Coronavirus

[MXLRplus]

States with the most testing (tests per million pop, Worldometer 4 MAY 20):

Rhode Island 70,164
New York 51,345
Massachusetts 47,476
North Dakota 46,203
Utah 40,935
Louisiana 38,796
New Mexico 37,266
District Of Columbia 34,763
Tennessee 31,791
New Jersey 31,063
West Virginia 29,564
Alaska 29,414
Connecticut 29,409
Vermont 27,732
Mississippi 26,659
Washington 26,593
Illinois 25,983
Delaware 25,392
Michigan 23,016
New Hampshire 22,950
Maryland 22,819
Hawaii 22,807
USA 22,414
Florida 21,652
Alabama 21,197
South Dakota 20,932
Nevada 19,595
Pennsylvania 19,200
California 19,103
Arkansas 18,204
Oklahoma 17,960
Georgia 17,772
Nebraska 17,755
Idaho 17,381
Indiana 17,069
Wyoming 15,994
Minnesota 15,548
Maine 15,487
Wisconsin 15,351
Oregon 15,202
Missouri 14,956
Colorado 14,708
Texas 14,610
Virginia 14,594
Montana 14,484
North Carolina 14,419
South Carolina 13,675
Kentucky 13,523
Ohio 13,253
Arizona 12,272
Kansas 11,357

 

[SMAlset]

Isn’t it health department policy for communicable diseases to have tracing if possible? Curious what diseases are on the list for that.

Maybe Jack doesn’t want to know if he infected anyone? Contact tracing where possible at least alerts asymptomatic carriers they have it and can get them to quarantine before spreading it to even more so i don’t get his reasoning or lack of it. Jack, having watched some of his videos looks like he could have a number of conditions to put him at higher risk so glad he’s at least wearing masks and feels the need for them.

I have to wonder if people who are refusing to wear masks to help reduce the spread just think it will happen to others not them. Sure this wouldn’t go over for privacy reasons, but wonder if for example grocery stores and other such places posted the photos of workers/individuals who tested positive (and mentioned those that died) on their doors and windows if those maskless people would take it more seriously and realize the cost to others. You know putting a face to the people that they might have come into contact with, making it more personable. As I said doubt it would happen but I have seen news stories of people who were shocked to get sick and hospitalized and then had words of caution for others about how bad it could be and to use care. I get some people are combative by nature and nothing will change their mind and forget caring about anyone else. Making this political is just wrong IMO.

Hey, BTW today with the initial lifting on some business in Santa Clara County, we have an electrician outside our house upgrading our main panel for subsequent Solar and PWs. Spoke with Tesla Energy today to update them we’ll be ready for their team by next week (assuming inspection approval next Monday) and they said they can’t say for sure but hope to be able to be out here and complete their installation work by end of May. That would be sweet. Feels good.

 

[AlanSubie4Life]

I increasingly think it's a futile exercise to try to chase down a single value because it's always going to depend on the expression of risk factors and the age in your cohort.

Which people will then use to claim the IFR is actually closer to 0.2% in "normal" populations.

 

[Norbert]

you can plot it in real time, but the last 7-14 days or so may have missing data (but that is missing from both graphs)!

This part is what I am talking about. In the "by onset" graph, the days which have incomplete data will most often look like there is a strong downward trend, even if there is an upward trend. This is usually 3-5 days, but in case of the Idaho graph, it seems to be as much as 14 days. (Which isn't directly visible anymore, since they are mostly in the past.)

 

[kbM3]

Cuomo has been quite upfront and transparent in his updates but he continues to only talk about part of the scope of the problem. It goes like this:

NYS has ~ 1000 new Covid hospitalizations a day. That works out to ~ 200 deaths a day, and using a 1% IFR it implies ~ 20,000 new infections a day. If contract tracing leads to e.g. 50 contacts per infection then the plan is to apply 14 day quarantines on 1M people a day.
SAH has failed in NYS, and barring other successful measures this test,trace and quarantine strategy just amounts to another somewhat worse SAH outcome.

NYS is not opening today, nor is it all opening at once. They will gradually and slowly reopen in the least hard hit regions first.

 

[Norbert]

You can say that there is a 97.5% chance of a sensitivity of no less than 95.1% (presuming that the 5% uncertainty is evenly spread on each side of your interval.)

If the upper bound of the confidence interval is 100%, there is 0% uncertainty on the upper side. That's one reason why the question arises if I can make such a presumption, in this case or even otherwise.

