COVID COVID-19 Coronavirus Containment Efforts

[kadiot]

There's bound to be huge recession; many will be poorer than when this pandemic began; 2008 recession will look like peanuts.

 

[bhobba]

I hope not...

Your hope is justified. Managed correctly until we get a vaccine, while very hard, is not impossible. Over here in Aus they often publish a graph of those infected, those who got over it, and those who never get it. Do nothing - we all get it. Take simple measures eg hand washing etc, and the number at any time that have it is flattened and we have about 20% or so that never get it. Add in social distancing and it flattens more plus more never get it. Lockdown - better again. A vaccine - well that's pretty obvious - just a trickle get it and most never do.

If I remember correctly in China only 1% actually ever got it.

Thanks
Bill

 

[chemisttree]

How are the multistory apartment buildings in NYC different than the cruise ships being refused dockage in Florida?

The passengers of those land-bound ships can freely come and go.

https://www.bloomberg.com/graphics/2020-united-states-coronavirus-outbreak/

 

[atyy]

The Philippine government is planning to start the "mass testing" of COVID-19 Person Under Investigation (PUI) and Person Under Monitoring (PUM) on April 14, 2020.

1. Mass testing is not testing everyone. It is “risk-based” testing. Basically, you test people in increasing circles of risk: test the PUI, then the close contacts, then the community. It is not a shotgun approach because no country can test every single citizen for COVID-19. So we need to figure out our priorities for testing, and WHAT TEST to use. You CAN’T test 100M people, but you can test the MOST AT RISK.

2. Understand the limitations of testing. No TEST is 100% accurate. There are trade-offs. The probability that a test is positive when the disease is REALLY present is called the SENSITIVITY. The probability that a negative test actually means the disease is REALLY NOT there is called the SPECIFICITY.

3. A good sensitivity means that a test is able to detect disease MOST of the time if it is PRESENT in a patient. Having a negative test when the disease is PRESENT is called a FALSE NEGATIVE. In other words, the test failed to detect a sick person.

4. A good specificity means that a test is NEGATIVE MOST of the time if there is NO DISEASE in a patient. Having a positive test when the disease is ABSENT is called a FALSE POSITIVE.

5. FALSE NEGATIVES are harmful because you say that someone is COVID-19-free when he actually has COVID-19 so that patient will be free to spread the disease.

6. FALSE POSITIVES are harmful because you will put a patient WITHOUT COVID-19 in the hospital, possibly with REAL COVID-19 patients such that the patient can get COVID, or be isolated needlessly.

7. So how good are the tests? There are two tests we can use for COVID-19 – RT-PCR and antibody tests.

8. RT-PCR is considered the best test for diagnosing ONGOING COVID-19 infection. PCR itself is very sensitive and specific, >90% for both. HOWEVER, the TYPE of specimen and the stage of disease (how many days with symptoms) can affect how often a test is positive. So for RT-PCR, using a nasopharyngeal swab in a patient WITH disease, the probability of getting a positive test is only 63%. So you will actually MISS 37% of cases. This is why we can do a REPEAT test after 48 hours in a patient who is getting sicker of what looks like COVID, but was NEGATIVE on the first test. The DANGER of RT-PCR is a FALSE NEGATIVE and you can end up clearing someone who actually has COVID-19. This can happen in UP TO 1/3 OF PATIENTS so its not a perfect test.

9. RT-PCR is also a highly technical process that not only involves having the right machine and kits, BUT also the proper SAFETY INFRASTRUCTURE like a BSL2 laboratory. Many labs and hospitals HAVE RT-PCR machines but they do not have the biosafety infrastructure.

10. Antibody tests include PRNT (Plaque reduction neutralization test, the gold standard), ELISA (enzyme linked immunosorbent assay) and lateral flow IgM/IgG. The first two are LABORATORY based assays and the last is a point of care rapid diagnostic test (POC-RDT).

11. As much as we would like to use rapid lateral flow assays (IgM/IgG) because of convenience, NONE of the lateral flow assays have used the industry standard PRNT assay as a gold standard. In other words, we have NO IDEA how good they are despite their claimed sensitivity and specificity. The biggest danger is that because it takes 5 to 10 days to make IgM antibody, the test has a high FALSE NEGATIVE rate in those who just started having symptoms. And so you will get a FALSE SENSE OF SECURITY and end up passing the virus to other people and your family members.

12. The OTHER problem with the lateral flow IgM/IgG is that there are other HUMAN CORONAVIRUSES that cause the common cold, and some antibodies against these viruses may CROSS-REACT with the test, giving you a FALSE POSITIVE, which is bad for the reasons stated.

The BOTTOM LINE is NONE OF THESE TESTS ARE PERFECT. FAR from it. Tests INFORM your response, but they still need to be INTERPRETED in the right context.

