Coronavirus

[gary17]

So does anyone know why is it that after Wuhan was shut down, we didn't see so many other cases in the rest of China?

I mean if it was so easy for Europe and the US to get out of control - surely it would have just been as easily for the rest of China to go out of control too...

what did the rest of China do that made the cases much lower than Europe / USA?

 

[Spekulatius]

So does anyone know why is it that after Wuhan was shut down, we didn't see so many other cases in the rest of China?

I mean if it was so easy for Europe and the US to get out of control - surely it would have just been as easily for the rest of China to go out of control too...

what did the rest of China do that made the cases much lower than Europe / USA?

 

Rest of  China had a lockdown too that was more stringent than in Europe or the US. Population is wearing masks and companies go to great length to avoid infection at the work place (I mentioned before that they shut down air circulation systems in factories /offices and vent with fresh air. They possibly are very good at contact tracing too (Big brother state).

 

I also think that the  Chinese government is lying about cases to some extend. Now if it were a full fledged epidemics, lying doesn’t work, but a few dozen unreported cases  orevendeath here and there to avoid public unrest seem to be plausible, If not likely...

[gary17]

So does anyone know why is it that after Wuhan was shut down, we didn't see so many other cases in the rest of China?

I mean if it was so easy for Europe and the US to get out of control - surely it would have just been as easily for the rest of China to go out of control too...

what did the rest of China do that made the cases much lower than Europe / USA?

 

Rest of  China had a lockdown too that was more stringent than in Europe or the US. Population is wearing masks and companies go to great length to avoid infection at the work place (I mentioned before that they shut down air circulation systems in factories /offices and vent with fresh air. They possibly are very good at contact tracing too (Big brother state).

 

I also think that the  Chinese government is lying about cases to some extend. Now if it were a full fledged epidemics, lying doesn’t work, but a few dozen unreported cases  or even death here and there to avoid public unrest seem to be plausible, If not likely...

 

Interesting. So did the rest of China do physical distancing / lockdown like what we are doing in Canada/USA/Europe?

 

I know Wuhan was shut and just opened a few days ago.  It seems pretty amazing China managed to keep the rest of the country operating.

 

 

 

[Investor20]

So does anyone know why is it that after Wuhan was shut down, we didn't see so many other cases in the rest of China?

I mean if it was so easy for Europe and the US to get out of control - surely it would have just been as easily for the rest of China to go out of control too...

what did the rest of China do that made the cases much lower than Europe / USA?

 

Rest of  China had a lockdown too that was more stringent than in Europe or the US. Population is wearing masks and companies go to great length to avoid infection at the work place (I mentioned before that they shut down air circulation systems in factories /offices and vent with fresh air. They possibly are very good at contact tracing too (Big brother state).

 

I also think that the  Chinese government is lying about cases to some extend. Now if it were a full fledged epidemics, lying doesn’t work, but a few dozen unreported cases  or even death here and there to avoid public unrest seem to be plausible, If not likely...

 

Interesting. So did the rest of China do physical distancing / lockdown like what we are doing in Canada/USA/Europe?

 

I know Wuhan was shut and just opened a few days ago.  It seems pretty amazing China managed to keep the rest of the country operating.

 

https://www.medrxiv.org/content/10.1101/2020.02.22.20025791v1

 

Results

There were in total 24,232 confirmed cases in China and 26 overseas countries. In total, 16,480 cases (68.01%) were from Hubei Province. The lgN rose as the average temperature went up to a peak of 8.72℃ and then slowly declined.

[Cigarbutt]

Important thread to understand what the antibodies tests actually mean:

...

The sensitivity and specificity of tests in a diagnostic context also apply this principle with the pre-test probability based on clinical presentation ie the test will increase the possibility that you have the disease if + and decrease the possibility of disease if -.

 

When used for screening, even slightly imperfect test specificity can raise significant issues. The concept that the thread describes is the positive predictive value. It can be a problem when (opposite scenario to CV) you receive a positive screening test while not having the disease. In this case 1-PPV means regret probability. Regret because it means one has to go through additional procedures, pain and anxiety for a statistical artefact. For the CV, the opposite plays out with the potential to create false confidence (think immunity is there while not having it for real) and this questions the usefulness of the immunity passport that some people suggested. Even if the prevalence goes up, on an individual basis, the positive predictive value increases and the individual likelihood of a true result increases but one is still left with a large absolute number of members of the population who are considered to be immune when they're not.

