Coronavirus

[KSilver2000]

3 week lockdown in San Francisco, that's insane.

Not insane.
It’s the logical thing to do right now. Should’ve done it sooner instead of taking baby steps and letting it spread more.
Either do it, or don’t, IMO.

 

[Nocturnal]

Not insane.
It’s the logical thing to do right now. Should’ve done it sooner instead of taking baby steps and letting it spread more.
Either do it, or don’t, IMO.

I don't mean it that way, I assume it's the smart plan. I mean that it's just crazy to see that happen.

 

[Cherry Wine]

I don't mean it that way, I assume it's the smart plan. I mean that it's just crazy to see that happen.

The headlines are surreal across the board. You live long enough, you're bound to see some crazy *sugar*, I suppose.

 

[bkp_duke]

I have read that some people have already gotten it multiple times, and that you do not develop immunity, not even form the same strain.

This does not appear to be true. Further evaluation of these patients has lead to the conclusion that instead of getting it multiple times, they actually never cleared the infection in the first place.

From a theoretical standpoint, this virus has a substantially lower mutation rate than Influenza. People that get COVID-19 and recover should have lasting immunity (at least beyond a year).

 

[bkp_duke]

3 week lockdown in San Francisco, that's insane.

Expecting tirade from Elon in 3 . . . 2 . . . 1 . . .

 

[Causalien]

The headlines are surreal across the board. You live long enough, you're bound to see some crazy *sugar*, I suppose.

In my memory this one probably tops all the market crashes I've experienced. Because all the actions and reactions have consequences in real life.

Life impact is greater than 2008. so I am starting to contemplate if that leads to financial market impact also greater than 2008.

 

[MD70]

How effective will shutdowns be if different cities are doing different things. Surely the logical thing is a national shutdown?

 

[linux-works]

No car parts, no cars, no customers.

everything will be slow, even when we are 'over' it.

I'm now very cautious about everything. thinking 'we are on our own' mostly. don't want to get into a car accident; don't want to be NEAR people if one happens. don't want to wait on parts that may take 10x as long to get here. delays will compound. triage will have be the norm and that means slipped schedules and things that we once expected are now 'best effort' (if ever).

 

[Nocturnal]

How effective will shutdowns be if different cities are doing different things. Surely the logical thing is a national shutdown?

The US is a big place. I'm not sure it makes sense to lock down places with little spread so far. Although we haven't been testing really so maybe there really aren't places without major spread.

 

[FoverM]

This does not appear to be true. Further evaluation of these patients has lead to the conclusion that instead of getting it multiple times, they actually never cleared the infection in the first place.

From a theoretical standpoint, this virus has a substantially lower mutation rate than Influenza. People that get COVID-19 and recover should have lasting immunity (at least beyond a year).

Adding to the rumor mill: I read an article the other day about one of the early patients who was basically turned into a guinea pig for testing. I think it was a German though it could be one of the cruise passengers. Anyway, several weeks into this lab experiment, he was still showing positive on tests yet when they analyzed his samples, he wasn't contagious anymore. The test isn't looking for the virus (contagious) but the byproducts of the infection and body's response. I'm sure the microbiologists out there can explain it better.

 

[EVNow]

3 week lockdown in San Francisco, that's insane.

What I don't know is - what is the end game for Covid-19 ?

Because as soon as the restrictions are listed, we are back to square one. Without a vaccine or herd-immunity level infections (40% to 70%) - how does the infection stop ?

 

[theschnell]

Ok I did not see this coming. (Shelter in Place in CA). My first impression is that this is pre-mature. I've been frustrated at the slow response, but this feels like going too far the other way.

I could be wrong...

 

[jerry33]

What I don't know is - what is the end game for Covid-19 ?

Because as soon as the restrictions are listed, we are back to square one. Without a vaccine or herd-immunity level infections (40% to 70%) - how does the infection stop ?

It probably doesn't, but if the spread can be slowed so that it won't overwhelm the facilities, the mortality rate can be kept to a minimum. In addition, typically virus become milder over time. It's not good ecology to kill your host quickly.

 

[dw4ngg]

Ok I did not see this coming. (Shelter in Place in CA). My first impression is that this is pre-mature. I've been frustrated at the slow response, but this feels like going too far the other way.

I could be wrong...

You're wrong - overreaction now is all we've got. CA has been slow and lackluster to respond. Too many folks not taking it seriously from what I've heard

 

[Nocturnal]

What I don't know is - what is the end game for Covid-19 ?

Because as soon as the restrictions are listed, we are back to square one. Without a vaccine or herd-immunity level infections (40% to 70%) - how does the infection stop ?

