Genuine points of uncertainty

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Opti
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Re: Genuine points of uncertainty

Post by Opti » Sat Dec 26, 2020 8:40 am

jimbob wrote:
Sat Dec 26, 2020 7:11 am


I was talking to Dad and some of his college friends, who all started in MAFF a few years before Opti, and whose first year included the 1967 Foot and Mouth outbreak. That lesson was known from then and included in the subsequent report
The good old MAFF knew how to deal with outbreaks of highly infectious disease. Test, Track, Isolate ... and Kill. Worked a treat.
He cannot be killed by conventional weapons. True. He and Mrs Opti are wicked cool.

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Re: Genuine points of uncertainty

Post by shpalman » Sat Dec 26, 2020 9:29 am

bob sterman wrote:
Sat Dec 26, 2020 8:03 am
shpalman wrote:
Thu Dec 24, 2020 3:40 pm
bob sterman wrote:
Thu Dec 24, 2020 3:33 pm


Yes - that could well be the case.

However, I don't think we can exclude the possibility that the relative importance of aerosols vs droplets differs. If aerosols are more importance for COVID-19, and droplets more importance for influenza, it's hard to imagine how we could create a situation where you'd get COVID-19 suppression without concomitant influenza suppression. Loose fitting masks can block droplets while letting aerosols out - but how could you achieve the opposite?
Well, you wouldn't. Do you have any links to research on modes of transmission or even the formal difference between "aerosols" (small droplets which float?) and "droplets" (bigger droplets which travel ballistically?) and how humans create them by sneezing/coughing?
I think there is even quite a bit disagreement over the definition of "aerosol" and "droplet" and as this is the "Genuine points of uncertainty" thread - I just wanted to point out that there is uncertainty - over the relative importance of these modes of transmission.

This obviously has important practical implications - e.g. for universities expecting staff to teach in rooms with students not wearing masks as they are spaced out at >2m.
But if "loose fitting masks [can let] aerosols out" anyway... what should we do? Not have in-person teaching at all? Define different standards on masks? Mandate ordinary masks anyway despite the >2m separation? Decide that the separation makes no difference since the air all recirculates? Leave all the windows open? Decide that blocking droplets is still better than nothing? Decide that since blocking droplets isn't relevant and there isn't anything practical you can do to block aerosols, to not bother with masks at all?

(Yes, it's uncertain what we should do, that's why it's in this thread, but this is scrutable and Nerd Lab rules apply so let's have a constructive discussion or at least try to reckon something.)

My own university greatly reduced the maximum capacity of each lecture room, mandated masks for all the students but let teachers remove their masks once they were in position at the front of the class, and changed the policy on air recirculation and/or having the windows open.

(Reducing capacity helps in maintaining distance between students in the room but also means that in the event of one student testing positive, fewer classmates will be obliged to self-isolate.)

As for fomites, it really makes you notice how much people touch their faces. Despite the whole "wearing a mask makes you touch your face more because you fiddle with it" trope I find that wearing a mask actually reminds me that we're under different conditions and I maintain enough awareness not to (without a mask on, I'm compulsively beard-stroking or nose-picking). And maybe having alcohol get available everywhere is helping with that to some extent. I'd already trained myself to cough/sneeze into my elbow a couple of years ago having seen on the internet that this was what medical professionals did.
bob sterman wrote:
Sat Dec 26, 2020 8:03 am
Here's a BMJ editorial on the issue...

Airborne transmission of covid-19

https://www.bmj.com/content/370/bmj.m3206

And one review published on this...

Transmission of COVID-19 virus by droplets and aerosols: A critical review on the unresolved dichotomy
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293495/

(My point about not being able to suppress aerosols without also suppressing droplets was to show why you probably wouldn't have naturally occurring examples of situations in which covid-19 was suppressed but influenza was not).
Well, people are working on it.

Modelling aerosol transport and virus exposure with numerical simulations in relation to SARS-CoV-2 transmission by inhalation indoors
molto tricky

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Re: Genuine points of uncertainty

Post by bob sterman » Sat Dec 26, 2020 10:28 am

shpalman wrote:
Sat Dec 26, 2020 9:29 am
But if "loose fitting masks [can let] aerosols out" anyway... what should we do? Not have in-person teaching at all? Define different standards on masks? Mandate ordinary masks anyway despite the >2m separation? Decide that the separation makes no difference since the air all recirculates? Leave all the windows open? Decide that blocking droplets is still better than nothing? Decide that since blocking droplets isn't relevant and there isn't anything practical you can do to block aerosols, to not bother with masks at all?

