COVID COVID-19 Coronavirus Containment Efforts

[anorlunda]

At a press conference held over Zoom, Nigel Goldenfeld, a physics professor who contributed to the school's reopening plan, said the campus's models had already anticipated parties and people not wearing masks — but they did not take into account that students would fail to isolate,

It sounds like they underestimated the stupidity of a small number of students.

To me it seems obvious. It was not because they were students, it was because they were drunk. The modelers didn't model intoxicated people.

The whole purpose of social drinking is to lower inhibitions. That leads to loud voices, no masks, and no social distancing. The government action that could have a positive effect would be a ban on public consumption of alcohol, in bars, on beaches, in parties, and all other settings. Not total prohibition, but a more restrictive ban.

If that didn't work, then a ban on parties of any size, public gatherings, or total prohibition would be the next more drastic step.

 

[Astronuc]

Out of 6500 students, do I see that right? Almost 10% got it?

About 500 students out of 6500, or about 7.7% of the students.

SUNY had elaborate plans for 64 campuses. https://www.suny.edu/campus-reopening/
That affects a little over 400,000 students, based on enrollment last autumn. https://www.suny.edu/about/fast-facts/

Each campus has their own plan.
SUNY New Paltz reports on 6 active cases and 1 recovered. https://www.newpaltz.edu/coronavirus-info/
The student population is 6807 undergraduates and 950 graduate students; faculty 344 full-time and 323 part-time. https://www.newpaltz.edu/about/glance.html

I don't know what testing is done before students arrive, and it's possible that testing and other precautions vary among the 64 campuses.

Pre-kindergarden, Kindergarden and grades 1-12 are supposed to start next week. Some learning will be done online, but I'm not sure how uniform that will be across the system.
http://www.nysed.gov/coronavirus/guidance-p-12-schools

 

[brainpushups]

Another relevant XKCD:

 

[vela]

To me it seems obvious. It was not because they were students, it was because they were drunk. The modelers didn't model intoxicated people.

That doesn't explain students who hosted, not just attended, parties when they knew they had tested positive.

 

[russ_watters]

That doesn't explain students who hosted, not just attended, parties when they knew they had tested positive.

I feel fine tho

 

[Vanadium 50]

SUNY Oneonta

I looked a bit at the student demographics. It's 99% in-state, and it's about a 50-50 mix of suburban New York (particularly Long Island), which has one of the highest infection rates, and upstate, which has one of the lowest. It also has a reputation as a party school.

The putative point of a quarantine is to separate the infectuous from the uninfected. Well, it used to anyway. This plan is to bring people from across the state, mix the infectuous with the uninfected for a few weeks, and then send everyone back into their communities.

 

[atyy]

I looked a bit at the student demographics. It's 99% in-state, and it's about a 50-50 mix of suburban New York (particularly Long Island), which has one of the highest infection rates, and upstate, which has one of the lowest. It also has a reputation as a party school.

The putative point of a quarantine is to separate the infectuous from the uninfected. Well, it used to anyway. This plan is to bring people from across the state, mix the infectuous with the uninfected for a few weeks, and then send everyone back into their communities.

Mind boggling.

It might be they only intended to allow those who have tested negative to leave campus.
https://abc7ny.com/suny-oneonta-college-covid-on-campus-reopen-new-york/6405321/
"Students who have tested negative for COVID-19 are being asked to sign up for a move-out time from Sept. 4 to Sept. 7."

https://www.nytimes.com/2020/09/03/nyregion/new-york-suny-oneonta-coronavirus.html
"Although SUNY Oneonta’s recent policy does not allow students to leave for home without the approval of the county health department, Ms. Dimonda said that her parents were able to pick her up on Monday, the day she was put in quarantine. She said she was now “stuck in my room” on Long Island."

 

[Ygggdrasil]

I looked a bit at the student demographics. It's 99% in-state, and it's about a 50-50 mix of suburban New York (particularly Long Island), which has one of the highest infection rates, and upstate, which has one of the lowest. It also has a reputation as a party school.

The putative point of a quarantine is to separate the infectuous from the uninfected. Well, it used to anyway. This plan is to bring people from across the state, mix the infectuous with the uninfected for a few weeks, and then send everyone back into their communities.

While downstate New York has had many more total Coronavirus cases, recently, the virus has been spreading slightly faster in upstate New York than downstate New York:

Apr 27, 2020 — Governor Andrew Cuomo offered some mixed news for Upstate New York in his daily briefing Sunday.

On one hand, he said state data found the rate of COVID-19 infection is now slightly higher in Upstate New York than in the New York City metro area. "Upstate the infection rate is one person infects .9. Downstate one person is infecting .75."

https://www.northcountrypublicradio...bove-downstate-but-reopening-could-start-here

Data from the NY Times also suggests the average daily new cases per capita in the past week is similar between upstate and downstate counties:

https://www.nytimes.com/interactive/2020/us/new-york-coronavirus-cases.html

Note that the county with the highest rate of new infections (the bright orange spot in the middle of the state) is Otsego County, home of SUNY Oneonta.

