I'd say human experimentation has become a big no-no. Pretty gnarly research has been done until the 70s, even 80s. Even for new drugs there are countless hoops to jump to get to the final human trials.
Right now you can study infected individuals just fine, but you can't go around inoculating people with diseases, even if they're volunteers.
One common pattern I've seen is that well known, old drugs, are either known to be ok for a pregnant woman, or not ok. But the bulk of drugs discovered since the 80s are "not advised unless necessary", "check with your doctor" and other variants of passing the hot potato.
This socially-distanced outdoor concert in Newcastle (in the UK) doesn't seem too bad. Everyone has their own 'pod'. However, it's not suitable for indoor concerts and the extra logistics might make it too impractical even for outdoor concerts.
Wear a mask, wash your hands, try to keep some sort of distance with people, don't go if you feel sick and try taking care of your immune system as much as you can before/after. Expect people having some sort of respect and do the same. Outdoor events would be a much bigger yes compared to indoor (note: concerts doesn't mean stacked onto each other's).
Of course, tests must be ubiquitous and this shouldn't happen while in an area having a peak of the epidemy. Restricting contacts with fragile people would also be wise.
I've been to hundreds of concerts/events and rarely been sick after one. Risks to catch a disease are in my opinion not higher than public transports or a crowded beach and probably lower than bars in general.
There's something innate about shaming people who do different things.
People are feeding off of panic and constant dread. If you don't affirm their apocalypse delusions you'll be shamed.
You'll be told attending a concert or even wanting to is a sign you're a selfish misanthrope and idiot.
They could just indefinitely stay locked in their home if they feel the risk is that grave...but no, they'll stop at nothing to extend their agoraphobia to everyone.
Sadly, selfish people will abuse this. They'll go even if they feel sick, likely justifying it as "but I already bought my ticket". Asymptomatic people will also increase the risk.
> Of course, tests must be ubiquitous and this shouldn't happen while in an area having a peak of the epidemy.
Anecdotally, a doctor I went to recently told me that the standard swab test is likely to be ruled invalid in the near future, he referenced a study that should be published soon.
So, we will be flying blind if large (indoor) events re-open.
I'm not a music fan but if I were I absolutely will go. The risk are minimal. The virus spread easily but not that dangerous. In fact I've been living my life as normal as I could possibly do all these times.
The issue isn't the risk to yourself, which is minimal. The problem is that spreading the virus widely (which seems easy to do at crowded events, precise transmission model not yet known) ultimately results in a bunch of other people somewhere in the future ending up in hospital or dead.
I expect more intellectual honesty and curiosity on this site tbh. Please don’t purposely reduce the quality of the experience here. Some context
>The match is being called "Game Zero" because it was played just two days before the first positive case of COVID-19 was confirmed in Italy. The head of pulmonology at a Bergamo hospital, which is outside of Milan and the usual home of Atalanta, recently described the Champions League match as "a biological bomb." There were also about 2,500 Valencia fans in the stands for the match, and 35 percent of Valencia's team tested positive for the coronavirus a few weeks later.
>Bergamo Mayor Giorgio Gori echoed that statement.
I understand that, that is the case with any infections diseases but covid death rate are very low. Most people are either asymptomatic or only have mild symptoms.
Do you drive personal vehicle at all ? However safe you are you have non zero chance to kill other people somewhere in the future.
Infectious diseases are older than humanity. Hell, bad years of flu killed more than covid yet we didn't cancel any types of events.
Some people dying to contagious diseases is something our species has always coexisted with. Neither the flu, nor dengue nor covid are ever going to go away.
There is no way you could take “risks” like these a couple of months ago. We simply did not know enough about the virus at the time.
Now we have improved treatment methods significantly, we know ways to drastically reduce the spread of the virus using simple mechanical strategies, and we are confident about the kind of people that are at the least risk.
In Germany the virus is also subdued enough that even if something goes wrong, it won’t become a drastic situation immediately. The US isn’t there yet, but thanks to mask wearing and social distancing might be there in a few weeks.
So once the conditions were feasible to do such studies, peop,e are doing such studies.
> we have improved treatment methods significantly
Have they? I haven't seen anything in the news besides a few practices evolving (prone positioning, avoiding ventilation too early).
> we know ways to drastically reduce the spread of the virus using simple mechanical strategies
Masks, hygiene, disinfection, distancing, were all known and encouraged since March.
We are almost entering September, and my impression is that there hasn't been any new discoveries, other than trial drugs or confirming earlier findings, since late May/June. If anything, you couldn't take those risks earlier because of public opinion, not any practical reasons.
That's besides the point; I'm arguing that "we simply did not know enough about the virus at the time" as said by the parent commenter is not really true, and probably irrelevant for why experiments like these did not happen before.
For what's worth using facemasks is still being discouraged by the Dutch government as we speak...
One of those principles is that if you’re going to actively expose people to something - to create a possible harm where there previously wasn’t one - you have to be honestly uncertain of the potential harm (eg, it’s ethical to give you a placebo vs experimental drug because I honestly don’t know if the drug will work).
It’s unethical to -certainly- cause harm.
In part that’s because, social dynamics and power structures being what they are, those “consenting” will skew towards the uneducated and powerless.
In part, consent isn’t even relevant - in this example, if they ended up stoking the flames of contagion, they wouldn’t just affect the concert goers but, by definition, all those exposed to the concert goers.
Amusingly, the above refers more to interventional studies - those with more than one arm. This doesn’t really have a control arm, or randomized assignment of people to exposure. It’s effectively an observational study - the sort of thing you don’t need to intentionally construct, but for the fact that people seem to not be going to concerts.
So... did they have to construct concerts artificially because not enough were occurring naturally? Did they have to create a harm that didn’t exist to begin with? Will it even be insightful? They filtered for the young, which specifically ensures there’s less of a chain of transmission available.
Considering Germany inspired so much of modern medical ethics work, it’s ironic to see them conduct such a study. I honestly wouldn’t have expected it.
I’m sure the relevant experts and authorities beat these questions to death, but even so, I’d be awfully curious to see those deliberations and what justifications were ultimately considered adequate.
