arcube Posted April 9, 2020 Share Posted April 9, 2020 I still think it pays to be humble given the unknowns. There is a lot we still don't understand. Why are these guys wasting their time. Very subtle. Link to comment Share on other sites More sharing options...
Liberty Posted April 9, 2020 Share Posted April 9, 2020 https://old.reddit.com/r/dataisbeautiful/comments/fxoxti/coronavirus_deaths_vs_other_epidemics_from_day_of/ Day 1 to 100 of various epidemics from the past 20 years. Link to comment Share on other sites More sharing options...
cubsfan Posted April 9, 2020 Share Posted April 9, 2020 https://www.dailywire.com/news/nyt-calls-out-de-blasio-cuomo-for-coronavirus-failures-readers-thanks-for-finally-saying-something NYT Calls Out De Blasio, Cuomo For Coronavirus Failures; Readers: Thanks For Finally Saying Something My gosh, this just can't be - must be fake news - not Cuomo! Link to comment Share on other sites More sharing options...
Dalal.Holdings Posted April 9, 2020 Share Posted April 9, 2020 https://www.dailywire.com/news/nyt-calls-out-de-blasio-cuomo-for-coronavirus-failures-readers-thanks-for-finally-saying-something NYT Calls Out De Blasio, Cuomo For Coronavirus Failures; Readers: Thanks For Finally Saying Something My gosh, this just can't be - must be fake news - not Cuomo! “Omg the libtards actually hold their own leaders accountable for their shortcomings...wonder what that’s like...” Maybe Cuomo will start trying to pass the buck to WHO or a NYC councilman in Queens... Glad the NYT doesn’t emulate the Hannity model of “journalism”... Link to comment Share on other sites More sharing options...
Spekulatius Posted April 9, 2020 Share Posted April 9, 2020 I dont think there is enough understanding to answer affirmatively. But it is possible if most of the infections are caused in close proximity in closed environments. Regarding microdroplets transmission in enclosed environments, the Chinese turned off all air circulation systems during the quarantine in buildings. Likely due to experiences with SARS. Link to comment Share on other sites More sharing options...
Castanza Posted April 9, 2020 Share Posted April 9, 2020 I dont think there is enough understanding to answer affirmatively. But it is possible if most of the infections are caused in close proximity in closed environments. Regarding microdroplets transmission in enclosed environments, the Chinese turned off all air circulation systems during the quarantine in buildings. Likely due to experiences with SARS. Do that during warm weather and your sure to end up with millions of dollars tied up in mold damage. My hometown built a new HS and to save costs they turned off the HVAC systems over the summer because the building wasn’t in use. Well when school came around they weren’t to happy to see their brand new building filled with mold costing hundreds of thousands of dollars to treat while also pretty much guaranteeing more issues down the line. Investment angle? Idk perhaps a lot of these commercial office space companies will likewise implement similar measures to cut costs unwillingly knowing what they’re doing. Link to comment Share on other sites More sharing options...
cubsfan Posted April 9, 2020 Share Posted April 9, 2020 https://www.mercurynews.com/2020/04/04/coronavirus-new-stanford-research-reveals-if-youve-been-exposed/ The 2,500 test slots on Friday and Saturday filled up within hours, as news of the project — the first large scale study of its type in the U.S. — spread quickly through the county. The test detects protective antibodies to the virus rather than the virus itself. This gives scientists a snapshot of how many people in the county have already been infected, but weren’t seriously sick and didn’t realize it. And it tells residents whether they carry potentially protective antibodies – so may be immune to future infection. “This is critical information,” said principal investigator Dr. Eran Bendavid, an infectious disease specialist and professor of medicine with Stanford Health Policy. Link to comment Share on other sites More sharing options...
cubsfan Posted April 9, 2020 Share Posted April 9, 2020 https://www.mercurynews.com/2020/04/09/jobless-claims-top-6-million-united-states-coronavirus-batters-economy-tech-retail-restaurant-hotel-supermarket/ 1 in 9 California workers have filed for unemployment as coronavirus batters state’s economy Link to comment Share on other sites More sharing options...
