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Re:A case for ending lockdown by JadeNB on Wednesday April 29, 2020 @06:59PM (#23025574)
Having, as you suggested, skipped just to the TL;DR, this bit jumped out at me as something that we very much don't know is true, and that it's dangerous to assume is true without proof:

> Once you get sick, you can’t get sick again for a long time. Eventually you might be able to get sick again, but it will not be very bad. When enough people have gotten sick and then gotten better, the sickness can’t spread any more.

(Incidentally, at one point you leave out the 'z' from "hospitalization".)

Re:A case for ending lockdown by postpawl on Wednesday April 29, 2020 @07:10PM (#23025675)
“There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection.”

From WHO a few days ago: https://www.who.int/news-room/commentaries/detail/immunity-p...

Re:A case for ending lockdown by ryankemper on Wednesday April 29, 2020 @07:38PM (#23025880)
This statement was the source of widespread criticism and I in fact criticized it myself in the writeup.

I considered going for a deeper debunking but held off for the initial draft. I might circle back if people feel it's valuable. Let me take a quick stab though:

When we talk about immunity we need to realize the term is used imprecisely by laypeople (btw I'm totally a layman if it's not already clear).

I think of it simplistically as two components:

(1) The presence of actively circulating antibodies in the bloodstream. This is what the (oddly controversial) serology studies are measuring. It is thought that having a significant quantity of these antibodies prevents infection - i.e., what most people envision when they talk about immunity.

(2) Even after the antibodies have faded, there are still Memory B Cells, which lay dormant up to decades, waiting for exposure to the characteristic antigen (in this case, an antigen telling them that they have encountered SARS-CoV-2), at which point they resume and rapidly scale up production of antibodies.

The thinking here is that reinfection is likely possible after a sufficient length of time - whether that's a couple months or a couple years isn't yet known - but when you do get infected, your immune system will respond sooner, more strongly, and thus you will achieve a far lower peak viral load meaning a less serious infection with reduced transmisibility.

This is a robust mechanism that we see across tons of disease, including common cold coronaviruses. In my completely uncredentialed opinion, this effect is so common and well-supported that we should essentially assume it happens until we really have proof that it doesn't. I know that might sound backwards, but it really is such an enduring mechanism.

--

Here's another argument you might prefer. We know that at least hundreds of thousands of people have successfully recovered from COVID-19. Loosely, we can divide the immune system into the "non-specific" and the "adaptive" subsystems. Given that we have seen extensive recovery from this illness and that those who have recovered have detectable levels of antibodies, and furthermore that there is a case of a women who could not manufacture antibodies due to a rare auto-immune disorder who failed to recover, it stands to reason that the same mechanism that provides medium-term immunity is the mechanism responsible for recovery.

That is to say, that it's very farfetched to think that people are recovering purely from non-specific immune responses and that the detectable presence of circulating antibodies is just a red herring. But I suppose you could try arguing that if you wished.

Re:A case for ending lockdown by lbeltrame on Thursday April 30, 2020 @09:57AM (#23030835)
> it stands to reason that the same mechanism that provides medium-term immunity is the mechanism responsible for recovery.

New tests for neutralizing antibodies like proposed by some groups[1] will make sure the antibodies not only are there, but that they actually work.

[1] https://www.researchsquare.com/article/rs-24574/v1

Re:A case for ending lockdown by mrfusion on Wednesday April 29, 2020 @07:59PM (#23026043)
Great write up. It’s so strange the WHO would release a statement like that.
Re:A case for ending lockdown by ryankemper on Wednesday April 29, 2020 @08:16PM (#23026173)
Very strange. If you haven't seen it, they did say why they did it here: https://www.who.int/news-room/commentaries/detail/immunity-p...

Specifically this part:

> People who assume that they are immune to a second infection because they have received a positive test result may ignore public health advice.

So, first of all, I think the concern is on its face totally unwarranted because people likely do have immunity to reinfection for several months, but regardless the presence of the immunological memory (provided they avoid getting infected with Measles which causes immunological amnesia) means that the second infection will be really not very bad and unlikely to transmit easily.

