COVID-19

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theanimal
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Re: COVID-19

Post by theanimal »

@ego- Have you read the following? It's in a similar vein. https://medium.com/@joschabach/flatteni ... a324fe9727

I didn't really think about it that way until reading it. The current popular strategy is not necessarily focused on reducing the number of those infected/die from this virus but rather extend it over a period of time. Why aren't we trying to stop it?

Concluding section of article linked above:
China has demonstrated to us that containment works: the complete lockdown of Wuhan did not lead to starvation or riots, and it has allowed the country to prevent the spread of large number of cases into other regions. This made it possible to focus more medical resources on the region that needed it most (for instance, by sending more than 10000 extra doctors to Wuhan and the Hubei region). Wuhan, the epicenter of the outbreak, now observes less than 10 cases per day. The rest of the Hubei region registered no new cases for over a week now. It is possible to stop the virus!

China has learned its lesson: after the lockdown of Hubei, other regions implemented effective containment measures as soon as the first cases emerged. The same happened in Singapore and Taiwan. South Korea was tracking its first 30 cases very well, until patient 31 infected over 1000 others on a church congregation.

For some reason, Western countries refused to learn the lesson. The virus spread in Italy, until their hospitals collapsed under the load. According to reports from the crisis region, resources became so scarce that older people or those with a history of cancer, organ transplants or diabetes were excluded from access to critical care. The US, UK and Germany are not yet at this point: they try to “flatten the curve” by implementing ineffective or half hearted measures that are only meant to slow down the spread of the disease, instead of containing it.

There will be some countries that do not have the necessary infrastructure to implement severe containment measures, which include widespread testing, quarantines, movement restrictions, travel restrictions, work restrictions, supply chain reorganization, school closures, childcare for people working in critical professions, production and distribution of protective equipment and medical supplies. This means that some countries will stomp out the virus and others will not. In a few months from now, the world will turn into red zones and green zones, and almost all travel from red zones into green zones will come to a halt, until an effective treatment for COVID-19 is found.

Flattening the curve is not an option for the United States, for the UK or Germany. Don’t tell your friends to flatten the curve. Let’s start containment and stop the curve.

CS
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Re: COVID-19

Post by CS »

I know nothing about the medium.com, but they have been writing some smoking articles lately. Just excellent.

@animal
Agree with you. I think France might end up a green country. They are prohibiting everything. The social support listed was impressive.
https://www.france24.com/en/20200316-li ... s-outbreak

For the USA, they only asked that people get together in groups of 10 or less. If you've seen that simulation going around, it's easy to see that will not be enough. We're going to become a danger zone until the vaccine.

Peanut
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Re: COVID-19

Post by Peanut »

I thought it was too late to contain the virus in the U.S. and Europe weeks ago already. The lack of testing in the beginning was a huge part of that. Mitigation is the only strategy left.

@Bankai: I was thinking about the rising unemployment -->rising deaths connection today. The Big Short movie claimed 1% increase in unemployment leads to 40k deaths. Of course this figure has been debated, but it's generally accepted that there is some impact. So yes, at some point reversing the economic carnage should take precedence over the continuance of mitigation efforts.

Peanut
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Re: COVID-19

Post by Peanut »

chenda wrote:
Mon Mar 16, 2020 5:33 pm
Can US states close their borders to each other ?
Not yet...

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Ego
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Re: COVID-19

Post by Ego »

Peanut wrote:
Mon Mar 16, 2020 7:21 pm
The Big Short movie claimed 1% increase in unemployment leads to 40k deaths.
Thank you for this. I've been searching for estimates on how the economy influences life expectancy.

George the original one
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Re: COVID-19

Post by George the original one »

Crap, I quoted the wrong day's data for Washington.
Last edited by George the original one on Mon Mar 16, 2020 7:54 pm, edited 1 time in total.

Jin+Guice
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Re: COVID-19

Post by Jin+Guice »

The things discussed in that medium article have been my suspicion for awhile. Isn't it also important that all other countries limit the disease as well? How long are we going to be willing/ able to keep the economy largely shut down for?

On the brighter side, how did SK limit the disease so effectively? They seem to have flattened the curve drastically, yet they don't seem to have taken the restrictive measures that China has.

While I doubt the U.S. response has been enough, it's also much more than I thought we'd be doing with <100 dead. What's the chance the U.S. + other European nations ramp this up enough in the next week or two to "only" require a month or two shut down. What are the chances we can actually pull that off?

