Investor20

Liberty, I am not sure what sounds bad. In this times while the world is shut down, a test that takes $200K, a professor from Stanford had to take 5000$ to do the test which everyone agrees needs to be done? They didn't have any funds from the 2 trillion dollars to do the study? The plan was to keep making decisions without knowing the real extent of spread and who is getting how much? That is what sounds bad. Many studies (and I posted recently on this) confirmed Stanford result. The studies confirmed the Stanford study results, that there are lot of asymptomatic carriers and the infection fatality rate is much lower than thought before. The buzzfeed is an attack article because it fails to mention I believe a dozen more studies done since then by different teams across world, many of them are reputed hospitals or professors. Buzzfeed "forgets" to mention this and goes on attacking a scientist for doing his job which frankly, the task force should have done long back. We are really going back to Galileos times attacking the scientist rather than looking at the result and its confirmation in multiple studies and its consequences of this new information. This attitude of Buzzfeed can take us to medieval ages and it is really shameful article. I respectfully disagree. Maybe there are more perspectives to this. For starters, the people doing the study had very publicly stated what they were looking for find. Confirmation bias did the rest. A lot of flaws are valid. First, funding from anyone is ok. What's not ok is the funder first going through various indirect channels to fund the study, and then directly being in touch with those conducting the study and even their collaborators trying to push things along. Second, not entirely the scientists fault but something that changes interpretation, is how participants were selected and who would opt in. There is an inherent bias in who will want to show up to get a blood test in the middle of a pandemic shelter in place order. Those who may have had mild symptoms or someone sick in their family and want to know if they had SAR CoV-2 are more likely especially given the way participants were recruited by email here, rather than random sampling. Third, if the test was showing a lot of false positives, this means the true %positive likely is lower than what they suggest. Lastly, look at who the lead investigator is, someone I and many others revered before reading this article. Only the highest standards are expected from someone like this. It would be standard in the industry to carefully do the basics I'm noting, make sure the test is valid, randomly sample the population etc. This is why collaborators are sour. And while we're at it, let's throw in going all over town to talk about the results before properly peer reviewing them. Seems par for the course nowadays. As they say, it takes a lifetime to build a reputation, but 15 minutes to destroy it. The Buzzfeed article says the money was given to a fund in Stanford which in turn was given to the investigators. It was a pool of money. The allegation is Newman gave 5000$ and Stanford professors put their reputation at stake for 5000$. On the surface of this, it looks ridiculous. From Buzzfeed article "Neeleman confirmed that he made a $5,000 donation to Stanford to be given to these researchers " Your second allegation is that the authors had pre-disposed idea about the result. Any scientist has a hypothesis and they test it by an experiment. That is the way they design an experiment. An experiment is to test a hypothesis. Scientists just dont go around doing random experiments hoping to find something. This is respectfully quiet a weird accusation because that is the way every scientist works. For example, when a vaccine is tested, they design to see if the vaccine works. But of course they hope it succeeds. Otherwise, why would they even test it? And they would test something that they hope succeeds. Not every random thing is tested to see if it works against Covid infection. Lastly, no one depends on one test. So irrespective of John Ioannidis did or did not design the test well is not as important as you and these allegations are making it out to be. The real test if an experiment result is correct is if it is replicated by other teams and other data collected by alternate methods. I have posted in this thread several antibody tests since done (Eg. Denmark, Miami-dade county, NY state). All of them came to same conclusion. The number of infected is at least a magnitude (10 fold) higher than the official confirmed cases. When the denominator is 10 fold (or even more), the Infection fatality rate would be 10 fold+ smaller. I also posted several other data such as prison data where they found when randomly tested (as opposed to general practice of testing symptomatic patients), a lot of asymptomatic carriers are found. So, without quibbling about the exact design, the fundamental finding that the infected are at least 10 fold higher than confirmed cases is established IMO. So, I do not understand what is that the complaint is about when multiple antibody tests and random PCR tests gave the same result. To add one more data point. There was a large outbreak in Tennesse prisons. So, mass testing was done. One of the major out break is at Trousdale Turner Correctional facility. They had second death out of 1300 infected with 98% asymptomatic. That gives 0.15% fatality rate. The 2% symptomatic gives 50 fold higher total infected, not just 10 fold. https://www.newschannel5.com/news/more-than-1k-at-trousdale-turner-correctional-center-test-positive-for-covid-19 More than 1,300 individuals at Trousdale Turner Correctional Center have tested positive for COVID-19. analysis of the test results confirmed that 98% of those who tested positive are asymptomatic. https://www.wsmv.com/2-deaths-reported-at-trousdale-turner-corrections-center/article_0a9df156-9480-11ea-b9f7-1bf51c57343a.html The Tennessee Department of Correction is reporting a second inmate who tested positive for COVID-19 at Trousdale Turner Correctional Center in Hartsville has died. I will also refer to posting number 5426 in this thread where I posted Ohio prisons for old and sick (a nursing home of prisons) had 1.4% fatality rate. If you read John Ioannidis or his collaborator Dr. Jay Bhattacharya, they expected a high asymptomatic cases NOT from ideology as you are making it out but because of data from Cruise ships, Iceland, Repatriated from China in US airports, small Italy town, where most of the people (not just symptomatic) were tested. Like the prison data above, they calculated a high level of asymptomatic carriers and hence expected the same in the antibody test. So, overall I am not clear what the worry is. Dr. John Ioannidis said there are lot of asymptomatic carriers (at least 10 fold higher than confirmed cases), and every other test is giving the same and that is the gold standard of testing a study. If you dont like Dr. John Ioannidis study, ignore it. But the result won't change.

