COVID-19 Thread

[igor67]

There are some interesting portions of your post Chorizo. I disagree for the moment with any significant assertion that the death rate is below 1%. It may in fact be, but of the attempts I have seen at arguing that the numbers don't work out in funny ways. For example if You apply that 0.3% to New York City, and assume no uncounted cases you discover that 6.4 Million New Yorkers have contract Covid already. But New York City itself only has a population of 8.4 million. This is a problem on 3 fronts. 1) It is a ridiculously higher percentage than measure by antibody testing. 2) It is over 10% higher than the high estimate of what is needed for herd immunity. 3) And any undercounted deaths only push it closer to going over 100%. It's also been fairly clear to me that Walz has been trying to build the proper capacity to keep the outbreak permanently under control. Not necessarily zero, but having the testing capacity and supplies to keep the cases at an ongoing low level.

1) I am curious to better understand why Florida hasn't completely erupted, but its not like they are winning either. Iowa and a lot of other places are simpler to understand. Your hardest hit places all had a lot of international travel and were clearly seeded multiple times with infected people before we started to catch on. I think MN just got lucky not with avoiding any travelers carrying it, but we seemed to avoid the bad lottery ticket of a traveler who turned into a super spreader. I think our population distribution may make it possible for something like the Swedish approach to help.

 

2) I have not picked up the same vibe on the nursing home front, but it is unfortunately all too possible and disheartening.

 

3) I do happen to think that whether it is a combination of treatments or a heroic early vaccine keeping the rate of spread slow enough does have significant value. We might be able to push the actual mortality rate down substantially. Even that 1 doctors post about remdesiivr missed thinking about the importance of just reducing the length of the disease 3-5 days. That is actually a really big reduction in the strain on hospital resources whether beds people or PPE.

[OldSchoolSnapper]

The math on death rate being less than 1% still checks out if you believe the reports coming out the infection rate was much higher than originally thought. I suspect in NYC both infections and deaths will be higher because of the population density. But if you believe 1/4 of the city had it already, which has been suggested, then it still works out to around .7%. I believe when this is all said and done, .7% will be on the very high end compared to most places.

[SoCalBrewfan]

That's a strange hill to die on, to be honest, but in any event I would be very cautious about any quantitative claims at this point.

 

I don't think the goalposts have moved; in the first frenzy of shutdown the concerns were getting things safe without (as I recall) any substantive discussions of when we would reopen beyond we need to flatten the curve. Since then most jurisdictions have specific measures that have been articulated as preconditions for easing shutdown orders; the big four are sufficient testing, contact tracing, sufficient treatment capacity / PPE, and a a decline in cases for two weeks. But as the former director of the CDC said in congressional testimony today, it's not exactly an on/off switch, it's more a dimmer switch. And nobody is claiming any of this is easy; there is still so much we don't know about this virus and who does and doesn't have it. I would tend toward caution and the polls say most Americans agree.

 

What is tough for working people is that if their job is not legally required to be shutdown, now they can't claim unemployment and in many cases need to make tough choices about health vs job. There are enough jerk bosses out there that people will be in bad situations.

[OldSchoolSnapper]

Not sure how pointing out some pretty basic math is "dying on a hill." If 1/4 of NYC actually did have it then the deaths are still under 1%. If you're only using deaths/confirmed cases then the mortality rate is like 10% in NYC which we all know is way high. It will be higher in NYC anyway and that was addressed in Chorizo's original post; he used a .3% global figure; it will be higher and lower in other places.

 

Just pointing out that converting .3% mortality to NYC's population is not a real compelling way to prove the global death rate will be >1%.

 

I don't think the mortality rate is a minor detail. The initial estimates on it look more off by the week and were a big driver in a lot of the actions taken. I've said I have no issue at all with the initial shutdowns because everybody was guessing. But I am puzzled by how anyone can say the goalpost hasn't moved.

 

What would piss me off if I owned a small business is driving around my town and seeing a line 40 people deep at the custard stand, the bustling liquor stores every night and a full Walmart parking lot while I can't sell trinkets in my shop or cut hair. None of it makes any sense and there a million opportunities for transmission going on all over the place. I can't help but find it laughable that we "contained" this. That ship sailed.

[reillymcshane]

Nonsense on Stilts by Massimo Piliguci is probably the single best source I can think of to point a non-scientist towards that provides a lot of insight into how to separate out garbage from more reliable (not not infallible) authority. Unfortunately the quacks have gotten more sophisticated over time, so it can be challenging even with good tools. Sorry if my book recommendations have gotten excessive, but as someone best described as a science generalist between my teaching experience and a very eclectic mix of publications my real specialty is educating students in how to think about and use science as future citizens.

