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

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181–190 of 462 posts

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

#181

Earlier quoted context omitted.

It's a meta-study looking at over 67 papers that address the question of the spread of respiratory viruses. Obviously, every virus is a new virus, that is always a problem. Yeah, and if any of those other viruses caused a world wide pandemic, I missed it. The article is a specious disaster. Why do we treat the virus like a black swan event, but not the unprecedented response of shutting economic and civil liberty dow…

>Yeah, and if any of those other viruses caused a world wide pandemic, I missed it. They do actually. Several of the outbreaks studied among the papers were influenza pandemics, coronavirus pandemics, and SARS. (page ~110-120) This rhetoric you're starting here about bringing out the war drums to fight invisible enemies is exactly what Ioannidis is afraid of. It is not scientific, it is not based on evidence, and it…

This rhetoric you're starting here about bringing out the war drums to fight invisible enemies is exactly what Ioannidis is afraid of. It is not scientific, it is not based on evidence, and it does not, weigh the tail risk of a global economic breakdown.

Science is a means of discovering the most likely state of things and an always uncertain one. Other human institutions have to come into play when it is necessary to act. Those institutions make the trade-off rather simply calculating them. In the current context, the institution of a war is appropriate (more appropriate than all the semi-wars we've had over the last 50 years in fact, better than "war on drugs" or "war on terror"). We confronted by tiny semi-living creature that happens to be very good at killing us. We should band together and engage in unified, determined action to protect ourselves.

As far the economy goes - the economy is a phenomena of society. The productive machinery should kept going as much as practical and the entire process managed by the government, essentially a machinery akin to WWII needs to be in place for the duration of this. Such war measures kept things running at that time and there's little reason to think they wouldn't work today. Now, as far as lots of people losing their investment. Well, sorry, investments aren't life. This, in a sense, very quick trip from 1929 to 1948 for y'all.

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

#182
I found this bit from the paper interesting.

  A Google search with “coronavirus” yielded 3,550,000,000 results on March 3 and 
  9,440,000,000 results on March 14. Conversely, “influenza” attracted 30- to 60-fold less 
  attention although this season it has caused so far about 100-fold more deaths globally 
  than coronavirus. 
First off, I am not sure how to comprehend those numbers. Back in the day a "result" was a page. What is that today? Are there really $9bn+ pages of useful content that mentions coronavirus? The number seems a bit arbitrary...

Second, the major issue with comparing flu deaths and coronavirus deaths is time. We have only known about covid-19 for a handful of months. The flu in all its forms has been with us for millennia. You simply cannot compare the two. For me this bit throws the credibility of the paper out the window.

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

#183
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.

Mt. Sinai in NYC is not currently reporting shortages of any kind. They are preparing for shortages, but are not currently experiencing them:

https://www.westsiderag.com/2020/03/23/mt-sinai-setting-up-o...

Perhaps you want to reconsider your news sources.

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

#184

Earlier quoted context omitted.

An economy is not something that one should have to shovels lives into to keep going. And in any case, if we sacrifice all the lives this virus could take to the economy, it won't help the economy at all - the massive dislocation involved in the deaths will certainly be far worse than the shutdown, if you really want to think that way. All that said, part of the collapse of things like the stock market comes through…

I definitely agree with you, but I want to see more data. Without broad testing it’s difficult to ascertain the true death rate of the virus (many infected are asymptomatic). But my hope is we can come up with similarly effective measures (e.g. require n95 masks in public, keeping the elderly at home, offer voluntary isolated infection to low-risk individuals to increase herd immunity, etc) that can achieve both.

South Korea did extensive testing when they successfully eradicated the virus. As user rramach points out, Ioannidis cherry picks the data in many ways, including ignoring the extensive data of South Korea. Not did was Koreans' testing program extensively documented (by Korean scientific institutions, The Western press, and etc), we know they found most or the larger portion of cases because they were able to bring new infections and deaths down to zero.

(e.g. require n95 masks in public, keeping the elderly at home, offer voluntary isolated infection to low-risk individuals to increase herd immunity, etc)

These "get the economy going" measures are totally nuts. You know 10-20% of even fairly healthy people get pneumonia and require hospitalization for virus. Most young people survive but many of those surviving suffer permanent lung damage.

