One single concept is needed to the general public to try and understand why all the fuss from governments worldwide: the Basic Reproduction Number must be lowered to < 1 to contain the disease and the Covid-19 Number is estimated at about 2.5 right now, which poses a risk because no vaccine still exists and health services may collapse under the strain of increasing people requesting intensive care. More about the Number here: https://en.m.wikipedia.org/wiki/Basic_reproduction_number
100% agree. I’m trained as an epidemiologist, and this coronavirus talk gets so frustrating. The problem doesn’t just boil down to R0 and CFR, but also considerations like how reliable is the data you’re receiving.
In grad school, our professors often commented that the unfortunate aspect of public health is that everyone views themselves as an expert (since we are all alive and have been sick at some point). This leads to a lot of overconfidence and incorrect statements/beliefs propagating.
I’m glad folks are interested in this - I just wish that interest would translate to academic pursuit and not armchair experts that have read a few blog posts.
You know, I am from Italy, people here wonder why the gov is quarantining the entire North of the country, in that almost killing an already weak economy... so two of the most respected Italian epidemiologists needed to come up with something fast, clear and effective to explain ordinary people why many thousand of them are losing income and jobs and why quarantine is needed for another week at least... it is not armchair expertise at play here, but the transition from academic conferences to the public discourse without losing the scientific anchor that is justifying semi-draconian mesaures.
I think you've described the primary issue right here.
There frequently seems to be a lack of effective, timely, and unambiguous communication on such topics. It seems like much of what's out there is either overly dense and confusing (to the layperson), or overly simplified to the point of not addressing the psychology of what people are worrying about. There's often no attempt to explain the _why_, and sometimes the tone even comes across as a bit condescending.
Such an environment seems like the perfect recipe to encourage rampant speculation and the subsequent spread of misinformation. Simply telling people "you're not an expert", no matter how well founded, doesn't really help anything here.
There's a snippet of a few minutes from the Washington State press release last night (starting @ 10:25) that I thought was an example of reasonably good communication on the topic. (https://www.youtube.com/watch?v=kILL-maWoJw&t=625)
In a lot of ways, public health communication has the same problem as Federal Reserve communication -- any communication is itself likely to influence the situation.
Consequently, the standard playbook seems to be "Say as little as possible, to avoid doing harm."
It feels like part of the problem is public communication not having adapted to the internet age. And we'll probably have to wait another ~10-20 years for that generational + academic shift.
Historically, you could get away with restricting communication on the limited number of mass market broadcast mediums.
Now, restricted information just creates a vacuum filled by random other internet voices.
That (video) was a very effective presentation ... telling the public the knowns, decreasing the natural fears of the unknowns that have been amped-up by weeks of (relatively uninformed) news.
This sort of communication should have begun weeks ago. People need assurance that this is a nasty flu, not the plague.
Part of it might be that when the experts try to lay it out for us laypeople, their explanations are sometimes simplified to a point where they clearly make no sense, which creates concern. When an expert says that "it is the case that A because of B" but we already know that B is false or impossible, what are we supposed to believe?
For example, when China changed the definition of a confirmed case, the new definition caused a big spike in the numbers. Later they changed back to the old definition (lower numbers) and the new number of old-definition cases was still higher than the new-definition peak, but with a lower rate of growth. The WHO called this an "encouraging trend", which was very confusing. The trend would look encouraging if you didn't know about the change in definition, but with the change in definition in mind it didn't look encouraging at all. Were they operating on a level beyond that where it does look encouraging again?
It would put many people's minds at rest, I think, if the experts would explain their reasoning better. "It looks encouraging. Now, I'm not talking about the superficial encouraging look of this graph here, which is just an illusion because ..., but if you look deeper still it surprisingly turns out to be encouraging nevertheless because ...".
That's predicated on things actually looking encouraging if you scratch the layers deeper than what the graph is indicating.
There are few actually-qualified folks talking openly about this kind of stuff (See https://www.youtube.com/channel/UCF9IOB2TExg3QIBupFtBDxg) which is as close as I've been able to find to an unbiased, qualified interpreter for the information coming out.
