Author Topic: How long can we wait while flattening the curve?  (Read 253617 times)

Northern gal

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Re: How long can we wait while flattening the curve?
« Reply #1150 on: April 25, 2020, 01:21:46 PM »
Does Australia have the option of complete eradication, perhaps alongside NZ?   And even China? The economic advantages of that over the rest of the world could be very considerable.

Wouldn't that require Australia to keep their borders locked for the next year or so?

That was my thought also when I read that NZ is going for eradication. No international traffic to countries with a large tourism industry that at least NZ have could prove to be difficult.

If I may chime in from Western Australia, which has
- closed all its borders to the other Australian states
- introduced new intrastate borders and closed those and
has had 0-1 new daily infections for a while now...

The opinion here, and I share it, is that the perception of eradication may be quite dangerous. You have asymptomatics, goods & parcels, logistics workers, returnees on mercy flights, essential workers etc. What is more important than to "report eradication", is to have the vigilance and capability to identify any new outbreaks as they occur. Which will be a formidable challenge given we are heading toward winter and the newest incubation time estimates are now up to 28 days.

Personally I expect a second wave. But likely / hopefully nothing like NY has seen.

How all that plays out economically is to be seen.

Kris

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Re: How long can we wait while flattening the curve?
« Reply #1151 on: April 25, 2020, 01:31:44 PM »
https://finance.yahoo.com/amphtml/news/time-consider-herd-immunity-york-011655336.html

https://www.npr.org/sections/coronavirus-live-updates/2020/04/25/844939777/no-evidence-that-recovered-covid-19-patients-are-immune-who-says
I mean. None besides the prior evidence that people are mostly immune from almost all viruses after catching them, at least for a period. I think it'd be more correct to say there is no direct evidence.

The WHO is taking care to point out that assuming is not necessarily in our best interests.

Quoting a friend who is an infectious disease specialist:

“LONG answer:  SARS-CoV-2 is an RNA virus and RNA viruses have significantly higher mutation rates than DNA viruses.  We don't yet know how much mutation is altering the behavior of the virus epidemiologically or clinically, but that is ongoing work.  Also, when we talk of antibody based-immunity we are interested in neutralizing antibodies.  When we are exposed to a pathogen, our B-cell immune system creates multiple antibodies directed against "foreign" immune targets.  Not all of these antibodies are neutralizing (ie, stop the virus from replicating and prevent the virus from causing pathologic impacts that we perceive as symptoms of disease.)  These antibodies may act as a marker of infection even though they do not stop continued infection.

 Examples include Hepatitis B and Hepatitis C where people may develop antibodies, but nonetheless have chronic infection (in SOME cases, not all).  And also HIV where the presence of anti-HIV antibodies does not confer immunity.   Immune response may not be durable as well.  Like the other Herpes viruses (the large family of viruses that includes but is not solely the virus causing cold sores or genital herpes), Chickenpox virus causes a lifelong infection with detectable antibodies.  Nonetheless, the latent virus - held at bay by the immune system- can nonetheless re-emerge and cause zoster (shingles) despite presence of antibodies.  Though someone recovers from an infection the effectiveness of the immune response wanes over time without re-exposure to the pathogen (or antigen).  This is why we need to give "booster" immunizations for example.  (Rabies inoculations given prophylactically to lab or animal workers for example usually need to be repeated every 2 - 3 years because of waning immunity). 

This coronavirus is only the 8th coronavirus known to cause human infections, so there is much we still need to learn about it.“


GardenerB

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Re: How long can we wait while flattening the curve?
« Reply #1152 on: April 25, 2020, 01:53:09 PM »
"Although, NYC probably has a 25% infection rate by now..."

I'm sure it's been discussed on this thread or another somewhere, but is there not a good chance it's even higher than that?  I realize the antibody testing estimated 21% for NYC, but the uncertainty margin there would be wide - Stockholm's similar testing results were 11%, range of 11% to 33%.

And, according to test rates, only 1.5% of NY state has been tested, with 36% positive.  Those are mainly those showing ILI (influenza-like illness).  What about the estimate of untested asymptomatic people who had it from as far back as January and on?  Note this was traveling around the world as of November when millions of travelers going in and out of China/Wuhan - it did not just start in March.

GB

obstinate

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Re: How long can we wait while flattening the curve?
« Reply #1153 on: April 25, 2020, 02:06:31 PM »
"Although, NYC probably has a 25% infection rate by now..."

I'm sure it's been discussed on this thread or another somewhere, but is there not a good chance it's even higher than that?  I realize the antibody testing estimated 21% for NYC, but the uncertainty margin there would be wide - Stockholm's similar testing results were 11%, range of 11% to 33%.

And, according to test rates, only 1.5% of NY state has been tested, with 36% positive.  Those are mainly those showing ILI (influenza-like illness).  What about the estimate of untested asymptomatic people who had it from as far back as January and on?  Note this was traveling around the world as of November when millions of travelers going in and out of China/Wuhan - it did not just start in March.

GB
I haven't read the NY study, but so far most of the sereological studies have had serious problems that would cause them to overestimate as well. The primary two being consent bias and unaccounted false positive rates from the tests.

Also, the notion that this was NY in November is unfortunately wishful thinking. It would be nice if it were true, as that would suggest that infection rates were much higher than currently believed. It started circulating in Wuhan in November, but even in December there were cases in Wuhan in the hundreds. It's unlikely that any of the early tens of cases made their way to NY. Especially since the evidence suggests that NY was mostly infected via Europe.
« Last Edit: April 25, 2020, 02:18:12 PM by obstinate »

Abe

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Re: How long can we wait while flattening the curve?
« Reply #1154 on: April 25, 2020, 02:14:47 PM »
The WHO raised a few points:
1. We don’t know for sure that people generate sufficient antibodies to be immune to reinfection (technically true since no one has done a study re-exposing people who had covid, but probably not relevant because that’d be very rare from what we know about most viruses). They advices that these tests should be done on volunteers who had mild symptoms and otherwise are low risk. Any volunteers here?

2. More relevant is that the tests themselves may not be specific enough and may detect antibodies to other coronaviruses (which cause colds, and likely many people have been exposed to this winter). It’s unclear if these tests have been validated in that regard, and will lead to false positives (people appear to have anti-covid antibodies but they are actually for other coronaviruses).

3. Also they note that several tests had poor quality control and were not specific enough, separate from the above issues.


A point that they didn’t raise is it’s unclear how long immunity to this coronavirus lasts after infection, because we do know that immunity to others does not last more than about a year. If we assume this coronavirus is immune sensitizing like others, we should also assume that the immunity wanes in a similar fashion. This is relevant if we don’t have a vaccine, because then this virus will be an annual issue like the others.

obstinate

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Re: How long can we wait while flattening the curve?
« Reply #1155 on: April 25, 2020, 02:21:16 PM »
Oh, so they are just reacting to the concept of an immunity passport? In that case, well enough. It is a stupid concept. Enabling the free movement of a small fraction of the population is not going to make a big difference. Restaurants, retail, etc. cannot operate on 5% of their usual clientele. And the incremental risk will stochastically push back the point at which society in general can resume.

