COVID-19

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steveo73
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Re: COVID-19

Post by steveo73 »

George the original one wrote:
Thu Mar 26, 2020 1:11 pm
No, because we're already seeing that the disease, faulty data or not, is shutting down ICUs.
To me it appears that both comments are true. The virus mightn't be that bad but lockdowns are required to manage it. We need to take precautions to ensure people don't die needlessly. At the same time hopefully the virus isn't that bad and we can keep the mortality rate below 1% in most locations.

CS
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Re: COVID-19

Post by CS »

@steveo73
Hospitals the US can barely (and not always) handle the flu, with a mortality of .2%. 1% is five times that.

steveo73
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Re: COVID-19

Post by steveo73 »

thrifty++ wrote:
Thu Mar 26, 2020 1:52 pm
I guess the problem is that no one really knows for sure. Its all so uncertain. I guess government responses will adjust proportionately as new information is unveiled.
Yep. I'm still a fan of lockdowns and social distancing. I think the economy can just suffer for a while. The economic cost is though huge. People are worried about their jobs and we are going to see massive amounts of unemployment. I think it was Ego that mentioned increased rates of suicide. There are going to be side effects like that.

black_son_of_gray
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Re: COVID-19

Post by black_son_of_gray »

There is also a "distribution problem," in the sense that while we have these large categories of "mild", "severe" (hospitalization), and "critical" (ICU), we don't know what the underlying shape of that distribution is.

If we were to plot "number of people" on the Y-axis and "disease severity" on the X-axis, we might assume the distribution looks like some smooth right-skewed function with one giant peak in "mild" and a long tail into the nastier outcomes. But I don't see why there couldn't be several peaks in the distribution, perhaps related to some factors known or unknown (e.g. gender, age, ancestry, preconditions, certain less obvious SNPs, microbiome, blood type, pollution/smoking/vaping, etc.). Said another way, the 80% "mild" bucket seems to include people with little to no noticeable symptoms and also people who have a horrible 2 weeks hacking their lungs out with sub-hospitalization pneumonia...and maybe those presentations of infection are actually two separate buckets. And then there's the apparently "mild" cases that might just drop dead on the street from viral myocarditis. If we could better understand the various underlying factors and stratify people out into better defined risk-buckets, that could go a long way towards allowing certain categories of people back out into the economy.

TL;DR: I'd really like to see more resolution than simply "mild," "severe," and "critical."

7Wannabe5
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Re: COVID-19

Post by 7Wannabe5 »

@Tyler9000:

That article is a pretty wishful thinking interpretation of what Ferguson actually said which also included revised estimate of Ro as more like 3 than 2.2. What the WSJ made of it is even worse. The only way the total death burden will remain that low is if extreme lockdown is followed by months of extreme tracking, testing and continued social distancing.

steveo73
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Re: COVID-19

Post by steveo73 »

CS wrote:
Thu Mar 26, 2020 2:22 pm
@steveo73
Hospitals the US can barely (and not always) handle the flu, with a mortality of .2%. 1% is five times that.
I get it. It can still be a catastrophe. I said earlier in this thread something like your health care system + population demographics + ability of people (including the government) to stop the spread of this will influence how bad this is.

Italy for instance is a disaster zone. I expect that these same effects will happen elsewhere. At the same time some countries will have recorded mortality rates less than 1%. I expect the mortality rate to be more like .5% in a lot of countries where more testing has occurred.

Lastly people dying unnecessarily to me simply isn't good so you have no option but to manage a potential health crisis at the expense of the economy. My parents are at much higher risks of dying if they contract this. My dad has stated he doesn't want to die unnecessarily and that to me is the point.

jacob
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Re: COVID-19

Post by jacob »

"Herd immunity: A rough guide".

Given a reproduction number R0, the herd immunity happens at (R0-1)/R0 (given random interaction chains ultimately connecting everybody). For nCov, this would be around (2.5-1)/2.5 = 60% (Germany's official prediction) which would be the expected number of people ultimately infected w/o a vaccine or functional isolation. Some countries are figuring on only 10% and if so, they're clearly making presumptions about flattening the curve far enough to develop a vaccine and/or engaging in tracing and isolation whether it's individuals or specific cities.

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jennypenny
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Re: COVID-19

Post by jennypenny »

IlliniDave wrote:
Wed Mar 25, 2020 10:18 am
I'd call and see if you can arrange a curbside pickup of sorts, at least avoids one of you having to go inside the office.
That's what we've decided to do. She is going in on Thursday for the whole day. They will come out to get her, be extremely vigilant in handling her (because they know of my son's condition), and bathe her right before we pick her up. Still, we've been under quarantine long enough to know we don't have the virus so taking her to the vet means we could be exposed. I'm considering grocery shopping on Tuesday so we limit our risk to one calendar day and can start the clock again.

