Coronavirus Craziness

For philosophical reflections on the COVID-19 pandemic. How can philosophy help us to understand it, to combat it and to survive it?

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attofishpi
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Re: Coronavirus Craziness

Post by attofishpi »

commonsense wrote: Tue Apr 14, 2020 8:46 pm !
...remains Y PORT NE.
commonsense
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Re: Coronavirus Craziness

Post by commonsense »

attofishpi wrote: Tue Apr 14, 2020 8:48 pm
commonsense wrote: Tue Apr 14, 2020 8:46 pm !
...remains Y PORT NE.
?
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attofishpi
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Re: Coronavirus Craziness

Post by attofishpi »

commonsense wrote: Tue Apr 14, 2020 9:05 pm
attofishpi wrote: Tue Apr 14, 2020 8:48 pm
commonsense wrote: Tue Apr 14, 2020 8:46 pm !
...remains Y PORT NE.
?
..an IONs QUEST.

As I said...the board and all the kings men R already owned. I know that much.

To put it rather blatantly - the 3rd party intelligence that is the ongoing construct to our real-IT-y - KNOWS EVERYTHING within the minds of wo/man, IT has the ability to CAUSE ALL DESTINY - but IT doesn't.

Thus.

We R in a system...the penultimate endgame remains - ENTROPY...Y PORT NE? SOULS.

QUEST_ION - a souls quest - throughout time - be good OR you will be ported to the B-EAST.

Now.

The ultimate endgame - well that would be the ultimate answer wouldn't it..


wack-job mode off.
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henry quirk
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C'mon in! The water's fine!

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This subforum is open!
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Re: C'mon in! The water's fine!

Post by RickLewis »

henry quirk wrote: Thu Apr 16, 2020 9:25 pm This subforum is open!
Yep. Sorry folks, I got the settings wrong when I created this sub-forum, hence the "you have insufficient permissions" message some of you have been seeing when trying to post here. Many thanks to Henry for pointing this out so I could fix it.
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Lacewing
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Re: C'mon in! The water's fine!

Post by Lacewing »

henry quirk wrote: Thu Apr 16, 2020 9:25 pm This subforum is open!
Hoorah! Looks like it was Atto's incessant nonsense babbling and insanity disease that crashed it. No surprise. Toxicity has that effect on things.
commonsense
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Re: Coronavirus Craziness

Post by commonsense »

attofishpi wrote: Wed Apr 15, 2020 2:10 am
commonsense wrote: Tue Apr 14, 2020 9:05 pm
attofishpi wrote: Tue Apr 14, 2020 8:48 pm

...remains Y PORT NE.
?
..an IONs QUEST.

As I said...the board and all the kings men R already owned. I know that much.

To put it rather blatantly - the 3rd party intelligence that is the ongoing construct to our real-IT-y - KNOWS EVERYTHING within the minds of wo/man, IT has the ability to CAUSE ALL DESTINY - but IT doesn't.

Thus.

We R in a system...the penultimate endgame remains - ENTROPY...Y PORT NE? SOULS.

QUEST_ION - a souls quest - throughout time - be good OR you will be ported to the B-EAST.

Now.

The ultimate endgame - well that would be the ultimate answer wouldn't it..


wack-job mode off.
I decoded the wack-job mode, but I still don’t know what you’re saying.
Last edited by commonsense on Fri Apr 17, 2020 12:35 am, edited 1 time in total.
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henry quirk
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Re: C'mon in! The water's fine!

Post by henry quirk »

RickLewis wrote: Thu Apr 16, 2020 9:29 pm
henry quirk wrote: Thu Apr 16, 2020 9:25 pm This subforum is open!
Yep. Sorry folks, I got the settings wrong when I created this sub-forum, hence the "you have insufficient permissions" message some of you have been seeing when trying to post here. Many thanks to Henry for pointing this out so I could fix it.
:thumbsup:
commonsense
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Re: Coronavirus Craziness

Post by commonsense »

I don’t think that flattening the curve will be the best course of action for the greater good. To be sure, flattening the curve preserved healthcare resources from even greater stress than what has occurred.

But flattening the curve may simply prolong the endpoint. In other words, all the people who have not become ill will still be vulnerable to infection when quarantines end. A percentage of them will get sick, pushing the end of the pandemic back until this second curve is resolved.

The area under the flattened curve will be the same as the area would have been under the steeper curve. The same number of people may become victims of this virus, but it will take longer until the last one recovers or dies.

Yet without quarantine and distancing the acute shortage of ventilators and PPE may have resulted in more deaths. But then, is the greater good best served by preserving population or by decreasing it?
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Re: Coronavirus Craziness

Post by Skepdick »

commonsense wrote: Fri Apr 17, 2020 12:57 am I don’t think that flattening the curve will be the best course of action for the greater good. To be sure, flattening the curve preserved healthcare resources from even greater stress than what has occurred.

