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A point in time (today) in the Death sweepstakes.
The USA (orange bar) is climbing the ranks quickly, and with the help of the Southern states has high aspirations.

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You are not responding to what I actually said, there is no point in discussing with you.

The only part of what you've said that wasn't addressed was:
"I'm saying that factories are not low risk. There are interactions all over the place. I also just took a quick look at some videos to make sure it is as I remember. Plus, you have hundreds or thousands coming in and getting out at the same time, probably many of them using public transportation or busses. You have open office space supporting the factory floor. And so on."

I thought that was addressed long ago and would be obvious, ergo my focus on the flawed assumption in my previous post.

So re-capping for clarity. Remember that one of my premises in my original post was that mitigation measures WORK! The factory inter-person contact points that you saw in your videos can be mitigated, unlike high risk environments like grocery stores - which by their very nature are full of inter-person contact points. As for the use of busses, those were charter busses, not public. So similiar to contact tracing, you'll know exactly who else were around you if you get infected (just scan their badges upon boarding the bus). Prevent anyone with a cough/sneeze from boarding, keeping the HVAC on fresh air, and everyone wearing masks are all mitigation measures. To date, how many of those factory workers have been infected (we don't know if that one case was an assembly contractor or was one of the office engineers)? This particular pool of bus riders represents a low-risk population pool, because they've already gotten the virus from their family/community due to SAH or don't have it and thus can't spread it others in the company ... until someone gets exposed to the virus OUTSIDE of the factory. In which case, refer back to primary premise - mitigation measures worked.

You might still have linear spread, but not exponential.


You'd think if that were actually the case, they could present their plan in full form to the governor, and then show a little bit of patience by waiting a week or two for feedback and revisions, before showing the plan to the public.

I don't see any evidence they're really taking this seriously. Not saying they aren't, but I haven't seen any evidence.

"Alameda County". Remember that sheriff who tweeted his disagreement with Tesla. He's the executive in charge at the county level. Don't tell me they don't have an ax to grind? But you're right, just post the plan to the public and see how the county responds then.
 
Yes, many will have no choice but to go into risk. This is not freedom.

And those who will get sick are also the innocent friends and family of those who suspend their understanding of cause and effect.

Yup, if the advocates for opening society were just risking their own lives, I'd be in favor of letting them have the risk, but they are putting others at risk. It's like letting people drive drunk.

There certainly were many potential issues that could have been disastrous such as legacy Fortran, COBOL, and other code at financial institutions, but the vendors alerted folks years before and provided solutions, but a lot of it was over-hyped. Particularly the PC part involving spreadsheets.

In a lot of areas it was overhyped in large part because the reporters delivering the news didn't really understand the problem. I work mostly in C and C++ and it was a non-issue in everything I worked with, but I have a friend who was a COBOL programmer and she made a mint in the last couple of years of the 90s. There were quite a few ancient control systems that had code that hadn't been touched in decades that needed to be reviewed and fixed.

I don't think there is an actual plan.

I have not heard of any study that would show masks and gloves are enough. Maybe in theory quite good, but in practice? It's like making a dangerous experiment with no controls or safeguards in place, unless you keep testing everyone.

8 people is more than enough to start a spread in an environment with Rt > 1. What I see in videos is counter to the idea that there are only few interactions.

And for example nobody is providing numbers about how many of the thousands of workers are using public transportation or busses, ride sharing, etc. Because the proponents don't really care, they are biased over their ears, and that's a likely cause of failure.

Another problem I saw yesterday when I did the shopping. The market I frequent started a mandatory mask policy and close to 3/4 of the people in the store just stopped social distancing. The last time I had been there they didn't have a mandatory mask policy and people social distanced quite well.

Psychologically a lot of people will participate in riskier behavior if they think x protects them. Safety leaves their mind because they are now "protected".

Someone posted something from Trevor Bedford on Twitter yesterday where he was saying the curve is going to plateau instead of go down. I figured that was going to happen from the start. The curves we were all shown at the start of this showed two scenarios, a sharp peak where hospital resources were exceeded or a longer, flatter curve where we stay below hospital peak capacity. The phrase everyone has been chanting for 2 months is "flatten the curve". A long plateau is what a flattened curve looks like.