We're not very consistent with this though. We consider it perfectly acceptable to put people in harms way as part of the armed forces. Even though the exact same demographic effects are in play.
Many people go into harms way because of a necessary duty (firefighters, etc).
The restrictions on medical trials is because of the power imbalance. If I take a job as a firefighter or soldier that’s different from me living my life and being enrolled in some study putting me at risk for harm.
I don't see how volunteering to enroll in a study (and being compensated for it) is any different to choosing to take a job as a soldier or firefighter.
Soldiers and firefighters also certainly skew less wealthy/educated/powerful, so a priori I'd say the same power dynamics apply there (though it's of course possible that the effect is smaller if you dig into the numbers).
It's also entirely possible that some people would feel driven to participate in a medical study out of a sense of duty (e.g. I'm young and healthy and want to put myself at a bit of risk to contribute to our understanding of the virus so that my much more vulnerable (grand)parents have a better chance).
And I agree, but isn't that a strong indictment of medical ethics? If medical ethicists would rather let a fire burn out of control than risk the lives of firefighters to put it out, they're not optimizing for the right thing.
I don't see why it is a strong indictment of any sort of ethics. Waging war is wrong, and saying that it's perfectly acceptable to do so is entirely missing the point.
Firefighters are a separate issue altogether, because the subject being discussed is a lot more ambiguous than firefighting (where the problem is clear, and the consequence for sending a firefighter is a positive result).
Even the linked BBC article will tell you as much, including that every participant was tested for Covid 19. I have seen/used such temporal contact network datasets, they are very important to understand the micro-dynamics of disease spreading.
So we’ve never done a lockdown before. We sort of knew there would be harms based on decades of research we’ve done on substance abuse, domestic violence, cancer, heart disease, etc. But there we go, running the worlds largest experiment on social distancing to try and find out which measures work or not. Except we didn’t even get good controls for it. Germany is doing that now apparently.
edit: how many papers are out there trying to quantify all of these measures? There's dozens of published papers and hundreds of pre-prints. How can we view this as anything but an experiment!?
The lock down is not a scientific study, but an emergency response. Leaders respond to emergencies by making educated guesses and having his followers live with the consequences. It is not that they DO NOT KNOW what will happen, but that they CANNOT KNOW. Decision under uncertainty is baked on the cake from the start.
We can debate whether the particular decisions being made around the World were appropriate for the emergency or not, - and in an ideal world the careers of the politicians/executives who made particularly poor decisions would be ruined beyond repair,- but the fact that they did not sit and look pretty until some peer reviewed article told them what to do was absolutely right. Otherwise there would be millions of death already, with dozens of millions who would have recovered with lifelong sequels. (And it would be naive to not think about the economic and social consequences of that as well)
But hey! At least we would be close to herd immunity by the end of the year.
This is such a banal thing to say. By that logic existing in the contemporary world is unethical. At that point who cares about ethics? Ethics to me is fundamentally about improving life not some nonsense sophist rhetoric.
A much better standard is to claim that "it's unethical to cause harm in order to study the harm done".
We don't expose people to radiation in order to study radiation poisoning, not even in order to research treatment.
We do however accept that some people might be exposed to radiation as part of their jobs or for medical treatments, and the harm caused by this exposure can be studied.
Is your better standard much better? It is unethical to cause harm in order to study the harm done but it is not unethical to cause harm in order to study something that is not the harm done? If not why even make the distinction to begin with?
I think the parent's example is pretty clear. If there were two medical treatments available, both had similar help/harm trade offs, but one caused harm that was "more useful for science", this should not be a factor in the recommendation given by the health care professional.
Life improves all on its own if you leave it alone. By the time ethics and morals are the center of attention, the way has already been lost. Ethics are a product of wrongthink, a capitalist packaging of systemic poison originating from the narrative that your so-called "freedom" is up for sale. Ethics thereby become the means by which to subjugate people and their power of thought, i.e. you and your mind, as a CUSTOM(export) in of itself. The poison is the belief of the promise of the ethic, the promise of the character, or the ethos disregarding the logos and the pathos, which is utilized to persuade large swaths of people and encourages the formation of public and counterpublics which creates a positive feedback loop especially with the structures of "safe spaces" or echo chambers with which to amplify the psuedo-appearance of a prolific environment by which many material goods become available (t-shirts, mugs, stickers, swag, books, etc. -- whatever is the "fashion" of era) in return for a parasitic-like colonization in the minds of human beings, but really it's more akin to the Ouroboros, an "Ethical Ouroboros".
Of course, to break the cycle, the dragon must spit out the Tail it is devouring, realize the tale being fed was simply a grand story of much harm and suffering, shadows on the cave walls of a fever dream, abandon the attitudes of self-annihilation, and move beyond the realm of the known into the fearsome great unknown where ethics has yet to be blown into a giant red balloon full of helium gas known as Penny-wise.
Looks like we need to develop some ethics around economic experimentation. The harm caused by lockdowns is going to absolutely dwarf any harm which may have been caused by live research of the virus, and perhaps even worse than if we just let the virus infect everyone until a herd immunity develops.
Herd immunity, in the United States, anyway, absent a vaccine, means between 5 and 8 million people dead.
If 8 million dead doesn’t move you, consider that it would take most of a decade.
Estimates at present of duration of post-infection immunity are less than six months, so it’s also possible that even after millions dead, herd immunity would never be reached.
This study was not about observing infections or exposing people, it was about movement and interaction patterns. Every single participant was tested before the event, and only those with negative results were allowed to participate. Of course it's not risk free, but it seems to be highly unlikely that anyone of the volunteers will be harmed (especially since they are all younger than 50).
FFP3 masks are usually not preferred for Covid-19 because they supposedly don't offer that much more protection and they are less comfortable. Because of their greater airflow restriction, they are often fitted with valves, that makes them much less effective at protecting others.
FFP3/N99 respirators are mostly used in industrial settings to protect against very fine particles like asbestos dust.
