Coronavirus

[cwericb]

Kind of sums it up nicely:

 

"The curve is flattening; we can lift restrictions = The parachute has slowed our fall enough; we can take it off now."

[Dalal.Holdings]

For the "nothing could be done anyway" and "please don't blame our leader" crowd:

 

https://www.bloomberg.com/news/articles/2020-04-18/seoul-s-full-cafes-apple-store-lines-show-mass-testing-success

 

Cafes bustled with customers, parks teemed with sunbathers, and the first Apple store to reopen outside China had lines snaking out the door as many South Koreans -- almost all wearing masks -- emerged from months of self-isolation.

 

Initially one of the hardest-hit with the second-highest number of cases globally, South Korea has managed to curb the spread without taking measures that were too severe. It didn’t require businesses to close or restrict travel.

 

While both the U.S. and South Korea confirmed their first virus cases around the same time in late January, the number of infections in the U.S. has swelled to more than 700,000 while Korea “flattened the curve” last month and cases have slowed to just over 10,000.

 

It's ok, it only cost our economy trillions of dollars. No big deal.

 

Let's not hold our federal gov't (CDC/FDA which botched testing and did not prepare back in January/Feb) accountable...

 

Actually, let's put all the blame on the lesser guys in federal government/state/local leaders (don't they run the FDA/CDC?), but leave nothing for the guy at the top. We need to provide him the asymmetry he always gets from his followers: no downside, only upside. Zero skin in the game "I take no responsibility" POTUS.

 

[cobafdek]

For the "nothing could be done anyway" and "please don't blame our leader" crowd:

 

https://www.bloomberg.com/news/articles/2020-04-18/seoul-s-full-cafes-apple-store-lines-show-mass-testing-success

 

Cafes bustled with customers, parks teemed with sunbathers, and the first Apple store to reopen outside China had lines snaking out the door as many South Koreans -- almost all wearing masks -- emerged from months of self-isolation.

 

Initially one of the hardest-hit with the second-highest number of cases globally, South Korea has managed to curb the spread without taking measures that were too severe. It didn’t require businesses to close or restrict travel.

 

While both the U.S. and South Korea confirmed their first virus cases around the same time in late January, the number of infections in the U.S. has swelled to more than 700,000 while Korea “flattened the curve” last month and cases have slowed to just over 10,000.

 

It's ok, it only cost our economy trillions of dollars. No big deal.

 

Let's not hold our federal gov't (CDC/FDA which botched testing and did not prepare back in January/Feb) accountable...

 

Actually, let's put all the blame on the lesser guys in federal government/state/local leaders (don't they run the FDA/CDC?), but leave nothing for the guy at the top. We need to provide him the asymmetry he always gets from his followers: no downside, only upside. Zero skin in the game "I take no responsibility" POTUS.

 

Should the President fire Fauci/Birx?

[LC]

The president should fire himself.

[UK]

https://www.bloomberg.com/news/articles/2020-04-18/china-tests-thousands-to-calculate-true-spread-of-coronavirus?srnd=premium-europe

[samwise]

 

I feel like you are assuming everyone will go to a dallas cowboys game on april 27th. Removing the stay at home order does not mean people will just go back to their old behaviors and R0 will go back to what it was. 

 

A very realistic way these states will open is, Businesses will open but have a limit on the number of customers at a time. Everyone will wear a mask. Still no large gatherings but at least most of the economy will be allowed to restart. The R0 will be much much lower than it was in New York 5 weeks ago. Don't have a number, but it's just common sense.

 

how do i know that's a realistic path? Because Europe is already doing it. I live in Poland, and i go for groceries wearing a mask (mandatory here), and keep my distance from people. I disinfect what I can when I get home. I consider the probability of me getting infected under my current behavior as quite low. the vast majority of the other people I see are practicing the same precautions and I anticipate the R0 rate in Poland to collapse in the coming weeks. America just hasn't gotten the mask idea, but they will. April 27 is still 9 days away. things move quickly these days.

 

Thanks for the news from Poland. Makes sense to me.

