The Virus - Are You Affected?

[Emily Lake]

Okay, educate me. Why would "do more testing" beat back the virus? It seems like more testing would just give us a better idea of how many people have or had the virus, but wouldn't do anything about controlling it. What am I missing?

Quarantine. Targeted and strict quarantine, not the generalised and weak lockdowns currently in use.

Without testing to determine who needs to be in strict quarantine and who doesn't, general lockdown is the only option - and general lockdowns can't be too strict, because people still need to eat.

Yep, and because you can be infected for up to 14 days without symptoms, if you test positive on day 3 and isolate yourself, that's 11 days you won't be putting anyone at risk.

Okay, thank you both.

 

[DrZoidberg]

 

[DBT]

Interesting.

 

[Jokodo]

Well there's a big problem with the idea that the true case fatality rate is in the 0.1% region: in hard hit areas, population level mortality is frequently above that: In New York City (8.5 million), there have been 19,000 confirmed and probable deaths by May 3 - that alone is over 0.22%. Adding the excess deaths not listed as COVID-19 (a normal daily death rate for the city is around 170, so for those 54 days we expect little more than 9000 instead of the 12000+ recorded as not linked to covid 19) gets us well above 0.25%.

Unless 250% of the city's population has been infected, the math doesn't work out for a 0.1% CFR. And people haven't stopped dying there either, so maybe 1% is more realistic at least for NYC.

It's even worse for the province of Bergamo where in March alone, the excess deaths (above the number of expected deaths) are estimated to be 0.4% of the population and the confirmed COVID-19 deaths 0.2%.

 

[DrZoidberg]

Well there's a big problem with the idea that the true case fatality rate is in the 0.1% region: in hard hit areas, population level mortality is frequently above that: In New York City (8.5 million), there have been 19,000 confirmed and probable deaths by May 3 - that alone is over 0.22%. Adding the excess deaths not listed as COVID-19 (a normal daily death rate for the city is around 170, so for those 54 days we expect little more than 9000 instead of the 12000+ recorded as not linked to covid 19) gets us well above 0.25%.

Unless 250% of the city's population has been infected, the math doesn't work out for a 0.1% CFR. And people haven't stopped dying there either, so maybe 1% is more realistic at least for NYC.

It's even worse for the province of Bergamo where in March alone, the excess deaths (above the number of expected deaths) are estimated to be 0.4% of the population and the confirmed COVID-19 deaths 0.2%.

We still have no idea the full extent of the spread. Which makes it hard to calculate mortality rates. But people dying is now going down in Sweden. From that we can make a stab at calculating how many have been infected and infer. But it's a huge error margin. I think you're making the mistake of thinking we have enough data to make assesements. Not even the experts make cocksure statements like you are doing.

I think you need to separate deaths in regions where the health care system was overwhelmed (Milano, New York) and regions where it wasn't (Stockholm, London). You'll have completely different mortality rates.

 

[DrZoidberg]

A South Korean friend reports that next week schools are re-opening. So things will be going back to normal there to.

Apart from concerts and festivals being cancelled this summer, I think in a months time Europe will be back to normal.

I think China fucked themselves over by clamping down so hard. Same goes for New Zealand.

 

[Jokodo]

Well there's a big problem with the idea that the true case fatality rate is in the 0.1% region: in hard hit areas, population level mortality is frequently above that: In New York City (8.5 million), there have been 19,000 confirmed and probable deaths by May 3 - that alone is over 0.22%. Adding the excess deaths not listed as COVID-19 (a normal daily death rate for the city is around 170, so for those 54 days we expect little more than 9000 instead of the 12000+ recorded as not linked to covid 19) gets us well above 0.25%.

Unless 250% of the city's population has been infected, the math doesn't work out for a 0.1% CFR. And people haven't stopped dying there either, so maybe 1% is more realistic at least for NYC.

It's even worse for the province of Bergamo where in March alone, the excess deaths (above the number of expected deaths) are estimated to be 0.4% of the population and the confirmed COVID-19 deaths 0.2%.

We still have no idea the full extent of the spread.

We know that there's a hard upper limit at 100%. Any assumption that leads to the estimation that the spread in New York should be around 250% fails the test of reality.

The only way out of this paradox is to drop the assumption that surviving an infection confers any immunity at all. If there's no immunity and the average New Yorker has had the disease 2.5 times already, the math works out.

Which makes it hard to calculate mortality rates. But people dying is now going down in Sweden. From that we can make a stab at calculating how many have been infected and infer. But it's a huge error margin. I think you're making the mistake of thinking we have enough data to make assesements. Not even the experts make cocksure statements like you are doing.

I think you need to separate deaths in regions where the health care system was overwhelmed (Milano, New York) and regions where it wasn't (Stockholm, London). You'll have completely different mortality rates.

