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Lewk will latch on to anything, even the retarded "the stay at home order is working, so we don't need stay at home orders" mindset that he is attempting with the elective surgeries, in an attempt to distance himself from the fact that thus far pretty much every claim he made for how this would shake out was deadly wrong.Quote:
Originally Posted by Loki
He's like an idiot saying that he's not been in a car crash this week so doesn't need a seat belt.Quote:
Originally Posted by Ominous Gamer
As is so commonly the case, it's the economics. It's not really that it's hitting minorities harder, it's that it's hitting the poor harder, and minorities make up a disproportionate part of that group. It's also hitting dense urban areas harder, and minorities make up a disproportionate part of that group too. It's a combination of population density, people who don't have the option to work from home, people who can't afford to just stop working for a couple months of quarantine, can't stop working just because they're sick, and probably don't have access to the same quality of medical care.Quote:
Originally Posted by RandBlade
TBF, it'd probably even out a lot more if we hadn't quarantined and had just carried on like normal. There wouldn't be many who didn't get infected, and only medical access would have a significant skewing effect.
If you look at variation within states (or NYC), you see that the minority areas are hit harder than equally poor white areas and dense areas have no more infections (per capita) than less dense ones.Quote:
Originally Posted by Wraith
I actually had a fascinating discussion about this the other day. My father-in-law sends me occasional links, and most of his other recipients are wealthy men in their 60s and 70s. Early on, I replied all to an email where I argued that lockdowns were probably warranted given the data available at the time (this was mid-March). A very wealthy and intelligent hedge fund manager responded with a fascinating take. Essentially, he argued that the benefits of various public health measures like lockdowns are not being appropriately balanced against their costs. He was correctly predicting 20 million+ unemployed, and that almost all of the people who would pay the economic price would be young and poor, while the benefits would almost entirely accrue to the old and rich(er) because of the mortality distribution. Given that the people making decisions on lockdowns were mostly old and rich, he found it manifestly unfair and wanted the data to be really solid that other measures wouldn't be reasonably effective while dramatically reducing the costs (e.g. why not just isolate the old, or put in place other social distancing measures, or whatever). (Others in the thread took rather extreme exception to this view.)Quote:
Originally Posted by Wraith
I wasn't fully sold on his opinion - I think the data was strong enough at the time to support such draconian measures, and I am confident I was right - but it was a fascinating perspective. Why should young people - who are largely going to be have little risk from coronavirus - pay such a staggering cost just to benefit a bunch of old people who aren't going to really help them out? Why should we discount their lives - shortened by increased mortality and decreased QOL from economic depression - for the benefit of a different group?
I'm not in the 'let the grandparents die for the economy' crowd, of course, but a thoughtful view of the entire set of costs and benefits of a given response is worth considering. Maybe there are advantages to skewing our response a little bit more towards younger populations.
Man, if this guy is concerned about the way the lockdown might exasperate intergenerational income inequality, wait till he finds out about the past forty years of neo-liberal economics. Hooo boy is he going to be pissed.
What I always miss in that kind of discussion is what the impact would be without a lockdown. Yes there's a massive cost to those measures, but a pandemic raging about also won't be good for the economy.
In 1920 -> 1921 the UK economy shrank by over 20% in nominal terms. Mitigated in real terms by very high deflation, but that plus WWI borrowing led to interest payments surging to over 44% of government expenditure.Quote:
Originally Posted by Flixy
Yeah. It's also worth noting that the countries with the fast and aggressive responses - such as New Zealand or South Korea - are the ones now thinking about opening back up, whereas in other countries who were slower the lockdown is still going dragging on to at least the end of May in some form, and in the US which appears to have no-coherent strategy at all, I just don't see a true end until there's a vaccine, and even then there's going to be this huge struggle about whether or not some private interests or other gets to charge thousands of dollars for access to it.Quote:
Originally Posted by Flixy
Very positive news coming from a vaccine out of Oxford, already in large scale human trials and also looks like we could have confirmation as early as next month as to whether it works or not.
Interestingly AstraZenica have already started mass-producing Oxford's vaccine just in case it works and gets approval - they're going to scrap what they've produced if it doesn't. That is unprecedented as far as I know.
to add to thisQuote:
Originally Posted by Wraith
https://www.theguardian.com/world/20...land-and-wales
Theres a reason the Boomers are called the Me Me Me generation. Can you imagine the uproar if we restricted libraries and parks to only those that aren't old or don't interact with old people? Or furloughed only the most vulnerable? Or asked for these people to possibly spend a little more for services from the gig the economy that might be able to keep them from catching community spread?Quote:
Originally Posted by wiggin
Georgia is telling all 65+ to stay home for another month.
