Corona Virus: It's a Marathon, Not a Sprint

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Max Peck
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Smoove_B wrote: Thu Jul 15, 2021 12:21 pm
Kurth wrote: Thu Jul 15, 2021 10:52 am Now the story may be repeating itself with Delta. It is significantly more contagious than even Alpha by almost every measure. It does not appear to be more severe, based on the data available so far.
Once again, the kicker is the vaccine, in terms of protecting the group we've already identified as the most vulnerable (elderly). I don't know that I've seen data suggesting Delta is worse for unvaccinated elders (65+) or the elder elders (75+), but I'm guessing someone is collecting it from whatever smaller pool of them remains (unvaccinated).

Since day one, everyone has been very focused on how "deadly" COVID-19 is (or is not), which is understandable; death is final. What I don't know (what no one knows) is whether or not Delta (or future variants) increase risk of chronic health problems in comparison to the original strain. Again, it would seem that symptomatic people (regardless of whether or not they're hospitalized) are at increased risk. So if Delta increases the chances of the virus working your body over like a speedbag, it would stand to reason that it increases your risk of chronic health impacts.

Regardless, the idea that we're continuing to allow (arguably, encouraging) uncontrolled spread is beyond frustrating.
From what I understood when trying to figure out what is happening in places like the UK and the Netherlands, the current Delta infections are primarily hitting a younger, largely unvaccinated demographic. COVID-19 has always produced milder symptoms for that age range. In order to really assess the severity of Delta vs the OG virus, they'd need to tunnel down to the same demographic in last year's mortality data, not just compare it to when the OG virus was tearing through vulnerable populations in long term care facilities and the like. Unless I missed it, the NYT article above doesn't seem to bother to do that when dismissing the claims that Delta is actually more severe.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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This thread is...something.

Hodor.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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I honestly haven't seen anyone in my field seriously talking about "herd immunity" for a long, long time. I think the notion of it happening has long disappeared, if there was any hope of it ever happening (personally, there wasn't).

I've been reading up a bit on a study that was published regarding Delta and thankfully the big-brains I trust have summarized it well for me. Basically, the study found that people infected with Delta amplify the virus faster, and then end up shedding a lot more of the virus - this is what is seemingly making it more infectious.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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As of July 12, national forecasts predict 54,000–383,000 new #COVID19 cases will likely be reported during the week ending August 7. More: http://bit.ly/CDC_CForecast.
If you follow through the Tweet, they also cover deaths and hospitalizations.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Smoove_B wrote: Thu Jul 15, 2021 1:23 pm EDIT: I think so much of my frustration lately is coming from this general perception I have that the media and the public (in general) is over COVID-19 - it's no longer an issue. No only in terms of the number of cases and deaths, but having it just spread around now. It feels like (to me) there's been an effort to minimize impacts now that he vaccine is out and it's summer. Meanwhile, random bad actors in various states are pushing anti-vaccination agendas and continuing to dismantle public health, seemingly building off the general sentiment that it's no big deal (anymore).
I think we're just ready for a new COVID. COVID-19 is so 19.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Smoove_B wrote: Thu Jul 15, 2021 1:23 pm
Serious isn't the same as likely. Namely, what is the incidence of "long COVID"? No one knows because we only have a little over a year's worth of data. Sure, it might not provide "serious" complications for the majority of children or adults, but it's a numbers game - like what we're seeing now with breakthrough infections. Allowing the virus to spread uncontrollably is a horrible strategy. My dad lost hearing (permanently) in one ear from a childhood mumps infection. Is that serious? On the scale of things that could have happened, probably not, but it's absolutely affected his life. For people with damaged lungs or hearts from COVID, is that "serious" if they're able to walk around and function without long-term assistance? Maybe no more sports or maybe it doesn't really impact their lives until they hit their 60s? Maybe it clips a few years off their lifespan.
i still haven't seen many... if any?... COVID downplayers directly address this. lots of playing at deaf ears on this subject (as it were). it's like they really are too dense to comprehend, or they're reallllly trying to not think about it (because then it doesn't exist, if you don't think about it).
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Smoove_B »

