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It does seem that we have blindly followed the Chinese's government's response to the outbreak without any real data. I'm guessing there may be large numbers of

by vondur 7y ago

It does seem that we have blindly followed the Chinese's government's response to the outbreak without any real data. I'm guessing there may be large numbers of people who are affected who aren't really showing any symptoms other than typical cold/flu symptoms.

steve_adams_86 7y ago
> without any real data The trouble is we can only get "real data" by testing more people. If we test more people we will almost certainly discover the numbers are worse than they appear now. All that is to say that the situation can only be worse than we already know. I'm not sure more data would lead us to isolate less at all. You might be right that there could be large numbers of people with the virus who are doing just fine right now, but we know from nearly 200,000 cases (that's plenty) that a non-trivial portion of cases require hospitalization. That's the whole problem, right there. So we know hospitals can be overwhelmed and a LOT of people die for it. Healthcare workers included. We know the situation is probably worse than it looks, but we won't know how much worse for weeks yet. So without real data, it seems to err on the side of caution is absolutely essential. This can bring countries to their knees within weeks, and it has. What would you propose we do without real data?
- parineum 7y ago
  >You might be right that there could be large numbers of people with the virus who are doing just fine right now, but we know from nearly 200,000 cases (that's plenty) that a non-trivial portion of cases require hospitalization. That's the whole problem, right there. You're not applying the logic all the way through. If a great number of people are already infected and do not require hospitalization it grossly affects the math on the potential for overwhelming our medical system. Those infected people unnoticeable to minor symptoms have the potential to be the herd immunity we'd want from a vaccine. > All that is to say that the situation can only be worse than we already know. I'm not sure more data would lead us to isolate less at all. More infected people who are unnoticed because they don't show severe symptoms and require hospitalization actually makes the situation better. It would lower the hospitalization rate and alter the projections drastically in the direction of less epidemic. We are being cautious right now. That, by definition, means we're likely overreacting.
  - travisporter 7y ago
    I was wondering if there’s an efficient way to screen a large population with low prevalence with limited tests. I’m thinking of the 1000 prisoner wine riddle with one drop of poison if that rings a bell
  - steve_adams_86 7y ago
    I thought that, but then how do you explain situations like Italy? Such a tremendous number of people are suffering.
- oldgradstudent 7y ago
  > The trouble is we can only get "real data" by testing more people. We get "real data" by properly testing, not necessarily by testing more people. Currently we are mainly testing people arriving with symptoms. This results in underestimate of the number of infected and an overestimate of mortality and morbidity rates.
oefrha 7y ago
“It won’t happen here.” “It could happen here, but it’s not a big concern.” “It’s happening here, and it’s a big concern, but we don’t have reliable data so let’s do nothing.” “We have reliable data now, but it’s too late to do anything.”
- teh_infallible 7y ago
  Are you quoting people from an actual conversation, or setting up a straw man to justify draconian actions based on limited data?
  - travisporter 7y ago
    While data is limited, the basic premise of viral spread and quarantine is nothing new or ineffective. There is no doubt there is exponential growth, and limiting that would be effective sooner than later health and economy wise.
    - spookthesunset 7y ago
      Is the growth of testing also exponential? Cause if it is, than it follows the confirmed infected will also look exponential even if the underlying actual growth number is totally different. You can make anything fit an exponential curve if you try hard enough.
    - sershe 7y ago
      There is no data as far as the latter is concerned. The current data (Fed actions, pronouncements of 18mo shutdowns, recession worse than 2008, etc.) is to the contrary. What, really, is the economic impact of virus deaths after exponential growth quickly bumps into population size and lots of mostly non-working people die? Nobody even tries to answer this.
- PeterisP 7y ago
  Are you suggesting the four stage strategy? https://www.youtube.com/watch?v=nSXIetP5iak https://www.youtube.com/watch?v=nSXIetP5iak
dragonwriter 7y ago
That is incorrect. The US, UK, and others were taking a mitigation strategy until the last couple of days; the change wasn't driven by delayed blind copying of China, but by this analysis, which was shared with governments as a WIP before being published: https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf https://www.imperial.ac.uk/media/imperial-college/medicine/s... There may be legitimate criticism of the broad policy approach, but “blindly following China” isn't one of them.

