Covid-19: the harms of exaggerated information and non‐evidence‐based measures • Hacker News Board

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#101

Post by empath75 » Tue, Mar 24, 2020, 4:06 AM UTC

RobertRoberts wrote: post #92

acqq wrote: post #14

Earlier quoted context omitted.

We have the data we need. We know how fast it grows, we know how bad it is. It's at least order of magnitude (as in, surely ten times) worse than flu: https://en.wikipedia.org/wiki/File:Is_COVID-19_like_a_flu%3F... As shown, in Italy there were 55 times more deaths per week (two weeks already) than the peek during the flu season. And it continues to grow. > are people actually going to hospitals when they don't need…

Consider this, if the news reported "Old people with pre-existing conditions should quarantine themselves because a deadly virus may kill them", that would be rational advice based on data. Instead, the entire economy has been shut down, and the solution? Test everyone regardless of risk or value of testing. This is not rational, and many scientists and doctors are saying this. Doctors and nurses should be tested reg…

What harm is there in testing everyone?

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#102

Post by rglullis » Tue, Mar 24, 2020, 4:07 AM UTC

RobertRoberts wrote: post #87

rglullis wrote: post #31

Earlier quoted context omitted.

This line of thinking is backwards. Usually the problems that we don't solve are the ones where we should have taken stronger measures (i.e, "panicked") earlier instead of waiting for evidence of a threat. We did listen to the ones crying (i.e, "panicking") over Y2K bug and a lot of money was spent on it before January 1st, 2000, so that got solved swiftly. On the other hand: - Had we listened to the ones crying (i.e…

Every circumstance you mentioned was not "solved" with panic, but was solved with thoughtful and persitant action. If you are proposing the only way to "thoughtful and persistent action" is by being induced by panic. Then I would appreciate your evidence of this. For example the 2038 problem is more serious that Y2k. My actions today (as soon as I found out about it) was to alter all current and future systems and pl…

My point is that what you call "panic" is not really panic.

It is not panic to leave a building as fast as you can when a fire alarm rings - even if we don't know what caused the alarm to ring in the first place. I don't care about "numbers over hyperbole" or "science vs conjecture", I leave the building and assume that I am at risk by staying inside.

Likewise, it is not "panic" to propose that we err on the side of precaution and take measures that could contain an epidemic of uncertain risk and dangers, instead of adopting a "wait-and-see" attitude that might be fatal. Chinese doctors wanted to ring the alarm in November and were silenced by the Communist Party. When we got to December/early January and even the Party couldn't hide it anymore, we should've taken that more seriously and started to look for the "way out of the building", even if we didn't know yet how big is the fire/what caused it/who started it/etc.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#103

Post by Barrin92 » Tue, Mar 24, 2020, 4:07 AM UTC

defen wrote: post #93

robocat wrote: post #84

Firstly, there is 10 weeks of evidence on what other countries have done to avoid transmission. Taiwan, Vietnam, South Korea, China, and Japan all show a variety of strategies and have some successes under their belts. Sure, it’s messy social data, and they have systematic differences from other countries, but it’s real data about what is working. Ioannidis says: “If we assume that case fatality rate among individual…

> “If we assume that case fatality rate among individuals infected by SARS-CoV-2 is 0.3% in the general population — a mid-range guess from my Diamond Princess analysis — and that 1% of the U.S. population gets infected (about 3.3 million people), this would translate to about 10,000 deaths.” Why would we use the Diamond Princess CFR instead of China's, or Italy's, or South Korea's? Where does the idea of 1% come fro…

>Why would we use the Diamond Princess CFR instead of China's, or Italy's, or South Korea's?

because everyone on the diamond princess was tested. So we know for sure how many cases we are dealing within the sample.

~0.3 and ~0.9% are also not optimistic guesses but the current numbers for Germany and SK. Italy sits at 9%. So the situation is either that Italy is vastly underestimating cases, or Germany and South Korea have lost a magnitude of corpses somewhere. I find the latter less likely than the former.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#104

Post by Gibbon1 » Tue, Mar 24, 2020, 4:09 AM UTC

wwweston wrote: post #88

ajnin wrote: post #83

What Ioannidis is advocating is to do nothing until we have scientific certainty of what the correct decision should be, and only then act. What he's not taking into account is that the situation is unfolding right now, and if "do nothing" turns out not to have been the correct decision then you can't go back and change that. If we overreact and cause 20% unemployment for the next year, then a harm has been caused, b…

> if we under-react and 20 million people die, then another harm would have been caused And it's worth noting if anything on the order of millions of people die, then there going to be economic impacts -- that's a hell of a demand crater and productivity shock.

Worst case. Instead of quickly developing herd immunity, the US ends up with persistent low level outbreaks over two to three years like the 1918 flu. If that happens the rest of the world will quarantine us.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#105

Post by odkamkfn » Tue, Mar 24, 2020, 4:10 AM UTC

acqq wrote: post #14

fraggle222 wrote: post #3

Earlier quoted context omitted.

