[WillPostForFood]

The article and discussions about Korea seem to mainly revolve around testing and contact tracing. These are complex and expensive, and substantially more difficult to manage in a country like the US which is 7x the population, and is somewhat decentralized (50 states).

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

[socialdemocrat]

I think in principle hindering spread is much EASIER in the US than in South Korea.

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.

[misun78]

I hope you are not including Cuomo — the governer at the epicenter of the worst hit NY — in your “list of good governers”? This was his quote from early March:

"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."

[frosted-flakes]

Yeah, he was wrong. But he's changed his tune, and has done a decently good job managing the situation.

[misun78]

As again with political analysis, I am seeing downright inconsistencies and biases in judging responses to this pandemic, based on what side one is on. Do you apply the same remarks to the POTUS as well?

[frosted-flakes]

Responding to your original post:

> 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.

[bkor]

> then goes and says that he wants to re-open the country by Easter

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.

[closeparen]

Ebola has an average case fatality rate of 50%. This is not Ebola.

[gnusty_gnurc]

He’s pretty much right though. It spreads worse than the flu and Dr. Ioaniddis recently published a serological study showing it seems to have a mortality rate similar to the flu. An overwhelming majority of people who get it will not die. Ioaniddis et. al. suggests the evidence points towards 1~2 out of a thousand mortality rate.

We should not be panicking. We should be mitigating the disease based on the evidence at hand.

[coldtea]

>He’s pretty much right though. It spreads worse than the flu

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...

[beagle3]

[citation needed] about cherry picking. The limits of their scheme was acknowledged and discussed in the paper. What cherry picking are you referring to that wasn’t addressed?

[pps43]

This paper?

"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...

[corkmask]

9 days ago Ioaniddis said

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,

[coldtea]

He also predicted about 10,000 deaths in total in his mid-March article -- and he even meant that number without any special measures like social distancing and WFH.

At this point he should stop predicting...

[gnusty_gnurc]

Should Imperial close up shop too?

[gnusty_gnurc]

If he's off by 1.5x (IHME model predicts 60k fatalities attributed to COVID-19), surely that's miles better than the what - 50x predicted at the start (I recall seeing 2mil fatalities passed around by Imperial for the US)? 40k deaths is a little less than a week of natural deaths in the US, for scale.

[coldtea]

That's with unprecedented social distancing measures - the 50x prediction was without...

Ioannides in his mid-March article was predicting "10,000" deaths in total in the US, without measures...

[corkmask]

at what multiplier would you consider being skeptical about what he says.

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.

[cameldrv]

The Ioaniddis survey was a total sham. The true fatality rate will wind up being something like 1-2%, if counted by excess deaths.

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.

[Reason077]

> “masks, masks, masks.”

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?

[stcredzero]

I wonder how many lives could have been saved if we (western/European countries) didn’t have such an aversion to wearing face masks

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.

[neurologic]

> Also, I don't really get the societal penalty for disaster preparation.

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.

[stcredzero]

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.

[greedo]

Crab pot metaphor.

[greedo]

I was in a similar position at work. I was continually pointing out from mid-January onwards, that this was a serious issue that might spread world-wide. That we should at least conduct some tests/drills to insure that our business could function remotely. I was treated like a third head had grown atop my shoulders.

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.

[stcredzero]

the same group was saying "It's just a flu."

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.

[mindslight]

My best theory so far is that when it comes to telling people what they themselves need to do (as opposed to inactionable general fear), mainstream media narratives are based around telling audiences the easy answer that they want to hear - eg you don't have to do anything to prepare, and those that do are wrong. Obviously this has always been an ongoing quality (eg no need to oppose the Iraq war since it's just), but with a public health emergency it's front and center.

[lonelappde]

How do you look when you look at someone like they are scum?

[tinus_hn]

In any case, harassing people for wearing a mask is stupid.

[baud147258]

Well, it was impossible to buy masks for much of the lockdown in France, so…

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

[seanmcdirmid]

No one has done a controlled study on this, so no one really knows. It ranges from zero to many.

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.

[saiya-jin]

Even basic mask works quite well in stopping infected person spreading it further. This isn't some recent covid-related revelation, but long known fact. To say it for the 1000th time - this doesn't make you magically virus-proof, but significantly lowers the infection rate of those who have it. On large enough scale, this behavior makes significant difference in infection rates.

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).

[Tiksi]

New York and New Jersey have gone past recommending masks, and have mandated them for anyone out in public, along with limiting the number of people allowed to go into a store, and a 6ft distance in any line/queue.

[hilbertseries]

Los Angeles has mandated you have to wear a face covering when going into essential businesses.

