Purgatory : Lockdown: The issues, ethical political and practical

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  • CrœsosCrœsos Shipmate
    Anteater wrote: »
    Croesos:
    Interestingly we have a parallel situation going on right now. The Indian and Bangladeshi governments are evacuating people from coastal areas in advance of Cyclone Amphan. @Anteater would seem to be willing to argue that the loss of "freedom of movement" in such involuntary evacuations is worse than the anticipated loss of life involved in leaving people in place and that this kind of "government overreach" is probably undertaken for malign reasons.
    Fair point although I cannot find out whether people who, for whatever reason, choose to stay knowing the risk, are being forcibly removed. Again you only posit two cases: 1. Leave them in place. 2. Arrest anybody who prefers to stay. Why not Evacuate but allow people to stay in place once the risk has been explained. OK they may be foolish to stay, but why is it not their right?

    Non-evacuees are also risking the lives and safety of rescue workers who will inevitably be required when things go wrong (as they will for at least some non-evacuees) and medical personnel who will have to treat them in a disaster zone. For that matter the people who are tasked with retrieving corpses from tricky places also risk injury or death while performing their tasks. I suppose a government could adopt a "leave desperate people to die" policy, though most are reluctant to do so. You can't just leave their bodies lying around though, as that's likely to cause health problems for survivors and anyone returning after evacuation.
  • Golden KeyGolden Key Shipmate, Glory
    When there are big, natural disasters in the US, usually hurricanes, authorities will sometimes announce (in no uncertain terms) that anyone who refuses to evacuate will be on their own--that emergency personnel won't risk their own lives to save people who refuse to go.

    Some people still refuse to go. Outcomes vary.
  • CrœsosCrœsos Shipmate
    Golden Key wrote: »
    When there are big, natural disasters in the US, usually hurricanes, authorities will sometimes announce (in no uncertain terms) that anyone who refuses to evacuate will be on their own--that emergency personnel won't risk their own lives to save people who refuse to go.

    Yes, but they'll still give aid in the aftermath. "On their own" doesn't mean "on their own for the rest of their lives".
  • lilbuddhalilbuddha Shipmate
    Taking a risk during a hurricane means you might die. Taking one during an infectious disease outbreak means you might cause others to die.
  • CrœsosCrœsos Shipmate
    lilbuddha wrote: »
    Taking a risk during a hurricane means you might die.

    You're also risking the life of whoever has to fish your corpse out of the river, or diverting medical resources to treat your cholera and broken leg in some makeshift field hospital.
  • Yes, some libertarians seem to see themselves as an island - it's my body to do what I want with, take risks with, etc. But this seems to ignore social ties, that I am bound up with others, as soon as I walk out the door. I remember that Toby Young nobly said that he would give up his life, if it meant no lock down, which prompted the old joke, I will lay down your life to preserve my own.
  • lilbuddhalilbuddha Shipmate
    Crœsos wrote: »
    lilbuddha wrote: »
    Taking a risk during a hurricane means you might die.

    You're also risking the life of whoever has to fish your corpse out of the river, or diverting medical resources to treat your cholera and broken leg in some makeshift field hospital.
    True, but if they die in a house, you could just seal it up. It is always risking others, but in a disease outbreak, the risk is even greater.
  • CrœsosCrœsos Shipmate
    lilbuddha wrote: »
    True, but if they die in a house, you could just seal it up. It is always risking others, but in a disease outbreak, the risk is even greater.

    Hey, you know what also causes disease outbreaks? Leaving dead bodies lying around.
  • lilbuddhalilbuddha Shipmate
    Crœsos wrote: »
    lilbuddha wrote: »
    True, but if they die in a house, you could just seal it up. It is always risking others, but in a disease outbreak, the risk is even greater.

