Coronavirus

[clutch]

Well, let's see what happens. I'm just very curious to see how these countries start to easy the lockdown measures, and how they will handle potential 2nd or 3rd waves... Just look at Singapore, and now S. Korea where a single club goer has caused another possible outbreak... which led the government to shut down bars/clubs again. Seems like they will have to go back and forth with measures, for the next 12+ months... At some point, I'm afraid that the whole society will lose its patience/integrity.

 

That's why you need a crapload of testing, good contact tracing, people wearing masks, discourage large events, etc.. This is how you avoid huge outbreaks that lead to large shutdowns. Easier to keep it to a simmer and crush little embers when they show up if you have measures to keep R0 as low as possible (under 1 ideally) and good testing to immediately catch things when they begin.

 

If you don't have that, outbreaks go undetected long enough that you can't contain them and you have to do larger shutdowns again and again.

 

Doing it right is easier than doing it wrong, which is the huge problem with the incompetence at the federal level in the US. A lot of all this could've been avoided with a competent early response (and I don't even mean super early like in January, but even later it would've made a big different because of the inherent properties of exponential growth).

 

Yeah, too late for the US. So not sure how these success stories would help them at this point.

 

Also, I'm not even sure how the measures such as "a crapload of testing, good contact tracing, people wearing masks, discourage large events, etc." would be able to be sustained for a year... If you look up images of schools that have opened up so far in other countries... I see the perfect resemblance of a dystopia and make me depressed.

[clutch]

 

Taiwan is now just one day away from completing two 14-day incubation periods with zero locally transmitted cases. Hong Kong is at 20 consecutive days with no new local cases

 

https://www.scmp.com/news/hong-kong/health-environment/article/3083627/coronavirus-hong-kong-records-no-new-cases-covid

 

While these are success stories now, I'm afraid once they open up the borders/businesses again... Boom.

 

Boom?

 

They'll keep screening people at the border and international travel will be pretty low until there's a vaccine or at least better therapies. Any time they gain now by crushing the curve and containing it is fewer deaths before a vaccine.

 

Well, let's see what happens. I'm just very curious to see how these countries start to easy the lockdown measures, and how they will handle potential 2nd or 3rd waves... Just look at Singapore, and now S. Korea where a single club goer has caused another possible outbreak... which led the government to shut down bars/clubs again. Seems like they will have to go back and forth with measures, for the next 12+ months... At some point, I'm afraid that the whole society will lose its patience/integrity.

 

 

The whole society will lose their integrity because they can’t go to bars? C’mon.

 

Also, we keep talking about lockdowns, but the US and Europe never had any “lockdowns”. We had “shelters in place” that are quite leaky, in some countries/ states more so than others.

In my state, many stores were open (hardware, groceries, liquor and of course drugstores), parks open, takeout food available and many business declared essential etc so people still went to work as usual. That’s not what I call a “lockdowns. lockdown is what the Chinese did when they prevented people from leaving their apartment for any reason. We never had a lockdown in the US or Europe.

 

The bars were just a recent example from S. Korea... Nice reading comprehension. I'm talking about all the measures as a whole...

 

and i'm just using "lockdown" in the sense used by the media.

[Spekulatius]

 

The mortality rate will be lower as the older/vulnerable population die first and as schools open and more kids get infected. (I know, that sounds horrible)

 

But I 100% agree with you that these projections are never brought up by the government. It's not just the WH, but many other governments who have gone the lockdown route and are now stuck on what to do next.

 

I think we will have to learn how to live with this virus...

 

I also think mortality rate will come down because we will learn how to treat patients better over time. That’s why I personally think it is better to get infected late rather than early personally.

 

I also know for sure they Germany and many other European states try to avoid the herd immunity route. Germany and opened schools again and some business and does test and trace to contain new outbreaks. Same with other Scandinavian states. Perhaps Italy is too far in and Spain in some areas at least to try this, I don’t really know.

 

I do think that the US has lost the optionality to avoid the herd immunity route, because the shelter in place were  were lifted early, so the case load is probably too high for test and trace to work.

 

We will see how it works out, I don’t really know what the best route is. I hope the best for Sweden, Germany, the US and all other nations to obtain a workable solution with a manageable human cost, but some area quite clearly doing much better than others for a variety of reasons.

