
Social distancing slowing not only Covid-19, but other diseases too - prostoalex
https://qz.com/1824020/social-distancing-slowing-not-only-covid-19-but-other-diseases-too/
======
ineedasername
There could be some selection bias here. It's based on thermometer readings
from Kinsa. And the articles states:

 _Kinsa is receiving two to three times more thermometer readings per day than
in previous flu seasons_

Many more people may be taking thermometer reading that don't really need to,
but are being cautious. That would cause the appearance of a proportional drop
in high temp readings compared to prior years when really it's just that lots
of not-so-sick people are taking their temp lots more.

~~~
JMTQp8lwXL
> Due to the emergence of the coronavirus, Kinsa is receiving two to three
> times more thermometer readings per day than in previous flu seasons.
> Historically, Kinsa’s methods have been able to account for a sharp rise in
> the number of people taking tests, said Benjamin Dalziel, a professor at
> Oregon State University who studies infectious diseases. For his research,
> Dalziel has ensured that a spike in testing didn’t lead to inaccurate
> predictions, and so he believes the current decline in illness is a result
> of social distancing, and not a statistical anomaly. (Dalziel has had
> research funded by Kinsa in the past).

It seems to be accounted for.

~~~
ineedasername
That'll teach me to rush to comment when I see something "off" instead of
reading the whole thing. I'm tempted to delete a post that isn't useful now,
but I should leave it as a minor embarrassing lesson to myself. I wish people
would stop upvoting me though... Each one makes me cringe: another person who
didn't read very carefully.

~~~
impendia
I agree with your original point, even if you no longer stand by it.

>Historically, Kinsa’s methods have been able to account for a sharp rise in
the number of people taking tests

What historical precedent is Kinsa referring to? There has never before been a
pandemic of this magnitude, in a time and place where many people owned
internet-connected thermometers.

Perhaps I am being uncharitable, but it seems that they are leaping to
conclusions here. I'm sure that they have done their best to account for this,
but the claim that "Dalziel has ensured that a spike in testing didn’t lead to
inaccurate predictions" is one I find difficult to take at face value.
_Ensured_?

You said that "there could be some selection bias here." _Could_. Sorry to
cause you to cringe again, but +1.

~~~
Bartweiss
I don't think this is uncharitable at all. I'm sure Kinsa has made a good
effort at controlling for testing frequency, and I'm sure it's helped. But
there's no reason to think the dynamics of COVID-motivated testing are the
same as for flu-season, or new-buyer novelty, or anything else.

And more importantly, _how could we know if it is_? That's not just a Kinsa
problem; we see this over and over again with peer-reviewed studies that
"control for" certain factors like socioeconimics or health history. They're
inherently limited to controlling for what they know about, and it's never
perfect. Often, the entire effect is from an undiscovered variable. Take, say,
the widely-promoted study finding that visiting a museum, opera, or concert
just once a year is tied to a 14% decline in early death risk. The researchers
tried to control for health and economic status, then concluded "over half the
association is independent of all the factors we identified that could explain
the link." [1]

Now, what seems more likely: that the unexplained half is from the profound,
persistent social impact of dropping by a museum or concert once a year? Or
that some of the explained factors like "civic engagement" can't be defined
clearly, others are undercounted (e.g. mental health issues), and some were
missed entirely?

I suspect Kinsa did much better than that, because they're not trying to
control for such vague terms. But I think "even after controlling for" should
basically _never_ rule out asking "what if it's a confounder"?

[1] [https://www.cnn.com/style/article/art-longevity-
wellness/ind...](https://www.cnn.com/style/article/art-longevity-
wellness/index.html)

------
rossdavidh
It's fascinating data, and I'm glad it's being taken, but...I am a bit
skeptical that we can draw any reasonable conclusions from it without limiting
the data to long-term users.

It seems implausible that there has not been a significant change in the
health-consciousness of the typical purchaser in the last month or two, vs.
prior to that. I can't tell you what the change would be, but I find it highly
implausible that it would be not at all different, given the biggest spike in
public awareness of a health issue in several decades.