To some lay persons like myself, we think that a positive is a positive, and a negative is a negative. To clinicians and scientists, they come with HUGE caveats in management. There are times they WILL NOT believe a test result because it is NOT CONSISTENT with the patient’s clinical picture. If we let ourselves be mislead by a test result without USING OUR BRAIN, people will DIE. And this also holds for doing public health strategies and mass testing.

Where did you get this from? It looked correct when I gave it a quick read.

 

[chemisttree]

If I remember correctly in China only 1% actually ever got it.

That story is far from finished.

“Some venues that had reopened were told by the government to close yet again.”

 

[atyy]

If I remember correctly in China only 1% actually ever got it.

That's not correct. The current status is that in Wuhan, the city where the outbreak began, approximately 1% got but it was still less than 1%. In Hubei, the province in which Wuhan is located, about 0.15% have had it. In China as a whole, the percentage is about 0.01%. The percentages may be about 20% higher if you include cases that are totally asymptomatic, but that does not change the qualitative picture.

 

[wukunlin]

That story is far from finished.

“Some venues that had reopened were told by the government to close yet again.”

Looks like asymptomatic cases will be wreaking havoc
https://www.scmp.com/news/china/soc...s-coronavirus-lockdown-country-tries-get-back

 

[DennisN]

Sweden's no lockdown policy is based on the recommendation of the country's leading epidemiologist. The strategy is totally opposed to what the rest of the world is doing. Let's see how this experiment turns out.

While there is no lockdown, there are many recommendations to limit contact and people are following them.

Well, I believe South Korea also has no lockdown, and they've been successful so far.

Yes. It seems we are quite compliant in Sweden, both judging from the news and from my own experience.

I just looked at the Reuters news site and there was a brand new article about Sweden's liberal strategy which is being questioned domestically:

Sweden's liberal pandemic strategy questioned as Stockholm death toll mounts (Reuters, April 3 2020)

Some quotes:

But Sweden’s liberal approach, which aims to minimise disruption to social and economic life, is coming under fire as the epidemic spreads in the capital.

“We don’t have a choice, we have to close Stockholm right now,” Cecilia Soderberg-Naucler, Professor of Microbial Pathogenesis at the Karolinska Institute, told Reuters.

She is one of around 2,300 academics who signed an open letter to the government at the end of last month calling for tougher measures to protect the healthcare system.

“We must establish control over the situation, we cannot head into a situation where we get complete chaos. No one has tried this route, so why should we test it first in Sweden, without informed consent?” she said.

...

The public face of Sweden’s pandemic fight, Health Agency Chief Epidemiologist Anders Tegnell, only months ago a little known civil servant but now rivalling the prime minister for publicity, has questioned how effectively lockdowns can be enforced over time.

“It is important to have a policy that can be sustained over a longer period, meaning staying home if you are sick, which is our message,” said Tegnell, who has received both threats and fan mail over the country’s handling of the crisis.

“Locking people up at home won’t work in the longer term,” he said. “Sooner or later people are going to go out anyway.”

 

[DrClaude]

I just looked at the Reuters news site and there was a brand new article about Sweden's liberal strategy which is being questioned domestically:

Sweden's liberal pandemic strategy questioned as Stockholm death toll mounts (Reuters, April 3 2020)

I wouldn't be surprised if Stockholm was put under lockdown in the coming days. Maybe even Malmö and Göteborg, looking at the current map of known cases:
https://en.m.wikipedia.org/wiki/202...eak_Cases_in_Sweden_by_Number_with_Legend.svg

I just hope the government doesn't go for a one-size-fits-all solution.

 

[kadiot]

Where did you get this from? It looked correct when I gave it a quick read.

Working draft from the inter-agency task force on emerging infectious diseases in the Philippines. I'll post here the final and official paper once it's done,

 

[peanut]

Saw this University of Cambridge published diagram and eventually found the original paper.

https://arxiv.org/pdf/2003.12055.pd...UYSdIpSgzc2V9bkYueivMv5Q9h7G2Nm9Y2VVCEMNcn_5E

 

[DrClaude]

There is a very interesting trend plotter: https://aatishb.com/covidtrends/

More explanation can be found in this video:

 

[russ_watters]

Researchers from the University of Nebraska Medical Centre and the National Strategic Research Institute at the University of Nebraska took air samples from 11 rooms where 13 confirmed cases were being treated.

As well as finding genetic material from the Coronavirus on lavatories and on everyday items, 63.2 per cent of air samples taken inside the rooms and 66.7 per cent of those taken outside also showed traces.

My take on this and the broader issue...

There are three layers to the "airborne" description:
1. Transmission by suspension in water droplets from coughing or aggressive singing is confirmed.
2. True "airborne transmission" is what happens after those droplets dry-out and the virus particles remain suspended in the air because they are small. This isn't confirmed.
3. The quote above is referring to likely inert virus debris being detected. That's an obvious thing that doesn't imply anything about airborne transmission.

