Coronavirus

[EVNow]

Herd immunity is the only lasting solution to any virus... Ok, a few exceptions like SARS-1 and Smallpox but for the majority of them.

Where in the article do they say the lockdown haven't "helped all that much"?

There was little local transmission before the lockdown. The hope was lockdown would prevent any local transmissions ...

Dr Muliyil said the first 21-day lockdown had in some states – but not all – reduced the rate of growth of the infection
​

For India to get to herd immunity would imply > 100k deaths, assuming only people < 60 years get infected.

 

[renim]

One of the most pessimistic takes I've read on Covid in India.

'Herd Immunity Is the Only Lasting Solution to the Coronavirus', Says Leading Epidemiologist

The initial 21 days lockdown was extended by 19 more days. Doesn't seem to have helped all that much. This could also mean the heat & humidity is not going to save rest of the northern hemisphere either.

Lockdowns can be seductive, but what about the morning after.

Time is valuable, lockdowns buy time, and flatten the curve, but the AUC area under the curve is still the same. If medical care improves it can all be worth it, but absent that, ouch, lockdowns in third world countries kills the poorest people. (Lack of food)

 

[EVNow]

NYC Health shows 9101 confirmed and 4582 probable through 4/19. That's 0.11% PFR for confirmed only and 0.16% PFR for confirmed+probable.

I picked up 0.18% from Reddit (and the assumption was population is lower now because people have gone out of town).

 

[EVNow]

Lockdowns can be seductive, but what about the morning after.

Time is valuable, lockdowns buy time, and flatten the curve, but the AUC area under the curve is still the same. If medical care improves it can all be worth it, but absent that, ouch, lockdowns in third world countries kills the poorest people. (Lack of food)

Interestingly one state that has done well is the "communist" Kerala.

A virus, social democracy, and dividends for Kerala

 

[Daniel in SD]

Lockdowns can be seductive, but what about the morning after.

Time is valuable, lockdowns buy time, and flatten the curve, but the AUC area under the curve is still the same. If medical care improves it can all be worth it, but absent that, ouch, lockdowns in third world countries kills the poorest people. (Lack of food)

Looks like your country (Australia) will be successful in eliminating the virus. Of course that will mean that international travel will be very painful until there is a vaccine.

 

[EVNow]

How much testing capacity do we need ? 500k per day ?

Why we need at least 500,000 tests per day to open the economy — and stay open – Pandemics Explained

Scott Gottlieb was saying in a podcast that anything above 1.5M/week is difficult for US because that is the setup capacity of pvt labs. Anything above would mean brand new infrastructure to be created.

 

[Norbert]

Lockdowns can be seductive, but what about the morning after.

Time is valuable, lockdowns buy time, and flatten the curve, but the AUC area under the curve is still the same. If medical care improves it can all be worth it, but absent that, ouch, lockdowns in third world countries kills the poorest people. (Lack of food)

How about the effect on young people riding motorcycles?

Flattening the curve is the effect of reducing Rt while remaining larger than 1. But a good lockdown has the effect of bringing Rt below 1, which greatly reduces the totals.

This website shows that in the US, we have that effect in many states:

rt.live

Currently about half of the states are below 1, but many more have been below 1 around April 12. Since then it got worse in many states, probably because of the mixed signals about opening up the country made people think it is already over.

 

[AlanSubie4Life]

but the AUC area under the curve is still the same.

This really isn't true. Of course, if you are talking about multiple waves, they will eventually add up roughly to the single unmitigated curve area. But when comparing the unmitigated curve to the first wave, obviously the areas will be very, very different.

And if you can drive actual cases down to zero - this is possible in countries which are completely isolated, then you can make the curve truly lower area.

The other part of the statement is true - the major thing that lockdown buys you is time, to help prepare to keep future waves well suppressed, etc. - all the things we're supposed to be doing right now.

 

[AlanSubie4Life]

Scott Gottlieb was saying in a podcast that anything above 1.5M/week is difficult for US

Trump says testing is super easy, easier than ventilators. So I guess that means we're golden.

Seems like we should be shooting for about 1%-2% positivity rates for properly administered tests, in every hotspot area. That's when we'll know we have enough.

