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Re: COVID-19

Posted: Fri Mar 27, 2020 8:49 am
by Jason
No worries in the US being that Trump walks through the world like he's Robert Duvall on the beaches of Viet Nam in Apocalypse Now.

Re: COVID-19

Posted: Fri Mar 27, 2020 8:55 am
by jacob
@Bankai - High profile people seemingly have very easy access to testing for even the lightest of symptoms indicating a wider spread. OTOH, politicians do shake hands and otherwise interact with a lot of different people making them great vectors indicating the opposite. It's tradition in the US when one president leaves the office to leave a letter with a piece of advice for the next president and IIRC, GWB give Obama a bottle of hand sanitizer and recommended using it.

Re: COVID-19

Posted: Fri Mar 27, 2020 8:57 am
by Gilberto de Piento
Another factor to consider when considering whether or not the current measures are needed is mutation. A few weeks ago there was a report that the virus had mutated so there was more than one type with variation on ability to spread and to kill. Maybe different types are operating in different areas making for different results. This along with all the other factors would make the measures look more or less necessary.

Re: COVID-19

Posted: Fri Mar 27, 2020 9:04 am
by Jason
This was in the NYT - how a ritzy Connecticut community became a hub of the virus for various reasons including fear of stigmatization.

https://www.nytimes.com/2020/03/23/us/c ... -zero.html

I felt when Tom Hanks announced that he and his wife caught the virus that it was somewhat a Magic Johnson has AIDS moment, at least in the US. I know when I told someone I wasn't feeling well the first thing they asked was "Do you have the virus?" I understood their concern as I was just with them a few days before but it felt that someone just spray painted COVID19 on my life.

High profile announcements at once reflect the discrepancy of testing but also serve as cautionary tales and anecdotal means to de-stigmatize.

Re: COVID-19

Posted: Fri Mar 27, 2020 9:40 am
by 7Wannabe5
@classical_Liberal:

First off, I am not a math whiz (call out to daylen/Jacob etc.) It does not take a math whiz to recognize the huge problem with the math/science in the WSJ/Stanford MDs opinion piece.

There are many examples of well conceived studies that extrapolate from a relatively small group to a larger population, for instance the Framingham Heart study. This only works if valid assumption that small group is reasonably representative of larger group. The extrapolation described in the WSJ opinion piece does the opposite. The population of Vo was not chosen for mass testing because representative or at random. It was chosen because early incidence was already detected there! So, the Stanford MDs are extrapolating rate of infection over entire region in violation of level of introducing bias into data that is taught at 8th grade level. Therefore, what I would be so bold as to extrapolate would be that the average WSJ reader must be at below 6th grade math/science competency.

Anyways, the simple answer to your question is that such an extensive survey would generate far more than enough data for valid statistical analysis. However, it would just generate a snapshot in time of what is a constantly changing situation. I am constantly updating my own take as I attempt to read more science (as opposed to either opinion pieces or hospital room anecdotes) and my current take is that the level of contagion is such that a reasonable degree of social distancing is generally effective and that is why/where curve flattens. IOW, large hidden already immune asymptomatic portion of population is not necessary or best fit explanation.

Re: COVID-19

Posted: Fri Mar 27, 2020 9:49 am
by George the original one
AnalyticalEngine wrote:
Thu Mar 26, 2020 10:11 pm
That's interesting. Did she mention in what ways the spread of COVID-19 doesn't match their models? Is it spreading faster than they were expecting?
They were expecting a faster spread.

Re: COVID-19

Posted: Fri Mar 27, 2020 10:04 am
by Tyler9000
7Wannabe5 wrote:
Fri Mar 27, 2020 9:40 am
It does not take a math whiz to recognize the huge problem with the math/science in the WSJ/Stanford MDs opinion piece.
To be fair, it also does not take a math wiz to recognize the huge problem with the math/science in the Imperial College study that everyone seems to hold as the gold standard. They assumed that there would be no community testing available at all to mitigate the spread until a vaccine is widely available, an important detail which is on the verge of being invalidated just a few weeks later. That makes a big difference! And if some of these treatments pan out in reducing the fatality rate and recovery time by external means, all bets are off with every study done so far. Models are hard, and even the very best ones require constant updates as new information becomes available.

In any case, I personally have no idea what will happen. Being a seasoned ERE reader, I'm pretty sensitive to trying to avoid sitting on top of Mt. Stupid. And frankly, most of the layperson/media research interpretations seem to be falling exactly into that trap with a false sense of expertise in fields they knew nothing about before reading about pandemic models on Wikipedia. If you read Twitter (please don't), apparently everyone is an epidemiology expert now and the actual people who have dedicated their lives to it are morons who don't know how science works. :roll:

So I'll keep sharing stories about different researchers who have competing ideas about what's going on in the hope that the truth is out there somewhere and will reveal itself in time.