I am not sure which prison data you are referring to. Here are some samples https://www.inquirer.com/news/coronavirus-testing-montgomery-county-jail-asymptomatic-philadelphia-prisons-20200428.html Montgomery County’s jail tested every inmate for COVID-19 — and found 30 times more cases than previously known "171 of those positive inmates exhibited no symptoms at the time their tests were administered." They had 177 test positive of which 171 asympatomatic again confirming Stanford study that there are many asymptomatic cases. Its just that all countries test only with symptoms that we have high CFR. https://www.usatoday.com/story/news/politics/2020/04/25/coronavirus-testing-prisons-reveals-hidden-asymptomatic-infections/3003307001/ Mass virus testing in state prisons reveals hidden asymptomatic infections; feds join effort More than 90% of the newly diagnosed inmates displayed no symptoms, https://www.axios.com/coronavirus-prisons-asymptomatic-8daaaa08-b53e-4368-adb7-88b7d93efece.html 96% of nearly 3,300 inmates with coronavirus were asymptomatic, survey shows https://www.reuters.com/article/us-health-coronavirus-prisons-testing-in/in-four-u-s-state-prisons-nearly-3300-inmates-test-positive-for-coronavirus-96-without-symptoms-idUSKCN2270RX Of the 2,028 who tested positive, close to 95% had no symptoms. I can go on...but the primary conclusion of Stanford study that when we are calculating case fatality rate after testing mostly symptomatic suspected patients, we are missing a lot of asymptomatic infected carriers which would give much smaller IFR. The WHO said 3.5% CFR with low asymptomatic rate which would make 3.5% IFR. WHO still says there are very few asymptomatic covid infected and never updated the 3.5% CFR. So, the prison data infact does support Stanford findings. I am referring to Ohio prison data. Pundits mention that 95% were asymptotic (which means exactly what with prisoners), but they still have around a 1% fatality rate. So ~20% of the symptomic prisoners died. I am not sure which prison you are mentioning. https://www.news5cleveland.com/news/continuing-coverage/coronavirus/nearly-80-of-inmates-have-covid-19-at-two-ohio-prisons At Marion Correctional Institution, 2,011 inmates of about 2,500 at the facility have tested positive for COVID-19, two of whom have died, as of Wednesday. At Pickaway Correctional Institution, 1,555 inmates of roughly 2,000 inside are infected. Ten inmates have died from COVID-19, as of Tuesday The two prisons house inmates at higher risk to complications from COVID-19, the respiratory disease caused by the new coronavirus. A state prisons spokeswoman said Wednesday that Marion houses “a high number” of older individuals, many of whom have pre-existing health conditions. Pickaway houses the prisons’ long term care center, similar to a nursing home. So lets say they are both worst case scenarios for prisons. Total 12 died out of 3566 (2011 at Marion + 1555 at Pickaway) gives 0.3%. These are two correctional facilities in Ohio of older people with pre-existing conditions. Updating with recent deaths at Marion and Pickaway: https://www.daily-jeff.com/news/20200516/lawsuit-seeks-release-of-15000-plus-ohio-inmates-amid-coronavirus-outbreak including 14 at Marion and 35 at Pickaway, which houses the prison equivalent of a nursing home for chronically ill and older inmates. Taking (14+35)/3566 gives 1.4% for prison inmates "equivalent of a nursing home for chronically ill and older inmates" in Ohio.

