Coronavirus

[RichardGibbons]

This one's been obvious for a while, but it's nice to hear someone state it plainly.

 

https://globalnews.ca/news/7075024/mask-wearing-fewer-coronavirus-deaths/

 

A two orders of magnitude effect is a lot.

 

[Guest cherzeca]

"I can't help but think that we are going to have very similar discussions regarding climate change in the near future."

 

the "science" of climate change is incredibly difficult, inasmuch as the earth's climate is a very large, multivariate, dynamic and nonlinear system.  easy to model poorly by supposed scientists, hard to know anything with certainty...not too many experts in the math of chaos theory.

 

what we have just experienced with covid and epidemiologists leading us blindly with not a shred of doubt into the greatest unforced error in recent memory (lockdown should have been for only elderly and at risk, but no, we send covid infected people to join the elderly) is only a small taste of the stupidity masquerading for science that we will see for the next decade.  and in the meanwhile, technologists will ignore the false debate and proceed to find non-petroleum based sources of energy, thankfully.

[KCLarkin]

Agreed.  As opposed to what that charlatan, Neil Ferguson, did with his POS useless model in which he used the median of all the crappy outputs to help justify the lockdowns.  ;)

 

James, a model always relies on imperfect inputs. The subsequent research (e.g. Serology tests) is to improve the inputs.

 

We are 6 months into this epidemic and we don't have a good answer to ANY of the inputs in Ferguson's model:

 

IFR - most experts think it is 0.5-1.0. But there is a vocal group that think it is 0.05-0.5

R0 - Many experts think the initial estimate of 2.5 was too low, but nobody knows

Herd immunity (with no interventions) - Some people think this could be as low as 20-30% (due to heterogenity, immune dark matter) or as high as 90% due to overshoot.

 

And as you make clear, it is impossible to make sound economic tradeoffs if you don't have good answers. So a respected scientist like Ionnidias producing and amplifiying crappy research only muddies the waters.

[RichardGibbons]

I can't help but think that we are going to have very similar discussions regarding climate change in the near future.

 

We will rely on prediction models that have no proof for causations (only correlations), no scientific validation (only based on incomplete data) and a ridiculously huge range of outcomes to make draconian decisions like a lockdown -- in this case, a "lockdown" of activities to prevent CO2 emissions.

 

People will say: "we have to do this for the worst-case scenario". Well, if that's your reasoning then you are not making a scientific decision. Just another version of Pascal's wager.

 

Just like people have abused religions and socialism to suppress freedom in the past, they will again do the same this time with science.

 

Note that I'm not discrediting science here -- but it's when people misuse/abuse the tool, the great danger arises.

 

Curious. We've studied a novel disease for a few months, and during that time understanding has changed. And you take that, and equate it with something that we've studied for 3 or 4 decades, scientists almost entirely agree on, and say that's the same thing?

 

Huh.

 

IMO, the primary value of your comment isn't actually the critique of how we view science, but rather in providing insight into the things you care about. Current economic interests are very important to you, but the long-term future isn't.

[RichardGibbons]

what we have just experienced with covid and epidemiologists leading us blindly with not a shred of doubt into the greatest unforced error in recent memory (lockdown should have been for only elderly and at risk, but no, we send covid infected people to join the elderly)

 

Ha, ha, ha!

 

Nope.

 

Even if you believe it was an error (it wasn't), in this pandemic that wouldn't be the greatest unforced error.

 

The greatest unforced error was Trump politicizing the use of masks. If he hadn't done that, USA would be able to give everyone masks, open its economy, and not worry about too many COVID-19 deaths.

 

USA could've had it's cake and eat it too, but Trump has eliminated that as a possibility. It's an insanely huge unforced error, costing both lives and the economy.

[Liberty]

Update to the chart:

 

 

So if the fall does bring a second wave because of factors like lower humidity/UV/vitamin D/etc, it's mathematically going to be much worse to have that wave from a high base than from a low base. This is a bad setup...

[Read the Footnotes]

what we have just experienced with covid and epidemiologists leading us blindly with not a shred of doubt into the greatest unforced error in recent memory (lockdown should have been for only elderly and at risk, but no, we send covid infected people to join the elderly)

 

Ha, ha, ha!

 

Nope.

 

Even if you believe it was an error (it wasn't), in this pandemic that wouldn't be the greatest unforced error.

 

The greatest unforced error was Trump politicizing the use of masks. If he hadn't done that, USA would be able to give everyone masks, open its economy, and not worry about too many COVID-19 deaths.

 

USA could've had it's cake and eat it too, but Trump has eliminated that as a possibility. It's an insanely huge unforced error, costing both lives and the economy.

