Coronavirus

[Cigarbutt]

The NEJM just released an editorial (very unusual) on how to assess if tests are passed and if immunity should apply.

At some point, a line has to be drawn in the sand.

[Liberty]

Here it is:

 

https://www.nejm.org/doi/full/10.1056/NEJMe2029812

 

Why has the United States handled this pandemic so badly? We have failed at almost every step. We had ample warning, but when the disease first arrived, we were incapable of testing effectively and couldn’t provide even the most basic personal protective equipment to health care workers and the general public. And we continue to be way behind the curve in testing. While the absolute numbers of tests have increased substantially, the more useful metric is the number of tests performed per infected person, a rate that puts us far down the international list, below such places as Kazakhstan, Zimbabwe, and Ethiopia, countries that cannot boast the biomedical infrastructure or the manufacturing capacity that we have. Moreover, a lack of emphasis on developing capacity has meant that U.S. test results are often long delayed, rendering the results useless for disease control.

 

Although we tend to focus on technology, most of the interventions that have large effects are not complicated. The United States instituted quarantine and isolation measures late and inconsistently, often without any effort to enforce them, after the disease had spread substantially in many communities. [...]

 

The United States came into this crisis with enormous advantages. Along with tremendous manufacturing capacity, we have a biomedical research system that is the envy of the world. We have enormous expertise in public health, health policy, and basic biology and have consistently been able to turn that expertise into new therapies and preventive measures. And much of that national expertise resides in government institutions. Yet our leaders have largely chosen to ignore and even denigrate experts.

[muscleman]

Arizona:

https://www.cdc.gov/mmwr/volumes/69/wr/mm6940e3.htm?s_cid=mm6940e3_w

 

The number of COVID-19 cases in Arizona stabilized and then decreased after sustained implementation and enforcement of statewide and locally enhanced mitigation measures, beginning approximately 2 weeks after implementation and enforcement of mask mandates and enhanced sanitations practices began on June 17; further decreases were observed during July 13–August 7, after statewide limitations and closures of certain services and businesses.

 

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.

 

Because it doesn't fit their propaganda that Trump is such a mess and COVID is really scary and they should shutdown everything and kill the economy. And BTW, the economy is so bad. It must be Trump's fault.

 

I already stopped arguing with these folks. They are not going to change their mind no matter what.

BTW, since this is an investing forum, I want to point out that the best investors I've seen are always able to change their minds and be flexible. They could be very bullish and a few weeks later be very bearish and a few weeks later change to very bullish again. That's the goal I am aiming for. Trying to have maximum open mind and flexibility and be ready to admit mistakes.

[LC]

I don't understand why people refuse to acknowledge the basic pattern of how epidemics unfold and eventually recede

 

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.

[Peregrine]

I don't understand why people refuse to acknowledge the basic pattern of how epidemics unfold and eventually recede

 

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.

[muscleman]

I don't understand why people refuse to acknowledge the basic pattern of how epidemics unfold and eventually recede

 

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.

 

No one could see the future. But that doesn't prevent us from making educated guesses. That's exactly what investors do. People who use this excuse for not making calls should not be investors. Instead they should be politicians who only look backward.

 

[LC]

So let me get this straight.

 

You're upset people aren't leaning on past history to predict the future course of COVID.

 

But when people point to the 2nd wave as an outlying historical event (respiratory illnesses historically recede in warm months, contrary to COVID), I guess that is not the "history" of your choosing.

 

Ok, fine.

 

So when I then ask you to instead make a definitive claim about the future course of COVID, both you and muscleman beat around the bush and refuse to do so.

 

You're trying to have it both ways, hence the frustration.

[Peregrine]

So let me get this straight.

 

You're upset people aren't leaning on past history to predict the future course of COVID.

 

But when people point to the 2nd wave as an outlying historical event (respiratory illnesses historically recede in warm months, contrary to COVID), I guess that is not the "history" of your choosing.

 

Ok, fine.

 

So when I then ask you to instead make a definitive claim about the future course of COVID, both you and muscleman beat around the bush and refuse to do so.

 

You're trying to have it both ways, hence the frustration.

 

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.

[LC]

This is you having it both ways:

 

I don't understand why people refuse to acknowledge the basic pattern of how epidemics unfold and eventually recede

 

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.

[LC]

And I've made my approach to assessing COVID severity very clear:

I assume all excess deaths in 2020 are COVID-caused.

I believe nobody can forecast with certainty whether a third wave will occur or not.

