Peregrine

NYC's positivity rate: Hardly signs of a second wave.

One thing we've learned about antibodies is that many who had mild symptoms or were completely asymptomatic didn't develop detectable antibodies and that antibodies wane over time. I think NYC's 20-25% seropositivity level is most likely an underestimate of the true number of infected - and possibly by a lot.

i think this is misinformation and perhaps disinformation. https://www.scientificamerican.com/article/how-covid-19-deaths-are-counted1/ https://www.cdc.gov/nchs/covid19/coding-and-reporting.htm Given the evolving evidence (balancing reasons that could lead to over- and under- reporting) and excess mortality inputs, at this point, some underestimation of reported deaths is likely. Disinformation from a public health source? Here's the excess mortality graph provided by the CDC: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm Saw a peak in early April that has since subsided. For the last week, it has fallen below the trend line. Agree that there's probably an undercount, but there's also a general acceptance that deaths from cold and other influenza-like illnesses are undercounted as well. Plus, how do we separate that from the increase in deaths that we've seen as a result of lockdown (people delaying treatments and not going to the hospital when they should, deferment of elective procedures, overdoses, suicides, etc) How do we understand the true lethality of this virus when there's this level of ambiguity? Btw, it doesn't look like it's just Toronto either - seems like the standard practice is to list all deaths for which the deceased tested positive as a COVID death. Here's Illinois's Department of Public Health explaining how they count: "Technically, if you died of a clear alternate cause, but you had COVID-19 at the same time - it's still listed as a COVID death," Dr. Ezike answered. "Everyone who's listed as a COVID death doesn't mean that was the cause of death, but they had COVID at the time." https://www.wandtv.com/news/why-and-how-covid-19-deaths-are-tracked-in-illinois/article_2085ddaa-93e8-11ea-b1c2-7fd058d907cf.html

Toronto’s public health department basically outright said that any death is marked as a COVID death as long as the person tested positive for COVID. So if you died in a car accident yet tested positive for COVID that’s still counted in the death count? How can anyone trust the numbers anymore?

Jumping in once again (dammit!) with a good report explaining Japan's conspicuously low death rate: https://www.bbc.com/news/world-asia-53188847 Gist of the story: -the Japanese (and many places in Asia for that matter) may already have strong cross immunity due to exposure to other coronaviruses -a culture of cleanliness and mask-wearing -generally healthier population with less comorbidities among the elderly -focus on hot spots of spread and encouraging to avoid them I don't think test and trace had much to do with it at all given that Japan has among the lowest testing rates of any other OECD country.

Lol at how dumb the conversations in this thread have gotten. Gonna step away from this thread for my own sanity.

Sorry, I didn't mean that it is solely attributable to bars. But we know from South Korea, Japan, and Austria that bars are extremely risky. I'm just using that as an example of poor budgeting. Protests are relatively lower risk. But more importantly, they are non-discretionary. "Law and Order" and curfews and police crack-downs didn't make the protests go away. Police reform is a long-term problem. So you just need to accept that you will need to slow re-opening to the extent protests create outbreaks. Agreed that outdoor transmission is relatively less risky. But these protests were taking place over whole days and weeks on end and involved hundreds of thousands of people often standing shoulder to shoulder and shouting. Now I do think masks help mitigate this spread but not all were wearing masks and those who were were likely not keeping them on the whole time. Not against protests at all or making political statements; in fact, I think that they're useful in analyzing what's happened with the virus's spread.