Clear, honest and consistent communication (not creating confusion by calling it a hoax for example) is even cheaper than masks and might have had just as positive an impact.

[clutch]

Update to the chart:

 

 

So if the fall does bring a second wave because of factors like lower humidity/UV/vitamin D/etc, it's mathematically going to be much worse to have that wave from a high base than from a low base. This is a bad setup...

 

Do you have the same chart but with deaths or deaths per million?

[Gregmal]

So I dont follow that closely, but WTF is going on in Los Angeles. Haven't they been on lockdown forever? Weren't they the ones who said theyre staying locked down til like late July? Why are they still reporting the type of numbers they are?

[RichardGibbons]

Do you have the same chart but with deaths or deaths per million?

 

I'd be surprised if Liberty has it just because it's a chart from a third-party. That said, it's pretty easy to visualize because the EU has about the population of the USA, plus a third.

 

So, keep the same line from the EU, and move the USA line up a third.

 

That said, I agree with your underlying point--the chart is a bit deceptive because, compared to the EU, USA has actually done even worse than you'd think just by looking at the chart.

[Dalal.Holdings]

Update to the chart:

 

 

So if the fall does bring a second wave because of factors like lower humidity/UV/vitamin D/etc, it's mathematically going to be much worse to have that wave from a high base than from a low base. This is a bad setup...

 

An absolute travesty of leadership.

[cwericb]

Today it seems that the EU is discussing refusing entry to travelers from the U.S.

https://www.nytimes.com/2020/06/23/world/europe/coronavirus-EU-American-travel-ban.html

[Dalal.Holdings]

Today it seems that the EU is discussing refusing entry to travelers from the U.S.

 

Smart move. They ate their vegetables, now they move onto dessert. USA? Stuck in futile "isolate seniors/vulnerables" until/if a vaccine ever emerges. Oh, and economy takes on water over longer term now even without any more lockdowns.

 

"Isolate seniors strategy" a.k.a. prepare for long term hits to tourism, entertainment, no spending by those who have money to spend (seniors/retirees), less spending even by young folks who also really don't want covid themselves, restaurant/hotel volume hits, etc etc.

 

Oh, and good luck completely sealing off seniors from the rest of the population. Maybe we can pull some seniors out of retirement to run the nursing homes...

[Jurgis]

Do you have the same chart but with deaths or deaths per million?

 

I'd be surprised if Liberty has it just because it's a chart from a third-party. That said, it's pretty easy to visualize because the EU has about the population of the USA, plus a third.

 

So, keep the same line from the EU, and move the USA line up a third.

 

That said, I agree with your underlying point--the chart is a bit deceptive because, compared to the EU, USA has actually done even worse than you'd think just by looking at the chart.

 

https://ourworldindata.org/grapher/daily-deaths-covid-19?time=2020-03-02..&country=USA~European%20Union

 

You can edit the chart to select the start-end dates, etc.

It's not a seven day rolling average though AFAIK.

[Viking]

Today it seems that the EU is discussing refusing entry to travelers from the U.S.

 

Smart move. They ate their vegetables, now they move onto dessert. USA? Stuck in futile "isolate seniors/vulnerables" until/if a vaccine ever emerges. Oh, and economy takes on water over longer term now even without any more lockdowns.

 

"Isolate seniors strategy" a.k.a. prepare for long term hits to tourism, entertainment, no spending by those who have money to spend (seniors/retirees), less spending even by young folks who also really don't want covid themselves, restaurant/hotel volume hits, etc etc.

 

Oh, and good luck completely sealing off seniors from the rest of the population. Maybe we can pull some seniors out of retirement to run the nursing homes...

 

The EU will not be alone in doing this. Canada keeps extending severe border restrictions with US and it is hard to see why they would be lifted with the spike in US cases. The rest of the world will likely continue shutting out the US. I am sure this fits with Trump’s re-election strategy... all part of the well thought out plan :-) ‘stable genius’ that he is.

[LongHaul]

Coronavirus: Dexamethasone proves first life-saving drug

~30% reduction in risk of death for those on ventilators. 

 

https://www.bbc.com/news/health-53061281

 

The longer everyone can hold out the more optionality there is on a lower rate of death, etc.

[Cigarbutt]

Do you have the same chart but with deaths or deaths per million?

I'd be surprised if Liberty has it just because it's a chart from a third-party. That said, it's pretty easy to visualize because the EU has about the population of the USA, plus a third.

So, keep the same line from the EU, and move the USA line up a third.

