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Imperfection, sometimes it’s all we’ve got, nature.
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I think their point is that there are choices and going for herd immunity is a bad one that will result in needless death.
Unfortunately the best we can probably hope for is to lessen the number of deaths, especially amongst the most vulnerable.
Some methods will be more effective than others. There aren't just two alternatives. It will require more testing, social distancing, mask wearing (to reduce spread from infected people) and getting the number of infections low enough that contact tracing (followed by quarantining of exposed individuals) can be effective.
When the number of infections are low enough -- if you have good testing and contact tracing -- you can have tight quarantines of outbreak regions and a "more normal" behavior (with strong social distancing and masks) elsewhere. But the number of infections have to be brought low.
The Hammer and the Dance still is a pretty good outline of the broad strokes. We do know things now that weren't known then (like the apparent effectiveness of masks when everyone wears them in terms of reducing the spread from an infected person): https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56
Well, Remdesivir seems to have been proved effective against the disease, not perhaps to the point of being the silver bullet against the pandemic, but hopefully enough to unburden hospitals by making people to recover faster and less likely to need intensive care.
Yes and locking down borders, quarantining travellers, surveillance apps.
Most epidemiologists seem skeptical of app-based surveillance and have been saying human contact tracing is critical to successful containment as is testing.
These are things some countries are doing and some countries haven't really prepared for.
The thing I fear about phone based contact tracing app is the bigger epidemic (that of stupidity) seems to be affecting people's ability to research and come to high quality opinions, and the wisdom of the crowd seems to be tipping toward not trusting anyone or anything, not trusting any company, not trusting any politician, not trusting your own country, not trusting advanced telephony technology and basically thinking nobody has their best interests at heart. Of course, they're wrong, but that's because they're stupid.
Anyway, I'm all for the idea of the phone app way of doing it (even though it's a lesser lever to pull than the human contact tracing methodologies, but they can operate separately anyway). Here's a thread I did on twitter to explain to the world how it works, to reassure everyone.
One of the fears multiple epidemiologists and technically savvy-public health folks have is that politicians and most people (including doctors) don't understand that human contact tracing can't be replaced and that the apps don't reduce the number of human tracers you need -- they simply add to the effectiveness by a fairly small margin -- due to the fact that people start transmitting the virus soon after exposure and before they are symptomatic.
Much smarter and earlier testing of everyone where there are infectious clusters is important -- and something that in the U.S. we aren't anywhere near to doing. We are still doing such a poor job testing and tracing that we aren't even sure why the infection rate has not slowed down in places where there is shelter-in-place. California is doing well compared to the country (given that community spread was happening hear by late January) but the infection rate has kind of plateaued -- it hasn't dropped anything like it has in New Zealand.
It is clear that there are weak links in how we have implemented things, but there are too many people and not enough tests for them to do effective enough tracing to understand where the weak links are.
As is almost universally agreed South Korea has been very successful at the control of Covid so far, here is how they did it.
https://www.businessinsider.com/coronavirus-south-korea-tech-contact-tracing-testing-fight-covid-19-2020-5?r=US&IR=T
For those thinking that mutation in the near-term will make COVID more deadly or less deadly, the answer is that it is highly unlikely as explained in the following Twitter thread from epidiemiologist/evolutionary biologist Carl Bergstrom:
https://threadreaderapp.com/thread/1242314692514598912.html
Apologies if this has been posted already, but I found this post to be very clear-headed and sensible:
https://www.erinbromage.com/post/the-risks-know-them-avoid-them?fbclid=IwAR30JwpLA_6CzU2FmZnGxtfsCnYpcLQ-yFuzMOVyk6EkTUVyFsjz-L-9MkA
This article by a virologist/epidemiologist who nearly died is worth reading and makes some points worth mentioning if someone says only 1% or 0.5% die from the disease: many survivors will suffer long-term consequence So:
https://www.sciencemag.org/news/2020/05/finally-virus-got-me-scientist-who-fought-ebola-and-hiv-reflects-facing-death-covid-19
This was very good - thanks for posting.
An interesting peek at how South Korea is keeping the clamps on the virus without general lockdowns:
https://threadreaderapp.com/thread/1258987354934538248.html
Really interesting thread and article about how the virus might spread in clusters:
I was reading that earlier, it’s very interesting.
Thanks Mister Yot. Missed this.
https://covid.idmod.org/data/Stochasticity_heterogeneity_transmission_dynamics_SARS-CoV-2.pdf
I think this is one of the most important papers I’ve read so far and at this stage represents a turning-point in what we should all now be able to understand.
....hmmm. And if you were going to sum it up in a half a paragraph for those of us (self) who didn't pass their biology O Level, what would you say Mister Ian?
80% of spreading is from 1 to 10% of infected people. This virus tends to spread from super-spreading events and disruption of possible events and quarantine of exposed individuals will radically disrupt the epidemic’s spread.
Thank you. And interesting. Here in Texas we (the missus and I) have defined July 1st as the day of calculation for this matter. Six weeks after the 're-opening'. We never got to the doubling here in Austin and while it's largely a young, fit town, many folks are still suitably careful. We'll see
Also, a significant point (among many in the paper) is that, well, I’ll quote from the paper:
This is significant because it means that most graphs drawn will be misleadingly monotonic, giving the impression that far worse than is happening, is happening. That’s not to say bad shit isn’t happening, but the charts will at most times have a tendency to give the impression that it’s going to be worse for longer periods than it actually turns out to be after a while.
It is more nuanced than that. If you aren’t controlling super-spreader events, over time you have something that looks like homogenous spreading (I.e. you have huge numbers of people becoming infected and dying as in NYC, Spain, Italy, UK, France, etc). This doesn’t happen if you prevent super-spreading events and trace and isolate exposed individuals.
It means that it is possible to change what sorts of social distancing practices are needed. But first you need to figure out where the choke points are.
Absolutely. The blunt measures of stay at home, work from home, worked excellently here in this context because it prevented SSE scenarios. It also ghost-prevented a lot of scenarios which were never going to amount to any kind of spread at all. However, the distinction between the two was lost. In effect, the whole class got detention because of the one student who wouldn’t own up. If it were possible to discern the SSE scenarios from the non transmission scenarios, we’d be much further ahead. This of course takes testing, lots of testing. Or does it? It could also take recognition of the kind of situation that permit SSE, and those that simply inhibit or diminish the possibility of SSE. So, for example, comparatively little restrictions on outdoor meeting (still with social distancing, and no religious behaviour such as singing etc), whereas indoor poorly ventilated situations get all the restrictions we can lay on. It’s a slightly more granular step than a blanket quarantine for everyone under all circumstances (the bluntest and so far the only tool).
You know, I'm not entirely sure what my guess would have been, but I'd still like to hear my explanation from a year ago as to what a super spreader event was...
I'm glad @robosardine went in that direction instead of the alternatives.
Sorry, couldn't resist...
https://cdn.cjr.org/wp-content/themes/cjr2017/images-body/esquire-05.jpg
Well at last some good news with Dexamethasone
https://www.bbc.co.uk/news/health-53061281