6 ms·

Do you have any evidence that cleaning subways is an effective way of preventing infection? From everything I have read the main vector of infection is by direc

Do you have any evidence that cleaning subways is an effective way of preventing infection? From everything I have read the main vector of infection is by direct droplet infection during personal contact with an infected person. Sure, maybe if you disinfect surfaces everywhere you may decrease the spread a tiny little bit, but everyone's resources are probably better spent elsewhere right now. You also can't just protect people above 65 and let the virus spread amongst young people. Have a look at the Imperial College study published a few days ago, where they modeled the effect of different interventions in the UK and US. Even if you could perfectly isolate all old people (and ignoring the mental health cost of that) the young people needing medical attention would still vastly overwhelm the health system. And I agree that widespread testing would be great, but there are simply only so many tests you can do with the resources available. It's easy to say "you should test everyone" but nobody ever has an answer for how.

chapium 7y ago
It has been shown that this virus can survive on surfaces for 3 days.
- oezi 7y ago
  Virus fragments. The ability of the virus to infect decreases quickly.
  - shadowprofile77 7y ago
    Honestly curious, do you by chance have a source for this ability to infect decreasing quickly? I would love to share it becasue many people are getting paranoid about how long a tabletop or doorknob could infect them after being touched.
- DangerousPie 7y ago
  That doesn't mean much without also accounting for how easily an infected person actually spreads the virus into their environment, as well as how likely copies of the virus left in the environment are to actually infect someone. I would suspect that as long as people don't sneeze/cough without a tissue they are not actually spreading that much copies of the virus on surfaces. And similarly I would also expect that if you wash your hands before eating or touching your face, you are not that likely to get infected even if you had touched a surface with viral particles on it. But of course I have no evidence for any of this since the studies have clearly not been done yet.
rsync 7y ago
"Even if you could perfectly isolate all old people (and ignoring the mental health cost of that) the young people needing medical attention would still vastly overwhelm the health system." I am willing to stipulate that this is correct. However, I feel that we've slowly developed (over the past few decades) an underlying assumption that "flu-like symptoms" automatically warrant a trip to the hospital. During normal times, if you went to an emergency room in rich, well-educated American cities, you would see many, many rich, well-educated people who had taken their children to the ER (or urgent care center) for flu-like symptoms and had asked for and been given antibiotics, wastefully, for a condition caused by a virus. This was, of course, irksome and disappointing, but now it is a matter of tremendous import for public health: what would our options look like if we did not assume every person exhibiting flu-like symptoms needed medical services ? What would our options look like if people understood that there is no such thing as cold "medicine" or flu "medicine" and that the doctor can do nothing for your not-critically-sick child other than prescribe rest and good nutrition ? Instead, we desire to be consumers of health-care because it is a modern imperative. I believe these were wrong-headed attitudes and we are now paying the price for them.
- cameronh90 7y ago
  There are medicines for flu: oseltamivir and zanamivir to name two. None for the cold as far as I'm aware. I don't think the desire for a cure is unreasonable on the part of patients though, but it's the job of public health and experts to temper those expectations. By now any doctor prescribing antibiotics for a virus or to placate a patient should be facing professional sanctions.
- DangerousPie 7y ago
  Are you implying that the reason the hospitals are overwhelmed is that they are admitting people that could just "ride it out at home"? Because that is certainly not the problem. Many COVID patients need to be on 24/7 ventilation in the ICU to stay alive, including young and healthy ones. Way more than the hospitals can cope with. This is not about people's attitudes towards healthcare, this is about thousands and soon millions of people suddenly requiring emergency medical treatment, way beyond what the health system can cope with.
FlorianRappl 7y ago
I don't claim that not cleaning spreads the virus, nor do I have any evidence that cleaning helps. For me its just an indicator that the cities / government do not work carefully. In South Korea pretty much all subways (at least from what I hear in Seoul and Daegu) and public buildings are cleaned very frequently during the pandemic. Look at their numbers / curve to see how well they handled this. The assumption regarding the health system is based on the official number, which is way too low. The official number right now is ~25k cases in Germany. The real number may be closer to 250k cases. Most people get mild or no symptoms at all. Also of these 25k cases - most people do not require intensive medical care. Yes, the deaths are tragic, but influenza death count is above 2k this year alone. In comparison each year we have 33k kills caused by superbugs in Europe. Do we act here (in some countries there are active measurements - not so in Germany)? So while flatten the curve is definitely important its all about the balance here. And I think the balance is way off ... Yes, I am aware that Germany has only 25k breathing machines (80% already taken) and would not be equipped for a full outburst - but that would not happen with general sanity, too (e.g., basic hygienic measures). For instance, in South Korea (sorry to use this example again) every citizen gets 2 facial masks per week. I know that these masks are not for your protection, but for protecting others - but that's exactly it. If everyone wears them (by order of the government) then the infection risk is drastically reduced. Again I don't want to claim all would be good, but claiming that now everything is good is certainly wrong, too. Without basic testing and other essential measures the spread will continue. If you need some evidence here then look at Italy. First country to act with such strong restrictions, still right now the one that has the most problems.
- DangerousPie 7y ago
  Honestly I don't have time to pick apart this entire comment, but just to address the most egregious assumption you make: You compare death numbers from the flu to COVID. COVID is a pandemic that is in its exponential growth phase, with zero existing immunity and no existing treatment. The flu is a well-known, well-studied disease for which we have a vaccine, to which many people will have some level of immunity and for which we actually have a treatment. The flu is also at the end of the season right now. COVID is only getting started. Even if we instituted perfect social distancing and prevented all further spread we can expect COVID deaths to double every few days for the next few weeks because of the incubation period. I am willing to bet good money that the 2k influenza deaths this year will dwindle in comparison to the number of COVID deaths when everything is said and done.
alisonatwork 7y ago
I think "ignoring the mental health cost of that" is exactly what most governments have been doing up until now. I am in mainland China (outside Hubei) where we had about 4 weeks of strict lockdown and then 4 weeks of shops slowly reopening but still fences and checkpoints and restrictions on where people are allowed to go... It's been devastating to my mental health, and that of many others. The schools still aren't open and parents are on their last thread. If there is a strategy for getting on top of this outbreak where less people have to go through the stress of lockdown, I think that would be worth investigating.

