Author Topic: How long can we wait while flattening the curve?  (Read 361187 times)

mizzourah2006

  • Pencil Stache
  • ****
  • Posts: 644
  • Location: NWA
Re: How long can we wait while flattening the curve?
« Reply #4600 on: November 07, 2020, 09:56:00 PM »
Looking like America is taking the virus very seriously today. Maybe Trump supporters were right because looking at my FB makes me think the virus did disappear. Tons of parties in the streets celebrating our new president elect.

habanero

  • Pencil Stache
  • ****
  • Posts: 786
Re: How long can we wait while flattening the curve?
« Reply #4601 on: November 08, 2020, 01:04:36 AM »
Anti-mask argument that there's no reason to wear a mask from five days ago:

If I were to look at only local data (i.e. only country where I live) the most obvious conclusion I could draw from available data would be that the more mask-wearing the more infected. Until recently almost noone wore a mask in the public here, and still Covid all but disappeared completely during May and stayed away until early August. Now new cases has gone up by quite a lot and mask-wearing has become much more widespread. Our health experts are rather lukewarm to the concept of masks in the general public, but the politicians decided otherwise and wearing is now much more strongly urged and mandatory in quite a few situations.

The reason why Covid came back is pretty well understood and also the main vectors during which it has spread. Lack of mask wearing has not been the explanation, but imported cases due to more international travel to and from various areas and domestic spread in larger households and/or various events, like weddings, student parties, religious gatherings etc. Very few cases can be traced back to restaurants/bars which has been open since May but will effectively close in large parts of the country effective tomorrow.

I find it a bit hard to grasp why masks seem to be viewed as the killer app that will save us all. If they work or not and how much is not my call to make, but there is pretty strong evidence that other measures have been much more effective.

former player

  • Walrus Stache
  • *******
  • Posts: 6090
  • Location: Avalon
Re: How long can we wait while flattening the curve?
« Reply #4602 on: November 08, 2020, 01:18:34 AM »
Looking like America is taking the virus very seriously today. Maybe Trump supporters were right because looking at my FB makes me think the virus did disappear. Tons of parties in the streets celebrating our new president elect.
Outdoors and masked, though.

lemanfan

  • Pencil Stache
  • ****
  • Posts: 989
Re: How long can we wait while flattening the curve?
« Reply #4603 on: November 08, 2020, 01:52:23 AM »
The Spanish news outlet El Pais made a nice and explanatory article recently about how the virus can spread in three different scenarios; a living room, a bar, and a classroom.  This is exemplified with current knowledge about masks, time together and ventilation will influence the risk:

https://english.elpais.com/society/2020-10-28/a-room-a-bar-and-a-class-how-the-coronavirus-is-spread-through-the-air.html

The short versions: masks helps significantly in some situations, but not in all.  Ventilation and shorter exposure time actually seems at least equally important.

The thing that I took with me most was the more recent knowledge about droplets vs aerosols.  But I haven't really kept up with the news in this matter.
« Last Edit: November 08, 2020, 01:58:15 AM by lemanfan »

mizzourah2006

  • Pencil Stache
  • ****
  • Posts: 644
  • Location: NWA
Re: How long can we wait while flattening the curve?
« Reply #4604 on: November 08, 2020, 05:38:35 AM »
Looking like America is taking the virus very seriously today. Maybe Trump supporters were right because looking at my FB makes me think the virus did disappear. Tons of parties in the streets celebrating our new president elect.
Outdoors and masked, though.

Sure, but using that argument it should be ok for us to go to sporting events like football and baseball games and have outdoor festivals because it's outside and people would be required to wear masks. I doubt most people would say that's reasonable right now.

former player

  • Walrus Stache
  • *******
  • Posts: 6090
  • Location: Avalon
Re: How long can we wait while flattening the curve?
« Reply #4605 on: November 08, 2020, 06:15:53 AM »
Looking like America is taking the virus very seriously today. Maybe Trump supporters were right because looking at my FB makes me think the virus did disappear. Tons of parties in the streets celebrating our new president elect.
Outdoors and masked, though.

Sure, but using that argument it should be ok for us to go to sporting events like football and baseball games and have outdoor festivals because it's outside and people would be required to wear masks. I doubt most people would say that's reasonable right now.
There is a difference, which I hope you can see, between an organised gathering such as a sporting event or Trump rally with spectators gathering closely in a confined space for a number of hours and a spontaneous one such as yesterday's street celebrations, taking place in open spaces where individual people could be moving through quite quickly (chances of infection increase hugely with the amount of time spent in proximity).   It's not ideal but it's easily distinguishable from the gatherings of Trump supporters next to election counts by the amount of mask wearing.  It's also a one-off rather than a series of events like Trump rallies.

iris lily

  • Magnum Stache
  • ******
  • Posts: 4026
Re: How long can we wait while flattening the curve?
« Reply #4606 on: November 08, 2020, 06:28:19 AM »
Looking like America is taking the virus very seriously today. Maybe Trump supporters were right because looking at my FB makes me think the virus did disappear. Tons of parties in the streets celebrating our new president elect.
Outdoors and masked, though.

Sure, but using that argument it should be ok for us to go to sporting events like football and baseball games and have outdoor festivals because it's outside and people would be required to wear masks. I doubt most people would say that's reasonable right now.
There is a difference, which I hope you can see, between an organised gathering such as a sporting event or Trump rally with spectators gathering closely in a confined space for a number of hours and a spontaneous one such as yesterday's street celebrations, taking place in open spaces where individual people could be moving through quite quickly (chances of infection increase hugely with the amount of time spent in proximity).   It's not ideal but it's easily distinguishable from the gatherings of Trump supporters next to election counts by the amount of mask wearing.  It's also a one-off rather than a series of events like Trump rallies.

I wonder if the virus sees much difference between outdoor gatherings of sportsball fans and outdoor gatherings of Not-Trump fans. I think your detailed explanation of the differences, while having some merit, is idealized for the protest crowd.

The protests I’ve seen and attended had the same groups of people hanging out together for quite a while.

I suppose it is like the difference between driving on 2 vodkas and driving on 4 vodkas, both wrong one a stronger degree of wrong.

mizzourah2006

  • Pencil Stache
  • ****
  • Posts: 644
  • Location: NWA
Re: How long can we wait while flattening the curve?
« Reply #4607 on: November 08, 2020, 06:29:15 AM »
Looking like America is taking the virus very seriously today. Maybe Trump supporters were right because looking at my FB makes me think the virus did disappear. Tons of parties in the streets celebrating our new president elect.
Outdoors and masked, though.

