COVID-19

[Jason]

The Department of Defense, The National Institute of Health and Dolly Parton. Like who's going to be paying attention in that meeting.

[Alphaville]

https://www.distractify.com/p/dolly-parton-vanderbilt

[George the original one]

White House task force might wind by end of May. Meanwhile, the virus is taking hold in rural places. USA had 10,000 deaths in the past 5 days, so looking pretty easy to hit 100,000 deaths in the remaining 25 days of May.

A top adviser to Vice President Mike Pence who has helped oversee the task force, Olivia Troye, has told senior officials involved in the task force to expect the group to wind down within weeks, a notice echoed by other top White House officials. While the task force met Tuesday at the White House, Monday’s meeting was canceled, and a Saturday session, a staple of recent months, was never held.

“If you include New York, it looks like a plateau moving down,’’ said Andrew Noymer, an associate professor of public health at the University of California, Irvine. “If you exclude New York, it’s a plateau slowly moving up.”

It is not just the major cities. Smaller towns and rural counties in the Midwest and South have suddenly been hit hard, underscoring the capriciousness of the pandemic.

Dakota County, Neb., which has the third-most cases per capita in the country, had no known cases as recently as April 11. Now the county is a hot zone for the virus.

https://www.msn.com/en-us/news/us/coron ... r-BB13BZhX

[Bankai]

The scientist behind Imperial College paper which caused UK's u-turn on lockdown quits after being caught breaking lockdown himself:

https://www.bbc.co.uk/news/uk-politics-52553229

[Peanut]

I'm not stating that I agree with his conclusions. I don't believe the herd immunity theory is proven yet and we shouldn't be stating it is. He is thinking correctly though in that it's countries like Australia and New Zealand who are the success stories now but if herd immunity is correct then maybe these countries are screwed. We need to be careful here though because maybe this herd immunity idea is BS. I'm not stating the theory isn't correct. I'm stating that in the case of this virus herd immunity may not be a factor in how the virus progresses. We need to see how this plays out over the next couple of years.

+1

Something I read early on was a virologist saying that no immunity after infection would be quite an unusual outcome for Covid 19. I took that at face value to mean it's likely some degree of immunity for some period of time is more likely than not. It's definitely not a guarantee, but the odds are better than 50/50.

I do think the prediction, cited again by this guy (https://unherd.com/thepost/german-virol ... 0-24-0-36/) that Covid 19 will become an endemic fifth coronavirus is very likely to pan out.


@7w5: I am not at all equipped to respond to your post, all I can say is it interested me. I was reminded of the understated point that viral load really matters, and also reminded of an earlier discussion about MMR vaccine being a factor in immunity. Read this related piece the other day about how getting other, older vaccines may offer some protection against Covid 19:
https://www.nytimes.com/2020/05/01/opin ... unity.html

[Ego]

There is a big flaw in the argument that we don't know if herd immunity works. If herd immunity does not work and we are waiting for a vaccination which by definition is the least lethal form of herd immunity, then there is little hope for the vaccine and little reason to try to stop the spread.

The general rule in immunology is that natural immunity (from the disease) is stronger than vaccinated immunity, but that is not always the case. For instance, those who had measles have an immune response that is about 3X that of someone who has been vaccinated.

Some other issues to consider wrt herd immunity.

-We do not know (because there is no way to know) the number of people who fight off Covid using T-cell response or other non-antibody producing immunity. These people are essentially immune to Covid but we cannot measure their immunity because they never produce antibodies. Studies (from China) show that they exist and a rather high percentage of the population.

-The super-spreader theory acknowledges the fact that certain people are extremely social while others are not social at all. We do not need to get 70% of the population infected, we need to get the people responsible for 70% of the interactions infected.

[steveo73]

There is a big flaw in the argument that we don't know if herd immunity works. If herd immunity does not work and we are waiting for a vaccination which by definition is the least lethal form of herd immunity, then there is little hope for the vaccine and no reason to try to stop the spread.

This isn't a flaw at all. It's about trying to get as good an understanding of how this virus progresses and what we can do to minimize it's impact to society.

There are many more possibilities than just herd immunity or a vaccine. The virus may not follow an exponential growth pattern upon which so many predictions were based upon. This is a real possibility. We also do not have a vaccine for HIV but the damage that virus has done is completely different to when the virus initially hit human society.

There are lots of viable options. To refute your initial point we could just socially distance ourselves for 6 months in limited fashions (so a relaxation of the lock down) and the virus may just die out. I'm not stating that this is the case but the reality is that this virus has shown that our scientific understanding of epidemiology is not scientific in a deterministic sense. It's statistics based upon models that do not represent reality well with conclusions drawn from the data that are more opinion based than science based.