(Yes, it's uncertain what we should do, that's why it's in this thread, but this is scrutable and Nerd Lab rules apply so let's have a constructive discussion or at least try to reckon something.)
Yes - blocking droplets has got to be better than nothing - and probably of major importance. Probably the most important thing we can do.

I think the uncertainty remains over what else we need to do in order to stop the rest of the transmission that this isn't preventing.

I don't have sufficient expertise in this area to make recommendations that anyone should pay attention to - but I worry about the role of persistent fomites, aerosols and faecal-oral routes. And perhaps a combination of these...

Possible Aerosol Transmission of COVID-19 Associated with an Outbreak in an Apartment in Seoul, South Korea, 2020
https://www.ijidonline.com/article/S...558-3/fulltext

The culprit here was aerosolized faecal matter - as in Amoy Gardens for SARS in 2003.

So while masks and distancing to reduce droplet spread seem to be most important - could there be something we're missing? Another route - that if addressed could block a lot of the remaining transmission we're failing to block?

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Re: Genuine points of uncertainty

Post by Woodchopper » Sat Dec 26, 2020 12:10 pm

I think that there has been some bias into investigations into how people have become infected. For good reasons the superspreader events have received most attention and all the ones I can think of have involved likely cases of spread by droplets or aerosols. But it could well be that spread vis fomites is common but mundane so doesn’t get as much attention.

New Zealand has had few enough cases that it’s been able to investigate them, and they’ve highlighted some fomite examples
eg https://www.stuff.co.nz/national/health ... nd-hygiene

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Re: Genuine points of uncertainty

Post by shpalman » Sat Dec 26, 2020 1:00 pm

I've heard it said here in Italy that "most transmission was within the home" or something, which of course doesn't help you figure out how the person who brought it into the home got infected in the first place.

It's also the case that if you isolate cases well enough that other people aren't let into their airspace, fomites are the only thing left for transmission, so it might account for a relatively small proportion of transmission in Europe or the US where a lot of asymptomatic (and unaware of it) people are wandering around.
molto tricky

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Re: Genuine points of uncertainty

Post by jimbob » Sat Dec 26, 2020 3:16 pm

bob sterman wrote:
Sat Dec 26, 2020 10:28 am
shpalman wrote:
Sat Dec 26, 2020 9:29 am
But if "loose fitting masks [can let] aerosols out" anyway... what should we do? Not have in-person teaching at all? Define different standards on masks? Mandate ordinary masks anyway despite the >2m separation? Decide that the separation makes no difference since the air all recirculates? Leave all the windows open? Decide that blocking droplets is still better than nothing? Decide that since blocking droplets isn't relevant and there isn't anything practical you can do to block aerosols, to not bother with masks at all?

(Yes, it's uncertain what we should do, that's why it's in this thread, but this is scrutable and Nerd Lab rules apply so let's have a constructive discussion or at least try to reckon something.)
Yes - blocking droplets has got to be better than nothing - and probably of major importance. Probably the most important thing we can do.

I think the uncertainty remains over what else we need to do in order to stop the rest of the transmission that this isn't preventing.

I don't have sufficient expertise in this area to make recommendations that anyone should pay attention to - but I worry about the role of persistent fomites, aerosols and faecal-oral routes. And perhaps a combination of these...

Possible Aerosol Transmission of COVID-19 Associated with an Outbreak in an Apartment in Seoul, South Korea, 2020
https://www.ijidonline.com/article/S...558-3/fulltext

The culprit here was aerosolized faecal matter - as in Amoy Gardens for SARS in 2003.

