Acute risks vs chronic risks

[sheldrake]

The risks and mitigations need to be considered on the same time scale for any comparison to make sense.

For covid, part of the worry was precisely the acute nature of the risk - overwhelmed hospitals and sudden mass mortality are more disruptive than spreading the illness and death over, say, a decade. Many of the consequences are nonlinear.

So, for example, you'd want to be comparing annual risks and annual precautions, especially as we don't know how long countries will be keeping vaccine passports (my guess is till after the winter, but then scrapping them if we get through ok).

Note that for driving there are a huge amount of preventative measures, from licences to use them in public, alcohol and drug restrictions, MOTs for vehicles, signs and lights absolutely everywhere, and so on. Freedom is massively curtailed for public safety.

I'm going to focus more on the future than the past here. I don't think that freedom is curtailed as much for driving risk as is being proposed for Covid risk. Imagine if you had to check in on some smartphone app and get permission to drive more than 5 miles from your home? that might massively reduce driving deaths, but I'd say it was excessive as it would affect a lot of people most days. That seems like a closer parallel to covid passports to enter place of work etc..

[bagpuss]

An argument I made in the other thread was that I think IFR for Covid is a good proxy for lifetime risk of death for the unvaccinated as it has a very low mutation rate (paper was cited) and the immunity you get from surviving it once is very strong (very small risk of reinfection, and the reinfected very rarely need hospital care or die). That argument may be wrong and it's worth exploring further.

You didn't actually present an argument - you simply made the claim. And the relevance of the "lifetime risk of death" from COVID when deciding what precautions to take during a wave of the pandemic is unclear.

You also then tried to compare it with a number that I think was supposed to be the IFR equivalent for cancer (although the thread was locked before I was able to ask you to clarify what the stat actually was), which doesn't make sense as you were not taking into account the likelihood of getting the disease in the first place.

[sheldrake]

You didn't actually present an argument - you simply made the claim.

That's untrue, I cited papers giving data in support.

[sheldrake]

You also then tried to compare it with a number that I think was supposed to be the IFR equivalent for cancer (although the thread was locked before I was able to ask you to clarify what the stat actually was), which doesn't make sense as you were not taking into account the likelihood of getting the disease in the first place.

Somebody else introduced the IFR equivalent for cancer and I simply used their figure to illustrate a point. The actual figure isn't super relevant for tha particular conceptual discussion. Although I think it's much more likely cancer will get most of us than covid, even if we're unvaxxed.

[bagpuss]

The risks and mitigations need to be considered on the same time scale for any comparison to make sense.

For covid, part of the worry was precisely the acute nature of the risk - overwhelmed hospitals and sudden mass mortality are more disruptive than spreading the illness and death over, say, a decade. Many of the consequences are nonlinear.

So, for example, you'd want to be comparing annual risks and annual precautions, especially as we don't know how long countries will be keeping vaccine passports (my guess is till after the winter, but then scrapping them if we get through ok).

Note that for driving there are a huge amount of preventative measures, from licences to use them in public, alcohol and drug restrictions, MOTs for vehicles, signs and lights absolutely everywhere, and so on. Freedom is massively curtailed for public safety.

I'm going to focus more on the future than the past here. I don't think that freedom is curtailed as much for driving risk as is being proposed for Covid risk. Imagine if you had to check in on some smartphone app and get permission to drive more than 5 miles from your home? that might massively reduce driving deaths, but I'd say it was excessive as it would affect a lot of people most days. That seems like a closer parallel to covid passports to enter place of work etc..

But that would be a ridiculous and pointless requirement (given the oft-recited stat that most accidents take place within 5 miles of home) so of course it would be excessive. Any mitigation that is some kind of apparently random restriction rather than something tailored to address the greatest risks, is always going to be excessive. The two things might be close parallels in your mind but they're not in mine and I suspect wouldn't be in most other people's minds.

[bagpuss]

You also then tried to compare it with a number that I think was supposed to be the IFR equivalent for cancer (although the thread was locked before I was able to ask you to clarify what the stat actually was), which doesn't make sense as you were not taking into account the likelihood of getting the disease in the first place.

Somebody else introduced the IFR equivalent for cancer and I simply used their figure to illustrate a point. The actual figure isn't super relevant for tha particular conceptual discussion. Although I think it's much more likely cancer will get most of us than covid, even if we're unvaxxed.

