Coronavirus

[Guest cherzeca]

" total fatalities from COVID-19" is an undefined term where so many fatalities have co-morbidities and are associated with elderly

 

Sure, but part of the point in looking at all causes mortality is to sidestep such semantic questions. If you see a lot more people dying in March and April of this year compared to the same period in the last five years, you can reasonably attribute most of the excess deaths to COVID-19 (assuming you don't find some other global phenomenon that could also be a cause). I mean this in the very basic sense that these deaths would not have occurred if not for  COVID-19. A few of the excess deaths -- such as a  higher number of suicides? -- might be due to the reaction to COVID-19 rather than to the disease itself; and some deaths could be due to folks with other conditions receiving worse care, as Dalal pointed out. Still, I find the excess all causes mortality data to be a decent way of estimating the impact of COVID-19.

 

disagree insofar as mistakes in public policy are being based upon this mistaken view of covid impact.  using same analysis, we should shut down country because of prostate cancer, since most every elderly male dies with prostate cancer. 

[Guest cherzeca]

" total fatalities from COVID-19" is an undefined term where so many fatalities have co-morbidities and are associated with elderly

 

Pretty sure those who died and would be alive otherwise feel much better because of this observation.

 

what makes you sure?

[Investor20]

https://www.reuters.com/article/us-health-coronavirus-prisons-testing-in/in-four-us-state-prisons-nearly-3300-inmates-test-positive-for-coronavirus-96-without-symptoms-idUSKCN2270RX

 

Incredible how transmissible this virus is. In one prison, 2028 out of a total of 2,300 tested positive for the virus and close to 95% of those who tested positive had no symptoms.

 

APRIL 2 WHO report:

 

"There are few  reports of  laboratory-confirmed  cases who  are truly  asymptomatic, and  to date, there has been  no documented asymptomatic transmission."

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf

 

Why is WHO so wrong on everything?

[Guest cherzeca]

"No conclusions can be drawn about the states that sheltered quickly, because their death rates ran the full gamut, from 20 per million in Oregon to 360 in New York. This wide variation means that other variables—like population density or subway use—were more important. Our correlation coefficient for per-capita death rates vs. the population density was 44%. That suggests New York City might have benefited from its shutdown—but blindly copying New York’s policies in places with low Covid-19 death rates, such as my native Wisconsin, doesn’t make sense."

 

https://www.wsj.com/articles/do-lockdowns-save-many-lives-is-most-places-the-data-say-no-11587930911?mod=hp_opin_pos_1

[Investor20]

Sweden:

 

 

There goes that lone example from the “do nothing” crowd. But what do you expect from people who lack any sense of objectivity and scientific literacy? Often wrong, never in doubt.

 

I think at this point, the Swedes have done OK in my opinion. As long as their health care system isn’t crashing in Stockholm, where the population density is highest, their approach isn’t really a failure.

 

They try to get herd immunity at an acceptable cost (in terms of lives). So far, by their own judgement, that is still the case and who are we to judge otherwise?

 

 

Also, besides that , Sweden isn’t really normal either, they just have a soft shutdown instead off hard one. not too different from what we have in some states in the US.

https://www.thelocal.se/20200424/interview-isabella-lovin-coronavirus-the-biggest-myth-about-sweden-is-that-life-is-going-on-as-normal

 

The plot ignores several other countries:

 

Deaths/Million from worldometer:

 

Belgium: 612

Spain: 496

Italy: 441

France: 350

UK 305

Netherlands: 261

Ireland: 220

Sweden: 217

USA 167

[cwericb]

You can argue your graphs, studies, and statistics all you want, but when you have a mentally ill lunatic in charge of the country all those facts mean little.

 

A few days ago I wrote here that the United States had become the laughing stock of the world. Here is what Ireland’s most respected mainstream political writer says...

         

Irish Times

April 25, 2020

By Fintan O’Toole

 

THE WORLD HAS LOVED, HATED AND ENVIED THE U.S. NOW, FOR THE FIRST TIME, WE PITY IT

 

Over more than two centuries, the United States has stirred a very wide range of feelings in the rest of the world: love and hatred, fear and hope, envy and contempt, awe and anger. But there is one emotion that has never been directed towards the US until now: pity.

However bad things are for most other rich democracies, it is hard not to feel sorry for Americans. Most of them did not vote for Donald Trump in 2016. Yet they are locked down with a malignant narcissist who, instead of protecting his people from Covid-19, has amplified its lethality. The country Trump promised to make great again has never in its history seemed so pitiful.

