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Plk_Lesiak

Coronavirus discussion thread

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Hey there people!

I apologize for my arguable overreach, but I've decided to take down the original thread as I felt troubled by the direction it was going. While everyone's free to discuss the pandemic, I strongly plead to everyone to keep the thread as fact-based as possible and focus on things we can do to keep ourself safe in this crisis. There's a lot of information floating around there and I won't allow this site to be another source of counter-productive panic, at least as long as other admins don't overturn my decision – you're free to appeal to them if you disagree, but for my part, I will observe this thread closely and act decisively.

In Poland, situation so far seems somewhat under control, but it's also because the government introduced some harsh preventive measures real quick. In other parts of the world, in Italy in particular, it's much worse. I'm myself probably going to be stuck at home for a few weeks while our family's company mostly switched to remote work and this is basically the main appeal to everyone, whether the virus is already spread out in your country or only starting to show up – stay at homes whenever you can and do research on what steps you can take to keep yourself safe when going out. Even things like masks are only effective if you use them right. If you are not worried about getting sick yourself, think whether there are vulnerable people around you: elderly, those with chronic conditions or weaker immunity.

And, in the end, don't panic or obsess over preventive measures either. There's only that much you can do, but those few crucial things like hygiene and minimizing contact with strangers are actually very likely to keep you safe. This will pass and if you keep acting responsibly, it'll pass sooner. Stay strong guys!

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Just addressing what @WinterfuryZX said in a post I've hidden for the reasons mentioned in the first post, a lot depends on how your government responds to the danger and it's probably a good idea to pressure them to not follow the early Italy or UK examples of not taking the threat seriously. In Poland, basically all public institutions, restaurants and entertainment hubs are closed off. It probably should be like that in all Europe right now, considering how fast the virus can spread.

However, there's still a lot you can do as an individual to minimize the danger and keep those important to you safer. Remember about both sides of the issue, but focus on the things you can do yourself.

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COVID-19, the infection, is a systems-level threat.  Unless you fall in one of the susceptible populations for pneumonia, you're not personally at high risk.  The main risks here are:

  1. The infection spreading rapidly through susceptible populations and overwhelming healthcare systems: Critically-ill patients with COVID-19 who would have survived with proper care end up dying.  People with other conditions also end up dying because they couldn't get proper care.
  2. The response itself causing as much harm (or more) than the disease: Every response has an opportunity cost--often, a human cost.  Quarantines and other commercial restrictions (voluntary or government-imposed) cause people to lose their jobs.  Panic-buying of surgical masks create shortages where they're actually needed.  Financial markets crashing causes people at or near retirement to potentially lose their livelihoods.  Anything that creates or exacerbates poverty could have long-term consequences on human health.

At this point in the spread of the infection, there is no silver bullet.  Under-respond and you get 1.  Over-respond and you get 2.  We can't know in advance exactly what the appropriate response is, but even the hypothetical optimal response will incur some degree of harm.  All we can do is listen to experts and hope our respective public health systems know what they're doing.  Since most of the risk most individuals will face is not from infection, but from systems-level effects, what we can each do personally is limited.

Edited by sanahtlig

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1 hour ago, sanahtlig said:

Since most of the risk most individuals will face is not from infection, but from systems-level effects, what you can do personally is limited.

Well, it's limited for sure, but not irrelevant. Your individual desitions can further the problem and if you have people from high-risk groups around you, it can literally kill them. I'm not worried about myself much, but I am about my mother who is over 60. Me getting infected would be very dangerous for her even if the health care system doesn't get overloaded. I'm in a very comfortable position that I can lower my exposure to risk factors very heavily and not everyone can do that, but everyone is able to take some precautions. Once more, both sides of the issue are important.

Edit: To summarize it a bit, there's not much you can do to help the situation outside of keeping yourself safe, but there's a lot you can do to make it worse. Don't be that guy. :P

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3 hours ago, Plk_Lesiak said:

Hey there people!

I apologize for my arguable overreach, but I've decided to take down the original thread as I felt troubled by the direction it was going. While everyone's free to discuss the pandemic, I strongly plead to everyone to keep the thread as fact-based as possible and focus on things we can do to keep ourself safe in this crisis.