Therefore, I believe prudency is necessary. If positive cases are increasing, social policies should be increased commensurately - in case those positive cases turn into excess deaths.

[Peregrine]

This is you having it both ways:

 

I don't understand why people refuse to acknowledge the basic pattern of how epidemics unfold and eventually recede

 

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.

 

How is that having it both ways? Read what you quoted again.

 

The first statement is true - that is how epidemics have historically ended. Spanish Flu (H1N1) never disappeared but it reached a balanced state where it became endemic in the population. This will happen with SARS-COV-2 as well - the only question is when. I think we can all agree that at some point the epidemic will end, it's just a question of when. I'm of the belief that the hardest hit areas are a lot further along on that timeline.

[Peregrine]

And I've made my approach to assessing COVID severity very clear:

I assume all excess deaths in 2020 are COVID-caused.

I believe nobody can forecast with certainty whether a third wave will occur or not.

Therefore, I believe prudency is necessary. If positive cases are increasing, social policies should be increased commensurately - in case those positive cases turn into excess deaths.

 

Though I disagree with the policy prescription, I think that's fair.

[Guest cherzeca]

the second shoe drops. https://www.zerohedge.com/medical/covid-19-unrestricted-bioweapon-whistleblower-releases-second-paper-alleging-large-scaley

[KCLarkin]

Because it doesn't fit their propaganda that Trump is such a mess and COVID is really scary and they should shutdown everything and kill the economy. And BTW, the economy is so bad. It must be Trump's fault.

 

MM, I've given you the benefit of the doubt so far since you were the one who reported the situation in Wuhan. But it is pretty clear you're just another MAGA-troll. Pandemics don't play politics. And I am done feeding the MAGA-trolls.

 

Edit to add: The problem isn't the MAGA. It is the trolling.

[LC]

And I've made my approach to assessing COVID severity very clear:

I assume all excess deaths in 2020 are COVID-caused.

I believe nobody can forecast with certainty whether a third wave will occur or not.

Therefore, I believe prudency is necessary. If positive cases are increasing, social policies should be increased commensurately - in case those positive cases turn into excess deaths.

 

Though I disagree with the policy prescription, I think that's fair.

 

See and that's also my own bias.

 

I live a comfortable life and I am young in the context of COVID.

I can afford social distancing.

 

There's an old line from that Dirty Jobs show, where the host (Mike Rowe) questions the whole, "safety first" attitude. Sometimes, he argues, it's "safety second, or third".

 

And that was in the context of the working class / paycheck-to-paycheck individuals. To say nothing of age ranges for which this virus has disparate impacts. So how do we both protect people and allow people to work and live?

 

Well first, what do we know? There was a violent initial spike, a somewhat extended but less-deadly second wave, and now we are entering flu season. OK - so then what is the optimal response here?

 

I think it is reasonable to plan for something closer to the "second wave". This is a compromise between both extremes: the initial violent spike on one end, and a situation where COVID has essentially run its course on the other end.

 

So then I would argue the optimal response would be continued mask wearing, some social distancing in high-exposure cities and events, and statewide-tailored responses with federal support for things like medical resources, unemployment resources, if needed.

[Cigarbutt]

the second shoe drops. https://www.zerohedge.com/medical/covid-19-unrestricted-bioweapon-whistleblower-releases-second-paper-alleging-large-scaley

Zerohedge has had an unusual focus on the bioweapon thesis. There have been many stories including this one:

https://www.zerohedge.com/geopolitical/visualizing-secret-history-coronavirus-bioweapon

 

Out of curiosity, in the event that the thesis is true (ie the virus is man-made and accidentally or even as part of a human plan, was released as a 'weapon'), this would have potential consequences for 'reparation'. But how does this change the defensive strategy, ie how to limit the damage, relatively speaking, in comparison to other countries for example, from a data point of view?

[Peregrine]

And I've made my approach to assessing COVID severity very clear:

I assume all excess deaths in 2020 are COVID-caused.

I believe nobody can forecast with certainty whether a third wave will occur or not.

Therefore, I believe prudency is necessary. If positive cases are increasing, social policies should be increased commensurately - in case those positive cases turn into excess deaths.

 

Though I disagree with the policy prescription, I think that's fair.

 

See and that's also my own bias.

 

I live a comfortable life and I am young in the context of COVID.

I can afford social distancing.

 

There's an old line from that Dirty Jobs show, where the host (Mike Rowe) questions the whole, "safety first" attitude. Sometimes, he argues, it's "safety second, or third".

