How’s the Economy Doing? Watch the Dentists(nytimes.com)
nytimes.com
How’s the Economy Doing? Watch the Dentists
https://www.nytimes.com/2020/06/10/upshot/dentists-coronavirus-economic-indicator.html
57 comments
I'm pretty sure many dentists are open to remote consultations. I know my doctor is. I assume my dentist would be as well.
I'm not sure what remote cleaning would look like other than "Be particularly observant to your brushing and flossing." I imagine untrained people hacking around with dental tools would cause more harm than good.
I'm not sure what remote cleaning would look like other than "Be particularly observant to your brushing and flossing." I imagine untrained people hacking around with dental tools would cause more harm than good.
Dentistry is the last industry I'd watch as a harbinger of the economy. Going to the dentist is truly playing russian roulette with corona. The aerosolization of particles is inevitable as is inhaling them. If there is corona to be aerosolized and transmitted, it will be. I can't imagine anyone getting elective dentistry right now. Then again, many Americans seem to have a death wish right now and would risk their lives for a cleaning.
A lot of dentistry is elective just like other forms of preventative care. But that doesn't mean you should push it off indefinitely. And if you look at the various projections, it increasingly doesn't look as if pushing this sort of thing out a couple of months will necessarily get you to the point where "everything's fine!" People don't go to dentists because it's a fun but unnecessary activity.
Most Americans will get COVID, and the risk of death is exceedingly low (0.3%). “Death wish” is exaggerating the situation. If you’re young and healthy (or even middle aged and healthy), it’s reasonable to take what others interpret as risky actions.
Are you predicting 500-900k deaths in the USA due to COVID-19?
Not a domain expert, so I make no predictions myself but do consume data from subject matter experts on the topic.
Healthy middle aged person who wears a mask in public but goes about his life with his family as if nothing happened. Haven’t gotten COVID, but if I do, I’ll take sick days and move on. What else would you expect people to do, hide inside forever? Curve was flattened, there’s no appetite to do so further if necessary, life goes on (or it doesn’t).
Healthy middle aged person who wears a mask in public but goes about his life with his family as if nothing happened. Haven’t gotten COVID, but if I do, I’ll take sick days and move on. What else would you expect people to do, hide inside forever? Curve was flattened, there’s no appetite to do so further if necessary, life goes on (or it doesn’t).
You don't think we would be better off if we had been as aggressive as countries like South Korea?
I think we would, but we won’t, so that’s what folks will optimize for (“open for business”).
Can’t fault people for responding to incentives and policy accordingly.
Can’t fault people for responding to incentives and policy accordingly.
It's hard for me to reconcile that you educate yourself by reading what experts are saying and you still are going about your life as if nothing had happened.
Are the policies and incentives so powerful that it's overriding your knowledge that you and your neighbors would be better off if you continued to self-quarantine as much as possible?
Are the policies and incentives so powerful that it's overriding your knowledge that you and your neighbors would be better off if you continued to self-quarantine as much as possible?
I too go about my life as nothing had happened. Simple reason: many people who get it are asymptomatic, many who get it only have mild symptoms, yes few unlucky people will be dead but the number are exceddingly low. Not worth it to be worrying about it.
This is such a repugnant and ignorant statement that it makes me despair for our society.
repugnant is very subjective but ignorant ? Can u point out which part of my statement that is ignorant ?
One only needs to look at Italy, Spain, NYC to spot the main problem(s) with the statement. I'm being generous in attributing them to ignorance - there is a very strong likelihood in today's environment that it's willful mis-statement.
Not the least problem is that it implicitly assumes that others will take steps to reduce the worst effects, so that you don't need to bother. The basic anti-social anti-vax position.
In any case it's so easily dissected that I'm going to invoke Brandolini's Law [1] and decline to waste the time to refute BS.
[1] https://en.wikipedia.org/wiki/Brandolini%27s_law
Not the least problem is that it implicitly assumes that others will take steps to reduce the worst effects, so that you don't need to bother. The basic anti-social anti-vax position.
