Coronavirus

[renim]

For the market bulls, what do they expect the world to look like in 6 months I wonder?

Singapore is too dependant on
A) eating out
B) public transport and low car ownership.

Masks (as opposed to respirators) are not demonstrated to be effective regarding Covid19.

I predict HK will handle this better than singapore, despite the challenges due to adversarial relationship between thier people VS government.

Japan has a far far better covid19 response than singapore, so what is the difference between those 2.

 

[AlanSubie4Life]

Yes we have. There was a lot of critique because in the initial phase we included suspect deaths from nursing homes, and that was supposedly too pessimistic. But now that we have tested the entire nursing home population, it turns out that 80% of the deaths in nursing homes are confirmed infections. From those 8000 deaths, over 4000 are from nursing homes. Only 16% of those are confirmed cases, but that’s because we didn’t test those cases early on in the epidemic. With the same way to evaluate the death cause, the last 24 hour we had 80% confirmed deaths, so it is reasonable to assume that we had the same percentage when we didn’t test as much.
I think when all is said and done, Belgiums death rate will have turned out to be accurate, and other country’s death rate will have turned out too optimistic

Brings me full circle to the argument for an IFR likely closer to 1.5% which is what I suspected over a month ago, but have since relaxed off of, though it may end up being true after all...

Primary evidence in the past was South Korea 250 deaths, 10800 cases (85% recovered). They contained epidemic so probably tested most people and didn't have massive numbers of untested folks (otherwise containment not possible). Assume 30% did not get identified, so 13800. Gives an IFR of 1.8% in a generally young population. At the lowest, I can't see it going less than 1.5% (6000 missed cases).

Other evidence from the following countries with quick control (suggesting reasonably thorough identification of cases):
New Zealand: 20/1485 => 1.4% (85% recovered)
Australia: 95/6781 => 1.4% (85% recovered)
Taiwan: 6/432 => 1.4% (75% recovered)
Iceland: 10/1798 => 0.55% (95% recovered) <= outlier here...but Iceland only had 300 infections of people over age 60, and 86 over age 70 - so that skews their statistics a lot. Also 45 of their still active cases are over age 50, and 32 over age 60, so there is definitely room for their number of deaths to increase (wouldn't be surprised with 15-20 deaths with existing infections). Data (Iceland has a very excellent website with some cool data about how good their quarantining was, etc.)

Anyway, I tend to think the IFR may well be close to 1.5% when we actually count all the deaths. The machine learning model will not be able to account for any uncounted deaths (hence it is coming up with about 1% for the IFR).

So it's possible Belgium is at closer to 8000/0.015 = 530k cases (but not all the deaths have occurred yet, so assuming they go up to 9k, that would be 600k cases).

So that gives 5.5% incidence of disease (I think it's very unlikely to be lower than that right now). Still might be enough immunity to account for a small amount herd immunity help of the taper (assuming heterogeneous distribution of the immune into mostly higher risk populations resulting in more of a herd effect than you might expect), but most likely the rapid taper you are seeing is due to adequate testing...

Wish we had adequate testing here!

 

[AlanSubie4Life]

Why do you think the employees would tolerate this sort of employer-imposed isolation? How much extra do you think Tesla will pay them? Or is your notion that people will be given a choice between (I) leting Tesla impose extreme isolation on them outside of work hours or (II) losing their jobs and unemployment benefits?

As I suggested, seems to me that working should not be mandatory. Those who want to stay home and can't deal with that condition of employment can stay home with furlough for the time being with no repercussions (they are I think largely made whole by the unemployment + supplemental from feds until July) until things cool down.

But if you want to work, this isolation would be a condition of employment, for the time being.

There are probably perverse incentives or issues in what I'm suggesting, but broadly speaking, I'd like it to be set up in a way where the employees did not feel pressured to work until things are actually safe (that probably won't be until late June), but also were properly incentivized to maintain strict isolation if they did decide to work.

I definitely want it to be advantageous to the employees - after all, the whole reason for doing this is to save their lives. The whole objective is to create an actual safe environment, in a quite crappy situation. Rather than just throwing in the towel and letting people get sick.

 

[AlanSubie4Life]

how hard have people thought about what this all means?

I think it means:

1) We need more molecular POC tests

2) We need even more contact tracing, properly adapted to the unique characteristics of this virus (asymptomatic and presymptomatic transmission).

