The LA Times's investigation into Purdue Pharma in 2016 revealed internal Purdue documents demonstrating the company's culpability in fueling the opioid crisis.
> The documents provide a detailed picture of the development and marketing of OxyContin, how Purdue executives responded to complaints that its effects wear off early, and their fears about the financial impact of any departure from 12-hour dosing.
I don't have many recurring subscriptions, and I don't live in LA, but I signed up for the Times the day the reporting came out. So rare is quality investigative journalism these days.
Fast forward 3 years, and "Purdue Pharma and the Sackler family were in negotiations to settle the claims for a payment of $10-$12 billion" (Wikipedia).
As far as I know the settlement was never finalized. And I don't want to make it seem that the Times was the only organization looking into Purdue. But I wish a fraction of that settlement could be re-invested into investigative journalism.
The journalists are just doing what their employer asks them too.
Their employer is trying to sell papers/clicks.
No enough people are willing to pony up for good journalism like the parent comment -- I'm generalizing but most people don't even like to read long form journalism anymore.
If we want to know why journalism sucks we need to look in the mirror.
“When you’re young, you look at television and think, There’s a
conspiracy. The networks have conspired to dumb us down. But
when you get a little older, you realize that’s not true. The networks are in business to give people exactly what they want. That’s a far more depressing thought. Conspiracy is optimistic! You can shoot the bastards! We can have a revolution! But the networks are really in business to give people what they want. It’s the truth.”
Jobs was right to say it's not part of some grand conspiracy, but if you look more closely, you see that people ("consumers") and media are both produced by the same ideological and economic forces that serve each other. It's not some sinister plot, it's just how culture has developed to this point.
The media does give people what they want, but where do people get ideas of what they want? It's a dialectic, not a one-way causative relationship.
If it's a two-way conversation, I think it's fairly lopsided. The reason is: competition. When consumers only have one choice or a few, sure, that company can exercise a lot of power in dictating what people read, and thereby influence what they want (by limiting what's possible for them to experience and be aware of).
However, there are countless competing sources of entertainment and news online. If any particular organization gets away from giving consumers what they want, and instead becomes overly wrapped up in trying to tell consumers what they should want, they'll get eaten by the competition.
The result is a web in which billions of people flock to whatever "channel" has the message that resonates best. Meanwhile the people running these organizations are doing their best to figure out what will resonate, so they can survive and thrive. If a story gets clicks and shares, repeat. If it doesn't, stop writing things like that. Survival of the fittest.
There are some mitigating factors ofc. For example, a lot of smaller media orgs will simply copy what the bigger ones are doing, which gives the bigger ones a lot of influence. Also, there's momentum. Once you have a loyal audience, there's friction for them to switch to reading a different source, so you get more leeway.
But all things told, I think reader demand drives most of the content we see.
An ironic quote, considering that Steve Jobs literally conspired with Google and other SV companies to illegally depress wages for tech employees--to the tune of hundreds of millions in lost wages.
When I look in the mirror, I don't see someone wanting clearly biased, opinionated, decontextualized, or downright unfacts, trying to be spun as news, with zero retractions or apologies when it's called out. Those are the reasons journalism sucks, and it has nothing to do with what I see in my mirror.
'When you look in the mirror' you see the 'story you tell' about yourself.
If you want to know what you really like - check your actual news browsing habits.
If you did that you might note you might click a lot of bait, and read things that micro-trigger you, and the local or boring news just doesn't get the attention.
Obviously, some more than others.
But certainly, the death of 'local news' at the very least is due to the fact we don't care about local stuff. Not only this, but we are also materially less engaged at the local level than at any time in history.
There was a writer on Sam Harris' podcast (I think Matt Taibbi in this episode[1]) who said he was having a really hard time getting interest in any article that wasn't about Trump. Interest virtually disappeared in anything else. The 24/7 reality TV show is what gets attention and it's easy to produce.
And if you think about it, there is a lot more money to go around.
Purdue was only responsible for roughly 8% of the market. That means whatever money we get from the Sacklers, in an ideal world, should only be 8% of what we ultimately collect!
That could fund a lot.
Now all that assumes an ideal and non-corrupt US where everyone is equal under the law and all politicians are not corrupt and judges and lawyers are not bent etc etc. So, it would not surprise me at all if even among the billionaires, the pattern of only the smaller drug dealers getting prosecuted continues to hold true. I'm hoping at least for some media pressure to help take down some of these larger dealers. Probably won't actually take the big boys down by itself, but it can't hurt to try. 92% is a lot of money to leave on the table. (Not to mention a lot of crime to let go unpunished.)
I think there is a lot to this idea. I've wondered whether something like the False Claims Act (https://en.m.wikipedia.org/wiki/False_Claims_Act) could be expanded or modified (or just used) to fund journalism.
Not perfect by any means but it would protect one of the most important functions of the papers.
Wonder if they still work for the Times?
Maybe if we rewarded the journalists behind the investigations more than the newspaper itself, they could all bandy together and create something that only does investigative journalism.
At the end of the day, if a doctor is prescribing medication against clinical guidelines, surely the doctor is at fault? If a pharma warehouse is burgled then it's on the burglars.
Am I missing something regarding this case? Did they mislead doctors?
Edit: Downvotes to -4 with no engagement for asking a question. This place has gone downhill rapidly
> there would have to be some wrongdoing to be proven
Are you claiming the extensive evidence brought in numerous cases across the country against Purdue and the Sackler family, accepted in many cases by juries and judges, has not done that?
If you're genuinely interested, there's so much reading on this. I'll quote one snippet here for you. Just to give you an idea. (This is not an invitation to reply to it and debate the issue. Just trying provide a pointer for reading more on the topic since you expressed interest.)
> The drugmaker admitted in 2007, when confronted with evidence gathered by prosecutors, that it trained sales representative to tell doctors that OxyContin was less addictive and prone to abuse than competing opioids, claims beyond the one approved by the F.D.A.
First, they I mislead doctors. They insisted very enthusiastically that’d OxyContin relieved pain for 8 hours, when 4-6 was much more common for most patients. Secondly, I don’t remember the laws and requirements exactly, but there are reporting requirements for abnormal behaviors that indicate drug abuse. One of the long form articles over the past few years saw a memo where Perdue deliberately decided not to report large orders in certain areas. Of course, I haven’t had coffee yet, so caveat lector.
Purdue mislead doctors, and the public, in several different ways.
They said that their medication was unlikely to lead to addiction if used to treat pain. They said their medication was less likely to lead to addiction than other opioids. They knew some doctors were prescribing vast quantities of opioids - far more than even Purdue recommended as treatment for pain. They used a variety of marketing to doctors and to members of the public, and some of that was designed to evade regulation of marketing. They used stealth marketing methods such as employing physicians to speak at conferences without disclosure. They interfered with the creation of treatment guidance. They used front groups. They targeted vulnerable and wealthy populations. They concealed what they knew about the addictiveness of their product. They concealed what they knew about the efficacy of their product (people may tolerate an addictive medication if it increases function. Purdue knew their meds didn't increase function for many patients.)
There's a huge list of absolutely scumbag behaviour from that company, and we need to recognise their part in driving death and misery to millions of Americans.
You might be right, but it's not an either or situation.
Some sales reps that told doctors Oxy was NOT or LESS addictive and knew that was untrue so they did lie.
Ironically the exact same thing happened a century earlier with Bayer and Heroin, history does indeed repeat itself.
The thieves that burgled drugs from pharma are also responsible obviously.
As far as the fast down votes, chances are everyone knows someone who has been hurt from the opiod crisis. It is a very painful subject for people. Playing the devils advocate is going to get a swift response that just the way it is.
My personal experience with the opiod crisis is typical, I had a friend who got hurt, started taking oxy, got hooked, his doctor cut him off, he spent a ton of money buying pills off the street, when the cost got too high he switched to heroin, when he decided to get help he went to a doctor for methadone, they did a blood test, because of the fentinyl he tested positive for abusing methadone and was refused. Three months later he was gone.
I feel the entire system failed him, ofcourse he was not without blame, everyone played a part in his death, including me for giving him money.
I linked to a 6,500-word article answering your question and you are surprised you got downvoted? Or feel free to look into why armies of lawyers on both sides negotiated a $10bn settlement. If "surely the doctor is at fault" held water, they wouldn't have come close to that number.
Why has no one developed a news subscription service yet?
I want to be able to pay 50¢ here or $1 there for an interesting article from NYT, WSJ, WaPo, Bloomberg, The Guardian, The New Yorker etc., without paying for a subscription.
I can't afford to subscribe to all of them. There are not enough hours in the day for getting a return on my investment.
New York Times $50/yr
Wall Street Journal $100
Bloomberg $420
LA Times $98
The Guardian £119
Washington Post ~$80
I don't want to subscribe to just one paper. There are so many good articles in all the papers.
A news combiner or aggregator would charge me for every article I select. At the end of the month, he charges my account credit card for the sum of all the articles.
He gathers up the money that all readers have paid for reading NYT articles, and remits it.
The newspapers don't have to manage micro-payments, journalism is saved, everyone is happy.
Blendle looks like they are trying to do this, but they've been in Beta since 2016.
>I don't want to subscribe to just one paper. There are so many good articles in all the papers.
A few years back I just went ahead and subscribed to the ones I wanted to support to try to support journalism. It was more affordable than I thought, but there is friction to keep them from taking advantage of you. For instance, at one point it was cheaper for me to subscribe to the Sunday edition of the NY Times to get digital access than just digital access. I live 1000 miles from New York City. lol Renewals are a pain if they try to shift you to the vanilla rates; no one has email support and it requires a call.
Anyway, I currently subscribe to NY Times, LA Times, Washington Post, Cincinnati Enquirer, St. Louis Post Dispatch, Las Vegas Review Journal and The Guardian US Edition. I would subscribe to the NY Post if they allowed it. Former WSJ subscriber, but they do not offer long time subscriber discounts. Bloomberg is too expensive.
My main complaint is only a few allow yearly subscriptions.
The only problem for us is, like others are saying, I don’t think our subscriptions are enough money and I don’t think it’s feasible financially for enough people to do so at the level needed to keep enough quality newspapers and journalists in business.
(in the us) The New York Times is arguably the only non-business paper that makes enough money from subscriptions to make sense sticking it out alone. Maybe the Washington Post, LA Times and a few others (and maybe not, i hear the subscription rates are horrible) too, but for the vast majority bundling digital subscription as a single package is the only way I see for small papers to attract significant numbers of subscribers.
It would be really great to read papers from Las Vegas and Cincinnati, but I can’t see myself ever setting up and managing individual subscriptions to them if I am being honest.
I'd posit that the average person who would make use of all the subscriptions, as the OP seems to be, could most certainly afford it. As hobbies go, it's really not that expensive.
> For instance, at one point it was cheaper for me to subscribe to the Sunday edition of the NY Times to get digital access than just digital access. I live 1000 miles from New York City.
The New York Times has nationwide printing and delivery in a lot of cities, so that's actually not that surprising. My parents had it delivered when I was growing up, and that was hundreds of miles from NYC. There's very few other papers that this is true of.
Good point. It just seemed odd to me they would subsidize a print edition, but I guess it was for the advertising. We never opened the blue bag except to recycle the paper.
You've got it exactly right. A print edition is worth a lot more to them in advertising revenue than the digital edition, so it costs less to the customer, even when you factor in the additional cost of printing and distribution. All those local advertising circulars are biiiiig business.
I think it is $59.90 if I added correctly. All are digital only subscriptions and do not include additional tiered access they may offer. IE: NY Times crosswords, LA times in person events, etc. The Guardian is a yearly subscription promo and will increase to around $19 a month when it ends.
I always wondered if Bloomberg dropped their rates would they make more money. They have appeal outside of people who work in the industry but at $35/m its a very hard hard sell to these people. For that price i could pick up WSJ($20/m),NY times($5/m), and Economist($10/m).
I suspect that most people, like me, don't want to be "nickel and dimed" for their news. There are very few articles that I want to read bad enough to pay $1 for. Almost as few for $.50.
For $50/yr, that means I could read 1 NYT article per week, or I could have the yearly subscription. If I care about that newspaper at all, the subscription makes a lot more sense.
The others are more like 2/wk instead, but still, if I'm only reading 2 articles per week from them, that seems really low.
But even if the price per article made economic sense, there's psychology to worry about. I can't find them at the moment, but I've read articles detailing that people will pick the 'unlimited' option over the cheaper per-piece option even when they know they'd pay less in the long run on the per-piece.
So while you might prefer to buy each article, that's generally not how people work.
The issue is you're looking at the value from journalism wrong. If you were to actually pay the cost of producing 1 article, it would be significantly more than you would be willing to pay to read it.
What you are paying for when you pay for journalism is not the value you perceive from reading the individual articles, but of supporting the entire organization's on-going production of journalism. You are a patron more than a customer.
Pick the one you want to subscribe to and stick with it. I would recommend subscribing to your local newspaper if you're only going to pick one.
But... thousands of people are paying to read that one article. The combined volume of all the people, who pay to read the same article, will pay for the cost of researching and writing the article.
ten thousand people pay ten cents to read an article. Yay, that's $1000!
The aggregator takes his cut, so now it's $900.
Taxes, $700.
So about $18 per hour pay for a single reporter assuming it only takes 40 hours to write the article.
And to be blunt, no one is going to pay more than ten cents.
The spotify model does not work to support creation of new works; it only causes monetization of an older back catalog or "gift" works where people essentially give it away while working their day job.
>I want to be able to pay 50¢ here or $1 there for an interesting article
That sounds... fucking terrible! I assure you that you are in the minority. The last thing in the world I want online is to have to think about every click costing money.
Before you know it everything would try to move that way.. I'll be paying 5 cents for every HN thread because of "server load" or something.
I don't know what the solution is.. ads are a stupid way to prop everything up.. but your suggestion is even worst in my opinion.
People pay $1200/yr for cable tv but don't want pay a couple hundred dollars a year for news. Thats the real problem, people don't value quality journalism.
Most people get far more enjoyment out of general TV than the news.
As for journalism being quality, well, I subscribe to a newspaper but sometimes I wonder why. For any claims of importance I'm always cross checking what they say and often they're lagging behind what I can find on blogs or other sources, or even just Reuters for that matter.
The whole "competing for clicks" model seems to lead inescapably to a race to the bottom.
I currently subscribe to the Boston Globe, but 90% of the articles I read from them is the sports section, but (I hope) less than 90% of my money is spent covering the Red Sox and Patriots. If it was pay by the article the incentives would be terrible.
Some systems need not to be optimized to chase metrics, they need slack and produce value that is hard to measure. This is the kind of problem that the technology and business worlds have been uniquely incapable of solving.
Apple News+ isn't exactly the same thing. It's more targeted at magazines, and doesn't have most of the relevant newspapers on board. But there are other issues:
1. It's run by Apple, which takes a hefty cut, and is thus oriented towards whatever is in Apple's best interests. It should be run by a consortium of newspapers instead and work in their best interest.
2. It's only available on Apple devices, which I don't have.
3. It has an app-based model. That's not what I want. What I want is an SSO passport login that lets me into all of the publisher's pre-existing sites. I don't want an app or a new site or anything, I just want a login that works on the existing newspaper sites.
Too US centric for my liking. Where are the like of Die Welt, Frankfurter Allgemein Zeitung, El Pais, le Monde, or even just Al Jazeera?
There are great articles in the US press, but if you do speak multiple languages and want a more nuanced point of view, you will find yourself turning to foreign press get those.
They need to have a higher tier at $15/month or something and get the big names onboard too. It's never gonna include Bloomberg too though; they're simply too expensive because they target the businessperson market. Bloomberg's digital subscription costs $35/month. WSJ likely wouldn't be in there for similar reasons, at $20/month.
This is similar to asking why there isn't a SaaS subscription service aggregating all of the SaaS products that lets you pay $1 to use any SaaS product for a day. It's not really sustainable to run a business by having people pay you smaller amounts and more sporadically.
Microtransactions in that way don't generate enough revenue to pay for the up-front work required to create a story like the oxycontin one mentioned in a separate thread here. A story like that costs thousands of dollars and hundreds of hours of work to create. It's not feasible to spend all that up-front work all for the possibility someone will maybe pay $1 to read it.
How about this. If you read, say, 10 articles in a month from a publication, go ahead and purchase a subscription. Financially, it should cost you the same as your proposed microtransaction scheme, but it is much more sustainable for the business you're supporting.
a... micropayments platform? Maybe regulated by a cryptocurrency or embedded blockchain based on eyeball tracking? That would analyze the articles you like and dynamically assemble articles that are related? That would collect "quality" ratings on the article based on how deep you scrolled into it?
Outside all the tech wordsoup I just spouted, there is real potential in that. Maybe it needs to be couched in an independent rating group that advertisers somewhat trust (aka Nielsen in TV land), that could actually drive legitimate ad revenue/investment.
It is strange, given that all newspapers are facing the same apocalypse now for a decade, and they (I think?) were subject to the same media consolidation that affected other channels.
You don't need any of those buzzwords, you just need a multi-site SSO login that you pay more per year for than any one individual paper and that lets you into the paywall of all of those paywalls. It's a trivial technology problem; the hard part is in the business partnership building, specifically in getting the different newspapers to come to an agreement in how revenue from this subscription is going to be shared amongst them.
This is a reasonable suggestion. I too hit paywalls on all those papers several times per month and more, but not remotely enough to be worth paying a full subscription to almost any of them save the NYT (which I do have a shared family subscription to). A newspaper passport that allows some form of limited access to all of them, like a multi-resort annual ski passport, would be pretty useful.
I would expect said passport to cost in the range of $100-200 per year (though they'd want to bill it at something like $15 per month to avoid sticker shock), and allow me to read a good number of articles from each newspaper, but maybe not an unlimited amount. And the funds from the passport could be distributed proportionally to members based on which papers you actually read most frequently, like how a ski mountain passport works.
Things are much worse at Gannett, parent company of usatoday. Personally, being laid off on March 31! Almost every employee is effected at this time, either furloughed for few hours a week, pay cut or let go !!
I'm surprised. I'd think online news would be one of the industries benefitting from this crisis. Is the revenue tied to lack of conversions on online ads?
It's tied to lack of ad spending. This is global across the entire advertising industry. Companies are spending less because of the pending recession and in particular they're spending a lot less on advertising, because people are not buying much right now (they often aren't even going anywhere for days at a time).
This, 100%. My institution advertises with local news agencies and newspapers. The local television CEO contacted our President to thank him personally for keeping up with the ad buys. They've had a 90% drop in ads being purchased.
