered just fine
There you go. All your old people are dead or immune. Yours are no longer threatened, so bugger everyone else.
> without visitors for the past nine months and the whole place still caught the virus.
That's not possible. Somebody with the virus had to to have visited in order for it to have spread.
Did all the other grandmas in the nursing home survive as well?
Near as I can tell things are pretty wide open here in Iowa. We even had the honor of getting an Atlantic scare article of "This is what happens when government does nothing"
Turns out what happens when government does nothing is things are perfectly fine.
The media went out of their way to make people think that Coronavirus was basically the only cause of death this year.
Combined with the bogus "positivity rate" that most lay people misinterpreted as the percentage of the population currently infected, this has been coordinated disinformation on a mass scale.
Coronavirus is the most significant new cause of death in 2020, of course the media is going to talk about it. It's newsworthy. You're just spouting random conspiracy theories.
Because on one hand the government thinks it's OK for people to die alone in ICU and bury them without their friends of family[1]. But on the other hand said that it's OK to meet people to celebrate Xmas with[2].
Meanwhile in Australia the "cricket has to go ahead", crowds and all, despite Sydney being on the knife-edge of heading towards a second wave. All because the politicians involved are huge cricket fans and even server on the boards of cricketing organizations.
I've never understood why politicians are allowed to have such blatant conflicts of interest, but they get to write the rules, not us...
Plenty of people outside. In fact, I would call it lightly crowded, although less than other years. Many people don’t wear masks. It’s not a surprise that transmission has increased.
Nevertheless, London looked absolutely beautiful. Not sure if this was worth the risks though.
The people in the video seem to just walk around outdoors and not very close to other people. That many people obviously will mean a risk that some of them go into stores, but if there is a reasonably safe thing to do outdoors (like a particularly nice street) it’s natural that this becomes extra popular when people want to find something to do outdoors.
Outdoors, especially in a humid night, is not a magical place where the virus is inactivated right at the mouth of the shedding individual. People being so close, people walking into air that someone recently exhaled—these are big opportunities for infection.
Can you quantify that? I've been under the impression that outdoors transmission was extremely rare and the vast majority of transmission was indoors. I've been meeting with people outdoors for walks thinking that was mostly safe. I've no sources unfortunately.
Wind, UV light from the sun, wearing a mask—these all help, but it’s never 100%. From the research I’ve seen, it’s 20 to 1 safer. But as the virus becomes more transmissible, as well as different outdoor environments, the risk can fluctuate. Be careful. Mental health is important, but so is your physical health. Keep distance on your walks, and choose outdoor areas with a lot of air circulation.
Most of them are far closer than I would be comfortable without a mask outside. I only take mine off when there is no one around for like 25 yards, because you never know when someone will cross paths with you and end up very much in your personal space.
You can be sure if people are this lax in a busy commercial district in public, they are just as lax when they gather with their friends and family in private, which is where the bulk of the spread happens. I wonder how many are gathering to watch football matches with booze and friends.
Yeah you would be fine at six feet too. But if that person just stopped moving to check their phone, turned around and doubled back my direction and passing me on the narrow sidewalk, all kinds of reasons that they would quickly close in from a safe distance to within six feet of me, that wouldn't be too great. Easier to just throw on the mask sooner than wait till the last minute.
You’d still be spending such a tiny amount of time in close contact that it doesn’t matter. You can even look them in the eye and say a friendly “hello” as you walk by each other.
My very amateur assessment of national and regional Covid trends is that higher rates of spread seem to correspond very highly with "indoors weather" conditions. That's heating season in colder climates, cooling season in warmer ones.
But yes: people gathering, indoors, largely with recirculated air.
Obviously it doesn’t look great but I think the experience with the various protests over the summer (despite looking, I think no one found significant increases in cases due to big protest marches in the US) suggests that this is reasonably benign, though maybe it’s worse with the new strain. In particular these people outside where the ventilation is good are not huddled together in bars or restaurants or sitting rooms with their friends/family which is a much more reliable way to spread the virus.
You could have taken a very similar video in parts of Melbourne during our (successful) lockdown with people sitting at the beach or walking around the parks, it made no difference to the elimination effort. The only major changes I see are far fewer people wearing masks and being nighttime (if UV has any benefit). Outdoor transmission is very low risk.
This is a consistent taking point among the more egregious parts of the “lockdown skeptic” crew and it is, of course, absolute bullshit - it’s based on shallow comparisons of numbers that are not comparable.
If you do decide to promote this talking point anyway, flag it with the appropriate disclaimer from the NHS:
…caution should be exercised in comparing overall occupancy rates between this year and previous years. In general hospitals will experience capacity pressures at lower overall occupancy rates than would previously have been the case.
Well but the NHS is the source of the data to begin with. And they communicate limitations along with the data. You can't just ignore those and use their data. You'd have to find another source that offers actually comparable numbers.
Hospital capacity has had to be organised in new ways as a result of the pandemic to treat COVID-19 and non-COVID-19 patients separately and safely in meeting the enhanced Infection Prevention Control measures. This results in beds and staff being deployed differently from in previous years in both emergency and elective settings within the hospital.
Do we know how effective those measures have actually been in practice? There's been some reporting that large numbers of people have caught it in hospital (and indeed I have a personal interest here as a close relative of mine caught it in hospital just before Christmas, though a very minor case and now fully recovered).
It makes sense to try to stop spread in hospitals but unless I've missed something there seems to have been very limited work done on if any of the protocols as actually implemented (ie not just in a theoretical world where they were designed) - and especially the costlier ones in terms of bed space - have worked, or at least worked enough to offset their cost in health terms.
AFAIK you have misunderstood the data; the “open” figure is not the number of unoccupied beds, but the total number of beds available for patients (1033) of which 882 were occupied by patients already (meaning 151 unoccupied).
I disagree. The word open is superfluous if that's the case. What's the meaning of the word open if not unoccupied or available?
Of course that begs the question, why did they use open instead of unoccupied?
If open is meant to mean bed that can be utilized, then we don't have a true number of beds or a reason why a bed would be closed.
Either way it's confusing but generally the term open as the opposite of occupied for filled. For example, open positions in a company aren't employees, they're vacancies.
You can disagree all you want you really are categorising these numbers incorrectly; the data as supplied lists the categories “open”, “occupied”, and “% of open beds occupied” - which seems pretty clear.
There is inherently no “true number” of beds because this number varies in response to things like hospital space configuration, staffing levels, and demand.
AFAIK the term “open” is analogous to that in “open for business” - there may be other physical “beds” available, but without staff or without some equipment or some other constraint that makes them not open.
I do appreciate that it’s confusing, because I had to doh me check myself. But it’s not without reason that it’s described that way.
> You can disagree all you want you really are categorising these numbers incorrectly; the data as supplied lists the categories “open”, “occupied”, and “% of open beds occupied” - which seems pretty clear.
I went back and looked and you're right. I didn't look at the XLS file, I just pulled the raw data from the CSV file which doesn't offer the %.
It's clear from the XLS that the % is derived from occupied/open and not occupied/(open+occupied) as I was thinking.
It's not a term used in America, outside of some extremely old black-and-white movies. Still I'd be surprised if someone born and educated here didn't know what it meant, since it must have been encountered in books or film or something.
Not in the US. It’s mainly thought of as an “old English” word. It hardly ever appears so you usually learn the length some time in school and then subsequently forget it.
Work places remain open. People continue not to wear masks with impunity. Closing schools will help a bit. But I doubt it will reverse the spread, it wasn't enough for the old covid 19, let alone the new strain.
