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Comment by pmoriarty | Hacker News Reader

The IFR would be worse if medical care wasn't available because of hospitals being over-capacity and health care workers burning out (or dying themselves). Fatalities from other causes would increase too (as they're already doing due to people avoiding medical care due to fear of infection at hospitals). The absolute number of dead would also rise were the lockdowns not in place. Just how many people do we want to sacrifice to keep restaurants open?

Also, fatalities aren't the only thing we have to worry about. People who survive can have very serious complications.

Finally, why should we only look at the effects on people younger than 70?

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>People who survive can have very serious complications.

This is true of several respiratory illnesses. For example there's evidence that the flu can increase the chance of a cardiovascular event for several months after recovery[0]. Is there evidence that covid has more severe long term complications than other respiratory illnesses?

>why should we only look at the effects on people younger than 70?

We shouldn't, of course. However we also shouldn't base policy off of a minority of the high risk population. Older people are also at a much higher risk of auto accidents. Instead of making the license process more difficult for everyone, several states have rules specifically for older people mandating more frequent vision tests and license renewals.

Instead of banning a low risk activity for a mostly low risk group, why don't we put resources into taking care of the high risk population(free grocery/medicine delivery, prioritized telehealth appointments, etc.) and let everyone else take care of their own risk assessment?

[0]https://academic.oup.com/eurheartj/article/29/1/96/2398118

Just a couple of days ago "the U.S. recorded over 3,100 COVID-19 deaths in a single day"[1]

I have a very hard time imagining that restaurant closings or any other lockdown measures are ever going to lead to this scale of death.

[1] - https://www.adn.com/nation-world/2020/12/03/more-than-2800-a...

“Just how many people do we want to sacrifice to keep restaurants open?”

Just how many lives do we save by keeping restaurants open? Healthier food, portion control, emotional health? People sacrifice their lives to eat in restaurants...implicitly, when they drive a car to/from and risk an auto accident. It is probably small numbers against small numbers...and erring on the side of choice and economic activity is a standard US thing.

The poster didn’t propose to ignore effects on the 70+...where did you read this?

It would have been wiser had the government health communicators introduced the notion of QALY to the US public at the start of this COVID event.

https://pubmed.ncbi.nlm.nih.gov/16877455/

Anyone dealing with aging parents is painfully aware of the need to balance remaining length of patient life with quality of life, including caregivers. The rest of the US needs to grow up about this. Politicians avoid talking about this...too much like leaving Grandma on the ice floe. It’s the medical/public health professionals role to do that.

"Just how many lives do we save by keeping restaurants open?"

You tell me. How many?

"People sacrifice their lives to eat in restaurants...implicitly, when they drive a car to/from and risk an auto accident. It is probably small numbers against small numbers"

Like I said elsewhere in this thread, just the other day the US had over 3,000 COVID-19 deaths in a single day. That doesn't sound like a small number to me, and I'd be surprised if anywhere near that number of people died driving to a restaurant that day.

"The poster didn’t propose to ignore effects on the 70+...where did you read this?"

Right. They just happened to only quote the IFR rate for people < 70 years old, and not mention the IFR for people 70 and older. That sounds like they ignored them to me.

>You tell me. How many?

Based on the available evidence, I think the number is close to zero.

>Restaurants have been mandated by the state to impose certain regulations and hygiene measures. They follow the general principles of harm reduction that Monica Gandhi[0], an infectious disease expert at UCSF, goes by: masks, distancing, ventilation and hand hygiene. "There is no evidence that I can find anywhere in the world that outdoor dining with those four procedures in play increases the risk of COVID-19," she said. [1]

So there seems to be no evidence that banning outdoor dining is going to do anything positive in stopping the spread, though we know for certain it will have destructive effects on people's well being and the economy.

[0] https://en.wikipedia.org/wiki/Monica_Gandhi

[1] https://www.houstonchronicle.com/bayarea/article/Is-outdoor-...

You didn't answer the question I asked, which was how many people's lives would be saved by keeping restaurants open.

Instead you answered a question I didn't ask: how many lives would be lost by allowing outdoor dining.

