Couldn't we go further, and just say "cities increase seasonal influenza mortality"? I mean, anything that is social, is almost certain to involve increased transmission of human-to-human infectious diseases. Live theater, classrooms, church services, drag shows, you name it, if it involves bringing a lot of people together, it's probably going to increase the spread of infectious diseases that spread by human-to-human transmission.
It's good to quantify and ballpark that damage instead of leaving it as an intuitive guess. If public policy demands the trading of lives, at least it shouldn't be done by way of blind poker.
This study ballparks it around 10-20 deaths per year per 100k residents.
> It's good to quantify and ballpark that damage instead of leaving it as an intuitive guess. If public policy demands the trading of lives, at least it shouldn't be done by way of blind poker.
Yes, except that once the COVID situation is under control (assuming it can be controlled; some might say that's a big assumption), lots of people will be monumentally pissed off if this kind of study is used to justify ongoing restrictions on attending sporting events, concerts, etc.
Everything in life is a risk. What I am painfully aware of at the moment is that whilst everyone I know is willing to follow government guidance related to COVID and to continue doing so for as long as is necessary, we are all craving a return to normality, and are unlikely to be tolerant of tenuous justifications for continuing restrictions after the crisis has passed.
Not all. I'm not. I'm missing a couple of things, but I'm not looking forward to "normality". Not wasting my life on commuting has made a huge difference in my life. I tend to get several colds per year, even in the summer, which has added up to a moderate benefit. I hope that our increased awareness of disease prevention will be enduring.
Look at the rest of my comment. When I said "all" I was clearly talking about people I know, not everbody everywhere. Specifically people that I know.
> Not wasting my life on commuting has made a huge difference in my life.
That's fair but it's also again quite clearly not what I was talking about. Read what I've actually said: I'm talking about leisure and social activities.
Seriously: stop picking random out of context fragments out of peoples' comments and building strawmen out of them just for the sake of being disagreeable.
> When I said "all" I was clearly talking about people I know, not everbody everywhere. Specifically people that I know.
That wasn’t clear to me at all. This is an important distinction because tastes of people we socialize with tend to be more similar to ours than not, and our tastes are rarely representative of the general public. Especially when public health decisions are concerned, some tastes happen to be more impactful, so it is inevitable that some section of the population will be disproportionately pissed when their favorite activities are restricted.
Gun or motor vehicle related hobbies, even having a pet have always been subject to restrictions when it comes to ensuring public safety. Turns out having a pandemic now renders new activities with a higher risk profile, well tough luck, we have to put up with it.
Seriously: stop picking random out of context fragments out of peoples' comments and building strawmen out of them just for the sake of being disagreeable.
Sometimes people are replying for the sake of everyone else reading, rather than just the specific comment to which their words are anchored. This is how conversations work in person, too, where a small fragment of one point can lead to a tangent just based on that fragment.
I took a communications class many years ago, and the one lesson that stuck in my mind was this:
"When someone misunderstands what you said or wrote, who is responsible for the miscommunication? You are. They didn't misinterpret you, your communication was unclear."
I (mis)read your "all" in the same way as the other commenter, as a reference to "all people" (including, but not limited to your group of friends).
There have been many times when I've said something that others "misunderstood". It was a hard lesson to learn, but it has served me well to take responsibility myself for the miscommunication, apologize for being unclear, and try to state things in a less ambiguous way.
> Read what I've actually said: I'm talking about leisure and social activities.
My life is already normal with respect to social and leisure activities. We only keep a lil more distance and do more outside, the former being fine, the latter being an improvement.
> It's good to quantify and ballpark that damage instead of leaving it as an intuitive guess.
Except it is hard to quantify the downside of that bears on quality of life and take that into account. My 70+ year old parents are homebound for last 5+ months, and their overall physical and mental health from lack of physical and social activities have significantly gone down, to the point I expect if this goes on another 6 months or more I might lose at least one of my parents.
This is a study which looks at the relative impact of pro sports on influenza deaths in cities, not a study on COVID-19. But if a pandemic did hit, and we didn't have any data on the relative impact of different events on death, then you're more blind than ever in making judgments like whether churches should be restricted to 50 (why not 25 or 100?).
Similarly, there ought to be discussions on increases in mortality for any other causes under current contexts, including deaths by suicide — there's certainly been a lot of resistance to discussing the impacts of lockdown on public health.
