In the live address they said that most implementations will be left to the county and local govts. The state isn't giving any specific guidance on masks, for example, leaving that to specific locales.
Pretty sure that's just the City of Los Angeles, not the county. I haven't been to any grocery stores outside DTLA that required masks. (though 7-11 did)
this is probably a little overly cautious relative to the actual reduction in risk (you'd have to be especially unlucky to get infected just from regular breathing in a grocery store), but not terribly unreasonable, particularly for those with co-morbidities.
but i routinely see people with masks and gloves on while walking outside. not shopping, or going to shop, just walking. it's so odd, and frankly, wasteful.
It seems that face masks are quite effective in reducing the spread of illness. For example, look at the numbers in South Korea, Japan, etc. (where mask-wearing is common) compared to ours. Masks don't need to do 100% of the job -- rather, we would hope that in combination with moderate social distancing, better hygiene, improved testing, etc. we could reduce the rate of transmission. If each infected person spreads the illness to an average of only 0.9 others, then it won't do much more damage.
Now, from an economic angle, the US government just passed a $2 trillion stimulus package, which works out to about $6,000 per American. There are calls to spend much more money. Suppose we spend 5% of this on face masks, so $300 per American.
Currently, face masks can be bought at $20 for a box of 50 on Amazon. That gets 750 face masks to every American, at a cost that is cheap relative to the other costs of Covid-19.
And this is ignoring economies of scale. If the government decided to distribute free face masks in every school, every restaurant, in every theater, etc., then it could produce them at much cheaper than 40 cents each.
All in all, it seems like a potentially good investment.
99% of the reduction in transmission comes from physical distancing alone while inside of closed spaces with strangers. hygiene is likely negligible outside of a very few high interaction zones inside those enclosed spaces. testing only improves targeting who to distance (isolate).
it's a virus that rides on tiny masses of water to hopefully jump into the nasopharyngeal cavity of the next host. if it doesn't make it to those warm and juicy brachiae, it exponentially decays to the elements in hours. relative to air, those virus-laden water masses are heavy. most fall at your feet. some fly a few feet. very few make it many feet.
then imagine your chances of making a full-court basket (94 feet, 9.4" diameter ball in 18" hoop) and then divide those odds by the several orders of magnitude smaller that viruses are relative to us.
wearing masks (or gloves) outside makes no sense. you might as well walk around with your own lightning rod too then.
that site serves to reduce anxiety rather than transmission risk. none of the graphs and pull quotes, presumably the strongest arguments they could find, address the added risk reduction of masks above other prevention measures like distancing, and especially not concerning outdoor, non-group settings for the general public.
emergency personnel, medical professionals, and essential business workers should wear masks because they are at elevated, face-to-face risk.
> 99% of the reduction in transmission comes from physical distancing alone while inside of closed spaces with strangers.
This is an extremely strong statement. Although it might be plausibly true, my impression is that the transmission of the disease isn't well enough understood to make such assertions with confidence.
Can you cite a reference for your claim?
I think it is agreed that physical distancing alone while inside of closed spaces with strangers is an extremely good idea. Wearing masks is, potentially, also an extremely good idea.
Shouldn't we adopt any and all measures that have the potential (not certainty; potential is enough) to substantially cut down on Covid-19 transmission, and whose economic and other costs are comparatively modest? Even if we later determine that only one of these measures was really necessary, I doubt that we'll regret our efforts.
"For example, look at the numbers in South Korea, Japan, etc. (where mask-wearing is common) compared to ours."
There seems to be a huge difference in the trajectory of cases in Japan, vs South Korea, so I don't know what you think you're saying, if you group them together. In South Korea, cases went up and then apparently flattened out almost completely. In Japan, the graph I saw has been lower than in other places but is, almost uniquely, not flattening so far, even in the way that Italy or the US has.
So it makes no sense to me to combine them and say "look, that is the example". If one is the example, the other most likely isn't.
I wear masks in public, even though I have no comorbidities, because of all the people I might subsequently spread it to if I got it. Remember that asymptomatic transmission for several days is common.
Putting on a mask takes a few seconds, so compared to all the suffering it might prevent, even at 0.01% probability, it's well worth it.
no one is arguing that you disregard others, especially those who have comorbidities, only that a mask adds negligible risk reduction outside, above and beyond the natural physical distancing of strolling down the sidewalk.
Do you have evidence that risk reduction outside is very small? I haven't seen any, and I think it would be nearly impossible to collect such evidence.