Sis is now sick and her symptoms match COVID (she's local and DD lives with her). Between that and the unplanned trip to the vet next week, I feel like the walls I worked so hard to build are crumbling. :(

steveo73
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Re: COVID-19

Post by steveo73 »

jacob wrote:
Thu Mar 26, 2020 2:32 pm
Some countries are figuring on only 10% and if so, they're clearly making presumptions about flattening the curve far enough to develop a vaccine and/or engaging in tracing and isolation whether it's individuals or specific cities.
Maybe. Italy has an infection rate of < 1% based on the data. It's probably massively understated but is 10% really a low figure for other countries.

CS
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Re: COVID-19

Post by CS »

@jp

Dang, so sorry to hear about your dog, and sister and DD! Man, when it rains... I hope they figure everything out for your dog, and your sister doesn't have it and gets well.

7Wannabe5
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Re: COVID-19

Post by 7Wannabe5 »

((jp))

I feel like those who are writing off the victims of this epidemic as mostly likely to die soon are way off base. The most frequent underlying issue listed is high blood pressure. I know people in their 60s with high blood pressure who bike 30 miles no problem.

Also, many of the “theories” being tossed about make no sense mathematically. For instance, how can you have 50% of a population asymptomatically infected before anybody dies? This would only make sense if it took months to die after contracting the disease. Yes, you could have a number of initial deaths written off as flu or other cause, but you still would not have the exponential increase in daily deaths once clear identification was in place.

For example, here are the daily Covid deaths in Michigan f over the last week-2,2,3,7,9,19,17. Wow, look the epidemic must be a hoax because already dropped from 19 to 17, huge percentage!, right? WRONG!!! Put these numbers/points on a graph and it becomes clear that all this is ONLY indicative of the difference between exponential growth leading to one or another horrendous amount of tragic death before April 9th.

1taskaday
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Re: COVID-19

Post by 1taskaday »

Jennypenny I can only imagine the stress that you are under trying to protect your son...every move you make outside your home makes you second guess yourself.

I am the same with my elderly parents when it's my turn to care for them.

All carers have been cancelled due to risk.

It is so difficult...all siblings have different ideas on how stringent to be.

It's gone from some shouting in the open window to them (one is completely deaf and the other one halfway there) and passing dinners in this way to others arm looping them on walks.

If anyone brings it to them they are gonners.

Tyler9000
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Re: COVID-19

Post by Tyler9000 »

Is the Coronavirus as Deadly as They Say?
Current estimates about the Covid-19 fatality rate may be too high by orders of magnitude.

(Dr. Bendavid and Dr. Bhattacharya are professors of medicine at Stanford.)

https://www.wsj.com/articles/is-the-cor ... _lead_pos5

Tyler9000
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Re: COVID-19

Post by Tyler9000 »

Hang in there, JP. I admire your perseverance and how you're doing a great job caring for your family.

AnalyticalEngine
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Re: COVID-19

Post by AnalyticalEngine »

I also feel like a lot of these headlines are taking the "asymptomatic" cases out of context.

For example, are these cases truly 100% asymptomatic or just presymtomatic? You can't know that unless you only report the data after all cases have resolved. Additionally, how contagious are true asymptomatics as opposed to presymptomatics? It could be that presymptomatics are far more likely to transmit the disease than true asymptomatics.

The data on asymptomatic cases is interesting to be sure, but it's important to be careful to not extrapolate too far on those data and understand how the data were measured in the first place.

Also, a high number of asymptomatic cases could mean this disease will have an even worse impact than we thought. Consider:

1. Asymptomatic infection may not prevent reinfection. That is, if your innate immune system nukes the virus before your b and t cells get enough time to make antibodies, you may not really be immune to the disease. Or the antibodies you make are weak and don't last longer than a year or two, like Lassa fever.

2. Imagine a disease where 50% of cases are asymptomatic and 50% result in death. This disease would still have a 25% IFR. A disease like this would be a disaster because it spreads asymptomatically and you can't contain it. So a high number of asymptomatic covid cases may actually lead to more deaths due to containment difficulties. This would imply we need more social distancing, not less.

3. About 95% of polio infections are asymptomatic, yet the 5% that aren't are so bad that polio continues to remain a significant public health problem in many countries.

4. In some diseases, weak antibodies are worse than no antibodies. Dengue fever is like this. Being vaccinated for dengue actually made the disease worse because you had enough antibodies to enhance the disease but not enough to prevent it. Is it possible that asymptomatics might be one reinfection away from critical?

Everything I said is speculation, but there's so much we don't know about this disease. So it's important to be careful from drawing too many conclusions.

thrifty++
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Re: COVID-19

Post by thrifty++ »

@JP - sorry to hear about your situation. We are all hoping for the best for you. Stay strong.

