Coronavirus

[AlanSubie4Life]

For the growth rate, it's true that the doubling rate sometimes used is 6 days (12.5% per day). But if you look at worldwide case growth rates it is growing at 20% per day. Not sure the reason for that discrepancy; it could be higher due to improving detection or whatever...

Ah, Trevor answered that question. The true growth rate is still likely about 12.5% per day. So we’ll likely be at 100k cases in two weeks unless we get serious. Assuming 20k cases today.

Trevor Bedford on Twitter

 

[AlanSubie4Life]

I'm not a virologist, but I find it hard to believe, that this will ever completely disappear without a worldwide vaccination program.

I agree. So we have to have massive testing and rapid response teams until a vaccine is developed.

I can’t speak to the differences between influenza virus and coronavirus - I am no virologist - but I got the impression they mutate at different rates.

 

[AlanSubie4Life]

Ok, you've convinced me.

Edit: For a more serious response, I never said ODH's numbers are correct. I certainly don't expect you to believe that mine are, either (i even said they don't make sense). But there was a lot more to my post than that. Feel free to reply to my other points...or not.

I’m glad I could be so convincing! But you can listen to an actual epidemiologist who has addressed this:

Trevor Bedford on Twitter

For the rest of your points, I agree it is confusing, but my best guess is the fatality rate is about 0.5%-1% based on Korea’s data. Remember, to stamp out the outbreak (which they have basically done), they really have to identify most people with the disease so as to prevent further transmission. So there is reason to think their denominator is “close.”

 

[goinfraftw]

Not sure if this was shared yet, but I found this to be informative.

Visualizing the History of Pandemics

 

[VValleyEV]

Thinking of the future.

This will probably have the effect of creating a baby boomer generation as it forces people in the whole wold to stay home at the same time for a long period of time yet condoms are not sold out and nobody I see at the grocery store or pharmacy are buying condoms.

The result is, let me coin it, "Viral babies"

We can expect the next 7 year to be focused on baby products... I need to brush up on which companies thrived at each period of the baby boomer wave.

 

[SageBrush]

Are you arguing it would be better for everyone to be out and about?

It is lunacy to shut down the country and ask 350 M people to hide at home and lock the doors. People should go to work and take care of their daily activities, but they have to be smart about it, which means wearing masks in public places and where social distancing is not maintained.

You posted earlier that wearing a mask requires 'training.' That is absolute rubbish and the worse kind of FUD
You posted earlier that face mask use is not central to the successful countries in Asia. Prove it, or redact the FUD

 

[KarenRei]

For what it's worth, random sampling in Iceland suggests that about 1% of the country is infected. This is lower than was expected. Last numbers I saw, 161 (0,04% of the country) was diagnosed, and over an order of magnitude more in isolation. Seems like they're doing a pretty good job staying on top of things so far. We now have a gathering ban, for groups of over 100 people, and smaller groups which can still meet have tighter disease control measures; they're adjusting the standards alongside the rate of spread.

At this point in time, I don't see much of a risk of a Lombardy situation occurring here. But time will tell.

 

[Fact Checking]

Ohio Department of Health (ODH) says there are 100k infected in Ohio alone: Ohio Department of Health believes 100,000 Ohioans are carrying coronavirus

That's... a lot.

None of the data make sense to me. Mortality rate in Germany is currently 0.175% (which is a drop from a few days ago). Italy's at 6.8%. South Korea at 0.46% (using confirmed cases) or 0.9% (using suspected cases). In fact, in all of the countries I've been following, mortality rate seems to be holding roughly steady even though the responses of each individual country have been very different. As far as I know, Germany hasn't implemented any extreme measures like France/Italy. Why aren't they being overwhelmed?

So these are all very different demographics, different containment, tracing and sampling methods:

• Early Wuhan: only the most severe cases got to a hospital.
• South Korea: extreme transmission tracing methods: they are using cell phone GPS data and CCTV footage to individually track down those unknown individuals who interacted with known cases and isolate them, within hours. Big Brother-esque but very effective: daily infections are now down to around 1-2% rate. Also young demography with 42 years average age.
• Italy: likely only the worst got to hospitals, likely tens of thousands to hundreds of thousands infected. Older demography of 65 years average age, and air pollution and pre-existing pulmonary conditions exacerbated the ICU overload.
• Germany: better tracking of clusters and younger demography. Containment measures are slow though, so this will peak much higher I'm afraid.
• Diamond Princess: best case study so far due to isolation and 100% test coverage, and low 1% mortality of the ~50 years old demography. Supports overall 0.5% mortality rate I used.

Note that these sampling biases are relatively stable, I.e. these countries will produce seemingly self-consistent but contradictory numbers.

Our lab made our own model the other day. Since we're dealing with exponential growth, the numbers change a lot depending on your assumptions. Our numbers were similar to ODH's but a bit higher...and they still don't make sense. The geographic area I live in is the epicenter of one of the outbreaks in the US. There should be thousands dying here right now, if our model is right, since our ICUs run at capacity on a good day.

Analyzing the data I'm pretty sure early transmission rate is at least 20%/day, but can be 40% in favorable clusters.

(Btw., what kind of lab is yours, roughly, if you can share?)

@Doggydogworld: the 12.5% rate used in the 20k estimate by Trevor Bedford is IMO excessively cautious - which is understandable, as they are one of the highest estimates already and have a reputation as non-alarmist experts to protect. Raw data I looked at from various countries shows peaks of 50% daily infections, 20%-30% sustained daily rates. (I'm not an epidemiologist.)

