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Re:Updating Herd Immunity Models for the US: Implications fo... by hammock on Thursday October 08, 2020 @11:08AM (#24719776)
Well, we could get to 2MM faster if we opened everything up for the less-vulnerable populations (i.e. everyone under 50 without obesity or heart conditions) for whom the survival rate is above 99.99%. You might then be looking at 500k a day rather than 50k.
Re:Updating Herd Immunity Models for the US: Implications fo... by meowzero on Thursday October 08, 2020 @04:39PM (#24723699)
That is a good strategy. Unfortunately, ppl with survival rate above 99.99% might live with more vulnerable population. It'll be difficult to figure out how to effectively quarantine the more vulnerable population away from the less-vulnerable.
Re:Updating Herd Immunity Models for the US: Implications fo... by guscost on Thursday October 08, 2020 @05:59PM (#24724370)
Why not allow healthy people to inoculate with a reasonable dose of the virus so they can control the timing, and then self-quarantine? I would have done that months ago if it was allowed. Even if it only has a partial chance of conferring immunity, doing that would have helped fewer vulnerable people get sick, but instead public health authorities are still clinging to “informed consent” nonsense, as if turning the world upside-down isn’t another serious risk to mitigate.
Re:Updating Herd Immunity Models for the US: Implications fo... by emodendroket on Thursday October 08, 2020 @08:47PM (#24725581)
Maybe I'm missing something but it seems like you're just independently inventing the concept of a vaccine.
Re:Updating Herd Immunity Models for the US: Implications fo... by casefields on Friday October 09, 2020 @02:50AM (#24727478)
Or a Pox Party: https://en.wikipedia.org/wiki/Pox_party

Not that outrageous.

Re:Updating Herd Immunity Models for the US: Implications fo... by nradov on Friday October 09, 2020 @07:21PM (#24735404)
Jail inmates in California did that in an attempt to get released.

https://www.cnn.com/2020/05/11/us/california-inmates-coronav...

Re:Updating Herd Immunity Models for the US: Implications fo... by emodendroket on Friday October 09, 2020 @05:51AM (#24728353)
Who's stopping you from doing that? Pretty much all the restrictions are on the honor system so if you think that's a good idea go ahead.
Re:Updating Herd Immunity Models for the US: Implications fo... by guscost on Thursday October 15, 2020 @09:40PM (#24796513)
The restrictions prevent me from buying a reasonable dose at the store. How am I supposed to do it, go around licking bus seats? I don’t know anyone positive in town, and asking in public forums has not gotten results.
Re:Updating Herd Immunity Models for the US: Implications fo... by emodendroket on Saturday October 17, 2020 @09:18PM (#24814845)
So you think that, like, 7/11 should be selling pure novel coronavirus? Not really the same idea as a pox party and seems like it has obvious downsides to just make that available to anyone.
Re:Updating Herd Immunity Models for the US: Implications fo... by nradov on Thursday October 08, 2020 @10:58PM (#24726296)
Travel is still way down. There are many vacant hotel rooms.
Re:Updating Herd Immunity Models for the US: Implications fo... by hammock on Thursday October 08, 2020 @11:14AM (#24719844)
Why the massive downvotes?
Re:Updating Herd Immunity Models for the US: Implications fo... by hcknwscommenter on Thursday October 08, 2020 @12:06PM (#24720443)
Because no demographic has been demonstrated to have a 99.99% survival rate?
Re:Updating Herd Immunity Models for the US: Implications fo... by jwlake on Thursday October 08, 2020 @12:37PM (#24720812)
Source? 0-4 and 5-17 are definitely that high. The 18-45 demo is different, but there's a lot more heterogeneity in that population as well.

