Super-spreading wedding demonstrates Covid-19 risk posed by holiday gatherings
latimes.com
latimes.com
"The York County Jail employee showed up for an eight-hour shift despite having COVID-19 symptoms. It was the first of five consecutive days of work for the employee..."
I see the main problem not as the wedding, because an infection can frankly happen anywhere, but as a failure to accommodate people who feel they can't miss work even though they are ill (need the money, fear repercussions, policy that limits sick days, etc.). I don't believe the individuals intentionally exposed others, but felt they had no other choice.
The only person I know that got Covid, his only symptoms was that he was sleepy, he slept for a whole week 14 hours a day. It's quite bad, but I could see many still going with it, sleeping 8 hours and still going to works sleepy. I got plenty of days I felt sleepy in the past and still went to work.
Headache is another symptom, again, never got any yourself? Pop an Advil and go with it? Would you miss work for that reason?... I may miss too many day if I had to consider that one.
I don't know what symptoms he had, but it could be pretty minor... yet we simply can't get a day of for every minor thing. I agree completely with you for major symptoms, but sadly, there's many case where people are asymptomatic or doesn't even know they are symptomatic because of how commons or hard to spot theses symptoms can be.
You know what we can do though easily though, postpone a wedding or have a wedding differently. They were 55 there, were they all required? Why do it inside? Why not refusing people without mask? Why not enforcing more strongly the few basic rules of social distancing?
Viewpoints on liberty and consent aside, there doesn’t seem to be much of a strategy or timeline yet and it’s time we do a cost/benefit analysis that considers all costs and complications beyond covid.
How so?
self·ish adjective (of a person, action, or motive) lacking consideration for others; concerned chiefly with one's own personal profit or pleasure.
> who want to visit their relatives for the holidays.
Thus, being selfish as they got no regards on the impact of others. In Quebec we got some private care home where 80% died of Covid. It only takes one to bring it.
> Perhaps it’s the politicians and others who are being selfish by imposing their will and desires.
Their will and desires of what? Of saving lifes? Sure caring about someone's else life is purely selfish, much more than wanting to spend time with others.
> it’s time we do a cost/benefit analysis that considers all costs and complications beyond covid.
The US is the one that killed the most to avoid theses "costs and complications". Was it worth it? Go see anyone that lost their grand parents because of this, many of them could have spend time with them today if it wasn't because someone else was selfish.
If you got high risk relative that you want to see, buy them a webcam or keep them permanently in your home please. Keep the risk to yourself. If you care about them, please reduce your risk too, they deserve that "cost and complication".
The two options are:
- Go for it, you have guaranteed quality time with family and (unknown) risk of dying.
- Stay isolated, guaranteed miserable time alone, then you die anyway a bit later.
I'm not surprised at their choices. We should not be optimizing for length of life at the cost of its quality.
In reality there is a whole continuum of options, such as reducing the number of relatives you visit, or not visiting them at the height of a wave of infections.
And of course "you die anyway a bit later" isn't true, with a vaccine on the way.
> 65% died within 1 year of nursing home admission
> 53% died within 6 months of nursing home admission
https://www.geripal.org/2010/08/length-of-stay-in-nursing-ho...
Why isn't this selfish? They put not only themselves, but also their families at risk.
Perhaps you'll say they're being "foolish" instead of "selfish" - perhaps they have been mislead to ignore or disbelieve the truth of how potent the virus is, or how miserable a way to die it is. But their own selfishness and their own self-interest can only make it easier for them to believe the lies or misinformation that would cause them to make such an error.
But clearly - even globally - more than enough people are aware that some people will absolutely destroy any semblance of normal life, and irreparably damage the fabric of society in a frenzy of fear and panic, waving the banner of science, without acknowledging any of the complex decisions around risks, costs, etc.
There's a very real plan, which is to develop a vaccine. And that plan seems to be going pretty well. The timeline will be dictated by the success of the plan, but it seems that most experts are reasonably confident that vaccines will be available next year.
Regardless, the wedding and reception behavior was entirely irresponsible. But the link between it and the long-term care cases seems tenuous, at best.
https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a5.htm
It looks like just contact tracing here, not genome sequencing.
The patient in question is A2 and the study does not say whether they ever tested positive or had symptoms.
Everyone seems to say "1-2 days before symptoms start", although some sources say "2-3 days". And yes, as you say, the 2-14 days for becoming symptomatic seems to be much more agreed upon.
That's where it seems to me to be a very rapid spread (below average) from the wedding to the LTCF. But not impossible.
I was also curious about the situation around the LTCF in the days leading up to that outbreak. I was expecting to find that perhaps there were other community cases around there that could have contributed to the LTCF.
However, looking at the MeCDC website for Somerset County (where the LTCF is reported to be located), the county seemed to be pretty "under control" in the days leading up to this event. The most recent confirmed cases had been over 2 weeks prior, on July 24th. It's actually the longest they had gone without a new case in almost 3 months.
Given that, I'm more likely (as the CDC concluded) to suspect the contact tracing from the wedding to the LTCF as being the cause. It's not an absolute link, but it's probably more likely than I originally assumed.
Edited
Stories like this are the main reason. Even if no one at the party gets very ill, the chance of further spreading it to others seriously scares me.
To answer the original question I don't plan to do anything for the holidays either. Our activities will be in-home with my wife and myself only. I don't really see that changing until vaccines are ubiquitous and the local R factor is well below 1. Unless the disease is eradicated which in the face of antivaxxers seems unlikely, I don't thinks things will ever entirely return to normal.
> Unless the disease is eradicated which in the face of antivaxxers seems unlikely, I don't thinks things will ever entirely return to normal.
