The Lack of Nuance in COVID messages

[Almighty God]

One of the things that bothers me about the government and media messaging about COVID-19 is the lack of nuance and critical thought applied to the messages about how people should calibrate their behaviors in order to prevent deaths and prevent hospitals from being overwhelmed.

To be more specific, the goals of masks, lockdowns, and social distancing as I understand them are to (1) Prevent as many deaths as possible, and (2) Prevent hospitals from becoming full. So, in theory, the number of cases does not matter as long as deaths and hospitalizations are minimized. In order to minimize the number of deaths and hospitalizations, each person should adjust their behavior accordingly in order to reduce the expected number of new hospitalizations that would occur as a result of them getting the virus. This expected number is a function of several variables, the most important being who this individual interacts with. For instance, a person who works in a nursing home has a much higher expected number of hospitalizations that would occur IF she contracted the virus, since the expected number of hospitalizations would be R_0 (expected number of people the virus is spread to) multiplied by the percentage of the people that would be hospitalized if they contracted the virus. As such, it makes sense for a person who works in a nursing home to take more precautions than a healthy person who lives alone and works from home, since the expected number of hospitalizations that would occur as a result of the nursing home worker contracting the virus would be significantly higher than a person who lives alone and works from home. Why? Because a healthcare worker interacts with dozens of vulnerable people on a daily basis, but a person who works from home does not.

So, what's the point of this? The only message I hear from health experts, the media, and governments, is a universal and equal plea to everyone to "stay home" and not interact with others. But, this implies that the expected consequences on society of contracting COVID are the same for everyone, which is demonstrably false as I just explained above.

 

[Unveiled Artist]

One of the things that bothers me about the government and media messaging about COVID-19 is the lack of nuance and critical thought applied to the messages about how people should calibrate their behaviors in order to prevent deaths and prevent hospitals from being overwhelmed.

To be more specific, the goals of masks, lockdowns, and social distancing as I understand them are to (1) Prevent as many deaths as possible, and (2) Prevent hospitals from becoming full. So, in theory, the number of cases does not matter as long as deaths and hospitalizations are minimized. In order to minimize the number of deaths and hospitalizations, each person should adjust their behavior accordingly in order to reduce the expected number of new hospitalizations that would occur as a result of them getting the virus. This expected number is a function of several variables, the most important being who this individual interacts with. For instance, a person who works in a nursing home has a much higher expected number of hospitalizations that would occur IF she contracted the virus, since the expected number of hospitalizations would be R_0 (expected number of people the virus is spread to) multiplied by the percentage of the people that would be hospitalized if they contracted the virus. As such, it makes sense for a person who works in a nursing home to take more precautions than a healthy person who lives alone and works from home, since the expected number of hospitalizations that would occur as a result of the nursing home worker contracting the virus would be significantly higher than a person who lives alone and works from home. Why? Because a healthcare worker interacts with dozens of vulnerable people on a daily basis, but a person who works from home does not.

So, what's the point of this? The only message I hear from health experts, the media, and governments, is a universal and equal plea to everyone to "stay home" and not interact with others. But, this implies that the expected consequences on society of contracting COVID are the same for everyone, which is demonstrably false as I just explained above.

I agree, it is situational. I think mixing up cases, diagnosis, and deaths is really what's driving the high numbers. Also, from experience, not all hospitals are equipped for COVID patients. When I got my test for another condition awhile back, the nurse said they "had to" write down a patient was a case for any symptoms at all. The diagnosis and other tests couldn't be made unless they sent him or her to another bigger hospital up the street. People are referred to as cases when hospitals and offices suspect they have COVID. But I do agree, watching the deaths is a bit more realistic than watching the cases. I haven't seen anything on media that shows how many do not have COVID. It would help put things into perspective.

 

[The Hammer]

I agree, it is situational. I think mixing up cases, diagnosis, and deaths is really what's driving the high numbers. Also, from experience, not all hospitals are equipped for COVID patients. When I got my test for another condition awhile back, the nurse said they "had to" write down a patient was a case for any symptoms at all. The diagnosis and other tests couldn't be made unless they sent him or her to another bigger hospital up the street. People are referred to as cases when hospitals and offices suspect they have COVID. But I do agree, watching the deaths is a bit more realistic than watching the cases. I haven't seen anything on media that shows how many do not have COVID. It would help put things into perspective.

The math there is simple. Number of cases minus number of people in country. US estimate is 318.2 million people nationwide. Last week's positive was 407,000 cases. Out of 1.1 million tests conducted. From here I would say the number of active infected is probably 3-4x higher then the tested average, based off of how fast this spreads and the fact that most are asymptomatic.

