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Covid-19 at a homeless shelter in Boston: Implications for universal testing

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Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#171
post #164
post #129

Earlier quoted context omitted.

Iceland’s peak was significantly more recent than China or South Korea which continued to have regular deaths over a month after their peak. So, my expectation is their deaths will likely double in the next three weeks. Which would be consist with ~1/2 their ICU cases dying. That said it’s a small sample size so significant variability is possible. Just compare new cases vs new deaths here: https://en.wikipedia.org/w…

I wish the media would focus more on the outliers of the doomsday narrative, as well as the long term consequences of the lockdown solutions being pushed. covid-19 is bad, but seems nowhere near comparable to what much of the developing world faces on a daily basis (4000 kids die a day from malaria?!?)

I have almost exclusively used Wikipedia for keeping track of the outbreak. Media has become really bad at communicating complex issues that are rapidly changing over time especially as different groups are trying to shape messages to the public.

Face masks for the general public being the most obvious example.

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#173
post #41

Earlier quoted context omitted.

Another explanation is that the exact infection level isn’t important when the observed all-causes fatality rate is double [0] its seasonal average and everyone is therefore busy firefighting the immediate and obvious problems. [0] varies by region, but see for example this graph of London: https://pbs.twimg.com/media/EVlO-28XQAA30xu?format=jpg&name=...

Don't take my word for it. Here is an article by a Stanford epidemiologist calling for random testing a month ago: https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-a... We need data to act objectively. As far as I can tell US state governments are doing all they can to prevent random data from being released.

What's the motivation?

I see plenty of motivation in some states to try to minimize the potential magnitude of the problem, or avoid "bad" numbers of infection rates.

I don't see a motivation for "milking" the crisis. The current actions by governments are restricting economic activity and revenue streams. Many states only make money on sales tax and that's probably not going super well right now.

I agree that there is hesitation to do widespread testing, but I don't know which government would intentionally cause a recession using this virus as an excuse.

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#174
post #153
post #140

Earlier quoted context omitted.

The US is doing a significant amount of testing compared to what's available almost anywhere else on the planet. I think Germany is still beating them, but they're basically the only large country that is at this point. Journalists here in the UK have actually been pointing to the US as one of the examples that proves we're the ones failing at testing for a while now.

Where are you getting that data? The 'Our World in Data' site says reporting is inconsistent, but the data they do have shows per-capita Germany, Italy, Belgium, and Austria doing more than the US, and France, the UK, and the Netherlands doing less. https://ourworldindata.org/grapher/full-list-cumulative-tota... (I'm using cumulative because the daily numbers are missing for Germany, France, and the Netherlands)

It's certainly possible other countries have passed the US since I last looked, the exact leaderboard does seem to vary depending on things like which country is hitting the biggest roadblocks in their test rollout right now. (Though Italy's lead in total per-capita tests is mainly because they were the first Western country to have their outbreak hit catastrophic levels and they ramped up testing fairly aggressively early on in response to that. I presume their testing wasn't so great prior to the collapse of their healthcare system, since they went from reporting only three cases to disaster alarmingly quickly.)

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#175
post #154

Earlier quoted context omitted.

We would have seen a higher death rate if the virus was here earlier. As for hiding within the flu statistics, we test for influenza so these deaths would not have been classified as flu related. It's possible to have flu and covid-19 but early on it would have been rare. It's probably still somewhat rare. I am sure flu surveillance samples will be retroactively tested for the virus that causes covid-19. Stanford did…

> We would have seen a higher death rate if the virus was here earlier. > What if this is already the "second wave". Something with lower symptoms wouldn't have warranted checking for a new strain, complications and deaths would fit into the normal distribution of last fall's flu season with no outlier spikes. I think you are misunderstanding what wave means here. It means an earlier not as deadly strain/conditions h…

We know this is not true because the mutation rate is too low.

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#177

Earlier quoted context omitted.

> Why is that the most preposterous hypothesis that doesn't warrant any review? It's not. What is preposterous is advancing the hypothesis without any meaningful evidence, to the detrement of more useful topics, or even useful discussion of the same topic. It's one thing to be an epidemiologist saying "hey, let's see how we can double check the exact origins of this", which is a potentially useful line of inquery. It…

People don't advance a hypothesis without enough anecdotes to say "look over there" People like you can help fill gaps of savants saying "this isn't a constructive methodology but it isn't inherently without merit" versus "I don't want to believe that because thats not consensus right now" versus "hm thats interesting maybe worth a look sometime before the 2022 congressional committee to fund the epidemiologists?"

> People don't advance a hypothesis without enough anecdotes to say "look over there"

They do so all the time. They'll advance hypothesis even without ancedotes on the vaguest of hunches, and bias towards Type I pattern recognition errors (https://www.youtube.com/watch?v=1AjLmU0Sfu4). This is in fact half the problem - why anecdotes alone aren't terribly useful, and must be treated with so much caution and skepticism. Needless to say that primary caregivers and epidemiologists are already drowning in such ancedotes as well, they're not exactly aided in us adding more noise to the discussion where they're not even looking.

