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

#111

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

3JPLW wrote: post #104

guscost wrote: post #92

Earlier quoted context omitted.

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.

If you compare the 80+ group (which has a much higher CFR), this town has closer to three times the percentage of the US population.

On top of that, this is in a region of Italy where the healthcare capacity has been completely overwhelmed. That's going to be devastating for the prognosis of an older person who needs a ventilator.

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

#112

Post by PeterisP » Thu, Mar 19, 2020, 5:06 PM UTC

wool_gather wrote: post #99

dboreham wrote: post #69

Earlier quoted context omitted.

Two things to know: 1. The current test is designed for the scenario that someone shows up to medical provider with symptoms. Test answers the question: are the symptoms caused by COVID-19?, quite reliably (negligible false positives, low false negatives). 2. The current test won't produce terribly useful data in someone without symptoms (either before, or after the illness). This is why for example certain well-know…

I'm curious about the technical reasons for what you're saying. Can you say more? Is it a problem with figuring out the false negative rate for people without symptoms?

If you test on antigen that matches the virus, then that will return a negative result in the very beginning of infection and after recovery.

If you want accurate numbers for statistics, including people who never had symptoms, you can do antibody testing on a random sample of population, that will indicate people who had the disease - but that's kind of too late for that particular location and those particular patients, that's for epidemiological studies and helping other locations. I recall reading about one such study for Covid, but I don't remember which country did it.

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

#113

Post by markkanof » Thu, Mar 19, 2020, 5:08 PM UTC

PappaPatat wrote: post #14

chrisa wrote: post #5

Earlier quoted context omitted.

One of the doctors on one of the press conferences (sorry, can't remember which one), said that she would prefer the term "physical distancing" as well for the same reason. She said that "social distancing" is a medical technical term that doesn't translate super well to the public.

> She said that "social distancing" is a medical technical term that doesn't translate super well to the public. Which is 100% the opposite of what I in my daily life observe: everyone, young & old, private & work, calls it social distancing. It addresses the issue better too, then the "proposed" physical distancing. When you pass people physically the (need and) possibility to keep that 2 meters is often impossible…

It's also just a disturbing use of language. Human beings are social creatures and derive a ton of benefit from our relationships with other people. If anything we should all be coming together socially to support each other through a difficult time, while trying to maintain an appropriate physical distance from one another.

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

#114

Post by djsumdog » Thu, Mar 19, 2020, 5:15 PM UTC

mattnewton wrote: post #96

PragmaticPulp wrote: post #83

Earlier quoted context omitted.

> I'm fairly certain I've just recovered from COVID-19 given my symptoms, but can't get tested here in Colorado. I'm glad you're better. Please be careful going forward, though. You shouldn't assume you have an immunity unless you have a positive test result. Even with the strict pre-test screening that focus strictly on high probability patients, some locations are reporting very high (90%) negative test results fro…

We are also not 100% certain that having the virus once grants immunity. People have tested positive again after appearing to make a full recovery. While these results are probably better explained by remaining infected and becoming asymptomatic for a period then getting symptoms again, we can’t yet rule out the possibility of reinfection to my knowledge. https://www.latimes.com/world-nation/story/2020-03-13/china-..…

I've heard this before and it's the most troubling. Humans have adaptive immune systems. When our bodies first encounter a virus and a while blood cell successfully attaches too and breaks down a virus, it should either replicate or release the right activator proteins that will aid in breaking down the virus.

Vaccines are all about tricking our immune system into preparing those specific antibodies before an infection occurs, so it can stop it quickly. If reinfection is true, what does that say about the nature of this virus and how difficult it is to create a vaccine? Are there other viruses that reinfect like this?

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

#115

Post by djsumdog » Thu, Mar 19, 2020, 5:18 PM UTC

PeterisP wrote: post #112

wool_gather wrote: post #99

Earlier quoted context omitted.

I'm curious about the technical reasons for what you're saying. Can you say more? Is it a problem with figuring out the false negative rate for people without symptoms?