Sure, but using that argument it should be ok for us to go to sporting events like football and baseball games and have outdoor festivals because it's outside and people would be required to wear masks. I doubt most people would say that's reasonable right now.
There is a difference, which I hope you can see, between an organised gathering such as a sporting event or Trump rally with spectators gathering closely in a confined space for a number of hours and a spontaneous one such as yesterday's street celebrations, taking place in open spaces where individual people could be moving through quite quickly (chances of infection increase hugely with the amount of time spent in proximity).   It's not ideal but it's easily distinguishable from the gatherings of Trump supporters next to election counts by the amount of mask wearing.  It's also a one-off rather than a series of events like Trump rallies.

I'm not comparing it to a Trump rally or condoning Trump rallies. I'm just saying given that we're seeing cases rise all over the world right now it's not behavior we should be condoning regardless of the reason. To me it's similar to the Notre Dame fans rushing the field. They were outside and wearing masks. They clearly should not have done that, but I'm seeing a lot more people rationalizing and condoning one situation and demonizing the second.

But perhaps I'm wrong and if people seem something personally important enough they can do something they would condemn others for doing for different reasons.

dandarc

  • Magnum Stache
  • ******
  • Posts: 4209
  • Age: 38
Re: How long can we wait while flattening the curve?
« Reply #4608 on: November 08, 2020, 06:49:58 AM »
The right-wing lemmings said exactly the same thing in March - they were even comparing the morons storming the capitol of Michigan because they just wanted to go to Applebee's to people standing in line to vote. Then again when George Floyd was murdered and they accompanying protests. "I guess we're not distancing now".

Conservative babbling is nothing if not consistent.

the_fixer

  • Handlebar Stache
  • *****
  • Posts: 1032
  • Location: Colorado
  • mind on my money money on my mind
Re: How long can we wait while flattening the curve?
« Reply #4609 on: November 08, 2020, 08:35:42 AM »
Looking like America is taking the virus very seriously today. Maybe Trump supporters were right because looking at my FB makes me think the virus did disappear. Tons of parties in the streets celebrating our new president elect.

I think people were so excited they let the jubilation cause them to slip, even an introvert like myself that avoids large crowds was tempted to go celebrate.

I expect we will see a few days of it then they will go back to social distancing at an appropriate levels.

No doubt that cases will come from it and they should have done a better job of distancing.

On the plus side the crowds celebrating Biden’s win did a great job of wearing masks with very few unmasked people in the crowd and even people walking around with large bottles squirting hand sanitizer so they did try.


Sent from my iPhone using Tapatalk

Abe

  • Handlebar Stache
  • *****
  • Posts: 1806
Re: How long can we wait while flattening the curve?
« Reply #4610 on: November 08, 2020, 06:36:58 PM »
It was a bad idea to crowd together, masked or unmasked, outdoors or indoors. It will be interesting to see if there's a spike in cases but that would be difficult to sort out.

So far, things look bad for infection rates, but death rates have not accelerated.

middo

  • Handlebar Stache
  • *****
  • Posts: 1223
  • Location: Country Western Australia
  • Learning.
Re: How long can we wait while flattening the curve?
« Reply #4611 on: November 08, 2020, 09:42:06 PM »
It was a bad idea to crowd together, masked or unmasked, outdoors or indoors. It will be interesting to see if there's a spike in cases but that would be difficult to sort out.

So far, things look bad for infection rates, but death rates have not accelerated.

Deaths tend to follow by about three weeks.  This was very obvious in Victoria when we had our outbreak.

habanero

  • Pencil Stache
  • ****
  • Posts: 786
Re: How long can we wait while flattening the curve?
« Reply #4612 on: November 08, 2020, 11:57:27 PM »
Deaths tend to follow by about three weeks.  This was very obvious in Victoria when we had our outbreak.

The patteren of the second wave in Europe has been that infections go up by a lot but almost nothing happens to death rates for quite some time, then hospitalizations, ICU patients and deaths start rising. The explanation given is that early on a very large portion of the infected are in the younger cohorts and they rarely get seriously ill, but then slowly infections creep into the older population and then it's on. You also see a steady increase in the percentage of positive tests. In France it is now over 20%.

Ans obviously testing is much more widespread so a lot of milder cases are now detected, in march/april these folks would never get a test.

marty998

  • Walrus Stache
  • *******
  • Posts: 7150
  • Location: Sydney, Oz
Re: How long can we wait while flattening the curve?
« Reply #4613 on: November 09, 2020, 12:32:50 AM »
Vertical is not the right sort of flattening the curve we are after.

Paper Chaser

  • Bristles
  • ***
  • Posts: 464
Re: How long can we wait while flattening the curve?
« Reply #4614 on: November 09, 2020, 06:31:04 AM »
The right-wing lemmings said exactly the same thing in March - they were even comparing the morons storming the capitol of Michigan because they just wanted to go to Applebee's to people standing in line to vote. Then again when George Floyd was murdered and they accompanying protests. "I guess we're not distancing now".

Conservative babbling is nothing if not consistent.

What I take from it is that back in the Spring, a bunch of people decided that protesting was worth the risk of catching the virus, while others that didn't see the need to protest saw it as risky and perhaps reckless activity.

That same dichotomy applies to pretty much any activity though doesn't it? Some people think that attending church in person is worth the risk, while others that may not be church goers consider that a silly risk to take, especially if video services are available. Someone who loves football games may think that it's totally worth the risk to go yell for a couple of hours in a big building. Somebody who wants to pick out their own produce or meat probably thinks that it's worth the risk compared to curb-side pick up or delivery, while those that do opt for those options give them the side eye. Somebody that loves to travel might be tolerant of the risks involved while somebody that's a home body considers the traveler to be a crazy risk to us all.

