9 ms·
The WHO seems to have been embarrassingly wrong or overconfident on many accounts: 1. Global air travel does not need to be stopped. 2. There is no evidence o
by longtom 6y ago
The WHO seems to have been embarrassingly wrong or overconfident on many accounts:
1. Global air travel does not need to be stopped.
2. There is no evidence of human-to-human transmission.
3. There is still a "window of opportunity".
4. Masks don't work (but health workers need them!).
5. The CFR is like 4%.
- joshuamorton 6y ago> Global air travel does not need to be stopped. This isn't what the WHO said. They said bans on air from specific places (especially those that disrupt supply chains) are bad. This is true. Banning all air travel to/from china would have hurt medical supply chains in the US, with very little benefit. > 2. There is no evidence of human-to-human transmission. When this claim was made (in early january), there was not clear evidence of human to human transmission. It was revised a few days later when there was. > 4. Masks don't work (but health workers need them!). This isn't what was said. They said that random people shouldn't go out of their way to acquire medical PPE (save it for medical personnel) > 5. The CFR is like 4%. Depending on the country, the CFR varies between 1.5% and like 15%. 4% seems like a reasonable estimate there. Unless you rely on the unfounded belief that there are large completely undetected swaths of the population that are infected but entirely asymptomatic, (which would have been found in South Korea, for example), the WHO's estimate is reasonable.
- koheripbal 6y agoHaving watched their briefings each day in Jan and Feb, this is absolutely not what the said. If you're going to misquote them, at least provide sources.
- factsaresacred 6y ago> They said bans on air from specific places (especially those that disrupt supply chains) are bad. This is true. The idea that bans on travel are 'bad' is nonsense. There's a global ban on civilian travel precisely because it is effective. > There is no evidence of human-to-human transmission. Sending out a message only to contradict it days later is poor communication and management. > They said that random people shouldn't go out of their way to acquire medical PPE No they said masks were not effective: ‘very little evidence of widespread benefit from masks use outside of these clinical settings’. Study after study contradicts this. Additionally, as a cynical example of subterfuge, their Director-General made up some lies about Taiwan being racist while at the same time, in mainland China, Africans were being banned from shopping malls and evicted from their homes. The WHO messed up, repeatedly. And now their word is apparently sacrosanct on social media by threat of deletion which is simply outrageous.
- joshuamorton 6y ago> The idea that bans on travel are 'bad' is nonsense. There's a global ban on civilian travel precisely because it is effective. There's not though. > Sending out a message only to contradict it days later is poor communication and management. I can hear the goalposts scraping by. > very little evidence of widespread benefit from masks use outside of these clinical settings’ The WHO never said this, I'm not sure what you're quoting, it appears to be some British group. Please stop spreading misinformation.
- factsaresacred 6y agoMy mistake, here is what the WHO said: > "If you do not have any respiratory symptoms...you do not need to wear a medical mask" Which is somehow worse.
- joshuamorton 6y agoI've yet to see any actual evidence that wearing a cloth mask while social distancing helps you, as a healthy individual. And I've seen some to the contrary[0]. One of the WHO's main concerns is to prevent shortages and supply chain issues (see their statements about travel and import bans). A run on medical masks is problematic, and the WHO's guidance prevents that. I'll note that basically no government suggested (or suggests) wearing medical masks[1], unless you are symptomatic, which is in line with the WHO's guidance. Social distancing is much more important, and while masks may help, especially in areas that are crowded (which you should avoid if possible anyway), they only really help if you are symptomatic, in which case you should absolutely not be outside. The bay area is fairly unique in requiring mask wearing, and while it's not a major imposition, the utility is probably pretty marginal. [0]: https://www.cidrap.umn.edu/news-perspective/2020/04/data-do-not-back-cloth-masks-limit-covid-19-experts-say https://www.cidrap.umn.edu/news-perspective/2020/04/data-do-... [1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118603/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118603/
- watwut 6y ago
- calibas 6y agoWas the fact that it kept spreading not strong evidence of human to human transmission? It seems they just went with the Chinese government instead of asking why people kept getting infected.
- knzhou 6y agoNo, because at the time the statement was made, most of the known cases were directly linked to a single wildlife market. (Also keep in mind that this announcement is within 2 weeks of discovering the virus, sequencing its genome, inventing the first ever tests for it, and deploying those tests!) Luckily, enough evidence came in that they were sure a few days later.
