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You are merely regurgitating the talking points. And what's this "we" sheet when it comes to evidence-based medicine?

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No, I'm telling you how I and many others practice medicine. Sometimes we act without peer reviewed evidence. It is how medicine grows in knowledge.

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The assumptions about ICUs, capacity, and treatment course as well as the "dire consequences of inaction" aren't evidence based. They are fear-driven.

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There are no randomized controlled studies proving driving off a cliff is fatal, but we intuitively know it is. Having more people needing ventilatory assistance than equipment to deliver ventilation cauing increased deaths is not controversial.

You are getting too emotional. It is what it is.

I think you'd like this NYT article

https://www.nytimes.com/2020/03/16/us/coronavirus-hype-overreaction-social-distancing.html?algo=combo_lda_unique_clicks_decay_6_50_ranks&fellback=false&imp_id=623909529&action=click&module=moreIn&pgtype=Articleion=Footer

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Calculating the economic costs of curtailing social interaction compared with the lives saved, he agreed, might yield a useful metric for policymakers. The U.S. government routinely performs such analyses when assessing new regulations, with the "statistical value of life" currently pegged by one government agency at about $9 million

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Gap said:

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eric76 said:

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Chuck Gay said:

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Pelayo said:

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The economic impact of both approaches will remain just guess work. I do think we are going to save lives if we manage to draw the pandemic out. Whether it's worth the cost depends on your worldview.

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And none of the models you are quoting take into account a strict quarantine of the elderly and at risk. You do know the mortality rates differ greatly by age don't you?

Can you show us any study that comprehends the quarantine I mention above?

And it is insulting to people who actually understand the economy to say it is "guess work". It is as insulting and uninformed as people who say the virus isn't a killer.

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It is guesswork if you don't have the fundamental information you need to make a rational analysis of the situation.

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Do you understand why all corporation's bonds don't yield the same rate? What the uninformed call guesswork, the knowledgeable call fundamental information.

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Oh, come on.

When trying to determine whether a particular corporation's bonds, there is plenty of relevant information out there to make a reasonable estimate.

For a much better example, we need something for which we have almost no information. Please estimate the odds for each college team of winning the NCAA title in men's and women's basketball in 2022. Just how accurate do you think your answer will be?

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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I sure hope you are right, but 10% of infections requiring ICU is flat out scary.

Signel said:

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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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I sure hope you are right, but 10% of infections requiring ICU is flat out scary.

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That would be true, but that percentage might not be factual at this point. Context matters.

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Will the number of cases and deaths actually be reduced (area under the curve)?

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Yes, they would. Because the measures in place to slow the spread also prevent some people from contracting the virus that otherwise would have. It would also reduce the strain on the healthcare system saving those people who otherwise would have died due to lack of healthcare resources.

I see someone hasn't read the relevant, primary scientific literature that was used to develop the "flatten the curve" model.

Bumping this thread so that we consider the overall cost of "flattening the curve'. Leadership is myopically focused on hospital beds and ventilators.

Now that we have shut down much of the service sector and seen a 30% drop in the market, we can begin to take stock of the true cost of "doing something".

Wildcat said:

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Bumping this thread so that we consider the overall cost of "flattening the curve'. Leadership is myopically focused on hospital beds and ventilators.

Now that we have shut down much of the service sector and seen a 30% drop in the market, we can begin to take stock of the true cost of "doing something".

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Not to mention - we're going to push this to next flu season by "flattening the curve"

Is anyone (and I hope the experts are) factoring in the population dynamics and density of these foreign countries and their situations compared to the U.S.? And among cities within the U.S.?

I don't want to unnecessarily minimize the situation, but I wonder if all is in proper perspective.

Fair to say that the heavy population dense areas are more prone to spreading than let's say the more rural areas, which the U.S. has a lot of?

Areas like China, East Asia, and even Italy are heavily densely populated in comparison to the U.S.

Milan has an average of 18,000 people per square mile. Dallas has about 3.500. Seattle has about 8,000. New York has about 26,000 per square mile and Manhattan alone has 66,000 people per square mile.

In America do we not also have more hospitals per square mile in comparison to Iran and Italy?

Seems to me it's reasonable to say that our country's precautionary tactics could be quite different and less severe compared to the rest of the world.

Where am I wrong?

Bumpity bump bump.

