Stay-at-home policy is a case of exception fallacy(nature.com)
nature.com
Stay-at-home policy is a case of exception fallacy
https://www.nature.com/articles/s41598-021-84092-1
74 comments
I live in New Zealand, where our first lockdown was taken VERY seriously by nearly everyone. If the population actually does it, lockdown works. A lot of people credited our current administration for our successful Covid elimination, but I think it comes down to our culture. We work together in close communities.
Maybe you're sick or hearing this argument, but I'm sure being the most isolated country on Earth helps in a pandemic.
Not that I doubt the civic mindedness of the NZ people!
Not that I doubt the civic mindedness of the NZ people!
I think both isolation and the strict initial lockdown were necessary conditions. Here in BC, Canada, we had a strict initial lockdown that also drove cases to essentially zero. However, even when community spread was wiped out in the summer of 2020, we would have a few cases imported each day, mostly from the US. The border was closed to non-essential traffic, but the economies of the US and Canada are so closely linked that even just essential traffic is many thousands of people each day. Therefore a policy of driving cases to zero and keeping them there just wasn't feasible here, because you'd have to maintain a strict lockdown indefinitely.
> However, even when community spread was wiped out in the summer of 2020, we would have a few cases imported each day, mostly from the US
Is this really the belief? Canada’s inferiority complex wrt to the US has made their perception of COVID out of touch with reality.
There was always significant community transmission in BC, even in the summer. Cases never went to zero, the lowest point was ~10/day. And it’s likely underestimating by a factor of >5 since testing in Canada was not done well. (This is despite the popular perception. Anecdotally, in Washington my family was able to roll into drive thru testing sites and get next day results for free, and in Canada it was a >$100 appt at the retail pharmacy and 3-5 days for results. I don’t how it is now, but Washington has been doing ~3x as much testing per capita as BC since early summer last year.)
So even if essential travelers crossing the border was importing a few cases a day (extremely unlikely IMO, and zero evidence supporting this), it would be accounting for a small single digit percentage of cases.
Is this really the belief? Canada’s inferiority complex wrt to the US has made their perception of COVID out of touch with reality.
There was always significant community transmission in BC, even in the summer. Cases never went to zero, the lowest point was ~10/day. And it’s likely underestimating by a factor of >5 since testing in Canada was not done well. (This is despite the popular perception. Anecdotally, in Washington my family was able to roll into drive thru testing sites and get next day results for free, and in Canada it was a >$100 appt at the retail pharmacy and 3-5 days for results. I don’t how it is now, but Washington has been doing ~3x as much testing per capita as BC since early summer last year.)
So even if essential travelers crossing the border was importing a few cases a day (extremely unlikely IMO, and zero evidence supporting this), it would be accounting for a small single digit percentage of cases.
BC has not been doing the quantity of testing that WA has, but it had been contact tracing all cases, and in the summer when cases were in the single to low double digits per day, the majority of cases were traced to travel, from the US and from elsewhere in Canada. For a number of weeks there was not significant community spread. You don't need to test the whole population to know that; if case that are found can be contact traced to a travel event, that is sufficient to demonstrate lack of significant community transmission. Of course many of these imported cases did transmit the virus to others locally, but the point was that the sequence of transmission could be traced back to a specific border crossing. As opposed to community spread, where the original source of introduction is unknown. This is based on evidence presented at the time in briefings from the BC public health officer. Do you have any basis for the claim that only a "small single digit percentage of cases" were imported from the US during the summer?
Certainly community spread has worsened significantly since then, but that's kind of my point; it was never realistic to essentially eradicate the virus and then open back up here, as NZ did, because there would always be a baseline number of imported cases ready to spark a new outbreak.
Certainly community spread has worsened significantly since then, but that's kind of my point; it was never realistic to essentially eradicate the virus and then open back up here, as NZ did, because there would always be a baseline number of imported cases ready to spark a new outbreak.
I think my point was not well constructed.
NZ locked down, had good isolation, and got a bit lucky.
The problem with COVID is that because there’s a large portion asymptomatic carriers, the success of contact tracing can vary a lot.
In Canada, it is politically expedient to point to (valid) US failings and throw them under the bus. I don’t doubt that this is something done by the BC health officer at the time. My math of single digit percentage is based on even having a few cases a day coming in contrasted with 10-20 cases underrepresented by a factor of ~5. It’s just guessing, but I doubt they have more than a few direct travel cases each day and therefore community transmission was significant. I would be curious if there was any data that suggests this guesstimate is wrong.
It’s possible to argue that all that community transmission was the result of border crossings, but the same is true everywhere and quickly becomes non-sensical. Would the virus have disappeared if not reseeded by travel cases? We do know that New Brunswick and Nova Scotia had the same essential travelers (i.e. baseline imports) but were able to effectively control and have had no deaths since August of last year (and very few cases).
I’m not saying that BC did a poor job — I’m not sure that BC could have done anything to contain the virus completely. But I also don’t think it’s reasonable to point the finger completely at travelers as the thing that prevented success.
NZ locked down, had good isolation, and got a bit lucky.
The problem with COVID is that because there’s a large portion asymptomatic carriers, the success of contact tracing can vary a lot.
In Canada, it is politically expedient to point to (valid) US failings and throw them under the bus. I don’t doubt that this is something done by the BC health officer at the time. My math of single digit percentage is based on even having a few cases a day coming in contrasted with 10-20 cases underrepresented by a factor of ~5. It’s just guessing, but I doubt they have more than a few direct travel cases each day and therefore community transmission was significant. I would be curious if there was any data that suggests this guesstimate is wrong.