Could you spit out what you're alleging? Also, statistics for this can be difficult to compare, because infection rates have not been uniform and there are a ton of variables to control for.Quote:
Originally Posted by Loki
I'm saying there's some other variable responsible for the higher African American infection and mortality rate. I don't know if it's biological, or African Americans being told to go home when they claim to have the virus (there are at least some reports of this happening), or the quality of healthcare in black areas (even compared to healthcare in poor white areas). But it's not a simple "African Americans are more likely have obesity/diabetes/asthma" explanation.Quote:
Originally Posted by Wraith
And yes this is a super complex issue.
There was a directive went out to the NHS telling them to risk assess their BAME staff working on the cornavirus wards after it was noted that a very high proportion of NHS workers who've died form covid-19 are non-white. I do think there's at least a possibility that there's a biological component to it, on top of the usual systemic racism. No one really knows why most people with covid get a mild illness and then in some people it just goes apeshit.
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Originally Posted by Steely Glint
122,000 tests yesterday. Going to be able to go back to tracing and tracing like South Korea after lockdown it seems.Quote:
Originally Posted by RandBlade
4 out of five of the states hit hardest by unemployment have republican majorities.
https://www.msn.com/en-us/money/care...Bnb7Kz#image=5
Might have something to do with those states having low minimum wages. Big incentive to remain unemployed for the next few months there.
In Florida that unemployment payout right now is something like $600. Accounting for taxes thats over a $20/hr rate FT.
I am in agreement that there is far to much poverty exploitation going on, but those benefits for the time being ain't bad.
From now on, I'm afraid that every time I hear someone complain about not being able to get a promotion because the old farts at the top just won't leave, I'm going to think: If only we'd listened to Trump...Quote:
Originally Posted by wiggin
Whenever some methuselahian Senator winds up in charge of technologies he doesn't have a hope of understanding: If only we'd listened to Trump...
Whenever a Gen Xer worries about getting their Social Security or a Millenial takes it for granted that they won't get one: If only we'd listened to Trump...
Whenever a politician wins an election just because the old can always outvote the young: If only we'd listened to Trump...
Whenever I hear how much we're missing the Paris Accords by, I'm going to wonder about how many forests we could have planted with all that new fertilizer we'd have if only we'd listened to Trump...
Maybe I need to go get a MAGA hat, because I'm starting to wonder if we really could have made America great again, if only we'd listened to Trump.
You ok?
Very droll Wraith ...
Covid-19 has some strange side-effects; yesterday I got people who signed an agreement to lease a vacant apartment before even seeing the place. In normal times the apartment is in a wanted location and it is heavily discounted, but to rent it without seeing it at all; that was a new one for me.
Speaking of rentals: my friend moved to a new place because their house is planned to be demolished in a few months. Since it wasn't going to be occupied after them they didn't bother so much with the state of the place (just empty), and put the laminate flooring on Ebay for anyone to break it out and take it. Then literally two hours after the floor was out they were contacted if they could leave it in, because the house is going to be used to house a couple who were on a long round-the-world trip but had to stop and no place to stay. Unfortunate timing for them, now they're in a house that doesn't even have flooring..
