Coronavirus

[Daniel in SD]

Not if the consensus is that overall mortality is less than 0.5%. Then you would be wrong even if 100% of the population was infected. For instance Germany with a relatively high testing rate is reporting 0.3% mortality. But the rate will drop further when truly asymptomatic carriers are included.

Germany's low coronavirus mortality rate intrigues experts

People keep making this mistake, you have to wait until the cases resolve to determine mortality. The people testing positive today won't die for another couple weeks.
How do you explain South Korea? Everyone was claiming that their mortality rate was super low a few weeks ago, now it's at 1.2% and rising.

 

[Doggydogworld]

Demand is shut off but the government can supplement it until it comes back.

Here's an idea. Send 11% of each non-financial sector business's 2019 tax return (top line, not bottom) back to them.

Amazon gets $30 billion. Buy AMZN!

Pay people unemployment, boosted to a special higher COVID rate. There's no reason to send checks to people who are still working.

Small businesses regularly file sales taxes, etc. There's a way to give lifeline relief for businesses that show large drops, especially in obviously affected categories like restaurants, bars, etc. Self-employed would need a new program, similar to unemployment, scaled by the change in top line income declared in their quarterly estimated tax filings.

There's no magic bullet, some will find a way to game any system. Maybe hire groups of laid-off workers to do detective work and give bounties for clear fraud.

 

[AlanSubie4Life]

“It will appear that the virus has become more dangerous, but this will be a statistical artefact, a distortion. It will simply reflect what’s already starting to happen: we’re missing more and more infections.”

That would be bad and represents failure of suppression.

An increasing CFR is also obviously a function of the shape of the case growth curve and the delay between onset of symptoms & diagnosis, and death.

 

[Compton]

People keep making this mistake, you have to wait until the cases resolve to determine mortality. The people testing positive today won't die for another couple weeks.
How do you explain South Korea? Everyone was claiming that their mortality rate was super low a few weeks ago, now it's at 1.2% and rising.

See my previous post. Screening asymptomatic people is hardly a top priority when the test kits are hard to come by even now. Meaning that they'll be underrepresented. Instead I guarantee that every single inpatient with serious respiratory symptoms is targeted with the test if one is available, thus catching most deaths due to or with the virus.

 

[TheTalkingMule]

People keep making this mistake, you have to wait until the cases resolve to determine mortality. The people testing positive today won't die for another couple weeks.
How do you explain South Korea? Everyone was claiming that their mortality rate was super low a few weeks ago, now it's at 1.2% and rising.

This has been covered. 111 deaths in a country of 51M does not equal anywhere near a 1% mortality rate, regardless of what kind of spread you assume.

 

[JRP3]

Yeah.. how about we pick the scientist who's actually a lifelong expert in the domain then?

Well there is this:

Michael Levitt, a Nobel laureate and Stanford biophysicist, began analyzing the number of COVID-19 cases worldwide in January and correctly calculated that China would get through the worst of its coronavirus outbreak long before many health experts had predicted.

 

[Daniel in SD]

This has been covered. 111 deaths in a country of 51M does not equal anywhere near a 1% mortality rate, regardless of what kind of spread you assume.

I think we're all talking about the mortality rate for people who get the virus. I'm sorry if it was confusing to you. Maybe now I can understand some of your confusion!

 

[Daniel in SD]

See my previous post. Testing asymptomatic or almost asymptomatic people is hardly a priority when the test kits are hard to come by even now.

You need to do more looking at South Korea. Apparently they've done 400k tests and extensive contact tracing. I haven't seen an explanation for how they could be missing a significant number of cases.

 

[Cosmacelf]

This is not good news for New York City from a modeling perspective of the ICU's being overwhelmed. Dr. Peter Attia is not an epidemiologist but he is a brilliant guy who I have been following for years. He has a private practice in New York City with a focus on Health Span for wealthy clients. He has a team of brilliant researchers that work for him so I believe his numbers. Interesting to see his analogy to cars approaching a cliff and how many of the other US Cities are faring better in the modeling thus far.

Yes, good video. He basically says that looking at country wide or even state wide figures isn't useful. It must be done on a metro basis with an eye to ICU bed capacity to know if the metro area's hospitals are going to be overrun.