I wish I was as good with words and stuff as some people


Instead of achieving population-level (herd) immunity, whereby >70% vaccinated wind up protecting those w/o immunity, the very high contagiousness of Delta has flipped the model—"un-herd" immunity—the unvaccinated are infecting each other and the vaccinated.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Smoove_B »

NJ is now at 516 new cases and a Rt of 1.24 for the state. I believe the last time we were at these levels (~515) was mid-May; we're going backwards.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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hitbyambulance wrote: Thu Jul 15, 2021 6:36 pm
Smoove_B wrote: Thu Jul 15, 2021 1:23 pm
Serious isn't the same as likely. Namely, what is the incidence of "long COVID"? No one knows because we only have a little over a year's worth of data. Sure, it might not provide "serious" complications for the majority of children or adults, but it's a numbers game - like what we're seeing now with breakthrough infections. Allowing the virus to spread uncontrollably is a horrible strategy. My dad lost hearing (permanently) in one ear from a childhood mumps infection. Is that serious? On the scale of things that could have happened, probably not, but it's absolutely affected his life. For people with damaged lungs or hearts from COVID, is that "serious" if they're able to walk around and function without long-term assistance? Maybe no more sports or maybe it doesn't really impact their lives until they hit their 60s? Maybe it clips a few years off their lifespan.
i still haven't seen many... if any?... COVID downplayers directly address this. lots of playing at deaf ears on this subject (as it were). it's like they really are too dense to comprehend, or they're reallllly trying to not think about it (because then it doesn't exist, if you don't think about it).
Address what? That some subset of those infected with COVID will experience some form of chronic health problems in the future? My take away from the NYT and VOX articles I linked to earlier is that that is really no different from any other virus we’ve encountered, including the seasonal flu. We’re just so focused on all things COVID that the discussion of “long COVID” has spun up into a whole other level.

I don’t take issue with Smoove’s position that “allowing the virus to spread uncontrollably” is a terrible strategy. That seems obvious.

I’m just saying that considerations about “long COVID” seem to be outsized in the reporting and in the risk analysis of many. Be concerned that you could end up hospitalized or dead. Be concerned that you could feel like death warmed over for a couple weeks. Be concerned that catching COVID could cause you to miss work or vacation or other life events. Be concerned that catching COVID, even an asymptomatic case, increases the likelihood of the generation of new variants.

But it doesn’t seem like people should be sitting around worrying that they could be one of the unlucky few who end up with unknown (unknowable at this point) chronic health problems due to “long COVID.”
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Smoove_B wrote: Fri Jul 16, 2021 11:55 am NJ is now at 516 new cases and a Rt of 1.24 for the state. I believe the last time we were at these levels (~515) was mid-May; we're going backwards.
Any numbers on what percentage of those new cases are in vaccinated/unvaccinated populations?
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Smoove_B »

Kurth wrote: Fri Jul 16, 2021 12:09 pm Any numbers on what percentage of those new cases are in vaccinated/unvaccinated populations?
I think it follows the national trend 95%+ are unvaccinated. I'm waiting to see if they give a summary for the week - all the cases (ages, vaccination status), but this is a full 5 days of daily increases.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Kurth wrote: Fri Jul 16, 2021 12:07 pm My take away from the NYT and VOX articles I linked to earlier is that that is really no different from any other virus we’ve encountered, including the seasonal flu.
When potential effects of seasonal flu in healthy people start including diabetes, cardiac damage, or loss of grey brain matter, then I'll consider it a valid comparison. Until then, I'm not willing to play Russian roulette and risk to be that "1 in xxx" breakthrough case that results in a lifelong disability.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Smoove_B wrote: Fri Jul 16, 2021 12:12 pm
Kurth wrote: Fri Jul 16, 2021 12:09 pm Any numbers on what percentage of those new cases are in vaccinated/unvaccinated populations?
I think it follows the national trend 95%+ are unvaccinated. I'm waiting to see if they give a summary for the week - all the cases (ages, vaccination status), but this is a full 5 days of daily increases.
Well, my faith in rational self interest will be tested soon. How can anyone read that greater than 99% of deaths are occurring in the unvaccinated and 95%+ of new cases are in the unvaccinated and think, “Yep, I’m sure glad I didn’t get that free, effective, and widely available vaccine.”?