    Hey, you know what also causes disease outbreaks? Leaving dead bodies lying around.
    I don't know what you think you are arguing against. I am not suggesting that one can actually isolate one's own risks from those that they impose on others during hurricanes or other such disasters. Just highlighting that disease outbreaks make attempting that isolation even worse because there is no period in which one is truly isolated.
  • We only have had 11 cases in our rural county, all from people traveling out of county and bringing it back, no spread within the county. We had no new cases for three weeks, then three people went out of county to a church service. Early on health department had them close down the lake to all boats, restaurants take out only, and all hotels closed. This kept people for the most part away. Our rural hospital has 28 beds. The county is opening the lake up next week. We will see what happens.
  • Anteater wrote: »
    I know of nobody that has equated COVID with flu

    Really? Literally *everyone* I know who thinks the lockdowns are "fascism" and/or an overreaction start their rants with some variation on the "it's no worse than the flu, people!!" talking point.
  • Anteater wrote: »
    My suspicion is that for many, the prospect of a further 15,000 deaths of mainly very old people with multiple health problems already, settles the issue.

    And they're expendable anyway, right? /end sarcasm
  • Anteater wrote: »
    I know of nobody that has equated COVID with flu

    Really? Literally *everyone* I know who thinks the lockdowns are "fascism" and/or an overreaction start their rants with some variation on the "it's no worse than the flu, people!!" talking point.

    If you go to Toby Young's blog, he has an aricle right now by Alistair Haimes, which inter alia, shows graphs for covid and a bad flu year, and says they're similar. Hang on, the present pandemic is 3 months old, are we treating it already as a finite historical thing?

    Hindsight is an exact science.
  • Alan Cresswell Alan Cresswell Admin, 8th Day Host
    In a bad 'flu year the extent of social distancing is limited to "I'm too sick to go to work". Even if the current coronavirus pandemic is spent and there's not going to be a significant rise in the total fatalities (a big if) and the figures we have are accurate (another big if, the current figures are almost certainly underestimates) then the effect of the lockdowns, contact tracing and testing has been to keep the death toll down to something similar to a bad 'flu year.

    So, even without hindsight Alistair Haimes is talking bollocks if he's saying coronavirus is just like a bad 'flu year.
  • KarlLBKarlLB Shipmate
    In a bad 'flu year the extent of social distancing is limited to "I'm too sick to go to work". Even if the current coronavirus pandemic is spent and there's not going to be a significant rise in the total fatalities (a big if) and the figures we have are accurate (another big if, the current figures are almost certainly underestimates) then the effect of the lockdowns, contact tracing and testing has been to keep the death toll down to something similar to a bad 'flu year.

    So, even without hindsight Alistair Haimes is talking bollocks if he's saying coronavirus is just like a bad 'flu year.

    It's the fucking Millenium Bug Effect again isn't it? It's like the idiots who argue that they shouldn't have IT forcing updates onto their PCs and application servers because they've never been compromised...
  • Didn't think a computer virus compares well to biological one.
  • KarlLBKarlLB Shipmate
    Didn't think a computer virus compares well to biological one.

    Good job I wasn't comparing them.

    My point is that people have this annoyingly tendency, when preventative measures have been to any extent successful, to think the danger was never real, or at least exaggerated, in the first place.
  • Golden KeyGolden Key Shipmate, Glory
    Yup, Karl, re your last paragraph.
  • Sort of like people who take meds for a disorder, then improve and feel alright so they stop their medication.
  • KarlLBKarlLB Shipmate
    Sort of like people who take meds for a disorder, then improve and feel alright so they stop their medication.

    Bit like that. The classic case was the Millenium Bug, where programmers worked hard at finding and patching bugs which would cause software to malfunction in 2000, where the two digit date would be interpreted by affected code as 1900. Because they did their job, there were relatively few software failures. The result was people claiming there never was much of a problem...
  • jay_emmjay_emm Kerygmania Host
    And to be fair, it was referenced as such in the op.
  • orfeoorfeo Suspended
    Didn't think a computer virus compares well to biological one.

    Y2K was not a computer virus. It was a computer bug.
  • ArethosemyfeetArethosemyfeet Shipmate, Heaven Host
    orfeo wrote: »
    Didn't think a computer virus compares well to biological one.

    Y2K was not a computer virus. It was a computer bug.

    But many computer system automatic updates are to help close holes exploited by viruses (and other cyber attacks) which I suspect is the part of Karllb's post NPNP was responding to.
  • EutychusEutychus Shipmate
    edited May 2020
    That's not the point. The point is that once any mitigation measures are applied, as Aslan so often reminds us, it's impossible to know what might have happened had they not been applied, which opens the way for criticism of whether it was worth applying them in the first place.

