Naked Science Forum
Life Sciences => Physiology & Medicine => COVID-19 => Topic started by: vhfpmr on 11/04/2020 15:53:15
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It would be interesting to see a list of all the major preventable causes of death, along with the costs of eliminating each. Air pollution reportedly kills 30,000 a year in the UK alone, I wonder how much that would cost to eliminate, compared with up to 24% of GDP that might be the price tag for lockdown.
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The "air pollution" figure is a guess since it is never reported as a cause of death apart from a very few cases of occupational hazard leading to well-characterised symptoms such as mesothelioma.
Anyhow the object of lockdown is to prevent a probable 80% infection rate and 700 - 900,000 UK fatalities occurring within 6 - 12 months, as predicted by recent studies of social interactions and the apparent infectivity of COVID. Your estimate of the cost of "doing nothing" (i.e. nursing an additional 5,000,000 patients with half the clinical workforce, and burying twice the average annual number of dead) would be interesting.
The preventable causes of death are headed by acute suicide, chronic suicide (i.e the consequences of smoking and obesity) and, in my view, pneumonia.
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It would be interesting to see a list of all the major preventable causes of death, along with the costs of eliminating each. Air pollution reportedly kills 30,000 a year in the UK alone, I wonder how much that would cost to eliminate, compared with up to 24% of GDP that might be the price tag for lockdown.
1600 people die each day apparently, less than the 3000 that i estimate. Air pollution( environmental), heart attacks strokes (stress) are all down.
Trouble is it takes an entire economy exept for shares and pr etc to make a wheel turn, you need nuts and bolts and etectric and sewage, they need steel factories electricians and plumbers, they need cars and bulbs etcetc, it can only subsist for so long. I would be very very interested to know the mortality rate this year versus last, minus the heart attacks and pollution, the weather was similar!
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What the lockdown has shown, I think, is that people who travel every day to work in an office probably don't need to. And it has also highlighted the fact that the critical people in most organisations are those who get paid the least. This will reshape a lot of employment.
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I agree with the op, it would be interesting. In fact somebody should have done the sums, speaking of which they should have done the sums years ago to know when old fasioned innoculation would be the best bet.
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In fact somebody should have done the sums, speaking of which they should have done the sums years ago to know when old fasioned innoculation would be the best bet.
They did those sums years ago.
That's why inoculation is old fashioned. It's not as good as modern vaccination.
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And you can't vaccinate against a virus that hasn't discovered you yet. Lockdown and isolation are the only effective first-strike against a novel zoonosis, and as we have seen, they don't work if the early cases aren't reported.
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I wasn't necessarily suggesting that we shouldn't lock down, but it would be interesting to see a price list for other measures that might save more per unit cost. I wonder how fixing climate change would compare, for example.
I'm intrigued by the debate about essential vs non-essential in the media too, quite a lot of the economy is essential eventually.
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In the present circumstances, doing nothing would have the greatest economic benefit. Most of the workforce would recover in 2 - 3 weeks, so the effect on production would be no more than having a long holiday or a short sabbatical. The elimination of the very young, the very old, and those with chronic health problems or poor immune response, would relieve the taxpayer of many burdens and the survivors would live happily ever after.
I set up an x-ray facility for a rural vet some years ago, and asked if she wanted it calibrated for sheep. The answer was "no - x-ray film is more expensive than sheep". It all comes down to what sort of society you want to live in.
quite a lot of the economy is essential eventually.
Civilisation is specialisation.
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doing nothing would have the greatest economic benefit.
Greatest economic benefit is not the same as saving most lives though.
The preventable causes of death are headed by acute suicide, chronic suicide (i.e the consequences of smoking and obesity) and, in my view, pneumonia.
This used to be on the NHS website for a while, I don't know if it was taken down because it was discredited:
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It's a weird mixture of causes and symptoms. Low fruit and veg may be associated with premature death in the UK, but not among the Inuit or Saami: the "five a day" slogan was actually invented not by any public health body, but the Californian Fruit Growers Association - and why not? My buddy Bob has as much right to make a living as any doctor! High blood pressure is a symptom that may be associated with early death, but suicide and murder are 100% effective, by definition.
As for economics, various government departments have "cost per life saved" targets, current minimum seems to be about £75,000. Some agencies spend a lot more, e.g. the US Environmental Protection Agency budget and regulations work out around $1,000,000,000 per life saved.
