Tweet perspective on Coronavirius and health care
- Thread starter NYShoreGuy
- Start date
It took two weeks but at least now you understand we are experiencing a worldwide pandemic. Had you realized it two weeks ago, you would have been called for more testing. But two weeks ago it was overreacting. Yes, you are consistent.
If you read my post, it was pretty clear that I was comparing the reported numbers and the actions that China was taking that wasn’t adding up. (Do I need to explain what on the one hand/on the other hand means?)
Two weeks ago the WHO did not classify it as a worldwide pandemic; now they have. Has nothing to do with what I realized. Just reporting facts.
[QUOTE="HALL85, post: 700048, member: 144"Just reporting facts.[/QUOTE]
Yup, it's a fact that two weeks ago you reported this whole thing struck you as an overreaction. That is exactly why we are where we are. We did not take advantage of the time when the numbers were small to better prepare ourselves. You won't be prepared for the next pandemic either. You are consistent.
Yup, it's a fact that two weeks ago you reported this whole thing struck you as an overreaction. That is exactly why we are where we are. We did not take advantage of the time when the numbers were small to better prepare ourselves. You won't be prepared for the next pandemic either. You are consistent.
Embarrassed by your own words, you have resorted to your standard response - insults. You are consistent.
I’m not going to get into your juvenile responses. Keep going if that makes you feel better.
More important things to discuss and act on regarding COVID-19. We need to assess what’s going on around us and respond accordingly. For instance why have European infections and deaths accelerated past the US? Were they too late in enforcing containment strategies (border closings and travel lockdowns between countries?). How are they getting testing deployed and what is the impact?
IMO, Fauci and Gottlieb are proving the most sound and measured assessments and recommendations.
Because it spread there earlier. We are about 10-12 days behind Italy.
Based on the who situation reports. (bit of a lag from other sources)
On March 2nd,
Italy - 1,689 confirmed cases and 35 deaths.
US - 62 confirmed cases and 2 deaths.
On March 15th
Italy - 21,157 confirmed cases and 1,441 deaths
US - 1,678 confirmed cases and 41 deaths.
I was referring to the other European countries that were lagging behind us (Spain, France, Germany, etc.) and now have accelerated past.
First cases in the US were from people who came back from travel abroad and were quarantined when they got here, not the same as in European countries. Likely patient zero in those countries was moving around freely so the spread traveled more quickly. Probably a little too optimistic to think we did something better at containing it once it was in the general population than those countries.
We've got a buffet of Dunning-Kruger Effect going on here. The 'it's not what they say it is' crowd needs to stop talking out of their asses immediately.
But...
"I looked at the numbers and..."
"The MSM blah blah blah..."
"You don't understand, I looked up..."
"I talked to someone..."
"Insert ignorance here..."
You know nothing on this subject. Nada. Zip. Zilch. You are not an expert. You lack 1% of the required knowledge to talk about this subject in a meaningful way, yet you continue on with the "I got this" routine which is painfully embarrassing and purely ignorant. You didn't have it weeks ago and you don't have it now. It's time for you folks to sit this out. Listen to experts and then do.
This is math. This is expertise:
https://static1.squarespace.com/sta.../Systemic_Risk_of_Pandemic_via_Novel_Path.pdf
Cite as:
Joseph Norman, Yaneer Bar-Yam, and Nassim Nicholas Taleb, Systemic risk of pandemic via novel pathogens – Coronavirus: A note, New England Complex Systems Institute (January 26, 2020).
Download PDF
The novel coronavirus emerging out of Wuhan, China has been identified as a deadly strain that is also highly contagious. The response by China to date has included travel restrictions on tens of millions across several major cities in an effort to slow its spread. Despite this, positively identified cases have already been detected in many countries spanning the globe and there are doubts such containment would be effective. This note outlines some principles to bear in relation to such a process.
Clearly, we are dealing with an extreme fat-tailed process owing to an increased connectivity, which increases the spreading in a nonlinear way [1], [2]. Fat tailed processes have special attributes, making conventional risk-management approaches inadequate.
General Precautionary Principle
The general (non-naive) precautionary principle [3] delineates conditions where actions must be taken to reduce risk of ruin, and traditional cost-benefit analyses must not be used. These are ruin problems where, over time, exposure to tail events leads to a certain eventual extinction. While there is a very high probability for humanity surviving a single such event, over time, there is eventually zero probability of surviving repeated exposures to such events. While repeated risks can be taken by individuals with a limited life expectancy, ruin exposures must never be taken at the systemic and collective level. In technical terms, the precautionary principle applies when traditional statistical averages are invalid because risks are not ergodic.
