breaking covid rules

[Warb]

And yesterday, there were only 31,914 new cases and 40 deaths. Hardly getting on top of the problem.

That might be the future, at least for a while!

The question boils down to whether we want the entire population to live in lockdown for months/years/forever in the hope that covid goes away.

Perhaps the real inconvenient truth is that this is something we can't avoid. Perhaps, as I said earlier, the reality is that do have to alter our current views on life expectancy. Maybe, just maybe, the reason that the "live with it, like we live with 'flu" line is starting to be pushed along with "'flu kills hundreds every year" (in fact over 3000 in 2018, in Australia alone) is that the powers that be are fully aware that this will never go away, and that no vaccine will 100% stop it.

When the Doherty modelling says "it's safe to open up at x% vaccinated", I am 100% certain that they are not saying "no-one else will ever die of covid" - such a concept defies all logic. What they are saying, I suspect, is that the small gains to be made by waiting beyond that % vaccinated do not justify the massive impact of lockdowns.

Perhaps I'll never get to see any grandchildren, but I think I'd rather have my kids enjoy their lives whilst I'm alive!

[BobL]

This is instructive -
The cause rankings stay pretty constant except for flu when from 2010 to 2019 went from #15 to #10 and also look at accidental falls.

Screen Shot 2021-08-24 at 3.52.56 pm.jpg

[pippin88]

Bob, the differences in the reported causes over those 10 years will be due to differences in reporting, not true changes of those magnitudes.

Influenza testing has become much more readily available / done.

Look at the differences in dementia deaths. Dementia incidence / prevalence has not changed to that degree.

A lot of the time when someone elderly, it gets labelled a heart attack (ischaemic heart disease). Many of these are a guess / something has to be written on the death certificate (rather than a true diagnosis). Many of these deaths may be labelled differently over time (perhaps they are being attributed to dementia now)

[Bushmiller]

What they are saying, I suspect, is that the small gains to be made by waiting beyond that % vaccinated do not justify the massive impact of lockdowns.

Warb

The law of diminishing returns. It must come to that one day. The big question, and no doubt will continue to be the subject of huge controversy, is when.

Regards
Paul

[BobL]

Bob, the differences in the reported causes over those 10 years will be due to differences in reporting, not true changes of those magnitudes.

Influenza testing has become much more readily available / done.

Look at the differences in dementia deaths. Dementia incidence / prevalence has not changed to that degree.

The other factor is as follows. At the dementia workshop for families I attended in 2019 this was discussed with the dementia specialist and she indicated that there's been a big rise is dementia deaths in the last 20 years. Some of this is due to people living longer and they are able to get their other illnesses attended to or managed but dementia is basically incurable so it gets them in the end.

[Warb]

Warb

The law of diminishing returns. It must come to that one day. The big question, and no doubt will continue to be the subject of huge controversy, is when.

Regards
Paul

Indeed! The problem is that at present many people are still under the belief (misapprehension) that the small number of people who have died so far in Australia will be the final tally, and that "soon" we will see an end to covid. You only have to look at the comments sections in the media, or many forums and social media, to realise that some people still believe we should lock down until there is zero covid, and that such a move would remove covid forever. It's completely unrealistic, of course, but as Arthur Dent once said, "I always find that the prospect of death contracts the mind wonderfully".

[A Duke]

Hi,
If you have out lived three score and ten, then you are on borrowed time already.
Regards

[GraemeCook]

... This is instructive - The cause rankings stay pretty constant except for flu when from 2010 to 2019 went from #15 to #10 and .....

The incidence of flu is very variable and is currently zero, as noted by the Royal Australian College of General Practitioners:

Flu Rates.jpg

(Source: www1.racgp.org.au/newsgp/clinical/australia-records-zero-flu-deaths-over-past-12-mon)

Bob, please note the RACGP graph relates to flu only, whereas your stats lump flu and pneumonia together.

[ian]

The other factor is as follows. At the dementia workshop for families I attended in 2019 this was discussed with the dementia specialist and she indicated that there's been a big rise is dementia deaths in the last 20 years. Some of this is due to people living longer and they are able to get their other illnesses attended to or managed but dementia is basically incurable so it gets them in the end.

Perhaps it's mostly due to Australia having an aging demographic.
Actuaries have the best handle on the relevant stats, but going off Treasury's Intergenerational reports --
Australia's dependency ratio (folks older than 70 and kids under 20 vs working age folks) is increasing as the average age of the population increases -- it's all the fault of those bloody baby boomers, again.
Add in all those restrictions on manual handling and the advanced exoskeletons that allow workers to lift heavy loads or stand for long periods without suffering fatigue and the country is "headed for the dogs". It is no longer acceptable -- as if it ever should have been to work a person till they wore out.
In my former industry labourers over the age of 50 were a rarity. By age 45 a worker's body was worn out and you would "terminate" them -- you just didn't use "extreme prejudice".




BTW
I read a report in the last two or three months suggesting that China's demographic is following a worse trajectory than Australia's. Not only did China's "one child policy" encourage the termination of female foetuses leading to an estimated 20 million (?) more male babies, the experience of a generation, or more, of mothers only having one child appears to be encouraging their kids to see only having a single child as "normal".

[D.W.]

Economic prosperity is also leading people in China to determine that maybe it's better to forgo having kids, and they're starting to deal with burnout, too (individuals both not wanting kids and wanting to withdraw from the mainstream economic system).