Will American prestige ever recover from this shameful episode? The US went into the coronavirus crisis with immense advantages: precious weeks of warning about what was coming, the world’s best concentration of medical and scientific expertise, effectively limitless financial resources, a military complex with stunning logistical capacity and most of the world’s leading technology corporations. Yet it managed to make itself the global epicentre of the pandemic.

As the American writer George Packer puts it in the current edition of the Atlantic, “The United States reacted ... like Pakistan or Belarus – like a country with shoddy infrastructure and a dysfunctional government whose leaders were too corrupt or stupid to head off mass suffering.”

It is one thing to be powerless in the face of a natural disaster, quite another to watch vast power being squandered in real time – wilfully, malevolently, vindictively. It is one thing for governments to fail (as, in one degree or another, most governments did), quite another to watch a ruler and his supporters actively spread a deadly virus. Trump, his party and Rupert Murdoch’s Fox News became vectors of the pestilence.

The grotesque spectacle of the president openly inciting people (some of them armed) to take to the streets to oppose the restrictions that save lives is the manifestation of a political death wish. What are supposed to be daily briefings on the crisis, demonstrative of national unity in the face of a shared challenge, have been used by Trump merely to sow confusion and division. They provide a recurring horror show in which all the neuroses that haunt the American subconscious dance naked on live TV.

If the plague is a test, its ruling political nexus ensured that the US would fail it at a terrible cost in human lives. In the process, the idea of the US as the world’s leading nation – an idea that has shaped the past century – has all but evaporated.

Other than the Trump impersonator Jair Bolsonaro in Brazil, who is now looking to the US as the exemplar of anything other than what not to do? How many people in Düsseldorf or Dublin are wishing they lived in Detroit or Dallas?

It is hard to remember now but, even in 2017, when Trump took office, the conventional wisdom in the US was that the Republican Party and the broader framework of US political institutions would prevent him from doing too much damage. This was always a delusion, but the pandemic has exposed it in the most savage ways.

Abject surrender

What used to be called mainstream conservatism has not absorbed Trump – he has absorbed it. Almost the entire right-wing half of American politics has surrendered abjectly to him. It has sacrificed on the altar of wanton stupidity the most basic ideas of responsibility, care and even safety.

Thus, even at the very end of March, 15 Republican governors had failed to order people to stay at home or to close non-essential businesses. In Alabama, for example, it was not until April 3rd that governor Kay Ivey finally issued a stay-at-home order.

In Florida, the state with the highest concentration of elderly people with underlying conditions, governor Ron DeSantis, a Trump mini-me, kept the beach resorts open to students travelling from all over the US for spring break parties. Even on April 1st, when he issued restrictions, DeSantis exempted religious services and “recreational activities”.

Georgia governor Brian Kemp, when he finally issued a stay-at-home order on April 1st, explained: “We didn’t know that [the virus can be spread by people without symptoms] until the last 24 hours.”

This is not mere ignorance – it is deliberate and homicidal stupidity. There is, as the demonstrations this week in US cities have shown, plenty of political mileage in denying the reality of the pandemic. It is fuelled by Fox News and far-right internet sites, and it reaps for these politicians millions of dollars in donations, mostly (in an ugly irony) from older people who are most vulnerable to the coronavirus.

It draws on a concoction of conspiracy theories, hatred of science, paranoia about the “deep state” and religious providentialism (God will protect the good folks) that is now very deeply infused in the mindset of the American right.

Trump embodies and enacts this mindset, but he did not invent it. The US response to the coronavirus crisis has been paralysed by a contradiction that the Republicans have inserted into the heart of US democracy. On the one hand, they want to control all the levers of governmental power. On the other they have created a popular base by playing on the notion that government is innately evil and must not be trusted.

The contradiction was made manifest in two of Trump’s statements on the pandemic: on the one hand that he has “total authority”, and on the other that “I don’t take responsibility at all”. Caught between authoritarian and anarchic impulses, he is incapable of coherence.

Fertile ground

But this is not just Donald Trump. The crisis has shown definitively that Trump’s presidency is not an aberration. It has grown on soil long prepared to receive it. The monstrous blossoming of misrule has structure and purpose and strategy behind it.

There are very powerful interests who demand “freedom” in order to do as they like with the environment, society and the economy. They have infused a very large part of American culture with the belief that “freedom” is literally more important than life. My freedom to own assault weapons trumps your right not to get shot at school. Now, my freedom to go to the barber (“I Need a Haircut” read one banner this week in St Paul, Minnesota) trumps your need to avoid infection.