Apparently it's us (community college), the state, and grocery stores still buying ads.
I guess the "adworth" of a single consumer is sort off fixed and when the consumer browses the internet twice the amount of time the revenue per impression falls. Also I guess the "adworth per capita" has gone down alot when people are reluctant consume extravagenza.
Each advertiser is trying to optimize ROI for the search ads it spends on. They do that by tracing clicks to subsequent purchases. This tells them how profitable/unprofitable the ad purchase was.
The advertising system is self balancing on cost per click if each advertiser optimizes it’s spend based on portfolio theory and because of the reverse Dutch auction that Google runs.
With the virus, some advertisers just don’t have anything they can sell right now (cruises, concerts, sporting events). They won’t even be bidding. Others will have things to sell that are in far less demand (cars, restaurants). The decreased demand will drive down cost per click (or adworth as you call it).
I have noticed many companies dive into emails to previous customers. They are also offering deals. This is cheaper than ads.
Entirely possible. They're predicting that half (1/2) of the businesses in my city will fail by the end of summer. If you're still holding on then you're cutting expenses to the bone... with the 2nd and 3rd order effects being that ad revenue, ether via click, or just in a "Eat At Joe's" ad in a local paper, is gone.
Apart from some online-only businesses, pretty much every business it cutting back at this point. Ads are one of the first ones to go. Esp. with the whole travel industry cutting by nearly 100%. Airlines, hotels and cruise ships spend a ton on ads and there's no point of running ads for them at this point.
Ad shows up with an ironic twist in a Coronavirus article >> somebody screenshots and posts to reddit >> instant front page >> even more free advertising but somebody calls the CEO who tells his subordinates to find somebody to yell at
For regular run of site ad buys, you're right. And a lot of CMS and ad systems come with a way to flag content as sensitive. For a small ad buy, nobody cares that much.
For big campaigns - bread and butter for print and web - different story. These are carefully designed in-your-face takeover ads and the brands care much more how they're presented.
The bigger problem is ad sales for newspapers is usually just AdSense backfill or national sales from the parent company. The former is just beer money unless your publication is NYT size, the latter is drying up because there's nobody to sell to!
Think this post is being slightly downvoted, but it is the reason according to multiple contacts in the industry. Even the ad spend which is out there is explicitly blocking COVID content for their ads.
There is no point in advertising if no one can buy your product right now. Retailers, dine-in restaurants, movies, hotels, travel, pro sports, big clothing brands, concerts, events, tourism. The list goes on and it is massive. All these industries are huge spenders on advertising.
Then there are all the products and services that _could_ be bought, but consumers and companies have pulled back on because of uncertainty. Why waste money on ads for TVs, new phones, SaaS software, hiring, etc?
We left our ads running even though conversion rates dropped by 75% because Google offered something like $!00M in ad credits for small businesses. We applied for the program but haven't heard anything. It might be time for us (marketplace for quality contract work) to stop spending on ads too.
Since ads are a supply-demand market, supply must equal demand. There is nobody who can store ad slots in a warehouse and sell them later.
Since publishers are unlikely in the short term to take down their websites just because revenue falls, that has led to prices dropping to near zero on the open market.
The only real revenues now are from advertisers who have fixed price per impression or per click contracts, or who aren't smart enough to see they could drop their bids 90% and still win the same spots.
That's not really how ads are priced, though. Google and FB will be reluctant to see the price of ads go down. They also control the supply of how many ads they put on the page. They make sure the supply of ads for keywords is always less than the demand to fit an optimal price/revenue curve.
Sure but they aren’t immune to the fact that absolute revenue for both them and the sites hosting the ads falls in proportion which is the point even if they keep price/ad fixed.
The element I was trying to add but not wording well is that even if some people are still paying for ads, and still have things to sell, they price they pay will be dropping dramatically.
Theres a reason Netflix has been advertising so heavily lately - with cheap ad spots, they might as well collect as many customers as possible now.
That, and they're one of the few products that people can still consume easily right now. So I suspect it'd still be worth it for them to increase advertising even if the ads were priced normally, but now that they're super cheap, it's an absolute no-brainer.
And nobody should be spending money beyond necessities right now - and stocking up on backup necessities.
It’s not the time to be buying a new car, it’s not the time to be trying new makeup products, and then we have other issues - it’s not the time for new films in the cinema, it’s not the time for sports, the lists go on.
It’s not time to buy new products, and certain subsets of products are no longer allowed to exist.
I hope advertising suffers a lot, to be honest; it’s an industry of corruption, manipulation, and lately, privacy violation.
We can't be at the extreme of consuming normally, because that requires all stores to be staffed normally.
We also can't go all the way to the other extreme. If we have unprecedented employment now, with partial non-essential consumption, we don't want to see what it looks like when we turn down consumption to further extreme degree on top of that.
We need an equilibrium, and shutting down the economy fully is as misguided as reopening it prematurely.
I’m definitely in the camp that “the cure cannot be worse than the disease” itself. Sitting in California where there are so few cases makes me wonder if the economic toll is totally worth it. Seems like we’ve used a tsunami to put out a campfire.
It's been very hard for me to understand this line of thinking. As I see it, there are so few cases in California because of the measures that have been taken. Do you think California would not have many more cases if the measures were relaxed? Or do you think that the cases would not be all that bad? Or do you think that they would only affect people that you aren't personally concerned about?
I'm asking honestly for an explanation here, because you're certainly not alone in this view, but I haven't heard a rational justification for it yet, and I haven't been able to come up with one myself.
> there are so few cases in California because of the measures that have been taken
This is probably true, but other countries haven't locked down hard and aren't seeing a big spread. Our options aren't binary. It's not as if the only choice is "Nuke everything" or "Surrender".
The US is not a very densely populated country, and density seems to have the biggest impact on the spread of this thing. We probably could do something like this:
- Dense city? Quarantine.
- Moderately dense? High risk individuals quarantine, everyone else social distances, but works.
- etc
Across the board, if your business is the sort that can WFH (such as software companies), then you do work from home. If not, then you're open, but with precautions. Restaurants are open, but pickup only, etc.
The point is, we've used a nuke, and it's not at all clear to me that that was the right decision.
> other countries haven't locked down hard and aren't seeing a big spread
Let’s be precise. Some other countries haven’t locked down hard and aren’t seeing a big spread yet.
You mentioned Sweden. Here was Time a few days ago:
> A head doctor at a major hospital in Sweden says the current approach will “probably end in a historical massacre.” He says healthcare workers at his hospital who have tested positive for the virus but are asymptomatic have been advised to continue working. He asked to remain anonymous because “it is frowned upon to speak of the epidemic or to go against the official vision” but said he felt a need to speak out from an “ethical and medical point of view.”
Stockholm (the worst hit part of Sweden) has about half the deaths per capita of the state New York (26 deaths per 100k vs 56 deaths per 100k) despite Sweden having laxer restrictions. And Stockholm is generally more densely populated.
So while I too am a bit skeptical of the Swedish policies it is doing pretty average on a global scale. Worse than some countries with harsh lockdown but also better than some countries with harsh lockdowns. It is too early to say for sure if the Swedish policy was stupid or not.
In Swedish news the currently most popular theory for why we have more deaths per capita than our Scandinavian neighbors is not necessarily our lax lockdown (though it may have made things worse) but lack of supplies and poor routines in old people's homes. This is of course speculation.
Most of the cases in New York are concentrated in and around NYC, which is an international travel hub with 3 very busy international airports in the area. I don't think there are many places in the world which are going to have had the same number of asymptomatic and symptomatic carriers pass through. So on that basis I don't think it's a good benchmark for most other cities or countries to use.
I wonder if it's better to compare Swedens overall per-capita infection rates with other states in the US where there is a lockdown but whose capitals/major cities are more secondary cities from the perspective of international travel. Let's try North Carolina (picked for being closest in population to SE and also being not a top airport hub or travel destination compared to its neighbors) though it does have significant business and educational centers, it's probably a fair comparison to Sweden wrt population density.
NC total population: 10.5 million
NC confirmed cases: 7,285
SE total population: 10.2 million
SE confirmed cases: 11,445
So anyway, there are other states and countries that are doing better and worse than Sweden, but I don't think that Sweden is in any way demonstrating that it is doing better by trying to ignore the problem and possibly to blame the lack of strict enough sanitation ("lack of supplies and poor routines"), it's just coming later than to higher-volume travel centers like WA, NYC, the UK, France, Italy, etc.
In any case, the idea of doing better or worse will, in the end, be measured in per capita deaths at the end of this disaster, and we haven't gotten there yet. I truly hope that Sweden finds its way through with as few deaths as possible, but I don't think that's what they've done.
You've gotta compare deaths, not confirmed cases, because cases are being so severely under-tested right now (especially in Sweden, which has a nearly 10% case fatality rate, indicating that they're probably only catching 1 case out of every 50, or more). Deaths are the most reliable statistic we have right now because they're the least likely to be under-reported (though they still suffer from that). Once this is all over and we can do population studies based on widespread blood antibody testing then we'll have better stats, but that's years out.
So, comparing the deaths per 10M population, Sweden is currently at 1,014, whereas North Carolina is at 114. So Sweden is suffering roughly one order of magnitude worse from the pandemic than North Carolina is at the moment. And keep in mind that North Carolina went into a shelter in place order over two weeks ago while Sweden hasn't yet, so there's a loooot more pending cases in Sweden's pipeline than NC's.
> Stockholm (the worst hit part of Sweden) has about half the deaths per capita of the state New York (26 deaths per 100k vs 56 deaths per 100k) despite Sweden having laxer restrictions.
So far. It's way too early into this unfolding disaster to be making pronouncements like this while the figures are still increasing exponentially. NYC has had shelter-in-place for several weeks now while Stockholm has not. If you'd done this analysis a week ago, and then two weeks ago, you'd see Stockholm looking progressively better and better in comparison to NYC the more you go back in time. In other words, they're catching up, because here in NY we're sheltering in place and it's working, and in Sweden they aren't (yet) and thus their spread is higher.
> And Stockholm is generally more densely populated.
Not in comparison to NYC it's not, which is the fair comparison for Stockholm because Stockholm is a city whereas all of New York is a much much larger state that amounts to 1/3rd of the land area of the entirety of Sweden. NYC's density is 10,715/km2 vs Stockholm's 4,200/km2.
Is it really the best comparison to use Stockholm vs. New York state instead of Stockholm vs New York city? A city-city comparison seems more logical, no? In the latter comparison, we have NYC 2x as dense as Stockholm with a much larger population.
I don't know the particularities of Sweden, so maybe it makes more sense as you have outlined it. My apologies if that's the case!
Without air traffic and closed borders, a country that's not that affected could get through it with few measures. Not sure if many countries are still at that stage but it's no coincidence that international travel hubs got affected worst.
The good thing is we’ll see in the end. Lots of predictions. It’s almost as if you can’t be criticized for being too cautious. Sure, but the good will won’t last forever.
The US accepts 22k deaths a year without blinking due to flu. That’s just the flu. What’s the magic number we’re willing to accept? 50k? 100? There has to be a percentage of the population we are willing to accept as casualty because we already do, just unstated.
The lockdown will ultimately spread misery far and wide if left unchecked. Massive rise in poverty, violence, drug abuse, depression, crime, suicide, homelessness, prostitution, etc.
People need to be more clear on what they’re willing to accept. Right now there is no real discussion on “what next”. Lots of obsessing over the current body count though.
The US spends a lot of effort trying to convince people to get flu shots, take antivirals if they get sick, and stay away from vulnerable populations while contagious; hospitals prepare extensively for increased use during flu season (and medical workers are vaccinated, making flu much less personally risky for them), widely distribute easy-to-administer flu tests, treat people and keep them alive as best they can, etc. Estimated flu death numbers are also not comparable to current reported Covid death numbers, because they include a ton of guesswork, since many of the people who die while infected with flu officially succumb to some other condition (according to death certificates).
We don’t go into total economic lockdown for 2 months per year, because it would be impossible to enforce and extremely expensive, but we sure did during the last comparable pandemic, the 1918 flu.
Currently (and this will hopefully change as medical knowledge improves), Covid seems to be more than 10x more deadly than seasonal flu for most demographic groups. In an unchecked Covid epidemic (with hospitals overwhelmed) it appears that on the order of 1% of the population dies. (This has happened in some towns in Italy, where a very high percentage of the population was likely infected.)
> lockdown will ultimately spread misery
Having 1% of the entire population die within a matter of months is going to cause an extremely severe economic shock with or without official actions.
The logic still applies. Obviously, I hope for zero deaths. But I also don’t forbid them from driving, despite the high number of deaths for that mode of travel. I don’t tell them to quarantine themselves every flu season.
Anyway, I’m not sure we’ve overreacted. I’m just saying it’s possible and it’s pretty amazing how it’s hard to have a conversation about it. People treat the topic like there’s only one answer and anyone who dissents is a murderer.
The risks of driving and seasonal flu are fairly well understood. And there are mitigation’s in place: seatbelts, traffic laws, theraflu, flu shots, etc.
I’m not calling you a murderer. I’m asking you to put a hard number in the risk you are willing to absorb.
To be perfectly fair, the current lockdown _IS_ going to kill people that would've survived otherwise. People that now won't go into emergency rooms out of fear of contracting Covid19, poor people whose source of income is completely dried out. And longer term, this is going to cost massive amounts of money, a fraction of which would of course be used to prolong someone's life in some way, eventually. I think the question raised in this thread is simply one of "what's the trade-off". It's very clear that there are costs to this lockdown, and at least to me it's also very clear that that some of those costs are human lives.
However, we can't estimate those costs. We do have a guess of the rough fatality rate of covid19, and we do have models that will tell us how many people will die if we don't go into lockdown. But we don't have the same luxury for estimating the amount of people hurt and dead because of it that could otherwise be saved. We can quantify the monetary loss, but not how much of that loss would've otherwise gone towards saving lives. I think the question of "what are the human costs of this lockdown" is a fair one to ask. Don't get me wrong, I too think the lockdown makes sense and overall does save lifes. But the lockdown is not without risk, and even more importantly: I have not seen any estimate of the risk. Is it lower than 0.5-5% of the population? I think so, but both of us haven't done the math, so you talking down to people who ask about it is wrong.
> To be perfectly fair, the current lockdown _IS_ going to kill people that would've survived otherwise. People that now won't go into emergency rooms out of fear of contracting Covid19
You've got the blame all wrong here. These people that are dying who would've survived otherwise are directly being killed by the pandemic, not by the lockdown. If the pandemic were completely uncontained then the hospital system would be way more overwhelmed and you'd be much more likely to die of other causes for lack of healthcare. The lockdown is saving lives by helping to preserve healthcare resources so that if you have some other need like a heart attack there might still be a doctor free.
It's not like, if the lockdown weren't happening, then there wouldn't be a pandemic. What would happen is that the pandemic would be way way worse.
> The US accepts 22k deaths a year without blinking due to flu. That’s just the flu. What’s the magic number we’re willing to accept? 50k? 100? There has to be a percentage of the population we are willing to accept as casualty because we already do, just unstated.
Unfortunately the worst case death numbers for an uncontrolled pandemic crack into the millions in the US alone. That is, frankly, more deaths than anyone with a sound conscience is willing to accept.
Also, we have vaccines for the flu that significantly decrease your chance from dying of it. I get the vaccine every year. There's a big difference between being completely at the whim of a disease and being able to take proactive measures against it to help protect yourself. The only proactive measure that works against COVID-19 (which is much deadlier than the flu mind you) right now is social distancing, so it's not surprising to see so many people using the only effective measure that currently exists. Don't underestimate people's desire to not suffer a debilitating illness that leaves them unable to breathe for a week before killing them. Social distancing would be happening regardless of the official stay at home orders.
> Lots of obsessing over the current body count though.
I mean ... yeah. These are our friends, our family, our neighbors. Each one of them was a real person who is dying unnecessarily, and more deaths like them could be spared through better social distancing. This isn't "obsessing", it's a very real concern. You'd care more if it were people you knew dying. I've already had people in my extended contacts die of it (I live here in NYC), and it's rough. Hell, I already got it, and fortunately recovered. Let me tell you, spending days unable to catch your breath even just from walking is terrifying. You'd understand more if this was affecting you more personally. It's not just some abstract discussion about numbers.
I keep hearing these stories about how Sweden's approach will end in disaster, but their new case rate is ~500 per day with >10,000 existing cases. A 5% growth rate of new cases strongly implies that they are already past the peak.
What am I missing that would imply things are about to get vastly worse there?
(I do see some other specific mistakes there that lead to a higher death rate, but I don't see the concern about things suddenly getting worse in the future)
Existing cases counts are at worst fantasist, at best state and policy dependent. You can't compare case counts between countries.
Then what you're missing is that sweden case counting method report very low numbers (either that or their mortality rate is absurdly high, which seems more unlikely).
And a good contrast is Bulgaria, which shutdown early, on March 13th or so (https://www.reuters.com/article/us-health-coronavirus-bulgar...), and which has a death rate on par with South Korea's. The neighbouring countries (Romania, Serbia, Greece) are also low but at least 2x that rate.
On a per capita basis sweden isn't really more worse off than many other countries that have shutdown. It's about middle of the pack. Personal responsibility lets us have our cake and eat it too.
But there is also "Beglium - 359 deaths / million" which had early lockdowns. They started their lockdown one day before Denmark. By cherry picking countries one can chose a story to tell. I think it is too early to say if Sweden's strategy was stupid or not.
Belgium counts deaths not in hospitals much more accurately. Really, looking at worldometer numbers and comparing between countries makes no sense whatsoever, yet everyone (including media) does it anyway.
Belgium has people concentrated in a few centers, is a travel hub in the middle of Europe and has a high density of EU employees. With that they imported cases from pretty much everywhere at an early stage.
one can argue that Sweden has a larger immigrant population than those countries. Majority of deaths in Sweden are from immigrant populations. They are blamed for not following the social distancing rules that most Swedens follow day to day. Also they are poorer, live in larger families in small houses etc. and it is harder for them to follow the rules.
One can also argue that the virus doesn't care about your ethnicity, and just because it's hit some particular community hard first doesn't mean it's not going to spread through the rest of your society too absent serious measures being taken. In the US, focusing on the "others" who had the virus, in our case the Chinese, while not taking effective measures early enough to stop the disease, was a huge mistake. It was a distraction, an excuse for racism and not doing more. This is not just a disease of poor immigrants. It's coming for everyone.
How much of that is related to a higher percentage of black people doing more dangerous jobs (one with increased contact with the public)
Of the three people they mention in the article, two take buses.
