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Comment by jMyles | Hacker News Reader

> Covid operates on its own schedule, not ours.

We do have some tuning knobs though, including vertical risk-stratification, which has collected dust around the world.

It is possible to have a much more acute and accelerated course among the least vulnerable populations while isolating the more vulnerable populations.

Whether Iceland and New Zealand will be viewed as successes depends in part on how much misery is inflicted during the long period it will take to finally reach herd immunity in those places, and how many people in vulnerable sub-populations are infected along the way.

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Population x Fatality Rate will tell you how much it "costs" to achieve herd immunity.

That also doesn't take into account long term impacts that are not fatal.

> Population x Fatality Rate will tell you how much it "costs" to achieve herd immunity.

...what? My comment was about risk-stratification. "Population x Fatality Rate" is the formula we are resigned to use because we're not doing risk-stratification.

This is what Katz, Ioannidis, Gupta, Osterholm, etc. (it, many of the most trusted experts on this topic) have been saying all along, and being ignored not only in the hugely ignorant US response, but also in the more sophisticated ones.

> That also doesn't take into account long term impacts that are not fatal.

Yes, there are rare complications from all viruses that can cause long-term disease. But we're fighting a pandemic right now, so it's probably not time to focus on phenomena of rounding-error incidence and which are not unique to this virus.

> That also doesn't take into account long term impacts that are not fatal

This is the new narrative and it makes no sense. The largest impact of this virus are the elderly and they can get long term effects from any infection, bacterial or viral. I read the 60+ person UK case study on long term effects published out of Charlottesville and almost all the major conditions were in the elderly or high risk workers (possibly medial workers; the paper didn't say for privacy reasons).

It's way too early to talk about "long term effects," when this hasn't even been around that long. Remember that 96% of fatalities in the US are people 55 and over, most of those in long-term care and retirement facilities. The areas that were hit the worst (Michigan, California, Kirkland/Seattle) were all cases of bad policy in regards to nursing homes.

"Vertical risk stratification" as a search phrase returns very few results. Could you explain?

Try 'risk stratification virus' on Google Scholar to start to get a sense of the research field.

For specifics on Covid, I think look for materials from John Ioannidis (a long-time personal hero of mine) if you're interested in the research side, or David Katz (also someone I have followed closely for a while - kind of a MD version of Michael Pollan) if you're interested in the clinical side.

Both have published papers if that's a good medium for you, and both have solid videos on youtube if that's more your speed.

Say, this?

https://www.nytimes.com/2020/03/22/opinion/coronavirus-econo...

If you have specific references in mind, it's rather more efficient, and considerate, to list them yourself.

I use to live in NZ. At times I wish I had stayed because at least they've been out of this, but it's also an isolated island with ~4 million people.

Even though they've mostly had elimination (with one re-lockdown due to Auckland), I do agree it's a bad long term strategy. The T-Cell immunity research shows there may be more people who are immune than we think, and Sweden shows us this virus can safely burn out in a population.

People from NZ may not be able to safely travel out/into their nation for years.

I am very doubtful of a safe vaccine in any reasonable amount of time. Fatalities have dropped to the floor across the board, so everyone is going on and on about cases. We don't even collect the viral load amounts for PCR tests in most countries, so we have no idea how many infections are just traces of virus, versus full infections.

This whole show has been a clusterfuck. I think my predictions from March are coming true:

https://battlepenguin.com/philosophy/covid-19-is-two-disease...

> The T-Cell immunity research shows there may be more people who are immune than we think

As far as I understand from the currently-available data, at best, cross-reactive T cells may lessen the disease, but not prevent it. However, the data are not definitive.

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