"We need to be clear. The world is facing a significant shortage of PPE for our frontline workers -- including masks and gloves and gowns and face shields -- and protecting our health care workers must be the top priority for use of this PPE."
That's very World Health Organization, which is used to operating under scarcity.
The embarrassing thing now is that, eight months on, we don't have a huge supply of N95 masks, which actually protect the wearer. On eBay, the price is starting to drop, from about $10 each to about $5 each. Normal price is about $1 each.
But, I did read recently about polio eradication from the African continent etc. Obviously not just by WHO but efforts by many organizations, but still a major achievement isnt it?
Update: I actually would like to know why WHO is not credible any more for some. Honest question.
At least earlier on the narrative was that "the WHO is in the pocket of China" [1] -- while in reality of course the Americans were a dramatically bigger contributor both financially and politically. Further at the same time, the Chinese were actually threatening the WHO and leadership for not playing ball.
Typical 2020 dumpster fire. And at the end of the day the people really hurt are once again the poor countries who depend on the WHO, and we're left with a pile of sadly misinformed "they have no credibility" armchair quarterbacks. It's always easier to try and tear down a system than understand and fix. That's my opinion anyways.
For a more balanced take I suggest this Atlantic piece [2].
[1] https://www.businessinsider.com/mike-pompeo-who-workd-health...
[2] https://www.theatlantic.com/politics/archive/2020/04/world-h...
This made me laugh out loud
I suppose next time I reply to a contentious topic I could find a more seemingly dispassionate source but these days most folks are too polarized to read any news source that doesn't align with their preconceived notions.
Current WHO head was elected in part thanks to chinese votes and influence. When the WHO recommended not closing any borders, how can you disentangle the professional epidemiology opinion from the political push? You can't.
Which is not to say it is evil or incompetent (it may be either, both, or none - I don't know enough) - but it seems to have an aura of "professional only" organization, which is unjustified.
The original plan that the WHO and the rest of the global health community came up to deal with this also seems like total magical thinking to me - basically, everywhere would drop the type 2 poliovirus component (which corresponded to a virus whose wild type had been eliminated) from their live vaccines at once, which would leave none to turn into vaccine-derived poliovirus and type 2 woud just go away. It didn't work that way. I can't fathom why it even should. Nonetheless, there were lots of fancy documents and presentations from the WHO and other such organisations explaining this strategy very hopefully. The current ones don't have the same level of hope.
I can fathom this easily. The general idea is to administer the type 2 oral vaccine (along with 1 and 3, but we’re talking about type 2 here) widely enough that you expect a high level of herd immunity. Specifically, you want sufficient immunity that any newly introduced cases of reverted-to-virulent type 2 will quickly die out. (If you have the resources, you also try to give almost everyone the injectable vaccine to prevent virulent type 2 cases from causing damage). Then you stop giving the type 2 vaccine. If it works, then type 2 is locally eradicated.
Maybe it’s “magical”, but this particular magic has worked in almost the entire world.
False. They said - "There is no specific evidence to suggest that the wearing of masks by the mass population has any potential benefit"
"In the community, we do not recommend the use of wearing masks unless you yourself are sick and as a measure to prevent onward spread from you if you are ill"
"The masks that we recommend are for people who are at home and who are sick and for those individuals who are caring for those people who are home that are sick,"
These are completely normal statements.
>2. Don’t close borders
False. The said "There is a “huge reason to keep official border crossings open” to avoid people entering irregularly and going unchecked for symptoms, "
"Certain containment measures will be appropriate, but widely banning travel, closing down cities, and hoarding resources are not realistic solutions for an outbreak that lasts years."
>3. COVID is not airborne
Please understand that airborne has a scientific meaning, and that is the terminology that scientists use. There is no actual clinical evidence of the airborne transmission of COVID.It is spread through large droplets. If it was airborne, those cloth and surgical masks that people wear would be useless, so you might as well not wear them.
--
>But it’s not clear to me that the WHO has any credibility left.
Maybe that is true for you, but ironically your wild accusations have let me wondering about your agenda here. :)
At this point, it's expert consensus that airborne transmission of COVID is a significant if not the major route of transmission[1].
https://www.pnas.org/content/117/26/14857
> If it was airborne, those cloth and surgical masks that people wear would be useless, so you might as well not wear them.
Not quite useless, but nowhere near as effective as people would like to believe them to be.
I read dozens of studies every day as part of my job in biotech, and most papers are junk and/or contain overly enthusiastic claims that few can replicate. I know somehow on HN linking to a paper is seen as a mic-drop, but that is not the case in the real world.
If the model evidence-based, falsifiable, and tested, applying modeling to a set of conditions is a way of deriving evidence-based conclusions about the likely outcome of those conditions.