I get a daily report on the state and number of hospitalizations at our academic medical center. Campus and town on lock down. One patient treated and released. Others in self-isolation with minor symptoms. No new cases.

But of course, the hospital and clinics are deemed necessary. So we have a fully functioning hospital system, but no one is showing-up for appointments that aren't life-threatening. Hospital and clinical staff sitting around bored out of their mind, waiting for the wave that isn't coming.

Have the epidemiologists modeled the number of deaths we can expect from the wave of poverty we have elected to endure? Will that number be greater or smaller from the number of COVID-related deaths?

Estimates in 2011

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Results. Approximately 245 000 deaths in the United States in 2000 were attributable to low education, 176 000 to racial segregation, 162 000 to low social support, 133 000 to individual-level poverty, 119 000 to income inequality, and 39 000 to area-level poverty.

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Looking forward to the opening of the thousands of lines of "undocumented" code being opened to the public in the model being sourced so often. Anyone think there won't be errors or very questionable assumptions?

It's been 11 days since this thread started and almost 2 full weeks since the NBA shut it down. 3 weeks since the WA nursing home?

FoxNews tracker shows 593 American deaths. And while tragic, the stories have indicated quite a few underlying factors. 50,000 "cases", and while a significant number, we've likely already seen that many layoffs and firings in half the time.

So does the number skyrocket today? Tomorrow? End of this week?

Math is easy if there are no variables.

Gap said:

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Looking forward to the opening of the thousands of lines of "undocumented" code being opened to the public in the model being sourced so often. Anyone think there won't be errors or very questionable assumptions?

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This is the primary guy that wrote the Imperial College report right?
If he's not willing to open his model to the world, he's not only selfish but a coward. Much of the world is acting on that Imperial College paper and I guess he's not willing to let those effected to challenge him. That's not science and he's not a scientist. You have be willing to be wrong.


eta: if he's holding onto the code for capitalistic, profit-motivates, I'm actually OK with that but be open and honest about your intentions. I bet he liked all the attention until he was questioned and economies went to hell.

How many ER beds and ventilators can be purchased for 6 Trillion?

Just saw that on the other thread.
I wonder if he just dropped an oopsie gif meme on his facebook or twitter

AP News

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WASHINGTON (AP) Nearly 3.3 million Americans applied for unemployment benefits last week almost five times the previous record set in 1982 amid a widespread economic shutdown caused by the coronavirus.

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According to CDC numbers that's over 60 jobs/case and 4,400/death.

It's been two weeks since I questioned the efficacy and wisdom of this "flatten the curve" policy. I have seen little evidence that various degrees of social distancing/shelter in place/etc. has significantly reduced the growth rate in the number of infections, hospitalizations or deaths. The outbreak hot spots appear to have more to do with whether or not contagious individuals happened to arrive undetected and population density.

The lack of efficacy could be due to inaccuracies in the underlying assumptions inherent in various models. Chief among these may well be the compliance of the American people with the directives. But that cannot be ignored.

Abstinence only is 100% effective at preventing teen pregnancy, but it isn't practical as a matter of public health policy. Eat less and exercise more is effective for weight loss, improved glycemic control, hypertension and dyslipidemia. Yet, we are a fat, unhealthy nation.

Over 3 million applied for unemployment last week, something like 6 trillion lost in market cap, passed a 2 trillion dollar stimulus package, and made another 4 trillion in loans available.

I would remind posters that the 2006 PNAS paper did not show significant reductions in the overall number of cases or deaths.

It goes without saying that we still have a long way to go and the impact of the alternatives will never truly be known. The overall societal cost of what we have done as a matter of public policy has yet to be fully realized. And I fear that handing over social control to public health officials who were (and remain) myopically focused on containing spread, will have done far more harm than good.

NPR

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The Federal Reserve announced several new lending programs Thursday, designed to pump an additional $2.3 trillion into a U.S. economy that has been severely battered by the coronavirus pandemic.

"People have been asked to put their lives and livelihoods on hold, at significant economic and personal cost," Fed Chairman Jerome Powell said during a webcast organized by the Brookings Institution. "As a society, we should do everything we can to provide relief to those who are suffering for the public good."

The new programs include a $600 billion "Main Street" lending program, aimed at small and medium-sized businesses that make a reasonable effort to keep workers on the payroll.

