Cigarbutt Posted June 24, 2020 Posted June 24, 2020 "The EU will not be alone" in doing this. Canada keeps extending severe border restrictions with US and it is hard to see why they would be lifted with the spike in US cases." I wonder if keeping the Canadian border closed is going to piss off Trump and will he threaten to retaliate? Then again, that didn't work out very well for him when he tried to steal the Canadian masks. Recently, i had discussions about "touristic" destinations next summer and it looks like some regions are developing "travel bubbles" and "corona corridors". i hear that Atlantic Canada is also planning some kind of bubble. There may be a need to carry two passports and the world may be getting smaller, at least for a while.
Investor20 Posted June 24, 2020 Posted June 24, 2020 Median Infection Fatality Rate Of COVID-19 For Those Under-70 Is Just 0.04% https://www.medrxiv.org/content/10.1101/2020.05.13.20101253v2.full.pdf Caution: Preprints are preliminary reports of work that have not been certified by peer review. They should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information. https://www.medrxiv.org/ John Ioannidis is the author of the discredited Santa Clara serology study. There were multiple issues with the study, including sampling bias, not adjusting for the sensitivity and specificity of the serology test, poststratification, and others. This new study aggregates his original study with a bunch of other seroprevalence studies with similar flaws, and gets the same as his original results....but with the same limitations. Perhaps the bottom line is best summed up by Nate Silver: There are a lot of well-intended and well-written critiques of the Santa Clara Co. serology study but at some point it's not that complicated. A test that *could* have a false positive rate of up to ~2-3% isn't saying very much if it detects 2-3% positives in some population When you look at locations with larger outbreaks, you see worse mortality rates. Why? Because if the false positive rate is 2%, then if the base rate of the population is 20% who have COVID, the error is only 10%, while if the base rate is 1%, it could be 200%. Serology surveys are used to tell us approximately what proportion of the population has had a disease, not typically to estimate the Infection Fatality Rate (IFR). There are numerous threads by good sources on Twitter from back in April on this by Trevor Bedford, Natalie Dean, PhD, and many others. One such thread here walks through a number of the limitations: A Columbia statistician named Andrew Gelman discusses the problems here: https://statmodeling.stat.columbia.edu/2020/04/19/fatal-flaws-in-stanford-study-of-coronavirus-prevalence/ Natalie Dean thread here: If you want an estimate based on less noisy data, you can look at the NYC population level deaths and you can calculate some back of the envelope estimates. Pretty clearly COVID hits older folks much harder, but I think the rates are higher than Ioannidis claims based on serology studies. https://www1.nyc.gov/site/doh/covid/covid-19-data.page Citywide, the death rate is .21% (that's of all people in NY, not just cases), with 75+ having a death rate of 1.57%, 65-74 0.63%, 45-64 0.19%, and 18-44 0.02%. That's on a population level, in a city with an estimated 25% prevalence, these numbers would have to be multiplied by 4 if you want to estimate the IFR, giving you approx 0.84% overall IFR, with subgroups 75+ 6.28%, 65-74 2.52%, 45-64 0.76%, 18-44 0.08%. Based on the data I've seen, those numbers look more realistic than Ioannidis. Like any good scientist, John Ioannidis is not basing it only on their testing in Santa Clara or even only the 20 other Seroprevalence testing (which should be enough). He also based it on PCR testing done on everyone (not just patients with symptoms) in Cruise Ships, people evacuated from Wuhan, Iceland, a small town in Italy, etc. For example, lets look at the Tennesse prisons where most prisoners were tested. As per below article, "is the third inmate to die after contracting the virus at the privately run Trousdale Turner Correctional Center" "Two weeks ago, Trousdale reported 1,299 inmates infected by the virus" That gives a CFR of (3/1299)*1000 = 0.23%. This is from PCR testing. Not Seroprevalence data. https://www.timesfreepress.com/news/breakingnews/story/2020/may/15/tennessee-prisons-report-fourth-inmate-death-virus-outbreak/523083/
KCLarkin Posted June 24, 2020 Posted June 24, 2020 That gives a CFR of (3/1299)*1000 = 0.23%. This is from PCR testing. Not Seroprevalence data. https://www.timesfreepress.com/news/breakingnews/story/2020/may/15/tennessee-prisons-report-fourth-inmate-death-virus-outbreak/523083/ 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).
Investor20 Posted June 24, 2020 Posted June 24, 2020 That gives a CFR of (3/1299)*1000 = 0.23%. This is from PCR testing. Not Seroprevalence data. https://www.timesfreepress.com/news/breakingnews/story/2020/may/15/tennessee-prisons-report-fourth-inmate-death-virus-outbreak/523083/ 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). If you read Prof. Ioannidis (yes he is the few I would give that respect in this drama), he stated very clearly in his articles, he is adjusting the profile of the studies to the US demographic profile.