Naive Empiricism
Next we address the problem of naive empiricism in discussions related to this problem.
Spreading rate: Historically based estimates of spreading rates for pandemics in general, and for the current one in particular, underestimate the rate of spread because of the rapid increases in transportation connectivity over recent years. This means that expectations of the extent of harm are underestimates both because events are inherently fat tailed, and because the tail is becoming fatter as connectivity increases.
Global connectivity is at an all-time high, with China one of the most globally connected societies. Fundamentally, viral contagion events depend on the interaction of agents in physical space, and with the forward-looking uncertainty that novel outbreaks necessarily carry, reducing connectivity temporarily to slow flows of potentially contagious individuals is the only approach that is robust against misestimations in the properties of a virus or other pathogen.
Reproductive ratio: Estimates of the virus’s reproductive ratio R0—the number of cases one case generates on average over the course of its infectious period in an otherwise uninfected population—are biased downwards. This property comes from fat-tailedness [4] due to individual ‘superspreader’ events. Simply, R0 is estimated from an average which takes longer to converge as it is itself a fat-tailed variable.
Mortality rate: Mortality and morbidity rates are also downward biased, due to the lag between identified cases, deaths and reporting of those deaths.
Increasingly Fatal Rapidly Spreading Emergent Pathogens: With increasing transportation we are close to a transition to conditions in which extinction becomes certain both because of rapid spread and because of the selective dominance of increasingly worse pathogens. [5]
Asymmetric Uncertainty: Properties of the virus that are uncertain will have substantial impact on whether policies implemented are effective. For instance, whether contagious asymptomatic carriers exist. These uncertainties make it unclear whether measures such as temperature screening at major ports will have the desired impact. Practically all the uncertainty tends to make the problem potentially worse, not better, as these processes are convex to uncertainty.
Fatalism and inaction: Perhaps due to these challenges, a common public health response is fatalistic, accepting what will happen because of a belief that nothing can be done. This response is incorrect as the leverage of correctly selected extraordinary interventions can be very high.
Conclusion: Standard individual-scale policy approaches such as isolation, contact tracing and monitoring are rapidly (computationally) overwhelmed in the face of mass infection, and thus also cannot be relied upon to stop a pandemic. Multiscale population approaches including drastically pruning contact networks using collective boundaries and social behavior change, and community self-monitoring, are essential.
Together, these observations lead to the necessity of a precautionary approach to current and potential pandemic outbreaks that must include constraining mobility patterns in the early stages of an outbreak, especially when little is known about the true parameters of the pathogen.
It will cost something to reduce mobility in the short term, but to fail do so will eventually cost everything—if not from this event, then one in the future. Outbreaks are inevitable, but an appropriately precautionary response can mitigate systemic risk to the globe at large. But policy- and decision-makers must act swiftly and avoid the fallacy that to have an appropriate respect for uncertainty in the face of possible irreversible catastrophe amounts to "paranoia," or the converse a belief that nothing can be done.
References
Do you know who these people are? Do you know what their expertise is?
Stick with CDC and WHO recommendations. Listen to experts. If it is overkill, that's a better version of wrong than the inverse and we get back to normal faster than anticipated. Stop trying to walk back or double down on your ill-conceived posts. Shut up...you don't have this.
P.S. If I have offended you, I don't care at all. You've earned it.
But...
"I looked at the numbers and..."
"The MSM blah blah blah..."
"You don't understand, I looked up..."
"I talked to someone..."
"Insert ignorance here..."
You know nothing on this subject. Nada. Zip. Zilch. You are not an expert. You lack 1% of the required knowledge to talk about this subject in a meaningful way, yet you continue on with the "I got this" routine which is painfully embarrassing and purely ignorant. You didn't have it weeks ago and you don't have it now. It's time for you folks to sit this out. Listen to experts and then do.
This is math. This is expertise:
https://static1.squarespace.com/sta.../Systemic_Risk_of_Pandemic_via_Novel_Path.pdf
Cite as:
Joseph Norman, Yaneer Bar-Yam, and Nassim Nicholas Taleb, Systemic risk of pandemic via novel pathogens – Coronavirus: A note, New England Complex Systems Institute (January 26, 2020).
