Global Pandemic Part III: A typical Spring, Just Ask China

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41,000 cases in France was by far the most disturbing figure I saw yesterday. We reported 4,300 cases in California yesterday, and our 40 million people is roughly 60% of France's total population.
 
The dangers of pride and nationalism over rationalism and conservative approach to unknown science - Europe very smugly championed their correct approach to the start of the pandemic as a victory in the face of science denying right wing leaders, but allowed price and nationalism to project victory. The very same thing these right wing politicians were doing all along.

Just watch out Australia. You’re next. It’s not under control and won’t ever be until the day we have a medical mitigation.
 
It was kind of obvious to me during the summer, based on conversations with friends in continental Europe, that the situation was not tenable. Basic social distancing norms were not respected, mask usage was down, summer holiday travel was quite frequent. It seems more like an issue with individual behavior than public policy (though obviously the latter should in principle affect the former), as most of these places have general nationwide strategies for lockdowns, etc.
 
27k new cases in the UK alone on Wednesday, unbelievable. Europe overall is pushing 100k a day.

At this point I think it’s fair to say the UK is more fucked than the US, as their next election isn’t until 2024 and Boris Johnson is completely uninterested in listening to his experts or giving an honest answer regarding his policies. Even in the highest of alert levels, which major cities such as Manchester and Liverpool are in, pubs are not required to close if they also serve meals. Meanwhile he is withholding support for these cities over a measly £5m in negotiation dispute and awarding lucrative tracing contracts to the usual old boy crowd.

At least Australia and New Zealand have things as under control as can be in the absence of a vaccine.

Oh yeah we are totally and utterly fucked in the UK- if Bozo listened to the SAGE people ( who are scared of their own shadows)- we would be locked away like prisoners for the next 5 years in case someone sneezes.

They have destroyed the economy, used the media as terror propaganda and have no way out...in Europe people in limited numbers are allowed to go to sporting events ( indoors as well)- as indeed they are in some parts of the US- in Borisville we can do almost nothing...they have royally fucked up everything they've touched and we are back where we started.

The rules change every other day, they've encouraged us to report on neighbours if they break the covid rules- much like people were encouraged to do in Nazi Germany in the 1930's. And now police are patrolling the Welsh border to stop drivers crossing in cars

Parts of the UK are having what the media are calling " fire breaks" ( ie near total lockdowns again) which will drag on for weeks or months or however long the likes of Sturgeon want- noone is remotely accountable, they are not wllling to show the logic behind the decisions ( it is whatever Cummings says) and no alternative options are allowed or even discussed- the media have been muzzled ( see Sweden and Barrington Declaration)and the collateral damage across the economy and peoples mental and physical well being will dwarf covid but noone gives a shit

On top of that we have the Brexit fascists about to drive the country off a cliff in a couple of months time for an act of national stupidity- the only beneficiaries of which will be Bozo, Cummings, Farage and the rest of the arseholes who've inflicted this utter garbage on us

Donald may be dangerous but in the US you can get rid of him- we are stuck with Bozo until 2023 and more importantly Brexit forever

Sorry rant over....
 
It was kind of obvious to me during the summer, based on conversations with friends in continental Europe, that the situation was not tenable. Basic social distancing norms were not respected, mask usage was down, summer holiday travel was quite frequent. It seems more like an issue with individual behavior than public policy (though obviously the latter should in principle affect the former), as most of these places have general nationwide strategies for lockdowns, etc.



Yes and the point I’m making is that we the western world are far more alike and politically diverse with stupid perspectives than a lot of the western world is willing to admit.

The strategy that I advocate for is some thing I’ve crafted up in my mind over the summer. Have routine restricted periods of enforced lockdown that are finite. The first 10 days of the month, for example. This paradigm would give people a sense of comfort in knowing that there is something to look forward to, with the hopes that the people might actually respect the lockdowns more. Sort of like a hurricane, you would routinely spend your days before the lockdown planning for your lock down. You can choose who to lock down with. Generally unconstrained society, like it is right now, which would allow for plenty of infections, but during the micro lockdowns, their ability to spread would be dampened. It’s a perspective that attempts to balance compliance with a statistical decrease in infections over a very long period of time.
 
Washington Post

Suicide rates during the pandemic remained unchanged. Here’s what we can learn from that.

Opinion by Jeremy Samuel Faust
Oct. 21, 2020 at 6:03 p.m. EDT


Jeremy Samuel Faust is an emergency physician at Brigham and Women’s Hospital in the Division of Health Policy and Public Health, and an instructor at Harvard Medical School.

In late March, right as the crest of the first wave of the novel coronavirus approached, President Trump was pushing to reopen the economy. There would be “suicide by the thousands” within weeks if businesses stayed closed and people were out of work, he argued.


The notion that economic shutdowns themselves could pose a greater threat to the health and safety of communities than the uncontrolled spread of a disease that has now killed more than 1 million people worldwide was and remains an important idea to consider.


But asserting a fact doesn’t make it true. Was Trump right? Did suicides skyrocket in March, April and May? Did a spike in suicide deaths outpace covid-19 deaths?

As an emergency room physician, I kept an eye out during my shifts in the weeks following Trump’s March 24 statement. It seemed to me that we had fewer suicidal patients than usual. I called a colleague across town at another hospital. He thought he might be observing the opposite in his ER, that there might have been an uptick in patients with suicidal thoughts or attempts.