My daughter is cross country right now visiting a friend in NYC. The two of them had plans to meet up with their other friend who lives in PA. She told me this morning they decided to cancel their plans to meet her because she still isn’t vaccinated. Craziness.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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gilraen wrote: Fri Jul 16, 2021 12:19 pm
Kurth wrote: Fri Jul 16, 2021 12:07 pm My take away from the NYT and VOX articles I linked to earlier is that that is really no different from any other virus we’ve encountered, including the seasonal flu.
When potential effects of seasonal flu in healthy people start including diabetes, cardiac damage, or loss of grey brain matter, then I'll consider it a valid comparison. Until then, I'm not willing to play Russian roulette and risk to be that "1 in xxx" breakthrough case that results in a lifelong disability.
Yep. Diabetes, cardiac damage or loss of grey brain matter are bad.

What about: Permanent Hearing Loss, Guillain-Barre Syndrome, Pneumonia and MRSA, Myocarditis, Reye Syndrome, Pregnancy Loss, Encephalitis or Meningitis? All risks from seasonal flu according to the first random Google result I just looked at.

This one from 2017 seemed relevant, too, and a bit more scientific: The hidden burden of influenza: A review of the extra‐pulmonary complications of influenza infection.

Again, I’m not saying that “long COVID” isn’t a thing. Just that in the overall risk analysis, all other things being equal, it doesn’t make sense to me that it would be a significant factor in someone’s decision making.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Kurth wrote: Fri Jul 16, 2021 12:34 pmAgain, I’m not saying that “long COVID” isn’t a thing. Just that in the overall risk analysis, all other things being equal, it doesn’t make sense to me that it would be a significant factor in someone’s decision making.
All things aren't equal. The risks of seasonal flu are well understood. The risk of COVID long term are not. There is no ability to make an accurate risk call here.


Edit: The interesting corollary is that the risk of not getting vaccinated and getting vaccinated are becoming clear yet people are holding on to the uncertainty about safety of the vaccine to take on a huge known risk. But I think a ground truth is that people are bad at evaluating risk.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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malchior wrote: Fri Jul 16, 2021 12:41 pm
Kurth wrote: Fri Jul 16, 2021 12:34 pmAgain, I’m not saying that “long COVID” isn’t a thing. Just that in the overall risk analysis, all other things being equal, it doesn’t make sense to me that it would be a significant factor in someone’s decision making.
All things aren't equal. The risks of seasonal flu are well understood. The risk of COVID long term are not. There is no ability to make an accurate risk call here.
I don’t think you’re correct there. The chronic health risks associated with seasonal flu are not at all well understood, at least, not from the articles this conversation has caused me to look at. Check out that VOX article.
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by malchior »

Kurth wrote: Fri Jul 16, 2021 12:45 pm
malchior wrote: Fri Jul 16, 2021 12:41 pm
Kurth wrote: Fri Jul 16, 2021 12:34 pmAgain, I’m not saying that “long COVID” isn’t a thing. Just that in the overall risk analysis, all other things being equal, it doesn’t make sense to me that it would be a significant factor in someone’s decision making.
All things aren't equal. The risks of seasonal flu are well understood. The risk of COVID long term are not. There is no ability to make an accurate risk call here.
I don’t think you’re correct there. The chronic health risks associated with seasonal flu are not at all well understood, at least, not from the articles this conversation has caused me to look at. Check out that VOX article.
Gotcha - will take a look. I guess another way to think about it is people have dealt with the flu for their entire lives. We have a year's experience with COVID and a lot of people died very recently. I'd hazard a guess that when Spanish Flu and other pandemics occurred it drove lots of behaviors. I think this is a factor because people have wide ranges of risk tolerance especially when its unknown/unquantifiable. That is probably normal in an evolutionary sense. :)
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Is anyone surprised?
One week before the top global sporting event kicks off, the first person has tested positive for COVID-19 at the Olympic Village in Tokyo, as more than 11,000 athletes, plus an estimated 79,000 journalists, officials and staff are slated to gather in Japan during the ongoing pandemic.

