COVID-19 - Wuhan Coronavirus (a non-political thread, see pg. 36 #1778)

[molson]

The numbers are important not no much because they represent what is actually happening (which they can't), but because they are what the world governments and businesses will be reacting to in terms of policy, when things will start to gradually open up, and how resources are utilized. The numbers are the only way we'll know, or at least think, that we're past the peak, and when things are furthered along enough to scale back restrictions.

I can understand that making a statistician uneasy. The data is very fuzzy and speculative. But its what we have and it matters a lot.

Edit: In other good number news, the number of people hospitalized in intensive care in Italy decreased for the first time since it all started.

[RainMaker]

My fear is that half these deaths are coming out of NY. What happens when it reaches all our other cities?

[Brian Swartz]

If NYC is repeated in most major cities, then clearly it gets a lot worse. What I've read though indicates that, for example, San Francisco and LA have a better handle on it. Atlanta, New Orleans, Detroit not so much. I think it'll depend on the city and naturally the more of them we can keep from exploding the better.

[tarcone]

Went to Orscliens(sp?) today. Figured if I cant get out, Im going to get weed killer to fight to dandelions.

There was a girl with a gun checking temps to see if they let you in. My temp was 96.3. WOOT. my trip to Gatlinburg did not kill me.

Not going anywhere else unless I want alcohol.

[molson]

We're not at the peak yet in most of the U.S., but the hope that it won't be as bad as NYC anywhere else is based on the fact that, and I say this with love, NYC is the most disgusting city in the U.S. when it comes to germs.

[Arles]

New York is the worst city in the US for handling this. I don’t think the geography, mass transit and density in other cities matches NY. We will see soon though.

[henry296]

Originally Posted by RainMaker

My fear is that half these deaths are coming out of NY. What happens when it reaches all our other cities?

My hope is that many other cities were able to start social distancing when the number of cases is much lower. For example in the Greater Pittsburgh Area of 2.4MM people has around 1,000 cases and about 15 deaths which is significantly lower rate than most of the other places. With social distancing I am much less likely to encounter someone with the disease. If those policies really work, we could be ok. There have been no major reports of issues in our hospitals yet. We are not out of the woods yet and can't relax but for now, this small section doesn't feel like it will become New York.

[whomario]

Originally Posted by molson

The numbers are important not no much because they represent what is actually happening (which they can't), but because they are what the world governments and businesses will be reacting to in terms of policy, when things will start to gradually open up, and how resources are utilized. The numbers are the only way we'll know, or at least think, that we're past the peak, and when things are furthered along enough to scale back restrictions.

I can understand that making a statistician uneasy. The data is very fuzzy and speculative. But its what we have and it matters a lot.

Edit: In other good number news, the number of people hospitalized in intensive care in Italy decreased for the first time since it all started.

Plus, seen in context some numbers do tell us and especially experts something. Of course you can't just look at new cases (or worse, total cases) but if like Italy you ramp up testing, still get similar numbers for new cases and have the currently active cases rising more slowly, you know you are getting somewhere.

Getting 7500 new cases while you are already at 150k and do 50k tests a day is a much better sign then getting 5000 while at 50k and doing 15k tests.

And if country A) gets way more positives, tests way more but gets less hospitalisations that means they get much closer to the real number than B) with less cases, less tests but more hospitalisations.

And even if 5 times as many are never discovered, the 'democratic nature' of the virus (infects everybody equally operating under the same rules) means that you can still judge trends as long as you manage to not utterly ignore areas.

[whomario]

I think the big Challenge for the US is to be ready for the long time frame before 'critical mass' is reached in some areas further removed from initial hotspots. In the european countries it spreads much faster throughout the country. Which is bad on one hand, but the opposite has it's own challenges like loosening restrictions prematurely despite the number being just at the edge of where it is poised for a rapid acceleration.

Ideally once the outbreak in New York and other current hotspots slows down you will be able to move ressources to other parts of the country (or test more there).

