COVID-19

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C40
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Re: COVID-19

Post by C40 »

Another update from the Glorious nation of Vietnam: Now they have allowed the opening of any and every type of business. I believe the only ones still forced closed were things like bars, dance clubs, karaoke lounges, and massage parlors. There have been no cases of community transmission of Covid here for one month. The only new cases are people brought into Vietnam from other countries - at this point just a repatriation flight here and there, and some flights of people coming for important work reasons.

Here's how the beach looks each evening. (It's not all so dense... this was the busy part of the beach)

Image

I've had a combination of good luck being here at the outbreak onset.. and good choice, by staying here rather than going back to the U.S. The government here has been proactive, effective, consistent, and overall protective of it's people. Its like being in a cozy warm blanket. Cue the patriotic communist theme songs..

tonyedgecombe
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Re: COVID-19

Post by tonyedgecombe »

Augustus wrote:
Fri May 15, 2020 6:29 pm
Since they're using euros? Does that make Boris a fucking genius?
The UK isn't and has never been in the Euro zone.

Also Boris is definitely not a fucking genius.

7Wannabe5
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Re: COVID-19

Post by 7Wannabe5 »

“Seppia” wrote: We do not have armed people in camo gear showing up in government buildings to "protest", for example.
Yup. That’s my neck of the woods. This is why I have lost my urge to travel much. Michigan is like a working model of the world as a whole with all its potentials for dystopia. Ann Arbor and parts of Oakland County stand as representative for affluent liberal Western Europe. Hamtramck is like a Middle Eastern refugee camp in a completely decrepit part of Eastern Europe. Then you have the Western part of the state with conservative affluent tulip growers and migrant crop workers. The quiet suburbs full of professional Asian immigrants. The neighborhoods of Detroit where children whose primary language is English only have 200 words in their spoken vocabulary at age 5. The Northern river and woods counties with County supervisors who own helicopters and pet bears they wrestle. Etc etc etc

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Ego
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Re: COVID-19

Post by Ego »

More evidence that those previously infected with one of the four seasonally recurring 'common cold' coronaviruses are showing cross-immunity to SARSCoV2.

https://www.biorxiv.org/content/10.1101 ... 4.095414v1
we demonstrate the presence of pre-existing immunity in uninfected and unexposed humans to the new coronavirus. SARS-CoV-2 S-reactive antibodies, exclusively of the IgG class, were readily detectable by a sensitive flow cytometry-based method in SARS-CoV-2-uninfected individuals with recent HCoV infection and targeted the S2 subunit.
Importance:
  • Herd immunity will be reached sooner than originally thought.
  • SARSCoV2 will be endemic like the other coronaviruses.
  • Antibody testing for Covid-19 is a waste of time.
  • States/Countries that followed the suppression strategy may suffer longterm as a result of lower overall 'common cold' coronavirus exposure.

JL13
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Re: COVID-19

Post by JL13 »

jacob wrote:
Fri May 15, 2020 7:49 am
A Spanish serology (IgM and IgG) study ... shows that 5% have been infected at some point
"The study also shows lower prevalence figures among children than among adults: 1.1% of babies under one year of age had antibodies against the coronavirus; for children between one and four years old, the rate was 2.2%, and for those between five and nine, it was 3%."

Keeping an optimistic mind here: since children seem oddly unaffected by the virus, might that also mean that they don't even develop antibodies? In theory, I would expect it to be nearly impossible for the babies under 1 to have lower exposure than the average parent: they have to be carried/held by their parents with constant contact throughout the day.

Will we will discover that a large portion of the population can't get the illness and doesn't develop antibodies, despite exposure to the virus?

