Coronavirus

[drzola]

Yep with Gates  OnBoard we can solve this maybe?" the age-old problem of “size estimation”…

[vinod1]

What do you think of the concept of Viral Load applied to Covid19? Link below has the detail and if true could explain why some younger people could also be at risk.

 

 

Vinod

[minten]

and if true could explain why some younger people could also be at risk.

 

don't we have pretty solid data from two different continents by now showing us that they aren't (apart from a few isolated exceptions)?

[drzola]

Very important annotation in my current modelling toolkits fyi

 

The WHO cluster survey method, which was originally developed to measure vaccination levels in a stable population, has been used indiscriminately in situations involving forced migration. Different techniques and types of samples need to be considered in crisis situations, so it is important that field staff understand the limitations and potential weaknesses of the various methodologies.

[vinod1]

and if true could explain why some younger people could also be at risk.

 

don't we have pretty solid data from two different continents by now showing us that they aren't (apart from a few isolated exceptions)?

 

Anecdotal, but I have two close relatives both around 40 years of age and with severe symptoms. A family member is a physician specializing in infectious diseases and helping these two relatives. Both are very healthy and with no other medical issues.

 

Vinod

[Spekulatius]

 

What we know for sure is that the government has basically guaranteed a bailout to bridge the gap between pre corona and a return to normalcy. The tricky part, really the only one, is to avoid getting snagged in an investment or business that doesnt have a firm footing on its own, or an ironclad bailout.

 

From another thread, here's a interesting scenario to highlight.

 

Two working parents, one a party/event planner for a reasonable sized corporation. The other a consultant to the energy industry and thus an independent contractor. Both made good money in 2018 and 19. The contractors work dries up and the event planner is laid off. Away goes their health insurance. Away goes their income. Their eligibility for stimulus money is nil because of their previous year income levels. And the contractor cant even file for unemployment....Their only fallback? An rental property in NYC, where the mayor just told tenants to stop paying rent...

 

This is potentially the scenario of a friend of mine, and one that could very easily apply to companies in jeopardized industries as well. (Note to myself and other small cap value investors: think twice or maybe three times before buying that distressed microcap hotel operator with owned real estate at 30% of book)

 

But all in all, the funny money being pumped into the system makes it impossible for stocks to ever get too cheap, for too long a period of time. If nothing else the scarcity and supply demand aspect for HNW and institutional dollars will keep the valuations elevated. More dollars and less assets can really only lead to higher prices.

 

No the government cannot bailout the entire economy. While the headline number of $2T is large, a lot of this is jut loans and liquidity bridges, it has to be paid back. The US economy is ~$22T in size, so $2T is roughly equivalent to one month of GNP. It is too large to bail out. The $2T is just a stopgap measure to prevent dominos from falling. They pro half will still fall, but slower and more controlled.

 

Also as you noted, a lot of folks will fall though the crack, have no health insurance,  might get sick from the virus. How to restart this is going to be a difficult task and a fine line to walk. The Eastern  get back to business date seems quite unrealistic to me, but numbers will dictate what is going to happen. Infection rates need to be way doen in order to open up again and even then, it will partly feel like quarantine. As it imagine a lot of measures still remain in place like no large crowds etc. I think this year you can forget about sports for example. might actually be a golden time for esports - Formula 1 did already an esports race they found quite an audience.

 

Another thing, think about litigation risk. You go to work, get infected though a colleague and go into the ICU. Sue the company and then get a good lawyer who proves that the companies practices were endangering employees, which I I can guarantee  you almost any company does. Examples - Dirty door handles which are not cleaned, no contactless entry possible, no contactless operation of bathrooms, shared microwaves in cafeterias. In litigation friendly America, that’s going to be a feast for lawyers.

[Guest Schwab711]

and if true could explain why some younger people could also be at risk.

 

don't we have pretty solid data from two different continents by now showing us that they aren't (apart from a few isolated exceptions)?