Usually when this kind of outlandish idiocy is displaying itself, there is the comforting thought that, if things were really serious, it would all stop. People would sober up. Instead, a large part of the US has hit the bottle even harder.

And the president, his party and their media allies keep supplying the drinks. There has been no moment of truth, no shock of realisation that the antics have to end. No one of any substance on the US right has stepped in to say: get a grip, people are dying here.

That is the mark of how deep the trouble is for the US – it is not just that Trump has treated the crisis merely as a way to feed tribal hatreds but that this behaviour has become normalised. When the freak show is live on TV every evening, and the star is boasting about his ratings, it is not really a freak show any more. For a very large and solid bloc of Americans, it is reality.

And this will get worse before it gets better. Trump has at least eight more months in power. In his inaugural address in 2017, he evoked “American carnage” and promised to make it stop. But now that the real carnage has arrived, he is revelling in it. He is in his element.

As things get worse, he will pump more hatred and falsehood, more death-wish defiance of reason and decency, into the groundwater. If a new administration succeeds him in 2021, it will have to clean up the toxic dump he leaves behind. If he is re-elected, toxicity will have become the lifeblood of American politics.

Either way, it will be a long time before the rest of the world can imagine America being great again.

 

[Guest cherzeca]

"Sweden is fighting coronavirus with common-sense guidelines that are much less economically destructive than the lockdowns in most U.S. states. Since people over 65 account for about 80% of Covid-19 deaths, Sweden asked only seniors to shelter in place rather than shutting down the rest of the country; and since Sweden had no pediatric deaths, it didn’t shut down elementary and middle schools. Sweden’s containment measures are less onerous than America’s, so it can keep them in place longer to prevent Covid-19 from recurring. Sweden did not shut down stores, restaurants and most businesses, but did shut down the Volvo automotive plant, which has since reopened, while the Tesla plant in Fremont, Calif., was shuttered by police and remains closed.

 

How did the Swedes do? They suffered 80 deaths per million 21 days after crossing the 1 per million threshold level. With 10 million people, Sweden’s death rate‒without a shutdown and massive unemployment‒is lower than that of the seven hardest-hit U.S. states—Massachusetts, Rhode Island, Louisiana, Connecticut, Michigan, New Jersey and New York—all of which, except Louisiana, shut down in three days or less. Despite stories about high death rates, Sweden’s is in the middle of the pack in Europe, comparable to France; better than Italy, Spain and the U.K.; and worse than Finland, Denmark and Norway. Older people in care homes accounted for half of Sweden’s deaths."

 

https://www.wsj.com/articles/do-lockdowns-save-many-lives-is-most-places-the-data-say-no-11587930911?mod=hp_opin_pos_1

 

[Investor20]

https://www.reuters.com/article/us-health-coronavirus-prisons-testing-in/in-four-us-state-prisons-nearly-3300-inmates-test-positive-for-coronavirus-96-without-symptoms-idUSKCN2270RX

 

Incredible how transmissible this virus is. In one prison, 2028 out of a total of 2,300 tested positive for the virus and close to 95% of those who tested positive had no symptoms.

 

APRIL 2 WHO report:

 

"There are few  reports of  laboratory-confirmed  cases who  are truly  asymptomatic, and  to date, there has been  no documented asymptomatic transmission."

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf

 

Why is WHO so wrong on everything?

 

How does WHO think the virus is spreading so fast? 

They think lot of people are going around sneezing and coughing? 

Its beyond stupidity to say no asymptomatic transmission.

[clutch]

https://www.reuters.com/article/us-health-coronavirus-prisons-testing-in/in-four-us-state-prisons-nearly-3300-inmates-test-positive-for-coronavirus-96-without-symptoms-idUSKCN2270RX

 

Incredible how transmissible this virus is. In one prison, 2028 out of a total of 2,300 tested positive for the virus and close to 95% of those who tested positive had no symptoms.

 

APRIL 2 WHO report:

 

"There are few  reports of  laboratory-confirmed  cases who  are truly  asymptomatic, and  to date, there has been  no documented asymptomatic transmission."

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf

 

Why is WHO so wrong on everything?

 

How does WHO think the virus is spreading so fast? 

They think lot of people are going around sneezing and coughing? 

Its beyond stupidity to say no asymptomatic transmission.

