COVID Economy

[GooooMarquette]

The rest of us can do our part by wearing masks, social distancing publicly, not bring risk to those older loved ones by visiting.

Unfortunately, huge numbers of people are ignoring these simple, common sense measures. This was yesterday afternoon in Ocean City....

https://twitter.com/HellgrenWJZ/status/1264311034996838401?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1264311034996838401&ref_url=https%3A%2F%2Fbaltimore.cbslocal.com%2F2020%2F05%2F23%2Foceancity-maryland-ocmd-memorialday-weekend-summer-boardwalk-coronavirus-health%2F

[Elonsmusk]

Gross cavalier attitude notwithstanding, which states aren't in the process of reopening?

California?  Minnesota?  Illinois?  Opening business to 25% capacity while "opening," isn't "opening."  You have barber shops/hair salons who can only open at 25% capacity.  Many restaurants the same. Many bars not able to open.  Those economics don't work.  Let them open 100%.  You walk into a restaurant/salon and feel it is too crowded?  Leave.  Nobody forces you or the employees to participate.

Yea, but what about hospitals then being overwhelmed?  Most who get COVID do not end up in the hospital, many are asymptomatic.  Hospitalization rate of COVID patients?  4.6 per 100,000. In highest risk group over 65?  13.8 per 100,000 people. 

The horror out of NYC is not something that can be replicated anywhere else in the U.S - aside from perhaps Chicago, San Francisco, Boston - cities reliant on mass transit.  NYC was the perfect breeding ground for massive outbreak - global tourism/business travel, subways where you are packed like sardines, same with sidewalks, people living on top of each other in apartment/condo buildings, population density greater than anywhere else in the U.S.

I don't find it cavalier to care about the 40 million healthy and able-bodied Americans out of work. COVID's mortality rate will eventually settle around 0.5%, and ~98% of those who do die are over 65 and have severe underlying health problems - who's quality of life was either already compromised or soon would be in decline.  For those in that risk group?  Stay home.  Don't take visitors.  The rest of us, stay away.  Don't think anybody with loved ones in high risk group would disregard what we know - to stay away.

BTW - As I recall you are involved in healthcare on some level?  And from past discussions, I know you are well-informed and bright on the healthcare side of things.  Do you think we will have a vaccine for COVID in next 12 months?

[forgetful]

Yea, but what about hospitals then being overwhelmed?  Most who get COVID do not end up in the hospital, many are asymptomatic.  Hospitalization rate of COVID patients?  4.6 per 100,000. In highest risk group over 65?  13.8 per 100,000 people. 

The horror out of NYC is not something that can be replicated anywhere else in the U.S - aside from perhaps Chicago, San Francisco, Boston - cities reliant on mass transit.  NYC was the perfect breeding ground for massive outbreak - global tourism/business travel, subways where you are packed like sardines, same with sidewalks, people living on top of each other in apartment/condo buildings, population density greater than anywhere else in the U.S.

You are citing hospitalization rates, that are based on total population, not cases. Those rates are during a nationwide shutdown/quarantine. They do not remotely represent the hospitalization rates on a case basis, or what would occur on a population basis if we have no shutdown/quarantine.

Regarding it can't happen anywhere else, well except for New Orleans, and Baton Rouge, and a number of other smaller cities in Louisiana...oh yeah, and that dense urban jungle called Montgomery, Alabama that is currently experiencing it.

What you are stating are no where near the reality on the ground.

I don't find it cavalier to care about the 40 million healthy and able-bodied Americans out of work. COVID's mortality rate will eventually settle around 0.5%, and ~98% of those who do die are over 65 and have severe underlying health problems - who's quality of life was either already compromised or soon would be in decline.

The mortality rate will likely be around the 0.8-1.0% that has been predicted from the early days. And your stat that 98% of those who do die are over 65 with severe underlying health problems is just completely false. In NY right now, 26% of all deaths have been under the age of 65. And they don't track "severe underlying problems" they track "underlying problems" which could be as mundane as being overweight, or high cholesterol.

You are being cavalier about disregarding human life. Not to mention, that many of the people that do survive in these younger age demographics may have life-long quality of life impacts from the disease.

[pbiflyer]

The rest of us can do our part by wearing masks, social distancing publicly, not bring risk to those older loved ones by visiting.