    Like all those masks the French government 'stupidly' stored for a pandemic that never happened, and disposed of, and then it did.
  • One odd thing about the prevention paradox expressed by some skeptics, is that it shows that lockdown works. I read a German protestor, who said, "why am I shut at home, when there have only been 8000 deaths?" The obvious reply is that maybe there are only 8000 because you have been shut at home. The same with Toby Young's infamous declaration that it's worth a few hundred thousand old people dying, to keep the economy solvent. So he is accepting that the lockdown prevents those deaths, but floreat capitalism.
  • Gee DGee D Shipmate
    Crœsos wrote: »
    Golden Key wrote: »
    When there are big, natural disasters in the US, usually hurricanes, authorities will sometimes announce (in no uncertain terms) that anyone who refuses to evacuate will be on their own--that emergency personnel won't risk their own lives to save people who refuse to go.

    Yes, but they'll still give aid in the aftermath. "On their own" doesn't mean "on their own for the rest of their lives".

    It can mean that - the rest of their lives is not very long.
  • KwesiKwesi Deckhand, Styx
    I agree that a small number of deaths suggests the success of lock-down. On the other hand there is the question as to whether it makes much difference amongst those under 50 or even 60. Clearly, the mortality figures would be hugely less had care homes been seriously isolated, quarantined, including the staff, at the outset.
  • ArethosemyfeetArethosemyfeet Shipmate, Heaven Host
    Kwesi wrote: »
    I agree that a small number of deaths suggests the success of lock-down. On the other hand there is the question as to whether it makes much difference amongst those under 50 or even 60. Clearly, the mortality figures would be hugely less had care homes been seriously isolated, quarantined, including the staff, at the outset.

    It makes a pretty big difference to those under 50 with long term but ordinarily not life-limiting conditions like diabetes. Type 1 diabetics seem to make up a high proportion of victims of the virus.
  • AnteaterAnteater Shipmate
    windsofchange:
    Anteater wrote: »
    I know of nobody that has equated COVID with flu
    OK so I think I need to retract that. I was taking the expression too literally, and of course there are important differences between COVID and Flu, especially in the area of our knowledge of the virus, and state of the art on vaccines.

    But obviously I have to admit that amongst lockdown skeptics, it is often quoted that the death rate is not that much higher than a bad flu year (28,330 in 2015). So I take the point that the comparison is becoming standard.
    And they (very old people) are expendable anyway, right?
    Sarcastic I accept but still an odd use of the idea of expendable. In the current situation decisions are being taken about priorities, with the main priority being the protection of the NHS - not as an end in itself but to ensure we have a functioning healthcare system to save lives.
    . This means the NHS is largely closed to other treatment, and that the fear of COVID has intimidated people into not going to hospital. Obviously, from the point of view of the overall economic activity of the UK, very old people are expendible, as am I. The point is that this is not taken as equating to worthlessness or a justification for bumping them off, in any sensible system of ethics. And as I have said so often, I do view the life of somebody with many decades of life ahead of them, possibly small kids and all that, as justifying a higher priority than those who have had their lives like me. And there's no basis for debate on that - you either see that as common sense or ageism. But people will lose out.

    I have lost out on having an elective surgery postponed with no date for when it will be done. That's reasonably ok, since I am unlikely to have a severe problem, and probably could have it done privately if it really becomes problematic. (I think!). Other's have had cancer treatment postponed, and that it more questionable. The Institute of Cancer Research using their modelling say that up to 5, 000 cancer deaths could result from the delay due to the focus on COVID. Some of this will be unavoidable, but I suspect some due to decisions to concentrate on COVID. My local GP surgery is effectively closed for business unless you are online which many vulnerable people are not. The phone is simply not answered, and the call back facility has been removed. And you can't go to the surgery. So effectively you don't have a GP until further notice.

