I think it’d be cool to go from microCOVIDs to expected QALYs lost, and then from there put a rough dollar figure on it based on the value of a QALY.
Edit:
10 microCOVIDS
= 1 in 100k chance of getting COVID
= 1 in 10M chance of dying from COVID @ 0.1% fatality rate
= 0.000005 expected QALYs lost @ 50 QALYs available to lose
= $0.10 @ $200k/QALY
= $0.01 / microCOVID with these assumptions
Eg. 10 microCOVIDs = 0.0005 expected QALYs lost (assuming 50 QALYs available to lose) = $100 (@ $200k/QALY).
Knowing that it “costs” about $100 to hang out with two friends outside feels a lot more concrete and actionable than knowing that there’s a 1 in 100k chance it gives me COVID, in no small part due to scope insensitivity.
A microCOVID (μCoV) is a 1⁄1,000,000 chance of catching COVID, not of *dying from* COVID. Off the top of my head, COVID has between a 1% and a 0.1% case fatality rate, so the cost of hangout death is something like $1 to $0.10. (Equivalently, a μCoV costs between 1 and 10 cents.) That hangout seems pretty cheap now!
You might separately check cost of going through COVID, which ranges from “no symptoms” to “pretty sick for a week to a month”. Being an affluent, reasonably healthy young person, I’d pay $1k to avoid the COVID experience but not $10k—so this additional cost is between $0.01 and $0.001 per μCoV. For simplicity’s sake, I’m combining both these figures into an overall 1 cent per microCOVID.
I definitely agree that a dollar framing helps make things actionable. Eating inside (5000μCoV = $50) is ridiculously expensive compared to outside (300μCoV = $3), and hitting up a bar, at 40k μCoV, has an astronomical cost of $400!
If I thought it was only worth $10k to avoid Covid, then I would stop trying to not catch it entirely, I’m giving up way, way more value than that and none of my actions make sense, and also the lockdown is a beyond obvious mistake (e.g. $10,000 times 300 million extra cases is both the beyond-worst-case and also 3 trillion so just let it happen modulo the most vulnerable).
Also, dollar framing this way excludes impact on others, so it’ll be a vast underestimate. Including it would likely give people a very bad idea.
I accept that my 10k figure is lower than typical; again, I’m relatively young (25) and risk tolerant. I’m curious where you’d bound your “cost of avoiding covid” at - $100k? $1M?
I did not model impact on others, and agree that this is a major oversight—as OP stated, there aren’t great models of this yet and we should try to do better.
But crucially, I don’t think “my current parameters leads to a massive underestimate” logically equates to “dollars are a bad framing device for understanding risk”. I almost feel like the fact that you can have such strong immediate opinions on seeing these dollar figures, means that converting to dollars provided a lot of clarity around our respective thought processes.
Of course it’s a simplification; it paints over, for example, the fact that two people with different incomes but the same risk tolerance would assign different dollar values. But on the flip side, literally every member of our society has grown up assessing the prices of things in dollars. QALY, micromorts, now microcovids, etc are incredibly esoteric by comparison.
Yeah, I’ve seen some posts trying to make similar “lockdown goes too far” arguments (including this one on the SSC Tumblr) that seem to be comparing life with COVID-19 mitigation to normal 2019 life or to that plus some chance of getting sick. Aside from understating the potential for long-term consequences, I think there’s a trend in those dollar-cost estimates towards significantly underestimating the negative effects of unmitigated pandemic spread beyond the effect on one’s personal health.
(Not that I expect that you disagree with this, but it stands out to me that “let it happen modulo the most vulnerable” is already begging the question. I’d expect if that were driving public policy that the “modulo the most vulnerable” part largely wouldn’t happen. It’s hard to protect any particular group from infectious disease when it’s widespread in the general population.)
surviving COVID might cost a lot of QALYs from permanent lung and brain damage. It might also cost a lot of future expected earnings for the same reason.
I hear this objection a lot but don’t have a sense of how likely/how bad “permanent lung/brain damage” is—do you happen to have any sources? I think this scenario is in the public conciousness because it’s scary and newsworthy, not because it’s common. Randomly guessing I’d say that permanent damage is meaningful in ~1% of all cases?
I tried to factor this already into my $1k - $10k COVID avoidance price, but I’d be happy to update on new data, and of course you might have different subjective valuations.
Also, don’t forget to factor in “kicking off a chain of onwards infections” into your COVID avoidance price somehow. You can’t stop at valuing “cost of COVID to *me*”.
Running the “microCOVID to $” conversion from the other end of the spectrum, the recommendation of 1% COVID risk = 10k μCoV to spend/year would suggest a conversion rate of $1 per μCoV (if your yearly discretionary budget is on the order of $10k/year).
