Fear and Loathing, a Rat Flu Odyssey

[jono]

You’re the one with anxiety and fear.
And stupid and expensive is continuing the shutdown. Thank the lord I’m not in the restaurant business. Those guys are fucked.

Yes they are. And it sucks. But they were fucked either way, the government orders have nothing to do with it. If you can't get enough patrons to operate above the shutdown point you're better off closing the doors. That's one of the sad realities that must be accepted--unless they can come up with a plan that makes people safe (and makes them feel safe).

The first step toward that is pushing through the fear to accept reality. Facing an existential threat is hard. The first stage of grief is denial and it can be a bitch. You gotta get past that before you can take rational actions. It's easier to ignore the problem by minimizing it with distractions and justifying that to yourself by claiming that since it's hopeless anyway there's nothing you can do. But that instinct leads to inaction and delays the necessary steps toward acceptance. Don't waste your life in that state.

This thing has obviously had a big effect on you. Is your wife any safer these days? I hope so. Mine has received a grudging level of support but would rather just not be working right now. She switches often between fear and courage and some kind of stiff upper lip determination. Some days it's all I can do not to go full Core Shot and start a thread called "Brush and floss and Listerine and skip the dentist if you don't want 19." This whole thing sucks. But it's not going to go away by giving up, it's going to require rational decisions and actions. Settle in for a marathon. We'll get through it. Probably.

[CantDog]

Old goat I respect your medical wisdom.

But after the first unknown scare where we didn’t know if this was the next Ebola shutdown made sense
Since then the data indicated that under fifty should not fear and needs to live life and work the economy.

Older and susceptible people need to shelter and mask etc.

This needs to run its course.

Under fifty, a new untested vaccine could easily kill more than the rona

We shall see. But 0.01% for under fifty is like the flu.
Old folks. Shelter in place.

Setting aside that it’s just ageist and ableist, who do you think cares for older adults? It’s not other old folks. What’s your grand proposal to isolate older adults and everyone they contact and magically split the healthcare system into a covid/noncovid system as it ‘runs its course?’

For the millionth time it’s not ‘like the flu’. Maybe that helps you to sleep at night, but when cases spike, you inevitably see younger sick patients. That’s exactly what would happen if it ‘ran its course’.

Youngest person I saw this weekend was in their 20s. If you’re seeing me you aren’t doing well.

[jono]

If we'd actually let medical pros manage the response it never would have gotten past the cruise ships and airports.
We're only here because Trump & Co decided they didn't want to follow beat practices and go their own stupid way.

Is there any other country in the world besides Sweden that actually let the public health department make the decisions on its own? That seems super ironic but I bet the real story turns out to be a very interesting study in human thought. Like, were the medical branch too afraid of overweighting the facts they understood so they over corrected to try to fix the aspects they didn't understand?

As bad as the US response has been I fully expect that without the existence of the Fed reports showing the positive economic effects of social distancing in the 1918 pandemic we would have made Sweden look smart. I guess we still might.

[frorider]

Now, providing there are no new and unexpected cases to marr the country’s 14-day streak of zero fresh instances of Covid-19, scientists say they expect to be able to declare next week that the virus has been eliminated from New Zealand – making it the first country among the OECD group of wealthy nations, and the first country that has recorded more than 100 cases to make such a statement, analysts said

....

[Benny Profane]

Is there any other country in the world besides Sweden that actually let the public health department make the decisions on its own? That seems super ironic but I bet the real story turns out to be a very interesting study in human thought. Like, were the medical branch too afraid of overweighting the facts they understood so they over corrected to try to fix the aspects they didn't understand?

As bad as the US response has been I fully expect that without the existence of the Fed reports showing the positive economic effects of social distancing in the 1918 pandemic we would have made Sweden look smart. I guess we still might.

Don't forget Brazil in all this. My money is on them winning the death total sweepstakes.

[Adolf Allerbush]

....

Did NZ take core shots approach?

[Core Shot]

Just FYI I’m not suggesting back to normal.
Distancing. Sneeze guards. No handshakes.
Every other table or barstool is fine with me.
PPE for close contact barbers etc.

But the fear masks and total shutdown is bullshit

Just my asshole opinion

[Adolf Allerbush]

Just FYI I’m not suggesting back to normal.
Distancing. Sneeze guards. No handshakes.
Every other table or barstool is fine with me.
PPE for close contact barbers etc.

