The economic value of lives saved - Printable Version
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RE: The economic value of lives saved - 2006alum - 05-27-2020
(05-27-2020, 04:32 PM)Genuine Realist Wrote: I think I have recounted how my wife and I were in New York between February 21st and 24th. We attended five crowded Broadway productions in four days. Every morning, I'd get up for breakfast and mosey down to a really nice place called Virgil's (highly recommended) and have a yogurt/fruitbowl for breakfast. I'm a much lighter sleeper than my wife and would kill time, for the hour or so until she woke and joined me, nursing a diet coke and watching the news. Very, VERY pleasant mornings, that I regret have passed. And . . .
. . . there was literally NOTHING about the virus, except for growing concern about the Italian experience. It was maybe the fifth lead down. No one in the City was at all worried. This wasn't a case where there were iceberg warnings on all sides, and the Titanic sailing blithely along. These weren't even serious news items. There weren't a batch of other countries battening down the hatches, shouted warnings all around, and certain nations (the US among them) ignoring all of the signs. There weren't any warnings.
I am impressed you had time to poll 8.4 million people. Just because the ones you saw weren't worried, that doesn't mean no one was. I, for one, was scheduled to fly back to NYC from SF on Feb. 25 and cancelled the trip in large part out of concern about SARS-COV-2. By that point I already had several friends who were avoiding the subway and crowds and wearing what we then called "SARS masks" in public. Indeed, Walgreens had sold out of surgical masks by late January - I remember, because they posted notices in every store window and I made an Amazon order of masks that same day - January 26. Clearly plenty of people were worried.
Unfortunately, de Blasio and Cuomo weren't two of them, and both messaged just the opposite, well into mid-March. Meanwhile, on Feb. 26, London Breed declared a state of emergency in SF. There were lots of reasons NYC was going to be much worse hit than SF regardless of leadership, but I am very confident as a former resident of NYC and a current resident of SF that the leadership choices made a big difference, too.
RE: The economic value of lives saved - Genuine Realist - 05-27-2020
(05-27-2020, 08:24 PM)2006alum Wrote:Pretty jejune. I mean as you walked around the City, there was no reaction, no alteration in lifestyle, no discussion . . . nothing. You get the feel for a public ambiance. This was a public that was less troubled(05-27-2020, 04:32 PM)Genuine Realist Wrote: I think I have recounted how my wife and I were in New York between February 21st and 24th. We attended five crowded Broadway productions in four days. Every morning, I'd get up for breakfast and mosey down to a really nice place called Virgil's (highly recommended) and have a yogurt/fruitbowl for breakfast. I'm a much lighter sleeper than my wife and would kill time, for the hour or so until she woke and joined me, nursing a diet coke and watching the news. Very, VERY pleasant mornings, that I regret have passed. And . . .
. . . there was literally NOTHING about the virus, except for growing concern about the Italian experience. It was maybe the fifth lead down. No one in the City was at all worried. This wasn't a case where there were iceberg warnings on all sides, and the Titanic sailing blithely along. These weren't even serious news items. There weren't a batch of other countries battening down the hatches, shouted warnings all around, and certain nations (the US among them) ignoring all of the signs. There weren't any warnings.
I am impressed you had time to poll 8.4 million people. Just because the ones you saw weren't worried, that doesn't mean no one was. I, for one, was scheduled to fly back to NYC from SF on Feb. 25 and cancelled the trip in large part out of concern about SARS-COV-2. By that point I already had several friends who were avoiding the subway and crowds and wearing what we then called "SARS masks" in public. Indeed, Walgreens had sold out of surgical masks by late January - I remember, because they posted notices in every store window and I made an Amazon order of masks that same day - January 26. Clearly plenty of people were worried.
Unfortunately, de Blasio and Cuomo weren't two of them, and both messaged just the opposite, well into mid-March. Meanwhile, on Feb. 26, London Breed declared a state of emergency in SF. There were lots of reasons NYC was going to be much worse hit than SF regardless of leadership, but I am very confident as a former resident of NYC and a current resident of SF that the leadership choices made a big difference, too.
Walgreen's sold out of surgical masks? Yawn. All you need is a few dozen survivalists - people who react to anything - to accomplish that?
The declaration of emergency? Another yawn. It's a predicate for action, not action itself - and there wasn't any, not for a couple of weeks, when everyone else acted.. On February 24th, Nancy Pelosi famously urged everyone to go out and celebrate Chinese New Year, 'because 'it is perfectly safe' to be here. Here's one link - https://yournews.com/2020/03/30/1536317/in-late-february-nancy-pelosi-encouraged-large-groups-to-congregate/. There are others.
I'm getting the same reaction I got when I posted 'Timelines'. Some of you are so wed to the idea that the US was delinquent that the notion that its reactions were roughly identical to the rest of the West are infuriating. Why that should be, I don't know.
