Coronavirus

[jamesmadison]

^In the spirit of balanced analysis and go-forward perspective, the recent rise in US and Sweden "cases" needs to take into account the rising number of tests. Also, it appears (at least in the US) that the median age of people with positive tests has been coming down, which would imply some mitigation for the number of hospitalized and ICU patients to come.

 

However, these adjustments only help slightly given the VERY unusual trend in curves in the US, compared to similar advanced economies and the heterogeneity in results will make it very hard (impossible?) to test and trace effectively. Calculated Risk produces regular updates related to this aspect and the author suggests that 3% rate of positive tests is a relevant threshold. The 3% is not a cause and effect criteria ie a low positive test rate does not cause the caseload to go down, it is associated with it.

https://www.calculatedriskblog.com/2020/06/june-20-covid-19-test-results-most.html

https://www.vox.com/2020/5/28/21270515/coronavirus-covid-reopen-economy-social-distancing-states-map-data

See goal 4.

 

A concerning aspect is that the rate of positive tests has started to go up versus the number of tests done, suggesting community spread to a degree which may become uncomfortable and which may render a "V"-shaped recovery (to previous economic trends) less likely.

 

A question: Why were frail CV+ patients sent back to nursing homes from hospitals?

A possible solution to this difficult question may be to avoid ending up in a situation when the question needs to be asked.

 

Glad you mention the declining age of positives.  I would posit this is directly a function of the type of "targeted" testing now going on.  Lots of employers requiring test prior to returning to work.  Some employers pre-screening with temperature checks.  Negative temps aren't counted in the figures, which distorts the testing results.  You also have examples like this - which should be hard to believe - but there it is.

 

https://twitter.com/boriquagato/status/1274432160682831872

https://twitter.com/boriquagato/status/1274426886194515968

 

Hat tip to the bad cat, once again.

 

[jamesmadison]

After Flu vaccine is given, number of cases of flu go down, not up.

After lockdown did cases go down or up?

 

I find that surprising since the CDC recommends getting the flu vaccine by the end of October each year.  Then the number of flu cases rise afterwards.

 

Because we all know that summer time respiratory diseases go down and winter they go up. Thats why they give flu vaccine in October.

 

Nevertheless.  Cases rising X amount after locking people down does not show that it was ineffective.  For example, let's say one person in my household was just exposed on the morning the lockdown began.  That person doesn't test positive for 10 more days, and then 10 more days after that a couple more people in the household come down with it.  That's 20 days of lockdown and an explosion in cases within my household.

 

Did you just accidentally make a case against lockdowns?  ;)

[jamesmadison]

Reposting a handy guide to keep track of all the ways the data's being salted

 

https://pbs.twimg.com/media/Ea_by3WXQAE0dKE?format=png&name=medium

 

[jamesmadison]

Lol! For some reason, there is a strong "correlation" between whether one favors Trump and their willingness to dismiss the pandemic--the (former politics section Trumper) brigade is out in full force in this thread. Anyone want to run a regression on it? As I said--you get the "analysis" you deserve, CoBF.

 

Here's one for people who are not beyond the level of reading graphs:

 

Nothing to see here folks--just fake news alarmism and another dumb graph! Clearly it's just a blip of a "second wave" for FL, not a surging first wave at all! After all, it's been in the millions since January!

 

And ignore those like me who disappear and then come back to warn like I did in early March. After all, I am focused on cases which in my flawed view are leading indicators of what's to come...Remember, we should ignore cases and focus on hospitalizations and mortality. Clearly mortality is going down when you divide by cases. And of course hospitalizations and mortality are the predictive indicators to look at right now, they are not lagging indicators, amirite? We clearly don't understand what lagging indicator means anyway on here...derp.

 

Also, those claiming it's been here and "millions were infected" and that they saw many patients who had it in January--so strange that it is only surging now in FL in June. Weird--if it was widespread in January, what took so long to get to FL? Top level analysis. Keep it up.

 

Florida seems to be doing just fine

 

 

You really should stop posting positive test case stats.  Absent context, they aren't particularly informative.  We all know that testing rates have increased and there's plenty of other targeting going on that's changing the dynamic.  The massive decline in average age of positive cases is evidence of that.