 

I'm far from approving WHO but I can tell you why. It's because they need significant scientific evidence to make any particular claim. Things like asymptomatic transmission, immunity for those infected, the benefit of wearing masks, etc., are all very hard to scientifically validate (i.e., with significant enough sample size), especially with a new virus.

 

The problem is that many of the governments are relying on WHO because they want to act based on scientific evidence. In some sense, they have became slave to the process, while perhaps they just need to act fast and safe. Science might be the best thing the mankind has created, but it shouldn't constrain us from taking the most reasonable action.

[treasurehunt]

" total fatalities from COVID-19" is an undefined term where so many fatalities have co-morbidities and are associated with elderly

 

Sure, but part of the point in looking at all causes mortality is to sidestep such semantic questions. If you see a lot more people dying in March and April of this year compared to the same period in the last five years, you can reasonably attribute most of the excess deaths to COVID-19 (assuming you don't find some other global phenomenon that could also be a cause). I mean this in the very basic sense that these deaths would not have occurred if not for  COVID-19. A few of the excess deaths -- such as a  higher number of suicides? -- might be due to the reaction to COVID-19 rather than to the disease itself; and some deaths could be due to folks with other conditions receiving worse care, as Dalal pointed out. Still, I find the excess all causes mortality data to be a decent way of estimating the impact of COVID-19.

 

disagree insofar as mistakes in public policy are being based upon this mistaken view of covid impact.  using same analysis, we should shut down country because of prostate cancer, since most every elderly male dies with prostate cancer.

 

I am missing something about your point; I can't quite make sense of the prostate cancer analogy.

 

Just to be clear, all I am saying is that if we expect X people to die based on past experience and in fact X+Y people die, and the only significant difference between the past and the present is COVID, then we can attribute Y deaths to COVID as a first approximation. How does this imply that we can attribute a ton of deaths to prostate cancer because a lot of elderly males have prostate cancer?

[Investor20]

https://www.reuters.com/article/us-health-coronavirus-prisons-testing-in/in-four-us-state-prisons-nearly-3300-inmates-test-positive-for-coronavirus-96-without-symptoms-idUSKCN2270RX

 

Incredible how transmissible this virus is. In one prison, 2028 out of a total of 2,300 tested positive for the virus and close to 95% of those who tested positive had no symptoms.

 

APRIL 2 WHO report:

 

"There are few  reports of  laboratory-confirmed  cases who  are truly  asymptomatic, and  to date, there has been  no documented asymptomatic transmission."

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf

 

Why is WHO so wrong on everything?

 

How does WHO think the virus is spreading so fast? 

They think lot of people are going around sneezing and coughing? 

Its beyond stupidity to say no asymptomatic transmission.

 

I'm far from approving WHO but I can tell you why. It's because they need significant scientific evidence to make any particular claim. Things like asymptomatic transmission, immunity for those infected, the benefit of wearing masks, etc., are all very hard to scientifically validate (i.e., with significant enough sample size), especially with a new virus.

 

The problem is that many of the governments are relying on WHO because they want to act based on scientific evidence. In some sense, they have became slave to the process, while perhaps they just need to act fast and safe. Science might be the best thing the mankind has created, but it shouldn't constrain us from taking the most reasonable action.

 

The scientific validation is that virus cannot spread so fast without asymptomatic transmission.

 

How strong a scientific validation is required is based on what are the negative consequences of an action.

 

Countries like Taiwan, Korea and Japan were worried about asymptomatic transmission and started requiring masks in January itself for everyone.

I gave links to this in this thread earlier which show that by January itself they were talking about significant asymptomatic transmission in Korea and Japan.

 

If masks did not really make a difference, at most people would have been uncomfortable for a while to wear them.

 

What scientific validation did WHO have for lockdowns which has major downturn including as per UN hundreds of thousands of childrens death, millions pushed in poverty?

 

Dont you require much higher scientific validation for a lockdown with major negative consequences rather than assume no asymptomatic transmission and not require masks and safe guards that mitigate asymptomatic transmission? If professional masks were not available, they could have asked people to cover their face with a cloth.

 

It is weird to require strong scientific validation for covering face with mask or cloth and not require that for lockdown.