I think you're way overestimating antivaxxers. They make a lot of noise on the Internet and in some media but they are far from being a majority. I'm confident we will be able to eradicate this virus with vaccines, like we have (mostly) done so in the past with diseases such as polio or tetanus.
No of course they're not a majority, but there are enough out there that it reduces herd immunity; I'm not epidemiologist so I can't really make an argument as to how much, but it will be > 0.
Yeah polio is unfortunately a perfect example of how one community for whatever reason choosing not to vaccinate leaves a reservoir for the disease and prevents total eradication. I'd be delighted if I'm proven wrong and we manage to eradicate Covid-19. I'm just personally skeptical compliance will be high enough to do it considering the anecdotal data just watching people wear masks now, which is frankly a much lower bar.
That process alleviates enough of the fear for us.
Edit: Why the downvote? This answers OP's question, and if I'm being downvoted due to concerns around spreading a virus then by all means, please feel free to start a discussion around why this option might be unsafe. Nobody in my family has traveled yet this holiday season and I'm not trying to be cavalier about this, so any additional input is welcome.
I carry rolls of dog poop cleanup bags. They make great temporary gloves that you can slip over your hand before touching the gas pump, and they slide off into the trash easily without touching the outside with the other hand.
Keep in mind that Clorox wipes still take 30 seconds to kill the virus (according to the manufacturer page). Most people don't tend to wait after disinfecting a surface before touching it, meaning the cleaning agent may become more diluted and less effective.
Better yet, disinfect and wear a baggie-glove while pumping. I don't disinfect the pump when wearing a plastic bag glove myself, but I do use hand sanitizer as soon as I'm done.
My wife has a pre-existing condition and we've been taking sheltering-in-place pretty seriously since the Bay Area shut down in mid-March. We've both been working from home and have only ventured out for walks, to sit in corners of parks away from everyone, or to go to a doctor. Groceries/food get delivered (I haven't even been into a grocery store since March, which feels weird) and we haven't hung out with friends in person or anything like that.
On the flip side, both of my parents are going into work and my mother works at a nursing home (which - so far - has not had a single case of the virus), so they come into contact with far more people during the day than we do. In addition, we have an eight month old which makes us doing a day-long road trip without stopping at a hotel next to impossible.
So since our contact with others remains next to 0, and my parents are totally cool with using the extra PTO to quarantine, get tested, then quarantine a bit more before driving down, we feel comfortable with it. Obviously I'm not going to view it through rose-colored glasses and act as though there's no risk, but there's a much, much smaller risk through this route than if they were to hop on a plane and come straight over sans negative test.
I want to have a big blowout party next year this time with all my friends and family, but in order to do that, this year has to be different.
This won't be our whole lives, this is temporary. One measly holiday season, that's what we're being asked to compromise. Surely we can manage that?
Think of our grandparents in WWII (or other wars) would have said: "just cancelling get-togethers for one single Christmas? And you're complaining? Ha! How many years we had to ration foods, gasoline, rubber, keep the lights off, curfews, etc?"
I weep for our society if we lack the personal discipline and civic pride to be able to handle this relatively limited set back responsibly.
The big extended family gathering (~40-50 people) at Christmas has already been cancelled.
Flying to Florida for a wedding in December, which I'm very unhappy with. But my wife's a bridesmaid, the bride's her best friend she hasn't seen for years, and the bride cut down on guests. She's doing a webcast for most family and friends. I wish they'd just delay it.
No Christmas gatherings.
And in a normal year, my wife would come down with bronchitis shortly thereafter. Recently we learned that's mostly due to a congenital immune deficiency that had been undiagnosed for years.
Given that, we'll of course be sitting this year out. We may do a drive-by visit to air-hug folks from the car or something, as long as they don't try to get to close to the window unmasked (as some have done in the past).
Make the choice that lets you sleep easy at night & be able to say "even though it was hard, I did the right thing." Standing up for what's right isn't always easy.
I'm afraid, quite a bit of people around me said that they will still do the same as usual. People that do care about Covid, that do talk about the risk and want to reduce the amount of propagation, but still won't make the concession of missing holidays. I'm from Quebec so it's probably that mentality that made us have more death per capita than the US.
Christmas is still being planned.
Almost none of my family have followed reasonable guidelines and I've seen snapchats, etc of them eating indoor at restaurants. There is zero chance I'm going in any of their houses even with a mask on.
Hell, I face a bigger risk coming in to work every single day because my employer insists on all hands on deck despite the pleading of my state's governor.
Maybe Goto the park a few times for my son.
Too much empathy to risk someone's life being selfish.
Pretty disappointing, Thanksgiving is my favorite holiday for seeing family.
In Denver, public and private gatherings are limited to 5 people. Statewide, gatherings limited to members from two households.
I'll wait for the vaccine before I pretend everything's normal again
There will be plenty of time next year when the vaccine comes out.
What about the news stories are overblown exactly? What's the motive for scaring people?
And not shaming for people for going to work with obvious Covid-19 symptoms, both to a prison and a long-term care facility.
It’s clear the editors needed a story about family gatherings and not yet another story about old folks homes being high risk.
Walmart, on the other hand, requires customers to wear masks, and they have and will impose occupancy limits as needed to help minimize exposure.
While we cannot practically reduce the risk of infection to zero, we should also behave wisely. This applies both inside the nursing home and outside it.
If a website left their admin portal open, didn't set a password and then got hacked, would you put the blame for that on the script kiddie who did it, or on the website's security team?
You needn't use your real name, of course, but for HN to be a community, users need some identity for other users to relate to. Otherwise we may as well have no usernames and no community, and that would be a different kind of forum. https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme...