I wonder whether the combination of colder fall weather plus the mixing of people as college students get sent to campus and then sent back home will drive another wave of spread in the coming months.

 

[Vanadium 50]

, the virus has been spreading slightly faster in upstate New York than downstate New York

And if they keep mixing people from Long Island and upstate, it will spread even faster!

 

[russ_watters]

That's all fun, but note that the positivity rate hasn't been above 1% in New York State since the first week in June.

 

[Astronuc]

That's all fun, but note that the positivity rate hasn't been above 1% in New York State since the first week in June.

While true, Long Island is currently about 1.1% and Western NY is about 2% according to the state website - https://forward.ny.gov/percentage-positive-results-region-dashboard.

I just found that Otsego County is in the Mohawk region. The region has a positivity rate of 0.9%. Otsego county has a positivity rate of 3.8%.
https://forward.ny.gov/percentage-positive-results-county-dashboard

In Western NY, the positivity rate is 2%, and Erie County has a positivity rate of 2.7%

SUNY Oneonta now reports 597 positive cases in students, up from 507 cases a few days ago.

https://suny.oneonta.edu/covid-19
https://t.e2ma.net/message/1s2udc/96qt6se

Back on August 25, the president of the college wrote, "Today the college learned that two SUNY Oneonta students have tested positive for COVID-19. These are the first confirmed cases of COVID-19 since April, when three employees tested positive." My bold for emphasis. The message goes on to indicate, "Both of the affected students live off campus."
https://t.e2ma.net/message/de7tcc/96qt6se

The next day, August 26, five more positive cases were reported, and on August 27, six new cases. On August 28, sixteen new positive cases were reported for a total of 29 at that point.

On September 1, 68 new cases were reported for a cumulative total of confirmed cases within the campus community of 245!SUNY University of Buffalo, with 21,607undergrad, reports 93 positive cases since August 21.
https://www.buffalo.edu/coronavirus/health-and-safety/covid-19-dashboard.html

Binghampton University, with 14,021 undergrad and ~3900 graduate students, has only 1 positive case, so far. https://www.binghamton.edu/restarting-binghamton/covid-19-dashboard.html

 

[Astronuc]

SUNY Oneonta confirmed 54 additional cases of COVID-19 today. A total of 651 students and 0 employees have tested positive since the start of the fall semester. Currently, 139 students are isolating on campus and 43 students are in quarantine on campus awaiting test results.
https://t.e2ma.net/message/xlaxdc/96qt6se

How not to reopen a school. All positive cases are students, and no faculty and staff. Students were informed about avoiding large gatherings, wearing masks and social distancing, but evidently many chose to ignore the warnings. Large gatherings happened off-campus.

 

[Ygggdrasil]

The spread of Coronavirus on college campuses seems to be a factor driving infection rates up across the country:

https://www.nytimes.com/2020/09/06/us/colleges-coronavirus-students.html

I hope that infections within the colleges don't spread to the surrounding communities (or to students' home communities if they are sent back home for remote learning).

 

[gmax137]

Is this not just because the schools are requiring all the students to be tested?

It seemed that students were testing positive in the first few days of arriving on campus - those positives were positive before they got to school, right? How many days after infection before you will test positive? I thought earlier this year they were talking about a week.

I agree the close-contact partying is a very bad idea, but I wonder how many of these "new cases" are really previously unidentified asymptomatic cases.

 

[Vanadium 50]

I agree the close-contact partying is a very bad idea, but I wonder how many of these "new cases" are really previously unidentified asymptomatic cases.

A few days in, the language changed from "cases" to "positive tests".

What we know is that the number of hospitalizations in that county is zero. For that age group, the fatality rate is two orders of magnitude down and the hospitalization rate is down an order of magnitude from the average (which is dominated by the elderly) so you wouldn't expect college students to be visible in the hospitalization statistics. It's hard to make an estimate based on small numbers, but somewhere between 0.015 and 0.06 hospitalizations is what you'd expect if every student were infected.

Certainly symptoms in this age group are milder. "Asymptomatic" is no longer a thing: who hasn't felt tired in the last 14 days? Or coughed at least once in the last 14 days? How much milder? Hard to say.

 

[Vanadium 50]

A total of 651 students and 0 employees have tested positive since the start of the fall semester. Currently, 139 students are isolating on campus and 43 students are in quarantine on campus awaiting test results.

Hmmm... 651 - 139 = 512. So the plan is sending 79% of those infected back into their communities?

 

[Astronuc]

Hmmm... 651 - 139 = 512. So the plan is sending 79% of those infected back into their communities?

I've been wondering the same thing, about the low numbers in isolation and quarantine, which have have been less than the number of cases. I don't quite understand what SUNY Oneonta is doing with respect to remote learning and sending students home.