A plausible rule of thumb seems to be: if you could smell someone's cigarette smoke, you could inhale their viruses. I certainly smell smoke from smokers I pass on the street.
there are no studies done, because, as you note, it would be difficult and costly, and it's a simpler (and more easily followable) message to tell people to wear masks all the time.
but here's some additional intuition:
1. it's true that virus particles are roughly the same size as smoke particles, but infected people exhale virus "pucks" that are agglomerations of multiple viruses and water, leading them to fall while smoke floats (giving us the 3-6 foot rule, per prior coronavirus studies).
2. a single virus particle in the air without water could float around but is overwhelmingly likely to fall apart quickly. the air doesn't provide the countervailing forces to keep it together, and the bombardment of energies from all around also pull it apart.
3. the fact that a homemade mask allows smoke right through but filters out some portion of the virus pucks (as per your prior link) is evidence in itself of the differential affinities of smoke and virus pucks.
but let's face it, most people wearing masks (outside) do it because they think it's protecting them from the filthy other people. however, if you're sick, all you're doing is concentrating the virus pucks in one place right in front of a face we'll each touch 30 times an hour. no lay person consistently observes the contamination rules that hospital personnel do, especially when infection rates are <0.1% and failure to do so has no obvious downsides. masks could in fact be more dangerous because of a false sense of security.
Does anyone have any tips for the "micro" lulls? I'm a professional programmer of 5 years. Back in December I was floating high, feeling so empowered and at the top of my powers. Now I feel just meh. Opening an IDE, writing tests, etc, all feel like a drag.
1. It's old people AND people with comorbidities, which is a ton of people.
2. Lots of old people, which for Covid is about 65, still work full time jobs. Some of them fly every week. These aren't 95+ year olds.
3. I'm sure people of all ages think their life is very valuable, and very few people consider themselves candidates for sacrifice. Certainly not for privacy concerns.
> 3. I'm sure people of all ages think their life is very valuable, and very few people consider themselves candidates for sacrifice. Certainly not for privacy concerns.
This guy also brought us, “childfuckers bad, no crypto for you”.
And don’t forget, “Arab scary, we track your emails”
4. And there's no preexisting immunity, unlike with the seasonal flu. Left unchecked, CoVID-19 will infect a much larger share of the population than flu.
That's not actually true. The seasonal flu affects 45,000,000 americans every year, and in part because it (a) mutates and (b) there's a huge number of strains, and different ones are dominant in different years. The flu shot is not particularly effective for those reasons (19-60% depending on the year).
COVID however, does not mutate, or has not yet. This means herd immunity is on the table, and so is a ~100% reliable vaccine -- like MMR, not like flu shot.
It is true. A substantial fraction of the population is immune to the circulating seasonal flu, both through vaccination and previous infection with closely related strains.
Only 5-20% of the population gets the flu each year. 60-70% of the population would have to get CoVID-19 before herd immunity brought the reproductive number below 1.
That doesn't make what I'm saying un-true. 20% of the population getting it is enourmous and demonstrates that the effect of herd immunity on the flu is negligible. At 20% infection rate annually after a few years, everyone's had it. But due to the virus propensity to mutate, we don't see herd immunity for the flu. Each new strain resets the counters.
We would see it for COVID. And chances are 15% of us have already had it according to the Gangelt survey.
Without pre-existing immunity, a much larger fraction of the population would get flu each year. That's one of the primary reasons why people worry about pandemic flu, as opposed to the regular seasonal flu. An entirely new strain has the potential to infect a much larger share of the population than the regular seasonal flu, precisely because there's no pre-existing immunity.
> chances are 15% of us have already had it according to the Gangelt survey.
No, that's a completely unfounded conclusion to draw from that study. Gangelt was chosen precisely because it was an extremely hard-hit town. Researchers wanted wanted good statistics, so they went to the place that has the largest case density. There was an early superspreading event in Gangelt, during Carnival celebrations back in February. Hundreds of people came into close contact with a known infected person. The population of the town is only 12,000 to begin with.
1. It's old people AND people with comorbidities, which is a ton of people.
Yep, and they should shelter in place. Nobody else should.
2. Lots of old people, which for Covid is about 65, still work full time jobs. Some of them fly every week. These aren't 95+ year olds.
Yep, and they should shelter in place, because they're in a risk category.
3. I'm sure people of all ages think their life is very valuable, and very few people consider themselves candidates for sacrifice. Certainly not for privacy concerns.
