COVID-19 Thread [V2.0]

[CheezWizHed]

 

Likely causes: Large cabins with minimal ventilation, regular singing and cheering.

 

https://www.livescience.com/summer-camp-covid-19-outbreak.html

 

https://www.theatlantic.com/health/archive/2020/07/why-arent-we-talking-more-about-airborne-transmission/614737/

The super-spreader–event triad seems to rely on three V’s: venue, ventilation, and vocalization. Most super-spreader events occur at an indoor venue, especially a poorly ventilated one (meaning air is not being exchanged, diluted, or filtered), where lots of people are talking, chanting, or singing. Some examples of where super-spreader events have taken place are restaurants, bars, clubs, choir practices, weddings, funerals, cruise ships, nursing homes, prisons, and meatpacking plants.

 

If they just stop the group-sings at those meat packing plants, everything would be good!

[stalton]

 

Likely causes: Large cabins with minimal ventilation, regular singing and cheering.

 

https://www.livescience.com/summer-camp-covid-19-outbreak.html

 

https://www.theatlantic.com/health/archive/2020/07/why-arent-we-talking-more-about-airborne-transmission/614737/

The super-spreader–event triad seems to rely on three V’s: venue, ventilation, and vocalization. Most super-spreader events occur at an indoor venue, especially a poorly ventilated one (meaning air is not being exchanged, diluted, or filtered), where lots of people are talking, chanting, or singing. Some examples of where super-spreader events have taken place are restaurants, bars, clubs, choir practices, weddings, funerals, cruise ships, nursing homes, prisons, and meatpacking plants.

 

If they just stop the group-sings at those meat packing plants, everything would be good!

 

I know you are joking but that partially explains why JBS had the outburst of cases.

[MrTPlush]

I saw an article that young children may transmit the virus for efficiently or something to that effects. I was too lazy to actually read the article...but I figured some here might find that of interest if they wanted to search for it.

 

The masks could make reopening really messy. From some polls I have seen schools do over a third of parents said their child would not wear one. That was before the mandate came down...so it would be interesting what that would do.

[tmwiese55]

I saw some meatpacking stuff a couple months back, roughly when GB area had the big outbreak from it. That article is odd to include that along with other seemingly recreational activities. But if you haven't seen anything on meat plants the reason is they have the facilities as small and cramped as possible because it costs so much money to cool the facilities to the temps needed. So, the result is you have the works literally shoulder to shoulder, in an enclosed cool environment, with poor ventilation. Sounded like a fairly bad working condition even before this happened. But it's kind of the perfect storm for it, probably even more than a crammed bar.

[igor67]

I came across this article which maybe more of interest to me, but

https://www.buzzfeednews.com/article/stephaniemlee/ioannidis-trump-white-house-coronavirus-lockdowns

 

It digs into the timeline of Jonathan Ioannidis' communications and publications. He was easily the most prominent scientist using antibody testing to get very high prevalence rates of the virus and as a result much lower lethality estimates. The article does not really supply a clear motivation for his behavior, but it does establish that very early on he was very anti-lockdown. So what I think happened is that for some reason or another he came to believe that a lockdown would cause serious devastation. From that given he spent months collecting and looking at data with that in mind, at some point I suspect his ego also kicked in and lead him to keep doubling down. I can't clearly demonstrate that explanation, but it is consistent with other episodes where prominent scientists go off the deep end. What I hope people can take away from this episode is not cynicism or lack of respect for the experts, but a good example of why the cross checking of peer review in science is so critical. This type of mistake is easy enough for anyone to fall into afterall. What makes the entire thing so noteworthy is that Ioannidis is most well known for taking a very hardline stance in methods and rigorous experimental and statistical techniques and standards. Standards he abandoned in this case.

[DHonks]

Well, we start classes on Wed. Glad to be back to work, and glad my district declared online-only for the first month, but I feel so unprepared to teach online (and I’m on the younger, more tech savvy side of the spectrum). We have been so bored with virtual professional development, I can’t imagine how bored the kids will be with 5-6 hours of school online, followed by 1-2 hours of homework (mostly online).

