Coronavirus

[EinSV]

Don't worry, I speak Dutch, but kind of you to offer a translation .

In all seriousness, it is indeed impossible to know right now how far off the data is skewed. And most likely it's skewed differently in different countries, depending on the (quality of the) health care system.

That's why the true data about COVID19 will only be known after lots and lots of testing, from all sorts of age/socioeconomic groups.

I agree 100%.

Also extent of the skew will likely vary depending on extent of testing relative to population and confirmed cases. Areas like New York with few tests per confirmed case (~40% positive tests!) are likely to be more skewed than places like Iceland with extensive testing and relatively few confirmed cases.

 

[Daniel in SD]

Look, I don't want anyone to die. I wish everyone could live forever. Ok? (I'm actually a futurist and I believe in Ray Kurzweil's idea that someday we will be able to live forever.)
But, here we are. And I just think it's not fair to run up an insane medical bill that future generations will have to pay for. I think that's reasonable.
What if another, more virulent virus, arises in 5 years? We should be saving our bullets for the big kahuna, not spending it all on this.

Who are future generations going to have to pay this bill to?
The South Koreans have been so effective in fighting this virus because they used their past experience with outbreaks of SARS and MERS. Think of this as a good practice run for the next even more dangerous virus. Hopefully we'll learn from this and do better next time.

 

[dfwatt]

Sadly they all seem to lie. Every War since WWII started on lies. And now we have learned to never end a war, much more profitable.
Not sure I can name them all, I think 8 if we include Somalia. +800 military bases in other peoples countries - that doesn't seem to stop any wars, but it sure is profitable. Obama promised change, and started 5 new wars, killed more people with drones than Bush. To be fair Bush probably had fewer drones to work with. Good luck voting for the lesser of 2 evils - never seemed to work for me. Felt best when I didn't vote red nor blue and tried the not part of the corporate bought system. We do have the best government money can buy. I just don't have enough money to be part of the buyers club.

Holyshit Batman! I think I may actually agree with the core idea in your post which is - at least if I'm interpreting it correctly - that power/money corrupts with absolute power/money corrupting absolutely. If that's what you're saying, great. If not, then , , , , nevermind.

But if you actually believe that, then the question becomes how do you reverse it? And why do you think power corrupts? If you can't answer those questions you can't envision real solutions. Curious what you think.

 

[Daniel in SD]

Speaking of which, here is another new one -- 3% of blood donors in the Netherlands test positive with antibody test v. about 0.17% of the population confirmed cases (worldometer data).

And about 0.02% of the population dead.

 

[mikevbf]

Here is a summary of NewYork-Presbyterian Hospital's update from yesterday:

"Numbers: 2,392 inpatient (50 patients fewer than yesterday). 733 are on ventilators and we have a lot of work to do to care for them. Hopefully this downward trend will continue.

Clinical trials: we need clinical evidence.

Two pieces of research that are launching this week: national survey to healthcare workers that ask questions about PPE and the emotional response of treating covid on the front lines. Next Wednesday a trial of 15,000 health care workers, 1,000 of them for our healthcare workers in NYC will look at Hydroxycloriquin used as prophylaxis vs. placebo to understand what we should be doing to keep our healthcare workers safe and healthy.

Testing:

There are a lot of fake tests out there. You have access to testing at our facilities.

Starting Friday we will have be blood test available.

We do have a good supply of PPE. If you are a direct caregiver you have access to N95.

Visitor policy: no change.

My Covid 19 Story: new project where people are telling their stories."

 

[MXLRplus]

Minor Tesla related News - Federal Express is refusing to deliver parcels in areas of California at this time.
Tesla uses FedEx to ship their accessories purchased at their store, and uses it internally for Hot parts and engineering.
The inability to purchase charging accessories for Teslas is not going to help matters. Delays in component shipping isn't going to help development time.

In our case, FedEx failure is delaying some medical device development projects. FedEx did not warn us prior to the change in their service. UPS is still active. USPS has always been a gamble for us.

 

[dfwatt]

I don't know if I really speak for others here, but I think many of us are having problems with your "over the top" posturing. Sure, it is sad that our generation does many short sighted things that will hurt our future generations. Sure, kids are our future, and need our protection. But the statements alluding to older folks being in effect "expendable" is just too much to accept and swallow like that. Where does it stop? Should we dump the sick people overboard? Pre-existing conditions get no care? There are tough calls to be made, for sure, but I think the accepted attitude is more of "everyone is equal" and no one person should be going around announcing who should be saved and who should be put out to pasture. Is age your only bias? My sense is you could rank people on some personal scale of who is more worthy than someone else based on whatever personal biases you are harboring. It is sort of ugly to see that stuff presented as if it is commonly accepted view points.

