The most interesting bit of misinformation that I've seen develop is the claim that N95 masks do not help when you are in public, despite the fact that they factually do help. The chain of events:
1. Concerns arise that respirator inventories will be depleted, leaving few or none available for medical personel. Media outlets spread this news.
2a. Thorough and factual news outlets spread the news that respirators have some effectiveness but are not a silver bullet. They may be used among other preventative measures. They talk about the differences between levels of effectiveness of dust masks and respirators.
2b. Sloppy outlets, and the ones more interested in helping the greater good (preventing hording), start lying, claiming that the dust masks do not work and respirators do not work. They often conflate the two. They go to the effort to shame hoarders and praise other people who practice washing and sanitizing hands, not touching your face, etc.
It's been fun and terrifying to watch. News outlets do not have an interest in giving a nuanced message. They are willing to lie if they think it helps. It's a good case study of when you should explicitly not trust a claim made by the media.
Meanwhile, I have a stack of 20 N95 respirators I bought for woodworking a year ago that I've been offering to friends and family. I've had no takers yet.
Saying "they don't work" followed with "we need them" is especially blatant. It cancels itself out. After all, no one would need them if they didn't work.
Another recent example was this on CNN and others: "38% of Americans wouldn't buy Corona beer "under any circumstances" because of the coronavirus, according to a recent survey."
This spread like... well, a virus. Even after it was debunked[1], CNN didn't remove or correct it[2].
I was finally able to get access to the full questions asked in the poll. These make clear that the survey was a fishing expedition designed to elicit viral stats. The questions asked in the poll include “Is Corona related to the coronavirus?” and “In light of the coronavirus, do you plan to stop drinking Corona?” Those presumably didn't get interesting answers, so they omitted them from the report, and instead published on the question of whether people "would not buy Corona under any circumstances now" and made it sound like the first questions. Good lord, it really is like the "Yes, Prime Minister" clip:
> Saying "they don't work" followed with "we need them" is especially blatant. It cancels itself out.
I have seen this lie/conflict of interest being told by Harvard medical board by the leaders of the disease fighting squad and I realized that I can't even know what other information I should believe from them.
Is it crazy to think that if they work (and they do) they'd be much more useful if they're used by health workers than by the average joe ?
But to me the real question is how fucked up your country is if it isn't able to reallocate stocks to hospitals instead of supermarkets/online shops. France isn't China but they requisitioned factories to produce masks and disinfectant exclusively for hospitals and pharmacies.
Is that really misinformation, or just people having different information (or understanding of information) than you have? I have talked to actual front-line doctors who have mentioned running out of medical-use-approved masks and have had to get emergency exemptions allowing them to use other N95s wherever they can find any. The shortage is already real, and likely to get worse since we're likely still in the early stages of this outbreak.
So yes, it's true that widespread use of masks is somewhat beneficial. It's also true that we don't have enough for absolutely everyone, and that health care workers being unable to procure masks would be detrimental. The question is not which is true, because both are. The question is what allocation best serves our public-health interest. People - even people much better informed and closer to the issue than either of us - can reasonably disagree without slinging the "misinformation" label. If that belongs anywhere, it's with people who present only one side of the story and then follow up by attributing motives they couldn't possibly know. ;)
> it's true that widespread use of masks is somewhat beneficial. It's also true that we don't have enough for absolutely everyone, and that health care workers being unable to procure masks would be detrimental. The question is not which is true, because both are.
But the misinformation at issue is the idea that masks don't help, not the idea that they do help.
That might be an weakness in phrasing, not actual misinformation. Masks are (arguably) not effective enough to justify the risk to supply for those with suspected/expected exposure, but the "enough" part is easily lost as information gets passed through many people who all mean well. Does that make it misinformation? I think it's a terrible idea to start using that label any time someone's wording isn't clear enough for our liking.
> Does that make it misinformation? I think it's a terrible idea to start using that label any time someone's wording isn't clear enough for our liking.
When someone's hypothetical sloppy wording changes their statement from true to false, it's fair to call that "misinformation". Telling people false things is spreading misinformation. Spreading misinformation with a pure heart is still spreading misinformation. The state of your heart doesn't matter.
"State of your heart" is itself a misleading phrase, implying good vs. bad or benevolent vs. malevolent when the operative distinction is intentional vs. unintentional. See how easy it is to misrepresent without meaning to? That distinction is well established in law, and most definitely does matter if people are calling for things to be censored.
> The distinction between intentional vs. unintentional is well established in law
Sure, this matters for things like negligence standards. Why would it matter here?
> and most definitely does matter if people are calling for things to be censored
Um... again, why? People usually call for censorship based on the content of the speech.
> This has nothing to do with the "state of one's heart" (nice strawman there)
I think you've confused our positions. I'm the one arguing that whether you're spreading misinformation has nothing to do with the state of your heart. You're the one arguing that it does. The whole argument you're making here is "even though this is misinformation, I would rather call it something else, because I sympathize with the people spreading it".
That's a heinous mischaracterization of my position. "Misinformation" has a common connotation of intent and malice, not mere accident or disagreement. You know, like when people deliberately misrepresent others' arguments because they think (mistakenly BTW) that it strengthens their own.
Because of that connotation, people call for misinformation to be eliminated from public platforms (i.e. censored). I think that's a terrible idea because we've already seen how that works out, every time Trump yells "fake news" and everyone rushes to suppress whatever got him angry. We don't need more of that.
You obviously feel differently and that by itself is OK, but the tactics you're using exemplify the problem and utterly destroy your own point. Please do continue without me.
If you make it sound as if they didn't help on an individual level that's clearly misinformation (intentional or unintentional). That due to shortages there might be adverse societal effects is another matter.
I'd argue that it's intentional misinformation so that people make potentially[1] suboptimal personal decisions that lead to better outcomes for society at large. But that's not their call to make. Give me the facts and I'll decide for myself. Otherwise prepare to be called out.
[1] That might or might not be the case depending on personal risk profiles and dependence on a functioning society. Also: a functioning society is worth little to a dead rational actor.
The question isn't whether N95 masks are/are not effective against transmission of the COVID-19 virus as a boolean yes/no answer.
The question is who should be supplied with the masks in a time of extreme shortage in a way that is most effective for the public at large, in terms of maximum effectiveness and lifesaving. It's all about ranking - what's the priority ordering for distribution?
The CDC and other well-educated organizations believe they should go to hospitals and other health care providers first, infected people second, vulnerable populations third, and others last.
Popular greed combined with ineffective controls are upsetting this logical ordering, and increase the overall risk for the population as a whole.
If we're talking about the media claims that the masks are ineffective, then it's completely orthogonal to the issue of who should be supplied with the masks. If CDC and other well-educated organizations believe they should go to hospitals and other health care providers first, infected people second, vulnerable populations third, and others last, that still does not excuse lying to the public, as that erodes trust in these organizations and ensures that all other information (e.g. regarding quarantines) would be distrusted.
> then it's completely orthogonal to the issue of who should be supplied with the masks.
it's really not. The general population has already tuned out when you go into a ten paragraph long debate about the masks.
The question is what 140 character message you give to people that induces the correct behaviour and in this case it's telling people bluntly that those masks don't help so people stop hoarding them. And they honestly don't help because most people don't know how to wear them or how often to change them anyway, so it's basically a meaningless discussion.
Masks work, but healthcare workers need them more.
I think a seperate and perfectly valid question is if public consumption of masks has had any impact on the health supply chain.
My understanding is the two are unrelated. Masks are had to come by because manufacturers are selling their entire capacity to hospital and consumer stores are not being restocked. The state and the fed (in the US) have tens of millions of masks, and are releasing some but not all of them to the hospitals.
Hospitals are not competing for the masks at hardware stores or amazon.
If anything, I wish the media would urge people to wear masks with lower ratings than N95.
Perfect is the enemy of the good. Catching even half particulate when an infected person coughs would be huge.
Because then they would have to say the unsaid part which is "Masks work but we failed to adequately prepare so we need to ration them severely."