 

Specificity can be improved by repeat testing with the same test at a different time or a different test at the same time but the complexity of the combination may not be worth it.

 

Exit scenarios may involve a certain amount of controlled trials and errors.

[UK]

https://www.wsj.com/articles/health-authorities-roll-out-new-coronavirus-tests-to-gauge-infections-spread-11586511004

 

"There are early signs that past infection by the new coronavirus can prevent future disease. But some infectious-disease experts say there are too many unknowns about the immune system’s response to the virus—including how long immunity might last and the likelihood of reinfection—to rely on the tests to predict complete immunity. “I don’t know we have enough trust in what an exposure means that it would change the way we deploy our workforce,” Kimberly Hanson, an infectious-disease physician at the University of Utah School of Medicine, said at a media briefing. “We’re still trying to figure out what detecting an antibody response means, and if it’s protective or not, we don’t know.” Given the potential shortcomings, early serology tests might prove more useful as a tool for gauging the spread of the virus through communities, rather than for determining whether individuals have full immunity, said Stanford’s Dr. Bendavid."

 

https://www.wsj.com/articles/why-doesnt-flu-tank-economy-like-covid-19-11586511000?mod=trending_now_4

 

"For starters, the flu tallies are estimates of total flu burden, while the Covid-19 figures are confirmed cases only. Eventually, the CDC will estimate the total Covid-19 burden, but for now, the numbers are not an apples-to-apples comparison.“We always know confirmed cases are an underestimate,” said Lynnette Brammer, who leads the CDC’s domestic influenza-surveillance team.

 

In addition, Covid-19 differs from the flu in how quickly it spreads, the length and severity of the illness, and the unusual demands a contagion with no cure places on medical staff and facilities. Instead of gentle waves of cases cascading across the country over a span of six months, like the flu, a tidal wave of Covid-19 cases has swept over a handful of cities in half the time. The concentration of quickly amassing serious infections overwhelmed the affected areas, and the fear is that without social distancing—for now the only effective intervention—other places will have a similar experience. A snapshot of the 2009 H1N1 influenza pandemic shows the difference in the speed of transmission between a raging flu and the new coronavirus. Comparing only laboratory-confirmed cases, in the first 102 days of the H1N1 flu pandemic, the CDC reported 43,677 illnesses and 302 deaths. In 22 fewer days, Covid-19 infected 11 times as many people and killed 60 times as many. “The flu season is spread out,” said William Schaffner, an infectious-disease specialist at Vanderbilt University Medical Center in Nashville. “This is being jammed up in a short time frame.” Covid-19 outbreaks have also been highly localized. “You’ve got a hot-spot pattern instead of an even pattern,” said Emily Martin, an epidemiologist at the University of Michigan School of Public Health. “All the pressure is concentrated in small areas.”

 

Not only are more Covid-19 patients coming into hospitals, they require longer care.The median length of stay for adults hospitalized with seasonal flu is 3.6 days, according to research published in the journal Clinical Infectious Diseases. In nine Seattle-area hospitals, where 12 of 24 Covid-19 patients died through March 23, the median stay was 12 days in the hospital, 9 days in ICU and 10 days on mechanical ventilators. (The median for survivors was 17 days in the hospital, 14 in ICU and 11 on a ventilator.) Having a hospital full of highly contagious patients leads to diminished stores of equipment intended to protect staff members who are also at risk of infection. The University of Michigan Medical Center now requires everyone to wear a mask. Additionally, anyone caring for patients who have or are suspected of having Covid-19 must wear a gown and eye protection. During flu season, the center uses “droplet protection” only in some rooms, and there is no universal masking requirement. “It’s a different world,” Dr. Lauring said. Most people have some immunity to the flu, either from vaccines or previous exposure, and nearly all health-care workers are protected by the flu shot. “It’s not unusual to have compliance rates above 95%,” Vanderbilt’s Dr. Schaffner said, referring to vaccinations of hospital employees. “That’s everybody—doctors, nurses, dietitians, people who clean at night—everybody.” Currently, there is no vaccine or specific treatment for Covid-19, so slowing or stopping its spread has required social distancing.