That's an unfortunate way of looking at this. The reality is everything we do in life involves risk. There's risk of harm in shutting down the economy, and there's risk of harm in opening the doors. The lifetime risk of death being involved in a car accident is 1%. The lifetime risk of dying of an opioid overdose is 2%. COVID is much lower than both. Locked inside domestic violence is up, alcoholism is up -- liquor stores are considered essential so alcoholics won't come in to hospital due to withdrawal.
What we do know is if we lock things down, then one person flies in from a foreign country with the disease the whole thing starts over. Hiding inside is not a sustainable strategy.
Which is why Sweden remains open for business. And you know what? They're doing just fine [1].
4. 10x deadlier than the flu.
It is not. We do not know how deadly it is, all we know is that of people who go to the hospital (implying that they're showing serious symptoms) between 0% and 9% of people, depending on their age and comorbidities, die.
That's adverse selection sampling bias. Studies show there's huge, huge quantities of people who either show no symptoms at all (which is the thing that makes this disease a challenge) or exhibit mild flu-like symptoms.
The numbers we're seeing are an upper-bound, by an order of magnitude. It's likely in line with the flu, although we should consider in line with the flu is bad -- it kills 650,000 people each and every year we've been alive.
It's also much harder to immunize against the flu (19-60% effective) due to its propensity to mutate and the huge number of strains that show up each season, with different ones being dominant each year.
On the other hand, COVID does not mutate -- or has not yet.
1. A healthy 30 something has an IFR of something like 0.1%. Doesn't justify a lockdown for a year; does for a couple months.
3. Sweden has experienced over 500 covid deaths in a week. That's a 30% excess death rate. Hardly "fine".
4. I see little evidence it is in line with the flu, unless you are talking about historically deadly flus, not seasonal ones. Flu would not have killed 1.5% of the Diamond Princess population that was infected. 0.7% IFR seems about right (Diamond Princess, Iceland, etc. suggest around this) and that's >7x bad seasonal flu years.
> A healthy 30 something has an IFR of something like 0.1%. Doesn't justify a lockdown for a year; does for a couple months.
It's not 0.1% for a 30-something. The Gangelt survey showed a total population fatality rate of 0.37%, and so far the CFR has ranged from 0% in children to 0.1% for 30-somethings to 15% for 85 year olds.
The Gangelt survey showed 0.37% actual vs. a CFR of 2% overall in Germany so we can divide the CFR for each age group likely by 10. It's probably close to 0.01% for a healthy 30-something.
> Sweden has experienced over 500 covid deaths in a week. That's a 30% excess death rate. Hardly "fine".
It ... is fine, when you take into account that they're never going to get it again, whereas every other country in the world is vulnerable to a single person showing up and re-starting the entire process for everyone. It's not this lockdown I'm worried about it's the next one, when a single person shows up in downtown NYC and we're right back at it again.
Hiding inside is not solving the problem because it's an incredibly infectious disease. Unless you can lock down every single person in the entire world for the entire duration, it will fail.
> I see little evidence it is in line with the flu, unless you are talking about historically deadly flus, not seasonal ones. Flu would not have killed 1.5% of the Diamond Princess population that was infected. 0.7% IFR seems about right (Diamond Princess, Iceland, etc. suggest around this) and that's >7x bad seasonal flu years.
The Gangelt survey showed 0.37% vs the flu at 0.1%. It's worse, I've long maintained it's worse, but it's not massively worse. Certainly not stop-the-world worse. [1]
(It's currently (among other points) debated how well the tests used for the Gangelt survey can tell SARS-CoV-2 from other coronaviruses, and given how little they've published unclear how they corrected for that. Hopefully they'll release more info soon, but lots of experts are skeptical of this specific study, they might very well have classified a bunch of folks that had a cold as "corona")
We have to be pretty careful about demographic adjustments. Does the town surveyed have any nursing homes or hospitals? If not, that'll drastically drop the death rate.
By my napkin math, you get to about a 2-fold difference which explains the 0.37% vs. 0.7% numbers. But remember the flu 0.1% also includes those highly susceptible people.
Heh, the delta is likely because: (1) Iceland has had 6 deaths so it's way, way too early to draw any conclusions from Iceland and (2) everyone onboard the Diamond Princess was onboard a cruise ship, and cruises tend to skew old. The median age of passengers was 69. That age group is affected ~100X harder than young folks (9% CFR vs 0.1% CFR) [1]. If you've got more data to back 0.7% please do share but I've found none compelling so far.
Although for what it's worth Iceland is showing 6 deaths and 1600 confirmed cases for a fatality rate of --- wait for it --- 0.35%.
