OT: Coronavirus chat

[Freudian]

We have Swedish posters here, how do you feel the strategy there is working?

We're probably protecting the economy a bit better than most other countries but we've had Covid-19 hit senior citizen homes and home services (many elders live by themselves but have people from the public service help them with cleaning and grocery shopping). It's probably inevitable. Most fatalities are older people. Some segregated areas of Stockholm with a lot of refugees and immigrants have been hit hard.

I think most Swedes are supportive of the current strategy. We are in general good about social distancing before Corona and have a high trust for authorities, so most follow the rules. There are of course people who demand that we shut everything down, but they are a loud minority. I think keeping the society open as much as possible prevents some of the big drawbacks from quarantine, such as increase in psychological unhealth, domestic violence, kids not getting proper nutrition because school meals were their main means of nutrition, fewer people losing their jobs and also a general fatigue. It's very hard for people to accept months and months of total lockdown. They start breaking the rules, which I suspect will be a big problem in a lot of countries when spring turns to summer. That's why we are seeing more and more countries planning to open up after Easter.

I think Sweden have some general advantages. Largest share single person households in the world. We are generally very conscientious about other peoples personal space in public and at work. We are good at following rules, so most are good with the washing of the hands and so on.

In general Swedens strategy isn't that different from most other countries. Stay at home if you have symptoms, wash your hands and protect the elderly. It's not like a lockdown with police handing people fines would ever work here. That's not how Sweden is wired as a society.

If this virus has the infectiousness recent data suggest, I'm not sure the eventual outcome will be that affected by domestic strategy. It's possible 30-50% of people here already have or have had it and we're moving towards herd immunity. We'll see when antibody testing starts to happen.

 

[henchman21]

While I'm going to be happy if things end up on the side of 50k deaths rather than millions. I hope people don't take that as reason to ignore the government in the future when something like this happens again.

Who knows how long it will be, but with an ever growing population humanity needs to be able to deal with pandemics like this. I'm very happy with the measures Colorado has taken on this. I can acutally see a light at the end of the tunnel.

That is my real fear here. When something comes around that does eventually kill at a higher rate and spreads faster, people will blow it off like another overhyped virus. They will state this was supposed to infect the whole US and millions would die, but it ended up much less than that... so why believe round 2? There is going to be a mistrust based upon the lasting economic damage, and that will be hard to win back over.

 

[ABasin]

They always said they thought it could be lower if the country was following the mitigation guidelines. Fauci emphasized this a few times, as well as the fact that the models are only as good as the assumptions they're based on. Which is absolutely true.

I think publicizing those numbers so much was an intentional effort to get the public's attention, because not enough people were staying home. Especially those worst case scenario numbers of 1.6-2.2 million if they did nothing.

No way is mitigation the only reason those numbers skewed that severely in that short a period of time. A 60/70/80% change in 4 days? For a disease that often takes 10-14 days to manifest itself in an obvious fashion? Those don't add up.

Bottom line: The numbers were very wrong in the beginning, or they're very wrong now.

In the end though, I'm cautiously optimistic, as this is all positive news. I don't doubt our stay-at-home mitigation has helped this situation a lot. Common sense tells us this is something that makes sense. I think I'm going to fall back on common sense with these things from here on out, do my part as a responsible citizen, and not pay attention to the hyped numbers anymore.

 

[Sheet]

Honestly with stuff like this it’s far better for everyone if we operate on a worse case scenario basis. I’d rather an over reaction versus under reaction. And for those being skeptical of the old vs new projections you have to understand the old projections were based off from old data. Not just regarding the disease.

availability of PPE, state requirements for shelter in place, etc etc. effectiveness of social distancing. As those numbers change the modeling data changes. It’s not as simplistic as just looking at an R NOD and going ok yep this is how many will get it. There’s too many variables. The projections weren’t wrong at the time. Just like these projections aren’t wrong at this time. Hindsight is 20/20.

