New research shows social distancing a must to beat Covid-19 • Hacker News Board

Re: New research shows social distancing a must to beat Covid-19

#101

Post by gbacon » Thu, Mar 19, 2020, 4:52 PM UTC

btilly wrote: post #59

scott_s wrote: post #46

Earlier quoted context omitted.

China tested hundreds of thousands of people in provinces with known cases, and found very little evidence of asymptomatic circulation. See my comment from a week ago, https://news.ycombinator.com/item?id=22475853 , which quotes Bruce Aylward, an assistance director general and epidemiologist for the WHO. Our current evidence points to there not being millions of asymptomatic people.

I see your HN comment from 2 weeks ago and raise you with a point in this article lifted from a recent Science paper. Namely, ...individuals with undetected infections were so prevalent in China that they apparently were the infection source for 86 percent of confirmed cases. This is strong evidence of asymptomatic circulation. This conclusion is not in contradiction to the evidence behind your previous comment. In m…

“I’ll see … and raise” is known as a string raise and is seen as bad form or even cheating. Actions in poker must be atomic.

https://upswingpoker.com/angle-shooting-string-bet-raise/

Re: New research shows social distancing a must to beat Covid-19

#102

Post by naasking » Thu, Mar 19, 2020, 4:54 PM UTC

sojournerc wrote: post #4

> For every confirmed case of COVID-19, there are likely another five to 10 people with undetected infections. I wish this was reflected more in the numbers being presented by various authorities. There is just too much confidence that confirmed cases are representative of the spread of the virus. This unknown denominator can change mortality rate, and severe case rate by orders of magnitude. Because of the dearth of…

> Because of the dearth of testing in the US, it seems highly likely that far more people are infected, and maybe even recovered.

It's not just highly likely, it's absolutely certain. I recommend the recent Khan academy video on this if you want to understand the math and you want a healthy dose of panic:

https://www.youtube.com/watch?v=mCa0JXEwDEk

Re: New research shows social distancing a must to beat Covid-19

#103

Post by paulmd » Thu, Mar 19, 2020, 4:55 PM UTC

SketchySeaBeast wrote: post #36

psychlops wrote: post #25

Given the ongoing statistics coming out of South Korea (which I'd suggest are the most accurate) where only one person under 50 has died. It seems that these safeguards would be best spent around those aged 60+ and perhaps those 50+ with other health issues. Those who are younger seem to be mildly affected for the most part and could go on with their lives as long as they didn't interact with the older population.

Deaths are all fine and good, but do you know statistics on hospitalizations for the under 50 crowd? Those are the resources that are important - even if the under 50 doesn't die from it but requires hospitalization that's both a resource that can't be used by the above 50's, as well as a possible death if there isn't a bed for them.

> even if the under 50 doesn't die from it but requires hospitalization that's both a resource that can't be used by the above 50's,

Frankly this is a wrongheaded position from a triage perspective. The macro-socially correct answer is that you should prefer the person who still has 40-60 years of life over the person who is going to die in 5 or 10 or 20.

It's a very boomer-centric perspective that youngs are somehow "stealing a bed" from a boomer. But that's nothing new from that generation. Really it's the other way around, treating grandma is stealing a bed out from underneath her grandkid and leaving them to die.

You may find that crass or distasteful, but that's the reality of triage. You don't do triage until you don't have enough medical resources to go around, but then you have to make choices.

In Italy, they won't admit 70+'s to a hospital at all. That's how triage works. That's the correct way for triage to work. It's harsh but true.

Re: New research shows social distancing a must to beat Covid-19

#104

Post by 3JPLW » Thu, Mar 19, 2020, 4:56 PM UTC

guscost wrote: post #92

3JPLW wrote: post #88

Earlier quoted context omitted.

It seems like you're pushing back on the CFR, possibly driven by trying to pessimize the need for action. In the small Italian city of Nembro in Bergamo, 0.6% of their entire population has died in the last 12 days. That's 70 people in a small town of 11,000 — typically there are fewer than 70 deaths every six months. Now we're certainly _overestimating_ the denominator and still getting a number that's larger than t…

You should include demographic information, since it is relevant to your argument: [Nembro] Age Distribution (E 2019) 0-9 years 1,018 10-19 years 1,191 20-29 years 1,179 30-39 years 1,192 40-49 years 1,640 50-59 years 1,850 60-69 years 1,465 70-79 years 1,181 80+ years 810 > In 2010, there were 119,551 people residing in Bergamo (in which the greater area has about 500 000 inhabitants), located in the province of Ber…

Cool, thanks for the data. Looks like their population is 30% over 60, whereas the US (for example) is 20%. Even if we assume _every_ death is someone over 60 (it's not), that'd adjust the percentage to 0.4% in a generic US town.

Note that Florida is similarly 28% over 60.

Re: New research shows social distancing a must to beat Covid-19

#105

Post by Darkphibre » Thu, Mar 19, 2020, 4:57 PM UTC

AntonStratiev wrote: post #87

Introducing social distancing for the entire population comes at huge economic and social cost. It is more effective to follow these three simple measures: 1. Symptomatic cases stay at home for 7 days 2. All household members of symptomatic cases stay at home for 14 days 3. Social distancing for the over 70 population only https://www.imperial.ac.uk/media/imperial-college/medicine/s... Social distancing of the entire…

Italy is proof that we need to slow this down for months longer. Our medical system was projected to only have enough N95 masks and related supplies for two weeks of a pandemic... sure enough, we're having to cobble together makeshift supplies MacGyver style here in Washington.

In a couple weeks, more of our front-line medical staff will start getting sick (the first case just occurred here), and requiring their 14-day quarantine... taking them out of rotation and adding even more strain.

