I ask out of ignorance. Has this study been done? Will the slow trickle that keeps schools and businesses closed for months, but spares the rush on the healthcare system, make sense in the end? Will the number of cases and deaths actually be reduced (area under the curve)?

I read the PNAS paper on Spanish flu on Philly and St Louis. That was 1918. It goes without saying that much has changed in both the economy and healthcare system in the last century.

I believe you answered your own question about whether flattening the curve will reduce deaths when you described deaths as the area under the curve...

Asking the American public to understand calculus is asking a lot.

In American politics, when you accept a certain number of dead old people bodies over sustained economic activity you've crossed the line. We are not China.

Just an Ag said:

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In American politics, when you accept a certain number of dead old people bodies over sustained economic activity you've crossed the line. We are not China.

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You are missing the point. If the number of sick and dead are not reduced, the "mitigation plan" failed. That it took 6 months instead of 6 weeks is irrelevant. So the question on the table is if the area under the curve is truly smaller. And if not, what are the relative costs.

I don't think we are flatting the curve. I think we are just moving the peak.

Under the "flatten the curve" model, the coronavirus is supposed to be with us for 12-18 months instead of being bunched in 2 months. A 6 month or longer shutdown is being discussed by those who have pushed the shutdowns as an effective action. Most organizations have left the question open or haven't discussed it publicly.

Not trying to be cold, but it seems this is why we don't shutdown the country during flu season. I've mentioned it before, but 80,000 Americans died from the flu over a 13 weeks period just 2 years ago. That is a daily average of 879 Americans dead.

And at the end of the day, how many of our most vulnerable will we save with a 6 month or more shutdown and at what cost to our standard of living? Will those most vulnerable then die the following flu season when we don't shut the country down?

The point is to reduce diffuse the Initial stress on the healthcare system and then leverage the reduced demand to permit time for best practices and natural innovation to dampen the marginal cost of treatment.

I think of it like a DCF. Push costs out and improve your NPV.

Why not?

Wildcat said:

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Just an Ag said:

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In American politics, when you accept a certain number of dead old people bodies over sustained economic activity you've crossed the line. We are not China.

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You are missing the point. If the number of sick and dead are not reduced, the "mitigation plan" failed. That it took 6 months instead of 6 weeks is irrelevant. So the question on the table is if the area under the curve is truly smaller. And if not, what are the relative costs.

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It's a dicey political issue, what else can I say? The "relative costs" is a losing argument in American Politics. You take moderate economic damage over dead people. At some point that argument turns the other way, but you first defer to saving lives.

I wonder how this economic impact will compare to 9/11.

My problem with the "curves" chart is that it is generally presented without any numbers or scale on the axes. How do we know the tails of the distribution are perfectly even? How do we know the delay causes us to get below that ICU capacity? How do we know the "do nothing" approach doesn't drop off on the backend like a cliff? Or maybe the delay doesn't turn into a large exponential growth the shoots right through the hospital capacity in 6 months?

Or maybe I'm the a-hole.

This situation is uncertain AF.

We don't "know" anything right now the situation is volatile and dynamic. Experts who actually do this professionally (rather than the derp arm chair experts) actually conduct meaningful and peer reviewed studies on this (albeit on the most recent available data set which is now a century old).

Nonetheless, a slightly less tired healthcare worker is better than a more tired healthcare worker. And the graphs you are seeing are oversimplified to resonate with the masses, however, they directionally quantify the expected result.

OldArmyBrent said:

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My problem with the "curves" chart is that it is generally presented without any numbers or scale on the axes. How do we know the tails of the distribution are perfectly even? How do we know the delay causes us to get below that ICU capacity? How do we know the "do nothing" approach doesn't drop off on the backend like a cliff? Or maybe the delay doesn't turn into a large exponential growth the shoots right through the hospital capacity in 6 months?

Or maybe I'm the a-hole.

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The numbers with the flattened curve apparently end at 12-18 months per the Wall St. Journal. That is new information I saw today. Perhaps, that was to be suppressed because it wasn't mentioned in the panic of all the cancellations earlier this week. I'm not sure it would have been accepted.

And for the theory to work we need more sick people now. We don't want to suppress it too much and have too large a spike later on.

And cities and schools postponing or cancelling things needs to be upfront with the public. We are going down a path where apparently some things are shut down for at least 6 months. Is that understood?
[url=https://nypost.com/2020/03/12/de-blasio-declares-nyc-state-of-emergency-to-stem-coronavirus/][/url]

Quote:

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De Blasio warned that he expects the crisis to last at least six months, with more time needed to recover.
"This will not be over soon. It's going to be a long, tough battle," he said.

