COVID-19 Thread

[FVBrewerFan]

I agree with some of what you said, but it's easy for me to say those things when my decisions dont have a direct impact on people dying. The people making these decisions are making life and death decisions and I don't think I would be willing to put people's lives at risk if I made the wrong choice. The old better safe than sorry.

 

Yet I don't think there's nearly enough discussion about people suffering and dying BECAUSE there's a shutdown. Partly because it's very difficult if not impossible to quantify, but it is significant.

 

My father is 88, with several health issues making him a prime candidate to die should he ever get C-19. Scary stuff. Here's the thing though. All of is medical appointments have been cancelled for March, and now April. So what if he does have an issue with his heart, lungs, etc. that's not being identified and treated? That will kill him too. Now, take that example and multiply it by hundreds of thousands of people in a similar situation. Death is the result, we'll never know how many.

 

Now, add domestic violence, child abuse (where schools used to be essentially a first responder,) suicide, depression, substance abuse, etc. The economic impact is always discussed, which needs to be, but the unintended consequences of shutting down causes a whole lot of misery and death beyond economic.

 

I was told by the experts, and by many of you early on in this topic the goal was to flatten the curve. We've done that. Now the goal has changed. Wait until there's more testing, wait until there's better treatments, even wait until there's a vaccine (which may never happen.)

 

May 1 needs to be the day. That gives everyone 3 weeks to plan. Get as many tests out by then as possible, set standards for meds- which very likely will change with advancements in med as time goes on. Continue to lock down NYC metro and possibly other hot spots if necessary. Continue to quarantine the elderly. Otherwise, back to it. Back to work, open the restaurants and stores. It's not perfect. No solution or time ever will be. But we can't keep extending the time for 300MM+ people to suffer and die to try to protect the 40,000. Sorry to say those 40,000 deaths are going to happen no matter what is done.

[PeaveyFury]

To me it's all about assessing unintended consequences to these measures taken on what is mainly a one sized-fits all approach, and quickly realizing the long term cost far outweighs the short term benefit of not allowing coronavirus to naturally work its way through the majority of the population that isn't at significant risk.

 

No offense, but are you basing this on anything other than your own opinion, and is that based on any sort of medical, microbiological, etc. training?

 

IMO the wrong approach was initially done based on unreliable data/fear and now we're stuck - what I think should have been done was to quarantine the elderly/immunocompromised as soon as it was apparent this disease put them most at risk.

 

Simulations WERE run for this type of selective quarantine, and the simulations consistently yielded worse results for 'flattening the curve' than the widespread social distancing efforts that we're currently undertaking.

[PeaveyFury]

Yet I don't think there's nearly enough discussion about people suffering and dying BECAUSE there's a shutdown. Partly because it's very difficult if not impossible to quantify, but it is significant.

 

The continued implication that these factors haven't been weighed and considered by the people-in-the-know is a bit puzzling to me. Of course those factors have been weighed.

 

 

May 1 needs to be the day. That gives everyone 3 weeks to plan. Get as many tests out by then as possible, set standards for meds- which very likely will change with advancements in med as time goes on. Continue to lock down NYC metro and possibly other hot spots if necessary. Continue to quarantine the elderly. Otherwise, back to it. Back to work, open the restaurants and stores.

 

Again, based on any sort of expertise or knowledge base? Assuming not, what makes you think you're better qualified than the actual experts to make this determination, or to say it in absolutes? Why do you get to decide that the 30 year old cancer survivor's horrible chemo treatments were all for not? Or that the father of the 3 year old with leukemia lose his job because his employer calls him back into the office and he can't take the risk? Why do our parents and grandparents need to be put at a heightened risk?

 

They'll lift the restrictions when they think it's best, factoring all of the considerations. Setting an arbitrary date does zero good, especially if it makes it more likely we'll have to do this all again as they have elsewhere.

[FVBrewerFan]

Again, based on any sort of expertise or knowledge base? Assuming not, what makes you think you're better qualified than the actual experts to make this determination, or to say it in absolutes? Why do you get to decide that the 30 year old cancer survivor's horrible chemo treatments were all for not? Or that the father of the 3 year old with leukemia lose his job because his employer calls him back into the office and he can't take the risk? Why do our parents and grandparents need to be put at a heightened risk?

 

All those examples you mentioned are at a higher risk during the lockdown because they can't see their doctor. Who am I to decide? Obviously I can't make that decision, seems like you're intentionally being obtuse.

