Author Topic: How long can we wait while flattening the curve?  (Read 248200 times)

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #650 on: April 16, 2020, 03:22:35 PM »
Regarding models:

https://science.sciencemag.org/content/early/2020/04/14/science.abb5793


REPORT
Projecting the transmission dynamics of SARS-CoV-2 through the postpandemic period
Stephen M. Kissler1,*, Christine Tedijanto2,*, Edward Goldstein2, Yonatan H. Grad1,,, Marc Lipsitch2,,

Science  14 Apr 2020:
eabb5793
DOI: 10.1126/science.abb5793

Assessing intervention scenarios during the initial pandemic wave
Regardless of the post-pandemic transmission dynamics of SARS-CoV-2, urgent measures are required to address the ongoing epidemic. Pharmaceutical treatments and vaccines may require months to years to develop and test, leaving non-pharmaceutical interventions (NPIs) as the only immediate means of curbing SARS-CoV-2 transmission. Social distancing measures have been adopted in many countries with widespread SARS-CoV-2 transmission. The necessary duration and intensity of these measures has yet to be characterized. To address this, we adapted the SEIRS transmission model (fig. S9) to capture moderate/mild/asymptomatic infections (95.6% of infections), infections that lead to hospitalization but not critical care (3.08% of infections), and infections that require critical care (1.32% of infections) (26)


Is this indicating that 95.6% of COVID-19 (SARS-CoV-2) are up to moderate, 3.08% are non-ICU hospital, and only 1.32% require critical care?

Those numbers seem very low to previous studies and estimates.

Davnasty

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Re: How long can we wait while flattening the curve?
« Reply #651 on: April 16, 2020, 04:29:22 PM »
Those numbers seem very low to previous studies and estimates.

Do they? What studies/estimates are you referring to?

I've seen 5% used as a rough estimate for hospitalization rates since early March. This report suggests 4.4%.

Keep in mind that of those who require critical care, most do not survive.

fattest_foot

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Re: How long can we wait while flattening the curve?
« Reply #652 on: April 16, 2020, 04:29:32 PM »

Even with New York, not a single hospital is overwhelmed. Open everything back up and if we see systems trending back to becoming overwhelmed, you re-implement quarantines.

Look at the post above mine. Just complete fear. "Well, it might kill hundreds of thousands. No choice but to not let anyone leave the house!" This is an insane response. I hope you realize that; maybe in retrospect.

Hi. New Yorker here. I went on a be-masked walk yesterday and saw (and smelled) the mobile morgues (refrigerated trailers) setup next to the Brooklyn Hospital. Please stop downplaying this. Its dangerous, insensitive, and plainly ignorant.

Not downplaying it. The point was to prevent hospitals from being overwhelmed. People are going to die. Period. We can't 100% prevent that. The goal was so extra people didn't die because the hospitals couldn't handle the overload.

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #653 on: April 16, 2020, 04:54:16 PM »
Those numbers seem very low to previous studies and estimates.

Do they? What studies/estimates are you referring to?

I've seen 5% used as a rough estimate for hospitalization rates since early March. This report suggests 4.4%.

Keep in mind that of those who require critical care, most do not survive.

I think about 85% that are put on a ventilator do not survive?

Let me look up the hospitalization estimates, but I thought I read from WHO documents they estimated 15% of the population would need to be hospitalized.

Thankfully, "news" like this did not come true:

https://www.nytimes.com/2020/03/31/us/coronavirus-covid-triage-rationing-ventilators.html

In other news:

"This study suggests that in hot spots like New York City, the level of #COVID19 exposure … could be high," Scott Gottlieb, former Commissioner of the U.S. Food and Drug Administration, posted on Twitter on Monday (April 13). "Not the 50%-66% needed to confer herd immunity, but much more than 10%." (Herd immunity refers to the idea that once a certain number of people have experienced a disease and developed immunity to it, that protection extends to a larger population.)

https://www.livescience.com/coronavirus-in-pregnant-woman-high-nyc.html

https://www.nytimes.com/2020/04/16/health/coronavirus-obesity-higher-risk.html

https://www.europeanscientist.com/en/article-of-the-week/covid-19-and-the-elephant-in-the-room/

Preliminary data indicate obesity is the #1 risk factor (after age) for hospitalization with COVID-19.
« Last Edit: April 16, 2020, 05:15:03 PM by egillespie »

nereo

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Re: How long can we wait while flattening the curve?
« Reply #654 on: April 16, 2020, 04:55:12 PM »

Even with New York, not a single hospital is overwhelmed. Open everything back up and if we see systems trending back to becoming overwhelmed, you re-implement quarantines.

Look at the post above mine. Just complete fear. "Well, it might kill hundreds of thousands. No choice but to not let anyone leave the house!" This is an insane response. I hope you realize that; maybe in retrospect.

Hi. New Yorker here. I went on a be-masked walk yesterday and saw (and smelled) the mobile morgues (refrigerated trailers) setup next to the Brooklyn Hospital. Please stop downplaying this. Its dangerous, insensitive, and plainly ignorant.

Not downplaying it. The point was to prevent hospitals from being overwhelmed. People are going to die. Period. We can't 100% prevent that. The goal was so extra people didn't die because the hospitals couldn't handle the overload.

