I've Read UNSCRIPTED
- Oct 16, 2014
You have very valid points, and these are things we need to consider. One of the hard things is that deaths be covid are what we would term deterministic, deaths by all these other things are stochastic. The problem with stochastic causes of death is that the numbers are never clear and it’s very very easy to put bias into the study or outcome.As pretty much everyone in this thread, I'm not an expert. I'm not taking any sides, either. Just wanted to point out something that I feel many people are missing as if it wasn't important while everyone is constantly checking the rising numbers of cases and deaths - the long-term effects of a lockdown, including countless personal tragedies and deaths, too.
There's no denying that without flattening the curve there would be many more deaths. It's also obvious that if "certain" countries decided to act as soon as possible there might have been no need for such restrictive measures (as the examples of still functioning relatively normally Singapore, South Korea, Hong Kong and Taiwan show as well as certain smaller countries that acted fast - here in Barbados the government and private business, without mandatory measures, took immediate action after identifying the first cases).
But the countries currently struggling the most are whey they are and they can't go back and implement the diligent Asian measures sooner. At this point, the question is whether it can really be contained given thousands of cases and the inability to properly perform contact tracing which has been so essential in countries that weren't as affected.
Which brings me to a thought I've been having recently: what if while everyone is focused on the current cases, it turns out that the biggest death toll will come later due to the effects of strict, economy-destroying measures? I'm not arguing for dollars here but for lives, too.
A study by researchers at Imperial College London linked 500,000 cancer deaths to the Great Recession. They found unemployment and health care cuts lead to these half a million tragedies (non paywall source mentioning this article: Chillingly, Scariest Coronavirus Death Toll May Not Come from COVID-19)
A study by University of Oxford researchers found 10,000 suicides tied to the Great Recession. That was in the US, Canada, and Europe alone.
The psychological strain of loneliness manifests physiologically, too. Harry Taylor, who studies social isolation in older adults, particularly in the black community, says that it’s one of the worst things that humans can do to their overall well-being, adding that “the mortality effect of social isolation is like smoking 15 cigarettes per day.” In older people, social isolation seems to exacerbate any preexisting medical conditions, from cardiovascular diseases to Alzheimer’s, but its ill effects aren’t limited to those over 60. (source: What Coronavirus Isolation Could Do to Your Mind (and Body))
The vulnerable today might avoid the virus (that isn't guaranteed to kill them) only to die later due to a lack of resources in hospitals caused by an economic downturn the world hasn't yet seen before. High stress can lead to cancer and other deadly diseases and health disorders. Strict isolation measures can ruin mental health and lead not only to indescribable suffering but also suicides.
All of this can be much worse than the casualties so far. It's a horrible trade-off, but that's where we are due to the failure of taking action sooner. I feel there should be a public discussion regarding what's the lesser of two evils now.
I get your point about economic effects not comparable to deaths. But what if because of a prolonged shutdown of the economy those 20 people can't find a job at all? What about their families that might now suffer hunger or enter a generational cycle of poverty? What if one of those 20 people commits suicide, unable to cope with the difficult situation? What if some of those 20 people or some of their family members get sick (after the current epidemic ends) and they can't afford treatment (cancer is a likely outcome of an extremely stressful trauma)? What if some of those 20 people need to resort to crime just to put some food on the table?
The deaths from coronavirus make headlines. Deaths from causes that can't be directly traced to it don't. Yet both are tragic and the secondary effects (the longer the lockdowns lasts, the worse) might eventually cause many more deaths (note the word "might" - I have no idea, just wanted to offer a different perspective).
I'm not arguing - just wanted to point out a different perspective which I feel is being ignored. Right now it might feel as if the world is ending but it will continue and we might have to face a much bigger death toll due to these secondary effects.
Again, I'm not taking any sides. I'm not an expert. I wouldn't want to be in a position where I have to choose which approach to follow. I too have family members that are vulnerable and I certainly don't think that it's fine for the elderly or other vulnerable people (or anyone for that matter) to die. It's a horrible trade-off either way. I'm just wondering if any countries around the world compared the short-term (still horrible) damages to the long-term effects (that might be even more horrible - or maybe not?).
Deterministic cause of death is like this. Person develops coronavirus pneumonia, person dies of coronavirus pneumonia.
Stochastic cause of death is like this. Person is isolated and practices social distancing because of covid quarantine, this person dies by suicide or cancer. These rates of suicide or cancer are higher than in the past, so we “assume” it is related.
But, these stochastic studies are extremely weak, because maybe it wasn’t the isolation at all but the effects of a massive number of people losing children, spouses, friends, and/or parents. Maybe it’s that millions develop chronic debilitating health conditions and it’s the depression they feel from not being able to live their lives the same.
Whenever I see something like “X is as bad as smoking 15 cigarettes a day”, my radar goes up. Yours should too, this is the equivalent of medical click bait.
I deal with stochastic risk all the time. For example we know that radiation exposure can increase risk of cancer because of that atomic bomb victims. What about getting a CT exam. This has been very aggressively studies to try and determine risk, and we have no absolute clear answer. There are some big studies trying to prove it, but it’s still a hugely open question.
Just look at the constantly changing recommendations about eating eggs, butter, different fats, etc... one decade they are the worst thing ever and you should avoid them at all costs. Another decade later they are the most nutritious thing Mother Nature has made and we should have them regularly in our diet. The problem is that we are trying to look at an input (E.g. eating eggs) 10 levels removed from the outcome (e.g. heart attack) and drawing a link between the two. In a complex system like the body those links are extremely hard if not impossible in most instance.
For me, personally, it is much better to base decisions on deterministic reasons (covid causes death directly in people that would not have died at that time otherwise) to fuzzy stochastic reasons (people in isolation may kill themselves, the isolation my have been a factor in them killing themselves, but there are a ton of factors also in the mix). Politicians love using stochastic risks as arguments for doing things, because they can mold the discussion, and create whatever justification they want. Their justification can neither be proven or disproven conclusively.
All that said, I think it’s valid to discuss the impacts that this cure will have on people and economies. All of life is risk, there is no living without taking and accepting risk. Literally everything we do everyday carries a risk with it. Take a shower you run the risk of falling and injury, eat a hotdog you could choke and die, drive a car you may crash and die, etc...
The goal is not to eliminate risk, but to find ways to mitigate the risk. When risk is extremely high we typically accept mitigation efforts that are very disruptive, when risks are very low we usually won’t accept any mitigation effort at all.
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