> "This study ballparks it around 10-20 deaths per year per 100k residents."
no, it's 1-4 per million[0], so basically inconsequential relative to the (low) ~hundreds per million who typically die each year.
dying from sporting event-acquired flu is really, really low on the list of dangers to worry about. worry about the trip getting there instead, if you must worry.
>dying from sporting event-acquired flu is really, really low on the list of dangers to worry about. worry about the trip getting there instead, if you must worry.
these kind of statistics are not for personal caution, they're for risk assessment and public policy.
141 total infant botulism cases were reported in 2017 -- it still warranted a report and investigation work in order to assess the possibility of future problems that stem from the case, spread characteristics, etc.[0]
My point being : the rarity and generalized 'total danger' of an event should not determine whether or not it is investigated by public-policy makers and groups like the CDC/WHO.
Another facet never mentioned : sporting event-acquired flu is really low on the list of dangers to prioritize, you probably won't be bothered by it -- but the existence of yet another now-quantified danger does nudge your average 'danger score' higher. It always did, of course, but now people have actionable data about it.
So, sure, event acquired flu is really rare -- but I bet more people than before will now consider this when planning the trip with or around people with compromised immune systems.
> "...they're for risk assessment and public policy."
even for that, it's inconsequential. there are many greater and more relevant risks to worry about at a policy level.
food-borne botulism has a different risk profile in that the ever-increasing centralization of food distribution can potentially unbound those risks.
> "...another now-quantified danger does nudge your average 'danger score' higher. ...more people than before will now consider this when..."
that's just fear-mongering. the risks of incidental/accidental deaths are the lowest in history. there's no reason to worry about this particular issue outside of research.
While you are inserting the worry here. I think a person who is susceptible to flu, such as the aged, should be aware that they should probably get a flu shot before they go to their favourite team that has lost for the last 50 years. Otherwise they might not make it to the day they finally win.
that's exactly the point: the vulnerable should get vaccinated because the flu can kill you anywhere, not specifically because you might get the flu at a game. that latter sort of reasoning is irrational because the added risk is inconsequential relative to the overall risk.
you shouldn't try to time the shot to right before going to games, because that's irrational. get it before the flu season, and then this tiny added risk matters even less.
"but the existence of yet another now-quantified danger does nudge your average 'danger score' higher"
Or lower. I would say that these numbers are actually smaller than my intuition suggested.
Public transit being another example of close-quarters contact in typically unsanitary conditions. And for those puritans who will inevitably attempt to reduce everything to a moral binary, I am not arguing against public transit. It’s a very good thing in many locations and I have no problem believing it is more ecologically friendly than many other modes of transit.
No, this is speculative. To be clear, the absence of evidence isn’t evidence of absence at least in the very short term. Research and analysis take time.
I trust reasoning from first principles and mechanisms of action* more than pure observation. Because principles are robust, while patterns are fleeting and don't necessarily generalize across time or space.
* Which are found based from observation and statistics mind you. In this case the mechanics of disease spread in public transportation are very obvious.
It doesn't seem hard to isolate; some people drive every day, and others ride transit. Common sense is often wrong, so it's good to interrogate it. (E.g., maybe constant low level exposures lead to stronger immune systems and less loss of life? Common sense tells me it's an effect!)
Which doesn’t follow because people who attend to local sporting events don’t only do that in a city, and the increase in question is upon the baseline mortality of a city. So turns out cities have a lot of headroom to increase flu mortality based on what activities take place in them and we can’t conclude “cities” as a uniform entity do increase flu mortality with the data at hand.
Before the impact of their health services kicked in, cities around the world did have different covid transmission patterns.
But what would be the point of saying that? It sounds like you have an implicit therefore of "life is risk, so there's nothing to be done". This touches on what I've noticed as a common logic flaw - reducing something to binary when it's the degree that matters. Yes, increased interactivity increases some sorts of risks (binary). But depending on the degree of that increased risk, we may wish to manage that somehow on a societal level.
(For instance, in a post-COVID world, NFL teams could issue a non-mandated team-branded cloth mask on every seat in the winter months.)
Everything is connected. Everything we do has some impact that causes benefits and harms, and if we dig deep enough, we can certainly go down the rabbit hole of attempting to show that we're hurting the entire world by merely existing and going about our daily lives.