From the article:
> A worker at the Maplecrest Rehabilitation and Living Center, a long-term-care facility 100 miles from Millinocket in Madison, Maine, came down with a “fever, chills, cough, myalgia, runny nose, and headache” — all symptoms consistent with COVID-19. This worker’s child had attended the wedding reception, and the two had been in close contact in the days right afterward.
> Despite having obvious signs of illness, the Maplecrest employee went to work that day, and the next.
Any idea why would that be?
Six of the residents ultimately died of COVID-19. All of them were at least 60 years old and had at least one preexisting medical condition."
6/7 deaths were from elderly people with pre-existing conditions in a long-term care facility.
https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precaut...
E.g. severe obese is one of them as well.
I've worked with people who were proud of coming into work with a hacking cough and temperature. They would take their temperature at their desk and announce it as if they were doing something amazing.
Even worse is when I've worked for managers who during your review compare you to those people saying things like you should make more effort to reduce your time off sick (even if under the average yearly sick days) or make more effort to come in when you're just feeling a "bit under the weather".
It is a terrible attitude but it is extremely common the world over sadly.
In North Dakota the governor just signed an executive order allowing Covid-positive healthcare workers to stay on job. Including nursing homes.
Another reason: don't work, no income. U.S. has no federal sick leave law. Most states don't either.
Keeping these measures in place until a vaccine is available will cause irreparable damage, with the underprivileged disproportionately harmed."
"Please don't post insinuations about astroturfing, shilling, brigading, foreign agents and the like. It degrades discussion and is usually mistaken. If you're worried about abuse, email hn@ycombinator.com and we'll look at the data."
https://news.ycombinator.com/newsguidelines.html
Users are overwhelmingly (as in, thousands of times) too quick to assume organized malice as an explanation for material that they don't like appearing on the internet. This is a symptom of how divided society is on divisive topics. People disagree, but they don't believe that the disagreements are legitimate. For a site like HN, accusations like what you posted are much more toxic than the problem you're complaining about. There's tons of past explanation here:
https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme...
Before anyone comes out with "dang says astroturfing doesn't exist"—no, the point is that there are two problems: real astroturfing, and imaginary internet accusations about it. Anyone assuming only the former is making a huge mistake. So what's the solution? Obviously we have to try to distinguish between the one and the other based on some sort of objective evidence. It's not enough to dislike someone else's view on a difficult topic like Covid and then say "brigading!"
No problem if you disagree about best response to covid but leave room to hear some opposing viewpoints without labeling them bizarre or rants.
Also, this tool assumes you are only seeing people from your county.
And humans are terrible at assessing compound risk. If the tool shows a 5% risk from a gathering, people will likely attend multiple events. ("Oh, it's only 5% to go to Thanksgiving. And 5% to go to Friendsgiving. etc.") When you consider multiple events, risk doesn't stay constant.
So while that tool is interesting, don't look at it as a mechanism to say, "Yeah, it's probably ok to have a gathering."
While you're not wrong that we might be under-estimating risk, I'll note that we do take into consideration seroprevalence in our calculations (so called, ascertainment bias). We provide estimates for two cases; 5x and 10x under-counting bias.
And you are right, that risk is additive (to a degree) if you go do multiple parties. And people are terrible at doing this sort of calculation. Our messaging, in our manuscript/press/social media has always been to limit gatherings of any size, and mask and gather outside as much as possible
https://english.elpais.com/society/2020-10-28/a-room-a-bar-a...
It's clear to most people, in that instance, that an ugly side of human thinking emerges around viral outbreaks and it presents itself in how we consider other human beings.
People so readily stigmatize and it's very clearly on display in this thread.
No human being without ill-intent can be blamed for a virus. Tragedy befalls humanity from time to time, this is certain; instead of pointing fingers, we should be more empathetic, not less.
What of empathy for those who have and will needlessly die alone in tents and hospital hallways and their grieving families who don't get to say goodbye? What of empathy for the medical staff who are working 12, 24, or 36 hour shifts with no end in sight? What of empathy for those who stock our shelves who are constantly put at risk? What empathy for an entire generation of children who will have worse educational attainment because they're forced to do a year or more of remote school?
But sure, let's empathize with someone who keeps eating out and refuses to wear a mask. It's not like they could have done anything to mitigate the tragedy that's going on, right?
Neither is it now? Even at the peak in NYC, the Javits center was never filled, nor the hospital ships. Likewise in the UK the nightingale hospitals were never used.
Should we be wary at all of our propensity for stigmatizing people with disease(especially a viral one)?
Should we berate anyone who gets HIV when they could have worn a condom?
> The entire state of Iowa is now out of staffed beds, Eli Perencevich, an infectious-disease doctor at the University of Iowa, told me. Worse is coming. Iowa is accumulating more than 3,600 confirmed cases every day; relative to its population, that’s more than twice the rate Arizona experienced during its summer peak, “when their system was near collapse,” Perencevich said. With only lax policies in place, those cases will continue to rise. Hospitalizations lag behind cases by about two weeks; by Thanksgiving, today’s soaring cases will be overwhelming hospitals that already cannot cope. “The wave hasn’t even crashed down on us yet,” Perencevich said. “It keeps rising and rising, and we’re all running on fear. The health-care system in Iowa is going to collapse, no question.”
Most of the US is likely to have their medical systems collapse this winter. That will lead to thousands of preventable deaths.
Stigmatizing people with HIV was bad because it was a proxy for stigmatizing gay men. Stigmatizing people who don't wear masks is stigmatizing anti-social behavior.
“Collapse” is too terse and paints a potentially misleading picture of the problem; “be overwhelmed and forced to ration care on bases other than medical need, such as expected future quantity and quality of life and chance of recovery” and “face significantly reduced total capacity because of COVID-19 impacts on staff” would be more precise.
Let's put a remind-me on this one.
