COVID19 Factors We Should Consider/Current Events COVID19 Factors We Should Consider/Current Events - Page 32

starting strength gym
Page 32 of 472 FirstFirst ... 2230313233344282132 ... LastLast
Results 311 to 320 of 4719

Thread: COVID19 Factors We Should Consider/Current Events

  1. #311
    Join Date
    Jul 2007
    Location
    North Texas
    Posts
    42,203

    Default

    • texas starting strength seminar september 2020
    • wichita falls texas december seminar 2020
    ◦ "We can't be sure that dead people who tested positive died (only) from COVID-19?"
    ▪ That's true, of course. But it's also true of pretty much any infectious disease, I suspect.

    None of whom we've decided to destroy the economy for.
    ▪ For example, in the 1918 Spanish Flu pandemic, 95% of deaths may have been from co/secondary bacterial infections (at the time no antibiotics were available)
    Need I point out that this is not 1918?
    ▪ The relevant question is whether the people who died would have died anyway without having contracted the Coronavirus
    ▪ Given that (at least currently) testing is based primarily on the display of *symptoms*, that seems extremely unlikely

    Seems again?
    ◦ "Nicholas Nassim Taleb says those Imperial College people who did the modelling everybody is talking about are Imbeciles"
    ▪ Right, and he is arguing for *a more agressive suppression and social distancing policy, right now* than what they considered
    ▪ The disagreement is only about whether, after an initial successful suppression, one can hope to prevent multiple waves of the outbreak without near-continuous strict social distancing after the first wave
    ▪ Also, he says that about everybody who holds differing opinions from him
    ▪ [spacediver: just to be clear, I know that you understood all this]

    He's right about modelers.

    • The Need for Herd Immunity

    ◦ "If this virus is really as infectious as everybody thinks, we'll all get infected anyway. So we should just try to let it run through the population as quickly as possible so that we get herd immunity as quickly as possible (once ~60% of the population have had it)"
    Models of an unchecked outbreak show that, at peak, the number of infected people requiring intensive care would exceed the number of available critical care beds by factors of ~30.
    ▪ *Even without taking this into account*, the total number of deaths in the US is then projected to be ~2 million
    ▪ In reality, it would presumably be considerably worse, because once health care systems are overwhelmed, people who could have been saved will actually die.
    ▪ In the Imperial College modelling (sic) study, they assume (based on the available clinical evidence), that ~50% of critical care cases will die even when treatment is available.
    ▪ Once the supply of critical care beds is exhausted, that number would presumably become ~100%
    ▪ In addition, once the health care system is on its knees, some/many milder cases would probably become critical. Also people with other (unrelated) illnesses would likely die at increased rates

    This is laziness and speculation, and is precisely why there is no toilet paper at Walmart.
    ▪ Perhaps most importantly, the example of China shows that *suppression* of the outbreak *is* possible, i.e. it is *not* inevitable that everybody will get infected.
    • the challenge is managing this for long enough that a vaccine can get developed and deployed

    China welded people inside their apartments. You probably think this is a good idea.

    • Killing the Economy

    ◦ "Even if this outbreak/disease is as bad as people claim, our (over-)reaction to it may kill the economy. If this leads to a Great Depression, the result of that would be even worse."
    ▪ In order to assess this quantitatively, we'd need to have a good model for the impact of Great Depressions on the national death rate, life expectancy etc. I would be interested to know if anybody has reliable info on this.

    You cannot be serious. You parade this baseless speculation about infection rates, and then request hard data from the 1920s?
    ▪ Perhaps more relevantly, what actions would proponents of this view actually take to prevent the collapse of the economy?
    • It's certainly true that, right now, simply not enforcing social distancing protocols will keep the economy running normally for longer
    • However, does anybody actually think that people would continue life as normal (go to work, eat in restaurants, drink in bars and pubs) once, say, 100,000 people have died and the health care system is broken?

    They certainly as hell can't live normally as things are now, since you people have decided these things for us.
    • And at *that* point, it would probably be too late to even attempt suppression strategies.
    • The resulting Great Depression in *that* case could easily be worse than the one this strategy is trying to prevent.

