The Georgia experiment - Printable Version
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RE: The Georgia experiment - oldalum - 06-15-2020
It may be necessary for some areas to go through a second (or first) lockdown in order for compliance with social distancing and masks to be sufficient in a second re-opening.
RE: The Georgia experiment - Genuine Realist - 06-15-2020
(06-15-2020, 08:09 AM)oldalum Wrote: It may be necessary for some areas to go through a second (or first) lockdown in order for compliance with social distancing and masks to be sufficient in a second re-opening.I don't think a second lockdown on wide scale - i.e., maybe in a town or city - is politically possible anywhere. My read is that the norms of social distancing have been largely accepted, but the extremes of lockdown remain controversial.
RE: The Georgia experiment - BostonCard - 06-15-2020
Quote:Those declines (Florida, Georgia) are in line with harder-hit states like New York, New Jersey, and Michigan, which maintain relatively aggressive lockdown measures—a result that lends credence to the growing number of studies questioning the efficacy of Draconian “stay-at-home” orders.
I like Rothman and he makes some good points in the article, but this is demonstrably wrong. First, he links two articles. The first one is titled "Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study", so unless he considers the US a low-income/middle-income country, it's not relevant to the US. Their conclusions are:
Quote:Our estimates are based on tentative assumptions and represent a wide range of outcomes. Nonetheless, they show that, if routine health care is disrupted and access to food is decreased (as a result of unavoidable shocks, health system collapse, or intentional choices made in responding to the pandemic), the increase in child and maternal deaths will be devastating. We hope these numbers add context as policy makers establish guidelines and allocate resources in the days and months to come.
Note that they don't attribute the increase in child and maternal deaths only to "intentional choices made in responding to the pandemic" but also to "unavoidable shocks" and "health system collapse", both of which the lockdowns are meant to prevent. Note that I do think that in many developing countries, harsh lockdowns are probably counterproductive, but I think the balances are different in rich countries versus middle income countries, and I don't think that study is relevant to evaluating California versus Georgia, for example.
The second article he linked is an editorial from a Swedish epidemiologist who was advising the Swedish government on its decision not to lock down. I think the Swedish experience is relevant, but rather than link an editorial at the lancet making it sound like there was an actual research study on it, he should have just noted the Swedish decision and its justification. And of course, the Swedish minister of health has since come out saying that were they to have done this again, they would have probably imposed somewhat harsher measures (though not as harsh as other countries).
But the big thing he gets wrong is the data on the declines in cases and deaths by state.
Since the peak in April, the average daily case load declined substantially in the three "harder hit" states (New York, New Jersey, Michigan); in New York by a factor of 10; in New Jersey by close to that; and in Michigan by 4-fold. Cases in Florida and Georgia (and Louisiana) have been rising since mid-May. California, Texas, and Arizona never peaked and have been slowly rising the whole time. If Rothman wanted to make a case, he should have compared Florida and Georgia to California.
That being said, even the state most affected right now (Arizona) has an estimated effective Rt of 1.18 (https://rt.live/) to 1.23 (https://covidactnow.org/us/az?s=48058). That's a lot less than New York at the height of its rising numbers, when Rt was on the order of 2 - 3. A positive number implies exponential growth, so this will eventually get bad for Arizona if they don't do something, but it won't happen as quickly as it did for New York, and it will require fewer measures to go from Rt of 1.2 to <1 than it was going from 2+ to <2.
BC
BC
RE: The Georgia experiment - oldalum - 06-15-2020
(06-15-2020, 08:17 AM)Genuine Realist Wrote: I don't think a second lockdown on wide scale - i.e., maybe in a town or city - is politically possible anywhere.you may be right. I'm thinking of the situation if some place gets to be like NYC when it was at its worst. On the other hand, maybe people will comply better with lesser mitigations if the infection really takes off locally, and they can muddle through.
RE: The Georgia experiment - Genuine Realist - 06-15-2020
(06-15-2020, 09:05 AM)BostonCard Wrote:I didn't link because of the medical opinions,which are clearly dated. The collation of insufferably patronizing comments (from the Washington Post and Atlantic Monthly, yet) are what is of interest. Medically not wiser, but SOOOOOO smug.Quote:Those declines (Florida, Georgia) are in line with harder-hit states like New York, New Jersey, and Michigan, which maintain relatively aggressive lockdown measures—a result that lends credence to the growing number of studies questioning the efficacy of Draconian “stay-at-home” orders.
I like Rothman and he makes some good points in the article, but this is demonstrably wrong. First, he links two articles. The first one is titled "Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study", so unless he considers the US a low-income/middle-income country, it's not relevant to the US. Their conclusions are:
Quote:Our estimates are based on tentative assumptions and represent a wide range of outcomes. Nonetheless, they show that, if routine health care is disrupted and access to food is decreased (as a result of unavoidable shocks, health system collapse, or intentional choices made in responding to the pandemic), the increase in child and maternal deaths will be devastating. We hope these numbers add context as policy makers establish guidelines and allocate resources in the days and months to come.
Note that they don't attribute the increase in child and maternal deaths only to "intentional choices made in responding to the pandemic" but also to "unavoidable shocks" and "health system collapse", both of which the lockdowns are meant to prevent. Note that I do think that in many developing countries, harsh lockdowns are probably counterproductive, but I think the balances are different in rich countries versus middle income countries, and I don't think that study is relevant to evaluating California versus Georgia, for example.
