Coronavirus

[Gregmal]

Yea I dont know. Market is a little wild to me right now. It seems as long as the government doesnt shut things down, the market is ok with the virus. Which does kind of make sense within the context of, again, the flu. 15% of the population get the flu annually, 30m urgent care/hospital visits annually, corona still nowhere near those figures, and the flu never moves the market. If the government shut down the economy every winter for the flu though....

 

 

[Gregmal]

I think if anything the way to look at the market is like 1970s blackjack. Where, IMO, the deck is stacked in a certain direction and the payout for wagers or hedges is favorable. But who knows, maybe that direction is up lol. I am, and would try to avoid gap downs or predictable, but surprise negative news flow, IE certain states routinely release certain data at certain times.

 

This all coming from someone who's 100% committed to investing in some of the dirtiest, coronavirus stricken businesses. Added to ESRT 16 times over the past 5 weeks. That said, for the first time ever, I do actually have a small cash position. Unique times for sure.

[Spekulatius]

Yea I dont know. Market is a little wild to me right now. It seems as long as the government doesnt shut things down, the market is ok with the virus. Which does kind of make sense within the context of, again, the flu. 15% of the population get the flu annually, 30m urgent care/hospital visits annually, corona still nowhere near those figures, and the flu never moves the market. If the government shut down the economy every winter for the flu though....

 

Except the government has shut down bars, restaurants and a few other things in several states. When you look at LA the Vast number of cases have been amongst Latino’s. Also note that  directly adjacent wealthy neighborhoods like Pasadena are doing much better.

http://publichealth.lacounty.gov/media/Coronavirus/locations.htm

 

This epidemic hasn’t a strong socioeconomic tilt, it prospers when it gets into the weaker parts of the underbelly in the society. That’s one reason why the US has been doing relatively poorly, besides the leadership issues. The US has a whole lot more soft underbelly than most states in Europe.

[Liberty]

Aerosols risk:

 

https://science.sciencemag.org/content/368/6498/1422.full

[cubsfan]

Hmm.. this is interesting:

 

https://saraacarter.com/who-admits-it-was-never-told-about-covid-by-china-instead-found-out-from-u-s-data/

WHO Admits It Was Never Told About COVID By China, Instead Found Out From U.S. Data

 

A quiet change to a timeline of COVID events in late June shows what many mainstream media outlets and government officials have denied for months: China didn’t inform the WHO about the outbreak. Instead, on December 31, “a translation of a Chinese media report about the outbreak is posted to ProMED, a U.S.-based open-access platform for early intelligence about infectious disease outbreaks,” according to a U.S. Naval Institute report.

[rb]

We know China didn't tell about the outbreak. It is the very reason why this thread was started exists.

[Cigarbutt]

...

But I still dont get California. They just dont seem to have a clue or a plan. You can look at Texas, or Arizona and see what their plan is. They just better get it right, and given there "plan", that basically means making sure you dont run out of hospital beds. NY/NJ/Conn have a clear "plan". Obviously this differs greatly from TX/AZ/FL. But California its just kind of head scratching.

California's strategy does not make sense from an enclaved-community-discretionary-spending point of view. The idea was to optimize containment (up to early March) and then to optimize mitigation. From that point of view and given the circumstances they can control, i would offer the opinion that they're doing quite well.

Houston (who chose a different mitigation strategy) is showing signs of strain whichever school of thought you adhere to:

https://www.msn.com/en-ca/news/us/houston-hospitals-transferring-covid-patients-we-re-running-out-of-icu-beds/ar-BB16fYE4?ocid=msedgntp

...

For Sweden from Mid April to now

Doubling cases per day gave raise to tenfold reduction in deaths.

The phrasing of the above bolded seem to imply a causal relationship which, IMO, is a stretch.

