Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

In the Asian Flu of 1957-58, they rejected lockdowns (2021)

aier.org

Post reply on HN
Print view View original

271–280 of 312 posts

Re: In the Asian Flu of 1957-58, they rejected lockdowns (2021)

#271

Post by tripletao »

mike_hearn wrote: post #261
aredox wrote: post #227

Earlier quoted context omitted.

It's not useless. Do you think all contagious illnesses spread at the same rate? InB4 "clouds don't exist, nobody can tell exactly where they start and end"

It would be useful to be able to measure some sort of inherent infectiousness, but R0 as actually defined and computed today is useless. It looks scientific on the surface but everyone who calculates it gets a totally different result, and because there's no actual underlying theory involved (just playing with stats), there's no way to decide which estimate is correct. To get meaningfully constant values for infectio…

> To get meaningfully constant values for infectiousness you'd probably need a theory that let you derive it from RNA sequences.

As others have already noted in this thread, the rate at which a disease spreads inherently depends on both the biology of the pathogen and human behavior. For example, if everyone goes to crowded nightclubs, then R0 for an airborne respiratory disease goes up. If everyone stays home, then it goes down. The biology of the pathogen and human behavior interact in complex, multidimensional ways; promoting condoms will reduce R0 for HIV, but not for influenza. The disease spreads only through human behavior, so the concept of infectiousness independent of that simply doesn't exist.

You are correct that R0 is determined by curve-fitting to actual case counts. It couldn't be otherwise though, since that's the only way to capture the actual human behavior. We expect different R0 in different situations, so the range you see for SARS-CoV-2 isn't a surprise. This is textbook stuff:

> Any factor having the potential to influence the contact rate, including population density (e.g., rural vs. urban), social organization (e.g., integrated vs. segregated), and seasonality (e.g., wet vs. rainy season for vectorborne infections), will ultimately affect R0. Because R0 is a function of the effective contact rate, the value of R0 is a function of human social behavior and organization, as well as the innate biological characteristics of particular pathogens. More than 20 different R0 values (range 5.4–18) were reported for measles in a variety of study areas and periods (22), and a review in 2017 identified feasible measles R0 values of 3.7–203.3 (23). This wide range highlights the potential variability in the value of R0 for an infectious disease event on the basis of local sociobehavioral and environmental circumstances.

https://wwwnc.cdc.gov/eid/article/25/1/17-1901_article

As with your confused understanding of PCR specificity, you may have been misinformed by indefensibly oversimplified public messaging as to the definition of R0. (I had a comment deleted from /r/coronavirus in 2020, because they considered my statement that R0 varies with environment and human behavior to be misinformation; the citation didn't help.) The literature is once again available for anyone who wishes to read it, though.

Re: In the Asian Flu of 1957-58, they rejected lockdowns (2021)

#272

Post by freedude »

throwaway72762 wrote: post #260
freedude wrote: post #243

Earlier quoted context omitted.

"China did actual lockdowns." Yes, they did, and literally made prisoners out of their own people. Which had the unfortunate consequence of killing people for lack of care, food and social contact. "Herd immunity? Never happened because infection isn't preventing reinfection with a different strain." This is exactly wrong. Once you get covid you may contract a different strain, and if you are a normal healthy individ…

Exactly re China: my point is people should stop describing the US response as lockdowns because they literally never happened. Re reinfection, good luck with that. Every time you catch covid you have a one in ten chance of long covid, and that's the current conservative estimate in meta analyses.

In order to calculate a one in ten chance of anything would require you to know two numbers. In this case, you would need to know the number of people that have contracted Covid and the number of people that have experienced long covid symptoms. I can guarantee there is no possible way to know either number so anything is probably a grossly inadequate estimate depending on bias.

Re: In the Asian Flu of 1957-58, they rejected lockdowns (2021)

#273

Post by peteradio »

fnordpiglet wrote: post #266
peteradio wrote: post #202

Earlier quoted context omitted.

I'm not seeing that we knew anything. I'm seeing that a lot of work had been done to create a potential for success. Can you point out where this "knowing" is coming from in the linked paper?

In real life there is no certainty when faced with a new thing in nature. But there were many concurrent potentials for success - including traditional vaccines like coronavac. But it’s important to note that human trials for mRNA started in March, a mere two months after the genome was released. As we know now the antibody response to mRNA vaccines are rapid and robust. This information didn’t reach us immediately,…

Are you talking about March 2020? That is pretty amazing!

