Thread by @ethanjweiss

Quick thoughts on the idea of there being a choice between lockdowns and dead bodies. I live in San Francisco. We had our first COVID cases here in early February. We have been conservative here, but hardly locked down. Restaurants have been open for outdoor dining. Bars now too

Gyms and salons recently reopened. Many workplaces are back at less than 100% capacity. Public schools have been closed but private schools have been opening since September

Life is fairly normal aside from the fact that people keep distanced & masked. When I'm out running, I leave my mask down & pull it up as I approach others. Invariably, they do the same. It has become something of a ritual. People are also pretty good about saying hi as well

We are not perfect. Every so often I will go to the bathroom at work and forget my mask. Nobody yells at me but I have gotten a very gentle reminder. It feels very collaborative. We are all invested

And (perhaps) as a result, San Francisco has an average recent rate of ~50 new cases per day. There has been a slight uptick lately but it remains generally low

And as you'd expect, this has meant that the number of patients in the hospital has stayed low. Currently, there are just over 30 patients hospitalized with COVID in all of San Francisco

And lastly, deaths. Again, as expected, the number is low. There are less than 150 people who have died from COVID (or with COVID if you choose) since Feb 4

Ok now let's compare the City of San Francisco, the 2nd most densely populated city in the country with a place that is not densely populated and has taken a different approach to COVID: South Dakota. The populations of SF and the state of South Dakota are roughly similar (~800K)

What is happening in South Dakota right now? Well there are now over 1500 new cases of COVID per day. Again, SF has ~30 and has had under 13,000 overall. Same number of people and these eople are packed into 49 square miles in SF and 77,000 sq miles in SD

Again, no surprise, this means more people in the hospital. Currently there are almost 500 hospitalized in the state of SD as compared to ~30 in all of SF

Deaths? Again, no surprise. In SD, there are over 10 new deaths/day and a total of 460. That number is going to increase. In SF, there have been 140 deaths most coming early in the pandemic and the number of new deaths is flat

And again, these are similarly sized populations but one is spread across 49 square miles and the other is spread over 77,000 sq miles. So if you had to pick which one would have a worse time with COVID, which would you pick?

I will state here that I am not criticizing the people of South Dakota. I feel awful for them. What I am trying to do is to point out that this pandemic can be manageable. Is it fun to live the way we live here now? No. Are there things I wish were different & more relaxed? Yes!

But when it comes to discussing trade offs, I think this is a useful comparison. I know which way I would want to live. It's a no-brainer

So going forward, please know that even absent new therapeutics or a vaccine, there is a way to manage this thing and there is a way to balance our freedoms and the economy against the very real morbidity and mortality that ensues when you go a different way

Lastly, there is a lot of nuance here & it is complicated. But we do ourselves a great disservice when we create false choices. We are all still learning how to do this with the right amount of disruption to our lives/welfare balanced against disease. We will hopefully get better