So now we get to see if we hit that hockey stick. There's a natural experiment at work here to see if everyone starts dying en masse. Sucks for people in the UK, and for folks like my cousins and aunt who work in the NHS, but doomsday is almost here so we get to see what doom is like.
We should play close attention from afar so we can learn.
Although lockdown measures in the UK look very similar to measures in other European countries I can tell that there is very little police control, probably due to lack of resources.
For example I don't know anyone who arrived from abroad being checked if they are self isolating at home as they declared.
Anecdotally compliance has actually been pretty high. And I think it's wrong to say there haven't been checks - I have a couple of friends have received visits or calls from the police to check they were in compliance with travel quarantine requirements.
It’s pretty obvious that this is the fate of the US and Europe too in the next 6 months. Unless we lock down hard. People are still in total denial though.
Looking at COVID models, the hospital admission peak is around the 10th of January UK wide. Cases have already started to level in London. Lockdown has been implemented too late to make any significant difference to that.
Not the most reliable source, but confirmed by other sources which are unfortunately behind a paywall.
> Cases have already started to level in London. Lockdown has been implemented too late to make any significant difference to that.
This is a common claim and I have seen it made about various periods of lockdown in various countries. "Look, rate of increase started to slow within a week of lockdown, but it should take two weeks to see the effect, so it can't be that lockdown has made any difference." There is usually far too much noise in the figures to make such a claim about small differences in time scale. Also if you were expecting a sudden drop after two weeks then you were bound to be disappointed. The amount of time it takes for an infection to become a recorded case of Covid will be random according to some distribution (possibly with a mean of one or two weeks) so the transition will be smooth.
I am not suggesting lockdowns do not work. Hospital peak was predicted to be around the 10th of January well before lockdown was announced and that has not shifted. Lockdown is undoubtedly going to change the shape of the curve after the peak has passed, but it didn't move the actual peak.
Adding android mobility trends % increase in stay at home is more illuminating. Qute a large percentage of the people that can afford to "lock down" already do: https://imgur.com/jPctkws (thats London) but lockdowns do add another layer to that.
I believe it's back on standby as is the one in my city, Nightingale Hospital North West, in Manchester. The issue is staff though, there simply isn't enough qualified staff to work it alongside their hospitals.
I've been working as a volunteer nursing assistant in hospital A&E departments through St John Ambulance it's honestly just insane. I don't know what the plan is for Nightingale but we're focusing on getting mass vaccination centres setup currently and delivering the vaccines.
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[ 4.1 ms ] story [ 181 ms ] threadThis is a consequence of loosening the lockdown for Christmas.
1: https://nypost.com/2020/12/20/londons-covid-19-christmas-loc...
EDIT: It's weird that people don't believe me. Here is a BBC article talking about the Tier 4 lockdown that occurred right before Christmas:
https://www.bbc.co.uk/news/uk-england-london-55380644
From the article:
"Millions of people across England have been banned from meeting friends and family indoors over the festive season as they enter a new tier-four level of Covid restrictions, while indoor mixing has been restricted to Christmas Day alone for the rest of the country."
Perhaps someone in the comments could show me evidence that London was "loosening the lockdown for Christmas"?
Also I live in London (and did during Christmas, where I cancelled my plans because of said lockdown), and am British.
Source: Being in UK.
Source: living in (what was at the time) a tier 4 area
The issue is the new strain, clearly. Cases were growing even during the November lockdown.
Wasn’t Kent the first place things started to really kick off and take a turn in mid Nov?
Little weird to be getting to -1 downvotes for something that's a google away...
London and the SE is where the new highly infectious strain originated from and was more or less entirely locked down. Big chunk of population here too...
Source: Being in London during Christmas.
[1] https://www.bbc.co.uk/news/uk-england-london-55380644
Also from the article:
"London saw wild scenes of a weekend mass exodus before the start of a Christmas lockdown and travel ban sparked by a new, more infectious mutation of COVID-19."
In real world it is not the restrictions that save lives, it is people following them. If people ignore restrictions it doesn't matter whether they were or were not tightened.
Actually, if people were sane we would not need restrictions. Everybody would wash their hands, avoid touching their face, wear their mask properly (ie. not faking wearing the mask) and avoid physical contact with other people unless necessary. And all research suggests that would be enough to deal with the virus.
The fact is that Christmas in almost every country resulted in mass movement of people that just have to go and meet their families. And it doesn't matter for what reason it happened, it is just a fact.
So, regardless of whether there were or were not tightened restrictions, there is going to be an inevitable increase in cases.
I don't think you're trying very hard, the comment was pretty clear. But in case you are truly confused, no, that is not what parent was saying.
It is absolutely the government’s job to enact policy to slow the spread of deadly disease. It is also the job of governing leaders to encourage and educate citizens on how and why they should comply with these policies. This is where the USA is failing miserably.
We could discuss the tradeoffs and the details, that’s fair, but it’s totally irresponsible of you to say that this massive spike in cases was ‘inevitable’.
I don't see how you arrived at your reading.
Source: am British also (and stayed home and saw no one at all over Christmas and new year, just sayin)
"London saw wild scenes of a weekend mass exodus before the start of a Christmas lockdown and travel ban sparked by a new, more infectious mutation of COVID-19."
The mass travel before the Boxing Day restrictions kind of proves people were away from home, seeing family etc this spreading the virus.
For people living in London, Christmas Day was indeed a lockdown.
I found it quite strange, since if you were staying at home and had zero symptoms, why would they need a test? However, somebody let slip that they were getting tested in order to get confidence travelling home to visit their family... Therefore, while people were locked-down, I think many worked around this.
https://www.gov.uk/government/speeches/prime-ministers-state...
The last minute changes are confusing to all of us. You can help by not citing anti-sources like the NY Post.
You’re inadvertently doing the London thing that Londoners do where you conflate a comment about the whole country to just be about London. London may have had increased restrictions (which I doubt had the level of observance they should have but hey ho) but the rest of the country didn’t. The parent comment didn’t specify London, they were talking generally and, generally, restrictions were loosened for Christmas.
And it is also ideal delay from Christmas to Dec 31st for most of the people that got infected over Christmas to start spreading the virus but not yet show symptoms.
This is a crying shame.
huh? There were lots of reports about ambulance queues last week already
https://www.bbc.co.uk/news/av/health-42570660
https://www.itv.com/news/london/2020-12-30/ambulances-with-c...
https://www.youtube.com/watch?v=Q6mCJt__oxQ
Takes 3 weeks from catching it to hospital - that’s still a few days away
The cases caught from Christmas Day and passed on multiplied to the school return on Monday. That political decision will have killed hundreds needlessly, maybe thousands, just because he didn’t want to back down.
How much of that is the new strain, how much is Christmas, and how much is government decisions (reopening universities, encouraging office workers to work in person, allowing foreign holidays, announcing an end date for the second lockdown before it had even started...) is hard to say.
However, an increased rate of spread (R factor) is a change in the parameter of the exponential curve, and cannot be dealt with by any sub-exponential response. The only thing that could possibly work is to change the factor. Rapid vaccination or lockdown. It's impossible to vaccinate the population of London in two weeks, which means a full lockdown is the only option now.
YC News is mostly a forum for software developers, which means that these notions ought to be familiar to most people here. When talking about software algorithms, we all learned about big-O notation. We all learned that Exponential time algorithms are (nearly) the worst case, and will always be worse for large data sets than a linear-time or quadratic algorithm, irrespective of the constant factor.
Essentially the new mutant strain changes the "R" term in Θ(a×exp(R×𝑡)), whereas increasing the lethality is a change in the "a" term.
People are concerned about the lethality getting worse, but they shouldn't be. This change in the infection rate is more scary.