But more importantly:

Our public health organizations (and the media) have adopted the following belief: It is worth it to either mislead the public or to outright lie in order to achieve compliance. If it's not clear from the article, I find such a position detestable, not only on ideological grounds but also because functionally it causes people to endanger their health by engaging in superstition.

This is my theory on why we've seen so many articles from previously-respectable organizations like CNN that seem to focus on the narrative that young people are dropping like flies from this. Why? Because they believe that if young people are not scared shitless for their personal health, that they will not comply with the lockdown measures.

So, the WHO is really not trying to hide their motivation here.

Now the irony is I oppose immunity passports on ideological grounds, at least when used _within_ a society. As far as being used as a literal passport, that's fine by me. If the rest of the world wants to practice containment, it's welcome to do so, but I think from an evidence-based perspective, containment seems like an incredibly dangerous proposition.

Re:A case for ending lockdown by lbeltrame on Thursday April 30, 2020 @02:25AM (#23027969)
> Our public health organizations (and the media) have adopted the following belief: It is worth it to either mislead the public or to outright lie in order to achieve compliance. If it's not clear from the article, I find such a position detestable, not only on ideological grounds but also because functionally it causes people to endanger their health by engaging in superstition.

In Italy it's pretty evident from the communication from the government, the experts (which released a "disaster story" of possible 150,000 ICU cases in a month, a number so high that should have been at least explained) and the media (including tabloids).

Since Germany has started reopening, media here (but, according to what I read - but please correct me if need be - not the case with the major German papers) started saying that "infections are accelerating elsewhere! See? Our model of lockdown is the only one that works!"

It might be true, but it should be grounded in facts and not in misrepresentation of them.

P.S.: Since you mentioned a critique of the widely-used model for this epidemic, do you have any more links to dig further? I simply do not know enough and I want to inform myself more.

Re:A case for ending lockdown by ryankemper on Thursday April 30, 2020 @03:11AM (#23028247)
https://www.lesswrong.com/posts/QuzAwSTND6N4k7yNj/seemingly-... is the critique (it's in the article but easy to miss)

The most important point of criticism is this section: https://www.lesswrong.com/posts/QuzAwSTND6N4k7yNj/seemingly-...

Re:A case for ending lockdown by lbeltrame on Thursday April 30, 2020 @03:22AM (#23028308)
I've read it, but (perhaps I'm wrong, I'm a biologist turned to computational biology so not expert on epidemiological models ;) didn't the author (and similar Stats News post) argue that it is too optimistic, IOW the opposite that you were arguing in the post?

I don't mean this is as a criticism, but it struck me as some dissonance as I was reading.

I've also heard that there might be criticism to other models like the Imperial College one, but so far I've never found anything with some substance.

Re:A case for ending lockdown by ryankemper on Thursday April 30, 2020 @03:36AM (#23028392)
Good question. I should have proactively addressed that:

The IMHE model, after re-estimating, _was_ too optimistic. My argument does not hinge on the IMHE model being too pessimistic; but rather simply that the IMHE model is basically useless and thus we shouldn't base policy on it.

I expect us to have well over 100,000 COVID-19 deaths - indeed probably 3x that but I admit I haven't sat down and done the age-bracket-weighted mortality napkin math. (Basically, take each age group's IFR and multiply by that age group's population in the US, after multiplying by some constant <1 which represnts the sum of herd immunity threshold plus overshoot)

So basically, I think that COVID-19 mortality is going to be way worse than the model predicts, but given the way I view the cost of lockdown, etc, I still think the approach I am proposing is superior to locking down.

Does that make sense?

Re:A case for ending lockdown by lbeltrame on Thursday April 30, 2020 @03:41AM (#23028426)
Yes, I understand your point now. Thanks a lot for clarifying.
Re:A case for ending lockdown by lbeltrame on Thursday April 30, 2020 @03:39AM (#23028418)
Answering above for the same reason of the nesting limit.

Some models (not published) from our expert panel in Italy are instead, in my ignorant view, very pessimistic (they say they elaborated 90 of them). The lockdown will be "eased" (quotes, for most people it's the same as before) on May 4th and one of the predictions said we'd get 150K ICU cases (as I wrote in the parent post). This looks very hyperbolic, at least on paper, because there are many measures still in place, so it's not the same as "no social distancing, no protection, everyone free".

