Coronavirus Sars-CoV-2/Covid-19 Megathread

[Sheilbh]

But I think that does need to be qualified as not producing a benefit and backfire and people pushing back because it's "overly draconian" have largely been phenomena unique to the US, rather than inevitably responses of humanity.

I disagree. The discarding of rules may have a unique political component in the US, but it is happening in Europe too.

What do you mean by discarding of rules? Just by individuals or the changes by the state?

You're probably right - but I think the political compenent feeds into that in the US which makes it more widespread, more acceptable in a soft social-rules kind of way for people (especially as communities and friendship groups are increasingly polarised) and creates a more fundamental challenge to the legitimacy of the rules/rule-makers.

And I don't think it's just a political thing, I mean I think a lot about California which was strict and was bending the curve but then lifted lockdown very early in the process of bending the curve and my understanding is that in part that was due to growing non-compliance/social pressure. Obviously that's a predominately liberal state so I wonder how much of the pressure on that reflects sort-of underlying social trust/solidarity (ie the same stuff that perhaps explains why the US has a less developed welfare system) or how much is material - did the economic support packages/guarantees work.

So it's not just the Trump/national leadership/state leadership of the GOP that's an issue, but other stuff in examples like California and I can't think of a similar case in Europe.

[DGuller]

Getting compliance out of American citizens is indeed hard, but it is what it is, you should be structuring policy around facts on the ground.  Knowing that getting compliance is hard, we should've been more careful at picking what measures we want to tax Americans' limited compliance skills on. 

I still suspect that the one collective blunder on the part of Americans in general was the whole bullshit with masks, and not putting most of the eggs into the basket of forcing everyone to wear the fucking mask.  I think that everything else, except maybe closing the bars, is far more debatable, and history may show the idiots to have been more right than the smart people on the other measures.  More than that, that other stuff took away the energy to get the mask policy sorted and legitimately enforced.

[alfred russel]

What do you mean by discarding of rules? Just by individuals or the changes by the state?

It is both. The point I was trying to get to before, and believe in now, is that very strict rules make sense if they are understood to be short term and in connection with a crisis moment with an overwhelmed heathcare system. For example, NYC or north italy. They don't make sense if they are outside of an immediate short term crisis because they aren't sustainable long term.

My example is that I was given a stay at home order in March and April. Compared to March and April the cases are off the charts right now. That is a governmental change, but it is accompanied by individuals changing too. I think if you look at the mobility data for the area, it is much greater now than when the restrictions were first lifted, as people have "given up" on following some of their personal protocols.

[Sheilbh]

I still suspect that the one collective blunder on the part of Americans in general was the whole bullshit with masks, and not putting most of the eggs into the basket of forcing everyone to wear the fucking mask.  I think that everything else, except maybe closing the bars, is far more debatable, and history may show the idiots to have been more right than the smart people on the other measures.  More than that, that other stuff took away the energy to get the mask policy sorted and legitimately enforced.

I am a mask truther so I think masks would have helped - I still think the reluctance was largely driven by pressures on the PPE market. But even there it appears to have become a culture war issue which is a little bit specifically US.

But the UK is still a lagard on this. I'd say maybe 20% of people wear masks outdoors, but now the rules are everyone in shops or public transport and today I was on both and only saw one person without a mask.

On the UK's weird outlier (with Australia and Northern Europe):
https://ftalphaville.ft.com/2020/07/09/1594305988000/Why-are-we-not-wearing-masks-in-the-UK-/

[Valmy]

I am a mask truther so I think masks would have helped

Mask truther?

[Eddie Teach]

He's used the expression a half dozen times.

[Valmy]

He's used the expression a half dozen times.

What does it mean?

[Sheilbh]

I am a mask truther so I think masks would have helped

Mask truther?

Western experts and the WHO were repeatedly emphasising how pointless masks were (which even happened with my friends in the NHS saying they're pointless) outside of a clinical setting. I think in part there were fears around pressures on the PPE market (the French government have admitted they were recommending against masks to avoid consumer competition with French healthcare requirements) and I've always suspected part of the reason for the lower infection rates in Asia were masks.

This is still very much a fringe position in the UK.

[Malthus]

Getting compliance out of American citizens is indeed hard, but it is what it is, you should be structuring policy around facts on the ground.  Knowing that getting compliance is hard, we should've been more careful at picking what measures we want to tax Americans' limited compliance skills on. 

