outbreak! (ebola, sars, coronavirus, etc)

XPs re MIT study:

Many mitigation measures which made sense for past respiratory infections likely had poor returns on effort with Covid-19, a disease that transmits mainly through small respiratory particles (airborne) rather than heavier ones landing on surfaces, mainly between households through superspreader events where only a few asymptomatic / presymptomatic infected generated a lot of infectious particles in indoor spaces with poor ventilation. So much effort screening with thermometers, sanitizing surfaces, mandating mask use outdoors, closing down beaches and parks, was in hindsight rather futile.

From my skim at the paper, the best responses for small businesses would have instead focused on requiring quality masking and limiting occupancy of public interior spaces, and importantly, increasing ventilation, so that each user of those spaces has less potential exposure to "infectious quanta" from current and recent occupants.

Interior choir practice may have been among the most dangerous activities for superspreader events. Lots of potentially assymptomatic/presymptomatic infected participants, producing a lot of respiratory particles, in spaces with limited ventilation. Move it to a breezy beach, and the same activity likely poses little risk.

I mean, yeah -- that's why limiting occupancy of public spaces was mandated and masking at the park, in most places at any rate, wasn't.

"You're not catching it off surfaces" was already conventional wisdom, like, a year ago

I think the one really big shift over time has been the importance of refreshing indoor air.

Infectious quanta of solace

XP eephus!:

There are still businesses that hire disinfection surfaces (which spray down the store with chemical sprayers) when an employee tested positive or transmission is discovered. As I recall, many experts had their doubts, but it wasn't till early this Spring that we started seeing news stories pointing out this probably did more harm than good.

Someone should tell the thousands of school districts and transit authorities (including the New York City subway) still practicing “deep cleaning” about this conventional wisdom.

people are saying things, caek

people are telling me all the time

finally read https://nymag.com/intelligencer/2021/03/how-the-west-lost-covid-19.html.

it's good.

there's a dash of mixture of jk simmons at the end of burn after reading, and contrarianism, but it's generally excellent.

the strongest conclusion (it's a long article, this doesn't do it justice) is that the dominance of the medical establishment (as opposed to the public health community) in "The West" is a problem. reading this bit (which was written before the J&J and AZ suspensions, but seems of a piece with it:

“One of the common features is that we are a medical-centric group of countries,” says Michael Mina, a Harvard epidemiologist who has spent the pandemic advocating for mass rollout of rapid testing on the pregnancy-kit model — only to meet resistance at every turn by those who insisted on a higher, clinical standard for tests. “We have an enormous focus on medicine and individual biology and individual health. We have very little focus as a group of nations on prioritizing the public good. We just don’t. It’s almost taboo — I mean, it is taboo. We have physicians running the show — that’s a consistent thing, medical doctors across the western European countries, driving the decision-making.” The result, he says, has been short-sighted calculations that prioritize absolute knowledge about everything before advising or designing policy about anything.

...

These were not narrowly American issues, or western ones—in fact, much of the problematic guidance came from the WHO. But in East Asia, countries didn’t wait for the WHO’s guidance to change on aerosols or asymptomatic transmission before masking up, social-distancing, and quarantining. “They acted fast. They acted decisively,” says Mina. “They made early moves. They didn’t sit and ponder: ‘What should we do? Do we have all of the data before we make a single decision?’ And I think that is a common theme that we’ve seen across all the Western countries—a reluctance to even admit that it was a big problem and then to really act without all of the information available. To this day, people are still not acting.” Instead, he says, “decision-makers have been paralyzed. They would rather just not act and let the pandemic move forward than act aggressively, but potentially be wrong.”

This, he says, reflects a culture of medicine in which the case of the individual patient is paramount. In the early months of the pandemic, the “heroic” medicine of doctors trying out experimental treatments on patients may have raised the death count considerably. And at the level of public guidance, throughout America and Europe, there has been a tendency to regard anything that didn’t offer perfect and total protection against transmission as needlessly risky behavior — outdoor exercise, socializing with masks, holiday travel with a negative test in hand. If you’re advising a single, vulnerable patient, Mina suggests, it might make sense to propose staying at home through a surge, but it’s not necessarily useful advice for everyone, and neglects to offer practical guidance for how to navigate a pandemic world in favor of an indefinite, exhausting, abstinence-only piece of quasi-propaganda. That’s not really public health, he says, it’s medicine. And even so, the guidance that was offered wasn’t all that illuminating at the individual level — with 10,000-times higher lethality rates hidden behind vague language like “the elderly are more at risk,” or comorbidities discussed as an almost uniform additional risk, so that my kidney-patient father-in-law, for instance, didn’t know that he was significantly more vulnerable than my mother with COPD.