Re: In the Asian Flu of 1957-58, they rejected lockdowns (2021)

#274

Post by jtc331 »

munch117 wrote: post #250
jjfoooo4 wrote: post #223

Earlier quoted context omitted.

At least in the American context, it’s far from clear the lockdowns reduced mortality [1]. Adjusting for age/health Florida had similar mortality to California’s. [1] https://www.mercurynews.com/2023/04/02/why-major-study-argue...

Observed excess US deaths: 1.34 million. Expected deaths from an unchecked epidemic: 330 million × 50% infection rate × 4% fatality rate = 6.6 million. 50% infection rate is the estimated no-lockdown epidemic penetration rate that I remember hearing from an epidemiologist. 4% was the fatality rate in Italy, February 2020, when hospitals were overwhelmed. Not even close.

4% in Italy isn't just "when hospitals were overwhelmed", it's with an aging population.

Re: In the Asian Flu of 1957-58, they rejected lockdowns (2021)

#275

Post by jtc331 »

timcederman wrote: post #268
freedude wrote: post #240

Earlier quoted context omitted.

Because of Covid science has proven masking is a waste of effort and resources. If you disagree you should really research the latest studies. Here is a great starting point from 2021. https://brownstone.org/articles/studies-and-articles-on-mask... They are a failure. Globally. https://www.amazon.com/Unmasked-Global-Failure-COVID-Mandate... One of the largest peer-reviewed European studies says... "These findings ind…

Are you suggesting N95 masks provide no protection against airborne viruses?

I believe that is what pre-COVID masking in hospital settings has shown, yes. Possibly COVID is different from the flu.

But the difficulty for proving masking helps is: 1. If it only takes ~20 virions to get infected, then masking has to have a basically perfect filtering rate and be worn perfectly 100% of the time, neither of which is obvious. 2. With an endemic virus even if masks slow down spread they aren't going to reduce your likelihood of being infected overall.

Re: In the Asian Flu of 1957-58, they rejected lockdowns (2021)

#276

Post by tripletao »

mike_hearn wrote: post #263
selimthegrim wrote: post #213

Earlier quoted context omitted.

https://arxiv.org/abs/2002.03268

So they did exactly what we're saying they do? The paper sets up some ad-hoc models unique to this academic group and then reversed them to find values of R0 that could fit. The problem is underdetermined so there are a huge array of values that could work. Key line: > Overall, we report R0 values are likely be between 4.7 and 6.6 with a CI between 2.8 to 11.3 That's an extremely wide CI by any measure. It's a bit un…

There's some minor variation due to different curve-fitting approaches, but the big variation (e.g. R0 from 3.7–203.3 for measles, per my other comment here) is real, simply because the environment or human behavior varied. As others have repeatedly noted, R0 is a function not just of the pathogen, but also of its environment, including the behavior of its human hosts.

Earlier, you wrote:

> It [R0] was never being established via lab work, as you might expect given its definition.

If you expected that "lab work" could establish R0, then you've grossly misunderstood its meaning and definition. It seems like you're looking for a concept of "R0 but for the pathogen alone, independent of environment and human behavior". That just doesn't exist though, any more than you could define the growth rate of a plant independent of weather and soil fertility.

Re: In the Asian Flu of 1957-58, they rejected lockdowns (2021)

#277

Post by timcederman »

jtc331 wrote: post #275
timcederman wrote: post #268

Earlier quoted context omitted.

Are you suggesting N95 masks provide no protection against airborne viruses?

I believe that is what pre-COVID masking in hospital settings has shown, yes. Possibly COVID is different from the flu. But the difficulty for proving masking helps is: 1. If it only takes ~20 virions to get infected, then masking has to have a basically perfect filtering rate and be worn perfectly 100% of the time, neither of which is obvious. 2. With an endemic virus even if masks slow down spread they aren't going…

https://www.cdc.gov/mmwr/volumes/71/wr/mm7106e1.htm

> Consistent use of a face mask or respirator in indoor public settings was associated with lower odds of a positive SARS-CoV-2 test result (adjusted odds ratio = 0.44). Use of respirators with higher filtration capacity was associated with the most protection, compared with no mask use.

I'll take a reduced risk, even if it's not perfect. Would you prefer to get covid one time, or five times? It's like arguing "why bother wearing a seatbelt, when it doesn't prevent injuries in accidents?"

Also, are you suggesting masking does not help with preventing influenza infection?

Re: In the Asian Flu of 1957-58, they rejected lockdowns (2021)

#278

Post by PurelyApplied »

mike_hearn wrote: post #96
RansomStark wrote: post #67

Earlier quoted context omitted.