There had been a small study recently that indicates that N95 masks with valve are likely worse then normal surgical masks (and even some self made ones). While fitted N95 make are already "excellent" wrt. Protecting others.
Only gotcha it's that the study was about introducing a simpler affordable way to measure the effectiveness of masks wrt. protecting others and get feeback for that method, so the number of tests they did are to small to be anything then an indicator for what might maybe be the result in a large study using that method.
Through it should be noted that the valved mask where still reasonable good.
Actually even a bandanna reduced the amount of water droplets in the air by nearly 50% (if I remember correctly) or at least the one they tested did so.
But fleece turned out to be terrible as it spliced the droplets into many smaller ones without hindering them much increasing the total amount of droplets in the air.
Thinks like that are why I thing we should have a larger study with that method or similar methods.
Because we don't know if all fleece masks are as bad or even worse then no mask or if it was just that fleece mask and if therefore we need to count fleece based home made masks as wearing no mask.
(This also would mainly affect people using fleece based scarfs as both scarf and mask as well as people having a fleece based cycler mask and using it as a protection mask too)
I have a different perspective. In a drug trial you have to prove that a new drug is safe before handing it out to a bigger number of people. The default case (if you don't test the drug) is that nobody gets it.
In this case, it is different. People will put pressure on the government to allow concerts again rather sooner than later and the default case is probably that there will be concerts again before the Corona situation is over. If you don't do the test, you have to make the decision whether / when to allow concerts again blindly.
So basically you have the situation where people will take the new drug anyway and you have the choice whether you want to test its safeness before they do.
If you do the test and it turns out to be unsafe, at least you have good arguments when you need to make the decision.
I never thought that the ethics of medical research could risk falling prey to the same traps of reasoning that cause short-sighted decisions in business - namely that easily measurable short-term concerns trump greater but less measurable long-term concerns.
But this is probably known to people who are in the field. You have to defend your decisions the same way you would in business or investing, but instead of people shorting your stock, you will have people trying to cut your funding, accuse you of causing harm and ultimately trying to destroy your reputation/career.
It’s fascinating how this trap of group fallacy has the potential to affect different fields, like there’s some universality to the human behavior behind it.
The "Corona situation" isn't going to be "over" in our lifetime. The first polio vaccine was developed in the 1950s, but the most recent had polio epidemic was this past September, almost a year ago. Taking a more nuanced view, it's already "over" for many people in lots of countries - offices, restaurants, hair salons, and bars are open. Places where people aren't wearing masks because they don't need to, and no one's getting COVID-19.
In a sane world, the government's reopening plans aren't dictated by the local restaurant owners, but rather by health organizations run by scientists. In such a world, concerts won't happen again before it is actually safe to do so. Surprisingly, there are some places in the world where that is actually the case!
The question though, isn't if a particular drug is safe or not. That's a very important question to answer, and one of the hurdles to pass, but in this context, the ethics are around exposing people to a potentially fatal disease, without actually knowing if the vaccine being tested successfully protects against the disease. If we inject people with a vaccine, and then with large amounts of the SARS-Cov-2 virus, and they develop COVID-19, then we can say that the vaccine being tested on them didn't work in that case. Unfortunately we directly injected them with a potentially lethal disease, possibly resulting in a life-long disability.
It's that last step that most hospital ethics boards aren't willing to take.
They test people's behavior not the spread of the virus any participant is tested beforehand (and won't participate if infected) which makes it it likely less dangerous then the daily public transport commute many have to do.
Well, strictly speaking this wasn't an unethical experiment in so far as that they tested for covid before, to make it safe, not after, to assess the damage.
But it gives off a certain "scientific whaling" vibe, I can't help questioning the intentions.
Stanley Milgram preformed an experiment that was incredibly valuable and has been replicated in many countries around the world. Variations of the experiment with different results helped narrow down important factors.
Today, it's unethical to preform the Milgram experiment. Michael/vSauce did preform the actual trolley experiment for a YouTube video, which is interesting, but it was bad scientifically because the sample size was too small, the experiment changed for one person, and the ethics for the entire thing was questionable.
This article is about the prison experiments. The Milgram experiments are a small paragraph at the bottom and there have been a number of people trying to discredit the experiments.
I've watched the original in University with the old black and white tapes. There have been interviews with people years later who said, "I really believe I killed that person in the other room," and furthermore, it has been replicated in other countries by other researchers.
We can argue about numbers and percentages, but the idea that you can put up walls of abstraction to get people to kill others is established in other research outside of Milgram.
> The experiment was repeated many times around the globe, with fairly consistent results.[6]
Even if there were problems with the original experiment (and I've read Dimow before and doubt what he's saying; there are interviews from former participants who said they really did believe they had killed the person in the other room), it's been replicated in other countries.
The Milgram experiment is complete bullshit. All it shows, if anything, is that if you put people into extremely contrived, untrustable, bizarre scenarios, you'll get some interesting responses.
This reminds me of arguments against polygamy. Yes, historical examples primarily skew towards abuses of power. But no, those examples do not prove that such arrangements cannot occur consensually and ethically.
The fact that people failed in the past should not result in banning people from trying to do better in the future.
I've heard the same argument for communism. "That wasn't real communism," and I bought into this for a while. But looking at it all objectively now .. no .. China, the Soviets .. it's real communism. Cults participate in high levels of communism too.
I've been to the museums in Moldova with displays dedicated to the people who were taken to gulags. I've read about the people who starved in the Ukraine. People like Adam Curtis liked to say communism/soviets were not as great a threat as they were made out and how Regan's teams overreacted .. but I don't know now.
We are seeing active experiments with polyamory today. It's different because you don't have the legal bindings in polygamy. My hypothesis is if you offered full legal polygamy marriages, it would not turn out well long term. We could try it, sure, but it never worked in the past. You thing you're magically going to get it right this time, like modern day Marxists? I have my doubts.
I think this is interpreted backwards.
It was a policy decision to allow a controlled amount of public gatherings. As a measure to return to normality.
Scientists are using the opportunity to investigate the outcome.
Thus they can advise the policy makers.