 

You also keep citing "experts." There are many experts beyond Dr. Fauci and Redfield, but they don't get the press those two do. Some believe herd immunization is the answer, some believe treatment already exists that is highly effective but not being endorsed, some project deaths as a results of the shutdown will surpass the number of deaths due to C-19. And on and on. These are not fringe nuts, they are well respected- just aren't in front of the camera every day.

 

Oh, and it's a cheap shot to say me or anyone else are complaining because we can't get our $6 latte. Really cheap shot.

[Fear The Chorizo]

No offense, but are you basing this on anything other than your own opinion, and is that based on any sort of medical, microbiological, etc. training?

 

Yes and yes. Also, basing these sort of decisions only on what infectious disease experts recommend is a recipe for overreaction.

 

Simulations WERE run for this type of selective quarantine, and the simulations consistently yielded worse results for 'flattening the curve' than the widespread social distancing efforts that we're currently undertaking.

 

Using the same faulty assumptions other simulations initially projected the rosiest death total to be 100K Americans based on country-wide shelter in place restrictions through August? Those have already been revised down nearly 40% over roughly 2 weeks and will continue being reduced. And it's not flattening the curve for an entire population with the end result being no risk after people return to public spaces, no matter how long these restrictions are extended - it's trying to flatten the curve for a specific portion of a population while avoiding societal/economic collapse during the initial outbreak. Not a perfect approach, but neither is the current method - which will drag the population-wide acute hardship we all have to deal with out much longer.

[homer]

Models are revised as new data comes in. Models are being revised downward because the social distancing is working.

[MrTPlush]

Models are revised as new data comes in. Models are being revised downward because the social distancing is working.

 

I don't think that is completely it. Many of those models took into account extreme social distancing over the long run. Yet they have dramatically reduced from prior projections. I know weeks ago one of the popular ones said we were already a week too late to avoid a doomsday scenario as far as overwhelming hospitals in Wisconsin even if we started social distancing. Yet now we aren't even projected to use 1/5 of our hospital beds and essentially have no ICU bed shortage at peak (now April 13th).

 

I can't imagine trying to accurately project something like this so I am not exactly surprised it is seeing big corrections with real life data. That was bound to happen.

[PeaveyFury]

All those examples you mentioned are at a higher risk during the lockdown because they can't see their doctor.

 

Possibly so. But if they catch COVID-19, they'll almost surely die.

 

Obviously I can't make that decision, seems like you're intentionally being obtuse.

 

Call it obtuse, call it frustration at people who are flippantly desiring to place other people at risk out of little more than impatience.

 

Oh, and it's a cheap shot to say me or anyone else are complaining because we can't get our $6 latte.

 

Fair enough, as you weren't the one mentioning the lattes earlier in the thread. But you were the one advocating people going out to get icecream to 'get out of the house' a few days ago. Sorry, needing to 'get out of the house' and putting guidelines that are working to the side to do so is the definition of self-centered behavior, which is frustrating in a time when so many people are making astounding sacrifices for the benefit of others, and when we all need to be doing so.

[nate82]

My employer has planned for 4-months for the stay at home. I work for a major bank in the US. This stay at home order was done in the middle of March. So that would put the end of this order around July from my employer.

 

I think a safe bet to start planning and assessing to lift the stay at home should be done in May and no later than the beginning of June.

[JosephC]

The actual hard data is pretty much showing that all the modeling that has been done is nothing but garbage.

 

Back on March 17, post #115 of this thread, I really questioned the estimates being thrown around that, at the time, were saying that 60% of the population would be infected. Even if the Chinese government were fudging their numbers in a big way, there was just no evidence at the time which suggested that the number would come anywhere close to even 10% being infected.

 

Let's move on to the death rate. The Chinese were saying 1-3% at the time, the US government is currently saying about 1%, and I'd say again that the actual numbers are showing the death rate is much higher.

 

Spain has surpassed Italy as the major population center with the highest rate of infection. Population = 46,754,778. Total cases = 157,022. Percent infected = 0.336%. They hit a high number of 8200+ cases on March 26 and are in a decline and are down to about 5000 cases per day. Odds are probably stacked against them even hitting 1%.