 

But there is one quality that might make Covid-19 less problematic than flu. “It’s not changing and mutating at the rate the flu can do,” said Allison Weinmann, an infectious-disease physician at Henry Ford Health System in Detroit. That could make it easier for pharmaceutical companies to develop an effective vaccine—and render Covid-19 no more remarkable than the seasonal flu."

[Liberty]

https://www.politico.com/news/magazine/2020/04/11/america-two-decade-failure-prepare-coronavirus-179574

[Liberty]

Forest Trump talking medicine:

https://twitter.com/atrupar/status/1248698754556923904?s=21

 

I am sorry if it sounds reasonable to you.

 

As we’ve known from the start, and as Rex Tillerson articulated so well, what a moron.

[cubsfan]

Another fluke?

 

https://www.dailywire.com/news/early-antibody-testing-in-chicago-30-50-of-those-tested-for-covid-19-already-have-antibodies-report-says

 

“A phlebotomist working at Roseland Community Hospital said Thursday that 30% to 50% of patients tested for the coronavirus have antibodies while only around 10% to 20% of those tested have the active virus,” Chicago City Wire reported Thursday.

 

“Sumaya Owaynat, a phlebotomy technician, said she tests between 400 and 600 patients on an average day in the parking lot at Roseland Community Hospital. Drive-thru testing is from 9 a.m. to noon and 1 to 4 p.m. each day. However, the hospital has a limited number of tests they can give per day,” the report detailed. “Owaynat said the number of patients coming through the testing center who appear to have already had coronavirus and gotten over it is far greater than those who currently have the disease.”

 

https://chicagocitywire.com/stories/530092711-roseland-hospital-phlebotomist-30-of-those-tested-have-coronavirus-antibody

 

Owaynat said the number of patients coming through the testing center who appear to have already had coronavirus and gotten over it is far greater than those who currently have the disease.

 

Sumaya Owaynat

“A lot of people have high antibodies, which means they had the coronavirus but they don’t have it anymore and their bodies built the antibodies,” Owaynat told Chicago City Wire.

[Spekulatius]

So does anyone know why is it that after Wuhan was shut down, we didn't see so many other cases in the rest of China?

I mean if it was so easy for Europe and the US to get out of control - surely it would have just been as easily for the rest of China to go out of control too...

what did the rest of China do that made the cases much lower than Europe / USA?

 

Rest of  China had a lockdown too that was more stringent than in Europe or the US. Population is wearing masks and companies go to great length to avoid infection at the work place (I mentioned before that they shut down air circulation systems in factories /offices and vent with fresh air. They possibly are very good at contact tracing too (Big brother state).

 

I also think that the  Chinese government is lying about cases to some extend. Now if it were a full fledged epidemics, lying doesn’t work, but a few dozen unreported cases  or even death here and there to avoid public unrest seem to be plausible, If not likely...

 

Interesting. So did the rest of China do physical distancing / lockdown like what we are doing in Canada/USA/Europe?

 

I know Wuhan was shut and just opened a few days ago.  It seems pretty amazing China managed to keep the rest of the country operating.

 

I think so different parts of China did different things.  Some had strict curfews in place. The info I got was from Folks here who work for an US high tech company with operations in China. They try to actively learn from their chinese colleagues how to deal with this specifically at the work place.

[mcliu]

USA Virus:

The Chinese Government Has Convinced Its Citizens That the U.S. Army Brought Coronavirus to Wuhan

 

https://www.vice.com/en_us/article/wxe9yq/the-chinese-government-has-convinced-its-citizens-that-the-us-army-brought-coronavirus-to-wuhan

[krazeenyc]

reinfection? relapse? a bit scary....

 

 

https://www.yahoo.com/news/recovered-coronavirus-patients-test-positive-161747102.html

 

 

[gary17]

USA Virus:

The Chinese Government Has Convinced Its Citizens That the U.S. Army Brought Coronavirus to Wuhan

 

https://www.vice.com/en_us/article/wxe9yq/the-chinese-government-has-convinced-its-citizens-that-the-us-army-brought-coronavirus-to-wuhan

 

but the acronym COVID-19 is clearly standing for China Originated Virus In December 2019...

[winjitsu]

 

but the acronym COVID-19 is clearly standing for China Originated Virus In December 2019...

