Coronavirus

[SageBrush]

Any suggestions on what to read

Hi

A deep dive is not really necessary, but it helps to be clear on the difference and relationship of PO2 and O2 saturation, and then take a look at the deoxyhemoglobin desaturation curve.

In my earlier posts I was really only pointing out that the oximeter is insensitive to significant lung infection, and by the time the O2 sat drops below 90% the time until respiratory failure can be brief. Since the overwhelming fraction of the lay population who buy oximeters for Covid do not understand these details, they are a very problematic recommendation.

Use of an oximeter can way too easily fall into the trump trap: by the time a problem is recognized the horse is out of the barn, across the river, and heading for the horizon.

 

[sparcs]

one store finally figured it out....

Costco Face Mask Requirements

To protect our members and employees, effective May 4, all Costco members and guests must wear a mask or face covering that covers the mouth and nose at all times while at Costco. This requirement does not apply to children under the age of 2 or to individuals who are unable to wear a mask or face covering due to a medical condition.

The use of a mask or face covering should not be seen as a substitute for social distancing. Please continue to observe rules regarding appropriate distancing while on Costco premises. Thank you for your understanding and cooperation.

 

[Doggydogworld]

He REALLY wants that stock grant,..

TSLA would have to crash pretty hard in May for him to miss out on that.

It’s like a competition to be dumber than Trump.

Donald "Lysol" Trump took a commanding lead last week, but Musk is not giving up!

Also, an actual ML model here.,.might be popular amongst the crowd here:

COVID-19 Projections | United States

I don't like the IHME model, but what really screwed them the past couple weeks was the sudden inclusion of "probable" deaths. Especially the retroactive changes. IHME really should have gone through the numbers for each country and US state, spreading the one-time increases over the past 30 days or so, and then announced a new IHME 2.0 model. That would have been a lot of work, though.

This Machine Learning model uses a SEIR-type simulation. Instead of directly curve-fitting against actual historical deaths, their algorithm searches for the R0 that drives their SEIR simulation to best match each state/country's historical curve. They add in some manual sanity checking and tweaking.

The interesting question, as you note, is how they model re-opening. It may not make that much difference. Nobody is goes from 100% closed to 100% open at the flip of a switch. Regardless of political rhetoric and media hype, states will re-open gradually and along a somewhat predictable timeline based on current death toll and red-state-ness. TX going from 40% locked down to 30% this week vs. mid-May probably doesn't change R0 that much.

 

[jhm]

As of today, 56,797 souls have passed. Weekend reporting lags seem to continue to suppress counts Sunday and Monday. So we are actually at the low point in the weekly cycle.

A curious thing has happened, ultimate projected deaths are nearly the same comparing the dumb-ass model (75,804) and the 14-day trend (79,139). You can also see this in the following chart.
View attachment 536653
Some folk may have a hard time appreciation the log scale used in this chart. It can give the impression that the model expects rates to decline very quickly. Perhaps using the nominal scale would help this perception.

View attachment 536658
So of you have questioned whether the growth rate can converge to zero within a finite number of deaths. You might also wonder if an exponential model might fit a little better. Well, I include an exponential fit curve in the above chart. The advantage is that the death rate goes to zero with infinite number of deaths, not finite. But alas the fit is not nearly as good 3 and 4 weeks ago. Let me know if you think this could be worth exploring further.

Here are the other charts.

View attachment 536662


View attachment 536663

Deaths were up 2469 to 59,266 total yesterday. This pushes the ultimates of both dumb-ass and 14-day models a bit to 78,832 and 88,473 respectively.

 

[SageBrush]

one store finally figured it out....

Good for Costco!
I worry about the "medical exemption."
That sounds way too similar to a "religious exemption" as abused by anti-vaxxers. I can too easily imagine the sick preferentially removing their masks.

Costco would have been a lot better off offering an alternative service for those "unable" to wear a mask.

 

[bkp_duke]

There’s not yet good evidence that presence of antibodies in the blood confers good immunity. Which makes going for herd immunity at this early stage a pretty brave strategy.

Seeing Musk on Twitter today, if I was Chairperson of the Board I’d be pretty tempted to yank him off the field for the investor call and stick in a boring numbers of operations guy.

Musk not being on the call would be a solid 100-150 point downswing in the stock price the next morning. No chair of the board is going to consider it.

 

[Dr. J]

So it is a long rough road until a vaccine arrives.

There is a better way, of course: eliminate the virus completely. Best to start soon.

Hopefully they’ll be able to take some shortcuts and recruit volunteers for vaccine trials in high risk groups and get a better idea of safety and efficacy faster than normal. And maybe they can pipeline things and do parallelism and produce multiple vaccines in parallel in high volume, before trials are complete. That would cut off additional time. Maybe we could have something by the end of the year or earlier. No idea what the minimum possible turn time is, if cost is no object.