3) May be a bit of a bumpy ride for market bulls but long term (9+ months) it’ll probably be fine. No idea on this one though.

 

[deonb]

Singapore is too dependant on
A) eating out
B) public transport and low car ownership.

Masks (as opposed to respirators) are not demonstrated to be effective regarding Covid19.

The majority of what South Korea calls "masks", we would call N95 respirators. Is that maybe the case in Singapore as well?

 

[Norbert]

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.

I hope #4 is actually : "develops symptoms" _or_ "tests positive themselves". In so far as possible, the idea would be to test all relevant contacts, including asymptomatic ones.

Do you have a source link? I found articles, but none with that level of detail yet.

I like this quote:

“We can have 30,00 to 40,000 people doing this in California — half salaried, half volunteers — or we can have the economy stopped,” Rutherford said. “You make the choice.”

San Francisco's new contact tracing program could help California emerge from isolation

 

[Economite]

As I suggested, seems to me that working should not be mandatory. Those who want to stay home and can't deal with that condition of employment can stay home with furlough for the time being with no repercussions (they are I think largely made whole by the unemployment + supplemental from feds until July) until things cool down.

But if you want to work, this isolation would be a condition of employment, for the time being.

I agree with you that this would be the only humane way to reopen quickly. Which is why I think it would be silly to reopen quickly. I think you are dramatically overestimating the number of people who would accept the offer to come back to work under these terms. People will choose to stay home and make due with the unemployment benefits. They would be silly not to.

I also think you are misunderstanding what Tesla is likely to do if it reopens that factory. I suspect Tesla will use fear of termination (and loss of unemployment) or fear of other negative employment consequences to arm-twist employees to come back. I have a big problem with that. And I doubt Tesla would even try to do the kind of disease controls over the lives of 10,000 workers that you suggest.

 

[Mader Levap]

Here we are, May 1, 2020.
19,509,000 people have died so far this year.
234,000 from Covid-19.
19,275,000 from other causes.
We can go to Walmart and ride on the subway. But we cannot surf in the vast ocean or go to the state park to bird watch.
Unemployment is the highest in modern history and we are only getting started.
Stupidity reigns as never before.

Numbers are obviously obsolete, but it is to-go response for denialists downplaying problem of COVID-19 with argument "people die from other things so why it is big deal".

 

[Alfred]

There are lots of data available about actual excess mortalities.
Detailed information for Europe e.g. can be found here: https://euromomo.eu/
Differences among countries are large. Countries e.g. with a lower incidence of infections also report less excess mortality. Countries where the limits of health care services were reached show high excesses.

 

[JRP3]

Reopening states will cause 233,000 more people to die from coronavirus, according to Wharton model

According to the Penn Wharton Budget Model (PWBM), reopening states will result in an additional 233,000 deaths the total projected to die from the virus — even if states don’t reopen at all and with social distancing rules in place. This means that if the states were to reopen, 350,000 people in total would die from coronavirus by the end of June, the study found.

 

[SageBrush]

Why a coronavirus vaccine could take way longer than a year

'The mumps vaccine—considered the fastest ever approved—took four years to go from collecting viral samples to licensing a drug in 1967. Clinical trials come with three phases, and the first stages of the current COVID-19 trials aren’t due for completion until this fall, spring 2021, or much later. And there are good reasons to allow time for safety checks. Some preliminary vaccines for the related coronavirus SARS, for instance, actually enhanced the disease in model experiments.'

There are different levels of confidence for differing vaccine scenarios, but at baseline it should be considered as an open ended question with low confidence either way.

Find a historical vaccine development proceeding along the same lines as Covid-19.
Hint: It does not exist

Second, your information is incorrect or outdated.

As one example, the Cambridge vaccine is already in production and is scaling up as fast as two of the largest vaccine manufacturers can manage ... just in case the vaccine turns out to be effective. This vaccine's phase I human trial started in April and will conclude in early June. At best the phase III trial will conclude in the fall.

Second, normally there is a long patient acquisition time for vaccine trials. In the case of Covid-19 it is measured in days.

Third, the usual delays associated with bureaucracy are in abeyance.

Fourth, the usual safety protocols have been modified to take into account the harms that accrue from delay.

----
Comparing the mumps vaccine to a Covid vaccine is like comparing a basketball game to war.

