Willy Wonka said:

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My understanding from the very beginning was that we were going to have a bunch of people get sick and an alarming number of people die.

We were told that we can't really do anything about that number. What we CAN do, however, is keeping them from all getting sick at once, so we needed to do what we did. The numbers that we were hearing in the beginning were 400k dead.

Now with social distancing that number was said to be 100k-200k dead. When we saw numbers of 80,000 dead, there were people that prematurely spiked the ball and mocked those initial estimates. Now it looks like by opening up we are staring at those 100-200k numbers again (or 134-200).

Has the objective changed? We still have the same number of people sick, just over a longer period of time.

And Gordo, please do not lecture me about how I don't care about human life. One of my dearest friends is laying in a hospital bed 10 miles away from me and his wife and his kids who can't see him. I care. I'm scared and I'm taking about 5 different supplements every single day to keep it away from me and we pray every day that the Lord would take it away.

But we were told, "if you do what we tell you, we can keep this to 100-200,000 deaths" and these were the rules we were given. What's changed and who decided that the objective had chanfed?

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Exactly. Goal posts seem to be moved quite a lot.

Capitol Ag said:

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Willy Wonka said:

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My understanding from the very beginning was that we were going to have a bunch of people get sick and an alarming number of people die.

We were told that we can't really do anything about that number. What we CAN do, however, is keeping them from all getting sick at once, so we needed to do what we did. The numbers that we were hearing in the beginning were 400k dead.

Now with social distancing that number was said to be 100k-200k dead. When we saw numbers of 80,000 dead, there were people that prematurely spiked the ball and mocked those initial estimates. Now it looks like by opening up we are staring at those 100-200k numbers again (or 134-200).

Has the objective changed? We still have the same number of people sick, just over a longer period of time.

And Gordo, please do not lecture me about how I don't care about human life. One of my dearest friends is laying in a hospital bed 10 miles away from me and his wife and his kids who can't see him. I care. I'm scared and I'm taking about 5 different supplements every single day to keep it away from me and we pray every day that the Lord would take it away.

But we were told, "if you do what we tell you, we can keep this to 100-200,000 deaths" and these were the rules we were given. What's changed and who decided that the objective had chanfed?

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Exactly. Goal posts seem to be moved quite a lot.

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honestly, its a little weird holding this up as some "gotcha" moment. This wasn't a sales forecast call or a football gameplan. Of course as more info came in the objectives would change.

Gordo14 said:

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beerad12man said:

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Most aren't saying be reckless. No, we don't need to go backwards. Not here in this part. Maybe some more aggressive hot spots with public transit and closer lifestyles and less resources.

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That's not near enough to make a meaningful difference though. The data is pretty clear we need something closer to what we've done the last month and a half than just being careful with public transit to keep this virus under control. We also do need society to function at some point. Which is why my outlook is very negative. The real possibility of keeping this virus contained is gone. We're now going to have to prevent it from going out of control - which means we really can't go much beyond the rate of spread we have had for the month of April. Given how contagious this virus is, that means (IMO), to sustainably exist we need to wear masks in public, not take public transport, constantly wash hands in when in public, focus on largely outdoor activities at social gathering places, probably keep schools and offices closed. I bet anything beyond that will likely have to revert to that if we don't want to lose the last bit of control we have left. We'll try to do all those things I'm sure. But I think they'll fail because we didn't get the active case count down.

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How much do you want to bet?

Interesting that you handle is expresswrittenconsent, did you ever hear in a press conference that we would be changing the objective once we got the curve flattened?

Capitol Ag said:

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Gordo14 said:

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beerad12man said:

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Most aren't saying be reckless. No, we don't need to go backwards. Not here in this part. Maybe some more aggressive hot spots with public transit and closer lifestyles and less resources.

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That's not near enough to make a meaningful difference though. The data is pretty clear we need something closer to what we've done the last month and a half than just being careful with public transit to keep this virus under control. We also do need society to function at some point. Which is why my outlook is very negative. The real possibility of keeping this virus contained is gone. We're now going to have to prevent it from going out of control - which means we really can't go much beyond the rate of spread we have had for the month of April. Given how contagious this virus is, that means (IMO), to sustainably exist we need to wear masks in public, not take public transport, constantly wash hands in when in public, focus on largely outdoor activities at social gathering places, probably keep schools and offices closed. I bet anything beyond that will likely have to revert to that if we don't want to lose the last bit of control we have left. We'll try to do all those things I'm sure. But I think they'll fail because we didn't get the active case count down.

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This goes against what doctors in NY and Pittsburgh have stated in the past week. Your dark outlook and opinions are fine. But from what I reading and seeing, we have hit the crest or peak and it's now time to emerse ourselves in the public if we are not senior or vulnerable. Unfortunately we have lives to live too and while some of those that are vulnerable are dependent on care of others, we also can't keep telling the healthy to live limited (ie disregard your rights and way of life) over a virus that 99% will be absolutely fine and recover from if they contract. No one scoffed at 300,000 either. It was the 2-3 million deaths predicted in America that was wrong. Also, why is a flu season where 60,000+ die not enough to make us shut down? Why is 100-300k too much that we must shut down? Where is that line and why wouldn't it be better to allow herd immunity to spread? And what are you basing your logic that we will all be like NY soon from? That's honestly my biggest question. B/c that was regional thing and greatly based on mistakes made by the State of NY. How come we didn't see it else where?