RE: The economic value of lives saved - Goose - 05-27-2020
(05-27-2020, 07:30 PM)BostonCard Wrote: The key in Germany is they tested early and they tested a lot.Yes they did, mostly because they had the professionals ready to act from day 1. It is also true that Charité – Universitätsmedizin Berlin had at least a 7 day lead on the CDC in generating their test. More importantly, there were people who knew how to administer that type of test ready to go. As it turned out, there were not quite enough of them to actually contain the disease, but for sure it helped.
Quote:The countries that struggled (Spain, Italy, the US) struggled because they were flying blind until lots of people started showing up in the hospital. Italy was caught unawares as one of the first countries outside of China to be hit hard. In the US, having a poorly developed and fractured public health response certainly didn't help, but the testing screw up compounded all the problems.In the US, the testing screw-up was at least partially foreseeable. The CDC was using the same model they did for H1N1, distributing the tests to state health department labs, qualifying those labs, and then letting them do the rest of the testing. The CDC's own documents showed that this was a slow process and that the actual number of tests the state labs could do was quite limited. Other CDC documents discuss this problem, and some possible avenues to explore, but nothing was changed. Best case, our testing would have been slow to come on line and have very inadequate capacity for COVID-19. The double whammy was that the CDC's production ability was not designed with adequate Q/A procedures. They didn't validate everything, and as a result their kits initially didn't work. This second problem arguably should have also been foreseen, but it was not. At least in that case it wasn't already documented as a problem in any CDC documents I am aware of.
Quote:Spaniards and Italians are not exactly known for compliance and following government orders. Their response was much too late, but when instituted was effective. Italy had 584 cases and 117 deaths in the last 24 hours, Spain had 510 cases and 1(!) death. And while the high death rate might have made them more willing to listen to their governments, UK has had similar death rates (plus news of their PM in the ICU) and is still struggling to get the epidemic under control (2013 new cases/412 new deaths).Yes, and why is that? My Italian friends are still bitching about people who didn't comply, but despite it all, they finally got the numbers down. Why can't we? How are people getting the disease? What can we change to fix the problem? Santa Clara County got hit with a pile of cases from a fish processing plant. Did they trace the source? I also heard nothing about anybody being quarantined. Looks like they just sent both the positives and the (at the present time) negatives home. I assure you their are fish processing plants in Italy, so that isn't the story.
RE: The economic value of lives saved - Genuine Realist - 05-27-2020
(05-27-2020, 07:30 PM)BostonCard Wrote: The key in Germany is they tested early and they tested a lot. The countries that struggled (Spain, Italy, the US) struggled because they were flying blind until lots of people started showing up in the hospital. Italy was caught unawares as one of the first countries outside of China to be hit hard. In the US, having a poorly developed and fractured public health response certainly didn't help, but the testing screw up compounded all the problems.I think you may have forgotten that Germany was one of the countries I examined on the Timeline post, since it was often held up as the better role model. In any case, here's the Wikipedia link to the German experience, somewhat updated.https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Germany
Spaniards and Italians are not exactly known for compliance and following government orders. Their response was much too late, but when instituted was effective. Italy had 584 cases and 117 deaths in the last 24 hours, Spain had 510 cases and 1(!) death. And while the high death rate might have made them more willing to listen to their governments, UK has had similar death rates (plus news of their PM in the ICU) and is still struggling to get the epidemic under control (2013 new cases/412 new deaths). I have a soft spot for Boris Johnson, but he has not dealt with the pandemic well; dithering at first whether to do a Swedish style response, then instituting the lockdown late, and then lifting it with the poorly defined slogan "stay alert!".
BC
In fine, the German experience through the time I wrote was almost identical with the US. Relative insouciance during January, rising case load during February, drastic government reaction in mid-March - almost identical with the US. The German health minister, Jens Spahn, expressed more concern about stigmatisation and xenophobia well into February. As late as February 13th,he opposed closing travel to China for that reason. (I believe he has resigned, as have the health ministers of France, Italy, Iran, Roumania,and others - I am not exactlu sure of this.) That's two weeks after Trump closed off travel to China and Europe, and was roundly condemned for it.
The supposedly well-prepared Germans also found themselves strikingly short of masks, hand sanitizers, and other medical equipment. To be sure, the German experience since the controls were implemented in mid-March have been better than other countries. But that's not because they were first, or better prepared, or any such thing. It almost certainly has to do with the culture and related demographics.
As to well-prepared health departments, to the best of my knowledge, the health secretaries of France, Germany, Italy, Iran, Brazil, Roumania, and God knows how many others have all resigned. (This may be mildly inaccurate). Everywhere, health departments were caught like peaceti armies, caught flatfooted in the face of a challenge that dwarfed anthing theyhad been prepared for.
I have been here before. You can espouse all the reverse exceptionalism you want. But when you search the worlc, you're not going to find any nation that got the jump on this, other than a few island and peninsular nations with regimented societies, probably reacting to SARS type virus and serendipitously meeting the challenge of Covid. This is not a world in which there were iceberg warnings everywhere, and nations (including the US) sailed blithely ahead. It was a world with no warnings at all until late February'early March, at which time every nation in the Western world did pretty much the same thing at the same time.