Download PDF
The novel coronavirus emerging out of Wuhan, China has been identified as a deadly strain that is also highly contagious. The response by China to date has included travel restrictions on tens of millions across several major cities in an effort to slow its spread. Despite this, positively identified cases have already been detected in many countries spanning the globe and there are doubts such containment would be effective. This note outlines some principles to bear in relation to such a process.
Clearly, we are dealing with an extreme fat-tailed process owing to an increased connectivity, which increases the spreading in a nonlinear way [1], [2]. Fat tailed processes have special attributes, making conventional risk-management approaches inadequate.
General Precautionary Principle
The general (non-naive) precautionary principle [3] delineates conditions where actions must be taken to reduce risk of ruin, and traditional cost-benefit analyses must not be used. These are ruin problems where, over time, exposure to tail events leads to a certain eventual extinction. While there is a very high probability for humanity surviving a single such event, over time, there is eventually zero probability of surviving repeated exposures to such events. While repeated risks can be taken by individuals with a limited life expectancy, ruin exposures must never be taken at the systemic and collective level. In technical terms, the precautionary principle applies when traditional statistical averages are invalid because risks are not ergodic.
Naive Empiricism
Next we address the problem of naive empiricism in discussions related to this problem.
Spreading rate: Historically based estimates of spreading rates for pandemics in general, and for the current one in particular, underestimate the rate of spread because of the rapid increases in transportation connectivity over recent years. This means that expectations of the extent of harm are underestimates both because events are inherently fat tailed, and because the tail is becoming fatter as connectivity increases.
Global connectivity is at an all-time high, with China one of the most globally connected societies. Fundamentally, viral contagion events depend on the interaction of agents in physical space, and with the forward-looking uncertainty that novel outbreaks necessarily carry, reducing connectivity temporarily to slow flows of potentially contagious individuals is the only approach that is robust against misestimations in the properties of a virus or other pathogen.
Reproductive ratio: Estimates of the virus’s reproductive ratio R0—the number of cases one case generates on average over the course of its infectious period in an otherwise uninfected population—are biased downwards. This property comes from fat-tailedness [4] due to individual ‘superspreader’ events. Simply, R0 is estimated from an average which takes longer to converge as it is itself a fat-tailed variable.
Mortality rate: Mortality and morbidity rates are also downward biased, due to the lag between identified cases, deaths and reporting of those deaths.
Increasingly Fatal Rapidly Spreading Emergent Pathogens: With increasing transportation we are close to a transition to conditions in which extinction becomes certain both because of rapid spread and because of the selective dominance of increasingly worse pathogens. [5]
Asymmetric Uncertainty: Properties of the virus that are uncertain will have substantial impact on whether policies implemented are effective. For instance, whether contagious asymptomatic carriers exist. These uncertainties make it unclear whether measures such as temperature screening at major ports will have the desired impact. Practically all the uncertainty tends to make the problem potentially worse, not better, as these processes are convex to uncertainty.
Fatalism and inaction: Perhaps due to these challenges, a common public health response is fatalistic, accepting what will happen because of a belief that nothing can be done. This response is incorrect as the leverage of correctly selected extraordinary interventions can be very high.
Conclusion: Standard individual-scale policy approaches such as isolation, contact tracing and monitoring are rapidly (computationally) overwhelmed in the face of mass infection, and thus also cannot be relied upon to stop a pandemic. Multiscale population approaches including drastically pruning contact networks using collective boundaries and social behavior change, and community self-monitoring, are essential.
Together, these observations lead to the necessity of a precautionary approach to current and potential pandemic outbreaks that must include constraining mobility patterns in the early stages of an outbreak, especially when little is known about the true parameters of the pathogen.
It will cost something to reduce mobility in the short term, but to fail do so will eventually cost everything—if not from this event, then one in the future. Outbreaks are inevitable, but an appropriately precautionary response can mitigate systemic risk to the globe at large. But policy- and decision-makers must act swiftly and avoid the fallacy that to have an appropriate respect for uncertainty in the face of possible irreversible catastrophe amounts to "paranoia," or the converse a belief that nothing can be done.
References
- Y. Bar-Yam, “Dynamics of complex systems,” 1997.
- —, “Transition to extinction: Pandemics in a connected world,” 2016.