 

[The Hammer]

One of the things that bothers me about the government and media messaging about COVID-19 is the lack of nuance and critical thought applied to the messages about how people should calibrate their behaviors in order to prevent deaths and prevent hospitals from being overwhelmed.

To be more specific, the goals of masks, lockdowns, and social distancing as I understand them are to (1) Prevent as many deaths as possible, and (2) Prevent hospitals from becoming full. So, in theory, the number of cases does not matter as long as deaths and hospitalizations are minimized. In order to minimize the number of deaths and hospitalizations, each person should adjust their behavior accordingly in order to reduce the expected number of new hospitalizations that would occur as a result of them getting the virus. This expected number is a function of several variables, the most important being who this individual interacts with. For instance, a person who works in a nursing home has a much higher expected number of hospitalizations that would occur IF she contracted the virus, since the expected number of hospitalizations would be R_0 (expected number of people the virus is spread to) multiplied by the percentage of the people that would be hospitalized if they contracted the virus. As such, it makes sense for a person who works in a nursing home to take more precautions than a healthy person who lives alone and works from home, since the expected number of hospitalizations that would occur as a result of the nursing home worker contracting the virus would be significantly higher than a person who lives alone and works from home. Why? Because a healthcare worker interacts with dozens of vulnerable people on a daily basis, but a person who works from home does not.

So, what's the point of this? The only message I hear from health experts, the media, and governments, is a universal and equal plea to everyone to "stay home" and not interact with others. But, this implies that the expected consequences on society of contracting COVID are the same for everyone, which is demonstrably false as I just explained above.

A person's risk of catching CoV, fluctuates based off of what they are doing. Grocery shopping increases risk, working not at home increases risk, etc etc. The lowest common denominator blanket messaging is normal for a widespread situation. B giving the most strict advice possible, they cover as many extraneous cases as possible.

Military does the same thing. Rules and Regulations are established at a lowest common denominator level. ie. If 0.08BAC is the legal drinking and driving limit, then for the military it is 0.01BAC so as to cover as much "nuance" as possible, to bring the cases as close to Zero as possible.

 

[Unveiled Artist]

The math there is simple. Number of cases minus number of people in country. US estimate is 318.2 million people nationwide. Last week's positive was 407,000 cases. Out of 1.1 million tests conducted. From here I would say the number of active infected is probably 3-4x higher then the tested average, based off of how fast this spreads and the fact that most are asymptomatic.

Not many people have a calculator to do subtraction, though. The media puts more emphasis on cases, deaths, and asymptomatic and not enough emphasis on life. In other words, more negatives rather than positives. Of course it's informative to be updated with the numbers. The OP mentioned it depends on the situation and whether one is at high risk environment or not. Our focus should be on the people not statistics.

 

[Almighty God]

I agree, it is situational. I think mixing up cases, diagnosis, and deaths is really what's driving the high numbers. Also, from experience, not all hospitals are equipped for COVID patients. When I got my test for another condition awhile back, the nurse said they "had to" write down a patient was a case for any symptoms at all. The diagnosis and other tests couldn't be made unless they sent him or her to another bigger hospital up the street. People are referred to as cases when hospitals and offices suspect they have COVID. But I do agree, watching the deaths is a bit more realistic than watching the cases. I haven't seen anything on media that shows how many do not have COVID. It would help put things into perspective.

That's true, but not exactly my point. To try to summarize it more concisely: Since the goal is minimizing the number of hospitalizations, a person's behavior should be calibrated based on the expected number of severe cases that would occur as a result of them getting the virus. Obviously this number is vastly different depending on the person. Wanna know who is primarily causing hospitalizations and deaths? Healthcare and nursing home workers who don't take precautions, NOT the average person.

 

[Unveiled Artist]

The math there is simple. Number of cases minus number of people in country. US estimate is 318.2 million people nationwide. Last week's positive was 407,000 cases. Out of 1.1 million tests conducted. From here I would say the number of active infected is probably 3-4x higher then the tested average, based off of how fast this spreads and the fact that most are asymptomatic.

A good example of number-obsession is if there were five people who had COVID and thousands of people who had not, would people take COVID just as seriously as they do now (hypothetically assuming the numbers have flipped flopped)?

 

[The Hammer]

Not many people have a calculator to do subtraction, though. The media puts more emphasis on cases, deaths, and asymptomatic and not enough emphasis on life. In other words, more negatives rather than positives. Of course it's informative to be updated with the numbers. The OP mentioned it depends on the situation and whether one is at high risk environment or not. Our focus should be on the people not statistics.

