Kind of a fun graphic
Well, we look like getting a vaccine!
Of course managing the policy response to the virus could know of this only as a possibility. But, looking like it is coming to pass, that possibility seems to produce a final scorecard well in favour of the competent lockdowns in Australia, New Zealand and China and against the incompetent ones in the UK, Europe and the US which vacillated between publicly supported lockdowns and ideologically supported lockdown scepticism and ‘balancing’ the health and economic welfare of their populations.
Sweden will have done relatively well economically, though not much better if at all than its near and equally competent neighbours. But it’s had ten times their death rate or something like that. So I’m calling for more good old-fashioned ClubTroppo humility from ClubTroppo’s own #LockdownSceptics.
Could not agree more.
Keep Troppo , Troppo not Catallaxy please
Troppo has never been in any danger of turning into Cesspitallaxy.
Paul just has a very different view to you.
Catallaxy has its moments.
I think you’re jumping the gun, Nick, for two very different reasons.
First, whilst I would love to believe this vaccine will solve all issues within a few month for just a few billion dollars, don’t count on it. Pretty likely the 10% for whom it is no help are the most vulnerable, meaning that this vaccine is only useful as a means of creating herd immunity around the most vulnerable. In stead of the strong and healthy getting this virus, they would then be asked to take the vaccine to achieve herd immunity that way. That means one needs a lot of vaccine doses which will take a year or more to produce and disseminate. Are you ok with another year of happy confinement for the lucky country? Funnily enough, in Europe and the Americas the populations will pretty likely achieve a large degree of herd immunity before this (or any other) vaccine is disseminated widely. So this thing is basically too late for most countries and is an unfortunate teaser for places like Australia to confine themselves another 12 months.
My second objection to your triumphalism is what is not on your scorecard. All the damage you do not acknowledge and thus do not count up to that final tally. Where is mental health? Where is collateral health damage? Where is the loss of liberty? Where is disruption to the lives of children? Sounds like you think of them as irrelevant.
And where is your humility, not merely in terms of the things that should matter to tallies, but also to the question of how you assign results to policy? In the case of China, I think the role of other factors like prior immunity might well have far more relevance to their outcomes than policy.
So would you really advocate to the future a repeat of the policies followed in Oz or China? Or a very different one to that followed in many countries? Do you really think of the disaster humanity has inflicted on itself as a fair exchange for what it has gotten?
+ 1
I should have said at the outset that the vaccine may disappoint. It’s certainly what I think. But what I wrote was seeking to write about the ‘if then’ of it being successful.
Unless you have some knowledge suggesting that your guess about who the 10 per cent who don’t react well has some science behind it, I’d be happy to move on. But let me know if it is.
As for the rest of it, the vaccine would allow lots of options to minimise the costs of continuing the quarantine. Those visiting Australia and those returning from OS can do so with an appropriate certificate of immunisation. Doesn’t seem like such a big deal. And in any event, international travel will remain crippled for as long as COVID rages through populations. And the countries that have it under control can open up to each other.
As for mental health and all that stuff, we seem to have run into counterfactual problems again.
If the virus takes off, we now have a lot of experience. What happens is that communities other than Swedish communities lockdown. That’s my counterfactual. And so the countries following your advice will have more time in lockdown, more mental illness, more deaths, more economic damage and so on. They already have. I know that if they appointed you as a benevolent dictator this would be different, and I’m happy to vouch for you as probably benevolent at least in intention. But even there I have no confidence that more damage of all the kinds you mention wouldn’t ensue from individuals and households locking down themselves.
Anyway, you ask me to be more humble on behalf of lockdowns. But I AM humble and always have been. I think I’m right but you might be. I’m arguing here:
1) it looks much less likely that I’m wrong if the vaccine performs well and there seems a reasonable chance it will.
2) you remain in your anti-humility bubble.
Paul, you’ve gone all quiet – first time I’ve seen it.
What’s wrong with my reasoning?
Hi Nick,
I actually read the protocols of the Pfizer study to figure out what they were doing to whom. As usual, its very hard to make sense of those protocols because it lists many studies, most of which have (probably) not yet started, and the press announcement doesnt really say which studies the announcement is about. So, for instance, we dont know how old the participants are of the trial reported in the news. I read one industry insider saying the study basically only has volunteers below 55, and another saying the initial plan of the study was to have 40% above 55. Neither knew for sure, presumably because they, like me, couldnt find that info. We wont know till the published paper. Nothing in the press announcement makes it clear, though I have to say it will be much easier to find younger volunteers and it makes for better PR because they will show less problems, so I suspect the first insider is right. If that’s the case it means we at present have no idea if this vaccine works for the vulnerable group.
A second such issue is that immunisation in general is more successful with people who have an active and healthy immune system: people who are vulnerable are vulnerable precisely because their immune system doesnt work so well anymore, which then shows itself in not learning from a vaccine what healthier people’s immune system learns from them. So from that perspective you’d expect the failures to be among the most vulnerable, and one can note that the announcement does not tally up the number of severe cases in treatment and control groups. Hence, really, the announcement is much less encouraging than news reports make them sound. See https://science.thewire.in/health/coronavirus-vaccines-clinical-trials/
On the issue of damage, I first always like to point as to what actions caused the damage and whether that is proportion to its potential gain. I dont see how else we can get to rational policy advice. Your answer to my claims that policies are doing huge damage is that other people’s policies also do huge damage and that its not that bad relatively in Australia. One major problem with that is the implicit acceptance of damage if others get damaged too, where damage includes authoritarianism. Its like saying slavery and persecution of minorities are ok if everyone else does it too. Another major problem is that one must look at all the big forms of damage and not get seduced by looking only at the elements a particular media and authority points to because they happen to look good on those scales. So tell me how many covid-deaths you would accept to prevent the move to government by decree. Zero?
As to the particular countries you name, I have to say the world is also much bigger than Sweden, the UK, and Australia. It has lots more variation than you seem aware of. Denmark and Norway dont have compulsory masks, for instance. Tanzania and South Dakota had no restrictions at all and Tanzania has basically had no deaths from covid at all, though admittedly almost surely because few vulnerable enough to die from covid have managed to survive there so far. Still, if you want to play the game of least covid damage, Tanzania wins.
As to humility, we are humble in different ways, it seems to me. It just veers into name-calling though to get into that, so I’d rather not. Let the gods be the gods.
Agree with your point about humility in different ways (and I’m not being ironic) :)
You’ve spent huge amounts of time on this and thrown yourself into it. Good on you. I’m going on some basic factoids.
Countries that I know that locked down early and hard – Australia and New Zealand for instance – look at this stage to have done themselves far less harm than countries that went the yo-yo and got caught by the culture wars going back and forth between lockdowns and government programs to open up like the UK Mud Wrestling to Help Out.
The progression of the virus seems to have damaged the US, UK and worst hit European economies to the tune of around 20% of GDP so far whereas the damage to Australia looks like being under half that.
The Scandanavian countries provide the closest thing to a controlled trial between similar countries. And the tradeoff between strictness in lockdown seems to show that all those Swedish deaths didn’t purchase much if any economic growth at least then.
In previous exchanges you’ve argued that Sweden has placed itself better for the future because they’re closer to herd immunity – which of course makes a number of assumptions – namely that it’s possible to get effective herd immunity naturally from the virus and that there won’t be an effective vaccine soon. So my post was addressed to the fact that there may now be an effective vaccine – though I agree it may not be.
Another claim you made on your first response to me is that Australia will be locked down and that will harm our economy. The only question there is how much and compared to what. So to repeat, once a vaccine arrives if it does, the quarantine we impose can be greatly rationalised. And we can open up to other COVID clear countries. Meanwhile in COVID land travel is crippled. Will Chinese students prefer to head to Australia or the US or Europe for their education. They should be able to sail right through customs if we can set up a bubble with China. Ditto tourism.
I think lockdown is looking better to me.
Let’s take the two claims you site of me, which indeed are things I have said for a while now.
On Sweden having a high degree of herd immunity, it does indeed look that way in this second wave Europe is experiencing. If you look at their second-wave experience so far (https://www.worldometers.info/coronavirus/country/sweden/) you see a wave of fatalities that is something like 10% of the first fatality wave in April, and already receding. The wave of new cases is concentrated among the younger healthier population, basically the group hiding away voluntarily first time round. So unlike France, Spain, and the UK, where the second fatality wave is looking like being about 50% of the first wave, or Germany where the second wave is bigger than their first wave (probably because the repression first time round merely delayed matters), Sweden is thus indeed showing a much higher degree of herd immunity. They probably have a lot of immune people around their more vulnerable populations.
My second claim of economic damage to Australia seems a no brainer to me. Its projected GDP decline in 2020 is 4.2% according to the latest IMF projections. That’s worse than Sweden (with a 3% projected decline in 2020). Moreover, it has no immunity to show for that damage meaning that all the economic disruption of an eventual wave is yet to come. And it has already seen a huge increase in authoritarianism and even a kind of fracturing of the union via all the interstate restrictions. And the mental health damage is enormous of the lockdowns. Its national debt is increasing fast, which masks the magnitude of the problems with unemployment and the economy. Etc. I would definitely advise the experience of Sweden over that of Australia. Sweden appears to have plateaud in terms of debt, covid deaths, and unemployment, with little mental health problems and whilst keeping their freedoms intact. I’d favour those outcomes by a large margin over Australia’s. Wouldn’t you?
I do agree with you the UK is a total basket case. There are not many countries with worse policies than the UK (though I think you wrongly ascribe their jo-joing to culture wars. There was no serious political opposition to lock downs. The government just really had no idea what they were doing). Maybe the endless lockdowns in Peru, India, or South Africa were even worse (and the Peru one was done quite early: the idea you seem to that early hard lockdowns are the magic pill dont survive a good look at the international experience).
You haven’t addressed my vaccine point. If a vaccine arrives and is good – we’re hearing of it being rolled out in March – then the damage stops. We’ve got a lot fewer deaths and similar GDP loss to Sweden.
Why that’s a no-brainer I have no idea
As for the ‘authoritarianism’, this has happened all around the world – though not in Sweden. And I don’t accept that it’s authoritarianism. It’s not LIBERtarianism, that’s all. Its taking emergency measures to control a virus. One’s liberty is subject to it not harming others. I do think the issue of liberty is an important question, but it would need a post of its own.
Suffice it to say that I have always been concerned with the ease with which our constitution could be subverted. But no-one seems interested in placing serious bulwarks around our liberties.
Like I tried to get one through parliament when I was working for John Button and got him to introduce a private members bill to ensure that parliament couldn’t lock people up for breach of parliamentary privilege without going before a magistrate. But no-one took any interest and it died on the notice paper. Was never debated.
Like I’d like to see the Democrats in the US introduce some basic constitutional reform – for instance, to remove the presidential pardon power.
Temporary measures in an emergency don’t come into that category. And ‘damage to the federation’ from temporary border closures on public health grounds – don’t make me laugh. The closure of borders against Victoria was obviously justified given that the whole country was committed to lockdowns if the virus got out of control, the remainder of border closures are silly and will be sorted out in the not too distant.
I think you too easily dismiss the new powers that politicians have grabbed, and the divisions between states, as temporary things that will soon be sorted out. Whilst I of course hope that occurs I could easily point out that dictators pretty much always promised those who let them get into power that it was just temporary because of some emergency. Now is not the time for complacency.
The no-brainer is that there has been significant self-inflicted economic damage to Australia.
Your reaction (problems are over in March with the vaccine) to me illustrates one the dangers in this whole covid-business: the seductive nature of promises of technological fixes and how it makes people go along with abuses and losses in the meantime.
