Coronavirus

[Dalal.Holdings]

Granted this is an opinion piece but this has been my position all along. Will be interesting to see what the end result of this. Glad to see this was published in WSJ.

 

Yes, your opinion is that, let's say, 6 million were infected as of March 9th. If the infection rate doubles every 3 days, there should be 200 million infected. And by Friday, every single person in the US will be infected.

 

The problem is that no evidence supports this opinion.

 

If millions were infected months ago, then why are NYC ICUs filling up now? Is it the last few million cases that are leading to sudden surge of severe cases? Why were ICUs not stacked in January? In February? FYI many of these patients are requiring 1 week+ on ventilators.

 

What would we have seen in January and February for the "millions infected for months" scenario to be valid? What NYC hospitals are revealing to me now vs back then tells me in very clear terms that this thesis is invalid.

 

Or, as Charlie would say: invert, always invert.

[ERICOPOLY]

Trump believes that shelter-in-place is a media plot to undermine his presidency:

 

https://twitter.com/realDonaldTrump/status/1242905328209080331?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Etweet

 

This tells us that he is resisting it in order to save his presidency.

[John Hjorth]

The Guardian [March 25^th 2020] : Brazil gangs impose strict curfews to slow coronavirus spread.

 

Well, when the Brazilian president considers the corona situation a "minor cold", one must take action one self to protect own moaty business, when a virus is picking up competition against the monopoly to kill people.

[Spekulatius]

The Guardian [March 25^th 2020] : Brazil gangs impose strict curfews to slow coronavirus spread.

 

Well, when the Brazilian president considers the corona situation a "minor cold", one must take action one self to protect own moaty business, when a virus is picking up competition against the monopoly to kill people.

 

LOL, more streetsmart than the government. These guys know a bit about surviving.

[RichardGibbons]

FWIW, I agree that the optimal economic solution was the South Korea/Taiwan solutions, but I don't think that solution is available now.

 

The optimal all around solution is the hammer one described in the Medium article, or maybe there's a third, hybrid way, which would be to close state borders, and attempt to do a South Korean solution in the states with low cases, and a hammer in states with high cases. If that were possible, maybe that would actually be best.

 

(I actually think you do pretty well at lowering the R0 just by giving everyone masks and telling them to wash their hands.)

 

WRT herd immunity, I have no clue, and no good basis for an opinion. But if forced to opine, I'd say that herd immunity will work for the same virus, and even with mutated versions, it may confer a reasonable degree of resistance. Even with mutations, I suspect the odds are low of getting perpetual waves of mutated viruses with similar infectivity and morbidity as COVID-19. But I have no basis for that suspicion except an observation that that non-manmade things which change the natural world forever are unusual.

[RichardGibbons]

Trump believes that shelter-in-place is a media plot to undermine his presidency:

 

https://twitter.com/realDonaldTrump/status/1242905328209080331?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Etweet

 

This tells us that he is resisting it in order to save his presidency.

 

Well, it could be second-order thinking--by creating an enemy, he might hope his supporters will focus on "us vs them" rather than the actual crisis, as they have been trained to do. (But I don't think he's actually sophisticated enough to do second-order thinking any more, so I agree that it's best to take him at face value.)

[Viking]

Trump believes that shelter-in-place is a media plot to undermine his presidency:

 

https://twitter.com/realDonaldTrump/status/1242905328209080331?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Etweet

 

This tells us that he is resisting it in order to save his presidency.

 

Canadian media (and federal and provincial governments ) is also in on the plot (to undermine Trump’s presidency) because they are saying the same thing. Europe too.

 

It finally makes sense. Trump has finally figured it out... and everyone in the globe is in on it :-)

[ERICOPOLY]

 

In a blog post titled “Is God Judging America Today?” a pastor who leads a weekly bible study group for members of President Donald Trump's Cabinet appeared to blame the coronavirus pandemic on several groups, including those who have “a proclivity toward lesbianism and homosexuality.”