It’s possible to argue that all that community transmission was the result of border crossings, but the same is true everywhere and quickly becomes non-sensical. Would the virus have disappeared if not reseeded by travel cases? We do know that New Brunswick and Nova Scotia had the same essential travelers (i.e. baseline imports) but were able to effectively control and have had no deaths since August of last year (and very few cases).
I’m not saying that BC did a poor job — I’m not sure that BC could have done anything to contain the virus completely. But I also don’t think it’s reasonable to point the finger completely at travelers as the thing that prevented success.
I'm not saying travelers prevented success, nor that BC's response was perfect. I definitely don't believe that was the case, and could even point to specific decisions I believe were poor, but it would be getting off topic. What I'm saying is, BC's leadership made a conscious choice not to aim for 'COVID zero', due to the fact that there would always be a baseline number of imported cases, so it would never be possible to eliminate the virus to the extent that restrictions could be meaningfully relaxed, as they were in NZ. To me that choice makes sense, although I do feel they took it a bit too far; as cases started really going up over the winter I would have liked to have seen increased measures restricting gathering sooner. But I'm also not operating with all the information they are, so can only second guess so much.
As for the Atlantic provinces, they are quite a bit more isolated than BC is, despite, yes, also having a certain amount of necessary traffic. And I agree with you that there's likely some luck involved as well.
As for the Atlantic provinces, they are quite a bit more isolated than BC is, despite, yes, also having a certain amount of necessary traffic. And I agree with you that there's likely some luck involved as well.
I’m not sure what distinction you’re making here, as most western jurisdictions have an ultimate goal of zero cases and applied the same lockdown policies to a first order approximation (with some succeeding, most needing to relax restrictions after time). But we agree more than we disagree, I just get annoyed at the canard that Canada is dealing with COVID only because of mismanagement in the US (which has caused weird side effects, like harassment of people with US plates).
Of course all jurisdictions have an 'ultimate' goal of zero cases, using vaccines. But what I'm saying is that BC's health leadership has explicitly stated that their goal thus far has not been to drive cases to zero, and the reason is that it is not practical given imported cases. It could be done in the short term with a strict lockdown, and was in late spring 2020, but there would not be sufficient benefit to justify the cost of maintaining that policy, because as soon as restrictions were relaxed, cases would rebound.
That's not the same as blaming the whole thing on US mismanagement. I agree that some people are doing that, and certainly I don't approve. (Although I wouldn't chalk it up to an 'inferiority complex'. If anything I would say too many people here are feeling a largely unjustified sense of superiority. Trump may have provided a very visual display of incompetence, but for the most part on the ground the responses were similar. And while Canada's results have been better than the US's, they've still lagged the world on average.)
I do understand this policy though. It's convenient to think that if not for incompetent leadership we could be like NZ. But unlike an isolated island nation, it is not possible for a Canadian province to cut itself off from the rest of the world to a sufficient extent that a COVID-zero policy would have been practical thus far. Instead, the stated goal has been to control infections at a level where they did not overwhelm 1) the hospital system or 2) the ability to trace contacts. As the latter has been stressed over the winter, restrictions were increased.
That's not the same as blaming the whole thing on US mismanagement. I agree that some people are doing that, and certainly I don't approve. (Although I wouldn't chalk it up to an 'inferiority complex'. If anything I would say too many people here are feeling a largely unjustified sense of superiority. Trump may have provided a very visual display of incompetence, but for the most part on the ground the responses were similar. And while Canada's results have been better than the US's, they've still lagged the world on average.)
I do understand this policy though. It's convenient to think that if not for incompetent leadership we could be like NZ. But unlike an isolated island nation, it is not possible for a Canadian province to cut itself off from the rest of the world to a sufficient extent that a COVID-zero policy would have been practical thus far. Instead, the stated goal has been to control infections at a level where they did not overwhelm 1) the hospital system or 2) the ability to trace contacts. As the latter has been stressed over the winter, restrictions were increased.
What was the grocery and other essentials shopping situation in the NZ lockdowns?
Can't speak to conditions in the NZ lockdowns, but during the strictest period of the Melbourne, Australia lockdowns there were only four reasons to leave your home/property: essential shopping (one person, once a day), exercise (one hour a day), care (your own or loved one), work (for essential services).
Groceries, as well as chemists and other specific industries were considered essential services that remained open. Lots of health and safety requirements put in place, including wearing masks, perspex screens between you and the cashier (or dividers at self-checkouts) to reduce droplet transmission. 1.5 meter minimum distance between people not from the same household. One person per four square meter density rules for indoor workplaces. The list goes on.
Movement was also limited to five kilometers from your home without a good reason (common sense exceptions in cases where your closest grocer was further away for instance, but not so you could travel to the other side of the city to go for a nice bush walk) and you had to wear a mask whenever not in your own home.
Elimination of community transmission was achieved during our (admittedly mild) winter. Not during our (admittedly mild) summer as a lot of people in other hemispheres seemed to assume.
While our geography was advantageous, it also required a huge effort of societal and political will and cooperation to achieve. It relied on following the advice of our health experts and scientists in the face of large economic and political pressures.
In Melbourne now we are enjoying reasonably normal conditions compared to B.C. (Before COVID) times. There's fairly little risk of community transmission. Most people are back at work and/or some combination of continued work from home. Schools are open. You still have to be carrying a mask when not at home, but only required to wear it in shopping centres and similar situations where there are large numbers of people indoors and similar. Plenty of hand sanitiser dispensers around. Aforementioned screens and dividers are still around.
We had a snap five day "circuit breaker" lockdown recently after a cluster of infections occurred (escaped from quarantine) which was successful but unsettling, particularly for those who had a harder time of it last year.
