Author Topic: How long can we wait while flattening the curve?  (Read 361839 times)

middo

  • Handlebar Stache
  • *****
  • Posts: 1223
  • Location: Country Western Australia
  • Learning.
Re: How long can we wait while flattening the curve?
« Reply #4800 on: November 17, 2020, 08:05:07 PM »
There are lots of things you can do. You can require people living in large families to not mingle with other families, i.e., impose lockdown measures based on living arrangements. Victoria did this briefly when we had some suburbs in stage 3 and some in stage 4; there was a political backlash, but it can be done. Or you can mandate testing for those who work and whose families are large. Or you can mandate asymptomatic testing in susceptible areas. Or you can mandate asymptomatic testing in high risk workplaces. Or you can pay hotel quarantine workers and their families a lot of money to enter hotel quarantine if they wish. Lots of different ways to do it.

You can say for example that people have a social bubble of, say, 6 people. So if you're in a family of 3 you can form a social bubble with another family of 3. If your family has more than 6 people that's fine but you can't socialise outside your family. Etc.

Lots of ways to do it.

As for casualisation of the workforce, my state paid $450 to any worker who needed a test and $1500 to any worker who had to self isolate for 2 weeks, so I suggest that makes inroads.  Certainly other states should have followed suit. Also, any casual worker who lost their job would have been eligible for 2x jobseeker or job keeper, both of which were very generous.

Mask wearing - your analogy is inapt. Drink driving you can still hurt someone (yourself) by driving drunk, and it's not possible to anticipate where the next car is going to come from. Mask wearing you can carry one in your pocket and put it on if there's social contact.

How do we know that all 15 were in the same house? It could have been multiple family units meeting for a BBQ or similar.

With the lockdown of individual areas/suburbs, the problem is that you need to lock down areas where cases may appear in a week or two, not just where cases are appearing now. Many of the worst affected postcodes in Melbourne were actually not part of the original 10 suburbs locked down at the beginning of July.

The new South Australian restictions (in place for six days) are even stricter than those that were in place in Victoria, but hopefully it stops the spread there.

Yes, the ten postcodes locked down was abandoned because it didn't work.

It seems SA is going the NZ route of "Go early, go hard".  I sincerely hope it works for them.  I wish Melbourne had locked down quicker and harder in the initial phase when it seemed to be getting out of control.

Bloop Bloop Reloaded

  • Bristles
  • ***
  • Posts: 305
  • Location: Australia
Re: How long can we wait while flattening the curve?
« Reply #4801 on: November 17, 2020, 08:16:46 PM »
I don't think you can say the "10 postcodes" thing didn't work. We don't know if it worked or not; it's not possible to separate its contribution to the second wave from the already-set-in-motion contribution of the second wave itself. That is to say, we don't know if it had 0% effect or whether it might have decreased the intensity of the second wave by 20%. There's  no control group so it's impossible to say.

This is what ABC news reports say about the South Australian family:
Quote
She comes from an extended family based in the city's northern suburbs, 15 of whom have now been diagnosed with COVID-19.

Members of this extended family work in aged care, health care and the prison system — all high-risk settings for the spread of COVID-19. It's possible some of these people worked while infectious, but this information hasn't been released yet.

Perhaps it was 15 people living under one roof. Perhaps it was three sets of families of five living in the same geographical region. Regardless, I would suggest that next time the plague/zombie apocalypse comes around, we have rules such as:

- Even when numbers are under control, social visits are limited to a bubble of 6 people (or whatever your household size is, if more than 6).
- Family members of high risk workers must be tested weekly regardless of symptoms. Adults get $50 per test taken, as an incentive.
- High risk workers must be tested regularly at the workforce regardless of symptoms.

Hopefully those measures can reduce the need for a true, statewide lockdown with everyone at stage 4.

I agree South Australia now has to have a harsh but brief lockdown, since the cat is out of the bag.

deborah

  • Senior Mustachian
  • ********
  • Posts: 11434
  • Location: Australia or another awesome area
Re: How long can we wait while flattening the curve?
« Reply #4802 on: November 17, 2020, 08:32:03 PM »
Quote
So three-fourths of deaths were above 70.
Oh, come talk to me when you are 69.5 and tell me if "meh, sure, I can die today."

Life expectancy is 79 years.  76 for men, 81 for women.  But hey, who cares if people lose 5-10 years of their lives to COVID, no biggie.

A significant number of my coworkers are over 60, and at least 3 or 4 are over 70.  My MIL is 77, and women in her family live to be well into their 90s.  Spry and healthy with all their faculties too!

Thanks for posting this.  Based on family history I've got a good 20+ years ahead of me.  I know lots of active vital people in their 70s and 80s and a few in their 90s.  It pisses me off to hear my age group thought of as throw-aways.  Even if someone has health issues that mean the need for assisted living, life is still worth living.

Let's also remember that dying of Covid is a lot nastier death than a lot of ways we die of old age.  And if you were really sick and survive you are going to be a long time getting better.  When I had pneumonia in my mid forties it was 4 months from start to finish.  Being a "never smoked in my life" person didn't save me from 4 months of lung damage, and my lungs were never the same after.  So many people discuss Covid as if it isn't the life changing disease it is.

When people discuss mortality numbers, please remember that every one of those numbers was a living person who most likely enjoyed life and wasn't ready to die.  Whether they had 20 years or 2 months of prospective life left, this was not how they wanted to die.

Rant over.

Just to play devils advocate, since you're one of the older posters around here I'd like to hear your thoughts regarding what amount of sacrifice is acceptable in an effort to save (mostly) old people. What price are you comfortable asking a teenager to pay so that you don't have to face a disease you're likely to beat anyway? Just as the physical outcomes disproportionately affect the old, the societal/economic outcomes disproportionately affect the young. What price do you see as "fair", and is there ever a point where you'd say "I can't ask them to do that on my behalf"? Is losing their job, having to give up their social life for months on end and delaying their education enough? Is it ok for a 20 year old to have reduced job prospects and lower career earnings so their 70yo grandparent might live longer? How many grandparents would willingly give up months or years of their remaining life for their kids and grandkids to have a better life?

Just as young people can be callous about the effect this can have on older people, I think older people can be pretty oblivious or even nonchalant about any harm that may come to younger generations as a cost for trying to add some months or years to their lives. Regardless of age, we're all going to be dealing with the ramifications of COVID for whatever is left of our lives. The elderly aren't the only ones with potential negative impacts from this.



A lot of the elderly would be prepared to give up their lives instead of the young. My parents (in their 90s) say this, and many of the elderly I associate with also have made these comments without being asked.

However, it’s not the 16 year olds who are infecting the elderly. They’ve charted it. Each age group tends to infect others in their age group. Except, the 25 - 40 year olds infect everyone, and are infected by everyone. This makes a lot of sense as people socialise with people of their own age, but 25 - 40 year olds tend to be the carers of both the young and the old. If we really wanted to stop transmission, this is the age group we should address, and vaccinate first.

Recent studies here have also looked at who is being the most affected by the economic outcomes. Again, it’s not the young now that the first economic shock has passed - they were the first affected, but were also the first to recover. People in casual jobs are regaining jobs sooner than full time jobs, and many full time jobs are being replaced by casual jobs for younger workers. Older workers, on the other hand are not being reemployed at the same levels as they were.

frugalnacho

  • Magnum Stache
  • ******
  • Posts: 4474
  • Age: 38
  • Location: Madison Heights, Michigan
Re: How long can we wait while flattening the curve?
« Reply #4803 on: November 17, 2020, 10:53:52 PM »
Just got word tonight that my wife's cousin's husband has covid and is in the hospital in pretty serious condition.  Serious enough that they are notifying extended family. He's in his 40's, great shape, is police officer. 

RetiredAt63

  • Senior Mustachian
  • ********
  • Posts: 14614
  • Location: Eastern Ontario, Canada
Re: How long can we wait while flattening the curve?
« Reply #4804 on: November 18, 2020, 05:51:08 AM »
Re what are the older people willing to do?  I can only speak for those I know, but we are doing the recommendations.  We wear masks and wash hands, we distance, we don't socialize, we have stopped all our group activities, we have much less family contact, we are super careful about any kind of shopping, we are basically shutting down our lives.  And the people I know are generally at least financially well off to have some sort of online access and are computer literate enough to dip their toes into Zoom. 

So, we are socially isolated just as much as anyone else, if not more.  And given that as we get older we are more likely to be widowed/divorced, there are an awful lot of us who live alone.  As in, no spouse for company.  So we may not be vocal about it, but it is hard.   It is really easy to become detached from society when that is your life. 

And I'm not there yet, but I've known really old people who have lived their lives, are perfectly happy, but won't fight to live if they get sick.  I've had a friend die from ovarian cancer and another from breast cancer, and their deaths at least were mediated by palliative care and pain killers, not with a breathing tube fighting for breath.  My mom died of pneumonia, and that was not an easy death, a lot more like a Covid death, breathing tube and all.  Covid is not a good way to die.

What we would like others to do is not be stupid.  Follow the same precautions.

What strikes me as a very short-sighted view is how people think this is all so unbearable.  We have been so healthy for the last 50 or so years that we take public health for granted and don't  see that we all have a part to play.  People should be washing their hands anyway.  People should be sneezing and blowing noses into a tissue anyway, and not spitting anyway. 


Way more people died of the Spanish Flu than died in WWI.  In most wars mortality came more from infected wounds and bad camp hygiene than from direct wounds.  People got polio.  People ended up with damaged hearts from rheumatic fever.  Babies were born deformed because of German measles.  People starved because of bad weather and crop failures.  I'm not suggesting we should be callous, I'm pointing out that people have always known that life was precarious and we needed to take precautions and plan ahead.


