Re: [Health] The Infectious Diseases Thread
Posted: Tue Apr 28, 2020 8:59 am
All the best things start with one random person bucking the trend and going against the grain. Just ask all the kids of anti-vaxxers.
That is not dead which can eternal lie, and with strange aeons bring us some web forums whereupon we can gather
http://garbi.online/forum/
All the best things start with one random person bucking the trend and going against the grain. Just ask all the kids of anti-vaxxers.
I didn't read the article, but didn't a study come out last week indicating that the strain of the virus most prevalent in NY most likely originated in Europe?Zarathud wrote: Tue Apr 28, 2020 8:50 am This one random doctor who correlates risk to Chinese immigrants coming to New York. Stupid.
I absolutely agree with this. I've postponed having a couple things checked on by doctors that suddenly didn't feel urgent enough to take up their time or expose myself to their waiting rooms.AWS260 wrote: Tue Apr 28, 2020 9:04 amIt's clear that the COVID response had led to fewer people receiving other important health services, for example.
Yes. Which makes sense, because our airports get many more travelers from Europe than China. That was the one line in the article that made me roll my eyes.Ralph-Wiggum wrote: Tue Apr 28, 2020 9:07 amI didn't read the article, but didn't a study come out last week indicating that the strain of the virus most prevalent in NY most likely originated in Europe?Zarathud wrote: Tue Apr 28, 2020 8:50 am This one random doctor who correlates risk to Chinese immigrants coming to New York. Stupid.
Be that as it may, I wasn't suggesting anyone ought to accept his opinion (or anyone else's, for that matter) as gospel.AWS260 wrote: Tue Apr 28, 2020 9:04 am Yeah, not to get too P&R, but if you look up that guy's writing pre-COVID, he often takes positions that I would characterize as outside the public health mainstream, but well within the NY Post mainstream.
Still, the overarching issues he raises are important ones. It's clear that the COVID response had led to fewer people receiving other important health services, for example. I just wouldn't necessarily take his word as gospel on these topics.
Indeed, but as was stated here and elsewhere right from the start, this exact argument was inevitable.YellowKing wrote: Tue Apr 28, 2020 9:46 amTo claim that the virus is not as bad as initially thought because we took measures to make it not as bad is flawed reasoning.
Yeah. Still, one advantage to predicting it is to be ready to throw it back at them to disarm them from spreading their mind poison to others outside the bubble.Zaxxon wrote: Tue Apr 28, 2020 9:50 amIndeed, but as was stated here and elsewhere right from the start, this exact argument was inevitable.YellowKing wrote: Tue Apr 28, 2020 9:46 amTo claim that the virus is not as bad as initially thought because we took measures to make it not as bad is flawed reasoning.
It's ironic that this contingent whose lives basically revolve around fear of something are now complaining about lockdowns being due to fear. They even want to force re-opening based on fear.YellowKing wrote: Tue Apr 28, 2020 9:46 am Claiming that there are all these states that are locked down out of "fear" is just a false construct. States locked down because of facts on the ground and models, not fear. And (most) are opening back up based on those same facts on the ground and new models.
Belgians are being called upon to eat fries at least twice a week as more than 750,000 tons of potatoes are at risk of being thrown away.
The coronavirus crisis has led to a surplus of potatoes in the small European country, as demand for frites — a national dish of twice-fried potatoes often eaten in bars and restaurants — has slumped amid Belgium’s government-enforced lockdown.
Speaking to CNBC in a phone call on Monday, Romain Cools, secretary general of Belgian potato industry body Belgapom, said around 750,000 tons of potatoes — enough to fill 30,000 big lorries — would probably not be processed because of the pandemic.
The issue was largely down to a fall in demand in the frozen potato sector, which accounts for around 75% of Belgium’s potato processing, he said. As inventories built up, freezer capacity was being squeezed. In order to mitigate the problem, Belgapom was appealing to Belgians to up their weekly intake of fries.