chapium 7y ago

It has been shown that this virus can survive on surfaces for 3 days.

oezi 7y ago
Virus fragments. The ability of the virus to infect decreases quickly.
- shadowprofile77 7y ago
  Honestly curious, do you by chance have a source for this ability to infect decreasing quickly? I would love to share it becasue many people are getting paranoid about how long a tabletop or doorknob could infect them after being touched.
DangerousPie 7y ago
That doesn't mean much without also accounting for how easily an infected person actually spreads the virus into their environment, as well as how likely copies of the virus left in the environment are to actually infect someone. I would suspect that as long as people don't sneeze/cough without a tissue they are not actually spreading that much copies of the virus on surfaces. And similarly I would also expect that if you wash your hands before eating or touching your face, you are not that likely to get infected even if you had touched a surface with viral particles on it. But of course I have no evidence for any of this since the studies have clearly not been done yet.

rsync 7y ago

"Even if you could perfectly isolate all old people (and ignoring the mental health cost of that) the young people needing medical attention would still vastly overwhelm the health system." I am willing to stipulate that this is correct. However, I feel that we've slowly developed (over the past few decades) an underlying assumption that "flu-like symptoms" automatically warrant a trip to the hospital. During normal times, if you went to an emergency room in rich, well-educated American cities, you would see many, many rich, well-educated people who had taken their children to the ER (or urgent care center) for flu-like symptoms and had asked for and been given antibiotics, wastefully, for a condition caused by a virus. This was, of course, irksome and disappointing, but now it is a matter of tremendous import for public health: what would our options look like if we did not assume every person exhibiting flu-like symptoms needed medical services ? What would our options look like if people understood that there is no such thing as cold "medicine" or flu "medicine" and that the doctor can do nothing for your not-critically-sick child other than prescribe rest and good nutrition ? Instead, we desire to be consumers of health-care because it is a modern imperative. I believe these were wrong-headed attitudes and we are now paying the price for them.