This gives a decent idea :

Virus hot spots in South poised for disproportionate suffering

[AlexB]

Originally Posted by henry296

My hope is that many other cities were able to start social distancing when the number of cases is much lower. For example in the Greater Pittsburgh Area of 2.4MM people has around 1,000 cases and about 15 deaths which is significantly lower rate than most of the other places. With social distancing I am much less likely to encounter someone with the disease. If those policies really work, we could be ok. There have been no major reports of issues in our hospitals yet. We are not out of the woods yet and can't relax but for now, this small section doesn't feel like it will become New York.

The issue with this, and this is the concern with most of the UK too, is how do you get out of the restrictions? If social distancing is effective in keeping infections down, it also means that there is no resistance to the virus. So how do you get to normal life again without waiting 18 months for a vaccine, should one be developed?

This is why the herd resistance theory makes sense if you can time it right and keep numbers to a level where health services are not overrun, it gives you more of an exit strategy. It does also rely on post-infection immunity of course, which is not certain right now.

[Brian Swartz]

Guh. Michigan going south in a hurry, seems things are worse here now (though thankfully not near me) than anywhere outside of NY/NJ.

[whomario]

Originally Posted by AlexB

The issue with this, and this is the concern with most of the UK too, is how do you get out of the restrictions? If social distancing is effective in keeping infections down, it also means that there is no resistance to the virus. So how do you get to normal life again without waiting 18 months for a vaccine, should one be developed?

This is why the herd resistance theory makes sense if you can time it right and keep numbers to a level where health services are not overrun, it gives you more of an exit strategy. It does also rely on post-infection immunity of course, which is not certain right now.

Yes, but i really don't see how you can time it. There seems no practical way to only expose those that are not at risk. Even if you get it 95% right, there will still be an inherently higher risk of infection for at-risk groups since there are so many more potential spreaders at the same time. And even the non-risk groups' would create way too many hospitalisations.
It is a good idea but seems entirely impossible to translate into the real world given what we know, especially when the epidemic has already started. You'd need years to put the infrastructure and procedures in place.

I mean, all countries already isolate people in homes (no visitations, no leave, very little interaction) as much as humanly possible and even with only a relatively small spread are utterly unable to keep the virus from getting into that population in force and and spread wildly. We just can't properly 'arm' the Institutions with Tests or protective gear. How would that work any better when more people outside were infected ?

The main reason to supress it early is to gain time, both for improving ressourses (like increased PPE production or more ventilators) and to allow science and technology to catch up. We will be a lot better equiped in May than we were in March. But that is for naught if by then the virus is so widespread that the new tools and ressources are still not enough.
Kinda like avoiding a fight without any weapons now to be able to fight it later once you are tooled up.

This explains it pretty well

https://medium.com/@tomaspueyo/coron...e-be9337092b56

[Arles]

Originally Posted by AlexB

The issue with this, and this is the concern with most of the UK too, is how do you get out of the restrictions? If social distancing is effective in keeping infections down, it also means that there is no resistance to the virus. So how do you get to normal life again without waiting 18 months for a vaccine, should one be developed?

This is why the herd resistance theory makes sense if you can time it right and keep numbers to a level where health services are not overrun, it gives you more of an exit strategy. It does also rely on post-infection immunity of course, which is not certain right now.

I agree here. That’s why I think we should start loosening some of the restrictions when it is hotter in July (at least for the lower risk population). This way the heat can also act as a “slowing” mechanism and we build up some immunity in the population by the colder months. The worst thing to do would be to stay social distancing until Sept/Oct and then unleash a massive round 2 in winter.

[whomario]

Originally Posted by Arles

I agree here. That’s why I think we should start loosening some of the restrictions when it is hotter in July (at least for the lower risk population). This way the heat can also act as a “slowing” mechanism and we build up some immunity in the population by the colder months. The worst thing to do would be to stay social distancing until Sept/Oct and then unleash a massive round 2 in winter.