What one person sees as "too risky" vs "acceptable" just boils down to that individual's preferences, and what amount of risk they're willing to accept to do what they prioritize.
« Last Edit: November 09, 2020, 06:33:28 AM by Paper Chaser »

ReadySetMillionaire

  • Handlebar Stache
  • *****
  • Posts: 1688
  • Location: The Buckeye State
Re: How long can we wait while flattening the curve?
« Reply #4615 on: November 09, 2020, 07:48:37 AM »
The right-wing lemmings said exactly the same thing in March - they were even comparing the morons storming the capitol of Michigan because they just wanted to go to Applebee's to people standing in line to vote. Then again when George Floyd was murdered and they accompanying protests. "I guess we're not distancing now".

Conservative babbling is nothing if not consistent.

Again, literally nothing else in the entire COVID-19 debate signals elitism, condescension, and a lack of empathy better than "they just wanted to go to Applebee's."


ReadySetMillionaire

  • Handlebar Stache
  • *****
  • Posts: 1688
  • Location: The Buckeye State
Re: How long can we wait while flattening the curve?
« Reply #4616 on: November 09, 2020, 07:49:42 AM »
The way this started - RSM says "there should be no rules, and further we should not even discuss individual choices with regard to risks they have externalized". Pretty standard fare from that user, and backed up by the usually dubious 'information' RSM provides.

Your reading comprehension is lacking.  I am not going to repeat myself so you can go through my post history to see what I actually said.

ReadySetMillionaire

  • Handlebar Stache
  • *****
  • Posts: 1688
  • Location: The Buckeye State
Re: How long can we wait while flattening the curve?
« Reply #4617 on: November 09, 2020, 07:53:16 AM »
There is a difference, which I hope you can see, between an organised gathering such as a sporting event or Trump rally with spectators gathering closely in a confined space for a number of hours and a spontaneous one such as yesterday's street celebrations, taking place in open spaces where individual people could be moving through quite quickly (chances of infection increase hugely with the amount of time spent in proximity).   It's not ideal but it's easily distinguishable from the gatherings of Trump supporters next to election counts by the amount of mask wearing.  It's also a one-off rather than a series of events like Trump rallies.

One reason Sweden does not recommend masks on a public-wide basis is because they give people a false sense of security.

The theory is that masks are not nearly as effective as people think, and distance is more important than masks. In other words, it is better for there to be a mass gathering that is distanced but no masks, as opposed to a mass gathering with no distance but masks.

ReadySetMillionaire

  • Handlebar Stache
  • *****
  • Posts: 1688
  • Location: The Buckeye State
Re: How long can we wait while flattening the curve?
« Reply #4618 on: November 09, 2020, 08:04:12 AM »
Looking like America is taking the virus very seriously today. Maybe Trump supporters were right because looking at my FB makes me think the virus did disappear. Tons of parties in the streets celebrating our new president elect.
Outdoors and masked, though.

Sure, but using that argument it should be ok for us to go to sporting events like football and baseball games and have outdoor festivals because it's outside and people would be required to wear masks. I doubt most people would say that's reasonable right now.
There is a difference, which I hope you can see, between an organised gathering such as a sporting event or Trump rally with spectators gathering closely in a confined space for a number of hours and a spontaneous one such as yesterday's street celebrations, taking place in open spaces where individual people could be moving through quite quickly (chances of infection increase hugely with the amount of time spent in proximity).   It's not ideal but it's easily distinguishable from the gatherings of Trump supporters next to election counts by the amount of mask wearing.  It's also a one-off rather than a series of events like Trump rallies.

The cognitive dissonance here is strong for a variety of reasons.

What makes it most glaring is that sports events are far more secure than the political protests (the ND rushing the field excluded). They are extremely well planned with significant coordination from local public health officials and professors at the university. These are stadiums that usually hold 80-100k+ fans and they are at 25% capacity. Fans are distanced more than 8-12 feet and wearing masks.

In-person attendance has been going on at ACC, SEC, and Big12 schools for 11 weeks now with no evidence of them being spreader events. In fact, the schools assuredly would have shut them down if they were (colleges get a significant bulk of money from TV revenue, not ticket sales, which is why the Big Ten and Pac 12 have not even bothered to allow fans).

Davnasty

  • Magnum Stache
  • ******
  • Posts: 2631
Re: How long can we wait while flattening the curve?
« Reply #4619 on: November 09, 2020, 08:08:03 AM »
Interesting that Cuomo is not going to order another shelter-in-place, noting that the "panic" it causes is "a bigger problem than the virus."

https://www.cnbc.com/2020/03/18/cuomo-says-he-wont-approve-coronavirus-shelter-in-place-order-for-new-york-city.html

People saying this in April, who advocated for a more targeted policy based on the data they were seeing from Asia and Europe, were of course unsympathetic assholes that just wanted millions of people to die.  Oh well.

You realize this article is from March 18?

If so, I'm not sure what you're trying to say.

For the record, he changed his mind two days later:

https://www.cnbc.com/2020/03/20/new-york-gov-cuomo-orders-100percent-of-non-essential-businesses-to-work-from-home.html

Maybe RSM has blocked me and isn't seeing my posts. Someone should let him know this article is from 3/18.

ReadySetMillionaire

  • Handlebar Stache
  • *****
  • Posts: 1688
  • Location: The Buckeye State
Re: How long can we wait while flattening the curve?
« Reply #4620 on: November 09, 2020, 08:10:52 AM »
Interesting that Cuomo is not going to order another shelter-in-place, noting that the "panic" it causes is "a bigger problem than the virus."

https://www.cnbc.com/2020/03/18/cuomo-says-he-wont-approve-coronavirus-shelter-in-place-order-for-new-york-city.html

People saying this in April, who advocated for a more targeted policy based on the data they were seeing from Asia and Europe, were of course unsympathetic assholes that just wanted millions of people to die.  Oh well.

You realize this article is from March 18?

If so, I'm not sure what you're trying to say.

For the record, he changed his mind two days later:

https://www.cnbc.com/2020/03/20/new-york-gov-cuomo-orders-100percent-of-non-essential-businesses-to-work-from-home.html

Maybe RSM has blocked me and isn't seeing my posts. Someone should let him know this article is from 3/18.

Didn't block you; just hadn't checked the forum over the weekend and missed this through all the other posts. Thanks for the correction. I will edit my post.

Davnasty

  • Magnum Stache
  • ******
  • Posts: 2631
Re: How long can we wait while flattening the curve?
« Reply #4621 on: November 09, 2020, 08:38:18 AM »
...This was the biggest argument against lockdowns and other less stringent isolation measures prior to COVID.