There's not even an attempt to control. Are black judges living in Westchester statistically more likely than white judges living in Westchester to suffer more from the disease?
That doesn't remotely change the fact that non-black people are still dying in droves, and you can't attempt to minimize this pandemic as saying "Well it's mostly black people dying, so if you're not black don't worry", which is the analogy to the post about the poor foreign immigrants dying from it in greater numbers in Sweden.
Don't just drop a link, let's hear your real argument here.
I'm not making an argument. I'm just providing a reference to counter the claim made. I have no dog in this fight other than I like to see references and evidence. Hence why I only dropped a link. You don't need to pick fights with everyone, you know?
It doesn't prove anything about lockdowns given that the UK has plenty of healthcare capacity and in fact like elsewhere its hospitals are nearly empty right now. If fewer British people survive in their hospitals all it may show is those hospitals aren't very good, but it wouldn't be due to being "too late" as that would require deaths due to overload.
If you look at the huge drop in cardiac ER admissions it's clear that people are dying because they are having heart attacks and not going to hospital when they should. There's actually a severe problem with hospital underload right now. Governments, supposedly following the science, have built emergency field hospitals and shut down other medical work to protect hospitals that are now nearly empty. This was not predicted by anyone pushing lockdowns and is a grotesque mis-prediction with deadly consequences.
Nobody will talk about it at the moment, but I suspect when all this is studied in years to come the UK will be seen to have done worse partly because its population over-reacted to government extortions to "stay home, save the NHS". People are going to die just because they aren't going to hospitals they've been told they need to "protect" as some sort of moral mission. The NHS is often called a national religion, which isn't quite right - it's a religion to some and unfortunately those people aggressively attack anyone who points out what an institutional failure it is. It's easily believable that people will be avoiding hospitals in the UK in greater numbers than elsewhere right now.
We need to watch out for a lot of retroactive nonsense in the coming months. People will claim epidemiologists predicted all this (they didn't), that the lack of lockdown explains differing death rates (already disproven completely by the case of Sweden). Cold logic is all that will clear the fog.
You may want to pick a less terrible example. UK went into lockdown very late, tried to insist on some bullshit herd immunity theory, very nearly lost even its PM, and is now paying the price in blood.
UK was the country that first wanted to isolate the elderly and get young people infected and immune. The current case count is a reflection of that rather than the lockdown which came afterwards.
By “personal responsibility” I guess you mean something like «each individual person makes their own decisions without official guidance about how their behavior might affect their neighbors – during a severe crisis when nobody has access to complete or accurate information – and we just all hold our breaths and hope none of them make bad choices».
Personally I would call this “government irresponsibility”, but I guess we’ll find how it turns out within a few more weeks.
I’m not sure “have our cake and eat it to” is a good way to describe a crisis that is killing a whole lot of people and smashing the economy (in Sweden and many other places).
> and we just all hold our breaths and hope none of them make bad choices. Personally I would call this “government irresponsibility”, but I guess we’ll find how it turns out within a few more weeks.
This approach absolutely infuriates me too, and it is the fault of "the government", but I am very curious what a more precise explanation is. Is it the current individuals in government? The ongoing culture within government? The broader culture of the country? Or maybe a mix of some of these, plus other things that I'm not able to perceive or imagine.
I bet we (humanity) could get get pretty close to the correct answer, if we made a collective and proper (easier said than done) effort to find out.
A good first step would be for you to stop supporting racist misogynistic islamophobic homophobic xenophobic narcissistic politicians who are pathological liars, science deniers, global warming deniers, and who don't believe doctors and epidemiologists, but do spread racist conspiracy theories.
Hi Don, I am always glad to hear from you (and I mean that 100% sincerely, though that may be hard for you to believe) - I think our perspectives and axioms are so incredibly divergent, that with a little effort on both our parts, a tremendous amount of learning could be achieved from proper discussion.
> A good first step would be for you to stop...
I have no hesitation whatsoever to admit that your approach may be correct, and mine incorrect, but I suspect this feeling is not mutual - is my intuition correct?
The problem (or more accurately, a problem) we have under our current form of democracy (in the US) is that we have an infinite number of variables that can be taken into consideration (and different people will select a different set for analysis), but we are only offered a single choice, with two options: Democrat or Republican.
I can respect your decision (analysis), and would be happy to devote literally hours to listening to your reasoning (I've extended such an offer in the past, as you may recall), but I suspect you don't feel the same way. Rather, it seems to me that you are determined to not like me, and accordingly, will look only at variables that support your conclusion, even if the values of those variables are absolutely incorrect (because they are based not on evidence, but rather speculation within your own mind).
In all of our conversations, you exhibit (so I perceive) extreme confidence and certainty in your beliefs, as well as an utter lack of concern (if not even realization of the very possibility) for the notion that you may not 100% correct in your beliefs - not just about me and my true beliefs, but also what is the necessary set of actions to achieve your (and my!) intended goals. If my perception is accurate, and if you are unwilling/unable to realize and rectify this situation, it seems reasonable that the consequences of this is that you will continue to have a highly flawed model of me in your mind.
I would recommend thinking of such ideas via mental experiments, such as: if one wrote software with such disregard for the importance of accurate analysis of reality, would you expect your program to function correctly? I suspect not. So why then would you expect different behavior when it comes to human and societal interactions? After all, are humans not in a sense extremely analogous to hardware that is executing software, all within a shared, interactive environment? I like to conceptualize humanity as a kind of MMORPG, not only because it's fun to look at it this way, but I think there is great utility in viewing things from a third person perspective, as it can often be helpful in achieving greater emotional separation from the situation, and therefore realize clearer thinking.
Furthermore, I speculate that if this sort of behavior is occurring at scale (across the broad population), the consequence may be that we may never be able to turn this ship around, and things will continue to get worse - ironically, bring about the very opposite of what your intended goal is!
Once again, I am putting a stake in the ground. Throwing down the gauntlet. I challenge you to engage in a proper conversation, with the goal (at least) of discovering what I really believe. I'm not asking that you agree with me, but only to face what my beliefs really are. Thus far, you[1] have been unwilling to engage in a serious, nuanced conversation, or even admit (consider?) that there could be value in such an exercise. You are free to do as you choose of course, as am I. I will continue to occasionally post comments from my perspective, and be open to proper discussion and challenges from all sides. If you choose to continue to respond with downvotes and inaccurate, hateful accusations, that is your right (although technically, it is very much counter to the HN Guidelines). And even though you may feel hate for me, and "people like me" (or so you subconsciously speculate), I will not feel hate for you, or people who hold beliefs similar to yours, because that road leads to hell.
[1] Actually, this is a bit harsh in that it could easily be interpreted as an assertion that you are unique in this regard. Rather, quite the opposite is true - it is my perception that I haven't encountered a single comment that has indicated a willingness to properly consider my fairly unique perspective. To be clear, this is not an assertion that all people on HN are in some way guilty of wrongdoing, but only that I have not encountered anyone "doing the right thing", for my definition of "the right thing" (dealing with this subset of reality honestly and ethically).
Let me know when you muster up courage proportional to your ego, and maybe we can have a discussion that consists of something more than insults and evasive tactics.
It's very hard to compare the US with Sweden. In Sweden people are able to stay at home without losing much income due to a strong welfare state - which has also been made event stronger due to the virus. In the I assume that a lot of people would be economically forced to disregard "personal responsibility".
On the other hand, Sweden also took measures, they just weren't as extreme. The virus spread in Europe mainly through travel and large groups of people. Sweden has neither (also because no neighboring country would allow travel). They didn't impose a lock down but it's not like nothing happened in Sweden.
Anders Tegnell - author of Swedish strategy says that the measures are working and deaths are concentrated in Somali, Iraqi and Syria - born population.
But it's not stopping the spread. A friend's office in Västerås just had a case and only now went wfh, while that friend already wfh but still drops off and picks his kids up from school and is getting symptoms now.
The comment about the deaths being primarily in particular communities sounds like the opposite of working, though. Can you provide context regarding why it's working if people in some communities are dying?
* Edit: thanks for clarifying. I didn't realize that your comment about measures working as intended was hinting at a eugenics motives of the policymakers when I first read it, but do now.
Well the real reason there is no lockdown in Sweden is that the owners of the country said No to lockdown. The rest is just unique Swedish doublespeak.
> An estimate from The Economist finds that the value of Swedish billionaires’ fortunes is equivalent to a quarter of the country’s annual gdp. Only in tax havens such as Cyprus or Monaco, or captured economies such as Russia or Georgia, are plutocrats more dominant
Maybe it's just concentrated on poorer parts of the population? Generally poorer people tend to live closer together and can't afford staying home when they're sick. Immigrants tend to be poorer in most countries, including Sweden. I'm not sure how it helps to name place of birth for infected, finding out the actual factors determining the spread would be more helpful.
Perhaps. Or perhaps cultural behavioral norms, or even just lack of understanding due to language barriers is to blame. Strategic, covert genocide seems fairly unlikely to me, but then I'm relying purely on personal heuristics, which in turn rely upon my limited knowledge of Sweden.
One of the traits of this virus that makes it so different from past potential epidemics is that it's able to spread rapidly through a population for up to two weeks before it starts becoming "visible" (symptoms start to arrive in large enough numbers to become alarming). At the tail end of those two weeks, the infection may have spread enough to become very difficult to control.
So, if we took some kind of middle road, and then two weeks later the virus exploded, would that change how you felt about the approach?
I'm still treating this question honestly, btw. I completely agree that it would be nice if such severe measures were unnecessary and the damage to people's livelihoods could start getting addressed. But, the problem that policy-makers are dealing with is that this isn't an infection that responds well to a "wait and see" approach; by the time you start to "see" and react, you could be in deep trouble.
Another complication and I'm sure the task force is wrestling with this. If you undo the restrictions you're never going to be able to put them back in place and have the adherence you did the first time. I just don't believe the people will accept being on lock-down for weeks, then getting a taste of getting back to work and then being asked to go back on lock-down. I also didn't believe people in the US would follow the lock-down rules anywhere near to the degree they have so :shrug: who knows?
Ooof, I hope you're wrong about this, and that people would enjoy more having sporadic periods of freedom rather than months straight of lockdown, but I can't say that for sure. You may be right.
It's also an open question for me. I'm wondering though if, even with the limited data we have now, there are examples of countries that took a similar approach and had their two-weeks-later 'explosion' (or possibly three, is what I've heard).
People want to make things complicated and not take anything at face value, but if you look at global cases on a log scale, you see how they started exponential, flattened out, and then once there was a foothold outside china, went exponential again, and now is flattening again.
Wouldn't it be logical to assume this will repeat as soon as people decide it's under control again? How can you go back to normal, before everyone has caught it, and expect the rate not to go back to exponential?
> - Dense city? Quarantine. - Moderately dense? High risk individuals quarantine, everyone else social distances, but works. - etc. Across the board, if your business is the sort that can WFH (such as software companies), then you do work from home. If not, then you're open, but with precautions. Restaurants are open, but pickup only, etc.
How is this _that_ much different from what's being done now?
Well for example there's lots of non-essential business that can operate while enforcing social distancing. Closing bars and restaurants makes sense. But closing stores were you walk in and walk out does not make sense. Banning fishing doesn't make sense. Very broad strokes have been used to lock stuff down.
And at least in Michigan, they're not taking the time to open up low risk businesses now - instead they're filling in even more of the gaps that allowed life to continue. No golf courses, even without any staff contact. No landscaping. No landscaping supplies. No motorboats or jet skis. No travel between two residences you own.
Some of these can be explained at least. Landscaping is very non-essential, and it's hard to maintain social distancing while doing it because the way the crews operate is it's a bunch of guys riding together in one truck between each job sites (it's not a caravan of different vehicles, one per vehicle).
Additionally, my mom has been complaining about the landscapers where she lives and is angry that they're still allowed, because they flagrantly violate social distancing and get near her when she's trying to go on walks around her neighborhood.
Things are getting so bad in Detroit that bodies are piling up in unrefrigerated rooms in hospitals. Now's not really the time to be questioning if they're being too strict with the social distancing; at this point they really just do need everyone staying home, period, and not coming into contact with anyone. Motorboats and jet skis sure as hell aren't essential, and might tempt people into congregating with people they shouldn't be congregating with (boating is typically a social endeavor for example).
I'd say that landscaping is at least a field that has the possibility of operating while social distancing.
As for bodies piling up in Detroit... While that's true, additional restrictions added today won't have any impact there. Either the previous restrictions were sufficient, in which case Detroit should be peaking soon, or they weren't sufficient and there'll be several times that number of bodies before these restrictions start to have an effect.
My personal view is that low-risk activities should be allowed whenever possible to maximize the time period that people will willingly endure these restrictions. It looks like this won't be a sprint but a marathon, and people's willingness to comply is extremely relevant there.
I am in Tokyo and it's been going on longer here than many places.
Gradually increasing pressure has been the approach. It feels to me like you're right. I am willing to accept more pressure, though already burdened. It's because there's been time to adjust.
You're missing the point, which is that if you think the situation is bad now, just wait how bad it'll be in two weeks if we don't act even more stringently now. Letting up on the restrictions now would be exactly the wrong thing to do when the healthcare system is already bursting at the seams; it'd make things much much worse in the weeks to come.
The very earliest that it makes sense to even start considering reducing the restrictions is once the healthcare system is back to operating at under its maximum capacity. And you have to ease things back slowly, ready to clamp back down if necessary if the healthcare system seems ready to be overwhelmed again.
My reading is that either restrictions were sufficient before, or the new ones won't be enough either. And the more onerous the restrictions, the less likely it is that people will be willing to follow the important ones in the future.
It doesn't logically follow that just because mild restrictions weren't sufficient, that stricter restrictions won't be. China used very strict restrictions and they stopped the spread of the disease hard.
Every incremental improvement you can do to decrease the R_0 will have its effect. Progressively stricter social distancing measures as required absolutely will work, so long as they are being obeyed anyway.
And that's MY point. How long will people be willing to obey the current restrictions? How long would they be willing to obey even stricter ones, or more lenient ones?
I don't think obedience can be assumed forever. Even China had to weld people inside their apartment buildings. And I don't know if that would be practical here.
> it's hard to maintain social distancing while doing it because the way the crews operate
I have no idea how to quantify it, but social distancing at a grocery store, surrounded by an ever-rotating group of people, seems much more risky than a work-crew, which is composed of the same 6 people all day.
The work crews are hanging out all day every day, whereas you do your grocery shopping once a week maximum, for less than an hour, and everyone wears a mask to reduce the chance of spreading anything.
On the work crew, if one person gets it, basically everyone else on the crew is guaranteed to get it too. In the grocery store, a single visit, especially with proper precautions taken, is unlikely to spread it.
But the grocery store workers are there all the time, and interacting with a wide variety of people. Sure, the chance per person is lower - but overall?
And the spread on a work crew is limited - there's only 6 people there. But that grocery store worker? Can you define super spreading event?
The talking point the anti-governor folks are repeating is that landscaping companies can’t even deliver mulch to your driveway. Which, sure, I guess that’s overly draconian but in the grand scheme of things I can’t bring myself to be angry about it.
There's inevitably the potential for person-to-person contact in business anyway, yes, even running a mulch yard, delivering mulch, getting a receipt signed on delivery, etc. It's not unreasonable at all to shut down all non-essential businesses until our healthcare system starts operating under its maximum capacity again, and to define "essential" strictly.
Given that we're in the early stages of the worst pandemic to hit the world in over a century, like you, I too can't bring myself to be angry about landscaping being shuttered, or jet skis, or whatever other silly unnecessary things people are complaining about. If even one more person dies because a landscaping company opened back up a month earlier, then it wasn't worth it. And that's easily a possibility we're looking at here.
What you're not thinking of is that restrictions such as this also cost lives. Suicides will be up and there will be much more economic stress afterwards.
Seriously, how is allowing kayaking/sailing but banning motor boats, even when alone, anything but taking advantage of the crisis to push through an environmental agenda?
People wonder why others are afraid to give the government more power, this is one of the best examples of why.
Over here in The Netherlands, most supermarkets have, to various degrees, implemented measures to protect workers (plexiglass, timed restocking, etc.) and measures to encourage social distancing (reminders and lines on the floors, a maximum number of customers via a set number of carts and having an employee wipe down the carts and handing them out manually at the entrance, old-people-hour in the morning, etc.).
The psychology behind this is fascinating. It's not just the measures that help, but the fact that simply being handed a cart after passing through the turnstile puts me (and I suspect everyone else) in 'awareness' mode. I've noticed that I myself generally pay more attention to not hover around employees, and take a detour via a quiet aisle whenever I can.
This stands in contrast to all the non-supermarket stores I occasionally visit. aisles are narrower, they don't have a designated entrance-employee, and at best there's some A4 glued somewhere asking me to pay by card if I can. Not only is it more difficult to practice 'social distancing', I don't notice a similar change in 'mindset' and have caught myself more than once leaning over an employee or passing close by other shoppers. And interestingly, both myself and said shopper seemed to notice this less (in the supermarket I've noticed many more older customers wait intentionally for me to pass at an appropriate distance).
And that's not even considering weird situations like our local HEMA (a very popular convenience store) implementing a bunch of measures, but then if you want to go and pay for your stuff you have to pick up an unclean scanner gun for the self-checkout, essentially undoing any measures they implemented. Out of curiosity I stuck around to see if these 'guns' are cleaned. They're not.
I guess my point is that stores are trying to implement sensible measures but so far it's mostly been supermarkets that seem to do a decent job (even if there's quite a bit of variation between stores from even the same company). I imagine it's much easier for these chain-stores to both get expert advice /and/ implement measures nation-wide. For those who have serious concerns it's a good reason to avoid 'mom and pop' stores though.
I guess what I’d like is for the gov to provide methods that would allow business to remain open if they complied with certain measures. They shouldn’t need their own expert, the gov should be able to provide measures.
I agree... they closed access to waterways here because they were seeing some boats too close together. That makes a lot of sense if you don't think about it, and clearly should not have happened.
Governors are forcing businesses closed or no seating allowed.
Those guidelines are good ones to maintain for perpetuity. Would decrease the thousands of flu deaths we see each year too but today's situation is closer to a nationwide lockdown than a PSA about washing hands
> density seems to have the biggest impact on the spread of this thing
Pick two random people Jo and Chris. If Jo wants to pass a letter from hand to hand via intermediary carriers so it gets to Chris, what’s the shortest time for it to get to Chris?
Ways to slow down the letter passing are to prevent long distance connections (close airports), slow down connections (only go to supermarket once a week), remove connections (close pubs).
