Where are you getting this "couple of million deaths" number?

As noted in the PNAS reference on page 1, the evidence for lives saved is scant. So even if that's the number, there is no scientific evidence that flattening the curve actually reduces deaths.

Wildcat said:

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Where are you getting this "couple of million deaths" number?

As noted in the PNAS reference on page 1, the evidence for lives saved is scant. So even if that's the number, there is no scientific evidence that flattening the curve actually reduces deaths.

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It's rather intuitive that if you don't have a critical mass of people needing critical care less lives will be lost. It also gives medicine a chance to determine optimal therapies.

As for the number, it's on the estimate of half the population getting the virus x 1%.

Pelayo said:

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Wildcat said:

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Where are you getting this "couple of million deaths" number?

As noted in the PNAS reference on page 1, the evidence for lives saved is scant. So even if that's the number, there is no scientific evidence that flattening the curve actually reduces deaths.

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It's rather intuitive that if you don't have a critical mass of people needing critical care less lives will be lost. It also gives medicine a chance to determine optimal therapies.

As for the number, it's on the estimate of half the population getting the virus x 1%.

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How does that number go down if you strictly quarantine the elderly and high risk? They only venture out at their own risk. Heck, quarantine everyone over 60 if that is what it takes.

There are thoughtful options.

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There are thoughtful options.

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Don't disagree. As we know more I hope governments will narrow their interventions.

Pelayo said:

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Wildcat said:

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Where are you getting this "couple of million deaths" number?

As noted in the PNAS reference on page 1, the evidence for lives saved is scant. So even if that's the number, there is no scientific evidence that flattening the curve actually reduces deaths.

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It's rather intuitive that if you don't have a critical mass of people needing critical care less lives will be lost. It also gives medicine a chance to determine optimal therapies.

As for the number, it's on the estimate of half the population getting the virus x 1%.

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Again, the numbers don't support this. Have you read the primary literature with actual patient populations? The modeling predicts it, but the experiential evidence doesn't support it.

The best argument I can see for the present policy is that of societal breakdown. If tens of thousands die in a month, social order could easily collapse. Make that a thousand a month for a year and change and order is maintained.

The experts in EM and ID I listen to believe those models are correct. I think we have to act with those assumptions.

What is your thought in my question posed to you?

My apologies. I don't see a question in your recent posts.

Wildcat said:

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My apologies. I don't see a question in your recent posts.

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What the cost of doing nothing and allowing the pandemic to peak quickly, is it > or < than what we're doing now

Pelayo said:

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The experts in EM and ID I listen to believe those models are correct.

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You'll need to forgive me in my lack of confidence in your run of the mill EM or ID doc. We can't even get most of the latter to sequence bacterial genomes to screen for antibiotic resistance alleles before plowing through a host of regimes known to fail.

Wildcat said:

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Pelayo said:

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The experts in EM and ID I listen to believe those models are correct.

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You'll need to forgive me in my lack of confidence in your run of the mill EM or ID doc. We can't even get most of the latter to sequence bacterial genomes to screen for antibiotic resistance alleles before plowing through a host of regimes known to fail.

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These are leaders in medical education I have been listening to for decades, they are not run of the mill.

Pelayo said:

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Wildcat said:

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My apologies. I don't see a question in your recent posts.

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What the cost of doing nothing and allowing the pandemic to peak quickly, is it > or < than what we're doing now

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That's the question in the OP. I don't claim to know, but I'm not drinking the kool aid on the flatten the curve policy. Yes, thousands in beds is a bad thing. But a bad thing is happening no matter what. Is the solution of shutting down the economy better than the alternative when considering societal costs outside of healthcare?

It's my question in the OP. And I think what I have read about the potential impact on the healthcare system and deaths vs economics makes me question public policy.

And again, I think the best counter-argument to my position is social order.

Pelayo said:

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There are thoughtful options.

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Don't disagree. As we know more I hope governments will narrow their interventions.

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Thoughtful discussion will get us there.

We can't have a pandemic kill millions and we can't destroy the world economy and create immense new poverty.

No one wins in either.

I'm liking the isolate the elderly and at risk option.

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.

I wouldn't be surprised if we move to something like that once the economic pain increases.

A lot of flattenin' the curve experts up in this mother****er.

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

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Not that it changes your poibt, but we have 3x the critical care beds per capita of any other country in the planet.

Source is sccm assessment of covid19.

Is Flattening the Curve a false dichotomy?

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.

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.

Agnzona said:

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Is Flattening the Curve a false dichotomy?

