Author Topic: How long can we wait while flattening the curve?  (Read 253712 times)

Michael in ABQ

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Re: How long can we wait while flattening the curve?
« Reply #3450 on: August 05, 2020, 02:35:01 PM »
Here are a couple randomizes studies that in fact show it does reduce in-hospital mortality. The first in Michigan, USA with 2,541 patients conducted mostly in March and April. The second in Milan, Italy with 539 patients conducted from February through May. Both included a control, hydroxychloroquine, and hydroxychloroquine + azithromycin (an antibiotic).

Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19
<snip>
That isn't a randomized study. It's a retrospective observational study. As yet, no randomized studies have demonstrated a benefit to HCQ, at least none that I'm aware of.

This one doesn't. https://www.nejm.org/doi/full/10.1056/NEJMoa2016638

Retrospective observational studies are subject to various types of non-correctable bias, especially when they are conducted at a single center and confounding variables cannot be controlled.

This study focuses on the prophylactic effect, not treatment and reduction in mortality. Also, as I interpret it they only measured outcomes for 14 days after potential exposure which is generally before someone would be hospitalized and die. It does say that they followed-up 6 weeks later but only 113 people in the trial tested positive and the median age was 40-41. At that age the likelihood of death is well under 1%.

So it confirmed that hydroxychloroquine does not prevent you from developing COVID-19 if exposed to the SARS-CoV-2 virus. However, it didn't have anything to do with hydroxychloroquine as a treatment to reduce the effects and mortality rate of COVID-19.

obstinate

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Re: How long can we wait while flattening the curve?
« Reply #3451 on: August 05, 2020, 02:38:10 PM »
Here are a couple randomizes studies that in fact show it does reduce in-hospital mortality. The first in Michigan, USA with 2,541 patients conducted mostly in March and April. The second in Milan, Italy with 539 patients conducted from February through May. Both included a control, hydroxychloroquine, and hydroxychloroquine + azithromycin (an antibiotic).

Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19
<snip>
That isn't a randomized study. It's a retrospective observational study. As yet, no randomized studies have demonstrated a benefit to HCQ, at least none that I'm aware of.

So does that make the results invalid or just less meaningful? Can you provide links to any randomized studies you are aware of? These are simply what I turned up in a few minutes searching on Google. I'm not a scientist or medical professional but these results are intriguing.
It dramatically hurts the evidentiary power, because everything is correlated with everything. There has also been a lot of motivated reasoning on HCQ in this particular case because of the political climate.

There have been several fully randomized HCQ trials. None of them have shown a benefit. Here's the RECOVERY trial. Here's one testing HCQ as post-exposure prophylaxis. There are others. Not a single one has demonstrated a significantly positive effect from HCQ.

IMO, for a rationalist, if it's not randomized, it basically shouldn't count as evidence, at least when it comes to HCQ.
« Last Edit: August 05, 2020, 02:42:35 PM by obstinate »

scottish

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Re: How long can we wait while flattening the curve?
« Reply #3452 on: August 05, 2020, 03:01:56 PM »
I'm seeing numbers of new cases per day in the 50K range now instead of the 70K range.   

https://www.worldometers.info/coronavirus/country/us/

Are new daily cases starting to come down?    Or is the white house mucking with the numbers?




NorthernBlitz

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Re: How long can we wait while flattening the curve?
« Reply #3453 on: August 05, 2020, 03:25:25 PM »
Here are a couple randomizes studies that in fact show it does reduce in-hospital mortality. The first in Michigan, USA with 2,541 patients conducted mostly in March and April. The second in Milan, Italy with 539 patients conducted from February through May. Both included a control, hydroxychloroquine, and hydroxychloroquine + azithromycin (an antibiotic).

Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19
<snip>
That isn't a randomized study. It's a retrospective observational study. As yet, no randomized studies have demonstrated a benefit to HCQ, at least none that I'm aware of.

This one doesn't. https://www.nejm.org/doi/full/10.1056/NEJMoa2016638

Retrospective observational studies are subject to various types of non-correctable bias, especially when they are conducted at a single center and confounding variables cannot be controlled.

Science doesn't answer questions quickly. This is a new virus and it takes time to answer questions. The good news seems to be that there are some therapeutics that are working who's study has avoided the political quagmire of HCQ.

My understanding is that we don't know if HCQ helps or not but the data seems to suggest that it doesn't hurt...except for the studies with fabricated data that were retracted (likely due to some combination of pressure to publish and political zealotry).

Science weeds out those kinds of biases when it's done properly, but it takes time to build consensus.

And MD's don't have time to wait for the consensus in the middle of a pandemic.

PDXTabs

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Re: How long can we wait while flattening the curve?
« Reply #3454 on: August 05, 2020, 03:30:39 PM »
Are new daily cases starting to come down?

It would appear so, but Faucci says that we really need to get to 10K before flu season and we are no where near that.

OtherJen

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Re: How long can we wait while flattening the curve?
« Reply #3455 on: August 05, 2020, 04:01:16 PM »
Here are a couple randomizes studies that in fact show it does reduce in-hospital mortality. The first in Michigan, USA with 2,541 patients conducted mostly in March and April. The second in Milan, Italy with 539 patients conducted from February through May. Both included a control, hydroxychloroquine, and hydroxychloroquine + azithromycin (an antibiotic).

Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19
<snip>
That isn't a randomized study. It's a retrospective observational study. As yet, no randomized studies have demonstrated a benefit to HCQ, at least none that I'm aware of.

This one doesn't. https://www.nejm.org/doi/full/10.1056/NEJMoa2016638

Retrospective observational studies are subject to various types of non-correctable bias, especially when they are conducted at a single center and confounding variables cannot be controlled.

Science doesn't answer questions quickly. This is a new virus and it takes time to answer questions. The good news seems to be that there are some therapeutics that are working who's study has avoided the political quagmire of HCQ.

My understanding is that we don't know if HCQ helps or not but the data seems to suggest that it doesn't hurt...except for the studies with fabricated data that were retracted (likely due to some combination of pressure to publish and political zealotry).

Science weeds out those kinds of biases when it's done properly, but it takes time to build consensus.

And MD's don't have time to wait for the consensus in the middle of a pandemic.

I have a PhD in immunology and have worked as a science editor for years so yeah, I do understand that. Our point is that because MDs are understandably throwing everything at the wall right now to see what sticks, that doesn't mean that everything that seems to be effective will actually turn out to be any sort of useful at all in the long-term. Retrospective observational studies use big, often incomplete sets of data. Every report of such a study includes a Limitations paragraph that discusses the possible biases, including the limitations and incompleteness of previously collected data and the likelihood that a potential confounding factor was not measured. For something like COVID-19, the confounding factors aren't even fully understood this early in the game.

Also, it was incredibly irresponsible for the President, who has absolutely no scientific or medical expertise (no matter what he claims), to start shilling a drug that 1) carries the risk of some significant adverse effects and 2) is actually used to treat other conditions such as autoimmune disorders. In spring, there was even less evidence to support the use of hydroxychloroquine to treat COVID-19 patients, and his rhetoric caused a shortage for patients who were currently using the drug as indicated for chronic diseases.
« Last Edit: August 05, 2020, 07:04:10 PM by OtherJen »

scottish

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Re: How long can we wait while flattening the curve?
« Reply #3456 on: August 05, 2020, 06:19:55 PM »
Pissed me right off that did.   In the end I was able to get my normal supply though.

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #3457 on: August 05, 2020, 07:44:31 PM »
It is sometimes forgotten that we have more than one problem in the world. And solving them all is impossible, we have to choose some balanced approach which minimises death and misery. In our focus on the latest problem we tend to forget this.

"According to one estimate, a three-month lockdown across different parts of the world and a gradual return to normal over 10 months could result in an additional 6.3 million cases of tuberculosis and 1.4 million deaths from it.