Arguments about exponentials mean nothing to anyone in any of these buckets— they'll be flaunting a lockdown up until and perhaps beyond the point where it is administered by force.
I don't know how to deal with this reality, but it feels like the greatest threat at this point.
Extremely good coordination with vaccine invention, extremely bad with all other aspects.
Humanity is irrational, most people believe crazy, inconsistent things, and are easily manipulated.
The average citizen is stupid, the government is vulnerable to sentiment from the average citizen (and partisan media orgs that seek to influence those citizens for their own power or money).
It's a bad situation.
It's basically like Asimov said, "The saddest aspect of life right now is that science gathers knowledge faster than society gathers wisdom."
So: * lockdowns are guaranteed not going to eradicate the virus the way it has in China. * lockdowns are guaranteed to crush small businesses and restaurants, creating an L-shaped economic recovery and putting the West at a disadvantage in future geopolitical conflicts. * the vaccine works but will take a year to rollout to everyone and it is unimaginable that the public will tolerate a lockdown for more than a month * herd immunity might work
I truly welcome any debate on this as I'd love to be wrong about my critique of my country's (Canada) approach to all this. We seem to be not having our cake and not eating it too.
And then cases started spiking in September, I suppose due to some combination of back-to-school, lockdown fatigue, increased indoor gatherings, etc. At that point I became extremely unhappy as it became apparent how little the Provincial gov't in particular had taken advantage of the long summer of low cases to build up test and hospital bed capacity, and to make plans for vaccine distribution. The second wave hit and it felt like basically just rewinding to March. This was apparent to everyone and I think it probably became a positive feedback loop as more and more people gave up and had in-person Thanksgiving and Christmas gatherings.
I think you mean infectivity (relating to transmission), not virulence.
Yes we can assume there is selection pressure for more benign strains. But that doesn't mean those strains will win.
They should. Lockdowns deal with the exponential phase, but in the long term the process is not exponential. The virus is probably going to infect half of population anyway. There simply aren't ten times more people it could infect. On the other hand, there are ten times more people it could kill or cripple.
Even with this faster spreading strain, it's possible that the vaccination efforts will win out and halt the spread before it reaches 50% of the population.
YC News is mostly a forum for software developers, which means most of us have a tendency to want to keep things simple. That's fine for simple thinks like operating systems or proving all problems in NP are also in P. But nature is on a completely different level.
And you or nobody else knows what the natural end would be for this virus.
A fast spreading variant could overall reduce deaths over the next 5 years.
> A fast spreading variant could overall reduce deaths over the next 5 years.
What do you mean by this?
Assume being infected from this variant grants some protection to future variants. If everyone was infected (or vaccinated) and protected then it would be difficult for the virus to spread and mutate.
A slower spreading virus would produce more mutations over time and its possible one of those mutations could be catastrophic (though unlikely). Not only do you have more mutations but you also have fewer people protected.
Mutation is not primarily a function of time but of infections. So mutation is higher when there are more hosts. Letting the virus infect people leads to more mutations.
Now we're probably not talking about the same thing when we say mutations. I mean the sum-total of mutations. You mean successful mutations. But here comes the connection: The virus is more likely to evolve into infecting vaccinated people when it is more widespread. Because there are more mutations and consequently more chances for one of them to evade the immune response of vaccinated people.
That's why we're all wearing face masks, limiting social interaction and even put whole countries in a full lockdown. WE all do this to LOWER the spread of the virus.
Which makes it of limited use.
Even if they were used in the first wave it was in the expectation that any hospitals sending patients there would also send staff to look after them, which was never realistic.
You can hire a hall and stick a bed in it, but if there’s no one to look after the sick person in it they don’t have much of a chance.
You can't build a hospital like that in a week, and there are no staff.
I've worked in Nightingale (London) and am on standby for Nightingale North West if needed. Luckily I didn't have to deal with any patients there and I hope we don't again.
Dunno why you're downing me but... The data is all here https://www.england.nhs.uk/statistics/statistical-work-areas...
5511 5861 6358 6733 6816 7034
So apparently increasing rapidly
[0]: https://www.england.nhs.uk/statistics/statistical-work-areas...
For a large metro area like London, you might have some hospitals at high utilization because they're very close to other ICUs and can redirect incoming patients. It's not supposed to be at high utilization regionally, otherwise a single minor disaster can cause the system to tailspin.
[1] https://protect-public.hhs.gov/pages/hospital-capacity
https://covidtracking.com/data/charts/us-daily-deaths
https://covidtracking.com/about-data/data-definitions
This is what COVID is like — First roll two D4: If you rolled a 1 in the first, you now have a liver injury; If you rolled a 1 on the other, you lose your sense of smell.
Now roll a D20:
• 1-4: asymptotic but still infectious
• 5-16: somewhere up to “mild pneumonia”
• 17-19: severe symptoms (dyspnea, hypoxia, etc)
• 20: critical symptoms (respiratory failure, shock, or multiorgan dysfunction)
And that’s with treatment. All that “flattening the curve” talk early last year was about making sure people could still get treatment — if you exceed the capacity of the healthcare system, you don’t get to save all the people whose conditions would have been well within your capacity in a non-overloaded system.
The odds are low for an individual. Sadly, 2% is a bigger deal when you get on a bus, walk through an airport, use an elevator, go to a public restroom, or walk down a crowded sidewalk.
This isn’t an issue of your health or my health. It’s an issue if everyone’s health.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533457/
If it's were, it absolutely would require isolation upon infection.
Edit: downvoting me doesn't make me wrong.
Incredible.
Fortunately isn’t not contagious and so the solutions to that issue can be different from the solutions we apply to Covid.
You say shutting down the economy so casually, as if it has no impact on an infectious disease spreading during a pandemic.
If there hadn't been any shutdown, it would lead to a tenfold increase in infections and an even higher than tenfold increase in death as hospitals will be completely overwhelmed and unable to provide normal healthcare.
But if you think a 20x death rate from the nr 1 cause of death (heart disease), preventable by a lockdown for a few more months as a vaccine is rolled out, is no big deal, then there really is no arguing with you.
I am not making the argument that it's "just a flu", but I will make the argument that it's "just death". Death is. Only a sheltered person is emotionally distraught because of this; and in turn, only a person who cannot handle this perspective would deem it logical to permanently damage society in order to reduce this number.
I am all for protecting older folks, even at great expense. We should have isolated every old folks' home and done everything possible to keep them COVID-free and well stocked with everything they need. These folks have served their time in society and deserve to be cared for with a higher standard than others. It's highly unfortunate that the exact opposite thing happened; I hope that we learn a lesson from this.
However, when we're talking about the non-elderly, it seems that the vast majority of people who are dying are simply in bad shape / vitamin deficient / etc. Sorry, I don't see any reason I should care about their death any more than I would care about it if they died from heart disease, which is almost certainly going to get most of the people in that demographic eventually anyway, if they don't get hit by a car first. It's sad for their families, and for us it's just a warning to get some sunshine and exercise ever so often, which is literally all it takes to put yourself in the group of people who have a massively high survival rate. In fact, we've all had a whole year with literally nothing else to do for amusement to have gotten in good shape during. At this point, anyone who is still ignoring that has made their choice.
It's about putting things in perspective. 50-100k people die from the flu every year in America for the past decade and nobody cared before and nobody will care about that 10 years from now either unless it's a really slow news day.
> there really is no arguing with you
There's plenty of arguing with me. Convince me why I should care about people who die of one disease when I already didn't care about all the people dying of a different one. That's fundamentally what this comes down to: blowing that level of care out of proportion while denying people the right to make their own decisions about what level of personal risk they are comfortable with.
