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A Swedish doctor's perspective on Covid

sebastianrushworth.com

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Re: A Swedish doctor's perspective on Covid

#181

Post by 8note »

refurb wrote: post #33
gnicholas wrote: post #9

Cynical perspective: Trump doesn't want to reopen too fast because it won't be clear by the election (October, when mail-in voting happens) that this was a good strategy. Democrats don't want to reopen too fast because keeping the economy shut down is bad for Trump's reelection chances. Too cynical? Perhaps. But I do think that perspectives like the author's are dismissed too quickly because neither 'side' sees a way…

Trump doesn't want to reopen too fast Hasn't Trump been the one flippantly saying "it's not a big deal" and "we'll be back to normal quickly" and "we'll get the kids back to school shortly"? How could anyone view his behavior as "not wanting to reopen too fast"? It seems the exact opposite to me.

He wants the points for arguing that it's the right thing to do, but without the risk of finding out it wasnt

Re: A Swedish doctor's perspective on Covid

#182

Post by zaroth »

hn_check wrote: post #154
xzel wrote: post #145

Earlier quoted context omitted.

How are sports teams a ghost of what they were? NHL playoffs are incredible right now. European soccer is wrapping up and play is great. NBA is just getting started. Most of them just canceled games or took a break, which, for example, the NHL used to do every 4 years for the Olympics. The only sport that seems to be having real trouble is the MLB, who just had a terrible plan. I admit, I have no belief the NFL has a…

"NHL playoffs are incredible right now" No fans. Playing in two bubble cities in Canada. "NBA is just getting started" No fans. Playing in one bubble city. And I was talking about NYC. Zero NBA or NHL games are taking place in NYC. In an average month in NYC, pre-COVID, there are dozens of enormous sports events. Hundreds of concerts. Tens of thousands of significant parties. If social interaction were on a scale fro…

Here’s a graph which speaks to exactly this topic - the R value charted versus two axis; social connectivity, and herd immunity.

Both are equally important pieces of the puzzle. They work together to get R below 1.

https://twitter.com/trvrb/status/1291860668342079490?s=21

Re: A Swedish doctor's perspective on Covid

#183

Post by PaulDavisThe1st »

chrisjs96 wrote: post #124
agildehaus wrote: post #95

Earlier quoted context omitted.

Delusional. For that, ~2700 more people would need to die in Finland. 14 people have died in Finland since June 1st and they're typically reporting 0 now. In Sweden, 40 people died ON June 1st. Both countries have it under control now. But it's clear Finland's shutdown saved lives.

It's not clear anything is saving lives. Once everything opens up we could be right where we started. Also we've said basically that people with coronavirus matter more than other illnesses. There will be millions of deaths around the world because of shutdown. Things like AIDs medicine. Then thousands due to lack of treatment of cancers and people not going to doctor(England did a study on this). Then you'll have th…

I don't think we're going to know in just 10 years. Maybe 50, or 100.

For myself, I definitely sense that we (collectively, or nation by nation) could have followed various pathways (and to some extent, we did). The "right" answer was (and is) not known, and we had a choice between erring on the side of caution over the damage caused by the disease versus that caused by economic disruption.

For now, I'm still in favor of erring in the direction of caution over the disease impact, but will concede that history may judge things quite differently.

Re: A Swedish doctor's perspective on Covid

#184

Post by zaroth »

I’ve posted this in replies but I want to put it as a top-level comment as well.

Here’s a chart showing the effective transmission rate (R value) as a function of “social connectivity” and “herd immunity”;

https://twitter.com/trvrb/status/1291860668342079490?s=21

I think what you can find in many examples across the globe is that without an innate geographical advantage or well-established cultural protocols, you cannot reduce “social connectivity” enough with an immunity of 0% to keep R below 1.

For most peoples and places, it’s only through a combination of reducing social connectivity and increased immunity that R will ultimately fall below 1.

Interestingly, both factors do not necessarily only move in one direction along the axis over time, and neither factor can be entirely controlled, even given an effective and widely produced vaccine.

I can only pray that at least immunity is quite durable, lest we find ourselves in a repeating cycle of R cresting well above 1.

At least until an effective vaccine is available, there is a massive cost to pay to push R downward, regardless of which axis you choose to push on.

And the next time someone laments why did we lockdown if only to end up with so many cases, I think for most countries the only answer to get to R below 1 is actually that “you need both”.

Re: A Swedish doctor's perspective on Covid

#185

Post by evan_ »

alyx wrote: post #170
refurb wrote: post #42

Earlier quoted context omitted.