 

[ABasin]

We’re learning now that it might not be ARDs from respiratory fatigue as much as it probably is from a cytokine storm leading to ARDs which may help vector treatment in the future if that pans out as true. Maybe immuno down regulating.

I read something along these lines. I think. How doctors are treating COVID patients by giving them meds that actually calm down the immune system, because the immune system is somehow not only attacking the virus, but is attacking the lung tissue itself, or causing lung inflammation. Which in turn allows secondary bacterial infection to come in and kill the patient. I'm not a medical person, so I'm writing this from a place of biology ignorance. But that's how I interpreted what I read.

If I have that right, is such a treatment a real balancing act for physicians? I mean, it seems to me that on one hand, we'd want the immune system rocking and rolling to nuke viruses. On the other hand, we have overactive immune systems actually hurting the situation. Tough balance, no?

 

[henchman21]

Honestly with stuff like this it’s far better for everyone if we operate on a worse case scenario basis. I’d rather an over reaction versus under reaction. And for those being skeptical of the old vs new projections you have to understand the old projections were based off from old data. Not just regarding the disease.

availability of PPE, state requirements for shelter in place, etc etc. effectiveness of social distancing. As those numbers change the modeling data changes. It’s not as simplistic as just looking at an R NOD and going ok yep this is how many will get it. There’s too many variables. The projections weren’t wrong at the time. Just like these projections aren’t wrong at this time. Hindsight is 20/20.

In the coronavirus pandemic, we're making decisions without reliable data

The warning signs were there in the numbers. We didn't have the right data, and we weren't willing to try to find the right data. It went to worst case assumptions right away. The reasonableness got lost in the noise and panic of people. It was shaped into a black and white argument where if you didn't support the draconian measures, you wanted millions to die. I get being careful and going a bit overboard for safety. Going straight to worst case scenario, panicking, yelling about needing 5+x the amount of ventilators than actually needing, etc. That causes public hysteria, and causes all sorts of problems outside the virus itself.

The big model being adjusted down was built with the assumption of the measures currently in place... even the places with the more extreme procedures taken into account from the beginning, they are adjusting down by huge numbers. It was flawed data through and through, and people jumped on it as gospel.

 

[Sheet]

I read something along these lines. I think. How doctors are treating COVID patients by giving them meds that actually calm down the immune system, because the immune system is somehow not only attacking the virus, but is attacking the lung tissue itself, or causing lung inflammation. Which in turn allows secondary bacterial infection to come in and kill the patient. I'm not a medical person, so I'm writing this from a place of biology ignorance. But that's how I interpreted what I read.

If I have that right, is such a treatment a real balancing act for physicians? I mean, it seems to me that on one hand, we'd want the immune system rocking and rolling to nuke viruses. On the other hand, we have overactive immune systems actually hurting the situation. Tough balance, no?

A lot of pathogens don’t directly kill you. A lot of times it’s our own immune response. Immunosuppressant therapy is used in a lot of different disease processes to stop or downward regulate the immune response. If you think of antipyretics like Tylenol, they are essentially suppressing an immune response to a pathogen. The pathogen it’s self doesn’t cause the fever.

As a rule fevers are harmless(edit: harmless short term is more accurate), and febrile seizures even rarely cause last harm, but it can lead to a host of other problems like denaturing enzymes vital to your survival, so we try to control the fever. Even though our body is increasing our temperature intentionally to make it inhospitable to the pathogen. So while a fever is typically harmless it can cause a lot of problems if left unchecked for too long.

 

[Sheet]

In the coronavirus pandemic, we're making decisions without reliable data

The warning signs were there in the numbers. We didn't have the right data, and we weren't willing to try to find the right data. It went to worst case assumptions right away. The reasonableness got lost in the noise and panic of people. It was shaped into a black and white argument where if you didn't support the draconian measures, you wanted millions to die. I get being careful and going a bit overboard for safety. Going straight to worst case scenario, panicking, yelling about needing 5+x the amount of ventilators than actually needing, etc. That causes public hysteria, and causes all sorts of problems outside the virus itself.

