Social distancing slowing not only Covid-19, but other diseases too
qz.com
qz.com
Kinsa is receiving two to three times more thermometer readings per day than in previous flu seasons
Many more people may be taking thermometer reading that don't really need to, but are being cautious. That would cause the appearance of a proportional drop in high temp readings compared to prior years when really it's just that lots of not-so-sick people are taking their temp lots more.
It seems to be accounted for.
I don't think upvotes mean something's correct, I think they mean that something (and the ensuing discussion) is worth reading.
Even though you were a little off base, it was a useful chain of discussion because presumably a large nonzero number of people would think the same thing. :)
>Historically, Kinsa’s methods have been able to account for a sharp rise in the number of people taking tests
What historical precedent is Kinsa referring to? There has never before been a pandemic of this magnitude, in a time and place where many people owned internet-connected thermometers.
Perhaps I am being uncharitable, but it seems that they are leaping to conclusions here. I'm sure that they have done their best to account for this, but the claim that "Dalziel has ensured that a spike in testing didn’t lead to inaccurate predictions" is one I find difficult to take at face value. Ensured?
You said that "there could be some selection bias here." Could. Sorry to cause you to cringe again, but +1.
And more importantly, how could we know if it is? That's not just a Kinsa problem; we see this over and over again with peer-reviewed studies that "control for" certain factors like socioeconimics or health history. They're inherently limited to controlling for what they know about, and it's never perfect. Often, the entire effect is from an undiscovered variable. Take, say, the widely-promoted study finding that visiting a museum, opera, or concert just once a year is tied to a 14% decline in early death risk. The researchers tried to control for health and economic status, then concluded "over half the association is independent of all the factors we identified that could explain the link." [1]
Now, what seems more likely: that the unexplained half is from the profound, persistent social impact of dropping by a museum or concert once a year? Or that some of the explained factors like "civic engagement" can't be defined clearly, others are undercounted (e.g. mental health issues), and some were missed entirely?
I suspect Kinsa did much better than that, because they're not trying to control for such vague terms. But I think "even after controlling for" should basically never rule out asking "what if it's a confounder"?
[1] https://www.cnn.com/style/article/art-longevity-wellness/ind...
Without this plus a stronger push for open-access publishing, readers often have absolutely no way to verify claims like this - and, moreover, have no way to learn how to apply similar methodologies to their own work. There's a lot of people in data science / analytics positions right now who could benefit from sharing knowledge around statistical tools to correct for highly unusual situations.
It is just a linear interpolation and backward looking. I’m definitely not convinced how this would control for how more healthy people take temperatures more frequent after govt announced social distancing to stop COVID-19.
And their data contradicts CDC, https://gis.cdc.gov/grasp/fluview/fluportaldashboard.html
Also very misleading variable labeling. y is CDC ILI activity, % outpatient visits for flu-like symptom, not actual % population that are ill, https://academic.oup.com/ofid/article/6/11/ofz455/5610164
Exactly what we'd expect. It's a silver lining on this whole mess.
>Recent data clearly show the spread of Covid-19. On March 19, the share of Americans with temperatures indicating they had flu-like symptoms was about 4.9% when it typically would be expected to be about 4.0%. This was likely a result of the spread of Covid-19, according to Kinsa’s researchers.
... means that 1 week ago 2,964,898 Americans (0.9%) had Covid-19. Today there are 65,950 recorded cases in the United States: https://www.worldometers.info/coronavirus/
Assuming 0.5% death rate after 3 weeks, then 3 weeks ago there were 200000 infected.
Assuming cases double every 5 days, then multiply that by 2^4, therefore:
The US has 3.2 million infected.
You get a much higher fatality rate if you're testing only people with severe symptoms or those who get hospitalized, which is what many countries are doing. For example, if you have mild symptoms, UK health service will tell you to isolate at home and call them for hospitalizatin if you get worse, and you'll get tested only if that happens. You also get a much higher fatality rate if hospitals are overloaded and people can't get proper lifesaving treatment, which wasn't the case yet in USA, so an estimate based on these numbers seems reasonable now.
I use this analysis because the number of deaths is hard to fudge, and the fatality rate after x days, and the infection rate are somewhat measurable (I believe there are statistically valid measurements of those numbers).
Any analysis based upon detected cases is deeply flawed IMHO, because detected cases can be anything (look at different countries with wildly different values with no basis in reality).
