Corona Virus... the second wave

[idleprocess]

leads to false sense of security, entices risky actions

Moral hazard is a very real risk in these situations that can take monumental effort to correct if the wrong signals are sent early on.

So... write an equation calculating probability of mask usage/non-usage helping/hurting for the 1) population as a whole 2) specific subgroups (elderly, healthcare, ignorant rednecks, etc). Now, communicate some VERY complex & predictive math to the nation as a whole, given the average person reads at about a 8th grade level.

Also, do this when...

• The available information is incomplete, speculative, and/or contains errors
• The behavior of the general public in the face of a threat most is almost wholly unknown since most people alive have never experienced something like this
• Policymakers pressing you for a decision with huge error bars
• Knowing that the media is going to run with the juiciest hot take
• And despite steady refinement to the model week over week - as well as preventative measures kneecapping the initial upper bound - you're still going to be hounded for that initial figure by the peanut gallery >13 months later about how 'scientists got it wrong'

People freak the f___ out over Ebola which is a horrible disease but has killed less than 20,000 people since first being described in 1976. Meanwhile despite dire warnings, lockdowns, mask mandates, many suddenly washing their hands regularly for the first times in their lives, and numerous other oft-decried measures COVID-19 has killed 25 times as many people as Ebola in the span of a little more than a year in just the United States. Despite significant improvements in therapies for the sick and effective vaccines being developed in record time it's predicted to continue getting worse.

And even today with the vaccines there's grumbling about how long until someone is considered immune, rage that face masks aren't being eliminated, anger that gatherings are still being restricted or simply suggested to be restricted ... despite the vaccine being available in quantity for a mere ~3 months and an abundance of caution being the sensible course until it is better understood and the guidance can be adjusted based on more data.

 

[turbodog]

...
Like you said... it is IMO unknowable and mandating masks IMO is all but worthless to many who are getting infected out there wearing them. Most places I go everyone is wearing a mask yet we still have lots infected so apparently they aren't working that well.
...

With respect, I think you made my point for me. And you are assuming that just because some people are infected with usage then they don't work. What if they are working... and no masks would be way worse?

My point is that public health POLICY is just that, POLICY. You've got to make a mandate that overall works for society as a whole. Yes, people will fall through the gaps. But overall it's the best recommendation.

 

[turbodog]

I'll talk about PUBLIC health policy a little more... as something just hit me like a ton of bricks.

Earlier today, a CPF member sent me a PM about a drug that _could_ show great promise as a tool to fill in some gaps while we get people vaccinated. It's cheap, _probably_ highly effective, and with a good safety record.

So, no brainer, right?

Well... not so fast. It's also a known drug that, in a roundabout way, either prevents pregnancy or is not allowed for pregnant women. So, even better! Win-Win, right?

So what happens in ~6 years when we have a huge gap in schoolkids? What does this do to education? Don't need first grade teachers since there a very few new first graders. Then the gap moves down the line, and eventually we have a year with no college grads and no generation entering the workforce.

Stuff like this crashes entire economies. So the facts are that drug "X" solves a ton of covid problems, but will destroy your economy, in stages, over the next 22 years. These decisions, even when we try to be impartial, are complex to say the least.

 

[Lynx_Arc]

With respect, I think you made my point for me. And you are assuming that just because some people are infected with usage then they don't work. What if they are working... and no masks would be way worse?

My point is that public health POLICY is just that, POLICY. You've got to make a mandate that overall works for society as a whole. Yes, people will fall through the gaps. But overall it's the best recommendation.

The problem is without facts and solid statistics we don't really know if masks are working well enough to counteract the easing up on cautiousness concerning this virus of people who wear them. When nobody was wearing masks I would go to stores they would limit how many could come in the store and enforce distancing rules and had lines and arrows and stuff. With masks distancing is about halfway adhered to and stores have about twice the people in them now in some cases and people are crowding each other too. In other words masks are psychologically making people feel safer than I believe they are effective and that "feeling safe" bit is making people wreckless which IMO is actually having a negative affect on halting the spread of the virus as instead of staying 6 feet or more away, we see poor examples on even an AMAZON commercial on TV where two people who cannot understand themselves because of wearing masks are almost ear to ear both reading on the same smart phone... hey this is a low price... They aren't even a foot and a half apart because... masks.
I watched a volleyball game on live tv the other night women college game. Everyone was wearing masks and I noticed that about half the girls were moving the masks and scratching their face because it was irritating them and pulling them down to take a breath at times and then guess what? they were all hitting the same ball back and forth and rubbing their mask and face. If they had no masks on they would probably be LESS likely to be infected by the virus because the need to tough the mask and their face.. would be GONE.

