It's open enrollment season at work. It's not like the neoliberalism of flexible spending accounts (both medical and dependent care) hasn't always been there and been irritating, but right now having to say that I know what my medical or childcare expenses will be next year is dumber than usual.
Mine was "recorded" here in Pa. Language is somewhat deceiving, as it is not counted yet. (Notoriously. There was traction to enable mail-in counting beofre E-day but that went by the wayside as feckless PA staties became part of the Trumpia/Kavanaugh potential ratfuck scheme.)
2: Tim's open enrollment just ended. Mine started 2 days ago. One day of overlap. That really ought to be standardized and some kind. Of default regulation, because, yeah, I am trying to figure out whether I can get an oral sleep device covered and whether any dentist is in my medical network for this. It appears that they are for Blue Cross HMO but not PPO.
Open enrollment for me also. I can choose either Plan X or Plan Y for y family of three people:
As an algebra problem,
(office visit costs +prescription costs + diagnostic testing costs above $1000) = a
number of office visits = b
Number of prescriptions = c
total diagnostic costs = d
If .5a = 65b + 10c + d + 2000, the costs of the two plans are equal. if the left side is a lower number I should choose X; if it's greater I should choose Y.
Except that in the event or surgery or something else extremely expensive, X is better because it has a much lower deductible ($1000 vs. 8000) and a slightly lower maximum annual liability ($14,500 vs. $16,300).
Any advice, other than "move to a civilized nation"?
1: I got a similar notice; it is a relief. (I always wonder how badly my signature has drifted; fortunately, not too much!)
No food today, so tomorrow I can get the camera. I'm normally not much of a grapefruit fan, but I roasted one and its juice was a delicious break from the rest of the day. The same for the flavored powder water packet--normally they're for my wife, to help her get caffeine without soda, but today it hit the spot.
We have only 2 choices at my work.
Both plans have the same co-pay if you stay within the preferred network, I.e. our hospitals and affiliated physician group. The other has lower co pays at other in network providers and does have non emergency out of network benefits. The max out of pocket is also lower, but you would be unlikely to hit the max out of pocket if you stayed within our system. Prescriptions are a separate insurance.
Tim has 3 choices, basic, buy up and HSA. If you think you'll use much health care at all the bug up is so much better of a deal even with 10% co insurance and a $200 deductible per person, because the max out of pocket is $2,000 for each of us and $4k for a family. My company pays me $90 not to take the insurance, so my effective premium is 8000. whereas with Tim's if we both maxed out on care the total cost would be $7500, some of which is pre tax and some post tax. Figuring out the FSA is hard. I definitely need to cover the deductible, pay for my tooth filling etc. I had thought that I was going to get 2 surgeries this year, but I got one in February and did not get the more expensive one.
I want to get a dental mouth guard for sleep, which is a medical service provided by a dentist, not a dental service. There are dentists in the Blue Cross HMO network but not in the PPO...And the out of network benefits are 70% coverage of whatever the UCR is. And that would be a couple thousand, maybe.
I'm so tired and blah from this rainy day that I couldn't remember what I had already written about the dentist.
But I voted! I had a mail in ballot, but I was afraid that I would forget to sign it, and they walk you through the process in person, and even glue the envelope for you.
dental mouth guard for sleep
To keep the spiders out.
Ours is only two choices and the HSA is clearly a better choice because PPO premiums = HSA premium + OOP - company HSA contribution. HSA makes your spending very uneven throughout the year but you either end up below the OOP max and save money vs the higher premiums, or you reach the OOP max and then are entitled to free colonoscopies because I hear that's what people would do if healthcare were free.
Woke up this morning to a light dusting of snow on the back deck. Not serious snow, not the kind that sticks and lasts (it's not yet cold enough for that); but a reminder that we're in for a long, hard winter.
"This sucks," says the PM, as he warns us that "it's going to be a tough winter."
Getting ready for a road trip home to Tucson, where I'll be stationed as an Election Day poll observer at a Baptist church on the south side. Hoping for a boring all-day shift with no superspreaders, no guns. The drive is thirteen mostly boring hours, but at least you can get cold coffee in a can these days.
Still here. Thinking about taking a break from some parts of the Internet until Tuesday, though. It hasn't been good for my mental health.