https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm

Re:Updating Herd Immunity Models for the US: Implications fo... by hcknwscommenter on Thursday October 08, 2020 @03:17PM (#24722724)
I cannot fathom how your link could possibly support your contention that 0-4 and 5-17 are "definitely" a 99.99% survival rate (IFR of 0.01% or 1 fatality out of every 10,000 infections). I suspect you are misreading the table? Care to elaborate?
Re:Updating Herd Immunity Models for the US: Implications fo... by elcritch on Thursday October 08, 2020 @11:13PM (#24726394)
Taking the data from the linked table for say 35-44 year olds is 1,798 deaths out of ~43 million population bracket, excluding influenza cases. That’s a 99.9956% survival rate. Taking all covid-19 and influenza it’s still a 99.9903% survival rate.
Re:Updating Herd Immunity Models for the US: Implications fo... by lostdog on Thursday October 08, 2020 @11:39PM (#24726549)
Nope, you're not even close to calculating the survival rate correctly. The population of ~43 million is the entire population, not the set of people who were infected.
Re:Updating Herd Immunity Models for the US: Implications fo... by elcritch on Friday October 09, 2020 @05:02AM (#24728092)
Schucks, you’re right, I didn’t read the fine print on the CDC site. Still it’s not as far off as that sort of error would seem to indicate.

According to this Sep 2020 article on reason.com (1) they quote CDC numbers of a 99.98 survival rate (0.02% IFR) for 20-to-49-year-olds. Or a 99.997% survival rate (0.003 IFR) percent among people 19 or less.

1: https://www.google.com/amp/s/reason.com/2020/09/29/the-lates...

Re:Updating Herd Immunity Models for the US: Implications fo... by lostdog on Saturday October 10, 2020 @03:31PM (#24741252)
Glad you took another look!
Re:Updating Herd Immunity Models for the US: Implications fo... by rednerrus on Thursday October 08, 2020 @04:59PM (#24723889)
Re:Updating Herd Immunity Models for the US: Implications fo... by rimliu on Thursday October 08, 2020 @03:28PM (#24722844)
I think in Italy they had 100% for 10-19 bracket.
Re:Updating Herd Immunity Models for the US: Implications fo... by em500 on Thursday October 08, 2020 @04:07PM (#24723304)
In the Netherlands it's 100% for the 0-14 bracket. 1 out of of the 6500 deaths so far was younger than 25 (he was in the 15-19 bracket).
Re:Updating Herd Immunity Models for the US: Implications fo... by mcguire on Thursday October 08, 2020 @12:40PM (#24720858)
Are you seriously suggesting we lock over 110,000,000 people (34% of the population) in close quarantine for the duration? How do you plan to feed them? Get them medical care (be sure you don't overwhelm the system with the under 50s that get sick)? Keep them from rioting against their captors?

What happens when you decide it's good enough and release them, and the residual infection sweeps through that population like wildfire?

Re:Updating Herd Immunity Models for the US: Implications fo... by hammock on Thursday October 08, 2020 @02:27PM (#24722135)
>Are you seriously suggesting we lock over 110,000,000 people (34% of the population) in close quarantine for the duration?

As opposed to 100% of the population? It sounds like an improvement to me. I'm suggesting relaxing restrictions for a part of the population, not increasing them.

Re:Updating Herd Immunity Models for the US: Implications fo... by xadhominemx on Thursday October 08, 2020 @05:19PM (#24724052)
Who is suggesting 100% of the population be under close quarantine? We haven’t seen anything like that since April.
Re:Updating Herd Immunity Models for the US: Implications fo... by sfblah on Thursday October 08, 2020 @05:52PM (#24724314)
Bay area resident here. My kids can't go to school. I barely go to the store. Even going for a walk is tricky, as unless you take massive precautions (which I'm fine with, btw) everyone yells at you. I basically have no human contact outside my family, and it's been like this for six months. So, yeah, for me the situation couldn't really get much more quarantined.
Re:Updating Herd Immunity Models for the US: Implications fo... by mcguire on Thursday October 08, 2020 @06:28PM (#24724609)
The Bay area sounds excessive, but consider that under the ancestor's idea, you couldn't do that if you were concerned with reducing your risk of infection.

I'm 53. I have asthma and I really hate hospitals. Right now, I have been going for groceries about once a week. I've gone to some appointments, but I've cancelled others. I've been getting take-out some, and I even went on one shopping expedition for craft supplies. I'm relatively comfortable with that because, while I have to assume everyone else is potentially infected, I can also assume that most of them are taking steps to protect me---a mask is significantly more effective at preventing spread from someone infected than it is at preventing an infection of the wearer.

Close quarantine means no going to the store at all. Not going for walks. It specifically means no human contact outside the people you are quarantined with.