 

It feels like the tone in the thread becomes adversarial at times, so please take this message as merely providing data. In general, it might be useful if we acknowledged each other's opinions instead of making this more of a debate (which I have been quite guilty of).

 

Yes, you are right, elderly folks are far, far more likely to have adverse outcomes. See the table below. As others have pointed out, it's also true that many otherwise healthy young folks may have adverse outcomes.

 

Here's what we know right now for the US:

https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm#T1_down

[Viking]

...Now is the question where do we go from here? The news on the epidemic continues to look grim, but Germany and even Italy have turned the corner, but Spain is getting worse. The economic news will look very grim and even the GFC looks pale to what we are going to be seeing.

 

...Turning the economy back on needs to happen, but how and when?

 

...I my opinion, the implied timeline that by April we turn on the economy and by May or June this is over just isn’t correct.

 

Yes, where we go from here is the million $ question. Three weeks ago looking at China, South Korea, Iran and Italy provided great insight of what was coming to North America. We got confirmation when the cluster was confirmed in Washington State and a week later in New York. The impact of the virus on a country for the first month or so has been fairly predictable.

 

The challenge looking forward is each country has taken rather different approaches to managing the virus. The asian countries have similar strategies built around testing, contact tracing and some social distancing measures. Europe and North America have executed very different strategies built around limited testing (resulting in rampant community transfer) followed by soft or hard lock downs (depending on severity).

 

Looking forward, i can see the asian countries path forward. They have been able to get control of their destiny. Again, it is built around aggressive testing and contact tracing and social distancing; slowly they will be able to find ways to bring more parts of the economy back on line. So my view is the asian countries will see their economies slowly start to grow again, but still slower than is expected. The virus is still present and strict measures will need to be in place, likely until a vaccine is ready (12-18 months?).

 

What is the path forward in Europe and North America? We are still out of control, with no articulated plan to get in control of our destiny. We also will need time to execute said plan. This tells me we are still in the early stages in our battle with this virus. And we are now losing precious time and falling behind asia in the process of recovering from this epidemic. This means it will take us longer for us to re-open our economy up (compared to asia).

 

Another learning from asia is what your economy looks like once you get the virus somewhat under control. It is definitely not V shaped recovery for the economy. Perhaps L For a couple of months with the prospect of U afterwards. if you do a great job of not letting the virus to get re-established. The economy needs time to adapt to a world where the virus is ever-present and trying to break out again.

 

All of the above leads me to the following conclusion: the time it takes to get control of the virus in Europe and North America is going to be much longer than people think. Therefore the economic impact is going to be worse than currently expected. And once we eventually get control of the virus in Europe and North America the ’recovery’ is going to be slower as The virus will still be with us and it will take time for everyone to adjust (people, companies and governments).

[drzola]

Simply tracking see file lol!

 

https://codeload.github.com/COVID19Tracking/covid-tracking-data/zip/master

 

 

[DocSnowball]

...Now is the question where do we go from here? The news on the epidemic continues to look grim, but Germany and even Italy have turned the corner, but Spain is getting worse. The economic news will look very grim and even the GFC looks pale to what we are going to be seeing.

 

...Turning the economy back on needs to happen, but how and when?

 

...I my opinion, the implied timeline that by April we turn on the economy and by May or June this is over just isn’t correct.

 

Yes, where we go from here is the million $ question. Three weeks ago looking at China, South Korea, Iran and Italy provided great insight of what was coming to North America. We got confirmation when the cluster was confirmed in Washington State and a week later in New York. The impact of the virus on a country for the first month or so has been fairly predictable.

 

The challenge looking forward is each country has taken rather different approaches to managing the virus. The asian countries have similar strategies built around testing, contact tracing and some social distancing measures. Europe and North America have executed very different strategies built around limited testing (resulting in rampant community transfer) followed by soft or hard lock downs (depending on severity).