Re:A case for ending lockdown by mrfusion on Wednesday April 29, 2020 @08:45PM (#23026317)
Yeah that makes total sense. I can’t believe how few people buy the media’s stuff so easily. I have relatives forwarding me the corana causes strokes in young people articles. Normally intelligent people.

This whole thing has really shaken my understanding of people.

Re:A case for ending lockdown by tinus_hn on Thursday April 30, 2020 @05:37AM (#23029071)
It’s not that strange, that’s what happens when you forget if you are a scientist or a politician. If you try to be both at the same time the result is you’ll misrepresent your scientific data to make it fit your political goals.

In this case they keep mentioning uncertainty and the argument is that otherwise the public may behave in a way they don’t want. Whatever your opinion on the arguments, that’s not science and it is also poor politics because sooner or later they’ll lose credibility and really that’s all they have.

Re:A case for ending lockdown by Mikeb85 on Thursday April 30, 2020 @02:38AM (#23028049)
And there's been studies out of Korea since that have shown that patients do indeed receive antibodies that provide immunity as well as showing that many recovered patients produce false negatives due to deactivated viruses still in their system. One of which was at the top of HN yesterday.

Also, the WHO said shit like this: https://nypost.com/2020/03/20/who-haunted-by-old-tweet-sayin...

Re:A case for ending lockdown by s1artibartfast on Thursday April 30, 2020 @12:16AM (#23027375)
The WHO also retracted their statement later.

https://mobile.twitter.com/who/status/1254160937805926405

Re:A case for ending lockdown by mrfusion on Wednesday April 29, 2020 @07:55PM (#23026017)
Hmm. I’d be curious to get your take on the lancet link. Are they just referencing different sources or does one have newer information?

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Re:A case for ending lockdown by cvwright on Thursday April 30, 2020 @01:46AM (#23027805)
Conversely, is there any evidence in the other direction, ie that those who have recovered have NO protection?

Remember the other famous WHO announcement at the beginning of this outbreak: “No evidence of human-to-human transmission”

Re:A case for ending lockdown by mrfusion on Wednesday April 29, 2020 @07:04PM (#23025615)
That’s a popular point with the talking heads on the media but I’d encourage you to read up on it. Best estimates look like 1-4 years of immunity [1]

1. https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Re:A case for ending lockdown by JadeNB on Wednesday April 29, 2020 @07:12PM (#23025695)
I hadn't seen the Lancet article—I was getting my latest information from the Quanta article also on the front page (https://www.quantamagazine.org/what-can-other-coronaviruses-... I guess it's a matter of language and personal preference, but "this global pandemic will be in abeyance for a year or so" doesn't match my informal understanding of "a long time". I also believe, as sibling postpawl (https://news.ycombinator.com/item?id=23025675) points out, that there is still at least a divergence of opinions here, and that it is dangerous to get it wrong.

(Personally, while I think voicing unpopular opinions is definitely a role we need in society, it seems to me that dismissing widely accepted opinions as due just to "talking heads on the media" puts disputants in an adversarial position that makes it more likely for people to hunker down in their existing opinions, and less likely for anyone's mind to change. Your refutation would have been more, not less, convincing to me if it had just pointed to the Lancet article.)

Re:A case for ending lockdown by mrfusion on Wednesday April 29, 2020 @07:35PM (#23025860)
You make a good point. Sorry about my reply. I’m so used to getting downvoted these days I’m trying out different writing styles. (Maybe this one is a fail)
Re:A case for ending lockdown by JadeNB on Wednesday April 29, 2020 @07:47PM (#23025960)
> Sorry about my reply. I’m so used to getting downvoted these days I’m trying out different writing styles. (Maybe this one is a fail)

No worries; I also missed that you're not the original author. COVID + policy is a perfect storm of temper-stoking conversational topics.

Re:A case for ending lockdown by ryankemper on Wednesday April 29, 2020 @11:31PM (#23027149)
https://gitlab.com/ryankemper/writings/-/commit/9071eebf0964...

Typo fixed! I think I've found at least 15 typos total now. Oops...