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Ego
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Re: COVID-19

Post by Ego »

jacob wrote:
Fri May 15, 2020 7:49 am
With the Spanish death count, this means that the IFR is 1-1.2% which is at the high end of similar numbers for other countries.
Using the same data:

Antibody testing in France/Spain estimate ~5% infected w/ COVID-19...10x higher prevalence than positive PCR tests

Excluding nursing home deaths, all-age IFR = 0.5%

Assuming 10:1 infection-to-PCR ratio, IFR by age group:

Ages
30-39: 0.01%
40-49: 0.03%
50-59: 0.04%
60-69: 0.19%

Source for CFR by age: https://ourworldindata.org/mortality-ri ... -19-by-age
https://twitter.com/JamesTodaroMD/statu ... 3409459200

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Re: COVID-19

Post by jacob »

Yes and ages...

70-79: 0.48%
80+: 1.56%

for a demographically sum total weighed (27563deaths/(5% of 46.94M population) 1.17%. The 10:1 infection:PCR brings a CFR = 27563deaths/276505positives = 9.8% down to IFR = 1.17%. The infection:PCR is then 9.8%/1.17% = 8.37:1 or "ten to one"ish.

Iff herd immunity is achieved at 70% (R0 = 3.5 in an open society), this means that the process is 70%/5% = 1/14th of the way there. Or that with 27500 Spanish deaths so far, 13*27500 = 357k additional deaths would occur to wash through for herd immunity. Yes, that would be mostly people older than 70.

This is an old discussion. Numbers seem to be highlighted in ways that promote a given position. For example 0.1% or 1% doesn't seem like a lot so if arguing for opening society, one uses percentages. Conversely, multiplying small percentages with large numbers do give substantial numbers. So for example, the 0.14/23.66=0.59% of 30-39 year olds who get tested and die out of a herd immune population of 46.94 million at 70% infection would be 46.94M*0.59%*1.17%*70%=2274 individuals between 30 and 39 out of a total death count of 46.94M*1.17%*70%= 384,438 where 15.6/23.66 = 65.9% would be over 80 years old.

It's the same number gymnastics happening in discussions when people argue whether food security is on a positive track because fraction of insecurity is going down or a negative track because the absolute number is going up. Ultimately, it depends on perspective (one's worldview, hence politics) and fractions (comparing a trend to another trend) makes it possible to suggest the opposite. Ditto in comparing to other numbers to either maximize or minimize effect. For example, using Spanish stats on the US population, herd immunity would cost the lives of 0.22/23.66*0.0117*331.4M*0.7=25,237 20-29 year olds. That's the same cost as a medium sized war. OTOH, it's nothing compared to deaths from causes that are taken as "normal". Therefore, opinions also vary according to whether CV19 is or should be considered normal or avoidable.

The mystery 23.66 number comes from adding up the Spanish percentages by age on https://ourworldindata.org/mortality-ri ... -19-by-age

Basically, the conclusion of the study is that herd immunity will cost 70% of 1.17% of the population under an open pre-corona style. Sweden is showing that change in behavior can reduce the reproduction number a lot. For example, if people keep socially-distancing on a voluntary basis to bring R0 down to 1.1, then herd immunity is achieved at a low 9% => Current death count is half way of the ultimate count. This means that we're halfway through if we keep acting like Sweden until the disease dies out. The caveat is that this would take a longer time.

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Ego
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Re: COVID-19

Post by Ego »

jacob wrote:
Sat May 16, 2020 2:30 pm
So for example, the 0.14/23.66=0.59% of 30-39 year olds who get tested and die out of a herd immune population of 46.94 million at 70% infection would be 46.94M*0.59%*1.17%=3249 individuals between 30 and 39 out of a total death count of 46.94M*1.17%= 549198 where 15.6/23.66 = 65.9% would be over 80 years old.

It's the same number gymnastics....
Numbers gymnastics indeed.

Let's take a closer look at what you did there.

Assumption 1: 70% infection for herd immunity which completely ignores a number of important facts regarding Covid
  • Those with previous exposure to the common cold coronaviruses show immunity (see three posts above).
  • Many people fight off the virus without producing antibodies
  • Kids and young people are basically immune from the get-go and are basically non-infectious. 24% of the US population is under the age of 18 and 60% is under 45.
So the 70% herd immunity number, while true for many types of infection, is nothing more than a manipulation technique when applied to Covid.