 

Looking forward, i can see the asian countries path forward. They have been able to get control of their destiny. Again, it is built around aggressive testing and contact tracing and social distancing; slowly they will be able to find ways to bring more parts of the economy back on line. So my view is the asian countries will see their economies slowly start to grow again, but still slower than is expected. The virus is still present and strict measures will need to be in place, likely until a vaccine is ready (12-18 months?).

 

What is the path forward in Europe and North America? We are still out of control, with no articulated plan to get in control of our destiny. We also will need time to execute said plan. This tells me we are still in the early stages in our battle with this virus. And we are now losing precious time and falling behind asia in the process of recovering from this epidemic. This means it will take us longer for us to re-open our economy up (compared to asia).

 

Another learning from asia is what your economy looks like once you get the virus somewhat under control. It is definitely not V shaped recovery for the economy. Perhaps L For a couple of months with the prospect of U afterwards. if you do a great job of not letting the virus to get re-established. The economy needs time to adapt to a world where the virus is ever-present and trying to break out again.

 

All of the above leads me to the following conclusion: the time it takes to get control of the virus in Europe and North America is going to be much longer than people think. Therefore the economic impact is going to be worse than currently expected. And once we eventually get control of the virus in Europe and North America the ’recovery’ is going to be slower as The virus will still be with us and it will take time for everyone to adjust (people, companies and governments).

 

+1

First order effects are now obvious. But social distancing has not been done in a systematic manner in the US. NYC is as ongoing disaster; unfortunately the Northeast is seeded now without fully realizing it because of inadequate testing. I think a prolonged phase is not priced into equities, the bounce back isn't making sense in terms of fundamental developments (US is the pandemic epicenter now and will remain for the next month, digest that and reflect if you thought that would be the case two weeks ago). I'm waiting for second order and third order effects to show as this plays our over a longer period of time. 

[minten]

It feels like the tone in the thread becomes adversarial at times, so please take this message as merely providing data. In general, it might be useful if we acknowledged each other's opinions instead of making this more of a debate (which I have been quite guilty of).

 

Good point

 

Yes, you are right, elderly folks are far, far more likely to have adverse outcomes. See the table below. As others have pointed out, it's also true that many otherwise healthy young folks may have adverse outcomes.

 

Here's what we know right now for the US:

https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm#T1_down

 

In my country (~7K cases reported, but very little testing, ~400 deaths) the youngest death is over 60 years old. Average age of death is over 80. But also here younger patients do occasionally get admitted to hospital; they just seem to always survive in the end.  Of course, these stats tell you nothing about possible permanent lung damage etc.

[Dalal.Holdings]

What do you think of the concept of Viral Load applied to Covid19? Link below has the detail and if true could explain why some younger people could also be at risk.

 

 

Vinod

 

Viral load likely matters and probably explains why Dr. Li Wenliang (who was in his 30s and likely exposed to a lot of virus in early days of outbreak) passed away.

 

So...your social distancing isn’t just to protect grandma, but probably you as well.

[orthopa]

and if true could explain why some younger people could also be at risk.

 

don't we have pretty solid data from two different continents by now showing us that they aren't (apart from a few isolated exceptions)?

 

It feels like the tone in the thread becomes adversarial at times, so please take this message as merely providing data. In general, it might be useful if we acknowledged each other's opinions instead of making this more of a debate (which I have been quite guilty of).

 

Yes, you are right, elderly folks are far, far more likely to have adverse outcomes. See the table below. As others have pointed out, it's also true that many otherwise healthy young folks may have adverse outcomes.

 

Here's what we know right now for the US:

https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm#T1_down

 

Not disputing the data the ICU admission criteria I think is self explanatory but I would like to know the admission criteria for the younger populations is/was as well as length of stay/treatment.

[orthopa]

Spain now disconnecting respirators from patients over 65 to give to younger people. Seniors being sedated so they don’t suffer.