So far, 44 people affiliated with the Games have tested positive since the beginning of July, most of them contractors.

...

The Olympic Village is part of efforts to keep athletes and staff in a bubble; a series of high-rise buildings provide housing, dining and medical care on the Harumi waterfront district of Tokyo. A "Fever Clinic" is equipped for COVID-19 testing and diagnosing.

In case of close contact with an infected person, every visitor to Japan is required to use smartphone apps to help with contact tracing.

Officials are encouraging but not requiring vaccination among Games participants. They say more than 80% of residents of the Olympic Village have been vaccinated.
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Zaxxon »

I'd be interested to hear Smoove's thoughts on this David Wallace-Wells piece.

https://nymag.com/intelligencer/2021/07 ... -time.html
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Re: Corona Virus: It's a Marathon, Not a Sprint

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A few immediate thoughts:

(1) He's very, very focused on death. Yes, he mentions chronic illness, but (to me) his entire argument smacks of "Kids don't die, so why are we trying to protect them?", and

(2) Kids were not (and still aren't) being tested at levels comparable to adults. I don't believe anyone is rock-solid confident in the data we do have regarding the actual number of cases for kids in the U.S. from 2020 (total, asymptomatic, etc..), and

The CDC study he's quoting regarding risk is from November of 2020. Risk in July of 2021 with the Delta variant is not the same risk at the data set that was used in November of 2020. I think this has been one of my biggest grrrr elements for the pandemic - it's a multi-headed hydra that changes. What we recommended in March of 2020 was wrong, so it had to change. What we recommended in July of 2020 was based on what we saw for those first 6 months. Recommendations (new, different) changed again for Fall of 2020 and once again in the Spring of 2021. Guess what? They need to change again *right now* because Delta is changing the equation. To be clear, when I say "recommendations" I am referring to individual behaviors - what people should be doing as they interact with others, situations they should be avoiding, etc...

While on paper it would seem the Delta variant isn't any more "deadly" than other versions of the virus, the fact that it can spread faster means more people (vaccinated and unvaccinated) can potentially be exposed. So using recommendations from 2020 to frame 2021 Delta behaviors and decisions is a bit disingenuous, imho.

This quote here is circles back to #1
But we are living in a very different world now, in which both the lion’s share of mortality risk has been eliminated through vaccination targeted at the elderly, and in which a much larger share of the ongoing transmission of the disease is producing much milder cases.
It's not just about death! Allowing the virus to spread uncontrollably under the moniker of "well, it's not killing old people anymore, so what's the big deal?" is not a position I could ever imagine defending.

He does make good points on the status of what's happening globally, so I guess we're in agreement there. :D

I don't agree that we're in the final chapter of the pandemic either; that is wishful thinking. Whatever is about to happen for "COVID Summer" is building, and then we get to see how this will all look nationwide as we head into winter. I am fully expecting disruptions again - not as widespread or as prolonged as 2020 and so much is going to depend on where you live, but disruptions nonetheless.

Regardless, from a fundamental standpoint, I cannot get on board with any argument that frames its position on mortality alone, particularly when 18+ months ago (as far as we know) this was not a disease of children in the United States.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Thanks. In less terrible news, some states are beginning to come around (though not yet mine)...

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Re: Corona Virus: It's a Marathon, Not a Sprint

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Hadn't seen it was up to 7 - that's encouraging.

