COVID-19

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thrifty++
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Re: COVID-19

Post by thrifty++ »

It looks like the State of Victoria in Australia has gone into its second lockdown which really sucks. And the State of New South Wales may potentially end up doing the same if it also gets the next wave.

In NZ we are still batting off community transmission. There hasnt been any for 72 days. However there are increasing numbers of NZ citizens returning to NZ because of it being one of the few virus safe havens in the world. So we are again seeing active cases. But they are all in quarantine. But so far four have escaped and left their hotels for a period until they were tracked down by police. And they exposed us to the risks of getting community transmission again, just as happened in Melbourne/Victoria State. I am totally shocked and angry that people seeking safe haven here have been so selfih to expose NZ to an outbreak while we are paying for their exhorbitant hotel costs.

I feel that the govt is too soft on quarantine and on the four who broke it. I think we are dancing on a knifes edge of getting community transmission. The govt has been increasingly ramping up quaranting measures. But I think there needs to be severe penalties for breaches.

tonyedgecombe
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Re: COVID-19

Post by tonyedgecombe »

nomadscientist wrote:
Sat Jul 11, 2020 4:34 pm
In the UK the alleged failure was due to government deferring to technical experts who allegedly made bad judgements*, which is harder for the index to wiggle out of.
They had a plan in place however it was deemed politically unpalatable by the government. I seem to remember it expected half a million deaths.

I do get the impression the government has been using the experts as human shields. Every time they are asked a difficult question they state they are deffering to the science even though some of the scientists have been raising questions.

We used to get a daily briefing with a minister and one or two experts. I noticed that if the experts answers don't support the political point enough then we don't see them again. The chief nurse is one example that comes to mind.

My biggest criticism though is what went on over the last ten years. We have been squeezing health and social care despite having an aging population. Those institutions were under resourced and over centralised. It's no surprise the virus moved through them quickly. Although not as bad as the US there is still a lot of inequality in the UK. Even in London, the richest city in Europe there are hotspots of deprivation and the people in these places have suffered more than most.

I do think we were dealt an unlucky hand. I understand we imported 1300 cases from Italy as people returned from travel, we are densly populated, have an aging population, a service based economy. However all through the crisis I had a feeling we weren't taking it seriously enough. We could have locked down earlier, we should have known what was going to happen in care homes. When we did lock down we didn't take it seriously enough (at an individual level) and we are probably coming out too early. A shorter sharper lockdown would have been better than what we are going through now.

Not that any of that matters now tha America has given up, it's going to be hard staying healthy when so many people around you are sick. I can't see us banning travel from the US for very long.

nomadscientist
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Re: COVID-19

Post by nomadscientist »

tonyedgecombe wrote:
Sun Jul 12, 2020 2:59 am
They had a plan in place however it was deemed politically unpalatable by the government. I seem to remember it expected half a million deaths.
The article is attacking the plan that was created by the technical experts, and defending the plan that was adopted by politicians fearing PR disaster, while implying that it's doing the opposite.
I do get the impression the government has been using the experts as human shields. Every time they are asked a difficult question they state they are deffering to the science even though some of the scientists have been raising questions.
Sure. If technical experts are really in charge, they become the government de-facto. They then have to be willing to not blink if they wish to sustain the argument that letting 500,000 people die is the best achievable outcome. This means they have to 1. actually believe that's true 2. trust they won't be hanged from lampposts if their judgement turns out to be reasonable but incorrect or if people just decide it isn't true because they don't like it. The reality is few countries have the ability to be run by technical experts regardless of what the government wishes to do, simply because they can't provide a beliveable guarantee that the technical experts will be protected. Meanwhile, the buck passing is a typical politics move if it can be made to fly (I think what actually happened is that Boris was blamed for the perceived failure of the advice he received, rather than the other way around; politically he got very lucky contracting the disease and surviving).
My biggest criticism though is what went on over the last ten years. We have been squeezing health and social care despite having an aging population. Those institutions were under resourced and over centralised. It's no surprise the virus moved through them quickly.
Johnson has been PM since last July.