Every country that's managed to bend the R0 curve has had masks as an integral part of their strategy and that's only been possible because masks were made a deliberate part of their public health strategy for over a decade (mostly due to SARS). It's only one leg of the stool as Japan is finding out as one of the few mask-wearing countries that's not getting it under control but a stool with one leg missing is a pretty useless stool!
Western countries are paying the price for a decade of staring on and going "those kooky Asians with their strange mask wearing practices".
Which historically-trusted media companies are claiming that the masks are "ineffective"? At the end of the day, it's a red herring, but I'm still curious.
But yes, many media companies are giving an appropriate message of either why there's little reason to wear a mask right now (little chance of random community spread today) or about the allocation of scarce masks to people who need them more.
> The CDC and other well-educated organizations believe they should go to hospitals and other health care providers first, infected people second, vulnerable populations third, and others last.
> Popular greed combined with ineffective controls are upsetting this logical ordering, and increase the overall risk for the population as a whole.
Look, it's not my fault that gov't didn't prepare for this situation — high demand for masks — and that I did.
A reasonable deal to me sounds like they can do one of three things:
* Procure from someone else
* Procure from me at my price
* Sign an irrevocable deal that at any point I will give them any N95 and P100 masks I have they desire and in exchange they will give me any healthcare I desire at any point. My life is no less valuable than theirs so I think this is fair.
The correct formula isn't what your lives are worth in absolute terms, though. It must be risk-adjusted. Specifically, one must calculate what lives are worth, multiplied by the probability of the hypothetical victim's vs. the current possessor's death due to not having a mask.
But again, this isn't so much an economic question as much as it is a moral one.
Oh it most certainly is a moral one, which is why I'm asking that you commit to save my life when it needs saving. Unless you somehow imagine that letting me die is morally desirable? At which point, it'll take a lot more to convince me.
If my life needs dollars to save, so does yours. And if you will take your pound of flesh, so will I. But I'm making an offer in good faith in your hour of need. I will not take a pound of flesh. I will take no thing. And in exchange, all I ask is that you do the same for me. Your reluctance to accept this tells me all I need to know about your so-called morality.
No, I do not believe it requires any such assumption. I am 100% likely to die, as is everyone. That's the nature of living. We all have an expiry date. When I'm wheeled in for whatever reason, car accident, fell in the bathroom, tomorrow, next month, ten years from now, exercise your morality and save me if I can be saved - no questions asked. That's all.
Listen, it's pretty obvious I never assumed I'd die in the near future without a mask, only that I might be put in a life threatening situation at some point - mask or no mask. I don't see how this is supposed to be such a hard choice to save my life. I'm rate-limited on HN, so this might be my last post, but if you find it so hard to say you'd help saving my life maybe you shouldn't be moralizing on how I should be saving others'.
Seriously. If they pay something good for it, then that gives a decent incentive for forward-thinking people to do some stockpiling for situations like this. If they don't, and if they go as far as trying to punish "price gouging", then there is no such incentive beyond stockpiling for personal use or for sale on the black market.
Let us assume for the sake of argument, up to the manufacturer's suggested retail price. They're asking because they believe people will probably unnecessarily die if they don't get more right away.
Well, if people's lives are at stake, why not pay more? ("Why not accept less?" It's the hospital's job to care for its patients—not to mention its workers.) I suspect the cost of one of the healthcare workers getting badly sick one week earlier is worth many times the cost of one box of masks.
If you offer the retail price, then that effectively covers the case of people who accidentally bought too much and would have otherwise wanted to return the masks (but were too lazy until now?). It doesn't incentivize anyone to make any forward-thinking stockpiles; their net profit would be zero, minus the transaction and storage costs.
Yup, you're right. And yet it doesn't matter because this is a moral issue, not an economic one. Not everything comes down to the cold, hard logic of economics and incentives - nor should it, for the sake of humanity.
In France, president Macron signed an presidential order last week requisitioning surgical masks and their production for healthcare use. Why isn't this possible in the US? Japan's prime minister, Abe Shinzo, altered the law to be able to declare formal state of emergency. He came under fire for poorly handling the outbreak.
The Department of Health and Human Services is doing just that:
> Late Wednesday night, HHS announced it would be buying 500 million N95 respirators over the next 18 months for the stockpile, “part of a broader effort to maximize the availability of personal protective equipment for health care workers who are on the front lines” fighting spread of the virus...
Yup, it's not about the effectiveness of the masks, it's simply because the US doesn't have enough stockpile and capacity to produce them. All east Asian countries recommend citizens to wear masks.
A while ago I saw some research that came out of China. One department consistently used N95 when dealing with Corona patients daily, and one department used no protection when dealing with patients occasionally.
The department with masks had zero personnel infections, the department without masks had 20.
I don’t know, but until someone proves to me otherwise, the N95 and up rated masks are super effective.
Which side of the debate were you trying to support? I don't think anyone disagrees that medical personnel should have masks. Some might say that's all the more reason that a finite supply should be allocated to them first.
>a finite supply should be allocated to them first.
i don't understand why medical facilities don't have a several month supply in storage. Such things like masks cost nothing in normal times and anyway is expected to be bought in bulk. The medical industry is highly consolidated and even without a pandemic there is always a risk of a supplier going off-line and anybody without enough supplies in stores is going to hang dry. Speaking anecdotally - several years ago a Novartis factory went off-line for whatever reason and we were scrambling to find the vet medicine we needed - normal vets quickly run out, and only one online pharmacy happened to fortunately still have it.
> i don't understand why medical facilities don't have a several month supply in storage
They might have several months' supply under normal circumstances in storage -- but when suddenly all their staff need one 24/7 and they're overwhelmed with patients, that supply lasts days.
The supply needed to handle every possible contingency might not be reasonable to store.
There's nothing sudden or 'every possible contingency' here - they have had months to prepare for this exact thing, knowing what's coming and what measures would be necessary, based on the events in Wuhan. The lack of preparedness by the medical system is astonishing.
I wasn't particularly trying to support either side. I was just trying to make clear that 'some' masks are definitely effective in preventing infection, even if most masks aren't.
I just hate the reporting that says 'masks aren't effective, period'.
N95 masks are utterly wasted on sick people. They prevent stuff coming in, not stuff going out.
The training needed to use the mask properly is basically ‘make sure it closes properly’ and ‘don’t touch the fucking thing unless you wash your hands afterwards’.
Masks ALWAY help, a little or more, in one way or other. Any masks. Period. If you have them or you can get them easily, use them!
They help because:
1. you have a significant chance of being already infected with a mild form and contagious even if you don't know it - wear a damn mask to protect the really vulnerable people around from your viruses!
2. any masks reduces even by a tiny amount the chance of infection - you eat more veggie fibers to reduce your chance of colon cancer by a single digit percent ...wear a goddam mask to reduce even if by very little the risk of catching (and then spreading) COVID-19!
3. by wearing a mask you'll be imitated by a few others and make it socially more acceptable for others to wear too - some of the people who end up wearing makes because of you are probably already infected and don't know it, so you'll have limited spread by promoting the "fashion"! (also, a few are probably immunodepressed or otherwise sensitive and might not even know it so simply copying a "fashion" could save their lives)
PLEASE, wear a mask, any masks, even wear it badly, but do! Do it for others and to slow the spread of disease worldwide enough to allow healthcare systems to have a chance of coping with it, and to give vulnerable or unlucky people developing the rare severe cases a decent chance of survival!
And wash your hands!
(Yeah, 50-70% of the human population will get this, eventually. But it's incredibly stupid if we get it all at fucking once! Unless you're shorting some stocks or pursuing a dubious political agenda, you don't want this to happen.)
EDIT+: ...but don't go the other extreme, buying them at exorbitant prices despite being healthy and not at high risk, or hoarding them.
I read something saying that people with masks had been observed to take them off to eat, put them down on a dirty table, and then put them back on their face. So you should add the caveat that properly used masks always help, all else equal.