That paper would give about 3% for a 70 year old. But remember that cruise passengers are healthy enough to be on cruises. 1.5% death rate seems about reasonable when you correct for that (again, this is where you might see that 2x difference).
Iceland has a considerable number of unresovled cases. Whether you use 7 deaths out of 751 recovered, or 20% hospitalization death rate, you get somewhere on the order of 0.9% CFR.
This is all case data, not population studies. The Gangelt study is different because they tested the entire population and not just people walking into hospitals. They found the CFR in Germany (2%) was roughly 10X higher than the actual mortality rate in town.
The CFR is always going to suffer from adverse selection bias at this stage because they're only including people sick enough to walk into a hospital, and not folks who were asymptomatic, and not folks who got mild symptoms and didn't tell anyone. That's going to be basically every young person. Only the old end up in hospital and they're dramatically worse hit.
Population studies are not directly comparable. A global CFR of 1.5-2.5% sounds right, but that doesn't mean that's a mortality rate. The mortality rate is closer to 0.37% based on the population study I cited.
You seem to be arbitrarily multiplying and dividing CFR by 2 to fit a narrative. I'd love to see other population data but I think this was the first and only study, which is why the numbers are much different than you're citing.
Does the town have any nursing homes? Those are accounting for a large percent of deaths in the United States. (Around 20% in California). If a small town has already shipped its least healthy population away, its IFR will look lower.
The ratio of asymptomatic to symptomatic people has been measured, and it's not nearly as high as you're saying. China has been quarantining and testing every single person entering the country, and they find that 2/3rds of cases are asymptomatic.
Moreover, Germany has conducted a randomized serological survey of the population of one town where there was a large outbreak, and determined that the true mortality rate was about 0.4%, which is an order of magnitude higher than mortality due to the flu. That's the mortality if there's excellent healthcare and the system isn't overwhelmed. Mortality will also depend on the age structure of the population, rates of obesity and smoking, etc.
Because a large fraction of the population is immune to the seasonal flu (both through vaccination and previous infection), far fewer people contract it than would contract CoVID-19 in an uncontrolled epidemic.
The combination of a much larger rate of infection than the flu and far higher mortality means that CoVID-19 would kill orders of magnitude more people in one year.
> Moreover, Germany has conducted a randomized serological survey of the population of one town where there was a large outbreak...
1. Results showed 0.37% mortality rate, which is an order of magnitude lower than the fatality rates being published, which is what I claimed -- so I re-iterate: "The numbers we're seeing are an upper-bound, by an order of magnitude." [1]
2. 14% of their town has had it already. [1]
3. That 0.37% rate includes all the old and at-risk folks which I was already suggesting we isolate. Since we know the fatality rate for them is 9% in hospital vs 0.1%, I'd suggest that the actual mortality rate of my plan would be incredibly low. [1] We don't know the demographic distribution of the town, and we do know that the disease is incredibly age-dependent so it's hard to project that onto the population.
Either way the flu is 0.1% so this isn't 10X worse, it's 3.7X worse. At most.
4. The study shows 15% of them are already immune to COVID.
[edit] I found the data [2]. Out of a population of 12,000, 6500 of them are in a risk group (over 45). So 55% of town. This needs to be projected onto the world population factoring into account non-linear risk response.
> Because a large fraction of the population is immune to the seasonal flu (both through vaccination and previous infection), far fewer people contract it than would contract CoVID-19 in an uncontrolled epidemic.
I don't think they are. The flu mutates regularly, and there's a ton of strains. Vaccinations are only 19-60% effective depending on the year. This is evidenced by the 650,000 worldwide deaths (60,000 US) and the 45,000,000 US cases of the flu each year.
> The flu mutates regularly, and there's a ton of strains.
... which a substantial fraction of the population is immune to. Only 5-20% of the population gets the flu each year. CoVID-19 will infect 60-70% of the population, at a minimum, unless measures are taken to contain its spread.
> Results showed 0.37% mortality rate, which is an order of magnitude lower than the fatality rates being published
I've seen most people assuming a mortality around 1%, which is not that far off from these results. In Italy, 1% may well be correct, given how the healthcare system was overwhelmed there.
> I'd suggest that the actual mortality rate of my plan would be incredibly low.
If you can successfully shield the entire at-risk population, which easily approaches half the population of many countries. Once you add up old people, obese people, people with diabetes, smokers, people with heart conditions, and all the other at-risk groups, you come to a sizeable fraction of the total population. Trying to shield those people while the virus infects most of the rest of the population sounds incredibly risky to me. It's not even obvious that you can achieve natural herd immunity without at-risk people getting sick, because you need 60-70% of the population to get sick.