Not sure why I ended up doing such a details write up to your inquiry. I suspect it was cathartic.
Groceries, as well as chemists and other specific industries were considered essential services that remained open. Lots of health and safety requirements put in place, including wearing masks, perspex screens between you and the cashier (or dividers at self-checkouts) to reduce droplet transmission. 1.5 meter minimum distance between people not from the same household. One person per four square meter density rules for indoor workplaces. The list goes on.
Movement was also limited to five kilometers from your home without a good reason (common sense exceptions in cases where your closest grocer was further away for instance, but not so you could travel to the other side of the city to go for a nice bush walk) and you had to wear a mask whenever not in your own home.
Elimination of community transmission was achieved during our (admittedly mild) winter. Not during our (admittedly mild) summer as a lot of people in other hemispheres seemed to assume.
While our geography was advantageous, it also required a huge effort of societal and political will and cooperation to achieve. It relied on following the advice of our health experts and scientists in the face of large economic and political pressures.
In Melbourne now we are enjoying reasonably normal conditions compared to B.C. (Before COVID) times. There's fairly little risk of community transmission. Most people are back at work and/or some combination of continued work from home. Schools are open. You still have to be carrying a mask when not at home, but only required to wear it in shopping centres and similar situations where there are large numbers of people indoors and similar. Plenty of hand sanitiser dispensers around. Aforementioned screens and dividers are still around.
We had a snap five day "circuit breaker" lockdown recently after a cluster of infections occurred (escaped from quarantine) which was successful but unsettling, particularly for those who had a harder time of it last year.
Not sure why I ended up doing such a details write up to your inquiry. I suspect it was cathartic.
I appreciated the details. Thanks!
Grocery stores stayed open but with limited capacity. Pharmacies stayed open, but small independent groceries and specialty food stores closed.
People were asked to queue 2m apart and wait your turn. We didn't bitch and moan about it, we just did it. 4 weeks of hard lockdown then 2 more weeks of slightly lifted restrictions, and in exchange we got a full summer of nearly completely free movement with cases being counted on one hand per day.
People were asked to queue 2m apart and wait your turn. We didn't bitch and moan about it, we just did it. 4 weeks of hard lockdown then 2 more weeks of slightly lifted restrictions, and in exchange we got a full summer of nearly completely free movement with cases being counted on one hand per day.
Flu counts are down because flu tests are not being administered. Everyone is testing for covid antibodies. If hackers new the five biological laws of nature as discovered by Dr Hamer the world would be a better place.
I was just talking to a stranger about this yesterday, COVID has suppressed flu cases in the US significantly. Since we live in a state with a soft lockdown COVID policy, Florida, our theory is it has a lot to do with masks, sanitizers, increased public/commercial cleaning, and people staying the fuck home if they have mild flu-like symptoms.
And that last bit is important because I knew far too many people dragging themselves into work with a runny nose and fever and basically spreading illnesses to anyone they come in contact with.
After the vaccine has reached herd immunity levels I hope there are real lessons learned about containing highly contagious diseases.
And that last bit is important because I knew far too many people dragging themselves into work with a runny nose and fever and basically spreading illnesses to anyone they come in contact with.
After the vaccine has reached herd immunity levels I hope there are real lessons learned about containing highly contagious diseases.
The sanitizers and cleaning part certainly didn't hurt. And people continue to go through the motions but it seems increasingly the view that it really didn't matter much, especially to the point where people were sanitizing all their grocery purchases or leaving their Amazon deliveries in the garage for 3 days.
I was at an event just over a year ago where we weren't handshaking and surfaces were being wiped down but otherwise we were taking zero precautions which was pretty much the norm at the time. So, basically, we weren't taking any meaningful precautions.
I was at an event just over a year ago where we weren't handshaking and surfaces were being wiped down but otherwise we were taking zero precautions which was pretty much the norm at the time. So, basically, we weren't taking any meaningful precautions.
The entire category of "is X associated with COVID" research is a recipe for p-hacking, because you're looking at relationships between slowly changing variables, with all sorts of confounds, and there are so many ways to do multiple regression/synthetic controls/and so on. It ends up telling you as much about the priors of the researchers as anything else. My favorite example of this is the research group that found that the Sturgis motorcycle rally increased COVID:
https://onlinelibrary.wiley.com/doi/full/10.1002/soej.12475
But the same research group found that BLM protests did not:
https://www.nber.org/papers/w27408
It's possible that both are true, but it's a bit suspicious that these findings are so well-aligned with the probable political associations of the authors.
https://onlinelibrary.wiley.com/doi/full/10.1002/soej.12475
But the same research group found that BLM protests did not:
https://www.nber.org/papers/w27408
It's possible that both are true, but it's a bit suspicious that these findings are so well-aligned with the probable political associations of the authors.
Disclaimer: I probably share a lot of those political leanings. With that said...
My understanding was that there were a lot of “mask-skeptic” folks at the Sturgis Motorcycle Rally openly flaunting safety protocols and doing stuff like hanging out in packed bars with no mask on. Sure, you can get away with some amount of line-stepping and even straight up rule-breaking and still not catch Covid, but when you have a gathering of people for whom flaunting Covid restrictions is actually a form of virtue-signalling... well it’s probably not going to end great.
Having attended the BLM protests myself (in Baltimore), I don’t think I saw a single person not wearing a mask. I’m sure they existed somewhere in America, but I’m pretty sure if you showed up without a mask someone would give you a disposable one. Why do I think that? Because there were also folks with hand sanitizer pumps giving away hand sanitizer for free. The walking marches were not perfectly socially distanced, but with everyone wearing masks and walking about 3ft apart in the open air, it makes sense that there would’ve been less spread. There were also marches that were done as parades of cars so that folks who were more at-risk for Covid had a safer way to participate.