I feel troubled as well. i don't know what was the old topic about, but this forum is (or was) about liberal expression as long as they no one breaks any rule, this is the first time I see a mod forcing their way because they have the authority to do so. Furthermore, as far as I remember, I saw far worse topic around about irl issue than coronavirus and no one said anything lol.

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16 minutes ago, Kirashi said:

I feel troubled as well. i don't know what was the old topic about, but this forum is (or was) about liberal expression as long as they no one breaks any rule, this is the first time I see a mod forcing their way because they have the authority to do so. Furthermore, as far as I remember, I saw far worse topic around about irl issue than coronavirus and no one said anything lol.

I'm sure there were discussions like that, but to be honest, there weren't that many IRL topics here lately outside of confessions or random small-talk. Thus, I have few points of reference, particularly with stuff this serious and immediate in its nature. I consider this a special case and as it's that far detached from the Forums' main topic, it's not the primary thing the rules are here to protect – free discussion of VNs and various popcultural topics. I feel this is necessary and I'm going to stand by it – if it's overturned or even costs me my admin powers, so be it.

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1 hour ago, sanahtlig said:

COVID-19, the infection, is a systems-level threat.  Unless you fall in one of the susceptible populations for pneumonia, you're not personally at high risk.  The main risks here are:

  1. The infection spreading rapidly through susceptible populations and overwhelming healthcare systems: Critically-ill patients with COVID-19 who would have survived with proper care end up dying.  People with other conditions also end up dying because they couldn't get proper care.
  2. The response itself causing as much harm (or more) than the disease: Every response has an opportunity cost--often, a human cost.  Quarantines and other commercial restrictions (voluntary or government-imposed) cause people to lose their jobs.  Panic-buying of surgical masks create shortages where they're actually needed.  Financial markets crashing causes people at or near retirement to potentially lose their livelihoods.  Anything that creates or exacerbates poverty could have long-term consequences on human health.

At this point in the spread of the infection, there is no silver bullet.  Under-respond and you get 1.  Over-respond and you get 2.  We can't know in advance exactly what the appropriate response is, but even the hypothetical optimal response will incur some degree of harm.  All we can do is listen to experts and hope our respective public health systems know what they're doing.  Since most of the risk most individuals will face is not from infection, but from systems-level effects, what we can each do personally is limited.

Most of the things you mention in 2. are things governments can in turn respond to by providing sensible relief for employees and economic stimuli and guarantees. People who die because of 1. don't come back and an overwhelmed healthcare system isn't too great for the economy or public trust in institutions either.

As an individual you can be careful without panicking. Should you buy rations for a few days in case become sick and can't leave your home? Probably (at least unless you usually buy a week's worth of groceries anyway). Should you buy all the toilet paper your local grocery has in stock? Of course not. Should you wash your hands more often and regularly disinfect surfaces several people might touch? Yes. Should you steal disinfectant from a children's cancer ward (which actually happened in Germany a few days ago)? Hell no! Avoid crowded spaces like bars or public transportation as far as possible, cough and sneeze into tissues or the crook of your arm, wash your hands regularly, avoid touching your face, stay at home when you're feeling sick, and maybe postpone the visit to your grandparents for a few weeks.

The institute in Germany responsible for disease control advises people not to use protective masks unless the are required to for professional reasons. The protection they provide is relatively low compared to the measures I mentioned above and it's suspected they can give a false sense of security leading to people letting the other stuff slide. Also places like hospitals and pharmacies need them more urgently than private citizens and their stocks are usually not big enough for a lasting epidemic.

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13 minutes ago, Plk_Lesiak said:

I'm sure there were discussions like that, but to be honest, there weren't that many IRL topics here lately outside of confessions or random small-talk. Thus, I have few points of reference, particularly with stuff this serious and immediate in its nature. I consider this a special case and as it's that far detached from the Forums' main topic, it's not the primary thing the rules are here to protect – free discussion of VNs and various popcultural topics. I feel this is necessary and I'm going to stand by it – if it's overturned or even costs me my admin powers, so be it.