    These are all decisions on priorities. Priorities between keeping the NHS safe and caring for the sick, and then decisions about concentrating resources on COVID to the detriment of anything else. Economic value is not the determining factor.
  • Alan Cresswell Alan Cresswell Admin, 8th Day Host
    It's almost impossible to adequately isolate care homes without significant suppression of disease incidence in the wider population, which means a more general lockdown. There will always be people moving back and forth across the property boundary - staff going home at the end of their shifts and coming back for the start of their shift, in turn coming into contact with their families or staff at the supermarket and others on the bus home; various delivery people, or tradespeople to fix a leaky tap or whatever other building maintenance is needed; doctors and nurses who need to visit those who are sick. If there's a low incidence of infection in the wider community the chances of these people bringing the virus into a care home are greatly reduced compared to a higher incidence of infection.
  • KwesiKwesi Deckhand, Styx
    You will note, Alan, that respecting a drastic lock-down in care homes that I included staff. As to the need for others to do so as well to sustain such a specific case, I think there will be more to be said, particularly as it now seems young adults have continued to socialise extensively, though denied more densely populated venues. Had the UK been better prepared a more nuanced approach might have been possible. Who knows?
  • EutychusEutychus Shipmate
    Kwesi wrote: »
    Had the UK been better prepared a more nuanced approach might have been possible. Who knows?
    With the benefit of a couple of weeks of relaxed lockdown conditions, I think that part of the outcome, aside from the immediate health issues, is social: we've had two months to get used to distancing, queueing a metre apart, masks, and so on, and the authorities have had two months to implement track and trace measures. I think it highly unlikely everyone would have accepted these without the lockdown period.
  • Alan Cresswell Alan Cresswell Admin, 8th Day Host
    Kwesi wrote: »
    You will note, Alan, that respecting a drastic lock-down in care homes that I included staff.
    Except, you can't include staff. Where are they going to sleep, relax after a hard shift, have a shower and store spare clothes (I'm sure you don't intend staff to wear the same clothes without a shower for three months or more)? Care homes are simply not designed for staff to stay on the premises. That means they need to leave the premises for the above purposes ... and there goes your ultra-strict quarantine of care homes.
  • KarlLBKarlLB Shipmate
    @Anteater
    But obviously I have to admit that amongst lockdown skeptics, it is often quoted that the death rate is not that much higher than a bad flu year (28,330 in 2015). So I take the point that the comparison is becoming standard.

    A bad flu year kills that many with no social distancing measures in place

    COVID-19 has killed more than that despite lockdown.

    The comparison is invalid.
  • ArethosemyfeetArethosemyfeet Shipmate, Heaven Host
    KarlLB wrote: »
    @Anteater
    But obviously I have to admit that amongst lockdown skeptics, it is often quoted that the death rate is not that much higher than a bad flu year (28,330 in 2015). So I take the point that the comparison is becoming standard.

    A bad flu year kills that many with no social distancing measures in place

    COVID-19 has killed more than that despite lockdown.

    The comparison is invalid.

    Or rather it proves the opposite of what the libertarian right want it to prove. Also, close to double isn't "not that much higher".
  • jay_emmjay_emm Kerygmania Host
    edited May 2020
    Kwesi wrote: »
    I agree that a small number of deaths suggests the success of lock-down. On the other hand there is the question as to whether it makes much difference amongst those under 50 or even 60. Clearly, the mortality figures would be hugely less had care homes been seriously isolated, quarantined, including the staff, at the outset.
    I can see that two ways, both of which come to the same problem.
    Firstly that because of basic necessity, co-operate concern or individual incompetence that the under 60's have been affected at the same (proportionately lower) rate as they would be without the lockdown. however studies show that infection seems to have been stopped at 1-5 % coverage which suggests that the lockdown did make a difference (depending on how it is exitted).

    Or secondly that the 2,200 (in hospital, diagnosed, Eng&Wal) deaths of under 60's (200 under 40's, 15 schoolkids) is a drop in the ocean compared to background noise. Which being frank, it probably is comparable to other risks.
    Unfortunately it runs into the same issue, if this is with infection at 5% and herd immunity doesn't kick in to 50% we need to compare with 22,000, 2,000 and 150. Which even ignoring the fact that over 60's matter (even the ones that voted for it) is definitely a non-trivial number.

