I guess the question is then whether the flattened curve is the result of the virus naturally burning itself out, or of the countermeasures.
Here in Connecticut, it is pretty clear that our flattened curve resulted from the countermeasures. As we move into phase III, we expect the number of cases to rise again; we are hoping that this rise will not overwhelm the healthcare system, the prevention of which was the original impetus for the lockdown. The authorities are comfortable with the idea of a rise in cases (and the consequent rise in deaths), because the economic and social effects of the lockdown are now outweighing the benefits. Surprisingly, my sister agrees with their logic. (I have to rely on her professional opinion, because I have no expertise in this area.)
Eventually, the virus and we will adapt to one another, but that process usually takes centuries, as is demonstrated by our history with syphillis, gonorrhoea, and rhinovirus, all of which are noticeably less severe today, as compared with historical accounts when they first appeared in the population in the Middle Ages.
Interesting that the tidal behaviour changed so quickly, after centuries of stability, no?
And the point is that, regardless of whether the change in tidal behaviour was natural or man-made, it needed to be dealt with. My point with regard to climate change is similar. Likewise, as regards the current pandemic.
Or, that having passed the initial large death rate spike of the epidemic that seasonality of respiratory diseases will set in as the standard pattern from the autumn onward. People will still sadly die. But not all of us, just yet.
I can appreciate that the USA as a whole has a different pattern to Europe due to the large geographical size of the USA. But it looks like Connecticut may follow the European pattern.
The question does remain, you are right.
Where on the curve were the countermeasures enacted?
The reason I ask is from my own observed opinion that in places where the virus became established as an infection most of the counter measures were enacted after the peak of deaths. The governmental response lagged. That makes it questionable about their true effect on the curve. Iām not saying there was no effect, but a strong case has been made that the epidemic dissipates from factors other than, or outside of, social measures. But Iām believing and parroting Ivorās interpretation here, so I may be wrong.
I can understand the concern for a community where the pandemic hit and how that would create worry on seeing another rising death rate.
There was a shark attack at my local beach 3 weeks ago. The community affected is wary of the water. However, tourists that are here for the long weekend are frolicking in the waves of the same beautiful beach.
I like how people adapt. We do recognise further mistakes will be made along with decisions. So letās make those mistakes decisively over and over again until we can learn from hindsight.
Personally, I donāt see how that has been demonstrated. An epidemic dissipates from (1) killing off all the hosts, (2) infecting enough people who recover, so that herd immunity can protect the rest, (3) isolating the infected population stringently enough to prevent its spread into the remainder of the populace.
We know that COVID isnāt 100% fatal, so case (1) is not a concern. But in Connecticut, case (2), while desirable over the long run, had unacceptable consequences, in terms of the ability of hospitals and morgues to handle an unrestricted epidemic. The lockdown was an attempt at approximating case (3), so to speak, in the sense that we knew we were never going to prevent the spread of the virus completely, but we did hope to slow it enough that the system could handle the case load. We seem to have achieved that, but we are clearly nowhere near achieving herd immunity (case 2) at this point. The epidemic has clearly not dissipated yet; the best we can hope for is to keep the rate of new cases low enough that hospitals and morgues can still cope.
Well, not making mistakes at all should be the goal. However, when we know the data are incomplete, we know we will probably make wrong guesses. In contrast to the question of changing the American diet, where Senator McGovern felt a degree of urgency that was probably inappropriate in the face of a chronic crisis, when faced with an acute crisis such as this one, we can but act to best of our ability.
Thereās a corollary statement to extended shutdowns, something like āfor everyone who thinks an indefinite shutdown is warranted, Iād like them to talk to the suicidal and disillusioned 20 year-olds that some of us hear from every dayā
Thereās a cost to panic and shutdown, and in most places lockdowns seem to have been closing the door after the horse escaped.
