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Coronavirus

Xd the great

By Xd the great
in Science & Spaceflight

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tater

tater

Posted
Posted (edited)
3 hours ago, Shpaget said:

3,5% of the world population

No, 0.35%, not 3.5%. If it's that high, we lose 3 years worth of flu patients in a year or two. Largely the same people who would die of the flu, too, the chances that this kills largely "excess" people is very nearly zero, the people dying are mostly the same fragile people flu takes out (flu happily doesn't take out as many these days because we have flu vaccines that mitigate this).

Also, since a COVID-19 vaccine is not going to be a thing for a few years (at best), those same 0.35% (or whatever the IFR actually is) will still die, they just won't die in Spring 2020, they will die over those next few years.

 

5 hours ago, mikegarrison said:

Yes, but IT'S ALL BEEN NEARLY USELESS IF WE DO IT TOO SOON. All the models seem to agree that we need to try to hold things together until mid- or late- May. Is that really too much to ask?

Sure, it seems like younger people aren't at a lot of risk, but all that means is that they are doing this to save the lives of others rather than their own. Younger people going out, catching the virus, and continuing to spread it and keep it burning in the population may not kill them, but it just keeps the damn thing active and churning and trying to get at the more vulnerable people. Whereas just a few weeks more of pretty good quarantine and it will be much easier to keep it from getting to the vulnerable people at all.

1. We're unsure of what the lockdowns are actually doing, we don't have the counterfactual data yet (Sweden?). That's fine, I think for a while they are an OK thing to do. The models are mostly based on assumptions. They "flatten the curve" via assuming this measure drops R0 by 0.4, and that one by 0.2, etc. Meanwhile different, curve fitting models can also suggest that everyone is following the same path. I don't know which is right, we won't until after this is over, frankly.

2. The point of flattening is to prevent healthcare overload. That hasn't happened, but the same number of people still have to get sick, and will still have to die. Different curve, same area under it. We actually want people sick, just cared for properly (if we have to hit herd immunity, we want that to happen sooner, not drag out for years, particularly if immunity isn't durable for more than a few years—if it's not durable long term, then we need it to burn out quickly (?) ).

3. Related to 2, there will probably never be so few cases we can crush this out of existence, it's endemic, particularly to the extent that we have large number of cases who don't get very sick (3/4 of flu infections never result in symptoms, either, this is not atypical—they simply won't get caught (everyone will have to get a COVID test every day they have a cough/cold, until they finally test positive some day).

4. Opening this up in a controlled way MUST happen. Did I post to abandon everything tomorrow? I don't recall ever saying anything like that. People keep using "the economy" like that's the stock market or something. It's the lady that usually cuts my hair (and my son's hair, and my father-in-law's hair), it's the waitress that doesn't get paid at the place I still get takeout from (at least the owners can hopefully stay in business until after), the small stores that barely stay alive in the Amazon world as it is, etc, ad nauseum. Not everyone can tele-commute, people need money. The POINT of staring to reopen the economy in a controlled way is that it allows for some of the measures to stay in place for longer. "Too soon" might be impossible to avoid if people get desperate for the basics they need for survival due to lack of money. If we can let the LEAST AT RISK go back in a controlled way we can sustain other efforts longer (notice I don't say WHEN, and haven't, past "as soon as possible").

 

3 hours ago, mikegarrison said:

It's not about "we'll never be the same again". It's about waiting just a few more weeks in order to head off a nasty "second wave".

How many weeks must we lockdown to guarantee no second wave? Few of the models I have seen even go past summer (and none have been very good at prediction at all so far, frankly).

I honestly think the only way there is no second wave is if this wave hits herd immunity somehow. The notion of contact tracing seems pretty unlikely to me. We will contact trace the people sick enough to present at the hospital, the 90% with mild cases will never even see a doc about it.

 

Quote

When you are busy adding up the dollars or rubles or yen or whatever for waiting out a couple more weeks, why not start factoring the cost of what happens if there is a second wave that sends us all back into this same position again in about four months?

Yeah, well I assume this is the case anyway. The more strict the lockdown, the shorter it can be. If we open in a controlled way, the point is that we go back to a new version of normal, not back to Dec 2019. The controlled, reopened economy is a mild lockdown that is sustainable for as long as required, vs right now, which is unsustainable.

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tater

tater

Posted
Posted (edited)

I'd say that what we need yesterday (been saying this for a few weeks) is some good, controlled, antibody testing to assess the actual extent of infection, the ascertainment rate of the PCR testing done so far, and hence the actual infection fatality rate, rate of hospitalization, and severe illness—the severe cases are honestly as important as deaths, and include all the deaths anyway—since many of the people who survive a severe case will be compromised going forward for many years (which means "for life" if they are already old).

Knowing this allows us to decide what the risks actually are, and who is least safe out in normal life, and who is most safe.

