COVID-19 - appropriate government response?

[brimstoneSalad]

Looks like the UK has finally changed its tune on the absurd "herd immunity" plan.

[teo123]

I honestly don't understand what's all the panic for. Sure, Coronavirus is bad, it has the fatality rate of 2% (most statistics show it's even less, some show it's more, let's say that's the right number), a few times higher than ordinary flu. But do we really think stopping the world because of that is a correct response? What percentage of people who drive die because of driving? Is then it OK to force people to limit driving because of that? If I go out somewhere right now, my chances of dying in a car accident are way higher than of dying of a Coronavirus, right? So, why stop the world to prevent people from dying from Coronavirus, but not to prevent them from dying in a car accident? Some people will also die because of damages bad policies do to the economy.
I don't know what's the appropriate response, but causing panic and stopping the world doesn't seem like one. Cancelling concerts and similar public events? Probably? Closing schools? Now, children very rarely get Coronavirus, so maybe that's not the right thing to do. Closing pubs and restaurants? I don't see why. Much less policing people not to leave the house unless "necessary", as is done in Istria in Croatia.

[brimstoneSalad]

I honestly don't understand what's all the panic for. Sure, Coronavirus is bad, it has the fatality rate of 2% (most statistics show it's even less, some show it's more, let's say that's the right number), a few times higher than ordinary flu.

OK, first the flu is a terrible comparison because we have vaccines and some level of herd immunity that massively slow its spread, particularly to those most at risk. Because of that very few people actually get it every year. This is a novel virus (to us) where it can spread unhindered by vaccination or herd immunity.

Second, that's 20 times higher than the flu, not just a few times. This is more than an order of magnitude worse.

More importantly, critical cases are closer to 5%, not 2%. That means people who need hospitalization for some reason OR they'll probably die. A good doctor with access to medicine and equipment can save most of those people, IF there is enough to go around.

The thing is that Chinese were (ultimately) more on top of this than countries outside of East Asia. Other countries like the U.S. and many of those in Europe are going to see their hospitals overflowing, that means two things:
1. Most of those critical patients will die simply because they can not receive care (it was about 3% at the epicenter in China).
2. Many other people will die because of anything else, from a car crash to child birth, which would not normally result in death, because the hospitals are overwhelmed.

There's also the fact that this was the result in *China*, where there are two very important variables:

1. Obesity. Doctors in Seattle have learned that obesity massively increases risk of death from complications of the Coronavirus, and the West is a hot spot, particularly the U.S. We're probably going to see a complication rate well above 5% because of this difference, including in a lot of younger people. How much higher? Nobody knows right now.

2. Immunological differences. You know how people in certain regions of Africa, India, and the Mediterranean are more resistant to malaria? Various strains and close relatives to the Coronavirus (although less virulent) have been around in China for a very long time, and have been affecting human beings there for generations. Tests for antibodies of these wild viruses in Chinese villages have often demonstrated that many people have already HAD them. Having had a similar virus, and particularly having a lineage whose immune system evolved in an environment where these viruses are present is likely to result in higher individual and herd immunity and lessen the severity of the virus. This strain happens to be much more virulent, but that doesn't mean the immune systems of the people who live in those areas were entirely unprepared for them. Aside from possibly some Asian-Americans, the population of the U.S. is completely naive to them in an immunological sense meaning they can rip through the population in a even more virulent and devastating way than they did in China.

I would not be surprised if it spreads faster and complications requiring hospitalization end up being double what they were in China since we have over twice the Chinese obesity rate of the worst Chinese cities (and the likely faster spread) once everything is accounted for. And I would not be surprised if most of those people die because hospitals are out of beds and out of medication.

This could kill anywhere from 1 - 30 million people in the U.S. alone unless the country goes on lockdown.

But do we really think stopping the world because of that is a correct response?

To save millions of people's lives, yes.

What percentage of people who drive die because of driving?

A much smaller percentage than this.

Is then it OK to force people to limit driving because of that?

We do. We have drivers licenses, we have speed limits, and we have traffic laws.
We restrain driving rights within a huge array of rules and regulations to reduce mortality. We also mandate that cars have certain safety devices like seatbelts and airbags, and we make people wear them.

