[Archived] Bogleheads community discussion - Coronavirus

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EasilyConfused
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Re: Bogleheads community discussion - Coronavirus

Post by EasilyConfused »

nigel_ht wrote: Thu Mar 19, 2020 8:21 am
EasilyConfused wrote: Wed Mar 18, 2020 10:17 am
Teague wrote: Wed Mar 18, 2020 1:39 am Right, but the point of hitting it hard now, as we transition through this inflection point toward rapid geometric growth, is that without such measures our hospitals will be overwhelmed by several times over their capacity. The most important case to prevent (delay) is the next one. The next most important case to prevent (delay) is the one after that. No one knows how well these interventions will work in real life. But we have a pretty good idea of what will happen should we not implement them, and it won't just be the older folks that are denied life-saving ventilators and ICU care.
I get all that. My point was -- the vast majority of the hospitalized will be the elderly and the vulnerable. If we take whatever government action is needed to make sure the old and infirm are able to comfortably remain in their homes and away from everyone else while the rest of society goes about its business, why wouldn't that be a faster, less expensive, and less disruptive approach than the unrealistic "shut everything down for as long as it takes" model we're pursuing now?

We're going to spend trillions on bailouts for every level of the economy, when I'm wondering if spending billions making sure the elderly are safe in their homes for a few months might not be a better solution.
“Among 121 patients known to have been admitted to an ICU, 7% of cases were reported among adults ≥85 years, 46% among adults aged 65–84 years, 36% among adults aged 45–64 years, and 12% among adults aged 20–44 years (Figure 2). No ICU admissions were reported among persons aged ≤19 years. Percentages of ICU admissions were lowest among adults aged 20–44 years (2%–4%) and highest among adults aged 75–84 years (11%–31%) (Table).”

Image

Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020. MMWR Morb Mortal Wkly Rep. ePub: 18 March 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6912e2 .

I don’t think it is clear cut that the vast majority of hospitalizations are for elderly. 38% of hospitalizations are under 55 and 48% of ICU admissions under 65.
I wrote that before the article on hospitalization ages was posted here. While it certainly changes the calculus, I still believe it's unrealistic to expect the young and currently healthy to maintain social distancing for the length of time some are recommending, and as others have now also pointed out the societal damage of such an approach may outweigh the costs. So we should be looking at ways to protect the elderly and the vulnerable over the long term while getting the rest of society back into their jobs in a relatively short time frame.
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Re: Bogleheads community discussion - Coronavirus

Post by fanmail »

protagonist wrote: Thu Mar 19, 2020 11:06 am
Stinky wrote: Thu Mar 19, 2020 10:25 am
LadyGeek wrote: Thu Mar 19, 2020 9:19 am I removed a post and reply which implied racism.
Thanks to you and all of the moderators for carefully policing this Forum.
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cjking
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Re: Bogleheads community discussion - Coronavirus

Post by cjking »

craimund wrote: Thu Mar 19, 2020 8:00 am The economic damage at some point becomes worse than the potentially avoidable consequences of the disease.
Not for the people who who would die if the economic price weren't incurred. I'd guess any amount of economic damage is OK with them. Those who think the death-set doesn't include themselves are probably more likely to agree with you.
All of these lock-downs and draconian measures are not going to prevent COVID-19 infection and death.
Surely the main objective of them is to prevent deaths? Why else do you think the measures are being implemented?
We may be able to mitigate some of the "extra deaths" caused by overwhelming the healthcare system.
For the UK I'm hearing 20,000 as a possible number of deaths if all measures are taken, and 500,000 if nothing is done. I've not been following the news properly, and may not accurately understood what you were trying to say. Am I wrong to the think the reason for incurring the economic cost is something of the order of a 96% reduction in total deaths?
JonnyB
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Re: Bogleheads community discussion - Coronavirus

Post by JonnyB »

HomerJ wrote: Tue Mar 17, 2020 5:45 pm How does that work? I know Bogleheads in general have no idea how the other 80% of the country works, but how do you work and leave a 6 year old at home alone? Oh, you just don't work? How do you FEED that 6-year old then?
The bill just passed provides emergency paid leave for parents who have to stay home to care for children out of school -- two-thirds of regular monthly pay. It doesn't cover everyone but its a good start.

Also included is 10 days of paid sick leave.
craimund
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Re: Bogleheads community discussion - Coronavirus

Post by craimund »

cjking wrote: Thu Mar 19, 2020 11:29 am
craimund wrote: Thu Mar 19, 2020 8:00 am The economic damage at some point becomes worse than the potentially avoidable consequences of the disease.
Not for the people who who would die if the economic price weren't incurred. I'd guess any amount of economic damage is OK with them. Those who think the death-set doesn't include themselves are probably more likely to agree with you.
All of these lock-downs and draconian measures are not going to prevent COVID-19 infection and death.
Surely the main objective of them is to prevent deaths? Why else do you think the measures are being implemented?
We may be able to mitigate some of the "extra deaths" caused by overwhelming the healthcare system.
For the UK I'm hearing 20,000 as a possible number of deaths if all measures are taken, and 500,000 if nothing is done. I've not been following the news properly, and may not accurately understood what you were trying to say. Am I wrong to the think the reason for incurring the economic cost is something of the order of a 96% reduction in total deaths?
Not saying that at all. Influenza kills tens of thousands in the US every year and many of those deaths are “avoidable” if certain measures were taken, including forced quarantines of infected people and household members and invasive South Korean style monitoring and contact tracing etc. This is not done. Therefore we accept some deaths by infectious disease and we must be balancing other considerations including civil liberties and damage to the economy when determining our response. Maybe the response here is justified. No one seems to be weighing the economic damage. When do we restart the economy and what if it flares up again or if this happens every year?
"When you ain't got nothing, you got nothing to lose"-Bob Dylan 1965. "When you think that you've lost everything, you find out you can always lose a little more"-Dylan 1997
EasilyConfused
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Re: Bogleheads community discussion - Coronavirus

Post by EasilyConfused »

cjking wrote: Thu Mar 19, 2020 11:29 am
craimund wrote: Thu Mar 19, 2020 8:00 am The economic damage at some point becomes worse than the potentially avoidable consequences of the disease.
Not for the people who who would die if the economic price weren't incurred. I'd guess any amount of economic damage is OK with them. Those who think the death-set doesn't include themselves are probably more likely to agree with you.
Poverty also causes suffering and death. Most people aren't Bogleheads.
KyleAAA
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Re: Bogleheads community discussion - Coronavirus