To avoid any carriers passing a letter to you, you want to avoid: highly connected social people; gatherings of connected people; reduce number of meetings.
Density is one aspect, but perhaps not the most important.
> This is probably true, but other countries haven't locked down hard and aren't seeing a big spread.
Which countries might that be? If you're referring to South Korea, they're ahead of the game enough on testing for this to be workable (unlike us). If you're referring to anyone else, they're simply not at that point yet in the curve, but will arrive there.
Sweden has more deaths per capita from coronavirus than the US, has an exponentially increasing death rate (i.e. they haven't turned the corner yet), and a very high case fatality rate of 9.4% indicating that they're severely under-testing. This is not what a successful disease prevention strategy looks like.
Sweden's deaths per capita is neck and neck with the United States and following approximately the same trajectory with no lockdown. It's neither appreciably better nor appreciably worse.
The US, like the UK, did a terrible job early on when containment was most critical. Several states are in lockdown now but arguably, the reason for our awful current new cases/death rate is due to the resistance to taking action in February when it first hit. There are also many places in the US that are not in lockdown. From another comment: “Approximately 44 of 50 states have lower per capita death rates than Sweden.“ The US cannot be compared directly to Sweden because it doesn’t have a single policy like Sweden. It’s also worth noting that Sweden has taken some lockdown measures ie your comment about “no lockdown” isn’t accurate. Finally, it’s early days and time will tell. The UK changed their policy because there is no credible evidence that herd immunity is effective. I believe Sweden will as well once the disease spirals out of control. And hopefully less people will die as a result. Unfortunately, there will also be the insufferable few that claim we could have survived without being cautious because you can’t prove that those measures were responsible for saving lives. Don’t be that person.
> the reason for our awful current new cases/death rate is due to the resistance to taking action in February when it first hit.
The reason is actually NYC, specifically Cuomo and DiBlasio passing the buck back and forth and doing nothing. If you remove just NYC, the rest of the country is for the most part doing a lot better than Europe.
It's even worse than that, de Blasio was basically in denial and wasn't doing anything, even through mid-March when cases were exponentially skyrocketing here. It took all the heads of his public health department threatening to resign for him to actually start doing things, and the idiot even went to his gym on the last day that gyms were even open.
Both he and Cuomo took way too late to act, and now we're all suffering for it. Cuomo has since at least gotten better, but de Blasio has been terrible throughout.
Sweden has by far the highest number of cases/deaths with respect to neighboring countries. Finland has 1/10th of the number of deaths per capita [0]. They are also faring much worse than Denmark and Norway (in terms of both cases and deaths) where much stricter measures are enforced.
Full quarantine is effective, almost tautologically so. If the virus is still increasing exponentially then whatever quarantine measures you do have in place simply aren't full enough yet. At the extreme end of a full quarantine, imagine everyone is prohibited from leaving their homes for any reason, and once a week someone in a fully sealed bunny suit comes by to drop off food for the week. That's a pretty darn full quarantine, and you better believe it'd be effective.
Fortunately, we don't need to go to such extreme measures to get the replication rate below 1, but my point is, that extreme measures absolutely do work. The virus isn't magic; it needs to spread through relatively close personal contact. If you eliminate personal contact and sharing of spaces entirely, it cannot spread at all.
But is it more effective than simple washing hands and social distancing?
I think Sweden is proving that it's not.
Additionally short of what you're proposing...full total lockdown...the virus isn't going anywhere...it will be in society when we emerge from quarantine immunologically naeive ready for another wave of Corona.
You have to compare states with comparable population density, cultural norms and roughly comparable initial cases. Climate plays a huge role in how much people engage in potential infection prone activities. E.g. like being outside in parks, beaches.
The question is: how many infections happened before the quarantine was established? In UK the quarantine was started way to late. That the UK has in common with Italy, Spain and France. But in all these countries, a massive infection rate has been drastically reduced by the quarantine.
In Sweden, there seem to have been only very few initial cases and the virus seems to be slow to spread there - it probably helps that Sweden is over 80% larger than the UK and has only 1/6 of the population. Also, at this time of the year it is much colder than the UK, less reason to be outside in big groups.
If you check the infection graphs, in the UK the quarantine finally seems to have an impact on the infection numbers, which stopped growing a while ago. Sweden still seems to have growing infection numbers.
> The US is not a very densely populated country, and density seems to have the biggest impact on the spread of this thing.
You might be right, and I hope you are. But at least 'intuitively' my experience is that the more insular a community is, the more exposed those /within/ that community are because of frequent interaction.
So, basically, a big city is not very insular, but people spread the virus via public transit and whatnot.
A small, rural town is insular, but the locals interact much more than the city-folk. All it would take is one infected out-of-towner to trigger rapid spread locally.
I wouldn't be surprised if the problem that, for now, seems to be contained to liberal metropolises, will find their way into all sorts of rural communities because just one person passed it on. I hope I'm wrong.
Sweden is one of the few countries that didn’t lock down. I’m Danish, and we locked down hard and are now on the process of reopening where as Sweden has 4-5 times the amount of deaths we do per capita, despite being a much, much larger geographical area and they’re closing down more and more as we are opening.
The political fallout the Swedish government will face over having so much more dead than Denmark and Norway is likely going to destroy their current government and lead to a further increase of their right-wing populist party.
So yeah, there are countries that didn’t close down hard, but they look royally fucked because of it. I think the only country where the government failed where the current administration is gaining popularity is the US. For some reason.
it seems to me it's not only density but mobility too. The US is a very mobile place, people can move around very easily. I think you have to consider that along with density when looking at how fast a virus can spread.
I hope a side effect of the virus spread is proving wfh feasible to many skeptics. Working from home goes a long way to reducing pollution and increasing productivity and morale. It's definitely not one size fits all and doesn't work for all personalities and jobs but it should be used where it can work. At a min, it keeps people off the roads/tracks.
> The US is not a very densely populated country, and density seems to have the biggest impact on the spread of this thing.
The US has the highest number of confirmed coronavirus cases of any nation. The US is seeing about 2,000 confirmed coronavirus deaths a day at the moment:
> The US has the highest number of confirmed coronavirus cases of any nation.
Your statement isn't very useful. It's the per capita death rate that matters the most of any metric. It's non-sense to compare the US to countries with 5% or 20% of the population using absolute numbers.
In terms of density, it's the NYC region that overwhelmingly accounts for the problem in the US. NY + NJ = majority of US deaths. The NYC region is the most dense on population in the US, which dramatically magnified its outbreak.
Approximately 44 of 50 states have lower per capita death rates than Sweden. Most US states are doing extraordinarily well in fact.
Half of US states are seeing no serious outbreak at all.
Arizona has 7.3 million people and only 131 deaths.
Belgium has 11.4 million people and 4,000 deaths. Sweden is considered a relatively good outcome in Europe so far, they have 10 million people and 1,000 deaths. Texas has three times the population of Sweden with 1/3 the deaths.
Some more examples:
Utah 19. Oregon 55. Arkansas 30. Washington DC 67. Delaware 41. Hawaii 9. Idaho 33. Iowa 49. Kansas 69. Maine 20. Minnesota 79. Nebraska 18. New Hampshire 23. New Mexico 31. North Dakota 9. South Dakota 6. Montana 7. Vermont 29. West Virginia 9. Wyoming 1. Puerto Rico 45.
Lower population density helps a lot in most cases. However San Francisco is also one of the most dense cities in the US and only has ~15 deaths or so. That's thanks largely to climate, which impedes transmission heavily. The same reason the entire San Diego County only has 53 deaths.
> Sweden is considered a relatively good outcome in Europe so far
I don't think that's true. Germany or Austria might be good outcomes. Sweden had few measures in place but their death rate is far higher than most neighbours.
Yes. Contrast Sweden and the US to Australia and South Korea. Australia and South Korea are doing much better. The Australian and South Korean response has been competent.
Australia has a mandatory stay-at-home order, and they issued it earlier in their outbreak than we did in theirs. That explains why they're doing so well.
In South Korea they all gravitated to masks very early, and they developed enough testing capacity early on to allow contact tracing to remain viable (so far).
Australia is outside of the Covid Belt of temperatures that is ideal for SARS-CoV-2 transmission.
Australia is spared for the same reason most of Latin America, most of Africa and hotter climates in Asia have been.
Nigeria, Egypt, Mexico, Argentina, Colombia, Indonesia, Vietnam and Thailand don't have such low death rates because they've been running testing at the rate of Germany and doing tracing & lockdown & testing & quarantine as well as South Korea. It's the hotter climates. It's hot in Melbourne, Perth and Sydney during the Winter in the Northern Hemisphere, ie during the outbreak so far. Melbourne has been shielded for the same reason Lagos Nigeria has been.
Australia's measures are without question further helping to limit cases. Having a warmer climate during the outbreak time while simultaneously implementing aggressive measures, is the ideal double whammy to get a good outcome. The climate makes it dramatically easier.
> Nigeria, Egypt, Mexico, Argentina, Colombia, Indonesia, Vietnam and Thailand
Indonesia is only testing at the rate of 116 tests per million people. You only find what you measure. When the rate of testing is that low you can't make any claims about the true coronavirus death rate in Indonesia:
Thank you I've been saying this for a while but have been being crucified by the flat curver movement who takes no accountability in proving that their method is working with hard data.
I personally think something should have been done, but it's an open question if we went too far or not far enough and am willing to listen to the argument that we went too far. It's unlikely what was done was the absolute perfect policy prescription given all the trade offs involved.
Personally I'm looking to Sweden's data, a country that instituted some social distancing measures (no crowds above 50) but not all (Restaurant dine in still open) for some clarity. Their numbers are worse than Denmark's right now but not absurdly so (2x deaths per capita).
> and am willing to listen to the argument that we went too far.
In all honesty I want to do the same. But upon reflecting, that's more to do with my desire for things to 'return to normal' than anything else.
There's so much we don't know yet. What if immunity isn't a thing (I'd say unlikely) or not as binary as we think (much more likely; multiple articles I've read indicate that having a mild version of this also provides mild inoculation)?
What if the hope of the 'iceberg' theory is untrue, or very selectively true?
What if allowing this thing to roam free and cause mass inoculation also leads to mutations that mess up our plans (unlikely, from what I've read about coronaviruses).
My point is that until we have a better grasp on these potentially game-changing issues, we should prioritize study, we should prioritize testing on mass scale, we should prioritize PPE for our health care workers, and we should prioritize finding ways to minimize the consequences of our possibly-too-careful aproach.
But we shouldn't let down on that 'over-careful' approach until we know more. Regardless of the economic impact.
Give it time. They're still in full exponential growth, whereas every place that enacted social distancing rules a couple weeks ago or more is now plateauing.
Possibly, their numbers the last 4 days are bizarre, potentially due to holiday effects.
My guess is what's going to happen is they will see more deaths, but not an unreasonable number and both sides of the debate will declare victory as they move the goal posts sufficiently.
My guess is that they'll end up having to do more stringent social distancing measures anyway, but that a lot of people will end up having unnecessarily died because they waited so long relative to other countries. Because currently they are on track for an unreasonable number of deaths, and it would reasonable to change the course of action so that that doesn't happen.
I'm not seeing a lot of subtlety in these outcomes, nor possibility of both sides (credibly) claiming that they were right. We'll know soon enough either way.
They've fallen behind in testing capacity, like many others. You have to go by hospitalizations and confirmed deaths because those are the only stats likely not to be underreported too badly.
15% of deaths happened in the past 24 hours, that's not a flattening of the curve
Maybe you're being fooled by the lack of reported deaths in the weekends in Sweden? It does mess up the curve quite a bit. But it's been like that every weekend if you look at daily deaths. And it makes the log graph look less exponential than it is
Also the log graph is a day behind the reported numbers, so tomorrow you'll see a sharp rise as they're at 1200 deaths now, making it clear that it's indeed exponential
So last tuesday they reported 114 deaths yesterday they reported 114 deaths. You can't be seriously looking at the bar graph of daily deaths and see an exponential growth. If anything it seems to have stagnated. Yes we underreport during the weekend and overreport the first days after the weekend and monday was a holiday for us. But it is clear as day if you look at the logarithmic chart over deaths that our growth is slowing.
Similar cherry-picking leads to: Last wednesday 96 deaths happened, which was around 15% of total deaths at the time. And this wednesday 170 is reported, which is around 15% of total deaths now. That's exponential growth
You are right though, given the numbers there's decent likelihood that it's stagnating. But there's also a decent risk that it's still exponential
Not all cities issued a shelter in place in California at the same time. Bay Area was early, and then the state issued one a week later. You think you’d see a hot spot somewhere in the state but doesn’t appear to be the case. Unclear to me that SIP is the main reason why we have few cases vs if we just required face masks and social distancing while keeping more businesses open.
Yeah, fwiw I would not argue with someone that claimed that nobody has a complete picture of all of the factors in the virus's infection rate. There has been a lot of conflicting and incomplete information and it's been difficult to stay up-to-date. It might be that there's some sort of difference between California and New York or northern Italy that would make California far less susceptible. Maybe environmental, or demographic, who knows.
The problem though is that we don't know that California would somehow turn out differently, and because of this thing's damnable asymptomatic incubation period and rates of spread, by the time you realize you haven't taken it seriously enough, it's going to be very bad.
So imagine you're sitting at the table with the governor and CalOES. They're asking you to make a decision today: tank the economy, or not. In two weeks you get to see how it turned out: either you saved the economy and only several hundred people died, or several thousand people have died and your healthcare system is on the verge of collapse and the economy tanked anyway because sick and dead people don't do a lot of shopping.
Sweden has far fewer cases and death rate without a massive lockdown. If this disease is really so deadly, why isn’t their country being massively depopulated? Same for states in the US that haven’t implemented any lockdown measures.
The data I have seen does not corroborate this — in fact exactly the opposite.
According to [0] Sweden has 11,445 cases and 1,033 deaths (CFR: 9%) as of 6pm PT 4/14. For a population of 10.3 million [1], this is a confirmed infection rate of 0.11%.
According to [2] California has 23,338 cases and 758 deaths (CFR: 3.2%) as of 6pm PT 4/14. For a population of 39.5 million [3], this is a confirmed infection rate of 0.06%.
By all accounts, Sweden is being hit far harder by this virus than California or Sweden’s own neighbors are, and based on this evidence it is reasonable to infer that the distancing measures or lack thereof have an effect on transmission.
52% of Swedish households are 1 person households[1] so they were sort of self-isolating by default. As you can see from the other replies, that wasn't enough to keep transmission at bay.
Sweden also has a fairly low population density outside its larger cities, as well as a relatively small (10M) population. And its measures aren't without criticism - consider they have 100 deaths per 1M people, which places them 10th on countries with over 1K cases.
There's states in the US with similar densities; I'd imagine those would be spared most of the deaths, even if stricter measures weren't implemented, but what about the coasts?
Honestly, the US, large and heterogenous as it is, should implement different measures per state. It's obvious to me that what works for some places may not work for others so well.
Even if you look at Germany, you will see huge regional differences. If you look at the map of the positive tested, you can clearly see spikes in the huge cities (Berlin, Hamburg, München) and in densely populated regions. You can also still see that the infection density is higher around the places of initial infections (Bavaria for example, many skiing tourists who got infected in Austria/Italy). On the other side, there are less dense populated regions with a noticeably smaller infection rate.
And interestingly, those on holiday seem to have brought it back at a much greater rate than business travelers. E.g. Frankfurt isn't an epicenter despite having the largest airport and a lot of business travel, esp. to China. Many of the early outbreaks can be traced back to either Italy or Austria during Easter holidays. And that's where centers of infection remain.
It's still early enough in the pandemic that the effect you're seeing here might only be that denser areas get it first, not that they get it worse. People in less dense areas do still regularly come in close contact with other people, so there is the potential for the virus to spread there even if the people live spread out on farms or whatever.
Given it a few more months and I suspect that the differences between the urbs and suburbs will be less.
Look at their fatality rate compared to other European countries. Also read the recent news about change of approach of Sweden and The Netherlands. Read about the current situation of the UK and go back in time an look at their initial response vs e.g. Germany. Compare the two. Lockdowns are saving lifes.
It is. The ongoing data already show it. And in another month or two it's going to be really obvious how much worse they were hit by countries that locked down sooner (I say sooner because at this rate it seems inevitable that Sweden will be forced into some form of lockdown too, just tragically too late to save many tens of thousands of lives). Let's regroup in a couple months and see precisely how poorly their strategy turned out.
While current Swedish strategy carries a high risk of bringing it to that point, that statement is absolutely false right now. Swedish deaths per 1 million are currently 102, significantly lower than Spain (397), Italy (348), France (241), Belgium (383), etc.
The stat that they're specifically referring to is the case fatality rate, but that has a lot more to do with the denominator (Sweden's utter failure to test) than the numerator (actual number of deaths).
I’ve participated in Homeland Security pandemic exercises. One in particular had a R0 of about 2, and a death rate of 1.3%, with a hospitalization rate of 10%, and and acute care rate of 3%. All numbers lower than CoVID-19.
What happened in the exercise was that all hospitals got over run, very quickly, it took months for the infection rates to flatten.
Nobody could get into a hospital and get any proper care, entire families started dying, the death rate jumped up to almost 12%. Remember the calculated death rate is based on proper care. Police, Fire, EMS, got hit hard and they all walked off the job.
Nursing homes, assisted living facilities had death rates of almost 75%, (we’re starting to see 50% now).
Hospital workers started walking off the job. The economy didn’t slow down the economy flew into the ground at 500mph and exploded in billions of tiny pieces. The country went into immediate shortages of everything, which didn’t really matter because basically everyone stopped going to work.
When you might get sick and you know you can’t get care and without care you have a 12 in 100 chance of dying you can’t get people to leave their house, for any reason. People start dying home alone.
The death rate gets even higher because of food shortages, prescription drug shortages, and underlying health conditions fuel the fire. Power disruptions, water, sewage issue because no one is working. Crime becomes a problem, because a) the police aren’t working and b) people get desperate.
Once things start to unravel you can’t simply re-ravel things.
In a normal flu season about 40 Million people get infected, with 30-67K dead a year spread out over 6 months.
If we respond to COVID-19 like we do with the flu, we could see 150-200 million infected because it spreads more easily, those numbers would overwhelm the country, maybe have 20-35 Million dead, the economy might stop for a year or two, or three or four.
We don’t know if infection confers immunity, what happens if it doesn’t? What if getting it makes you more susceptible to a second and worse infection? What if we can’t develop a vaccine?