Meanwhile, in Chapel Hill, NC, businesses are seeing much less patronage from students.
https://news.yahoo.com/its-been-pai...vid-19-s-toll-on-college-towns-144103867.html

 

[Ygggdrasil]

Hmmm... 651 - 139 = 512. So the plan is sending 79% of those infected back into their communities?

I've been wondering the same thing, about the low numbers in isolation and quarantine, which have have been less than the number of cases. I don't quite understand what SUNY Oneonta is doing with respect to remote learning and sending students home.

My guess is the difference between students living on campus vs off campus. The school can enforce quarantine/isolation for students living on campus (or may have even setup dedicated facilities for quarantine) but can't control what students do if they live off campus.

 

[Vanadium 50]

My guess is the difference between students living on campus vs off campus.

60% of students live on-campus.

but can't control what students do if they live off campus.

That's the whole problem. The parties were off-campus. One might argue that the policyes (" guests are not allowed in the residence halls for Fall 2020. Students may visit family members and friends off campus. ") encouraged this.

 

[mfb]

The spread of Coronavirus on college campuses seems to be a factor driving infection rates up across the country:

I expect that colleges are a big factor in this difference but it doesn't have to be the only one. Counties with large colleges differ from the rest in more than just the college. And, as mentioned, testing many students means more cases are found that might be missed elsewhere.

What we know is that the number of hospitalizations in that county is zero. The fatality rate is two orders of magnitude down and the hospitalization rate is down an order of magnitude from the average (which is dominated by the elderly) so you wouldn't expect college students to be visible in the hospitalization statistics. It's hard to make an estimate based on small numbers, but somewhere between 0.015 and 0.06 hospitalizations is what you'd expect if every student were infected.

0.015 to 0.06 hospitalizations from hypothetical ~6000 infected students? Where do you get a 10^-5 (or lower) hospitalization rate from?
CDC counts 16,000 hospitalizations in the 18-49 age range and 500 in the 5-17 age range. Both are way higher than 10^-5.

Hmmm... 651 - 139 = 512. So the plan is sending 79% of those infected back into their communities?

Stay at home, just like basically everyone does who doesn't need to go to a hospital?

 

[Vanadium 50]

CDC counts 16,000 hospitalizations in the 18-49 age range

OK, let's use those numbers and see where that takes us. That's out of 2.5M cases. Of course, the numbers will be different for 18-24 than 18-49, but using 18-49, that gets us to 38. There's a factor between 10 and 20 in fatalities on the high and low ends of the age group in question, so that takes us to 2-4 cases. More than I estimated (I started with fatalities and worked out - hence my comment on small numbers) but it doesn't change my conclusion. You don't expect a college outbreak to show up in hospitalizations the way you would at say a senior center.

Or if you like, you can't count college infections by looking at the closest hospital.

 

[russ_watters]

The spread of Coronavirus on college campuses seems to be a factor driving infection rates up across the country.

Er:
1. Infection rates continue to drop across the country, since a peak in mid-July.
2. This discussion has focused on New York, but again, their rates haven't budged either.
3. Your graph doesn't necessarily support an increase either. For the last two weeks the infection rates have gone up in "college towns" more than they have gone down elsewhere, but without comparing similar town sizes, the numbers don't tell us if the overall infection rate is going up or down (See #1: it is still going down). The likely issue? College towns can have more students than permanent residents, so the demographics change completely on the first and last day of school. And of course there are more non college towns than college towns.

To me this just says that college kids are more newsworthy but not necessarily more dangerous at college campuses than at home; The news is creating a false perception of a new danger.

 

[russ_watters]

I agree the close-contact partying is a very bad idea...

What we know is that the number of hospitalizations in that county is zero. For that age group, the fatality rate is two orders of magnitude down and the hospitalization rate is down an order of magnitude from the average (which is dominated by the elderly) so you wouldn't expect college students to be visible in the hospitalization statistics. It's hard to make an estimate based on small numbers, but somewhere between 0.015 and 0.06 hospitalizations is what you'd expect if every student were infected.

Certainly symptoms in this age group are milder. "Asymptomatic" is no longer a thing: who hasn't felt tired in the last 14 days? Or coughed at least once in the last 14 days? How much milder? Hard to say.

So is close-contact partying really a bad idea? If you take a very large group of invulnerable idiots and sequester them together where they all get infected and then recover, is that really a loss or is it a win? Quarantined in a college dorm, they can't infect/kill their parents or grandparents like they could if they were living at home. The vast disparity in death rate tells me perhaps we're better off eliminating the risk the kids pose to the rest of the population.

 

[mfb]

I still don't understand how you get your numbers (hospitalizations don't increase that rapidly with age compared to deaths) but I agree with the conclusion:

Or if you like, you can't count college infections by looking at the closest hospital.

 

[gmax137]

So is close-contact partying really a bad idea? If you take a very large group of invulnerable idiots and sequester them together where they all get infected and then recover, is that really a loss or is it a win? Quarantined in a college dorm, they can't infect/kill their parents or grandparents like they could if they were living at home. The vast disparity in death rate tells me perhaps we're better off eliminating the risk the kids pose to the rest of the population.