There is such a thing as "enough anecdotes" - when they're numerous enough to rise to the quantity of being actual statistically measurable data. But you yourself practically admit such ancedotes fail to meet that bar by suggesting some secret first wave that's indistinguishable from the regular flu season in the data. Either the ancedotes form useful data or they don't - you can't have it both ways.

"Enough ancedotes" led us to our current conclusions, not this hypothetical secret first wave stuff you suggest. "Enough ancedotes" say "don't bother looking over there, we've figured it out", on account of failing to rise to the standard of useful statistical data to contradict our current conclusions. We've been checking, and are going to continue to check, for contradictory evidence anyways - despite the lack of usefully contradictory ancedotes - just for thoroughness, given the size, scope, and impact of the epidemic.

> People like you can help

...by spending my time embracing social distancing, masks, calming the histronics of hypochondriacs, and by guiding doubt towards those who deserve it the most and where it's going to be the most useful, actionable, and effective. We have a number of botched pandemic responses - exacerbated by censorship, political manuvering, misinformation, and so much more - with direct lesson to teach us about how to properly react next time, and parts of our government and geopolitics we need to fix. There are ongoing problems like the lack of randomized testing to give us an idea of where we're at now. Things we have hard data for. Things we can change by voting or lobbying our congresscritters or influencing debate or through direct individual action to support those in need, or helping the helpers.

But entertaining the conspiracy theorist fueling armchair "hypothesizing" about alternative virus origin stories? Does our political and epidemic policy really change if, say, technically this started several months earlier than we realized in Russia? This "maybe hypothetically a second wave!" still kicked off in China, regardless. I don't see the hypothetical policy changes. I don't see the upside. I don't see how this hypothesizing "helps". I think, in fact, that it hurts - by further stressing people out when they're already stressed out (which has real health impacts), and driving them towards unreasonable levels of distrust in the scientific method and community (which has been very upfront about the many things that are actually properly unknown about this epididemic). I think it's the same nonsense that leads to the antivax mindset. It reminds me of gaslighting.

And so, on this topic, I think helping means poking all the obvious holes I can in said "hypothesizing" - as a perhaps useful example to follow - as to how one might differentiate this armchair debate from actual reasonable doubt. On the off chance that I'm wrong, it invites a proper useful rebuttal or counter-argument. On that note, I again emphasize:

>> If you have some epidemiologist's proposed study that you're trying to drive funding towards [...] it'd be a welcome breath of fresh air on the topic, and I'd suggest sharing that as a far more useful and constructive way of advancing the hypothesis.

But since you seem to be hypothesizing about 2022 congressional committees instead of any of the stuff actively being looked into while half the bloody economy has been put on hold, I won't hold my breath.

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#178

Earlier quoted context omitted.

https://www.reddit.com/r/medicine/comments/fyf0yh/megathread... you mean this serological study? And taiwan is at 1.5% CFR as well? And still 60 or so unresolved diamond princess cases with ~7 in critical condition?

Yes, I agree it is preliminary and not too much should be drawn off it. Every country is missing large numbers of cases, so CFR doesn't mean much - randomized testing is what is needed. Imperial College's paper (linked above which gives a 0.7% population IFR) uses Diamond Princess as an input. The relative risk ratio they give for someone age 70 (mean age on Diamond Princess) is something like 4.5x (IFR ~3%), so you'…

whoops, sorry it's 567 infections in passengers with 13 deaths. 2.3% CFR. Expected IFR 3% from Imperial College (17)

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#179

Earlier quoted context omitted.

It is not plausible they caught most cases. Here's the result of randomized testing in Iceland, which also has the virus under control and has done even more testing per capita ( https://www.nejm.org/doi/full/10.1056/NEJMoa2006100?query=fe... ) Randomized testing was still finding 0.6% of the population (outside those otherwise quarantined already) actively infected. This means even in Iceland, less than half of infe…

Half of Iceland's population lives in the Reykjavik area. The rest are thinly spread out over the country - which of which is still inaccessible due to ice (usually until April/May). Comparing this to a densely populated South Korea is incredibly difficult.

Also, different genetics, different climate, different culture, different population density, different connectedness to China, and a 2 orders of magnitude difference in population size. As a rule of thumb, whenever you want to compare Iceland to another country, you probably shouldn't.

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#180
post #141

Earlier quoted context omitted.

we don't. he is (perhaps unknowingly) spreading disinformation, but that's really very normal behavior. the hardest thing about this is finding real information and then accepting it.

Accusing someone of “spreading disinformation” Is a pretty hard line to take when all the facts are evolving and we’re learning more every day

We're about as confident that people gain long-lasting immunity as we are that it's a simple respiratory tract infection. It's not beyond question, but to raise the questions without mentioning that we're pretty confident in the consensus answers is either misinformed or misleading.
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