But did I miss his conclusion for NYC? He gave this great run up on positing what's the best case scenario, ie. no one else from here on out gets infected, but then doesn't say what that does to ICU bed capacity? In general I guess he is saying that NYC, and NYC alone looks screwed under realistic assumptions.

 

[Compton]

You need to do more looking at South Korea. Apparently they've done 400k tests and extensive contact tracing. I haven't seen an explanation for how they could be missing a significant number of cases.

I tried to check but couldn't find that they would be doing random screening. People with symptoms are much more likely to seek testing. Are they screening asymptomatic people randomly without known exposure? IgG assays will provide better data later about population level exposure.

 

[SMAlset]

Let’s not forget China took what many here in the U.S. would consider draconian steps. Tightly shutting almost everything down in a wide area. Those of us on the West coast who have been in stay-in-place for two weeks going on three now recognized how bad this will get and you don’t hear much grumbling (other than testing and supplies). The fact I’m seeing resistance already from other parts of the country on just being shut down to certain levels tells me a part of this country still doesn’t get what’s coming. For some I guess it won’t until someone they know ends up in the hospital or in ICU or the morgue.

 

[Quesder]

What does this remdesivir news imply? Wider use? Will it change everything?

Gilead's potential coronavirus treatment gets FDA's orphan drug label

Gilead's potential coronavirus treatment gets FDA's orphan drug label
Reuters Reuters•March 23, 2020
March 23 (Reuters) - Gilead Sciences Inc's experimental drug remdesivir, seen as one of the more promising potential treatments for the coronavirus, on Monday received the orphan drug designation from the U.S. Food and Drug Administration.

The announcement comes days after U.S. President Donald Trump called on the FDA to streamline its approval process for treatments such as remdesivir, which is currently being tested in clinical trials, with results expected as early as next month.

The orphan drug status provides a seven-year market exclusivity period, as well as tax and other incentives for drug companies developing treatments for rare diseases that affect fewer than 200,000 people.

 

[X Fan]

DeSantis with the winning Florida strategy. It's kind of like Trump's proven strategy.

'DeSantis said Florida is doing what it can, though he has not given a statewide stay-at-home order, despite calls from some legislators to do so. He said nothing he does will help control the spread of the coronavirus “if people from these hot spots keep pouring into our state.”

“It’s a big problem,” DeSantis said at a Monday afternoon news conference. “A week ago, they had 20 flights down here. As soon as that shelter-in-place order came down from the New York governor, the flights took off, and people just got the heck out of Dodge, so we’re ending up having to deal with it.”'

Deflect, deflect, deflect. To be clear I'd be fine with this strategy, if it were paired with a hard lockdown. I actually think California and Washington should be doing the same mandatory quarantine.

Actually, his steps are mostly in line with most states and currently is more restrictive than most non-lockdown states.

Florida is a huge geographical state (it takes me 6 hours of highway driving to get to the GA State line from Naples, 10 hours to Tallahassee) and as I noted the hot spot is in SE Florida with almost 60% of positives from that location.

Locations in many other parts of the State are reporting virtually no cases. Thus, he is straddling a fine line by taking restrictive steps, supporting locations such as Miami that enable tougher steps but yet allowing area that are food producing and low case loads to carry on their business. He was late to shut down beaches but that has been done now for a few days.

He is right re: visitors with SE Florida's huge numbers impacted. New Yorkers instead of isolating are escaping the city and naturally are flying down to homes and relatives in the State (for folks that don't know SE Florida has a huge NY/NJ/Ct/Ma visitor base in the winter). This has been compounded by the fact that most businesses have closed their offices and most staff are working remotely.

One positive from this afternoon's stats (contrasted from AM report) is that positive count went only up by 56 even though test count was up by 900. Yesterday, the increase was 300 AM to PM.

But, do I agree that there should be a minimum set of regulations that ALL municipalities and States are following. As an example, Governor Cooper of North Carolina is still allowing groups of 50 to meet (he just moved today down from 75) which is well beyond the Federal Government guideline. As a result, I suspect NC cases will continue to increase since he is not taking the right steps.

btw: I follow both States very closely since I have friends, family and homes in both.....

edit: Gov just announced that any person coming off a flight from NY, NJ, CT must isolate for 14 days, violators subject to criminal penalties.