Using a mask like you described still helps significantly. (Would help 10x more if the user would put it in a damn plastic bag, not on the table!). If you wear the mask on crowded bus or subway and take it off when you enter a not-so-crowded-and-frequented caffe you still did a lot!
What would help a lot would be smth. like a high-power-UV portable box that could fit in a backpack (or a chemical equivalent), to allow at least some imperfect but useful re-sterilizing of masks... single-use N95s are hugely wasteful...
I think our current focus on "perfect" and "100% correct" (whatever that even means...) hurts managing pandemics A TON! An approach where we'd recognize the probabilistic nature of contagion and fight for +1% probability of desired-event-X1, -0.1% prob. of undesired-event-X2 etc. would be much useful... at whole-population scales all measures will be sloppily implemented in practice and we need to accept than and just "tweak the odds" until "we're mostly winning"...
(For sure, use better proven and standardized methods in hospitals and other settings with well trained people paid to implement measures correctly. But don't expect most of the average population to bother doing things the optimal way even when they've been educated about it... there's opportunity costs to everything, even to "giving a f"!)
Putting a mask on a dirty table and putting it back on again does not render using the mask completely useless. It just lowers the risk reduction a bit.
I too, have a box N95 and some P100 I bought in preparation for California fire season way before this crisis. On the Internet, everyone is super concerned with insight porn style stuff. So "actually X won't" or "actually Y will". Well, they're welcome to that.
If the masks were useless healthcare workers wouldn't wear them because they do hinder working. So that leaves me, with my stack of masks from before the crisis. Yeah, I'm not going to throw them away.
EDIT: I'm rate-limited but I feel the same as user lvturner below.
Around 90% of the population of Hong Kong is wearing a mask right now. Despite the proximity to China, it's use as a transit hub and it's densely packed population - there are only 115 cases there.
While it's far from conclusive, I'd suggest this as valid evidence that the use of masks is helpful in reducing the spread of the virus.
We simply don't have the data to back that up. And unless you are a domain expert, you wouldn't be able to reliably come to that conclusion even if we had.
We know that the sum total of what Hong Kong is doing is effective: rates of all infectious diseases in Hong Kong have dropped precipitously since emergency measures were put in place.
> If the masks were useless healthcare workers wouldn't wear them
That's not how that works. The masks are less effective when used outside of a clinical setting, must be changed regularly (pretty much every time you take it off), and may prevent the transfer of disease from an infected healthcare worker to an otherwise vulnerable person.
Just because they're not effective for one situation doesn't mean all the advice is moot
Well, less effective isn't ineffective. The physical properties of the device don't change, so maybe the cost/benefit doesn't lie in buying them now, but I have my stack so it looks like it's worthwhile to use them.
There is disinformation about n95s. N95 is generally not useful for the public because they need to be fit tested to be effective. Front line workers needs them and use them properly and they are short of them because of the public. The public should use level 1-3 masks so they don’t spread viruses
The most extensive writeup with references that I have seen so far is at https://fastlifehacks.com/n95-vs-ffp/ . Not sure if this is an original summary, or ripped off from some other site though.
As others have corrected you on point 1 below, I know from a first hand account of 1 medical supply company in the US Midwest that is out of stock of surgical masks.
The virus itself is too small to be stopped by an N95 mask.
An N95 mask stops 95% of 0.3 micron particles. But the virus itself is far smaller. Healthcare workers exposed to SARS-CoV got the disease even wearing N95s.
ARRGH, NO, STOP, THIS IS EXACTLY THE PROBLEM. Sorry for the caps, but this stuff is important, and you are spreading exactly the kind of misinformation that the linked article complains about.
The study you link absolutely does not say that masks do not work. Here's what it ACTUALLY SAYS:
> N95 masks fulfill the filtering efficiency criteria of the National Institute for Occupational Safety and Health (NIOSH) and are approved for protection against droplet and airborne transmission of 95% of particles greater than 0.3 microns in size. N95 masks, which must be fit tested, are believed to offer protection against the contact and droplet spread of the coronavirus. At a minimum, N95 masks should be used for all known or suspected cases of 2019-nCoV, as well as for any asymptomatic “open airway’’ cases, e.g.: interventional pulmonology procedures
Basically: masks work. They don't work perfectly. You should use them if you are at risk.
Your nonsense about the virus itself being small is irrelevant. Respiratory transfer doesn't happen by virus molecules flying through the air, it happens on water droplets. The masks stop droplets. That's what they're for.
(They also prevent you from touching your nose and mouth, which is another preventative mechanism.)
Masks stop droplets, and reduce the spread by coughs and sneezes.
If everyone on your bus who's coughing is wearing a mask - even a simple 'surgical' mask not an N95 one - that means less chances of getting infected from them.
The article you shared directly contradicts your claim.
> N95 masks fulfill the filtering efficiency criteria of the National Institute for Occupational Safety and Health (NIOSH) and are approved for protection against droplet and airborne transmission of 95% of particles greater than 0.3 microns in size. N95 masks, which must be fit tested, are believed to offer protection against the contact and droplet spread of the coronavirus. At a minimum, N95 masks should be used for all known or suspected cases of 2019-nCoV, as well as for any asymptomatic “open airway’’ cases...
> "Meanwhile, I have a stack of 20 N95 respirators I bought for woodworking a year ago that I've been offering to friends and family. I've had no takers yet."
In absence of a sterilization method, they are going to last for only 20 days at most — since you can only use them once, for 8 hours max. I'd sell them for a premium actually to people thinking those 20 masks will save them.
Prevention methods need to be economically sustainable and practical. N95 masks are not only expensive and with an unreliable supply, but they are also pretty uncomfortable and most people don't wear them or dispose of them correctly.
Here's why masks are useless: You are going to take your mask off with your dirty hands. You're going to wear your mask dutifully while outside, then you're going to walk inside your house and the first thing you will do is take your mask off - with your dirty hands.
There are so many gotchas with wearing masks that it's best to just leave them for the people who are closest to the crisis. They're the ones with the greatest need and they have the training to make them effective.
And besides... the coronavirus is not airborne, you need to be hit with a droplet from an infected person's cough or sneeze. There's such a small chance of that happening while you're out-and-about that it's not worth it to wear these things. The real solution is to wash your hands because that's the main vector of infection.
You are claiming that the masks are useless. They are not. They have some effectiveness, and that effectiveness is limited. This is well-understood. Aerosol-based transmission is well-understood. Claiming that there are "gotchas" does not change the fact that wearing a mask reduces your risk.
You are doing the very thing that I pointed out as incorrect: removing nuance.
A more honest expression of your position would be "the limited effectiveness of the masks and their limited supply means that it is reasonable for the masks to be reserved for those who need them most." The honest debate around this position regards how much supply there is, how much individual liberty should dictate demand, and other such factors. The latter half of your post comes around to this, even though the first half is incorrect.
I thought the nuanced explanation is something more like "technically it's possible that a bit of material in front of your face could stop a droplet carrying a pathogen, but unless used as intended (which generally requires training) the masks are largely ineffective and you'll actually be less safe if you inaccurately estimate your risk due to thinking that a mask is an effective preventative device for you."
In other words, it's actually unnuanced for you to say "the masks are not useless." It must also be technically possible for a wide-brimmed hat to happen to block a pathogen-carrying droplet and prevent you from inhaling it. It's probably even possible that wearing a magnet around your neck could just ever-so-slightly nudge a single droplet and cause it to not enter your mouth or nose.
there isnt much training required. I worked in a BSL 3 lab with aerosolized tuberculosis and the training was like 5 minutes.
Even if you touch the mask with your hands and it is contaminated, if you wash your hands after taking the mask off you will be fine.
The "you need training" is part of the media agenda.
I agree that statistically masks wont stop the virus from spreading in the public. While masks used by health care workers will stop the virus from spreading to health care workers. The reason is that most of the public wont use masks while all health care workers will.