The big model being adjusted down was built with the assumption of the measures currently in place... even the places with the more extreme procedures taken into account from the beginning, they are adjusting down by huge numbers. It was flawed data through and through, and people jumped on it as gospel.

As we discussed previously I do agree that we very much operated on a worse case scenario and I don’t dispute we were trying to predict a tornado in Alaska by feeling a breeze in Florida.
What I’m saying is since that initial estimate several states have taken further measures and I don’t think anyone that was doing the modeling had much in the way of hope that Americans would actually socially distance and take preventative measures like they did.

I do think 100k out of the gate was kind of extreme. I do think that more reasonable models were available at the time. I think there was a few factors at play with really pushing that narrative.

From a government and healthcare response you have to operate on the worst possible scenario. I’d rather be wrong, have 30000 vents, only needing 10000 vs being wrong in the other direction.

From a social engineering perspective which I’m morally opposed to, six figures and 30k vents gets attention. It ups the severity. It maybe gets the public to be a bit more vigilante with infection control guidelines. The numbers weren’t a lie, but I don’t think they were released with the most integrity. Instead of we will need 30k vents in ny I’d have much preferred we might need if our worst outcomes come to light.

I have bigger problems with the messaging then the models, I guess.

 

[henchman21]

As we discussed previously I do agree that we very much operated on a worse case scenario and I don’t dispute we were trying to predict a tornado in Alaska by feeling a breeze in Florida.
What I’m saying is since that initial estimate several states have taken further measures and I don’t think anyone that was doing the modeling had much in the way of hope that Americans would actually socially distance and take preventative measures like they did.

I do think 100k out of the gate was kind of extreme. I do think that more reasonable models were available at the time. I think there was a few factors at play with really pushing that narrative.

From a government and healthcare response you have to operate on the worst possible scenario. I’d rather be wrong, have 30000 vents, only needing 10000 vs being wrong in the other direction.

From a social engineering perspective which I’m morally opposed to, six figures and 30k vents gets attention. It ups the severity. It maybe gets the public to be a bit more vigilante with infection control guidelines. The numbers weren’t a lie, but I don’t think they were released with the most integrity. Instead of we will need 30k vents in ny I’d have much preferred we might need if our worst outcomes come to light.

I have bigger problems with the messaging then the models, I guess.

I do agree that there was a lean on the messaging to scare people. My fear there is the backfire, and I think we are already starting to see it. When you say 2m will die and it ends up being less than 100k, it becomes a cry wolf sort of situation. There are only so many chances that the public will give before they tune out, and when we are having the economic fall out we are, there is more incentive for people to be angry at the initial response.

My problem with the vents comes down to it being a zero sum game... say if NY had gotten all 30,000 and they ended up with a 25,000 surplus... but Louisiana couldn't get extra because NY had all the excess capacity and ended up 3k short, that needlessly causes a shortage. There are only so many vents and so many in storage that can be used. The logistics need to be thought and planned out effectively, not off worst case. It needs to be data driven by what is actually happening, not the fear of what could happen.

 

[Sheet]

I do agree that there was a lean on the messaging to scare people. My fear there is the backfire, and I think we are already starting to see it. When you say 2m will die and it ends up being less than 100k, it becomes a cry wolf sort of situation. There are only so many chances that the public will give before they tune out, and when we are having the economic fall out we are, there is more incentive for people to be angry at the initial response.

My problem with the vents comes down to it being a zero sum game... say if NY had gotten all 30,000 and they ended up with a 25,000 surplus... but Louisiana couldn't get extra because NY had all the excess capacity and ended up 3k short, that needlessly causes a shortage. There are only so many vents and so many in storage that can be used. The logistics need to be thought and planned out effectively, not off worst case. It needs to be data driven by what is actually happening, not the fear of what could happen.

I agree with causing shortages elsewhere is a something avoidable.

