COVID-19 in Boston

[KentXie]

How does a broken economy help keep the supply chains open and running for the manufacture and delivery of such critical things as respirators and masks? How does a broken economy help keep hospitals, doctors, nurses, all medical providers doing their heroic work? How does a broken economy help keep the search for a “cure” going at full breakneck speed? How does a broken economy help keep police, fire and first responders doing their essential jobs? How does a broken economy help keep the support services necessary for all of the above going?

And for the rest of us: How does a broken economy help keep your kids fed, educated and safe? How does a broken economy help keep the heat and lights on, the water running, the phone working? How does a broken economy help you go where you need to go whether by car or transit? How does a broken economy help keep public order or crime from running rampant? How does a broken economy help keep intact a sense of shared community and looking out for your neighbors? How does a broken economy help keep personal financial fears and anxieties that take physical as well as mental tolls under control?

A functioning economy is as vital a part of beating this demonic virus as respirators and masks. The post-covid landscape can either resemble an earthquake zone or not.

Brad, you always try to sound smart but you can never think past the top layer. Let me ask you this, how does lifting restrictions, allowing people back to work, having a high percentage of them becoming sick and unable to work, having a higher than normal death rate because the nation's health care doesn't have enough to treat every ill patient, not going to break the economy? How does cutting restrictions early, resulting a new wave that puts us back into restrictions, going to benefit the economy in the long term? This stop and go, this uncertainty, does way more harm to the economy than doing it right the first time. No company is going to hire new workers if there's going to be a stoppage of work every few months because new waves of outbreaks happens. The economy would tank and it would tank for longer than had we just bit the bullet the first time.

So please, do us all a favor on this forum. Before you start with this devil's advocate spiel that you so crave, think 2 or 3 steps down the road from your initial thoughts.

By the way, there is currently no threats to the supply chain. However, even if there was, that is going to be out of the US's hand considering much of the component used for respirators and masks are produced outside the US, meaning lifting restrictions in the US makes no difference in keeping the supply chain going. Also, medical providers will tell you that it is better to flatten the curve than it is to lift restrictions because that at least gives them the capacity to treat patients. Overwhelming them by lifting the restriction would result in no treatment to anyone who is suffering from a non-COVID-19 illness, unnecessarily increasing the mortality rate of common illnesses like the flu, the cold, bronchitis, etc, as they will have nobody to treat them. Also, work on a "cure" is not impacted because pharmaceuticals are considered "essential" so there are no work stoppage, their products are necessities, meaning there is less likelihood that people will stop buying them than say a new tv (and most would be paid for via health insurance, in fact more would of it would have been covered if the Trump administration didn't gut Obamacare), and generally finding the cure will result in big profits that would more than cover any losses they sustained during the vaccine development as the government and the healthcare industry will be buying ample amounts of it. They will survive.

Stay positive, stay optimistic.

Hard to stay positive and optimistic if the news have to announce the death of millions of Americans because "the economy is more important" and the inability to control the virus because people lack patience. If you still don't know what this scenario is like, look at Italy.

You want to instill confidence in people? You get this pandemic under control so people can be confident that the next train ride they take won't result in them being taken to a hospital begging for a treatment.

 

[KentXie]

Here's a number to consider Brad:

Let's use Italy as a model. The mortality rate is currently about 9.5% in Italy. Let's say the US goes the same route as Italy and let say, with no restrictions, a third the US will eventually be infected by the disease (I'm using the 1918 influenza pandemic which resulted in 1/3 of the world infected). The current US population is 327 million people. A third of that is about 108 million cases. We also know that Italy has a better healthcare system than the US with more beds per capita so let's bump that mortality rate to 10%. 10% of 108 million is 10.8 million deaths

 

[stefal]

Here's a number to consider Brad:

Let's use Italy as a model. The mortality rate is currently about 9.5% in Italy. Let's say the US goes the same route as Italy and let say, with no restrictions, a third the US will eventually be infected by the disease (I'm using the 1918 influenza pandemic which resulted in 1/3 of the world infected). The current US population is 327 million people. A third of that is about 108 million cases. We also know that Italy has a better healthcare system than the US with more beds per capita so let's bump that mortality rate to 10%. 10% of 108 million is 10.8 million deaths

Italy has the second oldest population worldwide. Median age at hospitals in Italy is 67 compared to China at 46 - no numbers on US yet. Italy's method of reporting deaths is also apparently questionable compared to other countries, which could be bumping up their rate a little higher.

Not saying your argument is just: we should be careful about this and I too value human lives and health over a recession, but using Italy as an example can be a bit alarmist IMO.

 

[Brad Plaid]

Hard to stay positive and optimistic if the news have to announce the death of millions of Americans because "the economy is more important" and the inability to control the virus because people lack patience. If you still don't know what this scenario is like, look at Italy.