 

https://pbs.twimg.com/media/EbDdVccUwAAgRvw?format=jpg&name=medium

[KCLarkin]

And please, please stop with the belief in "peer reviewed" journals.  The Lancet and NEJM peer reviewed the crap they recently published on HCL and had to withdraw it within a couple of weeks.  Nowadays, it seems that "peer review" is shorthand for a study that confirms to current orthodoxy.

 

Retracted lancet HCL study is a good example of why publishing in a peer-reviewed journal is valuable. Almost instantly, 150 doctors demanded the Lancet explain how it passed peer review and it was retracted. Sadly, Gato doesn't get the same scrutiny.

 

You do make a good point about selection bias, though. Everyone is trying to publish Covid studies, so they are mostly garbage.

[jamesmadison]

KC: You are way too kind.  The fact that The Lancet published that POS after peer review is not an argument in support of peer review. 

 

Gato's work is being vetted much more thoroughly - the entire internet instead of a bunch of likeminded physicians/scientists who were credulous enough to believe that an entity like Surgisphere would emerge out of thin air with a global data set that would better than anything ever seen in history.   

 

Also, I think this is the guy who got the ball rolling on blowing up The Lancet.  Another twitter nobody like El Gato.

 

 

 

[Investor20]

KC: You are way too kind.  The fact that The Lancet published that POS after peer review is not an argument in support of peer review. 

 

Gato's work is being vetted much more thoroughly - the entire internet instead of a bunch of likeminded physicians/scientists who were credulous enough to believe that an entity like Surgisphere would emerge out of thin air with a global data set that would better than anything ever seen in history.   

 

Also, I think this is the guy who got the ball rolling on blowing up The Lancet.  Another twitter nobody like El Gato.

 

A company with hardly any technical background, with a person with background as Sci Fi writer as scientific expert and another with background as Adult entertainer as director of marketing.

 

But such miniscule details doesn't matter. Its Lancet, peer reviewed and signed off by Harvard professor.

[jamesmadison]

Have people been following the latest HCL disaster to come out of Great Britain?

 

The RECOVERY study.  They administered near fatal doses of HCL to patients.  Apparently, the doctors confused Hydroxychloroquine with hydroxyquinoline.  Oops.

 

 

 

[KCLarkin]

Gato's work is being vetted much more thoroughly - the entire internet

 

You posted his work on this thread. I (and several others) pointed out the obvious flaws. So I consider it vetted. No need to discuss further.

[Investor20]

After Flu vaccine is given, number of cases of flu go down, not up.

After lockdown did cases go down or up?

 

I find that surprising since the CDC recommends getting the flu vaccine by the end of October each year.  Then the number of flu cases rise afterwards.

 

Because we all know that summer time respiratory diseases go down and winter they go up. Thats why they give flu vaccine in October.

 

Nevertheless.  Cases rising X amount after locking people down does not show that it was ineffective.  For example, let's say one person in my household was just exposed on the morning the lockdown began.  That person doesn't test positive for 10 more days, and then 10 more days after that a couple more people in the household come down with it.  That's 20 days of lockdown and an explosion in cases within my household.

 

Did you just accidentally make a case against lockdowns?  ;)

 

Yup.  Eric just described how to get an explosion of cases.

 

The data from NYC itself is clear. More crowded, more cases.  People living in small houses, more cases.  People going out such as transit and police, less cases.

[physdude]

And to be clear, given the staggering economic and social costs of the lockdowns, those arguing for them must demonstrate their worth, not the other way around.

 

It's not possible that you have your causation backwards?

 

Physdude makes an excellent point. Almost nobody is talking about Vietnam. A country with 90MM people and 0 Covid deaths.

 

Europe and the Americas failed to control the virus. And they paid the price with heavy lockdowns, deaths, and staggering economic and social costs.

 

How many times do I need to make the following point.  I am NOT arguing FOR causation.  Therefore I cannot have something "backwards".  I am arguing that there is a LACK of [demonstrated] causation.  Big difference.