"A six-month disruption of antiretroviral therapy may lead to more than 500,000 additional deaths from illnesses related to H.I.V., according to the W.H.O. Another model by the W.H.O. predicted that in the worst-case scenario, deaths from malaria could double to 770,000 per year."

https://www.nytimes.com/2020/08/03/health/coronavirus-tuberculosis-aids-malaria.html

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #3458 on: August 05, 2020, 07:49:09 PM »
One major problem with saying that being fit helps covid is that it's not actually true.
Nothing reduces risk to zero. But you make your odds better or worse.


The notion of a risk-free life is particularly Western middle-classed. Such a thing doesn't exist. But you can change your odds.

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #3459 on: August 05, 2020, 07:52:16 PM »
My apologies. It appeared to me that you were reinforcing an argument that's been made the last couple days here that losing weight and exercising should be a priority or even a replacement for the advice to wear a mask and social distance.
Please quote even one person who's said that.

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #3460 on: August 05, 2020, 08:18:04 PM »
My apologies. It appeared to me that you were reinforcing an argument that's been made the last couple days here that losing weight and exercising should be a priority or even a replacement for the advice to wear a mask and social distance.
Please quote even one person who's said that.

The only thing that's said is that individual choices re health and food consumption can play a large, if not as large a role as, societal choices about things like masks.

Meanwhile, QLD performed 253 spot checks on people subject to isolation orders (positive tests and close contacts of positive tests). 250 of 253 were found at home.

Victoria conducted 3000 tests. Only 2200 were found at home.

What's going on here? Do we need jail time for people who refuse to stay at home after testing positive? I doubt $1600 fines are an effective deterrent since people will just refuse to pay them, and there's no way to enforce them other than assets seizure.

alsoknownasDean

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Re: How long can we wait while flattening the curve?
« Reply #3461 on: August 05, 2020, 08:39:25 PM »
What's going on here? Do we need jail time for people who refuse to stay at home after testing positive? I doubt $1600 fines are an effective deterrent since people will just refuse to pay them, and there's no way to enforce them other than assets seizure.

The fine's been recently increased to $4957. The issue with that is where would people go if they're caught? Would a separate prison need to be set up specifically for the purpose to prevent COVID-19 spreading through the prison system? Would you recommend that anyone who gets caught breaching self-isolation orders get fined and have to go into hotel quarantine?

Shane

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Re: How long can we wait while flattening the curve?
« Reply #3462 on: August 05, 2020, 08:42:59 PM »
In the US, politicization of public health crises isn't new. Back in the late 18th century, Dr. Benjamin Rush's "Republican cure" for yellow fever competed against a "Federalist Cure," heavily promoted by Alexander Hamilton. In hindsight, neither "cure" really helped very much. It wasn't until 1900 that scientists finally discovered that mosquitoes were responsible for transmitting yellow fever.

Politics of Yellow Fever in Alexander Hamilton's America

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #3463 on: August 05, 2020, 09:18:40 PM »
What's going on here? Do we need jail time for people who refuse to stay at home after testing positive? I doubt $1600 fines are an effective deterrent since people will just refuse to pay them, and there's no way to enforce them other than assets seizure.

The fine's been recently increased to $4957. The issue with that is where would people go if they're caught? Would a separate prison need to be set up specifically for the purpose to prevent COVID-19 spreading through the prison system? Would you recommend that anyone who gets caught breaching self-isolation orders get fined and have to go into hotel quarantine?

The thing is, $4957 versus $1600 will make no real difference. It's a whopping fine already out of the reach of most people who are going to get caught.

So perhaps give people the option of paying the fine, or if they cannot/refuse to pay it, they either choose 7 days in hotel quarantine (which they have to pay for - effectively creating a financial disincentive that's not quite as bad as the fine, but more pragmatically minded) or have to undertake 100 hours of unpaid community service once the lockdown is over?

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #3464 on: August 05, 2020, 11:49:06 PM »
Meanwhile, QLD performed 253 spot checks on people subject to isolation orders (positive tests and close contacts of positive tests). 250 of 253 were found at home.

Victoria conducted 3000 tests. Only 2200 were found at home.

What's going on here?
I don't think Victorians, culturally, are distinct enough from Queenslanders to explain the disparity. What are the other variables? Well, the actions of the police. We know as facts a few things,

1. The Chief Commissioner when questioned on examples was unable to answer whether certain actions would be legal, saying, "The reality is I donít know the answer to that."
2. In policing the virus restrictions, VicPol has used them to target already marginalised communities; this was confirmed by a recent report of the Upper House.
3. the new rules were posted at 11pm, to come into force one hour later
4. these rules are very complex, inconsistent and confusing, to say nothing of whether they relate at all to reducing the spread of the virus.
5. VicPol has, both in absolute numbers and proportionally, more police than any other jurisdiction in Australia - with one of the lowest crime rates, a crime rate which preceded every rise in police numbers, not followed it. Any large force will naturally have to lower standards for competence. You don't get the best and brightest if you have to take ever comer.
6. Victoria has had more covid fines than any other jurisdiction, and yet we have more infections, so the fines have been ineffective in their stated purpose.


And so it's reasonable to conclude that VicPol is bored and idle and looking for things to do, people to fine and arrest and just generally harass, and that even with the best-intentioned and most-competent police, the rules are complex and self-contradictory and muddled and confusing and most people will inadvertently break them six times a day before breakfast.


In all probability, a good number of the times people didn't answer the door the police just had the wrong fucking address. And the rest of the time, well maybe, just maybe, if armed uniformed people eager to harass and fine me knock on my door I'd rather not answer?

former player

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Re: How long can we wait while flattening the curve?
« Reply #3465 on: August 06, 2020, 01:59:54 AM »

6. Victoria has had more covid fines than any other jurisdiction, and yet we have more infections, so the fines have been ineffective in their stated purpose.

That logic is not unajacent to Trump's "we have more cases because we have more tests".

NorthernBlitz

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Re: How long can we wait while flattening the curve?
« Reply #3466 on: August 06, 2020, 03:13:29 AM »
Here are a couple randomizes studies that in fact show it does reduce in-hospital mortality. The first in Michigan, USA with 2,541 patients conducted mostly in March and April. The second in Milan, Italy with 539 patients conducted from February through May. Both included a control, hydroxychloroquine, and hydroxychloroquine + azithromycin (an antibiotic).

Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19
<snip>
That isn't a randomized study. It's a retrospective observational study. As yet, no randomized studies have demonstrated a benefit to HCQ, at least none that I'm aware of.

This one doesn't. https://www.nejm.org/doi/full/10.1056/NEJMoa2016638

Retrospective observational studies are subject to various types of non-correctable bias, especially when they are conducted at a single center and confounding variables cannot be controlled.

Science doesn't answer questions quickly. This is a new virus and it takes time to answer questions. The good news seems to be that there are some therapeutics that are working who's study has avoided the political quagmire of HCQ.

My understanding is that we don't know if HCQ helps or not but the data seems to suggest that it doesn't hurt...except for the studies with fabricated data that were retracted (likely due to some combination of pressure to publish and political zealotry).

Science weeds out those kinds of biases when it's done properly, but it takes time to build consensus.

And MD's don't have time to wait for the consensus in the middle of a pandemic.

I have a PhD in immunology and have worked as a science editor for years so yeah, I do understand that. Our point is that because MDs are understandably throwing everything at the wall right now to see what sticks, that doesn't mean that everything that seems to be effective will actually turn out to be any sort of useful at all in the long-term. Retrospective observational studies use big, often incomplete sets of data. Every report of such a study includes a Limitations paragraph that discusses the possible biases, including the limitations and incompleteness of previously collected data and the likelihood that a potential confounding factor was not measured. For something like COVID-19, the confounding factors aren't even fully understood this early in the game.

Also, it was incredibly irresponsible for the President, who has absolutely no scientific or medical expertise (no matter what he claims), to start shilling a drug that 1) carries the risk of some significant adverse effects and 2) is actually used to treat other conditions such as autoimmune disorders. In spring, there was even less evidence to support the use of hydroxychloroquine to treat COVID-19 patients, and his rhetoric caused a shortage for patients who were currently using the drug as indicated for chronic diseases.