 

[SageBrush]

Looks like the Abbott IgG antibody test is extremely accurate.

Delay of 3 weeks since infection is required. For a number of reasons that is not practical or desirable.

I think a better approach would be to screen with a test that is sensitive relatively soon after exposure, and then to retest the positives with a highly specific test.

 

[deonb]

Reopening states will cause 233,000 more people to die from a coronavirus, according to Wharton model

According to the Penn Wharton Budget Model (PWBM), reopening states will result in an additional 233,000 deaths the total projected to die from the virus — even if states don’t reopen at all and with social distancing rules in place.

Uhhh... My head hurts. That comment is worthy of Adley:

 

[NikolaACDC]

Pharma giant Roche gets US go-ahead for Covid-19 antibody test

"Swiss drug maker Roche Holding AG says it has received emergency use approval from the US Food and Drug Administration (FDA) for an antibody test...
...
Roche had previously pledged to make its antibody test available by early May and to boost production by June to “high double-digit millions” per month.
...its antibody test, Elecsys Anti-SARS-CoV-2, has a specificity rate of about 99.8% and sensitivity rate of 100%."

 

[bubb]

Reopening states will cause 233,000 more people to die from coronavirus, according to Wharton model

Thanks for sharing, here is the model put out by Wharton: Coronavirus Policy Response Simulator: Health and Economic Effects of State Reopenings — Penn Wharton Budget Model

 

[MXLRplus]

Reopening states will cause 233,000 more people to die from coronavirus, according to Wharton model

What makes this model for the USA more accurate than the 56% infection rate in California and 2.2 million dead in the entire US this year? Don't say lockdown, because the people who spread it the fastest never went into lockdown. That is the vector-class workers. PPE would be a valid argument if it were actually available to the general public in March and was in wide use everywhere.

 

[Doggydogworld]

I doubt we have 8-10% herd immunity. Here’s a map of infections per community: UPDATE. Bekijk het aantal coronabesmettingen in uw gemeente
Where I live, we have 2.7 confirmed infections per thousand. We ‘d need 30x unconfirmed infections to reach that herd immunity number. Our neighbour city has 8.28. The peak communities have 18 infections per thousand. Those regions may have 10% herd immunity, but most regions are like mine and probably have minimal herd immunity. Note that the high infection rate in our neighbour city is most likely caused by a giant outbreak in a nursing home (the biggest one in the region, it has it’s population decimated by Covid-19). The infection rate in the general population in that city is probably a lot less. We have systematically tested all personnel and residents in nursing homes (see section 2.2 of https://covid-19.sciensano.be/sites/default/files/Covid19/Meest recente update.pdf) and for entire Belgium, 3% of personnel (83K people) is infected. That 3% is probably representative of the entire population, and also corresponds to the outcome of antibody tests on random blood samples.
IIRC as of next week more systematic antibody testing will start, so we’ll probably know more about herd immunity levels in a week or 2.

Covid19 Projections estimates total infected of 8.6% but current infected is only 1.0%. Currently infected peaked at 3.7% in late March, consistent with the 3% found in your nursing home tests.

BTW, their current infections graph shows a sharp peak and decline in Belgium. They curve-fit (using ML-type algorithms) to death data, since you included nursing home deaths from early days your curve may be more accurate than for other countries.

 

[Daniel in SD]

Delay of 3 weeks since infection is required. For a number of reasons that is not practical or desirable.

I think a better approach would be to screen with a test that is sensitive relatively soon after exposure, and then to retest the positives with a highly specific test.

Well, yeah it's only useful for serology surveys and hypothetical "immunity passports".
This test is not cheap either, they say $100 is "at cost".
Of course PCR tests can detect infection before symptoms (causing much confusion over reports of huge majorities of asymptomatic cases).
Are there any technologies other than PCR that can detect viruses? Any possibility of a home test?

 

[iPlug]

Are there any technologies other than PCR that can detect viruses?

Antigen tests. None on the market yet. Cheap and fast. Less accurate than PCR.

How Reliable Are COVID-19 Tests? Depends Which One You Mean

 

[dhanson865]

Total deaths per week in the Netherlands from 1995 to 2020 (image)

from [OC] Total deaths per week in the Netherlands from 1995 to 2020 : dataisbeautiful (reddit comments)

note the first week and last week of the year don't have a full 7 days on average and explains the drop off at each end.