RichardGibbons

This has some nice quotes from COVID-19: https://thebeaverton.com/2020/04/we-need-to-open-up-the-economy-and-get-back-to-work-says-covid-19/

Nah, that requires math, not just common sense. So it must be wrong.

Ah, that makes sense. Thanks, slug.

The odd thing in this article is the R0 of 3.5 for SARS. I always thought that SARS didn't become a pandemic because its R0 was low enough that it was preventable. But the R0 of 3.5 indicates that wasn't the case. Does anyone know why SARS ended up being no big deal? Was our test and track just so much better? Did most people already have immunity? Something else?

ever ask a barber if you needed a haircut? LOL, these guys don't sell masks. I know it's a bizarre suggestion, but, during a pandemic, you might want to consider the idea that some people may want to stop that pandemic for reasons other than profit.

Yeah, the problem is that this common sense doesn't work, and experts know this while non-experts like you and me do not. (Well, I do know it now, but I didn't a few weeks ago.) The actual common sense is that the elderly need more contact with people in society than anyone else except children. If you get a huge percentage of the population infected with an easily-transmitted virus, then it's impossible to isolate the elderly. British Columbia has been among the most successful regions in the world at responding to the virus. Yet 26 Care Home just in the Vancouver area have had outbreaks. A long term care nurse lives with me, and her boss has been fantastic--locking down his care home before every other care facility in BC, preventing movement of employees across care homes early, fever testing everyone every day, PPEing all the staff... Even with that, one of the people there caught COVID-19 in early April, and worked in the care home with patients for several days before she became symptomatic and was diagnosed. And this is with extreme precautions in care homes and low per-capita cases everywhere in the province. Now give 50% of the population COVID-19, and assume that most of the elderly population isn't actually in care homes, but rather living in their own places or maybe being taken care of by their kids. Now, one could say that common sense should allow you to take that information, and extrapolate to a massive death toll among the elderly if your suggested approach were adopted. But I think that's wrong. It think it's more that you aren't educated enough on this topic to understand what would happen in this situation, and so you rely on incorrect "common sense" that would wipe out a large percentage of the elderly. (That said, I don't blame you at all for talking about your common sense approach--speculation is fine, and everyone knows you're no epidemiologist. You'd only deserve derision if you believe that your common sense is superior to the decades of knowledge of the epidemiologists who actually understand the consequences of what you propose.)

Yep, you're right, my argument doesn't make sense. Sorry for mocking you about that.

Yeah, the cool thing is, this was done for us already in Italy. It's fascinating that this huge, insane example of the consequences of a horrible pandemic were right there in Italy--and now in NYC as well!--and for some reason you think the "common sense reality check" was to pretend that evidence didn't exist. Actually, "pretend" is probably the wrong word. I do believe that you are speaking honestly, from your heart, and simply don't see the obvious. Like Westworld, "doesn't look like anything to me." As I've said before, I think Dunning-Kruger effects are playing a large role--something I think the conservatives are particularly susceptible to because of the degree to which their ideology glorifies ignorance. Heck, conservatives hate the idea that decades of education and study might make someone more likely to be correct than someone with a fifth-grade education.

Yay! Misunderstanding #1 again: misunderstanding of exponential growth. I'm kind of shocked that this misunderstanding is so persistent, but I guess if one understands exponential growth, then it basically destroys the "widespread growth in March" thesis, and that would be intolerable. Just to clarify my position, I believe mostly in what epidemiologists and the evidence seems to have indicated--that test and trace seems to be effective. (If epidemiologists abandon that position, then I'll almost certainly abandon it at the same time.) And in terms of it being actually necessary, I basically said yesterday that I wasn't sure it was necessary when I said this: Generally, I'll say that when I'm uneducated in a particular field, if both the experts and the data seem to point in the same direction, I'm happy to believe them and not try to cling to old, speculative theories that have long since been proven false.

I think that this is an extremely good point that has gotten lost over the past month or two. The goal is to avoid overwhelming the healthcare system, not to eliminate every potential death from the virus by remaining shut for a year. (Based on Canadian polling, it's pretty clear that Canadians in aggregate don't get it.) On the "how to reopen" list, it shocks me that they aren't bothering to require masks, since it seems to be a cheap and easy solution to reduce transmission (and deaths and medical costs). I wonder if there was some reasoning behind that, or if they were just writing down stuff on autopilot, and not really thinking. If they decided not to include it for cultural reasons, that puts the US at a competitive disadvantage relative to other countries that are more open-minded about such things.

So, that's the testing half of the numbers. What about the tracing part? Is there some way to quantify the tracing? I've been thinking about it, and have found nothing but anecdotes. One of the challenges is that effectively it's a system with feedback. Like, if you do good tracing, then the virus doesn't spread, which means that there are fewer "high risk" people to test, which means your per capita test rate can be low. This is an interesting discussion, because pretty well everyone accepts after the first explosion of cases, South Korea got the pandemic under control with test and track. So it would be interesting to have something quantitative that supports or contradicts the "track" part of the thesis. I guess one of the other things to keep in mind--which is obvious but tends to be ignored because people are too busy creating things like the 10 Commandments--is that multiple different strategies might work. Like, maybe "masks + handwashing + a culture that does these things when told to" is as effective at stopping the virus as "test + track + lock up people who were exposed".