My personal opinion on ventilators and PPE is that this should have been quarterbacked by the the federal government, not leaving it to a state level rat race. I’m all for small government but there is a time and place for the federal government to take the stick on things, and this to me is one of them. I do think the bureaucracy of the federal government could have made matters worse but that’s a different problem entirely.

The feds have the infrastructure and resources available to move materials around on a more real time basis, and it would limit hoarding at state and local level by some more capable areas with more resources versus smaller areas.

Probably not a popular view.

 

[ABasin]

Honestly with stuff like this it’s far better for everyone if we operate on a worse case scenario basis.

I'm having a hard time with that. If we did that with every serious social problem we have, we'd be paralyzed as a society.

I believe the situation needs to be well thought out, and presented that way. Not just default to a worst case scenario. Otherwise, we're in a perpetual state of overreaction, then correction. Which in itself can cause all kinds of secondary problems and damage.

And one of the real potential damages (and there are a number of them) of "operating on worst case scenarios" is the cry wolf problem. If this happens again - as soon as October, if this thing turns out to be seasonal - we are not likely going to get the public's buy in and cooperation a 2nd time. Because those early bogus numbers are going to result in the public feeling deceived. Which they may very well have been.

 

[ABasin]

The warning signs were there in the numbers. We didn't have the right data, and we weren't willing to try to find the right data. It went to worst case assumptions right away. The reasonableness got lost in the noise and panic of people. It was shaped into a black and white argument where if you didn't support the draconian measures, you wanted millions to die.

Exactly. You and I were right in the midst of that.

It was flawed data through and through, and people jumped on it as gospel.

It's looking more and more like that's the case.

We should probably wait until we're in the clear before anyone waves that flag too much though. We've got a ways to go.

 

[henchman21]

I agree with causing shortages elsewhere is a something avoidable.

My personal opinion on ventilators and PPE is that this should have been quarterbacked by the the federal government, not leaving it to a state level rat race. I’m all for small government but there is a time and place for the federal government to take the stick on things, and this to me is one of them. I do think the bureaucracy of the federal government could have made matters worse but that’s a different problem entirely.

The feds have the infrastructure and resources available to move materials around on a more real time basis, and it would limit hoarding at state and local level by some more capable areas with more resources versus smaller areas.

Probably not a popular view.

I agree... not sure the current administration would be good at it, but overall, I think that it should have been handled that way.

Exactly. You and I were right in the midst of that.



It's looking more and more like that's the case.

We should probably wait until we're in the clear before anyone waves that flag too much though. We've got a ways to go.

Oh yeah it is still too early to say it is settled and we can move on. We've dug our heels in this long with social distancing, we can go a while longer. Much of the damage is done, and any of the rest is fairly prectible, at least for a few more weeks. Hold steady and allow more and better data to come in... and hopefully heat and being outside instead of inside gives reprieve.

 

[ABasin]

I do agree that there was a lean on the messaging to scare people. My fear there is the backfire, and I think we are already starting to see it. When you say 2m will die and it ends up being less than 100k, it becomes a cry wolf sort of situation. There are only so many chances that the public will give before they tune out, and when we are having the economic fall out we are, there is more incentive for people to be angry at the initial response.

I agree.

I mean, who is going to believe anything the World Health Organization has to say, anytime soon? On January 14th, they said that there is no person to person transmission of coronavirus. Six weeks later, on March 4th, they said that the death rate of coronavirus is 3.4%. Now here we are, another six weeks later, and neither of those statements is (likely) anywhere near the truth. Not six months or six years later. Six weeks.

One could have such a criticism with our own Surgeon General. On February 29th, he said that face masks do not help prevent the general public from getting coronavirus. He doubled down on that on March 2nd, then again on March 31st. Then on April 6th, we get an instructional video from the same guy, showing us how to make face masks at home. That was immediately followed by all kinds of direction from governors/government, to wear face masks in public.

I believe these sorts of examples, along with the previously discussed bogus worst case numbers, could result in the public not cooperating the next time around, as much as it is cooperating this time around.