Post by KyleAAA »

EasilyConfused wrote: Thu Mar 19, 2020 11:45 am
cjking wrote: Thu Mar 19, 2020 11:29 am
craimund wrote: Thu Mar 19, 2020 8:00 am The economic damage at some point becomes worse than the potentially avoidable consequences of the disease.
Not for the people who who would die if the economic price weren't incurred. I'd guess any amount of economic damage is OK with them. Those who think the death-set doesn't include themselves are probably more likely to agree with you.
Poverty also causes suffering and death. Most people aren't Bogleheads.
Which is why suppression goes hand in hand with economic stimulus.
KyleAAA
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Re: Bogleheads community discussion - Coronavirus

Post by KyleAAA »

craimund wrote: Thu Mar 19, 2020 11:40 am
cjking wrote: Thu Mar 19, 2020 11:29 am
craimund wrote: Thu Mar 19, 2020 8:00 am The economic damage at some point becomes worse than the potentially avoidable consequences of the disease.
Not for the people who who would die if the economic price weren't incurred. I'd guess any amount of economic damage is OK with them. Those who think the death-set doesn't include themselves are probably more likely to agree with you.
All of these lock-downs and draconian measures are not going to prevent COVID-19 infection and death.
Surely the main objective of them is to prevent deaths? Why else do you think the measures are being implemented?
We may be able to mitigate some of the "extra deaths" caused by overwhelming the healthcare system.
For the UK I'm hearing 20,000 as a possible number of deaths if all measures are taken, and 500,000 if nothing is done. I've not been following the news properly, and may not accurately understood what you were trying to say. Am I wrong to the think the reason for incurring the economic cost is something of the order of a 96% reduction in total deaths?
Not saying that at all. Influenza kills tens of thousands in the US every year and many of those deaths are “avoidable” if certain measures were taken, including forced quarantines of infected people and household members and invasive South Korean style monitoring and contact tracing etc. This is not done. Therefore we accept some deaths by infectious disease and we must be balancing other considerations including civil liberties and damage to the economy when determining our response. Maybe the response here is justified. No one seems to be weighing the economic damage. When do we restart the economy and what if it flares up again or if this happens every year?
It WILL flare up again. That's why creating a vaccine is important. I believe we are all weighing the economic damage appropriately.
Last edited by KyleAAA on Thu Mar 19, 2020 12:20 pm, edited 1 time in total.
EasilyConfused
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Re: Bogleheads community discussion - Coronavirus

Post by EasilyConfused »

KyleAAA wrote: Thu Mar 19, 2020 12:13 pm
EasilyConfused wrote: Thu Mar 19, 2020 11:45 am
cjking wrote: Thu Mar 19, 2020 11:29 am
craimund wrote: Thu Mar 19, 2020 8:00 am The economic damage at some point becomes worse than the potentially avoidable consequences of the disease.
Not for the people who who would die if the economic price weren't incurred. I'd guess any amount of economic damage is OK with them. Those who think the death-set doesn't include themselves are probably more likely to agree with you.
Poverty also causes suffering and death. Most people aren't Bogleheads.
Which is why suppression goes hand in hand with economic stimulus.
What are we stimulating if nobody can leave their homes? If you think we can just render huge chunks of our economy nonproductive for 12-18 months and also write gigantic government checks to try to make up for the damage without major negative consequences I guess I'd like to see your math.
nigel_ht
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Re: Bogleheads community discussion - Coronavirus

Post by nigel_ht »

craimund wrote: Thu Mar 19, 2020 11:40 am
cjking wrote: Thu Mar 19, 2020 11:29 am
craimund wrote: Thu Mar 19, 2020 8:00 am The economic damage at some point becomes worse than the potentially avoidable consequences of the disease.
Not for the people who who would die if the economic price weren't incurred. I'd guess any amount of economic damage is OK with them. Those who think the death-set doesn't include themselves are probably more likely to agree with you.
All of these lock-downs and draconian measures are not going to prevent COVID-19 infection and death.
Surely the main objective of them is to prevent deaths? Why else do you think the measures are being implemented?
We may be able to mitigate some of the "extra deaths" caused by overwhelming the healthcare system.
For the UK I'm hearing 20,000 as a possible number of deaths if all measures are taken, and 500,000 if nothing is done. I've not been following the news properly, and may not accurately understood what you were trying to say. Am I wrong to the think the reason for incurring the economic cost is something of the order of a 96% reduction in total deaths?
Not saying that at all. Influenza kills tens of thousands in the US every year and many of those deaths are “avoidable” if certain measures were taken, including forced quarantines of infected people and household members and invasive South Korean style monitoring and contact tracing etc. This is not done. Therefore we accept some deaths by infectious disease and we must be balancing other considerations including civil liberties and damage to the economy when determining our response. Maybe the response here is justified. No one seems to be weighing the economic damage. When do we restart the economy and what if it flares up again or if this happens every year?
If we can control the infection rate to the same level as China without Wuhan then the period is about 8 weeks from lockdown to no new cases: Jan 23 to March 18.

Thus doesn't mean lockdown as in Wuhan but social distancing and not having crowds (sports games, bars, restaurants, churches, schools, etc).

And there is a marked difference between 20K deaths with mitigation and 500K deaths without. You can argue these numbers if you want but this isn't the UK. For us the estimate would be 1.7m in the worst case scenario.