I could have left out the training part of my comment because it's not important to my argument (although my guess is that you'd be very surprised how many people who wear these masks in public use them extremely cavalierly and improperly).
The rest of my argument stands if you drop the part about training.
It's not like there are week long courses on how to wear a mask. Most anybody watching a youtube video or two could wear a mask mostly correctly, so that it would mostly do what it is intended to do. Nothing is perfect, but the goal is risk reduction anyways. The correct response to the problem of improper mask use is give people the little bit of information they need and strongly encourage them to use that information, not fall into despair or indifference. I have a P100 mask with manufacturer published pandemic sterilization procedures for work[1]. It's not expensive and it's not hard.
And yes of course medical professionals need them before everyone else, but being shamed for taking basic precautions during a pandemic is just embarrassing for society.
Masks provide extreme risk reduction for others if the wearer has the virus. Combine that with the 2-week incubation period and masks are quite effective.
Mask wearing was a law in SF during the 1918 epidemic and saved many lives. Once again, history is forgotten.
the risk reduction is actually very high. But the probability of being in the presence of the virus is very low. Health care workers treating infected patients have a 100% chance of being exposed so epidemiological risk reduction is large.
I think the "useless" part actually refers to the the fact that the public at large wont be wearing masks so a few people wearing masks might protect themselves, but does nothing to alleviate the overall spread of the virus.
The probability for being in the presence of the virus is very low right now in USA, but it's quite high in many other places (e.g. Iran) right now and in USA in the near future.
If media can be pushed to destigmatize wearing of masks and stigmatize not wearing of masks, then this (combined with starting manufacturing large quantities of masks) would alleviate the overall spread of the virus in the post-containment mitigation phase, in which many countries are right now.
I understand that wearing a mask doesn't prevent the wearer (for most common masks) but instead protects other people. Should you be a carrier. It slows the spread, which is a good thing?
What is your basis for this? My understanding is that an N95 mask, worn by following the directions on the box, provides significant protection to the wearer. Also, if it has a vent for exhaling, that would suggest it is not necessarily such good protection for others.
In matters of life and death, being careful is important. Taleb and others have a lot to say about tail risk, and coronavirus looks like a large tail risk to me. If I were a resident or planned an urgent visit in a Seattle nursing home I'd spend a good bit of money on PPE.
The lottery ticket analogy does not work well. I'm reminded instead of the scenes in the Chernobyl mini-series where individuals are sent into unknown dangers- dangers that are impossible to see, difficult to understand, and require conscious thought and effort to avoid. Resources are scarce and authority figures do not have sufficient information to keep everyone as safe as they should. Whether you survive or not comes down to both luck (whether your place and duties precluded you from any other option) and ignorance (whether you picked up a chunk of radioactive graphite with your bare hand). Using PPE is an effort to counteract your ignorance.
>You are going to take your mask off with your dirty hands. You're going to wear your mask dutifully while outside, then you're going to walk inside your house and the first thing you will do is take your mask off - with your dirty hands.
Now that you've warned me not to do that, won't masks work? I can access the same training materials as hospital workers.
Also, what if I get a little cough? If I'm walking by your house, I'm sure you would like me to be wearing a mask.
Reading training materials does not mean that you are trained. Who is going to slap your hand away from your face when you reach inside your mask to scratch an itch? What if you wash your hands, take of your mask, and then touch the door handle you touched with your dirty hands?
I can come up with these scenarios all day. The point I'm making is that the real way to protect yourself is to wash your hands. That's it. The mask does nothing unless you're literally being coughed on by someone who is infected.
>Reading training materials does not mean that you are trained. Who is going to slap your hand away from your face when you reach inside your mask to scratch an itch? What if you wash your hands, take of your mask, and then touch the door handle you touched with your dirty hands?
These same caveats apply to medical workers, who occasionally get sick while treating cases. Risk reduction isn't risk elimination but that doesn't make it pointless.
>The point I'm making is that the real way to protect yourself is to wash your hands.
You could also come up with scenarios where someone who was insufficiently trained would fail to protect themselves with hand washing. Here are some:
- Insufficient washing time.
- Touching handle before and after.
- Only using water.
No measure is perfect, and I think we can all agree that a measure with a less-than-100% chance of working (whether hand-washing or mask wearing) is better than nothing.
It's not "better than nothing" if purchasing and wearing these masks is affecting people who actually need them. No official organization is advocating for their use. It is pure fear-mongering to purchase and wear them as a healthy person. Here's what the CDC says:
> CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory diseases, including COVID-19.
> Facemasks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).
CDC uses terminology that distinguishes a facemask from a respirator, as you will see from following the first link (‘health workers’) on the page you linked.
> … patients should wear a facemask to contain secretions.
> Use respiratory protection (i.e., a respirator) that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator before entry into the patient room or care area.
> Here's why masks are useless: You are going to take your mask off with your dirty hands. You're going to wear your mask dutifully while outside, then you're going to walk inside your house and the first thing you will do is take your mask off - with your dirty hands.
The problem isn't so much touching the respirator with dirty hands, its getting your hands dirty by touching a contaminated respirator.
Here's how to remove a mask without touching the (possibly contaminated) front:
N95 3M mask: How to Wear & Remove (by Singapore General Hospital):
I believe it is an epidemiological/statistical reason.
Health care workers have a 100% chance of coming into contact. We cannot afford for them to be sick.
The vast majority of people wont be wearing masks so a few people wearing masks wont stop the spread so it is pointless. Even if you do wear a mask your chance of coming into contact with virus is low so you are wasting a mask for little to no statistical gain.
There's also a big difference between "x works very bad for the untrained population, but let's pretend it doesn't, because my worldview demands some media conspiracy" and "x works well".
It certainly is not helping Vice President Mike Pence is requiring government health officials and scientists at CDC to coordinate all public health information through him for vetting and possibly censoring.
Seriously what is wrong with you, Americans? Your bipartisan political fundamentalism is stronger than religion, people just have to draw snark comments about either party or president. Can't you be reasonable for even once when there are crisis going on? It's just pure insanity.
Scientists and experts - the competent career people in any admin - should be speaking freely and directly, not running their communications through Mike Pence/politicians.
Competent career people say stupid things like don't buy up all the masks because we'll run out if you do. The population's obvious reaction was to buy all the masks. People like that, who are objective/scientific/facts minded should be kept mostly out of the spotlight, not allowed to speak off a script approved by someone who understands psychology, economics, and politics.
EDIT: Or, in a perhaps more nuanced approach, is that there is a natural tension between the desire to control messaging in order to prevent a panic, and the need to relevant information out to people as quickly as possible.
One issue is that if you ask 10 experts with egos you might end up with 10 different opinions. It's not helpful to the public to hear contradictory opinions from the same administration because then how do they know what to believe. Making sure people are on the same page isn't necessarily for the purpose of nefarious censorship.
yes that’s so you have consistent messaging. same reason you can’t have some new hire engineers be the spokesperson for Google. trump derangement system at its finest
The biggest problem is that this information compounds with the reality on the ground (for example the stringent test requirements in King county - symptomatic patients being turned away from testing) which further breeds mistrust in the government, panic and susceptibility to any explanation which makes sense.
This is kind of the problem. Tbe symptoms are basically the same as flu and many other things at least in mild cases, pretty much nowhere is testing all patients who have them, and the reaction of medical professionals to the idea that they should tends to involve words like "dangerous" and "irresponsible". But the mainstream media, including publications like the Times, fed the idea that not aggressively testing was basically asking for an epidemic, tied it to powerful partisan narratives, and now there's no going back.
there are some nuances to that and the symptoms are not basically the same. One of the MSFT employees who ended up testing positive was initially turned away from testing at the hospital as there was no travel abroad involved. She/he self-quarantined and ended up being tested by the 'Seattle Flu Study' which came up positive. A lot of reactions to that were along the lines of 'well, if the result is the same (you need to self-isolate, same treatment as the flu) why is it useful to know if you have the novel virus?'.