 

https://www.nbcnews.com/feature/nbc-out/trump-s-bible-teacher-says-gays-among-those-blame-covid-n1168981

[meiroy]

There's something that really worries me; what if this virus was much worse?  Where would we be now with the same lack of pandemic-response team that got dismissed and the same people in power that think it should all be left to the private sector?  What about the next time? There WILL be a next time.

 

Oh,and:

https://www.reuters.com/article/us-health-coronavirus-china-cdc-exclusiv/exclusive-u-s-slashed-cdc-staff-inside-china-prior-to-coronavirus-outbreak-idUSKBN21C3N5

 

"The Trump administration cut staff by more than two-thirds at a key U.S. public health agency operating inside China, as part of a larger rollback of U.S.-funded health and science experts on the ground there leading up to the coronavirus outbreak, Reuters has learned."

 

"Separately, the National Science Foundation (NSF) and the United States Agency for International Development (USAID), the global relief program which had a role in helping China monitor and respond to outbreaks, also shut their Beijing offices on Trump’s watch. Before the closures, each office was staffed by a U.S. official. In addition, the U.S. Department of Agriculture(USDA) transferred out of China in 2018 the manager of an animal disease monitoring program."

 

"“We had a large operation of experts in China who were brought back during this administration, some of them months before the outbreak,” said one of the people who witnessed the withdrawal of U.S. personnel. “You have to consider the possibility that our drawdown made this catastrophe more likely or more difficult to respond to.”"

 

[meiroy]

 

In a blog post titled “Is God Judging America Today?” a pastor who leads a weekly bible study group for members of President Donald Trump's Cabinet appeared to blame the coronavirus pandemic on several groups, including those who have “a proclivity toward lesbianism and homosexuality.”

 

https://www.nbcnews.com/feature/nbc-out/trump-s-bible-teacher-says-gays-among-those-blame-covid-n1168981

 

Religious fundamentalism is a virus far worse than covid19 and for some religions, it hides in a normal-looking suit and tie.

 

 

[thowed]

I guess I understand why a mostly investor/business crowd (this board) cares more about a pandemic as its an immediate known threat to ones life and when driven by fear even more so. I guess my point again tho is that people die every day in medicine. We run codes when the pt arrives with no pulse, sometimes they die. We see strokes paralyze people. We see people on dialysis who are dying right in front of your eyes. We see non compliant cardiac/DM patients who are taking years off their lives and dont care even though they know it.

 

This happens every day, all day, all across the world. This will likely be a flash in the pan looking at the big picture many years from now. The other diseases I have mentioned wont. And almost everyone on this board/parents loved ones will die of CA/MI/DM etc and surely right now care much more about Covid19. Does that many any sense? Dont be worried about what is going to kill you and how to change that but what your AFRAID might kill you?

 

My point regarding time spent with those dying wasn't necessarily a jab but is true. If we really cared that much about people dying we would be spending time in nursing homes, rehab facilities, dialysis centers etc. That obviously wont happen. Many non medical people have become very interested in deaths and treatment of the ill. Thats great but IMO is mostly due to a the natural flight or flight response we all have to an immediate know threat right in front of our face 24hrs a day.

 

I have read on twitter many people abhorred by the fact that the economy may open and people may die. That being said I cant believe how many people on waiting lists for lung/heart/kidney etc transplants die never getting an organ. You just don't hear about it everyday and we each have the power to control that directly, but few will. You can go down this rabbit hole quick but I think I made my point.

 

Hi Orthopa

 

First off, I think that this thread is so big now with so many people involved that it's hard to generalise about people's thoughts.

 

Secondly, I very much appreciate hearing your opinions with your medical background - it's really useful and interesting.

 

Thirdly, as you say this is an investor board, and so I think people here want to talk about the ramifications this will have on their investments.  I think their thoughts on the human impact is a separate issue that is less relevant here.

 

I think you make a good point about going down a rabbit hole with other illnesses - I think it has highlighted for some of us the arbitrary value of a life, both financially and in terms of consideration.

 

As I said, my understanding is that this thread is about the impact on investments, so I value your thoughts on infection rates, especially given your closeness to what's going on, and also the fact that they are different from a lot of what else we're hearing.  Echo chambers aren't useful.