>Assuming cases double every 5 days, then multiply that by 2^4, therefore:
... you're not allowed to assume that. It means on April 26th two thirds of all Americans (204.8 million）will be infected.
However, until the total number of infected is less than, say, 10% of total population, it certainly makes sense to just use the average doubling rate.
And that would just be the people with symptoms right now. It wouldn’t include recovered, asymptomatic, nor people in the incubation period.
In short it is not about your interest if you get tested it is about societies interest.
Even if you are not showing symptoms stay inside so you are not spreading the disease. Getting tested won’t prevent the spread, staying isolated will.
Look at China.
US can do what China did, heavy handed lock people inside with supplies and test anyone who moves outside of the house. You test positive you either go into mandatory quarantine (hospital) or you get an ankle monitor.
China method works better than SK method when you think about how we got the TSA and how it helps our daily lives
We failed at preparing for this. Let's not double down on failure.
[0] https://www.uptodate.com/contents/coronavirus-disease-2019-c...
[1] https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/s...
You might be spreading it everywhere right now and you wouldn’t have any symptoms for another two weeks.
Everyone should be doing this so you wouldn’t have to assume I am spreading it everywhere.
Look at China, its working.
The drive-through test sites are pretty well thought out. You're not likely to get the virus from the car in front of you.
Beats the heck out of everyone hiding under their bed for months.
So what is testing the world going to solve if no one is preventing the spread of contamination? Because the answer is that you will only overwhelm hospital resources
Look at China.
However, this idea that testing is worthless is frankly bizarre. You can’t control what you can’t measure, and “number of people occupying hospital beds” is a very poor measure for a disease that spreads silently for weeks before symptoms emerge.
Some of the tests have a 20% to 40% false negative rate.
Not saying the above scenario is a reason not to get tested, I’m saying it’s an argument against getting tested for the sake of getting tested. I am safer and I am making the world safer by locking myself down until this passes. See China as example. I urge you to do the same..
Look at China, is it testing that’s working there or the lockdown?
It seems implausible that there has not been a significant change in the health-consciousness of the typical purchaser in the last month or two, vs. prior to that. I can't tell you what the change would be, but I find it highly implausible that it would be not at all different, given the biggest spike in public awareness of a health issue in several decades.
It's nice to see that Dalziel has thought of the issue, but the article doesn't tell us much about _how_ he accounted for that. I could think of ways, but I could also think of ways to screw it up, and it doesn't say in this article how he "ensured" that the effect is real.
That is to say, that it’s due to less activity and not a changed mindset.
Aside from the difficulties of getting everyone in the world to agree that the first three weeks of February during a leap year are observed through social distance, it doesn't seem like it would be as bad on a recurring basis as it is during an emergency like this. You could plan for your self-isolation in advance, so there wouldn't be a rush for supplies the way there is now; you would already know not to schedule anything for February; you'd probably still have to solve some money problems for a large number of people, since being able to WFH probably anti-correlates with living paycheck to paycheck.
If you could actually eliminate -- or at least, dramatically reduce the incidence of -- common colds and seasonal flu through such a scheme, it would probably be worth both from a QoL standpoint for the everyone in the world (would you trade 3 weeks of cabin fever every four years for never having another actual fever?) and from an economic standpoint (three weeks of predictable low productivity is almost certainly better than the unpredictable constant costs associated with illness and death).
The only suggestion that seems remotely plausible is 'all participants getting tested first'. There are still issues with getting tested, as there are false negatives and it can be hard to get tested for all diseases, but this would dramatically reduce incident of STIs.
I recently picked up 1984 again and finally managed to complete it this time. I read the last line with a mixture of relief and a tinge of disappointment. Until the very end, I was hoping for a Hollywood-style turnaround in the political situation.
Some of us are lucky enough to be able to weather this without severe downsides. But we're in the minority.
I have been cooped up in my apartment for three weeks and only left it four times to go to the grocery store. Finally I have some time to spend on my oss projects
Very hard. We can’t even properly do it in the face of this pandemic.
And obviously colds and flu aren't the only way people get sick and miss work, but if you could cut those two weeks per year to one week per year by having three weeks of quarantine every four years, that's a productivity win before you include the more predictable "nothing happens in February this year", the economic value of the lives saved, and the savings on healthcare spending on the people who don't get sick.