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Tomorrow marks 4 weeks since I questioned the Economic Impact of what is now being called "Economic Suppression".

Between loans, direct payments and promises, I estimate we are bumping into the 8 trillion range (I admit I have lost count). That puts us somewhere north of 500 million per casualty.

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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No we are not. With each passing day, we slide ever more slightly towards a police state.

It's been roughly 7 weeks since I posited this question. To date, the economic impact of this policy includes 33 million in newly unemployed, 8-10 trillion in stimulus and loan guarantees (I've actually lost count), half a dozen major retailers filing chapter 11, employees that could go back to work preferring to stay home as their unemployment benefit is greater than their salary, etc...and many governors are saying we are still in the early phases.

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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China now mocks us for our response.

Or in a nutshell, the economic impact of "flatten the curve" is "flatten the economy."

Win At Life said:

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By flattening the curve, here are a few things they expect as a result:

1) Instead of 80,000 ICU patients hitting the system all at once and running out of critical care beds and equipment, you spread that out over time, allowing multiple people to cycle in and out of the same bed over the year. So, you can ultimately have the same number of ill, but spreading them out over time prevents you from running out of ICU beds during the peak (what happened to Italy; and they have more ICU beds per person than we do, BTW).

2) Push the time further out when most need treatment, to give the medical community more time to develop more effective treatments and/or drugs to reduce the death rate.

3) Pushing the time further out allows us more time to produce the test kits. We are basically rationing test kits right now and only the most severe are being tested. Once everyone can be tested immediately, we can identify those that need invasive care much earlier in their illness, thus reducing the death rate (see item #1).

4) Pushing the timeline further out allows the possibility of a vaccine to be develop that can be used on more of those at the tail end of this.

Probably other reasons that aren't coming to mind right now.

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The primary talking point, and really the only one MSM spewed, in the beginning was #1. #2-4 were secondary talking points at best. Now, they are grabbing on to #4 as an excuse to stay shut down longer.

#2-4 aren't really an element of flattening the curve in its purest of definitions (although the definition has been altered over the last few months). The term "flattening the curve" is NOT designed to reduce the number of cases. Take the definition from WebMD:

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The flatter curve shows what happens if the spread of the virus slows down. The same number of people may get sick, but the infections happen over a longer span of time, so hospitals can treat everyone.

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We flatten the curve to allow, or attempt to allow, proper treatment of all cases. Doing doesn't limit the death toll to patients who are unable to fight the virus with or without treatment (ie. they couldn't be saved in the end). It does limit the potential death toll for patients who wouldn't have an opportunity to be treated because of the stress on the hospital systems.

#2 and #3 are added bonuses, but are not intended to be a component of flattening the curve. Whether it's a pandemic or an every day elective procedure, we should benefit from the improvement of treatments, processes and procedures. When you make these a component of flattening the curve, you introduce a subjective element that can be manipulated. When do you "open back up"? When the procedures and treatments evolve to improve mortality by a certain percentage?

And #4 should have never been introduced as an argument for flattening the curve for a number of reasons. The timeframe to develop, test and introduce a viable vaccine is indefinite. Then you don't even have a picture of the efficacy of the vaccine until several months to a year of data accumulates. Some flu vaccines hit an effective rate of as low as 50%. As the COVID strain evolves over time, you lose sight of whether the vaccine will continue to work.



Whether we flattened the curve or not, I firmly believe that the toll from poverty will be multiples of what we see with COVID. There are too many around the world barely getting by that will be hit hard by the economic impact of shutdowns. I think this is a net worldwide killer every day we keep the economy at a standstill.

Matilda said:

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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).

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Condescension noted. Was it worth it?

Interesting thread in retrospect.....note the date.

Depends if you're working or not. That's the real bottom line in all this. If you aren't working because of this, then your hosed. If you are working and your situation basically hasn't changed, what curve? What disease? Where's Wuhan, China?

blindey said:

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Or in a nutshell, the economic impact of "flatten the curve" is "flatten the economy."

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And this post pretty much nailed it back in May.

Anything beyond a few weeks, or maybe 2 months to know exactly what we were dealing with, was wrong then and still wrong now

beerad12man said:

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Anything beyond a few weeks, or maybe 2 months to know exactly what we were dealing with, was wrong then and still wrong now

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It's just for two weeks... it's like the sign at the bar that says free beer tomorrow.