Further, people between 50 and 65 make a huge contribution to the economy and taking them out for an extended period would be highly costly like all this is highly costly (but quarantine should eliminate the virus so could be even quick). Just much, quarantining just some people would require moving a vast number of people from place. IE, what happen with young people living with old people (as happens a lot). The movement of people from place to place would naturally ... spread the virus extensively. More over, where do you get the extra places for either the young living or the old leaving? The UK talked about plans, true but abandoned quickly when infection began because they are obviously impractical fantasies.

Quarantining everyone is extremely simple and just requires doing what South Korea did but on a large scale.

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

#185
post #35

The title is funny, since Ioannidis is actually the one proposing measures ("do nothing") based on no evidence and exaggeration. Basically every number in the paper is tainted by him cherry-picking the most optimistic number possible, and then trying to twist it further into something even better. Like his argument for the R0 being near 1.3 is just that it's "probably" the case. At some point we need to be able to ca…

Weirdly enough, just yesterday I took all available sequence data currently on GISAID, used it to estimate R0, and got ... 1.3.

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

#186

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…

> Instead, the entire economy has been shut down, and the solution? The hospitals are being overrun. Your whole comments just reads like you're upset that you can't go out with your friends anymore. "Why should I have to stay at home, its the old people that are in danger, they should have to stay home." The hospitals are being overrun. That means that if left unchecked the virus overwhelms healthcare. Just yesterday…

They are being overrun with panic of the citizenry in the U.S. so far - not with people needing hospital care. At least so says my E.R. doctor sister.

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

#187

It’s much easier to quantify the harms of allowing business as usual and letting the infection spread (namely # of deaths) than it is quantifying the cascading repercussions of a massive global economic meltdown. Accordingly, world leaders are being judged based on their ability to contain the spread rather than prevent economic devastation. As a society we are faced with navigating the delicate balance between how m…

An economy is not something that one should have to shovels lives into to keep going. And in any case, if we sacrifice all the lives this virus could take to the economy, it won't help the economy at all - the massive dislocation involved in the deaths will certainly be far worse than the shutdown, if you really want to think that way. All that said, part of the collapse of things like the stock market comes through…

> An economy is not something that one should have to shovels lives into to keep going.

I think this is almost the literal definition of the economy. I've been shoveling my entire life and eventually I will die.

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

#189

Earlier quoted context omitted.

An economy is not something that one should have to shovels lives into to keep going. And in any case, if we sacrifice all the lives this virus could take to the economy, it won't help the economy at all - the massive dislocation involved in the deaths will certainly be far worse than the shutdown, if you really want to think that way. All that said, part of the collapse of things like the stock market comes through…

I definitely agree with you, but I want to see more data. Without broad testing it’s difficult to ascertain the true death rate of the virus (many infected are asymptomatic). But my hope is we can come up with similarly effective measures (e.g. require n95 masks in public, keeping the elderly at home, offer voluntary isolated infection to low-risk individuals to increase herd immunity, etc) that can achieve both.

For the record, in March 2018, 58 000 people died in Italy. We will see how many died this March 2020 :

http://demo.istat.it/index_e.html (see green section on the right, By Month)

Also the following study from August 2019 (before covid19) shows that Italy has more deaths due to influenza every year than any other EU country :

https://www.sciencedirect.com/science/article/pii/S120197121...

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

#190
post #42

I published a paper on outbreaks in a hospital setting and the problem is there is not a single RCT on methods to stop outbreaks. The problem is no organization is willing to approve a trial where you don't follow your protocols and commonly accepted methods to control the spread (ex. closing common areas, isolating patients, cohorting staff, enhanced cleaning). There is a good blog post about 'Riding the Wave' that…

South Korea got their infections down and their economy isn’t in the toilet. Compare to Italy’s reactive policy and subsequent failure. Or look to Taiwan and Japan with economies running and infection rates under control (at present). Your “perhaps the outbreak would have ended itself” will be shown to be false in multiple countries that lack the resources to manage their infection transmission rates... We have heard…

I’m really worried about India. So far it’s not a huge outbreak there yet, but they are hitting the beginning stages of the steep curve.
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