Mengele was a monster that had no scientific ground for his 'experiments', they were just torture in disguise.
Medical ethics has evolved a lot in the last couple of decades after numerous cases came to light that retrospectively showed that harm was being done to people, in many cases without their consent or any level of transparency about what the experiment was about.
Experimenting on humans is considered highly unethical. Studies like this are rare for a very good reason, looking back through history we have realized that such experiments when reviewed at a later date almost always turned out to be not in the best interest of the subjects of the tests.
I agree that experimenting on humans is unethical. Actually, let's put that a little more strongly... it's fucking evil.
That said, people are going to congregate in groups, including large groups, no matter what any government says or does. It's not something governments can realistically prevent. A varying but significant percentage of the population of any country will simply do as they wish regardless of the risk to themselves or others.
So if they're going to do it anyway, shouldn't we at least learn something from it?
Kucirka et al (https://www.acpjournals.org/doi/10.7326/M20-1495) did a pooled analysis of seven other studies and found that "over the 4 days of infection before the typical time of symptom onset (day 5), the probability of a false-negative result in an infected person decreases from 100% (95% CI, 100% to 100%) on day 1 to 67% (CI, 27% to 94%) on day 4. On the day of symptom onset, the median false-negative rate was 38% (CI, 18% to 65%). This decreased to 20% (CI, 12% to 30%) on day 8 (3 days after symptom onset) then began to increase again, from 21% (CI, 13% to 31%) on day 9 to 66% (CI, 54% to 77%) on day 21."
A lot of folks are jumping into this thread very confident that my numbers are wrong, but they're pretty well established and uncontroversial.
thanks for those! I wasn't trying to dispute them, just curious in general as I haven't heard much about the PCR-tests metrics. I recently had an IgG antibody test done and there the sensitivity was much higher, but also a function over time.
Let's assume the "real" share of infectious people in the population is 10/100k (That's twice as much as the most recent reported 7-day incidence (5.1/100k) of new infections for Leipzig, the area where the study was performed.)
Further let's assume a PCR Test has a 30% FNR, and a 10% FPR (numbers completely made up, I don't have a source).
Then out of 1500 People who have tested negative, we'd expect 0.05 to have the virus.
Probably more like 14-20 day window and much greater than 2x incidence as loads of people show little or no symptoms.
Once the expected value starts to creep over 1, then that's enough to infect quite a lot of people. It's not too much past that to expect that one of the infected has 'underlying condition' and risking death.
In British Coloumbia there's been a big outbreak due to a single gathering in the interior, notably (shamefully) attended by Medics and Doctors.
It's a little risky.
It's just not the time to have major gatherings, but at least this one is in the service of the science of 'stopping it' - which is better than most places are doing.
I don't think your percentage is correct. It depends on the PCRs target gene, the quality of the samples and the quality of the machine used. They are using reverse transcriptase quantitative PCR. What is your source for that FNR?
Kucirka et al (https://www.acpjournals.org/doi/10.7326/M20-1495) did a pooled analysis of seven other studies and found that "over the 4 days of infection before the typical time of symptom onset (day 5), the probability of a false-negative result in an infected person decreases from 100% (95% CI, 100% to 100%) on day 1 to 67% (CI, 27% to 94%) on day 4. On the day of symptom onset, the median false-negative rate was 38% (CI, 18% to 65%). This decreased to 20% (CI, 12% to 30%) on day 8 (3 days after symptom onset) then began to increase again, from 21% (CI, 13% to 31%) on day 9 to 66% (CI, 54% to 77%) on day 21."
Of course if you are testing proper samples from the airways and they come back negative, it’s not very likely these people can infect others through droplets from their airways at that moment. The problem is that they might be in the incubation period but that is irrelevant here.
And anyway PCR does not nearly have a 30% false negative rate, I’m not quite sure where you got these stats.
Kucirka et al (https://www.acpjournals.org/doi/10.7326/M20-1495) did a pooled analysis of seven other studies and found that "over the 4 days of infection before the typical time of symptom onset (day 5), the probability of a false-negative result in an infected person decreases from 100% (95% CI, 100% to 100%) on day 1 to 67% (CI, 27% to 94%) on day 4. On the day of symptom onset, the median false-negative rate was 38% (CI, 18% to 65%). This decreased to 20% (CI, 12% to 30%) on day 8 (3 days after symptom onset) then began to increase again, from 21% (CI, 13% to 31%) on day 9 to 66% (CI, 54% to 77%) on day 21."
Your first study takes rt-pcr testing as the reference and cannot make statements on its accuracy.
Your second study is flawed as indicated by the comments on it, it’s a meta study based on poor data.
If you choose a point and go looking for studies to support it, regardless of quality and ignoring studies that do not, that’s not science.
And by the way, your studies are about something that is not important here. What is important here is if the patient carries virus particles in his airways so they can infect others, not if they are infected themselves.
Only in one of the concerts did they do that. One of the concerts was meant to simulate pre-Covid days. No masks, no social distancing. At least that's how it read to me.
> All participants were tested for Covid-19 before taking part, and given face masks and tracking devices to measure their distancing.
Why would they not wear masks?
The amount of infected people is so low it’s basically impossible to scientifically test infections, that’s not what they are doing (especially given they tested everyone in advance). They are testing crowd movement, how many people do you get close to etcetera.
Hm, I expected this to be a real concert, with crowd standing and most people not wearing masks. To me it seems they tested how the virus spreads on healthy individuals (i.e. nobody had a virus prior to going there) who hold their distance while sitting still and wearing masks. Under those constraints, I'd expect around 0 new cases.
Edit: much clearer now, thanks to everybody who replied!
I think this is a very useful research. Considering the catastrophic effect of the pandemic on performing arts, knowing that concerts organized with due precautions are reasonably safe, it could directly lead to a very significant restart.
This is indeed (based on the article), the target of the research:
to investigate the conditions under which such events can be
carried out despite the pandemic
> The first of Saturday's three concerts aimed to simulate an event before the pandemic, with no safety measures in place. The second involved greater hygiene and some social distancing, while the third involved half the numbers and each person standing 1.5m apart.