Gin1984

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Re: How long can we wait while flattening the curve?
« Reply #1156 on: April 25, 2020, 03:07:57 PM »
https://finance.yahoo.com/amphtml/news/time-consider-herd-immunity-york-011655336.html

https://www.npr.org/sections/coronavirus-live-updates/2020/04/25/844939777/no-evidence-that-recovered-covid-19-patients-are-immune-who-says
I mean. None besides the prior evidence that people are mostly immune from almost all viruses after catching them, at least for a period. I think it'd be more correct to say there is no direct evidence.

The WHO is taking care to point out that assuming is not necessarily in our best interests.

Quoting a friend who is an infectious disease specialist:

“LONG answer:  SARS-CoV-2 is an RNA virus and RNA viruses have significantly higher mutation rates than DNA viruses.  We don't yet know how much mutation is altering the behavior of the virus epidemiologically or clinically, but that is ongoing work.  Also, when we talk of antibody based-immunity we are interested in neutralizing antibodies.  When we are exposed to a pathogen, our B-cell immune system creates multiple antibodies directed against "foreign" immune targets.  Not all of these antibodies are neutralizing (ie, stop the virus from replicating and prevent the virus from causing pathologic impacts that we perceive as symptoms of disease.)  These antibodies may act as a marker of infection even though they do not stop continued infection.

 Examples include Hepatitis B and Hepatitis C where people may develop antibodies, but nonetheless have chronic infection (in SOME cases, not all).  And also HIV where the presence of anti-HIV antibodies does not confer immunity.   Immune response may not be durable as well.  Like the other Herpes viruses (the large family of viruses that includes but is not solely the virus causing cold sores or genital herpes), Chickenpox virus causes a lifelong infection with detectable antibodies.  Nonetheless, the latent virus - held at bay by the immune system- can nonetheless re-emerge and cause zoster (shingles) despite presence of antibodies.  Though someone recovers from an infection the effectiveness of the immune response wanes over time without re-exposure to the pathogen (or antigen).  This is why we need to give "booster" immunizations for example.  (Rabies inoculations given prophylactically to lab or animal workers for example usually need to be repeated every 2 - 3 years because of waning immunity). 

This coronavirus is only the 8th coronavirus known to cause human infections, so there is much we still need to learn about it.“
That is not how latency works in VZV. It is silenced in the ganglion and when it is reactivated, it causes shingles by the nerve tissue damage. Then the rash is created as it moves into the skin from the nerve. The rash is cleared as the immune cells recognize the virus within the body.
« Last Edit: April 25, 2020, 03:09:38 PM by Gin1984 »

Kris

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Re: How long can we wait while flattening the curve?
« Reply #1157 on: April 25, 2020, 03:27:34 PM »
https://finance.yahoo.com/amphtml/news/time-consider-herd-immunity-york-011655336.html

https://www.npr.org/sections/coronavirus-live-updates/2020/04/25/844939777/no-evidence-that-recovered-covid-19-patients-are-immune-who-says
I mean. None besides the prior evidence that people are mostly immune from almost all viruses after catching them, at least for a period. I think it'd be more correct to say there is no direct evidence.

The WHO is taking care to point out that assuming is not necessarily in our best interests.

Quoting a friend who is an infectious disease specialist:

“LONG answer:  SARS-CoV-2 is an RNA virus and RNA viruses have significantly higher mutation rates than DNA viruses.  We don't yet know how much mutation is altering the behavior of the virus epidemiologically or clinically, but that is ongoing work.  Also, when we talk of antibody based-immunity we are interested in neutralizing antibodies.  When we are exposed to a pathogen, our B-cell immune system creates multiple antibodies directed against "foreign" immune targets.  Not all of these antibodies are neutralizing (ie, stop the virus from replicating and prevent the virus from causing pathologic impacts that we perceive as symptoms of disease.)  These antibodies may act as a marker of infection even though they do not stop continued infection.

 Examples include Hepatitis B and Hepatitis C where people may develop antibodies, but nonetheless have chronic infection (in SOME cases, not all).  And also HIV where the presence of anti-HIV antibodies does not confer immunity.   Immune response may not be durable as well.  Like the other Herpes viruses (the large family of viruses that includes but is not solely the virus causing cold sores or genital herpes), Chickenpox virus causes a lifelong infection with detectable antibodies.  Nonetheless, the latent virus - held at bay by the immune system- can nonetheless re-emerge and cause zoster (shingles) despite presence of antibodies.  Though someone recovers from an infection the effectiveness of the immune response wanes over time without re-exposure to the pathogen (or antigen).  This is why we need to give "booster" immunizations for example.  (Rabies inoculations given prophylactically to lab or animal workers for example usually need to be repeated every 2 - 3 years because of waning immunity). 

This coronavirus is only the 8th coronavirus known to cause human infections, so there is much we still need to learn about it.“
That is not how latency works in VZV. It is silenced in the ganglion and when it is reactivated, it causes shingles by the nerve tissue damage. Then the rash is created as it moves into the skin from the nerve. The rash is cleared as the immune cells recognize the virus within the body.

Then my doctor friend is wrong, I guess.

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #1158 on: April 25, 2020, 03:57:15 PM »
https://www.bbc.com/news/amp/world-europe-52395866

The idea that shutting down society and mass unemployment are justified because people are concerned their immune systems may fail is perverse.

Abe

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Re: How long can we wait while flattening the curve?
« Reply #1159 on: April 25, 2020, 04:54:24 PM »
Here's the latest updates on the Scandinavian countries' outcomes. Blue is Sweden.

js82

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Re: How long can we wait while flattening the curve?
« Reply #1160 on: April 25, 2020, 05:14:52 PM »
It's becoming abundantly clear to me at this point that the USA is in no man's land - and heading deeper into it.

What is no man's land for this virus?  It's the space in between going hard early on and knocking the virus out (a la Korea, Australia) and managing small numbers of residual cases through testing/contact tracing, and trying to minimize the damage while the virus runs its course(Sweden).  The Australia/Korea approach is the best from a public health perspective, while the Swedish approach should yield the best economic outcomes.

The problem is, if you half-ass your lockdowns and aim for a point in between the economic optimum and the public health optimum, you're probably going to end up with the worst of both worlds.  A long, half-assed lockdown could easily cost you more(economically) than a short, HARD lockdown and you may well end up with the virus running to its terminal state and causing large numbers of deaths anyways if you don't knock case numbers down to a manageable level that lets you track and isolate cases.
« Last Edit: April 25, 2020, 05:42:03 PM by js82 »

JGS1980

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Re: How long can we wait while flattening the curve?
« Reply #1161 on: April 25, 2020, 05:46:34 PM »
It's becoming abundantly clear to me at this point that the USA is in no man's land - and heading deeper into it.

What is no man's land for this virus?  It's the space in between going hard early on and knocking the virus out (a la Korea, Australia) and managing small numbers of residual cases through testing/contact tracing, and trying to minimize the damage while the virus runs its course(Sweden).  The Australia/Korea approach is the best from a public health perspective, while the Swedish approach should yield the best economic outcomes.

The problem is, if you half-ass your lockdowns and aim for a point in between the economic optimum and the public health optimum, you're probably going to end up with the worst of both worlds.  A long, half-assed lockdown could easily cost you more(economically) than a short, HARD lockdown and you may well end up with the virus running to its terminal state and causing large numbers of deaths anyways if you don't knock case numbers down to a manageable level that lets you track and isolate cases.