And by the way, when you are 30, 70 may look old, but when you are 70 and in good health 70 doesn't feel all that old.  Especially these days.  And remember, all you math whizzes, that average age of death at 45 (many historical societies) didn't mean people dropped dead of old age at 45.  It was an average, there was high infant and child mortality, death in war and childbirth for young adults.  If you survived all that you had good odds of making it to 70 and beyond.

Sorry this got a bit long.  Basic message, we are all in this together, do your part and quit your bitchin'.

GuitarStv

  • Senior Mustachian
  • ********
  • Posts: 17202
  • Age: 39
  • Location: Toronto, Ontario, Canada
Re: How long can we wait while flattening the curve?
« Reply #4805 on: November 18, 2020, 07:13:54 AM »
Re what are the older people willing to do?  I can only speak for those I know, but we are doing the recommendations.  We wear masks and wash hands, we distance, we don't socialize, we have stopped all our group activities, we have much less family contact, we are super careful about any kind of shopping, we are basically shutting down our lives.  And the people I know are generally at least financially well off to have some sort of online access and are computer literate enough to dip their toes into Zoom. 

So, we are socially isolated just as much as anyone else, if not more.  And given that as we get older we are more likely to be widowed/divorced, there are an awful lot of us who live alone.  As in, no spouse for company.  So we may not be vocal about it, but it is hard.   It is really easy to become detached from society when that is your life. 

And I'm not there yet, but I've known really old people who have lived their lives, are perfectly happy, but won't fight to live if they get sick.  I've had a friend die from ovarian cancer and another from breast cancer, and their deaths at least were mediated by palliative care and pain killers, not with a breathing tube fighting for breath.  My mom died of pneumonia, and that was not an easy death, a lot more like a Covid death, breathing tube and all.  Covid is not a good way to die.

What we would like others to do is not be stupid.  Follow the same precautions.

What strikes me as a very short-sighted view is how people think this is all so unbearable.  We have been so healthy for the last 50 or so years that we take public health for granted and don't  see that we all have a part to play.  People should be washing their hands anyway.  People should be sneezing and blowing noses into a tissue anyway, and not spitting anyway. 


Way more people died of the Spanish Flu than died in WWI.  In most wars mortality came more from infected wounds and bad camp hygiene than from direct wounds.  People got polio.  People ended up with damaged hearts from rheumatic fever.  Babies were born deformed because of German measles.  People starved because of bad weather and crop failures.  I'm not suggesting we should be callous, I'm pointing out that people have always known that life was precarious and we needed to take precautions and plan ahead.


And by the way, when you are 30, 70 may look old, but when you are 70 and in good health 70 doesn't feel all that old.  Especially these days.  And remember, all you math whizzes, that average age of death at 45 (many historical societies) didn't mean people dropped dead of old age at 45.  It was an average, there was high infant and child mortality, death in war and childbirth for young adults.  If you survived all that you had good odds of making it to 70 and beyond.

Sorry this got a bit long.  Basic message, we are all in this together, do your part and quit your bitchin'.

TLDR - Selfish old people don't want to die so I can go to a couple more house parties before we all get vaccinated mid next year.  Can you believe the gall of these people?  How much suffering do I have to endure?


:P

ReadySetMillionaire

  • Handlebar Stache
  • *****
  • Posts: 1688
  • Location: The Buckeye State
Re: How long can we wait while flattening the curve?
« Reply #4806 on: November 18, 2020, 07:45:56 AM »
New York Times: Danish Study Questions Use of Masks to Protect Wearers

https://www.nytimes.com/2020/11/18/health/coronavirus-masks-denmark.html

Quote
From early April to early June, researchers at the University of Copenhagen recruited 6,024 participants who had been tested beforehand to be sure they were not infected with the coronavirus.

Half were given surgical masks and told to wear them when leaving their homes; the others were told not to wear masks in public.

At that time, 2 percent of the Danish population was infected — a rate lower than that in many places in the United States and Europe today. Social distancing and frequent hand-washing were common, but masks were not.

About 4,860 participants completed the study. The researchers had hoped that masks would cut the infection rate by half among wearers. Instead, 42 people in the mask group, or 1.8 percent, got infected, compared with 53 in the unmasked group, or 2.1 percent. The difference was not statistically significant.

“Our study gives an indication of how much you gain from wearing a mask,” said Dr. Henning Bundgaard, lead author of the study and a cardiologist at the University of Copenhagen. “Not a lot.”

Dr. Mette Kalager, a researcher at Telemark Hospital in Norway and the Harvard School of Public Health, was persuaded. The study showed that “although there might be a symbolic effect,” she wrote in an email, “the effect of wearing a mask does not substantially reduce risk” for wearers.

You should read the full article, as there are objections to the study.

But I thought the end of the article was brave:

Quote
In an editorial accompanying the new study, Dr. Laine, Dr. Steven Goodman, an editor at the journal and an epidemiologist at Stanford University, and Dr. Eliseo Guallar, deputy editor of statistics at the journal, said that the Danish trial was “carefully conducted in a real world setting.”

Still, they acknowledged the risk of misinterpretation.

“With fierce resistance to mask recommendations by leaders and the public in some locales, is it irresponsible for Annals to publish these results, which could easily be misused by those opposed to mask recommendations?” the journal editors wrote.

“We think not,” they added. “More irresponsible would be to not publish the results of carefully designed research because the findings were not as favorable or definitive as some may have hoped.”
« Last Edit: November 18, 2020, 08:04:37 AM by ReadySetMillionaire »

ReadySetMillionaire

  • Handlebar Stache
  • *****
  • Posts: 1688
  • Location: The Buckeye State
Re: How long can we wait while flattening the curve?
« Reply #4807 on: November 18, 2020, 07:48:53 AM »
Re what are the older people willing to do?

This was not the question presented to you.

This was:

Just to play devils advocate, since you're one of the older posters around here I'd like to hear your thoughts regarding what amount of sacrifice is acceptable in an effort to save (mostly) old people. What price are you comfortable asking a teenager to pay so that you don't have to face a disease you're likely to beat anyway? Just as the physical outcomes disproportionately affect the old, the societal/economic outcomes disproportionately affect the young. What price do you see as "fair", and is there ever a point where you'd say "I can't ask them to do that on my behalf"? Is losing their job, having to give up their social life for months on end and delaying their education enough? Is it ok for a 20 year old to have reduced job prospects and lower career earnings so their 70yo grandparent might live longer? How many grandparents would willingly give up months or years of their remaining life for their kids and grandkids to have a better life?

Just as young people can be callous about the effect this can have on older people, I think older people can be pretty oblivious or even nonchalant about any harm that may come to younger generations as a cost for trying to add some months or years to their lives. Regardless of age, we're all going to be dealing with the ramifications of COVID for whatever is left of our lives. The elderly aren't the only ones with potential negative impacts from this.

You generally write in great prose, and I appreciate your advocacy for your demographic, but you are not answering the very difficult question being presented to you.

former player

  • Walrus Stache
  • *******
  • Posts: 6091
  • Location: Avalon
Re: How long can we wait while flattening the curve?
« Reply #4808 on: November 18, 2020, 08:25:48 AM »
Re what are the older people willing to do?

This was not the question presented to you.

This was:

Just to play devils advocate, since you're one of the older posters around here I'd like to hear your thoughts regarding what amount of sacrifice is acceptable in an effort to save (mostly) old people. What price are you comfortable asking a teenager to pay so that you don't have to face a disease you're likely to beat anyway? Just as the physical outcomes disproportionately affect the old, the societal/economic outcomes disproportionately affect the young. What price do you see as "fair", and is there ever a point where you'd say "I can't ask them to do that on my behalf"? Is losing their job, having to give up their social life for months on end and delaying their education enough? Is it ok for a 20 year old to have reduced job prospects and lower career earnings so their 70yo grandparent might live longer? How many grandparents would willingly give up months or years of their remaining life for their kids and grandkids to have a better life?

Just as young people can be callous about the effect this can have on older people, I think older people can be pretty oblivious or even nonchalant about any harm that may come to younger generations as a cost for trying to add some months or years to their lives. Regardless of age, we're all going to be dealing with the ramifications of COVID for whatever is left of our lives. The elderly aren't the only ones with potential negative impacts from this.

You generally write in great prose, and I appreciate your advocacy for your demographic, but you are not answering the very difficult question being presented to you.
It's not an either/or though.  You do not have to sacrifice lives, even those lesser lives of us old people, in order to provide an acceptable education and home and work life to the young.  What you do need to do is to put thought and resources into supporting education, family life and working opportunities.

I have no idea what all these people who are now so concerned about the disadvantaged young in this pandemic have been doing for the decades during which it has been obvious that there is, and has been for a long time, a significant proportion of young people who are disadvantaged by poverty, family circumstances and poor educational opportunities.  It is the young who were disadvantaged before the pandemic came along who are now suffering the worst, and if half the right-wing handwringing there is abut them now had been translated into action then there would be so much less opportunity for this fake and useless concern now.

Davnasty

  • Magnum Stache
  • ******
  • Posts: 2631
Re: How long can we wait while flattening the curve?
« Reply #4809 on: November 18, 2020, 09:02:32 AM »
New York Times: Danish Study Questions Use of Masks to Protect Wearers

https://www.nytimes.com/2020/11/18/health/coronavirus-masks-denmark.html


I see a number of problems with this article, the study itself, and some of the quotes from the study's authors that frame the study as more meaningful than it really is.

But before we get into any discussion of this article, have you acknowledged yet that masks are effective at preventing the spread of coronavirus to others?

I ask because the article you're citing suggests that this is established fact but not long ago you were arguing that masks do not work on a community wide basis.