It's nice to see that Dalziel has thought of the issue, but the article
doesn't tell us much about _how_ he accounted for that. I could think of ways,
but I could also think of ways to screw it up, and it doesn't say in this
article how he "ensured" that the effect is real.

~~~
peter_retief
There has also been a decrease in traffic accidents and violent crime. This is
data from hospital casualty units in South Africa

~~~
Swenrekcah
I’m purely guessing, but maybe the traffic deaths have decreased linearly with
traffic, and violent crime in some porportion to gathering size.

That is to say, that it’s due to less activity and not a changed mindset.

~~~
ekianjo
I doubt traffic accidents and traffic have a linear correlation. I would
assume it looks very different depending on the density of the traffic, i.e.
not linear at all.

------
andreygrehov
Randall Munroe did a small section on eradicating the common cold in his What-
if book, the basic idea is if that all of humanity stayed away from each other
for a week or two then the common cold would die out as it can't survive
outside of the human body for more than a week and normally survives by
continuously hopping from host to host.

~~~
saalweachter
This current situation had me wondering how hard it would be to coordinate a
regular -- maybe not yearly -- global self-isolation for say 2-3 weeks at a
time.

Aside from the difficulties of getting everyone in the world to agree that the
first three weeks of February during a leap year are observed through social
distance, it doesn't seem like it would be as bad on a recurring basis as it
is during an emergency like this. You could plan for your self-isolation in
advance, so there wouldn't be a rush for supplies the way there is now; you
would already know not to schedule anything for February; you'd probably still
have to solve some money problems for a large number of people, since being
able to WFH probably anti-correlates with living paycheck to paycheck.

If you could actually eliminate -- or at least, dramatically reduce the
incidence of -- common colds and seasonal flu through such a scheme, it would
probably be worth both from a QoL standpoint for the everyone in the world
(would you trade 3 weeks of cabin fever every four years for never having
another actual fever?) and from an economic standpoint (three weeks of
predictable low productivity is almost certainly better than the unpredictable
constant costs associated with illness and death).

~~~
myself248
I've theorized this about sexually transmitted diseases, too. It's even less
realistic to imagine compliance, but suppose everyone only had sex with people
who were born the same year as them. Any given disease would lose the ability
to spread into younger people, and simply fall off the end of the age
conveyor-belt.

~~~
javagram
It’s pretty easy to stop STDs just by only ever having sex with 1 person, or
more liberally, 1 person at a time and both getting tested before then. Having
to go with the “same year” rule is probably harder than that.

~~~
Cogito
Small reminder that STIs are not just transmitted by 'sex', but also through
other intimate acts like kissing.

The only suggestion that seems remotely plausible is 'all participants getting
tested first'. There are still issues with getting tested, as there are false
negatives and it can be hard to get tested for all diseases, but this would
dramatically reduce incident of STIs.

------
Robotbeat
I've noticed this anecdotally. My son usually goes to preschool (and Sunday
school and playdates and museums and parks). He has had an almost constant
runny nose for a while... as soon as one virus is fought off, another takes
its place. Nothing major, but clearly annoying to him (cheek red due to him
wiping his nose, in spite of our efforts to keep his face clean). A few days
to a week after soft-quarantine (school and church cancelled), his runny nose
is gone and hasn't come back.

~~~
o-__-o
This also means your little one is not getting that community immunity. You
want your little one to get sick at a young age to ward of invaders as they
get older.

Anecdote: my niece gets sick badly and passes it on to everyone in her house
at least every other month. She does not got to daycare. My LO does go to
daycare and comes home with a new mild sickness once every third week and is
fine a few days later. I’m interested to see how he fairs when school opens up
again

~~~
op00to
I could say the opposite. My son was sick 3 times prior to entering school, we
took care of him at home until age 5. Each resolved in a day or so. Upon
attending school, he’s got his share of colds and a fever or two, and clears
them out quickly.

------
tomerico
Here is a reason to believe that the data is biased. If you look at any county
in California - you’d see a large drop on the exact date that the statewide
shelter in place was ordered. This is obviously before any of the effects of
isolation would manifest themselves.

The reason is likely due to larger amount of testing done due to the panic,
that is not properly accounted for in their algorithm.