In general, the reunion of certain criteria, including rising tests numbers and improvement in other relevant criteria means that community spread is under control. In all other significant regions in the world apart from the US, this constellation of good criteria was always accompanied by a decreasing % of positive tests. The US is testing younger people but current evidence points to significant excess mortality going forward. It may be considered a price to pay for "success". (?)

That's an interesting concept and makes sense. The money's still there it is just going in different places. Restaurants are having a rough time, grocery stores are booming. Thanks for that.

Today, i listened to a recent interview with Mr. Lindsey Laurence, a former director of the National Economic Council. He basically said to stop worrying. Using simple math and basic inputs such as the Fed balance sheet expansion, the automatic effect on asset prices, he suggested that the S&P500 should get to 4000 very soon. Just use extrapolation, he said.

Yea I dont know. Market is a little wild to me right now. It seems as long as the government doesnt shut things down, the market is ok with the virus. Which does kind of make sense within the context of, again, the flu. 15% of the population get the flu annually, 30m urgent care/hospital visits annually, corona still nowhere near those figures, and the flu never moves the market. If the government shut down the economy every winter for the flu though....

If your assumptions are: 1-this is just the flu and 2-Arizona gets it right as far as the economy is concerned, you may want to take a look at the following. Taking Arizona as a poster child, so far, there have been twice the number of COVID deaths as typical flu-related deaths per year. In addition, using the last 7 day-average death rate (conservative assumption), going forward, the time it will take for COVID deaths to reach an additional flu-year milestone, is about 3 weeks.

A part of the spread is in the "young" who can take it more on the chin but, in Arizona these days, 40% of CV-hospitalized beds are occupied by people aged between 20 and 54. i think we both belong in that age group.

This epidemic hasn’t a strong socioeconomic tilt, it prospers when it gets into the weaker parts of the underbelly in the society. That’s one reason why the US has been doing relatively poorly, besides the leadership issues. The US has a whole lot more soft underbelly than most states in Europe.

It's been widely reported that the part of the population bearing the brunt of the disease don't occupy a corner office on an elevated floor.

There's been recent work showing that education also makes a difference:

https://www.frbsf.org/economic-research/files/el2020-17.pdf

It seems that you've read The Count of Monte Cristo so you may know about Victor Hugo's position on ignorance and the importance of education. Dumas focused more on the revenge part and i've always had the feeling that the main character regretted his actions in the end.

What is less discussed (even in popular social medias it seems) is that people who go to hospitals for COVID care don't get the same universal treatments. Even controlling for population-specific variables (which makes the personal-collective-responsibility discussion irrelevant), evolving data is pretty convincing that people most exposed to the virus tend to go to certain hospitals and end up sicker and dying more often. But who cares if the index keeps going up? The reasons mentioned to explain this phenomenon include more staffing, more access to equipment and drugs, more timely application of protocols in more "affluent" hospitals etc

---

In 1928, the Nazi party harvested 3.5% of the votes and, for the life of me, it's very hard to understand how the disconnect can be allowed to stretch this far. And, obviously, it's China's fault. Note: The "Spanish" flu likely originated from the US and we're not in Kansas anymore...

[Investor20]

Study finds hydroxychloroquine helped coronavirus patients survive better

 

"Our results do differ from some other studies," Zervos told a news conference. "What we think was important in ours ... is that patients were treated early. For hydroxychloroquine to have a benefit, it needs to begin before the patients begin to suffer some of the severe immune reactions that patients can have with Covid," he added.

 

Dr. Marcus Zervos, division head of infectious disease for Henry Ford Health System, said 26% of those not given hydroxychloroquine died, compared to 13% of those who got the drug.

 

The Henry Ford team wrote that 82% of their patients received hydroxychloroquine within the first 24 hours of admission, and 91% within the first 48 hours of admission.

 

https://www.msn.com/en-us/health/health-news/study-finds-hydroxychloroquine-helped-coronavirus-patients-survive-better/ar-BB16hifu

 

I posted before about this timing of administration of antivirals in this thread.  Antivirals would be expected to work better when administered early in infection.

