Stay-at-home policy is a case of exception fallacy
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If you want to see the impact that stay-at-home has had on COVID, a good place to start is looking at the prevalence of the Flu, for which was have years of baseline #s to compare to 2020, and Winter 2020 has seen the Flu practically disappear. This is of course not conclusive evidence, but it definitely shows that stay-at-home can be massively effective at preventing disease transmission.
And that last bit is important because I knew far too many people dragging themselves into work with a runny nose and fever and basically spreading illnesses to anyone they come in contact with.
After the vaccine has reached herd immunity levels I hope there are real lessons learned about containing highly contagious diseases.
I was at an event just over a year ago where we weren't handshaking and surfaces were being wiped down but otherwise we were taking zero precautions which was pretty much the norm at the time. So, basically, we weren't taking any meaningful precautions.
Not that I doubt the civic mindedness of the NZ people!
Is this really the belief? Canada’s inferiority complex wrt to the US has made their perception of COVID out of touch with reality.
There was always significant community transmission in BC, even in the summer. Cases never went to zero, the lowest point was ~10/day. And it’s likely underestimating by a factor of >5 since testing in Canada was not done well. (This is despite the popular perception. Anecdotally, in Washington my family was able to roll into drive thru testing sites and get next day results for free, and in Canada it was a >$100 appt at the retail pharmacy and 3-5 days for results. I don’t how it is now, but Washington has been doing ~3x as much testing per capita as BC since early summer last year.)
So even if essential travelers crossing the border was importing a few cases a day (extremely unlikely IMO, and zero evidence supporting this), it would be accounting for a small single digit percentage of cases.
Certainly community spread has worsened significantly since then, but that's kind of my point; it was never realistic to essentially eradicate the virus and then open back up here, as NZ did, because there would always be a baseline number of imported cases ready to spark a new outbreak.
NZ locked down, had good isolation, and got a bit lucky.
The problem with COVID is that because there’s a large portion asymptomatic carriers, the success of contact tracing can vary a lot.
In Canada, it is politically expedient to point to (valid) US failings and throw them under the bus. I don’t doubt that this is something done by the BC health officer at the time. My math of single digit percentage is based on even having a few cases a day coming in contrasted with 10-20 cases underrepresented by a factor of ~5. It’s just guessing, but I doubt they have more than a few direct travel cases each day and therefore community transmission was significant. I would be curious if there was any data that suggests this guesstimate is wrong.
It’s possible to argue that all that community transmission was the result of border crossings, but the same is true everywhere and quickly becomes non-sensical. Would the virus have disappeared if not reseeded by travel cases? We do know that New Brunswick and Nova Scotia had the same essential travelers (i.e. baseline imports) but were able to effectively control and have had no deaths since August of last year (and very few cases).
I’m not saying that BC did a poor job — I’m not sure that BC could have done anything to contain the virus completely. But I also don’t think it’s reasonable to point the finger completely at travelers as the thing that prevented success.
As for the Atlantic provinces, they are quite a bit more isolated than BC is, despite, yes, also having a certain amount of necessary traffic. And I agree with you that there's likely some luck involved as well.
That's not the same as blaming the whole thing on US mismanagement. I agree that some people are doing that, and certainly I don't approve. (Although I wouldn't chalk it up to an 'inferiority complex'. If anything I would say too many people here are feeling a largely unjustified sense of superiority. Trump may have provided a very visual display of incompetence, but for the most part on the ground the responses were similar. And while Canada's results have been better than the US's, they've still lagged the world on average.)
I do understand this policy though. It's convenient to think that if not for incompetent leadership we could be like NZ. But unlike an isolated island nation, it is not possible for a Canadian province to cut itself off from the rest of the world to a sufficient extent that a COVID-zero policy would have been practical thus far. Instead, the stated goal has been to control infections at a level where they did not overwhelm 1) the hospital system or 2) the ability to trace contacts. As the latter has been stressed over the winter, restrictions were increased.