For those that are interest in the nuances of modelling infections, I'm going to leave a Wikipedia extract here. "R_{0} is not a biological constant for a pathogen as it is also affected by other factors such as environmental conditions and the behaviour of the infected population. R_{0} values are usually estimated from mathematical models, and the estimated values are dependent on the model used and values of other…

> it is recommended not to ... compare values based on different models i.e. R0 numbers are worthless. You can't compare these values between pathogens, you can't even compare them between different academic groups studying the same pathogen or between outbreaks of the same pathogen as modeled by different versions of the same software. There's no agreed way to measure this value empirically. Instead they write a pro…

> > it is recommended not to ... compare values based on different models > i.e. R0 numbers are worthless. You can't compare these values between pathogens

That conclusion doesn't follow from the predicate. The model isn't a single simulation run. To mathematicians, the model is the entire framework. It's the SIR model, or the SIS model, or the SIER model, or my favorite model of immunity decay against pertussis... _those_ are the models. The virulence of the infection being modeled, resilience of the population, morbidity and mortality rates, rate and timing of population quarantine, vaccine adoption rate, vaccine efficacy, whether any of the aforementioned values are themselves functions of time... those are just parameters into your model. We absolutely compare the values between pathogens _within the same model_ when discussing the utility of the model.

But typically, the utility in reproduction ratio is as a point of comparison as you tune other parameters. This is part of why a comparison of reproduction ratio across models isn't recommended. It's not just that it's hard to draw meaning from the comparison, it's that the base assumptions of the models might be too different for the comparison to hold any meaning. The reproductive ratio between a continuous model with uniform population mixing is fundamentally different from the reproductive ratio approximated from discrete simulation. They may both broadly speak to "if everyone they saw was susceptible, how many people do you expect to get sick per sick person?" But what that ratio means is dictated by the context of the model.

A frequent utility in comparing ratios is to discuss intervention impact. One might write "Our model found that overall reproduction was reduced to a factor of 0.XYZ (comprehensive infectivity parameters a=nnn b=mmm c=ppp) when the population undertook vaccination schedule foo. Conversely, reproduction was reduced to a factor of 0.JKL for the same infection under vaccination schedule bar. See Figure 14 for complete population state levels over time."

That's all that is. It's a number that has some meaning in context, and one that is often removed from that context and unreasonably expected to retain its meaning. Averages don't mean as much if you don't know if your distribution is multimodal. It's the same thing - a summary stat that can give you a glimpse of the whole, but still just a summary stat.

Re: In the Asian Flu of 1957-58, they rejected lockdowns (2021)

#279

Post by jjfoooo4 »

mabbo wrote: post #253
jjfoooo4 wrote: post #223

Earlier quoted context omitted.

At least in the American context, it’s far from clear the lockdowns reduced mortality [1]. Adjusting for age/health Florida had similar mortality to California’s. [1] https://www.mercurynews.com/2023/04/02/why-major-study-argue...

There's two problems I have with this answer. First: we do not know that the lethality would have been without lockdowns. We didn't (often) see hospitals turning people away. The lockdowns succeeded in preventing that. But more importantly, it's not fair to judge people based on the decisions they made in the past with the information they had then, using the information we have now. Let's presume there was no differ…

The cost of the lockdowns was more than a missed party or two.

And the point of the study quoted above is that jurisdictions that did not implement lockdowns did not experience increased mortality

Re: In the Asian Flu of 1957-58, they rejected lockdowns (2021)

#280

Post by fnordpiglet »

peteradio wrote: post #273
fnordpiglet wrote: post #266

Earlier quoted context omitted.

In real life there is no certainty when faced with a new thing in nature. But there were many concurrent potentials for success - including traditional vaccines like coronavac. But it’s important to note that human trials for mRNA started in March, a mere two months after the genome was released. As we know now the antibody response to mRNA vaccines are rapid and robust. This information didn’t reach us immediately,…

Are you talking about March 2020? That is pretty amazing!

Yes March 2020

This is an interesting read… one of the challenges of the revisionism in articles like the original link is they simply ignore all context and lie about any context they include (deaths per capita being more extreme in 1959 etc). Besides being viral outbreaks almost nothing of the context is similar. That’s why people say in the thread this is an anti science article - a huge amount of the decision making context was the state of science and how amazing it is in 2020 vs any other time in all of humanity.

https://www.cdc.gov/museum/timeline/covid19.html

Post reply on HN