I agree with your point in general, but this claim is overblown:
> If we respond to COVID-19 like we do with the flu, we could see 150-200 million infected because it spreads more easily, those numbers would overwhelm the country, maybe have 20-35 Million dead
Even without any medical treatment at all, the death rate from COVID-19 is much lower than 13%. It might even be below 1%, once you factor in all the asymptomatic cases that we're only just starting to discover from blood antibody testing. So we're still talking about millions of deaths, which would be absolutely horrible enough in its own right, but we're not looking at double digit death numbers. COVID-19 fortunately isn't that deadly. Other diseases are though ... so in a way, as bad as this seems, we did still get somewhat lucky.
Your exercises were worthless because they were based on the assumption epidemiology is usefully correct, and it's clearly not.
I mean, I wonder how you reach the conclusions you do? Just read your own post back to yourself. You say the numbers in SARS-COV-2 are worse than for your simulation yet the outcomes observed in reality are empty hospitals that need to furlough workers because they are so underworked. Reality has disproven the simulations, but it sounds a lot like you're concluding reality is wrong?
"empty hospitals that need to furlough workers because they are so underworked"
This seems to be a meme, but I think it started with misinterpretation of elective procedures being cancelled and employees that couldn't be repurposed being furloughed. It doesn't make any sense to equate this with hospital resources in general being plentiful. The point of no elective procedures is that some resources are freed up. Bottlenecks aren't applicable to everything equally.
There's no mis-interpretation. All those procedures were cancelled because of a belief that hospitals would be overflowing and every bed would be needed. Clearly those predictions were well wide of the mark.
I think there are open questions about how much our current actions are preventing deaths vs delaying them, what the difference is in terms of number of deaths caused by stay-at-home order vs more mild social distancing, and what downstream effects and deaths will result from a new global depression (especially in the developing world).
Are there any examples of milder social distancing without extensive testing and contact tracing that has been effective? There are certainly a lot of examples of delayed or poorly enforced / adhered social distancing that has proved to be ineffective.
Wrong data. You're looking at confirmed cases, which Sweden is massively falling behind on because they're under-testing so badly, as you can see from their absolutely incredible (as in unbelievable) reported case fatality rate of 9%. It's not that 9% of their population is dying from this, it's that they're not even catching 1 out of every 50 people that even have it. Their stats look low because they're so severely under-reported.
The correct figures to be comparing here are per capita deaths. Sweden is currently sitting at 1,014 deaths per 10M people while the United States is at 789. Ergo, Sweden's outbreak is roughly a third worse than the US so far, and growing worse.
I totally believe that the coronavirus has been in California since December and peaked in February. I’m sure if we look back we can find evidence of people getting sick and recovering. Those who died were listed as death from pneumonia or something else.
The main snag with this model is hospitalizations. Even if we grant that there was no testing available, and that early deaths of covid19 would have been attributed to cardiac disease or pneumonia, and that there may have been some kind of less lethal early strain or some other voodoo, the hospitalization rate would still be expected to be constant, and it hasn't been. Health care workers have broadly been reporting pretty typical case loads up until early to mid March.
For some corroborating data, there's a "smart thermometer" company [1] that uses the aggregated data from their thermometers to maintain health "weather" metrics for the US [2]. Right on their health weather page, you can see a chart showing typical rates for seasonal infections across the US, up until March 1st. And if you're concerned that New York is tilting the results, then you can even zoom in to the San Francisco area [3] and see the same behavior.
Kinsa's CEO has published a writeup on medium [4] that compares a couple of different areas with different responses and timelines, and he says that the data he's seeing suggests that stay-at-home orders are making a big difference in infection rates. They have more stuff like this on their Twitter account [5].
I would think that if this were the same disease all the way back in December, the data would look very different. There'd be no explanation for the fall-off of fever rates all the way up to March 1, when it suddenly started climbing.
If COVID-19 had been spreading uncontrolled in California for four months prior to containment measures being enacted, the number of deaths by now would be truly mind-boggling. It's simply not possible for this to have been the case, because it would have been obvious sheerly looking at the all-cause death rate in the state increasing by many times its normal value months ago. This didn't happen, ergo COVID-19 was not spreading uncontained in California for that long.
It's rational, you just haven't seen the data causing people to ask these questions. Perhaps because aforementioned newspaper outlets aren't showing you.
Here is some.
Graphical comparison of UK (hard lock down) with Sweden (not much lockdown e.g. restaurants and shops still open)
Switzerland's proportion of positive tests as a fraction of all tests (i.e. is it spreading) shows no epidemic and no effect from lockdown, again, presented visually here in the tweet that's a reply to the first:
(you can delete the paywall to see the headline and summary)
There are other reasons to be skeptical. Epidemics naturally come and go very quickly. The "lockdown" concept comes from epidemiologists. These people have a history of proposing extreme measures that turn out to have had no effect when compared to control groups, or when people simply realise that the epidemic entered decline before the recommended measures were implemented. If the lockdown ends up having no effect it'd be counter-intuitive but entirely predictable from how things worked out in the past. For instance, look at the history of foot-and-mouth disease in the UK.
> As I see it, there are so few cases in California because of the measures that have been taken.
California has been spared because it's not in the Covid Belt. That's a term I've come up with to describe the ideal climate that SARS-CoV-2 thrives in. All hard hit regions exist in the Covid climate belt.
Not all the least hit areas (eg South Korea) exist outside of the Covid Belt. You can also limit its spread with other aggressive measures. Climate provides a substantial natural impediment, although it doesn't entirely stop the spread either. It's why Texas, New Mexico, Arizona look like they do right now versus Michigan and New York. It's not because Texas has had amazing testing and tracing and quarantine measures.
It's why Tehran was hammered by the virus but Baghdad was not. It wasn't luck, it wasn't testing, it wasn't tracing, it wasn't lockdown measures. Baghdad is a hotter climate than Tehran during the December > May time frame.
It's why Athens & Greece is largely spared but Milan is not. It's not because Greece implemented South Korea-style measures early on and they have a far better healthcare system than Britain. It's why Southern Italy is not hit like Northern Italy. They have different climates.
It's why Madrid is hit so hard but Barcelona and Lisbon are not. They have different climates.
It's why NYC is hit hard but San Francisco and Los Angeles and San Diego are not.
The entire San Diego County has 53 deaths.
It's why Texas is largely spared but Massachusetts and Michigan are not.
It's why Detroit was hit but Phoenix was not.
It's why Belgium and the Netherlands were hit but Mexico wasn't.
It's why Wuhan was hit but Hawaii and Jakarta and Singapore were not.
It's why Algiers (7.8m people in their metro, just south of Spain) isn't drowning in Covid cases and hasn't been hit like Madrid.
It's also why India and Pakistan have been largely spared bad outbreaks. Defying all predictions thus far to the contrary.
It's why Lagos Nigeria isn't being hit hard and the Netherlands and Britain were.
It's why Cairo isn't buried in dead bodies right now. The Cairo metro has 20 million people. Check out the temps in Cairo during the Nov > May time frame.
Look at the climates. Nearly all of the hardest hit areas exist in a sweet spot on temperature range.
See those higher highs through the flu season? That 8-10 degrees of higher temps throughout Winter is the difference. Getting as close to the ~55-60 F or higher temp zone at the highs as possible during Winter is where you want to be. The regions that are, have seen dramatically fewer cases. This spans all variations of circumstances between nations (rich vs poor, good testing vs weak testing etc). At 64 degrees F and above, we know that influenza, for example, is heavily impeded by the heat.
This is why so many experts have been predicting a big downturn in the virus as Spring & Summer temperatures roll in.
This has already been shown by several studies. We already know why. 90-95% of all cases of transmission have occurred in the Covid Belt areas that have ideal climates for the transmission of the virus (otherwise Africa would be drowning in Covid deaths right now).
Do you have any sources? Epidemiologists don't think that temperature has been playing a major role here, so do you have any sources that's not just you hypothesizing this?
Because one trend I see a lot on HN is people making wild guesses about things waaaaaaay outside their area of expertise ...
By wild guess you mean ignoring the comically epic pile of overwhelming evidence that shows climate is a very large factor in impeding the spread of the virus (and applies to locations regardless of testing rates or economic condition)?
I've been talking about this on HN for a while now. I've been making the same case over and over.
Guess what hasn't changed since I first floated it here? The higher temp areas I've been touting under this theory have continued to be spared compared to the Covid Belt climate areas, despite predictions by the so-called experts that everyone would be hit (the same experts that are so baffled by Texas and California). It's not testing or luck or lockdown measures or tracing. Texas did everything wrong compared to eg South Korea, they should look like New York / New Jersey / Michigan / Massachussets. It's the climate providing a big assist.
I've seen some really outlandish articles dancing around it. What crazy magic is this, that is protecting these states?!?
It's the climate.
Epidemiologists don't think so? Which ones? It's a proven fact that coronaviruses and influenza are both impeded by higher temperatures. What I'm describing makes perfect sense. We already know there is a direct correlation between higher temps and lower viability of such respiratory viruses.
From 2011 & SARS: "The Effects of Temperature and Relative Humidity on the Viability of the SARS Coronavirus"
I appreciate the effort you're putting in to this and it's a shame you're getting downvoted this heavily.
I would want to see a very careful treatment of this data before I could be convinced that temperature is a greater factor in transmission rates than stay-at-home policies or population density. It would be really easy to cherry-pick examples.
A couple of counter-examples that come immediately to mind are Chicago and Florida. Chicago's climate should fit your model but they have about 1/3rd the cases per capita vs New York City. Florida meanwhile should be warm enough to be outside of your "Covid Belt", but cases there are expanding extremely rapidly and it's likely to overtake Washington state in per capita cases and deaths. Louisiana similarly has one of the highest per capita death rates in the nation.
Climate might be one factor, but it's not clear that it's a big factor, let alone the most important one.
Can you put together some actual data then? Like, get all the relevant data for hospitalizations and deaths by locality and find a correlation against climate data? And then do the same for things like density, how early and strictly social distancing measures were put into effect, etc., and see if it has more or less correlation than those?
My gut feeling here is that climate is not a significant factor, but that those others are. And you haven't come close to actually demonstrating it with rigor beyond it just being a guess that you have (which is fine; guesses are useful).
And you're right, the connection between climate and the spread of a disease is well known, which is why if it were relevant here there would be lots of people besides you talking about it. The articles you linked do seem to show that the virus might not survive for quite as long on surfaces at high temperatures and humidities, but that's just not really that relevant for how this disease spreads. People are primarily either inhaling droplets directly, or touching things that others have touched recently and then getting it into their face. The virus surviving for hours on a surface before being touched and then touched again to a face orifice was always on the long tail of transmission methods, so flattening that tail a little bit doesn't make a meaningful difference in the overall spread of the virus.
It seems to all fit together but I would not be too hasty in proclaiming the actual heat to be the affecting factor. Colder place will naturally be more densely populated for example.
> Colder place will naturally be more densely populated for example.
That's plainly wrong. The world has huge numbers of hot, very dense cities that have not been hit hard. The Philippines, Indonesia, Mexico, India all have obvious of examples.
Mexico City should be in extremely bad shape right now.
Here are the top 10 most densely populated US metro zones (per the 2010 US census; population per sq mile):
Los Angeles, SF + Oakland, San Jose, NYC + NJ + CT (isolated, NYC is the most dense), Las Vegas, Miami, San Diego, Salt Lake City, Sacramento, New Orleans
Also, Riverside CA is #12, Phoenix AZ is #16. Both have been largely spared.
Now look at the per capita Covid deaths in LA, the Bay Area, Las Vegas, San Diego, Salt Lake City, Sacramento, Phoenix, Riverside. Then compare it to the Covid Belt areas.
If New Orleans hadn't made the mistake of holding Mardi Gras, they would look like other urban areas in Louisiana and the south broadly and would have dramatically fewer cases (eg Mississippi has 1/10th the deaths of Louisiana with 2/3 the population; Florida has over 4x the population of Louisiana, with half the deaths).
The Virginia Beach + Norfolk area is #22 on population density. It has so few deaths it barely registers. A couple million people live in that area, there have been only a handful of deaths. Average highs are 61 degrees F in November, around 50 from Dec > Feb, then 58 in March. ~12-15 degrees warmer than NYC throughout Winter. It never sinks into the Covid Belt ideal temperature zone, comparable to Milan, Wuhan, NYC, etc.
Check out most of the major cities in Florida. They're doing extremely well. The Jacksonville area has a dozen deaths in a metro of 1.5 million. Tampa and Orlando have done similarly well.
It's way too early to be making any definitive statements over what area has been hard hit or not. All we know right now is who got hit by it first, not worst.
> As I see it, there are so few cases in California because of the measures that have been taken
How do you know though?
The flat curver movement has set themselves up so there's no accountability, no reliance on data, no proof that it's working or not working. Just repeating what other people have said and patting themselves on the back that it's working.
Sweden has less per capita infections than many other countries and they have no full quarantine just basic social distancing and hand washing.
We’ve had more documented covid-19 deaths in ~6 weeks than we usually have murders in an entire year and it hasn’t even peaked yet. We have no clue how many cases there even are because we’ve utterly failed to do mass testing.
Serious question: do you have any family, friends, or even acquaintances that you would prefer not to have 3-6 weeks of terror and complete misery with a non-trivial chance of permanent disability or death?
Do you understand that millions of people are now out of work and won't be able to support their families, businesses are collapsing, calls to suicide lines are up massively, and society is general is not functioning?
This is a complex issue. Using hyperbolic emotional appeals to drown out discussion is not the right move.
> Using hyperbolic emotional appeals to drown out discussion is not the right move.
But isn't that what you just did here?
> Do you understand that millions of people are now out of work and won't be able to support their families, businesses are collapsing, calls to suicide lines are up massively, and society is general is not functioning?
So let's do some math instead.
The last stats I had were that 5% of people who catch it will die without a ventilator, 0.5% will die with it. So suppose we go "fast burn" to try to get "herd immunity" as quickly as possible, forget about overwhelming the health care system. 80% of your friends, family, acquaintances, and coworkers will catch it, and 5% of those will die.
I reckon most people have about 500-1000 people they feel connected to. So think about your network: which 20-40 people do you want to die so that the rest can go back to work?
No, because I'm not drowning out the discussion, simply pushing back on the usage of hyperbole for pushing an opinion.
> The last stats I had were that 5% of people who catch it will die without a ventilator,
Your stats are way off and I suggest doing better research. They also don't factor in the idea that the virus is far more widespread than initially thought, and that these death rates only account for people that are sick enough to get tested in the first place.
> Your stats are way off and I suggest doing better research.
I've been reading [1] daily more or less since early February, as well as lots of things posted here. I'm certainly no professional, but I think I'm reasonably well-informed for a layperson. If you think there's something I've missed, I think you'd do much better to actually point me to a resource you think is better.
I realize that "number reported" is an issue, and varies a lot from country to country. But consider Germany, who have [EDIT: ramped up to 400k+ tests per week] now. The most recent numbers from the situation report says that Germany has 125k reported cases, with 3k reported deaths -- a death rate of 2.3%. EDIT: Also consider Korea, which is alleged to have instituted a massive testing infrastructure as well. Their numbers are currently 10,564 cases, 222 deaths -- again, 2.1% death rate.
It's possible that both the German and Korean numbers of cases are massively underreported, but it can't be by much. That puts the death rate with non-overwhelmed hospitals at significantly higher than 0.5%.
If you want to convince me that the death rate for overwhelmed hospitals is less than 5%, you're going to have to do better than waving your your hands and saying "but what about people not sick enough get tested".
EDIT2: Been challenged on the "500k tests per day", acknowledging that while I look for support for that claim.
EDIT3: I slightly mangled my numbers from [2]. The numbers from that are that Germany has been doing 160K tests per week since 20 March; and that the government's goal is 200k per day. [2] According to [3], on the week ending April 5, Germany did 393k tests.
Your mental model is mostly meaningless. There's no such thing as a generic death rate for a disease, because the death rate is dependent on numerous factors. You cannot compare the death rate between countries with different demographic profiles and ask "which is correct". How old are they? How fat are they? The idea that 5% of a person's social network is going to die is not accurate because social networks aren't evenly distributed. Most people don't have many contacts over 80 unless they're over 80 themselves. Most people will see very few deaths to people they're connected to. Old people will see a lot. And it's sad, but most of the people dying are already above life expectancy and close to death from alternative causes.
Hospitals being overwhelmed is an exaggerated problem. It's not happening in many places. Most hospitals only need to provide a small amount of care and can actually scale this up rather quickly. You hear about people being triaged in Italy, but you need to remember that the people being triaged are likely to die regardless of whether or not they're admitted to the hospital. Averages are not your friend here. If 50% of ICU patients survive, that does not mean that everyone going into the ICU has a 50% chance of surviving. If we get to a point that triaging is needed (I think dubious in major US cities), that does not mean fatality rates will skyrocket.
Social distancing has been pretty darn effective, and it's probably a good idea to cautiously continue. But we also need to be pragmatic.
> Hospitals being overwhelmed is an exaggerated problem. It's not happening in many places.
...because people are introducing restrictions to keep the number of cases down.
> Your mental model is mostly meaningless. ...Social distancing has been pretty darn effective, and it's probably a good idea to cautiously continue. But we also need to be pragmatic.
Ok, but at least mine I told you what the exact numbers are and where they came from. What are your numbers, and where did they come from?
You can't not have a model: you can either have an explicit one that you can reason about and question, or you'll have an implicit one you can't reason about or question.
You've waved your hand about why 5% death rate for a "fast burn" scenario is probably not exactly the precise number. I never said it was; but I think there's a pretty good chance it's in that ballpark.
You, on the other hand, haven't said what you think the death rate for a "fast burn" will be.
It is IRRESPONSIBLE to recommend a course of action without thinking through the consequences. Just wishing that 5% of people won't die isn't going to prevent those people from dying.
I'd like a 0.001% fatality rate in a "fast burn" scenario as much as anybody. If you can convince me that's a good number, I'll go around and try to convince others. Until that time, I'm going to continue going with the best guess I have, and a guess which lots of experts seem to be making as well.
> ...because people are introducing restrictions to keep the number of cases down
I mean, yes, I do agree that social distancing is a good idea and that we should continue to do so. I acknowledged that much. But my real point here is that hospital capacity can scale up significantly higher than you might assume. Average level of care goes down for each person, but that's mostly fine. We can't treat people for this disease, so all the hospitals are doing is trying to keep people alive long enough to get over it themselves. A half hearted benefit of this is that since there isn't much you can do, you don't have to do much to help people as best as possible.