 

The one and only lever we humans have currently is to control R0. At normal behaviour R0=2-3 and the cases in ICUs compound. Then to regain some control you lock people in and drop R0 much below 1 to reduce cases in ICUs. Then at a low case load you allow some economic functions, just enough to keep caseload constant. The first article below seems to indicate this is Sweden’s choice. They have reduced riders on transit by 60%, and a constant caseload entering ICUs. Interesting that their politicians can’t actually do much, it’s the health agency’s choice.

 

The reopening in British Columbia seems to have a similar model. See article 2 below. Specifically the lines showing different growth rates in cases.

 

It’s like steering a car. You find cases rising, then you clamp down hard until it drops. Then you open up a bit and test, trace isolate; allow some activity but not others (which is a political problem of equity). And so on with constant feedback. It’s just how everyone drives the car, or the fed watches the data. Rolling lockdowns as Kashkari said.

 

Btw we can’t judge Sweden’s response purely by number of deaths, as article 3 below does. They have consciously chosen a position on the death-vs-economy trade off  where there will be more deaths. They are arguing that this path is economically sustainable. So you also need to judge how much better the economy is. I haven’t found out yet how much better an economy they have bought themselves in the trade off. They also claim their path is more sustainable. We will see. I do agree that this is a marathon, not a sprint.

 

How does it all end?

 

Best case: vaccine in a year, or a cure in a few months.

 

Base case: constant caseload, rolling lockdowns, 1% of the world population dies (80M) or whatever the true death rate is. Bad for the economy also.

 

Worst case: virus mutates and we have several cycles like 1918.

 

Article 1: https://www.vox.com/2020/4/9/21213472/coronavirus-sweden-herd-immunity-cases-death

 

Article 2: see the chart et the end. Basically they are with different R0. https://bc.ctvnews.ca/b-c-health-officials-say-some-covid-19-restrictions-could-be-lifted-in-mid-may-1.4901026

 

Article 3: https://www.project-syndicate.org/commentary/swedish-coronavirus-no-lockdown-model-proves-lethal-by-hans-bergstrom-2020-04

 

Edit: I guess the next decision, if you accept the above, becomes exactly how do you get the right level of R0, to maintain caseload in ICUs and maximize the economy. Which places should shutdown : hairdressers, nail parlours or bars? Who should sacrifice for society and how do you compensate them? Or you let everyone make their own risk assessment. Do you compensate for operational leverage for e.g. in restaurants, or do you let those businesses go bankrupt. It’s hard to run a whole economy by diktat, as the communists discovered. So do you make a market in risk: everyone pays every time they go out somewhere (thus increasing R0), and use the funds to recruit more contact tracers. Who collects the money and how? Can you increase decrease R0 by increasing decreasing the fees. But this is a regressive tax for the poor. Well, unless we get a cure/vaccine pretty soon, we’ll be solving these problems.

[Liberty]

Good podcast, includes impact on younger people, possible permanent lung damage:

 

https://overcast.fm/+PmW73DgEM

[Gregmal]

 

I was clear all along I am not a believer that Trump deserves much credit or blame for most of this. However others disagreed. Despite really refusing to give numbers, and declaring a disaster was a certainty, and that it was all Trumps fault, surely you'd think they'd be heaping praise on him now that the totals they were either projecting or implying were giant fairytales, no? Nah...Of course they dont. They just change the story. Again.

 

I think people are wishing it is Trump's fault because that means there actually is an obvious solution that will come out. I don't think anybody could have done much better or worse. I don't think anything could have been done at cities like New York that has large international travel and relies heavily on the subway system. The virus was likely seeded already before anybody knew about it and the large cities were screwed without draconian Wuhan style quarantines and nobody could have done that. The only obvious mistake I see is the absolute fiery conviction that western doctors had that civilians should not be masked.

 

Even now, I think there is a lot of blind faith that testing and contact tracing will work. I think it is actually getting more and more likely that we will be forced into the herd immunity route whether we like it or not.

 

I think this is a great way of rationally describing much of this.