Re: COVID-19

Posted: Fri Mar 27, 2020 10:20 am
by George the original one
7Wannabe5 wrote:
Fri Mar 27, 2020 9:40 am
IOW, large hidden already immune asymptomatic portion of population is not necessary or best fit explanation.
Exactly my thoughts.

COVID-19 has a long cooking time, 2-12 days with the average at 5 days. Those long and short tails may indicate that the length or concentration of exposure is a factor in transmission, while most models with wider/faster spread probably assume instant infection at exposure.

Beyond social distance, we know that washing hands and face masks reduce infectability, otherwise our health professionals would not be able to do their work.

The other thing we saw from the Chinese lockdown is that the virus is persistent. It took 6+ weeks of lockdown before they had no new cases.

Re: COVID-19

Posted: Fri Mar 27, 2020 11:17 am
by sky
Apparently industrial farming is causing risk of influenza outbreaks similar to COVID-19 which was likely caused by bushmeat.

(Long youtube video)
Pandemics, History and Prevention
https://youtu.be/7_ppXSABYLY

Re: COVID-19

Posted: Fri Mar 27, 2020 12:30 pm
by 7Wannabe5
@Tyler9000:

I don’t disagree. Every model is only as good as its assumptions combined with its math. My BIL who is an epidemiologist is now replying “I’m not a virologist!” ti any requests for his take in the situation :lol:

@GTOO:

The study on the mutation of the virus itself indicated high degree of variability in transmission. As in some humans pass it on to zero other humans and some humans pass it DIRECTLY on to 40 other humans. This evidence is independent of the human population surveys so lends credence to social distancing behaviors as effective mechanism to slow transmission. IOW, if everybody is taught/forced to exhibit behavior like unto that of least effective spreaders prior to widespread knowledge of epidemic, rate of transmission should be significantly reduced.

Re: COVID-19

Posted: Fri Mar 27, 2020 12:57 pm
by thrifty++
IlliniDave wrote:
Fri Mar 27, 2020 4:58 am
Looks like I'll have to make my own decision when enough is enough and I stop going into work.
My god I can't believe that your work has not taken steps to arrange for staff to work from home. That is completely negligent. Personally I would take charge myself and proceed to work from home.

Re: COVID-19

Posted: Fri Mar 27, 2020 1:04 pm
by George the original one
Missouri has got to be the weirdest state. What sort of governor calls out the National Guard to assist with COVID-19 response, gets a federal disaster declaration, yet refuses to issue a "stay at home" order because it will damage the economy? At least St. Louis and Kansas City mayors issued "stay at home" orders earlier this week.

Re: COVID-19

Posted: Fri Mar 27, 2020 1:07 pm
by George the original one
7Wannabe5 wrote:
Fri Mar 27, 2020 12:30 pm
The study on the mutation of the virus itself indicated high degree of variability in transmission. As in some humans pass it on to zero other humans and some humans pass it DIRECTLY on to 40 other humans.
COVID Georges, you say? :mrgreen:

Re: COVID-19

Posted: Fri Mar 27, 2020 1:25 pm
by Tyler9000
Augustus wrote:
Fri Mar 27, 2020 12:39 pm
My thinking is that it's prudent to base your personal decisions on a worst case set of numbers right now.
...
I fully expect the numbers to not be that bad, but it's just not worth the personal risk to assume things will be fine right now since no one knows.
That's a very reasonable approach. And as the situation changes, our plans can change as well.

Re: COVID-19

Posted: Fri Mar 27, 2020 1:39 pm
by George the original one
If you rank the states by case count (easily done with the Johns Hopkins map, Admin 2 tab after highlighting US on Admin 1 tab, https://coronavirus.jhu.edu/map.html) and don't bother to adjust for population, then I think the states to watch are the ones who do not have a "stay at home" order.

As of yesterday, in the top half of the list, they are:
  • Florida - bars, nightclubs closed Mar 17, state parks closed Mar 22
  • Pennsylvania - 7 counties "stay at home" Mar 23
  • Texas
  • Georgia
  • Tennessee
  • North Carolina - bars, nightclubs closed
  • Maryland
  • Alabama
  • Arizona
  • Missouri - St. Louis & Kansas City "stay at home" Mar 23 & Mar 24 respectively
  • Mississippi
  • Virginia

Re: COVID-19

Posted: Fri Mar 27, 2020 1:52 pm
by jacob
Augustus wrote:
Fri Mar 27, 2020 12:39 pm
I fully expect the numbers to not be that bad, but it's just not worth the personal risk to assume things will be fine right now since no one knows.
This is what I'm going with (not adjusted for age or comorbidity).