George the original one
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Re: COVID-19

Post by George the original one »

George the original one wrote:
Sun Mar 15, 2020 6:45 pm

Oregon Health Authority as of noon Sun, Mar 15
- 39 Positives
- 579 Negatives
- 182 Pending
- 355 Currently Monitoring
- 366 Completed Monitoring or no risk

Cases by County
- 1 Clackamas (Oregon City)
- 4 Deschutes (Bend)
- 1 Douglas (Roseburg)
- 2 Jackson (Medford)
- 1 Klamath (Klamath Falls)
- 10 Linn (Albany)
- 2 Marion (Salem)
- 1 Multnomah (Portland)
- 1 Polk (Dallas)
- 2 Umatilla (Pendleton)
- 13 Washington (Hillsboro)

Cases by Age Group
- 1 17 or younger
- 3 18-24
- 1 25-34
- 10 35-54
- 24 55+
Slow steady march added Benton and Yamhill counties.

Oregon Health Authority as of 10a Mon, Mar 16
- 47 Positives
- 689 Negatives
- 1 Death
- 184 Pending
- 352 Currently Monitoring
- 381 Completed Monitoring or no risk

Cases by County
- 2 Benton (Corvallis)
- 2 Clackamas (Oregon City)
- 6 Deschutes (Bend)
- 1 Douglas (Roseburg)
- 2 Jackson (Medford)
- 1 Klamath (Klamath Falls)
- 10 Linn (Albany)
- 3 Marion (Salem)
- 2 Multnomah (Portland)
- 1 Polk (Dallas)
- 2 Umatilla (Pendleton)
- 14 Washington (Hillsboro)
- 1 Yamhill (McMinnville)

Cases by Age Group
- 1 17 or younger
- 3 18-24
- 1 25-34
- 13 35-54
- 29 55+

theanimal
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Re: COVID-19

Post by theanimal »

Jin+Guice wrote:
Mon Mar 16, 2020 7:48 pm
On the brighter side, how did SK limit the disease so effectively? They seem to have flattened the curve drastically, yet they don't seem to have taken the restrictive measures that China has.
Aggressive testing and isolation of those who test positive. SK tests over 10k per day. The US has only tested something like ~14k in total. SK had their first 30 patients contained, but the 31st broke protocol and infected 2 separate clusters leading to higher totals.

More on their testing and patient 31 here: https://www.bbc.com/news/world-asia-51836898

George the original one
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Re: COVID-19

Post by George the original one »

George the original one wrote:
Sun Mar 15, 2020 6:53 pm
State of Washington published count as of 3:00p Sun, 15 Mar
- 769 Positives
- 9451 Negatives
- 42 deaths

Cases by County (County seats)
- 3 Clark (Vancouver)
- 1 Columbia (Dayton)
- 2 Grant (Ephrata)
- 1 Grays Harbor (Montesano)
- 6 Island (Coupeville)
- 3 Jefferson (Port Townsend)
- 420 King (Seattle)
- 3 Kitsap (Port Orchard)
- 3 Kittitas (Ellensburg)
- 29 Pierce (Tacoma)
- 4 Skagit (Mount Vernon)
- 176 Snohomish (Everett)
- 3 Spokane (Spokane)
- 3 Thurston (Olympia)
- 3 Whatcom (Bellingham)
- 4 Yakima (Yakima)
- 104 Unassigned (labs are having trouble keeping up and Dept of Health is working to determine the proper county)

Cases by Age
- 2% 0-19
- 7% 0-29
- 11% 30-39
- 12% 40-49
- 16% 50-59
- 14% 60-69
- 18% 70-79
- 20% 80+

Cases by Sex at Birth
- 53% Female
- 43% Male
- 4% Unknown
135 new cases and 6 deaths. Lewis & Lincoln counties have their first infections. Demographics of the infected population are shifting younger. Predictably, in my Facebook feed, those leaning to the right are calling Governor Inslee's restrictions unconstitutional and are looking to sue for the right of assembly.

State of Washington published count as of 3:45p Mon, 16 Mar
- 904 Positives
- 9451 Negatives
- 48 deaths

Cases by County (County seats)
- 4 Clark (Vancouver)
- 1 Columbia (Dayton)
- 3 Grant (Ephrata)
- 1 Grays Harbor (Montesano)
- 7 Island (Coupeville)
- 3 Jefferson (Port Townsend)
- 488 King (Seattle)
- 7 Kitsap (Port Orchard)
- 3 Kittitas (Ellensburg)
- 1 Lewis (Chehalis)
- 1 Lincoln (Davenport)
- 38 Pierce (Tacoma)
- 7 Skagit (Mount Vernon)
- 200 Snohomish (Everett)
- 3 Spokane (Spokane)
- 4 Thurston (Olympia)
- 3 Whatcom (Bellingham)
- 4 Yakima (Yakima)
- 126 Unassigned (labs are having trouble keeping up and Dept of Health is working to determine the proper county)