 

https://www.rte.ie/news/coronavirus/2020/0323/1124930-medics-on-the-frontline/

 

Spain has nearly 4,000 health workers infected with the coronavirus

 

Almost like this thing follows an order (regions hit later peak later). More holes in the "this has been widespread since January" thesis.

 

Spain becoming the new Italy. My fear is that the U.S. will be a late peaking country (due to it being a late onset country) and right now the focus is on NY/WA, but it has already seeded throughout the nation...  :-\

 

 

Not sure if this is a reliable source, if not throw it in the trash.

 

https://www.newscientist.com/article/2238578-uk-has-enough-intensive-care-units-for-coronavirus-expert-predicts/

 

"His comments come as a team at the University of Oxford released provisional findings of a different model that they say shows that up to half the UK population could already have been infected. The model is based on different assumptions to those of Ferguson and others involved in advising the UK government."

 

UK has 67 million people.

 

There is a link to a FT article about the Oxford Study, but I dont have a subscription for the text.

[orthopa]

Uh oh this is from our boy Fauci. And in the New England Journal of Medicine.

 

https://www.nejm.org/doi/full/10.1056/NEJMe2002387

 

"Either children are less likely to become infected, which would have important epidemiologic implications, or their symptoms were so mild that their infection escaped detection, which has implications for the size of the denominator of total community infections."

 

"If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively."

 

Uh oh, looks like Fauci saying maybe more along the lines of the flu? We will find out once antibody testing comes.

 

 

[orthopa]

Any of those that were predicting exponential deaths in Washington State have an explanation for why the death toll is only at 130 deaths? The first case was there and over 2 months ago to boot. For sure we should be way higher then that by now right? What gives?

[ERICOPOLY]

Uh oh this is from our boy Fauci. And in the New England Journal of Medicine.

 

https://www.nejm.org/doi/full/10.1056/NEJMe2002387

 

"Either children are less likely to become infected, which would have important epidemiologic implications, or their symptoms were so mild that their infection escaped detection, which has implications for the size of the denominator of total community infections."

 

"If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively."

 

Uh oh, looks like Fauci saying maybe more along the lines of the flu? We will find out once antibody testing comes.

 

At the very bottom it reads:

 

This editorial was published on February 28, 2020, at NEJM.org.

 

[Casey]

Any of those that were predicting exponential deaths in Washington State have an explanation for why the death toll is only at 130 deaths? The first case was there and over 2 months ago to boot. For sure we should be way higher then that by now right? What gives?

 

I don't know anything in particular about WAsh numbers, but check this story out.

 

https://www.buzzfeednews.com/article/nidhiprakash/coronavirus-update-dead-covid19-doctors-hospitals

[Liberty]

 

Thread of a couple’s experience with the disease. Young people.

[ERICOPOLY]

Any of those that were predicting exponential deaths in Washington State have an explanation for why the death toll is only at 130 deaths? The first case was there and over 2 months ago to boot. For sure we should be way higher then that by now right? What gives?

 

5% of their known cases are dead.  Higher than average death rate because of the Life Care Center where there were multiple deaths (37).

[Dalal.Holdings]

So the U.S. has now surpassed every single country worldwide in cases (85k, compounded 30% from yesterday's 65k). Despite being among the last places to get this outbreak (yes it is and the thesis that it has infected millions here for months is broken). A tragedy of mismanagement.

 

At this point, a waste of time to argue with those who are using models (to predict something that is already here and has played out around the world), proposing that it has been widespread for a long time, etc. So I will certainly not waste my own time on them.

 

Healthcare system in NYC hitting capacity. The focus has been on NY and WA which are early seeding locations, but LA, Michigan, FL, IL, MA have built up critical numbers/seeding and the hope is that distancing can stop this...also the response in the United States, due to federal gov't/executive branch dropping the ball is patchwork response--some local leaders (Cuomo) are taking it seriously while others are not. It may play out accordingly...

