Coronavirus

[MXLRplus]

???
It is, if you start test & trace very early. See also Iceland.

Not by itself. If you allow nearly a half-million people into your country from China AFTER you know there is a problem, you end up with a different kind of dispersion. SK and Iceland are basically islands without as much international traffic from China as the US.

 

[AlanSubie4Life]

As far as testing goes, best I can tell SK tested fewer than 2% of their population. That's not enough to stop an epidemic.

It certainly could be. This statement shows a profound misunderstanding of how test/trace/isolate can work, and also of the reason we initially failed in the United States.

 

[AlanSubie4Life]

If you allow nearly a half-million people into your country from China AFTER you know there is a problem, you end up with a different kind of dispersion.

Don't forget the filthy Europeans (primary driver of our outbreak in the eastern US), and the filthy American tourists coming from Europe.

Obviously, you have to test people who are coming from at-risk countries. But the % of the population tested is decoupled from whether or not you can stop an epidemic. It all depends on timing and prevalence.

 

[Norbert]

Not by itself. If you allow nearly a half-million people into your country from China AFTER you know there is a problem, you end up with a different kind of dispersion. SK and Iceland are basically islands without as much international traffic from China as the US.

Of course not by itself, not even in those countries. However that's one of the crucial components. For example, SK was outspoken about their use of masks, and Iceland about their diligent efforts to isolate lots of contacts, suspects and being careful with incoming travel.

 

[TheTalkingMule]

It certainly could be. This statement shows a profound misunderstanding of how test/trace/isolate can work, and also of the reason we initially failed in the United States.

The idea of SK testing not being enough so perfectly encapsulates the US mentality that more is better. Not testing and tracing properly, just MORE. If we ratchet up the lockdown even more, that's ALWAYS going to be better.

Nonsense. Korea tested precisely as much as they needed to and will continue their test/trace/isolate plan as long as is necessary. That's how it's done.

 

[AlanSubie4Life]

If we ratchet up the lockdown even more, that's ALWAYS going to be better.

The reason the lockdown has to persist in many places, for now, is that we did not start the lockdown soon enough. The sooner you start population-level intervention (i.e. "lockdowns"), the sooner you can transition to case-based interventions (assuming you are prepared to do so).

Population-level interventions and tuning of those interventions have to be calibrated to the local situation, based on actual public health data, in all cases. Otherwise you'll just have to go back to population-level intervention in a vicious, nearly unending cycle, and you never get to apply the basically completely non-disruptive case-based intervention regime.

In reality it is a blend, where you can conduct case-based intervention while population-based intervention is ongoing. And you can ramp up case-based intervention capacity to "meet in the middle" as the case curve arcs downward. But there's definitely some limit beyond which case-based intervention just can't practically keep up with the exponential contact network.

 

[Daniel in SD]

As far as testing goes, best I can tell SK tested fewer than 2% of their population. That's not enough to stop an epidemic.

It is if you test the right people. Testing random people for COVID-19 is a waste of time and resources.
Average positive test percentage seems to be the best predictor of whether or not a country stops an epidemic. Test and trace, it really shouldn't be a mystery anymore.
South Korea 1.7% positive rate
Australia 1.1% postive rate

 

[NikolaACDC]

Going to look ridiculous that we closed schools so early.

https://www.nypost.com/2020/04/30/no-evidence-of-kids-passing-coronavirus-to-adults-studies-show/amp/

https://zoonosen.charite.de/fileadm...s-of-SARS-CoV-2-viral-load-by-patient-age.pdf

Study from Germany, not peer reviewed.

"Analysis of variance of viral loads in patients of different age categories found no significant difference between any pair of age categories including children. In particular, these data indicate that viral loads in the very young do not differ significantly from those of adults. Based on these results, we have to caution against an unlimited re-opening of schools and kindergartens in the present situation. Children may be as infectious as adults."

Caveats:
- low sample size. Few children present with symptoms, and mostly only people with symptoms get tested.
- even if kids have similar viral loads to adults they probably will not spread as much because again they have fewer to no symptoms. Less sneezing/coughing.

 

[TespaceX]

It is if you test the right people. Testing random people for COVID-19 is a waste of time and resources.
Average positive test percentage seems to be the best predictor of whether or not a country stops an epidemic. Test and trace, it really shouldn't be a mystery anymore.
South Korea 1.7% positive rate
Australia 1.1% postive rate

I agree with what you said. But, conducting a tracing program the SK way in the US is a pipe dream. From what I read on FB, ND, Reddit, etc, too many people in the US, even in liberal states like CA, concerned about privacy won’t even voluntarily participate in the Google/Apple feature. And that API (by itself) is a heavily diluted form of tracing that SK has.

 

[jerry33]

A very close look here at the most common clinical features and co-morbidities. This is from a new, large study and has some surprises (obesity bad, smoking not so much).
Robin

Even the virus can't stand to be around a smoker.

 

[lascavarian]

Did he, or is he just saying, jokingly, that she's mad at him for selling all the homes when she's about to give birth?

Maybe it is a joke. I am looking for any sort of basis for his actions. Emotional outbursts during official corporate business I tend to view as evidence of unfitness. I have seen management that could hardly string 2 words together in private without one of them being a cuss word but that changes before the public. I don't perceive EM as being one given to strong cussery generally. So .... not sure what to make of it. Thanks for your comment.