“When people change their behavior," said Lauren Gardner, an associate professor at the Johns Hopkins Whiting School of Engineering who models epidemics, “those model parameters are no longer applicable,” so short-term forecasts are likely to be more accurate. “There is a lot of room for improvement if we act appropriately.”

https://www.nytimes.com/2020/03/13/us/c ... imate.html

This is why everyone is pushing hard for early containment because not doing so likely has an even greater economic impact. No politician WANTS to do closures and hurt the economy because when folks are hurting is when incumbents tend to get voted out. That so many has done so means there are so many experts telling them "Do this now or really bad things start to snowball out of control".
KyleAAA
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Re: Bogleheads community discussion - Coronavirus

Post by KyleAAA »

EasilyConfused wrote: Thu Mar 19, 2020 12:20 pm
KyleAAA wrote: Thu Mar 19, 2020 12:13 pm
EasilyConfused wrote: Thu Mar 19, 2020 11:45 am
cjking wrote: Thu Mar 19, 2020 11:29 am
craimund wrote: Thu Mar 19, 2020 8:00 am The economic damage at some point becomes worse than the potentially avoidable consequences of the disease.
Not for the people who who would die if the economic price weren't incurred. I'd guess any amount of economic damage is OK with them. Those who think the death-set doesn't include themselves are probably more likely to agree with you.
Poverty also causes suffering and death. Most people aren't Bogleheads.
Which is why suppression goes hand in hand with economic stimulus.
What are we stimulating if nobody can leave their homes? If you think we can just render huge chunks of our economy nonproductive for 12-18 months and also write gigantic government checks to try to make up for the damage without major negative consequences I guess I'd like to see your math.
Huge swaths of the economy can function just fine working from home. Restaurants and bars account for 14% of GDP. That's a big chunk, but the majority of the economy can still function with precautions, and the service industry can also adapt. The short-term shock will be bad, but stimulus will cushion the blow. Nobody is advocating forcing people to stay home for 12-18 months.
nigel_ht
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Re: Bogleheads community discussion - Coronavirus

Post by nigel_ht »

EasilyConfused wrote: Thu Mar 19, 2020 12:20 pm
KyleAAA wrote: Thu Mar 19, 2020 12:13 pm
EasilyConfused wrote: Thu Mar 19, 2020 11:45 am
cjking wrote: Thu Mar 19, 2020 11:29 am
craimund wrote: Thu Mar 19, 2020 8:00 am The economic damage at some point becomes worse than the potentially avoidable consequences of the disease.
Not for the people who who would die if the economic price weren't incurred. I'd guess any amount of economic damage is OK with them. Those who think the death-set doesn't include themselves are probably more likely to agree with you.
Poverty also causes suffering and death. Most people aren't Bogleheads.
Which is why suppression goes hand in hand with economic stimulus.
What are we stimulating if nobody can leave their homes? If you think we can just render huge chunks of our economy nonproductive for 12-18 months and also write gigantic government checks to try to make up for the damage without major negative consequences I guess I'd like to see your math.
8 weeks if we can do it right. That's still a long time but it's not a year.
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wshang
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Re: Bogleheads community discussion - Coronavirus

Post by wshang »

KyleAAA wrote: Thu Mar 19, 2020 12:14 pm It WILL flare up again. That's why creating a vaccine is important. I believe we are all weighing the economic damage appropriately.
Would you change your stance if there will never be a successful vaccine?

At the risk of sounding boorish, there has never been a successful coronaviral vaccine developed. Not to SARS. Not to MERS. Not for lack of trying. While I won't discount a future breakthrough, I would not think our technology sufficiently advanced since the last two coronaviral outbreaks that this will change for the medium term of 2-3 years.

I will grant you that we might find a drug which shortens the period of viral shedding or even ameliorates the symptoms. (FYI, I am a physician with infectious disease expertise.)

[Edit to fix formatting]
The cure shouldn't be worse than the disease.
EasilyConfused
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Re: Bogleheads community discussion - Coronavirus

Post by EasilyConfused »

nigel_ht wrote: Thu Mar 19, 2020 12:23 pm
EasilyConfused wrote: Thu Mar 19, 2020 12:20 pm
KyleAAA wrote: Thu Mar 19, 2020 12:13 pm
EasilyConfused wrote: Thu Mar 19, 2020 11:45 am
cjking wrote: Thu Mar 19, 2020 11:29 am
Not for the people who who would die if the economic price weren't incurred. I'd guess any amount of economic damage is OK with them. Those who think the death-set doesn't include themselves are probably more likely to agree with you.
Poverty also causes suffering and death. Most people aren't Bogleheads.
Which is why suppression goes hand in hand with economic stimulus.
What are we stimulating if nobody can leave their homes? If you think we can just render huge chunks of our economy nonproductive for 12-18 months and also write gigantic government checks to try to make up for the damage without major negative consequences I guess I'd like to see your math.
8 weeks if we can do it right. That's still a long time but it's not a year.
I hope so. I'm all for flattening the curve. I just don't want to do it forever and would like decisionmakers to look at strategies to help the most at-risk.
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Re: Bogleheads community discussion - Coronavirus

Post by KyleAAA »

wshang wrote: Thu Mar 19, 2020 12:27 pm
KyleAAA wrote: Thu Mar 19, 2020 12:14 pm It WILL flare up again. That's why creating a vaccine is important. I believe we are all weighing the economic damage appropriately.
Would you change your stance if there will never be a successful vaccine?

At the risk of sounding boorish, there has never been a successful coronaviral vaccine developed. Not to SARS. Not to MERS. Not for lack of trying. While I won't discount a future breakthrough, I would not think our technology sufficiently advanced since the last two coronaviral outbreaks that this will change for the medium term of 2-3 years.

I will grant you that we might find a drug which shortens the period of viral shedding or even ameliorates the symptoms. (FYI, I am a physician with infectious disease expertise.)

[Edit to fix formatting]
No, it would not change my stance. I am aware of the track record of coronaviral vaccine development.
KyleAAA
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Re: Bogleheads community discussion - Coronavirus

Post by KyleAAA »

EasilyConfused wrote: Thu Mar 19, 2020 12:30 pm
nigel_ht wrote: Thu Mar 19, 2020 12:23 pm
EasilyConfused wrote: Thu Mar 19, 2020 12:20 pm
KyleAAA wrote: Thu Mar 19, 2020 12:13 pm
EasilyConfused wrote: Thu Mar 19, 2020 11:45 am

Poverty also causes suffering and death. Most people aren't Bogleheads.
Which is why suppression goes hand in hand with economic stimulus.
What are we stimulating if nobody can leave their homes? If you think we can just render huge chunks of our economy nonproductive for 12-18 months and also write gigantic government checks to try to make up for the damage without major negative consequences I guess I'd like to see your math.
8 weeks if we can do it right. That's still a long time but it's not a year.
I hope so. I'm all for flattening the curve. I just don't want to do it forever and would like decisionmakers to look at strategies to help the most at-risk.
Which they are, in fact, doing.
7eight9
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Re: Bogleheads community discussion - Coronavirus

Post by 7eight9 »

over45 wrote: Tue Mar 17, 2020 10:44 am NC Governor just ordered all restaurants and bars to close down... wow.
CARSON CITY — Gov. Steve Sisolak on Tuesday significantly ramped up Nevada’s response to COVID-19 by announcing a statewide closure of all casinos, restaurants, bars and other nonessential businesses for 30 days, and he urged Nevadans to stay inside to reduce their chance of becoming infected and spreading the virus.
https://www.reviewjournal.com/local/loc ... s-1983950/

And what is "nonessential"?