I am not sure which prison data you are referring to. Here are some samples https://www.inquirer.com/news/coronavirus-testing-montgomery-county-jail-asymptomatic-philadelphia-prisons-20200428.html Montgomery County’s jail tested every inmate for COVID-19 — and found 30 times more cases than previously known "171 of those positive inmates exhibited no symptoms at the time their tests were administered." They had 177 test positive of which 171 asympatomatic again confirming Stanford study that there are many asymptomatic cases. Its just that all countries test only with symptoms that we have high CFR. https://www.usatoday.com/story/news/politics/2020/04/25/coronavirus-testing-prisons-reveals-hidden-asymptomatic-infections/3003307001/ Mass virus testing in state prisons reveals hidden asymptomatic infections; feds join effort More than 90% of the newly diagnosed inmates displayed no symptoms, https://www.axios.com/coronavirus-prisons-asymptomatic-8daaaa08-b53e-4368-adb7-88b7d93efece.html 96% of nearly 3,300 inmates with coronavirus were asymptomatic, survey shows https://www.reuters.com/article/us-health-coronavirus-prisons-testing-in/in-four-u-s-state-prisons-nearly-3300-inmates-test-positive-for-coronavirus-96-without-symptoms-idUSKCN2270RX Of the 2,028 who tested positive, close to 95% had no symptoms. I can go on...but the primary conclusion of Stanford study that when we are calculating case fatality rate after testing mostly symptomatic suspected patients, we are missing a lot of asymptomatic infected carriers which would give much smaller IFR. The WHO said 3.5% CFR with low asymptomatic rate which would make 3.5% IFR. WHO still says there are very few asymptomatic covid infected and never updated the 3.5% CFR. So, the prison data infact does support Stanford findings. I am referring to Ohio prison data. Pundits mention that 95% were asymptotic (which means exactly what with prisoners), but they still have around a 1% fatality rate. So ~20% of the symptomic prisoners died. I am not sure which prison you are mentioning. https://www.news5cleveland.com/news/continuing-coverage/coronavirus/nearly-80-of-inmates-have-covid-19-at-two-ohio-prisons At Marion Correctional Institution, 2,011 inmates of about 2,500 at the facility have tested positive for COVID-19, two of whom have died, as of Wednesday. At Pickaway Correctional Institution, 1,555 inmates of roughly 2,000 inside are infected. Ten inmates have died from COVID-19, as of Tuesday The two prisons house inmates at higher risk to complications from COVID-19, the respiratory disease caused by the new coronavirus. A state prisons spokeswoman said Wednesday that Marion houses “a high number” of older individuals, many of whom have pre-existing health conditions. Pickaway houses the prisons’ long term care center, similar to a nursing home. So lets say they are both worst case scenarios for prisons. Total 12 died out of 3566 (2011 at Marion + 1555 at Pickaway) gives 0.3%. These are two correctional facilities in Ohio of older people with pre-existing conditions.

"Even if you died of a clear alternate cause but you had COVID at the same time it's still listed as a COVID death." Illinois' Public Health Director Dr. Ngozi Ezike says people are listed as a coronavirus death even if they died of alternative causes.

