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BeyondtheWrap wrote: ↑

Sat Apr 25, 2020 10:40 am

So, current deaths / (people with antibodies + current deaths) should be a reasonable approximation for death rate.

Strongly disagree.

24% of the US population is under 18.
36.5% of the population is 18-45 years old
60.5% (herd immunity?!)



It is amazing to me that we've been (purposely?) incurious about why children are effectively immune to covid and those 18 - 45 experience it like the flu. Actually those under 65 without comorbidities experience it like the flu, but I digress.

I've said it before and will continue to say it. Their non-antibody producing innate immune system kills the virus before their antibody producing adaptive immune system has to kick in. So they never produce antibodies. So antibody tests are useless.

So in order to get an accurate Infection Fatality Rate (IFR) we have to consider the large number of people who have a robust innate immune response and never produce antibodies.

My understanding is that CA trends closer to TX than NYC because, despite the issue of those coming from China, it is 10th in density and is not reliant on a subway system.

I have not read about any deaths caused by economic deprivation i.e. suicide. Based on 2008, you know it's coming and imagine it will greatly impact discussion.

Being that there is no solution - vaccination - imminent, this is headed towards typical public policy decision making process. Trade-off. Usually there is a cost-benefit analysis accompanying a "plan" but I think Feds feel they are held by their short ones and cannot promulgate potential deaths because that's some little girl's grandmother and the Republicans know it makes Trump The Ghost of Corona Future with Christmas just six months away. Nonetheless, whether it gets on a powerpoint or not, that's coming as well.

The WHO is saying that contracting/recovering from COVID doesn't necessarily provide immunity. Are they just CYA? Or are they saying that to deter the push for immunity passports of some kind? Or is it actually true that immunity, and therefore herd immunity, isn't likely?

What would we do if it's true, with a vaccine unlikely and no possibility of effective herd immunity?

It does seem that many epidemiologists are advocating that in the absence of a vaccine or highly effective cure, lockdown or partial lockdown should continue indefinitely. That is not economically plausible and no one will actually follow it, so I guess the epidemiologists have decided not to take part in a constructive conversation.

@jp - Reports out of South Korea that recovered people have tested positive again for a few days by now. Dunno, if that's because test specificity is not 100% but presumably that would be the first thing to correct for. The other thing to correct for would be the sensitivity of the serological tests. At least some are falling through the statistical cracks. On top of this is simply a lack of understanding ... perhaps the antibodies don't work or last, etc.

It would be really nice if journalists reported margin of error when reporting numbers.

If a vaccine or herd immunity is not likely then CV19 just becomes part of the overall disease burden that we'll have to live with from now on. Kinda like the flu or measles ... hopefully evolving into something more benign over the years. This means shorter life spans and higher medical costs on society. Another solution is a cure for when one actually gets the disease insofar that is possible.

jennypenny wrote: ↑

Sat Apr 25, 2020 2:30 pm

The WHO is saying that contracting/recovering from COVID doesn't necessarily provide immunity.

They are saying it because it is true.

Let's say I have a robust immune system, encounter a small viral load of covid and fight it off with my innate immune system. I produce zero antibodies and do not possess "immunity". If I later encounter a large viral load I might have engage my adaptive immune system which would, among other things, produce antibodies which would then confer "immunity" for some period of time.

This is why antibody tests are useless.

If we can't get a handle on it, they'll have to come up with some creative ways to keep the right people home while letting the economy restart. They could lower the social security age to 50 or 55 to let higher risk people retire and stay home. Or extend SSDI to people who are high risk. Changing the social security age would at least dislodge the boomer generation from their dominant role in the workforce to allow younger folks to move up the ladder more quickly. SSDI would be trickier because IIRC 1 in 7 kids have asthma, so you'd have a lot of kids at home permanently. How would that work? Special schools? Hybrid homeschooling?

My fear is that this is a problem without a workable solution if (eventually) there's no vaccine or acquired immunity.

jennypenny wrote: ↑

Sat Apr 25, 2020 2:50 pm

My fear is that this is a problem without a workable solution if (eventually) there's no vaccine or acquired immunity.

