Coronavirus

[CorpRaider]

Man, I think I might have this thing.  Started with stomach pain and "discomfort" for like 24 hours then horrible, worst in my life, stomach flu symptoms, high fever nasty chills and aches for like 24 hours, now I've still got some stomach "issues" but with a little cough and mild tightness in the chest, no fever.  Hopefully, it gets better from here.  I read that a small percentage of people have experienced severed nausea etc then the cough and respiratory stuff...with corona.  If I could do the drive thru google test, I would, but I'm not going to go contaminate the hospital unless it gets a lot worse.

 

Lurker for years, my first post on this forum.

 

I had the sae thing in late January. Extreme stomach discomfort that started quite suddenly leading to bouts of vomiting. I couldn't even drive myself back home without puking into a bag. The stomach discomfort got better in 24 hours (mild fever also went away). Then the coughing started which later days. I'd wake up at nights to cough for few minutes each time. Chest tightness also began. I'm a lot better now, but my chest tightness isn't fully gone. If I fully relax my body I can feel a tiny bit of resistance to talking in a whole breath of air. I also have asthma and using my inhaler helped!

 

CorpRaider, keep hope and stay happy. Positivity helps the immune system. Thank God for Netflix. I watched a ton of comedy when I was going through the bug, whatever it was. Stay hydrated!!

 

I never considered Corona seriously but it does look like the symptoms are correlated. Now if there was community transmission in late January, just imagine how off we are with the denominator. I've been thinking about this a lot lately. The hard thing with exponentials is that it's easy to be way off if we are even slightly off in any parameter. What if we are wrong on the start date by a couple of weeks or so?

 

Orthopa's anecdotes and line of thought seems reasonable to me.

 

Thanks! I have little doubt about the denominator.  I had to really search for accounts of these symptoms.

[Read the Footnotes]

Man, I think I might have this thing.  Started with stomach pain and "discomfort" for like 24 hours then horrible, worst in my life, stomach flu symptoms, high fever nasty chills and aches for like 24 hours, now I've still got some stomach "issues" but with a little cough and mild tightness in the chest, no fever.  Hopefully, it gets better from here.  I read that a small percentage of people have experienced severed nausea etc then the cough and respiratory stuff...with corona.  If I could do the drive thru google test, I would, but I'm not going to go contaminate the hospital unless it gets a lot worse.

 

Lurker for years, my first post on this forum.

 

I had the sae thing in late January. Extreme stomach discomfort that started quite suddenly leading to bouts of vomiting. I couldn't even drive myself back home without puking into a bag. The stomach discomfort got better in 24 hours (mild fever also went away). Then the coughing started which later days. I'd wake up at nights to cough for few minutes each time. Chest tightness also began. I'm a lot better now, but my chest tightness isn't fully gone. If I fully relax my body I can feel a tiny bit of resistance to talking in a whole breath of air. I also have asthma and using my inhaler helped!

 

CorpRaider, keep hope and stay happy. Positivity helps the immune system. Thank God for Netflix. I watched a ton of comedy when I was going through the bug, whatever it was. Stay hydrated!!

 

I never considered Corona seriously but it does look like the symptoms are correlated. Now if there was community transmission in late January, just imagine how off we are with the denominator. I've been thinking about this a lot lately. The hard thing with exponentials is that it's easy to be way off if we are even slightly off in any parameter. What if we are wrong on the start date by a couple of weeks or so?

 

Orthopa's anecdotes and line of thought seems reasonable to me.

 

Thanks! I have little doubt about the denominator.  I had to really search for accounts of these symptoms.

 

I have said all along that I think there's some truth to Orthopa's observations and they should not be dismissed. I do think it's a mistake to see it as 100% good news or 100% bad news. With this virus it seems nothing is simple or easy to analyze. The analysts who were likely to do well with forecasting Coronavirus were the ones who dig deeply and account well for complexity. Heuristics and simple estimates had little use in understanding some features of the impact of this virus.