You might care to read https://lawofmarkets.com/2020/04/09/the-actual-cost-of-the-shut-down-is-300-million-per-life-saved
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This used to be on the NHS website for a while, I don't know if it was taken down because it was discredited:
If you smoke, you may well drink, rather than going for a run, you may get fatter, have diabetes, have a bad diet get cholesterol, get high blood pressure. Its more of a life style choice. If you take drugs you have more chance of getting murdered. War tends to stop all of that bad behavior, gets people fit, it sounds like a good idea.
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I wonder how fixing climate change would compare, for example.
The cost comparison is, for a politician:
- Coronavirus might kill me (or my mother, or a colleague) in the next 3 months. If I appear to do nothing, I might lose the next election.
- Climate Change won't kill me, or my mother, and probably not my children in the next 50 years. If I just keep saying it is "fake news", I can still win the next election.
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This gif uses data for USA specifically, but is likely reasonably extended to most industrialized nations. It is a fascinating and horrifying graphical progression:
https://public.flourish.studio/visualisation/1727839/
It indicates that in the order of a few weeks, deaths directly attributable to COVID-19 has eclipsed even heart disease as the leading cause of death (who knows how many otherwise preventable deaths will result from the flooding of hospitals and the exhaustion of physical and human resources associated with outbreaks).
That said, the value of human life is not infinite. The United States Department of Transportation defines the value of a statistical human life as about $10,000,000. So the difference between 100,000 deaths (locked down) vs 2,000,000 deaths (not locked down) is on the order of (1.9x106)(107) = $1.9x1013
Add to that lost wages assuming that everybody was still working, and it looks like without the lockdowns ~80% of people would contract the disease, of which about 50% would have no symptoms. So if 40% of the US working population were out sick for 2 weeks, with US median pay, that's about $1800x1.56x108x0.4 = $1.1x1011. Not so big compared to all the dying, but also not great.
It's hard to know what "would" have happened without lockdowns, but we can see example after example of places that "should" have locked down earlier (from a casualty perspective). But if we really want an "economical" strategy. Aggressive testing and tracking will be able to ensure that populations with low enough infection rates can return to business "as usual" while those with problematic infection rates can shelter in place for a few weeks at a time. (the more people self-isolate, the less time is required to strangle the infection: if only 10% of people isolate, there's no point at all)
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Lockdown and isolation are the only effective first-strike against a novel zoonosis, and as we have seen, they don't work if the early cases aren't reported.
Actually they work, regardless.
If every human in the world went "home" and stayed there for 3 weeks we would kill the virus. (I recognise not everyone has a home- that's a separate issue.)
https://xkcd.com/2287/
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xkcd should be on national television!
Apropos the value of a human life, there are four distinct valuations. The lowest is the actual lifetime economic impact which, for a UK citizen, is about £50,000. Next is the average insured value of a life - a somewhat contentious figure as not all adults carry life insurance, but if we average across families where at least the main breadwinner is insured, it's maybe £200k, the value the middle classes actually think it's worth paying premiums for. Surveys of "how much do you think the NHS should spend to save a life" tend to come out around £5,000,000 - how much we think everyone else should pay for us. The government figure varies across departments and is based on the cost of clearing up, apologising, paying defence lawyers and actuaries, promoting the guilty, saying "lessons have been learned - we will draw a line under it..." and all the other BS that accompanies death by incompetence.
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Apropos the value of a human life, there are four distinct valuations.
There are lots.
https://en.wikipedia.org/wiki/Value_of_life
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Various ways of calculating it, certainly, but they all seem to fit into four categories: what is the net contribution to the economy over a lifetime, how much is an individual prepared to pay to insure his life, how much does he think society should pay to keep him alive, and what is the treasury cost of a death attributable to an organisation?
In the last category it is worth recalling the words of Stalin: "One death is a tragedy, a million deaths is a statistic."
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As far as I can tell, this thread is going to consist of speculation about which of two numbers- both with arbitrary definitions, and subjective by nature- is bigger.
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Had an interesting discussion with a tropical agronomist today. He had been shown an anticorrelation between the incidence of malaria and COVID, which his source attributed to the use of chloroquinine. He pointed out that it was hardly used for the last umpteen years on grounds of ineffectiveness, but what was certain was the incidence and consumption of fruit bats in malarial areas.
