Coronavirus

[MXLRplus]

My funny car firesuit was too warm to wear for more than an hour at a time. So I got one of these off Amazon to protect me:

 

[AlanSubie4Life]

Masks

That would help, but we sadly do not have enough. Also, if it paradoxically encourages people to go out more, it might not actually reduce transmission vs. strict social distancing with no masks.

Certainly it would be nice to have them in use, for essential trips. But it is just one of various pieces of protective equipment you must use.

Used properly all that stuff of course could help - but you have to be trained to use it properly...and again, paradoxical bad behavior could mean that it makes things worse, not better.

 

[AlanSubie4Life]

Due to the German Robert Koch Institute they expect the true cases to be by a factor of 4 - 11 times higher which is a really huge number.

That seems about right - similar to Trevor Bedford estimates, something like 12k to 33k active infections in the United States. These numbers would comport well with Trevor’s estimate.

The German fatality rate did fall to 0.17%. today That down trend has been predicted from RKI before.

Remember it takes 1-2 weeks to die. I would expect that number to go up. Right now the number of cases is increasing rapidly and the early cases are only just now converting to fatalities.

Assuming the heath system is not overrun (a big assumption, but Korea managed to make it, barely), I would not expect the number to exceed about 1 to 1.5% or so, though.

Note that due to the speed of the early exponential if it's as low as 20k today, it will probably be 100k in 4-5 days

Yep. Sadly, that is something Trump just did not (and still does not) get. You’d think for a “numbers guy” he’d understand exponential growth. Guess he is not a real numbers guy. There’s no excuse for it - he has excellent information coming to him, and it was obvious how it works from Korea and China. There was so much time to get ready and suppress the growth. What a disaster. And a preventable one too.

 

[SageBrush]

Eyeballing S. Korea cases, the daily case rate is dropping by ~ 20% a day.
If I presume a 3 day incubation period then the R null is ~ 50% as a gross estimate

 

[SageBrush]

Used properly all that stuff of course could help - but you have to be trained to use it properly...and again, paradoxical bad behavior could mean that it makes things worse, not better.

FUD

 

[AlanSubie4Life]

FUD

Are you arguing it would be better for everyone to be out and about?

I said: 1) everyone should stay in unless absolutely necessary and 2) wearing masks would probably help assuming people only went out if absolutely necessary.


Masks are not the key to South Korea’s success. At this point they can pursue aggressive contact tracing without it being overwhelming, and they can quickly test people and isolate contacts (positive or not) from the population.

Would masks help, all else being equal? Sure. But I already said that.

It’s academic anyway - we don’t have enough of them.

 

[SageBrush]

Masks are not the key to South Korea’s success.

Please stop playing physician, and stop spewing FUD

 

[AlanSubie4Life]

Please stop playing physician, and stop spewing FUD

I’m not playing physician. If you could explain how you disagree with what I said, that would be helpful for dialogue.

Dr. Fauci (an actual physician) wants a full 14-day national shutdown NOW. He has told the President as much. He did not say anything about masks. I agree with his assessment.

 

[Johnny Ma]

The 100k infected in the U.S. is purely my estimate and it might be too high, but there was a two months long active suppression of testing and a disinformation campaign by the Trump administration, which created Wuhan levels of oblivion in at least half of the population.

Ohio Department of Health (ODH) says there are 100k infected in Ohio alone: Ohio Department of Health believes 100,000 Ohioans are carrying coronavirus

None of the data make sense to me. Mortality rate in Germany is currently 0.175% (which is a drop from a few days ago). Italy's at 6.8%. South Korea at 0.46% (using confirmed cases) or 0.9% (using suspected cases). In fact, in all of the countries I've been following, mortality rate seems to be holding roughly steady even though the responses of each individual country have been very different. As far as I know, Germany hasn't implemented any extreme measures like France/Italy. Why aren't they being overwhelmed?