Overall, I don't understand the motivation behind such a risky plan. Why not just go through a 6-week period of lockdown, and then control the epidemic afterwards with extensive testing, good contact tracing and social distancing measures? Countries other than the US appear to be successfully implementing this strategy. Some, such as South Korea, were acted competently enough that they didn't even require the lockdown phase.
> Only 5-20% of the population gets the flu each year.
Only 20% of America is 70,000,000 people. That's staggering. The economic impact of the flu is enormous.
> I've seen most people assuming a mortality around 1%, which is not that far off from these results. In Italy, 1% may well be correct, given how the healthcare system was overwhelmed there.
It may be 1% in Italy because the population of Lombardy was overwhelmingly old, and overwhelmingly sick. The average age of death in Italy was 80.5 and the average number of underlying medical conditions was three.
> Only 20% of America is 70,000,000 people. That's staggering.
So imagine 4x as many people getting infected with a virus that is many times as lethal.
> It may be 1% in Italy because the population of Lombardy was overwhelmingly old, and overwhelmingly sick.
And the US has other problems, such as obesity. But the mortality will be much higher wherever the virus overwhelms healthcare systems. As we've seen, that can happen very quickly.
If we, again, assume that 15% of the US has already had it (as in Gangelt), and that herd immunity kicks in at 60-70%, that means we'd expect to see another 45-55% of the population -- 147-179 million cases. If we actually isolate the vulnerable, basically nobody would die.
That would be an incorrect assumption. The Gangelt study is about one small town in Germany where there was a known superspreading event at the Carnival festival.
If 15% of the US had already been infected, then based on the Gangelt study, there would be 200 thousand deaths, and millions hospitalized with severe illness.
> The lifetime risk of death being involved in a car accident is 1%.
You're off by a factor of 100. It's .01%.
> The lifetime risk of dying of an opioid overdose is 2%.
For who? Someone who uses opioids? Maybe, on average, again you're off by a factor of 100 or more.
> We do not know how deadly it is, all we know is that of people who go to the hospital
No, of people who test positive, which includes people with relatively mild symptoms that don't go to the hospital, but had reason or ability to get tested.
South Korea is probably the best current testbed here, they had very widespread testing and they've had very, very slow growth recently so the CFR numbers are probably relatively accurate. They see a 3% CFR.
> Which is why Sweden remains open for business. And you know what? They're doing just fine [1].
Normalized by population, Sweden has seen more deaths and more infections than California, by about 50%, and it will likely continue to grow at a similar rate. The problem with exponential growth is that things look like they're doing just fine until suddenly they aren't and there's no way to fix things.
> For who? Someone who uses opioids? Maybe, on average, again you're off by a factor of 100 or more.
No, lol, it's not. Those are averages across the US population. Your lifetime odds in the US of dying in an automotive accident is 1:103 [1].
I should have said accidental poisoning which is 1:64 [2] but half of that is actually opioids (1:96) so you're still more likely to die of an opioid overdose than being a party to a car accident. Most people don't set out to get hooked on Oxy, they get hurt or undergo surgery, are prescribed them, and that's that.
There's 40,000 deaths per year related to car accidents, which if you multiply out by the average lifetime (78.69 years) is right around 3.2 million, or 1%.
This is fair to compare against COVID because due to its extremely limited propensity for mutation, the COVID mortality rate does represent what approximates lifetime risk. (i.e. unlike the flu, you won't get it again).
> South Korea is probably the best current testbed here...
I argue the best testbed is the German study I cited where they actually tested... everyone. CFR is not mortality rate, its about an order of magnitude higher, again, I cited my data. And in my intuitive explanation that you're not factoring out adverse selection risk of only very sick people going to the hospital in the first place.
> Normalized by population, Sweden has seen more deaths and more infections than California.
Because everyone in California is inside. I'm sure they've seen an order of magnitude more flu deaths too because nothing spreads when you're inside. They're probably seeing infinitely more car accident deaths, too. Life's risky, and you're not comparing honestly.
> Your lifetime odds in the US of dying in an automotive accident is 1:103 [1].
No they're not. The lifetime odds for the average American are. For opioids as an example, as someone who doesn't use opioids, my lifetime odds of dying from an overdose are essentially nil. The distribution is bimodal.