So while masks and distancing to reduce droplet spread seem to be most important - could there be something we're missing? Another route - that if addressed could block a lot of the remaining transmission we're failing to block?
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Re: Genuine points of uncertainty

Post by shpalman » Sat Dec 26, 2020 5:54 pm

I'm reading Modelling aerosol transport and virus exposure with numerical simulations in relation to SARS-CoV-2 transmission by inhalation indoors https://doi.org/10.1016/j.ssci.2020.104866
In a recent study (Leung et al., 2020) on the efficacy of facial mask in reducing the risk of coronavirus transmission via droplets and aerosols, the viral RNA was detected in 30% of the larger droplets (> 5 µm) while it was detected in 40% of the smaller aerosols (< 5 µm). It is also recently argued that the small aerosols (< 5 µm) exhaled in normal speech plausibly serve as an important and under-recognized transmission agent for SARS-CoV-2 (Asadi et al., 2020).
Pubs and restaurants need to stay closed. Talking while you have your mask off to eat or drink spreads the virus. No, you can't go to the pub or restaurant with people you live with anyway, you can perfectly well eat or drink together at home. Get a takeway, whatever. Paying pubs directly to stay closed would be cheaper in the long run than subsidizing people to go to them and then dealing with the resulting wave of infection. https://www.theguardian.com/business/20 ... e-in-covid

What I'm not sure about, is if there's any evidence that any of the measures we're taking to reduce contagion from aerosols or fomites are counterproductive. So if contagion is persisting it's because we're not doing them properly or not doing them enough.
molto tricky

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Re: Genuine points of uncertainty

Post by raven » Sat Dec 26, 2020 10:39 pm

This fomite thing. Lift buttons, communal bins, door handles - frequently touched surfaces getting contaminated makes sense, and I remember lift buttons being suspected with SARS first time around. But what about things you carry with you? Like mobile phones, for instance. If you should wash your hands regularly, then you should probably also clean your phone, at least now and then.

That's what I've been doing, but I don't know if that's common. Perhaps that might be a potential route we're missing.

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Re: Genuine points of uncertainty

Post by Millennie Al » Sun Dec 27, 2020 3:11 am

bob sterman wrote:
Thu Dec 24, 2020 2:41 pm
What are some points of legitimate debate about the pandemic, between actual (biological or social) scientists who don't have a political axe to grind?
I would say the relative importance of aerosol and fomite transmission is still up for debate.

I don't think there's much debate about respiratory droplets being an important mode of transmission - but I think the jury is still out on the importance of aerosols and fomites (i.e. the extent to which they are accounting for real world pandemic spread).
I think there is adequate evidence to show that aerosol transmission is the major mechanism. This is merely based on loking at measures which have been tried and failed. People have been told to wash their hands, and many have done so - see sales of sanitiser and the sanitiser available (and often required) in public places. I have not seen any reports of these being associated with noticeable drops in cases. Similarly, even relatively poorly fitting masks give substantial benefit against droplets, but a huge increase in mask wearing has not been followed by a significant drop in cases. This leads me to conclude that aerosols are the main means of transmission. Other means may be how a case escapes (especially fomites, which can outlast aerosols), but onward transmission is probably largely by aerosols. This means that people can gather outdoors in large numbers without spreading the disease very much as the aerosol will be quickly carried away by even a light breeze. We saw protests in the UK in the summer which involved large gatherings, but no surge in cases.

This suggests that when meeting indoors, the pattern of air circulation and ventilation is critical. If you have a high ceiling with high windows and air drawn in at a low level (e.g. a lecture theatre, where body heat causes exhaled air to rise) it should be reasonably safe, while a pub or restaurant where air circulates between tables would be quite dangerous.

Unfortunately, combating aerosols is harder than combating droplets or fomites, which is why it is so difficult to control the disease without extreme lockdowns. It's much harder to avoid breathing in air that someone else has exhaled than to merely keep 1m or 2m away from them as it depends on where they have been recently and the air circulation.
Covid-19 - Don't catch it: don't spread it.

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Re: Genuine points of uncertainty

Post by Cardinal Fang » Sun Dec 27, 2020 1:58 pm

Been seeing a lot of noise on social media the last few days about a meta-analysis of anti-parasitic drug ivermectin that supposedly shows it's good for treating COVID

Running my inexperienced eye over it, it seems to me that a lot of the studies seem to be in-vitro, in silico, animal studies or really tiny studies i.e. not very good to begin with studies. But could someone who knows a bit more about these sorts of thing run their eye over. Seems those with a vested interest in proving ivermectin works (who seem to share a significant overlap with those who used to tout HCQ) are lumping anything they can find together, yet it seems to me that one can't compare directly an in-vitro study to a study in hamsters, to a study in humans

https://c19ivermectin.com/

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Re: Genuine points of uncertainty

Post by Woodchopper » Sun Dec 27, 2020 3:12 pm

Cardinal Fang wrote:
Sun Dec 27, 2020 1:58 pm
Been seeing a lot of noise on social media the last few days about a meta-analysis of anti-parasitic drug ivermectin that supposedly shows it's good for treating COVID

