COVID-19

[Bankai]

@bigato: 25% sounds brutal and much higher than any other country. All the data I've seen indicate 97-99% of victims having at least one comorbidity. The average covid-19 victim in the UK is an 80 years old male with 2.7 comorbidities. I wonder if some of those not in high risk groups might have had undiagnosed issues, ie hypertension or diabetes are often undiagnosed for a long time.

[Jason]

I think the issue is that there is a difference between simplicity and simplistic. Simplicity does not deny complexity whereas simplistic does and that confusion gets smuggled into Occam's razor when people think the straightest line is merely simple and not possessing complexity. If all the information was available, it would be simple math to determine infection vs. death rates. I guess it's still relatively simple based on extrapolation of the numbers we have. However, quantifying remaining time in individual lives is not a simple endeavor based on many factors including but not limited to ethical implications. So to me, the danger is when this distinction between the two concepts - death rates vs. remaining life - is not acknowledged. One quantification is simple. One quantification is not. Now maybe the solution involves a straight line where the elderly become collateral damage. But the straight line shouldn't be a result of simple math.

[nomadscientist]

NYC may be the first place in the world where the disease has totally burnt out given that it now has a much lower rate of case growth than places where the disease broke out earlier and which imposed stronger lockdowns earlier.

0.1%-0.15% of the population; considerably better than many feared. A second wave is likely but with this many immune people it is likely to be much weaker.

[ZAFCorrection]

@Jason

I'm not sure of the simple vs simplistic situation, bit Occam's razor is like a meta-rational heuristic for choosing hypotheses to test. It's a lot closer to the beginning of the truth-finding process than the end. Research-wise, it's part of the sausage making that's tucked out of sight before something is published. I think you can potentially play all kinds of semantic games to say one thing is simpler/more simplistic than another.

On the moral front, it makes a lot of sense to include a moral component in the decision-making process. But it would be nice to see a systematic moral approach being used or advocated. We have finite resources to achieve a potentially infinite number of moral goods. It seems people generally bring up morality not because they are actually advocating for a particular system, but because it is an easy way of trying to get more attention for their pet issue. Or it's just a thought stopper.

[C40]

Vietnam started restrictions similar to stay-at-home orders (though not all that strict) on April 1, while getting about 10 new confirmed cases of Covid per day. Now, on the 22nd, they've had 6 straight days with no new cases. Over this lockdown period, they've released far more recovered patients than took in new cases, and are down to about 60 current patients. Today I believe they will loosen the restrictions and largely allow people to go back to their normal lives. I expect they'll keep the borders closed to non-citizens. I will celebrate with coffee, ice cream, and having dates meet me at the beach.

[JL13]

JL13 mentioned above that that R0 would be 1.15 in current lockdown conditions

That was what I inferred from the Mayor's projection for DC only. It should be different from NY:

http://systrom.com

That preliminary German study that Jacob linked showed a mortality rate of 0.4%. Where does that put us for NYC?

[nomadscientist]

nomadscientist: how to you conclude that the disease may have burn out through the nyc population if they are in lockdown and yet the cases are decreasing only now? Have you looked at the number of cases that are still active? We know that a percentage of them will also die, right. where do your numbers come from, are you ignoring the not tested cases that were registered as covid19 deaths due to the symptoms? What is your reasoning?

Burnt out means no longer growing. Sure, there are patients who caught CV before the burnout who still have CV and some will still die.

[classical_Liberal]

The ND case is interesting in that the uptick of positives over the past couple of days (prior to that it has been very stable) was related to a single place, a manufacturing company...
It'll be very interesting to watch over the next week to see if this spreads

New cases have returned to the flat numbers we were experiencing each day before this event. Quick response contact tracing, closure of that workplace, isolation and testing of employees/contacts seems to have stopped the outbreak dead in its tracks. ND remains one of only a handful of states without shelter in place, and without mandatory business closures (outside of entertainment-type venues that are close contact gathering places). Although many have closed voluntarily.

[steveo73]

Yes, he has his opinions, based on a lifetime of experience in the field. It struck me that he was willing to say way more than any other expert so far. I was also struck that he invited the interviewer to come back to him in a year and evaluate how accurate he was.

A couple of points here:-

1. He may be an expert but plenty of experts disagree with him.
2. All he has is opinions and the data right now says his opinion is wrong.
3. We don't know if his opinion is wrong or if he is right and we won't know until some time passes. Maybe that will be 1 years time. Maybe it won't be.

A side point that I think is important is that the idea of herd immunity may be in practice be a myth.

"It does have a connotation of eugenics," she said. "What you will see is a large increase in cases for little gain because probably by the time you get to about 20 to 30 per cent of the population impacted, you'll start putting the brakes on and having more lockdowns because the health system will be too severely impacted.

This problem is a really tough one to handle.

[classical_Liberal]

@Bigato
I would venture a guess that the cardiac arrest deaths are more likely related to a combination hospital overwhelm and people not seeking treatment for CV symptoms due to fear of being exposed at hospitals.

Edit: I see you just edited to reflect this great minds

[steveo73]

Why Narcisists Ignore Social Distancing
https://www.psychologytoday.com/intl/bl ... distancing

The problem with this is that calling everyone who doesn't confirm to your world view a narcissist to me is way too extreme. My wife loves the lock downs. We are now basically retired due to the virus. I'm working full time at home but my wife has quit. To my wife the lock downs are an excuse not to engage in any social events.