RetiredAt63

  • Senior Mustachian
  • ********
  • Posts: 14614
  • Location: Eastern Ontario, Canada
Re: How long can we wait while flattening the curve?
« Reply #4810 on: November 18, 2020, 09:33:11 AM »
Re what are the older people willing to do?

This was not the question presented to you.

This was:

Just to play devils advocate, since you're one of the older posters around here I'd like to hear your thoughts regarding what amount of sacrifice is acceptable in an effort to save (mostly) old people. What price are you comfortable asking a teenager to pay so that you don't have to face a disease you're likely to beat anyway? Just as the physical outcomes disproportionately affect the old, the societal/economic outcomes disproportionately affect the young. What price do you see as "fair", and is there ever a point where you'd say "I can't ask them to do that on my behalf"? Is losing their job, having to give up their social life for months on end and delaying their education enough? Is it ok for a 20 year old to have reduced job prospects and lower career earnings so their 70yo grandparent might live longer? How many grandparents would willingly give up months or years of their remaining life for their kids and grandkids to have a better life?

Just as young people can be callous about the effect this can have on older people, I think older people can be pretty oblivious or even nonchalant about any harm that may come to younger generations as a cost for trying to add some months or years to their lives. Regardless of age, we're all going to be dealing with the ramifications of COVID for whatever is left of our lives. The elderly aren't the only ones with potential negative impacts from this.

You generally write in great prose, and I appreciate your advocacy for your demographic, but you are not answering the very difficult question being presented to you.
It's not an either/or though.  You do not have to sacrifice lives, even those lesser lives of us old people, in order to provide an acceptable education and home and work life to the young.  What you do need to do is to put thought and resources into supporting education, family life and working opportunities.

I have no idea what all these people who are now so concerned about the disadvantaged young in this pandemic have been doing for the decades during which it has been obvious that there is, and has been for a long time, a significant proportion of young people who are disadvantaged by poverty, family circumstances and poor educational opportunities.  It is the young who were disadvantaged before the pandemic came along who are now suffering the worst, and if half the right-wing handwringing there is abut them now had been translated into action then there would be so much less opportunity for this fake and useless concern now.

This ^^^

What the pandemic has show is weaknesses in society.  Weaknesses for children.  Weaknesses in the way the job market is structured.  Weaknesses in care homes.  In Ontario most of the nursing home deaths were in private ones, not public ones.  Part time staff who work in more than one place to get close to full time hours. People who care more for their own comfort than the safety of others (masks, social gatherings).

Re sacrifices, we already sacrificed throughout our lives, some more than others, and in various ways.  Those of us who had children prioritized our time and money to the kids instead of other activities.  We are doing the not so obvious sacrifice of not bugging out kids about seeing the grandkids, or getting together for Thanksgiving (last October) or Christmas, or whatever.  And being "Willing to die for our kids/grandkids" doesn't mean a thing, it isn't going to keep them safe.  Being willing to stay in our bubbles and not invade theirs will keep them safer. 

When people first started wearing masks, I noticed that the older people at the grocery store, and the women at the grocery store, started wearing them first.  At that point the accepted wisdom was that we were wearing them for others' protection from us, not to protect ourselves from them. 

In Ontario right now the people getting sick are not just the elderly.  It is kids, young people, middle-aged people.  They aren't catching it from us.  They are catching it from each other.  There is nothing we can do to save them from each other.

Age Group   Cumulative   Active   Resolved   Deaths
            
Under 20       11,238       1914      9323              1
20-29           20,383       2671        17708         4
30-39           15,206       1999        13200          7
40-49           13,636       1874        11733         29
50-59           14,371       1788        12472         111
60-69            9,267       1191        7776            300
70-79            5,182        640           3946        596
80-89            5,338        460           3637        1241
90-99            3,528        281           2121        1126

From https://covid-19.ontario.ca/data
ETA  I edited about 5 times to make the numbers sort of line up, at least the table makes some sense now.
« Last Edit: November 18, 2020, 09:59:30 AM by RetiredAt63 »

ReadySetMillionaire

  • Handlebar Stache
  • *****
  • Posts: 1688
  • Location: The Buckeye State
Re: How long can we wait while flattening the curve?
« Reply #4811 on: November 18, 2020, 09:37:08 AM »
New York Times: Danish Study Questions Use of Masks to Protect Wearers

https://www.nytimes.com/2020/11/18/health/coronavirus-masks-denmark.html


I see a number of problems with this article, the study itself, and some of the quotes from the study's authors that frame the study as more meaningful than it really is.

But before we get into any discussion of this article, have you acknowledged yet that masks are effective at preventing the spread of coronavirus to others?

I ask because the article you're citing suggests that this is established fact but not long ago you were arguing that masks do not work on a community wide basis.

Meh, I'm not interested in another mask debate on here, but given the viral nature of this Danish mask study, I welcome hearing your criticisms of the study.

GuitarStv

  • Senior Mustachian
  • ********
  • Posts: 17202
  • Age: 39
  • Location: Toronto, Ontario, Canada
Re: How long can we wait while flattening the curve?
« Reply #4812 on: November 18, 2020, 09:45:45 AM »
There's nothing to debate regarding masks.

Montecarlo

  • Pencil Stache
  • ****
  • Posts: 671
Re: How long can we wait while flattening the curve?
« Reply #4813 on: November 18, 2020, 09:47:34 AM »


I am frankly tired of taking snapshots in time and using them to criticize or reward politicians. COVID-19 has been here for seven months; to look at a single rolling seven-day average and declare "this is working" or "this is not working" is just ridiculous.

Look at the Midwest right now. You have varying degrees of lockdowns and mask policies and closures and curfews and stay at home orders. You'd be hard-pressed to come up with any sort of common theme except "these states did not get hit yet."

Taking everything into account, seven states have higher deaths/million than North Dakota. Nineteen states have higher deaths/million than South Dakota. To the above comment, NY and NJ have over 1,750 deaths per million. Now, you still can't really compare these, because we are basically in the 5th inning of a baseball game.

***

Even more importantly, just looking at the raw COVID death data is misleading in itself. The only proper metric for this pandemic is excess deaths.

I was just curious and looked at the South Dakota data. 644 total deaths. 362 of those were older than 80 (56%). Another 129 were between 70-79 (20%). So three-fourths of deaths were above 70.

That's the governor's fault? Seriously, how long are we going to blame old people dying on politicians?

The Dakotas might experience a per capita excess death rate of a a couple-hundred people per million, and we apparently are going to pretend that the governors are mass murderers because they didn't shut their states down.

I definitely agree with the first half of your post. 

SunnyDays

  • Handlebar Stache
  • *****
  • Posts: 1497
Re: How long can we wait while flattening the curve?
« Reply #4814 on: November 18, 2020, 09:54:44 AM »
All well said, @RetiredAt63!  The vast majority of people today, even ones our age, don't know what serious hardship is.  They think it is having to stay home and watch Netflix instead of bar-hopping, and wearing a mask (because "breathing in your own carbon dioxide isn't good for you," said by a "friend").  We are all so soft and spoiled, it's truly mind-boggling.  And so discouraging.  We are back into the red zone with lots of closures again and I am staying home, only going out to get groceries (rarely, because I've stayed stocked up), and seeing that my elderly father is doing okay.  That's it.

RetiredAt63

  • Senior Mustachian
  • ********
  • Posts: 14614
  • Location: Eastern Ontario, Canada
Re: How long can we wait while flattening the curve?
« Reply #4815 on: November 18, 2020, 10:03:16 AM »
All well said, @RetiredAt63!  The vast majority of people today, even ones our age, don't know what serious hardship is.  They think it is having to stay home and watch Netflix instead of bar-hopping, and wearing a mask (because "breathing in your own carbon dioxide isn't good for you," said by a "friend").  We are all so soft and spoiled, it's truly mind-boggling.  And so discouraging.  We are back into the red zone with lots of closures again and I am staying home, only going out to get groceries (rarely, because I've stayed stocked up), and seeing that my elderly father is doing okay.  That's it.

I love these German Covid ads.

https://twitter.com/antoni_UK/status/1327701477008285696

https://twitter.com/antoni_UK/status/1327935017897570306

OtherJen

  • Magnum Stache
  • ******
  • Posts: 4139
  • Location: Metro Detroit
Re: How long can we wait while flattening the curve?
« Reply #4816 on: November 18, 2020, 10:21:20 AM »
All well said, @RetiredAt63!  The vast majority of people today, even ones our age, don't know what serious hardship is.  They think it is having to stay home and watch Netflix instead of bar-hopping, and wearing a mask (because "breathing in your own carbon dioxide isn't good for you," said by a "friend").  We are all so soft and spoiled, it's truly mind-boggling.  And so discouraging.  We are back into the red zone with lots of closures again and I am staying home, only going out to get groceries (rarely, because I've stayed stocked up), and seeing that my elderly father is doing okay.  That's it.

I love these German Covid ads.

https://twitter.com/antoni_UK/status/1327701477008285696

https://twitter.com/antoni_UK/status/1327935017897570306

Those ads are amazing.

Seriously, I keep wondering what all of these people who can't bear the thought of changing their habits even slightly would have done under blackout laws and curfews during a world war.

Davnasty

  • Magnum Stache
  • ******
  • Posts: 2631
Re: How long can we wait while flattening the curve?
« Reply #4817 on: November 18, 2020, 10:42:53 AM »
New York Times: Danish Study Questions Use of Masks to Protect Wearers

https://www.nytimes.com/2020/11/18/health/coronavirus-masks-denmark.html


I see a number of problems with this article, the study itself, and some of the quotes from the study's authors that frame the study as more meaningful than it really is.