@Abe very informative graph. Lets see what the next 30 days brings

@js82 I agree 100%. Ultimately the places that open up will just need to shut things down again when the never-finished first wave resumes its climb, or when a full on second wave threatens to overwhelm the medical system (again). At which point the same folks will say, "see, we should have never of shut down things because the total spread of this disease was inevitable!!!". This despite the evidence of other countries' practices to the contrary.


JGS1980

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Re: How long can we wait while flattening the curve?
« Reply #1162 on: April 25, 2020, 05:56:56 PM »
Obstinate, I think you misread that quote. Sweden actually does include the nursing home deaths, whereas some other countries do not.

obstinate

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Re: How long can we wait while flattening the curve?
« Reply #1163 on: April 25, 2020, 05:58:00 PM »
Obstinate, I think you misread that quote. Sweden actually does include the nursing home deaths, whereas some other countries do not.
You are correct. I retracted my comment (I hoped) before anyone read it, but clearly not fast enough! Thank you for the correction.

alsoknownasDean

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Re: How long can we wait while flattening the curve?
« Reply #1164 on: April 25, 2020, 10:53:05 PM »
Mathlete, based on your characterisation of the U.S. response, I don't have an issue with it. And from what I see in the news, the U.S. has certainly been less trigger-happy with the lockdown than Australia.

Here in Australia the rhetoric is about saving as many lives as possible, etc. There's no one (except a few newspaper columnists) who's said anything like "we can't let the cure be worse than the disease". Even now with ~15-20 nationwide infections per day, we're still being encouraged to observe lockdown.
And look at the result. We're just as locked down as Australia now, only with an extra 50k people dead.

Well, no you're not as locked down as we are. We've been locked down harder and longer than you guys. I can't even drive my car unless it's to get groceries. Can't visit my family.

The Australian stimulus has been about $200b too so unless your stimulus has been about 14x that ($2.8 trillion) then we've spent more money fighting it too. We've had a lot more investment in terms of both economic loss and human inconvenience. Time will tell whether the lives saved will have been worth it.

I'm seeing a surprising amount of traffic in the suburbs. It's not that far off normal levels really. Of course in/around the CBD is a different case, Lygon St is really quiet with all the restaurants closed.

As for eradication here, ultimately it can be done on a local level (there's been no new cases in the NT in over two weeks), but difficult on a national level. How long can a country operate in a complete vacuum, cut off from the rest of the world?

I'm assuming that each US state applies separate restrictions? Have any of the states closed their borders?

secondcor521

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Re: How long can we wait while flattening the curve?
« Reply #1165 on: April 26, 2020, 12:55:02 AM »
I'm assuming that each US state applies separate restrictions? Have any of the states closed their borders?

Correct.  Generally the governors of each state decide.  City mayors can also decide for their cities, sometimes the city mayors and the governors conflict.

None of the states have closed their borders, there is a Constitutional argument that they don't have that power.  My state has, however, instituted a 14-day quarantine order for anyone entering the state; I believe other states have similar restrictions in place.

The border question is getting some consideration here in the US since the states are opening up things in different ways and on different time tables, and the states' governors generally don't agree with each other on the details.  So the governor of state A, if s/he disapproves of the details of governor of state B's plans in its details, may want to block access from B to A for either pragmatic or political purposes.

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #1166 on: April 26, 2020, 02:49:36 AM »
Mathlete, based on your characterisation of the U.S. response, I don't have an issue with it. And from what I see in the news, the U.S. has certainly been less trigger-happy with the lockdown than Australia.

Here in Australia the rhetoric is about saving as many lives as possible, etc. There's no one (except a few newspaper columnists) who's said anything like "we can't let the cure be worse than the disease". Even now with ~15-20 nationwide infections per day, we're still being encouraged to observe lockdown.
And look at the result. We're just as locked down as Australia now, only with an extra 50k people dead.

Well, no you're not as locked down as we are. We've been locked down harder and longer than you guys. I can't even drive my car unless it's to get groceries. Can't visit my family.

The Australian stimulus has been about $200b too so unless your stimulus has been about 14x that ($2.8 trillion) then we've spent more money fighting it too. We've had a lot more investment in terms of both economic loss and human inconvenience. Time will tell whether the lives saved will have been worth it.

I'm seeing a surprising amount of traffic in the suburbs. It's not that far off normal levels really. Of course in/around the CBD is a different case, Lygon St is really quiet with all the restaurants closed.

As for eradication here, ultimately it can be done on a local level (there's been no new cases in the NT in over two weeks), but difficult on a national level. How long can a country operate in a complete vacuum, cut off from the rest of the world?

I'm assuming that each US state applies separate restrictions? Have any of the states closed their borders?

I was out and about today and vehicle traffic was pretty high. Probably about 2/3 of normal levels. A couple of weeks ago it was 1/3 of normal levels. I drove to a nearby park for a walk and it was chock full of people.

You can tell people to lockdown but you can't force them to ignore the national stats showing <20 infections per day every day for a week (and many of those new infections are tied to known clusters).

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #1167 on: April 26, 2020, 03:32:24 AM »
Listen to the experts, Bloop!

The Commonwealth's Chief Medical Officer says it's fine for children to go to school. Listen to the experts!

Victoria's Chief Health Officer says children should not go to school. Listen to the experts!

Now you just have to decide which one...

marty998

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Re: How long can we wait while flattening the curve?
« Reply #1168 on: April 26, 2020, 06:08:15 AM »
Listen to the experts, Bloop!

The Commonwealth's Chief Medical Officer says it's fine for children to go to school. Listen to the experts!

Victoria's Chief Health Officer says children should not go to school. Listen to the experts!

Now you just have to decide which one...

In my view it is healthy that there are a variety of opinions. If all three branches of government sing from the same song sheet all the time then you might as well give up the ghost and call yourselves China.

I suspect history is not going condemn the Premiers for taking one or two extra weeks longer to open things up than some of you think should be the case.

History will condemn them quite severely for opening up one or two weeks early.

The burden of responsibility is high in these days. It's a blessing you all are not the ones having to bear it.


Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #1170 on: April 26, 2020, 07:02:11 AM »
Listen to the experts, Bloop!

The Commonwealth's Chief Medical Officer says it's fine for children to go to school. Listen to the experts!

Victoria's Chief Health Officer says children should not go to school. Listen to the experts!

Now you just have to decide which one...

In my view it is healthy that there are a variety of opinions. If all three branches of government sing from the same song sheet all the time then you might as well give up the ghost and call yourselves China.

I suspect history is not going condemn the Premiers for taking one or two extra weeks longer to open things up than some of you think should be the case.

History will condemn them quite severely for opening up one or two weeks early.

The burden of responsibility is high in these days. It's a blessing you all are not the ones having to bear it.

Actually QLD and WA are opening up early. NSW is sending kids back to school. VIC is the prime holdout.

It may be that 1-2 weeks is trivial at the end of the day, but it might blow out to 1-3 months if you look at the states' eventual responses to full re-opening. And that will have real economic effects.

And as for the burden of responsibility, how many people under 40 in Australia have died? None. How many under 60? I don't know the figure but I bet it's less than 1/5 of the 80 who've died. But how many have lost their jobs and businesses? Millions.

ReadySetMillionaire

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Re: How long can we wait while flattening the curve?
« Reply #1171 on: April 26, 2020, 07:21:57 AM »
Listen to the experts, Bloop!