So let’s look closer at that promise. As I understand it at present, Australia has a call on 10 million doses of the Pfizer vaccine. Since they recommend two doses per person spread out a few months, that would mean 5 million people immunised. Since its likely this thing is not tested on the vulnerable, one should expect it to be given to health care workers and 5 million others in the healthy population. This vaccine needs to be stored at -80 so it will need a quite spectacular industrial effort, and of course 5 million people then have to go somewhere to get this thing, but let us for the sake of a reasonable argument say this can all be done and by the end of March Australia will have 5 million immunised adults of which only 2% will be symptomatic if they get exposed to covid, rather than the 20% that would be symptomatic otherwise (this is roughly the proportions you should think of). A few more will be infectious themselves if they catch covid, but not symptomatic.
Are you then back to normal? Only if you are willing to suffer a large glut of covid deaths, I am afraid. You see if you truly get back to the social and economic life pre 2020 you are still going to get a large wave of infections in the population (5 million is not enough to avert that), and unfortunately the most vulnerable have the habit of living close to those places most likely to become heavily infectious (care homes and hospitals). Indeed, those most infectious wont get immunised because they are the more vulnerable.
Moreover, we know from the smaller study that 8% of those immunised with this Pfizer vaccine has ‘severe adverse effects’ ranging from headaches to vomiting and fever, though not bad enough to require hospitalisation. Nevertheless, that is is then 640,000 out of those 8 million, quite a few of which will die (you always have a few unfortunate cases. that’s why quite a few of the other vaccine trials have stopped).
So in April you find yourself with 640,000 people complaining of headaches, where the government has taken up liability (part of the deal with Pfizer is that they are not responsible because the client took up the vaccines before the end of all the Phase III trials (which wont end for many years)). And you will have a covid-wave as soon as ‘normality’ resumes anyway.
All that is the optimistic scenario because it presumes this vaccine indeed is 90% effective. And for that, you would need to remain closed another 5 months at least, with maybe a few more lockdowns if there are more flare-ups.
This is not the end of the story either because viruses mutate and the unfortunate reality of vaccines is that they usually do not react to all parts of a virus but only one or two of them (that’s all you need against a particular virus). A mutation in just that part will mean the vaccine stops being effective, which btw is not true for people who had the actual virus because their immune system learns to defend against multiple aspects of the virus. So you will need more vaccines of different types later on, suffer all their side-effects, and live with the fact that they are unlikely to be fully effective on the vulnerable.
Now, if you are willing to shrug your shoulders at all those health problems coming down the line, the difference between that and the Sweden approach is not so different at all, is it.
However, let’s get a bit more sinister and think of the huge industry that has you firmly by the balls come April. They have sold you vaccines, lockdowns, masks, social distancing, inessential shops, and lots of other measures ‘for your benefit’. Another 5 months of growth later, why would they let you off the hook?
So consider the possibilities for keeping you imprisoned ‘for your safety’. The other vaccine companies will make you very aware of the side-effects of the Pfiser one. The mask sellers will make you very aware of mutated covid-viruses this vaccine does not help against. The sellers of tests will point to the 10% on which the vaccine doesnt work and how we need to keep testing. The politicians who sold you one fear will find themselves with a host of related ones to sell you next.
As i said in a previous post, the situation is much grimmer than many people realise.
I’m sure Nick has a few “basic factoids” to answer you. Talk about humility …
Paul, here are the trial parameters:
https://clinicaltrials.gov/ct2/show/NCT04368728 . You can see the doses and that they are looking at older groups.
Also when you’re quoting studies, they may well be using far higher doses than the stage 3 trial (for which the lower doses are usually chosen as they are likely cause less secondary effects).
I am personally surprised Pfizer is allowed to comment now on partial data — it is standard to wait until all the data is in, but these are clearly special times.
I imagine your questions will be answered once the data comes in.
Nick
If one looks at the experience of all countries there appears to be no evidence of any solid relationship between the severity of lockdowns and the resulting illness and mortality outcomes. It is hubris for any government to think they have had any real control over covid-19. Australia, NZ and other countries with apparently better outcomes are completely isolated from the rest of the world which is unsustainable. Sweden has had 10 times the death rate of its neighbours ? I have no idea which countries you could be referring to.
Just to focus on one aspect of the direct cost of the Australian lockdown, the Brain and Mind Centre at Sydney Uni has forecast 750 – 1500 additional suicides for up to five years. Did these people make it on to your scorecard ?
Your post is flippant and heartless.
+ 1
Also seems to be somewhat fact free. For example,
“Sweden will have done relatively well economically, though not much better if at all than its near and equally competent neighbours.” What’s the evidence for this claim?
The numbers from suicide are tiny. I imagine heart-disease (the biggest cause of death in Australia) caused by sitting inside all day would vastly out number suicide.
On the flip-side, chronic stress is a well known cause of heart disease, and I imagine many people running around with the thought of death from covid going through their minds all the time causes chronic stress. Chronic stress also causes depression which would cause more suicide.
So the counter condition to suicides from lockdown is death from heart disease and depression due to chronic stress from worrying about covid.
All this stuff about lockdowns not working is also rubbish — they worked well almost everywhere. That’s why Euroland had a second wave — because they reduced the numbers in the first one. If they hadn’t worked, they would have had just one big wave. It’s what happened after that made the difference, as it did in Victoria vs. the rest of Australia.
Conrad
Re “ they worked well almost everywhere” if they were one component of a total integrated strategy.
By analogy water bombers can reduce fire intensity enough to allow boots on the ground to get in close and deal with hot spots etc but water bombers without boots on the ground look impressive but can make little difference in the longer term.
It seems clear that in much of euro land and in Victoria the emphasis placed by earlier modelling on ’Lockdowns being the only thing that makes a difference ’ and ‘all other measures would not make a jot of difference’ was taken too literally so , what you do after you have reduced the outbreak initial intensity was not given near enough thought and effort.
I agree John. If you pay the price of lockdown, you need to capitalise on it to make it worthwhile so it doesn’t come back, which some countries have.
Even in Adelaide, however, I still see government stupidity. For example, I got tested twice for covid (once only a few weeks ago), and both times the nurses *doing the testing* were not wearing the PPE correctly, and didn’t even have hair nets. The person doing the talking was also doing the testing, and hence couldn’t wear a N95 mask (but had a faceshield). The second time I got tested, I couldn’t help but notice that some hair fell into the face of one the testers which she then just brushed out of her face without thinking. Perhaps people think covid is more or less gone in Adelaide so they are getting slack, but if you at the testing centre which is the most likely place you will find it, this clearly shouldn’t happen.
Conrad
Curious, was there any means by which you could provide feedback ?I.e. ‘you could do this a bit better’
As far as I’m aware, no. Although wearing hair PPE is pretty obvious, as is training to stick on properly. Things like have a talker and sample collector is less obvious (but if I can think of it, it clearly can’t be too hard). For that matter, getting rid of having to tell them you Medicare number would be a good idea too. You want to make it as quick and easy for people, including the staff taking the details. Given these are contractors, the government could just pay them the amount equivalent to the medicare amount they would get.
It would be curious to know if other states are so sloppy.
Conrad the nurses really were, RNs or ENs ?
Have no direct experience of testing in NSW , however most things re test track and trace were well organised in NSW
Going off recent trip to RPA protocols were being followed meticulously etc.
I’m not sure what type of nurses they were, although it’s clear it wasn’t their fault — it was whoever was organising it.
My wife trained as a theatre nurse
Such things should be instinctive for any trained nurse.
Hence my question
Dejavu. You can see the same problems never get solved. Another quarantine infection escaping.
https://www.adelaidenow.com.au/coronavirus/sa-records-three-new-cases-of-locally-acquired-covid19-contact-tracers-try-to-prevent-an-outbreak/news-story/a16f458d34b2d3f664806440b3d53a3e
Surely lockdowns will have some effect as they increase social distancing and by definition slow down the spread of the virus. But … there is surely huge costs to them. So whether they are a success or not cannot be assessed without some proper accounting of all the costs and benefits. By whatever measuring rod you take, QALBYs, WELLBYs, SEYLLs, what not.
Here is an important example of a country that might have done much better with the Swedish strategy: https://www.washingtonpost.com/world/the_americas/coronavirus-argentina-million-quarantine-lockdown/2020/10/26/65eefde2-149c-11eb-bc10-40b25382f1be_story.html
It’s pretty clear that for whatever the reason(s) lockdowns were not possible as a part of a real world, workable strategy for either the US or the UK , for them they have delivered the negatives but little in the way of positives especially if you take a long term view.
Agree.
To date, the shortest vaccine development ever was 5 years, for mumps.
I’m not saying they don’t have a vaccine. I would say however that vaccines need a TON of testing, because they are literally playing with people’s immune systems, and certain things done to certain people’s immune systems result in serious side effects, some permanent. This is not to be anti-vax… the goal is to be very careful, especially at the level of a potential vaccine that could potentially be given to everyone on earth.
If a vaccine were made available for public consumption tomorrow, it should, at first, be voluntary. And not just voluntary in the sense of people can make the choice to get it or not, but voluntary in the sense that we prohibit social restrictions from being applied to those who do not get it, except perhaps in healthcare and elder-care settings. I would only support making the vaccine mandatory after 5-10 years, depending on the accumulated data on its effects, and depending on epidemiological studies proving that COVID is still a danger enough at that point to suggest mandatory vaccination.
RE: lockdowns. I am new to this blog so I guess I’ll just state my position. I continue to be fully in support of the initial lockdowns (March-May/June 2020) as a means of governments buying time to get their house in order and to blunt the immediate death toll.
I am not in support of continued lockdowns based on cases/positive tests, as many of these are asymptomatic. Nor am I in favor of lockdowns based on hospitalizations, as hospitals, at least in the US, are designed to operate near maximum capacity anyway (yay for for-profit healthcare). Lockdown should only be applied in response to excess deaths, where deaths exceed expected numbers by certain percentages, or are expected to exceed expected numbers by a certain percentage, based on epidemiological data.
It is interesting to note, now that many countries are in the throes of a second/third-wave, that deaths, as a percentage of cases, is way, way, down. COVID took out the weak in the first round, plus virus mutations typically trend to be less lethal, plus our healthcare systems are now equipped to better treat it.
I am also very perturbed that all the data we are getting on worldwide cases is getting sourced from one site, Worldometer, which is not very transparent on how they get their data. Even Johns Hopkins is pulling their info from Worldometer. For metrics as important as this, I’d like to see some transparency and vetting. There was a theory going around that Worldometer was controlled by a Chinese company, but that turned out not to be the case. Still, one wonders.
One more observation. According to the data, China never had a second wave. Why? Everyone else, even countries like France who were praised for their effective lockdowns, had a second wave. The very nature of lockdowns means once you lift the lockdown, you get another wave. How did China escape a second wave? I find this hard to believe, and this leads me to extreme skepticism of Chinese data. My theories are, 1) China is counting deaths instead of cases, 2) China has had a vaccine since June, 3) The data is being faked, or 4) There was a mass die-off at the beginning that resulted in COVID burning itself out rapidly (there was atmospheric information early on suggesting China was running huge crematoriums near Wuhan). One or all four of these is going on, likely. For reference, I have a friend in China who can vouch that life seems normal, except for masks.
China cannot be trusted in general, and I get the feeling like we may never know the full truth of COVID for a long time, if ever.
Hi DT,
I see you read the data with the same scepticism as I am.
My theories on China are different, because you see the same low covid-deaths in Japan, South Korea, Singapore, and Taiwan. I dont believe they are all faking their data.
There are various dimensions not often talked about in the mainstream media that can explain country variation other than policy. One is the business of prior immunity. We know a Singapore study that found 50% had T-cells that gave partial immunity. That a lot more than the % in Europe. So perhaps China and that whole region simply had bigger prior waves of other coronaviruses that put them close to an R of 1 anyway so with minimal suppression they could avoid a wave (at the cost of having to suppress forever).