No, not overwhelming hospitals was ONE goal of the lockdown. Buying time to have better testing, comprehensive tracking, more effective treatment etc have been equally important goals.

mathlete

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Re: How long can we wait while flattening the curve?
« Reply #655 on: April 16, 2020, 05:03:03 PM »
News in scare quotes. Attributing a phantom unavailability of case data to political reasons...

Abe

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Re: How long can we wait while flattening the curve?
« Reply #656 on: April 16, 2020, 05:11:42 PM »
Honest question:

Does anyone have access to raw data concerning age/race/gender when it comes to cases and deaths?

I know in my state currently the median age of death is 78 years old. I I am curious if the data is similar nationwide?


Race/ethnicity distribution of deaths in California is roughly proportional to population:
https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/ncov2019.aspx

T-Money$

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Davnasty

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Re: How long can we wait while flattening the curve?
« Reply #659 on: April 16, 2020, 05:31:20 PM »
Thankfully, "news" like this did not come true:

https://www.nytimes.com/2020/03/31/us/coronavirus-covid-triage-rationing-ventilators.html

The purpose of this article was to discuss plans that hospitals have put in place to help them make difficult decisions if it comes to that, and yes that was/is a possibility.

What part of this do you have a problem with?

Channel-Z

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Re: How long can we wait while flattening the curve?
« Reply #660 on: April 16, 2020, 06:07:11 PM »
Ultimately, people will wait however long they are comfortable waiting. There's a protest of the stay-at-home order scheduled next week close to where I work (stay-at-home lasts until May 15 for now). Even if you "reopen everything" a certain percentage won't be comfortable going out for a long time.

KBecks

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Re: How long can we wait while flattening the curve?
« Reply #661 on: April 16, 2020, 06:22:42 PM »
Ultimately, people will wait however long they are comfortable waiting. There's a protest of the stay-at-home order scheduled next week close to where I work (stay-at-home lasts until May 15 for now). Even if you "reopen everything" a certain percentage won't be comfortable going out for a long time.

At least then they are free to choose and not being ordered by the government.

Nate79

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Re: How long can we wait while flattening the curve?
« Reply #662 on: April 16, 2020, 06:58:57 PM »
Perhaps the protestors should not be allowed to use the health system if they catch the coronavirus.

Sent from my SM-G950U using Tapatalk


nereo

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Re: How long can we wait while flattening the curve?
« Reply #663 on: April 16, 2020, 07:10:15 PM »
Ultimately, people will wait however long they are comfortable waiting. There's a protest of the stay-at-home order scheduled next week close to where I work (stay-at-home lasts until May 15 for now). Even if you "reopen everything" a certain percentage won't be comfortable going out for a long time.

At least then they are free to choose and not being ordered by the government.

True, but that also means that your neighbors are free to do whatever they want, even when it puts you and your family at risk. 

What happens if this lets open everything up, consequences be damned attitude results in outbreaks that makes our current situation seem tame?  I suspect both the economic and human costs will be even more catastrophic.

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Re: How long can we wait while flattening the curve?
« Reply #664 on: April 16, 2020, 07:12:14 PM »
Getting back to the OP's question; I think the answer is "not much longer."  Even with the SAH orders here in VA, I'm noticing that there is more traffic, and people are simply not following along.  My city already has a pretty low observance and I think it's getting more widespread.  People won't believe until they see the coughing and people keeling over around them. 

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Re: How long can we wait while flattening the curve?
« Reply #665 on: April 16, 2020, 07:14:10 PM »
Ultimately, people will wait however long they are comfortable waiting. There's a protest of the stay-at-home order scheduled next week close to where I work (stay-at-home lasts until May 15 for now). Even if you "reopen everything" a certain percentage won't be comfortable going out for a long time.

At least then they are free to choose and not being ordered by the government.

 "I don't care if the light is red!  The government can't tell ME to stop!"

KBecks

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Re: How long can we wait while flattening the curve?
« Reply #666 on: April 16, 2020, 07:18:32 PM »
Ultimately, people will wait however long they are comfortable waiting. There's a protest of the stay-at-home order scheduled next week close to where I work (stay-at-home lasts until May 15 for now). Even if you "reopen everything" a certain percentage won't be comfortable going out for a long time.

At least then they are free to choose and not being ordered by the government.

True, but that also means that your neighbors are free to do whatever they want, even when it puts you and your family at risk. 

What happens if this lets open everything up, consequences be damned attitude results in outbreaks that makes our current situation seem tame?  I suspect both the economic and human costs will be even more catastrophic.

I think the time to be *most* cautious is when things start to open up.  That's when we need the masks and the gloves and the distancing, etc. etc.  But people will need to be trusted to do their best and make their own choices at some point.

js82

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Re: How long can we wait while flattening the curve?
« Reply #667 on: April 16, 2020, 07:26:49 PM »
Getting back to the OP's question; I think the answer is "not much longer."  Even with the SAH orders here in VA, I'm noticing that there is more traffic, and people are simply not following along.  My city already has a pretty low observance and I think it's getting more widespread.  People won't believe until they see the coughing and people keeling over around them.

The thing that worries me, is that there are a lot of people going out, who aren't taking s**t seriously while they're out.  I went grocery shopping today, and half the people didn't have masks - in a state where masks are mandatory.  Most ignored the traffic flow that the store designed to encourage spacing between people.