De Blasio said he "won't be surprised" if the move forces some businesses to close, but said, "These are the rules we will enforce from now on."

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https://nypost.com/2020/03/12/de-blasio-declares-nyc-state-of-emergency-to-stem-coronavirus/

This entire thread will prove to be BS , the virus will calm down with April heat and humidity, we will think things are safe then, we will be exposed to a less contagious version during summer months, and next November we will see if it comes around again or not (weak or strong)

Just an Ag said:

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Wildcat said:

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Just an Ag said:

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In American politics, when you accept a certain number of dead old people bodies over sustained economic activity you've crossed the line. We are not China.

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You are missing the point. If the number of sick and dead are not reduced, the "mitigation plan" failed. That it took 6 months instead of 6 weeks is irrelevant. So the question on the table is if the area under the curve is truly smaller. And if not, what are the relative costs.

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It's a dicey political issue, what else can I say? The "relative costs" is a losing argument in American Politics. You take moderate economic damage over dead people. At some point that argument turns the other way, but you first defer to saving lives.

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I guess I am not being clear. I am questioning whether the flatter curve actually produces less of an impact. You seem to presume that a flatter curve equals a lower body count. I am questioning that.

If we lose 1200 this month vs 200/month for 6 months, we still have 1200 bodies. But with the latter, we disrupted a myriad of functions/activities for half a year. Is that actually a better outcome?

the last of the bohemians said:

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This entire thread will prove to be BS , the virus will calm down with April heat and humidity, we will think things are safe then, we will be exposed to a less contagious version during summer months, and next November we will see if it comes around again or not (weak or strong)

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The warm weather is anticipated to mitigate spread and severity, but I don't think you can merely brush this aside as "BS".

Here you go: Light Reading

Indications are that the death rate for those not receiving treatment is about 15% whereas its 1% for those getting treatment. If that's even close to correct it's a great argument for flattening the curve.

I preferred this source: PNAS 2006 Phily vs. St Louis

This article has been suggested to be the seminal paper in the justification for early responses and closures/social distancing for effectiveness. The data on "flattening" are compelling, but there are two caveats, the total number of deaths wasn't statistically significant and there was an inverse relationship between the initial wave (1918) and the second wave the following year(s). That is to say that more died in subsequent waves if the severity of the first wave was effectively mitigated.

It's also important to note that it was 1918, public and private sanitation were far different, the healthcare system was far different, and the bug was fundamentally different. So just how informative this study can really be is an open question.

LOYAL AG said:

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Indications are that the death rate for those not receiving treatment is about 15% whereas its 1% for those getting treatment. If that's even close to correct it's a great argument for flattening the curve.

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Flattening the curve is not about whether to provide medical treatment or not, but whether non-pharmaceutical interventions such as cancellations of public gatherings, social distancing, and other mitigation measures as well as their timing reduces peak and total disease and death rates.

You're agreeing with his point.

Just an Ag said:

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In American politics, when you accept a certain number of dead old people bodies over sustained economic activity you've crossed the line. We are not China.

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But why do when then allow 50k car and flu deaths each year not to mention the 10k inner city crime deaths? Those are acceptable, I as an older person am okay with old people dying.

On balance it would seem the approach to reduce strain now on total beds available doesn't add up. If the belief is the total affected of 1200 will rise to >400k within 90days and this placing strain on ICU, why would kicking the can down the road change?

If reports are true that the length and depth of CV19 stays on surfaces longer and transmits at an accelerated rate compared to other known viral strains why would the infected population totals not end up perhaps double or triple what it would be near term?

Is the belief that we will curb exponential increase in the long run because we will have found a vaccine?

That seems like a gamble. And if to one posters point that lives saved today is greater than economic effects, I wonder what long term economic effects will have on lives when individuals and families are put out of livelihoods because of economic shutdowns. Thus resulting in medical issues and perhaps more long term people homeless on the streets. We could likely list many more negative externalities to society with further consideration.

Assuming none of this universe of economically affected people results in deaths, would the mental anguish and prolonged ramifications not be worse for those folks? And if so, how many more people would then be in that scenario comparatively vs the amount of at risk population today and known numbers of <5k currently infected out of 330MM people?

Seeking to understand the balance between psychological fear of the unknown (people's/government's emotional reactions) and what is grounded in statistical outcomes. I appreciate the one life today is too many vs economic fallout, and using the same lens are we causing more lives in the future to be in a very bad spot or worse?