[HN Gopher] Google promised its contact tracing app was complete...
___________________________________________________________________
Google promised its contact tracing app was completely private, but
it wasn't
Author : EastSmith
Score : 416 points
Date : 2021-04-27 12:31 UTC (10 hours ago)
(HTM) web link (themarkup.org)
(TXT) w3m dump (themarkup.org)
| foolzcrow wrote:
| The elite have planned on controlling us for at least 80 years.
| [deleted]
| renewiltord wrote:
| Yeah, I wasn't going to touch this shit. Especially when all
| these people who were going on and on about privacy suddenly
| decided to about face, it made me very suspicious. No way.
| Ceezy wrote:
| Do we know what kind of users info are contained in these logs?
| It seems a bit misleading.
| FrameworkFred wrote:
| ...to which the scorpion replies: "I couldn't help it. It's in my
| nature."
| bpodgursky wrote:
| This is trite, inaccurate, and proves you didn't read the
| article whatsoever.
| pyronik19 wrote:
| The last entity in the world I would want to trust with all of my
| location data is google.
| robrenaud wrote:
| Which is why Apple/Google engineered this to not use GPS
| location data, instead each phone locally kept track of nearby
| bluetooth IDs. Which made the app scale quadratically rather
| than linearly with usage (10% adoption means 1% of possible
| transmissions caught), which made it basically useless without
| large scale adoption that it never got.
|
| Google/Apple timidly did some basically useless engineering,
| when they could have instead made a significant dent in
| limiting the spread of covid.
|
| If they were going to make the timid, quadratically scaling
| decision, they should have boldly made it opt out. A quadratic
| scaling, privacy preserving protocol plus a timid opt in
| strategy might have cost 30k lives if it ubiquitous/automatic
| contact tracing would have stopped 10% of the spread.
| ChrisArchitect wrote:
| just seems like google witch hunt from some random app security
| firm.
|
| Would rather hear from some of the notable developers of say the
| Canada Covid Alert App about what they think about this
| [deleted]
| twirlock wrote:
| That's so surprising how the company that hates privacy and tries
| to take our data against our will still hates privacy and still
| wants to take our data against our will.
| cheaprentalyeti wrote:
| Maybe I'm stupid but I thought the whole point of a Traffic
| Analysis app would have been to violate privacy.
| kenmacd wrote:
| The protocol was designed for privacy. In that it seems to have
| done okay if the worst thing we can complain about is that
| manufacturer apps that can already see your location, your
| email, your search history, and your pictures, could also read
| your generated codes.
| fudged71 wrote:
| My region never got access to this app, so I'm curious
|
| For those who have it, did it change your behavior? Did you have
| contact and it made you avoid crowded spaces? Did you get tested
| because of contact logs?
| zachberger wrote:
| I have had it installed since it became available in
| California. I received one exposure notification on April 11th
| from an exposure on April 1, which seems too late to be useful.
| I immediately tested and it was negative.
| PossiblyDog wrote:
| Why do you think this was too late?
|
| 14 days is the the CDC's window for contact tracing and self-
| isolation, based on how long it takes symptoms to show up
| after exposure. This seems in line with that.
| zachberger wrote:
| And here is what the exposure notification looks like:
| https://imgur.com/a/qyLHxUQ
| jrochkind1 wrote:
| I don't know of anyone in the USA who has used these apps. They
| never really took off. Since they rely on a "network effect" to
| be useful... even if you installed one, few people you came in
| range of would have it installed.
|
| https://apnews.com/article/us-news-smartphones-coronavirus-p...
| Forge36 wrote:
| I tried it, it was state specific and required self reporting
| positive cases to alert others. I suspect the heavy opt in
| nature made it much less useful. I'm curious if it was useful
| in some areas
| proactivesvcs wrote:
| Brit here. I refused to install the NHS Covid app until they
| revamped it to improve privacy. I once received a notice that
| my device recorded a beacon which was later submitted as from a
| infected person, but it didn't require me to take action as it
| was otherwise outside of criteria (either distance or
| duration). They eventually removed these warnings as they are
| not helpful.
|
| If it informed me that I had to quarantine and/or get tested I
| would definitely do so.
| pvorb wrote:
| I've been using the German version since it came out in July, I
| think. It's working great in that I've never been warned even
| once, but my social interactions also have been limited to
| going to the supermarket on Saturdays for a bit more than one
| year now. So probably it was correct to never warn me. Adoption
| is also low, so you really can't tell.
| woutr_be wrote:
| I've been using it here in Hong Kong ever since the government
| made it mandatory. I did have to get tested after someone in my
| gym tested positive.
| dripton wrote:
| I installed the contact tracing app as soon as it was
| available, and still have it running. I've never gotten a
| contact from it. Some of that is probably me being careful and
| not being around others much, and some of it is probably that
| almost nobody else is running it.
| avereveard wrote:
| people often forget the other half: the confirmed cases need
| to be uploaded. in Italy, that was the biggest weak point,
| even places with a fairly wide install base didn't get much
| benefit since the ausl didn't had the processes in place to
| share the test results, as the ingress effort was fragmented
| and left to be implemented with local resources, a mess of
| regional responsibilities and uncertain protocols, i.e. https
| ://corrieredelveneto.corriere.it/veneto/politica/20_ott...
| (source in italian)
| [deleted]
| dagmx wrote:
| I installed it immediately. However I've never got a notice,
| but I've also never tested positive so it's hard to say how
| well it worked, or know how many around me had it too.
|
| It did give me a little peace of mind when I went grocery
| shopping however.
| breischl wrote:
| Headline seems to be conflating two different kinds of promises.
| My recollection is that the promise was that Google and the
| government wouldn't (couldn't) track you with the data. That
| appears to be generally true. Finding a bug that exposes some
| data is unfortunate, but it seems the be an unintentional
| mistake.
|
| tl;dr, they didn't try to do anything evil, they just failed to
| be 100% perfect.
|
| Also as /u/arsome points out elsewhere, the other apps that can
| read this data could get better data more easily through another
| method anyway.
| arsome wrote:
| This title is kind of exaggerated. In order to obtain this data
| you'd need to get the Bluetooth identifiers from the system log.
| In order to get the system log, you need root or adb. At that
| point you can just log GPS directly, inject code straight into
| the COVID tracking app, etc. All bets are off.
| mkesper wrote:
| This is the interesting thing about it:
|
| The signals that a phone's contact tracing data generates and
| receives are saved into an Android device's system logs.
| Studies have found that more than 400 preinstalled apps on
| phones built by Samsung, Motorola, Huawei, and other companies
| have permission to read system logs for crash reports and
| analytic purposes.
| arsome wrote:
| But again, they also have system privileges on your phone and
| if they wanted to dump location data or bluetooth scans they
| could do so trivially.
|
| About the worst that could come of this is an accidental
| capture in a crash report.
| ballenf wrote:
| So maybe Google shouldn't have guaranteed privacy of this
| app on a phone OS where such a promise is impossible to
| deliver?
| Sebb767 wrote:
| Basically any device can be seen as compromised if anyone
| malicious had hardware or root access - including the
| manufacturer. If you don't trust your manufacturer, you
| have far bigger problems than bluetooth IDs in the log.
| dylan604 wrote:
| But that's just it. I DON'T trust Google one iota.
| nthj wrote:
| Then you shouldn't have an Android device. This isn't
| complicated.
| dylan604 wrote:
| I don't have an Android device presicely because of this.
| I don't use Google Chrome, search, etc. I block all
| GA,Tagmanager,blahblahblah as well.
| Dah00n wrote:
| The only option you have is a phone like the Nokia 3310
| then. Android and iOS are equally bad, just in different
| quantities of bad in different areas.
| prepend wrote:
| In regards to privacy they are not equally bad. And for
| this contact tracing app they aren't equally bad.
