Author Topic: How long can we wait while flattening the curve?  (Read 248209 times)

LaineyAZ

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Re: How long can we wait while flattening the curve?
« Reply #2250 on: May 27, 2020, 08:51:26 AM »
Just a note to add that, as a layperson/no higher math background, I am glad to read and follow along on this discussion.  It adds a depth to the headlines which only provide a very limited understanding of the big picture.

I'm sure we all get data fatigue but at the same time there are daily decisions being made by my family, friends, and me which can either contribute to this virus spreading or to its mitigation.  I want to make informed decisions and this all helps.

Davnasty

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Re: How long can we wait while flattening the curve?
« Reply #2251 on: May 27, 2020, 08:54:09 AM »
I don't even feel the need to die on the hill of the Imperial study. The conclusions were what they were. Caveats, conditions and all. That was one paper of many. One model of many.

Nor do I (although recent post count may suggest otherwise :). I don't even know enough to say it was good or bad work. My goal has been to point out specific flaws in reasoning and inaccurate claims. Not sure if that accomplishes anything. I don't expect to change the mind of the posters I argue with, but hopefully some of the people reading along will realize just how many of the claims drawn from research are wildly misinterpreted.

Interestingly, before I joined this discussion I might have agreed that Neil Ferguson's research was overly pessimistic but I'm not entirely sure why I would have thought that. Again, I really wasn't that familiar. I guess repeatedly reading headlines and claims really does seep into your brain, even when you know those claims are unverified and could be completely false.

Davnasty

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Re: How long can we wait while flattening the curve?
« Reply #2252 on: May 27, 2020, 09:10:43 AM »
Just a note to add that, as a layperson/no higher math background, I am glad to read and follow along on this discussion.  It adds a depth to the headlines which only provide a very limited understanding of the big picture.

I'm sure we all get data fatigue but at the same time there are daily decisions being made by my family, friends, and me which can either contribute to this virus spreading or to its mitigation.  I want to make informed decisions and this all helps.

This might be helpful

https://projects.fivethirtyeight.com/covid-forecasts/

LaineyAZ

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Re: How long can we wait while flattening the curve?
« Reply #2253 on: May 27, 2020, 09:30:22 AM »
Just a note to add that, as a layperson/no higher math background, I am glad to read and follow along on this discussion.  It adds a depth to the headlines which only provide a very limited understanding of the big picture.

I'm sure we all get data fatigue but at the same time there are daily decisions being made by my family, friends, and me which can either contribute to this virus spreading or to its mitigation.  I want to make informed decisions and this all helps.

This might be helpful

https://projects.fivethirtyeight.com/covid-forecasts/

Very interesting, I've saved that.

And a bit of anecdata:  I overheard a conversation this week about a family from Seattle that is going to travel to Arizona in 2 weeks because Arizona "has less restrictions."  Apparently their teenagers are bored and want to be able to be out and about as they please. 
I was alarmed at that, but it also made me wonder whether the shutdown fatigue coupled with nicer summer weather has been taken into consideration in these models, i.e., is the increased movement of people around the country being considered as a factor for an increase in virus infections?  Because from my untrained brain it sure looks like it's  like people equate "your state is opening up" with "pandemic is over."  And all of that equates to a jump in numbers in mid-June.

afox

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Re: How long can we wait while flattening the curve?
« Reply #2254 on: May 27, 2020, 09:39:51 AM »
Forgive me if this is a naive question but aren't those relatively low infection rates a bit misleading since for the most part they are infection rates during a shutdown and with maximum social distancing? Wouldn't infection rates for every communicable disease go way down if we had forced shutdowns? ie. if we want to compare covid to flu/etc should'nt the apples to apples comparison be covid IFR/mortality rates assuming normal life to normal life chances of dying from other causes?

beltim

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Re: How long can we wait while flattening the curve?
« Reply #2255 on: May 27, 2020, 09:49:57 AM »
Forgive me if this is a naive question but aren't those relatively low infection rates a bit misleading since for the most part they are infection rates during a shutdown and with maximum social distancing? Wouldn't infection rates for every communicable disease go way down if we had forced shutdowns? ie. if we want to compare covid to flu/etc should'nt the apples to apples comparison be covid IFR/mortality rates assuming normal life to normal life chances of dying from other causes?

This is an important fundamental question essential to the discussion.  Most of what we've been discussing recently have been case fatality rates (CFR), which are the percentage of people confirmed to have COVID-19 who then die because of COVID-19.  Because not everyone who has been infected has been tested, there has also been some discussion of infection/incidence fatality rates (IFR), which is an estimate of the number of people who are infected who go on to die because of the virus.  Neither of these should be affected by social distancing, although part of the purpose of social distancing was to prevent hospitals from being overwhelmed and allowed for better quality of care.

Other part of the discussion have talked about the growth of infections, which are strongly affected by the shutdown and social distancing.

Jon Bon

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Re: How long can we wait while flattening the curve?
« Reply #2256 on: May 27, 2020, 09:54:57 AM »
Just a note to add that, as a layperson/no higher math background, I am glad to read and follow along on this discussion.  It adds a depth to the headlines which only provide a very limited understanding of the big picture.

I'm sure we all get data fatigue but at the same time there are daily decisions being made by my family, friends, and me which can either contribute to this virus spreading or to its mitigation.  I want to make informed decisions and this all helps.

This might be helpful

https://projects.fivethirtyeight.com/covid-forecasts/

Very interesting, I've saved that.

And a bit of anecdata:  I overheard a conversation this week about a family from Seattle that is going to travel to Arizona in 2 weeks because Arizona "has less restrictions."  Apparently their teenagers are bored and want to be able to be out and about as they please. 
I was alarmed at that, but it also made me wonder whether the shutdown fatigue coupled with nicer summer weather has been taken into consideration in these models, i.e., is the increased movement of people around the country being considered as a factor for an increase in virus infections?  Because from my untrained brain it sure looks like it's  like people equate "your state is opening up" with "pandemic is over."  And all of that equates to a jump in numbers in mid-June.

Phase one of the pandemic is over.

1. The curve was flattened - hospitals were not overwhelmed (maybe a few?) enough time was bought to further increase capacity (field hospitals, USS comfort, etc) ppe seams to be making a comeback.
2. The virus was not nearly as bad as we feared
3. The pandemic is over, simply because we are over it. Pandemics end medically or socially, sounds like we are ending this socially by living with it and getting on with our slightly different lives.