Wikipedia (where else?) says They are also of interest to those involved in public health as they are natural reservoirs of several viruses that can affect humans.
and indeed they shed all sorts of endemic coronaviruses, so it is likely that the human population has actually evolved or acquired immunity.
Given the enthusiasm of the green movement for turning East Anglia back into a malarial swamp, maybe the best long-term response is indeed to do nothing!
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So is the suggestion that it's the quinine, or fruit bats, or both that's conferring the immunity?
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According to my source, the quinine is irrelevant. It's the habitual exposure to corona viruses that produces herd immunity in the local population. It may even be evolutionary, like the sickle cell response offers protection against malaria.
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I wasn't necessarily suggesting that we shouldn't lock down, but it would be interesting to see a price list for other measures that might save more per unit cost. I wonder how fixing climate change would compare, for example.
I'm intrigued by the debate about essential vs non-essential in the media too, quite a lot of the economy is essential eventually.
If your germany and you have invested in healthcare, rather than the nhs, lockdown is not worth it, people in that country have no qualms about calling the nhs, but the argument then becomes is investing in a good health care system worth it ? And taxing accordingly, if you are a member of the bullingdon club the answer was no !
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The preliminary fatality rate in Germany was much lower than in Italy or Spain, leading to a discussion and explanations citing the country's higher amount of tests conducted, higher amount of available intensive care beds with respiratory support, absence of COVID-19 analyses in post-mortem tests and higher amount of positive cases among younger people. The head of the Robert Koch Institute warned that the German death rate would increase over time.
my italics. In other words, the infection rate is probably as high as anywhere else, but postmortem recording is probably underplaying the actual fatality rate.
Fact is, there are no facts. Or at least very few credible facts.
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Given the enthusiasm of the green movement for turning East Anglia back into a malarial swamp,
No, that's your intention. The Greens are trying to stop the UK getting warmer and wetter.
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Had an interesting discussion with a tropical agronomist today. He had been shown an anticorrelation between the incidence of malaria and COVID,
How did they rule out
"poor countries can't afford covid testing"
as an explanation?
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This gif uses data for USA specifically, but is likely reasonably extended to most industrialized nations. It is a fascinating and horrifying graphical progression:
https://public.flourish.studio/visualisation/1727839/
It indicates that in the order of a few weeks, deaths directly attributable to COVID-19 has eclipsed even heart disease as the leading cause of death (who knows how many otherwise preventable deaths will result from the flooding of hospitals and the exhaustion of physical and human resources associated with outbreaks).
That said, the value of human life is not infinite. The United States Department of Transportation defines the value of a statistical human life as about $10,000,000. So the difference between 100,000 deaths (locked down) vs 2,000,000 deaths (not locked down) is on the order of (1.9x106)(107) = $1.9x1013
Add to that lost wages assuming that everybody was still working, and it looks like without the lockdowns ~80% of people would contract the disease, of which about 50% would have no symptoms. So if 40% of the US working population were out sick for 2 weeks, with US median pay, that's about $1800x1.56x108x0.4 = $1.1x1011. Not so big compared to all the dying, but also not great.
It's hard to know what "would" have happened without lockdowns, but we can see example after example of places that "should" have locked down earlier (from a casualty perspective). But if we really want an "economical" strategy. Aggressive testing and tracking will be able to ensure that populations with low enough infection rates can return to business "as usual" while those with problematic infection rates can shelter in place for a few weeks at a time. (the more people self-isolate, the less time is required to strangle the infection: if only 10% of people isolate, there's no point at all)
Whats the value of an 80 year old with rumatoid arthritis that lives in a carehome ?
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Given the enthusiasm of the green movement for turning East Anglia back into a malarial swamp,
No, that's your intention. The Greens are trying to stop the UK getting warmer and wetter.
https://www.greatfen.org.uk/creating-wetlands
Note: creating.
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Had an interesting discussion with a tropical agronomist today. He had been shown an anticorrelation between the incidence of malaria and COVID,
How did they rule out
"poor countries can't afford covid testing"
as an explanation?
The sudden appearance of clusters of unusual symptoms and an increase in deaths from respiratory disease, is unequivocal, even in the poorest of countries. Limited testing in the UK has actually distorted the statistics: it's quite obvious that deaths in non-hospital settings have increased but they aren't reported as COVID as there's been little or no testing in care homes and private houses.