I get the desire to open the economy, make a living, get back to something vaguely resembling a normal life - I want it too.  But this whole thing will go a lot more smoothly if we all do the little things (masks, hand washing, physical distancing where possible) to minimize the risks of transmission even as things loosen up.  Wearing a mask or taking a few minutes longer to shop because I'm keeping space from other people is a small price to pay in this situation, relative to the alternatives.

I wish people got the dynamics of epidemics.  Something that reduces transmission by 10 or 20% seems like it's barely worth using when it comes to protecting yourself, but it's a really big f***ing deal when it comes to the dynamics of an epidemic at the population level.
« Last Edit: April 16, 2020, 07:29:43 PM by js82 »

afox

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Re: How long can we wait while flattening the curve?
« Reply #668 on: April 16, 2020, 10:37:28 PM »
Today's planet money episode is on the economics of whether the "shutting down the economy" is "worth it".

https://www.npr.org/2020/04/15/835571843/episode-991-lives-vs-the-economy

Spoiler alert: its worth it.


Michael in ABQ

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Re: How long can we wait while flattening the curve?
« Reply #669 on: April 16, 2020, 11:59:24 PM »
Those numbers seem very low to previous studies and estimates.

Do they? What studies/estimates are you referring to?

I've seen 5% used as a rough estimate for hospitalization rates since early March. This report suggests 4.4%.

Keep in mind that of those who require critical care, most do not survive.

I think about 85% that are put on a ventilator do not survive?[/]

Let me look up the hospitalization estimates, but I thought I read from WHO documents they estimated 15% of the population would need to be hospitalized.

Thankfully, "news" like this did not come true:

https://www.nytimes.com/2020/03/31/us/coronavirus-covid-triage-rationing-ventilators.html

In other news:

"This study suggests that in hot spots like New York City, the level of #COVID19 exposure could be high," Scott Gottlieb, former Commissioner of the U.S. Food and Drug Administration, posted on Twitter on Monday (April 13). "Not the 50%-66% needed to confer herd immunity, but much more than 10%." (Herd immunity refers to the idea that once a certain number of people have experienced a disease and developed immunity to it, that protection extends to a larger population.)

https://www.livescience.com/coronavirus-in-pregnant-woman-high-nyc.html

https://www.nytimes.com/2020/04/16/health/coronavirus-obesity-higher-risk.html

https://www.europeanscientist.com/en/article-of-the-week/covid-19-and-the-elephant-in-the-room/

Preliminary data indicate obesity is the #1 risk factor (after age) for hospitalization with COVID-19.

The 15% survival rate was based off one study in Wuhan early on, only 3 of 22 patients placed on ventilators were able to come off them. Larger studies in the UK and US with 50-100 patients showed survival rates of 33% - 50% - though the US study in Washington ended before some patients came off the ventilators so they didn't die but they may have after the study. However, even those studies are at least a month old now. I'm sure there's a huge amount of data out there but unfortunately everyone is probably too busy to setup a scientifically valid study and then sit down and try to publish a peer-reviewed paper.

Then again, unless you're reading the study yourself any results that get filtered out through the media are going to be worthless. They'll only report whichever result is most shocking or best fits their particular narrative. And of course once something gets reported like "only 15% of people who go on a ventilator will ultimately survive" that becomes the accepted truth. If a dozen later studies say it's a 50% survival rate they either won't get reported, or won't break through the noise.

This is not a criticism of anyone specifically, it's a cognitive bias we all deal with. It's why propaganda is so effective. If you keep repeating a lie people will eventually accept it as the truth. Whether that lie was intentionally created or just the result of lazy/bad reporting.

former player

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Re: How long can we wait while flattening the curve?
« Reply #670 on: April 17, 2020, 02:42:32 AM »
Ultimately, people will wait however long they are comfortable waiting. There's a protest of the stay-at-home order scheduled next week close to where I work (stay-at-home lasts until May 15 for now). Even if you "reopen everything" a certain percentage won't be comfortable going out for a long time.

At least then they are free to choose and not being ordered by the government.
"Free to choose" doesn't apply to the people they infect, though, does it?  Sadly, a significant proportion of the population of most "free" countries will lack the will or ability to understand and follow the behaviours which will reduce transmission.  (Yes, I know how this sounds.  But there is a reason self government along the lines of a commune, which is basically what you are suggesting, only works on a very limited and self-selecting basis and usually for very limited periods of time.)

kei te pai

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Re: How long can we wait while flattening the curve?
« Reply #671 on: April 17, 2020, 03:09:20 AM »
Its looking like we might have done it here in NZ. 4 weeks of Civil Obedience. Fairly tight lockdown largely complied with. New cases down to 8 today and all traceable to existing clusters I think. Our curve has collapsed.
And we are staying at this level of lockdown for at least a few more days with minimal protests.
There has been a lot of kindness and good humour, tempered with sadness at 11 deaths.
Thankfully we have a capable, sensible government and effective civil service.

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #672 on: April 17, 2020, 03:17:19 AM »
Sadly, a significant proportion of the population of most "free" countries will lack the will or ability to understand and follow the behaviours which will reduce transmission.
https://www.korea-dpr.com

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #673 on: April 17, 2020, 05:05:05 AM »
Those numbers seem very low to previous studies and estimates.