It's going to get bad. We have to slow this down, to reduce the mortality rate. Or that 1% number people are throwing around is going to look like roses.

Re: New research shows social distancing a must to beat Covid-19

#106

Post by SketchySeaBeast » Thu, Mar 19, 2020, 4:58 PM UTC

paulmd wrote: post #103

SketchySeaBeast wrote: post #36

Earlier quoted context omitted.

Deaths are all fine and good, but do you know statistics on hospitalizations for the under 50 crowd? Those are the resources that are important - even if the under 50 doesn't die from it but requires hospitalization that's both a resource that can't be used by the above 50's, as well as a possible death if there isn't a bed for them.

> even if the under 50 doesn't die from it but requires hospitalization that's both a resource that can't be used by the above 50's, Frankly this is a wrongheaded position from a triage perspective. The macro-socially correct answer is that you should prefer the person who still has 40-60 years of life over the person who is going to die in 5 or 10 or 20. It's a very boomer-centric perspective that youngs are somehow…

I understand triage, but triage is only triage because it has to be - if we can prevent that from happening we should. That's my point. Let's try as much as possible to prevent these life or death scenarios from occurring. For young people to act in a way that will get us into a triage situation is an incredibly selfish act that is preventable.

Re: New research shows social distancing a must to beat Covid-19

#107

Post by dboreham » Thu, Mar 19, 2020, 4:59 PM UTC

sojournerc wrote: post #4

> For every confirmed case of COVID-19, there are likely another five to 10 people with undetected infections. I wish this was reflected more in the numbers being presented by various authorities. There is just too much confidence that confirmed cases are representative of the spread of the virus. This unknown denominator can change mortality rate, and severe case rate by orders of magnitude. Because of the dearth of…

>I wish this was reflected more in the numbers being presented by various authorities.

UK authorities presented this exact number at their press conference last week.

Re: New research shows social distancing a must to beat Covid-19

#108

Post by baron_harkonnen » Thu, Mar 19, 2020, 5:02 PM UTC

sojournerc wrote: post #4

> For every confirmed case of COVID-19, there are likely another five to 10 people with undetected infections. I wish this was reflected more in the numbers being presented by various authorities. There is just too much confidence that confirmed cases are representative of the spread of the virus. This unknown denominator can change mortality rate, and severe case rate by orders of magnitude. Because of the dearth of…

> This unknown denominator can change mortality rate, and severe case rate by orders of magnitude.

The two best data points we have would be South Korea and the Diamond Princess cruise ship. Both of these groups have high rates of testing and both have had enough time that we can know how the most of the cases played out, and in both cases we see the death rate at about 1%. This doesn't take into account possibly different age group distributions. The cruise ship probably has less children and less 80+ people than on typical distributions.

Additionally both the Diamond Princess and South Korea cases assume ready access to medical treatment. If the medical system is overwhelmed we will see much higher CFR due to critical cases not receiving adequate care.

Re: New research shows social distancing a must to beat Covid-19

#109

Post by naasking » Thu, Mar 19, 2020, 5:04 PM UTC

AntonStratiev wrote: post #87

Introducing social distancing for the entire population comes at huge economic and social cost. It is more effective to follow these three simple measures: 1. Symptomatic cases stay at home for 7 days 2. All household members of symptomatic cases stay at home for 14 days 3. Social distancing for the over 70 population only https://www.imperial.ac.uk/media/imperial-college/medicine/s... Social distancing of the entire…

> Social distancing of the entire population also slows the acquisition of immunity with zero and low risk age groups, which drags the whole situation out months longer.

Dragging it out is exactly the point. The total number of active cases should be kept as low as possible in order to stay below our healthcare system's capacity. Look at Italy for what happens when cases exceed capacity. Their death rate is partly so high because they have to let the worst cases die in order to save those that have a better chance at living.

Re: New research shows social distancing a must to beat Covid-19

#110

Post by paulmd » Thu, Mar 19, 2020, 5:05 PM UTC

SketchySeaBeast wrote: post #106

paulmd wrote: post #103

Earlier quoted context omitted.

> even if the under 50 doesn't die from it but requires hospitalization that's both a resource that can't be used by the above 50's, Frankly this is a wrongheaded position from a triage perspective. The macro-socially correct answer is that you should prefer the person who still has 40-60 years of life over the person who is going to die in 5 or 10 or 20. It's a very boomer-centric perspective that youngs are somehow…

I understand triage, but triage is only triage because it has to be - if we can prevent that from happening we should. That's my point. Let's try as much as possible to prevent these life or death scenarios from occurring. For young people to act in a way that will get us into a triage situation is an incredibly selfish act that is preventable.

We're going to be in a triage situation regardless. Yes, people shouldn't be doing stupid things that increase risk, but is it the cause of the problem, would not doing it fix the problem? No.

Singling out particular groups of people for doing stupid things at one point in time isn't really fair. There are olds who keep going to church as well, they have just as much culpability here.

But it's much more popular to point the news cameras at some kids on spring break than a church packed shoulder to shoulder with boomers. That generation makes a point of shitting on zoomers every chance they get, and if you point it out they cry about ageism as if that's not exactly what they were doing themselves.

It's "avocado toast" playing out all over again.

(in all of these cases, I think the states are rightfully clamping down on what's allowable. My parents spent the last two days whining at me that their reservation at a florida state park got cancelled. So that spring break thing probably won't repeat. And the maximum size for a public gathering is coming down rapidly... states were setting limits like 250 a week or so ago, now that number is 50 and some states are going to 5 or 10. This problem is basically solving itself. But are you being ageist about it by singling out zoomers as being some unique problem here? Yes, absolutely.)