But flattening the curve may simply prolong the endpoint. In other words, all the people who have not become ill will still be vulnerable to infection when quarantines end. A percentage of them will get sick, pushing the end of the pandemic back until this second curve is resolved.

The area under the flattened curve will be the same as the area would have been under the steeper curve. The same number of people may become victims of this virus, but it will take longer until the last one recovers or dies.

Yet without quarantine and distancing the acute shortage of ventilators and PPE may have resulted in more deaths. But then, is the greater good best served by preserving population or by decreasing it?
A flatter curve buys you time. Time gives you opportunity to plan/strategise/react/adapt: develop management techniques/control risk/invent vaccines/institute lockdowns. It's an OODA loop.

If you are arguing for:
1. decreasing populations.
2. Steeper curves (narrower -> less time from beginning to end)

There's a kind of event that satisfies the above properties. A rapid extinction event.

Modern societies have great many fail-safes built-in which extend the duration and quality of human life. Things you take for granted like electricity, drinkable water on-tap, sanitation, doctors, fire brigades, communication etc. If a cascading failure takes some or all of those systems out - society will become rapidly worse for all.

Some people buy into the myth of the noble savage. Not me. I like the perks of morern societies: like not-dying at 35 from preventable diseases.
commonsense
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Re: Coronavirus Craziness

Post by commonsense »

Skepdick wrote: Fri Apr 17, 2020 7:47 am
commonsense wrote: Fri Apr 17, 2020 12:57 am I don’t think that flattening the curve will be the best course of action for the greater good. To be sure, flattening the curve preserved healthcare resources from even greater stress than what has occurred.

But flattening the curve may simply prolong the endpoint. In other words, all the people who have not become ill will still be vulnerable to infection when quarantines end. A percentage of them will get sick, pushing the end of the pandemic back until this second curve is resolved.

The area under the flattened curve will be the same as the area would have been under the steeper curve. The same number of people may become victims of this virus, but it will take longer until the last one recovers or dies.

Yet without quarantine and distancing the acute shortage of ventilators and PPE may have resulted in more deaths. But then, is the greater good best served by preserving population or by decreasing it?
A flatter curve buys you time. Time gives you opportunity to plan/strategise/react/adapt: develop management techniques/control risk/invent vaccines/institute lockdowns. It's an OODA loop.

If you are arguing for:
1. decreasing populations.
2. Steeper curves (narrower -> less time from beginning to end)

There's a kind of event that satisfies the above properties. A rapid extinction event.

Modern societies have great many fail-safes built-in which extend the duration and quality of human life. Things you take for granted like electricity, drinkable water on-tap, sanitation, doctors, fire brigades, communication etc. If a cascading failure takes some or all of those systems out - society will become rapidly worse for all.

Some people buy into the myth of the noble savage. Not me. I like the perks of morern societies: like not-dying at 35 from preventable diseases.
Good post. Thanks.
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henry quirk
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sumthin' old, sumthin' new

Post by henry quirk »

henry quirk wrote: Sun Apr 05, 2020 12:21 am From George Avery, PhD. MPA

Dr. Avery has a PhD in Health Services Research from the University of Minnesota School of Public Health, and has conducted significant research in the area of public health emergency preparedness, including five journal articles and two book chapters on the topic. He has served on several CDC advisory boards, including a panel on preparedness and emergency response centers, and consulted for the Defense Department on Medical Civic Action program doctrine. He has edited a special issue of the research journal Bioterrorism and Biodefense and served as a reviewer for the Journal of Homeland Security and Emergency Management as well as Disaster Medicine and Public Health. He is a health services researcher with a medical analytics firm in the Midwest, and has formerly been a professor with the public health program at Purdue and worked from 1990-2000 with the Arkansas Department of Health’s Division of Public Health Laboratories.

We are seeing a panic reaction towards the newly emerged SARS-COVID-2 [Wuhan] epidemic, marked by panic buying of items including the much-joked about toilet paper, drastic action by political figures that often impinges on basic civil rights, and potentially devastating lasting economic impact. Much of this has been fueled by naïve and sensationalist reporting of fatality rates, such as a March 10, 2020 report by the Bloomberg news service that implies that 3.4-3.5% of infected individuals die (https://www.bloomberg.com/news/articles ... rus-update ). This has caused comparisons to the 1919 Influenza A:H1N1 pandemic and its 2.5% case fatality rate, which would qualify as a level 5 event on the CDC’s Pandemic Severity Index (PSI) and has led to a panicked overreaction worldwide. This case fatality rate, however, to a trained epidemiologist is obviously a significant overestimation of the actual fatality rate from the disease.