[thowfaraway]

There are many controlled studies on other respiratory disease like the flu, and some on other corona viruses like SARS the show high efficacy of masks. If you doubt the science, fall back on common sense. A respiratory barrier is going to have some value in diminishing the ability of a respiratory virus to spread.

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.

[smileypete]

>No one has done a controlled study on this, so no one really knows. It ranges from zero to many.

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.

[danans]

> Can't remember seeing any controlled studies on the efficacy of social distancing either.

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.

[pps43]

> no one really knows

Healthcare workers wear masks. I'm pretty sure they have a pretty good idea whether masks work.

[lonelappde]

Tools work, of course. But they don't always work well when handled by untrained amateurs.

[pps43]

They don't have to always work well. If Alice's mask stops half the particles and Bob's mask stops half the particles, the chance of Alice infecting Bob is now 4x lower. 50% is not as good as 95%, but surely better than 0%.

All we need to do is bring the reproductive number below 1, not necessarily all the way to 0.

[brewdad]

I've also seen a tendency for people to disregard all of the other social distancing measures now that masks are more common. Squeezing up next to someone to grab a bunch of parsley rather than waiting 5 seconds for them to move on. Tons of face touching from adjusting masks too.

[_ph_]

Well, first of all, there were no masks to wear. Not even enough to properly equip all medical personal. But yes, if people would wear masks whenever there is the risk that they are sick, be it Covid-19, the flu or just a cold, it would be beneficial.

[marvin]

You can make them yourself on a sewing machine, or even sewing by hand if you're desperate. My partner and I have made ~20 in some of our spare time in the last three weeks, for ourselves and our close family and friends. It's not high tech.

Didn't even have to go out and buy more materials.

[_ph_]

Making your own masks is certainly something many people can do, but also many that can't. But many who can, are doing that now. And slowly the supply of commercial masks is improving here in Germany too. As the lockdown is slowly released, people will be wearing masks and that should help a lot with keeping infection numbers down. And hopefully wearing masks becomes standard now when affected by any kind of infectious disease.

[lonelappde]

Most North Americans import their sewing from Asia and South America

[tpm]

That didn't stop some Eastern European countries from mandating their use in public and an industry quickly emerged around that.

[ghaff]

Although only maybe half of the people around where I live are wearing masks of any variety, it doesn't hurt to wear a bandana or a buff or whatever when you go into a store. It probably doesn't do much good but it doesn't hurt and isn't any real effort.

[PeterStuer]

we don't have an aversion to it. Neoliberal governments went out of their way to chastise mask wearing because it would paint a bad picture as they wanted people to actually just die "for the economy".

[James_Henry]

Also, they are very meticulous about taking their shoes off before going into a home and about keeping their floors clean. Which may be more important, especially in dense locations, than we might be realizing.

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

[BubRoss]

That says they detected it on floors in hospitals. Does it talk about it being on shoes, entering homes and ultimately infecting people?

[James_Henry]

No, there's evidence of it on half of the soles of ICU workers' shoes, and they found the virus on the floor of areas where patients were not found. From this they proposed that within the hospital, shoes could be a vector and highly recommend that people disinfect shoe souls before walking out of wards with Covid-19 patients.

There are not any reported cases of the virus infecting anyone by shoe though.

[gedy]

I’m confused/concerned by this as the US authorities are emphasizing that this is a respiratory virus and no need to be concerned about food transmission, etc

[SpicyLemonZest]

The best evidence is that there's no need for the average person to be concerned about food transmission. The hospital context is very different; transmission routes that are normally negligible can start to matter when you have 200 people coughing coronavirus into the air.

[greedo]

They tested in hospital/ICU areas. I think the odds are much higher in such an environment. Obviously medical workers should keep from transferring viral material to their homes, but to imply that this is being transferred by non-medical personnel is inaccurate.

[James_Henry]

Definitely there is more of the virus in hospitals and in the ICU. The virus is also probably on the floors of subway cars, elevators, and other public places if someone infected emits droplets in those areas.

Of course, I'm only suggesting that the idea of shoes as vectors might be something.

[cameldrv]

We are richer per capita, the large population of the U.S. should give us economy of scale (for software development etc), and the lower population density should mean less contacts to trace per case. There's no excuse. We passed a 2 trillion dollar coronavirus bill and there's no contact tracing army? Madness.

[jariel]

" These are complex and expensive, "

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.

[bkor]

> There is no evidence that masks are a solution.

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.

[jariel]

No, the evidence for masks is not there.

If they did materially help, governments everywhere would support them.

The fact 'they use them in Asia' is not evidence.