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

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

#301

Post by kgwgk »

cma wrote: post #223
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…

Ioannidis even questions if ventilators are helping. He basically says without evidence to the contrary, they may be a placebo (the part about ICU beds). And all the low CFRs he cherry picked have now increased dramatically.

"As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute."

https://www.bmj.com/content/327/7429/1459

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

#302

Post by heisenbit »

jsnell wrote: 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…

R0 is at the initial onset, without any immunity and any preventive measures. If the virus had R0 of 1.3 it would be easily containable. The reality is that it has an R0 of 2-6 and an effective R > 1 in most except Asian countries.

A R0 of 1.3 with an incubation time of 1 week would not lead to the doubling of cases in 4 days. The whole thing is a crime against math.

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

#303

Post by y7 »

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…

> Ioannidis says: “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.”

For anyone wondering, this quote is from [1] and doesn't appear in the linked article. I think the linked article is better worded and more nuanced.

> I think John has good reason to desire evidence based decisions, but sometimes you have to make decisions without enough data and change your game as it develops e.g. look at what effective entrepreneurs do in uncertain times?

I think comparing the measures that governments take with what effective entrepreneurs do is misleading for two reasons. First, for a country there is no single bottom line: a good balance has to be found between low mortality, good quality of life for those that do not die, and economy (which can be tied into the latter, or it can be independent if the government prioritises the wealth of a minority). Success of a company is mostly measured financially, or perhaps by visibility.

And second, the stakes are a lot higher for governments. They cannot fail and disappear if the measures are not a success. If they fail, human consequences are massive, but the country still exists. If entrepreneurs fail, the company might go into bankruptcy and disappear, but the impact is mostly financial. On the one hand this means that the risks can be acceptable if the consequences are only financial, and on the other hand this leads to a certain selection bias -- the successful entrepreneurs you see are ones that take risks and act decisively, and were lucky enough that their risks paid off.

1. https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-a...

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

#305

Post by EmilioMartinez »

A discourse vacuum was produced by lack of proper channels. I myself wouldn't have been so engaged in reading those papers and sifting through videos from obscure sources had I felt that the officials were not sleep at the wheel.

I'm still dumbfounded that China is let off the hook for delaying information a whole month, but even after declaring mass quarantines the west's officials took more than a month to take notice.

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

#306

Post by MaxBarraclough »

ant6n wrote: post #262
rramach wrote: post #174

Earlier quoted context omitted.

John's analysis is cherry picking in many ways. Death rate in Diamond Princess is 1.1% today and 2% is listed as severe. Assuming 50% of severe make it, final fatality rate for the ship may end up closer to 2%. John then adds a 50% discount factor but it is not clear how he picked that number. Also, the 1% of population infected seems to be another number pulled out of a hat. If we are basing our figures based only o…

The Diamond Princess is also likely not a random sample of the population - they are healthy enough to be fit for travel.

Isn't the average age on a cruise ship far older than in the general population? I would've thought the people on board would on average be far more vulnerable.

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

#307

Post by nopinsight »

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…

0.3% & 0.9% are optimistic.

South Korea's naive case fatality rate (CFR) is already 120 deaths/9037 cases = ~1.3% today, gradually going up from ~0.5-0.6% a few weeks ago. Why? People in a functioning healthcare system take time to die and these people were infected during an expansion phase of spread which rapidly increases #cases (denominator).

SK's cohort CFR is even higher. More properly, we should use the infection number from 3 weeks ago because it takes 3-4+ weeks from exposure to death: 120 deaths/4335 cases = ~2.8%

Germany's current naive CFR at 0.4% will also rise in a similar manner for the same reasons. (You can bookmark this.)

https://www.worldometers.info/coronavirus/country/south-kore... https://www.worldometers.info/coronavirus/country/germany/

South Korea has the 2nd highest number of hospital beds per capita in the world and 4 times the US number. Germany: 4th and almost 3 times.

https://en.wikipedia.org/wiki/List_of_countries_by_hospital_...

South Korea's and Germany's hospitals were never overwhelmed in the same manner as Italy's. A major reason Italy's fatality number is so high is because doctors there cannot save everyone anymore.

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

#308

Post by irq11 »

joe_the_user wrote: post #96
partiallypro wrote: post #7

Earlier quoted context omitted.

The craziest stat I heard today was on my local news, and it was about COVID19 in the county, Davidson County (Nashville, TN,) they said of all the active cases in the county only 2 had been hospitalized. That's out of 163. The others were sent home to be quarantined and medicated. I was floored. Why are stats like that not shared? That seems like very valuable information. Hospitalization rates should be one of the…

Sure but most of those are new cases. Do you have any idea what happened with those cases two weeks later or even if it's been two or three weeks for the cases? You'd only expect that 16-32 would require hospitalization in any case. But on the other hand, you can expect 326 visible or invisible cases the next week and gradually things get difficult, if the trend that's been documented continues.

Hospitalization rate is a function of age; if the 163 infected are young, you would expect a hospitalization rate of near zero.

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

#309

Post by ClumsyPilot »

drno123 wrote: post #245
ClumsyPilot wrote: post #145

Earlier quoted context omitted.

If 10% of the population needs ICU and dies because they cant get it, then there is no business as usual.

In Italy, median age of people who have died of Corona is 83 for women and 79 for men [1]. Normal life expectancy is lower than that in the United States [2]. Lockdown measures will have severe impact on GDP, and GDP is correlated with life expectancy [3]. It can easily happen that by killing economy in order to save lives, we may actually be doing the opposite in the long term. [1] https://www.iss.it/web/guest//comu…

It's not just 83 year olds on the ventilator. What's the economy going to be like with millions 'working from hospital?'

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

#310

Post by pjc50 »

panta wrote: post #286
dnautics wrote: post #227

Earlier quoted context omitted.

It's also possible that Italy is vastly unlucky for some generic reason, considering most of the deaths are in a particular region of the country and among an age bracket that is less cosmopolitan and more likely to reflect limited geographic genetic dispersion.

Italian here. The most probable cause for that is that these areas started being affected earlier, so the virus had more time to spread before the lockdown.

I've seen the claim that northern Italy's manufacturing industry is more integrated with China, so there was more cross traffic. I don't know how true this is.
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