Covid-19

[SoulBiter]

Mortality rates are a meaningless statistic in this scenario; until there is blanket or targeted testing on the population as a whole to establish the number of 'hidden' positives - ie those who have had or have the virus, but never appear on the radar because the symptoms are so mild that they never fall under the radar of the health services, or indeed never show symptoms at all - the percentages given are skewed beyond value.

Completely correct, Pete. Mortality rates are currently almost entirely worthless as a percentile stat.

Then of course infection rates are also a meaningless statistic because we don't know how many people are infected, never get counted as infected and just get better on their own. Matter of fact, if we are going to go down that road, historical infection rates are meaningless as mortality rates. Pick any random sickness that is being tracked by this kind of analytics and you can basically say the rates mean nothing because you don't know how many are uncounted. Heck you cant even say the infection numbers are accurate so why are we putting those out there? As you say, the numbers are skewed beyond measure because we don't know how many get infected and never get tested.

About the only measure you will have is, this is the number of deaths from the Covid-19 virus.

But analytics don't work that way. We measure what we have the ability to measure. Not the ones we don't. We know how many people got tested and we know how many died. So we have some idea of the mortality once someone is so sick they do get tested. You can call that what you will.

Edit to add, I could say the same thing about unemployment rates. The US posts them and the market reacts to them, but we have no idea how many people decided to retire rather than stay employed and we have no idea how many people gave up looking for a job but are employable. In fact we have had that debate here from time to time.

[TheFallen]

The only thing I'd say, SB is that although countries are inevitably using flawed rulers to measure for all the reasons you correctly point out, at least they're being consistent and using the same flawed ruler every time.

Therefore although the absolute numbers may be very suspect, any evidenced trend or change in movement of said measured flawed numbers will still have some validity behind it.

[Obi-Wan Nihilo]

Obi, just to float a theory about the "line of work" references, I suspect that Z may have confused your profession with that of a former member who worked as a mortician.

Ah, that makes sense.

On point, how much attention did you pay to the 62,000 flu deaths a couple of years ago? I searched, couldn't find a single post of yours on the topic. So it would appear that I'm exactly as callous as you. People die. That sucks for them and their loved ones. We're not putting millions out of work and crippling the economy every flu season. We don't put Detroit or Baltimore in lockdown to keep people from shooting each other.

Why oh why do people keep trotting out the winter flu paradigm and present it as if it has any relevance??? It's a classic logical error - one of false equivalency.

Are there similarities between winter flu and the current COVID-19 pandemic? Well duh, yes. Both are highly contagious respiratory viruses.

But that's as far as it goes. Sure, it is an audited fact that a bad winter flu epidemic can see the deaths of over 60,000 American citizens... BUT those deaths occur despite appropriate and sufficient healthcare resources being available, in place and applied. That is the crucial difference here and that's why claiming that winter flu is in any way a relevant paradigm is entirely fallacious.

No, it's not. All those people die every year, and we're not freaking out about it. A ton of people are killed every year by drunk drivers, and we don't go full-draconian.

These things happen. People die. We don't - or at least shouldn't - idle the rest of the world over it. On a good day 150,000 die. No one cares about that, so I'm not getting why everyone's losing their minds because an additional 2,000 or so are dying. Call me callous, I don't care. I'm not interested in saving all lives at all costs, and neither are you and Zara. I'd much rather have them die than have our liberties stolen and our economy wrecked.

However the goal could have been achieved by what I've suggested above, and the market would barely have blipped.

I entirely disagree - as does the available data. Merely asking those with flu-like symptoms plus the old and infirm to self-isolate would categorically not achieve the goal of suppressing new infection rates sufficiently.

Applying these measures you've stated support for alone was actually modelled by the ICL study and the prediction was that it would a) reduce the eventual death rate by 50% and b) reduce the overloading of healthcare resources from a factor of 30 times overloaded to a mere ( ) 8 times overloaded.

Again, oh well. Looking at Worldmeter there's less than 18,000 serious cases worldwide. The world's gone mad.

Case in point....

Are you familiar with the Patriot Act? Tell me again how we get these rights back. Tried taking a bottle of water from your house onto a plane? How about those rights? We can look at countless examples from the last 20 years where the government has infringed on our rights and not restored them.