 

As an amateur, the only common sense thing I notice is that the problem areas are the places of greatest people density and maximum domestic and international movement e.g. NYC, LA and other big capital cities, which makes total sense.  NYC sounds like it's getting really bad.

 

However if 'social distancing' works, then the situation will hopefully be much better in other parts of the country, simply because it's much easier to keep away from each other.

 

Obviously this is a gross oversimplification.  But it also doesn't tally with your belief that more people have it, but less people are getting ill.  I'd be very interested to know why you think NYC and other hotspots are worse than others.

 

 

 

 

[DocSnowball]

@Orthopa - there is always value in considering the disconfirming opinion. One data point that I have not been able to reconcile, while clearly being in disagreement with your views, is why deaths have plateaued in countries like Iran - is the CFR lower and it burns through the population after a few weeks? I don't know, will have to watch Europe and NYC to support or refute this. But I'm curious to see the death curve flattening out after a few weeks first in China and then Iran. Italy is still in the mid-700s daily deaths, but has stopped going up further. Social distancing is the obvious intervention everywhere and confounds this data. 

 

Another aspect is why so few cases in Asia south of China, despite fewer measures - is it much less contagious in warmer weather? It looks like that at this point. There was a publication to support that higher temperatures and humidity make it less contagious.

 

One new data point I'm seeing is that China and Korea continue to have about 100 or so cases daily. Until these go to zero for a months or two, one has to consider that the virus will remain in the human population somewhere around the globe and new outbreaks can occur despite the upfront economic costs we are incurring.

[Investor20]

https://www.wsj.com/articles/is-the-coronavirus-as-deadly-as-they-say-11585088464?mod=hp_opin_pos_2

 

"In Iceland, deCode Genetics is working with the government to perform widespread testing. In a sample of nearly 2,000 entirely asymptomatic people, researchers estimated disease prevalence of just over 1%. Iceland’s first case was reported on Feb. 28, weeks behind the U.S. It’s plausible that the proportion of the U.S. population that has been infected is double, triple or even 10 times as high as the estimates from Iceland. That also implies a dramatically lower fatality rate."

 

"The epidemic started in China sometime in November or December. The first confirmed U.S. cases included a person who traveled from Wuhan on Jan. 15, and it is likely that the virus entered before that: Tens of thousands of people traveled from Wuhan to the U.S. in December. Existing evidence suggests that the virus is highly transmissible and that the number of infections doubles roughly every three days. An epidemic seed on Jan. 1 implies that by March 9 about six million people in the U.S. would have been infected. As of March 23, according to the Centers for Disease Control and Prevention, there were 499 Covid-19 deaths in the U.S. If our surmise of six million cases is accurate, that’s a mortality rate of 0.01%, assuming a two week lag between infection and death. This is one-tenth of the flu mortality rate of 0.1%. Such a low death rate would be cause for optimism."

 

"This does not make Covid-19 a nonissue. The daily reports from Italy and across the U.S. show real struggles and overwhelmed health systems. But a 20,000- or 40,000-death epidemic is a far less severe problem than one that kills two million. Given the enormous consequences of decisions around Covid-19 response, getting clear data to guide decisions now is critical. We don’t know the true infection rate in the U.S. Antibody testing of representative samples to measure disease prevalence (including the recovered) is crucial. Nearly every day a new lab gets approval for antibody testing, so population testing using this technology is now feasible."

 

"If we’re right about the limited scale of the epidemic, then measures focused on older populations and hospitals are sensible. Elective procedures will need to be rescheduled. Hospital resources will need to be reallocated to care for critically ill patients. Triage will need to improve. And policy makers will need to focus on reducing risks for older adults and people with underlying medical conditions. A universal quarantine may not be worth the costs it imposes on the economy, community and individual mental and physical health. We should undertake immediate steps to evaluate the empirical basis of the current lockdowns."

 

Granted this is an opinion piece but this has been my position all along. Will be interesting to see what the end result of this. Glad to see this was published in WSJ.

