Coronavirus

KCLarkin · May 29, 2020

I am aware. This was already discussed upthread.

My point is the complete lack of "data" to support these estimates. Presumably, the CDC used published research to arrive at these estimates. But they didn't share the sources. Are they relying on deeply flawed serology studies?

Edit: Here the National Review asks a similar question:

https://www.nationalreview.com/corner/why-does-the-cdc-think-the-covid-19-fatality-rate-is-so-low-and-why-wont-it-tell-anyone/

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P.s. I choose not to go down this particular rabbit hole, but there is some indication of political interference. Like many Trump appointees, the CDC director is controversial:

"His nomination was considered controversial, and was opposed by the Center for Science in the Public Interest, which cited Redfield's lack of experience administering a public health agency, his history of scientific misconduct, and his religious advocacy in response to a public health crisis." -- Wikipedia

cwericb · May 29, 2020

“We talk about the VOVID-19 in the US a lot, but what is going on in Canada?”

Prince Edward Island - Canada’s smallest but most densely populated province.

Population: 160,000

Tourist visits yearly: 1,600,000

Locked down: Mid-March.

Total cases of COVID-19: 27

Total community spread: 0

Cases due to International travel: 27

Total hospitalized: 0

Total Deaths: 0

Total recovered: 27

Last positive case: April 28

Fine for not self isolating 14 days:

1st offense: $1,000

2nd offense: $2,000

3rd offense: $10,000

Applying U.S. figures would have predicted about 50 deaths. (If my math is correct)

ERICOPOLY · May 29, 2020

Because you ask:

https://www.msnbc.com/morning-joe/watch/anger-erupts-in-wake-of-george-floyd-s-death-84072005745

cubsfan · May 29, 2020

I just love this President:

https://www.nationalreview.com/news/trump-announces-u-s-terminating-relationship-with-world-health-organization/

Trump Announces U.S. ‘Terminating’ Relationship with World Health Organization

ERICOPOLY · May 29, 2020

I'm taking my ball and I'm going home because you won't play the game I want to play.

Gregmal · May 29, 2020

One of those sentences is a factual unbiased statement, the other is an opinion with a partisan narrative behind it. Yay news!

ERICOPOLY · May 29, 2020

I applied his narrative for cutting the funding to the WHO, which ties into his own words today: "Because they have failed to make the requested and greatly needed reforms"

Meanwhile Trump did not join with Australia and Europe to pressure the WHO to investigate China. Trump did not stick around to see that effort out, he put spin on it and pulled out. In other words, he wants the WHO to do what he demands instead of having an actual investigation into China. They would not play the game that he demanded they play, so he took his ball and went home.

Spekulatius · May 29, 2020

That’s going to show China. Soon they will be running the outfit. The US saves $550M or roughly $1.3 per head.

Read the Footnotes · May 29, 2020

Nature abhors a vacuum. That's what we learned the last time we tried isolationism. It doesn't seem to be going very well this time either.

rb · May 29, 2020

That's just a tad more than what the Bill and Melinda Gates Foundation spends on the WHO.

Spekulatius · May 30, 2020

Isolation doesn’t real work with pandemics. It is one thing where an ounce of prevention saves you a pound of cure quite literally. The WHO and China needs to be held accountable and China’s influence on this organization needs to be diminished, such that we can minimize the risk of a repeat.

The WHO has done great work and helped contain Ebola and SARS and perhaps other diseases. Saving $550M while we are spending 5 Trillion right now to help cope with the existing situation makes no sense if you think about risk rewards ratios.

Read the Footnotes · May 30, 2020

I meant isolationism as a failed political theory that Trump has pursued more broadly throughout his presidency. Withdrawing from international politics does not make international politics go away, it just means that you no longer have a seat at the table.

Each time Trump has gotten his feelings hurt and taken his toys and gone home, China or Russia has filled the void created by the USA's absence. This situation with the WHO will likely lead to a strengthening of Chinese leadership and a lessening of US leadership.