Lake of the Ozarks yesterday:

[Pakuni]

BTW - As I recall you are involved in healthcare on some level?  And from past discussions, I know you are well-informed and bright on the healthcare side of things.  Do you think we will have a vaccine for COVID in next 12 months?

I'm not in position to debate every point, but I'll just say allowing people to decide for themselves isn't an option with a pandemic. This isn't like smoking where a person makes a risky choice, gets cancer and dies. The spread doesn't stop with the person who takes the risk. That person carries the virus to friends, family, co-workers, fellow parishioners, etc., who can then pass it on to their friends, family, co-workers, fellow parishioners, etc. That's how a pandemic works and why "it's my choice" slogans are dumb. It may be your choice to go to a crowded restaurant, but it's not the choice of everyone you come into contact with for the next couple of weeks, or that of the people they come into contact with.
And forcing millions of out-of-work people to choose between unemployment without benefits and working in potentially dangerous conditions doesn't seem like much of a choice.

A .5% mortality rate would be devastating and there's almost no chance that 98 percent of those killed will be over 65 (that figure currently sits at about 73 percent, per the CDC).

Lastly, no, I'm not in the health care industry and anything I say about the prospects of a vaccine would be total speculation.

[#UnleashSean]

I'm not in position to debate every point, but I'll just say allowing people to decide for themselves isn't an option with a pandemic. This isn't like smoking where a person makes a risky choice, gets cancer and dies. The spread doesn't stop with the person who takes the risk. That person carries the virus to friends, family, co-workers, fellow parishioners, etc., who can then pass it on to their friends, family, co-workers, fellow parishioners, etc. That's how a pandemic works and why "it's my choice" slogans are dumb. It may be your choice to go to a crowded restaurant, but it's not the choice of everyone you come into contact with for the next couple of weeks, or that of the people they come into contact with.
And forcing millions of out-of-work people to choose between unemployment without benefits and working in potentially dangerous conditions doesn't seem like much of a choice.

A .5% mortality rate would be devastating and there's almost no chance that 98 percent of those killed will be over 65 (that figure currently sits at about 73 percent, per the CDC).

Lastly, no, I'm not in the health care industry and anything I say about the prospects of a vaccine would be total speculation.

If we do mass testing, the mortality rate will drop a lot. Guessing to .03-.05. The rate of hospitalization will also skew much more towards those over 65.

Right now the statistics are very skewed due to the little amount of testing.

[Elonsmusk]

You are citing hospitalization rates, that are based on total population, not cases. Those rates are during a nationwide shutdown/quarantine. They do not remotely represent the hospitalization rates on a case basis, or what would occur on a population basis if we have no shutdown/quarantine.

Regarding it can't happen anywhere else, well except for New Orleans, and Baton Rouge, and a number of other smaller cities in Louisiana...oh yeah, and that dense urban jungle called Montgomery, Alabama that is currently experiencing it.

What you are stating are no where near the reality on the ground.

The mortality rate will likely be around the 0.8-1.0% that has been predicted from the early days. And your stat that 98% of those who do die are over 65 with severe underlying health problems is just completely false. In NY right now, 26% of all deaths have been under the age of 65. And they don't track "severe underlying problems" they track "underlying problems" which could be as mundane as being overweight, or high cholesterol.

You are being cavalier about disregarding human life. Not to mention, that many of the people that do survive in these younger age demographics may have life-long quality of life impacts from the disease.

I guess I haven't seen the proliferation of cases/death coming out of Alabama.  Of course cases are going to be on the rise everywhere as we are testing exponentially more people, and as that happens mortality rate will come down to less than 1%.

I think it is great to be optimistic about a vaccine, yet that certainly isn't guaranteed, and if it does happen, my guess is it won't be ready for approval/use for 8-12 months.  But what if there isn't a vaccine in 12 months?  Looking at the carnage of the economy in the last 7 weeks - it can't continue.  Herd immunity ultimately might be the only solution.

[forgetful]

I guess I haven't seen the proliferation of cases/death coming out of Alabama.  Of course cases are going to be on the rise everywhere as we are testing exponentially more people, and as that happens mortality rate will come down to less than 1%.

I think it is great to be optimistic about a vaccine, yet that certainly isn't guaranteed, and if it does happen, my guess is it won't be ready for approval/use for 8-12 months.  But what if there isn't a vaccine in 12 months?  Looking at the carnage of the economy in the last 7 weeks - it can't continue.  Herd immunity ultimately might be the only solution.

