Coronavirus pandemic takes hold, we are making decisions without reliable data

> without any real data

The trouble is we can only get "real data" by testing more people. If we test more people we will almost certainly discover the numbers are worse than they appear now.

All that is to say that the situation can only be worse than we already know. I'm not sure more data would lead us to isolate less at all.

You might be right that there could be large numbers of people with the virus who are doing just fine right now, but we know from nearly 200,000 cases (that's plenty) that a non-trivial portion of cases require hospitalization. That's the whole problem, right there.

So we know hospitals can be overwhelmed and a LOT of people die for it. Healthcare workers included.

We know the situation is probably worse than it looks, but we won't know how much worse for weeks yet.

So without real data, it seems to err on the side of caution is absolutely essential. This can bring countries to their knees within weeks, and it has.

What would you propose we do without real data?

“It won’t happen here.”

“It could happen here, but it’s not a big concern.”

“It’s happening here, and it’s a big concern, but we don’t have reliable data so let’s do nothing.”

“We have reliable data now, but it’s too late to do anything.”

That is incorrect. The US, UK, and others were taking a mitigation strategy until the last couple of days; the change wasn't driven by delayed blind copying of China, but by this analysis, which was shared with governments as a WIP before being published:

https://www.imperial.ac.uk/media/imperial-college/medicine/s...

There may be legitimate criticism of the broad policy approach, but “blindly following China” isn't one of them.

So why aren't we scrambling to build more hospitals?

That doesn't answer the question though. Ioannidis addresses the worst case scenario. Lack of supplies, also, is made much worse by closing factories and tanking economy in general, as well as e.g. cancelling blood drives (a real case from King County), none of which are caused by the virus.

I see panic hoarding and empty grocery stores and laid off people worried about rent. And it’s been two weeks.

Do you mean as a result of the virus, or as a result of losing their livelihood and being plunged into poverty?

I'm afraid that on the long term, the social unrest and the economic consequences will far outweigh the damage done by the virus. There is no plan on how long you can shut down whole countries. Europe, for example is not like China, you are just locking down everything, you don't have any other regions to support you. Sure, some people can work from home now, but by having the economy run at minimum level, work will go down, there will be no more projects even for IT people. How many people are losing their jobs already, what will happen if we need to quarantine ourselves for another 6 months to flatten the curve, if jobs are cut after just 2 weeks? I might have enough saved to be able to live not working for a couple of years, but I don't think that will help me if the entire social order is collapsing.

This talk at the start of an exponential curve is exactly the problem

The problem is that so many people are ill or die within a very very short window instead of being spread out as it is before the epidemic.

From a purely selfish point of view, assuming the disease will be a minor inconvenience to you because you’re young and healthy, there are other things to consider:

- what happens to your (presumably much older) parents when they get sick? Death is a very real outcome there

- what happens when you have a car crash and need intensive care but all hospital beds are full and there are also younger patients than you to treat with a better outcome? You’re triaged lower priority and may not get the care you’d normally get or survive at all

For perspective, there really aren’t that many ICU hospital beds altogether because the usual number of people who need intensive care at any given point in a city of millions is in the hundreds (maybe low thousand?) Once the exponential nature of the epidemics hits and there are thousands of people who need care right now on top of the usual load, then it’s like in Italy where some are left to die just because choices must be made and there are either healthier victims with better prognosis.

I remember that the author of XKCD dug up that the EPA puts a human life around 8.4mil.

Don't forget about the age of deaths here. Divide the above by life expectancy at birth, then multiply by life expectancy at death from the virus. And possibly weigh by decade, I'd probably trade another decade of my 20ies over e.g. 80ies (not that I've been there). AFAIK /the average/ age in Italy is pushing 70.

~1 million is the current annual death rate in the US (~0.8% last I checked), and the disease kills older people much more than younger people. How many of those 2 million would have died anyway in the next couple of years? How many would have contributed to the economy over the next few years? How many of those who will die from a recession would have contributed to the economy?

These are tough questions, but I think they're worth answering so we know what we're really gaining by shutting down the economy. I know we want to save as many lives as possible, but we should also know the cost too.

Those estimates are based on constantly changing data. And “exponential curve” means a lot of things. We are just now starting very limited testing in the US... what do you want to bet the number of tests given follow an exponential pattern just by nature of how they are deployed? If your test deployment is exponential your infections is gonna look exponential even if the underlying data isn’t... at least for a little while.

You can curve fit anything if you forget about the bias in your data.

> the Imperial College paper estimates 2 million dead in the US with no response and ~1 million dead with a limited response that doesn’t involve a full shutdown.

The paper points that all these estimates are based on extremely biased data.

Testing a random sample of the population to get a reliable estimate of the scale of the epidemic is dirt cheap compared to the drastic measures currently being taken.

It's incomprehensible to me that this wasn't one of first steps taken.

What is the average age of death, and life-years lost compared to the severe economic impact? The article explicitly asks this question.

A distinctive feature of a pandemic event is that it really is a global thing. Even the world wars could claim to have quiet fronts... and that matters as a global society. Normally - since the modern era began - we're in a default state of national competition and every country is under some obligation to work itself to the bone and exploit what it can to get ahead of the others. Hence the default response to crises has long been "keep a strong international image, maintain business as usual". The crisis harms a select group somewhere and everyone else ignores it. But we did periodically have pandemics, and each one changed the character of things going forward.

And it's clear why that is the case; you can't really get ahead if you don't take care of the disease. The as-usual response fails because it affects everyone. Even AIDS, which was approached so, so reluctantly, eventually got an organized response.

And this response is more likely to be humane than most crisis management because there is so little room to evade the issue and try to fit it into the usual powermongering circus.

Not true. France is hit, eastern France's hospitals are at full capacity. Doctors are starting to consider letting people over 70 die without access to an ICU.

Also, it's kind of strange that on this forum people do not get the notion of exponential increase. It's twice worst every 72 hours. Time runs out really fast.