It really is relevant if the risks are in the opposite direction to the one you were claiming. I'm not saying they are but it is definitely relevant.

[sheldrake]

But that would be a ridiculous and pointless requirement (given the oft-recited stat that most accidents take place within 5 miles of home) so of course it would be excessive. Any mitigation that is some kind of apparently random restriction rather than something tailored to address the greatest risks, is always going to be excessive. The two things might be close parallels in your mind but they're not in mine and I suspect wouldn't be in most other people's minds.

The vast majority of covid deaths happen in people over the age of 70 who are already stricken with another life-threatening condition, so I don't agree these things are as divergent as you think,

[bob sterman]

You didn't actually present an argument - you simply made the claim.

That's untrue, I cited papers giving data in support.

You made the claim that current estimates of the IFR for COVID are a good "proxy" for the "lifetime risk of death" from COVID.

And you cited a paper on reinfection risk 1 year after primary infection, and something from June 2020 about how we don't have to worry about vaccine evading mutations too much (from June 2020 - before anyone had heard of Alpha, and Delta).

[bob sterman]

But that would be a ridiculous and pointless requirement (given the oft-recited stat that most accidents take place within 5 miles of home) so of course it would be excessive. Any mitigation that is some kind of apparently random restriction rather than something tailored to address the greatest risks, is always going to be excessive. The two things might be close parallels in your mind but they're not in mine and I suspect wouldn't be in most other people's minds.

The vast majority of covid deaths happen in people over the age of 70 who are already stricken with another life-threatening condition, so I don't agree these things are as divergent as you think,

Not sure all those folks in their 70s out playing golf with their high-blood pressure, diabetes and high cholesterol think of themselves as "stricken" and not worth protecting.

The fact is most risk factors for bad outcomes with COVID are comorbidities that are very common in the older population.

[sheldrake]

You didn't actually present an argument - you simply made the claim.

That's untrue, I cited papers giving data in support.

You made the claim that current estimates of the IFR for COVID are a good "proxy" for the "lifetime risk of death" from COVID.

And you cited a paper on reinfection risk 1 year after primary infection, and something from June 2020 about how we don't have to worry about vaccine evading mutations too much (from June 2020 - before anyone had heard of Alpha, and Delta).

We have Israeli data on reinfection from Delta, and I posted another paper about the mutation rate being more comparable to measles than flu.

[plodder]

I mean you guys know there is a National Risk Register where the hard sums have been done and the risks prioritised, right?

https://assets.publishing.service.gov.u ... -FINAL.pdf

So perhaps a more focussed and useful conversation (as opposed to what's in sheldrake's navel this morning) might be to critique the methodology used here?

[sheldrake]

I mean you guys know there is a National Risk Register where the hard sums have been done and the risks prioritised, right?

https://assets.publishing.service.gov.u ... -FINAL.pdf

So perhaps a more focussed and useful conversation (as opposed to what's in sheldrake's navel this morning) might be to critique the methodology used here?

Their highest risk category starts at '1000 deaths in the next year', and their only timescale is 'in the next year'. That's not really a sign of super thoughtful maths in my view. It's exactly he kind of thinking that leads to panic over a disease that kills 0.x% of people who catch it vs tough enforcement action against the food industry putting all kinds of heart-disease inducing transfats and unnecessary salt and sugar in good. The latter would probably save more lives but it's not kind of thing that forms the subject of a Hollywood disaster movie.

[plodder]

I mean you guys know there is a National Risk Register where the hard sums have been done and the risks prioritised, right?

https://assets.publishing.service.gov.u ... -FINAL.pdf

So perhaps a more focussed and useful conversation (as opposed to what's in sheldrake's navel this morning) might be to critique the methodology used here?

Their highest risk category starts at '1000 deaths in the next year', and their only timescale is 'in the next year'. That's not really a sign of super thoughtful maths in my view. It's exactly he kind of thinking that leads to panic over a disease that kills 0.x% of people who catch it vs tough enforcement action against the food industry putting all kinds of heart-disease inducing transfats and unnecessary salt and sugar in good. The latter would probably save more lives but it's not kind of thing that forms the subject of a Hollywood disaster movie.

from the intro "The NRR provides information on the most significant risks that could occur in the next two years and which could have a wide
range of impacts on the UK."

So, you know, dur.

eta hang on, are you saying all policy should be subject to a risk assessment?