The 0.8-1% is based on antibody testing in NY.

Regarding Alabama, it is rural, there aren't thousands of bodies piling up, so it doesn't get the attention.

https://www.cnn.com/2020/05/21/us/montgomery-alabama-icu-bed-shortage/index.html

https://www.businessinsider.com/dire-coronavirus-alabama-icu-no-beds-2020-5

[Elonsmusk]

The 0.8-1% is based on antibody testing in NY.

Regarding Alabama, it is rural, there aren't thousands of bodies piling up, so it doesn't get the attention.

https://www.cnn.com/2020/05/21/us/montgomery-alabama-icu-bed-shortage/index.html

https://www.businessinsider.com/dire-coronavirus-alabama-icu-no-beds-2020-5

Thanks for the links.  Cases are on the rise, certainly due to increased mobility AND increased testing.  We have concrete data that shows 40 million Americans have encountered financial distress and hardship due to COVID.  0.8% of people who get COVID will die.  To your earlier point in NYC - 74% were over 65.  Underlying health issues such as obesity, high cholesterol, increase risk of death as they do in general - no surprise there. We know who is most susceptible and should be quarantined. To me it's a utilitarian decision at this point.

What's your best guess on a vaccine timeline?  Do you feel it is feasible and realistic to have the continued the lockdown measures of the past 2 months, to extend out to your projected vaccine timeline?

I've seen half of my office let go/furloughed.  Some great people, some who are expecting newborns.  Some of my colleagues spouses also lost their jobs.  They have ZERO household income.  Many Americans have little to no savings.  Imagine their reality.  And they probably can't even go move back in with their parents due to their parents being 60+.

Virtually every company I encounter/call on has a spending freeze, hiring freeze. I think it is wishful thinking to think that the economy/business can bounce back from this.  The longer lockdown measures continue, you are exponentially increasing the timeframe for recovery.  Just feel we are to the point of needing to rip the band aid off - neither option is a good one - but we must get our country/world back to work.

[pbiflyer]

If we see a second wave after the economy opens back up that is similar or worse to the first one, I think you would see a permanent or very long term major hit to the economy.
Yes, we have to open back up, but I think recent visuals from Maryland and Missouri show that we can't trust the public to be responsible. So, we have to figure out a way to mitigate that. If you don't, we are almost ensuring a second wave. It will just be how bad to determine its long term impact.

[TSmith34, Inc.]

Herd immunity ultimately might be the only solution.

Just to put some numbers around this:

The most optimistic number I've seen for herd immunity is 70%.
Let's also optimistically say the fatality rate is .5%.

That comes out to 330M * .70 *.005 = 1,150,000 dead in the U.S.

I don't think 1.15M dead will be acceptable to the populace. But I also think we'll have better treatments coming along that will make this more survivable; I'm less optimistic that a vaccine will be effective.

So just keep in mind that fully opening up and going back to how we operated before COVID will consign more than another 1,000,000 people to death. And yeah, I'm not going to even get into the "well, they were over 65 anyway" line of rationalization.

[Elonsmusk]

If we see a second wave after the economy opens back up that is similar or worse to the first one, I think you would see a permanent or very long term major hit to the economy.
Yes, we have to open back up, but I think recent visuals from Maryland and Missouri show that we can't trust the public to be responsible. So, we have to figure out a way to mitigate that. If you don't, we are almost ensuring a second wave. It will just be how bad to determine its long term impact.

Generally agree.  In some ways, I feel the dipsh$ts in Missouri/Maryland are doing the rest of us a favor - they will simply accelerate the timeline for us to develop herd immunity.  The big unknown/risk factor ultimately probably is how the healthcare system can keep up should servere cases of COVID surge all at once.

Seems most in medical community seem resigned to the fact that there will be a second wave this fall/flu season - perhaps it is better to accelerate the cases over the summer to mitigate potential double whammy of flu season and COVID? 

[Elonsmusk]

Just to put some numbers around this:

The most optimistic number I've seen for herd immunity is 70%.
Let's also optimistically say the fatality rate is .5%.

That comes out to 330M * .70 *.005 = 1,150,000 dead in the U.S.

