8 ms·

How’s the Economy Doing? Watch the Dentists

18 points by prostoalex 6y ago

mnm1 6y ago
Dentistry is the last industry I'd watch as a harbinger of the economy. Going to the dentist is truly playing russian roulette with corona. The aerosolization of particles is inevitable as is inhaling them. If there is corona to be aerosolized and transmitted, it will be. I can't imagine anyone getting elective dentistry right now. Then again, many Americans seem to have a death wish right now and would risk their lives for a cleaning.
- toomuchtodo 6y ago
  Most Americans will get COVID, and the risk of death is exceedingly low (0.3%). “Death wish” is exaggerating the situation. If you’re young and healthy (or even middle aged and healthy), it’s reasonable to take what others interpret as risky actions.
  - gberger 6y ago
    Are you predicting 500-900k deaths in the USA due to COVID-19?
    - toomuchtodo 6y ago
      Not a domain expert, so I make no predictions myself but do consume data from subject matter experts on the topic. Healthy middle aged person who wears a mask in public but goes about his life with his family as if nothing happened. Haven’t gotten COVID, but if I do, I’ll take sick days and move on. What else would you expect people to do, hide inside forever? Curve was flattened, there’s no appetite to do so further if necessary, life goes on (or it doesn’t).
      - criddell 6y ago
        You don't think we would be better off if we had been as aggressive as countries like South Korea?
        toomuchtodo 6y ago
        I think we would, but we won’t, so that’s what folks will optimize for (“open for business”). Can’t fault people for responding to incentives and policy accordingly.
        criddell 6y ago
        It's hard for me to reconcile that you educate yourself by reading what experts are saying and you still are going about your life as if nothing had happened. Are the policies and incentives so powerful that it's overriding your knowledge that you and your neighbors would be better off if you continued to self-quarantine as much as possible?
        amluto 6y ago
        Will we be better off if we self-quarantine as long as possible? Under the assumption that a fixed percentage of Americans will get COVID-19 in the long run and that treatments will not improve, then self-quarantining may delay getting it and has some chance of pushing those who self-quarantine more effectively into the not-getting it category but will make little difference to the overall mortality rate. So, for increased isolation to make a big difference, something has to break one of those assumptions. Possibilities include: A vaccine. This may well happen in under a year. How much of a difference this makes will depend on the efficacy of a vaccine and how many people get it. Improved treatments. Some experts seem optimistic about monoclonal antibodies. Cost, production, and ability to administer early enough in the course of the disease are still unknown. Living in a country that is actually suppressing the disease. Countries that have competently managed COVID-19 are not on a course that will eventually infect a large fraction of the population. It seems likely that if all countries were this competent, then COVID-19 could be eradicated without a vaccine.
  - nickthemagicman 6y ago
    This is so true. Yet you're being downvoted. I don't understand it.
    - deleted 6y ago
      [deleted]
  - throwaway_pdp09 6y ago
    Where did 0.3% come from.
    - toomuchtodo 6y ago
      https://www.worldometers.info/coronavirus/coronavirus-death-rate/ https://www.worldometers.info/coronavirus/coronavirus-death-... > As of May 1, 23,430 people are estimated to have died out of a total population of 8,398,748 in New York City. This corresponds to a 0.28% crude mortality rate to date, or 279 deaths per 100,000 population, or 1 death every 358 people. Note that the Crude Mortality Rate will continue to increase as more infections and deaths occur (see notes under the paragraph "Herd Immunity" below for details). From a Google search of “Covid mortality rate”. As a healthy person, I would remain comfortable even if the death rate is substantially higher under the assumption that one can’t self quarantine forever and infection is inevitable.
      - throwaway_pdp09 6y ago
        From your own link: "Infection Fatality Rate (IFR) = Deaths / Cases = 23,430 / 1,694,781 = 1.4% (1.4% of people infected with SARS-CoV-2 have a fatal outcome, while 98.6% recover)" So 1.4%, about 4.67 times higher than what you say. That said I may have misunderstood so corrections welcome.
        toomuchtodo 6y ago
        Not a domain expert, perhaps I misinterpreted the rate posted (CMR vs IFR). I’m still comfortable with those odds you commented with (1.4%). If I was twice my age or had underlying health issues, I might be more concerned, but this falls within my personal risk tolerance. https://www.nytimes.com/2020/05/22/well/live/putting-the-risk-of-covid-19-in-perspective.html https://www.nytimes.com/2020/05/22/well/live/putting-the-ris... (New York Times: Putting the Risk of Covid-19 in Perspective)
        throwaway_pdp09 6y ago
        You're assuming rather a lot. I don't want to be alarming etc. but you're being a touch complacent. https://www.bbc.co.uk/news/uk-scotland-52506669 https://www.bbc.co.uk/news/uk-scotland-52506669 She said: "We are seeing that patients are suffering from moderate to severe acute kidney injury in about 20-30% of patients and 30% of patients who are admitted to intensive care for Covid infection are requiring dialysis so the numbers are much bigger than we envisaged based on the data coming out of China." (published May 2nd) It's not die-or-recover-completely.
  - mnm1 6y ago
    A death wish is not necessarily for oneself. Most Americans are wishing death upon others. Statistically, the younger and healthier, the more likely they are to kill someone else rather than themselves. Doesn't make it any less risky or horrifying. Well, it does to many Americans who simply do not care if their actions kill others. It's part of the culture as can be readily seen now and in the past.
- erulabs 6y ago