From a policy perspective, we've been receiving conflicting guidance on wearing masks. This is based in part on changing or differing risk/risk analysis and in part on logistics: there aren't enough masks (of any type) to go around. Framing the risk, I see three categories:
1. People who are sick need to wear masks to reduce the emission of virus-carrying droplets of saliva.
2. Not everyone who is sick knows it. Hence, potentially anyone could be sick and everyone should wear masks.
3. The value of wearing a mask if you are not sick is debatable, but it's not zero. Hence, again, everyone should wear masks.

Initial guidance was based on #1. Now people are changing to #2 and #3. But the logistic issue is still a problem.

So my personal opinion - not a doctor or policymaker - is that if you want a wear a mask, go ahead. But only if you aren't taking one from a first-responder/caregiver/sick person. I literally just found a new-in-package N95 mask on a shelf in my closet by my attic access. I have several masks of various types I use if I'm doing something dusty like working in my attic, and this happens to have gone unused. I'll keep it in the package for now.

 

[kith]

History may judge South Korea's reaction "right" and everyone else's "wrong", but when an awful lot of people independently come to the "wrong" conclusion, I think you have to accept that reality at face value: under most systems of logic, political philosophy, risk tolerance, institutional inertia, etc. the data did not support an aggressive response.

In his books "The Black Swan" and "Antifragile", Nassim Nicholas Taleb argues that the usual measures of risk are increasingly inadequate in the modern world. They deal only with a certain class of risks but not with events like the financial crisis in 2008 or the current Coronavirus crisis which are arguably much more influencial. He suggests a different approach to risk management based on identifying a specific class of big risks ("systemic" and "fat-tailed") and being more cautious towards them. In line with this, he co-authored a call to action regarding the current crisis in late January. I find his line of thinking quite interesting.

 

[Vanadium 50]

Saw this University of Cambridge published diagram and eventually found the original paper.

Their forecast doesn't seem to match the data.

 

[kith]

Do we have good data about the number of tests in individual countries (ideally over time)?
/edit: Here's our world in data on it: https://ourworldindata.org/covid-testing

 

[russ_watters]

How are the multistory apartment buildings in NYC different than the cruise ships being refused dockage in Florida?

The passengers of those land-bound ships can freely come and go.

https://www.bloomberg.com/graphics/2020-united-states-coronavirus-outbreak/

They have kitchens. Also, the building staff don't all live together in tiny quarters.

By the way, the 2 main problem cruise ships were granted permission to dock. The plan is in good agreement with what I was hoping for when I wrote my complaint post yesterday. The very-sick people went to hospitals, the kinda sick people stayed onboard and the apparently healthy people are getting charter flights back to their home countries.

https://www.usatoday.com/story/trav...merica-ships-dock-fort-lauderdale/5110778002/

 

[atyy]

In his books "The Black Swan" and "Antifragile", Nassim Nicholas Taleb argues that the usual measures of risk are increasingly inadequate in the modern world. They deal only with a certain class of risks but not with events like the financial crisis in 2008 or the current Coronavirus crisis which are arguably much more influencial. He suggests a different approach to risk management based on identifying a specific class of big risks ("systemic" and "fat-tailed") and being more cautious towards them. In line with this, he co-authored a call to action regarding the current crisis in late January. I find his line of thinking quite interesting.

Some interesting recent Tweets from him.

 

[PeroK]

In his books "The Black Swan" and "Antifragile", Nassim Nicholas Taleb argues that the usual measures of risk are increasingly inadequate in the modern world. They deal only with a certain class of risks but not with events like the financial crisis in 2008 or the current Coronavirus crisis which are arguably much more influencial. He suggests a different approach to risk management based on identifying a specific class of big risks ("systemic" and "fat-tailed") and being more cautious towards them. In line with this, he co-authored a call to action regarding the current crisis in late January. I find his line of thinking quite interesting.

I re-read Fooled by Randomness recently, but to be honest it just depressed me. One example was a market analyst who advocated avoiding over-exposure in certain stocks. Then, when those stocks went up the TV presenters declared that you would have lost money by following his advice!

Human beings generally seem to be ill-equipped to think like he advocates. For example, in UK politics something was a risk only when things go wrong!

 

[Stephen Tashi]

In his books "The Black Swan" and "Antifragile", Nassim Nicholas Taleb argues that the usual measures of risk are increasingly inadequate in the modern world.

What makes the situation different than in the pre-modern world? - whenever that was.

One thought is that epidemics can spread faster. Medical technology can also respond faster.

Another thought is that organizations with authority to do risk-management didn't exist in the pre-modern world. That would be a historical debate.

Given the large number of great but improbable catastrophies ( giant asteroid impacts, supervolcano erruption at Yellowstone etc. ) are there sufficient resources to be "adequately prepared" to meet all of them?

 

[Stephen Tashi]

This site shows data about deaths in the Europe from all causes: https://www.euromomo.eu/index.html
Anyone know of an online source for similar data about regions in the USA?