- N.N. Taleb, R. Read, R. Douady, J. Norman, and Y. Bar-Yam, “The precautionary principle (with application to the genetic modification of organisms),” arXiv preprint arXiv:1410.5787, 2014.
- N.N. Taleb, The Statistical Consequences of Fat Tails. STEM Academic Press, 2020.
- E.M. Rauch and Y. Bar-Yam, “Long-range interactions and evolutionary stability in a predator-prey system,” Physical Review E, vol. 73, no. 2, p. 020903, 2006.
Do you know who these people are? Do you know what their expertise is?
Stick with CDC and WHO recommendations. Listen to experts. If it is overkill, that's a better version of wrong than the inverse and we get back to normal faster than anticipated. Stop trying to walk back or double down on your ill-conceived posts. Shut up...you don't have this.
P.S. If I have offended you, I don't care at all. You've earned it.
Lotta supposition there. As the experts (Fauci, Gottlieb, etc.) have continued to say: containment, hygiene and social distancing. Hospitals are working now to ensure capacity is freed up in the event of more rapid hospitalizations.
Yeah, of course it is supposition. Though it is not accurate to say that they were lagging behind us and are now accelerating ahead.
Drag our trend line back a couple days and we are on the same line as them.
To be fair, it was the CDC which recommended testing only within the constraints of epidemiological risk, at first.
They did, but what does that mean? Nothing really. They are still experts. They are not infallible, but they still know better. A miss equals what? Throw out everything they offer? No.
Steph Curry makes 9 of 10 FTs. He’ll miss some. I still want him on the line shorting FTs for me. The message board “experts” are chucking shots from half-court while blindfolded.
Absolutely agree with that, although I am sure many of those who read that will think you can't possibly be talking about them.
The problem is that people here are listening to the experts and walking away with vastly different understandings.
To be clear, on this topic I am aware of my ignorance, I am just trying to convey here is what I have read from the experts, and the experts say the reason this virus is dangerous is because of how mild it can be, the long incubation period and how easy it has been to spread it.
That makes complete sense. Manage the risk first... but we need to expand that bubble quickly to stop the spread.
You're basically asking why non-experts question the experts. I gave you a glaring example. That said, I cringed at the pictures of pubs full of St. Patrick's Day revelers from this weekend. What distresses me is the politicization of something like this; people are lining up along very predictable ideological lines, and you have some acting like they just ate their last meal, and the others eating, drinking, and being merry -- shoulder to shoulder at the bar. Distressing times.
I'm basically saying stop talking out of your asses. Questioning is fair and healthy. That's not really what's happening here. Acting like you know when you don't know, especially in direct conflict with experts, is incredibly dumb in this case. It's the 'I got this' crowd. They don't have it. When it comes to basketball, talk out of your butts all you want. Who cares, that is irrelevant. Our current CV situation is a serious situation, don't spread ignorance. The politicization is predictable and frustrating. SOS, different day on that front.
The problem is the people not listening to experts, unaware of their ignorance, and vocal about their assessment of the situation. Full on Dunning-Kruger Effect.
Several of them on this board. A reason I generally stay away from LOTS and have several of them blocked.
2020 in a nutshell. Just block and tune out people who you don't agree with so you can live in your own bubble.
I don't block anyone on here (including you!) because I value different perspectives and opinions. Just a thought, but you should too! You'll be a better person for it.
I'm a fine person you don't know a thing about me, how I act, or who I associate with daily. Nice judgement, btw. What FL is spewing deserves to be blocked - I only deal with people in reality not Alex Jones reality. Maybe now that Trump has changed his tune, so will he?
And didn't know I was such a burden for you to read. Oh well.
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Sadly, I was expecting a close-minded response like that. A shame that we can't all get along and listen to different perspectives.
Lol. "A shame that we can't all get along and listen to different perspectives".
You can weigh Tony Fauci, WHO, CDC and FL against each other.
I'll listen to Tony Fauci, CDC, WHO.
You can listen to them and FL. Pretty sure you had some interesting things to say about them on the fee board last week fwiw.
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That is good to see. Really hope that is the start of a trend. Were they all symptomatic?
Unfortunately everything else I am reading is pointing in the other direction and looks like we are about two weeks away from our curve starting to flatten. Hope I am wrong there but if you look at the spread after the first 100 cases were diagnosed, we just passed Italy's trend line.