> This is fair to compare against COVID because due to its extremely limited propensity for mutation, the COVID mortality rate does represent what approximates lifetime risk. (i.e. unlike the flu, you won't get it again).
You claim this with great certainty, but it hasn't been around long enough to know that it won't mutate in annoying ways.
Further, it's still not fair to compare that way. In the past 2 decades, we've had 4 or more dangerous flus that aren't seasonal (SARS, MERS, H1N1, H5N1, COVID-19). Of these, most weren't infectious enough to be super dangerous, but two were (H1N1, COVID-19), each of which killed at least 100K people worldwide, and COVID-19 is on the path to claim a million lives worldwide this year.
That's not a once-in-a-lifetime event, it's once a decade or even once every few years.
> I argue the best testbed is the German study I cited where they actually tested... everyone.
And the flaws in that study have been noted elsewhere. SK is a better testbed since they also tested huge swaths of people, even those not showing symptoms, and
> CFR is not mortality rate
The CFR of the flu is .1%, which would make COVID more contagious, and 30x more deadly. I'm not sure why the mortality rate matters since given the higher infection rate, COVID would have an even higher mortality rate.
> Life's risky, and you're not comparing honestly.
And the risk from COVID goes up if everyone catches it simultaneously. The CFR goes up even further if hospitals are overwhelmed.
> No they're not. The lifetime odds for the average American are. For opioids as an example, as someone who doesn't use opioids, my lifetime odds of dying from an overdose are essentially nil. The distribution is bimodal.
So now you accept that I wasn't off by 2 orders of magnitude, but are pedantically calling out that I wrote "your" even though I specifically wrote "Your lifetime odds in the US" -- which, if we're going to be entirely pedantic, applies to everyone on earth. Maybe look up your numbers and share them?
You're ignoring how people end up addicted to opioids. The shape of the distribution is both entirely irrelevant and you haven't cited your source.
This makes me think your goal is to win an argument instead of having a genuine discussion.
> You claim this with great certainty, but it hasn't been around long enough to know that it won't mutate in annoying ways.
I'm citing data from experts [1].
> ...we've had 4 or more dangerous flus that aren't seasonal (SARS, MERS, H1N1, H5N1, COVID-19).
SARS, MERS and COVID are not flu viruses, they're coronaviridae. H1N1 and H5N1 are mutations/subtypes of the Influenza A virus. The coronaviridae are different.
> And the flaws in that study have been noted elsewhere. SK is a better testbed since they also tested huge swaths of people, even those not showing symptoms...
SK has not tested huge swaths of the population, they've tested around 1%. [2] They may have tested more than most people, but that's not what you claimed. They've tested some not showing symptoms. Huge difference as compared to testing 100% of the population.
> The CFR of the flu is .1%, which would make COVID more contagious, and 30x more deadly.
The study I referenced mentioned 0.1% for the flu vs 0.37% for COVID. Feel free to read it. That would make it 3.7X not 30X. Because the flu has been around so long the fatality rates are largely determined by mathematical modeling, and are very close to the actual fatality rate. On the other hand, we're still figuring it out for COVID.
Yes, its is more contagious. Nobody's argued that.
> And the risk from COVID goes up if everyone catches it simultaneously. The CFR goes up even further if hospitals are overwhelmed.
Which is why, scroll back up, we isolate the vulnerable.
> So now you accept that I wasn't off by 2 orders of magnitude.
You're right, but it doesn't make the numbers you're citing any more relevant.
> SARS, MERS and COVID are not flu viruses, they're coronaviridae. H1N1 and H5N1 are mutations/subtypes of the Influenza A virus. The coronaviridae are different.
Who is being pedantic now? The point is that novel viruses are not a once in a lifetime occurrence, so you can't compare the risk of "COVID-19" to "lifetime death rate", since a new novel virus will come along in a few years. The danger is not covid-19 in particular, but novel viruses in general, and doing nothing would lead to a 1-year fatality rate for a novel virus on par with the lifetime danger of driving. Which means the lifetime danger of the virus is 20x or more the danger of driving. That's
> The study I referenced mentioned 0.1% for the flu vs 0.37% for COVID. Feel free to read it. That would make it 3.7X not 30X. Because the flu has been around so long the fatality rates are largely determined by mathematical modeling, and are very close to the actual fatality rate. On the other hand, we're still figuring it out for COVID.
Yes, but the CFR of the flu is well understood. The CFR of COVID-19 is not, and your entire argument is based on one study which is not conclusive, has had some flaws pointed out elsewhere in this thread, and generally doesn't match observed CFR elsewhere.
