I think the Dakotas are already at herd immunity | Hacker News Reader

I think the Dakotas are already at herd immunity

rosshartshorn.net

19 pointsrossdavidh30 comments

I appreciate the analyses but struggle with the dissemination of opinion pieces from those who do not work in public health policy or have a MD.

Can someone please explain why we should give any weight to the musing of an EE software developer when this particular topic is so fraught with issue even from actual experts in the space?

Because the CDC said to not wear masks when this whole forum was citing papers and screaming that we should wear masks and wtf is the CDC doing?

And WHO. And Fauci. And Oxford.

And usually they doubled down when it was found out they were wrong.

The only person I know of who is facing any kind of accountability is Gov. Newsom, who will very likely face a recall vote over destroying the Calif. economy while taking federal funds and flouting the lockdown he himself ordered.

His ambition to run for US President dims as each day goes by.

The rationale that they gave at the time was that they feared people would buy up all the masks leaving hospitals undersupplied, and that people would think that wearing a mask meant that you wouldn't also need to distance yourself from others.

At the time, the rationale given was that masks don't work. The idea that people would go to Home Depot to buy up all the existing masks was a nonsense excuse later provided, since hospitals have their own supply mechanisms. Hoarding of toilet paper by the public did not cause a toilet paper shortage within hospitals.

I'll let the US Surgeon General's words speak for themselves. Note that he has since deleted his tweet; I wonder why?

"Seriously people- STOP BUYING MASKS!

They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can't get them to care for sick patients, it puts them and our communities at risk! https://t.co/UxZRwxxKL9"

— U.S. Surgeon General (@Surgeon_General) February 29, 2020[0]

Deleted tweet[1]

[0]https://www.cnn.com/2020/02/29/health/face-masks-coronavirus...

[1]https://twitter.com/surgeon_general/status/12337257852839321...

If the argument is sound and based on correct premises, any credentials or lack thereof are irrelevant. There is also a performative contradiction here, i.e. if the attitude of igmoring all arguments from non-credentialed people were held by everyone throughout history, science and modernity never would have developed.

Sure, but a credentialed person is more likely to be familiar with other research in the area and have expertise with state of the art techniques in the field.

So an uninformed reader (with less background than either to critically evaluate the work) should, all else equal, prefer the analysis of an expert. That's not to say the expert cannot be wrong, but a non-expert has a greater need to establish the credibility of their argument.

I tried to fix my car with sound arguments and correct premises once.

It’s what you don’t know that you don’t know that matters.

I fix my car all the time. You can fix almost all things in your car watching youtube videos. Am I just a super genious or just not intellectually lazy?

I wasn't really talking about cars.

> If the argument is sound and based on correct premises

Therein lies the rub. The problem with a layperson doing this kind of analysis is that they might not even realize that certain beliefs are unfounded assumptions. Obviously experts are also vulnerable to the same thing, and they can have other biases, but they won't make the unintuitive mistakes that their field has learned to avoid through empirical study.

I guess what this argues for is peer review, which I suppose is what this comments section is in a sense. But the article doesn't link to any criticism, nor does it seek it out.

The beauty of science is that reality will prove them correct or not.

Conversely, if the validity of an argument on complex subjects (like epidemiology) could be accurately judged by a lay audience with no deference to expertise they don't possess, then there would be no need for science and modernity.

I think you might not understand what science is. It's a process . It's making observations and proving a theory. When you burn your hand on the stove and make the theory that the stove caused your hand to be burned and don't do it again. That's science.

Or maybe we will just act like the state of Oregon when they didn't like that an engineer educated in the EU called them out for not properly timing their traffic lights, and fine him for reaching conclusions we don't like.

Agreed. People can find just about anything they like with the amount of covid data available.

It would be better if the author had vetted this with an epidemiologist or infectious disease specialist. I am an MD and I feel that this topic is outside my expertise and that I’m not qualified to comment on it. That said the author makes it clear his views are opinion and conjecture. He poses smart thoughtful questions I hadn’t considered and will discuss with colleagues in the future.

He has a pretty solid epidemiological analysis.

The beauty of science is that reality will either prove his theory correct or not.

Reality will prove them correct whether you believe them or not.

You ignore good ideas in favor of credentials at your own peril.

Well, if you were going to use this to, say, make a decision about a medical procedure, sure. I don't think anyone is suggesting that you would change your mind about any medical procedure based on this, I just think it's interesting.

I agree with you that most susceptible populations have probably gotten it by now, especially among people living on reservations. It's hard to imagine that the real numbers would have reached 70%, though, considering the total COVID deaths per 100k population in the Dakotas is 184 & 181 compared to New Jersey's 229, although I guess NJ does have a larger old population. I always imagine as life on the gigantic old homesteading plots to be isolated, but I have no idea.

it does seem very plausible that undetected cases are several times higher than confirmed/symptomatic cases. and/or, perhaps when things start to spike locally people begin to take it seriously and change their behavior a bit -- distancing/masks were not very common in the Dakotas before the post-Sturgis wave.

I'm not sure they're densely populated enough to easily know which X multiplier to apply to the positive rate. People speculate infection rates as high as 10x, I would speculate that multipliers of that sort will be positively correlated with population density, meaning a lower multiplier rate and further from herd immunity.

I think small towns could still replicate some of the exposure risk caused by population density since there will often be only one or two stores to buy groceries, generally located in the largest town in a larger rural area. People will gather in those stores in relatively dense numbers compared to the community at large.

Mix in a reluctance to wear masks and determining the correct multiplier becomes more challenging.

Except I don't think small towns represent small-world networks: they are likely to be clustered within themselves with just a few links outside.

I absolutely believe the multiplier would be different in different places. The fact that the back-of-the-envelope calculation for the U.S. and Slovakia give similar answers, though, suggests that it may not be so different. But sure, definitely no reason to expect it so be exactly the same.

It's seems the author didn't review previous literature on heard imunity on covid. For instance, Manaus had 76% of serumprevalence in October and the number of new cases seem stable. Fast Forward to this week, the health system collapsed, highest number of deaths in one day.

https://science.sciencemag.org/content/371/6526/288

https://www.reuters.com/article/us-health-coronavirus-brazil...

Most (all?) highly contagious viral infection only achieve heard imunity after widespread vaccination.

From the Science article you refer to: "When the percentage of infected people exceeds the herd immunity threshold of 60 to 67%, or 100 × [1 – (1/R0)], each infection generates fewer than one secondary case (case reproduction number Rt < 1) and incidence declines."

They used a similar reasoning as OP.

The huge increase on hospitalization in this month suggests heard imunity might not be possible. Either due reinfection, either because a more agressive variant is infecting people not yet imune.

Reports from region says the number of people with 40-50 years hospitalized substianlly increased when compared with first wave.

This new wave of infections seems to be caused by a new variant called P1, it include both B117 (UK) and E484K (SA) mutations.

This hypotesys is still under investigation, given the lack of genomic sequentialing during the first wave.

Yesterday a paper on this new variant was published (and given a new name).

People should be aware that is unlikely heard imunity will be achieved without vaccination. RNA virus are known to have a high mutations rate, and despite covid having a low mutation rate (given its large rna size), it still mutates a lot. And natural selection will favors the variation that spreads more.

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