 

[russ_watters]

In his books "The Black Swan" and "Antifragile", Nassim Nicholas Taleb argues that the usual measures of risk are increasingly inadequate in the modern world. They deal only with a certain class of risks but not with events like the financial crisis in 2008 or the current Coronavirus crisis which are arguably much more influencial. He suggests a different approach to risk management based on identifying a specific class of big risks ("systemic" and "fat-tailed") and being more cautious towards them. In line with this, he co-authored a call to action regarding the current crisis in late January. I find his line of thinking quite interesting.

It'll take me some time to dig into those, but its a subject that interests me, so I will. First impression is I like the overall idea, but at the same time the tweets show a theatrical flair that I don't really like. Tweets are like that, by nature though.

Specifically, the one about Italy "lowering" vs "risking" the economy; I think it is both: they are lowering the economy on purpose (as is everyone), but by an unplanned/unclear amount and with very unclear future impact. The unclear future impact of their actions is risk. In the first few paragraphs the first paper, he's saying that the burden of proof is on the people creating the risk and the default position should be to not take an action if you have a poor grasp of its outcome/risk. That's the opposite of what we're doing to the economy and the big conundrum here: the risk of deaths from doing nothing seems to be easier to predict than the risk to the economy of a prolonged shutdown. The chosen path has two main consequences, with opposite risk profiles.

 

[BillTre]

Here is a NY Times article on where and when travel restrictions were imposed in the US and what were its effects on distances traveled (based on cell phones).
Several maps and graphs.

 

[russ_watters]

Well, I believe South Korea also has no lockdown, and they've been successful so far. I think the two successful cases so far are China and South Korea. China's problem was bigger because the outbreak started there and they mishandled things initially. Nonetheless South Korea also handled a great challenge. So it seems that depending on how out of control things are, both countries show the range of potentially successful policies.

My understanding of the S. Korea situation is that they were strongly affected by the events of their SARS infections years ago. This lead them to:

• get ready for another epidemic
• take things seriously when the situation looked like a potential epidemic

The US medical experts are not stupid and could also learn from SARS...

I guess this would be in the set of things you are calling "systems of logic, political philosophy, risk tolerance, institutional inertia, etc.".
I'm OK with that if you realize that it has a lot to do with the political philosophy and their lack of foresight and consideration of effects on people as a population rather than as economic entities.
To many medically trained people (in the same country), the available data did support an (more) aggressive response.
I don't think it is something that should be forgotten since they will be doing this over and over again if not called out on it and similar things.

South Korea is a country that listened closely to experts.
Too many other governments were more concerned about their public image, about their re-election chances, about selling their private stocks before taking public action, and similar things, while too many people in these countries were more worried about their holidays than about the pandemic.
The reaction of South Korea made perfectly sense. It's just rare to see governments and most people listening to experts.

Yes, I'll go with a rare and unique combination of factors. In particular, the pain of experience is a powerful motivator, which they uniquely had. I expect they have many of the same political and social motives all humans have; they just got overridden.

I read Malcom Gladwell's "Outliers" recently, which is a book about the luck and cultural influences on success and failure. It has a chapter on a rash of airline crashes in South Korea a few decades ago. The reason? Their airline crews didn't work well together due to a cultural trait called (I think) superior-subordinate distance and the related respect for authority trait. S. Korea is one of the most, if not the most socially hierarchical societies on the planet (on the opposite end of those scales: the USA). So the first officer on an airliner would just sit with his mouth shut while his captain crashed the plane, instead of speaking-up about a problem he noticed that the captain didn't. Sometimes subordinating yourself to authority has a downside, but in the case of this pandemic it has its upside.

These traits, primed by the pain of experience likely had South Korea uniquely primed to listen to authority both from epidemiologists and government enforcers of quarantines.

 

[russ_watters]

Here is a NY Times article on where and when travel restrictions were imposed in the US and what were its effects on distances traveled (based on cell phones).
Several maps and graphs.

That graphic is hard to read or maybe just accept. It seems to be saying the most of northeast quadrant of the US was fully quarantined (zero travel), even most of PA and MD which didn't have orders to do so. That would be surprisingly effective.

I will say this though; I'm in the little sliver of southeastern PA containing Philadelphia and its neighboring counties, that did have mandatory stay at home orders. My area was considered a hot-spot several weeks ago, but seems to have fallen way behind other areas in new/total cases. So it is starting to feel like the social distancing is having a big positive impact.

...and I found my county on the "which counties reduced the most" graphic: 97% (Philadelphia: 85%).

 

[Vanadium 50]

This site shows data about deaths in the Europe from all causes: https://www.euromomo.eu/index.html
Anyone know of an online source for similar data about regions in the USA?

Very interesting. Onhttps://www.euromomo.eu/outputs/cumulated.html, the clearest trend, by far, is the reduction in deaths in the 5-14 bracket. Any explanation why?