[Liberty]

 

With a population of 21 million, Florida announced 10,109 new covid cases today.

 

With a combined population of 2.6 billion, China, Japan, Korea, Vietnam, Thailand, Malaysia, Indonesia, the Philippines, Australia, and the European Union are averaging 6,760 new cases.

[Liberty]

Thread on Chinese numbers:

[Liberty]

 

What does a mask do? Blocks respiratory droplets coming from your mouth and throat.

 

Two simple demos:

 

First, I sneezed, sang, talked & coughed toward an agar culture plate with or without a mask. Bacteria colonies show where droplets landed. A mask blocks virtually all of them.

 

What about keeping your distance?

 

Second demo: I set open bacteria culture plates 2, 4 and 6 feet away and coughed (hard) for ~15s. I repeated this without a mask.

 

As seen by number of bacteria colonies, droplets mostly landed <6 ft, but a mask blocked nearly all of them.

 

I'm aware that this simple (n=1) demo isn't how you culture viruses or model spread of SARS-CoV-2.

 

But colonies of normal bacteria from my mouth/throat show the spread of large respiratory droplets, like the kind we think mostly spread #COVID19, and how a mask can block them!

 

 

[LongHaul]

good stuff on masks.  thx Liberty.

 

Has anyone seen any research on Covid and transmission from the salt water at the beach?

Salt water can be be aerosolized at the beach from the waves.

 

If anyone sees any research, would be great to read about it.

 

[patience_and_focus]

Study finds hydroxychloroquine helped coronavirus patients survive better

 

"Our results do differ from some other studies," Zervos told a news conference. "What we think was important in ours ... is that patients were treated early. For hydroxychloroquine to have a benefit, it needs to begin before the patients begin to suffer some of the severe immune reactions that patients can have with Covid," he added.

 

Dr. Marcus Zervos, division head of infectious disease for Henry Ford Health System, said 26% of those not given hydroxychloroquine died, compared to 13% of those who got the drug.

 

The Henry Ford team wrote that 82% of their patients received hydroxychloroquine within the first 24 hours of admission, and 91% within the first 48 hours of admission.

 

https://www.msn.com/en-us/health/health-news/study-finds-hydroxychloroquine-helped-coronavirus-patients-survive-better/ar-BB16hifu

 

I posted before about this timing of administration of antivirals in this thread.  Antivirals would be expected to work better when administered early in infection.

 

I think we all should do some deep DD (as we do when investing) before posting on technical things like effectiveness of a treatment. Moreover, I really think these BS studies should not be published and will not be published in any reputed journal. There are plenty of substandard journals that exist where these show up and someone incompetent in the media picks it up.

Here is why this is a total BS study - (a) This is an retrospective observational study, not a randomized double blind clinical trial which is the gold standard and has shown no effectiveness. (b) Look at Table 1 of this study (https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext) - the age itself can explain the difference in mortality. The patients receiving hydroxychloroquine alone (median age = 53) were younger by 18 years on average than who received no treatment (median age = 71). We already know younger patients survive better than older ones. So the patients treated with hydroxychloroquine simply lived because they were younger. One couldn't have picked a worst retrospective dataset than this for the analysis.

 

[SHDL]

“Coronavirus: Japan's mysteriously low virus death rate”

 

https://www.bbc.com/news/world-asia-53188847

[Investor20]

Study finds hydroxychloroquine helped coronavirus patients survive better

 

"Our results do differ from some other studies," Zervos told a news conference. "What we think was important in ours ... is that patients were treated early. For hydroxychloroquine to have a benefit, it needs to begin before the patients begin to suffer some of the severe immune reactions that patients can have with Covid," he added.

 

Dr. Marcus Zervos, division head of infectious disease for Henry Ford Health System, said 26% of those not given hydroxychloroquine died, compared to 13% of those who got the drug.