London? Did you seriously just offer London as a positive example?
London's deaths in the three most recent weeks with data were: Week ending -

- April 03: 2511
- April 10: 2832
- April 17: 3275

A typical value for the season is around 900 (2019 there were 928, 937, and 834 in the 3 weeks up to April 19).

Here's the raw data by the Office for National Statistics: https://www.ons.gov.uk/peoplepopula...nalfiguresondeathsregisteredinenglandandwales

 

[Jokodo]

We know that there's a hard upper limit at 100%. Any assumption that leads to the estimation that the spread in New York should be around 250% fails the test of reality.

The only way out of this paradox is to drop the assumption that surviving an infection confers any immunity at all. If there's no immunity and the average New Yorker has had the disease 2.5 times already, the math works out.

Which makes it hard to calculate mortality rates. But people dying is now going down in Sweden. From that we can make a stab at calculating how many have been infected and infer. But it's a huge error margin. I think you're making the mistake of thinking we have enough data to make assesements. Not even the experts make cocksure statements like you are doing.

I think you need to separate deaths in regions where the health care system was overwhelmed (Milano, New York) and regions where it wasn't (Stockholm, London). You'll have completely different mortality rates.

London? Did you seriously just offer London as a positive example?
London's deaths in the three most recent weeks with data were: Week ending -

- April 03: 2511
- April 10: 2832
- April 17: 3275

A typical value for the season is around 900 (2019 there were 928, 937, and 834 in the 3 weeks up to April 19).

Here's the raw data by the Office for National Statistics: https://www.ons.gov.uk/peoplepopula...nalfiguresondeathsregisteredinenglandandwales

To add: I'm fairly positive all experts would agree that population level prevalence figures well above 100 percent are implausible. I assume most would be pretty damn cocksure about that.

 

[DrZoidberg]

We know that there's a hard upper limit at 100%. Any assumption that leads to the estimation that the spread in New York should be around 250% fails the test of reality.

The only way out of this paradox is to drop the assumption that surviving an infection confers any immunity at all. If there's no immunity and the average New Yorker has had the disease 2.5 times already, the math works out.

I think you need to separate deaths in regions where the health care system was overwhelmed (Milano, New York) and regions where it wasn't (Stockholm, London). You'll have completely different mortality rates.

London? Did you seriously just offer London as a positive example?
London's deaths in the three most recent weeks with data were: Week ending -

- April 03: 2511
- April 10: 2832
- April 17: 3275

London's health service has so far not been overwhelmed. They came close, but never over. That's just a fact. As long as they continually have empty beds available it's going on the list of countries that did everything right. So I'm not sure what you think they did wrong?

High death rates doesn't necessarily mean they have failed. Sooner or later Covid-19 will sweep through your community. It's the death tally at the end of it that matters. The UK having a high death rate now, doesn't mean they will still have it at the end of this. It might as well just mean that they have had it spread more aggressively and therefore are closer to herd immunity.

A typical value for the season is around 900 (2019 there were 928, 937, and 834 in the 3 weeks up to April 19).

Here's the raw data by the Office for National Statistics: https://www.ons.gov.uk/peoplepopula...nalfiguresondeathsregisteredinenglandandwales

But why are you mentioning flu season statistics? This is a discussion about Covid-19. So those statistics are irrelevant, surely?

 

[marc]

Now this is innovative. To deal with distancing rules this strip joint has been updated to be a drive thru

 

[southernhybrid]

It's true that we have no idea what the death rate is because we have no idea what percentage of people had the virus but were asymptomatic or had mild symptoms and were never tested. So let's stop making assumptions about the mortality rate.

Of course it's higher in places where people live in tight quarters, where there is more poverty, more obesity, more older adults and more people who have underlying health conditions.

Generally speaking, the Swedish people are healthier that Americans. America has a very high rate of obesity, which has been identified as a big risk factor, and people who suffer from obesity are more likely to have hypertension, diabetes and/or heart disease. People who live in poverty often have more underlying health conditions too. People who live in nursing homes are not only living in tight quarters, they are older and usually very frail.

Countries like Japan have a much higher percentage of older adults than some other 1st world countries, so it's expected that the death rate will be higher there.


Plus, there are cytokine storms, which I've mentioned many times. Cytokine storms are believed to be a genetic defect that impacts between 10 to 20% of the population. They can happen in otherwise healthy individuals. They can be treated, if they are recognized early enough. If you haven't read my other posts and links, you know that basically a cytokine storm causes the immune system to over react and attack the bodies organs.

There are way too many factors that impact the mortality rate and we don't have enough information to make an accurate statement about the mortality rate.

The simple truth is that we still have a lot to learn about this virus and why some people who seem otherwise healthy die, and some others who are very old, and have underlying conditions survive.