And there are a lot of informations on the media because this is a serious matter. People already know what to do because each country governement gave instructions for the well being of everyone. I don't know what you expect by censoring the people here (for personnal reason furthermore), because yeah, people will feel censored now, and it is everything but a good idea. Well, this is just my point of view, I can somehow understand yours and I respect it, but the difference is that we have to submit for something all of us might not agree. If the old topic was really a problem, you could just mod there, instead of deleting it and create your own.

It won't cost you anything, we all know this so no need to be so dramatic.

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47 minutes ago, Kirashi said:

If the old topic was really a problem, you could just mod there, instead of deleting it and create your own.

It won't cost you anything, we all know this so no need to be so dramatic.

Well, probably it won't, I just mean I take full responsibility for this and leave to the rest of the admin team the desition on how to interpret it. And yes, theoretically I could've just tried to mod that last thread, but it was the OP and much of the posts that reacted to it that I've found problematic, so there wouldn't be much left of it if I did that. So making a new one and setting out the rules felt more reasonable in this context, and less confusing for anyone reading it, even if it was against the usual practice of moderating around here.

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i feel like assholes are gonna pop up with the thought process of "eh, i dont care if i get it. im young so it wont kill me most likely" when thats not the only point. its also about not spreading it to those who are more vulnerable to the virus. the elderly, the ones with asthma, those are the people who cant handle it.

 

wash your hands, dont touch your face when youre out. when you get home, clean your clothes asap as the virus can stick to them and take a shower. be cautious and safe!!!

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Some experts are predicting that this infection will become endemic--that is, a large proportion of the population will be exposed sooner or later.  If you're in a susceptible population, this infection is dangerous.  So is the seasonal flu (which has a staggering death toll each year).  But normally our health system is equipped to handle the seasonal waves (we also have vaccines for the flu that provide a degree of protection).  The danger here is less the threat of infection and more the rate of infection--as well as the behavioral and social consequences of fear.

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Again: this a government problem, a single person can do very little to stop the contagion.

Anyway, provided the death rate is not the main problem of this infection, this absolutely not comparable to a seasonal flu, this is nonsense, death rate is like 100x higher.

In Bergamo they are getting close to 10x deaths per day then average.

(and no, we are not out of icu yet, tomorrow most probably the entire region of lombardy will already be full, there's around 20 beds left https://www.blogsicilia.it/palermo/coronavirus-a-bergamo-finiti-i-posti-due-pazienti-gravissimi-trasferiti-a-palermo-foto/523558/ they already transfering patients to the south.)

Edited by WinterfuryZX

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5 minutes ago, WinterfuryZX said:

Again: this a government problem, a single person can do very little to stop the contagion.

Anyway, provided the death rate is not the main problem of this infection, this absolutely not comparable to a seasonal flu, this is nonsense, death rate is like 100x higher.

In Bergamo they are getting close to 10x deaths per day then average.

The death rate is extremely hard to evaluate because cases without severe symptoms are likely to be overlooked in statistics while fatalities are obviously all noted. The death rate in Italy does not have to be a mutation, but come from different demographic structure than previously-affected regions and the massive overload of the healthcare system. Seasonal flu complication would also be much more deadly without proper care.

Anyway, I mostly know anecdotal evidence about the Italian case, but it seems that the incompetence of the government was coupled with some poor reactions from the general populace that made the problem even worse. If the government fucks up the epidemy can easily become so severe that avoiding infection becomes extremely hard. But even if the government acts properly, if people ignore safety measures it can easily lead to unnecessary tragedies. I don't undestand the reason to be absolutist about this. 

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The only incompetence I can attribute to the council of ministers is the denyal phase, when they suddenly stopped mass testing (they were scaring the people, yeah, bullshit) and started pressuring the media to minimize the situation and we started to see bullshit like this:

Endorsed by regional governors.

A week later SSN started to collapse and Lombardy, most of Emilia and some other regions were put in full lockdown.

Now the daily death rate of most affected area are decuplicated (10x).

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21 minutes ago, WinterfuryZX said:

The only incompetence I can attribute to the council of ministers is the denyal phase, when they suddenly stopped mass testing (they were scaring the people, yeah, bullshit) and started pressuring the media to minimize the situation and we started to see bullshit like this:

Endorsed by regional governors.

