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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

#261
post #232

Earlier quoted context omitted.

> shows that Italy has more deaths due to influenza every year than any other EU country I’ve read that if an elderly person dies in Italy while they have the flu or coronavirus, then that is recorded as the cause of death. Some other countries put down other reasons like diabetes complications, or heart failure. Possibly due to pressure from insurance, or avoiding liability for iatrogenic diseases, or avoiding KPIs…

What proves me that you understand them better than I do?

Nothing. But you are the one making conclusions based on some data series. If Italy is an outlier, are there papers about it?

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

#262

Earlier quoted context omitted.

>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…

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.

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

#263
One thing that seems really important is that we get testing right. Here is a paper stating up to 80% of false positives: https://pubmed.ncbi.nlm.nih.gov/32133832/ If that was true it would make all the stats nearly useless. I have also heard that the so called 'quick tests' are even worse.

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

#264

Earlier quoted context omitted.

The response will have it consequences too, lost lives, destroyed businesses, ruined families, lost requirement savings.

That's not an argument for letting this disease burn through our entire population. That's an argument for the government to step up and assist people during this time. Edit: and who gives a shit about your retirement account.

People who for whatever reason are utterly dependent on support from the state might well give a shit about the state's decreased capacity to provide aid thanks to additional demand on the part of those whose retirement funds (which allowed them to be self-sufficient) have been destroyed.

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

#265
Collecting stats on the progression from clinical presentation of the patient all the way to death seems to me a bit tedious, since death is altogether somewhat rare and when it does occur it's a lot of factors playing together.

But the following article really put the fear of god in me, as it's the first source I've discovered that gives you an idea of the rate at which patients progress from clinical presentation to "going severe". Here a doctor gives details on the criteria they use for separating patients which are not altogether that restrictive, basically just saying that the patient must test positive or have been in contact with someone who did: "We have an observation unit in the hospital, and we have been admitting patients that had tested positive or are presumptive positive; these are patients that had been in contact with people who were positive." Elsewhere in the article there is mention of the rate at which these patients progress to going severe: "About a third have ended up on ventilators."

https://www.propublica.org/article/a-medical-worker-describe...

My guess is that the clinical point of view around Covid-19 is currently probably a well-kept secret among clinicians and that Ioannidis probably doesn't have access to that kind of "inside information".

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

#266

Of course majority of HN readers will proceed to set up straw-men, disregard references & argue for legitimising the populist alarmist rhetoric.

Maybe, but please don't post unsubstantive comments here. I realize it's frustrating when others are wrong on the internet, but the only valid moves are to (1) patiently provide correct information, or (2) let go and not post. Snark and/or venting just makes things worse.

https://news.ycombinator.com/newsguidelines.html

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

#267
The answer seems so obvious. Do a hard, air tight quarantine of people of advanced age. People who are borderline or sick are told to stay inside. Encourage the rest of society to go about business as usual. Provide government support for all of it. Some people will die but probably less than if we have to do this over and over again without ever gaining herd immunity. And few enough to massively ease the burden on hospitals. And it’s the best way to avoid Great Depression 2020.

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

#268

Earlier quoted context omitted.

I don't think many people knowing the facts are expecting that. It's that people, including me, dread the moments when the facts become manifest. This will prove us right but I will take no comfort in that confirmation. On the off chance that these (implausible sounding) arguments turn out right, well, woohoo, great.

Finishing the math on this is very sobering which is why I was intrigued by the original post. I truly hope John Ioannidis is correct and SARS-CoV-2 is not as virulent. We are about to see in the next week or so.

The big thing is he's making a big assumption that there's some natural limit to the total infection rate that can be achieved by the virus - less than 100% and less than the 30% of the cruise ship. That seems plausible but it's essentially based on zero evidence. Diseases have wiped out societies so there's no rule I can saying Covid couldn't achieve a disastrous 30% penetration of the population. No country has had the guts just say "let's see how far this can go" and fortunately so.

An extreme worst case would be maybe 3% of the population dying. The Syrian civil war killed 2% of the Syrian population over several years, so this sounds bad. But US regular death rate is about 0.88% you could fudge and claim people would barely notice. But Covids is a very messy death and would destroy the health care system, which people would notice.

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

#269

The answer seems so obvious. Do a hard, air tight quarantine of people of advanced age. People who are borderline or sick are told to stay inside. Encourage the rest of society to go about business as usual. Provide government support for all of it. Some people will die but probably less than if we have to do this over and over again without ever gaining herd immunity. And few enough to massively ease the burden on h…

...keep in mind, that it may be the case that we're being lied to when we're told that young and healthy people have nothing to fear. The following article seems to suggest otherwise: https://www.propublica.org/article/a-medical-worker-describe...

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

#270
post #269

The answer seems so obvious. Do a hard, air tight quarantine of people of advanced age. People who are borderline or sick are told to stay inside. Encourage the rest of society to go about business as usual. Provide government support for all of it. Some people will die but probably less than if we have to do this over and over again without ever gaining herd immunity. And few enough to massively ease the burden on h…

...keep in mind, that it may be the case that we're being lied to when we're told that young and healthy people have nothing to fear. The following article seems to suggest otherwise: https://www.propublica.org/article/a-medical-worker-describe...

Another data point: The following source gives additional detail on the kind of thing that is meant by "preexisting condition" when they say "people without preexisting conditions have nothing to fear". One of them is high blood pressure. Who doesn't have high blood pressure, these days.

https://www.cebm.net/global-covid-19-case-fatality-rates/

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