 

[Jokodo]

London's health service has so far not been overwhelmed. They came close, but never over. That's just a fact. As long as they continually have empty beds available it's going on the list of countries that did everything right. So I'm not sure what you think they did wrong?

High death rates doesn't necessarily mean they have failed. Sooner or later Covid-19 will sweep through your community. It's the death tally at the end of it that matters. The UK having a high death rate now, doesn't mean they will still have it at the end of this. It might as well just mean that they have had it spread more aggressively and therefore are closer to herd immunity.

We don't know how failsafe immunity after a survived infection is, and we don't know how long it lasts, so herd immunity may not be achievable. The most likely scenario is that it is, but we don't know that yet, and I sure wouldn't want to bet tens of thousands of lives on the most likely scenario until we do know more. Like I don't drive 180kmh on the autobahn during heavy fog.

Also, there is a lot of active research into treatments going on. It is very plausible (though of course in no way certain) that a very significant number of the people who die now could be saved only a few months from now. Heaving the infections "spread more aggressively" in the initial phase will we still know so little about the virus is foregoing any chance of saving them.

A typical value for the season is around 900 (2019 there were 928, 937, and 834 in the 3 weeks up to April 19).

Here's the raw data by the Office for National Statistics: https://www.ons.gov.uk/peoplepopula...nalfiguresondeathsregisteredinenglandandwales

But why are you mentioning flu season statistics? This is a discussion about Covid-19. So those statistics are irrelevant, surely?

What the heck have you been reading? Because it sure as hell isn't my post you're replying to. The figures I quoted are total deaths, all causes. If we expect 900 people a week to die and find 3200, that's 2300 excess deaths. Since most causes of death will be down (road accidents, street crime, through less people on the streets, flu and other infectious diseases that are also reduced as a side effect of social distancing, infections by multi-resistent germs during non-essential hospital stays), we can safely conclude that at least those 2300 excess deaths are directly attributable to COVID-19.

 

[TSwizzle]

The insufferable prick of a governor of California seems to be easing the lockdown, allowing some stores to reopen and Orange County beaches providing they adhere to whatever arbitrarily diktat he decrees.

Gov. Gavin Newsom announced Monday that the next stage of reopening California's economy will begin Friday. Some businesses included in the state's "Stage 2" of reopening will be allowed to resume operations starting Friday, May 8, including bookstores, clothing stores, toy stores, florists and others. Associated manufacturers that support those retail supply chains will also be allowed to resume production. Those businesses will be allowed to reopen for curbside pick-up, given they follow additional safety and hygiene protocols that will be released Thursday, Newsom said. "This is a very positive sign and it has happened for only one reason: the data says it can happen," said Newsom.

News

Yeah, "the data says it can happen". Prick.

More likely he's getting nervous about the backlash.

 

[DrZoidberg]

We don't know how failsafe immunity after a survived infection is, and we don't know how long it lasts, so herd immunity may not be achievable. The most likely scenario is that it is, but we don't know that yet, and I sure wouldn't want to bet tens of thousands of lives on the most likely scenario until we do know more. Like I don't drive 180kmh on the autobahn during heavy fog.

Hypothetically, there is a chance that the immunity only lasts two years, based on other Coronaviruses. But SARS and MERS both gave permanent immunity (Or at least since 2002). As does most other influenza viruses. Some less than serious news outlets have drummed up this hypothetical risk to scare people into clicking the tabloid articles. But it's nothing keeping researchers up at night. They're researching it now, just so they can eliminate it. But nobody is worried it might not give permament immunity.

Also, there is a lot of active research into treatments going on. It is very plausible (though of course in no way certain) that a very significant number of the people who die now could be saved only a few months from now. Heaving the infections "spread more aggressively" in the initial phase will we still know so little about the virus is foregoing any chance of saving them.

Sure, that's a concern. But still somebody somewhere will have to bite the bullet to provide medical researchers with data to use in order to improve the treatments. Do you want to be the dick nation who isn't solidarical? Of course not. Nobody wants to be that. So it's a moot point. I also doubt it'll have such a large impact on overall mortality. There's only a tiny sliver of the population that risks death at all. So saving a couple more here and there because of improved methods... meh. Not worth fucking the economy up over.

But why are you mentioning flu season statistics? This is a discussion about Covid-19. So those statistics are irrelevant, surely?

What the heck have you been reading? Because it sure as hell isn't my post you're replying to. The figures I quoted are total deaths, all causes. If we expect 900 people a week to die and find 3200, that's 2300 excess deaths. Since most causes of death will be down (road accidents, street crime, through less people on the streets, flu and other infectious diseases that are also reduced as a side effect of social distancing, infections by multi-resistent germs during non-essential hospital stays), we can safely conclude that at least those 2300 excess deaths are directly attributable to COVID-19.