But before we get into any discussion of this article, have you acknowledged yet that masks are effective at preventing the spread of coronavirus to others?

I ask because the article you're citing suggests that this is established fact but not long ago you were arguing that masks do not work on a community wide basis.

Meh, I'm not interested in another mask debate on here, but given the viral nature of this Danish mask study, I welcome hearing your criticisms of the study.

Neither am I, I was asking to help me determine whether there's any point in discussing research with you. Previously you've made it pretty clear that you're seeking out studies that could plausibly back up your point of view while ignoring piles of evidence to the contrary. So until you can admit you were wrong about something that you were so clearly wrong about, I'll assume you're only pretending to be interested in discussion.

But just in case anyone else is interested, here's my take on the article-

Criticisms mentioned in the article: Critics were quick to note the study’s limitations. Among them: The incidence of infections in Denmark was lower than it is today in many places, meaning the effectiveness of masks for wearers may have been harder to detect. Participants reported their own test results; mask use was not independently verified, and users may not have worn them correctly.

Limitations acknowledged within the published study: Inconclusive results, missing data, variable adherence, patient-reported findings on home tests, no blinding, and no assessment of whether masks could decrease disease transmission from mask wearers to others.

And perhaps most importantly, I would add that the sample size was extremely small especially when considered with the low rate of infection.


Here are some misleading quotes:

Quote
“Our study gives an indication of how much you gain from wearing a mask,” said Dr. Henning Bundgaard, lead author of the study and a cardiologist at the University of Copenhagen. “Not a lot.”

Quote
Dr. Mette Kalager, a researcher at Telemark Hospital in Norway and the Harvard School of Public Health, was persuaded. The study showed that “although there might be a symbolic effect,” she wrote in an email, “the effect of wearing a mask does not substantially reduce risk” for wearers.

Quote
"The study’s conclusion flies in the face of other research suggesting that masks do protect the wearer."

All misleading because a single study of this size is nowhere near enough to make such claims.

And finally, I think there are arguments to be made on both sides of whether or not research like this should be published right now, so I won't call the authors of the study irresponsible for publishing, however conducting the research at all was irresponsible. Telling 3,000 people to intentionally not wear masks no matter their circumstances when we already know that masks reduce transmission to others is definitely irresponsible. That's why there aren't more studies like this.

Telecaster

  • Handlebar Stache
  • *****
  • Posts: 2365
  • Location: Seattle, WA
Re: How long can we wait while flattening the curve?
« Reply #4818 on: November 18, 2020, 10:55:11 AM »
Just to play devils advocate, since you're one of the older posters around here I'd like to hear your thoughts regarding what amount of sacrifice is acceptable in an effort to save (mostly) old people. What price are you comfortable asking a teenager to pay so that you don't have to face a disease you're likely to beat anyway? Just as the physical outcomes disproportionately affect the old, the societal/economic outcomes disproportionately affect the young. What price do you see as "fair", and is there ever a point where you'd say "I can't ask them to do that on my behalf"? Is losing their job, having to give up their social life for months on end and delaying their education enough? Is it ok for a 20 year old to have reduced job prospects and lower career earnings so their 70yo grandparent might live longer? How many grandparents would willingly give up months or years of their remaining life for their kids and grandkids to have a better life?

Just as young people can be callous about the effect this can have on older people, I think older people can be pretty oblivious or even nonchalant about any harm that may come to younger generations as a cost for trying to add some months or years to their lives. Regardless of age, we're all going to be dealing with the ramifications of COVID for whatever is left of our lives. The elderly aren't the only ones with potential negative impacts from this.

I lost my dad when I was about 30 and he was about 63-ish.  If I had the option of losing my job and having limited social contact for a year or keeping my dad, I can't imagine how overjoyed I'd be to go on unemployment. 

mm1970

  • Walrus Stache
  • *******
  • Posts: 8630
Re: How long can we wait while flattening the curve?
« Reply #4819 on: November 18, 2020, 10:57:45 AM »
Quote
What the pandemic has show is weaknesses in society.  Weaknesses for children.  Weaknesses in the way the job market is structured.  Weaknesses in care homes.  In Ontario most of the nursing home deaths were in private ones, not public ones.  Part time staff who work in more than one place to get close to full time hours. People who care more for their own comfort than the safety of others (masks, social gatherings).

Yes, this.  Everyone talks about "the children" but they don't want to give up socialization, eating out, bars, etc.

Quote
It's not an either/or though.  You do not have to sacrifice lives, even those lesser lives of us old people, in order to provide an acceptable education and home and work life to the young.  What you do need to do is to put thought and resources into supporting education, family life and working opportunities.

I have no idea what all these people who are now so concerned about the disadvantaged young in this pandemic have been doing for the decades during which it has been obvious that there is, and has been for a long time, a significant proportion of young people who are disadvantaged by poverty, family circumstances and poor educational opportunities.  It is the young who were disadvantaged before the pandemic came along who are now suffering the worst, and if half the right-wing handwringing there is abut them now had been translated into action then there would be so much less opportunity for this fake and useless concern now.

It's not either/or.  We don't have to be willing to let people die.  We could open schools WITHOUT killing adults and WITHOUT having people go hungry or get kicked out of their apartments due to lack of work.

You just have to pay people to stay home.  Strong social safety net.  The heck with giving stimulus money to companies, give it to families who need to pay rent, for food, and mortgage while they are out of work.  Give the money to the woman who owns a small spa/ massage place so that she can pay rent on the space while her business is closed.

Quote
Meh, I'm not interested in another mask debate on here, but given the viral nature of this Danish mask study, I welcome hearing your criticisms of the study.

Besides the obvious - that masks are shown to prevent the SPREAD of COVID.  MY wearing a mask probably only very slightly protects me (though if I'm in a busy place, I add a filter).  The real protection is preventing me from giving it to someone else.

OtherJen

  • Magnum Stache
  • ******
  • Posts: 4139
  • Location: Metro Detroit
Re: How long can we wait while flattening the curve?
« Reply #4820 on: November 18, 2020, 12:51:56 PM »
Crain's Detroit: Some hospitals hit capacity as Michigan adds 7,458 COVID-19 cases

Quote
Statewide, the number of patients hospitalized with COVID-19 was 3,320 as of Tuesday. A month ago when there were around 1,000.


habanero

  • Pencil Stache
  • ****
  • Posts: 786
Re: How long can we wait while flattening the curve?
« Reply #4821 on: November 18, 2020, 01:51:49 PM »
And finally, I think there are arguments to be made on both sides of whether or not research like this should be published right now, so I won't call the authors of the study irresponsible for publishing, however conducting the research at all was irresponsible. Telling 3,000 people to intentionally not wear masks no matter their circumstances when we already know that masks reduce transmission to others is definitely irresponsible. That's why there aren't more studies like this.

I thought they had some juicy stuff given the pre-noise, but now when it's out I kind of see why it was refused by 3(?) journals. The flaws are pretty freakin' obvious to me. I think the only thing you cannot hold against it is the sample size, they claimed it was the largest ever as far as I understood from the pre-noise.

I think asking 3k ppl not to wear masks in Denmark is entirely responsible during this time. It was also in line with Danish health authorities recommendations at the time (they have changed a bit now when infections are more widespread btw) but during the experiment time the risk of getting an infection in Denmark was extremely low and not many people wore masks there in the first place unless you worked in health service which is the only area masks were mandatory in Denmark at that time. Obviously noone in the sample were in a job or other position were masks were mandated.

Denmark was well into a proper semi-lockdown and it was probably more difficult to recruit 3000 people to wear masks in the first place than the non-masked control group and given how little mask use there was I strongly doubt all 3000 actually used it as intended. Which is one of the flaws of the study btw.

As mentioned earlier during the same time in Norway, with a "lockdown" almost exactly like the Danish version, Covid-19 almost entirely disappeard here and in Denmark as well almost without anyone wearing a mask. During this early period people really respected the social distancing thing, lots of stuff was shut anyway and there was never really any big public debate as to mandate masks or not save for a few voices.

From early april a couple of weeks into lockdown the hospitals emptied of covid patients at a very rapid pace and come end may there was probably like 10 patients left in all of Denmark's hospitals combined with a population of almost 6 million. The experience was not at all like in the US, there was, as april and may progressed a very strong feeling this was well contained. Mid-april schools started reopening in Denmark and stuff slowly got going again and covid infections were almost negliable for months.

Masks were never really an issue. It might sound odd, but if you wore a mask up here in April/May people though you were kind of a weirdo as almost noone did and frankly hardly anyone really saw the point in it. We bought our first package of face masks a few weeks ago. Its widespread use in shops now but it's not mandatory if you can maintain distance apart from "casual meets" (read:passing someone)

« Last Edit: November 18, 2020, 01:59:48 PM by habanero »

kenmoremmm

  • Pencil Stache
  • ****
  • Posts: 571
Re: How long can we wait while flattening the curve?
« Reply #4822 on: November 18, 2020, 02:22:43 PM »
i assume the only true "case study" we need to look at is here in the US. look at per capita infection rates and then compare to voting records. voting records of (R) will correlate to lower mask usage. i suspect it likewise corresponds to a higher per capita infection rate.

i always look at WA state, which was ground zero (in theory) for the US-based outbreak. our numbers are quite low in comparison to many states, and that's because the bulk of the state's population is in king, snohomish, and pierce counties, in which votes heavily (D) and has good adoption of mask usage.

anecdotal, i know.

Davnasty

  • Magnum Stache
  • ******
  • Posts: 2631
Re: How long can we wait while flattening the curve?
« Reply #4823 on: November 18, 2020, 02:47:47 PM »
And finally, I think there are arguments to be made on both sides of whether or not research like this should be published right now, so I won't call the authors of the study irresponsible for publishing, however conducting the research at all was irresponsible. Telling 3,000 people to intentionally not wear masks no matter their circumstances when we already know that masks reduce transmission to others is definitely irresponsible. That's why there aren't more studies like this.