Nationally I don't think we're going to see a flattened curve for long. With some states opening back up, cases are going to start going back up and the curve will go back up again. Parts of the country will plateau or start to decline slowly but other parts are going to have outbreaks like New York had.

The honest epidemiologists are making the point that a widely available vaccine is still a year or more out even if one or more of the current candidates proves viable. Vaccines take time to make and scaling up production takes time. The yearly flu vaccine has the strains of flu epidemiologists think will be the heavy hitters in the next flu season when they are planning the vaccine a year in advance. It takes most of a year to make enough to vaccines each year. And that's an established production process.

With a vaccine on the distant horizon, herd immunity is the only realistic option. But it has to be done in a way that doesn't overwhelm the hospitals because at that point a lot of people die who could have survived. But the cruel calculus is you need to let people get sick and let some die to get to herd immunity. Throwing open the doors and going back to normal will be a disaster as hospitals in those regions get overwhelmed.

But letting people out a bit more will allow the virus to spread more, but will also move us towards herd immunity.

Herd immunity only works if having the virus and getting over it leaves a person with immunity for at least some time. A lot of noise has been made about the few who got over it who later tested positive again. The South Koreans found a relative few people who still tested positive and think it was debris left in their system that hadn't been cleared out yet.

Something both my SO and I experienced that I haven't seen discussed anywhere is that this thing can relapse easily in the week or two after you get over it. In both our cases we let ourselves get too tired within a week of getting over it and started to feel it come back. In our cases we both made sure to get some extra sleep and it went away quickly. I experienced that a couple of times with the flu as a small kid, getting too active too soon and it relapsed on me. Once pretty severely. At least some of the reinfections may just be people relapsing.

In any case all this assumes immunity after infection for the vast majority of people for some period of time. It's reasonable. Most people develop immunity to viruses they have had for at least a while, and for some viruses the immunity is permanent.

If we don't get immunity from having COVID, then we're screwed. A vaccine will be impossible because that's the mechanism they use to make someone immune and people will just keep getting reinfected. Our only hope at that point will be antivirals and there will likely be side effects. I strongly doubt people who have had it don't have immunity (though there may be a relative few who don't for some unknown reason). Occam's Razor says that people who get over this will have immunity for at least a while.

Because of the massive screw ups with testing, we're flying mostly blind here. We need widespread active virus tests and widespread antibody tests. Both of which are accurate. We need to cull the counterfeit tests from the market ASAP. This relies on competent governing top to bottom, which we don't have right now. If we had an idea of how many people had gotten over the virus and how many were currently infected, leaders could make educated decisions about opening up the economy. Right now most leaders in the US are blind to how many active infections are out there and how many have likely immunity.

To get the economy going again we should also have some kind of certification system for people who test positive for the antibody. Germany is planning on doing it. This would give those who had the virus and are unemployed opportunities to get back to work doing jobs that are more risky for people who haven't had the virus.
 
Hawaii Update

* For the second day in a row, new cases were "1" statewide
* A total of 72 patients have been hospitalized since the pandemic began. Most are likely released now
* Hawaii County (Big Island of Hawaii) has had exactly 1 COVID19 hospitalization. This county's hospitals are bleeding red ink due to no COVID19 patients and no elective surgeries
* Elective surgeries, one on one sessions with doctors are still off limits. I have one neighbor who had cancer surgery on her tongue and is eagerly awaiting ability to get a checkup
* The statewide lockdown is in place until the end of May, after recently been increased by 30 days. Mayors of islands have some discretion to change rules, but they must be approved by governor. Golf courses and flower shops recently allowed to reopen on Oahu
* State is still likely less than halfway through unemployment claims filed in early March. Many people running out of money and not allowed to work.
* One food bank is seeing lines of cars MILES long as people are without ability to work while state unwilling to step up the unemployment check payment process
* First anti-lockdown rally at the capital was this week with 3 arrests but with many protesters who dispersed.
* Governor and Lt. governor are crowing about how safe Hawaii is relative to rest of world but haven't found the energy to get the unemployment checks out and haven't yet resorted to telling the breadless masses to "eat cake".

