• Isaac
    10.3k
    consider Australia's and New Zealand's COVID strategies. Those countries had a clear objective, which was zero community transmission. People understand the strategies needed to get there, and it has been demonstrated to work.

    These countries adopted a precautionary strategy from the start, versus a "let's try what we think might work and see what happens" strategy. The latter is fine when people's lives and well-being don't depend on the plan working. But a precautionary strategy is necessary when they do.
    Andrew M

    This may be true, but the situation in the US and the UK is not like that in Australia and New Zealand (largely because of gross negligence in the early stages). We now have a much larger community source and that changes the variables considerably. Lockdowns would have to be much longer to work (months not days), and lockdowns will be less effective (zero cases is literally impossible to achieve, the target is lower hospital admissions).

    So rather than comparing days of disruption to avoiding a local epidemic, we're comparing months of disruption to avoiding potential hospital over burdening. Considering the serious consequences of lockdowns, this is no easy decision. The consequences are much higher (I've already cited the papers on this) and the achievements much smaller and more unpredictable.

    I think Australia and New Zealand are excellent examples of what we should have done. They're of much less help now we are where we are.
  • Banno
    24.8k
    Yep. Tragic. Incompetent.
  • frank
    15.7k
    ...not to the same extent, apparently.Banno

    You're misunderstanding that. It's more airborne transmissible because it's more transmissible, not because it's more airborne.

    The previous version (from Europe) is very transmissible in all ways including bloodborne.
  • dazed
    105
    So no one has really pointed out flaws in the risk based covid policy approach suggested by Katz?
    I do wonder why no region has actually tried this approach. Sweden did sort of, but they didn't properly protect the vulnerable. Thinking about it more, it's really not all that complex. If we really made the vulnerable and those who come into contact with them shelter in place and let the rest of the population live normally, there is no question in my mind that we would better off. The collateral damage of the restrictions would be immensely diminished.

    The virus would spread through the non-vulnerable and eventually play itself out as immunity across the healthy population increases. The vulnerable would be protected from the virus as they isolate and avoid contact.

    The only tricky part of this plan is making sure those who come into contact with the vulnerable also shelter in place and stay locked down. It may well be that the impracticality of this is the barrier to implementation...

    The other barrier to this plan is of course those who say "you never know how it might affect one individual" which is where I get exasperated, we do know that the odds of a healthy person under 70 having serious implications from covid is about the same as winning the lottery, you can't plan social policy to avoid such an unlikely event.
  • dazed
    105


    I actually meant my reply to be at you, I don't think it actually is all that complex....
  • frank
    15.7k
    I actually meant my reply to be at you, I don't think it actually is all that complex....dazed

    To fail is to lose at the unwinnable game.
  • Baden
    16.3k
    I think Australia and New Zealand are excellent examples of what we should have done.Isaac

    I've been saying this from the start and I seem to remember you criticising me for it. Am I confused or have you changed your mind or what?
  • Changeling
    1.4k
    Didn't Aus and NZ have a bit of an advantage in that they're 'a bit out of the way' and not as much of an international travel hub compared to Europe? Their use of lockdowns has been impressive but they've been afforded by such an advantage.
  • Baden
    16.3k


    Yes, but the rest of us knew about the virus in time to take action. Politicians dithered and fucked about. E.g. In Ireland, we didn't cancel Paddy's day until the last minute. That was in March. Pubs still open that month. Stupid.
  • Changeling
    1.4k
    Politicians dithered and fucked about.Baden

    This is true and also a factor in Europe's struggles. As was the initial cover up in China due to the CCP's corrupt system of governance plus the WHO's subsequent confusing and contradictory advice.
  • Andrew M
    1.6k
    Lockdowns would have to be much longer to work (months not days), and lockdowns will be less effective (zero cases is literally impossible to achieve, the target is lower hospital admissions).Isaac

    For an alternative point of view:

    After more than 2 million deaths worldwide, perhaps there is an emerging agreement that the elimination of this coronavirus is not only necessary but also achievable.Richard Horton, Lancet editor-in-chief (January 30, 2021)

    The discussed paper:

