Reno and Hitchens Question the Shutdown

The Public Square
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Joseph, I have just finished reading the paper and watching the testimony, and I agree with you, Berenson is not a trustworthy source, and those tweets I copied above are a misunderstanding of both the paper and what he said in the video. Thanks for the heads up.

As you say, the ‘peak’ in a few weeks was mentioned in the paper and video, and refers to initial peak before suppression strategy has fully kicked in. It’s not implying anything about end of lockdowns since its with the assumption that suppression interventions are continued until vaccine arrives. Also, further peaks are anticipated if controlled relaxation/restart of interventions is undertaken whilst they wait for the vaccine. So he’s not even committed to a single, final peak. And the death total ranges from 5,600 to 48,000 for GB in the paper for the measures we are currently applying, so substantially less than 20,000 is not a totally new idea.

Me too.

A couple of things I am wondering:

  • In the video evidence Ferguson suggested half to 2/3 of those who die would have died relatively soon anyway, such that those people would not affect ‘excess mortality’. I’m wondering why the death rates in the back of the paper are not adjusted for that? Isn’t excess mortality the relevant statistic here?
  • The death totals in the paper (Table 4) are for a 2-year period. Should not these be reduced to account for a more realistic time wait for the vaccine (12-18 months)?
  • He said the R0 number (measure of transmissibility) has been revised upwards to 3. The reported results in the paper considered 2 to 2.6 (Table 4). Looking at the trend, higher R0 means higher death, and it’s hard to see how he would predict <20000 from the trend with R0=3. Perhaps he is accounting for the above 2 points, or something else?

That said, I’m still very doubtful that lockdowns is the side of caution here, considering the potential human cost of economic damage.

An interesting website is the European Mortality statistics. Presumably, we should expect the Covid-19 deaths to reflect some excess mortality in the charts:

So far it’s not looking like it, though Italy shows some rise but well within seasonal variations. Perhaps people will argue that this is because the lockdowns are working / it will take a bit more time for things the reach relevant magnitude?

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Really the numbers of deaths are still tiny, even in Italy and NY, where I have brought out the flu comparison. The reason it is so concerning is because Italy has 0.17% of its population that has tested positive. In NY, it is at 0.1%.

The quadrillion dollar questions are how many people have already gotten it and how many would have in the end before we got herd immunity? I think I read that 70% is required for herd immunity. If we’re at 30% already in those places, headed to 70% in the end, then it’s probably no big deal. If we’re at 10% headed to only 40%, that’s worse, but still not terrible. If we’re at 1% headed to 20% it’s going to hurt. If 0.5% to 70%, that’s downright horrific.

Nobody even knows the first number until we get some random antibody testing in those hard-hit places. I think Ferguson mentioned there were some Italian towns that had done this and that was why he was saying the evidence points to a very small percent of people being already infected. I’d love to track that info down, if I heard right.

With how contagious it is, and the number of deaths so far, and that being with a tiny fraction of people infected… then all the worry has been worth it, in my opinion.

I’ll have to go back and look at those tables again you mentioned.

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This is the only place I’ve seen negative tests reported:

Based on those numbers, about 84% of tests are coming back negative. I’m not at all clear on who is getting tests. For all I know, Harvey Weinstein and NBA players are all taking 10 per day. A woman in my church is a presumed case because her husband tested positive and she is symptomatic. So presumably they aren’t testing either the most likely cases or the least likely cases, but I assume that most of the folks getting tested now—Harvey Weinstein notwithstanding—are at least somewhat symptomatic with some sort of respiratory stuff. 85% coming back negative is terrifying.

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Yep I heard that too.

This morning Ferguson was interviewed for ~4mins on BBC radio, at the 1hr54mark (you have to register but for free):

https://www.bbc.co.uk/sounds/play/m000gt4s

He said they need to wait for the antibody testing which should begin in a matter of days for firm numbers, but current estimates are 2-3% for UK population as a whole, perhaps as many as 3-5% for hotspots like central London.

Given GB has a population of around 65 million, using 2.5% of that as number of +ve cases gives 1625000 positive cases. With currently <1500 deaths so far and around 200 new deaths per day, even allowing a few weeks for some current cases to result in death and bumping total deaths up to 5000, these numbers would suggest fatality ratio less than 0.3% which is lower than the 0.9% considered in his paper - though some comments in the paper might suggest the results were not that sensitive in the 0.25-1% range.

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I’ve been watching them here:

https://coronavirus.1point3acres.com/

Just scroll down to the list of states and click on the beaker icon next to a state. It will show you the positive (and what percent they are), negative, Total tests (and total population). Right now, NY is up to 34% positive.

I’m guessing it was the town of Vo. It was not antibody tests, but rather they tested every person in the town for the virus.

True, but you are assuming the current group of cases have a uniform spread through the population. I would expect and hope that older people are being more careful, given their huge risk, and that they are under-represented in current cases.