RE: The economic value of lives saved - 2006alum - 05-27-2020
(05-27-2020, 08:49 PM)Genuine Realist Wrote: Pretty jejune. I mean as you walked around the City, there was no reaction, no alteration in lifestyle, no discussion . . . nothing. You get the feel for a public ambiance. This was a public that was less troubled
Walgreen's sold out of surgical masks? Yawn. All you need is a few dozen survivalists - people who react to anything - to accomplish that?
The declaration of emergency? Another yawn. It's a predicate for action, not action itself - and there wasn't any, not for a couple of weeks, when everyone else acted.. On February 24th, Nancy Pelosi famously urged everyone to go out and celebrate Chinese New Year, 'because 'it is perfectly safe' to be here. Here's one link - https://yournews.com/2020/03/30/1536317/in-late-february-nancy-pelosi-encouraged-large-groups-to-congregate/. There are others.
I'm getting the same reaction I got when I posted 'Timelines'. Some of you are so wed to the idea that the US was delinquent that the notion that its reactions were roughly identical to the rest of the West are infuriating. Why that should be, I don't know.
Honestly, GR, I just don't think you know what you're talking about - you truly can't speak for everyone's experience. I went to a birthday brunch the last weekend in February in SF and COVID-19 was all anyone was talking about - no one hugged or touched and we all sat a few feet apart at an outdoor restaurant. That was my last social outing to date.
Early the next week, around March 3, SF was blanketed with door hangers that had information about COVID-19 in about six languages. Symptoms, what to do, how to avoid it, etc. I assume printing and distributing hundreds of thousands of door hangers in a week's time was only possible due to the emergency declaration. Once those went up, everyone started paying much more attention.
I don't know if you realize this, but Nancy Pelosi doesn't set policy in SF, and she is much more closely followed in DC than in SF. I greeted her Chinatown performative for what it was - a political response to a political response. I did not perceive it to be at all representative to how most people I knew in SF were thinking about COVID-19.
And when you look at countries in "the West" like Germany, Norway, Finland, New Zealand, and Australia, you realize that leadership makes a brobdingnagian difference. It is not a coincidence that the US and UK had leadership that resisted taking the virus seriously at all costs and are now numbers 1 and 2 for most deaths. Despite very different national infrastructures and healthcare systems, both bungled their responses in epic fashion and have tens of thousands of deaths to show for it.
RE: The economic value of lives saved - chrisk - 05-27-2020
Taiwan, our good friend which we are trying to get back into the WHO, took decisive action in January and early February. As a result, it was able to REOPEN schools on February 25, when Trump had not even unleashed his full denial mode.
The American Institute in Taiwan (our “embassy”) must have been providing real-time updates. Trump called Tsai Ing-Wen after he was elected
in 2020, he claims he was completely bamboozled by China. A phone call with Tsai early this year would have set him straight if that were really the case. However, Trump could not admit he had a problem.
His shutdowns of foreign travel look tame compared to Taiwan. All people entering the country, even returning residents, are isolated for 14 days, and they check on them continually.
The only person who has died from COVID-19 in Taiwan in the last month contracted it while visiting family in the US. That brought the grand total to 7, which is comparable to about 100 in the US, not the 100,000 milestone we passed today.
RE: The economic value of lives saved - BostonCard - 05-27-2020
The difference is that Germany’s rising case load was being detected in the community. As Goose mentioned, Charité developed the German test before our CDC developed the one in the US. Moreover, they were able to implement it widespread enough that they could test anyone with a flu-like illness, and thus were able to find the first case of community spread in Berlin early.
In contrast, the US had very few tests and was restricting testing only to people who had traveled from China. This missed a early community transmission, and it was only after a hospital in the Bay Area begged the CDC to test a critically ill patient with COVID-19 (and were denied several times before the CDC relented) that we finally saw that there had been community transmission. The other example happened when a cluster of deaths from an influenza like illness was identified in a nursing home in Washington.
So, while early case counts were similar, it’s because in Germany they actually were testing enough that they had a good handle of where the disease was spreading and how fast. In the US, the dearth of testing meant we were flying blind, and we took the absence of diagnosed Covid-19 cases as evidence that everything was hunky dory. In fact, Covid-19 was undoubtably spreading and it was only by mid-March, when those patients were showing up in hospitals that we recognized the gravity of the crisis. Had tests been available and been implemented, we would have seen many more cases in the US in late February, and might have implemented in early March measures we waited until mid to late March to put into place. That couple week delay led directly to thousands of lives being lost and trillions of dollars in economic damage.
BC
Spahn is still the health minister.
The health ministers of Italy and Iran have been in office since before the COvId-19 crisis.
The health minister of France (Agnes Buzyn) resigned in Mid-February to run to be mayor of Paris. (https://www.france24.com/en/20200216-french-health-minister-to-run-for-paris-mayor-after-sex-scandal-sinks-previous-candidate).