"In other words, an end can occur not because a disease has been vanquished but because people grow tired of panic mode and learn to live with a disease. "

https://www.nytimes.com/2020/05/10/health/coronavirus-plague-pandemic-history.html

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #2257 on: May 27, 2020, 10:46:49 AM »
https://www.theguardian.com/us-news/2020/may/26/andrew-cuomo-nursing-home-execs-immunity

"People are 7.5 times more likely to die from Covid-19 in states with corporate legal immunity"

Michael in ABQ

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Re: How long can we wait while flattening the curve?
« Reply #2258 on: May 27, 2020, 10:49:06 AM »
Forgive me if this is a naive question but aren't those relatively low infection rates a bit misleading since for the most part they are infection rates during a shutdown and with maximum social distancing? Wouldn't infection rates for every communicable disease go way down if we had forced shutdowns? ie. if we want to compare covid to flu/etc should'nt the apples to apples comparison be covid IFR/mortality rates assuming normal life to normal life chances of dying from other causes?

The CDCs best estimate is that ~0.3% of people who are infected with COVID-19 will die, concentrated mainly in those over 65. https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html#box This is based on their best estimate of 35% of cases being asymptomatic, and 0.4% of symptomatic cases being fatal, so about 0.3% of total cases are fatal. We have had approximately 100,000 deaths in the US attributed to COVID-19 and about 1.7 million confirmed cases. That means the case fatality ratio is about 5.8%, but we know that far more than 1.7 million people have been infected, that's just the number of positive tests.

How many more have been infected is unknown, but Indiana University conducted a randomized study of over 4,000 people that showed 11x higher infections than confirmed cases. https://news.iu.edu/stories/2020/05/iupui/releases/13-preliminary-findings-impact-covid-19-indiana-coronavirus.html So 1.7 million confirmed cases could mean 18.7 million actual infections, or about 5% of the US population. That would mean the infection fatality rate is about 0.53%, which is still within the CDCs range of IFR from 0.2% to 1.0%.

COVID-19 is definitely several times deadlier than seasonal flu. Cases of all communicable diseases have fallen with the measures we've taken the last few months, but it hasn't changed their underlying deadliness. Seasonal flu still has an IFR of about 0.1%, but cases of the flu have dropped this year as well.

HBFIRE

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Re: How long can we wait while flattening the curve?
« Reply #2259 on: May 27, 2020, 10:55:04 AM »
Seasonal flu still has an IFR of about 0.1%, but cases of the flu have dropped this year as well.

Has anyone been able to verify this?  It is often stated, but when I look at the CDC data this figure is calculated using case fatality rate of symptomatic cases (flu also has a high percentage of asymptomatic cases).  I haven’t been able to dig up the actual IFR for what we refer to as the common flu like illness.  It seems many publications get sloppy with CFR vs IFR.  I’m guessing the actual IFR of flu is well below 0.1%.  Even epidemiologists are referring to this figure as the IFR bit again as far as I can tell it is based on case data or known symptomatic infections.
« Last Edit: May 27, 2020, 10:57:58 AM by HBFIRE »

Michael in ABQ

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Re: How long can we wait while flattening the curve?
« Reply #2260 on: May 27, 2020, 11:07:18 AM »
Seasonal flu still has an IFR of about 0.1%, but cases of the flu have dropped this year as well.

Has anyone been able to verify this?  It is often stated, but when I look at the CDC data this figure is calculated using case fatality rate of symptomatic cases (flu also has a high percentage of asymptomatic cases).  I haven’t been able to dig up the actual IFR for what we refer to as the common flu like illness.  It seems many publications get sloppy with CFR vs IFR.  I’m guessing the actual IFR of flu is well below 0.1%.  Even epidemiologists are referring to this figure as the IFR bit again as far as I can tell it is based on case data or known symptomatic infections.

I'm just repeating what I've heard as well.

GuitarStv

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Re: How long can we wait while flattening the curve?
« Reply #2261 on: May 27, 2020, 12:01:01 PM »
I wish people would stop citing death rate as though it was the only problem associated with this disease.  It's not fair to ignore the percentage of people who survive but are saddled with other health problems, and gives a less correct idea of how concerned we should be.

waltworks

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Re: How long can we wait while flattening the curve?
« Reply #2262 on: May 27, 2020, 12:03:35 PM »
I wish people would stop citing death rate as though it was the only problem associated with this disease.  It's not fair to ignore the percentage of people who survive but are saddled with other health problems, and gives a less correct idea of how concerned we should be.

I'd like to hear more about this too. I have heard anecdotal stuff about lung damage, but I haven't seen any statistics or hard numbers. Are lots and lots of people surviving with life-altering problems, or is it pretty rare?

-W

MudPuppy

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Re: How long can we wait while flattening the curve?
« Reply #2263 on: May 27, 2020, 12:16:53 PM »
There’s not reliable hard data yet that I’m aware of (this is still happening in real time), but yes, a lot of the ones that were sick enough for hospitalization have had complications that require dialysis, amputations, sent home with oxygen or inhalers they didn’t need before.


habanero

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Re: How long can we wait while flattening the curve?
« Reply #2265 on: May 27, 2020, 01:17:06 PM »

Has anyone been able to verify this?  It is often stated, but when I look at the CDC data this figure is calculated using case fatality rate of symptomatic cases (flu also has a high percentage of asymptomatic cases).  I haven’t been able to dig up the actual IFR for what we refer to as the common flu like illness.  It seems many publications get sloppy with CFR vs IFR.  I’m guessing the actual IFR of flu is well below 0.1%.  Even epidemiologists are referring to this figure as the IFR bit again as far as I can tell it is based on case data or known symptomatic infections.

The seasonal flu varies a lot from year to year. Some years its pretty bad, others quite mild (over here this year's version was of a mild variety). It's generally assumed to be in the area of 0.1-0.2% but it's hard to measure as its hardly ever diagnosed with lab-tests as is Covid-19. It's generally estimated by looking at how much the death rate during the season deviates from the mean. But as an example, if we take Sweden, now famous for its Covid-19-handling, even now the weekly deaths are not the highest on record. During two particularily harsh flu seasons (think 1993 and 2000-something) the number of deaths from the flu was estimated to be higher than the current Covid-19-rate so far.