 

The idiocy of lockdowns isn't in locking down areas where its needed, its doing so to areas that arent. Sure, NYC was obvious...but the knee jerk to just declare a statewide shut down? WTF do the economies or landscape of Manhattan and say, Oneonta, NY have in common other than, NY, on the postal address? Small businesses in areas like Oneonta are significantly more fragile and will take longer to recover from this(if they recover at all) than "supposed" small businesses who can afford to pay $6,000 a month to rent an 850 sq ft cockroach infested shitbox in the 100xx zip area. The lockdown was done in a very lazy and sloppy manner.

[Guest cherzeca]

immunity testing is important imo.  I lived in our NYC apartment until 3/16 when we hightailed it to our country house. we used the subway, shopped in stores, and attended a large gathering indoors on 3/14...last weekend you could do this.  I also had a sore throat in January which I got over, which left something of a frog in my throat, which has slowly dissipated.  interestingly, I asked for a z-pack scrip which may have helped, as it is a senolytic which helps eliminate senescent cells upon which the virus "feeds".  I feel great. there are many people like me who would like to know if they can expand their social engagement, and it is in society's interest for people like me to do so at the earliest possible date.

[patience_and_focus]

immunity testing is important imo.  I lived in our NYC apartment until 3/16 when we hightailed it to our country house. we used the subway, shopped in stores, and attended a large gathering indoors on 3/14...last weekend you could do this.  I also had a sore throat in January which I got over, which left something of a frog in my throat, which has slowly dissipated.  interestingly, I asked for a z-pack scrip which may have helped, as it is a senolytic which helps eliminate senescent cells upon which the virus "feeds".  I feel great. there are many people like me who would like to know if they can expand their social engagement, and it is in society's interest for people like me to do so at the earliest possible date.

 

https://www.nytimes.com/2020/04/19/us/coronavirus-antibody-tests.html

 

Testing for serological tests for antibodies is one of the hardest things to get right, especially with now touted finger prick (think Theranos). These are "analog" tests (as opposed to digital PCR tests for testing viral RNA to determine positive for SAR-Cov2). I have worked in this space for 15 years now and it is pretty clear that most people do not realize how difficult protein measurements are as opposed to DNA/RNA measurements. If not done right, they will have unacceptable false positive and negative rates. The article above clearly points to that risk. Given that at a lot of testing kits and materials in US are coming from China and not being vetted, I can only imagine what kind of misinformation about antibodies is being given out. Quotes -

 

"The Food and Drug Administration has allowed about 90 companies, many based in China, to sell tests that have not gotten government vetting, saying the pandemic warrants an urgent response. But the agency has since warned that some of those businesses are making false claims about their products; health officials, like their counterparts overseas, have found others deeply flawed."

 

"For example, Britain recently said the millions of rapid tests it had ordered from China were not sensitive enough to detect antibodies except in people who were severely ill. In Spain, the testing push turned into a fiasco last month after the initial batch of kits it received had an accuracy of 30 percent, rather than the advertised 80 percent. In Italy, local officials have begun testing even before national authorities have validated the tests."

 

 

[Spekulatius]

immunity testing is important imo.  I lived in our NYC apartment until 3/16 when we hightailed it to our country house. we used the subway, shopped in stores, and attended a large gathering indoors on 3/14...last weekend you could do this.  I also had a sore throat in January which I got over, which left something of a frog in my throat, which has slowly dissipated.  interestingly, I asked for a z-pack scrip which may have helped, as it is a senolytic which helps eliminate senescent cells upon which the virus "feeds".  I feel great. there are many people like me who would like to know if they can expand their social engagement, and it is in society's interest for people like me to do so at the earliest possible date.

 

https://www.nytimes.com/2020/04/19/us/coronavirus-antibody-tests.html

 

Testing for serological tests for antibodies is one of the hardest things to get right, especially with now touted finger prick (think Theranos). These are "analog" tests (as opposed to digital PCR tests for testing viral RNA to determine positive for SAR-Cov2). I have worked in this space for 15 years now and it is pretty clear that most people do not realize how difficult protein measurements are as opposed to DNA/RNA measurements. If not done right, they will have unacceptable false positive and negative rates. The article above clearly points to that risk. Given that at a lot of testing kits and materials in US are coming from China and not being vetted, I can only imagine what kind of misinformation about antibodies is being given out. Quotes -

 

"The Food and Drug Administration has allowed about 90 companies, many based in China, to sell tests that have not gotten government vetting, saying the pandemic warrants an urgent response. But the agency has since warned that some of those businesses are making false claims about their products; health officials, like their counterparts overseas, have found others deeply flawed."