~~~
01100011
For what it's worth, some populations began isolating before the shelter in
place order. I went to Ranch 99 on 2/28 and panic buying was already in full
swing. Lots of masks. I think the Chinese community was very proactive and
took action early. It left an impression on me and I started WFH full time. I
think that was the day they announced the second community infection in Santa
Clara county.

------
mrfusion
I’ve heard there are 200 different cold viruses. It’s conceivable at least a
few of them become eradicated after this.

Anything with a low r0 is going to have a lot of trouble surviving right now.

------
mrfusion
Influenza only has an R0 of 1.3. I really wonder if we’ve managed to push it
below 1.0 world wide. Pretty wild to think about.

1.3 really isn’t that much. What if all the new people who’ve started washing
their hands keeps it below 1.0?

~~~
cycomanic
And then we would get an pandemic of another influenza type virus rushing
through the population like wildfire because nobody is immune. It's very
difficult to completely eliminate infections (even polio is still around
despite extensive immunisation), especially if it mutates as much as
influenza.

A little known fact btw, most of the influenza virii are descendents of the
Spanish flu which have mutated to be less deadly.

~~~
lotsofpulp
> It's very difficult to completely eliminate infections (even polio is still
> around despite extensive immunisation),

This is only the case because some people are refusing vaccinations, or not
able to get them.

------
lalos
"Historically, Kinsa’s methods have been able to account for a sharp rise in
the number of people taking tests, said Benjamin Dalziel, a professor at
Oregon State University who studies infectious diseases. For his research,
Dalziel has ensured that a spike in testing didn’t lead to inaccurate
predictions, and so he believes the current decline in illness is a result of
social distancing, and not a statistical anomaly. (Dalziel has had research
funded by Kinsa in the past)."

Huh, I was expecting the opposite of this. The previous data could be slightly
off because of smaller sample size and now that it has exploded they have a
better estimate to reality.

~~~
feanaro
The problem is the sample isn't random.

------
jakewins
Does anyone know if they account for their user base presumably being
mismatched with actual demographics?

ie. I assume their users are going to correlate with tech-savvy people, in
turn correlating with people able to work from home, giving a severely skewed
sample

------
FpUser
Well, the ultimate example of "social distancing" were tiny island nations.
They got visited by Europeans, caught whatever bugs they brought and now
they're all dead.

If you do not train your immune system it'll fail you. When we have some major
epidemic with an ugly consequences coming then sure social distancing can
help. However taking social distancing as a generic strategy for out future
lives I think will lead to a major f.. up.

------
kanox
Social distancing is pretty great.

My company temporarily banned meetings with more than 6 people; this should be
permanent.

------
phantom784
What about selection bias? I'd think that people are more likely to use a
thermometer even if they don't feel like they have a fever now than they would
have previously. That could account for numbers going down.

~~~
roywiggins
They think they have been able to correct for that.

> Due to the emergence of the coronavirus, Kinsa is receiving two to three
> times more thermometer readings per day than in previous flu seasons.
> Historically, Kinsa’s methods have been able to account for a sharp rise in
> the number of people taking tests, said Benjamin Dalziel, a professor at
> Oregon State University who studies infectious diseases. For his research,
> Dalziel has ensured that a spike in testing didn’t lead to inaccurate
> predictions, and so he believes the current decline in illness is a result
> of social distancing, and not a statistical anomaly. (Dalziel has had
> research funded by Kinsa in the past).

------
sudoaza
I was hoping for this, lets do social distancing a tradition for every winter

~~~
scrollaway
Do you really think we're going to come out of this period causing people to
lose their jobs, lose their savings, lose their loved ones, not see their
friends, stop going to sports and social events… and everyone's going to be
like "Hey, that was fun, let's do it again next year"?

