Open letter from Italy to the international scientific community • Hacker News Board

Re: Open letter from Italy to the international scientific community

#691

Post by Paradigma11 » Sun, Mar 15, 2020, 4:30 PM UTC

rcxdude wrote: post #658

jiggawatts wrote: post #230

Earlier quoted context omitted.

So, as a physicist, you should know how exponential growth works. Let's say you have a pile of Uranium that's juuuust sub-critical. You would likely to be confident to stand next to it without significant fear. But if someone throws on just enough additional Uranium for the pile to go supercritical , you would run for your life because none of the following will matter[1] all that much to the final outcome: 1) How mu…

I think this insight is exactly why the UK health experts are not advocating extreme measures yet. They know they will only delay the takeoff and they need to use those measures when it does, not beforehand, and these measures are meant to protect the most at risk from dying from the disease (I think the most contentious thing is how long these measures can work for. The UK experts are of the opinion they have a fini…

"This is a far bigger response than any country has achieved so far (and it's extra difficult because the at-risk groups are probably the most dependent on external aid, as well as already lacking social contact)"

How have they achieved this? What concrete measures?

Re: Open letter from Italy to the international scientific community

#692

Post by rcxdude » Sun, Mar 15, 2020, 4:36 PM UTC

Paradigma11 wrote: post #691

rcxdude wrote: post #658

Earlier quoted context omitted.

I think this insight is exactly why the UK health experts are not advocating extreme measures yet. They know they will only delay the takeoff and they need to use those measures when it does, not beforehand, and these measures are meant to protect the most at risk from dying from the disease (I think the most contentious thing is how long these measures can work for. The UK experts are of the opinion they have a fini…

"This is a far bigger response than any country has achieved so far (and it's extra difficult because the at-risk groups are probably the most dependent on external aid, as well as already lacking social contact)" How have they achieved this? What concrete measures?

They haven't yet (no-one has). The point is they are recognising that such measures are very hard on people, and so they don't think they can stay in force indefinitely.

Re: Open letter from Italy to the international scientific community

#693

Post by loeg » Sun, Mar 15, 2020, 4:37 PM UTC

apexalpha wrote: post #613

loeg wrote: post #53

Earlier quoted context omitted.

https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop... Start reading at "2. What Will Happen When These Coronavirus Cases Materialize?"

Who is this mr Pueyo? And why should we listen to him regarding this subject? From his Medium profile page it seems he is a 'Storyteller' and 'Viral marketer'. So, someone who knows how to tell a story with confidence even if you know nothing of the subject. I'm gonna listen to my government regarding this, rather than medium posts by viral marketeers. Thank you.

Your government is saying the exact. Same. Thing:

https://www.government.nl/latest/news/2020/03/12/new-measure...

https://www.rivm.nl/en/news/current-information-about-novel-...

> 15-03-2020 , 176 new patients, a total of 1135

> 14-03-2020 , 155 new patients, in total 959

> 13-03-2020 , 190 new patients, in total 804

> 12-03-2020 , 111 new patients, in total 614

> 11-03-2020 , 121 new patients, in total 503

> 10-03-2020 , 61 new patients, a total of 382

> 09-03-2020 , 56 new patients, a total of 321

> 08-03-2020 , 77 new patients, a total of 265

> 07-03-2020 , 60 new patients, a total of 188

> 06-03-2020 , 46 new patients, a total of 128

> 05-03-2020 , 44 new patients, a total of 82

> 04-03-2020 , 15 new patients, a total of 38

> 03-03-2020 , 6 new patients, a total of 24

> 02-03-2020 , 11 new patients, a total of 18

> 01-03-2020 , 1 new patient, a total of 7

...

Here's a log-scale graph: https://www.chartgo.com/embed.do?id=7e5c9f30aa

(And just for comparison, not log scale: https://www.chartgo.com/embed.do?id=7e5c9f30aa )

Looks like NL has had steady exponential growth over the past week or even 10 days.