I am not sure which prison data you are referring to. Here are some samples https://www.inquirer.com/news/coronavirus-testing-montgomery-county-jail-asymptomatic-philadelphia-prisons-20200428.html Montgomery County’s jail tested every inmate for COVID-19 — and found 30 times more cases than previously known "171 of those positive inmates exhibited no symptoms at the time their tests were administered." They had 177 test positive of which 171 asympatomatic again confirming Stanford study that there are many asymptomatic cases. Its just that all countries test only with symptoms that we have high CFR. https://www.usatoday.com/story/news/politics/2020/04/25/coronavirus-testing-prisons-reveals-hidden-asymptomatic-infections/3003307001/ Mass virus testing in state prisons reveals hidden asymptomatic infections; feds join effort More than 90% of the newly diagnosed inmates displayed no symptoms, https://www.axios.com/coronavirus-prisons-asymptomatic-8daaaa08-b53e-4368-adb7-88b7d93efece.html 96% of nearly 3,300 inmates with coronavirus were asymptomatic, survey shows https://www.reuters.com/article/us-health-coronavirus-prisons-testing-in/in-four-u-s-state-prisons-nearly-3300-inmates-test-positive-for-coronavirus-96-without-symptoms-idUSKCN2270RX Of the 2,028 who tested positive, close to 95% had no symptoms. I can go on...but the primary conclusion of Stanford study that when we are calculating case fatality rate after testing mostly symptomatic suspected patients, we are missing a lot of asymptomatic infected carriers which would give much smaller IFR. The WHO said 3.5% CFR with low asymptomatic rate which would make 3.5% IFR. WHO still says there are very few asymptomatic covid infected and never updated the 3.5% CFR. So, the prison data infact does support Stanford findings.

Its true there are different numbers coming from different places. Miami-Dade The preliminary results imply an infection fatality rate of 0.2 percent, similar to estimates from two California studies. https://reason.com/2020/04/26/miami-dade-antibody-tests-suggests-covid-19-infections-exceed-confirmed-cases-by-a-factor-of-16/ New York: https://www.ny1.com/nyc/all-boroughs/news/2020/04/23/governor-cuomo-daily-coronavirus-update-with-first-antibody-test-results That would indicate a statewide death rate of about 0.5 percent. Denmark: a combined IFR in patients younger than 70 is estimated at 82 per 100,000 https://www.medrxiv.org/content/10.1101/2020.04.24.20075291v1 82 in 100,000 would be 0.082% Germany: In Gangelt, the IFR after the SARS-CoV-2 outbreak is 0.37 percent," https://medicalxpress.com/news/2020-05-team-covid-infection-fatality.html The MLB study published by same Stanford team had zero fatalities with 5000+ samples. Zero IFR with that sample or too small sample of 5000+? They also had low infection rate of 0.7%. https://www.sfchronicle.com/athletics/article/MLB-antibody-study-7-percent-exposed-to-15260314.php Its true if you look at Bronx, Spain or Italy, the IFR may be high. Santa Clara or Miami, the IFR are lower. It may be a reflection of local demographics to how much the hospitals are overwhelmed.

Eric, in the Senate hearing, Dr. Fauci seemed upbeat about Vaccines, talking about "multiple winners". But if there is re-infection of already infected people there won't be a vaccine. Is Dr. Fauci wrong. There won't be vaccines? Beyond Vaccines, if as Dr. Fauci says the infection will come back in fall, what is the plan? Is the plan is to go through several cycles of lockdown and then if there is no vaccine, then get to herd immunity?

Liberty, I am not sure what sounds bad. In this times while the world is shut down, a test that takes $200K, a professor from Stanford had to take 5000$ to do the test which everyone agrees needs to be done? They didn't have any funds from the 2 trillion dollars to do the study? The plan was to keep making decisions without knowing the real extent of spread and who is getting how much? That is what sounds bad. Many studies (and I posted recently on this) confirmed Stanford result. The studies confirmed the Stanford study results, that there are lot of asymptomatic carriers and the infection fatality rate is much lower than thought before. The buzzfeed is an attack article because it fails to mention I believe a dozen more studies done since then by different teams across world, many of them are reputed hospitals or professors. Buzzfeed "forgets" to mention this and goes on attacking a scientist for doing his job which frankly, the task force should have done long back. We are really going back to Galileos times attacking the scientist rather than looking at the result and its confirmation in multiple studies and its consequences of this new information. This attitude of Buzzfeed can take us to medieval ages and it is really shameful article.