I thought they had some juicy stuff given the pre-noise, but now when it's out I kind of see why it was refused by 3(?) journals. The flaws are pretty freakin' obvious to me. I think the only thing you cannot hold against it is the sample size, they claimed it was the largest ever as far as I understood from the pre-noise.

I think asking 3k ppl not to wear masks in Denmark is entirely responsible during this time. It was also in line with Danish health authorities recommendations at the time (they have changed a bit now when infections are more widespread btw) but during the experiment time the risk of getting an infection in Denmark was extremely low and not many people wore masks there in the first place unless you worked in health service which is the only area masks were mandatory in Denmark at that time. Obviously noone in the sample were in a job or other position were masks were mandated.

Largest study of it's kind might be true, but that doesn't mean it's large enough to provide useful results. And to clarify, the number of participants is less important than the number of infections. As an extreme example, a study with a million participants and 100 total infections would still be "too small" to tell us if masks protect the wearer. A study with 1,000 participants and 500 infections would be much more informative.

Your point that people weren't wearing masks anyway at that time is fair so my criticism that this study specifically was irresponsible was misplaced.

If however, a study like this were conducted in a time and place where the virus was spreading, such a study would be unethical. For such a study to be meaningful you would need the virus to be spreading. So this kind of study is necessarily going to be unethical or uninformative.

habanero

  • Pencil Stache
  • ****
  • Posts: 786
Re: How long can we wait while flattening the curve?
« Reply #4824 on: November 18, 2020, 03:06:52 PM »
For such a study to be meaningful you would need the virus to be spreading.

Yep. and it wasn't to any meaningful extent, hence the results were if not pre-destined then at least post-destined to be a big "meh". As a side note, the very limited spread we actually had during this period was almost entirely in large families livnig in small households (read: immigrant families), so there is hardly any case of the few there was that would be prevented from mask wearing in the first place. Of course whoever brought it into a household got it somewhere, but cases were so few that it was pretty much down to bad luck.

Im talking  bit from the Norwegian perspective as I don't really know the fine details about Denmark, but the graphs of hospitalizations / deaths and how "lockdown" was implemented are pretty much blueprints of each other so I assume the Norwegian experience is pretty much the same as the Danish.

That there was almost no mask-wearing in Denmark as well is mentioned in the study and that correlates with what I have read about the lack of mask use in Denmark.

mizzourah2006

  • Pencil Stache
  • ****
  • Posts: 644
  • Location: NWA
Re: How long can we wait while flattening the curve?
« Reply #4825 on: November 18, 2020, 03:14:24 PM »
And finally, I think there are arguments to be made on both sides of whether or not research like this should be published right now, so I won't call the authors of the study irresponsible for publishing, however conducting the research at all was irresponsible. Telling 3,000 people to intentionally not wear masks no matter their circumstances when we already know that masks reduce transmission to others is definitely irresponsible. That's why there aren't more studies like this.

I thought they had some juicy stuff given the pre-noise, but now when it's out I kind of see why it was refused by 3(?) journals. The flaws are pretty freakin' obvious to me. I think the only thing you cannot hold against it is the sample size, they claimed it was the largest ever as far as I understood from the pre-noise.

I think asking 3k ppl not to wear masks in Denmark is entirely responsible during this time. It was also in line with Danish health authorities recommendations at the time (they have changed a bit now when infections are more widespread btw) but during the experiment time the risk of getting an infection in Denmark was extremely low and not many people wore masks there in the first place unless you worked in health service which is the only area masks were mandatory in Denmark at that time. Obviously noone in the sample were in a job or other position were masks were mandated.

Largest study of it's kind might be true, but that doesn't mean it's large enough to provide useful results. And to clarify, the number of participants is less important than the number of infections. As an extreme example, a study with a million participants and 100 total infections would still be "too small" to tell us if masks protect the wearer. A study with 1,000 participants and 500 infections would be much more informative.

Your point that people weren't wearing masks anyway at that time is fair so my criticism that this study specifically was irresponsible was misplaced.

If however, a study like this were conducted in a time and place where the virus was spreading, such a study would be unethical. For such a study to be meaningful you would need the virus to be spreading. So this kind of study is necessarily going to be unethical or uninformative.

Honestly both groups have a higher incidence of infection than the Pfizer vaccine study participants had.

Pfizer treatment infections: 9/19000 = 0.04%
Pfizer control infections: 85/19000 = 0.4%

Copenhagen study mask: 42/~2430 = 1.8%
Copenhagen study no-mask: 53/~2430 = 2.1%


Should we deem the Pfizer study results an issue because of the low incidence of infections in each group?

Bloop Bloop Reloaded

  • Bristles
  • ***
  • Posts: 305
  • Location: Australia
Re: How long can we wait while flattening the curve?
« Reply #4826 on: November 18, 2020, 03:19:39 PM »
All well said, @RetiredAt63!  The vast majority of people today, even ones our age, don't know what serious hardship is.  They think it is having to stay home and watch Netflix instead of bar-hopping, and wearing a mask (because "breathing in your own carbon dioxide isn't good for you," said by a "friend").  We are all so soft and spoiled, it's truly mind-boggling.  And so discouraging.  We are back into the red zone with lots of closures again and I am staying home, only going out to get groceries (rarely, because I've stayed stocked up), and seeing that my elderly father is doing okay.  That's it.

Serious hardship in my state befell sole traders who were told they could not visit their work premises even if they worked alone with no contact with others. The government evidently didn't care about small businesses.

I was not affected by this since I can work remotely and I found a loophole anyway. My mate who runs a mechanic's workshop was less fortunate. He lost three months of revenue. Even though all his work can be done without human to human contact on-site, he wasn't allowed to visit his place of work at all.

It was a silly rule by the government and one that lacked nuance or empathy for the needs of business owners. Sure, if your business requires human mingling then it ought not operate. But not all businesses do.

The government put in all sorts of rules and sub-rules to help, for example, parents working from home with children to access daycare; but when it came to things like small businesses that weren't in certain favoured industries (manufacturing and greyhound racing got exemptions), there was a heavy-handed approach.

It's the heavy-handed approach I dislike. There needed to be some nuance in the rules. When the active cases in Melbourne shrank so that they were concentrated mostly in two geographic hotspots we could have allowed some easing of the rest of the city first. There could have been a rule saying that if you live and work in a LGA with no active cases you could go back to work as long as you didn't cross a border.  Or something like that.

The heavy-handed curfew was in place well past its expiration date but got pulled the day before the court challenge to it.

And now the mask thing - compulsory mask wear outdoors at all times even when alone - is similarly off-key. It's silly and not backed by science to require someone to wear a mask (not just carry it in his or her pocket) when alone in the outdoors. Sure, mask rules can never hurt anyone. But the acceptance of arbitrary and non-objective rules can lead to an acceptance of other rules that do hurt people.
« Last Edit: November 18, 2020, 03:29:27 PM by Bloop Bloop Reloaded »

SunnyDays

  • Handlebar Stache
  • *****
  • Posts: 1497
Re: How long can we wait while flattening the curve?
« Reply #4827 on: November 18, 2020, 03:29:23 PM »
All well said, @RetiredAt63!  The vast majority of people today, even ones our age, don't know what serious hardship is.  They think it is having to stay home and watch Netflix instead of bar-hopping, and wearing a mask (because "breathing in your own carbon dioxide isn't good for you," said by a "friend").  We are all so soft and spoiled, it's truly mind-boggling.  And so discouraging.  We are back into the red zone with lots of closures again and I am staying home, only going out to get groceries (rarely, because I've stayed stocked up), and seeing that my elderly father is doing okay.  That's it.

Posting works?

What do you mean?

ReadySetMillionaire

  • Handlebar Stache
  • *****
  • Posts: 1688
  • Location: The Buckeye State
Re: How long can we wait while flattening the curve?
« Reply #4828 on: November 18, 2020, 03:58:00 PM »
i assume the only true "case study" we need to look at is here in the US. look at per capita infection rates and then compare to voting records. voting records of (R) will correlate to lower mask usage. i suspect it likewise corresponds to a higher per capita infection rate.

i always look at WA state, which was ground zero (in theory) for the US-based outbreak. our numbers are quite low in comparison to many states, and that's because the bulk of the state's population is in king, snohomish, and pierce counties, in which votes heavily (D) and has good adoption of mask usage.

anecdotal, i know.

I am not a scientist, just a layman (lawyer). I'm trying to look at this myself.

To my untrained eyes, the studies supporting mask use all suffer from at least one of three flaws: (1) they looked at snapshots in time (which would be like looking at one inning of a baseball game); (2) they were anecdotal (the Missouri mask study comes to mind); or (3) they are tested in a lab, not the real world.

We live on earth and have to deal with people acting like people and behaving like people. The mask studies all talk about proper fit, proper filtration, proper material, washing masks daily, etc. It's just not what happens in the real world.

So, to your point, look at the states and see how they are doing:

Illinois has had a mask mandate since April 30. They have the most cases in the country today and the most deaths.

Wisconsin is second on the list, with a mask mandate since July 30.  Second most cases.

Pennsylvania is fourth (mask mandate since July 1), Michigan is fifth (mask mandate since May 15).

Sandwiched in between all of these is Florida, which has not had a mask mandate since September. As noted previously, the Dakotas are also experiencing high per capita case counts/hospitalizations.