 

 

Actually believe its the Chinese-Originated Viral Infectious Disease #19, meaning there have been 18 before it.

[Dalal.Holdings]

https://www.bloomberg.com/news/articles/2020-04-11/u-s-now-has-the-world-s-deadliest-coronavirus-outbreak

 

American deaths from the coronavirus passed Italy’s, affirming the U.S.’s spot as the epicenter of the global pandemic.

 

Sure, we have a larger population than most countries, but after being among the last places to get surging cases from this outbreak, this is a tragic failure of leadership--and most of the blame lies at the Federal level (where CDC/FDA could have rolled out testing sooner, stocked up on resources, restricted international/inter-state travel, locked down places with known cases to restrict spread, etc).

[Cigarbutt]

Another fluke?

https://www.dailywire.com/news/early-antibody-testing-in-chicago-30-50-of-those-tested-for-covid-19-already-have-antibodies-report-says

“A phlebotomist working at Roseland Community Hospital said Thursday that 30% to 50% of patients tested for the coronavirus have antibodies while only around 10% to 20% of those tested have the active virus,” Chicago City Wire reported Thursday.

“Sumaya Owaynat, a phlebotomy technician, said she tests between 400 and 600 patients on an average day in the parking lot at Roseland Community Hospital. Drive-thru testing is from 9 a.m. to noon and 1 to 4 p.m. each day. However, the hospital has a limited number of tests they can give per day,” the report detailed. “Owaynat said the number of patients coming through the testing center who appear to have already had coronavirus and gotten over it is far greater than those who currently have the disease.”

https://chicagocitywire.com/stories/530092711-roseland-hospital-phlebotomist-30-of-those-tested-have-coronavirus-antibody

Owaynat said the number of patients coming through the testing center who appear to have already had coronavirus and gotten over it is far greater than those who currently have the disease.

Sumaya Owaynat

“A lot of people have high antibodies, which means they had the coronavirus but they don’t have it anymore and their bodies built the antibodies,” Owaynat told Chicago City Wire.

The power of the data here is very weak but it suggests that the virus is more widespread in low or no symptoms carriers, which is exactly the underlying challenge with this virus. Think of it as an iceberg. The previous CV episodes had a very visible tip and almost no invisible underwater component. This CV (COVID-19) behaves more like influenza with a potential for a much larger invisible underwater component feeding the visible part for future development.

Assessing if the wave of transmission is beginning, in the middle or at the end is important. Think of the Trojan Horse being rolled in the city. One could argue that the best scenario would have been to refuse the gift. An intermediate solution would have been to realize it was a mistake and try to mitigate the impact by containing the Horse. Another 'solution' would have been to (knowingly or not) go to sleep.

 

Whatever the exact size of the invisible part of the iceberg (with more tests, we'll know more but present data overall suggest that the invisible part is small to moderate and still has the potential to grow++), what do you think of the visible part (deaths, hospitalizations). Using standardized data such as deaths per one million population, days since 1/1 000 000 person deceased, it looks like the US (still early the game, with a lag) will do better than Spain and Italy, about the same as France, UK, Sweden and worse than many others. Why do you think that's the case?

[Guest Schwab711]

Another fluke?

 

https://www.dailywire.com/news/early-antibody-testing-in-chicago-30-50-of-those-tested-for-covid-19-already-have-antibodies-report-says

 

“A phlebotomist working at Roseland Community Hospital said Thursday that 30% to 50% of patients tested for the coronavirus have antibodies while only around 10% to 20% of those tested have the active virus,” Chicago City Wire reported Thursday.

 

“Sumaya Owaynat, a phlebotomy technician, said she tests between 400 and 600 patients on an average day in the parking lot at Roseland Community Hospital. Drive-thru testing is from 9 a.m. to noon and 1 to 4 p.m. each day. However, the hospital has a limited number of tests they can give per day,” the report detailed. “Owaynat said the number of patients coming through the testing center who appear to have already had coronavirus and gotten over it is far greater than those who currently have the disease.”

 

https://chicagocitywire.com/stories/530092711-roseland-hospital-phlebotomist-30-of-those-tested-have-coronavirus-antibody

 

Owaynat said the number of patients coming through the testing center who appear to have already had coronavirus and gotten over it is far greater than those who currently have the disease.

