Coronavirus

[dfwatt]

Question from a person who is not knowledgeable on this stuff. I think I read that the amount of infections may be as high as 4 to 5 times the number of cases confirmed by tests. If that is the case that would be about 1/2 a million people per day getting the virus. At that rate would herd immunity not be achievable by next spring.

That ratio may be somewhat optimistic. And there's a bigger problem namely the sole focus on case mortality as the only statistic that checks a herd immunity strategy. The real number is not the case fatality number but rather other numbers that are at least as important. What is the incidence of hospitalization? What is the incidence of ICU care? What is the incidence of so-called long-hauler syndromes in other words people who are ill for many many months? What is the percentage of people that suffer long-term organ damage? What is the incidence of people who suffer even more long range down stream consequences years or even decades later? For example we know that certain forms of chronic and refractory viral infection contribute significantly to the risk for Alzheimer's disease, which is my area. How many extra millions of cases of Alzheimer's disease will we have because of covid-19? Nobody knows. But it probably interdigitates with and amplifies many known risk factors such as various pro inflammatory lifestyle factors in a fashion that we are not able to map.

But these things are serious risks and in that sense this naive focus on herd immunity is staggeringly misinformed. Oh and there's one other statistic - how many people undergo bankruptcy because of covid-19 and I don't mean simply because of the recessionary impact of the pandemic but because of their medical bills? Until you're aware of all those numbers and understand all those relationships anyone recommending a herd immunity strategy is stupid. And the data that we have so far suggests that even if your case fatality rate can be kept low by newer and better treatments these other long-term punitive consequences make covid-19 something to fear. Care to find out how many trap doors there are in your private insurance plan that allow them to get out of paying costs so that you're stuck with a five-figure or even six-figure bill? Well covid-19 might be a good way to stress test your insurance plan and find out! Care to run that experiment? No thanks, at least not for me. I've seen too many of my patients bankrupted by our Healthcare System. I think I'll pass.

 

[Discoducky]

This seems to be the biggest spike currently: Belgium Coronavirus: 429,229 Cases and 11,625 Deaths - Worldometer

Anyone in Belgium able to comment? Really hope it isn't as bad as it looks. Maybe there's been more testing?

 

[dfwatt]

This seems to be the biggest spike currently: Belgium Coronavirus: 429,229 Cases and 11,625 Deaths - Worldometer

Anyone in Belgium able to comment? Really hope it isn't as bad as it looks. Maybe there's been more testing?

When hospitals fill up it's safe to say that the problem is not more testing. The notion that more testing is behind the explosion of covid-19 case counts is again a convenient fiction.

 

[dhanson865]

Medical professional trying to deal with a non-masker : aww

 

[AlanSubie4Life]

This seems to be the biggest spike currently: Belgium Coronavirus: 429,229 Cases and 11,625 Deaths - Worldometer

Anyone in Belgium able to comment? Really hope it isn't as bad as it looks. Maybe there's been more testing?

As @dfwatt says, hospitalizations and deaths are going up. A lot. This is fairly disturbing, since they already had an intense first outbreak and it’s probably not ripping through entirely different populations now.

Keep in mind average age in Belgium is 41.5 which is a lot older than the US (3 years) and could as much as double the IFR (probably a bit less than double), which does explain some of the extreme mortality.

In any case, gives an idea of how trajectories could go in the US if we were to relax suppression efforts at all. If you think right now is bad... Keep in mind that suppression efforts are relaxed, by definition, as infection numbers increase, since they do not scale with outbreak size.


The case to death lag in Belgium appears to be quite short too, which suggests to me it immediately entered the older population rather than starting in the young. This would also make mortality relatively worse (for now). Not sure if there is any infection by age data for Belgium.

 

[dhanson865]

So the cases since June 1 was posted previously. Compare that to the deaths since July 1 chart from the same source.

Odd that he doesn't use the same start date between the two graphs.



had I noticed it previously I would have posted the deaths graph instead of cases as it would have been less affected by testing levels and is more recent data by one month.

 

[AlanSubie4Life]

Rt of 1.3 means HIT is about 23%!

Correction: this should read R0 (but in this context, the R0 with suppression measures in place, not taking into account susceptibility of the population). Maybe call it R0’ , which changes based on how well we are preventing spread, but there is also the base R0 (no suppression measures) which for this virus appears to be around 3 on average (but it is very overdispersed for whatever reason, so for a few people it is R0 = 50, and for many others it’s more like 1 or lower). R by itself is a bit of a misleading measure, but in the context of herd immunity it can be helpful for broad estimates, but it is also simply a theoretical construct which doesn’t imply that herd immunity is a “solution”. It just tells you when infections will slow down. They won’t stop.