It is true that 30,000 cases today is not the same as 30,000 cases in April. But, the "just doing more testing" is wrong and is essentially a cover-up. Ontario is testing at roughly the same per-capita rate as Florida. And as I posted up-thread, there is actually an inverse correlation between testing in Ontario and cases. I agree that we aren't at a "gloom and doom" phase. But Texas needed to cancel elective hospital procedures because they reopened bars. This seems like a poor use of your "Rt budget". Don't think that you can attribute solely reopened bars for the increased spread. I think the widespread protests that has been occurring for a month now likely created plenty of vectors for spread. That some places are now seeing outbreaks shouldn't come as a surprise. What is a bit surprising is that NYC, by far the hardest hit city in the US, keeps seeing declines. Both are culprits but to different degrees. Bars are inside an enclosed place exposure, protests (and beaches and parks) are outside in open space exposure. This has dramatic impact on viral load and consequent spread and severity. Doesn’t explain why places with biggest protests are fine tho does it ?? FYI lots of protests happened in big EU cities too a few weeks ago after they saw what happened to Floyd. I think the most likely factor here is that the cities that saw very low levels of spread earlier on are now seeing more. That places like NYC and London continue to see declines in positivity rate despite widespread protests signals that the level of immunity in the population is an important factor. Nope, antibody positive rate in NYC is only about 15-20%. Also many EU cities had big Floyd protests and did not have spread like NYC previously. Try again. No one knows yet what’s the level of immunity required to see R0 sustainably below 1. There may well be large segments of the population who aren’t susceptible at all. Moreover, our immune systems are a lot more Complicated than just antibodies.

It is true that 30,000 cases today is not the same as 30,000 cases in April. But, the "just doing more testing" is wrong and is essentially a cover-up. Ontario is testing at roughly the same per-capita rate as Florida. And as I posted up-thread, there is actually an inverse correlation between testing in Ontario and cases. I agree that we aren't at a "gloom and doom" phase. But Texas needed to cancel elective hospital procedures because they reopened bars. This seems like a poor use of your "Rt budget". Don't think that you can attribute solely reopened bars for the increased spread. I think the widespread protests that has been occurring for a month now likely created plenty of vectors for spread. That some places are now seeing outbreaks shouldn't come as a surprise. What is a bit surprising is that NYC, by far the hardest hit city in the US, keeps seeing declines. Nice attempt to spin the narrative to protestors. Last I checked, largest protests were in MN, NYC, DC which are not seeing the spikes. Instead it’s AZ, TX, FL. This is really not that complicated. The physics of droplet spread outdoors with protestors wearing masks is not a significant source of spread. Oh I forgot we like economic tools like regressions on here instead of physics. Sorry to burst your political narrative. Deflect from the guy in charge who runs indoor, maskless rallies in AZ and OK in just the past week. Lol what? I never once said that reopened bars don’t increase risk of spread but thanks for putting words in my mouth. Btw, Southern California is also seeing rise in positivity rate despite bars being closed. I find it hard to attribute “blue state” policy to declining infections when that relationship is fairly shaky.

It is true that 30,000 cases today is not the same as 30,000 cases in April. But, the "just doing more testing" is wrong and is essentially a cover-up. Ontario is testing at roughly the same per-capita rate as Florida. And as I posted up-thread, there is actually an inverse correlation between testing in Ontario and cases. I agree that we aren't at a "gloom and doom" phase. But Texas needed to cancel elective hospital procedures because they reopened bars. This seems like a poor use of your "Rt budget". Don't think that you can attribute solely reopened bars for the increased spread. I think the widespread protests that has been occurring for a month now likely created plenty of vectors for spread. That some places are now seeing outbreaks shouldn't come as a surprise. What is a bit surprising is that NYC, by far the hardest hit city in the US, keeps seeing declines. Both are culprits but to different degrees. Bars are inside an enclosed place exposure, protests (and beaches and parks) are outside in open space exposure. This has dramatic impact on viral load and consequent spread and severity. Doesn’t explain why places with biggest protests are fine tho does it ?? FYI lots of protests happened in big EU cities too a few weeks ago after they saw what happened to Floyd. I think the most likely factor here is that the cities that saw very low levels of spread earlier on are now seeing more. That places like NYC and London continue to see declines in positivity rate despite widespread protests signals that the level of immunity in the population is an important factor.