Cases by Age
- 2% 0-19
- 7% 0-29
- 12% 30-39
- 13% 40-49
- 16% 50-59
- 15% 60-69
- 17% 70-79
- 18% 80+

Cases by Sex at Birth
- 53% Female
- 43% Male
- 4% Unknown

AnalyticalEngine
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Re: COVID-19

Post by AnalyticalEngine »

I'm having a hard time believing that 50%-75% of covid cases are asymptomatic. When WHO did their joint venture to China, they found only 1% of cases were asymptomatic. Maybe 20% are asymptomatic. But there is absolutely no way 70% of cases are asymptomatic. That doesn't even make biological sense how that could even happen. I can't find the original study for this 75% statistic, but would be almost certain this is some translation error or misunderstanding by journalists.

What is likely is that many cases of transmission are pre-symptomatic, which is vastly differently.

I just think it's important not to draw wild conclusions from one study when this virus is an evolving situation and we have contradictory data.

classical_Liberal
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Re: COVID-19

Post by classical_Liberal »

theanimal wrote:
Mon Mar 16, 2020 8:03 pm
Aggressive testing and isolation of those who test positive. SK tests over 10k per day. The US has only tested something like ~14k in total.
I think some of the barriers have been recently lifted. At least they have regionally in my state. Up until now, providers had to justify testing to the state DoH, who had ultimate authority over if someone was being tested. They were likely following CDC recommendations which required close contact or travel in addition to symptoms. Now, it's my understanding, the front line medical providers have authority to test without DoH approval. This is a huge step forward, IMO.
AnalyticalEngine wrote:
Mon Mar 16, 2020 9:42 pm
I'm having a hard time believing that 50%-75% of covid cases are asymptomatic...
I wonder if this is a situation in which of mild cases are having similar symptoms to common cold. So people know they are ill, but just go about daily lives, like everyone would normally do with a cough, etc. Technically they are not asymptomatic, but being considered as such by journalists. This may be where there is conflicting information? I'm not sure, but it makes sense.

black_son_of_gray
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Re: COVID-19

Post by black_son_of_gray »

black_son_of_gray wrote:
Mon Mar 16, 2020 2:24 pm
San Francisco essentially locked down starting tomorrow. Rest of California Bay Area expected to be similar.
For those of you who are curious what a lockdown situation might look like in your part of the USA, here is a FAQ about the SF lockdown, which starts tomorrow 3/17 and continues until 4/7 at least.

https://sf.gov/stay-home-except-essential-needs
Vulnerable populations must stay home. Everyone should stay home except to get food, care for a relative or friend, get necessary health care, or go to an essential job.
The FAQ restates a lot of similar questions to really drive home the point.
These essential services will remain open:

City/County government services: Police stations, fire stations, hospitals/clinics and healthcare operations, jails, courts, garbage/sanitation, transportation (including Muni), utilities (water, power and gas), and certain city offices. Use online or mobile services whenever possible.
Gas stations
Pharmacies
Food: Grocery stores, farmers markets, food banks, convenience stores, take-out and delivery restaurants
Hardware stores/plumbers
Banks
Community benefit organizations on a case-by-case basis
Laundromats/laundry services
I know @jacob mentioned a scenario where a pipe bursts and you need a plumber/hardware to fix it. They've taken that into consideration.
What can't I do?

You cannot engage in group activities in person with others.
You cannot have dinner parties. You cannot invite friends over to your home to hang out.
You cannot go to bars or nightclubs.
You cannot go to a nail salon or get your hair cut by a stylist or barber.
You cannot go shopping for non-essential goods.
You cannot take unnecessary trips on public transport or in your car or motorbike.
Is this mandatory or is it just guidance?

It is mandatory. This Order is a legal Order issued under the authority of California law. You are required to comply, and it is a misdemeanor crime not to follow the order (although the intent is not for anyone to get into trouble).

It is critical for everyone to follow the Order to prevent the spread of COVID-19 and protect themselves, their loved ones, friends, neighbors and the whole community.

All persons, businesses, and other entities are required to comply if they do not fall within the exemptions that are specified in the Order.
No visiting friends or family unless in a care-giving capacity and generally, no visiting sick loved ones at the hospital either. Deliveries from online shopping are considered essential services and will still happen.

It'll be really interesting in the next week or two to see: 1) if the data start to show that this is working (might be tricky considering how little testing data there actually are to begin with); 2) if other states/cities implement something similar or go for something more/less strict; 3) if being "early" relative to other places in the US really does help dramatically (I sure hope so!)

black_son_of_gray
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Re: COVID-19

Post by black_son_of_gray »

From the FAQ (emphasis mine):
Why now?