Again, good intent alone won’t stop the spread of a disease (it doesn’t care if you’re “trying real hard” to be safe). But when the culture of a group is focused around taking the virus seriously and trying to balance the goals of the movement with keeping people safe, it makes sense that you’ll have better outcomes.
My understanding was that there were a lot of “mask-skeptic” folks at the Sturgis Motorcycle Rally openly flaunting safety protocols and doing stuff like hanging out in packed bars with no mask on. Sure, you can get away with some amount of line-stepping and even straight up rule-breaking and still not catch Covid, but when you have a gathering of people for whom flaunting Covid restrictions is actually a form of virtue-signalling... well it’s probably not going to end great.
Having attended the BLM protests myself (in Baltimore), I don’t think I saw a single person not wearing a mask. I’m sure they existed somewhere in America, but I’m pretty sure if you showed up without a mask someone would give you a disposable one. Why do I think that? Because there were also folks with hand sanitizer pumps giving away hand sanitizer for free. The walking marches were not perfectly socially distanced, but with everyone wearing masks and walking about 3ft apart in the open air, it makes sense that there would’ve been less spread. There were also marches that were done as parades of cars so that folks who were more at-risk for Covid had a safer way to participate.
Again, good intent alone won’t stop the spread of a disease (it doesn’t care if you’re “trying real hard” to be safe). But when the culture of a group is focused around taking the virus seriously and trying to balance the goals of the movement with keeping people safe, it makes sense that you’ll have better outcomes.
To the bar point, I'd say it's a pretty common belief at this point that some combination of masks and distancing are important inside while, outside, it makes much less of a difference especially if you're at least somewhat distanced.
Around where I live, people are being pretty good about protocols inside. Outside? I don't live in a city but on trails and so forth, the common pattern is people will pull up a gaiter if they're going to pass a group wearing masks. These days, almost no one is. When I do pull up a gaiter it feels like theater.
Around where I live, people are being pretty good about protocols inside. Outside? I don't live in a city but on trails and so forth, the common pattern is people will pull up a gaiter if they're going to pass a group wearing masks. These days, almost no one is. When I do pull up a gaiter it feels like theater.
You don't think there might have been a difference in the behaviors and beliefs of the attendees of those two events?
The answer is that Sturgis had indoor parts too, whereas its hard to protest in groups outdoors.
The difference is that people felt unsafe during the BLM protests because they also lead to riots as well. A lot of people stayed at home, who otherwise would have gone outside. I skimmed another paper that reached a similar conclusion. A motorcycle rally doesn't have the same effect.
Not sure why I'm getting downvoted here. That is literally the reason specified by the paper posted by OP.
> Countries with > 100 deaths and with a Healthcare Access and Quality Index of ≥ 67 were included
So this excludes New Zealand. I think that’s an important point, as due to strict lockdowns we’ve had at least six months with no restrictions on movement at all, except through the border. We’ve had three community outbreaks and each time lockdowns combined with contact tracing have stopped the spread.
I’m no epidemiologist so have no clue if there’s other factors in play, but I appreciate having cafes and offices open.
So this excludes New Zealand. I think that’s an important point, as due to strict lockdowns we’ve had at least six months with no restrictions on movement at all, except through the border. We’ve had three community outbreaks and each time lockdowns combined with contact tracing have stopped the spread.
I’m no epidemiologist so have no clue if there’s other factors in play, but I appreciate having cafes and offices open.
Lots of New Zealand's neighbors are orders of magnitude less than Europe and the Americas, also, so it's not clear what to make of that. However, I think the rationale for using only countries with > 100 deaths would be that it's not looking at how to prevent things from starting, but rather what strategies are effective once they've already gotten seriously going (which was already the situation for many countries a year ago).
It also excludes Vietnam, a country with 100M bordering China, with the first evidence of community spread outside of China, which has experienced a total of 35 deaths so far in the pandemic. They also credit their success to effective lockdowns and contact tracing (tracing up to 3 degrees of connection, so typically putting more than 100 people in isolation for every case identified).
Edit: fixed geographical mistake :).
Edit: fixed geographical mistake :).
FWIW, by all accounts (I have family there), COVID is endemic in Viet Nam but simply isn't reported. Lots of elderly people were seriously ill with unusual "pneumonia" but the government doesn't test them. The sick people with likely COVID were being turned away from the hospitals, so many traveled to their family homes in the countryside. COVID doesn't exist because they refuse to measure it.
Which is about what you'd expect there.
Which is about what you'd expect there.
I don't have any family or other contacts there personally, but everything I've read about it completely contradicts what you are saying. The WHO and UN and foreign media organizations have had nothing but praise for their COVID-19 response, except for accusations of human rights violations in other areas. So I don't think your "by all accounts" comment is justifiable in any way.
Here is an excerpt from a WHO report [0]:
> Early activation of a strong response system, including surveillance and risk assessment, laboratory, clinical management and IPC, and risk communication, which enabled Viet Nam’s successful control of COVID-19.
Here is the UN summary [1]:
> Viet Nam’s response to the health system aspects of the COVID-19 pandemic has been one of the most effective in the world and this is now increasingly recognized at the global policy level. The country has now controlled the virus and pandemic multiple times including the recent outbreaks which started in Da Nang on July 25, 2020 after the country had achieved 99 clear days of freedom from local transmission of the COVID-19 virus
Here is Reuters reporting about this [2]:
> “It is organised, it can make country-wide policy decisions that get enacted quickly and efficiently and without too much controversy,” said Guy Thwaites, director of the Oxford University Clinical Research Unit in Ho Chi Minh City. Thwaites’s laboratory has been helping to process tests.
