Scrutable

Two minutes of insanity from the Mayor of Las Vegas

Oh

My

God

https://twitter.com/morgfair/status/125 ... 05248?s=20

shpalman wrote: Wed Apr 22, 2020 9:58 pm Interesting insight here: https://www.nytimes.com/2020/04/20/opin ... monia.html

tl;dr the covids mess up your lungs' ability to absorb oxygen, but since they still work fine for getting rid of carbon dioxide you don't consciously feel the need to breathe harder.

Yes - I bought a finger tip oximeter a couple of weeks ago. I thought I could lend it out to friends and family if any get ill as a way of knowing if and when to call the ambulance - I think that is what is being used to decide whether to bring someone in to hospital or stay at home - as the article says some people are definitely leaving it too late to call an ambulance. I'm thinking this is going to last at least a year. Hopefully it never needs to get used (although I have tried it a few times)

Stranger Mouse wrote: Wed Apr 22, 2020 10:58 pm Two minutes of insanity from the Mayor of Las Vegas

Oh

My

God

https://twitter.com/morgfair/status/125 ... 05248?s=20

Wow

It's odd how many people think Allowed to Reopen = Back to Normal.

The real mistake the Mayor makes isn't the mad control group stuff, but the belief permitting hotels, casinos and shows to reopen will mean Las Vegas will be back in business, with visitors filling those hotels, casinos and shows. In other words, the problem isn't Evil Government preventing the supply of casino entertainment, it's reluctant/impoverished humans with a lack of demand for casino entertainment.

Vegas isn't a place of easy profits, it's a highly competitive market where in normal times every hotel is fighting hard to keep occupancy levels above the breakeven point. People like to mock Trump for losing money with a casino - but it's a tough business to be in, vulnerable to recessions. Vegas hotels will be running at a loss for the next couple of years, even if they are completely free to reopen, and capitalism generally avoids running at a loss.

The same applies to UK pubs, restaurants, B&Bs, theatres, cinemas, tourist shops - they'd prefer to mothball for a year and get government rent relief plus furloughing staff, rather than be free to reopen without government subsidy. Even in normal times, the breakeven point is never far away and business failures are commonplace, with normal recessions every few years adding to the regular cull.

They changed the law yesterday when we weren't looking. Now illegal to remain outside your home without a good reason

https://davidallengreen.com/2020/04/the ... oncerning/

(Moving my post to treatment thread.)

lpm wrote: Thu Apr 23, 2020 10:28 am
The same applies to UK pubs, restaurants, B&Bs, theatres, cinemas, tourist shops - they'd prefer to mothball for a year and get government rent relief plus furloughing staff, rather than be free to reopen without government subsidy. Even in normal times, the breakeven point is never far away and business failures are commonplace, with normal recessions every few years adding to the regular cull.

I wonder if we're going to see some big changes to the rental values of commercial properties in the next while. For places like pubs and restaurants, I would guess that costs like wages, food and drink, and taxes all broadly scale with turnover, at least to a first approximation. So for them to remain viable while maintaining social distancing, what needs to come down are the fixed costs like the rents.

AMS wrote: Thu Apr 23, 2020 3:28 pm

lpm wrote: Thu Apr 23, 2020 10:28 am
The same applies to UK pubs, restaurants, B&Bs, theatres, cinemas, tourist shops - they'd prefer to mothball for a year and get government rent relief plus furloughing staff, rather than be free to reopen without government subsidy. Even in normal times, the breakeven point is never far away and business failures are commonplace, with normal recessions every few years adding to the regular cull.

I wonder if we're going to see some big changes to the rental values of commercial properties in the next while. For places like pubs and restaurants, I would guess that costs like wages, food and drink, and taxes all broadly scale with turnover, at least to a first approximation. So for them to remain viable while maintaining social distancing, what needs to come down are the fixed costs like the rents.

And business rates. In Oxford the rates recalculation and general high level, have highly contributed to many shops and businesses folding. Especially independent ones.

Today Italy reports more people "cured" of the virus (3033) than new positives (2646). 66658 swabs were performed.

It's certainly valid to claim that the number of new cases here hasn't been going down as much as it should over the past month since the number of swabs per day has generally kept increasing. Or rather, the number of cases during the exponential increase was underestimated since there wasn't the testing capacity to keep up.

With respect to the peak there are about half as many patients in intensive care now (2267 vs. 4068 on the 3rd of April) and about 6000 fewer patients in non-intensive care (22871 vs. 29010 on the 4th of April).