Didn't even look at my open enrollment materials. I feel a bit bad about that, but in all the time we've been married, my options have never been worth taking compared to Atossa's. We had coverage under my job for like a 6-week period when she was between jobs and that was it.
My mom invited us to come down to NM for Thanksgiving, which is tempting, but I think we're probably going to have to say no. Cases are skyrocketing both here and there and I don't see any reason to think the situation will improve in the next month.
10: I wanted to see if that was the case for us, but it was not. Even the company calculator suggested that we would want the buy up plan if we needed care. They give you like $1000 for a $5000 deductible and the premium is only $1000.00 less. I liked the idea of the HSA in a personal level (not a policy level) because you don't have to worry about putting in too much money and losing it at the end of the year.
I voted. I hate having to spend mental energy on choosing health plans, so I hate this (and any other) open season. I am recovering from a hospital stay (last week) due to bacteremia and sepsis following a procedure to improving peeing. At least that did work. A very real improvement in my life. I had already hit my deductible and expect to hit OOP. The ambulance trip alone will probably be $4K or so. Why we have these two "limits" puzzles and annoys me. Health insurance. Ha!
"Understanding Deductibles for Urinary Tract Surgery" was the second, but less known, book by I. P. Freely.
Yikes! Glad you are OK(ish), md. Sepsis is no joke.
Right. That too. This isn't a good time to be hospitalized either.
Sepsis is no joke.
It sure isn't. I felt much safer after getting admitted. It was caught early and is fairly easily treatable then. I'll be taking about a month of antibiotics to ensure it's defeated. E. coli, our frenemy.
This isn't a good time to be hospitalized either.
Yes! I started arranging this in late August to get it done before the predictable next wave. I've now had four COVID-19 tests. Only one was as advertised. That was the latest one so I was very surprised as the others had been easy.
Ditto to 18 and 19.
There are a couple of people who are anti deductible free insurance who think we should have smaller deductibles every month. It sounds too complicated to me.
21: it's not just too complicated, it's grossly dangerous. That's literally a bonus for putting off seeing a doctor until you collapse and get blued into the emergency ward, isn't it?
22: I think a $25 or$50 per month deductible is probably less of a barrier than a $300 or $600 annual deductible. You could do out of pockets on a monthly basis rather than an annual one.
Instead of $2400 for the year, say, it's $200/ month. I'm not paying $1,200 that month and don't feel bad about not scheduling my 2nd surgery this year to get it when you get it will cost me $1000 max (minus co-pays up to that point and prescriptions).
22: Further, yes, of course it is. But our whole system is set up that way.
My leave starts from today until November 22. I figured I'd better take the biggest chunk of it during the election because there's going to be no way I'll be able to concentrate on anything else. Will be weird to spend it just staying in Arrakis though.
At least the region has fewer armed, religious extremists than here.
4: If you are looking for a dental appliance to treat (mild to moderate) sleep apnea, this should be covered under medical insurance and not dental insurance. Note: appliances for snoring likely are not covered.
16: Hang in there, md. Glad you're on the mend. I had two annoying eye surgeries this month (same eye) and have been heartened to get past them before another spike in covid cases in the DMV.
There's a story today that Boston area has a quickly rising positivity rate which means not enough testing is happening, but there's plenty of testing capacity. It's just that no one is using it because most insurance still says if you go to a clinic without symptoms you have to pay for the test. There are some sites or mobile clinics that are free but no one's certain which they are so the fear of being hit with a $200 charge is keeping asymptomatic but exposed people from testing. I'd say that the pandemic seems exquisitely designed to illustrate the stupidity of the incentives of our health care system, but it's so much gum and toothpicks and duct tape that any kind of heath crisis was destined to blow up the whole thing.
29: Boston are wastewater Covid tracking.
Yeah our city is actually setting up their own testing to get finer shit resolution because it's one of three metrics used to determine when to close schools. Interesting it maybe peaked and is coming back down? The wastewater usually leads the infection data by a week or two.
27: Yeah, I know it's under medical, but I haven't found a dentist who takes my medical insurance. The admin guy at one said that Blue Cross won't let any dentists in their PPO for sleep devices even though it's a medical procedure that can only be performed by a dentist. Nonetheless, they let them in the HMO network. I find this unconvincing. Another dentist explicitly said she billed the PPO as out-of network. I think they just want their full fee.
