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Ask HN: Are we overreacting to coronavirus?

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Re: Ask HN: Are we overreacting to coronavirus?

#71

Post by notacoward »

threatofrain wrote: post #68
notacoward wrote: post #64

Earlier quoted context omitted.

> Are the numbers there... not high enough for you? They're not high enough to put strain on hospital resources, and therefore to move from a mostly-individual to a mostly-collective type of problem. Nobody else is likely to die because you didn't get a flu shot (BTW the existence of a vaccine is also a factor here) and tied up a ventilator that they also needed. That's a real concern with COVID-19. > hinting that th…

> You might feel you're Living Right and you're at no risk yourself, but - as has been pointed out many times but apparently not enough - It's Not Just About You. Your actions are connected to others' outcomes. There's a social responsibility to avoid becoming a vector for infection. How is it clear that we shouldn't organize as an entire society to deal with influenza? Because hospital resources aren't taxed? That m…

You seem to be setting up a false dichotomy between your original position ("that's too vague to justify destroying the economy") and your current one ("we should do this all the time for other diseases"). I reject that, as anyone who believes in logic should. There are places we can draw a line that affects behavior. I believe that one such line is between an immediate danger of someone dying for lack of life-saving resources vs. a situation where any such danger is more attenuated. You might think the line should be elsewhere, and that's fine, but you don't even seem to be trying to define one. Instead you seem to be looking only at the extremes, and using both as an excuse to argue with anything in between. Pretty low even for HN.

BTW, I have actually discussed this with children, and they have no trouble understanding how the current situation is different than flu. Maybe that's because they're not obfuscating for the sake of argument itself.

Re: Ask HN: Are we overreacting to coronavirus?

#72

Post by downerending »

dwaltrip wrote: post #60
chrismeller wrote: post #16

Overall I would have to say absolutely, yes. The number of infections doesn't justify this level of panic, let alone the number of deaths. I realise there is an element of "prevention" here, but far, far more people die of very common things (flu, traffic accidents, smoking-related conditions, being overweight, etc.) in the US alone every year, some of which are also 100% preventable, than have died worldwide of coro…

Why are you completely ignoring the exponential nature of coronavirus? The amount of deaths have doubled fairly quickly and are now at 10k worldwide. The number of cases worldwide continues to grow exponentially. 7 more doublings, which could happen as soon as 5 weeks from now (I believe the doubling rate is around ~5 days) would bring us to 1 million deaths. And there is no particular reason it would stop there. My…

Also, it's important to realize that a lot of our data is "old". The tests for "cases" were probably queued for many days, and even when there is a result, might take a day or two to show up in the official stats. Beyond that, the infected individual has probably already been infectious for a week or two (or more?) prior to the test.

Put all of that together, and a lot of our stats are stuck weeks in the past. Since the phenomenon itself is exponential and apparently has a fairly short doubling time (two to five days maybe), that delay is huge. We could be flying into the side of a mountain, and we probably wouldn't even know it.

Given that, it'd be difficult to "overreact".

Re: Ask HN: Are we overreacting to coronavirus?

#73

Post by thu2111 »

entee wrote: post #19

No. Very simply, an extreme response is required here. The most recent UCL study demonstrates that given everything we know about the virus, extreme social distancing may not even be enough [1]. Worse, if we are successful, it will look like we overreacted because the nature of exponential spread is that if you act when you’re on the steep part of the curve you’re too late. If you act beforehand, you never get to the…

Italian ICU capacity is completely overwhelmed, if not this virus, why?

Being a truly evil Devil's advocate for a moment:

1. Because it's not actually overwhelmed. See this discussion from 2 days ago about a Reuters report where the head of ICU for Lombardy says nobody has been turned away due to lack of beds: https://news.ycombinator.com/item?id=22605144

2. Because ICU demand expands to meet available capacity as nobody wants to switch off life support and modern medicine always gives one more intervention to try. Thus doctors are always describing their hospitals as overwhelmed the moment demand increases even a little bit.

Hospitals being described as overloaded, patients being treated in tents and doctors describing their wards as strained/at the edge of disaster/etc is not something unique to COVID-19. Here is the same thing happening in 2018 in the USA:

https://time.com/5107984/hospitals-handling-burden-flu-patie...

Here are some quotes. Remember, all this was Jan 2018 but it sounds like it could have been written yesterday.