 

Sumaya Owaynat

“A lot of people have high antibodies, which means they had the coronavirus but they don’t have it anymore and their bodies built the antibodies,” Owaynat told Chicago City Wire.

 

It says non-randomized. It doesn't say the selection method and provides no info on the false positive rate. 30%-50% isn't surprising if it's the family members of known severe cases or hard hit neighborhoods, you know?

 

I'm not saying throw this data out either. It's to be considered. But it's a data point. No one data point can drive decisions, even if we had sufficient context around it. The most accurate test approved right now should show 4.4% positive rate in a population with 0% infection. We just don't know, but we will in time.

[Spekulatius]

reinfection? relapse? a bit scary....

 

 

https://www.yahoo.com/news/recovered-coronavirus-patients-test-positive-161747102.html

 

Muscleman mentioned in this thread that his relative died from what seemed like a relapse ore reinfection, but it is hard to know. I think there are 3 distinct strains of COVI around it is possible they immunity to one strain does not guarantee immunity to the other. However, my understanding is that Coronaviruses don’t enough to overcome immunity. It’s all speculation Fauci was asked the same thing on Thursday if I remember correctly and he gave an evasive answer because there is no way of knowing.

[cubsfan]

Another fluke?

https://www.dailywire.com/news/early-antibody-testing-in-chicago-30-50-of-those-tested-for-covid-19-already-have-antibodies-report-says

“A phlebotomist working at Roseland Community Hospital said Thursday that 30% to 50% of patients tested for the coronavirus have antibodies while only around 10% to 20% of those tested have the active virus,” Chicago City Wire reported Thursday.

“Sumaya Owaynat, a phlebotomy technician, said she tests between 400 and 600 patients on an average day in the parking lot at Roseland Community Hospital. Drive-thru testing is from 9 a.m. to noon and 1 to 4 p.m. each day. However, the hospital has a limited number of tests they can give per day,” the report detailed. “Owaynat said the number of patients coming through the testing center who appear to have already had coronavirus and gotten over it is far greater than those who currently have the disease.”

https://chicagocitywire.com/stories/530092711-roseland-hospital-phlebotomist-30-of-those-tested-have-coronavirus-antibody

Owaynat said the number of patients coming through the testing center who appear to have already had coronavirus and gotten over it is far greater than those who currently have the disease.

Sumaya Owaynat

“A lot of people have high antibodies, which means they had the coronavirus but they don’t have it anymore and their bodies built the antibodies,” Owaynat told Chicago City Wire.

The power of the data here is very weak but it suggests that the virus is more widespread in low or no symptoms carriers, which is exactly the underlying challenge with this virus. Think of it as an iceberg. The previous CV episodes had a very visible tip and almost no invisible underwater component. This CV (COVID-19) behaves more like influenza with a potential for a much larger invisible underwater component feeding the visible part for future development.

Assessing if the wave of transmission is beginning, in the middle or at the end is important. Think of the Trojan Horse being rolled in the city. One could argue that the best scenario would have been to refuse the gift. An intermediate solution would have been to realize it was a mistake and try to mitigate the impact by containing the Horse. Another 'solution' would have been to (knowingly or not) go to sleep.

 

Whatever the exact size of the invisible part of the iceberg (with more tests, we'll know more but present data overall suggest that the invisible part is small to moderate and still has the potential to grow++), what do you think of the visible part (deaths, hospitalizations). Using standardized data such as deaths per one million population, days since 1/1 000 000 person deceased, it looks like the US (still early the game, with a lag) will do better than Spain and Italy, about the same as France, UK, Sweden and worse than many others. Why do you think that's the case?

 

I post this - because I really just don't know. But I have tremendous respect for some of the minds on CoBF - and certainly yours ranks right at the top.

You are always balanced and find a way to explain things without the heat. Thanks for weighing in. Have a nice Easter locked up!

[Viking]

What needs to be done after ‘lock down’ is starting to become clear. The question is when will Trump figure it out? More valuable weeks are being squandered. With limited national direction and lack of funding at the state and local level (to hire needed resources such as armies of contact tracers) then ‘lock down’ will likely need to be in place longer. States that end lock down too early (before having infrastructure set up to test, trace and quarantine) risk seeding new outbreaks. And outbreaks in these states risk spreading virus back to well managed states.