Our focus is fine where it is afaic, people just need to actively heed the advice that's been put out, and use critical thinking, yet they don't.

Wear a mask, stay roughly 6 ft apart where possible, and avoid going out for non-essential purposes. Easy day.

Our issue in the US is not the Medias reporting on Covid. It's on our administrations lack of clear directives from the get go, by not following expert opinion to begin with. And going of off Gut and Instinct.

 

[Almighty God]

A person's risk of catching CoV, fluctuates based off of what they are doing. Grocery shopping increases risk, working not at home increases risk, etc etc. The lowest common denominator blanket messaging is normal for a widespread situation. B giving the most strict advice possible, they cover as many extraneous cases as possible.

Military does the same thing. Rules and Regulations are established at a lowest common denominator level. ie. If 0.08BAC is the legal drinking and driving limit, then for the military it is 0.01BAC so as to cover as much "nuance" as possible, to bring the cases as close to Zero as possible.

Fair enough, however, wouldn't you agree that an emphasis should be placed on those who are routinely exposed to a high number of vulnerable people? Something like: "Everyone should stay home, ESPECIALLY those who interact with high risk people who have a higher probability of being hospitalized."

Furthermore, in your drinking and driving example, would you not agree that the penalties for drunk driving should correlate with the likelihood of crashing based on BAC level? For instance (I don't remember the numbers exactly), I think it is something like 5-10 times more likely to crash at .08, and as high as 300 times more likely to crash at .20. Doesn't it make sense to make the penalty more severe for driving at .20 instead of .08, just like the fines for driving 100 mph on the freeway are higher than for driving 75 mph? I'm not disagreeing with you exactly, but my problem is that no distinctions are being made.

 

[The Hammer]

A good example of number-obsession is if there were five people who had COVID and thousands of people who had not, would people take COVID just as seriously as they do now (hypothetically assuming the numbers have flipped flopped)?

Your simplifying this way too much.

Do you have any background in Disease vectoring or Epidemiology? My knowledge there is minimal, so I don't pretend to have info I don't. Also people don't behave as expected (ever).

We can't project into/onto an event that has not and will not occur without proper modeling so I will not reply here as to what our response would or should be, it's a pointless endeavor.
Y goal is to ensure that people take this virus seriously, so people like my rather healthy wife, don't get sick and nearly die while hospitalized because no one wants to take Covid seriously.

My cousin is an ER Doctor down in Seattle at UW and she is so burned out right now due to cases, she hasn't been home in over a week.

 

[The Hammer]

Fair enough, however, wouldn't you agree that an emphasis should be placed on those who are routinely exposed to a high number of vulnerable people? Something like: "Everyone should stay home, ESPECIALLY those who interact with high risk people who have a higher probability of being hospitalized."

Furthermore, in your drinking and driving example, would you not agree that the penalties for drunk driving should correlate with the likelihood of crashing based on BAC level? For instance (I don't remember the numbers exactly), I think it is something like 5-10 times more likely to crash at .08, and as high as 300 times more likely to crash at .20. Doesn't it make sense to make the penalty more severe for driving at .20 instead of .08, just like the fines for driving 100 mph on the freeway are higher than for driving 75 mph? I'm not disagreeing with you exactly, but my problem is that no distinctions are being made.

As far as the drunk driving, no I am ok with blanket penalties in this regard. Just like I am OK with flat tax rates. The people that are at the highest risk (nursing home workers, doctors, nurses, public service sector) are being given that advice typically from their doctors or employers, but again the Media and News organizations are set to the Lowest Common denominator, that way they cover as Many people/cas s as possible.

Our messaging could have been better on the beginning, but we also didn't know as much about this virus then as we do now.

 

[Unveiled Artist]

Our issue in the US is not the Medias reporting on Covid. It's on our administrations lack of clear directives from the get go, by not following expert opinion to begin with. And going of off Gut and Instinct.

It's because of bad timing not people's ignorance over a health related situation. Most people know to protect themselves from contagious disease. When it's in the middle of a political "election war" some people loose sight of that. I understand why.

A lot of the health advice changed over time (which makes sense the more you know, the more instructions fluctuate). Keeping up with everything, I can see why people are all over the place.

My thing has always been about the attitude. I think people can cooporates better and think (both sides) when you guys aren't attacking each other.

But, I get what you're saying... so it's really not the people's fault (in my opinion) but the government's fault. Now wonder people are protesting.

 

[The Hammer]

It's because of bad timing not people's ignorance over a health related situation. Most people know to protect themselves from contagious disease. When it's in the middle of a political "election war" some people loose sight of that. I understand why.