> Neither is it now?
https://www.grandforksherald.com/newsmd/coronavirus/6753876-...
https://dcist.com/story/20/11/13/dc-hospitals-covid19-metric...
https://www.washingtonpost.com/national/coronavirus-midwest/...
https://www.alaskapublic.org/2020/11/13/across-alaska-as-the...
https://www.rgj.com/story/news/2020/11/13/covid-updates-neva...
https://www.press-citizen.com/story/news/2020/11/13/coronavi...
https://www.nbcrightnow.com/news/oregon-gov-kate-brown-annou...
https://m.startribune.com/twin-cities-icu-space-at-red-alert...
> Even at the peak in NYC, the Javits center was never filled, nor the hospital ships
Yeah, whatever, that was months ago, and, leaving aside the debates about how meaningful that observation was at the time (which was argued quite a bit here on HN), that's not, and not relevant to, the current situation or forward risks. Right now medical systems in a lot of the country are exceeding capacity and turning away patients who would normally be hospitalized or treated due to the impact COVID-19 is happening.
Does this account for the dynamic aspect of capacity? e.g if health care providers had layoffs due to lack of cases wouldn't that result in reduced capacity?
Also I followed the Arizona ICU bed utilization and noticed the capacity figure followed the number of cases and the number of beds total varied by roughly 2x low to high. This implies the capacity was not fixed and followed utilization. Which makes sense from a business management perspective. But it invalidates utilization as a harbinger of TEOTWAWKI.
It's extremely tough for a while as a population experiences their wave and then the virus essentially becomes endemic. But every place so far around the world has gotten through their wave.
I certainly hope you're right as to a rough peak, but I'm perfectly happy enforcing pro-social behaviors during a crisis of this type. It's normal for the US and other democratic states. Go read some newspapers from 1918 shaming "mask slackers".
This is a fabulous question for online social media: when you go out it can seem like everyone is flouting the rules, no one is being careful, and you're the only one. This is largely because you don't see the people who are being careful because they are staying in so there's a massive bias towards careless, selfish jerks when you go out.
If you want to promote Covid safety, ask this question about holiday plans on Facebook, Twitter, whatsapp, or whatever social network you use. Or a more general question: "How are you/your family staying safe from Covid?"
This question brings everyone who is staying safe out of the shadows and into view, and all the sudden rather than feeling like you're "the only one" being careful, you realize you're in very good company. It's great to show other people as well. So if you want to "do something," start discussions on social media about what people are doing to stay safe!
(the article explicitly mentions this was at least in part in an indoor setting)
We have enough evidence to teach people that the very least they can do is paying attention to air flow. Somehow we aren't.
https://fivethirtyeight.com/features/what-a-summer-of-covid-...
> And if there is one thing we can definitively state, it’s that this virus is much, much less likely to spread outdoors than in. For example, in a study of 7,324 Chinese case reports, only two — part of the same transmission event — could be linked to outdoor settings. A database of more than 20,000 cases (including the 7,324 Chinese cases) found 461 that were associated with transmission in completely outdoor environments — predominantly crowded events like markets and rallies. Overall, only 6 percent of all the cases in that database were linked to events that were either totally or partially outdoors. The rest were tied to indoor events.
Anyway, I live in Tokyo. Tokyo Metro area has basically all of California (SF, SD, etc..) squeezed into an area the size of Los Angeles. 34 million people.
Tokyo has been mostly unlocked since June. Theaters and other venues are open (every other seat), clubs are open (WTFBBQ!), restaurants are open and many are full, everyone has masks off while eating and drinking though outside it's 99% masked.
Number shot up in the last 2 days, we'll see where it goes, but though September and October they stayed flat. About 100 to 200 a day (vs California, same population, 10k day or 100x)
Here are some videos from 3 different weekends in October Tokyo Metro Area
https://www.youtube.com/watch?v=d0UP9v5zOh8
https://www.youtube.com/watch?v=eQQl6z45QxY
https://www.youtube.com/watch?v=13WRmg1NX8g
No idea why the number are 100x less than California similar population. Especially given Tokyo is far more densely populated than California and trains are still packed during rush hour. Schools are open though they swap half the students each day. Lots of people have ideas, none of them proven.
* Japanese don't wear shoes indoors so don't track it into their houses :P
* Japanese are better at wearing masks? (ok, but walking by restaurants full of unmasked people doesn't seem to fit)
* Japan isn't testing as much. I think that's not true enough to get a 100x difference but even if it was hospitalizations and deaths would be up? They are not AFAIK
* Japan has a different version of the virus? Ok, so when the real one arrives were screwed.
* Japanese are healthier? (like obesity is 3.6% here vs 30% in USA)
* Japanese are not vitamin D deficient?
They have put lots of measures in though I assume that similar elsewhere. Every cashier is surrounded by various forms of transparent partitions. Fast food joints sometimes have partitions between every 2 seats. That said a cafe I used to hang out at as one large 20 person table and 8 or so bar seats near a window. I've walked by since it's near the grocery store I go to and it's full, people eating with masks off, no partitions.
I have plenty of pictures of full restaurants as I walk by.
Anyway, would certainly love to know why the numbers are so low relative to the USA and Europe. Maybe it's just luck? Seems unlikely
https://www.medrxiv.org/content/10.1101/2020.09.21.20198796v...
https://ourworldindata.org/coronavirus-data-explorer?zoomToS...
Since the beginning of November, your test-positive rate has more than doubled, from a relatively good 3% to 6%. 5% is considered "good" coverage for tests.
Test coverage per-capita does not seem to be increasing, and may have even dropped slightly in the same time period.
I'd advise against complacency in any country. We've seen just how quickly this thing can spike in a number of countries that appeared to have things "under control".