> Which is why, scroll back up, we isolate the vulnerable.
Which, ask any epidemiologist, doesn't work, since hospitals get overwhelmed anyway. The hospitalization rate of young people is still pretty high (maybe not quite 20% as it is for the overall population, but still more than 10%), they just don't die with reasonable care. There's a fair number of cases of healthy 20-something year olds who end up hospitalized for a week due or more due to COVID and need ventilators. Not to mention healthy something 40 year olds.
Even if you manage to perfectly isolate every at risk person, there's still a nontrivial risk of overwhelming ICUs anyway. And then the fatality rate among young people would go up as they couldn't get good care. And you're not going to perfectly isolate every at risk person. So the you have more young people hospitalized, more old people hospitalized, and well you're in a bad spot.
Or you end up expanding the definition of "at risk" to include "obese, heart disease, diabetes, or high blood pressure", and you've ended up essentially where we are now, with the majority of the US population in an "at risk" group.
> SK has not tested huge swaths of the population, they've tested around 1%
You realize that for population level statistics, that's fine. That means that 490000 tests have returned negative. If, as the Italians think, 10x as many people are infected, somehow there would need to exist 100K+ infected people, showing no symptoms, basically none of whom appeared in the 490000 negative samples. Such a probability is negligible. The sample sizes are large enough to remove the possibility.
Well, in the US for seasonal flu the deaths estimation [1] for this season are 24k-60k deaths, for covid19 is 60k-240k, where 60k is applying lockdown, not "everybody work normally". And obviously they are on top of the typical deaths.
The German survey showed an actual fatality rate of 0.37% vs the flu at 0.1%. We know herd immunity is in the cards due to the lack of mutation of COVID, and that kicks in at 60-70% of the population.
The German study also suggested up to 15% of people may already have it, so we can further reduce this number (an incremental 45-55% of the population getting infected) -- So, if we run some simple arithmetic, we'll see the number of fatalities will be approximately 60-70K.
This is in line with the number of fatalities in a difficult flu season. The difference is because COVID does not mutate (or has not yet), this will be a one-off, one-time, one-year issue. The flu kills 60,000 each and every year. The Swedes have it right.
We can mitigate this by isolating the vulnerable.
So yes, we are, in fact, overreacting.
[EDIT] I wonder if this is in fact in excess of deaths we'd see anyways. I'd imagine an 80.5 year old with 3 underlying medical conditions (average in Italy of the dead) isn't just as vulnerable to a bad flu as they are to COVID, so if COVID takes them, the flu won't.
Firstly, the German study analysed one small particularly hard hit town, so how you are extrapolating this to "people" in general is puzzling.
Secondly, there is a very wide range of reported fatality rates, with myriad factors known and unknown, so why you've chosen the lowest one globally (which, by the by, has always been an outlier and in any case is edging up past 1%) as the "actual" rate is, again, puzzling.
Finally, you are making a giant but unfortunately common logical error in using these already questionable death counts to make the case for an overreaction without attending to the obvious fact that without this "overreaction" every town, village and city on Earth would be Bergamo, where army lorries are conscripted to transport the dead from overwhelmed mortuaries, or worse.
> Finally, you are making a giant but unfortunately common logical error in using these already questionable death counts to make the case for an overreaction without attending to the obvious fact that without this "overreaction" every town, village and city on Earth would be Bergamo, where army lorries are conscripted to transport the dead from overwhelmed mortuaries, or worse.
Italy has the highest average age in Europe, and we know the virus is about 100X worse for people over 65 than it is for a 20 year old. Lombardy is the oldest region in the oldest country in Europe. The average age of the dead in Italy is 80.5 and has 3 underlying medical conditions. That's why it's so high there. I specifically called that out in the [EDIT].
I'd suggest doing some more reading.
The demographics in Gangelt skew older too, but otherwise they appear thoroughly average, and a totally reasonable representative sample. Especially as you yourself call out they were "particularly hard hit."
This actually isn't entirely on top of the typical deaths, as many of the folks dying of COVID are folks that were very likely to have died from their other underlying conditions anyway this year.
Especially now that we are counting all deaths in COVID-positive or presumed-positive individuals as COVID deaths regardless of cause of mortality.
The estimate for the "no mitigation" scenario by the Imperial College is 2.2 million deaths [1] in the US. There is a large range of estimates that have come out since then to take into account the mitigation that has happened and how effective they have been. Lately things have been looking better but without some comprehensive contact tracing and isolation system we cannot "reopen" and drop those mitigations without moving back into the range of hundreds of thousands of casualties.
