Corona Virus: It's a Marathon, Not a Sprint

[LawBeefaroni]

A while back I found out that while masks were required 'in school', our school interpreted that as 'while passing in the hall and at events' and if kids were in their seats it didn't apply, at which point it was up to individual teachers to decide whether masks should be required. That was when I switched my son from cloth masks to KN95s and had a talk with him about wearing them regardless of the teacher. And it included the comment that should he ever be told he wasn't allowed to wear a mask in class, he'd come to me about it. That never happened, thankfully.

Some People who are COVID-deniers: “I knew the CDC was full of shit. If they’re exaggerating the percentage chance of contracting COVID outdoors, what else are they lying to us about? The COVID death toll? The effectiveness of vaccines? And you know, some people are saying that many of the leaders in the CDC used to work for Dominion. See a pattern here? Trust no one. Live free or die.”

I don't hold the CDC responsible for irrational conspiracy theorists. Had they given a precise number down to the correct significant digit, people like that still would have found a way to twist the information to fit their narrative. As others have said, the real number is a lot more complicated than a single number, and when you're dealing with safety, you provide a buffer. Your magic show sparks might shoot five feet? You keep the audience back fifteen.

There's being abundantly cautious and then there's spreading fear instead. If the real number is, say, 1% and you just 10x it, that's using fear to drive behavior, not caution.

The CDC and public health in general have bungled a lot of the messaging. Not saying they had much of a choice most of the time but I hope they spend a bit of time, money, and thought on incorporating effective communication and PR techniques going forward.

[Blackhawk]

That's something I've heard repeatedly as a problem: The public health community using public health officials to communicate with the public rather than specialists in communications.

[Smoove_B]

Yes, I agree with both of you. Communication failures are high on my list of things that need to be addressed. However, part of that is also the building of credibility - which hasn't happened because we're still largely invisible.

[stessier]

But that is messed up. You can’t suggest that a risk is orders of magnitude off and shrug it off as just being careful.

...except, as I said it's what we do all the time in occupational safety in health. And not once (seriously, not a single time) has someone said to me in a working environment, "Well, I know the TWA for trichloroethylene has a safety factor of 10x, so we both know the level you're measuring isn't really that dangerous."

Indeed. My company takes the 8hr OSHA limits and cuts them by a third. So if OSHA says we can handle 1 ppm TWA, we say we can't exceed 0.3 ppm TWA. Makes for some fun engineering puzzles.

[LordMortis]

Sort of a corollary to measure twice and cut once only this is about less people dying and suffering hospitalizations and what may very well be life long debilitations and not saving a little time or wood.

[Smoove_B]

Makes for some fun engineering puzzles.

That's why they pay the engineers the big money.

In unrelated news, Nate Silver - still total garbage. Between his post and the apparent coordinated effort to somehow link the NIH to Chinese research in causing the pandemic, it would seem the war on reality continues:

https://twitter.com/NateSilver538/statu ... 5375833089

Assuming nearly all are vaccinated by this point—which I assume is a fairly safe assumption (the survey is limited to the US)—my takeaway is that epidemiologists are extremely risk-averse, much more so than public health guidelines say they need to be.

Again, looking at numbers and not at all understanding public health. Or even how this survey was conducted. He's a clown. I hate boosting his signal, but I'm astounded (no, seriously) that 12+ months later he's still spouting his nonsense. But I guess that's what pays his bills, so he continues.

[Kurth]

But that is messed up. You can’t suggest that a risk is orders of magnitude off and shrug it off as just being careful.

...except, as I said it's what we do all the time in occupational safety in health. And not once (seriously, not a single time) has someone said to me in a working environment, "Well, I know the TWA for trichloroethylene has a safety factor of 10x, so we both know the level you're measuring isn't really that dangerous."

Indeed. My company takes the 8hr OSHA limits and cuts them by a third. So if OSHA says we can handle 1 ppm TWA, we say we can't exceed 0.3 ppm TWA. Makes for some fun engineering puzzles.