As far as Mr Pueyo, in this context he appears to be an effective science writer, which is what matters. If you want a more succinct source from an academic, there's http://ctbergstrom.com/covid19.html .

Re: Open letter from Italy to the international scientific community

#694

Post by trashtester » Sun, Mar 15, 2020, 4:38 PM UTC

macintux wrote: post #324

tomp wrote: post #249

Earlier quoted context omitted.

Why even test? The decision procedure is the same: treat the ill, lock down everyone else at home, avoiding social contact at the max; enforce social isolation and/or masks in "critical" spaces (power plants, grocery stores, ...). What does a positive or negative test change?

How do we know when to initiate or let up on the lockdown if we don’t have any testing?

For the first question, the answer is: ANY country that currently is seeing exponental growth should take action at the same level of severity as China/Korea/Singapora, if not, they will be in the same situation as Italy in 1-3 weeks.

Once the growth is no longer exponential, measures can be rolled back slowly, especially if they have access to enough tests, masks and respirators.

The earlier action is taken, the cheaper it will be to stop this. Every week of delay can increase casualty rates by a factor of 10. A month of delay, can mean the difference between 10000 and 10 million dead.

Also, economic costs, both in direct treatment cost as well as the disruption to the productive side of the economy will rise sharply the longer we wait. (Well, at least if we don't see the death of sick and elderly as an economic benefit.)

Re: Open letter from Italy to the international scientific community

#695

Post by hatenberg » Sun, Mar 15, 2020, 4:53 PM UTC

nine_k wrote: post #447

psadri wrote: post #413

Earlier quoted context omitted.

Humans don’t understand exponential growth. But they could look at China and Italy and think - those guys are the same as us. We are not special. The same thing that is happening to them is going to happen unless we act now. The real sad part of all this is that this is simply human nature. And we are next gonna go down the same path with climate change. And then not even lock downs will help.

Unfortunately, seeing oneselves as special is one of the most widely spread cognitive biases :(

The German press was explaining Italy all week... mostly trying to explain how it's all different.

Having seen the cutting of rural hospitals over the last two decades it will be a shitshow

Re: Open letter from Italy to the international scientific community

#696

Post by mirimir » Sun, Mar 15, 2020, 4:53 PM UTC

bonzini wrote: post #541

MiroF wrote: post #521

Earlier quoted context omitted.

That's a terrible example, why would pick an explicitly sub-exponential relationship?

Because exponential is even worse.

Right. Because it's not linear.

The only truly exponential example that comes to mind is milk souring. But that's too slow, unless you keep notes.

Re: Open letter from Italy to the international scientific community

#697

Post by sdkaufman » Sun, Mar 15, 2020, 5:01 PM UTC

dependenttypes wrote: post #651

sdkaufman wrote: post #617

Earlier quoted context omitted.

It's not just about your health or your life. This is what R0 means - even if you end up fine after getting the disease, you're going to transmit it to other people who may end up dying because of you. In other words, it's also your liberty vs other people's lives. Are you going to be the grandson who kills his grandma? Or the employee who kills the CEO? Or the Trump supporter who ends up helping elect Biden?

The grandma and the CEO can quarantine themselves at home if they so wish.

Older people cannot just wall themselves off from the rest of society.

What if they live with or are cared for by other family members?

How will they get health care for existing conditions? Hospitals have been shown to be a major vector for transmission [1]. And how do they even get to the hospital if they can't drive?

What about grocery shopping over the next few months? The National Guard is stepping in to help deliver food in New Rochelle now. Can that scale to the entire nation? For how long?

What if they live in a nursing home? Look what happened in the Seattle one [2].

[1] https://jamanetwork.com/journals/jama/fullarticle/2761044

[2] https://www.foxnews.com/health/washington-state-nursing-home...

Re: Open letter from Italy to the international scientific community

#698

Post by dragontamer » Sun, Mar 15, 2020, 5:09 PM UTC

rcxdude wrote: post #654

dragontamer wrote: post #568

Earlier quoted context omitted.

