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Thread: COVID19 Factors We Should Consider/Current Events

  1. #301
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    Quote Originally Posted by abduality View Post
    I appreciate Rip et al's skepticism, but an open question in my mind is: Why were Italy and China's hospitals overwhelmed?. Whether it was CoV-19, or it was something else, the fact is that for a few weeks to a month now, those two places don't have a healthcare system (due to increased utilization -- whatever the cause may be). That is not an insignificant risk.
    Why? Because everyone that got the sniffles went to the damn hospital. Add that Italy's healthcare system is basically 3rd world. Socialized medicine for the win.

  2. #302
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    Quote Originally Posted by markus1 View Post
    Pity our AUS government is willing to sacrifice mass jobs/gdp on account of a bad flu but refused to accept job losses/gdp on account of climate change action. On one hand the hazard affects old sick people knocking on death's door.....or the other it affects millions of youth with their lives ahead of them.
    Amazing!

    Quote Originally Posted by bracemaker View Post
    Why? Because everyone that got the sniffles went to the damn hospital.
    Because the authorities and the Media told them they were going to die.

    Now, Weekly U.S. Influenza Surveillance Report | CDC

    CDC estimates that so far this season there have been at least 38 million flu illnesses, 390,000 hospitalizations and 23,000 deaths from flu.
    https://www.cdc.gov/flu/weekly/weekl...HL11_small.gif

    As of now, the total deaths worldwide attributed to COVID19 is 10,444. In the US, 223 deaths on 16,489 cases.

  3. #303
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    At least these regular press briefings from the president are leading to some of the best "Trump vs Reporters" exchanges of his entire presidency.

  4. #304
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    The deaths so far are tiny. A rounding error. Esp in China.

    Will the misery avoided by "flattening the curve" (call it Mf)

    Be greater than the misery caused by flattening the US economy (call it Me).

    This is the question nobody (almost) is asking.

    Keep in mind, nobody is saying that flattening the curve will prevent cases.

  5. #305
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    Japan is curious.
    No overbearing lockdown.

    Their population is weighted towards the elderly, very similar to Italy.
    Similar hospital beds:citizen ratio.
    High density country. ~128M vs ~60M people.

    Don't test everyone and anyone.
    Don't use hospital beds for quarantine purposes. hmmmm

    Bloomberg

    “Italy’s mortality rate is almost triple Japan’s,” said Yoko Tsukamoto, a professor of infection control at the Health Sciences University of Hokkaido. “Part of the reason is if you get tested, you get quarantined, so it means that they don’t have enough beds for relatively non-severe patients.”

  6. #306
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    Quote Originally Posted by Fulcrum View Post
    Japan is curious.
    No overbearing lockdown.

    Their population is weighted towards the elderly, very similar to Italy.
    Similar hospital beds:citizen ratio.
    High density country. ~128M vs ~60M people.

    Don't test everyone and anyone.
    Don't use hospital beds for quarantine purposes. hmmmm

    Bloomberg
    They love masks, which we are assured don't work. YouTube has all kinds of videos on how to easily make your own.

  7. #307
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    There have been a lot of arguments here that conclude that (a) there is no actual health crisis at all, and/or (b) current attempts to deal with the outbreak are an over-reaction or counterproductive.

    Well, I couldn't help myself and ended up looking at all of them. The resulting document is attached below.

    I doubt it will change anybody's mind. But if you believe (a) and/or (b), and are willing to read it carefully, I would genuinely love to discuss what specific parts of the analysis you disagree with.


    Quite a few people in this thread and elsewhere have argued that (a) the current outbreak may not actually be a big problem or (b) even if it is, that the government restrictions are an over-reaction and/or counterproductive. The following is an attempt to compile and analyse these arguments.

    I apologise for the length of this document. I also want to be clear from the outset that, like everybody else who is commenting in this thread, I am not an epidemiologist. But even somebody like me (and you) should be able to see that these “common sense” arguments do not hold up. So maybe, just maybe, we should trust the people who actually do know what they are doing and who are trying to prevent unnecessary loss of life and economic damage.

    • COVID-19 vs Influenza

    ◦ "The flu is just as bad or worse (and we don't panic over the flu)"
    ▪ COVID-19 seems to be about twice as infectious as the flu
    ▪ The rate of infected people who require hospitalization is much higher for COVID-19
    ▪ COVID-19 is several times more deadly than the flu
    ▪ There is no vaccine against COVID-19
    ▪ Nobody has had COVID-19 before, so nobody is immune due to prior exposure

    ◦ "The flu kills 10,000 - 100,000 people each year in the USA; COVID-19 has killed 154 so far (and we don't panic over the flu)"
    ▪ COVID-19 cases are currently in an exponential growth phase (in the US and most countries), with typical doubling times of 2-8 days (in the US, it's 2.8 days for cases)
    ▪ If unchecked, exponential growth at this rate would lead to ~160,000 deaths in about 1 month (10 doublings)
    ▪ Experts are worried about that *now*, because a "wait and see" attitude is impossible
    • after 2 weeks (5 doublings), there will still "only" be ~5000 cases, i.e. much less than the flu
    • but in the following 2 weeks (!), that ~5000 will appear to "explode" to ~160,000
    • the incubation period of the virus is probably around 5 days, so whatever non-medical intervention you make now will not kick in for at least that long
    • 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

