
Seattle Flu Study finds COVID19 likely spreading in Seattle for past 6 weeks - erentz
https://mobile.twitter.com/trvrb/status/1233970271318503426
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skat20phys
This has really hit home for me. I'm pretty sick with a 102 fever, cough, and
aches. My guess for various reasons is that it's influenza A, but there are
reasons to think it's not crazy to think it's COVID19.

The issue is that there's this kind of positive feedback loop about getting
tested. If you have symptoms consistent with COVID19, you're told it's
probably the flu and no need to go in and get tested unless you're high-risk.
People always say "have there been identified cases of COVID19 near you?" The
answer is basically "not that I know of," but if everyone is staying home and
not getting tested so as to not panic and overburden the system, you don't
know. As a result, it will look like nothing's there until suddenly there's a
de novo case that can't be traced to Asia, Europe, or anywhere else that's had
large numbers of cases. Then it's too late and is everywhere.

I understand the base rates, and that I probably don't have COVID19, but I
don't really have faith in assessments of where things are at if people are
rarely getting tested anyway.

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Fjolsvith
> Then it's too late and is everywhere.

So we get the flu. Life goes on.

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sixhobbits
Later in thread

> Trevor Bedford @trvrb · 14h I'd assess the p-value for this coincidence at
> 2/59=0.03 and so is statistically significant. Additionally, these two cases
> are geographically proximal, both residing in Snohomish County. 5/9

That's... really not how p values work. Does everyone have to mention p values
now just to try sound like they're authoritative?

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mlyle
I cringed when I read it. At the same time, you can have a meaningful p value
from a single observation. If you were assuming novel spread from China and a
random selection of virus genotype, you'd expect a coincidence like this to
happen about 3% of the time if the null hypothesis held. So it's not
completely bullshit.

Big caveat is-- inferring this from a single genetic difference with 59
reference sequences taken at different times is dubious. That 3% number could
be drastically different in reality.

Still-- cryptic spread from the earlier case is probably the most reasonable
explanation for what we've seen.

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unsignedint
This doesn't surprise me at all. Some country (like Japan) is seeing these
detected, because they are often seeing a doctor for the common cold. This is
very different dynamic in the country like the US where a lot of people don't
(or can't afford to) see a doctor for it -- thus I can only imagine there are
quite a few infected, but undetected cases behind numbers that are reported.

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soared
A good reply that summarizes my reaction:

Brian O'Roak @TheRealDrOLab

Replying to @trvrb

@JShendure and @seattleflustudy Do you really think Twitter is the best place
to post this information? Wild speculation on the number of cases without
confirmation is just going to panic people.

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thebigspacefuck
I've been interested in what the incentive is to avoid panicking people. What
does panic actually look like and why are people so against it? People buying
groceries and staying home? If panic looks like getting ready for a snow storm
or hurricane, staying at home watching a movie instead of going to the bar, or
washing my hands more frequently, I'm not sure what the downside is. It seems
like the outcomes are worse if you wait.

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pergadad
Panic means there's no more supermarket open because first the hordes come and
panic-buy, then the supermarket has to close as even the workers don't show
up. Panic means people not showing up to work, doctor's offices overcrowded,
streets blocked with people going to the countryside. Panic means the system
breaks down - electricians don't show up to fix issues, firefighters can't get
through as the streets are blocked, local businesses getting looted and going
bankrupt as they have to close, etc etc

Mild panic/mild fear/excessive carefulness will inconvenience you. Real panic
means people die and things break.

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sbierwagen
>streets blocked with people going to the countryside

A pandemic isn't a nuclear attack, leaving town won't get you anything.

Fleeing the towns was popular when the miasma theory of disease was in vogue,
and would have been useful for avoiding animal vectors, but you wouldn't
expect it to happen with COVID-19.