The purpose of this is to keep cases to a very low number, which allows test/trace/isolate to not be overwhelmed. If there are a lot of tracers and they don't have much work to do, they can be very thorough and you get few leaks.
When you do get leaks, targeted lockdowns work to suppress clusters while test/trace swarms in.
Lockdowns, quarantines, and mask mandates that are not actually enforced are much less useful than ones with teeth. There will always be a segment of the population that doesn't want to cooperate, and if they are not forced to comply, clusters will form among these populations, overwhelm test/trace, and then spread to the general population.
Those are all quite isolated countries without active land borders, except probably Vietnam.
And maybe that was your point.
But that's not what I wrote, so I take responsibility for being misunderstood :)
People were asked to queue 2m apart and wait your turn. We didn't bitch and moan about it, we just did it. 4 weeks of hard lockdown then 2 more weeks of slightly lifted restrictions, and in exchange we got a full summer of nearly completely free movement with cases being counted on one hand per day.
Groceries, as well as chemists and other specific industries were considered essential services that remained open. Lots of health and safety requirements put in place, including wearing masks, perspex screens between you and the cashier (or dividers at self-checkouts) to reduce droplet transmission. 1.5 meter minimum distance between people not from the same household. One person per four square meter density rules for indoor workplaces. The list goes on.
Movement was also limited to five kilometers from your home without a good reason (common sense exceptions in cases where your closest grocer was further away for instance, but not so you could travel to the other side of the city to go for a nice bush walk) and you had to wear a mask whenever not in your own home.
Elimination of community transmission was achieved during our (admittedly mild) winter. Not during our (admittedly mild) summer as a lot of people in other hemispheres seemed to assume.
While our geography was advantageous, it also required a huge effort of societal and political will and cooperation to achieve. It relied on following the advice of our health experts and scientists in the face of large economic and political pressures.
In Melbourne now we are enjoying reasonably normal conditions compared to B.C. (Before COVID) times. There's fairly little risk of community transmission. Most people are back at work and/or some combination of continued work from home. Schools are open. You still have to be carrying a mask when not at home, but only required to wear it in shopping centres and similar situations where there are large numbers of people indoors and similar. Plenty of hand sanitiser dispensers around. Aforementioned screens and dividers are still around.
We had a snap five day "circuit breaker" lockdown recently after a cluster of infections occurred (escaped from quarantine) which was successful but unsettling, particularly for those who had a harder time of it last year.
Not sure why I ended up doing such a details write up to your inquiry. I suspect it was cathartic.
https://onlinelibrary.wiley.com/doi/full/10.1002/soej.12475
But the same research group found that BLM protests did not:
https://www.nber.org/papers/w27408
It's possible that both are true, but it's a bit suspicious that these findings are so well-aligned with the probable political associations of the authors.
My understanding was that there were a lot of “mask-skeptic” folks at the Sturgis Motorcycle Rally openly flaunting safety protocols and doing stuff like hanging out in packed bars with no mask on. Sure, you can get away with some amount of line-stepping and even straight up rule-breaking and still not catch Covid, but when you have a gathering of people for whom flaunting Covid restrictions is actually a form of virtue-signalling... well it’s probably not going to end great.
Having attended the BLM protests myself (in Baltimore), I don’t think I saw a single person not wearing a mask. I’m sure they existed somewhere in America, but I’m pretty sure if you showed up without a mask someone would give you a disposable one. Why do I think that? Because there were also folks with hand sanitizer pumps giving away hand sanitizer for free. The walking marches were not perfectly socially distanced, but with everyone wearing masks and walking about 3ft apart in the open air, it makes sense that there would’ve been less spread. There were also marches that were done as parades of cars so that folks who were more at-risk for Covid had a safer way to participate.
Again, good intent alone won’t stop the spread of a disease (it doesn’t care if you’re “trying real hard” to be safe). But when the culture of a group is focused around taking the virus seriously and trying to balance the goals of the movement with keeping people safe, it makes sense that you’ll have better outcomes.