> Thwaites said the number of positive tests processed by his organisation’s lab was in line with government data. He said the hospital where he works on the wards – Ho Chi Minh City’s 550-bed Hospital for Tropical Diseases, serving a population of 45 million people in southern Vietnam – had not admitted any additional cases not reflected in the government’s numbers.
Here is the BBC [3]:
> Speckled among the praise showered on Vietnam for its handling of Covid-19 were some questions about the accuracy of the authoritarian state's data, which medical and diplomatic communities had widely agreed was reliable.
> "The new deaths reported shows that there is transparency in reporting Covid-19 in Vietnam and that previous 'no deaths' should have not been questioned in the first place," Dr Huong Le Thu, a senior analyst at the Australian Strategic Policy Institute, tells the BBC.
[0] file:///C:/Users/ionut/AppData/Local/Temp/Viet-Nam-MOH-WHO-COVID-19-Sitrep_(7Mar2021)_final.pdf
[1] https://vietnam.un.org/sites/default/files/2020-10/UN%20Asse...
[2] https://www.reuters.com/article/us-health-coronavirus-vietna...
[3] https://www.bbc.com/news/world-asia-53690711
Here is an excerpt from a WHO report [0]:
> Early activation of a strong response system, including surveillance and risk assessment, laboratory, clinical management and IPC, and risk communication, which enabled Viet Nam’s successful control of COVID-19.
Here is the UN summary [1]:
> Viet Nam’s response to the health system aspects of the COVID-19 pandemic has been one of the most effective in the world and this is now increasingly recognized at the global policy level. The country has now controlled the virus and pandemic multiple times including the recent outbreaks which started in Da Nang on July 25, 2020 after the country had achieved 99 clear days of freedom from local transmission of the COVID-19 virus
Here is Reuters reporting about this [2]:
> “It is organised, it can make country-wide policy decisions that get enacted quickly and efficiently and without too much controversy,” said Guy Thwaites, director of the Oxford University Clinical Research Unit in Ho Chi Minh City. Thwaites’s laboratory has been helping to process tests.
> Thwaites said the number of positive tests processed by his organisation’s lab was in line with government data. He said the hospital where he works on the wards – Ho Chi Minh City’s 550-bed Hospital for Tropical Diseases, serving a population of 45 million people in southern Vietnam – had not admitted any additional cases not reflected in the government’s numbers.
Here is the BBC [3]:
> Speckled among the praise showered on Vietnam for its handling of Covid-19 were some questions about the accuracy of the authoritarian state's data, which medical and diplomatic communities had widely agreed was reliable.
> "The new deaths reported shows that there is transparency in reporting Covid-19 in Vietnam and that previous 'no deaths' should have not been questioned in the first place," Dr Huong Le Thu, a senior analyst at the Australian Strategic Policy Institute, tells the BBC.
[0] file:///C:/Users/ionut/AppData/Local/Temp/Viet-Nam-MOH-WHO-COVID-19-Sitrep_(7Mar2021)_final.pdf
[1] https://vietnam.un.org/sites/default/files/2020-10/UN%20Asse...
[2] https://www.reuters.com/article/us-health-coronavirus-vietna...
[3] https://www.bbc.com/news/world-asia-53690711
Several members of the extended family in different parts of the country had unambiguous symptomatic COVID cases. Every last one was 1) never tested and 2) even the people with severe cases were turned away by the government hospitals, not even a cursory exam. You can get into the hospitals and get tested with a sufficiently large bribe, but the market clearing price for that bribe was unusually high so few people can afford it. The practical reality is that the government hospitals couldn't do anything even if you paid it, so why would you? People with enough money to pay that bribe would be using the foreign hospitals anyway.
Initially they did do severe lockdowns but the virus escaped into the population not long after and it was a lost cause. Realize that even though the lockdowns were severe, just about every such mandate is optional if you have money, both in theory and practice.
The above reporting isn't particularly credible. Having worked for the UN and been involved in the sausage-making at international NGOs, it would be a mistake to treat their outputs as a scientific fact-finding mission. Outputs are virtually always in service of narrow political or economic objectives that may be unrelated to the topic of the report, they aren't written for the purpose of conveying information per se. It is a formal writing style that makes heavy use of selective omissions.
Some countries were successful at containing COVID. In the specific case of Viet Nam, it would take a relatively naive review of the evidence to come to that conclusion. It may be authoritarian but it is much more corrupt and disorganized than many of the other "hard lockdown" countries.
Initially they did do severe lockdowns but the virus escaped into the population not long after and it was a lost cause. Realize that even though the lockdowns were severe, just about every such mandate is optional if you have money, both in theory and practice.
The above reporting isn't particularly credible. Having worked for the UN and been involved in the sausage-making at international NGOs, it would be a mistake to treat their outputs as a scientific fact-finding mission. Outputs are virtually always in service of narrow political or economic objectives that may be unrelated to the topic of the report, they aren't written for the purpose of conveying information per se. It is a formal writing style that makes heavy use of selective omissions.
Some countries were successful at containing COVID. In the specific case of Viet Nam, it would take a relatively naive review of the evidence to come to that conclusion. It may be authoritarian but it is much more corrupt and disorganized than many of the other "hard lockdown" countries.
Once again you claim all of this very forcefully from personal experience, but I haven't been able to find a single source which agrees with your story. I highly doubt that all of US and European media is collaborating with the Vietnamese authorities to hide their death toll - it is far more likely that the reports you have seen are colored by local political biases and conspiracy mongering.