> Ok, but at least mine I told you what the exact numbers are and where they came from. What are your numbers, and where did they come from?
When I say your mental model is meaningless, I'm referring to "which 20-40 people do you want to die so that the rest can go back to work". You're thinking in averages, and that's not the case. The CFR of any population is going to be determined, foremost by the age distribution. I don't know if this is still true, but a while ago the CFR in italy was lower in every age group relative to China but worse overall due to age group differences and simpsons paradox. The concept of death rate is truly meaningless. I'm not saying you're wrong, I'm saying its a pointless discussion. But sure, range of 0.5%-7% for a randomly chosen locale. Less than 1% average for those under 60 years old across the board.
For the record, I don't think rushing to herd immunity makes sense either, but there is a middleground.
> It is IRRESPONSIBLE to recommend a course of action without thinking through the consequences. Just wishing that 5% of people won't die isn't going to prevent those people from dying.
I think its pretty naive to say it's irresponsible to not have explicit threats on the disease but hand wave explicit threats on the economic consequences. I think it's better to let a 90 year old person die than to throw a 20 year old into poverty personally. Globalism is complicated. Depressions can cause famines, the rise of violent authoritarianism, and just general despair even if your particular society holds together. Poverty sucks, and it disproportionately hurts people who are already poor or in poor countries.
So I did mangle my numbers somewhat, thanks for checking. As of April 5th they'd done 1.3 million tests, found 95k cases, and had 1.4k deaths [1]. Presumably there are at least some people tested multiple times; so those 1.3 million tests don't represent 1.3 million people.
The only way to get the "die with the best medical care" number below 0.1% is if you have a million untested people who are sick.
If I was a proper statistician, with those numbers I could probably come up with models or estimates of how many possibly untested people there might be in Germany. My instinct is that number can't be millions, because at least some of those millions would be sick enough to go to the hospital, and then all of their connections would be tested and be found out.
But even then, what we really need is the "would have died without medical care" number, which is what the number would look like if we did a "fast burn" and let everyone get sick at once. For that number to be less than 1% (which would still be pretty dire), we need closer to 2 million unknown cases. I just don't see how 2 million positive cases can hide from the kind of testing Germany is doing. The same goes for Korea.
All models are wrong, but 1) some models are useful, and 2) you can't not have a model. If you don't have an explicit model, you have an implicit model.
I presented you a model; yes it's oversimplified, but it results in at least some sort of concrete answer; and you can actually examine where it came from and reason about how valid it is. You can make arguments for some other death rate or herd immunity rate. (I took 80% from the most recent article I heard on the subject, but previously I heard 60%.)
You also actually have a model in your head for how many people are going to die (or not die). But I don't know where it came from. I can't examine it or reason about it. If you were an old-timer who'd seen hundreds of pandemics, or a historical epidemiologist who had studied hundreds of epidemics, maybe your "gut feel" would carry some weight.
But since (AFAICT) you're a layperson like me, I'm not inclined to think your implicit model is going to be very accurate.
In the end no one will know if it was worth it since no country went in the other direction and just lived with it. The UK tried for a bit but then reacted harshly as the situation worsened.
Maybe not doing anything would've resulted in a few months of medical chaos and not much more, maybe it would've destroyed whole societies. But the polls I'm aware of show that the majority of people is supportive of measures nearly everywhere (I'm not aware of a poll that shows the opposite). In democracies, you'd expect politicians to act if the majority and experts support it.
You're right, but I'd classify Sweden as medium response. They still have measures in place, just not as harsh.
With poorer countries (which applies to most of Africa), I guess it'll take several months or years until we know what the excess death rate was. Esp. in rural communities, that data probably often won't be reported as a Covid death. Even Northern Italy had an excess death rate 2x as high as the reported deaths and they had all the attention.
Both these are tabloids and uses "considering" & "is looking at" just below the contradictory headlines. I'm Swedish and are browsing Swedish websites. Including the Public Service svt.se.
What new measures are they actually imposing? Neither of those articles has anything concrete.
The data both articles present for Sweden's death and infection rates also seem to suggest new measures might not be necessary (though admittedly the data seems pretty noisy; the recent drop in new deaths/infections could just be a fluke).
Sorry, I don't recall being democratically asked whether shutting down everything indefinitely was something I agreed with before it happened. Of course people will agree that it's a good idea when the media is blaring "PANDEMIC" at them 24/7.
"Of course" what? You're aware that different parts of the US have reacted very differently despite having similar national media blaring at them, right?
> But the polls I'm aware of show that the majority of people is supportive of measures nearly everywhere (I'm not aware of a poll that shows the opposite).
You weren't. But I'm sure pretty much all politicians got quick polls before enacting measures. That measures that strictly were enacted was only because politicians knew there wouldn't be large scale protests or riots.
Now I don't want to speculate why people are in favor. Maybe because they believe experts but that usually doesn't work well.. I guess public opinion during the outbreak is also going to be a heavily researched area for years to come.
You are correct that I have an emotional reaction to death, but I was not intending to spew a bunch of hyperbole.
Society isn’t a numbers game, it’s a shared set of values, and I find it appalling that we seem to be favoring the economy over human life. We have enough resources to take care of both, but chose to bail out corporations instead of people.
> we seem to be favoring the economy over human life
I really don't agree with this meme at all and the evidence doesn't support it whatsoever. The people that are hurt most by the shutdown are lower class service workers, not Wall Street stockbrokers. As I just mentioned, everyday people are hurting far more from the lockdown than from the virus. If you really cared about the average person, you'd want to get society running as soon as safely possible.
The idea that the government can support or pay for the salary of the entire/most of the population for a sustained period of time is also completely ludicrous and impossible.
The problem is that as the lock downs work, it's easy to lose sight of what could have been, they stop it getting out of control and it still looks bad as there was the initial clump of infections, but the abstract hundreds per day that are dying are still fairly remote for most of us as only 1%-2% of many of our populations got infected. One can still throw around figures of "it's less death than this" or "the lock down is causing X amount of economic + societal misery".
The scientific consensus seems to be that if the disease had just been left to run it's course, even with people being moderately careful given how infectious it is, it would have caused huge death figures. Perhaps that might be proved wrong when we see some countries that simply socially distanced instead of locking down, but was it ever worth the risk?
All these "well, it's bad, but look at the economic damage" have to be weighed against what could have been, not what is. And we just can't imagine this, we can say it, but how many of us can imagine 10,000s dead per day?
Your Aunt dead, a colleague dead and your best-friend's Dad dead, your Butcher's Grandmother dead, your barista's sister dead, a teacher at your primary school dead, your football team's goalie dead. And more, and more. Of the few hundred people you know you would have known several people who would have died, or the thousand or so you are a 2nd connection to you would have heard of many deaths.
On top of that all, New York and the UK only really have Italy and Spain to look at as any sort of predictor. They now have to watch just two countries to see what happens when they start easing the restrictions, and due to the massive lag between infection and hospitalisation/death and insufficient testing capacity, it's all still guess work.
Lift it a week or two too early, and you might have to go into another lock down in a few months time.
This isn't what the death statistics are showing, whatsoever. Unless your barista's sister, football team's goalie, etc. are all over 70 years old, it's extremely unlikely that they'd be dead. Your scenario is fear-mongering, plain and simple.
The Barista's sister would fall into the thousands (or even 10,000s) of 2nd connections you have, in which there will almost certainly be young deaths. The goalie might have had health complications. I personally know at least 2 people with diabetes, 2 with asthma, plus one post-cancer. Maybe I'm a little older than you, but many of us would know a young-ish person that would die (a quarter maybe if the 0.2% chance of 20-39 year old death is in the right order of magnitude).
Also, don't forget death rates would go up if a healthcare system collapses, which we haven't seen.
I think you're the delusional one, while your personal chance of dying is fairly low, you know hundreds of people, and those people know thousands more.
Are the chances of these people dying from COVID greater than other risks we take every single day, yet don't shut down society and curtail freedoms over?
Yes, for example covid deaths in Scotland are 1/3 of all deaths, deaths in UK:
"The Office for National Statistics said that in the week to 3 April, 16,387 people died in England and Wales, an increase of 5,246 deaths compared with the previous week and 6,082 more than the five-year average."
And that's WITH a lock down, way before the massive peak that could have happened.
It's like you're stuck in the wishful thinking stage the rest of us were in two months ago.
Yes, many people under 70 have died. Hundreds, perhaps a thousand, all of which are tragedies. People also die from a variety of other diseases, accidents, and other things on a regular basis in numbers that dwarf the coronavirus. Yet, we don't shut down society over it.
> How many of your family, friends, and acquaintances are you willing to put up for the experiment?
This kind of snarky comment is precisely the problem. I'm not "willing to put up my friends" for experiment, because this isn't some zero sum game with simple answers. As I have said a dozen times now: it is a complicated situation and this "but people are dying, so we have to be as draconian as possible" take is extremely shortsighted.
There are millions of people that will now have serious problems because of the total shutdown. Here's a number for you:
> 45,000 – or one in five – suicides a year worldwide to unemployment, with a further 5,000 deaths caused by the economic crisis.
45,000 people a year kill themselves because of unemployment. And that's just after 2008. We are apparently headed for a far worse crisis.
Have you considered the possibility that completely shutting down everything for months on end will result in more chaos and death than the virus itself? Even worse, this is entirely unpredictable?
The comment was not hyperbolic. Since you believe that, that means you don't believe the projections (or maybe the current statistics). That's fine, but don't respond by denigrating on the wrong basis. Instead of accusing people of exaggerating things as if they have some kind of agenda, just be straightforward and say I don't believe those numbers.
You've made a ton of huge leaps here. The comment is hyperbolic because it's using the tried-and-true tactic of "People are dying!!" to push their view and denigrate others'.
As I said above: it's a complex issue. The consequences of shutting the world down just might be worse than the death toll of COVID. At the very least, it's a discussion worth having.
People literally are dying. That's not the parent's hyperbole, it's a fact. Official projections from health organizations indicate trends will continue. Again, not the parent's hyperbole. If you think it's hyperbole then that means you don't believe the official death numbers.
And "it's not a hyperbole" does not mean "it's not a complex issue" or "the alternative is better" or "it's not a discussion worth having". By all means, have your discussion. Point out that it's a complex issue like you already did. And if you dispute the claimed facts, dispute them and bring your own facts. If you don't, then just don't falsely accuse people of exaggerating them. Don't sling mud at factual arguments made in good faith; it's not difficult for others to reciprocate.
Even if we are willing to accept a certain number of deaths in order for the economy (and many families) to survive, the problem is that our hospitals can't handle the number of sick people that will result.
You will have bodies abandoned in the streets, like in Ecuador.
I've read doctors have just been attributing deaths that look like Covid 19 to exactly that. Even without proper verification.
Also it's only what is reported. There could've been a million people with it in the US but nobody knew...and still don't.
I really agree that we used a tsunami to put out a campfire. There was no reason to close everything basically. If this was like a 25% mortality rate of all those who got it, then yeah, the response would've been appropriate. This is like less than a percent for the majority of the population, a few percent for infants, and a few extra percent for old people. Which already have been at risk just for the sake of being old.
This whole event is just the media at large and social media blindly following as well overexaggerating this "crisis." 2008 was a crisis cause a bubble burst and banks defaulted. This was something made up that really did not need to be this drastic.
Restaurant bookings and travel were falling sharply in CA even before the official stay-at-home policies[0], so your alternative is a world where huge chunks of the economy are still fucked.
Unless you want to force people to eat at restaurants, travel to conferences, host events, etc...
NYC too, to the point that the mayor tweeted encouraging "New Yorkers to go on with your lives + get out on the town despite Coronavirus", which did not age well even by 2020 standards.
The "disease" would be a lot, lot worse without the "cure" though. There'd still be really bad economic effects; there's no scenario in which everyone would just be going about doing business as usual pretending nothing is wrong while the news is reporting on catastrophically overwhelmed hospitals and how if you get to the point where you have serious trouble breathing, you're on your own and might easily die without a chance of being treated. People would be socially distancing of their own accord anyway, the main difference being this scenario has a much higher death toll since the distancing started way too late.
Well, the statistics are starting to show that if you're young and healthy, this is not much worse than the flu in terms of outcome. The hospitalization rate is also much lower than was reported earlier. Even just counting positive and confirmed test cases, this data is painting a pretty clear picture.
Here's the data out of new york city. You can see the chart showing hospitalizations and deaths per age. The trend is pretty biased towards old people. This makes me wonder if a more targeted response by the government would be better. The 2 trillion dollars might have been better spent.
https://www1.nyc.gov/site/doh/covid/covid-19-data.page
Well, spoiler alert, not everyone is young and healthy. In fact, the majority of Americans have at least one comorbidity for coronavirus.
> Covid for new york city has a death rate of about 75 per 100k.
So far. We're still experiencing hundreds of deaths per day in the city, significantly more than all other causes combined. Your analysis is vastly premature.
> So far. We're still experiencing hundreds of deaths per day in the city, significantly more than all other causes combined. Your analysis is vastly premature
Even if it's 150 per 100k, or even if it's 500 or 1000 per 100,000, is that too much? We need to establish an upper bound for the number of deaths we're willing to tolerate. It cannot be "zero". There is a balance between acceptable mortality and economic consequence that I fear few people are willing to discuss. The medical establishment's goal is to save as many lives as possible, and due to that strategy, they will go to any length to make that happen. I do not once see a medical professional saying "well we can't save all these lives because it would be too expensive". The concession seems to only go one direction: The economy must suffer at any and all cost to minimise mortality as far as possible.
So again, what is an acceptable mortality rate? 2%, 5%? A realistic upper bound that's a fair trade off between economic collapse and mortality rate needs to be decided.
I would say that doubling the death rate sounds bad. There is a point to be made that the main effect could be more on the side of reducing the high percentiles of lifespan rather than a long term increase in the death rate.
Also I think that setting an acceptable death rate is missing the point; depending on the illness anything between 0% to 100% is "acceptable" if there is nothing we can do. A more appropriate measure (IMHO) would be a something vaguely like lives_saved^2/effort.
In particular this need to consider the famous flattening the curve and the fact that for some categories of people the mortality rate can be very high.
On the other hand (and also on a more amoral side) it would be interesting how many alive man-months COVID-19 destroyed, as in how long was the average life expectancy of the people that died from it. I feel like this would be both harder to measure and more significant in term of sociological damage.
(in general this kind of conversations are hard as it is easy to insinuate that old people have less value which is both completely false and somewhat true, I personally do not possess the talent of walking this fine line of language)
>The economy must suffer at any and all cost to minimise mortality as far as possible.
Sounds good. After all, death is irreversible while economic damage is not.
>So again, what is an acceptable mortality rate?
I'd phrase it more like a flattened curve. Rather than focus on a specific mortality rate, the bound to reopen the economy should be something along the lines: when the curve is flattened enough so hospitals can deal with the incoming infection rate. So this would be local to an area (city size, maybe regional) and would also adjust based on local conditions. Infection rate low enough, open the economy a bit more. Infection rate trending up, close the economy a bit more.
If that doesn't result in economy numbers that make the billionaires happy, too god damn bad.
Maybe free market uber capitalistic unregulated invisible hand economic theory needs to be rewritten or adjusted for new realities, including a section on why exactly lower wage workers (retail, service) are expected to risk their lives so the economy built on top of them, the one in which the rewards mostly go elsewhere, can function.
This goes both ways, though. If you act early-- and way over-react-- and it works, you get to claim to be the savior of the country, even though the reaction was disproportionate.
But we have other countries that didn't react at all and their crematoriums have been running non-stop, like Iran, China and Italy. We also have NYC, which has brought in mobile morgues for their dead since the standard system can't handle the overflow. Why are we acting like we don't know what outcome we are trying to defend against?
You can't "disprove" overreacting, but you can disprove saving the country. Case in point, Italy was not saved. What would overreaction look like? Shutting an entire country down back in December? If your definition of "overreacting" is "shutting down a country before there's a single case", you can definitely prove or disprove that.
This is true, but also unhelpful. We all make significant choices all the time that cannot be proved effective, these are heuristics and not scientific theorems.
The gist is that this is more like avoiding rock climbing because you don't want to fall to your death. It's not likely that you fall to your death rock climbing, but it is MUCH less likely if you never climb. But, you can't know the future, so you can only take actions that are either right or wrong in hindsight.
Point of clarification: Are you saying that there's no way to disprove your claim of being a savior? Or no way to disprove the reaction was disproportionate.?
When you enact a bad policy, you can always claim it would have been worse if you hadn't acted. It's not like we can go back in time and see what would happen if the policy wasn't enacted.
The concern I have is the endgame with shelter in place rules. I'm fairly convinced they're working (although not completely so), but what happens when they're lifted? What is the timeline for doing so, and under what conditions? What do you do to prevent the infection crisis from hitting after lifting the rules?
There's already been huge economic impacts, and everyone seems to assume once this is all lifted things will be normal. But without a vaccine or systematic antibody testing, will we just end up delaying the worst of the virus?
My fear is one of two things will happen: either we will have done all this economic slaughter with the lockdowns and still end up with the direct effects of the virus, but delayed, because of lack of herd immunity; or we will do this indefinitely and the economic casualties will increase proportionately.
I'm not saying the lockdowns are or are not the wrong thing to do, but I do feel like doing them without a clear plan for getting out of them is. I also feel like in the absence of these plans, its unfair to compare no-lockdown policies to lockdown policies in current casualties because those places may just be experiencing pains that lockdown locations have temporarily avoided. Places with lockdowns too late may unwittingly be similar.
> I’m definitely in the camp that “the cure cannot be worse than the disease” itself. Sitting in California where there are so few cases makes me wonder if the economic toll is totally worth it. Seems like we’ve used a tsunami to put out a campfire.
You do realize that there are so few cases because of the lockdown, and otherwise those cases would not only be an order of magnitude higher, but also much much MUCH more likely to result in death because the medical system would be entirely saturated and unable to admit 80% of the people who show up ?
> those cases would not only be an order of magnitude higher
An order of magnitude is a week of the natural virus spread. How long has been the lockdown there? Two weeks would mean imply in a two orders of magnitude difference.
Presumably the cases are so low precisely because we have enacted these measures.
If we had not done that we'd probably look more like New York right now.
The more effective your measures are, the more it is going to look like they were unnecessary.
Or to reuse your metaphor: A campfire can turn into a wildfire really quickly. If we hadn't thrown the tsunami onto it when it was the size of a campfire, we might have gotten a wildfire burning down the whole state.