Did everyone read Ed Yong's piece on Missouri from yesterday? I had to re-read a few parts like this one, because I couldn't believe it:
The hospital is now busier than at any previous point during the pandemic. In just five weeks, it took in as many COVID-19 patients as it did over five months last year.
Without a vaccine, we were all powerless. To have this happening now at this scale is mind-boggling.
Last week, Katie Towns, the acting director of the Springfield–Greene County Health Department, was concerned that the county’s daily cases were topping 250. On Wednesday, the daily count hit 405. This dramatic surge is the work of the super-contagious Delta variant, which now accounts for 95 percent of Greene County’s new cases, according to Towns. It is spreading easily because people have ditched their masks, crowded into indoor spaces, resumed travel, and resisted vaccinations. Just 40 percent of people in Greene County are fully vaccinated. In some nearby counties, less than 20 percent of people are.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Smoove_B wrote: Sat Jul 17, 2021 1:04 pm A few immediate thoughts:

(1) He's very, very focused on death. Yes, he mentions chronic illness, but (to me) his entire argument smacks of "Kids don't die, so why are we trying to protect them?", and



It's not just about death! Allowing the virus to spread uncontrollably under the moniker of "well, it's not killing old people anymore, so what's the big deal?" is not a position I could ever imagine defending.
When we’re assessing risk, is it wrong that the chances COVID would lead to death would be the single greatest consideration?

We care a shit ton more about preventing deadly viruses and illness than we do things that carry with them a far less likelihood they could kill us. And society is generally much more willing to take extreme measures to prevent the spread of a deadly virus than one that’s not likely to lead to death.

Makes sense to me.
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Smoove_B »

Kurth wrote: Sat Jul 17, 2021 2:16 pm When we’re assessing risk, is it wrong that the chances COVID would lead to death would be the single greatest consideration?
Maybe. I think it still comes down to how I (and public health) frame the issue. Namely, how public and private health attack these problems. I think I've likely been skipping a lot of the calculus here for our discussions, but I'm hoping this clarifies things.

In short, public health and private health in the United States attack the same problems but at different points. Right now, the medical profession is taking the lead for COVID-19 as they're "fighting in the trenches" and dealing with the immediate impacts of people that contract the virus and experience some type of medical complication. Their goal is quick diagnosis and appropriate treatments to minimize the risk of death (first) and then try to do everything they can to return that person to a state of health that closely approximates the same level they experienced before becoming ill.

Public health, on the other hand is trying to avoid illness onset at all. We're doing everything that we can to avoid disease state. So our recommendations are focused on minimizing exposure risk and then the need to have the medical community address a disease condition in the first place.

Historically speaking, private health (practice) has been the dominant practice in America since the 1950s. Public health has been pushing for higher prioritization since the 1970s, but we're still very much a nation focused on response to problems, not prevention.

So to bring this back to death, if that's all someone is focused on, the private-health profession has a huge advantage right now with people being vaccinated - they have a leg up on keeping people alive. For those that are unvaccinated, they still have their hands full.

Public health is still focusing on the other side of equation. It's not that we don't care about death, but for us that's one of the endpoints after a disease condition occurs. We want to avoid that path because we're also tracking the time lost when someone becomes ill. The insurance burden. The administrative burden. Time lost by family members that are taking care of someone that's sick. Years of life lost. Disability Adjusted Life Years (DALYs) - things that in my experience, most aren't considering in their risk calculations focused on death.

I don't want to sound like I'm minimizing the medical profession in any way either. I just wanted to clarify why sometimes its difficult for me (and those in my field) to try and communicate why we feel the way we do or why we make the recommendations we do. If wearing masks right now (for example) reduces disease burden, reduces lost wages, reduces medical costs then that's why we push for it; that's how we're wired to think. Ultimately yes, it reduces death but that's not the first stop on the spectrum of disease flow chart.
We care a shit ton more about preventing deadly viruses and illness than we do things that carry with them a far less likelihood they could kill us. And society is generally much more willing to take extreme measures to prevent the spread of a deadly virus than one that’s not likely to lead to death.
Right, I think that's part of what I said above. Also, the medical profession has become really good at responding to things like heart attacks (death) and then offering treatments (stents) that prolong life. Why should I change my diet or stop smoking when doctors can fix me?

And that's also the difficulty with the masks, or even vaccination right now for healthy, younger folks. Why bother? It's not killing people any more. Why should I wear a mask or get vaccinated? This ties back into that lack of community - a lack of understanding of how the decisions individuals make, collectively impact the community they live in. I have people that live around me that want to open-burn yard waste and garbage and they're mad they cannot (it's illegal in NJ). If one person did it, in truth, it probably wouldn't be a big deal. But if you have dozens of people in a neighborhood or hundreds in a town? It adds up. Are they directly killing people directly by burning garbage? No. Are they impacting quality of life and contributing to variables that lower health? Absolutely.