 

[atyy]

Yes, I'll go with a rare and unique combination of factors. In particular, the pain of experience is a powerful motivator, which they uniquely had. I expect they have many of the same political and social motives all humans have; they just got overridden.

I read Malcom Gladwell's "Outliers" recently, which is a book about the luck and cultural influences on success and failure. It has a chapter on a rash of airline crashes in South Korea a few decades ago. The reason? Their airline crews didn't work well together due to a cultural trait called (I think) superior-subordinate distance and the related respect for authority trait. S. Korea is one of the most, if not the most socially hierarchical societies on the planet (on the opposite end of those scales: the USA). So the first officer on an airliner would just sit with his mouth shut while his captain crashed the plane, instead of speaking-up about a problem he noticed that the captain didn't. Sometimes subordinating yourself to authority has a downside, but in the case of this pandemic it has its upside.

These traits, primed by the pain of experience likely had South Korea uniquely primed to listen to authority both from epidemiologists and government enforcers of quarantines.

In the present case, I would guess many South Koreans (but not all, they have crazy aunties there) understand and agree with what the authorities are doing, which is different from the example of the aeroplane pilots.

Just for the record, I'm not a big fan of trusting experts unless I'm forced to (eg. Higgs boson, LIGO). I'm pretty sure in China and in South Korea, with respect to Covid, there was a huge amount of support for the government's actions - in fact, my impression is that the Chinese people largely disapproved of their government's initial mishandling. Society at large was well-informed enough to understand the basis of government decisions. Apart from its initial mishandling, China has done some additional stupid things like saying the virus could have come out of the US, but it is good that there are high level people who know that games with truth are not helpful.

Top Chinese official disowns U.S. military lab Coronavirus conspiracy
https://www.axios.com/china-coronav...kai-1b0404e8-026d-4b7d-8290-98076f95df14.html

 

[kadiot]

Their forecast doesn't seem to match the data.

It's in India (a.k.a. the worst case scenario), not in the USA.

 

[atyy]

Specifically, the one about Italy "lowering" vs "risking" the economy; I think it is both: they are lowering the economy on purpose (as is everyone), but by an unplanned/unclear amount and with very unclear future impact. The unclear future impact of their actions is risk. In the first few paragraphs the first paper, he's saying that the burden of proof is on the people creating the risk and the default position should be to not take an action if you have a poor grasp of its outcome/risk.

Well, if what happened in Wuhan happens throughout Italy and continues unchecked, it is pretty clear you cannot save the economy. On other hand, Italy had Wuhan's example to go on, and I'm pretty sure the Chinese government thought that it was saving the Chinese economy. So Italy could act knowing that Wuhan had been successful in suppressing the disease. At the time of the lockdown, there was not yet positive economic data out of China, but the successful suppression did make it probable. Now, we do have the first signs of positive economic data out of China https://www.scmp.com/economy/china-...a-manufacturing-economy-bounces-back-strongly, but of course we'll have to wait to see if this continues, especially since China will be affected by the rest of the world.

 

[russ_watters]

Very interesting. Onhttps://www.euromomo.eu/outputs/cumulated.html, the clearest trend, by far, is the reduction in deaths in the 5-14 bracket. Any explanation why?

Kids are dumb, but if you lock them inside, they have fewer opportunities to kill themselves by doing dumb things.

...also, they can't die in their parents' cars.

 

[Bystander]

5-14 bracket. Any explanation why?

Last summer, Paris riots? Strikes?

 

[Mary Conrads Sanburn]

SciLine \ AAAS
FOR JOURNALISTS FOR SCIENTISTS

Social Isolation, Mental Health, and COVID-19
THIS BRIEFING OCCURRED ON MARCH 30, 2020

TRANSCRIPT: PLEASE NOTE THIS IS AN UNEDITED TRANSCRIPT. ALL SCILINE BRIEFINGS ARE ON THE RECORD AND REPORTERS ARE FREE TO QUOTE FROM THEM. PLEASE REFER TO THE VIDEO (ABOVE) TO CONFIRM EXACT QUOTES.

Overview:
While the most immediate threat from COVID-19 is to the physical health of those infected, the pandemic will also have far-reaching effects on the social and mental health of others living through the crisis. SciLine’s media briefing explored what the science says about how social isolation, fear, and trauma can impact the health of adults and children—all challenges that countless people and communities will face, regardless of infection status.
Panelists:

• Dr. Julianne Holt-Lunstad, Brigham Young University
• Dr. Roxane Cohen Silver, UC Irvine
• Dr. Robin Gurwitch, Duke University School of Medicine
  Read the Panelist Biographies.
  https://www.sciline.org/s/Panelist-Resources.pdf

