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What Happens Next? Covid-19 Futures, Explained with Playable Simulations

286 pointsby blopeurabout 5 years ago

17 comments

dbattagliaabout 5 years ago
&gt; For policymakers: Make laws to support folks who have to self-isolate&#x2F;quarantine.<p>I live in NYC, and this is something that still feels like a gaping hole. My wife has been job hunting since before we were on lockdown in February, and its been truly horrifying how many businesses COVID-19 hiring plans have been along the lines of &quot;work from home until the very fist day the governor says we can go back to office&quot;. These aren&#x27;t just &quot;old school&quot; BigCorps either, most have been small tech firms. Even worse, she finally ended up with a &quot;offer&quot; from a government agency I won&#x27;t name that refuses to give her a start date yet because, even though the rest of the office workers are WFH, they refuse to hire remote because of &quot;taxpayers&quot; (who are ironically funding her to not work via NYS unemployment benefits).<p>It&#x27;s become quite clear to me that we can&#x27;t trust businesses to do the right thing here. The desire for &quot;butt in seat at office&quot; from folks making decisions at employers here is going to end up flooding our subways with commuters who have no choice but to come in because they don&#x27;t want to lose their jobs. Theres no reason office workers successfully working from home shouldn&#x27;t stay there as long as they feel comfortable, and not make it terrible for folks who truly do need to commute (retail, food service, medical, etc). Maybe I&#x27;m just biased because I work for a remote company already, but I&#x27;m seriously worried what the big cities in America will look like once the initial restrictions are lifted.
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pathumbaabout 5 years ago
While this is a very nice simulation and explanation it has a serious flaw: It assumes a fixed CFR, IFR, and hospitalisation rate. This doesn&#x27;t seem to be case as evidenced by the large differences between the countries with different response curves.<p>The inability to change the parameters is a major problem with the simulation and invalidates a number of conclusions at the end.<p>What we can observe so far is that CFR is heavily skewed towards the old and frail with significant co-morbidities. Most likely there is another, not yet fully identified, medical cofactor that makes this virus particularly difficult for a very small number of people of any age. Outside of those groups the virus doesn&#x27;t seem to be very symptomatic for the majority of infected people. Note that symptomatic in the medical sense and common usage is not the same. The latter having a way higher subjective threshold.<p>The simulation should also account for the &quot;weak tree&quot; effect in that the majority of the susceptible will succumb to it on the first contact. In the following years the number of susceptible will be much lower and only go up with the remaining people going into ill health and becoming susceptible, if they haven&#x27;t developed any immunity from the previous encounters.<p>A simulation to draw real conclusions from must have an adjustable IFR, CFR, the corresponding hospitalisation rates, and the age and health distribution of the population for a region to be modelled.
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strkenabout 5 years ago
From the article: &quot;Masks don&#x27;t stop you getting sick&quot;<p>From the article&#x27;s source (<a href="https:&#x2F;&#x2F;www.sciencedirect.com&#x2F;science&#x2F;article&#x2F;pii&#x2F;S0196655307007742" rel="nofollow">https:&#x2F;&#x2F;www.sciencedirect.com&#x2F;science&#x2F;article&#x2F;pii&#x2F;S019665530...</a>): &quot;None of these surgical masks exhibited adequate filter performance and facial fit characteristics to be considered respiratory protection devices&quot;<p>Well, what&#x27;s &quot;adequate filter performance and facial fit&quot;? For filter performance, they measured how good the surgical masks were at blocking tiny latex spheres that approximated an aerosol, and found that masks ranged from less than 1% penetration (best) all the way to 80% penetration (worst). For facial fit, they told subjects who &quot;were not screened for previous use of masks or respirators&quot; to wear masks and then sprayed an aerosolised bitter substance on them, and found all of the subjects could taste it after their first try.<p>The article is making the claim that masks don&#x27;t stop you getting sick, based on a source that indicates some masks don&#x27;t filter aerosols completely and that nobody wears masks correctly anyway. This is a bit of a stretch - their source says nothing about larger droplets, it says nothing about side effects like touching your face less, it says nothing about masks encouraging other people to socially distance, it says very little about how masks reduce the viral load that reaches you.<p>I don&#x27;t think there&#x27;s enough evidence to categorically state that masks do not stop you getting sick. I think it&#x27;s irresponsible to make such a firm statement without better evidence.
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dvtabout 5 years ago
It&#x27;s such a shame that COVID-19 has become so politicized, it&#x27;s hard to even find <i>scientific</i> sources that are being wholeheartedly honest. Here&#x27;s a few statements that are blatantly misleading:<p>&gt; Around 1 in 20 people infected with COVID-19 need to go to an ICU (Intensive Care Unit).<p>That statistic is contingent on infection rates. No one has these due to lack of testing. Therefore, the statistic is misleading at best, and wrong at worst.<p>&gt; However, pandemics are like poker. Make bets only when you&#x27;re 95% sure, and you&#x27;ll lose everything at stake.<p>This is highly alarmist. Pandemics aren&#x27;t like poker because you&#x27;re not going &quot;all-in&quot; on a 95% bet. Awful analogy, and just bad rhetoric.<p>&gt; (Rant about the confusion about pre-symptomatic vs &quot;true&quot; asymptomatic. &quot;True&quot; asymptomatics are rare.)<p>Let&#x27;s be real. In the study cited, N was like 900 (with asymptomatics = 4; 1.9%). We have no idea how &quot;rare&quot; asymptomatics are, and citing this study is just bad science. I don&#x27;t understand why not just be honest.