    This is sloppy thinking -- not really thinking at all, but merely feeling afraid. What we know now is that this thing has killed far fewer people than the flu ever does, and that fear of a worse outcome has irreparably damaged the economy of the country and the world. This is already a worse-case scenario, and you don't seem to grasp the significance of oil at $20 and the Dow at 10000, every waiter/waitress in the country unemployed, basic commodities unavailable or fought over, and the resulting effects on the welfare of those people you're trying to protect with your Social Distancing.


    I realize that the above doesn't exactly paint a rosy picture, nor does it propose any great solutions.
    The whole point is that it doesn't seem like there are any great solutions.

    What governments and public health experts are trying to do is find the least bad option among several really awful ones. And the sort of second-guessing and conspiracy theorising that's going on everywhere - and the resulting non-compliance with recommendations - is in danger of making their already difficult job impossible.


    The poor things.

  2. #312
    Join Date
    Jan 2011
    Location
    NJ
    Posts
    1,113

    Default

    Quote Originally Posted by lazygun37 View Post
    ▪ But we have concrete *data* from multiple countries about the infectiousness and lethality of the virus, so we *know*
    I guess this is really the crux of the disagreement right here. You believe that to be true, while I do not. The inclusion criteria for each country is different. Hell, the criteria for different agencies within a country is different. Even within a given agency, the numbers are not clearly reported and change every day. The percentage of the various populations tested differ. The various assumptions differ (and change daily - remember when cases doubled every 5 days and now it’s 2-8?). The WHO just changed how they report data yesterday.

    Every country is its own anomaly. China is an anomaly because of their draconian measures and they lie. Italy is an anomaly because they’re old, and count every death as being caused by COVID-19. Germany is an anomaly because they only count deaths that can be exclusively tied to COVID-19. Japan is an anomaly because they run fewer tests. South Korea is an anomaly because they run so many tests. The US is an anomaly because they made their own test.

    The data is shit. You can hand wave that away by saying “the models account for that”, but they certainly do not appear to. Running a few different models based of different assumptions is not the same as rigorously assigning a distribution to every data set based on how shitty it is and running a probabilistic model based on that. But that would be really hard, and ultimately inconclusive.

  3. #313
    Join Date
    Mar 2020
    Posts
    212

    Default

    I read through Taleb's response to the Ioannidis paper. I'm quite surprised at his response. He's not thinking according to form or what he's laid down in his books regarding anti-fragility and ergodicity. He's pulling out the Russian Roullette analogy and pointing to "abscence of evidence etc."

    A better analogy is that we have to play Russian Roullette due to the nature of life and this situation, and we have several guns to pick from.

    One gun has one bullet in a 6-round cylinder (the Imperial College study, for the sake of argument). The rest of the guns have an unknown number of bullets in cylinders of unknown capacity.

    We currently have our finger on the trigger of one of the unknown guns.



    It's an election year. There have been no major topics since impeachment ended. History has proven time and again that many people live for their stomachs and not for any kind of principle or value. The government is now flexing its muscle at a time that is far too convenient to be a coincedence.

    You may not agree with that statement, but this is the way many, many people in our country think, and appeals to the benevolence and omniscience of government and experts, over and against the history of government and experts, is not going to convince any of us.

  4. #314
    Join Date
    Mar 2014
    Location
    Brisbane Australia
    Posts
    290

    Default

    The headline figure of new infections always sound bad, but noone asks "compared to what"?

    Australian Stats:
    Cases Tested - 100,000 +
    +ve cases - 876 (<1%)
    Deaths 7 (<1% of infected)
    Serious / critical cases- 2 ( hope we can have enough critical care beds).


    We are going to find more cases as we are now actively looking for them and encouraging people to seek out testing where they may have previously gone to bed for a few days and not even seen a Dr. (The only times I have had a flu, this is what I did). Of the two people I know personally that are +ve; the first had chills for half an hour and a sore throat that he initially put down to heavy drinking the night before- he went and got tested as he had just returned from Italy....the other person has just gone to bed. these people would never have gotten into the regular flu stats, but are now part of the 876 infections we have here.