 

The Henry Ford team wrote that 82% of their patients received hydroxychloroquine within the first 24 hours of admission, and 91% within the first 48 hours of admission.

 

https://www.msn.com/en-us/health/health-news/study-finds-hydroxychloroquine-helped-coronavirus-patients-survive-better/ar-BB16hifu

 

I posted before about this timing of administration of antivirals in this thread.  Antivirals would be expected to work better when administered early in infection.

 

I think we all should do some deep DD (as we do when investing) before posting on technical things like effectiveness of a treatment. Moreover, I really think these BS studies should not be published and will not be published in any reputed journal. There are plenty of substandard journals that exist where these show up and someone incompetent in the media picks it up.

Here is why this is a total BS study - (a) This is an retrospective observational study, not a randomized double blind clinical trial which is the gold standard and has shown no effectiveness. (b) Look at Table 1 of this study (https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext) - the age itself can explain the difference in mortality. The patients receiving hydroxychloroquine alone (median age = 53) were younger by 18 years on average than who received no treatment (median age = 71). We already know younger patients survive better than older ones. So the patients treated with hydroxychloroquine simply lived because they were younger. One couldn't have picked a worst retrospective dataset than this for the analysis.

 

That is why they had propensity matched patients in table 3 and hazard ratio for such patients in table 4.

 

Agreed that the best way to do is randomized controlled studies.  Unfortunately none were done by the WHO or Fauci department.

 

But this is not the only study.  There are at least three more in US alone.

 

https://www.ny1.com/nyc/all-boroughs/news/2020/05/12/nyu-study-looks-at-hydroxychloroquine-zinc-azithromycin-combo-on-decreasing-covid-19-deaths

Researchers at NYU's Grossman School of Medicine found patients given the antimalarial drug hydroxychloroquine along with zinc sulphate and the antibiotic azithromycin were 44 percent less likely to die from the coronavirus.

 

https://link.springer.com/article/10.1007/s11606-020-05983-z#citeas

Risk Factors for Mortality in Patients with COVID-19 in New York City

 

A total of 858 of 6493 (13.2%) patients in our total cohort died: 52/2785 (1.9%) ambulatory patients and 806/3708 (21.7%) hospitalized patients. Cox proportional hazard regression modeling showed an increased risk of in-hospital mortality associated with age older than 50 years (hazard ratio

---

2.34, CI 1.47–3.71), systolic blood pressure less than 90 mmHg (HR 1.38, CI 1.06–1.80), a respiratory rate greater than 24 per min (HR 1.43, CI 1.13–1.83), peripheral oxygen saturation less than 92% (HR 2.12, CI 1.56–2.88), estimated glomerular filtration rate less than 60 mL/min/1.73m2 (HR 1.80, CI 1.60–2.02), IL-6 greater than 100 pg/mL (HR 1.50, CI 1.12–2.03), D-dimer greater than 2 mcg/mL (HR 1.19, CI 1.02–1.39), and troponin greater than 0.03 ng/mL (HR 1.40, CI 1.23–1.62). Decreased risk of in-hospital mortality was associated with female sex (HR 0.84, CI 0.77–0.90), African American race (HR 0.78 CI 0.65–0.95), and hydroxychloroquine use (HR 0.53, CI 0.41–0.67).

 

Conclusions

Among patients with COVID-19, older age, male sex, hypotension, tachypnea, hypoxia, impaired renal function, elevated D-dimer, and elevated troponin were associated with increased in-hospital mortality and hydroxychloroquine use was associated with decreased in-hospital mortality.

 

https://www.preprints.org/manuscript/202007.0025/v1

COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxychloroquine and Azithromycin: A Retrospective Case Series Study

 

Conclusions: Risk stratification-based treatment of COVID-19 outpatients as early as possible after symptom onset with the used triple therapy, including the combination of zinc with low dose hydroxychloroquine, was associated with significantly less hospitalizations and 5 times less all-cause deaths.