Also, a lot of people never get the flu in the first place, either because they have developed decent immunity or have taken vaccination. While the flu vaccine is not a sure thing, it generally leads to a milder illness if one is infected despite having taken the vaccine.

For Norway, with a population of 5.4 million, the seasonal flu in a normal year is estimated to lead to around 1000 deaths. It is generally the very old and partly the very young with the former by far being the biggest group.

So one thing is the higher death rate from Covid-19, but with zero immunity in the population the number of infeced can get very high. For the seasonal flu, between 5 and 10% of the population get it every year over here according to the estimates. If we use the higher number and run the math we get 540.000 infected / season. And 0.1% death rate gives 540 deaths so a figure of 0.1% to 0.2% resonates reasonably well with an estimated 1000 deaths / year on average. The vaccination rate for the flu is quite high in Norway, its common to get it for free through work and its pretty cheap even if you have t pay for it (think 30-40 bucks, I get it for free at work). The overal vaccination rate is around 20% and close to 40% in the groups at risk for severe illness.

Europe has a reporting system for deaths which purpose is to track the flu season. They then look at how it deviates from the mean and estimate based on that. Guess the US has something similar in place.
« Last Edit: May 27, 2020, 01:23:11 PM by habaneroNorway »

HBFIRE

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Re: How long can we wait while flattening the curve?
« Reply #2266 on: May 27, 2020, 01:22:01 PM »
COVID-19 and...

Stroke: https://www.healthline.com/health-news/what-to-know-about-covid-19-and-strokes

Kidney disease: https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-kidney-damage-caused-by-covid19
https://www.sciencedirect.com/science/article/pii/S0085253820303690

Cardiac complications: https://news.harvard.edu/gazette/story/2020/04/covid-19s-consequences-for-the-heart/

Lung/vascular complications: https://onlinelibrary.wiley.com/doi/full/10.1111/jth.14830

Pediatric multi-system inflammatory syndrome: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/children/mis-c.html

Other reading:
https://www.advisory.com/daily-briefing/2020/04/17/organ-damage
https://jamanetwork.com/journals/jamaneurology/article-abstract/2764549

These are just the early data (since the virus was only discovered 5 months ago). But sure, it's just the flu. No big deal.

As far as I understand, many of these risks can also be triggered by the flu.  This is from your Harvard link:

First, people with preexisting heart disease are at a greater risk for severe cardiovascular and respiratory complications from COVID-19. Similarly, research has shown that infection with the influenza virus poses a more severe threat for people with heart disease than those without cardiac problems. Research also shows that heart attacks can actually be brought on by respiratory infections such as the flu.

https://jamanetwork.com/journals/jamacardiology/fullarticle/2518762#nav


Also,

researchers found that having a flu-like illness increased the odds of having a stroke by nearly 40 percent over the next 15 days. This increased risk remained up to one year. Researchers estimated the odds of hospitalization for ischemic stroke after hospitalization for a flu-like illness.

and

Influenza can cause kidney injury, Sood said, who added that viral infections like influenza also caused muscle breakdown. Kidneys are damaged as they filter out the broken-down muscle cells


I would be curious to know after we have more robust research how much of this is truly unique to CV19.

These early studies are medically interesting as they are reporting what's being observed in a small number of patients. However, at this point, these studies usually don't provide any data about whether such observations are at all unique to CV19. For example, the same things may be found with similar frequency in flu, rhinovirus, adenovirus or seasonal coronavirus patients of the same age and same comorbidities who develop pneumonia to the same degree+duration and undergo similarly invasive life-saving treatment in an ICU (which is tens of thousands of people every year).

Remember that most severe CV19 cases are very elderly and the vast majority have serious pre-existing comorbidities. Patients who are that weak who require intubation often develop all kinds of complications. Being intubated is serious. Something like 80% of all patients last year who required emergency intubation in an ICU died. Intubation usually involves being put into a medically induced coma which has it's own negative effects and that's before considering the impact of the various drugs and treatments doctors may try as a patient's condition becomes increasingly severe from any respiratory virus. So, always look to see if the study discusses whether the findings are likely to be unique to CV19.
« Last Edit: May 27, 2020, 01:34:17 PM by HBFIRE »

frugalnacho

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Re: How long can we wait while flattening the curve?
« Reply #2267 on: May 27, 2020, 01:29:08 PM »
Why does it matter if it's unique to coronavirus or not?

HBFIRE

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Re: How long can we wait while flattening the curve?
« Reply #2268 on: May 27, 2020, 01:33:08 PM »
Why does it matter if it's unique to coronavirus or not?

I think it gives perspective, if the risks are comparable to other illnesses. 

Despite all the scary-sounding headlines vaguely implying CV19 is an alien super-disease that can get into your brain, heart, lungs or your BALLS... there's still no good evidence that CV19 has any magically evil traits that don't also sometimes occur (just as rarely) in other common respiratory viruses that millions of people get every year. The only difference is that anything related to CV19 that is remotely bad or scary-sounding is sought out and amplified by the media with little context on how rare it is or how other common respiratory viruses have been doing the same for years.
« Last Edit: May 27, 2020, 01:39:02 PM by HBFIRE »

frugalnacho

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Re: How long can we wait while flattening the curve?
« Reply #2269 on: May 27, 2020, 01:39:36 PM »
Two things can be bad at the same time.  You sound like you're being contrarian just for contrarian's sake. Like you've been assigned to defend the coronavirus, or are on the pro-coronavirus debate team. 

Coronavirus can lead to death...but so do gunshot wounds.  Fatal gunshot wounds have fuck all to do with coronavirus though.

waltworks

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Re: How long can we wait while flattening the curve?
« Reply #2270 on: May 27, 2020, 01:43:36 PM »
I think it matters a lot. If I get a mild case of C19 and recover, have I suffered lung/kidney/etc damage that will cause me future problems? Or, alternately, if I get *any* respiratory illness (including C19) and end up in the ICU/ventilated, is it about the same risk of long term complications?

In other words, if there's a risk after recovery from C19 that is unique and not just the risks that come with almost dying of a respiratory illness, we should be much more worried about it. If it's just basically the same as getting a severe case of the flu and barely surviving, then not as much.

I see lots of evidence that it's bad for you long term if you get very sick and are in the ICU. I'm not sure there's evidence that less severe cases cause permanent damage but we probably won't know for years for sure.