[Fear The Chorizo]

Sweden's Tuesday weekly new confirmed case totals since late June following a moderate ramp-up in testing (I picked Tuesdays because those are their high reporting days on a weekly basis due to weekend data lags and basically includes 2 days of results):

 

6/23 - 2,889 (their high daily reporting mark for new COVID-19 cases, significant for a country with ~10 million people that are pretty well spread out. Roughly the US equivalent of 100K new confirmed cases in a day, a total the US hasn't really come close to reaching since testing capacity actually got to those levels)

6/30 - 2,530

7/7 - 1,642

7/14 - 928

7/21 - 767

7/28 - 398

8/4 - 590

hospitalization and death trends for that country are trending even more rapidly in the right direction, too.

 

Spain's Monday weekly new confirmed case totals in that same timeframe (picked Monday because that's typically their weekly high water mark):

6/22 - 232

6/29 - 200

7/6 - 1,244

7/13 - 2,045

7/20 - 4,581

7/27 - 6,361

8/3 - 8,532 (this is worse than where the US is at in terms of per capita new cases per day - keep in mind the US is testing at a much higher rate than Spain, too).

 

As of yesterday, confirmed case rate rolling average totals in European countries over the last 14 days:

1. Sweden: Down 46 percent

2. The Netherlands: Up 205 percent

3. Belgium: Up 150 percent

4. Spain: Up 113 percent

5. France: Up 72 percent

6. Germany: Up 59 percent

7. Finland: Up 160 percent

8. Denmark: Up 81 percent

9. Norway: Up 61 percent

10. U.K.: Up three percent

 

France appears to be headed in the wrong direction again, although not quite to the level of Spain. France is tough to gauge on a case count basis, however, as their testing capacity has been very low compared to other western European countries per capita.

 

To date Italy has kept a very good handle on new confirmed cases, however recent news indicates their people are growing quite restless of mitigation measures still in place. Germany and England have also kept a pretty good handle on things. The difference between these countries and Sweden is that they have denser population centers and they've had sustained lockdowns to get their case trends to where they are - that means they likely have a larger group of people at risk of initial exposure and a better chance at new community infection spikes whenever they do decide to try resuming increased activities. In addition, most of these European countries suffered pretty significant death tolls right away before they imposed lockdowns - areas of Italy, France, Great Britain, and Spain exceeded New York/New Jersey in terms of fatality rates. The hardest hit portions of those countries may not be as susceptible to COVID case resurgences that lead to hospitalizations/death. Germany was the primary large western European country who seemed to avoid significant deaths across their population back in March/April, so they may be most susceptible to seeing a big 2nd surge once their working age populations obtain a more widespread exposure to the virus.

 

What will be very interesting as this year progresses is seeing what happens to Sweden relative to other European countries that enacted more severe lockdown measures in terms of periodic case/hospitalization spikes. Sweden's perceived spike in mid to late June in terms of cases in reality was already the downside of population-wide infection, limited testing up until June masked the size of their true initial highpoint sometime in early April or even March based on the timing of when their highest daily deaths were recorded (similar timeframe to many other European countries). On a per capita level, the gamble Sweden made with their no lockdown/mask-indifferent approach across their general population was that they presumed a quick fix (vaccine, miracle treatment) wasn't going to present itself in the near future that would drastically lower infection/hospitalization risks, and the best approach was to just social distance to prevent everyone from getting infected at once and carry on. Hell, even if we get a vaccine that's pretty effective against COVID in the next few months it won't suddenly give everyone immunity to getting infected.