 

"that’s a mortality rate of 0.01%"

 

WHO said 3.4%.

Then they said 1.0%

Then Germany they said 0.4%

Now 0.01%

That is a 340 fold difference.

 

They should really test with antibody to get the denominator correct.

 

WHO says Covid transmits less than regular Flu

If Covid also has less mortality rate than Flu, then this is less than Flu.

[Investor20]

The mean age of the patient subsample was 79.5 years (standard deviation [sD], 8.1), of whom,

only 601 (30.0%) were women.

Of all patients who died, 117 (30%) had ischemic heart disease,

126 (35.5%) had diabetes,

72 (20.3%) had cancer,

87(24.5%) had atrial fibrillation,

24 (6.8%) had dementia, and

34 (9.6%) had had a stroke.

 

The mean number of comorbidities was 2.7 (standard deviation, 1.6).

Only 3 patients (0.8%) had no underlying diseases,

89 (25.1%) had one, 91 (25.6%) had two, and 172 (48.5%) had three or more.

 

http://www.cidrap.umn.edu/news-perspective/2020/03/italian-doctors-note-high-covid-19-death-rate-urge-action

 

The patients were sicker than I thought before. 

They had 2.7 comorbidities on average including comorbidities like cancer and stroke.

Only 0.8% with no underlying disease.

 

The underlying scientific article says following:

https://jamanetwork.com/journals/jama/fullarticle/2763667

 

Definition of COVID-19–Related Deaths

A second possible explanation for the high Italian case-fatality rate may be how COVID-19–related deaths are identified in Italy.

Case-fatality statistics in Italy are based on defining COVID-19–related deaths as those occurring in patients who test positive for SARS-CoV-2 via RT-PCR, independently from preexisting diseases that may have caused death. This method was selected because clear criteria for the definition of COVID-19–related deaths is not available.

.......

Electing to define death from COVID-19 in this way may have resulted in an overestimation of the case-fatality rate.

.........

The presence of these comorbidities might have increased the risk of mortality independent of COVID-19 infection.

[rb]

All I have to say about this Bill nonsense is that I agree with Justin Amash.

 

Bills should be simple and on single issues. Every bill that hits the floor has hidden agendas and a bunch of unrelated nonsense attached to further degrade the freedoms of Americans while also further intrenching government. I mean how many times in the last two decades have we seen thousand page documents submitted and voted in all within 24hours. This is something everyone should be outraged about. From Obamacare to Omnibus the whole thing has been a joke.

 

—————————

 

Investment wise, I think a bill (regardless of what it is) will bring some much needed stability to the market. Then again, I kind of like the volatility.

I fully agree with you on the simplicity of bills. Sadly we don't live in that environment.

 

But c'mon, this is a 2 trillion dollar there's room in there for everyone's hobbies - Republican and Democrat. Usually those are pretty cheap too. But they wanted a 500 billion fund with no oversight to be used at the discretion of the Treasury - read  "Trump".

 

Now seriously, I don't care who you are lefty, righty, republican, democrat, agnostic, stoner, libertarian, extraterrestrial you can't tell me with a straight face that you trust Trump with 500 billion, no strings attached.

 

Start at 2:30 and see just a glimpse of all the add-ons. And no, I don’t trust Trump with 500B and I also don’t like the anonymity that was proposed for companies.

 

I looked at it, and as I've said they've included some hobbies and the price tags are pretty small. Pretty much  standard stuff, par for the course Washington DC stuff.

 

The anonymity for companies I suspect is the same idea as the stronger banks taking tarp money in to provide cover for the weaker banks and that all banks access the discount window now. Well back then and now it wasn't such a bad idea to have banks well capitalized (better than the alternative). But you can't have every company take a bailout in order to provide cover in this case. Not practical.

 

That being said, I don't like the idea either because then you rely to the Treasury to monitor compliance and they're not really good at it. So yeah, it sucks.

[rb]

3.28 million is actually not a bad number,

[Castanza]

The mean age of the patient subsample was 79.5 years (standard deviation [sD], 8.1), of whom,

only 601 (30.0%) were women.