This would be the equivalent to making people have a permit to leave their houses after passing a test and to wear masks at all times, and follow regulations to avoid crowds and physical contact or else get a ticket.

So driving is a bad analogy because we're already much more strict with it.

If I go out somewhere right now, my chances of dying in a car accident are way higher than of dying of a Coronavirus, right?

No, your chances of dying from the Coronavirus are much higher.
In any given trip your chance of dying in a car accident is extremely low, especially if you follow traffic laws and wear your seatbelt.

Some people will also die because of damages bad policies do to the economy.

Stimulus packages are being presented, and things like stopping evictions during this time and providing unemployment.
Some people may die because of a lockdown, like due to suicides because of depression, but far fewer than the Coronavirus would kill.
The economic depression will likely be short lived because this isn't an issue of market confidence, it's a liquidity panic because of the pandemic. When the pandemic is over the economy will bounce back faster than you've ever seen a recession recover.

If you have money invest heavily in about a month or two when it bottoms out and then sell when the economy bounces back next year. You'll make a fortune.

Closing schools? Now, children very rarely get Coronavirus, so maybe that's not the right thing to do.

Children absolutely get it, but they do not usually die from it or become seriously ill. At least, Chinese children didn't seem to. We don't know about elsewhere. Children will get it and pass it on to adults, including grandparents who are at the highest risk.

[teo123]

Second, that's 20 times higher than the flu, not just a few times.

What do you mean? Flu has a mortality rate of around 0.5%, right?

Many other people will die because of anything else, from a car crash to child birth, which would not normally result in death, because the hospitals are overwhelmed.

I haven't thought about it. Good point, actually. Still, if we stop the world, it will also be harder to extend hospitals. Extending hospitals takes human contact and transportation. It's a double-edged sword.

What percentage of people who drive die because of driving?

A much smaller percentage than this.

Why do you think that's the case? World-wide, 18'000'000 people die from heart disease each year, and that's around 25% of all deaths each year. Also, world-wide, 1'300'000 die in road incidents. So, if 18'000'000 is around 25%, then 1'300'000 is 1.8% percent mortality rate from driving. And that's assuming the entire world is driving. Of course, for those who actually drive, the number is higher. So, driving is about as dangerous as Coronavirus is... if you actually catch it. And the probability of catching Coronavirus is certainly nowhere near 100%.

We have drivers licenses

Evidence that they are effective? I think they may even be counter-productive because they give false confidence. I once almost caused a crash thinking I ought to go first, because I misinterpreted something we were taught at driving school. Good thing my father was with me to warn me.

traffic laws

Well, our driving teacher told us that, for some traffic laws, there is evidence they are slightly effective, like the circular intersections. However, he also told us there is little evidence traffic lights are effective at preventing accidents, probably because people who don't notice other cars or pedestrians on the road usually don't notice traffic lights either. Traffic laws are mainly there post-hoc, so that when the accidents happen, disputes can be resolved.

we have speed limits

Well, people generally don't obey them. If you try to obey them (as I often do, because I know how dangerous driving is), other drivers will horn at you.

we make people wear them

Well, my perception is that most of the people don't wear their seatbelt either.

Children absolutely get it, but they do not usually die from it or become seriously ill.

Well, this article claims that children rarely get infected with Coronavirus, and that scientists are not certain why:
https://www.tportal.hr/lifestyle/clanak ... o-20200306

[brimstoneSalad]

Second, that's 20 times higher than the flu, not just a few times.

What do you mean? Flu has a mortality rate of around 0.5%, right?

No, around 0.1%.
Maybe it's higher where you are.

Still, if we stop the world, it will also be harder to extend hospitals. Extending hospitals takes human contact and transportation. It's a double-edged sword.

No, essential services aren't being stopped. Just things like movie theaters, concerts, dine-in restaurants (except delivery).
Grocery stores will remain open, any and all infrastructure required for hospitals will remain open.

Why do you think that's the case? World-wide, 18'000'000 people die from heart disease each year, and that's around 25% of all deaths each year. Also, world-wide, 1'300'000 die in road incidents. So, if 18'000'000 is around 25%, then 1'300'000 is 1.8% percent mortality rate from driving.