Some people are just extroverted and require more social interactions.

[nomadscientist]

NYC probably had 200x the current death rate in cases, or 20% of the city's starting population. Not enough for herd immunity ordinarily, but given the lockdowns apparently enough.

A sudden total resumption of pre-virus life may reignite the disease, but that's not likely as a result of either policy or personal choices.

NYC will be a test case for relaxation procedures. Admittedly starting out with a ticker tape parade isnt a great sign.

[BeyondtheWrap]

The WHO is currently saying that a lot of people who recover don’t have antibodies, and it is still possible that antibodies do not confer immunity.

https://www.businessinsider.com/coronav ... ies-2020-4

So, if this is true, does this mean neither herd immunity nor vaccination will work?

In that case I guess the only viable strategy is to try to stop it from spreading using the testing, tracing and quarantine strategy.

[steveo73]

If immunity doesn't work as @bigato is speculating, this is the new usual. This is what life is now, and it will never go away.

Bigato may be right but I draw a completely different conclusion. We will handle this virus better in the future compared to now. It might be a vaccine but it might be a cure or an all purpose anti-viral treatment. I don't know.

So herd immunity may not be possible but like heaps of other viruses I think we will minimize it's effect on humanity over time.

[ZAFCorrection]

Just a day ago the story was that the preliminary serology studies were over-counting exposure -> maintain the lockdown. Now they are potentially under-counting exposure so...maintain the lockdown?

I thought the original narrative of the serology studies was that more people had been exposed for a certain level of hospitalization, so good news. Not sure how all roads lead to lockdown.

[steveo73]

steveo: requiring social interaction and not caring about the results of your actions on other people are two very different things, right.

I totally agree. I just don't think that this is just a narcissistic issue. We can already see people rebelling against social distancing now and not all of them will be narcissists or alternatively they are all narcissists but so is everyone staying stay at home because we are happy social distancing and we only care about our welfare.

I think social distancing is a complex issue and that currently there is no clear cut best way to manage this virus. It's a complex issue with no easy solutions.

[steveo73]

We are currently at about 180k deaths world wide and 45k deaths in the USA. How does everyone think we are tracking and how poorly or well have we handled this so far ? How much further does this have to go ?

My opinion is that this is turning out far better than what I expected and we've handled this well post some countries reacting too slowly (probably the UK and the USA). I reckon China should cop it big time but I don't think that excuses the fact we've all been caught with our pants down in this situation.

I have no idea if this is going to progress to wave after wave of infections that are progressively worse or we are going to get one spike and then it's going to be basically over.

I feel so sorry for anyone who has lost a loved one in this event. At the same time it's hard not to look at this virus from a total deaths perspective and believe it isn't relatively that bad but like I said who knows how this progresses.

[George the original one]

Hydroxychloroquine

Veterans Administration study says it is worse than no drug.

Researchers analyzed medical records of 368 male veterans hospitalized with confirmed coronavirus infection at Veterans Health Administration medical centers who died or were discharged by April 11.

About 28% who were given hydroxychloroquine plus usual care died, versus 11% of those getting routine care alone.

https://apnews.com/a5077c7227b8eb8b0dc23423c0bbe2b2

[jennypenny]

The WHO is currently saying that a lot of people who recover don’t have antibodies, and it is still possible that antibodies do not confer immunity.

This is what we were told this week on a town hall style meeting with doctors from the CF foundation. Their biggest concerns seem to be that (1) it's not known yet how long antibodies remain in the system and whether that depends on if a person was ill or only asymptomatic, so they don't know yet whether a positive antibody test would mean an 'all clear' for each individual, and (2) they don't know yet whether mild or asymptomatic cases produce similar lung damage to symptomatic cases (therefore being potentially harmful/dangerous to younger people who never feel ill).

When asked, they said that we could be a long way off from herd immunity -- even if case numbers are much higher than previously thought -- because we don't know yet whether exposure provides lasting immunity. If it doesn't, herd immunity isn't a viable strategy and it would make vaccines much more difficult to develop. (at that point they stressed again the need to determine whether mild or asymptomatic cases produced longterm damage to the body to know whether herd immunity through exposure would come at too high a price -- you don't want a generation of twenty- or thirty-somethings primed for early onset COPD)

They did say, anecdotally, that children's hospitals aren't being slammed and that compromised kids don't seem particularly vulnerable beyond what all asthmatics experience.

----

I think all of the NYC numbers should be taken with a grain of salt. Many NYers fled the city when it appeared a lockdown was imminent, and some of those people are/were sick. There are a lot of NYers on the NJ island where my in-laws live and some of them have tested positive. Sis moved back to her home near me in PA, and she said that when her office in Westchester county shut, a lot of employees left the area to stay with other family or at vacation homes. Point being, some of the severely ill cases and deaths that originated in NYC may end up being counted in neighboring states. The death rates calculated above may be undercounting by a bit.

[Bankai]

https://www.telegraph.co.uk/news/2020/0 ... und-world/

While people in developed countries protest against their rights being violated, developing countries see protests driven by economic hardship. So far these are only fairly isolated examples and I don't see protests escalating widely in Europe where there's strong public support for lockdowns (in the near term at least), However, most of the world cannot afford European/N.American measures.