Around where I live, people are being pretty good about protocols inside. Outside? I don't live in a city but on trails and so forth, the common pattern is people will pull up a gaiter if they're going to pass a group wearing masks. These days, almost no one is. When I do pull up a gaiter it feels like theater.
So this excludes New Zealand. I think that’s an important point, as due to strict lockdowns we’ve had at least six months with no restrictions on movement at all, except through the border. We’ve had three community outbreaks and each time lockdowns combined with contact tracing have stopped the spread.
I’m no epidemiologist so have no clue if there’s other factors in play, but I appreciate having cafes and offices open.
Edit: fixed geographical mistake :).
Which is about what you'd expect there.
Here is an excerpt from a WHO report [0]:
> Early activation of a strong response system, including surveillance and risk assessment, laboratory, clinical management and IPC, and risk communication, which enabled Viet Nam’s successful control of COVID-19.
Here is the UN summary [1]:
> Viet Nam’s response to the health system aspects of the COVID-19 pandemic has been one of the most effective in the world and this is now increasingly recognized at the global policy level. The country has now controlled the virus and pandemic multiple times including the recent outbreaks which started in Da Nang on July 25, 2020 after the country had achieved 99 clear days of freedom from local transmission of the COVID-19 virus
Here is Reuters reporting about this [2]:
> “It is organised, it can make country-wide policy decisions that get enacted quickly and efficiently and without too much controversy,” said Guy Thwaites, director of the Oxford University Clinical Research Unit in Ho Chi Minh City. Thwaites’s laboratory has been helping to process tests.
> Thwaites said the number of positive tests processed by his organisation’s lab was in line with government data. He said the hospital where he works on the wards – Ho Chi Minh City’s 550-bed Hospital for Tropical Diseases, serving a population of 45 million people in southern Vietnam – had not admitted any additional cases not reflected in the government’s numbers.
Here is the BBC [3]:
> Speckled among the praise showered on Vietnam for its handling of Covid-19 were some questions about the accuracy of the authoritarian state's data, which medical and diplomatic communities had widely agreed was reliable.
> "The new deaths reported shows that there is transparency in reporting Covid-19 in Vietnam and that previous 'no deaths' should have not been questioned in the first place," Dr Huong Le Thu, a senior analyst at the Australian Strategic Policy Institute, tells the BBC.
[0] file:///C:/Users/ionut/AppData/Local/Temp/Viet-Nam-MOH-WHO-COVID-19-Sitrep_(7Mar2021)_final.pdf
[1] https://vietnam.un.org/sites/default/files/2020-10/UN%20Asse...
[2] https://www.reuters.com/article/us-health-coronavirus-vietna...
Initially they did do severe lockdowns but the virus escaped into the population not long after and it was a lost cause. Realize that even though the lockdowns were severe, just about every such mandate is optional if you have money, both in theory and practice.
The above reporting isn't particularly credible. Having worked for the UN and been involved in the sausage-making at international NGOs, it would be a mistake to treat their outputs as a scientific fact-finding mission. Outputs are virtually always in service of narrow political or economic objectives that may be unrelated to the topic of the report, they aren't written for the purpose of conveying information per se. It is a formal writing style that makes heavy use of selective omissions.
Some countries were successful at containing COVID. In the specific case of Viet Nam, it would take a relatively naive review of the evidence to come to that conclusion. It may be authoritarian but it is much more corrupt and disorganized than many of the other "hard lockdown" countries.
I'm open to the possibility that they are cooking their numbers somewhat, as all authoritarian regimes are inclined to do, but it simply can't happen to the extent you are claiming without becoming at least a well-known conspiracy. Especially given that Viet Nam is not some great friend of the the US or Europe (say, a Saudi Arabia).
I think the more valuable examples are in asian countries where they share close land borders. I'd assume that their cultural differences enable to comply with the rules a bit more than western countries so I don't know if it was even possible to prevent something like that in countries like the US. There's just too much resistance to control like that and the amount of land border that'd we'd have to police
In all fairness, the US could seal its borders pretty tightly if it wanted to. But the land borders were kept open for commercial purposes and we allowed passenger flights in and out. And there are lots of reasons why shutting all that down would have been politically and economically challenging. But we could have done so (which is not to say we should have).