A lot of the health advice changed over time (which makes sense the more you know, the more instructions fluctuate). Keeping up with everything, I can see why people are all over the place.

My thing has always been about the attitude. I think people can corporates better and think (both sides) when you guys aren't attacking each other.

But, I get what you're saying... so it's really not the people's fault (in my opinion) but the government's fault. Now wonder people are protesting.

I bolded this particular portion here because I think that this is innacurate. I don't think the average person has the no how to properly reduce their risk of disease. We don't get sick enough anymore to have the instincts of what to do/avoid, not like we would have had 100kya.

I can walk into a bathroom with 30 men and watch 7 of them wash their hands when done, while the other 23 walk out. I see hundreds of pepe daily out without masks on, and even more wearing them incorrectly (nose showing). People do not know how to protect themselves because the average person thinks, it won't happen to me. Not realizing that it isn't about whether or not it happens to them, it's about whether or not they unknowingly have it, and are giving it to others by accident through daily activities.

 

[Almighty God]

As far as the drunk driving, no I am ok with blanket penalties in this regard. Just like I am OK with flat tax rates. The people that are at the highest risk (nursing home workers, doctors, nurses, public service sector) are being given that advice typically from their doctors or employers, but again the Media and News organizations are set to the Lowest Common denominator, that way they cover as Many people/cas s as possible.

Our messaging could have been better on the beginning, but we also didn't know as much about this virus then as we do now.

Hmm. Can't say I agree. Let's say the speed limit is 45. Should a person driving 46 be given the same fine as a person driving 106? If not, then what's the difference between this and drunk driving? Exceeding the speed limit by a small amount increases the likelihood of crashing by a smaller amount than exceeding the speed limit by a large amount. In the same way, exceeding the drinking limit by a small amount increases the likelihood of crashing by a smaller amount than exceeding the drinking limit by a large amount.

 

[A Vestigial Mote]

Hmm. Can't say I agree. Let's say the speed limit is 45. Should a person driving 46 be given the same fine as a person driving 106? If not, then what's the difference between this and drunk driving? Exceeding the speed limit by a small amount increases the likelihood of crashing by a smaller amount than exceeding the speed limit by a large amount. In the same way, exceeding the drinking limit by a small amount increases the likelihood of crashing by a smaller amount than exceeding the drinking limit by a large amount.

Not apples to apples in your analogy. A better analogy to your OP (and concerns therein) would be that "Person A" has been assigned a speed limit of 45, and "Person B" has been assigned a speed limit of 85. Now... take that as the perspective, and it automatically becomes clear that such a system just isn't going to work, nor is it at all feasible to manage or even begin to enforce by anyone at all. Not to mention that "Person A" is very likely sitting there complaining about how "Person B" gets to go 85 mph, and may very likely skirt the 45 mph guidelines they have been give as they can get away with. If everyone is assigned 45 mph as their speed limit, then you always know who is in violation and when, and no one can make excuses or point to some other guy who gets more and how unfair it all is.

 

[Left Coast]

One of the things that bothers me about the government and media messaging about COVID-19 is the lack of nuance and critical thought applied to the messages about how people should calibrate their behaviors in order to prevent deaths and prevent hospitals from being overwhelmed.

To be more specific, the goals of masks, lockdowns, and social distancing as I understand them are to (1) Prevent as many deaths as possible, and (2) Prevent hospitals from becoming full. So, in theory, the number of cases does not matter as long as deaths and hospitalizations are minimized.

Incorrect. Illness is still undesirable, and a drain on the system, whether the sick person has to be hospitalized or not.

In order to minimize the number of deaths and hospitalizations, each person should adjust their behavior accordingly in order to reduce the expected number of new hospitalizations that would occur as a result of them getting the virus. This expected number is a function of several variables, the most important being who this individual interacts with. For instance, a person who works in a nursing home has a much higher expected number of hospitalizations that would occur IF she contracted the virus, since the expected number of hospitalizations would be R_0 (expected number of people the virus is spread to) multiplied by the percentage of the people that would be hospitalized if they contracted the virus. As such, it makes sense for a person who works in a nursing home to take more precautions than a healthy person who lives alone and works from home, since the expected number of hospitalizations that would occur as a result of the nursing home worker contracting the virus would be significantly higher than a person who lives alone and works from home. Why? Because a healthcare worker interacts with dozens of vulnerable people on a daily basis, but a person who works from home does not.

So, what's the point of this? The only message I hear from health experts, the media, and governments, is a universal and equal plea to everyone to "stay home" and not interact with others. But, this implies that the expected consequences on society of contracting COVID are the same for everyone, which is demonstrably false as I just explained above.