-W

frugalnacho

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Re: How long can we wait while flattening the curve?
« Reply #2271 on: May 27, 2020, 01:45:39 PM »
Why does it matter if it's unique to coronavirus or not?

I think it gives perspective, if the risks are comparable to other illnesses. 

Despite all the scary-sounding headlines vaguely implying CV19 is an alien super-disease that can get into your brain, heart, lungs or your BALLS... there's still no good evidence that CV19 has any magically evil traits that don't also sometimes occur (just as rarely) in other common respiratory viruses that millions of people get every year. The only difference is that anything related to CV19 that is remotely bad or scary-sounding is sought out and amplified by the media with little context on how rare it is or how other common respiratory viruses have been doing the same for years.

Dude we have 100k+ dead americans, and it's likely an undercount, and it's still going.  This thing isn't the black plague, but it's bad, ok? It's worse than the flu, and I don't understand how anyone can still debate that. 


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Re: How long can we wait while flattening the curve?
« Reply #2272 on: May 27, 2020, 01:46:12 PM »
On the topic of whether the worst is already behind us, I haven't seen much discussion of this story:

https://www.cnn.com/2020/05/21/us/montgomery-alabama-icu-bed-shortage/index.html

Alabama issued a stay-at-home order on April 4 which expired at the end of April, and they did basically nothing else. Now their hospitals are full of COVID patients and the state is almost out of ICU beds.

Sick people from rural regions with no hospitals of their own are being sent to Montgomery, and because Montgomery's hospitals are filling up, sick people from Montgomery are being sent to Birmingham. What's going to happen to sick people in Birmingham? There's a nasty domino effect here:

Quote
The city of Montgomery, Alabama, which has only one intensive care unit bed left, is sending sick patients to Birmingham, more than an hour away, officials said.

Montgomery Mayor Steven Reed said on Wednesday that of the four regional hospitals, one is short three ICU beds, two have no ICU beds, and one has just one bed.

"Right now, if you are from Montgomery, and you need an ICU bed, you are in trouble," Reed said at a press conference. "If you're from central Alabama, and you need an ICU bed, you may not be able to get one."

The health care system in the state's capital is "maxed out," Reed said.

Alabama had 13,288 confirmed Covid-19 cases as of Thursday afternoon, according to Johns Hopkins University data. At least 528 people have died. That's 2,358 more cases than reported the same time last week. At that time, 450 deaths had been reported.

The shutdown bought them time, but they didn't do anything with that time, and as soon as restrictions were lifted, the virus came back as bad as ever. And if the hospitals fill up completely, people with other diseases that could have been treated won't be able to get care, so the death rate may rise much higher than a model of COVID-19's intrinsic fatality rate would predict.

We're going to see this pattern in many southern states over the course of the summer, I think. It seems premature to speculate on whether there'll be a second wave when we haven't even gotten past the first wave yet.

LibrarIan

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Re: How long can we wait while flattening the curve?
« Reply #2273 on: May 27, 2020, 01:49:38 PM »
It seems premature to speculate on whether there'll be a second wave when we haven't even gotten past the first wave yet.

Can't have a second wave if the first never goes away. guy pointing knowingly at head meme

HBFIRE

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Re: How long can we wait while flattening the curve?
« Reply #2274 on: May 27, 2020, 01:51:46 PM »

Dude we have 100k+ dead americans, and it's likely an undercount, and it's still going.  This thing isn't the black plague, but it's bad, ok? It's worse than the flu, and I don't understand how anyone can still debate that.

To be clear, I'm not debating the fatality rate of flu vs CV19 -- I don't think I did that.  CV19 is at least 3 times more deadly.  My comments were only directed to the discussion of secondary risks.

afox

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Re: How long can we wait while flattening the curve?
« Reply #2275 on: May 27, 2020, 02:00:21 PM »

Dude we have 100k+ dead americans, and it's likely an undercount, and it's still going.  This thing isn't the black plague, but it's bad, ok? It's worse than the flu, and I don't understand how anyone can still debate that.

To be clear, I'm not debating the fatality rate of flu vs CV19 -- I don't think I did that.  CV19 is at least 3 times more deadly.  My comments were only directed to the discussion of secondary risks.

I think the 100k has to be put in context. That is 100k WITH a national shutdown of virtually all in person business and travel, and that is 100k in 3 months.

MudPuppy

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Re: How long can we wait while flattening the curve?
« Reply #2276 on: May 27, 2020, 02:03:26 PM »
forget it
« Last Edit: May 27, 2020, 07:24:55 PM by MudPuppy »

habanero

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Re: How long can we wait while flattening the curve?
« Reply #2277 on: May 27, 2020, 02:08:07 PM »
I'm also missing some more quantitative info on the side effects from Covid-19. We do read a lot of stories, but I haven't seen much on the frequency. But seasoned ICU doctors do say they've not seen anything like it before so I guess its something that occurs more than "very rarely".

As a side note, does the following sound dangerous without any context? (what it actually is revealed at the end)

Hepatic
Common (1% to 10%): Increased aspartate aminotransferase

Rare (less than 0.1%): Increased hepatic transaminases

Frequency not reported: Liver failure[Ref]

Gastrointestinal
Very common (10% or more): Nausea (up to 34%), Vomiting (up to 15%)

Common (1% to 10%): Abdominal pain, diarrhea, constipation, dyspepsia, enlarged abdomen

Frequency not reported: Dry mouth[Ref]

Hypersensitivity
Postmarketing reports: Anaphylaxis, hypersensitivity reactions[Ref]

Hematologic
Common (1% to 10%): Anemia, postoperative hemorrhage

Very rare (less than 0.01%): Thrombocytopenia, leucopenia, neutropenia[Ref]

Dermatologic
Common (1% to 10%): Rash, pruritus

Rare (less than 0.1%): Serious skin reactions such as acute generalized exanthematous pustulosis, Stevens-Johnson syndrome, and toxic epidermal necrolysis

Very rare (less than 0.01%): Pemphigoid reaction, pustular rash, Lyell syndrome[Ref]

Respiratory
Common (1% to 10%): Dyspnea, abnormal breath sounds, pulmonary edema, hypoxia, pleural effusion, stridor, wheezing, coughing[Ref]

Cardiovascular
Common (1% to 10%): Peripheral edema, hypertension, hypotension, tachycardia, chest pain[Ref]