This is bad, IMO. It sends the message that there's some entity who wants the numbers to stay low via denying testing, while at the same time sending people on their way thinking 'it's not serious' who would then get back to their daily routine which would infect others.
As a King county resident looking at what's happening in Italy, I have this constant anxiety that this is only going to get worse. Coupled with the amount of bullcrap thrown around on Facebook, I'm worried that some people who were on the edge prior to this outbreak would snap. There's a Facebook group full of preppers (because of the Seattle big earthquake thing) which completely blew up with this outbreak. I'm talking people stocking up on ammo to ensure nobody steals their stash.
Or maybe reserving limited testing capacity for severe cases in which proper diagnosis makes all the difference? Would sound legit to me. Not saying that limited testing isn't a problem, the very least of which is biasing the numbers.
This isn't just a Facebook/Twitter thing. A person on MSNBC just said that 20% of the US will die from this virus. Why would you say that? No stat backs that up.
On the contrary the death rate in Germany is almost 0%. The median age for those that have passed in Italy is ~81. Most of the US deaths currently were from an end-of-life care center. A massive percentage of the deaths in China are from the original province. I'm not saying this isn't an issue, and we should especially look out for our elderly, but the stats simply aren't there to claim a 20% death rate.
I think that the 20% comes from the percentage of serious cases (It was 20% in past, now it's 12% https://www.worldometers.info/coronavirus/ ). Problem with serious cases are that they need medical attention, so if all of us get infected medical system will not be able to handle 20% of population, so they will have to be without it...
That being said, not all of 20% needs ICU, and not all people will be infected at the same time (specially now since people are panicking). OTOH, if medical system will be DDOS'd, then also other people will die that need medical attention (so mortality for other illnesses will go up). So in theory it could be as bad as 20% if we would ignore the virus, let it spread to everyone as fast as possible and don't do anything. But that is not what is happening.
A majority of those cases are new. Just look at germany’s numbers a week ago. Presumably it takes some time for the condition to get worse and eventually lead to death.
Could we just stop real-time counting of each and every single case? Germany has more than 81 million people, just to add some perspective. People die, it sucks, and that virus is not your common cold, but this case counting, in media and the internet, is really getting ridiculous.
And please refrain from using words like "suspiciously" which tend to transport negative messages. There is nothing suspicious about these numbers what so ever.
Sorry, no conspiracy intended. Only the observation that, relative to experiences elsewhere, Italy's mortality is high, Germany's is low. Far more than expected, which suggests other dynamics (again: unlikely some conspiracy) at play.
When you're used to dealing with numbers, numbers that don't match up to expectations are "suspicious", in that they suggest some underlying issue, though whether in data or ground truth can be hard to say.
The theory I've heard and find most probable is that Germany has more ICU beds per capita than Italy. A lot of people think hospital beds in general are most important, but a lot of experts disagree. You could setup a hospital bed anywhere, ICUs are much more involved. Both Germany and the US have very high ICU per capita rates relative to others. Were it not for the nursing home and some cruise ship patients not getting the ideal care early on, the US rate would probably be about as low as Germany's.
I suspect that Italy may have had undetected community transmission longer than Germany, that German testing is more comprehensive, and that we're seeing more case, detected earlier, and less advanced than Italy's, typically. In another week or two the gaps in experience may narrow.
Germany's recovereds are only 18 (of 1,224 cases), so the vast majority of cases are still ongoing. At a rate comparable to Italy's, we'd be looking at 88 recoveries.
For much of this epidemic, different countries aren't so much doing better or worse so much as being earlier or later in the process. Italy seems 1-2 weeks ahead of Germany.
Corollary: look for nationwide quarantine in Germany in 7-14 days.
Numberwise, yes you're right. The problem with is that in the public discussion "suspicious" is going to be understood differently and in ways that don't help.
Not to excuse but explain: but being recently deprived of a hardware keyboard and having to use onscreen soft keyboards is a major handicap to clear writing. It's a 50% cut in intelligence.
where he said "we know 80% of the population is going to survive, and a typically a 15-20% rate of mortality for those individuals that are both elderly or have underlying conditions".
Note the part in italics which you left out and which completely invalidates your original statement. The numbers he gave are a fairly standard analysis and there are stats to back that up.
Clause 1: we know 80% of the population is going to survive
AND
Clause 2: a typically a 15-20% rate of mortality for those individuals that are both elderly or have underlying conditions
Clause 1 is still total bs even with clause 2 added because it should say 80% of people who are elderly or have underlying conditions will survive. The actually percentage of people will be much higher. It's intentionally misleading.
Maybe they know something about the virus and what happens when it mutates, comes back, and reinfects you? (Or maybe someone who thinks the know something told 'em that.)
I mean I know nothing so that's just a wild guess, but I think it is equally naive to think that looking at the current stats is enough to extrapolate and say anything and everything that needs to be said.
I've spent a lot of time in recent years warning about disinformation and the value of flagging or deplatforming bad actors who exploit the valuable principle of free speech to deliberately make others worse off. Free speech is good, but the economics of information distribution often end up giving free reach to purveyors of information with negative truth value.
I'm not on board with the idea of distinguishing between speech and "reach." Forcing everybody to exercise their free speech in isolated 3'x3' cells would be functionally identical to silencing them, but you could use this same distinction to argue that you were only ensuring that they didn't have a platform.
One of the purposes of free speech is to make it possible to say things about authorities that holds them accountable and makes them uncomfortable. If the authorities had the ability to limit your "reach," they would use it to silence you in exactly the same way and to the exact same end as if they could silence your "free speech."
Ironically, a lot of the misinformation is coming from the authorities this time. And a lot of true information is coming out through gossip and back channels. China, being China, literally flagged and deplatformed the people giving early warnings. But the west isn't coming out looking great either.
And that right there is a huge part of the communication problems around COVID-19. People choosing to believe unverified rumours over public sources because of reasons.
In the marketplace of ideas, truth will always triumph against lies. We don't really have any reason[1] to believe that this will actually be the case, but we need to have absolute, unquestioning conviction in this axiom, lest we go to, ah, bad places.
[1] The observable triumph of this axiom is all the proof that is necessary for it.
Assuming your conclusions as your premise is known as circular reasoning. There's abundant evidence to the contrary for your claim; lies are documented to spread faster than truth, and while truth generally wins out over the long run (because environmental facts have a way of asserting themselves over mere beliefs), accumulated false beliefs can dominate long enough to be disastrous.
The problem with the whole 'marketplace of ideas' schtick is that it ignores the feedback loop which makes it more profitable to invest in lies so you can make money investing in lies.
I am getting a ton of messages from friends that seem to be in a panic.
I am no expert, and I don’t have answers.
I did read about a simulation called Operation Dark Winter that was done years back. One of the conclusions was that it was incredibly difficult to get correct information out to the public.
This was before mobile phones and social media were common. There is definitely a higher noise ratio out there. I don’t know how to solve this problem.
My governor tweets out that they have these meetings, but he provides no detail. I think giving more detail would help comfort people. Perhaps it they would not flock to unreliable sources online if they had more details.
I'm about ready to throttle the next "it's just a flu" person I read. It's real; it's serious and we should be taking rational actions to mitigate and contain it. Don't go to events, avoid restaurants, bars, gyms. Work from home if you can. Have a supply of food for home.
In some of the worst hit areas of Italy, it looks like they're already triaging people or considering it.
I'm not old, I don't look sick, or act sick but I have an autoimmune disease and take immunosuppressant medications. If one more person tells me not to freak out, I too will throttle them.
Off topic here. But what's kinda interesting about covid19 is that a significant amount of the fatalities appears to be associated with cytokine storm syndrome. Suggesting that the effects of the infection might not kill you, but your body's immune system overreacts and kills you.
We've gotten off track. I was referring to my interactions with people IRL and the joke about "throttling" was just playing of the parent comment. I'm not actually considering violence, just sick of people telling me "it's no big deal" when for me, it's a VERY big deal.
