Read on Twitter
*** Please read the entire thread before responding! ***
What is a tolerable level of deaths from COVID-19?
*** Please read the entire thread before responding! ***
/1
What is a tolerable level of deaths from COVID-19?
*** Please read the entire thread before responding! ***
/1
In the absence of an effective vaccine, or lasting immunity, I think that we are going to have to face up to this question.
I am aware that some of what follows may appear to be insensitive. That is not my intention, and I apologise if it upsets anyone.
/2
I am aware that some of what follows may appear to be insensitive. That is not my intention, and I apologise if it upsets anyone.
/2
First, a definition: By "tolerable" I don't mean "acceptable", or that if we got to any particular number we shouldn't try to reduce it. I mean, "what level of deaths could each of us live with?" (or perhaps "would society learn to live with") /3
For example, if you live in a Western country, there are probably between 3 and 10 deaths on the roads per 100,000 people each year. That's not "acceptable", and we mostly like measures that reduce that number, but most of us tolerate it. /4
So let's say that we know that COVID-19 is going to be around for 5 more years. We can do nothing, or we can have lots of mini lockdowns, or fewer major lockdowns, or maybe we can try and shield the vulnerable, or perhaps there's another solution. But at what cost? /5
I ask this question for two reasons. First, whatever solution you advocate, you need some measure of whether it succeeds or not. In particular, the more laissez-faire people need to tell us what level of extra deaths they find acceptable to save the economy certain freedoms. /6
Second, though, those of us who are more cautious also need to accept that (again, absent a good vaccine) deaths are not going to go down to zero, and COVID-19 will, at best, become just another healthcare system problem, like cancer. /7
As the measure, I propose the percentage excess in all-cause mortality above the five- or ten-year average. This will, hopefully, minimize the "most victims are old and would have died anyway" (or, conversely, "lots of people die without a test") arguments. /8
I'm aware that counting only deaths is a substantial oversimplification. A better model would include long COVID, organ damage, and the sheer terror of feeling like you can't breathe. But there are intangibles in the cost of lockdowns too, so this is my compromise for now. /9
With all that said, here is my number. I think that, if COVID-19 could be brought to a steady (non-exponential) state, we could - or, perhaps, "would, in practice" - tolerate perhaps 2% excess all-cause annual mortality over a five-year period. /10
In the UK, a little over 10,000 people die each week. 2% excess would be like an extra week per year. That's 10,000 COVID-19 deaths, among people who wouldn't have died in that year anyway --- and more, if you include the very frail who would have died that year. /11
This number sounds horrible; again, I am not advocating it as acceptable. But I think it could be *tolerated*. It would allow politicians to concentrate on the many other things they need to get done. It would hopefully not overwhelm hospitals or lead to PTSD among ICU staff. /12
OK, so I've made my pitch. I'm not going to ask _everyone_ to give their "tolerable" number; I suspect that for a lot of people it will be zero, and that's fine - in fact we need people in the debate who will neither accept nor tolerate any number of deaths from COVID-19. /13
But what I am asking is, specifically, for those people who want laxer measures than their government is currently putting in place to state, along with their demands to "open the economy" or "just shield the vulnerable", what they consider a tolerable cost to achieve that. /14
You can say any number you like, but own it. If you think a million excess deaths is tolerably, go for it. But don't pretend that there won't be any. Own your ideas, and their consequences. /15
(I'm aware that some people at the more radical end of that type of argument will claim that there are more deaths due to lockdown than to COVID-19. If you have proof of those, bring it, and you can deduct them from your tolerable cost. If you're just handwaving, go away.) /16
OK, this is the end of the thread. Some people may call me inhuman for raising the subject or suggesting 2%, some may consider me a hopeless optimist. But I think that at some point the conversation will need to be had. /17 /end