Yes, this is what I've been saying for six weeks. There is no good solution. We've got to protect the vulnerable and get the mass infection out of the way ASAP.

ETA, some mainstream experts have mentioned in passing that Asthma does not seem to be a risk factor and - paradoxically - being an active current smoker is protective. Previous smoking, of course, causes lung issues that make one vulnerable, so, grain of salt.

ETA2:

The CV19 specs are very similar to polio both in terms of basic reproduction numbers, the number of asymptomatic people, the number of people with severe symptoms, and the number of people with [ultimately] debilitating symptoms (death). A good "model" for understanding what society will ultimately do if a vaccine or cure can not be found might be found in how one culturally dealt with polio, since CV19 is about the same "impact size".

Now polio transmits via the fecal-oral route (bad hygiene/sewerage) whereas CV19 is droplet transmitted. Also, polio is mainly a childhood disease, whereas CV19 is mainly an old person disease. Therefore they will have different impact on how we behave or perceive them. Polio was a tragic event to happen to a child. I bet it won't be kosher to cough in the company of geriatrics going forward. Masks would also reach Japan-like levels. And I bet there are Mr Burns-types already calculating how much an endemic CV19 would save in pension fund payouts or change Medi* costs relative to how much they're losing in earnings from restructuring their businesses.

Anyhoo, w/o a cure or a vaccine, it will normalize within a few years just like we've normalized traffic deaths, cancer, diabetes, obesity, and cardiovascular diseases. There's no public outcry over the preventable lifestyle diseases that are responsible for 60% of US deaths. Eventually, CV19 will be the same.

https://www.theguardian.com/environment ... -pollution

Coronavirus has been detected on air pollution. It's speculated that exhaled droplets may combine with pollution particulates and thereby get carried for [much] longer distances. It is already known that this is possible for other bioforms. Recall how SARS-1 spread around in apartment buildings.

This study has not been peer-reviewed yet.

Immune system impairment not being a risk factor is terrifying.

I'm not a doctor, but it almost seems like most of the risk factors outside of age are also correlated with high levels of general inflammation in the body. I read somewhere that most people die due to immune system overreacting in the lungs...This would also explain why being immune suppressed isn't a risk factor. Just some thoughts. Maybe inflammation is a problem?

jennypenny wrote: ↑

Sat Apr 25, 2020 2:50 pm

My fear is that this is a problem without a workable solution if (eventually) there's no vaccine or acquired immunity.

Pretty much. Nobody seems to like the "crush the virus" plans except Vietnam and South Korea, maybe Australia & New Zealand.

0 new cases in Alaska yesterday. First time since testing began. No new cases in my community for past 15 days. Things partially opened back up yesterday. Hope it lasts...

jacob wrote: ↑

Sat Apr 25, 2020 2:44 pm

If a vaccine or herd immunity is not likely then CV19 just becomes part of the overall disease burden that we'll have to live with from now on. Kinda like the flu or measles ... hopefully evolving into something more benign over the years.

We don't know if herd immunity is going to work. There seems to be this assumption it will work even though there is no proof that this is true. That leaves any action that we can take to minimize it's impact. This could be a vaccine or squashing it or an anti-viral drug or a cure or social distancing measures going forward (it depends on the scale here).

I can see people just being more careful, washing their hands more regularly and going out less and different treatments being developed going forward. The health systems will just have to accept CV19 becoming an additional burden but hopefully not as bad as what it is right now.

People are clearly not accepting lock downs and it's only early. An alternative way to view the situation is society doesn't view CV19 as dangerous enough to change their behaviors significantly over the medium to longer term. Maybe if this was like Ebola but it's not.

@bigato I can agree with this sentiment.

Seems like going "back to the way it was" just opens us up to more situations like this down the line.

Sure, it's COVID-19 now, but in a few years, it could be something else.

Systems need to adapt.

Will they is a different question.

Even if one is on the "it's not worth the economy" side of things...maybe the next one will be, and if everything just goes back to the way it was, we'll be in the same position again.