 

[jtr1962]

The problem is without facts and solid statistics we don't really know if masks are working well enough to counteract the easing up on cautiousness concerning this virus of people who wear them. When nobody was wearing masks I would go to stores they would limit how many could come in the store and enforce distancing rules and had lines and arrows and stuff. With masks distancing is about halfway adhered to and stores have about twice the people in them now in some cases and people are crowding each other too. In other words masks are psychologically making people feel safer than I believe they are effective and that "feeling safe" bit is making people wreckless which IMO is actually having a negative affect on halting the spread of the virus as instead of staying 6 feet or more away, we see poor examples on even an AMAZON commercial on TV where two people who cannot understand themselves because of wearing masks are almost ear to ear both reading on the same smart phone... hey this is a low price... They aren't even a foot and a half apart because... masks.
I watched a volleyball game on live tv the other night women college game. Everyone was wearing masks and I noticed that about half the girls were moving the masks and scratching their face because it was irritating them and pulling them down to take a breath at times and then guess what? they were all hitting the same ball back and forth and rubbing their mask and face. If they had no masks on they would probably be LESS likely to be infected by the virus because the need to tough the mask and their face.. would be GONE.

And yet the countries which followed the science, as imperfect as it may be, did much better:

https://ourworldindata.org/covid-exemplar-south-korea

You're conflating measures which work when implemented properly with the failure of a large part of the population to either implement these measures correctly, or even at all. Your description of what's happening in stores is a perfect example. If you have a non-compliant and/or largely uneducated public (both are true in the US), there are only two real choices we had. One is to prevent the virus from reaching the US in large numbers. That boat sailed probably by January 2020, perhaps earlier. The other is to just shut down everything but non-essential services, and force people to shelter in place at home, perhaps delivering groceries regularly to enable this. Partial shutdowns can also work with success, as they did in NYC through the summer.

The biggest problem I see is we're too quick to try to get back to "normal" whenever the numbers drop. We have the summer wave in lots of the country. Measures to slow it were somewhat successful. The should have remained in place to reduce numbers further by the fall. Instead, we started opening things up too early. Then the holiday season compounded things. We should have shut down air travel, and severely restricted the highways to only essential traffic. We would have been in a great place now. As we started vaccinating people, maybe this month we could have slowly reopened things. By late summer things could have been almost back to normal. Instead, I'd say best case we might get back to normal by late fall if we don't have problems with variants. And we'll probably be looking at 600,000+ dead by then, versus well under 100,000 if we had done the things I mentioned.

 

[jtr1962]

So, no brainer, right?

Well... not so fast. It's also a known drug that, in a roundabout way, either prevents pregnancy or is not allowed for pregnant women. So, even better! Win-Win, right?

So what happens in ~6 years when we have a huge gap in schoolkids? What does this do to education? Don't need first grade teachers since there a very few new first graders. Then the gap moves down the line, and eventually we have a year with no college grads and no generation entering the workforce.

Stuff like this crashes entire economies. So the facts are that drug "X" solves a ton of covid problems, but will destroy your economy, in stages, over the next 22 years. These decisions, even when we try to be impartial, are complex to say the least.

Well, we're already facing this to a lesser degree:

https://www.scientificamerican.com/article/sperm-count-dropping-in-western-world/

In a century or two we might be facing the scenario from the movie Children of Men

Bad for us but in truth the planet would be far better off if we went extinct.

 

[turbodog]

The problem is without facts and solid statistics we don't really know if masks are working well enough ...

Think we can chalk this up to American exceptionalism. Didn't Taiwan, South Korea, and some other countries do extremely well in containing it?

But back to policy... you get to pick telling people a very simple set of recommendations. Can't leave it up to 'good judgement'. If everyone's judgement was that good we would not be in this trouble.

And for the record, I am against the premature decisions made by TX/MS governors. I don't know about TX, but MS is not a leader in healthcare that you want to follow.