And the speed with which it spreads in a population that has little immunity against the current strain should be a good indication of how little you'd save.
Part of the problem we have in our war against infectious diseases is that they mutate in endless variety. The cold you catch tomorrow is slightly different than the cold you had last week; the variety of the seasonal flu spreading this year is different than the variety of last year.
But these endless varieties are generated at a rate proportional to the available hosts. If we can successfully reduce the number of hosts available, we would also reduce the number varieties of colds and flu we have to contend with, and the rate at which new ones appear. Everyone not getting a little sick all the time might conceptually weaken our immune systems, but it would also weaken the diseases against we're fighting, and we would still have our other tools we use to fight them.
[*] The common cold is a half dozen distinct viruses.
Some of them coronaviruses. It makes sense, but it's funny that we classify the common cold by symptoms, ignoring that the viruses are in different families.
If so, it'll just immediately get reintroduced to humans even if we distance it out of our population successfully.
No mutations required.
We’re actually seeing a hint of what he described, thankfully not near the full scale.
Anecdote: my niece gets sick badly and passes it on to everyone in her house at least every other month. She does not got to daycare. My LO does go to daycare and comes home with a new mild sickness once every third week and is fine a few days later. I’m interested to see how he fairs when school opens up again
The reason is likely due to larger amount of testing done due to the panic, that is not properly accounted for in their algorithm.
I would also make an argument that individuals who invest in smart thermometers would be more concerned about illness than the typical population and thus highly responsive to governmental declarations of states emergency.
I think it’s really hard and misleading to look at this data and make any larger conclusions.
People that use these thermometers probably skew towards being more worried about the virus. They probably isolated and were more careful days before the shelter in place was ordered.
Anything with a low r0 is going to have a lot of trouble surviving right now.
1.3 really isn’t that much. What if all the new people who’ve started washing their hands keeps it below 1.0?
Also, of course, the R0 always goes below 1 in summer...
The corona virus sars-cov-2, as well as the first sars virus jumped from animals to humans. There are several animal species which carry variations of the sars virus, but fortunately, they don't make the transition to humans regularly. If we managed to prevent further transmissions of sars-cov-2 between people, there is a good chance, this virus could go away entirely, unless it manages to jump to some common animal.
A little known fact btw, most of the influenza virii are descendents of the Spanish flu which have mutated to be less deadly.
This is only the case because some people are refusing vaccinations, or not able to get them.
Huh, I was expecting the opposite of this. The previous data could be slightly off because of smaller sample size and now that it has exploded they have a better estimate to reality.
ie. I assume their users are going to correlate with tech-savvy people, in turn correlating with people able to work from home, giving a severely skewed sample
If you do not train your immune system it'll fail you. When we have some major epidemic with an ugly consequences coming then sure social distancing can help. However taking social distancing as a generic strategy for out future lives I think will lead to a major f.. up.
My company temporarily banned meetings with more than 6 people; this should be permanent.
> Due to the emergence of the coronavirus, Kinsa is receiving two to three times more thermometer readings per day than in previous flu seasons. Historically, Kinsa’s methods have been able to account for a sharp rise in the number of people taking tests, said Benjamin Dalziel, a professor at Oregon State University who studies infectious diseases. For his research, Dalziel has ensured that a spike in testing didn’t lead to inaccurate predictions, and so he believes the current decline in illness is a result of social distancing, and not a statistical anomaly. (Dalziel has had research funded by Kinsa in the past).
Make it a tradition where everyone with non-essential work stays home at least one week a year, all at the same time. More time is better, but even a little bit would likely cut back on disease. Governments already define Christmas/New Years/etc as a holidays and huge numbers of people aren't working on those days and economies don't die. It wouldn't be hard for companies to promote "Pre-Stay Home Week Extravaganza" sales and make people actually look forward to staying home, eating and watching movies/playing games/whatever.
Just doing the days between those two holidays would probably be a welcome reprieve for a lot of people.
But without the social distancing aspect.
I wonder if people are just ignorant of the widespread devastation caused by the lockdown, if they feel like people devastated by the lockdown did not “do enough to prepare” and so somehow deserve it, if they somehow believe people will be made whole by trillion dollar handouts, or what?
I personally know two family businesses which have laid off all their employees and may never start up again, and another which if it doesn’t see bailout funds before next month who won’t be able to make payroll.
To say nothing of the kids missing their friends, their educations, their graduations, the weddings canceled, even funerals, etc.