I didn’t look up the health minister of Rumania; you can do your own fact checking.
BC
RE: The economic value of lives saved - Genuine Realist - 05-28-2020
(05-27-2020, 09:15 PM)2006alum Wrote:BC, I know exactly what I'm talking about. You persist in discussing preventive measures that might have helped . . . in January. Check the time lines on any country you mention. You're going to see concern, but only moderate during January, rising awareness in February, on occasion some ad hoc cancellations, then a wholesale, society wide reaction in early March, culminating in the lockdown. Nancy Pelosi indeed does not make policy, but her insouciance as late as February 24th is typical.(05-27-2020, 08:49 PM)Genuine Realist Wrote: Pretty jejune. I mean as you walked around the City, there was no reaction, no alteration in lifestyle, no discussion . . . nothing. You get the feel for a public ambiance. This was a public that was less troubled
Walgreen's sold out of surgical masks? Yawn. All you need is a few dozen survivalists - people who react to anything - to accomplish that?
The declaration of emergency? Another yawn. It's a predicate for action, not action itself - and there wasn't any, not for a couple of weeks, when everyone else acted.. On February 24th, Nancy Pelosi famously urged everyone to go out and celebrate Chinese New Year, 'because 'it is perfectly safe' to be here. Here's one link - https://yournews.com/2020/03/30/1536317/in-late-february-nancy-pelosi-encouraged-large-groups-to-congregate/. There are others.
I'm getting the same reaction I got when I posted 'Timelines'. Some of you are so wed to the idea that the US was delinquent that the notion that its reactions were roughly identical to the rest of the West are infuriating. Why that should be, I don't know.
Honestly, GR, I just don't think you know what you're talking about - you truly can't speak for everyone's experience. I went to a birthday brunch the last weekend in February in SF and COVID-19 was all anyone was talking about - no one hugged or touched and we all sat a few feet apart at an outdoor restaurant. That was my last social outing to date.
Early the next week, around March 3, SF was blanketed with door hangers that had information about COVID-19 in about six languages. Symptoms, what to do, how to avoid it, etc. I assume printing and distributing hundreds of thousands of door hangers in a week's time was only possible due to the emergency declaration. Once those went up, everyone started paying much more attention.
I don't know if you realize this, but Nancy Pelosi doesn't set policy in SF, and she is much more closely followed in DC than in SF. I greeted her Chinatown performative for what it was - a political response to a political response. I did not perceive it to be at all representative to how most people I knew in SF were thinking about COVID-19.
And when you look at countries in "the West" like Germany, Norway, Finland, New Zealand, and Australia, you realize that leadership makes a of immense proportions difference. It is not a coincidence that the US and UK had leadership that resisted taking the virus seriously at all costs and are now numbers 1 and 2 for most deaths. Despite very different national infrastructures and healthcare systems, both bungled their responses in epic fashion and have tens of thousands of deaths to show for it.
Germany? Germany started taking the virus seriously at almost EXACTLY the same time as the US, and it had its own equipment shortages and problems with preparedness. As I mentioned, its health minister was making public statements debunking the danger of the virus well into mid-February. I"m not going to check the others - I've done enough. But New Zealand as an example is particularly irksome.
New Zealand is an island nation of 4.3 million. (Santa Clara County alone has 1.9 million). It did not have its first reported case until February 28th, long after the Italian catastrophe had alerted the whole world how dangerous the virus actually was. Testing and tracking was simple. Its practices have next to no relevance to a pluralistic nation of 330 million, with extensive domestic and international travelers, and a viral invasion that probably began in mid-January. There is nothing to be learned there.
You are going to strain to find any Western nation that deviated from the pattern I have described. You're not going to see serious steps at intervention anywhere in the West before the second week in March. (The effectiveness of policy since then varies quite a bit, depending on culture and politics. It is interesting that continental Europe apparently has done quite well, while the UK, USA, and Canada (!) have not fared well.)
The thought that the response was 'botched' because it did not occur earlier fails in my opinion to the observed universal experience. Because this mythical nation that jumped on the virus early on and got a head of the curve does not appear to exist.
RE: The economic value of lives saved - burger - 05-28-2020
GR, just because some other western countries are run by idiots does not make Donald Trump not an idiot, nor does it make his response adequate.
Your excuse making for him is so tiresome.
RE: The economic value of lives saved - Genuine Realist - 05-28-2020
(05-28-2020, 09:06 AM)burger Wrote: GR, just because some other western countries are run by idiots does not make Donald Trump not an idiot, nor does it make his response adequate.The problem is that every other country in the West seems to have been run by idiots.
Your excuse making for him is so tiresome.
Which, to translate, means that none of them were. It's too early to write history - though any number of people want to - but my bet is that when it is, the gating factor will turn out to be the cumulation of a reliable clinical data that hit critical mass about the end of February. This seems to be almost the universal pattern.
By the way, a tendency to call other people 'idiots' is as good an off-hand definition of 'elitism' as you're likely to find.
