Social distancing slowing not only Covid-19, but other diseases too • Hacker News Board

Re: Social distancing slowing not only Covid-19, but other diseases too

#201

Post by thaumasiotes » Thu, Mar 26, 2020, 1:12 PM UTC

TheSpiceIsLife wrote: post #74

thaumasiotes wrote: post #65

Earlier quoted context omitted.

> We'd find sharing tissues with strangers to be disgusting if it were introduced as a greeting today Sounds like you're unfamiliar with the practice of agreeing to a deal by both parties spitting into their hand and then clasping hands? There's also the idea of making a pledge by both parties cutting their hands and then clasping hands, mixing blood with each other.

When was the last time you saw anyone do either of those things, other than in a movie?

I've never seen anyone bow in greeting outside a movie either. (Assuming we're considering books to be "movies".)

Re: Social distancing slowing not only Covid-19, but other diseases too

#202

Post by saalweachter » Thu, Mar 26, 2020, 1:42 PM UTC

timwaagh wrote: post #165

saalweachter wrote: post #113

Earlier quoted context omitted.

This current situation had me wondering how hard it would be to coordinate a regular -- maybe not yearly -- global self-isolation for say 2-3 weeks at a time. Aside from the difficulties of getting everyone in the world to agree that the first three weeks of February during a leap year are observed through social distance, it doesn't seem like it would be as bad on a recurring basis as it is during an emergency like…

Economically you need to take into account that a lot of people barely get sick from flu. Certainly not two weeks a year.

I mean, even if most people don't get sick enough to miss work for 2 weeks a year, 10 sick days a year is a pretty common number to give an employee, either by statute or as part of the benefits package. Even if they don't get used completely every year, most businesses are budgeting for their employees to be non-productive due to illness for two weeks each year.

And obviously colds and flu aren't the only way people get sick and miss work, but if you could cut those two weeks per year to one week per year by having three weeks of quarantine every four years, that's a productivity win before you include the more predictable "nothing happens in February this year", the economic value of the lives saved, and the savings on healthcare spending on the people who don't get sick.

Re: Social distancing slowing not only Covid-19, but other diseases too

#203

Post by lukeschlather » Thu, Mar 26, 2020, 1:45 PM UTC

onion2k wrote: post #141

lukeschlather wrote: post #70

Earlier quoted context omitted.

The error bars on that 4% number are huge, I imagine. Like 4% - 2% or +15%. It's entirely possible you could get 4.9% with zero Covid-19 infections, just from normal variation. Not only possible but I'm sure there's a month in the past decade which had more.

Why would the error range be that high? We'd know about huge spikes like that through hospital data, insurance claims, and the sales of drugs, and there aren't spikes like that. The number of people who are ill is relatively stable year-on-year.

I'm not sure what you're basing your assertion on, but the estimated number of symptomatic flu illnesses ranges from 9.3 million to 45 million annually over the past decade, which as I said is roughly from between 3 and 15% of the US population.

https://www.cdc.gov/flu/about/burden/past-seasons.html

Re: Social distancing slowing not only Covid-19, but other diseases too

#204

Post by candu » Thu, Mar 26, 2020, 1:45 PM UTC

impendia wrote: post #192

ineedasername wrote: post #48

Earlier quoted context omitted.

That'll teach me to rush to comment when I see something "off" instead of reading the whole thing. I'm tempted to delete a post that isn't useful now, but I should leave it as a minor embarrassing lesson to myself. I wish people would stop upvoting me though... Each one makes me cringe: another person who didn't read very carefully.

I agree with your original point, even if you no longer stand by it. >Historically, Kinsa’s methods have been able to account for a sharp rise in the number of people taking tests What historical precedent is Kinsa referring to? There has never before been a pandemic of this magnitude, in a time and place where many people owned internet-connected thermometers. Perhaps I am being uncharitable, but it seems that they…

Yeah, I wish that science reporting would either a) mention specifics on methodology or b) link directly to papers.

Without this plus a stronger push for open-access publishing, readers often have absolutely no way to verify claims like this - and, moreover, have no way to learn how to apply similar methodologies to their own work. There's a lot of people in data science / analytics positions right now who could benefit from sharing knowledge around statistical tools to correct for highly unusual situations.

Re: Social distancing slowing not only Covid-19, but other diseases too

#205

Post by Bartweiss » Thu, Mar 26, 2020, 1:50 PM UTC

impendia wrote: post #192

ineedasername wrote: post #48

Earlier quoted context omitted.

That'll teach me to rush to comment when I see something "off" instead of reading the whole thing. I'm tempted to delete a post that isn't useful now, but I should leave it as a minor embarrassing lesson to myself. I wish people would stop upvoting me though... Each one makes me cringe: another person who didn't read very carefully.

I agree with your original point, even if you no longer stand by it. >Historically, Kinsa’s methods have been able to account for a sharp rise in the number of people taking tests What historical precedent is Kinsa referring to? There has never before been a pandemic of this magnitude, in a time and place where many people owned internet-connected thermometers. Perhaps I am being uncharitable, but it seems that they…

I don't think this is uncharitable at all. I'm sure Kinsa has made a good effort at controlling for testing frequency, and I'm sure it's helped. But there's no reason to think the dynamics of COVID-motivated testing are the same as for flu-season, or new-buyer novelty, or anything else.