— Entertainment and hospitality, including strip clubs and brothels, casinos, concert venues, arenas, auditoriums, stadiums, large conference rooms, meeting halls, and cafeterias.

— Recreation and athletic facilities including community and recreation centers, gyms, health clubs, fitness centers, yoga, barre and spin facilities.

— Beauty and personal care services and facilities, including barber shops, beauty, tanning, waxing hair salons, and nail salons and spas.

— Retail facilities including shopping malls except for pharmacy or other health care facilities within retail operations. Retailers are encouraged to continue online operations with pickup and delivery.

The list of nonessential businesses might be expanded.


https://www.reviewjournal.com/news/poli ... s-1985016/
I guess it all could be much worse. | They could be warming up my hearse.
cjking
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Re: Bogleheads community discussion - Coronavirus

Post by cjking »

craimund wrote: Thu Mar 19, 2020 11:40 am Not saying that at all. Influenza kills tens of thousands in the US every year and many of those deaths are “avoidable” if certain measures were taken, including forced quarantines of infected people and household members and invasive South Korean style monitoring and contact tracing etc. This is not done. Therefore we accept some deaths by infectious disease and we must be balancing other considerations including civil liberties and damage to the economy when determining our response. Maybe the response here is justified. No one seems to be weighing the economic damage. When do we restart the economy and what if it flares up again or if this happens every year?
I don't think anyone is planning for the long-term, various measures are for some or all of the next 12-18 months, which is the likely shortest time for a vaccine, if there's going to be one. Obviously plans are evolving from day-to-day, nothing is set in in stone.

I've just googled the UK figures for influenza and get a number of 17,000 deaths per year. The healthcare system is sized to deal with that, roughly speaking at least. The reason the UK government originally wanted to go for full herd immunity by the end of the summer months is that there is no spare capacity in winter to deal with COVID-19 on top of the normal influenza burden. (The "herd immunity" strategy was abandoned within a week of being announced, due to new data and modelling.) (The winter influenza load literally stretches the system to breaking point, having an efficient system is usually a good thing, but efficiency by definition means not have spare capacity to deal with exceptional demand.)

I think the point of the measures is to prevent the vast majority of deaths over the next year and a half, that would happen in the no-action scenaro. After that, if there is no cure or vaccine, and a constant background thread from COVID-19, there should eventually be a level of herd-immunity as there now is with influenza, and healthcare facilities will have resized to deal with both at the same time. This makes a big difference, as if we then stop quarantining to prevent infection, there won't be vast numbers of preventable deaths due to lack of healthcare capacity.
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Watty
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Re: Bogleheads community discussion - Coronavirus

Post by Watty »

quantAndHold wrote: Thu Mar 19, 2020 10:42 am
Watty wrote: Thu Mar 19, 2020 6:27 am There is a company, Kinsa, that makes a smart thermometer that connects to your smartphone and allows you to do various health tracking things with their app. It is apparently a popular and successful product that has sold millions of units over the last several years.

Prior to the Coronavirus researchers had noticed that they could track outbreaks of influenza by zip code by looking at that data, which had had identify information stripped from it. They have also tried to strip out what is typical to see atypical patterns in people with elevated temperatures, like people with Covid-19. It is more complicated so it is not possible to say that the atypical zip codes are actually Covid-19 since there can be local flu outbreaks but it appears that there is at least a strong correlation so it is very interesting information.

Here is the website,

Be sure to click the button that says Atypical Illness and also read the details about how this works.

https://healthweather.us/
Woah. Thanks.

Florida does not look good.
I noticed that too. It could just be that Florida has more people than typical with flu still going on which could account for more people having a fever.
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Re: Bogleheads community discussion - Coronavirus

Post by KyleAAA »

EasilyConfused wrote: Thu Mar 19, 2020 12:34 pm
KyleAAA wrote: Thu Mar 19, 2020 12:23 pm
EasilyConfused wrote: Thu Mar 19, 2020 12:20 pm
KyleAAA wrote: Thu Mar 19, 2020 12:13 pm
EasilyConfused wrote: Thu Mar 19, 2020 11:45 am

Poverty also causes suffering and death. Most people aren't Bogleheads.
Which is why suppression goes hand in hand with economic stimulus.
What are we stimulating if nobody can leave their homes? If you think we can just render huge chunks of our economy nonproductive for 12-18 months and also write gigantic government checks to try to make up for the damage without major negative consequences I guess I'd like to see your math.
Huge swaths of the economy can function just fine working from home. Restaurants and bars account for 14% of GDP. That's a big chunk, but the majority of the economy can still function with precautions, and the service industry can also adapt. The short-term shock will be bad, but stimulus will cushion the blow. Nobody is advocating forcing people to stay home for 12-18 months.
It's not just bars and restaurants. It's practically every low-income job. And most aren't specifically advocating forcing everyone into their homes for 18 months, but the suppression strategy you argued for all day yesterday incorporates that into large swathes of society for long periods during that timeframe. Again, that's unrealistic and damaging.
Nah, most low-wage jobs will be just fine after the shock period. Nail salons, barber shops, retail, etc workers will get back to work. Maybe the nature of the job will change. Or extra precautions will be taken. Or maybe something completely new will pop up to replace it in some cases. And yeah, suppression is damaging. That's why I also advocate for stimulus. It most definitely is not unrealistic. It seems clearly to be the least damaging overall path by a wide margin, even after taking the economy into account.
Last edited by KyleAAA on Thu Mar 19, 2020 12:58 pm, edited 2 times in total.
nigel_ht
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Re: Bogleheads community discussion - Coronavirus

Post by nigel_ht »

EasilyConfused wrote: Thu Mar 19, 2020 11:10 am
nigel_ht wrote: Thu Mar 19, 2020 8:21 am
I don’t think it is clear cut that the vast majority of hospitalizations are for elderly. 38% of hospitalizations are under 55 and 48% of ICU admissions under 65.
I wrote that before the article on hospitalization ages was posted here. While it certainly changes the calculus, I still believe it's unrealistic to expect the young and currently healthy to maintain social distancing for the length of time some are recommending, and as others have now also pointed out the societal damage of such an approach may outweigh the costs. So we should be looking at ways to protect the elderly and the vulnerable over the long term while getting the rest of society back into their jobs in a relatively short time frame.
There are unrealistic recommendations and there is a real world case study (aka China) where 8 weeks is probably the minimum timeframe to shoot for.