| oefrha wrote:
| Great, this "issue" is irrelevant to you and your off-
| topic rant adds exactly nothing to this discussion of a
| clearly defined risk. For other people who have made a
| relevant device choice, the point stands that it's a non-
| issue since there's no additional risk.
| dylan604 wrote:
| Actually, Google and Apple teamed up on a contact tracing
| concept. Even when it was first annouced, the fact that G
| was attached meant that I wasn't interested. Apple's
| involvement only lessened the distrust slightly to me,
| but not enough for me to want to bother with it.
| domnomnom wrote:
| As someone in a similar boat without an android, I think
| it adds to the discussion. It makes me feel warm and
| fuzzy inside to see such rants.
| procombo wrote:
| Hardly. Your privacy also depends on what devices your
| neighbors use. Bluetooth/Wifi/etc packet broadcast, etc.
| Apple does _some_ things to midigate privacy risks for
| their users, but not enough.
| heavyset_go wrote:
| This. My wireless networks, MAC addresses etc are
| collected on Google's end by my neighbors' Google devices
| for things like advanced location tracking.
| rantwasp wrote:
| buy an iphone?
| ryukafalz wrote:
| Then if you have an Android phone, you have no reason to
| believe your location data is private from Google, with
| or without the contact tracing app.
|
| I'm not saying this isn't a problem, I'm in the same boat
| here, just that the contact tracing app doesn't really
| add to it.
| radicalbyte wrote:
| I consider Facebook malicious, and I've just learnt that
| their pre-installed app basically has root on my Android.
|
| How is _that_ not the story here?
| arsome wrote:
| No, the Facebook app most likely does not have any
| special permissions. These are typically granted by
| manufacturers based on their own signing keys.
| ahupp wrote:
| A preinstalled fb app does not have any special
| permissions.
| Bud wrote:
| How are you even remotely surprised by that? If you are
| expecting any privacy or security from a combo of
| Facebook and Android, you've been asleep for the last 13
| years.
| gruez wrote:
| What type of guarantees did they promise?
| shawnz wrote:
| This seems like saying they shouldn't have guaranteed
| privacy because someone could be looking over your
| shoulder while you type your password. Maybe that's true,
| but it also seems like a uselessly impractical way to
| interpret things.
| macinjosh wrote:
| > About the worst that could come of this is an accidental
| capture in a crash report.
|
| So.. this data is exposed and available even though they
| said would/could never leak. Seems pretty cut and dry to
| me. It is a black and white issue. Accidental disclosure is
| still a disclosure.
| joshuamorton wrote:
| It's accidental exposure to someone who already had root
| and could record the data themselves.
| shadowgovt wrote:
| I think there's a practical difference between what an
| app _could_ do with root permissions and what is widely
| understood to be likely or acceptable. The "anything the
| app could do it is doing" model isn't really the right
| model to apply for vendor apps that are generally trusted
| by consumers (and observed by security researchers).
| We're not talking malware with root; we're talking the
| regular system health and monitoring apps that vendors
| install.
|
| So it's real unlikely that MotoCare is intentionally
| trying to de-anonymize someone's COVID-19 data by code
| injection or continuous GPS logging. It is extremely
| _likely and expected_ that the app is periodically
| grabbing the syslog as a crash report, and that means
| Google 's claim of keeping your data private now has to
| implicitly assume that MotoCare, _without doing anything
| special other than its regular behavior,_ is _also_
| keeping your data private. That 's not a claim Google
| should be implicitly making on behalf of MotoCare (let
| alone on behalf of every app that could hypothetically be
| installed on your system and is understood to be well-
| behaved in the sense that it just reads the syslog).
|
| It's really incumbent on a privacy-protecting application
| to not put private data in the syslog. If it's in the
| syslog, it's not private (even though it's more private
| than, say, a notification on the homescreen).
| lofi_lory wrote:
| I imagine for semi-criminal actors, injecting code or
| "accidentally" using systen data, are still two different
| scenarios. I mean, state actors could also just follow you
| around, or place agents as friends and family... so why
| bother about anything?
| not_knuth wrote:
| Link to studies?
| derpus wrote:
| The researcher linked to the paper (https://haystack.mobi/p
| apers/preinstalledAndroidSW_preprint....) in their original
| blog post on Appcensus
| (https://blog.appcensus.io/2021/04/27/why-google-should-
| stop-...)
| [deleted]
| compiler-guy wrote:
| Google did claim that the identifiers are ephemeral. They may
| be hard to access but they aren't ephemeral. This sets up the
| possibility of post-hoc attacks.
|
| Sure, if you get root, all bets are off generally, but now if
| you get root, you can figure out identifiers used before you
| got root, which isn't what Google said was possible.
| [deleted]
| PossiblyDog wrote:
| The identifiers are ephemeral.
|
| About 10 minutes for a given RPI (what gets broadcast over
| Bluetooth), 1 day for a TEK, and 14 days of local TEK
| history. The generated RPIs aren't retained, and the TEKs -
| which can be used to re-derive the RPIs - never leave the
| device unless you choose to report a diagnosis. All of this
| is destroyed after 14 days. This report doesn't change any of
| this.
|
| I recommend reading the GAEN cryptography spec:
| https://blog.google/documents/69/Exposure_Notification_-
| _Cry...
|
| The issue here is that privileged apps that are bundled with
| the OS could snoop on the system log to capture new RPIs when
| they're generated in real-time. Which isn't great... but
| privileged apps can already do much worse. If one of these
| apps is malicious, they could just log your GPS position
| directly (for example).
|
| Heck, an application with root could just read the 14-day TEK
| history directly off disk. Once we're talking privileged apps
| and processes running as root, all bets are off. You need to
| be able to trust the device's firmware.
| [deleted]
| jrm4 wrote:
| I get that this might not be useful from a technical point of
| view for this crowd, but it's not exaggerated _at all_ even if
| the point of failure isn 't Google and the app; if we want to
| be serious about fixing privacy issues, we can't just wave away
| vulnerabilities that we've accepted for a long time out of pure
| convenience and apparent difficulty to solve.
| nl wrote:
| Yeah it's a ridiculous assertion.
|
| It's basically arguing that because the phone knows it's own
| identity it's not private.
| joeblau wrote:
| On iOS, none of that is even possible with physical access.
| Nothing that you're saying sounds hard for a malicious actor to
| pull off. The interesting thing is that you're getting is a
| historical log without the need to install anything.
| arsome wrote:
| > Nothing that you're saying sounds hard for a malicious
| actor to pull off.
|
| A malicious actor would need to be your phone manufacturer,
| Google or someone with a root exploit (jailbreak in iOS
| terms) or this "vulnerability" would be completely useless.
|
| All of those parties could just as easily push code to your
| device any number of other ways that could do far worse than
| reading your logcat for BT IDs.
|
| I understand the concern, but if you're at the point where
| you can't trust the parties who push automatic updates with
| high privilege levels but you do need to be concerned about
| reading logcat your threat model here is pretty strange.
| Aerroon wrote:
| Isn't the difference based on time though? The device
| manufacturer can push a patch, but they would get access to
| the information after the patch, whereas access to the log
| gives you information from before the patch. Or have I
| misunderstood?
| hundchenkatze wrote:
| The device manufacturer has access to the device (at the
| hardware level even) the moment they start building it.
| They don't need to push a patch to gain access, they
| could access your logs at any point throughout the
| lifespan of the device.
| londons_explore wrote:
| On iOS, you have to trust Apple and everyone who writes code
| for Apple, directly or indirectly.
|
| If any Apple code that runs as root is evil, then your
| location data can be stolen in exactly the same way.
|
| In the case of Android, the equivalent is code written by
| Google, the OEM, the chipset maker, and anyone those people
| gave root access to (which is often a _long_ list of
| 'sponsorware' apps).
|
| Overall, the class of vulnerability is the same, but Apple
| just does a far better job of vetting and controlling the
| list of people/code.
| UncleMeat wrote:
| And people complain incessantly that they don't really own
| their iphones because they cannot install their own code on
| it. You can't win.