Of all patients who died, 117 (30%) had ischemic heart disease,

126 (35.5%) had diabetes,

72 (20.3%) had cancer,

87(24.5%) had atrial fibrillation,

24 (6.8%) had dementia, and

34 (9.6%) had had a stroke.

 

The mean number of comorbidities was 2.7 (standard deviation, 1.6).

Only 3 patients (0.8%) had no underlying diseases,

89 (25.1%) had one, 91 (25.6%) had two, and 172 (48.5%) had three or more.

 

http://www.cidrap.umn.edu/news-perspective/2020/03/italian-doctors-note-high-covid-19-death-rate-urge-action

 

The patients were sicker than I thought before. 

They had 2.7 comorbidities on average including comorbidities like cancer and stroke.

Only 0.8% with no underlying disease.

 

The underlying scientific article says following:

https://jamanetwork.com/journals/jama/fullarticle/2763667

 

Definition of COVID-19–Related Deaths

A second possible explanation for the high Italian case-fatality rate may be how COVID-19–related deaths are identified in Italy.

Case-fatality statistics in Italy are based on defining COVID-19–related deaths as those occurring in patients who test positive for SARS-CoV-2 via RT-PCR, independently from preexisting diseases that may have caused death. This method was selected because clear criteria for the definition of COVID-19–related deaths is not available.

.......

Electing to define death from COVID-19 in this way may have resulted in an overestimation of the case-fatality rate.

.........

The presence of these comorbidities might have increased the risk of mortality independent of COVID-19 infection.

 

Best post on this thread so far.

 

Thanks

[Cigarbutt]

The mean age of the patient subsample was 79.5 years (standard deviation [sD], 8.1), of whom,

only 601 (30.0%) were women.

Of all patients who died, 117 (30%) had ischemic heart disease,

126 (35.5%) had diabetes,

72 (20.3%) had cancer,

87(24.5%) had atrial fibrillation,

24 (6.8%) had dementia, and

34 (9.6%) had had a stroke.

 

The mean number of comorbidities was 2.7 (standard deviation, 1.6).

Only 3 patients (0.8%) had no underlying diseases,

89 (25.1%) had one, 91 (25.6%) had two, and 172 (48.5%) had three or more.

 

http://www.cidrap.umn.edu/news-perspective/2020/03/italian-doctors-note-high-covid-19-death-rate-urge-action

 

The patients were sicker than I thought before. 

They had 2.7 comorbidities on average including comorbidities like cancer and stroke.

Only 0.8% with no underlying disease.

 

The underlying scientific article says following:

https://jamanetwork.com/journals/jama/fullarticle/2763667

 

Definition of COVID-19–Related Deaths

A second possible explanation for the high Italian case-fatality rate may be how COVID-19–related deaths are identified in Italy.

Case-fatality statistics in Italy are based on defining COVID-19–related deaths as those occurring in patients who test positive for SARS-CoV-2 via RT-PCR, independently from preexisting diseases that may have caused death. This method was selected because clear criteria for the definition of COVID-19–related deaths is not available.

.......

Electing to define death from COVID-19 in this way may have resulted in an overestimation of the case-fatality rate.

.........

The presence of these comorbidities might have increased the risk of mortality independent of COVID-19 infection.

 

Best post on this thread so far.

 

Thanks

This study and related have been mentioned before and limitations related to the conclusions also (co-morbidities are now rampant).

Italy has done relatively poorly in terms of outcomes and there are several potential explanations: definition of death cause (when completing a death certificate, one has to document a cause leading to death and to add proximate causes which can be determinant), policy response (timing and type), healthcare resources and management as well as a relatively fragile population.

For the last part, a study published in November 2019, dealing with excess mortality related to influenza in Italy (study available if interested), the authors included the following: "Over 68,000 deaths were attributable to influenza epidemics in the study period. The observed excess of deaths is not completely unexpected, given the high number of fragile very old subjects living in Italy."