I wear a mask whenever I go out. I don't think people should be required to do so though. We should draft them to do so. Then they can be draft dodgers. This is a straw man argument. Most people argument against the lockdown is about their livelihood. I have heard minimum complaints about masks. The UN, Stanford professors argument against lockdown is that the costs are more than gains. More people can die than they save. The Harvard Dr. Lipstitch argument (though he specifically did not say he is against lockdown) is whatever one does 40-70% have to get infected. Example of UN argument against lockdown: https://www.reuters.com/article/us-health-coronavirus-children-un-idUSKBN21Y2X7 U.N. warns economic downturn could kill hundreds of thousands of children in 2020 You are exchanging lives of on average 80 year old for 8 year old kids - that's UN argument against lockdown.

Last week NYC study showed overwhelming hospitalizations for Covid are from people staying home. Also Cuomo said: https://news.yahoo.com/cuomo-frontline-workers-tested-antibodies-162530547.html During a press conference, New York Gov. Andrew Cuomo shared antibody testing results for essential workers and says the reason frontline workers' infection rate is lower is due to them consistently wearing masks. Thats why IMO, it worked in Japan. They had people go out wearing masks without lockdown. Which is better IMO than lockdown without masks which western world did.

First of all its not a doctors call. Dr. Fauci himself said he only advises on health matters, not on economy. But economy has lot of health effects. https://www.cbsnews.com/news/coronavirus-deaths-suicides-drugs-alcohol-pandemic-75000/ Coronavirus pandemic may lead to 75,000 "deaths of despair" from suicide, drug and alcohol abuse, study says And main logic presented for Children not going to school is they pass the infection back home. Except that: https://www.nationalreview.com/corner/icelandic-study-we-have-not-found-a-single-instance-of-a-child-infecting-parents/ Children under 10 are less likely to get infected than adults and if they get infected, they are less likely to get seriously ill. What is interesting is that even if children do get infected, they are less likely to transmit the disease to others than adults. We have not found a single instance of a child infecting parents.

That's an important "but" that can't be hand-waved away. A lot of antibody tests had false positives in the 50% range, depending the population being sampled (it'll be higher outside of the major outbreak zones). That's way too high to be very useful. Stanford Dr. Bhattacharya says he had 0.5% false positive in his test. The 0.5% may be important for Santa Carla study that found 3% infection rate. But still you can take 2.5% and calculate IFR. 0.5% false positive is not important for NYC with 20% infection rate. Or Boston Chelsea with 30% infection rate. The different studies gave infection fatality rate between 0.1% to 0.5%. NY had higher rate at 0.5%. For example Miami Dade study gave 6% and 0.5% is not very important. https://www.miamiherald.com/news/coronavirus/article242260406.html They say 165000 infected. Presently about 500 dead (I dont know numbers as of mid April). So a conservative number of using todays 500 deaths/165000 gives 0.3% IFR. Below is a study by Denmark: Using available data on fatalities and population numbers a combined IFR in patients younger than 70 is estimated at 82 per 100,000 (CI: 59-154) infections. Thats 0.082% for patients younger than 70. The seroprevalence was adjusted for assay sensitivity and specificity taking the uncertainties of the test validation into account when reporting the 95% confidence intervals (CI). New tests are even better. See below: Researchers at the University of Washington School of Medicine found Abbott’s test had a specificity rate of 99.9% and a sensitivity rate of 100%, suggesting very few chances of incorrectly diagnosing a healthy person with the infection and no false negatives. https://www.cnbc.com/2020/05/08/study-suggests-abbott-covid-19-antibody-test-highly-likely-to-give-correct-results.html Some people dont like the result of 0.1% to 0.5% IFR but it is now done by Denmark, Germany, Santa Carla, LA, Miami Dade, NYC, Boston by different well known professors and hospitals. The IFR is much lower if you take less than 70 population. At one point people need to agree with the data. I agree that some areas (NYC, Chelsea MA) are reaching numbers that imply that we are well on way of herd immunity. It that a true only in those heavily hit areas, not true in the rest of NY or MA and much less the rest of the country. It not true in Sweden either, Stockholm, Sweden represents only 10% of the Swedish population and that’s where the majority of the infection are for now. I am routing for the Swedes, they have a clear plan and are following it, so far within a fairly acceptable cost. Germany and other Skandinavien countries have pushed the curve far far down, so they have a chance squash the second waves ( the extend of which is a function of how far down the first wave have been pushed ) with aggressive test and track. What is our strategy? It depends on the state you are in and we just have to wing it. Sad. The strategy will depend on the data and scientists doing their studies and discussing their data and opinions openly without being attacked. Below is an interview with Dr. John Ioannidis. Initially Stanford team was criticized for their study conclusion of lower IFR and was told their experiment has serious short comings. Then as more and more teams got similar result across the world, he is being told everyone always meant much lower IFR than 1%, there is nothing new here........well read it https://undark.org/2020/05/09/john-ioannidis-responds/ UD: Who thought that? The WHO said that 3.4 percent was the case fatality rate. Epidemiologists I’ve talked to said that it was clear the true infection fatality rate would likely end up being much lower. One scientist described the argument you’re making right now as “a straw man.” JI: Well, let’s go back and check the exact announcement. [Note: The WHO announcement in question, from early March, specifies that “3.4 percent of reported cases have died.”] That was at the time when WHO had sent an envoy to China. And [the WHO envoy] came back and he said there’s no asymptomatic cases. Just go back and see what the statement was. He said there’s hardly any asymptomatic cases, it’s very serious and has a case fatality of 3.4 percemt. Of course, that [fatality rate] was gradually dialed back to 1 percent or 0.9 percent. And these are the numbers that went into calculations, and these are the numbers that are still in many of the calculations, you know, until very recently. You know, 1 percent is, is probably like the disaster case, maybe in some places in Queens, for example, it may be 1 percent, because you have all that perfect storm of nursing homes, and nosocomial infection [an infection that originates in a hospital], and no hospital system functioning. In many other places, it’s much, much lower. ...............

