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Talk about what is scientific epidemic prevention

 The original text comes from REDDIT




I'm a programmer, not an epidemiologist. I also have elderly people in my family. I'm just trying to think from a policy maker's perspective. I don't think my views are absolutely correct or perfect, but in the past two weeks, I have seen everyone's discussions and reflections on epidemic management policies because of the effects and practices of epidemic control in Shanghai and Jilin. Our discussions are still at the level of disagreement. I have done some thinking and research out of interest, and I want to share it with you. I hope it can inspire you a little. The figures in the text are for reference only, and the order of magnitude should have reference value.


too long! Lazy bag!

The risk of COVID-19 for people under the age of 15 is almost 0. Those 15-35 face an additional risk of around 5%, those 35-64 face an additional risk of around 10%, and those over 64 face an additional risk of around 20%. This additional risk is a multiple of the existing risk. The combined mortality rate in the United States in 2020 is about 0.8%, of which 0.1% is due to Covid. Your child is safer than you.


China's medical conditions are indeed lacking compared with those in the United States, but our processing capacity is not 0, but an average daily increase of about 70,000-100,000.


Because of the new crown, tens of thousands of people died, hundreds of thousands of people are not terrible, even for ordinary people (as for me) this is a very scary number. If you put it together with the number of natural and unnatural deaths every year, you will feel the difference.


Life has a price, and so does social shutdown.


Please treat not only me, but everyone's opinions and behaviors with scientific rationality and prudence and criticism.


What exactly is the risk to the public from Covid-19, especially the omicron variant that is now the most prevalent?

The United States has the most detailed information, so the United States was selected as the object of comparison. Better is actually South Korea, Japan or Hong Kong.


First, the age distribution of the population in China and the United States: (Statista)


United States (2020): 0-14 years old 18.37%, 15-64 years old and above 65%, 64 years old and above 16.63%


China (2020): 0-14 years old 17.9%, 15-64 years old and above 63.4%, 64 years old and above 18.7%


It can be seen that the age distribution of China and the United States is similar. China is slightly older, but the United States is younger due to severe obesity and Covid [https://www.science.org/content/article/why- covid-19-more-deadly-people-obesity-even-if-theyre-young], the author believes that the disease data of the two countries can be considered comparable.


United States: (Data from CDC, roughly added, for conceptual reference only)


To roughly observe the changes between different variants, we call it the pre-delta period before 2021.5. 2021.5-2021.11 is called the Delta period (coincidentally, around May is the time of mass vaccination) 2021.11-2022.4 is called the Omicron period






Total deaths in the pre-delta period, natural and non-natural causes (10,000 people) New crown deaths before the delta (10,000 people)) Total deaths in the delta period, natural non-natural causes (10,000 people) Delta new crown deaths (10,000 people) The total number of deaths in the Omicron period , natural and non-natural causes (10,000 people) Omicron and variants of new crown deaths (10,000 people)

Under 15 4.07 0.025 1.2 0.02 0.02 0.9

15-35 years old 15.7 0.53 5.4 0.49 0.3 3.9

35-63 years old 106.5 11.7 6.5 35.3 5.4 29.4

Over 64 356.7 47.4 10.3 99.6 15.2 99.3



One of the most misunderstood data on death tolls. First, it doesn't make much sense to look at the death toll from a disease alone. In a country, someone dies every day. The risk of any disease should be viewed in conjunction with the risk of death you already face. Seeing this form, I don't know what everyone thinks. **For children under 15, the additional risk to you from COVID-19 is almost 0. For those under 35, the additional risk is less than 5%. For middle-aged people aged 35-63, the additional risk is about 10%, and the impact is greatest for people over 64, but it is also below 20%. **This additional risk is relative to your existing risk of death, not a short-answer sum. To make the risk of death more concrete, we crudely lump people of all ages together. The combined death rate in the United States in 2020 is 0.828.7%, while the additional death rate from Covid is only 0.091%.


If we just look at a single death toll, we artificially magnify the risk of this disease to society as a whole.


What is the current situation of medical resources in my country, especially the medical resources needed for the treatment of new coronary pneumonia, and what is the current bearing capacity?