The question that is most interesting to me is how much will people agree to give up civil liberties in response to these discoveries? Another interesting question is will we equally study the benefits associated with the thing that also has a harmful result?
“The arrival of a new professional sports team in a city, and the commencement of play by that team, increases flu mortality in the city. The largest effect comes from a new NHL team. A new NHL team moving into a city and starting play causes an increase in weekly influenza mortality of 0.382 per 100,000 residents per flu season compared to cities with no professional sports teams. Based on the sample means on Table 1, this result represents a 24.6% increase in weekly flu mortality per 100,000 residents or a total increase of about 20 flu deaths over a year in each treated city. A new NFL team moving into a city causes an increase in annual influenza mortality rates of 0.249 per flu season, a 17% increase, equivalent to about 13 additional flu deaths over 52 weeks. A city that becomes home to a new NBA team experiences an increase in flu mortality rates of 0.066 which is a 4.7% increase. The effect of a new team on flu mortality is smallest in MLB where the entry of a new team results in an increase in flu mortality rates of 0.059 or 5.3% increase.”
I can foresee that one of the consequences of the pandemic will be a permanent change in the way that society views transmissible diseases. Prior to March, it was okay to gather in large groups and just get sick a few times a year. After the pandemic, I’m not sure people will be okay with that anymore.
So many forecasts i hear about the fallout of this, such as everyone living in private fortresses in the suburbs working from home, not going into large groups ever again, abandoning the cities, conferences, and universities for online vocational training seem dystopian to be honest.
And frankly, speaking from one of the hotspots: this isn't even in the rearview yet, and there's a huge fraction of people already grabbing denial with both hands and returning to life-as-usual. The idea that we won't get there when this is in the rearview mirror is like... it's not even a disagreeing forecast, it's actively ignoring what's happening right now.
If you're a backend engineer without social skills this type of life style seems perfect and desirable. Everyone else can't wait to meet people and interact again. There's a reason cities have existed for thousands of years.
I think lots of people will, but some people won’t and will attempt to dictate how everyone else lives their lives, according to their priorities. How successful will they be?
I hope it leads to the widespread adoption of the East Asian attitude that it is incredibly rude and inconsiderate to be sniffling, coughing, and sneezing, in public, without wearing a mask.
I think it's quite unlikely that it leads to a permanent taboo on large gatherings. They're too much fun.
I always find it interesting how people can think completely differently about this topic depending on how they frame it in their mind. If you think about it from the perspective of personal risk, then young people bristle at being told what to do. If you think about it from the perspective of contagion and at risk people who want to be able to participate in society, you would have a different perspective.
Hopefully we can agree that years where we lose 100,000 people from influenza are tragic, even if we've become accustomed to it. The optimistic possible outcome from this pandemic is maybe that rapid, inexpensive in-home testing for common virus infections becomes widespread. That'd allow a responsible person to test themselves before they went to a sporting event.
It'd also be wonderful if we invested more in a universal influenza vaccination. That's been right around the corner for decades now.
A healthcare system that doesn't bankrupt hundreds of thousands of people a year would also be a good start.
It turns out to be very hard to handle health risks politically rather than medically. Most early deaths are caused by cancer and heart disease, and both are preventable. Covid is terrible, but in terms of death toll it's not in the same league as the regular killers.
When it comes to avoidable death, this supposedly enlightened and scientifically educated culture actually operates at Victorian levels of public health. Obesity and poor nutrition are at epidemic levels and there's barely any formal cultural awareness of the political and social problems caused by emotional stressors, personality disorders, and other forms of psychological illness promoted by toxic workplace conditions and both social and mainstream media.
Your immune system is being exposed to pathogens all day long just from your immediate environment. You don't have to be exposed to thousands of people to develop a healthy immune system.
I’m hoping my cat’s vet and others will stop looking at me like a monster for skipping most vaccines. A cat that no longer goes outside and occupants that don’t interact with other cats basically means the cat is under total isolation.
And which virus would that be that lives in cats and bugs? And the cat’s too slow to catch a mouse nowadays. But it’s the same situation: most of what you’re vaccinating against is feline specific.
The cat’s free to go outside at any time, but nowadays prefers the comforts of being indoors.
The only solid argument against my strategy is nosocomial infections from the vet themselves.
Mosquitos, snails, slugs and fleas can absolutely carry worms to your cat. You can carry fleas on your clothing for example if you pet an infected animal on the street.