I'm trying to contact the dental school where they run the min8 residency in dental sleep medicine, but I haven't heard back.
29: The free sites have faster turn around times than the commercial ones. They are listed on the website. Of course, not everybody has home internet.
Texas turnout is already 95% of what it was in 2016. I demand to know what this means. And I must know RIGHT NOW.
This comment is on topic because it conveys my deteriorating mental state.
The top counties for turnout vs 2016 look suburban to me.
1. Hays +20%
2. Montgomery +18%
3. Williamson +15%
4. Denton +14%
5. Comal +14%
6. Collin +12%
7. Fort Bend +11%
8. Rockwall +6%
9. Travis +6%
10. Guadalupe +5%
WHAT DOES THAT MEAN!?!?? Those suburban fuckers are going to screw us, aren't they.
I voted - dropped off two mail-in ballots in an early voting site. There wasn't even a line.
36: Travis County is the core of the Austin area.
2016 results for those 10 counties:
Hays: 46.87%-46.04% Trump
Montgomery: 73.46%-22.40% Trump
Williamson: 51.30%-41.59% Trump
Denton: 57.13%-37.13% Trump
Comal: 72.59%-22.90% Trump
Collin: 55.62%-38.91% Trump
Fort Bend: 44.76%-51.39% Clinton
Rockwall: 71.22%-24.17% Trump
Travis: 27.14%-65.77% Hillary
Guadalupe 63.35%-31.81% Trump
I've been really disappointed with Silver's analysis of early voting, in that there's an enormous amount of data out there and he hasn't really dug into it. This table I've created doesn't really say anything, because it doesn't include the number of votes in each place. (And doesn't include other things that smart guys like Silver could figure out.)
I'm so glad he hasn't dug into it. This is a new situation for early voting, with known confounds and no way to control for them because it's new.
40: I suspect you're a mile ahead of me, stat-intelligence-wise, but everything Silver does is affected by the peculiarities of this year -- including (maybe especially) the early voting peculiarities. I think he sorts it out pretty well.
There's many people who can do the numbers. Where you should listen to the expert is when they say "That number is not going to be reliable".
I'm just back from the supermarket, and I found another reason to be optimistic. The supermarket tabloids are a different world from world from 2016. As I recall, it was hard to avoid headlines that proclaimed that Hillary was pretty much Satan in 2016. The headline I saw today was about the militia's plot to kidnap governors. People Magazine's cover was about a Covid-19 widow. There's a special issue of Life on Michelle Obama.
HOPE!
The thing the Nates won't say that I think is essential is at what point would they be comfortable calling bullshit on a reported result. Polls are used in other countries to identify ballot stuffing or tabulation system hacking. I'm guessing between EC, vote suppression, and reasonable polling errors even a 10 point Biden national lead is still within the realm of yeah the ballots that were allowed were counted and reported accurately for a Trump win.
43: One thing that hasn't changed is peep's inability to write in coherent sentences.
43: One thing that hasn't changed is peep's inability to write in coherent sentences.
At least you post it twice when you do write one.
891 cases on 3137 tests. Bad ratio.
But 43 is actually a bit cheering for me.
36: it means we're #1!
Hays swung significantly D from 2016 to 2018 - maybe 5+ percentage points?
48: that's down for you guys, isn't it? The numbers you were citing before were closer to 50% test positivity.
It swings wildly from day to day. One day we beat 50 the next it's 5.
Wouldn't it make more sense to use a 7-day average then?
Especially since the day of the week usually matters because of when the people making reports work.
So the 10 counties from 36 favored Trump by 5.6%, while the state itself favored Trump by 9%. The polls suggest that the state overall has moved 6% toward Biden. What does it all mean?
I'm thinking it probably means that the state overall has moved 6% toward Biden, as measured by the polls.
Turnout: we already have 73% of votes in, in the county, and there's a bit of a lag, so the real figure is higher.
Historical turnout in the county:
2016 -- 74
2012 -- 70
2008 -- 74
2004 -- 68
2000 -- 54
1996 -- 66
1992 -- 76
Our county chair set our goal at 80, which seemed completely ridiculous a year ago, but, while still a reach, isn't crazy. The question, of course, is whether historical non-voters in our county are blue or red. As a whole we're, say, 65% blue so there's room for some of the non-voters to be demoralized reds. Our leftish friends used to insist that they're all socialists, just waiting for the right platform (which, again, is not evident in 2020).
