COVID-19

[George the original one]

State of Washington published count as of midnight, Sat 28 Mar
- 4896 Positives
- 54896 Negatives
- 195 deaths

Cases by County (County seats)
- 7 Adams (Ritzville)
- 101 Benton (Prosser)
- 14 Chelan (Wenatchee)
- 6 Clallam (Port Angeles)
- 68 Clark (Vancouver)
- 1 Columbia (Dayton)
- 13 Cowlitz (Kelso)
- 5 Douglas (Waterville)
- 1 Ferry (Republic)
- 32 Franklin (Pasco)
- 50 Grant (Ephrata)
- 1 Grays Harbor (Montesano)
- 95 Island (Coupeville)
- 14 Jefferson (Port Townsend)
- 2161 King (Seattle)
- 56 Kitsap (Port Orchard)
- 7 Kittitas (Ellensburg)
- 7 Klickatat (Goldendale)
- 10 Lewis (Chehalis)
- 1 Lincoln (Davenport)
- 2 Mason (Shelton)
- 3 Okanogan (Okanogan)
- 288 Pierce (Tacoma)
- 3 San Juan (Friday Harbor)
- 101 Skagit (Mount Vernon)
- 1 Skamania (Stevenson)
- 1068 Snohomish (Everett)
- 136 Spokane (Spokane)
- 3 Stevens (Colville)
- 36 Thurston (Olympia)
- 6 Walla Walla (Walla Walla)
- 111 Whatcom (Bellingham)
- 6 Whitman (Colfax)
- 95 Yakima (Yakima)
- 387 Unassigned (labs are having trouble keeping up and Dept of Health is working to determine the proper county)

Cases by Age
- 2% 0-19
- 25% 20-39
- 33% 40-59
- 28% 60-79
- 12% 80+

Deaths by Age
- 0% 0-19
- 1% 20-39
- 6% 40-59
- 39% 60-79
- 54% 80+


Cases by Sex at Birth
- 51% Female
- 45% Male
- 4% Unknown

Washington's official reporting is somewhat functional again, only a day behind now. They reported 5062 cases on March 29, 5515 on March 30, & 5984 cases on March 31. That's 166 new cases March 29, 453 new cases March 30, & 469 new cases March 31.

It looks like Washington is off the COVID-19 trajectory and now going sideways at around 450-500 new cases per day.

State of Washington published count as of midnight, Tue 31 Mar
- 5984 Positives
- 68814 Negatives
- 247 deaths

Cases by County (County seats)
- 15 Adams (Ritzville)
- 108 Benton (Prosser)
- 17 Chelan (Wenatchee)
- 7 Clallam (Port Angeles)
- 99 Clark (Vancouver)
- 1 Columbia (Dayton)
- 16 Cowlitz (Kelso)
- 6 Douglas (Waterville)
- 1 Ferry (Republic)
- 37 Franklin (Pasco)
- 66 Grant (Ephrata)
- 2 Grays Harbor (Montesano)
- 106 Island (Coupeville)
- 17 Jefferson (Port Townsend)
- 2468 King (Seattle)
- 77 Kitsap (Port Orchard)
- 7 Kittitas (Ellensburg)
- 8 Klickatat (Goldendale)
- 10 Lewis (Chehalis)
- 1 Lincoln (Davenport)
- 5 Mason (Shelton)
- 3 Okanogan (Okanogan)
- 352 Pierce (Tacoma)
- 4 San Juan (Friday Harbor)
- 129 Skagit (Mount Vernon)
- 1 Skamania (Stevenson)
- 1221 Snohomish (Everett)
- 145 Spokane (Spokane)
- 4 Stevens (Colville)
- 46 Thurston (Olympia)
- 7 Walla Walla (Walla Walla)
- 123 Whatcom (Bellingham)
- 8 Whitman (Colfax)
- 195 Yakima (Yakima)
- 672 Unassigned (labs are having trouble keeping up and Dept of Health is working to determine the proper county)

Cases by Age
- 1.9% 0-19
- 26.1% 20-39
- 33.7% 40-59
- 26.7% 60-79
- 11.2% 80+
- 0.5% Unknown

Deaths by Age
- 0% 0-19
- 0.4% 20-39
- 6.5% 40-59
- 38.1% 60-79
- 55.1% 80+
- 0.0% Unknown


Cases by Sex at Birth
- 51% Female
- 45% Male
- 5% Unknown

[black_son_of_gray]

I've been tracking the number of confirmed COVID-19 cases in San Francisco, because:

• The California Bay Area was the first in the US to implement some form of "lockdown" policy (it is referred to as "shelter-in-place" here)
• San Francisco is surrounded by other Bay Area counties that also implemented the shelter-in-place order...so less susceptible to boundary effects
• Being the first example of an "American-style" lockdown, which seems to be considerably more lenient than European ones, I was curious to see how effective it might be in comparison.
• It's local to me.