The Commonwealth's Chief Medical Officer says it's fine for children to go to school. Listen to the experts!

Victoria's Chief Health Officer says children should not go to school. Listen to the experts!

Now you just have to decide which one...

It's interesting that this is also happening in Australia. 

Here in the US, there are plenty of scientists over here saying more "optimistic" things (children should go to school, CFR is way lower than originally anticipated), but it seems our politicians are only relying on the scientists with much more pessimistic predictions and outlooks.

In Ohio in particular, doctors at the Cleveland Clinic (one of the best hospitals in the world) are starting to question the stay at home orders, and think a much more targeted approach would be better; but it seems like Governor DeWine only wants to hear the worst of the worst.

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #1172 on: April 26, 2020, 07:58:07 AM »
I suspect history is not going condemn the Premiers for taking one or two extra weeks longer to open things up than some of you think should be the case.

History will condemn them quite severely for opening up one or two weeks early.
In Victoria it won't be 1-2 weeks' difference. The Premier has sought from parliament and got dictatorial powers until September 30th. He doesn't need to return to parliament for anything until then, having money supply, and being able to do things by regulation rather than legislation - including changes to the justice system. He hasn't sought powers for six months so he can lift restrictions 1-2 weeks or even 1-2 months from now. I expect us to remain at stage 3 for some months yet.

As I have noted before, the lockdown is not without costs in human lives and suffering. We know that each 1% rise in unemployment means a 1% rise in suicides. So from 5 to 10% unemployment would be an extra 150 suicides in Australia, to 15% would be 300. As well, the UK estimates an extra 60,000 (+36%) cancer deaths this year because their health system is overwhelmed; here because of the success of the lockdown in reducing covid rates, we have the opposite problem with empty beds awaiting covid patients we'll never see, but which will have a similar effect - there's been a 25-30% reduction in referrals for cancer diagnosis and treatment. If Australia saw a 36% rise in cancer deaths, that'd be 18,000 people. If it's even one-tenth that then it's 1,800 people. If we'd had 1,800 dead from covid I think the government and media would be hysterical.

As I have said, politics is a giant trolley problem. Whatever course is chosen someone will die. But it's one with less clear outcomes. Thus I think it was reasonable that they defaulted to locking everything down initially, because they just didn't know what would work and what wouldn't.

But now we know. 65% of Australia's infections have been recent arrivals from overseas, and another 20% have been those in their household. Thus, shutting the borders removed most of the possible infections. Allowing the recent arrivals to isolate at home rather than be quarantined meant another 20% got infected. It's only another 10% who were infected secondhand, and another 5% for whom the source is unknown.

Now, since in other countries the clusters of infections have come from large festive occasions where people's faces were close and they shared food and drink, it was also prudent to ban large gatherings like football matches and 500 person weddings.

Thus in Australia's case, the effective courses of action were,
1. shut the borders
2. quarantine Australians and permanent residents returning home
3. ban large festive gatherings
4. while building up medical capacity just in case.

Because we did #1 early, all the other stuff we did like close restaurants and gyms, playgrounds, and ban gatherings of more than 2 people, these are actually causing more harm than good. We didn't know this when we started, but we do now.

Again, it's different in a country where it's already out there and killed tens of thousands of people. But this situation does not obtain in Australia, and the Premiers need to stop pretending that it does. If there are bushfires in Sale there's no need for people in Broadmeadows to pack their bags.


Nonetheless, he is going to keep us locked down for a long time. I think our leaders are like Johnson with Brexit and Trump on election day - they weren't expecting to succeed, so now they don't know what to do. This is particularly so when they'd felt so much danger. One of the reactions people have in a high-adrenaline situation is to keep mindlessly repeating their last action.


MudPuppy

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Re: How long can we wait while flattening the curve?
« Reply #1173 on: April 26, 2020, 08:44:27 AM »
@Kyle Schuant what’s the testing situation like in australia? Are they testing all symptomatic or only those with symptoms and known exposure?

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #1174 on: April 26, 2020, 09:04:13 AM »
@Kyle Schuant what’s the testing situation like in australia? Are they testing all symptomatic or only those with symptoms and known exposure?

Anyone who wants to be tested can now be tested.

somebody8198

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Re: How long can we wait while flattening the curve?
« Reply #1175 on: April 26, 2020, 09:28:09 AM »
It has been quite obvious from the beginning that the actual rate of infection is likely an order of magnitude (or more) higher than the reported numbers. That's actually good and bad news, if it's true – it would mean that the fatality rate is more in line with 1.5-2x the standard flu, but it also means it will continue to spread even since everybody (or a large %, something like 40-50% of the population, in certain areas) already has it asymptomatically.

For one thing, the CDC numbers show reported cases in hospitals and doctors offices. NOT just positive test results (because we don't have tests in many places), but diagnoses – essentially, a guess that we think this person has it  based on symptoms.

But with something as infectious as SARS-Cov-2, it's difficult to imagine that ONLY the reported numbers are infected. CDC knows this – it's the rationale behind face mask covering in public, and they said it during every press briefing – "we're worried about asymptomatic spread." I might have it right now and I would never know. My parents came back from a cruise in January and had a horrible case of the flu that they recovered from in a few days. They might have had it, too. Who knows? Nobody.  We know the disease can cause  serious problems but we don't know if it causes  serious  problems in 4% of the infected population, or 0.4%, or 0.04%.

The phenomenon of the disease is as much a product of the mainstream media in 2020 as it is a biological contagion. The only cases you hear about in the mainstream press are severe cases requiring hospitalization or leading to death. These stories are presented in a way to maximize the drama and emphasize Covid-19.

For example, there was this recent case of a 5 year old  girl in Michigan who "DIED OF CORONAVIRUS" according to the headline. I Googled and read into the details of this because it was so shocking, and I felt like the story must be missing some crucial detail. I was right. This girl had meningitis. A rare disease with a 25-30% fatality rate. A tragedy in any case, but the way the story was presented in the media made it appear as though a perfectly healthy little girl had suddenly fallen ill with coronavirus and died. This was not the case. She was, in fact, a very ill little girl who was already in a lot of trouble.

Likewise other cases of people who "died of coronavirus." The singer John Prine died recently "of coronavirus." I thought that one seemed odd too, so I read up on his health history. As it turns out, the guy had multiple bouts of cancer and was considered such a high risk  of  stroke that he  was unable to as recently as last summer. He  was a 80 year old man with numerous serious health problems who was deemed too unhealthy to stand on a stage for an hour.

Cases like this beg the question – are the numbers in the death toll people who died FROM coronavirus, or are they people who died WITH coronavirus? In other words, if you're already at high risk of death from a serious illness, and then your get this new Covid-19 thing, is it like a breeze that knocks over a house of cards?

If someone comes into the ER with a comorbidity like meningitis or recurring cancer or heart disease, and the doctors determine during the course of treatment that they *also*  have signs of Covid-19, are we just submitting that as a Covid-19 death? Dare I ask, are many of these fatalities not people who would have died anyway?

If so, that would also seriously change the realistic outlook on the disease. It then makes much, much more sense to completely isolate anyone with a serious comorbidity – and it makes much less sense to lock away the rest of us who are healthy and able to work and live our lives like usual. If you ride a crowded train car, wear a mask, wash your hands, etc.

