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A case for ending lockdown

ryankemper.io

81–90 of 381 posts

Re: A case for ending lockdown

#81
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...

Conversely, is there any evidence in the other direction, ie that those who have recovered have NO protection?

Remember the other famous WHO announcement at the beginning of this outbreak: “No evidence of human-to-human transmission”

Re: A case for ending lockdown

#83
post #10

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…

> This is a living document and we encourage contributions in the form of pull requests. Who is "we"? I understand your use of "we" to speak from the perspective of us as a society through most of the article, but this makes it sound like there's more than one author.

This is fairly common for many styles of writing even when it's clearly just one author. Considering he's open to pull requests it makes even more sense.

https://academia.stackexchange.com/questions/2945/choice-of-...

Re: A case for ending lockdown

#84

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…

> First, `1/1-R_0`. This is exactly what Wikipedia says: https://en.wikipedia.org/wiki/Herd_immunity#Mechanics

I have no expertise in this area, but Wikipedia does not say:

    1/(1 - R_0)
It's:

    1 - (1/R_0)
Which makes much more sense to me on a math footing. You should probably fix that in your article so it doesn't confuse other pedants like myself.

Re: A case for ending lockdown

#85
Nice article, I think you’ve gotten a lot right, and i think analyses like this get down to the point where we can have a rational discussion. Here are some counterpoints:

1. Looking at NYC, the fatality rate is roughly 0.5%. This is based on a 20% positive antibody sample, which is getting large enough that the false positives aren’t overwhelming the data any longer.

2. If we take that as a given, then if 100% of the population becomes infected, we will have 1.5 million deaths. If we assume something more like 60%, then just one million people will die. If we lower the mortality rate to 0.3%, then maybe we are more like 750,000. I have a hard time believing it will be much lower, considering that 0.1% of NYC’s population has already died from covid-19

3. Additionally, if we give up on social distancing, then those people will die in a large wave, overwhelming our hospitals.

4. I would love to see a plan that keeps seniors safe and lets everyone else out. So far, that plan is not forthcoming. It’s hard to see how we keep them safe if their family living with them and their caregivers are all infected. So far, we’ve done a piss poor job of keeping them safe in senior living facilities, even with a lockdown.

5. On the comment that the same number of people will die with a flattened curve - that’s only true if hospitals don’t get overwhelmed, which may well still happen. Additionally, it turns out that the herd immunity point, where transmission drops below 1, is actually a function of the base transmission rate. We can actually reach herd immunity at a lower infection percentage if we are socially distanced, and thus avoid some of the deaths.

Ultimately, I think we will find ways to back off the lockdown, but health departments will be on the look-out and will be titrating the degree of lockdown as cases rise and fall. It’s hard to see e.g. restaurants getting back to anything close to full occupancy any time in the next year, and most of them don’t make enough profit per table to operate half-full (or less).

EDIT: additional point to add: yes, it seems that covid deaths will be heavily weighted to seniors. But so is mortality in general. Let’s roughly assume that the mortality rate for covid is 0.08% for 25-35 year olds. Guess what? The average annual mortality for 25-35 year olds is around 0.08%, so it will roughly DOUBLE if covid sweeps through the entire population this year. Covid could easily become the single largest killer of young adults this year.

Re: A case for ending lockdown

#86

Earlier quoted context omitted.

Great write up. It’s so strange the WHO would release a statement like that.

Very strange. If you haven't seen it, they did say why they did it here: https://www.who.int/news-room/commentaries/detail/immunity-p... Specifically this part: > People who assume that they are immune to a second infection because they have received a positive test result may ignore public health advice. So, first of all, I think the concern is on its face totally unwarranted because people likely do have immunity t…

> Our public health organizations (and the media) have adopted the following belief: It is worth it to either mislead the public or to outright lie in order to achieve compliance. If it's not clear from the article, I find such a position detestable, not only on ideological grounds but also because functionally it causes people to endanger their health by engaging in superstition.

In Italy it's pretty evident from the communication from the government, the experts (which released a "disaster story" of possible 150,000 ICU cases in a month, a number so high that should have been at least explained) and the media (including tabloids).

Since Germany has started reopening, media here (but, according to what I read - but please correct me if need be - not the case with the major German papers) started saying that "infections are accelerating elsewhere! See? Our model of lockdown is the only one that works!"

It might be true, but it should be grounded in facts and not in misrepresentation of them.

P.S.: Since you mentioned a critique of the widely-used model for this epidemic, do you have any more links to dig further? I simply do not know enough and I want to inform myself more.

Re: A case for ending lockdown

#87
post #80

Earlier quoted context omitted.

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

Thanks. That was helpful.

So then, it does seem that if we successfully contained the virus, and then avoided infection spread until a hypothetical future vaccine is developed, that we could avoid the number of infections required by some amount.

Just to tie it back to the broader lockdown vs not lockdown debate, we could probably say that a successful full containment strategy+vaccination could decrease the net area under the curve. As far as policy is concerned I still think the costs of locking down for that long (particularly given that the time is unbounded) is not worth it, but that is a very valid point that I will need to circle back and weave into the document.

Re: A case for ending lockdown

#88

Earlier quoted context omitted.

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.

Thanks, that does make intuitive sense. I wonder for a virus like SARS-CoV-2 that has a high R_0 and thus requires maybe 80% of the population to be immune for full herd immunity, if that means that the overshoot would be pretty mild?

Re: A case for ending lockdown

#89
post #40

> SARS-CoV-2 is a virus that can make you sick. Some people don’t feel sick at all, some people feel a little bit sick, and a very small group of people, especially old people, get very sick and might die. Maybe mention something about the long term issues that it appears could be a reality for even those who "don’t feel sick at all, some people feel a little bit sick"? Also, while the the goal of flattening the curv…

Disclaimer: I don't believe long term issues may not arise. I simply don't know.

That said, most evidence I've read is fairly anecdotal, or made up mainly by case reports. Has anyone compiled so far (this is a honest question, I don't know) the incidence (this is what matters) of different issues post-recovery?

Re: A case for ending lockdown

#90
post #84

Earlier quoted context omitted.

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…

> First, `1/1-R_0`. This is exactly what Wikipedia says: https://en.wikipedia.org/wiki/Herd_immunity#Mechanics I have no expertise in this area, but Wikipedia does not say: 1/(1 - R_0) It's: 1 - (1/R_0) Which makes much more sense to me on a math footing. You should probably fix that in your article so it doesn't confuse other pedants like myself.

Doh! Thanks for catching that. That is a really glaring mistake on my part.

(The irony in me having said it was "exactly" what Wikipedia says is not lost on me :P)

https://gitlab.com/ryankemper/writings/-/commit/093ade629447...

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