| wutbrodo wrote:
| How is this an instance of "you can't win"? Not "owning"
| your phone is a downside of iOS's approach, and avoiding
| the security issue as parent commenter mentions is an
| upside (ie a "win"). This martyr complex over phone OSes is
| very 2010.
| t0mas88 wrote:
| He means as a phone manufacturer you can't win, either
| you have an open OS and get criticised for not locking it
| down or you have a locked down OS and get criticised for
| not opening it up.
| jonny_eh wrote:
| Sandboxing exists.
| UncleMeat wrote:
| Of course it does. Sandboxing even exists on Android. The
| criticism here is that if you have some system that has
| root and can poke through sandboxes that you can access
| this data.
|
| You either have full access or you don't.
| jonny_eh wrote:
| That wasn't my point. It was that iPhones need not limit
| apps to the "App Store" in the name of protecting the
| system, since it can sandbox apps, wherever they come
| from.
| fulafel wrote:
| How is this prevented in ios if you have root (=jailbreak)?
| JAlexoid wrote:
| It's the fact that it logs other people's data, not just it's
| own, that makes it less than perfect anonymity.
|
| But then again... You'd need to have a list from the "other
| side", to actually deanonimize this data. At that point, you
| can just get WiFi and Bluetooth physical addresses.
| 6gvONxR4sf7o wrote:
| Isn't it saying that a bunch of preinstalled apps also have
| access to this info?
| privacyking wrote:
| And what is the most common privacy-violating preinstalled
| app? Facebook.
| rubidium wrote:
| It's a little surprising how much effort went into things early
| in the pandemic that didn't pan out.
|
| Official contact tracing in the US is a complete dud and had
| negligible impact on the spread. People informing their
| fiends/family "hey I just got Covid you should probably
| test/isolate" was what practically can make a difference.
|
| Ventilators were the critical thing until we realized they were a
| very sub optimal treatment.
|
| All the surface cleaning was a massive waste too... and the
| chemicals used in some places destroyed a bunch of furniture.
|
| Masks, fresh air, don't go out when sick or after close contact
| with someone when sick. Simpler things that make the most
| difference.
| stjohnswarts wrote:
| People wouldn't even wear masks, even more wouldn't have had a
| "government tracker" willingly in their pocket whether it not
| it was innocuous and anonymous or not.
| pvorb wrote:
| > [...] and the chemicals used in some places destroyed a bunch
| of furniture.
|
| and several throats due to the excellent advice of a smart
| person.
| Smaug123 wrote:
| Re ventilators specifically, remember that we had basically no
| treatment for severe Covid last March. The best we could do was
| sedate you, force air into your lungs, and hope for the best.
| Now we know that dexamethasone helps in severe cases, we have
| monoclonal antibody treatments, and generally we are better
| able to treat someone who would have needed a ventilator if
| we'd treated them last March.
|
| In general, I'm with the Tyler Cowen thought bubble: whatever
| we spent on _actual treatments_ which didn 't work out, it
| wasn't enough.
|
| Some of your criticisms are pretty incontrovertible. The Less
| Wrong zeitgeist in April 2020 (perhaps even earlier) was that
| surface cleaning was dubious -
| https://www.lesswrong.com/posts/riB8m9PBvXJziFYMv/on-covid-1...
| - much like they were extremely early on the "loss of taste and
| smell" train
| (https://www.lesswrong.com/posts/ACyGvQchWzGjGkKgS/march-
| coro...).
| nradov wrote:
| The latest research indicates that Methylprednisolone is more
| effective than Dexamethasone.
|
| https://doi.org/10.1177%2F0885066621994057
|
| https://covid19criticalcare.com/covid-19-protocols/math-
| plus...
| Smaug123 wrote:
| Even better! (I merely stated two treatments I knew of
| which were found to be effective well after the point when
| we were making ventilator-related decisions. I am doubtless
| unaware of many more.)
| pradn wrote:
| Also remember how the CDC didn't advise wearing a mask for the
| first month or two of the pandemic? We came around to that,
| too.
| c3534l wrote:
| Yeah, because there were problems making sure there was
| sufficient supply for medical staff.
| caddemon wrote:
| That doesn't mean that misleading the public about the
| effectiveness of masks in the early pandemic was the right
| way to go about it. The CDC came out and said that masks
| wouldn't protect the wearer.
|
| I also saw blog posts from people in public health
| departments at respectable universities about how masks on
| laymen have no effect because we can't wear them right/will
| touch our face too much to adjust them. Whether they
| believed that at the time is unclear to me, but that was
| the theory being pushed by a bunch of experts to explain
| the CDC guidance.
|
| I think we were overestimating the transmission risk from
| surfaces/face touching at that time. I also think we
| underestimated the effectiveness of basic cloth masks
| thinking that only filters would be useful. COVID is more
| likely to spread via larger droplets than some other
| viruses. However a closer look at literature from Asia on
| the previous SARS pandemic should have suggested that masks
| are more likely than not worth promoting.
|
| So I have to wonder if they considered what would happen
| if/when they had to flip the story once masks became more
| available. I doubt they expected it to become such a
| critical part of the pandemic response, otherwise they
| probably would have been more careful with messaging. Of
| course these decisions were made under a lot of pressure
| with not much time to strategize - I just hope they learn
| from this and reconsider a bit how they communicate.
| Because I do think this exacerbated the anti-mask issue.
| IMO they could have even avoided Trump making it political
| if one of the day 0 rallying cries was to ramp up mask
| production.
| wutbrodo wrote:
| > about how masks on laymen have no effect because we
| can't wear them right/will touch our face too much to
| adjust them. Whether they believed that at the time is
| unclear to me, but that was the theory being pushed by a
| bunch of experts to explain the CDC guidance.
|
| This is even more hilariously stupid than it sounds, as
| the same studies showed that only 10% higher a proportion
| of medical personnel than the general public can properly
| fit their masks. And yet it would be insane to claim that
| it's useless for medical personnel to wear PPE.
| mcguire wrote:
| It's a pity they didn't ask our advice; we could have
| told them exactly what to do to minimize damage.
| wutbrodo wrote:
| Given the impression I've gotten from your habit of
| replying with midwit snark to my comments, I don't
| suggest that you try doing so.
|
| But yes, there are plenty of fields full of intelligent,
| quantitative people that are better at basic scientific
| literacy and modeling uncertainty than our public health
| infrastructure has shown themselves to be. This isn't
| just theoretical; every single "heterodox" conclusion I
| was exposed to that was based on the science instead of
| whatever the fuck goes on at the CDC/FDA ended up
| becoming CDC/FDA policy, several months later.
|
| Medical culture's innumeracy[1], religious adherence to
| omission bias, and refusal to model reality outside of
| the exact parameters of an RCT is potentially adaptive
| for the normal clinical context. But it's an extremely
| poor fit for a pandemic, and has cost thousand and
| thousands of lives over the course of this one.
|
| It's a travesty that the CDC, FDA and WHO couldn't
| collectively manage to provide information a fraction as
| useful as accurate as (eg) Alex Tabarrok's freaking
| Twitter account.
|
| For someone of your, uh, limitations, it's probably
| better to slavishly follow public health advice, in the
| absence of the ability to do any critical thinking. For
| anyone with a median IQ, understanding when
| political/bureaucratic/cultural failures are cause for
| skepticism of public health conclusions is a must.
|
| [1] Famously, studies show 80% of doctors unable to do
| the most basic of statistics relevant to their job, like
| being able to interpret the chances of breast cancer
| given a positive mammogram. Over half of the doctors
| surveyed were off by a factor of NINE in their estimate
| (90% vs 10%). This isn't a random medical-themed math
| game with no clinical relevance; one's risk of breast
| cancer is influenced by multiple factors and false
| positives mean invasive procedures like biopsies that
| themselves are not riskless.