Also, if they can sort out R0 better by IDing unascertained cases, we get a better feel for where herd immunity is. Maybe some places are already close enough that they get to that point and go back to much closer to normal (at risk who have no antibodies have to stay at home possibly for a long, long time).

(I'm not sanguine about being near herd immunity, particularly if R0 is high).

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Hotel26

Hotel26

Posted
Posted (edited)
On 4/20/2020 at 5:58 PM, Shpaget said:

there are those that will claim that one life is a price too high, and that it's worth the effort to try to now save as many as possible no matter the long term cost.

Isn't this pretty easy to refute, though?

Supposing the cost to save the life of your grandmother was that everyone else in the world had to work 12 hour days, six days per week for one company, for low wages, doing whatever they are told, by managers who are ratbags, all their life until age 65...?

This supposition may seem just as absurd as the claim you mention above, but it immediately establishes that there are prices too high and provides the avenue for the refutation of the claim.

And once we've established the nature of the problem (cost allocation) we can go ahead and discuss the actual price -- using real numbers.

                                                                         

In the 70s and 80s, air safety was quite patchy and the news organizations made a feeding frenzy on the two or three spectacular accidents that occurred every year (not counting hijacking/terrorist incidents).  It really has gotten amazingly better.

Nevertheless, in 1996 a Valujet flight burned after take-off and subsequently crashed into the Florida Everglades.  It was determined that oxygen cylinders, stowed in the cargo hold, had contributed to a fire that burned so hot that the jet had no time to return to its airport of departure.

Elizabeth Dole, wife of Vice-President Dole, was the head of the Department of Transport at the time.  She sought to mandate that all airlines install fire detection and suppression equipment in the cargo holds of all larger passenger planes.

This was not, however, the way the NTSB works.  It came to light that this organization uses a cost-benefit analysis in which the hypothetical "value of a human life" was figured at 650,000 US$ (at that time, as best I recall).

It was also pointed out that it was ALREADY ILLEGAL to stow oxygen cylinders on passenger planes as cargo and that that regulation had been callously violated.  The mandate was fought off and the status quo stayed the same.  As far as I know, no similar accident, due to the same cause, has occurred since.

You can't make reasonable decisions when you include so-called "priceless" quantities into the decision-making.

Meanwhile, the air transport industry has now become one of the indisputably safest ways to travel.

I will end by pointing out that another completely "heartless" industry/endeavor is the medical industry which conducts ruthless self-examination of the efficacy of its own procedures.  At least at the technological level, that is responsible for the impressive advances in medical science that we've been privileged to observe/enjoy during the last half-century and more.

 

Edited by Hotel26
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sevenperforce

sevenperforce

Posted
Posted
2 hours ago, tater said:

I'd say that what we need yesterday (been saying this for a few weeks) is some good, controlled, antibody testing to assess the actual extent of infection, the ascertainment rate of the PCR testing done so far, and hence the actual infection fatality rate, rate of hospitalization, and severe illness—the severe cases are honestly as important as deaths, and include all the deaths anyway—since many of the people who survive a severe case will be compromised going forward for many years (which means "for life" if they are already old).

Knowing this allows us to decide what the risks actually are, and who is least safe out in normal life, and who is most safe.

Also, if they can sort out R0 better by IDing unascertained cases, we get a better feel for where herd immunity is. Maybe some places are already close enough that they get to that point and go back to much closer to normal (at risk who have no antibodies have to stay at home possibly for a long, long time).

(I'm not sanguine about being near herd immunity, particularly if R0 is high).

Unfortunately the most recent antibody tests don't work. 

https://www.propublica.org/article/he-spent--500-000-to-buy-coronavirus-tests-health-officials-say-theyre-unreliable

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tater

tater

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19 minutes ago, sevenperforce said:

Unfortunately the most recent antibody tests don't work. 

https://www.propublica.org/article/he-spent--500-000-to-buy-coronavirus-tests-health-officials-say-theyre-unreliable

A lot of them are lousy. Not all, they need to be tested.

Sensitivity and specificity. The Stanford tests were tested on 30 known positives, and 80 known negative samples. They had 100% specificity (zero false positives), and it was not as sensitive (~93%), so it underestimates positives. There are issues with the sample of people tested, we need broader, ideally random samples.

Anyway, it is really test dependent, and they need to test all of them before using them.

 

This is a reasonable take (like everyone else concerned about data he wants good serological studies ASAP):

 

To be clear, I am not saying we need mass antibody testing for the public to be allowed to go back to normal (ref: the lousy tests), I want controlled, scientific studies of immunity prevalence using well verified tests. This information is required to make rational policy decisions moving forward.

If that results in good tests being widely available, later, great. I want the data for population groups first, not individuals.