An evaluation of China's national conditions that often appears in discussions is "lack of medical resources." If such a statement is based on feeling, the first reaction is that it is difficult to argue. The general saying is that China has a large population, has vast rural areas, and lacks basic medical conditions. Urban areas are densely populated but have few resources per capita. Maybe you can also confirm this statement based on the actual life experience that it is difficult to register and see a doctor. However, the adequacy or scarcity of any resource is determined according to specific supply and demand. If a thing is too little, no one needs it, and it cannot be said to be lacking. vice versa. Therefore, it is unscientific to discuss whether resources are scarce or not directly based on life experience without quantifying demand and supply. To discuss whether medical resources are lacking, especially whether medical resources related to the treatment of new crown pneumonia are lacking, we must first know what kind of resources are needed for intensive care of new coronary pneumonia. Unfortunately, since the author is not a relevant professional in the medical industry, I cannot point out what hardware facilities are required for intensive care in the current practice. I had no choice but to settle for the next best thing, using the COVID-19 medical facilities that have been discussed in the media over the past few years. In the early days of the new crown epidemic in 2019-2020, there was a lot of discussion in the media about the number of ventilators and the number of ICUs.


Since the last time the number of ICUs cleared nationwide was in 2017, the researchers used some methods to estimate the number of existing ICUs, and concluded that there are about 4.5 ICUs per 100,000 people in my country, among which Beijing, Shandong, Jiangsu, Zhejiang and Shanghai are higher ( 5.5 and above), and other regions are generally in the range of 3-4. [Chen Yinzi, Li Jing, Wang Xiling. Forecast of short-term allocation of hospital health resources in my country. China Health Resources, 2021, 24(4): 453-457, 461. DOI: 10.13688/j.cnki.chr.2021.200805] and others Comparing countries, Statistica has a chart comparing the number of ICUs in various countries around the world, of which 2017 data is used for China (3.6 per 100,000 people). Since there is no actual data, assuming similar ICU development rates in various countries, the United States should have 10 times as many ICUs as China, twice as many in Japan, and three times as many in South Korea. Reliable data sources on the number of ventilators are difficult to find. The total number of ventilators in the United States should be between 150,000 and 170,000. Some articles mentioned that a large part of them cannot be used because of aging. This cannot be verified because no reliable information has been seen. The number of ventilators in China should be around 60,000 to 80,000. By reading the industry report of the securities company [Guoyuan Securities: Healthcare Industry Research Report April 9, 2020] (the author believes in the power of capital), my country's ventilator production capacity is 1,000 units per day, so the author believes that compared with ICU In other words, ventilators should not be the most scarce medical resources. ICU needs a complete set of medical equipment and support, and also implies the need for manpower, so here we analyze my country's medical resources based on the number of ICUs.




r/China_irl - A programmer talks about scientific epidemic prevention

The CDC has recorded the proportion of hospitalized patients requiring ICU since the outbreak. During the epidemic in the United States, even at the most severe time, there were no reports of ICU full and unable to treat. The author believes that the proportion here can reflect the needs of hospitalized patients for ICU. We can see that at the beginning of the epidemic, the utilization ratio of ICU was the highest, and then gradually decreased. The proportion of patients requiring ICU admission has hovered around 20% since August 2020.


r/China_irl - A programmer talks about scientific epidemic prevention

As for the total number of hospitalizations and the average daily number of hospitalizations, the highest seven-day average number of hospitalizations recorded by the CDC was 21,525, and the number of more than 20,000 hospitalizations began to decline after about 3 weeks. [https://covid.cdc.gov/covid-data-tracker/#new-hospital-admissions] This should be the largest infection in the world with relatively accurate statistics. During this period, the U.S. faced the highest number of hospitalizations, about 150,000, with ICU admissions up to 26,372, while the U.S. total ICU capacity was over 130,000 [https://ourworldindata.org/grapher/current- covid-patients-hospital?country=USA]. At this time, the average daily cases in the United States are seven to eight million, or even one million [https://www.nytimes.com/interactive/2021/us/covid-cases.html]. Since we do not have ICU needs for other conditions, to be conservative, it can be assumed that medical resources in the United States are exhausted in this situation and cannot afford more patients. Therefore, we make a bold inference, because the per capita ICU in China is one-tenth of that in the United States. If my country faces an increase of 70,000 to 100,000 daily cases, it should not have a higher mortality rate than the United States, that is, " Higher mortality due to lack of medical resources.” Due to the good mask habits of the Chinese (many people refused masks during the worst period of the epidemic in the United States) and better vaccination status (only 70% in the United States and more than 83% in China), this number will only be more optimistic.