Another issue is just how many vulnerable there are in a country and whether something else got to them before this virus. That is probably a big factor in Africa which is unlikely to have had large prior coronavirus waves but still very few covid deaths. It might also be an issue in a place like Denmark which has a very low life expectancy relative to Southern Europe. Maybe those places just have few very vulnerable left because they died of something else earlier.
Another issue is how care for the elderly is organised. Communities of the most vulnerable are far more at risk than elderly living alone or cared for by someone quite old in the suburbs. That too varies by country.
Then there are difference in climate, ventilation system, social conventions around hugging, and lots of other things. The tendency to ascribe virus outcomes to policy is very human, but one always has to keep in mind the known unknowns and the unknown unknowns.
RE: paul frijters
I think you are on to something, there, about non-policy factors.
+ 1
Additionally, there is evidence that the PCR tests being used return positives even when the virus is dead and non-transmissible. So what does that mean for all the hand-wringing over “cases”?
I have felt for some time, that this whole situation would resolve itself quickly after a Biden win in the US. We are already hearing positive news about a vaccine – here we go!
COVID has been politicized up the wazoo. That doesn’t mean it isn’t a real concern. But judicious handling has been overshadowed by political posturing, and that is unfortunate.
Agree that Chinese data can’t be trusted. Especially in the first half of the year where there is considerable evidence that they under-reported massively. That said, I believe their numbers right now can be trusted. They just would not be able to hide major outbreaks given how normal life is now in the major cities. See as background reading this: https://www.spiegel.de/international/world/a-berliner-in-beijing-what-life-looks-like-in-an-almost-covid-free-country-a-28cc9e94-e9d3-490d-ae56-3011976da738?fbclid=IwAR2a-m1t8CRQPq-WmxdT_jyg9N-Js8u6YVdInGGtcP-_pI8BgdD6RWzPrUI
Oh, and as Paul has pointed out already: there are several other countries that clearly have managed to keep the virus under control. Taiwan, Hongkong, Singapore, South Korea, Japan come to mind.
Especially Taiwan.
Almost never mentioned here in Australia. I watched a zoom conference about 6 months ago where one of the active participants was the Deputy Director of Health, Taiwan. He said the only “lockdown” Taiwan had done was closing the kareoke bars for 2 weeks.
Yet the infection/death rate there is tiny compared with Australia. So why does this remain almost unknown here in Aus ? Embarrassment, perhaps ?
that’s funny about the karaoke bars!
The experiences in Taiwan, Japan, Vietnam, etc., are also not discussed much in Europe: having almost no recorded covid-deaths with minimal restrictions just doesn’t fit the narrative.
The lack of real interest in analysis of what is going on tells me some kind of strange crowd behaviour is going on.
You guys should stay consistent with the trade-off game that you are to espouse for lockdowns. Thus, the amount of testing you should assume vaccines need should only need to be less than the cost of not having them, not harmful to less than 1 in 2 million.
Paul is catallaxysing yet again.
Mental health, collateral health damage, damage to the lives of children.
what would occur if all the legal and behavioral problems were overcome and herd immunity was adopted.
you have all the above problems in spades. People would die simply because the ICUs are full!
Just remember HI is 60-70% of the population getting the virus.
That means deaths in the hundreds of thousands.
In what way are school closures not the direct result of policy? Or, put otherwise, how many schools closed in the countries that had no lockdowns or quickly stopped having them (like Sweden’s close neighbours)?
In what way is the total isolation of the elderly and single people, which is a big cause of mental health problems, not the direct result of policy that forbids them to go to work or meet other people?
In what way is turning back non-covid patients from hospitals, which directly causes a lot of collateral health problems, not the direct result of policy?
Etc. Causation is quite easy to assign to things governments mandate.
Mate,
what would occur in your world where everybody is getting the virus. No-one but but no-one could visit the elderly and we are not yet even talking about the carers.
Are you so silly as not to understand in your brave new world hospitals would be overrun and patients turned away.
Which is the bigger?
It is your brave new world!
The only person catallaxising on this thread is you Homer.
Can you take a chill pill.
Homer being Ms Tracey, I trust?
+ 1
Nick Paul is saying the health system would be over run in a lockdown.
They were not and they would be indeed overrun under HI.
That is the very definition of catallaxyising.
If you wish to show this is false then show it.
Gee, chiiling (effect)! “The only person catallaxising on this thread is you Homer.
Can you take a chill pill.”
Nick, see some of the rhetoric above & prior driving you to make these posts. The discussion here is now touchy feely, and falling below ” Catallaxy may also be used to refer to a marketplace of ideas, especially a place where people holding diverse political ideologies come together to gain deeper understanding of a wide range of political orientations” wikip.
Feel free to call me out but beware, by doing so you’ll make my point.
I was going to make a supportive comment Nick. You obviously don’t need it.
And our elected representatve (hint: name starts with D) here Nick “heartless”. But no call.
And so to, PF says; “In what way is the total isolation of the elderly and single people, which is a big cause of mental health problems, not the direct result of policy that forbids them to go to work or meet other people?”
This way;
“LONDON (Reuters) – Many COVID-19 survivors are likely to be at greater risk of developing mental illness, psychiatrists said on Monday, after a large study found 20% of those infected with the coronavirus are diagnosed with a psychiatric disorder within 90 days.
…
“In the three months following testing positive for COVID-19, 1 in 5 survivors were recorded as having a first time diagnosis of anxiety, depression or insomnia. This was about twice as likely as for other groups of patients in the same period, the researchers said.
…
“People have been worried that COVID-19 survivors will be at greater risk of mental health problems, and our findings … show this to be likely,” said Paul Harrison, a professor of psychiatry at Oxford.”…
https://www.reuters.com/article/health-coronavirus-mental-illness-int-idUSKBN27P35N
As a mere plebian, I feel you have all gotten ahead of the evidence and are – as trained academics – using your hammers without the wood, nail, and context being fully exposed as yet.
But I like it, and thanks. Take a chill pill.
Thanks KT2
Unfortunately what you’ve written regarding me is written in a shorthand I don’t understand.
I take Homer’s reference to ‘catallaxising’ to be a reference to expressing oneself in some abusive or intemperate way. Paul isn’t doing that from what I can see. Paul generally does not do that. He doesn’t dish out abuse. He’s basically courteous at least as far as I can remember, which is quite a feat in these circumstances. But he’s direct. Direct but courteous. This is in Troppo’s mission statement and I quote:
you are wrong on that. Catallaxysing is asserting black is white.
Paul is asserting something that is worse on his measure as I have constantly shown. You have yet to show it is false!
On Sweden it is having a second wave.
Herd Immunity means one continuous wave.
you have second waves where a lockdown has not worked for whatever reason.
Nice 😊
Pfizer CEO sold 60% of his stock this week.
Just sayin …
My understanding ( Conrad can correct me if wrong) is that the people who have developed this vaccine are a pair of Germans whose main focus has been on ‘building from scratch “ immune system based treatments for cancer . As best as I understand roughly speaking they have worked on drugs that then ‘instruct’ human cells to produce quantities compounds that then trigger an immune response to say cancerous bladder cell .
I’d guess that’s why they have been able to move quite quickly compared to more traditional approaches.
The need to store at about minus 80 doesn’t seem to hard for Australia, that’s about the temp of dry ice ;should not be that hard to quickly make special transport options workable and most of the need would be in cities (but obviously most chemist shops would not at the moment have the needed fridge.) combined with what seems to be well honed track and trace system we should be ok.
Would seem that a bubble covering China ,Taiwan Vietnam, NZ and possibly Japan? Seems likely before too long?
Re Sweden the overwhelming percent of deaths were of people who had already signed a do not resuscitate doc I.e. people who by definition are never transferred to ICUs etc.
And it seems more and more clear that there is no second surge of deaths or icu admissions.
Re China the people on the ground that we know tell us that everybody is quite relaxed there are no rumours etc it’s definitely the case that factories are working traffic congestion is bad and restaurants are busy.
As far as I’m aware, it’s novel — but there are other companies using similar technology. The more standard vaccines may still work for all we know too, or they may fail completely. It is amazing they got 90% efficacy, although it is worthwhile waiting for the full results come out before reading just the headlines (and finding out how long immunity lasts, which seems to have been forgotten entirely). If it’s true, I would suspect lots of the others using similar technology will work unless this one was the accidental needle in the haystack.
I suspect the difficulty in transport and storage will be a big problem for 3rd world countries, as well as the two injections spaced over time. Rich countries should help them. There are nasal sprays and even tablets being tested, but these are further away and use different technology so I wouldn’t bet all my savings on them.
Thanks I have a family interest in immune system treatments for cancer. The background piece I read was in the AFR the other day if you wish I can find the link.
Strange thing is the BCG has been around for decades works well in the right situation, however nobody I’ve asked knows who and why somebody thought that the vaccine of TB was worth a try as a treatment for bladder cancer ( of all things) in the first place !
And it’s only in the past few years that researchers have shown much interest in other immune therapies for cancer at all .
John, as far as I’m aware, historically when looking for drugs at the very early preclinical stage, a lot of random searching went on. So you basically just got a whole pile of possibly likely compounds and looked at what they do to your virus/cancer/etc. cells. So it may well have been found fairly randomly. After that you can try and optimize things from what might work (although the success from preclinical to released drug is tiny — which is why company share prices do next to nothing when they release such findings). It is weird that such a compound works on such different things, although it basically shows how little we knew (and probably know).
Sure however BCG is very effective ( if the cancer hasn’t spread out from the bladder wall) was developed decades ago and works via the immune system.
But that did not trigger a search for other immune systems treatments , least not until many long years later.
BTW Agree completely about ‘90%’
My reading is that 94 people got Covid of those in the trials and that 85 got it in the control group and 9 in the treatment group. So the 90% figure seems to come from (85 – 9)/85 = 76/85 =~90.
Obviously you make all kinds of heroic assumptions here including that randomization was done properly …
Saupreiss, people just need to wait. It is unlikely the randomisation was done poorly (the company which does the testing is independent from the company which owns the drug), although it has been noted that some people in the non-placebo group would have known they had the injection due to side effects. But this should have had the opposite effect (“I’m invulnerable now, so I don’t need to worry about Covid”).
We still need to know how many people were in each of the groups they examined, which condition they were in (low or medium dose), and how many symptoms the people who had the injection had that still the got it vs. the control. This will come out soon.
Like I said above, I’m surprised they were allowed to look at the data early and release a press statement about it. This is atypical, but we are in atypical times, and presumably they want companies to start early manufacturing of it. Many of the other largely bureaucratic and pointless hurdles which also take forever and a day to comply with have also been reduced all over the place.
Agree with all. I am just pointing out how questionable that 90% efficiency number is (and where it seems to come from).
Yeah and it will be interesting to see what happens with that 90% number when n=94 gets scaled up to 7 .8 billion.
I understand that what gets scaled up to 7.8 billion was 2×22,000.
Looks more like a done deal now. https://www.sciencemag.org/news/2020/11/just-beautiful-another-covid-19-vaccine-newcomer-moderna-succeeds-large-scale-trial
It sure looks promising
Nicholas re the UKs sceptics it doesn’t seem ideological rather it seems a justifiable a scepticism that the UKs government- ruling class could actually get their act together and do their side of the bargain I.e. get track test trace up and rally working in a month of Sunday’s. Personally given the forced transfer of untested people from hospitals to aged care facilities ( with virtually no RNs PPE to boot) I would not trust the zuKs authorities as far as I can throw them either.
Nicholas it’s probably a bit premature to count your vaccines. And it definitely premature to start on the balance sheet , for one example presentations in many lockdown countries for minor heart attacks and strokes are way down on average , many of those things if not promptly treated can turn into longterm , life shortening conditions…
I honestly wonder if people posting here are looking at the correct data. Sweden is mostly definitely having a second wave. Test positivity is now > 10% and new case rates rival the US adjusted for population. The 14+ day lag between diagnosis and death means the death rate is only now ticking up, but it is definitely increasing.