But lockdown and the other measures aren't just meant to protect the high risk individuals. We still don't understand how the virus affects many lower risk individuals long term because it's a very new virus. Strictly looking at the "death rate" may make us miss that significantly large portions of recovered individuals (from the lower death risk segment) develop long term health issues that may significantly reduce their lifetime expectation.
And yet another reason for lockdown and the other measures is to keep the health system afloat for the other, much higher death risk, health conditions. If our entire ICU capacity is occupied with COVID patients we won't be able to offer the same quality treatment to much higher risk situations like in emergencies (accidents of every kind) not to mention the COVID death rate itself may spike a lot higher if we can't provide the same quality of health care that we've been able to so far.
But wait now, while you're deciding for them how they should live you're not accepting that they could also ask you to live differently during this pandemic. So when they take personal risk, like going grocery-shopping, and get infected, does that mean they have a lesser claim to a hospital bed than you, who wants to "make their own decision" about the risk of spreading the virus? Or do you accept the fact that an old fat guy might just block the ICU you could happen to need tomorrow?
What are you talking about? 3500 died in a single day, that's a 9/11. Multiply it by tenfold like you said, and do it for a year, you're looking at 12.7 million Americans dying alone. Is that a death rate you don't care about? For comparison, the 1st world war, second world war, vietnam war, korean war, war in afghanistan, war in iraq, combined, gets you to about 0.45m casualties.
And that's in one year and one country. On a global scale it'd be insane, and again, just one year. A year in which a vaccine is rolled-out and can end the lockdown. Ending that lockdown now without having rolled-out the vaccine makes no sense.
Covid rates have consistently grown at the lowest rate considered likely.
> HSJ understands that the briefing was part of an attempt to get senior clinical leaders to focus on what they would have to do, if current growth trends were not surpressed by the tighter lockdown.
So, er, what if the growth trends are suppressed by the tighter lockdown, as seems likely? Will things then be better than the "best" case scenario?
It sounds like there's a bit of misreporting going on here. The leaked document forecasts demand based on pre-lockdown trends, to highlight the significant risks. But the article is reporting it as if running of beds is totally guaranteed in all circumstances, which doesn't appear to be the case, if the lockdown works.
There's two lag factors to consider. The first is the lag between restrictions and cases dropping, this takes a couple of weeks and cases and the growth isn't likely to even slow for 1 week. The second is the lag between infections and people getting seriously sick and needing hospitalization, that takes 3-4 weeks. There's also the serious possibility that the restrictions arn't strict enough to make a big difference.
This scenario is basically baked in, avoiding it required action weeks earlier.
The population doesn’t take the message seriously unless the gravity of the situation is stressed and the necessary plans are clear, simple, consistent throughout, and ruthlessly enforced. When most of that happened, lockdowns worked.
But sure, things might have definitely been faster if only we just let more people die.
Looking at the infection rate curve, I think the lockdown was working right up until the more-infectious strain took over.
(“People tested positive” graph: https://coronavirus.data.gov.uk/)
The only meaningful change in the past couple of days is the "takeaway pint" ban (which is unlikely to make any difference and is purely symbolic).
Never, infections have always been a foucs of tracking because infections lead hospitalizations lead deaths (and hospitalizations have second-order impacts on mortality from other causes when they reach a critical level, even beyond direct COVID deaths.)
If you only focus on deaths, you are weeks behind the curve in reacting.
From a non-medical, "just following the news" perspective, there was a pronounced shift. A few simple google news search will show this.
That’s based on taking the IFR and working backwards from reported deaths at different ages.
Infections happen earlier than hospitalizations and deaths but the count depends on people getting tested.
I guess, death numbers weren't growing as expected.
It's a bit like climate warming temperature predictions.
I appreciate it's hard to do forecasts but the media doesn't help selling actual problems to the public by constantly twisting the narrative.
* coronavirus is invented as a government power grab
* the government locking down is a deliberate ploy to kill small businesses
* the government should just let this run its course, it’s Just A Flu TM
* hospitals are actually empty (the “proof” being people recording empty waiting rooms in outpatient departments on bank holiday weekends)
* coronavirus doesn’t exist (!)
Maybe this will be a bit of a wakeup call.
With the masses sedate at their screens, the bureaucracy has no cognitive experience or expectations for anything different.
Decades of headlines being fed to Main Street going on about growing inequality did not really motivate Main Street to do much but shuffle back into the office.
Relativity pervades all experience. Reading about history in books is not exactly experiencing history.
Even the nurse reports about "patients being in disbelief about dying". I would imagine lots of people who are about to die are in disbelief.
A friend of my mother died from the flu. He called her shortly before that. I think he probably also was in disbelief.
Do you expect to die from the flu?
https://www.england.nhs.uk/statistics/statistical-work-areas...
There was a good piece in the private eye a few years ago listing headlines saying the NHS is doomed tomorrow going back to before Blair.
https://twitter.com/KulganofCrydee/status/833654730849136641
>Just to flesh this out, the NHS could use more money, but it's worth saying that it's the only European healthcare system I'm aware of so fragile.
You've fallen for the very "NHS is more fragile than systems in other countries" mantra that the Private Eye piece mocks. COVID19 has overwhelmed the French, Belgian, and Italian systems too.
>If you ask a lot of British people they seem to think that the only alternative is the wild west found in the US, rather than the other healthcare systems in Europe.
The NHS is unique in being so unified. I'm not sure there's another European country in which one government entity runs insurance, billing, and delivery. Because the UK is the foreign country Americans are most exposed to (Canada doesn't count), this results in both Americans and Britons thinking that all healthcare plans outside the US are like the NHS, when actually the norm is something closer to that of France, Germany, or the Netherlands.
Government running every aspect of healthcare means that every aspect of healthcare is a political issue. The consequent level of weaponization of the NHS in British political rhetoric is flabbergasting. It's said that Social Security (the US version of UK National Insurance) is the "third rail" of American politics—any politician that touches it gets electrocuted—but there is no comparison. I, for one, have no desire whatsoever to ever experience the US equivalent of how in the UK the NHS is always, Always, ALWAYS the #1 or #2 topic of every single election, with every candidate competing to outdo the others in promising that the NHS will "always be free" and that he is the only candidate who can make sure that the local GP's surgery hours will widen and that the A&E will no longer be "the worst in England" or "the second-worst in Yorkshire". The Private Eye piece is the result of the above.
(Canada, also with a single-payer system, sensibly divorces billing from providers. As in the US private entities deliver most healthcare, and in both countries if one's doctor has inconvenient hours or if the local hospital has substandard care, one simply goes to another as opposed to having this being something politicians are expected to fix.)
I think Denmark apparently has the most comparable system in Europe, but I've not read much about it (just heard it in passing).
NHS does well in the Commonfund healthcare comparisons (https://www.commonwealthfund.org/publications/other-publicat...), especially given how small a share of UK GDP healthcare spending is. That's certain an argument for its unitary, top-down structure. That same integration, however, makes it vulnerable to the sort of political grandstanding that Private Eye satirized.
It has money.
Winter pressure this year, no matter how you count it, is considerably worse than it has been in the past.
Just like the US government banned (discouraged?) pictures of caskets coming back from war.
These images need to be on the news and on news websites 24/7.
But when this happened in Italy, a large number of the conspiracy crowd just said the photos were faked.
I'll argue, strongly, that right now - everything regarding Social Media misinformation is an epiphenomena of those factors.
To illustrate -
Misinformation based communication travels differently than "Fact" based information https://www.pnas.org/content/113/3/554.full.