My ballot chase calling shift was cancelled last night while they rejiggered the lists. We seem to be running out of Democrats to call, in the cities at least.
They are calling to confirm my shifts.
I'll note that Bill Clinton won the state in 1992, and Obama came close in 2008. Missoula turnout is a big part of that.
Remember when I got exposed to covid last week? Monday, the 19th? I JUST got a contact tracing call from the health department to let me know about that.
WHAT a SHITshow.
(I've been in the house since and no one in the exposure group, including the family of the kid that tested positive, has developed any symptoms or gotten a positive result back.)
Meanwhile the state school for the deaf and blind has shut down suddenly for 2 weeks because of a positive test in the staff somewhere. That's a residential school, so a hundred some kids have just been sent home to parents who didn't have any childcare set up and (mostly) can't communicate well with their children, with no virtual or other school assignments at all, from a campus with positive tests to towns all over the state. What anOTHER shitshow.
E. Messily!
Glad you're doing (more-or-less) okay, and those both sound like shitshows.
Re: testing in the area, I have discovered in the past week-ish that it is (newly?) almost impossible to get a test if you're asymptomatic. You have to either have a willing doctor & pay for it out of hand (~$500, according to the friend who did it) or wait for the order from the health department, which, as per above, takes 11 days. So I would expect positivity rates to skyrocket.
The woman on the the health dept call did say (I asked) that they are trying to add staff hours daily/weekly/constantly but the hiring & training process takes long enough that there's no way to catch up, at this point.
NickS! I am doing as fine as ever. I never leave the house even when I'm not specifically quarantined, so I barely even noticed.
Anyone who ever worked with Gle\nn Green\wald is cheering on the editor who wrote this "Don't let the door catch your arse as you leave" note.
I'm still around, but a lot of my coworkers aren't. Yesterday I got one single email from someone on the same contract as me for years but on another team, saying that he was losing his job "due to budget reasons". It was a sad surprise - he and I weren't the best of friends, but we've known each other long enough - but seemed like a one-off thing, so I was curious. Today I heard from my manager that the overall contract has been cut by 25 percent, including four of my 7-person team. I don't want to complain, I'm still healthy and I'm not one of the people losing their job, but this is still unsettling...
It's funny, I've thought of my current job as unusually secure. I was unaffected by the 2018 shutdown because this department is funded by user fees. But I should have thought a bit harder because those user fees are affected by the pandemic.
61: $500!? Seriously. Our cash prices around here are $160.
63: Delicious. Christ, what an asshole!
Costco is selling test kits (including analysis) for $120. I sense a profit opportunity!
For comparison, fish tank cleaner probably costs a few dollars a pack and if somebody is willing to buy it, you don't need to limited to pricing that reflects ordinary corporate greed.
||
This is a remarkable profile (almost _too_ good): https://mobile.twitter.com/drvox/status/1321922164736446464
|>
59 last -- Jesus.
61 -- It used to be that the folk advice to people wanted/needing tests was to go to Frenchtown.* That's probably no longer a solution. I've had a couple of tests related to voluntary don't-even-need-to-do-it-this-year procedures. Schedule the visit, they order the test,, then, I suppose, after the test, you can probably cancel the visit.
* Someday I'm going to get to say that I remember when we used to sit in the government yard in Frenchtown, but I think this is not that day. It is nonetheless a good place to observe hypocrites mingling with good people, though.
We've now exceeded our all-time record for number of general election ballots cast, set in 2008 when there was a local guy on the ballot.
I stepped away for 3 hours and came back and Twitter is completely apocalyptic about election problems. Like, more than usual.
Crap. 9% of Nebraska's Covid deaths have happened in the last seven days.
Maybe it's just bad journalism? That doesn't sound right.
It's not that implausible if they had had few deaths in earlier waves and are now hitting the point in this one where deaths start to rise.
That's definitely the position we're in. Today we had a record number of reported deaths (6).
The pandemic's only been going on for like 7.5 months, so that's only 0.09*7.5*30.5/7 ~= 2.94 times more than the average number of deaths per week since early March.