It strikes me that the lock-downs must come to an end very soon, in the US at least. There are already small protests, and the media can continue to spin those as "radical right wingers" or whatever. But give it another few weeks and I'll be out there too. In another few months, so will everyone.

The point of the "lock down" was to slow the growth rate of cases to a point where the hospital system can handle them. That is done. We did it. Anyone with a 5th grade knowledge of math can look at the data at this point and verify it isn't in exponential growth mode.

If you are going to now go and say, "that's not good enough, stay home through the end of the summer" people will begin to riot and cities will burn.

I don't think that will happen, but if it does, I will put the blame squarely on our highly polemicized media who profit off public fear over whatever the next / current crisis is. There is a lot to be gained politically from exploiting this situation. I went into this fairly neutral and mostly avoiding 24 hour news networks, but after watching this unfold, I will never watch CNN or MSNBC again even for a minute lest my brain rot through.

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #1176 on: April 26, 2020, 10:00:48 AM »
People won't necessarily riot, but they'll just stop listening. I've been breaching lockdown rules for days now in order to see my family and go on dates. There are enough ways for a smart and resourceful person to get around any police enforcement. I just don't care. If Victorian cases spike again (i.e., if we go from 3 cases a day to 4 cases a day, gasp, horror) you can put the blame all on me.

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #1177 on: April 26, 2020, 10:05:11 AM »
They'll riot if the government pushes them.  No jobs, no school, no healthcare.  At this point what do people have to lose?

The experiment of quarantining healthy people has never been done before, and it has likely changed the path of the virus little -- at the same time the dysfunctional policy of governments and the healthcare industry has destroyed the economic and mental health of citizens.  Time for its advocates to declare victory while that’s at least still arguable and retreat.

The politicians need to back down or else there could be large scale civil disobedience and/or a riot. 

One thing is for sure, this type of experiment will not be repeated again.




Jon Bon

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Re: How long can we wait while flattening the curve?
« Reply #1178 on: April 26, 2020, 10:17:59 AM »
People won't necessarily riot, but they'll just stop listening. I've been breaching lockdown rules for days now in order to see my family and go on dates. There are enough ways for a smart and resourceful person to get around any police enforcement. I just don't care. If Victorian cases spike again (i.e., if we go from 3 cases a day to 4 cases a day, gasp, horror) you can put the blame all on me.

This has been my experience as well. The worst has not come to pass, weather is getting nicer, and people are social animals. Folks are going to start to loosen up all on their own. There are limits to lock-downs.

OtherJen

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Re: How long can we wait while flattening the curve?
« Reply #1179 on: April 26, 2020, 10:19:26 AM »
For example, there was this recent case of a 5 year old  girl in Michigan who "DIED OF CORONAVIRUS" according to the headline. I Googled and read into the details of this because it was so shocking, and I felt like the story must be missing some crucial detail. I was right. This girl had meningitis. A rare disease with a 25-30% fatality rate. A tragedy in any case, but the way the story was presented in the media made it appear as though a perfectly healthy little girl had suddenly fallen ill with coronavirus and died. This was not the case. She was, in fact, a very ill little girl who was already in a lot of trouble.

Actually, you have misinterpreted the news. Meningoencephalitis was a complication of COVID-19 in this otherwise healthy little girl. Meningitis isn't always a primary condition, and it isn't always bacterial.

https://www.detroitnews.com/story/news/local/detroit-city/2020/04/19/5-year-old-first-michigan-child-dies-coronavirus/5163094002/

Quote
On Sunday, after spending two weeks on a ventilator, the Detroit girl died. Skylar had tested positive for COVID-19 in March and later developed a rare form of meningitis and brain swelling.
---
After Skylar was admitted to the hospital on March 29, she developed meningoencephalitis, a rare complication of the coronavirus, which caused swelling of brain tissue and a lesion on her frontal lobe, her parents said.[/quote/

MudPuppy

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Re: How long can we wait while flattening the curve?
« Reply #1180 on: April 26, 2020, 10:23:39 AM »
@Bloop Bloop that’s good that testing is readily available. Does it seem that many are taking advantage of the opportunity?


My state (I’m in the US) has had essentially come one come all testing for just over a week now thanks to the deployment of our state’s national guard. A fair % are taking advantage of it. My neighbor is in another county, more rural than ours, with her unit and said they tested 500 at her station just yesterday, which is heartening to me.

MudPuppy

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Re: How long can we wait while flattening the curve?
« Reply #1181 on: April 26, 2020, 10:27:24 AM »
Quote
Cases like this beg the question – are the numbers in the death toll people who died FROM coronavirus, or are they people who died WITH coronavirus? In other words, if you're already at high risk of death from a serious illness, and then your get this new Covid-19 thing, is it like a breeze that knocks over a house of cards?

If someone comes into the ER with a comorbidity like meningitis or recurring cancer or heart disease, and the doctors determine during the course of treatment that they *also*  have signs of Covid-19, are we just submitting that as a Covid-19 death? Dare I ask, are many of these fatalities not people who would have died anyway?


Speaking as a frontline healthcare worker, they’re dying of the virus, not of their underlying conditions. Of course they would have died anyway, since man is mortal.

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #1182 on: April 26, 2020, 10:31:25 AM »
@Bloop Bloop that’s good that testing is readily available. Does it seem that many are taking advantage of the opportunity?


My state (I’m in the US) has had essentially come one come all testing for just over a week now thanks to the deployment of our state’s national guard. A fair % are taking advantage of it. My neighbor is in another county, more rural than ours, with her unit and said they tested 500 at her station just yesterday, which is heartening to me.

Not sure how many people are being tested. This article suggests that as of a week ago, it was about 3,500 per day. There have been over 100,000 tests conducted overall in my state (which is about 2% of the population).

https://www.thecourier.com.au/story/6727922/victoria-records-just-one-more-covid-19-case-in-slowest-day-of-growth-yet/

Abe

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Re: How long can we wait while flattening the curve?
« Reply #1183 on: April 26, 2020, 10:59:55 AM »
Quote
Cases like this beg the question – are the numbers in the death toll people who died FROM coronavirus, or are they people who died WITH coronavirus? In other words, if you're already at high risk of death from a serious illness, and then your get this new Covid-19 thing, is it like a breeze that knocks over a house of cards?

If someone comes into the ER with a comorbidity like meningitis or recurring cancer or heart disease, and the doctors determine during the course of treatment that they *also*  have signs of Covid-19, are we just submitting that as a Covid-19 death? Dare I ask, are many of these fatalities not people who would have died anyway?


Speaking as a frontline healthcare worker, they’re dying of the virus, not of their underlying conditions. Of course they would have died anyway, since man is mortal.

Data from China and NYC indicate that most patients, and most patients who died, did not have significant pre-existing illnesses. I provided those data above somewhere in this thread.

Has Anyone wanting to open your state back up sent a letter to their state representative? Also, if you riot or participate in civil disobedience, wear a mask please.
« Last Edit: April 26, 2020, 11:01:42 AM by Abe »

Jon Bon

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Re: How long can we wait while flattening the curve?
« Reply #1184 on: April 26, 2020, 11:07:29 AM »
Quote
Cases like this beg the question – are the numbers in the death toll people who died FROM coronavirus, or are they people who died WITH coronavirus? In other words, if you're already at high risk of death from a serious illness, and then your get this new Covid-19 thing, is it like a breeze that knocks over a house of cards?