To use death rates as a criteria for lockdowns is a disastrously bad idea due to the aforementioned lag between diagnosis and death and the exponential nature of the pandemic spread.
https://ourworldindata.org/coronavirus-data-explorer?zoomToSelection=true&time=2020-03-01..latest&country=IND~USA~GBR~CAN~DEU~JPN~SWE®ion=World&casesMetric=true&interval=smoothed&perCapita=true&smoothing=7&pickerMetric=new_cases_per_million&pickerSort=desc
https://adamaltmejd.se/covid/
Here is a shortened link to that ourworld in data chart
http://tiny.cc/wcp4tz
seems the same data as (https://www.worldometers.info/coronavirus/country/sweden/). Very minor second wave so far. What does happen with Swedish data is that they tell the world much later about both cases and deaths than other countries do. Up to a week or two. I dont know why that is. So for instance, today the rolling average on deaths says deaths have been going down for a week. But whether it still looks that way in a week’s time?
And of course one shouldnt use deaths to determine lockdowns. Nor cases. One should ignore the fear and calmly compare likely costs and benefits.
I imagine deaths will reach more than 50 a day in the future in Sweden given it looks like their hospital system is now overwhelmed (or perhaps that’s just scaremongering). This slow trickle upwards compared to the first wave seems to happen at a different rate for different countries, but as far as I can tell, all that now happens is countries wait until it gets too bad and then pull the pin. Perhaps Sweden is simply good at slowing the process down, but now I imagine it is probably too late, although they are introducing other measures apparently.
I had a similar prediction with John some months ago about the UK when he was talking about how no-one was dying there, which is clearly not the case now. I also had a similar prediction about New York with you a longer time ago, when I believe you predicted cases wouldn’t go up (which they clearly are now too). I imagine we will unfortunately see an uptick in deaths there in a few months too. If not, I’ll admit that was the wrong prediction and your other hypotheses about other forms of immunity, which I think are exaggerated, are probably not so bad after all (Although they are implementing additional measures to try and stop the spread too — which I think are too weak to bother about).
Apart from this, unlike you and John who seem to think only really old people on their absolute last legs are dying (as noted in your slides for the UK), I think younger people will die too. This is already the case in the US.
Conrad
Current figures for icus in Sweden
https://experience.arcgis.com/experience/09f821667ce64bf7be6f9f87457ed9aa
At the peak of the first wave it was around 40+ a day currently it’s about 15 .
Re it largely only kills the very old.
In Sweden the deaths were very skewed towards people with do not resuscitate docs. The Swedes are famously pretty healthy.
Obviously in populations where severe obesity ,lack of exercise -and all the complications that goes with that – is common I.e. the US the numbers of relatively young people dying will be significantly higher.
BTW I really believe that much of the money spent on health awareness campaigns and the like would give much better long term outcomes if used to pay subsidies for fresh veggies etc and for compulsory cooking ( and how to shop) classes particularly in higher primary years . I worked in a youth support scheme decades ago was really struck by how many of them simply did not know how to buy and prepare the most simple of meals. Many came from homes where their parents had never cooked either.
I agree John, especially in countries with high inequality (or intractably poor groups). The evidence is with you too — if you give poor kids a healthy meal at school each day, they will turn up to get it, and probably eat better across their lifetime too. The No Child Left Behind program in the US did that, and it lifted their literacy rates in low SES groups considerably.
And therefore for some kids a oft overlooked bit of collateral damage related to lockdowns , was that school closures meant for them no decent daily meal.
Yep, although the counter condition isn’t life as normal.
Conrad
This whole thing reminds me of 1914- 18 . Most still think that we can return to how it was…
The Swedish reporting lag is why I included the second link, which is to a swedish site which attempts to predict the actual death rate based on the typical reporting lag.
https://adamaltmejd.se/covid/
Sweden’s outbreak is not minor. Population adjusted it is matching the USA, and on raw numbers is 4-5000/day. It could lead to more than 100 deaths/day in 3 weeks time, which is a greater rate than the first wave.
Nobody wants lockdowns. They are the result of unpreparedness in the first instance, and subsequently policy failure.
given the huge collateral damage lockdowns are just bad policy, and unfortunately many do want them.
On the Swedish numbers, thanks for the links. Ultimately its an empirical question how much immunity the Swedes already have. I did think their large first wave would have given them a fair degree of immunity and that’s what their serology and T-cell tests were indicating too, but we’ll see the coming weeks whether that is true or not. So far, their excess deaths the last 3 months, including the last 2 weeks, are below the historical average (https://www.euromomo.eu/graphs-and-maps) and indeed for Europe as a whole the second wave is much less pronounced than the first one. Yet the damage to the sectors closed down (schools, social life, business) is enormous and as I keep showing in my calculations, orders of magnitude bigger than what they might prevent in terms of covid.
There is a puzzle going on with the near disappearance in the data of seasonal influenza. I recall Conrad pointed this out in NSW data months ago too. I havent yet come across a convincing explanation. Maybe its bad testing. I have wondered about the role played by reduced contact of the healthy population with disseminating hubs (hospitals, care homes, perhaps other herd species).
Paul.
give it up,
you do not have second waves if a country has herd immunity.
on the cost what about the cost of herd immunity.
It would surely take at least two years.
Imagine the clogged up hospitals, the metal health problems all those couples trying to have IVF.
Of course the economy would not be very heathy either and without all that government support.
This is Paul’s brave new world
From the AFR
” Germany has not seen any excess mortality so far as a result of the second wave, while across Europe it remains much lower than during the first wave.”
Please get this into your brain:
Herd immunity either from a vaccine or by long general exposure to a virus, doesn’t mean that nobody gets infected or that occasionally somebody gets quite ill or dies.
I find that hard to believe seeing as the population adjusted death rate in Germany during the peak was 2.78/million and it is now at 2/million and rising.
Adian “excess mortality “ is the important term here.
I understand the difference.
As the Federal Statistical Office of Germany only has current data that is a month old, I expect this will not be the case in a month or so.
https://www.destatis.de/EN/Themes/Cross-Section/Corona/Society/population_death.html
This also highlights the issue with using excess deaths. This is something that is better looked at after the fact, as it does require careful analysis. It is not a leading indicator, and right now it is not useful for deciding on policy responses in the very near term.
I agree that the outbreak in Sweden is not minor – that’s why the Public Health Authority is tightening the screws. But … excess mortality is still nil: https://emanuelkarlsten.se/sa-raknar-norge-danmark-finland-och-sverige-dodsfall-med-corona/
More importantly, it seems that the Swedes have learned to protect more fragile segments of their population better (plus the virus has killed the most fragile people in the first wave). The mass of the infections are in any case now afflicting the 20 – 60 year old who have — as is now well-established — a fairly low probability of dying of/with the virus: https://emanuelkarlsten.se/coronaveckan-som-gatt-v45/
There is no way that the Swedes will have more than 100 deaths/day in 3 weeks’ time, I suspect it will be about 20 – 25 at most. Testable hypothesis. Mark it.
With the lag in Swedish death reporting of up to 3 weeks it may take 6 weeks to find out what the death rate is in 3 weeks time.
Adian
On the ground information is that the lag is about a week . Your figure of a a six weeks lag, given your other comments here ,sounds like ‘ wishful thinking’
and a more cynical man than I might wonder about your real motives for spreading fear and panic…
+ 1
See the first graph in here, which has a forecast including ave lag. Seems that my guess is pretty much on the money; Aidan’s not soo much. https://emanuelkarlsten.se/coronaveckan-som-gatt-v46/
Yeah nah. Probably 60/day right now and in a week? Well they’re forecasting between 100-140/day in December
https://translate.google.com/translate?hl=&sl=sv&tl=en&u=https%3A%2F%2Femanuelkarlsten.se%2Fcoronaveckan-som-gatt-v48%2F
Adian my ‘prediction’ is that no matter what the data etc show , you will somehow will be ‘correct’
I am by now so tired of “experts live at the cutting edge off conformity “ but too old too expect you of all
people,to think outside your box
“experts live at the cutting edge off conformity”
what a fantastic phrase. No escape possible from those though, in any period. Forgiveness is your best bet.
It wasn’t I who said this:
It has been tested and been found to be incorrect.
You put scare quotes around ‘correct’ like that is a bad thing.
Sweden did badly before and is doing badly again. The way they’re going many more of their citizens will die needlessly.
Numbers in ICU are slightly up https://experience.arcgis.com/experience/09f821667ce64bf7be6f9f87457ed9aa
However proportionate to the number of infections ( not ‘cases’) all of Swedens numbers are quite low.
The point about Sweden is if the modelling that hypothesised that ‘ only extreme mandated lockdowns ,nothing else, works’ was even vaguely correct the Sweden should have already have had a much worse outcome than the euro land average. It hasn’t ,therefore that hypothesis is proven to be false .
+ 1
“only extreme mandated lockdowns ,nothing else, works”
This is a straw man argument.
Extreme lockdowns occur because milder measures were not used, or were tried too late to be effective.
Aidian none the less that is exactly what the original and influential,Imperial college modelling claimed ; Their predictions made in March ,for Sweden are a matter of public record .
+ 1
From the AFR
“ There were grim reminders of the collateral costs of lockdown in the results of two German studies.
A study in the region of Hesse found the number of deaths from heart attacks rose 12 per cent during the first lockdown, and doctors warned serious heart conditions may have been undiagnosed because patients followed advice to stay at home and did not seek medical help.
A smaller scale study in the Waldshut area found that while local deaths were 37 per cent higher than usual in April, only 55 per cent of those excess deaths were linked to the coronavirus, while the rest appear to have been caused by other conditions which went untreated.
Germany has not seen any excess mortality so far as a result of the second wave, while across Europe it remains much lower than during the first wave.”
Re Sweden I gather that they wait a week to get their figures corect. So we will see.
Conrad
That thread is to squeezed.
Re SA and quarantine.
Taiwan has been running quarantine for months without any apparent problems ( and in general they are gold star on the whole biz) . It’s about time that , how Taiwan does things is a compulsory subject for governments.
By now it’s apodictically clear that the real appeal of lockdowns to ,many governments is that they cannot properly do anything else .
Shifting nearly all the work needed onto the shoulders of the public, simply allows government structures that are overburdened with management ‘costs’ , so complex that they don’t even know where the ‘frontend’ is, to continue on doing things like we have always done them.
+1
Conrad
Further to the historical echos
Yeats meditations in time of civil war seem eerily apt to our time:
We had fed the heart on fantasies,
The heart’s grown brutal from the fare,
More substance in our enmities
Than in our love; O honey-bees,
Come build in the empty house of the stare.
Adian that thread is too squeezed
This seems reasonably up to date https://www.worldometers.info/coronavirus/country/germany/
While deaths ( and infections) are on the rise they are still in absolute terms pretty low. And Germany’s first wave in comparison to say the UK was fairly small beer .
During the fires I witnessed real leadership ,it’s cool and clear when most of us are either scared shitless or simply lost in a fog of smoke and heat.
A narrow focus on covid will lead to poor overall outcomes.
For example if a exclusive focus on covid deaths blinds us to significantly raised premature deaths from heart attacks in relatively young people (which seems to be the case) then that is not a good net outcome .
Adian if you really want me too , I can look it up, however the influential Imperial College modelling back in March was quite clear in its predictions : anything short of extreme restrictions on human movements would not work.
There was nothing nuanced or gray about imperials predictions, and reality has proven them wrong.
BTW “ after the fact” is a fat load of good when you need to decide,now.
And that Imperial College modelling was written in FORTRAN ( 1970s vintage) had thousands of lines of unannotated code , no nesting etc and was clearly prone to self reflexive recursion i.e intrinsically chaotic and worthless as a model of anything,real.
There was as really good deconstruction of the program months ago by some young kid – can’t find it right now — along the lines that you critique.