But the fear masks and total shutdown is bullshit

Just my asshole opinion

I'm giving you shit man...and maybe this isn't the appropriate place to do so given our collective circumstances. I'm an asshole tho.

I agree with your post I quoted. I think you're taking a realist view.

[Deebased]

ultra small <8 class sizes for k-6? Think the states will give up the edu gravy train $$?

[jono]

Realists are aware of Japan and the effectiveness of masks. Obviously the right answer is to take the most efficient steps. Denial about the effectiveness of masks is not that.

[Deebased]

Realists are aware of Japan and the effectiveness of masks. Obviously the right answer is to take the most efficient steps. Denial about the effectiveness of masks is not that.

Wasn't there a study showing eye protection was slightly more effective than masks 15 vs 18% if I recall?

I'll look around and add if I find it.

[jono]

I'm gonna go out on a limb and say you won't find what you just said, but bring what you do find.

[Deebased]

Here it is. Memory was slightly off, but still interesting.
https://www.eurekalert.org/multimedia/pub/233365.php

[jono]

From that study the risk difference with vs. without (unadjusted for mask or eye protection quality) was higher for masks than eye protection, though both show helpful effects. Since it's a meta analysis there's no telling what really constitutes eye protection, which is a shame. (ETA: They considered face shields, glasses and goggles, but weighting of these and how often their numbers reflect use along with a mask or not would be good to know. Ironically, they state that better studies are needed while their own study serves to water down better studies with worse ones, but everybody has to eat.)

The study cited in that link is at https://www.thelancet.com/journals/l...142-9/fulltext

Face mask use could result in a large reduction in risk of infection (n=2647; aOR 0·15, 95% CI 0·07 to 0·34, RD −14·3%, −15·9 to −10·7; low certainty), with stronger associations with N95 or similar respirators compared with disposable surgical masks or similar (eg, reusable 12–16-layer cotton masks; pinteraction=0·090; posterior probability >95%, low certainty). Eye protection also was associated with less infection (n=3713; aOR 0·22, 95% CI 0·12 to 0·39, RD −10·6%, 95% CI −12·5 to −7·7; low certainty).

[MultiVerse]

I'm not questioning whether masks and distancing work. I wear a mask the few times I go shopping or if I have to have a worker in our house. (Had the chimney cleaned the other day--the two guys wore masks as did we.) My question is whether or not there's a point where there are enough people exposed for long enough in a closed environment that distancing and masks no longer work. I'm not saying that is true although I suspect it is. My point is not to discourage distancing and masks but to question whether we can rely on them to significantly reduce the risk when people go back to work or whether they give a false sense of security.

IMO the best way to allow people to return to work with relative safety is repeated, aggressive screening, but I doubt people are going to want to have a swab stuck up their nose every week at work.

Yeah, I understood what you meant and I think the answer to the masks in a closed environment where the disease is prevalent is similar to a health care setting. Masks under that scenario are less effective in the general population because the masks aren't fitted and people aren't as trained and disciplined. Nothing short of maximum safety measures is going to provide complete protection from infection in a high risk environment.


However, that's the wrong way to think about mask use because with the general population risk is pooled. In other words, it's not hygiene or social distancing or masks or eye protection or test & trace or climate or dose or innate immunity—it's those things working in combination with one another. None of the precautions people take have to be perfect to work. All we need is some combination of interventions that bring R less than 1.

Allowing the epidemic to get out of control should be thought of as a systems failure, not a mask or whatever failure. Both stay at home orders and a high death toll are an unnecessary self inflicted wound.

[Ottime]

You’re right. Everyone stay home and the federal reserve can print enough money for amazon to deliver us food and essentials. No need to work
Money printer go brrrrrrrrrrrrrrrrrrrrrrrrrrr

You binary bro? Think between the 1s and zeros. Seriously, it is as if you think there is a magic age that viruses don’t work before.

[Ottime]

ultra small <8 class sizes for k-6? Think the states will give up the edu gravy train $$?

How many new portables do we need to make that happen?

[DBdude]

i love beating a dead horse as well as the next man

[old goat]

Yeah, I understood what you meant and I think the answer to the masks in a closed environment where the disease is prevalent is similar to a health care setting. Masks under that scenario are less effective in the general population because the masks aren't fitted and people aren't as trained and disciplined. Nothing short of maximum safety measures is going to provide complete protection from infection in a high risk environment.