It is true that 30,000 cases today is not the same as 30,000 cases in April. But, the "just doing more testing" is wrong and is essentially a cover-up. Ontario is testing at roughly the same per-capita rate as Florida. And as I posted up-thread, there is actually an inverse correlation between testing in Ontario and cases. I agree that we aren't at a "gloom and doom" phase. But Texas needed to cancel elective hospital procedures because they reopened bars. This seems like a poor use of your "Rt budget". Don't think that you can attribute solely reopened bars for the increased spread. I think the widespread protests that has been occurring for a month now likely created plenty of vectors for spread. That some places are now seeing outbreaks shouldn't come as a surprise. What is a bit surprising is that NYC, by far the hardest hit city in the US, keeps seeing declines.

This is a good short read on this question - https://www.nature.com/articles/s41564-020-0690-4.pdf?proof=true1 Thanks. I've found this as well: https://www.webmd.com/lung/news/20200603/claims-of-a-weaker-covid-19-virus-disputed In addition to a far better understanding of the virus and better treatment, there is a belief from Italian doctors on the ground that the virus's severity is declining: "In response to the WHO’s rebuttal of his claims, Bassetti says, “The WHO does not take care of patients. They are seated at a table in Geneva. These are the impressions of the majority of doctors on the ground. We have admitted more than 500 [COVID-19] patients at San Martino hospital since the beginning of the epidemic, and I have seen a dramatic reduction in the severity of the disease.”

Here's a question: is it common for viruses to become less virulent over time? I've read that virus mutations do tend to make them less deadly, that in a Darwinian way lower virulence ensures that they are better able to replicate. But haven't seen any data on that so wondering if anyone else has come across anything.

The way that NYC's hospitalization and positivity rates have fallen so steeply (despite weeks of mass protests beginning a month ago) looks a lot like that of other hard hit cities like Lombardy and London. With time I'm leaning more and more to the view that this virus is extremely aggressive in attacking the susceptible population quickly, upon which it fairly quickly subsides as it finds far fewer susceptible bodies to enter. This might also explain why the younger population have had far lower infection rates in comparison, despite being far more socially interactive than older folks. Seems clear that there are other aspects of the immune system at play other than just antibodies.

Perhaps ... https://pbs.twimg.com/media/EbTNx76UwAA6mZV?format=jpg&name=900x900 It is very curious that U.S. is the only country showing these dynamics. Canada, as an example, has increased testing but decreased cases and hospitalizations despite reopening. And our cases are also skewing younger. And it is very strange how the sunbelt was largely spared in March but seems on the edge of a major outbreak now. So weird. There's so much we don't know about this virus so assuming the worst experiences and extrapolating that everywhere else is probably faulty. If anything, the hardest hit places look like the outliers.

What's been shown in the past is that beds and ICUs are fairly easy to create more of - it's healthcare staff that's the binding constraint. Anyway, hospital bed utilization for the whole of Harris County (which Houston is a part of) is currently at 82%, which is within normal ranges of 80-85%. Seems like ICU utilization is particularly high at one specific hospital, Houston Medical Center. Don't think this is as dire as it has been made out to be.

The risk seems to be non-linear with age, so the absence of <20 year olds would cause less skew than the absence of >60 year olds. But the health comment is a fair point. Also, 3 deaths is not enough to draw meaningful conclusions. Yes, it's hard to say. Basically, the share of deaths of the under-18 cohort in the US rounded to the nearest whole percentage point is 0 while the share of deaths of the over-65 cohort is over 90%.