The 2017-2018 influenza epidemic is sending people to hospitals and urgent-care centers in every state, and medical centers are responding with extraordinary measures

"We are pretty much at capacity"

Tallia says his hospital is “managing, but just barely,” at keeping up with the increased number of sick patients in the last three weeks. The hospital’s urgent-care centers have also been inundated, and its outpatient clinics have no appointments available

The story is similar in Alabama, which declared a state of emergency last week in response

In California, which has been particularly hard hit by this season’s flu, several hospitals have set up large “surge tents” outside their emergency departments to accommodate and treat flu patients

Nurses are being “pulled from all floors to care for them," ... "Many nurses have also become sick, however, so the staff is also short-handed."

"More and more patients are needing mechanical ventilation due to respiratory failure from the flu and other rampant upper respiratory infections"

https://www.dailymail.co.uk/health/article-5279685/Californi...

Flu drives hospitals into 'war zone' conditions: Tents on the street in California, 'state of emergency' in Alabama, and Boston is using GATORADE to plug shortage of IV drips

Remember - all that was in 2018. The world didn't end. The exact same terms and language are being used now.

Now, I'm not saying this case is the same as flu of 2018 in the USA. Clearly, there are critical differences and this one is much more serious. But how much more serious is being muddled by the fact that our data is all useless and so people fall back on testimony from doctors, which sounds extremely dramatic, but there's a history of describing tough flu seasons in exactly the same way.

In a way it makes sense. ICU capacity is expensive. It'd be weird to have lots sitting idle all the time, unused, whilst other people were being switched off life support.

Re: Ask HN: Are we overreacting to coronavirus?

#74

Post by [deleted] »

notacoward wrote: post #71
threatofrain wrote: post #68

Earlier quoted context omitted.

> You might feel you're Living Right and you're at no risk yourself, but - as has been pointed out many times but apparently not enough - It's Not Just About You. Your actions are connected to others' outcomes. There's a social responsibility to avoid becoming a vector for infection. How is it clear that we shouldn't organize as an entire society to deal with influenza? Because hospital resources aren't taxed? That m…

You seem to be setting up a false dichotomy between your original position ("that's too vague to justify destroying the economy") and your current one ("we should do this all the time for other diseases"). I reject that, as anyone who believes in logic should. There are places we can draw a line that affects behavior. I believe that one such line is between an immediate danger of someone dying for lack of life-saving…

[deleted]

Re: Ask HN: Are we overreacting to coronavirus?

#75

Post by enchiridion »

TYPE_FASTER wrote: post #54

Well, so far judging by deaths / cases on plague.com, we're looking at 4% fatality rate. The average seasonal flu fatality rate is 0.1%. The mortality rate for H1N1 was 0.02%. For Ebola, the average mortality rate is around 50%. China severely restricted travel and managed to keep the infection rate around 0.008% of their population. We're still in the early stages in the US, with about 0.00269% of the population inf…

Thank you for explaining.

Any idea what the mortality increase would be?

Re: Ask HN: Are we overreacting to coronavirus?

#76

Post by sergiotapia »

Yes we are. I want you to keep this fact in mind: We don't know how many people are infected. We only the number from people who go in to get checked. For all you know there's a ton of people with a slight flu that are now fine. My son and myself had a pretty rough cough and fever Feb 30. Could that have been the chinese virus? We don't know. Extrapolate.

Based on everything I've read there's two schools of thought:

1. Let the virus take hold. Save the economy, let God sort out the vulnerable.

2. Quarantine and contain. Save the vulnerable, life-support the economy until the virus dies out.

US and others are doing #2.

England is doing #1.

We'll see how that plays out.

Re: Ask HN: Are we overreacting to coronavirus?

#77

Post by enchiridion »

astrophysician wrote: post #12

I mean, some people are overreacting about some aspects of this, but the main thing is: - the fatality rate for covid is high. People make a valid point about how we don’t know the “actual” (unbiased) fatality rate, that may be hard to estimate, but at this point it’s more or less irrelevant —- we already know for a fact that it is high enough to overwhelm the healthcare system, as is already happening elsewhere. We’…

I'm not so sure about the out of business part of it. Temporary closing sure.

They may have to take on additional debt to get started again, but there will be huge demand once restrictions are lifted.

Re: Ask HN: Are we overreacting to coronavirus?

#78

Post by TheAlchemist »

It depends - if we think nothing is off the table - including isolating older people or doing war-time like strategies, then maybe we are overreacting.

But if the only cases we consider are traditionnal approaches - confinment vs doing basically nothing, then the short answer must be no - if anything, we are underreacting (by we, I assume you mean the West - EU and US).