Most commenters here didn't read the article properly and completely misunderstood what this is about. To be fair, it's not explained super clearly.
So to clarify: This was not done to study the spread of the virus, but rather to study the behavior of people at this type of event. Only people who tested negative were allowed to the event.
My first reaction was: wouldn't people who tested negative -- and knew their results -- behave differently from people who didn't know what their infection status was? Wouldn't that skew the study?
But then again, from observing my friends (who are mostly younger), many of them behave as if they didn't have the virus anyway -- even those who hadn't been tested. So yes, the results might be a little skewed, but the results should still be instructive.
Presumably real large-scale events will also require a negative test result from participants in the near future. In that case, the study would be applicable.
There is also always the risc that you contacted it since the last test, so the period in which you can feel to safely not be infectious is rather short.
That risk is much lower if it takes 15-minute to get the test results, as opposed to tests that take an unknown amount of days/weeks to get results. The linked article does not discuss in depth what kind of testing took place, only that it did.
Yes but not if the short tests work reliably. The best not yet on the market short tests we have do have a lot sensitivity but high specificity, i.e if they say you have it you most likely have it but if they say you don't have it you can't rely on it at all. (As as I know)
This is still somewhat useful as it turns out they still do a reasonable good job wrt. Sensitivity iff you are highly infectious.
So it might be useful to at least "weed out" the most infectious people before grant events or e.g. school, which would probably already be a great improvement I guess.
> Only people who tested negative were allowed to the event.
I can't confirm that. The BBC article doesn't mention testing at all, and Spiegel Online writes:
"Mitmachen darf jeder, der keine Vorerkrankungen der Lunge oder des Herzens hat und zwischen 18 und 50 Jahre alt ist."
(Anyone with no prior illness of the lungs or heart and between 18 and 50 years of age is allowed to participate.)
and
"Alle Teilnehmer mussten zwei Tage vor dem Studientag einen Abstrich aus ihrem Rachen abliefern, der auf eine Corona-Infektion getestet wurde. Eine Probe war positiv."
(All participants had to submit a throat swab two days prior, which was tested for Corona infection. One sample was positive.)
The first part seems to refer to prior illnesses other than Covid, even though it doesn't specifically say so. The second part doesn't say that the positive sample was excluded from the concert. Reading between the lines, this whole experiment does indeed appear to test the spread of the actual virus.
Wasn't there a article about "read the paper and then comment" in the too of hackernews yesterday or so?
It's sad that many didn't learn anything from this and are now discussing how bad such a study is on basis of assumption which ate easily disproven if you read the article :(
(It's a study about human behavior, about how certain distance rules might work and how not, it's also testing the potential thread of smearing based infections by using desinfec which glows under UV light and by simulating the airflow in the hall and similar. All pacipiants are tested to not be infected, all are required to wear FFP2 masks properly all the time, no food is given out, drinking is only allowed in the emergency, hands are desinfected on entry and potentially later one, too...., So no this should not lead to any relevant increased risk of spread. But might lead to potential reopening of concert halls and similar if it's found to be feasible under some conditions).
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[ 2.2 ms ] story [ 181 ms ] threadRight now you can study infected individuals just fine, but you can't go around inoculating people with diseases, even if they're volunteers.
One common pattern I've seen is that well known, old drugs, are either known to be ok for a pregnant woman, or not ok. But the bulk of drugs discovered since the 80s are "not advised unless necessary", "check with your doctor" and other variants of passing the hot potato.
That's pretty much every aspect of society anymore. Few people will take responsibility if the option to pass it exists, in general.
I'm in Hungary and was at a jazz concert myself this weekend
This socially-distanced outdoor concert in Newcastle (in the UK) doesn't seem too bad. Everyone has their own 'pod'. However, it's not suitable for indoor concerts and the extra logistics might make it too impractical even for outdoor concerts.
Pic of the setup: https://dynaimage.cdn.cnn.com/cnn/q_auto,w_1100,c_fill,g_aut...
Here's a write-up of what it was like to attend:
This is what it was like to attend the UK’s first ever socially distanced gig:
https://thetab.com/uk/2020/08/14/this-is-what-it-was-like-to...
Wear a mask, wash your hands, try to keep some sort of distance with people, don't go if you feel sick and try taking care of your immune system as much as you can before/after. Expect people having some sort of respect and do the same. Outdoor events would be a much bigger yes compared to indoor (note: concerts doesn't mean stacked onto each other's).
Of course, tests must be ubiquitous and this shouldn't happen while in an area having a peak of the epidemy. Restricting contacts with fragile people would also be wise.
I've been to hundreds of concerts/events and rarely been sick after one. Risks to catch a disease are in my opinion not higher than public transports or a crowded beach and probably lower than bars in general.
We need to stop this non-sense.
People are feeding off of panic and constant dread. If you don't affirm their apocalypse delusions you'll be shamed.
You'll be told attending a concert or even wanting to is a sign you're a selfish misanthrope and idiot.
They could just indefinitely stay locked in their home if they feel the risk is that grave...but no, they'll stop at nothing to extend their agoraphobia to everyone.
Sadly, selfish people will abuse this. They'll go even if they feel sick, likely justifying it as "but I already bought my ticket". Asymptomatic people will also increase the risk.
> Of course, tests must be ubiquitous and this shouldn't happen while in an area having a peak of the epidemy.
Anecdotally, a doctor I went to recently told me that the standard swab test is likely to be ruled invalid in the near future, he referenced a study that should be published soon.
So, we will be flying blind if large (indoor) events re-open.
>The match is being called "Game Zero" because it was played just two days before the first positive case of COVID-19 was confirmed in Italy. The head of pulmonology at a Bergamo hospital, which is outside of Milan and the usual home of Atalanta, recently described the Champions League match as "a biological bomb." There were also about 2,500 Valencia fans in the stands for the match, and 35 percent of Valencia's team tested positive for the coronavirus a few weeks later.