    I've heard that there were 6 male suicides in Australia the previous week. This week I felt like joining them a few times, some friends have stepped up and I'm feeling much better.

  5. #315
    Join Date
    Jan 2014
    Posts
    87

    Default

    Quote Originally Posted by Dr.T View Post
    The death rate is dropping daily as the denominator rises. May end up close to Influenza. (but not in children/ young, where it is looking like zero)
    Could you please provide evidence for this? All reliable sources I have seen agree that the true number is hard to estimate still, but is likely to be at least several times higher than for the flu. I can provide references, but those numbers are very widely available.

    Quote Originally Posted by Dr.T View Post
    Writer doesn't understand influenza immunity.
    As I said, I'm not an epidemiologist, so please school me. My understanding is that exposure to one season's influenza provides at least partial immunity to similar future strains (e.g. Immunity following influenza disease and administration of influenza vaccines).

    This is obviously not the case for COVID-19 (unless you take Rip's view that this virus has been around for much longer than is generally thought, which is a separate argument).

    Quote Originally Posted by Dr.T View Post
    Italy is an outlier. A brief glance at the deaths/pop tell us this.
    I'll assume you mean deaths/case numbers, rather than deaths/population, since the latter is a meaningless quantity that depends entirely on how long the outbreak has lasted in a given country.

    On this point, I agree I should have been much clearer. It is true that the apparent *mortality* rate in Italy at the moment (8.6% based on simply dividing deaths by confirmed cases) is higher than that in (I think) all other countries. That said, the same number for Spain at the moment is 5.1%. And while 8.6% is certainly a lot worse than 5.1%, both are vastly higher than the (much better established) mortality rate of influenza, which I believe is around 0.1%. In fact, even Germany's abnormally low number of 0.3% is still 3x higher than influenza (all numbers from Operations Dashboard for ArcGIS),

    But my actual statement is/was that "Italy is not an outlier. Most countries are on similar trajectories." So what I was trying to get at is that Italy is *not* an outlier at all in terms of the *evolution* of case numbers and deaths -- i.e. the exponential growth rate. In fact, right now it is somewhat slower than, for example, in the US. See here: 17 (or so) responsible live visualizations about the coronavirus, for you to use | Chartable

    Quote Originally Posted by Dr.T View Post
    The writer wants quantitative data on the misery/health effects of the Great Depression for comparison. LOL.
    I always find LOL to be the most convincing argument myself. But I'm actually not entirely sure how to take this. I *think* the idea is that the Great Depression was quite obviously worse than... what? I.e. how many death should we be willing to tolerate to avoid a Great Depression? I'm not being facetious here. These are exactly the kind of calculations public health officials have to make every day. I was literally saying I'm not sure how to do this for something like the Great Depression.

    And while it may seem obvious to you that a terrible event like the Great Depression would result in many excess deaths, the actual data says otherwise. Counterintuitively, overall mortality rates *decline* during recessions -- including the Great Depression (Life and death during the Great Depression | PNAS). Obviously that doesn't mean we should all pray for recessions so we can live longer. But it sure as hell shows that the question deserves more thought than "LOL".

  6. #316
    Join Date
    Nov 2012
    Location
    Toronto, Ontario
    Posts
    1,003

    Default

    Quote Originally Posted by lazygun37 View Post
    ▪ [spacediver: just to be clear, I know that you understood all this]
    Figured as much even before I read your note, but appreciate the courtesy. And thanks for taking the time and effort on your post. It's clear that your intention here is to seek truth rather than enforce it, and it may generate some useful discussion!

    Quote Originally Posted by Mark Rippetoe View Post
    What is it called when we sentence a man to death based on incomplete/biased/imperfect testimony? Pretend the economy is that man.
    This analogy is good insofar as it reminds us to consider the very serious harms associated with economic damage. I can think of outcomes due to economic damage that are far worse than the 1918 pandemic.