I think you provided the answer. Even places like Singapore and Korea that halted the spread, what are they going to do? Keep their borders closed for the next year? I think we are headed towards herd immunity, with those most at risk being forced into quarantine until a vaccine is ready.

But they are currently injecting people with the vaccine. Fingers crossed.

 

[bkp_duke]

Adding to the rumor mill: I read an article the other day about one of the early patients who was basically turned into a guinea pig for testing. I think it was a German though it could be one of the cruise passengers. Anyway, several weeks into this lab experiment, he was still showing positive on tests yet when they analyzed his samples, he wasn't contagious anymore. The test isn't looking for the virus (contagious) but the byproducts of the infection and body's response. I'm sure the microbiologists out there can explain it better.

Microbiologist here (well, molecular biologist).

It depends upon the test being used. Basically, to my knowledge, there are 3 tests:

1) ELISA - this is a rapid test (good for use in the field, but there can be false positives and false negatives - so must be followed up with #2). It tests for viral protein particles (more specifically, a specific one). It is possible that these protein fragments are still present even after someone has cleared the infection.
2) PCR - This is the most sensitive and specific (and time consuming) of the tests. It basically is checking for viral RNA, which is the gold standard for having an active infection
3) IgG and IgM serum antibodies - this test can be used in the right clinical setting to determine if someone is infected, or at the very least has prior exposure. The body produces different antibody (Ig) subtypes in a specific order. The IgM subtype is the first to show up and is a good indicator of current, or very recent infection. The IgG subtype shows up later and is more indicative of a previous exposure in time. This is the least sensitive and specific, but is valuable because it gives you the immune status of the patient.

 

[dhanson865]

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?

In 2019, the USA population density was approximately 92.9 residents per square mile of land area.
Italy is 532 people per mi2 by comparison. So the population density makes it easier to spread.

US is behind and more spread out and there are other differences as well.

I'm willing to say the curves look similar even if the reasons why are different.

 

[bkp_duke]

What I don't know is - what is the end game for Covid-19 ?

Because as soon as the restrictions are listed, we are back to square one. Without a vaccine or herd-immunity level infections (40% to 70%) - how does the infection stop ?

This the the big unknown, but there are a few likely scenarios.

1) Vaccine development progresses and in the meantime social distancing keeps us from overwhelming ICU beds. Positive news is that vaccines for SARS and MERS (both coronaviruses) had made substantial progress in the past 5-10 years, and the companies that did that research were able to piggyback it and advance Phase 1 candidates for COVID-19 more quickly. This is exactly why we were able to start Phase 1 (today, none-the-less, and in Seattle). Last time I looked there were 30+ companies doing Phase 1 vaccine development, and that is very encouraging.
2) People are stupid and when restrictions are lessened, they all go nuts and we see a 2nd wave of this, which is worse than the first because probably all local communities are "seeded" with infectious individuals.
3) We get REALLY lucky and Remdesivir (less likely chloroquine) shows great effectiveness at reducing both morbidity and mortality. Basically, this would change the R0 value of the virus to < 1 and allow for containment. Remdesivir is already been through one set of Phase 1 trials in the past (for Ebola) and that should jumpstart the trials for COVID-19.

 

[Mich]

What I don't know is - what is the end game for Covid-19 ?

Because as soon as the restrictions are listed, we are back to square one. Without a vaccine or herd-immunity level infections (40% to 70%) - how does the infection stop ?

Does the SF shutdown really applies to the industry? Here in Austria/Europe the shutdown is just for B2C (all shops except grocery stores etc.). All factories are still allowed to continue to produce (as long as there are not more than 100 pax in one room).

 

[EVNow]

Study just out … from UK.

https://www.imperial.ac.uk/media/im...-College-COVID19-NPI-modelling-16-03-2020.pdf

To avoid a rebound in transmission, these policies will need to be maintained until large stocks of vaccine are available to immunise the population – which could be 18 months or more. Adaptive hospital surveillance-based triggers for switching on and off population-wide social distancing and school closure offer greater robustness to uncertainty than fixed duration interventions and can be adapted for regional use (e.g. at the state level in the US). Given local epidemics are not perfectly synchronised, local policies are also more efficient and can achieve comparable levels of suppression to national policies while being in force for a slightly smaller proportion of the time. However, we estimate that for a national GB policy, social distancing would need to be in force for at least 2/3 of the time (for R0=2.4, see Table 4) until a vaccine was available.
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Seriously, we need on-off population-wide social distancing based on # of cases in the ICU ?