But, that overdispersion is a big deal for this so-called herd immunity. It doesn’t help if you have 70% of a sub-population immune, and one person with superspreading ability enters it - people are going to get infected and infections may propagate! And then when that sub-population transmits to an elderly sub-population with 5% immunity...disaster!

There is certainly technical, more precise terminology than presented here. IANAE.

 

[dhanson865]

Half of Slovakia's population tested for coronavirus in one day

Half of Slovakia's population tested for coronavirus in one day
More than 2.5 million Slovaks took swab tests on Saturday, with 25,850 testing positive

from a reddit comment

There were about 4900 testing state places, approximately copying the polling places usually with 8 people (2 doctors/nurses/paramedics taking swabs, 2 other medical professionals/pharmacists/vets/laborants/ processing the tests, one soldier, one policeman or firefighter and about 2 administrative workers and some volunteers). One place averagely dealt with 60 people/hour, some places asked the inhabitants to come by the alphabet or house numbers, however it was just a recommendation and every person could come to whatever the place they have chosen at any time.

Without the negative test you have to quarantine yourself for 10 days (you can go out to the nearest pharmacy, groceries, doctor and that is it, you can not go to the work and wont recieve money for 10 days if your presence there is required, you can stay on home office if your boss allows it). With negative test next week you can go to work, all different types of shops and dine outside.

and the rest get tested today (anyone over 10 years old was slated to get tested yesterday or today)

 

[AlanSubie4Life]

Due to the viral sequence being quite unique, they may be able to determine infections resulting from the WH outbreak in the future. So we’ll likely be able to assign blame for future deaths, which is always key.

https://twitter.com/trvrb/status/1323011782714159105?s=21

Tests Show Genetic Signature of Virus That May Have Infected President Trump

 

[TEG]

Someone's Leaked Federal Covid-19 Hospitalization Data

 

[dhanson865]

Someone's Leaked Federal Covid-19 Hospitalization Data

the source of that is NPR, Internal Documents Reveal COVID-19 Hospitalization Data The Government Keeps Hidden

 

[cwerdna]

Stanford Medical Faculty Lambaste Former Colleague and Trump Coronavirus Advisor Dr. Scott Atlas

points to the letter at https://twitter.com/RoxanaDaneshjou/status/1303904515607855104?s=20.

Then again, he surrounds himself with yes-men like Scott Atlas and his previous doctors who claimed him to be the healthiest President ever. Maybe he'll demand Hydroxychloroquine or that herbal snake oil from the pillow guy. Kinda makes you wonder. One hopes his self-preservation instincts will kick in, and he'll actually listen.

WH Adviser Scott Atlas Apologizes For Interview With Kremlin-Backed News Outlet (RT)

In the interview published Saturday, Atlas downplayed the severity of the U.S. coronavirus surge and said that lockdowns aimed at curbing the spread of COVID-19 are "not impactful" and "killing people."

"The lockdowns will go down as an epic failure of public policy by people who ... were wrong, refused to accept they were wrong, didn't know the data, didn't care, and became a frenzy of stopping COVID-19 cases at all costs and those costs are massive," Atlas said.

He also said protective measures like mask wearing and social distancing are "creating a generation of neurotic children," and said one in four Americans ages 18-24 thought of taking their lives in June because of lockdowns.
...
Atlas, a radiologist, joined the White House as a coronavirus adviser in August and has since drawn scrutiny for circulating misinformation and reportedly promoting the controversial theory of "herd immunity."

Last month, Twitter removed a post by Atlas in which he falsely stated that masks do not offer protection from the virus.

Sigh... Dr. Atlas should be fired from the task force and a certain someone should be ignoring his "advice".

 

[golfcart]

I agree 100% that people who don’t take precautions increase their risk of catching the virus and that policies can play a role in that to the extent that they are enforceable.

Is highlighting repeatedly the motivated discounting of epidemiologic science and the undercutting of simple recommendations for masking and social distance trolling? Isn't the discounting of basic epidemiologic science why we are nudging up against a hundred thousand new cases a day? Or actually are those scientific viewpoints being responded to with trolling by an ideologically rabid crowd that believes well for example that Anthony Fauci started covid-19 so that he could make money on a vaccine and that hospitals are inflating Covid death statistics so they can make more money that way? Who's the troll in all that?

What exactly does this have to do with the post you responded to? And how does this response, which has nothing to do with the post it responds to, get 3 likes and 3 loves? Just more evidence that thing thread has gone off the rails.

 

[Paracelsus]

This Tweet is now 4 days old but still amazes me. Traffic jams over 435 miles (700 km) long in an attempt to get out of Paris before lockdowns.

https://twitter.com/MichaelEWebber/...8?ref_src=twsrc^google|twcamp^serp|twgr^tweet

 

[NikolaACDC]

Not peer-reviewed:

Cellular immunity to SARS-CoV-2 found at six months in non-hospitalised individuals

Cellular (T cell) immunity against SARS-CoV-2 is likely to be present within most adults six months after primary infection, a new pre-print on bioRxiv suggests.