 

[traxila]

What does this remdesivir news imply? Wider use? Will it change everything?

Gilead's potential coronavirus treatment gets FDA's orphan drug label

Gilead's potential coronavirus treatment gets FDA's orphan drug label
Reuters Reuters•March 23, 2020
March 23 (Reuters) - Gilead Sciences Inc's experimental drug remdesivir, seen as one of the more promising potential treatments for the coronavirus, on Monday received the orphan drug designation from the U.S. Food and Drug Administration.

The announcement comes days after U.S. President Donald Trump called on the FDA to streamline its approval process for treatments such as remdesivir, which is currently being tested in clinical trials, with results expected as early as next month.

The orphan drug status provides a seven-year market exclusivity period, as well as tax and other incentives for drug companies developing treatments for rare diseases that affect fewer than 200,000 people.

Means nothing outside of patent protection. But if it floats your boat, I am ready to get on board!

All Aboard the Remdesivir Cure Express!

 

[TheTalkingMule]

I think we're all talking about the mortality rate for people who get the virus. I'm sorry if it was confusing to you. Maybe now I can understand some of your confusion!

Makes sense now. You think in a country of 51M there are only 9,250(111/.012) infections by a virus that spreads as bad or worse than any flu strain. Gotcha.

 

[bkp_duke]

What does this remdesivir news imply? Wider use? Will it change everything?

Gilead's potential coronavirus treatment gets FDA's orphan drug label

Gilead's potential coronavirus treatment gets FDA's orphan drug label
Reuters Reuters•March 23, 2020
March 23 (Reuters) - Gilead Sciences Inc's experimental drug remdesivir, seen as one of the more promising potential treatments for the coronavirus, on Monday received the orphan drug designation from the U.S. Food and Drug Administration.

The announcement comes days after U.S. President Donald Trump called on the FDA to streamline its approval process for treatments such as remdesivir, which is currently being tested in clinical trials, with results expected as early as next month.

The orphan drug status provides a seven-year market exclusivity period, as well as tax and other incentives for drug companies developing treatments for rare diseases that affect fewer than 200,000 people.

It's the FDA prepping the drug for wider use. Right now it can ONLY be prescribed as "compassionate care" - and Gilead closed that today because of overwhelming requests (each request has to be evaluated one by one - this is not practical). Orphan usage will allow Gilead to open it up to more widespread usage, without it having to be "indicated" for COVID-19 diagnosis.

A lot of this is billing and housekeeping on the way drug usage works. The take-away should be that Gilead can now ship this to a few select hospital pharmacies for them to use as physicians prescribe it for the most critical cases. Up to this point, Gilead had to ship a single batch to each hospital (one per compassionate care exemption).

I've been through compassionate care exemption requests - NO FUN. This should streamline the process substantially.

Oh, and it also protects Gilead's patent rights at the same time (for better or for worse).

 

[bkp_duke]

Means nothing outside of patent protection. But if it floats your boat, I am ready to get on board!

All Aboard the Remdesivir Cure Express!

At this time this DOES NOT mean wide availability of the drug. Hospitals have in-house ICU pharmacies (separate from their main pharmacy). Likely this will be stocked on in those locations.

 

[bkp_duke]

All Aboard the Remdesivir Cure Express!

For the record, it's more a treatment, not a cure. The mechanism of action of the drug allows for it to slow down viral replication. Basically, it gives the immune system time to mop up and get the upper hand.

 

[Daniel in SD]

Makes sense now. You think in a country of 51M there are only 9,250(111/.012) infections by a virus that spreads as bad or worse than any flu strain. Gotcha.

Yes. I believe that South Korea is not lying about their data and they have done a very good job so far of containing it. They have done extensive contact tracing and testing. I'm hoping we can get it under control here in the US and do the same.

 

[byeLT4]

Pay people unemployment, boosted to a special higher COVID rate. There's no reason to send checks to people who are still working.

While some of the people working are putting in more hours, many who are still working are getting less hours or getting less pay (tips, commission and whatnot) due to current policy. They could use some of this money too.