Our lab made our own model the other day. Since we're dealing with exponential growth, the numbers change a lot depending on your assumptions. Our numbers were similar to ODH's but a bit higher...and they still don't make sense. The geographic area I live in is the epicenter of one of the outbreaks in the US. There should be thousands dying here right now, if our model is right, since our ICUs run at capacity on a good day.

If we don't start seeing major outbreaks in Shanghai* and other parts of China soon then the only conclusion that makes sense to me is that 1) the mortality rate is far lower than suspected 2) the number of recovered is enormous. In other words, the virus may have already run its course in some parts of the world and areas are starting to reach herd immunity.

I'm not in any position to make policy decisions and I fully admit my analysis could be wrong. My main concern now is what effects the policies we're implementing world-wide will have on the economy. I think we're racing past recession and now a global depression is on the table. It's to the point that we should be considering how many will die because they've become poor and unemployed and weighing it against our public health options. I know there will be a lot of poor, hungry kids in my area tomorrow, since their families have come to rely on free lunch at public schools. There will be thousands of these knock-on effects and we won't be able to consider them all.

*Shanghai did not start isolating international travelers until 2 weeks ago.

 

[AlanSubie4Life]

Ohio Department of Health (ODH) says there are 100k infected in Ohio alone: Ohio Department of Health believes 100,000 Ohioans are carrying coronavirus

This number is total nonsense and generated by someone with no idea of how statistics or sampling works. They have a biased sample!

That being said, they have a lot more cases that their current published number. People in Ohio should be concerned and self-isolating and shutting everything down NOW.

 

[kbM3]

To see the area "constant" argument is false - just look at both China and South Korea. The area under Korea's curve will certainly end up lower than it would have been if they had taken no action! This is completely separate from whether the hospitals could have handled it. Long term, NOT everyone will get it. We need to work (with the current social distancing and extreme shutdown measures) to get the infections down to an extremely low level, which can then be met with immediate strong response to prevent spread (local "strike teams" to introduce local quarantines, school shutdowns, etc), for the next 18 months or so, hoping that vaccines will become available to create herd immunity.

Watch the Joe Rogan podcast with Michael Osterholm. Very near the beginning he explains that he and many of his colleagues believe it will come back in China as soon as they relax the restrictions.

The area under the curve remaining constant is from the Johns Hopkins expert interviewed by Sam Harris in podcasts I linked earlier.

I’m not stating my opinion. I’m regurgitating what I’m hearing from experts. They may be wrong. I may have misunderstood, misinterpreted or misremembered, but I am not just giving my opinion.

Do you have any links to experts that justify your statement? I am trying to learn as much as possible. This is definitely a time to listen to the experts on the matter.

If you want my opinion, here it is:

Lengthening the curve reduces fatalities as follows:
1) Doesn’t overload facilities
2) If we can stretch it out until anti-virals arrive, that also helps. My understanding is that is months away, So if warmer weather helps, that will make a huge difference.
3) Stretch it out til vaccines. The Johns Hopkins expert predicted 12-18 months.

Right now it looks like it is infections are increasing at 15% / day according to @DaveT. We need to get below that to stretch the curve out until anti-virals arrive. We need to get way below 5% to stretch it out til vaccines arrive.

 

[Johnny Ma]

This number is total nonsense and generated by someone with no idea of how statistics or sampling works. They have a biased sample!

That being said, they have a lot more cases that their current published number. People in Ohio should be concerned and self-isolating and shutting everything down NOW.

Ok, you've convinced me.

Edit: For a more serious response, I never said ODH's numbers are correct. I certainly don't expect you to believe that mine are, either (i even said they don't make sense). But there was a lot more to my post than that. Feel free to reply to my other points...or not.

 

[Yggdrasill]

Masks are not the key to South Korea’s success. At this point they can pursue aggressive contact tracing without it being overwhelming, and they can quickly test people and isolate contacts (positive or not) from the population.

Would masks help, all else being equal? Sure. But I already said that.

Masks may be a net negative, all else being equal. Norwegian government does not recommend using masks, as they irritate and cause you to touch your face more often. (I haven't seen anyone wearing a mask yet - we'll see how it goes.)