Not to beat a dead horse, but that's a real understatement of the CDC exaggeration: It's more like if your company took the OSHA 1 ppm TWA limit and you said you can't exceed .003 PPM. It's off by two decimals, and that's not the same as cutting a number by a third.

[stessier]

But that is messed up. You can’t suggest that a risk is orders of magnitude off and shrug it off as just being careful.

...except, as I said it's what we do all the time in occupational safety in health. And not once (seriously, not a single time) has someone said to me in a working environment, "Well, I know the TWA for trichloroethylene has a safety factor of 10x, so we both know the level you're measuring isn't really that dangerous."

Indeed. My company takes the 8hr OSHA limits and cuts them by a third. So if OSHA says we can handle 1 ppm TWA, we say we can't exceed 0.3 ppm TWA. Makes for some fun engineering puzzles.

Not to beat a dead horse, but that's a real understatement of the CDC exaggeration: It's more like if your company took the OSHA 1 ppm TWA limit and you said you can't exceed .003 PPM. It's off by two decimals, and that's not the same as cutting a number by a third.

No, OSHA already did what the CDC did. That's what Smoove is saying - those safety factors are present everywhere.

[Blackhawk]

However, part of that is also the building of credibility - which hasn't happened because we're still largely invisible.

You're a representative of science. It's science that people have lost belief in. If people believe in science, anybody with scientific credentials comes with a degree of built-in credibility.

In other words, Merica is too dum for listen smarties.

[Smoove_B]

In other words, Merica is too dum for listen smarties.

That's part of it - no doubt. But in a more practical sense, my peers are literally invisible - they're not meeting with important community members (the gatekeepers - the people we're hoping are going to make a difference right now with vaccinations) regularly in my experience. They're not involved in community building programs or largely interacting with community groups. They continue to be very insular - meeting with each other and hospital executives and trying to "plan from above" with limited community engagement. Yes, there are examples of what should be happening, but overall public health continues to be a fragmented, disorganized, underfunded mess.

So when we do appear from behind the curtain and start using science-laced communications, I can appreciate how we sound like out of touch eggheads. I am genuinely hoping things change in this regard, but communities have pushed back so hard against state and local officials, I'm half expecting it to get worse (somehow), as they're now more afraid than ever to engage. But I do think this is where we need to do the work - we need to identify the communities that have solid relationships with their local officials and we need to learn from them what we should have been doing all along.

That's my professional/career soapbox for today.

[malchior]

Again, looking at numbers and not at all understanding public health. Or even how this survey was conducted. He's a clown. I hate boosting his signal, but I'm astounded (no, seriously) that 12+ months later he's still spouting his nonsense. But I guess that's what pays his bills, so he continues.

It's funny how many people seem to be missing the clown part though. He is still 'very serious' to many. It's incredibly frustrating.

[malchior]

In other words, Merica is too dum for listen smarties.

That's part of it - no doubt. But in a more practical sense, my peers are literally invisible - they're not meeting with important community members (the gatekeepers - the people we're hoping are going to make a difference right now with vaccinations) regularly in my experience. They're not involved in community building programs or largely interacting with community groups. They continue to be very insular - meeting with each other and hospital executives and trying to "plan from above" with limited community engagement. Yes, there are examples of what should be happening, but overall public health continues to be a fragmented, disorganized, underfunded mess.

So when we do appear from behind the curtain and start using science-laced communications, I can appreciate how we sound like out of touch eggheads. I am genuinely hoping things change in this regard, but communities have pushed back so hard against state and local officials, I'm half expecting it to get worse (somehow), as they're now more afraid than ever to engage. But I do think this is where we need to do the work - we need to identify the communities that have solid relationships with their local officials and we need to learn from them what we should have been doing all along.

That's my professional/career soapbox for today.