I haven't seen this study, but the obvious drawback is that prisons (aircraft carriers, cruise ships, etc) aren't representative populations. I'm not sure about the stats in that prison, but in Canada the majority of prisoners are young (20-40) males. So a CFR of 0.23% in that population would be consistent with a much higher IFR in the wider population. Did Ionnidis attempt to make this adjustment? Naively, I'd think that data would support an age-adjusted IFR closer to 1%. I'd also be reluctant to compare death rates between countries. According to CIA World Factbook, the U.S. has twice the obesity rate of Italy. In the U.S., I'd also be worried about the disparity in health care coverage. IFR is also not static. It depends on how stretched health care capacity is and the quality of treatment (which is evolving quickly). There's a tighter age distribution in prisons compared to the general population, i.e. less really young people and less really old people. So perhaps the lesser representation on both age extremes balances itself out somewhat. But by no means can the prison population be considered "healthy" - they have far lower life expectancies than the general population and most come with multiple comorbidities. They're also not receiving the same level of health care. On the subject of IFR, I think it's clear that early estimates for this virus's IFR was heavily sampled against severe cases that over-represented the older population. That positivity rates have been rising over the past few weeks in select states yet death rates continue to decline provides further evidence that the IFR across the entire population is likely well lower than 1%.

https://www.japantimes.co.jp/news/2020/06/19/national/japan-contact-tracing-app-launched/#.Xu-DNndFwls That app was launched just recently and as far as I'm aware, Japan hasn't done individual contact tracing like South Korea has. I'd be all for it if an app gets developed, is useful and can be scaled up well.

I think you need to add contact tracing too. Largely, the places that have done well have done that. That too, though I question the practicality of it in western countries. Japan hasn't done contract tracing yet they've done just two simple things: wash your hands thoroughly and wear masks in crowded indoor settings. I find that example a lot easier for countries to replicate.

What’s funny is that you fail to see that the convergence is only happening in places that failed to control this early on. S Korea, Japan, much of EU and even Italy and Spain now are doing well due to less new cases thanks to aggressive lockdowns and measures nationwide. The countries that are “converging” to your (brutal) strategy of essentially herd immunity are the ones that failed to control this when they had a chance thanks to laissez faire attitude—USA, Sweden, etc. And let me tell you—even without lockdown, and with “isolating the elderly”, many will perish and the economy will suffer for very long time with this strategy. Equivalent to the Grandma Rule: eating your carrots before you move onto dessert, USA didn’t eat its carrots so there will be no dessert. There are places in USA that did strap down like NY and NJ and so their new cases have plummeted, but that effort may now be in vain due to a surge in southern states. Other countries, particularly in EU will be able to move one from here because they ate their carrots. They will be in dessert phase while US muddies along with “seniors isolated” and months, maybe years of reduced economic output while you try to achieve that herd immunity... Thanks to pretty much no central (federal) leadership, USA will now learn what happens when you go from pandemic to endemic... Maybe you misinterpreted my post. The consensus method of mitigating the spread of this disease seems to be converging on 1) protecting the old and vulnerable; and 2) encouraging social norms of being more careful about personal hygiene (including mask wearing) and social distancing. Never once did I mention herd immunity. South Korea and Japan never locked down. Japan has the lowest deaths per capita of any OECD country and this with nearly the oldest population in the world and some of the densest cities in the world.

It's funny that after all this time, the conventional idea of how to mitigate this is converging on the original one: protect the old and vulnerable and everyone else be careful.

The fake "wokeness" that has so embedded western culture has become unbearable. Everyone is righteous and everyone is sanctimonious and anyone who disagrees or even questions is evil and demonized.

I'm guessing even 100%. Japan has virtually been unaffected despite having one of the oldest populations in the world and some of the densest cities in the world. Tokyo's subways remain as crammed as ever and yet few COVID deaths - think it has to be tied to widespread mask use in crowded indoor settings.

The Medallion fund doesn't do equities I believe and has been deliberately kept small to keep the high returns going. Their marketed funds have not been as successful due to size and different asset classes that they're involved in. Not true, Medallion does whatever Medallion wants to do. I'm sure most of it is equities. And "small" is $5b+ year in the fund returning 40-50% year after year, if not greater. Yes, they return all the excess capital annually, but that's still a lot of capital for those kind of returns. Amazing. I recall from reading the new book written on Jim Simon that Medallion's bread and butter was not equities; in fact, they had historically struggled to build profitable models on equities. A reason why Medallion pays out so much is that they've found it comparably difficult to reliably generate returns by trading new asset classes.