Meanwhile I can't find a roommate at all. Everyone balks when I request their current landlord as a reference.Quote:
Originally Posted by Hazir
Rent here is $600-700 for a 2-bedroom. Just saying. :o
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Originally Posted by RandBlade
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Originally Posted by Timbuk2
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Originally Posted by Flixy
See my numerous posts about how little work I've had for the past couple of months—only partly due to extreme luck wrt scheduling. The first two weeks after mobilization in response to the Sthlm outbreak, we saw an sharp reduction in the number of neuro patients in the ER, and a reduction of like 30% for the ER as a whole. Acute care has begun to return more or less to normal, but the elective side of things is very different—almost all of our patients are in risk groups, so we've switched over almost completely to phone & video, and are relying more on primary care centers to help us with investigations. This has freed up a lot of personnel, so we're all just puttering about, on standby, while following up patients, reading, doing research, catching up on paperwork etc. Some of our most commonly used investigations have been postponed or cancelled on many occasions. From an intellectual perspective, this is a stimulating state of affairs, because it increases the importance of clinical skills & judgement. There's a value proposition for patients as well—apart from lower risk of infection and death, they are also spared many mostly unnecessary visits and investigations (we have a lot of those b/c of a tendency to rigidly adhere to routines designed to facilitate research and of course monitor quality of care—both of which are somewhat more beneficial to doctors & admin than for individual patients). So, all in all, here in the frozen north, things are still quite peaceful—for me, at least. The major difference is that everything I do requires more consideration and more effort—the former being pretty fun, and the latter just being incredibly wearisome (putting on and removing PPE over and over again, having to be much more aware of every action b/c of risk of contamination, etc).Quote:
Originally Posted by RandBlade
My friends in the Sthlm region and in adjacent counties are working their asses off though, largely because most of them work in specialties that are directly affected by covid. In several counties, they've activated crisis deals or some sort of equivalent, leading to more work (often on short notice) but ofc. with increased pay and/or comp time. A couple of hospitals have been hit especially hard, necessitating transfers between ICUs, which is rarely ideal. ICU utilization is many, many times higher than it usually is, and it's been difficult to ensure adequate staffing even with support from staff freed up from adjacent specialties. ECMO resources have been pretty heavily taxed.
Wrt reduction in patients in ER, I know that my friends in other countries in particular have noticed an increase in patients who have delayed seeking care, and I'm certain Sweden has been similar in this respect (albeit perhaps a little less so than in eg. NYC). Common examples are patients with eg. appendicitis who've waited so long that they've had a significantly elevated risk of complications, patients with heart attacks or strokes who have waited (or who haven't been noticed by their usual caregivers), etc. I think we're going to miss many more pulmonary embolisms than usual, and see more patients suffer larger heart-attacks than they would've otherwise. Flixy's point re. delayed cancer diagnosis is also important. Officially, very little has changed wrt routines for cancer diagnoses, but obv. there will be delays due to changed behavior; difficult to say what the real-world impact of this will be. I'm more concerned about the impact on heart attacks tbh. Our ambulance services have mostly remained functional and I believe the effect wrt. stroke patients has been minimal (anecdotally confirmed—I've seen about as many stroke patients per shift as I usually do). There's been a massive reduction in trauma patients, presumably because people aren't out driving as much as they usually do. This is notable because my hospital gets neurotrauma patients from a very large area covering like half of Sweden, in which almost no cities/communities have had major outbreaks. People are staying put.
The greatest reduction—for my clinic—has been among those patients who are typically referred to the ER from primary care clinics. Patients who would otherwise have ended up in the ER for prompt (often overzealous) evaluation now have an easier time just staying at home and getting better on their own. An illustrative example is the reduction in the number of patients who are referred for headaches. If you have a headache, and you have to work, you want it evaluated and treated asap; if you don't have to go in to work, you can wait it out. My colleagues in pediatrics have seen a similar trend wrt their ER patients—new parents feel much more motivated to stay home and see how things go (obv. with easy access to guidance by phone). This pandemic has forced us to implement a form of watchful waiting on a very broad scale.
An important observation made by several commentators is that many western govts went all in on drastically increasing surge capacity in their healthcare systems (freeing up ventilators, opening up field hospitals, etc) when it's becoming increasingly clear that going all in on the distinctly medieval strategy of quarantine might've been much more effective. Almost all countries in the west immediately accepted a "virus wins, we lose" framing—and so the virus won on walkover.
Difficult to draw this conclusion due to unreliability of official case & mortality stats, but, even if that weren't the case, it's hard to argue that the date itself signifies anything special.Quote:
Originally Posted by RandBlade
Other people will die :) especially black people.Quote:
Originally Posted by Steely Glint
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Originally Posted by RandBlade
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Originally Posted by Wraith
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Originally Posted by Loki
There are several putative explanations, but it's difficult to regard any of them as compelling until you have reliable clinical studies showing a significant disparity that persists even after adjusting for clinical characteristics. Before trying to determine which explanation is right, we have to determine whether there is something to explain! But I believe, even if you adjust for important clinical characteristics, there will be differences wrt risk of infection (which can no doubt be partly attributed to socioeconomic factors) as well as the risk of becoming severely ill, both from the infection itself as well as from medical problems secondary to the infection (notably exaggerated immune response and excessive clotting, both of which appear to major determinants of risk of death). We're still learning.Quote:
Originally Posted by Steely Glint
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Originally Posted by Steely Glint
This is a summary of the Swedish debate:Quote:
Originally Posted by Flixy
Critics: "We need to impose a strict lockdown starting two months ago, to save lives."