zippy1 Posted April 9, 2020 Share Posted April 9, 2020 1) There was no exponential growth in India before shutdown. Hardly 1-2 deaths a day till March 22nd. In fact on March 21st its ZERO deaths. The exponential growth came after shutdown - I didn't know that is the purpose of shutdown. So you're saying that the shutdown caused exponential growth of deaths? Like, your expectation would be if you isolate people into groups of 4 and never let them have any sort of contact with any other group, your death rate from COVID-19 would be higher than allowing everyone to intermix to their heart's content? Huh. That's kind of a strange theory, but OK. "When you put in the lockdown, it seems like it's about 2 weeks until cases fall" -2.5 weeks later zero deaths on March 21st came to about 24 deaths on April 07th 3, 4, 5 are irrelavant to India as the absolute cases are small for a country of billion+ people. Yeah, I included those in there because I thought you wanted an explanation of when deaths should be decreasing, not to discredit your "quarantining causes order-of-magnitude spikes in COVID-19 deaths" theory. My mistake. I dont have any theory. I dont think there is enough information to make a theoretical model. Empirically the theory YOU proposed doesnt match the data at hand. In India the exponential growth started after lockdown. Thats not a theory. Thats data. Also, the deaths all of South East Asia are low where there were no lockdowns till now. Thats not a theory.. Not a model. Thats data. That sure sounds like a logical cry you are making - Yes that is DATA. In itself it is useless, and has to be interpreted in some manner within a context. You keep talking about South East Asia - What countries are you counting in those? Eventhough not separate country, Hongkong, and then Taiwan, Japan, Malaysia, Singapore. There were a bunch of articles about Taiwan how well they managed. And they didnt have shutdown. Ok let's assume they have managed it, tell us please how they managed it and at what stage. And let's say that we were too late to manage it the way they managed, what were the options left for us? Regarding Taiwan there were many articles recently. I posted earlier a bloomberg article: https://www.bloomberg.com/opinion/articles/2020-04-05/taiwan-s-advance-on-who-in-covid-19-shows-its-place-in-world Two points given in this article are 1) Early travel restriction from Wuhan and then China. 2) Early implementation of masks, in January itself. As per worldometer the tests/million for Taiwan ~1700 US ~6500 S.Korea ~9300 Italy ~13000 So, it doesnt seem Taiwan did a lot of tests. But as per reports they did have early travel restrictions along with strict quarantine for visitors. "Like, your expectation would be if you isolate people into groups of 4 and never let them have any sort of contact with any other group, your death rate from COVID-19 would be higher than allowing everyone to intermix to their heart's content?" I dont think there is enough understanding to answer affirmatively. But it is possible if most of the infections are caused in close proximity in closed environments. There are articles talking about dangers of bringing home young adults from colleges who may be asymptomatic carriers and put them in homes with grandparents. Also when people are out, there is automatically more distancing than people are restricted inside, especially in small homes. To the level aerosol microdroplet transmission is possible, closed environments will be worse. Please watch this video about microdroplets https://www.youtube.com/watch?v=H2azcn7MqOU As given in that video, masks would help with microdroplet transmission. Again, I dont think theoretically its easy to come up with answers. What I am trying to do is look at it empirically. There are other possible contributing factors that may have helped Taiwan in this crisis. I am not sure whether they will help US or Canada at this stage of crisis or not. Nevertheless, let me put them down as they may be useful for future crises. 1. It has universal BCG vaccination. Before 1973, it used French strain (Pasteur). After 1973, it used the local Tokyo strain. 2. The societal acceptance for social distancing is high. Part of this was cultural. In our culture, hugging people and kissing people on the cheek are not normally done. Part of this was from the experience of SARS. So people stopped shaking hands but greets people by holding two hands together 3. Even though there is no lock-down, people do have to adopt. a. many industrial companies in Hsinchu Science park organized workers in TeamA/TeamB and physically separate these teams to reduce face-to-face interaction. b. restaurants do see big drop off in traffic c. people reduce going out. However, when they do go out they drive instead of use public transportation 4. Taiwan increased its mask production from 1.8 million/day in January to current 15million/day. The projection is that by end of April, the number will reach 20 million per day. Government reached a "equipment for mask" deal with the mask making industry. The deal is that the government would invest US $6.7million to buy the production equipment. The companies then install these in their factory and in return need to give the government 72million masks. Afterwards, the companies own the equipment outright. This really is not a big investment, to be frank..... This is the reason why the Taiwanese government can donate 16 million masks to US, EU and other of its allies. 5. its geography does allow it to use border control to contain the outbreak. However, throughout the crisis, Taiwan maintains flight with US, EU, China (except Wuhan and Wenzhou), Japan and other countries. So this is not a case of just shutdown the flights. The devil is in the details. Below is a PBS video showing a Taiwanese lady returning from London. I was told by friends that US and Canada did not utilize such procedures for their people returning from abroad. https://www.pbs.org/newshour/show/taiwans-aggressive-efforts-are-paying-off-in-fight-against-covid-19 Yesterday afternoon, the daily new COVID case count dropped to 1, which is a piece of good news. Link to comment Share on other sites More sharing options...
