Coronavirus

[alloverx]

Washington Post just updated their stats page to accommodate for population.

 

[Daniel in SD]

Would be really nice to know just from a practical can I visit my Grandma or donate blood standpoint. Or better yet can I give my antibodies or whatever to her, wish it was that simple

The CDC thinks up to 25% of people who get COVID-19 are truly asymptomatic. There's a lot of confusion because people often test positive before they develop symptoms. Also people are contagious before they develop symptoms.
If there is any chance you could have been exposed then you should not visit grandma. If you've tested positive and then recovered, maybe?

 

[tander]

I think one thing almost all of us would agree on is that it's a bad idea to visit your Grandma, no matter how good you feel.

For those who can afford it, this is a great time to give an older person who doesn't have one a smart phone or tablet and teach them how to use Facetime, WhatsApp, Zoom or whatever.

We gave an iPhone we no longer used to our 90+ year old friend and an iPad to an elderly relative over the past couple years. After a little work getting them up and running they ended up loving having the face-to-face calls.

Def, didn't mean to suggest I was contemplating visiting her, just would be nice if I could safely do so. Seems kind of a waste to leave her all alone (she lives alone) for weeks or months if it turned out I already had it and could have been visiting all this time. She has an iPad and is a little afraid of it but she likes google hangouts, facetime, and words with friends. I tried the iPhone but she didn't like it because the data plan for a month is about what she pays a year for her current phone.

 

[AlanSubie4Life]

Couldn't half the population have it and we just wouldn't know because they feel fine and haven't been tested?

The main piece of evidence that I can think of against this possibility is the fact that Korea has largely controlled their outbreak. This would not be possible if most of the people with the disease were asymptomatic (without a strict 2-week lockdown, that is - which Korea did not do - they just had some selective shutdowns in cities). There would be no way to find those people and they would keep spreading it to more people and the whole thing would blow up. This is not what has happened so far in Korea.

That being said, the CDC does believe that up to 25% of people are asymptomatic. That seems like a reasonable upper bound - it would make mitigation pretty difficult, but perhaps not impossible. I suspect the real number is a bit lower than that - perhaps 5% truly asymptomatic. "Symptoms" are likely very subjective for mild cases, I would think, and there is a tendency for people to deny they have symptoms, of course, given there is a mild stigma associated with having the disease.

 

[tander]

The CDC thinks up to 25% of people who get COVID-19 are truly asymptomatic. There's a lot of confusion because people often test positive before they develop symptoms. Also people are contagious before they develop symptoms.
If there is any chance you could have been exposed then you should not visit grandma. If you've tested positive and then recovered, maybe?

Yeah again not visiting Grandma right now or suggesting people do, just would love to know when I can.

 

[tander]

The main piece of evidence that I can think of against this possibility is the fact that Korea has largely controlled their outbreak. This would not be possible if most of the people with the disease were asymptomatic (without a strict 2-week lockdown, that is - which Korea did not do - they just had some selective shutdowns in cities). There would be no way to find those people and they would keep spreading it to more people and the whole thing would blow up. This is not what has happened so far in Korea.

That being said, the CDC does believe that up to 25% of people are asymptomatic. That seems like a reasonable upper bound - it would make mitigation pretty difficult, but perhaps not impossible. I suspect the real number is a bit lower than that - perhaps 5% truly asymptomatic.

Hmm that's a good point. The only thing I wonder about with comparing the US to countries like South Korea is they tend to already be really good about wearing masks and hygiene in general compared to the US even before the virus. I have a feeling that when you've got a respiratory illness and a large % population wears masks already that probably is pretty significant. Don't get me started on bidets vs toilet paper

 

[Norbert]

????????
"The "total cases" are still rising, so we don't even have that peak yet."
Um, yeeaahhh.... Kind of by definition of "peak"

"The "deaths per day" peak follows in some distance."
Um, yeeaahhh.... Kind of by definition of "peak"

"In China, it was about 14 days"
WHAT was about 14 days? The time from what to the peak?

The longer answer:
First off:
- I'm talking about national numbers at this point.
- There are two peaks. The two peaks are the peaks of "daily new cases" and "daily deaths".
- 14 days refers to the time from one peak to the other.

Now:
Today, in the US, the number of new cases was 32,284. That's about 8% more than just yesterday, and previous days had roughly similar increases. To me, that suggests we are not even close to the peak of new cases.

Then:
It takes a while for these new cases to either recover or die. In China (admittedly not the most reliable source of information), it took about 14 days from the peak of new cases to the peak of daily deaths. The first peak was Feb 4. The second peak is more difficult to specify, since it is distributed over several days. But I would guess that if you curve-fit the kind of curve that is drawn by the IHME models, its peak would be around Feb 18. That's 14 days later.

For the US, unless it is very different than the China data suggests to me, this means that the peak of new cases is at least a few days out, and the peak of daily deaths will be maybe 14 days later.

Even more so since there are reports that the testing in the US is not keeping up with the increase in positive test results. It even seems to have stalled at an absolute level. (If that didn't change today.)

However, very few numbers today appear reliable, and these numbers are no exception.

 

[TheTalkingMule]

Fake coronavirus testing sites appear in Kentucky

 

[AlanSubie4Life]

The test I referenced above says 100%.
For the home test Cellex just got approved here are the results of their very small study:
View attachment 528933

A little more detail on the implications of these numbers for the Cellex test:

Thread by @zbinney_NFLinj: The FDA has approved the first antibody test for COVID-19, from Cellex. It theoretically tells you if you've had it & are, as far as we…

 

[Norbert]

Washington Post just updated their stats page to accommodate for population.