Air travel could have been shutdown for a bit, at least other than to let Americans get back home. But no way it would ever have been sealed for months.
Looking at the article, is about a computer model that somebody built - these are incredibly easy to (intentionally or unintentionally) bias, and I’d say that looking at this critically is entirely appropriate.
I had a look at the german numbers and often the public reacted before the policy. Similarly they might subvert policies if they disagree, different cultures certainly got together in different ways, ect.
On the other hand I had a look at the "stringency index" of ourworldindata and found it doesn't represent all the little more or less compromising compromises in the policies very well.
This is an interesting site with respect to mobility (in the US). https://covid19.gleamproject.org/mobility I played around with it a bit and you can certainly pick and choose cases where less mobility seemed to correspond to better outcomes. But you can also find other cases where less or more mobility didn't seem to lead to especially different outcomes.
> In this ecological study, data from www.google.com/covid19/mobility/, ourworldindata.org and covid.saude.gov.br were combined. Countries with > 100 deaths and with a Healthcare Access and Quality Index of ≥ 67 were included. Data were preprocessed and analyzed using the difference between number of deaths/million between 2 regions and the difference between the percentage of staying at home.
This is the kind of result where I do worry a lot about that, since it is one of a very few topics where a null result might still be newsworthy, and where the result grossly defies common sense (if people are really staying home, pretty much any model of disease spread would predict less spread).
That's the point I've also mentioned in a post. If an applied statistics paper yields results that directly contradict good analytical causal models, then you know something is wrong with it. But I was heavily downvoted for that and deleted my post. I believe there are trolls or bots in this thread on HN today.
None of us are living in hermetically sealed clean rooms, either.
Society does not seem to be on a good course at the moment. The new Authoritarian chic may delay rational dialogue by several centuries until the Dark Age has passed.
I had one cold this winter, rather than counting on get sick 4-5 times.
I do have a self-centered concern on opening up though.
My life was lousy before the epidemic. I didn’t see a great economy. I saw a lot of really lousy jobs, and a lot of desperate competition.
I noticed some societal pressure to produce/succeed lighten up during the pandemic, at least for myself. In a weird way, it was kind of a positive. With each day they are counting to opening up, I noticed my sleep, and depression worsen.
In the future, I don’t want to act as if all my fellow humans might have cooties, as I think that’s more damaging than the slight increase in viral infections.
Anyway, watch those numbers. They show measured "herd immunity". They're not a projection from some other data.
[1] https://www.cdc.gov/coronavirus/2019-ncov/covid-data/seropre...
> Pubs, restaurants, and barbershops were open in Ireland on June 29th and masks were not mandatory, after more than 2 months, no spike was observed; indeed, death rates kept falling.
It's obvious there's a gigantic seasonality effect in Covid. Whereas Ireland reopened in December and the cases shot up.
Only some pubs were reopened during that time in Ireland (with limitations, distancing, etc) and you can bet most people kept their masks in barbershops.
The article clearly states “ With our results, we were not able to explain if COVID-19 mortality is reduced by staying at home in ~ 98% of the comparisons after epidemiological weeks 9 to 34.”
And everyone’s conclusion in Hacker News is that the study must be flawed.
Scientists harp on the fact that correlation and association, do not mean causation. Except in virology where circumstantial evidence is enough to upend the freedom of the world for the sake of an abundance of caution. This religion of virology.
We have a long way to go from here, but I'm hopeful that governments move their focus to providing solid data with information about collection methodology to keep the public informed. All the central planning and ruling with the threat of being thrown in a cage as a penalty is too exhausting.
So the only realistic solution is a shutdown for everyone. It would be impractical to enforce in a free society and widely perceived as "unfair" to only have a stay-at-home for high-risk individuals.
They live in a society. If that society is letting the virus run rampant, they will be exposed. This has been demonstrated many times and we don't need any more naive assertions about 'just stay at home if you are scared'.