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A case for ending lockdown

ryankemper.io

71–80 of 381 posts

Re: A case for ending lockdown

#71
post #5

Earlier quoted context omitted.

Having, as you suggested, skipped just to the TL;DR, this bit jumped out at me as something that we very much don't know is true, and that it's dangerous to assume is true without proof: > Once you get sick, you can’t get sick again for a long time. Eventually you might be able to get sick again, but it will not be very bad. When enough people have gotten sick and then gotten better, the sickness can’t spread any mor…

“There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection.” From WHO a few days ago: https://www.who.int/news-room/commentaries/detail/immunity-p...

The WHO also retracted their statement later.

https://mobile.twitter.com/who/status/1254160937805926405

Re: A case for ending lockdown

#72
Ryan since you have asked for comments here are some from me.

1. The true IFR is hard to estimate at this point, but looks to be around 1%. This is a very difficult question to answer with the data we have and all the limitations.

2. There is little evidence that we can reach herd immunity levels of infection with a Coronavirus like SARS-CoV-2 as both the unconstrained R0 is too high and the immunity too short lived.

3. The IFR has a threshold where it dramatically increases when the number of new cases overwhelms the hospital capacity. We have seen this to a certain extend in Wuhan, Northern Italy and NYC.

4. As treatments improves the IFR should fall. This mean if we can shift an infection to the future we should see less people die. Flattening the curve is more than just avoiding overwhelming the hospital system, it is also about shift cases to a time when we have improved treatments.

5. Sweden has shown that it doesn’t matter if you have an official lockdowns or not, most people will self isolate on their own. There is little extra economic damage from imposing official lockdown policies since all the damage is done by people avoiding infection on their own.

Re: A case for ending lockdown

#73

Earlier quoted context omitted.

> Specifically, once the proportion of recovered in the population reaches 1/(1-R_0), there are no longer enough vectors (infectable indviduals) remaining for a serious outbreak to occur. It’s worth noting that this is the same principle that vaccination relies upon; vaccination is just an artificial way to build immunity without having to undergo a full infection. I should learn to never read anything from random pe…

I'm sure you're getting weary at this point, but I really need your help understanding what you're saying here, because to me it seems supremely untrue. First, `1/1-R_0`. This is exactly what Wikipedia says: https://en.wikipedia.org/wiki/Herd_immunity#Mechanics And it makes intuitive sense that once you infect > The idea that vaccination and epidemics need the same percent of immunity is completely 100% wrong. An act…

Even when the R0 reaches 1.0 those who are infected will still infect one more person (on average). Infections continue to happen after the R0 is below 1.0.

Re: A case for ending lockdown

#74
post #22

Why was this flagged? I don’t even necessarily agree with the author’s arguments and conclusion, and honestly I have no clue what to think with all the information I hear that is constantly changing from the various tribes. But when something gets flagged simply because he advocates for ending the lockdown, I go from thinking the lockdown is probably necessary and trust the decision is made for reasons I don’t unders…

Glad to see this no longer appears to be flagged. I'm curious if anyone knows what HN's process is for unflagging an entry. How do they decide what remains flagged?

Re: A case for ending lockdown

#75

If it's not obvious, I wrote this. The intent is to be a fairly comprehensive coverage of what we know about COVID-19 and what it means for our policy. Note that the article is written from a US-based perspective although I suspect it's relevant to a broader audience. In general, I believe that the case against lockdown has been highly stigmatized and thus many people have not been exposed to a convincing argument of…

[deleted]

Re: A case for ending lockdown

#76

Ryan since you have asked for comments here are some from me. 1. The true IFR is hard to estimate at this point, but looks to be around 1%. This is a very difficult question to answer with the data we have and all the limitations. 2. There is little evidence that we can reach herd immunity levels of infection with a Coronavirus like SARS-CoV-2 as both the unconstrained R0 is too high and the immunity too short lived.…

My feeling is the author seems pretty open to criticism.

You should open a PR incorporating your reasoning into the document. Be respectful but make it better. I'd hope the best ideas would win out but then again the author has the authority to merge or not.