Here are the results as of today (April 2, 2020). Shelter-in-place orders started March 17, 2020, when SF had only 43 confirmed cases.



The top plot has a linear y-axis, middle has a log y-axis, and the bottom graph is growth rate from previous day.

The good news is that it looks like the shelter-in-place has started bending the curve: the top plot is ever so slightly starting to look logistic (S-shaped), and the middle curve shows a kink off of the exponential trajectory beginning about 10 to 11 days after the shelter-in-place too effect. The daily growth rate for the last couple of days has been <10%, and today was <4%.

Potentially transferable conclusions:
1) From the beginning of a city's lockdown, it'll take a little under two weeks to see results. From the start of the lockdown until starting to see results, expect your city's number of cases to grow ~10x (!). That's worrisome for cities starting a lockdown with hundreds of cases.
2) If the daily growth rate is <5% or so, and your hospitals are not already swamped, this is approximately sustainable. This is because 1 new patient staying on a ventilator for 20 days on average (just using that number as an approximately accurate guess, feel free to plug in a better number) means you can afford a 1/20=5% growth rate. SF hospitals are not currently overwhelmed, so we are in the clear as long as we maintain the current low growth rate.
3) Between neighborhood walks and a few drives around town, I can say that SF's shelter-in-place is not super strict by any means. There are plenty of people in the parks, on the sidewalks, walking dogs, jogging, lined up outside of restaurants, grocery stores, etc. I was worried this wasn't going to work, but it appears to be.
4) If the Bay Area continues to look good in coming weeks, it will probably also be America's guinea pig when it comes to policies oriented towards getting people back to work. Good to keep an eye out for how that goes.

Special concern: San Francisco's Department of Public Health runs a massive public nursing home/hospital/rehabilitation center (Laguna Honda Hospital) that has 750 patients that are essentially all very high risk. Already, about a dozen staff and a few patients have tested positive and the current situation is very worrisome (they've brought in state and national containment experts). If COVID-19 takes off there, hundreds could die.

[George the original one]

Oregon Health Authority as of 8:00a Wed, Apr 1
- 736 Positives
- 14132 Negatives
- 19 Deaths

Cases by County
- 13 Benton (Corvallis) - Note two are actually in Washington state, though they're residents of Benton County.
- 56 Clackamas (Oregon City)
- 3 Clatsop (Astoria)
- 1 Columbia (St. Helens)
- 27 Deschutes (Bend)
- 10 Douglas (Roseburg)
- 1 Grant (Canyon City)
- 2 Hood River (Hood River)
- 22 Jackson (Medford)
- 10 Josephine (Grants Pass)
- 5 Klamath (Klamath Falls)
- 18 Lane (Eugene)
- 3 Lincoln (Newport)
- 37 Linn (Albany)
- 1 Malheur (Vale)
- 151 Marion (Salem)
- 1 Morrow (Heppner)
- 134 Multnomah (Portland)
- 18 Polk (Dallas)
- 3 Tillamook (Tillamook)
- 5 Umatilla (Pendleton)
- 1 Union (La Grande)
- 1 Wallowa (Enterprise)
- 7 Wasco (The Dalles)
- 189 Washington (Hillsboro)
- 17 Yamhill (McMinnville)

Cases by Age Group
- 14 19 or younger
- 76 20-29
- 103 30-39
- 136 40-49
- 142 50-59
- 127 60- 69
- 77 70-79
- 59 80 and over
- 2 Not available

Hospitalized by Age Group
- 1 19 or younger
- 6 20-29
- 6 30-39
- 29 40-49
- 27 50-59
- 42 60- 69
- 31 70-79
- 25 80 and over
- 0 Not available

Hospitalized
- 167 Yes
- 471 No
- 98 Not provided

Sex
- 400 Female
- 331 Male
- 5 Not available

Hospital Capacity
- 291 Available adult ICU beds
- 2006 Available adult non-ICU beds
- 66 Available pediatric NICU/PICU beds
- 193 Available pediatric beds
- 762 Available ventilators
- 134 COVID-19 admissions
- 38 COVID-19 patients on ventilators

90 new cases. Hopefully tomorrow will be fewer or else I'll have to go back on the idea that Oregon has leveled off.