Goodwill for the USA's CDC (and other medical branches) that was built up over decades has been destroyed very rapidly and would be very expensive to try to replicate from scratch.

The withdrawal from the Trans Pacific Partnership is an interesting analogue since many believe the TPP would have increased US influence and decreased the influence of China. For some reason, Trump wanted to walk away from that too. He sure does seem to enjoy Chinese visitors at Mara Lago. Maybe we will find out the truth about that situation some day.

meiroy · May 30, 2020

1. This is not a natural system, it is man-made, but if you wish, the lack of leadership can be replaced with chaos or conflict. It is not necessarily going to be filled by anyone else, for the simple fact:

2. This leadership (military, reserve currency, funding entities etc.) comes with a great cost which so far has been borne mostly by the USA. Trump is right in asking others to pay for their share. The American household contribution to the world and its support of various economies has been taken for granted for far too long.

A reminder: the country with the highest current account surplus in the world is Germany. By far. Germa elite/businesses have greatly benefited and are the ones responsible for a lot of negative economic impact on USA and European households. Time to pay.

Investor20 · May 30, 2020

How can WHO be useful in containing the pandemic while they still showing this guideline:

If you are healthy, you only need to wear a mask if you are taking care of a person with COVID-19.

Wear a mask if you are coughing or sneezing.

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks

LC · May 30, 2020

The power of deregulation:

Years before the nation's nursing homes experienced a heavy COVID-19 death toll, the Trump administration rolled back the federal rules and regulations put in place by the Obama administration aimed at improving infection control in these kinds of facilities.

https://www.salon.com/2020/05/30/by-undoing-obamas-nursing-home-regulations-trump-opened-the-door-for-the-deaths-were-seeing/

Spekulatius · May 31, 2020

Pretty good summary of COVID-19 from a medical POV.

https://www.bbc.com/news/52760992

clutch · June 1, 2020

Who knew a violent protest would come after a Coronavirus lockdown... and not because of the lockdown.

With protestors wearing masks, of course.

2020 has been truly absurd.

alpha · June 1, 2020

Even Elton John is hurting, to the tune of 75mil: https://canoe.com/entertainment/celebrity/elton-john-lays-off-band-after-losing-us75-million-due-to-cancelled-tour

DooDiligence · June 1, 2020

That stinks.

He's a brilliant composer / performer & is worth every penny he's ever made.

Coincidentally, I started learning Don't Let the Sun Go Down on Me last week & had already cued up Rocket Man, Country Comfort, Border Song & Take Me to the Pilot, which officially makes June Elton John month in my house.

---

On another note (pun intended) I recently watched a documentary called "Hired Guns" which talks about supporting pop/rock musicians & the slivers they get paid in comparison to the branded stars. I hope his long standing band mates are financially prepared.

---

Back to the virus...

Cigarbutt · June 2, 2020

^The trajectory of this thread and the course of human effects signal dwindling interest which is too bad in a way because we shouldn't let the sun go down on the virus as interesting data continues to come in and this is the time when beginnings of answers can be formulated for many important questions. There has been a lot of noise.

Take the chloroquine issue. At first, the medication was heavily recommended with limited data and limited conceptual support and, at some point along the way and during good quality trials, the Lancet publishes a "warning" article (relatively poor method and limited validity) and the medication is declared dangerous, ending several trials prematurely. Disclosure: chloroquine is unlikely to be beneficial but this remains a position based on present knowledge and this interim conclusion could be changed.

When a company is affected by (or reports) an unexpected event, the actual price action often has little correlation with the real intrinsic effect on value. It typically takes a while for a more correlated pattern between price and value. When CV started to spread, there was a lot of uncertainty (not necessarily an excuse for poor policy). From January to March 2020, 1,741 COVID-19 focused articles were published across 59 countries and in 447 journals with unusual short times to publication and often a truncated peer review. Somebody came up with a flattened curve infodemic concept with two waves of data. A point has been reached where the proportion of solid data will be higher. If interested:

Looking at the picture for 5 to 10 seconds is probably sufficient.

