😷 COVID | Traveling during Covid-19

[Marco]

@finley

I don’t really have any argument with the quarantine system. It’s probably the simplest, least-invasive (for the general population!) and most effective way to ensure Taiwan stays COVID-19 free, although one might argue about whether that’s even important and how long it can be sustained. It’s all the other silliness that upsets me. IMO they should just let people fly, assume that infection will spread on the plane, and use the quarantine system to deal with it.

I reckon it’s only there to discourage people from travelling here.

[finley]

@afterspivak

This allows small businesses and others to operate (mostly) as before.

Quite. The needs of the many outweigh the needs of the few. Or the one. I was railing against all the rest of the ritual, not the quarantine system.

@afterspivak

I fail to see why this is a problem.

The problem is that the Taiwanese population have not been exposed to the virus, and therefore to them it is still entirely novel. They have had no chance to build up any immunity to it, and when it gets in and runs wild (which it will, one way or another) they will have to make decisions about how to deal with an epidemic.

Of course there’s no way of knowing how that might pan out. Maybe there will be vaccines that work, or maybe there won’t. Maybe the virus will have mutated into something that’s even less virulent than it already is, and it won’t matter. The policy decision has been made, and the quarantine system is straightforward, practical, and has a very good cost-to-payback tradeoff.

[DrinkDaddy2020]

@finley

The problem is that the Taiwanese population have not been exposed to the virus, and therefore to them it is still entirely novel. They have had no chance to build up any immunity to it, and when it gets in and runs wild (which it will, one way or another) they will have to make decisions about how to deal with an epidemic

Quite the opposite actually. It’s here, but in trace amounts:

(https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(20)30041-9/fulltext)

It’s been speculated with some authority that the Bacillus Calmette-Guérin (BCG) vaccine, cheap, effective, and archaic as it is, can be somewhat effective against Covid-19. The BCG vaccine has been widely distributed in Taiwan but is not as common anymore in the West.

Studies name Bacillus Calmette-Guérin vaccine as latest help against...

[finley]

@DrinkDaddy2020

Quite the opposite actually. It’s here, but in trace amounts

It did occur to me that perhaps Taiwan is not, in fact, COVID-19 free, but simply hasn’t noticed that we have cases because the disease is usually asymptomatic in healthy individuals, or is easily confused with some minor Lurgy. Taiwan has a much lower rate of metabolic syndrome than Europe and the US (around 10-15% here, compared with 40-70% elsewhere), so the number of critical cases is going to correspondingly smaller, and it’s going to spread less dramatically.

I don’t really understand why the BCG vaccine would be helpful, and since it’s been standard in the UK for decades while the UK still has one of the highest COVID-19 death rates in the world, it doesn’t seem to be very useful in practice.

[afterspivak]

@finley

It did occur to me that perhaps Taiwan is not, in fact, COVID-19 free, but simply hasn’t noticed that we have cases

Since you just arrived here, perhaps you are unaware of the Changhua / NTU study that attempted to find out. They ended up finding a miniscule number of people with viral traces. Now it’s possible that these numbers have changed since that controversial study was conducted. But the consensus seems to be that very very few people in Taiwan have been infected and carry antibodies.

Guy

[finley]

They ended up finding a miniscule number of people with viral traces.

The paper DD links to suggests there could be (or were in Sep. 2020) several thousand people in the general population who have been infected at some point. Is that the same paper you’re referring to?

The mystery is: why didn’t those people cause an explosion of subsequent cases? It might be because of the masks etc., but in that case how did such interventions fail so badly elsewhere?

[afterspivak]

@finley

The paper DD links to suggests there could be (or were in Sep. 2020) several thousand people in the general population who have been infected at some point. Is that the same paper you’re referring to?

It’s not the same paper. The one you’re referring to has been widely dismissed as BS. The inimitable @Brianjones knows this stuff better than I do and could no doubt explain it more clearly should he be around. Other forumosans may also be able to help.

Regarding the Changhua / NTU study, you could have a look at these reports:

Changhua antibody study highlights success of CECC - Taipei Times

Low rates of COVID-19 exposure found in Changhua antibody study - Focus Taiwan

Guy

[finley]

@afterspivak

The one you’re referring to has been widely dismissed as BS.

You can’t just dismiss published papers as BS. Unless you can spot some fatal flaw in their experimental method, one has to assume they’re telling the truth.

In any case, DDs paper, and the one you’re quoting, are asserting approximately the same result, allowing for statistical noise. So if the first is BS, so is the second. They’re not entirely comparable because of different subject selection methods, but I’m not sure that that in itself puts the first paper in doubt.

If they are (both) correct, then there are perhaps 20,000 people who have, or have had, COVID-19 in Taiwan.