vinod1 Posted April 9, 2020 Share Posted April 9, 2020 The vice president of Taiwan is a Johns Hopkins trained epidemiologist. https://en.wikipedia.org/wiki/Chen_Chien-jen#Early_and_personal_life Vinod Link to comment Share on other sites More sharing options...
Liberty Posted April 9, 2020 Share Posted April 9, 2020 https://www.dailywire.com/news/nyt-calls-out-de-blasio-cuomo-for-coronavirus-failures-readers-thanks-for-finally-saying-something NYT Calls Out De Blasio, Cuomo For Coronavirus Failures; Readers: Thanks For Finally Saying Something My gosh, this just can't be - must be fake news - not Cuomo! “Omg the libtards actually hold their own leaders accountable for their shortcomings...wonder what that’s like...” Maybe Cuomo will start trying to pass the buck to WHO or a NYC councilman in Queens... Glad the NYT doesn’t emulate the Hannity model of “journalism”... Ha! Some people have ZERO self-awareness. They've been holding double standards for so long that they forget how transparent it looks to the rest of us. Link to comment Share on other sites More sharing options...
cubsfan Posted April 9, 2020 Share Posted April 9, 2020 https://www.dailywire.com/news/tests-might-explain-lower-virus-numbers-in-ca-hit-earlier-than-suspected Researchers are testing a theory that the coronavirus COVID-19 may have arrived in California much earlier than suspected, and thus the state’s lower number of cases compared to elsewhere in the nation may be due to a kind of herd community. Hard to explain the difference between NY and CA - California has 2X the population of NY, yet NY has 13X the deaths from COVID-19. California was supposed to be an epicenter given the largest population of Chinese in America - and the most Asian travelers from China. If California were it's own country - it would rank much lower than Germany, which is a supposed success story. California is 1/2 the death rate of Germany. So what explains the difference NY and CA? Certainly, not density - as San Franscio, Santa Clara and LA are jam packed with people? In Fresno county with 1.2M people, there is only 1 death. This article suggests perhaps herd immunity. There is a lot we still don't understand. There is no way this is possible. A couple people here told me so. Cant wait to see those antibody tests. Hopefully for everyone this speeds the timeline to herd immunity up. Two ideas that I still cant bring together are 1. The virus is very contagious, 2. A low level of the population has been exposed. Looking at normal flu year and the number of people that become infected compared to a virus like this that is "much more contagious" it doesn't make sense at first glance. I dont posit flu based on deaths but means of spread via sneezing, coughing, close contact etc. Flu Luckily we have a known benchmark, the 2018-2019 flu season with 35.5 million cases, wide spread testing and a cheap available vaccine given. https://www.cdc.gov/flu/about/burden/2018-2019.html 160ish million flu vaccines given in 2019 (not sure of efficacy for argument sake assume 50% so you protecting 80 million people from spreading it once exposed via respitory mechanisms) https://www.cdc.gov/flu/fluvaxview/coverage-1819estimates.htm Flu season running from November peaking in Jan and out to March/April. Partial/Inherited immunity Corona First cases in a country with daily flights to US in mid November, lockdown from said country 2.5 months later, widespread lock down mid march. Point is plenty of time for unfettered spread into the country at major international airports across the entire US. No vaccine and no monitoring for months. More contagious then flu, no herd immunity or individual immunity. Suspected very high asymptomatic and mild symptomatic case load contributing to exponential spread while in unoticed incubation period. ___________________________________________________________ That being said we come to the conclusion that the number exposed is very low? I dont get it, and didnt get it from the beginning. How do those 2 statements come together, anyone? 10% of the population definitively gets the flu with 50% of the nation vaccinated but only 1-5% has Corona now? Idk. :o Yes, quite difficult to comprehend. Link to comment Share on other sites More sharing options...
mcliu Posted April 9, 2020 Share Posted April 9, 2020 The vice president of Taiwan is a Johns Hopkins trained epidemiologist. https://en.wikipedia.org/wiki/Chen_Chien-jen#Early_and_personal_life Vinod Also don’t forget deep mistrust of PRC and better on the ground intelligence for govt and population (same language) Less reliant on WHO. Link to comment Share on other sites More sharing options...