If the students all stay at school and infect only each other, the yeah OK maybe that's not so bad.

I thought the problem was, the students are hauling ass home. Who can blame them? With classes canceled or made remote-only, and the news suggesting all your classmates are infected, and no more parties, who wouldn't leave?

And without the disparity in severity, the idea of keeping them all together is no different then the "we're all going to catch it, so let's get it over with fast" idea that was roundly criticized way back in February / March. If you happen to be one of the unlucky 20-year olds that dies from it, "tough luck"?

 

[Vanadium 50]

f the students all stay at school and infect only each other, the yeah OK maybe that's not so bad.

One could make that argument (the fatality rate of 18-24's is very low, well below murders), but they also have to not infect the faculty and staff. Would you trust the administration of SUNY Oneonta to get that right? Given their track record, I sure wouldn't.

 

[Astronuc]

Daniels, the director of sports cardiology at Ohio State, had also been busy, working to publish a three-month study whose preliminary findings were presented to Pac-12 and Big Ten leaders before they shut down football earlier this month. Daniels said that cardiac M.R.I.s, an expensive and sparingly used tool, revealed an alarmingly high rate of myocarditis — heart inflammation that can lead to cardiac arrest with exertion — among college athletes who had recovered from the coronavirus.

The survey found myocarditis in close to 15 percent of athletes who had the virus, almost all of whom experienced mild or no symptoms, Daniels added, perhaps shedding more light on the uncertainties about the short- and long-term effects the virus may have on athletes.

But as Daniels’s survey awaits the rigors of peer review, it has received scant attention, in part because Ohio State has refused to make public any testing data about its athletes — who make up the bulk of the study — other than to announce last month that it had shut down workouts because of positive virus tests.

https://www.nytimes.com/2020/08/23/sports/ncaafootball/college-football-myocarditis-coronavirus.html

Myocarditis is an inflammation of the heart muscle (myocardium). Myocarditis can affect your heart muscle and your heart's electrical system, reducing your heart's ability to pump and causing rapid or abnormal heart rhythms (arrhythmias).
https://www.mayoclinic.org/diseases-conditions/myocarditis/symptoms-causes/syc-20352539
Severe myocarditis weakens your heart so that the rest of your body doesn't get enough blood. Clots can form in your heart, leading to a stroke or heart attack.

Acute myocarditis is a known (I don't know about well-known) consequence of influenza infection.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533457/

So students with a Covid-19 infection are at risk of myocarditis and hear damage.

 

[jack action]

And without the disparity in severity, the idea of keeping them all together is no different then the "we're all going to catch it, so let's get it over with fast" idea that was roundly criticized way back in February / March. If you happen to be one of the unlucky 20-year olds that dies from it, "tough luck"?

I don't see why this argument is so important with COVID. Before COVID, nobody cared about catching the flu and spreading it to other people who might died of it. Most people didn't die of it; people who had more chance of having complications, protected themselves better; and the risk analysis was left to every individual ("Do I want to protect myself or not? And how far am I willing to go?"). When someone died, everybody said "tough luck", and nobody thought other sick people were responsible for spreading the disease.

Pathogens are here to stay. We have immune systems to protect ourselves, but some will loose the battle once in a while, no matter how hard we fight (especially when we haven't a clue about what we're doing).

What is so different about COVID? We cannot reinvent life by blaming individuals who just make the best decisions they can based on the information they got. Just like they were doing with the flu.

 

[russ_watters]

I don't see why this argument is so important with COVID. Before COVID, nobody cared about catching the flu and spreading it to other people who might died of it. Most people didn't die of it; people who had more chance of having complications, protected themselves better; and the risk analysis was left to every individual ("Do I want to protect myself or not? And how far am I willing to go?"). When someone died, everybody said "tough luck", and nobody thought other sick people were responsible for spreading the disease.

Pathogens are here to stay. We have immune systems to protect ourselves, but some will loose the battle once in a while, no matter how hard we fight (especially when we haven't a clue about what we're doing).

What is so different about COVID? We cannot reinvent life by blaming individuals who just make the best decisions they can based on the information they got. Just like they were doing with the flu.

Pointing out the disparity in attitude is valid, but there is a reason for it: it's more contagious, the fatality rate is much higher and the old-young disparity much larger. So there is a much greater opportunity for the bad decision of one person to affect an [a hundred] other(s). "We" made a decision that a threshold was crossed that makes COVID "different"/worse.

And I do grumble if a coworker comes into work sick, and I have seen them occasionally sent home. Those attitudes vary by office/profession, but in pharma, people tend to take "don't come into work sick" somewhat seriously.

 

[Vanadium 50]

What is so different about COVID?

I see three:

1. It is, as Russ said, both more contagious and more deadly than seasonal flu
2. When it first appeared, it was thought to be much, much more ontagious and deadly than it is. Tens of millions of deaths were forecast.
3. The decision-makers are less impacted by their decisions than their subjects.

