The curve is flattened enough

[DMC]

@SayTwo

Yes, I did. That’s how I was able to observe that they all looked similar.

You think a Gaussian and a Gompertz function look alike? I thought you were supposed to be a math teacher.

[Stranger_On_A_Train]

@DSeid

I’d just pick a hypothesis and see if the data supports it or not.

…

As powerful as your approach? Maybe not. But still useful.

The problem with that approach is that if there are multiple different measures being applied or released, it may be difficult to see which are most significant unless you have clear tracking & tracing where you can identify the chain of exposures (as with the South Korean bar example). If you have multiple measures such as letting barbershops open AND churches to resume services, both using the same distancing and face-covering procedures with similar compliance, being able to discern which one has the greater impact may be difficult because there will be a lot of crossover in the cohort, and it isn’t as if you can design an experiment to feed into an ANOVA-type analysis. However, if you can collect a lot of data and use it to compare to the relative quantities of potential interactions, you can (in theory) tease out which one results in more infections and feed that posterior back into the model to predict changes in those parameters. In reality, I doubt there is enough precision (and accuracy) in reported data to make really confident predictions but you can at least estimate relative sensitivity provided you have a long enough baseline to accommodate the latency period.

@zimaane

Skepticism is good, but the central point is still valid - Nearly a month after Georgia began reopening, there is no evidence of the widely anticipated ‘spike’ in new cases.

There are a lot of reasons to question the accuracy of the reporting of testing in Georgia. And if the trend that infections in Georgia are not increasing despite relaxing isolation measures, it begs the question as to why that is because it would seem to defy all expectations of how the contagion has spread elsewhere. If Georgians have the ‘special sauce’ as to how to reopen but keep infection rates under control then we’d like to understand that so it could be applied elsewhere. But that seems unlikely without a clear discriminator and that we’re not seeing everything in the data being reported.

Stranger

[DMC]

@zimaane

Skepticism is good, but the central point is still valid - Nearly a month after Georgia began reopening, there is no evidence of the widely anticipated ‘spike’ in new cases.

Georgia isn’t even close to reopening. While our governor is doing stupid things, most of the mayors of our major cities are pushing back. My company, which was in no way a work from home company (only the executive team had laptops before this), hasn’t even started the conversation about when we might return to the office. While I realize that that is anecdotal, anyone who knows the Atlanta area can simply look at spaghetti junction or the split downtown and tell you that we’re not even close to open again. Yes, hairdressers have started opening and some restaurants are carefully testing the waters, but we’re still locked down pretty tight, even if it is mostly self-imposed at this point.

[Trom]

@DSeid

Not being a data scientist I’d be not so fancy!

I’d just pick a hypothesis and see if the data supports it or not.

To pick one at not so random, the hypothesis that keeping schools closed is a critical part of keeping rates low. If several re-openings have included re-opening schools and daycares without seeing any resurgence in new case numbers, increased percent positive cases, hospitalization rates, ICU utilization rates, or death rates, at appropriate time lags, and the places that have had flares and had to reimpose restrictions did not mostly share that they re-opened schools, then the hypothesis begins to become falsified. A big deal thing. Of course you need to look at each case to see what else might be correlated with it but it still informs.

Alternatively pick the hypothesis that keeping bars closed matters: South Korea’s experience supports that strongly.

As powerful as your approach? Maybe not. But still useful.

Take a look here: Coronovirus Government Response Tracker from the University of Oxford

@University of Oxford

Systematic information on which governments have taken which measures, and when, can help decision-makers and citizens understand the robustness of governmental responses in a consistent way, aiding efforts to fight the pandemic. The Oxford COVID-19 Government Response Tracker (OxCGRT) systematically collects information on several different common policy responses governments have taken, scores the stringency of such measures, and aggregates these scores into a common Stringency Index.
…
OxCGRT collects publicly available information on 17 indicators of government responses. Eight of the policy indicators (C1-C8) record information on containment and closure policies, such as school closures and restrictions in movement. Four of the indicators (E1-E4) record economic policies, such as income support to citizens or provision of foreign aid, and five indicators (H1-H5) record health system policies such as the COVID-19 testing regime or emergency investments into healthcare.
…
The tracker aggregates the policy scores (not the financial scores) into a common ‘Stringency Index’. Note that this index simply records the number and strictness of government policies, and should not be interpreted as ‘scoring’ the appropriateness or effectiveness of a country’s response.

Here’s a Bloomberg piece discussing the study.