The not wearing shoes inside really needs to be called out as bunk on two levels. First of all, coronavirus is extremely weak and does not live at all outside of droplets. This means that fomites, that is the spread of infection through residues on surfaces is negligible. You need droplets or aerosol for an infection. Second, as a housecleaner I have found that the no shoes indoors rules leads to less floor cleaning and dirtier floors since the reality is still that gravity takes every crumb and speck down and walking around spreads all that. It is unpopular to say, but in my experience shoes allowed in the house results in cleaner floors because people understand that crud is always accumulating there rather than being in denial.
Carpet is also unusual in Japan. Tatami are not uncommon but they are easy to clean where as carpet is not.
In the US carpet is not only common but is often required for noise reduction. In this environment not wearing shoes is not enough to keep floors clean and it is common for people who do not wear shoes in the house to have filthy floors that take extra effort to clean.
I have cleaned around ten thousand homes during my career as a cleaner. How many homes have you attended?
Honestly, though, it's probably the masks. Adherence isn't very good in the US. And maybe a third of the people I see with a mask are wearing them below their noses.
Other factors I can think of is that the Japanese are particularly obedient. Tell them to wear a mask and they wear a mask, they don't organize protests instead. They also take hygiene seriously in their day to day life.
Another thing is that despite the population density, the Japanese naturally keep their distances. Not much handshakes, hugging, and touching each other unless it can't be helped.
As for a "different virus", it is very unlikely, but a different population, that's possible. As I understand it, the Japanese population is relatively homogeneous, and they may have a genetic advantage.
> None of the victims who lost their lives had attended the party.
It's sort of like the pool at my kids' swim school. If other toddlers were being allowed to go in the pool without a swim diaper, then it really wouldn't matter if my own kid is wearing one or not. They'd still be swimming in water that's repeatedly being fouled by uncontained feces.
Regular masks absolutely provide substantial - admittedly, not perfect, but substantial - personal protection.
There is no evidence for this, and if you read the CDC guidance document that suggested it this week, you'll see that every citation in the newly added section refers to studies about filtration efficiency, which is a very different question:
https://www.cdc.gov/coronavirus/2019-ncov/more/masking-scien...
The high-quality evidence for masks has not changed substantially since March. The few lines of direct evidence suggest that it's possible they help a tiny amount, but we haven't been able to detect much evidence of this, either way. Only by combining multiple (poor) studies together, pooling the data and statistically re-weighting the pooled results was the WHO meta-analysis able to find any signal at all, and the signal wasn't strong:
http://www.economicsfaq.com/retract-the-lancets-and-who-fund...
In 2020, we've had a number of studies that attempt to use statistical analysis of infection data from late spring (when cases were declining in the northern hemisphere) to draw conclusions about masks, and a handful of anecdotes that are repeated frequently by the media -- the Missouri hairdresser, the Korean Starbucks -- that were neither controlled, nor subjected to statistical analysis of any sort.
The only randomized controlled trial conducted on masks for personal protection against Covid -- the highest quality form of evidence for a health intervention -- has been completed since June, and rejected by three major publications:
https://clinicaltrials.gov/ct2/show/NCT04337541
https://www.berlingske.dk/videnskab/professor-stort-dansk-ma...
Moreover, as we have now seen, most of the places around the world with mask mandates and high rates of self-reported compliance are experiencing spikes in infection. At the very least, these call into question the publications that attempted to make claims based on data from the spring. We're starting to see retractions related to this:
https://www.medrxiv.org/content/10.1101/2020.10.21.20208728v...
Imagine, for instance, that we started tracing HIV strains and jailing gay people.
And then arguing that having sex isn't really necessary and abstinence is the only way to prevent transmission.
The implications of what you're saying is appalling.
If someone went around having unprotected sex without telling their partners, then I don't see a problem with a civil suit from anyone they infected to make them pay for the damages they inflicted.
If I were to distort your view like you did mine, I'd say that you're arguing for the ability to go around punching anyone else in the face because to prevent you from doing so would be starting down a slippery slope that would lead to authoritarianism.
"you must face the consequences" is perhaps the most authoritarian thing you could say when arguing in favor of severe penalties.
I expect there will also be social penalties. The world isn't going to forget the people who chose not to take basic steps to protect each other. It's a violation of the social contract, and that comes with consequences.
The wedding attendees used their "personal choice" to attend the wedding and get sick. But we don't know how they transmitted it to people once they left. Were the people they infected taking precautions? Or were they also using "personal choice" not to?
But, it's reasonable question to ask, what's the acceptable number of casualties. The answer is not zero. We have plenty of other diseases that kill lots of people. COVID is more but we still have to pick a number.
Is 1 in 100 ok? 1 in 500? 1 in 1000? 1 in 5k? (the car rate), 1 in 10k? (the flu rate).
I heard about this thinking on the Sam Harris podcast. He mentioned some people claiming if we lifted all restrictions by their estimates deaths would be 1 in 300. He and his interviewee dismissed out of hand without giving it any thought which was very disappointing. Whether or not it actually would be 1 in 300 we still have to pick a number below which we'd accept the losses. Is there a reasonable way to decide that number? Flu is around 1 in 10k (or at least my 30 seconds of searching seem to put it in the same order of magnitude) so apparently that's an acceptable number and we don't apparently get upset as a society that people go around spreading the flu. (though I get super upset personally)
We need to face the reality that on average people make bad choices which leads to substantial negative outcomes for any group. In particular, the COVID-19 pandemic again confirms empirically that humans on average don’t have self-responsibility.
How can philosophical ideas that are founded on principles such as “humans have self-responsibility” then still deem credibility for any larger group of people?
Why do we need laws that mandate seatbelts? Won’t people wear them by themselves? And if not, what does that mean to the whole house of cards of Liberalism?