That said, I agree with your underlying point--the chart is a bit deceptive because, compared to the EU, USA has actually done even worse than you'd think just by looking at the chart.

https://ourworldindata.org/grapher/daily-deaths-covid-19?time=2020-03-02..&country=USA~European%20Union

You can edit the chart to select the start-end dates, etc.

It's not a seven day rolling average though AFAIK.

The rising positive test % rate is puzzling and unusual.

It raises the possibility that some areas are behind the ball.

It may represent delayed community spread, higher testing capacity, higher testing in the younger population as well as targeted contact tracing.

In many states, this appears to be mostly noise but, in some states, there is signal in the data suggesting that the uncoordinated response will "succeed" in preventing the slope of deaths from going down.

After a deeper look, it seems that Texas, for example, may be one of the worst examples of this. The State is showing higher positive tests, higher positive rate %, higher hospitalizations and ICU occupation, younger age profile in the hospitalized group and Texas is scored low in its capacity to test and trace. In this case, rising positive test % shows an inability to contain the virus. It's also interesting to note that hospitals in general have "reopened" for elective cases which means that "excess" capacity is now much lower than it was a few weeks ago. In Texas, i hear that a pediatric hospital is making modifications to now accept young CV+ adults..

It is ironic that some may eventually express the "no-brainer" opinion that the eventual rise in poor outcomes will have been caused by the senseless (relative) re-lockdowns to be announced which, in fact, will have resulted from the lack of respect for the margin of safety concept.

[John Hjorth]

Today it seems that the EU is discussing refusing entry to travelers from the U.S.

 

Smart move. They ate their vegetables, now they move onto dessert. USA? Stuck in futile "isolate seniors/vulnerables" until/if a vaccine ever emerges. Oh, and economy takes on water over longer term now even without any more lockdowns.

 

"Isolate seniors strategy" a.k.a. prepare for long term hits to tourism, entertainment, no spending by those who have money to spend (seniors/retirees), less spending even by young folks who also really don't want covid themselves, restaurant/hotel volume hits, etc etc.

 

Oh, and good luck completely sealing off seniors from the rest of the population. Maybe we can pull some seniors out of retirement to run the nursing homes...

 

The EU will not be alone in doing this. Canada keeps extending severe border restrictions with US and it is hard to see why they would be lifted with the spike in US cases. The rest of the world will likely continue shutting out the US. I am sure this fits with Trump’s re-election strategy... all part of the well thought out plan :-) ‘stable genius’ that he is.

 

Viking, Dalal.Holdings & cwericb,

 

Naturally, this is somewhat saturated of political tactics. But there is also some logic in some places of this. Going anecdotal and local, here in Denmark the travel restrictions for persons crossing the Danish border has been made dynamic, so that if a country has a number of confirmed cases per x citizen measured as an average over a given time span over a preset treshold, it considered a "bad country", and citizens from that particular country are not welcome here, and Danes aren't allowed to travel to that particular country. So the management of "open ["good"] countries" and "closed ["bad"] countries" has been made quite mechanical and dynamic.

 

- - - o 0 o - - -

 

As a European CoBF member I also want to express my sincere concerns to my fellow US board members about how this calamity evolves over time in USA. The mental load on you must be enormous while trying live the daily life as well as possible. I hope that you take care of those near and dear to you, and that you have not had casualties in your personal sphere. Please hang in there. The enemy is genetically coded not to show signs of fatigue. There is no such thing as defeat or rising the white flag. We all have to ride this out.

[clutch]

Do you have the same chart but with deaths or deaths per million?

 

I'd be surprised if Liberty has it just because it's a chart from a third-party. That said, it's pretty easy to visualize because the EU has about the population of the USA, plus a third.

 

So, keep the same line from the EU, and move the USA line up a third.

 

That said, I agree with your underlying point--the chart is a bit deceptive because, compared to the EU, USA has actually done even worse than you'd think just by looking at the chart.

 

https://ourworldindata.org/grapher/daily-deaths-covid-19?time=2020-03-02..&country=USA~European%20Union

 

You can edit the chart to select the start-end dates, etc.

It's not a seven day rolling average though AFAIK.

 

If you see this chart, you don't see the same spike of deaths in US as with cases.

 

Could it simply be that they are doing more tests?

 

[cwericb]

"The EU will not be alone" in doing this. Canada keeps extending severe border restrictions with US and it is hard to see why they would be lifted with the spike in US cases."

 

I wonder if keeping the Canadian border closed is going to piss off Trump and will he threaten to retaliate? Then again, that didn't work out very well for him when he tried to steal the Canadian masks.

[Spekulatius]

Do you have the same chart but with deaths or deaths per million?