What we need is more data. What is the % of Covid-19 cases that require hospitalization (and are people actually going to hospitals when they don't need to?) ? Is it 20x that of flu or 2x? We need random testing throughout the population to know true mortality rate and herd immunity.

We have the data we need. We know how fast it grows, we know how bad it is. It's at least order of magnitude (as in, surely ten times) worse than flu: https://en.wikipedia.org/wiki/File:Is_COVID-19_like_a_flu%3F... As shown, in Italy there were 55 times more deaths per week (two weeks already) than the peek during the flu season. And it continues to grow. > are people actually going to hospitals when they don't need…

We do not have all the data we need. Just for starters, we don't know why the situation is so much worse in Italy than in Japan.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#106

Post by amykyta » Tue, Mar 24, 2020, 4:10 AM UTC

Geee wrote: post #64

I saw the videos from Wuhan hospitals 2 months ago and it was clear that the severity of this was off the charts. You can pretty much scale up the situation from a single hospital, because it tells you that it's impacting locally more than the hospital can respond. You don't need "evidence" of how many are actually infected or what is the correct R or CFR or which way it spreads. Just look how it's impacting the loca…

Spot on. Too many comments are see-sawing on details of parameters and trade offs but just talk to a doctor in NYC, they are out of room in ICUs and terrified about triaging that will start taking place.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#107

Post by defen » Tue, Mar 24, 2020, 4:10 AM UTC

Barrin92 wrote: post #103

defen wrote: post #93

Earlier quoted context omitted.

> “If we assume that case fatality rate among individuals infected by SARS-CoV-2 is 0.3% in the general population — a mid-range guess from my Diamond Princess analysis — and that 1% of the U.S. population gets infected (about 3.3 million people), this would translate to about 10,000 deaths.” Why would we use the Diamond Princess CFR instead of China's, or Italy's, or South Korea's? Where does the idea of 1% come fro…

>Why would we use the Diamond Princess CFR instead of China's, or Italy's, or South Korea's? because everyone on the diamond princess was tested. So we know for sure how many cases we are dealing within the sample. ~0.3 and ~0.9% are also not optimistic guesses but the current numbers for Germany and SK. Italy sits at 9%. So the situation is either that Italy is vastly underestimating cases, or Germany and South Kore…

Bruce Aylward's visit to China made it sound like they were testing everyone too.

Germany is at 0.42 and South Korea is at 1.24 now that more diagnosed people have had time to die.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#108

Post by usaar333 » Tue, Mar 24, 2020, 4:10 AM UTC

dannykwells wrote: post #20

Let's check back on this piece in...2 weeks, say, when there are 10,000+ Corona deaths in the US. Well see how it ages then. Source: https://www.nytimes.com/interactive/2020/03/21/upshot/corona... 427× 16 =11102

That rate is highly unlikely to hold. There's enough stay in place restrictions in effect to drive it down after about a week or so.

FWIW, at this point, it looks like NYC is going to take a huge hit and the other outbreaks (Seattle, California) will look mild comparitively.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#109

Post by yongjik » Tue, Mar 24, 2020, 4:11 AM UTC

avsteele wrote: post #62

jtsnow wrote: post #22

Ioannidis continues to push this evidence-based approach, but I have not yet seen an adequate response to critics such as Nassim Taleb or Yaneer Bar-Yam. They argue that one doesn't need raw evidence to act if the statistical evidence shows that the risks are catastrophic. They published a paper on January 26th which lays out arguments for why conventional risk management approaches are inadequate in these situations…

I find Taleb's argument specious. The risk inherent in a reaction can be pretty catastrophic as well; for example we are now seeing some project 20%+ unemployment in the next quarter. In addition, we do have data on the possible harms from Coronovirus, since we have more CFR data at this point. This puts bounds on possible harms. For more detail see John's other article in statnews. The results of the Diamond Princes…

Diamond Princess (pop. 3,711) was stationed right next to Japan (pop. 126M) and could use its full medical resource. That's not a good model for an actual country hit with the virus.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#110

Post by odkamkfn » Tue, Mar 24, 2020, 4:11 AM UTC

empath75 wrote: post #101

RobertRoberts wrote: post #92

Earlier quoted context omitted.

Consider this, if the news reported "Old people with pre-existing conditions should quarantine themselves because a deadly virus may kill them", that would be rational advice based on data. Instead, the entire economy has been shut down, and the solution? Test everyone regardless of risk or value of testing. This is not rational, and many scientists and doctors are saying this. Doctors and nurses should be tested reg…

What harm is there in testing everyone?

If it can be done cheaply and easily while preventing additional infections, no harm at all. In fact, testing as many people as possible to isolate carriers is, I believe, the single best way to handle this crisis. It's not doable at this point, although hopefully we'll get there.