If someone comes into the ER with a comorbidity like meningitis or recurring cancer or heart disease, and the doctors determine during the course of treatment that they *also*  have signs of Covid-19, are we just submitting that as a Covid-19 death? Dare I ask, are many of these fatalities not people who would have died anyway?


Speaking as a frontline healthcare worker, they’re dying of the virus, not of their underlying conditions. Of course they would have died anyway, since man is mortal.

Data from China and NYC indicate that most patients, and most patients who died, did not have significant pre-existing illnesses. I provided those data above somewhere in this thread.

Has Anyone wanting to open your state back up sent a letter to their state representative? Also, if you riot or participate in civil disobedience, wear a mask please.

Like this kind?


(sorry could not resist)

Abe

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Re: How long can we wait while flattening the curve?
« Reply #1185 on: April 26, 2020, 11:30:30 AM »
Haha, as long as it keeps the coughing on the inside!

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #1186 on: April 26, 2020, 11:35:18 AM »
Quote
Cases like this beg the question – are the numbers in the death toll people who died FROM coronavirus, or are they people who died WITH coronavirus? In other words, if you're already at high risk of death from a serious illness, and then your get this new Covid-19 thing, is it like a breeze that knocks over a house of cards?

If someone comes into the ER with a comorbidity like meningitis or recurring cancer or heart disease, and the doctors determine during the course of treatment that they *also*  have signs of Covid-19, are we just submitting that as a Covid-19 death? Dare I ask, are many of these fatalities not people who would have died anyway?


Speaking as a frontline healthcare worker, they’re dying of the virus, not of their underlying conditions. Of course they would have died anyway, since man is mortal.

Data from China and NYC indicate that most patients, and most patients who died, did not have significant pre-existing illnesses. I provided those data above somewhere in this thread.

Has Anyone wanting to open your state back up sent a letter to their state representative? Also, if you riot or participate in civil disobedience, wear a mask please.

Can you provide a reference?

https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths-04252020-1.pdf

The data I see from the NYC Department of Health shows that 99.43% of COVID-19 fatalities had pre-existing conditions.  Once the correlation was established weeks ago that showed obesity being the most significant risk factor, it became apparent COVID is a disease of those already unhealthy.

I will be rioting without a mask as I am not in a COVID risk group and mask efficacy has not been established.   It’s important to riot in the spirit of scientific evidence.

https://www.cebm.net/covid-19/covid-19-masks-on-or-off/
« Last Edit: April 26, 2020, 11:39:41 AM by egillespie »

Abe

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Re: How long can we wait while flattening the curve?
« Reply #1187 on: April 26, 2020, 12:34:31 PM »
They're somewhere above in my posts. Just search. Also, people don't die acutely of obesity or hypertension, which are the most common co-morbidities in these patients. They don't help for sure, but people who show in the ER with either of those conditions aren't expected to die acutely. Keep in mind that both are also very common in US adults, so if you consider those comorbidites that are worth throwing the towel in for, that will go against the "few people are at risk" argument: https://www.cdc.gov/nchs/products/databriefs/db360.htm and https://www.cdc.gov/bloodpressure/statistics_maps.htm
« Last Edit: April 26, 2020, 12:38:16 PM by Abe »

bacchi

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Re: How long can we wait while flattening the curve?
« Reply #1188 on: April 26, 2020, 12:48:14 PM »
Data from China and NYC indicate that most patients, and most patients who died, did not have significant pre-existing illnesses. I provided those data above somewhere in this thread.

Has Anyone wanting to open your state back up sent a letter to their state representative? Also, if you riot or participate in civil disobedience, wear a mask please.

Can you provide a reference?

https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths-04252020-1.pdf

The data I see from the NYC Department of Health shows that 99.43% of COVID-19 fatalities had pre-existing conditions.  Once the correlation was established weeks ago that showed obesity being the most significant risk factor, it became apparent COVID is a disease of those already unhealthy.

Eh? 2842 of the 5313 10961 deaths are in the "Underlying Conditions Unknown" column.

You can't just assign an underlying condition to someone when it's unknown whether they have one (even if being old is counted as an underlying condition, it's not 99.43%).
« Last Edit: April 26, 2020, 01:01:04 PM by bacchi »

Abe

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Re: How long can we wait while flattening the curve?
« Reply #1189 on: April 26, 2020, 12:58:56 PM »
Oh and that too. Good call @bacchi

obstinate

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Re: How long can we wait while flattening the curve?
« Reply #1190 on: April 26, 2020, 01:02:43 PM »
People won't necessarily riot, but they'll just stop listening. I've been breaching lockdown rules for days now in order to see my family and go on dates. There are enough ways for a smart and resourceful person to get around any police enforcement. I just don't care. If Victorian cases spike again (i.e., if we go from 3 cases a day to 4 cases a day, gasp, horror) you can put the blame all on me.

This has been my experience as well. The worst has not come to pass, weather is getting nicer, and people are social animals. Folks are going to start to loosen up all on their own. There are limits to lock-downs.
IMO, this just indicates that the government isn't providing the right incentives. It isn't a surprise that westerners are horrifically short sighted and selfish. This is well known. If the government doesn't provide a self-interest-based reason to stay home, a fraction of the population will of course violate quarantine. Something like, "We'll fine you the greater of $5k or 5% of your net worth" would probably do it.

Since governments aren't taking those steps, I expect the crisis to be prolonged. Human society is half-broken machine. This is probably not the worst example of it, but it is a little sad since it's so immediate.
« Last Edit: April 26, 2020, 01:05:50 PM by obstinate »

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #1191 on: April 26, 2020, 01:26:30 PM »
Data from China and NYC indicate that most patients, and most patients who died, did not have significant pre-existing illnesses. I provided those data above somewhere in this thread.

Has Anyone wanting to open your state back up sent a letter to their state representative? Also, if you riot or participate in civil disobedience, wear a mask please.

Can you provide a reference?

https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths-04252020-1.pdf

The data I see from the NYC Department of Health shows that 99.43% of COVID-19 fatalities had pre-existing conditions.  Once the correlation was established weeks ago that showed obesity being the most significant risk factor, it became apparent COVID is a disease of those already unhealthy.

Eh? 2842 of the 5313 10961 deaths are in the "Underlying Conditions Unknown" column.

You can't just assign an underlying condition to someone when it's unknown whether they have one (even if being old is counted as an underlying condition, it's not 99.43%).

Almost all of the “unknown” column have eventually been put into the “known” column since the pandemic began.  How that is done I don’t know (but I’m interested to find out), so therefore I included them as known since it seems that’s how things have gone in the past.

Regarding the pre-conditions, obesity is obviously preventable, type 2 diabetes is about 90% preventable and essential hypertension about 85% preventable.  Those are huge numbers of risk factors that could be avoided. 

As for the government policies and their unlikelihood to be followed in the future, increasingly people do not have an incentive to follow them.   Without a job or healthcare, what’s the point to do anything the government advocates?   The elderly and ill demand society destroy itself so they can reduce their risk, yet the ability of society to take care of those economically and mentally effected isn’t even discussed.  Not once have I heard what the government is going to do for those that have lost their jobs and healthcare. 

For most people the consequences of the reaction are much worse than the risks from the virus — which is exactly why the stay-at-homes are ending.  There is no longer an incentive to follow them.