[ . . . ]Introduction:
[00:00:00]
RICK WEISS: Just to take one minute up-front to introduce some of you to SciLine if you're not familiar with our work already. We are a philanthropically supported, editorially independent free service for reporters, based at the American Association for the Advancement of Science in Washington, D.C., and we are here to help, in various ways, get more research-backed scientific evidence into news stories and to do that, helping journalists like yourselves make direct contact with scientists and get access to scientifically validated, credible information to put into your stories. We offer a variety of services including our matching service through which you can get in touch with us when you're working on a story and we will find you, and put you in touch with, a scientist with exactly the right expertise for what you need and someone who has been vetted for both their scientific expertise and communication skills, and other services that you can check out at sciline.org, including media briefings like this one.
The structure for today is, we have three people to talk to you briefly for about five or seven minutes each to make some introductory comments on different aspects of the topic at hand today. Their full bios on the website so I'm not going to take the time to run through them now, but I'll just tell you briefly who they are and in what order they will speak, and once they have made their presentations you are welcome to hover down at the bottom of your screen and on the Q&Aa box--or even sooner than the end--feel free to stick in your questions, tell us if you want to direct that question to a particular speaker or just generally to the panelists and I will be reading those questions aloud to the panelists for them to provide their answers. So the lineup today, we're going to hear first from Dr. Roxane Cohen Silver, a Professor in the Department of Psychological Science in the Department of Medicine and the Program in Public Health at the University of California, Irvine.
Her research deals with the short-term and long-term psychological and physical reactions to stress and anxiety, and the media's impact on some of these dynamics, exceedingly relevant ideas for the situation today. Secondly, we will hear from Dr. Julianne Holt-Lunstad, she's a Professor in the Department of Psychology at Brigham Young University where her research is focused on the long-term health effects of physical and social connection and isolation. And finally, third, Dr. Robin Gurwitch, Clinical Psychologist and a Professor in the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center and the Center for Child and Family Health. Dr. Gurwitch conducts research on the impact of trauma and disasters on children and will address some of the ways that parents and other adults can support children dealing with the life changes imposed by this pandemic. So why don't we just get started with Dr. Roxane Cohen Silver.
BACK TO TABLE OF CONTENTS

Psychological and Physical Reactions to Stress and Anxiety
Dr. Roxane Cohen Silver
[00:03:08]
Good morning or good afternoon. I'm sorry, I'm in California, it's still my morning. I'd like to thank AAAS for sponsoring this morning's or this afternoon's event, and I'd like to speak today about coping with the anxiety during a pandemic and how we can best ensure population resilience. This is a stressful time for our country, indeed our world. And we've all been through community traumas before. We've weathered mass violence, we've weathered natural disasters, and indeed my colleagues and I have studied many such events, including the September 11th terrorist attacks, the Boston Marathon bombings, the Orlando nightclub shootings, hurricanes Irma and Harvey. And our research tells us that most will get through these situations. Humans are quite resilient, but somehow this event feels different and it is.
[00:04:00]
And I'd like to take a few minutes to discuss how COVID-19 is unique. This is an invisible threat, we don't know who is infected and anybody could infect us. This is an ambiguous threat, we have no idea how bad this will get. We have a very uncertain future, we don't know how long this will last. And this is a global threat, no community is safe. Moreover, our need to social distance conflicts with our natural desire to connect with our friends and family during stressful times. And our typical sources of distractions such as national or personal sports or going to the gym, going to restaurants or bars, movies or travel, are all restricted by this crisis. And it has disrupted all aspects of our lives from our social lives, to our work lives, to the ways in which we worship.
It is extremely important however that we acknowledge that this uncertainty is stressful. And in fact, this anxiety is appropriate under the circumstances. This is a normal reaction to our new normal. And I think it's important that journalists acknowledge this fact. It's also important that we tell the truth. The situation may get worse before it gets better. Evidence is strongly suggesting that we are probably not yet in the eye of the storm. But there is a potential to help frame a more positive message, if we work together, we can save lives. And minimizing the uncertainty is disingenuous.
I have been studying the role of the media in the aftermath of disasters for several decades. And it is extremely important for journalists to provide trusted information. People seek trusted information via the media and the media can provide critical guidance in ways in which the public can clearly understand. But rumors and misinformation can appear on social media because it's not vetted for accuracy, there is no editor deciding what is going to be posted. And sadly, this misinformation can be transmitted widely and very rapidly. And once it is out there, it is very difficult to correct. For about 20 years, my colleagues and I have also studied the ways in which overexposure to the media can amplify stress, with downstream mental and physical health effects, and at the end of my presentation I will present some references that can be accessed on this specific topic.
[00:07:15]
There are several factors that can impede community resilience such as conflicting political agendas and contradictory messages from our leaders. Insincerity from one's leaders also impedes community resilience and fostering any kind of community conflict can impede the likelihood of our community bouncing back from this crisis. But there are also several ways in which we can maximize community resilience. We can enlist community support, via strong social institutions that were in existence before this crisis began, such as faith-based alliances. We can promote shared values and community solidarity. And we can bolster confidence in trustworthy authorities such as health professionals who are fighting the disease on the front lines.
It's also extremely important that we recognize that anxiety is contagious, but so is compassion. And there are ways in which we can bring our communities together, even if virtually. We can take advantage of the technologies that are now at our fingertips. We can encourage positive community outcomes such as altruistic behavior, social cohesion, volunteerism, reaching out to those who are living alone or who are seniors. And as I said, this is a challenging time, but journalists play a very important role, and I thank you for your commitment to helping us as we all cope with this new reality. I have some references that are accessible and can be downloaded free via my web page. Thank you.
[00:09:12]
RICK WEISS: Thanks Dr. Cohen Silver. And I'll take this opportunity to remind or tell the reporters on the briefing today, all the slides and the reference at the end of the slides, and the video and transcript will be posted on our website within a day or two after this briefing so you can refer back to them. Second, we've got Dr. Julianne Holt-Lunstad.
BACK TO TABLE OF CONTENTS