~~~
fiblye
Some countries have week-long holidays where most people go home/travel/don't
work. Their economies aren't dead.

Make it a tradition where everyone with non-essential work stays home at least
one week a year, all at the same time. More time is better, but even a little
bit would likely cut back on disease. Governments already define Christmas/New
Years/etc as a holidays and huge numbers of people aren't working on those
days and economies don't die. It wouldn't be hard for companies to promote
"Pre-Stay Home Week Extravaganza" sales and make people actually look forward
to staying home, eating and watching movies/playing games/whatever.

~~~
Terretta
In Europe this is called "August".

~~~
orangecat
_In Europe this is called "August"._

But without the social distancing aspect.

------
anonsubmit2671
Apparently, the new term is "physical distancing," because it's not like
people are mass unfriending people or calling them Mr./Mrs. SoAndSo.

~~~
noway421
Funny thing is, term "physical distancing" doesn't make sense without
mentioning "social distancing", because without that context and by itself it
might mean different things.

------
beamatronic
“What if we made a better world...and it was all for nothing”

------
stagas
I am betting also driving and particularly drunk driving related accidents and
deaths will also drop during this quarantine.

~~~
Exmoor
..And suicides will likely go way up.

Probably a lot of other issues as well that may be more difficult to track.
Mental health crisis, domestic violence, etc.

~~~
dlivingston
As you hint at, unemployment numbers are directly proportional to suicide
rates. The effects of shutting down the world are much higher than just missed
paychecks and business bankruptcies. You list a few of them.

There must be a cost-benefit analysis done where we find the breakeven point
between lives saved by quarantine vs. lives damaged by quarantine side
effects.

~~~
marcosdumay
The entire world is going on with it this time because the cost-benefit
analysis is quite trivial. The entire world also doesn't go with it every few
years to stop the flu because the cost-benefit analysis is quite trivial.

There has got to be something in between, but on the land of exponential
growth and slow-down, that line is very thin. This one pandemic will cross the
line at some point, but I bet we will resume business as usual even before
that.

------
bluedevil2k
I was thinking if we go all in on this stay-in-place and we get it working
around the world, could we eliminate measles? Chicken pox? Any other human-
virus disease that relies on human-to-human contact to spread?

~~~
nxc18
Unfortunately, I think a more significant cause of the continued existence of
these diseases is failure to vaccinate, either by choice (anti-vax) or due to
circumstance (cost of vaccination, access to health care, etc).

There are several diseases that society could eradicate that we simply choose
not to.

Even wealthy tech people are affected by this; I was just told my very good
insurance doesn't cover a vaccine that my doctor prescribed. It would cost
$400, so I need to weigh my actual risk of getting the disease against cost of
vaccination. I'd think the long-term return on investment for society would
justify making just about every vaccine free to all.

edit: consider how much easier it is to just get a few shots, compared to
never going to a bar, restaurant, sporting event, public transit or shared
workspace ever again. Going all-in on social isolation is a nonstarter, even
discounting the people who won't comply (there are many) or the toxic
political environment that has pitted half the US against science and
expertise.

~~~
dathinab
Not sure why you got down voted, I can only agree.

Social distancing only slows distribution it doesn't prevent it reliably also
some disease are spread by animals which are not at all affected by social
distancing.

And then vaccines are also not enough as it had shown for some disease where
we did try to eliminate them by handing out free vaccines in affected
countries.

Lastly social distancing has a super high cost if continued. Not only
economically but a super high health cost. Humans are not meant to live
permanently social distanced they are inherently social animals and the
internet can't really replace it. E.g. for people fighting depression social
distancing can be like poison. It prevents them or at least restrict them from
doing many the thinks which can help fighting depression and causes "physical"
isolation (Internet is helping but has limits, it's not helping enough to
counter it). Another group most likely majorly negatively affected are people
with "home" problems, like violent partners or parents (or just to controlling
partners or parents). To just name some example.