I'm an actuary. I'm not a health pricing actuary, nor do I have access to any data re: dementia. My mother was diagnosed with dementia about 2 years ago at age 71 (she's 73 now, of course). She's not a basket case yet, but my grandfather suffered from what we'd call "senility" at a slightly later age, to the point that his cognition was really poor. He was a physical worker his whole life (a farmer born in the early 1900s), and a nearby son assisted with his day to day affairs, as was often the case with older relatives. Because of that, his lack of cognition never showed up (he died at 79 of a heart attack after cutting down trees of all things - something he was very familiar with, and would've been one of the last things to go). I see the following potential issues:
1) more utilization of health care (so more folks with cognitive deficiencies are seen)
2) better identification of disease in general (we don't just write folks off as "old" if they are easily confused and weren't a couple of years ago, or if they've lost sense of timelines, spatial things, short term memory and proper nouns)
3) far greater intake of medication (no clue if this is an issue - but there are a lot of anticholinergic medications and it appears that their intake is associated with onset of dementia at later ages)
4) worse physical condition and perhaps bloodwork profiles (not sure if after the medication that it's worse). I read a study not that long ago that stated that if you're overweight all your life and you're hoping to improve bloodwork to improve cognition, fair chance that things may go the other way (as in, a fat hungry brain may not cooperate if you cut the fat that fuels it).

I don't know that there's a definitive answer - not because you can't analyze the data, but because the data sourcing hasn't been that consistent, and now we generally identify causes of deficient mental or physical health rather than describing them as "senility" or "old age".

if there is good data on something like this, it will have to come from countries with standardized systems and standardized reporting. Once things get looser in terms of where the data came from, how it was reported, etc, how that changed over time, it just gets harder and harder to make definitive statements (but I've noticed a lot of non-actuarial studies like to come to a fairly firm conclusion even when I would be hesitant).

Maybe I'm getting old and outdated, but it seems like when complex modeling and a lot of effort is involved, sometimes the effort leads folks to become more and more confident and attached to their outcome vs. just "reporting the facts" as they are and stating that the modeling or adjustments were needed just to get something workable. We *do* live in a world where nobody really likes to fund a study and then get a bunch of maybes. I like maybes if they're legitimate, because the maybe may get you toward a correct answer once you start sorting through it. Far better than an assertive incorrect answer and then much later correction.

[Warb]

Once things get looser in terms of where the data came from, how it was reported, etc, how that changed over time, it just gets harder and harder to make definitive statements (but I've noticed a lot of non-actuarial studies like to come to a fairly firm conclusion even when I would be hesitant).

This seems to be a consistent pattern in the way we do things at the moment. We compare data from multiple sources, taken with multiple methodologies, sometimes even editing the historical data because "we don't think it was correct", then make a conclusion (normally one that supports our original hypothesis). This is then supported by statements like "you can't argue with the science".

My original qualification, a very long time ago and far from my subsequent career path, was in the sciences. We were taught that science was based on facts, and that a scientist tries their hardest to disprove a hypothesis, and only when unable to disprove it can it be thought of as correct. These days I get the impression that the process has changed somewhat!

[BobL]

Perhaps it's mostly due to Australia having an aging demographic. .

I doubt Australia's demographic has changed that much over those 10 years, probably medical advances don't explain it all either. Something that has increased significantly is early onset dementia but not enough to explain these numbers. I agree reporting causes change over time as well. Probably a combo of all of these factors.

[ian]

I doubt Australia's demographic has changed that much over those 10 years, probably medical advances don't explain it all either. Something that has increased significantly is early onset dementia but not enough to explain these numbers. I agree reporting causes change over time as well. Probably a combo of all of these factors.

Hi Bob

see this chart lifted from Treasury's 2010 Intergenerational Report
In 2010, the dependency ratio was projected to move 600 basis points between 2010 and 2020, and 1200 basis points between 2010 and 2030.
That's more than a little shift.
Also note the increasing percentage of Australia's population expected to be aged over 65 in 2020 and later years.
(BTW, I can't see a similar chart in the 2021 IGR)

Note that the first of the baby boomers became eligible for the pension in 2010, and the last of them (those born in 1965) will become eligible for the pension in 2032.

[GraemeCook]

... (BTW, I can't see a similar chart in the 2021 IGR) ...

As a former insider, one can hypothesise that the absence of such a chart may indicate a "discontinuity".
Translation: "Our former guestimates did not pan out. Hope no one notices."

One pertinent factor not covered by that chart is the impact of superannuation:

1970 - very few retiring in 1970 had adequate superannuation,

Now - many more retirees now have superannuation pensions, but still a lot of room for improvement.

Future - governments need to "encourage" - probably by both carrot and stick - almost everyone to have better superannuation. (But there are big philosophical barriers within the Parties complicating policy development.)

[GraemeCook]

I doubt Australia's demographic has changed that much over those 10 years, probably medical advances don't explain it all either. Something that has increased significantly is early onset dementia but not enough to explain these numbers. I agree reporting causes change over time as well. Probably a combo of all of these factors.

It seems rather incredible, Bob, but Australia's life expectancy has been increasing by about one year every four years since 1900.

Life Expectancy.jpg

Also, birth rates are down. The young'ns arne't as active as we were, and we were certainly less proficient than our grandparents.