(FWIW I actually love the idea of an extreme and short shut-down to put a stop to the spread wherever it is and allow for the community to find ways to protect the vulnerable in the ensuing months. Itās the long-running shutdowns that I think are devastating, with a particular cost to our youngest generations. In my part of the US, kids havenāt been in school since February; small, family-run businesses are closing every day; single parents are under unbelievable stress; and the income and achievement gap is widening by the month. At this point I think that weāre taking measures to protect a small segment of our oldest and sickest population, with the long-term burden of those measures falling primarily on our youngest population. That seems crazy to me.)
I agree that discussion is good, and that bringing things into question is too. But itās not either/or - nobody says the emperor has all the vestments in the world, and nobody should be saying there are no clothes at all. If all that Ivor was doing was encouraging discussion and bringing up things that logically and rationally are in question, then all well and good.
But Ivor goes well past that - heās made some demonstrably false statements and engaged in deliberate deception. This is the stuff that to many of us āfails the smell testā as Bokkiedog said. Even if itās not totally clear at first, you know somethingās wrong. The response from Alex Selby that Richard linked to illustrates and expands this.
I donāt claim to be a genius, but right away I checked on some of the same things that Alex did, and sure enough - Ivor is full of crap, there. Itās not true that āthe emperor has no clothesā and whatever Ivorās aims and points may be, itās disappointing and counter-productive for him to be unable to stay away from purposeful deception. And, IMO, we all should agree on that, regardless of where we are on the Covid issue.
I certainly agree that we should not generalize from the particular, Ivor in this case. Personally, it does not much matter who is saying something, but rather what they are saying. There are plenty of medical doctors and PhDs in other fields where we can find some of their statements and assertions to be simply āstupidā in the opinion of everybody or almost everybody on this thread and on this entire forum.
āApplicable now more than ever. āCarl Saganās rules for critical thinking offer cognitive fortification against propaganda, pseudoscience, and general falsehood.ā
We really donāt know about that ahead of time, however. The countries that have taken it āthe most seriouslyā and acted very strongly and early have exceedingly low death rates. Even with very strong action, quite a few countries didnāt act early enough and ended up with fairly high death rates and death numbers. So, what, really, is ātoo seriouslyā?
We can talk about individual countries, but itās not so simple as that there is a āOh, thatās taking it too seriously,ā ahead of time, in a general sense. I havenāt kept up on what country is doing this or that, exactly, but for a specific example, now, after the fact, Iād say thereās an argument that the UK may be going too far with restrictions, considering how the death rate has trailed off so much.
Even here, I donāt see it as black/white. Death rates have turned up a little, and we donāt know whatās going to happen through fall and winter. Still, in the end it may be that the UK has been restricting things more than was worth it; a subjective thing but Iād say firmly in the realm of rational discussion.
I agree with those who say that Ivorās production is targeted toward confirmation bias. There has been a lot of stuff about the virus, all along, thatās the same way.
Hereās a guy, likely just as smart or smarter than Ivor, and certainly more qualified in his own field, highly regarded, distinguished New York University law professor, read by many including the White House. He started out by predicting about 500 deaths for the US, then changed it to 5000. This was at a time when US death numbers were rapidly increasing - a ten year old could see that 5000 would be far exceeded and very soon, in fact. (And less than a week later, it was.)
Talk about not passing the smell test. And really - Ivorās video is no different.
Yet how many suicides have really resulted? Does anybody really have hard numbers on this, or is it just more vague āwhataboutismā?
No people just got fed up with flooding in London and decided to do something about it.
It has zero to do with climate change and was a response to the enormous likely costs of clearing up after yet another flood. https://en.wikipedia.org/wiki/Thames_Barrier
In 1974 when construction started I doubt anyone had even heard of āglobal warmingā or "climate changeā and in fact were predicting the next ice age soā¦ and that didnāt happen yet either.
As always, it depends on the context. No, it is not pointless, here, and neither would a chart be if it was adjusted for population size. The point is that Ivor was cherry-picking data, and that would have been true on a population adjusted chart - the only difference is that the slope of the decline into 2011 would be steeper, and the slope of the uptrend from 2011 to 2018 would be less. 2018 would still be the highest point since 2011, and Ivor would still be falsely acting as if the difference between 2018 and 2019 was meaningful, here, even to the extent of saying, āSo this is most likely the biggest factor driving Swedenās numbers, and most countriesā numbers, actually, independent of lockdowns and distancing.ā
That is positively insane.