  I think the key word is "elective" here. I've been scheduled for an implant for ~4 months now, and waiting for things to calm down before getting it done - but it's not exactly "elective" - there are serious health consequences of not getting the work done - it will be more painful and more expensive the longer I wait. So I get to balance increased pain with increased risk of infectious disease. Compared to most things, it's absolutely a legitimate barometer of how safe I feel doing the riskiest activities _that I have to do_.
  - ghaff 6y ago
    I'm pretty much in the same boat. I was scheduled for a crown when things shut down. After they opened, they called me to reschedule. Sure I could hold off some number of months but I actually had some temporary sensitivity in the tooth so it seemed reasonable on balance to go ahead and get it done. (And, if I were in the office for the temporary crown anyway, I might as well get my rescheduled cleaning done anyway which is also "elective" up to some point, but who knows what outbreaks could happen that shut things down again. So, yes, it's a risk but it seems a reasonable calculated one. Others may of course disagree.
  - DanBC 6y ago
    > but it's not exactly "elective" - there are serious health consequences of not getting the work done That's what "elective" means. Planned in advance, non-emergency.
- cat199 6y ago
  "How long it takes those jobs to come back entirely will be a crucial indicator of whether Americans feel safe returning to normal activities, and if they have the economic means to do so. “I’m obsessed with dentists because, if the only thing we’re doing is putting the economy on pause, and then going back to normal, all of them should be coming back,” Ms. Stevenson said. “We’re not really recovered until all the dentists are back to work.”
- ghaff 6y ago
  A lot of dentistry is elective just like other forms of preventative care. But that doesn't mean you should push it off indefinitely. And if you look at the various projections, it increasingly doesn't look as if pushing this sort of thing out a couple of months will necessarily get you to the point where "everything's fine!" People don't go to dentists because it's a fun but unnecessary activity.
- matz1 6y ago
  Death wish ? That's seems like huge exaggeration isn't it ? This virus is not like ebola where you most likely will be dead if you get it.
  - praiseDang 6y ago
    OP may be obese, sick, or old. For these groups, Coronavirus might be a death sentence.
claudeganon 6y ago
What’s strange to me about all these stories is their veiled, counterfactual suggestion that any of this is really safe given the trajectory the US is on. If the US had reacted early and competently, like South Korea, New Zealand, Taiwan, or many other countries, people could be going to dentists without too much concern. But we didn’t, are on a bad and dangerous path, and now have to somehow pretend that we’re not, based solely on popular sentiment. The reality of COVID-19, how it spreads, and what’s proven to quash it have absolutely nothing to do with how people feel about the pandemic.
- postalrat 6y ago
  Is it a coincidence that all the countries you listed are more or less islands?
  - claudeganon 6y ago
    South Korea is an island? That’s news to me. Their major COVID outbreak started about the same time as our’s. See also Vietnam. And they both share a border with China. https://en.m.wikipedia.org/wiki/COVID-19_pandemic_in_Vietnam https://en.m.wikipedia.org/wiki/COVID-19_pandemic_in_Vietnam
    - SpicyLemonZest 6y ago
      South Korea does not share a border with China.
      - deleted 6y ago
        [deleted]
    - dctoedt 6y ago
      South Korea's only land border is with North Korea. The GP was correct that (in this context) for practical purposes South Korea is an "island" because there's relatively little land travel between North- and South Korea. Map: https://www.google.com/maps/d/viewer?ie=UTF8&hl=en&source=embed&msa=0&ll=35.9302740559874%2C129.32957000000002&spn=4.443673%2C9.831391&mid=1Bu81fI2lSAp-feL9JbPvY6gw3eI&z=7 https://www.google.com/maps/d/viewer?ie=UTF8&hl=en&source=em...
doliveira 6y ago
What is the deal with this denialism on Hacker News? Suddenly it seems everyone here incarnated the Elon Musk spirit.
- jrobn 6y ago
  Combination of disinformation, “entitle-ism”, denial, and money.
- LiquidSky 6y ago
  The Hacker News crowd tends to be pretty well off, so I imagine it’s that classic Upton Sinclair quote: “It is difficult to get a man to understand something when his salary depends on his not understanding it.”
- ghaff 6y ago
  You don't need to be denialist to think that it may be appropriate to get back to delayed medical procedures.
  - doliveira 6y ago
    I assume emergency procedures are still being done.
    - ghaff 6y ago
      I'm not sure what that statement has to do with mine. Many medical procedures/visits that don't need to happen right now should nonetheless not be postponed indefinitely. Dental cleaning is certainly one of those. Others are operations to correct chronic pain or to forestall a future emergency. Now, you're certainly welcome to think that we should continue pushing those kind of visits/procedures out indefinitely but health officials in most places disagree.I'm being quite conservative in general but I have gone back to the dentist since they reopened.
- insickness 6y ago
  Sounds like your definition of denialism is anyone who wants to end the quarantine faster than you do--or at all.
jonnycat 6y ago
Given the innovation we've seen from some industries in these times, I'm surprised I haven't seen any in dentistry. I'm probably just naïve about the challenges – or maybe it's happening and I'm just not aware. But I'm surprised my family (3 dental offices between us) hasn't gotten any emails from our dentists selling cleaning kits with elaborate instructions or offering Zoom consultations where they ask the same old questions they'd be asking at a cleaning, planning treatment, etc. Yes, I realize these things are no replacement for regular cleanings or appointments, but certainly they'd be better than... nothing?
- ghaff 6y ago
  I'm pretty sure many dentists are open to remote consultations. I know my doctor is. I assume my dentist would be as well. I'm not sure what remote cleaning would look like other than "Be particularly observant to your brushing and flossing." I imagine untrained people hacking around with dental tools would cause more harm than good.

18 points by prostoalex 6y ago

mnm1 6y ago

Dentistry is the last industry I'd watch as a harbinger of the economy. Going to the dentist is truly playing russian roulette with corona. The aerosolization of particles is inevitable as is inhaling them. If there is corona to be aerosolized and transmitted, it will be. I can't imagine anyone getting elective dentistry right now. Then again, many Americans seem to have a death wish right now and would risk their lives for a cleaning.

toomuchtodo 6y ago
Most Americans will get COVID, and the risk of death is exceedingly low (0.3%). “Death wish” is exaggerating the situation. If you’re young and healthy (or even middle aged and healthy), it’s reasonable to take what others interpret as risky actions.
- gberger 6y ago
  Are you predicting 500-900k deaths in the USA due to COVID-19?
  - toomuchtodo 6y ago
    Not a domain expert, so I make no predictions myself but do consume data from subject matter experts on the topic. Healthy middle aged person who wears a mask in public but goes about his life with his family as if nothing happened. Haven’t gotten COVID, but if I do, I’ll take sick days and move on. What else would you expect people to do, hide inside forever? Curve was flattened, there’s no appetite to do so further if necessary, life goes on (or it doesn’t).
    - criddell 6y ago
      You don't think we would be better off if we had been as aggressive as countries like South Korea?
      - toomuchtodo 6y ago
        I think we would, but we won’t, so that’s what folks will optimize for (“open for business”). Can’t fault people for responding to incentives and policy accordingly.
        criddell 6y ago
        It's hard for me to reconcile that you educate yourself by reading what experts are saying and you still are going about your life as if nothing had happened. Are the policies and incentives so powerful that it's overriding your knowledge that you and your neighbors would be better off if you continued to self-quarantine as much as possible?
        amluto 6y ago
        Will we be better off if we self-quarantine as long as possible? Under the assumption that a fixed percentage of Americans will get COVID-19 in the long run and that treatments will not improve, then self-quarantining may delay getting it and has some chance of pushing those who self-quarantine more effectively into the not-getting it category but will make little difference to the overall mortality rate. So, for increased isolation to make a big difference, something has to break one of those assumptions. Possibilities include: A vaccine. This may well happen in under a year. How much of a difference this makes will depend on the efficacy of a vaccine and how many people get it. Improved treatments. Some experts seem optimistic about monoclonal antibodies. Cost, production, and ability to administer early enough in the course of the disease are still unknown. Living in a country that is actually suppressing the disease. Countries that have competently managed COVID-19 are not on a course that will eventually infect a large fraction of the population. It seems likely that if all countries were this competent, then COVID-19 could be eradicated without a vaccine.
- nickthemagicman 6y ago
  This is so true. Yet you're being downvoted. I don't understand it.
  - deleted 6y ago
    [deleted]
- throwaway_pdp09 6y ago
  Where did 0.3% come from.
  - toomuchtodo 6y ago
    https://www.worldometers.info/coronavirus/coronavirus-death-rate/ https://www.worldometers.info/coronavirus/coronavirus-death-... > As of May 1, 23,430 people are estimated to have died out of a total population of 8,398,748 in New York City. This corresponds to a 0.28% crude mortality rate to date, or 279 deaths per 100,000 population, or 1 death every 358 people. Note that the Crude Mortality Rate will continue to increase as more infections and deaths occur (see notes under the paragraph "Herd Immunity" below for details). From a Google search of “Covid mortality rate”. As a healthy person, I would remain comfortable even if the death rate is substantially higher under the assumption that one can’t self quarantine forever and infection is inevitable.
    - throwaway_pdp09 6y ago
      From your own link: "Infection Fatality Rate (IFR) = Deaths / Cases = 23,430 / 1,694,781 = 1.4% (1.4% of people infected with SARS-CoV-2 have a fatal outcome, while 98.6% recover)" So 1.4%, about 4.67 times higher than what you say. That said I may have misunderstood so corrections welcome.
      - toomuchtodo 6y ago
        Not a domain expert, perhaps I misinterpreted the rate posted (CMR vs IFR). I’m still comfortable with those odds you commented with (1.4%). If I was twice my age or had underlying health issues, I might be more concerned, but this falls within my personal risk tolerance. https://www.nytimes.com/2020/05/22/well/live/putting-the-risk-of-covid-19-in-perspective.html https://www.nytimes.com/2020/05/22/well/live/putting-the-ris... (New York Times: Putting the Risk of Covid-19 in Perspective)
        throwaway_pdp09 6y ago
        You're assuming rather a lot. I don't want to be alarming etc. but you're being a touch complacent. https://www.bbc.co.uk/news/uk-scotland-52506669 https://www.bbc.co.uk/news/uk-scotland-52506669 She said: "We are seeing that patients are suffering from moderate to severe acute kidney injury in about 20-30% of patients and 30% of patients who are admitted to intensive care for Covid infection are requiring dialysis so the numbers are much bigger than we envisaged based on the data coming out of China." (published May 2nd) It's not die-or-recover-completely.
- mnm1 6y ago
  A death wish is not necessarily for oneself. Most Americans are wishing death upon others. Statistically, the younger and healthier, the more likely they are to kill someone else rather than themselves. Doesn't make it any less risky or horrifying. Well, it does to many Americans who simply do not care if their actions kill others. It's part of the culture as can be readily seen now and in the past.
erulabs 6y ago
I think the key word is "elective" here. I've been scheduled for an implant for ~4 months now, and waiting for things to calm down before getting it done - but it's not exactly "elective" - there are serious health consequences of not getting the work done - it will be more painful and more expensive the longer I wait. So I get to balance increased pain with increased risk of infectious disease. Compared to most things, it's absolutely a legitimate barometer of how safe I feel doing the riskiest activities _that I have to do_.
- ghaff 6y ago
  I'm pretty much in the same boat. I was scheduled for a crown when things shut down. After they opened, they called me to reschedule. Sure I could hold off some number of months but I actually had some temporary sensitivity in the tooth so it seemed reasonable on balance to go ahead and get it done. (And, if I were in the office for the temporary crown anyway, I might as well get my rescheduled cleaning done anyway which is also "elective" up to some point, but who knows what outbreaks could happen that shut things down again. So, yes, it's a risk but it seems a reasonable calculated one. Others may of course disagree.
- DanBC 6y ago
  > but it's not exactly "elective" - there are serious health consequences of not getting the work done That's what "elective" means. Planned in advance, non-emergency.
cat199 6y ago
"How long it takes those jobs to come back entirely will be a crucial indicator of whether Americans feel safe returning to normal activities, and if they have the economic means to do so. “I’m obsessed with dentists because, if the only thing we’re doing is putting the economy on pause, and then going back to normal, all of them should be coming back,” Ms. Stevenson said. “We’re not really recovered until all the dentists are back to work.”
ghaff 6y ago
A lot of dentistry is elective just like other forms of preventative care. But that doesn't mean you should push it off indefinitely. And if you look at the various projections, it increasingly doesn't look as if pushing this sort of thing out a couple of months will necessarily get you to the point where "everything's fine!" People don't go to dentists because it's a fun but unnecessary activity.
matz1 6y ago
Death wish ? That's seems like huge exaggeration isn't it ? This virus is not like ebola where you most likely will be dead if you get it.
- praiseDang 6y ago
  OP may be obese, sick, or old. For these groups, Coronavirus might be a death sentence.