Finally, it just cannot be stated enough that a very very very small proportion of those infected actually die from this or even require hospitalization. This is not "world ending" virus at all.

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I'm in the camp that believes we must re-engage the economy, but am willing to accept that it will not be back to "business as usual" for a long time, perhaps another year or two. I'm 32 and will by all rights will be fine if I were to catch it, but more than half my family, and more than a few close friends, are high enough risk that the inconvenience that comes along with a changed paradigm is (to me) an acceptable trade off.

I think the great concern with this thought of attaining herd immunity is that it appears champions of the idea ignore it will necessarily require something like the 2-3 million American deaths to get to. The 0.5-1% fatality rate applied across a large population is a lot of people, and given the anecdotes we've seen from doctors posting here it cannot be ignored that death or complete recoveries are two opposite ends on a spectrum of outcomes that we're just starting to understand, including some (presently unknown) percentage of people in addition to the dead that "recover" but will be on dialysis for the rest of their lives or require a new liver or have one-third the lung function.

This might be a little blunt, but to me the heart of the debate is less so "what is an acceptable loss of life" but rather what value do we put on others' lives lost or disaffected that's an acceptable balance. The threshold is different for everyone I suppose.

homeschooling kids for a year plus is going to get people's give a damn to bust faster than you think

It is amazing that we can't find a plan that people can live with to shelter the elderly and high risk and move on. I'm thinking the issue is too many of them are in positions of power and can't stand the thought they would lose it. From CEOs to elected officials they want to bring down the planet to keep their spot.

It sucks to be told to crawl in a hole and try not to die, but there's no better way forward.

With respect, I think you're under estimating the number of people that are at some level of elevated risk. Something like 1/3 of the country is 50 or older, which represents 95% of the deaths so far. That also makes up 1/3 of the US workforce.

If there were more information on what particular genetic nuance this bug acts on and puts certain people at more risk, the strategy becomes a lot more realistic but even 6 months into this today it's still almost like throwing a dart at a board on who's asymptomatic and who may go down hard.

People will get back to work and eating out if they could make risk calculated decisions, but the data hasn't been able to inform that just yet.

what % of the deaths is 65 and older?

also, what % of deaths in the 50-65 cohort could be labeled as vulnerable based on a BMI/hypertension/diabetes score of 2 or more?

I don't know off hand. Certainly a valid question.

From a mechanical perspective I'm not sure it makes a terrible lot of difference in feasibility to implement a shelter strategy, though. You're still talking about several tens of millions of people domestically.

Appreciate your response and the considerations. I do debate the point about the 2-3 million, though. I didn't mean to imply that's how many I think that will eventually succumb, but rather at a 0.5-1% fatality rate that's roughly how many deaths could be expected if herd immunity were to be achieved "the natural way" across a population of 320+ million.

Now, we could certainly debate the % death rate dropping or strategies to limit deaths in the the at-risk population as it burns through the rest of society, but on order of magnitude herd immunity has a large cost without a vaccine to get you there. That's all I was referencing.

isn't what we're doing now already an unfeasible shelter strategy?

i don't see how informing people of their relative risk is an any way non-valuable

40% of the population can't be at high risk for a disease that kills 1% or less

furthermore, NYC hospitalization rates seem to track at 3-4x the death rate. serology estimating 1% IFR and 3.5% hospitalization across all ages.

so the catastrophe math doesn't really work, unless the vulnerabilities compound in some way that's predictable

Fitch said:

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Appreciate your response and the considerations. I do debate the point about the 2-3 million, though. I didn't mean to imply that's how many I think that will eventually succumb, but rather at a 0.5-1% fatality rate that's roughly how many deaths could be expected if herd immunity were to be achieved "the natural way" across a population of 320+ million.

Now, we could certainly debate the % death rate dropping or strategies to limit deaths in the the at-risk population as it burns through the rest of society, but on order of magnitude herd immunity has a large cost without a vaccine to get you there. That's all I was referencing.

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The herd immunity approach is a tough pill, no doubt. Wish I had a better answer.

expresswrittenconsent said:

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Capitol Ag said:

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Willy Wonka said:

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My understanding from the very beginning was that we were going to have a bunch of people get sick and an alarming number of people die.

We were told that we can't really do anything about that number. What we CAN do, however, is keeping them from all getting sick at once, so we needed to do what we did. The numbers that we were hearing in the beginning were 400k dead.

Now with social distancing that number was said to be 100k-200k dead. When we saw numbers of 80,000 dead, there were people that prematurely spiked the ball and mocked those initial estimates. Now it looks like by opening up we are staring at those 100-200k numbers again (or 134-200).