I think relying on the good will of the masses as volunteers is like bringing a knife to a gun-fight. The opposing side does disinformation for profit[1] and has a budget for it.
So how can someone do that on a platform such as Twitter?
Edit: I did expect a serious response to this from someone that might know more about effectively delivering feedback to the algorithms that display this content. Frankly, it seems like the nonchalant responses(to say the least) are contributors to why this misinformation continues to proliferate.
My interactions have been in person. Even friends and family who know I have a compromised immune system seem to "forget in the moment". It's baffling.
But seriously, I wonder if we can take the lessons from mitigating a biological viral epidemic, and apply them to mitigating an informational viral epidemic.
At first, you made me think about how a quarantine/isolation plan could be implemented on the internet. Something that is controlled mostly by a limited number of entities.
However, what if there was a habit for individuals to "feel clean" after exposure to misinformation? Something that could be accomplished on a personal level. Like washing your hands or brushing your teeth. Something where afterward you feel like you contributed to both the community and your own wellbeing.
I think people understand the basics of COVID-19 well. What they don't realize are how many "sick" people are around them. See also the health care debate over "pre-existing" conditions. Until you have one, or have a family member with one, you're pretty clueless.
Autoimmune diseases are under diagnosed, but some estimates say it's more than 1% of the population. That's roughly 3.3 million Americans that may be taking medications that reduce the efficacy of their immune system.
TLDR; Don't assume everyone is healthy / carries the same risk, even if they look healthy.
I don't understand why we should all self-isolate just because some people are immunocompromised... Surely x% of people staying home/not working is better than 100% of people staying home/not working?!
> Pregnancy loss, including miscarriage and stillbirth, has been observed in cases of infection with other related coronaviruses [SARS-CoV and MERS-CoV] during pregnancy. High fevers during the first trimester of pregnancy can increase the risk of certain birth defects.
How about "Follow official recommendations" instead ? In France Macron made a show of going to the theatre urging people to live normally (within the new regulations, e.g. no mass gathering above a certain size).
Advising people to stockpile food this early is sure to make the situation even worse.
>Advising people to stockpile food this early is sure to make the situation even worse.
If the food stockpiling can be spread out so that a lot of it happens before the first local case is announced, then it will ease the burden on the system when the crisis arrives. Buying extra toilet paper at Costco does not stress the system if you do it months before there's a big problem, and it will ease the load during the crisis because you won't be buying toilet paper then. However stockpiling after the run has already begun might not be so useful...
FEMA also recommends you always have days or weeks of supplies stockpiled in case of unpredictable natural disasters. Everyone in my main circle of friends knows you should have a stockpile for this reason, and the lack of one is talked about more as an embarrassment. But online not having one seems more like a badge of honor. Its just weird to me.
So we went from "everybody should stockpile" to " high risk people should stockpile" and "general FEMA and similar guidelines may have a reason". Which sounds a lot less dramatic already, doesn't it?
If you get sick, the recommendation is to quarantine yourself. If you do not have a stockpile of food already, how will you be able to keep quarantine?
By calling people in your social network, offline not online, to go grocery shopping for you? Just an idea that popped to my mind, I am sure there are other means. If just someone would have started, you know like company or so, a kind of service that would allow you to order food online and they deliver it to you...
Yeah, so long as the people delivering the groceries are able to completely avoid contact with the infected, then that can work. However, having reasonable reserves at home and not needing others to delivery your groceries in the first place is going to be more effective.
I never aruedagainst having food at home, did I? But going out to stores now and emty shelves is the opposite of that. especially since over night the majority of stuff will be back in shelves anyway.
Also, if you have grocceries delivered overall demand stays the same. So no additional stress. Also it is way easier to protect and monitor delivery drivers. The group is much smaller than all shoppers.
Fun fact, delivery personnel can only be protected if enough PTE gear is available for them and not horded in someones garage or wherever.
These kinds of stunts are happening everywhere, with governments left and right oriented. My parents remember how everyone was panicked because of the Chernobyl disaster in Turkey, how Cahit Aral (then Turkey's industry and trade minister) drank tea in front of the cameras to prove the Black Sea region, which produces most of Turkey's tea, wasn't contaminated, and how Turgut Özal (then Turkey's PM) commented that radioactive tea tasted better (huge sigh).
Funny, it occurs that the little increase of radiation in that region really had no significant effect on cancer rates, but those people didn't know that. I still can't explain why government officials keep doing such stunts. Maybe there should be a Wikipedia list for these.
>These kinds of stunts are happening everywhere, with governments left and right oriented.
It reveals how leaders think of their constituents - they are not approaching this from the perspective of informing the public on how to best deal with this real but not world-ending danger, instead they are thinking of it in terms of "stopping the cattle from stampeding."
The official recommendations are insufficient and are more concerned with optics than actual public health. The US is a great example of this, where the official infection numbers are quite low, because only a small fraction of suspected cases are getting tested.
>Advising people to stockpile food this early is sure to make the situation even worse.
Completely agree. Telling everyone to go out and stockpile food is just the sort of dangerous, panic inducing rhetoric we don't need right now. Follow recommendations of professionals. No large gatherings, etc. But there is no need to panic. And certainly no need to tell people to behave in a manner consistent with panicked people.
> Telling everyone to go out and stockpile food is just the sort of dangerous, panic inducing rhetoric we don't need right now.
I don't think so. The problem is you don't want people to freak out and overdo it now, and you don't want them to freak out and overdo it in the future if some drastic measures are needed.
I think it would be totally prudent to give people specific sensible things they can do to prepare for the worst case. E.g.
1. Keep an extra week's worth of household consumables and whatever food they typically eat on hand.
Don't go splurge on 100 lbs of rice and pinto beans and two years worth of toilet paper. This isn't going to be a like nuclear war: public utilities will remain online, the water supply will be safe, food will be available in stores. The only possible issue with these products is that people may not be able to go out and buy them as frequently as they're used to.
2. Keep an extra month's worth of prescription medications, for similar reasons.
3. Buy a couple of small bottles of hand sanitizer (like travel size), for use on the go, which will last XX weeks for a typical person.
But no big deal if you can't find any since washing your hands works well.
> No large gatherings, etc. But there is no need to panic. And certainly no need to tell people to behave in a manner consistent with panicked people.
It's a prisoner's dilemma. It's in the interest of the country for the officials to say "don't panic" even if/when the reasonable response it to panic. In an individual interest is to panic before the government says, "panic".
The alternative is, obviously, that cases keep rising until a newspaper leaks on a Sunday night that your government will imminently start restraining you. Is it then time to panic?
The flu literally kills people which is part of why everyone is strongly encouraged to get a yearly flu shot: To create herd immunity and protect people who might die if they catch it.
I work from home and our company has suspended all "non-essential" travel. The head of our division however has won an award so we are all required to go to the award ceremony in the middle of the metro. It's an industry award so people from all over the country are flying in for the event. I wasn't invited at first, too low level, but now that the big wigs have bowed out, the low level folks are being forced to go so he'll have a cheering section when he gets his award. Somehow this isn't covered by the travel ban. Normally I'd take the subway into the city but will probably drive and pay $40 for parking instead to avoid being in close proximity with so many. That won't help during the awards ceremony. There have already been confirmed cases in the metro and some schools have shutdown so while still unlikely, the chance of infection is far from zero.
It seems silly to quit over this with things being in the risk limbo they are now but it also seem reckless to require employees to show up to watch you get an award that could be easily mailed to you. Wonder if I can get workman's compensation if I get sick.
You'll have to line up and take a number. Sick and tired of people downplaying this. That's what really will make this thing worse. Much worse. Italy is like a war zone right now. I read some first person accounts from health care providers there that read like they are straight from the days of the plague.
What is a realistic typical mild/moderate case? You get a fever for one week similar to the flu? Or is it a longer fever? I haven’t been able to find this information. Do you just isolate yourself and manage it with Ibuprofen and Gatorade? And then wait a week or two before going back to work?