"...100 individuals who tested sero-positive for SARS-CoV-2 in March/April 2020 (average age 41 (range 22–65); 23 men, 77 women).
All 100 individuals experienced either mild/moderate symptoms or were asymptomatic (56 versus 44 people) and none were hospitalised for COVID-19.
...
Findings of the study
T cell responses were present in all individuals at six months after SARS-CoV-2 infection. The cellular immune response was directed against a range of proteins from the virus, including the Spike protein that is being used in most vaccine studies. However, comparable immunity was present against additional proteins, such as nucleoprotein, which suggests that these may be of value for incorporation in future vaccine protocols. This indicates that a robust cellular memory against the virus persists for at least six months.
The size of T cell response differed between individuals, being considerably (50%) higher in people who had experienced symptomatic disease at the time of infection six months previously. Further research will be needed to determine the significance of this finding. It is possible that heightened cellular immunity might provide increased protection against re-infection in people with initial symptomatic infection, or that asymptomatic individuals are simply able to fight off the virus without the need to generate a large immune response."
------------------
Goodygood.

 

[Daniel in SD]

This Tweet is now 4 days old but still amazes me. Traffic jams over 435 miles (700 km) long in an attempt to get out of Paris before lockdowns.

The farthest point in France from Paris is the border with Spain which is about 435 miles. Not where I would go to avoid lockdowns!
It's interesting that the traffic jams go in all directions.

 

[JRP3]

Don't Ignore the Good News On Covid-19 From Asia

The strategies pursued by South Korea, Vietnam, China and others do still seem to be paying off. While the total Covid-19 death toll is between 500-700 per million people in France, the U.K., Spain and the U.S., in China and South Korea it is below 10 per million. Cases are a less perfect measure, but there’s a similar observable gap. Wuhan, once the epicenter of Covid-19, is welcoming tourists again.

The perception of an Asian advantage in this pandemic often falls prey to essentialist thinking: That somehow the East is doing things the West could never do, and that it’s largely down to profound differences in values, politics and culture. If China is able to contain Covid-19, it must be because of draconian government policy and the social bonds of Confucianism. If Singapore has 28 deaths, credit must lie with Lee Kuan Yew’s founding legacy of authoritarian pragmatism.

There are likely far less intangible forces at work. If the key to avoiding more lockdowns is finding a way to “live with the virus” — through widespread testing, tracing of contacts and isolating positive cases to slow transmission — Western countries have made structural, not cultural, errors.

 

[wdolson]

This Tweet is now 4 days old but still amazes me. Traffic jams over 435 miles (700 km) long in an attempt to get out of Paris before lockdowns.

https://twitter.com/MichaelEWebber/status/1321878671213416448?ref_src=twsrc^google|twcamp^serp|twgr^tweet

View attachment 604685

And all those people fleeing Paris are taking the viru with them.

 

[Norbert]

Keeping track: 7-day average of US new cases, compared to Sept 27th:

Oct 11th: + 20%
Oct 15th: + 30%
Oct 20th: + 46%
Oct 24th: + 62%
Oct 26th: + 70%
Oct 28th: + 81%
Nov 2nd: + 107% (today)

A doubling of the new case rate in 5 weeks to record heights, following policy changes.

 

[AlanSubie4Life]

Not sure if there is any infection by age data for Belgium.

There is:

Belgian COVID-19 Dashboard - Sciensano

You can see in the latter half of October infections definitely moved into older age brackets, but it isn't like infections started in the elderly, as I thought might be the case.

It's a little hard to read these plots - ideally you have attack rates in each population vs. time, to get a real sense for the trajectory. I included the Belgium population pyramid for reference. (Apply age-stratified IFR and the age-stratified attack rate to project the future mortality.)

But what is clear is that keeping the virus out of the elderly population...has not happened in Belgium. It's not clear that it's possible to do that anywhere. No one has shown it is possible yet.

It's also clear the 40-59 year old age group are doing a really poor job of shielding themselves, and the 60-69 year old age group isn't doing that great either.

Keep in mind average age in Belgium is 41.5 which is a lot older than the US (3 years) and could as much as double the IFR (probably a bit less than double), which does explain some of the extreme mortality.

Apparently Belgium has one of the most aggressive ways of counting coronavirus deaths, which also partially explains their higher mortality. They may now test every death (I'm not sure), but in the early days even probable cases were classified as coronavirus deaths. Testing every death for C19 makes sense - can always fix the data later and analyze it to rule out deaths that likely were not caused by C19. But can't dig up people (or peruse their ashes) to test them for C19!