Evidence over Hysteria – Covid-19 • Hacker News Board

Re: Evidence over Hysteria – Covid-19

#41

Post by nabla9 » Sat, Mar 21, 2020, 7:28 PM UTC

dmix wrote: post #27

nabla9 wrote: post #15

Earlier quoted context omitted.

There are large number of government organizations, pandemic experts, medical professionals, and research groups communicating in the social media and blogs. There is no reason to post news articles or blogs from random Joes in HN when you can post directly from experts.

There was a time when blog posts by “regular Joes” was the norm on HN and it wasn’t necessarily a bad thing. Quality content can come from anywhere. I’d rather judge them on the merits of their contribution than some meta signals.

> I’d rather judge them on the merits

This assumes that you can do that. If you are not an expert you can't possibly have the background to put things in the perspective.

This is not the issue of the ability to read and study, it's about missing variables and weighting evidence. If you don't have the background, you must spend weeks studying to get some hold of issues.

Argument from authority is fallacy of reasoning but it's not fallacy when learning and gathering relevant information. We you can reason only after you have learned the subject.

Social media is full of people who learned basic math behind SIR model and are building layman theories based on them.

Re: Evidence over Hysteria – Covid-19

#42

Post by qwytw » Sat, Mar 21, 2020, 7:38 PM UTC

guscost wrote: post #40

Analemma_ wrote: post #37

Earlier quoted context omitted.

As of right now, Italy’s fatality rate is almost 9% [0], so saying “it might not be within an order of magnitude of 0.6%!” is optimistic to the point of delusional. [0]: https://mobile.twitter.com/ARanganathan72/status/12414116867...

Italy is looking like a “perfect storm” tragedy no matter what. The older population, combined with rapid, widespread transmission, to the point where critical cases completely overwhelm the health infrastructure, is absolutely a recipe for horrible CFR numbers like that. The fear that healthcare infrastructure elsewhere could be overwhelmed by another sudden outbreak is really the only reason experts are freaking ou…

The fatality rate and the total number of cases reported by Italy don't really mean much if anything at this point. Because their health system is overwhelmed they are mainly only testing people who already have severe symptoms which inflates the fatality rate as most mild cases are never identified. While it's reasonable to assume that's it's higher there than in places like South Korea or Germany it's very likely that it's still considerable less than anything close to 9%.

Re: Evidence over Hysteria – Covid-19

#43

Post by hackeraccount » Sat, Mar 21, 2020, 7:44 PM UTC

dmix wrote: post #30

andbberger wrote: post #11

Now is the time for extreme caution. We can laugh about how it was an overreaction later.

When people are losing jobs at a higher rate than the worst recession in the modern era, while kids miss out on critical education time, and everyone is basically self-imprisoned in homes I think it’s fine to constantly question if we are overreacting. Even if that answer is mostly no, we’re not. Emergency funding will only go so far and once we get past a month of extraordinary measures the serious pain hitting mill…

This exactly. Medicine is all about the dosage. If we are overreacting than we're not helping people extra - we're actively hurting people.

Re: Evidence over Hysteria – Covid-19

#44

Post by jsnell » Sat, Mar 21, 2020, 8:56 PM UTC

guscost wrote: post #34

loudmax wrote: post #32

The trouble with an article like this is that it mixes well reasoned arguments with nonsense. The economic cost of closing schools and shutting borders is real, especially as the epidemic continues for months. The trouble is that the article downplays the seriousness of covid-19. A mortality rate of 0.6% means nearly one million deaths if covid-19 spreads to half all Americans. The article points to South Korea as an…

On the other hand, the problem with your argument is that there is absolutely no way to be sure, today, that the mortality rate is even within an order of magnitude of 0.6%. And as more evidence comes out that this thing is spreading faster and more stealthily than expected, one consequence is that the true mortality rate may be much lower than those estimates.

