To repeat: don't take this as a sign that Korea believes it has successfully managed the outbreak.
Certainly, a lot of it has to with migrant workers and their living situations, but it also underscores how even when you have things under control, the virus can spread rapidly when your guard is down.
A lot of people were perplexed by Japan's lack of testing. Seems like Japan's strategy (whatever it was) didn't work out in the end.
[1] https://en.wikipedia.org/w/index.php?title=Template:COVID-19...
South Korea is still testing aggressively. Recently they even started re-testing recovered patients. Those who tested positive had their contacts traced and tested too. As long as they remain vigilant, they will not see another big explosion. They seem to have the right attitude.
I’m waiting to see if there will be a little outbreak as a result of the elections they held recently.
It is closer to 20% A lot of articles stating more are mis-interpreting those numbers from prospective studies. It is possible that the authors of such studies would downplay false positives as well.
So at the moment no-one really knows for certain.
Most of them will eventually begin showing symptoms
Almost everyone shut down travel from China (particularly Wuhan) but no one shut down travel from Europe during March. Biggest mistake ever. I don't know enough if it was tourists or whether it was returning Singaporeans but they should have instructed them to remain where they were for the sake of the country.
The USA did shut their border to a lot of Europe in early March. But at the time the WHO opposed border closure.
Over 10 million a year from Germany, Italy, Spain, France, and UK alone. Just tourist visas.
https://en.wikipedia.org/wiki/Tourism_in_the_United_States#V...
My point was that tourism to the US is probably not uniform throughout the year, and March is likely on the lower end of tourism. Hence the ratio of traffic being Americans returning home is higher.
The mistake was not letting them it, but to let them self-quarantine at home. This led to them infecting other family members who then spread it further.
This has changed now as anyone entering Singapore has to be quarantined in a separate facility.
As I mentioned in the previous post, they now quarantine them in dedicated facilities for 2 weeks.
Numbers outside these locations are going down because of the recent "circuit breaker" they introduced a few weeks ago.
South Korea has had fewer deaths than other nations, South Korea has a semi-open economy now. What better model for managing the outbreak is there? (The condition of Europe and the US look very dismal) It's kind of strange seeing this claim with no substantiation beside "repeat" apparently staying on the top of HN for a while.
South Korea hasn't entirely averted the danger and is clearly still keeping it in mind. The virus is going to be around for a while and normalizing life is needed and it seems South Korea has to the testing and contact tracing infrastructure needed for this. What is the counter-argument?
Uh really?
South Korea suppressed an epidemic and strengthened the tools they had for suppressing epidemics, maintaining economic strength and social cohesion.
How are they not best position in the stage of managing the epidemic (the appropriate term used by the ggp).
Oh, I know one really bad answer people are ready with - they didn't let the virus burn through their population to acquire herd immunity. The degree to which any other approach is going to leave a society ready to deal with new waves of this seems really, really low. Certainly, current US events aren't preparing for any future crisis.
For example: behavioural scientists tell us that people will only stand one major lockdown; using that lockdown early to keep deaths to a minimum initially may not be the best strategy. So thinking about the long-term is essential.
Not saying you're wrong that South Korea has a good track record to this point. I am saying you're wrong to extrapolate that out to the likely arrival of a vaccine programme in 2021.
Should we trust those numbers? I'm going to say no.
Social distancing, wearing masks, staying home when sick, cleaning all fomites frequently are things the Japanese were doing before this pandemic culturally, I imagine those actions are in over drive now.
I'm reminded of when the subway tunnels in Japan flooded and the water was so clear you'd have thought it was a swimming pool. Even Chinese netziens commented on how absurdly clean Japan is when the pictures emerged.
Also note Japan has a large elderly population, or about 32+K, who die unnoticed in solitude every year.
Testing isn't even useful at this point, we should operate under the assumption everyone has or will have it, and just treat those who are having complications. You don't need to get tested to know you have a cold, just deal with it.
In the US it wasn't just a matter of getting tests made, but getting all the various states and private testing centers connected so the federal government could aggregate the data. Smaller countries or those with socialized/public healthcare had an easier time at this because their systems were already unified. Tiny countries like South Korea trying to talk down the US for not getting tests out as fast is them is humorous. California alone has greater landmass and 80% of SK's population.
Besides that, Japan is still doing very well despite their population density meeting/exceeding many major hotspots. And the US is likely out of the woods, we should definitely be back to normal next month.
