Coronavirus

[SageBrush]

Correct. That's why masks, distancing, and good hygiene are essential.

Amen to that.

This pre-print
https://www.preprints.org/manuscript/202004.0203/v1/download

has this interesting map relating mask use and mask quality to Rt. It works out to 80% compliance with surgical masks to reach an Rt of 1.0

 

[PeterJA]

Yes Elon questioned the experts in Epidemiology when he stated that the United States would be at zero new infections two weeks ago.

Actually Elon didn't state that. As I recall, he said "If current trends continue..." He usually qualifies his estimates like that.

And uninformed opinions may sometimes prove to be correct.

And informed opinions can prove to be wrong. You assume Elon's opinion was uninformed. What's your evidence for that? That he was wrong?

But how laughably wrong was that opinion?

So were many others. As I recall, opinions from experts were all over the map. Some predicted millions of deaths by now.

The larger question is what evidence led Elon to make that statement. What logic, what modeling, what evidence led him to make that statement?

Excellent questions. Why are you chastising him if you don't know the answers?

Has Elon ditched whatever spectacularly uninformed decision process led him to downplay the seriousness of an epidemic while we are in its midst?

Elon constantly tries to improve his decision-making process. Do you have evidence that he hasn't here?

Has Elon learned from how atrociously wrong he was when he exercised his “right” to question experts by predicting we would be nearing zero new U.S. infections two weeks ago?

Do you mean wrong in his estimate or wrong to question experts? I'd guess: Yes. No.

Did you immediately believe him when he stated it? If so, have you questioned why you think Elon’s “right” to question Epidemiologists might led him to be just a tad less accurate in his prediction, than they have been?

I believed he might be right because he often is, although he is sometimes wrong.

Do you now understand why we might be just a little better off listening to the experts in the field rather than someone exercising their “right” to question Science? Even someone as brilliant in many other fields which he has studied, as Elon?

Again, which experts? When experts disagree, and the data used for modeling is noisy, it's hard to know which experts to trust. It's not fair to cherry-pick one model after the fact and say: "See? The experts were right."

 

[feigen66]

This topic is extremely pertinent to Tesla investing (before the mods ban it).

during the conference call, it was stated that Tesla has modeled several different scenarios, and believe they are financially equipped to handle all of them. I would like to believe, that they have modeled a realistic worst case scenario, where we do enter a multi year depression, have trouble stopping coronavirus, and there is a big worldwide drop in demand of automobiles of all types. In such a scenario, it could very well be wise for Tesla to slow down growth a little and conserve cash. If Elon is in the room shooting down worst case scenarios, it has a direct bearing, on all of out investments. We need Elon to have the best possible handle on the real world.

Nobody questions whether science can be questioned. This is how it advances. But when Einstein questioned Newton’s theory of gravity, he did it through having better data, solving discrepancies, putting tons of thought into it, providing a cohesive theory that explained all the facts... It’s not like he was some biologist who hazarded an opinion that Newton was wrong. The Equivalent of what Elon is doing.

1) Elon was wrong in predicting zero new U.S. cases as of two weeks ago.

2) Elon was wrong linking to the Bakersfield doctor’s reports that had the following glaring errors:
A) The population tested was not representative of the population as a whole. I.e., they were obviously more disposed to test positive because they were showing up at the clinic.
B) Infection testing does not include those recovered. I.e., serology studies with very low false positive rates are required, not infection testing.
C) Deaths lag infections by up to 4 weeks or more, so using the death rate at the time is erroneous.

The whole study and conclusion was so erroneous, Google removed the video.

3) On Joe Rogan, Elon stated that the infection fatality rate was between a factor of 10 to a factor of 100 less than epidemiologists are stating. Let’s take a conservative viewpoint of a factor of 25. Epidemiologists believe a midpoint IFR of 0.75% is reasonable. So Elon’s claiming a fatality rate of 0.03% (which is much less worrisome than flu), which leads to the conclusion that over 600% of the population of NYC has been infected.

So keeping track the score is:
Epidemiologists = 3
Elon = 0

Of course the most troubling aspect, is that Elon seems to be getting his information from conservative sources of disinformation, and falling for conspiracy theories. The EXACT same thinking that leads many to question Climate Change thinking heir opinion is just as valid a Climatologists, Oceanagraphic and Atmospheric Scientists!

I am not sure where you get 0.75% iCFR from. That's not how iCFR being computed. Current trend is 0.25% ~ 0.3% according to JHU-CSEE data. Anyway, you don't need to take my word for it but I do work in the field with one of credentials you mentioned. Maybe you could trust "expert"?

There are a lot of "Epidemiologists" hired by the media but they are not really working in infectious disease. Have you heard to "nutrition epidemiology". It has nothing to do with current virus but they still gave questionable opinions on MSM and people buy them.