Well said. I might only add that it is not "sort of ugly" to see dehumanization rationalized and argued for on an industrial scale it is incredibly ugly. It's that kind of thinking - that some lives are simply expendable - that leads to not just racism and all forms of prejudice but has the potential to have some individuals eventually act on that dehumanization in various forms of hate crime, and when organized societies and large groups with power act on it into genocide. And the idea that one group in a position of dominant power has the right to decide who deserves to live and who deserves to die is actually on the Teflon slope into that very dark territory.

 

[Norbert]

No, because the case number will increase in every age cohort

Of course the case numbers all increase. We need to consider lag in all cases to be more precise. We all keep reverting to the use of naive CFRs. It's just a reminder.

 

[winfield100]

The avg age of death from Covid is 80. Think about that.
The avg life expectancy in the US is 78. If you make it past that you're playing with house money. Those folks (and their kids) enjoyed economic expansion like the world has never seen and never will see. And yeah, they pretty much went about destroying mother nature in the process (and we gonna have to clean up that mess too).

We should be looking out 20 - 40 years. Those 80 year olds won't be alive. But we'll still be paying off their medical bills while trying to do a lot of crazy and important and complicated *sugar*. Let's not be so sensitive about death; because we sure as hell weren't before Covid. We don't shut down McDonald's to prevent heart disease (#1 killer). People smoke despite their being a cancer warning on the label (why not make it illegal? and what about deaths from 2nd hand smoke?). People accept the risk of death for certain benefits. We don't ban sky diving and rock climbing, and swimming near sharks and scuba diving and MMA and etc etc etc. Point is - never have I ever seen people so sensitive to death. It's really bizarre. 140,000 kids died of measles last year (in poor countries), but you never heard of it. All of a sudden we're hysterical about a bug that has a modest death rate, and that's IF you get it.

Remember, avg age of 80. We're incurring trillions of cost. That is one big fat medical bill for the elderly that their grandchildren will have to pay off. That's literally what it is, at a macro level. But on a micro level; it doesn't happen - grandpa does not put his medical bill on the shoulders of his grandkid. He wouldn't even think about it.

@dqd88
@TEGthank you for expressing some of my feelings

@dqd88 it is very kind of you to unilaterally decide that I in my early 70’s am essentially “expendible”,
“over and out” so to speak.
Please send cyanide pills for me so I may stop being a ‘drain on society’ though my spouse might demur

Perhaps if you had or dodged by sheer dumb luck, the same capricious, ‘judge, jury, executioner’, your tune would change

Your local library may have this on loan to read a downloaded copy,
Get back when you have absorbed a portion
The Origins of Totalitarianism - Wikipedia
Hannah Arendt
“The banality of evil” is a nice quote

 

[AlanSubie4Life]

they are finding a much higher percentage of infections than have been identified through the normal testing process.

I agree, but it is an open question how big the gap is between reported cases and actual infections -- 10X, 30X, 50X, more?

We really don’t know if we’ve been 10 times off or 100 times off in terms of the cases. Personally, I lean more towards the 50 to 100 times off.

Man, these epidemiologists are so optimistic! I’m surprised that he says this though, because if you look at the plausible number of cases given the introduction time and known disease parameters, it is hard to get to 100x the positive test results for actual prevalence in most locations. It simply is unlikely that it spread that fast. Obviously the difference between 10x and 100x is just 3+ doublings, but with the info we have it’s much more likely to be ~10x. (Caveat that it depends on where we are talking about.)

Anyway, as you say, the overcount will obviously vary by country and location. In the US, based on the time of introduction and the dynamics, it’s looked like it is about a 10x ratio on average, Maybe it is closer to 20x in New York.

In the end, practically, the reason this matters is because it affects IFR. And that looks like it is going to be closer to 1% than 0.1% unfortunately. (Obviously for a typical age distribution population.). And as we know, 0.1% is a very high infection fatality rate - we do extensive vaccination campaigns for diseases reaching that threshold - like flu. So 1% is nearly catastrophic for healthcare systems and the emotional well being of a population (as we have seen).

And about 0.02% of the population dead.

*So far - the mortality from that 3% of the population infected is not yet complete.

Hooray! Only 0.7% IFR! (So far.). What was all the panic about?

Should we have a corona party?

 

[Norbert]

The first results from Finland's antibody testing program have come out. The sample size is small, but consistent with other recent studies they are finding a much higher percentage of infections than have been identified through the normal testing process.