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tater

tater

Posted
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European variant might be making more viral load, worse outcomes (faster spread?):

https://www.scmp.com/news/china/science/article/3080771/coronavirus-mutations-affect-deadliness-strains-chinese-study

 

 

There was a map that showed the W coast got a strain from China, and the East coast was dominated by the European variant... can't find the map, though.

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tater

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https://academic.oup.com/cid/article/doi/10.1093/cid/ciaa424/5819060

Quote

In this cluster, 12 Covid-19 cases (one asymptomatic) were linked to one single index case. One child, co-infected with other respiratory viruses, attended three schools while symptomatic, but did not transmit the virus, suggesting potential different transmission dynamics in children.

The kid was tracked to contact 86 others, zero of whom contracted COVID-19. He also had flu, which he spread to 19 people.

 

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tater

tater

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https://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm

(same as linked up thread)

Age data interesting, and a useful reality check for risk assessment.

Death rate so far for people under 45 is ~0.27:100,000. Car accidents for the pop at large are around 12:100,000 (~44 times more likely than COVID for this age cohort).

Death per 100,000 for 45-64 YO is 3.8:100,000. About a third of car deaths.

For 65+ it's 26:100,000, more than twice the risk of automobile deaths.

Note this is current data. If the totals end up being 2X current (current ~17k deaths US for the data included in that CDC page), then those numbers would double. Assume 10X current deaths (170k all said and done), then for under 45 risk is only 4.4 times less than car wrecks instead of 44, and over 45 would be ~3X car death risk. At 5X current total deaths (over85k dead), 8.8X less under 45, and ~1.5X car deaths for over 45.

 

Edited by tater
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kerbiloid

kerbiloid

Posted
Posted
Spoiler

Humans are wishing so much to discover a microbiological lifeform on Europa that are discussing how to send a submarine to bring it here.

But at the same time they are ferociously trying to kill the lifeform which is already here and is trying to get close to them itself.

What a disappointing duplicity...

 

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tater

tater

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https://translate.google.com/translate?sl=fr&tl=en&u=https%3A%2F%2Fnews-24.fr%2Fau-moins-11-des-suedois-pourraient-avoir-contracte-covid-19-selon-une-etude-sur-les-anticorps%2F

Original French: https://news-24.fr/au-moins-11-des-suedois-pourraient-avoir-contracte-covid-19-selon-une-etude-sur-les-anticorps/

Preliminary data show 11% in Stockholm test positive for antibodies. Test is not very sensitive (70-80%), so under reports, but is 100% specific (no false positives).

They are working on testing more people.

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Flavio hc16

Flavio hc16

Posted
Posted
54 minutes ago, tater said:

https://translate.google.com/translate?sl=fr&tl=en&u=https%3A%2F%2Fnews-24.fr%2Fau-moins-11-des-suedois-pourraient-avoir-contracte-covid-19-selon-une-etude-sur-les-anticorps%2F

Original French: https://news-24.fr/au-moins-11-des-suedois-pourraient-avoir-contracte-covid-19-selon-une-etude-sur-les-anticorps/

Preliminary data show 11% in Stockholm test positive for antibodies. Test is not very sensitive (70-80%), so under reports, but is 100% specific (no false positives).

They are working on testing more people.

here in Italy, especially in Lombardy we are at around 15-20% in the same metric ( donors that are positive)

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tater

tater

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12 minutes ago, Flavio hc16 said:

here in Italy, especially in Lombardy we are at around 15-20% in the same metric ( donors that are positive)

20% would be an IFR of 0.2% for Italy as a whole.

(total cases would in fact be those with antibodies plus active cases that don't yet have antibodies)

It's interesting that all the studies converge towards a similar IFR. Still possibility for loads of variation based on pop demos.

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DDE

DDE

Posted
Posted

Broke: we're neck-deep in coronavirus, so here come the swine flu outbreaks

Woke: we're neck-deep in coronavirus, so let's suspend all environmental regulations


I think the Russian Alliance of Entrepreneurs and Industrialists has just won Ambulance Chaser of the Year with that one.

https://www.kommersant.ru/doc/4327027

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tater

tater

Posted
Posted

~4% in LA.

There are all kinds of twitter wars about the accuracy of various serological testing studies, and at lower numbers like 3-4% the uncertainty is greater, but every single survey done everywhere on Earth shows large numbers of undetected cases, some well outside uncertainty (32%, 11%, etc).

This would I suppose be a sort of good news (lower IFR and lower hospitalization rate), but unless the % is really high, it's not near herd immunity, so all we know is that it's really infectious.

I suppose one possibility is that the spike in deaths occurs once you hit a critical mass of infections such that the most at risk from this virus get exposed, then it bumps them off, and once the most susceptible are gone, it continues as a more mild illness (gotta make sense of substantial breakouts like NY).

There's a paper on reproductive number up the thread that discusses very low R0s with high variability being possible—generally low transmissibility, but with a subset of super-spreaders. Wonder if this could be a thing?

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