Japan = Olympics; willful neglect, deception
Meanwhile, the on the street observations in the article are: masks, masks, masks. Masks are cheap and easy. So let's start with masks, masks, masks first while we figure out and ramp up testing and contact tracing.
the first Apple store to reopen outside China had lines snaking out the door as many South Koreans -- almost all wearing masks
At Han River park in Seoul’s Banpo district, families -- also in masks -- were having picnics
including requiring voters to wear masks and disposable plastic gloves while casting their ballots
People are still wearing masks and mind talking face-to-face with strangers
A Chinese study found that the virus was probably being moved around by people's shoes https://wwwnc.cdc.gov/eid/article/26/7/20-0885_article
There are not any reported cases of the virus infecting anyone by shoe though.
Of course, I'm only suggesting that the idea of shoes as vectors might be something.
Exactly. I wonder how many lives could have been saved if we (western/European countries) didn’t have such an aversion to wearing face masks, even in a time of pandemic?
The reason government and medical signaling on the subject has been so mixed is that it isn’t apparent they are very effective, especially the jury rigged cloth masks that people are using.
https://www.preprints.org/manuscript/202004.0203/v1
The reason government and medical signaling on the subject has been so mixed is that it isn’t apparent they are very effective
The reason signaling has been mixed is because they were trying to preserve supply for medical professionals. The reason that medical professionals need them is because they work.
I have yet to see a single western leader to recommend those masks for all the interactions (indoor at least). Case point - yesterday I went shopping in fairly large supermarket in Switzerland, and there were maybe 5 other customers (out of at least 100 in the store during that time, probably close to 200 plus all the staff) wearing masks, or gloves. People at least often kept their distance (not always possible in aisles), but that's about it. In a country which has one of most per-capita infections globally.
Why? They rely heavily on politicians doing right stuff. Mostly it works, but in these times politicians prefer keeping economy running (they delayed strong measures when things were getting worse than bad in Italy few kms from their border due to fear of financial impacts... well now they are worse but delayed by few days).
Can't remember seeing any controlled studies on the efficacy of social distancing either.
Many of the healthcare professionals in the countries that dealt with SARS are calling for universal mask wearing. I'd much rather trust their intuition and judgement than governments and media outlets passing the buck to the WHO.
No, but we have mountains of evidence from respiratory diseases throughout history, including the common cold and seasonal flu, that distancing lowers transmission.
It's why people are encouraged to stay home from work when they are sick, and why in normal situations, people in lines of work where they cannot afford to stay home from work get sick more often.
Social distancing is one of the oldest public health protocols we have for disease transmission control.
Sure, many old practices for disease prevention amount to nothing but old wives tales, but social distancing likely isn't one of them.
Healthcare workers wear masks. I'm pretty sure they have a pretty good idea whether masks work.
All we need to do is bring the reproductive number below 1, not necessarily all the way to 0.
Didn't even have to go out and buy more materials.
My wife and I were one of the few people wearing masks at the start of the pandemic, before the closing and work from home orders came. We were harassed by random people shouting at us.
Also, I don't really get the societal penalty for disaster preparation. It's completely illogical. Just a few weeks before the news was really onboard with the pandemic, a woman at my apartment was looking at how many amazon boxes I had on my hand cart. I told her, "In times like this, it pays to be prepared." She looked at me like I was scum. My understanding is that some news outlets were actually denigrating disaster preparation at that point.
It makes a lot of sense: if you're preparing for a disaster, you won't go down with everyone else when disaster strikes. This creates some feeling of resentment which caused people to lash out at you.
A well known psychologist was castigated a few years back for his likening people to lobsters. Yet here we have a perfect example of people acting like the proverbial lobsters who drag the escaping lobster back into the pot.
Jump to mid-March, when the pandemic was obvious to anyone with the least amount of curiosity, and the same group was saying "It's just a flu." The only thing that was socially acceptable to discuss was how many guns you might need in an apocalypse.
Denial is a powerful opiate.
Technically, not an influenza virus. However, from what we know of virus diseases that cross species, it's not the 1st time a virus with this severe capability to spread rapidly has crossed over into humans. It's also not going to be the last.
The aspect of that statement that's true, which is worse than a lie, is that, "It's just a flu," puts people in mind of a disease that's a normalized part of everyday life. It's often the case, that when a virus crosses over to our species, the situation is far more dire than normal.
IIRC, when syphilis crossed over into humans, it would flat-out kill people in 2 weeks.
