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A Third Solution

paulbuchheit.blogspot.com

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Re: A Third Solution

#51

Post by johnnyo »

marcell wrote: post #21
johnnyo wrote: post #12

Earlier quoted context omitted.

The things that generally kill Americans (heart disease, cancer, car crashes, diabetes, etc) aren’t contagious, so this is a bad analogy.

No analogy is perfect, but people need context to understand fatality rates, and see what risk is acceptable. Society doesn't have a goal of 0% death rates. We all accept some risk of death as a cost of continued existence. New data is showing that the fatality rate from covid-19 is more like existing risk we were all previously exposed to in the course of our existence, and not like a second version of smallpox.

As you said, you gotta die of something. If the covid rate equals the regular rate, then the US death rate would effectively double if we simply did nothing.

That’s assuming no second order effects like a shortage of medical care making things worse.

Re: A Third Solution

#52

Post by pb »

xyzzyz wrote: post #47
pb wrote: post #38

Earlier quoted context omitted.

That's why I think testing at the door is the more straightforward way to start. We can reopen factories, office buildings, even shopping malls, but no one gets in without passing the screen.

What door? You mean my front door? I'm not letting anyone in, and I'm not leaving either. What are you going to do, call the cops to kick in the doors to test me?

No, I mean the door to the office building, shopping mall, or other place where groups of people gather and potentially transmit the virus.

Re: A Third Solution

#53

Post by gus_massa »

johnnyo wrote: post #12
marcell wrote: post #6

> First of all, it’s not “just the flu”. It is something much more dangerous. Catching this virus is a bit like playing a round of Russian roulette. You’ll probably be fine, but you could end up dead I think this is mischaracterizing it. People have to die eventually. One year of existence has a mortality rate of 1%. For a 75-84 year old individual it is nearly 5%. Above 85 it's 14%. [1] The coronavirus infection fat…

The things that generally kill Americans (heart disease, cancer, car crashes, diabetes, etc) aren’t contagious, so this is a bad analogy.

The numbers from Wikipedia are very different, many death are due to contagious illness https://en.wikipedia.org/wiki/List_of_causes_of_death_by_rat...

  Cardiovascular diseases              29.34%
  Infectious and parasitic diseases    23.04%
  Malignant neoplasms (cancers)        12.49%
  Respiratory diseases                  6.49%
  Unintentional injuries *              6.23%
  Perinatal conditions                  4.32%
  Digestive diseases                    3.45%
  Intentional injuries +                2.84%
  Neuropsychiatric disorders            1.95%
  Diabetes mellitus                     1.73%
  Diseases of the genitourinary system  1.49%
  
  * includes car accidents
  + suicide, violence, war, etc.

Re: A Third Solution

#54

Post by centimeter »

jawns wrote: post #11

> If we were able to identify and quarantine everyone who is contagious, including those who are asymptomatic, then we could let everyone else out of lockdown and resume ordinary social and economic activity. > Even with imperfect screening, if we are able to prevent 90% of disease transmission, then the virus’s reproductive number, or R0, will drop below one and the pandemic will quickly fade. There is no risk of re…

Not trying to show bravado or anything, just pointing out that I and probably others feel this way; I would fight tooth and nail against pervasive, mandatory "test and release" policies on humans (and the necessary concomitant growth of the surveillance state). The second-order social and political effects of such a policy would be disastrous - orders of magnitude worse, in the long run, than the population-level health effects of this virus. People anticipating these effects would probably be prone to civil disobedience, making the logistical nightmare even worse than what you would get with a fully passive and compliant population.

Re: A Third Solution

#55

Post by tlb »

vikramkr wrote: post #41
jawns wrote: post #11

> If we were able to identify and quarantine everyone who is contagious, including those who are asymptomatic, then we could let everyone else out of lockdown and resume ordinary social and economic activity. > Even with imperfect screening, if we are able to prevent 90% of disease transmission, then the virus’s reproductive number, or R0, will drop below one and the pandemic will quickly fade. There is no risk of re…

Compliance is tough. And my main concern would be false positives- if we are screening more people more frequently, we would have a lower expected percent of true positives, and even a small false positive rate could lead to significant overdiagnosis and disruption. The more often the test the more stringent that requirement. I dont know much about the testing method described in the article, but I wonder if it has u…

A reasonable policy is to go home when the machine at the door to your office gives a positive result. Then get a more specific PCR test, and maybe come back to work. So the cost of a false positive can be one lost day.

The false positive rate of lockdowns is 100%.

Re: A Third Solution

#56

Post by pb »

scott_s wrote: post #40
pb wrote: post #22

Earlier quoted context omitted.

I have not found any mainstream sources that advocate screening everyone every day (which is very different from simply doing "more testing"). Would love some pointers if I'm wrong.

Paul Romer, an economist at NYU, has been advocating for testing millions of people a day for a few weeks. He is co-author of a piece in The Atlantic, "Without More Tests, America Can’t Reopen", https://www.theatlantic.com/ideas/archive/2020/04/were-testi... Googling for "romer covid 19" should turn up a lot of news sources covering the notion of testing millions of people a day.

Yes, he is the best I've found. This proposal is still at least an order of magnitude more testing though :) (on the order of 100 million tests/day, not 1 million tests/day)

Re: A Third Solution

#57

Post by LiquidSky »

pb wrote: post #38
jawns wrote: post #24

Earlier quoted context omitted.

But how realistic is daily screening on a wide scale? You're going to face major issues with compliance.

That's why I think testing at the door is the more straightforward way to start. We can reopen factories, office buildings, even shopping malls, but no one gets in without passing the screen.

But that just moves the compliance and logistics problem back one step. Who's doing this massive amount of testing? If it's the government, you'd need armies of workers spread out everywhere. If it's the owners of these buildings, who checks to ensure compliance?

Imagine trying to enforce this on every non-residential building in, say, NYC. It would be practically impossible.

Re: A Third Solution

#58

Post by johnnyo »

gus_massa wrote: post #53
johnnyo wrote: post #12

Earlier quoted context omitted.

The things that generally kill Americans (heart disease, cancer, car crashes, diabetes, etc) aren’t contagious, so this is a bad analogy.

The numbers from Wikipedia are very different, many death are due to contagious illness https://en.wikipedia.org/wiki/List_of_causes_of_death_by_rat... Cardiovascular diseases 29.34% Infectious and parasitic diseases 23.04% Malignant neoplasms (cancers) 12.49% Respiratory diseases 6.49% Unintentional injuries * 6.23% Perinatal conditions 4.32% Digestive diseases 3.45% Intentional injuries + 2.84% Neuropsychiatric dis…

Those are world rates, not US rates.

In the US, it’s largely the things I listed.

Re: A Third Solution

#60

Post by scott_s »

marcell wrote: post #21
johnnyo wrote: post #12

Earlier quoted context omitted.

The things that generally kill Americans (heart disease, cancer, car crashes, diabetes, etc) aren’t contagious, so this is a bad analogy.

No analogy is perfect, but people need context to understand fatality rates, and see what risk is acceptable. Society doesn't have a goal of 0% death rates. We all accept some risk of death as a cost of continued existence. New data is showing that the fatality rate from covid-19 is more like existing risk we were all previously exposed to in the course of our existence, and not like a second version of smallpox.

Correct, Covid-19 is not as bad as smallpox. But it's still bad. Focusing on fatality rates misses the infection rate. Two diseases with the same case fatality rate can kill widely different number of people if one is more infectious than the other. We have learned that SARS-CoV-2 is way more infectious than the flu, meaning that way more people are getting it. With way more cases, we have way more deaths. (And, of course, way more strain on the medical system.)
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