However, that's the wrong way to think about mask use because with the general population risk is pooled. In other words, it's not hygiene or social distancing or masks or eye protection or test & trace or climate or dose or innate immunity—it's those things working in combination with one another. None of the precautions people take have to be perfect to work. All we need is some combination of interventions that bring R less than 1.

Allowing the epidemic to get out of control should be thought of as a systems failure, not a mask or whatever failure. Both stay at home orders and a high death toll are an unnecessary self inflicted wound.

Let me say it again--I am not saying don't wear masks and distance as much as possible. I do both. I will continue to do both. I am not discounting the effectiveness of either. I am saying that masks and distancing might give a false sense of security in crowded close environments and that the key to safe return to work is widespread and frequent testing to keep carriers out of the work place as much as possible. Obviously the two are not mutually exclusive but I worry that because masks and distancing are much easier than testing, employers and govts will rely on the first and ignore the second.

As the pandemic has gone on we are seeing that closed crowded environments are the sources of most cases and the risk assessment for various activities has changed. I would like to see the effectiveness of various preventative measures defined in various environments. So far what I have seen has been generalized. That's why I asked if someone could point me to studies that examine the effectiveness of preventative measures in different environments.
As things open up we will see if there are clusters coming from office and factory environments where masks and distancing are practiced. It would be nice to know sooner.

[Adolf Allerbush]

Realists are aware of Japan and the effectiveness of masks. Obviously the right answer is to take the most efficient steps. Denial about the effectiveness of masks is not that.

Agreed. I'm just reporting what I'm seeing first hand in central oregon or elsewhere. It's a lot of people SD'ing, not wearing masks all the time, but taking precautions...lots of people doing fuck all. I'm saying CS is being a "realist" in that he's probably doing SD'ing, taking precautions, but in reality a lot of people are doing next to nothing.

[old goat]

NYT asked 511 epidemiologists (are there really 511 epidemiologists?) when they personally would resume various activities
https://www.nytimes.com/interactive/...gtype=Homepage

[KQ]

Let me say it again--I am not saying don't wear masks and distance as much as possible. I do both. I will continue to do both. I am not discounting the effectiveness of either. I am saying that masks and distancing might give a false sense of security in crowded close environments and that the key to safe return to work is widespread and frequent testing to keep carriers out of the work place as much as possible. Obviously the two are not mutually exclusive but I worry that because masks and distancing are much easier than testing, employers and govts will rely on the first and ignore the second.

As the pandemic has gone on we are seeing that closed crowded environments are the sources of most cases and the risk assessment for various activities has changed. I would like to see the effectiveness of various preventative measures defined in various environments. So far what I have seen has been generalized. That's why I asked if someone could point me to studies that examine the effectiveness of preventative measures in different environments.
As things open up we will see if there are clusters coming from office and factory environments where masks and distancing are practiced. It would be nice to know sooner.

Quarantine fatigue: Why some of us have stopped being vigilant and how to overcome it

[jono]

NYT asked 511 epidemiologists (are there really 511 epidemiologists?) when they personally would resume various activities
https://www.nytimes.com/interactive/...gtype=Homepage

That's cool. Always interesting to see how people think. The curious wrinkle in that for me was how many expect to eat in a restaurant before they expect to stop wearing masks regularly. Left me wondering how many of those threw the "if it's outdoors" qualifier on the restaurant question and how many are just willing to risk a restaurant (though they all seem pretty united about no sports or concerts).

[old goat]

Quarantine fatigue: Why some of us have stopped being vigilant and how to overcome it

good article. I know I'm experiencing some caution fatigue. One thing I would add is that the more rigorous one's initial quarantine regimen is, the faster they will get fatigued. The measures that work the best are the one's that people will comply with. The better is the enemy of the good. Or what I say--how good is good enough? In most situations perfection is not necessary, except as an end in itself. Perfection becomes a problem when it makes undertaking something so difficult that people don't bother starting, or when efforts to achieve perfection cause more damage than imperfection would.

Caution fatigue is not one of the heuristic traps of skiing in avalanche terrain but it should be.

Changing the subject a little--
Shutdowns prevented 60 million coronavirus infections in the U.S., study finds
https://www.washingtonpost.com/healt...s-study-finds/

But shouldn't the headline read "delayed 60 million coronavirus infections . . . "?

[The AD]

But shouldn't the headline read "delayed 60 million coronavirus infections . . . "?

Perhaps it all depends on how long till a vaccine is available.