Two completely different questions.

However, if one of the requirements for making outdoor dining safe is to wear masks, I don't see how it can be made safe, since as far as I know people can't eat or drink with masks on.

Furthermore, at least in my own informal witnessing of people dining outdoors, the norm is for people to socialize at tables without masks, with only a couple of feet between them. I wouldn't call that social distancing either.

That's two strikes against outdoor dining: lack of masks and lack of social distancing.

I'd love to have asked that UCSF expert what she had to say about this.

Something else to consider is that restaurants aren't only doing poorly because they're being locked down, but even when they're open many people are choosing (very sensibly, from my perspective) to avoid them. That won't be fixed by ending lockdowns.

Anyway, I'm still waiting to hear someone tell me how many lives would be saved by allowing restaurants to open. Is it going to be anywhere near 3,000 in a single day? Somehow I very much doubt it.

I did answer the question you asked. The answer for "how many lives would be saved" and "how many lives would be lost" if outdoor dining is/isn't banned is the same; approximately zero based on the evidence. You also have to consider that even if all restaurant dining is banned, that doesn't mean people are suddenly going to stop eating together, they'll just do it elsewhere, somewhere that's probably much riskier than an outdoor patio such as a car or inside someone's house.

>I don't see how it can be made safe, since as far as I know people can't eat or drink with masks on.

Clearly the principles of harm reduction discussed in the article account for patrons eating without a mask on while they are seated at a table, but I suspect you already knew that.

>I'd love to have asked that UCSF expert what she had to say about this.

I'd love to hear what she would have to say as well. Though seeing as she has a long career studying infectious diseases and has studied covid extensively over the past year, I'm inclined to think she has a good understanding of the risks involved in certain activities, certainly beyond the anecdotal evidence of commenters on HN.

>I'm still waiting to hear someone tell me how many lives would be saved by allowing restaurants to open. Is it going to be anywhere near 3,000 in a single day? Somehow I very much doubt it.

I'm not sure why you're waiting for this answer. The number of deaths in a day(3000) is unrelated to restaurants allowing outdoor dining, so why are you comparing them? Closing restaurants will not bring that number down, based on the science we have available, but if you have evidence that suggests otherwise feel free to share.

You're here to save lives. Great. Do you want to start by banning all alcohol consumption, ban unprotected sex, or by making private vehicle ownership illegal?

Banning abortion saves lives too. Also motorcycles.

> ...but even when they're open many people are choosing (very sensibly, from my perspective) to avoid them

We should just open them then if nobody is going to go to them. In one breath you say we need to restrict them and in the other breath you say nobody will go. "I don't like to go there any more, it's too crowded" -- Yogi Berra

Another amazing feat of physics - like masks. When Covid cases go up it's because people aren't wearing masks. When the CDC and other international organizations record near-zero flu deaths for the year 2020 it's due to mask usage.

Somehow both things are happening at the same time.

"You're here to save lives. Great. Do you want to start by banning all alcohol consumption, ban unprotected sex, or by making private vehicle ownership illegal? Banning abortion saves lives too. Also motorcycles."

Except for banning abortion, none of those things has a chance of actually being made illegal any time soon, so no use talking about any of them. And I don't think getting in to an argument about abortion in this thread would be productive.

Let's see what else you've got...

"We should just open them then if nobody is going to go to them. In one breath you say we need to restrict them and in the other breath you say nobody will go."

Except some highly inconsiderate, ignorant, and/or stupid people are still going. It's those we have to worry about. So I'd vote to keep them closed.

"Another amazing feat of physics - like masks. When Covid cases go up it's because people aren't wearing masks. When the CDC and other international organizations record near-zero flu deaths for the year 2020 it's due to mask usage."

You know, it could be both? Because the flu might not be as contagious, and there are other measures being used as well, like increased hand washing, which might be more effective for preventing the flu than preventing COVID-19. And even if all the measures are equally effective, there just might not be as much flu going around this year. Anyway, the fact that flu deaths are also going down, probably due to some of the lockdown, mask, and distancing measures is is even more reason to continue them.

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