Do they? What studies/estimates are you referring to?

I've seen 5% used as a rough estimate for hospitalization rates since early March. This report suggests 4.4%.

Keep in mind that of those who require critical care, most do not survive.

I think about 85% that are put on a ventilator do not survive?[/]

Let me look up the hospitalization estimates, but I thought I read from WHO documents they estimated 15% of the population would need to be hospitalized.

Thankfully, "news" like this did not come true:

https://www.nytimes.com/2020/03/31/us/coronavirus-covid-triage-rationing-ventilators.html

In other news:

"This study suggests that in hot spots like New York City, the level of #COVID19 exposure could be high," Scott Gottlieb, former Commissioner of the U.S. Food and Drug Administration, posted on Twitter on Monday (April 13). "Not the 50%-66% needed to confer herd immunity, but much more than 10%." (Herd immunity refers to the idea that once a certain number of people have experienced a disease and developed immunity to it, that protection extends to a larger population.)

https://www.livescience.com/coronavirus-in-pregnant-woman-high-nyc.html

https://www.nytimes.com/2020/04/16/health/coronavirus-obesity-higher-risk.html

https://www.europeanscientist.com/en/article-of-the-week/covid-19-and-the-elephant-in-the-room/

Preliminary data indicate obesity is the #1 risk factor (after age) for hospitalization with COVID-19.

The 15% survival rate was based off one study in Wuhan early on, only 3 of 22 patients placed on ventilators were able to come off them. Larger studies in the UK and US with 50-100 patients showed survival rates of 33% - 50% - though the US study in Washington ended before some patients came off the ventilators so they didn't die but they may have after the study. However, even those studies are at least a month old now. I'm sure there's a huge amount of data out there but unfortunately everyone is probably too busy to setup a scientifically valid study and then sit down and try to publish a peer-reviewed paper.

Then again, unless you're reading the study yourself any results that get filtered out through the media are going to be worthless. They'll only report whichever result is most shocking or best fits their particular narrative. And of course once something gets reported like "only 15% of people who go on a ventilator will ultimately survive" that becomes the accepted truth. If a dozen later studies say it's a 50% survival rate they either won't get reported, or won't break through the noise.

This is not a criticism of anyone specifically, it's a cognitive bias we all deal with. It's why propaganda is so effective. If you keep repeating a lie people will eventually accept it as the truth. Whether that lie was intentionally created or just the result of lazy/bad reporting.

Thanks for the post.  And I agree about the biases and propaganda.  It's very difficult to find reality, and the reality itself changes as more is known.  Even with scientific studies, I think it's best to tread with skepticism:

https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124

Some scientific fields are most scientific than others, and I'm of the opinion once science gets tainted by politics and/or money it is corrupted beyond repair.

And that is excellent news about New Zealand.  Truly remarkable. 

JGS1980

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Re: How long can we wait while flattening the curve?
« Reply #674 on: April 17, 2020, 07:40:05 AM »
Its looking like we might have done it here in NZ. 4 weeks of Civil Obedience. Fairly tight lockdown largely complied with. New cases down to 8 today and all traceable to existing clusters I think. Our curve has collapsed.
And we are staying at this level of lockdown for at least a few more days with minimal protests.
There has been a lot of kindness and good humour, tempered with sadness at 11 deaths.
Thankfully we have a capable, sensible government and effective civil service.

Wow New Zealand, great for you! 11 deaths here is a drop in the bucket, unfortunately. For a population of nearly 5 million people, that is a great result.

Question, does NZ plan on having its borders closed to the rest of the world until this resolves?


aspiringnomad

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Re: How long can we wait while flattening the curve?
« Reply #675 on: April 17, 2020, 08:05:59 AM »
Its looking like we might have done it here in NZ. 4 weeks of Civil Obedience. Fairly tight lockdown largely complied with. New cases down to 8 today and all traceable to existing clusters I think. Our curve has collapsed.
And we are staying at this level of lockdown for at least a few more days with minimal protests.
There has been a lot of kindness and good humour, tempered with sadness at 11 deaths.
Thankfully we have a capable, sensible government and effective civil service.

Wow New Zealand, great for you! 11 deaths here is a drop in the bucket, unfortunately. For a population of nearly 5 million people, that is a great result.

Question, does NZ plan on having its borders closed to the rest of the world until this resolves?

It's a great question and one that I've been curious about as a NZ resident currently living in the US. Right now, tourists aren't allowed in and citizens and residents must quarantine for 14 days in government-provided hotels. Initially, I was thinking that if there's enough confidence in quick and reliable testing, they'll open up to tourists by their next summer season pending a negative test result at the departure airport.

But as important as tourism is to the NZ economy, I'm not so sure the country would be willing to risk a false negative especially if an effective vaccine is around the corner at that point. Post-vaccine they can just make the tourist visa dependent on vaccination. In the meantime, if Australia can also stamp out the virus which (fingers crossed) is looking promising, then they can share relatively open borders with each other while closing off tourism from the rest of the world.

nereo

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Re: How long can we wait while flattening the curve?
« Reply #676 on: April 17, 2020, 08:26:06 AM »
Its looking like we might have done it here in NZ. 4 weeks of Civil Obedience. Fairly tight lockdown largely complied with. New cases down to 8 today and all traceable to existing clusters I think. Our curve has collapsed.
And we are staying at this level of lockdown for at least a few more days with minimal protests.
There has been a lot of kindness and good humour, tempered with sadness at 11 deaths.
Thankfully we have a capable, sensible government and effective civil service.