------
aaron695
> they may not have realized that they were also combatting other infectious
> diseases, such as the seasonal flu.

No, they fully realise. We have to also reduce the flu. It also takes up many
ICU beds. This is vital. Any plan knows this.

Whether they are implementing measure like free Flu shots and are ramping up
supply of Flu shots using the military if they have to, I doubt, because no
one wants to think ahead more than a day.

------
known
India is practicing Untouchability for 2700 years
[https://en.wikipedia.org/wiki/Rigveda](https://en.wikipedia.org/wiki/Rigveda)

Social Distancing is not different/difficult for them;
[http://archive.vn/bEMTt](http://archive.vn/bEMTt)

------
hyperdunc
"Social distancing" is such a weird and ambiguous phrase. Are we not
socializing right now over the Internet while maintaining physical distance?
Arguably, we're socially closer than before because of this crisis.

~~~
mrob
Which is why the WHO changed their recommended terminology to "physical
distancing". Previous HN discussion:

[https://news.ycombinator.com/item?id=22665506](https://news.ycombinator.com/item?id=22665506)

~~~
hyperdunc
Difficult to replace a phrase that's already caught on. Good to know, though.

------
rossdavidh
Hypothesis: people who are stuck at home have more time and inclination to
check their temperatures, even when they don't feel sick.

~~~
maxerickson
That wouldn't generate an unusual number of 'fever' readings, and then a
pretty simple model would do some accounting for repeated use of each
thermometer (so 'extra' normal readings shouldn't be reducing the expected
number of 'fever' readings).

~~~
rossdavidh
Agreed, but it could easily generate an unusual number of "not a fever"
readings, which would make it look as if there were a smaller than normal
number of people getting sick with the flu. Or, maybe it doesn't do that. I
don't see how you can say for certain which way it would shift, but I find it
implausible that it would stay the same.

~~~
maxerickson
That's what I mean by a simple model.

Like a dead stupid one would be to compare to historical data for fevers/week
per thermometer.

That is barely a model at all and it manages to ignore how many readings are
done and accounts for multiple readings during a period of illness and
readings for multiple sick members of a household and so on.

------
101404
Sounds more like more people are taking their temperature despite not feeling
sick. Hence the sudden increase in readings they receive. So a pronounced
decline in the percentage of high temperature readings should be expected.

------
geuis
Wish I had seen this hours ago.

Their data is visualized at
[https://healthweather.us/](https://healthweather.us/)

I’ve been checking this daily for the last week or so.

------
ggm
I expect norovirus and rotovirus D&V will decline but salmonella will rise.
Maybe even accidental mushroom poisoning, ptomaine? (Foraging, tinned meat)
and bad salami caused an outbreak of life threatening kidney and other
problems in South Australia some years back, so people going into cured meats
be warned.

Alcohol poisoning from home stills is a constant.

~~~
belenos46
I'm not too worried about alcohol poisoning RE: home stills. It's people who
don't toss the heads and tails that have a bad time: methanol poisoning sucks,
and is the cause of most home distilling dangers (blindness, kidney failure,
etc).

~~~
ggm
This is what I suspect most people will miss. Worldwide I think alcohol
poisoning is adulteration of spirits with industrial alcohol but the heads and
tails are not just methanol, it can have metal and chemical residues as well.

------
agumonkey
A worldwide fast through slow

------
deevolution
I wonder if viruses will adapt to this hostile social distancing climate.

------
lez
I prefer to call it physical distancing. Social distancing is when the
Internet goes off.

------
a_t48
I was just wondering about this yesterday. Neat, thanks for sharing.

------
bregma
I image new cases of the clap are going to tumble precipitously.

------
jb775
TLDR: Social distancing is also slowing the normal flu

------
MobileVet
Just imagine how many fewer people would fall ill each year with the flu if we
didn’t shake hands as our default greeting?

~~~
fiblye
I really hope this helps kill the concept of handshaking entirely.