 

[Norbert]

How much testing capacity do we need ? 500k per day ?

Why we need at least 500,000 tests per day to open the economy — and stay open – Pandemics Explained

Scott Gottlieb was saying in a podcast that anything above 1.5M/week is difficult for US because that is the setup capacity of pvt labs. Anything above would mean brand new infrastructure to be created.

I'd say that is all the more a reason to create that infrastructure, as we may also need it for future pandemics that are even worse. In a recently posted video interview with one of South Korea's medical experts, he said we now have something new with increasing frequency. Every few years.

 

[TEG]

Testing the association between blood type and COVID-19 infection, intubation, and death

Study Suggests Blood Type A Associated With Higher Risk of COVID-19

How blood group A might be a risk and blood group O be protected from coronavirus (COVID-19) infections (how the virus invades the human via blood group carbohydrate).

 

[NikolaACDC]

How about the effect on young people riding motorcycles?
Flattening the curve is the effect of reducing Rt while remaining larger than 1. But a good lockdown has the effect of bringing Rt below 1, which greatly reduces the totals.
This website shows that in the US, we have that effect in many states:
rt.live
Currently about half of the states are below 1, but many more have been below 1 around April 12. Since then it got worse in many states, probably because of the mixed signals about opening up the country made people think it is already over.

Aren't these numbers skewed by limited testing?
You don't test -> you don't detect (re-)infections -> R looks small

 

[renim]

This really isn't true. Of course, if you are talking about multiple waves, they will eventually add up roughly to the single unmitigated curve area. But when comparing the unmitigated curve to the first wave, obviously the areas will be very different.

And if you can drive actual cases down to zero - this is possible in countries which are completely isolated, then you can make the curve truly lower area.

The other part of the statement is true - the major thing that lockdown buys you is time, to help prepare to keep future waves well suppressed, etc. - all the things we're supposed to be doing right now.

It basically is true, in a pre vaccine world, lockdowns buy time but not much else. suppression is needed long term cause the lockdown and ignore is basically a mirror image of ignore and lockdown.

What is different this time is that hopefully medical treatment will develop significantly, allowing the fatally rate to drop significantly.

India ia not Australia, india still has perhaps 500 million people so poor that they dont have electricity. If their lockdown causes food to rot in the fields or warehouses. Disaster.

Some countries the lockdown is enforced by gunshot, that is serious.

 

[dfwatt]

LA County of Public Health and USC have issued a press release on the first round of antibody studies conducted by USC in Los Angeles.

Here is a summary of results:

"Based on results of the first round of testing, the research team estimates that approximately 4.1% of the county's adult population has antibody to the virus. Adjusting this estimate for statistical margin of error implies about 2.8% to 5.6% of the county's adult population has antibody to the virus- which translates to approximately 221,000 to 442,000 adults in the county who have had the infection. That estimate is 28 to 55 times higher than the 7,994 confirmed cases of COVID-19 reported to the county by the time of the study in early April. The number of COVID-related deaths in the county has now surpassed 600.​

"We haven't known the true extent of COVID-19 infections in our community because we have only tested people with symptoms, and the availability of tests has been limited," said lead investigator Neeraj Sood, a USC professor of public policy at USC Price School for Public Policy and senior fellow at USC Schaeffer Center for Health Policy and Economics. "The estimates also suggest that we might have to recalibrate disease prediction models and rethink public health strategies." Press Release:USC-LA County Study: Early Results of Antibody Testing Suggest Number of COVID-19 Infections Far Exceeds Number of Confirmed Cases in Los Angeles County
​

More info in the release for anyone interested (I haven't reviewed in detail yet).

I find it puzzling that this is announced prior to peer review and with so many potential unanswered questions about their statistical assumptions and with still just really preliminary data about the antibody test itself. If that were not enough to raise questions then there is the very public study author political agenda which they have made quite explicit, again well before the publication of even preliminary results. All of this is incredibly unusual in serious science.

An interesting question to ponder is which is greater - the scientific esteem that you gain by being the first to discover something versus the approbation that you receive from your fellow scientists if you jumped the gun and your results are falsified by the results of careful, better collected data sets. In that regard the study authors took huge risks. More than I would have taken. If much larger scale and much less self-selected and demographically biased sampling of antibodies in the community falsifies their result . . . . they have huge and I really do mean huge egg on their faces.