 

I am not particularly familiar with Vietnam or the mitigation efforts they pursued.  You might want to consider two more basic attributes, however: 

 

1. Demographics - Vietnam has a much much younger population than all western countries; and

 

2. Weather - Hanoi is 21 degrees north vs NYC 41 degrees north

 

You know who else avoided Covid: Eritrea, Syria and Zimbabwe.  These are barely functioning countries.  I doubt there was much of a well coordinated lockdown strategy.  It's something else. 

 

Perhaps it makes sense to then learn about their approach if you don't know much about it? Zero fatalities and a very small number of cases are not explained by latitude or weather or age profile - good polices and governance are the only reasonable explanation.

 

Why don't you also consider other places that avoided Covid - Taiwan, HK, Macao etc.? Those three are very much highly functioning countries (and have one thing in common - they constitute Greater China which means that they have a lot of interaction with China) but are inconsistent with your narrative. 

[ERICOPOLY]

Because we all know that summer time respiratory diseases go down and winter they go up. Thats why they give flu vaccine in October.

 

Though everyone was fighting with me in March when I said cases will go down in summer. 

 

So they were modelling cases exponentially continuously going up without lockdown.  But that is not correct.  Cases will start going down in summer and an honest modelling will take that into account.

 

Are cases starting to go down?

[ERICOPOLY]

After Flu vaccine is given, number of cases of flu go down, not up.

After lockdown did cases go down or up?

 

I find that surprising since the CDC recommends getting the flu vaccine by the end of October each year.  Then the number of flu cases rise afterwards.

 

Because we all know that summer time respiratory diseases go down and winter they go up. Thats why they give flu vaccine in October.

 

Nevertheless.  Cases rising X amount after locking people down does not show that it was ineffective.  For example, let's say one person in my household was just exposed on the morning the lockdown began.  That person doesn't test positive for 10 more days, and then 10 more days after that a couple more people in the household come down with it.  That's 20 days of lockdown and an explosion in cases within my household.

 

Did you just accidentally make a case against lockdowns?  ;)

 

Yup.  Eric just described how to get an explosion of cases.

 

The data from NYC itself is clear. More crowded, more cases.  People living in small houses, more cases.  People going out such as transit and police, less cases.

 

I take it you are being facetious.  Intra-household spread is going to occur regardless of policy.

[Investor20]

Because we all know that summer time respiratory diseases go down and winter they go up. Thats why they give flu vaccine in October.

 

Though everyone was fighting with me in March when I said cases will go down in summer. 

 

So they were modelling cases exponentially continuously going up without lockdown.  But that is not correct.  Cases will start going down in summer and an honest modelling will take that into account.

 

Are cases starting to go down?

People who propose lockdowns are the one who have to show cases and more importantly deaths are going up after lockdowns are stopped.

 

Lockdowns have severe economic, psychological and medical negative consequences.  Just in US 75000 people are estimated to have suicides because of lockdowns.  UN warned that hundreds of thousands of children could die because of lockdown. Let alone millions who lose their jobs.

 

People who propose lockdowns are those who have to show lockdowns are worth that price.

[Investor20]

After Flu vaccine is given, number of cases of flu go down, not up.

After lockdown did cases go down or up?

 

I find that surprising since the CDC recommends getting the flu vaccine by the end of October each year.  Then the number of flu cases rise afterwards.

 

Because we all know that summer time respiratory diseases go down and winter they go up. Thats why they give flu vaccine in October.

 

Nevertheless.  Cases rising X amount after locking people down does not show that it was ineffective.  For example, let's say one person in my household was just exposed on the morning the lockdown began.  That person doesn't test positive for 10 more days, and then 10 more days after that a couple more people in the household come down with it.  That's 20 days of lockdown and an explosion in cases within my household.

 

Did you just accidentally make a case against lockdowns?  ;)

 

Yup.  Eric just described how to get an explosion of cases.

 

The data from NYC itself is clear. More crowded, more cases.  People living in small houses, more cases.  People going out such as transit and police, less cases.

 

I take it you are being facetious.  Intra-household spread is going to occur regardless of policy.

