Author Topic: How long can we wait while flattening the curve?  (Read 675181 times)

GuitarStv

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Re: How long can we wait while flattening the curve?
« Reply #3400 on: August 05, 2020, 07:47:02 AM »
The USA is a melting pot with so many different cultures.  Even with a different president pre-covid, I do not think we would have been able to follow the model of South Korea.

This is a reasonable position to take.  The US was likely never going to have perfect execution.

That said, this administration has done the wrong thing at nearly every turn.
- Trump dismantled the group responsible for handling just this sort of crisis before there was a problem.
- Trump ignored the security briefing warnings he got about the pandemic as it was escalating.
- Trump ignored what the experts were telling him about the danger of the virus and then told everyone in the US that there was nothing to worry about, that it would be the same as the flu, that it would go away in summer, that injecting bleach into yourself would cure it, that hydroxychloroquine would cure it, etc.
- Trump publicly accused health workers of lying about the amount of protective equipment that they needed (and insinuated that they were stealing PPE).
- Trump refused to provide any national leadership regarding what steps should be taken by states - leading to a piecemeal and inconsistent approach that increased spread of the disease
- Trump and most in his administration were extremely anti-mask for a long time, telling the country that there was no reason to wear a mask and that it wouldn't be beneficial or necessary to stop the spread of the disease.
- Trump held campaign rallies in areas where the infection was spreading rapidly and it was unwise to group together large numbers of people.

Given this, I think it's also reasonable to expect a competent leader to have radically improved the pandemic results in the United States.

Davnasty

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Re: How long can we wait while flattening the curve?
« Reply #3401 on: August 05, 2020, 07:54:43 AM »
One major problem with the government coming out and saying "being fit will help you fight COVID" is that the general public cannot follow multiple messages.

We've seen this when we were first suggested to wear masks. People initially thought that meant masks were better than 6-ft distancing. They couldn't, and some still can't, comprehend that distancing is the number 1 driver of safety but masks are good when you can't stay over 6 ft apart. They heard masks and thought they could skip the distancing piece.

So if we tell people being fit will help you fight COVID, what will happen? Fit people will stop worrying about distancing and masks, which even if they don't get sick, they could still spread the disease.

Not everything is about math, sometimes it's about psychology. (as a math major, this is not easy for me to admit)

One major problem with saying that being fit helps covid is that it's not actually true. (At least by my understanding, but I'm not a scientist or anything of that nature.) I have seen many reports of young and healthy people either being hospitalized for weeks, having long term effects or even passing away from covid. Maybe they weren't "fit" in the sense of they work out regularly, but they were "healthy with no underlying conditions". I do think you are right about not being able to follow multiple messages though, which is why leadership (or lack thereof in this case) is so important. I imagine any other president would have been wearing a mask for weeks, if not months, by now. Actions speak louder than words.

Some people die in car accidents despite wearing a seatbelt, does that mean seatbelts don't help?

Being younger and in better health absolutely helps with covid outcomes, but it doesn't make you invincible.

You're saying we should argue with a person to wear their seat belt while they're chugging their fifth beer of the afternoon and twirling their car keys around their finger right in front of you.  The seat belt might save their life, but putting the beer and the keys away is a better solution that they're willfully ignoring.

The icing on the cake of your driving analogy is they're equally likely to seriously hurt someone else whether the drunk driver wears a seat belt or not.

I said no such thing.

I'm not arguing for or against anything, I'm just pointing out that being in better shape does help and anecdotal evidence that healthy people can have bad outcomes doesn't negate the statistical benefits of being in good health.

I assume your drunk driving analogy is referring to wearing a mask and other good pandemic behaviors, which of course are more important than getting in shape(in the short term). I never disputed that.

Please don't make assumptions about what "side" of an argument I'm on just because I corrected an incorrect statement.

Travis

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Re: How long can we wait while flattening the curve?
« Reply #3402 on: August 05, 2020, 08:03:40 AM »
The USA is a melting pot with so many different cultures.  Even with a different president pre-covid, I do not think we would have been able to follow the model of South Korea.

I don't think the US really even tried. The president spent months insisting it wasn't a big deal, then pushed responsibility on individual states to come up with their own plans despite our borderless nation making this impossible while insisting "my money, my rules" when it suited him.  Each state did its own thing, with some following the president's lead of "ignore it" and others half-assing it because they didn't want to upset too many voters.

In this context I think we have one culture in the USA, and that's to do the opposite of whatever the other political party suggests.  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.  The Patriot Act was the largest increase in domestic surveillance and police powers since the beginning of the war on drugs and was passed by a Republican president and Republican Congress. Not a peep from the "my rights" and "don't tread on me" crowd.  A Democrat suggests wearing a piece of cloth over your mouth to save the lives of your neighbors and you'd swear the Gestapo was coming based on some of their reactions.

President Moon is a controversial leader around here and you'll get fierce arguments about just about any political subject, but the opposition to his COVID actions was an insignificant minority.  The older crowd do what the government tells them most of the time, but the younger generations can be as defiant as their American counterparts. They still wear their masks because pandemics have happened here before and generally there's still deference to their elders. 