I keep coming back to the “dollars conversion” because there’s a very real sense in which we’re trained our entire lives to evaluate how to price things in dollars; if I tell you a meal costs $25 you have an instant sense of whether that’s cheap or outrageous. Since we don’t have a similar fine-tuned model for risk, piggybacking one on the other could be a good way to build intuition faster.
I keep coming back to the “dollars conversion” because there’s a very real sense in which we’re trained our entire lives to evaluate how to price things in dollars; if I tell you a meal costs $25 you have an instant sense of whether that’s cheap or outrageous. Since we don’t have a similar fine-tuned model for risk, piggybacking one on the other could be a good way to build intuition faster.
That’s a great way to put it. And since the goal of the microCOVID project is behavior change (presumably), I think it’s crucial to get the “have an instant sense of whether it’s cheap or outrageous” part right. Without that I fear that only the most committed people would be motivated enough to change their behavior, but a lot of those people are probably being cautious to begin with.
Anecdotally, I was talking to my brother (not super committed) about it last night, and that data point supported what I’m saying.
One way to bound the risk of long term consequences is to assume the long term consequences will be less severe than the infection itself. So if 1% of people in their 20′s experience reduced lung capacity during infection, you can assume that less than 1% will have permanently reduced lung capacity. I have never heard of a disease which was worse after you recover than before.
I suspect that some people are hesitant to discuss the rate of long term consequences for young covid patients for fear of encouraging people not to social distance. But then the cost is a loss of trust between people and the information provider.
Interesting. The study discusses fatigue. Do we know if the fatigue is caused by reduced lung capacity or by the hormones/neuro stuff our body does to conserve energy while sick. If reduced lung capacity is a big part of that 1⁄5 I would update upward on permanent lung capacity rate.
I think it’d be cool to go from microCOVIDs to expected QALYs lost, and then from there put a rough dollar figure on it based on the value of a QALY.
Edit:
10 microCOVIDS
= 1 in 100k chance of getting COVID
= 1 in 10M chance of dying from COVID @ 0.1% fatality rate
= 0.000005 expected QALYs lost @ 50 QALYs available to lose
= $0.10 @ $200k/QALY
= $0.01 / microCOVID with these assumptions
Eg. 10 microCOVIDs = 0.0005 expected QALYs lost (assuming 50 QALYs available to lose) = $100 (@ $200k/QALY).Knowing that it “costs” about $100 to hang out with two friends outside feels a lot more concrete and actionable than knowing that there’s a 1 in 100k chance it gives me COVID, in no small part due toscope insensitivity.A microCOVID (μCoV) is a 1⁄1,000,000 chance of catching COVID, not of *dying from* COVID. Off the top of my head, COVID has between a 1% and a 0.1% case fatality rate, so the cost of hangout death is something like $1 to $0.10. (Equivalently, a μCoV costs between 1 and 10 cents.) That hangout seems pretty cheap now!
You might separately check cost of going through COVID, which ranges from “no symptoms” to “pretty sick for a week to a month”. Being an affluent, reasonably healthy young person, I’d pay $1k to avoid the COVID experience but not $10k—so this additional cost is between $0.01 and $0.001 per μCoV. For simplicity’s sake, I’m combining both these figures into an overall 1 cent per microCOVID.
I definitely agree that a dollar framing helps make things actionable. Eating inside (5000μCoV = $50) is ridiculously expensive compared to outside (300μCoV = $3), and hitting up a bar, at 40k μCoV, has an astronomical cost of $400!
If I thought it was only worth $10k to avoid Covid, then I would stop trying to not catch it entirely, I’m giving up way, way more value than that and none of my actions make sense, and also the lockdown is a beyond obvious mistake (e.g. $10,000 times 300 million extra cases is both the beyond-worst-case and also 3 trillion so just let it happen modulo the most vulnerable).
Also, dollar framing this way excludes impact on others, so it’ll be a vast underestimate. Including it would likely give people a very bad idea.
I accept that my 10k figure is lower than typical; again, I’m relatively young (25) and risk tolerant. I’m curious where you’d bound your “cost of avoiding covid” at - $100k? $1M?
I did not model impact on others, and agree that this is a major oversight—as OP stated, there aren’t great models of this yet and we should try to do better.
But crucially, I don’t think “my current parameters leads to a massive underestimate” logically equates to “dollars are a bad framing device for understanding risk”. I almost feel like the fact that you can have such strong immediate opinions on seeing these dollar figures, means that converting to dollars provided a lot of clarity around our respective thought processes.