 

[Viking]

"Sweden is fighting coronavirus with common-sense guidelines that are much less economically destructive than the lockdowns in most U.S. states. Since people over 65 account for about 80% of Covid-19 deaths, Sweden asked only seniors to shelter in place rather than shutting down the rest of the country; and since Sweden had no pediatric deaths, it didn’t shut down elementary and middle schools. Sweden’s containment measures are less onerous than America’s, so it can keep them in place longer to prevent Covid-19 from recurring. Sweden did not shut down stores, restaurants and most businesses, but did shut down the Volvo automotive plant, which has since reopened, while the Tesla plant in Fremont, Calif., was shuttered by police and remains closed.

 

How did the Swedes do? They suffered 80 deaths per million 21 days after crossing the 1 per million threshold level. With 10 million people, Sweden’s death rate‒without a shutdown and massive unemployment‒is lower than that of the seven hardest-hit U.S. states—Massachusetts, Rhode Island, Louisiana, Connecticut, Michigan, New Jersey and New York—all of which, except Louisiana, shut down in three days or less. Despite stories about high death rates, Sweden’s is in the middle of the pack in Europe, comparable to France; better than Italy, Spain and the U.K.; and worse than Finland, Denmark and Norway. Older people in care homes accounted for half of Sweden’s deaths."

 

https://www.wsj.com/articles/do-lockdowns-save-many-lives-is-most-places-the-data-say-no-11587930911?mod=hp_opin_pos_1

 

Yes, countries have all managed the virus in very different ways. Some, like Italy, had a health catastrophe. To suggest that Sweden’s approach would have helped in Italy makes no sense. Each country had its own unique situation (general preparedness, clusters, testing, culture, population density, geographic size etc) that required a specific response. Bottom line, when you mismanage the virus you will have to resort to lock down. This was true in Feb and this is just as true on April 26. All governments have been warned. Moving forward we will see who is up to the challenge.

[clutch]

For those who argue that more people could die because of "overflow" in hospitals: At least in Canada, its quite the opposite. Operating rooms are empty while cancer patients' surgeries are getting delayed:

 

https://www.google.com/amp/s/beta.ctvnews.ca/national/coronavirus/2020/4/24/1_4910699.html

 

Who knows how many of such patients would die because of delayed surgeries...

 

And no, CTV news ain't Fox.

[sys]

Th NY antibody study with a 21% positive rate in NYC let’s me believe, that there will be too many active cases to prevent further spreading regardless of what we do with test and trace. The testing is probably capacity is probably 2 order of magnitude too lower to test most people if we open the economy, which we have to do no matter what, before the vaccine is a factor in 18 month (best case).

 

china crushed the outbreak in hubei province without mass testing and with much less information about the biology of the virus than we have.

 

the idea that we can't, in the united states, accomplish what what many countries around the world (china and most of western europe in squelching raging outbreaks; australia, nz, most of east asia and eastern europe in managing transmission rates to prevent small outbreaks from flaring into large outbreaks) is extremely disheartening.

 

china stopped the virus cold, with a lockdown yes, but also with isolation of infected individuals.  we could do the same, we're just choosing not to insist that our governments take the necessary steps to hunt down and eliminate the virus.  look at what vietnam has done while sitting in china's backyard.  look at taiwan.

 

for one of the wealthiest countries of the world, out behavior is ridiculous.

 

https://twitter.com/Comparativist/status/1254459647068532736

[KCLarkin]

https://www.reuters.com/article/us-health-coronavirus-prisons-testing-in/in-four-us-state-prisons-nearly-3300-inmates-test-positive-for-coronavirus-96-without-symptoms-idUSKCN2270RX

 

Incredible how transmissible this virus is. In one prison, 2028 out of a total of 2,300 tested positive for the virus and close to 95% of those who tested positive had no symptoms.

 

APRIL 2 WHO report:

 

"There are few  reports of  laboratory-confirmed  cases who  are truly  asymptomatic, and  to date, there has been  no documented asymptomatic transmission."

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf

 

Why is WHO so wrong on everything?

 

Can I suggest that the problem isn't WHO, but your inability to read or think for yourself? The WHO bulletin you posted says:

it is possible that people infected with COVID-19 could transmit the virus before significant symptoms develop.

There are few reports of..truly asymptompatic...this does not preclude the possibility it may occur. Asymptomatic cases have been reported as part of contact tracing efforts in some countries.

 

They are summarizing the reports that were available on April 2nd. Most of the studies showing asymptomatics were published after April 2nd. The author likely didn't read the reuters article from April 24th because time machines are so expensive.

 

--

This is probably too subtle for you to comprehend, but few of the reports you are referring (including this prisons report) are even capable of determining whether someone is truly asymptomatic (as defined in that WHO bulletin). The researchers would need to monitor for 14 days to determine whether symptoms later develop. There are a couple studies that have done this, but most, if not all, published after April 2nd.