RE: The economic value of lives saved - Goose - 05-28-2020
(05-27-2020, 11:29 PM)BostonCard Wrote: The difference is that Germany’s rising case load was being detected in the community. As Goose mentioned, Charité developed the German test before our CDC developed the one in the US. Moreover, they were able to implement it widespread enough that they could test anyone with a flu-like illness, and thus were able to find the first case of community spread in Berlin early.
The week head start that the Germans had with an available test was important. It was also due mostly to luck, because there was ongoing SARS research that the PIs immediately applied to COVED-19. The second point I keep trying to make (without much traction, I fear) is that it was critically important the German public health services were there to aggressively pursue containment and surveillance. The first cases of the virus were detected in Bavaria on January 27. That outbreak was contained. Unfortunately, Germany was ultimately unable to contain all the outbreaks and eventually ended up with community spread. However, they knew that because they were out there looking for cases and tracing known outbreaks.
In the US, we had a slightly longer development cycle, and more importantly botched the manufacturing of the tests. However, we had a totally inadequate active network of public health care people out there ready to aggressively search out and contain the disease. Our model was wait until people get sick and go to the hospital. Then we test them, say "yep, you have it", and then do nothing. When we finally got enough cases, we started doing something, but that was SIP. We had no shot at containment at all. We also had little real on the ground intelligence regarding where the disease was and how widespread it was (or was not).
Germany actually wasn't much ahead of the USA in their lockdown. On 13 March, schools were closed and nursing home visits banned. On March 15 the borders with the 5 neighboring countries were closed, and on March 22 the nation-wide lockdown went into effect. California was already in lockdown. The difference was that Germany had a much better idea on the extent of the disease spread, while we here in the USA were guessing. New York started their lockdown on March 22.
(05-28-2020, 12:00 AM)Genuine Realist Wrote: The thought that the response was 'botched' because it did not occur earlier fails in my opinion to the observed universal experience. Because this mythical nation that jumped on the virus early on and got a head of the curve does not appear to exist.To be clear, I assume you mean "Western Nation", because Taiwan, HK, and Korea did manage to contain the outbreak. I omit Singapore because they got overrun too. It is just that the population that got overrun was guest workers and they just locked them all up. Actually, I agree with you in large part. All the western nations were flying blind. They didn't really know what was happening in terms of disease spread or the degree to which it had penetrated the population. Germany kind of did. They thought for a while they could contain it. However, in the end it got away from them and they had to lockdown as well. We will see how they do keeping Rt below 1. The health services are out there actively trying to do that.
RE: The economic value of lives saved - Genuine Realist - 05-28-2020
(05-28-2020, 10:03 AM)Goose Wrote:I think the trope of 'peacetime army', which is implied in your post, is dead on the money, though the state of readiness varies. The point is that no one in the West reacted on a war footing until early March. There were no warnings that went unheeded. Some nations did better than others, but even Germany had to deal with equipment shortages and various other administrative issues. As I reviewed the matter cursorily, containment seemed random, based on whether the nation was fortunate enough to identify a patient zero or small cluster. Even that failed to halt community spread.(05-27-2020, 11:29 PM)BostonCard Wrote: The difference is that Germany’s rising case load was being detected in the community. As Goose mentioned, Charité developed the German test before our CDC developed the one in the US. Moreover, they were able to implement it widespread enough that they could test anyone with a flu-like illness, and thus were able to find the first case of community spread in Berlin early.
The week head start that the Germans had with an available test was important. It was also due mostly to luck, because there was ongoing SARS research that the PIs immediately applied to COVED-19. The second point I keep trying to make (without much traction, I fear) is that it was critically important the German public health services were there to aggressively pursue containment and surveillance. The first cases of the virus were detected in Bavaria on January 27. That outbreak was contained. Unfortunately, Germany was ultimately unable to contain all the outbreaks and eventually ended up with community spread. However, they knew that because they were out there looking for cases and tracing known outbreaks.
In the US, we had a slightly longer development cycle, and more importantly botched the manufacturing of the tests. However, we had a totally inadequate active network of public health care people out there ready to aggressively search out and contain the disease. Our model was wait until people get sick and go to the hospital. Then we test them, say "yep, you have it", and then do nothing. When we finally got enough cases, we started doing something, but that was SIP. We had no shot at containment at all. We also had little real on the ground intelligence regarding where the disease was and how widespread it was (or was not).
Germany actually wasn't much ahead of the USA in their lockdown. On 13 March, schools were closed and nursing home visits banned. On March 15 the borders with the 5 neighboring countries were closed, and on March 22 the nation-wide lockdown went into effect. California was already in lockdown. The difference was that Germany had a much better idea on the extent of the disease spread, while we here in the USA were guessing. New York started their lockdown on March 22.