 

So far there has been 98,379 deaths and 366,673 recoveries worldwide. 98379/465052*100 = 21.15% death rate. OK, can't trust that number because more people are aware and getting treatment and from this point forward the number of recoveries will increase more than the number of deaths. OK, currently there have been 1,633,448 confirmed cases. 98379/1633448*100 = 6.02%. So if every single current diagnosed individual recovers, 100% of them, the death rate is still 6.02%. How are people coming up with 1% based on the data out there(?)...unless they want to play the game of "6 of 7 will never show any symptoms" game, which then means they can bend the numbers to say whatever they want them to say. That's not really valid either IMO. If you go through the winter without getting the flu, when spring comes around you say you didn't get the flu, you don't say you probably got the flu because X% get the flu and you just didn't know that you actually had it.

 

So let's look at Iowa's Stay at Home order...or lack of Stay at Home order. Unlike most states, who took the approach of shutting down everything and then immediately exempted almost all "big business," Iowa worked in reverse order, leaving everything open and then shutting down non-essentials bit-by-bit. On March 17th they shut down dine-in restaurants. On March 22 they closed barbershops and salons. On March 26 they closed down clothing retailers and bookstores. Just this week they shut down amusement parks, bowling alleys and malls. And despite all of this, their numbers were hanging around at about 80 new positive cases per day for the last week and half and now it looks like they may start an upward acceleration or they may have spiked. But so far, the increasing number of closures haven't significantly increased or decreased the number of positive cases. But a key point in all of this is that Iowa's lack of a stay at home order was considered to be very risky by much of the media....and as of this morning....Wisconsin has 2885 confirmed cases out of 5,822,434 people and Iowa has 1270 confirmed cases out of 3,155,070 people. Rate of infection in Wisconsin = 0.050%. Rate of infection in Iowa = 0.040%. And if I'm not mistaken, I believe Iowa's first confirmed case happened prior to Wisconsin's first confirmed case (might be wrong about that).

 

Obviously Wyoming and North Dakota are so sparsely populated that a comparison with Wisconsin isn't valid. But looking at some other states with "loose" stay at home orders.....Utah = 0.062% infection rate...Arkansas = 0.0386% infection rate.

 

So I'll raise doubts over the stay at home orders as well. Agree 100% that if people stay home, the virus will stop spreading. I just question and seriously doubt the true effectiveness of stay at home orders where a vast amount of people are still going to work....going to the grocery store....going to the hardware shop....going to the auto parts shop....going to the laundromat...etc...etc...etc. And I really find it debatable when the government says they are going to save me by closing all clothing retailers and causing mass herds to pile into big box stores because they've closed everything else.

[igor67]

Chorizo I don't think you understand how big the at risk category is. Normally healthy individuals do seem quite low risk, maybe even at a tolerable risk level. But the underlying conditions category includes both diabetes and asthma, and anybody currently in cancer treatment. Diabetes is 10.5% of the population, asthma is around 8%. 65+ is 13% of the population. Now obviously we can't just the percentages together, but there are a host of other less common conditions that would need to get added in as well. So a rough ball park is 30% of Americans needing to function more or less under stay at home type orders anyway.

 

You seem to dismiss items as projections, when they are calculations. Well validated calculations on the professional level. In some cases they have changed because of new information about the disease. But the end point number of deaths I calculated above is about as rock solid as gravity. What has clearly had a bigger impact on the calculations are actual changes in human behavior. Importantly though they are mostly changes in timing, which as we have seen is important to prevent other spin-off deaths due to lack of appropriate medical care.

 

We've seen plenty of examples in the vaunted private sector of how poorly they are dealing with rapid shifts as well, much of the mitigation is geared to prevent that. Regrettably we've seen entirely preventable shortages like chlorquinine because of promoting of flawed information. Which has meant people who actually are known to benefit are missing out on the drug.

[igor67]

Just to clarify the vaccine pessimism. A primary reason there is no common cold vaccine is that, the common cold is a dump category of symptoms caused by a bunch of different viruses, the majority of which are not coronaviruses. Second both SARS and MERS were coronaviruses that there has been prior success developing vaccines for. It also lacks the genetic characteristics of the flu, which allow it to change so rapidly we have to develop a new vaccine every year. Betting on a single vaccine candidate to make it all the way through would be silly, but folks have really identified a pretty large number of candidates with different methods already, so there is pretty good reason for optimism.

[homer]

 

We've seen plenty of examples in the vaunted private sector of how poorly they are dealing with rapid shifts as well, much of the mitigation is geared to prevent that. Regrettably we've seen entirely preventable shortages like chlorquinine because of promoting of flawed information. Which has meant people who actually are known to benefit are missing out on the drug.