Look at this 108 page CDC document from 2007 -- https://stacks.cdc.gov/view/cdc/11425

It thoroughly discusses the pros and cons of various policies, from masks to social distancing to closing schools to home isolation. Unfortunately, discussing the "cons" has somehow become aligned with "TRUMP" because, well, who knows.

Read it for yourself, but COVID is quite clearly a "Category 2" Pandemic. We are implementing Category 5 protocols, and all of you guys are using Category 5 logic. Why?

Someone else already pointed this out but you didn't respond so I thought maybe you missed it.

Throughout this document it's stated no less than 10 times that pandemic severity should be based primarily on case fatality rate, which would make the current pandemic a solid 5. Excess deaths is a secondary measure and is based on an "unmitigated pandemic without interventions". Obviously the current pandemic is not unmitigated but projections* based on that reality would have put it at a 4-5 on the severity scale.

Does that answer the question of why?

*For further clarification, projections is what the document calls for when assigning severity. It seems you may have been thinking in terms of actual deaths.

I'd like to continue the deeper discussion, but if you don't have the time a simple yes or no would be appreciated.

Glad to hear it. I was just starting to wonder because there were some other posts I hadn't seen a response on, like the one above.

From my reading it's seems more likely that this 2006 document* would classify the current pandemic as a 5, or at least a 4. Would you dispute that conclusion, and if so, are there other factors involved in the classification scale that I missed? Admittedly I only skimmed the document for key words.

*and I'll reiterate that I think current CDC stance supersedes pre-pandemic documents from 2006/2017 but it's still worth trying to understand the what and the why of these prior documents, especially if one thinks the current CDC stance has been unduly influenced by politics.

ReadySetMillionaire

  • Handlebar Stache
  • *****
  • Posts: 1688
  • Location: The Buckeye State
Re: How long can we wait while flattening the curve?
« Reply #4622 on: November 09, 2020, 09:25:06 AM »
Glad to hear it. I was just starting to wonder because there were some other posts I hadn't seen a response on, like the one above.

From my reading it's seems more likely that this 2006 document* would classify the current pandemic as a 5, or at least a 4. Would you dispute that conclusion, and if so, are there other factors involved in the classification scale that I missed? Admittedly I only skimmed the document for key words.

*and I'll reiterate that I think current CDC stance supersedes pre-pandemic documents from 2006/2017 but it's still worth trying to understand the what and the why of these prior documents, especially if one thinks the current CDC stance has been unduly influenced by politics.

I am looking at Page 30. There are five factors -- CFR, excess death rate, illness rate, potential number of deaths, and 20th Century Experience.

My reading is that we are in Category 2.  Seems like we will end up in that range with deaths.

"Excess deaths" will be almost impossible to determine because lockdowns will have played a significant role in these (I believe CDC currently estimates 1/3 of excess deaths could be lockdown-related). Per this CDC dashboard (https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm), there have been a total of 239k-324k excess deaths this year, and between 34k-112k that are not COVID-related. So excess deaths could be as low as 127k or as high as 290k. So, again, we are on border between Category 2 and 3.

CFR is also a moving target, but it has been steadily declining since March. COVID is also unique because CFR also varies incredibly widely by age (1918, for example, had a consistent CFR among age groups, making it especially fatal for younger populations because there were simply many more of them). 

I would call this Category 2, maybe Category 3; but we are not even remotely close to Spanish Flu (CDC's example for what Category 5 entails). That would mean 6-7M deaths (adjusted for population) and we aren't even going to hit 10% of that.

And again, this manual talks about doing these types of interventions for weeks, not nine months (as does the current manual).

dandarc

  • Magnum Stache
  • ******
  • Posts: 4209
  • Age: 38
Re: How long can we wait while flattening the curve?
« Reply #4623 on: November 09, 2020, 09:52:53 AM »
As usual, RSM is misreading something (deliberately by my estimate) and reaching an unfounded conclusion.

The only thing shown in that chart that is used to evaluate the severity is the case fatality rate.

The illness rate is another input - you can see that all 5 categories have the same value there. 20-40%

Then excess death rate is derived from those 2 things, as is the potential number of deaths.

20th century experience is simply an example of this level of pandemic.




But we're supposed to trust your interpretation of data and think you have anything meaningful at all to add to a discussion about policy? C'mon man.

Davnasty

  • Magnum Stache
  • ******
  • Posts: 2631
Re: How long can we wait while flattening the curve?
« Reply #4624 on: November 09, 2020, 10:04:38 AM »
Glad to hear it. I was just starting to wonder because there were some other posts I hadn't seen a response on, like the one above.

From my reading it's seems more likely that this 2006 document* would classify the current pandemic as a 5, or at least a 4. Would you dispute that conclusion, and if so, are there other factors involved in the classification scale that I missed? Admittedly I only skimmed the document for key words.

*and I'll reiterate that I think current CDC stance supersedes pre-pandemic documents from 2006/2017 but it's still worth trying to understand the what and the why of these prior documents, especially if one thinks the current CDC stance has been unduly influenced by politics.

I am looking at Page 30. There are five factors -- CFR, excess death rate, illness rate, potential number of deaths, and 20th Century Experience.

My reading is that we are in Category 2.  Seems like we will end up in that range with deaths.

"Table 1 provides a categorization of pandemic
severity by case fatality ratio—the key measurement
in determining the Pandemic Severity Index—and
excess mortality rate.  In addition, Table 1 displays
ranges of illness rates with potential numbers of
U.S. deaths per category"

In other words, CFR is the primary data point used to determine severity. If the virus classifies as a pandemic and has a CFR over 2% then it rates as a category 5 pandemic.

The excess mortality rate is secondary and only relevant if we know that 30% of the population has been infected.

As dandarc mentioned "Potential number of Deaths" is not an input, it's an output. It's an estimate based on zero intervention.

"Figure 4 provides a graphic depiction of the U.S.
Pandemic Severity Index by case fatality ratio, with
ranges of projected U.S. deaths at a constant 30
percent illness rate and without mitigation by any
intervention."

Davnasty

  • Magnum Stache
  • ******
  • Posts: 2631
Re: How long can we wait while flattening the curve?
« Reply #4625 on: November 09, 2020, 10:21:56 AM »
CFR is also a moving target, but it has been steadily declining since March. COVID is also unique because CFR also varies incredibly widely by age (1918, for example, had a consistent CFR among age groups, making it especially fatal for younger populations because there were simply many more of them). 