None of this has to be accepted or conceded to, somehow East Asian countries are able to do to this right, even New Zealand just so we don't start hovering on West vs East, this is absolutely not "humans on average don't have self-responsibility", this is a specific culture that has promoted entitlement, selfishness, materialist hedonism, and ruthless, hackneyed individualism since the late 60s and now the bill has come due
But you’re right that culture can bring out the worst out of people and that we are getting the bill now.
If Covid were an STD there would be huge social pressure on it even though it would be passed less frequently.
HIV/AIDS was that.
Covid-19 is interesting in that it's on the margin for death rates, and its long-term health effects are more varied and subtle than those for, say, polio.
And yet people in many countries reject it.
If a significant amount of people already makes a bad choice at this point where it affects themselves we cannot expect these people to make good choices to protect others.
Also, the laws aren't solely about the wearer; not wearing seatbelts at scale has societal costs.
Is there really? One thing that has always struck me since the beginning of this pandemic is precisely why people would be more willing to attach their seatbelts than to wear a mask. Perhaps not the best comparison to make, though.
From personal experience and the experience of many friends I can confirm (anecdotally, but still) that in Eastern Europe there exist many societies where putting on a seatbelt is socially stigmatized.
It's fascinating to watch, for example, people commenting on Facebook about vehicles driving too fast in winter conditions, endangering other road users. But those same Facebook commenters will say that nobody can order them to wear a mask...
It's the easiest thing to enforce, too. In my city alone, a single police officer with two functioning eyes could probably issue hundreds of mask violations a day. It's not like you have to search someone or go out of your way to see they aren't wearing a mask.
odd comparison to make. I find that in the midatlantic US, speeding and DUI are not enforced very consistently. with speeding, there seem to be only a couple days of the month (usually the last few days) where a bunch of cops are out with radar/lidar pulling people over. with DUI, you are quite likely to get away with it if you aren't intoxicated to the point where your driving is noticeably erratic. the exception would be the few times each year where they actually have checkpoints on certain roads.
> It's the easiest thing to enforce, too. In my city alone, a single police officer with two functioning eyes could probably issue hundreds of mask violations a day. It's not like you have to search someone or go out of your way to see they aren't wearing a mask.
this seems like it could be counterproductive. for one thing, issuing a ticket is necessarily a close physical interaction. for another, what if the interaction goes south and the cop has to grapple with the offender, arrest them, and take them to jail? does this really serve the goal of preventing covid transmission?
and vice versa, do you think?
The thinking is that the restaurant should be certified by industry not by the government, kind of like how the ASE certifications work for mechanics.
Libertarians that I've read and met, in general, want to remove government policies that force entanglement or reliance on the government. A good example is DUIs; reasonably, we know that driving while impaired is dangerous, but what we don't want is for someone to make the mistake of doing that being beholden to the governments whims for their entire lives, which is currently how it works.
There's risk in everything we do, including for other people. What amount of risk is acceptable is a subjective choice.
This is why masks and gathering limits are prudent.
There's a difference between reckless endangerment/homicide than an accident. Ridiculous false equivalency.
Poor example, as Firearms safety 101 would prevent this:
- always point weapon in safe direction
- finger off trigger until ready to fire
- know your target and what is behind it
- treat every weapon as if it were loaded.
- wash your hands
- wear a mask
- practice social distancing
- avoid extended periods indoors with non-household members
https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-si...
...which isn't different than any other year.
Every year, the flu kills tens of thousands (in the US -- higher worldwide). Disproportionately children.
Every year, driving kills hundreds of thousands, even when you exclude the effects of alcohol.
Every year, people have sex without condoms, and pass on harmful -- possibly fatal -- viruses.
Every year, millions of people die from communicable disease of every sort, ranging from pneumonia to HIV.
This is the first time in my life that we've tried to apply transitive risk logic to justify curtailing of individual freedoms. Masks are one thing, but telling people that they can't have family gatherings because it might hurt you?
This seems wrong to me. You can use this logic to justify literally any curtailment of personal freedom.
Seems wrong to me, too. There exists no society (that I'm aware of) where the decisions of an individual don't have second or third order effects on other members of the society. We manage and deal with this risk every day of our lives. Sometimes it flat out sucks. However, you can't control for it without raising a lot of very, very uncomfortable questions about what personal choices get to be made, by whom, and under which conditions.
This boils down to how you see the world, I guess. Much like any of the usual contentious political topics, both 'camps' view the other side as morally reprehensible.
I'm not "free" to start cooking commercially out of my home kitchen without inspections and licensing. This impacts my ability to earn an income -- because otherwise I might make you sick.
It's public health risk mitigation. We do it all the time.
The Republican Party, Trump, and Fox News did that deliberately because Trump early on chose to downplay the virus and response to it. Backtracking on that would have made Trump lose face and harmed the Republican brand in an election year, so instead they chose to politicize it and double-down on not wearing masks.
This has nothing to do with personal choice and everything to do with culture war nonsense being spread at the expense of just about everyone, purely for the political gain of a tiny fraction of a percent.
Driving kills hundreds of thousands of innocent people a year.
Where is the line when it’s OK to control peoples lives because you are afraid?
This is how authoritarianism starts.
[1] https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm
https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
Which numbers on that page are you looking at? Here's what I see:
all deaths involving covid-19: 223,984
all deaths involving influenza, with or without covid-19 or influenza: 6,789
If you permit me to stereotype the HN demographic here- you are probably reading this comment from the comfort of a warm apartment with running water and you're probably not hungry. Removing personal choice is an extremely dangerous idea where those reliable things that you take for granted start to disappear. All you have to do is look to N. Korean, Turkey, Hungary, Venezuela right now, this day to see how disastrous it is. You may call me hyperbolic but this is exactly how it starts. If we have to lose some elderly people to a virus (with an IFR of .1%, median age of death of 84 and 92% with comorbidity), i'm sorry to say that we have to lose them. The alternative is authoritative oppression, starvation and misery for hundreds of millions of others. Make no mistake, this is exactly what is at risk when you talk about removing personal freedoms.