 

[Astronuc]

Before COVID, nobody cared about catching the flu and spreading it to other people who might died of it.

I disagree. When I had the flu, I didn't report to work, as I knew not to do so, but rather I went to an urgent care clinic (I called Monday morning for an appointment). When I entered the clinic, I immediately donned a face mask, since I was coughing. The doctor determined I had the flu, and I was prescribed Tamiflu and a cough suppressant, and I was told not to report to work for 4 days. I then informed my management that I had the flu and would not appear at work for 4 days. When I went to collect my prescription for Tamiflu, I work a face mask and maintained distance from other people so as not to infect others.

My employer is adamant about people not coming to work if they have any communicable disease, and they expect to be informed. With respect to COVID-19, we are required to file a report each day, prefarably each morning, concerning whether or not we have symptoms of, or positive test for, a COVID-19 infection, may have been exposed, or have a family member or close contact who has tested positive or is awaiting a test for COVID-19. One can only appear at the worksite if one is negative with respect to symptoms or potential exposure. If one were found to be positive for COVID-19 and came to work anyway, one would be subject to disciplinary actions including up to termination.

My employer strongly encourages all staff to get influenza vaccines every year during October. It's voluntary, but a majority of the staff get the vaccine.

 

[jack action]

So there is a much greater opportunity for the bad decision of one person to affect an [a hundred] other(s).

What bad decision are you referring to? [SARCASM]People losing their jobs, businesses closing, people anxiety increasing (even committing suicide) or kids education thrown in the garbage?[/SARCASM]

They're always two sides to any decision, otherwise the choice would be obvious. And with such decisions, the odds are not the same for everyone. An older, sick, person will probably favor high protection. A young, local small business owner might be more afraid of losing his livelihood. I don't think there is a right answer that is mutual to everyone.

"We" made a decision that a threshold was crossed that makes COVID "different"/worse.

But if someone points out that COVID is not so bad, that there are not that many deaths or that mostly people already close to death are dying, you are immediately offered with the "all lives are important" response. I'm not arguing with the answer, I'm just wondering why "all lives" did not have that importance with the flu.

And I do grumble if a coworker comes into work sick, and I have seen them occasionally sent home.

This is a good example. If your boss see someone sick coming in and decide that this person shouldn't work to protect the others, good for everyone. But what if your boss doesn't care and you don't either? Well, also good. But what if your boss doesn't care and you do? Then, it is up to you to make a decision. Do you take the risk or do you get away from what you consider a dangerous environment?

The best example are survivalists. They don't agree with what the average Joe does to protect himself and they do a lot more for themselves, often because they think the average Joe doesn't do enough in general. Wouldn't it be terrible if they dictate laws to force everyone going their way?

Everybody would like to have everybody else think exactly like them, but you have to adapt to others. (It's maybe even you who might be wrong.)

I disagree. When I had the flu, I didn't report to work,

So you cared when you had the flu. But did you care when you didn't have it? Were you wearing a mask, washing your hands before entering any store and keep a 6 ft distance during all flu season, just in case you could catch it and contribute to its spreading to people with a weak immune system?

 

[OmCheeto]

...
But if someone points out that COVID is not so bad, that there are not that many deaths or that mostly people already close to death are dying, you are immediately offered with the "all lives are important" response. I'm not arguing with the answer, I'm just wondering why "all lives" did not have that importance with the flu.
...

According to the CDC, an average of 38,000 people died of the flu each year over the last 8 flu seasons.
From my best estimate, if everyone were to catch Covid, 1.6 million people would die, in the US alone. That's the equivalent of 42 flu seasons. That seems kind of significant to me.

 

[jack action]

According to the CDC, an average of 38,000 people died of the flu each year over the last 8 flu seasons.
From my best estimate, if everyone were to catch Covid, 1.6 million people would die, in the US alone. That's the equivalent of 42 flu seasons. That seems kind of significant to me.

The point is not that 1.6 million is a small number (although it is an estimate, not reality). The point is: Shouldn't we have done all we could do to save those 304 000 people those last 8 flu seasons? (Wearing masks, washing hands, social distancing)

At what level of death/suffering are we deciding "Enough! No more people die! No matter the economic and social costs." An who decides? @russ_watters mentioned "We". I probably missed that meeting ...

 

[vela]

What is so different about COVID?

In addition to what the others have pointed out, the long-term effects of COVID-19 aren't known yet. Victims are reporting suffering from issues months after they supposedly recovered.

 

[Ygggdrasil]

Here's a good figure illustrating the differences in mortality from influenza versus COVID-19, examining death data from England:

Figure source
Data source

 

[vela]

Shouldn't we have done all we could do to save those 304 000 people those last 8 flu seasons? (Wearing masks, washing hands, social distancing)

Yes. That's the reason why the CDC, doctors, and other public health experts for years have implored people to get vaccinated, to stay home and isolate themselves when they have the flu, to wash their hands regularly, etc.