Ascertainment bias is a systematic error in statistical estimation of a population parameter resulting from errors in measurement - usually, in undermeasurement of a parameter. In this case, we are underestimating the actual number of cases in the population, which is the denominator in the calculation of the estimated case fatality rate. We are accurately estimating deaths, but to get the case fatality rate, we divide deaths by our estimate of the number of cases. Because that it too low due to measurement error, the estimate of the case fatality rate is too high.

For example, for a hypothetical disease if we have three deaths and observed ten cases, then the case fatality rate is 30% (3/10=0.3 or 30%). If, however, there were actually 300 cases, and only 10 were observed and reported, ascertainment bias has led us to underestimate the cases and overestimate the case fatality rate, which is actually 1% (3/300=0.01 or 1%).

In this case, in the absence of population-based screening to more actually estimate the total number of cases, we are only counting cases who are sick enough to seek health care -- almost all disease reports are made by healthcare professionals. We are missing people who have no more than a cold or who are infected but show no symptoms, individuals who almost certainly make up the overwhelming majority of actual cases. Thus, as in my hypothetical example, we are overestimating the case fatality rate for the disease.

There is, however, data available on SARS-COVID-2 [Wuhan] that allows us to get a better grasp on the actual case fatality rates for the virus.

One case is that of the cruise ship Diamond Princess, which achieved some notoriety from the well-publicized outbreak among its 3711 passengers and crew in January and February of 2006. Held aboard in constricted quarters, the population was subject to 3068 polymerase chain reaction (pcr) tests, which identified 634 individuals (17%) as infected, with over half of these infections (328 ) producing no symptoms. Seven infected passengers died, all of them over the age of 70. Adjusting the data for age, researchers at the London Institute of Tropical Medicine have estimated a fatality rate per infection (IFR) for the epidemic in China of 0.5% (95% CI: 0.2-1.2%) during the same period. This is far below the earlier estimates of 3.4% or greater that were promoting panic over the epidemic. See Russell et al, Estimating the infection and case fatality ratio for COVID-19 using age-adjusted data from the outbreak on the Diamond Princess cruise ship, MedRXIV 2020 at https://www.medrxiv.org/content/10.1101 ... 2.full.pdf.

South Korea has also implemented far wider population-based screening than the US, expanding their screening past suspected cases to voluntary population screening in geographies frequented by identified cases. As of March 15, as Stanford University economist Richard Epstein has noted, they performed over 235,000 tests and identified 8, 162 infections with 75 deaths (CFR=0.91%). Again, only about 10% of the deaths were in the population under the age of 60. See https://www.hoover.org/research/coronav ... t-pandemic . While their population screening efforts were far better than that of the United States, this was still not a broad-based screening effort (such as was used on the Diamond Princess), being biased because while it looked at a broader population, it still was enriched with cases by looking only at a segment of the population with a higher risk. Still, the case fatality rate is significantly below the 3.4% rate that caused the public panic.

What we are likely seeing, in my estimation, is an epidemic with a real case fatality rate between 0.2 and 0.5%, which is similar to the 1957 Asian Influenza A:H2N2 or 1968 Hong Kong Influenza A:H3N2 pandemics, which were also essentially virgin field respiratory epidemics. These pandemics rate, not as PSI5 events, but as PSI2 events on the CDC scale. They are certainly atypical and more severe than a PSI1 event (such as a routine seasonal flu epidemic), but not a shattering event like the 1919 influenza A:H1N1 pandemic. These earlier pandemics essentially tripled the number of deaths due to influenza experienced annually, and were posed little long-term economic or other damage to the population despite being handled without the extreme measures that are currently being adopted or proposed by political figures. Like those pandemic events, SARS-COVID-2 [Wuhan] has its most significant impact on elderly or otherwise compromised individuals, with few fatalities observed in the population under the age of 60. From what we have observed, half of those infected show no symptoms, 40% show mild symptoms such as a cold, and only about 2% advance to serious or critical illness. What is needed now is for politicians and the population to pause, take a deep breath, and address the epidemic with rational measures, such as social distancing of the older population, ring screening around identified cases, quarantine of identified infected individuals, and adequate hospital triage systems to protect other patients and health care staff rom infection in order to preserve our ability to treat the most severe cases. This is a strategy identified by myself and colleagues at Purdue in 2007 to ensure adequate capacity to deal with another true influenza pandemic, and it applies to this one as well.
-----

Scott W. Atlas, MD, is the David and Joan Traitel Senior Fellow at Stanford University’s Hoover Institution and the former chief of neuroradiology at Stanford University Medical Center.

The tragedy of the COVID-19 pandemic appears to be entering the containment phase. Tens of thousands of Americans have died, and Americans are now desperate for sensible policymakers who have the courage to ignore the panic and rely on facts. Leaders must examine accumulated data to see what has actually happened, rather than keep emphasizing hypothetical projections; combine that empirical evidence with fundamental principles of biology established for decades; and then thoughtfully restore the country to function.

