Personal Freedoms/Choices & Public Health Measures

And I think it is especially dangerous to deny people the freedom to make their own choices.

There was an excellent interview Sunday on BBC of a former Supreme Court Justice. His points included the fact that we should not imprison an entire society because some will be irresponsible.

The interview was better than the transcript, but here it is:

By the way, the SciMoms article does not do a very good job of presenting the Covid-19 mortality rate (and likely significantly overstates it due to the many asymptotic infections).

The variable of age is exceptionally important in the risk assessment. People my age and older are much more at risk than young people. The mortality rate is high in nursing homes, and that has much to do with comorbidity.

Isolating, or self-isolation of, the subset of the population that is vulnerable is much more reasonable than the one-size-fits-all rules.

Unless their choices lead to harm of others.

As it was written in March. But the point still stands. People are awful at evaluating personal risk as well as the risk that their actions have on others.

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The high end given in their figure is too high; the low end is about right, maybe a bit high.

Doing that effectively requires a lot of planning and organization, something that can’t be done in a week or two while an epidemic is out of control. That’s what a global lockdown is supposed to buy you – time to plan, stock up on supplies, start trying out different therapeutic approaches. Different countries around the world, and different states in the US, have been trying to figure out the best way to move toward a functioning economy with minimum restrictions, while still keeping the outbreak from running wild and still protecting as many as possible. Some are doing a better job than others. Regrettably, the Federal government has been largely counterproductive in these efforts.

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Yes, that is why we have speed limits and require people to pass driving tests.

But that is not the case with coronavirus. People who want to isolate can isolate. Then the isolationist will not be put at risk.

An example:
My oldest daughter has a degraded immune system. She is isolating at home with her daughter and husband. There is no personal external contact.

This isolation is her right. The National Guard will not come to her house and drag her to the Chic-fil-a.

So I have not been allowed to visit, and I am fine with that. She has freedom to control her life. And she does.

So she sent a set of criteria that my wife and I must meet in order to visit. Tough criteria. Things we would not normally do.

I am packed. We leave in the morning. It was our choice to meet the criteria. It took some time. We exercised our freedom.

—————
I live in Georgia.
Governor Kemp took a lot of body shots for opening the state early. He trusted us. He believed in our freedom.
Now the new case rate is half what it is in the US on average (cases doubling every two months in Georgia vs. cases doubling every month in the US).

That’s simply not true in many cases. Lots of people can’t stay home from work without losing their jobs. People in nursing homes can’t be isolated from those caring for them.

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The low end of SciMom’s range is likely high, when the asymptotic cases are eventually tabulated with Antibody tests.

I’m including asymptomatic cases. The infection fatality rate undoubtedly depends on the health and age of the population and on the availability of good medical care, and possibly on other factors. But the most reliable estimates I’ve seen from antibody tests imply an IFR close 1.0%.

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I agree that there are repercussions for those working people isolating. They can still isolate.

But restricting everyone is not the answer.

And many, many people have lost their jobs because they were declared “nonessential.” They did not have a choice. Their freedom was taken.

How? We don’t know how many there are.

Those taking the antibody test, as I have, are not random samples.

I took the antibody test because I passed through customs at JFK twice in early March. And a person in my tour group in Egypt in early March tested positive. And there were 24 hours on airplanes. But I have not had Covid-19.

Depends on what testing you’re talking about. Spain surveyed random households for their large seropositivity study.

Now I’m confused – they drew blood from you at the airport? And as far as I know, the FDA had not given permission for any antibody testing to be done in the US in early March. Are you sure it was an antibody test?

The antibody test I took was in late April. I took that test because of my movement through high risk areas in early March.

Ah, thanks – that makes much more sense. Yes, a big problem with the antibody tests (especially some of them) is their false positive rate. That’s why I pay the most attention to surveys of places (like NY City and Spain) that have had a lot of people exposed, since the false positives skew the results less there.

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I would be interested in seeing the numbers, especially the data on the population that has antibodies and the death count.

The treatment of comorbidity is also very important.

Mine was one of the accurate tests (according to my doctor), with a vial of blood drawn.

Here and here are two different takes on the New York results. Here is a smaller but respectable (and random) study from Germany that suggests a lower IFR. And here is some info on the Spanish study.

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I read the first study. Here is the summary:

  1. Conclusion
    The COVID-19 pandemic has a lot of uncertainty about the ratio of deaths to total infections. That confounds the calculation of how deadly the novel coronavirus is. The serology sampling in New York City and elsewhere makes estimates of infections more reliable. We estimate that the infection fatality rate (IFR) from serology studies in nine different sampling locations in the United State and Europe is on average 0.38 percent. We analyze the data from New York City in-depth to estimate that the IFR for all ages and genders in New York City was 0.85 percent. New York City is a preferable location to estimate IFR because it has one of the highest infection rates in the world. Thus, random sampling is less prone to an upward bias in false positives. In addition, New York City’s official counts are less likely to understate deaths than in other locations in the United States. We find that the infection fatality rates from New York vary a great deal by age and gender. Females ages 0 to 17 can expect infection fatality rates of 0.001 percent while males of age 75 and over can expect infection fatality rates of 9.127 percent.

Very low mortality on average.

It kills old people, with a very high mortality and much comorbidity,

Let old people with underlying conditions isolate. Set other people free.

To imprison and deny the ability to make a living to low risk demographics is shameful.

From National Geographic:

People will suffer or die from these delays.

But the deaths of NYC are with people isolating - young and old. The pandemic is going to spread like wildfire in NYC. We would see up to 5x the deaths if they just open up. With some estimated 23,000 deaths (5% of those being under 65 with no previous risk factors) we are looking at 6,000 some people dying that are in the work force with none of the listed risk factors in NYC alone. But yeah, let people do whatever they want, who cares about 6,000 people or the up to 90,000 in a risk category that could die if we let this thing go. People want to go back to life already and we shouldn’t stop their freedoms.

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The active cases in NYC are people isolating.

What data support your claim that those are the deaths?

I think there is not data to support that assertion.