- calibas 6y agoIn those few days it began spreading internationally, I'm not sure I'd call that "lucky". In the WHO's defense, China was actively trying to cover up the outbreak. People were starting to panic because more people were getting sick, so they went full authoritarian and banned mention of it on social media. More people kept getting sick because it was spreading between people, people were getting worried, then WHO announced no evidence of human to human transmission and recommended no restrictions on travel to Wuhan. We know full well in hindsight that was a mistake.
- stateofnounion 6y agoThere are large swathes of the population that have been infected asymptomatically: https://www.nytimes.com/2020/04/23/nyregion/coronavirus-antibodies-test-ny.html https://www.nytimes.com/2020/04/23/nyregion/coronavirus-anti... There are similar studies and similar findings in both the US and Europe. tl;dr The virus is much less lethal for the average person than models predicted before we had more data.
- watwut 6y agoCFR is case fatality ration and is literally defined as "people who we know are sick to people who died". It does not mean overall lethality and it never meant that. CFR is not prediction nor model, it is input into the mode. Asymptomatic non tested population is literally not supposed to be counted into CFR.
- nostrebored 6y ago'asymptomatic non tested population' is an interesting way to refer to people with covid 19 antibodies found via immunoassays. This sizeable population shows that our cfr estimates have enough error to be meaningless.
- watwut 6y agoCFR does not have "error rate" this way. It is just defined differently then you thought it is defined. You thought it is mortality, it never was. It is the only number available at the beginning of epidemic (no matter which one). "asymptomatic non tested population" is the most exact description of people who were not tested, had no symptoms and therefore don't count as "cases". Yes, we measure them by measuring antibodies if precise tests are available.
- joshuamorton 6y ago> There are large swathes of the population that have been infected asymptomatically: https://www.nytimes.com/2020/04/23/nyregion/coronavirus-anti.. https://www.nytimes.com/2020/04/23/nyregion/coronavirus-anti.... No, there are tests that have high false-positive rates. The studies in both the US and Europe used similarly flawed tests and didn't correctly account for the false-positive rates of those tests. [0] There are two ways to think through how these results are flawed: the first is that the false positive rates of the tests is vastly higher than the prior (which we'll assume is approximately the confirmed case rate per capita) is. There were three studies, NYC, Santa Clara, and one in Europe that I know of. All three tests had false positive rates over 2%, and one test had a false positive rate of like 10%. So when a study shows that a large percent of the population have the virus, and that percentage is suspiciously similar to the false-positive rate of the test, you pause. The second is a much more grokkable one. Let's assume that 2% of people in Santa Clara were infected (per the study), then 40,000 people are infected, and of them around 2000 people were symptomatic enough to get tested and be hospitalized/tested (per available stats). Or 5% of infections are symptomatic enough to get noticed, ish. Then we'd see that NYC would have ~3.5 million people infected now, or something like 40%. So we'd expect to see 40% (or more actually) of people tested in NY and NYC test positive for covid. But we don't[1]. We see that as NY adds more tests, the positive rate of the more reliable tests is going down, because they can test more people and because NY appears to be over the hump. At peak, 20% of people were testing positive daily, now it's down to closer to 10%. And note that most of the tests are going to people who have some symptoms of something, which is why it's that high. 40% of NY residents were infected, we'd expect to see more than 40% of the tests positive, but we don't. If you do the same calculation but with death rate, you find that there are more people in NYC with Covid than live in NYC. In conclusion: those studies are bad because the tests they use are unreliable. [0]: https://statmodeling.stat.columbia.edu/2020/04/19/fatal-flaws-in-stanford-study-of-coronavirus-prevalence/ https://statmodeling.stat.columbia.edu/2020/04/19/fatal-flaw... [1]: https://health.data.ny.gov/d/xdss-u53e/visualization https://health.data.ny.gov/d/xdss-u53e/visualization
- longtom 6y ago> They said bans on air from specific places (especially those that disrupt supply chains) are bad. No, they advised "against the application of travel or trade restrictions to countries experiencing COVID-19 outbreaks." Which is identical with not restricting global air travel. https://www.who.int/news-room/articles-detail/updated-who-recommendations-for-international-traffic-in-relation-to-covid-19-outbreak https://www.who.int/news-room/articles-detail/updated-who-re... > When this claim was made (in early january), there was not clear evidence of human to human transmission. It was revised a few days later when there was. True, the exact wording was "no clear evidence", but this is widely regarded as a cover-up, especially because it is known there were attempts at covering up the outbreak. https://nypost.com/2020/03/20/who-haunted-by-old-tweet-saying-china-found-no-human-transmission-of-coronavirus/ https://nypost.com/2020/03/20/who-haunted-by-old-tweet-sayin... > This isn't what was said. They said that random people shouldn't go out of their way to acquire medical PPE (save it for medical personnel). Again false. They wrote for individuals without respiratory symptoms, "a medical mask is not required, as no evidence is available on its usefulness to protect non-sick persons". https://apps.who.int/iris/bitstream/handle/10665/330987/WHO-nCov-IPC_Masks-2020.1-eng.pdf?sequence=1&isAllowed=y https://apps.who.int/iris/bitstream/handle/10665/330987/WHO-... > 4% seems like a reasonable estimate there. All epidemiologists seemed to have agreed at that time that CFRs were inflated when compared with a more stable situation with more testing kits being available due to the unknown denominator. Simply using the country average was extremely silly data. There were much better data available from Wuhan and that cruise ship.