I think there is another angle on this too. I think some professions are taking too much ownership of the general dysfunction in our society. In general, I think we see many people forming opinions then seek out the data that fits it and throw out everything else that doesn't. In this landscape, it might not matter how much they trust you if you aren't saying what they want to hear in the first place. That's hard to overcome even with the best communicators in the world. Heck maybe they were a bit invisible but the visible ones got harassed and threatened with death. Fauci who is top of his field and a good communicator had a protection detail.

All of this might just be more another indicator that we are an ahem clown shoes society in steep decline. The hatred of expertise is cutting across multiple lanes right now. We see it in science, health, business, politics, etc. IMO it's very hard to learn the right lessons and worse very difficult to course correct for the crazy we are seeing out there.

[Blackhawk]

So when we do appear from behind the curtain and start using science-laced communications, I can appreciate how we sound like out of touch eggheads.

It isn't just egghead lingo. We're in an era of anti-intellectualism. Any information coming to the public from a scientific source is going to be automatically discounted by some, doubted by some, and openly scorned by others. It's one of the same reasons we can't make much headway on climate change. It's science, and people have been trained to prefer emotional reassurances over science, hope over facts, happy lies over unpleasant truths.

It's not Trump that did this. Hell, I'd almost think that Trump was made possible because of it. It's been building for a century, accelerated during the 60s, and leapt wildly forward with the rise of the internet and the sudden ability to choose our facts. Don't like what's on the news? Read the other news. It has spiked as religion as waned, as it is seen as a cause of the waning. It has spiked as we've begun to see the consequences of profit, because the intellectuals keep telling the people in power that they need to reduce profits. And it isn't just the anti-vaxxers and the climate deniers and the flat-earthers, either. It isn't usually that extreme. It's the average guy who, when confronted with unpleasant facts, has learned to look away rather than going through the discomfort and work to understand them. It has killed education, as education makes you smart, and being too smart is something to be suspicious of. We have a mediocre education system, and a lot people like it that way. We push our kids to be successful. We don't push them to be smart.

We came into this doomed. The only way out was facts and reason, and nobody was going to accept facts and reason - regardless of the source.

Honestly, if this had happened in 2012, people would have responded better just because they'd have something other than science to look to.

[Blackhawk]

We came into this doomed. The only way out was facts and reason, and nobody was going to accept facts and reason - regardless of the source.

You know, I had a thought reading over that again: rack and peanut steering.

There yet?

People don't care about smart stuff. They want extremely large beverage holders and bubble domes.

We didn't need better communicators. We didn't need PR. Those still rely on reason. No, we needed an ad agency that could manipulate people into doing the smart thing the same way they manipulate them into sucking down energy drinks for their health.

(Yes, this would backfire. I'm just an a 'humans are idiots mood today.)

[Smoove_B]

Yes, the words of Carl Sagan have been echoing in my brain since last March. He really predicted everything with an eerie accuracy, imho.

If I didn't have dozens of examples of communities from around the U.S. where they are actually improving things, I'd likely be even more despondent. I'm seriously considering going back to get additional course work and certification in health education at this point as I'm feeling pretty strongly it's the path forward.

Unrelated, but it is interesting to see some of the presentation from today regarding the Pfizer approval coming out:

https://twitter.com/pwhickey/status/1392593148766007302

Slides from today’s ACIP meeting on COVID vaccines focusing on pediatric indications:

School age children are over-represented in the disease burden relative to their % of the population.

Can we stop with the “kids don’t get infected” no talking points?

...

Children are dying because of COVID. Child deaths in general are rare, yet several ACIP committee members pointed out that COVID is now in the top leading causes of death for children. Others have pointed out that the CDC figures are most likely an undercount.

The one I'm a little confused about it this:

School based outbreaks are well described as is backwards transmission into the home. Adults living with a child in school are more likely to develop illness compatible with COVID then those that don’t.

Maybe he's just using different terminology than I'm used to seeing, but I've always referred to this as secondary spread. I think it will be our biggest issue in the Fall in states/communities where vaccination among adults and children is a problem, particularly when you have children that cannot be vaccinated (because it hasn't been approved yet) and a community of adults that refuses to vaccinate. By way of example, my wife's office announced today that (1) in-person work resumes the first week of September, expect to be in the office a minimum of 3 days a week (2) there's no vaccination requirement.