 

[RobStark]

It looks like the US will end up with a death per capita right around were the Dutch will end up.

Excluding micronations and excluding reported deaths in some developing countries exploding that would put us 7th or 8th after ........

Sweden
Belgium
Spain
Italy
France
UK

 

[Norbert]

My extensive studies show 98.3% [0%, 99.9%] of people misinterpret date of onset and date of death graphs. These graphs always show a dramatic reduction for the most recent days (or weeks) due to reporting lags. I can't tell you how many times I've corrected people who claimed "numbers have peaked and are declining" based on these graphs. And a very high percentage of otherwise intelligent people stick to their claim even after I explain it. They accuse me of committing various crimes against data. One very sharp guy made the same claim multiple times, even as weeks went by and his "peaks" kept getting higher and higher. He's finally starting to get it -- "it seems like today's new death reports are somehow being applied to earlier days", lol. This after I explained it several times, most recently in 3rd grader terms.

Visual info is extremely powerful, especially when it confirms a bias.

Exactly. No joke. In the context of fast moving COVID-19, these "recent days are incomplete" graphs are sometimes kind of dangerous. Even the NYC website that I often link has them. I'm afraid they contribute to the sweet talking interpretations, and the current exaggerated optimism/wishful thinking that this wave is almost over.

 

[Red Leader]

Agreed. But the tragic problem is 42% of adults and 18% of children in the US are obese.
Obesity is a Common, Serious, and Costly Disease
Childhood Obesity Facts | Overweight & Obesity | CDC

And nearly 70% of American adults age 40–79 are on prescription drugs, most of which may increase vulnerability because they increase ACE2 receptors in the lungs that provide entry to the virus.
Products - Data Briefs - Number 347 - August 2019
ACE inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19, paper suggests

That was an early worry that ACEI and ARBs would up regulate the ACE2 receptor but there is little clinical data to support that thesis. It is more likely that hypertension is a marker for other risk factors. Don't stop taking your Rx and don't drink bleach (same advice that Gramma would give).

 

[uujjj]

CV2 incubates far longer and transmits far easier than Swine Flu therefore it's very likely to be "less deadly", but it's novel so it'll kill a LOT of at-risk people if we're not careful. We're not being even remotely careful, so an unnecessarily high number of at-risk people are dying. With proper distancing/testing/tracing/isolation, we could have cut this eventual US death count in half with little to no nationwide shutdown.

It is true that COVID incubates longer and transmits easier than H1N1. In general, a virus with a longer incubation period and easier transmission is less deadly than a similar one with a quicker incubation and harder transmission. But this is not a hard and fast rule that can be applied to unrelated viruses. COVID is closely related to SARS, and compared to SARS, COVID is easier to transmit and less deadly, as expected.

How can you claim "we're not being even remotely careful" when the whole country is shut down? That makes no sense.

It is absolutely true that with proper distancing/testing/tracing/isolation, we could have cut the eventual US death count by orders of magnitude, without a shutdown. But that ship sailed in mid February.

 

[AlanSubie4Life]

Isn’t it health department policy for communicable diseases to have tracing if possible?

Yes, California has about 3000 contact tracers in place (currently, and I think normally). 23/61 departments (58 counties plus 3 cities in LA area) are currently actively contact tracing SARS-CoV-2 in California. (This will become all departments presumably.)

Historically they have tracked STDs, HIV, measles, TB, etc.

 

[dfwatt]

That was an early worry that ACEI and ARBs would up regulate the ACE2 receptor but there is little clinical data to support that thesis. It is more likely that hypertension is a marker for other risk factors. Don't stop taking your Rx and don't drink bleach (same advice that Gramma would give).

They do up regulate the receptor possibly giving more points of entry but it appears to be a wash in terms of actual impact according to the latest review on this. This may be because this class of medicines also has a modest downstream restraining effect on the disinhibition of the renin-angiotensin system that appears to be a factor in disease severity. I was hoping that this class of medicines - perhaps even in combination - would be a possible treatment but there's no data to support that yet and that maybe a vain hope.

 

[uujjj]

That was an early worry that ACEI and ARBs would up regulate the ACE2 receptor but there is little clinical data to support that thesis. It is more likely that hypertension is a marker for other risk factors. Don't stop taking your Rx and don't drink bleach (same advice that Gramma would give).

Why do smug liberals keep distorting what Trump said? Trump NEVER said to drink bleach!