Wow New Zealand, great for you! 11 deaths here is a drop in the bucket, unfortunately. For a population of nearly 5 million people, that is a great result.

Question, does NZ plan on having its borders closed to the rest of the world until this resolves?

It's a great question and one that I've been curious about as a NZ resident currently living in the US. Right now, tourists aren't allowed in and citizens and residents must quarantine for 14 days in government-provided hotels. Initially, I was thinking that if there's enough confidence in quick and reliable testing, they'll open up to tourists by their next summer season pending a negative test result at the departure airport.

But as important as tourism is to the NZ economy, I'm not so sure the country would be willing to risk a false negative especially if an effective vaccine is around the corner at that point. Post-vaccine they can just make the tourist visa dependent on vaccination. In the meantime, if Australia can also stamp out the virus which (fingers crossed) is looking promising, then they can share relatively open borders with each other while closing off tourism from the rest of the world.

A lot is riding on a vaccine being "just around the corner".  While there are several in early trial stages, its optimistic to think that any of these will be effective and readily-available by NZ's summer season in ~7 months.  Even great vaccines are not 100% effective, and we won't know the efficacy of a future vaccine until it's used on hundreds-of-thousands of patients which span the full range of age/sex/genetic makeup, and can follow those individuals for some time.

fattest_foot

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Re: How long can we wait while flattening the curve?
« Reply #677 on: April 17, 2020, 08:30:00 AM »
Wow New Zealand, great for you! 11 deaths here is a drop in the bucket, unfortunately. For a population of nearly 5 million people, that is a great result.

Question, does NZ plan on having its borders closed to the rest of the world until this resolves?

So it's cool for New Zealand, but everyone in the US should remain on lockdown indefinitely?

My county of almost 1 million has been sitting at 3 deaths for the last 2 weeks.

Like I said, remove NYC and this whole thing looks ridiculous. But call me an idiot and "science denier." This board has become an echo chamber.

mathlete

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Re: How long can we wait while flattening the curve?
« Reply #678 on: April 17, 2020, 08:45:05 AM »
Wow New Zealand, great for you! 11 deaths here is a drop in the bucket, unfortunately. For a population of nearly 5 million people, that is a great result.

Question, does NZ plan on having its borders closed to the rest of the world until this resolves?

So it's cool for New Zealand, but everyone in the US should remain on lockdown indefinitely?

My county of almost 1 million has been sitting at 3 deaths for the last 2 weeks.

Like I said, remove NYC and this whole thing looks ridiculous. But call me an idiot and "science denier." This board has become an echo chamber.

If you remove NYC, we've still doubled the total USA deaths from Swine Flu. Months ahead of schedule. With severe lockdown measures.

And consider the implications of, at the very least, not restricting travel. NYC got hit because it's a travel hub for passengers from Europe. Two large international hubs, Newark and JFK, are in the metro area. There's also a third, pretty large domestic hub in LaGuardia. 5 to 6 million people board flights at these airports every month to travel all over the US and internationally.

What does the rest of the country look like right now in a world where air travel hasn't fallen by 90%?

This is not me trying to call anyone an idiot. This is me knowing the facts and trying to hold the things others say to account.

aspiringnomad

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Re: How long can we wait while flattening the curve?
« Reply #679 on: April 17, 2020, 08:45:49 AM »
Its looking like we might have done it here in NZ. 4 weeks of Civil Obedience. Fairly tight lockdown largely complied with. New cases down to 8 today and all traceable to existing clusters I think. Our curve has collapsed.
And we are staying at this level of lockdown for at least a few more days with minimal protests.
There has been a lot of kindness and good humour, tempered with sadness at 11 deaths.
Thankfully we have a capable, sensible government and effective civil service.

Wow New Zealand, great for you! 11 deaths here is a drop in the bucket, unfortunately. For a population of nearly 5 million people, that is a great result.

Question, does NZ plan on having its borders closed to the rest of the world until this resolves?

It's a great question and one that I've been curious about as a NZ resident currently living in the US. Right now, tourists aren't allowed in and citizens and residents must quarantine for 14 days in government-provided hotels. Initially, I was thinking that if there's enough confidence in quick and reliable testing, they'll open up to tourists by their next summer season pending a negative test result at the departure airport.

But as important as tourism is to the NZ economy, I'm not so sure the country would be willing to risk a false negative especially if an effective vaccine is around the corner at that point. Post-vaccine they can just make the tourist visa dependent on vaccination. In the meantime, if Australia can also stamp out the virus which (fingers crossed) is looking promising, then they can share relatively open borders with each other while closing off tourism from the rest of the world.

A lot is riding on a vaccine being "just around the corner".  While there are several in early trial stages, its optimistic to think that any of these will be effective and readily-available by NZ's summer season in ~7 months.  Even great vaccines are not 100% effective, and we won't know the efficacy of a future vaccine until it's used on hundreds-of-thousands of patients which span the full range of age/sex/genetic makeup, and can follow those individuals for some time.