Travis

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Re: How long can we wait while flattening the curve?
« Reply #3403 on: August 05, 2020, 08:12:24 AM »
One major problem with the government coming out and saying "being fit will help you fight COVID" is that the general public cannot follow multiple messages.

We've seen this when we were first suggested to wear masks. People initially thought that meant masks were better than 6-ft distancing. They couldn't, and some still can't, comprehend that distancing is the number 1 driver of safety but masks are good when you can't stay over 6 ft apart. They heard masks and thought they could skip the distancing piece.

So if we tell people being fit will help you fight COVID, what will happen? Fit people will stop worrying about distancing and masks, which even if they don't get sick, they could still spread the disease.

Not everything is about math, sometimes it's about psychology. (as a math major, this is not easy for me to admit)

One major problem with saying that being fit helps covid is that it's not actually true. (At least by my understanding, but I'm not a scientist or anything of that nature.) I have seen many reports of young and healthy people either being hospitalized for weeks, having long term effects or even passing away from covid. Maybe they weren't "fit" in the sense of they work out regularly, but they were "healthy with no underlying conditions". I do think you are right about not being able to follow multiple messages though, which is why leadership (or lack thereof in this case) is so important. I imagine any other president would have been wearing a mask for weeks, if not months, by now. Actions speak louder than words.

Some people die in car accidents despite wearing a seatbelt, does that mean seatbelts don't help?

Being younger and in better health absolutely helps with covid outcomes, but it doesn't make you invincible.

You're saying we should argue with a person to wear their seat belt while they're chugging their fifth beer of the afternoon and twirling their car keys around their finger right in front of you.  The seat belt might save their life, but putting the beer and the keys away is a better solution that they're willfully ignoring.

The icing on the cake of your driving analogy is they're equally likely to seriously hurt someone else whether the drunk driver wears a seat belt or not.

I said no such thing.

I'm not arguing for or against anything, I'm just pointing out that being in better shape does help and anecdotal evidence that healthy people can have bad outcomes doesn't negate the statistical benefits of being in good health.

I assume your drunk driving analogy is referring to wearing a mask and other good pandemic behaviors, which of course are more important than getting in shape(in the short term). I never disputed that.

Please don't make assumptions about what "side" of an argument I'm on just because I corrected an incorrect statement.

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.

gaja

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Re: How long can we wait while flattening the curve?
« Reply #3404 on: August 05, 2020, 08:32:58 AM »
I work with climate communication, and the theory behind that and pandemic communication is quite similar. @Jouer is correct that the message has to be kept incredibly simple. All government officials have to say the same thing, repeat it ad nauseum, and keep the message short and clear. Three points are typically a good limit, and the most important ones are 1) social distance 2) wash your hands 3) don't cough on people.

The center for public health has been responsible for the pandemic response in Norway. We all know what they think about diet and exercise. They've spent decades repeating that message in school and public: 1) eat greens and fish (or other sources of vitamin D) 2) eat less sugar 3) exercise at least 30 minutes a day. During the pandemic, they have talked less about diet, and more about exercise - I think all of the ministers have been interviewed by media on a "brisk walk in the forest" the last months.

Jouer, I disagree.

I think the public is very capable of adhering to a coherent and persistent message reinforced at every level of government. The countries that have done well so far have emphasized consistent messages with few changes along the way.

In the US, not so much.

Yes, messaging in USA has been a disaster. I guess I have less faith in the populace than you. The countries who have done well so far are better listeners to authority, not the strong suit of many Americans.

Not sure what you mean by "listeners to authority"? According to the experts I've seen discussing this topic, it comes down to trust rather than obedience. Both of those would cause you to listen to the government, but the communication from the government, and the people's reactions would be very different.

Norwegians are not obedient. At all. Everything that comes from the government has to be justified and logical. If it is not, we won't do it. But we have very high trust in our government. And their pandemic response has been largely good. I think they could have been clearer on some points, and that we could have kept the borders shut for tourism a while longer (both outgoing and ingoing). But overall, they've done decent job on this issue.

Jouer

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Re: How long can we wait while flattening the curve?
« Reply #3405 on: August 05, 2020, 09:08:39 AM »
I work with climate communication, and the theory behind that and pandemic communication is quite similar. @Jouer is correct that the message has to be kept incredibly simple. All government officials have to say the same thing, repeat it ad nauseum, and keep the message short and clear. Three points are typically a good limit, and the most important ones are 1) social distance 2) wash your hands 3) don't cough on people.

The center for public health has been responsible for the pandemic response in Norway. We all know what they think about diet and exercise. They've spent decades repeating that message in school and public: 1) eat greens and fish (or other sources of vitamin D) 2) eat less sugar 3) exercise at least 30 minutes a day. During the pandemic, they have talked less about diet, and more about exercise - I think all of the ministers have been interviewed by media on a "brisk walk in the forest" the last months.

Jouer, I disagree.