claudeganon 6y ago

What’s strange to me about all these stories is their veiled, counterfactual suggestion that any of this is really safe given the trajectory the US is on. If the US had reacted early and competently, like South Korea, New Zealand, Taiwan, or many other countries, people could be going to dentists without too much concern. But we didn’t, are on a bad and dangerous path, and now have to somehow pretend that we’re not, based solely on popular sentiment. The reality of COVID-19, how it spreads, and what’s proven to quash it have absolutely nothing to do with how people feel about the pandemic.

postalrat 6y ago
Is it a coincidence that all the countries you listed are more or less islands?
- claudeganon 6y ago
  South Korea is an island? That’s news to me. Their major COVID outbreak started about the same time as our’s. See also Vietnam. And they both share a border with China. https://en.m.wikipedia.org/wiki/COVID-19_pandemic_in_Vietnam https://en.m.wikipedia.org/wiki/COVID-19_pandemic_in_Vietnam
  - SpicyLemonZest 6y ago
    South Korea does not share a border with China.
    - deleted 6y ago
      [deleted]
  - dctoedt 6y ago
    South Korea's only land border is with North Korea. The GP was correct that (in this context) for practical purposes South Korea is an "island" because there's relatively little land travel between North- and South Korea. Map: https://www.google.com/maps/d/viewer?ie=UTF8&hl=en&source=embed&msa=0&ll=35.9302740559874%2C129.32957000000002&spn=4.443673%2C9.831391&mid=1Bu81fI2lSAp-feL9JbPvY6gw3eI&z=7 https://www.google.com/maps/d/viewer?ie=UTF8&hl=en&source=em...

doliveira 6y ago

What is the deal with this denialism on Hacker News? Suddenly it seems everyone here incarnated the Elon Musk spirit.

jrobn 6y ago
Combination of disinformation, “entitle-ism”, denial, and money.
LiquidSky 6y ago
The Hacker News crowd tends to be pretty well off, so I imagine it’s that classic Upton Sinclair quote: “It is difficult to get a man to understand something when his salary depends on his not understanding it.”
ghaff 6y ago
You don't need to be denialist to think that it may be appropriate to get back to delayed medical procedures.
- doliveira 6y ago
  I assume emergency procedures are still being done.
  - ghaff 6y ago
    I'm not sure what that statement has to do with mine. Many medical procedures/visits that don't need to happen right now should nonetheless not be postponed indefinitely. Dental cleaning is certainly one of those. Others are operations to correct chronic pain or to forestall a future emergency. Now, you're certainly welcome to think that we should continue pushing those kind of visits/procedures out indefinitely but health officials in most places disagree.I'm being quite conservative in general but I have gone back to the dentist since they reopened.
insickness 6y ago
Sounds like your definition of denialism is anyone who wants to end the quarantine faster than you do--or at all.

jonnycat 6y ago

Given the innovation we've seen from some industries in these times, I'm surprised I haven't seen any in dentistry. I'm probably just naïve about the challenges – or maybe it's happening and I'm just not aware. But I'm surprised my family (3 dental offices between us) hasn't gotten any emails from our dentists selling cleaning kits with elaborate instructions or offering Zoom consultations where they ask the same old questions they'd be asking at a cleaning, planning treatment, etc. Yes, I realize these things are no replacement for regular cleanings or appointments, but certainly they'd be better than... nothing?

ghaff 6y ago
I'm pretty sure many dentists are open to remote consultations. I know my doctor is. I assume my dentist would be as well. I'm not sure what remote cleaning would look like other than "Be particularly observant to your brushing and flossing." I imagine untrained people hacking around with dental tools would cause more harm than good.