The South Korean testing has been quite extensive, and not just limited to the people with the most obvious symptoms unlike in the west. Given they appears to have contained the virus without resorting to a full lockdown, it seems unlikely they would have missed a large number of cases. If they had, those asymptomatic or mild cases should be constantly restarting the chain of transmission.

1.1% of their cases have died, and an additional 0.8% are in serious or critical condition. And they're a best case scenario: the health care system was not overloaded, and their diagnosed cases are skewing disproportionately young.

The Diamond Princess also has had a fatality rate so far of 1.1%. In that case we know with absolute certainty that there is no massive hidden iceberg of infected but undiagnosed people. There might be a hidden iceberg of unreported fatalities though, since once they were off the ship, the cases stopped being tracked as Diamond Princess cases. On the plus side, the demographics obviously skewed very old.

Anyway, there's very good reason to believe that the IFR is at least 0.6%. Suggesting that it's actually <0.06% seems just ludicrous. Is there any evidence at all supporting that, or are you just arbitrarily demanding "absolute certainty" in a time-critical situation?

Re: Evidence over Hysteria – Covid-19

#45

Post by basscomm » Sat, Mar 21, 2020, 10:09 PM UTC

guscost wrote: post #19

andbberger wrote: post #11

Now is the time for extreme caution. We can laugh about how it was an overreaction later.

I’ve talked to a lot of folks in the past few weeks who aren’t laughing at all over what might be an overreaction. It’s making their lives very hard. If it turns out this is indeed an overreaction, they’re going to be totally pissed off, and I’m probably going to agree with them. You’re free to laugh all you want, but it’s a privilege that you probably don’t appreciate.

>I’ve talked to a lot of folks in the past few weeks who aren’t laughing at all over what might be an overreaction.

It's a no-win situation for a lot of people with a certain mindset. If we take extreme measures and the infection is worse than predicted, then they'll say that everyone should have done more.

If we take extreme measures and 'flatten the curve' enough so that the hospitals aren't overwhelmed and the number of deaths is lower than expected, then they'll say that all those measures were an overreaction to something that turned out to not be that bad. Even though that was the desired outcome of taking those extreme measures in the first place.

There is also a worryingly-large number of people that will insist that everything is overblown, everything is fine, et cetera, until they (or someone they know personally) is impacted. Until then all these things are happening to 'someone else' and can be ignored.

Re: Evidence over Hysteria – Covid-19

#46

Post by ludamad » Sat, Mar 21, 2020, 10:10 PM UTC

tjr225 wrote: post #7

Unrelated - is there a term for exhaustion of opinions? I swear you could go into any HN comment thread related to this outbreak and it breaks down to; Person A saying X is going to happen and then Person B saying Y is going to happen and then Person C saying that No! Z is going to happen! How did everyone get so opinionated about something so unpredictable and unprecedented? In any case I think we should all calm do…

My family is unemployed right now, an opinion has to be formed, then we are all kept indoors. I foresee continued growing pains

Re: Evidence over Hysteria – Covid-19

#47

Post by dnautics » Sat, Mar 21, 2020, 10:13 PM UTC

guscost wrote: post #23

dnautics wrote: post #22

Earlier quoted context omitted.

There's an overreaction budget that when you exhaust goes into 'boy who cried wolf' territory.

Yep, this is another huge potential problem. If we just wasted everyone’s tolerance for collective action on a nasty cold, that’s pretty fucking stupid.

don't forget that we are also using tolerance on other, non-pandemic things, like school shooting drills, wars on terrorism, etc.

Re: Evidence over Hysteria – Covid-19

#48

Post by guscost » Sat, Mar 21, 2020, 10:30 PM UTC

jsnell wrote: post #44

guscost wrote: post #34

Earlier quoted context omitted.

On the other hand, the problem with your argument is that there is absolutely no way to be sure, today, that the mortality rate is even within an order of magnitude of 0.6%. And as more evidence comes out that this thing is spreading faster and more stealthily than expected, one consequence is that the true mortality rate may be much lower than those estimates.