I may not completely believe 0 new cases in China but I do believe that they have it contained in a major way and can restart their economy while making sure outbreaks are caught early and stamped out.
ThankYouJack
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Re: Bogleheads community discussion - Coronavirus

Post by ThankYouJack »

cjking wrote: Thu Mar 19, 2020 11:29 am
For the UK I'm hearing 20,000 as a possible number of deaths if all measures are taken, and 500,000 if nothing is done. I've not been following the news properly, and may not accurately understood what you were trying to say. Am I wrong to the think the reason for incurring the economic cost is something of the order of a 96% reduction in total deaths?
Do you know where those numbers came from? Hopefully it's lower than expected.
GCD
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Re: Bogleheads community discussion - Coronavirus

Post by GCD »

I've been skeptical of the need for such a crazy response to this virus, but this article increased my skepticism further. It says 99% of Italy's CV deaths had significant pre-existing illnesses. Half of the CV deaths had 3 significant pre-existing illnesses; high blood pressure, diabetes, heart disease.

https://www.bloomberg.com/amp/news/arti ... ssion=true

When I look on the CDC website I find that 3 millionish Americans die every year as a natural course of things. Life expectancy in normal circumstances is only 78.6 in the US. About 890,000 deaths in 2017 were attributed to heart disease, respiratory disease and diabetes.

https://www.cdc.gov/nchs/fastats/deaths.htm

So the question to me is: How many Coronavirus deaths are really just normal deaths that would have occurred anyway due to old age or another condition?
ThankYouJack
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Re: Bogleheads community discussion - Coronavirus

Post by ThankYouJack »

Anyone know what the experts are currently saying with the latest round of data? The growth factor seems quite high, but I'm hoping that's a bit inflated due to the US starting to test more.
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knpstr
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Re: Bogleheads community discussion - Coronavirus

Post by knpstr »

EasilyConfused wrote: Thu Mar 19, 2020 11:10 am
nigel_ht wrote: Thu Mar 19, 2020 8:21 am
I don’t think it is clear cut that the vast majority of hospitalizations are for elderly. 38% of hospitalizations are under 55 and 48% of ICU admissions under 65.
I wrote that before the article on hospitalization ages was posted here. While it certainly changes the calculus, I still believe it's unrealistic to expect the young and currently healthy to maintain social distancing for the length of time some are recommending, and as others have now also pointed out the societal damage of such an approach may outweigh the costs. So we should be looking at ways to protect the elderly and the vulnerable over the long term while getting the rest of society back into their jobs in a relatively short time frame.
But of course 12% of ICU cases are ages 20-44. (according to NYT).

Folks in their late 40s and 50s aren't "young" anymore.
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Re: Bogleheads community discussion - Coronavirus

Post by cjking »

ThankYouJack wrote: Thu Mar 19, 2020 1:27 pm
cjking wrote: Thu Mar 19, 2020 11:29 am
For the UK I'm hearing 20,000 as a possible number of deaths if all measures are taken, and 500,000 if nothing is done. I've not been following the news properly, and may not accurately understood what you were trying to say. Am I wrong to the think the reason for incurring the economic cost is something of the order of a 96% reduction in total deaths?
Do you know where those numbers came from? Hopefully it's lower than expected.
Note those are UK figures, not US, which will be larger. Checking if I had the right figures, looking in this paper

https://www.imperial.ac.uk/media/imperi ... 3-2020.pdf

there is a table where they measure the effect of a strategy of repeatedly turning social distancing on and off. So, taking one possible scenario from the table, if infectivity (R0) is 2.4, if we are using all social distancing measures, we turn the measures on when more than 100 ICU cases a week and off when less than 50 ICU case a week, we'd have 13,000 deaths. If the on-switch is set at 200, we'd have 24,000 deaths. With no social distancing, there are 510,000 deaths. For these scenarios, social distancing would be "on" 74% to 77% of the time.

(The deaths are the total for a two-year period.)
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Re: Bogleheads community discussion - Coronavirus

Post by quantAndHold »

EasilyConfused wrote: Thu Mar 19, 2020 12:20 pm What are we stimulating if nobody can leave their homes?
Paying rent. Buying food. Stuff like that.
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Re: Bogleheads community discussion - Coronavirus

Post by ThankYouJack »

cjking wrote: Thu Mar 19, 2020 1:51 pm
ThankYouJack wrote: Thu Mar 19, 2020 1:27 pm
cjking wrote: Thu Mar 19, 2020 11:29 am
For the UK I'm hearing 20,000 as a possible number of deaths if all measures are taken, and 500,000 if nothing is done. I've not been following the news properly, and may not accurately understood what you were trying to say. Am I wrong to the think the reason for incurring the economic cost is something of the order of a 96% reduction in total deaths?
Do you know where those numbers came from? Hopefully it's lower than expected.
Note those are UK figures, not US, which will be larger. Checking if I had the right figures, looking in this paper

https://www.imperial.ac.uk/media/imperi ... 3-2020.pdf

there is a table where they measure the effect of a strategy of repeatedly turning social distancing on and off. So, taking one possible scenario from the table, if infectivity (R0) is 2.4, if we are using all social distancing measures, we turn the measures on when more than 100 ICU cases a week and off when less than 50 ICU case a week, we'd have 13,000 deaths. If the on-switch is set at 200, we'd have 24,000 deaths. With no social distancing, there are 510,000 deaths. For these scenarios, social distancing would be "on" 74% to 77% of the time.