People assign truth value based on heuristics, one of which is how many times information is repeated. If you self select a network of people who believe the same things and repeat it, with slight modifications - you can ensure people will believe conspriacies.
With the ability to self select nodes/people who tend to be conspiracy inclined you will easily cross the number of people needed to make an idea seem socially valid.
The pace and size of our information networks naturally supports the evolution of highly viral content - not truthful content.
Unfortunately in this context, it is illegal to film people in a hospital. I think that's a fair rule but I really would like to have a few videos floating around with no voiceover and no commentary just to scare the shit out of people. I think it would work.
Yet there are some people who still say that it's no worse than flu, and that it only kills old people.
And there are many theories to explain, for example NY morgues may have been overflowing because morgue owners were afraid to accept people who died from Covid.
Is there actual evidence that people died because they couldn't receive care? Even in Italy I have not seen the evidence, just YouTube videos of some alleged doctors making such claims.
Serious question. I would love to see evidence of people dying because they couldn't receive care (in the Western world).
What evidence would you accept?
None of those reports citing the alleged doctor actually checked with the hospitals.
Maybe that should be the minimum: actually checking the situation, rather than repeating some random claims.
https://theintercept.com/2020/12/27/covid-photography-hospit...
And I think there's a direct line between this suppression and the behavior of many people.
Me, too. And, obviously, so did Severino and his boss.
What we actually believe, "Governments have proven they cannot effectively contain this, so if the choice is between security theater or freedom, obviously take freedom."
Go back to guzzling down the mainstream media propaganda that's "informing" you.
Isn't it just an opinion? I personally think that way. Why wouldn't I be allowed to think that?
So let me ask: on what basis did you arrive at your opinion?
[Edit: HN comment from 10 months ago: https://news.ycombinator.com/item?id=22578742]
What’s more, do you have any reasonable figures to suggest why letting a percentage or more of the population die unnecessarily, consigning even larger numbers to long-term health problems and so forth is somehow a good choice?
If I squint my eyes a bit. Reduce the burden on the pension system?
Long-term disabled or ill people who are unable to work will effectively take early retirement (in some cases they can draw on their actual pension early too), and depend on state support from then on whether it's called pension or something else. The duration of payouts will be longer than for ordinary retirement age.
It's not just miserable for those survivors, it's expensive for the state.
Long-term health problems are also likely to cost more in healthcare later.
I’d guess so, based on what I read so far, but not sure.
If you ask people to cite statistics for their claims, you should also do so for your claims such as this one.
It is an axiom of healthcare that outcomes suffer in an overburdened healthcare system, and readily apparent why that is the case. That said, for those too lazy to look, here’s literally the top result for me when googling terms related to this: https://www.kabc.com/news/covid-19-mortality-rates-rise-as-h...
Have you considered that of 100 friends, family and acquaintances you’d see two die and 10 would have a painful and difficult future?
We don't know how many people have ... whatever you are proposing we compare that against.
So faced with the options of "prevent the deaths of over a million people" and "matz1 doesn't like lockdown but doesn't want to talk about or quantify it" I think the choice is pretty clear. Unless you want to elaborate further?
What you have said is that people will suffer under lockdown - but you haven’t really tried to quantify that. You’ve decided that’s a lost cause and have moved onto “lockdown causes death” ! Amazing.
Likewise If you get covid, doesn't mean you will die from covid. vast majority of people will be fine.
>If you lockdown, you don’t get covid. It’s a simplification but it’s a start
Maybe you don't get covid but if you lockdown, you may suffer/die from starving/mental health issue instead.
>What you have said is that people will suffer under lockdown - but you haven’t really tried to quantify that
Is it really hard to think that lockdown would cause at least some unemployment, some bankruptcy, some mental health issue ?
>“lockdown causes death”
Unemployment has long been associated with a significantly increased risk of death.
I don't have the precise number but how are you sure that the damage from virus is greater than damage from lockdown ?
Basically - this is not nothing, it’s being treated like a Big Deal because it legitimately is. There’s a lot of talk from the “treatment is worse than the disease” crowd, scant few of whom are experts. And like climate change and evolution deniers many of the arguments seem to boil down to conspiracy theories or the It’s Always Sunny In Philadelphia argument - “science is a liar ... sometimes”: https://youtu.be/Zgk8UdV7GQ0
[ EDIT: the number I originally used for "requiring hospitalization" were way off. I've edited to reflect data from September provided by the CDC. The 20% -> ICU figure comes from the NYC experience in May, but seems roughly correct from other global hotspots ]
Roughly 0.4% of those who catch COVID19 will require hospitalization. Of those, 20% will require ICU treatment.
In the end, the entire human race will be exposed to SARS-COV-2. If that happens all on the same day, or week, or month or probably even year, no health care system in the world can possibly deal with the case load.
Some of those who might have survived COVID19 with hospital care will die.
But (and this is the important part) those with other medical conditions that timely and effective health care could have treated will also die. Trauma (e.g. car or tool accidents). Infectious disease. Cancer. Chronic health conditions.
And in killing all these people, you've made nothing better for those who survive, because if you think the economy has gone to hell under current attempts to deal with it, you clearly cannot imagine it as the entire health care system melts down.
COVID19 is not a personal health crisis. Most people will not die of it (even though hundreds of thousands will, which is not going to be much comfort to their families, friends, colleagues and neighbors. It is a public health crisis that threatens to overwhelm our health care systems and thus have far worse effects than just the disease itself.
Where do you get this from? I do think, of those requiring hospitalization, there is somewhere around a <20% mortality rate (it seems to vary by region).
Where do you get these numbers from? California has about 50k new cases per day, with probably another 50k cases that were not tested. According to your stats 20k people will require hospitalization and 5k will require an ICU bed per day.
This statement is false.
(With regard to any reasonable definition of exposure to the current virulent strains and assuming the vaccines do their job.)
One major purpose of the vaccines is to cause R < 1 and the virus to fade out, so that most humans will not be exposed to the virus ever in their lives. The other major purpose is for those humans who are exposed to it, to significantly reduce the chance of the virus causing harm.
Like putting out a fire before it spreads everywhere. Some things are burned but not everything is even touched by the flame, if it's put out.
Sure, it's certainly up for debate (and the future) whether or not the rate will drop low enough that most humans escape exposure. That will depend on more than just R0 - we still don't know if the vaccines (any of them) prevent transference, and the emergence of new variants with higher R0 values but identical infection mechanisms (which most people would agree is the same virus) may also complicate this quite a bit.
So sure, maybe I should have dialed it back to "it's entirely possible that the entire human race will be exposed to SARS-COV-2, though if we are lucky that probably won't happen".
I don't think that changes my fundamental point that the crisis for a pandemic like this is not in personal health - "Am I going to die?" - but in the public health - "can my society's health care systems still function?"
The evolution of viruses like this is they tend to mutate into milder strains as they become endemic. At that point the milder version may still cause excess deaths (like flu does, and unfortunately it would be in addition to flu deaths), but not at the same virulence.
But an endemic virus does not necessarily mean every human will be exposed to it. There are diseases which are almost but not quite eradicated by widespread vaccination, and keep going in clusters, surviving in pockets here and there.
No, you sacrifice an uncertain percentage of the population (but probably larger than you suggest because healthcare systems would be quickly overwhelmed by a massive spike in cases) to both death and long-term sickness and disability, but for what? Lockdown causes people to lose their jobs, children to miss school, and others to suffer problems with mental health (although to use your phrasing, this would just be "a few percent" of the population) but it saves people's lives and health.
I'm also really disappointed that people don't get the idea that people dying and having long-term health issues doesn't screw the economy too.
