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A case for ending lockdown

ryankemper.io

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Re: A case for ending lockdown

#331

Post by rootusrootus »

krapp wrote: post #291
rootusrootus wrote: post #288

Earlier quoted context omitted.

The encouraging thing about HN is that much of the community seems aware of the propensity for software engineers to think they have the answer to all the problems of the world. IMO, acknowledging that and not taking ourselves too seriously helps keep this forum from completely degenerating into another Reddit.

>IMO, acknowledging that and not taking ourselves too seriously helps keep this forum from completely degenerating into another Reddit. Ironic, because many people here seem to believe not taking ourselves too seriously will lead to this forum degenerating into another Reddit.

Touché. I guess I'm describing my wishes more than reality.

Re: A case for ending lockdown

#332

Post by mdemare »

ryankemper wrote: post #328
mdemare wrote: post #277

Earlier quoted context omitted.

> 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). The Diamond Princess has 13 deaths for 712 cases, so 1.8%.

That's the case fatality rate, not the infection fatality rate. As you can see in your quote, I was talking about IFR. In general - and this is a theme of the writeup BTW - we should be looking at IFR and not CFR. With IFR we can reasonably extrapolate how many deaths we'll have before new infections halt, whereas CFR is borderline impossible to use because we'd need to know how many cases we would expect per infecti…

That article is from early March. It’s May now, no need to estimate anymore. I agree that CFR is fairly useless. But if you test everyone, as was the case on the Diamond Princess, IFR = CFR.

Re: A case for ending lockdown

#333

Post by ryankemper »

Balgair wrote: post #289
gbrown wrote: post #218

Earlier quoted context omitted.

Yeah, if you model New York with an appropriate epidemiological model using just mortality (which is more reliable than cases), the lockdown event is massive and trivial to detect. Anyone who claims otherwise is either dishonest or foolish.

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 assume that the deaths are about 15% more than we can count, but not include them in official modeling, because we will never really know.”

It does pay some lip service to the notion that some of these at-home deaths could be precisely because of the "elective" (meaning, scheduled) surgeries that we had postponed.

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?

Re: A case for ending lockdown

#334

Post by ryankemper »

ausbah wrote: post #183
grumple wrote: post #165

The premise of this post is extremely flawed: > Weeks and months later, facts on the ground show that the purported collapse of the healthcare system did not occur. Yes, because we locked down population centers quickly. That's the whole point. ICUs have still been over capacity though. Without the lockdowns, it's obvious we'd have a lot more dead people the past month. > Moreover, this was not due to success in seri…

this is a good example of people saying the response was overblown, because the response had its intended effect

Note that this classic "pro-lockdown" talking point is an unfalsifiable claim. I don't think there's any figure I could pull out that might sway you otherwise, right?

Simply put, this argument is invalid. Why? Because my writeup went into the IFR. Therefore we can calculate how many deaths might occur in the "do nothing" scenario, and compare that to lockdown-induced deaths.

Also we should note that social distancing and lockdown are different things, and it _appears_ that the former is much more responsible for the slowed rate of transmission. My proposal does not involve getting rid of social distancing, although it does encourage it to be voluntary as opposed to compelled.

Re: A case for ending lockdown

#335

Post by ryankemper »

legulere wrote: post #248
merpnderp wrote: post #227

Earlier quoted context omitted.

NYC, while under pretty extreme lockdowns still likely had 25% of its population infected as of over 2 weeks ago. If the serological surveys are correct, we know two things, it spreads rampantly even under harsh lockdowns and the IFR (infection fatality ratio) is likely I tend to think we should stay locked down to slow the spread if that's even still a thing given how fast it has spread in NYC. But on the bright sid…

How do you come to the conclusion of IFR likely <.5%? I’ve seen it consistently reported as 0.5-1.5%.

That upper bound seems way too high.

I think the Diamond Princess is the perfect case study to use as an upper bound, since we conducted extensive testing and the population is heavily skewed towards the elderly (and therefore higher risk than general population).

See https://www.medrxiv.org/content/10.1101/2020.03.05.20031773v...

> Adjusting for delay from confirmation-to-death, we estimated case and infection fatality ratios (CFR, IFR) for COVID-19 on the Diamond Princess ship as 2.3% (0.75%-5.3%) and 1.2% (0.38-2.7%).