Why do we need to think about coexistence policies at the expense of others?

As an ordinary person, it is difficult to face death in your own life. Even if it is a murderer, the life damage that can be caused to the society is very limited, and a few hundred people are already a very exaggerated number. But for policy makers, they should consider the interests of society as a whole. If the death of tens of thousands of people is unacceptable, then why is there still war? Our country has suffered for a hundred years, and the number of dead is tens of millions. Should we give priority to human life and surrender immediately? For society as a whole, no policy can be without victims. If a policy is scientifically sound, even if we as ordinary people feel sympathy for the victims, we should rationally consider the comprehensive interests of the entire society when discussing public policies. The rationale for such a policy should not be dismissed as soon as it is said that people will lose their lives. So how do we discuss the cost of life in policy issues?


How to take into account economic development, the freedom and happiness of individual and family, and other quality of life issues in the face of life?

This is another hot topic. There are basically two viewpoints. One side believes that human life is at stake. When people are dead, what is the point of talking about economic development and making money. The death of a person will damage the happiness of the family, and no amount of money can save the relatives. The other faction believes that the long-term closure of the city to restrict economic activities will affect the lives of the majority of people, making some people "worse than death" and harming social interests. Both sides are right, but there is no way to draw any meaningful conclusions from this form of argument. First of all, life is priceless for everyone. Once life is lost, other things don't have much meaning in existence. But for society, this society is made up of thousands of people. No one person is indispensable to this society, history and society are ruthless. What seems to be before us is an irreconcilable contradiction: personal and social interests. And in order to discuss which priority, one question we cannot get around is whether life is priceless. The author here provides you with a way to think about this problem. The value of life cannot be calculated with money, but it can be calculated with time. According to data reported by the media, the average life expectancy in my country has reached 77.3 [https://opinion.huanqiu.com/article/46Buo5AJrmt]. We assume that every moment of a person's life is equally precious. Then if a 50-year-old person leaves, we can say that this society, this person, lost the value created in 27.3 years, and also lost the joy and happiness in these 27.3 years. If the quality of life of 20 people declines, life expectancy declines by one year, which is equivalent to the social and personal loss of a 57-year-old person leaving. This is how we can quantify the lives lost. In the same way, for a person who has not lost his life due to the new crown, the inconvenience of life caused by various epidemic prevention measures, mental illness, income decline, unemployment, etc. will also lead to a decline in the quality of life in the long run, a decrease in the number of births, and a decrease in the average number of births. shortened lifespan. This loss can also be quantified. The specific quantification method and details need a lot of data support. Since I do not have such data, I only propose a way of thinking about quantifying life.


The following content will definitely be called cold-blooded and ruthless. A blunt estimate that a city with a population of 20 million is shut down for a month will cause secondary damage to the citizens, assuming that each person loses half a month of happiness and created value, which is equivalent to more than 20,000 37-year-old people, or six Thousands of people over the age of 64 have left us. This data must be inaccurate. Everyone has different ideas about the value of life. The shutdown of the city does not mean that you have no life this month, but the author only provides a way of thinking, everyone can substitute their own Think, estimate in your mind how much value happiness and well-being is lost to society as a whole by such measures. The shutdown of society is not only a material and economic cost, but also a loss of life.


Didn't the success of China's previous epidemic prevention policies reduce the number of deaths?

We must not forget to always look at problems with a developmental perspective. In the early stage of the epidemic, there was a lack of understanding of the virus, lack of treatment methods and resources, the virus was highly virulent, and there was no vaccine. The more extreme epidemic prevention policy is understandable at this time, because we do not know whether the epidemic is influenza or SARS

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