I don't have the personal freedom to get drunk and drive my car down the highway because that puts the lives of everyone on the road in jeopardy. Spreading disease is the same thing. Your personal freedoms end when they start invading my personal freedom to continue living.
Let me ask you something; Has there been any setting in the past 50 years other than changing sexual mores in which people have gained any personal freedom? And have any of the instances in which people lost bits of their freedoms in that same timeframe ever been reversed (again aside from changing sexual mores)?
If you do want to ignore all those issue, I will point out that freedom of speech is more prominent today than it was 50 years ago. After repeal of the fairness doctrine, the loosening of obscenity laws, and various court cases including Citizens United most recently, free speech rights might be at an all time high in the US.
Also there are examples of freedom being lost and regained in gun ownership. The assault weapons ban in the US that lasted 10 years is one that comes to mind.
What about their personal freedom? What about the people who don’t want to work in an environment that might put them or one of their loved ones at risk? You talk about living in a bubble but you don’t seem to consider the teachers, first responders, medical workers, who have to make the choice between working during a pandemic or losing their livelihood.
None countries you mentioned didn’t descend into authoritarianism by enforcing restrictions during a once-in-a-century pandemic.
[0] https://www.nbcnews.com/news/us-news/north-dakota-lets-healt...
So when a pandemic is hitting us and our collective personal responsibility is failing, our only choice is to roll over and get sick?
There are plenty of options to feed those who are going hungry due to COVID, but you should look at who is throwing up roadblocks to assistance.
The current best estimates of IFR for SARS-CoV2 are:
* 0-19 years: 0.00003 (0.003%)
* 20-49 years: 0.0002 (0.02%)
* 50-69 years: 0.005 (0.5%)
* 70+ years: 0.054. (5.4%)
https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...
"Using these age-specific estimates, we estimate the overall IFR in a typical low-income country, with a population structure skewed towards younger individuals, to be 0.23% (0.14-0.42 95% prediction interval range). In contrast, in a typical high income country, with a greater concentration of elderly individuals, we estimate the overall IFR to be 1.15% (0.78-1.79 95% prediction interval range)."
It's very strange that people won't just wear a mask (with it over their mouth and nose). There might be some tiny fraction of people that have a real issue with it, but not anywhere the number of people that feel the need to loudly object to it.
Surely obvious, but there are people who will think that you make bad personal choices and need to make better ones. If those people also wield extraordinary power, well, it becomes less fun to find yourself suddenly having wrongthink.
Let's not forget the cadre of objectors who want us to wear a mask to protect their peace of mind, explicitly stating this goal as needful. Or those who vociferously demean anyone who objects for personal reasons (e.g. I tear up and start sneezing if I wear a typical cloth mask or sterile surgical mask for more than a few minutes, and have a sinus headache for several hours subsequent; I'm not the only one in this class).
Can you cite the transmission rate for asymptomatic carriers? The false positives for the various tests? The critical aspects of the efficacy of masking?
The easiest way to get infectious people to wear masks is to have everybody do it in high contact situations, there's no need to be fancy about who wears mask during a raging pandemic, so your other two questions don't really need answering.
(I mean inside places; I don't wear a mask outside either, as I am not going places where there are crowds outside)
The measures we've taken are deteriorating society in more subtle ways, and there are deaths and suffering indirectly caused by these measures. They are just not easy to sum up. How many people have killed themselves because of the lockdowns and economic problems? I know of at least one. How many people in third world countries are starving as a result of it? I've read millions. How many families are being torn apart due to increased divorces? These kinds of effects pay out their harm over longer periods of time, and in less obvious ways. We aren't tracking those on a widget on TV.
Because the pro-lockdown, pro-authoritarian case is so much easier to back with clear and obvious numbers the government and media are able to easily manipulate the population, most of whom won't consider the trade-offs, into conformity. This is so sad to watch.
It's not the government ruining people's lives, it's the pandemic.
I wish we'd evaluate actual risk rather than perceived.
Seven people died. This isn't some hypothetical where people are acting like there's risk where there isn't; it's a story of seven real, living, breathing humans passing away.
I'm becoming more and more callus about the whole thing and beginning to think we just need to adjust our expectations and accept that people die.
I was told recently that my town is in terrible shape and the hospitals are nearly overwhelmed. Listening further, I learned that "nearly overwhelmed" meant we had capacity for two or three people to be really sick with Coronavirus.
If we need to decimate our economy because only two or three people can be really sick at once, then that is the wrong trade-off in my opinion.
Would you believe it if I told you that not fighting the virus has an even bigger toll on the economy? Imagine if we'd aggressively addressed this problem back in March, how much less economic impact would have resulted. But then, as now, we wanted to "protect the economy" and avoid restrictions as long as possible. But this time the strategy will work? I have trouble believing that.
Europe had about the strictest lockdown you can imagine and their economy isn't exactly peaches and cream right now.
And they have spiking case counts just like the US right now.
Um, no. No, we didn't. The lockdown in Europe (which was different in every single different country in Europe) was sloppy in the extreme. You shouldn't be looking at Europe as an example of a good way to deal with the virus and protect the economy, you should instead look at South Korea, New Zealand, and Australia.
Lockdowns should be early and hard, until there are no unknown cases left in the population (that is, all cases have been tracked down and isolated, and there are no new surprise infections popping up). The earlier and harder the lockdown, the lower the number of deaths, the sooner the virus is eradicated, and the quicker the economy can go back to making money.