Except the consensus right now seems to lean more towards it not slowing enough to make a big difference

https://ccdd.hsph.harvard.edu/will-c...armer-weather/

Fact check: will Covid-19 fade in the summer – then return later like the flu? | US news | The Guardian

Of course this might allow some loosening, but only combined with other efforts and still with the goal to keep it low overall.

And again, the problem is that a low risk population with lots of infected poses a higher risk for the high risk population, be it directly or indirectly (most obvious chain: kid infects mom, mom works in a home. This happens a lot more the more Kids are infected)

I just fail to seen how a 'targeted immunity' approach can even remotely work with the existing healthcare system and societal overlap. Even if you could pinpoint the exact risk for everybody or at what age/health the individual risk is low enough that massive numbers don't crash the system. And what about at-risk people living with others less at risk ?

Restrictions will likely be loosened due to being better equiped*, not due to it being preferable at one time over another. If there are antibody tests, more capacity for normal tests or fast tests, more proper masks for people at work, maybe even somewhat effective medication or treatment (like blood plasma transfer) and more ventilators, that's when you loosen stuff i think. Though stuff like big events might not happen all year ...

* Even now Germany can get by with a bit looser restrictions than Italy, Spain or France due to slowing the first wave early with better testing capacity and thus better detection rates and more targeted quarantine at the beginning. And because we have more and more widespread ICU/Ventilator coverage than anybody else per capita. (By coincidence we are well equipped in that one area , not because the system is awesome as a whole)

[Atocep]

Originally Posted by larrymcg421

AL has not gone on lockdown.
MS goes on lockdown 4/3.
TN order took effect 4/2.
NC went on lockdown on 3/30
SC is still not on lockdown.
VA went on lockdown 3/30

I'll help you with the math. 2 weeks ago would be 3/19.

3 of those states (Alabama, Tennessee, Virginia) are projected to be in the top 10 in COVID19 deaths. Alabama is projected to have the most deaths per capita.

And Georgia has reopened its beaches

[tarcone]

As scary as this virus is, it will never be as scary than this picture:



I cannot imagine unloading on Omaha beach. And that is called the greatest generation, and for a reason.

[thesloppy]

Similarly, it's somewhat therapeutic for me to reflect on the fact that Americans 100 years ago lived through WW1, the Spanish Flu, and the Great Depression, in relatively quick succession. As apocalyptic & unprecedented as this can feel, we're not even close to that level of misery yet.

[NobodyHere]

Originally Posted by thesloppy

Similarly, it's somewhat therapeutic for me to reflect on the fact that Americans 100 years ago lived through WW1, the Spanish Flu, and the Great Depression, in relatively quick succession. As apocalyptic & unprecedented as this can feel, we're not even close to that level of misery yet.

Yeah, some people pretend like we're in Venezuala or something.

[Brian Swartz]

I think it's just because this is new to us. War, disease, etc. are just part of life for most of human history. It's good that that they aren't as common as they used to be, but at the same time we have a lot to learn about how to handle crises that pop up in the modern world.

[tarcone]

Originally Posted by thesloppy

Similarly, it's somewhat therapeutic for me to reflect on the fact that Americans 100 years ago lived through WW1, the Spanish Flu, and the Great Depression, in relatively quick succession. As apocalyptic & unprecedented as this can feel, we're not even close to that level of misery yet.

And how.

[SirFozzie]

https://www.washingtonpost.com/sport...t-like-answer/

No sports until 2021,Possibly? Eek.

(This almost seems like the plot for a Billionaire to purchase an island, build all the different fields, and then say to all the teams "You can play here, but you have to stay on the island")

[Atocep]

Originally Posted by SirFozzie

https://www.washingtonpost.com/sport...t-like-answer/

No sports until 2021,Possibly? Eek.

(This almost seems like the plot for a Billionaire to purchase an island, build all the different fields, and then say to all the teams "You can play here, but you have to stay on the island")

Which sounds like the plot to a zombie movie.