...No, that's your risk of dying in a car crash *in your lifetime*, not this year, or just today when you go out. Almost all of your risk from Coronavirus is concentrated in the immediate present as the pandemic is spreading like wildfire.

Also, those numbers are skewed by countries will little to no driving regulation and that have incredibly high traffic mortality rates.

Tables like this will give you a better picture of your actual risk:
https://en.wikipedia.org/wiki/List_of_c ... death_rate

You can also reduce that by wearing a seatbelt, and not driving at certain hours.

And that's assuming the entire world is driving.

Those tables account for deaths per vehicle if you want to adjust for that.

So, driving is about as dangerous as Coronavirus is... if you actually catch it. And the probability of catching Coronavirus is certainly nowhere near 100%.

No, very wrong.
And if we did not institute these policies your probability of catching it would be nearly 100%. You don't seem to comprehend how contagious this is or how exponential growth works.

Evidence that they are effective? I think they may even be counter-productive because they give false confidence. I once almost caused a crash thinking I ought to go first, because I misinterpreted something we were taught at driving school. Good thing my father was with me to warn me.

Well the driving in your country is objectively worse than places like the U.S., and so too probably the drivers education and clarity of traffic regulations to drivers. However your risk of dying from driving on any given day is still much lower than catching and dying from the Coronavirus.

However, he also told us there is little evidence traffic lights are effective at preventing accidents, probably because people who don't notice other cars or pedestrians on the road usually don't notice traffic lights either. Traffic laws are mainly there post-hoc, so that when the accidents happen, disputes can be resolved.

No. Traffic laws and lights do quite a bit. Now if you remove them, then fatalities don't rise very much, but that's because you have drivers who have already been trained by those lights, stop signs, etc. and follow careful driving rules intuitively. Comparing countries paints a much different picture, and not all of that is attributable to things like circular intersections.
The presence of stop lights without changing the drivers mostly just speeds up traffic more safely by regulating flow (instead of a clumsy and slow four way stop). Speeding up traffic ultimately ends up resulting in more people driving, so the intersection doesn't necessarily become safer overall, but it does per capita of commuters.

Well, people generally don't obey them. If you try to obey them (as I often do, because I know how dangerous driving is), other drivers will horn at you.

Laws don't mean much if they aren't enforced. That's also a major difference between different countries, and probably why your roads are more dangerous.
Places with automated cameras enforcing speed limits see them obeyed pretty well.

Well, my perception is that most of the people don't wear their seatbelt either.

In places like the U.S. that isn't true. Again, another factor in the differences between countries.
Put on YOUR seatbelt and your risk will be massively reduced compared to the norm in your country.

Well, this article claims that children rarely get infected with Coronavirus, and that scientists are not certain why:

I don't know what that article says or why. There's no reason to believe that children are not transmitting this. Many asymptomatic adults are testing positive too. Some people don't show many if any obvious symptoms, which is one of the things that makes this so dangerous. It also has a very long incubation time.

[teo123]

No, essential services aren't being stopped. Just things like movie theaters, concerts, dine-in restaurants (except delivery).

It reminds me of the saying "A curious task of economics is to show people just how little they know about what they imagine they can design." by Hayek.
It's all interconnected. Workers who produce stuff needed for hospitals need to eat somewhere, and, if you close down many restaurants, that will slow them down.
Besides, in Croatia, much of the public transport has stopped, as well as many factories. And for those factories that aren't closed, well, workers have trouble getting there. And many stores are closed, and those that aren't are only allowed to operate for few hours a day. There is no doubt that will slow down the extension of the hospitals.

No, that's your risk of dying in a car crash *in your lifetime*, not this year, or just today when you go out.

But isn't it logically fallacious to look at it that way? Isn't that the same fallacy as "Would you rather get 100$ now or 110$ after a month? And would you rather get 100$ after 10 months or 110$ after 11 months?".

Also, those numbers are skewed by countries will little to no driving regulation and that have incredibly high traffic mortality rates

I haven't really studied it that much, my perception is that driving is a very dangerous activity, but that it's also crucial to the economy, and that that's why it's legal in spite of being very dangerous.

And if we did not institute these policies your probability of catching it would be nearly 100%.