    That's not to say the other issues aren't important and that we shouldn't try to get almost all the benefits of lock-down with mitigating almost all the various costs (at the end of the day the risks with closed door football is probably mostly financial, even if they all got it you'd probably only kill one or two players in a league* and lose twenty from active play, and with care you ought to prevent more than 15 getting it) BUT that is not the same as saying lockdown has costs, lets not do it.

    *plus any indirect relatives/friends/etc...
  • Alan Cresswell Alan Cresswell Admin, 8th Day Host
    KarlLB wrote: »
    @Anteater
    But obviously I have to admit that amongst lockdown skeptics, it is often quoted that the death rate is not that much higher than a bad flu year (28,330 in 2015). So I take the point that the comparison is becoming standard.

    A bad flu year kills that many with no social distancing measures in place

    COVID-19 has killed more than that despite lockdown.

    The comparison is invalid.

    Or rather it proves the opposite of what the libertarian right want it to prove. Also, close to double isn't "not that much higher".
    Double the number of deaths in two months compared to the approx. 6 months of 'flu season.
  • Toby Young in yesterday's tweet, "covid no more deadly than a bad bout of seasonal flu". As above, flu doesn't have a lockdown.
  • Anteater wrote: »
    The Institute of Cancer Research using their modelling say that up to 5, 000 cancer deaths could result from the delay due to the focus on COVID.

    Yeah, but those people are expendable, apparently.

    But honestly, I don’t see the big problem with acknowledging that some people are expendable. I mean, people on this thread have been justifying the sacrifices of lockdown by saying we coped with similar strictures during the war. Well, during the war we also had a massive population of people who were quite literally expendable in the name of winning the battles - soldiers, sailors and airmen. And they had a hell of a lot more years of future life to sacrifice for the greater good than old folks do today.
  • KarlLBKarlLB Shipmate
    It's not a case of people being expendible. It's a case of deaths from course of action A being more or fewer than from course of action B.
  • KarlLBKarlLB Shipmate
    Toby Young in yesterday's tweet, "covid no more deadly than a bad bout of seasonal flu". As above, flu doesn't have a lockdown.

    Toby Young is a complete moron.
  • AnteaterAnteater Shipmate
    I would value people's reaction to the latest interview with Prof Sunetra Gupta here.

    It may lower your prejudice if I point out that she obviously believes the Libertarian use of her work is a pain in the arse, though she is to nice to use those words. But she makes it plain that she thinks they are giving lockdown alternatives a bad name.

    I would have liked her to expand on her statement at the end that lockdown is a luxury that is fine for the middle classes and richer nations but is disastrous for the poor; since she doesn't go into the evidence.

    I think it is a balanced view. She accepts it is possible (not quite happy with plausible) that Fergusons model is right and the mortality fall off is due to the lockdown, and she cannot disprove it, but she thinks it more likely that the decay in cases is just a natural decay and would happen without lockdown. Of course we may never have proof.

    I am no lockdown opponent (like I am a JW opponent), because of my lack of knowledge and reliance on the various divergent points of view. I just wish more points of view were heard, since there is no agreed science, and the government are just using highly selected science as something to hide behind.

    I am slightly surprised at the total acceptance on this ship of whatever the government says, and the devaluation of the skeptical mindset, but maybe that's a thought for the What is the Ship Coming To thread. There was a time when skepticism, especially of government policies, was viewed as a Good Thing. I remember those days.
  • ArethosemyfeetArethosemyfeet Shipmate, Heaven Host
    I have a lot of scepticism about government policies when they look foolish or dangerous. Less so when they look necessary and sensible.
  • I suggest that you may have missed a number of threads where there is open disagreement with what the UK Government says.

    One of the ways of considering whether lockdown is working or not is comparing countries with early and significant lockdown strategies and those countries where lock down was implemented slowly or not as intensively - so comparing the death and infection rate of Germany with, say the UK, or Sweden against the other Scandinavian countries, or the USA and Brazil against Canada and Argentina.
  • jay_emmjay_emm Kerygmania Host
    I think you'd need some explanation for the natural decay. The two obvious ones being "we've all had it" which unfortunately is countered by the studies showing that <5% have had it.
    Or that 10% of us are just fundamentally unlucky (which I think is countered by deGalle and Roosevelt).
    Or some external conditions, like temp.