Metabolic
Common (1% to 10%): Hypokalemia, hyperglycemia[Ref]

Nervous system
Common (1% to 10%): Headache, dizziness

Frequency not reported: Dystonia

Musculoskeletal
Common (1% to 10%): Muscle spasms, trismus

Psychiatric
Common (1% to 10%): Insomnia, anxiety

Genitourinary
Common (1% to 10%): Oliguria

Local
Common (1% to 10%): Infusion site pain, injection site reactions

Ocular
Common (1% to 10%): Periorbital edema

Other
Common (1% to 10%): Pyrexia, fatigue

Rare (0.01% to 0.1%): Malaise


... these are the side effects reported for acetaminophen, the active ingredient in Paracetamol.

https://www.drugs.com/sfx/paracetamol-side-effects.html

frugalnacho

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Re: How long can we wait while flattening the curve?
« Reply #2278 on: May 27, 2020, 02:11:25 PM »

Dude we have 100k+ dead americans, and it's likely an undercount, and it's still going.  This thing isn't the black plague, but it's bad, ok? It's worse than the flu, and I don't understand how anyone can still debate that.

To be clear, I'm not debating the fatality rate of flu vs CV19 -- I don't think I did that.  CV19 is at least 3 times more deadly.  My comments were only directed to the discussion of secondary risks.

I think the 100k has to be put in context. That is 100k WITH a national shutdown of virtually all in person business and travel, and that is 100k in 3 months.

Yeah, and for additional context it's at least 3X as deadly, if you get infected.   However, you are more likely to get infected with coronavirus than the flu because you don't have any natural immunity to it like you do to the flu, and you didn't get a vaccine for it like you did to the flu, and both of those factors compound to make it even more likely that you are exposed it in the general population.  Of course that is mitigated by social distancing and hygiene measures, but it should make you realize how important those mitigation techniques are. 

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #2279 on: May 27, 2020, 02:20:56 PM »

Dude we have 100k+ dead americans, and it's likely an undercount, and it's still going.  This thing isn't the black plague, but it's bad, ok? It's worse than the flu, and I don't understand how anyone can still debate that.

To be clear, I'm not debating the fatality rate of flu vs CV19 -- I don't think I did that.  CV19 is at least 3 times more deadly.  My comments were only directed to the discussion of secondary risks.

I think the 100k has to be put in context. That is 100k WITH a national shutdown of virtually all in person business and travel, and that is 100k in 3 months.

Yeah, and for additional context it's at least 3X as deadly, if you get infected.   However, you are more likely to get infected with coronavirus than the flu because you don't have any natural immunity to it like you do to the flu, and you didn't get a vaccine for it like you did to the flu, and both of those factors compound to make it even more likely that you are exposed it in the general population.  Of course that is mitigated by social distancing and hygiene measures, but it should make you realize how important those mitigation techniques are.

Wasn't the argument of the Oxford scientists that there is likely considerable natural immunity to COVID-19?

“In almost every context we’ve seen the epidemic grow, turn around and die away — almost like clockwork. Different countries have had different lockdown policies, and yet what we’ve observed is almost a uniform pattern of behaviour which is highly consistent with the SIR model. To me that suggests that much of the driving force here was due to the build-up of immunity. I think that’s a more parsimonious explanation than one which requires in every country for lockdown (or various degrees of lockdown, including no lockdown) to have had the same effect.” - Sunetra Gupta

Perhaps she is incorrect, but it seems too soon to say there isn't considerable natural immunity to COVID-19?

With 1/3rd of those infected in America remaining asymptomatic and countries like Japan and Taiwan having very low cases of infection and death, perhaps natural immunity is possible to some extent?
« Last Edit: May 27, 2020, 02:25:53 PM by T-Money$ »

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #2280 on: May 27, 2020, 02:27:56 PM »

Dude we have 100k+ dead americans, and it's likely an undercount, and it's still going.  This thing isn't the black plague, but it's bad, ok? It's worse than the flu, and I don't understand how anyone can still debate that.

To be clear, I'm not debating the fatality rate of flu vs CV19 -- I don't think I did that.  CV19 is at least 3 times more deadly.  My comments were only directed to the discussion of secondary risks.

The mitigation strategy would be VERY different at 3x flu death rate versus 10x flu death rate (which was the commonly cited statistic at the start of the pandemic). It goes from a bad flu to something much worse - by a factor of 3, obviously.

HBFIRE

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Re: How long can we wait while flattening the curve?
« Reply #2281 on: May 27, 2020, 02:49:05 PM »

The mitigation strategy would be VERY different at 3x flu death rate versus 10x flu death rate (which was the commonly cited statistic at the start of the pandemic). It goes from a bad flu to something much worse - by a factor of 3, obviously.

Indeed, and we're now finally seeing that and acting on it.

habanero

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Re: How long can we wait while flattening the curve?
« Reply #2282 on: May 27, 2020, 03:02:29 PM »

“In almost every context we’ve seen the epidemic grow, turn around and die away — almost like clockwork. Different countries have had different lockdown policies, and yet what we’ve observed is almost a uniform pattern of behaviour which is highly consistent with the SIR model. To me that suggests that much of the driving force here was due to the build-up of immunity. I think that’s a more parsimonious explanation than one which requires in every country for lockdown (or various degrees of lockdown, including no lockdown) to have had the same effect.” - Sunetra Gupta

Perhaps she is incorrect, but it seems too soon to say there isn't considerable natural immunity to COVID-19?

With 1/3rd of those infected in America remaining asymptomatic and countries like Japan and Taiwan having very low cases of infection and death, perhaps natural immunity is possible to some extent?

Some modellers in Sweden has made a similar case (at least for the capital Stockholm which is the epicenter), not by referring to some immunity present, but to a very large proportion of the population having been through an infection with no or very mild symptoms. One of those mathematicians has backtracked a fair bit now I think and antibody tests conducted in Sweden does, as other places, not support a vast amount of unconfirmed cases. There is, I think, some debate on to what extent you develop antibodies if you never got sick in the first place from the infection, how long it takes and how accurate these tests actually are, but from what I get there is some creeping uncertainty in Sweden that they have picked the wrong approach to this. They were very confident in the beginning, but the epidemiologists in the government now are a fair bit more reserved and openly admit they don't know what will turn out best in the end. On the other hand ICU admissions have dropped steadily in Sweden's capital and they have indicated that they start seeing signs of herd immunity, but it might also be the result of people being careful and listening to general advice.