We need risk management decision making in the face of uncertainty. Trying to create certainty that doesn't exist is the wrong approach.

[Bankai]

we could just socially distance ourselves for 6 months in limited fashions (so a relaxation of the lock down) and the virus may just die out.

Like, by achieving herd immunity? Or are you saying that it will "just go away"?

The virus is/will become pandemic, no doubt about it. You make a good point on potential drug treatment even if a vaccine is not available. It did work with HIV but HIV was limited to specific groups/regions and close to 100% mortality initially and it took decades to develop good enough drugs; it's not as easy to isolate the whole world for extended periods where the risk for more than half of the population is tiny.

[Ego]

Any effort to try to stop the spread is counterproductive. It simply slows down an inevitable and moves it to a time (fall/winter) when the most vulnerable are also more prone to flu, the common cold and other co-infections. We need to get the superspreaders infected and immune.

The medications/therapies that are being used today are the same that we learned about from China where they tried every possible treatment under the sun against the virus. I posted about each of these months ago...

Oxygen
Hydroxychloroquine (yes, it works very well if administered early)
Remdesivir
Convalescent Plasma Therapy
IL6 Inhibitors

The only important thing that changed about a month ago is that ventilators are now (mostly) bad. Superman position is good.

The virus may not follow an exponential growth pattern upon which so many predictions were based upon. This is a real possibility.

I am so glad you pointed this out. About 70 pages back many here (not you) were saying that the innumerates are too dumb to understand exponential growth. It is wonderfully ironic that the innumerates were right (dumb luck?) not to trust these assumeholes™ that it would grow exponentially for a long time. It doesn't. Another example of how the assumeholes™ made assumptions that were dead wrong.

Get the super spreaders immune, keep the vulnerable protected as best we can and get on with life.

[Peanut]

@Hristo

https://www.theguardian.com/world/2020/ ... ber-retest

Thought this was interesting. France confirms they had coronavirus cases as early as Dec 27. Subject perhaps contracted it from his asymptomatic wife who worked near a sushi stand (with workers of Chinese origin who may or may not have traveled back and forth).

[steveo73]

Like, by achieving herd immunity? Or are you saying that it will "just go away"?

This is the interesting thing but I don't think it matters. Viruses often just die out. You can call that herd immunity but I don't believe that is what happens. The virus just doesn't transmit to everyone. It might be people socially distancing themselves or whatever.

Don't think that HIV is the only epidemic that has occurred that has been treated more effectively over time without a vaccine being available. The mortality rate of a virus tends to go down over time. Sometimes it's a vaccine, sometimes it dies out, sometimes the treatment simply improves.

@Ego - I'm nowhere near as confident as you in relation to the next steps however yes it was clear then and it's clear now. A lot of science today is not deterministic science. It can guide decisions but we need to review the science critically and make risk based decisions. Predictions of the future even what appears a relatively simple prediction as per this epidemic are fraught with danger.

[thrifty++]

Back to new cases in NZ again. But only 2 new cases today.

1 new death. Bringing us to 21 deaths in total

1488 cases in total. But all recovered except for 151 active remaining cases.

We had an unemployment rate of 4.2% announced today. However this only captures the first quarter up to 31 March. However its still very low, much lower than expected. As the virus has been affecting business here since early Feb. NZ is so slow at reporting unemployment data. We will have to wait months until we know the unemployment rate as at now.

[Alphaville]

We need risk management decision making in the face of uncertainty. Trying to create certainty that doesn't exist is the wrong approach.

this, a thousand times. wishful thinking has been the real enemy all along.

[Alphaville]

Larry Summers: “Given what we’re losing in GDP, we should be spending far more to develop tests”

some choice quotes:

“ the United States is in danger of overemphasizing the impact of the crisis on the economy — and massively underinvesting in the health measures that are ultimately most important.”

“ We are embarked on a policy path of opening things up without major complementary measures, an approach based more on wishful thinking than on logic or evidence. ”

“ Basic but grim arithmetic implies that if we move from lockdown even 20 percent of the way back to normal life, the epidemic will again be potentially explosive. ”

“ hope is not a strategy”

“ on a rough estimate covid-19 is reducing the gross domestic product by 20 percent — $80 billion dollars a week. The problem is that the main constraint on economic activity is not mandatory lockdowns. Rather, whatever is technically permitted, people will be reluctant to resume normal behavior for fear of being infected.”

“ The most promising strategy is establishing a system of pervasive targeted testing. If we were able to identify individuals who have potentially been infected, then quarantine those who test positive, we could substantially reduce the transmission rate. Suppose this required testing every American every week and that each test cost $20. (Both are pessimistic assumptions.) The $6.6 billion price tag would be less than one-tenth of the weekly cost of the Cares Act.”