No, it's a way to derive evidence based hypotheses. A model that does not include a confounding variable (of which there are many) cannot give any conclusion about that variable - at most a hypotheses.
I've spent some time looking at the models, all of them fail - some spectacularly so (those that inform policy much more so, unfortunately). To the point of being useless, I might say, because their stated assumptions usually apply almost everywhere, but their prediction (and back testing results) match only a small sample (e.g. a few specific countries or cities).
The source is for the "if not majority" part of that sentence. The other part is just me making an admittedly unsubstantiated claim.
https://www.nytimes.com/2020/07/04/health/239-experts-with-o...
> I know somehow on HN linking to a paper is seen as a mic-drop, but that is not the case in the real world.
Sure, but this is HN. You often have to source stuff just to not get downvoted.
"The evidence is admittedly incomplete for all the steps in COVID-19 microdroplet transmission, but it is similarly incomplete for the large droplet and fomite modes of transmission. The airborne transmission mechanism operates in parallel with the large droplet and fomite routes [16] that are now the basis of guidance."
By using arbitrarily high standards for evidence, I might as well claim there's no evidence that COVID is transmitted by large droplets or by smear infection. Where's the randomized trial that proves beyond any doubt that coughing in each other's faces will spread COVID?
I'm kind of surprised that there isn't much of a discussion about that, because if it is indeed a significant route (say 30%), all the masks and distancing in the world won't help until this is also addressed.
If your response is "well, that sucks", yes, I agree. It sucks to live in a world where people and institutions whose sole job is supposed to be making sure true information gets to the public, every time, no exceptions, are either unwilling or unable to do that job right.
That's not to say I behave irresponsibly: I wear a mask in public (because "better safe than sorry"), my family self-quarantined for two weeks when one of us got sick, etc. I just don't assume what "experts" say is necessarily the truth. (To be fair, I also don't trust myself to reach correct conclusions—hence my personal policy of "better safe than sorry.")
I personally feel like too much of modern society involves idolizing experts and institutions—after all, it's nothing more than the argument-to-authority logical fallacy (admittedly, even if it's often a useful heuristic)... but that's a discussion for another time :-P
Saying "better safe than sorry" makes it sound as though you're not sure about this, but this one isn't in doubt - masks reduce the spread of the virus, and that's their primary purpose.
Here's an article about it: https://www.ucsf.edu/news/2020/06/417906/still-confused-abou...
See the section titled "What evidence do we have that wearing a mask is effective in preventing COVID-19?"
All I'm saying is that, as I see it, society's idea of "science" often conflates it with scientists and/or institutions themselves (hence the "argument to authority" part of my comment above). This is, of course, the opposite of what science means, which is why it bothers me enough to have written these comments :-P
Same here. My wife and I were wearing masks, social distancing, not going to public places like restaurants where there was a high risk of catching something, weeks before any public health authorities were recommending such measures, and before the case rate in our area started to spike. To us it was obvious common sense.
When I remember back on the news about the other recent pandemic scares (ebola, swine flu, zika), I don't remember hearing any mention of the WHO. I'm sure it happened, but not nearly as much as CDC. We hear about their announcements a lot more often now, but how much is that due to being cast as antagonists by DC?
I'm now leaning more toward my hypothesis that they haven't changed behavior much, but US reporters are citing them now because the current administration brought them into the story. In the past, reporters probably read the WHO announcements but quoted from CDC same academic experts. Again, WHO info is dry.
https://www.reuters.com/article/us-china-health-who-idUSKBN1...
On Jan 14, 2020, the WHO had no clear evidence of human-to-human transmission yet. It came (to them) shortly afterwards.
That China may have had such evidence and kept it private doesn't make the WHO's statement any less truthful at the time it was issued. They aren't an intelligence organization; they rely on cooperative member nations.
https://www.factcheck.org/2020/04/factchecking-trumps-attack...
> While there is a debate about what was known when — and it seems clear that China knew more than what it reported — the WHO never said the virus was not communicable. Instead, the agency always considered the possibility, even if it also shared information from China that found no evidence of such transmission.
> Lack of evidence, especially of “preliminary” results, does not mean the WHO was saying the novel coronavirus could not be spread between people. The same day as the tweet, the WHO cautioned that there might be some human-to-human transmission of the virus among family members in China.
> According to a timeline of events, Van Kerkhove, who is also the WHO’s technical lead for the COVID-19 response, also said that human-to-human transmission wouldn’t be unexpected, since that is what occurs with SARS and MERS, which are also coronaviruses.
Just a few days later:
> By Jan. 19, the WHO was more definitive, saying in a tweet that there was “some limited human-to-human transmission occurring between close contacts.”
Trying to use this tweet to justify US inaction months later is silly and transparent.
