Coronavirus

[Norbert]

Here's an analysis of case underreporting by country. I've posted this before, but it looks like they've updated their results with plots of % reporting over time for many countries.

Looks like the US is at about 20% reporting (which is a little higher than I thought, but just within my private confidence interval - implies about 2 million US cases - so maybe keeping deaths below 50k is possible, if we are perfect...???)

Using a delay-adjusted case fatality ratio to estimate under-reporting

I'm not getting a clear picture of their definition of what they call "baseline CFR". Is it the IFR, or the CFR that would result from testing all symptomatic cases, or something else?

EDIT: Currently the percentage of positive results, as far I understand, is 40% in some regions, and 25% in some other regions. That indicates a lower test coverage than some time ago when it was 14%. This percentage is a different ratio and doesn't directly correspond to the ratio of "20% reporting" percentage, but it indicates that it is quite low.

 

[Norbert]

Unfortunately, for a couple posters, their “eyes roll” whenever new scientific reports or data are posted that contradict conclusions they reached too hastily — before the evidence was in. It is a sign of confirmation bias at work.

You keep making such remarks, like you wouldn't cherry pick the reports you quote. BTW, are you a scientist yourself?

 

[RobStark]

For the middle aged folks. Do any of you have parents that don't have an underlying condition? Chances are if they've been to the doctor more than once in the last year they do.

My dad is 93 and doesn't have diabetes,hypertension, or any heart/lung problems. Not obese either.

Sees doctor 2-4 times per year. Sometimes doc says see me in 3,4,or 6 months.

He has hypothyroidism,enlarged prostate,macular degeneration,gastritis,moderate-severe arthritis in knees and hips. Sometimes gets a low platelet count and Dr advises he eat liver and iron supplements.

His mind is as sharp as ever too.

 

[SageBrush]

I think it is absurd

Clue: positive test load is a poor predictor of community infection burden.

You would be much better off paying attention to hospitalization data. That is not available so far as I know for NYS but Cuomo has said that that discharges > admissions. That is a fine leading indicator, and it gives confidence to the IHME projection

 

[carterm2]

anti-viral development

COVID-19

 

[cwerdna]

Hope these aren't reposts (there's too much for me to keep up with in this thread):
Foxconn and Other Chinese Factories Implement Strict Measures to Prevent Another Outbreak

Foxconn and Other Chinese Factories Implement Strict Measures to Prevent Another Outbreak
Wednesday April 8, 2020 4:26 pm PDT by Juli Clover
Foxconn and other factories in China have implemented stringent measures to prevent the another viral outbreak in the country, according to an overview of the practices shared today by The Washington Post.

I found a copy not behind a paywall at Infrared cameras, personal towels: China factories go to extremes to fend off virus. Was interesting...

Coronavirus: Photos of Wuhan after 11-week lockdown - also has an under 1.5 minute video

First 2.5 minutes or so of

has an account of what's going on there.

A bobblehead of Dr. Fauci will help pay to produce masks for health workers
Dr. Fauci is now a bobblehead, and a portion of each sale will go towards producing medical masks for healthworkers - CNN

 

[SageBrush]

ECDC data, through Apr 8

US still rising
Spain and Italy over the hump
Germany and Switzerland on the plateau

 

[LN1_Casey]

@AlanSubie4Life , you totally missed the point.

If those over 65 and those with pre-existing conditions make up 98% of the deaths, we need to protect them from the economic necessity of going back to work in the first wave.

As for your personal choice as a 42 year old, you're free to do as you wish.I'd really like to see some type of social safety net extended to the workers over 65 and to those with pre-existing conditions during the first wave of return to work. That group is where 98% of our deaths would come from.

And yes, you would need to do social distancing from those at risk if you return to work.

Yes.

I'm 31, no preexisting conditions, and I live alone. I have a pretty strong change of survival over the disease, and a low risk of infecting others were I to know I am infected and isolate for the duration of the illness. I'd even volunteer to be a test subject of a control group, and then use my blood (were I to survive) as assistance to those who need it. I don't think my job will allow me to do so (outside of it's own use), but the intent remains.

Herd immunity is built off the people who survive the disease, and without a vaccine, there is one way to get it.