Of course there were other factors, but that doesnāt change the facts as they relate to the 2011 - 2018 period, and the relationship between 2018 and 2019. Again, Ivor cherry-picked 2018, and made false statements about several countries as well as presenting a demonstrably illogical conclusion.
Iām not particularly defending his position; I just think that someone who questions the official narrative is helpful in the big picture. Gabeās certainty that thereās a āconsensusā is a pretty common one, and I really like it when there are voices that counter that belief.
Yes, I agree that we donāt know, but I disagree with your statement about countries that acted strongly and have low death rates (in fact thatās contradicted by your next sentence). The countries that had advance warning and took it very seriously have low death rates. They were in an enviable position vis a vis the virus. NYC took it incredibly seriously and has what I think might be the highest per capita death rate (and a pretty glum economic/social situation to boot). I donāt blame the policies for that; itās just that the virus was already pretty widespread in the city by the time they shut it down (exacerbated likely by higher viral load, high concentration of people).
We donāt know about the virus and we also donāt know about the long-term effects of shutdowns.
I donāt need to see suicide numbers to be concerned about the mental health of our young people. I think that what theyāre going through will have long-term ramifications that we canāt yet imagine.
Thereās a lot we donāt know yet. Right now, I would say that the timing of a suitable vaccine and what will happen without one in the October - March period are prominent issues. Connecticut is in that group of northeastern US states where now almost everybody realizes the severity of the virus. Speaking of the US, in several western states, and Alaska and Hawaii, the outbreak has been much more muted and slow-developing, and attitudes vary more, all the way to āthe virus is a hoax.ā
You are equally guilty of ācherry pickingā (not so sure that Ivor is )but donāt seem able to admit it thoughā¦ hey hoā¦
Yoru graph which I see you have used elsewhere in a similar context doesnāt show what you want it to.
If you want to look at UK death figures then go to the ONS data sets.
Thatās where my data came from.
I think Gabeās point about the consensus was well-taken. Hey, Iām all for questioning things too, but at the least people should avoid falsehoods and deliberate deception when doing so.
:: bangs head against wall :: Itās two different things. Acting early enough or not is part and parcel of it.
NYC didnāt act early enough, and the city leaders acknowledged that quickly. I agree that not all places had the same opportunity to prevent the virus spread. NYās large amount of travelers and enormous metro area - as a practical matter related to our consciousness of the virus at the time - meant they simply were not going to control it as well as Singapore, Thailand, Vietnam, New Zealand, South Korea, Japan, etc.
Thatās really not an answer. In the US, 200,000 - 300,000 are already dead from the virus. Nobody says you canāt be concerned about young people and mental health, but per se thatās no reason to be against measures aimed at slowing the virus spread. Take it to its logical extreme - āIām worried about so-and-so over there, with mental illness. So letās lift restrictions even though it will result in X number of deathsā¦ā
I grant you that thatās a āsevereā example, and that few people indeed are saying, āGo ahead and kill Grandma.ā But we are talking about drawing the line somewhere as to restrictions or not, and without a compelling number of suicides itās not much of a factor.
I wonder - among the countries that really did have long and hard lockdowns/restrictions, was a meaningful increase in suicides observed?
False in the sense that SARS viruses are even remotely comparable to a bad flu season. Heās downplaying the severity of this virus that hasnāt made itās way through the whole population yet. Thereās plenty of healthy and vulnerable A+ blood types.
Itās just that youāre saying that places that took it seriously enough had extremely low death ratesā¦ except for the places that took it seriously that had extremely high death rates. NYC officials may be saying that they could have acted sooner but with the data that we had at that point, itās hard to imagine what could have worked. They basically would have needed a shutdown in late December or early January, which at the time would have seemed ridiculous.
Iām not sure about number of suicides. I get your point about meaningful data, and maybe thatās part of my frustration. Death is measurable, but quantifying the downsides of the shutdowns are much more difficult.