 

It is becoming more clear to me that a national strategy is critical to successfully manage the virus. This also is the quickest solution. But Trump does not want the political heat that will come with this strategy.

 

Looking further out it is also clear that an international strategy is also required. This would get global economy back the quickest. We all know Trump is looking for less international cooperation not more.

 

Bottom line, the next couple of months will be very interesting. Lots of fat tail risks, getting fatter with each passing week.

 

A plan to defeat coronavirus finally emerges, but it’s not from the White House

- https://www.washingtonpost.com/health/2020/04/10/contact-tracing-coronavirus-strategy/

 

A national plan to fight the coronavirus pandemic in the United States and return Americans to jobs and classrooms is emerging — but not from the White House.

 

Instead, a collection of governors, former government officials, disease specialists and nonprofits are pursuing a strategy that relies on the three pillars of disease control: Ramp up testing to identify people who are infected. Find everyone they interact with by deploying contact tracing on a scale America has never attempted before. And focus restrictions more narrowly on the infected and their contacts so the rest of society doesn’t have to stay in permanent lockdown.

 

But there is no evidence yet the White House will pursue such a strategy.

 

Instead, the president and his top advisers have fixated almost exclusively on plans to reopen the U.S. economy by the end of the month, though they haven’t detailed how they will do so without triggering another outbreak. President Trump has been especially focused on creating a second coronavirus task force aimed at combating the economic ramifications of the virus.

 

Administration officials, speaking on the condition of anonymity to describe internal deliberations, say the White House has made a deliberate political calculation that it will better serve Trump’s interest to put the onus on governors — rather than the federal government — to figure out how to move ahead.

 

“It’s mind-boggling, actually, the degree of disorganization,” said Tom Frieden, former Centers for Disease Control and Prevention director. The federal government has already squandered February and March, he noted, committing “epic failures” on testing kits, ventilator supply, protective equipment for health workers and contradictory public health communication. The next failure is already on its way, Frieden said, because “we’re not doing the things we need to be doing in April.”

[Spekulatius]

Yeah, I agree with Viking. They should really get an army of contact tracers and testing facilities installed as quickly as possible. Any outbreak will just totally undermine the economy if we start up and get large scale outbreaks again. Outbreaks will happen, so it is important get people confident that can be squashed quickly. Sounds like each state will have to figure out on their own how to do it, unless Trump provides a credible framework.

 

Just uttering 10x in each WH briefing “ we have to open the economy “ is not going to do so. I actually agree we need to open it come May, but it is critical that it is done right.

[Liberty]

https://masks4all.co/

[LongHaul]

https://masks4all.co/

 

Totally agree Liberty. 

 

Let's look at this analytically. 

 

R0 without masks:  2.5

 

Mask reduction effect on RO:  70% (my assumption)

 

RO with masks:    2.5 * .3 = .75

 

Essentially an R0 of .75 equals an exponential decline in Covid.

 

This means we kill the virus. 

 

FYI - read of a couple that died in my hometown after getting Covid in the supermarket.  If you go the market (high risk) then you should definitively wear a mask.

I strongly prefer surgical or N95 (if you have them).

[Viking]

Yeah, I agree with Viking. They should really get an army of contact tracers and testing facilities installed as quickly as possible. Any outbreak will just totally undermine the economy if we start up and get large scale outbreaks again. Outbreaks will happen, so it is important get people confident that can be squashed quickly. Sounds like each state will have to figure out on their own how to do it, unless Trump provides a credible framework.

 

Just uttering 10x in each WH briefing “ we have to open the economy “ is not going to do so. I actually agree we need to open it come May, but it is critical that it is done right.

 

The crazy thing is we have all these unemployed people. We want to pay them for doing nothing.

 

We also have this virus thing where we need a bunch of people to staff up a bunch of different things (like contact tracing)...

 

Too obvious a fit? I am buying into the suggestion that Trump simply does not want to get involved. Too much personal risk. Better to let States and Municipalities struggle their way through it. Then he can come in after the fact and ‘throw some paper towel rolls to the needy’. Much better to sit in the weeds, let others fight the good fight and then come in as the dust settles with money, lots of ‘i told you so’ and look like the saviour.

[LongHaul]

https://masks4all.co/

 

If you have not seen this site recently they have really added a lot of data and information.  Highly recommend it.