Of course it’s a simplification; it paints over, for example, the fact that two people with different incomes but the same risk tolerance would assign different dollar values. But on the flip side, literally every member of our society has grown up assessing the prices of things in dollars. QALY, micromorts, now microcovids, etc are incredibly esoteric by comparison.
He was saying that it is worth $10k to him to avoid the experience of being sick with but not dying from Covid.
Impact on others can be incorporated into the dollar estimate using R0 and the value you place on those other lives as parameters.
Edit: microCOVIDs also excludes impact on others.
Yeah, I’ve seen some posts trying to make similar “lockdown goes too far” arguments (including this one on the SSC Tumblr) that seem to be comparing life with COVID-19 mitigation to normal 2019 life or to that plus some chance of getting sick. Aside from understating the potential for long-term consequences, I think there’s a trend in those dollar-cost estimates towards significantly underestimating the negative effects of unmitigated pandemic spread beyond the effect on one’s personal health.
(Not that I expect that you disagree with this, but it stands out to me that “let it happen modulo the most vulnerable” is already begging the question. I’d expect if that were driving public policy that the “modulo the most vulnerable” part largely wouldn’t happen. It’s hard to protect any particular group from infectious disease when it’s widespread in the general population.)
Ah I see. My mistake for missing that!
surviving COVID might cost a lot of QALYs from permanent lung and brain damage. It might also cost a lot of future expected earnings for the same reason.
I hear this objection a lot but don’t have a sense of how likely/how bad “permanent lung/brain damage” is—do you happen to have any sources? I think this scenario is in the public conciousness because it’s scary and newsworthy, not because it’s common. Randomly guessing I’d say that permanent damage is meaningful in ~1% of all cases?
I tried to factor this already into my $1k - $10k COVID avoidance price, but I’d be happy to update on new data, and of course you might have different subjective valuations.
Also, don’t forget to factor in “kicking off a chain of onwards infections” into your COVID avoidance price somehow. You can’t stop at valuing “cost of COVID to *me*”.
We don’t really know how to do this properly yet, but see discussion here: https://forum.effectivealtruism.org/posts/MACKemu3CJw7hcJcN/microcovid-org-a-tool-to-estimate-covid-risk-from-common?commentId=v4mEAeehi4d6qXSHo#No5yn8nves7ncpmMt
Good point, thanks.
Running the “microCOVID to $” conversion from the other end of the spectrum, the recommendation of 1% COVID risk = 10k μCoV to spend/year would suggest a conversion rate of $1 per μCoV (if your yearly discretionary budget is on the order of $10k/year).
I keep coming back to the “dollars conversion” because there’s a very real sense in which we’re trained our entire lives to evaluate how to price things in dollars; if I tell you a meal costs $25 you have an instant sense of whether that’s cheap or outrageous. Since we don’t have a similar fine-tuned model for risk, piggybacking one on the other could be a good way to build intuition faster.
That’s a great way to put it. And since the goal of the microCOVID project is behavior change (presumably), I think it’s crucial to get the “have an instant sense of whether it’s cheap or outrageous” part right. Without that I fear that only the most committed people would be motivated enough to change their behavior, but a lot of those people are probably being cautious to begin with.
Anecdotally, I was talking to my brother (not super committed) about it last night, and that data point supported what I’m saying.
Sadly nothing useful. As mentioned here (https://www.microcovid.org/paper/2-riskiness#fn6) we think it’s not higher than 10%, but we haven’t found anything to bound it further.
One way to bound the risk of long term consequences is to assume the long term consequences will be less severe than the infection itself. So if 1% of people in their 20′s experience reduced lung capacity during infection, you can assume that less than 1% will have permanently reduced lung capacity. I have never heard of a disease which was worse after you recover than before.
I suspect that some people are hesitant to discuss the rate of long term consequences for young covid patients for fear of encouraging people not to social distance. But then the cost is a loss of trust between people and the information provider.
https://www.cdc.gov/mmwr/volumes/69/wr/mm6930e1.htm found that ~1 in 5 of 18-34 year olds with no underlying health conditions had symptoms 3 weeks later (telephone survey of people who’d been symptomatic and had a positive test).
Other discussion in comments of https://www.lesswrong.com/posts/ahYxBHLmG7TiGDqxG/do-we-have-updated-data-about-the-risk-of-permanent-chronic
Interesting. The study discusses fatigue. Do we know if the fatigue is caused by reduced lung capacity or by the hormones/neuro stuff our body does to conserve energy while sick. If reduced lung capacity is a big part of that 1⁄5 I would update upward on permanent lung capacity rate.