| caddemon wrote:
| That's literally exactly the problem when experts mislead
| the public. Particularly if it was intentional to save
| mask supplies or prevent other stupid behavior, that
| completely erodes trust and it becomes a game of "what is
| the expert actually trying to say" when future statements
| are made.
|
| If it was a mistake due to incomplete information, then
| it happens, but discussion about what went wrong should
| be encouraged and there should be transparency (perhaps
| at a later date) about what could be done differently in
| the future. Experts are going to be right more often than
| laypeople, but they are still sometimes wrong, and if
| that can't be acknowledged it's a systemic problem.
|
| Ironically, blasting the US for pausing the J&J vaccine
| was highly upvoted on HN, even though that was also
| expert decision making, and it was actually in the midst
| of the issue without the benefit of hindsight. I wonder
| why the topic of early pandemic mask messaging seems to
| attract downvotes on HN.
| wutbrodo wrote:
| > Ironically, blasting the US for pausing the J&J vaccine
| was highly upvoted on HN, even though that was also
| expert decision making, and it was actually in the midst
| of the issue without the benefit of hindsight. I wonder
| why the topic of early pandemic mask messaging seems to
| attract downvotes on HN.
|
| I suppose for the same reason that so many consider mask
| requirements an unacceptable intrusion on their most
| sacred freedoms: it's become heavily politicized, most
| people only "care" about issues to the extent that
| they're able to signal tribal membership, and moral
| indignation isnt any less addictive when it's detached
| from reality.
| watwut wrote:
| Medical staff don't use cloth masks, there would be no
| issue to recommend those.
| xdennis wrote:
| - Medics exist to protect patients, not the other way
| around.
|
| - They didn't say: "we need to prioritize medics", they
| said "masks have no effect" and sometimes "masks are BAD
| for you".
|
| - They have doctors in Japan/Taiwan/China too, but they
| said from the beginning there to wear masks.
| mattferderer wrote:
| .NET Rocks did a great Geek Out podcast on that which
| explained it in layman's terms -
| https://www.dotnetrocks.com/?show=1720
|
| If I recall, the CDC was recommending treatment that worked
| against past similar viruses. This one turned out to be
| spread in a completely different way than typical.
| wutbrodo wrote:
| This excuse doesn't make any sense. Their messaging at the
| time was "masks aren't effective, plus we need them for
| healthcare workers to care for pandemic patients". If
| they're not effective, why would healthcare workers need
| them? Higher viral loads put you at higher risk, but the
| messaging decidedly wasn't that masks are only protective
| at high viral loads. Let alone the incredibly basic prior
| on respiratory diseases' vector being limited by _covering
| up the sources of spread_.
|
| The initial recommendation, the flip-flop, and attempts to
| explain it away have been universally incoherent, because
| the real reason is that the CDC and FDA combine the worst
| of the federal government's bureaucratic inefficiency with
| medical culture's innumeracy and blind status quo bias.
|
| Leaving aside the failures of pandemic preparedness
| stretching back multiple administrations (the PPE stockpile
| had been depleted since 2013, and I don't need to describe
| the trump admin's failures..), it would have been trivial
| to do what we eventually did, and what many other countries
| did: recommend face coverings of any sort, and encourage
| people to save n95s for medical personnel. The insane route
| we ended up taking had people hoarding n95s anyway and
| deeply poisoned the well of trust in public health
| authorities in general and masks in particular (helped
| along by our president).
| caddemon wrote:
| They also at one point early on said that wearing a mask
| if you have COVID can prevent you from spreading it, it
| just won't protect you from getting it at all. This was
| simultaneous with the recommendation that laymen not wear
| masks, but also with the recommendation that everyone
| should behave as if they have COVID because of
| asymptomatic spread. The messaging not only raised red
| flags based on both Asian SARS experience and just using
| common sense, it was also internally contradictory.
| ff317 wrote:
| > masks aren't effective, plus we need them for
| healthcare workers to care for pandemic patients
|
| I noted this at the time as well, but I read it (perhaps
| between the lines a bit) as more like: masks probably
| help, but if you all go panic-buy masks like you do TP,
| there will be none left for healthcare workers, who need
| them more than you do.
| wutbrodo wrote:
| That's possible, but the route we went with got us the
| worst of both worlds. There were gov'ts that simply told
| the entire country to use scarves or sew string to cloth
| and put it over their mouth. Lying about the efficacy of
| all masks to preserve a specific kind is just about the
| stupidest approach to the problem I can imagine.
|
| Note that even if your theory is correct, it also means
| that public health authorities have been continually
| lying to us after their mask flip-flop, with the Surgeon
| General claiming in April that it's because they didn't
| know asymptomatic transmission was possible. This is, of
| course, horseshit, as there were Chinese reports of
| asymptomatic transmission as early as January.
|
| The only theory which fits all the evidence is the one I
| laid out: asymptomatic transmission did not have a solid,
| high-quality study behind it yet, and medical culture has
| serious problems doing anything but rounding priors and
| weak evidence down to "zero evidence" instead of doing
| the difficult work of choosing the best option under
| uncertainty. It's ludicrous to claim that telling people
| to put scarves over their face would deplete , and that
| this cost-benefit suddenly flipped the moment the level
| of evidence for mask efficacy rose from "no-brainer if
| you're capable of modeling uncertainty" to "has a
| specific high-quality study supporting it in narrow
| conditions".
| DanBC wrote:
| > Their messaging at the time was "masks aren't
| effective, plus we need them for healthcare workers to
| care for pandemic patients". If they're not effective,
| why would healthcare workers need them?
|
| Isn't it simple statistics? If you're on a ward with 10
| people who are ill and coughing at you you'll need a
| mask. If you're walking about in the street, not getting
| closer than 2m to anyone, and not spending much time in
| close proximity to anyone, the mask isn't doing much.
| wutbrodo wrote:
| > Isn't it simple statistics? If you're on a ward with 10
| people who are ill and coughing at you you'll need a
| mask.
|
| I addressed this in my comment:
|
| > Higher viral loads [and longer exposure] put you at
| higher risk, but the messaging decidedly wasn't that
| masks are only protective at high viral loads. Let alone
| the incredibly basic prior on respiratory diseases'
| vector being limited by _covering up the sources of
| spread_.
|
| "Medical workers need masks more because they have more
| exposure" is not the same thing as "masks don't work for
| the general public", and brazenly and badly lying to the
| public has costs that have been demonstrable throughout
| the pandemic (helped along by our dear insane President
| over the course of the pandemic).
|
| > If you're walking about in the street, not getting
| closer than 2m to anyone, and not spending much time in
| close proximity to anyone, the mask isn't doing much.
|
| This is a general-purpose argument which explains away
| the existence of community spread, which we know was
| happening (33m US cases later...). Especially given what
| we now know about air vs surface transmission, people
| were clearly spreading it to each other last spring in
| ways that masks would have mitigated. Knowing what we now
| know about the difficulty of outdoor spread, people by
| definition were not universally adhering to what you're
| describing. Leaving aside the non-compliant (some portion
| of whom would have worn masks despite violating indoor
| gathering guidelines), many people were unable to avoid
| this: nursing homes, grocery stores, meatpacking plants,
| and all manner of essential workers[1] were clearly
| enough to drive robust spread.
|
| [1] Here's a list of just how expansive the "essential
| worker" category was in NYS:
| https://www.lawandtheworkplace.com/2020/03/new-york-
| state-ma....
|
| (Note that I don't mean that as a criticism, just a note
| that your postulated world of 100% of people never coming
| within 2m of anyone, including outside, is not reflective
| of reality)
| DanBC wrote:
| > This is a general-purpose argument which explains away
| the existence of community spread,
|
| But that wasn't people waking past each other in the
| street, that was people working with each other in poorly
| ventilated spaces.
|
| Public health officials during the early stages fully
| expected all the other recommendations they were making
| to be taken up: proper lockdowns, vigorous test and trace
| with good quality supported isolation.