Five key facts are being ignored by those calling for continuing the near-total lockdown.

Fact 1: The overwhelming majority of people do not have any significant risk of dying from COVID-19.

The recent Stanford University antibody study now estimates that the fatality rate if infected is likely 0.1 to 0.2 percent, a risk far lower than previous World Health Organization estimates that were 20 to 30 times higher and that motivated isolation policies.

In New York City, an epicenter of the pandemic with more than one-third of all U.S. deaths, the rate of death for people 18 to 45 years old is 0.01 percent, or 11 per 100,000 in the population. On the other hand, people aged 75 and over have a death rate 80 times that. For people under 18 years old, the rate of death is zero per 100,000.

Of all fatal cases in New York state, two-thirds were in patients over 70 years of age; more than 95 percent were over 50 years of age; and about 90 percent of all fatal cases had an underlying illness. Of 6,570 confirmed COVID-19 deaths fully investigated for underlying conditions to date, 6,520, or 99.2 percent, had an underlying illness. If you do not already have an underlying chronic condition, your chances of dying are small, regardless of age. And young adults and children in normal health have almost no risk of any serious illness from COVID-19.

Fact 2: Protecting older, at-risk people eliminates hospital overcrowding.

We can learn about hospital utilization from data from New York City, the hotbed of COVID-19 with more than 34,600 hospitalizations to date. For those under 18 years of age, hospitalization from the virus is 0.01 percent per 100,000 people; for those 18 to 44 years old, hospitalization is 0.1 percent per 100,000. Even for people ages 65 to 74, only 1.7 percent were hospitalized. Of 4,103 confirmed COVID-19 patients with symptoms bad enough to seek medical care, Dr. Leora Horwitz of NYU Medical Center concluded "age is far and away the strongest risk factor for hospitalization." Even early WHO reports noted that 80 percent of all cases were mild, and more recent studies show a far more widespread rate of infection and lower rate of serious illness. Half of all people testing positive for infection have no symptoms at all. The vast majority of younger, otherwise healthy people do not need significant medical care if they catch this infection.

Fact 3: Vital population immunity is prevented by total isolation policies, prolonging the problem.

We know from decades of medical science that infection itself allows people to generate an immune response — antibodies — so that the infection is controlled throughout the population by “herd immunity.” Indeed, that is the main purpose of widespread immunization in other viral diseases — to assist with population immunity. In this virus, we know that medical care is not even necessary for the vast majority of people who are infected. It is so mild that half of infected people are asymptomatic, shown in early data from the Diamond Princess ship, and then in Iceland and Italy. That has been falsely portrayed as a problem requiring mass isolation. In fact, infected people without severe illness are the immediately available vehicle for establishing widespread immunity. By transmitting the virus to others in the low-risk group who then generate antibodies, they block the network of pathways toward the most vulnerable people, ultimately ending the threat. Extending whole-population isolation would directly prevent that widespread immunity from developing.

Fact 4: People are dying because other medical care is not getting done due to hypothetical projections.

Critical health care for millions of Americans is being ignored and people are dying to accommodate “potential” COVID-19 patients and for fear of spreading the disease. Most states and many hospitals abruptly stopped “nonessential” procedures and surgery. That prevented diagnoses of life-threatening diseases, like cancer screening, biopsies of tumors now undiscovered and potentially deadly brain aneurysms. Treatments, including emergency care, for the most serious illnesses were also missed. Cancer patients deferred chemotherapy. An estimated 80 percent of brain surgery cases were skipped. Acute stroke and heart attack patients missed their only chances for treatment, some dying and many now facing permanent disability.

Fact 5: We have a clearly defined population at risk who can be protected with targeted measures.

The overwhelming evidence all over the world consistently shows that a clearly defined group — older people and others with underlying conditions — is more likely to have a serious illness requiring hospitalization and more likely to die from COVID-19. Knowing that, it is a commonsense, achievable goal to target isolation policy to that group, including strictly monitoring those who interact with them. Nursing home residents, the highest risk, should be the most straightforward to systematically protect from infected people, given that they already live in confined places with highly restricted entry.

The appropriate policy, based on fundamental biology and the evidence already in hand, is to institute a more focused strategy like some outlined in the first place: Strictly protect the known vulnerable, self-isolate the mildly sick and open most workplaces and small businesses with some prudent large-group precautions. This would allow the essential socializing to generate immunity among those with minimal risk of serious consequence, while saving lives, preventing overcrowding of hospitals and limiting the enormous harms compounded by continued total isolation. Let’s stop underemphasizing empirical evidence while instead doubling down on hypothetical models. Facts matter.
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