    But the analogy fails when we consider the mismatch in the counterfactual parallels: i.e. consequences of [not locking down] vs. [acquitting a man].

    In the former there is a non trivial risk of severe pandemic harm, and in the latter, then even if the man is guilty, he probably doesn't go on to cause more harm after acquitted.

    And this is precisely why probabilities are a major player here. It can be rational to take extreme action even if you're not fully confident that it's necessary (e.g. when applying the precautionary principle).

    Also important to remember that we're playing dice with the economy either way.


    Quote Originally Posted by Mark Rippetoe View Post
    Seems? You are happily destroying the economy of the US and by extension the World, because of the way something seems.
    See above. Nothing wrong with epistemic qualification in moderate doses.

    Quote Originally Posted by Rob Waskis View Post
    The data is shit. You can hand wave that away by saying “the models account for that”, but they certainly do not appear to. Running a few different models based of different assumptions is not the same as rigorously assigning a distribution to every data set based on how shitty it is and running a probabilistic model based on that. But that would be really hard, and ultimately inconclusive.
    Agreed, and your gun analogy is good (I think, I'm not fully confident I understand it).

    I don't think the cliff that Ioannidis claims we've jumped off is that big. I think (I hope) that we are agile enough as a society that we can reverse course swiftly and gracefully if necessary.

    And our connectivity is excellent. This will certainly help mitigate economic, social, and psychological damage.

    But yes, I have no doubt that much damage has certainly already been cemented in many's fates, even due to measures this recent.

  7. #317
    Join Date
    Jan 2014
    Posts
    87

    Default

    Rip, I apologize for using language like "seems", "estimates", "if unchecked" etc. I will try to follow your lead and present uncertain numbers as universal physical constants, and my opinions and hunches as physical laws. Got it.

    Seriously though: if you are unable to understand -- or unwilling to engage with -- that all numbers are necessarily uncertain in situations like this, but that there are well-understood statistical methods that help us make the best possible decisions under uncertainty, then I don't know what to tell you.

    Quote Originally Posted by Mark Rippetoe View Post
    ▪ COVID-19 seems to be about twice as infectious as the flu[/I]
    Seems? You are happily destroying the economy of the US and by extension the World, because of the way something seems.
    A perfect example -- I'm sorry I acknowledged that the true number probably isn't 2.00000. Anyway, I didn't really think I had to provide references here, because all numbers I adopted are widely used and cited standard values. I had naively thought that if somebody disagreed with them, it would be up to *them* to provide evidence for their dissenting view.

    But OK, here you go. As you know, infectiousness is usually quantified by R0, the number of people an infected person typically infects. A study in The Lancet found a best estimate of R0=2.3 (with a 95% confidence interval of 1·15–4·77) for COVID-19, prior to the introduction of travel restrictions. A similar study of the Diamond Princess found R0 = 2.28 (2.06-2.52 at 95% confidence). For influenza, R0=1.3 under the same condition. Or, you know, "COVID-19 seems to be about twice as infectious." (Lancet Estimation of the reproductive number of novel coronavirus (COVID-19) and the probable outbreak size on the Diamond Princess cruise ship: A data-dr... - PubMed - NCBI).

    Quote Originally Posted by Mark Rippetoe View Post
    ▪ The rate of infected people who require hospitalization is much higher for COVID-19
    ▪ COVID-19 is several times more deadly than the flu

    These are not factual statements.
    Right, so we know that these numbers are much higher for COVID-19 than for the flu. But since we don't know *precisely* how much higher, we should make decisions on the basis that they are the same. Excellent.

    But since you asked, here are the detailed age-stratified numbers used in the Imperial College study (https://www.imperial.ac.uk/media/imp...16-03-2020.pdf), which in turn came from Verity et al (https://www.medrxiv.org/content/10.1...357v1.full.pdf).

    ferguson.jpg

    Is it OK if I leave you to convince yourself that, integrated over a population, these numbers are significantly higher than for influenza?

