Coronavirus

[Investor20]

1) There was no exponential growth in India before shutdown. Hardly 1-2 deaths a day till March 22nd.

    In fact on March 21st its ZERO deaths.

 

  The exponential growth came after shutdown - I didn't know that is the purpose of shutdown.

 

So you're saying that the shutdown caused exponential growth of deaths?  Like, your expectation would be if you isolate people into groups of 4 and never let them have any sort of contact with any other group, your death rate from COVID-19 would be higher than allowing everyone to intermix to their heart's content?

 

Huh. That's kind of a strange theory, but OK. 

 

"When you put in the lockdown, it seems like it's about 2 weeks until cases fall"

      -2.5 weeks later zero deaths on March 21st came to about 24 deaths on April 07th

 

3, 4, 5 are irrelavant to India as the absolute cases are small for a country of billion+ people.

 

Yeah, I included those in there because I thought you wanted an explanation of when deaths should be decreasing, not to discredit your "quarantining causes order-of-magnitude spikes in COVID-19 deaths" theory. My mistake.

 

I dont have any theory.  I dont think there is enough information to make a theoretical model.

 

Empirically the theory YOU proposed doesnt match the data at hand.  In India the exponential growth started after lockdown. Thats not a theory.  Thats data.

 

Also, the deaths all of South East Asia are low where there were no lockdowns till now.  Thats not a theory.. Not a model.  Thats data.

 

That sure sounds like a logical cry you are making - Yes that is DATA. In itself it is useless, and has to be interpreted in some manner within a context. 

 

You keep talking about South East Asia - What countries are you counting in those?

 

Eventhough not separate country, Hongkong, and then Taiwan, Japan, Malaysia, Singapore.

 

There were a bunch of articles about Taiwan how well they managed.  And they didnt have shutdown.

 

Ok let's assume they have managed it, tell us please how they managed it and at what stage. And let's say that we were too late to manage it the way they managed, what were the options left for us?

 

Regarding Taiwan there were many articles recently.  I posted earlier a bloomberg article:

https://www.bloomberg.com/opinion/articles/2020-04-05/taiwan-s-advance-on-who-in-covid-19-shows-its-place-in-world

 

Two points given in this article are 1) Early travel restriction from Wuhan and then China.  2) Early implementation of masks, in January itself.

As per worldometer the tests/million for

Taiwan ~1700

US ~6500

S.Korea ~9300

Italy ~13000

 

So, it doesnt seem Taiwan did a lot of tests.

But as per reports they did have early travel restrictions along with strict quarantine for visitors.

 

"Like, your expectation would be if you isolate people into groups of 4 and never let them have any sort of contact with any other group, your death rate from COVID-19 would be higher than allowing everyone to intermix to their heart's content?"

 

I dont think there is enough understanding to answer affirmatively.  But it is possible if most of the infections are caused in close proximity in closed environments. 

 

There are articles talking about dangers of bringing home young adults from colleges who may be asymptomatic carriers and put them in homes with grandparents.

Also when people are out, there is automatically more distancing than people are restricted inside, especially in small homes. 

To the level aerosol microdroplet transmission is possible, closed environments will be worse.

Please watch this video about microdroplets

https://www.youtube.com/watch?v=H2azcn7MqOU

As given in that video, masks would help with microdroplet transmission.

 

Again, I dont think theoretically its easy to come up with answers.  What I am trying to do is look at it empirically.

[dwy000]

 

"Black Mirror update: Outside the NY metro area, hospitals are empty."

 

can confirm this is true in Jax

 

Considering they cancelled all elective procedures and appointments (or doing them by phone or video) and everything else, and people are probably doing EVERYTHING humanly possible to avoid going to the hospital right now, that makes sense.

 

And this is why I'm long the health insurers during the biggest health pandemic.  Just as the auto insurers are making a fortune (and giving credits) due to the slowdown in driving, the health insurers are likely making a fortune due to the severe drop in non-covid healthcare usage.  Emergency room admissions (including covid) have fallen in half and doctor visits (non covid related) have also plummeted.  KKR is cutting doctor salaries at Envision Healthcare due to lack of business.

[RichardGibbons]

 

"Like, your expectation would be if you isolate people into groups of 4 and never let them have any sort of contact with any other group, your death rate from COVID-19 would be higher than allowing everyone to intermix to their heart's content?"

 

I dont think there is enough understanding to answer affirmatively.  But it is possible if most of the infections are caused in close proximity in closed environments. 

 

Yeah, I don't think it's possible, and think that this is pretty much to the last hypothesis than anyone should actually test because it makes no sense.  But it would be fun to write a science fiction story where this was the case. (Like some sort of scenario where everyone is infected by a disease, and the only way to avoid death is to interact frequently with people who have different genetics--all the people with type A genetics have to interact with types B, C, D, E, and F at least once a week or they die, etc. Figuring that out for the first time would be a bitch.)