 

Friend of mine takes it for Lupus. She said the price has been jacked sky high.

[igor67]

Joseph it is very important to distinguish arm chair calculations floating around, from real calculations done by epidemiologists. As I noted above human behavior changes will necessarily alter the final calculation. But behind that one publish number or estimate are going to be a lot of data and discussion about to handle all of these different questions. If you haven't participated in that kind of scientific process it is hard to quickly convey. Having seen what passes for analysis often times in other fields it is far more rigorous, especially with this level of scrutiny.

 

Or if you prefer a goofy example this would be like jumping out of a plane with a parachute and complaining that all of these projections about what gravity was going to do to me were nonsense.

[Fear The Chorizo]

Models are revised as new data comes in. Models are being revised downward because the social distancing is working.

 

I keep seeing this, but the modeling parameter of time is basically the one parameter that is known with absolute certainty - meaning the initial assumptions of community spread rate during this period of social distancing/shelter in place through August and most importantly hospitalization/lethality rates of this virus for the general population were wildly off, particularly for large portions of the US that aren't densely populated. Don't get me wrong, that's fantastic news for public health and I'm happy this is the modeling flaw compared to Covid-19 effects being worse. Social distancing/shelter in place surely does work, but that's not why the initial models appear to have been significantly incorrect - it's not that we're really good at it as a country (as evidenced by swipes about ice cream shops and jogging paths), it's that the potential difference between doing nothing and fully sheltering in place as a society isn't as drastic as it was originally believed to be for this particular virus.

 

I guess my overall point is decisions based on these initial models got us to present conditions, which is in a state of indefinite uncertainty as to when we can reopen society anywhere close to "business as usual", and as actual data is processed it's becoming more apparent that the medical system as a whole could have withstood a more measured approach across a huge portion of the country - particularly when compared to the longer-term strain it's going to be dealing with now. My sincere hope is that society at large comes to this realization quickly and changes its approach to live with the presence of Covid-19, before the 2nd wave of economic destruction that is coming for public sector/white collar workers becomes insurmountable to re-establishing life anywhere close to what we all knew it just one month ago. Maintaining the current status quo into the summer just isn't a reality we should embrace knowing what the long term result of that approach would be.

[igor67]

Actually since we are discussing exponential type growth relatively small adjustments in the R factor can translate to pretty big changes in how long everything takes. If I had some really good coding skills I'd whip up come sample charts.

[PeaveyFury]

.Wisconsin has 2885 confirmed cases out of 5,822,434 people and Iowa has 1270 confirmed cases out of 3,155,070 people. Rate of infection in Wisconsin = 0.050%. Rate of infection in Iowa = 0.040%.

 

Doesn't all of this data cited here rely on equal testing rates, though? What are the number of tests conducted in Iowa vs. Wisconsin?

[JosephC]

Joseph it is very important to distinguish arm chair calculations floating around, from real calculations done by epidemiologists. As I noted above human behavior changes will necessarily alter the final calculation. But behind that one publish number or estimate are going to be a lot of data and discussion about to handle all of these different questions. If you haven't participated in that kind of scientific process it is hard to quickly convey. Having seen what passes for analysis often times in other fields it is far more rigorous, especially with this level of scrutiny.

 

Or if you prefer a goofy example this would be like jumping out of a plane with a parachute and complaining that all of these projections about what gravity was going to do to me were nonsense.

 

That's interesting because my arm chair calculations are done with real verified numbers, and the epidemiologists "real" calculations are done with...well who knows what(?). Maybe that's why the stuff I posted on March 17th has stayed the same over the course of nearly a month while the situation was decreasing in China, at full impact in Italy/Spain and was ramping up in the US. Meanwhile the epidemiologists numbers have pretty much changed on a weekly basis.

[Fear The Chorizo]

.Wisconsin has 2885 confirmed cases out of 5,822,434 people and Iowa has 1270 confirmed cases out of 3,155,070 people. Rate of infection in Wisconsin = 0.050%. Rate of infection in Iowa = 0.040%.

 

Doesn't all of this data cited here rely on equal testing rates, though? What are the number of tests conducted in Iowa vs. Wisconsin?

 

To date, WI has tested roughly 0.58% of its state population based on the above numbers, while Iowa has tested roughly 0.47%...not exactly the same but also not drastically different per capita. Since WI has larger population centers than IA, I'd expect both its infection and testing rates to be a bit higher in the groups actually tested to this point.