New York was only a few days behind California. Density matters so much that it's going to take a long time to arrive at good answers for how much lockdowns affected this, and there will be very strong pressure for a long time not to arrive at any conclusion other than "it worked", regardless of whether that's the truth. Which, obviously, it might well be!
A few days is a very long time when you're talking about an exponential curve. Shutting down a few days earlier relative to the start of the outbreak can easily halve the total number of deaths. And CA shut down 4 days before NY on an absolute basis and even earlier than that on a basis relative to the progression of the spread of the outbreak.
The economic toll of shelter in place vs enforced social distancing + mask wearing while keeping most businesses open is huge though. I’m not convinced quarantine is/was necessary for most of the country, including California.
I'm not sure the economic toll is necessary. We just haven't bothered to try to mitigate it. It's like the lockdown itself; do nothing for a long time, then we'll use a nuke.
The question will be what will happen in 4-5 months. If California manages a total lockdown and by July-August is back to being normally operative then the lockdown was a good choice.
On the other extreme case there might be so few cases that there will be zero herd immunity in September and a second even worse lockdown might be needed again.
Calculations for operating "business as usual" in the USA gave ranges from 1.7 to 5 million dead with extremes of 4-8% death rate (13+ million).
This is based on a collapsed health care system causing the vast majority of cases requiring ventilators to result in death.
Roll two die, if you roll snake eyes you would die.
But, in my experience, most people saying things like "cure cannot be worse than the disease" are young, healthy and have access to good health care. Would that describe you? My father is in the 18+% fatality zone.
I remember people screaming that it would be worse than 9/11 and Pearl Harbor two weeks ago. Still waiting on anything that level of sheer panic and pandemonium. Sadly I don't think anyone is going to be willing to admit they were wrong anytime soon.
In a population of 325 million, not really. I remember back in March when the media was saying at least 6 million people would die and that bodies would be piling up in the streets. Currently seems like the biggest threat will be unemployment and continued economic downturn
The fun part about this virus is that it works on a 10 day delay, so you can either prevent infections long before it has a chance to start killing people, or you can start dealing with the epidemic once it's too late to stop it.
Also, California ICUs are at 80% capacity, so there isn't that much room left to relax unless you want them to get verwhelmed and start sending people back home to die.
The numbers there are funky. Best guess is that their "total available" beds are the estimated number of statewide beds that would normally be empty, and the "ICU beds needed" number is just for Covid patients.
> About 1,178 confirmed and 374 suspected COVID-19 patients were under treatment in California’s ICUs on Tuesday, according to the latest figures from the California Department of Public Health.
> On a typical day, about 58 percent of the state’s ICU beds are occupied by patients needing treatment. Although the exact number of ICU beds currently in use was not released, the increase in COVID-19 cases suggests that about 80 percent of the ICU beds in California may now be filled.
> In California, where the confirmed number of coronavirus cases was 2,181 on March 23, there are 7,345 ICU beds. Eleven counties have no ICU beds or no hospitals at all.
Given how quickly forecasts were cut from 200,000 to 60,000 it is likely those estimates of millions of deaths were never correct. However, for the sake of argument lets assume that it was accurate and 2 million would have died. We can estimate the value of those lives saved using the value of statistical life that the EPA has for evaluating the effect of regulations[1]. Adjusting for inflation gives a value of $9.5 million today. Saving 2 million lives at 9.5 million per life gives a value of $19 trillion. The 2008 Great Recession cost Americans $22 trillion[2]. Many expect the recession now to be worse than the 2008 financial crisis[3][4].
It was probably the right thing because it was conceivable to end up with 30 million pneumonia victims and no way to treat them all. But we shouldn't forget we had to waste 0.1% of all 328 million lives (one month/78.54 years under house arrest) and counting.
> But we shouldn't forget we had to waste 0.1% of all 328 million lives (one month/78.54 years under house arrest) and counting.
It's only a waste if you need to waste it. I'm sure plenty of people are using this time to be productive doing things they would otherwise not have the time to do.
I’m not under house arrest. I’m working from home with my family around me. I’m actually enjoying it for the most part. We’ve picked up baking, started going on walks together as a family. It’s not anything like dying for a month or whatever weird equivalence you’re trying to draw.
They have made a calculation based completely on productivity and effect on GDP. The USA lost 1 month of "critical" productivity and we only have time with children, a resurgence of baking and netflix watched lists to show for it. That you and your family weren't part of the "dead" statistics didn't even factor into their equations.
My fear is that 2-3 months of lockdown isn't a cure, it turns into on-and-off lockdown, herd immunity is never established because immunity wears off in 2 years, and a vaccine is 2-5 years out.
Ignoring the economics, preserving life takes on new meaning if you count a every locked down day as taking away an hour of life from someone. Take the Bay Area. At 7.7M people, every day, there are 11.7 lifespans wasted by lockdown. There have been 3.2 covid-19 deaths per day.
There's no basis for your fear that immunity would wear off in two years. Unlike the cold and the flu, these coronavirus strains do not mutate quickly enough to cause quick loss of immunity. It seems more akin to chickenpox, which you can only catch once (and shingles doesn't count).
common cold = caused by coronaviruses, COVID-19 = an uncommonly deadly coronavirus
RNA viruses have a faster mutation rate than DNA viruses.
Chickenpox = DNA virus, Coronavirus = RNA virus.
That Chickenpox is a DNA virus is why, like HIV, it can survive in the body for the long term and re-emerge decades later as shingles. DNA has a double helix which has error-correction and is more stable. However that makes it also physically larger and more complicated. RNA is small, sloppy, and cheap.
So I do not believe your comment is factually correct. Sadly, the COVID-19 causing virus should have a high potential mutation rate similarly to all RNA viruses.
Nope. The common cold is a catch-all term for over 200 different mild upper respiratory viruses, the clear majority of which are not coronaviruses. The most common strain of virus causing the common cold is a rhinovirus, which does have the property of mutating well and thus being hard to develop a resistance to. It is true that some of the common cold strains are coronavirus, but not most of them, and regardless, they aren't COVID-19 (which is of recent zoonotic origin). Preliminary analysis of COVID-19 indicates that catching it once is likely to confer life-long immunity.
It seems like you know more than I do -- that's good news, thank you for correcting me! I was wrong about coronavirus causing all forms of the common cold. They only cause 15%, whereas rhinoviruses as you say, cause 30–80%.
Still, "the Coronavirus" COVID-19 causing virus is an RNA virus correct? Those mutate rapidly & in fact, evading immune systems via rapid evolution, is part of what has allowed RNA viruses to exist & thrive.
There's a lot, lot, lot more to it than simply saying that it's a DNA vs an RNA virus and that one categorically mutates faster than the other. The most relevant factor here is that COVID-19 only has a single strand of RNA, whereas e.g. influenza has 8. This allows a lot more mutation from pieces of RNA swapping around between different strands, which just can't happen on COVID-19. You can sort of think of it as analogous to sexual vs asexual reproduction; the former has a lot more potential for variation. Plus there's factors relating to the specific mechanism that coronaviruses use to attach to animal cells that make them less capable of mutating into any sort of a different shape that's still effective at all.
And I'm nothing close to an expert on any of this. But refer to sources, e.g.:
> My fear is that 2-3 months of lockdown isn't a cure, it turns into on-and-off lockdown, herd immunity is never established because immunity wears off in 2 years, and a vaccine is 2-5 years out.
I wonder if any models take into account the availability of drugs. I wonder because (perhaps because I studied pharmacology back in the days) while not effective as a vaccine, proper clinical management of this disease with drugs would help a lot in helping hospitals.
Instead the media seems only to focus on a vaccine (which is putting all eggs in one basket, if it fails).
Most of the drugs being trialed are repurposed drugs, so we can't expect miracles. Scant evidence (at least until the trials end) say that giving them early on may lead to better response.
Currently, there are a number being tested by WHO and other trials, I list the ones that come to mind:
- remedisivir (repurposed anti-Ebola drug): several trials to end by May-June
- lopinavir/ritonavir (anti-HIV drugs): those delivered bad results in a recent study, but those so far were (a limitation noted by the study authors) on patients with rather severe sympthoms, so it's still undecided whether they're effective or not
- Chloroquine family (chloroquine/hydroxychloroquine, with or without azithromycin): some preliminary studies may have shown interesting effects, but there were small sample sizes (also in another study which apparently was not very successful). U of Minnesota started a largish (3000 people) trial to see if it's prophylactic for immediate post-exposure to the virus. Another one started a couple of days ago to test the combination with the antibiotic (whose reported purpose is to fight off secondary infections)
There are others with less spotlight such as favipiravir, which provided a (modest) improvement in a small trial in China, and it's now part of a Phase 3 trial in Japan, or whole classes of drugs to combat the secondary but clinically important sympthoms like overinflammation (which occurs in some patients) like tocilizumab.
A lot of eyes are pointed on the chloroquines because they are already available (although they do present significant side-effects).
Neither of these drugs (or many others, see for example https://biocentury.com/coronavirus for some lists) will likely provide miracles. What the trials will do (hopefully!) is to help understanding how early they must be taken, and how effective they are in clinical management. An advantage, however, is that they will be available faster than a vaccine (modulo some non trivial issues like mass production).
You can start worrying about that when the economic impact caused by the restrictions kills more people than the virus would without the restrictions. Sure, unemployment can worsen mental health and cause suicide indirectly, but those numbers must be nothing compared to the deaths would be caused by the virus without the restrictions.
This is relatively true, but it is also completely missing the point. Iperrationalism is not a substitute for ethics. In particular I see no reason why a headcount should be an obviously correct solution to the trolley problem.
You are right, but at a larger level the economy itself may be a cure that kills the patient. Pursue economic growth even if it doesn't make us happier and destroys the natural environment. In that sense, the current events can be seen as the antidote to the cure that was harming the otherwise healthy patient.
We aren't worried about economic growth. We are worried about livelihoods. The type of economic devastation that leaves people unable to put food on the table. The civil unrest won't be pretty.
Don’t we need to see the end results to know? If we can somehow bootstrap the economy quickly and there is pent up demand, maybe this is just a short temporal blip with relatively limited impact. If it’s the next big depression and takes 30 years to come out of then there certainly be plenty that will say we should have done nothing and just taken it on the chin.
I’m predicting that we will panic at the financial numbers, open things up in June and then this fall there will be a bigger second wave, hopefully we stock the pantry with PPE and everything the medical professionals need in the mean time. It will be a Hail Mary, hoping we can get a vaccine in to play by September
It’s not “forbidden” for y’all freethinkers or autodidacts or whatever the term today is to debate such things and to make the claim is dishonest.
You’d have to find somebody to debate with, however, and most people are not particularly interested in “hang your Grandma for my stocks”. That is not a restriction of debate, it’s the social dumpstering of people beyond either statistics or empathy and that’s a feature and not a bug.
You seem to believe that 'stocks' are some abstract entity and are relevant only to the lives of people without grandmas to hang.
We don't live in a vacuum. Economic activity is not some cute thing people do in their free time. Recession also costs lives, including those of some grandmas.
Yes, and one of the interesting questions would be *why is our government so much more effective at propping up "the stocks" while everyone loses their job? There's miles of room for argument over the economic policy response.
But instead what we get is "the economic effects aren't worth it" where none of the assumptions are quantified.
I submit that you don't know what gaslighting is. Further, I submit that you're attempting to coopt the language of marginalized groups to buttress a weak and selfish viewpoint.
You're right, the stakes are civil society. Which you no longer get to claim you have when you sacrifice the weak and the sick to Moloch for pseudofictional accounts in a computer somewhere.
We must take care of each other, it is our basic obligation as citizens of a civil society, and this is the only way we can do that right now.
Hmm I'm not as sure, and I'm not sure why other people are so sure. People seem to generally respond 'of course not' and get offended that I've suggested it. I'm not really sure why.
On the off chance that you're saying this in good faith? Generally speaking it's because Just Asking Questions comes with motives that suck. Maybe you're the one whose don't and you are tragically caught up amidst the sewage flow of "screw 'em" types, but playing the percentages on bad-faith argumentation is pretty safe. Trolls and other turds make a point of wasting people's reserves of good faith as a tactic to dominate discourse--there's no reason to let them do so. Flat dismissal is the milder form of "block and move on".
I'm just as confused. It's prompted another strong reaction in you but I genuinely don't get why. I don't know what motives you think I have, or why I might be arguing in bad faith, or why you're talking about trolls and turds (?).
Why is it so wrong to ask 'are we sure we're going the right way - this way seems to have a lot of problems - are we sure the other way has more?' Some people literally kill themselves when they become unemployed. We have millions of new unemployed people.
You say it's not forbidden but you're comparing me to a turd for doing it. Why does it cause people to abuse me?
We are confident the other way has more problems and more outright destruction because the other way blows up our hospitals and everyday life becomes nonfunctional anyway.
This is my last message in this subthread because your misreading of my post to put on a hairshirt has convinced me that you are not here to discuss the topic in good faith. HAND.
Millions of people would have become newly unemployed regardless, as a result of the pandemic. The pandemic is an ongoing global catastrophe. Refusing to take efforts to mitigate it doesn't mean it's not still a catastrophe. Social distancing was always going to happen regardless of whether it was mandated. People are rational enough that they won't put themselves into close proximity with others if it could easily mean death (especially because of how overcrowded the hospitals would be).
There isn't a country on Earth right now that isn't doing social distancing of one form or another. It's an inevitable consequence of a pandemic; it's not some elective choice that we made.
I know next to no one who ever uses "Stocks" to pay for everyday costs of raising a family or just getting by. I am aware that, yes, retirees stand to lose a lot; which is tragic, and also why I downright disagree with the idea of privatized retirement accounts based on held and sold equity based on the assumption that growth will always occur. In fact, the architecture of such a system is the driving force in the propagation of cross-generational fiscal inequality, and will inevitably result in a slow inexorable trickle up without an active mechanism in place to ensure that wages grow by the same factor that technology obviate the need to have someone do a job. In a crisis, someone is inevitably left with the empty bag as things spiral.
That said; the economy taking a dive is preferential to the population doing the same. There will always be work to be done as long as we wake up every day; and the trick is figuring out how to adapt to new circumstances to get that done.
For instance, now would be a fantastic time to train additional medical personnel or build additional infrastructure for them. Research efforts into mitigating the pandemic are also highly desirable. Logistics solutions to enable financial compensation and product dispatch from community kitchens restauraunts, etc without necessitating physical congregation are sure bets, and just about anything that isn't dependent on getting a bunch of people all in the same place at the same time is also good.
The economy is perfectly fine if you don't assume there is an implicit guarantee that the same endeavors that were profitable yesterday must remain so always. What we're experiencing is an economic record scratch and pivot.
Perhaps for a while most actual economic transactions will be centered on "because it needed to be done, and the government is subsidizing everything until we can find a way to get private enterprise running freely again." Who cares? Life'll have to keep going. If a Jubilee has to happen to reset things... Oh well. It'll suck; but no one asked for this.
The type of work to have people thrown at it is what has changed, and the acceptable methods of execution have been altered. I doubt we'll see a wholesale collapse of civilization by a long shot. What'll be far more interesting to see is if we'll weather the transition to less globalised work smoothly or not. The predictability of life just took a hit; that's all. Time to show how to change. No?
Just a few months into this thing, infections still accelerating, and food supply chains are showing signs of widespread stress and deterioration. Everything from harvest to logistics to stocking shelves is being fretted over by the people in charge of them.
I could be wrong, but I'm going to guess you have no idea what you're talking about on this particular topic.
I see it brought up quite a bit on HN, and yet... very rarely with much rigor.
It is often of this sort of "I feel that the economic costs will be worse than the human life costs" without any hard backing to explain that. Challenging the opinions of the people getting airtime is fine, but only if you've got the material to back you up.
...what? Who would wish for this? Maybe you're pattern-matching to something for which you have a political response, without actually listening to the worry that is being expressed.
I understand modern media is slinging fear and outrage because that's what gets clicks, but their whole business model is anachronistic. I've watched previously reasonable publications go from honest fact-based reporting to pure narrative/agenda based drivel. Like wow, Washington Post, what happened bro?
If most media organizations went out of business from the impending COVID economic catastrophe, I think that would be karmic justice. They did their part to cause it after all. The stress they've induced, the fear they've sown; they've earned every bad thing that befalls them.
It's time for a new paradigm. Long form journalism as we knew it is gone. But there are other formats ascending. Podcasts, Youtube series, etc are all possibilities to fill the void of in depth reporting. Time will tell if someone can figure it out, but our current media is a problem, not an answer.
In related news I have noticed that most things I search on Google don't show any ads at all. I went hunting for it and found that common household items are showing ads, but other things don't. And most certainly there is no obnoxiousness like an entire page of ads before the content.
Well, ad revenue is gonna be off a cliff in the next quarterly earnings, but I don't think that's going to be a surprise. Good thing they have so much cash saved up.
IT's clear, though, that GOOG and FB are losing major ad clients. The entire travel industry is not advertising and they spent bank trying to convince you to try some new hotel chain.
For a few quarters. They'll survive and be back where they are now when the economy bounces back (whenever that may be). They could take a 100% cut for several quarters without cutting expenses. Small ad companies are the ones that will really suffer. They don't have Google's deep pockets and diversification.
The current online experience is not remotely possible without ads. I'm willing to wager that the vast majority of content that you consume online is advertising supported, not directly supported by you. All of that is gonna start going away without advertising revenue.
Facebook will be in a great position with people having more and more phone time due to the quarantine. Might be a short term hit but a big boost down the road
Facebook doesn't live off views, they live off ad spend. Unless people continue to use it more when they have to go back to work, I don't believe FB will profit here.
Big tech companies like Google and Facebook are seeing record usage (i.e. increased costs) at exactly the same time that advertising revenue is plunging. YouTube watches are at record highs while pays per view might be at record lows. This just means that the expenses go up even as revenue falls. It's not a good thing for profitability.
That's why they've stockpiled $105B and $55B in cash respectively, though. Facebook could run the company for 1.5 years if their revenue went to zero; Google could run it for 2 years. They know how the business works and position themselves to weather and profit from downturns.
Some weaker shareholders may sell if they're only interested in quarterly numbers, but in the long term their revenues go back up to what their userbase justifies.
Maybe I am missing something, but how will it be a big boost?
Most users who use Messenger, Instagram and FB already are familiar with the platform. Them using it more during the lockdown is not introducing them to new features or new content.
It is unlike a product like Netflix, where you delve more into their content (ie international stuff u may have not ventured in) or Zoom, which some ppl may not have known about previously.
It's not funny, it's just tired and repetitious, and HN discourages joking around anyway because it leads to low quality conversations and contests over who can be funnier instead of who can contribute the most meaningfully to a conversation.