Yes, CFR is a tricky number to pin down. I'm a little bit surprised by the way it's used in this document because it is highly dependent on our ability to properly diagnose cases. I think this is a good indication that whatever the purpose of this document was, it was not meant to be used as the sole means of determining government response.

However, as long as you're using this document to make your assertions you need to stick to the guidelines of the document. Based on the current CFR of 2.38% in the US, this document informs us that we are in a category 5 pandemic.

Davnasty

  • Magnum Stache
  • ******
  • Posts: 2631
Re: How long can we wait while flattening the curve?
« Reply #4626 on: November 09, 2020, 10:26:27 AM »
And again, this manual talks about doing these types of interventions for weeks, not nine months (as does the current manual).

I haven't disputed this. My intent was limited to pointing out that you were reading the document incorrectly in order to arrive at the conclusion that the current pandemic ranks at severity level 2.

In determining which actions are and are not appropriate we need to take into account a much larger body of evidence which is not limited to but should certainly include current CDC recommendations.

ReadySetMillionaire

  • Handlebar Stache
  • *****
  • Posts: 1688
  • Location: The Buckeye State
Re: How long can we wait while flattening the curve?
« Reply #4627 on: November 09, 2020, 01:34:17 PM »
In other words, CFR is the primary data point used to determine severity. If the virus classifies as a pandemic and has a CFR over 2% then it rates as a category 5 pandemic.

The excess mortality rate is secondary and only relevant if we know that 30% of the population has been infected.

CFR is also a moving target, but it has been steadily declining since March. COVID is also unique because CFR also varies incredibly widely by age (1918, for example, had a consistent CFR among age groups, making it especially fatal for younger populations because there were simply many more of them). 

Yes, CFR is a tricky number to pin down. I'm a little bit surprised by the way it's used in this document because it is highly dependent on our ability to properly diagnose cases. I think this is a good indication that whatever the purpose of this document was, it was not meant to be used as the sole means of determining government response.

However, as long as you're using this document to make your assertions you need to stick to the guidelines of the document. Based on the current CFR of 2.38% in the US, this document informs us that we are in a category 5 pandemic.

I understand the input/output distinction of your above posts, but I think the outputs are at least a hypothetical guidepost as to what the real CFR actually is.

We cannot simply use CFR at the outset because the CFR is always going to be high when the denominator (observed cases) is low at the beginning of a new viral strain. By your logic, we would always have to trigger Category 5 measures at the outset of every virus until we get the CFR to a lower number. That's not sustainable.

In my opinion, and based on what I read from Harvard/Oxford/Stanford/NYU folks, the CFR is going to continue to plummet as it has since March. Our testing capacity was a joke in March/April, leaving our denominator of actual cases way too low for what actually occurred in NY/New England.  We probably missed millions of cases in just those two months.

So yes, I am just inferring, but the *observed* output measures right now, to me, are indicative of a much lower CFR than what we are currently able to calculate; and a large part of this is how woefully unprepared we were when this all started.

***

And I guess the point I'm making goes back to what I've been saying since April -- viewing things through raw CFR leads to a really, really distorted view as to how to approach this.  It's why triggering Category 5 protocol at the outset is a bad idea.

This from the WHO is enlightening --

Quote
The severity of COVID-19 has been widely reported to be influenced by age, sex and underlying comorbidities [10,16,17], and there is some evidence that other factors, such as ethnicity, are also independent risk factors [18]. Any attempt to capture a single measure of fatality in a population will fail to account for the underlying heterogeneities between different risk groups, and the important bias that occurs due to their different distributions within and between populations [19]. Therefore, efforts should be made to calculate risk-group-specific estimates of fatality risk in order to better describe the true patterns of fatality occurring in a population.

I posit that this simply has not been done. We have been acting as Category 5 since April, and it's just not true.  We should be implementing a more targeted approach.

dandarc

  • Magnum Stache
  • ******
  • Posts: 4209
  • Age: 38
Re: How long can we wait while flattening the curve?
« Reply #4628 on: November 09, 2020, 01:42:38 PM »
The point you've been making since April is that you really want to go to Applebee's. Nothing more. Every time you try to back up your opinion, you misrepresent whatever data you think proves your point. Consistently. For seven months.

I'd think with the end in sight due to today's good news, you'd back off a little - today we have a clear answer to the question this thread asked. How long can we wait while flattening the curve? Only about another 6 months - it is almost over!

Incidentally just about the exact timeframe Dr. Fauci posited that wasn't good enough for Trump.

Davnasty

  • Magnum Stache
  • ******
  • Posts: 2631
Re: How long can we wait while flattening the curve?
« Reply #4629 on: November 09, 2020, 01:49:58 PM »
The point you've been making since April is that you really want to go to Applebee's. Nothing more.

That's not true. We all accept that there are pros and cons to the measures we've used to reduce spread and some of the cons RSM has discussed are very serious like kids being out of school for extended periods of time.

Quote
Every time you try to back up your opinion, you misrepresent whatever data you think proves your point.

That's not true either. It's almost every time.

Davnasty

  • Magnum Stache
  • ******
  • Posts: 2631
Re: How long can we wait while flattening the curve?
« Reply #4630 on: November 09, 2020, 01:56:52 PM »
We cannot simply use CFR at the outset because the CFR is always going to be high when the denominator (observed cases) is low at the beginning of a new viral strain. By your logic, we would always have to trigger Category 5 measures at the outset of every virus until we get the CFR to a lower number. That's not sustainable.

It's not my logic, it's the logic of the document you brought to the discussion. I showed you where it said so. Can you show otherwise with citations from the document?

And no, every new virus would not be immediately categorized as a category 5 pandemic because it would first need to be categorized as a pandemic. If it's not a pandemic, this document does not apply.

dandarc

  • Magnum Stache
  • ******
  • Posts: 4209
  • Age: 38
Re: How long can we wait while flattening the curve?
« Reply #4631 on: November 09, 2020, 01:57:17 PM »
I took my writing classes at Trump University - apologies.