I love the stuff you post. Thank you. And keep it up.

[igor67]

Just for clarity I was not arguing for a death rate higher than 1%, SoCal is right that getting any kind of precision on that number is fraught with peril. I was specifically saying the 0.3% was implausibly low. 0.7% could be possible, but that level of specificity is going to require reliable testing and measurements as well as expertise in this type of calculation. There are a lot of complicating factors in pinning that down and would require a specialist.

 

When it comes to goalposts for me anyways its driven by lessons from public service. I have sat through many public meetings over the years where I have seen incredibly impassioned pleas and accusations aired. The vast majority of the time those speeches makes all kinds of sense based on the facts the people cite. However education is riddled with private information that can't be shared in a public meeting, and time and time again that additional information significantly changes the picture. So I try to extend that when interpreting and evaluating public figures. On top of people's comments earlier in the thread about the information overload, I know this to be a common teaching problem and a communication problem for public bodies. So I see a communication strategy 'flatten the curve' that conveys a lot of truth and can be repeated to try and reach people. Mix that with a situation that had to evolve from the beginning, and applying the term 'moving the goalposts' seems to miss the mark. I can understand why a person would come to that, but I come back to that need to evolve as we learned more. It wasn't that long ago when it was plausible to think covid might effectively disappear and be seasonal (it still may dip) for example. That would have pretty radically altered how things could be handled.

I have seen my own share of inconsistencies (a family member whose manufacturing job was considered essential? even though its basically a high end niche construction product), and I would not defend any of them on an individual basis. But in a fast moving situation at even a local level some of that is inevitable and at a state or national level it is going to happen even more. It is easy to get worked up about these things (my family member also got sick, but probably not covid) and but focusing just on them I don't consider a reliable way to judge a policy (it's like obsessing whether or not your #2 hitter is a good bunter). I hope that helps understand my angle.

[FVBrewerFan]

Just for clarity I was not arguing for a death rate higher than 1%, SoCal is right that getting any kind of precision on that number is fraught with peril. I was specifically saying the 0.3% was implausibly low. 0.7% could be possible, but that level of specificity is going to require reliable testing and measurements as well as expertise in this type of calculation. There are a lot of complicating factors in pinning that down and would require a specialist.

 

When it comes to goalposts for me anyways its driven by lessons from public service. I have sat through many public meetings over the years where I have seen incredibly impassioned pleas and accusations aired. The vast majority of the time those speeches makes all kinds of sense based on the facts the people cite. However education is riddled with private information that can't be shared in a public meeting, and time and time again that additional information significantly changes the picture. So I try to extend that when interpreting and evaluating public figures. On top of people's comments earlier in the thread about the information overload, I know this to be a common teaching problem and a communication problem for public bodies. So I see a communication strategy 'flatten the curve' that conveys a lot of truth and can be repeated to try and reach people. Mix that with a situation that had to evolve from the beginning, and applying the term 'moving the goalposts' seems to miss the mark. I can understand why a person would come to that, but I come back to that need to evolve as we learned more. It wasn't that long ago when it was plausible to think covid might effectively disappear and be seasonal (it still may dip) for example. That would have pretty radically altered how things could be handled.

I have seen my own share of inconsistencies (a family member whose manufacturing job was considered essential? even though its basically a high end niche construction product), and I would not defend any of them on an individual basis. But in a fast moving situation at even a local level some of that is inevitable and at a state or national level it is going to happen even more. It is easy to get worked up about these things (my family member also got sick, but probably not covid) and but focusing just on them I don't consider a reliable way to judge a policy (it's like obsessing whether or not your #2 hitter is a good bunter). I hope that helps understand my angle.

 

I think we understand why "the goalposts have moved." What's puzzling is some still dent that they have. Everyone from Trump, Fauci, Redfield, governors, mayors, all of the media said the same thing. Flatten the curve so the hospitals aren't overrun with cases. Now that has changed. In fact, the time frame has changed too. 15 days is what they all said, goalposts moved on that as well. We can debate if it should have been changed, but it absolutely has changed. Hence, "moving the goalposts" is an accurate description.

 

I don't think people realize how many things need to happen in WI under the Badger bounce back. It's far more than downward trend for 14 days in % of positive cases. It's far more than the 3 main items that they will be tracking. Again, people may or may not think the entire plan is logical, but it doesn't change the fact the goalposts have moved.