The second article he linked is an editorial from a Swedish epidemiologist who was advising the Swedish government on its decision not to lock down. I think the Swedish experience is relevant, but rather than link an editorial at the lancet making it sound like there was an actual research study on it, he should have just noted the Swedish decision and its justification. And of course, the Swedish minister of health has since come out saying that were they to have done this again, they would have probably imposed somewhat harsher measures (though not as harsh as other countries).
But the big thing he gets wrong is the data on the declines in cases and deaths by state.
Since the peak in April, the average daily case load declined substantially in the three "harder hit" states (New York, New Jersey, Michigan); in New York by a factor of 10; in New Jersey by close to that; and in Michigan by 4-fold. Cases in Florida and Georgia (and Louisiana) have been rising since mid-May. California, Texas, and Arizona never peaked and have been slowly rising the whole time. If Rothman wanted to make a case, he should have compared Florida and Georgia to California.
That being said, even the state most affected right now (Arizona) has an estimated effective Rt of 1.18 (https://rt.live/) to 1.23 (https://covidactnow.org/us/az?s=48058). That's a lot less than New York at the height of its rising numbers, when Rt was on the order of 2 - 3. A positive number implies exponential growth, so this will eventually get bad for Arizona if they don't do something, but it won't happen as quickly as it did for New York, and it will require fewer measures to go from Rt of 1.2 to <1 than it was going from 2+ to <2.
BC
BC
RE: lex24 - burger - 06-15-2020
(06-14-2020, 11:00 PM)oregontim Wrote:(06-14-2020, 07:05 PM)burger Wrote: Unfortunately, there is probably no putting the genie back in the bottle now. I think we're in big trouble.
I don't dispute the Oregon numbers shown in that data, but I don't get why. We closed quickly and Portland — where all the new cases are — still hasn't even gone to phase 1 opening. Seems counter intuitive, unless it's either testing or (gulp) crowds in demonstrations.
I think it'll be a few weeks before we see any effects of the protests on case numbers. And a few weeks more before it shows up in hospitalizations and deaths. If the protests don't have a brobdingnagian effect, it may be difficult to separate them from the reopening and ongoing decreases in voluntary social distancing.
Oregon's numbers don't look especially bad to me. Some of the recent increase in cases can be explained by more testing. And hospitalizations are flat.
RE: The Georgia experiment - BostonCard - 06-15-2020
(06-15-2020, 09:57 AM)Genuine Realist Wrote: I didn't link because of the medical opinions,which are clearly dated. The collation of insufferably patronizing comments (from the Washington Post and Atlantic Monthly, yet) are what is of interest. Medically not wiser, but SOOOOOO smug.
I think that's a fair critique. There were a lot of articles that were sure that there was going to be another spike. That doesn't mean we won't see things rise again, but I agree that several articles were overly alarmist about the prospect of Georgia and Florida (and others) reopening.
BC
RE: lex24 - Mick - 06-15-2020
(06-15-2020, 11:18 AM)burger Wrote: I think it'll be a few weeks before we see any effects of the protests on case numbers. And a few weeks more before it shows up in hospitalizations and deaths. If the protests don't have a of immense proportions effect, it may be difficult to separate them from the reopening and ongoing decreases in voluntary social distancing.
It'll be a bit more difficult given that de Blasio has banned the 1,000 NYC contract tracers from asking people if they had attended protests:
https://www.foxnews.com/politics/nyc-contract-tracers-not-asking-people-who-test-positive-for-coronavirus-if-they-attended-protests-report
RE: lex24 - burger - 06-15-2020
(06-15-2020, 05:32 PM)Mick Wrote:(06-15-2020, 11:18 AM)burger Wrote: I think it'll be a few weeks before we see any effects of the protests on case numbers. And a few weeks more before it shows up in hospitalizations and deaths. If the protests don't have a of immense proportions effect, it may be difficult to separate them from the reopening and ongoing decreases in voluntary social distancing.
It'll be a bit more difficult given that de Blasio has banned the 1,000 NYC contract tracers from asking people if they had attended protests:
https://www.foxnews.com/politics/nyc-contract-tracers-not-asking-people-who-test-positive-for-coronavirus-if-they-attended-protests-report
We should all be so lucky as to live in a state with the covid trends of NY. If cases spike there again, then maybe your criticism is valid. Until then, who cares? Not me
RE: lex24 - Mick - 06-15-2020
(06-15-2020, 06:32 PM)burger Wrote:(06-15-2020, 05:32 PM)Mick Wrote:(06-15-2020, 11:18 AM)burger Wrote: I think it'll be a few weeks before we see any effects of the protests on case numbers. And a few weeks more before it shows up in hospitalizations and deaths. If the protests don't have a of immense proportions effect, it may be difficult to separate them from the reopening and ongoing decreases in voluntary social distancing.
It'll be a bit more difficult given that de Blasio has banned the 1,000 NYC contract tracers from asking people if they had attended protests:
https://www.foxnews.com/politics/nyc-contract-tracers-not-asking-people-who-test-positive-for-coronavirus-if-they-attended-protests-report
We should all be so lucky as to live in a state with the covid trends of NY. If cases spike there again, then maybe your criticism is valid. Until then, who cares? Not me
Couldn't ask de Blasio anyway. He's out sick.
https://www.fox5ny.com/news/mayor-bill-de-blasio-cancels-coronavirus-briefing-due-to-illness