>Bergamo Mayor Giorgio Gori echoed that statement.
https://www.cbssports.com/soccer/news/coronavirus-how-a-cham...
More sources.
https://de.wikipedia.org/wiki/UEFA-Champions-League-Achtelfi...
I'm having a hard time with these articles that take quotes with extreme language and pass it off as definitive evidence of reality.
Anyone can call something a "biological bomb" - where's the studies?
Do you drive personal vehicle at all ? However safe you are you have non zero chance to kill other people somewhere in the future.
Some people dying to contagious diseases is something our species has always coexisted with. Neither the flu, nor dengue nor covid are ever going to go away.
Now we have improved treatment methods significantly, we know ways to drastically reduce the spread of the virus using simple mechanical strategies, and we are confident about the kind of people that are at the least risk.
In Germany the virus is also subdued enough that even if something goes wrong, it won’t become a drastic situation immediately. The US isn’t there yet, but thanks to mask wearing and social distancing might be there in a few weeks.
So once the conditions were feasible to do such studies, peop,e are doing such studies.
Have they? I haven't seen anything in the news besides a few practices evolving (prone positioning, avoiding ventilation too early).
> we know ways to drastically reduce the spread of the virus using simple mechanical strategies
Masks, hygiene, disinfection, distancing, were all known and encouraged since March.
We are almost entering September, and my impression is that there hasn't been any new discoveries, other than trial drugs or confirming earlier findings, since late May/June. If anything, you couldn't take those risks earlier because of public opinion, not any practical reasons.
For what's worth using facemasks is still being discouraged by the Dutch government as we speak...
One of those principles is that if you’re going to actively expose people to something - to create a possible harm where there previously wasn’t one - you have to be honestly uncertain of the potential harm (eg, it’s ethical to give you a placebo vs experimental drug because I honestly don’t know if the drug will work).
It’s unethical to -certainly- cause harm.
In part that’s because, social dynamics and power structures being what they are, those “consenting” will skew towards the uneducated and powerless.
In part, consent isn’t even relevant - in this example, if they ended up stoking the flames of contagion, they wouldn’t just affect the concert goers but, by definition, all those exposed to the concert goers.
Amusingly, the above refers more to interventional studies - those with more than one arm. This doesn’t really have a control arm, or randomized assignment of people to exposure. It’s effectively an observational study - the sort of thing you don’t need to intentionally construct, but for the fact that people seem to not be going to concerts.
So... did they have to construct concerts artificially because not enough were occurring naturally? Did they have to create a harm that didn’t exist to begin with? Will it even be insightful? They filtered for the young, which specifically ensures there’s less of a chain of transmission available.
Considering Germany inspired so much of modern medical ethics work, it’s ironic to see them conduct such a study. I honestly wouldn’t have expected it.
I’m sure the relevant experts and authorities beat these questions to death, but even so, I’d be awfully curious to see those deliberations and what justifications were ultimately considered adequate.
Many people go into harms way because of a necessary duty (firefighters, etc).
The restrictions on medical trials is because of the power imbalance. If I take a job as a firefighter or soldier that’s different from me living my life and being enrolled in some study putting me at risk for harm.
It's also entirely possible that some people would feel driven to participate in a medical study out of a sense of duty (e.g. I'm young and healthy and want to put myself at a bit of risk to contribute to our understanding of the virus so that my much more vulnerable (grand)parents have a better chance).
I doubt people on an ethics board for medical studies would find that perfectly acceptable.
Firefighters are a separate issue altogether, because the subject being discussed is a lot more ambiguous than firefighting (where the problem is clear, and the consequence for sending a firefighter is a positive result).
The point is not to study or provoke infections. Everyone must wear medical grade masks (forgot the actual name).
There are still ethical considerations here but I don't think it is as severe as it may sound from your post.
edit: how many papers are out there trying to quantify all of these measures? There's dozens of published papers and hundreds of pre-prints. How can we view this as anything but an experiment!?
The lock down is not a scientific study, but an emergency response. Leaders respond to emergencies by making educated guesses and having his followers live with the consequences. It is not that they DO NOT KNOW what will happen, but that they CANNOT KNOW. Decision under uncertainty is baked on the cake from the start.
We can debate whether the particular decisions being made around the World were appropriate for the emergency or not, - and in an ideal world the careers of the politicians/executives who made particularly poor decisions would be ruined beyond repair,- but the fact that they did not sit and look pretty until some peer reviewed article told them what to do was absolutely right. Otherwise there would be millions of death already, with dozens of millions who would have recovered with lifelong sequels. (And it would be naive to not think about the economic and social consequences of that as well)
But hey! At least we would be close to herd immunity by the end of the year.
This is such a banal thing to say. By that logic existing in the contemporary world is unethical. At that point who cares about ethics? Ethics to me is fundamentally about improving life not some nonsense sophist rhetoric.
A much better standard is to claim that "it's unethical to cause harm in order to study the harm done".
We don't expose people to radiation in order to study radiation poisoning, not even in order to research treatment.
We do however accept that some people might be exposed to radiation as part of their jobs or for medical treatments, and the harm caused by this exposure can be studied.
Of course, to break the cycle, the dragon must spit out the Tail it is devouring, realize the tale being fed was simply a grand story of much harm and suffering, shadows on the cave walls of a fever dream, abandon the attitudes of self-annihilation, and move beyond the realm of the known into the fearsome great unknown where ethics has yet to be blown into a giant red balloon full of helium gas known as Penny-wise.
Looks like we need to develop some ethics around economic experimentation. The harm caused by lockdowns is going to absolutely dwarf any harm which may have been caused by live research of the virus, and perhaps even worse than if we just let the virus infect everyone until a herd immunity develops.
If 8 million dead doesn’t move you, consider that it would take most of a decade.
Estimates at present of duration of post-infection immunity are less than six months, so it’s also possible that even after millions dead, herd immunity would never be reached.
https://arstechnica.com/science/2020/08/first-confirmed-case...
FFP3 masks are usually not preferred for Covid-19 because they supposedly don't offer that much more protection and they are less comfortable. Because of their greater airflow restriction, they are often fitted with valves, that makes them much less effective at protecting others.