    ◦ "This coronavirus might just be (related to) the normal flu (and we don't panic over the flu)"
    ▪ Even if this were true, it would only make sense if
    • we were far more immune to the virus than we think, or
    • the virus is far less infectious/deadly than we think
    ▪ But we have concrete *data* from multiple countries about the infectiousness and lethality of the virus, so we *know* that neither of those things is true

    • (Bad) Data / Analysis
    ◦ "The data we are making decisions on is horrendously incomplete/biased/whatever"
    ▪ This is certainly partially correct, but these imperfections can be (and are) taken into account in decision-making
    ▪ For example, it's clearly true that, while testing is sparse, hospitalization and mortality rates will appear to be inflated (because only very sick people will get tested). However,
    • experts and decision makers obviously know about this bias and try to take it into account
    • we have sufficient data from multiple sources/locations now to know for sure that both of these rates are *significantly* higher than for the flu, for example, which means it's a *huge* problem

    ◦ "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

    ◦ "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
    ▪ 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

    ◦ "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.
    ▪ 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)
    ▪ 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

    ◦ "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]

    • 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 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
    ▪ 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

    • 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.
    ▪ 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?
    • 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.

    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.
    Attached Files Attached Files

  8. #308
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    Quote Originally Posted by ForbiddenDonut View Post
    I was saying 3 weeks ago the best thing we could do is put it in the water supply. I am pretty heartless though. But I suppose living through a great depression will bring life long memories.

  9. #309
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    Almost every line in that document is wrong. Just a few:

    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)

    Writer doesn't understand influenza immunity.

    Italy is an outlier. A brief glance at the deaths/pop tell us this.

    Writer dismisses secondary motivation and gain of government/media other countries. These imperfections can be (and are) taken into account in decision-making" This document is a joke.

    The writer wants quantitative data on the misery/health effects of the Great Depression for comparison. LOL.

    In the Great State of Texas, currently 5 deaths, all over the age of 60.

  10. #310
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    starting strength coach development program
    I'm not that busy today, so:

    • COVID-19 vs Influenza

    ◦ "The flu is just as bad or worse (and we don't panic over the flu)"
    ▪ COVID-19 seems to be about twice as infectious as the flu

    Seems? You are happily destroying the economy of the US and by extension the World, because of the way something seems.
    ▪ 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.
    ▪ 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.
    ▪ Nobody has had COVID-19 before, so nobody is immune due to prior exposure
    You absolutely do not know this to be true.


    ◦ "The flu kills 10,000 - 100,000 people each year in the USA; COVID-19 has killed 154 so far (and we don't panic over the flu)"
    ▪ COVID-19 cases are currently in an exponential growth phase (in the US and most countries), with typical doubling times of 2-8 days (in the US, it's 2.8 days for cases)
    ▪ If unchecked, exponential growth at this rate would lead to ~160,000 deaths in about 1 month (10 doublings)

    If unchecked? Has anyone suggested that we stop washing our goddamn hands? That we start breathing on each other?
    ▪ Experts are worried about that *now*, because a "wait and see" attitude is impossible
    • after 2 weeks (5 doublings), there will still "only" be ~5000 cases, i.e. much less than the flu
    • but in the following 2 weeks (!), that ~5000 will appear to "explode" to ~160,000

    If unchecked. Right.
    • the incubation period of the virus is probably around 5 days, so whatever non-medical intervention you make now will not kick in for at least that long
    It was two weeks, two weeks ago.
    • 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.

    ◦ "This coronavirus might just be (related to) the normal flu (and we don't panic over the flu)"
    ▪ Even if this were true, it would only make sense if
    • we were far more immune to the virus than we think, or
    • the virus is far less infectious/deadly than we think
    ▪ But we have concrete *data* from multiple countries about the infectiousness and lethality of the virus, so we *know* that neither of those things is true

    You don't have any concrete data from anybody except the cruise ship. Read the Ioannidis piece above, and refute that for us.

    • (Bad) Data / Analysis
    ◦ "The data we are making decisions on is horrendously incomplete/biased/whatever"
    ▪ This is certainly partially correct, but these imperfections can be (and are) taken into account in decision-making

    What is it called when we sentence a man to death based on incomplete/biased/imperfect testimony? Pretend the economy is that man.
    ▪ For example, it's clearly true that, while testing is sparse, hospitalization and mortality rates will appear to be inflated (because only very sick people will get tested). However,
    • experts and decision makers obviously know about this bias and try to take it into account

    Try? Experts and decision makers are ... who?
    • we have sufficient data from multiple sources/locations now to know for sure that both of these rates are *significantly* higher than for the flu, for example, which means it's a *huge* problem
    No, we don't. As I mentioned earlier.

    ◦ "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.

    ◦ "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.

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