CNBC buried the pessimistic portion of what he said, but if you want to be a human guinea pig in a mass trial, you might be lucky enough to be vaccinated by this fall.

Dr. Scott Gottlieb sees millions of coronavirus vaccine doses ready for testing this fall

It will be “well into 2021 until anyone is going to have a vaccine available in the kinds of quantities that would be required to inoculate the entire United States or the entire European continent or other countries, low and middle-income countries,” he said.

“We are a ways off in terms of having a vaccine available at .. that kind of scale,” he said. “But in doses of millions, it could be available much sooner than that.”

 

[dfwatt]

There’s not yet good evidence that presence of antibodies in the blood confers good immunity. Which makes going for herd immunity at this early stage a pretty brave strategy.

Seeing Musk on Twitter today, if I was Chairperson of the Board I’d be pretty tempted to yank him off the field for the investor call and stick in a boring numbers of operations guy.

In science it is always safe and probably desirable in a number of ways to emphasize what you don't know and lead with a default humility position. And I believe that this is the principal reason why you are hearing so many people emphasize that we don't know for sure whether or not antibodies in covid-19 confer immunity. However it would be a one-off case if there was no significant post-infection immunity conferred in covid-19, particularly given the relative genomic stability of covid-19 versus influenza, which means that antibodies don't have to deal with shifting epitopes. People don't really understand what it would mean if antibodies and a successful resolution of covid-19 meant that you had no downstream immunity at all. This would mean a bizarre scenario in which the adaptive immune system which comes in to clean up the tail end of most viral infections, and produces both IGM (acute phase) and IGG (chronic) antibodies, that despite this adaptive immune system being successful in cleaning up the virus that those antibodies have no value on immediate re-challenge. If that's true you have to ask how did your immune system resolve the first challenge? It would also mean that vaccination is likely to be impossible because that is also based on an antibody strategy of one kind or another.

Just based on what we've experienced with many other coronaviruses, I think it's highly unlikely that there is not some degree of immunity conferred for an unknown peroid of time but probably many months to several years if prior experience provides any kind of yardstick. That may not be permanent protection and it may not be bulletproof so to speak.

All of that however is very distinct from the lunacy of allowing a naturalistic herd immunity to be the default strategy, letting the virus run its course so to speak. That's crazy, and is part of an anti-science denial.

 

[MD70]

Inside Donald Trump and Jared Kushner’s Two Months of Magical Thinking

An excellent account of what’s actually been going on. Unfortunately it looks like the US will continue to stumble through the pandemic and with people like this in charge, you are all on your own.
“I told Jared that if Trump won a second term, he wouldn’t have to worry about running again and you can really help people. Jared just looked at me and said, ‘I don’t care about any of that.’”

 

[jerry33]

When did they do that? Recent articles say Ford engineers are applying the finishing touches from home and still plan to ship on time. Obviously if Michigan lockdowns continue another 3-4 months that won't be possible, but I haven't seen any Ford announcements yet.

There was a post in the investment thread yesterday with a link to the announcement. (It was shortly before the link to the Rivan/Lincoln post).

 

[azaz]

Perhaps Musk feels that climate change is actually the most immediate existential threat to civilization, with COVID a distant and inconsequential competitor, and delaying action on climate change mitigation by thrusting the world into a economic depression is disastrous.

Not saying I agree. Just trying to figure out his thought process.

this is a respectable position but let’s be clear, it’s not the argument he’s making. the argument he’s been making from the start is that it’s overhyped. When C19 first started impacting us he claimed it was nothing to worry about, the projections and experts were wrong, he compared it to the common cold expecting it to be not much more fatal (laughably wrong and also it’s not mainly a respiratory illness at all), claimed that new infections would be over by end of April, irresponsibly promoted along with fellow board member Larry Ellison the use of hydroxycloriquine etc.

frankly being optimistic about the virus is forgivable it’s the next part which is despicable. Doubling down by claiming the stats are wrong, doctors are intubating for for money, doctors are lying, politicians are robbing people of freedoms on purpose, promoting junk science etc is abhorrent. Frankly this willingness to double down and seek out more and more fringe sources to validate your ideas instead of just admitting you are wrong is deeply troubling behavior from a CEO. And you can see why he’s become this arrogant by looking at the amount of dislikes given out in the daily thread to just mild criticism of this despicable position he holds. The fanboy-ism didn’t use to be to this level 3-4 years back. He’s been a complete idiot about C19 from the start and he’s followed all the same hydroxy will fix it, doctors are lying, give us our freedom backetc memes that denialists on the right have promoted that I wonder how much of this behavior is influenced by Larry Ellison. Ellison is right wing and was apparently instrumental in getting Trump to promote the disastrous hydroxy treatment.