Death rate: 1.2% with vents still available, 2.4% with no more vents. (I've previously explained my rationale for these numbers.)
Hospitalization(*) rate: 0.024/0.15 = 16%. (15-20% of all hospitalizations go into critical, ratio seems to hold all over the world)
Asymptomatic rate: 70% (Vo, IT). (Also includes the "I'm not sure I have it, but I have something, maybe?" cases)
Non-hospitalized but with symptoms up to and including pneumonia: The rest or 14%. (Includes the, "I definitely had it/sickest ever/I pulled through" cases)

Total number of infected before herd immunity is achieved given no change of behavior: (2.5-1)/2.5 = 60% with R0=2.5
Total number of infected before herd immunity given Italian lock down: 5-30% (we don't know yet since the curve has yet to break)

(Interestingly, normal influenza has an reproduction number of ~1.4 which is lower and thus easier to control. A nice side-effect of the social distancing and other measures is that the number of ordinary flu cases have seen a significant decline.)

(*) Alternatively a cot in a convention center together with 500 other people.

Being in the US, even if one is fearless of death or nobly willing to chance it for the continued prosperity of the stockmarket economy, the medical bill from spending a week in the hospital should give pause. Though maybe there's a discount on the "cot#481 in a sports hall"-package? #facetious

Re: COVID-19

Posted: Fri Mar 27, 2020 1:54 pm
by Tyler9000
George the original one wrote:
Fri Mar 27, 2020 1:39 pm
...I think the states to watch are the ones who do not have a "stay at home" order.
Texas is a big state. The major metropolitan areas like Houston, Dallas-Ft.Worth, Austin, and San Antonio have all issued local stay-at-home orders already, while other more remote cities with minimal or no cases have not needed to yet. While I agree with your premise, IMO only looking at state-wide orders doesn't necessarily tell the whole story.

Re: COVID-19

Posted: Fri Mar 27, 2020 2:00 pm
by Jin+Guice
@thrifty++: The U.S. is responding in a highly regional manner. IIRC iDave lives in Alabama. Despite the fact that the southwestern edge of Alabama is only a little bit over 100 miles from where I'm sitting right now in New Orleans, they appear to be more than a week behind us in both cases and response (and that's assuming you're in a city, if you're not, than you're further "behind"). In a twisted way, it's sort of amazing to watch one state/ city refuse to learn from another nearby state/ city. Put another way, I have noticed a high degree of "that won't happen here" syndrome repeating over and over again throughout the country with lag times of a few days to a few weeks depending on the region. I guess that's just the kind of maverick mentality it takes to create something as culturally significant as the Cowboy Burger.

Re: COVID-19

Posted: Fri Mar 27, 2020 2:09 pm
by CS
The ones who survived the holocaust were those who moved fast (and were lucky enough to find a way). They didn't wait. They ignored those who said they were overreacting.

I try to never forget that.

Re: COVID-19

Posted: Fri Mar 27, 2020 2:21 pm
by jacob
@J+G - It's "interesting" (again in the morbid way) to compare the spread of COVID to the way the black death spread in Europe in 1346+ and how similar it is. The "port cities" that see a lot of international connections get it first. That's Seattle for Asia and NYC for Europe. The Black Plague spread with the cargo along the coast from port city to port city and then diffusing inland from there.

COVID spreads via people (rather than cargo) and thus the next epicenters come from areas that see a lot of travel to and from the initial cities. That's Chicago, SF, LA for the business travelers and New Orleans (and Florida) for the tourists. (In Europe it was the ski resorts that acted as incubators.)

Next and now we begin to see the spread along the interstates from people taking it from the big cities to the nearest big city, e.g. from NYC to Albany, NY and so forth.

Many in the hinterland, whether it's say upstate New York or flyover country, definitely operate under a "it can't happen here" down to the point of believing it's an outright hoax or that it can be explained away as a "big city problem" ("Perhaps their health care politics are failing? Someone should look into that.")

But it's coming slowly along the freeways and highways as some grandparent drives 200 miles across state to visit their grandchild; maybe infects a gas station attendant along the way, ... eventually getting everywhere.---I have not heard of any city blockading all entry and exit roads yet. During the Black Death, the cities that did that actually fared pretty well.