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A case for ending lockdown

ryankemper.io

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Re: A case for ending lockdown

#371

Post by lbeltrame »

ModernMech wrote: post #250
wegs wrote: post #137

Earlier quoted context omitted.

Well, here's the problem: The statements your making are quantifiably incorrect throughout the article, and by large amounts. The article sounds authoritative, but it's not. It's the definition of Internet misinformation. I think getting your opinion out there is important, but to be honest, the article needs a heck of a lot more in terms of disclaimers, and much less in terms of confident statements and grandstandin…

> 1) The economic costs of ending the lock-down may be astronomical. This is especially true with what we learn about COVID19 and lung damage (or potentially other organ damage). If even a small fraction of the population is on long-term disability, the costs go up super-quickly. I have a feeling a lot of people advocating ending the lockdown are doing so on the basis that only old and infirm people die, as if the ot…

> Yes corona is mostly deadly to older people, but even for those who do not die there are negative health outcomes which impact their ability to work and take care of themselves. What is the economic impact of that?

We need to know the incidence of these issues. Response needs to be completely different in case they're the majority of cases, or if they happen in the minority.

So far the evidence collected from what I've seen is case reports, so nothing clear or definitive.

Re: A case for ending lockdown

#372

Post by cies »

TeMPOraL wrote: post #168
cies wrote: post #158

Earlier quoted context omitted.

> Are we really going to isolate or quarantine 4 out of 10 US adults and imagine the economy can get back on track? It's a good start. Also "encourage" is different from "enforce".

"Encourage" is different from "enforce", but very similar to "doesn't work". Once isolation becomes voluntary, the job market will make sure that people won't isolate even if they wanted to. A common thread of the current pandemic measures is that people get to protect themselves in ways that would destroy their careers if they weren't mandated top-down by the government.

> Once isolation becomes voluntary, the job market will make sure that people won't isolate even if they wanted to.

Depends on your labour laws, and facilities more than on the market IMHO.

Re: A case for ending lockdown

#373

Post by shkkmo »

ryankemper wrote: post #366
shkkmo wrote: post #357

Earlier quoted context omitted.

> This is not a fair characterization; I was very clear that this represented my "first draft" and that I was looking for feedback specifically to have people poke holes in it. Where was this made clear? The closest I can see is at the very end where you call it a living document and will accept pull requests that match the "style and intentions of this document" which to me sounds like you are only interested in mee…

Okay, I half concede your point. I expressed the desire to have holes poked in my top-level comment contextualizing HN submission / thread comments itself, but did not make clear reference to it in the document itself. So the external dependency means that you are by-and-large correct. The part I don't concede is this notion: > Instead you decided to broadcast your ignorance with confidence about an area already ripe…

> In that, it strays far too close to the dangerous notion of "advocating for ending the lockdown, however flawed, is killing people".

I have no problem with advocating to end the lockdown. We need to do it as soon as practicable. You ar correct in supposing that a lockdown that lasts longer than necessary ends lives. I think there are some good steps we can take towards that, such as reopening underutilized hospitals in areas where that utilization has plateued.

You are doing more than that, you are trying to summarize everything we know about covid. In an environment with so much misinformation about covid floating around that is demonstrably dangerous, it behooves is to be extra care to not feed into that cycle.

Re: A case for ending lockdown

#374

Post by scott_s »

ryankemper wrote: post #365
scott_s wrote: post #209

Earlier quoted context omitted.

I am unaware of a "massive excess of capacity" in NY; quite the opposite. Where do you make that conclusion from? NY, to my knowledge, has been well over capacity and has had to take severe measures. Hospitals have had more patients than they can deal with and the staff is overworked. Elective procedures have been cancelled, no visitors are allowed, doctors and nurses who ordinarily work elsewhere are working in Covi…

By massive excess I was referring to vents/tents. Estimates of vents needed were far too high due to the models being relied upon (i.e. not because we surprised ourselves with how flat the curve got given the seroprevalence was not expected from policymakers as far as I can tell). Still, I _don't_ know about how we are doing in terms of healthcare workers. That's almost certainly the bottleneck and it may be that it'…

I am unsure what the NYC capacity is right now, but I know in some parts of the city, patients literally died in hallways before even getting a proper room. I also personally know a nurse in a hospital in Westchester county (just north of the city), and they had to make impromptu Covid-19 ICUs out of various parts of the hospital, and that turns doctors and nurses who ordinarily did other things (such as surgeries) into ICU doctors and nurses.

NYC built more hospital capacity as a response to the dire situation in their hospitals. That some of that extra built capacity is unused is not evidence of overreaction. I also find it odd to separate out the availability of doctors and nurses from the physical beds when our primary question here is whether the hospitals are strained; a bed is of no use with doctors and nurses to help the patient.

I'm honestly curious: have you not read the news papers articles talking to doctors and nurses who have personally witnessed the over capacity hospitals in NYC and Chicago?

Re: A case for ending lockdown

#375

Post by ryankemper »

danieltillett wrote: post #359
ryankemper wrote: post #103

Earlier quoted context omitted.

> 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. An IFR of 1% seems too high. This doesn't seem to line up with data from the Diamond Princess (~1% IFR in a population biased towards elderly). We can also look as a lower bound at the Theodore Roosevelt (the navy ship), which had I believe 840 posi…

1. Estimating the IFR is difficult because of difference in populations infected - in the end you need to make an estimate based on the best data possible. The Diamond Princess data was not biased towards the elderly as much it would appear as a large number of the positive case were in the crew who are younger. We also don’t know the true death rate as many cases were lost to follow up. Even if the IFR turned out to…

I don't have anything substantive for right now, but just wanted to say that I've gotten a lot of value out of your responses in this thread and really appreciate you taking the time to do so.