If we don't start seeing major outbreaks in Shanghai* and other parts of China soon then the only conclusion that makes sense to me is that 1) the mortality rate is far lower than suspected 2) the number of recovered is enormous. In other words, the virus may have already run its course in some parts of the world and areas are starting to reach herd immunity.

Shanghai and China is employing extreme social distancing measures at workplaces as well, which dropped R0 well below 1.0.

I believe Shanghai's data that they haven't had a new infection in 7 days, despite much of the area back to work for the last 35 days.

Herd immunity is a pipe dream I'm afraid, the virus didn't have (nearly) enough time to spread globally I believe.

 

[goinfraftw]

For what it's worth, random sampling in Iceland suggests that about 1% of the country is infected. This is lower than was expected. Last numbers I saw, 161 (0,04% of the country) was diagnosed, and over an order of magnitude more in isolation. Seems like they're doing a pretty good job staying on top of things so far. We now have a gathering ban, for groups of over 100 people, and smaller groups which can still meet have tighter disease control measures; they're adjusting the standards alongside the rate of spread.

At this point in time, I don't see much of a risk of a Lombardy situation occurring here. But time will tell.

For the inundated like myself, what's a "Lombardy situation"? If you don't mind me asking!

 

[SageBrush]

of

CoronaVirus does not have the mutation frequency of Influenza. The latter lacks replication fidelity mechanisms

 

[KarenRei]

Meanwhile in America.... lines due to people queuing for the CDC "enhanced screening" due to the US travel ban....

Travelers stuck in long lines at DFW due to CDC questionnaire and enhanced screening, airport says

Hello, super-seeding events....

 

[KarenRei]

For the inundated like myself, what's a "Lombardy situation"? If you don't mind me asking!

Complete collapse of the healthcare system, to the point where only the young and healthy get ventilators (due to limited supply) and the rest are left to die. Where medical students have to be drafted into the hospitals because so many doctors are in quarantine because they waited too long and took too few precautions, and spread it to each other and their patients. Etc, etc, etc. The worst case scenario that we're trying to avoid from recurring around the world.

 

[Matias]

CoronaVirus does not have the mutation frequency of Influenza. The latter lacks replication fidelity mechanisms

Ok. good. So it would be possible to eradicate corona or it can naturally burn out?

 

[dhanson865]

So I'm at work today and I see a group of people standing in a rough circle with the distance between them to the sides less than an arms length and the distance across the group being less than a persons length. Mentally I'm thinking where is the social distancing and assuming everyone in that group just got exposed.

They stood there for quite a while discussing movies and laughing and talking loudly. I quietly sat at my desk half way down the hall reading about Covid-19.

I guess we'll know in a few weeks if any of them are infected.

 

[SageBrush]

Shanghai and China is employing extreme social distancing measures, which dropped R0 well below 1.0.

I believe Shanghai's data that they haven't had a new infection in 7 days, despite much of the area back to work for the last 35 days.

Outstanding post -- Bravo

Shaghai has a handful most days, although some of them are imported.

I find this WHO website to be excellent one stop shopping for Covid-19 data

 

[KarenRei]

I wish I could get away with taping a 2-meter diameter circle on the floor around my desk with a "do not chat within this space" sign in it.

Oh well, at least I have a mask. Helps me tolerate the misbehavior of others which I can't control better.

 

[AlanSubie4Life]

You posted earlier that wearing a mask requires 'training.' That is absolute rubbish and the worse kind of FUD
You posted earlier that face mask use is not central to the successful countries in Asia. Prove it, or redact the FUD

I can’t prove it. I have read that nurses and doctors receive training on the correct use and removal of PPE. And they still get infected. So I will defer to the experts on that.
As far as other countries and the key to their success, my impression is it involved extremely aggressive social distancing measures (Hubei, and China), and extremely fast and widespread testing and tracking (Korea). But that is just my impression. It’s not clear to me that masks played a role - and it seems like in China at least it would not make much difference if they were already completely shut down.

Can you prove that masks were the reason for the success in China and Korea? I am basing my statements on what the experts say and my observations. I can’t prove them.

To be clear, I would wear one if they were readily available for cheap (because that would indicate no shortage), and healthcare workers had all the masks they needed.

 

[KarenRei]

I can’t prove it. I have read that nurses and doctors receive training on the correct use and removal of PPE. And they still get infected.

And they're constantly surrounded by one highly infectious patient after the next, in close range, all day. It's not even remotely the same situation. And even still, most stay protected - even if protection measures fail some, for one reason or another.

One should never let perfect be the enemy of the good. It's almost impossible to reduce the rate of transmission to zero. But masks help greatly. The virus "wants" to be in your lungs, and the easiest and most common way for it to get there is riding on droplets from infectious patients and being breathed in by you. A mask is a barrier for those droplets. This is a very good thing. It's not 100% protection, but it's still significant protection.

We don't need to get R0 to precisely zero. We need to get it to less than 1. Heck, even greater than 1 is fine, so long as it's not so high that it overwhelms the medical system.

 

[JRP3]

It is lunacy to shut down the country and ask 350 M people to hide at home and lock the doors.

That's what China and Korea did, and it worked.

 

[SageBrush]

Ok. good. So it would be possible to eradicate corona or it can naturally burn out?

Eradication strikes me as optimistic but progressive herd immunity is reasonable until the next great recombination event.

People are focused on themselves but the bigger picture is finding a formula that lets communities and countries get back to business as usual with occasional contained outbreaks. It will require a mass readjustment of herd behavior so that
1. People develop lifelong habits of personal hygeine
2. Mask wearing for any URI and early testing, followed by isolation and contacts containment when Covid-19 is diagnosed

Murkins currently are either in dodo land or engaged in xenophobic hysteria. They have to look eastward for lessons.