ReadySetMillionaire

  • Handlebar Stache
  • *****
  • Posts: 1688
  • Location: The Buckeye State
Re: How long can we wait while flattening the curve?
« Reply #4632 on: November 09, 2020, 01:57:42 PM »
RSM is on my ignore list, which means they've engaged in trolling / dishonesty (lying about what is in that CDC document you just linked, for example) often enough that I decided I should warn myself about that before reading their posts.

So, I'm just going to assume RSM really does just want to go to Applebee's, and is offended by the suggestion because they know how terrible the food is there. RSM, like any reasonable human being over the age of 12 should not want to got Applebee's. Ever. Pandemic or not. But deep down, that's all RSM really wants, and admitting that openly is a bridge too far right now.

Maybe 6 months till we can all go to Applebee's as much as we want.

The point you've been making since April is that you really want to go to Applebee's. Nothing more. Every time you try to back up your opinion, you misrepresent whatever data you think proves your point. Consistently. For seven months.

I'd think with the end in sight due to today's good news, you'd back off a little - today we have a clear answer to the question this thread asked. How long can we wait while flattening the curve? Only about another 6 months - it is almost over!

Incidentally just about the exact timeframe Dr. Fauci posited that wasn't good enough for Trump.

The right-wing lemmings said exactly the same thing in March - they were even comparing the morons storming the capitol of Michigan because they just wanted to go to Applebee's to people standing in line to vote. Then again when George Floyd was murdered and they accompanying protests. "I guess we're not distancing now".

Conservative babbling is nothing if not consistent.

Get a new schtick dude.

skp

  • Stubble
  • **
  • Posts: 220
  • Location: oh
Re: How long can we wait while flattening the curve?
« Reply #4633 on: November 09, 2020, 02:14:18 PM »
Don't just love it when someone makes a HUGE point that the person is on their ignore list and then makes multiple posts arguing with them.

dandarc

  • Magnum Stache
  • ******
  • Posts: 4209
  • Age: 38
Re: How long can we wait while flattening the curve?
« Reply #4634 on: November 09, 2020, 02:17:38 PM »
I also pointed out exactly why that was the case - thought maybe RSM's tune had changed with the news today so I clicked "show". That turned out to be a mistake, as it usually is. Misinformation is a really big deal, and I just can't help myself when I see something so obviously misleading.

Watchmaker

  • Pencil Stache
  • ****
  • Posts: 829
Re: How long can we wait while flattening the curve?
« Reply #4635 on: November 09, 2020, 02:19:59 PM »
I understand the input/output distinction of your above posts, but I think the outputs are at least a hypothetical guidepost as to what the real CFR actually is.

The CRF is explicitly the ratio of fatalities to confirmed cases. If the CDC had meant to use IFR I'm sure they would have.
« Last Edit: November 09, 2020, 02:50:27 PM by Watchmaker »

ReadySetMillionaire

  • Handlebar Stache
  • *****
  • Posts: 1688
  • Location: The Buckeye State
Re: How long can we wait while flattening the curve?
« Reply #4636 on: November 09, 2020, 02:21:09 PM »
Posted this in another thread and I'm going to leave it here. I'll check back in tomorrow when I have more time to waste on this stupid website.

One thing is absolutely clear to me from the close results - Trump could have easily won the re-election if he could have found it in him to act like a responsible adult in a leadership position back in February / March.

Yep, exactly. Trump own-goaled himself into this defeat.
The faintest of silver linings to all the unnecessary death.

And RSM - I was debating whether I should point this out here, but you're still going hard with "the cure is worse than the disease!" bullshit on the other thread. So yeah life should be getting back to normal in spring more or less, except for those who will already be dead or dealing with long-term problems and their friends and families.

As of two years ago, you were a roughly 37 year old individual, married, with no kids, with a net worth of more than $640,000.  Your income was $146,000 in 2014 with $66,000 in expenses. You have been able to pay off your mortgage within several years after moving.  Since last paying off your mortgage, I believe you and/or your spouse are semi-retired.

By now you probably have close to a $1M net worth with no mortgage (unless you moved again). I also don't believe you have kids, although I could be wrong.

Forgive me for thinking that you might not be in the best position to grasp the significant tradeoffs that lockdowns, school closures, and other government measures had on wide swaths of the population. Quite frankly, you were tailor-made to endure it. Those of us with kids? Much harder.

I live in a county where the average household income is 1/4 of what your household salary was. The local city school reported that 79% of students did not log in for a single remote learning session when schools closed in March. The local Chamber of Commerce projects that roughly 60% of local restaurants will close. I work in City Government and have been dealing with COVID employment issues left and right and passing out food every Wednesday to people who lost their jobs and have NOTHING.

Suicides, overdoses, homicides, and domestic violence are all up 100% in my county.

As someone who has voted Democrat in three of the past four presidential elections, I'm just going to be blunt and say it -- you are the classic elitist liberal that pays lip service to the middle class but doesn't give a flying fuck about what the real middle class goes through on a daily basis.

The major budgetary transition is settling down, so February NW Update:

Assets
Current Assets
Checking13000
Emergency Fund20000
Dan Taxes4100
Change200
Total Current37300
Long Term
House125000(at Cost)
HSA2200
BH-StateRetirement33400
BH-45792300
BH-Roth-AmericanFunds26500
BH-Roth-Vanguard8000
BH-Traditional-Vanguard10600
JA-Roth-Vanguard40200
JA-Traditional-Vanguard57300
JA-Traditional-SoloK229400
JA-Roth-SoloK18100
Total Retirement518000
Total Long Term643000
Total Assets680300
Liabilities
CC Balance9200
Car23700
Estimated Taxes - Not Paid Yet4100
Total Liabilities37000
Net Worth643300

Networth is down $12,700 since November.  Mr. Market + adding some during this transition time (mostly Mr. Market) has offset spending way too much on a car and financing it (note the liability section - it is 0% at least).  'Stache is $518K now, up nearly $20K since November in spite of my best efforts to screw everything up financially in the last 3 months or so.  New CC balance item is simply timing things - all CC's on autopay so there shouldn't be any interest paid on that.  I expect that to be lower in future months as well, as our 2017-18 donation to our church is still working its way through.

I've been fucking up the money left and right, to include an ill advised trip to a casino recently (are trips to casino's ever not ill-advised?).  If I can lock all that down, we'll just keep on keeping on.  Everything that can be easily automated is automated at this time.  Hopefully a new job will come through in the near-ish term - that might help with depression which seems to lead me astray in many other areas.  Kind of crazy how we've got the foundation solid enough that we're still going up in spite of the excess spending.  Guess doing pretty good for 2013-2016 or so is paying benefits.