He said to inject bleach!

 

[TheTalkingMule]

How can you claim "we're not being even remotely careful" when the whole country is shut down? That makes no sense.

Just from my vantage point at the back of my house I have:

• Twenty-something neighbor partying in his yard with two brothers and all their girlfriends. Only the owner lives there and the other 5 come and go back to Jersey.
• Two girls in another house who come and go so many times a day it's hard to imagine what they could be doing.
• Newest neighbor and wife seem to stay for two days or so then disappear, I assume back to a parents house in Jersey
• Thousands of people walking by every day
• All the supermarkets are open and packed

Some regions may be "locked down", but not in my city. Perhaps all the highly at-risk older folks are isolating, everyone else is out and about. The motorcycle guys have been like a swarm of locusts since Friday.

Edit: Forgot my favorite one. Went to my corner pizza shop two days ago, the guy and his wife are running it exactly the same as any other day. No masks, no gloves. Walk right in and up to the counter for your order. Hilarious.

 

[BOBTHEJOCKEY]

I got corona'd out. But here's something you wrote and I have a thought.There was also something else about #2 and 12% but I lost interest.

The N.Y. anti-body tests randomly asked people at grocery stores to be tested. Although not perfectly random, it is far better. The results showed an infection fatality rate of 0.5% to 1%. I would think 0.8% is a good bet.
if you are obese, have diabetes, cancer, high blood pressure, or are old, you are in pretty high danger of hospitalization and possible death. Otherwise, it’s not too bad.

And if you have non of the above illnesses, then you've got way less than .8% chance of dying, as in maybe even 1/1,000. That's me except I am 59. But I bet that signal is mixed in with general health issues. As in, are healthy older people dying any more than younger ones? IDK. Interesting puzzle for sure. Then mix in Elon, wow! PapaFox has a nice read on EM. Higher stock makes it more challenging to open the doors.

And that whole Vitamin C IV misunderstanding in China, I gave up and did some yard work.

People are now aware of the problem. Just keep publicizing the deaths. People know if they are at risk and they don't need to be told anymore. What about the 11 million young and healthy undocumented people that need to go to work now. Their fear of being homeless is greater than their fear of infecting their parents.

 

[lascavarian]

Hey, BTW today with the initial lifting on some business in Santa Clara County, we have an electrician outside our house upgrading our main panel for subsequent Solar and PWs. Spoke with Tesla Energy today to update them we’ll be ready for their team by next week (assuming inspection approval next Monday) and they said they can’t say for sure but hope to be able to be out here and complete their installation work by end of May. That would be sweet. Feels good.

That is encouraging. I am stuck in the mud with Tesla Energy at this point. They have twice refunded my deposit for 2 different reasons. I am not sure if there is a real problem or not. Maybe I will wait until after battery day and see if there is any news.

As for tracing. I think this is a well understood process regardless of what Jack thinks. Even though it is not a familiar one.

My late mother when young and in nursing school did communicable disease tracing for Syphilis back about 1929ish. She said it was part of her RN training (public health maybe). She and another young nurse would walk into the city neighborhoods and knock on doors searching for people known to have been exposed to Syphilis that could benefit from the latest treatments. They would arrange a free hospital appointment. Penicillin was just appearing (no longer a night with Venus and a life with Mercury) and able to make progress against a communicable disease plaguing humanity for centuries. Interesting reading.

Brief History of Syphilis

 

[Red Leader]

Why do smug liberals keep distorting what Trump said? Trump NEVER said to drink bleach!

He said to inject bleach!

I stand corrected, good sir. He did suggest injection; and also, shoving a "black light" up ones butt. ;-)

 

[AlanSubie4Life]

This part is what I am talking about. In the "by onset" graph, the days which have incomplete data will most often look like there is a strong downward trend, even if there is an upward trend. This is usually 3-5 days, but in case of the Idaho graph, it seems to be as much as 14 days.

Sure. But you could also argue that plots "by day of test" are unnecessarily pessimistic (sometimes), since they show potentially huge spikes which don't reflect the actual epidemic.

In any case, all plots of deaths by date and cases by date of onset should shade a period of time (whatever is appropriate) showing which data is likely to change. Like the Washington State data does.

My point that is with that information presented that way, the "by day of onset" plots are a more useful tool for evaluating the progress of the epidemic.