The headline of their press release reads: "Number of people with coronavirus infections may be dozens of times higher than the number of confirmed cases." A bit sensationalist given the small sample size (147 tests, 5 positive in the key sample), but the text of the release is more balanced. The press release does not state selectivity or specificity of the test used.

Number of people with coronavirus infections may be dozens of times higher than the number of confirmed cases - Press release - THL

You forgot to mention that the 150 samples from the previous week had no positives at all, and the 145 from the week before that had just 1 positive.

This could easily have been a coincidence or a local super-spreading event. A 5 people "super spreading" event.

I'm starting to get tired of having to "refute" all these micro-verse claims, or academics who have a different opinion than the CDC. Just be a bit patient until we have real studies. By the way, it is very likely that at least in some areas and/or times in the US the number of infected is much larger than the known "cases", simply because testing has often been limited to the most serious cases who were in need of hospitalization. However in many of those situations the CFR considering lag may also have been extremely high.

 

[dfwatt]

I agree, but it is an open question how big the gap is between reported cases and actual infections -- 10X, 30X, 50X, more? For example, Michael Mina, a Harvard epidemiologist, said recently that he leaned toward actual infections being 50-100X confirmed cases, which is much higher than many others are guesstimating:

MICHAEL MINA: Yes. I was touching on this a little bit earlier, I think that the very first thing we have to do is just get a sort of order of magnitude understanding of how many people have actually been infected. We really don’t know if we’ve been 10 times off or 100 times off in terms of the cases. Personally, I lean more towards the 50 to 100 times off.​

And we’ve actually had much wider spread of this virus than testing and the numbers are really giving us the moment. And that’s generally a feature of just extreme limited numbers of tests.​

https://www.hsph.harvard.edu/news/f...9-press-conference-with-michael-mina-04-3-20/

We are just beginning to get a few scattered (and generally pretty low quality) reports of antibody testing from around the world to start to answer that question.

Speaking of which, here is another new one -- 3% of blood donors in the Netherlands test positive with antibody test v. about 0.17% of the population confirmed cases (worldometer data).

Caveats: donors are not representative of the population and it is a press report (no details on tests provided).

https://www.nu.nl/coronavirus/6045092/rivm-ongeveer-3-procent-bloeddonoren-heeft-antistoffen-tegen-coronavirus.html (in Dutch -- open in Google Chrome for English translation).

Here's the problem. To assume that there are many more undiagnosed cases then diagnosed cases seems safe. To assume that that ratio is between 30 and 100 seems wildly optimistic and without an evidence base at all. Additionally, and even more troubling, that assumption seems to be in the service of minimization of the severity of the pandemic. And is often times used to rationalize the undermining of mitigation. In the absence of widespread and statistically valid high density population sampling for IgG, the arguments you are proposing or seem to be proposing simply do not have a scientific basis. Do you understand that? Or do you believe that there is some proxy extrapolation that you can substitute for IgG? Because if it's the latter I think you've missed the scientific boat on this one.

Additionally, that high-density sampling of antibodies provides the only valid basis for determining who is safe to operate without restriction, in the service of opening up the economy. I won't get into the issue of whether or not IgG provide some version of blanket immunity. That's a basket of complexities but I think we have to assume as a default that the immunity is substantial. It's not clear to me therefore that you have your eyes on the prize so to speak - it is IgG testing.

And this does not replace or obviate the need for an accurate tests for the virus itself. Unfortunately our performance on this latter subject raises questions about whether we can get our act together to create a proper antibody test and dispense that in volume.

 

[bkp_duke]

I don't think there is consensus in the medical/scientific/academic communities. Seems like it's not even discussed much. Would love to know the answer.

It's called the inoculum (the amount of virus you are exposed to - i.e. inoculated with).

Once you hit a certain minimum threshold, you are getting infected, it doesn't matter if you are around someone 2 minutes or 2 days. There is an argument that a larger inoculum can cause a worse disease, but the data to support/refute that is not good and varies wildly by other vactors.

Inoculum is one of the key factors that determines R0, and they are inversely proportional in most cases. Higher R0, lower inoculum.

SARS-CoV-2 has an R0 of about 3, without any social distancing. Substantially higher than influenza. Not much of a "dose" is required to get you sick.

 

[EinSV]

Here's the problem. To assume that there are many more undiagnosed cases then diagnosed cases seems safe. To assume that that ratio is between 30 and 100 seems wildly optimistic and without an evidence base at all. Additionally, and even more troubling, that assumption seems to be in the service of minimization of the severity of the pandemic. And is often times used to rationalize the undermining of mitigation. In the absence of widespread and statistically valid high density population sampling for IgG, the arguments you are proposing or seem to be proposing simply do not have a scientific basis. Do you understand that? Or do you believe that there is some proxy extrapolation that you can substitute for IgG? Because if it's the latter I think you've missed the scientific boat on this one.