    The NO-COVID target and the Green Zone strategy, for which we advocate, have already been applied successfully in several countries, thereby enabling their populations to return to a nearly normal life situation. For the Federal Republic of Germany and other European countries this path is both possible and optimal.A proactive approach to fight SARS-CoV-2 in Germany and Europe

    Also the five week CovidZero plan from Yaneer Bar-Yam at the New England Complex Systems Institute:

    CovidZero is adaptive based upon the local conditions and the strengths and capabilities of the community. Setting the goal and using all available capabilities to get there has been shown to work in Australia, China, New Zealand, Taiwan, Thailand, Vietnam, and Atlantic Canada.
    ...
    This [CovidZero] strategy is robust to social conflict as individual communities can achieve success for themselves. It is robust to individual behavior and doesn’t require 100% compliance. Most people care about their families and communities and given the opportunity to get to a clearly desirable goal will do their part, especially if it can be done rapidly.
    Yaneer Bar-Yam, CovidZero: How to end the pandemic in 5 weeks, New England Complex Systems Institute (January 8, 2021)

    Bar-Yam (along with Norman and Taleb) stressed the need to reduce mobility right at the beginning of the pandemic, which is just as necessary today:

    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.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)
  • Andrew M
    1.6k
    Didn't Aus and NZ have a bit of an advantage in that they're 'a bit out of the way' and not as much of an international travel hub compared to Europe? Their use of lockdowns has been impressive but they've been afforded by such an advantage.The Opposite

    It's an important point. Bar-Yam addresses it here:

    Implement travel restrictions and quarantines. Prevent importing cases into nations, states, communities, neighborhoods, even city blocks through strict travel restrictions. The smaller the local area protected by travel restrictions the faster is the process of getting to zero locally. Then use a Green Zone Exit Strategy opening up protected CovidZero areas and connecting them by travel progressively over a few weeks.Yaneer Bar-Yam, CovidZero: How to end the pandemic in 5 weeks, New England Complex Systems Institute (January 8, 2021)
  • Isaac
    10.3k
    I've been saying this from the start and I seem to remember you criticising me for it. Am I confused or have you changed your mind or what?Baden

    Yes. I've always been in favour of early decisive lockdowns.

    "Lock down hard and early" is a future principle that I don't think anyone sensible could now deny.Isaac

    The effectiveness of some kind of lockdown is, I think, beyond question.Isaac

    What I took issue with earlier, with you, was the assumption as to the causal relationship between lockdown strategies and death rates in two countries (Ireland and Sweden). Effective response to emerging viruses is complex and multi-faceted, it's an oversimplification to assume all progress is made by lockdowns alone. The 'anti-lockdown' crowd are as much to blame for this as anyone else, but It is an all too common trend in the face of conspiratorial scepticism of any government or scientific intervention to respond by painting it instead as a panacea sine qua non, without appurtenant effects.
  • Isaac
    10.3k


    You've either misunderstood those papers or misunderstood my comment. It's not clear which. Neither of those papers are suggesting we will end up in a situation where it is no longer necessary to respond to outbreaks of covid-19. The green zone type responses are about local elimination - shutting down outbreaks quickly and decisively, not about creating a world in which there are no such outbreaks.

    As Professor Heymann said in the last WHO briefing...

    It appears the destiny of SARS-CoV-2 [Covid-19] is to become endemic, as have four other human coronaviruses, and that it will continue to mutate as it reproduces in human cells, especially in areas of more intense admission.

    Fortunately, we have tools to save lives, and these in combination with good public health will permit us to learn to live with Covid-19.
    — Professor Heymann chair of the WHO’s strategic and technical advisory group for infectious hazards

    Or Dr Ryan

    The likely scenario is the virus will become another endemic virus that will remain somewhat of a threat, but a very low-level threat in the context of an effective global vaccination program.

    It remains to be seen how well the vaccines are taken up, how close we get to a coverage level that might allow us the opportunity to go for elimination,

    The existence of a vaccine, even at high efficacy, is no guarantee of eliminating or eradicating an infectious disease. That is a very high bar for us to be able to get over.
    — Dr Ryan The head of the WHO emergencies program

    I admire some of the work coming out of the New England Complex Systems Institute, but you have to recognise that this is a cutting edge application of novel statistical models to an emerging situation. Taleb and co are pushing a very new and untested methodology. I think it's got a tremendous amount of potential, but we should not be treating it as if it were rock solid evidence.
  • counterpunch
    1.6k
    "Covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid, covid"

    Will y'all shut up about Covid? What more could there possibly be to say?