I don't disagree with you.

But as a prof in Engineering I have a vested interest in the public retaining trust in science and the scientific method. Especially now when it's under pressure from ideologues on both sides of the political spectrum.

I think that's why the retracted papers on HCQ are pretty damning.we already have hyperpartisanship destroying faith in institutions. Now we see it slip into science, which is supposed to be the tool we have for putting bias aside to try to understand complex systems.

I think we see the same loss of faith when media over sells results from individual papers because it confirms their biases.

Kyle Schuant

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bigblock440

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Re: How long can we wait while flattening the curve?
« Reply #3468 on: August 06, 2020, 06:30:11 AM »
If President Obama or a President Clinton were to say from Day 1 "wear a mask," Republicans would ignore them out of spite.  If President Trump said the same thing, Republicans would wear them and Democrats would probably be defiant.

Not sure if this is true.

If Trump said from day 1 "wear a mask" and all the public health officials said "wear a mask" I suspect that most Democrats would wear a mask too.  Democratic policy is largely designed to push the idea of helping one another . . . which is exactly what wearing a mask does.  The Republican party also has a long history of science denialism and distrust of educated people that the Democratic party typically doesn't share.

I can point to my own province as some evidence.  It is led by a Conservative who told people to follow the guidelines and recommendations of health providers.  Even though our Premier is well disliked by left voters and left wing parties (and there exists a pretty strong partisan opposition to him) everyone of all political stripes listened to what he had to say.  There was no partisan divide on this matter.

No need to guess, we have a great example from February.  Trump said the virus was a problem, shut down travel from the Wuhan area, and the democrats said he was Xenophobic and to keep congregating in bars and come on down to Chinatown, no need to worry about a virus.  They were already calling him authoritarian and fascist, had he tried to invoke any kind of national order (masks, travel restrictions, etc.) there's have been a huge outcry.

LMAO. That's a pretty tall tale you're tellin' there.

Yeah, and he didn't shut down travel from anywhere else so more US index cases appeared to travel from Europe than from China. Damn those pesky facts.

Not until Italy was showing to be a hotspot with 1,000 cases.  And people still complained about that too.

bigblock440

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Re: How long can we wait while flattening the curve?
« Reply #3469 on: August 06, 2020, 06:32:13 AM »
If President Obama or a President Clinton were to say from Day 1 "wear a mask," Republicans would ignore them out of spite.  If President Trump said the same thing, Republicans would wear them and Democrats would probably be defiant.

Not sure if this is true.

If Trump said from day 1 "wear a mask" and all the public health officials said "wear a mask" I suspect that most Democrats would wear a mask too.  Democratic policy is largely designed to push the idea of helping one another . . . which is exactly what wearing a mask does.  The Republican party also has a long history of science denialism and distrust of educated people that the Democratic party typically doesn't share.

I can point to my own province as some evidence.  It is led by a Conservative who told people to follow the guidelines and recommendations of health providers.  Even though our Premier is well disliked by left voters and left wing parties (and there exists a pretty strong partisan opposition to him) everyone of all political stripes listened to what he had to say.  There was no partisan divide on this matter.

No need to guess, we have a great example from February.  Trump said the virus was a problem, shut down travel from the Wuhan area, and the democrats said he was Xenophobic and to keep congregating in bars and come on down to Chinatown, no need to worry about a virus.  They were already calling him authoritarian and fascist, had he tried to invoke any kind of national order (masks, travel restrictions, etc.) there's have been a huge outcry.

LMAO. That's a pretty tall tale you're tellin' there.

So you disagree that anyone thought Trump was authoritarian and fascist?  Or that people wouldn't have lost their shit if he tried locking down parts of the country or putting in more restrictive measures?

bigblock440

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Re: How long can we wait while flattening the curve?
« Reply #3470 on: August 06, 2020, 06:42:19 AM »
No need to guess, we have a great example from February.  Trump said the virus was a problem, shut down travel from the Wuhan area, and the democrats said he was Xenophobic and to keep congregating in bars and come on down to Chinatown, no need to worry about a virus.  They were already calling him authoritarian and fascist, had he tried to invoke any kind of national order (masks, travel restrictions, etc.) there's have been a huge outcry.

You should read this, even though you won't: https://www.factcheck.org/2020/03/the-facts-on-trumps-travel-restrictions/

Did, did you read it?  Or do you think Trump should have banned American citizens from returning, and did you think that in January?

frugalnacho

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Re: How long can we wait while flattening the curve?
« Reply #3471 on: August 06, 2020, 07:12:00 AM »
Like I said, a fucking twilight zone episode.  Some people are living in a parallel reality, side by side with us in the real world.  I wish I could get out of threads like this.

ender

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Re: How long can we wait while flattening the curve?
« Reply #3472 on: August 06, 2020, 07:13:38 AM »
Like I said, a fucking twilight zone episode.  Some people are living in a parallel reality, side by side with us in the real world.  I wish I could get out of threads like this.

I would spend so much more time on the MMM forum if there was a way to unsubscribe from threads that I've posted in.

C'est la vie. It makes the "new replies to your posts" view nearly useless because of how many 50-100+ page threads there are that I naively post in before I realize they're going to be that way.

GuitarStv

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Re: How long can we wait while flattening the curve?
« Reply #3473 on: August 06, 2020, 07:25:14 AM »
Here are a couple randomizes studies that in fact show it does reduce in-hospital mortality. The first in Michigan, USA with 2,541 patients conducted mostly in March and April. The second in Milan, Italy with 539 patients conducted from February through May. Both included a control, hydroxychloroquine, and hydroxychloroquine + azithromycin (an antibiotic).

Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19
<snip>
That isn't a randomized study. It's a retrospective observational study. As yet, no randomized studies have demonstrated a benefit to HCQ, at least none that I'm aware of.

So does that make the results invalid or just less meaningful? Can you provide links to any randomized studies you are aware of? These are simply what I turned up in a few minutes searching on Google. I'm not a scientist or medical professional but these results are intriguing.

Randomized studies?

Quote
Among patients hospitalized with mild-to-moderate Covid-19, the use of hydroxychloroquine, alone or with azithromycin, did not improve clinical status at 15 days as compared with standard care.
https://www.nejm.org/doi/full/10.1056/NEJMoa2019014

Quote
Hydroxychloroquine did not substantially reduce symptom severity in outpatients with mild, early COVID-19.
https://www.acpjournals.org/doi/10.7326/M20-4207

Quote
Current data do not support the use of hydroxychloroquine for prophylaxis or treatment of COVID-19. There are no published trials of prophylaxis. Two trials of hydroxychloroquine treatment that are in the public domain, one non-peer reviewed, are premature analyses of trials whose conduct in both cases diverged from the published skeleton protocols registered on clinical trial sites. Neither they, nor three other negative trials that have since appeared, support the view that hydroxychloroquine is effective in the management of even mild COVID-19 disease.
https://www.cebm.net/covid-19/hydroxychloroquine-for-covid-19-what-do-the-clinical-trials-tell-us/

Quote
In patients hospitalized with COVID-19, hydroxychloroquine was not associated with reductions in 28-day mortality but was associated with an increased length of hospital stay and increased risk of progressing to invasive mechanical ventilation or death.
https://www.medrxiv.org/content/10.1101/2020.07.15.20151852v1
Quote
After high-risk or moderate-risk exposure to Covid-19, hydroxychloroquine did not prevent illness compatible with Covid-19 or confirmed infection when used as postexposure prophylaxis within 4 days after exposure
https://www.nejm.org/doi/full/10.1056/NEJMoa2016638

Quote
There was no significant difference in the primary endpoint of 28-day mortality (25.7% hydroxychloroquine vs. 23.5% usual care; hazard ratio 1.11 [95% confidence interval 0.98-1.26]; p=0.10). There was also no evidence of beneficial effects on hospital stay duration or other outcomes.
https://www.ox.ac.uk/news/2020-06-05-no-clinical-benefit-use-hydroxychloroquine-hospitalised-patients-covid-19



There's also this observational study of 1400 patients that shows no benefit to hydroxychloroquine (https://www.nejm.org/doi/full/10.1056/NEJMoa2012410).