This is exactly the type of scenario that sets up cluster outbreaks where kids are giving it to parents or parents are giving it to kids and you're having these seeming random outbreaks at either the school or work place until you connect the dots with contact tracing. Largely preventable, but only if communities follow guidelines.

[Zaxxon]

We didn't need better communicators. We didn't need PR. Those still rely on reason. No, we needed an ad agency that could manipulate people into doing the smart thing the same way they manipulate them into sucking down energy drinks for their health.

We're kind of getting this in Ohio, in the form of DeWine setting five $1M jackpot lotteries for those who get the vaccine.

Bad at math? Terrible at risk assessment? Have an affinity for gambling? Step right up!

https://twitter.com/therecount/status/1 ... 59142?s=19

[Zaxxon]

As usual, Mr. Fed for the win...

https://twitter.com/Popehat/status/1392 ... 79330?s=19

[Zarathud]

We sold the power of internet crowdsourcing information and data, forgetting that the people who were about to join are stupid idiots who would poison everything.

We sold that news and data should be free so we could exchange bad information without a gatekeeper.

We monetized views using groups which pandered by selling conversation biases and hate.

Trump seized these broken levers of power. They feed his profit and ego, so he will hold them in a death grip.

[Kraken]

It's been building for a century, accelerated during the 60s, and leapt wildly forward with the rise of the internet and the sudden ability to choose our facts.

The Space Race initiated an explosion in STEM education like this country had never seen before, lasting from Sputnik through Apollo (and building on roots in the 1940s war effort). I agree with the rest of your post, but disdain for science did not accelerate during the 60s. Disdain for authority, yes, definitely, but anti-intellectualism didn't become mainstream until the Reagan years. Even the 60s counterculture liked intellectuals.

[Isgrimnur]

A Cult of Ignorance
- Isaac Asimov, 1980.

[El Guapo]

It's been building for a century, accelerated during the 60s, and leapt wildly forward with the rise of the internet and the sudden ability to choose our facts.

The Space Race initiated an explosion in STEM education like this country had never seen before, lasting from Sputnik through Apollo (and building on roots in the 1940s war effort). I agree with the rest of your post, but disdain for science did not accelerate during the 60s. Disdain for authority, yes, definitely, but anti-intellectualism didn't become mainstream until the Reagan years. Even the 60s counterculture liked intellectuals.

This is also an area where people tend to remember some distant glorious past that never really existed. People have always been ignorant and dumb.

[Zaxxon]

It's been building for a century, accelerated during the 60s, and leapt wildly forward with the rise of the internet and the sudden ability to choose our facts.

The Space Race initiated an explosion in STEM education like this country had never seen before, lasting from Sputnik through Apollo (and building on roots in the 1940s war effort). I agree with the rest of your post, but disdain for science did not accelerate during the 60s. Disdain for authority, yes, definitely, but anti-intellectualism didn't become mainstream until the Reagan years. Even the 60s counterculture liked intellectuals.

This is also an area where people tend to remember some distant glorious past that never really existed. People have always been ignorant and dumb.

I don't think that's true.

[noxiousdog]

I love how we're all turning into old people. BACK IN MY DAY.....

[Smoove_B]

I'm glad Ed Yong is back from writing his book to posting on The Atlantic again. His new piece is really good.

But there is another crucial difference between May 2020 and May 2021: People have now lived through 14 months of pandemic life. Millions have endured a year of grief, anxiety, isolation, and rolling trauma. Some will recover uneventfully, but for others, the quiet moments after adrenaline fades and normalcy resumes may be unexpectedly punishing. When they finally get a chance to exhale, their breaths may emerge as sighs. “People put their heads down and do what they have to do, but suddenly, when there’s an opening, all these feelings come up,” Laura van Dernoot Lipsky, the founder and director of the Trauma Stewardship Institute, told me. Lipsky has spent decades helping people navigate the consequences of natural disasters, mass shootings, and other crises. “As hard as the initial trauma is,” she said, “it’s the aftermath that destroys people.”

