Mister Lorenzo
Dirk Diggler
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Posts: 238
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« Reply #615 on: Monday, March 16, 2020, 15:30:10 » |
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Taken from another forum but also interesting;
I am trained as an epidemiologist and a communicable disease physician. I have also worked in predictive modelling in healthcare and in international health systems development. I am not, however, claiming to be an expert, but I would like to make an few observations...
1... it is unwise to draw parallels from one country to another. Many factors will be different from place to place, population age structure, population density, breadth of healthcare coverage, reliability and breadth of testing facilities, reliability and breadth of contact tracing capability, stage of spread when control measures were first introduced, population mobility, and many other things.
2... epidemic curves are a base case estimate and bear little comparison with real world spread. The more a disease spreads, the less reliable they become and the more complex a situation is, the less predictive they will be.
3... In the UK, the actual experts on this sort of thing are known as "Consultants in Communicable Disease Control". In other countries there are different arrangements. While others, such as intensive care specialists, microbiologists, virologist, mathematicians, journalists, acute physicians, behavioural psychologists have a contribution to make, they are not experts on disease spread in the community and should not be regarded (or present themselves) as such
4... Almost everything that I have seen on social media is misleading and inaccurate. Some of it is extremely dangerous. If you want high quality information, you can get it from the health ministry, public health authority or health system of the country you are in. If you don't want to rely solely on government information, look at the official statements from reputable health orientated universities and departments. London School of Hygiene and Tropical Medicine, Johns Hopkins and the TH Chan School of Public Health at Harvard are a good place to start. The World Health Organisation has good information, but it has to work in a range of very different countries and so may not be the most practically useful for a particular country.
5... we are not testing everybody in the world, so we can't reliably measure death rates. A simple totting up of the numbers will be a massive overestimate. In addition to this, the way people are tested varies massively from place to place. A low number of cases could mean not much disease or not enough testing.
6... There are only two meaningful strategies for managing an emerging infection. The first is containment, where you isolate cases and trace and test their contacts. If spread within a community becomes too great, this strategy becomes ineffective. The second strategy is herd immunity. The basis of this is that when a certain proportion of people have become immune to an infection, it can no longer spread and so people who are not immune are protected. This is why we vaccinate children. Part of a herd immunity strategy is to protect people at particular risk of harm until lots of low risk people are immune, so the disease can't spread to the vulnerable. A herd immunity strategy is not about culling the vulnerable, it is about protecting the vulnerable. This is a new infection and we are learning about it and our immune responses over time. Strategies will change and develop as knowledge grows
7... in many outbreaks, more people die (usually of things like heart attacks and strokes) because they can't get access to healthcare than die of the infection itself. It is extremely important to make sure that health services are not overwhelmed so that people can get the help they need.
8... there are three key ways we can protect health services. Firstly we need to ensure that, if we don't need to seek healthcare we stay away. Secondly, we "flatten the curve" to stretch out the number of people getting the infection over a longer time period, so they don't all arrive at hospital at the same time. Finally we need to ensure that we have enough people to staff our health and care services. If people can't get childcare, they may not be able to work, so we must be very cautious about closing schools etc.
9... nothing is simple and every action will have risks of negative consequences that we may not initially be aware of, so if something that is obvious to you is not happening, it doesn't necessarily mean that others are stupid or wicked, it is more likely that you are missing part of the picture...
10... social isolation can do a great deal of harm to people, particularly older people and the more vulnerable. As containment and delay measures increase it will be really important that our friends, families and neighbours are supported. If we all check in on those around us, no one will suffer unnecessarily. Now is a good time to start sharing phone numbers.
11... wash your hands
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