    There kind of is an agreed well developed basic science for infectious diseases, determining the details is more complicated. But at the end of the day anyone who draws a straight line is talking bollocks

    As for the lockdown as implemented being set to be fine for the middle classes but disastrous to the (unpaid) poor. There is a good case for that. Non-lockdown as implemented* is also going to be better for the middle classes than the (martyred) poor (in closer conditions, doing more dangerous jobs and with less rights).
    Making something that works better, I'm all for.

    *NB By certain governments.
    The ship (and even ++Cantuar) was at least a week ahead of them.
  • EutychusEutychus Shipmate
    Anteater wrote: »
    I think it is a balanced view. She accepts it is possible (not quite happy with plausible) that Fergusons model is right and the mortality fall off is due to the lockdown, and she cannot disprove it, but she thinks it more likely that the decay in cases is just a natural decay and would happen without lockdown. Of course we may never have proof.

    Even if the decay is "natural" (whatever that means), and it would have happened without lockdown (however that might be), this is still missing at least part of the point.

    Without a lockdown, there would in all likelihood have been a higher spike and higher mortality rates over a shorter period of time, leading to hospitals being more overwhelmed and thus more people dying due to a lack of hospital care plus a real danger of the collapse of other critical infrastructures in the short term.

    Do you think the Italian experience is just because they're especially dirty and unhygienic or something?
  • CrœsosCrœsos Shipmate
    Kwesi wrote: »
    You will note, Alan, that respecting a drastic lock-down in care homes that I included staff.
    Except, you can't include staff. Where are they going to sleep, relax after a hard shift, have a shower and store spare clothes (I'm sure you don't intend staff to wear the same clothes without a shower for three months or more)? Care homes are simply not designed for staff to stay on the premises. That means they need to leave the premises for the above purposes ... and there goes your ultra-strict quarantine of care homes.

    In the U.S. there's also the problem that nursing home staff often works at more than one nursing home.
    [T]hese commonly accepted factors are not the only reason COVID-19 is proliferating in our nursing homes: The poverty wages paid to caregivers and the understaffing of our long-term care facilities are also to blame.

    The national median wage of Certified Nursing Assistants, who make up the bulk of the nursing home workforce, is $14.25 per hour — or $29,640 per year with a 40-hour work week. Although wages are somewhat higher locally, they are nowhere close to a living wage. Many who work in these facilities hold multiple jobs — in another nursing home or home care agency, for example — in order to pay rent and put food on the table. Given how COVID-19 is transmitted by asymptomatic individuals, when an outbreak begins in one facility, it is unlikely to be contained there for very long.

    In an outbreak across several nursing homes in Washington state beginning in February, investigators from the Centers for Disease Control and Prevention found that in part “staff members working in multiple facilities contributed to intra- and interfacility spread.” If we ever get a full accounting, the same will surely prove to be true here in Massachusetts and across the country.

    The article goes on to note that nursing homes are frequently understaffed (by the standards recommended for optimum care and infection prevention) and that payrolls will rise just before government inspections as more staff are hired, only to return to normal (deficient) levels after the inspection. The free market at work!
  • Yes, the Italian experience seriously freaked people out. Hospitals being overwhelmed means adopting a triage system, I think. This means that a portion of patients are not treated, or hopefully given morphine, for a painless death. (I haven't been present at this). In plain English, this means being left to die.

    Presumably, skeptics would feel OK with this. I assume politicians are terrified of it, as the sight of mass deaths of untreated patients would be a vote loser.
  • KarlLB wrote: »
    It's not a case of people being expendible. It's a case of deaths from course of action A being more or fewer than from course of action B.

    The problem with that is the complete unwillingness to consider any factor other than deaths when deciding which course of action to take.
  • chrisstileschrisstiles Hell Host
    Anteater wrote: »
    I would value people's reaction to the latest interview with Prof Sunetra Gupta here.

    Simple reaction: “Infection Fatality Rate is less than 1 in 1000 and probably closer to 1 in 10,000.”

    The population of the UK is 66M and not even Prof Guptra is contending that only around 6600 people have died of covid in the UK. I think she's misplaced a decimal point at the very least.
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