Now, I'm not an infectious disease expert and there are tens of thousands of studies going on regarding treatments for Covid right now so I just trust the work of groups of scientists.  Right now most researchers and scientists are indicating that there's no benefit to hydroxychloroquine based on the available evidence.  This is why the WHO, FDA, NIH, etc. do not recommend using the drug to treat covid.
« Last Edit: August 06, 2020, 07:45:27 AM by GuitarStv »

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #3474 on: August 06, 2020, 07:27:37 AM »
$1 billion to save and free us all in Victoria
Since those awaiting test results (up to 10 days in some instances, typically 2-5) and those testing positive are now required to not leave their homes for any non-emergency medical reason on pain of a large fine, we can expect a drop in testing rates. This is not what we want.
Rather than stick, let's try carrot.
1. get tested
2. if test negative, go on your way
3. if testing positive, you and your dependents go to hotel quarantine
4. for which you get $14,000, tax-free (not your dependents)
5. if you test negative twice in the last two days, after 14 days you can leave
6. if you refuse a test, that's fine, you stay another 14 days - still getting the original $14,000, but no more
7. give this $14k to anyone hospitalised with covid, too, why not.
This approach would give time and space for cases to come down, and almost everyone covid positive would go into hotel quarantine. People would want to get tested. This would also have the effect of reaching into marginalised communities - I don't care how little English that Sudanese single mother in Dandenong speaks, she'd hear about this and get tested.
There are currently 7,227 active cases in Victoria, giving this a total price tag of $101 million. Let's be pessimistic and assume stage 4 restrictions don't sort it out for us and we get 5 times as many cases, and let's continue to have the state pay for the hotel accommodation, and say it costs a round $1 billion.
Current state govt deficit: $10 billion
Commonwealth FY 2019-20 deficit: $86 billion
2020-21: $184 billion
Expected loss to Victorian economy for stage 4 to September 1st: $9 billion.
This is cheaper and much less drama. For a billion bucks, we could encourage everyone to get tested, and voluntarily lock themselves up for 2-4 weeks each.
We could, then, ease back the restrictions on the rest of the state, and do away with the authoritarian divisiveness of fining and dobbing on and wagging a moral finger at everyone.

marty998

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Re: How long can we wait while flattening the curve?
« Reply #3475 on: August 06, 2020, 07:50:26 AM »
$1 billion to save and free us all in Victoria
Since those awaiting test results (up to 10 days in some instances, typically 2-5) and those testing positive are now required to not leave their homes for any non-emergency medical reason on pain of a large fine, we can expect a drop in testing rates. This is not what we want.
Rather than stick, let's try carrot.
1. get tested
2. if test negative, go on your way
3. if testing positive, you and your dependents go to hotel quarantine
4. for which you get $14,000, tax-free (not your dependents)
5. if you test negative twice in the last two days, after 14 days you can leave
6. if you refuse a test, that's fine, you stay another 14 days - still getting the original $14,000, but no more
7. give this $14k to anyone hospitalised with covid, too, why not.
This approach would give time and space for cases to come down, and almost everyone covid positive would go into hotel quarantine. People would want to get tested. This would also have the effect of reaching into marginalised communities - I don't care how little English that Sudanese single mother in Dandenong speaks, she'd hear about this and get tested.
There are currently 7,227 active cases in Victoria, giving this a total price tag of $101 million. Let's be pessimistic and assume stage 4 restrictions don't sort it out for us and we get 5 times as many cases, and let's continue to have the state pay for the hotel accommodation, and say it costs a round $1 billion.
Current state govt deficit: $10 billion
Commonwealth FY 2019-20 deficit: $86 billion
2020-21: $184 billion
Expected loss to Victorian economy for stage 4 to September 1st: $9 billion.
This is cheaper and much less drama. For a billion bucks, we could encourage everyone to get tested, and voluntarily lock themselves up for 2-4 weeks each.
We could, then, ease back the restrictions on the rest of the state, and do away with the authoritarian divisiveness of fining and dobbing on and wagging a moral finger at everyone.


Can you imagine. A dumbfuck 19 year old with $14,000 in their pocket locked up in a five star hotel.

Buys a lot of cocaine for a weekend party which they happily invite the cute security guard to and away we go again.

GuitarStv

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Re: How long can we wait while flattening the curve?
« Reply #3476 on: August 06, 2020, 07:53:48 AM »
$1 billion to save and free us all in Victoria
Since those awaiting test results (up to 10 days in some instances, typically 2-5) and those testing positive are now required to not leave their homes for any non-emergency medical reason on pain of a large fine, we can expect a drop in testing rates. This is not what we want.
Rather than stick, let's try carrot.
1. get tested
2. if test negative, go on your way
3. if testing positive, you and your dependents go to hotel quarantine
4. for which you get $14,000, tax-free (not your dependents)
5. if you test negative twice in the last two days, after 14 days you can leave
6. if you refuse a test, that's fine, you stay another 14 days - still getting the original $14,000, but no more
7. give this $14k to anyone hospitalised with covid, too, why not.
This approach would give time and space for cases to come down, and almost everyone covid positive would go into hotel quarantine. People would want to get tested. This would also have the effect of reaching into marginalised communities - I don't care how little English that Sudanese single mother in Dandenong speaks, she'd hear about this and get tested.
There are currently 7,227 active cases in Victoria, giving this a total price tag of $101 million. Let's be pessimistic and assume stage 4 restrictions don't sort it out for us and we get 5 times as many cases, and let's continue to have the state pay for the hotel accommodation, and say it costs a round $1 billion.
Current state govt deficit: $10 billion
Commonwealth FY 2019-20 deficit: $86 billion
2020-21: $184 billion
Expected loss to Victorian economy for stage 4 to September 1st: $9 billion.
This is cheaper and much less drama. For a billion bucks, we could encourage everyone to get tested, and voluntarily lock themselves up for 2-4 weeks each.
We could, then, ease back the restrictions on the rest of the state, and do away with the authoritarian divisiveness of fining and dobbing on and wagging a moral finger at everyone.


Can you imagine. A dumbfuck 19 year old with $14,000 in their pocket locked up in a five star hotel.

Buys a lot of cocaine for a weekend party which they happily invite the cute security guard to and away we go again.

Is cocaine on the room service menu in Australia, or would the dumbfuck 19 year old need to already know a dealer?  :P

frugalnacho

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Re: How long can we wait while flattening the curve?
« Reply #3477 on: August 06, 2020, 09:50:50 AM »
Excuse me, this hotel is being used to quarantine positive covid cases, what are you doing here?  Oh I'm here to deliver cocaine.  Oh, ok, proceed then, here is a key card.

mm1970

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Re: How long can we wait while flattening the curve?
« Reply #3478 on: August 06, 2020, 10:51:02 AM »
No need to guess, we have a great example from February.  Trump said the virus was a problem, shut down travel from the Wuhan area, and the democrats said he was Xenophobic and to keep congregating in bars and come on down to Chinatown, no need to worry about a virus.  They were already calling him authoritarian and fascist, had he tried to invoke any kind of national order (masks, travel restrictions, etc.) there's have been a huge outcry.

You should read this, even though you won't: https://www.factcheck.org/2020/03/the-facts-on-trumps-travel-restrictions/

Did, did you read it?  Or do you think Trump should have banned American citizens from returning, and did you think that in January?
He shut down nothing.  I have coworkers who came back to the US from China (they are Chinese citizens who live and work here).  They just flew in through other countries.  One of them came back from Wuhan.

mm1970

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Re: How long can we wait while flattening the curve?
« Reply #3479 on: August 06, 2020, 11:02:40 AM »
Personally, I always find your exercise posts inspiring/motivating, @mm1970. Agree with your POV. Personally if I don't keep switching up goals/activities, I get bored and blubbery LOL.
Same.  I've always been that way. Except for the couple years of straight up running...(I guess I did that on two separate occasions), I switch things up a lot.  It's more fun that way.