Re: A case for ending lockdown

#376

Post by danieltillett »

ryankemper wrote: post #375
danieltillett wrote: post #359

Earlier quoted context omitted.

1. Estimating the IFR is difficult because of difference in populations infected - in the end you need to make an estimate based on the best data possible. The Diamond Princess data was not biased towards the elderly as much it would appear as a large number of the positive case were in the crew who are younger. We also don’t know the true death rate as many cases were lost to follow up. Even if the IFR turned out to…

I don't have anything substantive for right now, but just wanted to say that I've gotten a lot of value out of your responses in this thread and really appreciate you taking the time to do so.

Excellent. This is the what makes HN so valuable (when it works) - bring together intelligent people in a forum where they can discuss a topic in a respectful way - the opposite of Twitter :)

Re: A case for ending lockdown

#377

Post by Izkata »

pbhjpbhj wrote: post #325
fluffything wrote: post #238

Earlier quoted context omitted.

In the EU there are graphs showing the "daily deaths / day" over the last 2 years. One can pretty easily see the impact of COVID-19 there, even on countries that are not testing and therefore not reporting any cases... Unfortunately I haven't been able to find that data for the US.

https://www.worldometers.info/coronavirus/country/us/ They include "deaths per day" in one of the charts. Early on I found their stats to be consistent with other trusted sources; but I've not confirmed that recently.

"Excess deaths" is the thing to search for: https://www.economist.com/graphic-detail/2020/04/16/tracking...

In the graphs right at the top of the page you can see several locations have more deaths than usual even if you subtract the covid19 ones. These are likely covid19 deaths that haven't been included in the stats, probably due to lack of testing.

According to that page, New York City, where almost 1 in 600 of the total population (not just of the infected) have died, is likely now tracking its stats pretty accurately.

Re: A case for ending lockdown

#378

Post by dangus »

ryankemper wrote: post #346
dangus wrote: post #212

> About me > I’m a software / site reliability engineer based out of Santa Barbara, California. People need to stop chiming in on subjects on which they are not experts. Ryan, as a site reliability engineer, I know you’re annoyed annoyed when people on the street talk to you about your job and misinterpret just about everything about how technology works. I had a potential customer of my employer express interest (ba…

As you can tell, I read everyone's feedback. I don't share your views on this matter. I think, particularly given that public policy is relevant to all of us, that it does make sense for even a layperson to engage in the conversation. This is not merely a scientific issue. Rather, we need to don our scientist caps to try to figure out what is likely to happen under different scenarios from an epidemiological standpoi…

I do believe that you believe your article was written in good faith...

You said you didn’t sink 200 hours into this project, and that is my exact criticism. The people working on covid-19 mitigation in hospital systems, labs, pharmaceuticals, and within the CDC and state health agencies actually do this for a living and have spent well over 200 hours per-capita figuring this stuff out. I mean, heck, that’s only about a month’s worth of full time work. That’s how little expertise you’re bringing to the table here: basically less time than a summer internship.

Re: A case for ending lockdown

#379

Post by DanBC »

pbhjpbhj wrote: post #325
fluffything wrote: post #238

Earlier quoted context omitted.

In the EU there are graphs showing the "daily deaths / day" over the last 2 years. One can pretty easily see the impact of COVID-19 there, even on countries that are not testing and therefore not reporting any cases... Unfortunately I haven't been able to find that data for the US.

https://www.worldometers.info/coronavirus/country/us/ They include "deaths per day" in one of the charts. Early on I found their stats to be consistent with other trusted sources; but I've not confirmed that recently.

I think people are talking about excess mortality, or all cause mortality.

Here's the EU version: https://www.euromomo.eu/graphs-and-maps#excess-mortality

There's some lag in these figures. The CDC will have something eventually.

Re: A case for ending lockdown

#380

Post by DanBC »

ryankemper wrote: post #333
Balgair wrote: post #289

Earlier quoted context omitted.

The Washington Post had a good article a while ago on the issues with estimating death rates. The math is a bit complex, so I'll let them explain it to you (instead of a HN comment box). It's nuanced, as these pandemic things tend to be. TLDR: We're undercounting deaths due to covid-19 by ~60% nationally, and 40% in NYC. https://www.washingtonpost.com/investigations/2020/04/27/cov...

So, I've read the article, and it seems to not support this assertion of yours: > TLDR: We're undercounting deaths due to covid-19 by ~60% nationally, and 40% in NYC. What it does say is this: > “Thus I would probably add about 15% or so to the known death toll,” she wrote to two city officials. “However — no city or state will be factoring this in or reporting it, so I don’t think we should either. We should just as…

>> “Thus I would probably add about 15% or so to the known death toll,” she wrote to two city officials.

There's a few different numbers and it's important to keep them clear.

The main number that people know is "died after being tested positive with covid-19 from a covid-19 like illness". For a while this number only included people who died in hospital.

The next number (which the 40% to 60% refers to) is "died from a covid-19 related cause after testing positive, or after being suspected of being covid-19 positive". This includes all the frail people in nursing homes where tests were not carried out (they weren't being tested because it wasn't going to affect their treatment).

The 15% appears to refer to all the people who live alone at home.

> Interestingly per the https://www.cdc.gov/heartdisease/facts.htm, we see something like 647,000 heart disease deaths per year. So, I haven't done the napkin math, but could the 20%-odd spike of cardiac arrest events they mentioned have more to do with postponed surgeries?

I agree that cancelled surgeries, and also people delaying seeking help when they start to have heart problems, is really worrying and has caused some of this excess death.

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