JQH wrote: Wed Apr 22, 2020 1:35 pm

Gfamily wrote: Wed Apr 22, 2020 1:31 pm

JQH wrote: Wed Apr 22, 2020 1:17 pm "What about fat people?"

"Old people would have died anyway!"

Jeez ...

You saw the "people age 50 should only count as 0.5" comment

I did indeed. I wonder what I would rate as a retiree in my 60s?

We know Cummings allegedly regarded pensioners as expendable so possibly the answer is 0.

Sorry, but that's the way the world works. On any coldly rational perspective, young people are worth more than old people. Healthcare is, must be, always has been, and always will be, rationed. As Phil Hammond points out in Private Eye, NICE sets a cost-effectiveness threshold for treatment of £25,000 per QALY. If you haven't got many QALYs left, no-one's going to spend money to treat you. That's reality.

If the lockdown costs 5% of a year's GDP (likely to be an underestimate), then I calculate we need to save 6 million QALYs. If everyone in the UK gets it with a 1% chance of death, then each death averted needs to give 10 QALYs. It's not at all clear that the lockdown is coldly cost-effective.

Have we hit peak stupid from Donald Trump?

Following a briefing from someone who told him that UV and disinfectant (bleach and IPA (Not the beer)) are good at killing the virus he actually suggested either getting UV inside the body or injecting disinfectant as potential cures...

FlammableFlower wrote: Fri Apr 24, 2020 6:45 am Have we hit peak stupid from Donald Trump?

Following a briefing from someone who told him that UV and disinfectant (bleach and IPA (Not the beer)) are good at killing the virus he actually suggested either getting UV inside the body or injecting disinfectant as potential cures...

I had just read that m'self, and couldn't decide which quote to high-light, it's a friday special.
Peak stupid? Maybe the start of a l-o-n-g gentle arc.

tenchboy wrote: Fri Apr 24, 2020 7:07 am

FlammableFlower wrote: Fri Apr 24, 2020 6:45 am Have we hit peak stupid from Donald Trump?

Following a briefing from someone who told him that UV and disinfectant (bleach and IPA (Not the beer)) are good at killing the virus he actually suggested either getting UV inside the body or injecting disinfectant as potential cures...

I had just read that m'self, and couldn't decide which quote to high-light, it's a friday special.
Peak stupid? Maybe the start of a l-o-n-g gentle arc.

The US government continues its longstanding policy of flattering the perv.

Tricky to know which thread to discuss it in. Impeachment thread? Trump is ill thread? General Covid thread?

I think it should be in Treatments thread in the Nerd forum. Deserves a proper in-depth analysis as it seems very promising.

He'll flat out deny having said it anyway.

Sciolus wrote: Fri Apr 24, 2020 1:38 am Sorry, but that's the way the world works. On any coldly rational perspective, young people are worth more than old people. Healthcare is, must be, always has been, and always will be, rationed. As Phil Hammond points out in Private Eye, NICE sets a cost-effectiveness threshold for treatment of £25,000 per QALY. If you haven't got many QALYs left, no-one's going to spend money to treat you. That's reality.

If the lockdown costs 5% of a year's GDP (likely to be an underestimate), then I calculate we need to save 6 million QALYs. If everyone in the UK gets it with a 1% chance of death, then each death averted needs to give 10 QALYs. It's not at all clear that the lockdown is coldly cost-effective.

Another back of the envelope calculation, coming to the conclusion that the lockdown is cost effective

Sciolus wrote: Fri Apr 24, 2020 1:38 am

JQH wrote: Wed Apr 22, 2020 1:35 pm

Gfamily wrote: Wed Apr 22, 2020 1:31 pm

You saw the "people age 50 should only count as 0.5" comment

I did indeed. I wonder what I would rate as a retiree in my 60s?

We know Cummings allegedly regarded pensioners as expendable so possibly the answer is 0.

Sorry, but that's the way the world works. On any coldly rational perspective, young people are worth more than old people. Healthcare is, must be, always has been, and always will be, rationed. As Phil Hammond points out in Private Eye, NICE sets a cost-effectiveness threshold for treatment of £25,000 per QALY. If you haven't got many QALYs left, no-one's going to spend money to treat you. That's reality.

If the lockdown costs 5% of a year's GDP (likely to be an underestimate), then I calculate we need to save 6 million QALYs. If everyone in the UK gets it with a 1% chance of death, then each death averted needs to give 10 QALYs. It's not at all clear that the lockdown is coldly cost-effective.

I don't have access to the Yee*, can you point me to a slightly more formal reference for that 25k GBP figure? Is there a comparison across countries anywhere? It is also interesting to contrast the price of QALYs and the price per life saved/economic loss averted for interventions on the roads and railways.