To the author maybe you should give one other person you respect whose opinion differs from yours the ability to merge PRS as well. Maybe...

Re: A case for ending lockdown

#77
post #41

Earlier quoted context omitted.

Out of curiosity, do you know if it being flagged means it's now invisible to others? Or is "flagged" the intermediate state between a normal submission and a dead one?

It's the latter. It's possible for a submission to get so many flags that it also gets killed, but the software doesn't do that once there are lots of comments.

That seems like a pretty good algorithm.

Re: A case for ending lockdown

#78
post #66

Earlier quoted context omitted.

This is not a great place to start... > I’m a software / site reliability engineer > based out of Santa Barbara, California. Given the stakes, we should have a preference for Coronavirus articles written by experts. It's fine for authors to trash the WHO or to disagree with the government, but they should have the chops if the rest of us are going to upvote them. I'm disappointed with the HN community. The past few w…

There have also been many articles by experts. I'd be careful about making general conclusions based on what you remember, because most of us are far more likely to notice and remember the things we disliked ( https://hn.algolia.com/?dateRange=all&page=0&prefix=true&que... ). More importantly, though, there may be a misunderstanding about what HN is. It's an internet watercooler, the purpose of which is gratifying cu…

Yes, but it’s not the moderation here I have an issue with. It doesn’t bother me at all that programmers write and submit posts about medicine. What I would like to see is our peers submitting and up-voting more articles by experts. Expertise comes in many forms, to be sure, but, as readers, we should be checking the background of certain kinds of posts before we boost them.

Re: A case for ending lockdown

#79
I appreciate the article.

I think your argument I find most dubious is the idea that we have lessened health care capacity by sheltering at place and closing businesses. Even if we have furloughed hospital workers, and I'm not saying that isn't a huge blow to those people and their livelihoods, and stopped elective surgeries, and I'm also not saying that those elective surgeries aren't things that don't matter, I think in terms of the next 6 months, the chance that our hospitals have less capacity to deal with serious illnesses that lead to death seem unlikely. If anything the decrease in deaths from other things, like drunk driving, and influenza might offset the loss in capacity from those furloughed.

I agree that if the timeframe is long enough it is very likely to ultimately lead to more deaths from missing elective surgeries and preventative healthcare, and I think the argument for Pareto-efficiency and only asking those who are at risk to shelter in place isn't dismissed with this argument, but I don't think a time frame of say 6 months to a year would lead to more deaths in the way you state. I think you should maybe specify (or point out to me where you state this if I missed it, i'm not a careful reader) what kind of timeframe you believe that the combination of lack of capacity and missing out on preventive measures would start to lead to more deaths and indicate where you think we would reach pareto efficiency. Have we already passed the point of pareto efficiency? Was it never good at all, and the most efficient thing to do was no response?

I personally think you wouldn't see the effects you are talking about for probably at least a year, and I'm hoping it doesn't last that long. I think you might start to see an increase in deaths from other things like, overdose, alcohol, and suicide, in a shorter timeframe than that though, and that is something that probably should be weighed in picking the best time to end the lockdown too.

Re: A case for ending lockdown

#80

Earlier quoted context omitted.

> Specifically, once the proportion of recovered in the population reaches 1/(1-R_0), there are no longer enough vectors (infectable indviduals) remaining for a serious outbreak to occur. It’s worth noting that this is the same principle that vaccination relies upon; vaccination is just an artificial way to build immunity without having to undergo a full infection. I should learn to never read anything from random pe…

I'm sure you're getting weary at this point, but I really need your help understanding what you're saying here, because to me it seems supremely untrue. First, `1/1-R_0`. This is exactly what Wikipedia says: https://en.wikipedia.org/wiki/Herd_immunity#Mechanics And it makes intuitive sense that once you infect > The idea that vaccination and epidemics need the same percent of immunity is completely 100% wrong. An act…

This is called 'overshoot'.

See here for a good explanation https://twitter.com/CT_Bergstrom/status/1252077930286444545

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