Coronavirus

[AlanSubie4Life]

Why would you reduce the numbers? I'm not as sure about the calculation for the percentage of hospitalizations, but the naive CFR (Case Fatality Rate) in general has doubled since then. In other words, the percentages in the "Case-fatalities" column should be larger, possibly by 2x.

The numbers I was quoting were hospitalization ratios. It's 14-20% amongst 20-44 year olds. Those are naive hospitalization ratios. I'm just saying that given the ACTUAL number of infections, especially in that age group, the actual hospitalization ratio is likely quite a bit lower. If you search the internet (I did yesterday), you'll find that the asx group is heavily weighted towards the lower age groups (not surprisingly).

But yes, on the other hand, since hospitalization also lags diagnosis, even the CDC's data is likely a bit optimistic on hospitalization of the cohort they looked at (I don't know the time lag between the cases they looked at and when they published the study - you can check the link I provided). But I'd guess the asx or mildly sx denominator would be quite a bit larger than the CDC's N=705 in reality.

But in any case, even the likely optimistic 2% hospitalization is brutal for 20 to 44 year olds. That's really amazingly severe.

 

[Az_Rael]

I had not noticed the health care system on the verge of collapse with prior flu seasons, but maybe I was just not keeping up.

Worst flu season stuff I have seen is tent hospitals set up here in CA a few years ago during a bad flu season to treat the overflows of patients. But those weren’t ICU bed overflows, as I recall. Obviously, this virus seems to be worse than the flu as far as straining the system vs a bad flu year.

 

[AlanSubie4Life]

Per this report, Italy had "excess deaths" due to the flu of 24,981 in 2016/17 season (I know, it shocked me too). So, based on this, it does appear the Covid is a bad flu season. You do not hear about it because the world is numb and acclimated to flu.

We also didn't hear about it because those excess deaths took place over the course of the ~5 month flu season, while the same number of deaths from COVID-19, which likely substantially exceed 25k when measured in terms of "excess deaths", occurred in just 5 weeks.

 

[renim]

I just thought it was an insightful list.

The corona hardly affects kids. It's the kids we should worry about. Like a virus that kills kids, that's when we should do a lock down, not for a virus that spares kids. The kids are the future....

Its a chivalrous virus, it spares kids and women of breeding age. (Except hospital staff in the fight against it)

Covid19 economic effect will affect breeding rate, but biologically the virus is very well behaved, no reduction in human race fertility from covid19 pandamic. Makes for a long term virus once novelty has worn off.

 

[NikolaACDC]

We also didn't hear about it because those excess deaths took place over the course of the ~5 month flu season, while the same number of deaths from COVID-19, which likely substantially exceed 25k when measured in terms of "excess deaths", occurred in just 5 weeks.

And additionally the 25k deaths in 5 weeks occurred despite (eventual) stay-at-home and social distancing orders in place. Hardly anybody changes behaviour because of flu season.

 

[dqd88]

Well what's done is done. We are going to open back up soon. Govt has no choice. They need the tax revenue.

New York is broke. I don't want to hear any state workers complain about not getting bonuses. You can't have it both ways. Reality will be sinking in real soon. If you shut down the economy then you (the state) will need to make cuts. Cut non-essential parts from the budget. Don't be a hypocrite. Yet, when they feel real pain, as main street has, then they'll get serious about turning things on.

 

[Daniel in SD]

That's my point. Let's become Spaniards not Aztecs.
Obviously it depends on the lethality of the pathogen. Corona is not nearly as bad as many others. Look at what our grandparents went through; they all actually got measles, mumps, chickenpox, and probably other stuff.

I'm still confused, what mistake did the Aztecs make in your analogy? How could they become Spaniards?

The reaction should match the lethality. I feel our reaction is out of tune with the risk of Corona. We went overboard.

Did New York go overboard? If you ask someone working at a hospital in NYC what would they say?
Your proposed solution of controlling the spread is tricky to pull off. Unless your solution is to simply not have medical care for everyone who needs it.

 

[DanCar]

... I feel our reaction is out of tune with the risk of Corona. We went overboard.