 

[jerry33]

I certainly think it's reasonable to take a position re: coronavirus mitigation measures that differs from "lock down everything until there are no new cases". I'm an evolutionary biologist. My wife is a disease ecologist. We both recognize the complexity and uncertainty of the current situation. Other countries have demonstrated that a competent response centered on transmission-mitigation and intelligence gathering from mass-testing can reduce the spread of the virus and permit safe, phased restarting of local economies.

Perhaps that's all Elon is trying to convey, but if it is, he is being very, very bad at communicating his position. Instead, his message on Twitter is literally identical to those printed on signs by the people yelling about "muh freedom" and brandishing AR-15s at state capitols around the country.

It is not helpful, it does not account for the complexity or nuance of the situation, and it does not reflect the evidence-based, first principles thinking that makes him such a great visionary and leader at both Tesla and SpaceX.

The problem is the "appropriate steps" part, which he said, but it's overlooked due to the rest of the phrasing. Opening up is relatively easy with manufacturing (excludes sweat shop manufacturing where people are close to each other), but offices and retail are hard to do because first they need to install HEPA filters and UVC lights in the HVAC system, and then they need to distance people. Of course, the office people could always continue working from home if the managers and HR weren't so dead set against it. I have no idea how places like hair salons are going to open unless there is a way to certify health. And there needs to be a supply of real protective masks (not just the fake ones you can purchase or make) and surface sanitizer (doesn't look to be available for a couple of months or more). Hand sanitizer supply seems okay.

 

[JRP3]

From the investor thread.

OT...
Not even if every person on the planet wants the vaccinne as if their life depended on it? Maybe not... Pretty steep demand on that vs a test, but at least now I'm questioning my own statement devoid real numbers.
I think my view stems from clear pharma greed everywhere. The answer is almost always money not health.

Everyone needs to be tested, some multiple times. Testing should be more profitable than a vaccine.

Now doctors are calling the shots? That's scary, for me anyway.

Which experts should be calling the shots during a medical emergency? Accountants?

And the way people react is worse, giving some credence to how govt hides truth on aliens fearing a War of the Worlds type panic. Toilet paper and bleach confirms that we need to get our kids in school asap.

The same schools which educated the existing public? So those kids can spread the virus and bring it home to their families?

Americans appear really stupid - en mass. And I cant wait for the comparison between countries as it relates to their diets. I fully expect the US to be down near the bottom. Health as a function of resistance to covid. Some countries have reportedly shaken this flu and I dont think this is only behavior driven.

Health is a factor but mostly it's either lock down or test and quarantine which has been effective in those countries.

 

[canoemore]

The problem is the "appropriate steps" part, which he said, but it's overlooked due to the rest of the phrasing. Opening up is relatively easy with manufacturing (excludes sweat shop manufacturing where people are close to each other), but offices and retail are hard to do because first they need to install HEPA filters and UVC lights in the HVAC system, and then they need to distance people. Of course, the office people could always continue working from home if the managers and HR weren't so dead set against it. I have no idea how places like hair salons are going to open unless there is a way to certify health. And there needs to be a supply of real protective masks (not just the fake ones you can purchase or make) and surface sanitizer (doesn't look to be available for a couple of months or more). Hand sanitizer supply seems okay.

Good points.

 

[NikolaACDC]

Hmmm...Fauci fearing the same
https://www.washingtonpost.com/world/2020/04/29/coronavirus-latest-news/
(can't find a permalink)

as researchers in Germany
Why Researchers Fear a Second Wave - DER SPIEGEL - International

Fauci:
"...said a second wave of infections is “inevitable” in the United States, which has recorded more than 1 million confirmed cases — nearly one-third of the global total. Fauci also warned that “we could be in for a bad fall and a bad winter” if the right countermeasures aren’t put in place."

German epidemiologists:
"Germany’s strict limitations on contact between people haven't conquered the virus - they have merely bought the country more time. Epidemiologists believe a second wave will come."