Literally every Tom, Dick and Harry: "Oh yeah? Well have you considered the lives that would be lost due to the economic crisis brought on by a lockdown??!"
It's the most obvious objection to a lockdown, and the dominant discourses in the public debate all implicitly frame the dilemma as being a choice between a) Reducing number of lives lost to covid, but tanking the economy, or b) saving the economy, but losing more lives—sooner—to covid. Of course, in reality, all scenarios come with a large helping of economic devastation. As Flixy points out, an out-of-control pandemic is not great for the economy. How do the numbers work out? We have little real-world evidence to work with, but a couple of analyses of the 1918 pandemic found that US cities that swiftly imposed strict suppression measures saw better outcomes both wrt lives saved as well as wrt economic recovery. Obviously there are caveats, and obviously the global economy looks different now than it did in 1918, but that's the most directly applicable real-world evidence we have. We can mitigate the harmful impact of an economic crisis exacerbated (if that's really how it plays out) by suppression measures; for example, you can pay people, you can check up on them, you can ensure they have access to various kinds of support. However, the only effective strategy we have for reducing the cost—in human lives—of an out-of-control pandemic causing a disease we can't effectively treat... is to control the pandemic and reduce the number of people who contract said disease.
Thing is, many Boomers are also financially vulnerable during this pandemic. There are 40 million "younger" Boomers in the US—ie. below retirement age—who are losing a lot of income. The broad label conceals a great deal of heterogeneity wrt socioeconomic resources.Quote:
Originally Posted by Ominous Gamer
Economic impacts of an unconstrained pandemic likely include:
* Downturn in the clubs, bars, restaurants, fast food, entertainment etc sectors
* Downturn in productivity due to large % of workforce being off sick
* Overwhelmed health-system
* Complete cessation of foreign tourism from non-dumbshit countries
* Outright travel bans from non-dumbshit countries
Waiting for a vaccine was never the goal! :donkey:Quote:
Originally Posted by Lewkowski
Stay-at-home policies were meant to slow the virus, spread infections over a longer time frame ("bend the curve"), protect hospitals from being overwhelmed, and preserve supplies of PPE. No US state had a full lock down; no one was under house arrest, and even isolation/quarantine was voluntary.
OG is right about the other things, including people traveling across borders and between states to get "concierge" health services. It's not just Snow Bird seniors going to Florida, but wealthy people with second homes and vacation homes going to the Hamptons or the Carolinas, etc.
And you really don't understand how our fee-for-service and private insurance healthcare system works if you're surprised that nurses and doctors have had their hours cut, or were furloughed during the pandemic. Many physician groups are owned by private equity firms or hedge funds, and they aren't thinking of public health (or the public good) but their own profits....which come from elective *non-emergency* procedures. :bored:
Nothing like a bunch of rich old men pontificating about socio-economic inequality and 'manifest unfairness', huh. :bored:Quote:
Originally Posted by wiggin
On the flip side -- why should the young and poor (or heavily in debt with school loans) continue to work in the service or hospitality sectors, or the gig economy *which benefits those rich old men more than anyone* when they don't have health insurance, paid sick time, family leave, hazard pay, and can barely afford rent, let alone Child Care?
The "essential workers" lives have been discounted for decades. The fruit picker, farm worker, grocery store clerk, bus driver, janitor, nurse's aide, restaurant cook -- they're valued for their *work* but it's not reflected in their wages/income, so they have to work 2-3 jobs just to keep up (running in place but still falling behind).
They're treated as expendable human beings. That's not just tragic but paradoxical, since the "professionals" who can work from home are the "non-essential" workers, easily replaced by computers and virtual reality. :bulb:
Don't forget that Boomers have more expendable income than any other generation, which helped to "expand" the service/hospitality (and healthcare) industries in the first place. They're the ones who have vacation homes, take cruises, travel the world, spend money in hotels, restaurants, theaters, etc. Many have private employer retirement pension plans that include health insurance for life (vs Medicare), and don't need to live on SS (but they'll take it anyway). On top of that, they also get senior and AARP discounts for all sorts of goods and services, regardless of income. :bulb:Quote:
Originally Posted by Ominous Gamer
They have a large political lobbying influence, too. And since most of congress is comprised of rich old (white) men....