FFP3/N99 respirators are mostly used in industrial settings to protect against very fine particles like asbestos dust.
Only gotcha it's that the study was about introducing a simpler affordable way to measure the effectiveness of masks wrt. protecting others and get feeback for that method, so the number of tests they did are to small to be anything then an indicator for what might maybe be the result in a large study using that method.
Through it should be noted that the valved mask where still reasonable good.
Actually even a bandanna reduced the amount of water droplets in the air by nearly 50% (if I remember correctly) or at least the one they tested did so.
But fleece turned out to be terrible as it spliced the droplets into many smaller ones without hindering them much increasing the total amount of droplets in the air.
Thinks like that are why I thing we should have a larger study with that method or similar methods.
Because we don't know if all fleece masks are as bad or even worse then no mask or if it was just that fleece mask and if therefore we need to count fleece based home made masks as wearing no mask.
(This also would mainly affect people using fleece based scarfs as both scarf and mask as well as people having a fleece based cycler mask and using it as a protection mask too)
In this case, it is different. People will put pressure on the government to allow concerts again rather sooner than later and the default case is probably that there will be concerts again before the Corona situation is over. If you don't do the test, you have to make the decision whether / when to allow concerts again blindly.
So basically you have the situation where people will take the new drug anyway and you have the choice whether you want to test its safeness before they do.
If you do the test and it turns out to be unsafe, at least you have good arguments when you need to make the decision.
But this is probably known to people who are in the field. You have to defend your decisions the same way you would in business or investing, but instead of people shorting your stock, you will have people trying to cut your funding, accuse you of causing harm and ultimately trying to destroy your reputation/career.
It’s fascinating how this trap of group fallacy has the potential to affect different fields, like there’s some universality to the human behavior behind it.
In a sane world, the government's reopening plans aren't dictated by the local restaurant owners, but rather by health organizations run by scientists. In such a world, concerts won't happen again before it is actually safe to do so. Surprisingly, there are some places in the world where that is actually the case!
The question though, isn't if a particular drug is safe or not. That's a very important question to answer, and one of the hurdles to pass, but in this context, the ethics are around exposing people to a potentially fatal disease, without actually knowing if the vaccine being tested successfully protects against the disease. If we inject people with a vaccine, and then with large amounts of the SARS-Cov-2 virus, and they develop COVID-19, then we can say that the vaccine being tested on them didn't work in that case. Unfortunately we directly injected them with a potentially lethal disease, possibly resulting in a life-long disability.
It's that last step that most hospital ethics boards aren't willing to take.
Please read the article before commenting and making strong accusations.
In fact, they created an ultra-safe environment where the chance of getting infected would be close to zero.
https://en.wikipedia.org/wiki/Tuskegee_Syphilis_Study#Racism "Our estimates imply life expectancy at age 45 for black men fell by up to 1.4 years in response to the disclosure"
https://en.wikipedia.org/wiki/Baltimore_Lead_Paint_Study#Aft... "After the study ended, many poor, African-American children ended up with neurological disabilities as a result, often incurring permanent nervous damage."
https://en.wikipedia.org/wiki/Stateville_Penitentiary_Malari... "The international Nuremberg Code of human experimentation ethics, which resulted from the trials, contained clauses directly violated by the Stateville experiments."
https://en.wikipedia.org/wiki/Contraceptive_trials_in_Puerto...
etc. https://en.wikipedia.org/wiki/Unethical_human_experimentatio...
But it gives off a certain "scientific whaling" vibe, I can't help questioning the intentions.
Today, it's unethical to preform the Milgram experiment. Michael/vSauce did preform the actual trolley experiment for a YouTube video, which is interesting, but it was bad scientifically because the sample size was too small, the experiment changed for one person, and the ethics for the entire thing was questionable.
[0] https://www.vox.com/2018/6/13/17449118/stanford-prison-exper...
I've watched the original in University with the old black and white tapes. There have been interviews with people years later who said, "I really believe I killed that person in the other room," and furthermore, it has been replicated in other countries by other researchers.
We can argue about numbers and percentages, but the idea that you can put up walls of abstraction to get people to kill others is established in other research outside of Milgram.
Even if there were problems with the original experiment (and I've read Dimow before and doubt what he's saying; there are interviews from former participants who said they really did believe they had killed the person in the other room), it's been replicated in other countries.
The fact that people failed in the past should not result in banning people from trying to do better in the future.
I've been to the museums in Moldova with displays dedicated to the people who were taken to gulags. I've read about the people who starved in the Ukraine. People like Adam Curtis liked to say communism/soviets were not as great a threat as they were made out and how Regan's teams overreacted .. but I don't know now.
We are seeing active experiments with polyamory today. It's different because you don't have the legal bindings in polygamy. My hypothesis is if you offered full legal polygamy marriages, it would not turn out well long term. We could try it, sure, but it never worked in the past. You thing you're magically going to get it right this time, like modern day Marxists? I have my doubts.
Doesn't sound very ethically controversial.
Medical ethics has evolved a lot in the last couple of decades after numerous cases came to light that retrospectively showed that harm was being done to people, in many cases without their consent or any level of transparency about what the experiment was about.
That said, people are going to congregate in groups, including large groups, no matter what any government says or does. It's not something governments can realistically prevent. A varying but significant percentage of the population of any country will simply do as they wish regardless of the risk to themselves or others.
So if they're going to do it anyway, shouldn't we at least learn something from it?
however as thought experiment let us say if you can develop a safe vaccine by killing hundred people and save millions , should you do it ?
Should I develop a self driving AI to choose life of child over dozen people Adults ?
These are not easy questions to answer while the first may not happen , the second scenario is not far off
https://en.wikipedia.org/wiki/Utilitarianism
Kucirka et al (https://www.acpjournals.org/doi/10.7326/M20-1495) did a pooled analysis of seven other studies and found that "over the 4 days of infection before the typical time of symptom onset (day 5), the probability of a false-negative result in an infected person decreases from 100% (95% CI, 100% to 100%) on day 1 to 67% (CI, 27% to 94%) on day 4. On the day of symptom onset, the median false-negative rate was 38% (CI, 18% to 65%). This decreased to 20% (CI, 12% to 30%) on day 8 (3 days after symptom onset) then began to increase again, from 21% (CI, 13% to 31%) on day 9 to 66% (CI, 54% to 77%) on day 21."