Re:Updating Herd Immunity Models for the US: Implications fo... by xadhominemx on Thursday October 08, 2020 @07:22PM (#24725025)
That doesn’t sound like close quarantine at all
Re:Updating Herd Immunity Models for the US: Implications fo... by mcguire on Thursday October 08, 2020 @06:42PM (#24724728)
If you think 100% of the population of the United States is in quarantine now, I suggest you check the definition of quarantine.

If you relax "restrictions" on a part of the population, more of that population becomes infected. If you do not increase the restrictions on the remainder of the population, the higher prevalence increases the transmission rate in that remainder. And thus deaths.

I'm sorry if my existence is inconveniencing you.

Re:Updating Herd Immunity Models for the US: Implications fo... by majormajor on Thursday October 08, 2020 @03:02PM (#24722534)
You would have to increase restrictions for the vulnerable group because if you allow them to mix at all (even at today's levels) with the "free spreading" group they are going to have much worse odds than they do today. Since you're intentionally trying to increase the proportion of sick people in the less-vulnerable group. People like the "grandma living with family with school age children" or the "30 year old immunocompromised cancer patient with a roommate" get fucked if all those people around them (and around them, etc) simply go back to normal and you don't more actively isolate them.

This might not be a terrible idea, though, if compared to a several-year-extension of what we have now... because over time, the cumulative probably of exposure for the vulnerable will just keep rising and rising if we stay at something like the status quo.

But... that's where things like vaccine and treatment development come in. If a vaccine makes catching it much less likely in 6 months, or treatment improvements make it much less deadly even for the vulnerable in six months, then it's worth spending another 6 months in the current situation.

Re:Updating Herd Immunity Models for the US: Implications fo... by nradov on Thursday October 08, 2020 @11:05PM (#24726339)
No one is seriously suggesting we forcibly lock vulnerable people in close quarantine. Instead we should provide those at greatest risk with free hotel rooms if they want to quarantine on a voluntary basis.
Re:Updating Herd Immunity Models for the US: Implications fo... by mcguire on Friday October 09, 2020 @12:40PM (#24731676)
Where they would have to stay. For the duration. With minimal contact. If they don't want to take a significant chance of dying.
Re:Updating Herd Immunity Models for the US: Implications fo... by goalieca on Thursday October 08, 2020 @01:35PM (#24721567)
This is roughly what is called for here by some of the leading experts: https://gbdeclaration.org/
Re:Updating Herd Immunity Models for the US: Implications fo... by regularfry on Thursday October 08, 2020 @04:36PM (#24723660)
These are not "some of the leading experts". https://www.wired.co.uk/article/great-barrington-declaration...
Re:Updating Herd Immunity Models for the US: Implications fo... by goalieca on Thursday October 08, 2020 @08:17PM (#24725422)
Wired? Seriously? I don’t even trust them for tech news.

Here are the authors. They are well credentialed

Dr. Martin Kulldorff, professor of medicine at Harvard University, a biostatistician, and epidemiologist with expertise in detecting and monitoring of infectious disease outbreaks and vaccine safety evaluations.

Dr. Sunetra Gupta, professor at Oxford University, an epidemiologist with expertise in immunology, vaccine development, and mathematical modeling of infectious diseases.

Dr. Jay Bhattacharya, professor at Stanford University Medical School, a physician, epidemiologist, health economist, and public health policy expert focusing on infectious diseases and vulnerable populations.

Re:Updating Herd Immunity Models for the US: Implications fo... by regularfry on Friday October 09, 2020 @02:51AM (#24727486)
And I'm sure at some point one of them is going to publish an epidemiological model in support of their position, and not a press release. Until then, they're not even at Wired's level.
Re:Updating Herd Immunity Models for the US: Implications fo... by myk9001 on Friday October 09, 2020 @04:58AM (#24728066)
Here's a published epidemiological model that supports Kulldorff, Gupta, and Bhattacharya position. Though the author is not one of them. https://journals.plos.org/plosone/article/peerReview?id=10.1...

One of the authors' twitter thread with the paper's summary: https://twitter.com/WesPegden/status/1288140129677332482

Re:Updating Herd Immunity Models for the US: Implications fo... by regularfry on Friday October 09, 2020 @01:47PM (#24732449)
That paper doesn't consider reinfection risk or non-fatal outcomes.

