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Wednesday, May 20, 2020

Safe Spaces?


Silverfiddle Rant!

Where are we most likely to become infected by Coronavirus?  Least likely?

Quillette editor Jonathan Kay put some analytical thought into COVID-19 Super Spreader Events (SSE), and wrote an essay that has now started a project by a group of scientists who took over where he left off.

COVID-19 Superspreader Events in 28 Countries: Critical Patterns and Lessons

The article is an interesting analysis of what types of activities do and do not cause SSEs.  He caveats his work: Although he holds a scientific degree and has hands-on experience with mathematic modeling, he is not an epidemiologist and he is using anecdotal data that is not a proper statistical sample.

Here is the bottom line of his analysis:
When do COVID-19 SSEs happen? Based on the list I’ve assembled, the short answer is: Wherever and whenever people are up in each other’s faces, laughing, shouting, cheering, sobbing, singing, greeting, and praying. You don’t have to be a 19th-century German bacteriologist or MIT expert in mucosalivary ballistics to understand what this tells us about the most likely mode of transmission.
And when COVID-19 SSE's do not happen... 
It’s worth scanning all the myriad forms of common human activity that aren’t represented among these listed SSEs: watching movies in a theater, being on a train or bus, attending theater, opera, or symphony [...] These are activities where people often find themselves surrounded by strangers in densely packed rooms—as with all those above-described SSEs—but, crucially, where attendees also are expected to sit still and talk in hushed tones.
It makes sense to me, although if this bears out, church services and live music concerts are potential hot zones.  What say you?

See Also:

People ‘shed’ high levels of coronavirus early in the infection

London Coronavirus Protests

Fury in Germany

47 comments:

  1. "Where are we most likely to become infected by Coronavirus? Least likely?"
    I don't think there's much you can do about it, short of moving to a state or county with a lower background case load (which would be irresponsible). Sure, you can avoid SSEs. If few enough people in your neighbourhood are still going to those, that does a lot to retard the general spread and reduce the threat level you all share in common. But on an individual level? You're stuck breathing the same air and touching the same ATM machines as everybody else.
    As for what constitutes an see... maybe cinema audiences are just so much smaller than sporting crowds? And how far would you travel to catch a movie Vs attend a live gig?
    Still don't fancy the tube at rush hour, sorry!!

    ReplyDelete
    Replies
    1. A virus works its will, lockdowns or no.

      Delete
    2. True. But a lockdown isn't entirely ineffective, we can compare different countries to see how much difference it can make.

      Delete
    3. I would add to “most likely” category the brilliant decisions of a few governors to transfer COVID-19 patients to elder-care facilities, which some have said resulted in a 70% death rate among the elderly residents of those facilities —which we may agree borders on criminal malfeasance. An interesting read at Bunkerville:

      https://bunkerville.wordpress.com/2020/05/19/marooned-in-no-mans-land-a-nursing-home/

      Delete
    4. Jez,

      I have yet to see any advocate of lockdowns make the statistical case. I have yet to see any hints of correlation

      https://www.realclearpolitics.com/coronavirus/

      Delete
    5. Don't expect to see a correlation emerge from reading a table like that. You need to account for geography and, especially, time. The hypothesis we're testing is to do with the effect of an intervention on the rate of spread, not a single snapshot of the case load or cumulative deaths at some arbitrary moment.
      statisticsbyjim.com and nationalgeographic.com have some useful introductory level comparative analyses of different countries, and motherjones.com has been publishing some really pretty curves.

      Delete
    6. I'll be interested to see the methodology when someone brings forward a statistical case. Confirmed cases/1M population is cumulative, and says much. Sweden is way up there, but the UK, Italy and US numbers are higher.

      Of course, the entire set of data is unreliable because of differing methodologies from all the US states and world nations that report, and the basis is just cases we know of.

      So, I repeat what I said earlier: I have yet to see any advocate of lockdowns make the statistical case. I have yet to see any hints of correlation

      Delete
    7. "Confirmed cases/1M population is cumulative, and says much."
      Sure, but not the efficacy of a given intervention because it doesn't distinguish between the late application of a powerful intervention, vs the prompt application of a much weaker intervention. The power of an intervention lies in the speed at which it reduces the rate of new cases.

      Delete
    8. You look at which nations did intervene forcefully and early. South Korea is an example.

      I refer everyone again to compare New York and Florida, although the ballgame is not over.