Yeah, the "around the corner" was intentionally vague but probably should have been more vague. I'm no expert, but I've read some promising information on the vaccine front. 100 plus candidates; at least a handful already showing promise; a couple already entering phase 2 clinical trials; nothing in the virus' genome to suggest that a vaccine will be impossible; governments, NGOs, and corporations readying funding and production in advance for many of those candidates in case they turn out to be effective. Either way, a vaccine won't save the economy in the short- or even medium-term, but this is one area of this pandemic where I've seen reason for longer-term optimism.

nereo

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Re: How long can we wait while flattening the curve?
« Reply #680 on: April 17, 2020, 08:47:38 AM »
Wow New Zealand, great for you! 11 deaths here is a drop in the bucket, unfortunately. For a population of nearly 5 million people, that is a great result.

Question, does NZ plan on having its borders closed to the rest of the world until this resolves?

So it's cool for New Zealand, but everyone in the US should remain on lockdown indefinitely?

My county of almost 1 million has been sitting at 3 deaths for the last 2 weeks.

Like I said, remove NYC and this whole thing looks ridiculous. But call me an idiot and "science denier." This board has become an echo chamber.

My state is seeing its number of cases and number of hospitalizations rise, even under lock-down.  There is substantial community spread, and we are severely constrained by testing; only those who exhibit symptoms or have had close contact for >10 minutes are even eligible to be testing right now.  The economic costs of reopening front-facing businesses - particularly without ample testing and tracking - would be far greater than what we are currently experiencing, nevermind the human and physcological cost.  That's both my opinion and that of our state government, as well as some recent economic assessment from our state university system.

The entire POINT of putting places under lockdown is to keep other cities from becoming another NYC.  With lots of community spread and a general lack of testing this is almost certain to happen shoudl everything open up.

ReadySetMillionaire

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Re: How long can we wait while flattening the curve?
« Reply #681 on: April 17, 2020, 08:49:19 AM »
Interesting article here from STAT, which is the most critical I've seen the scientific community of the IHME model:

https://www.statnews.com/2020/04/17/influential-covid-19-model-uses-flawed-methods-shouldnt-guide-policies-critics-say/

Jon Bon

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Re: How long can we wait while flattening the curve?
« Reply #682 on: April 17, 2020, 08:51:04 AM »
NYC reports cases and deaths by age bracket and sex on a daily basis:

https://www1.nyc.gov/site/doh/covid/covid-19-data.page#download

Using yesterday's data (because today's is a little odd since they started reporting deaths with probable diagnosis for the first time)

Code: [Select]
Age Cases Deaths CFR Pct of Deaths
0-17 2150 3 0.1% 0.0%
18-44 42127 309 0.7% 4.5%
45-64 40559 1,581 3.9% 23.1%
65-74 14025 1,683 12.0% 24.6%
75+ 12331 3,263 26.5% 47.7%

CFR is "case fatality rate" or just simply confirmed deaths over confirmed cases. Pct. of Deaths is the percentage of total deaths attributable to that age bracket.

Thanks for real data, much better then fear and uncertainty.

I read this as we should probably send a large number of our work force back to work as it looks like they will be mostly fine. According to the data it only kills folks if you are on social security anyways.

So the May 1st "soft opening" of the economy is probably about right.


mathlete

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Re: How long can we wait while flattening the curve?
« Reply #683 on: April 17, 2020, 08:55:20 AM »
Thanks for real data, much better then fear and uncertainty.

I read this as we should probably send a large number of our work force back to work as it looks like they will be mostly fine. According to the data it only kills folks if you are on social security anyways.

So the May 1st "soft opening" of the economy is probably about right.

Most people will be fine. The problem is they become dangerous disease vectors for every old or immunocompromised person they interact with. If we could, with surgical precision, only lock down the elderly, people with heart disease, type 1 or 2 diabetes, respiratory conditions, etc, that would be the move. That's probably not feasible though.

I don't think we need some big date for the whole country. I'd rather see cities and counties make decisions based on what they think is best while the Federal guild lines stay in place. Then we can collect data on what is and isn't safe.

dandarc

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Re: How long can we wait while flattening the curve?
« Reply #684 on: April 17, 2020, 08:57:41 AM »
That . . . is an overly optimistic conclusion I'd say @Jon Bon

Although I did make the joke somewhere a while back - "kills old people, young folks staying home so a small baby boom - demographic crisis solved!"

nereo

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Re: How long can we wait while flattening the curve?
« Reply #685 on: April 17, 2020, 08:58:05 AM »


I read this as we should probably send a large number of our work force back to work as it looks like they will be mostly fine. According to the data it only kills folks if you are on social security anyways.

So the May 1st "soft opening" of the economy is probably about right.

What the hell??  First, 27.6% of deaths are people under the typical age of SS (65), with almost 5% being young adults.  Second, how is that somehow ok?  Who do you think will be responsible for many of the infections of older individuals?

mathlete

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Re: How long can we wait while flattening the curve?
« Reply #686 on: April 17, 2020, 09:01:13 AM »
Interesting article here from STAT, which is the most critical I've seen the scientific community of the IHME model:

https://www.statnews.com/2020/04/17/influential-covid-19-model-uses-flawed-methods-shouldnt-guide-policies-critics-say/

Saw this this morning. I get the criticism on the basis that it apparently doesn't use traditional epidemiology methods. But that doesn't make it not useful IMO. I also totally do not understand this criticism:

"That the IHME model keeps changing is evidence of its lack of reliability as a predictive tool"

Models should change as they take in actual experience or new information. Steadfastly holding to earlier predictions is silly. Nate Silver's election models get this criticism all the time. Most recently, when his model swung strong towards Biden after Super Tuesday. But why shouldn't it have? If there was more time for polling between the SC primary and Super Tuesday, the model probably would have captured the swing earlier, but there wasn't.