    Mask, Wash, Space, Jab - done!
  • frank
    15.7k

    How does it fit into your theory of European supremacy that Europe was hammered by the virus?
  • Benkei
    7.7k
    was? You optimist, you! :cry:
  • ssu
    8.5k
    I think Australia and New Zealand are excellent examples of what we should have done.Isaac

    Yes. Be an island in the southern hemisphere and be so lucky that the virus didn't reach your shores when COVID-19 still was "under the radar" as a peculiar flu. That's a great policy what to follow! :razz:
  • counterpunch
    1.6k
    How does it fit into your theory of European supremacy that Europe was hammered by the virus?frank

    Huh? I think you got the wrong fella, fella!

    But, rather proves my point there's nothing left to say about Covid!
  • ssu
    8.5k
    If not earlier noticed:

    (Feb 3rd, 2021) A team of investigators led by the World Health Organization visited a virus research laboratory in China’s central city of Wuhan and met with a prominent virologist there in its search for clues to the origins of the COVID-19 pandemic.The experts spent about 3-1/2 hours at the heavily-guarded Wuhan Institute of Virology, which has been at the centre of some conspiracy theories that claim a laboratory leak caused the city’s first coronavirus outbreak at the end of 2019.

    “Extremely important meeting today with staff at WIV including Dr Shi Zhengli. Frank, open discussion. Key questions asked & answered,” team member Peter Daszak said on Twitter. Shi, a well-known virus hunter who has long focused on bat coronaviruses - earning her the nickname “Bat Woman” - was among the first last year to isolate the novel coronavirus that causes COVID-19.

    Most scientists, including Shi, reject the hypothesis of a lab leak. However, some experts speculate that a virus captured from the wild could have figured in lab experiments to test the risks of a human spillover and then escaped via an infected staff member. “Very interesting. Many questions,” Thea Fischer, a Danish member of the team, called from her car as it sped away from the lab following Wednesday’s visit, in response to a question whether the team had found anything.

    Some scientists have called for China to release details of all coronavirus samples studied at the lab, to see which most closely resembles SARS-CoV-2, the virus that causes the respiratory disease.

    56436205_401.jpg
  • frank
    15.7k
    think you got the wrong fella, fella!counterpunch

    Oh good.

    Be an island in the southern hemisphere and be so lucky that the virus didn't reach your shores when COVID-19 still was "under the radar"ssu

    It's a subcontinent, isn't it?
  • frank
    15.7k
    was? You optimist, you! :cry:Benkei

    It'll be summer before you know it. It'll be better then.
  • Andrew M
    1.6k
    The virus would spread through the non-vulnerable and eventually play itself out as immunity across the healthy population increases. The vulnerable would be protected from the virus as they isolate and avoid contact.

    The only tricky part of this plan is making sure those who come into contact with the vulnerable also shelter in place and stay locked down. It may well be that the impracticality of this is the barrier to implementation...
    dazed

    Indeed, and there is little room for error:

    Achieving herd immunity through natural infection, to me, is very dangerous,” said Walter A. Orenstein, MD, the associate director of the Emory Vaccine Center and director of Emory Vaccine Policy and Development, in Atlanta. “And I don’t see how that would be protective, because basically you are allowing uncontrolled infection to go on. And when infection is uncontrolled, it can hit vulnerable populations, like nursing home residents, because all you need is one introduction.COVID-19: Great Debates, Sweden and Herd Immunity

    As I see it, Katz fails to acknowledge the unknown risk in pursuing herd immunity. Maybe it will work out for the best, as Sweden hoped for early on. Or maybe it will be an unmitigated disaster.