 

[Sheet]

I'm having a hard time with that. If we did that with every serious social problem we have, we'd be paralyzed as a society.

I believe the situation needs to be well thought out, and presented that way. Not just default to a worst case scenario. Otherwise, we're in a perpetual state of overreaction, then correction. Which in itself can cause all kinds of secondary problems and damage.

And one of the real potential damages (and there are a number of them) of "operating on worst case scenarios" is the cry wolf problem. If this happens again - as soon as October, if this thing turns out to be seasonal - we are not likely going to get the public's buy in and cooperation a 2nd time. Because those early bogus numbers are going to result in the public feeling deceived. Which they may very well have been.

I don’t disagree but when planning a national or even state wide contingency I don’t know of any time you’d not want to lean towards worst possible scenario. If you prepare for the worst and it’s not the worst, then you were prepared.

I get the social implications for sure. I don’t have a great solution to the issue. I guess what I would have liked to see was a change in the messaging. Make it clear we’re prepping worst case but anticipate it’ll fall somewhere more medial between best and worst outcomes. The messaging could have been more tempered.

I personally feel we grossly underprepared, given the long lead time we had. The PPE shortages should have never been a problem and if they were it should have been easily rectified. It was almost like we adopted a it won’t happen to us stance. I’m bias here, I know that. It really grinds my gears when I see my colleagues reusing items meant for one use. It didn’t have to shake out that way if we anticipated a worst case scenario as a country when this outbreak was still in its infancy.

 

[henchman21]

Yeah the PPE shortage is a real dumb thing that could have been easily avoided. I'll say it irritates me when I see young people in the grocery store with N95 masks, not fitted properly... those should be in health care worker's hands, not a random 20-35 year old.

 

[CobraAcesS]

Yeah the PPE shortage is a real dumb thing that could have been easily avoided. I'll say it irritates me when I see young people in the grocery store with N95 masks, not fitted properly... those should be in health care worker's hands, not a random 20-35 year old.

I'm that person, but its because I have a few laying around from my own fit testing at work.

Actually it's all I have. I don't have any surgical masks. So it's that or the neck gator looking like a militia member.

 

[Foppa2118]

No way is mitigation the only reason those numbers skewed that severely in that short a period of time. A 60/70/80% change in 4 days? For a disease that often takes 10-14 days to manifest itself in an obvious fashion? Those don't add up.

Bottom line: The numbers were very wrong in the beginning, or they're very wrong now.

In the end though, I'm cautiously optimistic, as this is all positive news. I don't doubt our stay-at-home mitigation has helped this situation a lot. Common sense tells us this is something that makes sense. I think I'm going to fall back on common sense with these things from here on out, do my part as a responsible citizen, and not pay attention to the hyped numbers anymore.

That wasn't what I was saying. What I was saying is that Fauci and others were telling EVERYONE that they could get below those numbers. They were also trying to get people's attention with those projections, so they'd stay home, because not enough people were.

The mitigation was only part of the reason the numbers were lowered. The other reason, as Fauci stated multiple times, was that the models were only as good as the assumptions made, and the assumptions were only as good as the data they had. And the data was incomplete, everyone knew that.

Now people are saying the projections were wrong like someone made a mistake. Everyone knew they might be lower than the projections. The mistake was they didn't have enough testing, which even a lay person would know affects the accuracy of the projections.

So I'm a little confused why some are making such a big deal out of this. Nobody in the epi world is surprised by this. Feels like it's an effort to suggest they didn't need to take the extreme measures they did, which is absolute false.

They only had the data they had to base those recommendations on. What were they gonna do just ignore what the data was saying because of a hunch? That's not how science works. You work with the data you have, and when tens or hundreds of thousands of people might die, and there's a big risk of overwhelming the health care system, you err on the side of caution.