 

 

[Dalal.Holdings]

Any of those that were predicting exponential deaths in Washington State have an explanation for why the death toll is only at 130 deaths? The first case was there and over 2 months ago to boot. For sure we should be way higher then that by now right? What gives?

 

5% of their known cases are dead.

 

And their cases are clearly growing exponentially (see link), but confirmation bias is a helluva drug.

 

https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Washington_(state)

[ERICOPOLY]

Any of those that were predicting exponential deaths in Washington State have an explanation for why the death toll is only at 130 deaths? The first case was there and over 2 months ago to boot. For sure we should be way higher then that by now right? What gives?

 

5% of their known cases are dead.

 

And their cases are clearly growing exponentially (see link), but confirmation bias is a helluva drug.

 

https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Washington_(state)

 

Yes, and it's actually 147 dead (up 13% since Orthopa's 130 was posted).

[Guest cherzeca]

Fascinating interview regarding the link between cell senescence, covid-19 and the efficacy of senolytic drugs like azithromycin (already clinically proved to be safe and off patent): 

[Gregmal]

 

What we know for sure is that the government has basically guaranteed a bailout to bridge the gap between pre corona and a return to normalcy. The tricky part, really the only one, is to avoid getting snagged in an investment or business that doesnt have a firm footing on its own, or an ironclad bailout.

 

From another thread, here's a interesting scenario to highlight.

 

Two working parents, one a party/event planner for a reasonable sized corporation. The other a consultant to the energy industry and thus an independent contractor. Both made good money in 2018 and 19. The contractors work dries up and the event planner is laid off. Away goes their health insurance. Away goes their income. Their eligibility for stimulus money is nil because of their previous year income levels. And the contractor cant even file for unemployment....Their only fallback? An rental property in NYC, where the mayor just told tenants to stop paying rent...

 

This is potentially the scenario of a friend of mine, and one that could very easily apply to companies in jeopardized industries as well. (Note to myself and other small cap value investors: think twice or maybe three times before buying that distressed microcap hotel operator with owned real estate at 30% of book)

 

But all in all, the funny money being pumped into the system makes it impossible for stocks to ever get too cheap, for too long a period of time. If nothing else the scarcity and supply demand aspect for HNW and institutional dollars will keep the valuations elevated. More dollars and less assets can really only lead to higher prices.

 

No the government cannot bailout the entire economy. While the headline number of $2T is large, a lot of this is jut loans and liquidity bridges, it has to be paid back. The US economy is ~$22T in size, so $2T is roughly equivalent to one month of GNP. It is too large to bail out. The $2T is just a stopgap measure to prevent dominos from falling. They pro half will still fall, but slower and more controlled.

 

Also as you noted, a lot of folks will fall though the crack, have no health insurance,  might get sick from the virus. How to restart this is going to be a difficult task and a fine line to walk. The Eastern  get back to business date seems quite unrealistic to me, but numbers will dictate what is going to happen. Infection rates need to be way doen in order to open up again and even then, it will partly feel like quarantine. As it imagine a lot of measures still remain in place like no large crowds etc. I think this year you can forget about sports for example. might actually be a golden time for esports - Formula 1 did already an esports race they found quite an audience.

 

Another thing, think about litigation risk. You go to work, get infected though a colleague and go into the ICU. Sue the company and then get a good lawyer who proves that the companies practices were endangering employees, which I I can guarantee  you almost any company does. Examples - Dirty door handles which are not cleaned, no contactless entry possible, no contactless operation of bathrooms, shared microwaves in cafeterias. In litigation friendly America, that’s going to be a feast for lawyers.

 

The government is and will continue to take measure that down the line, create absolutely massive amounts of inflation.

 

I agree as well re: litigation. A few very well respected lawyers Ive spoke with, including at public firms like Burford, have this entire thing circled and are just waiting to cash checks.