 

I don't like using test result totals to extrapolate and compare statewide infection rates, as the datasets are skewed heavily towards likely cases showing symptoms and frankly aren't statistically significant anyway due to testing limitations. In an ideal world widespread testing can help us move past our current state, particularly if it involves antibody/immunity testing - hell, even NY state has only tested 2% of its overall population at best, and these tests are really just snapshots in time for individuals that aren't providing the more important information on who has antibodies in their system that may be indicative of a level of immunity to the virus. Furthermore, I'd guess a good percentage of total testing numbers to date are for medical personnel treating patients that have been tested multiple times.

[homer]

.Wisconsin has 2885 confirmed cases out of 5,822,434 people and Iowa has 1270 confirmed cases out of 3,155,070 people. Rate of infection in Wisconsin = 0.050%. Rate of infection in Iowa = 0.040%.

 

Doesn't all of this data cited here rely on equal testing rates, though? What are the number of tests conducted in Iowa vs. Wisconsin?

 

And date of first case. If you didn't get a case until mid March you probably benefited by overall diminished travel.

[adambr2]

Testing is the key to everything.

 

Testing for the virus, and testing for the antibodies. Mass testing will answer so many questions. All the stats we have tell us nothing if we don't have testing. The number of infected and dead in Wisconsin tells us almost nothing. If you have symptoms, and you get told you can't get tested because you don't need hospitalization and you just need to go home and rest for 2 weeks and call if you get worse, we need to do better. Imagine how many infected have no symptoms at all, and in many cases we can't get the midly symptomatic tested.

 

If we could test everyone for the virus and antibodies, this thing would be over soon. I heard in March about a 5 minute test that was going to start being produced at the rate of 50K per day on April 1st, but I haven't heard much since.

[superfly]

Models are revised as new data comes in. Models are being revised downward because the social distancing is working.

 

Models showed “no social distancing, business as usual”, social distancing, full lockdown, etc. Obviously numbers will change as time goes on, nobody disputes that. But it is very disingenuous for sources to now on the back end use that as an excuse when we’ve went from millions dead to “maybe 60,000.” As critics have said from the beginning, the death toll sounds like it will be similar to a bad flu season, and here we are weeks later with the numbers very much trending in that direction.

 

What I would really like to know is how this virus just happened to mutate or “get loose” as the United States was signing a very large trade deal with China, and the wreckage that ensued. When it’s all said and done, was this perpetrated by China to scare the living heck out of the world and damage our economies? Xi is no stranger to optics, and things like bolting and welding sick people into their homes to die or survive is merely numbers to him. China needs to pay for the damage they’ve sewn on the world.

 

I know I’m going to get told to put tinfoil on, but we really need to analyze exactly what set this whole thing off so it NEVER happens again.

[homer]

Once again, if everyone got the flu within a 6 week time period we'd be hosed. It does not spread as fast as this does hence why it's over a 5 month period and our healthcare system can easily handle it. This is not the flu.

[3and2Fastball]

Just to clarify the vaccine pessimism. A primary reason there is no common cold vaccine is that, the common cold is a dump category of symptoms caused by a bunch of different viruses, the majority of which are not coronaviruses. Second both SARS and MERS were coronaviruses that there has been prior success developing vaccines for. It also lacks the genetic characteristics of the flu, which allow it to change so rapidly we have to develop a new vaccine every year. Betting on a single vaccine candidate to make it all the way through would be silly, but folks have really identified a pretty large number of candidates with different methods already, so there is pretty good reason for optimism.

 

Thanks. That’s good to hear

[LouisEly]

What I would really like to know is how this virus just happened to mutate or “get loose” as the United States was signing a very large trade deal with China, and the wreckage that ensued. When it’s all said and done, was this perpetrated by China to scare the living heck out of the world and damage our economies? Xi is no stranger to optics, and things like bolting and welding sick people into their homes to die or survive is merely numbers to him. China needs to pay for the damage they’ve sewn on the world.

 

I know I’m going to get told to put tinfoil on, but we really need to analyze exactly what set this whole thing off so it NEVER happens again.

No need for a tinfoil hat, this is the THIRD novel virus to come out of China in the last 20 years. Once is an accident, twice is a trend, three times is a problem.

 

I think cancelling the United States' bond debt to China would be a good start. China's been deserving of that for a while, given their rampant currency manipulation, but that's probably a topic for the political forum.