The overall impression I get is 'this thing is pretty bad, there are prudent measures that can and should be taken to limit spread and slow rates of infection to prevent services becoming overwhelmed. So far measures have been inadequate leaving us facing into a worse situation than could have been'.
> I see folks who couldn't define PCR tossing around R0 with the confidence of someone who's been working in wet labs their entire career.
What does working in a wet lab, or PCR, have to do with having knowledge of an epidemiological concept, or being an epidemiologist? Basically, epidemiologists collect and analyze data on disease determinants and some perform or recommend interventions based on that analysis. Those diseases can be chronic or acute, infectious or environmental.
Most professional epidemiologists have never worked in a wet lab, nor do they have medical degree (some epidemiologists do, but it's less common). Likewise, most doctors have zero formal training in epidemiology. A few medical schools have integrated a module on biostatistics and epidemiology into their curriculum, but it's not common (or at least it wasn't ~20 years ago, if that's changing I'm happy). I'm always amazed at how many doctors fail to understand basic biostatistical measures used in epidemiology and biostatistics, such as specificity and sensitivity, much less positive predictive value (also very important to know when interpreting test results like doctors do every day).
As we know on HN, people tend to misunderstand what computer scientists do. They assume they're more or less programmers, when in fact, they're doing a kind of applied math in a specific domain. In the same way, people misunderstand what epidemiologists do. They assume they're all doctors working on infectious diseases. In fact, you could look at epidemiology as also being a kind of applied math in a specific domain (population health).
(if it matters, I did a master's degree in epidemiology many years ago, and worked briefly on epidemiological grant research for a university. I changed professions soon afterwards, and have forgotten most of what I learned. But I do have a good idea of how epidemiologists are trained, and what they do on a daily basis.)
>A few medical schools have integrated a module on biostatistics and epidemiology into their curriculum, but it's not common (or at least it wasn't ~20 years ago, if that's changing I'm happy)
It is changing, I had bio stats and epidemiology. How much I paid attention to it is up for debate. I can say that epidemiology from my experience is easy to have a grasp on what's going on, but to understand the nuances of data you have to go through rigorous training.
>such as specificity and sensitivity, much less positive predictive value (also very important to know when interpreting test results like doctors do every day)
This is the only thing I think physicians are getting good at. although the older ones may not have the palate that younger physicians have for this kind of thing. Compared to epidemiology sensitivity and specificity have daily implications on patient outcomes so it becomes imperative whereas epidemiology isn't as important for day to day tasks. I like your part on how lay people, such as myself, have little idea of what a computer scientist does and how that can cause frustration. I'm finding as I get older the less I know about what other people do and the more I should listen instead of speculate.
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[ 3.7 ms ] story [ 19.7 ms ] threadI see folks who couldn't define PCR tossing around R0 with the confidence of someone who's been working in wet labs their entire career.
Most people are ignorant, true. But that doesn't mean a little knowledge is all it takes to be an expert.
In grad school, our professors often commented that the unfortunate aspect of public health is that everyone views themselves as an expert (since we are all alive and have been sick at some point). This leads to a lot of overconfidence and incorrect statements/beliefs propagating.
I’m glad folks are interested in this - I just wish that interest would translate to academic pursuit and not armchair experts that have read a few blog posts.
There frequently seems to be a lack of effective, timely, and unambiguous communication on such topics. It seems like much of what's out there is either overly dense and confusing (to the layperson), or overly simplified to the point of not addressing the psychology of what people are worrying about. There's often no attempt to explain the _why_, and sometimes the tone even comes across as a bit condescending.
Such an environment seems like the perfect recipe to encourage rampant speculation and the subsequent spread of misinformation. Simply telling people "you're not an expert", no matter how well founded, doesn't really help anything here.
There's a snippet of a few minutes from the Washington State press release last night (starting @ 10:25) that I thought was an example of reasonably good communication on the topic. (https://www.youtube.com/watch?v=kILL-maWoJw&t=625)
Consequently, the standard playbook seems to be "Say as little as possible, to avoid doing harm."