[drzola]

I am an Population and virology migrant species modeller so read the below rule;

 

Denominator problems

 

Another major problem with surveillance is the lack of denominator to calculate incidence rates. Surveillance systems provide data only on cases of disease, not on the population from which they came. The population denominator, which is often unknown in humanitarian emergencies, must come from somewhere else.

 

Uncertain population denominator

 

In Goma, Zaire in 1994, deaths were counted by counting the bodies which were picked up for burial by the size of the road. For the month between July 14 and August 14, 48,347 bodies were counted. To calculate the mortality rate, this number of deaths was divided by the population. But what was the population? Some early very rough estimates put the number as high as 1,000,000. Later estimates were 500,000 - 800,000. One camp had an estimated population of 350,000 until a more accurate assessment was done using aerial photography, when the estimate dropped to 180,000. Which number do you put in the denominator?

 

One recurrent problem in acute humanitarian emergencies is initially using a very rough estimate of total population which everyone knows is probably inaccurate for want of anything better. Then a registration, census, or more accurate assessment is done. Often, the apparent incidence rate of disease jumps suddenly because the population denominator has suddenly declined. To avoid such sudden changes in disease rates, most public health workers continue to use the old, inaccurate estimate unless there is other evidence of a sharp rise in the incidence rate. Or they will apply past disease totals to the new population estimate and recalculate past rates so that they can be accurately compared to current rates using the new population estimate.

 

In addition, the size of the population in emergencies often changes rapidly. Keeping track of an accurate population size is often very difficult unless there is an ongoing registration of people leaving or entering the population.

 

 

[Guest Schwab711]

The mean age of the patient subsample was 79.5 years (standard deviation [sD], 8.1), of whom,

only 601 (30.0%) were women.

Of all patients who died, 117 (30%) had ischemic heart disease,

126 (35.5%) had diabetes,

72 (20.3%) had cancer,

87(24.5%) had atrial fibrillation,

24 (6.8%) had dementia, and

34 (9.6%) had had a stroke.

 

The mean number of comorbidities was 2.7 (standard deviation, 1.6).

Only 3 patients (0.8%) had no underlying diseases,

89 (25.1%) had one, 91 (25.6%) had two, and 172 (48.5%) had three or more.

 

http://www.cidrap.umn.edu/news-perspective/2020/03/italian-doctors-note-high-covid-19-death-rate-urge-action

 

The patients were sicker than I thought before. 

They had 2.7 comorbidities on average including comorbidities like cancer and stroke.

Only 0.8% with no underlying disease.

 

The underlying scientific article says following:

https://jamanetwork.com/journals/jama/fullarticle/2763667

 

Definition of COVID-19–Related Deaths

A second possible explanation for the high Italian case-fatality rate may be how COVID-19–related deaths are identified in Italy.

Case-fatality statistics in Italy are based on defining COVID-19–related deaths as those occurring in patients who test positive for SARS-CoV-2 via RT-PCR, independently from preexisting diseases that may have caused death. This method was selected because clear criteria for the definition of COVID-19–related deaths is not available.

.......

Electing to define death from COVID-19 in this way may have resulted in an overestimation of the case-fatality rate.

.........

The presence of these comorbidities might have increased the risk of mortality independent of COVID-19 infection.

 

Best post on this thread so far.

 

Thanks

 

It's funny that all of this was posted, but because of the conclusion it's the best post in the thread. This has been known. Overall CFR is going to be slightly less than 1% (probably in the ballpark of +/- 0.5%, depending on efforts to slow down the spread). It increases the expected mortality of every individual on Earth by 2x - 5x (see 2nd post). On average, it is ~100x more deadly than the flu right now (because none of us have immunity this year and treatments are still in experimentation).

 

Depending on testing, US will look more like China, not Italy. I say that because SK's initial cluster was not representative of the population. It is likely that clustering in NYC at this point is probably representative (maybe skews young).

 

I still predict everyone will call this a nothingburger in 6 months because the global resources dedicated to improving HC outcomes will make it look like we overreacted. Basically, it's going to be a catch-22 imo. If we stay the course, things will look good and skeptics will think they are right and people will jump back in to spending because of pent up demand. If we say we should just move on, things will get pretty rough, people will stop going out, and we'll overrun the HC system/have a more severe recession. I'm guessing the opposing views will either choose the course of action or be right, but not both.