And more importantly, how could we know if it is? That's not just a Kinsa problem; we see this over and over again with peer-reviewed studies that "control for" certain factors like socioeconimics or health history. They're inherently limited to controlling for what they know about, and it's never perfect. Often, the entire effect is from an undiscovered variable. Take, say, the widely-promoted study finding that visiting a museum, opera, or concert just once a year is tied to a 14% decline in early death risk. The researchers tried to control for health and economic status, then concluded "over half the association is independent of all the factors we identified that could explain the link." [1]

Now, what seems more likely: that the unexplained half is from the profound, persistent social impact of dropping by a museum or concert once a year? Or that some of the explained factors like "civic engagement" can't be defined clearly, others are undercounted (e.g. mental health issues), and some were missed entirely?

I suspect Kinsa did much better than that, because they're not trying to control for such vague terms. But I think "even after controlling for" should basically never rule out asking "what if it's a confounder"?

[1] https://www.cnn.com/style/article/art-longevity-wellness/ind...

Re: Social distancing slowing not only Covid-19, but other diseases too

#206

Post by o-__-o » Thu, Mar 26, 2020, 1:57 PM UTC

macintux wrote: post #195

o-__-o wrote: post #138

Earlier quoted context omitted.

Where am I spreading germs all over the place if I’m isolating myself in my home? Please read my text.. I agree Let’s not double down on failure. Look at what China did, it worked let’s follow them. Practice social distancing until July. There is no other option until our hospitals are under control...

You’re missing the point. You might be spreading it everywhere right now and you wouldn’t have any symptoms for another two weeks.

I have been locked in for two weeks, if I am spreading it everywhere then my house is a biological war zone. But that’s the point of self isolation, it’s to make sure you are not spreading it to others. Why would I go to get a test if I’m isolating? If I’m negative that doesn’t mean I will never get it. So why not just stay inside until hospitals are less overwhelmed (and THEN get tested on a regular basis to avoid contamination — you know what we should have been doing since day 1)

Everyone should be doing this so you wouldn’t have to assume I am spreading it everywhere.

Look at China, its working.

Re: Social distancing slowing not only Covid-19, but other diseases too

#207

Post by o-__-o » Thu, Mar 26, 2020, 2:01 PM UTC

cycomanic wrote: post #149

o-__-o wrote: post #71

Earlier quoted context omitted.

I dont understand what millions of millions of test kits will do. I’m not going to get tested because I have no symptoms. If I had symptoms I would stay in lockdown until it got worse. I don’t see rationale for anyone going to get tested just because (and based on some of the photos from drive through testing, a very easy way to contract COVID yourself)

It's not just about people with symptoms to get tested. It's about people who are known to have had contact with infected to get tested. Also importantly you want to regularly (at least once a week) test health workers and others who are in contact with vulnerable people. And finally, by doing lots of so called sentinel tests (random testing around the country) you can get a much better picture of how the virus sprea…

Hey I agree with you, but I am not a health worker. I think we need to remember what spawned this thread and not move the goalposts for talking points.

Even if you are not showing symptoms stay inside so you are not spreading the disease. Getting tested won’t prevent the spread, staying isolated will.

Look at China.

Re: Social distancing slowing not only Covid-19, but other diseases too

#208

Post by o-__-o » Thu, Mar 26, 2020, 2:04 PM UTC

macintux wrote: post #196

DanBC wrote: post #194

Earlier quoted context omitted.

The tests can tell you if you have covid-19. What they can't do, because they have such a high false negative rate, is tell you that you don't have it.

That’s fine. Get a preliminary test, rule it out if you can, and if it comes back positive then take other tests or self-isolate, or both. Beats the heck out of everyone hiding under their bed for months.

But if you catch co19 t-0 after leaving the testing site then you can spread it, right?

So what is testing the world going to solve if no one is preventing the spread of contamination? Because the answer is that you will only overwhelm hospital resources

Look at China.

Re: Social distancing slowing not only Covid-19, but other diseases too

#209

Post by o-__-o » Thu, Mar 26, 2020, 2:05 PM UTC

ceejayoz wrote: post #193

o-__-o wrote: post #120

Earlier quoted context omitted.

the human element will always be a failure mode. Every photo I have seen in my area has shown the testers either reaching into the car or having contact with the patient. So you may be asymptomatic or you may not, but then you possibly end up catching it at the test site but your test was negative so you continue about your routine and start spreading it for real. Not saying the above scenario is a reason not to get…

The testers wear PPE - gloves, gowns - that gets changed between tests.

I don’t believe that when we have a shortage. The guidelines even state don’t come to a testing site if you are not showing symptoms as you may catch the covid. I mean why are you not even considering my viewpoint?

Look at China, is it testing that’s working there or the lockdown?

Re: Social distancing slowing not only Covid-19, but other diseases too

#210

Post by macintux » Thu, Mar 26, 2020, 2:10 PM UTC

o-__-o wrote: post #208

macintux wrote: post #196

Earlier quoted context omitted.

That’s fine. Get a preliminary test, rule it out if you can, and if it comes back positive then take other tests or self-isolate, or both. Beats the heck out of everyone hiding under their bed for months.

But if you catch co19 t-0 after leaving the testing site then you can spread it, right? So what is testing the world going to solve if no one is preventing the spread of contamination? Because the answer is that you will only overwhelm hospital resources Look at China.

I don’t think anyone is proposing that testing is a magical cure for the overall problem; obviously you’d have to use testing in conjunction with treatment and isolation and presumably other tactics.

However, this idea that testing is worthless is frankly bizarre. You can’t control what you can’t measure, and “number of people occupying hospital beds” is a very poor measure for a disease that spreads silently for weeks before symptoms emerge.