A lot of folks are jumping into this thread very confident that my numbers are wrong, but they're pretty well established and uncontroversial.
Let's assume the "real" share of infectious people in the population is 10/100k (That's twice as much as the most recent reported 7-day incidence (5.1/100k) of new infections for Leipzig, the area where the study was performed.)
Further let's assume a PCR Test has a 30% FNR, and a 10% FPR (numbers completely made up, I don't have a source).
Then out of 1500 People who have tested negative, we'd expect 0.05 to have the virus.
Once the expected value starts to creep over 1, then that's enough to infect quite a lot of people. It's not too much past that to expect that one of the infected has 'underlying condition' and risking death.
In British Coloumbia there's been a big outbreak due to a single gathering in the interior, notably (shamefully) attended by Medics and Doctors.
It's a little risky.
It's just not the time to have major gatherings, but at least this one is in the service of the science of 'stopping it' - which is better than most places are doing.
Kucirka et al (https://www.acpjournals.org/doi/10.7326/M20-1495) did a pooled analysis of seven other studies and found that "over the 4 days of infection before the typical time of symptom onset (day 5), the probability of a false-negative result in an infected person decreases from 100% (95% CI, 100% to 100%) on day 1 to 67% (CI, 27% to 94%) on day 4. On the day of symptom onset, the median false-negative rate was 38% (CI, 18% to 65%). This decreased to 20% (CI, 12% to 30%) on day 8 (3 days after symptom onset) then began to increase again, from 21% (CI, 13% to 31%) on day 9 to 66% (CI, 54% to 77%) on day 21."
> the person was unlikely to be infectious at the time of the test.
https://www.health.govt.nz/our-work/diseases-and-conditions/...
Of course if you are testing proper samples from the airways and they come back negative, it’s not very likely these people can infect others through droplets from their airways at that moment. The problem is that they might be in the incubation period but that is irrelevant here.
And anyway PCR does not nearly have a 30% false negative rate, I’m not quite sure where you got these stats.
Kucirka et al (https://www.acpjournals.org/doi/10.7326/M20-1495) did a pooled analysis of seven other studies and found that "over the 4 days of infection before the typical time of symptom onset (day 5), the probability of a false-negative result in an infected person decreases from 100% (95% CI, 100% to 100%) on day 1 to 67% (CI, 27% to 94%) on day 4. On the day of symptom onset, the median false-negative rate was 38% (CI, 18% to 65%). This decreased to 20% (CI, 12% to 30%) on day 8 (3 days after symptom onset) then began to increase again, from 21% (CI, 13% to 31%) on day 9 to 66% (CI, 54% to 77%) on day 21."
You are mistaken.
Your second study is flawed as indicated by the comments on it, it’s a meta study based on poor data.
If you choose a point and go looking for studies to support it, regardless of quality and ignoring studies that do not, that’s not science.
And by the way, your studies are about something that is not important here. What is important here is if the patient carries virus particles in his airways so they can infect others, not if they are infected themselves.
Why would they not wear masks?
The amount of infected people is so low it’s basically impossible to scientifically test infections, that’s not what they are doing (especially given they tested everyone in advance). They are testing crowd movement, how many people do you get close to etcetera.
Edit: much clearer now, thanks to everybody who replied!
This is indeed (based on the article), the target of the research:
> The first of Saturday's three concerts aimed to simulate an event before the pandemic, with no safety measures in place. The second involved greater hygiene and some social distancing, while the third involved half the numbers and each person standing 1.5m apart.
So they did it in three parts.
So to clarify: This was not done to study the spread of the virus, but rather to study the behavior of people at this type of event. Only people who tested negative were allowed to the event.
This has a lot more detail (but is in German): https://www.spiegel.de/wissenschaft/medizin/corona-konzert-r...
But then again, from observing my friends (who are mostly younger), many of them behave as if they didn't have the virus anyway -- even those who hadn't been tested. So yes, the results might be a little skewed, but the results should still be instructive.
This is still somewhat useful as it turns out they still do a reasonable good job wrt. Sensitivity iff you are highly infectious.
So it might be useful to at least "weed out" the most infectious people before grant events or e.g. school, which would probably already be a great improvement I guess.
I can't confirm that. The BBC article doesn't mention testing at all, and Spiegel Online writes:
"Mitmachen darf jeder, der keine Vorerkrankungen der Lunge oder des Herzens hat und zwischen 18 und 50 Jahre alt ist."
(Anyone with no prior illness of the lungs or heart and between 18 and 50 years of age is allowed to participate.)
and
"Alle Teilnehmer mussten zwei Tage vor dem Studientag einen Abstrich aus ihrem Rachen abliefern, der auf eine Corona-Infektion getestet wurde. Eine Probe war positiv."
(All participants had to submit a throat swab two days prior, which was tested for Corona infection. One sample was positive.)
The first part seems to refer to prior illnesses other than Covid, even though it doesn't specifically say so. The second part doesn't say that the positive sample was excluded from the concert. Reading between the lines, this whole experiment does indeed appear to test the spread of the actual virus.
It's sad that many didn't learn anything from this and are now discussing how bad such a study is on basis of assumption which ate easily disproven if you read the article :(
(It's a study about human behavior, about how certain distance rules might work and how not, it's also testing the potential thread of smearing based infections by using desinfec which glows under UV light and by simulating the airflow in the hall and similar. All pacipiants are tested to not be infected, all are required to wear FFP2 masks properly all the time, no food is given out, drinking is only allowed in the emergency, hands are desinfected on entry and potentially later one, too...., So no this should not lead to any relevant increased risk of spread. But might lead to potential reopening of concert halls and similar if it's found to be feasible under some conditions).