The Patriot Act was legislation. Nothing that has happened recently has the force of law. Laws do tend to be permanent. This isn't. I don't mean to sound sarcastic, but . . . a bottle of water? Seriously? I think I need more of those "countless examples" to be convinced.

You're clearly not reading the news, or you're being deliberately obtuse. Several governors have made clear that the "gatherings of 10 or less" rule will be enforced by force of law. And if you don't think that the security theater we go through at airports isn't an example, then I don't know what to say to you. You yourself have argued that many times in the past. Massive surveillance and data collection by the government came about after 9/11, and it hasn't gone away.

On point, how much attention did you pay to the 62,000 flu deaths a couple of years ago? I searched, couldn't find a single post of yours on the topic. So it would appear that I'm exactly as callous as you.

I never made any specific posts downplaying those deaths, no. That doesn't make me callous.

Doesn't it? You're clearly okay with ignoring certain deaths, why are the current COVID-19 deaths such a big deal? Hell, 9071 gun deaths in the US this year, but I don't see you calling for draconian crackdowns over them.

Why is this a big deal? We're all born to die.

You realize that it's hard to take your continued concern for lung damage seriously when you smoke (at least you used to).

I don't believe I've ever admitted to smoking, but yes, I did smoke a little in my 20s. I rolled my own, American Spirits. About a cigarette a day. It didn't last long. I haven't smoked in 15+ years. I have enjoyed pot, but vaped that (naturally, not the vape pens). That has also been many years ago. All of this is completely different from a respiratory disease. Also, I wasn't talking about permanent lung damage here, but dying from a respiratory disease.

You're not going to die from a respiratory disease. At least, not today. There's a new one out there, granted, but you're always at risk of catching something. This is just something new.

We're far more at risk from 30% unemployment.

I think that could come either way.

It could, but it's the greater of the two dangers, and we're foolishly ignoring it.


Meanwhile.....

[Wosbald]

+JMJ+

Catholic moral theology has important role as pandemic causes ethical dilemmas [In-Depth]

A nurse at a drive up COVID-19 coronavirus testing station set up by the University of Washington Medical Center wears a face shield, mask, and other protective gear as she waits by tents, Friday, March 13, 2020, in Seattle. (Credit: Ted S. Warren/AP)


As the world faces the unprecedented effects of the COVID-19 coronavirus pandemic, thorny moral questions are arising.

From every level and sector of society, people are asking: What is the right thing to do?

From mundane issues such as how much toilet paper is too much toilet paper, to the life-and-death decisions being made in hospitals in northern Italy, ethical dilemmas abound.

Joseph Meaney is the president of the Philadelphia-based National Catholic Bioethics Center, and he told Crux that the Catholic moral framework is "centered on willingness to make sacrifices for others."

What follows are excerpts of his conversation with Crux.

===========================================================================================================================================================================================================================================================================================================

Crux: First of all, this is probably the most drastic international event since World War II -- with huge sacrifices being asked of people. Are these sacrifices justified?

Meaney: In a word yes. The Catholic moral framework is centered on willingness to make sacrifices for others. There are many people whose lives can be saved by taking extraordinary measures. These strong measures are justified and even necessitated by the real potential for overburdening the health sector, especially intensive care capacities, in various countries.

It has to be said, however, that effectively shutting down huge sections of modern economies comes at a tremendous cost. The ethical analysis of what we should do as societies needs to take into account the potential for more deaths resulting from the loss of employment and the economic hardships and potential civil disorder that will result from an extended disruption of the normal activities of nations.

One of the problems associated with the COVID-19 pandemic is the large number of hospitalizations which -- as we see in Italy -- can overwhelm healthcare systems. This leads to major ethical questions, primarily: Who gets help? What must be taken into consideration when making these decisions.

There is a medical-moral duty to deliver care, so no one should be refused medical help. The agonizing problem that is currently confronting Italy, and potentially other countries soon, is that certain very intensive therapies cannot be given to more than a certain number of patients at a time. There are only so many ventilators available, for instance. A just form of triage may need to be put in place. The medical term "triage" refers to sorting patients on the basis of their immediate treatment needs while keeping in mind their chances of benefiting from available therapies.