...

The pandemic itself has not fully abated, either. Even as Americans ponder “post-pandemic” life, 600 people are still dying of COVID-19 every day. Despite the historic success of the vaccination campaign, the rate of vaccinations is slowing, and is lowest among the most socially vulnerable communities. COVID-19 is burning with renewed ferocity through India, much of South America, and other countries. Globally, the pandemic is set to kill more people in 2021 than in 2020.

On the current situation:

Similar tendencies are apparent now, as commentators wonder why many Americans are still anxious and risk averse, even as the U.S. begins to wake from its pandemic nightmare. “I think some people believe we pressed ‘pause,’ and we’ll go back to the way things were before, as if we didn’t have all the intervening experiences, as if 2020 didn’t happen, as if getting a vaccine erases your memory,” Gold said.

...

For some people, taking off a mask will mean just exposing the bottom half of their face. But for others, it signifies that they must reevaluate their understanding of risk and danger yet again, with fewer emotional reserves at hand. “I feel more clingy towards the routines I’ve established,” Whitney Robinson, a social epidemiologist at the University of North Carolina at Chapel Hill, told me. “Summer feels like an unknown, and kind of exhausting. [It means] navigating new situations, reestablishing relationships, and deciding on COVID norms. It feels tiring.”

[El Guapo]

I love how we're all turning into old people. BACK IN MY DAY.....

I mean, that is generally how it works.

[noxiousdog]

I love how we're all turning into old people. BACK IN MY DAY.....

I mean, that is generally how it works.

Yeah, but I wish it wasn't so soon.

[LordMortis]

The pandemic itself has not fully abated, either. Even as Americans ponder “post-pandemic” life, 600 people are still dying of COVID-19 every day. Despite the historic success of the vaccination campaign, the rate of vaccinations is slowing, and is lowest among the most socially vulnerable communities. COVID-19 is burning with renewed ferocity through India, much of South America, and other countries. Globally, the pandemic is set to kill more people in 2021 than in 2020.

When I look at the raw numbers as advertised on worldometers, we're doing worse now than we were in late May of 2021 with the big difference being that the spread is everywhere now and vs us still trying to contain it this time last years, or at least that was what we were doing in name.

[Smoove_B]

When I look at the raw numbers as advertised on worldometers, we're doing worse now than we were in late May of 2021 with the big difference being that the spread is everywhere now and vs us still trying to contain it this time last years, or at least that was what we were doing in name.

That's what's so frustrating (and very American) about what's happening right now. People are moving on; COVID-19 isn't in their neighborhoods anymore so it's over. Yet I'm getting pulled into meetings about dealing with the next pandemic and already seeing stuff about what needs to be done for 2022. I am a strong proponent of public health (I know, you're all surprised), but it's been a non-stop element of my life for the last 15 months; I'm f-ing exhausted at this point and it's not even close to being over. Am I personally doing anything about India? Of course not. But as things around the world change, it absolutely impacts what's happening around America (in terms of preparedness and awareness).

And none of this in any way addresses all the goddamn attacks on public health happening nationwide or all the regular public health work that should be happening that isn't because communities are still focused on COVID-19 issues.

[El Guapo]

That's one thing that's really been hammered home to me through the pandemic is how hard it is to see the broader context / situation beyond what's in your own world / neighborhood. Like all things considered, the pandemic has really barely impacted me personally. My wife and I are both working from home, but we're still doing the same work and neither of us lost our jobs. The kids were remote schooling for about four months and then didn't have summer camp, but were back in school as of last fall. Neither of us got COVID, and beyond that no one in our families got COVID (or at least, got a symptomatic case or a positive test result), which is pretty genuinely shocking for my wife's family since none of them were being super duper cautious as far as I can tell.