Yeah but that's not vaccination. His cat's vet is upset he doesn't vaccinate the cat, so I think it's safe to say he's not avoiding the vet in general.
> A cat that no longer goes outside and occupants that don’t interact with other cats basically means the cat is under total isolation.
Which is not entirely true. Even indoor cats can get worms, and periodic deworming is part of preventative care as vaccinations. The fact that deworming vs vaccinations interact with the cat’s immune system differently is an implementation detail that is inconsequential to this discussion.
> so I think it's safe to say he's not avoiding the vet in general.
And I “can get” yellow fever if someone with it comes back to my neighbourhood, a mosquito bites them and then bites me. But it’s largely a waste of money for me to get vaccinated anyway.
Considering risk vs. cost of prevention seems to be lost when dealing with vets (whom also often lack strong evidence for their interventions).
If anything, it’s the humans in the household that could benefit from preventative de-worming, not the cat exclusively eating canned cat food.
> If anything, it’s the humans in the household that could benefit from preventative de-worming
If you have a habit of nibbling on the bugs and the flies that wander into your house like cats do, I think indeed you could benefit from deworming.
Besides, if yellow fever is carried as frequently as worms in your neighborhood, you should definitely get vaccinated.
Finally, your cost-benefit analysis is a strawman argument. OP thinks their cat is completely isolated, I posited that it is not. I am not saying they have to get treatment nor I am moralizing them not doing it. It is perfectly fine to take an educated risk, but that hinges on the education of what vectors are still available to your indoor cat.
To even take an educated risk, there would need to be a model of that risk. Fleas are an age-old problem. I simply reject that the risk is high enough if the best evidence for infection risk from vets is “it could happen” when the risk factors are so low.
I’ll consider anecdotes and case reports on a new unknown disease, but not for one that’s been around since antiquity. Or there was research indicating that the risk is low in these circumstances, but it’s suppressed because it’s not the narrative that the study sponsors want anyone to hear.
It happens in human research, I wouldn’t put it past vet research.
> To even take an educated risk, there would need to be a model of that risk.
I consider the move from "my cat is completely isolated indoors" to "there are still vectors of transmission" an improvement of that model. Demanding that we need the exact likelihoods or otherwise completely reject the possibility is fallacious.
> Or there was research indicating that the risk is low in these circumstances, but it’s suppressed because it’s not the narrative that the study sponsors want anyone to hear.
It is interesting that your standard of evidence is much lower for this hypothesis of conspiracy and you use it to negate your cat's threat model.
I agree the risk is low, but your initial responses "what virus would live in cats and bugs" "the cat is under total isolation" "cat is too slow to catch a mouse" etc show that you were not informed on this topic. To give an anecdote, an odd fly, spider, mosquito etc walks in to my friend's house all the time, despite all windows being screened, and their fully indoor cat would go after them with joy every time he finds them (he would try to eat them). They don't do periodic deworming either, but they still accept that there is a risk albeit small, and don't externalize their discomfort to conspiratorial veterinarians.
My wife and I both qualify as being in the high-risk, elderly population. Once we had some grasp of the situation, we were both in immediate agreement that our lives would have to be very different until there was an efficacious remedy. We even postponed our 40th anniversary celebration indefinitely, ala Ringo Starr. In the temporal realm everything can be replaced or done without except for life itself. It makes no difference to us what others say or do in this regard. We have cast our lot with science and best practices...
Seems like solution is open air stadiums, and minimum seat size. Sun's UV tends to kill germs, and fresh air dilutes them.
We should get a study on how much cramped seating contributes to blood clots. This is definitely an issue on long flights. But probably in some stadiums too.
I went to an NHL arena for a concert. Seats were so cramped, my feet were hurting halfway through. It was torture.
As an analogy, opening my window increases my chance of getting skin cancer by letting more light in. Should I therefore always keep my window closed? Is the increased risk of cancer worth the benefit of having my window open? Should we all be forced to live underground, because that would definitely save a multitude of lives from skin cancer.
Sports events will always increase deaths, even in non-covid times. More people will die from the regular flu and other non-covid disases. More people will die from the increased travelling and accidents from that. More people will die from the extra pollution associated with the extra amount of traveling. More people will die when stressing themselves physically to perform at a high level at the sport event. The same arguments can be made about anything humans do.