cameronh90 7y ago
There are medicines for flu: oseltamivir and zanamivir to name two. None for the cold as far as I'm aware. I don't think the desire for a cure is unreasonable on the part of patients though, but it's the job of public health and experts to temper those expectations. By now any doctor prescribing antibiotics for a virus or to placate a patient should be facing professional sanctions.
DangerousPie 7y ago
Are you implying that the reason the hospitals are overwhelmed is that they are admitting people that could just "ride it out at home"? Because that is certainly not the problem. Many COVID patients need to be on 24/7 ventilation in the ICU to stay alive, including young and healthy ones. Way more than the hospitals can cope with. This is not about people's attitudes towards healthcare, this is about thousands and soon millions of people suddenly requiring emergency medical treatment, way beyond what the health system can cope with.

FlorianRappl 7y ago

I don't claim that not cleaning spreads the virus, nor do I have any evidence that cleaning helps. For me its just an indicator that the cities / government do not work carefully. In South Korea pretty much all subways (at least from what I hear in Seoul and Daegu) and public buildings are cleaned very frequently during the pandemic. Look at their numbers / curve to see how well they handled this. The assumption regarding the health system is based on the official number, which is way too low. The official number right now is ~25k cases in Germany. The real number may be closer to 250k cases. Most people get mild or no symptoms at all. Also of these 25k cases - most people do not require intensive medical care. Yes, the deaths are tragic, but influenza death count is above 2k this year alone. In comparison each year we have 33k kills caused by superbugs in Europe. Do we act here (in some countries there are active measurements - not so in Germany)? So while flatten the curve is definitely important its all about the balance here. And I think the balance is way off ... Yes, I am aware that Germany has only 25k breathing machines (80% already taken) and would not be equipped for a full outburst - but that would not happen with general sanity, too (e.g., basic hygienic measures). For instance, in South Korea (sorry to use this example again) every citizen gets 2 facial masks per week. I know that these masks are not for your protection, but for protecting others - but that's exactly it. If everyone wears them (by order of the government) then the infection risk is drastically reduced. Again I don't want to claim all would be good, but claiming that now everything is good is certainly wrong, too. Without basic testing and other essential measures the spread will continue. If you need some evidence here then look at Italy. First country to act with such strong restrictions, still right now the one that has the most problems.

DangerousPie 7y ago
Honestly I don't have time to pick apart this entire comment, but just to address the most egregious assumption you make: You compare death numbers from the flu to COVID. COVID is a pandemic that is in its exponential growth phase, with zero existing immunity and no existing treatment. The flu is a well-known, well-studied disease for which we have a vaccine, to which many people will have some level of immunity and for which we actually have a treatment. The flu is also at the end of the season right now. COVID is only getting started. Even if we instituted perfect social distancing and prevented all further spread we can expect COVID deaths to double every few days for the next few weeks because of the incubation period. I am willing to bet good money that the 2k influenza deaths this year will dwindle in comparison to the number of COVID deaths when everything is said and done.

alisonatwork 7y ago

I think "ignoring the mental health cost of that" is exactly what most governments have been doing up until now. I am in mainland China (outside Hubei) where we had about 4 weeks of strict lockdown and then 4 weeks of shops slowly reopening but still fences and checkpoints and restrictions on where people are allowed to go... It's been devastating to my mental health, and that of many others. The schools still aren't open and parents are on their last thread. If there is a strategy for getting on top of this outbreak where less people have to go through the stress of lockdown, I think that would be worth investigating.