Other critical assessments of that program:
https://necsi.edu/review-of-ferguson-et-al-impact-of-non-pharmaceutical-interventions
https://twitter.com/yaneerbaryam/status/1239936951823843328/photo/1
https://www.bloomberg.com/opinion/articles/2020-03-20/coronavirus-complicated-models-fell-short-on-changing-details
Comment Title:-
Dakota is the new Sweden.
John Quiggin said:-
“Problem for testing efficacy of Covid restrictions is govts always lock down when the pandemic gets really bad, leaving open possibility of spontaneous remission. With Sweden now locking down, best test cases for “let er rip” are Dakotas. Things are not looking good.”
@johhnqiggin – twiter
****
“The Dakotas are ‘as bad as it gets anywhere in the world’ for COVID-19
“South Dakota welcomed hundreds of thousands of visitors to a massive motorcycle rally this summer, declined to cancel the state fair and still doesn’t require masks. Nowits hospitals are filling up and the state’s current COVID-19 death rate is among the worst in the world.
“The situation is similarly dire in North Dakota, with the state’s governor recently moving to allow health care workers who have tested positive for COVID-19 to continue working if they don’t show symptoms. It’s a controversial policy recommended by the U.S. Centers for Disease Control and Prevention in a crisis situation where hospitals are short-staffed.
“And now — after months of resisting a statewide mask mandate — North Dakota Gov. Doug Burgum changed course late Friday, ordering masks to be worn statewide and imposing several business restrictions.
“Our situation has changed, and we must change with it,” Burgum said in a video message posted at 10 p.m. Friday. Doctors and nurses “need our help, and they need it now,” he said.
https://www.usatoday.com/story/news/health/2020/11/14/covid-19-north-south-dakota-masks-kristi-noem/6237635002/
****
Sweden maintains controversial COVID-19 strategy despite surge in coronavirus cases
https://abc.net.au/news/2020-11-14/sweden-second-wave-covid-19-strategy-surge-cases/12884194
****
Up, up, up… now masks. Check back in a month – or is that 2 weeks or 6 weeks?
https://www.worldometers.info/coronavirus/usa/south-dakota/
Re masks here is a probably (apologies if I am wrong unkle rob) a libertarian deciding for him and his closenfamiky andntelling us… worth a watch. Sth Dakota needs Uncle Rob.
Uncle Rob says:-
“Covid-19 vs Surgical Mask.
Fungerar masker eller inte?
Testar kirurgiska masker mot spridningen av covid-19. Kommer de att arbeta för att stoppa spridningen eller inte?
Varning: Farbror Rob är en “professionell” Var inte en idiot.
Covid-19 vs Surgical Mask. Do Masks Work Or Not?
Testing surgical masks against the spread of covid-19. Will they work to stop the spread or not?
Disclaimer:
Uncle Rob is a “professional”
Don’t be a moron.
https://m.youtube.com/watch?v=x6cTDGqcUpA
****
Burgum announces new requirements for businesses, gatherings and masks, delays winter activities to slow spread of COVID-19
Friday, November 13, 2020
“BISMARCK, N.D. – Gov. Doug Burgum tonight announced several mitigation measures aimed at slowing the accelerating spread of COVID-19 in North Dakota in order to protect the vulnerable, ensure hospital capacity and keep schools and the economy open.
“Capacity is strained across the state’s health care system, jeopardizing the ability of hospitals to provide the first-rate treatment North Dakotans are accustomed to – not only for COVID-19 patients, but also for those seeking care for heart attacks, cancer, trauma and other urgent needs, Burgum noted.
“Our doctors and nurses heroically working on the front lines need our help, and they need it now. Since the beginning, we’ve taken a data-driven approach to our pandemic response, focusing on saving lives and livelihoods. Right now, the data demands a higher level of mitigation efforts to reverse these dangerous trends, to slow the spread of this virus and to avoid the need for economic shutdowns,” Burgum said in a video message announcing the measures. “Our situation has changed, and we must change with it. Tonight, we’re announcing four measures designed to reduce the spread of infections in our communities to protect our most vulnerable and to ensure hospital capacity.”
https://www.governor.nd.gov/news/burgum-announces-new-requirements-businesses-gatherings-and-masks-delays-winter-activities
****
I wonder if Mike Canon-Brooks had a word in Burgum’s ear?
…” Burgum joined Great Plains Software in 1983 and became its president in 1984. He sold the company to Microsoft for $1.1 billion in 2001. At Microsoft, he became the head of Microsoft Business Solutions. He began serving as chairman of the board for Atlassianin 2012. “…
https://en.wikipedia.org/wiki/Doug_Burgum
****
And I am mildly amused nobody takes John R Walker’s suggetion to conclusion;
“John R walker says:
November 14, 2020 at 1:30 pm
“Nicholas it’s probably a bit premature to count your vaccines. And it definitely premature to start on the balance sheet…”
https://clubtroppo.lateraleconomics.com.au/2020/11/10/the-vaccine-and-the-covid-culture-war/#comment-666610
JRW, I thought tis would be a good clip to start off PF’s new post. Fun.
****
Not at all. The site I linked above plots delay until full death count is reached (within 10% of final total) and that is 14 days.
https://adamaltmejd.se/covid/
The lag between diagnosis and death varies a lot between countries, and sometimes between outbreaks, depending on the age structure of those affected and the stress on the health system. This article suggests 20 days between symptom onset (often when tested) and death
https://www.theatlantic.com/ideas/archive/2020/07/why-covid-death-rate-down/613945/
and highlights even in the US that there can be a lag of up to a week before the death is recorded by the CDC.
Given Sweden seems to have even higher lags I don’t think 6 weeks is too much of a stretch to make sure it is capturing the full impact, but perhaps 5 weeks is closer to the mark. 3 weeks is definitely too short a time.
Adian As best as I can understand ( my Swedish is very basic)the official figures re numbers in ICUs are updated about once a week so expect to see something in the next day or so.
Re sites that predict trends, that is something that has proven to be a ‘large project ‘ during all of this biz.
BTW I’m told that the CDCs systems at the start of all this were woeful often literally pen and paper or running on ( error prone) heritage software of the likes of Fortran or Dos.
In fact I’m told that even NSWs health systems at the beginning of all this were also often DOS based . In the UK only about 15 percent of PHE entire budget was allocated to infectious diseases and most of that was spent on Vaccine promotion.
Its extraordinary given how much we spend on Health and Public Health, how little ended up being spent on critical systems re the control of serious pandemics etc.
And its not as if the nations to the north of us have not had close runs with SARs type diseases in the last twenty years.
On a related matter if it wasn’t for the philanthropic generosity of Judith Nielson Australia would not have a single professional Journalist stationed in Jakarta !
Adian
I asked that Swedish doctor how is it going his response.
Sebastian Rushworth, M.D. says:
17 November, 2020 at 08:59
Hi John,
There has been a slow gradual increase in hospitalizations and deaths over the course of October and November. Seems to be stabilizing now at around 15-20 covid deaths per day, which is a significantly lower level than in spring (when over 100 people were dying per day with covid).
Reply
Rushworth is an unreliable source. He predicted in April – May that Sweden was done with the virus. He also commented on the recent Danish mask study without apparently having read it carefully, simply mispresenting what it says.
Adian https://www.worldometers.info/coronavirus/country/sweden/
The data’s trend doesn’t seem to be inline with your
predictions
As we’ve established, Sweden’s death reporting appears to lag. This is due to the way they report deaths, and is nicely explained here:
https://ourworldindata.org/covid-sweden-death-reporting
So there really isn’t much point discussing their death data in real time. Wait and see.
In any case Sweden is now imposing tougher restrictions to try and curb their current outbreak
https://www.news18.com/news/world/swedish-coronavirus-cases-rise-new-measures-welcomed-3090302.html
I’m not really sure what we’re debating now.
As we also established, about 90 percent of the Sweden’s deaths are reported within 2 weeks, so we can fairly reliably extrapolate from the current numbers.
Germany’s COVID19 death/day is now worse than the first wave and rising rapidly. They have stabilised their rate of new infections, but it is not dropping as yet.
Sweden’s cases/day has also stabilised at around 5000, but at a level that is currently twice that of the UK and Germany adjusted for population, and with a test positivity rate > 10%. It is likely the deaths/day in Sweden is now 60 or more, but it is very difficult to say for sure.
https://adamaltmejd.se/covid/
Adian https://www.worldometers.info/coronavirus/country/sweden/
Deaths are clearly trending down and were never near the levels they reached the first time round.
As for the rest of it unless the current death rate in say france or the UK was to drop quite dramatically below the current rate in Germany (or Sweden) for quite some time the , relative positions will not change that much.
I.e. it’s clear that
There are a number of large European nations ,that went for repeated severe mandated lockdowns that have come out definitely worse off health wise ,and economic wise , than Sweden.
John, this has been covered extensively. Sweden reports deaths differently, and attributes them to the day of death, not the day the death is reported. Arguably this is a more accurate method, but it does mean the deaths reported on any given day are artificially low compared to all other EU countries. New deaths are added to previous days as time goes by. See
https://adamaltmejd.se/covid/
It is clear from this plot
https://bit.ly/2J5WqVR
that the second wave in the UK, France and Italy took off before Sweden and Germany. For those first three countries the rate of new cases is dropping countries due to their respective control measures.
Germany has stabilised new case numbers per day, but not reduced them yet. Sweden is a bit hard to tell, they definitely stopped increasing for a week or so, but they’re not out of the woods. Their test positivity rate is still above 10%, which suggests it is nowhere near under control.
Adian it would take the UK France Spain and the like having virtually no additional deaths and Sweden to have an awful lot of deaths for the relative positions to change. Therefore it’s still simply undeniable that quite a few major European nations that went for severe repeated mandated lockdowns have had worse results than another European nation that did not copy them.
Obviously they all would have been better served to have copied Taiwan or vietnam or even Australia but that would be a big ask of any European nation.
There is no control available, so it is possible (I would say probable) that Spain, Italy and the UK would have had much much worse outbreaks had they not used enacted severe lockdown policies.
From this chart it is pretty obvious that Sweden did much worse in the first wave than it’s neighbours Denmark, Norway and Finland. In fact France did a fair bit better than Sweden, Italy and Spain in the first wave, but has caught up in the second wave
https://bit.ly/2Vg1OYJ
It isn’t clear to me that Sweden will do better than Fra/Ita/Uk/Spa, but it is hard to tell with it’s lagging death reporting. It’s case numbers are on par with Italy and the UK, though lagging Spain and France
https://bit.ly/37nmq6W
https://www.worldometers.info/coronavirus/country/sweden/
Adian
The figures are continuing to drop.
Concrete Evidence that lockdowns made a jot of positive difference is very thin.
This is just not the case John. You cannot look at the death numbers at worldometers for Sweden and blithely say they are dropping.
Look at this site
https://adamaltmejd.se/covid/
Look at the trend for the green bars and orange bars, and see it is rising. Soon enough there will be other deaths retrospectively added to those days and the final death toll for the last week of November will be 50-60/day.
Sweden’s is at 5000 cases/dayand is not dropping, This is only slightly lower than the *peak* of the first wave.
there is no doubt that there is a delay in the Swedish figures and that they report their numbers differently: when they update they retrospectively assign deaths to the days they occurred, not when they where recorded in their systems. The bottom line of this is that if you look at worldometer data, it always looks as if the numbers are going down, even if they are going up. It does make it harder to spot when the turn truly has come because the projections on the site you link to will by design not forecast the turn until long after it has happened. That’s because they are essentially moving average estimators and hence will not include second derivatives (as far as I can see. So all we can say about Sweden’s death count so far is that it is quite low compared to the first wave, but we cannot yet say how high it will get until we are about two weeks past the unknown turning point.