This Order is being issued now because the infection rates in the Bay Area have reached a level that means the situation is either critical or will be soon. Some jurisdictions believe their health care systems may start becoming overwhelmed in the next week. For those jurisdictions, the spread has to be stopped immediately. For the other jurisdictions in the Bay Area, which are just a week or so behind, now is the time to take the strongest action possible to avoid allowing the disease to reach the point in the next few weeks that may overwhelm the health care system. The sooner these extreme measures are taken, the more effective they are because of how the virus spreads.
Soooo..... 1-2 weeks more of business as usual and the Bay Area heath care systems might become overwhelmed? :shock:

classical_Liberal
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Re: COVID-19

Post by classical_Liberal »

I have some ears in the healthcare grapevine in the Midwest region. Hospitals are beginning to stop scheduled non-emergent surgeries in preparation. My hospital system is taking this very seriously with many measures now in place. I won't go into specifics, but I'm pretty impressed, given we do not have an epicenter of cases in our region.

Person to person talk in the healthcare biz; we are all gearing up personally for some potentially heavy loads. Please do your part in prevention and patience. If you have any healthcare workers in your tribe, reach out to give them some support if it gets tough in your area, I'll be appreciated.

I'm not sure if this will make any of you feel any better, but it should. Your nurses and doctors have your back, as best as we will be able. Stay healthy!

ertyu
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Re: COVID-19

Post by ertyu »

In my country, nurses have been quitting over what they perceive as inadequate preparation and hazard pay. (They are probably right). RIP.

classical_Liberal
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Joined: Sun Mar 20, 2016 6:05 am

Re: COVID-19

Post by classical_Liberal »

theanimal wrote:
Mon Mar 16, 2020 8:03 pm
Aggressive testing and isolation of those who test positive. SK tests over 10k per day. The US has only tested something like ~14k in total.
Second quote on this, sorry @theanimal. It looks like politico is aggregating state data for us. https://www.politico.com//interactives/ ... new-cases/
As I suspected, some of the barriers for testing seem to have come down. As of 3/12 there had only been about 10,000 total tests. That number has surged to over 41,000 as of 3/16. So about 8,000 per day since last Friday.

steveo73
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Re: COVID-19

Post by steveo73 »

These situations really make me realize (and my wife) how important it is to save money. We've lost a lot of money but it's only paper money and if we batten down the hatches and spend at bare minimum level I think we could survive indefinitely. My wife isn't going into work because she is paranoid about the whole situation but we can actually afford to do that. She is still getting paid but her boss is putting pressure on her to come into work. She has no problems refusing. It's work from home or sick leave. If they aren't cool with that she will quit.

thedollar
Posts: 149
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Re: COVID-19

Post by thedollar »

@Jacob

I think you're right regarding your forecast. People hospitalised with Covid-19 more than doubled overnight: https://i.imgur.com/hYMotI6.png which I guess is an indicator of how things are developing.

Let's see where we are at in a week's time. I think a curfew is unavoidable by now and will be imposed before next week.

As far as I can understand the testing capability is not overwhelmed. They have changed the strategy from containment to trying to slow it down and the advice is to just stay home if you get sick - no tests. Everyone is to be considered a disease carrier.

Update: Statens seruminstitut is now estimating 9,000 to 90,000 cases in Denmark.
Last edited by thedollar on Tue Mar 17, 2020 3:53 am, edited 1 time in total.

AnalyticalEngine
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Joined: Sun Sep 02, 2018 11:57 am

Re: COVID-19

Post by AnalyticalEngine »

@c_L - I think you're right. They most certainly have to mean either that 50%-75% are mild or that pre-symptomatic transmission happens in 50%-75% of cases. 50%-75% completely without any symptoms just doesn't match the data we have. If it were true that only a quarter people show symptoms, we'd see things like only a quarter of family members getting it or a quarter of healthcare workers. Instead what we've seen is that transmission inside of households is a massive driver of new cases. Plus data in places like China, SK, cruise ship, etc show that most people do have symptoms. This is just a slow burning virus that can take many days to develop.

In other news, the job offer I was going to get fell through. The company decided to wait on hiring due to "city wide shutdowns." It's probably for the best to wait until after a quarantine here, but I just hope this doesn't trigger a recession such that they can never hire me. At least I still have my old job.

Colorado banned all seating at restaurants state wide for the next 30 days. Numerous small restaurant owners have had to lay off all their employees. With only ~160 cases, Colorado is choosing to be proactive. It's the right thing to stop the spread, but I'm really concerned for all the laid off workers and owners who can't pay rent on their buildings. I hope this doesn't have to be long and that the state economy will pull through...

ETA: Found a paper that describes the asymptomatic rate at 18%. That's a lot more reasonable: https://www.eurosurveillance.org/conten ... l_fulltext

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