Succinctly speaking, objective criteria must be used to give the most limited intensive therapies to those most in need who can still benefit from them. It is tragic when a patient has so many organ system failures that they are extremely unlikely to survive, and it would also be wrong to prioritize these patients for the limited number of ventilators over other seriously ill patients who would likely survive if given this chance. Similarly, it would be unacceptable to place a patient on a ventilator when they could clearly survive without one and when others are at grave risk of death if they cannot receive this medical care.

I add that everything must be done to increase the quantities of scarce medical equipment that is needed at this time. Also, compassionate care, including pain medication, must be provided to all patients, even if they cannot receive all the therapies we would wish to provide.

COVID-19 disproportionately affects the elderly. The median age of fatal cases in Italy is 79.5. However, there are still a large number of younger people needing ventilation in the hospital as they recover. This has led to some proposals to refuse ventilators for people over a certain age. Given the limit of resources, and the relative expectation of recovery based on age, can that be ethical?

No. It would not be ethical to triage a person out simply on the basis of their age, disability, sex, etc. It is true that some elderly patients may not meet objective criteria for ventilator access in a crisis situation because they are dying and it is impossible to save them, but that can also be true of younger patients. We have to be very mindful of not discriminating. The slippery slope goes downhill very rapidly once one starts on that road.

[...]

[wayfriend]

All those people die every year, and we're not freaking out about it. A ton of people are killed every year by drunk drivers, and we don't go full-draconian.

These things happen. People die. We don't - or at least shouldn't - idle the rest of the world over it.

This is a sample of the latest misinformation messaging I see being put out, and I will respond to this as such an example:

The flu doesn't overrun hospitals' ability to cope with the influx of patients. Automobile deaths don't overrun hospitals' ability to cope with the influx of patients. 60,000 deaths in a week is a very different matter than 60,000 deaths in a year. And 60,000 deaths in a week presupposes 300,000 or something people needing intensive hospital care IN A WEEK.

Don't be dangerous. Stop repeating misinformation about a deadly virus.

[TheFallen]

Obi, you'll know how vanishingly rare it is for me to agree with anything WF says...

...but he's bang on right here, for all that he's merely reiterating what several of us (me, Zee, SB) have been saying for the last couple of weeks.

I just don't get why you insist on repeatedly drawing the same false equivalency? Repeatedly making the same "apples with oranges" fallacious comparison?

Again, yes, lots of people die every day. From a variety of causes, including winter flu, auto accidents, drunk driving or whatever.

BUT NONE OF THESE CAUSES OF DEATH EITHER DO OR WILL OVERWHELM EXISTING HEALTHCARE RESOURCES IN ANY WAY. They occur despite the best efforts of sufficiently available administered healthcare.

The majority of COVID-19 deaths will occur because there simply isn't sufficiently available healthcare to go around. And for that reason, they'll occur in a short period of time - unless infection rates are slowed. Just look at Italy fer Gawds sakes - and don't go giving me that "Oh well, they're all geriatrics living in large and extended family units who all smoke like chimneys" nonsense.

Why do you keep quite deliberately choosing to ignore that very stark and very obvious differentiator between COVID-19 and the other causes of frequent death that you cite?

Look, if you want to make an argument on absolutist and idealistic grounds regarding the utter sacrosanct nature of enshrined liberties and freedoms, then logically I can accept that - though I personally think it shows a distinct lack of appropriate and desirable pragmatism.

Or if you want to make a purely pragmatic economic argument that current imposed social distancing measures are simply unaffordable and that the "cure" is thus economically worse than the expected mortality outcome of the pandemic unchecked, then logically I can accept that too (and I ought to say that, although it's a brutal argument, it's the counter-position that to me holds most water).

But for the love of God, don't keep portraying the current pandemic in frames of reference that simply do not apply to it. It is in its very nature and effects markedly and radically different from winter flu, auto accidents, gun-related deaths, drug abuse or any other exemplar you may care to come up with.

[Obi-Wan Nihilo]

Of course it's different, I get that. I'm emphatically not saying that it is, no matter how many times you tell me that I'm doing it.

People die. We can take reasonable measures to prevent people from dying, but they're still going to die. It is not reasonable to me to disrupt the world's economy and infringe on civil liberties because there's a viral outbreak that may have a 1% mortality rate. If we were seeing a 40% mortality rate, I'd feel differently.

