Coronavirus

The Coronavirus Is Scary Enough. Governments Shouldn't Make It Scarier by Withholding Information.

The point isn't only to provide reassurance to the public, but also to guide policymakers who have to make decisions on things such as opening or closing public schools, libraries, or playgrounds.

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Early in Taffy Brodesser-Akner's 2019 novel Fleishman Is in Trouble, there's a scene in which a man recently separated from his wife is interrogated by another parent in his child's class.

It was a familiar pattern: "Had things been hard for long?" "Had you tried therapy? "Did you guys have a regular date night?"

Brodesser-Akner's character observes, "these questions weren't really about him…people pretended to care for him while they were really asking after themselves."

So it is with the COVID-19 crisis.

As David Lat, a legal blogger-turned-recruiter who was on a ventilator at NYU Langone Medical Center, put it, "Suddenly getting lots of queries about my health (from folks not familiar with my story). I'm 44, not overweight, no smoking, no drugs, hardly any drinking. No health conditions except exercise-induced asthma, which I manage with an inhaler."

We want to know these things, not because we are particularly curious about Lat, but because we want to reassure ourselves by distinguishing our own medical history and demographic profile from his and others afflicted with severe or deadly cases of COVID-19.

In reporting COVID-19 fatalities, state health authorities seem to be trying to strike a balance between protecting patient privacy and feeding the public's insatiable desire for details.

Different states are trying different approaches. Massachusetts, where I live, is reporting deaths by age ("100s," "90s"), sex, county, preexisting conditions (yes/no/unknown), and whether the person had been hospitalized.

There have been medical journal articles and journalistic speculation linking COVID-19 risk to everything from blood type (A is higher risk, O is lower) to blood-pressure medication (it might hurt, or it might help). There may be genetic predispositions. Merely describing someone as having a "preexisting condition" isn't much help, as by some expansive definitions (high blood pressure, obesity) the federal government has claimed that as many of 50 percent of Americans have some sort of pre-existing condition.

It'd be useful for the states or federal authorities to publish this information. Were the coronavirus fatalities smokers or vapers? If they had pre-existing conditions, what precisely were they? What prescription or over-the-counter medications were they on?

Modern "big data" analytic computer science is quite sophisticated at finding patterns in data like this, especially if there is a way to compare the data for the COVID-19 deaths with recovered severe cases, with milder cases, or with the general population.

The point isn't only to provide reassurance to the public, but also to guide policymakers who have to make decisions on things such as opening or closing public schools, libraries, or playgrounds. Individuals make risk assessments all the time. Do I get on this airplane, get in this Uber, walk down this city sidewalk, go for this swim in the ocean, take this downhill ski trail, eat this steak with French fries? In most cases those choices are informed by life experience and, in some cases, by rigorous long-term observational studies like the Framingham Heart Study and the Nurses' Health Study.

What's baffling about COVID-19 is that it is so new—literally, the novel coronavirus—that people don't have a decent sense of what their risk is. Testing is so limited that no one understands well what the chances are of dying of it are. The chances could be less than one in a thousand, or they could be more.

Anyway, government officials have taken aggressive action in response to the disease, from infringing on freedoms of assembly and religion to ordering General Motors to make ventilators and imposing stay-at-home orders on large populations.

So long as the government is ordering people and businesses around, let it order up some transparency. It may help find a cure for the disease, or, at the very least, allow preventive measures that are more narrowly tailored than shutting down much of the American economy. Maybe insurers can use the data to devise actuarial tables, allowing people to eventual insure some of their COVID-19 risk.

Best of all, such transparency can help individuals make better informed, less panicked decisions about their own risks. Without it, instead of making our own free choices, we're all prisoners of politicians following rapidly changing epidemiological models.

To return to the Fleishman Is in Trouble example, it'd be as if rather than letting individuals decide for themselves whether to get married, the politicians decided to pause all dating based on some demographer's prediction about the future divorce rate. People prefer to know the details of the individual cases, and for good reason.

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  1. Or they could just get the fuck out of the way so we could get antibody testing ourselves. Wouldn’t that be great?

