COVID-19

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Seppia
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Re: COVID-19

Post by Seppia »

Maybe I'm missing the obvious, but you know that's The Onion right?

George the original one
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Re: COVID-19

Post by George the original one »

enigmaT120 wrote:
Mon Mar 16, 2020 9:59 am
Last I saw still no cases in Eugene, though my friend and his babies are sick with something. Sure just as I finally learn to make new friends again I can't go hang out with them!!!
Still a mystery to me why Lane County has avoided having any reported cases. I can only assume people just are being good about staying home if ill and/or not calling their doctor.

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Ego
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Re: COVID-19

Post by Ego »

https://papers.ssrn.com/sol3/papers.cfm ... id=3551767
This paper investigates how air temperature and humidity influence the transmission of COVID-19. After estimating the serial interval of COVID-19 from 105 pairs of the virus carrier and the infected, we calculate the daily effective reproductive number, R, for each of all 100 Chinese cities with more than 40 cases. Using the daily R values from January 21 to 23, 2020 as proxies of non-intervened transmission intensity, we find, under a linear regression framework for 100 Chinese cities, high temperature and high relative humidity significantly reduce the transmission of COVID-19, respectively, even after controlling for population density and GDP per capita of cities. One degree Celsius increase in temperature and one percent increase in relative humidity lower R by 0.0383 and 0.0224, respectively. This result is consistent with the fact that the high temperature and high humidity significantly reduce the transmission of influenza. It indicates that the arrival of summer and rainy season in the northern hemisphere can effectively reduce the transmission of the COVID-19

George the original one
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Re: COVID-19

Post by George the original one »

Finally some honesty from the Trump admininstration regarding COVID-19!
"We are at a critical inflection point in this country, people. We are where Italy was two weeks ago in terms of our numbers," U.S. Surgeon General Dr. Jerome Adams told Fox News. "When you look at the projections, there's every chance that we could be Italy."

George the original one
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Re: COVID-19

Post by George the original one »

It indicates that the arrival of summer and rainy season in the northern hemisphere can effectively reduce the transmission of the COVID-19
Except west coast USA is transitioning to the dry season...

black_son_of_gray
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Re: COVID-19

Post by black_son_of_gray »

San Francisco essentially locked down starting tomorrow. Rest of California Bay Area expected to be similar.

"Shelter in place" for next 3 weeks. Wow, that came on fast.

https://www.sfchronicle.com/bayarea/art ... 135087.php
Counties are shutting down all but the most critical operations. Places that attract clusters of people, like gyms, nightclubs or bars, will have to close down. Restaurants must serve only take-out or delivery orders. Hospitals, grocery stores, banks and pharmacies will remain open.

The order calls for all “routine medical appointments” and elective procedures to be canceled or rescheduled.

Daycare centers and veterinarians will remain open with some restrictions, as will laundry services. Emergency services, like police and fire operations, will also continue.

All non-essential gatherings of any size are now banned.

George the original one
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Re: COVID-19

Post by George the original one »

Figured I'd check on hospital bed availability in my little town of Seaside, Oregon. The hospital currently operates 25 beds, but has been licensed in prior years for as many as 56 beds... don't know if they're currently licensed for the 56 beds, but it indicates a possible overflow potential to have that many if there is adequate staff to serve.

Seaside population is 6707 per a 2017 estimate and was 6514 at the 2010 Census. Nearby Cannon Beach population is 1728 per 2017 estimate and 1690 at the 2010 Census. Have to also throw in the even closer community of Gearhart, population 1593 per 2017 estimate and 1462 at the 2010 estimate. Sticking with the 2017 estimates, the Seaside hospital serves 10,028 people.

If 50% of the people come down with COVID-19, then that's 5014 cases. 20% of them will become serious cases = 1002... okay, we're waaay over capacity by then!

Let's try the other direction, how many cases are the maximum that can be handled? Best case, 56 beds times 5 means 280 cases which is a mere 2.79% of the local population. A more realistic expectation is that the local hospital will be out of capacity when less than 1% of the population is infected.

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Re: COVID-19

Post by jacob »

@GTOO - Hang on! I'd estimate it differently. SK with wide testing and the situation under control (having an experienced government in charge must be nice) has a CFR of 0.7%. Lets presume they found everyone who was infected so this is the true CFR. This means that Seaside will have at least 0.007*6707=47 fatalities.

Roughly only half of who goes into critical survive, so this means that 2*47=94 ICUs are needed. (ICUs are as far as understand needed for 1-2 weeks... it takes about 1 week to die w/o a fancy ventilator) Of those getting admitted to hospitals, about 15-20% end up going to critical. If the rest get normal beds, then the system needs 94/0.15*0.85=532 regular beds.

Seaside, therefore, needs 94 ICUs and 532 beds insofar the curve is not flattened. Once the ICU count is exceeded, ~everybody who needs it but doesn't get access dies.

So if the entire population is infected, 47 will die after using 94 ICUs; 532 will survive on a regular hospital bed; and the rest (6707-532-{47:94}) ~ 6100 will survive in home quarantine with various levels of symptoms... everything from nothing-burger to non-hospitalized pneumonia.

(This is the best I can do in terms of estimating iceberg effects. Also, I don't know what the odds of regular hospital bed vs at home treatment is. Hopefully, there will be a better handle of this soon. Without widespread testing and more countries sorting themselves out and arriving on the other side, it's rather hard to know.)