Also, without opening up things like parks and schools and moderating policy at least a bit, having objective standards about when to allow businesses to open — policy is less likely to be followed.   It’s through the governments own hysteria, irrationality and short-sightedness that these policies will fail. 

Society can only do so much to reduce the risks of preventable illness and pre-conditions, and locking up the healthy and children seems immoral and inhumane.  At some point there needs to be an acceptance that the way we choose to live has a significant outcome on our overall health.  I think there is a more appropriate middle ground the government could take at reducing the risks, yet also maintaining the economy and rights for those that are healthy.  The government hasn’t done that, so it’s time to end the “plan”.
« Last Edit: April 26, 2020, 01:32:47 PM by egillespie »

waltworks

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Re: How long can we wait while flattening the curve?
« Reply #1192 on: April 26, 2020, 01:47:34 PM »
Data from China and NYC indicate that most patients, and most patients who died, did not have significant pre-existing illnesses. I provided those data above somewhere in this thread.

Has Anyone wanting to open your state back up sent a letter to their state representative? Also, if you riot or participate in civil disobedience, wear a mask please.

Can you provide a reference?

https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths-04252020-1.pdf

The data I see from the NYC Department of Health shows that 99.43% of COVID-19 fatalities had pre-existing conditions.  Once the correlation was established weeks ago that showed obesity being the most significant risk factor, it became apparent COVID is a disease of those already unhealthy.

Eh? 2842 of the 5313 10961 deaths are in the "Underlying Conditions Unknown" column.

You can't just assign an underlying condition to someone when it's unknown whether they have one (even if being old is counted as an underlying condition, it's not 99.43%).

I would side with egillespie on this. The "underlying conditions unknown" doesn't count in either column until a category can be determined.

We can certainly say that of the cases where we know anything about underlying conditions, virtually every death features them.

Obviously it is true that hypertension and obesity are widespread in the United States, so that is simultaneously a rejection of "only old people are at risk" and a confirmation that people's own choices have led to their being at risk in many cases.

-W

Abe

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Re: How long can we wait while flattening the curve?
« Reply #1193 on: April 26, 2020, 01:55:36 PM »
UW’s group has updated their models to suggest when quarantined can start being lifted:

https://covid19.healthdata.org/united-states-of-america

New York/New Jersey: late May
California, Washington, Oregon: Mid May

Full list here: https://www.npr.org/sections/health-shots/2020/04/25/844088634/when-is-it-safe-to-ease-social-distancing-heres-what-one-model-says-for-each-sta

We’re planning on resuming non-urgent operations around mid May here in SoCal.

bacchi

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Re: How long can we wait while flattening the curve?
« Reply #1194 on: April 26, 2020, 02:29:24 PM »
Data from China and NYC indicate that most patients, and most patients who died, did not have significant pre-existing illnesses. I provided those data above somewhere in this thread.

Has Anyone wanting to open your state back up sent a letter to their state representative? Also, if you riot or participate in civil disobedience, wear a mask please.

Can you provide a reference?

https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths-04252020-1.pdf

The data I see from the NYC Department of Health shows that 99.43% of COVID-19 fatalities had pre-existing conditions.  Once the correlation was established weeks ago that showed obesity being the most significant risk factor, it became apparent COVID is a disease of those already unhealthy.

Eh? 2842 of the 5313 10961 deaths are in the "Underlying Conditions Unknown" column.

You can't just assign an underlying condition to someone when it's unknown whether they have one (even if being old is counted as an underlying condition, it's not 99.43%).

Almost all of the “unknown” column have eventually been put into the “known” column since the pandemic began.  How that is done I don’t know (but I’m interested to find out), so therefore I included them as known since it seems that’s how things have gone in the past.

Is that done in the same report? How long does that usually take?

former player

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Re: How long can we wait while flattening the curve?
« Reply #1195 on: April 26, 2020, 02:31:04 PM »
Data from China and NYC indicate that most patients, and most patients who died, did not have significant pre-existing illnesses. I provided those data above somewhere in this thread.

Has Anyone wanting to open your state back up sent a letter to their state representative? Also, if you riot or participate in civil disobedience, wear a mask please.

Can you provide a reference?

https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths-04252020-1.pdf

The data I see from the NYC Department of Health shows that 99.43% of COVID-19 fatalities had pre-existing conditions.  Once the correlation was established weeks ago that showed obesity being the most significant risk factor, it became apparent COVID is a disease of those already unhealthy.

Eh? 2842 of the 5313 10961 deaths are in the "Underlying Conditions Unknown" column.

You can't just assign an underlying condition to someone when it's unknown whether they have one (even if being old is counted as an underlying condition, it's not 99.43%).

Almost all of the “unknown” column have eventually been put into the “known” column since the pandemic began.  How that is done I don’t know (but I’m interested to find out), so therefore I included them as known since it seems that’s how things have gone in the past.

Regarding the pre-conditions, obesity is obviously preventable, type 2 diabetes is about 90% preventable and essential hypertension about 85% preventable.  Those are huge numbers of risk factors that could be avoided. 

As for the government policies and their unlikelihood to be followed in the future, increasingly people do not have an incentive to follow them.   Without a job or healthcare, what’s the point to do anything the government advocates?   The elderly and ill demand society destroy itself so they can reduce their risk, yet the ability of society to take care of those economically and mentally effected isn’t even discussed.  Not once have I heard what the government is going to do for those that have lost their jobs and healthcare. 

For most people the consequences of the reaction are much worse than the risks from the virus — which is exactly why the stay-at-homes are ending.  There is no longer an incentive to follow them.

Also, without opening up things like parks and schools and moderating policy at least a bit, having objective standards about when to allow businesses to open — policy is less likely to be followed.   It’s through the governments own hysteria, irrationality and short-sightedness that these policies will fail. 

Society can only do so much to reduce the risks of preventable illness and pre-conditions, and locking up the healthy and children seems immoral and inhumane.  At some point there needs to be an acceptance that the way we choose to live has a significant outcome on our overall health.  I think there is a more appropriate middle ground the government could take at reducing the risks, yet also maintaining the economy and rights for those that are healthy.  The government hasn’t done that, so it’s time to end the “plan”.
BiB: I'm not sure what point you are making here: a different lifestyle can avoid most of those issues but not in the timescale of this pandemic.

You seem to suggest that the obese, the type 2 diabetic and the hypertensive are not worthy of having their health protected from a pandemic, and/or that the healthy should not be put to any inconvenience to protect them.
 
That's a pretty jawdropping attitude.

bacchi

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Re: How long can we wait while flattening the curve?
« Reply #1196 on: April 26, 2020, 02:40:25 PM »
Data from China and NYC indicate that most patients, and most patients who died, did not have significant pre-existing illnesses. I provided those data above somewhere in this thread.

Has Anyone wanting to open your state back up sent a letter to their state representative? Also, if you riot or participate in civil disobedience, wear a mask please.

Can you provide a reference?

https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths-04252020-1.pdf

The data I see from the NYC Department of Health shows that 99.43% of COVID-19 fatalities had pre-existing conditions.  Once the correlation was established weeks ago that showed obesity being the most significant risk factor, it became apparent COVID is a disease of those already unhealthy.

Eh? 2842 of the 5313 10961 deaths are in the "Underlying Conditions Unknown" column.