 

[jack action]

Here's a good figure illustrating the differences in mortality from influenza versus COVID-19, examining death data from England:
View attachment 269110
Figure source
Data source

Once again, I do not care about the numbers. COVID numbers are higher than flu numbers. Nobody's arguing. (at least in this discussion)

The real question is about the criteria where we say: "Cannot trust people anymore to do the right thing" [whatever that might be] "We will tell them what to do." If people that are responsible enough to not go to work when they got the flu, why wouldn't they react responsibly when faced with an even deadlier diseases? Where does this lack of trust comes from?

I can't imagine someone going about his business everyday like nothing is happening, while people are getting sick and dying around him.

 

[vela]

And without the disparity in severity, the idea of keeping them all together is no different then the "we're all going to catch it, so let's get it over with fast" idea that was roundly criticized way back in February / March.

It's the same argument some anti-vax parents make about "harmless" childhood diseases like chickenpox.

 

[jack action]

Yes. That's the reason why the CDC, doctors, and other public health experts for years have implored people to get vaccinated, to stay home and isolate themselves when they have the flu, to wash their hands regularly, etc.

But it has never been a law. No businesses were closed for lack of taking measures or individual issued a ticket or quarantined. Why were we trusting people? Didn't we care about the flu victims as much as we care about the COVID victims? How many deaths does it takes to put the economics and social relationships in jeopardy?

 

[vela]

I would guess it's because the flu has been around for a really long time, and many people just think of it as a fact of life. Just look at the resistance to wearing a mask when out in public. I can already imagine the tremendous backlash from some quarters if the government tried to enact measures to slow the spread of the flu.

 

[Astronuc]

So you cared when you had the flu. But did you care when you didn't have it? Were you wearing a mask, washing your hands before entering any store and keep a 6 ft distance during all flu season, just in case you could catch it and contribute to its spreading to people with a weak immune system?

I had the flu the one year (of the last 6 years) when I missed (and didn't get) the vaccine, otherwise, I get the flu vaccine.

I did not usually wear a mask in public, but if I had/have a cold, I generally did/do not go out in public, or I would probably wear a mask if I had to, or otherwise keep a distance from folks, e.g., going to a store at night when there are few people present. I generally avoid crowded places, since I don't like crowds, and I don't like noise.

Certainly at work, I would keep a distance and let folks know if I had a cold (and frequently wash my hands), or otherwise work from home. On the other hand, I don't remember having a cold during the last 6 years, although I did have a cold when I interviewed for the job, and I made sure folks knew to keep a distance.

At work, we started social distancing in February as a precaution. When the state mandated closures of businesses, my employer mandated teleworking, with few exceptions. Anyone coming to the office needed approval, had to wear a face mask, maintain distance, and use hand sanitizer. Restrictions have been relaxed, but most of the staff telework or visit the office as needed. There are restrictions on gatherings/meetings, which must be planned and approved in order to avoid folks getting too close. The office complex has a positivity rate of 2.4% for staff from a two county area that has10-12% positivity (seven day rolling average) in the last three weeks. Testing is done on a limited basis.

 

[Ygggdrasil]

But it has never been a law. No businesses were closed for lack of taking measures or individual issued a ticket or quarantined. Why were we trusting people? Didn't we care about the flu victims as much as we care about the COVID victims? How many deaths does it takes to put the economics and social relationships in jeopardy?

Historically, quarantine and social distancing measures were enforced to combat previous epidemics and pandemics from the black death plague (the word quarantine derives from the Italian word for fourty days, the time period ships were required to isolate before being allowed to enter Venetian ports) to influenza epidemics (e.g. 1918 pandemic influenza). This situation changed, however, in modern times with the introduction of vaccines and antiviral treatments to stem the spread of infections and better treat new infections. In the absence of a vaccine or effective treatments for the COVID-19, we have to go back to the old methods of social distancing to contain the spread of the disease.

 

[mfb]

Once again, I do not care about the numbers.

If you don't care about numbers you cannot make informed decisions. A disease that kills one person every year warrants a different reaction than a disease that kills thousands every day.

 

[256bits]

Historically, quarantine and social distancing measures were enforced to combat previous epidemics and pandemics from the black death plague (the word quarantine derives from the Italian word for fourty days, the time period ships were required to isolate before being allowed to enter Venetian ports) to influenza epidemics (e.g. 1918 pandemic influenza). This situation changed, however, in modern times with the introduction of vaccines and antiviral treatments to stem the spread of infections and better treat new infections. In the absence of a vaccine or effective treatments for the COVID-19, we have to go back to the old methods of social distancing to contain the spread of the disease.

Does it work?
120 year old system.
We should have by now at least have some better idea of how viral diseases are spread, but apparently do not.

 

[gmax137]

A disease that kills one person every year warrants a different reaction than a disease that kills thousands every day.

