COVID topic vol 2

[George the original one]

This shit is for real people.

I do wonder about the people that still believe North Dakota and South Dakota are only leading the country in per capita infections merely because of expanded testing. COVID-19 deaths there are rising as fast as the cases did.

There is definitely a seasonal component to the virus spread. Oregon & Washington's infection rates have been doubling in a day for awhile and now people are wondering where all the cases come from, but I haven't seen any voluntary change of behavior yet. I think people here have forgotten how slow it is to turn around the SS Covid unless government intervenes... at least the UK saw the light and acted in a timely fashion whereas the USA has 22 states with infection rates higher than the UK!

[DutchGirl]

...whereas the USA has 22 states with infection rates than the UK!

I miss a word here, George...?

[Stahlmann]

some jock from HS who is larping as (young) "economist advisor".

Ladies and Gentlemen, the actual state of affairs is that the health care system has collapsed and these signals are coming from all over Poland (refusal to admit patients, ambulances standing by). The worst thing is that in March, not only doctors, but also economists, clearly informed the government about the state of Polish health care and what steps to take.

Hospitals all over Poland are asking for help. If you can, please do shopping tomorrow, even for 1 patient, pack it and send it to the selected hospital. "Let's adopt a patient" in his hometown or other place in the country! Below, let's compile a list of all hospitals in PL that are calling for help (request for comments with links) and share it further.

0o

[jacob]

https://www.nytimes.com/2020/11/09/heal ... fizer.html ...

Pfizer announcing early vaccine trial results with an efficacy of 90%. 90% is [unexpectedly] really good. Recall that early R0 (before people started changing their social behavior) was in the 3.5--4.5 range. This mathematically required 4.5/(1+4.5)=81% infected to achieve herd immunity insofar immunity was long-lasting. (There are indications with people getting reinfected in less than 6 months indicating that this is not the case.)

Since 90% is more than 81%, this means that insofar a 81%/90%=90% vaccination rate can be achieved, the disease could be stamped out. This depends on the speed of which such a vaccine could be rolled out globally. How long it lasts (I don't know)? And to which degree residual patient zeros can be contact traced and have their neighborhoods/cities vaccinated. (To compare, see how smallpox was hunted down.)

Based on previous behavior clear that some countries (most of ASEA) and states (Vermont) has the organizational capability to implement such a program. We'll see if it goes for all of us.

[Alphaville]

this is really good news provided viral mutation as in the case of mink zoonosis plus antivaxxer behavior doesn’t manage to get around that.

so i’m as excited as everyone else right now, but with some reservations.

[Crusader]

This mathematically required 4.5/(1+4.5)=81% infected to achieve herd immunity insofar immunity was long-lasting.

How did you come up with that formula? My thinking was that R0 of 4.5 means that one infected person will infect 4.5 other people, so if you have one infected person, out of the 4.5 people they would normally infect, you want only up to 1 person to get infected, i.e. 3.5/4.5 = 78% should not get infected. Anything better than this would mean that the numbers would go down. So a vaccination with >78% efficacy would mean that the disease would get irradiated over time (not 81%). (I am ignoring reinfection time frames)

[jacob]

Ugh .. my bad (misremembered).. the equation is (R0-1)/R0 .. so 3.5/4.5=77.7% which is even better.

Thanks for the correction.

[Crusader]

You are welcome. In fact, if we assume that the infected person has 100% immunity, it's even better (how much so depends on the number of actual COVID infections).

We can even account for the amount of anti-vaxxers we would be able to sustain

(100 - X)*.90 = 77.8
X = 13.6

So, even if 13.6% people don't get vaccinated, the disease will get eradicated (assuming a uniform distribution of anti-vaxxers, which is not a good assumption).

[7Wannabe5]

I think it will be even better than that because some portion of the population should have acquired immunity by having the virus.

I am also happy because the BNTX I acquired when they bought up NTGN last year just took the pop I was waiting for. Maybe I can now afford an awning on my micro-camper!

[George the original one]

I miss a word here, George...?