UK healthcare spending isn't unusual in world comparison (see e.g. this).

Of course there is always a lobby to make it arbitrarily higher, which has a lot of emotional appeal in the UK and British people may not be very aware that this is unusual in the world - try going to the US and saying we need more spending on healthcare and healthcare workers need bigger salaries, under the banner of either party!
However all through the crisis I had a feeling we weren't taking it seriously enough. We could have locked down earlier, we should have known what was going to happen in care homes.
The technical advice was that lockdowns would be disruptive and ultimately ineffective even if they shuffle around the time point at which deaths occur*.

I entirely agree on the care homes and this is hard to forgive regardless whether lockdown or herd immunity strategy is adopted (shielding care homes arguably makes even more sense in herd immunity case).

OTOH as to Time's argument that this is all due to eeeevil Trumpbrexit, who failed on care homes in the US? Maximally respectable figures de Blasio and Cuomo. Trump does not have constitutional authority over care homes.


*this may still turn out to be correct

tonyedgecombe
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Re: COVID-19

Post by tonyedgecombe »

nomadscientist wrote:
Sun Jul 12, 2020 3:30 am
Johnson has been PM since last July.
The Conservatives have been in government for that period and he is a member of that party. I don't think a change of leader absolves the party from everything that went before.
UK healthcare spending isn't unusual in world comparison (see e.g. this).
It's near the bottom for similar sized economies and as I said we have an ageing population.
The technical advice was that lockdowns would be disruptive and ultimately ineffective even if they shuffle around the time point at which deaths occur*.
That kind of assumes that we are going to let it work through the population until we get herd immunity. The trouble is we don't know how long immunity lasts and hence whether that is even possible.

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jennypenny
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Re: COVID-19

Post by jennypenny »

Someone else we know died of COVID yesterday.

Whether you think the pandemic is overblown or underblown, a lot of people have died. I wonder if this is what it was like during Vietnam. I'm too young to remember much, but I had friends growing up who'd lost older brothers or other family members during the war. Did people know people who died and watched the numbers on the nightly news, then go on with their lives as usual? Was it just a normal part of life in the end? I wish my parents were alive so I could ask them.

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Seppia
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Re: COVID-19

Post by Seppia »

Sorry for the loss JP

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jennypenny
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Re: COVID-19

Post by jennypenny »

Thanks Seppia. He was only an acquaintance. The closest person we've lost is one of the boys' teachers. It's just so strange to me how many people we've known. We have an outside BBQ with other family every weekend (our only social outings) and every week we talk about who died or who has it. Then we talk about other things, like COVID/COVID deaths are a normal thing. It bothers me how routine it is. (I'm not only criticizing others, also myself for doing the same thing.)

jacob
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Re: COVID-19

Post by jacob »

I don't think people (the average person) normalize to COVID (or military adventures) as much as the average person sincerely and genuinely simply does not think very much about anything that has not or is not personally happening to them "right now and and right here". Babies don't understand object permanence to until they're half to a year old. However, I think when it comes to more abstract things than a spoon in front of one's nose, even many adults do not process object permanence when it comes to more abstract quantities like infectious diseases, government programs, wars overseas, the potential consequences of driving over the speed limit, ...

(Sure adults can talk about these things or have an opinion when asked or pointed out, but such discussions are compartmentalized and so do not make a functional behavioral difference. This is not a difference in intelligence. Even highly intelligent people will do this. It's something else.)

I don't intend to be condescending as much as express my continuous amazement of how the normal human brain processes the world. If life is a chess board, very few would see the full game or think multiple steps ahead. Some would see the most of the game and some see part of the game and think several steps ahead. However, we would often presume that an individual piece, like a rook, would be aware of which enemy pieces are threatening it in the next move. My posit is that very many humans aren't even looking that far. They only register what happened, when they are knocked out. If it's not happening right here, right now, it's in a very practical sense not thought of as real or relevant.