|
| If you're looking at "late lockdown with poor test and
| trace" then yes, you're right, not pushing masks doesn't
| make much sense. But it's odd to focus on the mask advice
| and not the late lockdowns.
| mcguire wrote:
| 1. Convincing the public to wear effective masks,
| correctly and consistently was known to be very
| difficult. Still is.
|
| 2. Most epidemiologists it the US, at least, believed
| that corona- and similar viruses were transmitted by
| larger droplets generated by coughing or sneezing. These
| droplets would not remain airborne long, resulting in the
| advice for social distancing and surface cleaning. The
| "flip-flop" occurred very shortly after it was
| demonstrated that they were transmitted by aerosol
| particles.
|
| 3. This event primarily demonstrates the difficulty of
| communicating science---a "this is the best advice we can
| give now based on our limited understanding" is treated
| as permanent, universal truth by the general public; any
| later changes in that advice is "insane" and "deeply
| poisons the well" of trust.
| stjohnswarts wrote:
| #3 especially, most people don't really understand
| science and think statements are absolute so the first
| time they heard "no masks necessary with what we know
| currently" became "no masks" and "well we've discovered
| that masks will help" and people heard "we lied to you
| before, now you need masks because we're trying to
| control you and take away all your freedoms" at least
| that's what happened with the Trump crowd.
| Izkata wrote:
| > 2. Most epidemiologists it the US, at least, believed
| that corona- and similar viruses were transmitted by
| larger droplets generated by coughing or sneezing. These
| droplets would not remain airborne long, resulting in the
| advice for social distancing and surface cleaning. The
| "flip-flop" occurred very shortly after it was
| demonstrated that they were transmitted by aerosol
| particles.
|
| That makes even less sense, masks only stop the heavier
| droplets. The virus is small enough to go right through
| cloth masks when aerosols, or get carried out the sides
| of surgical marks by your breath.
|
| But I remember the aerosol realization happening around
| summer/fall last year, way after the mask flip-flop
| anyway.
| wutbrodo wrote:
| > The "flip-flop" occurred very shortly after it was
| demonstrated that they were transmitted by aerosol
| particles.
|
| This is both false and doesn't make any sense.
|
| 1) There was ample evidence of the distinct _possibility_
| of airborne transmission, certainly by March. Medical
| culture has a severe problem with confusing "absence of
| evidence" and "evidence of absence", and the cost-benefit
| tradeoff of mask recommendations given what we knew back
| then was crystal-clear (and there were people loudly and
| consistently saying so throughout).
|
| 2) The CDC and Surgeon General (of "Seriously people,
| STOP BUYING MASKS" fame) have claimed[1] that the "flip-
| flop" was due to a change in concern about asymptomatic
| spread. It's not a coincidence that this is the _third_
| distinct (and often mutually-contradictory!) excuse I've
| heard on this thread: because the real reason is
| basically down to systemic cultural rot in the field
| (especially at a scale that large and politically-
| influenced) and no one wants to admit that.
|
| > 3. This event primarily demonstrates the difficulty of
| communicating science---a "this is the best advice we can
| give now based on our limited understanding" is treated
| as permanent, universal truth by the general public; any
| later changes in that advice is "insane" and "deeply
| poisons the well" of trust.
|
| Scientific consensus changes all the time, and no stigma
| is (or should be) associated the work on the earlier,
| less accurate model. That's just what science _is_. I'm
| not sure if you're being intentionally obtuse or
| accidentally so, but my point is obviously that the
| initial no-masks assessment was insane, and based on a
| shoddy interpretation of both the science of the virus
| and the fundamentals of how public policy works.
|
| [1] https://www.axios.com/surgeon-general-reversal-face-
| mask85e2... .
| caddemon wrote:
| My understanding is that it is not atypical for SARS
| though? I thought that was the main reason Asia was big on
| masks, which should have suggested that we ought to at
| least consider masks.
|
| My guess is it was some combination of uncertainty about
| effectiveness in the general public and wanting masks to be
| available for healthcare workers, so they ran with the
| messaging they did. IMO if they didn't want to make a
| statement that could lead to hoarding in the early days
| they should have just said nothing about masks until
| production was ramped up. Masks are such a minimally
| invasive preventative measure that given uncertainty about
| their effectiveness you would normally err on the side of
| encouraging.
| mcguire wrote:
| The other downside of such statements is excessive
| belief: "wearing medical-grade masks correctly might
| help" is understood as "wearing anything over your face
| will provide perfect protection".
| caddemon wrote:
| Can you point to any countries that encouraged mask use
| where that ended up being the general sentiment? It's not
| like encouraging mask use means restrictions on shopping,
| dining, etc. wouldn't also exist.
|
| Besides, you could make the same argument for something
| like wearing a helmet while bike riding. I'm sure there
| are situations where false peace of mind is a problem,
| but I don't see why we should assume mask wearing would
| be one of them.
|
| At the time they were obviously operating with limited
| information, but it's crazy to me that people continue to
| defend the early pandemic mask messaging. They screwed
| up, it happens, but it should be acknowledged and there
| should be a post mortem.
| craftinator wrote:
| That was more a political and logistics issue than well
| reasoned health position. Any reasonable person knows that
| wearing a mask will help stop the spread of an airborne
| disease. It's why doctors, nurses, and surgeons wear them.
| Basic knowledge of either physics or biology will inform a
| person of this.
| throwaways885 wrote:
| I still can't believe the amount of people that make the
| "like using a chain-link fence to stop mosquitos"
| analogy...
| Rebelgecko wrote:
| When the CDC says "Don't wear a mask, it won't help you",
| that has the effect of degrading trust in the CDC. People
| who know that's BS won't trust the CDC in the future, and
| people who don't know that's BS will lose trust when the
| CDC flip-flops and says that maybe masks actually are
| helpful. I think that contributed to the politicization of
| mask wearing in the US.
| icelancer wrote:
| The noble lie. Never works. Contributes to populism.
| teachingassist wrote:
| Contact tracing is an sort of interesting solution
|
| It works great when you have just a few cases and are highly
| motivated to stop them from spreading (Asia/Oceania)
|
| and it doesn't work at all, when you have a lot of cases and
| have no interest in doing what's necessary to contain them
| (Americas/Europe)
|
| Mass-market contact tracing, in hindsight, was completely
| pointless. I'm not personally aware of anyone who has been
| informed accurately of potential infection via a Bluetooth app.
| jfoster wrote:
| Are you sure? My take on why mass market contact tracing
| didn't pan out was that it was insufficiently
| implemented/used. If it were on every phone and on by
| default, perhaps even mandated, would it still not have
| worked? I know that many people take significant issue with
| that approach, but it would have made more of a difference,
| right?
| lofi_lory wrote:
| I think in Germany it fails, because reporting positive
| tests fails. Nobody doubts, if the app was promoted and
| reporting working flawlessly, it would hugely contribute to
| managing the spread.
| teachingassist wrote:
| There are a number of prerequisites, for this to work, that
| were not mandated in the US and Europe.
|
| If someone is informed of a potential or likely infection,
| but then typically [chooses to/is able to] go about their
| day the same as usual, then what's the point of tracing
| them?
|
| Initial modelling that showed contact tracing to
| potentially work assumed: 80% uptake, over 70s to be
| isolated in any case, and people to strictly follow
| isolation rules, none of which was considered politically
| possible in the West:
| https://www.bbc.com/news/technology-52294896
| jfoster wrote:
| Yeah, a lot of it might not be politically or culturally
| possible. As far as I can tell, it was always technically
| possible to have very good automated contact tracing,
| though.
| robrenaud wrote:
| Adoption was by far the biggest problem. If Apple/Google
| just shipped it in the OS and made it opt out, I bet it
| would have had a significant impact. Not like turning the
| US into Australia, but even a 10% reduction in covid
| cases worldwide could have saved 300k lives.
| dariusj18 wrote:
| > Ventilators were the critical thing
|
| Ventilators are still a critical thing, but they are a last
| resort, not a normal treatment. The reason they were a big deal
| was because with a large enough spike we would run out of them
| (availability-wise) and I don't think people understand what
| that would do to the psyche of the populace.