I think the public is very capable of adhering to a coherent and persistent message reinforced at every level of government. The countries that have done well so far have emphasized consistent messages with few changes along the way.

In the US, not so much.

Yes, messaging in USA has been a disaster. I guess I have less faith in the populace than you. The countries who have done well so far are better listeners to authority, not the strong suit of many Americans.

Not sure what you mean by "listeners to authority"? According to the experts I've seen discussing this topic, it comes down to trust rather than obedience. Both of those would cause you to listen to the government, but the communication from the government, and the people's reactions would be very different.

Norwegians are not obedient. At all. Everything that comes from the government has to be justified and logical. If it is not, we won't do it. But we have very high trust in our government. And their pandemic response has been largely good. I think they could have been clearer on some points, and that we could have kept the borders shut for tourism a while longer (both outgoing and ingoing). But overall, they've done decent job on this issue.

Fair point about trust.

GuitarStv

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Re: How long can we wait while flattening the curve?
« Reply #3406 on: August 05, 2020, 09:22:30 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.

Kris

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Re: How long can we wait while flattening the curve?
« Reply #3407 on: August 05, 2020, 09:27:46 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.



Exactly right.

RetiredAt63

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Re: How long can we wait while flattening the curve?
« Reply #3408 on: August 05, 2020, 09:32:35 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.

Probably Ford voters listened to Ford and non-Conservative voters listened to the health experts, and were surprised he was too.  Yes, colour me cynical.  ;-)

bigblock440

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Re: How long can we wait while flattening the curve?
« Reply #3409 on: August 05, 2020, 11:17:05 AM »
The USA is a melting pot with so many different cultures.  Even with a different president pre-covid, I do not think we would have been able to follow the model of South Korea.

I don't think the US really even tried. The president spent months insisting it wasn't a big deal, then pushed responsibility on individual states to come up with their own plans despite our borderless nation making this impossible while insisting "my money, my rules" when it suited him.  Each state did its own thing, with some following the president's lead of "ignore it" and others half-assing it because they didn't want to upset too many voters.

In this context I think we have one culture in the USA, and that's to do the opposite of whatever the other political party suggests.  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.  The Patriot Act was the largest increase in domestic surveillance and police powers since the beginning of the war on drugs and was passed by a Republican president and Republican Congress. Not a peep from the "my rights" and "don't tread on me" crowd. A Democrat suggests wearing a piece of cloth over your mouth to save the lives of your neighbors and you'd swear the Gestapo was coming based on some of their reactions.

President Moon is a controversial leader around here and you'll get fierce arguments about just about any political subject, but the opposition to his COVID actions was an insignificant minority.  The older crowd do what the government tells them most of the time, but the younger generations can be as defiant as their American counterparts. They still wear their masks because pandemics have happened here before and generally there's still deference to their elders.

Just because it was 20 years ago doesn't mean we can just make things up about it, there was plenty of opposition at the time and the whole reason it had sunsets built in was at the insistence of a Texas Republican.  There was also only a single no vote.  There's been a few bills that have attempted to reign it in the years immediately after it's passage too, most bipartisan.  You could also make the argument that because of things like the Patriot act, the "my rights" crowd is speaking up more now, though I think it's mostly just social media that you can "hear" more people now than you used to.

bigblock440

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Re: How long can we wait while flattening the curve?
« Reply #3410 on: August 05, 2020, 11:23:13 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.

Kris

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Re: How long can we wait while flattening the curve?
« Reply #3411 on: August 05, 2020, 11:33:23 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.

OtherJen

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Re: How long can we wait while flattening the curve?
« Reply #3412 on: August 05, 2020, 11:40:36 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.

RetiredAt63

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Re: How long can we wait while flattening the curve?
« Reply #3413 on: August 05, 2020, 11:40:50 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.

No-one in North America was worrying about it in February.  I was in New Zealand, watching the news and wondering if I should go home early, and things only came to real public concern in March.

simmias

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Re: How long can we wait while flattening the curve?
« Reply #3414 on: August 05, 2020, 11:48:59 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/

GuitarStv

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Re: How long can we wait while flattening the curve?
« Reply #3415 on: August 05, 2020, 12:04:16 PM »
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.



What you're saying is badly taken out of context.  Let's look at it in context, starting with the :

Jan 17, 2020 - “This is a serious situation. … [W]e believe the current risk from this virus to the general public is low. … The situation could indeed change quickly. Therefore, we are taking a cautious approach to this outbreak and we’re preparing ourselves to respond quickly to any new developments.” - Dr. Nancy Messonnier, CDC

Jan 22, 2020 -
“We have it totally under control. It’s one person coming in from China, and we have it under control. It’s going to be just fine.” - Trump

Jan 24, 2020 -
“China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency. It will all work out well. In particular, on behalf of the American People, I want to thank President Xi!” - Trump

Jan 30, 2020 -
“We only have five people. Hopefully, everything’s going to be great. They have somewhat of a problem, but hopefully, it’s all going to be great. But we’re working with China, just so you know, and other countries very, very closely. So it doesn’t get out of hand. But it’s, you know, it’s something that we have to be very, very careful with, right? We have to be very careful.” - Trump

Jan 31, 2020 -
“I want to emphasize that this is a serious health situation in China, but I want to emphasize that the risk to the American public currently is low.” - CDC Director Robert Redfield, at a coronavirus task force briefing

Trump bars most travelers from China, but there are exceptions for U.S. citizens, lawful permanent residents and close family.