 

There are really three categories of "silent spreaders":

Presymptomatic - no symptoms at time of test, but will go on to develop symptoms.

Subclinical - symptoms are so mild or atypical, that patient or doctor doesn't notice them or consider them COVID symptoms (perhaps a slight change in pulse or breathing).

Truly asymptomatic

 

There isn't any clear answer on what the relative proportions are. Even some people who think they have no symptoms show significant lung damage on CT scans.

 

 

 

 

[Jurgis]

 

Staying away from sunk costs and how 'others' have been wrong before, then what's the implication for the US, in terms of go-forward policy?

 

This is one I am unsure about too. Th NY antibody study with a 21% positive rate in NYC let’s me believe, that there will be too many active cases to prevent further spreading regardless of what we do with test and trace. The testing is probably capacity is probably 2 order of magnitude too lower to test most people if we open the economy, which we have to do no matter what, before the vaccine is a factor in 18 month (best case).

 

So in opinion this means that we go down the path of heard immunity, at least in bigger cities, but most likely everywhere unless we constrain movement between states or even cities for 18 month.

 

Now heard immunity or vaccines may or may not even exist or be feasible, but no matter, virtually everyone just isn’t get the virus in this case sooner or later.

 

I would like hear different viewpoints on how we still contain this using test and trace from out current starting point of test capacity and the likely opening of the economy in May or early June.

 

Also, I would like to hear if anyone thinks that schools can be closed for 18 month. Opening up a school (which can be staggered into kindergartens, elementary school etc) will simultaneously expose a large number of people to the virus and most likely create  a significant spike in cases, no matter how we do it. Can we keep them closed? Should we? I don’t think we can, but others may have a different viewpoint.

 

I guess you are saying that we cannot reopen and keep the R0 below one. And that any significant reopening (e.g. one that includes schools) will spread the virus across (most of) entire population if we look at ~12-18 month period.

 

Unfortunately, this sounds a possible - and grim - scenario. Basically this will cause IFR deaths across 40-70% of population. Plus whatever non-fatal Covid aftereffects.

 

I don't think I can suggest a way out unless cure or vaccine or both are discovered faster than in 12-18 months. You are quite possibly right that lockdown with R0 < 1 won't work for 12-18 months. Perhaps social distancing, hand washing and masks after lockdown will be enough to prevent full spread of the virus. Perhaps in US the car culture will be another factor to limit the spread. But I think I agree with you that it won't be easy to avoid bad scenarios if there's no cure/vaccine soon.

[samwise]

 

Sweden:

 

 

 

I think at this point, the Swedes have done OK in my opinion. As long as their health care system isn’t crashing in Stockholm, where the population density is highest, their approach isn’t really a failure.

 

They try to get herd immunity at an acceptable cost (in terms of lives). So far, by their own judgement, that is still the case and who are we to judge otherwise?

 

 

Also, besides that , Sweden isn’t really normal either, they just have a soft shutdown instead off hard one. not too different from what we have in some states in the US.

https://www.thelocal.se/20200424/interview-isabella-lovin-coronavirus-the-biggest-myth-about-sweden-is-that-life-is-going-on-as-normal

 

Their government cannot legally do a lockdown it seems. So they have guidance only. And despite shops being open, it seems activity is down. GDP is definitely taking a hit as the bodies pile up in the corner. If anyone has an idea of their GDP hit versus Denmark, please do share.

 

I suspect (speculate) that not having a lockdown doesn't help too much with GDP. However it means that the government will not offer subsidies and support, and if people don't show up to shop, a small business still has to make payroll and rent. In neighboring Denmark , the government will pay 75% of your payroll.

 

I'm really interested in the economic impacts from Swedens approach.

[RichardGibbons]

For those who argue that more people could die because of "overflow" in hospitals: At least in Canada, its quite the opposite. Operating rooms are empty while cancer patients' surgeries are getting delayed:

 

https://www.google.com/amp/s/beta.ctvnews.ca/national/coronavirus/2020/4/24/1_4910699.html

 

Who knows how many of such patients would die because of delayed surgeries...

 

And no, CTV news ain't Fox.

 

I agree with this. In BC in particular, I think they are too slow in relaxing restrictions. It's quite clear now that the curve has flattened, and it's at the point where high-priority operations should start, and lower-risk non-essential services should open (with masks and distancing.)