| ddalex wrote:
| Sadly this is the case now in India....
| Izkata wrote:
| No, in March last year doctors were prematurely jumping to
| ventilators because of a confusing hypoxia-like symptom:
| blood oxygen levels dropping into "you should already be
| dead" levels. Ventilator use dropped off once this stopped
| and they switched to other treatments for the less serious
| cases.
| lofi_lory wrote:
| Could you elaborate or link a source. I have a hard time
| believing acting on lethal blood oxygen levels somehow does
| not apply if infected with SARS2.
| stjohnswarts wrote:
| You should look it up for yourself, there are tons of
| articles saying that respirators were being used too
| quickly when things like putting the patients facedown
| were a better solution in most cases. This is before much
| was known about the virus and doctors were using the
| tools they knew about. Obviously they are still being
| used but much more sparingly than initially.
| Izkata wrote:
| Some excerpts from here:
| https://www.statnews.com/2020/04/08/doctors-say-
| ventilators-...
|
| > What's driving this reassessment is a baffling
| observation about Covid-19: Many patients have blood
| oxygen levels so low they should be dead. But they're not
| gasping for air, their hearts aren't racing, and their
| brains show no signs of blinking off from lack of oxygen.
|
| > [..]
|
| > An oxygen saturation rate below 93% (normal is 95% to
| 100%) has long been taken as a sign of potential hypoxia
| and impending organ damage. Before Covid-19, when the
| oxygen level dropped below this threshold, physicians
| supported their patients' breathing with noninvasive
| devices such as continuous positive airway pressure
| (CPAP, the sleep apnea device) and bilevel positive
| airway pressure ventilators (BiPAP). Both work via a tube
| into a face mask.
|
| > [..]
|
| > But because in some patients with Covid-19, blood-
| oxygen levels fall to hardly-ever-seen levels, into the
| 70s and even lower, physicians are intubating them
| sooner. "Data from China suggested that early intubation
| would keep Covid-19 patients' heart, liver, and kidneys
| from failing due to hypoxia," said a veteran emergency
| medicine physician. "This has been the whole thing
| driving decisions about breathing support: Knock them out
| and put them on a ventilator."
|
| > [..]
|
| > To be "more nuanced about who we intubate," as she
| suggests, starts with questioning the significance of
| oxygen saturation levels. Those levels often "look beyond
| awful," said Scott Weingart, a critical care physician in
| New York and host of the "EMCrit" podcast. But many can
| speak in full sentences, don't report shortness of
| breath, and have no signs of the heart or other organ
| abnormalities that hypoxia can cause.
|
| > [..]
|
| > One reason Covid-19 patients can have near-hypoxic
| levels of blood oxygen without the usual gasping and
| other signs of impairment is that their blood levels of
| carbon dioxide, which diffuses into air in the lungs and
| is then exhaled, remain low. That suggests the lungs are
| still accomplishing the critical job of removing carbon
| dioxide even if they're struggling to absorb oxygen.
| That, too, is reminiscent of altitude sickness more than
| pneumonia.
| wpietri wrote:
| > Official contact tracing in the US is a complete dud and had
| negligible impact on the spread.
|
| The problem with contact tracing in the US definitely wasn't an
| excess of effort:
| https://www.nature.com/articles/d41586-020-03518-4
|
| And more generally, I think it's great that lots of effort went
| into things that were then superseded by things that worked
| better. Sitting around waiting for perfect knowledge would have
| meant a much larger death toll. Indeed, the knowledge about
| better treatments came because people tried a great number of
| things and then doubled down on the ones that worked. Trying
| things is never wasted effort if at the time they were a good
| guess about what might work.
| Naga wrote:
| All the surface cleaning _was_ a massive waste? How about _was
| and continues to be_. At least where I live in Ontario, stores
| still won 't let you touch products, require hand washing, wipe
| down all the carts, etc. It's all theatre that doesn't really
| do anything to stop the spread of covid but has the benefit of
| making it look like they are doing something.
|
| Another example is that while schools are closed now again
| (because they aren't safe), the government until a few weeks
| ago was bragging about how safe schools were because of their
| extensive cleaning procedures, which did nothing to make
| schools safe since ventilation was the key!
| [deleted]
| sdljfjafsd wrote:
| In Portland retail stores require you to hand sanitize every
| time you enter which becomes a bit cumbersome if you enter a
| few stores during a trip. And yes, the extra effort has a
| cost, because I've been told to sanitize in front of
| employees who are interacting with groups of customers at
| close distance (while masked tbf). At the end of the day
| humans have a small set of things they can juggle in their
| minds and that focus should be on ventilation, spacing, and
| masking instead of wasting focus on unnecessary surface
| cleaning.
| olyjohn wrote:
| There's a go-kart track near me... and they have someone who
| goes around after each session and sprays some kind of fog on
| the karts. I presume it's a "sanitizer" but if you look how
| sanitizers work, they still take time to act and it takes a
| decent quantity of it to work. Meanwhile the steering wheels
| are covered in pourous foam / plastic / rubber, which is
| soaking up everybody's sweat, germs and bacteria... and some
| how this fog, which is safe for the person spraying it to
| stand in, sanitizes the entire kart in under a few seconds
| and leaves behind no residue...
| jborichevskiy wrote:
| Still better are the two-person crews in full gear spraying
| this fine mist over airport lobby chairs and furniture (and
| people sitting nearby) while wearing enough PPO to look
| like late stage Chernobyl responders.
|
| Security performance theater.
| robocat wrote:
| Perhaps they should add a mitred hat, some beads, a
| censer, and a droning chant...
|
| Change it from theater to ceremony!
| barkerja wrote:
| Maybe it was/is a dud for COVID-19, but there does appear to
| be many gains from this outside of COVID-19. Infectious
| diseases that ARE highly transmissible on contact has been
| dramatically reduced.
|
| Am I suggesting we continue with this level of rigor for
| cleaning after the pandemic has ended? No. But it does
| highlight how much "healthier" we can be as a society with a
| little more emphasis on general hygiene.
| stjohnswarts wrote:
| It almost definitely reduces the spread of flu. I highly
| doubt it continues post-covid though. Some people seem to
| love the idea of wearing masks indefinitely though so I
| think we'll see more of that.
| omginternets wrote:
| >But it does highlight how much "healthier" we can be as a
| society with a little more emphasis on general hygiene.
|
| The counter-argument to this is that excessive hygiene also
| seems to (quite probably) _cause_ health problems [0].
| There appears to be some tension between protecting the
| weak and protecting the herd, so it 's not at all clear
| that this increase in sanitization will ultimately be a net
| gain for public health (to say nothing of environmental
| impact).
|
| [0] I leave it to the curious to run a few google scholar
| searches. "hygiene hypothesis" is a good start, pointing to
| relationships between excess (or more exactly, a wrong kind
| of) cleanliness and poor development of the intestinal
| microbiome.
| tjs8rj wrote:
| I think this is a consequence of "make your product for the
| customer". I think it should've been obvious that Americans
| weren't Koreans or Kiwis in attitude, numbers, or behavior, and
| so the solutions requiring that level of cooperation and
| attention should've never left the drawing board. As we've seen
| and as should've been obvious: Americans are resistant to
| authority for one. Solution that get too overbearing too
| quickly can work, but they have to keep that in mind when
| considered. At the public health level I hope the architects of
| these policies at least recognized that fact, even if the
| whirlwind of spins and politicization in the public made it
| seem like everything was failing spectacularly.
| CarelessExpert wrote:
| > It's a little surprising how much effort went into things
| early in the pandemic that didn't pan out.
|
| Is it?
|
| Thousands of people began dying from a novel mass pandemic,
| while years of complacency ensured governments weren't prepared
| for this inevitability.
|
| Who would be surprised that they threw everything they could
| against the wall?