In any case it's so easily dissected that I'm going to invoke Brandolini's Law [1] and decline to waste the time to refute BS.
[1] https://en.wikipedia.org/wiki/Brandolini%27s_law
>One only needs to look at Italy, Spain, NYC to spot the main problem(s) with the statement
Many are asymptotic, many have mild symptom, yes there is deaths but low in number. Is it not the same case as in Italy, Spain, NYC ?
>Not the least problem is that it implicitly assumes that others will take steps to reduce the worst effects, so that you don't need to bother
I don't assumes others will take steps to reduce the worst effects. Even in in the worst case situation where everyone eventually will get infected (including me), it didn't bother me.
Many are asymptotic, many have mild symptom, yes there is deaths but low in number. Is it not the same case as in Italy, Spain, NYC ?
>Not the least problem is that it implicitly assumes that others will take steps to reduce the worst effects, so that you don't need to bother
I don't assumes others will take steps to reduce the worst effects. Even in in the worst case situation where everyone eventually will get infected (including me), it didn't bother me.
What do you believe to be a reasonable duration of time to aggressively quarantine if health services aren’t overloaded?
I defer to experts. I would assume that once Rt is well below 1 and an aggressive testing apparatus is in place it would be safe to cautiously resume public life.
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Yes. I do not agree that me and my neighbors would be better off if we hid inside until 2021; I think the kind of trauma that creates would be more damaging than the worst-case projections for the virus.
Will we be better off if we self-quarantine as long as possible? Under the assumption that a fixed percentage of Americans will get COVID-19 in the long run and that treatments will not improve, then self-quarantining may delay getting it and has some chance of pushing those who self-quarantine more effectively into the not-getting it category but will make little difference to the overall mortality rate. So, for increased isolation to make a big difference, something has to break one of those assumptions. Possibilities include:
A vaccine. This may well happen in under a year. How much of a difference this makes will depend on the efficacy of a vaccine and how many people get it.
Improved treatments. Some experts seem optimistic about monoclonal antibodies. Cost, production, and ability to administer early enough in the course of the disease are still unknown.
Living in a country that is actually suppressing the disease. Countries that have competently managed COVID-19 are not on a course that will eventually infect a large fraction of the population. It seems likely that if all countries were this competent, then COVID-19 could be eradicated without a vaccine.
A vaccine. This may well happen in under a year. How much of a difference this makes will depend on the efficacy of a vaccine and how many people get it.
Improved treatments. Some experts seem optimistic about monoclonal antibodies. Cost, production, and ability to administer early enough in the course of the disease are still unknown.
Living in a country that is actually suppressing the disease. Countries that have competently managed COVID-19 are not on a course that will eventually infect a large fraction of the population. It seems likely that if all countries were this competent, then COVID-19 could be eradicated without a vaccine.
Your assumptions about treatment not improving have already been proven wrong by dexamethasone: https://www.nature.com/articles/d41586-020-01824-5
I think that a significant part of what people see as an aggressive response is read backwards on the countries that happen to have had good results. There are a lot of countries and regions who were praised for their aggressive response in March and April, who've now been memory-holed as their pandemic ramps up. It's fair to say the US made missteps that South Korea didn't, but the idea that there's some universally correct response which can be imposed from the top by fiat seems incompatible with the facts on the ground.
Where did 0.3% come from.
https://www.worldometers.info/coronavirus/coronavirus-death-...
> As of May 1, 23,430 people are estimated to have died out of a total population of 8,398,748 in New York City. This corresponds to a 0.28% crude mortality rate to date, or 279 deaths per 100,000 population, or 1 death every 358 people. Note that the Crude Mortality Rate will continue to increase as more infections and deaths occur (see notes under the paragraph "Herd Immunity" below for details).
From a Google search of “Covid mortality rate”. As a healthy person, I would remain comfortable even if the death rate is substantially higher under the assumption that one can’t self quarantine forever and infection is inevitable.