      Delete
  2. I don't think the cited article makes much sense, but I think the basic point is off target. Rather than asking about the risk of catching the virus I think we should be asking about what happens if one does catch the virus.

    I an 76 years old, have had several strokes, one heart attack and have 60% lung capacity due to emphysema. Between 2015 and 2018 I was hospitalized three times, each time for more than two weeks, for pneumonia, and I have Parkinson's Disease. If I develop Covid19 I am a dead man, right?

    Wrong. I did become infected by the Corona virus. I was uncomfortable. Ran a fever of 104. Lost 18 pounds in two weeks. My wife took care of me and never became sick at all. Today I am fine.

    If you catch the Corona virus and you do not live in a nursing home, there is one chance in 10,000 that you will die from it.

    The Marines did not win at Okinawa or Iwo Jima by hiding in foxholes. We talk about previling over this virus and returning to normal, and we think we're somehow going to do that by hiding under our beds. We think we're going to do that at no cost.

    My sense we don't even want to do that if there is any cost associated with it. At least not a cost we have to pay. We'd rather just continue to hide under our beds until someone else prevails for us. ("Finds a vaccine," or develops "a total cure.")

    "We are not the men our father were."

    ReplyDelete
    Replies
    1. I've never been a soldier, but I imagine that you don't win by jumping up from your foxhole in plain site, giving away your buddies' position, either. "Hiding" as you call it, is effective at slowing transmission, so it's not all cost and no benefit.
      Also, there's not much else we can do -- beyond caring for the afflicted at present we can't really affect your odds of survival once infected (cure and vaccine are both medium/long-term projects) so the emphasis on infection rate is purely pragmatic IMO.

      I'm glad you weren't hospitalised, but I don't think your prognosis was ever quite that gloomy. I appreciate your medical history places you an intersection of vulnerable categories, but based on your age-group alone, estimates from NY data suggest a mortality less than 10%.
      One in ten thousand OTOH is fanciful. NY's 15k "official" CV deaths (an underestimate) is already more than one ten thousandth of NY population, and of course many New Yorkers haven't been infected.
      I don't know if your father was old enough to recall the Spanish 'flu. My own father is jittery: we're both worried about my mum. I don't think either of us is irrational (not for that reason, anyway!)

      Delete
    2. The utility of such data analyses is to inform those who want to avoid infection, although my own adventures in amateur reading of scientific info sez avoidance is merely delay--barring a vaccine, most of us will get it.

      Delete
    3. Jez: afraid of catching the virus? Stay home.
      Don't make me stay home.

      Forced vax? Why? Want the vax? Take it. My not taking the vax has no effect on your health.

      Delete
    4. Autonomy is an alien concept to those on the left. You have no right to make your own decisions, or choose your own path,

      Delete
    5. @ed I am not scared of catching the virus. I'm "scared" of my mum catching it. I can prevent her from catching it directly from me, but I can't individually do anything about the general level of infection in her neighbourhood, cooperation is the only way of impacting that. Libertarians, meet the Commons.

      Delete
    6. Whether the data is used by rational individuals or by governments to drive policy, it's counter-productive to introduce made-up statistics.

      Delete
    7. Jez,
      I'm "scared" of my mum catching it. I can prevent her from catching it directly from me

      Very commendable.

      How long are you willing to protect your mum in that way?

      As one who is being "protected" by my cousin, who is like a daughter to me, I can tell you that this isolation wears on my nerves.

      I'm not sure that I've ever gone this long without seeing my cousin -- and getting occasional help with caregiving here.

      Yesterday, in fact, I had to throw myself on the sympathies of my neighborhood network to get some supplies that I need for caregiving. The stores were stripped of what I needed. Now, I am grateful for my neighborhood network when one of my neighbors brought not only what I needed but also chocolate cookies and a bouquet of flowers (all of these things left on my front porch in a "touchless" exchange).

      But I miss seeing my cousin -- and, by extension, my cousin's cute little six-year-old granddaughter.

      Delete
    8. "How long are you willing to protect your mum in that way?"

      She's a sociable person, so I want her out and about as soon as possible.

      "But I miss seeing my cousin -- and, by extension, my cousin's cute little six-year-old granddaughter."

      I'm not dismissing how tough this is. Uncomfortable fact is, vulnerable groups will need to spend longer in isolation if we botch the end of this lockdown. The quickest route to seeing your little cousin again (safely) is via gradual re-opening with lots of testing IMO.

      Delete
    9. Jez,
      I have questions in my mind as to the reliability of the testing.