The Minnesota case is fucked up, to use the technical legal term.
63: I can't think of another recent left-to-right defection that was so widely remarked upon-- seems like that's basically what this is, and it's nothing new in general, but there has been a lull. Am I forgetting anyone obvious?
78: Certainly seems to me. Not a lawyer of course. But standing, timing of the lawsuit. Specific legislative provisions followed in creating the extension and on and on.
Courts and the president playing off each other and adding to the permission structure to either steal the election if it is close or encourage vast swathes of Americans to not accept its legitimacy if it is not.
Trump will categorically declare victory sometime on Election night (or early next morning) unless Florida and or Texas go Biden.
BTW, where the gell is Bill Barr? Has there been any sitings since shortyl after the Covid Amy announcement?
Election Anxiety: https://xkcd.com/2378/
The day before yesterday, about 5pm, an ambulance pulled up in front of one of the houses on our street, a couple houses down from us. The paramedics took someone away in a stretcher; they were wearing respirators so we wondered at first if it was a COVID-related call but they may just be wearing them on all calls just in case. We don't know those neighbors and it wasn't clear exactly what had happened, but it's a tough time for everyone right now in so many ways. Amadea decided to make them some chili. We needed a few ingredients so I made a run to the store. She initially wanted to do the cooking that night, but the meat needed to thaw so she waited until the next day.
So yesterday she made the chili, along with some cornbread and chocolate cake. It was done around 5pm when I got off work so we carried it over and rang the bell, then walked back to our house. (Got to be COVID safe!) Amadea left a note saying that things had looked rough the day before so we made them the food, and she left her cell phone number in case they needed anything else.
We can see their front porch from our window, so we watched to see if they would open the door. After a couple minutes a woman opened it, read the note, and brought in the food. A few minutes later Amadea got a call.
Our neighbor was very appreciative of the "glorious food," as she called it. It turned out her husband and fallen and broken his artificial knee, which he had had put in after slipping on the ice and breaking his regular knee a few years ago. He was still in the hospital but was doing well.
Anyway, just a little story about neighborliness even in these dark, stressful times.
That sounds like a very nice meal.
I made a cake last weekend but none of my neighbors are clumsy so we just ate it ourselves.
This is the first morning that's actually felt like fall and it's glorious. Low 70s, light breeze, the beginnings of Hawaii winter light (less water in the air makes everything more beautiful). Walking the dog this morning, I could almost forget it's 2020 (which presumably means an asteroid will be along any minute).
I just got a reminder from the school about the senior class trip to Disney World, scheduled for June 2021. They are not altering the way it's always been done: packed buses for the 16 hour drive to and from Disney World, and four kids per motel room for three nights. The covid mitigation strategy is apparently to assume a vaccine will be tested, approved, and distributed even to healthy high school seniors (the lowest possible risk group) by June 2021.
$400 non-refundable deposit due today. We're going to pass.
The class of 2020 didn't go since Disney was closed, and didn't get full refunds (full cost, $1600, had been paid before cancellation). The kids got Disney vouchers that they may be able to use some day, perhaps when their own kids are graduating from high school.
4 goddamn inches of snow in October. I still have vegetables in the garden.
You should consider harvesting them.
Drove lurid + child to the airport for their flight to Wisconsin, packing up for my weekend trip to Arizona. No one's going to be sleeping well for a while.
91: I can't seem to control my thermostat, I.e the heat isn't on yet. When I didn't have it on, it was 70 degrees, and just for kicks, I turned it up to 75, and it's still showing 70.
My evaporative humidifier doesn't seem to be working either., because the water level isn't going down and our hygrometers not budging.
You think it's easy to visit so many houses in one night?
You turn on the boiler? I thought it was just the super.
96: it's a fan over a wick with water as opposed to one of those cool mist things.
I've never had one. We run a dehumidifier.
Somebody is running pro-Trump ads using a guy who sounds very much like Sam Elliot if Sam Elliot were a piece of shit.
100: My in laws did that in the winter, because they were worried about mold on the wood windows. My skin was painfully dry when I would go over Christmas.
102: Bummer. He lived a long life, but a real loss.
103: My skin was painfully dry my whole life until I moved out of the midwest. I would definitely consider one if I ever went back that way.