That's an important "but" that can't be hand-waved away. A lot of antibody tests had false positives in the 50% range, depending the population being sampled (it'll be higher outside of the major outbreak zones). That's way too high to be very useful. Stanford Dr. Bhattacharya says he had 0.5% false positive in his test. The 0.5% may be important for Santa Carla study that found 3% infection rate. But still you can take 2.5% and calculate IFR. 0.5% false positive is not important for NYC with 20% infection rate. Or Boston Chelsea with 30% infection rate. The different studies gave infection fatality rate between 0.1% to 0.5%. NY had higher rate at 0.5%. For example Miami Dade study gave 6% and 0.5% is not very important. https://www.miamiherald.com/news/coronavirus/article242260406.html They say 165000 infected. Presently about 500 dead (I dont know numbers as of mid April). So a conservative number of using todays 500 deaths/165000 gives 0.3% IFR. Below is a study by Denmark: Using available data on fatalities and population numbers a combined IFR in patients younger than 70 is estimated at 82 per 100,000 (CI: 59-154) infections. Thats 0.082% for patients younger than 70. The seroprevalence was adjusted for assay sensitivity and specificity taking the uncertainties of the test validation into account when reporting the 95% confidence intervals (CI). New tests are even better. See below: Researchers at the University of Washington School of Medicine found Abbott’s test had a specificity rate of 99.9% and a sensitivity rate of 100%, suggesting very few chances of incorrectly diagnosing a healthy person with the infection and no false negatives. https://www.cnbc.com/2020/05/08/study-suggests-abbott-covid-19-antibody-test-highly-likely-to-give-correct-results.html Some people dont like the result of 0.1% to 0.5% IFR but it is now done by Denmark, Germany, Santa Carla, LA, Miami Dade, NYC, Boston by different well known professors and hospitals. The IFR is much lower if you take less than 70 population. At one point people need to agree with the data.

How do we know where it "matters most"? Masks. Nursing homes where more effort is put in separating infected from not infected. Better ventilation and training at Nursing homes.