 

Again, I dont think theoretically its easy to come up with answers.  What I am trying to do is look at it empirically.

 

Empiricism is good, but you are much more efficient and maximize the value if you include some reasonable thought as well. (E.g. why wasn't your theory that infection rates are based on the number of letters in the name of each country's capital city?  Or the per-capita number of people in the country who have one leg?)

 

That said, analysis unsupported by data is as pointless as data without reason, so I like your dedication to empiricism.

[ERICOPOLY]

the health insurers are likely making a fortune due to the severe drop in non-covid healthcare usage. 

 

Dental insurers must be very, very happy.

[ERICOPOLY]

I think this helps explains why California has done better.

 

Nobody walks in LA.

[DooDiligence]

Sad day.

 

www.npr.org/2020/04/07/750894794/john-prine-obituary

[randomep]

 

"Black Mirror update: Outside the NY metro area, hospitals are empty."

 

can confirm this is true in Jax

 

+1

 

It pays to have an open mind.

 

[Investor20]

 

"Like, your expectation would be if you isolate people into groups of 4 and never let them have any sort of contact with any other group, your death rate from COVID-19 would be higher than allowing everyone to intermix to their heart's content?"

 

I dont think there is enough understanding to answer affirmatively.  But it is possible if most of the infections are caused in close proximity in closed environments. 

 

Yeah, I don't think it's possible, and think that this is pretty much to the last hypothesis than anyone should actually test because it makes no sense.  But it would be fun to write a science fiction story where this was the case. (Like some sort of scenario where everyone is infected by a disease, and the only way to avoid death is to interact frequently with people who have different genetics--all the people with type A genetics have to interact with types B, C, D, E, and F at least once a week or they die, etc. Figuring that out for the first time would be a bitch.)

 

Again, I dont think theoretically its easy to come up with answers.  What I am trying to do is look at it empirically.

 

Empiricism is good, but you are much more efficient and maximize the value if you include some reasonable thought as well. (E.g. why wasn't your theory that infection rates are based on the number of letters in the name of each country's capital city?  Or the per-capita number of people in the country who have one leg?)

 

That said, analysis unsupported by data is as pointless as data without reason, so I like your dedication to empiricism.

 

"why wasn't your theory that infection rates are based on the number of letters in the name of each country's capital city?  Or the per-capita number of people in the country who have one leg?"

 

Because aerosol transmission for Covid is now recognized as important way to transmit

Because recognition of substantial asymptomatic people who can produce these aerosol just by talking - no need to sneeze or cough

This transmission is most efficient in closed and close environment.

I provided a video of Japanese researchers in this thread to show how it works.

Why two people talking close to each other in a closed room is worse.

Why the small droplets can hang over in a closed environment for prolonged period raising chances of infection.

 

https://www.cidrap.umn.edu/news-perspective/2020/03/commentary-covid-19-transmission-messages-should-hinge-science

Some pointers for your education (for talking rudely to me I have to use similar language.  We can either make it a pleasant discussion or a rude argument)

 

Underlying the CDC and WHO statements about transmission is this: Inhalation of particles near the source may be an important mode of transmission.

 

Droplet transmission is probably much less important for most respiratory infectious diseases than is short-range aerosol transmission by inhalation. Aerosol particles are not all large, and they do not all immediately fall to the ground. It is rare for coughs or sneezes to be propelled into nearby mouths or noses.

 

An increasing number of studies with animals and in human settings indicate that close-range aerosol transmission by inhalation is important for influenza.

[Liberty]

Japanese study on micro-droplets that hang in the air as a potential infection vector:

 

[cubsfan]

NY has 26X as many deaths as CA - yet the California coast is densely populated. You also have thousands living in filthy tent cities and no out break.

In CA you have hospitals full of illegal immigrants - perhaps not overwhelmed yet...

The social policies with both governors were implemented within days of each other.

You had thousands of Chinese per day flying into NYC, LA, SF - more than any areas of the country.

 

It all looks pretty similar..

 

There is an awfully lot of guessing going on here, that's for sure. Can't possibly be herd immunity, could it?

 

Keep an open mind.

[cubsfan]

^ I would say that NYC is still different than SF or LA in that most people use public transportation in  NYC which is not to the same extend the case in SF or LA. If you ever took the subway or the LIRR (in my case) in NYC you knows how got of a transmission vector this might be. Boston also has significant public transportation for commute and is a hot spot as well. Likely other reasons like SF being really proactive (shelter in place on February 25) or perhaps the warmer weather might be factor too.

 

That’s the thing with exponential growth models , a couple of seemingly small factors can make a huge difference in the end.