Things have gotten pretty bad here in Kakania, as in most of Europe. Worse now per capital than in the USA as a whole, and showing more than exponential growth. Severe restrictions coming next week, including curfew, but they seem to be prioritizing keeping schools and daycare open.
The severity of this European 2nd wave is dealing a blow to my beliefs that the US, partly because of Trump and partly because of its broken health insurance system, was and would continue to be international outliers in COVID outcomes. It's kind of puzzling and very distressing -- it's not clear at all to me what has been driving this wave.
106 is depressing. How consistent is everyone about mask wearing?
The belief that I'm very attached to is that a society lives or dies by the mask. If there is scrupulous mask wearing indoors, then cases stay low, end of story.
108: Sorry, no. Looks right now like masks, ventilations, and limited time.
https://english.elpais.com/society/2020-10-28/a-room-a-bar-and-a-class-how-the-coronavirus-is-spread-through-the-air.html
(I'm back to being fairly worried about my worksite. I think ventilation is what will help me since I'm basically under best possible indoor conditions, but there are tech offices with groups sitting and eating/drinking together, the cafeteria is getting larger groups sitting close despite increasingly alarmed reminders from management . . .
109: Important caveats to that story: https://mobile.twitter.com/ASPphysician/status/1321798685991186434
109: There was a guy at Columbia who was advocating for a specific wave of far uv c light which does not appear to harm human skin or eyes. You could have that in hospitals and airports or elevators to try to kill the aerosolized particles that don't fall to the floor.
I still don't understand why ventilation systems aren't using more uv light as part of filtering air even if this far uv-c light isn't safe enough for humans to stand under them.
111: Oh, that's helpful. I got that it was a simulation but assumed they'd used actual case rates/epidemiological findings to figure out likelihood of infection numbers they were presenting rather than something like particle dynamics. General point stands, though - infections in office buildings, restaurants, etc. all seem to be telling us that time and ventilation are really important, not just masks.
111/113: The article was using the tool here, which uses parameters calibrated from COVID data, but acknowledge large uncertainties. It does seem like the parameters are too high compared to actual household infection rates, but OTOH maybe the Twitter critic is wrong to compare the 6-people-partying scenario with HH attack rates, since loud talking is an order of magnitude worse than normal talking, and real households don't yell at each other constantly.
¯\_(ツ)_/¯
But household transmission includes all your interactions with household members. If there's any unmasked loud talking, that isn't cancelled our by all the quiet time.
... loud talking is an order of magnitude worse than normal talking,
It hurts me to know that McMegan was correct.
I do think that twitter thread should be taken as a caveat -- that it offers more precision than the data would warrant -- not, "ignore the article." As he says, "I wish this article could be rewritten, acknowledging the epidemiological evidence we have and the uncertainty. Heck, I'd even be willing to co-author it! In meantime, caveat emptor."
Here is the longer version of Andrew Morris's feelings about that article.
I want to illustrate this with an absolutely beautifully constructed article. It is a really easy read, and I encourage you to read it. Please read it now before continuing further.
(Did you read it yet? Please! Go read it first!)
OK, I hope you read it. This is your last chance. I hope you came away with the unmistakable conclusion that the most important mode of transmission is aerosol, and the risk of transmission when exposed to an infected indoors approaches a near certainty. The only problem, that would be wrong. I am going to dissect for you the various tools used by the authors to lead you to this conclusion. (Truth: I found myself falling for it at first, so don't feel bad. Many other experts did, too, although when I posted about this on Twitter, the large number of world experts who endorsed my dissection included both the WHO's Chief Scientist and COVID-19 Technical Lead, and some of the top virologists and infectious diseases experts in the world.)
First, we know that aerosols are not the major source of transmission, because most infected people have been in close contact with an infected person. (If the major source of transmission were aerosols, we would be seeing plenty of infected people who were never in close contact with a case.) The CDC, WHO, and others have acknowledged that aerosol transmission occurs and is important, but they also point out that the main route of transmission is "droplet" (i.e. ballistic or close contact).