But things got pretty bad in Massachusetts, and people were literally dying by the thousands here for some time. But I didn't see any of that firsthand, so that never seemed fully real. Now I read a lot of politics and news, so I'm certainly aware mentally of how bad it has been. But I can totally see how someone could be living their life and not really comprehend how bad things have been.

[malchior]

Now I read a lot of politics and news, so I'm certainly aware mentally of how bad it has been. But I can totally see how someone could be living their life and not really comprehend how bad things have been.

It depended on what news they consumed and we found out a lot of people didn't care. Especially because the right people (poor/black/brown) were dying.

[Smoove_B]

The marathon continues in the U.S.

https://twitter.com/drdavidmichaels/sta ... 9528407044

We are not out of the woods yet.

The impressive ability of COVID vaccination to prevent serious illness and death hides the continued impact of the virus on the lives of the unvaccinated.

[Zaxxon]

Turns out, incentivizing those who are bad at math works well.

[Kraken]

Turns out, incentivizing those who are bad at math works well.

Whatever works.

Although I like OH's approach of entering ALL vaxxed people better than NY including only the latecomers.

[stessier]

Turns out, incentivizing those who are bad at math works well.

I'm curious why you used the "bad at math" moniker. This is by far the best chance people will ever have to win $1 million at zero cost to themselves.

[LordMortis]

Radio said Meijer is giving $10 credit to anyone who gets vaccinated there and they also said if you didn't get vaccinated there, show 'em your vaccination card and they'll give you $10 credit anyway.

[Zaxxon]

Turns out, incentivizing those who are bad at math works well.

I'm curious why you used the "bad at math" moniker. This is by far the best chance people will ever have to win $1 million at zero cost to themselves.

On the grander scheme, because it's targeting the same whims that make lotteries so popular in general, and that if they were good at math they'd have gotten the vaccine already since the math on that decision is super-clear without any need for an incentive.

The chance at winning the cash is of far smaller value than that of the shots themselves.

[Isgrimnur]

Better than being stoned to death, I guess.

[RMC]

Turns out, incentivizing those who are bad at math works well.

I'm curious why you used the "bad at math" moniker. This is by far the best chance people will ever have to win $1 million at zero cost to themselves.

On the grander scheme, because it's targeting the same whims that make lotteries so popular in general, and that if they were good at math they'd have gotten the vaccine already since the math on that decision is super-clear without any need for an incentive.

The chance at winning the cash is of far smaller value than that of the shots themselves.

You guys are all going to not feel the same way when it's me who wins the OH lottery for getting the vaccination... Although I got it in Jan, so now I am worried I need a booster shot soonish... Sigh..

[Smoove_B]

In case you're wondering, COVID-19 hasn't stopped people from trying to climb Mt. Everest. Well, not exactly.

A total of 408 foreign climbers were issued permits to climb Everest this season, aided by several hundred Sherpa guides and support staff who’ve been stationed at base camp since April. In late April, a Norwegian climber became the first to test positive at the Everest base camp.

The climbing season closes at the end of the month. Mountaineering was closed last year due to the pandemic.

And yes, I know it's a huge source of income for the locals and they lost out last year, but it's still gross that rich travelers are taking advantage...and seemingly showing up unvaccinated.

[El Guapo]

Turns out, incentivizing those who are bad at math works well.

I'm curious why you used the "bad at math" moniker. This is by far the best chance people will ever have to win $1 million at zero cost to themselves.

On the grander scheme, because it's targeting the same whims that make lotteries so popular in general, and that if they were good at math they'd have gotten the vaccine already since the math on that decision is super-clear without any need for an incentive.

The chance at winning the cash is of far smaller value than that of the shots themselves.

Yeah, the math is definitely different here because unlike lottery tickets the vaccinations are zero cost (and in the full analysis are essentially negative costs given the benefits of vaccination). But it is still true that anyone who wasn't going to get vaccinated who then gets vaccinated because of the lottery is probably bad at math and/or has bad judgment overall.