Assumption 2: 1.17% death rate for the 30-39 year olds. Perhaps we should call that a Ferguson?

These 'boy who cried wolf' techniques are going to haunt us for generations. When another major infection hits - and it will - we will completely ignore the experts. A whole generation of young people who had a great deal of trust in science now understand how it has been used to manipulate them and they are waking up to the fact that they are the victims of a generational hate crime. Not to mention what it will do for the Global Warming model debate.

I am fortunate to interact with a lot of young people and I am seeing in them the exact same sentiment that TopHatFox expressed in one of his threads - that this is all some big scam.

I don't think it is a scam. Covid is killing people. Mostly very old people. That is a tragedy. The fact that number-gymnastics was used to manipulate people into believing that the scope and scale of the tragedy was orders of magnitude worse than it really is.... well.... that is an even bigger tragedy.

7Wannabe5
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Re: COVID-19

Post by 7Wannabe5 »

@Ego:

Re: Assumption 2. Jacob clearly included a correction factor for age cohort in his math. Perhaps we should just call your response a “Gomer?”

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Ego
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Re: COVID-19

Post by Ego »

7Wannabe5 wrote:
Sat May 16, 2020 5:03 pm
@Ego:

Re: Assumption 2. Jacob clearly included a correction factor for age cohort in his math. Perhaps we should just call your response a “Gomer?”
Perhaps we should. Does that make you feel smart to call me a Gomer?

And what was the basis of that correction factor?

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Re: COVID-19

Post by jacob »

@Ego - No, you misunderstood the calculation in assumption 2. The 0.59% multiplier accounts for the 30-39 year old (it's the percentage of 30-39 dead out of all the dead). It goes in along with the 1.17% (the number of dead out of the total infected number). Please go through the math again if you want to argue this. This is likely just a slip. I doublechecked the probability factors when I wrote the post.

As for assumption 1, the 70% comes from R0=3.5 (herd im.=(R0-1)/R0) which is what the early estimates of the basic reproduction number were before people started modifying their behavior (resulting in a lower R0). The 3.5 number would account for kids and young people being immune and non-infectious and also account for the immunity of those with previous exposure to common coronaviruses. The reason is that the 3.5 is experimentally measured based on early spreading rather than computed from detailed knowledge about children or antibodies. A SIR model example is given upthread for how it can be derived---all that's required is the growth in the death rate and how long it takes to die or recover. R0 is initially independent of shadow numbers(*). The dynamics of the virus does not change because we now those these details. (Similar to how gravitational acceleration didn't change when Newton wrote his second law and measured g=9.8m/s^2.) It changed because we modified our behavior and because the fraction of recovered people increased.

(*) This is because there's only a 2-12 day latency between exposure and when people present at the hospital. It's not like HIV where the disease had 5-15 years to spread around before resulting in what was initially seen as mysterious symptoms. IOW, it's impossible to infect 10% or even 0.1% of the population with SARS-CoV2 before people start showing up at the hospitals.

(The 3.5 is just the average of early calculations. It ranged from 2.5 up to 7+ but most had it in the 3ish range. I'd be perfectly happy to use other reasonable numbers. I used 1.1 for Sweden because that seems to be their path goes forward. FWIW, the entire world is converging on R0=1. I explained why I think that is in an earlier post as well.)

The only contention here that changes the numbers is you second bullet point, that is, whether people fight off the virus w/o producing antibodies. (In other words, whether the Spanish study says something useful about the total infection rate.) If that's the case, then even more people have been infected. This then means that the IFR is lower and that we're further ahead towards the R0 based herd immunity; that it's not a factor 13 to go and that the eventual death count from going there will be lower. I do note that a factor 13 is a lot (way outside the ballpark of current experiences). It means that up to most people would fight off the virus w/o producing antibodies. I don't know how normal that is?