 

[EinSV]

Report from Danish Health Authority:
https://www.sst.dk/-/media/Udgivels...hash=6819E71BFEAAB5ACA55BD6161F38B75F1EB05999

Seems to only be in danish so far...
Page 27:
"I Statens Serum Instituts arbejde med modellering af udvikling af epidemien i Danmark har man på baggrund af undersøgelser i blandt andet Island og Tyskland valgt at arbejde med,at det reelle antal smittede i Danmark er 30-80 gange højere end det antal, der bliver påvist."

My attempt at translation:
"In the work done by the National Serum Institute regarding modelling of the development of the epidemic in Denmark we have, due to studies in Iceland and Germany, chosen to hold the belief that the real number of infected in Denmark is 30-80 times higher than the number which is proven by actual tests."

Clarification: "30-80 gange højere" translates as "30-80 times higher". It is not percent. It this is correct that is a huge number of people who are infected. This is news to me.
(Variation: "...valgt at arbejde med..." could be also be: "chosen the working hypothesis that" ...)

Not sure how firm the 30-80 times range is... One paragraph further down the range 30-70 times is used. Possible the range is very uncertain due to lack of testing. They intend to do a lot more testing.


Disclaimer: Not a doctor, not a translator.

This is interesting data. My reading of the slightly different ranges (30X-70X v. 30X-80X) is that the 30-70X was from the Danish data and the 30-80X took into account modeling from Iceland and Germany, but that's just a guess (with translation issues mixed in) and could be wrong.

I also thought it was noteworthy that the high number of previously undetected cases is causing the Danish authorities to reassess previous thinking about the fatality rate for the virus:

"It should also be noted that it also means the mortality rate of infection with SARS-CoV-2 (infection fatality rate, IFR) is lower than the mortality rate of registered cases of infection (CFR) and possibly lower than that assessed by WHO. The WHO has estimated that the IFR is between 0.3-1.0 with wide variation across age groups. With more accurate knowledge of the darkness, IFR will for the COVID-19 epidemic in Denmark could be specified and the expected mortality would be accurately estimated. ...

The above also means that the previous assessment of the excess mortality associated with COVID-19 in Denmark is no longer true. When one more is obtained accurate assessment of the actual prevalence of infection on the basis of epidemiological surveillance as well as an estimated IFR for the Danish epidemic is estimated could be estimated a new and true mortality forecast." https://www.sst.dk/-/media/Udgivelser/2020/Corona/Status-og-strategi/COVID19_Status-6-uge.ashx?la=da&hash=6819E71BFEAAB5ACA55BD6161F38B75F1EB05999 (Page 27 -- per Google translate)​

Hopefully, we will start seeing more serological data soon to get a better handle on fatality and infectiousness. In addition to more data from Denmark, we should get results of Stanford's initial round of serological testing this weekend.

 

[SageBrush]

A poster suggested a sliding scale of money for co-morbidities.

I think it should be called FAT CASH
trump can be the mascot

 

[SageBrush]

Regarding a higher R moving cases to the left, if I understand you correctly, that also means that a lower R (but still higher than 1.0) would move cases to the right.

It means that as R(effective) trends down, its effect will be to increase the mean days post admission for the hospitalized cohort.

 

[SageBrush]

While some had hoped for a tapering off, not seeing it.

~ Linear growth

The rest of the country should be that lucky (or smart)

 

[1208]

You couldn't make this stuff up. It's like we are living in a dystopian novel or something. People don't learn! Evil.

Bloomberg - Are you a robot?

Coronavirus: Wuhan wet markets re-open as lockdown restrictions lifted in the city

Wuhan wet market horror laid bare as gruesome practice starts up AGAIN despite COVID-19

 

[LN1_Casey]

You couldn't make this stuff up. It's like we are living in a dystopian novel or something. People don't learn! Evil.

Bloomberg - Are you a robot?

Coronavirus: Wuhan wet markets re-open as lockdown restrictions lifted in the city

Wuhan wet market horror laid bare as gruesome practice starts up AGAIN despite COVID-19

The Chinese have been eating weird eTron for centuries. Why are you acting surprised?