Funny that MMMs new blog post touches on that too, the "sweet spot" for exercise.

Samuel

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Re: How long can we wait while flattening the curve?
« Reply #3480 on: August 06, 2020, 11:03:10 AM »
$1 billion to save and free us all in Victoria
Since those awaiting test results (up to 10 days in some instances, typically 2-5) and those testing positive are now required to not leave their homes for any non-emergency medical reason on pain of a large fine, we can expect a drop in testing rates. This is not what we want.
Rather than stick, let's try carrot.
1. get tested
2. if test negative, go on your way
3. if testing positive, you and your dependents go to hotel quarantine
4. for which you get $14,000, tax-free (not your dependents)
5. if you test negative twice in the last two days, after 14 days you can leave
6. if you refuse a test, that's fine, you stay another 14 days - still getting the original $14,000, but no more
7. give this $14k to anyone hospitalised with covid, too, why not.
This approach would give time and space for cases to come down, and almost everyone covid positive would go into hotel quarantine. People would want to get tested. This would also have the effect of reaching into marginalised communities - I don't care how little English that Sudanese single mother in Dandenong speaks, she'd hear about this and get tested.
There are currently 7,227 active cases in Victoria, giving this a total price tag of $101 million. Let's be pessimistic and assume stage 4 restrictions don't sort it out for us and we get 5 times as many cases, and let's continue to have the state pay for the hotel accommodation, and say it costs a round $1 billion.
Current state govt deficit: $10 billion
Commonwealth FY 2019-20 deficit: $86 billion
2020-21: $184 billion
Expected loss to Victorian economy for stage 4 to September 1st: $9 billion.
This is cheaper and much less drama. For a billion bucks, we could encourage everyone to get tested, and voluntarily lock themselves up for 2-4 weeks each.
We could, then, ease back the restrictions on the rest of the state, and do away with the authoritarian divisiveness of fining and dobbing on and wagging a moral finger at everyone.


I'm certain more than a few people would be intentionally trying to get COVID if it came with $14k. Careful what you incentivize...

mm1970

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Re: How long can we wait while flattening the curve?
« Reply #3481 on: August 06, 2020, 11:07:12 AM »
Quote
In a longitudinal study in the UK of many thousands of men, they tested their strength (by bench press and leg press), cardiovascular fitness and recorded everything else about them health-wise. Then waited 15-20 years to see who died, and of what.

The bottom third in strength were much more likely to get cancer and die from other causes (falls, etc), but strength made no difference to heart disease. The bottom third in endurance were much more likely to die of all causes. Interestingly, being in the top third gave them no benefit in reducing mortality. I would still encourage it, since being stronger and fitter can improve quality of life, even if not quantity - but that's the stats: just don't be in the bottom third.

The boring government advice of 150-300' moderate or 75-150' vigorous endurance work weekly, and 2-3 muscle strengthening sessions, along with the dietary guidelines, are more than sufficient to keep people out of the bottom third of strength and endurance.
I liked these points.

I remember reading once that a group studied older people and walking pace.  They could predict, with fairly good accuracy, how long the elderly would live based on how long it took them to walk a mile.  >30 minutes was not good.  There was a similar study that focused on "getting up off the floor" (unaided, with your hands to boost you up, using furniture, etc.)

My FIL is 77 and he recently worked to lose about 15 lbs because he was at his highest weight ever.  He's been walking and doing yoga, but was complaining to my husband that even though he's the same weight he was X number of years ago, he still has a spare tire because he's lost muscle.  Which: duh.

Even at 77, he could and should probably do some weight training (in addition to the yoga).  He's got rheumatoid arthritis though, which may impact him a bit.

gaja

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Re: How long can we wait while flattening the curve?
« Reply #3482 on: August 06, 2020, 01:20:12 PM »
This is fantastic: https://www.cdc.gov/coronavirus/2019-ncov/travelers/map-and-travel-notices.html

"COVID-19 risk in Norway is high.
If you get sick in Norway and need medical care, resources may be limited."

Uh, ok? In total, 8 persons were admitted to hospital due to corona in Norway last week, 1 was admitted to ICU, and 1 person died. We are not at capacity yet. Due to tourist season we are seeing a small surge in cases, but nothing compared to US levels. But maybe this is the easiest way to convince US citizens to avoid travelling to countries were they will be denied entry?

frugalnacho

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Re: How long can we wait while flattening the curve?
« Reply #3483 on: August 06, 2020, 01:27:36 PM »
$1 billion to save and free us all in Victoria
Since those awaiting test results (up to 10 days in some instances, typically 2-5) and those testing positive are now required to not leave their homes for any non-emergency medical reason on pain of a large fine, we can expect a drop in testing rates. This is not what we want.
Rather than stick, let's try carrot.
1. get tested
2. if test negative, go on your way
3. if testing positive, you and your dependents go to hotel quarantine
4. for which you get $14,000, tax-free (not your dependents)
5. if you test negative twice in the last two days, after 14 days you can leave
6. if you refuse a test, that's fine, you stay another 14 days - still getting the original $14,000, but no more
7. give this $14k to anyone hospitalised with covid, too, why not.
This approach would give time and space for cases to come down, and almost everyone covid positive would go into hotel quarantine. People would want to get tested. This would also have the effect of reaching into marginalised communities - I don't care how little English that Sudanese single mother in Dandenong speaks, she'd hear about this and get tested.
There are currently 7,227 active cases in Victoria, giving this a total price tag of $101 million. Let's be pessimistic and assume stage 4 restrictions don't sort it out for us and we get 5 times as many cases, and let's continue to have the state pay for the hotel accommodation, and say it costs a round $1 billion.
Current state govt deficit: $10 billion
Commonwealth FY 2019-20 deficit: $86 billion
2020-21: $184 billion
Expected loss to Victorian economy for stage 4 to September 1st: $9 billion.
This is cheaper and much less drama. For a billion bucks, we could encourage everyone to get tested, and voluntarily lock themselves up for 2-4 weeks each.
We could, then, ease back the restrictions on the rest of the state, and do away with the authoritarian divisiveness of fining and dobbing on and wagging a moral finger at everyone.


I'm certain more than a few people would be intentionally trying to get COVID if it came with $14k. Careful what you incentivize...

Millions of people are already getting it for free with absolutely no positive incentive.  Most of them seemingly intentionally. 

Michael in ABQ

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Re: How long can we wait while flattening the curve?
« Reply #3484 on: August 06, 2020, 01:43:43 PM »
Quote
In a longitudinal study in the UK of many thousands of men, they tested their strength (by bench press and leg press), cardiovascular fitness and recorded everything else about them health-wise. Then waited 15-20 years to see who died, and of what.

The bottom third in strength were much more likely to get cancer and die from other causes (falls, etc), but strength made no difference to heart disease. The bottom third in endurance were much more likely to die of all causes. Interestingly, being in the top third gave them no benefit in reducing mortality. I would still encourage it, since being stronger and fitter can improve quality of life, even if not quantity - but that's the stats: just don't be in the bottom third.

The boring government advice of 150-300' moderate or 75-150' vigorous endurance work weekly, and 2-3 muscle strengthening sessions, along with the dietary guidelines, are more than sufficient to keep people out of the bottom third of strength and endurance.
I liked these points.

I remember reading once that a group studied older people and walking pace.  They could predict, with fairly good accuracy, how long the elderly would live based on how long it took them to walk a mile.  >30 minutes was not good.  There was a similar study that focused on "getting up off the floor" (unaided, with your hands to boost you up, using furniture, etc.)