Unfortunately everything else I am reading is pointing in the other direction and looks like we are about two weeks away from our curve starting to flatten. Hope I am wrong there but if you look at the spread after the first 100 cases were diagnosed, we just passed Italy's trend line.
I believe they are only testing symptomatic patients. Looking at the CDC numbers by state, approximately three states account for half the cases and fatalities (NY, CA, WA). So perhaps the trend line is more skewed to those three states and the rest of the country on that graph. Makes the case for containment.
On another front, I understand the New Jersey State police was thinking about potentially shutting down all interstate highway travel to discourage movement between states. The curfew also discourages residents from that as well.
TMO now shipping high volume https://www.cnbc.com/2020/03/16/the...us-tests-aims-to-make-5-million-per-week.htmltest kits now.
On another front, I understand the New Jersey State police was thinking about potentially shutting down all interstate highway travel to discourage movement between states. The curfew also discourages residents from that as well.
TMO now shipping high volume https://www.cnbc.com/2020/03/16/the...us-tests-aims-to-make-5-million-per-week.htmltest kits now.
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Great news on the test kits.
My concern right now in regards to the growth is if those states are leading the way because they were first, or because that is where the cases will ultimately be concentrated. Looking back 2 weeks ago from where we are today On March 2nd we had 100 cases total in the US.
There are now at least 10 states with over 100 cases. Each one of them could see the same type of exponential growth that we are seeing now in NY, CA and WA.
Given the incubation period and the fact that we really just started social distancing, the math seems to suggest there will be over 100k cases confirmed within 2 weeks from now and then we will hopefully begin to see the curve flatten out as we benefit from social distancing.
My concern right now in regards to the growth is if those states are leading the way because they were first, or because that is where the cases will ultimately be concentrated. Looking back 2 weeks ago from where we are today On March 2nd we had 100 cases total in the US.
There are now at least 10 states with over 100 cases. Each one of them could see the same type of exponential growth that we are seeing now in NY, CA and WA.
Given the incubation period and the fact that we really just started social distancing, the math seems to suggest there will be over 100k cases confirmed within 2 weeks from now and then we will hopefully begin to see the curve flatten out as we benefit from social distancing.
That would be a fantastic scenario. I think the large population centers will ultimately -- and by far -- bear the brunt of this. On a smaller scale, I heard yesterday that the only counties in NJ with 0 cases (could be changed today) were Sussex, Cumberland, and Salem -- three of the least densely populated.
what kinda fugazi logarithmic scale is that? and why would anyone compare absolute values of countries with different populations?That is good to see. Really hope that is the start of a trend. Were they all symptomatic?
Unfortunately everything else I am reading is pointing in the other direction and looks like we are about two weeks away from our curve starting to flatten. Hope I am wrong there but if you look at the spread after the first 100 cases were diagnosed, we just passed Italy's trend line.
we passed italy in number of cases, but have 5x more people than them. whats the ratio?
im basically putting aside a 1 yr emergency plan... im taking this very seriously, but i feel like theres so much data being thrown out without context.
any link for the NJ state police/highway situation? im planning an escape from NYC soon and dont want to be stuck
I want to know what some people here think about this basically saying it our lives will be like this for 18 months?
A
anon_ezos2e9wn1ob0
Guest
Our lives will suck, but people who saved will be fine. Many people who never put money aside will be screwed, housing market collaspe again, lost goes on and on, would be very bad.
The context is more about how quickly it spreads than the percentage of the population that is infected.
Just like us, Italy still starts with one person infected which spreads to 2 - 4 etc... Not like the US starts with 5 which spreads to 10 then 20.
I'm actually somewhat more optimistic on the timeline to return to normalcy. I think things are heading in the right direction.
Testing needs to increase dramatically and it looks like we are close there. We are starting clinical trials on a vaccine, so hopefully we work that out before the fall when we can start giving it to those most at risk of the virus killing them.
My hope is that we start to see a peak in the region in about 2-3 weeks and then signs of improvement, and then another 3-4 weeks before things start to become normalized here.
Testing needs to increase dramatically and it looks like we are close there. We are starting clinical trials on a vaccine, so hopefully we work that out before the fall when we can start giving it to those most at risk of the virus killing them.
My hope is that we start to see a peak in the region in about 2-3 weeks and then signs of improvement, and then another 3-4 weeks before things start to become normalized here.