I'm open to the possibility that they are cooking their numbers somewhat, as all authoritarian regimes are inclined to do, but it simply can't happen to the extent you are claiming without becoming at least a well-known conspiracy. Especially given that Viet Nam is not some great friend of the the US or Europe (say, a Saudi Arabia).
I'm open to the possibility that they are cooking their numbers somewhat, as all authoritarian regimes are inclined to do, but it simply can't happen to the extent you are claiming without becoming at least a well-known conspiracy. Especially given that Viet Nam is not some great friend of the the US or Europe (say, a Saudi Arabia).
Edit to repair link [0]: https://www.who.int/vietnam/internal-publications-detail/cov...
New Zealand did have serious local spread last March, our R value was over 2. We’ve never been able to completely prevent Covid-19 outbreaks.
People always use New Zealand and Australia as a shining example, but as an average joe, my first though is that they're already isolated which gives them a tremendous advantage.
I think the more valuable examples are in asian countries where they share close land borders. I'd assume that their cultural differences enable to comply with the rules a bit more than western countries so I don't know if it was even possible to prevent something like that in countries like the US. There's just too much resistance to control like that and the amount of land border that'd we'd have to police
I think the more valuable examples are in asian countries where they share close land borders. I'd assume that their cultural differences enable to comply with the rules a bit more than western countries so I don't know if it was even possible to prevent something like that in countries like the US. There's just too much resistance to control like that and the amount of land border that'd we'd have to police
>the amount of land border that'd we'd have to police
In all fairness, the US could seal its borders pretty tightly if it wanted to. But the land borders were kept open for commercial purposes and we allowed passenger flights in and out. And there are lots of reasons why shutting all that down would have been politically and economically challenging. But we could have done so (which is not to say we should have).
In all fairness, the US could seal its borders pretty tightly if it wanted to. But the land borders were kept open for commercial purposes and we allowed passenger flights in and out. And there are lots of reasons why shutting all that down would have been politically and economically challenging. But we could have done so (which is not to say we should have).
Yeah, I appreciate your comment and agree with you. They weighed the options and clearly though covid was easier to deal with than shut borders. For a time, I remember being reported or downvoted for even suggesting the economic impacts of a true, complete shutdown. I still don't know what the better strategy was.
Especially with Canada, shutting the border would have been untenable in all probability, perhaps to the degree of creating real food issues. Certainly the two countries are very intertwined economically.
Air travel could have been shutdown for a bit, at least other than to let Americans get back home. But no way it would ever have been sealed for months.
Air travel could have been shutdown for a bit, at least other than to let Americans get back home. But no way it would ever have been sealed for months.
They could have allowed food and medical shipments through while banning any other land trade.
They could have done a lot of things but mostly IMO keeping the border open for commercial travel was almost certainly the right decision, especially given that most of Canada is close to the US border anyway. They're not really that distinct geographically.
> 11 March 2021 Editor’s Note: Readers are alerted that the conclusions of this article are subject to criticisms that are being considered by the Editors. A further editorial response will follow once all parties have been given an opportunity to respond in full.
Reading through the abstract it immediately doesn’t appear that they are using the correct statistical test to come to the conclusion they are claiming. Like another comment says, it takes minutes to criticize what takes months to make, so I’ll read through the article and work through how they came to their methodology before saying more.
When the science doesn't match your preconceived notions
You don’t know that was the issue. There may be other (more or equally valid) scientific data that contradicts the article, or there may be flaws in the analysis.
Looking at the article, is about a computer model that somebody built - these are incredibly easy to (intentionally or unintentionally) bias, and I’d say that looking at this critically is entirely appropriate.
Looking at the article, is about a computer model that somebody built - these are incredibly easy to (intentionally or unintentionally) bias, and I’d say that looking at this critically is entirely appropriate.
Article like this takes months to put in. It takes one minute to put this disclaimer basically cancelling the article with "but we will tell you why we're cancelling it later".
Trained scientists are capable of reading any article with a healthy dose of skepticism and does not need to be reminded of this for any paper. All papers have limitations and just because it is published even in a prestigious journal does not make it true. I think this notice exists for the casual reader and reporter and I also doubt the message would have been posted if it did not counter public policy.
I wonder if policies are the best measurement. Why not take e.g. the google movement data directly?
I had a look at the german numbers and often the public reacted before the policy. Similarly they might subvert policies if they disagree, different cultures certainly got together in different ways, ect.
On the other hand I had a look at the "stringency index" of ourworldindata and found it doesn't represent all the little more or less compromising compromises in the policies very well.
I had a look at the german numbers and often the public reacted before the policy. Similarly they might subvert policies if they disagree, different cultures certainly got together in different ways, ect.
On the other hand I had a look at the "stringency index" of ourworldindata and found it doesn't represent all the little more or less compromising compromises in the policies very well.
Yes, official policies seem a fairly poor proxy for how people have actually acted.
This is an interesting site with respect to mobility (in the US). https://covid19.gleamproject.org/mobility I played around with it a bit and you can certainly pick and choose cases where less mobility seemed to correspond to better outcomes. But you can also find other cases where less or more mobility didn't seem to lead to especially different outcomes.
This is an interesting site with respect to mobility (in the US). https://covid19.gleamproject.org/mobility I played around with it a bit and you can certainly pick and choose cases where less mobility seemed to correspond to better outcomes. But you can also find other cases where less or more mobility didn't seem to lead to especially different outcomes.
I haven't finished the paper the the abstract reads as if the authors used mobility data, not official policy, to measure stay at home.
> In this ecological study, data from www.google.com/covid19/mobility/, ourworldindata.org and covid.saude.gov.br were combined. Countries with > 100 deaths and with a Healthcare Access and Quality Index of ≥ 67 were included. Data were preprocessed and analyzed using the difference between number of deaths/million between 2 regions and the difference between the percentage of staying at home.
