Coronavirus

[SageBrush]

Thank you. The speculation around a "second, deadlier wave" comes up so often that I really want to delve into some literature on the issue. From a layman's perspective, I don't understand why it should be considered a given, or even likely, for a virus to temporarily recede within the population only to return in a more virulent form.

Your skepticism is warranted.

 

[bkp_duke]

It's a bad flu. Old and imunosuppressed people are at high risk.

Yes . . . but that is a very heavyhanded over-simplification of the situation.

 

[KarenRei]

It's a bad flu. Old and imunosuppressed people are at high risk.

Unfortunately, it's a bad enough flu to crash healthcare systems if nothing is done, which causes people to die needlessly.

It's also shown that the west's response to pandemics has two modes: 1) Do nothing but quarantines and token gestures, without any real behavior modifications, particularly in schools and workplaces where it matters; and 2) Realize that #1 didn't work, freak out and lock down everything and mandate people stay in their homes except to buy the bare necessities.

 

[bkp_duke]

See my previous posts on this. From a scientific standpoint your statement is wrong, or at least it is so misleading as to be virtually wrong. Older people are not necessarily immunosuppressed. It's not that simple. That's a simpleminded and therefore appealing but ultimately misleading concept.

See my edited reply above. There is some good data in that paper that helps guide clinicians on which patients to be most concerned about. I still believe no one has sorted out the "chicken and the egg" problem regarding inflammatory markers. Are they a byproduct of a more severe infection? Are they indicative of an improper immune response? There is not data at this time to discern. My 0.02.

 

[KSilver2000]

This is indeed good news. My take though is that we've been hearing about how testing will expand dramatically in the US for more than a week, with no actual meaningful change in the scale of testing.]

So I do keep an eye on what's being said, but I view it as aspirational until it's followed up with actual changes in the scale of available testing.

Exactly.
As of yesterday, the hospitals conducting tests around me had throughput of much less than 100 tests a day.

 

[nwdiver]

Is it working? No. Give more $$$ to rich people. Working now? No. Keep giving money to the rich. Has it worked yet? No. Give more money to the rich. More!

The waitress down the street lost her job because all the restaurants are closed and can't pay rent! Well.... give more $$$ to the banks somehow that will help.

What's the definition of insanity?

 

[Doggydogworld]

It's also shown that the west's response to pandemics has two modes: 1) Do nothing but quarantines and token gestures, without any real behavior modifications, particularly in schools and workplaces where it matters; and 2) Realize that #1 didn't work, freak out and lock down everything and mandate people stay in their homes except to buy the bare necessities.

This is driven by lack of data. If you know who is infected you can make intelligent decisions. If not you're flying blind. The same ignorance which fed our apathy is now feeding our panic.

 

[dfwatt]

See my edited reply above. There is some good data in that paper that helps guide clinicians on which patients to be most concerned about. I still believe no one has sorted out the "chicken and the egg" problem regarding inflammatory markers. Are they a byproduct of a more severe infection? Are they indicative of an improper immune response? There is not data at this time to discern. My 0.02.

I don't know about you but I think the leukopenia combined with the elevated cytokines is a huge and telling bifurcation, but not well captured by any notion of an "improper" immune response. It suggests that the immune system in the folks that died was dropping the ball on B and T cell production. Again that's a finding associated with activation or lack thereof in the adaptive branch of the immune system. I think that this data suggests that exaggerated innate immunity and declining adaptive immunity may go hand-in-hand and script a bad outcome.

 

[Nocturnal]

We should be testing everyone that shows up with any flu like symptoms. My ex just went in to urgent care with a sore throat, tested for regular flu and strep. No Covid test. Now she is starting to have a fever at home. The ironic part is that she is a rep for one of the companies rolling out testing.

 

[dfwatt]

We should be testing everyone that shows up with any flu like symptoms. My ex just went in to urgent care with a sore throat, tested for regular flu and strep. No Covid test. Now she is starting to have a fever at home. The ironic part is that she is a rep for one of the companies rolling out testing.

Sorry to hear that nocturnal. That's a bummer and Incredibly upsetting. Hope you get some clarity.

 

[dfwatt]

This is driven by lack of data. If you know who is infected you can make intelligent decisions. If not you're flying blind. The same ignorance which fed our apathy is now feeding our panic.

Exactly. If we knew where the concentrations or hotspots were we could much more accurately rollout stricter and harsher containment and isolation measures. Other places with almost no cases could probably make do with much less restriction. But as it stands now it's entirely possible that the number of known cases is a tiny fraction of the actual cases that are flying under the radar. Worst case scenario for containment and mitigation

 

[cusetownusa]

It's not that you don't bother testing, it's that there's not enough capacity to test people with mild symptoms. Two friends of mine had flu like symptoms one week ago, and they could just forget about testing since they had no known contacts and didn't work in healthcare.