1. It was spreading rapidly in humans
2. It was a coronavirus and therefore was similar to other coronaviruses
If you were following a precautionary principle, you’d have said “it likely is spreading between humans given we’ve never seen any other form of transmission this rapid in any virus that isn’t, and it’s a coronavirus”.
If you think their “don’t wear masks” lie was ok because it was trying to keep medical workers from a shortage, then, how can you not see this as hypocritical? You can’t think the mask lie was ok, due to abundance of caution, and then a total disregard for caution at a much more crucial early stage as ok.
But again, if you were paying attention, watching the WHO make statements like this was terrifying. Like driving in a car with a drunk driver who is stepping on the gas. Who in their right mind would make such a totally braindead, reckless press release like that. Technically there’s no direct evidence, but there’s a whole lot of reason to be worried it likely is airborne. So the headline should be “it’s highly possible it’s airborne, we are waiting for concrete data, but recommend caution given exponential spread within humans”.
The WHO did things similarly shockingly bad three times or so during the pandemic. I was paying attention to all of them and couldn’t help but think something was up. Something was wrong with the WHO. Not just being conservative, but being totally negligent and backwards time and time again. It really seems they were playing either protection for China, or some sort of interference against a good chunk of the world.
If they had done better, many many lives would have been saved. It was some internal politics that broke them. Any halfway sane person knew it at the time.
As the excerpts I've cited demonstrate, the WHO's statements at the time are longer than what can be fit in a single 280 character tweet. The tweet is accurate; the WHO was also issuing far more detailed statements including cautions about exactly what you assumed at the time - that further information was likely to arrive later.
Again:
> According to a timeline of events, Van Kerkhove, who is also the WHO’s technical lead for the COVID-19 response, also said that human-to-human transmission wouldn’t be unexpected, since that is what occurs with SARS and MERS, which are also coronaviruses.
They were making the exact point you claim they didn't make.
> International traffic: no restrictions recommended. Wuhan city is a major domestic and international transport hub. Currently, there are no reports of cases outside of Wuhan City. Given the heavy population movements, expected to significantly increase during the Chinese New Year in the last week of January, the risk of cases being reported form elsewhere is increased. WHO does not recommend any specific health measures for travellers. It is generally considered that entry screening offers little benefit, while requiring considerable resources. In case of symptoms suggestive to respiratory illness before, during or after travel, the travellers are encouraged to seek medical attention and share travel history with their health care provider. WHO advises against the application of any travel or trade restrictions on China based on the information currently available on this event.
It’s a good thing Trump didn’t listen to them and limited immigration by end of January. They made many more reckless recommendations like this well after they knew people were dying, it was spreading rapidly, and it was a coronavirus.
https://www.washingtonpost.com/outlook/2020/10/01/debate-ear...
> The measure that the Trump administration implemented could not be described as a “ban” that “closed the country”: It only prohibited U.S. entry to foreign nationals who had visited China in the last 14 days. Americans and U.S. permanent residents returning from Hubei Province were still allowed, subject to a 14-day quarantine. After these policies were enacted, hundreds of thousands of travelers continued to arrive in the United States via direct flights from China. Until Feb. 27, no other travelers to the United States faced such travel restrictions and quarantine requirements — even if they were arriving from other nations that were reporting coronavirus cases.
> Restricting flights from China did nothing to prevent the virus from arriving from other parts of the world. Genetic analyses have shown that the large epidemic that unfolded in New York was linked to travelers from Europe. In the early days of the U.S. epidemic, testing was restricted to people with a travel history to China, which limited the ability to detect locally the cases and infections among travelers from other countries.
> By the time Trump expanded travel restrictions to Iran on Feb. 28 and to European nations on March 12, it was largely too late. By mid-March, the United States was approaching 2,000 confirmed cases and experiencing severe shortages in testing capacity that meant many infections likely went undiagnosed. The travel restriction did not initially apply to the United Kingdom, which already had hundreds of reported cases. And, implementation caused chaos. Photos showing large crowds of Americans stranded together in long lines and tight corridors for hours at airports may have increased virus transmission among those travelers who eventually made their way back to the United States.
https://apnews.com/article/0dc271ad7f7917374a5a0cfb49273783
> A recent study from the journal Science found China’s internal crackdown modestly delayed the spread of the virus. It cast doubt that travel restrictions elsewhere will do much compared with other preventive measures, citing in part the likelihood that a large number of people exposed to the virus had already been traveling internationally without being detected.
I personally know someone coming here from China who was disallowed end of January.
That he didn’t go all the way and ban US nationals is only because that would have probably been untenable politically and legally.
Travel restrictions absolutely prevent spread to argue against that shows fundamentally you’re willing to make silly arguments to win, I won’t engage further.