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Yes . Read the medium link posted above. We'd have to spread the curve over decades to prevent overwhelming our medical system.

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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Under that definition almost everything is "guess work" if it is in the future. Is a projected mortality rate "guesswork"?

Pelayo said:

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Wildcat said:

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Where are you getting this "couple of million deaths" number?

As noted in the PNAS reference on page 1, the evidence for lives saved is scant. So even if that's the number, there is no scientific evidence that flattening the curve actually reduces deaths.

---

It's rather intuitive that if you don't have a critical mass of people needing critical care less lives will be lost. It also gives medicine a chance to determine optimal therapies.

As for the number, it's on the estimate of half the population getting the virus x 1%.

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Better to have a million layoffs and a Great Depression than for the already sick and elderly to catch pneumonia.

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.

Pelayo said:

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I wouldn't be surprised if we move to something like that once the economic pain increases.

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If it is foreseeable, why in the world wouldn't we do this before the pain begins?

Where did thread get off track... I thought this was about Daisy Dukes?

ABCDE said:

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The only reason to flatten the curve is to prolong the crisis because this is an election year.

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Now THIS is a smart man. Or woman. Why does there always have to be a global shot at the US economy a few months before a really close presidential election?

Aggiebrewer said:

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Wildcat said:

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Wasn't that "straitnen the curves and flatnen the hills"?

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Yes. But it still comes to mind.... as does Daisy Duke

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Nothing straight about these curves...

WestAustinAg said:

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ABCDE said:

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The only reason to flatten the curve is to prolong the crisis because this is an election year.

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Now THIS is a smart man. Or woman. Why does there always have to be a global shot at the US economy a few months before a really close presidential election?

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I am no economist or infectious disease expert.
Why not stagger the work schedules and commutes with reduced hours? That way shops still open... Businesses that require jobs that cannot be complete at home still function.

Maybe it is too hard in the modern day to coordinate between your neighbors/co-workers?

Ellis Wyatt said:

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Aggiebrewer said:

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Every time I read Flattening the curve I think of the Dukes of Hazard theme

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Zactly.

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Someday the mountain might get em but the virus never will.

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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You can think it all you like. You can hope for it. You can wrap yourself with it like a blanket if it helps you sleep better at night.

But there isn't any real data to actually support this conclusion, only models. And models are useful, but you can't get an FDA approval for a drug without any real data. So why is the CDC enacting these policies without any real data?

Because there is a phenomenon in leadership that compels people to "Do Something". If you don't "Do Something", you aren't doing your job. Doing whatever it is you are doing might not make any sense or be supported by scientific data, but hey, we had to "Do Something".

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But there isn't any real data to actually support this conclusion, only models

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Oftentimes in medicine, we act without having peer reviewed evidence to back us up as long as the putative mechanism is sound based on known science. I imagine public health is the same way. They act on models.

You are welcome to hate the drastic choices being made but apparently we will act when models show dire consequences of inaction.

And yes, not overwhelming ICU's with critical patients they don't have the capacity for at once will save lives. And buying time until we see what therapies work will as well.

Sometimes I think of China hadn't of said that this was a new virus and we would've just let everyone gotten this thing, and had it over with, would the world have had such a crisis as people are saying?

I think when the final numbers were tallied it just would've looked like a very bad flu season. I'm sure all the doom and gloomers will point to their worst case scenario numbers, but I'm not convinced it would've overwhelmed us. People would've felt bad for a little bit and gone back to normal life. Then people who needed to get treatment would have gone to the hospital like normal. Some doctors would've gotten a touch sick too, like normal. Now that we are on hyper alert of course anyone that has a slight wheeze is going to run to the ER.

Matilda said:

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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.

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Is the proper term "quarantative easing"?

Pelayo said:

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Quote:

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But there isn't any real data to actually support this conclusion, only models

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Oftentimes in medicine, we act without having peer reviewed evidence to back us up as long as the putative mechanism is sound based on known science. I imagine public health is the same way. They act on models.

You are welcome to hate the drastic choices being made but apparently we will act when models show dire consequences of inaction.

And yes, not overwhelming ICU's with critical patients they don't have the capacity for at once will save lives. And buying time until we see what therapies work will as well.

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You are merely regurgitating the talking points. And what's this "we" sheet when it comes to evidence-based medicine? The point of the thread is that there is little evidence to support the present course of action.

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

Enjoy your two-week stay at home. That appears to be the next step in flattening the hypothetical curve that has never been formally tested.

But hey, we "did something".