It's the same thing here.

mathlete

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Re: How long can we wait while flattening the curve?
« Reply #687 on: April 17, 2020, 09:03:19 AM »


I read this as we should probably send a large number of our work force back to work as it looks like they will be mostly fine. According to the data it only kills folks if you are on social security anyways.

So the May 1st "soft opening" of the economy is probably about right.

What the hell??  First, 27.6% of deaths are people under the typical age of SS (65), with almost 5% being young adults.  Second, how is that somehow ok?  Who do you think will be responsible for many of the infections of older individuals?

Not included in my numbers were that most of the people under 65 who died had comorbidity with a preexisting condition or were immunocompromised.

But even so though, I don't think you can implement policy that surgically identifies these people and gets them  to stay home while the rest of the world keeps turning.

Jon Bon

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Re: How long can we wait while flattening the curve?
« Reply #688 on: April 17, 2020, 09:12:49 AM »


I read this as we should probably send a large number of our work force back to work as it looks like they will be mostly fine. According to the data it only kills folks if you are on social security anyways.

So the May 1st "soft opening" of the economy is probably about right.

What the hell??  First, 27.6% of deaths are people under the typical age of SS (65), with almost 5% being young adults.  Second, how is that somehow ok?  Who do you think will be responsible for many of the infections of older individuals?

2.8 million Americans die every year, and lots of them are old. Lots of them are sick with preexisting conditions.  Folks at high risk will continue to self isolate at various levels depending on the risk/reward trade off. If ever there is a time to quit smoking or lose some weight sounds like this might be the time.

Also last I checked its not up to me.


ReadySetMillionaire

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Re: How long can we wait while flattening the curve?
« Reply #689 on: April 17, 2020, 09:14:15 AM »


I read this as we should probably send a large number of our work force back to work as it looks like they will be mostly fine. According to the data it only kills folks if you are on social security anyways.

So the May 1st "soft opening" of the economy is probably about right.

What the hell??  First, 27.6% of deaths are people under the typical age of SS (65), with almost 5% being young adults.  Second, how is that somehow ok?  Who do you think will be responsible for many of the infections of older individuals?

I think the point is that while 27.6% of deaths seem high, people ages 0-64 make up roughly 84% of the United States population (source here -- https://www.kff.org/other/state-indicator/distribution-by-age/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D).

When 84% of the population is accounting for just 28% of the deaths, that is evidence that the disease dramatically affects the over 65 crowd to a far higher degree.

mathlete

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Re: How long can we wait while flattening the curve?
« Reply #690 on: April 17, 2020, 09:21:57 AM »
2.8 million Americans die every year, and lots of them are old. Lots of them are sick with preexisting conditions.  Folks at high risk will continue to self isolate at various levels depending on the risk/reward trade off. If ever there is a time to quit smoking or lose some weight sounds like this might be the time.

Also last I checked its not up to me.

Excess mortality is a big deal. We plan for 2.8 million people to die. And even so, it causes grief, anguish and lost productivity. There is value in trying to make sure we prevent preventable deaths. It's why warning labels and backup cameras exist.

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Re: How long can we wait while flattening the curve?
« Reply #691 on: April 17, 2020, 09:24:32 AM »


I read this as we should probably send a large number of our work force back to work as it looks like they will be mostly fine. According to the data it only kills folks if you are on social security anyways.

So the May 1st "soft opening" of the economy is probably about right.

what's your point, just that older people have a higher chance of dying from covid? Older people have a  higher chance of dying from flu and nearly every other disease too.

What the hell??  First, 27.6% of deaths are people under the typical age of SS (65), with almost 5% being young adults.  Second, how is that somehow ok?  Who do you think will be responsible for many of the infections of older individuals?

I think the point is that while 27.6% of deaths seem high, people ages 0-64 make up roughly 84% of the United States population (source here -- https://www.kff.org/other/state-indicator/distribution-by-age/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D).

When 84% of the population is accounting for just 28% of the deaths, that is evidence that the disease dramatically affects the over 65 crowd to a far higher degree.

nereo

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Re: How long can we wait while flattening the curve?
« Reply #692 on: April 17, 2020, 09:28:36 AM »


I read this as we should probably send a large number of our work force back to work as it looks like they will be mostly fine. According to the data it only kills folks if you are on social security anyways.

So the May 1st "soft opening" of the economy is probably about right.

What the hell??  First, 27.6% of deaths are people under the typical age of SS (65), with almost 5% being young adults.  Second, how is that somehow ok?  Who do you think will be responsible for many of the infections of older individuals?

2.8 million Americans die every year, and lots of them are old. Lots of them are sick with preexisting conditions.  Folks at high risk will continue to self isolate at various levels depending on the risk/reward trade off. If ever there is a time to quit smoking or lose some weight sounds like this might be the time.

Also last I checked its not up to me.