My FIL is 77 and he recently worked to lose about 15 lbs because he was at his highest weight ever.  He's been walking and doing yoga, but was complaining to my husband that even though he's the same weight he was X number of years ago, he still has a spare tire because he's lost muscle.  Which: duh.

Even at 77, he could and should probably do some weight training (in addition to the yoga).  He's got rheumatoid arthritis though, which may impact him a bit.

I'm going live to 100+ then. I've been on a base walking virtually everywhere for the last 9 months. In all that time only a single person has ever caught up to me and no one has ever passed me. Maybe it's the fact that it's usually 100+ degrees but everyone around me seems to walk so damn slow. I'd pass people on the way from the dining facility to my room (about 1,000 feet) and look back and they were still hundreds of feet behind me.

AnnaGrowsAMustache

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Re: How long can we wait while flattening the curve?
« Reply #3485 on: August 06, 2020, 01:57:00 PM »
Like I said, a fucking twilight zone episode.  Some people are living in a parallel reality, side by side with us in the real world.  I wish I could get out of threads like this.

Stupid people are stupid. Watchagonnado......

waltworks

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Re: How long can we wait while flattening the curve?
« Reply #3486 on: August 06, 2020, 02:05:13 PM »
Just get a squeeze ball or one of those old school spring hand exerciser thingies, you'll be immortal!

https://www.clinicaladvisor.com/home/topics/rheumatology-information-center/hand-grip-strength-associated-with-all-cause-mortality-other-adverse-outcomes/

-W

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #3487 on: August 06, 2020, 07:01:00 PM »
I'm certain more than a few people would be intentionally trying to get COVID if it came with $14k. Careful what you incentivize...
How? The cases would all be in quarantine.

Meanwhile...

#coronapanic in Victoria
Now we're arresting people for planning peaceful protests.

"The "Melbourne Freedom March" is planned for Sunday with attendees claiming their rights are being compromised by coronavirus restrictions. They charged a 41-year-old man from Mooroolbark with incitement. The offence, in the Crimes Act, involves a person inciting someone else to pursue a course of conduct which will involve the commission of an offence.The man was bailed and is due to appear at the Melbourne Magistrates Court on January 21 next year."

************

"Prisoners of conscience Ė someone has not used or advocated violence but is imprisoned because of who they are (sexual orientation, ethnic, national or social origin, language, birth, colour, sex or economic status) or what they believe (religious, political or other conscientiously held beliefs)."

https://www.amnesty.org/en/what-we-do/detention/

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #3488 on: August 06, 2020, 07:17:54 PM »
I'm certain more than a few people would be intentionally trying to get COVID if it came with $14k. Careful what you incentivize...
How? The cases would all be in quarantine.

Meanwhile...

#coronapanic in Victoria
Now we're arresting people for planning peaceful protests.

"The "Melbourne Freedom March" is planned for Sunday with attendees claiming their rights are being compromised by coronavirus restrictions. They charged a 41-year-old man from Mooroolbark with incitement. The offence, in the Crimes Act, involves a person inciting someone else to pursue a course of conduct which will involve the commission of an offence.The man was bailed and is due to appear at the Melbourne Magistrates Court on January 21 next year."

************

"Prisoners of conscience Ė someone has not used or advocated violence but is imprisoned because of who they are (sexual orientation, ethnic, national or social origin, language, birth, colour, sex or economic status) or what they believe (religious, political or other conscientiously held beliefs)."

https://www.amnesty.org/en/what-we-do/detention/

Strange. They didn't charge the organisers of the Black Lives Matter protests with incitement.

Guess optics reigns supreme everywhere.

I wouldn't be supporting any protests in the current Melbourne climate at all. But different groups should be treated equally.

MudPuppy

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Re: How long can we wait while flattening the curve?
« Reply #3489 on: August 06, 2020, 07:40:02 PM »
Well thatís one take I guess

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #3490 on: August 06, 2020, 09:00:45 PM »
Strange. They didn't charge the organisers of the Black Lives Matter protests with incitement.
They let the BLM protests go ahead, then charged three of the organisers afterwards with ordinary covid stuff, not incitement.

This pro-democracy protest they charged two organisers first, obviously in the hopes that the protest won't happen. With 18,500 police in the state and the 5km travel limit they should be able to stop it before it starts, just put cops en masse at train stations etc.

Dan Andrews is Victoria's Sir Joh. And as enthusiastically as the Nats supporters embraced their loss of freedoms, so too are the ALP supporters here. And in both cases, the Opposition were useless.

marty998

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Re: How long can we wait while flattening the curve?
« Reply #3491 on: August 07, 2020, 04:19:02 AM »
$1 billion to save and free us all in Victoria
Since those awaiting test results (up to 10 days in some instances, typically 2-5) and those testing positive are now required to not leave their homes for any non-emergency medical reason on pain of a large fine, we can expect a drop in testing rates. This is not what we want.
Rather than stick, let's try carrot.
1. get tested
2. if test negative, go on your way
3. if testing positive, you and your dependents go to hotel quarantine
4. for which you get $14,000, tax-free (not your dependents)
5. if you test negative twice in the last two days, after 14 days you can leave
6. if you refuse a test, that's fine, you stay another 14 days - still getting the original $14,000, but no more
7. give this $14k to anyone hospitalised with covid, too, why not.
This approach would give time and space for cases to come down, and almost everyone covid positive would go into hotel quarantine. People would want to get tested. This would also have the effect of reaching into marginalised communities - I don't care how little English that Sudanese single mother in Dandenong speaks, she'd hear about this and get tested.
There are currently 7,227 active cases in Victoria, giving this a total price tag of $101 million. Let's be pessimistic and assume stage 4 restrictions don't sort it out for us and we get 5 times as many cases, and let's continue to have the state pay for the hotel accommodation, and say it costs a round $1 billion.
Current state govt deficit: $10 billion
Commonwealth FY 2019-20 deficit: $86 billion
2020-21: $184 billion
Expected loss to Victorian economy for stage 4 to September 1st: $9 billion.
This is cheaper and much less drama. For a billion bucks, we could encourage everyone to get tested, and voluntarily lock themselves up for 2-4 weeks each.
We could, then, ease back the restrictions on the rest of the state, and do away with the authoritarian divisiveness of fining and dobbing on and wagging a moral finger at everyone.


Can you imagine. A dumbfuck 19 year old with $14,000 in their pocket locked up in a five star hotel.

Buys a lot of cocaine for a weekend party which they happily invite the cute security guard to and away we go again.

Is cocaine on the room service menu in Australia, or would the dumbfuck 19 year old need to already know a dealer?  :P

The security guards were also dumbfuck 19 year olds who by all reports seemed like they probably were dealers.

Bears pointing out that it is rare in history that two people have immediately fucked an entire state by...fucking. But here we are.

You could call it a Sexually transmitted disaster...
« Last Edit: August 07, 2020, 04:20:47 AM by marty998 »

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #3492 on: August 07, 2020, 04:20:44 AM »
Fortunately the defection rate for positive tests and close contacts has gone below 15% from about 25% previously.

1050 tests conducted yesterday and only 150 not at home

Still you wonder what those 150 people were doing? Not working; you have to work from home. Not exercising; though the rest of us are allowed to exercise, positive tests and close contacts are not.

I suspect if you door knocked 1050 of the general population (not even subject to positive tests, therefore not legally forced to stay at home) you'd get a compliance rate higher than that.