 

No, I am not being facetious. See below.

 

https://www.cnbc.com/2020/05/06/ny-gov-cuomo-says-its-shocking-most-new-coronavirus-hospitalizations-are-people-staying-home.html

Cuomo says it’s ‘shocking’ most new coronavirus hospitalizations are people who had been staying home

[Gregmal]

This "engineer" missed basic math apparently.

 

End of lockdown + Memorial Day + Protests + Reopening of the economy + (just for you libtards) Trump campaign rally = Increase in positive cases, especially amongst younger people, especially in Red states who implemented these things first(despite again, the cases being largely in blue neighborhoods).... go figure.

 

Not farfetched either.

 

No joke, I saw a headline today stating "COVID cases go up after Trump rally"... they were expecting 0 I guess.

[Spekulatius]

After Flu vaccine is given, number of cases of flu go down, not up.

After lockdown did cases go down or up?

 

I find that surprising since the CDC recommends getting the flu vaccine by the end of October each year.  Then the number of flu cases rise afterwards.

 

Outdoors temperatures also tend to go up after people turn on their air conditioning. Anybody noticed this? It happens every year like clockwork.

[Dalal.Holdings]

Florida seems to be doing just fine

 

 

You really should stop posting positive test case stats.  Absent context, they aren't particularly informative.  We all know that testing rates have increased and there's plenty of other targeting going on that's changing the dynamic.  The massive decline in average age of positive cases is evidence of that.

 

https://pbs.twimg.com/media/EbDdVccUwAAgRvw?format=jpg&name=medium

 

I'm literally attaching the graph from your "Florida seems to be doing just fine" tweet and circling June hospitalizations here in case you miss it (#1 and #2 are the phased reopening marked by original tweet)...

 

Again, you do not seem to understand how lagging indicators work. Hospitalizations/mortality move after delay due to the time course of covid infection (weeks after cases which are the leading indicators). Here you see hospitalizations trend down slightly after reopening, then back up in June (due to inherent delay) as expected.

 

 

Younger age of cases does explain some of decreased mortality (so far) and weather/climate/humidity might help too (though it doesn't help Brazil). However there is a clear rise in % of positive tests, there are too many uncertainties, and this movie has played itself many times before in the same way to be ignored.

 

Bottom line is that cases are shooting up in many states, hospitalizations are trending up, and hospitalizations/mortality are lagging indicators that should not be looked at as early warning signs...

[orthopa]

Lol! For some reason, there is a strong "correlation" between whether one favors Trump and their willingness to dismiss the pandemic--the (former politics section Trumper) brigade is out in full force in this thread. Anyone want to run a regression on it? As I said--you get the "analysis" you deserve, CoBF.

 

Here's one for people who are not beyond the level of reading graphs:

 

Nothing to see here folks--just fake news alarmism and another dumb graph! Clearly it's just a blip of a "second wave" for FL, not a surging first wave at all! After all, it's been in the millions since January!

 

And ignore those like me who disappear and then come back to warn like I did in early March. After all, I am focused on cases which in my flawed view are leading indicators of what's to come...Remember, we should ignore cases and focus on hospitalizations and mortality. Clearly mortality is going down when you divide by cases. And of course hospitalizations and mortality are the predictive indicators to look at right now, they are not lagging indicators, amirite? We clearly don't understand what lagging indicator means anyway on here...derp.

 

Also, those claiming it's been here and "millions were infected" and that they saw many patients who had it in January--so strange that it is only surging now in FL in June. Weird--if it was widespread in January, what took so long to get to FL? Top level analysis. Keep it up.

 

https://www.tampabay.com/news/health/2020/05/05/coranavirus-was-in-florida-before-we-knew-it/

 

At least 26 people who contracted COVID-19 started showing symptoms in late December or January — and at least eight of them both had not traveled and did not have contact with another person infected by the virus. The trend continued into February.

 

“That’s community spread,” said Eric Toner of the Johns Hopkins Center for Health Security. “It’s invisible, it’s invisible, it’s invisible, until it’s suddenly obvious.”