[Liberty]

She’s good:

[dwy000]

She’s good:

 

she's hilarious.  Which is really weird given all she does is lip sync word for word.

[clutch]

https://www.nytimes.com/2020/05/09/world/asia/coronavirus-south-korea-second-wave.html

 

So only few days after they have lifted social distance measures, there is now a community outbreak created by a single spreader. The latest number of confirmed cases from this incident is 54.

 

Compared to the numbers in the US, that might look trivial. However, people are now pushing for delaying the reopening of high schools.

 

Well, that sounds like an overreaction... but I believe this is what a lockdown does to your society. Even if what you have done so far is considered as the gold standard by other countries. As restrictions are lifted, and as the public sees the sudden increase in cases, the fear spreads again and you have nowhere to go but to return to your restrictions. In fact, this rebound effect might be stronger for those countries who have taken more stronger measures and been successful so far. The chance of a big 2nd wave is greater while the public expectation is much higher.

 

It's a double edged sword situation. At one hand, you can go to the Swedish route but risks many more deaths immediately. On the other hand, stronger lockdown measures can prevent such deaths now but now you are stuck in a limbo always fearing the 2nd wave and almost impossible to return back to normal.

 

And I believe that we will only know which was better after this pandemic is over.

 

Disclosure: has many relatives in S. Korea

[Spekulatius]

Hmm, who could have known:

https://www.channel3000.com/72-got-covid-19-after-being-at-large-event/

[Liberty]

She’s good:

 

she's hilarious.  Which is really weird given all she does is lip sync word for word.

 

I think it's because we've become desensitized to Trump over time and judge him to a totally different standard than a normal human.

 

So when we hear his words said by someone different, we can judge them more on their own merit and realize how crazy and stupid he sounds.

 

Someone should lip-synch Trump to video of other presidents (from both parties -- Bush or Reagan or Clinton or Obama -- saying some of these things).

[Gamecock-YT]

Germany is now estimating a R0 above 1, granted a small sample size but it was in the .7's a week or two ago.

 

https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberichte/2020-05-09-en.pdf?__blob=publicationFile

 

The number of incident cases estimated using the nowcasting approach is presented as a moving 4-day

average to compensate for random effects of individual days (Fig. 5). With this approach, the point

estimate of R for a given day is estimated as the quotient of the number of incident cases on this day

divided by the number of incident cases four days earlier. The current estimate is R= 1.10 (95%

prediction interval: 0.90- 1,34) and is based on electronically notified cases as of 09/05/2020, 12:00 AM.

Today’s estimate of the reproduction number R is above 1. Any interpretation of this number needs to

take into account that the estimate is linked to a degree of uncertainty that is reflected by the prediction

interval published daily alongside the actual number. A low number of case reports could increase the

statistical variation. Thus, it is too early to infer whether the number of new infections will continue to

decrease as in passing weeks or increase again. The increase of the reproduction number R necessitates

a close monitoring of the situation in the coming days.

 

 

[Spekulatius]

Germany is now estimating a R0 above 1, granted a small sample size but it was in the .7's a week or two ago.

 

https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberichte/2020-05-09-en.pdf?__blob=publicationFile

 

The number of incident cases estimated using the nowcasting approach is presented as a moving 4-day

average to compensate for random effects of individual days (Fig. 5). With this approach, the point

estimate of R for a given day is estimated as the quotient of the number of incident cases on this day

divided by the number of incident cases four days earlier. The current estimate is R= 1.10 (95%

prediction interval: 0.90- 1,34) and is based on electronically notified cases as of 09/05/2020, 12:00 AM.

Today’s estimate of the reproduction number R is above 1. Any interpretation of this number needs to

take into account that the estimate is linked to a degree of uncertainty that is reflected by the prediction

interval published daily alongside the actual number. A low number of case reports could increase the

statistical variation. Thus, it is too early to infer whether the number of new infections will continue to

decrease as in passing weeks or increase again. The increase of the reproduction number R necessitates

a close monitoring of the situation in the coming days.

 

Ye, and increasing infection rate is expected when you open the economy back up. Germany has opened up some schools, more stores are open and some factories (automobile) have started back up again.