Running my inexperienced eye over it, it seems to me that a lot of the studies seem to be in-vitro, in silico, animal studies or really tiny studies i.e. not very good to begin with studies. But could someone who knows a bit more about these sorts of thing run their eye over. Seems those with a vested interest in proving ivermectin works (who seem to share a significant overlap with those who used to tout HCQ) are lumping anything they can find together, yet it seems to me that one can't compare directly an in-vitro study to a study in hamsters, to a study in humans

https://c19ivermectin.com/

CF
Some skepticism here:
https://www.tandfonline.com/doi/full/10 ... 20.1775118
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253113/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172803/


FDA Letter to Stakeholders: Do Not Use Ivermectin Intended for Animals as Treatment for COVID-19 in Humans
https://www.fda.gov/animal-veterinary/p ... -19-humans


Articles in good journals report positive findings, but conclude that randomized control trials on humans are needed: https://www.sciencedirect.com/science/a ... 9220348984
https://www.nature.com/articles/s41429-020-0336-z

Actual small, non-blinded RCTs find no statistically significant benefit
https://scholar.google.com/scholar?hl=e ... 7t7GQeStYJ
https://assets.researchsquare.com/files ... af9551.pdf

Other study on people finds no benefit
https://journals.plos.org/plosone/artic ... ne.0242184

Studies on humans finding a benefit
https://www.medrxiv.org/content/10.1101 ... 20219345v1
https://www.medrxiv.org/content/10.1101 ... 20219345v1

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Re: Genuine points of uncertainty

Post by Woodchopper » Sun Dec 27, 2020 3:15 pm

So after a quick Google. It doesn’t seem to be a miracle cure.

Most positive findings in biomedical research are wrong. Small, methodologically weak studies and publication bias lead to lots of false positives. What’s needed is a large scale RCT. Until then meh.

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Re: Genuine points of uncertainty

Post by Herainestold » Sun Dec 27, 2020 3:40 pm

Millennie Al wrote:
Sun Dec 27, 2020 3:11 am
bob sterman wrote:
Thu Dec 24, 2020 2:41 pm
What are some points of legitimate debate about the pandemic, between actual (biological or social) scientists who don't have a political axe to grind?
I would say the relative importance of aerosol and fomite transmission is still up for debate.

I don't think there's much debate about respiratory droplets being an important mode of transmission - but I think the jury is still out on the importance of aerosols and fomites (i.e. the extent to which they are accounting for real world pandemic spread).
I think there is adequate evidence to show that aerosol transmission is the major mechanism. This is merely based on loking at measures which have been tried and failed. People have been told to wash their hands, and many have done so - see sales of sanitiser and the sanitiser available (and often required) in public places. I have not seen any reports of these being associated with noticeable drops in cases. Similarly, even relatively poorly fitting masks give substantial benefit against droplets, but a huge increase in mask wearing has not been followed by a significant drop in cases. This leads me to conclude that aerosols are the main means of transmission. Other means may be how a case escapes (especially fomites, which can outlast aerosols), but onward transmission is probably largely by aerosols. This means that people can gather outdoors in large numbers without spreading the disease very much as the aerosol will be quickly carried away by even a light breeze. We saw protests in the UK in the summer which involved large gatherings, but no surge in cases.

This suggests that when meeting indoors, the pattern of air circulation and ventilation is critical. If you have a high ceiling with high windows and air drawn in at a low level (e.g. a lecture theatre, where body heat causes exhaled air to rise) it should be reasonably safe, while a pub or restaurant where air circulates between tables would be quite dangerous.

Unfortunately, combating aerosols is harder than combating droplets or fomites, which is why it is so difficult to control the disease without extreme lockdowns. It's much harder to avoid breathing in air that someone else has exhaled than to merely keep 1m or 2m away from them as it depends on where they have been recently and the air circulation.
Interesting hypothesis. How would you test it? If true what measures would you have to make? N95 masks for everybody? Permanent closures of bars and restaurants, gyms and hairdressers?