Yes, of course. But I think @jack action was probing for the dividing line. 100,000 per year? 10,000 per year? It seems to be somewhere in that range, if the 30,000 per year from flu is considered "business as usual."

 

[jack action]

If you don't care about numbers you cannot make informed decisions. A disease that kills one person every year warrants a different reaction than a disease that kills thousands every day.

Let's talk numbers then.

Fact #1:

For COVID-19, data to date suggest that 80% of infections are mild or asymptomatic, 15% are severe infection, requiring oxygen and 5% are critical infections, requiring ventilation.

80% are mild or asymptomatic? Not a really high number, bu not a low number either.

Fact #2:

As of mid-April 2020, nearly half of the COVID-19 deaths in Canada were at long-term care facilities.

So, obviously, older people are more at risk, presumably due to a weaker immune system.

Fact #3:

The Quebec figure jibes with a British study that found a two-year length of stay in nursing homes

Strengthening the previous fact, half of the people who died of COVID would have died within a two-year period without COVID.

These are cold numbers. The difference between those numbers and the ones for the flu is actually only affecting the first one. Although I don't have a value, I know that the mild/asymptomatic cases are much much higher for the flu than for COVID. But - without having numbers to back this up - the severe cases are probably spread to people with weak immune systems in a similar ratio.

Facts from my personal experience

Now to my own personal experience. I don't have COVID. I don't know anyone with COVID. I don't know anyone who knows someone with COVID. When I read the obituaries, there is not an unusual high number of people listed. There doesn't seem to be a particularly large amount of people in the local hospital either. For me, COVID is on TV only. Not denying it's out there, I just don't see any threat around me. That's a fact. For me, this is exactly the same experience as with the flu. Actually, I've seen people with the flu (but nobody dying of it, though).

Reading the numbers I previously wrote, most people will react by saying that I'm an horrible person who doesn't care about people who have a life expectancy of 2 years. If I don't wear a mask of wash my hands, it's basically equivalent of me being responsible for their death. Even if I don't have the disease, even if I don't know anyone who has it.

Even as I'm writing these lines, the Prime Minister is on TV, saying that, starting today, "irresponsible people" [his actual words] who don't wear their mask will be fined, because the curve is going upward again since schools reopened. I'm not sure how he arrived at this conclusion, but apparently the curve going upward when people began to regroup again is only due to the people not respecting the social distancing protocol.

[RANT]One could say that if people get sick, it is their own fault for not protecting themselves well enough. But, apparently. if someone followed the protocol and still gets sick, that is not his or her fault ... but the fault of the ones who didn't follow protocol. A weird reasoning coming from people who are always looking for someone to blame. Of course, never themselves.[/RANT]

Comparison to the flu

But last year, and the years before, there was the flu. Old people were dying of it. Nobody made me feel responsible for their deaths. There were fewer of them, so what? Is there a number of deaths that makes it OK for me to be irresponsible towards old people?

What was expected with the flu? Well, we expected the old people to protect themselves (or doing it for them). Most of the time, there was a vaccine, so it was a lot easier. But if there wasn't one or if it wasn't too efficient, we asked them to be more careful: Stay home, wash your hands, wear masks. Nothing more than usual was really expected from everybody else. Even for the people at risk, nothing was forced. We informed everyone and trusted their judgment.

With COVID, there is no vaccine, it's easier to catch and deadlier. My instinctive response is to tell people with weak immune systems to stay home, wash your hands and wear masks ... with a little more insistence. There is probably a need to control who goes inside your home as well. If you go outside, a hazmat suit might not be a stupid idea either. The disease is not exclusive to those people: Under these special circumstances, I'm even willing to help financially anyone who simply fear catching the disease. Again: Inform and trust people's judgment. Nobody wants to die or kill others.

But when did healthy and/or fearless people became responsible for spreading a disease, especially if it doesn't affect them? What do we win as a society by isolating healthy people? Don't we need them more than ever to pick up the slack for those who cannot work and for those who need more care?

 

[Ygggdrasil]

Does it work?
120 year old system.
We should have by now at least have some better idea of how viral diseases are spread, but apparently do not.

Yes, there is plenty of evidence that social distancing measures are effective at stopping the spread of communicable diseases (the text below is modified from my previous post in this thread from March):

There is quite a bit of data supporting the effectiveness of instituting social distancing policies on stopping disease spreads from studies of past pandemics/epidemics, such as the 1918 flu pandemic ("This reduction in the clinical attack rate translates to an estimated 260 per 100 000 lives having been saved, and suggests that social distancing interventions could play a major role in mitigating the public health impact of future influenza pandemics") or the 2014 ebola outbreak ("Among all the control measures, we find that social distancing had the most impact on the control of the 2014 Ebola epidemic in Libreria followed by isolation and quarantining").