I don't think 1.15M dead will be acceptable to the populace. But I also think we'll have better treatments coming along that will make this more survivable; I'm less optimistic that a vaccine will be effective.

So just keep in mind that fully opening up and going back to how we operated before COVID will consign more than another 1,000,000 people to death. And yeah, I'm not going to even get into the "well, they were over 65 anyway" line of rationalization.

I generally agree with your sentiments.  I too believe there will be some treatments in the next 3-6 months that reduce fatality from COVID. 

To clarify, I am not saying those over 65 aren't valuable to our society, etc.  My Mom is in a high risk group - diabetic and 75. She's taking all pre-cautionary measures and I don't visit her.  I feel pretty confident that she won't contract COVID due to her decision to truly shelter in place, and her friends/loved ones NOT exposing her to potential risk through visits.

My over-arching theme there is that if you are in a high risk group due to age/underlying health - stay quarantined and keep loved ones away.  Common sense.  However, for those of us highly, highly, highly unlikely to die from COVID?  We need to get back at it and out and about supporting businesses (with masks on).

[pbiflyer]

Generally agree.  In some ways, I feel the dipsh$ts in Missouri/Maryland are doing the rest of us a favor - they will simply accelerate the timeline for us to develop herd immunity.  The big unknown/risk factor ultimately probably is how the healthcare system can keep up should servere cases of COVID surge all at once.

Seems most in medical community seem resigned to the fact that there will be a second wave this fall/flu season - perhaps it is better to accelerate the cases over the summer to mitigate potential double whammy of flu season and COVID?

If we just had a crystal ball. We are all guessing and no one really knows the answer. I hope that it is less of a problem than some forecast, as we see, I doubt the American public has the ability to do the right thing.

[Pakuni]

Generally agree.  In some ways, I feel the dipsh$ts in Missouri/Maryland are doing the rest of us a favor - they will simply accelerate the timeline for us to develop herd immunity.  The big unknown/risk factor ultimately probably is how the healthcare system can keep up should servere cases of COVID surge all at once.

Seems most in medical community seem resigned to the fact that there will be a second wave this fall/flu season - perhaps it is better to accelerate the cases over the summer to mitigate potential double whammy of flu season and COVID?

Given what we're seeing from Sweden's herd immunity experiment, it seems a vaccine will come along well before natural realization of herd immunity, it it's even possible.

[forgetful]

What's your best guess on a vaccine timeline?  Do you feel it is feasible and realistic to have the continued the lockdown measures of the past 2 months, to extend out to your projected vaccine timeline?

I'm optimistic we have some type of vaccine by January. That is because it has become a political competition, so no matter what I think something is forced out. Now, I'm very hesitant on what that means and what its effectiveness is, and I have some concerns about the safety of whatever vaccine is pushed forward. I've discussed that to some extent in the vaccine thread.

And if you look on here, I've been a proponent of the original plan. To use social distancing as a way to get things under control, develop proper testing, and to have adequate contract tracing, so we could rationally open and handle any surges in cases. As I've commented on here, the problem was we had a leadership failure in pushing testing, pushing contract tracing, and empowering the CDC to do its job. That has all but screwed the original plan.

So now what? Honestly, we are in a jam. We weren't in a situation where we could open safely, because we squandered the time we bought. We are now in a place where I think we have to open to at least 50%, simply because there is no indication that we will be better prepared, because we wait longer, and because of inherent economic risks. Sadly, that means many are likely to die. I place those deaths on those in charge who failed in regards to testing, leadership, and contact racing.

We are now forced to risk an even worse economic possibility, that we have a massive second wave and have to shut things down entirely again, or risk 1-2M lives. If that happens, the economic fallout will be even greater than staying closed for 2-months. We are essentially praying that summer has a significant impact.

[tower912]

I think the scientists are close to nailing down a treatment regimen.   Need all the survivors to donate plasma.   The states are opening.   If it goes well they will open further.   If it goes sideways, we are going to need a better plan.   I hope it goes well.

[Jockey]

I'm optimistic we have some type of vaccine by January. That is because it has become a political competition, so no matter what I think something is forced out. Now, I'm very hesitant on what that means and what its effectiveness is, and I have some concerns about the safety of whatever vaccine is pushed forward. I've discussed that to some extent in the vaccine thread.