- joshuamorton 6y ago> All epidemiologists seemed to have agreed at that time No, the 4% was based on academic papers and epidimeoligists. Granted there was and is disagreement, but the whole "it's less than 1%" thing was from nonreperts. > but this is widely regarded as a cover-up By who? Some people believe China wasn't forthcoming with evidence, sure. That's possibly true. > Which is identical with not restricting global air travel. Well no, general travel restrictions and reductions, and travel bans instituted by areas under outbreak are both within the WHO policy. That is, Italy can ban all travel out (which they did). But the US shouldn't ban all flights from China. > They wrote for individuals without respiratory symptoms Yes, and if you read into the underlying papers, not just the headlines the reasons they recommend this are to prevent shortages and because it's easy to mishandle masks. I am not sure what your goal is here, you seem to be disagreeing for the sake of disagreeing.
- knzhou 6y ago> 2. There is no evidence of human-to-human transmission. This is one of those completely false things that people only believe is true by repetition. Go back and actually read the full set of WHO statements in mid-January. They have a bunch of statements saying that nations should get prepared, one saying that specific studies haven’t yet found hard evidence for person-to-person transmission (because at that point most of the cases they’d managed to find were tied to the market). The WHO never, ever said that it can’t be transmitted, and they absolutely never said that people should do nothing about COVID-19. They were urging nations to act for months before they actually did. > 4. Masks don't work (but health workers need them!). They don't say masks don't work either, they say that health workers need them more. Here you need to remember that the W stands for "World". They worry the most about the poorer countries who have much fewer masks available.
- langitbiru 6y ago"they said that healt workers need them more" -> WHO could say that normal people should use cloth masks (not surgical/N95 masks). Problem solved. I still think WHO made a blunder in their recommendation about mask usage.
- Kiro 6y agoWhy would they say that when there is no scientific consensus yet?
- langitbiru 6y agoWe already had experience with similar type of virus (SARS). Based on this experience, Korea and Taiwan did just fine. Why couldn't WHO?
- jfoster 6y ago> Here you need to remember that the W stands for "World". So they give dubious advice to the entire world since the good advice doesn't perfectly fit the world in entirety? There are many better options: don't give advice, explain two sets of advice, ask for advice from governments to be followed, make the advice generic enough that it still applies to the world. An example of advice that might apply anywhere in the world: "Face coverings will help to reduce transmission. In most parts of the world, masks will be in short supply and needed by health care workers much more than the general population. Masks can be made from any type of cloth. Although these may not have the same efficacy as high grade masks and the efficacy will be dependent upon the material used as well as the degree of seal against the face, these will help to reduce transmission."
- brickmort 6y agoIn the USA, if travel restrictions hadn't been put in place in late January (going directly against WHO recommendations at the time), the virus would have propagated much quicker into the country and the US would have been in way worse shape today than it is now.
- syrrim 6y agoYou don't know that. Italy had early travel restrictions, and had it very bad. Canada had no travel restrictions until much later, and has it better than (parts of) the US. That so many believe the travel restrictions were warranted seems to solely be the product of them having been considered an outsize response at the time, rather than evaluating the arguments against them not qualified on the danger of the pandemic. In particular, travel restrictions become actively harmful when they reduce the capacity to detect and therefore apply extra scrutiny to those travelling through affected countries. Insofar as people will travel anyways, they only serve to hide that fact from authorities. This of course does not apply to the US, which had no testing capacity at the time. But we can no more suppose that the US would have been worse off as we can suppose they would have been better off.