Masks and vaccinations are the same right now for so many. It's not about what it's doing for you as an individual. It's how those decisions are rippling out and affecting others in your surrounding area. The idea that we won't collectively accept wearing masks again now because "COVID isn't killing kids" is a mindset I just can't process. It's literally the least we can do and it would have measurable benefits to children.

I'm likely off topic at this point.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Smoove, I really appreciate that explanation. My sister is an ER doc, so I hear an awful lot about things from the medical side. Your explanation was really the first time I’ve heard the distinction between public/private health efforts crystallized like that. Very helpful!

I’m still not sure I understand what the “measurable benefits to children” are that you refer to at the end of your post, but I think I have a better understanding of what you’re getting at from the pubic health perspective of stopping illness onset rather than treating and weighing the impact of treating disease condition.
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Smoove_B »

Kurth wrote: Sat Jul 17, 2021 3:50 pm Smoove, I really appreciate that explanation. My sister is an ER doc, so I hear an awful lot about things from the medical side. Your explanation was really the first time I’ve heard the distinction between public/private health efforts crystallized like that. Very helpful!
I'm always happy to talk about public health and grateful I'm able to do so here and in real life.
I’m still not sure I understand what the “measurable benefits to children” are that you refer to at the end of your post
The measurable benefit is that it reduces their risk (while at school, maybe I should have clarified that) of being exposed. Again, to go back to the general mentality we want to encourage polices and behaviors that will minimize the risk of the virus ever being able to infect a child. We can't vaccinate them, so our current go-to strategy is out. We can recommend spacing and increased ventilation, though we know that for many schools this was a problem in 2020 and largely only possible when they had A/B schedules and reduced facility use. Handwashing is always important, but that's not going to be a leading recommendation for schools in the Fall of 2021. All that's left is wearing masks and we know that wearing masks reduces risk of exposure - even if its just a cloth mask. In the same way requiring that a child is put in a rear-facing car seat or requiring helmets for kids on bikes, skateboards or skiing - they're all reducing risk and have had measurable benefits over decades of implementation (more the car seats than the helmets).
but I think I have a better understanding of what you’re getting at from the pubic health perspective of stopping illness onset rather than treating and weighing the impact of treating disease condition.
Most excellent then. I'm glad I could get that all out clearly. :D
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Kurth »

One other thing about kids and masks that I find interesting: Setting aside wearing them during sports, kids seem much more chill about mask wearing than many parents. At least anecdotally, the kids I know (including my 8th grader, Junior and senior), generally seem to feel like wearing masks is no big deal.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Kurth wrote: Sat Jul 17, 2021 5:49 pm One other thing about kids and masks that I find interesting: Setting aside wearing them during sports, kids seem much more chill about mask wearing than many parents. At least anecdotally, the kids I know (including my 8th grader, Junior and senior), generally seem to feel like wearing masks is no big deal.
Same. It's one reason why I really feel like it's a near-zero cost intervention until the vaccine is available for them. My kids are younger (7 and 9), but neither they nor their friends give a single shit about being asked to wear them.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Like so many other things, I think it comes back to what the parents are saying and how they acting. If parents are modeling the behavior, the kids follow suit. I'd be amazed to learn of parents that are steadfast believers in masking that have kids in the ~7-11 year old age range that refuse to wear masks. I get that there's always exceptions and not every kid is going to wear one, but I can also say that anecdotally I am always pleasantly surprised to see ~5 year old kids wearing masks with their mask-wearing parents.

If you look at the studies on alcohol use and tobacco use, it's the same - kids pick up on what their parents are doing or how their parents feel about alcohol and tobacco and they mirror behaviors as they internalize their own patterns and beliefs. Yes, there are other influences (like their peers, media, the MTV), but parental attitudes are quite powerful.