A study of the 1918 flu pandemic compares the course of the disease in two cities, Philadelphia (which did not ban public gatherings until late in the epidemic) and St Louis which was early to ban public gatherings and institute social distancing:

Lets you believe that this is cherry picking data, here's a chart from a study comparing death rates from the 1918 flu in various cities based on when they began to institute government-enforced (not voluntary) responses such as closing schools or instituting social distancing through bans of large gatherings:

(images taken from: here)

Retrospective looks at data from the 1918 pandemic has also shown that it is important not to end social distancing measures too early. For example, here is data from Denver in 1918 showing a "second wave" of cases after the city ended its social distancing measures too quickly:

https://www.washingtonpost.com/outl...stancing-must-continue-longer-than-we-expect/

Unfortunately, policy makers in many areas of the US did not heed these lessons of the past, and we have seen similar graphs of Coronavirus cases in many states throughout the US.

For further reading here is a nice piece from the Guardian on the topic: https://www.theguardian.com/comment...-pandemic-offer-stark-lessons-coronavirus-now

 

[mfb]

Does it work?
120 year old system.
We should have by now at least have some better idea of how viral diseases are spread, but apparently do not.

Eating bread is a 10,000 year old system. Should we abandon it just because people invented it quite early? Keeping infected - or likely infected - people away from uninfected people is a really useful approach, knowing more how viruses spread didn't change anything about that.

Yes, of course. But I think @jack action was probing for the dividing line. 100,000 per year? 10,000 per year? It seems to be somewhere in that range, if the 30,000 per year from flu is considered "business as usual."

The 30,000 for the flu is a very questionable number, and you can find that being discussed at least twice in the post history. If you assume 30,000 for the flu then you should multiply the confirmed COVID-19 cases by a factor 2-4 as comparison. Because that's the method how you get 30,000 for the flu.

80% are mild or asymptomatic? Not a really high number, bu not a low number either.

Where the opposite to "mild or asymptomatic" is a severe disease requiring oxygen based on your reference. That's a very lenient definition of "mild". It's also ignoring long-term health effects that are not immediately obvious. These can occur in the mild/asymptomatic cases, too.

So, obviously, older people are more at risk, presumably due to a weaker immune system.

Just like for basically every disease, yes.

Now to my own personal experience. I don't have COVID. I don't know anyone with COVID. I don't know anyone who knows someone with COVID. When I read the obituaries, there is not an unusual high number of people listed. There doesn't seem to be a particularly large amount of people in the local hospital either.

Well, congratulations? I do know someone. I know people who know people with COVID. And that despite living in a place with a low case rate, and not seeing many people recently. I don't think obituaries are a useful estimate for the number of people who die, statistics would be better.
How did you count the number of people in your local hospital? Did you ask them? Did you go there?

One could say that if people get sick, it is their own fault for not protecting themselves well enough. But, apparently. if someone followed the protocol and still gets sick, that is not his or her fault ... but the fault of the ones who didn't follow protocol. A weird reasoning coming from people who are always looking for someone to blame. Of course, never themselves.

Masks are mainly preventing the wearer from infecting others, the other direction does offer some protecting but it's not as good. And as you mentioned, many cases show weak to no symptoms. You don't know if you have it. It's probably not very likely, but it is certainly possible.

Nobody made me feel responsible for their deaths.

If you have the flu and think that's the best time to go to crowded places and cough on everyone around you, then we should. If you behave in a way that puts others at a large risk unnecessarily, then yes, I absolutely blame you for your actions.

But when did healthy and/or fearless people became responsible for spreading a disease, especially if it doesn't affect them?

Tell "it doesn't affect them" the tens of thousands of younger people who died from the disease. Go to the long-haulers and tell them "it doesn't affect you! Yeah, you are out of breath from the slightest physical activity months after the disease, but you are not 80 years old so it doesn't affect you!"
What an absurd statement. If you think this cannot harm you, you are wrong.

Is there a number of deaths that makes it OK for me to be irresponsible towards old people?

You can't fix this to a single number, but yes, the risk matters. What was normal in 2019 because the risk to infect someone with a potentially deadly disease was tiny can be irresponsible now because the risk is orders of magnitude higher.

 

[jack action]

Lets you believe that this is cherry picking data, here's a chart from a study comparing death rates from the 1918 flu in various cities based on when they began to institute government-enforced (not voluntary) responses such as closing schools or instituting social distancing through bans of large gatherings:

(images taken from: here)

From the study:

History is not a predictive science. There exist numerous well-documented and vast differences between US society and public health during the 1918 pandemic compared with the present. We acknowledge the inherent difficulties of interpreting data recorded nearly 90 years ago and contending with the gaps, omissions, and errors that may be included in the extant historical record. The associations observed are not perfect; for example, 2 outlier cities (Grand Rapids and St Paul) experienced better outcomes with less than perfect public health responses. Future work by our research team will explore social, political, and ecological determinants, which may further help to explain some of this variation.

Let's also note that the red arrow (that clearly mathematically ignores St Paul and Grand Rapids) is not part of the original image. It was added by this author, who clearly indicates in the text: «(the arrow is my least squares eyeball)».