In short, the success with lockdown and mask wearing is now being overshadowed by government incompetence in paying unemployment claims in a reasonable timeframe and reopening businesses, particularly medical businesses, as the low numbers of COVID19 active cases should allow.

If case counts are that low, I don't understand why they don't use test & trace to ease on the lockdown, unless incoming travelers are still a problem, though I guess they would be part of the case count. South Korea seems able to handle that.
 
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With a vaccine on the distant horizon, herd immunity is the only realistic option.
Let's put some numbers to your conjecture.
Currently in the US there are ~ 100 new test+ cases per million per day. A prior calc of mine (based on 1% IFR; you are welcome to disagree) suggests 10 infections per every confirmed case, so 1000 new infections per million per day.

If 'herd immunity' is 85% immune, you are going to wait ~ 2.33 years. You can double the daily infections and then wait ~ 14 months.

---
My opinion:
Since I anticipate mass vaccination in 12 - 18 months I reject the notion of natural vaccination given the attendant increase in morbidity and mortality.
 
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Nationally I don't think we're going to see a flattened curve for long. With some states opening back up, cases are going to start going back up and the curve will go back up again. Parts of the country will plateau or start to decline slowly but other parts are going to have outbreaks like New York had.

Why is there so much hesitance in this country about making test & trace work? What kind of death toll are you prepared to accept from herd immunity?

There are several states that are at a level where they should be able to demonstrate to the rest of the country that test & trace works not only in South Korea, but also in the US. Somehow they seem to have better things to do, or share Trump's blind spot on testing.

I expect California to be among the states that will be able to do it (unless people like Elon cause too much damage). And once one of the states has shown that it can work in the US, all other states will want to do it as well. That's what is going to happen. The question is just how much time we will need to get there, how much hesitance will slow us down.
 
Something both my SO and I experienced that I haven't seen discussed anywhere is that this thing can relapse easily in the week or two after you get over it.

Have you got your antibody tests yet? I know someone in Seattle who was sure she had it, got her antibody test - nope (of course).

I think you said you were sick late in February so it seems possible, but pretty unlikely.


what kind of luck would you expect when the virus came in large jets into massive airports, spread over hundreds of cities?

You are right, we should just give up.
 
If we don't get immunity from having COVID, then we're screwed. A vaccine will be impossible because that's the mechanism they use to make someone immune and people will just keep getting reinfected.
You could always get a booster shot.
Let's put some numbers to your conjecture.
Currently in the US there are ~ 100 new test+ cases per million per day. A prior calc of mine (based on 1% IFR; you are welcome to disagree) suggests 10 infections per every confirmed case, so 1000 new infections per million per day.

If 'herd immunity' is 85% immune, you are going to wait ~ 2.33 years. You can double the daily infections and then wait ~ 14 months.

---
My opinion:
Since I anticipate mass vaccination in 12 - 18 months I reject the notion of natural vaccination given the attendant increase in morbidity and mortality.
This is the same back of the envelope calculation that I've done. Obviously we could handle way more hospital utilization in the vast majority of the country than we are using right now. If we implemented "death panels" like Sweden is doing we could go even faster. Getting the majority of the public to cooperate and get infected is going to be a challenge though. Just in case it isn't clear, I don't think this is a good idea.
 
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If case counts are that low, I don't understand why they don't use test & trace to ease on the lockdown, unless incoming travelers are still a problem, though I guess they would be part of the case count. South Korea seems able to handle that.

Incoming travelers require 14 days of quarantine, and that includes travelers between islands. Every day the police are arresting some tourists for violating the quarantine rule and often escorting them to the airport for their immediate departure. Hotels appear to be very good at alerting police about offenders. New cases are now community spread rather than travel-related. I agree that now would be a good time for test and trace.

The plot thickens since Hawaii's top industry is tourism. The tentative plan is to open back up in July to visitors and not requiring quarantine. An approved COVID19 test must be passed within 72 hours of departure, and temperatures would be taken before getting on the plane to Hawaii and upon arrival in Hawaii. These measures add a great amount of safety to incoming visitors, but they're not perfect. Some new cases will be introduced, nonetheless. So, it doesn't look like becoming coronavirus free is going to be sustainable even if it can be temporarily met.
 