- Advocating for the death of a million people when it's avoidable is abhorrent
- It would be more than that, due to the collapse of health services, causing people who would currently survive to die instead
- It would be more again due to the increased likelihood of viral mutations when left to run rampant
- Also due to the collapse of health services, most deaths would be outside hospitals, i.e. at home, slowly suffocating to death
- Some would survive with brain damage due to lack of oxygen at home
- While dying, people at home would know if they could get a hospital place they'd probably survive, and avoid brain damage, but they can't get one
- It wouldn't even boost the economy, because a million deaths is actually quite a drag on the economy, especially when most of them are dying at home with their families staying at home to look after them due to collapse of the health services
- It would be horrendously traumatic; a lot of people would struggle to work afterwards after watching their family members, friends, neighbours and people they know die at home slowly from an avoidable cause
- It would cause tremendous social division, as many of the traumatised people having watched their family members (& friends, etc) die, avoidably, would know it was caused by the actions of their own neighbours & local community, along with national decision-making to "sacrifice" those million
- That's just deaths; survivors with long Covid would also be a large drag on the economy, struggling or unable to work, requiring support, and potentially expensive for the healthcare services and their familiies in later life if it's long-term organ damage as some fear. The numbers with long Covid would exceed the current number of official unemployed
- Advocating for serious life-long disability for another several million people when it's avoidable is abhorrent too
I will answer this, although more than likely my comment will get killed soon:
I believe that the high-risk people (elderly, immuno-compromised, people with diseases that put them at risk) should go into voluntary quarantine if they wish, together with a government package to support them. Anyone who wishes to undergo lockdown can also do so, although with no package beyond what they would normally get. The rest can do as they please.
This will not stop the ICU beds from filling up obviously, which is why they should be triaged to high-risk patients, frontline staff, and people who underwent quarantine and lockdown. When capacity allows, other people too. The people who chose not to lockdown deal with it, or die.
This is probably unimplementable in the real world. That said, it would mean the lowest amount of economic stress (which kills silently) for the following years. On some level, it also appeals to the human need for cause: those people that died of corona and didn't get treatment "did it to themselves". The high-risk people do not get sacrificed.
What makes you think so? Did you look at the life-expectancy impact of severe economic downturns and compare them to likely excess fatality figures due to your proposed policy? I suspect not, because last I looked for it I didn't seem to find much evidence for silently killing economic stress.
> This will not stop the ICU beds from filling up obviously,
That's a bit of a problem, because those ICU beds are also known to be useful for people suffering from urgent non-covid related problems. Even if you managed to turn away all the non-lockdowners (how would you even check? Police patrols tattooing people spotted on the street during voluntary lockdown?), you might still find that just the "legitimate" cases are enough to really mess up urgent health care for a lot of other people.
Not the point I was making. I do not know which option will lead to less death, neither do you, neither do really the scientists (although they have a better idea). However, a full lockdown will lead to more economic loss at least in the short term than a voluntary lockdown. Long-term, as I said, I don't think any of us can say.
> you might still find that just the "legitimate" cases are enough to really mess up urgent health care for a lot of other people.
Like is currently happening? Yes, my solution wouldn't stop all bad effects. There will be much death regardless, the hope is that the people who are left to die as they chose no protection will "help out" with the number of ICU beds needed in general.
> how would you even check ?
You are in lockdown until you fill in some sort of form with the government, waiving your rights to hospital care in the case of catching Corona. This list is used to make decisions. This part at least is implementable.
What point were you making then? And yes, I think I do know which option will lead to less death, because I actually took the time to do some minimal research and the relevant information wasn't hard to find or terribly ambiguous. It's fine to have a contrarian opinion, based on some effort to ascertain facts and reason about them and we could then have a productive discussion on why our conclusions differ but from everything you said so far my current impression is that you made no such effort whatsoever.
> However, a full lockdown will lead to more economic loss at least in the short term than a voluntary lockdown. Long-term, as I said, I don't think any of us can say.
For some farcial definition of "short term" and "can't say" maybe, but for anything a sane person would care about (quarters or longer) we can just try to compare economic stats.
I mean to me it seems like the herd-immunity/corona-is-a-hoax/hands-off-response countries weren't doing that hot economically either:
https://tradingeconomics.com/sweden/gdp
https://tradingeconomics.com/united-kingdom/gdp
https://tradingeconomics.com/brazil/gdp
vs
https://tradingeconomics.com/new-zealand/gdp
https://tradingeconomics.com/south-korea/gdp
https://tradingeconomics.com/taiwan/gdp
https://tradingeconomics.com/china/gdp
> You are in lockdown until you fill in some sort of form with the government, waiving your rights to hospital care in the case of catching Corona. This list is used to make decisions. This part at least is implementable.
Why would anyone in their right mind sign such a form, no matter whether they intend to flout lockdown or not? Not without massive penalities. How would you enforce them?
What about all the nurses who die in the line of duty treating all these new infections? Should they be allowed to opt-out of infection risk?
I understand the desire to keep things going, but so long as there is community spread the lockdown can never end, and the virus would never go away.
What's being done about them now? How is this better? They're losing everything they own, their house, and getting $600 from the government? Many would take a chance of corona over that.
> What about all the nurses who die in the line of duty treating all these new infections? Should they be allowed to opt-out of infection risk?
Nurses (along with all healthcare personnel) should always receive priviledged treatment. One nurse dying is not a person dying, it is many people dying.
> but so long as there is community spread the lockdown can never end, and the virus would never go away.
Vaccines will hopefully change that.
.. all good points though, and I thought of them too as I was writing out my thoughts. I'm not fully satisfied with these answers, but I do not believe the direction we're headed in right now is much better.
I agree the economic issues are problematic and painful. Sadly, I don’t see a way around a lot of financial pain for everyone over coming months regardless of the status of a lockdown. Depending on your job and industry, there simply isn’t any work to be done while there’s a real risk of death (tourism comes to mind).
I think one big sticking point for me around arguments to reopen boil down to our medical care workers—doctors, nurses, and everyone who supports them. I’m not comfortable telling _anyone_ that they need to die to keep the economy going, especially when our medical workers don’t have a say in the matter.
In Scotland, the mean COVID death age was higher than the average lifetime expectancy[1], which indicates that on average those people would probably live <10 years had they not contracted the disease. The expected remaining lifetime of the average individual in Scotland (if it remains unchanged) is ~37 years, which would reduce the lifetime adjusted death toll by at least 3.7.
There have been a significant amount of excess deaths that are not attributable to COVID [2]. I suspect that such deaths have a lower average age (e.g. due to suicides), than COVID deaths, further reducing the average life years saved due to the lockdowns.
I'm not proposing that we should optimise for life years saved, but I do think that the death of a 86 year old is less tragic than that of a 38 year old, and that we perhaps shouldn't evaluate lockdown vs no lockdown purely based on the percentage of the population which died.
[1] https://www.bbc.com/news/uk-scotland-54433305 [2] https://www.newswise.com/factcheck/are-a-third-of-the-excess...
I of course agree with that. Just stating lives lost in isolation is misleading. It simply much easier to use for back-of-envelope math, and generally back of the envelope math indicating a course of action would lead to millions of excess deaths is enough to conclude that probably it won't be a great idea.
> which indicates that on average those people would probably live <10 years
This is plausible, but it may not be much less than 10 years either. The life expectancy of someone who reaches average UK life expectancy is close to another 10 years. And we'd probably both prefer neither ourselves nor any elderly relatives or friends to suffocate 10 years before their or our time.
> There have been a significant amount of excess deaths that are not attributable to COVID [2].
