[klmadfejno]

I think this is accurate. Fears of medical systems being overrun are generally overstated. The threat to doctors is already maximal, and by extending the length of the epidemic we're just extending the time they're at maximal risk. There's an argument towards buying time for more PPE availability but I think that's a bad bet. Lockdowns lifted before something like herd immunity is reached isn't going to help. If less than 10% of the population is immune, then you're in the same boat when the lockdown is lifted and you've achieved basically nothing but buying time. I don't think anybody would say we can endure a lockdown FOREVER. I think it's naive to think we can endure a lockdown for even one year without economic devastation causing far more harm than the virus, let alone the ambiguous timeline towards a vaccine.

A lot of people are going to die. More people will die if the lockdown is lifted, and many of those who would have died anyway will die sooner. But famine, crime, war, and authoritarianism will cost more. On a global scale I have no doubt that disease is less harmful than poverty in terms of happiness or lives lost. The same for any given country as a whole. For wealthy communities perhaps not.

It is frustrating to me that saying such things comes off as right wing or anti-science. I feel the calls to keep the lockdown going are a thing of entitlement from those who can afford to do so. There's a middleground where you lockdown those at risk, reduce travel, and encourage sanitation practices but open things up.

[greedo]

I live in a small Midwestern state. A friend's mother is going through oncology, and is having complications due to the treatment regimen. Yesterday she had to be put in ICU for a day because every other bed in the facility was being used for COVID-19.

This isn't in the local news, nor regional news. It's almost like it's a dirty secret.

You may not consider this "overrun" but I do. I sure hope I don't have appendicitis or a stroke because it'll be an issue...

[klmadfejno]

That is an issue, but its a separate issue. The concern that COVID is going to drastically overrun hospitals to the point at which we simply cannot take in more people and cause even the young to die is mostly not an accurate depiction of how hospitals and their capacity works.

It's true, a prolonged lockdown could potentially keep hospital usage low enough that things like this aren't happening, but only temporarily, and not in a way that meaningfully diminishes the threat of the virus and similar hospital burdens occurring later. You can't slowly let everyone acquire immunity. The disease either exponentially spreads to a sufficient scale or it spreads too slowly to build up a community resistance that permits a lockdown to end without consequence.

I really do empathize with people who are suffering, but what do you do if 6 months from now the disease is still here, we don't have a vaccine, and the economic situation is worse? You either release it, and put us back at the beginning with these same woes we're encountering now, or we keep holding the lockdown for short term loss of life avoidance at significant economic cost.

[DiogenesKynikos]

The hospitals were overloaded in Lombardy, in exactly the way you're saying will not happen.

[klmadfejno]

From everything I've read, the hospitals in Lombardy could have surged even higher. Hospitals, in general, can expand care to many more people than they're scoped to handle. It means that each person gets worse quality care, but for an untreatable disease, there's little you can do to treat it anyway. Ventilator mortality is extremely high. My sense is ballpark 80% mortality rate, and that's just an average. With ventilator + age + pre-existing conditions assessment there's a large number of people that have extremely low chances of survival. At the level of triage decisions being made, I'd expect very few additional lives to have been lost.

I get that this is tragic. I get that people are dying. I get that this is an enormous mental and emotional toll on doctors. I get that we should be cautious and avoid needless exposure, especially to vulnerable populations or with unnecessary large social gatherings. But the lockdown is not saving lives. It's delaying inevitable deaths, at an economic cost which could kill even more people!

[greedo]

Not an accurate depiction? Perhaps you should read up on how Lombardy's health care system fared for Italy. Or travel to Bellevue Nebraska, and ask why non-COVID patients are being kept in ER (hint: it's because all the non-ER beds are full of COVID patients).

Also, you're idea of how herd immunity functions is not accurate.

We'll have the virus here in 6 months; no doubt in my mind. We'll have it combined with the annual flu. We won't have a vaccine either, though perhaps some therapeutic treatment if we're lucky.

No, we won't reach herd immunity for at least a year at this rate. And the political pressure to "open up" the economy will become too great since we don't have a real welfare net in America.

So my estimate at the end of the year is that we'll have about 40% of the population infected or recovered. We'll have roughly 19M hospitalized during the next 8 months, and 1.4M deaths. This will cripple our country, our economy, and our people. Yeah, I'm a pessimist. Everything I've seen about how this country is reacting confirms my priors.

How can we avoid this? Keep things shut down to a bare minimum of true essential services. Protect the employees doing essential services to the max. Implement a social safety net so workers don't lose everything. Do the same for businesses, since demand is drying up fast. Listen to scientists instead of firing them for disagreeing with the POTUS about hydrochloroquine. Develop reliable serological tests so that immune people can safely work.

Most importantly, be lucky. The US has been lucky for a long long time; for most of its history. Hopefully that will continue, and rub off on the rest of the world that is in far dire straits.

[klmadfejno]

Commented on Lombardy elsewhere.

You cannot "just" provide a social safety net. That's not how the economy works. Somewhere between 10 and 20% of households with kids did not have enough to eat. Now more people, especially the poor, are out of work, and food prices have gone up because we're producing less food. Giving a handout to keep people afloat makes sense as a short term fix but it's not a viable long term solution.

You're saying we're going to see 1.4M deaths on the current track. Well what's the deaths on your track? There's NO WAY to open up the economy without the virus resuming its spread. You haven't lowered the deaths, you've just delayed it at great economic cost.