You say that, but I do not think you have an actual example of me cherry-picking. Meanwhile, to any rational and reasonable eye, Ivorās cherry-picking is unmistakable.
My graph came from ONS data. It most certainly shows what I want to convey - that Ivor cherry-picked to a silly and shameful extent (the comparison with climate-change deniers and 1998 is entirely apt).
Go ahead and adjust it for population. Now we have ādeath rateā instead of ādeaths.ā UK population grew by 5% from 2011 to 2018, while the number of deaths increased 11.5%. The exact same facts are still in evidence - that 2018 was a relatively āhighā point (and thus Ivorās cherry-picking). Same as before, 2018 was the highest point since 2011 (and in fact, whether we look at the per-capita death rate or the raw number of deaths, one would have to go back farther in time than 2011 to find as high a year as 2018).
It is also not that the broader trends are all that matter here. Ivor is struggling with the illogical contortions necessary to validate his thesis, i.e. āSo this is most likely the biggest factor driving Swedenās numbers, and most countriesā numbers, actually, independent of lockdowns and distancing.ā In doing so, he pretends that the differences between 2018 and 2019 are not only significant but oh-so-very-important - when in fact at the most it is random distribution, likely abetted in some cases by 2018 being a āhighā point. I would say to Ivor: 1.) Donāt cherry-pick, and 2.) It doesnāt matter anyway, you are pretending that very small normal variations are somehow āthe biggest factor,ā which is frankly nonsensical.
On the countries that Ivor mentioned and that I ran the numbers for in my above post - Great Britain, The Netherlands, Spain, Sweden, Norway and Finland, the average change in mortality from 2018 to 2019 was -1.1%. And this is after Ivor cherry-picked 2018 as a āhighā year. And thereās Ivor, saying that Great Britain had āa huge troughā in mortality in 2019. Come onā¦
Likewise, Norway was down 0.38%, and Sweden was down 3.8%. And thereās Ivor, saying, āthis is most likely the biggest factorā when heās being stared in the face by the reality that Sweden has a 1080% higher per-capita death rate than Norway. So again, come onā¦
No, just taking it seriously enough isnāt it - obviously, action had to be taken as well, and past a point in time, action, no matter how vigorous, wasnāt going to slow the virus spread as it would have earlier. I did say acting āvery strongly and early.ā
I agree that there was no totally stopping the virus, there. But they really did pull the trigger late on several things, and this was after they knew what was happening in China and Europe. The first recorded case in NYC (at least this was true a few months back) was a woman coming from Iran, her final leg being on a big plane from Qatar. Once she was known as a positive case, the mayor and governor said that everybody from that flight would be tracked down, but they never were. Things like this matter a lot, early in a virus outbreak. At that point the powers-that-be didnāt act strongly or early enough.
Well, thereās going to be a lot of quantifying in the future, as well as enormous numbers of people being negatively affected - I think thereās no debate there. And thatās regardless of what a given government will do. And yet weāre a tough species, eh?
Yes, fair enough. I guess what Iām wondering is once we recognize that distinction shouldnāt that change the approach. I.e. if you are early enough, a full lockdown is ideal. Once the virus has had a few months to spread within a population, Iām not sure that shutdowns help, and I think a more targeted approach would be wise.
Among the the things that I wish were mentioned - and here weāre all probably in agreement on this forum - since metabolic syndrome is such a strong risk factor for death and hospitalization, it would be really nice to see some official guidance that mentions it. (And maybe we shouldnāt have hospital food that doesnāt seem specifically designed to induce metabolic dysfunction?)
One highly publicized US COVID death was a 72 yo man who was obese with diabetes, heart disease, high blood pressure. His widow blamed policies, saying āhe did everything right, but he died of the virus.ā I think by āeverythingā she meant that he wore a mask, worked from home, and washed his hands. There are so many people who donāt realize that in fact they can lower their risk a lot (itās not a guarantee, I know, and weāve had a few cases on this forum) but controlling your blood sugar is doable, and it should be at least part of the official message.
Itās two different things. Acting early enough or not is part and parcel of it.
Hope your head is ok!