If you think a comment is inappropriate, flag it. Don't complain about it -- the guidelines ask you not to. Just flag it.
I found that guideline when looking for the 'discourage joking' guideline.
I never found the joking one, though. I don't think that it exists.
I sort of get what you mean that it's discouraged, but I don't think it's something as broad as 'joking', more like "Jokes require substance and relatability to the topic, class, and cleverness".
My larger point here is that everyone on HN knows about ad blockers and is using them if they want to be, so it's tired and repetitious to keep seeing the same smug "Well why are you even seeing ads, just use an ad blocker" comments. The ads matter, even if you aren't personally seeing them. Ads are what funds the majority of content online. Most people are still seeing them. It's reasonable to have a discussion about ads, and responses like "Just use an adblocker" are just thread derails, as we're seeing here.
It's also not 100% a joke, if you really think about what that post was saying. I'm betting most people on this site don't get the 'regular' user experience, because we are more likely to use alternate search sites and ad blockers than standard users. Honestly, had the original poster not pointed out the change in ad placements, I never would've known.
And that now has me thinking about what kind of ads people like my parents are seeing, and how that informs their worldview.
"Milk it?" This is the biggest worldwide pandemic in over a century. It's going to fundamentally reshape society for many years to come.
You can't bury your head in the sand about this. Frankly, in comparison to this, almost nothing else is even worth mentioning. And anyway, it's not like there's sports to cover. Almost nothing else is going on besides the pandemic because everything was shuttered to fight the pandemic and even that is just barely enough.
What a ridiculous comment. God forbid LA Times reports on the state of the country; the pandemic is affecting everyone significantly everyday, it would be laughable if their pages weren't filled with COVID news.
It's mostly just every news outlet rehashing the same top stories of the week slightly differently. I get local news items running things about their area, and pieces about the state of things periodically.
As it is now it's just overwhelming to look at any news.
It doesn't help their case that they massively publicise things like panic buying, knowingly causing the issue to spread.
Yeah, the Guardian and some of the other British papers have been complaining about how advertisers are refusing to run ads on Covid-19 related articles and how terrible it is that they're not funding journalism: https://www.theguardian.com/media/2020/apr/01/newspapers-to-...
Not sure if that isn't just an easy way for companies to save money. Not all companies want to go around telling others they're struggling. Cutting ad budgets online or with newspapers due to Covid can be an easy way to cut expenses without getting public attention.
Quite the opposite. The ads I still see often advertise how these companies can help during Covid 19. The only companies making money at the moment are those that help people work from home or manage their life and business despite the virus. If done right, that can be a powerful message.
And I don't think many companies are concerned appearing next to a Covid article, they're ubiquitous anyway. They just need to save money and online marketing can be cut within minutes.
Is there a good news site worth paying for today that actually has ALL news. It infuriates me that when I go to CNN.com's "news" site, there are ads at the bottom with things like "Before you review Amazon Prime, read this" and "America's #1 Stock Picker: 'Must buy now'" How can anyone be okay with this?
This is like picking up an astronomy journal that has ads in the back for psychics.
Its not just CNN, all of them are doing it. Another really bad one: EBay!
At this point we need to realize that websites are just placeholders for virtual billboards that they then sell to advertisers. It's a really bad incentive for them to add to their website, as it fundamentally changes their revenue model. It's no longer about (as an example) making sure you find the right product (and lots of it) so that they can make a large cut out of the sale. Instead, they prioritize "eyeballs" and ridiculous page after page views of exactly the same products because they get more ad-views that way.
CNN used to be my preferred news site but its turned into garbage as you mentioned. I tried to read a lost this morning about antibody tests and gave up when I faced 2 ads, 2 stock pictures, and an image of the author before I had made it to the 4th sentence.
Would gladly pay a reasonable amount of money for a news site.
Upon closer inspection I see that cost per click is down quite a bit. But the increased traffic makes up for it.
Strange, I would think that in the current times, the value of a visitor is higher for many companies. If they sell digital goods and services, people should have more time now for those.
My understanding is AdSense is based on click-throughs and sales, which will be more reader-dependent than product-dependent.
How do you feel your reader demographic stacks up against the LA Times?
AdSense tends to be only certain types of advertisers. I can't say that I've ever seen a concert ticket or movie advertisement in an AdSense window, but I've also been running ad blocking tools for quite some time now.
At larger revenue levels, a lot of advertising deals may be more direct. For example, perhaps a major band advertises their show dates directly with the Times. Bands are currently putting the kibosh on their tours, so all of that revenue goes to zero.
You're not even in the position to see the change, is the issue. The cost per click on all these ads could be way down from what it was a couple months ago and you'd have no idea.
Do we know how much of their ad revenue is from ads on their website and ads in the paper version? From what I have seen from other places it is ads in the paper version of newspapers that are hit the most
I think what is even worse is what recovery looks like. Seems like we are going to be recovering for a very long time. We don't even know how deep the wounds are yet.
We did have a similar Artie and discussion yesterday about how people making videos for/on Google see the viewing skyrocketing and ad-revenue collapsing. Nobody is selling this nobody advertised, plus the (thank you - I haven't thought of this) when crises hit, the ad budget is the first one to get slashed.
Are newspapers going to start selling subscriptions without advertisements and trackers? I would love to pay for one. I recently canceled my subscription to my local paper over the unnecessary tracking: https://twitter.com/mcculley/status/1247247733133660160
Not really relevant. Equities are completely divorced from reality at the moment. FB and GOOG could guide down 2020 revenue by 50% and the stocks would pop AH because $6T new money has to find returns somewhere.
We've already been seeing this to some degree with harder and harder paywalls--which mostly don't work besides lucrative niche and global brands. But I suspect we're increasingly headed towards a case where quality content is only available to those willing and able to pay for it.
Yep. Maybe we move to a model where low quality/#FakeNews is free but quality costs and, presumably, you then move to a point where pooled subscriptions are a thing under that model. And it costs a substantial amount of money or you get it through a library. There's a lot less accessibility under that model, especially for those that don't really have disposable income. There's also the question of whether enough will really pay for the quality. But it's certainly a scenario.
e.g. you pay $100/month for an all-pubs subscription which is not all that out of line for people who pay for newspapers or DirectTV.
>Maybe we move to a model where low quality/#FakeNews is free but quality costs
Are you being facetious with the fake news reference? I don't know what the answer to this problem is, but I hope it isn't a system in which we just lie to poor people and they can only get the truth if they pay up.
Prestige newspapers might not have been widely available for free, but there were certainly credible news sources that were. Free over the air TV and radio broadcasts were once the primary news sources for many Americans, but unfortunately the quality of both has declined. It is a chicken and egg problem so I don't know which started to decline first, but easy access to high quality news is important for an educated electorate which is crucial to a well functioning democracy.
>Are you being facetious with the fake news reference?
Not really. Broadcast news is ad-supported too--hence the decline in quality. You either have subscriptions--ad-supported, or taxpayer supported--as has been historically the case in the UK. So, yes, if ads don't work, either only the wealthier get access to higher quality news, people use libraries (good luck with that), or the government funds (which has its own source of issues).
Ok, I understand your reasoning. The use of the specific term "fake news" rubbed me the wrong way. That term is linked with malicious propaganda so your initial comment called to mind dystopian ideas of having an underclass that the rest of society agrees to keep in their place through lies and deceit.
There are other options beyond just ad supported and tax payer supported. You can make news reporting a requirement of other government deals like what happened with over the air TV. You can do some sort of patronage model. That can range anywhere from a single source like people expected Bezos to handle WaPo, to the NPR model over numerous patrons, to the early internet model of still selling subscriptions but not putting the news behind a paywall. I'm sure there are plenty of other models out there too.
In France, where I live, there have been calls to institute a "content tax" that would be redistributed to companies that produce content. In exchange, there would be no more laws to prevent piracy. That means that torenting/reading/listening to everything would be legal whatever the means but you'd have to give the state X$/month that are then redistributed to companies based on some factors.
That could also apply to news companies or to journalists individually.
This reminded me of the ROMS and the allOfmp3 saga of years ago. That site was a decade head of it's time an "explouting" a Russian law, but it showed exactly this. When contend per se has no differentiation value, companies have to compete on the delivery method, and we get amazing experiences as Netflix or Steam or Tidal (or allofmp3 arguably).
About the only US publication that seems to be making decent money from subscriptions is the New York Times, and I suspect they're at least partly trading on their name. The quality of their reporting... well, let's just say that I didn't expect to see the day when Snopes ended up debunking a conspiracy theory about the US president started by the NYT: https://www.snopes.com/fact-check/trump-profit-hydroxychloro...
That isn't a debunking of the NYT's story. It is a debunking of an interpretation of the story that many made due to either news illiteracy or malicious intent. That line got shared all over the place out of context. In context it was not the focus of the piece and was instead buried in the details as a disclaimer regarding the larger issue of who profits from this drug. Snopes isn't disputing anything actually reported by the NYT.
I've come across so many terrible and one sided Snopes articles. This is why all the talk of 'regulating' fake news scares me more than the fake news.
Does every slant need to make their own credibility machine now too to keep up?
(Not making a statement regarding this particular link, just personal experience in other areas I'm more invested in. NYTimes went off the partisan 24hrs news cliff long ago and are just burning old reputation at this point, it's becoming old hat.)
The focus of the piece was, to quote the headline, "Trump’s Aggressive Advocacy of Malaria Drug". The article leads into the claim by talking about how that advocacy "has raised questions about his motives". Literally the only reason to mention Trump's "small personal financial interest in Sanofi" in this context is to suggest that interest is, in fact, his motive. Everything leading up to that paragraph is background recapping of stuff people already know; the article is structured with this as the key point. Crucially, the New York Times piece also omitted to mention the one piece of information that made this conspiracy theory utterly ridiculous and that Snopes used to debunk it: just how tiny that financial interest really was.
Now, a few of the more cynical and distrusting people did realise that probably meant his interest was so small that the narrative the Times would pushing would fall apart if they mentioned actual numbers, and they were right - but all the people who trusted the most respected and prominent paper on the planet not to mislead them into a nonsensical conspiracy theory took that narrative as it was intended to be taken and spread it all over social media.
Much of government, including elements somewhat more capable than the press, manages not to be absolutely partisan: police, military, courts, intelligence, inland revenue, the post office.
Just curious if Google has suffered similar level of revenue damage. If so it would be really bad since they got a hundred thousand people on paycheck.
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Rob Corddry in 2004 gave the similar "facts themselves are biased" and "facts in Iraq have an anti-Bush agenda" on Jon Stewert's Daily Show:
Corddry: How does one report the facts in an unbiased way when the facts themselves are biased?
Stewart: I'm sorry, Rob, did you say the facts are biased?
Corddry: That's right Jon. From the names of our fallen soldiers to the gradual withdrawal of our allies to the growing insurgency, it's become all too clear that facts in Iraq have an anti-Bush agenda.
A quote by a liberal (Krugman) writing an opinion piece for the nytimes is hardly an argument. He even had to follow it up to specify that they had a center-left bias.
Journalists in general have been covering up stories where it not convenient for the narrative, have done hit coordinated hit pieces on members of the public and are generally a bunch of scumbags. No I won't ever be supporting these people.
I was in a hurry and forgot to say that they differ from real news reporting in the way that porn differs from a real relationship. Of course, the op-ed/opinion columns in traditional news media are also mostly emotional porn; but the point is that opionating is cheap and while doing it well and entertainingly does require some research and planning each day, when you get down to it it's just a performance rather than painstaking and often slow production of factual data.
This doesn't matter. Low quality news sources are a dime a dozen, and the good news costs money. You have to be sophisticated enough to be able to differentiate news sources. For instance, as a WSJ subscriber, I'm not going to read the editorials. They're complete garbage in terms of factual content. The business page is gold.
And this is very good. All the freeloaders who block ads and only use low-quality news will get poorer information and they will be out-competed. That's a good thing. Humanity will move forward. So block your ads on your ad-supported sources, grumble about "inequity of information", and exclaim in horror that you can't access good information because of a paywall. This is it. The future is here: ads are disappearing (temporarily, I think) and you're seeing what happens when your desired world comes to be.
There's no schadenfreude here. Many of you were just sawing on a branch you sat on, with the natural consequence. The LA Times railed against targeted advertising. Well, they got what they wanted. And now they're subject to the razor's edge that is the market.
That sounds like a foolish use of my time when I can simply watch other people do it for me. And I want a greater difference between me and them. I want them to be wrong and for me to be right. This only helps.
I can only see this being the case if you exist in a community which is a zero-sum competition for resources. This is not the world as I understand it, and I can't understand why you thinks this helps.
It’s the model most practise, except I do so knowingly. I’m Not against information sharing. It’s just that I do so in a parochially altruistic manner.
Besides we all know everyone will gladly partake in a negative sum game if it means they come out better. I just do that knowingly. That is, if other participants have x and I have y, I will gladly take actions that lead to long-term effects of me having y+delta and them having x-epsilon even if delta < n times epsilon. Everyone gladly does this. So I don’t have a zero sum view of the world but that’s irrelevant to this because the sum of human utility is less important than the utility to my parochial group.
A practical example is that I will often share stuff I know better than others but I won’t try too hard to convince them.
Not in CA, but our governor is deciding what must close, and even what items stores can sell. I suspect any news outlet (sans politics) would be desired to stay open. But you can't legislate everything.
> Not in CA, but our governor is deciding what must close, and even what items stores can sell. I suspect any news outlet (sans politics) would be desired to stay open. But you can't legislate everything.
What are you referring to with 'Not in CA'? This is in California.
I think you're confused about what's going on here, which is why you're being down-voted. This isn't about whether the LA Times is allowed to stay open or any Government direction on what businesses should be open. They are still open. It's about their sharply declining revenue from advertising.
Whenever there are furloughs or layoff, any payouts or profits for the C-Suite and managers that are higher the average employee, is put into an annuity for the laid off employees.
So if a CEO makes 30,000,000, and the average worker is paid 125,000. A 29,875,000 fund will be made to deposit a monthly check into the bank of the fired employees. This includes any profits made from selling stocks.
To avoid loopholes and ensure enforcement, CEO's waive personal financial privacy, giving regulators full access into international finance accounts and to withdraw from those account debt due to workers. The lookback/forward time can be tweaked to go up to 36 months to ensure it's not worked around.
This will retain employees - while simultaneously keep businesses operating profitably.
Additionally, if there are any dividends by the company, any employees who worked a certain time (even if fired) are entitled to payout, since they're part of the collective. This shows appreciation for the employees which boosts performance - they know a successful quarter will have their success kept - not given only to investors.
Even if the scale of the difference divided by the number of employees were enough to be useful (it's not), all this would do is incentivize executives to run inefficient businesses into the ground.
> all this would do is incentivize executives to run inefficient businesses into the ground.
What incentive would an executive have to run a business into the ground?
It's a business - the motive to gain profit and ambition won't leave because profit is shared.
Regardless - my point is - what's wrong with being generous to workers? Why not share a bit of that with people who work so the motivation and incentives are spread out?
Why don't we try some ideas, test some regulations and see how they work, so we know what incentivizes and what doesn't?
Have an administrative body view it on a case by case basis and come up with a novel payment plan, in a case where a CEO gets a golden parachute and employees are left unemployed, that payment would be suspended and apportioned fairly. Maybe it will even go back to investors.
> What incentive would an executive have to run a business into the ground
The one given above: laying off workers to make the business competitive results in having your salary clawed back for three years. Staying inefficient and getting out-competed does not.
> laying off workers to make the business competitive results in having your salary clawed back for three years.
If the company goes out of business due to inefficiency - then the market will supply another one that can treat workers and investors well.
And maybe it should be clawback against all assets and profits earned in the CEO's lifetime. That will give them motivation to pay off the spurned employees the fired, then start earning more for themselves.
Since this is all about free markets and scale, we need to have optimistic forecasts. There's a credit against the CEO to pay off the employees due to management failing, but the CEO can always try again in the future to pay off their newly accrued debt by making better decisions for investors and employees.
Imagine - if all management decisions were binded 50% to the welfare of the employee and 50% to profit? Bound by the law? Or face strict liability, financial penalties and possibly criminal charges for causing jeopardy to the workers? That's absolute genius.
It's all about how we define competition. What if competition is redefined to imply responsibility and obligation to caretake for workers, and every business on Earth is subject to it? What's wrong with that?
If the CEO has a bunch of shares and their value crashes, do the employees need to pay up to offset the CEO's loss? After all, they are a part of the collective.
I'm not saying CEO's and management shouldn't have their traditional responsibilities.
What's wrong with a windfall to make sure employees are protected. If a layoff is needed, clearly the CEO's leadership had issues - so something needs to done proportionally as severance.
A large change in the lives of employees needs a large annuity fund for the laid off workers. The company can file a loan and pay it out over the next few years. Which will improve the credit score of the company.
Here's another idea, for the sake of a thought experiment: the CEO may need to be fired for not assuring rising salaries and benefits for the workforce. A two-tiered performance system. Employees share voting rights along with the board, and it's by statute so all businesses must comply with it.
Why not consider factoring in laborer's collective time and personal life circumstances as human beings into the equation?
> Why not consider factoring in ... human beings into the equation?
You'd get much further in your arguments if you didn't often insinuate that others are vicious for not agreeing with you. You'd be hard pressed to find the leader who doesn't care or pretend to care about the human beings in the equation. If you choose not to believe them, OK, but it's extremely easy to dismiss someone who says "don't be evil" when you don't believe yourself to be evil.
I only gave ideas. My first word was, "Idea". And even for the ideas I gave, the replies were vague and didn't cite examples of why the hypothetical was a no go.
If I were to guess, the thought experiment was so different - it brought unease.
Which in itself is valuable to me. People are willing to accept extreme unfairness - even if it is harmful to people (layoffs) - if they can ease their anxiety and socially conform.
> The documents provide a detailed picture of the development and marketing of OxyContin, how Purdue executives responded to complaints that its effects wear off early, and their fears about the financial impact of any departure from 12-hour dosing.
I don't have many recurring subscriptions, and I don't live in LA, but I signed up for the Times the day the reporting came out. So rare is quality investigative journalism these days.
Fast forward 3 years, and "Purdue Pharma and the Sackler family were in negotiations to settle the claims for a payment of $10-$12 billion" (Wikipedia).
As far as I know the settlement was never finalized. And I don't want to make it seem that the Times was the only organization looking into Purdue. But I wish a fraction of that settlement could be re-invested into investigative journalism.
https://www.latimes.com/projects/oxycontin-part1/