      Some older folks will go around the bend into senility with isolation measures. I am particularly concerned about folks in nursing homes. They rely on their social contacts -- at least within the facility.

      Delete
    10. That's always my first question too, but we can't let perfect be the enemy of good. You're absolutely right about mental health as well.

      Delete
    11. Jez,
      To be clear, I'm not expecting perfection.

      Delete
  3. @ Jez
    All this supposition is interesting, but the fact is that there is too much we don’t know about Covid-19 to make any rational conclusions. In piecemeal, scientists are claiming that the virus is more dangerous to older people because older people are more likely to have diabetes. That makes sense to me, and so it follows that we should do what we can to protect those “most susceptible” to diabetes/Covid infections ... but there seems to be no justification (so far) for locking down an entire nation. Perhaps we should withhold our judgments until we know all the facts. That will be in about another ten or twenty years.

    ReplyDelete
    Replies
    1. We don't have the luxury of waiting for certainty,
      you find out what you can but in the end you've got to work with doubt. The justification for shutdown is avoiding an unmanageable spike in hospitalisations. I'm sure there are all sorts of indefensible details local to you, but it's not like we shut down for fun.

      Delete
    2. "We don't have the luxury of waiting for certainty..."

      And yet that's what we're doing, and what you advocate. Lock down until a vaccine or until a total cure is developed. Until there is no danger. Stay under the bed until SOMEONE ELSE removes the danger.

      Obviously you have not been a soldier, Jez. FYI, soldiers do not jump up out of a foxhole, wave their arms and shout, "Here we are, shoot my buddies." They jump up out of their foxholes, face the enemy toe to toe and kill him.

      Delete
    3. Where have I advocated that? I don't think we should/could wait that long. While we can be confident of avoiding the hospital overrun, I think we should be cautiously opening up.

      Delete
    4. We flattened the curve... and the economy. Mission accomplished.

      Government needs to get the hell out of the way and let everybody go back to work.

      Delete
    5. SF: I agree with all your comments.

      Delete
    6. I don't. In the foxhole analogy, abrupt derestriction is the equivalent of jumping up, dumping ammo and stripping down to the waist to show off your full-body target tattoo. If you can, work from home.

      Delete
    7. We have a better understanding of this than we did in February. CDC has just updated its guidance, saying touch surfaces don't appear to be big spreaders. Its close contact and respiratory droplets.

      Armed with this information, we can protect the vulnerable and let everybody else get back to living and working, with reasonable precautions in place.

      Governments don't have their own money and they don't create anything. They live off of the economic activity of people and businesses.



      https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html

      Delete
    8. SF,
      CDC has just updated its guidance, saying touch surfaces don't appear to be big spreaders.

      Indeed.

      There goes the new cottage industry of deep cleaners.

      Delete
    9. See Servpro, which is just one of such companies that have sprouted up in the last few weeks.

      Delete
  4. By now we all know who is at risk, and what can be done to protect both ourselves, and those who are at greater risk than ourselves. We don't need Governors to order us to stay at home, to close businesses, or to restrict travel. We can make those decisions for ourselves.

    The very idea that doing so lies within the power of government is, and ought to be anathema to most Americans.

    Government is, or should be, our servant, not our master. By all means do everything within it's sphere to protect and prevent the importation of disease, and provide us us the information we need to react responsibly to this situation, but otherwise step aside. It does not lie within the power, or the purview, of government to dictate the behavior of individuals beyond the limits of the Constitution.

    To the claims that such power is inherent in governance is fallacious in the extreme. There is, at least here in America, no higher law than the Constitution, and at my last count at least half a dozen Governors have been upbraided by the courts for violating it. Their claims to "Common Law" powers fall flat when reminded that common law only applies where it has not been replaced by statute. And that the "statutes" and precedents that they are relying on cannot supersede the Constitution, nor the Bill of Rights.





    ReplyDelete
    Replies
    1. Very well said. Thank you for saying it.

      Delete
    2. Viburnum,
      We don't need Governors to order us to stay at home, to close businesses, or to restrict travel. We can make those decisions for ourselves.

      The very idea that doing so lies within the power of government is, and ought to be anathema to most Americans.

      Government is, or should be, our servant, not our master.


      HEAR, HEAR!

      Delete
  5. At what cost does safety come?

    Personal story....

    The Department of Health has once again shut down my cousin's husband's electrical contractor business -- and the entire building site where he, along with several other contractors were working -- for two weeks.