|
| The real question is: will we learn anything from this going
| forward?
| IQunder130 wrote:
| What is there to learn? Events like this are rare enough that
| it's hard to justify any overhead for dealing with them in
| the off-period and it inevitably gets cut. Same as with that
| extreme weather event taking down the Texas grid.
| dylan604 wrote:
| >What is there to learn?
|
| Lots actually. Just like Edision found 999 ways not to make
| a light bulb. We also learned (re-learned) that common
| sense is not so common, and that people are just really not
| into being told what to do.
|
| >Events like this are rare enough
|
| Things that used to be "rare" are occurring more frequently
| to be considered "rare". Maybe more into the area of
| "uncommon". The Texas grid example is something so stupid
| to have allowed to happen after it just happend 10 years
| prior and with a simple (yet expensive-ish) solution.
| COVID-19 has had warnings of its level of spread for years
| with SARS, bird flus, etc. Those in charge of disaster
| prevention/recovery have failed us.
| throwawayboise wrote:
| > COVID-19 has had warnings of its level of spread for
| years with SARS, bird flus, etc.
|
| To me this was all "boy who cried wolf" stuff. I
| certainly remember media fear porn about SARS, about the
| expected severity of the next upcoming flu season, etc.
| It never amounted to anything significant in reality.
| dylan604 wrote:
| But here we are with COVID-19. Each of those flus were
| slightly worse than the previous leading up to where we
| are now. It's not that the scientists/doctors were wrong
| to make the warnings. Similar in how NWS is not wrong to
| issue Severe Weather warnings as frequently as they do.
| All it takes is the one time to have had advance warning
| and to not use it.
| tolbish wrote:
| The Ebola outbreak should have primed us for this.
| lofi_lory wrote:
| Neither extrem weather events, nor pandemics are expected
| to be freak events in the coming years. SARS1 was a warning
| shot.
|
| I don't think pandemic monitoring and response preparation
| are a that expensive, even if you use them just once a
| decade or two.
|
| And lots of failings highlighted by the pandemic are of a
| general nature concerning infrastructure debt. If health
| care wasn't run at max human capacity for "cost
| effectiveness" we may not have to talk about triage. If
| broadband internet access and digital literacy were a
| thing, WFH would run more smoothly.
| throwawayboise wrote:
| Nature has its ways of managing unsustainable population
| growth. Basically, starvation or disease. Maybe humanity
| is just at that point, and there's not a lot we can do
| absent some really breaking changes to how we live, work,
| and produce what we need.
| UncleMeat wrote:
| Are they rare enough? SARS wasn't that many years ago and
| was caught before becoming a pandemic, but that certainly
| wasn't a guarantee. Huge disease pandemics aren't black
| swans. They are common events throughout pretty much all
| human history.
| choward wrote:
| One thing we should learn and should have already known
| before the pandemic is that public health officials
| shouldn't be deliberately lying to the public.
| Unfortunately, Fauci has no remorse and hasn't apologized.
| He thinks he did the right thing which is a huge problem.
|
| Another thing is that we should have more explicit goals.
| Fauci is still not giving an explicit answer and pretty
| much just says that we'll just know when to go back to
| normal. Then they wonder why there is vaccine hesitancy.
| atonse wrote:
| Sure there's a lot to be learned.
|
| Even something as basic as having a national stockpile
| again, learning that we should have a decent manufacturing
| base for these kinds of critical items, and all the lessons
| about how to communicate with the public regarding health
| recommendations. There's plenty to be learned.
| jnwatson wrote:
| In my kid's high school (in Virginia, US), we have detailed
| contact tracing for all positive COVID tests.
|
| Contact tracing is done, and it seems to be done fairly
| thoroughly here.
| skybrian wrote:
| Another example: instead of contact tracing with PCR tests,
| skip the tracing part and have everyone regularly take much
| cheaper antigen tests a couple times a week.
|
| As a result of the lack of vision, there was no urgency in the
| US to approve over-the-counter antigen tests and they only
| became available in pharmacies last week.
| cameronh90 wrote:
| We are doing that in the UK and it's pretty controversial,
| with many credible medical/epidemiology experts saying it's a
| bad idea.
|
| One risk is people assuming a negative test means they don't
| have covid.
|
| Personally I think they're a good idea, but it really depends
| on people understanding and following the guidance. The tests
| are not overly simple to administer.
| mdoms wrote:
| Just because something didn't work in USA doesn't mean it
| "didn't pan out". Contact tracing has been used to track down
| contacts very rapidly in my country and presumably several
| others.
| fossuser wrote:
| The Bluetooth contact tracing would have been amazing, the
| design was smart, privacy preserving, and worked.
|
| The issue was a few things:
|
| - Opt-in instead of opt-out
|
| - People (even those on HN) not understanding how it worked and
| loudly and wrongly stating that it was a privacy nightmare. See
| this thread: https://news.ycombinator.com/item?id=25629304
|
| Unfortunately this lead governments and others to just buy data
| from brokers/3rd party app collectors and such that are _not_
| privacy preserving. A pretty frustrating situation.
| cactus2093 wrote:
| Completely agree with this. And the opt-in problem was
| twofold, you needed to opt in to receive notifications (and
| in California this option wasn't even available until like 6
| months after the frameworks were available) and also needed
| to remember to manually upload your result to the system
| after testing positive. The testing centers should have been
| asking for people's contact tracing id info and they should
| have been the ones reporting results into the system. (They
| already have your full name/contact info when you book an
| appointment, and the contact tracing id is anonymous, so
| again this is not sacrificing your privacy any further).
|
| It seems like a major factor in why this idea was never taken
| seriously by governments was that professional contact
| tracers are still using the playbook from 70 years ago from
| the polio era where the only thing you try is cold calling
| people's home phones. The public health field seemed entirely
| uninterested in technological solutions, even though it seems
| incredibly obvious that these could have had massive benefits
| over the old fashioned way of doing things.
|
| As with several other things that happened over the course of
| this pandemic, I really just can't wrap my head around why
| the "experts" were so willing to just let half a million
| deaths rack up in the US rather than trying any new ideas. I
| would be interested to read more about contact tracing now
| though, and if any of them have changed their mind by this
| point.
| fossuser wrote:
| Agreed - the cold calling was a joke and only really
| started after community transmission was super widespread
| anyway.
| [deleted]
| Lammy wrote:
| I just don't want to be tracked, ever, for any reason, by
| anyone. It doesn't matter how the system works or how private
| it is. It still normalizes surveillance to those who
| participate, and I won't :)
| fossuser wrote:
| You'll be tracked, it'll just be worse and not in a way
| that protects your privacy.
|
| You'll also be generally ignored by people that care about
| solving these problems.
|
| You'll also make it harder for people that care about the
| distinction between pragmatic solutions that protect
| privacy and simple solutions that don't.
|
| When your response to both is the same the response from
| governments is: "the privacy people are going to complain
| no matter what, so just ignore them".
|
| Your comment is basically an example of the kind of
| misleading knee-jerk response I was talking about. The
| bluetooth alerting design is not tracking, but your
| response to it is more likely to lead to solutions that
| are.
|
| Clever technological solutions can allow us to preserve
| privacy and still do important hard things. The bluetooth
| exposure notification design is an example of that, people
| that care about privacy should be excited about it.
| Lammy wrote:
| You're totally ignoring my point. I'm not talking about
| the tech. It affects the way people in general will think
| about having tech track them.
| fossuser wrote:
| I understand it, I just don't find it compelling.
|
| Second order effect arguments are often weak, in this
| case - not using a cleverly designed system that doesn't
| track them because it could make some theoretical person
| more comfortable with the idea of tracking in general
| doesn't hold up to me.
|
| The point of this is that it doesn't track them, but
| still achieves the goal of exposure notifications.