[Zarathustra]

We are already seeing some hospitals at full capacity. Today. As I type this. With extreme social distancing. Nothing we've ever seen has done this before. Comparisons to other deaths are irrelevant because this is entirely unprecedented.

The stock market is seeing record gains. The DOW was at 18,000s a few days ago, now it's back up to 22,000. Yes, people are unemployed. That will change in a few weeks/months. We're going to get through this.

Obi, I never flew on a plane until after 9/11. I can't compare before/after. So I don't remember the Utopia that was airport security that you so lament. However, clearly our security measures were lacking prior to 9/11, or we wouldn't have had 4 planes taken over with dudes wielding box cutters. It was absurdly easy.

Are you familiar with TSA Preapproval? You can go through a shorter line and don't have to take off your shoes, belt, coat, empty pockets, or take out your laptop. We've had it since 2011. So apparently, some freedoms do return. Do you avail yourself of this returned freedom?

[SoulBiter]

Italy number of cases has gone down again. But deaths have remained high.

80539 cases vs 8215 deaths. Thats 10.2% just in case you are counting. I expect that percentage to increase if the number of deaths doesnt start to decrease. That is with the current lock down they are doing. Imagine if they had never locked down anything...

At the end of the day we are left with this. This virus is going to kill a lot of people over the next year. Yes we are going to flatten the curve and try not to overwhelm the system. But this will be historical not just economically. Even more, unless we build up some community immunity and/or this virus mutates itself into something less deadly, we will see years of deaths from this.

[Obi-Wan Nihilo]

Obi, I never flew on a plane until after 9/11. I can't compare before/after. So I don't remember the Utopia that was airport security that you so lament. However, clearly our security measures were lacking prior to 9/11, or we wouldn't have had 4 planes taken over with dudes wielding box cutters. It was absurdly easy.

It would still be easy.

Are you familiar with TSA Preapproval? You can go through a shorter line and don't have to take off your shoes, belt, coat, empty pockets, or take out your laptop. We've had it since 2011. So apparently, some freedoms do return. Do you avail yourself of this returned freedom?

Are you freaking serious? PreCheck costs money and requires fingerprinting. How in the hell is that a freedom returning?

Who the hell are you, and what have you done to Zara?

[TheFallen]

So ICL has issued an updated report on COVID-19 modelling, based on the latest available data. You can find the report summary plus the full report here:-

https://www.imperial.ac.uk/mrc-global-i ... ronavirus/

Key take-out points are as follows:-

A "do nothing" strategy is predicted to result in a 90% global infection rate and 40 million global COVID-19 deaths within 2020. All healthcare systems globally get utterly swamped in such a scenario.

A "mitigation" strategy, where those with flu-like symptoms self-isolate as do the elderly and the infirm is predicted to reduce that number of global deaths by 50% - so 20 million global COVID-19 deaths within 2020. All healthcare systems globally still get overwhelmed in this scenario, with a divide between richer and poorer nations. Richer ones get overloaded by a factor of 7 and poorer ones by a factor of 25.

A "suppression" strategy with additional imposed social distancing of all is predicted to reduce that number of global deaths by 95% IF AND ONLY IF social distancing is imposed quickly and early in the infection rate growth curve - so 1.3 million global COVID-19 deaths within 2020. In this case, health systems are predicted to be able to cope.

However, if social distancing is imposed later and only once the virus is established within a population, the number of global deaths is predicted to only reduce by 75%, so 10 million global COVID-19 deaths within 2020.

Yes these are still assumptions, but best guess ones based on the most up to date data available.

[Obi-Wan Nihilo]

I'll post nude photos of myself if there are 10 million global COVID-19 deaths in 2020.

[Savor Dam]

Not that I previously wanted that scale of mortality, but I now truly dread it.

No offense, but definitely not something for which I can muster any enthusiasm. Maybe photos of your liquor cabinet or thermidor (not that you talk about those anymore), but not even those pictures when lives are at stake.

Edited to add that I've never paid for TSA Pre-Check, but get that status a bit more than half the time I fly, as do Dam-sel and/or Menolly when they accompany me. No idea why we get that sometimes and other times not.