 

On the positive side, it is possible that more people have already been inoculated, recovered and developed immunity this would:

lower the CFR ultimately, once the final CFR is known

 

On the other hand it means that in many places of the country they are even more likely to underestimate the risk that the healthcare system will become overwhelmed in the next couple of weeks.

 

A different issue is that it is possible there have been people who died from COVID-19 and were never diagnosed

 

It is also possible that college kids have been passing this amongst themselves symptomatically and the effect of dispersing the college kids throughout the country has not been full appreciated or prepared for.

[John Hjorth]

Imperial College COVID-19 Response Team [March 16^th 2020] : Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand.

 

This should be the report that made Mr. Johnson & his government change strategy for the UK.

 

 

[Dalal.Holdings]

https://www.nytimes.com/2020/03/16/health/coronavirus-statistics-undetected.html

 

Scientists tracking the spread of the coronavirus reported on Monday that, for every confirmed case, there are most likely another five to 10 people in the community with undetected infections. These often-milder cases are, on average, about half as infectious as confirmed ones, but are responsible for nearly 80 percent of new cases, according to the report, which was based on data from China.

 

“It is crucial to implement wide-scale testing,” said Dr. Elizabeth Halloran, a professor of biostatistics at the University of Washington and a senior researcher at the Fred Hutchinson Cancer Research Center. “And it’s important to develop inexpensive tests so people can get tested whenever they need to be.”

 

So we have a virus with 1) a long incubation time, 2) many individuals who catch it having mild/no symptoms (i.e. not knowing they have it unless they are tested for it), 3) easy spread via respiratory droplets, and 4) high mortality in certain subgroups such as elderly.

 

Essentially it is a deadly virus for certain subgroups with a rapid rate of spread in the wider population. Though a majority of cases will be mild, the sudden surge in severe cases overwhelm healthcare systems which already have low capacity.

 

This explains why we have seen what we have and why widespread testing is necessary--ie do NOT limit tests to high risk/symptomatic people, but let those healthy people who have it know they have it so they stay away from others/elderly.

 

Most people may in the end get this, but if you concentrate all infections in a short time period (weeks--months), then the surge in severe cases (though a minority) will overwhelm.

 

There are people arguing with anecdotes that it has been in the U.S. in large numbers for months--never underestimate the power of anecdotes (to mislead). We are merely weeks behind the Euro countries.

[Liberty]

Potential for exponential decline if we do this right:

 

 

Edit: Bill Gates TED Talk from 5 years ago (excerpt about risk of pandemic):

 

[Dalal.Holdings]

Potential for exponential decline if we do this right:

 

 

Take some pain upfront and get out quickly or drag your feet and the cumulative pain will be much worse...

 

"An ounce of prevention is worth a pound of cure"

 

A useless saying (to some).

[Cigarbutt]

Imperial College COVID-19 Response Team [March 16^th 2020] : Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand.

 

This should be the report that made Mr. Johnson & his government change strategy for the UK.

-I think they (UK relevant leaders) have looked at this and they will. The situation is dynamic.

-On a personal level (people close to me), the measures taken for the frail and elderly has a net negative effect on the short term and a questionable value long term. Second-order consequences (especially long term) are hard to assess.

-On a personal level, most young members of the household are back to the household and I've started to see the consequences of keeping productive individuals idle. It's not all positive.

-Flattening the curve is a good idea but there are costs, some of which are long term and the same way humans are not naturally wired to assess long term consequences, humans are not wired to appreciate long term costs of dealing with those consequences.

-Flattening the curve assumes a long term commitment and I wonder if this thread will become inactive when it perhaps shouldn't.

-Last night, i was asked to review stuff i learned in the 80's and I will try to do my part.