Yup. "... higher than the UK."

[UK-with-kids]

I don't think the disease will be eradicated any time soon. For one thing, only one disease has ever been eliminated by a vaccine - that was smallpox and it took 200 years. You have to ask why we would prioritise eradicating this particular disease when there are still worse killers out there like malaria and even polio which is still hanging on in central Asia. When you have diseases that strike down healthy adults and children it's hardly the priority to protect the unhealthy elderly (median age of death with Covid is around 82). Then you have the problem that the Pfizer/BioNTech vaccine has to be stored below -80°C (-112°F) so distribution is a huge barrier. The world population is so large now that the most likely thing is that this will just become another endemic coronavirus alongside the others but one that occasionally finds its way into western countries and kills a small number of people before it's jumped on. A bit like measles but not as deadly. If there is money to spare for trying to vaccinate the whole world against Covid then it would be better spent dealing with all the side effects of focusing solely on Covid for most of this year - missed cancer screenings, the mental health epidemic, an anticipated surge in winter flu next winter due to the lack of immunity being built up over this winter, and so on.

[jacob]

I don't think the disease will be eradicated any time soon. For one thing, only one disease has ever been eliminated by a vaccine - that was smallpox and it took 200 years. You have to ask why we would prioritise eradicating this particular disease when there are still worse killers out there like malaria and even polio which is still hanging on in central Asia.

Sure, okay. And I can answer that ...

The reason malaria has not been eliminated is that there is an animal reservoir (mosquitoes) and the efficacy of the current best malaria vaccine is too low (about 30%). To eliminate it, one would therefore have to eliminate all the mosquitoes (the vector) because vaccinating everybody won't cut it. Various strategies have been pursued to various effects. Screened windows and draining swamps (malaria used to be endemic in the US but is no more). Spraying with DDT which kinda backfired. And inserting sterile mosquito males into the population. The US has a program at the southern border too. Anyhoo, this basically hinges on eliminating mosquitoes or finding a vaccine with a higher efficacy which because of the non-human reservoir would need to be 99%+ so that the distance between non-infected humans is >> than the maximum flight path of mosquitoes. Note that there are several different malaria strains which complicates things. The disease is evolving.

The only reservoir for polio, on the other hand, is humans, so it's similar to smallpox and is being eradicated with the same methods. Contact tracing patient zero(*) and then isolating and vaccinating everybody around them---much like on those exciting movies. We could have handled COVID in the same way initially if testing had been sufficient and dawdling hadn't been endemic. Anyway, there are just a few hundred/thousand cases of polio concentrating in just a few countries in the world at this stage. It's almost gone.

(Measles is human-only similar to polio and it was almost stamped out by a rather effective (95%+) vaccine until anti-vaxxing allowed a resurgence. OTOH, influenza has animal reservoirs (both pigs and birds) so it will never go away. Ditto Ebola.)

(*) This is why the reservoir is important. You can contact trace a human. Tracing which particular mosquito infected someone is a lot harder

But in short, there are programs for practically all infectious diseases out there. But since the diseases are different, the strategies and success rates are also different.

[nomadscientist]

Add to which, another reason malaria etc. are not completely eliminated is that they are negligible risks in developed countries already so those who are capable of elimination now have other priorities. A Corona vaccination program doesn't have to be all that comprehensive to get the disease to that point. Assuming the vaccine is 90% effective in immunising the old*, it would only take vaccination of 10-20% of the population to reduce expected mortality rate to that of the flu in developed countries. While poorer countries are likely to remain as corona reservoirs, they also tend not to have large populations of elderly who are at high risk of death from the disease.

There is another question whether the media and officials will ever agree to put down their favourite new toy. Enough anecdotes of individual deaths of young people reported as international news stories and many people can be persuaded that it remains a major threat to their life even when statistically it isn't. But practically speaking, the disease can be pushed down into the noise by an effective vaccine quite easily. Elimination would just be making the rubble bounce.