I still suspect that the one collective blunder on the part of Americans in general was the whole bullshit with masks, and not putting most of the eggs into the basket of forcing everyone to wear the fucking mask.  I think that everything else, except maybe closing the bars, is far more debatable, and history may show the idiots to have been more right than the smart people on the other measures.  More than that, that other stuff took away the energy to get the mask policy sorted and legitimately enforced.

Not sure I agree - just looking at our experience in Canada as an example; we enacted a package of measures that did not contain using masks at first (apparently there was an initial concern that if mask use was enforced, health care professionals may not have enough for their use).

However, despite not making mask use a mainstay from the outset, the other measures (social distancing, shutting stuff down, etc.) appear to have made a very material difference.

Seems to me all of the measures "work" to some extent if they are followed, but it is unclear how the cost/benefit Analysis breaks down.

[Valmy]

Western experts and the WHO were repeatedly emphasising how pointless masks were (which even happened with my friends in the NHS saying they're pointless) outside of a clinical setting. I think in part there were fears around pressures on the PPE market (the French government have admitted they were recommending against masks to avoid consumer competition with French healthcare requirements) and I've always suspected part of the reason for the lower infection rates in Asia were masks.

This is still very much a fringe position in the UK.

Really? Huh. I have been wearing my mask since March, I was not aware there was any controversy about that...I mean at least not from smart people.

[Malthus]

I am a mask truther so I think masks would have helped

Mask truther?

Western experts and the WHO were repeatedly emphasising how pointless masks were (which even happened with my friends in the NHS saying they're pointless) outside of a clinical setting. I think in part there were fears around pressures on the PPE market (the French government have admitted they were recommending against masks to avoid consumer competition with French healthcare requirements) and I've always suspected part of the reason for the lower infection rates in Asia were masks.

This is still very much a fringe position in the UK.

What I have heard, though I lack the scientific knowledge to evaluate, is that the really important factors are (1) adopting measures very quickly, and (2) consistently following them until the infection rate is low enough to ruthlessly trace every outbreak.

The exact mix of measures (Masks, social distancing, travel restrictions, shut down) might not be as important - though obviously, more measures are better than less: so adding masks to social distancing and shut down is better than not, just as adding a shut down to social distancing and masks is better than not, etc.

Agree that the early messaging that masks don't help was a huge mistake and throughly confused people.

[Sheilbh]

Really? Huh. I have been wearing my mask since March, I was not aware there was any controversy about that...I mean at least not from smart people.

Sure but there was a lot of pushback on the idea of masks in January/February.

And in the UK there's been lots of pushback against the idea of wearing masks, e.g. - Deputy Chief Medical Officer of England (who criticised Cummings for breaking the rules):
https://www.bbc.co.uk/news/av/uk-52153145/coronavirus-we-do-not-recommend-face-masks-for-general-wearing

And from that FT article:

And minutes from the government's Scientific Advisory Group for Emergencies (SAGE), as well as other official evidence, do suggest that the scientists were, especially early on, unconvinced about the efficacy of mask-wearing. Minutes from the April 7 meeting show The New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) concluded that an increased use of masks would have "minimal effect" in preventing the spread of the virus. The following week's meeting produced more scepticism, and an apparently detailed discussion of the drawbacks of mask-wearing.

In their April 20 advice to SAGE on face masks, the behavioural science subgroup SPI-B listed a whole host of concerns, some quite strange, such as the possible harassment of people not wearing coverings. It also suggested outlining "an 'exit strategy' for masks — determining and articulating at what point would they no longer be recommended". (Because clearly, Britain needs to add the risk that we all carry on wearing masks ad infinitum to its list of things to worry about.)

Minutes from the April 21 SAGE meeting, however, showed a slight change:

SAGE advises that, on balance, there is enough evidence to support recommendation of community use of cloth face masks, for short periods in enclosed spaces, where social distancing is not possible.

Although it did also call the evidence that it could stop an infectious person from spreading the disease "weak".

Professor Mills suggests that there's been an over-reliance on randomised control trials — studies in which people are randomly assigned to groups to test a specific treatment or other intervention, with one group typically given a placebo — in the evidence submitted to government, rather than on behavioural or social studies. She told us:

Those don't work for behaviour very well — that's kind of known. It doesn't work for ethical and practical reasons — people don't really comply . . . 