Yes, we agree that Covid-19 is a deadly disease best avoided. But since we can't avoid it we'll have to come up with some other strategy.

So I still don't understand why you're bringing up those statistics? If there was a way to avoid Covid-19 all together we can discuss it. But we can't, so what's the point?

 

[lpetrich]

The insufferable prick of a governor of California seems to be easing the lockdown, allowing some stores to reopen and Orange County beaches providing they adhere to whatever arbitrarily diktat he decrees.
...

Yeah, "the data says it can happen". Prick.

I think that he is on the right track. Open up low-risk activities first and move to higher and higher risk if that opening up proves to be safe.

There is a recent Chinese study about COVID-19 outbreaks and all but one of the 350-odd outbreaks that they looked at were indoors. The only outdoor one was from two people having a conversation. This result is not surprising, because outdoor air can be windy enough to blow away exhaled droplets. Also, indoor areas can have a low turnover rate - a time of several minutes or more.

So it's outdoor activities that are opening first, including business activities that happen outdoors, activities like picking up purchased stuff at the store that it was purchased from. Outdoor restaurant seating may also be OK.

More likely he's getting nervous about the backlash.

He looks very careful about that, and I think that he's been doing a MUCH better job than the so-called "president".

 

[DrZoidberg]

Spain will allow gatherings up to 800 in June. I think Europe has the worst behind them now. Corona lockdowns is ending soon. Yay.

 

[bilby]

London's health service has so far not been overwhelmed. They came close, but never over. That's just a fact. As long as they continually have empty beds available it's going on the list of countries that did everything right. So I'm not sure what you think they did wrong?

High death rates doesn't necessarily mean they have failed. Sooner or later Covid-19 will sweep through your community. It's the death tally at the end of it that matters. The UK having a high death rate now, doesn't mean they will still have it at the end of this. It might as well just mean that they have had it spread more aggressively and therefore are closer to herd immunity.

This is true if (and ONLY if) we believe that there will NEVER be a vaccine, nor any more effective treatment than those currently in use.

If either of these is untrue, then delaying the exposure of a large fraction of the population until a vaccine or effective treatment are available could save hundreds of millions of lives.

That's a big stake you a placing on your bet that our medical response today is as good as it will ever be.

 

[DrZoidberg]

London's health service has so far not been overwhelmed. They came close, but never over. That's just a fact. As long as they continually have empty beds available it's going on the list of countries that did everything right. So I'm not sure what you think they did wrong?

High death rates doesn't necessarily mean they have failed. Sooner or later Covid-19 will sweep through your community. It's the death tally at the end of it that matters. The UK having a high death rate now, doesn't mean they will still have it at the end of this. It might as well just mean that they have had it spread more aggressively and therefore are closer to herd immunity.

This is true if (and ONLY if) we believe that there will NEVER be a vaccine, nor any more effective treatment than those currently in use.

If either of these is untrue, then delaying the exposure of a large fraction of the population until a vaccine or effective treatment are available could save hundreds of millions of lives.

That's a big stake you a placing on your bet that our medical response today is as good as it will ever be.

A vaccine is minimum 1 year. Realistically 18 months. Being in lockdown until then is unrealistic. This virus is too sneaky and transmissible for it to be contained. Australia and New Zealand are special cases because... Geography.

 

[bilby]

London's health service has so far not been overwhelmed. They came close, but never over. That's just a fact. As long as they continually have empty beds available it's going on the list of countries that did everything right. So I'm not sure what you think they did wrong?

High death rates doesn't necessarily mean they have failed. Sooner or later Covid-19 will sweep through your community. It's the death tally at the end of it that matters. The UK having a high death rate now, doesn't mean they will still have it at the end of this. It might as well just mean that they have had it spread more aggressively and therefore are closer to herd immunity.

This is true if (and ONLY if) we believe that there will NEVER be a vaccine, nor any more effective treatment than those currently in use.

If either of these is untrue, then delaying the exposure of a large fraction of the population until a vaccine or effective treatment are available could save hundreds of millions of lives.

That's a big stake you a placing on your bet that our medical response today is as good as it will ever be.

A vaccine is minimum 1 year. Realistically 18 months.

That sounds about right.

Being in lockdown until then is unrealistic.

No, it isn't.

This virus is too sneaky and transmissible for it to be contained.

Not according to the South Koreans.

Australia and New Zealand are special cases because... Geography.

Perhaps. Why is South Korea a 'special case'?

Simply labelling something you don't personally like as "unrealistic" doesn't make it so.

 

[Jayjay]

I think the vaccine will come sooner than expected, because of all the resources poured into developing it and the human trials will be expedited due to political pressure. But it's still probably latter half of 2020.