*the statistics aren't that good yet so it may turn out to be less than 90% effective, and it may be least effective for the old

[Alphaville]

While poorer countries are likely to remain as corona reservoirs, they also tend not to have large populations of elderly who are at high risk of death from the disease.

i’m having a hard time reading this is a non-triggering way. what do you mean by it?

[jacob]

That the number of person-years lost in a bottom-heavy population pyramid is much smaller than the person years lost in a cylindrical or even top-heavy one. While this is obviously as bad for the few elderly individuals who do catch it, the structural impact on society is not as large (because the relative number of elderly individuals is much smaller). On the flip side, the cost effort of vaccinating the elderly population (improving odds by a factor 9) is much smaller even if it does not create herd immunity.

Of course ideally the entire planet would be vaccinated within a time span of however long immunity lasts. This might be logistically impossible though. Might come down to contact tracing and rapid reaction forces dealing with local outbreaks similar to smallpox and polio. It could take years or decades to put all the worms back in the can.

[UK-with-kids]

i’m having a hard time reading this is a non-triggering way. what do you mean by it?

Nomadscientist will need to answer for himself but that was part of my thinking as well as to why CV vaccination wouldn't be a priority in developing countries. Basically, almost everyone dying from CV is very old and/or seriously ill - median age 82 and with co-morbidities. In poor countries those people are mostly already dead as they don't have access to the same healthcare keeping them alive for so long despite having various chronic conditions. This is the same reason that the Asian Flu of 1957 isn't much remembered as there wasn't such an elderly population at that time due to life expectancies being around 15-20 years shorter. CV is much more comparable to the 1957 pandemic than the 1918 Spanish Flu in terms of which age groups were most effected.

[Laura Ingalls]

I do wonder about the people that still believe North Dakota and South Dakota are only leading the country in per capita infections merely because of expanded testing. COVID-19 deaths there are rising as fast as the cases did.

South Dakota and North Dakota have pretty different positivity rates and testing regimens. I suspect the virus is actually worse in SD. DH’s hometown had a tavern where the proprietor actively forbade masks. All the barfly sorts got sick. And now lots of people that have never set foot in the bar have gotten sick.

We have plenty of problems in my current location, but I am greatly to have gotten out of a place completely overrun by Trump kool-aid drinkers.

[ertyu]

It is actually the worst in south dakota; there was a chart earlier today being spread around on twitter. could ptobably hunt down if sourcing is needed.

another factoid from twitter: vaccine needs to stay at very negative temperatures (-70, though I forget C or F), which is a big limitation on the practicality of wide application outside richer parts of first world.

[nomadscientist]

In poor countries those people are mostly already dead as they don't have access to the same healthcare keeping them alive for so long despite having various chronic conditions.

That is not primarily what I am getting at but the fact that families are larger so older people are a smaller proportion of the population naturally* -> covid is inherently going to have a much lower population mortality rate there even if entirely uncontrolled. It's of course also true that some countries, particularly in Sub-Saharan Africa where HIV is endemic, also have life expectancies sitting around or below the point where covid infection fatality rate exceeds the Western population average.

My guess is that countries that haven't eliminated malaria (which used to be endemic in e.g. Rome) will also fail to eliminate covid for the same reason: limited state capacity. However, given that much more external effort may be applied, that perhaps isn't certain.


* maybe it isn't well known how enormous this effect is and how enormously different many of the poorest populations look to US/European ones. E.g. ~2/3 of the population of Nigeria is under 35:

[jacob]

It is actually the worst in south dakota; there was a chart earlier today being spread around on twitter. could ptobably hunt down if sourcing is needed.

The case rate is highest in North Dakota (177/100k/day vs 137/100k/day). The ICU load is worst in South Dakota (100%+ occupied vs 37%). The exponential increase rate (reproduction number) are both slightly positive (R~1.1) and about average for the US as a whole.

Add: The positivity test rate is 18.7% and 23% respectively, both of which are pretty high indicating insufficient testing to catch/count everyone.

https://covidactnow.org/?s=1306315