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isoprophlexabout 5 years ago
Fantastically illustrated once again, ncase if you&#x27;re reading this, you&#x27;re one of my internet heroes.<p>The &#x27;masks protect others from you, and wont protect you from others&#x27; illustration is very useful, too.
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glofishabout 5 years ago
This is simply a non-realistic toy visualization created to propagate the groupthink that is already so pervasive.<p>the problem with this simulation is as with all models, it treats everyone equally likely to need medical care (this is how the ICU bed capacity is drawn). That is not the case a least bit. Millions of people have recovered with minor discomfort and they have all predictable traits (say age) that clearly indicated their preponderance to risk.<p>Show me a model that accounts for this, then I will take it seriously.
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jdkeeabout 5 years ago
FWIW, I found this thread by Jeremy Konyndyk enlightening and depressing.<p><a href="https:&#x2F;&#x2F;threader.app&#x2F;thread&#x2F;1256090422188953600" rel="nofollow">https:&#x2F;&#x2F;threader.app&#x2F;thread&#x2F;1256090422188953600</a>
nkkollawabout 5 years ago
Cool animation, but how reliable are the numbers?<p>There are no reliable tests, governments are not doing a lot of testing, most cases are asymptomatic.<p>How do you even know the death rate, and how many people need ICU? The animation says 1-20, seems crazy.
squidproquoabout 5 years ago
If anyone has been doing Covid-19 simulations for the United States. I&#x27;m crowdsourcing forecasts on this site: <a href="https:&#x2F;&#x2F;www.unitarity.com&#x2F;app&#x2F;challenges&#x2F;us-coronavirus-outbreak&#x2F;events&#x2F;may-20" rel="nofollow">https:&#x2F;&#x2F;www.unitarity.com&#x2F;app&#x2F;challenges&#x2F;us-coronavirus-outb...</a>
wiz21cabout 5 years ago
When Alice sends what she said to the hospital, I&#x27;m afraid she&#x27;s not anonymous anymore. Indeed the hospital (or whoever owns the phone (I&#x27;m looking at google&#x2F;apple)) knows who it&#x27;s talking to. For Alice to remain anonymous, she must be able to send what she said through an anonymous channel...<p>Am I right ?
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deeglesabout 5 years ago
Isn&#x27;t it a big assumption that immunity is permanent? How would it affect the herd immunity threshold if a person can be reinfected every year?
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_redabout 5 years ago
This somewhat a classic Strategy vs Tactics problem:<p>The best Strategy is to do nothing<p>The best Tactic is the complex array of shutdowns, mask, social distancing, pharmaceuticals.
augusttabout 5 years ago
What&#x27;s the reasoning behind this incredibly strong statement: &quot;Most epidemiologists expect a vaccine in 1 to 2 years.&quot; ?
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claudeganonabout 5 years ago
Yes, it’s become obvious that this whole situation is not so much a threat to white-collar work, but to the necessity of the hierarchy and authoritarian control structures that define American workplaces.
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hedoraabout 5 years ago
The simulation doesn’t take into account new strains. Coronavirus mutates at least once a year. It’s likely there will be strains that are similarly contagious, but with higher or lower case fatality rates.<p>Prior pandemic case fatality rates were 10x what we’re seeing with COVID-19.<p>Also, in 1918, shelter in place contributed to a W shaped pandemic, where the second wave was much more deadly, and also killed lots of kids and young adults.<p>If more people in those age groups had been infected in the first wave, many fewer people would have died in total.
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gns24about 5 years ago
A great explanation of a lot of things, but this looks wrong to me: &quot;To put a number on it: surgical masks on the sick person reduce cold &amp; flu viruses in aerosols by 70%. Reducing transmissions by 70% would be as large an impact as a lockdown!&quot;<p>Reducing the amount of virus in aerosols won&#x27;t reduce the number of infections by the same amount. If a cough produces ten times the infective dose, then with the mask that&#x27;s still three times.<p>Masks are still likely to help (and maybe having a smaller dose will make the disease milder if someone does catch the virus), but it&#x27;s not possible to make a statement like this about the effect on R.
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ytNumbersabout 5 years ago
I&#x27;m quite impressed with the work that went into these simulations. The folks who put this together did a great job. It would have been a great method to explain to the public how lock-downs save lives by not overwhelming our hospital ICU bed capacity, but for one critical omission. My idea for a way to improve these simulations would be to include what could be the most important public policy issue of them all: In many US states, the governor has forbidden (or greatly restricted) pharmacies from dispensing hydroxychloroquine. How many people could be kept out of the ICU (when the medicine is used in conjunction with azithromycin or zinc) if governors allowed pharmacies to dispense this medicine? I&#x27;ve yet to see a study where hydroxychloroquine, when used in conjunction with z-pak or zinc, was found to be ineffective against COVID-19. Of course, that&#x27;s not proof of anything, but, with 25% unemployed in some of the biggest US cities, rigorous scientific studies may wind up taking more time than we can afford to wait. Therefore, it seems to me that the best way to find out what works to save lives (and keep people out of the ICU) is to look at what the front-line doctors are doing at one of the most prestigious hospitals in the world:<p><a href="https:&#x2F;&#x2F;www.the-hospitalist.org&#x2F;hospitalist&#x2F;article&#x2F;221558&#x2F;coronavirus-updates&#x2F;yales-covid-19-inpatient-protocol-hydroxychloroquine" rel="nofollow">https:&#x2F;&#x2F;www.the-hospitalist.org&#x2F;hospitalist&#x2F;article&#x2F;221558&#x2F;c...</a>
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