It's far worse than a tax. It's a third party capriciously changing contracts after signing.

Can you please show data to prove that? I was mainly talking about Taiwan, Germany, and South Korea. (Full disclosure: a couple of weeks ago, Singapore would've been on my list of test & trace success stories, but it seems to be breaking down.)

Have either of you heard a plausible explanations for the increase in insurance rates? That sort of jump seems very strange to me. Like, were these things priced to make a huge loss five years ago, or are the new high prices just to make a massive profit? I would've guessed that the insurance markets are close enough to efficient that a 100-300% increase in premiums without an extreme event would never happen. But I'm clearly wrong, so what's the deal here?

Yeah, I think the increase is a result of insurance rates skyrocketing.

This warning from a reddit post is so true....

Nah, your assumption is wrong. As far as I can tell, cobafdek is thoughtful and smart, and has a high degree of integrity.

This is a really great point, but for some reason I'm still hopeful. I think a few good leaders could reverse this trend. Trump and most Republicans have abandoned good faith efforts to rule, but I still believe that people in aggregate are intrinsically good, and most people who get into politics really do want to do what they believe is best for the country. The only question is whether this phase in USA politics is a short-term thing, or if the system has been broken to the point where it's impossible for good leaders to be elected. If the latter, then I'd expect to see American power to continue to plummet in the world, as it drives away its allies and its anti-science/anti-education mentality dramatically weakens the country's competitive position. Just as happened with the Soviet Union, I think it's very hard to sustain (for much more than a century) a system whose values don't match reality. But I still think it's more likely that USA will pull out of this descent and remain a superpower. (Or that the blue states separate and become the new superpower, producing 2/3rds of the USA GDP--effectively the same thing. Secession isn't likely today, but after a few elections where the majority is repeatedly thwarted through tricks like voter suppression and gerrymandering, I think it becomes more likely.)

Sure. It's pretty simple. You were saying early on that hundreds of thousands or millions of people in the USA probably had it, and that testing was pointless. Then, hundreds of thousands of people in NYC actually got it and more than 10K died, which wouldn't have happened if all those people were infected already. And the countries that have done the best have been the ones who were good at testing and tracing. That said, I have come down more harshly on you than others simply because you're dishonest, and because--if you are actually a doctor--I think that dishonesty makes you dangerous. (I would have no problem whatsoever with you if you were simply wrong and adjusted your beliefs as the evidence changed. In fact, I'd have a whole pile of respect for you, if that were the case.) I also think that anyone who makes the argument that the worst case didn't arise so the worst case scenario couldn't possibly be true--after there was a massive, month-long lockdown to prevent the worse case scenario--is either disingenuous or stupid or both.

No, they were appallingly bad, to the extent that I'd lose a some degree of respect for all doctors if it weren't for Dalal's sensible posts on this thread to pull me back off that ledge. Frankly, it terrifies me that doctors exist who ignore evidence for gut feel, make wild speculations not even supported by common sense let alone facts, and then when the evidence proves them wrong, continue to insist that they were right. (What the heck is one to do if one seriously needs a doctor, and this is the doctor one gets? Just roll over and die?)

Yeah, kudos to you for saying early on that you thought it was unlikely to work.

This is unfortunate. https://www.scmp.com/news/china/science/article/3080055/anti-malarial-treatment-hailed-trump-has-no-benefit-coronavirus

Yeah, any solution won't be perfect. It's nice, however, that everyone involved recognizes that the perfect is the enemy of the good. I imagine that the epidemiologists' understanding of exponential growth will allow them to see that a solution that reduces the R0 by 70% is worthwhile even if it doesn't reduce it by 100%.

Yeah, obviously it requires test and trace. But it doesn't make much sense to say, "we haven't done this well in the past, therefore this article sucks because it suggests we do it in the future." Like, no kidding that the USA screwed up early and that it isn't capable of doing test and trace today. While you claim he's saying to open the country today and simultaneously scale up test and trace, the author doesn't say that. In fact, he implies the opposite. Test and trace are two of the Ten Commandments. Commandments because those two things are super important to do, because they're not just irrelevant details that we can ignore if we don't have the capability today. The reason the article's interesting and compelling is because it lays out what needs to be in place to start opening things up, including a effective test and trace strategy. So if you're looking to see if we're ready to open up, one criteria might be whether you've got the resources to do test and trace on the expected number of new infections. I agree with everyone else though--saying that it's OK to open schools because kids don't die doesn't make much sense, and doesn't fit with his "avoid events where people mix with a lot of different people" reasoning.

It's an interesting article, making a pretty compelling case for reopening the world except for large gatherings. I'm curious what an epidemiologist would think of it.