Now, maybe it's the red areas. But just for example, I look at the Michigan county-by-county map, and the Democratic areas have the most cases. Now, that map is a little difficult, because you'd like to see per capita, but it is what it is. https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173---,00.html

From my completely anecdotal experience, people bitch about masks but wear them (including me).  I always wear one at work, at the grocery store, etc. I'd estimate Ohio's compliance at 90%. We are hitting our surge, hard, now.

In any event, I would love a fifty state survey of all these policies. But just looking at things, I just do not see statistically significant correlations between NPIs and outcomes. 

And that is probably my biggest frustration. COVID might be the ultimate Rorschach test -- you see what you want to see.  The only reason I return to this thread is to be reminded of my biases.  I try to confront them, the discussion here being one of the useful tools.

But again, I'm just looking at the data, and I don't see much of a correlation with NPI's and outcomes. The NPI's are all theoretical and have never been tried on this widespread of a basis.

And that's probably my ultimate point -- I have no doubt that these policies all theoretically make sense (including masks) in a lab or in some sort of computer simulation -- but we live on earth, and that's not how things work.
« Last Edit: November 18, 2020, 04:05:10 PM by ReadySetMillionaire »

dandarc

  • Magnum Stache
  • ******
  • Posts: 4210
  • Age: 38
Re: How long can we wait while flattening the curve?
« Reply #4829 on: November 18, 2020, 04:01:23 PM »
@mizzourah2006 -

The Pfizer result is statistically significant. The Denmark mask study's result is not.

As you're counting folks who have confirmed covid infections who are in your study, you see whether they were in the control group or the vaccine group. The further your result diverges from a 50/50 split, the less likely the null hypothesis "vaccine does not work" is true. The data from the clinical trials is telling everyone that these mRNA vaccines are in all probability very effective, because the odds of getting these results (162 infections in placebo, 8 in vaccine group from today's update from Pfizer) are extremely low if the vaccine is in fact, not effective.

If I was flipping a coin 170 times and got heads 162 times and tails only 8, of course it is possible that the coin is fair and that was just a random result. But it is far, far more likely that the coin is in fact, not fair.

Whereas had I flipped a coin 95 times and gotten 42 heads and 53 tails, we don't have as clear a case to reject the null hypothesis that the coin is fair.

ReadySetMillionaire

  • Handlebar Stache
  • *****
  • Posts: 1688
  • Location: The Buckeye State
Re: How long can we wait while flattening the curve?
« Reply #4830 on: November 18, 2020, 04:24:20 PM »
The Canadians in this thread might find this interesting, from a recent Edmonton City Council meeting.

Dr. Roger Hodkinson, MA, MB, FRCPC, FCAP, CEO and medical director of Western Medical Assessments, spoke at the Edmonton City Council Community and Public Services Committee meeting on Nov. 13. Hodkinson was trained at Cambridge University in the UK. He is ex-president of the pathology section of the Medical Association. He was the chairman of the Royal College of Physicians of Canada Examination Committee and Pathology in Ottawa, Canada.

He calls COVID a "hoax," says "all testing should stop," "masks are utterly useless," etc. Says we cannot control the virus via all these NPIs.

https://www.westernstandardonline.com/2020/11/senior-doc-says-alberta-politicians-playing-medicine-media-driving-hysteria/

Transcript of his comments:

Quote
I do appreciate the opportunity to address you on this very important matter. What I’m going to say is lay language, and blunt. It is counter-narrative, and so you don’t immediately think I’m a quack, I’m going to briefly outline my credentials so that you can understand where I’m coming from in terms of knowledge base in all of this.

I’m a medical specialist in pathology which includes virology. I trained at Cambridge University in the UK. I’m the ex-president of the pathology section of the Medical Association. I was previously an assistant professor in the Faculty of Medicine doing a lot of teaching. I was the chairman of the Royal College of Physicians of Canada Examination Committee and Pathology in Ottawa, but more to the point I’m currently the chairman of a biotechnology company in North Carolina selling the COVID-19 test.

And [inaudible] you might say I know a little bit about all of this. The bottom line is simply this: There is utterly unfounded public hysteria driven by the media and politicians. It’s outrageous. This is the greatest hoax ever perpetrated on an unsuspecting public. There is absolutely nothing that can be done to contain this virus. Other than protecting older, more vulnerable people. It should be thought of as nothing more than a bad flu season. This is not Ebola. It’s not SARS. It’s politics playing medicine and that’s a very dangerous game.

There is no action of any kind needed other than what happened last year when we felt unwell. We stayed home, we took chicken noodle soup, we didn’t visit granny and we decided when we would return to work. We didn’t need anyone to tell us.

Masks are utterly useless. There is no evidence base for their effectiveness whatsoever. Paper masks and fabric masks are simply virtue-signaling. They’re not even worn effectively most of the time. It’s utterly ridiculous. Seeing these unfortunate, uneducated people — I’m not saying that in a pejorative sense — seeing these people walking around like lemmings, obeying without any knowledge base, to put the mask on their face.

Social distancing is also useless because COVID is spread by aerosols which travel 30 meters or so before landing. Enclosures have had such terrible unintended consequences. Everywhere should be opened tomorrow as well as was stated in the Great Barrington Declaration that I circulated prior to this meeting.

And a word on testing: I do want to emphasize that I’m in the business of testing for COVID. I do want to emphasize that positive test results do not, underlined in neon, mean a clinical infection. It’s simply driving public hysteria and all testing should stop. Unless you’re presenting to the hospital with some respiratory problem.

All that should be done is to protect the vulnerable and to give them all in the nursing homes that are under your control, give them all 3,000 to 5,000 international units of vitamin D every day which has been shown to radically reduce the likelihood of Infection.

And I would remind you all that using the province’s own statistics, the risk of death under 65 in this province is one in 300,000. One in 300,000. You’ve got to get a grip on this.

The scale of the response that you are undertaking with no evidence for it is utterly ridiculous given the consequences of acting in a way that you’re proposing. All kinds of suicides, business closures, funerals, weddings etc. It’s simply outrageous! It’s just another bad flu and you’ve got to get your minds around that.

Let people make their own decisions. You should be totally out of the business of medicine. You’re being led down the garden path by the chief medical officer of health for this province. I am absolutely outraged that this has reached this level. It should all stop tomorrow.

Thank you very much.
« Last Edit: November 18, 2020, 04:28:19 PM by ReadySetMillionaire »

T-Money$

  • Stubble
  • **
  • Posts: 233
  • Location: New York
Re: How long can we wait while flattening the curve?
« Reply #4831 on: November 18, 2020, 04:29:07 PM »
Some of you have the hubris to debate the only large scale randomized and controlled study on mask efficacy?

H8TRs gonna H8.

#ibelieveincognitivedissonance

mizzourah2006

  • Pencil Stache
  • ****
  • Posts: 644
  • Location: NWA
Re: How long can we wait while flattening the curve?
« Reply #4832 on: November 18, 2020, 04:41:55 PM »
@mizzourah2006 -

The Pfizer result is statistically significant. The Denmark mask study's result is not.

As you're counting folks who have confirmed covid infections who are in your study, you see whether they were in the control group or the vaccine group. The further your result diverges from a 50/50 split, the less likely the null hypothesis "vaccine does not work" is true. The data from the clinical trials is telling everyone that these mRNA vaccines are in all probability very effective, because the odds of getting these results (162 infections in placebo, 8 in vaccine group from today's update from Pfizer) are extremely low if the vaccine is in fact, not effective.

If I was flipping a coin 170 times and got heads 162 times and tails only 8, of course it is possible that the coin is fair and that was just a random result. But it is far, far more likely that the coin is in fact, not fair.

Whereas had I flipped a coin 95 times and gotten 42 heads and 53 tails, we don't have as clear a case to reject the null hypothesis that the coin is fair.

I get that. Not statistically significant is a result though. If I hypothesize x and my study finds the p-value of x is 0.25 I don't toss out the results. That's data that supports the null. Thanks for the intro to research methods though....brings me back to when I used to teach it at University :)

With regards to the Pfizer update today it seems a bit odd to me. Last week they were 1.25 months into a study of 40k people and had 94 confirmed cases a week later they basically doubled that and miraculously had an efficacy rate slightly better than Moderna's. Did 76 more people really test positive (all in the control group) in 1 week?

I'm not saying the vaccine(s) don't work, just the timing of it all with literally no explanation is very odd.
« Last Edit: November 18, 2020, 04:46:12 PM by mizzourah2006 »

mm1970

  • Walrus Stache
  • *******
  • Posts: 8630
Re: How long can we wait while flattening the curve?
« Reply #4833 on: November 18, 2020, 04:58:43 PM »
Quote
With regards to the Pfizer update today it seems a bit odd to me. Last week they were 1.25 months into a study of 40k people and had 94 confirmed cases a week later they basically doubled that and miraculously had an efficacy rate slightly better than Moderna's. Did 76 more people really test positive (all in the control group) in 1 week?
I don't know the actual data, but both groups said that yes, the fact that COVID is spreading SO quickly is why they are getting results ahead of time.  Much faster than predicted.

dandarc

  • Magnum Stache
  • ******
  • Posts: 4210
  • Age: 38
Re: How long can we wait while flattening the curve?
« Reply #4834 on: November 18, 2020, 05:01:14 PM »
You asked how the results were different - that's a pretty big way they are different.

And the reason there are more infections reported so quickly seems to me to most likely be because of the shitty job we're doing containing the virus. 0.2% of people in the trial becoming infected within a week, is unfortunately, in-line with rates of new positive cases we've been seeing, at least here in the US lately. 150K per day is about 0.3% of the population per week.