It is difficult though for many people to keep all these country-specific caveats in their heads when talking about so many countries and issues.
Paul some are saying that Sweden’s total deaths from all causes for this year are likely to be within the average range
I.e. that the while the cause of death might have changed,the date of death if it changed at all was only by a few months.
Do you have any data?
yeah, those things are arguable but unlikely. The covid spike is too clear in the Swedish excess data to be due to normal annual variations. How long the covid victims would have otherwise lived? Unknown, but a few months minimum, probably longer.
John,
It is likely although I admit not to knowing, that Sweden’s total excess deaths wil lbe influenced by people dying from flu. given google stats show social distancing is the norm in Sweden it is likely fewer possibly far fewer people dies from flu.
Golly gosh what does that do to excess deaths.
yes, Germany hardly had a first wave, which was a bit of a mystery (they like to believe its policy but I suspected it was high prior immunity and few highly vulnerable left). With so many cases now, track and trace becomes useless so we will learn how to read that first wave during this bigger second one.
Some beautiful graphs on that Swedish website. There is clearly a big delay issue.
What is still striking though is that in the (reported) excess death data, Sweden is actually below normal for this time of year which is not true for places with a clear second wave like France or Belgium (https://www.euromomo.eu/graphs-and-maps). Maybe its delays in that statistic too or maybe we are looking at some kind of displacement in the statistics for causes of death.
That now pulled John Hopkins paper suggested the second US wave was totally artificial with some people who die of a heart attacks and other causes now attributed to covid. Its the kind of possibility the medics will eventually ferret out. I very much doubt it would be deliberate in the case of Sweden but maybe its something left-field like people with the common cold corona variety showing positive in the PCR tests that are now done standard on all dying patients. We’ll find out at some point.
I now suspect that John Hopkins newsletter was a hoax, a student prank. Yet another thing we have to wait and see!
Excess death data is by it’s nature the slowest statistic to be generated, so is really only of use as a (pardon the pun) post-mortem tool in my opinion.
The various lockdown measures also confound the interpretation of that statistic, as measures of mobility show there have been very large decreases in people’s movements. This would likely to lead to reductions in normal accidental causes of death, though I don’t know if that is significant. The normal flu toll seems much reduced as well, maybe due to increased hygiene and social distancing measures, particularly among the older population.
As for Germany:
From https://www.journalofinfection.com/article/S0163-4453(20)30596-X/fulltext
This is a very interesting paper which tries to put into perspective the scale of loss of life due to COVID19 by estimating the reduction in the life expectancy for a couple of scenarios (250K v 2M), and comparing them to events like HIV/AIDS and the Opiod epidemic
https://www.pnas.org/content/117/36/22035
Adian
Another sketch of the overall picture
Global perspective of COVID‐19 epidemiology for a full‐cycle pandemic
https://onlinelibrary.wiley.com/doi/10.1111/eci.13423
Shame it is so sloppy, as apparently there is much to commend the broader point. Perhaps moot however with effective vaccines now available
https://twitter.com/GidMK/status/1315447757067362305?s=20
I believe it when I see it.
Just curious: what you think is sloppy about the piece by Ioannidis?
Did you read the twitter thread I referenced? It goes into quite some detail.
Ah, thanks, no. Here is the whole thread:
https://threadreaderapp.com/thread/1315447757067362305.html
Well, this Health Nerd has a few good points (e.g., about Ioannidis’s dismissal of others and too much self-referencing). That said, it is not useful to make claims such as “not really substantiated by the evidence at hand” or “there is fairly good evidence” etc. when the evidence is not referenced (and the claim, e.g., that in the majority of cases COVID-19 was indeed the primary cause of death, despite comorbidities, is dubious)
Adian my gut feeling is that you have never, yourself, been that close to a ,life and death decision frontline. I say that because of the, narrowness of your focus.
Why don’t we stick to numbers rather than intuit the motives of others.
The name is spelled A i d a n BTW
Fair points.
Aidan apologies for the misspelling.
Re Sweden and all that, my original hypothesis re lockdowns was the null hypothesis I.e. that Sweden and most of Europe would re deaths , in the end would come out much the same. It now seems to me that what really matters , what makes a difference, is how good is a nations voluntary community level response
There is some truth to this, but also everywhere has different circumstances.
Germany has a large and excellent health system. So a regional outbreak can be managed by transferring patients to other locations. Germany was even taking patients from neighbouring countries.
The US has groups that are more susceptible to severe adverse effects: black, latino, poor, in some cases 10x more likely die IIRC. They also have higher proportion of insecure work and leadership that has failed them.
New Zealand has a large polynesian population, high rates of obesity and diabetes and a relatively small number of intensive care beds. It simply could not afford for an uncontrolled outbreak.
If a country does have an uncontrolled outbreak then some restrictive measures will be required to bring it under control. The question then becomes what is required, for how long, and what are the trade-offs? For the most part those in power have been unwilling to take risks and probably overshot with control measures, but that is generally what the experts have advised. As we’ve demonstrated above, it can be very difficult to know how effective control measures are with the long lag times between infection and hospitalisation, and asymptomatic spread.
In the end controlling the spread relies on very widespread, fast and effective testing, with isolation and ideally contact tracing.
Sweden still has positivity rates above 10%. The rate of new cases per day is increasing again and is comparable to the US when adjusted for population.
We have yet to see what this will translate into as far as deaths is concerned, but their crude case fatality rate is about 3% now, which implies 150 deaths per day.
“In the end controlling the spread relies on very widespread, fast and effective testing, with isolation and ideally contact tracing.”
Agree ,however that’s only pragmatically true if the initial outbreak was suppressed quickly. If you get to a situation where possibly hundreds of thousands are carrying the virus then the chances if even the best run system coping are close to zero.
And therefore if the systems both government and civil are in general not up to the job, you will endup with the worst of both worlds.
Fair points.
Andrew Gelman on that mask study
Aidan
The lag in reporting for Sweden is around ten days. Your figure of 100 death a day is simply total nonsense.
Yes, for now, but by now not longer impossible: https://adamaltmejd.se/covid/
Andreas all the null hypothesis needs is that there be little difference between the results of nations that did lockdowns after lockdowns and a nation in the same geographic and cultural area that did not do lockdowns.
The prior that has not for me changed is this , if you couldn’t for whatever reason get the initial outbreak under strong control while it was localised and relative to total population numbers small , then it was too late, no second chances. I acknowledge that Victoria did eventualy get it under control however in many ways it was still a first outbreak and Victoria is not in the middle of Europe. Much of its borders are ocean or thinly populated and fairly easy to police ,and none of its neighbours had large numbers of infected people either.
the main question surely is which country would you rather be living in?
Sweden or Australia.
At least in Australia if you come here you must have 14 days of self isolation.
Obviously any of the following would be first picks , Taiwan ,vietnam, Australia followed closely by Japan etc.
However if your choice was between lock-downed Belgium or Sweden what would you choose?
Don’t forget South Korea and Iceland for that matter.
And yes it is interesting how Ms Tracey picks her comparables.
Fact is that Sweden has already dropped out of the Top Twenty of the league table of COVID-19 related deaths per million trailing USA, UK, France, Italy, Spain, Belgium, Czechia, and several other small European countries as well as Armenia and a long list of South and Middle American countries by hundreds in most cases. And that is accepting that the numbers of countries such as Russia, Iran, Poland, Hungary, Romania, Bulgaria, etc. are legit. Which I do not believe they are.
And of course they pandemic is far from over.
And in the end it will not just be about VSL of those that died a COVID-19 related deaths but many other indicators.
Going off a reading of a small number of reports, Belgium’s awful results seems to have several familiar factors ; chaotic government structures, a very divided community , an relative to total population very large number in aged care facilities plus a large percent of Covid19 death certificates that are not backed by an actual test for covid.
BTW when I was a child my dad’s office was a demountable on the opera house building site ,just down the corridor from the likes of Arp.
The idea that the Swedes of all people would set out to mislead really sticks in my craw.
Do things differently yes.
Sometimes do things that don’t work out yes.
And sometimes do things that are brilliant , beautiful, unique and worth all the effort, yes.
But set out to bullshit and mislead definitely,no.
Aidian re what we are arguing about.
You have repeatedly suggested that the figures from Sweden are not just delayed- I.e. that the evident trends in the official figures are misleading.
I would not characterise that as my position. I will explain again to clear it up:
1. COVID19 deaths lag positive test results by 0-10 weeks, depending on when the test is done in the course of the disease. There are some people who present at hospital feeling unwell and are dead within hours. Others linger in ICU for weeks before the damage to their lungs is deemed irreparable and the life support is turned off. Having said which, typically if death occurs it is 2-3 weeks after diagnosis.
https://wwwnc.cdc.gov/eid/article/26/6/20-0320_article
Because it is a severely lagging indicator death data are not a good way to assess the seriousness of an outbreak in real time.
2. Sweden’s death data is reported differently to all other European nations, namely it is reported by day of death. Typically that means on any given day there are likely to be zero deaths reported *for that day*, but deaths are reported, and added to the totals for the day when they person died. This is well documented in this page
https://adamaltmejd.se/covid/
which also shows that Sweden’s overall reporting delay is increasing (bottom left panel) such that it is taking 3 weeks before 90% of the final death total is reached. This makes it even harder to say for certain how many people are dying *right now*, because there is very little short term signal on which to base a prediction.
3. The effectiveness of any countries response should not rely on a lagging indicator
like deaths, but this in the case of Sweden this is doubly so. Most deaths occur 2-3 weeks after infection, and the reported deaths lag a further 3 weeks behind that, so 5-6 weeks before the total deaths resulting from infections today are 90% of their true value.
“which also shows that Sweden’s overall reporting delay is increasing (bottom left panel) such that it is taking 3 weeks before 90% of the final death total is reached. ”
not quite, I think you have missed a trick in that website.
The left-bottom graph shows the number of days till there is very little additional information coming in. That one has crept up till 19 days, but that is not the average number of days till 90% of the deaths are reported. Rather, it is the actual number of days till further changes are below 10%, but also below 1, 5, and 2% (which you can see from the coloured lines which almost perfectly overlap).
The right-bottom shows how much the daily reports relate to deaths in days past. The 90-percentile line on that is at 14 days since end of Oktober. That also means 90% is reported within 14 days (if 90% of the daily reported deaths are about the last 14 days and that relation is constant, then 90% of the deaths on a particular day will on average also be reported within 14 days).
Not that it matters much, but if you are going to play the nerd game I want to join in :-).
Thanks, you’re right I misinterpreted the bottom charts as you explained.
Agreed 2 weeks it is. As you point out, it makes the lag 3-5 week until the total number of deaths is known from the infections on any given day.
Aidan could you give me your definition of the difference between, tactics and strategy? Do you understand the difference?
Having said which, given that Sweden is not managing to improve their testing, so the positive rate is still > 10% it is reasonable to use a crude estimate of case fatality rate to predict the future death rate.
Given the crude fatality rate in Sweden is between 2-3% (2% is very unlikely, but this is a lower bound) and they have 5000 case/day diagnosed, it is reasonably to guess that this will lead to death rates of 100-150/day by the end of the month.
Given that cases have been > 4000/day for the past 3 weeks we might expect the current number of deaths/day to be 80-120, which is what this page currently predicts:
https://adamaltmejd.se/covid/
Sweden: a failed experiment?
https://www.reuters.com/article/health-coronavirus-sweden-hospitals/we-need-help-says-stockholm-healthcare-chief-as-covid-fills-intensive-care-wards-idUSKBN28J23M
Here we go again.
Covid-19 related deaths per some reference point is not, and should not be, the only reference point, and is a poor measure anyways as the discussion about excess deaths shows.
But even if we accept the importance of that measure, note that Sweden has dropped out of the Top Twenty of that particular league table weeks ago …
If Sweden is a failed experiment what do you call UK, Netherlands, Belgium, France, Spain, Italy, Greece, Czechia, Austria, all those Balkan states, etc.?