[Brayne_Ded]

@Thudlow_Boink

One question I haven’t seen answered is just how much can hospiutals effectively do to treat Covid-19?

I know that a lot of people who get infected never need hospitalization. And I know that a substantial number of people who do get hospitalized or put on ventilators end up dying anyway. What I wonder about is how many people survive because they got hospital treatment who would have died if they hadn’t—how much does medical treatment improve a person’s chance of survival?

I get the impression that the hospitals cannot do much to help those who are in bad shape anyway, what with the ventilators possibly being worse than useless, if some reports are to be believed. The problem that affects younger and fitter people appears to the the same sort of cytokine storm (excessive reaction of the body’s immune system) that caused so many deaths in the Spanish 'flu epidemic of 1918-21, and the dpocs cannot do anything about it, AFAIK.

[Stranger_On_A_Train]

@Brayne_Ded

I get the impression that the hospitals cannot do much to help those who are in bad shape anyway, what with the ventilators possibly being worse than useless, if some reports are to be believed. The problem that affects younger and fitter people appears to the the same sort of cytokine storm (excessive reaction of the body’s immune system) that caused so many deaths in the Spanish 'flu epidemic of 1918-21, and the dpocs cannot do anything about it, AFAIK.

Neither of these statements are true. The statistics on mechanical ventilation for the elderly are not good, but that is not the same thing as “worse than useless”, and if it is caught in time the inflammation from cytokine response syndrome can be managed by suppressing interleukin 1β (IL-1B) and developing antibodies to block interleukin 6 (IL-6). Although a significant people with very serious presentations die regardless of treatment, many also survive with supplemental oxygen, BiPaP and mechanical ventilation, and extracorporeal membrane oxygenation. This notion that “people are going to die anyway, let’s just expose them all and get back to normal most ricky-tick” is just an abeyance of medical and societal ethics in favor of some hypothetical convenience, as if we’ll just have a few million casualties and go back to watching baseball.

Stranger

[Rodentia]

@CurtC

The “flatten the curve” idea became well-known a couple of months ago, and we in the US have responded better than I could have imagined.

The whole point of that was not to reduce the number of people who eventually get infected, but to keep them from being infected all at the same time, to keep the hospitals from being overwhelmed. Because when enough of the population is infected that it overwhelms the hospitals, that’s when people die in excess of the mortality rate you’d see if the hospitals can adequately treat those who are hard-hit.

[1] Isn’t that right?

…
[2] Where do we go from here? …

[3] Should we just accept that most people are going to get it,
…

[4] Or is there some other goal? A

I am a healthcare systems analyst, not a clinician, but here’s what I can tell you.

1. Yes, you have accurately described the primary goal of flattening the curve. i.e. prevent overwhelming the system and avoid increasing sickness and death in the COVID patients, but also avoiding higher injury and death in the patients you would normally be treating for heart failure, stroke, cancer, etc who would be receiving less care.
2. Where we should go is massive increase in testing to be able to isolate infectious people faster and reduce spread, as well as targeted isolation
3. Yes and no. We have to accept that there will be infection and death, but we can HUGELY reduce that. New York was an example of how to do it wrong, and what the cost is for doing so. If NY has introduced quarantining and stay-at-home just a week earlier, there would likely have been 30k fewer deaths.
4. Yes. Although flattening the curve has a primary goal of preventing the system from breaking down, it has a secondary goal of buying time in which there is a possibility to improve treatment methods, develop a cure, or develop a vaccine. Buying time is very important and can reduce the total infection and death outcomes

[DSeid]

@Trom

Take a look here: Coronovirus Government Response Tracker from the University of Oxford

Here’s a Bloomberg piece discussing the study.

Very interesting. Thanks for the link.

[nelliebly]

@Stranger_On_A_Train

This notion that “people are going to die anyway, let’s just expose them all and get back to normal most ricky-tick” is just an abeyance of medical and societal ethics in favor of some hypothetical convenience, as if we’ll just have a few million casualties and go back to watching baseball.

Stranger

Thank you for this. I’m pretty high-risk, and the dismissiveness has been deeply troubling and depressing.

[Irishman]

@kenobi_65

The issue seems to be that a significant minority of the U.S. population isn’t interested in “dialing it back just a bit” – as states have been opening things back up, some people are acting like everything can and should be back to normal now. They refuse to wear masks, they’re crowding into bars and restaurants, etc.