 

[Foppa2118]

One could have such a criticism with our own Surgeon General. On February 29th, he said that face masks do not help prevent the general public from getting coronavirus. He doubled down on that on March 2nd, then again on March 31st. Then on April 6th, we get an instructional video from the same guy, showing us how to make face masks at home. That was immediately followed by all kinds of direction from governors/government, to wear face masks in public.

I'm not a big fan of the current Surgeon General, but he was right that the masks people are wearing don't help much in the prevention of contracting the virus. There's too much leakage around the sides, and they start to break down once they get wet from your breath.

He was saying this because too many people were buying masks in bulk, and nurses and doctors didn't have enough for themselves. Causing them to make their own out of supplies.

What the masks do is help prevent someone who does have the virus, from spreading it by catching some of the respiratory droplets on the INSIDE of their mask.

They're recommending them now because they've partially addressed the shortage issue, and to help cut down on the spread by people wearing some sort of barrier for a little while. It's a numbers game. It's not going to cut down on the spread drastically, but it will a certain percentage, and that could save lives.

 

[henchman21]

I'm that person, but its because I have a few laying around from my own fit testing at work.

Actually it's all I have. I don't have any surgical masks. So it's that or the neck gator looking like a militia member.

So they've been used more than once?

At this point it is getting to be too late as Michigan turned the corner a while ago, but assuming they were packaged, would have been a good donation!

 

[Foppa2118]

In the coronavirus pandemic, we're making decisions without reliable data

The warning signs were there in the numbers. We didn't have the right data, and we weren't willing to try to find the right data. It went to worst case assumptions right away. The reasonableness got lost in the noise and panic of people. It was shaped into a black and white argument where if you didn't support the draconian measures, you wanted millions to die. I get being careful and going a bit overboard for safety. Going straight to worst case scenario, panicking, yelling about needing 5+x the amount of ventilators than actually needing, etc. That causes public hysteria, and causes all sorts of problems outside the virus itself.

The big model being adjusted down was built with the assumption of the measures currently in place... even the places with the more extreme procedures taken into account from the beginning, they are adjusting down by huge numbers. It was flawed data through and through, and people jumped on it as gospel.

You're not looking at this objectively based on the language you're using. Nobody in science was unwilling to try to find the right data. And none of the health experts jumped on the data as "gospel."

What were they supposed to rely on for the models, if not the flawed data? A hunch from the business world not to shut everything down for so long?

Again, EVERYONE knew the models could be wrong, and that the data was incomplete. Nobody in science was framing it as a black and white argument. They were literally telling you what the projections were, while simultaneously telling you they could get lower than that, and that the models were only as good as the assumptions being made.

They literally told you multiple times what you keep saying they should have known.

 

[Bonzai12]

it's incredible to me how badly our society flails in the wind without "data"

I'm watching people go mind numb because there's not 15 years of research, statistics, algorithms, numbers, etc on covid...... And there's not going to be - for a while.....It's absolutely fascinating to watch and see just how frustrated and desperate people are for "numbers". I used to be a super data/process driven guy but stepping back and looking at it now - I've let go a bit. Sometimes people are trying to do what's best for them just with what's faced in front of their eyes at single instantaneous moments......I could tell you a doctor in NY probably doesn't give two $h$#'s about a curve/model/whatever right now.

 

[The Kingslayer]

Yeah the PPE shortage is a real dumb thing that could have been easily avoided. I'll say it irritates me when I see young people in the grocery store with N95 masks, not fitted properly... those should be in health care worker's hands, not a random 20-35 year old.

I had a few N95 masks before all this. Maybe those kids did aswell?

 

[henchman21]

I had a few N95 masks before all this. Maybe those kids did aswell?

Certainly could, but if they were still packaged, they could have gone to better use elsewhere. Judging by the amount I see, I'd find it hard to believe that they all had some prior.

 

[Foppa2118]

I had a few N95 masks before all this. Maybe those kids did aswell?

More likely they bought them on the market, or from someone who bought a huge supply just to make money. That's why there's such a big shortage of the N95's for nurses and doctors.