You’ve been fooled by fake news. Just google and you’ll find the truth. Here’s an article from February 2 “All over the world, countries are imposing travel bans on visitors who’ve been to China“ https://qz.com/1795615/coronavirus-travel-bans-on-china-impo...
So it’s the exact opposite of what you said - politicians all over the world were doing just that.
According to a later analysis at https://www.politifact.com/factchecks/2020/apr/13/joe-biden/...
“ By the group’s count, Biden is correct about 45 nations restricting travel from China before the United States.That number covers variations of travel restrictions in effect up to and including Feb. 1.”
First, US closed late Jan before they are citing many others than closed right after that, I know someone who was disallowed before the 31st but they wouldn’t be straightforward on why, so the admin was restricting travel even before the announcement.
And I was referring mostly to within the US there, and with the WHO. Here’s Biden right after the ban:
> We need to lead the way with science -- not Donald Trump's record of hysteria, xenophobia and fear-mongering.
And before you reply saying he didn’t mean directly at the ban, I don’t buy it. It was sent directly after the announcement specifically saying “xenophobic” and suggesting the alternative was “science”. That isn’t someone who is signaling they support it.
Saying "The WHO did things similarly shockingly bad three times or so during the pandemic" and then pivoting to praise Trump on his COVID handling is pretty hilarious.
Editing here as I can’t reply. I’m not debating on failure vs success in the US in this thread, you seem to be caught up in that. I’m simply completely refuting that the WHO was even close to doing well.
Here’s a decent summary of multiple mistakes and pandering to China: https://foreignpolicy.com/2020/04/02/china-coronavirus-who-h...
The WHO themselves even said they made a “huge mistake”. So I guess you’re out there on your own in defending them.
But more than that, anyone paying attention saw they were in China’s pocket. You’re grossly misinformed.
What's your definition of failing?
We didn’t even do that properly - American citizens were allowed to return, weren’t screened, and were asked to observe a “voluntary” quarantine.
We wound up mostly getting it from Europe, where we similarly didn’t restrict until it was far too late.
This leads some credence to the theory that the various restrictions on travel were, and continue to be more politically, than medically motivated.
"No evidence" is falsely interpreted by the layperson as evidence of absence, or at least that there isn't a good reason to expect it to be true. But given the asymmetric costs involved, it is exactly the wrong assumption that people need to make.
Assume there is airborne transmission -> low cost but hedge extreme downside risk.
Assume there is no airborne transmission -> slightly lower cost, but huge downside risk if incorrect.
Policymakers were misled by the WHO.
> Policymakers were misled by the WHO.
Man, if only "policy makers" had access to "scientific circles" so they could stop getting their public health pandemic response ideas from reading Twitter.
That's only ~10% of the reason that people are critical of the WHO though. They also refused to declare a pandemic until until weeks after it had spread globally, even though early R estimates were around 3, which delayed countries' ability to respond quickly. They wouldn't recommend masks until months into the pandemic, even though similar viruses such as SARS were airborne.
The list of heinous mistakes is laundry-list long.
One week later, the WHO had already conducted its own field visit in Wuhan and concluded that human-to-human transmission is likely taking place [1].
[1] https://www.who.int/china/news/detail/22-01-2020-field-visit...
Let's also not forget that they refused to declare a pandemic until weeks after there was evidence of global spread.
The negligence (intentional or otherwise) is truly shocking.
https://www.nature.com/articles/d41586-019-01726-1
Edit: downvoted for stating facts and linking to a Nature article? I guess HN has a soft spot for peddlers of pseudoscience and rhino boner pills as long as it their side politically.
https://www.nature.com/articles/d41586-018-06782-7
This is where I draw the line.
https://www.nature.com/articles/d41586-018-06782-7
Please don’t twist yourself batting for this nonsense.
Can you please paste the relevant quote from the article? Because I'm not seeing that. The part I looked at was:
"In a statement on 4 April, it insisted that the TCM chapter does not discuss particular remedies. Rather, it is meant to give doctors the chance to diagnose patients using both TCM and Western medicine — what it calls “optional dual coding”. These categories “do not refer to — or endorse — any form of treatment”, the statement says."
But it’s not clear to me that the WHO has any credibility left.
Edit:
This is not a coded American Politics statement. Here are examples of where the WHO provided directly counterproductive recommendations:
1. Don’t wear masks (https://www.google.com/amp/s/amp.cnn.com/cnn/2020/03/30/worl...)
2. Don’t close borders (https://www.reuters.com/article/us-china-health-who/who-says...)
3. COVID is not airborne (https://m.facebook.com/WHO/posts/3019704278074935) (pedantic takes aside you should obviously treat it is if it were)