In my view, it's hard to justify the Great Depression damage both economically and socially for a virus with iCFR rate with 0.25% ~ 0.3%.

Elon did not downplay the risk the disease in JRE. You took the words out of context. Subsequently, from the quote you left out, he immediate told Joe Rogan that giving time there will be a much more deadly disease that we need to prepare.

Currently solution is not really viable. There are several emerging viruses that have iCFR > 10% transmittable through air. If a virus with iCFR < 1% can push us back to Great Depression, I cannot imagine a virus with iCFR of 10%. That will kick us back to stone age.

Also iCFR is not constant. Naturally it will reduce is lethality while increasing R-0. This is what COVID-19 does comparing with its predecessor SARS.

Currently the data in US has been manipulated. If you really want to look at good data, then German or Nordic countries has been doing a pretty good job.

 

[Norbert]

I should have clarified that the growing evidence is about unexplained deaths. Where we're seeing more, and more reports of unexplained deaths. I would expected the lack of traffic accidents to reduce the number of deaths. So why are there so many unexplained deaths?

https://www.bloomberg.com/news/articles/2020-05-11/new-york-city-had-24-172-excess-deaths-as-outbreak-accelerated

Now maybe there is an easy explanation like they could be Covid-19 deaths where they simply decided against going to the doctor, and then they died. They weren't tested so they don't officially fall under Covid-19 deaths.

The Mystery of ‘Excess Fatality’

Thanks for the references.

This seems to be a very different situation. These numbers, such as 5,293 excess deaths, are deaths that are recognized and counted, just not categorized as COVID-19. They are commonly considered an indication of under counting (not over counting). We have discussed them on this thread, but didn't have an update since the number was about 4,000.

Just one reason is that (according to what I have read) death certificates often take months to get filled out and then processed.

The growing fear is that people are dying not from Covid-19, but from other things.

First of all, growing fear is not growing evidence. It is quite possible that some of them may have died from other reasons. However, there does not appear to be any other cause for an increase in death, except that some may have not received (or avoided) proper care. It is well known that many who have symptoms don't get tested if the symptoms are not severe at that point in time, and that many more are positive than get tested. Then, in New York City, avoiding care is not just out of fear, but also out of real danger and other actual reasons that are a valid indirect result of a high level of infection as in NYC. When there is a real danger, fear is inevitable (almost). It is still a consequence of COVID-19. But most likely, many of those deaths are plain non-attribution for lack of testing.

So I think this evidence is evidence of under-counting.

 

[Norbert]

Castle Rock restaurant reopens in defiance of statewide public health order

View attachment 540783

Yes... they are doing something...

( Kid in the center is covering his face to not be seen... Wait! Don't touch your face!... )

If that doesn't look like a super-spreading event, then I wonder what they look like. Or maybe they are media hoaxes?

 

[Norbert]

Amen to that.

This pre-print
https://www.preprints.org/manuscript/202004.0203/v1/download

has this interesting map relating mask use and mask quality to Rt. It works out to 80% compliance with surgical masks to reach an Rt of 1.0

View attachment 540844

That's a cool graph. Here is a a link to the same manuscript that doesn't require downloading: Face Masks Against COVID-19: An Evidence Review

 

[kbM3]

Actually Elon didn't state that. As I recall, he said "If current trends continue..." He usually qualifies his estimates like that.


And informed opinions can prove to be wrong. You assume Elon's opinion was uninformed. What's your evidence for that? That he was wrong?


So were many others. As I recall, opinions from experts were all over the map. Some predicted millions of deaths by now.


Excellent questions. Why are you chastising him if you don't know the answers?


Elon constantly tries to improve his decision-making process. Do you have evidence that he hasn't here?


Do you mean wrong in his estimate or wrong to question experts? I'd guess: Yes. No.


I believed he might be right because he often is, although he is sometimes wrong.


Again, which experts? When experts disagree, and the data used for modeling is noisy, it's hard to know which experts to trust. It's not fair to cherry-pick one model after the fact and say: "See? The experts were right."

Really? No experts were as wrong as Elon. Rather than new infections decreasing to near zero, they increased greatly since that time of the tweet. He was so incredibly far off, it was laughable. If you have any prediction from CIDRAP, WHO, CDC, NIH... that were that far off, then please post.

 

[AlanSubie4Life]

Thanks for the references.

This seems to be a very different situation. These numbers, such as 5,293 excess deaths, are deaths that are recognized and counted, just not categorized as COVID-19. They are commonly considered an indication of under counting (not over counting). We have discussed them on this thread, but didn't have an update since the number was about 4,000.

Just one reason is that (according to what I have read) death certificates often take months to get filled out and then processed.