I think his point is you can't compare the impact of the flu because 1) it hits every year (versus a quick outbreak) and 2) many people are vaccinated. Don't forget the '17 flu seasons was 65k deaths in the US. So we're at a little under 3x right now. So yes, Covid is worse, but we don't bat an eye at 65k deaths due to the flu.

Pull the flu/influenza death numbers from the CDC for the last decade. I dare you. In the last ten years we (in the US) have lost +500,000 people to the flu. For some reason the people that died from the flu must be lesser in value because nobody did anything about it. You would think that a single year of 65k deaths would be enough for everybody to wear masks the following flu season. And yet? No economic shutdowns.…

With shutdowns, masks, and closed schools, COVID has killed in six months about a quarter of the people who die from the flu in a decade

How is that an argument for less-drastic measures?

Re: A Swedish doctor's perspective on Covid

#187

Post by refurb »

Marsymars wrote: post #98
refurb wrote: post #26

Earlier quoted context omitted.

If Covid has taught me anything, it's to stop assuming a best case scenario. Even if a vaccine is approved in Q'21, due to manufacturing, supply chain and just general operations issues, it's going to be a while before a large part of the population is vaccinated. I assume they'll prioritize medical workers and the elderly, then start working through the rest of the population. It wouldn't surprise me if it takes ano…

> We're probably looking at end of 2021 for enough vaccinations to happen for things to go back to "normal". In my eyes, that is the best case scenario.

Yeah, you're most likely right. If we have a couple vaccines fail in phase 3, add another 6 months. And there is a chance it's another year before we have a somewhat effective vaccine.

That pushes out herd immunity to late 2022.

The positive thing is there a lot of vaccine in development. I feel confident we'll find one that's at least somewhat effective.

Re: A Swedish doctor's perspective on Covid

#188

Post by giantDinosaur »

lsllc wrote: post #155
foogazi wrote: post #146

Confused by this: > Shutting down completely in order to decrease the total number of deaths only makes sense if you are willing to stay shut down until a vaccine is available. Wouldn’t shutting down completely for a month or two effectively end covid ?

The UK, France, Spain, India and Australia who all shutdown (to varying degrees) are now experiencing significant upticks in cases. Even Vietnam is now fighting hard to tamp down a resurgence of C19 despite impressive initial measures to try to stop it. You'd have to be completely sure that during your lockdown, the virus burned itself out inside each household. You'd have to have a really strict lockdown (e.g. troop…

It's potentially the case in Melbourne, which is where the outbreak is essentially located, that the cases and potentially most of the outbreak are derived from extensive failures in the so called 'hotel quarantine' system. People have a misplaced belief that given a reasonably competent government you always get competence, which for a variety of reasons was not the case in this particular instance. I think a major planning failure is the result of optimism bias - i.e. that if we decide to do something we can actually do it well consistently.

Re: A Swedish doctor's perspective on Covid

#189

Post by chrisjs96 »

mcguire wrote: post #150
chrisjs96 wrote: post #124

Earlier quoted context omitted.

It's not clear anything is saving lives. Once everything opens up we could be right where we started. Also we've said basically that people with coronavirus matter more than other illnesses. There will be millions of deaths around the world because of shutdown. Things like AIDs medicine. Then thousands due to lack of treatment of cancers and people not going to doctor(England did a study on this). Then you'll have th…

This is one reason you need to look at all cause mortality. Another is that COVID specific counts don't catch all related deaths and include possible unrelated deaths.

I'm aware of excess death or all cause. This doesn't take in account the delay of deaths we're going to have. So we need to look at all cause globally in a year or two or ten

Re: A Swedish doctor's perspective on Covid

#190

Post by giantDinosaur »

HarryHirsch wrote: post #90
refurb wrote: post #42

Earlier quoted context omitted.

I think his point is you can't compare the impact of the flu because 1) it hits every year (versus a quick outbreak) and 2) many people are vaccinated. Don't forget the '17 flu seasons was 65k deaths in the US. So we're at a little under 3x right now. So yes, Covid is worse, but we don't bat an eye at 65k deaths due to the flu.

Consider that recovery from coronaplague is lengthy and that a good amount of those discharged form hospital are looking at permanently reduced lung function. Death isn't the best metric here.

How many? I'm all for some variant of the precautionary principle, but we should be getting better data about long(er) term effects now that this has been ongoing for 6+ months. Can you put some actual concrete numbers to this?
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