Current Affairs Coronavirus Thread - Serious stuff !!!

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Interesting read.
Think he makes a persuasive on a lot of it, especially the care home stuff, but am a bit skeptical about the claim Sweden did well - most data I’ve seen suggested mich worse outcomes both in terms of fatalities and economy than their comparable neighbors.

 
It's not really big numbers though is it? 100-300 cases per million for all of them there..
Don’t know about other countries but here in the US both the Delta wave and currently Omicron there are big regional differences which somewhat obscure the hit to hospitals on the ground.

Florida for instance was slammed during Delta but there wasn‘t much hospitalization here in the Bay Area but the two together would average out as looking not too dire but in practical terms care was compromised in Florida for a while as you can’t share the load between two places so far apart.
 
Think he makes a persuasive on a lot of it, especially the care home stuff, but am a bit skeptical about the claim Sweden did well - most data I’ve seen suggested mich worse outcomes both in terms of fatalities and economy than their comparable neighbors.

I would call this armchair quarterbacking with the benefit of hindsight. Thanks to @Deckard2049 for posting it. It's interesting. I think it's absolutely unfair to say that the policy-makers were wrong to impose lockdowns under the circumstances, given available information. If you want to argue that we should have done a better job in January and February, I'm 100% on board that train. March and April were very easily foreseeable, though the cat may well have been out of the bag by early February.

The best comparison we had available to inform decisions was the natural experiment across St. Louis and Philadelphia in 1918. St. Louis cancelled public events and was aggressive in preventive measures; Philly did not do so. Philly got crushed; St. Louis did not. Philly had something like half a million cases against 16,000 deaths (ie: 30% of the population infected and a bit over 3% died), so we're talking similar lethality here early on during the period when health care was overwhelmed (assuming you buy the infected count this time around, which is dodgy).

I'd say that the Sweden numbers tend to support the lockdown case.

His argument that lockdowns don't work and are "a failure of public health policy" feels a bit like the "economic sanctions don't work" argument to me. Of course sanctions don't work - you only impose them when deterrence fails and the other side has already determined they are 100% comfortable with the clearly communicated consequences of non-compliance. It's the threat of sanctions that's potent. Similarly, lockdowns are a last-resort plan, and you're only going to see them during an outbreak which was not contained at the outset.
 
Not only will not testing mean more transmission from pre-symptomatic/asymptomatic people but Monoclonal antibodies and new Paxlovid drug are better taken early in infection.



Honestly this just appears a “numbers are too high, stop counting” approach.

You could make an argument that we should only be aggressively testing those who are disproportionately at-risk.

That argument presumes some things about public health. It presumes that we're comfortable with some low-risk people dying that otherwise would not, in order to protect health care workers. It presumes that testing has to be done in facilities, which is perhaps bogus depending on your comfort level with false positives/negatives resulting from people incompetently administering tests at home, and the cost of a support system for testing in this manner. It presumes that an accurate case count is not sufficiently important to overwhelm those concerns. It presumes, as you point out, that we don't care all that much about asymptomatic/pre-symptomatic community spread. I wouldn't say that those positions are indefensible, but it's a brave set of positions to stake out.

The worst thing about that video is a public health official supporting the "people should be able to make the decisions they want" approach with respect to vaccination, which is absolutely not what a public health official should be doing on the evidence.
 
You could make an argument that we should only be aggressively testing those who are disproportionately at-risk.

That argument presumes some things about public health. It presumes that we're comfortable with some low-risk people dying that otherwise would not, in order to protect health care workers. It presumes that testing has to be done in facilities, which is perhaps bogus depending on your comfort level with false positives/negatives resulting from people incompetently administering tests at home, and the cost of a support system for testing in this manner. It presumes that an accurate case count is not sufficiently important to overwhelm those concerns. It presumes, as you point out, that we don't care all that much about asymptomatic/pre-symptomatic community spread. I wouldn't say that those positions are indefensible, but it's a brave set of positions to stake out.

The worst thing about that video is a public health official supporting the "people should be able to make the decisions they want" approach with respect to vaccination, which is absolutely not what a public health official should be doing on the evidence.
The thing with just testing the disproportionately at risk though is that they often get it from someone who isn’t themselves at high risk - a nursing home resident catching it from one of their carers, a mum undergoing breat cancer treatment catching it from their kid via a school outbreak, or an organ transplant recipient otherwise in good health who gets it from a co-worker.

Few of those vulnerable people can just seal themselves up to avoid those contacts so they are pretty reliant on those less at risk to test to reduce as much as possible their own exposure risk.

Especially since Florida doesn’t seem to care about any other mitigations like indoor masking or vaccine mandates the testing seems a particularly important tool.
 