    Quote Originally Posted by Mark Rippetoe View Post
    ▪ There is no vaccine against COVID-19
    The vaccine for the flu last year was estimated post-event to be about 20% effective. Not much better than no vaccine. Irrelevant anyway -- we didn't destroy the economy because we had a shitty flu vaccine.
    Tsk, tsk, tsk -- "estimated to be about 20% effective"? Those are not factual statements.

    Anyway, the CDC begs to to differ. First, 2018-2019 seems to have been -- sorry, absolutely was! -- a mild outlier, but even then the estimated effectiveness was 29%. Typical numbers are around 40% - 50%. (Past Seasons Vaccine Effectiveness Estimates | CDC). Which I agree is far from perfect. But the point is that (a) this effectiveness can obviously still significantly reduce R0; (b) the flu's R0 is already closer to the critical value of 1; (c) the flu is a hell of a lot less deadly than COVID-19.

    Quote Originally Posted by Mark Rippetoe View Post
    ▪ If unchecked, exponential growth at this rate would lead to ~160,000 deaths in about 1 month (10 doublings)[/I]
    If unchecked? Has anyone suggested that we stop washing our goddamn hands? That we start breathing on each other?
    You are completely missing the point, which was simply to provide a rough reference time frame for reaching flu-like death numbers,

    Quote Originally Posted by Mark Rippetoe View Post
    • so even if, after 2 weeks, you could magically manage to completely suppress the outbreak instantaneously (perhaps because 5000 deaths is enough to convince you), you will end up with *at least* ~2 more doublings, i.e. ~20,000 deaths
    Which means it still didn't kill as many as the flu.
    Yes. And you do, of course, have a plan for achieving complete instantaneous suppression at the point where the number of deaths is 5000. As a reminder, at that point the number of *cases* will be ~500,000. Should be pretty straightforward to find those half a million people and track their contacts. At least you'll have a full 3-5 days before the number of cases will have become 1 million.

    I honestly cannot understand how smart people like yourself do not get the fundamentals of exponential growth. Suppressing an outbreak while the numbers are small can be done. Suppressing it when they are large is almost impossible. And with exponentials, small becomes large seemingly overnight.

    Quote Originally Posted by Mark Rippetoe View Post
    [B]You don't have any concrete data from anybody except the cruise ship. Read the Ioannidis piece above, and refute that for us.
    Honestly, I have read it and would normally love to critique it, but I am already spending far too much time and effort on this. Check what Nassim Taleb says about it -- I thought you trusted his judgement.

    Quote Originally Posted by Mark Rippetoe View Post
    ◦ "Comparisons with Italy are meaningless, because Italians are old, smoke a lot and have a socialized public health system”
    ▪ Italy is not an outlier. Most countries are on similar trajectories

    You're not really familiar with this data.
    Please see my earlier response to DrT.

    Quote Originally Posted by Mark Rippetoe View Post
    ◦ "What about the Diamond Princess? Most passengers didn't get infected and very few died."
    ▪ Social distancing *was* implemented on the ship to slow/suppress the spread of the disease

    "Social Distancing" can be implemented everywhere without closing down all the businesses in the United States. And since it was not possible to "close down" the Diamond Princess, or leave the premises, the data stands.
    ▪ Modelling suggests that, in the absence of these interventions, 80% of the passengers would have been infected by late Feb.
    ▪ The mortality rate amongst the infected passengers is in line with those seen elsewhere

    The modeling is of the same quality we've come to expect from epidemiologists, and the infection rate on the ship was 17%. Of that 17%, the mortality rate was comparable to that of an older demographic, because that's who takes cruises.
    You are making these statements on the basis of precisely no evidence. Have you even looked at the paper I cited previously where they, you know, actually try to do the maths? (https://academic.oup.com/jtm/advance...aaa030/5766334)

    From their abstract: "The basic reproduction rate was initially 4 times higher on-board compared to the in the epicentre in Wuhan, but the countermeasures lowered it substantially. Based on the modeled initial of 14.8, we estimated that without any interventions within the time period of 21 January to 19 February, 2920 out of the 3700 (79%) would have been infected. Isolation and quarantine therefore prevented 2307 cases, and lowered the to 1.78."