(05-28-2020, 12:00 AM)Genuine Realist Wrote: The thought that the response was 'botched' because it did not occur earlier fails in my opinion to the observed universal experience. Because this mythical nation that jumped on the virus early on and got a head of the curve does not appear to exist.To be clear, I assume you mean "Western Nation", because Taiwan, HK, and Korea did manage to contain the outbreak. I omit Singapore because they got overrun too. It is just that the population that got overrun was guest workers and they just locked them all up. Actually, I agree with you in large part. All the western nations were flying blind. They didn't really know what was happening in terms of disease spread or the degree to which it had penetrated the population. Germany kind of did. They thought for a while they could contain it. However, in the end it got away from them and they had to lockdown as well. We will see how they do keeping Rt below 1. The health services are out there actively trying to do that.
I read an article yesterday that questioned whether the Washington state cluster in the retirement home, usually assumed to be the first in the United States, actually was so. (I will try to find the link). There is evidently strong reason to believe that the virus was already resident in the population and spreading, by mid-January. If so, the US never had a realistic chance at containment. This seems to me intuitively plausible, given the number of people that traveled to and from Wuhan and the US in December and January.
You are quite right that I deliberately except the Asian nations as anomalous in terms of the West. The societies are more regimented, more authoritarian, homogenous, more accepting of the use of social media data, more insular (literally, in a couple of cases), and - IIRC - in the case of South Korea (Taiwan?), so badly burned by a SARS disaster a few years ago that they were on high alert. Their experience doesn't signify too much to the West.
The point of the exercise is not to make points for You Know Who. It's a rejoinder to the cultural war that the MSM has already begun, in which Blue-SIP- (of course, anti-Trump) is GOOD, and Red-Reopen-(potentially pro Trump) is BAD. This always comes with the corollary that US institutions have failed, are failing, that someone is to blame. But in fact both sets of values - Blue and Red - are pretty important, and I don't think failure modes get you anywhere. (The NYT, the Washington Post, and CNN all seem to have forgotten that they decried even the limited measures put into effect, as did most of the Democratic leadership. No one got this right, because no one had any warning.)
I do believe Covid-19 is an epic natural disaster, one that is going to be with us for half a generation or more, and transform society in ways we can't even imagine. So starting from the standpoint that the present mess is due to some human error or failing will not do. Politicizing it will not do. It's way, way beyond that.
RE: The economic value of lives saved - BostonCard - 05-28-2020
I think the disconnect between us is that based on your post, it looks like you see a binary state: "containment" or "out of control", and that any country that didn't reach containment failed, and thus the fact that the US didn't reach containment is not a big deal, since no other industrialized country in Western Europe and North America was able to reach containment.
If that is your metric, then I agree with you. The fact that we didn't achieve early containment in the US was almost inevitable. The fairly non-specific presentation of COVID-19, the fact that you can get presymptomatic and asymptomatic transmission, and the relative high reproductive rate means that traditional means of containment are much harder for COVID-19 than a lot of other infections. To be clear, I don't blame Trump for the fact that there is community transmission of COVID-19.
However, within the "out of control" category, action to bring down the transmission rate early makes a big difference in the ultimate mortality rate. As I've mentioned in another post, a delay of one week in implementing shelter in place measures meant an additional 36,000 deaths in the United States. Moreover, actions are not binary either, a choice between lockdown and doing nothing; there is a lot that could have been done short of shelter in place to reduce the spread of COVID-19.
Let's compare the action of two governors (both Democratic).
On March 4, with 53 confirmed cases and one death from COVID-19 in the state, Governor Gavin Newsom declared a state of emergency.
On March 12, with 252 confirmed cases and four deaths, Governor Newsom announced that mass gatherings over 250 people were banned until the end of March and issued an order to permit the state to commandeer hotels and medical facilities to treat coronavirus patients.
On March 15, with 478 confirmed cases and six deaths, Governor Newsom called for voluntary closure of bars and in-home self-isolation of seniors 65 and older, as well as persons at-risk due to underlying conditions.
On March 19, with 1067 confirmed cases and nine deaths, Governor Newsom announced a statewide stay at home order with all residents except those working in essential occupations urged to stay at home. The state has asked the Department of Defense to deploy the USNS Mercy hospital ship in California.
On the other hand
In New York Mario Cuomo issued the state of emergency when the case count was at 89.
Cuomo announced bans on gatherings on the same day as Newsom, but set the threshold at gatherings of 500 people instead of 250 (326 cases in)
It doesn't look like Cuomo issued a call for voluntary closures
On March 19, when Newsom announced the shelter in place order in California, there were 4161 confirmed cases and 39 deaths.
When Cuomo announced the SiP order for New York, there were 7113 cases and 68 deaths. Moreover, the order wouldn't go into effect on March 22, by which time there 15,188 cases and 142 deaths.
Every step of the way, Cuomo was only a couple calendar days behind Newsom, but when you add in the fact that New York was further ahead in the pandemic, the cumulative effect was that New York putting its shelter in place order into effect March 22 was the equivalent of California putting its order into effect April 6. That effective two week delay meant that New York wound up with over 250,000 more cases and 25,000 more deaths than California.