 

[AlanSubie4Life]

LA County of Public Health and USC have issued a press release on the first round of antibody studies conducted by USC in Los Angeles.

Here is a summary of results:

"Based on results of the first round of testing, the research team estimates that approximately 4.1% of the county's adult population has antibody to the virus. Adjusting this estimate for statistical margin of error implies about 2.8% to 5.6% of the county's adult population has antibody to the virus- which translates to approximately 221,000 to 442,000 adults in the county who have had the infection. That estimate is 28 to 55 times higher than the 7,994 confirmed cases of COVID-19 reported to the county by the time of the study in early April. The number of COVID-related deaths in the county has now surpassed 600.​

"We haven't known the true extent of COVID-19 infections in our community because we have only tested people with symptoms, and the availability of tests has been limited," said lead investigator Neeraj Sood, a USC professor of public policy at USC Price School for Public Policy and senior fellow at USC Schaeffer Center for Health Policy and Economics. "The estimates also suggest that we might have to recalibrate disease prediction models and rethink public health strategies." Press Release:USC-LA County Study: Early Results of Antibody Testing Suggest Number of COVID-19 Infections Far Exceeds Number of Confirmed Cases in Los Angeles County
​

More info in the release for anyone interested (I haven't reviewed in detail yet).

Before you post the next serology result (since you seem to be one of the best here at digging up the study results), please run the raw data from the study through these calculators, and post the picture of the distribution, along with your summary of the study results.

That will help keep everyone on the same page of what the results mean & how much we can interpret from them. We need to keep this thread as on target and as full of good information as possible:

Prevalence calculator (known sensitivity and specificity)

And here's another that takes into account the serology test calibration data, which you should also post (it is key for interpreting the results):

Prevalence calculator (lab calibration data)

Should be a relatively easy thing for you to do prior to posting the next good serology study result you come across.

I ran it with some approximate numbers for the Stanford study (I didn't use exact numbers for the test calibrations, but they are close):

 

[AlanSubie4Life]

It basically is true, in a pre vaccine world, lockdowns buy time but not much else.

I'm pretty sure you can look at South Korea's curve (which you can view as terminated) and China's curve, and it's quite clear that the area under the curve is lower than it would have been otherwise.

Let's not spread misinformation here. Focus on the fact: the terminated first wave curve will have dramatically lower area than an unmitigated curve.

As I said, obviously in the absence of a vaccine, all you can do is slow the spread. But that rate of spread can be kept extremely low - to a point where with everyone implementing maximum countermeasures (but still having an open economy), a significant number of people would die from other causes (maybe after 10-15 years of suppression) rather than the disease.

And of course, most likely the countermeasures would only be kept in place for a year or two, by which time a vaccine would be available.

So, as I said in my last post, when comparing no suppression to suppression, the area under the curve will be very different.

And suppression by lockdown is pointless if you're not doing massive deployment of alternative suppression strategies during the lockdown. A huge amount of resources of each affected nation should be focused on implementing alternative suppression strategies during lockdown (what else have people got to do? - should be a readily implemented government job program, and labor costs can be low!).

 

[Norbert]

Aren't these numbers skewed by limited testing?
You don't test -> you don't detect (re-)infections -> R looks small

The numbers show a relative development. I'm assuming that generally, testing capacity has improved and would progressively add a negative bias over time instead of a positive one. (Increase the reported number of cases.) But I don't really know.

 

[sparcs]

Georgia’s governor says many shuttered businesses can reopen Friday

Georgia’s governor announced plans Monday to restart the state’s economy before the end of the week, saying many businesses that closed to mitigate the spread of the coronavirus could reopen as early as Friday.

The governor in neighboring Tennessee planned to let businesses in most of his state begin reopening as soon as next week.

 

[bkp_duke]

Georgia’s governor says many shuttered businesses can reopen Friday

And here comes wave 2 . . . .

 

[AlanSubie4Life]

I ran it with some approximate numbers

There is a bug in the sampling in those pictures I posted, which they'll resolve soon. That high bar in prevalence near zero is not correct. (Has to do with a bug in the browser code - the underlying code is fine.)