 

And that was in the context of the working class / paycheck-to-paycheck individuals. To say nothing of age ranges for which this virus has disparate impacts. So how do we both protect people and allow people to work and live?

 

Well first, what do we know? There was a violent initial spike, a somewhat extended but less-deadly second wave, and now we are entering flu season. OK - so then what is the optimal response here?

 

I think it is reasonable to plan for something closer to the "second wave". This is a compromise between both extremes: the initial violent spike on one end, and a situation where COVID has essentially run its course on the other end.

 

So then I would argue the optimal response would be continued mask wearing, some social distancing in high-exposure cities and events, and statewide-tailored responses with federal support for things like medical resources, unemployment resources, if needed.

 

Thanks for being objective. I agree with much of what you said. I think anti-masking is silly - I think even anti-maskers can concede that it is a minor inconvenience for most with little drawback. I also think that people are naturally social distancing and that the enormous resources deployed so far could find far better uses (i.e. more funding to elderly homes).

 

Where we may differ a bit is in the question of whether younger people should live more normal lives. I think that there has been enough evidence that shows that the risk to the young is similar to or even below that of the flu.  And compounded with the fact that the young recover faster and are thus infectious for shorter windows of time, chains of transmission are broken quicker, thereby reducing the possibility of increased transmission in more vulnerable groups. I think given the immense age-stratification in the risk of this disease we should be deploying an age-stratified strategy, unfortunately, we haven't yet been using this well-established knowledge to our advantage.

[LC]

Frank, this is becoming too reasonable for such a contentious topic.

 

I think given the immense age-stratification in the risk of this disease we should be deploying an age-stratified strategy, unfortunately, we haven't yet been using this well-established knowledge to our advantage.

 

I think the reason is because this is difficult to implement.

 

First, what is the cutoff? 30 years old let's say? Sounds reasonable, maybe +/- 5 or so years.

 

Now even with a threshold, not many aspects of society are so cleanly segmented by age. Schools would be the most obvious one, but even those are filled with teachers and administrators.

 

In theory it makes sense but I think implementation is the challenge.

[Gregmal]

In other news, after opening bars and nightclubs, Florida has now OK'd stadiums and venues to operate at 100%. Any advice on how to bet on 9% of the population dying in 2 weeks? Its god's waiting room remember? The next Italy(said Italy but meaning Lombardi).

[LC]

In other news, after opening bars and nightclubs, Florida has now OK'd stadiums and venues to operate at 100%. Any advice on how to bet on 9% of the population dying in 2 weeks? Its god's waiting room remember? The next Italy(said Italy but meaning Lombardi).

 

Go for a fishing trip! Heck, you might land this sweet catch:

 

[Peregrine]

Frank, this is becoming too reasonable for such a contentious topic.

 

I think given the immense age-stratification in the risk of this disease we should be deploying an age-stratified strategy, unfortunately, we haven't yet been using this well-established knowledge to our advantage.

 

I think the reason is because this is difficult to implement.

 

First, what is the cutoff? 30 years old let's say? Sounds reasonable, maybe +/- 5 or so years.

 

Now even with a threshold, not many aspects of society are so cleanly segmented by age. Schools would be the most obvious one, but even those are filled with teachers and administrators.

 

In theory it makes sense but I think implementation is the challenge.

 

I'm glad that a discussion can be reasonable, and why should it not be?

 

As for practicality, should it be more difficult to implement than striving to suppress the virus among the entire population?

 

I don't think it should necessarily be that difficult. We can start with the elderly homes - increase funding and staffing, which has been a chronic problem with elderly homes that finally blew up in the open. In schools, those who are older or with pre-existing conditions may teach virtually or assist in other aspects, such as grading and marking papers or helping to plan lessons for teachers in class. Allot specific times for businesses to open specifically for the elderly. Older people living in multi-generational households can be given the option for temporary stays in the many hotels that are sitting empty right now (what's ironic is that the lockdown strategy has actually increased multi-generational mixing). These are all things that can be practically done, especially considering the immense resources being devoted to this.

[Gregmal]

In other news, after opening bars and nightclubs, Florida has now OK'd stadiums and venues to operate at 100%. Any advice on how to bet on 9% of the population dying in 2 weeks? Its god's waiting room remember? The next Italy(said Italy but meaning Lombardi).

 

Go for a fishing trip! Heck, you might land this sweet catch:

 

 

And folks say to watch out for alligators and snakes down there....yuck.