 

SK vs. Italy (they have the same CFR by age bracket, infected clusters in Italy were generally older):

https://www.cornerofberkshireandfairfax.ca/forum/general-discussion/coronavirus/msg400925/#msg400925

 

It's just like the flu:

https://www.cornerofberkshireandfairfax.ca/forum/general-discussion/coronavirus/msg400726/#msg400726

[Guest Schwab711]

I am an Population and virology migrant species modeller so read the below rule;

 

Denominator problems

 

Another major problem with surveillance is the lack of denominator to calculate incidence rates. Surveillance systems provide data only on cases of disease, not on the population from which they came. The population denominator, which is often unknown in humanitarian emergencies, must come from somewhere else.

 

Uncertain population denominator

 

In Goma, Zaire in 1994, deaths were counted by counting the bodies which were picked up for burial by the size of the road. For the month between July 14 and August 14, 48,347 bodies were counted. To calculate the mortality rate, this number of deaths was divided by the population. But what was the population? Some early very rough estimates put the number as high as 1,000,000. Later estimates were 500,000 - 800,000. One camp had an estimated population of 350,000 until a more accurate assessment was done using aerial photography, when the estimate dropped to 180,000. Which number do you put in the denominator?

 

One recurrent problem in acute humanitarian emergencies is initially using a very rough estimate of total population which everyone knows is probably inaccurate for want of anything better. Then a registration, census, or more accurate assessment is done. Often, the apparent incidence rate of disease jumps suddenly because the population denominator has suddenly declined. To avoid such sudden changes in disease rates, most public health workers continue to use the old, inaccurate estimate unless there is other evidence of a sharp rise in the incidence rate. Or they will apply past disease totals to the new population estimate and recalculate past rates so that they can be accurately compared to current rates using the new population estimate.

 

In addition, the size of the population in emergencies often changes rapidly. Keeping track of an accurate population size is often very difficult unless there is an ongoing registration of people leaving or entering the population.

 

+1! It's hard to make accurate estimates quickly

[thepupil]

So this is admittedly hearsay / anecdote, but I have several friends that are doctors/on the front lines and they speak of a lot of 30-50 year olds with no co-morbitities that are intubated and/or critical, as well as hospitals not being particularly forthright with respect to the number of cases and severity thereof.

 

I have not taken any investment action with respect to this, I maintain long-term optimism, but I do not think this should be dismissed as only killing the old and the already sick.

 

I always prefer data to anecdote, but these are people I've known for 10 years / went to college with; they are credible and are tops in their respective field (prestigious undergrad, med schools/fellowships.

[drzola]

CO-founder of Canadian Cooperative Wildlife Health Center here in Saskatoon Saskatchewan Canada where I collaborate on multidisciplinary directed studies told on of our PHD candidates in these exact words ' it's the dosage and morbidity rate that sets the endemic rate of growth". I never forgot that.

 

Cheers.

[LC]

If we stay the course, things will look good and skeptics will think they are right and people will jump back in to spending because of pent up demand. If we say we should just move on, things will get pretty rough, people will stop going out, and we'll overrun the HC system/have a more severe recession

 

I agree with this, and then of course the inevitable political bickering that will result from it.

[orthopa]

Granted this is an opinion piece but this has been my position all along. Will be interesting to see what the end result of this. Glad to see this was published in WSJ.

 

Yes, your opinion is that, let's say, 6 million were infected as of March 9th. If the infection rate doubles every 3 days, there should be 200 million infected. And by Friday, every single person in the US will be infected.

 

The problem is that no evidence supports this opinion.

 

I guess better then your opinion that I was adding zero value by assuming there were way more infections then thought? I believe I said hundreds of thousands/millions fuck me for not zeroing it in with all of my up to the minute tests. How about your 3000 people tested 100 infections in Ontario or whatever that was you posted. I was right in theory, but you my friend were completely wrong with your opinion. Still bothers you huh? ;D