 

"the data show the virus spread silently through Central and even North Florida during January, a time when testing for the contagion didn’t exist in the United States"

 

"“Many of us have long suspected that there were undetected cases in the U.S. long before we had our first confirmed case,” Toner said. The new data “helps to explain what appeared to be a sort of explosive outbreak out of nowhere.”

 

We are back to this huh? How can tell how many people had it with no testing? As soon are the testing ramps up, the cases ramp up and you crow!!!!

 

 

[orthopa]

Florida seems to be doing just fine

 

 

You really should stop posting positive test case stats.  Absent context, they aren't particularly informative.  We all know that testing rates have increased and there's plenty of other targeting going on that's changing the dynamic.  The massive decline in average age of positive cases is evidence of that.

 

https://pbs.twimg.com/media/EbDdVccUwAAgRvw?format=jpg&name=medium

 

I'm literally attaching the graph from your "Florida seems to be doing just fine" tweet and circling June hospitalizations here in case you miss it (#1 and #2 are the phased reopening marked by original tweet)...

 

Again, you do not seem to understand how lagging indicators work. Hospitalizations/mortality move after delay due to the time course of covid infection (weeks after cases which are the leading indicators). Here you see hospitalizations trend down slightly after reopening, then back up in June (due to inherent delay) as expected.

 

 

Younger age of cases does explain some of decreased mortality (so far) and weather/climate/humidity might help too (though it doesn't help Brazil). However there is a clear rise in % of positive tests, there are too many uncertainties, and this movie has played itself many times before in the same way to be ignored.

 

Bottom line is that cases are shooting up in many states, hospitalizations are trending up, and hospitalizations/mortality are lagging indicators that should not be looked at as early warning signs...

 

How are you differentiating between hospitalizations for medical issues other then covid/post op patients and those only with a postive covid dx and need for treatment? Am I missing this in the graph somewhere? ER vists across the country are up 100% of percent month over month. Are you counting admissions from this and non outpatient surgeries?

[jamesmadison]

And to be clear, given the staggering economic and social costs of the lockdowns, those arguing for them must demonstrate their worth, not the other way around.

 

It's not possible that you have your causation backwards?

 

Physdude makes an excellent point. Almost nobody is talking about Vietnam. A country with 90MM people and 0 Covid deaths.

 

Europe and the Americas failed to control the virus. And they paid the price with heavy lockdowns, deaths, and staggering economic and social costs.

 

How many times do I need to make the following point.  I am NOT arguing FOR causation.  Therefore I cannot have something "backwards".  I am arguing that there is a LACK of [demonstrated] causation.  Big difference.

 

I am not particularly familiar with Vietnam or the mitigation efforts they pursued.  You might want to consider two more basic attributes, however: 

 

1. Demographics - Vietnam has a much much younger population than all western countries; and

 

2. Weather - Hanoi is 21 degrees north vs NYC 41 degrees north

 

You know who else avoided Covid: Eritrea, Syria and Zimbabwe.  These are barely functioning countries.  I doubt there was much of a well coordinated lockdown strategy.  It's something else. 

 

Perhaps it makes sense to then learn about their approach if you don't know much about it? Zero fatalities and a very small number of cases are not explained by latitude or weather or age profile - good polices and governance are the only reasonable explanation.

 

Why don't you also consider other places that avoided Covid - Taiwan, HK, Macao etc.? Those three are very much highly functioning countries (and have one thing in common - they constitute Greater China which means that they have a lot of interaction with China) but are inconsistent with your narrative.

 

Here's how Taiwan responded according to Time Magazine.  Seems consistent with my narrative, which is that lockdowns don't appear to the driving source of success or failure, either anecdotally or analytically (acknowledging the limitations of data we are dealing with). 

 

Taiwan (443 cases; 7 deaths)**

 

In the initial days of an outbreak, the only thing as bad as being the epicenter of a global pandemic is being right next door to one… especially one that has it out for you (politically speaking). Despite that, the self-governing island has managed a truly admirable response in less-than-ideal circumstances; as of this week, Taiwan has registered just 443 cases and seven casualties.