[ . . .]

###
https://www.sciline.org/media-briefings-blog/social-mental-covid

 

[bhobba]

Their forecast doesn't seem to match the data.

They do not seem to.

Thanks
Bill

 

[kadiot]

They do not seem to.

Thanks
Bill

Which part are you referring to?

 

[bhobba]

Which part are you referring to?

The widely publicised initial Cambridge models now seen far too pessimistic. To be fair I think the assumptions that went into them did not take into account the strong measures most countries are taking in light of the spread of the virus.

Thanks
Bill

 

[mfb]

Specifically, the one about Italy "lowering" vs "risking" the economy; I think it is both: they are lowering the economy on purpose (as is everyone), but by an unplanned/unclear amount and with very unclear future impact. The unclear future impact of their actions is risk. In the first few paragraphs the first paper, he's saying that the burden of proof is on the people creating the risk and the default position should be to not take an action if you have a poor grasp of its outcome/risk. That's the opposite of what we're doing to the economy and the big conundrum here: the risk of deaths from doing nothing seems to be easier to predict than the risk to the economy of a prolonged shutdown. The chosen path has two main consequences, with opposite risk profiles.

On one side we have millions of deaths plus some unclear but still huge economic damage.
On the other side we have ... millions of additional people needing social security for a while? Yeah, we won't have a good estimate for how many and for how long. But it's a really easy decision. So easy that it's made everywhere. The earlier that decision is made the smaller the impact of it.

Kids are dumb, but if you lock them inside, they have fewer opportunities to kill themselves by doing dumb things.

...also, they can't die in their parents' cars.

It's a decrease in Summer 2019. There is no 2020 data on that website.

 

[peanut]

The widely publicised initial Cambridge models now seen far too pessimistic. To be fair I think the assumptions that went into them did not take into account the strong measures most countries are taking in light of the spread of the virus.

Thanks
Bill

Lock down for 49 days is ideal situation. No breakage in between. Benefits are more than anything. Corona will be eliminated.

 

[peanut]

COVID-19 now reached Falklands. 1 case now reported. Oh dear! One would think islands safe as there's more sheep there than humans.

 

[Vanadium 50]

It's in India (a.k.a. the worst case scenario), not in the USA.

I can read, thank you.

Which is the data it doesn't match. Figure 4 shows a prediction of 250 infected individuals today. Instead India has 2900.

You (and peanut) could have checked this `before posting. Maybe even should have.

 

[mfb]

I'm not sure what these numbers are supposed to be. Clearly not the total number of infections, as that can't drop at the day a lockdown starts. The number of confirmed cases they expect? That makes no sense, it doesn't drop that quickly. The number of new infections? That is much larger. The number of new infections, scaled by some factor? That is possible. That wouldn't be in disagreement with the data, but then plotting it against confirmed cases makes no sense.

 

[kadiot]

I can read, thank you.

Which is the data it doesn't match. Figure 4 shows a prediction of 250 infected individuals today. Instead India has 2900.

You (and peanut) could have checked this `before posting. Maybe even should have.

Figure 4 is with mitigatory social distancing.

 

[Vanadium 50]

@mfb, there may be something of value in that paper, but the authors sure don't make it easy to find, especially if to interpret it you have to assume that the plot labeling is wrong.

 

[kadiot]

@mfb, there may be something of value in that paper, but the authors sure don't ,make it easy to find, especially if to interpret it you have to assume that the plot labeling is wrong.

Sorry I am not as smart as you. Don't worry I will refrain from posting here. Thank you everyone.

 

[russ_watters]

On one side we have millions of deaths plus some unclear but still huge economic damage.
On the other side we have ... millions of additional people needing social security for a while? Yeah, we won't have a good estimate for how many and for how long. But it's a really easy decision.

You're vastly underestimating the "known" and totally ignoring the "unknown"/potential impact (and left the potential death toll very vague), but sure, if we use that characterization it makes the decision easy.

The "known" part is that the GDP loss in those two months(we hope) is money you can't get back. People are treating it like a "fake recession" because they think you can just shut the economy off and turn it on again like nothing happened. But it doesn't work that way. The economy isn't like a dimmer switch. You can't just turn it down 30% for two months and then back up at the end and everything goes back to normal. We don't get back the money we lost.