Feb. 2, 2020 -
“We pretty much shut it down coming in from China.” - Trump

Feb. 3, 2020 -
“We expect to find additional cases of novel coronavirus infection in the United States. We expect to see more cases of person-to-person spread among close contacts.” - The CDC’s Messonnier, in a briefing with reporters.

Feb 4, 2020 -
“We are coordinating with the Chinese government and working closely together on the coronavirus outbreak in China. My administration will take all necessary steps to safeguard our citizens from this threat.” - Trump

Feb 10, 2020 -
“Looks like by April, you know, in theory, when it gets a little warmer, it miraculously goes away. I hope that’s true. But we’re doing great in our country. China, I spoke with President Xi, and they’re working very, very hard. And I think it’s going to all work out fine.” - Trump

Feb 11, 2020 -
“In our country, we only have, basically, 12 cases and most of those people are recovering and some cases fully recovered. So it’s actually less.” - Trump

Feb 12, 2020 -
“We can and should be prepared for this new virus to gain a foothold in the U.S. The goal of the measures we have taken to date are to slow the introduction and impact of this disease in the United States, but at some point, we are likely to see community spread in the U.S.” - The CDC’s Messonnier, who also acknowledged problems with the test kits distributed to states. The lack of functional test kits at state labs meant all samples had to be sent to the CDC, and limits were placed on who could be tested.

Feb 24, 2020 -
“The Coronavirus is very much under control in the USA. We are in contact with everyone and all relevant countries. CDC & World Health have been working hard and very smart. Stock Market starting to look very good to me!” - Trump

Feb 26, 2020 -
“I understand this whole situation may seem overwhelming and that disruption to everyday life may be severe. … I told my children that while I didn’t think that they were at risk right now, we as a family need to be preparing for significant disruption of our lives.” - The CDC’s Messonnier, who warned that the government’s containment strategy would likely have to move to mitigation measures such as closing businesses and schools

“The degree of risk has the potential to change quickly, and we can expect to see more cases in the United States.” - Azar (at the white house press briefing)

“When you have 15 people, and the 15 within a couple of days is going to be down to close to zero, that’s a pretty good job we’ve done.” - Trump

Feb 28, 2020 -
“The reason you’re seeing so much attention to it today is they think this is going to be what brings down the president. That’s what this is all about.” - Mick Mulvaney

“Now the Democrats are politicizing the coronavirus. … One of my people came up to me and said, ‘Mr. President, they tried to beat you on Russia, Russia, Russia.’ That didn’t work out too well. They couldn’t do it. They tried the impeachment hoax. That was on a perfect conversation. They tried anything, they tried it over and over. … And this is their new hoax.” - Trump

 - https://www.npr.org/2020/04/21/837348551/timeline-what-trump-has-said-and-done-about-the-coronavirus  (I'd encourage you to continue reading for the months that follow as Trump's message becomes more and more dangerous and out of touch with reality.



The only consistent pattern that I've seen is telling the public the opposite of what public health officials are saying.

Sure, Trump banned people travelling from China - and that was a good idea.  But it's important to point out that as he was doing that, he was telling people that there was nothing to worry about from the virus.  At the same time, the travel ban didn't prevent a lot of infected people from coming back to China because of the exemptions that were made . . . so it seems largely to have been done as a symbolic 'fuck you' to Chinese people rather than out of concern about the virus.  This read is corroborated by Trump's continued messaging that there was nothing to worry about while public health officials were saying that things were dramatically worsening.

As far as Democratic opposition . . . to the best of my knowledge there wasn't widespread Democratic opposition to his ban.  None of the Democratic congressional leaders did.  Also important to note that Trump and his administration immediately politicized the virus and painted it as a Democrats vs Republicans issue, all while ignoring what his scientists and advisors were saying.

Everyone is entitled to their own opinion . . . but not their own facts.  The facts are pretty clear regarding Trump's handling of coronavirus.

HPstache

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Re: How long can we wait while flattening the curve?
« Reply #3416 on: August 05, 2020, 12:25:33 PM »
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.

Example #2, Hydroxychloroquine .  Everything about it.  It could have (and still might) have completely prevented the spread of the virus and reduced the death count drastically.  But since it wasn't one side's idea, and since Trump thought it could be helpful, it was completely shut down with misinformation campaigns about it being super dangerous and anti-science.

GuitarStv

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Re: How long can we wait while flattening the curve?
« Reply #3417 on: August 05, 2020, 12:33:48 PM »
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.