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Re: Genuine points of uncertainty

Post by sTeamTraen » Sun Dec 27, 2020 4:06 pm

Millennie Al wrote:
Sun Dec 27, 2020 3:11 am
Similarly, even relatively poorly fitting masks give substantial benefit against droplets, but a huge increase in mask wearing has not been followed by a significant drop in cases.
I suggest that the huge increase in mask wearing has kept transmission down to R < ~1.5 levels, but hasn't stopped growth precisely because people don't wear masks (a) at home and (b) in pubs and restaurants, which are the main places (apart from schools) where transmission is probably occurring.
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Re: Genuine points of uncertainty

Post by sTeamTraen » Sun Dec 27, 2020 11:04 pm

Chris Preston wrote:
Sat Dec 26, 2020 3:12 am
There is no real doubt that lockdowns work. It is the political will to do it and get cases to zero, which allows opening the economy back up with some limited restrictions.
I recently read a marvellous quote from Jean-Claude Juncker, back when he was PM of Luxembourg. Talking about climate change, he said, "We all know what to do, but we don't know how to get re-elected once we have done it". I suspect some variant of that sentiment guides policy on a lot of issues.
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Re: Genuine points of uncertainty

Post by Millennie Al » Mon Dec 28, 2020 1:55 am

Herainestold wrote:
Sun Dec 27, 2020 3:40 pm
Millennie Al wrote:
Sun Dec 27, 2020 3:11 am
I think there is adequate evidence to show that aerosol transmission is the major mechanism.
...

This suggests that when meeting indoors, the pattern of air circulation and ventilation is critical. If you have a high ceiling with high windows and air drawn in at a low level (e.g. a lecture theatre, where body heat causes exhaled air to rise) it should be reasonably safe, while a pub or restaurant where air circulates between tables would be quite dangerous.

Unfortunately, combating aerosols is harder than combating droplets or fomites, which is why it is so difficult to control the disease without extreme lockdowns. It's much harder to avoid breathing in air that someone else has exhaled than to merely keep 1m or 2m away from them as it depends on where they have been recently and the air circulation.
Interesting hypothesis. How would you test it? If true what measures would you have to make? N95 masks for everybody? Permanent closures of bars and restaurants, gyms and hairdressers?
Using track and trace data, find out where a suitable sample of people got infected. The suitable cases are those where it was indoors. Go to the locations and use a smoke test to check air circulation patterns. If aerosol transmission occurred, we must find that there is a path carrying contaminated air from where the infectious person was to where the infected person was. With so many cases, it should be possible to find enough examples.

Or just require pubs and restaurants to allow indoor smoking. If you're bothered by someone's smoke, you're inhaling their air and so in danger of getting infected if they're infectious. You could instead wear an N95 mask, as cigarette smoke particles are mostly a fair bit bigger than the SARS-COV-2 virus.

Or require premises to test air circulation patterns and remain closed unless they could show that there is no location where an infecter person's exhaled air is circulated to someone else.
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Re: Genuine points of uncertainty

Post by bob sterman » Mon Dec 28, 2020 8:32 am

Millennie Al wrote:
Mon Dec 28, 2020 1:55 am
Using track and trace data, find out where a suitable sample of people got infected. The suitable cases are those where it was indoors. Go to the locations and use a smoke test to check air circulation patterns. If aerosol transmission occurred, we must find that there is a path carrying contaminated air from where the infectious person was to where the infected person was. With so many cases, it should be possible to find enough examples.
A bit like this study of transmission in a restaurant in China...

https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article

The authors suggest this outbreak did not depend on true aerosol transmission - rather the propagation of smaller droplets via the airflow created by the air conditioning system. Either way - it's transmission over distances greater than 2m.

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Re: Genuine points of uncertainty

Post by Millennie Al » Tue Dec 29, 2020 3:02 am

bob sterman wrote:
Mon Dec 28, 2020 8:32 am
Millennie Al wrote:
Mon Dec 28, 2020 1:55 am
Using track and trace data, find out where a suitable sample of people got infected. The suitable cases are those where it was indoors. Go to the locations and use a smoke test to check air circulation patterns. If aerosol transmission occurred, we must find that there is a path carrying contaminated air from where the infectious person was to where the infected person was. With so many cases, it should be possible to find enough examples.
A bit like this study of transmission in a restaurant in China...

https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article

The authors suggest this outbreak did not depend on true aerosol transmission - rather the propagation of smaller droplets via the airflow created by the air conditioning system. Either way - it's transmission over distances greater than 2m.
Yes, that's exactly what we need. I would guess that the exhaust fan on the wall between tables B and D was the reason why only tables A, B, and C were affected. If we had more such data it might be possible to determine how long the virus remains viable in different size droplets or aerosols and at different air temperatures (cases from meat processing plants suggest that cold air preserves it, and cases from choirs suggest that it can spread long distances at ordinary air temperatures if generated in sufficient volume).
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Re: Genuine points of uncertainty