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #3493 on: August 07, 2020, 04:21:47 AM »
$1 billion to save and free us all in Victoria
Since those awaiting test results (up to 10 days in some instances, typically 2-5) and those testing positive are now required to not leave their homes for any non-emergency medical reason on pain of a large fine, we can expect a drop in testing rates. This is not what we want.
Rather than stick, let's try carrot.
1. get tested
2. if test negative, go on your way
3. if testing positive, you and your dependents go to hotel quarantine
4. for which you get $14,000, tax-free (not your dependents)
5. if you test negative twice in the last two days, after 14 days you can leave
6. if you refuse a test, that's fine, you stay another 14 days - still getting the original $14,000, but no more
7. give this $14k to anyone hospitalised with covid, too, why not.
This approach would give time and space for cases to come down, and almost everyone covid positive would go into hotel quarantine. People would want to get tested. This would also have the effect of reaching into marginalised communities - I don't care how little English that Sudanese single mother in Dandenong speaks, she'd hear about this and get tested.
There are currently 7,227 active cases in Victoria, giving this a total price tag of $101 million. Let's be pessimistic and assume stage 4 restrictions don't sort it out for us and we get 5 times as many cases, and let's continue to have the state pay for the hotel accommodation, and say it costs a round $1 billion.
Current state govt deficit: $10 billion
Commonwealth FY 2019-20 deficit: $86 billion
2020-21: $184 billion
Expected loss to Victorian economy for stage 4 to September 1st: $9 billion.
This is cheaper and much less drama. For a billion bucks, we could encourage everyone to get tested, and voluntarily lock themselves up for 2-4 weeks each.
We could, then, ease back the restrictions on the rest of the state, and do away with the authoritarian divisiveness of fining and dobbing on and wagging a moral finger at everyone.


Can you imagine. A dumbfuck 19 year old with $14,000 in their pocket locked up in a five star hotel.

Buys a lot of cocaine for a weekend party which they happily invite the cute security guard to and away we go again.

Is cocaine on the room service menu in Australia, or would the dumbfuck 19 year old need to already know a dealer?  :P

The security guards were also dumbfuck 19 year olds who by all reports seemed like they probably were dealers.

Bears pointing out that it is rare in history that two people have immediately fucked an entire state by...fucking. But here we are.

You could call it a Sexually transmitted disaster...

How do you know this Marty? I know there are rumours floating around but is there any cogent source?

If it's true, the guards should be named and shamed.

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #3494 on: August 07, 2020, 05:08:18 AM »
1050 tests conducted yesterday and only 150 not at home

Still you wonder what those 150 people were doing?
It helps that I've a daughter who's a paramedic, and know several doctors, people working in the health department and someone working in Victoria Police. They've given me the story.

The federal health dept reports that in the last week of July about 6% of the covid+ ended up in hospital; worldwide the average is 20%, but that's probably an overestimate since many countries test poorly.

The Department of Health and Human Services administers tests and keeps their results, passing the list of covid+ people directly to ESTA, which is the unit dispatching emergency services to here and there. However, despite managing hospitals, the DHHS does not pass on lists of hospitalised people to the police, and the DHHS and ESTA otherwise have no communication, as that would violate patient privacy (patient privacy was one of the contributing factors to the spread in meatworks, as DHHS could not tell a workplace that So-And-So had tested positive).

Thus, of the 1,150 people whose door was knocked on, 69 to 250 could be expected to actually be in hospital. 150 is bang in the middle of that.

As well, the DHHS in some cases has given lists of covid+ names to ESTA before notifying the individual involved, and people awaiting test results (typically 2-5 days, but a bit under 10% had to wait 10 days for results) are not required to self-isolate if they are asymptomatic or mildly symptomatic - which at least 80% of people are. Police have thus knocked on someone's door, "We're just checking to see if you as a covid positive person are home as required, good to see," and the person's replied, "I tested positive? They didn't tell me yet."

There have also been a number of cases where an aged care resident had a relative's address as their mailing address, as that person handled all their correspondence, bills and so on, and the police knocked on that door.

And there are of course a small fraction of actually wrong addresses and numbers recorded in the system. A friend of mine had to pursue the DHHS for her test results after 6 days, it took her another 5 days to discover that they'd got one number in her mobile phone number wrong; the system didn't allow them to correct this and she had to take a second test. She was mildly symptomatic and thus not required to self-isolate while awaiting results, had the police knocked on her door one day they might have found her out at the shops.

Between the hospitalised, those awaiting test results and wrong addresses, I'm impressed the no-answer rate is only 13%.

This is known in government, however it's not talked about because it doesn't fit the narrative, which is that "Victorians are irresponsible, so we have to have this tough lockdown." If in fact the people are almost all following the rules, and yet we still have rising infections, then that indicates that

either: the lockdowns are ineffective, and something else needs to be tried
or: this virus is going to be with us for a long time, and we have to find a way to live with it

since neither of those conclusions support the narrative, the data - that Victorians are in fact adhering very closely to the restrictions - is ignored or denied.
« Last Edit: August 07, 2020, 05:09:59 AM by Kyle Schuant »

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #3495 on: August 07, 2020, 06:00:57 AM »
But if we are actually adhering closely to the restrictions, how did the case numbers jump from <30 to >700?

I know there were massive clusters in meat works, the Islamic school, aged care centres, hospitals and certain suburbs. Is that all that's driving the spread? If so, why lock down retail businesses and all the other suburbs?

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #3496 on: August 07, 2020, 07:54:14 AM »
Yes, it's mostly those places.

The ABC has a good, regularly-updated page that shows the clusters and much other information. Relevant to your question is the clusters, for example St Basil's alone is currently associated with 172 cases.

https://www.abc.net.au/news/2020-03-17/coronavirus-cases-data-reveals-how-covid-19-spreads-in-australia/12060704

It helps to understand that the DHHS does not actually call it "community transmission", they call it unknown connections "which may indicate community transmission," more specifically they call it "acquired in Australia, unknown source." The news reports take out the "may", just as when Sutton said it was "conceivable" that most or all the current cases came from the hotel quarantine, they took out the "conceivable."

If you watch the figures closely you'll find they go down, for example today may say 400 such cases, then tomorrow the news reports that there are 100 more, but now the total is... 460? It's because 40 were resolved.

Infection like so many other things follows an 80/20 rule, usually not literally so, but a majority of events (income, infection, etc) coming from a minority of people (customers, infected, whatever). A study in Vic in May of 1,200 or so cases concluded that 9% of people caused 91% of infections - one guy who worked at 3 hospitality venues infected 76 other people.

Thus, superspreading events make up the bulk of new infections. As a fictional scenario, imagine:

June 1st: Ravi works as a security guard at hotel quarantine. Lacking proper PPE and training, he acquires covid from a resident there.
June 3rd: Ravi is asymptomatic and only slightly infectious. He has lunch with 5 other security guards. He rubs his nose with his knuckle and passes the salt to one of them, who passes it his buddy. Now Andy and Bob are infected.
June 5th: Ravi is now symptomatic. He calls in sick. He now has enough viral load to pass it to his wife Malika, who passes it to her children.
June 7th: Having had symptoms for a couple of days, Ravi now goes and gets tested. The DHHS respects his privacy and does not inform his workplace that he is infected. Ravi's boss isn't stupid so passes the word around anyway.

Neither Andy nor Bob are yet symptomatic, well Bob has some congestion and headaches but he often gets hayfever so he thinks nothing of it. Asymptomatic people are refused testing (unless they are close contacts of someone known to be covid+, healthcare or aged care workers, see here). Andy and Bob don't count as close contacts, but their boss is cautious so they sit around watching TV for two weeks at home, just occasionally popping out to the shops - contacts of covid+ are still not, to this day, required to stay inside all day. If my wife is sick and I'm caring for her, I can still go out.

Andy lives alone but is a friendly guy who shakes hands with people, including a guy at his building Charlie, who has a son Ginger who goes to the local school. This son plays rugby and often gets into other people's faces. When Ginger gets sick and tests positive, his dad probably will, too - Ginger's infection source is known. But Charlie's infection source will be unknown, because contact tracers will never find out he shook hands with Andy, and anyway Andy never got a test so he won't be on the system.

Bob has a wife Dina, who works in aged care. By coincidence, so does Malika. When Malika infects her aged care home, they will pretty quickly figure out that it was her tested covid+ husband Ravi who was the source of her infection. But when Dina infects her aged care home, because Bob was never tested, they won't know for sure she got it from - since he worked with Ravi, they'll suspect - but they won't know. And they'll wonder if it was maybe someone else who worked at the aged care home who gave it to Dina, or even one of the residents after a family member visited.