Incoming travelers require 14 days of quarantine, and that includes travelers between islands. Every day the police are arresting some tourists for violating the quarantine rule and often escorting them to the airport for their immediate departure. Hotels appear to be very good at alerting police about offenders. New cases are now community spread rather than travel-related. I agree that now would be a good time for test and trace.

The plot thickens since Hawaii's top industry is tourism. The tentative plan is to open back up in July to visitors and not requiring quarantine. An approved COVID19 test must be passed within 72 hours of departure, and temperatures would be taken before getting on the plane to Hawaii and upon arrival in Hawaii. These measures add a great amount of safety to incoming visitors, but they're not perfect. Some new cases will be introduced, nonetheless. So, it doesn't look like becoming coronavirus free is going to be sustainable even if it can be temporarily met.
By July there should be quite a few countries in the "COVID free world". Hawaii should start advertising to China, Taiwan, South Korea, Australia and New Zealand.
 
Because even if that were a real problem, we wouldn't be able to do anything about it. <-- sarcasm
Just from a brainstorming perspective:

There were over 100,000 passengers inbound on non-stop China to US flights many whom were in Wuhan, before the US was aware of the virus. Another 100k+ before there was a test, then another quarter million before travel restrictions. Tracing probably isn't the safest path.

Analogy.
You see smoke from a house. You go in and a wastebasket is on fire. What do you do? You put out the wastebasket. (SK)
You see smoke from a house. You find the house is fully engulfed and has unburned gasoline drums in various parts of the home. What do you do? You clear out the surrounding houses first, and you protect them, THEN worry about the house fire. (US)

Trying to back trace >1,000,000 cases is going to take time. More than 14 days. So that's out. Horse/barn/door thing.
We found over 30,000 new cases yesterday alone through testing. How many days will it take to back trace them to April 16, and of course all the branches that emanated?
But that's not all the cases, all indicators still point towards a 7:1 ratio or higher of non-symptomatic cases, so you are only dealing with a small fraction of the 'hot' people.

If somebody believes that tracing less than a 1/7th of the vectors is going to shut this down in a reasonable amount of time, they are kidding themselves.

So we cut off fuel for the fire (travel restrictions) and protect people not already infected (PPE+distancing) so they don't catch fire as easy, and let it burn itself out.
 
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Trying to back trace >1,000,000 cases is going to take time. More than 14 days. So that's out. Horse/barn/door thing.

You do not appear understand how TTIQ works.

You do not appear to understand that you don’t actually have to find every node of the network. Nor do you have to start “at the beginning.”

The idea is to reduce the spread. It is a means of pushing Rt downwards. Obviously you need a manageable number of cases to make it work at scale, but the returns are not diminishing - the returns become greater with time.

We found over 30,000 new cases yesterday alone through testing. How many days will it take to back trace them to April 16, and of course all the branches that emanated?

The plan is to have over 100k contact tracers nationwide. I do not know the timeline, but hiring and training is taking place.
 
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sourcing for this?

It is correct that there are likely about 9.5 million cumulative cases in the United States right now. That’s always been well understood, and antibody testing has confirmed it.

If you look at all the models, you’ll see that is also their assumption. Of course we don’t KNOW the exact number or ratio, but it’s likely not far off of 7:1. The ratio obviously depends on the amount of testing being done.

However, it is almost certainly not correct to call these cases “non-symptomatic”. Nearly all of these uncounted cases are symptomatic.
 
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It is correct that there are likely about 9.5 million cumulative cases in the United States right now. That’s always been well understood, and antibody testing has confirmed it.

If you look at all the models, you’ll see that is also their assumption. Of course we don’t KNOW the exact number or ratio, but it’s likely not far off of 7:1. The ratio obviously depends on the amount of testing being done.

However, it is almost certainly not correct to call these cases “non-symptomatic”. Nearly all of these uncounted cases are symptomatic.

yeah asymptomatic cases are anywhere from 20-43% of total cases. 7:1 seemed odd to me.
 