Post by Cardinal Fang » Tue Dec 29, 2020 5:37 pm

Woodchopper wrote:
Sun Dec 27, 2020 3:12 pm
<Snip>
Cheers m'dear
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Re: Genuine points of uncertainty

Post by nezumi » Thu Dec 31, 2020 5:09 pm

I know how you all feel about anecdote vs evidence, but please take my N=1 :)

As I'm sure you all know I've been shielding throught this entire escapade and I have come to the conclusion that the only way to avoid catching anything is to isolate. I've done so well (so far, touch wood etc.) that I haven't even picked up a cold. In 9 months! No colds, no chest infections, nothing! I usually have about 6 colds a year, once every 3 years on average I get something so bad it nearly kills me, despite flu jabs. It's been 5 years since the last one so I have to be ridiculously careful.

We are tier 4 and I'm supposed to start shielding again but I basically never stopped. I've left the house 8 times since March - I counted. On average, since I've been shielding with Mr Mouse my mental health has improved. However, I am lucky enough to be WFH and been able to go part-time as well as access a psychiatrist and get my medication consistently. Priority delivery has been a godsend and I wish I could have it forever, when I struggled at the very beginning the community stepped right up and delivered food free of charge to keep us both for a week as well as following up later.

So, with adequate support shielding is absolutely doable and need not murder your mental health. I am lucky enough to speak with lots of the general public on a daily basis (most of them are utterly lovely, in all honesty) and I've had this conversation with about 20 other shielders, with a basic response of "well it's not perfect but I'd rather be alive/my family member be alive and we're actually mostly doing fine, ta", the ones who've suffered are the ones without resources or support. bl..dy obviously. Therefore, the answer is "stop being a cheapskate and put the bl..dy funding in place, you effing haystack".

But that's the difference between being right and being Right. Being right means putting adequate supports in place now in order to save money later. Being Right means saving/making money now at the expense of the entire structure of your economy, society and environment.

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Re: Genuine points of uncertainty

Post by Herainestold » Fri Jan 01, 2021 8:42 pm

nezumi wrote:
Thu Dec 31, 2020 5:09 pm
I know how you all feel about anecdote vs evidence, but please take my N=1 :)

As I'm sure you all know I've been shielding throught this entire escapade and I have come to the conclusion that the only way to avoid catching anything is to isolate. I've done so well (so far, touch wood etc.) that I haven't even picked up a cold. In 9 months! No colds, no chest infections, nothing! I usually have about 6 colds a year, once every 3 years on average I get something so bad it nearly kills me, despite flu jabs. It's been 5 years since the last one so I have to be ridiculously careful.

We are tier 4 and I'm supposed to start shielding again but I basically never stopped. I've left the house 8 times since March - I counted. On average, since I've been shielding with Mr Mouse my mental health has improved. However, I am lucky enough to be WFH and been able to go part-time as well as access a psychiatrist and get my medication consistently. Priority delivery has been a godsend and I wish I could have it forever, when I struggled at the very beginning the community stepped right up and delivered food free of charge to keep us both for a week as well as following up later.

So, with adequate support shielding is absolutely doable and need not murder your mental health. I am lucky enough to speak with lots of the general public on a daily basis (most of them are utterly lovely, in all honesty) and I've had this conversation with about 20 other shielders, with a basic response of "well it's not perfect but I'd rather be alive/my family member be alive and we're actually mostly doing fine, ta", the ones who've suffered are the ones without resources or support. bl..dy obviously. Therefore, the answer is "stop being a cheapskate and put the bl..dy funding in place, you effing haystack".

But that's the difference between being right and being Right. Being right means putting adequate supports in place now in order to save money later. Being Right means saving/making money now at the expense of the entire structure of your economy, society and environment.
We could end this in six weeks if we brought in a strict Chinese style lockdown.
Nobody goes outside except essential workers or if there is no other recourse, essential trips to grocery, pharmacy, doctor etc.
Military incl territorials, used to aid essential food and medicine deliveries, and secure the lockdown.
Better relations with China, bring in Chinese public health pandemic experts, to help out.

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