So that's why when I see all these anti mask parents talking about how their kids hate masks and can't wear them, it's no surprise at all.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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So really what you're saying is that Kurth and I are awesome role models.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Zaxxon wrote: Sat Jul 17, 2021 9:03 pm So really what you're saying is that Kurth and I are awesome role models.
Ummm. That alcohol thing . . . Maybe not so much these days.
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Smoove_B »

:D

As someone that finished ~6 bottles of Scotch between September and January, you'll get no judgements from me. it's been a hell of year.

Global update from France:

On Monday, French president Macron ordered

1) compulsory vaccination of all healthcare workers and

2) proof of either vaccination or negative COVID test to enter cafés, cinemas, shopping malls, etc.

Result: record vaccinations, 3 million in 5 days
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Some evidence from Israel that breakthrough cases are more likely to occur in people who are more vulnerable (older or have comorbidities):
“Overall, we can say that the main thing is that these are not healthy people,” Brosh told The Jerusalem Post in an interview. “Almost all of them (96%) had comorbidities: heart disease, lung disease, renal disease, dementia, cancer, or other common ailments. So, people who get breakthrough infections and are admitted are sicker than a usual person.”
“If you are older and have comorbidities – and definitely, if you have a lot of comorbidities – or are immunocompromised, you cannot assume you will be well protected by the vaccine,” Brosh said. “When there is a lot of transmission in the community, you should take care of yourself.”
https://www.jpost.com/health-science/wh ... jab-673788
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Smoove_B wrote: Sat Jul 17, 2021 8:57 pm Like so many other things, I think it comes back to what the parents are saying and how they acting. If parents are modeling the behavior, the kids follow suit. I'd be amazed to learn of parents that are steadfast believers in masking that have kids in the ~7-11 year old age range that refuse to wear masks. I get that there's always exceptions and not every kid is going to wear one, but I can also say that anecdotally I am always pleasantly surprised to see ~5 year old kids wearing masks with their mask-wearing parents.

If you look at the studies on alcohol use and tobacco use, it's the same - kids pick up on what their parents are doing or how their parents feel about alcohol and tobacco and they mirror behaviors as they internalize their own patterns and beliefs. Yes, there are other influences (like their peers, media, the MTV), but parental attitudes are quite powerful.

So that's why when I see all these anti mask parents talking about how their kids hate masks and can't wear them, it's no surprise at all.
Yeah, my kids have been going to school masked since last fall. I was expecting there to be *some* trouble on it or at least whining, but there really wasn't. And when there would be (outdoor) school gatherings I didn't see any other kids complaining or trying to not wear masks - seemed pretty easy.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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stessier wrote: Tue Jul 06, 2021 12:39 pm OSHA guidance says
OSHA has stated that employers are obligated to implement multiple controls to protect not-fully-vaccinated employees, visitors, business partners and customers based on CDC guidance.
CDC guidance says that anyone fully vaccinated has face coverings optional (among other things).

So we're asking vaccination status and then managing people's hygiene requirements (which falls to the supervisors). This is going to get interesting.

At least we didn't interpret the OSHA guidance to mean everyone had to remain in face coverings to protect the unvaccinated. While undoubtedly the safest route, I'm not in a particularly charitable mood this week.
We got out of masks at work around 7/12. At that point, our 14 day rolling average was around 2.5 cases/100k. We are now above 6.0 and have to go back into masks if we get above 10. We have until 7/30 to fill out a report on our vaccination status to allow us to remove masks. I'm betting we end up mandated back in them before everyone gets out of them.
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by LordMortis »

And as of today people with proof of vaccination no longer need to mask in shared spaces and room restriction of three people has been removed. And not by coincidence, I am going to be working from home whenever I can again.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by LawBeefaroni »

Smoove_B wrote: Sat Jul 17, 2021 2:40 pm
Kurth wrote: Sat Jul 17, 2021 2:16 pm When we’re assessing risk, is it wrong that the chances COVID would lead to death would be the single greatest consideration?
Maybe. I think it still comes down to how I (and public health) frame the issue. Namely, how public and private health attack these problems. I think I've likely been skipping a lot of the calculus here for our discussions, but I'm hoping this clarifies things.