If necessary, open a derail thread on QALYs

*Grauniad in-joke

Sciolus wrote: Fri Apr 24, 2020 1:38 am

JQH wrote: Wed Apr 22, 2020 1:35 pm

Gfamily wrote: Wed Apr 22, 2020 1:31 pm

You saw the "people age 50 should only count as 0.5" comment

I did indeed. I wonder what I would rate as a retiree in my 60s?

We know Cummings allegedly regarded pensioners as expendable so possibly the answer is 0.

Sorry, but that's the way the world works. On any coldly rational perspective, young people are worth more than old people. Healthcare is, must be, always has been, and always will be, rationed. As Phil Hammond points out in Private Eye, NICE sets a cost-effectiveness threshold for treatment of £25,000 per QALY. If you haven't got many QALYs left, no-one's going to spend money to treat you. That's reality.

If the lockdown costs 5% of a year's GDP (likely to be an underestimate), then I calculate we need to save 6 million QALYs. If everyone in the UK gets it with a 1% chance of death, then each death averted needs to give 10 QALYs. It's not at all clear that the lockdown is coldly cost-effective.

In addition to the other points, as lpm has argued, the choice isn't between a lockdown and business as usual. Its between a government enforced lockdown and voluntary social isolation by businesses and individuals. As we saw in the week before the UK lockdown, people stopped going out and venues closed anyway. A voluntary lockdown would probably be less effective that a state imposed lockdown though.

So the counterfactual isn't business as usual. Working out the economic effects of the government enforced lockdown compared to a voluntary one would be complex.

an you point me to a slightly more formal reference for that 25k GBP figure?

https://www.nice.org.uk/process/pmg6/ch ... ectiveness

It's a bit fiddlier: £25k-£30k depending on, stuff.

This (para 5.1.13) looks like an example of the £25k (actually 20-30 range) but I haven't read it properly to be sure of its meaning and interpretation.

Also, I wouldn't place too much weight on a calculation done in two minutes at three in the morning by someone in the throes of insomnia.

whoops. Typo. Yes £20k-£30k, with a fast track for under £10k as it goes

Ta johnjohn, better link found faster. Interestingly, this article claims (without links, natch) that those generous, open-handed bleeding-heart softies at the Home Office use £80k per QALY.

Sciolus wrote: Fri Apr 24, 2020 1:38 am

JQH wrote: Wed Apr 22, 2020 1:35 pm

Gfamily wrote: Wed Apr 22, 2020 1:31 pm

You saw the "people age 50 should only count as 0.5" comment

I did indeed. I wonder what I would rate as a retiree in my 60s?

We know Cummings allegedly regarded pensioners as expendable so possibly the answer is 0.

Sorry, but that's the way the world works. On any coldly rational perspective, young people are worth more than old people. Healthcare is, must be, always has been, and always will be, rationed. As Phil Hammond points out in Private Eye, NICE sets a cost-effectiveness threshold for treatment of £25,000 per QALY. If you haven't got many QALYs left, no-one's going to spend money to treat you. That's reality.

If the lockdown costs 5% of a year's GDP (likely to be an underestimate), then I calculate we need to save 6 million QALYs. If everyone in the UK gets it with a 1% chance of death, then each death averted needs to give 10 QALYs. It's not at all clear that the lockdown is coldly cost-effective.

Not disputed. But we're not talking about who gets treatment; I've never been in any doubt that if I were hospitalised with covid19 I would not be a priority for treatment.

What we're talking about here was the frantic BTL attempts to make the actual death toll seem smaller than it actually is.

Ta johnjohn, better link found faster. Interestingly, this article claims (without links, natch) that those generous, open-handed bleeding-heart softies at the Home Office use £80k per QALY.

...they may for all I know. The ways QALYs are calculated are not straightforward or uncontested (see recent controversies on EQ-5D calue sets). Most social care would be several times threshold and never funded if same criteria were applied as for health. Whatever, I'm not close to this, I just appreciate back of the envelope calculations which can often end up close to the conclusions of months of analysis.

Sciolus wrote: Fri Apr 24, 2020 10:10 am Ta johnjohn, better link found faster. Interestingly, this article claims (without links, natch) that those generous, open-handed bleeding-heart softies at the Home Office use £80k per QALY.

I think the reference to £80K per QALY relates to "the Home Office £80,000 valuation of a crime-related QALY" as recorded in a 2009 House of Commons Health Committee on Alcohol
https://publications.parliament.uk/pa/c ... 51we24.htm (section 7.5)