Are you seriously assuming that people will act appropriately to their own risk tolerance (while mentioning smoking and drinking in the very next sentence)??  People (and in particular young people) are spectacularly bad at assessing risk, both to themselves and particularly to others.  That's why we require vaccinations, have speed limits and restrict sales of drugs and alcohol.  Or that individuals won't go to work if they feel sick (which we as a society are already very, very bad at doing)?

This isn't primarily about an individuals' risk to himself/herself.  It's the risk to the community.  If the risk was only to the individual I might agree with you, which is why I don't particularly care if some idiot wants to ride a motorcycle with no helmet.  But these infected indivuals with mild or no symptoms will just go around spreading the virus and ultimately kill a bunch of other people, and wreak economic havoc in their wake. 

Jon Bon

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Re: How long can we wait while flattening the curve?
« Reply #693 on: April 17, 2020, 09:43:16 AM »
People weigh risk every single day, it's why I wear my seatbelt.

I agree that we love to work while sick, but with this new information it likely effects our decision making.  Again with new information about smoking and obesity it might cause people to rethink the risk of being a fat smoker.

Lastly I am literally parroting what the politicians are saying which is a soft opening around May 1st.  Maybe I think I can make my own decisions, and don't need the authorities to tell me what to do. I am responsible for my own health, in the end I can only control what I do.





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Re: How long can we wait while flattening the curve?
« Reply #694 on: April 17, 2020, 09:49:16 AM »
I am responsible for my own health, in the end I can only control what I do.

With a highly communicable disease, you are also responsible for the health of all those around you too.

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Re: How long can we wait while flattening the curve?
« Reply #695 on: April 17, 2020, 10:02:32 AM »
Quote
Thanks for real data, much better then fear and uncertainty.

I read this as we should probably send a large number of our work force back to work as it looks like they will be mostly fine. According to the data it only kills folks if you are on social security anyways.

So the May 1st "soft opening" of the economy is probably about right.
Wow, 4% death rate for my age group doesn't give me the warm and fuzzies.  Only hits social security?  Tell that to the widows with small children who have lost their 50 year old husbands. etc.

mathlete

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Re: How long can we wait while flattening the curve?
« Reply #696 on: April 17, 2020, 10:14:02 AM »
Something people should be aware of is that case fatality rates aren't indicative of ultimate mortality since cases are probably under reported. Contemporary research suggests that actual mortality may be below 1.0% (still skewing heavily towards the elderly and immunocompromised).

This does not however, mean that COVID19 shouldn't be taken seriously. Daily deaths attributed to COVID19 are currently higher than heart disease; America's number one killer. There's still a lot of comorbidity to sift through, but we don't go from zero to 30,000 deaths in a little over a month for something that is no big deal.

The lock down is probably responsible for helping severely curb the spread in Texas and California. The two most populous states. If people were dying there like they are dying in Louisiana, total deaths would be 50% higher right now. What we are doing is working. Even in places that people claim aren't locking down like Sweden, universities have closed and people are being ask to work from home. It's also worth mentioning that Sweden's per capita deaths are currently above the US's. And even places reacting less harshly see benefits from their neighbors doing stricter lock downs. The entire United States, and probably the entire world, benefits from the fact that New York City is boarding 90% less passengers right now.

Maybe Sweden has the optimal approach though. I don't know. But even the countries that are "doing nothing" like Sweden are in fact, doing something and taking this very seriously. Nearly every country on the planet, as advised by their medical experts and economists, is taking this seriously.

If you think you've out thought the room on this, you're probably wrong.
« Last Edit: April 17, 2020, 10:16:34 AM by mathlete »

YttriumNitrate

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Re: How long can we wait while flattening the curve?
« Reply #697 on: April 17, 2020, 10:16:55 AM »
I read this as we should probably send a large number of our work force back to work as it looks like they will be mostly fine. According to the data it only kills folks if you are on social security anyways.
So the May 1st "soft opening" of the economy is probably about right.
What the hell??  First, 27.6% of deaths are people under the typical age of SS (65), with almost 5% being young adults.  Second, how is that somehow ok?  Who do you think will be responsible for many of the infections of older individuals?

Don't forget that social security covers more than just those over 65. I don't think it would be a far stretch to expect the mortality rate of those on Social Security disability to be significantly higher than the average for their age group.

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #698 on: April 17, 2020, 10:42:48 AM »
Regarding the excess mortality amount, is there data that shows the excess mortality the last month vs. what it typically is during the same months a year or two ago? 

mathlete

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Re: How long can we wait while flattening the curve?
« Reply #699 on: April 17, 2020, 10:57:03 AM »
Regarding the excess mortality amount, is there data that shows the excess mortality the last month vs. what it typically is during the same months a year or two ago?

Not that I'm aware of. The CDC does research on an annual basis, but there's no central repository for this kind of thing.

Life insurers will start reporting quarterly earnings soon. I plan to read their reports and see what they say. It's possible we may even see mortality decline. Things like accidents and gun violence kill a lot of people. Tens of thousands per month. March 2020 was famously the first March in 18 years without a school shooting. If people aren't out there shooting each other, driving dangerously, and being over served at bars and making bad choices in public, the potential for accidental deaths may go down.

And the lock down could also curb the spread of non COVID communicable diseases too. We probably won't have satisfactory answers for at least a year though.