Liberty Posted April 9, 2020 Share Posted April 9, 2020 There is no way this is possible. A couple people here told me so. Cant wait to see those antibody tests. Hopefully for everyone this speeds the timeline to herd immunity up. Two ideas that I still cant bring together are 1. The virus is very contagious, 2. A low level of the population has been exposed. Looking at normal flu year and the number of people that become infected compared to a virus like this that is "much more contagious" it doesn't make sense at first glance. I dont posit flu based on deaths but means of spread via sneezing, coughing, close contact etc. Flu Luckily we have a known benchmark, the 2018-2019 flu season with 35.5 million cases, wide spread testing and a cheap available vaccine given. https://www.cdc.gov/flu/about/burden/2018-2019.html 160ish million flu vaccines given in 2019 (not sure of efficacy for argument sake assume 50% so you protecting 80 million people from spreading it once exposed via respitory mechanisms) https://www.cdc.gov/flu/fluvaxview/coverage-1819estimates.htm Flu season running from November peaking in Jan and out to March/April. Partial/Inherited immunity Corona First cases in a country with daily flights to US in mid November, lockdown from said country 2.5 months later, widespread lock down mid march. Point is plenty of time for unfettered spread into the country at major international airports across the entire US. No vaccine and no monitoring for months. More contagious then flu, no herd immunity or individual immunity. Suspected very high asymptomatic and mild symptomatic case load contributing to exponential spread while in unoticed incubation period. ___________________________________________________________ That being said we come to the conclusion that the number exposed is very low? I dont get it, and didnt get it from the beginning. How do those 2 statements come together, anyone? 10% of the population definitively gets the flu with 50% of the nation vaccinated but only 1-5% has Corona now? Idk. :o Some stuff that comes to mind immediately reading this: We know what COVID19 from Sars-COV-2 looks like, right? If we started getting infections in November and in the interim had had millions and millions of infections, in such a scenario, why did nobody notice clusters of anomalous multi-day fevers, pneumonias and deaths, especially in older populations? X-rays and CT scans showing glass opacities? Why nothing until the WA infection clusters and such? Why hasn't healthcare system been sounding the alarm much sooner? And would all other countries also have not noticed? South-Korea and the US had their first cases at the same time (showing how much different they've handled it), were they both fooled by the virus for months and just happened to notice at the same time? Infections started in November in China, but at that point the number was so small for a country of 1bn+, what are the chances that infected people happened to travel on a plane to the US? If this started in November, then China would still be ahead on getting herd immunity, right? And if this thing was so asymptomatic, then the whole country would've gotten it before they could've locked down Wuhan, right? Much easier to move around China than to fly across the world to the US. Yet why hasn't the rest of the country seen the Wuhan experience replicated everywhere with fevers and pneumonias and deaths? Is China that good at hiding it around the country with lots of western companies watching locally and people on VPNs able to leak info? And why did things only start in Wuhan that late if the R0 is high enough for infection to proceed as fast as you theorize? Coronavirus isn't the influenza. The influenza has a way of mutating and evading vaccines that the coronavirus isn't known for, so trying to compare flu shot effectiveness to theoretical corona herd immunity doesn't work. Seems like the facts on the ground don't line up with your theory. i think there's clearly a lot more people infected than people who got tested positive, that's not controversial at all. Experts have various estimates, I've seen 10x, 30x.. But to think that the number is 100x or 200x over many months and nobody has noticed sounds implausible. Early serum tests seem to show low single digit positives, but time will tell. And trust me, I really want to believe that this is way more asymptomatic and that we're way closer to herd immunity than it seems. That would be AMAZING. But the data doesn't show that, afaict. Also, guessing this will be one of Time's photos of the year, or it should be: Link to comment Share on other sites More sharing options...
cubsfan Posted April 9, 2020 Share Posted April 9, 2020 California had a bad flu outbreak last fall - any chance it was missing COVID19 instead? https://patch.com/california/pacificpalisades/early-flu-deaths-hint-nasty-flu-season-california https://www.forbes.com/sites/brucelee/2019/12/04/flu-is-now-widespread-in-10-states-including-california-texas-alabama/#3dd6c30949a4 https://www.latimes.com/local/california/la-me-ln-flu-surge-20180106-htmlstory.html Link to comment Share on other sites More sharing options...