[Guest cherzeca]

the second shoe drops. https://www.zerohedge.com/medical/covid-19-unrestricted-bioweapon-whistleblower-releases-second-paper-alleging-large-scaley

Zerohedge has had an unusual focus on the bioweapon thesis. There have been many stories including this one:

https://www.zerohedge.com/geopolitical/visualizing-secret-history-coronavirus-bioweapon

 

Out of curiosity, in the event that the thesis is true (ie the virus is man-made and accidentally or even as part of a human plan, was released as a 'weapon'), this would have potential consequences for 'reparation'. But how does this change the defensive strategy, ie how to limit the damage, relatively speaking, in comparison to other countries for example, from a data point of view?

 

imo, not in any respect.  but the veracity of this claim is perhaps the single most important foreign policy issue today...and it is not being discussed as such, although trump has been alluding to it...put another way, how would you react to a bombing conducted by China against the US that resulted in 200k deaths?  I know this is being provocative but my intent is to provoke thought.  my understanding of the bioscience is quite limited, but sufficient to appreciate these claims as legitimate

[Cigarbutt]

the second shoe drops. https://www.zerohedge.com/medical/covid-19-unrestricted-bioweapon-whistleblower-releases-second-paper-alleging-large-scaley

Zerohedge has had an unusual focus on the bioweapon thesis. There have been many stories including this one:

https://www.zerohedge.com/geopolitical/visualizing-secret-history-coronavirus-bioweapon

Out of curiosity, in the event that the thesis is true (ie the virus is man-made and accidentally or even as part of a human plan, was released as a 'weapon'), this would have potential consequences for 'reparation'. But how does this change the defensive strategy, ie how to limit the damage, relatively speaking, in comparison to other countries for example, from a data point of view?

imo, not in any respect.  but the veracity of this claim is perhaps the single most important foreign policy issue today...and it is not being discussed as such, although trump has been alluding to it...put another way, how would you react to a bombing conducted by China against the US that resulted in 200k deaths?  I know this is being provocative but my intent is to provoke thought.  my understanding of the bioscience is quite limited, but sufficient to appreciate these claims as legitimate

But i thought the 200K+ deaths were either fake news or, if real, all as a direct consequence of the "lockdowns"?  ::)

It is amazing how the intensity and direction of blame allocation as well as the alleged damages can change, depending on the perspective...

 

It is completely appropriate to investigate this and to allocate adequate time and energy depending on objective developments. An external threat can be useful to help bring out the better angels of our nature and constructive comments around the concept can have unifying effects towards common goals. However the use of external threats can result in poor (and sometimes unintended) consequences.

 

More provocative comments here and i assume that the phenomenon described after does not apply to you.  8)

Assumptions:

-The social distancing spectrum (from the common sense "protect the weak" to full state-imposed lockdowns; from low costs no-nonsense to sophisticated and model-based) can result in lower morbidity and mortality arising from the virus.

-The median citizen is not looking to spread it indiscriminately to all and is not hiding in his or her basement. The median citizen is reasonable and will determine behaviors based on reasonable self-appreciation of facts. This means that good information has to spread freely, that messages from experts may influence the responses to some degree and that specific government mandates may modulate the individual ways to adapt.

https://iaap-journals.onlinelibrary.wiley.com/doi/full/10.1111/aphw.12223

TL;DR version:

One of the unintended consequences of unusual focus on external threats may fuel conspiracy theories and the phenomenon may, directly or indirectly, be correlated (even causal?) to the undermining of basic social distancing strategies useful in mitigating damage. A fascinating aspect is that the phenomenon may have an unconscious basis.

 

Personal note: as i write this, i'm watching an objective report on national TV which is relevant for snowbirds who are considering going to Florida next winter. They are showing a segment from last summer where anti-mask groups were 'raiding' stores when excess mortality was peaking.

[samwise]

1. Meanwhile, back in the muddled middle (away from extremes of Sweden or New Zealand models) this is what the effort to control COVID looks like. https://www.cbc.ca/player/play/1793499715656

 

One the one hand I feel that it’s ridiculous that our public health  officials are writing memos on runny noses, on the other hand this is very real for me as my son gets his nose checked whenever I drop him off for childcare.

 

2. Are we going to witness a natural experiment comparing flu and COVID this flu season? It’s so many controls we should see a milder flu season. Can we compare flu deaths versus COVID deaths over the next 6 months? Or is this not possible because flu gets seeded in the population in a different way?