 

"For example, Britain recently said the millions of rapid tests it had ordered from China were not sensitive enough to detect antibodies except in people who were severely ill. In Spain, the testing push turned into a fiasco last month after the initial batch of kits it received had an accuracy of 30 percent, rather than the advertised 80 percent. In Italy, local officials have begun testing even before national authorities have validated the tests."

 

Yea, that’s one issue. Then there is a the issue if presence of antibodies constitutes immunity.

[Spekulatius]

This is an article about the increased Chinese influence on the WHO (in German):

https://www.spiegel.de/politik/ausland/coronavirus-who-weltkrankheitsorganisation-a-29c74432-aea1-4f9a-b1ff-fcc4bb43cc4e

 

Seems like some critique here is justified. Ousting some of WHO’s leadership would be a better way than withholding funding right now, imo.

[Dalal.Holdings]

immunity testing is important imo.  I lived in our NYC apartment until 3/16 when we hightailed it to our country house. we used the subway, shopped in stores, and attended a large gathering indoors on 3/14...last weekend you could do this.  I also had a sore throat in January which I got over, which left something of a frog in my throat, which has slowly dissipated.  interestingly, I asked for a z-pack scrip which may have helped, as it is a senolytic which helps eliminate senescent cells upon which the virus "feeds".  I feel great. there are many people like me who would like to know if they can expand their social engagement, and it is in society's interest for people like me to do so at the earliest possible date.

 

https://www.nytimes.com/2020/04/19/us/coronavirus-antibody-tests.html

 

Testing for serological tests for antibodies is one of the hardest things to get right, especially with now touted finger prick (think Theranos). These are "analog" tests (as opposed to digital PCR tests for testing viral RNA to determine positive for SAR-Cov2). I have worked in this space for 15 years now and it is pretty clear that most people do not realize how difficult protein measurements are as opposed to DNA/RNA measurements. If not done right, they will have unacceptable false positive and negative rates. The article above clearly points to that risk. Given that at a lot of testing kits and materials in US are coming from China and not being vetted, I can only imagine what kind of misinformation about antibodies is being given out. Quotes -

 

"The Food and Drug Administration has allowed about 90 companies, many based in China, to sell tests that have not gotten government vetting, saying the pandemic warrants an urgent response. But the agency has since warned that some of those businesses are making false claims about their products; health officials, like their counterparts overseas, have found others deeply flawed."

 

"For example, Britain recently said the millions of rapid tests it had ordered from China were not sensitive enough to detect antibodies except in people who were severely ill. In Spain, the testing push turned into a fiasco last month after the initial batch of kits it received had an accuracy of 30 percent, rather than the advertised 80 percent. In Italy, local officials have begun testing even before national authorities have validated the tests."

 

Yea, that’s one issue. Then there is a the issue if presence of antibodies constitutes immunity.

 

Absolutely--and we should note that coronaviruses are not new. Many cause the common cold, so many individuals may already have antibodies to coronavirus proteins that do not confer immunity to covid-19. You have to somehow make sure the antibodies you are testing for are specific to covid-19 and not the coronaviruses that cause run-of-the-mill common cold...

 

The propensity for false positives with COVID-19 antibody testing is high and in medical statistics, it is well known (among those trained in this, but not doctors in general) that via Bayesian statistics positive predictive value (if a test is positive, you have the illness) is proportional to disease prevalence (contrast this with sensitivity and specificity which do not change with prevalence).

 

If a disease is rare (as we know covid is thus far), then positive predictive value will be low and so you will have a large number of false positives, especially with an antibody test that is prone to false positives. This is one of many criticisms of the Stanford study.

 

More info for those who have intellectual curiosity:

https://online.stat.psu.edu/stat507/node/71/

[Viking]

Here is an update on one industry that is in deep shit. Lots more just like them. But don’t worry, the Fed is printing money and governments are spending like never before... so it doesn’t matter :-)

 

The Coronavirus Doesn’t Care When Sports Come Back: The prolonged shutdown of the sports world is taking a huge financial toll. And comeback plans all have a pesky hurdle — public health.