KCLarkin Posted June 24, 2020 Posted June 24, 2020 Maybe That gives a CFR of (3/1299)*1000 = 0.23%. This is from PCR testing. Not Seroprevalence data. https://www.timesfreepress.com/news/breakingnews/story/2020/may/15/tennessee-prisons-report-fourth-inmate-death-virus-outbreak/523083/ 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). If you read Prof. Ioannidis (yes he is the few I would give that respect in this drama), he stated very clearly in his articles, he is adjusting the profile of the studies to the US demographic profile. I don’t see the Trousdale prison “study” in this meta-analysis. Or is that in a different paper? If you read Prof. Ioannidis (yes he is the few I would give that respect in this drama) Given how shoddy the Santa Clara study was, is there any reason (other than confirmation bias) why you still trust him? As far as I can tell, his reputation was largely destroyed with this one study.
Investor20 Posted June 24, 2020 Posted June 24, 2020 Maybe That gives a CFR of (3/1299)*1000 = 0.23%. This is from PCR testing. Not Seroprevalence data. https://www.timesfreepress.com/news/breakingnews/story/2020/may/15/tennessee-prisons-report-fourth-inmate-death-virus-outbreak/523083/ 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). If you read Prof. Ioannidis (yes he is the few I would give that respect in this drama), he stated very clearly in his articles, he is adjusting the profile of the studies to the US demographic profile. Maybe I am dense, but I don’t see the Tousdale prison “study” in his Metaanalysis. Or is that in a different paper? I have not seen it in Prof. Ioannidis studies either. It is my search for cross checking. But he has covered other PCR studies to support himself. This is another https://www.npr.org/sections/coronavirus-live-updates/2020/04/20/838943211/73-of-inmates-at-an-ohio-prison-test-positive-for-coronavirus A state prison has become a hot spot of the COVID-19 outbreak in Ohio, with at least 1,828 confirmed cases among inmates — ..... The large cluster of cases was found through mass testing of everyone at the Marion Correctional Institution; 109 staff members were also positive. No COVID-19 deaths have been reported at the prison. "Because we are testing everyone — including those who are not showing symptoms — we are getting positive test results on individuals who otherwise would have never been tested because they were asymptomatic," the Ohio Department of Rehabilitation and Correction says.
Peregrine Posted June 24, 2020 Posted June 24, 2020 That gives a CFR of (3/1299)*1000 = 0.23%. This is from PCR testing. Not Seroprevalence data. https://www.timesfreepress.com/news/breakingnews/story/2020/may/15/tennessee-prisons-report-fourth-inmate-death-virus-outbreak/523083/ 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%.
KCLarkin Posted June 24, 2020 Posted June 24, 2020 So perhaps the lesser representation on both age extremes balances itself out somewhat. 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.
Spekulatius Posted June 25, 2020 Posted June 25, 2020 So perhaps the lesser representation on both age extremes balances itself out somewhat. 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. When you look at updates from the Ohio prison outbreak from late May, you will find that more prisoners and even 2 wards have died from COVID-19. They also didn’t didn’t everyone despite stating so earlier.
Peregrine Posted June 25, 2020 Posted June 25, 2020 So perhaps the lesser representation on both age extremes balances itself out somewhat. 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%.
Spekulatius Posted June 25, 2020 Posted June 25, 2020 At least the Virus has a V-shaped recovery in the US. It sounds like in Houston, hospital are essentially full, which means that another shutdown is very likely. Hospital utilization will drive shutdowns. I am surprised they let it rise to 97%, but maybe they are not counting overflow capacity. https://www.khou.com/article/news/health/coronavirus/gov-abbott-texas-facing-massive-outbreak-as-coronavirus-cases-continue-to-soar/285-8671a837-d723-4e06-a438-8bbc19e1c86b
Dalal.Holdings Posted June 25, 2020 Posted June 25, 2020 At least the Virus has a V-shaped recovery in the US. It sounds like in Houston, hospital are essentially full, which means that another shutdown is very likely. Hospital utilization will drive shutdowns. I am surprised they let it rise to 97%, but maybe they are not counting overflow capacity. https://www.khou.com/article/news/health/coronavirus/gov-abbott-texas-facing-massive-outbreak-as-coronavirus-cases-continue-to-soar/285-8671a837-d723-4e06-a438-8bbc19e1c86b Pretty much. Unfortunately, the R governors of FL and TX who Daddy "Hydroxychloroquine 'n Bleach" Trump whispers into the ears of will have a much higher threshold before they consider lockdowns. They may even try to avoid them. It will not be pretty. Just watch as all the Cuomo bashing goes quiet over the next weeks...
jamesmadison Posted June 25, 2020 Posted June 25, 2020 It's hard to know exactly what's going with the increase in positive testing in the warmer states. There are a number of theories out there. I strongly recommend watching the video below. Assuming some level of immutability of virus behavior, we may simply be seeing what happens in a very large country with dramatically different geographies.