Other countries have tested more people per capita than S Korea, without the draconian measures. I fail to see how less information is more useful. It is wasteful to test unnecessary people such as asymptomatic young people. Yes ofcourse staffers at Nursing homes needs to be tested, which Cuomo just seemed to have realized. But otherwise testing cannot stop the spread of virus since there are lot of asymptomatic carriers. You all praise S. Korea. So, lets listen to the S. Korean expert (see video link below). He says social distancing, hand washing and masks are most important. Listen to video below. If you dont have time just listen to his message to western countries in last one minute. Listen at 14.30 minutes where he says, one needs to have symptoms to test in S. Korea. At 16 minutes he calls western policy (now changed) of not having masks odd. He criticized WHO for saying no need of masks. At 18 minutes he says masks "absolutely" helped reduce infection in S. Korea. Nowhere he makes that claim about testing. So its not just information for sake of information. The purpose is to reduce spread of infection. And resources needs to be focused on where it matters most.

Nah, we should reopen it! And no testing, tests are overrated! Make the White House Open Again! I asked several times in this thread. Go to worldometer and show that there is a relationship between tests/million and deaths/million. Japan had 1,694 tests/million with 5 deaths/million Germany 32,829 tests/million with 91 deaths/million US 29,182 tests/million with 246 deaths/million UK 28,309 tests/million with 472 deaths/million US, UK and Germany have similar level of testing with five fold wide range of deaths/million. Japan very low testing with very low deaths/million.

Evidence mounts that outside is safer when it comes to COVID-19 https://thehill.com/policy/healthcare/496483-evidence-mounts-that-outside-is-safer-when-it-comes-to-covid-19 Health experts say people are significantly less likely to get the coronavirus while outside, a fact that could add momentum to calls to reopen beaches and parks closed during the COVID-19 pandemic.

Japan is a fascinating case study. Another East Asian Country that I would give an A+. My neighbor was a high level protein researcher and we have discussed it a lot. 1. They wear masks. Before Covid they would wear masks culturally - if sick, allergies, etc. 2. Social distancing - bows, etc. 3. Quieter culture. The louder a culture is perhaps the more the virus spreads. Explains the big mouth New York theory! 4. Clean culture of washing hands carefully, etc. I think the biggest thing is the masks though. Reduces the RO a ton. I am not sure if I posted this but Island in Northern Japan had increase in virus after pressure to open up https://time.com/5826918/hokkaido-coronavirus-lockdown/ In my opinion the US has handled this whole thing very badly (could have been worse though) because of Trump not being an intelligent and effective leader. The reality is that in the US this has turned into the survival of the fittest - if you have a weakened immune system or put yourself at risk you are more likely to die. I agree most of your points than the leadership part. It is not like all western leaders are bad and SE asian countries leaders are good but there is a big difference by an order of 40 to 100 fold the difference in results. Their approaches have been different, culturally different too and that made the majority of difference. Interestingly even though our Trump bashers here keep saying its the testing that made difference, you dont find from worldometer any correlation between testing and the deaths per million. For example Germany is supposed to be best from west and has 86 deaths/million. Japan has 4 deaths/million and Taiwan 0.3 deaths/million. If you watch the Korean expert, he also says its the masks that made the difference and does not high light testing. If you dont have time to listen to all of it, just try to listen to last one minute of his advise to western countries. Its masks he says.

This anomaly was apparently what got some people to look into the BCG theory that I posted about a while ago. It has some merit (IMO) and a clinical trial is underway in Australia and a few other places. I hope it proves correct as that would greatly improve the outlook. China always had BCG. UK had till 2005 France till 2007 Spain 1981 Since most people dying are very old, they must be BCG vaccinated in China, UK, France and Spain. I picked Japan though most south east asian countries have low Covid incidence since Japan is cold, with older population, has subways and crowded. If Japan had low incidence because of BCG, China should have had low incidence too and not need lockdown. UK, France and Spain would had low Covid too. http://www.bcgatlas.org/index.php

For the coagulation part, it's been suggested that anticoagulation could be associated with a better outcome for more severe presentations but most people admitted in ICUs these days typically get anticoagulation anyways so this does not seem promising in terms of more than a possible marginal improvement in some cases. The more promising treatment options will likely directly interfere with the viral load itself and not with the consequences of the virus. From the Massachusetts General Hospital guidelines "All patients admitted to MGH for COVID-19 (including non-critically ill) should receive standard prophylactic anticoagulation with LMWH" Looks like all admissions, not just ICU.