[homer]

I think people, in general, have a hard time with gray area science. It isn't yes or no, black or white and that's hard to wrap our heads around.

[Ron Robinsons Beard]

I think people, in general, have a hard time with gray area science. It isn't yes or no, black or white and that's hard to wrap our heads around.

 

And the fact that we are seeing more and more people refer to actual scientific research as "fake news" when they disagree with it or it counteracts an agenda that they believe in.

[igor67]

Except that moving the goal posts as a fallacy applies to arguments. We are talking about policies that we explicitly enacted with imperfect information, so changes and adjustments should have been expected from the beginning, all of my co-workers were certainly expecting that back in early March. None of us were terribly surprised by first having to stay open, basically as daycare for essential workers, then closed for a few weeks to prepare for the possibility of distance learning, then doing distance learning, and finally distance learning for the rest of the year. If you prefer I could go over the the investment thread and wait for companies to announce earnings that don't match expectations and claim that all of those companies are moving the goalpost. I don't think most companies when they miss are deliberately trying to mislead or obscure ahead of time anymore than I think most of the public figures are trying to save face which is the connotation that comes with claiming someone is moving the goalposts.

[JosephC]

I think people, in general, have a hard time with gray area science. It isn't yes or no, black or white and that's hard to wrap our heads around.

 

That is hilarious. The COVID-19 science is being done in laboratories by people working on treatments and doing other related experiments like testing stability on certain surfaces. What the statisticians...and therefore the media and politicians as they have ate up everything that the statisticians projected...have been doing has nothing to do with science because they've never based anything they've done on actual observations.

 

"Gray area science" indeed!

[homer]

There is a lot we don't know about this virus.

[igor67]

Homer thanks for the book recommendation, its not an accident that like Piligucci the authors of Calling Bull*** are evolutionary biologists. 100+ years as a field in the crosshairs of parts of the public has sharpened our awareness of both the need and difficulty of public engagement.

[OldSchoolSnapper]

We are talking about policies that we explicitly enacted with imperfect information, so changes and adjustments should have been expected from the beginning, all of my co-workers were certainly expecting that back in early March.

 

The information we have now makes the virus look a lot less scary. So yes, adjustments should be expected, just not the ones we have seen. Flatten the curve was a hashtag, it was everywhere. It's flat, that part is over. The hospitals are not getting overwhelmed. But now that's not good enough and we have to extend locking down to prevent a "2nd wave curve" that may not happen. That's not what they were saying 6 weeks ago.

 

This is a weird situation I find myself in as a mostly left-leaning, advanced degree-educated individual that is normally the person at odds with people I'm suddenly aligned with. I'm not quite in the crowd alleging Bill Gates made COVID19 in a lab, and I think most of these people would be protesting regardless of the situation, but I think we are going about this all wrong at this point and making huge mistakes.

 

Sustaining this into the fall with mortality rates possibly <.5% because we're afraid a second wave might hit? Essentially banning int'l travel into the spring? We need to be practicing targeted lockdown in a way that actually makes sense, i.e. nursing homes and hospitals, not K-12 schools and cherry picking small businesses on a criteria that makes no sense whatsoever.

 

You don't need to look beyond this thread to see that I was all for this in the beginning, but it's time to reassess the risk and begin to accept some of the inherent risk of getting out of bed each day. The people I work with and speak to daily are not thinking straight because of the fear campaign and now have a completely unrealistic threshhold for "safety."

[DuWayne Steurer]

I agree with something Snapper said a few posts ago. If I were a small business owner, who's shut down, and driving past Frosty Freeze and seeing 20-30 people lined up shoulder to shoulder for an ice cream cone, I'd be pretty hot right now. Ice Cream is not essential, and there's places that are closed that offer services that could conceivably open and operate safely at this point within the guidelines of social distancing and wearing masks and only allowing a few customers in at a time.

 

I'm 100% for leaning towards safety and saving every life that can be saved until we gather more information about this thing, but I think there's a middle ground here, and having 40 people buy ice cream cones while small businesses that could safely operate shutter isn't it.

[igor67]

So was or was not the Santa Barbara antibody study released a couple of weeks ago headed up by Jonathan Ioannidis, science Joseph? The one that suggested 2-5% of Californians had already been effected. The same study that used highly non random samples of a test that has a false positive rate high enough to account for a majority of the detected 'infections'. A study that frankly violates a number of the methodological rules that Ioannidis himself has strongly argued need to be implemented in all medical studies for years. Different fields necessarily have rather distinct methodologies, and theoretical/ computational methods are pretty mainstream in a lot of them. Of course they require validation, but the vast majority of news stories I've seen began with some professional doing some level of analysis on some type of data.