    Evidence is taken as randomised control trial medical evidence. When it's more weighed in that direction and you discount all these observational studies where people are asked how do you feel about wearing a mask — if that's all discounted then of course you're not going to get the right evidence, if you block out everything that's behavioural or social.

As I say we're an outlier.

My trutherism is more about January and February that masks were downplayed deliberately due to pressures on PPE supply chains and/or from a sort of slightly racist attitude to masks within public health as being something Asian countries do with minimal effectiveness rather than something we could all learn from.

[Sheilbh]

It is both. The point I was trying to get to before, and believe in now, is that very strict rules make sense if they are understood to be short term and in connection with a crisis moment with an overwhelmed heathcare system. For example, NYC or north italy. They don't make sense if they are outside of an immediate short term crisis because they aren't sustainable long term.

Yeah I mean I think I'd see it slightly differently. For me it is a really blunt tool. I think the point isn't to wait until you have a crisis to lockdown because if you do that you will have a lot of deaths - the biggest correlating factor is still basically the size of the outbreak regardless of different treatment protocols or even healthcare capacity etc.

It's purpose is if you know it's spreading in a way that's out of control it buys you time to build a system to monitor the disease and be more targeted in the future (ie local lockdowns if it gets into the community - you have an outbreak in a meat-packing plant etc). Especially because in NY and Northern Italy I think it was a surprise - I don't think it's like it is now where they could slowly see this coming, I think their testing was probably far less widespread and maybe focused on the wrong communities so there was this widespread transmission going on that they weren't fully aware of until it started turning up in volume at hospitals.

I think many US states probably locked down too early and, from what I can see, haven't used the time to build up a monitoring system. The counter for me would be Greece which locked down hard and fast, like many US states, but then built a very sophisticated and, by all accounts, really effective contact tracing system - so they used the time well. The other side of it is Spain which got to a crisis point - from what I've read they haven't really built much of a monitoring system (the number of contact tracers is quite a lot lower than Germany or the UK, allegedly) and we're sort of seeing that now, so maybe the Spanish government didn't use the time that well.

They are not and no-one should be thinking lockdown measures are sustainable. As I say I think they reflect a policy failure, more than anything else. They're incredibly blunt, broad and effective so they just buy you time and space to try and get what you fucked up the first time right.

My example is that I was given a stay at home order in March and April. Compared to March and April the cases are off the charts right now. That is a governmental change, but it is accompanied by individuals changing too. I think if you look at the mobility data for the area, it is much greater now than when the restrictions were first lifted, as people have "given up" on following some of their personal protocols.

Yeah - I mean I suppose it'll be interesting (if sad) to see what happens now in the US. Because I think there was a shift in government guidance, but the behaviour change is because people felt safer. Infections were falling, deaths were falling. Even if the US lifted most of its lockdowns earlier than European states did (in terms of the "stage" of the curve) the numbers were still going in the right direction.

So now my suspicion is that as the numbers go back in the wrong direction, even if governments don't do anything people will change their behaviour and we'll see more people basically choosing to lockdown. I don't think this stuff has been driven by people's fatigue with the rules so much as people's perception of risks and safety.

[alfred russel]

Part of what leaves me in such a negative mood is that I've basically been going with the flow in real life. Back when we went into lockdown, I tried making the same points in real life as I made on this forum, and wanted to still go climbing and get cabins while going cross country. Absolutely no one in my friend/climbing group wanted to hear it (and I heard that enough all my discussion on the topic moved here), and I followed the rules if only because of peer pressure.

Now, we are regularly meeting up to climb indoors and there are a bunch of cross country trips planned. The peer pressure is actually working in the opposite direction: when I mentioned someone didn't want to go to an event because she was taking covid seriously, I got the response, "why? she needs to start living her life."

I think that there is just a sense of covid fatigue and people are worn out. That doesn't include old people: the older people in my family have been sticking to home. If there is a silver lining maybe the disease will exhaust itself on the low risk.

[Syt]

Rep. Louie "I shan't wear a mask" Gohmert has tested positive for Covi-19, thinks it might have come from wearing a mask.

https://twitter.com/CharlieGileNBC/status/1288525505881350144?s=20