    As of this writing, my cousin has not tested positive. Neither has my cousin's husband or any of his employees.

    So, why the shut down?

    Two workers on the building site tested positive -- with symptoms, BTW.

    This same thing happened a few weeks ago. Two weeks of quarantine that time, too -- for anyone who came into a positive worker and anyone on that building site and their families. Ever widening circles.

    Of course, all these contractors are no-work-no-pay workers.

    I am grateful that my cousin and not her husband carries the family's health insurance via her employer's health insurance plan.

    ReplyDelete
    Replies
    1. "As of this writing, my cousin has not tested positive. Neither has my cousin's husband or any of his employees."

      Have they been tested?

      Delete
  6. Somewhere above in this thread Ed said... "Forced vax? Why? Want the vax? Take it. My not taking the vax has no effect on your health.

    Ed, would it then be okay for churches, businesses and schools, as they used to do, refused to admit people who chose to avoid vaccines? Was the US wrong in requiring ppl for years to be vaccinated to attend school?

    Was our push towards vaccines, a push that 100% conquered small pox, wrong? Now we have the freedom to not get a small pox vaccine, but only because for a period of time, we vaccinated everyone so we could beat that disease.

    I'm curious as to why now we seem unwilling to adopt the very attitude that allowed to vaccinate and wipe out diseases like polio and small pox.

    Were we wrong to have done so? Were we robbing people of their freedoms? Or were we acting in the collective best interests of the US and the world?

    ReplyDelete
    Replies
    1. I have been advised by three doctors -- a neurologist, an internist, and a urologist -- never to again get a live vaccine. I've twice reacted to a live vaccine, one at 6 months old and again at 64 years old.

      Note: there are others like me, quite a few others.

      Delete
    2. Dave,
      Perhaps one concern is lack of full disclosure about the possible side effects of a vaccine. And I wonder if there will be enough testing to determine the possible side effects.

      Just sayin'.

      Delete
    3. One more point....COVID-19 has a long incubation period, and there is conflicting information about the contagion level during that asymptomatic incubation period.

      Delete
    4. I'm with Dave on this one. In my opinion "My not taking the vax has no effect on your health" is an untrue statement, and it belongs to a class of error that is extremely hard to avoid: it is wishful thinking. Ed would like it to be true, because if the universe did work that way, the libertarian position would become trivially easy to defend. But the universe isn't like that. Even so, I don't think libertarianism is a terrible idea, but the case for it isn't quite the slam dunk it would be if our actions didn't affect one another.

      Delete
    5. AOW of course should follow her doctor's advice and avoid live vaccines. And I agree that a relatively untested hurriedly-approved vaccine is a different animal from the long-established routine vaccines which are fully tested.

      Delete
    6. Jez,
      I had no idea until 2015 that getting a live vaccine would be so hard on me. BTW, that live vaccine was the chickenpox vaccine. The Shingles Vaccine was a live vaccine, too, at that time; but because I hadn't had the chickenpox (I was tested to make sure), I had to get that particular vaccine. I reacted at the time (just a rash, which I ignored), but ignored that reaction, which was, after all, not an unbearable reaction.

      A few months later? Kidney trouble. Excruciating pain, some of which I still have even after kidney surgery.

      I've since learned that live vaccines sometimes result in kidney trouble, particularly for those of us over age 60. **sigh**

      Delete
  7. Jez... re the vaccine timetable. Those are my worries about a "Warp Speed" move towards that vaccine.

    AOW... there are always ppl who, for some medical reason cannot, or should not be vaccinated. And they are the ones who need as many others as possible to be vaccinated. So as to reduce the risk to those who may not be able to get the shot.

    That's how we vanquished small pox, polio, and I hope one day, Covid.

    ReplyDelete
    Replies
    1. Dave,
      there are always ppl who, for some medical reason cannot, or should not be vaccinated.

      Indeed. But sometimes those people don't find out till after the fact. See my comment above to Jez.

      BTW, do you recall that history of the polio vaccine? See Vaccine-induced polio.

      Delete
  8. I do recall that. My mom had polio so I've always been somewhat alert to polio news. Look, as most here would attest, nothing is 100% safe and everything medical trends towards managing risk.

    While not minimizing those who maybe lost their lives to the vaccine, I bet that number was quite a bit lower than we would've seen had we decided to let the disease runs its course while waiting for herd immunity.

    Maybe...

    ReplyDelete

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