A week later SSN started to collapse and Lombardy, most of Emilia and some other regions were put in full lockdown.

Now the daily death rate of most affected area are decuplicated (10x).

Well, minimazing the threat rather than implementing safety measures and educating people on what do to is already pretty huge. Anyway, I would have to study the timeline properly, but the general impression outside of Italy is that both local and central authorities were slow to react. It allowed for both rapid spread of the infection and mass movement of people from affected areas (like, in tens of thousands), which will likely make it impossible to contain the situation within the Northern regions. It seems unlike what happened in other European countries (we'll see how UK ends with their approach). 

In Poland, all the harsh restrictions, like banning public events, international travel and closing entertainment hubs were being implemented with just a few dozen cases spread around the country. TV and social media all encourage people to stay at homes, avoid crowds etc. At least at first glance, most things that could've been resonably done were done. We'll see where it gets us, but the fact people seem to be listening, really laying low as much as possible, makes me hopeful it'll not get completely out of hand.

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Nah, first response was correct.

They initially found a 38yo patient with an abnormal pnemumonia that wasn't reacting to any known remedies, a nurse went againts useless WHO protocols (only people linked to China should have been tested and other dangerous restrictions) and insisted to test him tor covid19, they eventually tested him and found the first case.

Then they fucked off who protocols and started to do mass testing to anyone around him, found out the first clusters of the infection and put in place a few but very restricted quarantinized ares with almost china level quarantine.

Then... They suddenly decided those measures were too scary for the people, the denyal phase started, mass testing was stopped, bullshit like "it's only the flu" started to spread, everything went downhill fast.

 

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25 minutes ago, WinterfuryZX said:

Then... They suddenly decided those measures were too scary for the people, the denyal phase started, mass testing was stopped, bullshit like "it's only the flu" started to spread, everything went downhill fast.

Yeah, but that's exactly it... I don't think this happened anywhere else in Europe. Even in UK, I think the delay in preventive measures is more about wrong priorities than straight-up denial. :michiru: Those mortality rates in the North clearly show that the infection rate must be massive and only the speed of testing and people getting through the disease outside of the system are obscuring the real numbers. At that point, there's not that much either a single person or the government can do. But this is the only case so far of things getting this severe outside of maybe Iran. Hopefully it will be contained outside of these regions... 

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We were initially focused on people coming from China, but the virus most probaly came here indirectly from Germany, and WHO guidelines doomed us.

https://www.tgcom24.mediaset.it/cronaca/coronavirus-galli-paziente-0-arrivato-dalla-germania-il-25-26-gennaio_15995099-202002a.shtml

Anyway most countries didn't react fast enough. UK NHS is far worse than ours an I think only a stroke of luck can save them at this point, unless they are really planning to deny hospitalization to severe covid patients. A plan to obtain herd immunity from mass spreading could only be attempted by Germany, which has tons of ICU beds, not by the uk, it will be suicidal.

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3 hours ago, Plk_Lesiak said:

The death rate is extremely hard to evaluate because cases without severe symptoms are likely to be overlooked in statistics while fatalities are obviously all noted. The death rate in Italy does not have to be a mutation, but come from different demographic structure than previously-affected regions and the massive overload of the healthcare system. Seasonal flu complication would also be much more deadly without proper care.

The Diamond Princess quarantine represents a unique social experiment, as we have a population that was thoroughly tested and thus where we know both the total infected as well as the total dead.  5 weeks after the start of the outbreak, 7 had died.  A total of 619 were infected.  This allows us to compute a fatality rate of 1.1%. 

https://www.usnews.com/news/world/articles/2020-03-07/diamond-princess-passenger-dies-bringing-ships-death-toll-to-seven-nhk
https://www.medicalnewstoday.com/articles/quarantine-on-covid-19-cruise-ship-may-have-led-to-more-infections
https://cmmid.github.io/topics/covid19/severity/diamond_cruise_cfr_estimates.html

But this is an overestimate for the general population, since the ship's population skewed elderly.

18035ba414c94202de6c30dd343645db.png 

Adjusting for this puts the estimated death rate in the (Chinese) general population at ~0.5%, which is more deadly than the seasonal flu ( ~0.1%), but not "100x" so.  Note that all the deaths observed in this particular sample were in people aged 70+.
 