Has that ever happened? Is that even possible? I mean, in school, we are taught viruses have a very limited number of generations before the necessary genetic information is lost. When you have a virus and you infect somebody, you don't infect them with the same virus you were infected with, but with some virus that has more genetic mutations in its RNA. And after a few generations, at least one part of the core parts of the program written in the RNA (finding which cell to enter, entering the cell, making the cell copy the RNA, information about which amino-acids make the protein shell around the RNA to be assembled by the ribosomes...) is bound to become unreadable, and virus won't procreate any more. The reasons why other living things can have large number of generations are that they use DNA, which is better at self-replicating without errors than RNA is, that they have mechanisms to repair the DNA, and that we use sex or some similar method of procreation (conjugation in bacteria) which makes broken genes less effective.

There's no reason to believe that children are not transmitting this.

And that article on tportal saying that isn't a reason to believe that?

I don't know, it's so hard to figure out what the truth is about that. There is an obvious incentive from the rulers to overreact, it assures people they need a government. There is also an obvious political incentive for things like banning air travel: both left-wingers and right-wingers want to do that, and here is finally an excuse for that. Left-wingers have long been talking about how air travel causes catastrophic climate change, and right-wingers have long been talking about how immigration promotes terrorism and destroys the economy. On the other hand, I hear rumours that the number of people in Osijek who have been infected by Corona is in hundreds, rather than in the low tens, but that the government is suppressing that information to make it look like their policies are working, when in fact they aren't. Do you think it's reasonable to believe that?

[brimstoneSalad]

It's all interconnected. Workers who produce stuff needed for hospitals need to eat somewhere, and, if you close down many restaurants, that will slow them down.

What don't you get about take-out/delivery only? There's still food, just minus the social aspect of sitting in a restaurant.

And many stores are closed, and those that aren't are only allowed to operate for few hours a day. There is no doubt that will slow down the extension of the hospitals.

There's quite a bit of doubt on that.
If done incompetently it could, but most areas of the world we're talking about restaurants delivering or allowing take-out, and mostly just removing social entertainment options to slow the spread.

No, that's your risk of dying in a car crash *in your lifetime*, not this year, or just today when you go out.

But isn't it logically fallacious to look at it that way? Isn't that the same fallacy as "Would you rather get 100$ now or 110$ after a month? And would you rather get 100$ after 10 months or 110$ after 11 months?".

No, that's not the same thing. It's "would you rather get $100 this month, or $10 ten years from now?"

I haven't really studied it that much, my perception is that driving is a very dangerous activity, but that it's also crucial to the economy, and that that's why it's legal in spite of being very dangerous.

It is dangerous, but not remotely as much as this pandemic is. This shutdown is also only short term. If we could stop driving for a couple weeks and eliminate traffic accidents for a lifetime that might be worth it.

Ultimately we're going to be replacing human drivers with automated systems which are safer.

I mean, in school, we are taught viruses have a very limited number of generations before the necessary genetic information is lost.

You have misunderstood something, I do not know what.

When you have a virus and you infect somebody, you don't infect them with the same virus you were infected with, but with some virus that has more genetic mutations in its RNA. And after a few generations, at least one part of the core parts of the program written in the RNA (finding which cell to enter, entering the cell, making the cell copy the RNA, information about which amino-acids make the protein shell around the RNA to be assembled by the ribosomes...) is bound to become unreadable, and virus won't procreate any more.

If every viral particle that infected a cell resulted in ONE "offspring" then that would be a serious issue.
I'll let you figure out what you don't understand here.

And that article on tportal saying that isn't a reason to believe that?

No. Children do become symptomatic, and it appears some have died, it's just much more rare and mild for them.

I don't know, it's so hard to figure out what the truth is about that.

We don't know very much about this virus, but the idea that it would somehow not infect children is very silly. There's nothing magically different about their cells that would make that not work. Their immune systems respond differently, but the virus can still infect their tissues and replicate in them as carriers.

There is an obvious incentive from the rulers to overreact, it assures people they need a government.

No, the opposite is true. The party in power wants the economy to do very well so they can claim credit for that and stay in power.
Trump actually tried to prevent more testing in the U.S. to make the numbers appear low to avoid doing anything about it.