by vondur 7y ago

steve_adams_86 7y ago

> without any real data The trouble is we can only get "real data" by testing more people. If we test more people we will almost certainly discover the numbers are worse than they appear now. All that is to say that the situation can only be worse than we already know. I'm not sure more data would lead us to isolate less at all. You might be right that there could be large numbers of people with the virus who are doing just fine right now, but we know from nearly 200,000 cases (that's plenty) that a non-trivial portion of cases require hospitalization. That's the whole problem, right there. So we know hospitals can be overwhelmed and a LOT of people die for it. Healthcare workers included. We know the situation is probably worse than it looks, but we won't know how much worse for weeks yet. So without real data, it seems to err on the side of caution is absolutely essential. This can bring countries to their knees within weeks, and it has. What would you propose we do without real data?

parineum 7y ago
>You might be right that there could be large numbers of people with the virus who are doing just fine right now, but we know from nearly 200,000 cases (that's plenty) that a non-trivial portion of cases require hospitalization. That's the whole problem, right there. You're not applying the logic all the way through. If a great number of people are already infected and do not require hospitalization it grossly affects the math on the potential for overwhelming our medical system. Those infected people unnoticeable to minor symptoms have the potential to be the herd immunity we'd want from a vaccine. > All that is to say that the situation can only be worse than we already know. I'm not sure more data would lead us to isolate less at all. More infected people who are unnoticed because they don't show severe symptoms and require hospitalization actually makes the situation better. It would lower the hospitalization rate and alter the projections drastically in the direction of less epidemic. We are being cautious right now. That, by definition, means we're likely overreacting.
- travisporter 7y ago
  I was wondering if there’s an efficient way to screen a large population with low prevalence with limited tests. I’m thinking of the 1000 prisoner wine riddle with one drop of poison if that rings a bell
- steve_adams_86 7y ago
  I thought that, but then how do you explain situations like Italy? Such a tremendous number of people are suffering.
oldgradstudent 7y ago
> The trouble is we can only get "real data" by testing more people. We get "real data" by properly testing, not necessarily by testing more people. Currently we are mainly testing people arriving with symptoms. This results in underestimate of the number of infected and an overestimate of mortality and morbidity rates.

oefrha 7y ago

“It won’t happen here.” “It could happen here, but it’s not a big concern.” “It’s happening here, and it’s a big concern, but we don’t have reliable data so let’s do nothing.” “We have reliable data now, but it’s too late to do anything.”

teh_infallible 7y ago
Are you quoting people from an actual conversation, or setting up a straw man to justify draconian actions based on limited data?
- travisporter 7y ago
  While data is limited, the basic premise of viral spread and quarantine is nothing new or ineffective. There is no doubt there is exponential growth, and limiting that would be effective sooner than later health and economy wise.
  - spookthesunset 7y ago
    Is the growth of testing also exponential? Cause if it is, than it follows the confirmed infected will also look exponential even if the underlying actual growth number is totally different. You can make anything fit an exponential curve if you try hard enough.
  - sershe 7y ago
    There is no data as far as the latter is concerned. The current data (Fed actions, pronouncements of 18mo shutdowns, recession worse than 2008, etc.) is to the contrary. What, really, is the economic impact of virus deaths after exponential growth quickly bumps into population size and lots of mostly non-working people die? Nobody even tries to answer this.
PeterisP 7y ago
Are you suggesting the four stage strategy? https://www.youtube.com/watch?v=nSXIetP5iak https://www.youtube.com/watch?v=nSXIetP5iak

dragonwriter 7y ago

That is incorrect. The US, UK, and others were taking a mitigation strategy until the last couple of days; the change wasn't driven by delayed blind copying of China, but by this analysis, which was shared with governments as a WIP before being published: https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf https://www.imperial.ac.uk/media/imperial-college/medicine/s... There may be legitimate criticism of the broad policy approach, but “blindly following China” isn't one of them.