So is Cuomo blameless for his delay, because look, California also would up with an out of control pandemic? Does that mean that Cuomo couldn't have been better, because Newsom wasn't perfect either? Does this mean there was nothing New York could have done better, because look, every state has been affected? Does it not matter all that much, because they responded more or less at the same time?
No, at every step of the way, New York was slower to react than California, despite the fact that the epidemic was more advanced in New York than California (and growing faster), and for the COVID-19 pandemic, days, let alone weeks make a really big difference in how the pandemic plays out.
Of course there are things you can question about California's response. It might have seemed like an overreaction at the time, but even Newsom could have been more aggressive and realized that even though there were "only" 250 cases on March 12, the rate of increase was 4 - 5x fold per week. He could have been more aggressive about limiting large gatherings earlier. But the fact that Newsom could have been more aggressive doesn't excuse the lackadaisical response by New York.
BC
RE: The economic value of lives saved - CardinalSagehen - 05-28-2020
(05-28-2020, 12:10 PM)BostonCard Wrote: I think the disconnect between us is that based on your post, it looks like you see a binary state: "containment" or "out of control", and that any country that didn't reach containment failed, and thus the fact that the US didn't reach containment is not a big deal, since no other industrialized country in Western Europe and North America was able to reach containment.
If that is your metric, then I agree with you. The fact that we didn't achieve early containment in the US was almost inevitable. The fairly non-specific presentation of COVID-19, the fact that you can get presymptomatic and asymptomatic transmission, and the relative high reproductive rate means that traditional means of containment are much harder for COVID-19 than a lot of other infections. To be clear, I don't blame Trump for the fact that there is community transmission of COVID-19.
However, within the "out of control" category, action to bring down the transmission rate early makes a big difference in the ultimate mortality rate. As I've mentioned in another post, a delay of one week in implementing shelter in place measures meant an additional 36,000 deaths in the United States. Moreover, actions are not binary either, a choice between lockdown and doing nothing; there is a lot that could have been done short of shelter in place to reduce the spread of COVID-19.
Let's compare the action of two governors (both Democratic).
On March 4, with 53 confirmed cases and one death from COVID-19 in the state, Governor Gavin Newsom declared a state of emergency.
On March 12, with 252 confirmed cases and four deaths, Governor Newsom announced that mass gatherings over 250 people were banned until the end of March and issued an order to permit the state to commandeer hotels and medical facilities to treat coronavirus patients.
On March 15, with 478 confirmed cases and six deaths, Governor Newsom called for voluntary closure of bars and in-home self-isolation of seniors 65 and older, as well as persons at-risk due to underlying conditions.
On March 19, with 1067 confirmed cases and nine deaths, Governor Newsom announced a statewide stay at home order with all residents except those working in essential occupations urged to stay at home. The state has asked the Department of Defense to deploy the USNS Mercy hospital ship in California.
On the other hand
In New York Mario Cuomo issued the state of emergency when the case count was at 89.
Cuomo announced bans on gatherings on the same day as Newsom, but set the threshold at gatherings of 500 people instead of 250 (326 cases in)
It doesn't look like Cuomo issued a call for voluntary closures
On March 19, when Newsom announced the shelter in place order in California, there were 4161 confirmed cases and 39 deaths.
When Cuomo announced the SiP order for New York, there were 7113 cases and 68 deaths. Moreover, the order wouldn't go into effect on March 22, by which time there 15,188 cases and 142 deaths.
Every step of the way, Cuomo was only a couple calendar days behind Newsom, but when you add in the fact that New York was further ahead in the pandemic, the cumulative effect was that New York putting its shelter in place order into effect March 22 was the equivalent of California putting its order into effect April 6. That effective two week delay meant that New York wound up with over 250,000 more cases and 25,000 more deaths than California.
So is Cuomo blameless for his delay, because look, California also would up with an out of control pandemic? Does that mean that Cuomo couldn't have been better, because Newsom wasn't perfect either? Does this mean there was nothing New York could have done better, because look, every state has been affected? Does it not matter all that much, because they responded more or less at the same time?
No, at every step of the way, New York was slower to react than California, despite the fact that the epidemic was more advanced in New York than California (and growing faster), and for the COVID-19 pandemic, days, let alone weeks make a really big difference in how the pandemic plays out.
Of course there are things you can question about California's response. It might have seemed like an overreaction at the time, but even Newsom could have been more aggressive and realized that even though there were "only" 250 cases on March 12, the rate of increase was 4 - 5x fold per week. He could have been more aggressive about limiting large gatherings earlier. But the fact that Newsom could have been more aggressive doesn't excuse the lackadaisical response by New York.
BC
Agree wholeheartedly.
Going back to the title of this thread, Cuomo has also bragged to the media about how he considers lives to be "priceless" and rejects any analysis based on placing statistical value on them. This is either ignorant or disingenuous and political - if you don't place some sort of value on lives, how can you do your best to make the right trade-offs that save the most lives?