I have never said and I have never heard anyone say “the economy is more important”. This is not an either/or, mutually exclusive situation of mostly saving patients or mostly saving the economy. This battle has 2 fronts and both need to be fought aggressively.

 

[Brad Plaid]

And who are you to intelligently question anything here? What credentials and experience do you have in medicine and public health?

Who am I to question anything? I have a stake in this just like you and everyone else on the planet so yeah questions should be asked about how something as destructive as this is being handled. Is there 100%, across-the-board agreement among epidemiologists? If not are the challengers to the orthodoxy at least being listened to or are they being dismissed outright? How could discussion and consideration of different pandemic strategies possibly be a bad thing?

The same thing applies to the economic action plans. What would work best? I don’t know but the consequences of bad decisions will be a wee bit more significant than a toilet paper shortage. Again, we need only the coolest and least emotional of heads to tackle the huge challenge of protecting the world’s economies and making the hard decisions.

 

[George_Apley]

Still waiting for any actual evidence countering decisions being made by states to maximize social distancing, Brad.

 

[kmp1284]

Who am I to question anything? I have a stake in this just like you and everyone else on the planet so yeah questions should be asked about how something as destructive as this is being handled. Is there 100%, across-the-board agreement among epidemiologists? If not are the challengers to the orthodoxy at least being listened to or are they being dismissed outright? How could discussion and consideration of different pandemic strategies possibly be a bad thing?

The same thing applies to the economic action plans. What would work best? I don’t know but the consequences of bad decisions will be a wee bit more significant than a toilet paper shortage. Again, we need only the coolest and least emotional of heads to tackle the huge challenge of protecting the world’s economies and making the hard decisions.

In other words the same exact approach Republicans have taken on climate change ... find a few outliers who tell you what you want to hear and hang on to them like grim death. You’re a lot more predictable than you realize.

This is the time for aggressive containment, not pussyfooting around discussing the most politically beneficial strategies, even if it means that some suffer a temporary economic setback.

 

[Brad Plaid]

Still waiting for any actual evidence countering decisions being made by states to maximize social distancing, Brad.

George, please show where I specified social distancing was an ineffective strategy. You’ll save yourself time and effort not looking though because it was never said—it may very well be that it and the other protocols are the most effective possible. What I have been saying is that something with stakes as high as covid should be continuously scrutinized from many different angles and that those with "contrarian" opinions or suggestions shouldn't self-censor for fear they could be seen as “heretics”—and that protecting the economy as best it can be protected is of critical importance. Thanks for the article, it was an interesting read.

 

[Brad Plaid]

In other words the same exact approach Republicans have taken on climate change ... find a few outliers who tell you what you want to hear and hang on to them like grim death. You’re a lot more predictable than you realize.

This is the time for aggressive containment, not pussyfooting around discussing the most politically beneficial strategies, even if it means that some suffer a temporary economic setback.

It's obvious you're twisting around what I've said to fit your own bias and completely ignoring what is actually there. Have at it.

 

[George_Apley]

George, please show where I specified social distancing was an ineffective strategy. You’ll save yourself time and effort not looking though because it was never said—it may very well be that it and the other protocols are the most effective possible. What I have been saying is that something with stakes as high as covid should be continuously scrutinized from many different angles and that those with "contrarian" opinions or suggestions shouldn't self-censor for fear they could be seen as “heretics”—and that protecting the economy as best it can be protected is of critical importance. Thanks for the article, it was an interesting read.

Forgive me for interpreting this: “the country (the world) is rapidly going scorched-earth policy in what could be a well-intentioned but very misguided containment effort,” as suggesting that social distancing is the wrong tack. I think most people would interpret it that way.

 

[KentXie]

I have never said and I have never heard anyone say “the economy is more important”. This is not an either/or, mutually exclusive situation of mostly saving patients or mostly saving the economy. This battle has 2 fronts and both need to be fought aggressively.

Great, answer my questions instead of ignoring them. I took the time to address all of yours.

 

[KentXie]

Italy has the second oldest population worldwide. Median age at hospitals in Italy is 67 compared to China at 46 - no numbers on US yet. Italy's method of reporting deaths is also apparently questionable compared to other countries, which could be bumping up their rate a little higher.

Not saying your argument is just: we should be careful about this and I too value human lives and health over a recession, but using Italy as an example can be a bit alarmist IMO.

Italy also has universal healthcare and better life expectancy than the US. This estimate is on the high end but when you factor other metrics in and include getting rid of restrictions that Italy is currently enforcing, this estimate doesn't sound so alarmist.

 

[Czervik.Construction]

Is construction completely halted in Boston? In NYC, external construction is still going on around me on 3 different projects in Hudson Yards.

 

[George_Apley]

Is construction completely halted in Boston? In NYC, external construction is still going on around me on 3 different projects in Hudson Yards.