“We’re working with supermarkets to see whether we can launch a campaign asking Belgians to do something for the sector by eating fries — especially frozen fries — twice a week during the coronavirus crisis,” Cools said. “What we are trying to do is to avoid food waste, because every lost potato is a loss.”
My experience is that chemo isn't being put off. Or rather, it is only being put off if a doctor deems it not extremely time-sensitive. Not being an oncologist, or any other type of clinician, I'm not sure how often it is vs. isn't but I do know for a fact that our chemo and infusion centers have remained open 24-7 and are among the service lines near normal capacity.gameoverman wrote: Tue Apr 28, 2020 3:34 pm
Someone who is putting off chemo right now is in a bad situation, no argument from me. But how is it better if they can't get chemo anyways because the hospital is shut down due to everyone there getting sick? For someone out of work and therefore without income, isn't it better to have unemployment and/or other financial aid rather than to have to go to a job where they are only getting part time hours because the business is struggling? You can't plan on that paycheck, since the business could be shut down anytime due to infections or simply because of bankruptcy. On top of all that the worker still has to worry about getting infected at work. I'm not seeing the upside of rushing to reopen.
Yep.YellowKing wrote: Tue Apr 28, 2020 4:01 pm Ok, so we open things back up with social distancing, requiring masks, etc. That's great, but that's not "normal". And it's not going to magically produce normal economic results. Restaurants at half capacity only need wait staff at half capacity.
I scanned it to see that it quoted the USC and Standford studies as evidence for mortality rate, saw that they were referenced and immediately threw the hold thing in the trash.YellowKing wrote:Ah another case where the majority of doctors and scientists in the entire world are wrong, and this one random doctor has seen through the conspiracy to bring us the truth.
OK, then what scientific, factual evidence is being used to justify keeping huge swaths of the west coast locked down until at least through early May? Gov. Newsom suggests "the virus could spread if people travel to and from places with eased restrictions," but that's merely an opinion (arguably based on fear) with no facts presented:YellowKing wrote: Tue Apr 28, 2020 9:46 amClaiming that there are all these states that are locked down out of "fear" is just a false construct. States locked down because of facts on the ground and models, not fear.
WSJ.com wrote:Along the West Coast, Democratic governors, who were among the first in the nation to issue stay-at-home orders, are facing pressure and defiance from some counties to relax uniform stay-at-home policies. Unlike states such as Georgia and Texas that are beginning to ease restrictions, Mr. Inslee, California’s Gavin Newsom and Oregon’s Kate Brown aren’t bending from plans to keep strict orders in place at least through early May.
“We do not have the same level of exposure that San Francisco or Los Angeles has, and we’re watching our local economy collapse,” said Ron Sullenger, chairman of the board of supervisors in Sutter County, about 40 miles north of Sacramento. “One size doesn’t necessarily fit all counties in our situation and we would want some flexibility.”
Mr. Sullenger and other elected officials in Sutter are sending a letter to the governor asking him to grant certain counties flexibility to open local businesses. The county has so far reported three coronavirus-related deaths and 42 confirmed cases.
Mr. Newsom has argued that a broader approach is necessary because the virus could spread if people travel to and from places with eased restrictions. He acknowledged in a briefing Thursday that he is hearing grievances from several counties. “By making sure all of us are checking off the same list, then we are going to be able to advance some loosening of our stay at home orders sooner as opposed to chasing folks down that get ahead of themselves only to find that perhaps they went too soon, too fast,” Mr. Newsom said.
Dunno which model you're referring to, but the influential IHME model specifically did include social distancing.YellowKing wrote: Tue Apr 28, 2020 9:46 amThe "worst case scenario" models he derides were exactly what they reported to be: worst case scenario models that demonstrated the outcomes without social distancing or lockdowns.
Plenty of experts disagree:YellowKing wrote: Tue Apr 28, 2020 9:46 amBecause those numbers didn't come to pass is not because the models were flawed.
statnews.com wrote:A widely followed model for projecting Covid-19 deaths in the U.S. is producing results that have been bouncing up and down like an unpredictable fever, and now epidemiologists are criticizing it as flawed and misleading for both the public and policy makers. In particular, they warn against relying on it as the basis for government decision-making, including on “re-opening America.”