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Just from a brainstorming perspective:

There were over 100,000 passengers inbound on non-stop China to US flights many whom were in Wuhan, before the US was aware of the virus. Another 100k+ before there was a test, then another quarter million before travel restrictions. Tracing probably isn't the safest path.

Analogy.
You see smoke from a house. You go in and a wastebasket is on fire. What do you do? You put out the wastebasket. (SK)
You see smoke from a house. You find the house is fully engulfed and has unburned gasoline drums in various parts of the home. What do you do? You clear out the surrounding houses first, and you protect them, THEN worry about the house fire. (US)

That depends on how many resources and fire fighters are available, If there are enough, you can do both. But...

Trying to back trace >1,000,000 cases is going to take time. More than 14 days. So that's out. Horse/barn/door thing.
We found over 30,000 new cases yesterday alone through testing. How many days will it take to back trace them to April 16, and of course all the branches that emanated?
But that's not all the cases, all indicators still point towards a 7:1 ratio or higher of non-symptomatic cases, so you are only dealing with a small fraction of the 'hot' people.

If somebody believes that tracing less than a 1/7th of the vectors is going to shut this down in a reasonable amount of time, they are kidding themselves.

The "trace" in "test & trace" refers to contact tracing, not to back tracing. It's not about finding patient zero. It goes in both directions:

We currently find cases mostly by testing those who have severe symptoms. Contact tracing means you look not specifically for the person who infected that person, but also for everyone who potentially got infected by that person. So you start with those who have symptoms, and then you test everyone they have infected, which includes asymptomatic and pre-symptomatic cases, and continue with those who are positive.

So that's not just 1/7th of the vectors (or whatever the ratio is, I believe much smaller).

That's just explaining how test & trace works, not addressing any remaining disagreement there might be.

EDIT: So we would start with 30,000 cases, not 1,000,000. But that's still too many, which is why we are saying we need to mitigate with SAH as long as we are above some lower lever. (Aside from other measures.)

EDIT 2: Maybe it isn't clear that even asymptomatic and pre-symptomatic cases test positive (except in the very beginning). So you can continue with tracing those who were infected by someone asymptomatic, and then, even if those are asymptomatic as well, further continue tracing those.
 
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UCSF team has discovered drugs that block coronavirus, paving way for 'a better drug sooner'
A global team of scientists led by UCSF has discovered a range of existing drugs and experimental compounds that block the new coronavirus in lab tests, revealing some of the virus’ key weaknesses for the first time. Their findings point to possible treatments for COVID-19, according to a paper released Thursday in the journal Nature.
The other four approved drugs that showed antiviral effects in the lab tests were haloperidol, often sold as Haldol, a widely available drug to treat schizophrenia; cloperastine, a cough suppressant that has been around since the 1970s; clemastine, an antihistamine; and progesterone, a natural hormone that is also available as a medication.
 
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You do not appear understand how TTIQ works.

You do not appear to understand that you don’t actually have to find every node of the network. Nor do you have to start “at the beginning.”

The idea is to reduce the spread. It is a means of pushing Rt downwards. Obviously you need a manageable number of cases to make it work at scale, but the returns are not diminishing - the returns become greater with time.

The plan is to have over 100k contact tracers nationwide. I do not know the timeline, but hiring and training is taking place.

So, I’ve been trying to follow the developments of the San Francisco public tracing program.
The way they are going about it is:
  1. Infected person is interviewed by a tracer and asked for the identity/phone number of everyone who the patient came in close contact with.
  2. The tracer then text messages all these exposed contacts with a number to call for further follow-up to inform them of next steps. (The identity of the infected patient is never disclosed, but obviously can be deduced in certain circumstances).
  3. The exposed individuals are asked to self-quarantine for 2 weeks, and a follow-up call is made at 7 and 14 days to see whether any symptoms develop.
  4. 2nd degree of contacts (by the exposed individuals) are not contacted unless an exposed individual develops symptoms and tests positive themselves
One worker in the program said that trying to reach out and speak with exposed individuals to explain their situation can take an entire day for a single case. One tracer said they’ve had some patients with just a couple contacts to call, and some with 30 contacts to call.
 
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