    1. How? We’d have to wait in line ordering from China and then hope the kits actually work.

      As bad as the FDA is, we’ve basically decided to make everything medical related in China or other countries.

      1. The [WE] foundation basically decided to make everything medical related in China. Some of us are actually insisting the [WE] foundation doesn’t actually get to decide that. We will NOT sell our souls down-stream to the [WE] foundation.

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    3. That’s all I care about. I’m a nurse and I had it already and liken most, was largely unaffected since it was so mild (O blood type and yes, viruses do run this way and HLA plays a huge factor also). All I hear about is that my “safety” is being looked after. F that! Let us all get back to work. Lockdown and the quarantine of healthy people is un-American and tyrannical. This narrative should be on the removal of civil liberties instead of which medicine. The fact of that matter is that most who will die have one foot in the grace already and we are still less than 1/3 the death rate of the 2018 flu and NO it isn’t because of social distancing.. ????

      1. That’s all I care about. I’m a nurse and I had it already and like most, was largely unaffected since it was so mild (O blood type and yes, viruses do run this way and HLA plays a huge factor also). All I hear about is that my “safety” is being looked after. F that! Let us all get back to work. Lockdown and the quarantine of healthy people is un-American and tyrannical. This narrative should be on the removal of civil liberties instead of which medicine. The fact of that matter is that most who will die have one foot in the grave already and we are still less than 1/3 the death rate of the 2018 flu and NO it isn’t because of social distancing..

  2. I agree. Much of the data the media is reporting is binned in ways that make analysis impossible or useless. I have to keep going back to the Wuhan data and the Diamond Princess, because it’s literally the best data that’s available, and has been for almost a month, despite what should have been tons of new useful data.

    Ideally, we’d get 10 year age bins with separate statistics for the top 5-10 comorbidity conditions in each bin, if available. Also, best estimates for: average time from estimated infection till symptoms, average time from symptoms to hospital admission, average time in the hospital by case severity until recovery or discharge, and average time in the hospital till death for fatalities.

    Those flatten the curve graphs imply very short hospital stays, which doesn’t feel plausible at all (CDC estimates 10-13 days from admission to recovery for severe cases). If instead of being seen once and immediately discharged, but people are instead admitted and stay for two weeks, you don’t get smooth curves like that, you get accumulating resource usage that lasts throughout most of even the flattened curve (because the x-axis is measured in *days*). And since the area under those curves is equal (Fauci has said flattening the curve won’t reduce total cases, just spread them out), if cases just accumulate in the hospital, the flattened curve peak will end up being about as high as the unflattened curve. Duration effects matter for making decisions here… a lot.

    1. It’s like that chart simply showed an idea and didn’t have any actual science behind it :/

      1. Well,that was obvious when no one would put an actual scale on that x-axis.

        I’ve found only one source courageous enough to do that, and they put the vast majority of the flattened curve over ~4 weeks. If 2 week stays are average, that’s not promising.

    2. For this first wave, the Asian data is going to be the only valuable disease/epidemiology info. They handled the issue early – which is why they could collect meta-data early. Which includes data which can be collected early as well as data that necessarily lags. Europe has some structural data privacy which will prevent release of data until there are big enough sample sizes to prevent inadvertent disclosure of individual info. The US simply lagged so long there will be nothing very useful for a long while. eg the three ultimate ‘outcomes’ for positive confirmed cases – death (3%), recovery (5.5%), and still active/pending/unknown (91.5%). You can’t just stick those actives/pending/unknown into death or recovered because chances are very high that in fact they are different ages/morbidities/etc than the ‘more quickly resolved’ cases. And like almost everywhere, once we caught up with testing – we have been comfortable ‘plateauing’ to play wait-and-see rather than taking the next step.

      At this point, the best route for analysis – and need for transparency – is on the input side not the output side. And the problem there is that countries that do have a ‘public health process’ function that is govtl are hesitant to display their dirty underwear – and countries that don’t have that (eg the US) have no underwear at all.

      I hoped a couple months ago when I first saw this would become global, that this might produce a public debate here (and maybe elsewhere) about how different places deal with the general information and processes needed to deal with and manage a ‘pandemic’. But that hasn’t happened at all. Without that demand for info to fuel a public debate, the info won’t get released.