Re “what do you call UK, Netherlands, Belgium, France, Spain, Italy, Greece, Czechia, Austria, all those Balkan states, etc.?”
‘At the cutting edge” :-)
That article was about stress on the hospital system, not deaths per se
The problem is small proportion of COVID19 patients become very ill and spend a long time in hospital before recovering or dying. This integrates the number of cases over time, whereas diagnosis and death are point data.
I would say that the other countries you cite are also failures, all with their own modes of failure with some commonalities.
You didn’t cite Norway, Finland or Denmark? Curious.
https://ourworldindata.org/coronavirus-data-explorer?zoomToSelection=true&time=2020-03-01..latest&country=SWE~DNK~NOR~FIN®ion=World&deathsMetric=true&interval=total&perCapita=true&smoothing=0&pickerMetric=new_cases_per_million&pickerSort=desc
https://www.expressen.se/debatt/nu-pagar-den-storsta-masshysterin-nagonsin/?fbclid=IwAR2kODWSjHqzwYeBDKCXhUyiQT4_EoiC8ij2XzBu4qhB0_spN19jz8r-OBs
https://emanuelkarlsten.se/last-week-in-sweden-a-covid-report-november-29-december-6-2020/?fbclid=IwAR37jbgWvkRpJNt5Tkjfyyt_FknUIue1DhOFdYixhv3EpLjFmoAgEZozQ_Y
https://www.worldometers.info/coronavirus/country/sweden/
The data underlying the trend of that graph would need to be a lot more than a bit out for the trend to be going in the opposite direction to the visible trend.
A question would comparing total deaths, from all causes be a better proxy for how things have gone over the last year for any nation?
There was a lot of minimising of the severity of the COVID19 outbreak in Sweden:
Earlier Paul said:
John R Walker said:
Saupreiss said
All of them proved to be resoundingly wrong.
I said
This was, unsurprisingly, and sadly, correct.
Now we have John R Walker saying this just 8 days ago:
Again, we will have to wait to show for the final figures to trickle out, but this is certainly the predicted toll for today
https://adamaltmejd.se/covid/
And Saupriess:
This was six days ago, when we have a whole thread detailing why using Sweden’s current death rate to compare to other countries is simply untenable.
You all have useful things to say, but this fetishisation of Sweden pervades and undermines your own arguments. Give it up. They’re not special. They are not a useful example.
They are a very useful example of how in a situation of multiple unknowns
it is best to rely on standard responses based on the proven public health policies.
It is the case that Sweden’s second wave is larger than I thought it was going to be and that the degree of herd immunity they had at the end of the summer was less than I thought likely they had. Yet it is still the case, so far, that in relative terms their second wave is much smaller than much of Europe and in particular their neighbours Denmark and Germany.
But otherwise your claim is Trumpian: Sweden has been overtaken by much of Europe and the Americas in terms of the % of deaths from covid whilst those other countries have largely followed what Murph seems to think as “proven public health policies” (whereas they are in fact the opposite of the science on pandemics of the last 50 years!). So without hurting themselves in all the other, much bigger ways, Sweden is quietly becoming a low covid-death country relative to most of Europe and the Americas. They remain the reluctant poster child of (relatively) sensible policies.
I am still watching South Dakota with great interest. The number of positive cases is now higher than 10% of its population. Its % of covid-deaths ia already about 0.13% and looks like climbing to 0.2% before their wave is over. Still they are so far following the Great Barrington Declaration script. It will be very interesting to compare the final tally on lots of outcomes between them and several of their neighbours who followed very different policies.
Exactly!
And Aidan I’m not focused on Sweden at all ,rather I’m focused on all the EU country’s that followed’ best practice’ and ended up like Belgium .
I repeat I expected that the results would be much the same, i did not expect that those who followed “standard “ responses ( to a unstandard event) would actually come out worse.
You guys have been under-predicting deaths and over predicting immunity now for ages, so it is good to see you are finally admitting that you under-predicted immunity. Given the Northern hemisphere is only half way through the first month of winter I imagine, unless the vaccines are rolled out quickly, things are not going to look a lot better.
I also doubt comparing Sweden to the Americas apart from Canada is worthwhile given the hopeless state of their health care systems, the poverty, and the larger and more densely populated cities. Also, at least for Germany, the Swedish wave isn’t smaller given Germany has about 80 million people
Conrad
Nothing I’ve seen contracts the null hypothesis.
And that above all was and is my Prior.
Conrad interested in your response, i have read that the deaths from all causes for both Denmark and Sweden for this year are both close to the long term average.( a Caveat is that the true number of people living in any nation is always a bit of a guess).
Second question, it’s still the case that the median age of Covid19 death in most developed nations is close to the average life expectancy in that particular nation.
Given the well established link to co-morbidities and covid deaths ,what’s the odds that Covid19 is selectively killing far more of those who would have otherwise lived to ninety plus I.e.the healthiest of that pop , than the less healthy I.e.e those who were previously destined to die at 83?
“it’s still the case that the median age of Covid19 death in most developed nations is close to the average life expectancy in that particular nation.”
I don’t have the average, but you can see lots of younger people are dieing, despite your claims. https://www.euromomo.eu/graphs-and-maps.
Aside from this, you are simply using the wrong values here. The number of years lost is not when you die minus the average. It is when you die compared to how long you would have lived given your current age.
For example, if you were 75 and the average age of death was 82, you didn’t lose 7 years. You probably lost perhaps 15 — because if you had already lived to 75 the average you would live without such a death is perhaps 87 (or whatever it actually is). If that doesn’t make sense, think about death at 100 — you didn’t lose negative 18 years.
Apart from just deaths, part of the problem is also somewhat younger people filling up your hospitals (and hence others dieing because they can’t get a bed), and people who get long term complications, which presumably will have a strong correlation with how sick they were.
Finally, you seem to be under the incorrect belief that co-morbidities are rare. They are not. Once you add obesity, diabetes, high blood pressure etc. up, it is quite a decent percentage of the population, and presumably why deaths have been higher in countries with lots of fat people.
Conrad an awful lot of the deaths have been in aged care facilities. Very few go into aged care before they are very very frail. Typically live about two years after admission. And a lot of people over 70 something are on a lot of treatments that’s why they live longer than the proverbial three score and ten , no?
I agree aged care facilities have been obvious problems. But not everyone in aged care will die tomorrow, not everyone is very frail, and it is certainly not the only problem (aged care itself is not homogenous — I have lived close to two centres — one which is like the miserable stereotype, and another which was for largely healthy people that were still active enough). Part of the problem is no doubt the way viruses spread in these centers (which appears to be very easily), and not just the health of the people inside. I am willing to bet people equated for health looked after by their relatives/children would be far better off.
As for people using lots of treatments for various health conditions, it’s not just people over 70. We have drugs for any number of things which historically would have shortened our lives. This is includes the obvious ones like hypertension, and less obvious but common ones like people have for many years after they have had cancer to stop recurrence. Most people taking those drugs are not close to death.
In terms of comorbidities and how common diseases are here is a good little report for you. In Australia, the rate of heart disease is almost 20%, and apparently 2.6% have COPD (who would be sitting ducks for covid). 11% have asthma.
This is as close as Paul willever say he was WRONG. Apart from his Davidson like change of the definition of herd immunity which was trumpian in itself you will always get into a tangle in trying to show up his mistakes.
His solution was always much worse that the lockdowns in almost every respect as has always been shown.
that in itself is very Davidson like .
Like I have said too much of imitating Catallaxy
Offical figures are https://www.worldometers.info/coronavirus/country/sweden/
Trumpian altfacts is a good description of you .
+ 1
Conrad
In the facility that my father in law is in ( high standard ) which has about 120 beds about 25 beds are in the locked dementia ward ,of the remainder maybe 30 percent are reasonably able bodied , the rest are in wheelchairs or bed ridden ,in the two years or so that he’s been there most of the able bodied -mobile enough to walk up to him and start a chat- friends he made on arrival are now dead and his main complaint is he’s got nearly nobody to talk with, he’s bored.
Now the Swedish fantasies have been shown up you’re crushing on South Dakota?
Unbelievable. Is it so hard to just admit you were wrong, actual epidemiologists and infectious disease experts know a thing or two, and the best course of action is to follow best practice advice?
The ego and motivated reasoning/confirmation bias is just astonishing.
“the best course of action is to follow best practice advice”
As a shining beacon for relatively reasonable policies Sweden is only looking better and better over time. That the Swedes have more of a second wave than I anticipated is of course a pity for them, but the second wave in the lockdown countries has been far worse and on top of that they have wrecked their economies, their citizenry and their freedoms to a far greater degree. Have you for a moment stopped to acknowledge that and realise its implications? No. Why not? Because you are apparently totally uninterested in deciphering what good policies are or what is in the interest of whole countries. The headless chicken just keeps pecking there where the media and government spin leads him, and even in that little pen you dont look around. Your gullibility scares me because it illustrates how easily populations are mislead.
I have been mentioning South Dakota a few times the last few months. As well as Tanzania and a few others. You have just not been paying attention.
Talking about motivated reasoning, I conjecture that Aidan is one of the privileged ones: https://www.nytimes.com/2020/12/14/opinion/sunday/the-people-who-actually-had-a-pretty-great-year.html?referringSource=articleShare
Not among those 3.5 million on job keeper or the 1.6 million on job searcher support here in Australia, not among the almost 4 million that raided their superannuation accounts to various degrees to make ends meet, not among the tens of thousands that had the livelihoods shut down, not among the hundreds of thousands that had the dreams crushed (and lost literally months of human capital accumulation), not among the ones struggling with mental-health issues.
In other words, an immoral and heartless [choose your favorite descriptor here].
+1
Covid induced suicides in Australia forecast to be 750-1500/year for up to 5 years (Brain and Mind Research Institute forecast).
Such a bold prediction when suicide rates in Australia historically have been poorly correlated with major events (excluding WWII when they went down), including the much higher than now unemployment rates of the 90s. You can see the historical figures here here
Here is my favourite quote from that release:
“The modelling is unique in integrating economic and mental health data, highlighting the value of dynamic systems modelling (used in the COVID-19 response) ”
As most people in the world have probably noticed by now, most of the COVID-response modelling has not exactly been very accurate.
During our mid-90’s recession the unemployment rate peaked around 1993. Over the next 4 years annual suicides rose from 2081 to 2722 which is a 30% increase. Brain and Mind Institute forecast is for additional 1100 (mid point) suicides on 3318 (2019 data) which is a 33% increase. So it’s not a very bold prediction.
I assume you think we will get back to 11% unemployment (or at least very high), which I assume is rather unlikely. It is currently 7% (despite the Victorian situation) and most Australian states seem to be getting back to normal in that regard — unemployment is not blowing out in a dire way. The China situation may make that somewhat more exciting if Xi Jin Ping decides more lose-lose behavior is a good idea.
Alternatively, when I think about 1993, states like Victoria were also almost bankrupt, and the problems were not caused by a virus people will forget about quickly. Things like the labor market were highly regulated compared to now, there was no gig economy, and very little in the way of service culture that employs lots of people and can be set up quickly (cafes etc.). We are clearly much better off now.
The 7% doesn’t include 3 million people on Jobkeeper, many of whom would be unemployed without it.
7% unemployment in Australia is an illusion and something the ABS should be ashamed of.
I think it is a standard crappy measure used across countries and has been for ages, so it’s not really the fault of the ABS — they do in fact report an under employment measure. Since the measure had the same problems in 1993, the difference still remains. So unless the end of jobkeeper causes a 4% spike in unemployment that remains for years (it took until 1999 to get unemployment below 7%) I don’t see the situation as dire. I guess we will have better idea once once jobkeeper is axed.