 

There is no hope in BC of successfully emulating New Zealand's strategy of attempting zero cases, so the optimal strategy is to slowly reopen, and see what happens. (It would be interesting knowing what epidemiologists' arguments against a gradual reopening starting tomorrow would be.)

[Investor20]

https://www.reuters.com/article/us-health-coronavirus-prisons-testing-in/in-four-us-state-prisons-nearly-3300-inmates-test-positive-for-coronavirus-96-without-symptoms-idUSKCN2270RX

 

Incredible how transmissible this virus is. In one prison, 2028 out of a total of 2,300 tested positive for the virus and close to 95% of those who tested positive had no symptoms.

 

APRIL 2 WHO report:

 

"There are few  reports of  laboratory-confirmed  cases who  are truly  asymptomatic, and  to date, there has been  no documented asymptomatic transmission."

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf

 

Why is WHO so wrong on everything?

 

Can I suggest that the problem isn't WHO, but your inability to read or think for yourself? The WHO bulletin you posted says:

it is possible that people infected with COVID-19 could transmit the virus before significant symptoms develop.

There are few reports of..truly asymptompatic...this does not preclude the possibility it may occur. Asymptomatic cases have been reported as part of contact tracing efforts in some countries.

 

They are summarizing the reports that were available on April 2nd. Most of the studies showing asymptomatics were published after April 2nd. The author likely didn't read the reuters article from April 24th because time machines are so expensive.

--

This is probably too subtle for you to comprehend, but few of the reports you are referring (including this prisons report) are even capable of determining whether someone is truly asymptomatic (as defined in that WHO bulletin). The researchers would need to monitor for 14 days to determine whether symptoms later develop. There are a couple studies that have done this, but most, if not all, published after April 2nd.

 

There are really three categories of "silent spreaders":

Presymptomatic - no symptoms at time of test, but will go on to develop symptoms.

Subclinical - symptoms are so mild or atypical, that patient or doctor doesn't notice them or consider them COVID symptoms (perhaps a slight change in pulse or breathing).

Truly asymptomatic

 

There isn't any clear answer on what the relative proportions are. Even some people who think they have no symptoms show significant lung damage on CT scans.

 

That is absolutely wrong. I can give a lot of references to asymptomatic before April 2nd.  But here are four examples: 

 

April 2:

https://www.cnn.com/2020/04/02/politics/fact-check-georgia-gov-brian-kemp-coronavirus-no-symptoms-stay-at-home/index.html

Fact check: Georgia governor says we only just learned people without symptoms could spread coronavirus. Experts have been saying that for months

 

February 10:

https://focustaiwan.tw/society/202002100010

Asymptomatic transmission of Wuhan virus 'almost certain': expert

 

February 24

https://www.sciencealert.com/researchers-confirmed-patients-can-transmit-the-coronavirus-without-showing-symptoms

A Person Can Carry And Transmit COVID-19 Without Showing Symptoms, Scientists Confirm

 

January 27th

https://www.straitstimes.com/asia/east-asia/masks-out-as-japan-s-korea-report-new-cases

the fact that carriers of the virus may not show detectable symptoms has been a major cause of concern.

 

So why does WHO says on April 2nd

"There are few  reports of  laboratory-confirmed  cases who  are truly  asymptomatic, and  to date,

there has been  no documented asymptomatic transmission.""

[UK]

https://www.thetimes.co.uk/article/the-man-who-convinced-the-swedish-not-to-go-into-lockdown-9qhcc608n

 

Meanwhile, the Swedish economy has been far less badly hit than that of other European countries and is expected to contract by only 4 per cent this year. “I’m not an economist, but the UK is far more affected with more out of work,” Tegnell says, although he insists that he would never want to sacrifice lives to protect GDP.

[Liberty]

https://www.newyorker.com/magazine/2020/05/04/seattles-leaders-let-scientists-take-the-lead-new-yorks-did-not

 

Also, on testing progress:

 

[Spekulatius]

 

Staying away from sunk costs and how 'others' have been wrong before, then what's the implication for the US, in terms of go-forward policy?

 

This is one I am unsure about too. Th NY antibody study with a 21% positive rate in NYC let’s me believe, that there will be too many active cases to prevent further spreading regardless of what we do with test and trace. The testing is probably capacity is probably 2 order of magnitude too lower to test most people if we open the economy, which we have to do no matter what, before the vaccine is a factor in 18 month (best case).