However, that's basically the weakest assumption in all these calculations. That there's a large shadow number out there. So the argument now is that antibodies don't measure [the shadow number] either and that some people are just naturally immune. Okay ... but if that's the position, there's really nothing I can say that can make a convincing point otherwise. There's any number of assumptions one can make that if true would mean the pandemic is largely over. However, I will note that the numbers that are currently coming out (3-4 months in) are very much in line with very early estimates. That these have not been falsified yet speaks well for the original models.

Anyway, I have no personal stake in the outcome because---cynical as I am---I've deliberate set myself up to be independent of the outcome. I'm prepared for things to go either way. I've long accepted that people are reluctant to accept anything that hasn't affected them personally yet (case in point, THF generally seems to want to learn things the hard way usually rejecting good advice when it doesn't fit what he wanted to hear---an attitude which I consider perfectly normal, maybe especially for younger people) and are not going to listen to the experts (except when they eventually need help to deal with the consequences). Humanity's waffling reaction to CV19 has just confirmed that we're not up to the task of dealing with complex problems that require coordination at all levels of society. I consider that my basic assumption. We're in over our heads. The ingenuity gap is here. As I mentioned earlier, if people can't even deal with the fallout of a pandemic economically or culturally---a kind of training wheel exercise for more serious 21st century challenges---there's no way they would be able to meet the 2C CO2 reduction goal before 2030. People are already ignoring that despite 40+ years of heads-up.

The majority of people can't even figure this out in their personal lives. The majority is steadily sailing into lifestyle diseases that will kill them but they're fine with that because they believe they're the exception. Experts can provide a pill for everything, but they can't fix stupid, so I'm pretty fatalistic as far as all this is considered. The main benefit of expertise is knowing what's coming. Not in preventing anything bad from happening. Sure, there will be a bigger pandemic at some point or even an actual food crises (as opposed to a temporary TP shortage). People will be warned ahead and proceed to ignore the warnings. This is all baked into the cake.

7Wannabe5
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Re: COVID-19

Post by 7Wannabe5 »

@Ego:

1) I did not call you a Gomer. I suggested that your response might be called a Gomer.
2) Smart is not a feeling.
3) I imagine the feeling I did experience to be somewhat similar to the one you experienced making use of the term “a Ferguson.”
4) Jacob clearly and kindly went out of his way to explain his use of the Spanish statistics.

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Ego
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Re: COVID-19

Post by Ego »

Okay, I concede my gomer, with conditions... ;)

@Jacob, the CFR of .14% for those in the 30-39 age group is based on the number who actually went to a doctor and tested positive as of March 24th. Since so many in that age group experienced mild symptoms, never went to a doctor and were never tested, they were not included in the denominator used to arrive at the .14% CFR. How many? Everyone is screaming for antibody quick tests to find out. But...

Up thread I linked to the study from China where they found that some 30% of those admitted to hospital who tested positive for Covid and recovered were found to have either not produced antibodies at all or produced them at extremely low rates so as to be useless. Again, these were people who were sick enough to be hospitalized. And in both cases (positives & antibodies) they were lab results not quick tests.

It begs the question, how many in the 30-39 y/o age group experienced mild or no symptoms, fought the infection and never produced antibodies?

It is certainly frustrating that we cannot know these numbers. It must be a significant number, but at least we know that we cannot know. In other words, they are known unknowns.

Up to now those doing the modeling have been pretending that they don't exist.

slowtraveler
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Re: COVID-19

Post by slowtraveler »

@Ego

I appreciate all your well cited posts. They stand out amidst the noise and tangential disagreements. I'm impressed by your stamina to keep going, really.

To support your point, I'll share my perspective. While the virus itself likely isn't a scam, you're correct that a lot of people see this as manipulation by the government to increase control, surveillance, and transfer more power away from the people.

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Ego
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Re: COVID-19

Post by Ego »

slowtraveler wrote:
Sat May 16, 2020 7:55 pm
While the virus itself likely isn't a scam, you're correct that a lot of people see this as manipulation by the government to increase control, surveillance, and transfer more power away from the people.
Thanks ST!