As I mentioned earlier, the data from Norway suggests that the milder things like social distancing, no large crowds and good hygiene account for the bulk of the drop in the infection rate and a complete lockdown does not add that much to it and is not worth the massive extra cost. It is also only an estimate and not that much time has passed, but that's what our modellers have indicated at least. The reopening of society here also supports this claim so far, the number of new infections is now extremely low (8 new today, for example (480 if scaled to US population) and they estimate that if they did random sampling they would have to conduct 12.000 tests to discover one case of Covid-19, but at the same time they would get 14 false positives so it serves no purpose to do it here - only person with symptoms or someone close to a confirmed case is tested pretty much.

Based on our data the modellers have taken down the estimate of asymptotic cases, and as a result of that the estimated infection fatality rate has gone up from 0.3% to 0.7%.

Sweden also had a slightly embarassing incident where they modelled that they had 1000 actual infections per confirmed case in the capital. Some simple math based on that would mean that the number of infected people in the capital was 3 times the population. The error was quickly pointed out and they had a wrong parameter (was constant instead of variable) and after correcting that and re-ran it the model spit up 75 as the number of actual infections per confirmed case. 
« Last Edit: May 27, 2020, 03:15:52 PM by habaneroNorway »

habanero

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Re: How long can we wait while flattening the curve?
« Reply #2283 on: May 27, 2020, 03:36:41 PM »
Another interesting case you don't hear a lot about is Iceland.

Iceland has quite a few things that makes it a great test lab for Covid-19. The population is very small - only 365.000 live there. Of those about 230.000 live in the capital region. It is also an island which these days severely limits people going in and out and they have, for their small size, a pretty big company doing genetic research. When they had to suspend their regular activity they had people with nothing to do, good lab capacity and the correct skill set, so the CEO suggested "why don't we just test everyone in the country?". They never had a lockdown (but social distancing, contact tracing, isolation of confirmed cases etc) and as of now they have tested a whopping 17% of the population. The health care system took those who were actually sick or at risk while the company offered tests to anyone who wanted one as far as I understand. The numbers from Iceland say 1805 confirmed  infected or 2.7% of the population. So far 10 people have died and they have had like 8 new cases this month so the number is not expected to rise meaningfully any time soon.

Due to the said company and the very small population Iceland is able to do extremely detailed tracking on how the virus spreads by looking at the small genetic variations in the infected people About half the confirmed cases in Iceland were asymptomatic as of mid-april and there has ben quite few confirmed cases since then.

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #2284 on: May 27, 2020, 03:38:34 PM »

js82

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Re: How long can we wait while flattening the curve?
« Reply #2285 on: May 27, 2020, 04:37:27 PM »
On the topic of whether the worst is already behind us, I haven't seen much discussion of this story:

https://www.cnn.com/2020/05/21/us/montgomery-alabama-icu-bed-shortage/index.html

Alabama issued a stay-at-home order on April 4 which expired at the end of April, and they did basically nothing else. Now their hospitals are full of COVID patients and the state is almost out of ICU beds.

Sick people from rural regions with no hospitals of their own are being sent to Montgomery, and because Montgomery's hospitals are filling up, sick people from Montgomery are being sent to Birmingham. What's going to happen to sick people in Birmingham? There's a nasty domino effect here:

---------

We're going to see this pattern in many southern states over the course of the summer, I think. It seems premature to speculate on whether there'll be a second wave when we haven't even gotten past the first wave yet.

I agree.  The early hot spots (NYC/CT/RI/NJ/PA/MA, Detroit, New Orleans) have peaked, and probably have enough people who developed herd immunity that a second wave of the same size is unlikely.

On the other hand, CA/NC/VA/WI/AL/MI/AR/ND/ME/WV are all increasing, and many others (FL,IL,MD,GA,TX) have been pretty flat.

On the national level I expect the data to have a very long, very flat tail - much longer and flatter than other countries, owing to the geographical vastness of the United States.  The early statistics were dominated by the massive cluster of cases in the greater NYC area.  Now we're going to have lots of little waves as places reopen and/or less-densely populated areas reach their peak.

The question is, will people continue to do enough such that our medical system can treat the people who come down with it?  In most areas it probably doesn't require closing down large numbers of businesses, but it does require some level of basic social distancing and basic regard for the health of one's fellow citizens.

GardenerB

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Re: How long can we wait while flattening the curve?
« Reply #2286 on: May 27, 2020, 05:30:42 PM »
On the topic of whether the worst is already behind us, I haven't seen much discussion of this story:

https://www.cnn.com/2020/05/21/us/montgomery-alabama-icu-bed-shortage/index.html

Alabama issued a stay-at-home order on April 4 which expired at the end of April, and they did basically nothing else. Now their hospitals are full of COVID patients and the state is almost out of ICU beds.

Sick people from rural regions with no hospitals of their own are being sent to Montgomery, and because Montgomery's hospitals are filling up, sick people from Montgomery are being sent to Birmingham. What's going to happen to sick people in Birmingham? There's a nasty domino effect here:

---------

We're going to see this pattern in many southern states over the course of the summer, I think. It seems premature to speculate on whether there'll be a second wave when we haven't even gotten past the first wave yet.

I agree.  The early hot spots (NYC/CT/RI/NJ/PA/MA, Detroit, New Orleans) have peaked, and probably have enough people who developed herd immunity that a second wave of the same size is unlikely.

On the other hand, CA/NC/VA/WI/AL/MI/AR/ND/ME/WV are all increasing, and many others (FL,IL,MD,GA,TX) have been pretty flat.

On the national level I expect the data to have a very long, very flat tail - much longer and flatter than other countries, owing to the geographical vastness of the United States.  The early statistics were dominated by the massive cluster of cases in the greater NYC area.  Now we're going to have lots of little waves as places reopen and/or less-densely populated areas reach their peak.

The question is, will people continue to do enough such that our medical system can treat the people who come down with it?  In most areas it probably doesn't require closing down large numbers of businesses, but it does require some level of basic social distancing and basic regard for the health of one's fellow citizens.

I agree - almost all predictions/trends for most countries and States are for a long gradual tail, except for Arizona to rise somewhat into the summer (then of course Brazil, Peru etc. in the South).