[Ur Dead]

A question.
What will you think if (hope never) a member of the watch gets the disease?
I've been careful but I am in the very high risk for not recovering.
65 plus and a heart condition.

[Savor Dam]

I don't know, Ur Dead. Still, I'm entirely with you in being concerned.

As I've said before, where we live is where the first US outbreak occurred a month ago. Everybody in my household is some combination of over 60, a cancer survivor (Menolly three times over), or a member of another high-risk group. We've been hunkered down all month, and just cancelled long-standing travel plans for celebrating my Dad's 90th in a few months. Not safe for him, not safe for us.

[Avatar]

Well, latest I see is 18k new cases in the US, and 2.2k in the UK.

To address and earlier question of Peter's, experts have already warned of a second wave that they expect to occur when restrictions are lifted, and pointed out that the Spanish Flu of 1918 (50 million dead) occurred in 3 waves, the 2nd of which was the most deadly.

https://www.washingtonpost.com/news/pow ... 01a752cd1/

--A

[peter]

I'm categorised as a 'key worker' in this crisis and (I don't know) expected?, requested?, allowed? to keep working through it. (As a by the by, two weeks ago I was a 'shop assistant' worthy of minimum wage. I'm still worthy of minimum wage - but now I'm a 'key worker' at least ) Point is that last night I served a hundred plus people, all making essential basic need meeting purchases of booze, tobacco, scratch cards and chocolate. Eighty percent plus paid in cash despite our request for card only payment. Sixty percent ignored the request to stand back from the till. One responsible family sent their two children up to the shop three times to make purchases for them and multiple people came in more than once to make trivial purchases like lottery or pop.

Don't know why I'm posting this; it gets to me is all!

Edit; But then again it shouldn't. I am the one after all who said that life, sooner or later, must go on. And at the end of the day, this is people doing just that. The scratchies and booze, the fags and chocolate - this is just people despatatly clinging on to the things that keep them going even at the best of times. I should be more sympathetic - except in the case of the kids....... that's just stupid!

[TheFallen]

I'll post nude photos of myself if there are 10 million global COVID-19 deaths in 2020.

Well, for you to be correct in your personal prediction, there are only two factors for you to play around with.

The first is obviously the proportion of the global population that will become infected by the COVID-19 virus in 2020. The latest study I linked to above predicts between 6% to 90%, purely dependant on whether stringent social distancing measures are imposed - and quickly - at one end of the scale or whether no action at all is taken at the other.

The second is equally obviously the resulting mortality rate. The latest study models a range of mortality rates from 0.6% worst case down to 0.4% best case. I'm actually really surprised at such low projected eventual mortality rates, but I'll go with them.

In other COVID-19 related news...

Yesterday the US showed a 25.3% rise in newly identified cases, taking its total up to over 85,000, When looking at countries with 2,000 or more identified COVID-19 cases, that rate of identified infection increase is only beaten by Belgium (26.3%) and Turkey (49.2%), but those countries have under 7,000 and 4,000 total identified cases respectively,

At this rate of increase, the US will reach over a quarter of a million identified COVID-19 cases by April 1st.

Yesterday's figures elsewhere were:-

UK - a 22.3% increase (total now 11.6k)

Spain - a 16.7% increase (total now 57.8k)

Italy - an 8.3% increase (total now 80.6k)

[Avatar]

...essential basic need meeting purchases of booze, tobacco, scratch cards and chocolate...

Tobacco and alcohol sales suspended here, at least for now.

(Don't care about the booze, but god damn I went out and stocked up on cigarettes as soon as that news broke before the lock-down.)

Experts are warning that banning alcohol sales (in a country apparently rated 5th highest alcohol consumers in the world (I did not know that)) could have unexpected effects, including death from withdrawal shock among alcoholics.)

As for TF's other news...

US Virus Deaths May Top 80,000 Despite Confinement

London Hospitals Facing Tsunami of Virus Patients

And these are "first world" developed countries. I wonder what Africa is going to look like...

(First two deaths announced here today, (age 48 and 28...) and just topped 1,000 known infections.)

--A

[TheFallen]

Brutally interestingly enough, some latest research predicts that, although third world countries are going to suffer more greatly from having such healthcare resources as they do possess being more overwhelmed, in terms of eventual mortality they will see some benefit from in general not having such elderly populations in the first place.