[molson]

Big crowds for sports and concerts and festivals feels like the very last thing that will be opened up. I'm pretty optimistic that we're going to start the gradual process of normalization in a month or two, but, 50,000 people in a stadium? It's hard to put a timetable on that.

[SirFozzie]

Well, I was thinking about the actual games (100K crowds at the horseshoe), but are we sure that college campuses are going to be open at the beginning of the fall semester?

[Brian Swartz]

I think we're not sure of anything that far out. My perspective is we're in a spot where we concern ourselves with the next month or two and beyond that can wait.

[sterlingice]

Originally Posted by SirFozzie

https://www.washingtonpost.com/sport...t-like-answer/

No sports until 2021,Possibly? Eek.

(This almost seems like the plot for a Billionaire to purchase an island, build all the different fields, and then say to all the teams "You can play here, but you have to stay on the island")

And who would be that billionaire?

You guessed it. Frank Stallone!



SI

[JPhillips]

Originally Posted by thesloppy

Similarly, it's somewhat therapeutic for me to reflect on the fact that Americans 100 years ago lived through WW1, the Spanish Flu, and the Great Depression, in relatively quick succession. As apocalyptic & unprecedented as this can feel, we're not even close to that level of misery yet.

Not that extreme, but if you were born in 1990 your adult memories are 9/11, the Iraq War, the Great Recession, and now this. They don't really have much time of "normal" life. It's no wonder their politics are generally more radical than older Americans.

[SirFozzie]

I mean, my generation (45) at least had the hope spot of the Wall coming down, the fall of communism, etcetera.

[whomario]

What weirds me out is that people talk about the age Covid deaths as if in normal times people would die when they are young (if that makes sense). In Germany 80% of all deatgs occurr past 70 and the average 80 year old still has 8-9.5 years to live depending on Gender.
Meaning that once you get to stay alive till 80 you are normally much more likely to get to 90 than drop dead at 81.

So if like in Bergamo/Lombardy suddenly 5 times as many 80 year olds die than usually, that is still a big freaking aberration.

[albionmoonlight]

How To Tell If We're Beating COVID-19 - YouTube

Covid Trends

A way of trying to map when various countries are getting of the exponential curve.

[albionmoonlight]

At this point, the US is not looking good, but I do think that enough states are taking this seriously now that we will start to see results in the next couple of weeks.

[JPhillips]

Originally Posted by albionmoonlight

At this point, the US is not looking good, but I do think that enough states are taking this seriously now that we will start to see results in the next couple of weeks.

Trump's inability to stay the course, though, jeopardizes a lot of that progress. The more he talks about the cure worse than the disease, etc. the more people are going to ignore the stay at home orders and the longer this is going to take to show enough progress.

[miked]

I'm still in shock that people compare this to the flu. There are like 300-400 average daily deaths for the flu. We are hitting over 1k/day and that is with extreme measures being taken. If people had not been social distancing and finally closing things off, this would have been catastrophic.

[miami_fan]

Driving around this morning, most church parking lots were empty for the normal early services. I passed the Roman Catholic Church down the street from my mom's house. The priest was giving Communion to people in their cars drive thru style. A couple of others were holding the drive in services that they were holding last week. Many more people wearing masks than Friday.

[Brian Swartz]

I haven't heard people still comparing coronavirus to the flu. Unless there's a wide difference between areas (which there probably is), I think that ship has pretty much sailed.

[HerRealName]

Originally Posted by Brian Swartz

I haven't heard people still comparing coronavirus to the flu. Unless there's a wide difference between areas (which there probably is), I think that ship has pretty much sailed.

I generally avoid Facebook but this was the first thing I saw this morning:

[sterlingice]

Originally Posted by miked

I'm still in shock that people compare this to the flu. There are like 300-400 average daily deaths for the flu. We are hitting over 1k/day and that is with extreme measures being taken. If people had not been social distancing and finally closing things off, this would have been catastrophic.