I’ve always found it odd that a lot of the vaccination fliers etc actually show the injection itself - must be really off putting to the needle phobic. Surely there are better ways to do the public messaging, we manage to encourage pap smears, mammograms and colonoscopies without showing the actual procedure so why not vaccination?
 
The thing with just testing the disproportionately at risk though is that they often get it from someone who isn’t themselves at high risk - a nursing home resident catching it from one of their carers, a mum undergoing breat cancer treatment catching it from their kid via a school outbreak, or an organ transplant recipient otherwise in good health who gets it from a co-worker.

Few of those vulnerable people can just seal themselves up to avoid those contacts so they are pretty reliant on those less at risk to test to reduce as much as possible their own exposure risk.

Especially since Florida doesn’t seem to care about any other mitigations like indoor masking or vaccine mandates the testing seems a particularly important tool.
I agree with this. I'll take the other side for fun.

- They're screwed anyway, whether we test or we don't. As you point out, they can't completely reduce their contacts to zero. This thing is going endemic, and we're all going to catch it eventually, unless we go the full Thoreau at Walden Pond. All you're doing by testing like crazy is buying some time for them. Maybe.
- We're spending a lot of money testing for little to no tangible benefit as a consequence. Sooner or later, we're going to figure this out, the companies that expanded for the purposes of doing the testing are going to cut those jobs, and we'll have unemployment and retraining. On the other hand, we could stop this nonsense now, and taxpayers and governments could instead use that money for something that would promote actual long-term economic growth and stable jobs in the meantime.
- If people want to protect grandma or mum, they can. They can buy the tests and pay to administer them to themselves, and take more aggressive precautions. We can require higher testing standards for caregivers. Reasonable employment accommodations for the organ transplant recipient can be demanded, and made, under the ADA. He/she/the attack helicopter/whatever can work from home in some situations and can work individually in as sanitized a situation as the employer can reasonably provide in the others.

This is fairly preference and belief-based stuff. If you start from the assumptions that we're all going to catch it eventually, and that spreading out the time frame over which the most at-risk catch the thing doesn't much matter, the rest can be justified.


Yay, we're not gonna die! Probably. *knocks on desk*
 
I’ve always found it odd that a lot of the vaccination fliers etc actually show the injection itself - must be really off putting to the needle phobic. Surely there are better ways to do the public messaging, we manage to encourage pap smears, mammograms and colonoscopies without showing the actual procedure so why not vaccination?

For some reason I'm picturing Christopher Walken's character in Pulp Fiction doing a voice-over on the colonoscopy PSA.

Good shout.
 
I agree with this. I'll take the other side for fun.

- They're screwed anyway, whether we test or we don't. As you point out, they can't completely reduce their contacts to zero. This thing is going endemic, and we're all going to catch it eventually, unless we go the full Thoreau at Walden Pond. All you're doing by testing like crazy is buying some time for them. Maybe.
- We're spending a lot of money testing for little to no tangible benefit as a consequence. Sooner or later, we're going to figure this out, the companies that expanded for the purposes of doing the testing are going to cut those jobs, and we'll have unemployment and retraining. On the other hand, we could stop this nonsense now, and taxpayers and governments could instead use that money for something that would promote actual long-term economic growth and stable jobs in the meantime.
- If people want to protect grandma or mum, they can. They can buy the tests and pay to administer them to themselves, and take more aggressive precautions. We can require higher testing standards for caregivers. Reasonable employment accommodations for the organ transplant recipient can be demanded, and made, under the ADA. He/she/the attack helicopter/whatever can work from home in some situations and can work individually in as sanitized a situation as the employer can reasonably provide in the others.

This is fairly preference and belief-based stuff. If you start from the assumptions that we're all going to catch it eventually, and that spreading out the time frame over which the most at-risk catch the thing doesn't much matter, the rest can be justified.


Yay, we're not gonna die! Probably. *knocks on desk*
You missing sparring with a certain poster? lol

Got some dinner to cook now but will try to reply to your devil’s advocate points tomorrow.

Meant to tag you on the J&J news, love the SA data, finally get to know how our vaccine performs - the US barely covers it!
 
You missing sparring with a certain poster? lol

Got some dinner to cook now but will try to reply to your devil’s advocate points tomorrow.

Meant to tag you on the J&J news, love the SA data, finally get to know how our vaccine performs - the US barely covers it!
Nah, it was there and I figured I'd get it out on the table. It's not an insane argument. It just comes from a place that is anathema to a lot of health care professionals, with different priorities. The point of discussing this stuff in a reasonable manner (if you're asking someone long on bargaining theory, anyway) is to figure out where the points of disagreement are, resolve what can be resolved on the facts and logic, and agree to disagree on what's left.

I think I found some similar J&J data last week in a mainstream outlet. Don't remember where. Might have been the BBC or CNN. I don't think I posted about it, and I don't think you were the source, but source confusion is a thing.
 
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