The South Korean testing has been quite extensive, and not just limited to the people with the most obvious symptoms unlike in the west. Given they appears to have contained the virus without resorting to a full lockdown, it seems unlikely they would have missed a large number of cases. If they had, those asymptomatic or mild cases should be constantly restarting the chain of transmission. 1.1% of their cases have di…

> If [South Korea] had [missed a large number of cases], those asymptomatic or mild cases should be constantly restarting the chain of transmission.

If enough people have already recovered from mild or asymptomatic cases (it would have to be a pretty hefty percentage, granted) then that, combined with not-total-lockdown conditions, could bring down the R0 value enough to cause the same result. Do you think it’s much more likely that the virus has been totally contained?

> The Diamond Princess also has had a fatality rate so far of 1.1%. In that case we know with absolute certainty that there is no massive hidden iceberg of infected but undiagnosed people.

This might be the strongest evidence against the “mild and everywhere” theory. However, there are still something like five out of six passengers who tested negative but could have recovered before they were tested. Even if they’re not a great representative sample, testing them all for antibodies might be a good move.

Re: Evidence over Hysteria – Covid-19

#49

Post by ankushnarula » Sat, Mar 21, 2020, 10:35 PM UTC

notacoward wrote: post #29

Starts well enough, but gets more questionable in the middle and downright risible at the bottom. Claims to be more objective, empirical, etc. than others are unrelated to actually being more objective, empirical, etc. > driven by data from medical professionals and academic articles ...as filtered through one person's understanding and biases. Often this results in a very different picture than perusal of the origin…

"Transmission in China happened among family members and close contacts. True “community spread” was less common.

“This virus is not circulating in the community, even in the highest incidence areas across China,” Van Kerkhove insisted.

What’s the difference between spread among close contacts and community spread, you might wonder? Van Kerkhove said the data the mission saw in China pointed to the virus finding its way into households and transmitting there. One family member gets infected and infects others. The “secondary attack rate” — the percentage of people in a household who got infected after someone brought the virus into the home — was between 3% and 10%.

Van Kerkhove said true community spread involves transmission where people get infected in a movie theater, on the subway, or walking down the street. There’s no way to trace back the source of infection because there’s no connection between the infected person and the person he or she infects. That’s not what the Chinese data show, she said.

Marc Lipsitch, an infectious diseases epidemiologist at the Harvard School of Public Health, found this claim puzzling. “I have reached out to the World Health Organization to understand the basis of some of those statements. My perception is that there is significant community transmission, especially when you aren’t aware that someone is sick, because there’s not enough testing,” he said.

https://www.statnews.com/2020/03/06/were-learning-a-lot-abou...

Re: Evidence over Hysteria – Covid-19

#50

Post by guscost » Sat, Mar 21, 2020, 10:54 PM UTC

basscomm wrote: post #45

guscost wrote: post #19

Earlier quoted context omitted.

I’ve talked to a lot of folks in the past few weeks who aren’t laughing at all over what might be an overreaction. It’s making their lives very hard. If it turns out this is indeed an overreaction, they’re going to be totally pissed off, and I’m probably going to agree with them. You’re free to laugh all you want, but it’s a privilege that you probably don’t appreciate.

>I’ve talked to a lot of folks in the past few weeks who aren’t laughing at all over what might be an overreaction. It's a no-win situation for a lot of people with a certain mindset. If we take extreme measures and the infection is worse than predicted, then they'll say that everyone should have done more. If we take extreme measures and 'flatten the curve' enough so that the hospitals aren't overwhelmed and the num…

You’re not even acknowledging the third possibility: if it doesn’t turn out “that bad” and the extreme measures don’t make much of a difference.

This is the possibility I would be super pissed about, not the other two. Unfortunately, in either “not that bad” outcome it’s going to be very hard to prove which one it is, which of course won’t stop a bunch of folks from parading around and bragging about how they saved the world.

I’ve seen this pattern more than once in my short time alive. But assuming what we all hope, that one of the “not that bad” scenarios plays out, the difference this time will be that many millions of lives will have been directly ruined because of those extreme measures.