Example #2, Hydroxychloroquine .  Everything about it.  It could have (and still might) have completely prevented the spread of the virus and reduced the death count drastically.  But since it wasn't one side's idea, and since Trump thought it could be helpful, it was completely shut down with misinformation campaigns about it being super dangerous and anti-science.

You believe that the WHO is a deep state anti-Trump Democratic plant?

It's the first link in their 'Mythbusters' section:

Quote
FACT: Studies show hydroxychloroquine does not have clinical benefits in treating COVID-19
Hydroxychloroquine or chloroquine, a treatment for malaria, lupus erythematosus, and rheumatoid arthritis, has been under study as a possible treatment for COVID-19. Current data shows that this drug does not reduce deaths among hospitalised COVID-19 patients, nor help people with mild or moderate disease.

The use of hydoxychloroquine and chloroquine is accepted as generally safe for patients with malaria and autoimmune diseases, but its use where not indicated and without medical supervision can cause serious side effects and should be avoided.

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters?gclid=CjwKCAjwsan5BRAOEiwALzomX33XgUQIPR90cLklxiDK-EWpJnxWz2ikfrrrNx001CcenLLnxYP4WBoCZy4QAvD_BwE#chloroquine




But even ignoring the WHO as a deep state anti-Republican plant that relies on that terribly un-conservative 'science' stuff . . . if disgust with Trump shut down studies of hydroxychloroquine, how come there are more than 600 studies that are either underway or have been done on the drug?  Every researcher in the world right now is grasping at straws to find any cure possible . . . because it'll make them world famous and super rich.  You really think they're all going to drop something that may be promising just because the blowhard in charge of the US threw another twitter tantrum?  Or are all scientists deep state liberal plants as well?  How deep does your personal rabbit hole go?

NorthernBlitz

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Re: How long can we wait while flattening the curve?
« Reply #3418 on: August 05, 2020, 12:34:20 PM »
anyone have an opinion on the decreasing number of daily cases as reported by NYT? today we're at mid-40k territory. i don't think that people have largely changed patterns, and for sure, there has been little national guidance.

I'm hoping that the paper below in Nature is directionally correct for the US.
https://www.nature.com/articles/s41586-020-2550-z

The abstract:
Quote
Memory T cells induced by previous pathogens can shape the susceptibility to, and clinical severity of, subsequent infections1. Little is known about the presence of pre-existing memory T cells in humans with the potential to recognize SARS-CoV-2. Here, we first studied T cell responses to structural (nucleocapsid protein, NP) and non-structural (NSP-7 and NSP13 of ORF1) regions of SARS-CoV-2 in COVID-19 convalescents (n=36). In all of them we demonstrated the presence of CD4 and CD8 T cells recognizing multiple regions of the NP protein. We then showed that SARS-recovered patients (n=23) still possess long-lasting memory T cells reactive to SARS-NP 17 years after the 2003 outbreak, which displayed robust cross-reactivity to SARS-CoV-2 NP. Surprisingly, we also frequently detected SARS-CoV-2 specific T cells in individuals with no history of SARS, COVID-19 or contact with SARS/COVID-19 patients (n=37). SARS-CoV-2 T cells in uninfected donors exhibited a different pattern of immunodominance, frequently targeting the ORF-1-coded proteins NSP7 and 13 as well as the NP structural protein. Epitope characterization of NSP7-specific T cells showed recognition of protein fragments with low homology to “common cold” human coronaviruses but conserved amongst animal betacoranaviruses. Thus, infection with betacoronaviruses induces multispecific and long-lasting T cell immunity to the structural protein NP. Understanding how pre-existing NP- and ORF-1-specific T cells present in the general population impact susceptibility and pathogenesis of SARS-CoV-2 infection is of paramount importance for the management of the current COVID-19 pandemic.

Basically, they found "memory T-Cells" that attack covid and seem to have some role in fighting infection in (1) Covid patients, (2) SARS1 patients, and (3) 50% of people who weren't infected with covid / SARS1. The T-cells in group (3) seemed to attack a different part of the virus than (1), so it doesn't seem like people in (3) were just asymptomatic.

If these T-cells give you something like resistance instead of immunity, maybe that explains why we see such dramatic differences in people that test positive for covid?

We know that in places like NY, antibody tests come back at something like 20% positive. If that's the case, maybe something like 40% of the remaining population has these memory T-Cells (which seem to be long lived since SARS1 was 17 years ago)? If so, that would put resistance / immunity at ~ 60% of the population so maybe we're much closer to herd immunity than we thought in places that have seen a 1st wave. This assumes that the 50% they found here is comparable to whatever we'd see in the US (the study was done in Singapore at Duke-NUS Medical School).

There's a lot of ifs in there and it could be totally wrong. But its kind of what I've been thinking as a reason that we haven't seen any resurgence in upstate NY when places with much more stringent rules (CA is where I'm thinking of) were seeing a spike. But this seems like a pretty hopeful paper to me.

I don't know if you can really avoid the first spike from covid. You can push it off by locking down, but it seems like once restrictions are relaxed the spike comes. Hopefully, the time we bought made treatment better (which seems to be the case).