Liberty Posted April 9, 2020 Share Posted April 9, 2020 California had a bad flu outbreak last fall - any chance it was missing COVID19 instead? https://patch.com/california/pacificpalisades/early-flu-deaths-hint-nasty-flu-season-california https://www.forbes.com/sites/brucelee/2019/12/04/flu-is-now-widespread-in-10-states-including-california-texas-alabama/#3dd6c30949a4 https://www.latimes.com/local/california/la-me-ln-flu-surge-20180106-htmlstory.html They test for the flu. The disease isn't the same. Why the resurgence now if this was on the loose without any containment measures last fall? This is getting really stupid. Link to comment Share on other sites More sharing options...
orthopa Posted April 9, 2020 Share Posted April 9, 2020 There is no way this is possible. A couple people here told me so. Cant wait to see those antibody tests. Hopefully for everyone this speeds the timeline to herd immunity up. Two ideas that I still cant bring together are 1. The virus is very contagious, 2. A low level of the population has been exposed. Looking at normal flu year and the number of people that become infected compared to a virus like this that is "much more contagious" it doesn't make sense at first glance. I dont posit flu based on deaths but means of spread via sneezing, coughing, close contact etc. Flu Luckily we have a known benchmark, the 2018-2019 flu season with 35.5 million cases, wide spread testing and a cheap available vaccine given. https://www.cdc.gov/flu/about/burden/2018-2019.html 160ish million flu vaccines given in 2019 (not sure of efficacy for argument sake assume 50% so you protecting 80 million people from spreading it once exposed via respitory mechanisms) https://www.cdc.gov/flu/fluvaxview/coverage-1819estimates.htm Flu season running from November peaking in Jan and out to March/April. Partial/Inherited immunity Corona First cases in a country with daily flights to US in mid November, lockdown from said country 2.5 months later, widespread lock down mid march. Point is plenty of time for unfettered spread into the country at major international airports across the entire US. No vaccine and no monitoring for months. More contagious then flu, no herd immunity or individual immunity. Suspected very high asymptomatic and mild symptomatic case load contributing to exponential spread while in unoticed incubation period. ___________________________________________________________ That being said we come to the conclusion that the number exposed is very low? I dont get it, and didnt get it from the beginning. How do those 2 statements come together, anyone? 10% of the population definitively gets the flu with 50% of the nation vaccinated but only 1-5% has Corona now? Idk. :o Some stuff that comes to mind immediately reading this: We know what COVID19 from Sars-COV-2 looks like, right? If we started getting infections in November and in the interim had had millions and millions of infections, in such a scenario, why did nobody notice clusters of anomalous multi-day fevers, pneumonias and deaths, especially in older populations? X-rays and CT scans showing glass opacities? Why nothing until the WA infection clusters and such? Why hasn't healthcare system been sounding the alarm much sooner? And would all other countries also have not noticed? South-Korea and the US had their first cases at the same time (showing how much different they've handled it), were they both fooled by the virus for months and just happened to notice at the same time? Infections started in November in China, but at that point the number was so small for a country of 1bn+, what are the chances that infected people happened to travel on a plane to the US? If this started in November, then China would still be ahead on getting herd immunity, right? And if this thing was so asymptomatic, then the whole country would've gotten it before they could've locked down Wuhan, right? Much easier to move around China than to fly across the world to the US. Yet why hasn't the rest of the country seen the Wuhan experience replicated everywhere with fevers and pneumonias and deaths? Is China that good at hiding it around the country with lots of western companies watching locally and people on VPNs able to leak info? And why did things only start in Wuhan that late if the R0 is high enough for infection to proceed as fast as you theorize? Coronavirus isn't the influenza. The influenza has a way of mutating and evading vaccines that the coronavirus isn't known for, so trying to compare flu shot effectiveness to theoretical corona herd immunity doesn't work. Seems like the facts on the ground don't line up with your theory. i think there's clearly a lot more people infected than people who got tested positive, that's not controversial at all. Experts have various estimates, I've seen 10x, 30x.. But to think that the number is 100x or 200x over many months and nobody has noticed sounds implausible. Early serum tests seem to show low single digit positives, but time will tell. And trust me, I really want to believe that this is way more asymptomatic and that we're way closer to herd immunity than it seems. That would be AMAZING. But the data doesn't show that, afaict. We surely still don't have the answers and as a clinician without a test and symptoms mimicking the flu I think many were blinded by experience and diagnosed