There are many problems with the GBD, but the simplest is that we don't know who the high-risk groups are. Yes, we know age and certain categories of pre-existing condition make for higher risk of death. But we also know that perfectly healthy young people end up with strokes, heart damage, and lung damage, and we're not really sure why. We don't know why some people end up with debilitating symptoms months after infection.

We don't even know if herd immunity is actually possible, or if we'd be committing ourselves to years of intermittent lockdown controls as local outbreaks come and go.

This paper is a similar (if slightly more mathematically detailed) approach, and is more recent: https://www.pnas.org/content/early/2020/09/21/2008087117. It comes to the opposite conclusion. What they find is that while it's technically possible to achieve herd immunity this way, it's logistically unfeasible. It needs monitoring, compliance, and reactiveness that we demonstrably can't (or won't) implement - if we could, we wouldn't be in this mess.

Besides which, neither this paper nor that supports any idea that these three are "leading experts". As far as I can see they're vocal and have a history of being proved wrong by events.

Re:Updating Herd Immunity Models for the US: Implications fo... by goalieca on Friday October 09, 2020 @02:43PM (#24733035)
> but the simplest is that we don't know who the high-risk groups are

We absolutely do. We have such a wealth of data and the signal is very strong.

> That paper doesn't consider reinfection risk or non-fatal outcomes.

That's because reinfection is extremely rare and risk for non-fatal outcomes is typical of other influenza like illnesses. An interesting note is that many / most people have some sort of cross-protection through T-cell immunity (likely from other coronaviruses).

> We don't even know if herd immunity is actually possible

Yes we do. Pretty much every disease tails off. The only debate right now is where this threshold is at for various jurisdictions. It is likely as low as 20%. The 60% number quoted early in the pandemic was assuming homogenous population with equal susceptibility and perfect mixing.

> This paper is a similar (if slightly more mathematically detailed) approach, and is more recent: https://www.pnas.org/content/early/2020/09/21/2008087117. It comes to the opposite conclusion. What they find is that while it's technically possible to achieve herd immunity this way, it's logistically unfeasible.

All models are wrong but some are useful. If this model cannot explain real data from cities and countries (eg: stockholm, UK locales) then it is relatively useless.

Re:Updating Herd Immunity Models for the US: Implications fo... by regularfry on Saturday October 10, 2020 @11:46AM (#24739710)
> We absolutely do. We have such a wealth of data and the signal is very strong.

We know who is likely to die. We do not know who is at risk of a life-long debilitating illness.

> That's because reinfection is extremely rare

We don't know this. What we know is that reinfection with a different strain is rarely detected, and that's a long way from the same thing.

> risk for non-fatal outcomes is typical of other influenza like illnesses

This is false.

> An interesting note is that many / most people have some sort of cross-protection through T-cell immunity (likely from other coronaviruses).

At best this is optimistic. We know some (less than half) have a T-cell response. We don't know yet if that response is beneficial, harmful, or has no effect at all. It would be premature to start any sort of public health intervention founded on this assumption.

> Yes we do. Pretty much every disease tails off.

This strongly depends on the reinfection rate. Which we don't know.

> The only debate right now is where this threshold is at for various jurisdictions. It is likely as low as 20%.

This is false. To get anywhere near 20% you need to know the effect of the T-cell response, or have some other mechanism for discounting a large portion of the population.

> All models are wrong but some are useful. If this model cannot explain real data from cities and countries (eg: stockholm, UK locales) then it is relatively useless.

Have you read either of them? Both models in this thread are predictive models of situations that haven't happened yet. Both use real data (from the US and the UK). Neither can describe reality, so do we throw them both out? That leaves the GBD lot with no epidemiological support at all, which would make my point rather concisely.

We simply don't have enough information to know whether the GBD proposal is safe or, even if it was, whether it could be implemented, and it's all the more suspicious because its three proponents have been making very similar arguments against general lockdown since at least April, when we knew dramatically less. They do not seem to have changed their stances based on new information, which moves the GBD out of science and into politics. Only they're leaning on their academic credentials to lend it airs of legitimacy it can't back up, which makes it complete, utter bullshit that nobody should pay any attention to. It's preying on desperation and optimism to deepen social division and reinforce political hysteria at the worst possible time. No credible health authority is paying any attention to it, nor should they. Please don't bring that sort of content to HN.