But banning the sale of masks isn't the most stupid idea we had in France, I'd say it was forbidding jogging from 10h to 19h in Paris was the worst, with all the joggers clustering from 8h to 10h and 19h to 20h
The US has a huge advantage in its low population density and spread out population. That slows down the spread of disease. Not to mention the advantage of a car centric society. In the US you can travel from A to B without exposing yourself to other people. Americans also mostly live in separate houses further reducing the risk of the spread of disease.
All through human history population density has been a major contributor to pandemics. One can see e.g. how New York is much harder hit than LA. LA is low density housing and almost no public transport.
Europe and Asia in contrast is almost all more like New York. IMHO that makes the success in South Korea more impressive not LESS.
We see the same in Europe. The densely populated countries tend to be harder hit. E.g. Denmark has enacted equally strict measures as Norway sooner yet has twice the number of deaths. Norway has an advantage in being more like the US, having a relatively spread out population.
I don't think the decentralization is the main problem at the moment. Germany is also decentralized. It is a federal republic like the US. However unlike the US, Germany has a cooperation oriented leadership where the central government listens to the leaders of the states and coordinate with them.
In the US it seems to be all postering and blame game. It is very hard to evaluate the US results without taking into account its current disastrous leadership. The US is lead by a reality star. Germany is led by a former scientific researcher with a PhD in quantum chemistry. Should we be surprised why Germany is having the best results in the West, while the US is rapidly approaching the worst results?
What saves the US is that there are numerous governors who are good leaders and to some degree counterweight the absurdity of the federal government.
But seriously in what country does the President encourage riot in provinces of their own country? Looking from abroad the US is looking increasingly like a Banana republic. I how things work out fine for everybody. But I am worried.
"People are reacting like this is the Ebola virus. This is not the Ebola virus. This hysteria that you see, this fear that you see, the panic that you see is unwarranted. We have dealt with worse viruses. This spreads like the flu, but most people will have it and they get on with their lives."
> Not to make this too political but can't the same logic be applied to the POTUS too? Changed tone and done a decent job using the fed muscle to beef up on ventilators and testing. What am I missing when I hear contradicting analysis around politicians, presumably based on which "side" one is on. We should be consistent in acknowledging that no one (at least in the US) got the severity of this correct.
The same logic does apply to President Trump. But he has not changed his tune. He's done some of the right things under pressure, but then goes and says that he wants to re-open the country by Easter, etc. I don't follow what he says closely (after all, I don't live in the US), but the picture I've gotten about him is that he's inconsistent and not really trustworthy.
From what I noticed (it's been a while) the reporting on that was a bit weird. The statement was more like "I hope it'll be fine by Easter". That's still a weird thing to say, but less strange than what was reported.
The way statements were made to the public seems to be different per country. E.g. in NL the prime minister said something like "we need to take this very seriously and it will take a long time". They showed a similar presentation from France, were the statement included stuff about "fighting a war". So despite needing to say similar things, the messaging can differ quite a bit per country. In US the statements seem quite strange; dismissing the importance as authority figure seems dangerous and irresponsible.
We should not be panicking. We should be mitigating the disease based on the evidence at hand.
If I were to make an informed estimate based on the limited testing data we have, I would say that covid-19 will result in fewer than 40,000 deaths this season in the USA,
Ioannides in his mid-March article was predicting "10,000" deaths in total in the US, without measures...
From his article [1]:
> If we assume that case fatality rate among individuals infected by SARS-CoV-2 is 0.3% in the general population — a mid-range guess from my Diamond Princess analysis — and that 1% of the U.S. population gets infected (about 3.3 million people), this would translate to about 10,000 deaths.
[1]: https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-a...
He ventured a prediction of the CFR. And then just calculates the amount of deaths from a pretty arbitrary infected percentage of the population (there's no mention of the time scale either). Never does he predict that 1% will be infected. He's arbitrarily picking a number to illustrate the amount of deaths we'd see, but that all depends on how the disease spreads. Oddly enough his serology study ends up being somewhat close - instead of 1%, they saw 1.80-3.17% (in Santa Clara).
But he uses exactly this in his argument, in the same paragraph: "If we had not known about a new virus out there, and had not checked individuals with PCR tests, the number of total deaths due to “influenza-like illness” would not seem unusual this year. At most, we might have casually noted that flu this season seems to be a bit worse than average."
Then later: "Some worry that the 68 deaths from Covid-19 in the U.S. as of March 16 will increase exponentially to 680, 6,800, 68,000, 680,000 … along with similar catastrophic patterns around the globe. Is that a realistic scenario, or bad science fiction?"