[cubsfan]

Perhaps this Morningstar assessment has been posted already:

 

https://www.morningstar.com/articles/971254/morningstars-view-the-impact-of-coronavirus-on-the-economy

 

 

[Liberty]

Study: 'Relationship between Vitamin D status and Viral Pneumonia in Children': https://www.liebertpub.com/doi/abs/10.1089/ped.2017.0750?journalCode=ped&

 

Study: 'Association between serum concentration of 25-hydroxyvitamin D and community-acquired pneumonia: a case-control study': https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5692194/

[Spekulatius]

Man, I think I might have this thing.  Started with stomach pain and "discomfort" for like 24 hours then horrible, worst in my life, stomach flu symptoms, high fever nasty chills and aches for like 24 hours, now I've still got some stomach "issues" but with a little cough and mild tightness in the chest, no fever.  Hopefully, it gets better from here.  I read that a small percentage of people have experienced severed nausea etc then the cough and respiratory stuff...with corona.  If I could do the drive thru google test, I would, but I'm not going to go contaminate the hospital unless it gets a lot worse.

 

Lurker for years, my first post on this forum.

 

I had the sae thing in late January. Extreme stomach discomfort that started quite suddenly leading to bouts of vomiting. I couldn't even drive myself back home without puking into a bag. The stomach discomfort got better in 24 hours (mild fever also went away). Then the coughing started which later days. I'd wake up at nights to cough for few minutes each time. Chest tightness also began. I'm a lot better now, but my chest tightness isn't fully gone. If I fully relax my body I can feel a tiny bit of resistance to talking in a whole breath of air. I also have asthma and using my inhaler helped!

 

CorpRaider, keep hope and stay happy. Positivity helps the immune system. Thank God for Netflix. I watched a ton of comedy when I was going through the bug, whatever it was. Stay hydrated!!

 

I never considered Corona seriously but it does look like the symptoms are correlated. Now if there was community transmission in late January, just imagine how off we are with the denominator. I've been thinking about this a lot lately. The hard thing with exponentials is that it's easy to be way off if we are even slightly off in any parameter. What if we are wrong on the start date by a couple of weeks or so?

 

Orthopa's anecdotes and line of thought seems reasonable to me.

 

This might be neither the flu nor COVID-19. It happens quite a bit that viral infections are diagnosed (by exclusion?) and it tests negative for flu. My son years ago had periodic spouts of sickness we could never get to the bottom of. Sometimes, it was just a stomach flu (vomiting), sometimes it was high fever (so high they we went to the ICU with him because were scared) and always tested negative for flu.

 

These period spouts of virus infection went away by itself thankfully as he grow older. I am not a doctor, so don’t claim to know much, but seem seems to be quite often viral infections around they don’t seem to test positive for flu.

 

Anyways, good luck and hopefully you feel better. Even if its’s just a  stomach flu it’s no fun, I had my fair shares of those way back,

[Read the Footnotes]

Perhaps this Morningstar assessment has been posted already:

 

https://www.morningstar.com/articles/971254/morningstars-view-the-impact-of-coronavirus-on-the-economy

 

Thanks for sharing. I think the framework presented will be useful for some people. Here are my thoughts after a quick skim:

1) Short-term impacts seem too optimistic

2) Long-term impacts seem too pessimistic

3) This was dated March 10, my guess is that if they could start from scratch today, they would use different assumptions and inputs

 

A shallow dive on this subject without a deep and specific understanding will make it very difficult to see the future in this case.

[cubsfan]

I agree - it's such a fast moving situation. It does demonstrate the wide range of outcomes due to the unknowns.

[Jurgis]

Man, I think I might have this thing.  Started with stomach pain and "discomfort" for like 24 hours then horrible, worst in my life, stomach flu symptoms, high fever nasty chills and aches for like 24 hours, now I've still got some stomach "issues" but with a little cough and mild tightness in the chest, no fever.  Hopefully, it gets better from here.  I read that a small percentage of people have experienced severed nausea etc then the cough and respiratory stuff...with corona.  If I could do the drive thru google test, I would, but I'm not going to go contaminate the hospital unless it gets a lot worse.