“ Similarly, investments in contact tracers for those who identified with covid-19 would have an extraordinarily high return. Suppose the total cost of a contact tracer is $400 daily, and that 300,000 tracers are needed to follow up on all newly discovered positive cases. The cost would only be $600 million a week, less than 1 percent of the cost of the Cares Act.”

“The same kinds of calculations make the case for much more spending on masks, on potential therapies and on pursuing production of plausible but still unproven vaccine candidates.”

lol, i copypasted a large chunk, but the whole thing is here:

https://www.washingtonpost.com/opinions ... story.html

[steveo73]

I do think the prediction, cited again by this guy (https://unherd.com/thepost/german-virol ... 0-24-0-36/) that Covid 19 will become an endemic fifth coronavirus is very likely to pan out.

This guy here to me gets it spot on. Interestingly it appears this came out yesterday so maybe it's just the timing.

This guy ends with another way we may deal with this virus. It just stays with us but we manage it better. It's not herd immunity. We also don't beat it. Interestingly he makes the point that the initial out break can be worse because a strong dose of the virus is transmitted. Maybe going forward we will just wash our hands more often and get rid of the practice of kissing when we greet people. The virus bubbles away but the doses that people get typically aren't as strong and when older people die off we just accept that because it's not so intense.

[tonyedgecombe]

Another example of how the assumeholes™ made assumptions that were dead wrong.

I should keep a note of all these tiny insults and play them back if it turns out you are wrong (which seems quite likely to me).

[IlliniDave]

this, a thousand times. wishful thinking has been the real enemy all along.

Not just wishful thinking, IMO, but also woe and doom pessimism (though maybe that's wishful thinking from a different perspective). Caution and optimism have their places, of course, and I think letting "the science" govern is a bit snake oily, but a measure each of caution, optimism, and reason, seasoned with reliable, well-understood data, should all be tossed into the shepherd's pie. A one-ingredient pie--not so good.

[7Wannabe5]

@Ego:

I am curious about your assumption of the existence of Super Spreaders. I have a few questions you might answer...

1) What percentage of the general population do they constitute?
2) How many contacts do they infect on average during their period of contagion?
3) How many contacts do those who are not Super Spreaders infect on average?
4) What is the threshold of number of contacts differentiating Super Spreader from not-so-Super Spreaders?
4) At what level do you believe herd immunity will be achieved based on these assumptions? What would the level be if the number of average Super Spreader contacts was half of your initial estimate?
5) How and when will you adjust your initial assumptions and update your predictions based on new evidence?

[Peanut]

This guy here to me gets it spot on. Interestingly it appears this came out yesterday so maybe it's just the timing.

+1

Other points of interest Streeck made:

-15% rate of getting infecting within households. Secondary attack rate is actually quite low. Not like norovirus where everyone in a household is pretty much going to get sick.
-He described the German carnival super-spreading event where maybe 40% of attendees got infected. This took place inside, with a lot of indiscriminate kissing going on and a bartender was blowing his whistle spreading the virus in the air.
-Hope for a vaccine is somewhat of a pipe dream. There have been decades of research for Hep C without success. There has not been a successful vaccine developed against any coronavirus. So to say in 18 mos we will have an effective vaccine...

[George the original one]

Grand Island, Nebraska, is a city worse off than NYC when it comes to per capita infections. It is damned if you do and damned if you don't shut down.

Local officials have now confirmed hundreds of coronavirus cases, with more than 200 linked to a local JBS USA beef plant and another 40 to area nursing homes. There were 1,228 Covid-19 cases as of Tuesday in a city of roughly 51,000, according to the regional health department. That puts its per capita rate of infection well above that of New York, the hardest-hit state in the nation by the coronavirus pandemic.

“The shelter-at-home model does not fit my city,” said Republican Mayor Roger Steele in an interview. “You can’t pick up a laptop computer and go home and build a combine. You can’t pick up a laptop computer and go process beef from your living room.”

https://www.msn.com/en-us/money/compani ... r-BB13Gd4I


Congruently, US (& Canada) meat workers are becoming no-shows at work.

At a JBS USA plant in Greeley, Colorado, absenteeism is running as high as 30%. Before the pandemic, it was about 13%. The company is paying about 10% of the workforce -- people deemed vulnerable -- to stay home. Others aren’t coming in because they are sick.

But some workers are staying home because they are “scared,” according to Kim Cordova, president of United Food & Commercial Workers Local 7 union, which represents workers at the plant. She couldn’t provide specific numbers but noted on a recent visit that production speeds at the plant were “really slow” because of the labor crunch.

https://www.msn.com/en-us/money/compani ... r-BB13FaCF