After the US government goes several extra trillions of dollars in debt at a time when we already have high debt (and the rest of the world several tens of trillions), then we'll have to deal with that situation. Some businesses will be permanently closed, many people won't get their jobs back, and millions (billions?) will wake up that morning with 2-months worth of overdue rent/mortgage payments and electric bills. Maybe we'll have another foreclosure/mortgage crisis like 2008 and banks will start collapsing. Maybe the debt will force austerity measures and cause economic stagnation and high inflation for a decade like in the 1970s. Maybe the bankruptcy of social security will be moved up a few years and it'll combine that into a long-duration depression like the 1930s. These are the "unknown" risks.

There's a wide range of what could potentially happen when we turn the dimmer back up, but 'nothing' is certainly not a possibility.

Now, sure, maybe it's still worth it to make that decision, but I don't agree with others who say the propaganda value in scaring everyone with unrealistic death predictions while ignoring the economic impact is a good thing. We'll just have to wait and see if 6 months from now we have buyer's remorse.

So easy that it's made everywhere.

Well that isn't true. The containment efforts have been very uneven. Here's what a Swedish immunologist has to say about the lack of a lockdown there: "The government thinks they can’t stop it, so they’ve decided to let people die."
https://metro.co.uk/2020/04/02/sweden-not-lockdown-12497681/?ito=cbshare

The earlier that decision is made the smaller the impact of it.It's a decrease in Summer 2019. There is no 2020 data on that website.

Oops!

 

[atyy]

Now, sure, maybe it's still worth it to make that decision, but I don't agree with others who say the propaganda value in scaring everyone with unrealistic death predictions while ignoring the economic impact is a good thing.

No sensible person is saying such a thing. As far as I understand most countries are acting with the economy in mind, they are trying to save the economy. You may disagree with the calculations, but there is no intention to scare with unrealistic death predictions, and there is every intention to act for the best economic outcome.

 

[vela]

I'm not sure what these numbers are supposed to be. Clearly not the total number of infections, as that can't drop at the day a lockdown starts.

I think it is the number of infections. Their model appears to assume the effect of a lockdown kicks in in less than a day, anyone who is infected is symptomatic, individuals who know they're infected reduce contacts with others, and those contacts are only within households.

 

[anorlunda]

What happens to government revenue during this period of lockdown? We can pass stimulus bills distributing trillions of dollars, but when it comes time for government to pay the bill where will the money come from? Income tax and sales tax revenues (and VAT in Europe) during this crisis must be dramatically reduced.

If they just print more money, that would trigger inflation.

When the mortgage loan forbearance period is over, the lenders have the right to demand all back payments be caught up in one lump payment. Few have that money, so what happens then? I'm not sure how it works with student loan forbearance.

My point is that this is not just a financial crisis for business and workers, it is a crisis for government also.

 

[OmCheeto]

...
When the mortgage loan forbearance period is over, the lenders have the right to demand all back payments be caught up in one lump payment. Few have that money, so what happens then?
...

Although I don't remember taking advantage of it, I seem to recall that credit card, mortgage, and auto-loan companies I dealt with offered payment "holidays". Basically, they offered to let me skip an entire months payment, charge me only interest, and I would have ended up paying very little "noticeable" extra in the future.

I'm guessing that's how it "should" work. Also guessing that "mean spirited" mortgage companies you are describing might lose a lot of business to their competition.

 

[Vanadium 50]

"mean spirited" mortgage companies

That would be me. And probably you. And anyone else who has money in the bank. If you're a saver, you are loaning to borrowers. The bank is just an intermediary.

If "furloughed Joe" can't make his mortgage, it comes out of "sweet old Granny's" savings.

 

[russ_watters]

No sensible person is saying such a thing.

I don't know what a "sensible person" is, but we had considerable discussion a few weeks ago about the Imperial College report that predicted 2.4 million deaths in the US (.5M in the UK) if no containment efforts were undertaken. The predicted outcome was never a realistic possibility, but nevertheless the report is credited with having a significant impact on policy:
https://www.cnn.com/2020/03/17/health/coronavirus-uk-model-study/index.html

Still today, people are saying it's an "easy decision". I'm not saying it's the wrong decision, I'm just saying it is wrong to base a decision on bad information, and either way it shouldn't be an "easy decision".

As far as I understand most countries are acting with the economy in mind, they are trying to save the economy. You may disagree with the calculations, but there is no intention to scare with unrealistic death predictions, and there is every intention to act for the best economic outcome.

They are taking reactive actions to limit economic damage, yes, but I haven't seen any actual predictions of what that damage may or could be*. No equivalent of the 2.4 million deaths, for the economic impact.

*Other than the normal periodic prediction/reporting of economic data; last weeks unemployment numbers, for example, which were badly underestimated.