That write-up was based on extremely early CFR data, with no population studies having been conducted at the time. Latest data is pointing to, as I called out, a fatality rate of 1/10th the CFR. This is especially true as we're counting anyone who tested positive for COVID as a COVID death, even if they were hit by a truck.
It could only work if everyone wear a phone. And then what's next? Forcing everyone by law to always wear a phone at all time?
I would rather see new phone sensors that scan the air, the breath and the body for diseases than a new tracking technology. We could also develop new medicines, etc. Not tracking.
Edit : we also don't have much knowledge about why the virus is more lethal for some people than others. We should focus effort at predicting who will be asymptomatic and who will develop complications, rather than trying to stop the virus from spreading by isolating people
Why does anyone talk to a journalist when they don't get anything out of it or advance their interests? People like to tell their story, especially when aggrieved.
That's a great point I always struggle with coming up with UIs for side projects, but really everything I come up with will always look cheap compared to the efforts of 13 experts.
I don't think that's a low bar. The US is an advanced economy. Why would people being unable to get fresh produce or have a balanced and varied diet be acceptable? Especially when you consider the obesity problems the country is facing.
I think that food insecurity meaning literal hunger pains is way too low a bar for the US. That number should be literally 0%. Food security for us should mean food that is healthy and excellent.
"food insecure at least some time during the year" includes people who at some point during the year didn't like the food they had available ("reduced desirability"). For example, someone could be getting their food from Meal Hubs and still be counted as food insecure.
If you surveyed specifically on whether people had access to fresh produce you'd get a much lower number.
I personally don't think that ~10% of people who are in the low food security box are doing great. They still seemed to do horribly in some of the metrics they gathered. For example, 80% of them felt they could not afford a balanced meal.
Then if you look at the very low security group, roughly 4% or 5 million people, it gets really worrisome. 32% of households said an adult had gone an entire day without eating anything.
And I think this is compounded by something like Covid-19. 85% and 95% of the low and very low food security groups said they were worried food would run out. What happens to them when people make a run on the stores like this last month? Their ability to buy food is strongly tethered to the day of the month when their EBT card is reloaded.
I think a lot of this is subjective, and globally the US is doing quite well compared to all countries. But I suspect we do poorly compared to other industrialized/advanced economies.
I'm relatively sure that saying "That chicken was alright, but the brine set in too strong and it was just too salty" doesn't fall within anyone's definition of food insecure.
Does the US government subsidize them at all? I wish we would pivot faster to renewable energy, but in the meantime we should also ensure we are not reliant only on authoritarian states for energy.
Yes, oil industry in the US is heavily subsidized. They pay less taxes than any other industry and receive free land and other government incentives for oil and gas exploration.
This is something "everybody knows", that it is "heavily subsidized" but I'm not aware of what rules and regulations are written to favor and apply only to the industry. Maybe you could summarize a bit?
The easiest to spot is the favorable tax treatment. The oil industry has a sweet deal that slashes taxes on oil investment. The provisions are complex and written to facilitate big investments in this industry [1].
I don't mean to be glib, but isn't this a good opportunity for her to learn those skills? I wasn't a good self-learner until I was in AP Bio and the teacher was very incompetent and I had to just face down the book. That groundwork helped me so much as a freshman in college where there were lots of kids who had always had awesome, attentive teachers. Especially if you are there with her!
I love Khan Academy, and the cool thing about youtube is there are so many content creators that there will be someone your daughter thinks has a nice voice or is easy to understand or funny.
YouTube videos are great for some resources, but they aren't a substitute for a competent teacher.
Fun thing to think about: there are videos that measurably improve students' performance on a task, but students rate those videos as "confusing" and "not helpful". The videos that students do like? They have zero effect.
> but isn't this a good opportunity for her to learn those skills?
I think that’s a fair question, and I’d love to be optimistic about her ability to hunker down and build those skills. But, she has some behavioral challenges and just getting her to do homework is a nightly struggle consisting of meltdowns and arguments, so I’m not as hopeful that she’ll be able to do it. She’s a bright kid, but definitely one who -needs- the structure of a classroom to be successful.
Has anyone ever been refused a developer account? I wanted to write some scraper and did the form, but they rejected, told me in the email there was no appeal, and I guess that's it?
Actually, yes I recall now this is exactly what happened to me! I applied and forgot about it, assuming it didn't matter to them when I responded. What a bummer