I'm having a tough time quantifying it. I went to the CDC mortality page, which has data from 2017:FastStats - Deaths and Mortality

If we want to quantify it by average deaths per day, that year an average of 7708 people died every day during the year. Here's all the causes with more than 100 deaths per day:

Heart Disease: 1774
Cancer: 1641
Accidents: 465
Respiratory disease: 439
Stroke: 401
Alzheimers: 332
Diabetes: 229
Flu: 152
Kidney disease: 139
Suicide: 129
Liver disease: 114
Sepsis: 112 (wth? 40K people a year die of sepsis?!?)

So, yeah, we're already past everything but heart disease and cancer and we'll pass those this week, most likely. That's with all these heavy measures being taken.

We think about, say, if we keep the numbers to "only" 200K people, that's a win. It will still be the 3rd highest killer of people this year in the US. If we have some less good outcomes and hit 700K, it's the #1 killer in the US this year.

SI

[whomario]

Originally Posted by miked

I'm still in shock that people compare this to the flu. There are like 300-400 average daily deaths for the flu. We are hitting over 1k/day and that is with extreme measures being taken. If people had not been social distancing and finally closing things off, this would have been catastrophic.

Confirmation bias is a powerfull thing.

And the real kicker that always has me shaking my head is that people trot out flu deaths as certainty when they are actually estimates. Whereas with Covid19 they take the official numbers and want to know if they aren't counted too liberally since afterall the disease is not certain to be the dominant cause* (and 'only' the final nail in the coffin) for a percentage of cases rather than wondering if there aren't many more dying without ever being diagnosed.

* Which btw is true for the seasonal flu as well (which is why only a fraction gets diagnosed. Heck, most just die at home in bed or in a home).

In Germany a former Professor (of a related field) keeps spouting that nonsense on Youtube, presenting the current low numbers here as proof for the lack of danger and the measures as a convient way to rob the citizens of their freedom.

[whomario]

Originally Posted by sterlingice

I'm having a tough time quantifying it. I went to the CDC mortality page, which has data from 2017:FastStats - Deaths and Mortality

If we want to quantify it by average deaths per day, that year an average of 7708 people died every day during the year. Here's all the causes with more than 100 deaths per day:

Heart Disease: 1774
Cancer: 1641
Accidents: 465
Respiratory disease: 439
Stroke: 401
Alzheimers: 332
Diabetes: 229
Flu: 152
Kidney disease: 139
Suicide: 129
Liver disease: 114
Sepsis: 112 (wth? 40K people a year die of sepsis?!?)

So, yeah, we're already past everything but heart disease and cancer and we'll pass those this week, most likely. That's with all these heavy measures being taken.

We think about, say, if we keep the numbers to "only" 200K people, that's a win. It will still be the 3rd highest killer of people this year in the US. If we have some less good outcomes and hit 700K, it's the #1 killer in the US this year.

SI

And then there are numbers like the following as a worst case (and even that includes social distancing and a lockdown from March 8th !), happening in a country perhaps more succeptible but still a decently well-off Region with a decent healthcare system:



Even allowing a great amount of uncertainty on numbers and sample size, this is insane.

And like i said before, the 'victim profile' of the flu is similar and it's a general truism that older people with more health issues are more likely to die.

Another graphic, for which i wished i had the skills to extend the scale (by now NY is getting 3k+ a week. In confirmed deaths, i am not sure if New York really tracks Influenza in real time but suspect these are estimates based on excess mortality)

https://i.redd.it/oc5exnk2dep41.jpg

[Thomkal]

I ventured forth to get a Walmart pickup order-still had to substitute things or go without a few, but ended up getting a lot of the stuff I ordered. They have the front doors semi-barricaded so you can only go in one side, out the other. I had to go in briefly, and saw inconsistent protective measures, almost no masks on checkers, some without gloves, I had gloves on both most customers did not appear to have any protective gear on.