Yes, this is troubling to me as well. I get the very real need to reopen the economy, the impact to people’s lives and livelihoods. The struggle to get enough to eat, the worry over paying bills. But too many people are acting like the panic is over. It’s like they’ve taken on the fatalistic outlook that doing anything to reduce the crisis is too hard, that people are going to die and there’s nothing we can do to stop it. “Pandemic schmandemic, I’m going to hang out with my friends!”

@UltraVires

Right. I think it is terribly irresponsible for some in the media to be reporting as if TX is failing here. It was always about flattening the curve, then relaxing restrictions, and once they were relaxed, of course we would see an increase in cases. That doesn’t mean it failed or it was too early, it was exactly as predicted.

But Texas is violating the guidelines and gaming the system to justify the rush to reopen. Gov. Abbott was on the news Friday answering questions about the reopening. The primary criteria for reopening is the 14 day decline in new cases and deaths, which of course we don’t meet. But he says the alternative criteria is a decline in the daily percentage of positive tests. That means each day’s testing has a smaller number of positive results.

There is some validity to that approach, but it is predicated on the assumption that the basis for those numbers is consistent. Except we don’t have that. At first, testing was only available for people exhibiting symptoms and testing negative for the flu. Of course under those conditions you will have a high positive rate. As testing has become more available, they’ve opened the criteria to get a test so now more people can get a test if they want one, regardless of symptoms or exposure. Naturally, the percent of tests giving positive results will fall. That doesn’t mean fewer people are being infected.

The flipside is there is now a push to open more testing in black and Hispanic communities that are harder hit and haven’t had as much access. That should drive the percent of positive cases back up. But what do you want to bet that increase will be explained away while neglecting the original problem I noted above?

And now we find out some states are combining results from antibody tests with active case tests, muddying the waters even more.

[Irishman]

@MandaJo

I think one issue is that the promises/plans to preserve social distancing are either intentionally disingenuous or pipe dreams. Businesses can’t enforce social distancing rules on their customers–they just can’t. The whole “customer is always right” culture makes it impossible for a clerk or a cashier to tell someone or a group to leave a store, or even remind them forcefully to observe the rules.

@Broomstick

That’s why we clerks and cashiers don’t do that at my store - we call a manager or store director to do it for us.

I wish. We can’t even do that. Hell, we can’t even get the employees to comply. And many of the ones who are wearing masks are wearing them wrong - not covering their nose, or pulled down around their throat. And complaining to managers doesn’t do any good, some of them are the worst offenders.

What we struggle with, at least at my store, is enforcing item limits. You know, telling people that no, you can’t roll out of here with a cart full of meat, you get only two pork, two beef, two chicken. (Yes, there are some people with large families - they can get two “family packs” which are 7-10 pounds of meat each, available in all of the above categories. That’s 15-20 pounds each of chicken, beef, and pork or 45-60 pounds of meat. In addition to sausage, turkey, lamb, etc.)

But even there, we can call in a manager or director. And those folks can call the police (and have in a few instances). Sure, some people threaten to never come back (which, to be honest, won’t break our hearts) but we really are an essential service. We are where the food is.

Actually, the worst for me is the store stopped taking returns. The principle I assume is to not take in stuff people have taken home and handled a bunch so as top reduce the risk of cross-contamination. But this is Walmart - we always take returns. So I’ve got customers coming is wanting to return spoiled milk or just canned goods the don’t want our products where the picked the wrong one. Standard stuff we get all the time and take back with no fuss, even if we can’t restock it top sell again.

Only now we’re not supposed to take it back - pandemic. We even have signs posted at all the registers (though frankly they are in small print and easy to miss). But customers still come in daily with their returns, and are surprised we wouldn’t want the stuff. And some of them get into a huff about it. I’ve had customers leave the stuff on my counter because they don’t want it. Stuff they paid for and aren’t getting money back or an exchange.

[drivekiller]

@CurtC

The “flatten the curve” idea became well-known a couple of months ago, and we in the US have responded better than I could have imagined…

30 percent of reported cases are in the US and we’re hardly testing anybody. How is that even possible?

You can sort each of the columns by clicking on the headers.
https://www.worldometers.info/coronavirus/#countries

Let’s go, Sweden!

[Great_Antibob]

@Irishman

And now we find out some states are combining results from antibody tests with active case tests, muddying the waters even more.

Yeah, and Texas is one of those states. They claim they’ll stop doing so this week, but it’s clear they’ll continue to cook the numbers to the extent they believe they can get away with.