This noise vs signal issue is also found on this Board (IMO). i've been spending time in various threads (historical) {Thank you Sanjeev} and the threads tend to show a pattern where posts with the most "impact" are found in a pattern of spaced (in time) exchanges. There seems to be a lot of noise when discussions are densely packed?

Anyways, there's a reference that proposes an acronym that helps to define (validate) an 'expert':

Transparency about conflicts of interest

Resume that supports expertise

Use of high-quality data to support opinions

Strength and reputation of affiliations

Testimonials from other respected experts in relevant field

clutch · June 2, 2020

^ interesting observation. Especially regarding the dwindling interest. Sort of shows you the significant effect the media has on people's current focus/interest, even with supposedly highly intellectual people we have on this board. As the racial issue and the protest occupy the people's news feed, both the interest and the fear of COVID-19 seem to have faded away.

Reminds me of what Johan Giesecke, the Swedish epidemiologist, said in one of his interviews... "We won't learn anything from this pandemic... we will forget about this [again]." Such is human nature, unfortunately.

Spekulatius · June 2, 2020

First time I hear the term infodemic but it rings very true.

Jut went though a pretty good article (in German) about Sweden. Some folks in twitter seem to believe that Sweden is the model for how to deal with en epidemic and it is true - Sweden so far has avoided shutdowns and hasn’t really descended into a disaster like Italy or NYC.

However, looking at what actually is happening there, it is obvious that the Swedes did show restraint that is on par what happened in other countries in Europe simply based on recommendation from the government. While this is great, it is not clear to me that the same would have worked anywhere else in Europe, much less on the US.

Second, economy (Based on forecasts) is actually not doing better than in other countries in Europe. Actually, if you accept the above, then it’s not really a surprise either. Below charts show two different graphics - GDP forecast for 2020 and google cell data for presence at work. Basically the data for both for Swedes is middle of the pack, which means that the Swedes have done what others European countries did just based on their government recommendations.

https://www.spiegel.de/politik/ausland/corona-krise-schwedens-sonderweg-eine-zwischenbilanz-in-zahlen-a-c7b3cea2-63be-4072-8df9-afdb765afb54

As to whether the same nudging has a chance of working in the US, we can draw our own conclusion.

clutch · June 2, 2020

+1

Americans should blame themselves (as individuals) first and foremost.

Investor20 · June 2, 2020

The sad thing about Hydroxychloroquine is the doses and patients proposed to be treated by the proponents were never properly tested in a randomized blinded studies.

But for virus which is non-living, and hence cannot be killed unlike bacteria, one would expect it to work when given early before it replicated and spread through the body.

Here is a new study that is supporting this:

https://www.indiatoday.in/india/story/4-hydroxychloroquine-hcq-doses-coronavirus-healthcare-workers-icmr-1684112-2020-06-01

The National Task Force for coronavirus in India recommended once a week maintenance dose for seven weeks i.e., 400 mg once every week, following the loading dose of 400 mg. Adherence to this recommended regimen is underlined by the findings of the study, researchers said.

Scientists who co-authored the study said, "It has been noticed that 4th week onwards there is a risk reduction of contracting the Covid-19 virus if the maintenance dosage is being taken as prescribed for seven weeks. Of course, this doesn't rule out the risk minimisation of those frontline workers who are treating Covid-19 patients while wearing PPEs and taking further precautions."

CDC recommended prophylactic dose for malaria:

Both adults and children should take one dose of hydroxychloroquine per week starting at least 1 week before traveling to the area where malaria transmission occurs. They should take one dose per week while there, and for 4 consecutive weeks after leaving.

The weekly dosage for adults is 310mg base (400mg salt).

How long is it safe to usehydroxychloroquine?