So this sounds initially plausible (lockdown stress/economic hardship leading to an increase in suicides) but I believe it's bullshit and that these deaths are in fact due to covid. Since we were talking about the UK, let's go back to look at that: the baseline figure of suicides is pretty low (~6k in the UK for 2019, which is 1e-4 per individual per year). The number of excess deaths in 2020 is at least 12 times higher than that. So the suicide rate would have had to at least double to account for a significant part of that. And nationwide suicide rates are quite stable, year-on-year, including, crucially, during times of severe economic hardship.
I am sick of this tone of superiority so often used here. It's so elitist and so out of touch.
Our hospitals would be overwhelmed, the morality rate would skyrocket amongst COVID and non-COVID patients alike.
It is crazy how people opinion like mine is fully ignored in Europe. today we tolerate flu deaths so that people can live freely, why shouldn't we tolerate covid deaths to live freely?
And so if you equate the two, a lot of people think that is crazy.
"It's crazy" how much people are willing to risk just because they can't be patient.
Couldn't you argue that a loved one may die because of the consequences of the lockdown? Undiagnosed cancer, depression, suicide, aftermath of the ruined economy? Is anyone keeping this tally?
To the other points: yes, things will be hard. We can quantify how hard each approach will be.
In the case of a lockdown, there will be orders of magnitude fewer deaths.
A tally is being kept—all the numbers were run before a lockdown was even considered. The only reason this debate continues is because so many ignore the hard work medical administrations, public health departments, virologists, economists, and policy makers have already done.
Your proposal is a fantasy; it sounds as if you're wishing this was similar in effect and scope to the flu (and I'm sure we all wish that) but clearly that seems not to be the case
With covid left unchecked, the intensive care isn't intensive at all because the health care resources are spread more thinly.
Over a large enough population, this will lead to many more deaths that would not have happened had those people not been in a healthcare system that was overwhelmed.
So as a society we'd be saying that "these people died because our health service was overwhelmed, we knew that this would happen if we didn't lock down, and we chose to not lock down anyway".
>It is crazy how people opinion like mine is fully ignored in Europe.
I don't believe it's crazy that your opinion is ignored. I think it's rational and moral to do the opposite of your opinion.
I just happen to think your opinion is selfish and deliberately and unproductively obtuse.
We could decide that lockdowns / restrictions are not good but then we also have to be okay with letting lot of people die gasping for air and drowning in their own lungs at home / in the hospital corridors. As much as I hate not being able to socialize how I like I still prefer that and it seem to also be the case for most of the population.
I have no idea if we'll ever be able to eradicate the Covid but if we don't it might become just an other flu when enough people are vaccinated or had it.
Wouldn't you say that's rather staggeringly high number to simply let things run course?
Maybe most people do believe what you do, but majority opinion isn't automatically right opinion. You know what else will kill people? Economic shock.
It's so arrogant to act like an opinion like yours is completely obviously right, and to tell someone to "prepare to feel embarrassed often". You should feel embarrassed.
I mean, the evidence is pretty clear by now isn't it?
Countries that responded to the pandemic with swift strong action, especially restrictions on movement, have had the best outcomes for both health and the economy.
Countries that tried to protect the economy / their nation's finances by enacting watered down measures have fared very much worse.
It's interesting to me how far views in different places have diverged on where the balance point is for this. Australia's recently been having a debate about whether or not 20 cases a day is enough to justify a full lockdown of a city (the NSW premier decided no) and border closures (most states decided yes). Meanwhile, in the UK...
Then there is China, whose numbers can't be trusted. And some remote island states seem to have done well. Most interesting case perhaps Taiwan (which incidentally also belongs to China).
I think the evidence is clear that it's endemic to the world (like Tuberculosis still is, with most ppl carrying a latent infection). Things are deadly in the world. As far as pandemics go, this one is about as bad as the modern world can handle...ok, some govts can handle. If economies/governments fall apart, it will run it's course as well. The bet that the entire world will lock down their borders and get vaccines every 6 mo for the rest of our lifetimes, is silly. Will corona basically be gone this year? Next year? The year after that?
It's all hand wringing theater at this point. I think there's plenty of evidence that govts are taking advantage of the situation, but that's not the same as it being a grand conspiracy to release a virus for transhumanistic purposes (to get ppl used to getting govt injection). That's also nonsense.
That is, a country that has a large WFH-capable population would feel less economic pain than another otherwise similar country?
And thus, maybe a swift and harsh lockdown is the best move for one country, but the cons for another would outweigh the pros? That is another country would enter an economic decline that overall costs more lives than would have been saved?
We don't know the answers to these questions, but I think we shouldn't dismiss these considerations.
It doesn't help, however, when activist NHS nurses lie on (and abetted by) national media; imagining bed occupancy and oxygen supply levels out of thin air, implying the mutant strain is more virulent among children etc. causing panic, confusion, and supplying fuel to the very people you're trying to lampoon.
Not saying they don't fit the definition... but maybe the reaction doesn't actually help.
We're hearing this:
A: "I'm dying inside because of lockdown. I can't work and I'm this close to the end of my rope."
Should the response be this?
B: "People are dying outside because of COVID. I don't care about your pain. You are an idiot."
A: [storms capitol]
Or this?
B: "This sucks all around for sure. Your pain is real, and I feel it too. The tradeoffs made by society as a whole based on available data are X Y and Z, but here's a list of things you can do for now to help make ends meet and keep it together...."
A: "Thanks, I'm glad we're able to help one another out."
The pace of interaction and information has simply overwhelmed the ability of human one on one interaction. Most of our actions are with a mobile phone near us, meaning that the social sphere is directly with us and only a twitter/FB/Reddit/HN glance away.
Doesn't even help that the sites are designed to be competitively addictive on top of it.
IF that is the case - no matter how much you listen to someone, a few seconds after they return to their phone they are part of the new outrage cycle.
Do note that the whole thing above is doable with cable television as well. IF your uncle goes back home to listen to X TV channel day in and day out, your one on one interaction is going to only have a tiny impact.
The saddest part of what tech has created is a faster pace of communication that is orienting itself inimically to slower one on one human interaction.
Even this para above is built with the idea that parts of it will be broken off by people who read it and then reused later on. It's not a conversation with just the person I am responding to, but to everyone else reading it.
Good on you if you can help people who are struggling, but recognize that when people push back against the lockdown there are often ideological factors in play.
https://www.reddit.com/r/NoNewNormal/comments/kl15z4/italian...
I’m not sure I see what kind of upside they see for anyone if this happens, much less the government.
I don't necessarily think the government is doing it on purpose and colluding with big businesses that are profiting from the situation, I think it's more likely that politicians are just incompetent (they need to save face with people who are pro and against a lockdown) and that big companies are better positioned and can push the government a bit to get what they want. As usual.
If you fear for you life isolate yourself. If you can't afford to isolate ask for charitable donations (even if the more preferred approach has been to just give taxpayers money, taken with force from everyone).
I isolated myself and my family 2 weeks before the government forced a lockdown on us, because there was no data and I was scared of the mortality rate. After seeing the mortality rate and the age range, I stopped caring but I started keeping a distance from old people. I still led a pretty isolated life for personal reasons - and wore my mask to avoid fines and to respect my social contract with society, which took this decision against my will.
I'm genuinely curious to see if the doomsday is going to arrive or not in 2-4 weeks time.
If it does, I hope it will crash the economy and that I'll make a profit or that house prices will go down (assuming I don't die, given my kids go to nursery and are probably spreading all kind of viruses).
If it doesn't, your argument won't look very good and you'll regret calling idiots those with a different opinion. And I guess there is still a chance of an economy crash, given the lockdown.