[lpm]

covid passports to enter place of work

You keep repeating this one. What on earth country is proposing this?

[sheldrake]

covid passports to enter place of work

You keep repeating this one. What on earth country is proposing this?

It's happening in the US and I think our current government are mendacious enough to start with 'it's just nightclubs' then expand the use over time. Once it exists, individual workplaces will also try it on (particularly certain US corporations)

[bagpuss]

But that would be a ridiculous and pointless requirement (given the oft-recited stat that most accidents take place within 5 miles of home) so of course it would be excessive. Any mitigation that is some kind of apparently random restriction rather than something tailored to address the greatest risks, is always going to be excessive. The two things might be close parallels in your mind but they're not in mine and I suspect wouldn't be in most other people's minds.

The vast majority of covid deaths happen in people over the age of 70 who are already stricken with another life-threatening condition, so I don't agree these things are as divergent as you think,

Do people over the age of 70 with other life-threatening conditions not go out*?

And even the ones that don't, they're the equivalent of the passengers and pedestrians and cyclists and others who are protected by drivers needing to be trained and registered and cars needing to be maintained to a level of safety.





*Here is a clue in case you're not sure - I have 2 close family members well over 70 with underlying conditions. Both go out to places where covid passports might be needed.

[sheldrake]

eta hang on, are you saying all policy should be subject to a risk assessment?

Not that, but I'm suggesting that we should be looking at longer timescales when creating our hierarchy of risks. I believe that focussing on 'acute' things often triggers alarmist, heavy-handed responses.

[sheldrake]

Do people over the age of 70 with other life-threatening conditions not go out*?

They can get vaccinated and if still worried mask up, can't they? Do you feel that doesn't reduce the risk sufficiently without requiring all of the young healthy people around them to be subjected to IDs etc.. ?

[bagpuss]

Do people over the age of 70 with other life-threatening conditions not go out*?

They can get vaccinated and if still worried mask up, can't they? Do you feel that doesn't reduce the risk sufficiently without requiring all of the young healthy people around them to be subjected to IDs etc.. ?

But I'm a safe driver and don't drive too fast and look after my car so why should I have to worry about MOTs and observing speed limits when I think they're too restrictive?

We have these rules and restrictions to protect everyone and we mostly willingly submit to them so that we can have the convenience of driving. If we don't like it, we don't drive (except the idiots who will anyway, but there are always some t**ts). Same for covid passports and going out.

And that's without getting into the fact that the biggest benefit of a mask is to protect others, not the wearer.

[sheldrake]

But I'm a safe driver and don't drive too fast and look after my car so why should I have to worry about MOTs and observing speed limits when I think they're too restrictive?

I don't think that represents an equivalent risk reduction.

[bagpuss]

But I'm a safe driver and don't drive too fast and look after my car so why should I have to worry about MOTs and observing speed limits when I think they're too restrictive?

I don't think that represents an equivalent risk reduction.

I wasn't saying that it does. Just making the point that there are many rules that apply across the board even though not all people are equally at risk of either being impacted or impacting others.

[shpalman]

covid passports to enter place of work

You keep repeating this one. What on earth country is proposing this?

Italy, as of a few days ago.

[lpm]

covid passports to enter place of work

You keep repeating this one. What on earth country is proposing this?

It's happening in the US and I think our current government are mendacious enough to start with 'it's just nightclubs' then expand the use over time. Once it exists, individual workplaces will also try it on (particularly certain US corporations)

It's not happening in the US. I don't think you understand how US government works.

[dyqik]

You keep repeating this one. What on earth country is proposing this?

It's happening in the US and I think our current government are mendacious enough to start with 'it's just nightclubs' then expand the use over time. Once it exists, individual workplaces will also try it on (particularly certain US corporations)

It's not happening in the US. I don't think you understand how US government works.

Yeah, that's not what's happening in the US. The requirements in the latest executive order is "vaccination or weekly testing" as a health and safety requirement for employees that applies to businesses with more than 100 employees. US wide vaccination orders are for Federal government only, which is the employer requiring it of its employees.

It's not a CoVID passport, either. It's a one time proof of vaccination submitted to the employer, or taking part in the weekly testing program. It's a trivial thing, significantly less onerous than the mandated annual safety trainings for office workers.

[lpm]

covid passports to enter place of work

You keep repeating this one. What on earth country is proposing this?

Italy, as of a few days ago.

Italy is mad. It won't happen though.