Yeah let’s totally do this every year. This is so out of touch with reality it’s bizarre.
If people's take away from this all is to wash their hands,stay home when sick, and cough into their arms, tens of thousands of lives will be saved
Here it Europe, it is quite common for businesses to shut entirely down for a few weeks every year. The reason is managing employee vacations. It is easier managing this by shutting down entirely. Even the big car companies have two weeks every year, where the production is mostly shut down. And even many US companies have mandatory shut-downs on thanksgiving or christmas.
Like state health departments could declare that influenza is trending in the state and businesses could have less face to face meetings, and maybe churches cancel some of their non-worship gatherings, and so on.
For example, the orange scenario on https://covidactnow.org/state/MI includes possibly closing schools. States are doing the ones down at the bottom of the graph, social distancing is less severe and less effective, but still compares favorably to not adjusting behavior.
School closures in response to infections could probably be done more aggressively than we usually do now, but doing it on a statewide basis also probably doesn't make sense.
“I am deeply concerned that the social, economic and public health consequences of this near total meltdown of normal life — schools and businesses closed, gatherings banned — will be long lasting and calamitous, possibly graver than the direct toll of the virus itself. The stock market will bounce back in time, but many businesses never will. The unemployment, impoverishment and despair likely to result will be public health scourges of the first order.”
Let’s not do social distancing, or even “social distancing lite” at all please. It’s disastrously damaging to public health.
But whatever, we can call the thing where we take simple, effective public health measures that do not have grave economic impacts something else.
(the irony to me is that reducing the spread of things like flu would have economic benefits, many of which would be concentrated with those that are economically vulnerable)
But don't worry, the government is here to save everyone! /s
We're definitely not volunteering for this every year.
It's fine if done once due to a bigger health emergency but it only should be a last effort if we have no better way to handle it.
Instead I would prefer:
1. Better wide spread education about all kind of disease and related thinks, especially de-stickmatization. But this would need major changes like proper sexed (required for proper education about STD's).
2. Wide spread vaccination where applicable. (maybe even required, e.g. for children when entering school).
3. Good health system so that people can always get help to fight illnesses, at least infectious ones.
Probably a lot of other issues as well that may be more difficult to track. Mental health crisis, domestic violence, etc.
There must be a cost-benefit analysis done where we find the breakeven point between lives saved by quarantine vs. lives damaged by quarantine side effects.
There has got to be something in between, but on the land of exponential growth and slow-down, that line is very thin. This one pandemic will cross the line at some point, but I bet we will resume business as usual even before that.
We already have measles and chicken pox pretty well licked with vaccines. Smallpox was eliminated in the wild, polio is nearly there. There's no need to change our entire way of life permanently just for diseases we can easily vaccinate against.
It would be interesting to see a list or to survive it to see a documentary about its effects.
There are several diseases that society could eradicate that we simply choose not to.
Even wealthy tech people are affected by this; I was just told my very good insurance doesn't cover a vaccine that my doctor prescribed. It would cost $400, so I need to weigh my actual risk of getting the disease against cost of vaccination. I'd think the long-term return on investment for society would justify making just about every vaccine free to all.
edit: consider how much easier it is to just get a few shots, compared to never going to a bar, restaurant, sporting event, public transit or shared workspace ever again. Going all-in on social isolation is a nonstarter, even discounting the people who won't comply (there are many) or the toxic political environment that has pitted half the US against science and expertise.
Social distancing only slows distribution it doesn't prevent it reliably also some disease are spread by animals which are not at all affected by social distancing.
And then vaccines are also not enough as it had shown for some disease where we did try to eliminate them by handing out free vaccines in affected countries.
Lastly social distancing has a super high cost if continued. Not only economically but a super high health cost. Humans are not meant to live permanently social distanced they are inherently social animals and the internet can't really replace it. E.g. for people fighting depression social distancing can be like poison. It prevents them or at least restrict them from doing many the thinks which can help fighting depression and causes "physical" isolation (Internet is helping but has limits, it's not helping enough to counter it). Another group most likely majorly negatively affected are people with "home" problems, like violent partners or parents (or just to controlling partners or parents). To just name some example.
No, they fully realise. We have to also reduce the flu. It also takes up many ICU beds. This is vital. Any plan knows this.