Perhaps marketing is why the announcements are coming so quickly, but there is not a reason on the surface to doubt the results being reported.

mizzourah2006

  • Pencil Stache
  • ****
  • Posts: 644
  • Location: NWA
Re: How long can we wait while flattening the curve?
« Reply #4835 on: November 18, 2020, 05:37:34 PM »
You asked how the results were different - that's a pretty big way they are different.

And the reason there are more infections reported so quickly seems to me to most likely be because of the shitty job we're doing containing the virus. 0.2% of people in the trial becoming infected within a week, is unfortunately, in-line with rates of new positive cases we've been seeing, at least here in the US lately. 150K per day is about 0.3% of the population per week.

Perhaps marketing is why the announcements are coming so quickly, but there is not a reason on the surface to doubt the results being reported.

I didn't ask how the results were different. I was specifically replying to the point they made about the reason the study wasn't worthwhile was because the infection rate was so low.

And to clarify, the number of participants is less important than the number of infections. As an extreme example, a study with a million participants and 100 total infections would still be "too small" to tell us if masks protect the wearer. A study with 1,000 participants and 500 infections would be much more informative.

I was simply showing that the infection rates in the vaccine study is magnitudes lower, so you agree with me in saying that the person I was responding to was inaccurate in their statement that what matters in studies is the total number of infections. Glad we can agree on something :)


 

dandarc

  • Magnum Stache
  • ******
  • Posts: 4210
  • Age: 38
Re: How long can we wait while flattening the curve?
« Reply #4836 on: November 18, 2020, 06:11:03 PM »
https://blogs.sciencemag.org/pipeline/archives/2020/09/21/the-vaccine-protocols explains it well

The infection rate was low, combined with the close spread on the results means they did not have enough infections to conclude much of anything from that data. This small sample size, combined with a close split means "this data does not support that masks protect the wearer a lot". To prove "masks protect wearer a little", you'd need larger numbers.

Pfizer and Moderna each had a similarly low number of infections, but the split between "infected" vs. "not infected" was massive. Erego the low number was not nearly as much of a problem for those studies to declare success.

Montecarlo

  • Pencil Stache
  • ****
  • Posts: 671
Re: How long can we wait while flattening the curve?
« Reply #4837 on: November 18, 2020, 07:36:33 PM »
The Canadians in this thread might find this interesting, from a recent Edmonton City Council meeting.

Dr. Roger Hodkinson, MA, MB, FRCPC, FCAP, CEO and medical director of Western Medical Assessments, spoke at the Edmonton City Council Community and Public Services Committee meeting on Nov. 13. Hodkinson was trained at Cambridge University in the UK. He is ex-president of the pathology section of the Medical Association. He was the chairman of the Royal College of Physicians of Canada Examination Committee and Pathology in Ottawa, Canada.

He calls COVID a "hoax," says "all testing should stop," "masks are utterly useless," etc. Says we cannot control the virus via all these NPIs.

https://www.westernstandardonline.com/2020/11/senior-doc-says-alberta-politicians-playing-medicine-media-driving-hysteria/

Transcript of his comments:

I enjoy hearing dissenting opinions, and I think dissent is vital to a free society.  I also think this guy is extreme in his comments.  A bad flu?  The proportions aren’t even close.

I think when all is said and done, we’ll find more overreactions than underreactions.  But go about your lives and eat chicken noodle soup is an irresponsible sentiment.

Bloop Bloop Reloaded

  • Bristles
  • ***
  • Posts: 305
  • Location: Australia
Re: How long can we wait while flattening the curve?
« Reply #4838 on: November 18, 2020, 07:43:13 PM »
It is no worse, in fact it is milder, than a bad flu for those under 30. At least based on Australian data. We have no deaths under 30. I posted the actual figures earlier in this thread.

I think it's really important to have dissenting opinions and it seems that when it comes to the difficult question of how many deaths are tolerable in the context of wide scale, onerous restrictions, dissenting opinions are not being given enough oxygen.

I also think the Canadian guy is being too lax and too permissive. But certainly I think a lot of opinions out there about locking everything down, etc, are way too restrictive. It would be nice to get a bit of balance in the discourse rather than having knee jerk reactions on either side of the spectrum.

There has been good discussion behind closed doors but governments are doing an extremely bad job of explaining (much less quantifying) the QALY dilemma that exists with shutting down jobs, schools and even just social interaction. Citizens are clever and deserve to be given proper analysis. The Victorian government's messaging has been criticised for being blunt and "one size fits all" and I think that's an entirely valid criticism.

Montecarlo

  • Pencil Stache
  • ****
  • Posts: 671
Re: How long can we wait while flattening the curve?
« Reply #4839 on: November 18, 2020, 07:45:15 PM »
It is no worse, in fact it is milder, than a bad flu for those under 30. At least based on Australian data. We have no deaths under 30. I posted the actual figures earlier in this thread.

Yes, but unfortunately for us all those pesky seniors get practically decimated.

Bloop Bloop Reloaded

  • Bristles
  • ***
  • Posts: 305
  • Location: Australia
Re: How long can we wait while flattening the curve?
« Reply #4840 on: November 18, 2020, 08:10:24 PM »
Yes. More than decimated, in fact. The death rate exceeds 10% for those over 80.

I'm not arguing that covid is, on the whole, no worse than a bad flu. It is. And neither is it right to say that because it affects different populations differently, one population shouldn't value the needs of another.

Paper Chaser

  • Bristles
  • ***
  • Posts: 465
Re: How long can we wait while flattening the curve?
« Reply #4841 on: November 18, 2020, 08:24:53 PM »

What the pandemic has show is weaknesses in society.  Weaknesses for children.  Weaknesses in the way the job market is structured.  Weaknesses in care homes.  In Ontario most of the nursing home deaths were in private ones, not public ones.  Part time staff who work in more than one place to get close to full time hours. People who care more for their own comfort than the safety of others (masks, social gatherings).

Re sacrifices, we already sacrificed throughout our lives, some more than others, and in various ways.  Those of us who had children prioritized our time and money to the kids instead of other activities.  We are doing the not so obvious sacrifice of not bugging out kids about seeing the grandkids, or getting together for Thanksgiving (last October) or Christmas, or whatever.  And being "Willing to die for our kids/grandkids" doesn't mean a thing, it isn't going to keep them safe.  Being willing to stay in our bubbles and not invade theirs will keep them safer. 

When people first started wearing masks, I noticed that the older people at the grocery store, and the women at the grocery store, started wearing them first.  At that point the accepted wisdom was that we were wearing them for others' protection from us, not to protect ourselves from them. 

In Ontario right now the people getting sick are not just the elderly.  It is kids, young people, middle-aged people.  They aren't catching it from us.  They are catching it from each other.  There is nothing we can do to save them from each other.

Age Group   Cumulative   Active   Resolved   Deaths
            
Under 20       11,238       1914      9323              1
20-29           20,383       2671        17708         4
30-39           15,206       1999        13200          7
40-49           13,636       1874        11733         29
50-59           14,371       1788        12472         111
60-69            9,267       1191        7776            300
70-79            5,182        640           3946        596
80-89            5,338        460           3637        1241
90-99            3,528        281           2121        1126

From https://covid-19.ontario.ca/data
ETA  I edited about 5 times to make the numbers sort of line up, at least the table makes some sense now.

Good post! Thanks. And thanks for the data too. I often watch similar demographics for my area, and while the general numbers vary by location, the rate of infection and death between the demographics is pretty similar in every location I've looked at.
I always like to calculate the survival rate by demographic because it's not something that I see or hear about, and I think it's helpful to focus on any positive that we can when trying to quantify the risks.
With your data I get:
Age Group         Survival rate
            
Under 20             ~100%
20-29             ~100
30-39             ~100
40-49               99.8
50-59               99.3
60-69               96.8
70-79               88.5
80-89               76.8
90-99               68.1

There's a lot of doom and gloom discussed and reported as it relates to this virus but in every location that I've seen, the vast majority of people infected with COVID survive, even in the oldest/most at risk demographics. I think knowing that can and should be accounted for in our individual decision making for any sacrifices we might make.

Abe

  • Handlebar Stache
  • *****
  • Posts: 1806
Re: How long can we wait while flattening the curve?
« Reply #4842 on: November 18, 2020, 09:11:48 PM »
Regarding mask studies: I have previously cited a meta-analysis of randomized trials in hospital (thus, high risk) settings over a full flu season showing benefit to mask wearing in reducing influenza-like illness and influenza in particular. Conversely, a study of RCTs in lower-risk (community) settings showed no benefit in reducing viral infections, but did show a benefit for bacterial infections. Thus it is reasonable to believe it would be effective in high-risk settings unless someone can propose a mechanism in which this virus is physically significantly different from other respiratory-spread viruses. Based on well-done analysis of indoor spread, it has been concluded that being indoors with a person who has COVID-19 is a high-risk setting (at home, in an office or in restaurants). If we could rapid-test everyone at every indoor setting to confirm they don't have it, then we could forgo masks. Obviously that would be extremely expensive. Some of the data supporting this conclusion is cited here: https://jamanetwork.com/channels/health-forum/fullarticle/2773247

In low-risk settings masks are probably not necessary. I think in general this means outdoors. High-risk settings are most indoor locations. 

Regarding "Republican" vs "Democrat" areas (which I think means rural vs urban?) please explain the "per capita" map of COVID-19 infections in the Midwest and Northeast. Note the location of the cities. (couldn't fit the whole country and show cities, so using this as a reference section). Can only reference https://www.washingtonpost.com/news/politics/wp/2018/07/30/presenting-the-least-misleading-map-of-the-2016-election/ for a map of the 2016 presidential results by county for comarison.

Regarding studies with null results - they can be underpowered, in which case that isn't a useful result. That is a major known risk of low enrollment or low event randomized trials.