Decided to pay off the house today.  Today because it was exactly 3 years after closing on current house, and we only needed $2850 to do it.  Also am stacking up money currently until we're more certain of what post-wife-quits job life looks like.  That's the idea anyway.  I do need to get another $14K into my soloK before year end, then a bunch more by next April, so we'll see where we're at in December.

Last time we were in a paid off house, we wound up deciding to move within 3 months of paying it off, and the deal was done within 6, along with another $50K mortgage.  Hopefully I can wait a little longer this time before getting the itch to move.  Smack in the middle of town now, so location isn't an issue the way it was in 2014.

dandarc

  • Magnum Stache
  • ******
  • Posts: 4209
  • Age: 38
Re: How long can we wait while flattening the curve?
« Reply #4637 on: November 09, 2020, 02:37:33 PM »
Acknowledged my privilege on the other thread. I'm not the one of us over and over again misrepresenting facts.

dandarc

  • Magnum Stache
  • ******
  • Posts: 4209
  • Age: 38
Re: How long can we wait while flattening the curve?
« Reply #4638 on: November 09, 2020, 02:43:11 PM »
Hey - that's a good "was presented with new information so I corrected my thinking story" too. Eventually. Cheddar Stacker was hammering on me to not pay off the mortgage. I just corrected that big mistake I made in the 2014-2017 time frame this time last year. Sitting in the same house with a mortgage payment right now. Timing was looking dicey for a bit, but ultimately the market will prevail.

Incidentally I stopped the journal because it became a pointless log of incremental progress - waste of my and everyone who read it's time.

Surprised you didn't find some of the more recent posts where I was whining how company insisted I take a $150K W-2 position instead of renewing a $100 / hour 1099 arrangement. "COSTS THEM MORE AND I GET LESS! RIDICULOUS!"

I didn't spend 7 months lying about the tax code to back up my frustration though.
« Last Edit: November 09, 2020, 03:40:07 PM by dandarc »

ReadySetMillionaire

  • Handlebar Stache
  • *****
  • Posts: 1688
  • Location: The Buckeye State
Re: How long can we wait while flattening the curve?
« Reply #4639 on: November 09, 2020, 04:03:20 PM »
I didn't spend 7 months lying about the tax code to back up my frustration though.

You linked "The Hammer and the Dance" article at least three separate times in this thread. Are you aware that the author of that piece is a Vice President of Course Hero, an online education platform? And that his company has profited significantly from scaring the shit out of people into not wanting kids to go to school?

The misinformation in the article is just incredible. Just to pick out the two most glaring ones --

On projected deaths --

Quote
If we do nothing: Everybody gets infected, the healthcare system gets overwhelmed, the mortality explodes, and ~10 million people die (blue bars). For the back-of-the-envelope numbers: if ~75% of Americans get infected and 4% die, that’s 10 million deaths, or around 25 times the number of US deaths in World War II.

On excess deaths because ICUs would be flooded --

Quote
But what happens if all your healthcare system is collapsed by coronavirus patients? Others also die from other ailments...There are 4 million admissions to the ICU in the US every year, and 500k (~13%) of them die. Without ICU beds, that share would likely go much closer to 80%. Even if only 50% died, in a year-long epidemic you go from 500k deaths a year to 2M, so you’re adding 1.5M deaths, just with collateral damage.

Those numbers were cartoonish then and they are cartoonish now. And that article was the most viral article of the pandemic, with over 40M views. It no doubt affected policy.

Please do not lecture me about spreading misinformation in this thread when you yourself have linked to arguably the greatest literary swindle of this entire pandemic.

dandarc

  • Magnum Stache
  • ******
  • Posts: 4209
  • Age: 38
Re: How long can we wait while flattening the curve?
« Reply #4640 on: November 09, 2020, 04:31:50 PM »
How does linking that article months ago (which you obviously still don't understand) have anything to do with me not lying about the tax code?

Australia pulled off exactly what was proposed in that article and got to have some time with lowered restrictions. Including in-person attendance of sports, which I'd hope would resonate with you. Yes they had to lock down again, but they wind up with far fewer dead people on a population adjusted basis and have now beaten the disease into submission twice. And a relative party in between the two lockdowns. And with never having had an outbreak anywhere near as bad as even the initial one here in the US.

dandarc

  • Magnum Stache
  • ******
  • Posts: 4209
  • Age: 38
Re: How long can we wait while flattening the curve?
« Reply #4641 on: November 09, 2020, 04:48:49 PM »
Vertical is not the right sort of flattening the curve we are after.
I don't care who you are - that's funny. Well said.

GuitarStv

  • Senior Mustachian
  • ********
  • Posts: 17199
  • Age: 39
  • Location: Toronto, Ontario, Canada
Re: How long can we wait while flattening the curve?
« Reply #4642 on: November 09, 2020, 06:19:52 PM »
Vertical is not the right sort of flattening the curve we are after.
I don't care who you are - that's funny. Well said.

+1

Paper Chaser

  • Bristles
  • ***
  • Posts: 464
Re: How long can we wait while flattening the curve?
« Reply #4643 on: November 10, 2020, 03:56:13 AM »
Australia pulled off exactly what was proposed in that article and got to have some time with lowered restrictions. Including in-person attendance of sports, which I'd hope would resonate with you. Yes they had to lock down again, but they wind up with far fewer dead people on a population adjusted basis and have now beaten the disease into submission twice. And a relative party in between the two lockdowns. And with never having had an outbreak anywhere near as bad as even the initial one here in the US.

Is it possible that remote islands have an easier logistical task of controlling a viral outbreak? A whole bunch of the examples of nations that people champion for a strong COVID policy/response are islands or essentially islands (Australia, Hong Kong, New Zealand, South Korea, etc). They have fewer entry points and less international travel. It's much faster, cheaper and easier to shut down a couple of international airports and isolate than it is to shut down hundreds of airports, and thousands of miles of land borders.