So what did the authors do? First, they start off with this: At the beginning of the pandemic, it was believed that the large droplets we expel when we cough or sneeze were the main vehicle of transmission. This sets the reader up to believe that this initial idea was wrong. There is no evidence it was. They then go on to say an article in the prestigious Science magazine found that there is "overwhelming evidence" that airborne transmission is a "major transmission route" for the coronavirus. Except the article wasn't an article "finding" overwhelming evidence, but rather it was a letter claiming overwhelming evidence. Two top US scientists, Drs. Angela Rasmussen (virologist) and Saskia Popescu (epidemiologist) told me they refused to co-sign the letter because of the misleading wording.
Finally, the beautiful visualizations--and they are beautiful--lead the non-expert reader to believe that they approach some kind of truth, even though they acknowledge some of the limitations. I guess the visualizations are what attracts readers. But the simulations used for these graphics are based on models that are entirely unrealistic. For example, we know from many studies that household members have, at most, a 50% chance of getting infected from another member. (That high number comes from a study that came out today, and may be lower overall.) And yet the model shows that there is a near certainty that everyone sharing a room with an infected person will be infected after 4 hours. It is an absurd model.
The last thing I will say on this article: it is a fantastically written and illustrated model, with many important takeaways. In fact, I agree on masking, and the benefits of ventilation/fresh air. But you will note that it doesn't even mention physical distancing. And herein lies the danger of over-emphasizing aerosol transmission: it seems that some experts keep on banging something so hard that they are even starting to drown out some of the most importance stuff.
Works out to about 40 deaths per rally. I don't actually mind it but it might be non-attendees that die.
Am I missing something? What's the difference between close proximity and aerosols? I understand that you can have one without the other, technically, but the correlation has to be so high that the advice would be the same 99 percent of the time.
118: Oh, that is a satisfying confirmation of my beliefs. I haven't looked at the paper, but I hope it doesn't use the same methodology as the estimates of transmission from the Sturgis event.
First, we know that aerosols are not the major source of transmission, because most infected people have been in close contact with an infected person. (If the major source of transmission were aerosols, we would be seeing plenty of infected people who were never in close contact with a case.) The CDC, WHO, and others have acknowledged that aerosol transmission occurs and is important, but they also point out that the main route of transmission is "droplet" (i.e. ballistic or close contact).
I'm not an expert, but the pro-aerosol experts I've read would contest this, I think -- "aerosol" is a continuum, and a lot of particles are big enough to be much more concentrated nearby, but small enough to not just fall to the ground. I've at least been persuaded by arguments against the insistence that ballistic droplets are the main route.
119: Close proximity, as I understand it, means roughly that ballistic droplets would hit you. Aerosol means that the air in the room gradually gets dangerous.
Basically, if you're ten feet away from someone not talking with a mask on, that never turns into close proximity, but over time it'd be a big aerosol risk. (This is all my very rough understanding.)
And I think 121 is right, that there's not a clean line between aerosol and ballistic, but my impression is that the muddy gradient of danger is closer to "transmission is mostly ballistic" than to "aerosols are equally important."
Oops, that wasn't really the link i meant. Jimenez (the big aerosol guy) has a powerpoint here with his summary of the evidence for the importance of aerosols in COVID transmission. (Note: he does *not* include, "I have spent my life studying aerosols, so I'm inclined to see them everywhere"...)
What's the difference between close proximity and aerosols?
I assume the difference is whether you think distancing and plexiglass barriers have much effect.
I've at least been persuaded by arguments against the insistence that ballistic droplets are the main route.
I haven't looked at this in depth (and will look at that link), but I'm curious (a) if there may be a difference between the ratios "given current interventions" and "without any interventions." For example, what if, without any interventions R is around 3.5, and decreasing close contact (as most countries have done) is enough to get that down to (say) 1.4. That would suggest that controlling aerosol's is key to getting below 1, but you could still say that close contact was the biggest risk. (b) I'm not sure that a pro-aerosol position explains all the observed evidence. For example, there's some clear cases of spread in enclosed spaces without close contact (like elevator spread) I remember the early evidence that there was minimal evidence of transmission on public transit, and that would suggest that you're not having one person infecting everyone on in the space -- perhaps people just don't spend enough time in public transit, but it isn't like they spend a lot of time in an elevator.
Again, I don't claim to have a firm opinion -- I believe aerosol spread is important but don't have a clear sense of _how_ important.