such as flu like symptoms and or pneumonia. https://www.scmp.com/news/china/society/article/3076334/coronavirus-strange-pneumonia-seen-lombardy-november-leading There is that, surely anecdotal and at this point unless you dig up the dead bodies who knows. But again in medicine if your not looking for something (ie cant test for it) it can be under your nose and have no idea its there. Exact opposite now FWIW. I don't remember hearing about a strange pneumonia in Italy in November either just like you I'm sure, and look what happened there. I am aware of the ability for the flu to mutate, thus my hypothetical efficacy at 50% which is maybe on the high end of history but a round number so I chose it. :) https://en.wikipedia.org/wiki/Influenza_vaccine Although early this data may change your mind. Will be interesting to follow for sure. https://www.bccourier.com/these-are-the-first-lessons-of-the-heinsberg-study/ These are the first, but already representative interim results: 1) at 15 Percent of the examined Gangelts residents were found to be infected 2)The likelihood of dying from the disease lies in gear at 0.37 percent 3)For comparison: According to the Johns Hopkins University, the lethality in Germany is currently 1.98 Percent – five times higher. Not herd immunity levels but worth following. Link to comment Share on other sites More sharing options...
cubsfan Posted April 9, 2020 Share Posted April 9, 2020 Thanks much Liberty - I'll assume you are correct as usual - and that this Stanford Medical study is a complete waste of time and money. https://www.ksbw.com/article/new-study-investigates-californias-possible-herd-immunity-to-covid-19/32073873 MONTEREY, Calif. — Researchers at Stanford Medicine are working to find out what proportion of Californians have already had COVID-19. The hypothesis that COVID-19 first started spreading in California in the fall of 2019 is one explanation for the state's lower than expected case numbers. As of Tuesday, the state had 374 reported COVID-19 fatalities in a state of 40 million people, compared to New York which has seen 14 times as many fatalities and has a population half that of California. Social distancing could be playing a role but New York's stay-at-home order went into effect on March 22, three days after California implemented its order. Hanson said he thinks it is possible COVID-19 has been spreading among Californians since the fall when doctors reported an early flu season in the state. During that same time, California was welcoming as many as 8,000 Chinese nationals daily into our airports. Some of those visitors even arriving on direct flights from Wuhan, the epicenter of the coronavirus outbreak in China. If Californians were exposed earlier than the rest of the country to COVID-19 we may have had a chance to build up some herd immunity to the disease. We won't know if that is the case until results from the Stanford Medicine study come back. The results of the study could also help us all to feel less scared of COVID-19. Limited testing has resulted in an artificially high death rate. The more people we can test who have mild symptoms, who are asymptomatic or who have recovered the less-lethal COVID-19 will seem. Link to comment Share on other sites More sharing options...
Cigarbutt Posted April 9, 2020 Share Posted April 9, 2020 Additional animated perspective: https://nymag.com/intelligencer/2020/04/the-rapid-increase-of-u-s-coronavirus-deaths-in-one-graphic.html Technical considerations: -The number of CV deaths may plateau or even decline as the NY peak is being passed, with lagging peaks from populous states (Florida, California and Texas) coming next before tapering over the next few weeks. -The other non-traumatic categories are averages and do not take into account a small adjustment (down) as a function of the number of CV deaths that would have been accounted to another cause over a relatively short term period, in the absence of COVID-19. -The accident category is also an average and does not take into account an adjustment (down) as a function of the actual decrease of accidents resulting from public health measures for COVID-19. -the period during which COVID-19 death rates go below suicide rates is a period when it will be suggested to go back to business as usual. Link to comment Share on other sites More sharing options...
Liberty Posted April 9, 2020 Share Posted April 9, 2020 orthopa, none of that is convincing. There are many epidemic tracking units that flag unusual disease activity by tracking statistics across hospitals and clinics around the country (and many countries have them). Even just one doctor noticing a weird pattern in their cases and going to social media or writing an op-ed. Even if it had been missed at the time, it would have surfaced in the past couple months that the whole world has been looking at this from all angles. We know the mortality rate for the flu quite well, and we're seeing what COVID19 does to various age groups.. it would stand out quite clearly. And a study of 509 people in one heavily-affected district of Germany is too little to extrapolate from, I'm afraid. Some places are hit hard while others very little; if you study one of the hard-hit place, it doesn't tell you about what immunity might be elsewhere. Link to comment Share on other sites More sharing options...