 

Lurker for years, my first post on this forum.

 

I had the sae thing in late January. Extreme stomach discomfort that started quite suddenly leading to bouts of vomiting. I couldn't even drive myself back home without puking into a bag. The stomach discomfort got better in 24 hours (mild fever also went away). Then the coughing started which later days. I'd wake up at nights to cough for few minutes each time. Chest tightness also began. I'm a lot better now, but my chest tightness isn't fully gone. If I fully relax my body I can feel a tiny bit of resistance to talking in a whole breath of air. I also have asthma and using my inhaler helped!

 

CorpRaider, keep hope and stay happy. Positivity helps the immune system. Thank God for Netflix. I watched a ton of comedy when I was going through the bug, whatever it was. Stay hydrated!!

 

I never considered Corona seriously but it does look like the symptoms are correlated. Now if there was community transmission in late January, just imagine how off we are with the denominator. I've been thinking about this a lot lately. The hard thing with exponentials is that it's easy to be way off if we are even slightly off in any parameter. What if we are wrong on the start date by a couple of weeks or so?

 

Orthopa's anecdotes and line of thought seems reasonable to me.

 

This might be neither the flu nor COVID-19. It happens quite a bit that viral infections are diagnosed (by exclusion?) and it tests negative for flu. My son years ago had periodic spouts of sickness we could never get to the bottom of. Sometimes, it was just a stomach flu (vomiting), sometimes it was high fever (so high they we went to the ICU with him because were scared) and always tested negative for flu.

 

These period spouts of virus infection went away by itself thankfully as he grow older. I am not a doctor, so don’t claim to know much, but seem seems to be quite often viral infections around they don’t seem to test positive for flu.

 

Anyways, good luck and hopefully you feel better. Even if its’s just a  stomach flu it’s no fun, I had my fair shares of those way back,

 

I am afraid that because COVID-19 is not tested, a lot of people may self-diagnose as COVID even though it isn't. (Of course, there's also the opposite: people may self-diagnose as non-COVID even though it is.)

Even if these people are tested negative for flu (but then flu testing is also not very common), it's still not necessarily COVID.

[Dalal.Holdings]

 

Well it looks like data is presenting with flu symptoms. Does not mention deaths. I would hope to god if people died they were tested for covid19. Dead people get just as much of a right to a test as living plus in this day and age a requirement I would imagine. I would imagine the data is due to.

 

1. Covid19 of course, it has flu like symptoms

2. Worries individuals/paranoid.

 

Otherwise how do you fake flu symptoms?

 

 

 

 

"Katie S

@scoville_katie

Replying to

@chrislhayes

I noticed about a month ago that we were treating a lot of patients for the flu that had negative flu tests. My mind goes back to that and I just wonder if we missed the bus even before we thought we did."

 

Maybe I work where Katie works LOL! jk. Worth a read of her thread!

 

 

No it starts to increase March 1st, now that is giving a generous 14 day time to death! So we still have to wait some more?

 

I've attached the graph here. You seem misled by the x-axis labeling. I guess you are entitled to your own facts if you choose...

 

It should be noted that in addition to real COVID cases, something else that can explain the spike in these numbers is awareness of COVID outbreak leading to more people going to see healthcare providers who otherwise would have powered through a non-COVID URI illness on their own.

[cobafdek]

Here's my one hopeful observation that the Covid-19 pandemic may not really be as much of a pandemic as it feels like right now.  It has to do with the testing issue.

 

All the testing we hear about in the news is about a screening test.  RT-PCR is a screening test.  That's the only testing available so far.  It is not a diagnostic test.  All "diagnoses" and "cases" reported in the news (worldwide 188,609 cases to date as of this post) is based on a screening test.