So far using the 'compare' tool at IHME, those other States show that, while absolute cases and death counts are rising, the trends per 100,000 daily are all falling.

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

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #2287 on: May 27, 2020, 05:41:40 PM »
The problem in Alabama must be localized as statewide it seems like they are far from capacity with ICU beds?

Also, the IHME model output shows a peak within a week or two (95% CI) then a decline.  The state doesn't come close to ICU capacity?


frugalnacho

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Re: How long can we wait while flattening the curve?
« Reply #2288 on: May 27, 2020, 05:51:15 PM »

Dude we have 100k+ dead americans, and it's likely an undercount, and it's still going.  This thing isn't the black plague, but it's bad, ok? It's worse than the flu, and I don't understand how anyone can still debate that.

To be clear, I'm not debating the fatality rate of flu vs CV19 -- I don't think I did that.  CV19 is at least 3 times more deadly.  My comments were only directed to the discussion of secondary risks.

I think the 100k has to be put in context. That is 100k WITH a national shutdown of virtually all in person business and travel, and that is 100k in 3 months.

Yeah, and for additional context it's at least 3X as deadly, if you get infected.   However, you are more likely to get infected with coronavirus than the flu because you don't have any natural immunity to it like you do to the flu, and you didn't get a vaccine for it like you did to the flu, and both of those factors compound to make it even more likely that you are exposed it in the general population.  Of course that is mitigated by social distancing and hygiene measures, but it should make you realize how important those mitigation techniques are.

Wasn't the argument of the Oxford scientists that there is likely considerable natural immunity to COVID-19?

“In almost every context we’ve seen the epidemic grow, turn around and die away — almost like clockwork. Different countries have had different lockdown policies, and yet what we’ve observed is almost a uniform pattern of behaviour which is highly consistent with the SIR model. To me that suggests that much of the driving force here was due to the build-up of immunity. I think that’s a more parsimonious explanation than one which requires in every country for lockdown (or various degrees of lockdown, including no lockdown) to have had the same effect.” - Sunetra Gupta

Perhaps she is incorrect, but it seems too soon to say there isn't considerable natural immunity to COVID-19?

With 1/3rd of those infected in America remaining asymptomatic and countries like Japan and Taiwan having very low cases of infection and death, perhaps natural immunity is possible to some extent?

I'm talking preexisting immunity. Many of us have variable immunity to different influenza strains because we've been coexisting with them for a long time.  We also have flu shots every season.  No one has ever had a coronavirus vaccine though, and no one has (as of 6 months ago) antibodies, so 7.7B people were likely susceptible when first exposed to the virus.  How many people have acquired antibodies by this point, I don't know.

My point was that even if coronavirus is only just as lethal as the flu, it's actually deadlier because more people were/are susceptible. 

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #2289 on: May 27, 2020, 06:27:29 PM »
https://medicalxpress.com/news/2020-05-prevalence-silent-covid-infection-higher.html

https://www.usnews.com/news/health-news/articles/2020-05-27/silent-covid-19-more-widespread-than-thought

"As countries progress out of lockdown, a high proportion of infected, but asymptomatic, individuals may mean that a much higher percentage of the population than expected may have been infected with COVID," he suggests.

More interesting stuff on comorbidity and improvement in ICU care:

https://www.bmj.com/content/369/bmj.m1966
« Last Edit: May 27, 2020, 06:30:59 PM by T-Money$ »

Gremlin

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Re: How long can we wait while flattening the curve?
« Reply #2290 on: May 27, 2020, 06:53:07 PM »

Dude we have 100k+ dead americans, and it's likely an undercount, and it's still going.  This thing isn't the black plague, but it's bad, ok? It's worse than the flu, and I don't understand how anyone can still debate that.

To be clear, I'm not debating the fatality rate of flu vs CV19 -- I don't think I did that.  CV19 is at least 3 times more deadly.  My comments were only directed to the discussion of secondary risks.

Whilst we, as a society, have to make decisions NOW about how serious we regard CV19, it is going to be YEARS before we truly understand this.  It's a consequence of this disease being novel.  We do know that it's two friends, SARS and MERS, both left 30%+ of survivors with long term lung damage.  For SARS and MERS, long term damage wasn't simply limited to those with severe cases of the disease.  Roughly 1 in 6 mild cases developed long term lung damage. 

Secondary effects CV19 may be substantially better than that - maybe no more so than the flu.  Or it may be worse.  We don't yet know.  Early indications suggest that it might impact a wider range of organs than SARS/MERS but again, the key thing is that we just don't know to what extent and how permanent any conditions may be.

It's a right shitty situation.  We know that opening the economy will almost certainly lead to an increase in transmission rates, at a "manageable" level or otherwise.  From a purely economic perspective, countries such as the US and most of Europe are effectively betting on the severity of secondary impacts.  If it turns out that they are as prevalent (or more so) than SARS/MERS, then the economic cost of the future health care required for those impaired will far outweigh any economic gain of opening up in the short term. 

js82

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Re: How long can we wait while flattening the curve?
« Reply #2291 on: May 27, 2020, 08:01:18 PM »

Dude we have 100k+ dead americans, and it's likely an undercount, and it's still going.  This thing isn't the black plague, but it's bad, ok? It's worse than the flu, and I don't understand how anyone can still debate that.

To be clear, I'm not debating the fatality rate of flu vs CV19 -- I don't think I did that.  CV19 is at least 3 times more deadly.  My comments were only directed to the discussion of secondary risks.

The mitigation strategy would be VERY different at 3x flu death rate versus 10x flu death rate (which was the commonly cited statistic at the start of the pandemic). It goes from a bad flu to something much worse - by a factor of 3, obviously.

I think the other piece of it is that there's at least 2 orders of magnitude difference in mortality rate between the elderly versus younger populations.  The main thought process governing my behavior is not the risk to myself, but the risk of contracting an infection and passing it on to my parents or an older coworker.  Figuring out how to deal with this aspect of the disease as effectively as possible is the crucial part of any response.

Along that line of thought, the question should not be of reopening schools or not, but of how to do so while protecting A) older staff members who are at-risk, and B) students who live with older/at-risk relatives.

I think it's possible to do this in a thoughtful, nuanced manner that opens up a large chunk of society with relatively little impact on the number of deaths/severe cases, if we're thoughtful about it.