CS
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Re: COVID-19

Post by CS »

@jacob

In Strength Finder speech, that is because you are high in Strategic and most people are not. It's my number two out of thirty four. There is a lot of conflict to be had when one side sees the consquences immediately and the other side sometimes cannot follow to the end even when led.

The thing the blurb below doesn't mention is that the strength is near instantaneous. Some other strengths take time to ripen. This one does not, which makes the communication all the more difficult when the correct answer pops out of your mouth in seconds, much to the dismay (or disbelief) of some.

The strengths test costs money, but I'm finding it worth while to use with some coaching to structure my writing career. Plus my number one strength is Learner, so this is a form of pleasure for me too.
The Strategic theme enables you to sort through the clutter and find the best route. It is not a skill that can be taught. It is a distinct way of thinking, a special perspective on the world at large.

This perspective allows you to see patterns where others simply see complexity. Mindful of these patterns, you play out alternative scenarios, always asking, "What if this happened? Okay, well what if this happened?" This recurring question helps you see around the next corner. There you can evaluate accurately the potential obstacles.
https://www.gallup.com/cliftonstrengths ... theme.aspx

The thinking behind the Strengths framework is that it is much more efficient to get thousands of percent gains by focusing on things that you are naturally good rather than squander than effort on the lower strengths that will not improve all that much no matter how much effort is poured into the process of improvement. Mostly it is aimed at corporate land, but it has life and self-employment general benefits as well.


And to keep this post sort of on topic, here is some covid info:

This might partially explain the blood type connection.
https://medicalxpress.com/news/2020-07- ... actor.html
Anna Aksenova, a senior research associate at the Laboratory of Amyloid Biology at St Petersburg University, has advanced a hypothesis that the severe course of COVID-19 may be associated with the von Willebrand factor, one of the main components of the blood coagulation system. As the researcher suggests, the replication of the virus stimulates the development of microdamage on vessel walls. In its response to this, the body releases von Willebrand factor into the blood, trying to 'patch' possible holes. As a result, the risk of thromboses increases. It is with this clotting that a significant part of the deaths from COVID-19 are associated.

And it can give you diabetes too. Not that shocking since type 2 is thought to be an autoimmune disease, but still, one more piece of not great news to add to the pile...
https://www.technologynetworks.com/tn/n ... arn-336065
Clinical observations so far show a bi-directional relationship between COVID-19 and diabetes. On the one hand, diabetes is associated with increased risk of COVID-19 severity and mortality. Between 20 and 30% of patients who died with COVID-19 have been reported to have diabetes. On the other hand, new-onset diabetes and atypical metabolic complications of pre-existing diabetes, including life-threatening ones, have been observed in people with COVID-19.

ertyu
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Re: COVID-19

Post by ertyu »

if covid does all this, goes endemic, and we don't develop any meaningful immunity (as was suggested in a couple of news articles i read today so, disclaimer), it will meaningfully shorten life expectancy. Less for me to have to save for. Not the way I'd have hoped for the current shiller PEs and their impact on swr to get resolved, but i'll take it as long as it makes it less likely that the money will run out.

AnalyticalEngine
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Re: COVID-19

Post by AnalyticalEngine »

Coronaviruses generally are an interesting family of viruses. They're a big source of infection for livestock, so we do have working vaccines in animals. (See bovine coronavirus) SARS-CoV-2 is an RNA virus with a huge genome. RNA virus means its prone to mutation, but SARS-CoV-2 transcribes proteins in a unique way, which makes it less prone to mutation than something like influenza or HIV. It's also not a herpesvirus or a retrovirus, which are pretty much impossible to vaccine against due to the way they can hide in cells. Influenza is probably the most similar virus that people are familiar with. Herd immunity doesn't last with influenza due to how it mutates, circles around the world, and can infect animals. Covid is similar to this.

The future will probably look like this: they develop a vaccine, but you have to get it every year, just like influenza. They'll be enough people with herd immunity that we don't see pandemics, but the disease does become endemic, and it's another thing you have to watch out for/vaccine against.