There is insufficient evidence to conclude the true rate of infections is one order of magnitude higher than confirmed cases or two. 10X, 50X or 100X. And as @jeewee3000 mentioned, it's likely to vary from one area to another.

Many experts lean toward one end of that spectrum, others lean toward the other. You can choose one side or the other based on policy preferences or risk assessment (precautionary principle). That's a fine way to approach it. I'm personally more interested in following the data to see where it leads, and I'll keep posting interesting information that some people may find useful, even if some find it upsetting.

Also, a gentle reminder that this is a Tesla investor forum. The idea is to share information to make better investing decisions. It's not a debate society. There are no arguments to win, and no internet points are awarded for being right or wrong.

 

[bkp_duke]

Bloodbank tests in the Netherlands indicate around 3% have some anti-bodies for COVID-19. For 18-20 years old around 3.6% and then slightly decreasing with age.

Seems there are unknowns with regard to immunity. But at least it's an indication for exposure to COVID-19 among the population.

Sadly that 3% rate is about the same as the false positive rate for the antibody test. Not many conclusions can be drawn from that data.

 

[dfwatt]

There is insufficient evidence to conclude the true rate of infections is one order of magnitude higher than confirmed cases or two. 10X, 50X or 100X.

Many experts lean toward one end of that spectrum, others lean toward the other. You can choose one side or the other based on policy preferences or risk assessment (precautionary principle). That's a fine way to approach it. I'm personally more interested in following the data to see where it leads, and I'll keep posting interesting information that people may find useful, even if some find it upsetting.

When I challenge you about a claim you provide additional claims. This suggests that you're not in the Sciences professionally. The gold standard in the Sciences for supporting and generating claims is properly vetted peer-reviewed data. Please point me to properly vetted peer-reviewed data that support your 30 to 100 times estimate of infection versus cases.

Please do not support your claim of that with additional claims. That actually only weakens your argument. To suggest that I or others are challenging your claims simply because I or others are upset by your argument is, well, beneath responding to.

 

[Norbert]

Yesterday night the worldometer number of new deaths in the US was 2,482 after the daily cut-off. Now the "Yesterday" number shows 2,763. Definitely a new high both ways, even though the graph's bar for April 14 now shows 6,185 deaths for that single day since that is how those ~3,700 non-hospital deaths were added retroactively.

Explanation for the 2,763 number here, for those who keep track of these numbers:
April 14 - 15 Change in US COVID-19 Data - Worldometer

EDIT: This is what the graph looks like now:

 

[EinSV]

When I challenge you about a claim you provide additional claims. This suggests that you're not in the Sciences professionally. The gold standard in the Sciences for supporting and generating claims is properly vetted peer-reviewed data. Please point me to properly vetted peer-reviewed data that support your 30 to 100 times estimate of infection versus cases.

Please do not support your claim of that with additional claims. That actually only weakens your argument.

I'm not here to debate or argue. If you think the experts in the field you disagree with (like Dr. Mina) are wrong, that's your prerogative.

I look forward to this thread being more about data and information, less argument. Right now, it's pretty useless from my perspective.

 

[OPRCE]

In china: as they have started to relax restrictions they are seeing a spike, which is what we don’t want

The vast majority of new cases in China these days are imported, i.e. mainly Chinese citizens returning from abroad + trickle of foreign businesspersons ... but anyhow, all are tested on arrival and go into mandatory 14-day quarantine. Strict tracking measures on mobile phones remains in place, must show status GREEN to permit entry into public buildings/mass transit, etc.
China's Travel Restrictions due to COVID-19: An Explainer

 

[bkp_duke]

The first results from Finland's antibody testing program have come out. The sample size is small, but consistent with other recent studies they are finding a much higher percentage of infections than have been identified through the normal testing process.

The headline of their press release reads: "Number of people with coronavirus infections may be dozens of times higher than the number of confirmed cases." A bit sensationalist given the small sample size (147 tests, 5 positive in the key sample), but the text of the release is more balanced. The press release does not state selectivity or specificity of the test used.

Number of people with coronavirus infections may be dozens of times higher than the number of confirmed cases - Press release - THL

Ugh. Again - 5 positives out of 147 tests . . . is within the false positive range of this kind of test.

It would be far more appropriate to list it as "ZERO to 5 people tested positive".


As an old professor once beat into my head - NEVER trust a dataset that doesn't include error bars.