    Faced with unknown risk, one should take a precautionary approach. As it turns out, those countries that did so - such as Australia, NZ, Vietnam, Taiwan and others - are the countries that have been the most successful at minimizing harm.
  • frank
    15.7k
    Vietnam, Taiwan and others - are the countries that have been the most successful at minimizing harm.Andrew M

    So far. This collection of viruses is with us long-term now. It's easily conceivable that from the vantage point of a century, it will make little difference which route was taken by whom.
  • Andrew M
    1.6k
    So far. This collection of viruses is with us long-term now. It's easily conceivable that from the vantage point of a century, it will make little difference which route was taken by whom.frank

    Could be. It's also easily conceivable that a much more deadly pandemic hits us in the future, and nothing was learnt from this one...
  • frank
    15.7k
    Could be. It's also easily conceivable that a much more deadly pandemic hits us in the future, and nothing was learnt from this one...Andrew M

    Super lethal organisms and viruses don't blow up into pandemics because they kill off hosts too fast to spread. You need a moderately deadly super transmissible pathogen that people can carry around with no symptoms. Like the ones we've got.
  • tim wood
    9.2k
    Politicians dithered and fucked about.Baden
    I dunno, I think this is generous beyond fault to plain mistake. True of some maybe, but others should pray to God they're not called to account. Language fails in describing their failures. Trump and his, and I suppose others around the world, have a place in history books as mass-murderers. The question is why they acted as they did.
  • Andrew M
    1.6k
    You've either misunderstood those papers or misunderstood my comment. It's not clear which. Neither of those papers are suggesting we will end up in a situation where it is no longer necessary to respond to outbreaks of covid-19. The green zone type responses are about local elimination - shutting down outbreaks quickly and decisively, not about creating a world in which there are no such outbreaks.Isaac

    The NO-COVID/CovidZero strategy outlined by those papers is a multiscale approach - applicable to large geographical regions such as the US and Europe as well as smaller states and communities. That outbreaks can still subsequently happen after a geographical region gets to zero due to imported cases is, of course, true - it's the reason why Australia and NZ have experienced outbreaks at all in recent months.

    Excerpting from your provided quotes:

    It appears the destiny of SARS-CoV-2 [Covid-19] is to become endemic...

    ...will permit us to learn to live with Covid-19.

    The likely scenario is the virus will become another endemic virus...
    Isaac

    That is indeed the goal and expected outcome of the usual "mitigation" strategy that most countries employ, and is exactly what the NO-COVID/CovidZero strategy is an alternative to. As Bar-Yam says:

    CovidZero is an exit strategy. It is unlike the usual strategy called living with the virus, mitigation, flattening the curve, or allowing the disease to become endemic with or without a vaccine which is passive, reactive, ineffective and massively costly in lives, long term health, and the economy.Yaneer Bar-Yam, CovidZero: How to end the pandemic in 5 weeks, New England Complex Systems Institute (January 8, 2021)

    I admire some of the work coming out of the New England Complex Systems Institute, but you have to recognise that this is a cutting edge application of novel statistical models to an emerging situation. Taleb and co are pushing a very new and untested methodology. I think it's got a tremendous amount of potential, but we should not be treating it as if it were rock solid evidence.Isaac

    The results achieved in Australia and NZ are successful tests of it at that scale, and so are instructive for what could be achieved in other regions. Their methodology has also been successfully applied to Ebola epidemics in West Africa:

    The results were dramatic. The epidemic that was exponentially growing, fell exponentially [17] (see Fig. 5). To the confusion of some international observers, the expected number of sick people weren’t showing up at the special Ebola care facilities constructed in Liberia. Even two months later, reports in the news were saying that they didn’t know where bodies were, that they must be being hidden [18,19].
    ...
    While early on there was a strong resistance to quarantines, by the following summer with the Ebola epidemic still a problem in Guinea, news reports were talking about how communities welcomed quarantine to finally get rid of the disease [25].
    Yaneer Bar-Yam, How community response stopped Ebola, New England Complex Systems Institute (July 11, 2016)
  • frank
    15.7k
    The results achieved in Australia and NZ are successful tests of it at that scale,Andrew M

    So all you have to do is ignite the boosters and blast spaceship Australia and NZ into space. Then you'll be free!
  • Changeling
    1.4k
    I imagine that's what some NZ residents want. It's the ultimate white flight destination.
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