    And from the Introduction: "The public health measures taken according to news reports and the media were removal of all PCR positive passengers and crew from the ship and their isolation in Japanese hospitals. The remaining test-negative passengers and crew remained on board. Passengers were quarantined in their cruise ship cabins, and only allowed out of the cabin for one hour per day.

    Sounds like they really let the virus grow completely unchecked on board. As, of course, you would.

  8. #318
    Join Date
    Jul 2007
    Location
    North Texas
    Posts
    42,203

    Default

    So your point is that whatever is necessary to do to stop this epidemic -- up to and including the dismantling of modern society -- is just fine, because it is a cause of death. Is this a fair characterization? And I do understand the exponential growth thing; I also understand the Infection Fatality Ratio of 0.66%-thing too. And I understand that the airlines are talking about bankruptcy. You must be very wealthy, to so completely ignore the other part of this horrible equation.

  9. #319
    Join Date
    Mar 2020
    Posts
    212

    Default

    Quote Originally Posted by lazygun37 View Post
    As I said, I'm not an epidemiologist, so please school me. My understanding is that exposure to one season's influenza provides at least partial immunity to similar future strains (e.g. Immunity following influenza disease and administration of influenza vaccines).
    All you are doing is appealing to experts. There is no such thing as an expert, beyond what you as an individual are willing to trust as an expert.

    I worked for several years as an electrician. Among the people and companies I worked for, there were financially successful individuals who got to that position because they ignored building codes and were good at making deals with the right people. An outside observer may have called one of these people an expert based on their position and financial success, but that in no way made them an expert electrician. These were the same people possessing a license that said they were a "master electrician". An appeal to an expert or a speculative data set is unpersuasive. This is what people are trying to point out to you.

    Quote Originally Posted by lazygun37 View Post
    And while it may seem obvious to you that a terrible event like the Great Depression would result in many excess deaths, the actual data says otherwise. Counterintuitively, overall mortality rates *decline* during recessions -- including the Great Depression (Life and death during the Great Depression | PNAS). Obviously that doesn't mean we should all pray for recessions so we can live longer. But it sure as hell shows that the question deserves more thought than "LOL".
    So if mortality rates are lower during a recession, our ideal is to always have the economy in recession, because that means lower mortality rates?

    Do you understand that trying to predict and model anything in the way these papers are trying to is impossible? Do you understand that these types of papers are just fluff that men in high castles come up with to try and and justify their existance? That trying to model anything that doesn't adhere to a controlled, quantifiable set of data is essentially impossible?

    It is impossible to say anything of substance about how many people died because of the Great Depression except to say that it was a lot. It led to World War II. It was responsible for the US dropping two atomic bombs on Japan. It caused food shortages across the globe. It's effects were so large that they are impossible to quantify.

    The reason people are giving you flippant responses is because your entire argument is an appeal to experts who a large number of people do not consider to be experts on anything but keeping their asses comfortable at the rest of the world's expense.

  10. #320
    Join Date
    Nov 2012
    Location
    Toronto, Ontario
    Posts
    1,003

    Default

    starting strength coach development program
    Quote Originally Posted by Mark Rippetoe View Post
    So your point is that whatever is necessary to do to stop this epidemic -- up to and including the dismantling of modern society -- is just fine, because it is a cause of death. Is this a fair characterization?
    What do you think happens if we don't impose these measures?

    Have you considered the economic risks of a full on outbreak?

    An economy going buck wild out of fear is far harder to manage than it is in a contained situation.

    Quote Originally Posted by ltomo View Post

    The reason people are giving you flippant responses is because your entire argument is an appeal to experts who a large number of people do not consider to be experts on anything but keeping their asses comfortable at the rest of the world's expense.
    Except we don't have to appeal to experts in this case. The amount of data sharing on this topic is unprecedented.

    There is a treasure trove of open access information out there right now, including raw data which is updated daily, whose quality is improving as we learn more.

    There doesn't seem to be a big gap between what government and experts have access to in terms of data and research, and what we have if we choose to explore it.

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •