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I thought we already agreed it was mostly aerosol/airborne. I mean influenza is essentially non existent now, but covid is still flying around.
Herd Immunity and Belgium
- Thread starter GeneralVeers
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Yup. This reductionist and defeatist BS is part of the reason we have the problems we do. Yes we’re in for a tough time even if most do a great job masking and staying at home. That doesn’t mean it wouldn’t be much, much worse without those measures. If we had no vaccine on the horizon you could argue that we’d all get it anyways and it’s just important to manage bed capacity. But we do. We are less then 6 months away from vaccines for everyone. Every case we prevent from happening is one potential prevented morbidity or mortality.
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It almost certainly is to a degree. And clearly non N95 masks aren’t perfect protection. But they are a heck of a lot better then nothing.
Maybe you could take a step back, take a breather, and try to counter me with data that backs up your feelings? I know it feels right that having governments do as much as possible just has to help...but what real world results support this gut feeling? Governments are effective in specific situations but not in what’s been done today.
What I said is 100% true.
South korea and taiwan were successful WITHOUT the use of blanket lockdowns...they caught the virus at the start with efficient contact tracing and isolation.
For countries where spread is too far gone, virus will virus as it does- it’s too late. Why else did europe have a big second wave despite harsher restrictions than the US? Why are more restrictive US states having higher deaths and case rates now versus the more open states?
Also, masks absolutely do work. It’s obvious, as covid transmission from patients is negligible among healthcare workers wearing them properly. However, mask mandates don’t work because in the long run, nobody wears them at home or other indoors, and many don’t use them correctly. but I think there’s nothing wrong with having governments impose mask wearing as an advisory, there is no harm in doing so
lockdowns on the other hand are absolutely senseless. Don’t try and hand wave that covid would cause the economy to be just as bad without lockdowns, that’s factually not true. Can you explain why harsher lockdown countries/US states have suffered higher unemployment and worse recession than those with fewer restrictions?
As I said earlier in this thread which no one could respond against:
“It's even more callous to ignore the negative impacts of lockdowns vs actual deaths due to COVID19 infection/life expectancy impact.
"The average age at death for those who died with Covid-19 in Scotland was 79 for men and 84 for women. Elsewhere in the NRS report it showed that life expectancy in Scotland is 77.1 for males and 81.1 for females." Covid death figures: 10 things we've learned
Large scale artificially induced unemployment, businesses destroyed The Effect of Lockdown Measures on Unemployment
Government repression/crushing of protests and increase in riots/unrest/looting People across Italy violently protested new lockdown measures imposed after a spike in COVID-19 cases, setting fires and looting luxury stores Protesters against COVID-19 restrictions clash with police in Spanish cities Chile police using Covid-19 quarantine as pretext to crush protest, activists say
Suicides, depression, anxiety https://www.washingtonpost.com/health/2020/11/23/covid-pandemic-rise-suicides/
Millions of increased deaths due to starvation thanks to artificial economic lockdowns https://www.washingtonpost.com/worl...ds-millions-people-toward-starvation-poverty/
Massive plummet in preventive care, cancer screening which will lead to non-covid deaths in the future https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7436906/
And all this for what? When less restrictive states like Florida perform better in mortality AND economy, better than restrictive states like Illinois, what was the benefit from all this? “
https://www.statista.com/statistics/1109011/coronavirus-covid19-death-rates-us-by-state/
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I'm glad that you're so concerned about access to preventative care, the impact that economics has on nutrition among the poor, and the unacceptable state of mental health services in our country.
Can I count on you to support efforts to improve Americans' access to mental health and preventative care? How about programs to ensure that we don't allow Americans to starve or for children to be malnourished or slowly poisoned by contaminated drinking water?
This is good! I think we're getting somewhere.
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Your problem is your binary thinking. Something works or it doesn’t. COVID is spreading so mask mandates don’t work and so on. When in reality they are beneficial but insufficient alone to stop spread. Also, part of the reason they are in sufficiently effective is limited compliance. That would be like saying we shouldn’t prescribe BP meds since some patients don’t take them.
Also taiwan and other countries were able to avoid mass lockdowns because they had a rapid effective federal response in terms of limiting entry, testing, tracing, and quarantine. Our federal government botched that opportunity, so we’re left with mitigation strategies, all of which are only partially effective without perfect compliance.
Did you read my post?
Not sure how anything you are replying with disagrees with what I said?
1. I wrote that masks DO work but mask mandates don’t work due to a variety of population level factors (ACP Journals). however, because there is no harm in advising mask wearing, nothing wrong with mandates.
2. Also literally what i said, SK and taiwan did NOT impose artificial blanket lockdowns because initial government response with aggressive contact tracing worked. But once the virus HAS spread, it’s too late, and lockdowns won’t be beneficial either.
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So how does saying any of this counter the evidence that lockdowns don’t work and are harmful?
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If you answer my question, I'll answer yours.
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Got it, thanks.
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Should we force patients to take BP meds then? We can recommend wearing masks as an additional measure. I've never had issue that. My issue has always been government making it compulsory with fines/threats of jail.
Sure we botched initial contact tracting and isolation. So did almost every other government in Europe. Add to that Canada, Mexico, Brazil, Russia, and India. It's not a uniquely American problem.
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False equivalence. The analogy was purely to show that compliance is needed for efficacy. Meds shouldn’t be compulsory because you not taking your meds doesnt give me hypertension. You not masking could give me and mine COVID.
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I didn't bring up the BP meds as an example, just pointing out why forcing people to do things is not productive.
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False premise. Show me data that lockdowns don’t work. This is a kind of line that is frequently parroted but not correct. Kind of like voter fraud. Lockdowns have been effective in limiting spread with efficacy being related to compliance and enforcement. Spread tends to occur when restrictions are limited.
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But look at the graph about deaths in Sweden at arbitrary intervals. If those don’t completely make the case against lock downs, I have some data on milk production from Denmark in the 1600s, 1700s, and the 2nd-27th of November 2020 that should absolutely clinch the deal. Can’t argue with data man.
I mean, even Sweden is saying that Sweden's policy doesn't work. I think Sweden knows more about Sweden than I do.
Sweden’s king on coronavirus strategy: ‘We have failed’
Sweden’s king said in a new address that the country’s strategy to slow the spread of COVID-19 has “failed” as the fatality count in the Scandinavian country continues to rise. Carl XVI Gustaf…
thehill.com
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It shouldn't be up to us to prove lockdowns DON'T work. The burden of proof is on the people making the policy and the claims. I want the evidence the lockdowns work as compared to a control where there are no lockdowns. And by working I don't mean temporarily reducing the spread. For a lockdown to "work" it has to lower the overall mortality from the disease in a given population. If we nuke the economy, but end up with the same number of total deaths, then it's all in vain.
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Once again, it's not supposed to be about total deaths it's about preventing hospitals getting overwhelmed.
That said, now that we have 2 effective vaccines it actually could be about saving lives. But until recently that was not the case.
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Right I understand this theory. But it's looking more and more like we will hit a certain mortality regardless of our efforts.
The only truly effective lockdown would have been to shut down the country for an entire year until the vaccine was developed and broadly distributed. That would almost have certainly significantly reduced deaths. Of course the economy would be a smoldering husk at the end of it.
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I just don't understand why it's so hard to understand (I'm not directing this at you VA). Delaying infection and death actually reduces morbidity and mortality because we learn more about the virus, the disease process, infection control, how to treat, what works, what doesn't work, developing a vaccine, etc.
This has been said ad nauseum.
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well fine, I’ll prove it.
NYC pre lockdown. 760 deaths per day.
post lockdown 5 deaths per day
Italy pre lockdown. 500-600 deaths per day. Post lockdown 10 deaths per day.
This is demonstrated around the world. Before you protest, yes this data isn’t perfect. It is confounded by seasonal changes, increasing population immunity over time, changes in individual behavior not as a result of lockdown measures, etc. but it’s the data we have, and we’re not getting a RCT in this area.
The choice is simple. Lockdown and universal masks in hotspots or let more people die or suffer serious illness.
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Fair enough.
But if we're going to be true to burden of proof, then you have the burden of establishing that "lockdowns" have caused economic harm.
Alternative theories include: regression to the mean after a decade of unprecedented growth, Trump's economic policy, and (as mentioned above) consumers being afraid of dying.
In fact, economists predicted this downturn before we heard anything about SARS CoV2: Remember the inverted yield curve that made news in December 2019? I do.
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I agree with you. Lockdown and reducing human interaction stop the spread and deaths.... Temporarily. That wasn't my argument.
Wrong. Deaths don’t change in the long run, lockdowns or not.
Virus is gonna virus, because humans are humans- the population cannot be made to obey mandate commands like a robot in perpetuity.
Here’s actual data:
A Model to Explain Statewide Differences in COVID-19 Death Rates
COVID-19 death rates per 100,000 vary widely across the nation. As of September 1, 2020, they range from a low of 4 in Hawaii to a high of 179 in New Jersey. Al
papers.ssrn.com
“Notice in Figure 3 that in quintiles Q1 and Q4, states with higher mean mandate scores experienced higher increases in mean death rates. But quintiles Q2, Q3, and Q5 show that states with lower mandate scores had higher increases in mean death rates. The fact that there is no general tendency for states with higher (lower) mandate scores to exhibit lower (higher) death rates suggests that, at least at the state level, the efficacy of impairing mandates is not empirically supported.”
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Wrong. Deaths don’t change in the long run, lockdowns or not.
Virus is gonna virus, because humans are humans- the population cannot be made to obey mandate commands like a robot in perpetuity.
Here’s actual data:
A Model to Explain Statewide Differences in COVID-19 Death Rates
COVID-19 death rates per 100,000 vary widely across the nation. As of September 1, 2020, they range from a low of 4 in Hawaii to a high of 179 in New Jersey. Alpapers.ssrn.com
“Notice in Figure 3 that in quintiles Q1 and Q4, states with higher mean mandate scores experienced higher increases in mean death rates. But quintiles Q2, Q3, and Q5 show that states with lower mandate scores had higher increases in mean death rates. The fact that there is no general tendency for states with higher (lower) mandate scores to exhibit lower (higher) death rates suggests that, at least at the state level, the efficacy of impairing mandates is not empirically supported.”
Saying “wrong” or “virus gonna virus” doesn’t make it so. It is simple math. More people get the virus before they get a vaccine means more hospitalizations and deaths. Fewer people getting it means fewer deaths. We are trying to buy time to vaccinate the population. Unless you are arguing that nothing in human behavior can alter viral spread, your “virus gonna virus” is simply factually wrong.
Your data points are interesting, but you may be reversing causality. By that I mean places with the worst outbreaks then put in the most restrictions, so have a higher lockdown score. Not that the lockdown failed to prevent the outbreak. I do think that there is a reasonable argument that much of the country was too tight in restrictions when case volumes were good, and too loose when things blew up, but that’s for another time.
Do you also realize lockdown orders are often placed AFTER new cases were already naturally falling...which leads to politicians and people like you to conclude that lockdowns must have worked.
UK for example:
Yet the opposite is never heard- if cases rise during lockdowns, I don’t hear anyone saying that means lockdowns are NOT .
Like In CA, cases continue to explode...despite increasing mandates weeks ago...
California breaks daily coronavirus case record again as deaths continue to rise
Friday's 53,326 new coronavirus cases in California represented another single-day high, and more than 1,500 people have died in the last week — 7% of the state's total COVID-19 deaths.
State Issues Limited Stay at Home Order to Slow Spread of COVID-19 | California Governor
Non-essential businesses and personal gatherings are prohibited between 10 PM and 5 AM beginning Saturday, November 21 at 10 PM SACRAMENTO – In light of an unprecedented, rapid rise in COVID-19 cases…
You ain’t getting it.
virus gonna virus is simply a quick way of saying on a population level, human beings will do as they please.
masks work really really well. I wear a simple surgical mask seeing covid patients day in and day out (unless nebs, intubated or high flow/nippv) and myself nor any my colleagues or nurses have contracted covid..from work
instead, 1/3 of my group/their family have gotten covid over time because of community household spread. Their nanny got it so their spouse got it and they got it. Their kid got it so they are barred from working. Etc. Now why is that happening? Weren’t mask mandates or stay at home orders and closing businesses supposed to work??
It’s simple. People gonna do what they want. NOBODY will wear a mask in their home and that’s how it spreads. Doesn’t matter squat if you keep yours on going to Target, but you keep it off while visiting your sister in the next town over.
I mean.. look at the politicians in charge who tell everyone to stay home yet they couldn’t help themselves from flying to another state to visit grandma for thanksgiving...it’s human freaking nature
Is this a joke...lockdowns 100% will harm the economy more vs no-lockdown
“We find that households living in counties that went into lockdown earlier expect the unemployment rate over the next twelve months to be 13 percentage points higher and continue to expect higher unemployment at horizons of three to five years. They also expect lower future inflation, report higher uncertainty, expect lower mortgage rates for up to 10 years, and have moved out of foreign stocks into liquid forms of savings. The imposition of lockdowns can account for much of the decline in employment in recent months as well as declines in consumer spending.”
..states that didn’t issue stay at home orders (Utah, South Dakota, Nebraska, Iowa, and Arkansas) fared just as well if not better than other states. In particular, Utah and Nebraska did extraordinarily well maintaining a 4.5% and 4.8% unemployment rate, respectively while keeping death rates low.
In contrast, pro-lockdown states like New York, California, and Massachusetts saw catastrophic unemployment numbers, 15.9%, 13.3%, and 16.1% respectively, alongside high COVID-19 death rates
Perhaps the most disheartening cases are states like Maine, which issued stay at home orders and overall maintained a high amount of government involvement. The state saw very little cases and deaths much like its neighbors Vermont and New Hampshire.
All three of these states maintained relatively strict lockdowns even as cases as well as deaths remained low. Instead of being able to live out the pandemic in relative peace, the lockdown policies brought about economic devastation as seen by the 9.9%, 8.3%, 8.1% unemployment rates, respectively. The Maine Policy Institute released a report detailing the unnecessary damage such policies brought on the state in their report.
A Closer Look at the States that Stayed Open
"There is no definitive evidence to suggest that stay at home orders are effective at addressing COVID-19. Furthermore, the United States experiment with the policy has yielded results that are not favorable to Dr. Fauci’s suggestion regarding the nationwide implementation of stay at home...
www.aier.org
The Effect of Lockdown Measures on Unemployment
Do the timing and length of lockdowns explain state-level differences in unemployment?
www.richmondfed.org
This paper evaluates the short-term labour market impact of the COVID-19 containment measures in Germany. By assessing the treatment effect on unemployment via difference-in-difference estimation, we find that 60% of the considerably increased inflows from employment into unemployment in April 2020 were due to the shutdown measures.
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Wrong. Deaths don’t change in the long run, lockdowns or not.
Virus is gonna virus, because humans are humans- the population cannot be made to obey mandate commands like a robot in perpetuity.
Here’s actual data:
A Model to Explain Statewide Differences in COVID-19 Death Rates
COVID-19 death rates per 100,000 vary widely across the nation. As of September 1, 2020, they range from a low of 4 in Hawaii to a high of 179 in New Jersey. Alpapers.ssrn.com
“Notice in Figure 3 that in quintiles Q1 and Q4, states with higher mean mandate scores experienced higher increases in mean death rates. But quintiles Q2, Q3, and Q5 show that states with lower mandate scores had higher increases in mean death rates. The fact that there is no general tendency for states with higher (lower) mandate scores to exhibit lower (higher) death rates suggests that, at least at the state level, the efficacy of impairing mandates is not empirically supported.”
It's almost like grouping politically, socially, and population density disparate states into arbitrary quintiles and ignoring the temporal effects of high death rates on implementation and scope of state mandates produces junk data. Are you planning on showing any data that directly supports your point?
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wait...it looks like we agree!
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Well I mean you are immune from facts and counter-arguments.
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Sweden did the right thing. They prioritized the whole picture rather than focusing narrowly on tight virus control.
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But without lockdown would be 30,000. There's a chart.
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We didn't know if we'd be able to get a decent vaccine before this swept through the whole population, so I'm not sure that should be a consideration.
Also not really sure we've really improved on treatment since March. I'm not on the front lines of this, but hearing ICU and EM folks in other places talk they don't seem to think anything we're doing differently in the last 9 months has made a huge difference. I could be wrong as my sample size is low I'll admit.
Coronaviruses are hardly new, its not like we came up with brand new infection control strategies.
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Not sure about your shop but we're doing lots of things differently.
to name a few off the top of my head:
High flow O2.
Prone positioning.
Permissive hypoxia.
No early intubation.
Remdesivir.
Dexamethasone.
Judicious fluids, not sepsis bolus fluids.
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Yea...well I disagree actually. I think you do delay and flatten the curve to try to make a vaccine. You try...you may not succeed...but you try. If this virus could kill 1% of herd immunity in the world (~66%) of 7,000,000,000 over a few years of infectivity...that's 46M dead. So you do things to try to minimize spread, lower the 1% to 0.1%, etc. A vaccine might be the best way to lower the 1% to 0.1% or even 0.01%.
And while I'm not an expert on treatment, was NYC using all the treatments available in March that we are doing now? They intubated vastly more people, we really didn't know about proning, and dex, rem, tolc, convalescent plasma, and now we even have outpatient treatment with monoclonal antibodies.
The data I wish I had, which I don't ... is hospitalization and ICU mortality in March vs now, especially adjusted for age.
Q: If you were to get COVID-19 and need to be hospitalized, would you want to get in March or now?
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And this is true Coronaviruses have been around for centuries circulating among humans. but they caused minor symptoms like runny nose and URI stuff. So we never cared about it.
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Data from my prior hospital system (which is using everything we’ve developed) shows mortality rate in hospitalized patients to be roughly constant with a slight downward trend from April until now. I think steroids and avoiding early intubation dropped it from 11% to 8% between March and April. We had a further dip in June when our hospital was empty and we were admitting almost everyone that tested positive when we didn’t know remdesivir was the tamiflu of COVID. Once we went back to only admitting hypoxic patients it’s stabilized at 7-8% and remained there since.
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What is the actual asymptomatic spread rate of COVID-19?
A study of 9.9 million people found an symptomatic spread rate of 0.0%.
Nature 11/20/20
“There were no positive tests amongst 1,174 close contacts of asymptomatic cases.”
If it's true the asymptomatic spread rate is 0%, please calculate the maximum percent reduction in spread we can achieve by quarantining people who are asymptomatic and have a 0% chance of spreading the virus?
If it's not 0%, what is the number? Only published, peer reviewed data, please.
Thanks.
A study of 9.9 million people found an symptomatic spread rate of 0.0%.
Nature 11/20/20
“There were no positive tests amongst 1,174 close contacts of asymptomatic cases.”
If it's true the asymptomatic spread rate is 0%, please calculate the maximum percent reduction in spread we can achieve by quarantining people who are asymptomatic and have a 0% chance of spreading the virus?
If it's not 0%, what is the number? Only published, peer reviewed data, please.
Thanks.
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I don’t know the math you’re asking about, but in the real world and not the super controlled environment of China during their lockdown there’s no way to discern between asymptomatic and Presymptomatic cases unless people quarantine away from others.
So if you test positive on day 1, how can you predict that you’re not going to have symptoms on Day 4? I don’t have time to find another article, but I’ve read in multiple sources that most people seem to be the most infectious 2 days before symptoms and then up to 5 days after symptom onset. So those 2-3 days before symptoms start are pretty important to reducing the spread.
Also in the article you posted it says: "Of the 300 asymptomatic positive cases, two cases came from one family and another two were from another family. There were no previously confirmed COVID-19 patients in these two families."
Obviously it’s a very small number, but we might be able to presume from that in the 2 families that had 2 separate people test positive that 1 person gave it to the other person. So yes it did spread.
I think there are still a lot of unknowns but it does seem like people do have a viral load to spread COVID to others a few days before they develop symptoms, so reducing contact with others, especially those at risk during that time period of pre-symptoms is likely a good idea.
https://storage.googleapis.com/plos...8d2cf7ea752e5e0aaf94adc98c59745a15627ea4999c7
Adding: Anecdotally I have a family member who is now dead due to likely Presymptomatic spread. She lived with her daughter and didn’t go out. The daughter did things like errands. The daughter got symptoms and that same day she locked herself in her bedroom and wore a mask when going to the bathroom while her mom was downstairs. They live in another country where you can get tests mailed to your home and she did that and tested positive still while locking herself in her bedroom. Unfortunately the mom still got COVID and is no longer alive, so likely a case of Presymptomatic spread, which you can’t distinguish unless you look 1 week in the future.
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It's an unknowable number for obvious reasons, but apparently high enough that healthy people need to be locked down.
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I'm going off stuff like this: https://forums.studentdoctor.net/th...spf-megathread.1398173/page-142#post-22073406
Because government lockdown policies end up not working and throw people out of work needlessly.
A great and heartbreaking example:
Telling restaurant outdoor dining to close...
But declaring a massive catering/dining area for the “essential business” Good Girls sitcom tv show as ok.
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Yet people in CA keep supporting these hypocritical people who make these decisions. There are plenty of hypocritical Republican governors too......