Along with a team of researchers, I set out to try to find out what was happening. But we would have to wait. Death by suicide takes longer to be reported and finalized than most other causes of death. Every suicide death is investigated and its final cause directly adjudicated by a medical examiner, making the process slower but ultimately more reliable.


It turns out that both I and my crosstown colleague were mistaken. Suicide rates in Massachusetts neither rose nor fell last spring. Suicide rates did not change from expected rates at all.

Just to be sure, we performed what researchers call a sensitivity analysis — a fancy way of saying we asked the same question in a number of ways to make sure we were not deluding ourselves. We compared this year’s rates in March, April and May with those from last year and other years.

Whether we considered the months individually or combined, year by year, there was just no change. We ran the numbers again, this time assuming that each of the few dozen deaths in 2020 that occurred during March through May in which the cause of death was yet to be determined were in fact suicides. The scenario was unlikely, but one we had to consider. No matter how we looked, we kept finding the same thing. Suicide rates did not budge during the stay-at-home advisory period (March 23 until a phased reopening began in late May) in Massachusetts, which had one of the longest such periods of any state in the nation.


Studying the effects of stay-at-home advisories is still in its infancy, and what is learned will help inform the decisions of public health officials as they consider measures to address future infectious-disease outbreaks or another covid-19 spike. Some worries about stay-at-home periods will turn out to be overblown, others not. Concerns about the limitations of remote learning for children increasingly appear to be justified, for instance, and concerted efforts to address the problem are urgently needed.

But government officials, the media and others need to remember that anecdotes and assumptions are not the same as robust public health data. Early in the pandemic, media reports — rumors, really — suggested that few covid-19 patients taking the drug remdesivir were dying. Earlier this month, data from actual studies showed that the drug has no effect on mortality. And then there were the president’s musings on the “miracle” drug hydroxychloroquine and other supposed solutions so deranged that they don’t warrant repeating.

Many well-informed and well-meaning people fell for the cognitive trap that if something rings true, it must be true — and thus assumed that suicide deaths were destined to rise during shutdowns. Certainly, more study on this subject is needed. The Centers for Disease Control and Prevention recently reported, “During late June, 40% of U.S. adults reported struggling with mental health or drug use,” with 1 in 4 people between the ages of 18 and 24 saying they had “seriously considered suicide” in the previous 30 days.


There are legitimate questions to be raised about the pandemic’s toll on mental health. Some of the impact may have more to do with the continuing inability to control the virus, and with the ensuing economic fallout, than with Americans’ staying home for weeks and even months in the spring. That said, a rise in suicides or other suffering resulting from temporary stay-home advisories is neither guaranteed nor inevitable.

To get this right, both now and in the future, we have to keep asking the right questions and awaiting the actual answers — and remember that the questions themselves, no matter how obvious their implications might seem, do not provide the answers. They remain what they are: questions.
 
It was kind of obvious to me during the summer, based on conversations with friends in continental Europe, that the situation was not tenable. Basic social distancing norms were not respected, mask usage was down, summer holiday travel was quite frequent. It seems more like an issue with individual behavior than public policy (though obviously the latter should in principle affect the former), as most of these places have general nationwide strategies for lockdowns, etc.

Everyone I know in Europe went on their usual 3-4 week vacation to x/y/z, went to restaurants, cafes, etc. Public transit rammed, allegedly masks were mandatory in a lot of places but there was little to no enforcement. The European vacation season sparked the flames. Also, many European nations, particularly the ones in Eastern Europe managed to keep their numbers of infected and deaths VERY low in the first wave. Some of them had really draconian quarantine rules, but they worked. In a lot of the western nations, certainly in many US states and in a number of Canadian provinces, our first wave outbreaks in long-term facilities were catastrophic, and many people who were absolutely the highest risk died. I heard an epidemiologist describe it very bluntly as the virus "picking off low hanging fruit" (and he apologized profusely for saying it in such a way). A lot of these European countries will likely go through that same process now unless they radically change their ways.
 
Everyone I know in Europe went on their usual 3-4 week vacation to x/y/z, went to restaurants, cafes, etc. Public transit rammed, allegedly masks were mandatory in a lot of places but there was little to no enforcement. The European vacation season sparked the flames. Also, many European nations, particularly the ones in Eastern Europe managed to keep their numbers of infected and deaths VERY low in the first wave. Some of them had really draconian quarantine rules, but they worked. In a lot of the western nations, certainly in many US states and in a number of Canadian provinces, our first wave outbreaks in long-term facilities were catastrophic, and many people who were absolutely the highest risk died. I heard an epidemiologist describe it very bluntly as the virus "picking off low hanging fruit" (and he apologized profusely for saying it in such a way). A lot of these European countries will likely go through that same process now unless they radically change their ways.



Yep. All of this.

And just as I write, just got the news that some close friends in Switzerland have tested positive, as well as their elderly parents, one of whom is in the hospital. Things are pretty bad over there.
 
Also, NJ apparently has the highest R0 in the country right now, so NY’s good fortune is unlikely to last much longer.
 
It was kind of obvious to me during the summer, based on conversations with friends in continental Europe, that the situation was not tenable. Basic social distancing norms were not respected, mask usage was down, summer holiday travel was quite frequent. It seems more like an issue with individual behavior than public policy (though obviously the latter should in principle affect the former), as most of these places have general nationwide strategies for lockdowns, etc.


Yup, I got the same sense from friends and family over there.
Switzerland had a test positivity over just over 20% yesterday. If they can't handle it... This isn't going to end well
 
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