I am still leaning toward the idea that we are simply a blundering, scared gerontocracy but I am increasingly concerned about how those fearful old people are using this as an excuse to borrow from your generation (and your children) to avoid the unavoidable and sustain the unsustainable.

I would have expected last week's schizophrenic flip in the special election in California's 25th district to be a wakeup call, especially for those in the state with national ambitions, but it seems not. I predict an interesting November.

George the original one
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Re: COVID-19

Post by George the original one »

California has had 10,000-12,000 new COVID-19 cases per week since Apr 23 and 500+ COVID-19 deaths per week since Apr 18. While the virus is highly contagious, it has only been applying social distancing more than a month prior that slowed the infection/death rate.

That remains the insidious nature of it. Any lockdown has to be in effect for at least a month before there's any stability. The SS COVID-19 steers more slowly than the Exxon Valdez, so it's very difficult to know whether you're going to hit the rocks or not.

We had to restrict "normal life" to get PPE, tests, contact tracing, and understand how to adapt to life with this virus. The reality of New York and Massachusetts and New Jersey could easily have kept spreading around the eastern seaboard. Many places still do not have adequate paraphrenalia and there's no second wave because we're still dealing with the first wave, the one that's barely crested. The noble experiment of adapting to the virus continues and we'll know in another 3 weeks whether we've cleared of the rocks.

horsewoman
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Re: COVID-19

Post by horsewoman »

Ego wrote:
Sat May 16, 2020 3:52 pm
  • Kids and young people are basically immune from the get-go and are basically non-infectious. 24% of the US population is under the age of 18 and 60% is under 45.
This is not true, or rather not yet as confirmed as your sentence suggests. In Berlin at the Charité a lot of work is being done regarding how infectious children really are. Prof. Drosten freely owns that there is little data to be had because children are not tested much and are often without symptoms. The existing data points suggests that children (symptomatic or not) have the same viral load in their throats like adults, there seems to be no significant difference.

https://zoonosen.charite.de/fileadmin/u ... nt-age.pdf

Prof. Drosten records a podcast twice a week in which new developments are discussed in depth. It is in German however, so not much use to link it here. Here is the English link to the virology department in Berlin, for those who interested:

https://virologie-ccm.charite.de/en/research/

saving-10-years
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Re: COVID-19

Post by saving-10-years »

As @Horsewoman says there is no real evidence of immunity by virtue of young age. But the effect of the virus does appear to be largely absent. (Edit: I mean young people don't appear to have ill effects unless they have other underlying conditions)

https://fullfact.org/health/infection-i ... ronavirus/
The ONS found, with a degree of uncertainty, that there was no evidence that the rate of infection differed by age group, but being infected doesn’t necessarily mean you become ill and display symptoms.
ONS - Office of National Statistics (UK).

What is worrisome (understatement) is that the damage caused by the virus does not seem to be fully understood. What was first described as a respiratory disease appears to (in at least some cases) severely affect other organs. Is there evidence that 'asymptomatic' |(which many young people apparently are) means no damage at all? My son appears to have had this virus asymptomatically (DH and I had mild symptoms and he was living with us at the time so is extremely unlikely to have avoided it).

If he had any symptom this was fatigue (i.e. sleeping lots). As a 23 year old sleeping lots can also of course be completely normal behaviour.

JL13
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Re: COVID-19

Post by JL13 »

While we're back on the subject of herd immunity for a moment...can someone help me understand something? Once we reach herd immunity with zero social distancing - so 60%-75% of the population or whatever - does that mean the virus *dies out*, or does it switch from epidemic to endemic?

Surely, even after herd immunity is reached, the virus is still out there. And even if it's eliminates from the human population of your town, it can still be reintroduced from tourists or even from contact with animal reservoirs, right?

wouldn't Rt converge on 1 then, and just consistently infect a certain portion of the population forever? I'm struggling to understand the math here.

tonyedgecombe
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Re: COVID-19

Post by tonyedgecombe »

The technical definition for herd immunity is when R=1. You would expect to continue to get infections and may well overshoot.

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