Re: A case for ending lockdown

#336

Post by ryankemper »

pinkfoot wrote: post #294
logicchains wrote: post #253

Earlier quoted context omitted.

>Seriously, the list of scientist and medical organizations advising through this period is so long, I don't know why anyone who isn't at equally experienced tries to counter-claim their insights. The average scientist or medical organisation has no more economic knowledge than a layman. The costs of the lockdown are primarily economic. We couldn't possibly make the best decisions by listening to people who are only…

Why is a intelligent, qualified, experienced team of epidemiologists "only in a position to identify the (medical) benefits of the lockdown and not the costs." After all, you were able to recognise both parameters?

Epidemiologists are not equipped to understand the economic ramifications that occur when large portions of society are forced to halt their business operations. This seems self-evident.

Public policy wrt Covid basically occurs at the intersection of epidemiology and economics. The epidemiologists can help tell you what will happen under different scenarios, and the economists can tell you what will happen economically speaking in those same scenarios.

We're basically balancing the economic impact directly attributable to sick days and to COVID-19 deaths, with the impact of the shutdown itself.

As you already know, my conclusion is that the latter is far more severe. But that balancing act is of course precisely what all the debate is about.

Re: A case for ending lockdown

#337

Post by ryankemper »

mchusma wrote: post #186
ryankemper wrote: post #51

Earlier quoted context omitted.

FWIW, I will probably circle back here and switch to "I", since I think it's probably worth it to avoid confusion.

I may submit a PR then it would become "we".

Thanks. I'm going to leave it as is. As another commentator has mentioned, use of the singular "we" is very common in academic writing anyway, not that I'm saying that this blog post of mine is "real" scientific research or anything

Re: A case for ending lockdown

#338

Post by ryankemper »

UncleSlacky wrote: post #233
hkai wrote: post #201

Earlier quoted context omitted.

I've read the whole thing and I have these comments: - I think the part about the freedoms is unnecessary because I feel the vast majority of the pro-lockdown people do not share your enthusiasm for freedom and public discourse. While your main argument may shift their opinion, the part about liberty may cause them to stop reading and discard your other arguments. - I think some claims would sound more persuasive if…

I laughed at this: > Other countries do not even have the concept of freedom of speech/assembly embedded into their founding documents. as it was clear that the author hadn't done any research on this - many countries explicitly or implictly have these in their founding documents.

Yes, the statement as I wrote it was imprecise enough to be false. I am going to circle back and fix it.

In short, the important distinction is not that it's embedded into the founding documents, but that we do not place the limitations on free speech that other countries do.

i.e. places like UK, germany, france - while they may have the phrase "free speech" in their documents, the limitations put on it are extreme enough that they're basically referring to a totally different concept.

So, it would be more accurate to say that other countries do not share our concept of free speech, in that ours has _very_ few limits put on it.

Re: A case for ending lockdown

#339

Post by ryankemper »

docdeek wrote: post #251
rootusrootus wrote: post #245

Earlier quoted context omitted.

> The CDC suggests that +42% of the US adult population is obese For what it's worth, this is the same CDC that suggests that the level of obesity that increases COVID risk is BMI 40+ [0], which is more like 6-7% of the US population. [0] https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precaut...

That's a good point. The OP didn't specify a BMI, just obesity. Still an enormous number of people but far lower than 40ish percent.

Yes, I should have used more precise language.

I should have made it clear but I wasn't attempting to construct an exhaustive list of risk factors, but more give an example of what that might look like

Re: A case for ending lockdown

#340

Post by ryankemper »

meheleventyone wrote: post #143
ryankemper wrote: post #20

Earlier quoted context omitted.

I have no directly relevant credentials whatsoever and don't claim to. (I actually considered saying as such in the writeup but it's already so verbose that I felt it wasn't worth it). I'm just a dude that likes to read research papers. As an aside, there is totally an archetype of the software engineer that thinks they're equipped to dive into unrelated fields, and I definitely match that trope. I will say in my def…

> I have no directly relevant credentials whatsoever and don't claim to. IMO this should be a disclaimer in bold right at the very top of the article.

Done.

https://gitlab.com/ryankemper/writings/-/commit/05b4b616c5e0...

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