Why social distancing matters now more than ever
There is a lot of debate in this country about when the proper time to relax social distancing and work to re-open. Everyone agrees we have to re-open at some point but the discussions around when and how are filled with misinformation. An epidemiologist I know who has obviously been getting a lot of questions pulled this together to help simplify what the models are showing (he's a maryland fan, hence the turgeon reference). The tl;dr version is that social distancing is working but we need it for another few weeks to get to the optimal outcome from both a public health and economic perspective. I hope people find this informative as they think through the issue.
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Friends, we are beating COVID-19. We have the lead. We have the momentum. We can't let up. We're not a Turge team in the B1G Tournament. We can finish out this game.
Aggressive social distancing is just as important now as it has ever been. It is in our public health AND economic interest to do so. I have attached the following scientific figures* to show where we are, and where we might be headed.
*MS Paint drawings, inspired by real-life epidemiological models.
Figure 1 shows where we are. This is the "flattening the curve" graph we all became familiar with in mid-March. We have just started the downslope. Congrats y'all, the curve is flattened. The red line is dead.
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Figure 2 shows our immediate options, projecting out until roughly early fall.
1. We can fully re-open (gold line). This would kill just as many people as if we had never done anything at all, only a little faster this time around.
2. We can partially re-open (blue line). We can go to the barber and have restaurants and churches that are 25% full, and we can keep the number of cases just below national capacity as long as we can.
3. We can keep doing what we're doing now (green line), with aggressive distancing.
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Note that that the difference between #2 and #3 is tens of thousands of American lives. And a lot of those restaurants that barely turned a profit before went out of business when they had to go to 25% capacity.
Figure 3 shows the potential second wave in the fall and winter. Sorry, a vaccine probably won't swoop in and save us in time for college football season. Let's check in on our 3 options.
1. In the second half of 2020, we've killed people at roughly the same rate as the extermination phase of the Holocaust. Your barber was open up until the day before he died. (gold line)
2. Everyone's out of business because they couldn't operate at full capacity, AND several hundred thousand people are dead. (blue line)
3. We won the race. We implemented containment before the second wave hit. There are still some restrictions on large gatherings, but by and large, the economy is open, and we had a total of 100k-125k deaths in 2020. Prevalence has fallen to a level where we can do testing and tracing, and we contain local pockets of infection. (green line)
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The choice is pretty obvious to me. The option that is best for public health is also the one that is best for the economy. We have to bite the bullet for the next little while. We have to continue to socially distance as aggressively as ever, y'all.
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We can beat this thing. If you'd like to get deep in the weeds of some pretty advanced epidemiology, Figure 4 shows how aggressive social distancing at this stage can manipulate the coronavirus' transmission dynamics in such a way that we save both a whole bunch of lives and a whole bunch of jobs.
OK, but if your mechanic says "I know you just came in to get your wipers looked at, but actually your car is unsafe to drive and you'd better buy a new one," you'd ask for a second opinion, right?
I wouldn't say that the predictions have been pretty accurate. Some of them have, if only by necessity -- if you make 100 guesses, one or two of them are probably close. And, you're right, the data are ever-changing, which should make us more skeptical, not less.
The point is, we need to have a discussion about the best way to proceed, but it's nearly impossible to have that discussion in an environment where the LARPers and the "won't somebody PLEASE think of the children???" crowd dominate the discourse. (Not to mention the idiots shooting people for asking them to put on a mask. I may be the most anti-mask person on the blog, but I'm equally anti-murder. Good God).
J. -
I sincerely believe that if you were MORE anti-murder than you are anti-mask, not equally, you'd see this whole topic with more common sense, empathy, and insight.
To compare the two, even in an offhand "have we tried injecting clorox yet" way, shows an amazing lack of perspective. And I'm sure it's a blind spot for you, and based on your many posts on this topic over these last couple days, one you're not likely to quickly let go of.
But message received - you DON'T like wearing a mask, enough to have shut yourself in your home for weeks now...