- https://www.nytimes.com/2020/04/19/sports/coronavirus-sports-economy.html?action=click&module=Top%20Stories&pgtype=Homepage

 

A Major League Baseball season to be played entirely in the Arizona desert without fans, and with teams isolating themselves from the outside world.

 

The N.B.A. taking over a hotel on the Las Vegas Strip so its stars can dine and dunk in their own bubble — but only after the league gets access to instant coronavirus tests.

 

Mixed-martial-arts fights live on TV from a private island … somewhere.

 

More than a month into the coronavirus shutdown, the American sports industrial complex is getting creative, or perhaps desperate, searching for a moonshot that might bring professional athletics back to a nation largely cooped up at home and suffering from collective cabin fever.

 

Fans are clamoring for something, anything, to distract from the pandemic and restore sports to the rhythm of American life; even Dr. Anthony S. Fauci, the presidential adviser on infectious diseases, recently mused about seeing the Washington Nationals defend their World Series title.

 

Meanwhile, owners, executives and athletes — and all the related businesses and workers who depend on them — are increasingly worried about the economic damage from this prolonged, inescapable off-season.

 

But the hurdles to any return are numerous, and they start with securing access to tests for the virus and persuading players and officials to agree to strict confinement, among other conditions.

 

Over the past two decades, the business of sports in the United States has ballooned into a chunk of the economy that generates well over $71 billion annually and employs tens of thousands of people, from superstar athletes to hot dog vendors. But all of that has ground to an abrupt halt. The financial losses climb every day, as games go unplayed and are absent from television, and entire seasons could be canceled.

[Gregmal]

On the flip side, we ve had plenty of lengthy lockouts where full or partial seasons were lost. It always comes back.

[minten]

Base case: constant caseload, rolling lockdowns, 1% of the world population dies (80M) or whatever the true death rate is. Bad for the economy also.

 

I don't want to come across as cynical or anything (and I'm definitely not making any immoral suggestions), but if you look at the profile of that 1% I'm not so sure that would be bad for the economy as a whole at all.

[Liberty]

Rhonda Patrick (research scientist) podcast Q&A on various COVID19-related stuff:

 

https://www.foundmyfitness.com/episodes/covid-19-episode-1

[Guest cherzeca]

immunity testing is important imo.  I lived in our NYC apartment until 3/16 when we hightailed it to our country house. we used the subway, shopped in stores, and attended a large gathering indoors on 3/14...last weekend you could do this.  I also had a sore throat in January which I got over, which left something of a frog in my throat, which has slowly dissipated.  interestingly, I asked for a z-pack scrip which may have helped, as it is a senolytic which helps eliminate senescent cells upon which the virus "feeds".  I feel great. there are many people like me who would like to know if they can expand their social engagement, and it is in society's interest for people like me to do so at the earliest possible date.

 

https://www.nytimes.com/2020/04/19/us/coronavirus-antibody-tests.html

 

Testing for serological tests for antibodies is one of the hardest things to get right, especially with now touted finger prick (think Theranos). These are "analog" tests (as opposed to digital PCR tests for testing viral RNA to determine positive for SAR-Cov2). I have worked in this space for 15 years now and it is pretty clear that most people do not realize how difficult protein measurements are as opposed to DNA/RNA measurements. If not done right, they will have unacceptable false positive and negative rates. The article above clearly points to that risk. Given that at a lot of testing kits and materials in US are coming from China and not being vetted, I can only imagine what kind of misinformation about antibodies is being given out. Quotes -

 

"The Food and Drug Administration has allowed about 90 companies, many based in China, to sell tests that have not gotten government vetting, saying the pandemic warrants an urgent response. But the agency has since warned that some of those businesses are making false claims about their products; health officials, like their counterparts overseas, have found others deeply flawed."

 

"For example, Britain recently said the millions of rapid tests it had ordered from China were not sensitive enough to detect antibodies except in people who were severely ill. In Spain, the testing push turned into a fiasco last month after the initial batch of kits it received had an accuracy of 30 percent, rather than the advertised 80 percent. In Italy, local officials have begun testing even before national authorities have validated the tests."