Note that there are already endemic human-only diseases with vaccines that you can only catch once, and these still remain a massive global problem (ie, measles).

Covid will probably end up like heart disease in that it's a preventable cause of death (vaccine) that everyone just accepts as another life hazard.

ETA: For more on coronavirus virology, I recommend: https://www.youtube.com/watch?v=8_bOhZd6ieM

classical_Liberal
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Re: COVID-19

Post by classical_Liberal »

ertyu wrote:
Mon Jul 13, 2020 3:13 pm
Less for me to have to save for. Not the way I'd have hoped for the current shiller PEs and their impact on swr to get resolved, but i'll take it as long as it makes it less likely that the money will run out.
Holy crap man! This is depressing to read. I suppose it's no different than wishing away 5 years of life to a job you hate now to reach FI, but still. Money is just money, but your life is all you've really got.

@AE
Good post. Again, this is why I think societal interventions should only be used to the extent that:
a) People at risk of poor outcomes have the right to minimize their exposure until vaccine availability.
b) Everyone who gets infected is given their best chance at best outcomes. So we need to avoid medical system overload in any particular region, or other potential bottlenecks (ie testing, proven drug treatments, PPE, etc)

Obviously this is more difficult than simply making the above points. However, if those two things were our guiding principles for action, I think it's the best we can hope for.

shemp
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Re: COVID-19

Post by shemp »

ertyu wrote:
Mon Jul 13, 2020 3:13 pm
if covid does all this,..., it will meaningfully shorten life expectancy.
To get an truly accurate estimate of life expectancy lost, you'd need to plug information about each person who dies of covid into a life insurance company formula, based on life expectancies prior to covid. But since we don't have that, you can look at other info and make an educated estimate. Here are statistics and graphs for England and Wales for covid deaths in May 2020:

https://www.ons.gov.uk/peoplepopulation ... ginmay2020

You'll note from charts on that page that it's mostly old people (biggest group was 90 years and up) and 90% had at least 1 pre-existing condition. I couldn't find "average age" for some reason. Applying info from that page to population of England/Wales, I would estimate maybe a few months of lost life expectancy in the worst case if covid never goes away, with most of this loss concentrated in people with avoidable bad health (obesity, in particular, appears to be a huge factor, since obesity is driving a lot of the diabetes, Alzheimer's, heart disease). That's meaningful in the statistical sense but still not much.

I brought up a similar point previously, but didn't pursue the argument. @Jacob said this issue had been discussed in the thread previous to my comment, but didn't provide a link and the thread is too enormous for me to find that previous discussion.

ertyu
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Re: COVID-19

Post by ertyu »

I guess what's changed from those previous times is that we have better idea of the nature of the illness and of its long-term effects. Also, I would raise my feeble INFP voice here and argue that the fact that we can't make precise calculations doesn't mean that worrying at an idea is useless. Precise calculations would be meaningless to me anyway: I was thinking about the impact on my own life, here, and trying to find some small comfort in the face of this illness. An accurate population-wide average isn't really meaningful information to one person.

chenda
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Re: COVID-19

Post by chenda »

shemp wrote:
Tue Jul 14, 2020 12:54 am

I brought up a similar point previously, but didn't pursue the argument. @Jacob said this issue had been discussed in the thread previous to my comment, but didn't provide a link and the thread is too enormous for me to find that previous discussion.
Its here: viewtopic.php?p=209250#p209250

You seemed to have revised your initial estimate that it would be 'less than one day' of life expectancy lost.viewtopic.php?p=218098#p218098

bostonimproper
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Re: COVID-19

Post by bostonimproper »

It's unclear to me how long short-term immunity even lasts in some cases. One article I've seen cites a case where a patient gets infected again within 6 weeks of recovery from previous symptoms (with multiple negative nose swabs between). Also, if main pathway is via lungs, at what point can body even mount an antibody response? Presumably you'll still see some level of lung damage upon each reinfection first.

So imagine getting this thing again and again and again, progressively worse symptoms each time. Accumulating blood clots, lung damage, thrombosis upon each iteration. Not great.