(The deaths are the total for a two-year period.)
Thanks, I haven't had a chance to go through it all, but I'm hoping that some of these CFR estimates based on China's data are high. Seems like it's most likely under 1% for overall but there's a huge difference between say .9% and .2%. I'm just trying to be a bit optimistic about it. With that said, my family is social distancing ourselves.
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Re: Bogleheads community discussion - Coronavirus

Post by KyleAAA »

GCD wrote: Thu Mar 19, 2020 1:43 pm https://www.cdc.gov/nchs/fastats/deaths.htm

So the question to me is: How many Coronavirus deaths are really just normal deaths that would have occurred anyway due to old age or another condition?
Effectively zero. Even individuals with one or multiple of those conditions tend to have life expectancies stretching out decades. It would be highly illogical to conclude the death of a 65 year old with diabetes would have occurred within the next 12-24 months anyway. The chances of that are astronomically small.
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Re: Bogleheads community discussion - Coronavirus

Post by technovelist »

KyleAAA wrote: Thu Mar 19, 2020 2:42 pm
GCD wrote: Thu Mar 19, 2020 1:43 pm https://www.cdc.gov/nchs/fastats/deaths.htm

So the question to me is: How many Coronavirus deaths are really just normal deaths that would have occurred anyway due to old age or another condition?
Effectively zero. Even individuals with one or multiple of those conditions tend to have life expectancies stretching out decades. It would be highly illogical to conclude the death of a 65 year old with diabetes would have occurred within the next 12-24 months anyway. The chances of that are astronomically small.
The estimates of coronavirus deaths, as with all such estimates, are of the number dying who would not have died in the absence of the pandemic.

So the answer is "actually zero".
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Re: Bogleheads community discussion - Coronavirus

Post by LadyGeek »

A contentious interchange regarding the shutdown of economies vs. saving lives has been removed. As a reminder, see: General Etiquette
We expect this forum to be a place where people can feel comfortable asking questions and where debates and discussions are conducted in civil tones.

At all times we must conduct ourselves in a respectful manner to other posters.
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Re: Bogleheads community discussion - Coronavirus

Post by sam_m »

This may be the solution, it is under investigation by FDA. There are some instance in India where they cured few COVID-19 patients using this medicine -

https://abcnews.go.com/Health/chloroqui ... d=69664561
totallynotsure
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Realistically, how long do you think most folks with be working remotely?

Post by totallynotsure »

how long do you anticipate the working from home edict to last?

[This thread was merged into the ongoing Bogleheads community discussion - Cornonavirus- Mod Misenplace]
Morford
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Re: Realistically, how long do you think most folks with be working remotely?

Post by Morford »

I expect through June.
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Re: Bogleheads community discussion - Coronavirus

Post by KlangFool »

jibantik wrote: Wed Mar 18, 2020 11:20 pm
KlangFool wrote: Wed Mar 18, 2020 10:54 pm jibantik,

Please redo your post with the log scale. I do not know how to do that. That is more interesting. It shows exponential growth. It shows about 10 times increases in about every 8 days.

KlangFool
There is a toggle on the website at the URL I pasted, but here it is:

Image
Folks,

3/2 = 100 cases
3/11 ~ 1,000 cases
3/19 ~ 10,000 cases

Increases about 10 times by every 8 or 9 days. Let's assume that it is 10 times every 9 days. We will reach 100K on 3/28, 1 million by 4/6/2020, 10 million by 4/15/2020.

About 20% of the cases need hospitalization.

So, it is 20K on 3/28, 200K by 4/6/2020, 2 million by 4/15/2020

For some local/hot areas, we would run out of hospital beds way before 4/15/2020.

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fortyofforty
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Re: Bogleheads community discussion - Coronavirus

Post by fortyofforty »

People,

Do we know how many people are already infected without symptoms serious enough to warrant hospitalization or even testing?
Do we know for how long will each patient will require ICU care? After partial recovery, is there any chance a patient is transferred to non-ICU facilities for continued recovery, thus freeing up a ventilator? So much we still don't know.
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Re: Bogleheads community discussion - Coronavirus

Post by EasilyConfused »

KyleAAA wrote: Thu Mar 19, 2020 12:54 pm Nah, most low-wage jobs will be just fine after the shock period. Nail salons, barber shops, retail, etc workers will get back to work. Maybe the nature of the job will change. Or extra precautions will be taken. Or maybe something completely new will pop up to replace it in some cases. And yeah, suppression is damaging. That's why I also advocate for stimulus. It most definitely is not unrealistic. It seems clearly to be the least damaging overall path by a wide margin, even after taking the economy into account.
You're just making things up. Why would any of that be true? If we're in a situation where bars and restaurants still can't operate operate and all of society is still practicing social distancing for 18 months, then what magic is going to occur that's going to make it OK for a barber or a nail salon operator or a dental hygienist to stand over people's faces all day, or pay a retail worker who has no one coming into her store because everyone is staying home and ordering online, or give work to a janitor with nothing to clean because everyone in the office building is now telecommuting? And in 18 months, a lot of the places where those people work will go out of business. Yes, I know something will eventually replace them but not right away and the disruption will be very painful to people with very little margin of safety.

Yes, stimulus. Sure. But the price tag of stimulus to make up for nonoproductivity of a gigantic proportion of the economy for an 18 month period will be outrageous, and will cause real suffering to some segment of society.
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Re: Bogleheads community discussion - Coronavirus

Post by KyleAAA »

EasilyConfused wrote: Thu Mar 19, 2020 6:08 pm
KyleAAA wrote: Thu Mar 19, 2020 12:54 pm Nah, most low-wage jobs will be just fine after the shock period. Nail salons, barber shops, retail, etc workers will get back to work. Maybe the nature of the job will change. Or extra precautions will be taken. Or maybe something completely new will pop up to replace it in some cases. And yeah, suppression is damaging. That's why I also advocate for stimulus. It most definitely is not unrealistic. It seems clearly to be the least damaging overall path by a wide margin, even after taking the economy into account.
You're just making things up. Why would any of that be true? If we're in a situation where bars and restaurants still can't operate operate and all of society is still practicing social distancing for 18 months, then what magic is going to occur that's going to make it OK for a barber or a nail salon operator or a dental hygienist to stand over people's faces all day, or pay a retail worker who has no one coming into her store because everyone is staying home and ordering online, or give work to a janitor with nothing to clean because everyone in the office building is now telecommuting? And in 18 months, a lot of the places where those people work will go out of business. Yes, I know something will eventually replace them but not right away and the disruption will be very painful to people with very little margin of safety.