“It’s not a model that most of us in the infectious disease epidemiology field think is well suited” to projecting Covid-19 deaths, epidemiologist Marc Lipsitch of the Harvard T.H. Chan School of Public Health told reporters this week, referring to projections by the Institute for Health Metrics and Evaluation at the University of Washington.
Others experts, including some colleagues of the model-makers, are even harsher. “That the IHME model keeps changing is evidence of its lack of reliability as a predictive tool,” said epidemiologist Ruth Etzioni of the Fred Hutchinson Cancer Center, who has served on a search committee for IHME. “That it is being used for policy decisions and its results interpreted wrongly is a travesty unfolding before our eyes.”
The IHME projections were used by the Trump administration in developing national guidelines to mitigate the outbreak. Now, they are reportedly influencing White House thinking on how and when to “re-open” the country, as President Trump announced a blueprint for on Thursday.
The chief reason the IHME projections worry some experts, Etzioni said, is that “the fact that they overshot will be used to suggest that the government response prevented an even greater catastrophe, when in fact the predictions were shaky in the first place.” IHME initially projected 38,000 to 162,000 U.S. deaths. The White House combined those estimates with others to warn of 100,000 to 240,000 potential deaths.
That could produce misplaced confidence in the effectiveness of the social distancing policies, which in turn could produce complacency about what might be needed to keep the epidemic from blowing up again.
Cite? Because it seems kinda silly and highly unscientific to assume the colossal difference between COVID-19 deaths in New York vs. the most populous state in the union was solely because the state of California was locked down one day earlier than New York.
healthdata.org wrote:How do social distancing measures factor into your model?
We use social distancing measures in our model to project COVID-19 deaths. Data from Germany, Italy, the US, China, and Spain have demonstrated how social distancing measures can save lives. Using data from these countries helps us understand how quickly we can expect deaths to decline after a location implements social distancing measures.
Starting April 17, we began using anonymized mobile phone data to better assess the impact of social distancing across locations. These data revealed that social distancing was happening to a larger degree than previously understood, and even before social distancing mandates went into effect.
With this new insight from mobile phone data, we have revised our projections for COVID-19 deaths. This has important implications for locations with few or nonexistent social distancing mandates, namely that the death projections are lower and peaks are projected to occur earlier. Beginning April 17, our model no longer assumes any future changes in social distancing mandates. To learn more, visit our estimation update for April 17.
Note that our model does not yet reflect how easing or lifting social distancing measures could increase COVID-19 infections and deaths. We are working to project COVID-19 trends in areas that have eased social distancing measures, and we will release these projections as soon as possible.
Ummm...models like this? It's one model that shows high death tolls for Georgia if they open prematurely. And it's one of seven that the CDC listed showing the same thing for states opening prematurely. It's not like people are just making this stuff up.anonymous bosch wrote:OK, then what scientific, factual evidence is being used to justify keeping huge swaths of the west coast locked down until at least through early May?
Pretty much what I was thinking.Smoove_B wrote:I can completely understand your concerns. Our local supermarket is heavily staffed by teenagers and 20 somethings in front-line positions and I'm genuinely amazed at what they're willing to do in light of everything going on.Xmann wrote: Mon Apr 27, 2020 1:04 pm I'm struggling on when to decide it's ok for my teenage son to go back to work at Chic Fil A. He's been off since this has started and is bored out of his mind. Making some extra money for college next year would be nice too.
On one hand, what's the difference in letting him go back tomorrow compared to a month from now? He doesn't cashier, he works the back. I don't know if wearing a mask is required.
Our community is opening back up Friday and my thought was to wait and see what happens with people. But again, what is my deciding factor?