Anyway, that's my reading of that paper. I'm used to reading papers as part of my job, but in Engineering and not Medicine. So I certainly could have misinterpreted things here.
« Last Edit: August 05, 2020, 12:37:19 PM by NorthernBlitz »

OtherJen

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Re: How long can we wait while flattening the curve?
« Reply #3419 on: August 05, 2020, 12:41:28 PM »
anyone have an opinion on the decreasing number of daily cases as reported by NYT? today we're at mid-40k territory. i don't think that people have largely changed patterns, and for sure, there has been little national guidance.

I'm hoping that the paper below in Nature is directionally correct for the US.
https://www.nature.com/articles/s41586-020-2550-z

The abstract:
Quote
Memory T cells induced by previous pathogens can shape the susceptibility to, and clinical severity of, subsequent infections1. Little is known about the presence of pre-existing memory T cells in humans with the potential to recognize SARS-CoV-2. Here, we first studied T cell responses to structural (nucleocapsid protein, NP) and non-structural (NSP-7 and NSP13 of ORF1) regions of SARS-CoV-2 in COVID-19 convalescents (n=36). In all of them we demonstrated the presence of CD4 and CD8 T cells recognizing multiple regions of the NP protein. We then showed that SARS-recovered patients (n=23) still possess long-lasting memory T cells reactive to SARS-NP 17 years after the 2003 outbreak, which displayed robust cross-reactivity to SARS-CoV-2 NP. Surprisingly, we also frequently detected SARS-CoV-2 specific T cells in individuals with no history of SARS, COVID-19 or contact with SARS/COVID-19 patients (n=37). SARS-CoV-2 T cells in uninfected donors exhibited a different pattern of immunodominance, frequently targeting the ORF-1-coded proteins NSP7 and 13 as well as the NP structural protein. Epitope characterization of NSP7-specific T cells showed recognition of protein fragments with low homology to “common cold” human coronaviruses but conserved amongst animal betacoranaviruses. Thus, infection with betacoronaviruses induces multispecific and long-lasting T cell immunity to the structural protein NP. Understanding how pre-existing NP- and ORF-1-specific T cells present in the general population impact susceptibility and pathogenesis of SARS-CoV-2 infection is of paramount importance for the management of the current COVID-19 pandemic.

Basically, they found "memory T-Cells" that attack covid and seem to have some role in fighting infection in (1) Covid patients, (2) SARS1 patients, and (3) 50% of people who weren't infected with covid / SARS1. The T-cells in group (3) seemed to attack a different part of the virus than (1), so it doesn't seem like people in (3) were just asymptomatic.

If these T-cells give you something like resistance instead of immunity, maybe that explains why we see such dramatic differences in people that test positive for covid?

We know that in places like NY, antibody tests come back at something like 20% positive. If that's the case, maybe something like 40% of the remaining population has these memory T-Cells (which seem to be long lived since SARS1 was 17 years ago)? If so, that would put resistance / immunity at ~ 60% of the population so maybe we're much closer to herd immunity than we thought in places that have seen a 1st wave.

There's a lot of ifs in there and it could be totally wrong. But its kind of what I've been thinking as a reason that we haven't seen any resurgence in upstate NY when places with much more stringent rules (CA is where I'm thinking of) were seeing a spike. But this seems like a pretty hopeful paper to me.

I don't know if you can really avoid the first spike from covid. You can push it off by locking down, but it seems like once restrictions are relaxed the spike comes. Hopefully, the time we bought made treatment better (which seems to be the case).

Anyway, that's my reading of that paper. I'm used to reading papers as part of my job, but in Engineering and not Medicine. So I certainly could have misinterpreted things here.

Memory T cells doesn't need to be in quotes, that's the term we use in the field for previously naive T cells that have encountered their cognate (specific) antigen, mounted a reaction, and are now primed for a stronger secondary reaction when they encounter the antigen again. Vaccines induce memory T and/or B cell formation, and this is what is meant by immunity against a pathogen. You can call it resistance, as conceptually that term is not wrong, but adaptive immunity is the field norm. There are a lot of other moving parts involved in an adaptive immune response, but that's the elevator explanation.

Adaptive immunity to a pathogen can be induced either by direct exposure to the pathogen (what we're seeing now), or by vaccination. Obviously, the second is much easier to control and results in much less morbidity and mortality, which is why we vaccinate for infectious diseases once the candidate vaccines clear clinical trials and are approved for human use.

NorthernBlitz

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Re: How long can we wait while flattening the curve?
« Reply #3420 on: August 05, 2020, 12:43:42 PM »
Memory T cells doesn't need to be in quotes, that's the term we use in the field for previously naive T cells that have encountered their cognate (specific) antigen, mounted a reaction, and are now primed for a stronger secondary reaction when they encounter the antigen again. Vaccines induce memory T and/or B cell formation, and this is what is meant by immunity against a pathogen. You can call it resistance, as conceptually that term is not wrong, but adaptive immunity is the field norm. There are a lot of other moving parts involved in an adaptive immune response, but that's the elevator explanation.