 

I am agreeing with you that randomized controlled studies are needed.  When four studies above have given 40-80% reduction in death rate, for a medication that is essentially free, it should be done immediately .  Unfortunately is not done yet.

[Spekulatius]

Here is some paper on the D614G mutation of the Virus, which seems to be more transmissible but not necessarily more severe in terms of how it plays out. This mutation seems to be 3-6x more transmissible (Due to higher prevalence of spike proteins on its surface) in lab experiments which should lead to a higher Ro. I think this was the mutation that Fauci was talking about recently.

 

From an evolutionary POV,  a variant of the Virus that is more transmissible will probably become dominant over time. This also may help explaining the ferocity of recent outbreaks in the US, besides the other factors that were mentioned before (holiday gatherings, opening high risk establishments like gyms, bars, lack of precautions).

https://www.cell.com/cell/pdf/S0092-8674(20)30817-5.pdf

[ERICOPOLY]

If Donald Trump Jr's girlfriend has it, then I don't see how he doesn't also have it too (unless he was with another girlfriend lately):

 

https://www.cnn.com/2020/07/03/politics/kimberly-guilfoyle-positive-coronavirus-test/index.html

 

Guilfoyle has "been with a lot of the campaign donors" in recent days, one source familiar with the matter said.

Billed as a "Mountain West Ranch Retreat," one event occurred in Gallatin Gateway, Montana, from Tuesday until Thursday, according to one of the people.

Another event was billed as the "Rapid City Roundup Retreat" in Rapid City, South Dakota, from Thursday to Friday.

The people said Guilfoyle was not seen wearing a mask during the events.

 

 

[Peregrine]

Jumping in once again (dammit!) with a good report explaining Japan's conspicuously low death rate:

 

https://www.bbc.com/news/world-asia-53188847

 

Gist of the story:

 

-the Japanese (and many places in Asia for that matter) may already have strong cross immunity due to exposure to other coronaviruses

-a culture of cleanliness and mask-wearing

-generally healthier population with less comorbidities among the elderly

-focus on hot spots of spread and encouraging to avoid them

 

I don't think test and trace had much to do with it at all given that Japan has among the lowest testing rates of any other OECD country.

[patience_and_focus]

 

I am agreeing with you that randomized controlled studies are needed.  When four studies above have given 40-80% reduction in death rate, for a medication that is essentially free, it should be done immediately .  Unfortunately is not done yet.

 

NIH halts clinical trial of hydroxychloroquine

 

https://www.nih.gov/news-events/news-releases/nih-halts-clinical-trial-hydroxychloroquine

[Cigarbutt]

Here is some paper on the D614G mutation of the Virus, which seems to be more transmissible but not necessarily more severe in terms of how it plays out. This mutation seems to be 3-6x more transmissible (Due to higher prevalence of spike proteins on its surface) in lab experiments which should lead to a higher Ro. I think this was the mutation that Fauci was talking about recently.

From an evolutionary POV,  a variant of the Virus that is more transmissible will probably become dominant over time. This also may help explaining the ferocity of recent outbreaks in the US, besides the other factors that were mentioned before (holiday gatherings, opening high risk establishments like gyms, bars, lack of precautions).

https://www.cell.com/cell/pdf/S0092-8674(20)30817-5.pdf

This study is a nice example of what patience_and_focus is doing in this thread. The idea started in early May with a publication and the thesis was tested (destroyed to a significant degree) when exposed to a peer review.

https://www.eurekalert.org/pub_releases/2020-07/cp-htp070220.php

Viruses may be our 'ancestors' and the application of the evolutionary theory remains controversial:

https://www.nature.com/articles/s41564-020-0690-4.pdf?proof=true1

[Spekulatius]

[Gregmal]

Having spent the last few days at various NJ shore locations, I can tell you one thing; people definitely seem to be OK living with the virus. Same sort of shit we heard about in Arizona and Texas. Business as usual, except where there is government intervention. IE bars are closed, but you have shit tons of people gathered together drinking on the beach or at motel pools on the shore. Restaurant outdoor dining and takeout is booming too.