 

Many PCRs for many different infectious diseases are known to have unacceptably high false positive rates.  This can only be determined by a gold standard test, such as a viral culture.  I've searched and so far have found no information about viral cultures or other confirmatory testing for Covid-19.

 

There are many coronaviruses out there.  It's possible there is significant cross-reactivity between some of these other coronaviruses, or other non-corona respiratory viruses, with the Covid-19 RT-PCR.  In other words, many of the cases currently being identified may actually be identifying something else.

 

This situation is obviously natural early in the outbreak of a novel pathogen.  The fact that the Chinese rapidly developed a test so early is amazing.  But a rapidly available test means you sacrifice accuracy.  For epidemiological screening, you need to identify possible cases quickly with a rapid test that that has a high sensitivity rate.  But a test with high sensitivity means you're sacrificing specificity.  Epidemiologists will get a better handle on specificity over time as confirmatory tests become available.

 

 

 

[Dalal.Holdings]

Here's my one hopeful observation that the Covid-19 pandemic may not really be as much of a pandemic as it feels like right now.  It has to do with the testing issue.

 

All the testing we hear about in the news is about a screening test.  RT-PCR is a screening test.  That's the only testing available so far.  It is not a diagnostic test.  All "diagnoses" and "cases" reported in the news (worldwide 188,609 cases to date as of this post) is based on a screening test.

 

Many PCRs for many different infectious diseases are known to have unacceptably high false positive rates.  This can only be determined by a gold standard test, such as a viral culture.  I've searched and so far have found no information about viral cultures or other confirmatory testing for Covid-19.

 

There are many coronaviruses out there.  It's possible there is significant cross-reactivity between some of these other coronaviruses, or other non-corona respiratory viruses, with the Covid-19 RT-PCR.  In other words, many of the cases currently being identified may actually be identifying something else.

 

This situation is obviously natural early in the outbreak of a novel pathogen.  The fact that the Chinese rapidly developed a test so early is amazing.  But a rapidly available test means you sacrifice accuracy.  For epidemiological screening, you need to identify possible cases quickly with a rapid test that that has a high sensitivity rate.  But a test with high sensitivity means you're sacrificing specificity.  Epidemiologists will get a better handle on specificity over time as confirmatory tests become available.

 

So what you are saying is that we have a lot of false positives out there. That would mean that the denominator of cases is potentially smaller than we think it is and the mortality is higher. That would not be reassuring to me.

[minten]

Here's my one hopeful observation that the Covid-19 pandemic may not really be as much of a pandemic as it feels like right now.  It has to do with the testing issue.

 

All the testing we hear about in the news is about a screening test.  RT-PCR is a screening test.  That's the only testing available so far.  It is not a diagnostic test.  All "diagnoses" and "cases" reported in the news (worldwide 188,609 cases to date as of this post) is based on a screening test.

 

Many PCRs for many different infectious diseases are known to have unacceptably high false positive rates.  This can only be determined by a gold standard test, such as a viral culture.  I've searched and so far have found no information about viral cultures or other confirmatory testing for Covid-19.

 

There are many coronaviruses out there.  It's possible there is significant cross-reactivity between some of these other coronaviruses, or other non-corona respiratory viruses, with the Covid-19 RT-PCR.  In other words, many of the cases currently being identified may actually be identifying something else.

 

This situation is obviously natural early in the outbreak of a novel pathogen.  The fact that the Chinese rapidly developed a test so early is amazing.  But a rapidly available test means you sacrifice accuracy.  For epidemiological screening, you need to identify possible cases quickly with a rapid test that that has a high sensitivity rate.  But a test with high sensitivity means you're sacrificing specificity.  Epidemiologists will get a better handle on specificity over time as confirmatory tests become available.

 

maybe you're right, but don't you think the number of false positives would be greatly exceeded by people that were never even tested at all?