 

[EinSV]

Pretty interesting interview of Marc Lipsitch by USA Today.

Covers many issues being discussed here.

He says that the key unanswered question is extent of immunity, and emphasizes the need for serological testing in order to assess that.

Coronavirus ‘is the Big One: Harvard epidemiologist

 

[AlanSubie4Life]

Pretty interesting interview of Marc Lipsitch by USA Today.

Covers many issues being discussed here.

He says that the key unanswered question is extent of immunity, and emphasizes the need for serological testing in order to assess that.

Coronavirus ‘is the Big One: Harvard epidemiologist

Pretty much fully agree with what he says. It confirms my priors. I only wish he were less defeatist about the idea that we can scale testing (though I understand he is simply reflecting the reality of the current competence of our leadership).

It’ll be interesting to see whether President Newsom can find a way to team with industry to get significant testing capacity online on his own. At least California and the West Coast could get going in late May.

Saw the news today that Trump is putting together a task force to reopen as much of the economy as possible by April 30th. Seems like this will go poorly. I wonder if they realize we’ll likely still be growing cases by about 5-10k per day at that point?

 

[EinSV]

Preliminary results of serological testing in a hard-hit area in Germany is out and the results are very interesting.

They tested every participant in the study by PCR and found 2% infected.

But antibody testing (IgG/IgA) found 15% had been infected -- 7.5X higher.

https://www.land.nrw/sites/default/...ischenergebnis_covid19_case_study_gangelt.pdf (in German)

 

[cusetownusa]

Preliminary results of serological testing in a hard-hit area in Germany is out and the results are very interesting.

They tested every participant in the study by PCR and found 2% infected.

But antibody testing (IgG/IgA) found 15% had been infected -- 7.5X higher.

https://www.land.nrw/sites/default/...ischenergebnis_covid19_case_study_gangelt.pdf (in German)

Unfortunately I am a little rusty with my German.

Did the results surprise them...ie were they expecting less infected and way less that had been infected? Was any portion of the infected or previously infected surprised to learn that they have it or have had it?

 

[EinSV]

Unfortunately I am a little rusty with reading German.

Did the results surprise them...ie were they expecting less infected and way less that had been infected? Was any portion of the infected or previously infected surprised to learn that they have it or have had it?

They don't say anything about individual reactions but here are a few more nuggets via Google Translate:

• Test followed WHO protocol and done in coordination with WHO representative
• Form letter sent to approximately 600 households, 400 responded (1000 total people)
• Preliminary results are for 500 individuals

They seem to suggest that by avoiding high initial viral load, they can reduce the severity of infections and fatality, but no explanation is provided:

• "By adhering to stringent hygiene measures, it is to be expected that the virus concentration in the event of an infection in a person can be reduced to such an extent that the disease will become less severe, while at the same time developing immunity.
  These favorable conditions do not exist in the event of an extraordinary outbreak event (superspreading event, e.g. carnival session, apres ski bar Ischgl). With hygienic measures, favorable effects with regard to all-cause mortality can also be expected."

Based on this, they recommend gradually removing quarantine conditions while maintaining hygiene to reduce severity/fatalities:

"We therefore strongly recommend implementing the proposed four-phase strategy of the German Society for Hospital Hygiene (DGKH). This provides for the following model:

Phase 1: Social quarantine with the aim of containing and slowing down the pandemic and avoiding an overload of the critical care structures, in particular of the health care system.

Phase 2: Beginning withdrawal of the quarantine while ensuring hygienic framework conditions and behavior.

Phase 3: Removal of the quarantine while maintaining the hygienic framework.

Phase 4: State of public life as before the COVID-19 pandemic (status quo ante)."
​

There is also some discussion of mortality rate being much lower than previous estimates from Johns Hopkins data, but the details are confusing.

They estimate mortality rate of 0.37% (down from previous estimate of 1.98%) but also say the mortality rate is 0.15% based on the full population. I'm not sure what the relationship between those two numbers is so maybe something is lost in translation.

 

[dhanson865]

Coronavirus Deaths vs Other Epidemics From Day of First Death (Since 2000) [OC] : dataisbeautiful