I have, in general, stopped focusing on argument for or against prevention measures since there is low compliance in many areas regardless. Luckily I live in an area with the lowest infection rate in a relatively low infection rate area, even though a large fraction of the population works in hospitals. Many of us wear masks all day at work even pre-COVID so it's just not a big deal to wear them, and compliance is high indoors. People don't normally wear masks outdoors in low-density locations, and infection rates remain low. At this point I'm really only concerned about my friends and family, and the general population can do whatever they want.
« Last Edit: November 18, 2020, 09:45:21 PM by Abe »

waltworks

  • Magnum Stache
  • ******
  • Posts: 4580
Re: How long can we wait while flattening the curve?
« Reply #4843 on: November 18, 2020, 10:00:15 PM »
Mask use/compliance is 100% where I live (Utah) - I literally haven't seen anyone in a public indoor setting without one in months. The LDS church has a lot of sway and pushed hard to get people to wear masks, so we're much better at it than most red states.

But cases are spiking here too. If the masks helped, it's hard to tell.

That said, masks certainly aren't going to hurt anything. At the very least they help visually remind everyone to stay the hell away from each other if possible. I think.

Everyone in Utah is going to do a big family get together for Thanksgiving, though (to be clear: my family won't) because I guess that's just what you do. I know people who wear a mask when alone, outdoors, on a walk... who are going to a Thanksgiving get-together with 40 people, indoors, unmasked. Insanity - and probably the end of our in-person school which has thus far been a big/safe success. Doh.

-W

Davnasty

  • Magnum Stache
  • ******
  • Posts: 2631
Re: How long can we wait while flattening the curve?
« Reply #4844 on: November 18, 2020, 10:17:36 PM »
And finally, I think there are arguments to be made on both sides of whether or not research like this should be published right now, so I won't call the authors of the study irresponsible for publishing, however conducting the research at all was irresponsible. Telling 3,000 people to intentionally not wear masks no matter their circumstances when we already know that masks reduce transmission to others is definitely irresponsible. That's why there aren't more studies like this.

I thought they had some juicy stuff given the pre-noise, but now when it's out I kind of see why it was refused by 3(?) journals. The flaws are pretty freakin' obvious to me. I think the only thing you cannot hold against it is the sample size, they claimed it was the largest ever as far as I understood from the pre-noise.

I think asking 3k ppl not to wear masks in Denmark is entirely responsible during this time. It was also in line with Danish health authorities recommendations at the time (they have changed a bit now when infections are more widespread btw) but during the experiment time the risk of getting an infection in Denmark was extremely low and not many people wore masks there in the first place unless you worked in health service which is the only area masks were mandatory in Denmark at that time. Obviously noone in the sample were in a job or other position were masks were mandated.

Largest study of it's kind might be true, but that doesn't mean it's large enough to provide useful results. And to clarify, the number of participants is less important than the number of infections. As an extreme example, a study with a million participants and 100 total infections would still be "too small" to tell us if masks protect the wearer. A study with 1,000 participants and 500 infections would be much more informative.

Your point that people weren't wearing masks anyway at that time is fair so my criticism that this study specifically was irresponsible was misplaced.

If however, a study like this were conducted in a time and place where the virus was spreading, such a study would be unethical. For such a study to be meaningful you would need the virus to be spreading. So this kind of study is necessarily going to be unethical or uninformative.

Honestly both groups have a higher incidence of infection than the Pfizer vaccine study participants had.

Pfizer treatment infections: 9/19000 = 0.04%
Pfizer control infections: 85/19000 = 0.4%

Copenhagen study mask: 42/~2430 = 1.8%
Copenhagen study no-mask: 53/~2430 = 2.1%


Should we deem the Pfizer study results an issue because of the low incidence of infections in each group?

I didn't realize the infection counts in the Pfizer study were so low. That's surprising to me but maybe I'm missing something.


There are reasons why the number of infections in the mask study would need to be much higher than in a vaccine study to be meaningful.

First, someone who is vaccinated remains that way 24/7. Someone who is given a box of 50 masks and told to wear them in certain situations is not.  it's guaranteed that participants had varying degrees of discipline in mask-wearing, especially if mask-wearing was uncommon among the general public at the time. It's difficult to wear a mask when it's not the norm.

Consider a study on the efficacy of condoms. 6,000 sexually active participants, 3,000 are given a box of condoms and told to use them in "certain situations"/ 3000 are told to go without. In a given time period 42 of the test group and 53 of the control group become pregnant. Are these numbers sufficient to claim condoms are ineffective? I'd say not. But in a study on the efficacy of IUDs if 9 in 19,000 with an IUD got pregnant and 85 in 19,000 without got pregnant, that would be more meaningful. (the actual disparity between these groups would be much greater, IUDs are more than 99% effective on an annual basis)

Second, it's likely that a large majority of those transmissions occurred among family and other groups whom the participants weren't told to wear masks around.

When you throw in false positives from transmission that occurs when not wearing a mask, you need a much larger sample size/number of infections to compensate.
« Last Edit: November 18, 2020, 10:20:12 PM by Davnasty »

Abe

  • Handlebar Stache
  • *****
  • Posts: 1806
Re: How long can we wait while flattening the curve?
« Reply #4845 on: November 18, 2020, 10:24:42 PM »
Post hoc power analysis shows the danish mask study (using the data provided above) had only 11% power to detect a true difference amongst the arms when incidence rates were as reported. Put another way, a trial designed with a sample they had would not have 80% power to detect a 40% decrease in infections. I’d be interested in how they determined their necessary sample size. Could someone link to the article? Couldn’t find it online.
« Last Edit: November 18, 2020, 10:27:31 PM by Abe »

Davnasty

  • Magnum Stache
  • ******
  • Posts: 2631
Re: How long can we wait while flattening the curve?
« Reply #4846 on: November 18, 2020, 10:47:32 PM »
Post hoc power analysis shows the danish mask study (using the data provided above) had only 11% power to detect a true difference amongst the arms when incidence rates were as reported. Put another way, a trial designed with a sample they had would not have 80% power to detect a 40% decrease in infections. I’d be interested in how they determined their necessary sample size. Could someone link to the article? Couldn’t find it online.

https://www.acpjournals.org/doi/10.7326/M20-6817

alsoknownasDean

  • Handlebar Stache
  • *****
  • Posts: 2345
  • Age: 36
  • Location: Melbourne, Australia
Re: How long can we wait while flattening the curve?
« Reply #4847 on: November 18, 2020, 11:16:58 PM »
It is no worse, in fact it is milder, than a bad flu for those under 30. At least based on Australian data. We have no deaths under 30. I posted the actual figures earlier in this thread.

I think it's really important to have dissenting opinions and it seems that when it comes to the difficult question of how many deaths are tolerable in the context of wide scale, onerous restrictions, dissenting opinions are not being given enough oxygen.

I also think the Canadian guy is being too lax and too permissive. But certainly I think a lot of opinions out there about locking everything down, etc, are way too restrictive. It would be nice to get a bit of balance in the discourse rather than having knee jerk reactions on either side of the spectrum.

There has been good discussion behind closed doors but governments are doing an extremely bad job of explaining (much less quantifying) the QALY dilemma that exists with shutting down jobs, schools and even just social interaction. Citizens are clever and deserve to be given proper analysis. The Victorian government's messaging has been criticised for being blunt and "one size fits all" and I think that's an entirely valid criticism.

Yes you're right that the survival rate for younger people is very high, but it's not just the elderly who are being impacted by COVID. There's the hospital staff if the system is overloaded, the people who suffer because their non-COVID conditions are unable to be treated (or delayed treatment) when the medical system is over-run with COVID patients, and even those that survive COVID can have long lasting effects.

https://apnews.com/article/ap-top-news-tennessee-coronavirus-pandemic-74a1f0dc3634917a5dc13408455cd895

160,000 cases per day in the US. It's awfully sad that so many people still don't take COVID seriously over there.

habanero

  • Pencil Stache
  • ****
  • Posts: 786
Re: How long can we wait while flattening the curve?
« Reply #4848 on: November 19, 2020, 12:44:58 AM »

I didn't realize the infection counts in the Pfizer study were so low. That's surprising to me but maybe I'm missing something.

It was supposed to be even lower for the prelimiary results now published.

They published when they had 96 cases. Initial idea was 30-something but that wasn't accepted to I think they settled on 50-something as the threshold. But while they were arguing about that they got more cases so it ended up at 96 in the end.

For the final results they need a total of 164 cases in the sample.

The Moderna prelim phase-3 results are on 95 cases in total.

« Last Edit: November 19, 2020, 01:35:35 AM by habanero »

Abe

  • Handlebar Stache
  • *****
  • Posts: 1806
Re: How long can we wait while flattening the curve?
« Reply #4849 on: November 19, 2020, 05:21:56 AM »
Post hoc power analysis shows the danish mask study (using the data provided above) had only 11% power to detect a true difference amongst the arms when incidence rates were as reported. Put another way, a trial designed with a sample they had would not have 80% power to detect a 40% decrease in infections. I’d be interested in how they determined their necessary sample size. Could someone link to the article? Couldn’t find it online.

https://www.acpjournals.org/doi/10.7326/M20-6817

Thanks. Looks like the authors assumed a 50% efficacy and thus powered their study for that. They also note the results were inconclusive as demonstrated by the large confidence interval, limited time of intervention and variable compliance (only 47% full compliance). Thus their study was quite under-powered. They also note that the study doesn’t address efficacy of widespread masking, as that was not its design. So really the only thing we can say is that short-term wearing masks, when hardly anyone else is and only half the people wear it properly, and with severe social distancing policies in place, does not reduce covid infection by 50% in a low-risk setting. Not a sweeping conclusion about mask efficacy at all.