 

It is interesting to note that there was also an outbreak cluster in meat processing plant as well ( Coesfeld). That triggered a setback for this county in terms of opening the economy further son e a threshold of 50 new cases/100k population was exceeded. Almost logical. :o

https://www.dw.com/en/coronavirus-outbreak-closes-german-meat-packing-plant/a-53374478

 

As in the US the meatpacking plant outbreak occurred with guest workers (from  Bulgaria) with not that great working and living conditions. The virus is very good at finding weak spots apparently.

[Viking]

For those who like a historical perspective...

 

How Pandemics End

- https://www.nytimes.com/2020/05/10/health/coronavirus-plague-pandemic-history.html?action=click&module=Top%20Stories&pgtype=Homepage

 

When will the Covid-19 pandemic end? And how? According to historians, pandemics typically have two types of endings: the medical, which occurs when the incidence and death rates plummet, and the social, when the epidemic of fear about the disease wanes.

 

“When people ask, ‘When will this end?,’ they are asking about the social ending,” said Dr. Jeremy Greene, a historian of medicine at Johns Hopkins.

 

In other words, an end can occur not because a disease has been vanquished but because people grow tired of panic mode and learn to live with a disease. Allan Brandt, a Harvard historian, said something similar was happening with Covid-19: “As we have seen in the debate about opening the economy, many questions about the so-called end are determined not by medical and public health data but by sociopolitical processes.”

 

Endings “are very, very messy,” said Dora Vargha, a historian at the University of Exeter. “Looking back, we have a weak narrative. For whom does the epidemic end, and who gets to say?”

 

[Liberty]

Masks:

 

Gary Kasparov:

[Liberty]

We're still learning so much about this. Another reason to try not to get sick in the early phase of this..

 

On blood oxygen levels and ventilators:

 

https://www.wsj.com/articles/some-doctors-pull-back-on-using-ventilators-to-treat-covid-19-11589103001

 

Doctors have dubbed these patients “happy hypoxemics,” a reference to the paradox of abnormally low levels of oxygen found in their blood combined with an ability to breathe relatively easily. In recent weeks, doctors at Stony Brook Hospital have used ventilators less on these patients, turning instead to the CPAP or BiPAP machines or high-flow nasal cannulas.

[samwise]

For those who like a historical perspective...

 

How Pandemics End

- https://www.nytimes.com/2020/05/10/health/coronavirus-plague-pandemic-history.html?action=click&module=Top%20Stories&pgtype=Homepage

 

When will the Covid-19 pandemic end? And how? According to historians, pandemics typically have two types of endings: the medical, which occurs when the incidence and death rates plummet, and the social, when the epidemic of fear about the disease wanes.

 

“When people ask, ‘When will this end?,’ they are asking about the social ending,” said Dr. Jeremy Greene, a historian of medicine at Johns Hopkins.

 

In other words, an end can occur not because a disease has been vanquished but because people grow tired of panic mode and learn to live with a disease. Allan Brandt, a Harvard historian, said something similar was happening with Covid-19: “As we have seen in the debate about opening the economy, many questions about the so-called end are determined not by medical and public health data but by sociopolitical processes.”

 

Endings “are very, very messy,” said Dora Vargha, a historian at the University of Exeter. “Looking back, we have a weak narrative. For whom does the epidemic end, and who gets to say?”

 

We are already seeing people tired of the restrictions. I think human society will accept a reduced human life expectancy. If life expectancies fall by 5-10 years (worst case, probably much less than that in reality), that only takes us back to 1950s, a period of good economic growth. And humans have lived with diseases which had no cure for hundreds of years. Society will accept that too. The plagues we hear about in history had horrible death rates. Diseases with lower death rates were just a part of normal life.

 

If this happens within a year (or a cure or vaccine is found), then the stock market is realistically priced right now.

 

If society decided to “stay calm and carry on” as they did in wartime Britain in 1918, the economic losses would be much smaller, sharper, and more focused on travel and entertainment. The human losses would be large.

 

So the current pain is a choice. ....

 

Since it’s a choice, there is a limit to how much people will tolerate.