My theory is that it's because the Japanese are culturally socially distanced compared to most other cultures and are also happy to wear masks. Do you have any other theories, Investor20? Agreed. Also they started early with masks in January itself. They also seem to emphasize the small droplets due to asymptomatic carriers which can carry longer distances and wont deposit on surfaces like larger droplets after coughing and sneezing. Masks help in reducing spread of smaller droplets. One can also open windows and doors for fresh air to clear the smaller droplets from air. I am not suggesting not to clean surfaces, hands, etc. I am suggesting all of them have to be done (masks, cleaning, social distancing, having air flow) and Japan suggests we can have low transmission even without lockdown. If I have to meet someone, I will meet them outdoors.

Looks like treatment for Covid is changing. https://science.sciencemag.org/content/368/6490/455 "Among the many surprises of the new coronavirus is one that seems to defy basic biology: infected patients with extraordinarily low blood-oxygen levels, or hypoxia, scrolling on their phones, chatting with doctors, and generally describing themselves as comfortable. Clinicians call them happy hypoxics." ..... In serious cases of COVID-19, patients struggle to breathe with damaged lungs, but early in the disease, low saturation isn't always coupled with obvious respiratory difficulties. Carbon dioxide levels can be normal, and breathing deeply is comfortable—“the lung is inflating so they feel OK,” says Elnara Marcia Negri, a pulmonologist at Hospital Sírio-Libanês in São Paulo. But oxygen saturation, measured by a device clipped to a finger and in many cases confirmed with blood tests, can be in the 70s, 60s, or 50s. Or even lower. Although mountain climbers can have similar readings, here the slide downward, some doctors believe, is potentially “ominous,” says Nicholas Caputo, an emergency physician at New York City Health + Hospitals/Lincoln. Seems like doctors have identified blood coagulation as a potential reason and using heparin. Here is a hospital guideline. https://www.massgeneral.org/assets/MGH/pdf/news/coronavirus/guidance-from-mass-general-hematology.pdf https://www.news-medical.net/news/20200426/Early-Heparin-therapy-improves-hypoxia-in-COVID-19-patients.aspx The systemic use of heparin for treating severe coronavirus disease (COVID-19) showed significant improvements in oxygen exchange and overall clinical presentation of patients, as reported by a study from Brazil available on a preprint server medRxiv. Some articles are also recommending using oximeters as breathing would seem ok and would help to get early treatment* https://www.nytimes.com/2020/04/20/opinion/sunday/coronavirus-testing-pneumonia.html Some doctors are recommending starting with CPAP/Bipap oxygen support as the patients are breathing ok https://www.statnews.com/2020/04/08/doctors-say-ventilators-overused-for-covid-19/ Even as hospitals and governors raise the alarm about a shortage of ventilators, some critical care physicians are questioning the widespread use of the breathing machines for Covid-19 patients, saying that large numbers of patients could instead be treated with less intensive respiratory support. Would be interesting to see how these changes would effect the fatality rates.

Why no discussion about Japan? The daily cases show steady decrease after maximum at about 600 in middle of April to now about 180-200. For a crowded, cold country with subways and bullet trains (public transport), old age its pretty good without lockdown. https://www.worldometers.info/coronavirus/country/japan/

According to some articles, the migrant workers who live together in Singapore got high infection rate, who are young and healthy. The government was able to protect old and vulnerable and low infection rates in older people. Together they had high infection rate with low deaths - low fatality rate. This argues against closing colleges and sending college students back home from dorms. It will be interesting to see the antibody tests in SE asian country by age vs Europe/US.

https://en.wikipedia.org/wiki/Scandinavia https://www.worldatlas.com/webimage/countrys/eu.htm You dont mind comparing US with Korea on other side of globe or US with Germany across atlantic but dont want to compare Sweden which is close to UK and Netherlands. New York to Seoul : 6867.74 miles New York to Berlin: 3977 miles Stockholm to Amsterdam: 700 miles https://www.mapdevelopers.com/distance_from_to.php If New york to Seoul or New York to Berlin comparisons are O.K., then Stockholm to Amsterdam comparision is just fine.