 

So in opinion this means that we go down the path of heard immunity, at least in bigger cities, but most likely everywhere unless we constrain movement between states or even cities for 18 month.

 

Now heard immunity or vaccines may or may not even exist or be feasible, but no matter, virtually everyone just isn’t get the virus in this case sooner or later.

 

I would like hear different viewpoints on how we still contain this using test and trace from out current starting point of test capacity and the likely opening of the economy in May or early June.

 

Also, I would like to hear if anyone thinks that schools can be closed for 18 month. Opening up a school (which can be staggered into kindergartens, elementary school etc) will simultaneously expose a large number of people to the virus and most likely create  a significant spike in cases, no matter how we do it. Can we keep them closed? Should we? I don’t think we can, but others may have a different viewpoint.

 

I guess you are saying that we cannot reopen and keep the R0 below one. And that any significant reopening (e.g. one that includes schools) will spread the virus across (most of) entire population if we look at ~12-18 month period.

 

Unfortunately, this sounds a possible - and grim - scenario. Basically this will cause IFR deaths across 40-70% of population. Plus whatever non-fatal Covid aftereffects.

 

I don't think I can suggest a way out unless cure or vaccine or both are discovered faster than in 12-18 months. You are quite possibly right that lockdown with R0 < 1 won't work for 12-18 months. Perhaps social distancing, hand washing and masks after lockdown will be enough to prevent full spread of the virus. Perhaps in US the car culture will be another factor to limit the spread. But I think I agree with you that it won't be easy to avoid bad scenarios if there's no cure/vaccine soon.

 

Yes, that’s my thesis. I don’t think we have the capacity to test and track. It is important to keep in mind that R0 is an average number, but I think the outbreaks are going to be local with R0>>1, if a company or school opens up and probably will be detected only once we have 50 cases or so, given current testing constraints.

 

What we really would need to do is having the capacity to test asymptotic people preemptively , which right now is not the case. Currently, we do not even screen high risk personal (health care workers ) preemptively.

 

Perhaps, the preemptive measures we have taken (Masks, Hand washing, separation ) are preventing high R0 generally, but I doubt it. I do think that the states and countries that are opening up will provide some interesting data in a couple of weeks (4-8 weeks).

[Dalal.Holdings]

A lesson in not celebrating too soon:

 

https://www.bloomberg.com/news/articles/2020-04-26/singapore-reports-931-more-virus-cases-total-exceeds-13-600

 

Singapore -- which has one of Asia’s smallest populations -- is emerging with the region’s highest number of coronavirus cases after the world’s two most populous countries.

 

The island-nation reported 931 new cases on Sunday, with the total number of infections exceeding 13,000, overtaking Japan. Only China and India have more cases in Asia.

 

Interestingly, they have heat and humidity in abundance. They also have density though (migrant dorms, public transit, etc).

 

Only 12 deaths which means 1) they are testing like crazy and/or 2) the deaths will grow as these relatively new cases run their course (likely a combination of the two).

[Dalal.Holdings]

https://twitter.com/realDonaldTrump/status/1254747293414305792?s=20

 

Blame the Democrats for any “lateness” in your Enhanced Unemployment Insurance. I wanted the money to be paid directly, they insisted it be paid by states for distribution. I told them this would happen, especially with many states which have old computers.

 

Delays checks so he can put his name on them...then attempts to shift blame onto other party.

 

Brilliant--will 100% work on his muppet followers. Donald "I have total authority" yet "I accept no responsibility" Trump.

 

A great leader and an even better puppeteer!

[KCLarkin]

That is absolutely wrong. I can give a lot of references to asymptomatic before April 2nd.  But here are four examples:

 

Did you actually read any of these "reports"? (WHO means published research studies not popular press clippings. Posting multiple articles that discuss the same case doesn't bolster your argument.)

 

Referencing a Chinese case (edit: this is actually the same case as the german case below):

Interviews with the Chinese patient at the center of the case revealed she may have actually had mild, nonspecific symptoms.

 

Referencing a German case:

But the researchers had not spoken with the woman, who had in fact experienced mild symptoms at the time of transmission.

 

Referencing a Taiwan case:

What was curious, Ho said, is that the woman did not start showing symptoms until Jan. 25, while the husband started showing symptoms just a day later, on Jan. 26

 

So most of the cases mentioned were actually mildly symptomatic or presymptomatic, not "truly asymptomatic".

 

In that bulletin, WHO clearly stated that presymptomatic and asymptomatic transmission was possible.