Originally Posted by Did you just call me Coltrane? (Post 527585)

Thought experiment (and I'm not making an argument, just trying to think this through logically - feel free to fire away...in fact, I think that's the whole point: for someone to tell me I'm not thinking about this correctly*):

We are all more likely than not to become infected, right?

And the goal of social distancing is flattening the curve, right?

And the goal of flattening the curve is easing the stress on health care facilities, i.e., slowing down the infection rate to keep it within the U.S. health care system's capacity, right?

And the goal of keeping things within the U.S. health care system's capacity is to limit/prevent deaths from COVID-19, right? In other words, if the health care system's capacity is exceeded, certain people who have COVID-19 will not get medical attention and will die, and certain of these people's deaths could have been prevented had they been able to obtain medical care. Right?

Are we prioritizing preventable deaths from COVID-19 over other easily preventable deaths? We could easily ban tobacco/smoking - that would prevent (exponentially) more deaths than what we are doing for COVID-19. And it wouldn't be nearly as costly. So, are we saying that people who may die from COVID-19 are more important than people who may die from smoking?


*and I'm not necessarily thinking this way - it's just one thought that has crossed my mind.

Originally Posted by sebastian_dangerfield (Post 527589)

We're trying to prevent both Covid deaths and deaths of others who need medical care and won't be able to get it because ERs are flooded with Covid patients.

Heart attacks, strokes, seizures, and aneurysms are going to continue regardless of whether Covid is hogging most of the ICU beds.

Originally Posted by Greedy,Greedy,Greedy (Post 527586)

Total tobacco related US mortality is about 500,000 per year, all in (cancer, heart disease, etc.). But much of that results from past use - if you banned tobacco today the number would decline to zero only over 40-50 years. You'd basically get 10 years of life expectancy for the portion of the population that smokes back.

Max. deaths from this round with the TrumpVirus approaches about 3 million.

Assuming high numbers on both, even if you fully eliminate all tobacco consumption, it would likely take more than a decade to save as many lives as we can with good management of this problem.

It's a big fuckin problem.

Originally Posted by Tyrone Slothrop (Post 527590)

We have a health-care system that is designed to operate at near-full capacity in the ordinary course, so that we don't pay for facilities that we are not using. We can't handle a big surge in cases. Heart attacks and strokes and seizures and the like are going to continue, but there are only so many ICU beds and they are going to be full.

Originally Posted by sebastian_dangerfield (Post 527592)

We're talking here about doubling or tripling the number of ICU cases.

In Italy, they are simply picking who is likely to survive and who isn't. Docs are deciding who lives and who dies. And dies badly - suffocating effectively.

We will have situations where younger people with injuries unrelated to covid will be prioritized over older covid patients. That will be terrifically ugly for a country where everyone thinks it makes sense to spend ungodly sums to keep the very old alive for a few more months at the end, in usually rotten circumstances.

If you know a doc, nurse, or other provider, when this is all done, buy him or her a drink. They're going to go thru some miserable shit. And a number of them are going to die.

Originally Posted by sebastian_dangerfield (Post 527593)

This is logically unassailable, both from a containment and paring of economic damage perspective: https://www.forbes.com/sites/antoine.../#2351fbc65571

The only assholes I've heard against this are rentiers. They fear their payment streams will be permanently altered. No, you dumb fucks, just paused. And your obligations will be paused too! No harm to anyone.

And the rentiers aren't going to be getting paid anyway. Whether by edict today, at great saving of lives, or by natural economic forces later, with consequential huge cost of lives, The Economy Will Shut Down. Pick which way: Forbearance, or carnage?

Originally Posted by sebastian_dangerfield (Post 527591)

If you bend Coltrane's point a bit, however, you highlight a trade-off at the heart of this thing:

We are sacrificing a lot of the young, in many ways, to save the old.

It's true. Younger docs will be in harm's way (bombarded over and over again with the virus, which repetition can cause death in healthy young adults), younger people will lose tons of jobs, younger people will suffer losses of homes and businesses.

There's a daisy chain of horrible things that will be suffered by the young to ensure the old don't perish. Most significantly, immunity, for at least a time, to this virus. For most younger people, its not a big deal. Get it, get over it, and you're protected from it for some period of time. Instead, they're hunkering down and avoiding something that's not much of a risk to them.

So while Coltrane's point about valuing Covid deaths over tobacco deaths might be comparing apples and oranges, the argument that we are prioritizing the lives of the old over the younger cannot be avoided.

If one were an economist, he would say this is valuing the less productive over the more productive. If one looked at it as a business person, he'd said it was protecting cost centers over profit centers.

How much more are we going to demand in sacrifice for the boomers? I understand the humane need to do it. But this is brutally unfair to millennials, who are going to eat the brunt of this if it becomes a U shaped rather than V shaped crisis.

Originally Posted by Tyrone Slothrop (Post 527595)

Closing the borders makes no f*cking difference now, and it's pathetic that people like him feel they have to say sh*t like that to get credibility with racist *ssholes in the White House to be taken seriously on the other stuff.

Originally Posted by Tyrone Slothrop (Post 527596)

Why have hospitals at all? Wouldn't it be more efficient to just let sick people die?They aren't as productive as everyone else.

Originally Posted by Adder (Post 527588)

We don't ban tobacco because we know it doesn't work - my wife worked on tobacco policy for 10 years - prohibition will just lead to an active black market. We know other policies, like higher tobacco taxes, do work and help save lives. These days, they're working on raising the smoking age to 21, on the theory that it will make it harder for teenagers to get them and delaying when kids try them prevents people from becoming new smokers.

The wife has left tobacco policy but was/is skeptical that the science was there do back up this theory, but it's what her old org is doing.

But there are lots of things around cars and guns we could do that wouldn't cost that much (ban SUVs, lower speed limits, repurpose street space to other modes to narrow lanes, background checks, etc) and prevent lots of deaths. In many cases, the political will isn't there.

And then there are the side effects of not preventing a lot of deaths in a crisis, like economic panic and uncertainty.

But let's not forget that what's going on now is out of desperation, after having spent month not doing anything. We should have the capacity for widespread testing, and might have with a competent administration. We should have been doing temperature checks on arriving passengers for months. Our leadership completely dropped the ball.

Speaking of which, some friend were in Spain when Trump announced the European travel ban. 48 hours of chaos but they came home early from their trip. No one asked them where in Spain they had been or did anything to check their health. Until the Uber driving taking them home.

They're on day four, I think, of voluntary self-quarantine.

Originally Posted by Did you just call me Coltrane? (Post 527577)

They will have to catch me. That is one rule I will break if it comes to it.

Originally Posted by sebastian_dangerfield (Post 527598)

Not sick. Old.

We could cover all the compromised younger people who get covid and not stress the ERs. But that generation born between 46 and 55 are the ones who'd bust capacity.

The sick are often productive. Sick and productive aren't mutually exclusive. Old and retired (and bailed out twice already, in 2000 and 2008) is a different story.

I'm not arguing against doing it. I'm not an ogre. But this is all to ensure the safety of the boomers. And they'd better be fucking thankful.

Originally Posted by Tyrone Slothrop (Post 527596)

Why have hospitals at all? Wouldn't it be more efficient to just let sick people die?They aren't as productive as everyone else.

Originally Posted by sebastian_dangerfield (Post 527597)

The rest of what he's saying makes total sense. In fact, it's urgently needed. I'll take the small amount of useless or patronizing shit if it'll get the rest of the message, which is actually a fucking alarm that needs to be sounded, through to leadership.

https://www.cnbc.com/2020/03/18/bill...-down-now.html