[Ron Robinsons Beard]

We are talking about policies that we explicitly enacted with imperfect information, so changes and adjustments should have been expected from the beginning, all of my co-workers were certainly expecting that back in early March.

 

The information we have now makes the virus look a lot less scary. So yes, adjustments should be expected, just not the ones we have seen. Flatten the curve was a hashtag, it was everywhere. It's flat, that part is over. The hospitals are not getting overwhelmed. But now that's not good enough and we have to extend locking down to prevent a "2nd wave curve" that may not happen. That's not what they were saying 6 weeks ago.

 

This is a weird situation I find myself in as a mostly left-leaning, advanced degree-educated individual that is normally the person at odds with people I'm suddenly aligned with. I'm not quite in the crowd alleging Bill Gates made COVID19 in a lab, and I think most of these people would be protesting regardless of the situation, but I think we are going about this all wrong at this point and making huge mistakes.

 

Sustaining this into the fall with mortality rates possibly <.5% because we're afraid a second wave might hit? Essentially banning int'l travel into the spring? We need to be practicing targeted lockdown in a way that actually makes sense, i.e. nursing homes and hospitals, not K-12 schools and cherry picking small businesses on a criteria that makes no sense whatsoever.

 

You don't need to look beyond this thread to see that I was all for this in the beginning, but it's time to reassess the risk and begin to accept some of the inherent risk of getting out of bed each day. The people I work with and speak to daily are not thinking straight because of the fear campaign and now have a completely unrealistic threshold for "safety."

 

This is a really good post Snapper. The "Safer at Home" order and "Badger Bounceback" was enacted with the idea that it was fluid and could be changed as more info came in. Fact is, though, other than very minor changes (golf courses can now open, some non-essential businesses can offer curbside service), it hasn't. I live on the border of two northern Wisconsin counties. One has had 7 positive cases, 6 of which have completely recovered. The 7th came late last week after nearly 5 weeks of no positive tests. The other county has had 4 positive cases, all of which were confirmed more than 6 weeks ago, and all have recovered. People are following quarantine and social distancing guidelines for the most part, and it has worked. I'm all for fairness, but how is it fair that we are dependent on the hundreds of thousands that live in Milwaukee, Dane and Brown counties getting their crap together before we can start to open things up in northern Wisconsin?

[homer]

I'm fine with opening things up regionally within a state. Yeah you might have people from Milwaukee come up to go fishing or whatever but keep tabs on case counts in the hospitals and adjust accordingly.

[igor67]

Snapper I don't think we are terribly far off in what we want things to look like at all. Both WI and MN have loosened a few things and we are going to see what impact that has within a week. Hopefully when adjusted for increasing test capacity that doesn't lead to any significant increase rate of news cases and we can take a few more steps after that... I'm mostly concerned about getting the discussion right. It's a big, real issue. Its new. We don't have to have versions of the same mediocre political discussions that we've had for decades, its a chance to do this one better. For example I saw that the WI manufacturers had released some ideas about a week ago. At my relatively quick glance there were some potentially good ideas on how to save people and the economy so to speak.

[reillymcshane]

Wisconsin showed a spike in testing ability up to 14,800 today, so I guess that is nice. The overall percent of positive cases has been declining pretty steadily this month...but now that meat plants are forced back open that probably won’t last long.

 

Maybe it lasts long enough for us to get some added freedoms.

The 14,800 is not what we are actually testing. Or even can test at this time.

 

Wisconsin actually did about 4,200 tests yesterday. https://www.jsonline.com/story/news/2020/05/06/wisconsin-coronavirus-cases-up-335-testing-ramps-up/5175162002/

 

That's a record for the state - but we are no where near being able to run nearly 15,000 tests.

 

My wife's organization is listed as having the capacity of testing several thousand people a day - but the reality is that they can only do a few hundred.

 

Sorry for the broken record, but they just can't get the supplies to do the tests. They are ready to do the tests. They have the facilities and the people ready - but they don't have the supplies to actually do the tests. And it's killing them. They are losing a ton of money, and need to start doing more procedures and so forth - but they just can't.

 

Things are getting better - but we have a long way to go. We've got to get a reliable supplies of materials to make it happen.