[whomario]

Originally Posted by Thomkal

I ventured forth to get a Walmart pickup order-still had to substitute things or go without a few, but ended up getting a lot of the stuff I ordered. They have the front doors semi-barricaded so you can only go in one side, out the other. I had to go in briefly, and saw inconsistent protective measures, almost no masks on checkers, some without gloves, I had gloves on both most customers did not appear to have any protective gear on.

Gloves especially seem more 'nice to have' for ones own peace of mind if anything. A current study in a german hotspot has so far not been able to find any viable virus in a bunch of homes with multiple people currently infected and with symptoms living in them.. Not even on remotes or doorknobs. This mode of transmission really tends to be feared way more than it warrants, maybe because of the mystery of not knowing the 'other half' (who touches it before you).

Study

The earlier study often referenced was a pure lab study which essentially proved only that it is possible by creating optimal conditions (by directly spraying surfaces with tons of virus RNA).

[Fidatelo]

Just participated in a birthday parade for our friend's 6-year old. They live on a farm 30 minutes out of town. Everyone came in cars and lined up a block away from their lot, and the family had the girl dressed up and they were sitting in lawn chairs on their driveway. Then we all slowly drove past in a procession honking and saying happy birthday. The car in front of us (grandparents) threw a present in a bag out of their car into the ditch as they drove by, lol.

The whole thing was both hilarious and surreal.

[henry296]

Unless they are changing gloves after each interaction according to my wife who is a nurse it doesn't do much. The gloves can pass the virus to the next person just like your hands. That is why nurses change gloves after each patient.

[Thomkal]

Here are some links to VR space tours from Nasa and elsewhere for your boredom or to keep your kids occupied


NASA Is Offering Awesome Virtual Space Tours To Help You Escape Quarantine Boredom | HotHardware

[AlexB]

Boris Johnson admitted to hospital ‘for tests’ after failing to shake CV-19...

[whomario]

Originally Posted by henry296

Unless they are changing gloves after each interaction according to my wife who is a nurse it doesn't do much. The gloves can pass the virus to the next person just like your hands. That is why nurses change gloves after each patient.

That too. I mean, it's still the same thing, wether you touch your face with skin or glove.
The main rationale why it might make sense for normal people might simply be that you are less likely to actually touch your face absentmindedly and definitely do it less.
Kinda like putting bitter tasting lotion on a childs fingers/nails. But that's true regardless of corona.

Though again, it does not seem like surface transmission plays much of a role anyway short of actually handling an infected person like in a hospital. It's just not very likely virus goes from mucous membrane to hand to surface to hand to mucous membrane. That's essentially 4 transmissions where less and less viral RNA gets transported of a virus that is not 'designed' to be very stable when transfered that way. And that's still lowered if you wash your hands after shopping/handling deliveries.

As an aside: From what i have seen from people wearing masks, one can only hope this is correct. Because most of them touch their face under the mask and the front of their mask constantly.
I have some practice having worked in patient care before, but even then i catch myself doing it way more often than i'd want ...

[whomario]

Originally Posted by AlexB

Boris Johnson admitted to hospital ‘for tests’ after failing to shake CV-19...

I actually thought he looked pretty miserable in his little clip yesterday tbh and continuing to work all day can't be healthy once you develop symptoms. Hope some Rest is all he needs here !

[whomario]

Easter could be really explosive as far as interaction between police and the "it's been 3 weeks, fuck this" crowd ...

[AlexB]

Originally Posted by whomario

I actually thought he looked pretty miserable in his little clip yesterday tbh and continuing to work all day can't be healthy once you develop symptoms. Hope some Rest is all he needs here !

It does seem as if it is just tests as to why he’s not shaking the symptoms rather than them causing problems

[JPhillips]

Damn.

A tiger at the Bronx Zoo has tested positive for coronavirus, and several other animals are also showing symptoms. "Public health officials believe these large cats became sick after being exposed to a zoo employee who was actively shedding virus"