Whether they are implementing measure like free Flu shots and are ramping up supply of Flu shots using the military if they have to, I doubt, because no one wants to think ahead more than a day.
Social Distancing is not different/difficult for them; http://archive.vn/bEMTt
Like a dead stupid one would be to compare to historical data for fevers/week per thermometer.
That is barely a model at all and it manages to ignore how many readings are done and accounts for multiple readings during a period of illness and readings for multiple sick members of a household and so on.
Their data is visualized at https://healthweather.us/
I’ve been checking this daily for the last week or so.
Alcohol poisoning from home stills is a constant.
I think the future might be better with a polite nod instead. But that is because I do not like this contact with just anyone (I did a lot of business travel and it is scary to see how few people wash their hands after doing whatever on the toilet). Obviously with friends/people you know well things are different; I am referring to contact with just anyone you meet.
Is there any research about infectious diseases and greetings? Especially handshaking, hugging (another one I could do without unless close friends) and kissing.
Unfortunately, there's still a large segment of dirty-handed people who think you can judge a person based on their handshake.
Bro hug with a friend I haven't seen in a while? Okay. Sweaty hand contact with a stranger? Never.
Sounds like you're unfamiliar with the practice of agreeing to a deal by both parties spitting into their hand and then clasping hands?
There's also the idea of making a pledge by both parties cutting their hands and then clasping hands, mixing blood with each other.
And also article is not discussing air pollution at all, they talk about less fevers detected on smart thermometers. Those are caused by seasonal flu and other viral seasonal colds, obviously because people now take more care, so those other infectious diseases are blocked from spreading too.
Yet people are emotional creatures and not all deaths are equal.
1. "New thing X puts us at risk of losing Y lives every day."
2. "We lose Y lives to car accidents every day".
3. "Ergo, X is harmless!"
Except you now have 2Y lives lost every day.
Furthermore, car accidents kill an insane amount of people, and cars suck. This is not the bar.
These lockdowns can clearly prevent the spread of existing diseases and save magnitudes more lives as presented by the article along with the inevitable traffic statistics to come out showing the effects.
I'm wondering how someone here supporting lockdowns can justify not repeating it once this pandemic is over? Is ten young healthy lives taken by cars not worth one old ill one taken by a disease?
Point: I don't have a car, yet I'm locked in my home right now. Hmmmmm.
And yes, I would support forbidding cars altogether for most things they're used for today that can be done with different vehicles.
And yes I have; I've been advocating something similar for years.
and yes, it absolutely sucks that we accept a million deaths a year worldwide due to cars. same for the flu. we should absolutely try to raise that bar.
I don't think that is going to happen now, though, thankfully.
This is true in many fields. For example, if you said 30 years ago that everyone should carry all the counter-privacy implications of a smartphone in their pockets at all times, how do you think people would react?
Is it reasonable to expect people to freak out en masse about it today? No it's not. Why is a bigger question but i suspect you instinctively know that I'm correct here.
Does that mean smartphones are a net good on privacy? No. The negatives still exist even if people accept them.
Does that mean the negatives outweigh the good, and we should all throw away our smartphones? No, I don't think so either. The positives are massive. But introducing them today would give us the opportunity to address the privacy issues ahead of time.
Should both cities react the same way?
This whole "the flu/cars/heart disease is way worse" shtick people are leaning on has got to stop. It's true until exponential growth suddenly means it's not.
EDIT: And those are the worldwide numbers. In the US specifically, covid-19 is killing about 200 people/day, compared to 100 people/day for car accidents, and is of course going to go way up from here.
So "and will probably get there in another week or so" is probably too slow. If it's really 2000 deaths per day now, I can safely estimate 4000 deaths per day in just three to four days. Then in next 4 days it will be 8000. Save this estimate and compare.
In order for the effect you describe to happen (the maximum to be reached) the most popular estimate is that the number of infected has to reach around 70% of the population. Until that point the doubling of deaths every few days, without the measures to prevent that, would continue, deaths happening in always bigger amounts, but concentrated in the few weeks.
Imagine 5% of the world’s population requiring hospitalization all at roughly the same time. We don’t have 350,000,000 ventilators and hospital beds and health care professionals to take care of them, so the death toll and general suffering would be unimaginable.
https://www.nytimes.com/2020/03/25/nyregion/nyc-coronavirus-...
You want a lockdown before your city turns into a medical disaster zone. Celebrate the fact that it's being done early.