Coronavirus

[AlanSubie4Life]

If FL reaches the same state as Italy earlier, where some patients are denied ICU beds, the state will at least partially shutdown again, and this has national consequences as other states will undoubtedly follow, since they’re relaxing social distancing as well. FL just looks to be the early canary in the coal mine.

Generally agree that if patients start spilling out of the hospitals it is going to be a problem. I do wonder about the necessity for ICU beds and whether they are prepped for using non-ICU beds at this point (I would hope so!). There are 15k of those left in Florida, and unless they're really colossally stupid, I can't imagine they're going to let this go unabated until the momentum takes it past that. I think that's unlikely - but I could be wrong! How many actual ICU beds they really need and how adequate normal beds are, I have no idea.

As I said before, though - kind of needs to be viewed at a very granular level. Doesn't help to have beds available in the panhandle if all hell is breaking loose in Miami.

Not looking good for the NBA season. Guess they should take @Daniel in SD 's idea and play in New Zealand. Trump Trigger Alert!

 

[kbM3]

Generally agree that if patients start spilling out of the hospitals it is going to be a problem. I do wonder about the necessity for ICU beds and whether they are prepped for using non-ICU beds at this point (I would hope so!). There are 15k of those left in Florida, and unless they're really colossally stupid, I can't imagine they're going to let this go unabated until the momentum takes it past that. I think that's unlikely - but I could be wrong! How many actual ICU beds they really need and how adequate normal beds are, I have no idea.

As I said before, though - kind of needs to be viewed at a very granular level. Doesn't help to have beds available in the panhandle if all hell is breaking loose in Miami.

Not looking good for the NBA season. Guess they should take @Daniel in SD 's idea and play in New Zealand. Trump Trigger Alert!

As you say, FL is huge. How far would they transfer patients if local beds are full?

 

[eevee-fan]

Arizona casinos’ virus safety plan mirrored Las Vegas casinos’; now they’re closed

So I guess AZ is the first Control Group, Las Vegas is retesting as the 2nd Control Group just to be sure.

 

[SageBrush]

Surprised this isn’t talked about more:

https://www.newsweek.com/multiple-florida-hospitals-run-out-icu-beds-coronavirus-cases-spike-1511934

Asi understand it even if FL reshutdown today, hospitalizations would still increase for the next 10 days.

The NYC playbook will be pulled out:

Cancel elective surgeries;
Widen the patient sharing duties between hospitals;
Reduce intubations of patients with a poor prognosis.

They have a ways to go before the sh1t really hits the fan, but they are trying real hard to get there as fast as they can. With the help of trump and santis I'll guess that by the end of the month even trumpers on the street will want an update and will wonder if a rally is not ideally timed.

 

[davepsilon]

COVID-19 Projections have tightened their confidence intervals considerably and lowered their projected number of deaths (due to reducing IFR from various causes).

I tend to think this could still be slightly optimistic, given the current behavior in the "hot" states, but very hard to predict, as it depends on people's behavior at this point. Overall these current outbreaks ARE relatively small compared to the big outbreaks we've seen so far. But we'll see whether they remain that way - I tend to think they have more momentum than this projection gives them credit for (I think it's based on deaths, so it will tend to lag, and I'm not sure how they deal with that). I think there's a real chance that people losing patience with physical distancing and falling for anti-mask nonsense is going to lead to less impact from those measures than expected, and there are now a lot of vectors wandering around, so it should propagate quickly if the transmissibility is high enough to sustain transmission in summer (which it appears to be).

Projecting 184k deaths by October 1st. [155k, 220k]

COVID-19 Projections Using Machine Learning

COVID19-projections.com is now a junk model. Toss it in the trash like IMHE, not helpful tool when looking at Southern state outbreaks. Look at their Arizona infection predictions for today and the forecasted trend. They don’t make sense. C19-projections forecast 5.3k total new infections today in Arizona. I’m supposed to believe they tested more than half of the new infections while having a ~20% positive rate. Bogus. And their estimated Rt is too low in Arizona, Florida, Texas, probably some others. Their claim to fame was nailing the slow death draw down curve. Doesn’t mean they are any good at modeling late bloomers.