Adaptive immunity to a pathogen can be induced either by direct exposure to the pathogen (what we're seeing now), or by vaccination. Obviously, the second is much easier to control and results in much less morbidity and mortality, which is why we vaccinate for infectious diseases once the candidate vaccines clear clinical trials and are approved for human use.

Thanks for the clarifications OtherJen.

frugalnacho

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Re: How long can we wait while flattening the curve?
« Reply #3421 on: August 05, 2020, 12:51:23 PM »
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.

Example #2, Hydroxychloroquine .  Everything about it.  It could have (and still might) have completely prevented the spread of the virus and reduced the death count drastically.  But since it wasn't one side's idea, and since Trump thought it could be helpful, it was completely shut down with misinformation campaigns about it being super dangerous and anti-science.



I can't take any discussion about the pandemic seriously anymore.  It's like the fucking twilight zone it's so god damn insane. 

Davnasty

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Re: How long can we wait while flattening the curve?
« Reply #3422 on: August 05, 2020, 01:15:11 PM »
Example #2, Hydroxychloroquine .  Everything about it.  It could have (and still might) have completely prevented the spread of the virus and reduced the death count drastically.  But since it wasn't one side's idea, and since Trump thought it could be helpful, it was completely shut down with misinformation campaigns about it being super dangerous and anti-science.

I can't take any discussion about the pandemic seriously anymore.  It's like the fucking twilight zone it's so god damn insane.

Right? I've been trying to think of how to respond to this but it's so wrong, I don't know where to begin. It's pure fantasy.

I'm tired of fact checking things. Instead, could @v8rx7guy provide some evidence to back up their claims?

I think it's telling that the first two examples of Democrats being irrational/anti science due to partisan politics are straight up false.

Michael in ABQ

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Re: How long can we wait while flattening the curve?
« Reply #3423 on: August 05, 2020, 02:09:44 PM »

Example #2, Hydroxychloroquine .  Everything about it.  It could have (and still might) have completely prevented the spread of the virus and reduced the death count drastically.  But since it wasn't one side's idea, and since Trump thought it could be helpful, it was completely shut down with misinformation campaigns about it being super dangerous and anti-science.

You believe that the WHO is a deep state anti-Trump Democratic plant?

It's the first link in their 'Mythbusters' section:

Quote
FACT: Studies show hydroxychloroquine does not have clinical benefits in treating COVID-19
Hydroxychloroquine or chloroquine, a treatment for malaria, lupus erythematosus, and rheumatoid arthritis, has been under study as a possible treatment for COVID-19. Current data shows that this drug does not reduce deaths among hospitalised COVID-19 patients, nor help people with mild or moderate disease.

The use of hydoxychloroquine and chloroquine is accepted as generally safe for patients with malaria and autoimmune diseases, but its use where not indicated and without medical supervision can cause serious side effects and should be avoided.

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters?gclid=CjwKCAjwsan5BRAOEiwALzomX33XgUQIPR90cLklxiDK-EWpJnxWz2ikfrrrNx001CcenLLnxYP4WBoCZy4QAvD_BwE#chloroquine




But even ignoring the WHO as a deep state anti-Republican plant that relies on that terribly un-conservative 'science' stuff . . . if disgust with Trump shut down studies of hydroxychloroquine, how come there are more than 600 studies that are either underway or have been done on the drug?  Every researcher in the world right now is grasping at straws to find any cure possible . . . because it'll make them world famous and super rich.  You really think they're all going to drop something that may be promising just because the blowhard in charge of the US threw another twitter tantrum?  Or are all scientists deep state liberal plants as well?  How deep does your personal rabbit hole go?


Here are a couple randomized 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
Published in the International Journal of Infectious Diseases
Volume 97, August 2020, Pages 396-403
https://www.sciencedirect.com/science/article/pii/S1201971220305348
Quote
Results
Of 2,541 patients, with a median total hospitalization time of 6 days (IQR: 4–10 days), median age was 64 years (IQR:53–76 years), 51% male, 56% African American, with median time to follow-up of 28.5 days (IQR:3–53). Overall in-hospital mortality was 18.1% (95% CI:16.6%–19.7%); by treatment: hydroxychloroquine + azithromycin, 157/783 (20.1% [95% CI: 17.3%–23.0%]), hydroxychloroquine alone, 162/1202 (13.5% [95% CI: 11.6%–15.5%]), azithromycin alone, 33/147 (22.4% [95% CI: 16.0%–30.1%]), and neither drug, 108/409 (26.4% [95% CI: 22.2%–31.0%]). Primary cause of mortality was respiratory failure (88%); no patient had documented torsades de pointes. From Cox regression modeling, predictors of mortality were age>65 years (HR:2.6 [95% CI:1.9–3.3]), white race (HR:1.7 [95% CI:1.4–2.1]), CKD (HR:1.7 [95%CI:1.4–2.1]), reduced O2 saturation level on admission (HR:1.5 [95%CI:1.1–2.1]), and ventilator use during admission (HR: 2.2 [95%CI:1.4–3.3]). Hydroxychloroquine provided a 66% hazard ratio reduction, and hydroxychloroquine + azithromycin 71% compared to neither treatment (p < 0.001).