Has the objective changed? We still have the same number of people sick, just over a longer period of time.

And Gordo, please do not lecture me about how I don't care about human life. One of my dearest friends is laying in a hospital bed 10 miles away from me and his wife and his kids who can't see him. I care. I'm scared and I'm taking about 5 different supplements every single day to keep it away from me and we pray every day that the Lord would take it away.

But we were told, "if you do what we tell you, we can keep this to 100-200,000 deaths" and these were the rules we were given. What's changed and who decided that the objective had chanfed?

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Exactly. Goal posts seem to be moved quite a lot.

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honestly, its a little weird holding this up as some "gotcha" moment. This wasn't a sales forecast call or a football gameplan. Of course as more info came in the objectives would change.

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Sure, but the so should the mitigation strategies, which some think we should not be doing.

Except data has come out that suggests this isn't as bad for the majority of the population and in regards to overwhelming the majority of areas hospitals as originally thought.

So what new data has come out that made this worse so we should have extended the original measures?

Fitch said:

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With respect, I think you're under estimating the number of people that are at some level of elevated risk. Something like 1/3 of the country is 50 or older, which represents 95% of the deaths so far. That also makes up 1/3 of the US workforce.

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Almost 99% of deaths were from 18 and over. Do you know how many Americans are 18 and over? That almost the entire US workforce!

In all seriousness - I think the average age for death here was in the 80s(??) and an overwhelming % had at least one comorbidity to go along with it, obesity and diabetes seem to be up at the top. If you took that same group of people in a normal year, what would the rate they would pass?

References to the Vietnam war as well as to auto accidents are both relevant. We make decisions that a certain number of people die from. The problem I have is we made this a political decision. The number of deaths go up every day - oh my!!! But if the number of deaths in the US go up by one every day for the next 10 years - I think society will be ok with that.

Now think about hospitals shutting down because they can't perform elective procedures. Think about not having routine mammograms or colonoscopies to discover cancer as soon as possible. What about all the people loosing medical coverage with the loss of jobs? Think about people scared to go to the emergency room when they get chest pain. Are COVID deaths more dear?

Fitch said:

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With respect, I think you're under estimating the number of people that are at some level of elevated risk. Something like 1/3 of the country is 50 or older, which represents 95% of the deaths so far. That also makes up 1/3 of the US workforce.

If there were more information on what particular genetic nuance this bug acts on and puts certain people at more risk, the strategy becomes a lot more realistic but even 6 months into this today it's still almost like throwing a dart at a board on who's asymptomatic and who may go down hard.

People will get back to work and eating out if they could make risk calculated decisions, but the data hasn't been able to inform that just yet.

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I could give two ****s about eating in restaurants. I get it that people really need that, but stuff like restaurants and churches seem too high risk for the value, and ability to do those things remotely.

If I gotta wear a mask to go shopping fine. I just want my kids back in school and a world without 30% unemployment. If that means we tell some old ladies to sit out their library job on disability, so be it.

culdeus said:

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If that means we tell some old ladies to sit out their library job on disability, so be it.

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I'm 100% for opening up - but this is not the correct narrative. My Aunt's in a nursing home right now - had a stroke right as this all started. She's by herself, can't see any family. Since she's in the nursing home right now, a visit by a Dr means 14 quarantine in her room. Food is left outside her room so staff doesn't come into contact. She's had 3 different quarantines going in and out of hospitals - 6 weeks that she couldn't be anywhere near anyone. Honestly not looking good and we're possibly going to have remote funeral????

Another lady there is on a morphine drip that has to be changed once a month. Every time, 14 day quarantine.

With parents in their 70s and my aunt in her 80s - this is a horrendous way to leave this world. No question in my mind but to open it up - just understand the impact to all of our elderly even if the COVID never comes close to them.

dude95 said:

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culdeus said:

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If that means we tell some old ladies to sit out their library job on disability, so be it.

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I'm 100% for opening up - but this is not the correct narrative. My Aunt's in a nursing home right now - had a stroke right as this all started. She's by herself, can't see any family. Since she's in the nursing home right now, a visit by a Dr means 14 quarantine in her room. Food is left outside her room so staff doesn't come into contact. She's had 3 different quarantines going in and out of hospitals - 6 weeks that she couldn't be anywhere near anyone. Honestly not looking good and we're possibly going to have remote funeral????

Another lady there is on a morphine drip that has to be changed once a month. Every time, 14 day quarantine.

With parents in their 70s and my aunt in her 80s - this is a horrendous way to leave this world. No question in my mind but to open it up - just understand the impact to all of our elderly even if the COVID never comes close to them.

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I am in the same boat. I haven't seen either parent face to face since the middle of February. But just because the rest of society is allowed to open back up doesn't mean that these care facilities have to follow suit. I would presume that they would stay locked down whether or not the movie theatres open back up.

And the more recovereds we get working the more people we will have that are able to go and change that IV bag without it involving a reset of the Q-clock.