 

Sweden has both the population density and overall public health level to "play the long game" - and in addition their culture lends itself better to living life practicing social distancing measures for an extended period of time. Countries like Norway and Finland often get pooled together as an example of how locking down could have kept Sweden's COVID death/hospitalization numbers much lower than what they presently are, but that's in a vacuum that doesn't consider future conditions - what happens if Sweden is able to keep doing their thing while their case counts dwindle despite never locking down and these other nordic countries struggle with delayed reopenings to prevent the inevitable spread as this drags into fall/winter? For what it's worth, Sweden never fully shut down in-person schools for children under 16 and has no sort of nationwide mask mandate, since these are the current hot button issues many of us with kids are dealing with.

 

In other parts of the world, unfortunately India appears to be in the midst of a significant outbreak - likely beginning a long time ago but their daily new case totals are finally spiking as their testing capacity has been slowly catching up. India has both the population density and limited medical infrastructure to create a medical catastrophe in that country, however thankfully their saving grace in terms of avoiding massive COVID-related deaths may be how young their population is - particularly how few people in that country are older and have many of the comorbidities COVID is most lethal to (overweight, heart disease, diabetic, immunocompromised due to other significant ailment, etc). The primary reason we aren't seeing widespread death due to COVID in many developing countries is there just isn't the life expectancy in them to have large groups of 80+ year olds with other health issues around to get infected relative to their overall population.

[tmwiese55]

Good summary. I've been generally keeping an eye on the Sweden thing the last few weeks once their drop started happening, I think I posted in here too. All their stats were quite bad for so long but now it seems it might be paying off. But even if that happens that approach just does not seem feasible in the US due to our dense large cities. I think their biggest city is roughly the size of Madison. But it would make it seem rural areas can kind of try that approach and numbers probably/hopefully will never get out of control. Another key thing missed by the faction that's been obsessed with this approach is they have universal healthcare. Worlds colliding for that faction politically haha.

 

And another thing I've been waiting to compare to the US vs Europe is what happens when EU starts opening. If you look at the graphs obviously their process so far looks astronomically better. But, if they re-open and the same kind of boom happens that we're having now well then it seems it was kind of inevitable and we don't look so bad and we in theory would've helped our economy by going sooner. AS of now I'm still guessing starting from the drastically lower point like they're doing is going to be better, but we'll see. Plus with a vaccine hopefully not too far out the fewest people we can have die before then the better. So again, what they did would work better for that. But we'll see how the next 1-2 months go over there.

[homer]

Please link to your data. Thanks.

[CheezWizHed]

I didn't try to duplicate the rates, but you need absolute numbers with the rates. If I had 10 cases yesterday and 20 today, its 100% increase. If I had 100 cases yesterday and 110 today, it is 10% increase. Yet, I would rather have 20 cases/day...

 

But I did start poking into the death/million population and found some surprising info (source is John Hopkins + spreadsheet math):

- In the "very good" category, Norway (47.1), Denmark(106.1), Germany(110.4) and Switzerland (231.2) have very low rates.

- In the middle are: France (450.5), Sweden(561.8) and UK(624.1)

- The worst are Spain(939.6), Belgium(859.5), and Italy (703.0)

 

Those are the only EU countries I looked at and wasn't cherry-picking countries, except Sweden (based on the different approach).

 

Obviously, Italy and Spain had a pretty hard go of it early in the COVID crisis. But overall, Sweden really isn't an outlier here.

 

Looking at infections/million population, Sweden(8000) is just behind Spain (9983) and ahead of Belgium (6135) where the rest range from 1720-4965.

 

This just tells me that their death rate really wasn't out of line with other EU nations. Maybe it could've been better...maybe not (unfortunately, you can't "test" a historical decision like this).

[tmwiese55]

If you'd have done this same type of thing 6-8 weeks ago (maybe even longer now with how long its been) Sweden should have been in the top 5. The last several weeks have really turned things for them. I'm not aware of anything specific they did which led to it. But it seems the long game could end up playing out well.

 

Since it's impossible to know an alternate timeline it's impossible to know that if due to their advantages if they would've done more drastic steps if they'd have saved lots of lives. But it's feasible. And the same would apply to many other countries approaches in either direction. the big thing is the density. Remember UK started down this same path for a while (obviously their density is much much different than Sweden) and they got bad results they're still paying for.