Oregon Health Authority as of 8:00a Thur, Apr 2
- 826 Positives
- 15259 Negatives
- 21 Deaths

Cases by County
- 15 Benton (Corvallis) - Note two are actually in Washington state, though they're residents of Benton County.
- 61 Clackamas (Oregon City)
- 3 Clatsop (Astoria)
- 1 Columbia (St. Helens)
- 32 Deschutes (Bend)
- 9 Douglas (Roseburg)
- 1 Grant (Canyon City)
- 3 Hood River (Hood River)
- 27 Jackson (Medford)
- 12 Josephine (Grants Pass)
- 8 Klamath (Klamath Falls)
- 21 Lane (Eugene)
- 4 Lincoln (Newport)
- 37 Linn (Albany)
- 1 Malheur (Vale)
- 164 Marion (Salem)
- 1 Morrow (Heppner)
- 160 Multnomah (Portland)
- 18 Polk (Dallas)
- 3 Tillamook (Tillamook)
- 5 Umatilla (Pendleton)
- 3 Union (La Grande)
- 1 Wallowa (Enterprise)
- 7 Wasco (The Dalles)
- 211 Washington (Hillsboro)
- 18 Yamhill (McMinnville)

Cases by Age Group
- 15 19 or younger
- 89 20-29
- 112 30-39
- 157 40-49
- 159 50-59
- 144 60- 69
- 86 70-79
- 63 80 and over
- 1 Not available

Hospitalized by Age Group
- 1 19 or younger
- 8 20-29
- 8 30-39
- 30 40-49
- 32 50-59
- 46 60- 69
- 36 70-79
- 27 80 and over
- 0 Not available

Hospitalized
- 188 Yes
- 510 No
- 128 Not provided

Sex
- 448 Female
- 369 Male
- 9 Not available

Hospital Capacity
- pending Available adult ICU beds
- pending Available adult non-ICU beds
- pending Available pediatric NICU/PICU beds
- pending Available pediatric beds
- pending Available ventilators
- pending COVID-19 admissions
- pending COVID-19 patients on ventilators

[theanimal]

Blog post comparing costs of shutting down the economy versus opening up sooner in terms of $ vs. $

https://medium.com/@jseims/covid-19-mea ... 4b75a12fca

The premise is that each day under lockdown is an economic cost of $14 billion and an individual human life is valued at $8 mil (based off US govt figures). With the worst case outcomes being over 2.2 million people dead, makes sense for as long as 3.5 years until a vaccine is found...

I'm sure there will be disagreements in the actual value of a human life and if one has the same value if the person dying is older in age. Idk. It's worth a read though.

[ZAFCorrection]

This is gonna sound super amoral, but...

The average victim of covid-19 is like 65 and has heart disease. $8 million at birth is plausible, but at some point that value goes to zero or even negative. If one falls back to "but it's a human life!", then what was the point of the calculation?

[Ego]

Ugh. The article presents two choices:

• A) Allow this virus to run through our population?

• B) Go into societal lockdown to hold off the epidemiological tsunami?

How about a strong lockdown of the vulnerable. Unlock the non-vulnerable.

BTW: Remember "The Deplorables?" Well, just imagine the "Revenge of The Non-Essentials" .

[theanimal]

He mentions in the post that if you use a disability adjusted life years framework the cost is much lower for older individuals. If it's $100k per year, 10 years at 65 would be $1 million.

[CS]

You want to lock the entire south of the United States then? More young people in the south are getting sick and dying than in the north -confluence of health factors, poverty (bringing its health factors with it) and access.

Edited for grammar

[theanimal]

Who is non vulnerable to the virus? This continues to ignore that pesky hospitalization rate.

[Ego]

That pesky hospitalization rate continues to ignore the difference between those with and without comorbidities, as CS mentions above.

[CS]

I don't think anyone is not vulnerable. I wanted to highlight what a difficult moving target it would be to even say 'this group go back to work', except those with antibodies. The article about the south just came out today.

[theanimal]

@ego- We differ in our estimations of health of the rest of the country in comparison to NYC. I in no way think it is better and in specific regions such as the south think it is far worse. The comorbidities of certain age groups arent just a regional feature.

Edit: here's the article I believe CS is referring to: https://amp.theatlantic.com/amp/article/609241/

[Ego]

I think we'd agree that some young people have health issues that make them more vulnerable to hospitalization than others. Some young people have no health issues and have a very low likelihood of hospitalization as a result of covid. We are treating those healthy kids in the exact same way we are treating 80 year old smokers with COPD, diabetes and kidney disease. Makes no sense.