It feels like part of the problem is public communication not having adapted to the internet age. And we'll probably have to wait another ~10-20 years for that generational + academic shift.
Historically, you could get away with restricting communication on the limited number of mass market broadcast mediums.
Now, restricted information just creates a vacuum filled by random other internet voices.
This sort of communication should have begun weeks ago. People need assurance that this is a nasty flu, not the plague.
The deadliest epidemic in history was a nasty flu (the 1918 Spanish flu). That killed around 50 million people.
This virus appears to be at least 100X deadlier than the endemic seasonal flu.
For example, when China changed the definition of a confirmed case, the new definition caused a big spike in the numbers. Later they changed back to the old definition (lower numbers) and the new number of old-definition cases was still higher than the new-definition peak, but with a lower rate of growth. The WHO called this an "encouraging trend", which was very confusing. The trend would look encouraging if you didn't know about the change in definition, but with the change in definition in mind it didn't look encouraging at all. Were they operating on a level beyond that where it does look encouraging again?
It would put many people's minds at rest, I think, if the experts would explain their reasoning better. "It looks encouraging. Now, I'm not talking about the superficial encouraging look of this graph here, which is just an illusion because ..., but if you look deeper still it surprisingly turns out to be encouraging nevertheless because ...".
There are few actually-qualified folks talking openly about this kind of stuff (See https://www.youtube.com/channel/UCF9IOB2TExg3QIBupFtBDxg) which is as close as I've been able to find to an unbiased, qualified interpreter for the information coming out.
The overall impression I get is 'this thing is pretty bad, there are prudent measures that can and should be taken to limit spread and slow rates of infection to prevent services becoming overwhelmed. So far measures have been inadequate leaving us facing into a worse situation than could have been'.
What does working in a wet lab, or PCR, have to do with having knowledge of an epidemiological concept, or being an epidemiologist? Basically, epidemiologists collect and analyze data on disease determinants and some perform or recommend interventions based on that analysis. Those diseases can be chronic or acute, infectious or environmental.
Most professional epidemiologists have never worked in a wet lab, nor do they have medical degree (some epidemiologists do, but it's less common). Likewise, most doctors have zero formal training in epidemiology. A few medical schools have integrated a module on biostatistics and epidemiology into their curriculum, but it's not common (or at least it wasn't ~20 years ago, if that's changing I'm happy). I'm always amazed at how many doctors fail to understand basic biostatistical measures used in epidemiology and biostatistics, such as specificity and sensitivity, much less positive predictive value (also very important to know when interpreting test results like doctors do every day).
As we know on HN, people tend to misunderstand what computer scientists do. They assume they're more or less programmers, when in fact, they're doing a kind of applied math in a specific domain. In the same way, people misunderstand what epidemiologists do. They assume they're all doctors working on infectious diseases. In fact, you could look at epidemiology as also being a kind of applied math in a specific domain (population health).
(if it matters, I did a master's degree in epidemiology many years ago, and worked briefly on epidemiological grant research for a university. I changed professions soon afterwards, and have forgotten most of what I learned. But I do have a good idea of how epidemiologists are trained, and what they do on a daily basis.)
It is changing, I had bio stats and epidemiology. How much I paid attention to it is up for debate. I can say that epidemiology from my experience is easy to have a grasp on what's going on, but to understand the nuances of data you have to go through rigorous training.
>such as specificity and sensitivity, much less positive predictive value (also very important to know when interpreting test results like doctors do every day)
This is the only thing I think physicians are getting good at. although the older ones may not have the palate that younger physicians have for this kind of thing. Compared to epidemiology sensitivity and specificity have daily implications on patient outcomes so it becomes imperative whereas epidemiology isn't as important for day to day tasks. I like your part on how lay people, such as myself, have little idea of what a computer scientist does and how that can cause frustration. I'm finding as I get older the less I know about what other people do and the more I should listen instead of speculate.
If there are very dry conditions, all reports of fires require an emergency response, even if they’re just a couple tiny little camp fires.