 

[uujjj]

We all know Elon Musk is both brilliant and crazy. This guy head butted a car on the production line the last time he had a meltdown (2018). I'm not surprised that a month of isolation is bringing out the crazy.

Musk suggested that the California stay-home orders (which are similar to those in 42 states) are "fascism" and "house arrest", and that people are being arrested for leaving their homes. Obviously, all of us here in California who can look outside our windows know that's not true. (Does Elon's house not have windows?) There's lots of people walking around. Parks, trails, and beaches are mostly open. Restaurants are open for takeout. Many stores are open, though some only allow curbside pickup. Construction is running. About 70% of the economy is still running. Nobody is getting jailed for leaving their homes. It's far from normal, but Elon's description of a Wuhan-style lockdown is not at all the reality, as he should be able to see outside his own window!

 

[omgwtfbyobbq]

Agreed. What I find strange is the "outbreaks" count in the weekly report. I do feel like the health department could give us a much more detailed view of what is happening in San Diego. It might even help people understand what to avoid, if they understand the nature of the outbreak.

What does this "outbreaks" number mean, exactly? Any epidemiologists here? How many of the cases are due to just these outbreaks, and how much is background community transmission? If the vast majority of cases are isolated to outbreaks, we might not be THAT far from being able to execute on case-based suppression techniques with TTI/Q.

That's the other thing about these state numbers that can be misleading. It's a lot different to have 1000 community transmission cases than it is to have 1000 cases all focused in one facility. You're a lot closer to containment when you have a single outbreak of 1000 cases than you are with 1000 diffuse cases of unknown origin.

I've not seen this really broken out (in detail) anywhere in any state's data presentation.

View attachment 537799

https://www.sandiegocounty.gov/content/dam/sdc/hhsa/programs/phs/Epidemiology/COVID-19 Watch.pdf

I think outbreaks are just groups/clusters of infections. Roughly half of them are in group homes of some sort, which makes sense.

 

[SageBrush]

China's SinoVac is in phase II human trials of its vaccine. This is the only company I know of that has chosen to to develop killed/attenuated wild type virus as a vaccine rather than boutique engineering. My guess is that they will end up with a vaccine that is not quite as effective as the others and it will cause some Covid itself but it will be one of the first, if not the first vaccine available and they will scale quickly.

I've thought for months that this is the right approach so I'm glad to see a serious effort underway and making good progress.

 

[SageBrush]

About 70% of the economy is still running

Thanks for the informative post. Where does that 70% number come from ?

 

[Papafox]

Haha, it's happening!

More U.S. Carriers Mandate Passengers Wear Face Masks In The Cabin

Executives at American, Delta, and Frontier just blinked. They're sitting there thinking, "Those SOBs at JetBlue just enacted an everyone wears a mask in the cabin rule that we were afraid to enact, and now they're potentially going to be stealing our passengers while simultaneously making us look bad!" So, the result is that three more U.S. airlines just decided upon an everyone wears masks in the cabin policy. The thing is that such policies make flying safer and will lead to a quicker return of business. It just took one airline to get the ball rolling. Thank you JetBlue!

Edit: I see that United just joined the movement. That was inevitable, as inevitable of trying to retain a smoking section while everyone else goes smoke free.

 

[uujjj]

Thanks for the informative post. Where does that 70% number come from ?

Same place my poop comes from.

Actually it's a guess from adding the ~30% of workers that are essential to the ~40% that can work from home.

 

[SageBrush]

Of course not by itself, not even in those countries. However that's one of the crucial components. For example, SK was outspoken about their use of masks, and Iceland about their diligent efforts to isolate lots of contacts, suspects and being careful with incoming travel.

You are right that multiple ingredients make up a good recipe but the daily new cases per million starting point is central to tailoring a recipe to be successful. The USA has way too high a daily case load to implement any of the Asian strategies successfully today. It needs to reduce the daily load by more effective measures that reduce infectivity, and perhaps targeted measures if it turns out that the case load is concentrated.

 

[SageBrush]

Actually it's a guess from adding the ~30% of workers that are essential to the ~40% that can work from home.

WAG for sure, but it sounds reasonable

 

[TheTalkingMule]

The reason the lockdown has to persist in many places, for now, is that we did not start the lockdown soon enough. The sooner you start population-level intervention (i.e. "lockdowns"), the sooner you can transition to case-based interventions (assuming you are prepared to do so).

Population-level interventions and tuning of those interventions have to be calibrated to the local situation, based on actual public health data, in all cases. Otherwise you'll just have to go back to population-level intervention in a vicious, nearly unending cycle, and you never get to apply the basically completely non-disruptive case-based intervention regime.

In reality it is a blend, where you can conduct case-based intervention while population-based intervention is ongoing. And you can ramp up case-based intervention capacity to "meet in the middle" as the case curve arcs downward. But there's definitely some limit beyond which case-based intervention just can't practically keep up with the exponential contact network.

I see no plans to do widespread case-based intervention anywhere except maybe this talk in Maryland. Essentially our plan is to "wait it out" or what was termed at the onset "flatten the curve". Basically nothing.

That's likely what has Elon and others a bit peeved. This lockdown is not part of a plan to move into case-based tracing, so there's really no point to it if in fact the curve has been flattened and/or it looks like we have hospital capacity.

We're not tracing anyone, not that I can see anyway. Certainly nothing like that is happening or planned in PA.