> In this ecological study, data from www.google.com/covid19/mobility/, ourworldindata.org and covid.saude.gov.br were combined. Countries with > 100 deaths and with a Healthcare Access and Quality Index of ≥ 67 were included. Data were preprocessed and analyzed using the difference between number of deaths/million between 2 regions and the difference between the percentage of staying at home.
thanks!
I did not read this in detail (I did read it, but I didn't work out the math, etc, which is what a proper commentary would require), but it's worth pointing out that it's extremely easy to set up an analysis in a way that makes it highly unlikely that you'll achieve statistical significance, whether accidentally or on purpose or some combination of the two. Typically there's zero incentive for a researcher to do so, since nobody publishes "we failed to reject the null hypothesis" as a breakthrough result, but it's a really common mistake. Smooth out one too many variables, bucket broadly, do too many pointless comparisons and let the Bonferroni correction push your significance threshold to the moon, etc. It's arguably easier to slip into accidental insignificance than to p-hack or any of the other well known stats shenanigans that make most observational studies worthless.
This is the kind of result where I do worry a lot about that, since it is one of a very few topics where a null result might still be newsworthy, and where the result grossly defies common sense (if people are really staying home, pretty much any model of disease spread would predict less spread).
This is the kind of result where I do worry a lot about that, since it is one of a very few topics where a null result might still be newsworthy, and where the result grossly defies common sense (if people are really staying home, pretty much any model of disease spread would predict less spread).
> if people are really staying home, pretty much any model of disease spread would predict less spread
That's the point I've also mentioned in a post. If an applied statistics paper yields results that directly contradict good analytical causal models, then you know something is wrong with it. But I was heavily downvoted for that and deleted my post. I believe there are trolls or bots in this thread on HN today.
That's the point I've also mentioned in a post. If an applied statistics paper yields results that directly contradict good analytical causal models, then you know something is wrong with it. But I was heavily downvoted for that and deleted my post. I believe there are trolls or bots in this thread on HN today.
Regardless of weather stay at home orders worked for COVID I can tell you one delightful side effect. The last time I was ill of any description was late Feb 2020, I had the worst cold/flu of my life that lasted 3 weeks, I’ve had nary a sniffle since. Usually I have 6/7 colds per year (summer and winter) but in the last 12 months - nothing. Seems very likely that is down to not seeing people, wearing a mask, washing hands etc.
Do you think it’s possible that normalization may cause a surge of new illnesses due to lack of normally developed immunities?
If fewer people caught colds/flus, maybe there are fewer mutations that resulted? It isn't as if flu/colds were having their normal spreads somewhere, and after quarantine the doors between former-quarantineland and normal-land will be thrown open, releasing a year of backlog.
If immune systems forgot everything that quickly, vaccines wouldn’t work.
None of us are living in hermetically sealed clean rooms, either.
None of us are living in hermetically sealed clean rooms, either.
I have come to the conclusion that a rational, scientifically sound analysis of things like mask-wearing, social distancing, stay-at-home, closing schools, WFH, etc. is all going to have to occur a few years from now, when tempers have cooled. The initial analysis of any complex system is virtually certain to be riddled with errors, even when it is something like the growth patterns of crab claws in the southern hemisphere, about which few people have strong emotions. Little has been demonstrated to my satisfaction so far in this pandemic, except for these two things:
1) the vaccines appear to work (whew)
2) we aren't really able, as a society, to think clearly about a pandemic while it's happening
My hope is that social distancing continues—not at concerts, etc., but places we are forced to go, like grocery stores, etc. I’ve even gotten used to the mask, but feel that will be a welcomed good riddance by most.
I had one cold this winter, rather than counting on get sick 4-5 times.
I do have a self-centered concern on opening up though.
My life was lousy before the epidemic. I didn’t see a great economy. I saw a lot of really lousy jobs, and a lot of desperate competition.
I noticed some societal pressure to produce/succeed lighten up during the pandemic, at least for myself. In a weird way, it was kind of a positive. With each day they are counting to opening up, I noticed my sleep, and depression worsen.
I had one cold this winter, rather than counting on get sick 4-5 times.
I do have a self-centered concern on opening up though.
My life was lousy before the epidemic. I didn’t see a great economy. I saw a lot of really lousy jobs, and a lot of desperate competition.
I noticed some societal pressure to produce/succeed lighten up during the pandemic, at least for myself. In a weird way, it was kind of a positive. With each day they are counting to opening up, I noticed my sleep, and depression worsen.
I hope that social distancing entirely disappears, leaving us only with an increased acceptance of working from home and a dramatic increase in the unacceptability of going to the office when sick.
In the future, I don’t want to act as if all my fellow humans might have cooties, as I think that’s more damaging than the slight increase in viral infections.
In the future, I don’t want to act as if all my fellow humans might have cooties, as I think that’s more damaging than the slight increase in viral infections.
where do you live?
The most disappointing part of this is the lack of some basic numbers. Like "how many people have antibodies to the coronavirus". The US CDC has ongoing coronavirus seroprevalence studies, but the main one runs two months behind.[1] As of mid-January, 18% of the US population showed coronavirus antibodies. This is measured from random blood samples taken from medical tests used for other purposes, so it's anonymous and the samples are from people less healthy than average. There's also a survey based on blood samples from blood donors, who are more healthy than average. Those should provide a high and low bound.
Anyway, watch those numbers. They show measured "herd immunity". They're not a projection from some other data.
[1] https://www.cdc.gov/coronavirus/2019-ncov/covid-data/seropre...