 

So if this is true - NYC and Boston, and a few others have public transportation spreading the disease - the rest of the country, including

rural America needs to be on total lockdown?

[Liberty]

NY has 26X as many deaths as CA - yet the California coast is densely populated. You also have thousands living in filthy tent cities and no out break.

In CA you have hospitals full of illegal immigrants - perhaps not overwhelmed yet...

The social policies with both governors were implemented within days of each other.

You had thousands of Chinese per day flying into NYC, LA, SF - more than any areas of the country.

 

It all looks pretty similar..

 

There is an awfully lot of guessing going on here, that's for sure. Can't possibly be herd immunity, could it?

 

Keep an open mind.

 

Nice peak into your mental model of what different places look like.

 

NYC has very widely used public transportation, lots of international travel and close proximity living, making it more likely to have a higher R0 and so to emerge first. California would emerge latter in any case unless it got unlucky, because the conditions aren't as favorable to the virus as NYC.

 

It can't be herd immunity, because to get to herd immunity with a disease with a R0 between 2-5 you need maybe 40-80% of the population to be infected. But if we already had herd immunity this quick, the R0 would have had to have been much higher, like measles or pertussis, right? But with a R0 of 12 or more, you need over 90% of the population to be infected before you get herd immunity.

 

If 90% of california had SARS-CoV-2, believe me, it wouldn't have happened without anyone noticing it.

 

So in short, your theory doesn't make sense.

 

Not to mention that so far, testing in random population samples seems to give results closer to 1% for antibodies, nowhere near enough for herd immunity.

 

[Liberty]

So if this is true - NYC and Boston, and a few others have public transportation spreading the disease - the rest of the country, including

rural America needs to be on total lockdown?

 

You don't understand exponential growth and R0.

 

Places that are set up in a way that R0 is higher emerge first. Other places take longer, but they still get there. Remember how in exponential curves it looks like nothing happens for the longest time and then it all happens in a very short amount of time?

 

Rural places still get colds and the flu, right?

 

In fact, they can potentially be hit harder per capita than big cities because their healthcare isn't as advanced and their populations tend to be less healthy (more obesity, diabetes, etc).

[krazeenyc]

NY has 26X as many deaths as CA - yet the California coast is densely populated. You also have thousands living in filthy tent cities and no out break.

In CA you have hospitals full of illegal immigrants - perhaps not overwhelmed yet...

The social policies with both governors were implemented within days of each other.

You had thousands of Chinese per day flying into NYC, LA, SF - more than any areas of the country.

 

It all looks pretty similar..

 

There is an awfully lot of guessing going on here, that's for sure. Can't possibly be herd immunity, could it?

 

Keep an open mind.

 

California coast not nearly as dense as NYC.

According to the NYT, the the majority of New York cases are European in origin.

 

https://www.nytimes.com/2020/04/08/science/new-york-coronavirus-cases-europe-genomes.html

 

Keep and open mind.

[cubsfan]

NY has 26X as many deaths as CA - yet the California coast is densely populated. You also have thousands living in filthy tent cities and no out break.

In CA you have hospitals full of illegal immigrants - perhaps not overwhelmed yet...

The social policies with both governors were implemented within days of each other.

You had thousands of Chinese per day flying into NYC, LA, SF - more than any areas of the country.

 

It all looks pretty similar..

 

There is an awfully lot of guessing going on here, that's for sure. Can't possibly be herd immunity, could it?

 

Keep an open mind.

 

California coast not nearly as dense as NYC.

According to the NYT, the the majority of New York cases are European in origin.

 

https://www.nytimes.com/2020/04/08/science/new-york-coronavirus-cases-europe-genomes.html

 

Keep and open mind.

 

I am keeping an open mind, I'm wondering why these brilliant epidemiologists from Stanford are wasting their time looking at the

herd immunity issue.  Good thing they are not on this thread - since they don't understand exponential growth and R0 !

[Liberty]

I am keeping an open mind, I'm wondering why these brilliant epidemiologists from Stanford are wasting their time looking at the

herd immunity issue.  Good thing they are not on this thread - since they don't understand exponential growth and R0 !

 

You know what they say.

 

Keeping an open mind is good.

 

But don't have it so open that your brain falls out...

 

Herd immunity could be an end state if we can't suppress and contain it long enough for a vaccine. It's actually not unlikely, sadly.

 

That's different from saying that California already has herd immunity because it has fewer deaths than NYC.

 

It's also very useful to do serum tests for antibodies to random samples of the population to try to better nail down the R0 and CFR of the disease, but I don't think anyone seriously expects that we're already at herd immunity and we just don't know it yet.

[cubsfan]

So if I understand this - lack of outbreak in CA is due to no subways and crowded public transportation and because it supposedly

arrived in NYC from Europe from someone that was in Wuhan.