Can anything be done to drive the total infections down and the infection fatality rate (IFR) down? Obviously the quarantine is about keeping total infections low, which should also drive the IFR lower, because

  1. you protect the most vulnerable
  2. you keep the medical field from getting overwhelmed, so they can devote more care to each case
  3. And it gives them time to find better treatments
  4. And ultimately gives enough time for a vaccine to be created

Surely after seeing Italy, many old people in the U.K. are smart enough to hide inside, even if the government didn’t require it. That alone should be enough to make a dent in the IFR (in my own unprofessional opinion).

Perhaps the Imperial paper is naive in starting from a disaster scenario in China, but I don’t think so. The whole question is what would happen if we did nothing. I think China at the start was a good model for that. Perhaps the Imperial paper is naive in assuming literally “nothing” is done to try to stop the infections in its worst case, but I don’t know what else you would use as a baseline.

Perhaps we could drastically lower the IFR simply by seriously quarantining the elderly, and maybe that would have way less economic effects. I don’t know. I don’t think we should assume they are too dumb to have thought of them, though, since there were movements that direction and it’s the first thing anybody would ask when looking at the rates by age.

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A post was split to a new topic: Covid-19 vaccines and aborted fetal cell lines

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The Imperial paper (Ferguson) found social distancing of just the over 70s didn’t make much impact on transmission rates, but did reduce overall mortality but it was not enough as there was still an 8-fold exceeding of critical care bed capacity in both UK and US. Though with the updated higher NHS bed capacity in the parliamentary video I think Ferguson said this gets reduced to 3-fold, though I’d have to check. I assume you mean their definition of this social distancing of over 70s could be much tighter in practice:

Reduce contacts by 50% in workplaces, increase household contacts by 25% and reduce other contacts by 75%. Assume 75% compliance with policy.

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A post was merged into an existing topic: Rebellion is rebellion, whether in the home, church, or society

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@henrybish, I forgot all about that. You could also drop the age to 60. At any rate, as I said, I’m not an expert, but I tend to trust that they have thought about these things. You rightly point out, they have.

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Sobering announcement from the White House.

The White House on Tuesday evening predicted that total American deaths from COVID-19 would fall if current social-distancing guidelines are maintained.
According to [Worldometers], U.S. deaths from the outbreak currently sit at 3,780 as of 6:30 p.m. EST.
Trump called Americans to brace for “a very tough two-weeks”:
“I want every American to be prepared for the hard days that lie ahead,” Trump said. “We’re going to go through a very tough two weeks.”

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I want to remark on the last entry of the thread. Perhaps this thread has gotten too lengthy, but I want to take note of one thing. We have been told that COVID-19 will peak sometime in the next month, which is why stay-at-home orders are in effect until that time, at least here in Indiana and across the river in Kentucky. Current American deaths sit at around 3700, as the news story reports. The White House is predicting 100K-240K total American deaths.

Have these people completely lost their minds? Folks, as one of my old math professors (a feisty New York Jew) used to say, “This isn’t Nobel Laureate stuff.” How does the math add up? 3700 deaths in 2 months, with an expected peak one month from now, and we are expecting 100,000 deaths, on the low end?

I’m not telling anyone to disobey or defy the authorities. Nor have I ever, nor am I now condemning churches who have decided not to meet. But one of the features of our republican form of government is that we get to ask questions of our rulers. And once again, what is being said and done does not add up. Stuff like this does nothing to tamper down my skepticism; it only grows it.

What we are witnessing is a society and government composed of men who profess to be wise, but are fools. While we should still give honor to whom honor is due, by virtue of the office, the government may not compel me nor anyone else to say that what they’re doing is wise, well thought out, or necessary. After praying for our leaders, may I suggest also sending them some strongly worded letters?

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I’m completely at a loss, @bencarmack, as to what you are saying. What exactly do you object to in the current estimates? It sounds like you think the number of deaths predicted now (at least 100k) is way too high to be believable. Is that what you are saying?

If so, a few things are worth noting. First, the projected peak in approximately two weeks is not the end of the deaths. In fact, the peak is clearly expected to come early in the cycle, with the majority of the deaths coming after the peak. Second, there were 1069 new deaths yesterday. The fact that there were 3700 deaths in two months is hardly evidence that the total can’t go up exponentially from there, just as it has been. Here’s a screenshot of the graph from the White House presentation.

Screen Shot 2020-04-02 at 5.18.12 PM
Screen Shot 2020-04-02 at 5.18.12 PM1420×548 144 KB

This is obviously only the graph, not the complete mathematical equation, but it does not appear insane to me. In fact, the estimate for yesterday on this graph is slightly low, but basically accurate. Will the number of deaths keep going up at the rate they projected? God only knows, but it sure looks like it to me. And I say that looking at the increasing rates of new cases and the increasing case fatality rates around the country, not just this graph.