Last week the FDA released a "best practices" document that was sourced from the restaurant industry leaders. If I were being asked to come back to work in a restaurant or retail food operation, I'd want to know how they're following the recommendations here. They don't seem unreasonable, but the key would be local management and what their policies/modifications to address workflow, sick staff members and customer interactions.
In terms of risk, I am not capable of communicating that unfortunately. Depending on how it is trending in your area there very well could be greater or diminished risk sending him there today or a month from now. Whether or not it's an appreciable risk, I cannot say. Unfortunately this is going to be something that needs to be addressed regardless in the mid to long term (modified work process) for anyone working retail so above and beyond actual risk right now, having risk mitigation plans in place that are being followed would be paramount (for me).
Not sure how helpful that is, but it's nice to see the industry helping to form guidelines.
Again, read your other links for all the reasons why this model is mocked by other epidemiologists.Anonymous Bosch wrote:I was in kind of a hurry when I posted, so mea culpa for any SNAFUs. I mentioned the IHME model simply because it was influential and also flawed, and linked to their FAQ in which they explain how social distancing measures have been factored into their model:
Fair enough. But California is more than three times the size of NC, and Gov. Newsom has provided little in the way of facts or the particular model(s) being used to justify his decision to extend the lockdown, even in counties where they've had hardly any coronavirus-related deaths at all. Just last month he was projecting that 56 percent of the population of California would be infected with coronavirus over an eight-week period. So his "facts on the ground and models" seem more than a wee bit dubious to say the least.YellowKing wrote: Tue Apr 28, 2020 6:33 pm In short, the claim that states are staying locked down "out of fear" is simply not true. I can't speak for California, but in NC they are based on data thresholds. If X criteria are met, models show risk is relatively low for additional outbreaks. If X criteria are not met, models show risk is high for additional outbreaks. It's not rocket science. I would assume California is not unlike NC in that they are using similar data points to drive their decision making.
I'd also caution against throwing the baby out with the bathwater when it comes to modeling. Of course no model is perfect, particularly for a new virus that we're still learning about. You make decisions based on the models you have at the time, and you refine those decision as newer, better models come along.
I hope no one assumes that. To assume that means you assume every other possible factor in how this virus was spread is exactly the same in both states. Since this pandemic is still ongoing, we're not in a position to know all that.Anonymous Bosch wrote: Tue Apr 28, 2020 5:18 pmCite? Because it seems kinda silly and highly unscientific to assume the colossal difference between COVID-19 deaths in New York vs. the most populous state in the union was solely because the state of California was locked down one day earlier than New York.
It might seem that way but no, it's not. There are "dead end" hosts for agents. Take for example, influenza A:Daehawk wrote: Tue Apr 28, 2020 8:11 pm I dont like how they say your pet can get it from you but not the other way around. I sure dont believe that one. Its just common sense it works both ways if one way.
The dates listed there aren't correct. New York locked down on March 22nd. It was only announced on March 20th.Anonymous Bosch wrote: Tue Apr 28, 2020 5:18 pm
Cite? Because it seems kinda silly and highly unscientific to assume the colossal difference between COVID-19 deaths in New York vs. the most populous state in the union was solely because the state of California was locked down one day earlier than New York.
Admits to being curious what logic jump prompted the revelation that flu travels from aquatic water fowl to whales....Smoove_B wrote: Tue Apr 28, 2020 8:18 pmIt might seem that way but no, it's not. There are "dead end" hosts for agents. Take for example, influenza A:Daehawk wrote: Tue Apr 28, 2020 8:11 pm I dont like how they say your pet can get it from you but not the other way around. I sure dont believe that one. Its just common sense it works both ways if one way.
Aquatic water fowl give it to everything. Horses give it to dogs (potentially). Chickens give it to humans (potentially). Pigs and humans can pass it back and forth, but no other species. This is why influenza strains vary every year - that human/pig connection and the genetic mixing that can occur when it goes back and forth. But sometimes, diseases are just one way streets.
LOL, you might laugh but I ordered a set with my hockey team logo today. 'Cause...why not.