Unfortunately, there's still a large segment of dirty-handed people who think
you can judge a person based on their handshake.

~~~
SomeGuy789
There's a lot of hidden value in physical contact. I don't think it should be
disregarded so easily considering society as a whole became much more distant
in recent years.

~~~
fiblye
Potentially. But I find there to be zero value in touching the hands of
someone I only just learned the name of. Especially considering I don't even
know whether they're the type to cough in their hands, or the type to not wash
after using the toilet.

Bro hug with a friend I haven't seen in a while? Okay. Sweaty hand contact
with a stranger? Never.

~~~
hackeraccount
The danger is higher - that's exactly why we do it. It's an easy way to create
intimacy with a stranger quickly. There's a reason politicians shake hands and
kiss babies.

~~~
fiblye
Handshakes far predate modern germ theory of disease. The "danger" doesn't
really help with intimacy in any way. It's completely unnecessary danger. We'd
find sharing tissues with strangers to be disgusting if it were introduced as
a greeting today, but touching the hands of someone right after they've
sneezed and coughed into them--after which we often unknowingly touch our own
face--is regarded as a sign of intimacy or respect.

~~~
thaumasiotes
> We'd find sharing tissues with strangers to be disgusting if it were
> introduced as a greeting today

Sounds like you're unfamiliar with the practice of agreeing to a deal by both
parties spitting into their hand and then clasping hands?

There's also the idea of making a pledge by both parties cutting their hands
and then clasping hands, mixing blood with each other.

~~~
TheSpiceIsLife
When was the last time you saw anyone do either of those things, other than in
a movie?

~~~
thaumasiotes
I've never seen anyone bow in greeting outside a movie either. (Assuming we're
considering books to be "movies".)

------
justlexi93
This is just temporary but effective way to lessen the spread of contagious
disease. No other country wants to be the next Italy.

------
ivanhoe
the title should really be "other INFECTIOUS diseases"

~~~
mrob
Reduced air pollution reduces non-infectious disease too.

~~~
ivanhoe
Can you please explain me how is air pollution affected by social distancing?

And also article is not discussing air pollution at all, they talk about less
fevers detected on smart thermometers. Those are caused by seasonal flu and
other viral seasonal colds, obviously because people now take more care, so
those other infectious diseases are blocked from spreading too.

~~~
mrob
Physical distancing prohibits all non-essential travel, much of which would
have happened by motor vehicle.

------
ShorsHammer
The lockdown of non-essential businesses has essentially reduced traffic
accidents here to zero when usually there'd be a over a hundred deaths and few
thousand injuries per week. By comparison there's only been 20 deaths from
covid-19 over the space of 3 months, nearly all of them elderly people with
pre-existing conditions.

Yet people are emotional creatures and not all deaths are equal.

~~~
Analemma_
As of right now, covid-19 is killing about 2,200 people/day, compared to about
3,300 people/day for car accidents. So it hasn't caught up yet, but it's still
on an exponential climb and will probably get there in another week or so, and
then keep right on climbing.

This whole "the flu/cars/heart disease is way worse" shtick people are leaning
on has got to stop. It's true until exponential growth suddenly means it's
not.

EDIT: And those are the worldwide numbers. In the US specifically, covid-19 is
killing about 200 people/day, compared to 100 people/day for car accidents,
and is of course going to go way up from here.

~~~
lotsofpulp
Wouldn’t the number of people the virus will kill will reach a maximum and
then decline rapidly as the remaining population will be immune to it?

~~~
acqq
Yes, but not so soon: at the moment in most of the places it grows
exponentially, the numbers doubling every three to four days.

So "and will probably get there in another week or so" is probably too slow.
If it's really 2000 deaths per day now, I can safely estimate 4000 deaths per
day in just three to four days. Then in next 4 days it will be 8000. Save this
estimate and compare.

In order for the effect you describe to happen (the maximum to be reached) the
most popular estimate is that the number of infected has to reach around 70%
of the population. Until that point the doubling of deaths every few days,
without the measures to prevent that, would continue, deaths happening in
always bigger amounts, but concentrated in the few weeks.