 

[nbp]

@Lynx Arc

The fact that you still think "everyone is masking but cases still went up so masks don't work" tells me you don't actually go to any Of the places where the virus has been primarily spreading to see how people actually behave. Your anecdotal evidence is flawed at best. If your only sample is the grocery store or your workplace where things are constantly sanitized and 90+% of people are masked I could see why you might think that. That isn't where people are getting sick. Why don't you visit some bars, restaurants, gyms, churches, college campuses, holiday parties, and see how people actually operate. You might be surprised. And take into consideration that many places never had a mask mandate or let it expire. If you don't want to wear a mask just be honest and say "hey I hate these masks and I am not interested in doing even the smallest thing that might help my neighbors be safe". We all know that's what it is anyways. But don't come around with your junk science claiming everyone followed rules and they didn't work when we know a huge number of people basically did nothing to follow the rules.

 

[idleprocess]

And for the record, I am against the premature decisions made by TX/MS governors. I don't know about TX, but MS is not a leader in healthcare that you want to follow.

Yeah, uhm, TX ain't so hot either. Highest percentage residents uninsured:

#50 Becker's Hospital Review
#50 America's Health Rankings
#50 US News

With regard to overall rankings, TX fares better per US News at 31 aggregate with Healthcare Access / Healthcare Quality / Public Health ratings of 45 / 39 / 18 respectively. The last is really surprising but local county public health agencies have been sleeper impressive in their mass vaccination site planning and execution, vaccinating thousands of people per day with excellent organization - a bright spot in the state's otherwise subpar response to the crisis.

 

[Lynx_Arc]

And yet the countries which followed the science, as imperfect as it may be, did much better:

https://ourworldindata.org/covid-exemplar-south-korea

You're conflating measures which work when implemented properly with the failure of a large part of the population to either implement these measures correctly, or even at all. Your description of what's happening in stores is a perfect example. If you have a non-compliant and/or largely uneducated public (both are true in the US), there are only two real choices we had. One is to prevent the virus from reaching the US in large numbers. That boat sailed probably by January 2020, perhaps earlier. The other is to just shut down everything but non-essential services, and force people to shelter in place at home, perhaps delivering groceries regularly to enable this. Partial shutdowns can also work with success, as they did in NYC through the summer.

The biggest problem I see is we're too quick to try to get back to "normal" whenever the numbers drop. We have the summer wave in lots of the country. Measures to slow it were somewhat successful. The should have remained in place to reduce numbers further by the fall. Instead, we started opening things up too early. Then the holiday season compounded things. We should have shut down air travel, and severely restricted the highways to only essential traffic. We would have been in a great place now. As we started vaccinating people, maybe this month we could have slowly reopened things. By late summer things could have been almost back to normal. Instead, I'd say best case we might get back to normal by late fall if we don't have problems with variants. And we'll probably be looking at 600,000+ dead by then, versus well under 100,000 if we had done the things I mentioned.

Ironic you talk about figures and have "bought in" to the idea that we aren't doing absolutely fantastic with this pandemic in fact we have greatly surpassed even blown away what the 1918 pandemic figures were. I estimated that at 500k deaths based upon the population percentage compared to 1918 our efforts would have lowered their 600k to 180k and their 600k then would be the same as about 2.1M now so we should think instead of saving 100k more think we are 1.5 million LESS than we should be and people are all freaking out over that extreme success?

 

[idleprocess]

Ironic you talk about figures and have "bought in" to the idea that we aren't doing absolutely fantastic with this pandemic in fact we have greatly surpassed even blown away what the 1918 pandemic figures were. I estimated that at 500k deaths based upon the population percentage compared to 1918 our efforts would have lowered their 600k to 180k and their 600k then would be the same as about 2.1M now so we should think instead of saving 100k more think we are 1.5 million LESS than we should be and people are all freaking out over that extreme success?

Bad analogy - the needle has moved considerably over the last century. Take life expectancy - 53.22 in 1920, 78.81 in 2020 or twenty-five more years. Or look at the common causes of death in 1920 vs 2010 - numerous common causes of death in 1920 have either vanished or have greatly reduced (cardiovascular disease and cancer are notable exceptions; the former due to increasingly sedentary lifestyles and "modern diets", the latter likely due to better diagnoses and longer lifespans).

The comparison to South Korea - another advanced economy - is quite apt and the stark differences in responses correlate very strongly to the huge divergence in outcomes. Per Worldmeters.info :

• United States : 29M cases | 540k deaths | 89k cases / million | 1627 deaths / million
• South Korea : 93k cases| 1648 deaths | 1827 cases / million | 32 deaths / million

We're doing things very wrong relative to South Korea.