You're assuming that all cases are Coronavirus. People will continue to get the Flu, Colds, HIV / AIDs even throughout this whole shebang. We need to know COVID19 cases specifically, to know if our lockdown methodology is being effective.

For that you just need to test in hospitals.

USA doesn't have enough tests even for that. I'm proposing we at least test the cases that reach the hospital stage.

Re: Open letter from Italy to the international scientific community

#699

Post by trashtester » Sun, Mar 15, 2020, 5:09 PM UTC

rcxdude wrote: post #658

jiggawatts wrote: post #230

Earlier quoted context omitted.

So, as a physicist, you should know how exponential growth works. Let's say you have a pile of Uranium that's juuuust sub-critical. You would likely to be confident to stand next to it without significant fear. But if someone throws on just enough additional Uranium for the pile to go supercritical , you would run for your life because none of the following will matter[1] all that much to the final outcome: 1) How mu…

I think this insight is exactly why the UK health experts are not advocating extreme measures yet. They know they will only delay the takeoff and they need to use those measures when it does, not beforehand, and these measures are meant to protect the most at risk from dying from the disease (I think the most contentious thing is how long these measures can work for. The UK experts are of the opinion they have a fini…

Well, if I try hard to imagine how they think, without assuming incompetence, it would be as follows:

Assumption 1: Our country will not be able to take measures that are extreme enough to stop exponential growth. Assumption 2: Once a certain level is reached, we can drastically lower the doubling time so that the number of simultanious cases are kept below what our healthcare system can handle. Assumption 3: If we stay below the level that the healthcare system can handle, mortality rates will be low, maybe lower than 1%. Assumption 4: The total number of individuals that will require hospitalization is low enough that the healthcare system can treat all patients needing treatment in a few months.

If assumptions 2 is not met, the mortality rates of pations that require treatment is likely to be similar to what is seen in Italy, ie roughly 15%.

If assumption 3 is wrong, and the real mortality rate is about 3-5%, having about half the population infected, will still lead to huge numbers of dead, more than the population is likely to accept.

If assumption 4 is wrong. Italy is currently unable to handle 20000 cases. A country like the UK may be able to handle maybe 10000-20000 simultaneusly. If 10% of the population requires hospitalization, and each patient will stay there an average of 1 month, measures will have to be dragged out over several years, anyway.

Assumption 5: This only needs to be done once, meaning there will not be second or third waves or mutaded viruses that will need to spread in a similar fashion in the same time period.

At some point, I think every country will realize that they need to take drastic measures, enough to stop the spread from being exponential. Doing that after detecting 100000 cases is VERY different from doing it after detecting 1000.

The downside, of course, of preventing exponential growth, is that most measures will have to be kept in place until there is a vaccine or other cure, and that could take 2 years.

Re: Open letter from Italy to the international scientific community

#700

Post by sdkaufman » Sun, Mar 15, 2020, 5:10 PM UTC

syshum wrote: post #668

sdkaufman wrote: post #617

Earlier quoted context omitted.

It's not just about your health or your life. This is what R0 means - even if you end up fine after getting the disease, you're going to transmit it to other people who may end up dying because of you. In other words, it's also your liberty vs other people's lives. Are you going to be the grandson who kills his grandma? Or the employee who kills the CEO? Or the Trump supporter who ends up helping elect Biden?

>>Are you going to be the grandson who kills his grandma? My grandparents are long long dead >>Or the employee who kills the CEO? Maybe the CEO should have thought about that and given his employees a work from home, or other policies to allow themselves to self quarantine. I also find it telling you talk about the employees giving it to the CEO and not the other way around... I am sure there is a Parable in there ab…

> My grandparents are long long dead

er...what are you trying to say? So other people's grandparents can go f* themselves?

> I do find it amusing you believe only Trump supporters support liberty

Nope, I mentioned Trump supporters because Trump was dragging his feet on cancelling his massive rallies [1]. Thankfully they've been cancelled now.

[1] https://www.vox.com/policy-and-politics/2020/3/11/21174945/b...