17 ms·

Coronavirus: Why Everyone Was Wrong

15 points by hudon 6y ago

lbeltrame 6y ago
A few good points (like the PCR detecting only RNA which does not equate to live virus) in a sea of "interesting" spin about the current data. I really don't understand why it's "us vs them" in either camp ("doom and gloom" and "skeptics"). This makes things worse, since both camps tend to quote only evidence which support their respective claim (two examples: the Guardian saying that asymptomatic people spread more virus than the symptomatic ones, despite the study they quote saying that it can't be said, because they did not check for live virus; and some web page called "Swiss policy research" which quotes only the parts of the studies which conform to the "skeptical" narrative).
- Zenst 6y ago
  Indeed, with so much published stuff about it and still so much in the unknown and with that, our best evidence so far is what is published. then the ability to cherry pick across many sources of published data/reports and stitch together those in a way that you could make so many things appear legit, well. It really don't help as other people will just reference the sewn together published article and propagate from their. Vague news is after all, latent fake news most of the time alas.
danlugo92 6y ago
Less than 2% mortality for those under 65 years of age in developed countries. I think we should have only quarantined the elderly.
- rogerkirkness 6y ago
  The CFR is under 2%, the IFR is way less than this for people under 67 years old who don't have other conditions.
  - rurban 6y ago
    A good ballpark number is the IFR being a tenth of the CFR. And for under 65 divide by hundred.
- NotSammyHagar 6y ago
  Let's separate the mortality rate from the actual impacts, which are multiple. The hospitals in multiple places are overwhelmed for months with cv19 cases. The mortality doesn't matter when NYC, much of Italy and Spain, and now Texas and Florida hospitals are overfull with patients being treated for cv19, and other patients are hurt because they can't be treated or are afraid to go. There is excess deaths (ie more people dying than would otherwise, more than a typical flu year). In the us we went through a long period of shutdown and we still ended up with this happening in several places. If we only quarantined the elderly, we'd still have this happening, but it would have been much much worse. Even if the death rate ends up being low, like 2%, we'll still kill a lot of people through hospitalization overload. That's why we need to social distance and wear masks - we don't need to wear masks only if the death rate is > 2%. It's to decrease the whole impact. Plus when this article was written it was back in the magical thinking period that somehow in the summer the incidence would go to almost 0. We now see that it's still very infectious and will be ruining people's lives for a long time.
  - tripletao 6y ago
    The IFR is far below 2% for young people--a recent meta-analysis[1] got 0.7% over all ages. That study didn't break it down by age, but an older one that did[2] (and got a similar IFR over all ages) got 0.14% for <60 years old, mostly from the older end of that. There's moderate evidence for seasonality, from studies comparing countries with different climates and trying to control for other factors, trying to regress against actual weather over weeks, etc. That's empirically not enough to bring R < 1 in the summer in the USA in combination with whatever we've been doing, but a big effect might still be there--we might just have relaxed the social distancing by enough to more than offset. If that's the case, then we're potentially in for a terrible fall and winter (and places that have built up some degree of herd immunity--whether quasi-intentionally like Sweden or accidentally like NYC--could end up better off in the end). As to excess deaths: As far as I understand, most of those actually observed are probably unconfirmed coronavirus deaths, rather than unrelated deaths due to an overrun medical system or people afraid to seek care. I've seen speculation that the latter may occur, but no strong evidence (since even NYC barely occupied the Navy hospital ship or other temporary facilities, and since no excess deaths have been seen in areas with the lockdowns that would discourage people from seeking care but without big coronavirus prevalence). To be clear, I'm strongly pro-mask, and pro-social-distancing. (I do think stuff like factory and school closures comes at an unacceptable social cost for the benefit to public health, though that's been reversed most places.) I just want to make the argument with the right facts. 1. https://www.medrxiv.org/content/10.1101/2020.05.03.20089854v4.full.pdf https://www.medrxiv.org/content/10.1101/2020.05.03.20089854v... 2. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext https://www.thelancet.com/journals/laninf/article/PIIS1473-3...
- Zenst 6y ago
  The driving factors for lockdown was driven by the need to manage hospital resources, and had they not had a lockdown, many who would've needed hospital admission would of not got that and the mortality rate would of escalated much more with people who would of survived with intervention being cut off from that support as it was saturated. Once you get to that stage, people lose hope, panic, riot and it would of been far worse IMHO. FWIW I worked on https://en.wikipedia.org/wiki/The_Good_Judgment_Project https://en.wikipedia.org/wiki/The_Good_Judgment_Project for the COVID project, so seen lots of data and projections.
- rsynnott 6y ago
  Totally cutting off everyone over 65 from contact with everyone under 65, for months, is impractical. The UK briefly considered this before backing rapidly away. And, er, 2% isn’t nothing.
jgilias 6y ago
It's funny in a sad way to read an article like this one now a month later when it has become very clear that the virus comes back with vengeance in places that have lifted restrictions summer or no summer. Also, the semantics of whether it can be called novel or not doesn't matter one iota when the virus-caused pneumonia overwhelms medical systems in mere weaks if left to roam unchecked.
- glofish 6y ago
  it really sounds like the youth got sick and tired of the lock-down and would rather get sick than continue with the never ending prison like conditions it probably is the right course of action - even though ethically no official can suggest that the paper is supported in the sense that everyone is wrong about how dangerous the disease is, and whether people should be allowed to decide what risk they are willing to take
  - NotSammyHagar 6y ago
    I disagree with your last point - this is very infectious and because we can't know in many cases if we are carrying it, it's incumbent on everyone to protect others by wearing a mask. Because many don't know they have it, it's different than the flu where ordinary flu often has clear symptoms before infectiousness starts.
    - glofish 6y ago
      the "mask" is the red herring of every discussion. It is a talisman that people cling to as a way to ward off any of the ills. I happen to be convinced that some types of masks, like the reusable cloth masks actually make you sicker. Here is a well research piece with a randomized trial that shows how continuously worn cloth masks are worse than using them more rarely (control) (leading to 4% more infections): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/ Of course I don't expect this research to be quoted in the current hysterical environment. But I would not be surprised if by this time next year the world will be full with publications on how cloth masks cause more trouble than worth with a strong recommendation to avoid them.
nextaccountic 6y ago
> Those young and healthy people who currently walk around with a mask on their faces would be better off wearing a helmet instead, because the risk of something falling on their head is greater than that of getting a serious case of Covid-19. I'm healthy and young and I might not die from Covid. But if I catch it I will almost certainly kill my mother.
- glofish 6y ago
  Or she will have no symptoms at all. You have no basis to expect that it will kill her, or that she will even manifest any serious symptoms. Remember the vast majority of people have mild symptoms, the CDC stated that the actual number of cases is about 10x of the reported ones. It is hard to believe but 30% of nursing home residents infected with the disease were also asymptomatic. That in turn was one of the early confounding factors that made the spread in the nursing homes so hard to identify.
- rurban 6y ago
  "Certainly" being 1%. We must have different opinions on certainty.
  - soganess 6y ago
    Baring some grand miscalculation on my part, I'd likely win the wager that you don't actually know their mother or the comorbidities she might have that lead them to that conclusion. They are likely overestimating her odds of death, but your flippant response without knowledge or her situation is more than certainly underestimating it. Humans overvalue perspective lose to themselves, it's one of our worse traits. That said, we also presuppose knowledge we can't fathom to have. I believe both were on display just now. And for $deity's sake, we're living through an unprecedented pandemic, this person is worried about the well-being of their family, have some compassion. To the grandparent poster: I worry about that as well. :/
- tripletao 6y ago
  Either there's something very unusual about your personal situation, or you're using "almost certainly" to mean "well under ten percent", or your statement is simply false. Estimates of the household secondary attack rate vary but are typically low tens of percent[1][2], and the IFR even for patients >80 years old is about 8%[3]. The probability that your mother would die if you became infected is the product of those two. To be clear, I wear a mask and I support orders requiring that, since the cost of mask-wearing seems very small to me in exchange for the possible benefit. (If anyone finds a mask uncomfortable, I'd suggest a better mask. Surgical-style masks are much easier to breathe through than fabric, and widely available near pre-pandemic prices.) We should avoid hyperbolic, misleading, or false statements in support of a noble cause, though. 1. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30471-0/fulltext https://www.thelancet.com/journals/laninf/article/PIIS1473-3... 2. This is unintuitive given the close contact sharing a household and R0 = 2.5, but consistent with the theory that spread is driven by a small fraction of super-spreaders, while most infected transmit the disease to no one at all. 3. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext https://www.thelancet.com/journals/laninf/article/PIIS1473-3...
NotSammyHagar 6y ago
It's hard to get past this being another wrong medium article that doesn't match reality. Why does covid19 attract so many quacks who cant help but argue that it's no problem really, go on about your lives (with 130k dead in the us, 600k dead in the world). It's actually a problem. It hasn't gone away somehow, even with massive amounts of magical thinking for the past 6 months. Edit: we're actually a week away from reaching 600k, per https://www.worldometers.info/coronavirus/#countries https://www.worldometers.info/coronavirus/#countries. Will it take 200k dead in the us before we can stop arguing it's no big deal? A million in the world?
- glofish 6y ago
  The 1 million deaths are a big deal only because it may include rich white people or even, gasp, you and I. This is the only reason this number is quoted with such an incredulity. Throughout history we have had and we continue to have far bigger problems than that. Did you know that 20K people DIE every day of hunger (9 million per year)? And this has happened like so for the past twenty years? Where is the counter for that? Why aren't we locking everything down until we fix that? I tell you why, because you and I are at zero risk of dying of hunger. Stating that 1 million deaths is a big deal sounds extremely hollow.
  - NotSammyHagar 6y ago
    Thanks for posting that. More than 4 million dead already from hunger this year [1], that's an even more horrible statistic. Yes, we need to continue to fight that. I'm that typical person in the west who, might send money to international food aid charities, but doesn't know what else to do. I think increasing democracy around the world could help and fewer wars can lead to stability and improved lives. 9 or 10 million a year is such a large number it's unbeliveable. The fact that it's improved tremendously over time [2] doesn't excuse continuing to work on it to help our fellow humans. I'm mostly just fortunate to be born in a prosperous country, through no action of my own. 1. https://www.theworldcounts.com/challenges/people-and-poverty/hunger-and-obesity/how-many-people-die-from-hunger-each-year https://www.theworldcounts.com/challenges/people-and-poverty... 2. https://ourworldindata.org/uploads/2013/10/Famine-death-rate-since-1860s.png https://ourworldindata.org/uploads/2013/10/Famine-death-rate...
croes 6y ago
In the middle of a pandemic he suddenly realizes why everyone was wrong and now he is right. I totally believe him ... not. The long term effects of the virus are still unknown, if infected have long term immunity is unknown.
moistly 6y ago
I find it discouraging that exceptionally little is said about the outcomes for those who survive a bad case. IMNSHO, the big scare isn’t death, it’s being out of breath for the rest of a considerably shorter life, or being tied to a dialysis machine, or being perpetually foggy brained and easy to anger, etc. The long-term damage to the country will be from damage to survivors, not from deaths.

15 points by hudon 6y ago

A few good points (like the PCR detecting only RNA which does not equate to live virus) in a sea of "interesting" spin about the current data. I really don't understand why it's "us vs them" in either camp ("doom and gloom" and "skeptics"). This makes things worse, since both camps tend to quote only evidence which support their respective claim (two examples: the Guardian saying that asymptomatic people spread more virus than the symptomatic ones, despite the study they quote saying that it can't be said, because they did not check for live virus; and some web page called "Swiss policy research" which quotes only the parts of the studies which conform to the "skeptical" narrative).

Zenst 6y ago
Indeed, with so much published stuff about it and still so much in the unknown and with that, our best evidence so far is what is published. then the ability to cherry pick across many sources of published data/reports and stitch together those in a way that you could make so many things appear legit, well. It really don't help as other people will just reference the sewn together published article and propagate from their. Vague news is after all, latent fake news most of the time alas.

danlugo92 6y ago

Less than 2% mortality for those under 65 years of age in developed countries. I think we should have only quarantined the elderly.

rogerkirkness 6y ago
The CFR is under 2%, the IFR is way less than this for people under 67 years old who don't have other conditions.
- rurban 6y ago
  A good ballpark number is the IFR being a tenth of the CFR. And for under 65 divide by hundred.
NotSammyHagar 6y ago
Let's separate the mortality rate from the actual impacts, which are multiple. The hospitals in multiple places are overwhelmed for months with cv19 cases. The mortality doesn't matter when NYC, much of Italy and Spain, and now Texas and Florida hospitals are overfull with patients being treated for cv19, and other patients are hurt because they can't be treated or are afraid to go. There is excess deaths (ie more people dying than would otherwise, more than a typical flu year). In the us we went through a long period of shutdown and we still ended up with this happening in several places. If we only quarantined the elderly, we'd still have this happening, but it would have been much much worse. Even if the death rate ends up being low, like 2%, we'll still kill a lot of people through hospitalization overload. That's why we need to social distance and wear masks - we don't need to wear masks only if the death rate is > 2%. It's to decrease the whole impact. Plus when this article was written it was back in the magical thinking period that somehow in the summer the incidence would go to almost 0. We now see that it's still very infectious and will be ruining people's lives for a long time.
- tripletao 6y ago
  The IFR is far below 2% for young people--a recent meta-analysis[1] got 0.7% over all ages. That study didn't break it down by age, but an older one that did[2] (and got a similar IFR over all ages) got 0.14% for <60 years old, mostly from the older end of that. There's moderate evidence for seasonality, from studies comparing countries with different climates and trying to control for other factors, trying to regress against actual weather over weeks, etc. That's empirically not enough to bring R < 1 in the summer in the USA in combination with whatever we've been doing, but a big effect might still be there--we might just have relaxed the social distancing by enough to more than offset. If that's the case, then we're potentially in for a terrible fall and winter (and places that have built up some degree of herd immunity--whether quasi-intentionally like Sweden or accidentally like NYC--could end up better off in the end). As to excess deaths: As far as I understand, most of those actually observed are probably unconfirmed coronavirus deaths, rather than unrelated deaths due to an overrun medical system or people afraid to seek care. I've seen speculation that the latter may occur, but no strong evidence (since even NYC barely occupied the Navy hospital ship or other temporary facilities, and since no excess deaths have been seen in areas with the lockdowns that would discourage people from seeking care but without big coronavirus prevalence). To be clear, I'm strongly pro-mask, and pro-social-distancing. (I do think stuff like factory and school closures comes at an unacceptable social cost for the benefit to public health, though that's been reversed most places.) I just want to make the argument with the right facts. 1. https://www.medrxiv.org/content/10.1101/2020.05.03.20089854v4.full.pdf https://www.medrxiv.org/content/10.1101/2020.05.03.20089854v... 2. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext https://www.thelancet.com/journals/laninf/article/PIIS1473-3...
Zenst 6y ago
The driving factors for lockdown was driven by the need to manage hospital resources, and had they not had a lockdown, many who would've needed hospital admission would of not got that and the mortality rate would of escalated much more with people who would of survived with intervention being cut off from that support as it was saturated. Once you get to that stage, people lose hope, panic, riot and it would of been far worse IMHO. FWIW I worked on https://en.wikipedia.org/wiki/The_Good_Judgment_Project https://en.wikipedia.org/wiki/The_Good_Judgment_Project for the COVID project, so seen lots of data and projections.
rsynnott 6y ago
Totally cutting off everyone over 65 from contact with everyone under 65, for months, is impractical. The UK briefly considered this before backing rapidly away. And, er, 2% isn’t nothing.

jgilias 6y ago

It's funny in a sad way to read an article like this one now a month later when it has become very clear that the virus comes back with vengeance in places that have lifted restrictions summer or no summer. Also, the semantics of whether it can be called novel or not doesn't matter one iota when the virus-caused pneumonia overwhelms medical systems in mere weaks if left to roam unchecked.

glofish 6y ago
it really sounds like the youth got sick and tired of the lock-down and would rather get sick than continue with the never ending prison like conditions it probably is the right course of action - even though ethically no official can suggest that the paper is supported in the sense that everyone is wrong about how dangerous the disease is, and whether people should be allowed to decide what risk they are willing to take
- NotSammyHagar 6y ago
  I disagree with your last point - this is very infectious and because we can't know in many cases if we are carrying it, it's incumbent on everyone to protect others by wearing a mask. Because many don't know they have it, it's different than the flu where ordinary flu often has clear symptoms before infectiousness starts.
  - glofish 6y ago
    the "mask" is the red herring of every discussion. It is a talisman that people cling to as a way to ward off any of the ills. I happen to be convinced that some types of masks, like the reusable cloth masks actually make you sicker. Here is a well research piece with a randomized trial that shows how continuously worn cloth masks are worse than using them more rarely (control) (leading to 4% more infections): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/ Of course I don't expect this research to be quoted in the current hysterical environment. But I would not be surprised if by this time next year the world will be full with publications on how cloth masks cause more trouble than worth with a strong recommendation to avoid them.

nextaccountic 6y ago

> Those young and healthy people who currently walk around with a mask on their faces would be better off wearing a helmet instead, because the risk of something falling on their head is greater than that of getting a serious case of Covid-19. I'm healthy and young and I might not die from Covid. But if I catch it I will almost certainly kill my mother.

glofish 6y ago
Or she will have no symptoms at all. You have no basis to expect that it will kill her, or that she will even manifest any serious symptoms. Remember the vast majority of people have mild symptoms, the CDC stated that the actual number of cases is about 10x of the reported ones. It is hard to believe but 30% of nursing home residents infected with the disease were also asymptomatic. That in turn was one of the early confounding factors that made the spread in the nursing homes so hard to identify.
rurban 6y ago
"Certainly" being 1%. We must have different opinions on certainty.
- soganess 6y ago
  Baring some grand miscalculation on my part, I'd likely win the wager that you don't actually know their mother or the comorbidities she might have that lead them to that conclusion. They are likely overestimating her odds of death, but your flippant response without knowledge or her situation is more than certainly underestimating it. Humans overvalue perspective lose to themselves, it's one of our worse traits. That said, we also presuppose knowledge we can't fathom to have. I believe both were on display just now. And for $deity's sake, we're living through an unprecedented pandemic, this person is worried about the well-being of their family, have some compassion. To the grandparent poster: I worry about that as well. :/
tripletao 6y ago
Either there's something very unusual about your personal situation, or you're using "almost certainly" to mean "well under ten percent", or your statement is simply false. Estimates of the household secondary attack rate vary but are typically low tens of percent[1][2], and the IFR even for patients >80 years old is about 8%[3]. The probability that your mother would die if you became infected is the product of those two. To be clear, I wear a mask and I support orders requiring that, since the cost of mask-wearing seems very small to me in exchange for the possible benefit. (If anyone finds a mask uncomfortable, I'd suggest a better mask. Surgical-style masks are much easier to breathe through than fabric, and widely available near pre-pandemic prices.) We should avoid hyperbolic, misleading, or false statements in support of a noble cause, though. 1. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30471-0/fulltext https://www.thelancet.com/journals/laninf/article/PIIS1473-3... 2. This is unintuitive given the close contact sharing a household and R0 = 2.5, but consistent with the theory that spread is driven by a small fraction of super-spreaders, while most infected transmit the disease to no one at all. 3. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext https://www.thelancet.com/journals/laninf/article/PIIS1473-3...

NotSammyHagar 6y ago

It's hard to get past this being another wrong medium article that doesn't match reality. Why does covid19 attract so many quacks who cant help but argue that it's no problem really, go on about your lives (with 130k dead in the us, 600k dead in the world). It's actually a problem. It hasn't gone away somehow, even with massive amounts of magical thinking for the past 6 months. Edit: we're actually a week away from reaching 600k, per https://www.worldometers.info/coronavirus/#countries https://www.worldometers.info/coronavirus/#countries. Will it take 200k dead in the us before we can stop arguing it's no big deal? A million in the world?

glofish 6y ago
The 1 million deaths are a big deal only because it may include rich white people or even, gasp, you and I. This is the only reason this number is quoted with such an incredulity. Throughout history we have had and we continue to have far bigger problems than that. Did you know that 20K people DIE every day of hunger (9 million per year)? And this has happened like so for the past twenty years? Where is the counter for that? Why aren't we locking everything down until we fix that? I tell you why, because you and I are at zero risk of dying of hunger. Stating that 1 million deaths is a big deal sounds extremely hollow.
- NotSammyHagar 6y ago
  Thanks for posting that. More than 4 million dead already from hunger this year [1], that's an even more horrible statistic. Yes, we need to continue to fight that. I'm that typical person in the west who, might send money to international food aid charities, but doesn't know what else to do. I think increasing democracy around the world could help and fewer wars can lead to stability and improved lives. 9 or 10 million a year is such a large number it's unbeliveable. The fact that it's improved tremendously over time [2] doesn't excuse continuing to work on it to help our fellow humans. I'm mostly just fortunate to be born in a prosperous country, through no action of my own. 1. https://www.theworldcounts.com/challenges/people-and-poverty/hunger-and-obesity/how-many-people-die-from-hunger-each-year https://www.theworldcounts.com/challenges/people-and-poverty... 2. https://ourworldindata.org/uploads/2013/10/Famine-death-rate-since-1860s.png https://ourworldindata.org/uploads/2013/10/Famine-death-rate...

croes 6y ago

In the middle of a pandemic he suddenly realizes why everyone was wrong and now he is right. I totally believe him ... not. The long term effects of the virus are still unknown, if infected have long term immunity is unknown.

moistly 6y ago

I find it discouraging that exceptionally little is said about the outcomes for those who survive a bad case. IMNSHO, the big scare isn’t death, it’s being out of breath for the rest of a considerably shorter life, or being tied to a dialysis machine, or being perpetually foggy brained and easy to anger, etc. The long-term damage to the country will be from damage to survivors, not from deaths.