121 and 122: I think that a lot of infectious disease specialists hear "aerosols" and think "measles" which hangs around for ages and is highly infectious. A lot of lay people hear droplets and imagine someone coughing on you. The people who study environmental and occupational health particle dynamics, or whatever it is, use the term somewhat differently from the ID folks, and they see it as more of a continuum.
Mostly, I'm agreeing with 123. I'm also disagreeing with. 118.2(b).
I'm just going to keep avoiding being inside without a mask except in my own house.
Boy am I glad that touching infected stuff turned out to not be a big deal. That's a category of precaution I was simply unable to make myself take.
Seconding 127 & 128. I do walk outside without a mask when I'm not planning on going indoors and will stay 6ft away from anybody.
I ate lunch in a restaurant yesterday. Howling gale outside, so I ate inside. Masked staff, place under 20% full. High ceilings. Closest patrons more than 15 feet away. Ate quickly and left, which seemed to be the pattern. Odds are in my favor, but not something to do every day.
Chicken enchiladas with mole sauce. I'm not saying they were worth dying for, necessarily, but the relatively small risk of death actually involved here makes it a closer question.
127: I did take my mask off, because my PCP had to look at my tonsils. Her eyes were shielded, but it felt really wrong.
So, I guess I'm going inside the hallways of large apartment buildings because that's where Joe Biden wants me to go. In sum, I won't fear the air because this thread was helpful.
Just opened a front door, thinking it was the entryway to a house divided into apartments. It was not and there was an empty room with a beer pong table and a ton of empties.
Now I'm in a building that is basically a nursing home.
Jesus wept.They were going to announce a (belated) lockdown here on Monday but this shitwhow can't even get that right. the whole plan was leaked to the Times and the Mail earlier this afternoon (the Spectator had the supporting Sage documents) and so a press conference was hurriedly scheduled for five this afternoon. That has now been put back for an hour and a half. Because, obviously, if the Johnson government can't even organise a press conference it must be the right lot to run the country.
Meanwhile, the Brexit negotiations are due to crash out, too in the next ten days. My friend R used to have a political podcast called "remainiacs". It has recently been renamed "Oh God What Now?" And so wail all of us.
since loud talking is an order of magnitude worse than normal talking, and real households don't yell at each other constantly.
Shit, we're doing it wrong.
Boy am I glad that touching infected stuff turned out to not be a big deal. That's a category of precaution I was simply unable to make myself take.
Boy, this is me too. I'm dreading the next pandemic when I actually have to wipe down groceries and sing songs that last a full 30 seconds while I wash my hands, because I haven't done either of these things, or avoid doorknobs, etc etc etc.
I still wash my hands really well, at least compared to how I used to wash them.
Meanwhile, the Brexit negotiations are due to crash out, too in the next ten days. My friend R used to have a political podcast called "remainiacs". It has recently been renamed "Oh God What Now?" And so wail all of us.
When's the right time to have a thread on this? Wait till the 10th day, or before then?
There was a study (some studies?) published a few weeks ago about the "overdetermined" nature of this particular pandemic, which among other things also means that most cases come from very few people, and that even close proximity, indoors, for an extended time does not always result in infection, while short and "safe" interaction sometimes does. This is both interesting and frustrating- my take is that it is one of the factors leading to people behaving really irresponsibly.
My exposure a couple of weeks ago was indoors, in close proximity, maskless, for two hours. There were three adults and six children. We were signing, not talking, but we were still indoors sitting around together for two hours. Two weeks later, still only the one three year old has tested positive- her parents and 5 year old sisters did not ever catch it, even after living in the same house (with all three kids in a shared bedroom). This isn't because it's a fake disease, it's because different people emit different amounts of virus into the air and some people are more dangerous than others to be around.
My understanding at this point is that some people are extremely contagious even without some/all of the "danger" factors everyone keeps talking about, while other people are really not contagious at all. There's no way to tell who is which, other than by looking at how many people they infected after the fact.
So it's pass/fail, but not only won't they tell us what's going to be on the final, they won't even tell us what class it is.
I mean there probably is some way to tell who is highly contagious and who isn't, theoretically, given the advanced state of scientific knowledge and the amount of wealth in the world. Or at least there could be a way to tell, if certain people decided they wanted there to be. But there is not a way for any of us people living in the current scenario to tell.