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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

#41
post #30

I am worried there is a fine line between 'realism' and a backlash against care for the elderly and chronically ill. When people realise that their earnings have been slashed, they have been burdened with years of increased taxes, the economy has plunged, and swathes of businesses have gone bust, for the sake of people who were going to die soon anyway... Realism is good. But it is easy to 'evidence' biased anti-vuln…

>I am worried there is a fine line between 'realism' and a backlash against care for the elderly and chronically ill.

I guarantee you that if we don't target our lockdowns on the at-risk population (elderly being the most numerous in that group), whatever backlash there is will be worse when the general population realizes they aren't at any significant personal risk.

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

#42
I published a paper on outbreaks in a hospital setting and the problem is there is not a single RCT on methods to stop outbreaks. The problem is no organization is willing to approve a trial where you don't follow your protocols and commonly accepted methods to control the spread (ex. closing common areas, isolating patients, cohorting staff, enhanced cleaning). There is a good blog post about 'Riding the Wave' that basically says that perhaps the outbreak would have ended itself and we simply just take credit saying "what we did worked" but in reality we'll never know.

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

#43
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…

Um. He doesn't advocate do nothing. He specifically says the opposite. Read the paper. WTF?

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

#44

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…

It doesn't seem like hospitalization rates are being as consistently tracked. Or if they are, not disseminated. My state's official page tracks changes daily, but doesn't include hospitalizations.

There are countries that do report:

"17 March: the total number of cases was 1705, of which 314 patients had been admitted to the hospital"

That was week ago, now it's 1230 people in the hospital, or 4 times more. So I expect 5000 at the end of the next week in the Netherlands. The growth of the infection by the novel virus is exponential, until strong enough measures start to work, and the Netherlands wasn't (due to the politicians) ready to seriously enforce them.

So it's around 20%, once one has more than a few cases. And that's far from being a small percentage.

https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_t...

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

#45

Let's check back on this piece in...2 weeks, say, when there are 10,000+ Corona deaths in the US. Well see how it ages then. Source: https://www.nytimes.com/interactive/2020/03/21/upshot/corona... 427× 16 =11102

China quarantined 700 million of its citizens for fun and it still killed thousands. I'm sure that they regret the policies they implemented right now as they've finally gotten a hold of the outbreak. Edit: I was being sarcastic here. China messed up the initial response but their draconian tactics worked well.

Yes, only thousands. The point of the quarantine was to avoid deaths of millions. China has flattened thoer curve, no one else has.

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

#46
It's easy to point at others for imperfect data and imperfect science when the situation is evolving so fast and data is so hard to come by. It seems to me that papers being retracted due to inaccurate evidence is not a sign of sensationalism but of sound science. Once can argue that more diligence should be practiced in the review process, but I assume everyone is trying their best to get the information out there ASAP.

In any case, policies need to be enacted now (or rather two weeks ago) in any but the best case scenarios. There is no time to wait for more accurate information. If one argues that exaggeration is rampant and we should learn more before making hasty decisions, then that's essentially arguing for inaction. Even if that was the right action I suspect the induced panic in the society will be even greater.

The author also seems to be implicitly weighing the dire consequences of a pandemic (maybe millions more people dying) against the supposed reputation damage to science, which is bizarre to say the least.

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

#47

Let's check back on this piece in...2 weeks, say, when there are 10,000+ Corona deaths in the US. Well see how it ages then. Source: https://www.nytimes.com/interactive/2020/03/21/upshot/corona... 427× 16 =11102

The number of coronavirus deaths is already over 10,000: https://coronavirus.jhu.edu/map.html

Updated: comment was only for US since John is based at Stanford.

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

#48

It's easy to point at others for imperfect data and imperfect science when the situation is evolving so fast and data is so hard to come by. It seems to me that papers being retracted due to inaccurate evidence is not a sign of sensationalism but of sound science. Once can argue that more diligence should be practiced in the review process, but I assume everyone is trying their best to get the information out there A…

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

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

#50
post #22

Ioannidis continues to push this evidence-based approach, but I have not yet seen an adequate response to critics such as Nassim Taleb or Yaneer Bar-Yam. They argue that one doesn't need raw evidence to act if the statistical evidence shows that the risks are catastrophic. They published a paper on January 26th which lays out arguments for why conventional risk management approaches are inadequate in these situations…

It's weird because I'm just as afraid of a black swan of unforeseen, runaway financial collapse due to pandemic countermeasures. People seem awfully glib about how many will die from the pursuant depression.
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