That analogy would make sense if you believe the world's epidemiologists and scientists have a hidden, monetary agenda that would lead to their direct enrichment. But, you're missing the point - I go to the mechanic because he has expertise (I've dodged hustler mechanics who tried to bullshit me but that's all beside point) and knows more than me. I tend to trust him. You're ascribing the motives of a greedy mechanic to the world's most prominent public health officials. If a mechanic who has my best interests in mind tells me my car will burst into flames if I take it on the highway, I'm going to listen to him. He might be wrong, but I'm not gonna take my chances.
You don't have to believe them 100% but massive, widespread distrust of experts is foolish and dangerous.
Yanet Garcia has never been wrong.
https://www.youtube.com/watch?v=iA4yOVQNdHg
How do you or anyone out there explain that at the NY State press conference yesterday, Gov Cuomo showed that 66% of COVID hospitalizations came from those who stayed at home?
I am not making this up. This reveals a lot. Other studies? We shall see.
You can show me a dozen graphs on how we flattened the curve and perhaps this plan worked. For those who think we need to wait for a vaccine or until sometime in 2021, then I say get a hazmet suit or remain indoors at home.
The part of that presentation that interested me was the age demographics and that ~95% of all hospitalizations were people with comorbidities*. It seems like there could be an effective, targeted, approach to safely reopening that doesn’t involve mandatory lock-in for everyone.
*I didn’t check the fine print, but I’m assuming that this includes obesity (I think CDC defines as BMI > 35%). That obviously includes a lot of people.
Yeah the problem is that a 1/3 of the US population has something that would qualify as a risk factor under Covid (obesity, diabetes, age). We just aren't a healthy enough society to successfully protect those at risk while opening things up, you can't protect a third of society from 2/3s of it.
It's worse than 1/3.
Just diabetes and obesity get you well over 40%.
Close to 50% of adults in the USA have qualifying risk factors.
ROFLMAO.... shhhhhhhhhh you'll offend all of the lard-asses on the Blog!
**HAVE ANOTHER BEER GUYS!
Very interesting! There are also many doctors (Jay Bhattachayra and Dan Erickson, for instance) that disagree strongly with the "curve-flattening" stay-at-home models.
Sadly, I think there are agendas beyond the virus at work here. We are, at least to some degree, suspending many Constitutional rights and allowing edicts and proclamations from our governors to carry the weight of law in the face of the so-called invisible enemy. More than a few folks aren't comfortable with this. The models our leaders are using to take decisions aren't necessarily accurate and are possibly causing irreparable harm to the economy.
It's truly hard for the public to discern what to believe. For example, in California, more than one study suggests the mortality rate is .1% to .3%, similar to the normal flu. Here in Michigan, our current numbers suggest something close to 9% death rate. Is this accurate? Is this intentionally inaccurate? A variance in strain mutation causing higher mortality rates? It's just hard, if not impossible, to know.
I side with being cautious, social distancing (within reason), hand-washing and discretionary mask-wearing while opening up the economy and protecting the most vulnerable among us (elderly, immune system compromised people, etc...). We've never exercised these types of draconian measures for any other pandemic in our history. My humble opinion is that we shouldn't now, either.
Excellent post. Social distancing kills.
The spanish flu killed 7000+/million population. That's 20-30x as deadly as covid. Plus the average life expectancy was 54 years in the USA at that time, so that pandemic probably closer to 100-1000x as deadly adjusting for the age impacted by it.
Even with that, schools stayed open. Businesses stayed open with staggered shifts. This is certainly unprecedented action what we have done.
I"M OFFENDED.... YOU SAID "SPANISH" flu.... that's completely racist!
You think maybe its possible the Spanish Flu killed so many people because those things stayed open? A virus with a 1% mortality rate (its currently 4% in the US right now) that infected everyone in the US would kill 3 million people. Of course 100% of people wouldn't get infected but if you look at what happens when healthcare systems get overrun, like for example in northern Italy, the death rate spikes up because people can't get proper care and deaths from other issues, like heart attacks and stroke also increase because care isn't available. Personally I'm cool with shutting down the country for 3 months to save millions of lives.