There is also an obvious political incentive for things like banning air travel: both left-wingers and right-wingers want to do that, and here is finally an excuse for that.

No, no mainstream political parties want to ban air travel. These politicians all *use* air travel themselves.

Left-wingers have long been talking about how air travel causes catastrophic climate change,

No, there's not a lot of focus on air transit there. These are all politicians who want to rationalize their own use of air transportation which is ubiquitous.

and right-wingers have long been talking about how immigration promotes terrorism and destroys the economy.

Yeah and they want border walls to stop people coming in illegally. Essentially all entries via air are legal.

On the other hand, I hear rumours that the number of people in Osijek who have been infected by Corona is in hundreds, rather than in the low tens, but that the government is suppressing that information to make it look like their policies are working, when in fact they aren't. Do you think it's reasonable to believe that?

Yes, there's reason to believe that politicians are likely suppressing information like that. Trump outright prevented tests from being used because he wanted the numbers to appear lower because he didn't want to hurt the economy and hurt his chances in the next election. I think it's more to justify *not* shutting things down to avoid making people angry and harming the economy than to make it look like what they're doing is working.

[teo123]

What don't you get about take-out/delivery only? There's still food, just minus the social aspect of sitting in a restaurant.

As far as I know, Croatia closed all restaurants, including the take-out and delivery-only ones.

No, that's not the same thing. It's "would you rather get $100 this month, or $10 ten years from now?"

How? The probability of dying from driving in your lifetime is about the same as the probability of dying from coronavirus in the next few weeks. So, it's more like "Would you rather get $100 this month, or $100 next month.".

You have misunderstood something, I do not know what.

And why would it be more likely that I have misunderstood something than that you have misunderstood something?

If every viral particle that infected a cell resulted in ONE "offspring" then that would be a serious issue.

Well, yes, virus that enters a cell has a lot of offspring, in fact, its offspring need to break the cell membrane to infect another cell. However, all the viruses of some specie in your body share a common ancestor: that one virus that infected you. So, they all have at least as many genetic mutations as the virus that infected you has, and most of them have even more. So, when you infect somebody else, you almost certainly infect them with a virus with even more genetic mutations than the virus that infected you has. And as the virus keeps transmitting between people, the genetic information inside those new viruses gets less and less legible.

We don't know very much about this virus, but the idea that it would somehow not infect children is very silly.

Why? Cells in children are different, they have ends of the chromosomes that adults don't.

The party in power wants the economy to do very well so they can claim credit for that and stay in power.

Well, it's quite obvious for most people that economy works best if the government isn't intervening, so the party can't take credit for economy doing well if it isn't doing anything. Franklin Delano Roosevelt was good in the eyes of the public because he was doing a lot of stuff and the economy was getting better, so he could (in all likelihood, wrongly) take credit for it.

No, no mainstream political parties want to ban air travel.

Greta Thunberg and Alexandria Ocasio Cortez don't? They are relatively mainstream.

Essentially all entries via air are legal.

Well, most of the illegal immigrants in the USA probably came via air travel, but their visa expired.

Yes, there's reason to believe that politicians are likely suppressing information like that.

But isn't that a conspiracy theory?

[DrDavid]

Isolation is effective in short term. Herd immunity (while still isolating risk groups) might be a better approach in the long run. It will be interesting to see what happens in China now that they're starting to open up again. I suspect they will be forced into another lockdown again in a couple of months.

Isolation vs herd immunity is also dependent on when/if a vaccine becomes available.

Economy is also a factor that must be considered when it comes to general health. I have no idea which approach deals with that problem best.

[Jebus]

Isolation is effective in short term. Herd immunity (while still isolating risk groups) might be a better approach in the long run. It will be interesting to see what happens in China now that they're starting to open up again. I suspect they will be forced into another lockdown again in a couple of months.

Isolation vs herd immunity is also dependent on when/if a vaccine becomes available.

Economy is also a factor that must be considered when it comes to general health. I have no idea which approach deals with that problem best.

I suspect another important factor is whether old people tend to live alone or in large extended families. In my country, one often finds three generations under the same roof.

Is Sweden the only country employing the herd immunity strategy or are there others?