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The deaths seem to lag 2-3 weeks past the infections, so if we think the new infections will peak in 2-3 weeks, then the deaths will start to peak 2-3 weeks after that. Also consider that our hospitals have a capacity, and once that capacity is reached, the death rate will go up even more. People who can survive because they have a team of healthy doctors, an exclusive icu nurse, and a ventilator may not survive when any one of those things are taken away. This will affect more that just just the Covid deaths: the heart patients and the cancer patients and the kids who fell riding their bike all will not have the same level of medical care as normal. It’s going to be ugly and sad.

I have no expertise in this area, but I am bracing myself for quarantine through at least May and possibly June, and that once the shelter in place orders are lifted, it will be months and months before life returns to “normal.” I believe the authorities are only currently calling for an end date of April 30 because 1) they are hoping they won’t have to extend it, even if they think they will 2) to keep the economy propped up and avoid talking about additional tax refunds for now 3) it’s probably easier for them to tell us two weeks at a time and get people on board than it is to announce a sweeping 2-3 month shutdown. Again, I have no special knowledge. I hope everyone is wrong and that somehow the deaths have already peaked—but nothing at all that I have read anywhere suggests that. Even if you look at the (presumably falsified to look less awful than it was) death rate data from the Chinese, will we in America be able to reproduce their quarantine conditions? The authoritarian government there dragged people from their homes and centralized food delivery. That is not going to happen here, and our quarantine will be much less perfect.

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If deaths double every three days, we’ll be well into six figures in 15 days. If that marks both the peak and the halfway point of the epidemic, that puts us at almost 250,000 total deaths across approximately five total months.

Plug 3700 x 2 into your calculator and then press = until you get a number > 100,000. It took me five presses. If you assume a three-day doubling rate, that’s 3 x 5 = 15 days.

Whether any of those assumptions are correct, I have no idea, but none of them seem at all crazy. Some may be pretty optimistic.

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Zero people in the United States will be welded into their homes.

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Exactly. And if it wasn’t clear, by using the word “perfect,” I wasn’t implying endorsement. :wink: I just meant that we can’t hope to have compliance like the communists did.

We have other factors going against us here: obesity, and lack of experience with the first SARS. Notice how the people of Asian countries just have experience with the containment and mask wearing. This is all new to most people here.

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Another way of looking at it is that most recently it was 3700 in 5 days.

Yes, the peak deaths are delayed from peak cases, but I think there are additional factors that keep it from being quite that far apart. For example, the super unhealthy make up the majority of deaths and probably die more quickly. Also, note that they are expecting the deaths to peak in a couple of weeks. I have my doubts. I expect the peak will be later.

Yeah, we are on a 23% growth rate right now, meaning we are a little bit more than 3 days to double. Of course, the goal of flattening the curve is that the growth rate will go down. So far, however, there is no deviation from 23% growth in deaths for the last 15 days. Again, the death curve should trail the case curve, so if we see flattening of the case curve, the idea is that the death curve will flatten soon thereafter.

The odd thing is that the projection of the peak at 2,214 deaths requires that the growth in deaths start slowing dramatically in a few days or we’re going to be on the high-end trajectory. We’ve not seen a dramatic slowdown in rate of infections. We’ve seen some change, but not a dramatic slowdown.

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I doubt that we even have anything like a case curve right now. Or if we do, it’s from a model with a boatload of assumptions built into it. Testing has been so haphazard and non-random and so widely variant from place to place that I don’t think we can even begin to get a bead on what percentage of Americans in a given area have Covid right now. The death curve is not without its problems, but dead people are a lot easier to count than cases at this point.

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What I’m hearing from Joseph and from John M. is engineerish graph talk, which obscures the big picture. The Big Picture is that this thing has killed far less than 100,000 people worldwide. at this point. The United States is not China. We are not Italy. We have modern medical facilities and higher standards of sanitation. 100K-240K predicted is fear mongering. It is based on no evidence. It is unreasonable, on its face. Frankly, it’s infuriating that anyone takes this seriously.

Here’s another Big Picture question. If 100K-240K people are going to die anyway, with draconian social distancing regulations in place, then clearly what we’re doing is not working and will not work. So why are we doing it? What’s the justification for it? What’s the cost/benefit? Is it worth it to have an economic depression and 200,000 people dead?

That’s my final comment on this thread.

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I hope you are right. I hope we can peak right at 1250 deaths per day [edit: Well, 39 minutes later, that’s clearly a pipe dream.] in the whole country and drop below 500 per day by the end of the month, and 0 by the end of May.

However, with both the number of confirmed cases and the death rate from confirmed cases still rising, I don’t hold out much hope for that.

If you are wrong, and that many do die, I hope you will reconsider whether the same people who made that (correct) prediction might have been right with their prediction of what would have happened without social distancing. Right now in New York, more people are dying from Corona Virus than everything else combined. I would say the purpose of social distancing where I live in Cincinnati is to prevent that from happening here. So far it seems to be mostly working.

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