Then he claims that "The most valuable piece of information for answering those questions would be to know the current prevalence of the infection in a random sample of a population"
But I claim he already had, at the moment he wrote that article, much better data than that already available: specifically, that all the statistics everybody could find even in the Wikipedia already gave much more information that he claimed has to be obtained by "a random sample of a population."
One can evaluate "how random" all already known cases, at the time he wrote the article, were. But also one can evaluate, if these known cases, even if they weren't random, were actually saying more, not less, by the nature the numbers were obtained.
And that was exactly the case: time and again, in country after country, the statistics included much more people than the small randomness based study would include, and it gave reasonable estimates about both the speed of the spread and percentage of the people affected.
His argument was not based on analyzing already available data, but on "not knowing" by *refusing to even look at the already available data.
Which is fraudulent, ignorant or both. But there were some big names doing exactly the same, exactly at the time he published that article. So his article was just political, not scientific at all.
your comparison of the 2 mil which was the worst case scenario months ago, and now irrelevant, with 40k which was his prediction from 10 days ago is wrong.
At this point he should stop predicting...
Ioannidis' already 4x surpassed prediction was 10K deaths without measures.
Given that we have 4x WITH measures, this means we would be many times more wrong if we followed his advice and didn't take any...
Err, it spreads much better, several times more than the flu.
>and Dr. Ioaniddis recently published a serological study showing it seems to have a mortality rate similar to the flu
Dr. Ioaniddis study was cherry-picked and bogus, much like the studies he was famous for criticizing...
"I think the authors of the above-linked paper owe us all an apology. We wasted time and effort discussing this paper whose main selling point was some numbers that were essentially the product of a statistical error."
https://statmodeling.stat.columbia.edu/2020/04/19/fatal-flaw...
Test kit availability adds another layer. At some point New York had 200 confirmed cases, and two weeks later 400 deaths, yet CFR is unlikely to be as high as 200%.
So yes, all statistics should be taken with a grain of salt, but magnitude and direction of that grain may be different.
A town in Italy, Castiglione d'Adda, had 1.4% of its population die in March. Normally 0.1% dies in a month. That town did a serological survey of blood donors, and 70% came up positive. That exact number won't apply everywhere because there are different age distributions, different comorbibitities, different genes, etc., but that is the ballpark we're looking at.
0.15% of New York City has already died. That should tell you how reliable Ioaniddis' numbers are.
It's infinitely cheaper than shutting down the economy and the massive ensuing bailouts.
"on the street observations in the article are: masks, masks, masks. "
There is no evidence that masks are a solution.
Just the opposite: contact tracing is definitely a primary driver of success.
We should have enacted aggressive contact tracing and widespread testing a long time ago, and recommended 'surgical/cloth' masks for public but strongly discouraged N95's as there are limited quantities and those need to go to the front lines.
Masks are not meant to solve/prevent Corona. It's meant to slow down the spread of the virus. It needs to be used in combination with other measures such as social distancing.
Unfortunately the Dutch government keeps saying that masks do not help, sometimes they suggest that a mask can make things worse. The reason behind this seems to be to prevent people from stealing masks from hospitals, something that seemed to have happened in every country.
That said, please check the effectiveness of masks. It doesn't need to be perfect, just slow down the spread.
If they did materially help, governments everywhere would support them.
The fact 'they use them in Asia' is not evidence.
Or is that just that the family clusters are good news copy (ugh) and over-represented?
but they have successfully managed it. it's just that they're still managing it and are not done.
You can get the immunity only two ways 1) enough people have been gone trough the disease or 2) vaccination.
South Korea must use mitigation/supression until they have enough people vaccinated or it flares up again. Complete eradication without immunity is not feasible unless you isolate whole country from the rest of the world permanently.
Just something like 1 infected entering per day or week means that you must keep up suppressing and tracing.
However, the latest cluster in Heilongjiang involved an asymptomatic student returned from USA, completed 14 day quarantine, tested negative before and after, but still went on to infect her family and neighbors who infected more at the hospital. Total confirmed cases in this cluster is ~50 right now.
Most of the spread in this case happened because of negligence in the hospital thinking coronavirus is eradicated there so they didn’t take precautions. Coastal cities like Shanghai are taking good measures so there hasn’t been a problem despite it being where most international flights land and basically 100% back to work for over a month now. The biggest danger is people becoming tired of wearing masks and avoiding gatherings over time.