[Investor20]

 

I am agreeing with you that randomized controlled studies are needed.  When four studies above have given 40-80% reduction in death rate, for a medication that is essentially free, it should be done immediately .  Unfortunately is not done yet.

 

NIH halts clinical trial of hydroxychloroquine

 

https://www.nih.gov/news-events/news-releases/nih-halts-clinical-trial-hydroxychloroquine

 

Yes and they wont test it and keep saying no randomized clinical studies available for HCQ, while HCQ is a tablet and generic and is available very cheap - essentially free.

 

Meanwhile for Remedesivir which is expensive and given by IV which requires hospitalization, WHO and Dr. Fauci prioritized and did clinical studies already.  So lets look at these study results

 

https://www.gilead.com/news-and-press/press-room/press-releases/2020/6/gilead-announces-results-from-phase-3-trial-of-remdesivir-in-patients-with-moderate-covid-19

Gilead Announces Results From Phase 3 Trial of Remdesivir in Patients With Moderate COVID-19

 

In addition, non-statistically significant increases in clinical worsening or death were observed in the standard of care only group compared with the remdesivir groups.

 

https://www.healthline.com/health-news/what-to-know-about-potential-covid-19-treatment-remdesivir

 

Study sub-investigator Dr. Robert M. Grossberg, an associate professor of medicine at Albert Einstein College of Medicine and an infectious disease specialist at Montefiore Health System, said the results of this trial are “preliminary, but very promising.”

 

“This was a well-designed study that proved that an antiviral drug could improve outcomes in patients with moderate to severe COVID-19,” he said.

 

As for whether it keeps people from dying, he said the study “suggested that there might be a mortality benefit, but that wasn’t quite proven yet.”

 

In early June, Gilead announced that other data showed that people with moderate COVID-19 recovered more quickly when given the drug for 5 days, although the benefit was “modest.”

 

A 10-day course of the drug also improved patient outcomes, but the change wasn’t statistically significant. Patients in this study were hospitalized but didn’t need mechanical ventilation.

 

............................................

 

Now, can someone explain to me why would WHO and government organizations prioritize an expensive IV drug that needs to be given in a hospital including 10 day IV courses over a tablet that is generic and so cheap that it is essentially free, that can be given at home for clinical studies?

[RichardGibbons]

Now, can someone explain to me why would WHO and government organizations prioritize an expensive IV drug that needs to be given in a hospital including 10 day IV courses over a tablet that is generic and so cheap that it is essentially free, that can be given at home for clinical studies?

 

Sure, I can help you with that.

 

The IV drug might provide some benefit, while random trials of the generic drug indicate it provides no benefit.

[Investor20]

Now, can someone explain to me why would WHO and government organizations prioritize an expensive IV drug that needs to be given in a hospital including 10 day IV courses over a tablet that is generic and so cheap that it is essentially free, that can be given at home for clinical studies?

 

Sure, I can help you with that.

 

The IV drug might provide some benefit, while random trials of the generic drug indicate it provides no benefit.

 

Can you show me a randomized clinical study of Hydroxychloroquine of about 400 mg per day (approved dosage already for other diseases by FDA) for 5 -14 days.  Preferably with Zinc.  Given early in the infection.

 

Can you  cite me one?  This is the dosage shown to be successful in restrospective studies, for exampe NYU grossman study given below.

 

https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v1.full.pdf

Patients were categorized  based on their exposure to hydroxychloroquine (400 mg load followed by 200 mg twice daily for five days) and azithromycin (500 mg once daily) alone or with zinc sulfate (220 mg capsule containing 50 mg elemental zinc twice daily for five days) as treatment in addition to standard supportive care.