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Comment by nostromo | Hacker News Reader

I’ll be very direct because of the dire situation at hand.

If you die of Covid-19 you were already dying. This illness was simply the straw that broke the camel’s back.

99% of fatalities in Italy are among people with a prior illness. About 50% of the deaths were people suffering from at least three other illnesses.

The average age of fatalities in Italy is over the median life expectancy of an Italian man.

https://www.bloomberg.com/news/articles/2020-03-18/99-of-tho...

We may have a wave of elders die this year if we don’t quarantine them immediately. (And the next year or two we’ll have fewer elders die than ever.) But there is no need to quarantine the whole world. The young and healthy need to start building up antibodies.

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Yeah, a prior illnesses like high blood pressure or diabetes with which you can live many more years and which are very prevalent in the 50+ age bracket.

We're still very early in the epidemic. The people dying now are naturally the weakest. Even among young people a percent or two needs hospitalization. If you cumulate up to 50 years, 10% or so need hospitalization and 2% need critical care. Good luck providing for them when millions are infected.

You're also discounting all the additional deaths caused by a healthcare system that runs way over capacity.

> You're also discounting all the additional deaths caused by a healthcare system that runs way over capacity.

This hypothetical situation people keep referring to hasn’t happened in Wuhan or Italy.

Young people didn’t die there in large numbers, despite a strained healthcare system.

The situation in Wuhan or Italy is not over yet and they did implement the harsh measures that you criticize.

> This hypothetical situation people keep referring to hasn’t happened in Wuhan or Italy.

China built sixteen new hospitals in Wuhan in two weeks.

Italy is overwhelmed. Listen to any Italian doctor. https://www.independent.co.uk/news/world/europe/coronavirus-...

It has happened in Wuhan. Mortality was 0.7% outside the quarantine zone and 5.8% inside.

If you don't quarantine everyone, you spread the disease. Hospitals are already crowded, look at Europe. If you, 30's something, have severe a health issue for some reason, you won't be treated properly. You'll die or crowd the hospitals more. As will hundreds of thousands. Your antibodies are useless against an heart disease or an accident. Don't spread the disease, don't be a selfish idiot.

Here in Czech Republic hospitals are not overwhelmed yet and all is done to keep it that way - all elective surgeries have been cancelled, same for regular medical checkups and non critical medical consultations.

Also 3 hospitals have been selected as main treatment centers for coronavirus patiens & capacity in them cleared as much as possible. Also in paralle ventilators have been ordered, about 500 so far with first 50 hopefully ariving early newt week.

BTW, for the current numbers here in Czech Republic: 15584 tested, 1047 infected, 6 recovered and 11 vonnected to ventilators. And so far no one died.

But how much earlier are they dying than they otherwise would have? After all, anything that kills you is just killing you before something else would have killed you. It’s not very satisfying to say “they would have died anyway” without giving some time frame on that, since that’s literally always true.

You basically present the herd immunity argument with the caveat that it's okay for people older than the median life expectancy to die if they become infected.

I agree this would be a solution, with the huge caveat, that it becomes socially acceptable to euthanize the old instead of dedicating medical resources trying to save them. As others point out, those resources will be needed to maintain normal healthcare operations and treat younger Covid-19 victims who require it.

With the current "save everyone" strategy, I think it should be a fairly easy argument that the older generation, for whom you convincingly argue benefit most from the measures, pays for it. You do this by printing a huge amount of money (diluting those who hold savings) and transferring to the workers whose livelihoods are being destroyed. Increasing public debt should be seen as unacceptable, no bank would ever make a loan for end of life care.

Edit: PS, in Europe printing money will require Germany to allow the ECB to fire up the printing press, which would be fascinating to see.

> If you die of Covid-19 you were already dying. This illness was simply the straw that broke the camel’s back.

People with covid-19 need ventilators and intensive care. This isn't just old people with severe comorbid illness, it's younger relatively healthy people too.

If we ignore for a moment the old people who were going to die this year with or without covid-19 we're still left with huge numbers of younger people needing intensive care and ventilation. This has knock-on effects: many healthcare systems have cancelled almost all elective healthcare. You might say that a cancelling a knee replacement doesn't matter, but these kinds of surgeries transform life and allow people to live independently for longer.

Covid-19 is flooding our hospitals with very ill people, and some of them are going to be pretty poorly when they're ready to be discharged, and some community care or care homes are going to have to deal with a larger number of ill people.

The jargon word for this is "acuity". Increased patient acuity increases costs of healthcare, increases risks of harm, increases rates of HCP burnout, decreases access to health care etc etc.

Covid-19 is going to have long lasting effects on healthcare systems even though it's mostly killing people who would have died anyway.

Younger people have lung damage. Read the reports of MERS and SARS survivors to see how that goes.

Also, we don't need to kill our economy:

https://docs.google.com/document/d/1YbtJGn7ida2IYNgwCFk3Sjhs...

SARS was much more dangerous than Covid19 is, so you can't really generalize like that.

Not without CT scans of COVID-19 patients and doctors' reports, I couldn't. We do have those, however.

We can't know what percentage end up with lung scarring. With CT scans, we need to wait to see how lungs recover with time. With doctor's reports, it's anecdotal; we have no statistics.

It might be 1%, or it might be 20%. I'm betting on the 5-6% range. That's an educated guess, based on hospitalization and ICU rates and how the disease progresses.

> If you die of Covid-19 you were already dying.

No, this is simply untrue. For some patients the comorbities were things like diabetes.

Also, death is only one outcome. We know covid-19 can affect the lungs, fertility, and can cause neurological damage.

>> The average age of fatalities in Italy is over the median life expectancy of an Italian man

And that is probably because they give preference to younger people. If they did not, they'd likely have fewer fatalities overall, but slightly more fatalities in the lower age ranges. Someone made the tough call that if you're 80+ you are "already dying".

But half the US is obese, that's one of the biggest health issues in the ones dying from SARS 2.

Technically, half the US is already dying from obesity, but I don't think that means they should be all killed off at once.

The cases in critical care in Sweden are younger. This indicates spread in Italy has been different due to social differences in contacts between age groups.

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