Yes, stimulus. Sure. But the price tag of stimulus to make up for nonoproductivity of a gigantic proportion of the economy for an 18 month period will be outrageous, and will cause real suffering to some segment of society.
Yes, nobody is arguing disruption won't be painful. But it will not collapse the economy, either. Even with the near-total lockdown, the hours worked by workers mentions are down by only around 35%. That's bad, but this will only last a few months and stimulus will get them through it. Longer-term, after suppression is relaxed, the hours worked will likely only drop in the 10-15% range. Not great, but hardly catastrophic or unmanageable. The proportion of the non-productive section of society just is not going to be gigantic.
Last edited by KyleAAA on Thu Mar 19, 2020 6:19 pm, edited 1 time in total.
EasilyConfused
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Re: Bogleheads community discussion - Coronavirus

Post by EasilyConfused »

quantAndHold wrote: Thu Mar 19, 2020 2:13 pm
EasilyConfused wrote: Thu Mar 19, 2020 12:20 pm What are we stimulating if nobody can leave their homes?
Paying rent. Buying food. Stuff like that.
Hopefully. As a landlord I won't be allowed to evict anyone for a while, so I'm all for folks using their stimulus money on rent checks!
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Re: Bogleheads community discussion - Coronavirus

Post by EasilyConfused »

KyleAAA wrote: Thu Mar 19, 2020 6:17 pm Yes, nobody is arguing disruption won't be painful. But it will not collapse the economy, either. Even with the near-total lockdown, the hours worked by workers mentions are down by only around 35%. That's bad, but this will only last a few months and stimulus will get them through it. Longer-term, after suppression is relaxed, the hours worked will likely only drop in the 10-15% range. Not great, but hardly catastrophic or unmanageable. The proportion of the non-productive section of society just is not going to be gigantic.
Most states aren't anywhere near a total lockdown yet. Most restaurants are still trying to figure out ways to stay open. My brother went out for a haircut yesterday. It's about to get a whole lot worse for hourly workers.
guyinlaw
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Re: Bogleheads community discussion - Coronavirus

Post by guyinlaw »

guyinlaw wrote: Thu Feb 13, 2020 8:59 am - China has acted much faster that in 2003 SARS
- movement of people anywhere is like airport security.
Eg- people move back to cities after holiday, people getting back to work. Long lines..
- People are moving around last few days getting back from holidays..this will keep happening as factories open..
- many factories will open in mid March. When people return to factory cities, they have to be in 14 days isolation before they can mix with others.

So we will find over next 2 months the true impact.

China is doing things that are really draconian. People are suffering a lot. Prayers that suffering is less..
-- people who are infected are sometime being arrested and quarantined
China acted with draconian measures 2 months ago and today they have zero infections. Their economy will start to rebound soon..

We dragged our feet.. USA will add > 5000 cases today(3/19), I am afraid in a few days we will be adding > 15,000 cases/ day. (like Europe)

Bar were open for St. Patricks Day on Tuesday (3/17) and Primaries were held on Tuesday. Many non essential shops are still open today..

See the study below "Had China acted 1 week earlier their number of cases would have been 66% less."

There will be studies in the future.. If US had acted 1, 2, 3 weeks earlier... Wonder how many Trillions will be lost. And many lives will be lost that could have been saved


https://www.medrxiv.org/content/10.1101 ... 20029843v3

By closing additional stores, there will be more unemployment, but reduction in infections is necessary now..

Economy and markets will see more turmoil for many weeks, stimulus does not stop infections.
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Re: Bogleheads community discussion - Coronavirus

Post by ElJefeDelQueso »

As of this week there is preliminary but compelling evidence that both remdesivir and chloroquine-based therapies are effective against SARS-COV-2 in human patients. I am optimistic that the need for ventilator support will soon be diminished or avoided for a substantial portion of cases.
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Re: Bogleheads community discussion - Coronavirus

Post by technovelist »

ElJefeDelQueso wrote: Thu Mar 19, 2020 6:35 pm As of this week there is preliminary but compelling evidence that both remdesivir and chloroquine-based therapies are effective against SARS-COV-2 in human patients. I am optimistic that the need for ventilator support will soon be diminished or avoided for a substantial portion of cases.
Combine chloroquine and azithromycin and you get very good results according to this study:

"The proportion of patients that had negative PCR results in nasopharyngeal samples significantly differed between treated patients and controls at days 3-4-5 and 6 post-inclusion (Table 2). At day6 post-inclusion, 70% of hydroxychloroquine-treated patients were virologicaly cured comparing with 12.5% in the control group (p= 0.001). When comparing the effect of hydroxychloroquine treatment as a single drug and the effect of hydroxychloroquine and azithromyc in combination, the proportion of patients that had negative PCR results in nasopharyngeal samples was significantly different between the two groups at days 3-4-5 and 6 post-inclusion (Table 3). At day6 post-inclusion, 100% of patients treated with hydroxychloroquine and azithromycin combination were virologicaly cured comparing with 57.1% in patients treated with hydroxychloroquine only, and 12.5% in the control group (p<0.001). These results are summarized in Figures 1 and 2. Drug effect was significantly higher in patients with symptoms of URTI and LRTI, as compared to asymptomatic patients with p<0.05 (data not show). "

https://www.mediterranee-infection.com/ ... I_IJAA.pdf
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Re: Bogleheads community discussion - Coronavirus

Post by vv19 »

This article is worth reading and pondering over.

https://medium.com/@yishan/free-widespr ... 52ee9201dd
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Re: Bogleheads community discussion - Coronavirus

Post by wshang »

technovelist wrote: Thu Mar 19, 2020 6:39 pm
ElJefeDelQueso wrote: Thu Mar 19, 2020 6:35 pm As of this week there is preliminary but compelling evidence that both remdesivir and chloroquine-based therapies are effective against SARS-COV-2 in human patients. I am optimistic that the need for ventilator support will soon be diminished or avoided for a substantial portion of cases.
Combine chloroquine and azithromycin and you get very good results according to this study:

"The proportion of patients that had negative PCR results in nasopharyngeal samples significantly differed between treated patients and controls at days 3-4-5 and 6 post-inclusion (Table 2). At day6 post-inclusion, 70% of hydroxychloroquine-treated patients were virologicaly cured comparing with 12.5% in the control group (p= 0.001). When comparing the effect of hydroxychloroquine treatment as a single drug and the effect of hydroxychloroquine and azithromyc in combination, the proportion of patients that had negative PCR results in nasopharyngeal samples was significantly different between the two groups at days 3-4-5 and 6 post-inclusion (Table 3). At day6 post-inclusion, 100% of patients treated with hydroxychloroquine and azithromycin combination were virologicaly cured comparing with 57.1% in patients treated with hydroxychloroquine only, and 12.5% in the control group (p<0.001). These results are summarized in Figures 1 and 2. Drug effect was significantly higher in patients with symptoms of URTI and LRTI, as compared to asymptomatic patients with p<0.05 (data not show). "

https://www.mediterranee-infection.com/ ... I_IJAA.pdf
The devil is always in the details of the study. Count 'em, six not included in the treatment side analysis including three who went into the ICU and one who died. 26-6=20 left for the treatment side versus 16 control patients.

"Six hydroxychloroquine-treated patients were lost in follow-up during the survey because of early cessation of treatment. Reasons are
as follows: three patients were transferred to intensive care unit, including one transferred on day2 post-inclusion who was PCR-positive on day1, one transferred on day3 post-inclusion who was PCR-positive on days1-2 and one transferred on day4 post-inclusion who was PCRpositive
on day1 and day3; one patient died on day3 post inclusion and was PCR-negative on day2; one patient decided to leave the hospital on day3 post-inclusion and was PCR-negative on days1-2; finally, one patient stopped the treatment on day3 post-inclusion because of nausea and was PCR-positive on days1-2-3.
"

I want to be as optimistic as anyone else, but we need to analyze data for ourselves.
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Re: Bogleheads community discussion - Coronavirus

Post by JMacDonald »

Here is a fascinating New Yorker article written in 1997 about the Spanish Flu:
https://www.newyorker.com/magazine/1997 ... -dead-zone
The Wuhan area of China is mentioned in the article.
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technovelist
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Re: Bogleheads community discussion - Coronavirus

Post by technovelist »

wshang wrote: Thu Mar 19, 2020 7:12 pm
technovelist wrote: Thu Mar 19, 2020 6:39 pm
ElJefeDelQueso wrote: Thu Mar 19, 2020 6:35 pm As of this week there is preliminary but compelling evidence that both remdesivir and chloroquine-based therapies are effective against SARS-COV-2 in human patients. I am optimistic that the need for ventilator support will soon be diminished or avoided for a substantial portion of cases.
Combine chloroquine and azithromycin and you get very good results according to this study:

"The proportion of patients that had negative PCR results in nasopharyngeal samples significantly differed between treated patients and controls at days 3-4-5 and 6 post-inclusion (Table 2). At day6 post-inclusion, 70% of hydroxychloroquine-treated patients were virologicaly cured comparing with 12.5% in the control group (p= 0.001). When comparing the effect of hydroxychloroquine treatment as a single drug and the effect of hydroxychloroquine and azithromyc in combination, the proportion of patients that had negative PCR results in nasopharyngeal samples was significantly different between the two groups at days 3-4-5 and 6 post-inclusion (Table 3). At day6 post-inclusion, 100% of patients treated with hydroxychloroquine and azithromycin combination were virologicaly cured comparing with 57.1% in patients treated with hydroxychloroquine only, and 12.5% in the control group (p<0.001). These results are summarized in Figures 1 and 2. Drug effect was significantly higher in patients with symptoms of URTI and LRTI, as compared to asymptomatic patients with p<0.05 (data not show). "

https://www.mediterranee-infection.com/ ... I_IJAA.pdf
The devil is always in the details of the study. Count 'em, six not included in the treatment side analysis including three who went into the ICU and one who died. 26-6=20 left for the treatment side versus 16 control patients.

"Six hydroxychloroquine-treated patients were lost in follow-up during the survey because of early cessation of treatment. Reasons are
as follows: three patients were transferred to intensive care unit, including one transferred on day2 post-inclusion who was PCR-positive on day1, one transferred on day3 post-inclusion who was PCR-positive on days1-2 and one transferred on day4 post-inclusion who was PCRpositive
on day1 and day3; one patient died on day3 post inclusion and was PCR-negative on day2; one patient decided to leave the hospital on day3 post-inclusion and was PCR-negative on days1-2; finally, one patient stopped the treatment on day3 post-inclusion because of nausea and was PCR-positive on days1-2-3.
"

I want to be as optimistic as anyone else, but we need to analyze data for ourselves.
Absolutely. But I think if there isn't any alternative treatment available, then this has to be tried.
In theory, theory and practice are identical. In practice, they often differ.
frand
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Re: Bogleheads community discussion - Coronavirus

Post by frand »

Our hospitals are begging for mask donation! And we are far from reaching the peak yet! This is a disaster.
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Re: Bogleheads community discussion - Coronavirus

Post by KyleAAA »

EasilyConfused wrote: Thu Mar 19, 2020 6:22 pm
KyleAAA wrote: Thu Mar 19, 2020 6:17 pm Yes, nobody is arguing disruption won't be painful. But it will not collapse the economy, either. Even with the near-total lockdown, the hours worked by workers mentions are down by only around 35%. That's bad, but this will only last a few months and stimulus will get them through it. Longer-term, after suppression is relaxed, the hours worked will likely only drop in the 10-15% range. Not great, but hardly catastrophic or unmanageable. The proportion of the non-productive section of society just is not going to be gigantic.
Most states aren't anywhere near a total lockdown yet. Most restaurants are still trying to figure out ways to stay open. My brother went out for a haircut yesterday. It's about to get a whole lot worse for hourly workers.
The numbers were for areas in total lockdown. It is unlikely to get substantially worse in those areas.
dukeblue219
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Re: Bogleheads community discussion - Coronavirus

Post by dukeblue219 »

California is now on state-wide shelter-in-place per CNN.
Locked