 

[bubb]

this is a respectable position but let’s be clear, it’s not the argument he’s making. the argument he’s been making from the start is that it’s overhyped. When C19 first started impacting us he claimed it was nothing to worry about, the projections and experts were wrong, he compared it to the common cold expecting it to be not much more fatal (laughably wrong and also it’s not mainly a respiratory illness at all), claimed that new infections would be over by end of April, irresponsibly promoted along with fellow board member Larry Ellison the use of hydroxycloriquine etc.

frankly being optimistic about the virus is forgivable it’s the next part which is despicable. Doubling down by claiming the stats are wrong, doctors are intubating for for money, doctors are lying, politicians are robbing people of freedoms on purpose, promoting junk science etc is abhorrent. Frankly this willingness to double down and seek out more and more fringe sources to validate your ideas instead of just admitting you are wrong is deeply troubling behavior from a CEO. And you can see why he’s become this arrogant by looking at the amount of dislikes given out in the daily thread to just mild criticism of this despicable position he holds. The fanboy-ism didn’t use to be to this level 3-4 years back. He’s been a complete idiot about C19 from the start and he’s followed all the same hydroxy will fix it, doctors are lying, give us our freedom backetc memes that denialists on the right have promoted that I wonder how much of this behavior is influenced by Larry Ellison. Ellison is right wing and was apparently instrumental in getting Trump to promote the disastrous hydroxy treatment.

Agree pretty much 100%, it's very distressing that he is trafficking in skeptic memes which shows little discipline or original thought behind the scenes. It's a really bad tell that he is resorting to this junk rather than constructive things such as delivering a plan to the county for evaluation regarding the reopening of Fremont in a safe way for workers & surrounding community.

 

[NikolaACDC]

Gilead says clinical trials show coronavirus patients responding to antiviral drug

Gilead Sciences on Wednesday revealed some promising news about remdesivir, an antiviral drug that has been touted as a potential COVID-19 treatment.
...
As for Gilead's trial, which involved 397 patients with severe COVID-19 cases, at least 50 percent of patients treated with a 5-day dosage of remdesivir improved and more than half were discharged from the hospital within two weeks. The overall mortality rate of the study was 7 percent, and relatively few patients developed bad side effects from the drug.

There are caveats, of course. The trial wasn't evaluated against a control group of patients who didn't receive the drug. It's also unclear if the high survival and improvement rates may have been natural recoveries from less severe cases. Still, the news is considered encouraging, albeit far from a "home run," as former Food and Drug Administration Commissioner Scott Gottlieb said after seeing the results. He also reiterated that even if remdesivir is effective, it's a treatment, not a cure."

 

[NikolaACDC]

Coronavirus is much deadlier than the flu, whichever data you use

Too long to quote it all, but I think a good summary of the numberwang surrounding CFR & IFR

 

[Daniel in SD]

Perhaps Musk feels that climate change is actually the most immediate existential threat to civilization, with COVID a distant and inconsequential competitor, and delaying action on climate change mitigation by thrusting the world into a economic depression is disastrous.

Not saying I agree. Just trying to figure out his thought process.

I'm going for the bank shot. Maybe he realizes that the best way to stop climate change is a global depression (after all, carbon emissions are way down). A prolonged cycle of opening up and shutting down could keep the economy depressed for much longer.
Flight volume and vehicle miles have cratered, we've probably already offset more carbon than all the Teslas that could be produced in the next decade. For example Tesla claims that their vehicles have offset 3.6 million tons of CO2 total, aviation emits 860 million metric tons of CO2 a year.

 

[TheTalkingMule]

this is a respectable position but let’s be clear, it’s not the argument he’s making. the argument he’s been making from the start is that it’s overhyped. When C19 first started impacting us he claimed it was nothing to worry about, the projections and experts were wrong, he compared it to the common cold expecting it to be not much more fatal (laughably wrong and also it’s not mainly a respiratory illness at all), claimed that new infections would be over by end of April, irresponsibly promoted along with fellow board member Larry Ellison the use of hydroxycloriquine etc.

frankly being optimistic about the virus is forgivable it’s the next part which is despicable. Doubling down by claiming the stats are wrong, doctors are intubating for for money, doctors are lying, politicians are robbing people of freedoms on purpose, promoting junk science etc is abhorrent. Frankly this willingness to double down and seek out more and more fringe sources to validate your ideas instead of just admitting you are wrong is deeply troubling behavior from a CEO. And you can see why he’s become this arrogant by looking at the amount of dislikes given out in the daily thread to just mild criticism of this despicable position he holds. The fanboy-ism didn’t use to be to this level 3-4 years back. He’s been a complete idiot about C19 from the start and he’s followed all the same hydroxy will fix it, doctors are lying, give us our freedom backetc memes that denialists on the right have promoted that I wonder how much of this behavior is influenced by Larry Ellison. Ellison is right wing and was apparently instrumental in getting Trump to promote the disastrous hydroxy treatment.

It's the end of April and new cases do seem to be slowing dramatically.

A month and a half ago this thread was flipping out that at a minimum 1M Americans were about to die and that doubled if we don't execute well. I would call that over-hyped.

I haven't been following Elon's tweets, but I haven't seen much of him latching onto the "freedoms" bandwagon. Yesterday he said Silicon...

This is where I stopped and checked Elon's Twitter feed.............Yikes. Not a good look the past 24hrs. Other than that, his general stance had been generally correct.