Staff in healthcare settings do take more precautions than average Joe's and Jane's working from home. They wear additional PPE, for example. Tbe messages you're hearing are ones for the general public. And that messaging is accurate: everyone should stay home as much as feasible.

 

[The Hammer]

Hmm. Can't say I agree. Let's say the speed limit is 45. Should a person driving 46 be given the same fine as a person driving 106? If not, then what's the difference between this and drunk driving? Exceeding the speed limit by a small amount increases the likelihood of crashing by a smaller amount than exceeding the speed limit by a large amount. In the same way, exceeding the drinking limit by a small amount increases the likelihood of crashing by a smaller amount than exceeding the drinking limit by a large amount.

Speeding is on a spectrum, catching a disease is not on a spectrum, you either have it or don't.

You can speed a little bit, but you don't only get partially sick, you are either infected/ious or not. And should (like a gun, if you know weapons safety) always act like you're contagious.

 

[sun rise]

To be more specific, the goals of masks, lockdowns, and social distancing as I understand them are to (1) Prevent as many deaths as possible, and (2) Prevent hospitals from becoming full.

Those are primary goals. Other goals include to prevent long term disability and minimize economic damage.

I would agree that nuance in messaging would be better IF people were thoughtful and kept well-informed. Given the reality of too many people, that's not the case. A simple message might get through while a nuanced message would confuse people.

Personally I read bits and pieces of actual research results, read high quality and reliable medical web sites as well as noting research on the effectiveness of different kinds of masks. My behavior is based on that knowledge.

So, for example, having an idea of how long the virus survives on various surfaces, I reuse masks after they've sat for a few days sometimes, discard them after I've been in elevated risk locations such as grocery stores other times and so forth.

 

[lewisnotmiller]

One of the things that bothers me about the government and media messaging about COVID-19 is the lack of nuance and critical thought applied to the messages about how people should calibrate their behaviors in order to prevent deaths and prevent hospitals from being overwhelmed.

To be more specific, the goals of masks, lockdowns, and social distancing as I understand them are to (1) Prevent as many deaths as possible, and (2) Prevent hospitals from becoming full. So, in theory, the number of cases does not matter as long as deaths and hospitalizations are minimized. In order to minimize the number of deaths and hospitalizations, each person should adjust their behavior accordingly in order to reduce the expected number of new hospitalizations that would occur as a result of them getting the virus. This expected number is a function of several variables, the most important being who this individual interacts with. For instance, a person who works in a nursing home has a much higher expected number of hospitalizations that would occur IF she contracted the virus, since the expected number of hospitalizations would be R_0 (expected number of people the virus is spread to) multiplied by the percentage of the people that would be hospitalized if they contracted the virus. As such, it makes sense for a person who works in a nursing home to take more precautions than a healthy person who lives alone and works from home, since the expected number of hospitalizations that would occur as a result of the nursing home worker contracting the virus would be significantly higher than a person who lives alone and works from home. Why? Because a healthcare worker interacts with dozens of vulnerable people on a daily basis, but a person who works from home does not.

So, what's the point of this? The only message I hear from health experts, the media, and governments, is a universal and equal plea to everyone to "stay home" and not interact with others. But, this implies that the expected consequences on society of contracting COVID are the same for everyone, which is demonstrably false as I just explained above.

Speaking from a different situation to what the US is in, but definitely another factor worth considering is contact tracing. It's a MAJOR factor here, in so far as each instance of COVD results in an attempt to trace all contacts, and get them to test, as a means of preventing the disease spreading.
At a certain point of saturation, that becomes impossible, but our response to that was a hard lockdown until it became once again possible.

This prevents the exponential growth in numbers. Whilst I might not require hospitalisation if I get COVID, and the ten people I contact might not, if each of those ten then contact another ten...well, somewhere in that growth cycle the problem lies.

 

[Unveiled Artist]

That's true, but not exactly my point. To try to summarize it more concisely:

Since the goal is minimizing the number of hospitalizations, a person's behavior should be calibrated based on the expected number of severe cases that would occur as a result of them getting the virus.

Obviously this number is vastly different depending on the person. Wanna know who is primarily causing hospitalizations and deaths? Healthcare and nursing home workers who don't take precautions, NOT the average person.

It makes sense that healthcare workers would take more precautions than lay people. Are you saying (after re-reading the OP) that the media and orders are not taking each person's account differently based on whether one is at high risk than someone who is not?

How do you know they aren't taking precautions?

Is there a comparison chart (of some sort) that shows high death rates caused by healthcare professionals given their high risk as opposed to layman who are not at high risk?