You lost me when you claimed a 4% mortality rate....they have no idea on mortality because we have no idea how many asymptomatics are walking around. There are studies that show this could have a 0.5% mortality.....a far fry from 4%....but very few are taking a straight line of how many are dead and how many are confirmed infected to come up with mortality rates.
A virus with .5% mortality rate would still kill 1.5-2 million people, the point still stands
Over 3 million people die annually anyway. Many of them from co-morbidities of the China Flu (heart disease, cancer, dementia, etc).
There's a reason this virus has ravaged nursing homes and not kindergartens: because it primarily kills people who were already in poor health. 2 million is not a horrifying number when you realize that the vast majority of them were going to die soon anyway.
Is there a chance societal interaction in the U.S. might be somewhat different now than it was during the 1918 Spanish flu pandemic or other pandemics prior to that?
Is there a chance we have more insight, better modeling capability, and general understanding today than we did 102 years ago?
Clearly not, otherwise we would have treated this disease like China and done the lockdown BEFORE the disease disseminated throughout the country.
Instead, we decided to act when it was far too late and thus had negligible impact
Key word..."WE"... however let's elaborate more.
"WE THE PEOPLE"... (don't blame this shit on leadership)
What on earth are you talking about?
You think the common citizen has any impact on day to day, week to week infectious disease response?
If you had an inkling of how dysfunctional leadership has been on this pandemic, even you would start to question your vote and loyalty.
Let's not give China too much credit! Their initial response was to silence & isolate the Dr that first discovered the virus, until he ultimately died of it!
They practiced a whole lot of denial before they took action, which helped the virus to move freely about the planet for weeks & months!
It was not "discovered." Do some research
Dr. Western is here, direct from 4chan, to inform us the virus was created, not discovered?!
Thanks! Very revealing!
Done like China? As in welding people into their apartments? Or did you mean disappearing 3-4 Drs who tried to sound the alarm?
You cited the two immunology "experts" from the well-known research center of Bakersfield, CA. Excellent.
HOLY SHIT... I've driven through Bakersfield many times from Vegas to LA, and I think they only have a population of a few thousand. Didn't realize they had a University or any sort of medical expertise. Nice...
Instead of Hopkins, I should have gone to Bakersfield....
Bakersfield population: 380k
AA population: 120k
Baltimore population: 620k
Stick to checking out dudes while they take a piss.
WHOA WHOA WHOA, you went to Hopkins!?!?! Why haven't you ever mentioned that? That's amazing. It isn't even relevant to your post, but you still managed to work it into your comment. Very, very impressive. What field of medicine did you go into?
Stretch - I was going to ask lost-JH-wages the same question!
Ok Einstein... explain then for me the "agendas" behind keeping everyone at home, from a politicians perspective?
1) Let me piss off my voters by making everyone stay at home during spring and summer; that's a great way to get myself re-elected
2) Let me stop a greater portion of commerce under my jurisdiction, so people are out of jobs and completely discontent; that's certainly going to get me re-elected
3) Let me fear monger, because that impresses people; I'm all about impressing my voters.
**Seriously bruh... give me something to work with here!
Here's one for you...
"Trump says re-open. He's trying to euthanize the old people. We need to save their lives!" <- Paraphrasing CNNs Morning Joe.
Not saying we SHOULD open up today - but if you believe this isn't being politicized to some extent I don't know how to convince you.
" For example, in California, more than one study suggests the mortality rate is .1% to .3%, similar to the normal flu. "
A rough statistical analysis shows that somewhere between 0% and 80% of the positives in that study are false positives.
So... it could be similar to the flu... or way worse.
Ah, a coronavirus classic: only acknowledging the testing error that works in my favor.
No - I acknowledge the whole range.