Bedrest and fluids is pretty much all one can do for a virus of this kind, I think hospice care is mostly about keeping the airways open or giving an IV if necessary.
There are reported some (20%?) cases that are asymptomatic where you don't really do anything except infect others. But that's disputed by other sources and it's also plausible that these are presymptomatic cases with long incubation period.
Out of the mild cases, some are comparable to severe flu with symptoms like cough, fever, achiness all over and sometimes (10%?) diarrhea. There's a difference in that symptoms common in flu and colds such as runny nose and sneezing are not associated with Covid-19, this is more targeting the lungs. Something like half of mild cases would get pneumonia i.e. bed-ridden with fluid in your lungs and difficulty of breathing; that's significantly beyond most cases in flu, but comparable to the complications of a bad flu, which sometimes results in pneumonia. That's counted under the mild cases, as there are no invasive procedures required and you're going to survive this without hospitalization - that is the criteria for a mild case, it doesn't imply that the patient would call it mild, it means that they'll feel shitty in their bed but not die.
Moderate cases (perhaps 10-15% of total, reports vary significantly between countries) have severe pneumonia that would require hospitalization and supplementary oxygen. If you try to go to work with a case that turns out to be moderate, that's where you can become the "videos of people collapsing" event because during that single day you can get worse and start lacking oxygen. Still, you're going to be mostly conscious and survive that if you're in a hospital, i.e. if the hospital system isn't totally overwhelmed.
In severe cases (something like 5%) you can't breathe on your own even with extra oxygen. This requires intubation and ventilation for a prolonged time (weeks), which is a limited capacity (both in terms of ventilators and of the skilled medics needed to do that), a big strain on your body, and you're going to die if hospitals can't provide that. And there are reports from Italy that even right now with just 7500 confirmed infected cases they can't ventilate everyone who needs it, and they need to triage who won't be getting it.
We have data that older people are much more likely to die. However, as far as I know, data does not suggest that young people are less likely to get hospitalized and need invasive interventions - it's just that they are strong enough to survive the ordeal. The case of Italy/Lombardy first known case may be illustrative of severe cases in younger patients - it's a 38 year old marathon runner, he's supposedly released from intensive care yesterday as he's able to breathe on his own again. He was hospitalized for a bit more than three weeks, two of those in intensive care with artificial breathing/ventilation.
While COVID-19 mutated from SARS it has a number of characteristics that are different so I don't think it's reasonably to assume it'd be the same. Could be worst or better.
Many survivors end up with "honeycomb" patterns in their lungs because the immune system response blew holes in alveoli, which then merged together as they healed.
is it worth waiting for definitive proof? there are plenty of CT scans out there showing damage. i am not aware of a nicely written trusted source for it. at this point it's not an unreasonable model to assume, and avoid it. if everyone wants to avoid this, and changes behavior now, we will all be safer.
I was with you. Until the last paragraph, that turned to rumour spreading and that everything is so much worse. No idea where you have the triage idea from.
Neither nor. Respect hygiene, avoid masses and generally a lot of contact with people. Don't panic. And don't take medical equipment away from the people needing it. Because that just makes you a bad person. not you personally, but you get the idea.
SF BART was just as full today as it usually is. Headlines might be that big tech companies are telling staff to WFH and paying their hourly employees during this, but most people at most jobs are going about their lives per the usual, because everyone's locked into it.
No, it's because of the asymptomatic nature of it and carelessness by the officials.
Without supply and strong backend infrastructure, panic will only cause situation to worsen as people crowd up to get supplies, find them out of stock and blow themselves up over it.
Panic will also cause a shortage of human resources which are required to handle the situation. People will line up over small issues and displace those who truly need the help like what happened with masks and hand sanitizers. Hospitals won't be able to keep up. The staff will have other problems to deal with as their toddlers or family members are in panic at home due to schools, offices etc everything shutting down.
Mortality rate for people under 40s is not high. When you consider the risk factor, you would be more likely to die from using escalators and stairs over a period of 1-2 year.
> Without supply and strong backend infrastructure, panic will only cause situation to worsen as people crowd up to get supplies, find them out of stock and blow themselves up over it.
If you do not give people social permission to take reasonable precautions when things are still good, the panic that happens when things get bad will be worse.
> Panic will also cause a shortage of human resources which are required to handle the situation. People will line up over small issues and displace those who truly need the help like what happened with masks and hand sanitizers. Hospitals won't be able to keep up. The staff will have other problems to deal with as their toddlers or family members are in panic at home due to schools, offices etc everything shutting down.
The more people are able to take reasonable precautions that involve social distancing and self-isolation, the more drastically we can reduce the number of people infected, and the less impacted the healthcare system will be.
> Mortality rate for people under 40s is not high.
It's still higher than the flu, and the risk of hospitalization is still pretty high.
"Healthy people under 40" are not the only demographic that should be considered when responding to a pandemic. Many people are not "healthy people under 40". Many of us have dependents who would be at grave risk if they were to be infected with the virus. The danger to them is significantly higher than the flu.
There are no vaccines, and no treatments for this disease. Our only recourse is to reduce spread through social distancing. Fortunately, unlike with the seasonal flu, it may still be possible to stamp out this disease.
Yes, exactly this. And if you have any concern for the at-risk populations in your area, rather than just yourself, you should quarantine yourself if you get sick, and you'll want to have the supplies on hand to do that.
Fear will cause more damage than the disaster itself. I don't agree with your priorities, I think your behavior is just as destructive as you must think mine is, and none of that is likely to change.
I listed some simple actions that many people can do. They're not 'panic'; they're a rational response to something that spreads between people: stay away from other people as much as possible.
Please, could we refrain from using Twitter as a source by now? Also, the first strain is, from what I understood, in the wild since January in Italy. Wouldn't be surprised if that's the case across Europe, so. Back then nobody panicked. But now the media, and even worse the internet, is on it and people start to loose their heads.
Estimates for the COVID-19 mortality rate put it anywhere between 4 and 20 times higher than a severe flu. Hospitalization rates are even higher. There are no vaccines, and no therapies.
Why would you think I believe this isn't serious? The medical advise does not say to avoid public places, avoid travel, or to panic. Inventing medical guidance not provided by the experts and panicking will not make you safer.
I accept your back-peddle, but that doesn't answer my question. I am honestly curious.
I have noticed that when people are emotionally inflamed about a subject they tend to lose objectivity, gravitate towards like-minded opinions, and selectively pick at certain data. When that selectivity demands data that isn't available the gap will be filled with an assumption.
On Reddit, which does not have a limitation upon negative vote totals, you can fine tune this behavior to study group dynamics, which is reflected in the comments.
What question? You asked "how is this different from the flu" and I answered.
If you want to know why I thought you weren't taking this seriously, it's probably because you're making an ill-informed comparison with the flu. The World Health Organization has already addressed how the two diseases are different on their twitter feed.
I never suggested in any way that these diseases were similar.
Why did you ask which question when you devoted a paragraph to answering it? It feels, and this is just my personal opinion, that you cannot read but you like to hear yourself talk. If that’s true, and it probably isn’t, then you either like to attack people for narcissism or you are just easily confused and embarrassed by it.
> You qualify your own speculation and immediately demand somebody else not do that.
There's no equivalence between making an inference about the meaning of your words and their implications (an inference I was clearly not the only one to make) and you trying to psychoanalyze me.
> I prefer to waste my time watching memes about people hoarding toilet paper.
Clearly you have plenty of time to waste. If you ever wish to return to the original discussion, I'm game.
The average age of coronavirus victims in Italy is 81.
The average life expectancy is 82.
Before "throttling" the next person that says it, have you considered these people's opinion that this will not be anywhere near as bad as a regular flu season and far from a severe one which is over 600,000 deaths globally? There's a good chance corona is displacing a lot of the deaths that would have occurred anyway due to the flu.
As far as things are going, the infections and death toll is nowhere near what flu has already inflicted on the global population in the last 4 months.