Maybe this will be a bit of a wakeup call.
hospitalization by state:
342 per million FL
569 per million CA
444 per million PA
442 per million NY
Can anyone point me to similar chart for death per million, by state, over time?
Death is tragic, but it's also a fact of life.
A lot of people have fallen into the trap of making fear a virtue this year.
So then... what's your point?
Our schools opened in the fall and have been able to stay open. Everything I've heard about "remote learning" points to that being a huge blessing for the families in our state.
I am thankful every day that our state and local government has had the backbone to let people live their lives.
Don't be obtuse. Neither of those things are contagious.
> Death is tragic, but it's also a fact of life.
Death is a fact of life. But nobody wants you around if you have a contagious deadly disease.
> A lot of people have fallen into the trap of making fear a virtue this year.
The opposite is true. Those who've made fear a virtue have survived and helped keep the elders in their family alive.
It's the brave idiots who don't wear masks who're killing the old people. I guess without your dad and uncle, you have nobody old left that you care about.
My 98 year old grandma was the first person in my family to catch the coronavirus. Since then I've an aunt and uncle both catch it. All three have recovered just fine, as have my five or six neighbors who also caught it, and nearly everyone in my broader community who has caught it.
But yes, me and my cold dead heart killing old people. I'd personally much rather that than the reality of my grandma being locked in her nursing home without visitors for the past nine months and the whole place still caught the virus. Maybe now with the vaccine coming out she can finally have some comfort in her life instead of sobbing and threatening to run away every day.
There you go. All your old people are dead or immune. Yours are no longer threatened, so bugger everyone else.
> without visitors for the past nine months and the whole place still caught the virus.
That's not possible. Somebody with the virus had to to have visited in order for it to have spread.
Did all the other grandmas in the nursing home survive as well?
Well, there are 8 siblings on my dad's side and six on my mom's, so not really.
> That's not possible. Somebody with the virus had to to have visited in order for it to have spread.
Yup. The physical therapist.
> Did all the other grandmas in the nursing home survive as well?
I think when I asked maybe six people died.
FL 104.7
CA 72
PA 134.1
NY 201.1
highest:
ND 176
Lowest:
OH 80.9
Turns out what happens when government does nothing is things are perfectly fine.
127 per 100,000 people in Iowa http://91-divoc.com/pages/covid-visualization/?chart=states&...
Compared to
70 per 100,000 people in California. http://91-divoc.com/pages/covid-visualization/?chart=states-...
Given that no single cause of death is more than 50% of deaths, this is true for any cause of death.
Combined with the bogus "positivity rate" that most lay people misinterpreted as the percentage of the population currently infected, this has been coordinated disinformation on a mass scale.
Sources:
[1]https://www.bbc.com/news/uk-england-london-52312653
[2]https://www.bbc.com/news/explainers-55056375
Edit: Downvoted? It's not even my opinion. It's facts. Damn.
Or do you think that's not the reason? Timing-wise it matches pretty well.
I've never understood why politicians are allowed to have such blatant conflicts of interest, but they get to write the rules, not us...
Plenty of people outside. In fact, I would call it lightly crowded, although less than other years. Many people don’t wear masks. It’s not a surprise that transmission has increased.
Nevertheless, London looked absolutely beautiful. Not sure if this was worth the risks though.
You can be sure if people are this lax in a busy commercial district in public, they are just as lax when they gather with their friends and family in private, which is where the bulk of the spread happens. I wonder how many are gathering to watch football matches with booze and friends.
But yes: people gathering, indoors, largely with recirculated air.
https://youtu.be/3RlQFy9WaBE
https://www.england.nhs.uk/statistics/statistical-work-areas...
https://www.england.nhs.uk/statistics/statistical-work-areas...
1033 open adult critical care beds; 882 in use. 85% utilisation.
Best-case forecast Jan 2021:
2078 critical care beds required, 1,661 available (increase of ~600). Forecasted 125% utilistation.
The columns in the spreadsheet are "Sum of Number of adult critical care beds open" and "Sum of Number of adult critical care beds occupied".
If you do decide to promote this talking point anyway, flag it with the appropriate disclaimer from the NHS:
…caution should be exercised in comparing overall occupancy rates between this year and previous years. In general hospitals will experience capacity pressures at lower overall occupancy rates than would previously have been the case.
https://www.england.nhs.uk/statistics/statistical-work-areas...
Why?
Literally from the link.
It makes sense to try to stop spread in hospitals but unless I've missed something there seems to have been very limited work done on if any of the protocols as actually implemented (ie not just in a theoretical world where they were designed) - and especially the costlier ones in terms of bed space - have worked, or at least worked enough to offset their cost in health terms.
Does anyone know if there's any data on this?
I'm sorry that I briefly lowered the tone by linking to data, thanks for your help.
Of course that begs the question, why did they use open instead of unoccupied?
If open is meant to mean bed that can be utilized, then we don't have a true number of beds or a reason why a bed would be closed.
Either way it's confusing but generally the term open as the opposite of occupied for filled. For example, open positions in a company aren't employees, they're vacancies.
There is inherently no “true number” of beds because this number varies in response to things like hospital space configuration, staffing levels, and demand.
AFAIK the term “open” is analogous to that in “open for business” - there may be other physical “beds” available, but without staff or without some equipment or some other constraint that makes them not open.
I do appreciate that it’s confusing, because I had to doh me check myself. But it’s not without reason that it’s described that way.
I went back and looked and you're right. I didn't look at the XLS file, I just pulled the raw data from the CSV file which doesn't offer the %.
It's clear from the XLS that the % is derived from occupied/open and not occupied/(open+occupied) as I was thinking.
This is compared to beds that are not available because eg the hospital is in critcon4.
Kid: Dad, what's Fortnite?
Me: Fourteen days
Kid: What? That makes no sense
Me: It's an old word that means two weeks
Kid: Okay I want to play it
Me: What? That makes no sense
Kid: I want to play it, what does it mean?
Me: It means two weeks. What do you mean you want to play it?
Kid: I want to play it. What does it mean?
etc, etc. Weird drive home until I went online.
So closing schools and universities reduces R values by 38% (16%-54%) per your excellent link. England R value is about 1.3 at last count.
1.3*(1-38%) = 0.806
So hopefully that's enough.
I'm a cynic and pessimistic so I worry that:
London is likely higher (more workers, denser, people use public transport).
Keeping nurseries open and some pupils in schools will reduce the 38%.
The spike from christmas/new year will ruin things.
I guess the optimist would say:
1.3m people vaccinated (especially in high risk groups) means the hospitalisation rate should go down.
We should play close attention from afar so we can learn.
For example I don't know anyone who arrived from abroad being checked if they are self isolating at home as they declared.
Your scam has been revealed:
https://www.reddit.com/r/NoNewNormal/comments/kl15z4/italian...
Not the most reliable source, but confirmed by other sources which are unfortunately behind a paywall.
https://www.dailymail.co.uk/news/article-9115357/amp/Coronav...
This is a common claim and I have seen it made about various periods of lockdown in various countries. "Look, rate of increase started to slow within a week of lockdown, but it should take two weeks to see the effect, so it can't be that lockdown has made any difference." There is usually far too much noise in the figures to make such a claim about small differences in time scale. Also if you were expecting a sudden drop after two weeks then you were bound to be disappointed. The amount of time it takes for an infection to become a recorded case of Covid will be random according to some distribution (possibly with a mean of one or two weeks) so the transition will be smooth.
I've been working as a volunteer nursing assistant in hospital A&E departments through St John Ambulance it's honestly just insane. I don't know what the plan is for Nightingale but we're focusing on getting mass vaccination centres setup currently and delivering the vaccines.