I've tried to be smart about the numbers, which are definitely not rock solid now, but just look at what happened in places that tried to underreact - Wuhan (not their fault), Lombardy. Have you ever seen military trucks coming into a city, during peace time, to move coffins out ? Here you go: https://twitter.com/guidosalva/status/1240555847849312256?s=...

We can argue as long as we want about age structure etc, but this kind of horror, definitely never happens unless there is something extremely unusual (and deadly) happening.

Re: Ask HN: Are we overreacting to coronavirus?

#79

Post by threatofrain »

notacoward wrote: post #71
threatofrain wrote: post #68

Earlier quoted context omitted.

> You might feel you're Living Right and you're at no risk yourself, but - as has been pointed out many times but apparently not enough - It's Not Just About You. Your actions are connected to others' outcomes. There's a social responsibility to avoid becoming a vector for infection. How is it clear that we shouldn't organize as an entire society to deal with influenza? Because hospital resources aren't taxed? That m…

You seem to be setting up a false dichotomy between your original position ("that's too vague to justify destroying the economy") and your current one ("we should do this all the time for other diseases"). I reject that, as anyone who believes in logic should. There are places we can draw a line that affects behavior. I believe that one such line is between an immediate danger of someone dying for lack of life-saving…

> You might feel you're Living Right and you're at no risk yourself, but - as has been pointed out many times but apparently not enough - It's Not Just About You. Your actions are connected to others' outcomes. There's a social responsibility to avoid becoming a vector for infection.

Influenza kills tens of thousands per year, and people are getting sick through social contact. The fact that the medical system is having trouble doesn't change the how -- sick people getting other people sick. That's the part that makes it a social problem, the part where one person's actions potentially kills another.

The "logic" can be made pretty clear but you just prefer to respond with... "logic" instead of figures. I've asked who is paying for whom and how much. That is the uncertainty I see in the situation, and the discussion which I see lacking.

There's not even a 6-month vision for what's going to happen.

Re: Ask HN: Are we overreacting to coronavirus?

#80

Post by notacoward »

threatofrain wrote: post #79
notacoward wrote: post #71

Earlier quoted context omitted.

You seem to be setting up a false dichotomy between your original position ("that's too vague to justify destroying the economy") and your current one ("we should do this all the time for other diseases"). I reject that, as anyone who believes in logic should. There are places we can draw a line that affects behavior. I believe that one such line is between an immediate danger of someone dying for lack of life-saving…

> You might feel you're Living Right and you're at no risk yourself, but - as has been pointed out many times but apparently not enough - It's Not Just About You. Your actions are connected to others' outcomes. There's a social responsibility to avoid becoming a vector for infection. Influenza kills tens of thousands per year, and people are getting sick through social contact. The fact that the medical system is hav…

You want figures? I've already cited a report estimating a possible 4.4M people needing ICU-level care. That's vs. ~85K ICU beds and ~62K ventilators.

https://www.healthaffairs.org/pb-assets/documents/blog/blog_...

http://www.centerforhealthsecurity.org/resources/COVID-19/20...

Even if those patients were spread evenly over the whole year and across hospitals, which is totally unrealistic, that's tens of thousands who couldn't get the care they need and would probably die. This has already happened in Italy, which has a better ratio of resources to population than the US. BTW, that doesn't even count the people who need those resources for completely separate reasons (including the flu you pretend to care about), or those who get a bed/ventilator and die anyway, or those who never even get as far as the hospital. Add all that up and COVID-19 could exceed even heart disease as the year's #1 killer - as I already said.

By contrast, hospitals have been absorbing the congruent load related to flu, on top of the normal load from everything else, for years. "More than we can handle" vs. "less than we can handle" is a pretty basic kind of difference, and a good example of the quantitative becoming qualitative. And if you had spent half the effort looking these numbers yourself that you've spent stealth-advocating for one position by attacking its opposite (didn't see you giving chrismeller this much of a hard time for a less-supported answer) you'd be familiar with those numbers already.

> one person's actions potentially kills another

The set of actions that could potentially kill another is vast. Making that the standard without addressing likelihood or intent or anything else is solipsistic.

> I've asked who is paying for whom and how much

Ah, always with the dollars. I won't even dignify that with a detailed response. It's your turn to take an actual stand, and defend it as you demand others defend theirs. What numbers are you assuming for the economic collapse you've predicted? What rational basis is there for believing that the cure is literally worse than the disease? Can you debate with facts instead of "avoid bad things" and emotion?

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