[jennypenny]

Is age and comorbidity the only way we're valuing individuals? I'd fail that test, so who's getting my vent? One of those idiot spring breakers from UT Austin? Some Kardashian wannabe Instagram girl? Some guy who's famous for the dumb shit he does on youtube? Sounds like a great future for America.

[George the original one]

State of Washington published count as of midnight, Tue 31 Mar
- 5984 Positives
- 68814 Negatives
- 247 deaths

Cases by County (County seats)
- 15 Adams (Ritzville)
- 108 Benton (Prosser)
- 17 Chelan (Wenatchee)
- 7 Clallam (Port Angeles)
- 99 Clark (Vancouver)
- 1 Columbia (Dayton)
- 16 Cowlitz (Kelso)
- 6 Douglas (Waterville)
- 1 Ferry (Republic)
- 37 Franklin (Pasco)
- 66 Grant (Ephrata)
- 2 Grays Harbor (Montesano)
- 106 Island (Coupeville)
- 17 Jefferson (Port Townsend)
- 2468 King (Seattle)
- 77 Kitsap (Port Orchard)
- 7 Kittitas (Ellensburg)
- 8 Klickatat (Goldendale)
- 10 Lewis (Chehalis)
- 1 Lincoln (Davenport)
- 5 Mason (Shelton)
- 3 Okanogan (Okanogan)
- 352 Pierce (Tacoma)
- 4 San Juan (Friday Harbor)
- 129 Skagit (Mount Vernon)
- 1 Skamania (Stevenson)
- 1221 Snohomish (Everett)
- 145 Spokane (Spokane)
- 4 Stevens (Colville)
- 46 Thurston (Olympia)
- 7 Walla Walla (Walla Walla)
- 123 Whatcom (Bellingham)
- 8 Whitman (Colfax)
- 195 Yakima (Yakima)
- 672 Unassigned (labs are having trouble keeping up and Dept of Health is working to determine the proper county)

Cases by Age
- 1.9% 0-19
- 26.1% 20-39
- 33.7% 40-59
- 26.7% 60-79
- 11.2% 80+
- 0.5% Unknown

Deaths by Age
- 0% 0-19
- 0.4% 20-39
- 6.5% 40-59
- 38.1% 60-79
- 55.1% 80+
- 0.0% Unknown


Cases by Sex at Birth
- 51% Female
- 45% Male
- 5% Unknown

And we're caught up with Washington state. 601 new cases.

State of Washington published count as of 11:59p, Wed 1 Apr
- 6585 Positives
- 72833 Negatives
- 262 deaths

Cases by County (County seats)
- 20 Adams (Ritzville)
- 133 Benton (Prosser)
- 18 Chelan (Wenatchee)
- 7 Clallam (Port Angeles)
- 112 Clark (Vancouver)
- 1 Columbia (Dayton)
- 16 Cowlitz (Kelso)
- 6 Douglas (Waterville)
- 1 Ferry (Republic)
- 43 Franklin (Pasco)
- 68 Grant (Ephrata)
- 2 Grays Harbor (Montesano)
- 114 Island (Coupeville)
- 19 Jefferson (Port Townsend)
- 2609 King (Seattle)
- 85 Kitsap (Port Orchard)
- 9 Kittitas (Ellensburg)
- 8 Klickatat (Goldendale)
- 12 Lewis (Chehalis)
- 1 Lincoln (Davenport)
- 10 Mason (Shelton)
- 4 Okanogan (Okanogan)
- 368 Pierce (Tacoma)
- 5 San Juan (Friday Harbor)
- 148 Skagit (Mount Vernon)
- 1 Skamania (Stevenson)
- 1266 Snohomish (Everett)
- 167 Spokane (Spokane)
- 5 Stevens (Colville)
- 49 Thurston (Olympia)
- 8 Walla Walla (Walla Walla)
- 124 Whatcom (Bellingham)
- 10 Whitman (Colfax)
- 216 Yakima (Yakima)
- 920 Unassigned (labs are having trouble keeping up and Dept of Health is working to determine the proper county)

Cases by Age
- 2% 0-19
- 26% 20-39
- 34% 40-59
- 27% 60-79
- 11% 80+
- 0% Unknown

Deaths by Age
- 0% 0-19
- 1% 20-39
- 6% 40-59
- 37% 60-79
- 55% 80+
- 0% Unknown


Cases by Sex at Birth
- 50% Female
- 44% Male
- 5% Unknown

[Jin+Guice]

Some numbers based on the death table that @jacob supplied (https://www.cdc.gov/nchs/fastats/deaths.htm):

To simplify the presentation I rounded the results (but not the original numbers used, so the math won't always add up). I used 2017 numbers for everything since that's when the CDC U.S. death numbers are from.