 

i'm personally starting to come around to the exact opposite conclusion:  much more people have it than we think, but don't know it.  which as i think i said before, isn't necessarily bad news either.

[Liberty]

https://www.sciencemag.org/news/2020/03/coronavirus-cases-have-dropped-sharply-south-korea-whats-secret-its-success

 

Amid these dire trends, South Korea has emerged as a sign of hope and a model to emulate. The country of 50 million appears to have greatly slowed its epidemic; it reported only 74 new cases today, down from 909 at its peak on 29 February.

 

Also: https://www.washingtonpost.com/business/2020/03/16/cdc-who-coronavirus-tests/

 

"By the end of February, a Berlin start-up had produced 1.4 million tests for coronavirus to ship around the world.  The US said no thanks; we can create our own. "

[Dalal.Holdings]

https://www.sciencemag.org/news/2020/03/coronavirus-cases-have-dropped-sharply-south-korea-whats-secret-its-success

 

Amid these dire trends, South Korea has emerged as a sign of hope and a model to emulate. The country of 50 million appears to have greatly slowed its epidemic; it reported only 74 new cases today, down from 909 at its peak on 29 February.

 

Also: https://www.washingtonpost.com/business/2020/03/16/cdc-who-coronavirus-tests/

 

"By the end of February, a Berlin start-up had produced 1.4 million tests for coronavirus to ship around the world.  The US said no thanks; we can create our own. "

 

"Zero responsibility" Trump virus "like the Flu" in February but in March "very bad" doing 10/10 great job!

[cobafdek]

So what you are saying is that we have a lot of false positives out there. That would mean that the denominator of cases is potentially smaller than we think it is and the mortality is higher. That would not be reassuring to me.

 

The numerator would also be smaller.  Change in mortality rate would depend on which changes more.

 

maybe you're right, but don't you think the number of false positives would be greatly exceeded by people that were never even tested at all?

 

i'm personally starting to come around to the exact opposite conclusion:  much more people have it than we think, but don't know it.  which as i think i said before, isn't necessarily bad news either.

 

What "it" is, is my point.  What is "it"?  [edit:  The only way to know that more people have "it" is if we know that the positive predictive value is very high, and no one knows this number yet.]

 

Keep in mind I am not changing my behavior based on my speculation.  I'm still running like hell.

[Dalal.Holdings]

So what you are saying is that we have a lot of false positives out there. That would mean that the denominator of cases is potentially smaller than we think it is and the mortality is higher. That would not be reassuring to me.

 

The numerator would also be smaller.  Change in mortality rate would depend on which changes more.

 

 

So what are those people dying from? Run-of-the-mill coronavirus that typically causes common cold?

[cobafdek]

So what you are saying is that we have a lot of false positives out there. That would mean that the denominator of cases is potentially smaller than we think it is and the mortality is higher. That would not be reassuring to me.

 

The numerator would also be smaller.  Change in mortality rate would depend on which changes more.

 

 

So what are those people dying from? Run-of-the-mill coronavirus that typically causes common cold?

 

Strictly speaking, they are dying from something associated with a positive RT-PCR Covid-19 test, the test characteristics (accuracy and predictive value) of which has not been systematically evaluated.

[Liberty]

https://www.connexionfrance.com/French-news/French-researcher-in-Marseille-posts-successful-Covid-19-coronavirus-drug-trial-results

[minten]

interesting well-argumented contrarian opinion piece from an epidemiology professor on why fatality ratio of this virus might be much lower than we think:

 

https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/?utm_content=buffere08f7&utm_medium=social&utm_source=twitter&utm_campaign=twitter_organic

 

 

 

[LC]

minten, thank you for posting. This explains why testing i.e. accurate information is a critical factor in early stage viral outbreaks.

 

For all we know, widespread testing could show the severity of this virus is totally overblown as critics on this thread have suggested, and therefore the pandemic responses are unwarranted. Our portfolios and emotions could have been spared much stress.