I'd be surprised if Liberty has it just because it's a chart from a third-party. That said, it's pretty easy to visualize because the EU has about the population of the USA, plus a third.

So, keep the same line from the EU, and move the USA line up a third.

That said, I agree with your underlying point--the chart is a bit deceptive because, compared to the EU, USA has actually done even worse than you'd think just by looking at the chart.

https://ourworldindata.org/grapher/daily-deaths-covid-19?time=2020-03-02..&country=USA~European%20Union

You can edit the chart to select the start-end dates, etc.

It's not a seven day rolling average though AFAIK.

The rising positive test % rate is puzzling and unusual.

It raises the possibility that some areas are behind the ball.

It may represent delayed community spread, higher testing capacity, higher testing in the younger population as well as targeted contact tracing.

In many states, this appears to be mostly noise but, in some states, there is signal in the data suggesting that the uncoordinated response will "succeed" in preventing the slope of deaths from going down.

After a deeper look, it seems that Texas, for example, may be one of the worst examples of this. The State is showing higher positive tests, higher positive rate %, higher hospitalizations and ICU occupation, younger age profile in the hospitalized group and Texas is scored low in its capacity to test and trace. In this case, rising positive test % shows an inability to contain the virus. It's also interesting to note that hospitals in general have "reopened" for elective cases which means that "excess" capacity is now much lower than it was a few weeks ago. In Texas, i hear that a pediatric hospital is making modifications to now accept young CV+ adults..

It is ironic that some may eventually express the "no-brainer" opinion that the eventual rise in poor outcomes will have been caused by the senseless (relative) re-lockdowns to be announced which, in fact, will have resulted from the lack of respect for the margin of safety concept.

 

The increasing number of % positive tests while the rate of testing is increasing and the increasing number of hospitalizations is a sure indication of the virus circulating more in the population. We see this unholy trinity of data Trends  in TX, AR, NC, FL and worst of all AZ:

https://public.tableau.com/profile/peter.james.walker#!/vizhome/COVID-19SeeYourState/YourStateKeys

 

In AZ for example,, the percentage of positive texted has increased from ~6.5- to ~24% while the test rate has increased. The only this can happen, if there are a whole lot more infected around. it should be noted that all the states with issues above were states that did didn’t really get hit early on in March and April. Some red states that did get hit early on like Georgia and Colorado don’t really show the same issue right now, Despite opening up too,  likely because people are more careful there.

 

What we haven’t seen a rapid increase in the number of death. This is probably because the newly infected seem to skew young (as some Gouverneurs have stated) , death are a lagging indicator and treatment has improved since March. I do think that with so much VIRUS circulating , we soon see more infection of older people as well. People >64 year old are ~13% of the population, that’s a lot to protect. And that doesn’t even include the younger folks with one or several or existing conditions that may be vulnerable as well.

[Dalal.Holdings]

Speaking of Arizona, from today:

 

https://www.azcentral.com/story/news/local/phoenix/2020/06/23/phoenix-rally-president-donald-trump-barely-mentions-covid-19-crowd-mostly-unmasked-supporters/3239570001/

 

The crowd of about 3,000 supporters appeared similarly disinterested in dwelling on the pandemic, which has killed 1,342 Arizonans and 121,176 Americans since arriving in the U.S. early this year.

 

Most of the attendees who packed into Dream City Church in north Phoenix did not wear face coverings. Nor did any of the event speakers, including the president.

 

...inside the mega church, the vast majority of people flouted the new laws and questioned whether the pandemic was of real concern.

 

During his speech, the president repeatedly assured his crowd that the U.S. was at "the end of the pandemic."

 

First OK and now AZ. This guy just wants to seed it throughout the nation I guess. And AZ which is not looking too good right now...SMH

 

Someone said this is like Global Warming--true in the sense that the same people who want to pretend Global Warming is not real are the same ones who want to pretend the Pandemic is not real. And the overlap is not a coincidence. Nonlinear, multi-order effects are very hard (for some people) to understand, especially when you're incentivized to not understand it. Apparently, so is invoking precaution in the face of risky outcomes.

 

We Americans are getting more than a taste of what happens when we put these folks in the driver's seat...

[Cigarbutt]

"The EU will not be alone" in doing this. Canada keeps extending severe border restrictions with US and it is hard to see why they would be lifted with the spike in US cases."

I wonder if keeping the Canadian border closed is going to piss off Trump and will he threaten to retaliate? Then again, that didn't work out very well for him when he tried to steal the Canadian masks.

Recently, i had discussions about "touristic" destinations next summer and it looks like some regions are developing "travel bubbles" and "corona corridors". i hear that Atlantic Canada is also planning some kind of bubble. There may be a need to carry two passports and the world may be getting smaller, at least for a while.