The numbers are a bit behind (we have a distinct new max for daily deaths) but interesting.

By population (per local capita), the hot spots are more all over the place than otherwise.

 

[AlanSubie4Life]

The numbers are a bit behind (we have a distinct new max for daily deaths) but interesting.

By population (per local capita), the hot spots are more all over the place than otherwise.

An interesting visualization I ran across today, broken out per capita per county, based on NY Times data. Sorry if I'm reposting this...can't keep track:

Visualization of NYT COVID-19 Data

The scale on the national map could definitely do with some adjustment or additional granularity...

It's also got a couple of ways of viewing the growth rate/doubling time in certain counties/cities.

 

[Daniel in SD]

A little more detail on the implications of these numbers for the Cellex test:

Thread by @zbinney_NFLinj: The FDA has approved the first antibody test for COVID-19, from Cellex. It theoretically tells you if you've had it & are, as far as we…

Yeah, this test only seems useful for testing people who have a high chance of having COVID-19 or previously having had COVID-19.
Also there is window after being infected where this test will not be able to detect antibodies. How long is that?

 

[Norbert]

The main piece of evidence that I can think of against this possibility is the fact that Korea has largely controlled their outbreak. This would not be possible if most of the people with the disease were asymptomatic (without a strict 2-week lockdown, that is - which Korea did not do - they just had some selective shutdowns in cities). There would be no way to find those people and they would keep spreading it to more people and the whole thing would blow up. This is not what has happened so far in Korea.

That being said, the CDC does believe that up to 25% of people are asymptomatic. That seems like a reasonable upper bound - it would make mitigation pretty difficult, but perhaps not impossible. I suspect the real number is a bit lower than that - perhaps 5% truly asymptomatic. "Symptoms" are likely very subjective for mild cases, I would think, and there is a tendency for people to deny they have symptoms, of course, given there is a mild stigma associated with having the disease.

Not so long ago some of us were discussing the possibility of about 50% to 75%. If 25% is like an upper bound, and if we agree that the CFR in South Korea is heading towards about 2%, and that testing in South Korea is very good,

then that, I think, speaks in favor of assuming a higher IFR than otherwise.

 

[AlanSubie4Life]

then that, I think, speaks in favor of assuming a higher IFR than otherwise.

The 50-75% I have discussed before has really been in reference to people with mild symptoms or no symptoms - not truly asymptomatic folks.

So...it might still be close to 1%. Because while there may not be that many truly asymptomatic people, surely there are a considerable number of Koreans who had a mild illness, who thought they were likely COVID-19 cases, who simply stayed home and did not get tested, and did not infect anyone else. This is presumably happening in New York (perhaps by the hundreds of thousands - hard to know right now how many people), as we discuss this.

These cases would not be counted in the denominator.

It's really hard to say how many of them there would be, of course. But they would not be classified as asymptomatic. They would know they were ill, and know well enough to stay home and not infect anyone.

 

[Norbert]

The 50-75% I have discussed before has really been in reference to people with mild symptoms or no symptoms - not truly asymptomatic folks.

So...it might still be close to 1%. Because while there may not be that many truly asymptomatic people, surely there are a considerable number of Koreans who had a mild illness, who thought they were likely COVID-19 cases, who simply stayed home and did not get tested, and did not infect anyone else. This is presumably happening in New York (perhaps by the hundreds of thousands - hard to know right now how many people), as we discuss this.

These cases would not be counted in the denominator.

It's really hard to say how many of them there would be, of course. But they would not be classified as asymptomatic. They would know they were ill, and know well enough to stay home and not infect anyone.

There you lost me.

Do you perhaps see a difference between people "with no symptoms" and "truly asymptomatic folks", or am I misunderstanding?

So If I differentiate the following groups, which ratio does 25% refer to, and which ratio does 1% refer to, and what are any other ratios for which you have an estimate:

1) not infected
2) infected without any symptoms
3) infected with mild symptoms
4) infected with serious symptoms
5) infect and dead or bound to die.

 

[TheTalkingMule]

NYPD now has 1400 positive cases and 6000 out sick.

 

[SageBrush]

There you lost me.

Do you perhaps see a difference between people "with no symptoms" and "truly asymptomatic folks", or am I misunderstanding?

So If I differentiate the following groups, which ratio does 25% refer to, and which ratio does 1% refer to, and what are any other ratios for which you have an estimate:

1) not infected
2) infected without any symptoms
3) infected with mild symptoms
4) infected with serious symptoms
5) infect and dead or bound to die.

infected != infectious;
and people transition across groups over time

This is why the armchair medical conclusions are so misleading

 

[Norbert]

infected != infectious;
and people transition across groups over time

This is why the armchair medical conclusions are so misleading

That's why everything is misleading. In this case, I'm not asking about "infectious" at all. I'm asking about the end-state, because I'm interested in CFR and IFR.

People don't transition from dead to non-dead. Hopefully.

 

[dc_h]

Incidentally, in case anyone was wondering why we didn’t have a strategic stockpile of masks, it was because it never got replenished after the 2009 H1N1 epidemic. We used 97% of the stockpile, and never replenished it. That was under the Obama administration for those that like to assign blame.

https://www.washingtonpost.com/inve...e57316-60c9-11ea-8baf-519cedb6ccd9_story.html

I’d blame Mitch on not restocking. Recall he fought most stimulus programs and we had the budget limits for defense and social spending until Trump was elected. It succeeded in reducing the deficit 75%, but limited defense restructuring and inhibited wise social spending.

 

[TheGrimSweeper]

NYPD now has 1400 positive cases and 6000 out sick.