Anyway, watch those numbers. They show measured "herd immunity". They're not a projection from some other data.
[1] https://www.cdc.gov/coronavirus/2019-ncov/covid-data/seropre...
> a few years from now, when tempers have cooled. The initial analysis of any complex system is virtually certain to be riddled with errors
Society does not seem to be on a good course at the moment. The new Authoritarian chic may delay rational dialogue by several centuries until the Dark Age has passed.
Society does not seem to be on a good course at the moment. The new Authoritarian chic may delay rational dialogue by several centuries until the Dark Age has passed.
the fact that stay at home does not explain differences in death rates does not exclude that reduction of contacts (at work, social life etc.) doesn't explain it either. In other words, it may be enough to just "avoid people" a bit more than usual to bring down infections, instead of self-isolating at home.
My (deep blue) state has never had real "stay at home"/lockdown orders. But indoor dining/bars were shut down, many/most offices were closed, people were masking (at least indoors), distancing, mostly not going to stores more than necessary, etc. So just because people weren't in "lockdown" behavior was nothing like normal.
Yes, even NYC didn't force people to stay inside, but drastically expanded outdoor dining, closed down streets in neighborhoods without parks so people can walk outside, and has kept playgrounds open since June 22nd.
There are too many variables, and it seems to me the main issue is comparing cities between themselves (where there are several variables more to consider) than each city with itself, which presents problems as well
> Pubs, restaurants, and barbershops were open in Ireland on June 29th and masks were not mandatory, after more than 2 months, no spike was observed; indeed, death rates kept falling.
It's obvious there's a gigantic seasonality effect in Covid. Whereas Ireland reopened in December and the cases shot up.
Only some pubs were reopened during that time in Ireland (with limitations, distancing, etc) and you can bet most people kept their masks in barbershops.
> Pubs, restaurants, and barbershops were open in Ireland on June 29th and masks were not mandatory, after more than 2 months, no spike was observed; indeed, death rates kept falling.
It's obvious there's a gigantic seasonality effect in Covid. Whereas Ireland reopened in December and the cases shot up.
Only some pubs were reopened during that time in Ireland (with limitations, distancing, etc) and you can bet most people kept their masks in barbershops.
Even at the first months the WHO said that lock-downs were last resort measures and that aggressive contact tracing and testing was the only practical solution before vaccines and effective treatments were found. It was also known early that at home transmissions formed the vast majority of transmissions and that Vitamin D and zinc deficiencies were determinant for complication and mortality rates. It is clear by now that stay-at-home orders are maintained or ended for political reasons.
I love how all the “rational” “analytical” “science-trusting” commenters in her choose to ignore data and “science” when it doesn’t fit their beliefs.
The article clearly states “ With our results, we were not able to explain if COVID-19 mortality is reduced by staying at home in ~ 98% of the comparisons after epidemiological weeks 9 to 34.”
And everyone’s conclusion in Hacker News is that the study must be flawed.
The article clearly states “ With our results, we were not able to explain if COVID-19 mortality is reduced by staying at home in ~ 98% of the comparisons after epidemiological weeks 9 to 34.”
And everyone’s conclusion in Hacker News is that the study must be flawed.
You apparently don’t believe viruses exist, so maybe sit this one out? https://news.ycombinator.com/item?id=26461410
Particles exist, yes. A few scientists have spun the narrative that transmissible particles CAUSE illness. That is not proven.
Scientists harp on the fact that correlation and association, do not mean causation. Except in virology where circumstantial evidence is enough to upend the freedom of the world for the sake of an abundance of caution. This religion of virology.
Scientists harp on the fact that correlation and association, do not mean causation. Except in virology where circumstantial evidence is enough to upend the freedom of the world for the sake of an abundance of caution. This religion of virology.
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The factors in COVID are age and obesity, countries with older and/or fatter populations have more cases per capita and hence deaths. Lockdown is a rounding error.
Stay-at-home policy has unintended consequences that should be studied with similar scrutiny. "Virus going to virus" is too true, the economic and mental health impact from the fear-mongering and death counting is largely understated.
We have a long way to go from here, but I'm hopeful that governments move their focus to providing solid data with information about collection methodology to keep the public informed. All the central planning and ruling with the threat of being thrown in a cage as a penalty is too exhausting.
We have a long way to go from here, but I'm hopeful that governments move their focus to providing solid data with information about collection methodology to keep the public informed. All the central planning and ruling with the threat of being thrown in a cage as a penalty is too exhausting.
I thought what drove the stay-at-home policy was the fear that Hospitals would exceed capacity.
So the only realistic solution is a shutdown for everyone. It would be impractical to enforce in a free society and widely perceived as "unfair" to only have a stay-at-home for high-risk individuals.
So the only realistic solution is a shutdown for everyone. It would be impractical to enforce in a free society and widely perceived as "unfair" to only have a stay-at-home for high-risk individuals.
It' not impossible because of some feelings, it's impossible because there is no way to effectively protect the aged, immune-suppressed, and those with pre-existing risk factors.
They live in a society. If that society is letting the virus run rampant, they will be exposed. This has been demonstrated many times and we don't need any more naive assertions about 'just stay at home if you are scared'.
They live in a society. If that society is letting the virus run rampant, they will be exposed. This has been demonstrated many times and we don't need any more naive assertions about 'just stay at home if you are scared'.
If you want to see the impact that stay-at-home has had on COVID, a good place to start is looking at the prevalence of the Flu, for which was have years of baseline #s to compare to 2020, and Winter 2020 has seen the Flu practically disappear. This is of course not conclusive evidence, but it definitely shows that stay-at-home can be massively effective at preventing disease transmission.