 

Rather than shuttering its economy for weeks on end in an attempt to slow the virus, Taiwan went another way—after quickly closing its borders and banning exports of surgical masks, the government used contact tracing and mobile Sim-tracking to identify and ensure those in quarantine were actually abiding by the rules. Taiwan has a single-payer healthcare system, medical officials held briefings for the public daily, and businesses were kept open by using aggressive precautionary measures like taking temperatures and providing sanitizer before patrons could enter business establishments. Throughout, the government’s centralized response was seen as convincing and credible—it certainly didn’t hurt that Taiwan’s vice president is an epidemiologist.

_______________

 

You are, however, absolutely right about the importance of good governance and policies more broadly, which have been sorely lacking in the USA.  As I have previously mentioned, the four worst states in per capita deaths all mandated that nursing homes take back Covid+ patients.  That's bad governance and policy.  I also would acknowledge and argue that various countries started with vastly different circumstances.  Taiwan is tiny and homogenous, with a centralized government.  The USA is huge and diverse with a federal system of government.  No surprise that Taiwan was able to quickly put in place policies that probably had no chance of working in the USA.

 

[Dalal.Holdings]

Florida seems to be doing just fine

 

 

You really should stop posting positive test case stats.  Absent context, they aren't particularly informative.  We all know that testing rates have increased and there's plenty of other targeting going on that's changing the dynamic.  The massive decline in average age of positive cases is evidence of that.

 

https://pbs.twimg.com/media/EbDdVccUwAAgRvw?format=jpg&name=medium

 

I'm literally attaching the graph from your "Florida seems to be doing just fine" tweet and circling June hospitalizations here in case you miss it (#1 and #2 are the phased reopening marked by original tweet)...

 

Again, you do not seem to understand how lagging indicators work. Hospitalizations/mortality move after delay due to the time course of covid infection (weeks after cases which are the leading indicators). Here you see hospitalizations trend down slightly after reopening, then back up in June (due to inherent delay) as expected.

 

 

Younger age of cases does explain some of decreased mortality (so far) and weather/climate/humidity might help too (though it doesn't help Brazil). However there is a clear rise in % of positive tests, there are too many uncertainties, and this movie has played itself many times before in the same way to be ignored.

 

Bottom line is that cases are shooting up in many states, hospitalizations are trending up, and hospitalizations/mortality are lagging indicators that should not be looked at as early warning signs...

 

How are you differentiating between hospitalizations for medical issues other then covid/post op patients and those only with a postive covid dx and need for treatment? Am I missing this in the graph somewhere? ER vists across the country are up 100% of percent month over month. Are you counting admissions from this and non outpatient surgeries?

 

That graph is from jamesmadison’s twitter source and it only includes FL covid hospitalizations per the author.

 

As to your other point, I cannot speak for anyone else on here, but the argument was on how widespread covid was in USA in Jan/Feb and the difference of opinion I had with you was that it was not widespread, but did exist here in certain places like WA state back in January in smaller clusters in early stage exponential growth...

 

I believe that the notion of it being “widespread” meaning millions or hundreds of thousands of cases in USA in Jan/Feb is debunked and there is nothing I have seen that supports that thesis, that is all.

[jamesmadison]

According to Worldometer, USA had 267 Covid deaths yesterday.  That's the lowest figure since March 23rd, yet for some odd reason I can't seem to find any headlines at any major media outlet talking about it.  Weird.

[Dalal.Holdings]

According to Worldometer, USA had 267 Covid deaths yesterday.  That's the lowest figure since March 23rd, yet for some odd reason I can't seem to find any headlines at any major media outlet talking about it.  Weird.

 

Lol...

 

Something else that’s “weird”—the mortality graph is shifted to the right when compared to the case graph...almost like mortality lags cases and cases can be seen as an early warning sign of where mortality might be headed...hmmm...

 

[meiroy]

According to Worldometer, USA had 267 Covid deaths yesterday.  That's the lowest figure since March 23rd, yet for some odd reason I can't seem to find any headlines at any major media outlet talking about it.  Weird.

 

If it's due to treatment having improved than that's pretty good.