0% could be false positives. In that case - this is very similar in fatality rate to seasonal influenza.
80% could be false positives. In that case - this is WAY WORSE than seasonal influenza.
...and it largely isn't "testing error" that is an issue with the California study in question. It's the combination of testing error and prevalence (one massively effects the other) along with sample bias (self selected on Facebook).
Two other U.S. studies (Chelsea, MA, Massachusetts General) and a Danish study also came up with numbers in the 0.1-0.5% range and all studies noted that they didn't know how may people had gotten the virus and already recovered so the real mortality could be (I continue to hope) lower.
The mortality rates of other flu and viruses are well known. The characteristics of coronaviruses 1 through 10 indicate a U.S. death total between 60K and 110K according to table I looked at in February. The U.S. pays more to hospitals for each case found (than other countries) so I suspect that may be inflating the U.S. numbers.
So many models...Used to be a good thing.
I’d like to see ESPN start a COVID-19 model league. Put it on the Ocho. Let’s add some competition and cash prizes to this.
Maybe a Gus Macker style Toilet Bowl division for the really bad modelers.
I'd like to see a "COVID19 Challenge / Toilet Bowl Licking" model. Just to verify my hunch on the percentage of the USA population that Darwin has failed to address. Anything over 5%, and this will be evidence that there really is a GOD, no other way so many idiots could survive.
Not a league, but this post from 538 lets you look at some recent model comparisons relative to actual numbers. It lets you look back as far as April 7 at 5 different time periods. April 7 only has the IHME forecast, Each future date added additional models.
https://projects.fivethirtyeight.com/covid-forecasts/?ex_cid=rrpromo
Serenity Now
When this is all over, I could envision the US being a case study, for future virus containment, on exactly what not to do.
We're on the road to becoming a global laughingstock (if we're not already), but that's what happens when your leadership dismisses scientific findings when they happen to be politically inconvenient.
Without the former MSM nobody would even know cerveza20 exists.
I suspect people in places like Albany, Georgia and Mew York City might have suspected something was going on
China and South Korea both handled it way worse. They've mitigated the virus in the short-term, but they have no long-term plan. They're going to be stuck with a half-open economy until a vaccine is developed. At least the US, Sweden, Spain, Italy, and a few other European countries are well on their way to developing significant levels of immunity. They'll be able to open up sooner and get through this with lesser economic damage than countries like South Korea.
I was in the grocery store the other day and less than half of the people were wearing masks. It doesn't seem like a difficult sacrifice to make. It doesn't seem like an infringement of liberty to me.
Hopefully the seasonal theory is more valid than theories of bleach injections. Otherwise, this thing could easily take off again if we aren't smart. I would be far more in favor of opening up if I were observing better behaviors. And it's mainly the same people who are most vulnerable that seem to refuse to adhere to all the guidelines.
So I tend to agree with all the experts revising up the projected death tolls lately.
The masks make people sick. You need to exercise your immune system so it's healthy. Hiding and shying away from people in masks and at your house so your immune system decays is 100% the wrong approach. USC already showed that 0.1% of cases are fatal, the same as the flu. Not to mention 90% of the 0.1% are over 80 years old with other health issues.
New York State clearly shows it is more fatal than the flu.
2018 - bad year for flu - 4749 deaths in New York State
https://www.cdc.gov/nchs/pressroom/sosmap/flu_pneumonia_mortality/flu_p…
Covid-19 - 26,187 deaths so far in New York State
https://www.worldometers.info/coronavirus/country/us/
5.5 times as many deaths in New York State from Covid than from the flu in a recent bad year.
1335 deaths for every million people in New York (note, people, not cases, think we can agree that not everyone in New York has had it). Therefore mortality rate must be significantly higher than 0.1335.
The New York numbers are 100% fake and for an agenda. Overall death rates are far below last year in USA and globally. All the social distancing / masks will ensure a second wave.
US deaths per million from 2018 flu were about 185 (61,000 deaths/330 million US). 7 states are at more than twice that number.