[Samurai Bucky]

My biggest downer thus far comes after speaking with multiple people working in elderly care / alzheimer facilities over the past few weeks...They are seeing rapid declines in their residents and are losing them much sooner than they would have expected - these facilities haven't been exposed to coronavirus, but the measures staff are having to take coupled with the lack of actual interactions with family/friends is devastating to quality of life in those settings...it's heartbreaking, especially considering that any sort of virus mitigation measures would be impacting nursing home facilities and the most vulnerable at the twilight of their lives the same way.

Bingo. I have one daughter who works as a CNA at a Senior Care facility. My son also works there as a dietary aide (started the job about 3 weeks ago). It is tough enough when things were normal for many of the residents. Now with the Stay at Home order, the residents are, to coin a phrase, in solitary confinement. They are high at risk and cannot really come into contact with anybody except for the caregivers.

 

Early on, there were some social workers who were not taking this seriously and introduced COVID into the facility. The first person who was diagnosed was taken to the hospital. Now, the people are placed in a wing that is isolated. Also, only nurses are allowed to be in that section. As far as I know, none of the residents have died from COVID, but there are so many variables, who really knows? Post-mortem, if there is any trace of the virus in their system, I'm sure it will be tallied as a COVID death.

 

All of the workers, even my son (who also doubles as a dishwasher) need to have a test. Currently, it takes 48-72 hours to get a result. The facility they are at is already running very low on nurses and CNAs. If somebody turns up positive, that is going to put an even bigger strain on the staff. They have been asked to start working 12-hour shifts.

 

When one of the first people was diagnosed with COVID, my daughter had contact with the resident. She had to keep a log of her temperature twice a day, report it to the facility each day, and (I think) give the end result of the log to the local health department in our community. Very very stressful for all.

[Samurai Bucky]

I agree with something Snapper said a few posts ago. If I were a small business owner, who's shut down, and driving past Frosty Freeze and seeing 20-30 people lined up shoulder to shoulder for an ice cream cone, I'd be pretty hot right now. Ice Cream is not essential, and there's places that are closed that offer services that could conceivably open and operate safely at this point within the guidelines of social distancing and wearing masks and only allowing a few customers in at a time.

 

I'm 100% for leaning towards safety and saving every life that can be saved until we gather more information about this thing, but I think there's a middle ground here, and having 40 people buy ice cream cones while small businesses that could safely operate shutter isn't it.

To follow up --

 

People complain that voting in Wisconsin was an incubation chamber for the virus to spread...

 

... but it is really cool to see people lined up to get tacos on Cinco de Mayo.

 

[sarcasm]Let's do a study in the next couple of weeks and see if any COVID cases can be traced back to people standing in line for tacos.[/sarcasm]

Love the Sarcasm feature...

[Samurai Bucky]

Wisconsin showed a spike in testing ability up to 14,800 today, so I guess that is nice. The overall percent of positive cases has been declining pretty steadily this month...but now that meat plants are forced back open that probably won’t last long.

 

Maybe it lasts long enough for us to get some added freedoms.

The 14,800 is not what we are actually testing. Or even can test at this time.

 

Wisconsin actually did about 4,200 tests yesterday. https://www.jsonline.com/story/news/2020/05/06/wisconsin-coronavirus-cases-up-335-testing-ramps-up/5175162002/

 

That's a record for the state - but we are no where near being able to run nearly 15,000 tests.

 

My wife's organization is listed as having the capacity of testing several thousand people a day - but the reality is that they can only do a few hundred.

 

Sorry for the broken record, but they just can't get the supplies to do the tests. They are ready to do the tests. They have the facilities and the people ready - but they don't have the supplies to actually do the tests. And it's killing them. They are losing a ton of money, and need to start doing more procedures and so forth - but they just can't.

 

Things are getting better - but we have a long way to go. We've got to get a reliable supplies of materials to make it happen.

This might have been covered in a previous post. I apologize if it has been.

 

Is one of the main causes for the lack of available testing because there isn't as much manufacturing in the US?

[MrTPlush]

I never claimed they were testing 14k people.

 

That being said there was about 1,400 more tests today compared to yesterdays record amount. The most notable part about that is we actually had less positive tests despite that huge increase in testing, 314 down from 335. The positive rate was 5.7%.

 

Also, when do they decide to shoot down the safer at home order or not? May 25th?

[OldSchoolSnapper]

It could be blocked by the Supreme Court in a matter of days but I don't think anyone really knows. It wouldn't be shot down on May 26, it would just end. And probably some lighter form of it extended.