You can't just assign an underlying condition to someone when it's unknown whether they have one (even if being old is counted as an underlying condition, it's not 99.43%).

I would side with egillespie on this. The "underlying conditions unknown" doesn't count in either column until a category can be determined.

Still not 99.43%. :-) But I see your point.


Quote
We can certainly say that of the cases where we know anything about underlying conditions, virtually every death features them.

Obviously it is true that hypertension and obesity are widespread in the United States, so that is simultaneously a rejection of "only old people are at risk" and a confirmation that people's own choices have led to their being at risk in many cases.

-W

Almost 31% of the underlying condition deaths were <65. Agreed, that's pretty damn high for an "old person's" disease.

At least 25% of New Yorkers are obese. Compared to, say, Mississippi's 37%, that's low. Consequently, we should eventually see a higher death rate in Mississippi, all else being equal.

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Re: How long can we wait while flattening the curve?
« Reply #1197 on: April 26, 2020, 03:00:07 PM »

BiB: I'm not sure what point you are making here: a different lifestyle can avoid most of those issues but not in the timescale of this pandemic.

You seem to suggest that the obese, the type 2 diabetic and the hypertensive are not worthy of having their health protected from a pandemic, and/or that the healthy should not be put to any inconvenience to protect them.
 
That's a pretty jawdropping attitude.


Is it a jawdropping atitude?

I don't think so.  Empathy is a two-way street. 

To me it seems very self-absorbed to knowingly live an unhealthy lifestyle and then demand society destroy itself to avoid the consequences of previous decisions.

I think there is a middle way that could be followed, but locking up healthy people and children isn’t part of that.  The government was given several chances to moderate it's policies, it has chosen to move forward with draconian policies that are irrational and destructive.  Oh well, not my pig, not my farm.

I will not destroy my family to reduce the risk of those I don't know.  Not going to happen, not for a million years.  If the government wanted longer compliance then they should have been "empathetic". 

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Re: How long can we wait while flattening the curve?
« Reply #1198 on: April 26, 2020, 03:06:59 PM »
Data from China and NYC indicate that most patients, and most patients who died, did not have significant pre-existing illnesses. I provided those data above somewhere in this thread.

Has Anyone wanting to open your state back up sent a letter to their state representative? Also, if you riot or participate in civil disobedience, wear a mask please.

Can you provide a reference?

https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths-04252020-1.pdf

The data I see from the NYC Department of Health shows that 99.43% of COVID-19 fatalities had pre-existing conditions.  Once the correlation was established weeks ago that showed obesity being the most significant risk factor, it became apparent COVID is a disease of those already unhealthy.

Eh? 2842 of the 5313 10961 deaths are in the "Underlying Conditions Unknown" column.

You can't just assign an underlying condition to someone when it's unknown whether they have one (even if being old is counted as an underlying condition, it's not 99.43%).

I would side with egillespie on this. The "underlying conditions unknown" doesn't count in either column until a category can be determined.

Still not 99.43%. :-) But I see your point.


Quote
We can certainly say that of the cases where we know anything about underlying conditions, virtually every death features them.

Obviously it is true that hypertension and obesity are widespread in the United States, so that is simultaneously a rejection of "only old people are at risk" and a confirmation that people's own choices have led to their being at risk in many cases.

-W

Almost 31% of the underlying condition deaths were <65. Agreed, that's pretty damn high for an "old person's" disease.

At least 25% of New Yorkers are obese. Compared to, say, Mississippi's 37%, that's low. Consequently, we should eventually see a higher death rate in Mississippi, all else being equal.

The NYC data was updated Sunday evening.  Since it is an issue, let's remove the "unknown" column.

https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths-04262020-1.pdf

Without the unknown column, the deaths from those without previous conditions is 0.7%.  *Zero* non pre-condition children 17 and under have died, 10 non pre-condition adults (18-44) have died.  49 non pre-condition adults ages 45-64 have died.  There have been over 11,000 deaths total.

The data *clearly* shows this is not even a disease of the elderly, this is a disease of the sick.  The consequences of preventable illness compound with age.  It is totally unacceptable to destroy the lives of the healthy and children.

If I have done my math correctly, using the iFR of 0.56% from last weeks antibody studies of NYC...the risk of death for those that don't have pre-conditions is (across the entire range of ages) is 0.004368%.  And people want lockdowns for this?  Bull sh*t. 

That's .43 out of every 1,000 people if you are healthy (assuming infection, and this number is being conservative, it's likely less).  I have much greater odds of dying from many other things at my age.    The iFR on the West Coast has been much less.
« Last Edit: April 26, 2020, 03:15:32 PM by egillespie »

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Re: How long can we wait while flattening the curve?
« Reply #1199 on: April 26, 2020, 03:13:53 PM »
Data from China and NYC indicate that most patients, and most patients who died, did not have significant pre-existing illnesses. I provided those data above somewhere in this thread.

Has Anyone wanting to open your state back up sent a letter to their state representative? Also, if you riot or participate in civil disobedience, wear a mask please.

Can you provide a reference?

https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths-04252020-1.pdf

The data I see from the NYC Department of Health shows that 99.43% of COVID-19 fatalities had pre-existing conditions.  Once the correlation was established weeks ago that showed obesity being the most significant risk factor, it became apparent COVID is a disease of those already unhealthy.

Eh? 2842 of the 5313 10961 deaths are in the "Underlying Conditions Unknown" column.

You can't just assign an underlying condition to someone when it's unknown whether they have one (even if being old is counted as an underlying condition, it's not 99.43%).

I would side with egillespie on this. The "underlying conditions unknown" doesn't count in either column until a category can be determined.

Still not 99.43%. :-) But I see your point.


Quote
We can certainly say that of the cases where we know anything about underlying conditions, virtually every death features them.

Obviously it is true that hypertension and obesity are widespread in the United States, so that is simultaneously a rejection of "only old people are at risk" and a confirmation that people's own choices have led to their being at risk in many cases.

-W

Almost 31% of the underlying condition deaths were <65. Agreed, that's pretty damn high for an "old person's" disease.

At least 25% of New Yorkers are obese. Compared to, say, Mississippi's 37%, that's low. Consequently, we should eventually see a higher death rate in Mississippi, all else being equal.

The NYC data was updated Sunday evening.  Since it is an issue, let's remove the "unknown" column.

https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths-04262020-1.pdf

Without the unknown column, the deaths from those without previous conditions is 0.7%.  *Zero* non pre-condition children 17 and under have died, 10 non pre-condition adults (18-44) have died.  49 non pre-condition adults ages 45-64 have died.  There have been over 11,000 deaths total.

The data *clearly* shows this is not even a disease of the elderly, this is a disease of the sick.  The consequences of preventable illness compound with age.  It is totally unacceptable to destroy the lives of the healthy and children.
Are there figures for NYC deaths where there has not been a positive COVID-19 lab test?  Are these holding steady or has there been an increase matching the increase in recorded COVID-19 deaths?  I ask because in a lot of countries which publish overall death rates there has been an increase in non-virus death which tracks the increase in virus deaths, and while there could be indirect causes for this the most obvious direct cause would be that these are unrecorded COVID-19 deaths, either because there were lung infection symptoms but no official test or because the virus is killing people other than through lung infections. 

Without that information your analysis is incomplete.