> As of May 1, 23,430 people are estimated to have died out of a total population of 8,398,748 in New York City. This corresponds to a 0.28% crude mortality rate to date, or 279 deaths per 100,000 population, or 1 death every 358 people. Note that the Crude Mortality Rate will continue to increase as more infections and deaths occur (see notes under the paragraph "Herd Immunity" below for details).
From a Google search of “Covid mortality rate”. As a healthy person, I would remain comfortable even if the death rate is substantially higher under the assumption that one can’t self quarantine forever and infection is inevitable.
From your own link:
"Infection Fatality Rate (IFR) = Deaths / Cases = 23,430 / 1,694,781 = 1.4% (1.4% of people infected with SARS-CoV-2 have a fatal outcome, while 98.6% recover)"
So 1.4%, about 4.67 times higher than what you say.
That said I may have misunderstood so corrections welcome.
"Infection Fatality Rate (IFR) = Deaths / Cases = 23,430 / 1,694,781 = 1.4% (1.4% of people infected with SARS-CoV-2 have a fatal outcome, while 98.6% recover)"
So 1.4%, about 4.67 times higher than what you say.
That said I may have misunderstood so corrections welcome.
Not a domain expert, perhaps I misinterpreted the rate posted (CMR vs IFR). I’m still comfortable with those odds you commented with (1.4%). If I was twice my age or had underlying health issues, I might be more concerned, but this falls within my personal risk tolerance.
https://www.nytimes.com/2020/05/22/well/live/putting-the-ris... (New York Times: Putting the Risk of Covid-19 in Perspective)
https://www.nytimes.com/2020/05/22/well/live/putting-the-ris... (New York Times: Putting the Risk of Covid-19 in Perspective)
You're assuming rather a lot. I don't want to be alarming etc. but you're being a touch complacent. https://www.bbc.co.uk/news/uk-scotland-52506669
She said: "We are seeing that patients are suffering from moderate to severe acute kidney injury in about 20-30% of patients and 30% of patients who are admitted to intensive care for Covid infection are requiring dialysis so the numbers are much bigger than we envisaged based on the data coming out of China." (published May 2nd)
It's not die-or-recover-completely.
She said: "We are seeing that patients are suffering from moderate to severe acute kidney injury in about 20-30% of patients and 30% of patients who are admitted to intensive care for Covid infection are requiring dialysis so the numbers are much bigger than we envisaged based on the data coming out of China." (published May 2nd)
It's not die-or-recover-completely.
I’m being pragmatic with a touch of nihilism, although I can see how that would appear to be complacent or caviler to an observer.
I’m unwilling to live in my home as if it’s a moon base until a vaccine is developed, which could be 6-18 months from now, but as I mention elsewhere in this thread I wear a mask whenever I’m in public (to prevent impacting others if I happen to be a carrier but am asymptomatic). If you’re concerned for my health, appreciate it, but we’re all dead eventually.
I’m unwilling to live in my home as if it’s a moon base until a vaccine is developed, which could be 6-18 months from now, but as I mention elsewhere in this thread I wear a mask whenever I’m in public (to prevent impacting others if I happen to be a carrier but am asymptomatic). If you’re concerned for my health, appreciate it, but we’re all dead eventually.
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Can you elaborate on what you mean by "remain comfortable"?
You mention in another comment that you do wear a mask. Are there other things you would do if they were simple and were likely to, if done by a statistically substantial number of people, save lives?
Getting people to wear masks (not even all the time everywhere, just in public buildings/crowds) and stay home when they are obviously sick will make a huge difference, but we as a country seem to have said "fuck it, that's too hard".
You mention in another comment that you do wear a mask. Are there other things you would do if they were simple and were likely to, if done by a statistically substantial number of people, save lives?
Getting people to wear masks (not even all the time everywhere, just in public buildings/crowds) and stay home when they are obviously sick will make a huge difference, but we as a country seem to have said "fuck it, that's too hard".