I think the shutdowns were an interesting successful experiment. But agree, would be nice if we could open the Fremont factory with volunteers who get paid well. And with lots of checks:

1. temperature checks at intrance, lunch and leaving. If elevated temp, then out for two weeks.
2. no use of anti fever meds
3. lots of masks and gloves
4. Training if requested on how not to get infected.
5. Anyone clearing their throat, coughing, sneezing, runny nose gets two weeks probation.
6. Measures taken to facilitate social distancing. What happens during break?
7. Removal or frequent cleaning of commonly touched surfaces. Remove bathroom doors?

 

[Norbert]

The numbers I was quoting were hospitalization ratios. It's 14-20% amongst 20-44 year olds. Those are naive hospitalization ratios. I'm just saying that given the ACTUAL number of infections, especially in that age group, the actual hospitalization ratio is likely quite a bit lower. If you search the internet (I did yesterday), you'll find that the asx group is heavily weighted towards the lower age groups (not surprisingly).

But yes, on the other hand, since hospitalization also lags diagnosis, even the CDC's data is likely a bit optimistic on hospitalization of the cohort they looked at (I don't know the time lag between the cases they looked at and when they published the study - you can check the link I provided). But I'd guess the asx or mildly sx denominator would be quite a bit larger than the CDC's N=705 in reality.

But in any case, even the likely optimistic 2% hospitalization is brutal for 20 to 44 year olds. That's really amazingly severe.

My (first) comment was just about the CFR values in that large table (as I wrote).

The hospitalization lag is surely much shorter on average

 

[Norbert]

Bookmark this! Great tool to allow you to track the historical shifts in the IHME model. Will be expanded to other models later it sounds like. Remember the IHME model is just a curve fit of a symmetric sigmoid function.* I'd expect that the projections will increase significantly this week as the lagging death numbers continue to come in higher than the current curve fit and it fits a broader sigmoid. We'll see what happens tomorrow.

COVID Projections Tracker

*It doesn't look symmetric AFAIK because the plot is composite of actual data and projected data. However, some of the recent projects show some humpiness in the mean value on the falling side, so maybe they have adjusted their curve fit underpinnings. No idea. Haven't RTFM.

Thanks for the link.

I think the curve is now a composite of curves for each region, although I'm not completely sure if those briefing comments applied to the IHME model specifically.

 

[MC3OZ]

I think the shutdowns were an interesting successful experiment. But agree, would be nice if we could open the Fremont factory with volunteers who get paid well. And with lots of checks:

1. temperature checks at intrance, lunch and leaving. If elevated temp, then out for two weeks.
2. no use of anti fever meds
3. lots of masks and gloves
4. Training if requested on how not to get infected.
5. Anyone clearing their throat, coughing, sneezing, runny nose gets two weeks probation.
6. Measures taken to facilitate social distancing. What happens during break?
7. Removal or frequent cleaning of commonly touched surfaces. Remove bathroom doors?

IMO it is worth Tesla going overboard with testing.... (contract or in house)
1) Test all staff antibody and active virus before openning.
2) Test any staff with symptoms after 2 week absence.
3) Redesign workflows or add perspex screens to separate workers where possible,
4) Where it isn't possible to separate workers, try to use workers with known immunity... (even if some retraining is needed)
5) Stagger breaks, put green sticker on any cleaned lunch station which must be removed by the staff member using that station.
6) Try to reduce touching of services when entering and using bathrooms... have additional disposable gloves in bathrooms.,.
7) Safety protocol around transport to/from work.

IMO regulators and health authorities should be impressed with a well thought out detailed and comprehensive plan.. it is worth the time and money to get this right.

 

[AlanSubie4Life]

Detailed article on the Iceland study.

Aside: Looks like @dqd88 may have been right - the New York Pause is likely increasing family transmission. On the plus side, this may be one reason why the curves take longer to decay and have an unexpected "plateau" at the top. The apparent R0 stays above 1 for a bit longer while each patient infects most of their family. After that goes away after another couple weeks, we should start to see R0 decay below 1 (hopefully). Definitely the picture below would suggest that - family transmission has to go away eventually!