yeah that part definitely hits home - I saw so many of my friends say something to the effect of, "we don't know exactly what this is yet so I'm not gonna change my life" when it's like uhhh shouldn't you be doing the exact opposite then

banaka to thread

And at the level of public guidance, throughout America and Europe, there has been a tendency to regard anything that didn’t offer perfect and total protection against transmission as needlessly risky behavior — outdoor exercise, socializing with masks, holiday travel with a negative test in hand. If you’re advising a single, vulnerable patient, Mina suggests, it might make sense to propose staying at home through a surge, but it’s not necessarily useful advice for everyone, and neglects to offer practical guidance for how to navigate a pandemic world in favor of an indefinite, exhausting, abstinence-only piece of quasi-propaganda.

Most of that excerpt makes sense to me, but this part seems off-base. Other countries banned mildly risky activities too; in fact they banned them more quickly and more thoroughly, back at the start of the pandemic when we didn't really know how the virus was transmitted or where the highest risks were. And while I agree with the basic premise that the US is more focused on the individual than the group, this paragraph gets the effect of that completely backward imo.

If you're advising one patient, you could reasonably tell them it's not that risky for them, personally, to travel during a surge. But if you don't want the surge to get massively worse, you need to tell everyone not to travel unless they have to. Our focus on individual rather than collective risk is why people did travel at Thanksgiving and Christmas, and it's why there were Covid surges after both holidays.

Second Pfizer is weird - I've never really felt bad, no fever, but now (22 hours post-shot) all my joints feel like I did a high school football two-a-day at my current fitness level.

I had none of the usual effects, but the next morning upon waking my right ankle felt like a joint was dislocated, and I walked with a limp for a couple days. That's never happened before. Most likely I managed to twist it oddly in sleep, but I don't discount some systemic inflammation contributed.

In November, the @nytimes published an article about efforts in Asia to fight back COVID. They mentioned specifically 3 countries (Hong Kong, Korea and Japan) and outlined long histories of policy implementation by health officials in these nations trying to combat infections

— Siyanda Mohutsiwa (@SiyandaWrites) April 25, 2021

Well worth reading that whole thread. US coverage of Africa is absolute garbage.

it's worth noting that the over 65 population of sub-saharan africa is 3%. this is at least part of the reason there have been so few deaths in africa.

the assumption of corruption and incompetence and death is of course extremely condescending and racist.

Good

WASHINGTON (AP) — AP Exclusive: US to begin sharing up to 60M AstraZeneca COVID-19 vaccine doses with world after federal safety review.

— Jonathan Lemire (@JonLemire) April 26, 2021

There are so many variables in COVID by country (age, population health, density, government system, climate) that I think it's a bit pat to try to make COVID death toll about any one thing, let alone a "selfish culture of individualism" that "disdains the public good" or w/e. I'm sure American individualism is a factor, but so are high rates of obesity, diabetes, heart disease and high blood pressure, poor levels of medical care for many people with those conditions, densely populated cities in colder climates, Trump's botched response, amount of interdependence on foreign economies, and the fact that even the best president would have a hard time creating a unified national response as a result of our federalist system/limitations on federal power.

Also the constant focus on holiday travel, the super bowl, etc.--while those are factors, they are a bit too easy to place all the blame on from the herman miller armchair of a keyboard warrior, while COVID also spreads heavily in the takeout kitchens and meat processing plants and amazon warehouses servicing the keyboard warriors.

quit making this as complicated as it is

It's almost as if countries where processed food is shoveled down peoples' gullets to keep them passive and addicted to government-sponsored propaganda might be...bad.

¿?

The Twinkie Offense

I'm sure American individualism is a factor, but so are high rates of obesity, diabetes, heart disease and high blood pressure, poor levels of medical care for many people with those conditions, densely populated cities in colder climates, Trump's botched response, amount of interdependence on foreign economies, and the fact that even the best president would have a hard time creating a unified national response as a result of our federalist system/limitations on federal power.

Lol, in other words, American individualism.

My post was rightly taking to task the idea that the blame for all of these health problems and the poor level of medical care can be placed entirely at the feet of the individual; to do so is ignorant and patently ridiculous.

Right, that's also what I was getting at - I mean, yes, on some level a lot of the things I named could be said to add up to "culture of individualism" but that still makes it sound like the byproduct of a bunch of selfish individuals making poor decisions instead of living under a particularly harsh form of capitalism and under a constitutional government that is designed in a way that makes it harder to use for national social good.