Rt Covid-19 Updated their model today, and it looks like a good change. Every Rt estimate they have makes sense to me now (and many went up). Great job showing the situation as it is. But they don’t make predictions. And they don’t distinguish which states still have small absolute sized infections just whether a state’s pandemic is growing or shrinking

and just to share here’s a useful plotting tool I have found informative: 91-DIVOC : Flip the script on COVID-19

 

[madodel]

Pennsylvania is doing well now and all but one county will be in the Green phase by the end of next week. Our Governor is still requiring masks to worn in public. What is his reward for navigating this pandemic fairly well? Republicans are trying to impeach him.
Group Of Republican Lawmakers Move To Impeach Governor - LevittownNow.com

 

[SageBrush]

For your viewing pleasure, here is how they do it in OK.
Covid-19 sh1tshow aside with a case doubling time of 18.5 days, the graph is pretty nifty and encapsulates a lot of data

 

[AlanSubie4Life]

COVID19-projections.com is now a junk model. Toss it in the trash like IMHE, not helpful tool when looking at Southern state outbreaks

Yeah, agreed. Seems to be deviating from reality.

Good thread from Trevor on why mortality rates are declining (it does appear to be a. because we're finding more cases and b. the people getting infected are generally younger, as we've said here - but he actually plotted the relevant data).

https://twitter.com/trvrb/status/1274144864196653057?s=20

You can see of identified cases, younger people are slightly higher prevalence. But more important than that, the positivity rates have changed a lot over time, especially for the older groups. So we're catching many more of the older people who are sick now, whereas before we tended to catch only the sickest. So the CFR in the older group will be reduced, even if IFR within that group hasn't changed much.

I would expect that this will tend to lead to reduced mortality due to other causes during any potential second peak. It'll be an interesting data set to gather on this second wave, and may help identify how many of the deaths due to heart attack/diabetes/dementia that rose in the first peak (see CDC Wonder) were actually COVID deaths (we'd expect to see very little in the way of a blip during the second wave, at least for primary cause of death...all depends on how Wonder is actually set up which I'm not an expert on - I know that multiple causes of death can be logged, but not sure how that is dealt with when you look at plots of excess mortality by cause).

 

[AZRI11]

For your viewing pleasure, here is how they do it in OK.
Covid-19 sh1tshow aside with a case doubling time of 18.5 days, the graph is pretty nifty and encapsulates a lot of data

View attachment 553806

Deaths are down in Oklahoma. Strange how cases go up, and deaths go down.

Oklahoma Coronavirus: 9,706 Cases and 367 Deaths (COVID-19 ) - Worldometer

 

[SageBrush]

Deaths are down in Oklahoma. Strange how cases go up, and deaths go down.

Oklahoma Coronavirus: 9,706 Cases and 367 Deaths (COVID-19 ) - Worldometer

Why do you think it is "strange" ?

Is that a dog whistle for some conspiracy theory ?

 

[FoverM]

Has the virus been around longer than thought?

Bloomberg - Are you a robot?

I wonder if this thing has been circulating in healthy people for a long time. Many were asymptomatic, others minimally ("I had a bad cold"), and another set had the "flu" (felt wiped out, fever, etc.). However, we know that the excess deaths began in March, so it hadn't reached the vulnerable population until then.

I don't understand epidemics and viruses. We had the early outbreak in SW GA where it spread like wildfire at the two funerals. There was the church in AR (?) with another wildfire. I haven't read anything that indicates those events had a more contagious version of the bug yet a significant percent of those exposed caught it. Why wasn't that significant percentage replicated across the country? Is it all down to "superspreaders"? If so, what makes a person a superspreader?

 

[AlanSubie4Life]

Has the virus been around longer than thought?

Bloomberg - Are you a robot?

Seems reasonable. Would not be at all surprising that it would be detected some time in January. Or even December (late). It started spreading in November sometime in China, approximately. I’d only expect it in one or two places other than the origin at such an early time, though. Certainly explains why the Italy outbreak got so much momentum. Seems like it was not recognized early enough.