Propose something else simple to do beyond wearing a mask, washing and sanitizing hands frequently, etc. Self quarantine is not simple, and it is unreasonable to request it indefinitely.
Fly less.
Avoid dense crowds.
Etc.
Avoid dense crowds.
Etc.
We don’t fly at all (lot of miles expected on the EVs this year, single use nitrile gloves for handling Supercharger stall cabling). We avoid all crowds (requested refunds for upcoming concerts instead of electing to go). Anything else?
Did you avoid crowds prior to Covid, or is that something you do differently but didn't acknowledge?
How about temperature checks after potential exposure?
I also think you are missing my point. I'm not trying to enumerate all the possibilities, I'm pointing to there being quite a lot of options between quarantine and going back to life the way it was. If we talk about things like concerts being choices, more people look at them that way. If we figure out the small mitigations that make the biggest difference and get them widely adopted, everybody wins.
How about temperature checks after potential exposure?
I also think you are missing my point. I'm not trying to enumerate all the possibilities, I'm pointing to there being quite a lot of options between quarantine and going back to life the way it was. If we talk about things like concerts being choices, more people look at them that way. If we figure out the small mitigations that make the biggest difference and get them widely adopted, everybody wins.
Unfortunately, there are too many stakeholders and not enough coordination for the efforts you describe to be implemented in the US. People don’t even want to wear masks, so most of what you’re asking for is beyond our grasp collectively. It is what it is.
Bullshit.
(note that we are on equal footing here, asserting opinions, I just did it more curtly)
(note that we are on equal footing here, asserting opinions, I just did it more curtly)
https://www.aljazeera.com/news/2020/06/coronavirus-face-mask...
https://www.marketwatch.com/story/why-do-so-many-americans-r...
https://slate.com/news-and-politics/2020/05/masks-coronaviru...
My favorite, from a Costco:
https://www.marketwatch.com/story/i-woke-up-in-a-free-countr...
> “I got every f—ing right to not wear a mask,” he said. “This isn’t about wearing a mask, it’s about control. I’m not the f—ing sheep ... I was one of the only people in that store not wearing a mask.”
The mistake you might make is to assume that this feeling is held by a single person. The data indicates there is a broad contingent of citizens who adhere to these views, therefore your suggestion (“If we figure out the small mitigations that make the biggest difference and get them widely adopted, everybody wins.”) would “impose on their freedoms”, making broad scale implementation untenable.
https://www.marketwatch.com/story/why-do-so-many-americans-r...
https://slate.com/news-and-politics/2020/05/masks-coronaviru...
My favorite, from a Costco:
https://www.marketwatch.com/story/i-woke-up-in-a-free-countr...
> “I got every f—ing right to not wear a mask,” he said. “This isn’t about wearing a mask, it’s about control. I’m not the f—ing sheep ... I was one of the only people in that store not wearing a mask.”
The mistake you might make is to assume that this feeling is held by a single person. The data indicates there is a broad contingent of citizens who adhere to these views, therefore your suggestion (“If we figure out the small mitigations that make the biggest difference and get them widely adopted, everybody wins.”) would “impose on their freedoms”, making broad scale implementation untenable.
A death wish is not necessarily for oneself. Most Americans are wishing death upon others. Statistically, the younger and healthier, the more likely they are to kill someone else rather than themselves. Doesn't make it any less risky or horrifying. Well, it does to many Americans who simply do not care if their actions kill others. It's part of the culture as can be readily seen now and in the past.
I think the key word is "elective" here.
I've been scheduled for an implant for ~4 months now, and waiting for things to calm down before getting it done - but it's not exactly "elective" - there are serious health consequences of not getting the work done - it will be more painful and more expensive the longer I wait. So I get to balance increased pain with increased risk of infectious disease. Compared to most things, it's absolutely a legitimate barometer of how safe I feel doing the riskiest activities _that I have to do_.