I'm not trying to excuse the situation in the US. It's fine to want to illustrate that the US hasn't handled COVID well. But I think you can make the same point while keeping the comparison more fair to reality. If we're going to see how countries with similar environments compare to the US approach to COVID, lets look at Canada or Germany or France. Island nations have some built in 'privilege' in a way that many other nations don't when it comes to containing an outbreak.

deborah

  • Senior Mustachian
  • ********
  • Posts: 11433
  • Location: Australia or another awesome area
Re: How long can we wait while flattening the curve?
« Reply #4644 on: November 10, 2020, 04:23:11 AM »
That’s true to a certain extent. However, Australia is a nation of travellers. We’ve STILL got people coming home, being quarantined and then released into the community. We’ve still got new cases every day from overseas. The recent Victorian outbreak was from one of our quarantine places that leapt to the security personnel and into the community. Unfortunately, that outbreak resulted in the return process being reduced, so there are still a lot more people trying to get home. It wasn’t helped by airlines closing their routes here.

And, in our first wave, most infections came as a result of the Ruby Princess debacle.

We have a lot of ports, and are still exporting and importing goods. Some are in very remote places with little medical availability. Every ship that brings goods here has sailors who may be infectious - there are several here now with sailors who’ve got it, and have been taken ashore to hospitals. Mandatory quarantine has been paid for by our government.
« Last Edit: November 10, 2020, 04:24:49 AM by deborah »

habanero

  • Pencil Stache
  • ****
  • Posts: 786
Re: How long can we wait while flattening the curve?
« Reply #4645 on: November 10, 2020, 04:31:05 AM »
Is it possible that remote islands have an easier logistical task of controlling a viral outbreak? A whole bunch of the examples of nations that people champion for a strong COVID policy/response are islands or essentially islands (Australia, Hong Kong, New Zealand, South Korea, etc). They have fewer entry points and less international travel. It's much faster, cheaper and easier to shut down a couple of international airports and isolate than it is to shut down hundreds of airports, and thousands of miles of land borders.

On another side of the spectrum it worked pretty well on Iceland, then it didn't. They eventually got the 2nd wave as well, but it looks to be fading now. Iceland is a bit special case (apart from being tiny and pretty much everyone in the country live in one city) as they had, right from the onset massive testing capacity due to a small population but a pretty big genetic research company located there which did a lot of the testing. They did everything by the book as they reopened - mandatory testing on arrival and all. Which of course is easier when pretty much everyone arrives via one single airport,  but despite all this they eventually got the 2nd wave as well.

As for where I live we are not an island but and we kept infections at very, very low numbers for months but now they have climbed quite a lot again. Over here cases were kept low despite society being pretty open relative to mest of the world in terms of restrictions in place since late May and the general population caring less and less about the regulations still in place. But now the 2nd wave has hit us again and there is real worry it will escalate further so measures are being taken. It has been pretty much the same story all over Europe, really.

Iceland has a case fatality ratio of 0.45 so far. So they are one of very few places where it's reasonable to assume they have actually captured a pretty decent proportion of the actual cases. It's on small numbers, however (23 dead / 5100 cases so far).

middo

  • Handlebar Stache
  • *****
  • Posts: 1223
  • Location: Country Western Australia
  • Learning.
Re: How long can we wait while flattening the curve?
« Reply #4646 on: November 10, 2020, 04:42:02 AM »
I would suggest that Australia also has a set of state governments that were prepared to close their borders to each other, and also cut their own state into smaller regions to restrict travel.  That allowed for the outbreak in Victoria to be contained to only two states, and now possibly eliminated.

We also have a compliant educated civil community that mostly get that the difficult lockdowns were for the greater good.  As a teacher, I have worked from home more than from the classroom this year.  I returned to the "office" but many are still working from home.

Hospitality has literally just reopened in Victoria.  A beer at the pub requires me to leave my name and phone number, in case of a future outbreak.  I am happy to do that so I can enjoy these freedoms.

I have two (young) adult children in another state.  I have not seen them since Christmas, even though we had tickets booked for April.  We accept that as a consequence of what is necessary to keep everyone safe.

I saw my 83 year old father last weekend for the first time since February, but no hugs.  We shared a meal and just enjoyed actually seeing each other.

It has been a long haul to get Australia back to no local transmission.  It has also been worthwhile.

bigblock440

  • Stubble
  • **
  • Posts: 236
Re: How long can we wait while flattening the curve?
« Reply #4647 on: November 10, 2020, 07:58:09 AM »
How does linking that article months ago (which you obviously still don't understand) have anything to do with me not lying about the tax code?

Australia pulled off exactly what was proposed in that article and got to have some time with lowered restrictions. Including in-person attendance of sports, which I'd hope would resonate with you. Yes they had to lock down again, but they wind up with far fewer dead people on a population adjusted basis and have now beaten the disease into submission twice. And a relative party in between the two lockdowns. And with never having had an outbreak anywhere near as bad as even the initial one here in the US.

Have you traveled farther than 3 miles from your home or visited more than 1 person at a time?  Congratulations, you're part of the problem.

mizzourah2006

  • Pencil Stache
  • ****
  • Posts: 644
  • Location: NWA
Re: How long can we wait while flattening the curve?
« Reply #4648 on: November 10, 2020, 11:12:20 AM »
Here it comes for parents again. I have a few friends with young kids ~4-7 across the country that are going back to remote learning after Thanksgiving. I guess I'm somewhat lucky that if that happens to us I still have about 2 weeks of vacation I haven't used this year, but man is it tough to have 2 working parents and young kids right now. Hopefully everyone else in a similar situation finds a way to get through these next few months.

Longwaytogo

  • Handlebar Stache
  • *****
  • Posts: 2146
  • Age: 40
  • Location: MerryLand
Re: How long can we wait while flattening the curve?
« Reply #4649 on: November 10, 2020, 01:17:06 PM »
Here it comes for parents again. I have a few friends with young kids ~4-7 across the country that are going back to remote learning after Thanksgiving. I guess I'm somewhat lucky that if that happens to us I still have about 2 weeks of vacation I haven't used this year, but man is it tough to have 2 working parents and young kids right now. Hopefully everyone else in a similar situation finds a way to get through these next few months.

Ugggh, I'm jealous. My kids never even went back! I wish they would have had the opportunity for 3 months of distance learning Sept-Nov :(

-------------

Good news on the new Pfizer vaccine though!!  Hopefully that'll be some improvements by this time next year. Still in for a long Winter/Spring I'm sure though.