I increasingly believe this virus will be a fact of life that will significantly shorten average human lifespan (years, not months or days) and bolster the efforts and perceived legitimacy of government surveillance programs. Even with bimonthly vaccination or prophylactic treatments, I don't see how we can avoid it killing a lot of people and progressively weaken the health of the population over time. With the exception of the genetically immune-- survival of the luckiest and all that jazz.

jacob
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Re: COVID-19

Post by jacob »

I can run the calculation again allowing for multiple passes through the population. At this point, assumptions begin to influence the result more than the precision it offers, so I'd rather just back-of-the-envelope it ...

Strictly speaking, my actuarial and covid death data is sorted into 10 year cohorts. So if the virus passes through the population every 10 years, they will "refresh" (recreating the same comorbidities as they grow into the next decade presuming those morbidities aren't already changing for other reasons, yadda yadda...) and so, living about 75 years, the resulting loss in life expectancy would be 75/10*(6--8 weeks) = about a year.

This does not account for side-effects in the survivors which could increase morbidity elsewhere. Also no "dengue fever" effects, where subsequent infections get worse.

In terms of higher bounds, it seems that even the most infected areas (allowing for disappearing antibodies) have only reached 20% in about half a year. That means it takes 6mt/20% = 2.5 yrs to hit "everybody" presuming that herd immunity is not a thing because antibodies fade faster than that. In that case, the average person can expect to get infected 30 times over a lifetime (4 times in each decade). A detailed calculation would show a lower number since cohorts no longer have time to grow into the next morbidity range, but that would create an upper bound of 180--240 weeks or about 3-5 years of lost lifespan.

That is pretty mild for an infectious disease. It'll be worse if/when we lose antibiotics or functional sewerage w/o a replacement.

Those science fiction covers showing people running around outside wearing masks are becoming "realer" by the moment. It's the obvious technological solution to sociopolitical failure.

Tyler9000
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Re: COVID-19

Post by Tyler9000 »

ertyu wrote:
Mon Jul 13, 2020 3:13 pm
if covid does all this, goes endemic, and we don't develop any meaningful immunity (as was suggested in a couple of news articles i read today so, disclaimer), it will meaningfully shorten life expectancy.
Ignore the doom porn. It's just manipulative clickbait.

Here's an article by a good science writer who takes the time to discuss recent inflammatory headlines with a virologist. The conclusions are much more reassuring. https://gizmodo.com/what-s-the-evidence ... 1844364577

jacob
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Re: COVID-19

Post by jacob »

I'm counting on the world reaching a point where COVID will just be one of those things people tend to die most of. Current rates put it in the mid-low end of the usual causes, which are,
  • heart disease(*)
  • cancer(*)
  • COPD(**)
  • alzheimer(*)
  • accidents
  • COVID
At this point, I know people who have died from all of these except COVID but I'm sure that's just a matter of time. Other causes are rare. People still die from the flu/pneumonia, but I don't personally know anyone because it's rare enough. In short, it'll be normalized. In particular, since lifestyle choices does influence the probabilities somewhat but one also has to die of something, we'll see people putting in different efforts to live longer. No reason a super-diligent average person (no priors) shouldn't live to 85-90, but these guys will be wearing masks in public in the same way that they watch their diet, exercise, don't smoke, etc. today... Whereas others will decide that it's not worth it and take off years of their life expectancy in accordance of what they decide is worth a reduced life expectancy; whether it's not wearing a mask, not smoking, not being sedentary, not drinking, ... Masks will just be added to the list of "healthy lifestyle tips".

PS: I marked the causes of death which weren't common in the 19th century by * and ditto ** for the ones in the 20th century.

chenda
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Re: COVID-19

Post by chenda »

jacob wrote:
Tue Jul 14, 2020 10:43 am
Masks will just be added to the list of "healthy lifestyle tips".
Unless/till we get a vaccine you mean?

I'm sure people will be more diligent about common colds and flu a la the the far east, but I don't see our current precautions as culturally sustainable long term.

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