I don't understand epidemics and viruses. We had the early outbreak in SW GA where it spread like wildfire at the two funerals. There was the church in AR (?) with another wildfire. I haven't read anything that indicates those events had a more contagious version of the bug yet a significant percent of those exposed caught it. Why wasn't that significant percentage replicated across the country? Is it all down to "superspreaders"? If so, what makes a person a superspreader?

Certainly the dynamics of spread are complicated. There are various studies that suggest that something like 80% of the infections are caused by 20% of the infected people.

The simplest thing is to assume the approximate timeline that all the evidence points to, assume stochastic spread especially at the start of an outbreak, and then just get rid of the virus, like we do with Ebola.

Stochastic: one of the first people infected in South Korea (probably she was not the first though I don’t remember the exact timeline) was a superspreader and hit a large group gathering. That may not have happened in Italy. Makes a big difference in how quickly things take off.

Definitely there is an element of luck and superspread contribution in the early going. I think we can see that in the way the various states have behaved. But it is weird! I am just guessing.

We’ll probably get more of the story in a year or two.

 

[AZRI11]

Why do you think it is "strange" ?

Is that a dog whistle for some conspiracy theory ?

Younger people are making up a larger percentage of cases. That's why IFR is lower.

 

[AlanSubie4Life]

Deaths are down in Oklahoma. Strange how cases go up, and deaths go down.

Oklahoma Coronavirus: 9,706 Cases and 367 Deaths (COVID-19 ) - Worldometer

1) Early in the pandemic we had limited tests so only the sickest people were identified, so they tended to be older people. And they also died more often.

2) Because of above, outbreak was probably larger than it appeared to be from the data, earlier ( you’d have to look at historic positivity).

3) Younger people are getting sick now since the elderly are protecting themselves.

4) Deaths lag. Look again in 2 weeks. I expect an increase, though it may not be as bad as before (depends on how high this peak ends up getting!).

5) Treatment for the disease is more standardized and probably helps save some people (also early diagnosis helps).


Looking at the death curve should give a much better idea of the actual qualitative shape of infections in the population than cases (with a delay). But even it is imperfect, since some deaths are missed, especially early and near the peak. And as the IFR reduces, as the population adapts, the tail of the death curve might understate the number of infections, so there may not be as much dropoff in infections as it appears, just by looking at deaths.

 

[HG Wells]

We are screwed.

 

[SageBrush]

Younger people are making up a larger percentage of cases. That's why IFR is lower.

Right. What is "strange" about that ?

 

[SageBrush]

We are screwed.

The EU has about 4/3 the population of the US so currently there is ~ 8x more Covid-19 per capita in the US than in the EU.

And the US is on the upswing

 

[AZRI11]

Right. What is "strange" about that ?

Strange is the media never mentions daily deaths in these states, only total deaths in USA and daily cases in some states. They want to give it as bad a look as possible because they hate trump (same as I do). And media never mentions hospitals have started elective surgeries and that is part of the reason hospitalized patients is way up.

 

[AlanSubie4Life]

And media never mentions hospitals have started elective surgeries and that is part of the reason hospitalized patients is way up.

I somewhat agree with your point (the emphasis on COVID spread at Coronapalooza tonight is silly - it’ll probably happen, but much more significant is the terrible example it will set, which has amplifying effects on large gatherings all over the country). There are so many people in this country and it’s what they are doing on average each day that matters. Same reason the protests didn’t really matter much - but perhaps set a bad example (that is debatable - I think people should have protested, but assumed they were infected afterwards and take all precautions).

However, note that many states track COVID hospitalizations separately, and those are indeed trending up significantly in several states. See AZ dashboard as an excellent example.

 

[SageBrush]

And media never mentions hospitals have started elective surgeries and that is part of the reason hospitalized patients is way up.

"Media" is a very broad brush. Are you suggesting that Faux news and the NYT report the same ?

You are wrong about the 'hospitalized' number. That is Covid-19 specific when reported on Covid webpages. For at least the media I read (mainstream and progressive, not Faux News), reports of increasing 'hospitalized' numbers are Covid related. Hospital occupancy stats are all patients.