If you test on antigen that matches the virus, then that will return a negative result in the very beginning of infection and after recovery. If you want accurate numbers for statistics, including people who never had symptoms, you can do antibody testing on a random sample of population, that will indicate people who had the disease - but that's kind of too late for that particular location and those particular pati…

I heard in an interview with Michael Osterholm, that scientists in China started testing people who had come in contact to those who were sick in the early days of the outbreak, and found people who were not showing any symptoms, but had a large amount of viral load in their throats they were actively breathing out.

What kind of testing they do in those situations?

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

#116

Post by magduf » Thu, Mar 19, 2020, 5:29 PM UTC

gbacon wrote: post #101

btilly wrote: post #59

Earlier quoted context omitted.

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/

Sorry, I don't know anything about poker, but didn't Riker do this all the time on TNG?

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

#117

Post by 3JPLW » Thu, Mar 19, 2020, 5:35 PM UTC

guscost wrote: post #111

3JPLW wrote: post #104

Earlier quoted context omitted.

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.

If you compare the 80+ group (which has a much higher CFR), this town has closer to three times the percentage of the US population. On top of that, this is in a region of Italy where the healthcare capacity has been completely overwhelmed. That's going to be devastating for the prognosis of an older person who needs a ventilator.

Very true. Here's some more comprehensive numbers from Italian media:

https://translate.google.com/translate?hl=en&sl=it&u=https:/...

Since Feb 25 there have been 91 deaths with positive COVID-19 diagnoses. In total there have been 330 deaths. I'd be very curious what the age breakdowns are.

Anyhow, this was just a small example that shows that we're already seeing significant mortality relative to the _total population_ and not just by confirmed positive cases.

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

#118

Post by btilly » Thu, Mar 19, 2020, 5:38 PM UTC

gbacon wrote: post #101

btilly wrote: post #59

Earlier quoted context omitted.

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/

I will keep that in mind if we ever play poker.

But the phrase remains a common idiom. And in an internet discussion like this, the rationale that makes it bad form in poker does not apply. I cannot see anyone's reactions until after my action is complete and I hit "reply". And therefore I cannot gain a read and final decision based on my incomplete first stage of the action.

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

#119

Post by odorousrex » Thu, Mar 19, 2020, 5:47 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…

>It might even be logical with the above 3 steps in place for zero/low risk group to deliberately seek out the virus. This grants immunity quicker, and if they become sick, they can receive treatment whilst hospitals are still underwhelmed.

This is extremely irresponsible. The long-term effects of the virus are currently unknown but there are some worrying signs of possible long-term lung and other-organ damage that have been reported (anecdotally) from China and Italy. It's going to take time for these studies to be done.

Not to mention the immunity period length is unknown at this time. If this coronavirus follows the pattern of other coronaviruses, immunity could last 6 months to a year tops. That is ... not good. And a secondary infection could be worse than the first due to immune system overresponse/cytokine storm.

It's important we take the time to study these secondary effects and allow time for treatments and/or a vaccine to be developed and studied before we come up with any long-term plan.

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

#120

Post by sojournerc » Thu, Mar 19, 2020, 5:52 PM UTC

djsumdog wrote: post #114

mattnewton wrote: post #96

Earlier quoted context omitted.

We are also not 100% certain that having the virus once grants immunity. People have tested positive again after appearing to make a full recovery. While these results are probably better explained by remaining infected and becoming asymptomatic for a period then getting symptoms again, we can’t yet rule out the possibility of reinfection to my knowledge. https://www.latimes.com/world-nation/story/2020-03-13/china-..…

I've heard this before and it's the most troubling. Humans have adaptive immune systems. When our bodies first encounter a virus and a while blood cell successfully attaches too and breaks down a virus, it should either replicate or release the right activator proteins that will aid in breaking down the virus. Vaccines are all about tricking our immune system into preparing those specific antibodies before an infecti…

I've also heard it, but I think we need more data.

If true, it would go against all priors for how humans build immunity to viruses - especially coronavirus (common cold).

There may be a time limit to immunity, but having none at all after recovery would be rare indeed.

Without significant evidence (more than one somewhat anecdotal case of re-emergence), there's little reason to assume the body doesn't "remember" the virus after recovery with antibodies.

Seems like unnecessary FUD to spread that idea around without more evidence.