First of all, growing fear is not growing evidence. It is quite possible that some of them may have died from other reasons. However, there does not appear to be any other cause for an increase in death, except that some may have not received (or avoided) proper care. It is well known that many who have symptoms don't get tested if the symptoms are not severe at that point in time, and that many more are positive than get tested. Then, in New York City, avoiding care is not just out of fear, but also out of real danger and other actual reasons that are a valid indirect result of a high level of infection as in NYC. When there is a real danger, fear is inevitable (almost). It is still a consequence of COVID-19. But most likely, many of those deaths are plain non-attribution for lack of testing.

So I think this evidence is evidence of under-counting.

NYC has done a study in New York using NYC's DOHMH near real-time death reporting system. It's going to come down to drilling down on the causes behind these ~5k excess deaths to figure out the amount of undercount:

"During March 11–May 2, 2020, a total of 32,107 deaths were reported to DOHMH; of these deaths, 24,172 (95% confidence interval = 22,980–25,364) were found to be in excess of the seasonal expected baseline. Included in the 24,172 deaths were 13,831 (57%) laboratory-confirmed COVID-19–associated deaths and 5,048 (21%) probable COVID-19–associated deaths, leaving 5,293 (22%) excess deaths that were not identified as either laboratory-confirmed or probable COVID-19–associated deaths (Figure)."

Preliminary Estimate of Excess Mortality During the COVID-19 ...

 

[azaz]

Of course the most troubling aspect, is that Elon seems to be getting his information from conservative sources of disinformation, and falling for conspiracy theories. The EXACT same thinking that leads many to question Climate Change thinking heir opinion is just as valid a Climatologists, Oceanagraphic and Atmospheric Scientists!

Climate deniers are the best analogy for the disinformation campaign Elon has fallen for

 

[Norbert]

NYC has done a study in New York using NYC's DOHMH near real-time death reporting system. It's going to come down to drilling down on the causes behind these ~5k excess deaths to figure out the amount of undercount:

Sure, but what additional reasons might you expect? Fear, lack of information? To some percentage, but how would you be able to avoid those in a situation like New York City, where about 1 in 420 people (population, not just infected) died of COVID-19, without counting excess deaths? Even if some percentage of them didn't die directly, medically, of COVID-19, are they not still likely to be an indirect consequence, so to speak?

Perhaps more experience in dealing with this or coming epidemics will allows us to handle it better in some cases, but even that wouldn't mean that part is not a valid part of the COVID-19 statistic.

 

[Daniel in SD]

NYC has done a study in New York using NYC's DOHMH near real-time death reporting system. It's going to come down to drilling down on the causes behind these ~5k excess deaths to figure out the amount of undercount:

"During March 11–May 2, 2020, a total of 32,107 deaths were reported to DOHMH; of these deaths, 24,172 (95% confidence interval = 22,980–25,364) were found to be in excess of the seasonal expected baseline. Included in the 24,172 deaths were 13,831 (57%) laboratory-confirmed COVID-19–associated deaths and 5,048 (21%) probable COVID-19–associated deaths, leaving 5,293 (22%) excess deaths that were not identified as either laboratory-confirmed or probable COVID-19–associated deaths (Figure)."
View attachment 540855

Preliminary Estimate of Excess Mortality During the COVID-19 ...

What's especially sad is that NYC had additional emergency hospital capcity. I wonder if this is a result of "silent hypoxia" and could partly explain why hospitalizations were so much lower than expected. It seems likely that the number of additional people who should have been hospitalized far exceeded the number of excess deaths.

 

[PeterJA]

Really? No experts were as wrong as Elon. Rather than new infections decreasing to near zero, they increased greatly since that time of the tweet. He was so incredibly far off, it was laughable. If you have any prediction from CIDRAP, WHO, CDC, NIH... that were that far off, then please post.

Well I can't find the article that I vaguely remember. I think it quoted a famous British scientist with a prediction of millions of deaths, which was indeed "as wrong as Elon."

But a quick search now supports my claim that expert opinions were all over the map. So when you say Elon should've trusted the experts, which ones?

After researchers at Imperial College reported on March 17 that the impact of a go-slow response to the virus in the U.K. and the U.S. would be devastating, Johnson changed course. And Donald Trump stopped comparing the virus to the winter flu. A week later, a team from Oxford University, led by Sunetra Gupta, a professor of theoretical epidemiology, and Jose Lourenco, made a splash with the publication of a dramatically different model of the disease’s prevalence....
Bloomberg - Are you a robot?

The near doubling of coronavirus death predictions in a closely followed model this week underscores a frustrating reality for officials weighing how and when to reopen society: Many basic facts about the new coronavirus remain unknown....
The Tricky Math Behind Coronavirus Death Predictions​

 

[AlanSubie4Life]

Sure, but what additional reasons might you expect? Fear, lack of information? To some percentage, but how would you be able to avoid those in a situation like New York City, where about 1 in 420 people (population, not just infected) died of COVID-19, without counting excess deaths? Even if some percentage of them didn't die directly, medically, of COVID-19, are they not still likely to be an indirect consequence, so to speak?

