Hey what's up it's ya boy, back with another analysis. I'm trying something new and going more detailed than my usual stuff. Here it goes.

THE TRADE-OFFS WE FACE DURING THE COVID-19 PANDEMIC.

This thread focuses on the trade-offs we face today due to the pandemic. The thread itself is concise and to the point, but I will leave references which can also be a reading list for you. This time, I also included some appendices for more detailed explanations of some parts.

TL;DR

1) The current situation is forcing doctors to make tough decisions which can be as difficult as deciding which patients will live and which patients will die. This can weigh heavy on the doctors who have to do this a lot on a daily basis.

2) If you were wondering which is better at saving more lives: lockdown vs no lockdown, the answer is yes lockdown.

3) If you were wondering which is better economically in the long term: lockdown vs no lockdown, the answer is still yes lockdown.

4) Through models, we expect a second wave of infections once the lockdown is lifted. So intuitively, the ideal situation is to wait for the first wave to die down and give hospitals a bit of time to prepare for the second wave before lifting.

5) After all this mess is done, we need to help the losers of the tradeoffs we had to make, most especially those who suffered economically due to the lockdown. These are mostly the unemployed, which is forecasted to shoot through levels worse than the 2008 financial crisis.

SO. This thread is divided into two main parts: first, we will talk about the two main kinds of trade-offs we have to deal with (medically and economically) and what they imply. Second, I will examine America’s handling of the crisis and what we can learn and imply from it.

MEDICAL TRADE-OFFS

The concept of a triage was first conceptualized by a French military surgeon named Dominique-Jean Larrey [1]. It was a system of segregating and prioritizing medical attention and resources to wounded troops with the highest chance of survival.

It is necessary but can feel hard hearted.

Doctors are doing the same thing right now considering the surge of patients and the lack of supplies. [2]

Imagine you have two patients in need of a ventilator but you only have one, the decision on who to give it to usually flows like this:

1) First rule of thumb is to give the supplies to the person with the highest chance of survival.

2) If both have an equal chance, give it to the person who is more likely to live longer once recovered. [3]

These decisions had to be made by doctors everyday and at quantities big enough to break them down emotionally.

These choices are further complicated by certain realities relating to Covid-19, of which I will highlight three:

1) Ventilators are necessary when combating a severe case of the virus.

2) Ventilators are tough on the body. Frail and old bodies cannot sustain the stress from a ventilator for more than 3 weeks.
3) Patients on a ventilator truly need it and when taken away from them, they will die within minutes. [3]

These realities can lead to decisions devastating to morale.

For example, if a young patient arrives and is in need of a ventilator, under the triage rule of thumbs, it is better to take a ventilator being used by an older patient and transfer it to the young because: 1) the young has more chances of surviving the virus,

2) the young has more chances of surviving the stress of the ventilator, and 3) the young, once recovered, will live a longer life. While ethically reasonable, it is burdensome to basically kill the older patient. [4]

ECONOMIC TRADE-OFFS

It can feel wrong to discuss economics when there’s thousands of people dying from the pandemic out there. However, the very fact that the numbers are that high is the very reason why it is necessary.

To manage and fight an enemy with this scale, we need to strategize.

The main trade-off economically is in knowing which is worse: the cure or the problem; the cure being putting everything in lockdown and the economy is in a coma.

To keep it fair, we will look at two scenarios: 1) no lockdown, versus 2) with a lockdown. To understand the rationale behind the pros and cons, I delved into one of the most common epidemiological models (the SEIR model) in Appendix A.

1) No lockdown.
PROS
- The pandemic would’ve been over sooner.
- The economy would’ve kept going.
CONS
- 1 million more people will die (number based on America. This is 458% more than the worst estimate with a lockdown). [20]

2) Lockdown.
PROS
- A 78% reduction in deaths. [20]
CONS
- A second wave of infection is expected once the lockdown is lifted.
- The economy is in a coma.

Looking at the pros and cons, it’s clear that the amount of lives saved is enough to convince that “yes lockdown” is a better option.

But even if you crunch the numbers and calculate the lifetime cost to the economy of losing that many people, it still shows that “yes lockdown” is a better option. The calculations for this is detailed in Appendix B.

But one crucial note: there’ll be a duration wherein the lockdown will do more harm than good. Next question: then what? Let’s break that down into three questions, all with differing scenarios and time frames.

When do we lift the lockdown?

Since we are expecting a second wave, it would make sense to lift it once the first wave (what we are experiencing right now) dies down.