Why are people not taking the same precautions for the flu in the last few years? Why do people suddenly care so much? It's very much a media driven situation.
SARS in 2002 had no cases anywhere after two years of outbreaks. Something to think about. History can look back on these comments here and judge.
> The average age of coronavirus victims in Italy is 81. The average life expectancy is 82.
A proper comparison would be the average life expectancy of someone who is 81. The comparison you make gives the impression on average these people were all going to die next year which isn’t the case. E.g. in 1994 in the US the life expectancy of an 80 y/o male was 7 years, female 9 years. [1]
The death rate of 3.4% as claimed is massive. Some people look at that and think it's small, but for something so contagious that's huge. If it spreads on a pandemic scale someone you know will die from it, almost guaranteed. You just can't say that about the flu.
The death rate of 3.4% as claimed is a mathematical artifact, not an estimate for “how likely am I to die if I get COVID-19”. Most knowledgeable authorities I've seen suggest reasonable estimates for that second number are 1% or lower, although admittedly that's still a much higher range than the flu.
Italy has basically suspended its citizens' civil liberties across huge swaths of the country. That does not seem like anything close to a proportional response, and I am very troubled by how okay everyone seems to be with the curtailing of civil liberties.
Remember, the 1st amendment guarantees the right of free association and assembly in the United States. Even though I'm voluntarily limiting my exposure to at-risk populations, I will not comply if someone tries to forbid me from moving around; that would set an awful precedent.
The principle characteristic of epidemics is the collective and community risk and response tremendously outweigh individual aspects.
Measures taken do comparatively little to address any one individual's risk or concerns. Addressing individuals simply isn't viable or useful.
Taking measures to assure population health, dynamics, spread, total healthcare system load, etc., are what matter.
As someone who'se quite the champion of individual rights, for now: individual rights be damned in the interest of community health.
Please note that this statement has multiple elements, all critical:
- The overall interest is community health outcomes (CHO).
- Individual rights not associated with CHO are not affected. Rights suppressions not advancing or relating to CHO are inappropriate.
- The principle is temporary, for the duration of the epidemic, or until such time as any control is utterly futile.
Epidemiological response is about reducing vectors, contacts, reservoirs, and susceptibility, as well as second-order risks. Limiting movement, enhanced disease monitoring, contacts-tracing, quarantine, free treatment, mandatory vaccination (if available), financial aid and intervention to individuals, businesses, and the financial sector (in that order), rationing, if necessary, and measures taken against community-detrimental actions (a long list: disinformation, misinformation, hoarding, price-gouging, intentional contamination or spreading disease, flouting quarantine/curfew, requiring sick workers to work orfiring them, etc.)
That leaves a broad set of other rights, but is a substantial curtailment.
There is a bunch of Supreme Court precedent that says it is legal for states to impose mandatory quarantines. They have to provide due process, not be arbitrary, yadda yadda.
Grant Sanderson is a great guy and makes wonderful educational videos, but he isn't a math professor (not that that's relevant to this discussion either).
Bottom line: You have come into contact with coronavirus - the government asks you to self-isolate at home. Do you? Or do you go off to your favourite bar?
Obviously you don't run off to your favorite bar, but it all depends. If the government won't pay you to skip work and your workplace won't give you PTO, you might not have a choice if you want to make rent.
And I would certainly flee the area if it were couched as an order rather than a request; I will not put myself in a position where I am essentially under arbitrary arrest by a capricious authority which changes its response every few hours, and I am shocked that anybody would.
I don't think any society, no matter how libertarian or anarchic, is going to allow people to move freely and conduct business as usual in the face of a pandemic. As always "the right to extend one's fist ends where the nose of another begins".
At the very least, individuals with the disease are endangering their fellow citizens if they don't isolate. Arguably, employers that do not make reasonable accommodations for sick employees are also guilty of public endangerment.
Of course, their is always the risk that the drastic measures persist once the threat to public health dies down, but it's by no means necessary that such will be the case.
Remember: even a small decrease in the growth rate of a disease spread can result in a large decrease in the total number of cases that occur.
You do, but you're talking about self-isolating. Here's the scenario we're discussing: the US decides that Assange has Diphtheria and tells him to stay home and not talk to anybody. Does he? Cambodia decides that the opposition party conference is full of dirty politicians and cancels it. Do they still try to meet?
In the first case, Assange would be protected by due process and a public hearing (that is the present US law for quarantine orders). In the second case, there might be a problem. You do not want the government using an emergency as an excuse to grab unlimited and unchecked power.
I don't even know why facebook could possibly be considered useful for news, considering the high density of plain idiots who post. Twitter is quite better , because you can unfollow idiots; they aren't forced upon you by social convention by being real life friends. But i d like to extoll the virtues of Reddit. Communities like r/china_flu or r/covid19 are moderated, contain a reasonable amount of rumors and early information that a moderately smart person can benefit from, and the density of information is quite high.
Makes one wonder why those facebooks and instagrams get all the advertising money ...
Seriously. At this point I'm ready to accept that the world is what we made it. If that means we kill ourselves because we're too daft to read social media critically then as a species we get what we deserve.
There's a cute, loose correlation between internet access:
In theory, we know the people who post on Facebook and assess their credibility personally. Unfortunately, it's difficult to assess information even from people we know personally when we only see written statements, many of which are copied from elsewhere.
It could be exactly the same thing as "forward this email to at least 20 people and Bill Gates will give you a million dollars," or "Facebook is checking for account activity, share this."
It's not necessarily malicious intent, but regardless of whether it is, it is truly idiotic; just like the above examples.
If everyone wore even cheap surgical masks coughs would be coughs by the mask reducing spread even by nonsymptomatic people. Think of it like reducing the effective range of infection to a couple of cm instead of maybe a meter. They don't have to be n95 or better to help reduce r0
This feels like the ultimate outcome of both companies' lax moderation policies. Ironic that about a year ago there were several articles about how Facebook will suppress misleading anit-vax content but will not remove it [1]. I imagine a lot of managers saying "let's just treat this virus misinfo. the same way."
I know you won't care, least of all because I don't maintain an account here anymore, but I have come to pretty much detest seeing your username in any thread. That's a first, to remember an HN handle for such repeatedly crappy content.
could you at least be less of a jackass and articulate yourself? are you denying (1) current numbers (2) that the existing trends that are being followed so far will stop holding true (3) that old people count as people? Because otherwise I (and likely everyone else) have no damn idea where you're coming from.
It's worth noting that finding that delicate balance between suppressing false information and preserving freedom of speech (plus privacy) still requires a lot of human attention. At the same time, many thousands of workers at Facebook, Twitter, and just about every other major service are adjusting to working from home (in Facebook's case having to overcome what's often a severe addiction to in-person interaction). Plus a good many know somebody who's affected and might not be at 100% effectiveness due to anxiety. So response might be a bit attenuated, and even before that it was always easy for NYT reporters to cherry-pick examples from the company they consider a threat to their own livelihoods. Should these companies do better? Of course. Is it realistic to expect that they'll do a lot better than more traditional sources, including NYT itself? Of course not.
1. Concerns arise that respirator inventories will be depleted, leaving few or none available for medical personel. Media outlets spread this news.
2a. Thorough and factual news outlets spread the news that respirators have some effectiveness but are not a silver bullet. They may be used among other preventative measures. They talk about the differences between levels of effectiveness of dust masks and respirators.
2b. Sloppy outlets, and the ones more interested in helping the greater good (preventing hording), start lying, claiming that the dust masks do not work and respirators do not work. They often conflate the two. They go to the effort to shame hoarders and praise other people who practice washing and sanitizing hands, not touching your face, etc.
It's been fun and terrifying to watch. News outlets do not have an interest in giving a nuanced message. They are willing to lie if they think it helps. It's a good case study of when you should explicitly not trust a claim made by the media.
Meanwhile, I have a stack of 20 N95 respirators I bought for woodworking a year ago that I've been offering to friends and family. I've had no takers yet.