Edited by sanahtlig

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There must be something wrong on how we are reading the flu data. 

In the ex-red zone (Lombardy, most of Emilia, and other selected areas) daily death rate is around 580 per day. Now we are registering around 150 deaths per day due to sars-cov2 infections alone, and this number is increasing fast.

Of course they are not evenly distributed, if you look at the most affected cities, like Bergamo, at the moment, you'll start to notice there's 10 times more deaths than normal.

And yes most of them are 70+yo that's correct.

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3 hours ago, WinterfuryZX said:

There must be something wrong on how we are reading the flu data. 

In the ex-red zone (Lombardy, most of Emilia, and other selected areas) daily death rate is around 580 per day. Now we are registering around 150 deaths per day due to sars-cov2 infections alone, and this number is increasing fast.

Of course they are not evenly distributed, if you look at the most affected cities, like Bergamo, at the moment, you'll start to notice there's 10 times more deaths than normal.

And yes most of them are 70+yo that's correct.

Well, the simple answer is still that the official data massively underreports the number of cases in Italy, as no one is able to do testing on such a scale (and honestly, it's not even the priority anymore with how many people require immediate care regardless of whether it's the virus). It might already be getting close to the spread in mainland China and we just don't have a way of knowing, while combined with a much older population and overload of the healthcare system it creates death numbers that look absolutely horrifying, but might not be that far from the severity of the original Wuhan virus. 

The question why it spread this fast is crucial and I think the whole world is analyzing it now. What I've seen/read suggests that only focusing on travel from China and the government's denial lead to extremely counter-productive behaviour from normal people, like visiting the sick by whole families and continuing with social engagements as usual. Then people started fleeing in mass from regions that already were experiencing an epidemic... It's a mess, but thankfully somewhat unique in that. When it goes to the full extent of the epidemic, we're unlikely to get reliable numbers on how many people got infected. Sorry for how morbid it will sound, but the death count is probably the more reliable measure of the virus' spread, also showing how different the situation in Italy is from the rest of Europe.

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7 hours ago, WinterfuryZX said:

We were initially focused on people coming from China, but the virus most probaly came here indirectly from Germany, and WHO guidelines doomed us.

https://www.tgcom24.mediaset.it/cronaca/coronavirus-galli-paziente-0-arrivato-dalla-germania-il-25-26-gennaio_15995099-202002a.shtml

Anyway most countries didn't react fast enough. UK NHS is far worse than ours an I think only a stroke of luck can save them at this point, unless they are really planning to deny hospitalization to severe covid patients. A plan to obtain herd immunity from mass spreading could only be attempted by Germany, which has tons of ICU beds, not by the uk, it will be suicidal.

Even Germany wouldn't be able to handle the mass-spreading approach. They may have greater capacities in terms of hospital beds and ICU units than other European countries, but still way to few to be able to manage rates like Italy has right. Also Germany has few nurses per hospital bed when compared to other countries so risks like medical personnel getting infected are higher than elsewhere.

Also, comparing death rates between northern Italy right now and other countries isn't really helpful. Someone pointed out earlier that an overwhelmed healthcare system causes the death rate to go way up (this very long article discussing all the statistics we knew five days ago estimates a factor of around 8 compared to a proper response). A comparison to the total amount of deaths caused by the flu doesn't make a lot of sense either as infection rates for it are so low that it doesn't spread a lot and only a small fraction of the population get it at all.

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Influenza is unstable on surfaces.  It lasts for only a few minutes on the skin, which means there's much less opportunity for hand-to-face transmission.  Meanwhile SARS-CoV-2 appears to last for hours or days on many surfaces.  It can survive suspended in the air for hours.
https://abcnews.go.com/Health/covid19-days-surfaces-experiment-findings/story?id=69569397

Since it can spread without symptoms, anything except a proactive quarantine isn't terribly effective.  This allows for sudden spikes in regional death tolls without a high infection-fatality rate, and also explains why it's so dangerous for the elderly--by the time it starts killing people, the general community has already been exposed. 

Edited by sanahtlig

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