George the original one
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Re: COVID-19

Post by George the original one »

George the original one wrote:
Wed Mar 25, 2020 5:09 pm
Oregon Health Authority as of 9a Wed, Mar 25
- 266 Positives
- 5476 Negatives
- 10 Deaths

Cases by County
- 6 Benton (Corvallis) - Note two are actually in Washington state, though they're residents of Benton County.
- 21 Clackamas (Oregon City)
- 1 Clatsop (Astoria)
- 10 Deschutes (Bend)
- 3 Douglas (Roseburg)
- 1 Grant (Canyon City)
- 1 Hood River (Hood River)
- 4 Jackson (Medford)
- 2 Josephine (Grants Pass)
- 1 Klamath (Klamath Falls)
- 5 Lane (Eugene)
- 1 Lincoln (Newport)
- 25 Linn (Albany)
- 43 Marion (Salem)
- 33 Multnomah (Portland)
- 3 Polk (Dallas)
- 2 Umatilla (Pendleton)
- 1 Union (La Grande)
- 96 Washington (Hillsboro)
- 7 Yamhill (McMinnville)

Cases by Age Group
- 5 19 or younger
- 15 20-29
- 32 30-39
- 55 40-49
- 42 50-59
- 57 60- 69
- 34 70-79
- 25 80 and over
- 1 Not available

Hospitalized
- 75 Yes
- 135 No
- 56 Not provided

Sex
- 142 Male
- 123 Male
- 1 Not available
50 new cases. Added Tillamook and Wasco counties. Exciting new data about hospitalization by age group and bed/ventilator availability!

Oregon Health Authority as of 8a Thur, Mar 26
- 316 Positives
- 6953 Negatives
- 11 Deaths

Cases by County
- 6 Benton (Corvallis) - Note two are actually in Washington state, though they're residents of Benton County.
- 21 Clackamas (Oregon City)
- 2 Clatsop (Astoria)
- 15 Deschutes (Bend)
- 3 Douglas (Roseburg)
- 1 Grant (Canyon City)
- 1 Hood River (Hood River)
- 4 Jackson (Medford)
- 4 Josephine (Grants Pass)
- 1 Klamath (Klamath Falls)
- 7 Lane (Eugene)
- 1 Lincoln (Newport)
- 26 Linn (Albany)
- 57 Marion (Salem)
- 45 Multnomah (Portland)
- 6 Polk (Dallas)
- 1 Tillamook (Tillamook)
- 2 Umatilla (Pendleton)
- 1 Union (La Grande)
- 1 Wasco (The Dalles)
- 104 Washington (Hillsboro)
- 7 Yamhill (McMinnville)

Cases by Age Group
- 5 19 or younger
- 19 20-29
- 39 30-39
- 63 40-49
- 52 50-59
- 70 60- 69
- 40 70-79
- 27 80 and over
- 1 Not available

Hospitalized by Age Group
- 0 19 or younger
- 3 20-29
- 4 30-39
- 14 40-49
- 12 50-59
- 28 60- 69
- 21 70-79
- 8 80 and over
- 0 Not available

Hospitalized
- 90 Yes
- 170 No
- 56 Not provided

Sex
- 170 Male
- 144 Male
- 2 Not available

Hospital Capacity
- 362 Available ICU beds
- 2193 Available non-ICU beds
- 684 Available ventilators

7Wannabe5
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Re: COVID-19

Post by 7Wannabe5 »

@Tyler9000:

The Stanford research used the incident rate in Vo and projected it out to include the entire province and also relied on NBA testing data? :? In Veneto, where 8% of the population was tested with attempt to go deep enough to hit asymptomatic, the death rate was much lower than Lombardy, but still over 2% due to similar aged population-IOW reflective of near 1% rate in less aged population.

bostonimproper
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Re: COVID-19

Post by bostonimproper »

I'm really confused by the recent wave of "this is not as fatal as you think" pieces when none of the data we've seen seems to support IFR << 1%. It's like the media pendulum has to have "both sides", even in a pandemic.

That said, I am eagerly waiting for serology tests so we can do population sampling. If you look at the distribution of cases by age range from Germany, Italy, and South Korea, number of infected for children are well below what you'd expect based on local demographics. I'm wondering people are either just naturally immune or are kicking the virus to the curb before its able to multiply to detectable levels by nose&throat swab PCR tests. That'd be good news and would support a "this is not as fatal as you think" conclusion, but obviously no data tending toward that way yet.

CS
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Re: COVID-19

Post by CS »

Data on the cases cared for in Nebraska.

There is support for airborne transmission.

Abstract: Lack of evidence on SARS-CoV-2 transmission dynamics has led to shifting isolation guidelines between airborne and droplet isolation precautions. During the initial isolation of 13 individuals confirmed positive with COVID-19 infection, air and surface samples were collected in eleven isolation rooms to examine viral shedding from isolated individuals. While all individuals were confirmed positive for SARS-CoV-2, symptoms and viral shedding to the environment varied considerably. Many commonly used items, toilet facilities, and air samples had evidence of viral contamination, indicating that SARS-CoV-2 is shed to the environment as expired particles, during toileting, and through contact with fomites. Disease spread through both direct (droplet and person-to-person) as well as indirect contact (contaminated objects and
airborne transmission) are indicated, supporting the use of airborne isolation precautions.

https://www.medrxiv.org/content/10.1101 ... 1.full.pdf

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