Liberty Posted April 9, 2020 Share Posted April 9, 2020 Thanks much Liberty - I'll assume you are correct as usual - and that this Standoff study is a complete waste of time and money. https://www.ksbw.com/article/new-study-investigates-californias-possible-herd-immunity-to-covid-19/32073873 MONTEREY, Calif. — Researchers at Stanford Medicine are working to find out what proportion of Californians have already had COVID-19. The hypothesis that COVID-19 first started spreading in California in the fall of 2019 is one explanation for the state's lower than expected case numbers. As of Tuesday, the state had 374 reported COVID-19 fatalities in a state of 40 million people, compared to New York which has seen 14 times as many fatalities and has a population half that of California. Social distancing could be playing a role but New York's stay-at-home order went into effect on March 22, three days after California implemented its order. Hanson said he thinks it is possible COVID-19 has been spreading among Californians since the fall when doctors reported an early flu season in the state. During that same time, California was welcoming as many as 8,000 Chinese nationals daily into our airports. Some of those visitors even arriving on direct flights from Wuhan, the epicenter of the coronavirus outbreak in China. If Californians were exposed earlier than the rest of the country to COVID-19 we may have had a chance to build up some herd immunity to the disease. We won't know if that is the case until results from the Stanford Medicine study come back. The results of the study could also help us all to feel less scared of COVID-19. Limited testing has resulted in an artificially high death rate. The more people we can test who have mild symptoms, who are asymptomatic or who have recovered the less-lethal COVID-19 will seem. They can study it, but it's probably a waste of time. California isn't some isolated island cut off from the rest of the US, so if it had gotten it last fall, everywhere else would have gotten it. And we're seeing quite clearly on the ground what it looks like when this virus is infecting people, and we weren't seeing that last fall. Link to comment Share on other sites More sharing options...
mcliu Posted April 9, 2020 Share Posted April 9, 2020 @MDs of cobf, Any thoughts or anecdotes on hydroxychloroquine and azithromycin to treat cv? Thanks Link to comment Share on other sites More sharing options...
cubsfan Posted April 9, 2020 Share Posted April 9, 2020 Additional animated perspective: https://nymag.com/intelligencer/2020/04/the-rapid-increase-of-u-s-coronavirus-deaths-in-one-graphic.html excellent graphic! Link to comment Share on other sites More sharing options...
cubsfan Posted April 9, 2020 Share Posted April 9, 2020 There is no way this is possible. A couple people here told me so. Cant wait to see those antibody tests. Hopefully for everyone this speeds the timeline to herd immunity up. Two ideas that I still cant bring together are 1. The virus is very contagious, 2. A low level of the population has been exposed. Looking at normal flu year and the number of people that become infected compared to a virus like this that is "much more contagious" it doesn't make sense at first glance. I dont posit flu based on deaths but means of spread via sneezing, coughing, close contact etc. Flu Luckily we have a known benchmark, the 2018-2019 flu season with 35.5 million cases, wide spread testing and a cheap available vaccine given. https://www.cdc.gov/flu/about/burden/2018-2019.html 160ish million flu vaccines given in 2019 (not sure of efficacy for argument sake assume 50% so you protecting 80 million people from spreading it once exposed via respitory mechanisms) https://www.cdc.gov/flu/fluvaxview/coverage-1819estimates.htm Flu season running from November peaking in Jan and out to March/April. Partial/Inherited immunity Corona First cases in a country with daily flights to US in mid November, lockdown from said country 2.5 months later, widespread lock down mid march. Point is plenty of time for unfettered spread into the country at major international airports across the entire US. No vaccine and no monitoring for months. More contagious then flu, no herd immunity or individual immunity. Suspected very high asymptomatic and mild symptomatic case load contributing to exponential spread while in unoticed incubation period. ___________________________________________________________ That being said we come to the conclusion that the number exposed is very low? I dont get it, and didnt get it from the beginning. How do those 2 statements come together, anyone? 