"Symptoms of Disease
Among the participants with positive results for SARS-CoV-2, symptoms of Covid-19 were reported by 93% of those in the overall targeted-testing group and by 57% of those in the overall population-screening group. However, 29% of participants who tested negative in the overall population-screening group also reported having symptoms. Reports of symptoms became less common among participants in the population screening during the study period (Fig. S4)."


https://www.nejm.org/doi/full/10.1056/NEJMoa2006100

How about those unknown exposures, though? Crazy. Also, notably, I learned that Iceland has not shut down their elementary schools. I wonder how that experiment will go. It sounds like it is going well since they identified NO disease in their random sampling of children under 10. It's possible the attack rate is just really low in that population, and it's not just due to high asx. Wonder whether we'll ever find out.

 

[Daniel in SD]

The numbers I was quoting were hospitalization ratios. It's 14-20% amongst 20-44 year olds. Those are naive hospitalization ratios. I'm just saying that given the ACTUAL number of infections, especially in that age group, the actual hospitalization ratio is likely quite a bit lower. If you search the internet (I did yesterday), you'll find that the asx group is heavily weighted towards the lower age groups (not surprisingly).

But yes, on the other hand, since hospitalization also lags diagnosis, even the CDC's data is likely a bit optimistic on hospitalization of the cohort they looked at (I don't know the time lag between the cases they looked at and when they published the study - you can check the link I provided). But I'd guess the asx or mildly sx denominator would be quite a bit larger than the CDC's N=705 in reality.

But in any case, even the likely optimistic 2% hospitalization is brutal for 20 to 44 year olds. That's really amazingly severe.

Here's actual hospitalization rates from NYC. Divide by percentage of population you think is infected to get real hospitalization rates. That would be a conservative estimate since people are avoiding the hospital like the plague there, so much so that apparently many are dying at home.
Overall is 0.35% so if you assume 10%-20% of city infected that would imply that overall hospitalization rate is 1.75%-3.5%.
0.13% for 18-44 year olds would imply a hospitalization rate of 0.65%-1.3% for that age group. That's a real bad flu...

 

[SMAlset]

.... I feel our reaction is out of tune with the risk of Corona. We went overboard.

and where do you think the CV19 numbers would be for the sick, hospitalized, ICU, intubated, and dead if cities and states hadn’t taken the measures they have and which are still continuing? Remember this disease is highly infectious, carriers are asymptomatic or those with symptoms don’t show for days despite being contagious during that time, and the spread is exponential in short order. I guess how many dead per country is acceptable to you?

 

[bkp_duke]

For many people, esp elderly, flu and cold can have very bad effects. In bad flu seasons the outcome is similar to what we are seeing with Covid.

In the past 6 weeks we've seen as many deaths from COVID-19 as we did from influenza in the past 12 months.

That's with ZERO social distancing for influenza, and nearly nationwide social distancing for SARS-CoV-2.


But please, continue your arm-chair quarterbacking. Those of us with M.D.'s in this thread are getting a great chuckle.

 

[AlanSubie4Life]

I think the curve is now a composite of curves for each region,

Ah. That would make sense of the humpiness. So probably it's just a composite of sigmoids, so my prior denunciations of the model for being wrong on the downward slope of the curve stand. We'll see whether my criticisms stand the test of time.

 

[AlanSubie4Life]

Those of us with M.D.'s in this thread are getting a great chuckle.

Also those of us without M.D.s. I'm ROFLMAO.

 

[MC3OZ]

and where do you think the CV19 numbers would be for the sick, hospitalized, ICU, intubated, and dead if cities and states hadn’t taken the measures they have and which are still continuing? Remember this disease is highly infectious, carriers are asymptomatic or those with symptoms don’t show for days despite being contagious during that time, and the spread is exponential in short order. I guess how many dead per country is acceptable to you?

Sadly any objective analysis must conclude that US did too little testing and was too slow to implement lock-downs.

Vietnam may be the new gold standard:-
With no deaths reported, Vietnam's response to coronavirus pandemic earns praise

 

[bkp_duke]

Covid19 economic effect will affect breeding rate

Yes it will. We will have a baby boom in 9 months.

What do you think people do when they have nothing else to do and are home?

 

[DanCar]

Worst flu season stuff I have seen is tent hospitals set up here in CA a few years ago during a bad flu season to treat the overflows of patients. But those weren’t ICU bed overflows, as I recall. Obviously, this virus seems to be worse than the flu as far as straining the system vs a bad flu year.

That depends on the region. My wife's friend said she strolled through a bay area hospital. Everything was calm, and plenty of nurses standing around idle. Some places have let go of staff.