George the original one
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Re: COVID-19

Post by George the original one »

Augustus wrote:
Mon Mar 16, 2020 3:49 pm
5% or less require hospitalization based on what I've read. Serious just means you feel like crap at home. Age is also a major factor, if the population skews younger, then fewer people will need hospitalization.
80:20 ratio from China was serious=hospitalization.

Of reported cases in Oregon, about 50% have been hospitalized as of last Wednesday. Unfortunately, that number is no longer being reported now that commercial labs are reporting test results.

George the original one
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Re: COVID-19

Post by George the original one »

jacob wrote:
Mon Mar 16, 2020 4:05 pm
2*47=94 ICUs are needed.
Okay... the campus map shows 4 rooms in ICU. That's going to be 8 beds max.

Demographics here are slanted to retired folk, too, with a median age of 43.

thedollar
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Re: COVID-19

Post by thedollar »

Sadly we have dropped the ball in Denmark.

Testing has basically been halted since last week despite WHO's call to 'test, test, test'.

We may have above 10,000 cases despite the official figure of less than 1,000.

Schools have been closed but a lot of people are not taking the measures seriously.

The only logical step now is to impose a curfew for everyone. Wonder how much pressure the healthcare system needs to be under before it's imposed.

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Bankai
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Re: COVID-19

Post by Bankai »

I wonder how much damage will multi-month-long lockdown cause?

* people who lost jobs/businesses committing suicide
* people depressed/lonely being cut off from community - mental illness or suicide
* elderly people dying sooner due to imposed loneliness
* more time at home is very bad for children/spouses in abusive relationships
* less time outdoors = worse health -> earlier deaths
etc.

Unintended consequences on the societal level will be quite serious, even disregarding hit to the economy.

chenda
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Re: COVID-19

Post by chenda »

Can US states close their borders to each other ?

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Re: COVID-19

Post by jacob »

@thedollar - I noticed the numbers where flattening out. In my [simple] modeling, I calculate between 5000 and 20000 walking cases for each fatality in non-overwhelmed system. This is based on SK CFR, inadequate lock down, a 4 day doubling rate, and roughly 3-4 weeks between infection and potential death. Most of those will not present or be asked to stay in quarantine. Median incubation time is 4 days but can be up to 12. It takes several days of symptoms after which they either get better or rapidly worse. It's only the last outcome that gets tested and registers in countries where the testing system is overwhelmed with demand>>supply. This has been the case in the US. Might be the case in Denmark too now.

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Ego
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Re: COVID-19

Post by Ego »

The things nobody is saying aloud.

PDF LINK: https://www.imperial.ac.uk/media/imperi ... 3-2020.pdf

Image

Two strategies:

Mitigation: focuses on slowing but not necessarily stopping epidemic spread – reducing peak healthcare demand while protecting those most at risk of severe disease from infection.

Suppression: aims to reverse epidemic growth, reducing case numbers to low levels and maintaining that situation indefinitely

We find that that optimal mitigation policies (combining home isolation of suspect cases, home quarantine of those living in the same household as suspect cases, and social distancing of the elderly and others at most risk of severe disease) might reduce peak healthcare demand by 2/3 and deaths by half. However, the resulting mitigated epidemic would still likely result in hundreds of thousands of deaths and health systems (most notably intensive care units) being overwhelmed many times over. For countries able to achieve it, this leaves suppression as the preferred policy option.

We show that in the UK and US context, suppression will minimally require a combination of social distancing of the entire population, home isolation of cases and household quarantine of their family members. This may need to be supplemented by school and university closures, though it should be recognised that such closures may have negative impacts on health systems due to increased absenteeism. The major challenge of suppression is that this type of intensive intervention package – or something equivalently effective at reducing transmission – will need to be maintained until a vaccine becomes available (potentially 18 months or more) – given that we predict that transmission will quickly rebound if interventions are relaxed. We show that intermittent social distancing – triggered by trends in disease surveillance – may allow interventions to be relaxed temporarily in relative short time windows, but measures will need to be reintroduced if or when case numbers rebound. Last, while experience in China and now South Korea show that suppression is possible in the short term, it remains to be seen whether it is possible long-term, and whether the social and economic costs of the interventions adopted thus far can be reduced.

Ego addition: This does not take into account what Bankai just mentioned, the increased death rate due to the resultant economic downturn. Some economists have estimated that increase to be more than the projected Covid deaths. But that cannot be said aloud because everyone has changed their twitter handle to "Flatten The Curve" Fred. Feels eerily similar to when we returned to the US after 9/11 and during the Iraq war when everyone was wearing American Flag clothing and had giant flag bumper stickers.

18 months of shutdown? Will it last until April 1?
Last edited by Ego on Mon Mar 16, 2020 6:51 pm, edited 1 time in total.

theanimal
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Re: COVID-19

Post by theanimal »

Interesting chart showing state responses so far

Image

CS
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Re: COVID-19

Post by CS »

@ego

I'm really surprised people didn't think this would last that long. The only thing that will cut that down is a good anti-viral therapy and/or vaccine. One is in testing now (not volunteering).

I guess I went through my grief over it last week, but I'm sure that emotional pain will come back in waves as event after event passes by with radically different behaviors (birthdays, Holidays, etc). And I'm able to do something I like from home. Even so, putting off future plans for nearly two years is heartbreaking.

Edit:

I watched everyone's talk today. Macron was the best, in my opinion. That said, I've heard there are troops in Paris tonight.
Last edited by CS on Mon Mar 16, 2020 9:22 pm, edited 3 times in total.

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.

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