"The people that are frail and old will die first, when that group of people are sort of thined out we will get less deaths"
I mean, that bizarre. That could be an excuse for renal disease.
Oh, patient is ESRD, lets not dialyze them, at the beginning there might be a spike of deaths due to renal failure but once they die first and the group of people are thined out, we will get less deaths.
- UK policy on lockdown and other European countries are not evidence-based
That is not totally accurate. It is true that the highest standard of evidence when it comes to health sciences, the double blinded randomized trial (or even better, meta-analysis) is not something that we have done, nor we can do to find out if social distancing (or other lockdown-type policies) are effective and if so by what magnitude. That being said, evidence does exist. We are not in the dark ages in which people did not know how diseases are transmitted.
We also know the approximate distance that droplets (which is the primary mean of transportation of respiratory viruses) can travel and the approximate time that they remain suspended. There is an interconnection between airborne and droplet but this is quite complicated and frankly I am not an expert in this so I would not go into more details.
We know, the farther we are from someone that has symptoms, the safer. The 6ft is just an arbitrary number that someone thought was doable while minimizing the risk of some particles (presumably the ones produced by speaking, if an uncovered cough is coming your way, you better be far farther than 6 feet, and if its a sneeze you probably want to be like 200feet away, ideally not in the same room and with no air-duct communication.
Some of this shit is not feasible. Remember, these are not meant to be guidelines for 100% protection but rather to slow down the spread.
- The correct policy is to protect the old and the frail only
That might**** be the best strategy for them. Remember, we are comparing different health systems and with different social structures. If in some of these European countries with strong social support the restaurant server fall ill, this person calls in sick, she or he still gets paycheck and health insurance, etc. When this happens here, that server needs the $$ otherwise she goes homeless. So when you have someone that has all the incentives to work even though they SHOULD NOT! you have a problem. The server might be young, healthy and only have the sniffles for a day or two and then feel better. But all the people he/she served, the diabetics, the immunocompromised children, the elderly... all of those are at risk.
Not to mention, that frankly some of these European countries have very pragmatic views to end-of-life care. It is unlikely that they will have many 92 year olds in the ventilator for 2 weeks or more. This is not the practice in the US where people with much less understanding of health and a higher prevalence of religious views tend to keep people in vents much longer. This puts a drain in resources (not just vents, but medications, devices, human capital, etc.)
I am not saying that you cannot get cues from other systems, I am saying that when you do, you should be careful to the conclusions you draw.
- This will eventually lead to herd immunity as a “by-product”
Perhaps so. We don't really know what degree of immunity catching the virus does. There have been reports of poor antibody response by those that have recovered and reports of re-infection. Again, this is a new virus and we know very little about it. Proceed with caution.
- The initial UK response, before the “180 degree U-turn”, was better
Thats his opinion. Something happened in the UK to drive that turn.
Frankly, we might never know which approach was better. The way to find this out is with randomized blinded studies and we clearly cannot do this. The existing variables between countries and health system structures as well as societies understanding of health are so vast that we definitely cannot really compare strategies. To put it mildly we are experimenting as we go.
- The flattening of the curve is due to the most vulnerable dying first as much as the lockdown
I don't think that is accurate. At the very least he does not have the data to make such claims. In the US there are about 50M people over 65 years of age. There are less than 1 million infected people in the US, for the "flattening" of the curve to have a meaningful impact from those at risk just dying off, we would have had to have far more infections to see that effect. And this is not including those with "frail" health such as those immunocompromised and with multiple comorbidities.
- The results will eventually be similar for all countries
Again, the details matter. The deaths of COVID, unless we find any therapeutic agent, are indeed likely going to be similar amongst countries with similar level of health-care system development. However that does not take into account that if the rate of infection is not controlled, you might have massive surges like the ones in Italy and New york in which the systems become overwhelmed.
- Covid-19 is a “mild disease” and similar to the flu, and it was the novelty of the disease that scared people.
That is not supported by the data that we have.
- The actual fatality rate of Covid-19 is the region of 0.1%
Actually the data points towards a mortality rate in the ballpark of 5% for most places around the world. If they have less, well, they are lucky I guess.
For instance, there have been more than 10k deaths in NYC so far. NYC has a population of 8m. When you do do the math you do get about 0.1% death rate, but the implications of that would mean that every single human in NY is already infected which is highly unlikely, specially when they are still seeing new cases. That also does not take into account the people that are going to continue to die (aka, a large percentage of all that are currently connected to a ventilator will eventually die to the disease as the mortality rate among the subset that develop ARDS/severe pneumonia is in the 30%+ range.
So yeah, this sort of speculation does not seem accurate.
- At least 50% of the population of both the UK and Sweden will be shown to have already had the disease when mass antibody testing becomes available
That is speculative at best, flat out wrong at worse.
Besides, if that is the hypothesis, we should be rushing to have widespread serology. Don't get me wrong, it would be a huge relief for me and most of the people if we find out that a large percentage of the population has been infected in the past, are doing fine and presumably has some degree of inmmunity.
Contrary to popular believe, nobody like lockdowns.