Norway has tested a record amount of people per capita (top 3-5 in the world), but even here its been very low (8000 tests in total or something), now we have the capa

They will, but will it be bad? While everyone is focusing on federal govt action or inaction, I think at the individual level, pretty much everyone has the message. All sports events are cancelled, as well as concerts, church services, any mass gathering. Business has quickly adapted, allowing those who can, work from home. Business meetings have been cancelled, with videoconferencing being used instead. Schools are closing - our schools for my kids are doing online learning. People are practicing social distancing. I guarantee if anyone goes out into public with as much of a cough or sniffle they will get the shunning treatment if not several people telling them to get a clue. You don't get 300 people lineups at grocery stores without a mass realization that the situation has changed.

So I'm left wondering if the worst part of the virus effects will be blunted in the US.

This one avoids the percentage pitfall and has dates so if you share it it won't be misleading as it ages.

r/dataisbeautiful/comments/fjj2xn/oc_covid19_us_vs_italy_11_day_lag/

How much bigger is the US population compared to Italy? Isn't it a lot bigger, so wouldn't expect our numbers to be a lot higher?

 

[cusetownusa]

Exactly. If we knew where the concentrations or hotspots were we could much more accurately rollout stricter and harsher containment and isolation measures. Other places with almost no cases could probably make do with much less restriction. But as it stands now it's entirely possible that the number of known cases is a tiny fraction of the actual cases that are flying under the radar. Worst case scenario for containment and mitigation

I live in a part of NY that has only 1 confirmed case. Even so, NY has shut down most everything (schools, restaurant, bars, etc.). A lot of people are going to be losing their jobs. Seems extreme but Im no expert. Wish they had a way to do mass testing so that these extreme measures could possibly be avoided.

 

[dfwatt]

How much bigger is the US population compared to Italy? Isn't it a lot bigger, so wouldn't expect our numbers to be a lot higher?

We are roughly a week to 10 days at most behind Italy's curve. That's all. Shape of the curve looks about the same. It's an exponential ramp. The only way you break that is with a massive disruption of the transmission chains and that means the extremely unpopular containment, isolation, quarantine, rapid identification of contagious individuals. That means testing. You know where we been on that one! A day late and a dollar short. And that's putting it kindly.

 

[mblakele]

https://xkcd.com/2281

 

[cusetownusa]

We are roughly a week to 10 days at most behind Italy's curve. That's all. Shape of the curve looks about the same. It's an exponential ramp. The only way you break that is with containment, isolation, quarantine, rapid identification of contagious individuals. That means testing. You know where we been on that one! A day late and a dollar short. And that's putting it kindly.

I agree...but wouldn't that graph make more sense if it was number of infections/death per 1 million people or something?

 

[Cherry Wine]

Any effort to assist in mitigating spread is welcome.

LVMH Converts Perfume Production to Hand Sanitizer

LVMH is converting perfume manufacturing at all its Christian Dior, Guerlain, and Givenchy facilities to the production of hand sanitizer that will be made available for free by French health authorities to combat the spread of COVID-19.

The decision by Bernard Arnaut, CEO of the Paris-based luxury goods giant LVMH Möet Hennessy Louis Vuitton, was announced by the French firm on Sunday. The distribution of the gel began on Monday.

“Through this initiative, LVMH intends to help address the risk of a lack of product in France and enable a greater number of people to continue to take the right action to protect themselves against the spread of the virus,” the firm said in a news release.

According to the release, LVMH will continue making the gel for “as long as necessary, in connection with French health authorities.”

 

[dfwatt]

I agree...but wouldn't that graph make more sense if it was number of infections/death per 1 million people or something?

Part of the problem is the number of infections and deaths have a variable ratio. Early on that ratio favors a higher case fatality rate, probably again because by definition the early cases that come to attention tend to be more severe, and where individuals head into respiratory distress and hospitalization. A whole lot of people in the community on the other hand may never get pneumonia, and those folks may not enter your statistical pool without very extensive testing. My point is that we have no clue what the actual number infected people is in the United States. Safe to assume that the published stats are way, way under the actual number of Covid-19 infected individuals. We are flying blind in this country. People see widespread testing as some kind of panicky knee-jerk response. It's not. The only way you know what you're looking at. And therefore is the only way to plan intelligently.

The other problem is that without the early isolation and quarantining of affected individuals, you quickly swamp the healthcare system In terms of exceeding the number of ICU beds and Respirators. That easily doubles the mortality rate because a good fraction of people with severe pneumonia will recover If given respirator and other supportive care. There's already been dozens of postings on this so I won't post another graphic showing the difference between staying on the exponential ramp and moderating that so you reach a plateau. That plateau can be under your critical care threshold capacity. The exponential ramp always - eventually anyway - exceeds it. And that (the "unnecessary" deaths) always exacerbates panic and increasing societal disorganization.

 

[EVNow]

He better not to Canada before April 1. I've got a critical business trip I cannot miss.

Like I said, Oh well ...

Justin Trudeau says he will close Canada's border to non-citizens amid pandemic.​

 

[ReddyLeaf]

I’m not sure if this modeling paper has been posted here yet, but it’s very interesting, though way over my intelligence level. Perhaps this is some of the stuff that helped convince local officials in Seattle to act.

2019-nCoV: preliminary estimates of the confirmed-case-fatality-ratio and infection-fatality-ratio, and initial pandemic risk assessment