 

I guess my biggest takeaways if these trends continue is that for less dense/rural areas they can probably be less restrictive in terms of lockdowns, as long as you keep this all in mind in regards to distancing, masks, etc. But, in the US we can't even get the rural areas to say ok to that so it's a tough road here regardless. Also, it's easier to do this in their rural country and keep the international border shut so intermixing can't happen. In a big country like ours, it's still very easy to have the cities mixing in and out with the rural. Which would kind of undermine the strategy in the rural areas. Also, universal healthcare there.

 

For what happens without shutdown in a highly dense city, just look at NY in March/April. Let's not forget that happened.

 

If we're looking at comparing strategies. Wouldn't it be quite simple to look at the US as NY/New England region vs rest of country. They started super high, did all this very aggressively, listened and are now super low. The rest of the country started very low, didn't listen to the guidelines and are now much higher and trending the wrong way. You'd basically have exact opposite lines if you had them on a graph. Very tough to look at a graph like that and say the 'rest of the country' line is the one you'd want.

[xisxisxis]

[pre]Country Population Total Cases Deaths 7 day Ave

Norway 5,542,713 9,362 256 29

Denmark 5,793,679 14,073 616 64

Finland 5,424,203 7,483 331 10

Total (NDF) 16,760,595 30,918 1,203 103

Sweden 10,108,080 81,181 5,747 242[/pre]

 

Not sure how you spin the Sweden numbers in any way.

 

They are the US of Scandinavia (4.3x the cases, 7.9x the deaths, 3.9x current cases by 7-day average).

[CheezWizHed]

I wasn't spinning the Sweden numbers. I simply put them out there with several other EU countries for comparison. Only comparing them to other Scandinavian countries is spin.

 

Its a complicated problem and I'm not saying Sweden did it right. I knew Sweden's death totals were poor, but I was surprised to see them in line with the UK, France and better than Belguim.

[homer]

I dunno. I think comparing them to their neighbors makes more sense than comparing them to Spain. That's like comparing Wisconsin to Alabama instead of Minnesota. There's a little more apples to apples in terms of culture comparing Sweden to Norway and Finland.

 

Regardless I don't think you can say anything definitive about the Swedish approach until we get through regular flu season this winter. I would certainly not use a 14 day sample as representative of anything particularly when cases counts for some of those countries have been single digits on some days.

[CheezWizHed]

Spain and Italy are the exceptions in the EU because they were hit early, before anyone really reacted to do anything about it.

 

But France, Belgium and the UK are interesting because they did react, yet fared no better than Sweden. Either way, if your focus is too small, you will miss patterns. That is why I didn't limit my data to just their neighbors. Plus, in this case, I don't see anything effected due to geographic location (I could be wrong). Climate doesn't seem to have an effect either as people hoped.

 

Seems like number of travelers and general population movement seems to be more important than geography. Not sure how Sweden compares to Norway, Finland or Denmark in terms of travelers, but there are enough unknowns in the equation to look at the larger picture.

[OldSchoolSnapper]

I don't know why people were clinging to the climate fantasy as long as they were. One of the first places it badly exploded was Iran.

[CheezWizHed]

I think Iran gets "dismissed" due to the perception of poor health care (I honestly don't know if it is good or poor). I know, I personally "hoped" that it would die out in the summer like the flu normally does -- who wouldn't? Dealing with a known (i.e. flu) is easier than the unknown mentally.

[tmwiese55]

I don't know why people were clinging to the climate fantasy as long as they were. One of the first places it badly exploded was Iran.

 

Good point. Put that on the list of many things.

 

However, this is a legit question with no idea or opinion on it myself. Since the idea on that was because normal flu subsides in warmer weather. Have you or anyone seen if maybe this shows the reason normal flu goes down is just because schools are closed in the summer so less mixing it up there. Or is there an actual scientific/biologic reason the virus is weaker in warm weather? I remember thinking that back then but don't recall ever seeing an answer.