Nonessential projects in the City of Boston itself are halted per orders from Mayor Walsh. He's left the door open for that order to be amended going forward. State projects within the city are not halted.

 

[JumboBuc]

Italy also has universal healthcare and better life expectancy than the US. This estimate is on the high end but when you factor other metrics in and include getting rid of restrictions that Italy is currently enforcing, this estimate doesn't sound so alarmist.

I totally agree that this coronavirus is absolutely the most critical threat facing society today, and that it requires the strongest response possible. I'm not trying to minimize that at all. But I also don't think it's appropriate to assume that the US will be worse off than Italy is for any social / demographic reasons.

As stefal noted, Italy has the second oldest population in the world (after Japan). It's also a country where intergenerational coresidence is extremely common. So Italy has a much higher percentage of people in old-age (remember, "better life expectancy" = "more old people"), and older Italians are much more likely to live with and interact with younger people who are out-and-about in society. This is a very bad combination when a viral epidemic breaks out.

Will the trajectory of this virus in the US -- or at least in certain regions of the US -- get as bad as in certain regions of Italy? Possibly, but hopefully not. Are there social / demographic reasons to assume that the trajectory of the virus will be worse in the US than in Italy? I don't see any.

Also, for all its faults and delays, the US has still been more proactive in responding to the threat of this virus than Italy was at the same relative stage of the epidemic. Italy is ~2 weeks ahead of the US in the course of outbreak but ~1 week ahead in terms of response.

 

[KentXie]

I totally agree that this coronavirus is absolutely the most critical threat facing society today, and that it requires the strongest response possible. I'm not trying to minimize that at all. But I also don't think it's appropriate to assume that the US will be worse off than Italy is for any social / demographic reasons.

As stefal noted, Italy has the second oldest population in the world (after Japan). It's also a country where intergenerational coresidence is extremely common. So Italy has a much higher percentage of people in old-age (remember, "better life expectancy" = "more old people"), and older Italians are much more likely to live with and interact with younger people who are out-and-about in society. This is a very bad combination when a viral epidemic breaks out.

Will the trajectory of this virus in the US -- or at least in certain regions of the US -- get as bad as in certain regions of Italy? Possibly, but hopefully not. Are there social / demographic reasons to assume that the trajectory of the virus will be worse in the US than in Italy? I don't see any.

Also, for all its faults and delays, the US has still been more proactive in responding to the threat of this virus than Italy was at the same relative stage of the epidemic. Italy is ~2 weeks ahead of the US in the course of outbreak but ~1 week ahead in terms of response.

I agree with you that the US would not get as bad as Italy...if you keep the ongoing restrictions in place just like Italy is doing right now. The estimate I did is if the US decides to just do away with all restrictions early which would put them on a trajectory worse than Italy. Please do not ignore that caveat in my posts.

In addition, the US also has the third largest population of adults over 65+, courtesy of the Boomer Generation, so while the US may not have the oldest population, they have a large number of older adults.

Countries With the Oldest Populations in the World

Informing a Smarter World

www.prb.org

 

[DZH22]

The US just passed 50,000 cases and counting (compared to 410,000 worldwide). By the time most of you read this post the numbers will be somewhere between higher and much higher. 28 countries have had at least 1000 cases, 27 still have 1000+ active cases, and more are knocking on the door and will surpass this in the next 1-2 days. Worldwide we're at about 1800 deaths a day. Expect this number to climb drastically over the next few weeks.

If a bunch of people stop their social distancing and return to work anytime soon there will be catastrophic results. What we really need is more time, to get more beds and ventilators into hospitals, to get more treatments, and eventually to get a vaccine. Everyday we can slow this down is going to save an absolute ton of lives in the long run.

 

[erom]

Not sure if anyone mentioned it but Somerville is also shutting down construction: https://www.somervillema.gov/news/non-essential-construction-suspended-somerville

Notably it doesn't kick in till Friday. The last two days the sites near me have been really busy, presumably because workers can't go into boston so they are staying busy in the periphery. I would have though the state-wide order would have shut them down but I guess not.

 

[George_Apley]

Not sure if anyone mentioned it but Somerville is also shutting down construction: https://www.somervillema.gov/news/non-essential-construction-suspended-somerville

Notably it doesn't kick in till Friday. The last two days the sites near me have been really busy, presumably because workers can't go into boston so they are staying busy in the periphery. I would have though the state-wide order would have shut them down but I guess not.

Statewide order says this wrt general construction being exempted from the stoppage order: "Construction Workers who support the construction, operation, inspection, and maintenance of construction sites and construction projects (including housing construction)"

Which means that construction sites can continue to operate. I believe they're still under the social distancing orders though.

 

[stellarfun]

The state has characterized construction workers as essential, and that they can continue working.

According to the Globe,

According to a list released by the state shortly after, here’s a look at other businesses that can remain open:
- Construction workers (a Baker administration representative said the state will work with Boston on construction)