Wombaticus Rex » 03 Apr 2020 13:43 wrote:This is a solid piece that cleanly encapsulates some shit I've just been screaming obscenities about in my kitchen over the past three weeks.
https://medium.com/@wpegden/a-call-to-h ... 156686a64bIt's heavy on graphics but I will omit them because I care about your load times and fuck it, you've already clicked the link anyway. Key points:
Recently there has been a proliferation of modeling work which has been used to make the point that if we can stay inside, practice extreme social distancing, and generally lock-down nonessential parts of society for several months, then many deaths from COVID-19 can be prevented.
For example, a new study by Christopher J.L. Murray at the University of Washington models hospital and ICU utilization and deaths over a 4 month period of mitigations, and estimates that “Total deaths” can be kept under 100,000.
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Hiding infections in the future is not the same as avoiding them
A keen figure-reader will notice something peculiar in Kristof’s figure. At the tail end of his “Social distancing for 2 months” scenario, there is an intriguing rise in the number of infections (could it be exponential?), right before the figure ends. That’s because of an inevitable feature of realistic models of epidemics; once transmission rates return to normal, the epidemic will proceed largely as it would have without mitigations, unless a significant fraction of the population is immune (either because they have recovered from the infection or because an effective vaccine has been developed), or the infectious agent has been completely eliminated, without risk of reintroduction. In the case of the model presented in Kristof’s article, assumptions about seasonality of the virus combined with the longer mitigation period simply push the epidemic outside the window they consider.
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Unfortunately, extreme mitigation efforts which end (even gradually) reduce the number of deaths only by 1% or so; as the mitigation efforts let up, we still see a full-scale epidemic, since almost none of the population has developed immunity to the virus.
Seasonal variability? Probably won't happen.
Herd immunity? Open question and a dangerous bet.
Vaccines? The math is not on our side. And that, that is the key bet behind all of these "flatten the curve" models -- that big pharma will ride to the rescue in time. Yet it's demonstrably already too late.
It's increasingly clear that what happened here has broken the world and that needs to be grappled with instead of obfuscated. The cost of maintaining lockdowns is unbearable on every level, and the cost of reversing them is politically unthinkable. We're already off every map. And this isn't even close to the worst thing that's gonna happen in the next ten years.
The future is the only place we can hide these infections given the limits we have on our medical systems.
In Australia we are gambling that we can manage it by doing this lock down bullshit. The economy is fucked anyway. We're so dependent on China, we were smashed by the fire season and ongoing climate meltdowns. But we're a long way away, have some control on our borders right now and seem to be managing our infection rates. This is a convenient excuse for the government in a lot of ways. It hides their mismanagement and if somehow things aren't as bad as where you guys live for example they'll come out smelling like roses instead of what you feed to roses. It's a bit of a Claytons lockdown. (The lockdown you have when you're not having a lockdown. Look it up.). Buying beer is considered an essential activity. Hairdressing isn't. It's weird, but not as mental as other places. If our figures are accurate, which I doubt but who knows ... We're doing lots more testing than we have positives and we have few cases that don't fit a traceable chain of infection. So far so good.
We might lose it soon be a use there are definitely untraceable cases, community transmission, so its out there.
However if we manage our rate of infections we may be able to minimise the death, especially among the medical profession. And people without Covid 19 who die because of the overwhelmed medical system.
This is the bullshit in that comorbidity or other deaths would happen anyway argument. They might not but because of the pressures this added disease puts on medical systems they certainly will now.
Plus it does buy us time. Time to produce more hydrochlorowjatever it is for example. Time to build more equipment, for people to survive or not on respirators without someone else waiting. Time to test vaccines, even if it's too quickly. The people at the synchrotron in Melbourne tpreckon they have mapped the entire surface of the virus and are making it public, open source for the whole world to use. This is good.
They are excited about a particular structure of proteins that may effective in this case.
If you follow that GoF research or the potential of this virus to develop what's called Antibody Dendent Enhancement, a full scale "3D" map of the surface of the virus makes it easier to develop antibodies that will not enhance the viruses ability to access cells. Time to do that.
Even without that ... young people need ventilators too. They make up most of the small percentage that survive them. We want to avoid having to make those choices. We want to minimise the damage to our medical systems, psyche as a nation, sense of ethics and to individual people and families.
We're already talking about when this should end, how bad things will get etcetc, but what are the limits of the states power and the limits of the way we value things. This can only be good for us after what we went thru last fire season.
We could be about to fall off a cliff, we know that as well.
But I look at the USA and think... You guys are fucked anyway. No offence but ... Capitalism and pandemics don't mix. Your country has a shortage of medical PPE and yet stuff that's being made there is being shipped offshore till (I presume) Russians sell it back to you.
In some ways you might be right, you're gonna lose maybe 10% of the people who get infected, maybe less or more who knows and a good chunk of the best of your medical profession. Bite the bullet and get it over with and the sooner you start rebuilding or fighting over whatever comes next.