 

[jtr1962]

Ironic you talk about figures and have "bought in" to the idea that we aren't doing absolutely fantastic with this pandemic in fact we have greatly surpassed even blown away what the 1918 pandemic figures were. I estimated that at 500k deaths based upon the population percentage compared to 1918 our efforts would have lowered their 600k to 180k and their 600k then would be the same as about 2.1M now so we should think instead of saving 100k more think we are 1.5 million LESS than we should be and people are all freaking out over that extreme success?

Back in 1918 we didn't have the tools we have now. We didn't have effective treatments, and we didn't develop a vaccine at all, much less within a year after the virus surfaced. The best comparison of how the US did isn't to compare us to how we did in 1918. It's to compare us to how other countries did now. The death rate per million people in the US is now at 1633. Japan is at 66, Australia is at 35, South Korea is at 32, New Zealand is at 5. Taiwan and Vietnam are at 0.4! If the US had that death rate only a little over 100 people would have died. Or if you want to compare us with a country on the same continent, Canada is at 587. The US is number 12 in death rate out of over 200 countries. Not something to be proud of, and certainly not "absolutely fantastic" as you say. The one great thing we helped do was to quickly get vaccines. If only we had taken measures before then to slow the spread. Also, I totally don't understand stuff like what's happening in Texas and Mississippi. Now with vaccines, the end is in sight. All we have to do is hunker down a few more months. So why risk more spread and the possibility of more variants by opening things up now, never mind getting rid of mask mandates which is something I was flabbergasted by? Masks are the one thing which allows you to keep more things open.

 

[markr6]

The comparison to South Korea - another advanced economy - is quite apt and the stark differences in responses correlate very strongly to the huge divergence in outcomes. Per Worldmeters.info :

• United States : 29M cases | 540k deaths | 89k cases / million | 1627 deaths / million
• South Korea : 93k cases| 1648 deaths | 1827 cases / million | 32 deaths / million

We're doing things very wrong relative to South Korea.

Lots going on here though. It's a small country, a peninsula surrounded by water and North Korea. Even if their population density was 100x higher than the US, the differences in infrastructure, healthy system and previous experience with SARS and MERS make it an apples and hammers comparison. That last point is key and likely the main reason why everyone took it seriously...and may have even had masks stashed in their residences prepared for the next one. And I'm not sure how their country is organized, but I'm sure it's not 50 separate areas doing whatever they feel like.

 

[idleprocess]

Lots going on here though. It's a small country, a peninsula surrounded by water and North Korea. Even if their population density was 100x higher than the US, the differences in infrastructure, healthy system and previous experience with SARS and MERS make it an apples and hammers comparison. That last point is key and likely the main reason why everyone took it seriously...and may have even had masks stashed in their residences prepared for the next one. And I'm not sure how their country is organized, but I'm sure it's not 50 separate areas doing whatever they feel like.

Ah, but with that density (something like >50% of the population living in the Seoul metro area) comes NYC-like conditions yet they managed it like a champ. And despite the geographical and structural differences, we're still doing things wrong.

But hey, how about our neighbor to the north that's more similar?

• Canada : 893k cases | 22k deaths | 53k cases / million | 587 deaths / million

60% of the per-capita caseload, 36% of the mortality relative to the US.

 

[markr6]

NYC-like conditions yet they managed it like a champ.

I would expect that for the reasons I listed above. Hopefully everyone can learn from this...but I doubt it.

 

[turbodog]

...And I'm not sure how their country is organized, but I'm sure it's not 50 separate areas doing whatever they feel like.

I've said this before, but it bears repeating. People forget that the USA is literally United STATES of America. 50 states with their own governors, health depts, etc. Heck... and the US is so large that we span several time zones and climates. These are additional challenges that many countries don't face.

That said... given our money and possibilities... we should had led the world in response to this threat. I give us a "D" at best in regards to preparation, prevention, communication, etc. I give healthcare an "A+" for dedication to try and keep us from killing ourselves.

 

[markr6]

I wonder how many other countries politicize everything...EVERYTHING...as much as we do.

 

[scout24]

I'm not sure, markr6. What I am sure of though is that things here in this thread have been drifting in that direction again. I understand as well as anyone it's a hot button topic and everyone has opinions and thoughts as to the political aspect of the virus. And I understand for some these threads are a place to vent or make their opinion known with relative annonymity and safety, no blowback or reprisal in real life. I implore you all to stop so there's a place here on CPF to discuss the myriad of other facets of the pandemic without bringing politics back in and having the entire topic be shut down hard. Please use "Downstairs" or hold your peace...