[CheezWizHed]

For the flu, there is scientific evidence (sorry, I don't have a link but I've read credible sources) that humidity effects the "shelf-life" of the virus. So it dies quicker and lowers the chance someone can pick it up. Obviously, being outside (i.e. spread out) and less mixing (i.e. kids in school) are big parts of that, too.

 

That doesn't seem to be true for COVID-19 or not as much.

 

Still, I want a sauna...

 

Edit: Found a CDC link. Its not the one I read previously, but says about the same thing.

[Machu Peach]

I don't know why people were clinging to the climate fantasy as long as they were. One of the first places it badly exploded was Iran.

 

What about Iran's climate makes you think it's an example of a climate fantasy? The average highs in Tehran in Feb/March are probably about 50 degrees. They're significantly cooler in more northern cities like Tabriz or if you gain any elevation.

[OldSchoolSnapper]

I don't know why people were clinging to the climate fantasy as long as they were. One of the first places it badly exploded was Iran.

 

What about Iran's climate makes you think it's an example of a climate fantasy? The average highs in Tehran in Feb/March are probably about 50 degrees. They're significantly cooler in more northern cities like Tabriz or if you gain any elevation.

 

The temperatures were in the 70s in Tehran when the virus was exploding there during the first week of April. That July and August would stop the virus in the northern US made no sense. If anything, it seemed to get worse in the South, where people went indoors, and in the North, where people started hanging out together again. But that didn't stop anyone, including some people here, from saying the summer would save us. As a person who badly wanted that to be true, it never seemed logical to me at all.

[CheezWizHed]

The temperatures were in the 70s in Tehran when the virus was exploding there during the first week of April. That July and August would stop the virus in the northern US made no sense. If anything, it seemed to get worse in the South, where people went indoors, and in the North, where people started hanging out together again. But that didn't stop anyone, including some people here, from saying the summer would save us. As a person who badly wanted that to be true, it never seemed logical to me at all.

 

I'll raise my hand as someone that suspected summer to quell the virus. The logic comes from seeing the effects of the summer (and humidity specifically) on other virus based diseases, like influenza. The hope was that COVID was similar enough to the flu to have a similar weakness. That unfortunately wasn't true. But it was a logical thought - just no proof at the time (either direction) of legitimacy.

[OldSchoolSnapper]

That's one of the reasons it didn't make sense to me. "This isn't the flu" was an early mantra, there was all kinds of info (some incorrect) that the spread was way different than flu. It didn't sound like anything based in reality, just wishful thinking. That and it was thriving in 70+ temps in Iran.

[Machu Peach]

That and it was thriving in 70+ temps in Iran.

I was going to ignore this because it really don't matter, but you're repeating it again and it's incorrect.

 

If one looks at daily infections (a poor metric as the testing was extremely limited at the time), the virus began spread in Iran in late Feb and peaked at the end of March, not April. If one looks at daily mortality (a much better metric) the virus was at it's worst throughout March, not April. The highs in Tehran in March were mostly in the 60s, with the max being a day of 72. The lows were generally in the 40s. One has to go to April 20th to get the first day with a high of over 72. Other parts of the country were even cooler. This is all very easy to check on a number of websites.

 

That said, according to my Iranian wife and her family, their government vastly underreported the extent of COVID early on. I obviously don't know, but the numbers may be suspect.

[OldSchoolSnapper]

I'm aware it's easy to look up as I did so before making the comment. On April 4, the one day I bothered looking up before I said anything, the temperature reached 72. Your hang up on this is frankly weird to me. Whether it was 64 or 75 I don't really care. It wasn't 27 like it is here in February. So a virus, doing just fine in the 60s and low 70s, is going to just fold in Milwaukee's/NYC's summer?

 

Sounded like wishful thinking. That was my only point. I didn't do a deep dive on Iran's weather, but knew enough that it was not at all similar to ours when people were saying those things.