If a vaccine is out in January, will you get vaccinated? In such a case there will have been no trials on long-term effects. As someone who has shown themselves to be very knowledgeable on the Covid board, what would your feelings be?

[GooooMarquette]

I think the scientists are close to nailing down a treatment regimen.   Need all the survivors to donate plasma.   The states are opening.   If it goes well they will open further.   If it goes sideways, we are going to need a better plan.   I hope it goes well.

I like your optimism... and I hope enough survivors donate plasma (repeatedly) to make it a viable large-scale treatment.

If we can get enough convalescent plasma and the idiots in places like Ocean City don’t bring a huge second wave, we may have a puncher’s chance of getting through without a second shutdown.

[forgetful]

If we do mass testing, the mortality rate will drop a lot. Guessing to .03-.05. The rate of hospitalization will also skew much more towards those over 65.

Right now the statistics are very skewed due to the little amount of testing.

Your numbers make no sense, and have no logical basis. At the time of this post, we have already had 0.03% of the US population die from COVID. So if everyone in the entire US gets this, and not a single other person dies, we would still be at the lower end of your 0.03%.

If we use NY as an example, which has been hardest hit. 0.15% of the entire population of NY has already died from COVID. So that should be the lower bound of any mortality estimate, and even that assumes no one else in NY will die, and everyone will eventually be infected, which is entirely unrealistic.

Using antibody testing in NY as a baseline, says 15% of NY has been infected. If you scale that up to the entire population, and assume death rates remain constant, that is a 1% mortality. Assuming that the antibody tests do not have too many false positives that should be the upper bound.

All this assumes we are not undercounting deaths currently, which most experts think we are.

If we get better treatments onboard, I can see the floor being around 0.4-0.5%. But 0.03-0.05 is simply an impossibility and ignores reality. Like Tower, I am also optimistic we get a good treatment regimen in, but even in that scenario I think the floor is around 0.4%. The virus is too aggressive and will still ravage vulnerable parts of the community, what the treatments will do is limit the loss of life for those under 65.

[Warriors4ever]

I see lots of people here and elsewhere saying how high -risk people should quarantine. But what about high-risk people, whether by age or health, who need to work? Not all high risk people are retired, and even some retirees need to supplement their social security. How do they support themselves, if we are telling them to quarantine so others can go back to work. Or low-risk people who live with high-risk people? 

[forgetful]

I see lots of people here and elsewhere saying how high -risk people should quarantine. But what about high-risk people, whether by age or health, who need to work? Not all high risk people are retired, and even some retirees need to supplement their social security. How do they support themselves, if we are telling them to quarantine so others can go back to work. Or low-risk people who live with high-risk people?

I've thought about posting on this. In poorer communities, these high risk people often work. They have to. They also can't afford to have food delivered, etc, and often either have to live with family members that also can't afford to stay home, or they live alone and are heavily reliant on things like mass transportation to even sustain life.

They are vulnerable with no options.

Your average person on here has little understanding of what life is like in these communities, those people are forgotten, and in some regards discarded.

[Pakuni]

Or low-risk people who live with high-risk people?

Yep. According to this, 64 million Americans live in a multi-generational household.  If one of those household members is over 65, obese, suffers from diabetes, etc., do we expect everyone else in the home to quarantine? Kids living with grandma to homeschool? Seems like an unreasonable expectation.
And what about people at risk who need caretakers or therapy in or out of the home?
 

[Lennys Tap]

Yep. According to this, 64 million Americans live in a multi-generational household.  If one of those household members is over 65, obese, suffers from diabetes, etc., do we expect everyone else in the home to quarantine? Kids living with grandma to homeschool? Seems like an unreasonable expectation.
And what about people at risk who need caretakers or therapy in or out of the home?

Pakuni 

Say 40 million fit that bill - it’s still better than quarantining 300 million. As for people at risk who need caregivers, It’s awful but they are at risk no matter what you do.

[GooooMarquette]

I see lots of people here and elsewhere saying how high -risk people should quarantine. But what about high-risk people, whether by age or health, who need to work? Not all high risk people are retired, and even some retirees need to supplement their social security. How do they support themselves, if we are telling them to quarantine so others can go back to work. Or low-risk people who live with high-risk people?

Good point. And given recent evidence that obesity seems to be the most significant risk factor other than age, the number of “high-risk” people is likely much greater than people realize.