Again, note that a significant number of cases are missing when viewing the data in either format, when using it to analyze disease trends. There is always a lag in reporting, no matter which way you look at it. It's just a question of how those missing cases are distributed across the graph (in the case of the by-report-day graph they would all be distributed over the next few days in the future in some uneven fashion).

 

[BOBTHEJOCKEY]

I didn't mention there's a bright side to these tragic statistics: Understanding a problem is the first step to solving it.

COVID-19 is killing thousands of Americans because most Americans are chronically ill due to unnatural living, primarily diet. Overwhelming scientific evidence now shows that all common chronic diseases (obesity, heart disease, stroke, diabetes, hypertension, common cancers, and many others) are primarily caused by excess animal foods and high-calorie low-nutrient processed foods. Nearly 70% of middle-aged Americans are being medicated for their diet, because mainstream medicine has few incentives for teaching patients how to eat rather than pushing pills, and because most doctors know little about nutrition except to sneer at it, due to their drug-and-surgery-dominated education.
HOW NOT TO DIE: The Role of Diet in Preventing, Arresting, & Reversing Our Top 15 Killers | NutritionFacts.org
https://www.amazon.com/How-Not-Die-Discover-Scientifically-ebook/dp/B00Y7USB14/

But a backlash has been building for years. The huge growth of fake-meat sales is one sign. These processed products are not nutritionally ideal, but can help folks transition to whole plant foods. Another sign is the huge growth of so-called alternative medicine (aka complementary, integrative, functional, holistic, naturopathic), despite its near total lack of insurance coverage. Many alternative doctors are little better than conventional ones, because they mostly push different pills (nutritional supplements) instead of healthy foods. But their proliferation suggests a vast sea-change is coming. COVID-19 could accelerate that.
Global Complementary and Alternative Medicine Market Is Set For Swift Growth, To Reach Around USD 163.3 Billion by 2025

Right now, dying COVID-19 patients are being saved with nutrients (vitamin C and others) in China and at least one NY hospital system. The safety and effectiveness of high-dose intravenous vitamin C is well established for other types of viral pneumonia (and many other conditions), and clinical trials are underway in China to confirm those results for COVID-19. The new trial results are due this fall. If they become widely known (via Internet, because drug-dominated media and government are unlikely to do it), the sea-change could happen fast. If most people find out that all the deaths and suffering from COVID-19, and all the vast economic damage from shutdowns, could have been avoided with cheap and available nutrients, a very great anger could arise. And the population and medical industry could be dragged, kicking and screaming, toward health and safety from future waves of COVID-19 and other pandemics.
Cheng Integrative Health Center Blog
New York hospitals treating coronavirus patients with vitamin C
Protected Group Immunity, Not a Vaccine, is the Way to Stop the COVID-19 Pandemic

Bring on the sneers from retired doctors here.

I am 68 and almost never go to the doctor. When I have a problem I immediately go to uncle google and start reading and thinking. It works every time. I cured my hip joint problem by riding my unicycle for a year instead of running. I cured my Urinary Tract Infection by drinking lots of cranberry juice. My left foot used to tingle after walking. Cured that with Ginko Biloba. Many many more to numerous to mention.

 

[uujjj]

Just from my vantage point at the back of my house I have:

• Twenty-something neighbor partying in his yard with two brothers and all their girlfriends. Only the owner lives there and the other 5 come and go back to Jersey.
• Two girls in another house who come and go so many times a day it's hard to imagine what they could be doing.
• Newest neighbor and wife seem to stay for two days or so then disappear, I assume back to a parents house in Jersey
• Thousands of people walking by every day
• All the supermarkets are open and packed

Some regions may be "locked down", but not in my city. Perhaps all the highly at-risk older folks are isolating, everyone else is out and about. The motorcycle guys have been like a swarm of locusts since Friday.

"Lock down" is an inaccurate term. That's why I never say "lock down". The orders (here in California, probably similar elsewhere) explicitly permit outdoor activities. Walking in the neighborhood, going to parks, hiking, biking, all encouraged.

(That's why I don't understand Elon's rant. He seems to think we're like Wuhan but there's tons of people walking around, at the park, at the beach. Does his house not have windows?)

The biggest risks have been shut down. We are in Ramadan and every mosque in our area has been closed the whole month. I'm pretty sure the mosque, my office, and my kids' schools are the source for most of my colds, and those are all closed. It's probably the same for church/temple people. The other places to get sick are parties, big events, and travel. All those are closed.