Conclusions and relevance
In this multi-hospital assessment, when controlling for COVID-19 risk factors, treatment with hydroxychloroquine alone and in combination with azithromycin was associated with reduction in COVID-19 associated mortality. Prospective trials are needed to examine this impact.


Effectiveness of Hydroxychloroquine in COVID-19 disease: A done and dusted situation?
A letter to the editor published in the International Journal of Infectious Diseases
https://www.ijidonline.com/article/S1201-9712(20)30600-7/fulltext
Quote
After adjusting for a number of key confounders (see table), the use of hydroxycholoroquine + azithromycin was associated with a 66% reduction in risk of death as compared to controls; the analysis also suggested a larger effectiveness of hydroxychloroquine in patients with less severe COVID-19 disease (PO2/FiO2 > 300, interaction p-value<.0001). Our results are remarkably similar to those shown by Arshad et al.

Here are some of the studies that I found cited by this article - https://www.factcheck.org/2020/05/trump-misleads-on-hydroxychloroquine-again/ - as showing hydroxycholoroquine  was ineffective or even harmful. These studies were based on data gathered from March to April.


Risk of QT Interval Prolongation Associated With Use of Hydroxychloroquine With or Without Concomitant Azithromycin Among Hospitalized Patients Testing Positive for Coronavirus Disease 2019 (COVID-19)
https://jamanetwork.com/journals/jamacardiology/fullarticle/2765631
This study had a small sample size of 90 and was focused on some undesirable side effect I'm not familiar, torsades de pointes, with but it basically said it was a risk. The larger study I posted with 2,500 patients indicated none of them developed this side effect. Perhaps the dosage was refined between this earlier study and the larger one in Michigan.

Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data
https://www.bmj.com/content/369/bmj.m1844.short
This study had a small sample size of 181 patients in France that showed only minor, and probably not statistically significant, improvement with hydroxychloroquine.

Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19
https://www.nejm.org/doi/full/10.1056/NEJMoa2012410
This was a larger study of 1,376 patients that essentially concluded there was no benefit but it did include this interesting line "Hydroxychloroquine-treated patients were more severely ill at baseline than those who did not receive hydroxychloroquine". I am not nearly competent enough in this field to interpret this study but it does appear they did a lot of analysis to adjust for that.



An important distinction should be made. Trump has said (or implied in his rambling manner) that hydroxycholoroquine  is a prophylactic, that is it prevents COVID-19. There doesn't seem to be any evidence of that. However, there is clearly some evidence that it can help treat COVID-19 and reduce the mortality rate. It's not a cure, but reducing the mortality rate by 66% among people sick enough to be admitted to the hospital is a huge deal. Unfortunately Trump has poisoned the well when it comes to this drug and so most people will just dismiss the use of it off hand because changing your mind when presented with new evidence is a very hard thing to do. Especially for people in the public spotlight. Even more so when it's even remotely, possibly, maybe admitting that Trump was right about something - or at least partially right.
« Last Edit: August 05, 2020, 02:21:12 PM by Michael in ABQ »

habanero

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Re: How long can we wait while flattening the curve?
« Reply #3424 on: August 05, 2020, 02:14:53 PM »
At least outside the US I think most health authorities are capable of judging medicine on its own merits and documented effect or lack there off regardless of what Trump might have said, rambled or tweeted. And the medicine isn't widely used as far as I know. I have read what our FDA has written on it related to Covid-19 and oddly enough, there is no reference to Trump in their evaluation. And oh, we don't use the medicine for treating Covid-19 btw.

If it did in fact save 66% or patients I'm pretty certain we would. Despite Trump. If new evidence should pop up saying otherwise as to the effect I'm pretty certain it will be used. Again regardless of what Trump has rambled about it.

obstinate

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Re: How long can we wait while flattening the curve?
« Reply #3425 on: August 05, 2020, 02:17:20 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.

OtherJen

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Re: How long can we wait while flattening the curve?
« Reply #3426 on: August 05, 2020, 02:20:48 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.

Michael in ABQ

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Re: How long can we wait while flattening the curve?
« Reply #3427 on: August 05, 2020, 02:24:22 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.

Michael in ABQ

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Re: How long can we wait while flattening the curve?
« Reply #3428 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 #3429 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 #3430 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 #3431 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 #3432 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 #3433 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 #3434 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 #3435 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

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Re: How long can we wait while flattening the curve?
« Reply #3436 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 #3437 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.

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Re: How long can we wait while flattening the curve?
« Reply #3438 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 #3439 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?

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Re: How long can we wait while flattening the curve?
« Reply #3440 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 #3441 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?

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Re: How long can we wait while flattening the curve?
« Reply #3442 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 don’t 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 #3443 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 #3444 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.

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bigblock440

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Re: How long can we wait while flattening the curve?
« Reply #3446 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 #3447 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 #3448 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 #3449 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.