As of this morning: https://www.theage.com.au/politics/federal/job-ads-back-to-pre-pandemic-levels-as-iron-ore-improves-budget-deficit-20201216-p56o0e.html
Hi Andreas,
yes, the blindness towards the mass suffering that covid-policies have caused is a curious aspect of the saga. Its not just Aidan. The blindness is institutionalised and carried by most of the media. As if suddenly a whole class of suffering has been deemed unworthy of attention and simply condemned to silence. Like abuse by priests in the 1960s, or domestic violence for centuries: a suffering that was known but that polite society pretended did not exist and was not their problem.
We humans all ignore lots of suffering for good reason: we cannot carry the weight of all the suffering of 8 billion people. So we must all ignore the majority of it and somehow categorise suffering into things that are our problem and things that are not our problem. For instance, most of the suffering in other countries is not our problem in any era. Most of the suffering inside our countries is similarly deemed unavoidable and is thus usually ignored, such as deaths from old age.
During this saga, many types of suffering that were at the center of policy making before have been removed from view and basically deemed unworthy, such as loneliness, depression, and unemployment. This happened in a space of a week in March. What I find perhaps most revealing is how large numbers of people can pretend not to see the suffering of their own children, simply because it is not validated by the crowd.
+ 1
Yes, immoral and heartless monsters all (Aidan, Ms Tracey, the whole gallery)
not as blind as to the policies you advocated but would be far worse as has been shown time and time again .
This is a hell of a long bow from me criticising those who held up Sweden (and now South Dakota!) as exemplars.
Where did I say I wanted people to suffer? Have their dreams crushed? Good grief, the hyperbole is quite something. Governments should do all in their power to support their citizens when they take actions like lockdowns which affect their livelihoods.
Sweden is a poor example because they have never done enough testing and contact tracing to seriously back up their less interventionist approach. Their test positivity rate is still increasing. This is a major failing.
Those who wanted Sweden to succeed should have been very disappointed, as this has undermined their ability to succeed with their initial light touch approach.
Do you choose basket cases on purpose?
Over the last week South Dakota has the highest population adjusted death rate in the USA (2.4/100,000) due to COVID19. It is second in total cases adjusted for population (10,365/100,000), but cases counts are now falling.
It is not a success story.
Now Taiwan is another matter …
Anthony Fauci think herd immunity is 80% of the population.
And here we go again. Number of deaths as the sole criterion for the success of a pandemic strategy. The usual gutter journalism that I have come to expect. Of course with no-trade-off public-health-uber-alles economists working their priviledged megaphones it’s hardly a surprise.
And since we are at it, one out of six economists is not 99 percent. Not even close.
“”We are doing what we have done throughout this pandemic, the right measures at the right time. And this is what this is,” Lofven said.
With the number of deaths close to 8000, Sweden’s death rate per capita is several times higher than that of its Nordic neighbours but lower than several European countries that opted for lockdowns.”
https://www.smh.com.au/world/europe/sweden-introduces-toughest-measures-yet-in-the-face-of-second-covid-19-wave-20201219-p56ovv.html
+1
Deaths were used as a criterion because that is the ground that Paul et al chose to fight: minimising the seriousness of the virus, and the possibility of high death tolls. When the numbers of dead far exceeded their initial low-ball estimates the rhetorical fall back was to minimise the importance of those deaths as they were mostly elderly or others who would not live long in any case.
Lately the argument has turned to excess mortality, arguing that it is not greatly higher, but simultaneously that there were many people dying of heart attacks and suicide because of lockdown.
As far as I can tell there has never been any serious engagement with the position that left unchecked the epidemic would cripple hospitals and result in much higher death tolls. That as it is the crisis in hospitals in much of the northern hemisphere has had a devastating impact on the mental health of essential health workers and their families.
Nor have I have seen any acknowledgement of the much higher impact on minorities and the poor in the USA.
Not to mention the serious long term health effects of COVID19 on many survivors, so called “long covid”.
There are many other areas worth focussing on, but none of them suit the argument for minimal intervention, so seem to be ignored round these parts.
Bullshit was the only tune the band could play,
For the record I do not make the case for minimal intervention, ot let-it-rip. Mask wearing in crowded and cramped spaces for example seems a no-brainer as is various forms of social distancing, contact tracig and quarantining, etc.
So not sure what tree you are barking up.
Comment was directed at Aidan.
Realise that. And second your remarks.
My interest is in what works best with the least collateral damage for what is likely to still be a very long campaign. All throughout this I’ve tried to imagine how John Monash would have approached it.
that sounds like you do not disagree more than a millimeter with the path taken.
Is it so hard?
Raina McIntyre today on ANC radio said herd immunity is at least 70% of the population.
this leaves Paul’s definition which has never been enunciated in tatters yet again.
We must remember Paul’s evil herd immunity thesis would have 175,000 die from this policy.
Of course it would be much higher as Hospitals would be vastly over run and personnel tired from too much work they have to do over the two probable years it would be in operation
You seem to be utterly confused about things like herd community, let-it-rip strategy, Swedish strategy, the effects of lockdowns, etc.
Oh, and just because Raina has an opinion does not mean Paul’s is in tatters.
Mate Paul’s definition changes from minute to minute.
That is part of the reason his policy prescription is in tatters.
to help those interested in definitions of herd immunity understand what is happening:
https://twitter.com/simondolan/status/1341306917076021248
the June 2020 WHO definition (which it subsequently butchered, pretty clearly for political purposes):
“Herd immunity is the indirect protection from an infectious disease that happens when a population is immune either through vaccination or immunity developed through previous infection. This means that even people who haven’t been infected, or in whom an infection hasn’t triggered an immune response, they are protected because people around them who are immune can act as buffers between them and an infected person. The threshold for establishing herd immunity for COVID-19 is not yet clear.”
Note that ‘protection’ does not mean 100% protection just as a coat protects more again the cold than a shirt but neither protect 100%, an issue the more extensive definition Simon linked to in the tweet above makes clear. One should speak of degrees.
“A more reasonable conclusion from the data would be that Sweden has had much the same level of death as other countries, without resorting to mask orders and authoritarian lockdowns, whose costs are yet to be assessed.”
Personal liberty sacrificed at the altar of Covid public safety
ADAM CREIGHTON
https://www.theaustralian.com.au/exclusives/personal-liberty-sacrificed-at-the-altar-of-covid-public-safety/news-story/158ba49b6b01bdf2ab70dbceac3974b5
wrong again. Sweden had an informal lockdown.
google stats clearly showed Sweden little different to Germany.
Germany’s lockdown as formal Sweden’s was not.
both clearly inferior to ours.
A new possibility raised by Dr Norman Swan – ring fencing immunisations.
It is a reason to keep working on approval of new vaccines.
NSW’s current situation would benefit considerably but would the population cooperate?
one clear message from all this. A person who claims Sweden had herd immunity is ignorant in the extreme.
They neither understand what herd immunity ( without a vaccine) means nor what occurred in Sweden.
Funny, me thinkst the only consistently uninformed and clueless poster on CT is you, Ms Tracey.
Funny, me thinkst the only consistently uninformed and clueless poster on CT is you, Ms Tracey.
from the person who knows not what herd immunity is or what occurred in Sweden.
I believe people call that projection
Paul the other day Raina McIntyre predicted that NSW by next weekend could have hundreds or even thousands of new infections. OTOH a expert from ANU expressed cautious confidence that NSW systems were working well and were on top of contains the outbreak .
It bugs me that the ,expert, modelling systems still seem incapable of evaluating strategies that are more subtle than do nothing vs hammer everything.
Re “millimetre” ,the difference between NSWs approach and say the UK seems more like a meter than a millimetre.
Yes, it is kinda amazing how some epidemiologists dabble in alarmism, MacIntyre surely being of them. Here is a link to her most recent claim:
https://au.news.yahoo.com/coornavirus-nsw-expert-warns-thousands-cases-in-weeks-221047449.html
And below is a decent assessment of the current Northern Beaches situation. It is not coincidence that the article’s author relies on Bennett who consistently has made good calls regarding the Melbourne situation and now seems to do the same re the NB situation.
https://www.smh.com.au/national/the-nsw-outbreak-has-similar-numbers-to-the-early-days-of-melbourne-s-second-wave-is-the-same-thing-happening-20201222-p56plj.html
so far, I have to admit, the NSW approach looks not too bad, even to me. Contact tracing at such low levels of outbreak might work in terms of low-level objectives and, most importantly, has very little collateral damage. Siphoning off a small district, even if its for show, also has very low damage. Its when schools gets closed state-wide and millions are forced into loneliness and unemployment that the collateral damage very quickly (ie within weeks) starts to be higher than anything the virus could do.
Of course, the whole ‘close the country till some form of salvation comes’ is hugely damaging to a country as dependent on global movements as Australia, but that is not NSW’s fault alone. Compared to Victoria, NSW is looking a bastion of sanity at the moment.
Something like 60,000 tests in the past few days, rapid tracing like crazy and fingers crossed it’s a lot of work and very much a team project. The collateral damage aspect and the need to remain, balanced whole of picture focused is very much on the NSW governments mind .
The worry is that victoria is still not up to it and is still unable to see more than one thing .
No joke. They do not even get elementary things straight such as consistent tracing and announcement of what they find. And then there is this kinda thing; there is a reason why they have to shut down their borders and throw tens of thousands people’s life into chaos. It’s because Andrews and his government are incompetent (as clearly established by the Quarantine investigation report).
This the latest example:
First Brisbane flight after lockdown arrives in Melbourne to … nothing
By Rachael Dexter
The first flight from Brisbane to Melbourne to arrive after the 6pm lockdown took effect in Greater Brisbane landed earlier tonight.
As with earlier flights from Brisbane today, passengers were not greeted by authorised officers to inform them of a request to test and isolate until Monday.
Qantas passengers Jen and Dan, with children Pippa and Tilda, arrive in Melbourne from Queensland on Friday.
Qantas passengers Jen and Dan, with children Pippa and Tilda, arrive in Melbourne from Queensland on Friday.CREDIT:LUIS ENRIQUE ASCUI
One passenger, Jess, told The Age and The Sydney Morning Herald she was going to organise to be tested as soon as possible and go straight home.
Jez!
Yes, NSW is a bastion of sanity and has been for months, notwithstanding massive internet bullying of NSW decision makers … and alarmists like Raina MacIntyre who predicted 3,000 new cases for January 8 (yesterday) in an SMH article on 20 December and urged NSW to shut down for Xmas and NYE. What is particularly encouraging is that those NSW decision makers have started to push back against the no-trade-off terrorists and stress that there are trade-offs and considerable costs to lockdowns. The narrative is definitely shifting.
very encouraging to hear the narrative shifting, Andreas, though the experience in other countries suggests that when cases increase, the political pressure to be seen to do something (whether it works or not, and whatever collateral damage there is) rises very strongly. Germany is a good example of that. In the West, only the administration of South Dakota seems to have been able to withstand the pressure that comes with a large wave. Scandinavia and Florida have been relatively good at withstanding that pressure.
A country which adopts herd immunity without a vaccine cannot have second , third or whatever waves. It has one continuous wave. This is the result of exponential growth which occurs. The said country embraces covid. Only countries which attempt to suppress it can have second ,third or whatever waves.
HI would of course put hospitals under way too much pressure so anti-lockdown advocates must want covid disallowed as a disease and not be treated at a hospital.
This would mean a lot of laws would need to be amended for both the public and private sector
An careful, thorough summary of excess deaths in the UK in 2020 from the Office of National Statistics
https://threadreaderapp.com/thread/1346860617735532544.html
TL;DR
73,000 excess deaths (14% above 5 year average).
Worst single year excess deaths since 1941 and worst crude population adjusted excess death rate since 1951.
Master Stat man Kaiser Fung on excess deaths
The link doesn’t work for me Homer.
Try THIS then.
Kaiser’s blog is essential reading for stats