I looked at the two leading causes of death in the U.S. (cancer and heart disease) as well as the flu.

U.S. population: ~330 million
U.S. deaths per day: ~7,700 (~2.81 million total)
U.S. deaths per day from heart disease: ~1,800 (~650,000 total)
U.S. deaths per day from cancer: ~1,650 (~600,000 total)
U.S. deaths per day from the flu and Pneumonia: ~150 (~56,000 total)

Using worldometer for deaths:
The highest U.S. death toll was yesterday: 1,049

I got the info for Italy and Spain from googling. I couldn't find the flu numbers so I didn't include them.

Italy population: ~60 million
Italy deaths per day: ~1,730 (~630,000 total)
Italy deaths per day from heart disease: ~300 (~110,000 total)
Italy deaths per day cancer: ~201 (~75,000 total)

The highest Italian death toll per day was on March 27th: 919

Spain population: ~50 million
Spain total deaths per day: ~1,160 (~425,000)
Spain deaths per day heart disease: ~145 (~55,000 total)
Spain deaths per day cancer: ~150 (~55,000 total)

The highest Spanish death toll was today: 961

Note that I'm averaging these deaths over a year while taking the worst day for the coronavirus so far. It's important to ask, if drawing any conclusions from this, whether given a course of action average coronavirus deaths per day would increase, decrease or remain similar over the course of the next year.

[Bankai]

Looking at this mortality table, anyone <40 and definitely <30 should be good to go (back to work). Bear in mind these include only confirmed cases so 'true' mortality is likely much lower and will be lower still considering only 50% gets infected. Isolate the most at risk 10% of <40 and we're probably looking at mortality of 0.01% at most (speculation but probably not far off).

[George the original one]

Looking at this mortality table, anyone <40 and definitely <30 should be good to go (back to work). Bear in mind these include only confirmed cases so 'true' mortality is likely much lower and will be lower still considering only 50% gets infected. Isolate the most at risk 10% of <40 and we're probably looking at mortality of 0.01% at most (speculation but probably not far off).

Absolutely agree on the numbers, but, once again, you're talking about breaking up families to achieve the goal and that's highly unpalatable. At least it is in the USA (excluding illegal immigrants).

[Bankai]

Half of the households contain a single person. I assume the vast majority of couples <40 live either alone or with their kids only. There are of course families where one partner is older, or someone is at higher risk or living with grandparents, but these should be a minority - haven't looked up stats but Imagine <20% and possibly <10% which would be covered by the 10% highest risk to exclude.

[Jin+Guice]

RE: Getting some people back to work.

I'm not convinced this is the solution, but I'm also not convinced it's a bad idea. Consider the massive cost of 1) letting the disease run rampant; 2) shutting down the entire economy. These scenarios are pretty fucking bad and I think the "quarantine the most at risk" is being asked to live up to a much higher standard.

The problem with quarantining the most at risk is 1) How do you decide who is quarantined and who isn't? Do people on the margin get to sue? & 2) What do you do with people who should quarantine but don't want to and people who want to quarantine but aren't categorized as high risk?

That's a lot of bureaucracy and cooperation. It doesn't mean this solution wouldn't work.

We are *sort of* pursuing this strategy now. Many people are still working from home. Healthcare workers are working overtime. As far as I've heard, work is still available for those who want it delivering food, working for amazon and stocking grocery store shelves (note: In New Orleans these are actually considered decent jobs since it's most service industry here). Have you guys seen the unemployment benefits in the U.S.? They are amazingly ku$h (obviously this doesn't help the economy). What we are not doing is quarantining by risk, which may be smarter than quarantining by job description.



ERE Question: I've been nervous to ask this because we're so divided on what strategy we think is best. In the U.S., the list of "essential services" is pretty lenient. I know unemployment numbers are hitting all kinds of records, and I know there are A LOT of people are on the margins of going broke for various reasons, but, if the goal is to change attitudes about work, is cancelling restaurant service and having the dudes who write the code for facebook ads work from home for a few months really the worst thing?

FWIW the 65 yr old homeless man living under my house doesn't seem very stressed. He's still getting free food, doing yard work and selling stolen bicycles successfully.