[Investor20]

Median Infection Fatality Rate Of COVID-19 For Those Under-70 Is Just 0.04%

 

https://www.medrxiv.org/content/10.1101/2020.05.13.20101253v2.full.pdf

 

Caution: Preprints are preliminary reports of work that have not been certified by peer review. They should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

 

https://www.medrxiv.org/

 

John Ioannidis is the author of the discredited Santa Clara serology study.  There were multiple issues with the study, including sampling bias, not adjusting for the sensitivity and specificity of the serology test, poststratification, and others.  This new study aggregates his original study with a bunch of other seroprevalence studies with similar flaws, and gets the same as his original results....but with the same limitations.

 

Perhaps the bottom line is best summed up by Nate Silver:

There are a lot of well-intended and well-written critiques of the Santa Clara Co. serology study but at some point it's not that complicated. A test that *could* have a false positive rate of up to ~2-3% isn't saying very much if it detects 2-3% positives in some population

 

When you look at locations with larger outbreaks, you see worse mortality rates.  Why?  Because if the false positive rate is 2%, then if the base rate of the population is 20% who have COVID, the error is only 10%, while if the base rate is 1%, it could be 200%.  Serology surveys are used to tell us approximately what proportion of the population has had a disease, not typically to estimate the Infection Fatality Rate (IFR).

 

There are numerous threads by good sources on Twitter from back in April on this by Trevor Bedford, Natalie Dean, PhD, and many others.

 

One such thread here walks through a number of the limitations:

 

A Columbia statistician named Andrew Gelman discusses the problems here:

https://statmodeling.stat.columbia.edu/2020/04/19/fatal-flaws-in-stanford-study-of-coronavirus-prevalence/

 

Natalie Dean thread here:

 

 

If you want an estimate based on less noisy data, you can look at the NYC population level deaths and you can calculate some back of the envelope estimates.  Pretty clearly COVID hits older folks much harder, but I think the rates are higher than Ioannidis claims based on serology studies.

https://www1.nyc.gov/site/doh/covid/covid-19-data.page

 

Citywide, the death rate is .21% (that's of all people in NY, not just cases), with 75+ having a death rate of 1.57%, 65-74 0.63%, 45-64 0.19%, and 18-44 0.02%.  That's on a population level, in a city with an estimated 25% prevalence, these numbers would have to be multiplied by 4 if you want to estimate the IFR, giving you approx 0.84% overall IFR, with subgroups 75+ 6.28%, 65-74 2.52%, 45-64 0.76%, 18-44 0.08%.

 

Based on the data I've seen, those numbers look more realistic than Ioannidis.

Like any good scientist, John Ioannidis is not basing it only on their testing in Santa Clara or even only the 20 other Seroprevalence testing (which should be enough).  He also based it on PCR testing done on everyone (not just patients with symptoms) in Cruise Ships, people evacuated from Wuhan, Iceland, a small town in Italy, etc.

 

For example, lets look at the Tennesse prisons where most prisoners were tested.  As per below article,

 

"is the third inmate to die after contracting the virus at the privately run Trousdale Turner Correctional Center"

 

"Two weeks ago, Trousdale reported 1,299 inmates infected by the virus"

 

That gives a CFR of (3/1299)*1000 = 0.23%.  This is from PCR testing. Not Seroprevalence data.

https://www.timesfreepress.com/news/breakingnews/story/2020/may/15/tennessee-prisons-report-fourth-inmate-death-virus-outbreak/523083/

[KCLarkin]

That gives a CFR of (3/1299)*1000 = 0.23%.  This is from PCR testing. Not Seroprevalence data.

https://www.timesfreepress.com/news/breakingnews/story/2020/may/15/tennessee-prisons-report-fourth-inmate-death-virus-outbreak/523083/

 

I haven't seen this study, but the obvious drawback is that prisons (aircraft carriers, cruise ships, etc) aren't representative populations. I'm not sure about the stats in that prison, but in Canada the majority of prisoners are young (20-40) males. So a CFR of 0.23% in that population would be consistent with a much higher IFR in the wider population. Did Ionnidis attempt to make this adjustment? Naively, I'd think that data would support an age-adjusted IFR closer to 1%.

 

I'd also be reluctant to compare death rates between countries. According to CIA World Factbook, the U.S. has twice the obesity rate of Italy. In the U.S., I'd also be worried about the disparity in health care coverage.

 

IFR is also not static. It depends on how stretched health care capacity is and the quality of treatment (which is evolving quickly).