10% of the population definitively gets the flu with 50% of the nation vaccinated but only 1-5% has Corona now? Idk. :o Some stuff that comes to mind immediately reading this: We know what COVID19 from Sars-COV-2 looks like, right? If we started getting infections in November and in the interim had had millions and millions of infections, in such a scenario, why did nobody notice clusters of anomalous multi-day fevers, pneumonias and deaths, especially in older populations? X-rays and CT scans showing glass opacities? Why nothing until the WA infection clusters and such? Why hasn't healthcare system been sounding the alarm much sooner? And would all other countries also have not noticed? South-Korea and the US had their first cases at the same time (showing how much different they've handled it), were they both fooled by the virus for months and just happened to notice at the same time? Infections started in November in China, but at that point the number was so small for a country of 1bn+, what are the chances that infected people happened to travel on a plane to the US? If this started in November, then China would still be ahead on getting herd immunity, right? And if this thing was so asymptomatic, then the whole country would've gotten it before they could've locked down Wuhan, right? Much easier to move around China than to fly across the world to the US. Yet why hasn't the rest of the country seen the Wuhan experience replicated everywhere with fevers and pneumonias and deaths? Is China that good at hiding it around the country with lots of western companies watching locally and people on VPNs able to leak info? And why did things only start in Wuhan that late if the R0 is high enough for infection to proceed as fast as you theorize? Coronavirus isn't the influenza. The influenza has a way of mutating and evading vaccines that the coronavirus isn't known for, so trying to compare flu shot effectiveness to theoretical corona herd immunity doesn't work. Seems like the facts on the ground don't line up with your theory. i think there's clearly a lot more people infected than people who got tested positive, that's not controversial at all. Experts have various estimates, I've seen 10x, 30x.. But to think that the number is 100x or 200x over many months and nobody has noticed sounds implausible. Early serum tests seem to show low single digit positives, but time will tell. And trust me, I really want to believe that this is way more asymptomatic and that we're way closer to herd immunity than it seems. That would be AMAZING. But the data doesn't show that, afaict. We surely still don't have the answers and as a clinician without a test and symptoms mimicking the flu I think many were blinded by experience and diagnosed such as flu like symptoms and or pneumonia. https://www.scmp.com/news/china/society/article/3076334/coronavirus-strange-pneumonia-seen-lombardy-november-leading There is that, surely anecdotal and at this point unless you dig up the dead bodies who knows. But again in medicine if your not looking for something (ie cant test for it) it can be under your nose and have no idea its there. Exact opposite now FWIW. I don't remember hearing about a strange pneumonia in Italy in November either just like you I'm sure, and look what happened there. I am aware of the ability for the flu to mutate, thus my hypothetical efficacy at 50% which is maybe on the high end of history but a round number so I chose it. :) https://en.wikipedia.org/wiki/Influenza_vaccine Although early this data may change your mind. Will be interesting to follow for sure. https://www.bccourier.com/these-are-the-first-lessons-of-the-heinsberg-study/ These are the first, but already representative interim results: 1) at 15 Percent of the examined Gangelts residents were found to be infected 2)The likelihood of dying from the disease lies in gear at 0.37 percent 3)For comparison: According to the Johns Hopkins University, the lethality in Germany is currently 1.98 Percent – five times higher. Not herd immunity levels but worth following. Could be more than anecdotal for Italy: https://rmx.news/article/article/was-coronavirus-already-present-in-italy-during-the-fall Italian researchers are looking at the higher than the usual number of cases of severe pneumonia and flu in Lombardy in the last three months of 2019, as they suspect that the new coronavirus may have spread beyond China earlier than previously thought. Adriano Decarli, an Italian epidemiologist and professor of medical statistics at the University of Milan, said that the number of hospitalized patients with flu and pneumonia in the Milan and Lodi area increased significantly between October and December last year. According to Decarli, compared to previous years, hundreds more such cases appeared in the area at that time https://www.reuters.com/article/us-health-coronavirus-italy-timing/italian-scientists-investigate-possible-earlier-emergence-of-coronavirus-idUSKBN21D2IG He told Reuters he could not give exact figures but “hundreds” more people than usual had been taken to hospital in the last three months of 2019 in those areas - two of Lombardy’s worst hit cities - with pneumonia and flu-like symptoms, and some of those had died. Link to comment Share on other sites More sharing options...
Liberty Posted April 9, 2020 Share Posted April 9, 2020 26-min interview with Bill Gates: Link to comment Share on other sites More sharing options...
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