CDC has no limits on the use of hydroxychloroquine for the prevention of malaria. When hydroxychloroquine is used at higher doses for many years, a rare eye condition called retinopathy has occurred. People who take hydroxychloroquine for more than five years should get regular eye exams.

https://www.cdc.gov/malaria/resources/pdf/fsp/drugs/Hydroxychloroquine.pdf

Comparison with Lancet study:

The Lancet study of nearly 100,000 coronavirus patients had shown no benefit in treating them with anti-viral drugs hydroxychloroquine and chloroquine and even increased the likelihood of them dying in hospital.

"This apparent disparity with the findings of the current investigation could be explained by the two different application contexts. While the observational study involving registry-analysis focussed on the treatment of hospitalised COVID-19 patients, our emphasis was on the prevention of infections among healthcare workers. In treatment settings, severe COVID-19 patients are likely to have a very high viral load and cytokine levels, which may not be improved by HCQ therapy," the study said.

"Biologically, it appears plausible that HCQ prophylaxis may inhibit the virus from gaining a foothold," the study said. In the absence of clinical trial results on safety and efficacy of HCQ chemoprophylaxis in healthcare workers, this study offers evidence of public health importance.

https://www.news18.com/news/india/icmr-says-hcq-reducing-risk-among-healthcare-workers-even-as-lancet-study-questions-drug-benefits-2647007.html

How effective HCQ is in prophylactic use:

Fifty % of those not on HCQ tested positive and upto 70% of those who’d taken a weekly dose of 400 mg of HCQ for three week tested positive. However, only 40% of those who’d taken 4-5 doses tested positive and—only 10% of those on the drug for six weeks or more reported testing positive.

https://www.thehindu.com/news/national/coronavirus-hydroxychloroquine-with-ppe-reduces-odds-of-covid-19-in-health-workers-icmr-researchers/article31724680.ece

Cigarbutt · June 2, 2020

Sweden is interesting on many levels. Yes, the social measures have been applied, in practice, to similar degrees (despite the first level impression) but there are differences. For instance, daycares and schools (age 16 and under) have remained open. Potential bias: the house is full now and i may overestimate the downside to school closures...They have reported higher numbers in relation to a slightly different application of measures but it is interesting to note that this appears to be a (collective) decision made consciously and with a fair degree of consensus. Also, it appears that keeping schools open may have been a good decision because there is good evidence showing that 1-young individuals don't tend to become COVID+ even with exposure which may be related to a relative absence of receptors (specific to entry of CV) on the surface of cells of their respiratory tracts, 2-even when COVID+, young people tend not to become sick and 3-asymptomatic COVID+ kids don't seem to spread very well (for example, there's this reported case of a young (European) person who turned out to be both influenza+ and CV+, who happened to travel places and the person was quite efficient at spreading the flu but not CV).

Sweden shows the potential inter-geography outcomes from different application of measures but there's also the inter-temporal differential outcomes. The 1957 flu in the US occurred in waves (two or three in 1957-8, also came back (maybe a new virus) significantly in 1968). In 1957-8, the US population was about half of what it is now and the estimated excess mortality (numbers vary) came to about 100K for the 1957-8 period and the mortality included younger age groups. At that time, the President and the people were different:

From 1957 (before the fall wave and the vaccine came around the first peak):

"In addition to the steps mentioned above [vaccine distribution related], President Eisenhower has asked for a $500,000 special appropriation from Congress (raised by Congress to $800,000), as well as for authority to transfer about $2,000,000 of public health funds for use in the event of a widespread outbreak. Specifically, the additional $800,000 would be used to develop diagnostic sera to detect the disease, prepare educational material to encourage the use of the vaccine, and to make 10 specialists in epidemic control available for work with state authorities."

Then, the US demographic profile was different and so were the relative absence of comorbidities as well as some cultural differences perhaps.

i guess it's reasonable to affirm that we have improved in some areas but this very statement paints an incomplete picture.

In 1958 (year 2 of the partnerships era), Mr. Buffett was investing in the Sanborn Map Company but he felt that the market was expensive.

Coronavirus

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