I think the best comparison to draw is China and New Zealand. They have the strictest lockdowns you can imagine and the virus has been completely contained in those countries. Whole cities are locked down after just a few cases. China has been limiting and disinfecting frozen food imports as it is one of the few remaining vectors the virus has been reentering the country. As far as I understand, their economies and daily life have been saved, but it comes at a huge cost to individual freedom, a cost that North America or Europe would never accept. There is no point in imagining Chinese disease control measures in America. It's beyond the realm of possibility. We need other solutions.
The spring lockdown made sense, in that we didn't really have much information. At this point, we have a bunch of other tools that we aren't using, because people have decided that doing anything is somehow the equivalent of a strict lockdown.
Absolutely not.
Also, the word for "cruel disregard" is callous.
The economy goes up and down. It's a fact of life. Why worry about it?
In the grand scheme of "the economy", my portfolio is up something like 8% for the year last time I checked. My job is stable.
In the locality of "the economy", I have heard multiple businesses in my area say that they are barely hanging on by a thread and will be forced to close permanently if the state forces them to shut down again.
People might not be dying from the shutdowns, but it sure is an uneven load we're asking people to carry. Particularly from this high pulpit of HN, where we nearly all have cushy tech jobs where we don't have to interact with anyone to get paid.
The science is clear that the risk of COVID morbidity and mortality is not evenly distributed. There could be more than one good way to manage this risk and keep our healthcare system functioning. As we start distributing the vaccine, we are going to have a great opportunity to mitigate a large portion of the risk for some people, while accepting a lower risk for others as the price to pay for getting back to normal as soon as possible. We make these kinds of population risk decisions all the time and no one bats an eye. Simply getting in your car every day and trusting your life to its imperfect safety systems is one example.
Soon we will need to draw that line of what risk we, as a society will accept, and then get on with it.
You have to be in a high risk group for what? To die? As far as I know, while some health conditions or age raise risk of covid death or morbidity, there is no group that is without risk of death, i.e. anyone might die from Covid19. Is that your understanding as well, or do you know of some demographic group that has experienced 0 deaths?
I am happy to grant that the risk is much smaller, but just like the "kids can't get or spread covid" MYTH that people have been grasping to for dear life in the face of overwhelming evidence to the contrary, this "only old people die of it" myth needs to be squashed.
For young healthy people, it's true in the same sense that you don't have to worry about getting struck by lightning or attacked by a shark. These things happen, but they're so rare that it's silly to go through your life in constant fear.
besides being incredibly selfish
It is not selfish to consider whether it's possible to protect vulnerable people without demanding that everyone give up their social lives, children's education, and jobs for a year.
just like the "kids can't get or spread covid" MYTH that people have been grasping to for dear life in the face of overwhelming evidence to the contrary
What evidence? Schools haven't been significant drivers of infection or deaths anywhere in the world. Yes, the risk is not literally zero, but if that's your criterion then you'd never leave your bedroom.
this "only old people die of it" myth needs to be squashed
If everyone had the risk factor of a healthy 30 year old (say, 1 in 10,000 chance of death and 1 in 2500 chance of serious complications), would you still support shutting everything down?
Hundreds of thousands of Americans have perished from this disease and it didn't have to be this way. There is a major thrust of anti-intellectualism in the US, Brazil, and other countries. As "hackers," we try to understand what the intellectuals believe. Then, we figure out what's happening in the real world, and finally, we break the intellectuals' rules in pragmatic (but not expedient) ways.
The guy who just won the US presidential election claimed that we are entering a "dark winter," and it's a pretty relevant topic to HN in my view. COVID-19 sits at the unlikely confluence of medical science, tethics (shout out to Gavin Belson), statistics, system dynamics, and public policy.
It means that there are some people who produce and share far more viral material than average (right-tail individuals, so to speak).
There is no more a connection between "super-spreaders" and "super-predators," as there is between either of those two terms and "superman."
https://www.technologyreview.com/2020/06/15/1003576/whats-a-...
If you're afraid of the word "spreader," then I suggest that you stay away from the lawn care section of your local home improvement retailer.
People are afraid of disease. That doesn't mean we should stop using the word "disease."
EDIT: I can't speak for the LA Times, and I'm not trying to defend them. Maybe they have an axe to grind. My comments are restricted to the terminology itself.
My own father passed of pneumonia and although sad it also was normal.
Everyone could be rationed a certain number of gatherings per month and then each person would be free to choose how to use them. They could use one to see family during the holidays, they could go to a protest, go to a wedding, celebrate in the street, go to a movie, etc.
We could even track them as discrete tokens, or "social credits" using blockchain technology. This would allow contact tracing software to be able to determine the "cost" of an event based on how many people were exposed and then withdraw the appropriate number of credits from the participants.
In a system like this, people who don't go anywhere or see anyone would be able to redeem their excess social credits for things XBoxes or VR headsets.
Why doesn’t the government actually just enforce rules? So many lockdowns, mandates and laws but so little enforcement, or the penalty is not commensurate with the risk. What’s the point?
Because there is no government to enforce the rules. Only a loose aggregation of individuals, each with their own personal interests. Those interests often include things like, "I don't want to do anything that might anger people and lose me the next election," or, "If I cite someone for this, I am going to have even more paperwork to do when I get back to the station."
This way of thinking about how civic institutions behave becomes particularly important in a country like the USA whose cultural values tend to place individual freedom above many other things, including civic duty.
Not enough people talk about the good things the police don't do because they are too busy doing the the bad things.
Edit: also the federal government can't just "demand" things of the states. That whole republic thing gets in the way there.