COVID Era: Updating On Life Risks

post by jmh · 2021-11-29T17:27:28.354Z · LW · GW · 2 comments

This is a question post.

I've been struggling in posing the questions/thoughts I am currently having an written, then deleted, a few versions of this question post. I've decided I will just keep it simple and just offer some illustrative examples that I hope extend into a more complex, realistic setting.

I was wondering about the impact of the pandemic on life expectancy. Looks like we've lost about 15 years of gains and the current estimates are about what were held in 2005.  One might then ask "Why are we not living our lives as if it were 2005 rather than as we are now?" One answer might just be that our life risks are not what they were in 2005 -- they are MUCH worse so we have to take more extraordinary steps. The other might be that we're only able to use that 2005 baseline in the context of the current risk controls. But at some point we still need to accept that the risk profile to being alive now is different that it was prior to the pandemic and I don't think it's going back to what it was before. The virus is here to stay as part of the territory but it seems like many want to apply maps that are more fitting to the pre-pandemic territory.

To put this in a slightly different light, consider motor vehicle transportation. We know it kills some people. It seems we have some risk control social rules but they seem rather light and in many ways more about coordination than outright risk mitigation. They seem just different than how the risks from COVID are getting managed. That seems to be true of other disease risk mitigation compared to COVID as well.  Mostly we seen to let people individually and privately (as opposed to large public policy) manage the risks while socially producing the infrastructure that deals with the risk events -- hospital emergency room, EMV response and the like -- and that is balanced with the volume of events occurring. Supply and Demand equilibration as it were. We don't seem to really be going in that direction though. 

Even though it seems we're getting closer to entering the 3rd year of the pandemic the discussion seems to be on public policy on controlling the risk exposure by individuals and not on social infrastructure to dealing with the new, riskier world we're in. 

Going back to the life expectancy is now 2005, what might be a reasonable live risk profile expectations to hold for the new COVID world and how does the way our public choice policies on living activities match up with that period of time? Take a hypothetical and say all in all the life risk profile is pretty much that of 1950 and using travel (admittedly a problematic topic) as a metric, do the existing public policies produce a similar level or travel as was present and expected in that period? Are people generally choose a similar level or travel and interaction on their own as the general statistic of that time might show? Obviously that is not a pure apples to apples type of comparison so some control related to travel patterns given concern of disease transmission is needed but the basic question should be valid. Assuming the social distribution for risk tolerance is pretty stable how well to the two response pictures fit with the (assumed) similar risk profile confronted.

A quick switch to the issue of travel and travel restrictions at this point. South Africa as said it is being punished for being the first country to report the omicron variant. It seems that might not be a bad assessment given just how many places have already confirm they have the new virus. Are there two aspects here. One is at outset does travel restrictions, quarantine response, work best but once a pandemic has occurred is it a really poor tool? I would think that once the virus has spread globally restricting travel is rather pointless unless one thinks a) one can keep the virus out and eliminate it entirely in the isolated region and b) one is prepared to remain isolated from the world until the virus is completely eliminated by the rest of the world.

Related, do travel restrictions based on a newly emerging version of the virus actually prevent that mutation from occurring elsewhere? It seems that some of the thinking here is that such mutations are purely random and extremely low probability so effectively 0 chance of a mutation occurring in some location ever occurring in some other place. That seems questionable. I would think that mutations, while being somewhat random, are also limited by both the structure of the virus and its genome which would then greatly reduce the number of purely random changes one can imagine just based on simple chemical reactions and genomic error. Similarly, the mutations also seem to occur within the host and while everyone is a bit different it would seem that the similarity of individuals of a species is the critical aspect for mutation events. Same virus, same environment and probably trillions of chances a day do we really think the specific version only traces to a single infected person? Not sure but seems worth asking.

Second to that, given the problem of identification time lags it seems that the costs of discouraging first/rapid reporting may well outweigh the cost of dealing with the new version given we already have the general virus in circulation. This also seems to point to controlling the risk exposure by people though public policy or focus on infrastructure dealing with outcomes, and perhaps mitigating the severity of the outcome, while letting individuals manage their own risk exposure.

 

Just quick update with link to NIH article about this history or quarantines. Some interesting points to note. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3559034/

Answers

answer by NormanPerlmutter · 2021-11-30T06:20:40.786Z · LW(p) · GW(p)

I am skeptical of the claim that a substantially new risk profile is here to stay for the long term. The best reference case we have for this pandemic, I think, is the flu pandemic from 100 years ago. At that time we had no vaccines for the pandemic, and furthermore the flu mutates much more easily than covid. Nonetheless, the pandemic was pretty much over in two years or so.  Not because there was no flu left in the world, but because humans developed enough immunity to this especially virulent flu that it reduced back to the threat level fo the flus that had been around for many years prior. I expect that something similar will happen with covid. Over the next year or two, humans will continue to develop immunity through vaccination and through infection. Technology for covid treatment will also continue to progress. Covid will stick around indefinitely, but after a couple years it will not present too much larger risk than the coronaviruses that have been around for a long time. Maybe a bit larger but not like it is now.

That being said, there is still the question of whether a couple years is too long to wait before returning to a more normal life. I think it is probably too long, and now that I have gotten my booster I am planning to mostly return to a normal life as best I can, as long as Omicron doesn't get too bad. The world at large will not return to normal for a while most likely, but as individuals we can decide what risks we are personally willing to take. Eventually ordinary people and politicians will be tired of all the protective measures and move back to a world substantially similar to 2019, at least in most countries. (My prediction for "eventually" is 75% probability within the next 4 years, 50% within the next 2 years, though I'd have to operationalize the claim better to make that a serious prediction.)

The comparison to the mortality rate of 2005 or 1950 doesn't feel quite right either. That is just looking at the overall mortality rate, but the distribution of mortality has changed as well. I'm fairly certain that compared to 2005 there is way more mortality in developed countries due to infectious diseases that can be spread by asymptomatic people through casual social contact. The particular preventative measures in place are moderately effective at preventing that particular type of mortality. Possibly compared to 1950 as well, though I'm not sure, we've made a lot of progress against infectious disease since 1950 [LW · GW].

Would we be better off as a society if we dropped the covid prevention measures and focused all those resources on preventing other causes of mortality such as cardiovascular disease? Quite possibly so, but unfortunately we're not well enough coordinated to do that.

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comment by Florin (florin-clapa) · 2021-11-30T02:28:04.787Z · LW(p) · GW(p)

Mild pandemic = mild policy response