 

Yea, that’s one issue. Then there is a the issue if presence of antibodies constitutes immunity.

 

I'll take "creeping" immunity...meaning better defended against covid than without antibodies.  as my doctor as told me, after enough tick bites, your antibody test becomes so strong that doxycycline may no longer be indicated.

[Viking]

On the flip side, we ve had plenty of lengthy lockouts where full or partial seasons were lost. It always comes back.

 

We have never had a situation where NFL, MLB, NBA, NHL, PGA, NCAA, World Soccer etc were all shuttered at the same time for an indefinite period of time: minimum 6 months and more likely 12 months or longer.

 

This is just one of many industries facing the exact same reality. My basic point is all of these closures have to add up to some meaningful economic contraction that will likely last a year (until a vaccine is ready). Financial markets are off to the races higher and likely pricing in a V shape recovery. We will see :-)

[Gregmal]

On the flip side, we ve had plenty of lengthy lockouts where full or partial seasons were lost. It always comes back.

 

We have never had a situation where NFL, MLB, NBA, NHL, PGA, NCAA, World Soccer etc were all shuttered at the same time for an indefinite period of time: minimum 6 months and more likely 12 months or longer.

 

This is just one of many industries facing the exact same reality. My basic point is all of these closures have to add up to some meaningful economic contraction that will likely last a year (until a vaccine is ready). Financial markets are off to the races higher and likely pricing in a V shape recovery. We will see :-)

 

I agree. I dont care for the enthusiastic degree to which we've already recovered. I just have a hard time seeing basic fundamental human behavior being broken so easily. Look at the near riots going on in some places because folks want to go out. Granted, sports are different. People will definitely still go, but do owners take on the liability of opening too soon?

[cobafdek]

Bill Maher, and the whole Trump-is-a-War-Criminal-He-did-Nothing-in-February crowd, get taken to the cleaners by Congressman Dan Crenshaw:

 

[ERICOPOLY]

Testing nationwide is currently at 150,000 per day, they said, adding that "If we can't be doing at least 500,000 tests a day by May 1, it is hard to see any way we can remain open."

President Donald Trump and Vice President Mike Pence say there is ample testing capacity for states to begin the first phase.

 

But Gov. Ralph Northam of Maryland called the assertion "delusional" and said his state doesn't even have sufficient swabs to conduct testing.

 

https://www.cnn.com/2020/04/19/health/us-coronavirus-sunday/index.html

[Guest]

Bill Maher, and the whole Trump-is-a-War-Criminal-He-did-Nothing-in-February crowd, get taken to the cleaners by Congressman Dan Crenshaw:

 

 

That was a legit smackdown. Dang.

[matts]

live R number estimates by states.

 

https://rt.live/

 

 

It was done by one of the Instagram co-founders. Interesting visualization of the changes. I'm not nearly smart enough to understand whether they are accurate.

 

 

[LongHaul]

Rhonda Patrick (research scientist) podcast Q&A on various COVID19-related stuff:

 

https://www.foundmyfitness.com/episodes/covid-19-episode-1

Nice find Liberty.  Good thing I am a REDNECK!

 

Vitamin D and respiratory tract infectionsVitamin D is a steroid hormone. It is available in small quantities in food, but the primary source is via endogenous synthesis. This process occurs in a stepwise manner that starts in the skin following exposure to ultraviolet light and continues in the liver and kidneys, where the vitamin's active hormone form is made. Since ultraviolet light is required for vitamin D synthesis, reduced exposure to the sun or having dark-colored skin impairs vitamin D production. Approximately 70 percent of people living in the United States are vitamin D insufficient and ~30 percent are deficient.Robust evidence suggests that vitamin D is protective against respiratory tract infections. Data from 25 randomized controlled trials from around the world demonstrate that daily or weekly supplementation of vitamin D reduced the risk of acute respiratory infection by more than 50 percent in people with low baseline vitamin D levels. People with higher baseline vitamin D levels also benefited, although the effect was more modest, with only a 10 percent risk reduction. Vitamin D and the renin-angiotensin-systemhttps://www.foundmyfitness.com/episodes/covid-19-episode-1