[afterspivak]

The difference between the paper linked by DD and the Changhua / NTU study that I mentioned is that the latter does not claim to extrapolate their findings based on a subset (in the case of the Changhua study, this included “4,841 subjects with a higher risk of COVID-19 exposure, including the contacts of confirmed cases and people in home quarantine after returning from abroad [NOTE: this is why this study was highly controversial—they yanked people out of quarantine to test them without being authorized to do so], as well as healthcare workers and other epidemic prevention staff”).

Within this presumably high exposure group in Changhua, they found “a positive rate of 8.3 per 10,000 people.” They don’t presume to state that’s the positive rate across Taiwan’s population, while IIRC the other paper does.

As I stated before, I am far from an expert in any of this. I’ll let others take over at this point.

Cheers,
Guy

[finley]

@afterspivak

mentioned is that the latter does not claim to extrapolate their findings based on a subset

Neither does the first. The extrapolation was mine.

In any case, extrapolation is valid under certain circumstances. Extrapolation of the Changhua study would not be valid because of their subject selection (what they call “high risk” individuals). The other paper just picked people at random in hospitals. There is no reason to believe that people in hospitals are in any important respect different from the general population (at least not regarding their COVID-19 exposure) so extrapolation is not entirely unreasonable. One merely needs to be aware that both signal and noise are amplified in the extrapolation, and there is a lot of noise because of the small number of participants, the low prevalence of the disease, and the false positive rate of the testing method. Which is why I wrote ‘20,000’ to one significant figure.

Might be 10,000, or it might be 50,000, but it’s not just a handful of cases. And as BrianJones often points out, even a handful can quickly become several thousand if they are roaming around unidentified. So why didn’t it happen?

@afterspivak

I am far from an expert in any of this.

I am, at least regarding experimental design and statistics.

[Brianjones]

@finley

And as BrianJones often points out, even a handful can quickly become several thousand if they are roaming around unidentifie

Yep, coronavirus is extraordinarily infectious as we have seen. It doesn’t hang around doing nothing much. There’s no proven immunity out there to it unless you have been exposed or vaccinated.

I haven’t read both those papers in detail, I skimmed the Changhua one previously that’s all.

I have read quite a few hacked together papers on covid infection though and you just cant extrapolate across a population from one local study at one point in time with one testing technology with poor specificity.

I only trust continuous monitoring studies at multiple sites to get a true picture of the trends…Are they going up…Are they going down.

It’s easier to see these kinds of trends than to get the absolute numbers out there that have been infected or are currently infected .

The UK government is actually acutely aware of this problem (bias in the results from the technology used and biomarkers assessed ) so they are trying to bring in new platforms to compare against PCR and antibody and antigen tests.

[ponlaihop]

Welcome back! Are you staying in a Government place? Keep us posted about your progres…

[Icon]

Eh, where do we start? Aside from no CECC authorization nor oversight of any kind:

Illegally obtained made in China reactives.

Lied to subjects, made them come out of quarantine without escort nor safety measures.

Biased from the start. Yet even them could not forge the data enough to be convincing.

[finley]

Not sure what you mean. Are you saying the official numbers are inflated, or that they are unrealistically low?

Unless there’s a genuine reason to believe otherwise, I’d say the reported 0.05% rate among the general public, and the 0.08% rate among “higher risk” individuals, sounds about right.

[finley]

Nah, staying at home. Not really a problem. Have loads of stuff to do. And there’s foodpanda.

Quarantining in Elbonia, OTOH, is a whole different barrel of rotten prawns.

[Icon]

I am talking about the problems with the study we dismissed and why it is not considered serious, publications my foot.

[finley]

Yeah, I read that they broke quarantine protocols to get subjects for that study. But that’s an issue of ethics/legality, not methodology. Do you think the results are unrealistic?

[Icon]

I think that if they used illegally obtained materials - China blood related products are forbidden in Taiwan- and their hubris led them to test people unsafely and without permission nor oversight from their peers, their results cannot be trusted.

Having worked with "famous"scholars from “top” universities, I know they tend to bend the rules, engage in doubtful practices. Hence, pardon my skepticism on their findings results. In spite of the numbers bring logical, considering where they come from, it is more likely they copied the results from somewhere or the results were fed to them by other parties.

[cake]

I know someone currently in a Q hotel and is a vegan. He told them countless times and they still deliver pork meals daily. You would think with the price people have to pay, you’d get a decent food offering.
Maybe the decision to have these Q hotels is to keep them running due to zero tourists arriving in Taiwan.

[finley]

OK, I see what you mean. Still, it appears that the two papers mentioned above are about all we’ve got. So although it’s fine to take them as potentially unreliable, unreliable information is generally better than no information at all.

Depends on the magnitude of “unreliable”, of course. I think it’s a bit unlikely they just made stuff up. It happens, but the risk to one’s career usually makes it not worthwhile.