Sure. I expect most are COVID-19 related. But a certain % are people who died of heart attacks, etc, but may not have died under normal circumstances.

Furthermore, this analysis does not subtract the reduced deaths due to fewer workplace accidents, traffic accidents, etc. That's been discussed here before.

On balance, I'm guessing that this number will end up being about the real number of additional COVID-19 deaths (after subtracting the heart attack deaths "caused" by lack of access to care, and adding the deaths which are making up for reduced other causes of mortality).

Anyway, at some point there will be an analysis. But it seems extremely safe to say we are undercounting COVID-19 deaths by a lot! That's completely normal, and happens with all infectious diseases as far as I can tell.

Unrelated, I'm beginning to worry about those serology tests in NYC. Why don't they just do a proper analysis and tell us the prevalence? I'm beginning to think it may be less than 20% in reality! Even at 20%, that would be bad! We'd be looking at an IFR of about 1.9% (32k/(0.2*8.4e6) = 1.9%! And we still have something like 1500 people in ICU beds in NYC, don't we (I can't find the exact numbers, as usual)?

It's all very grim.

 

[azaz]

Andrew Cuomo on Twitter

I love how Cuomo is presenting this stuff. Being transparent, clear and detailed is a good way to center the debate

 

[Norbert]

Well I can't find the article that I vaguely remember. I think it quoted a famous British scientist with a prediction of millions of deaths, which was indeed "as wrong as Elon."

As far as I know, "millions of deaths" was a worst-case scenario for no mitigation, coming from the same expert who predicted 100K-200K deaths in case of mitigation, and it does look like the US will go above 100K even with mitigation.

 

[PeterJA]

As far as I know, "millions of deaths" was a worst-case scenario for no mitigation, coming from the same expert who predicted 100K-200K deaths in case of mitigation, and it does look like the US will go above 100K even with mitigation.

That's not what I recall, but I can't find the article so can't confirm my recollection. I could be wrong.

 

[Norbert]

That's not what I recall, but I can't find the article so can't confirm my recollection. I could be wrong.

Please do look for those references.

 

[SageBrush]

Andrew Cuomo on Twitter

View attachment 540866

I love how Cuomo is presenting this stuff. Being transparent, clear and detailed is a good way to center the debate

Yep.

I wish them luck with reopening but they are starting from an unenviable position of a lot of daily admissions. The NYS criteria of less than 2 new daily admissions per 100k population strikes me as a number based on hospital capacity rather than one based on likelihood of constraining R(t) to < 1.0. It certainly is already much higher than we have in my state of NM* and we are still under SAH orders due to an R(t) > 1.0 despite extensive testing and an early (for the USA) response.

* Recent net increase of 4 per day per 2M population. I cannot tease out admissions - discharges

 

[Norbert]

Sure. I expect most are COVID-19 related. But a certain % are people who died of heart attacks, etc, but may not have died under normal circumstances.

Yes, and some % of those % may be of a kind that could be considered "collateral damage" of COVID-19, so to speak, an indirect consequence.

Furthermore, this analysis does not subtract the reduced deaths due to fewer workplace accidents, traffic accidents, etc. That's been discussed here before.

On balance, I'm guessing that this number will end up being about the real number of additional COVID-19 deaths (after subtracting the heart attack deaths "caused" by lack of access to care, and adding the deaths which are making up for reduced other causes of mortality).

Anyway, at some point there will be an analysis. But it seems extremely safe to say we are undercounting COVID-19 deaths by a lot! That's completely normal, and happens with all infectious diseases as far as I can tell.

Yep, I think so as well.

Unrelated, I'm beginning to worry about those serology tests in NYC. Why don't they just do a proper analysis and tell us the prevalence? I'm beginning to think it may be less than 20% in reality! Even at 20%, that would be bad! We'd be looking at an IFR of about 1.9% (32k/(0.2*8.4e6) = 1.9%! And we still have something like 1500 people in ICU beds in NYC, don't we (I can't find the exact numbers, as usual)?

It's all very grim.

Yes, I was hoping for an update on the serology tests today (because it is Monday). (EDIT: or ~25K = ~1.5% IFR)

 

[PeterJA]

Please do look for those references.

I don't think it matters, since my point remains that no single expert-consensus existed at the time of Elon's qualified prediction ("If current trends continue..."). But the gist of the article I read was that humanity is screwed no matter what we do, and the expert quoted was somebody famous, like "the father of epidemiology" or something like that. This was early in the days of toilet-paper-rioting panic.