My "joke" was from the view that our present capitalist/government system is American individualism as a governing principle. So I am agreeing with blaming the system and not individuals - but we wouldn't have this system without unchecked American individualism.

https://www.cnn.com/2021/04/27/health/cdc-mask-guidance-fully-vaccinated-bn/index.html

is there any hard data regarding fully vaxxed people getting sick or spreading it themselves? feel like "even once you're vaccinated you still shouldn't do anything" is not really helping here

feel like "even once you're vaccinated you still shouldn't do anything" is not really helping here

That is exactly not what this says tho

https://www.washingtonpost.com/wp-apps/imrs.php?src=https://arc-anglerfish-washpost-prod-washpost.s3.amazonaws.com/public/A5PZX2KHTFC7JHKAONIL4ESEGY.jpg&w=767

yes, xp

CDC keeping track of breakthrough infections in U.S., rate remains astoundingly low. Out of 87 million fully vax, only 5079 symptomatic breakthroughs (0.005%) & only 0.0003% hospitalizations related to COVID-19 & only 0.00009% deaths related to COVIDhttps://t.co/83MMPFXstc

— Monica Gandhi MD, MPH (@MonicaGandhi9) April 25, 2021

the information design of that CDC stuff is terrible btw.

Sadly, there is a large chunk of Americans that will take a look at that graphic and say, "well fuck it, if I still have to wear a mask to do all that stuff there's no point in getting vaccinated".

I missed that chart, just saw "still avoid indoor gatherings" which reads to me like "don't go to restaurants or bars". which is probably okay advice but you can guess how conservative media is gonna spun that

CDC overstresses the minor risks imo.

I mean, really, we know and the CDC knows that small outdoor gatherings with vaccinated and unvaccinated people are low risk yet there's the graphic telling you to wear a mask!

Sadly, there is a large chunk of Americans that will take a look at that graphic and say, "well fuck it, if I still have to wear a mask to do all that stuff there's no point in getting vaccinated".

― soaring skrrrtpeggios (jon /via/ chi 2.0),

They weren't getting jabbed anyway but otm. I guess these mostly apply to cities like NYC or L.A. where you must wear masks at all times outdoors.

a graphic telling the unvaccinated to wear a mask at small outdoor gatherings, let me be clear

the CDC is kind of in a shitty posish, partially because the previous director destroyed a lot of their credibility, partially because reactions on both the pro and anti-vax side seem to embrace extreme opinions. you still have vaccinated people telling everybody (including other vaccinated) to stay home 24/7, you have anti-vax/maskers basically saying "re-open everything up", and then you have the folks capable of understanding nuance, which is much smaller than it should be.

hell, look at the blowback Wallensky got when she said (in general) vaccinated people didn't get infected or spread the disease? it was an over-the-top walkback, IMO, that hurt their messaging. humorous also because CDC officials didn't seem all that eager to contradict Redfield.

CDC overstresses the minor risks imo.

CDC is trying to control a disease (it's right there in the name) that has proved itself highly transmissible and alarmingly deadly or debilitating. After watching it burn through the nation and cause 565,000 deaths they are naturally going to be very risk averse.

Aimless otm, but also the reality of America in 2021 means that part of controlling risk is making sure the messaging isn't pushing them further away from getting vaccinated. Which is not to suggest that there are any easy answers, I don't have them, but Neanderthal also otm in that they are in a terrible position right now.

exactly

and as Neanderthal can tell you we have communities in which it's been 2019 since last summer

esp Pasco and Brevard counties

Seminole is actually looking at lifting their mask 'mandate' and making it a 'recommendation', an utterly stupid move because they already can't fine you for not wearing one, so it's toothless to begin with - why 'weaken' it further.

Messaging is clearly not part of the CDC's major expertise. Even if they have some experts in that field, those experts are so peripheral they can easily be overruled or overridden by the medical experts.

Maybe they should hire more messaging experts?

I mean, not picking a fight here, but they absolutely play a huge role in messaging around diseases and outbreaks. Just because it's particularly hard in America, 2021 doesn't excuse their role in it.

on the plus side, at least they're taking a more active role in it. Fauci only become the 'face' of fighting COVID because Redfield/Trump decided to shove the CDC to the background in terms of COVID messaging. I don't even recall if I saw Redfield make any public statements, whereas Director Wallensky has frequently done so. the CDC is very much responsible for messaging, and that was one of the chief criticisms last year, that they weren't doing it at all.

To be clear, I'm not criticizing them. It's a tough position and they are doing much better than they did last year, to be certain. I was just responding specifically to Aimless' claim about them not being messaging experts.

My frustration is more aimed at America in general than the CDC. I'm furious that we have a path out of this and so many people just refuse to take it out of stupidity. The CDC can never fix that.

my response was more to Aimless, as messaging *is* one of their responsibilities.

Yeah, I think we're on the same page. I just wanted to note that I wasn't disparaging the job the CDC is doing on the whole.