Funny, I asked some in my family on a video call if they thought it would go back to normal.

The young open-minded kid: "No way."

The lady: "Of course" and then scoffed at the kid's opinion .

Humans/society so f'd. This world's a joke.

@bigato: I agree. I believe this is what most governments are planning to do anyway. The goal should be to protect the most vulnerable while affecting the economy as little as possible. Some quick wins that help with social distancing while not destroying the economy are:

- work from home: yes, your favorite coffee place might struggle if everyone does it and your company might realize it doesn't really need an office, which will, in turn, hurt the landlord and then those invested in REITs, however, the benefits are too great to not do it (less pollution, less traffic, more time for everyone, etc.). I expect that strong suggestion to work from home whenever possible will be in place until everyone is vaccinated

- large gatherings, like concerts or sports games in large areas: it's very hard to keep social distancing in those places; even if they plan to leave every second place empty, you also need the places right in front of you and right behind you empty to keep >1m distance between people. At this point, it's probably not even worth doing considering the costs of security, etc. Also, it will be a logistical nightmare to let people in and out while maintaining the distance. So that's another area I expect will keep shut for a long time, possibly until the vaccine

- pubs & night clubs: those are usually very crowded and also operate of a thin margin. Any measure of social distancing will make them unprofitable to run; I expect only some will reopen. To survive on drastically lower revenues, they'll need to reduce both variable (easy) and fixed (not so easy) costs

- more online learning: there's no reason why pupils and students in vulnerable groups would need to ever attend a class/lecture/exam in person - all of those can and should be done online. Again, until vaccine as you don't want to keep people inside forever as they'd miss out massive benefits of socialization with peers

- 'shielding' old and vulnerable people: providing them with food and essential items to allow them to self-isolate as much as possible; some will still probably live as normal but hopefully most will be smart enough to stay inside

There are also some 'quick fails' which don't really make much sense if we're in it for the long run:

- closing schools: children are the most resistant group to this virus (<17 constitute 0.04% of deaths) and keeping them at home hurts the economy badly due to parents not being able to work. Schools should be reopened as soon as possible and high-risk pupils should be given the option of online learning

- (almost) everyone below 45 (4.5% of deaths * 0.3% death rate = chance of dying of 1/7500 i.e. not worth worrying about); again with exception of vulnerable people

- shutting borders: unless you're SK, it doesn't make sense since the virus is endemic at this point

- all businesses able to adapt and operate while maintaining the required level of social distancing; i.e. what's the point of closing construction sites when there's very little close interaction? Shops can have limits as to how many customers can be inside at any given time, etc.

However, I don't quite like this one:

bigato wrote: ↑

Sat Apr 25, 2020 9:02 pm

there's no reason to not make a rule of wearing masks in public if it's proven to be helpful enough

I think forcing people to wear anything on their body is going too far - precedents include WW2 Europe and Muslim countries. We don't want to go that route, even for 'the greater good'.

The "Depression" vs. "Dead Nanas" dichotomy is a heuristic imposed by the current political/media climate, at least in the US. It merely sets the outer-bounds of the argument. And in some regard, its probably a good thing, to know the black and white of the situation before inevitably implementing an in the gray re-entry (unless a vaccine is created). Furthermore, re-entry will be inclusive of forces outside of government agencies as politicians are ultimately guided by public opinions polls. The "I don't want to go out if there is still a 1% chance I will die of Corona" crowd will at some point only be able to maintain that stance if they are financially able to do so.

And in the US, forcing people to wear masks when our leader does not? Good luck with that. Well, unless its red with a slogan on it.

Doubling period: 10.5 days.
300 districts now corona free.
PM says wearing mask in public places a sign of civility in post-covid world while launching apps for local self governance.

Bankai wrote: ↑

Sun Apr 26, 2020 7:32 am

I think forcing people to wear anything on their body is going too far - precedents include WW2 Europe and Muslim countries. We don't want to go that route, even for 'the greater good'.

I would look at the "wearing a mask" obligation more akin to "wear a seatbelt" rather than "wear David's Star", honestly.