|
| It's like the seat-belts are worse argument - if people
| wear seatbelts they'll drive more dangerously therefore
| seatbelts are bad. These type of second order arguments
| can sound contrarian or smart, but they rarely hold up to
| scrutiny. (Similarly masks are bad because they make
| people touch their face or w/e nonsense was pushed early
| on in the pandemic).
|
| The average person is tracked completely by modern web
| companies, telcos, and random apps and they give up that
| willingly already - how does privacy preserving contact
| tracing make that worse? I don't buy it.
|
| It's more likely using services that preserve privacy by
| design get people to understand why they're different
| than everything else, and why that's valuable. When you
| dismiss them along with the bad ones you make it harder
| for people to make that distinction.
| warkdarrior wrote:
| Your point of view will drive the deployment of fully
| passive tracking, where you have absolutely no say in
| how/when/which data is collected. Things like pervasive
| cameras, cell tower dumps, etc., will become the norm
| whether you want it or not, but with the added downside
| that you have not say in it.
| dahart wrote:
| > I just don't want to be tracked, ever, for any reason, by
| anyone.
|
| Curious what this means to you in practice? I'm trying to
| imagine what zero tracking looks like... and wondering if I
| misunderstand what you mean by "ever, for any reason, by
| anyone." or if you're really serious about your wish and
| mean it as literally as it sounds.
|
| You don't want your doctor to have records of your previous
| visits? (Prefer to be offered the Covid Vaccine every time
| from now on?) You don't want the ability to have any
| personal bank / investment accounts? Our HN account & posts
| are being "tracked", what's an alternative to this
| discussion? How should governments manage the basics of
| things like social security or driver's licenses? How would
| anyone even contact you or employ you without some kind of
| telephone number or internet address that can be tracked?
| How would you find gainful employment, and do you want to
| re-negotiate your compensation daily?
|
| Framing all information storage as "tracking" and all
| information retrieval as "surveillance" seems to turn a
| blind eye to the many benefits we enjoy, while stoking a
| general and vague fear. I think I'm more privacy conscious
| than most, and I think we have some massive privacy issues
| at the moment, but I have to recognize the benefits I enjoy
| at the same time and seek to find a reasonable and
| practical balance. So, I accept some tracking, and what I
| want is always opt-in by default and control over who
| tracks what.
| toast0 wrote:
| > Ventilators were the critical thing until we realized they
| were a very sub optimal treatment.
|
| Ventilators and ICU beds are the shortages people are/were
| talking about, but the real issue is staff to operate the
| ventilators and care for the people in the ICU beds.
|
| You can work to quickly manufacture more equipment and it was
| done, but training people to do ICU nursing isn't fast;
| especially when in-person learning is inadvisable. Even if you
| train up non-ICU nurses to do ICU nursing, you need to train
| replacements for what they were doing (or go without). We don't
| have a lot of spare nursing capacity, especially when there is
| near-worldwide excess demand.
| heavyset_go wrote:
| Contact tracing would have worked if there wasn't an
| exponential amount of community spread in the US compared to
| other countries.
| yosito wrote:
| It would be interesting to see a metric for which countries
| did well with contact tracing and which didn't. Many
| countries tried it, and gave up. Some countries tried it and
| succeeded. A few countries didn't try at all.
| s1artibartfast wrote:
| I am personally convinced that US contract tracing results were
| suppressed. Massive amounts of data was collected and I believe
| it was possible to compile data from it about the situations
| and activates where transmission was known to occur.
|
| My guess is that the data could be used to argue against the
| public health policies of the same organizations that were
| collecting it. I looks forward to some of the data analysis
| released in the coming years.
| stonesweep wrote:
| > Official contact tracing in the US is a complete dud and had
| negligible impact on the spread.
|
| I am a US citizen, I simply have lost confidence in any promise
| made by any tech company in regards to my privacy and roll back
| to War Games - the only winning move is not to play. We have
| lost all confidence that any data shared will be kept private,
| there is little oversight or penalty for abuse of it.
| selimthegrim wrote:
| Po-Shen Loh's NOVID app from CMU held some promise.
| davidthewatson wrote:
| Indeed, Novid did have promise. Po's work should be
| celebrated.
|
| The problem is that Novid depends on self-report. Self-
| report is not reliable, or else we'd have seen success
| around this kind of self-reported contact tracing, which
| does not model reality accurately at scale.
|
| The problem is that a surveillance network is perfect for
| this kind of healthcare application, where the balance of
| power is toward the invisible surveiller and does not
| depend on the surveilled being compliant.
| pydry wrote:
| I think a lot of people think this way even outside of tech.
| srswtf123 wrote:
| I agree 110% -- The best solution is to _stop using their
| products_ ; put down the smartphones, remove FAANG & co. from
| your life entirely.
|
| You end up less lonely, less depressed, less tracked, and
| oddly, somehow now I feel better informed.
| mcherm wrote:
| > It's a little surprising how much effort went into things
| early in the pandemic that didn't pan out.
|
| It's not surprising at all!
|
| We had a choice between taking actions some of which might be
| wasted (like manufacturing large quantities of vaccines that
| hadn't yet completed the approval process, or creating a
| contact tracing app that might or might not prove useful), or
| not taking any actions until we were done investigating.
|
| No vaccines have yet been approved for Covid-19. There are,
| however, several which have received temporary authorizations
| for emergency use.
|
| I think we made the right choice. Waste a few resources, if
| need be, because we don't know for sure which approaches will
| pan out. But the ones that DO pan out will (HAVE) save hundreds
| of thousands of lives, perhaps millions.
| salawat wrote:
| Funny. I doubt the horsehoe crab population being decimated
| at an industrial scale when a synthetic alternative was
| available, but langishing unapproved would agree.
|
| https://www.nationalgeographic.com/animals/article/covid-
| vac...
|
| 3+ different vaccine production lines. 1 species as a supply
| bottleneck, and no one giving a damn that there needs be
| affordances made to not potentially drive a species to
| extinction.
|
| I'm normally not big on environmentalist concerns as a first
| order thing because it tends to get you tuned out in some
| circles but the scale becomes absolutely impossible to ignore
| in this case.
|
| Then you had other potential routes for treatment completely
| ignored due to the fact they're biologics and cannot be
| patented. Echinaecia purpurea among them. (Came in handy for
| me early on), and vitamin C to keep immune cell exhaustion at
| bay.
|
| No one ever heard about or researched any of it, nor was
| anyone comfortable bringing it up lest one get dog-piled as a
| "disinfo-spreading quack". Gotta wait for Big Pharma to bail
| you out doncha'know?
|
| The entire thing has just been one massive shitshow. It's a
| Catch-22. There's no way to define anything as medically
| sound except to have a company go balls-to-the-wall double-
| blind cert study, but no one will do that for something that
| can't be patented or have an industrial business model built
| around it.
|
| The externalities are a bit on the extreme side in my view.
| throwaways885 wrote:
| Americans really do get the short end of the stick. Having
| to pay full whack to fund healthcare development while
| single payer systems just take the result at bargain
| basement prices.
|
| The only solution is to fund basic science research
| directly and remove the perverse incentives, but (as an
| outsider) it seems America does not have the political will
| to do anything so bold right now.
| salawat wrote:
| There is some slow movement in that direction, but there
| is a lot of opaqueness that has to be worked through and
| have public scrutiny turned it's way.
|
| At the end of the day though, no matter how you slice the
| pie of dollars, the motivation of a majority of the
| market is to make more money. Not to solve problems one
| and done. Always remember, healthcare is an industry
| first and foremost; cures aren't good business. Just look
| at what Wall Street has to say on the matter.
|
| https://science.slashdot.org/story/18/04/14/0059236/is-
| curin...
|
| So Market mechanisms don't really work unless you
| structure things correctly; which includes building a
| prize pool to pull from for each actor to further the
| state of the art. Try doing that in the U.S. and people
| will get all bent though because all that capital ends up
| locked away instead of lining everyone's pockets..
| throwaway122378 wrote:
| Surprise surprise
| williesleg wrote:
| Of course, it's google.
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