StubbleJumper Posted June 25, 2020 Posted June 25, 2020 At least the Virus has a V-shaped recovery in the US. It sounds like in Houston, hospital are essentially full, which means that another shutdown is very likely. Hospital utilization will drive shutdowns. I am surprised they let it rise to 97%, but maybe they are not counting overflow capacity. https://www.khou.com/article/news/health/coronavirus/gov-abbott-texas-facing-massive-outbreak-as-coronavirus-cases-continue-to-soar/285-8671a837-d723-4e06-a438-8bbc19e1c86b Pretty much. Unfortunately, the R governors of FL and TX who Daddy "Hydroxychloroquine 'n Bleach" Trump whispers into the ears of will have a much higher threshold before they consider lockdowns. They may even try to avoid them. It will not be pretty. Just watch as all the Cuomo bashing goes quiet over the next weeks... Why would the Cuomo bashing go quiet? If things turn badly in Texas, Arizona and elsewhere over the next few weeks, should that make people re-evaluate the quality of decision making in NY State during March/April? Explain how the two are linked. SJ
jamesmadison Posted June 25, 2020 Posted June 25, 2020 It's hard to know exactly what's going with the increase in positive testing in the warmer states. There are a number of theories out there. I strongly recommend watching the video below. Assuming some level of immutability of virus behavior, we may simply be seeing what happens in a very large country with dramatically different geographies. Perhaps ... https://pbs.twimg.com/media/EbTNx76UwAA6mZV?format=jpg&name=900x900
Peregrine Posted June 25, 2020 Posted June 25, 2020 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.
jamesmadison Posted June 25, 2020 Posted June 25, 2020 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. Agreed. Anyone worried that hospitals are running at 82% utilization doesn't know anything about the way hospitals operate. ICU utilization is frequently 90-100% as well under normal circumstances.
Dalal.Holdings Posted June 25, 2020 Posted June 25, 2020 ...And we just hit a record high for daily new covid cases in the U.S... Just "hype" from the "media". Nothing. To see. Here. Carry on.
KCLarkin Posted June 25, 2020 Posted June 25, 2020 It's hard to know exactly what's going with the increase in positive testing in the warmer states. There are a number of theories out there. I strongly recommend watching the video below. Assuming some level of immutability of virus behavior, we may simply be seeing what happens in a very large country with dramatically different geographies. 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.
jamesmadison Posted June 25, 2020 Posted June 25, 2020 It's hard to know exactly what's going with the increase in positive testing in the warmer states. There are a number of theories out there. I strongly recommend watching the video below. Assuming some level of immutability of virus behavior, we may simply be seeing what happens in a very large country with dramatically different geographies. 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. Are you being sarcastic? It's hard to tell. Regardless, the video literally answers your question. There's no part of Canada that's tropical, while large swaths of the US are. Thus, the US is partially like Italy (NYC) and partially like tropical regions (Tx, AZ, etc.) and we may be seeing the death curves regionally match up.
Peregrine Posted June 25, 2020 Posted June 25, 2020 It's hard to know exactly what's going with the increase in positive testing in the warmer states. There are a number of theories out there. I strongly recommend watching the video below. Assuming some level of immutability of virus behavior, we may simply be seeing what happens in a very large country with dramatically different geographies. 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.
KCLarkin Posted June 25, 2020 Posted June 25, 2020 It's hard to know exactly what's going with the increase in positive testing in the warmer states. There are a number of theories out there. I strongly recommend watching the video below. Assuming some level of immutability of virus behavior, we may simply be seeing what happens in a very large country with dramatically different geographies. 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. Are you being sarcastic? It's hard to tell. Regardless, the video literally answers your question. There's no part of Canada that's tropical, while large swaths of the US are. Thus, the US is partially like Italy (NYC) and partially like tropical regions (Tx, AZ, etc.) and we may be seeing the death curves regionally match up. No, not being sarcastic. I’ve been to many of these states, so I agree geography and climate must be responsible but haven’t seen a great explanation why. I will give your video a chance.
BG2008 Posted June 25, 2020 Posted June 25, 2020 It's hard to know exactly what's going with the increase in positive testing in the warmer states. There are a number of theories out there. I strongly recommend watching the video below. Assuming some level of immutability of virus behavior, we may simply be seeing what happens in a very large country with dramatically different geographies. 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. I also found this to be weird. Maybe it's because in the sunbelt, the winters are milder so that people tend to go outside in March. But June is hot and scorching so people tend to stay indoors in AC. So you have the opposite of the NYC in winter dynamic where everyone is coup up inside. Can't really go outside that much in Texas during the day or Vegas for that matter.
KCLarkin Posted June 25, 2020 Posted June 25, 2020 I will give your video a chance. Well, that was a mistake. Everyone knows Flu is seasonal (and experts assume Covid will have a second wave in the fall). The thing that doesn't make sense is that Flu season is over! Even in Arizona and Florida.
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