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #2292 on: May 28, 2020, 05:04:31 AM »
https://onlinelibrary.wiley.com/doi/10.1111/jep.13415

Peer reviewed argument for wearing face masks in public.

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #2293 on: May 28, 2020, 06:08:24 AM »
While we're engaging in statistical jiggery-pokery to argue that 100,000 dead isn't that bad, really, and arguing about face masks and shit, and some of are thinking about drinking bleach for our health, let's take a moment to consider that maybe we should import some expert advice from... Mongolia.

https://medium.com/@indica/covid-underdogs-mongolia-3b0c162427c2

LaineyAZ

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Re: How long can we wait while flattening the curve?
« Reply #2294 on: May 28, 2020, 08:07:21 AM »
While we're engaging in statistical jiggery-pokery to argue that 100,000 dead isn't that bad, really, and arguing about face masks and shit, and some of are thinking about drinking bleach for our health, let's take a moment to consider that maybe we should import some expert advice from... Mongolia.

https://medium.com/@indica/covid-underdogs-mongolia-3b0c162427c2

Great article, thanks. 
This whole thing - Covid19, medical response, political response, even family and friends' personal response - has been eye-opening for me.  Feels like a carnival ride that you want to be over but it keeps going so you just hang on for the ride.

cerat0n1a

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Re: How long can we wait while flattening the curve?
« Reply #2295 on: May 28, 2020, 08:16:04 AM »
While we're engaging in statistical jiggery-pokery to argue that 100,000 dead isn't that bad, really, and arguing about face masks and shit, and some of are thinking about drinking bleach for our health, let's take a moment to consider that maybe we should import some expert advice from... Mongolia.

https://medium.com/@indica/covid-underdogs-mongolia-3b0c162427c2

Thanks for posting that.

OtherJen

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Re: How long can we wait while flattening the curve?
« Reply #2296 on: May 28, 2020, 08:19:35 AM »
While we're engaging in statistical jiggery-pokery to argue that 100,000 dead isn't that bad, really, and arguing about face masks and shit, and some of are thinking about drinking bleach for our health, let's take a moment to consider that maybe we should import some expert advice from... Mongolia.

https://medium.com/@indica/covid-underdogs-mongolia-3b0c162427c2

Seriously impressive. Thanks for sharing it.

GardenerB

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Re: How long can we wait while flattening the curve?
« Reply #2297 on: May 28, 2020, 12:17:34 PM »

Dude we have 100k+ dead americans, and it's likely an undercount, and it's still going.  This thing isn't the black plague, but it's bad, ok? It's worse than the flu, and I don't understand how anyone can still debate that.

To be clear, I'm not debating the fatality rate of flu vs CV19 -- I don't think I did that.  CV19 is at least 3 times more deadly.  My comments were only directed to the discussion of secondary risks.

I think the 100k has to be put in context. That is 100k WITH a national shutdown of virtually all in person business and travel, and that is 100k in 3 months.

Yeah, and for additional context it's at least 3X as deadly, if you get infected.   However, you are more likely to get infected with coronavirus than the flu because you don't have any natural immunity to it like you do to the flu, and you didn't get a vaccine for it like you did to the flu, and both of those factors compound to make it even more likely that you are exposed it in the general population.  Of course that is mitigated by social distancing and hygiene measures, but it should make you realize how important those mitigation techniques are.

Wasn't the argument of the Oxford scientists that there is likely considerable natural immunity to COVID-19?

“In almost every context we’ve seen the epidemic grow, turn around and die away — almost like clockwork. Different countries have had different lockdown policies, and yet what we’ve observed is almost a uniform pattern of behaviour which is highly consistent with the SIR model. To me that suggests that much of the driving force here was due to the build-up of immunity. I think that’s a more parsimonious explanation than one which requires in every country for lockdown (or various degrees of lockdown, including no lockdown) to have had the same effect.” - Sunetra Gupta

Perhaps she is incorrect, but it seems too soon to say there isn't considerable natural immunity to COVID-19?

With 1/3rd of those infected in America remaining asymptomatic and countries like Japan and Taiwan having very low cases of infection and death, perhaps natural immunity is possible to some extent?

I'm talking preexisting immunity. Many of us have variable immunity to different influenza strains because we've been coexisting with them for a long time.  We also have flu shots every season.  No one has ever had a coronavirus vaccine though, and no one has (as of 6 months ago) antibodies, so 7.7B people were likely susceptible when first exposed to the virus.  How many people have acquired antibodies by this point, I don't know.

My point was that even if coronavirus is only just as lethal as the flu, it's actually deadlier because more people were/are susceptible.

There should be more studies coming out soon on this.  I.e. some preprints on anti-bodies/immunity studies suggest cross-immunity may be a factor since this virus is behaving similar to most other coronaviruses already out there.  Again these are only 'for future study' statements in the pre-prints.

I believe there were some virologists on this thread recently - maybe some thoughts?

https://blogs.sciencemag.org/pipeline/archives/2020/05/15/good-news-on-the-human-immune-response-to-the-coronavirus

"And here’s something to think about: in the unexposed patients, 40 to 60% had CD4+ cells that already respond to the new coronavirus. This doesn’t mean that people have already been exposed to it per se, of course – immune crossreactivity is very much a thing, and it would appear that many people have already raised a response to other antigens that could be partially protective against this new virus. What antigens those are, how protective this response is, and whether it helps to account for the different severity of the disease in various patients (and populations) are important questions that a lot of effort will be spent answering. As the paper notes, such cross-reactivity seems to have been a big factor in making the H1N1 flu epidemic less severe than had been initially feared – the population already had more of an immunological head start than thought."

jambongris

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Re: How long can we wait while flattening the curve?
« Reply #2298 on: May 28, 2020, 07:22:14 PM »
This info graphic provides an interesting perspective on the relative lethality of COVID-19 to date:

https://public.flourish.studio/visualisation/2562261/
« Last Edit: May 28, 2020, 07:23:50 PM by jambongris »

HBFIRE

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Re: How long can we wait while flattening the curve?
« Reply #2299 on: May 28, 2020, 07:45:41 PM »
This info graphic provides an interesting perspective on the relative lethality of COVID-19 to date:

https://public.flourish.studio/visualisation/2562261/

This is neat, but it selectively excludes the top 7 causes of death.