I've been scheduled for an implant for ~4 months now, and waiting for things to calm down before getting it done - but it's not exactly "elective" - there are serious health consequences of not getting the work done - it will be more painful and more expensive the longer I wait. So I get to balance increased pain with increased risk of infectious disease. Compared to most things, it's absolutely a legitimate barometer of how safe I feel doing the riskiest activities _that I have to do_.
I'm pretty much in the same boat. I was scheduled for a crown when things shut down. After they opened, they called me to reschedule. Sure I could hold off some number of months but I actually had some temporary sensitivity in the tooth so it seemed reasonable on balance to go ahead and get it done. (And, if I were in the office for the temporary crown anyway, I might as well get my rescheduled cleaning done anyway which is also "elective" up to some point, but who knows what outbreaks could happen that shut things down again.
So, yes, it's a risk but it seems a reasonable calculated one. Others may of course disagree.
So, yes, it's a risk but it seems a reasonable calculated one. Others may of course disagree.
> but it's not exactly "elective" - there are serious health consequences of not getting the work done
That's what "elective" means. Planned in advance, non-emergency.
That's what "elective" means. Planned in advance, non-emergency.
"How long it takes those jobs to come back entirely will be a crucial indicator of whether Americans feel safe returning to normal activities, and if they have the economic means to do so.
“I’m obsessed with dentists because, if the only thing we’re doing is putting the economy on pause, and then going back to normal, all of them should be coming back,” Ms. Stevenson said. “We’re not really recovered until all the dentists are back to work.”
“I’m obsessed with dentists because, if the only thing we’re doing is putting the economy on pause, and then going back to normal, all of them should be coming back,” Ms. Stevenson said. “We’re not really recovered until all the dentists are back to work.”
Death wish ? That's seems like huge exaggeration isn't it ? This virus is not like ebola where you most likely will be dead if you get it.
OP may be obese, sick, or old.
For these groups, Coronavirus might be a death sentence.
For these groups, Coronavirus might be a death sentence.
What is the deal with this denialism on Hacker News? Suddenly it seems everyone here incarnated the Elon Musk spirit.
You don't need to be denialist to think that it may be appropriate to get back to delayed medical procedures.
I assume emergency procedures are still being done.
I'm not sure what that statement has to do with mine. Many medical procedures/visits that don't need to happen right now should nonetheless not be postponed indefinitely. Dental cleaning is certainly one of those. Others are operations to correct chronic pain or to forestall a future emergency.
Now, you're certainly welcome to think that we should continue pushing those kind of visits/procedures out indefinitely but health officials in most places disagree.I'm being quite conservative in general but I have gone back to the dentist since they reopened.
Now, you're certainly welcome to think that we should continue pushing those kind of visits/procedures out indefinitely but health officials in most places disagree.I'm being quite conservative in general but I have gone back to the dentist since they reopened.
The Hacker News crowd tends to be pretty well off, so I imagine it’s that classic Upton Sinclair quote: “It is difficult to get a man to understand something when his salary depends on his not understanding it.”
Combination of disinformation, “entitle-ism”, denial, and money.
Sounds like your definition of denialism is anyone who wants to end the quarantine faster than you do--or at all.
No, my definition of denialism is someone who 'till this day is still defending the "it's just the flu" meme, just in a little more sophisticated package.
No where in these comments did anyone say "it's just the flu" or anything like that. You're straw-manning.
> I think its quite likely that without the media storm, we would have put it down as a really bad flu, once in a quarter century, and got on with life. Last time Sweden's death rate was this high was during their 1993 Flu pandemic (an event which is entirely forgotten). [1]
[1] https://news.ycombinator.com/item?id=23593222
[1] https://news.ycombinator.com/item?id=23593222
I'm probably just naïve about the challenges – or maybe it's happening and I'm just not aware. But I'm surprised my family (3 dental offices between us) hasn't gotten any emails from our dentists selling cleaning kits with elaborate instructions or offering Zoom consultations where they ask the same old questions they'd be asking at a cleaning, planning treatment, etc.
Yes, I realize these things are no replacement for regular cleanings or appointments, but certainly they'd be better than... nothing?