 

Maybe I should also assume that CA doesn't have crowded elevators, shopping malls, restaurants , sporting events, etc.

Nope - COVID19 is now a disease of the subway.

 

Not to mention those direct daily flights into CA from Wuhan - I guess those planes are just not crowded enough - even given

CA has the largest Chinese continent in the country.

 

Why are these guys wasting their time.

 

 

[Mephistopheles]

I posted this link previously but the “BCG helps” theory does a curiously good job fitting several cross country/region differences in how things are going:

 

https://www.jsatonotes.com/2020/03/if-i-were-north-americaneuropeanaustral.html

 

Could be just a coincidence but interesting nonetheless. A controlled experiment is underway in Australia and we should know the results in a few months.

 

Some conflicting data - France and Spain are not doing well. Spain is actually worse than Italy right now. Spain and

France both habe BCG vaccination.Also, Portugal, which has no BCG vaccination and is poorer does much better than Spain, it’s direct and richer neighbor which does have BCG vaccination. So quite a few countries run counter this trend eventhough they are otherwise comparable.

 

You've got it backwards. Portugal has mandatory BCG vaccine and Spain does not. France had BCG vaccine only for school children up until 2007 and for healthcare workers until 2010.

[ERICOPOLY]

I still think it pays to be humble given the unknowns.

 

There is a lot we still don't understand.

 

Why are these guys wasting their time.

[Liberty]

So if I understand this - lack of outbreak in CA is due to no subways and crowded public transportation and because it supposedly

arrived in NYC from Europe from someone that was in Wuhan.

 

Maybe I should also assume that CA doesn't have crowded elevators, shopping malls, restaurants , sporting events, etc.

Nope - COVID19 is now a disease of the subway.

 

Not to mention those direct daily flights into CA from Wuhan - I guess those planes are just not crowded enough - even given

CA has the largest Chinese continent in the country.

 

Why are these guys wasting their time.

 

Are you actually trying to be this obtuse just for the sake of arguing every single obvious point, or it just comes naturally?

[Santayana]

So if I understand this - lack of outbreak in CA is due to no subways and crowded public transportation and because it supposedly

arrived in NYC from Europe from someone that was in Wuhan.

 

Maybe I should also assume that CA doesn't have crowded elevators, shopping malls, restaurants , sporting events, etc.

Nope - COVID19 is now a disease of the subway.

 

Not to mention those direct daily flights into CA from Wuhan - I guess those planes are just not crowded enough - even given

CA has the largest Chinese continent in the country.

 

Why are these guys wasting their time.

 

Are you actually trying to be this obtuse just for the sake of arguing every single obvious point, or it just comes naturally?

 

I read that post and thought is he really trying to compare the density of NYC to California as a whole?  I'm guessing he's never made it west of Chicago.

[Liberty]

I read that post and thought is he really trying to compare the density of NYC to California as a whole?  I'm guessing he's never made it west of Chicago.

 

He may still be looking for the exit to his parents' basement, who knows?

 

Both places have elevators, right? Visa and Sears both have revenues, basically the same company.

[Liberty]

https://arstechnica.com/tech-policy/2020/04/trump-admin-pulls-funding-for-drive-through-covid-19-testing/

 

The feds will stop covering the tab for most community testing sites as of Friday (tomorrow), April 10, NPR reports.

 

The funding program originally included 41 testing sites nationwide, representatives with FEMA and the Department of Health and Human Services told NPR. Some, such as the site in Montgomery County, as well as in nearby Philadelphia, will close when the money dries up. Others will be "transitioning to state-managed sites," HHS told NPR. While many of those locations will close or change hands, however, local media in Texas report that two Dallas locations have received extended funding through May 30.

[Dalal.Holdings]

So if this is true - NYC and Boston, and a few others have public transportation spreading the disease - the rest of the country, including

rural America needs to be on total lockdown?

 

You don't understand exponential growth and R0.

 

Places that are set up in a way that R0 is higher emerge first. Other places take longer, but they still get there. Remember how in exponential curves it looks like nothing happens for the longest time and then it all happens in a very short amount of time?

 

Rural places still get colds and the flu, right?

 

In fact, they can potentially be hit harder per capita than big cities because their healthcare isn't as advanced and their populations tend to be less healthy (more obesity, diabetes, etc).

 

Only a cesspool urban dweller would try to rationalize disease spread in dense areas with fancy terms like R0...

 

These places are not “real America” anyway (though we’ll take their disproportionate GDP output)

 

Japan shows how this grows in urban places (Tokyo, Osaka):

https://flo.uri.sh/visualisation/1782780/embed

[arcube]

I still think it pays to be humble given the unknowns.

 

There is a lot we still don't understand.

 

Why are these guys wasting their time.

 

Very subtle.