 

Edit: Near term, we still want to ensure everyone who needs it gets ICU treatment though. So probably have a year of some restrictions ahead of us. But i’m thinking of this becoming a part of seasonal diseases. Part of the worst case scenario with no cure and no vaccine and no lasting immunity.

[Viking]

“I think human society will accept a reduced human life expectancy.“

 

Sam, the problem is we still do not understand the virus very well. If you let the genie out of the bottle the death toll may spike much higher than expected. And at that point you have made the wrong decision but you are screwed.

 

My guess is the health authorities in Wuhan, in Northern Italy and in Iran all made what they thought at the time were rational decisions based on their projections of what the virus would do (based on the actions they were taking).  My guess is that today ‘human society’ in those regions are not happy with the decisions made.

 

It is not as simple as virus or economy. The two are actually highly linked. When you have this much incomplete information there is no right answer; just a bunch of options with probability distributions (that likely are not very accurate). We are flying blind.

 

PS: i am not proposing a specific course of action. I really have no idea. It will be very interesting to see how it plays out :-)

[clutch]

We are flying blind.

 

That is the life. Existence is suffering. You have to embrace the chaos and move forward. And we will.

[samwise]

“I think human society will accept a reduced human life expectancy.“

 

Sam, the problem is we still do not understand the virus very well. If you let the genie out of the bottle the death toll may spike much higher than expected. And at that point you have made the wrong decision but you are screwed.

 

Yes, there’s forces pulling and pushing here. As seen on this board and in the news.

 

Pull: we humans won’t accept overloaded ICUs. And a 4-5% death rate.

 

Push: But equally unlikely we will accept our livelihoods gone for over a year.

 

Let’s see how it plays out.

 

As an investor I have counted on the second “push” to construct a downside fundamental risk scenario as I buy stocks over the last month. Of course, this doesn’t restrict the market from doing anything in the interim, or I could simply be wrong.

[Liberty]

We are flying blind.

 

That is the life. Existence is suffering. You have to embrace the chaos and move forward. And we will.

 

There’s degrees of flying blind. And there’s flying reckless.

 

https://twitter.com/sam_baker/status/1259801828591534080?s=21

 

“ S. Korea had to re-clamp down because it got 34 new cases in one day. We have 25,000 per day and all we’re talking about is opening up. There’s even a risk of an outbreak inside the White House.

 

We know what we’re on for.”

[Spekulatius]

Seems like we need to close down the White House, quarantine the inhabitants and deep clean it.

[Charlie]

Melinda Gates says Trump Administration's COVID response is 'costing lives'

 

https://finance.yahoo.com/news/melinda-gates-says-trump-administrations-covid-response-is-costing-lives-120013294.html

[clutch]

We are flying blind.

 

That is the life. Existence is suffering. You have to embrace the chaos and move forward. And we will.

 

There’s degrees of flying blind. And there’s flying reckless.

 

https://twitter.com/sam_baker/status/1259801828591534080?s=21

 

“ S. Korea had to re-clamp down because it got 34 new cases in one day. We have 25,000 per day and all we’re talking about is opening up. There’s even a risk of an outbreak inside the White House.

 

We know what we’re on for.”

 

I agree with this but imagine what would happen if the US took measures like S. Korea (clamping down after 34 new cases). There would be a civil war.

 

It's not always the government's fault -- it's on individuals as well.

[Guest]

Seems like we need to close down the White House, quarantine the inhabitants and deep clean it.

 

Don't forget Congress! ;)

[Jurgis]

Seems like we need to close down the White House, quarantine the inhabitants and deep clean it.

 

Nah, we should reopen it! And no testing, tests are overrated! Make the White House Open Again!

[Investor20]

Evidence mounts that outside is safer when it comes to COVID-19

 

https://thehill.com/policy/healthcare/496483-evidence-mounts-that-outside-is-safer-when-it-comes-to-covid-19

 

Health experts say people are significantly less likely to get the coronavirus while outside, a fact that could add momentum to calls to reopen beaches and parks closed during the COVID-19 pandemic.

[cubsfan]

the great heather Macdonald  https://amgreatness.com/2020/04/22/the-deadly-costs-of-extended-shutdown-orders/

 

Great article - thanks for posting