Peregrine

I think that you're misinterpreting what I mean. I do think that it's a possibility that COVID is seasonal, although there are arguments against just how seasonal it is. There is evidence within states that counties that were hit hard in the spring have thus far been spared while neighboring counties have seen spikes (see Blaine, Idaho and the New Orleans parishes in Louisiana - both were hit hard in the spring but have not seen spikes since even as the rest of the state has). Why are you so insistent on getting a definitive statement? So that perhaps it can be used as a "gotcha" in the future? I don't feel that's constructive nor do I feel it's constructive to gloat if a prediction does come to pass. It is foolish to make definitive statements about the future. I lean toward the idea that endemicity is a lot closer in the hardest hit areas thus explaining their recent benign experience but I'm not so closed-minded to not think that future waves are out of the realm of possibility in those areas as well. The fact that so many refuse to even acknowledge either possibility makes a balanced discussion difficult.

I didn't realize you could see the future! With such a gift, can you confirm if there will be a "third wave" as we emerge flu season, or if COVID has run its course? Please, be definitive. Nothing is definitive. But we can draw inferences from the data that we see and from what we know about past epidemics. I don't think it's useful to draw causation when there's ample direct evidence refuting it and a more sensible answer is apparent. Another thing: we don't have the luxury of waiting until we know things for certain. Policy-making is never done with a crystal ball. The stakes today are never higher because of the immense trade-offs that society has seemingly willfully accepted as a necessary evil to apply the consensus-favored policy of today.

AKA "herd immunity" 1. Arizona never had a state wide mask mandate. 2. A lot of the restrictions were soft, not well-enforced and unlikely to have had significant effect in reducing interaction. Google mobility data in the state was fairly consistent over the summer and in some counties are now even above 2019 baseline levels. I mean, forget Arizona - look at what's happened in Florida. Even less mitigation and their hospitalizations are down nearly 80% from peak levels. I don't understand why people refuse to acknowledge the basic pattern of how epidemics unfold and eventually recede. Why don't we just call it endemicity threshold (ET) rather than herd immunity threshold? Since HIT has become so toxic and politicized.

Yes, we do call that an epidemic. We have seasonal flu epidemics every single year. CDC defines the threshold for an epidemic as 7.2% of total deaths, so no we don't get flu epidemics every year. But yes, some years the flu can get quite bad.

Hmm. It's almost like the "immunity" in herd immunity means something... Exactly. Which is why the herd immunity term in the general lexicon has become a complete misnomer. This virus will be around long after a vaccine is widely available but at some point (and a lot sooner than many think), it will no longer be an epidemic. Instead, it will become endemic in the population just like all the other respiratory viruses that circulate regularly. This is how previous pandemics ended - viral infections were never eliminated.

Oh, this is ironic. If Rt is perpetually below 1, that means perpetual decline in the number of infections with the end state being 0. This has never happened with respiratory viruses. The Spanish flu (H1N1) still circulates today as do the thousands of other coronaviruses and influenza.

The literal definition of HIT is Rt<1. No it isn't. Rt for the seasonal flu can be above 1 during the winter but do we still call that an epidemic? For Rt to be perpetually below 1 would mean the elimination of the disease, for which is not possible. I don't think you understand the implications of this math all that well.

Doubt Cuomo will allow a full second wave. But increasing positivity and Rt > 1 despite heavy restrictions are clear indicators that herd immunity threshold hasn’t been reached. Edit to add: schools and restaurants haven’t even been open a full incubation period, so too early to detect a second wave. There's a big misconception about what the herd immunity threshold even is. For many, it seems to mean the point at which 1) the virus disappears or 2) that the virus no longer spreads. But that's not possible given the thousands of different respiratory viruses that circulate normally. Rather, the herd immunity threshold is better described as the point in which the virus crosses over from epidemic to endemic. Under that definition, HIT being reached and Rt>1 is not incompatible. The virus will still be around long after the epidemic has ended. So it's because of Cuomo's excellent leadership that a second wave will be avoided? Florida's rt has been estimated as below 1 since late June, even below that of NY's...by your thinking, was it DeSantis's doing as well?

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%.