And so within 10 days, the initial infection of one person has led to the infection of 10-20 others, and because of their work, it risks infection of 100-200 others. The cases are unknown origin because they can't trace them that quickly. They have to go through all those people, every resident of the aged care homes, all the people who worked with and visited them, and all the people who worked with or visited those people - and they'll probably never catch that handshake in the hallway, or the salt shaker that was passed around.

Now, if we have 50 new infections a day then the contact tracers can pretty much keep on track of it. But if we have 500, they can't. And so as we get more cases we get more "acquired in Australia, unknown source", which may be community transmission - but it may not be. We just don't know for sure.

And this is half the reason for the lockdown - in the hopes of slowing things enough that the contact tracers can keep up. The other half is the natural authoritarianism of Australians, and the good old ordinary government thing of, "something must be done, this is something, therefore it must be done." That's why the Premier went beyond the advice of the Chief Health Officer in ordering Stage 4, and why even the DHHS can't really say clearly why we need a curfew.

https://www.abc.net.au/news/2020-08-07/will-melbournes-stage-4-curfews-be-effective-against-coronavirus/12520994

The troubles with contact tracing is one reason they do genomic sequencing analyses. So they can say that X infected Y and Z, and Y infected A, B and C, while Z infected no-one. Genomic analyses is a bit faster than contact tracing but it's still always a couple of weeks behind, unfortunately. The Chief Health Officer has this genomic data but can't release it without the Premier's say-so, and the Premier says it's the CHO's data and not for him to speculate on because there's an ongoing inquiry and...

If the genomic data indicated that most of the infections came from community transmission, and from outside hotel quarantine, I think we can be sure they'd be released - because they'd support the Stage 4 restrictions. So we must conclude that the genomic data indicates it all started with the hotels.

That doesn't really matter now, except inasmuch as we can get the government to, if not avoid making mistakes, at least not make the same mistakes again. The point is that even with everyone doing the right thing according to the rules, this virus can still churn rapidly through households, who then go on to infect co-workers and customers and patients and so on.

But it doesn't really matter to most of us if we get infected. 80% have no or mild symptoms. What matters is that we keep it away from the vulnerable. That's why there have been hundreds of cases at meatworks but very few deaths from them, whereas the aged care infections have been most of the deaths. Unfortunately, we are still not keeping it away from the vulnerable. The most obvious current failing is that if an aged care resident tests positive, they are NOT sent to hospital until they actually require hospitalisation - typically ICU. Thus, you have aged care staff working in a non-hospital setting with a person offering them a high viral load.

Now, those aged care staff have had poor PPE and training, which can be remedied somewhat. But even when the federal government deployed their AUSMAT team to St Basil's, several of them got infected. The most highly-trained, well-equipped medical staff we have got infected. What hope then does an aged care worker have? They're going to get infected, and they're going to pass it on.

Other states take them out the moment they test positive, and stick them in hospital. Most of them require ICU in 3-7 days anyway. But those are 3-7 very high viral load days.

As I mentioned earlier, Sutton himself didn't support going to stage 4, because it didn't address the areas where the spread is happening. This is what's now happening in the next month,

- Schools: all closed, and children aren't very infectious to their households, so cases will DROP
- Meatworks: reduced staff and full PPE, but the staff will still infect their households, and they'll still socialise in the workplace somewhat, so cases will STEADY
- Healthcare: already using the best PPE and training they can, but facing a high viral load so some still get infected, and as they go off work they're replaced with "surge" staff who have less training, mistakes will happen, though fewer over time, so cases will RISE
- Aged care: staff are now no longer permitted to work at several centres, and most though not all staff now have PPE, but only about 1/3 have completed the online course the federal government has offered, and it's only an online course so won't do much good. They continue to keep covid+ residents in the residence until they need hospital, so cases will RISE - a lot

By mid-September we will see daily new cases a bit over 200, and we'll see an extra 200-300 deaths, mostly connected with aged care. As usual the state government has not stated the precise criteria for easing or increasing restrictions, but last time it took a couple of weeks of 10-20 new cases a day before they did so. That won't be the six weeks of stage 4 currently planned for.

As I mentioned earlier, from imposition of restrictions to their easing in the first lockdown was 87 days, if that happened this time then it'd be October 25th. I'd expect cases to still be 50-100 a day at that point, and probably simmer along at that level for some time. The numbers won't justify opening up in December, but it'll be politically hard not to, as nobody wants to be the Premier who cancelled Christmas - unless we have 100 people a day dying or something, at the least they'd have to reopen retail. And of course, whatever the rules say, people will see their extended families at Christmas, between the shopping and the gatherings there'll be a new surge of cases and a fresh panic in the New Year.

This will be simmering along for a long time yet. And even if we opened up tomorrow, the economic and social effects will take years to get over, and excess deaths from other causes will be significant.

Think of it this way: even DPRK, who has iron control over its border, and whose people live in perpetual lockdown, where the state can simply grab them and carry them off for execution without cause - even that level of lockdown hasn't kept the virus out. They won't say, but they most likely have thousands infected.

https://www.bbc.com/news/world-asia-53541730

A lockdown can be useful in buying time to boost healthcare capacity, and in buying time for contact tracing and the like. But it'll never eliminate the virus. (Before anyone says, "But New Zealand -" yeah, just wait, Victoria thought it had it under control, too.) No, this does not mean "let it rip." But I think that Sweden had the right idea, not necessarily in its precise measures or lack thereof, but in asking: "Whatever measures we put in we have to be prepared to keep going with for three years. What are the things we're willing to do for three years?"

I am willing to go for three years with bans on gatherings of over 50 people, masks encouraged but not mandated, not more than 1 customer per 4 square metres and that sort of thing.

I am not willing to go for three years with a suspended parliament, a curfew, an hour a day for exercise, nobody coming around for dinner, not seeing my elderly mother, and my children unable to use the playground.
« Last Edit: August 07, 2020, 07:57:39 AM by Kyle Schuant »

Shane

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Re: How long can we wait while flattening the curve?
« Reply #3497 on: August 07, 2020, 10:15:41 AM »

A lockdown can be useful in buying time to boost healthcare capacity, and in buying time for contact tracing and the like. But it'll never eliminate the virus. (Before anyone says, "But New Zealand -" yeah, just wait, Victoria thought it had it under control, too.) No, this does not mean "let it rip." But I think that Sweden had the right idea, not necessarily in its precise measures or lack thereof, but in asking: "Whatever measures we put in we have to be prepared to keep going with for three years. What are the things we're willing to do for three years?"

I am willing to go for three years with bans on gatherings of over 50 people, masks encouraged but not mandated, not more than 1 customer per 4 square metres and that sort of thing.

I am not willing to go for three years with a suspended parliament, a curfew, an hour a day for exercise, nobody coming around for dinner, not seeing my elderly mother, and my children unable to use the playground.


Anders Tegnell, etal, readily admit that they made some mistakes: 1) Didn't lock down aged care homes quickly or effectively enough. 2) Didn't do a good enough job at communicating with their immigrant communities. What I like about the Swedes' strategy, though, is that they designed it from the beginning to be sustainable for the long(er) term. Yeah, Sweden lost more people in the beginning than its neighbors, but what the Swedes are doing, by design, can be easily sustained for years if necessary. Complete lockdowns, school closures, etc., cannot, by definition, be sustained for very long, at all. When we look back at various countries' responses to covid, 5 or 10 years from now, whose strategy will have worked the best is still completely up in the air, IMHO.

Spud

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Re: How long can we wait while flattening the curve?
« Reply #3498 on: August 07, 2020, 12:03:26 PM »
Check out Sweden's deaths at the moment. They've definitely turned a corner.

kenmoremmm

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Re: How long can we wait while flattening the curve?
« Reply #3499 on: August 07, 2020, 01:04:25 PM »
^ clearly a bad strategy /s