 

[VQTRVA]

Ferrari has no problem selling cars even today. They operate in different air.

Maranello closed. This was only a matter of time.
They are Italians breathing the same air as everyone else there.
There is no magic during a pandemic for lack of staff attending to the supply chain.

Ferrari shuts down F1 and road-car factories amid coronavirus outbreak

 

[aubreymcfato]

Maranello closed. This was only a matter of time.
They are Italians breathing the same air as everyone else there.
There is no magic during a pandemic for lack of staff attending to the supply chain.

Ferrari shuts down F1 and road-car factories amid coronavirus outbreak

Maranello is in the Modena province, where tomorrow will start the 4th week of closed schools.
It's where I live, and we have been the 2nd region to shutdown after Lombardy.
I'm actually surprised they still worked.

 

[AlanSubie4Life]

Watch the Joe Rogan podcast with Michael Osterholm. Very near the beginning he explains that he and many of his colleagues believe it will come back in China as soon as they relax the restrictions.

They’re of course right. China is now sending people who come back into the country immediately into a 14-day quarantine in Beijing. Citizen or non-citizen, it does not matter.

Of course in the absence of a vaccine there would be an enormous, painful, long, low tail on the curve. And eventually the area would be the same. But that would be terribly painful to endure and catastrophic (also about 10% of the old people would still *eventually* die which is awful).

I am saying you have to assume the virus is completely eliminated (like smallpox) or a vaccine is created, which terminated that tail.

I don’t have any sources for my assertion but I can poke around. It just doesn’t make sense to me that the area would be the same - unless you count that really long tail and a painful end game. I mean, it’s apparent in South Korea that they are MUCH better off than they would have been with no action, in terms of total number of cases (area under the curve). Do they still have to be vigilant to prevent further outbreaks until a vaccine is available? Sure.

That Washington Post model from yesterday (currently on their front page) is informative and helpful, and the area under the curves there would be the same in their various situations that they model. But it’s a short timescale and they don’t assume a vaccine or the actual complete elimination of the virus. If you can get the transmission rate low enough the outbreak will just stop. Then you have to worry about reintroduction.

 

[davecolene0606]

I think its great that we are starting to get test kits out there.

I don’t know if it was mentioned earlier but I think these tests could be used in conjunction with a geotagged app that tags if you are infected or not. That way if infected then you pop up as a red dot on the app. If not infected you’re a green dot. It could be set so the color changes back to green after 2 or three weeks. That way people know who to stay away from.

If google really is partnering with the health department for drive through testing I’d imagine it would go like this.
1) register on a website for testing
2) download the app to show when you show up to be touch less and paperless to further avoid spread.
3) if positive then it transmits to app

then restaurants/ stores/ events etc can screen people using the app... if green can go in... if red go home and use a delivery service. If no app then go get tested. Others can avoid areas with lots of hits on a map. This can really slow down spread/ flatten the curve so the medical system can handle it.

Makes me wonder if that is what google might be planning? Doing a quick google search similar apps are the top apps being downloaded in Korea right now on the google store.

and what happens when you get it the following week after your first test?

Fire Away!
(It’s (STILL) the batteries, Stupid!)

 

[skivi]

Switzerland has already 3.5 times more officially cases than yesterday. I think they have also more to shut down in the near term as it is now.

 

[Matias]

If you can get the transmission rate low enough the outbreak will just stop. Then you have to worry about reintroduction.

I'm not a virologist, but I find it hard to believe, that this will ever completely disappear without a worldwide vaccination program.

My guess is, it will in the future come slightly mutated once a year, like influenza. And in that case there is no permanent eradication, just as we can't permanently eradicate influenza. But in the future seasonal epidemics will be relatively mild, because many have some kind of immunity.

 

[VQTRVA]

Maranello is in the Modena province, where tomorrow will start the 4th week of closed schools.
It's where I live, and we have been the 2nd region to shutdown after Lombardy.
I'm actually surprised they still worked.

Stay safe my friend.
My prayers are with you.