Without trying to get political or even taking a side, I'm really pretty unhappy with all sides of government on this issue. One side wants things to go back to normal at any cost to human life, and the other side wants to save lives from this one particular disease at any cost to the economy. Neither side has focused on enough data collection. Both sides have rejected the necessary level of quantitative analysis in favor of political expediency.
RE: The economic value of lives saved - burger - 05-28-2020
(05-28-2020, 02:09 PM)CardinalSagehen Wrote: Without trying to get political or even taking a side, I'm really pretty unhappy with all sides of government on this issue. One side wants things to go back to normal at any cost to human life, and the other side wants to save lives from this one particular disease at any cost to the economy. Neither side has focused on enough data collection. Both sides have rejected the necessary level of quantitative analysis in favor of political expediency.
How can you say that democrats will tolerate any cost to the economy? Just about every state with a democratic governor is opening up to some extent. In California, you can get a haircut now in most counties, and guidelines for gyms reopening are coming soon.
If the economy continues to stink, it will be because people are voluntarily staying home, not because democrats have decided they're okay with a depression.
BTW, in politics, any statement that begins with "both sides" is probably half wrong.
RE: The economic value of lives saved - 82 Card - 05-28-2020
(05-27-2020, 09:15 PM)2006alum Wrote: I went to a birthday brunch the last weekend in February in SF and COVID-19 was all anyone was talking about - no one hugged or touched and we all sat a few feet apart at an outdoor restaurant.
In San Francisco, the word was getting around by the middle of February. I'm not the type to normally pay attention to such stuff. However, the signal was strong enough this time that by February 20 I had discussed the matter with the boss and gotten approval to greatly expand telework. I went into the office twice in the following two weeks, after which everyone went on telework till further notice.
RE: The economic value of lives saved - CardinalSagehen - 05-28-2020
(05-28-2020, 02:45 PM)burger Wrote:(05-28-2020, 02:09 PM)CardinalSagehen Wrote: Without trying to get political or even taking a side, I'm really pretty unhappy with all sides of government on this issue. One side wants things to go back to normal at any cost to human life, and the other side wants to save lives from this one particular disease at any cost to the economy. Neither side has focused on enough data collection. Both sides have rejected the necessary level of quantitative analysis in favor of political expediency.
How can you say that democrats will tolerate any cost to the economy? Just about every state with a democratic governor is opening up to some extent. In California, you can get a haircut now in most counties, and guidelines for gyms reopening are coming soon.
If the economy continues to stink, it will be because people are voluntarily staying home, not because democrats have decided they're okay with a depression.
BTW, in politics, any statement that begins with "both sides" is probably half wrong.
I was intentionally painting an extreme view of both sides, but the general point is that I don’t trust that enough data collection and analysis is being prioritized.
Too much polling data, not enough scientific data.
A good example of this phenomenon on the other side of the aisle is that most states (especially red states) basically just ignored the CDC's criteria for re-opening because it was politically undesirable not to re-open.
RE: The economic value of lives saved - 76lsjumb - 05-28-2020
(05-28-2020, 02:45 PM)burger Wrote: BTW, in politics, any statement that begins with "both sides" is probably half wrong.
Because, of course, the only side that is EVER right is burger's side.
That's just science...
RE: The economic value of lives saved - burger - 05-28-2020
(05-28-2020, 09:23 PM)76lsjumb Wrote:(05-28-2020, 02:45 PM)burger Wrote: BTW, in politics, any statement that begins with "both sides" is probably half wrong.
Because, of course, the only side that is EVER right is burger's side.
That's just science...
The idea that both political parties are equally bad and that the true answer to our problems lies in the Aristotelian golden mean between them is facile and specious. It has poisoned our politics and made the country cynical.
Thanks for the personal attack, though. Really elevated the discussion.
RE: The economic value of lives saved - CardinalSagehen - 05-28-2020
(05-28-2020, 09:53 PM)burger Wrote:(05-28-2020, 09:23 PM)76lsjumb Wrote:(05-28-2020, 02:45 PM)burger Wrote: BTW, in politics, any statement that begins with "both sides" is probably half wrong.
Because, of course, the only side that is EVER right is burger's side.
That's just science...
The idea that both political parties are equally bad and that the true answer to our problems lies in the Aristotelian golden mean between them is facile and specious. It has poisoned our politics and made the country cynical.
Thanks for the personal attack, though. Really elevated the discussion.
I do not ascribe to that idea. If you must know, I think the federal response has been abysmally, atrociously, embarrassingly bad.
But we are talking about a specific issue here, and I do not have to like everything that all leaders in my own party have said or done. Cuomo in particular has struck me as slow-on-the-uptake. Perhaps it was academic and nit-picky, but he also rubbed me the wrong way with his self-righteous refusal to quantify the cost of saving lives.
This crisis has left me with the overarching, sinking feeling that our system and leaders are poorly equipped to deal with highly quantitative, scientific problems. Hyper-politicization of the issues is one of the very problems that we face.