In short, public health and private health in the United States attack the same problems but at different points. Right now, the medical profession is taking the lead for COVID-19 as they're "fighting in the trenches" and dealing with the immediate impacts of people that contract the virus and experience some type of medical complication. Their goal is quick diagnosis and appropriate treatments to minimize the risk of death (first) and then try to do everything they can to return that person to a state of health that closely approximates the same level they experienced before becoming ill.

Public health, on the other hand is trying to avoid illness onset at all. We're doing everything that we can to avoid disease state. So our recommendations are focused on minimizing exposure risk and then the need to have the medical community address a disease condition in the first place.

Historically speaking, private health (practice) has been the dominant practice in America since the 1950s. Public health has been pushing for higher prioritization since the 1970s, but we're still very much a nation focused on response to problems, not prevention.

So to bring this back to death, if that's all someone is focused on, the private-health profession has a huge advantage right now with people being vaccinated - they have a leg up on keeping people alive. For those that are unvaccinated, they still have their hands full.

Public health is still focusing on the other side of equation. It's not that we don't care about death, but for us that's one of the endpoints after a disease condition occurs. We want to avoid that path because we're also tracking the time lost when someone becomes ill. The insurance burden. The administrative burden. Time lost by family members that are taking care of someone that's sick. Years of life lost. Disability Adjusted Life Years (DALYs) - things that in my experience, most aren't considering in their risk calculations focused on death.

I don't want to sound like I'm minimizing the medical profession in any way either. I just wanted to clarify why sometimes its difficult for me (and those in my field) to try and communicate why we feel the way we do or why we make the recommendations we do. If wearing masks right now (for example) reduces disease burden, reduces lost wages, reduces medical costs then that's why we push for it; that's how we're wired to think. Ultimately yes, it reduces death but that's not the first stop on the spectrum of disease flow chart.
We care a shit ton more about preventing deadly viruses and illness than we do things that carry with them a far less likelihood they could kill us. And society is generally much more willing to take extreme measures to prevent the spread of a deadly virus than one that’s not likely to lead to death.
Right, I think that's part of what I said above. Also, the medical profession has become really good at responding to things like heart attacks (death) and then offering treatments (stents) that prolong life. Why should I change my diet or stop smoking when doctors can fix me?

And that's also the difficulty with the masks, or even vaccination right now for healthy, younger folks. Why bother? It's not killing people any more. Why should I wear a mask or get vaccinated? This ties back into that lack of community - a lack of understanding of how the decisions individuals make, collectively impact the community they live in. I have people that live around me that want to open-burn yard waste and garbage and they're mad they cannot (it's illegal in NJ). If one person did it, in truth, it probably wouldn't be a big deal. But if you have dozens of people in a neighborhood or hundreds in a town? It adds up. Are they directly killing people directly by burning garbage? No. Are they impacting quality of life and contributing to variables that lower health? Absolutely.

Masks and vaccinations are the same right now for so many. It's not about what it's doing for you as an individual. It's how those decisions are rippling out and affecting others in your surrounding area. The idea that we won't collectively accept wearing masks again now because "COVID isn't killing kids" is a mindset I just can't process. It's literally the least we can do and it would have measurable benefits to children.

I'm likely off topic at this point.

I've heard the private/public health thing explained like this. Imagine a river with some deceptively difficult rapids. People boat down this river, hit the rapids, and many capsize, get battered on the rocks, drown, etc. Some survive the rapids only to drown further downstream. Private health are the rescuers after the rapids who go in and try to save all the drowning, injured individuals.

Public health is upstream from the rapids, trying to tell people to turn around.
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Smoove_B »

Yeah, that's a great way to think about it.

In other news, models for TX not looking great:


The @UTAustin modeling consortium now expects COVID hospitalizations in North Texas to be around 3,300 by August 13.

That's where we were in late January.

They project Texas to be around 12,600 patients by August 13, that's about 2,000 above last summer's peak.
No masks and school starting. I don't even know what to say about it anymore.
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