      1. “I hoped a couple months ago when I first saw this would become global, that this might produce a public debate here (and maybe elsewhere) about how different places deal with the general information and processes needed to deal with and manage a ‘pandemic’. But that hasn’t happened at all. Without that demand for info to fuel a public debate, the info won’t get released.”

        Instead, you stand on the corner, waving your PANIC!!!!! flag and screaming at the top of your lungs.
        There has been plenty of debate here, but since it’s in the self interest of chicken littles like you, the media and the government to keep the PANIC at as high a level as possible, any demand for data will produce as close to zero as possible.

        1. Speaking of not being able to handle data if it is unpleasant…and look who shows up

          1. look who shows up

            Says the NPC who actively wished for 10,000,000 Americans to be out of work and the economy to be set on fire then bulldozed over the cliff for good measure.

            I hoped a couple months ago when I first saw this would become global

  3. We get total cases and total hospitalized not active cases. Not helpful.

    1. Feature, not bug.

      Every number we’re being told is a fabrication from pure ether.

      We don’t know the number of infected because they’re not testing anyone except those who are seriously ill, which, “coincidentally” brings the “serious effects”, “hospitalization”, and “death” rates up artificially, while depressing the actual number of infected.

      We don’t know how many have died from C-19 because state and local agencies are being directed to note primary COD as C-19 if there are ANY symptoms, no matter how mild or whether even the person tested positive before death, or even the possibility that something else was the true cause. Add to that we don’t even know how many are infected and hence cannot get an accurate death rate.

      But these fake numbers are the ones being reported everywhere, and the ones used by government officials everywhere to destroy the economy and stomp on rights.

  4. …the politicians decided to pause all dating…

    That’s already happened. How do you date and maintain social distancing?

    “Hey babe, wanna hang out six feet away from one another? Your mask or mine? Let’s get takeout and eat in separate cars.”

    Dating is totally fucked right now.

    1. Dating is totally fucked right now
      Pun intended, I’m sure.

    2. Shouldn’t your dating status comment be in an ENB sex worker article?

      1. I haven’t paid for sex since I got divorced.

        1. The homeless guys give sarcasmic sex for free.

  5. Yeah! The government should please impose a 24 hours Lockdown. i guess that will also be of help to this pandemic.

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    1. Only if it has an “Orange Man Bad” slant.

  6. The REAL question is – why does healthcare information sharing have to do with policy-making short of anonymity (privacy law)????

    If patients allow anonymous data collection (not sure why anyone would object) what’s stopping the vast collection of information? How’s this related to government at-all?

    1. Partly because they realize that “anonymous data collection” is often not as anonymous as its claimed to be. If I had a dollar for every news story I’ve seen about researchers (or ordinary schlubs) taking so-called anonymous data and figuring out who the data was collected from, I could go to Disneyland.

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  8. Transparency is not allowed. Too many corporations and politicians vested in taking an unknown and turning into economical collapse, then I’m sure the blame goes to trump.

    It may be years before we find out how many corporations and politicians were involved, but suffice it to say the cia has plenty of experience facilitating not just nationwide propaganda campaigns, but worldwide campaigns as well as seen in every war we’ve been in.

    The fact of the matter is that the level of control the people have over their country is clearly very little – if any. To be so brazen as to conduct the last two coup’s was remarkable enough. When they saw how much of the world needed trump out, they had most of their work done.

    Goodbye beloved pursuit of liberty and happiness. We are left with pursuing life from here on out.

  9. It is in the self-interest of both the government and the media to fudge the numbers, making the epidemic worse than it actually is.
    To expect either to do otherwise is naive at best.

    1. In Ohio, they do not publish recovered cases among the key metrics that they provide during the daily press briefings. Additionally, they make sure to show the age range and median age of confirmed cases (1-101 and 54, respectively), but do not present the same figures for deaths. If one wants to go through the data on their own, they can find out that two of Ohio’s 142 deaths have come between the ages of 30-49, 38 are from ages 50-69 and 102 deaths (72%) are aged 70 and above.

  10. If you are scared of KungFlu, you are a big pussy.

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