COVID-19 updates

[LesPalenik]

Enough of politics already.

Which part in chez post was political? "Dying", "Not knowing", "seasonal", "good looking"?

[Alan Klein]

Which part in chez post was political? "Dying", "Not knowing", "seasonal", "good looking"?

His post was a back-handed political attack on Trump.  If I'm wrong, let him defend himself.

[Alan Klein]

The toilet paper rush at Costco's.
https://twitter.com/i/status/1238215769445388288

[Alan Klein]

Osterholm's comments are not entirely correct.  The US Dept of Defense has had a robust research program into vaccines and other treatments for a long time.  Some of the vaccines that will be going into testing came from DOD funded research.  As I said in my earlier post, it was the early stage human trials where data is needed. HERE is a good article on Zika vaccine development and you can see how much work has been done.  I don't know if the results from trials are available.  Look at table 2; some of the companies listed have already announced that they have COVID-19 candidate vaccines.  There are lots of partnerships being formed right now to see how fast things can be developed.

Curious about isolation research.  So we're all locking ourselves away from catching it and spreading it.  But will that matter?  SO it slows down a little.  Then we all come out of hiding and the one or two who still carry it start the spread all over again.  So what do we do?  Go into hiding again?  Shutdown the world and the economies of all countries?  Wouldn't it be better to just let it play out so it's over with in two months and then get on with our lives. 

If the disease has to go through all the people, won't it anyway regardless of the isolation measures?  I wonder if there's any research on this idea?

[John Camp]

Curious about isolation research.  So we're all locking ourselves away from catching it and spreading it.  But will that matter?  SO it slows down a little.  Then we all come out of hiding and the one or two who still carry it start the spread all over again.  So what do we do?  Go into hiding again?  Shutdown the world and the economies of all countries?  Wouldn't it be better to just let it play out so it's over with in two months and then get on with our lives. 

If the disease has to go through all the people, won't it anyway regardless of the isolation measures?  I wonder if there's any research on this idea?

It does matter, and a lot. We have finite (if slowly increasing) hospital facilities. The reason for isolation is not really to prevent people from getting it, but to spread (lower) the peak of the disease. If the peak is at X, and hospital facilities are at X, then we are in a condition to handle the disease, though some people may still die. If the hospitals are at X, and the disease is a 3X or 4X, then a lot of people won't get needed treatment and many more will die. There's an interesting inter-active graph that was published by the NY Times showing the effects of early and later intervention on how the peak of the disease might be lowered.

[John Camp]

Here is a link to a whole set of informational graphs on the spread of the disease.

https://informationisbeautiful.net/visualizations/covid-19-coronavirus-infographic-datapack/

[BJL]

...
What are being reported as the current provisional plans to prohibit large gatherings of people seem to me to be sensible: one must always plan for the worst. The rationale, however, appears not to be that more people become infected in such gatherings, as people who are already infected are unlikely to pass it to those not in their immediate vicinity and those who acquire it at the gathering do not themselves become infectious for some days. Rather, it is aimed at avoiding the stress on public services caused by the need to police such gatherings.

Rather than size, it seems that density is the risk factor (amount of time spent within "coughing distance" of multiple other people), but the two go together somewhat, so maybe "number of people" is being used as a proxy for "density".

There is no sensible rationale, it seems to me, behind closing schools: the young appear, oddly enough, not to be severely affected by the virus and the need for thousands of parents to absent themselves from work - including work in the NHS, the police and so on - to be with children who are not at school would have potentially catastrophic consequences.

There are definitely trade-offs to be assessed. Children still do get infected and become carriers to family members, teachers, etc., and it is very hard do maintain adequate "social distance" in a school environment. On the other hand many children out of school are likely to spend more time with (at higher risk) grand-parents  — particularly as caregivers when parents must still work.

[Alan Klein]

It does matter, and a lot. We have finite (if slowly increasing) hospital facilities. The reason for isolation is not really to prevent people from getting it, but to spread (lower) the peak of the disease. If the peak is at X, and hospital facilities are at X, then we are in a condition to handle the disease, though some people may still die. If the hospitals are at X, and the disease is a 3X or 4X, then a lot of people won't get needed treatment and many more will die. There's an interesting inter-active graph that was published by the NY Times showing the effects of early and later intervention on how the peak of the disease might be lowered.

But there are other factors to be considered.  BJL mentions a couple in the last post regarding children as carriers.  There's too much we don't know.  So we're guessing at what seems to be the best approach.  But we really don't know and won't know until it's all over and look back.  Who for example really knows if the stock market is at a bottom or will do another big dump?  Scientists aren't infallible anymore than economists are. 

Let's take my example.  So by hiding we don;t expose a large percentage of the population.  Then we all go back to work and the couple who still carry re-infect the populace.  So are we going to shut down the world again?

Regarding hospital facilities, the one guy who got it in my township was sent home to self-quarantine.  What care is really needed for people who get sick?  Do we know?  Could they be placed in temporary wards set up just for that purpose.  What did the Chinese do? They seem to have a handle on it. What about the damage to society by extended and possible repeated isolations and shutdown of the economy?  My wife and I were to go out to eat but cancelled.  The waitress missed on a a nice tip, money to feed her kids.  What about that damage?  As an older person who has diabetes and other issues, I'm one who can really have survivability problems.  So I'm not taking this lightly.  I've cancelled all doctor and other appointments with everyone.  Good time for contemplative isolated photography outdoors.  The weather's getting nice around here.   

[BJL]

Curious about isolation research.  So we're all locking ourselves away from catching it and spreading it.  But will that matter?  SO it slows down a little. ...

If the disease has to go through all the people, won't it anyway regardless of the isolation measures?  I wonder if there's any research on this idea?

Slowing down the spread, as in the slogan "flatten the curve", is a core strategy now that containment has largely failed: spreading the case load over a longer time period so that at any given time the demand for intensive care beds and respirators does not exceed capacity, or does not exceed it by as much. Italy is already hitting capacity limits and having to send other patients (including for example chemotherapy patients) home more quickly than is preferred.

P. S. I expect that in a year or a bit more, most of us will have either had COVID-19 and recovered, or will receive a vaccination. (Dare I speculate on how anti-vax science-denialists will react when faced by a 1%–4% death rate?)

[kers]

Here in The netherlands - everything gathering people that is not vital gets closed.

Just now i was sitting in a bar and the news told me all bars had to be closed at 6PM till the 6th of april-

So I took the last beer.

However, The virus is here and i do not think it can be contained anymore- but it can be delayed; we may hope for a working vaccin.

That said i read about some Dutch scientists that say they have an antibody for the virus and i came across this article:

https://www.aljazeera.com/ajimpact/lure-german-firm-working-virus-vaccine-report-200315165703635.html

Berlin is trying to stop Washington from persuading a German company seeking a coronavirus vaccine to move its research to the United States, prompting German politicians to insist no country should have a monopoly on any future vaccine.

German government sources told Reuters news agency on Sunday that the US administration was looking into how it could gain access to a potential vaccine being developed by a German firm, CureVac.

If it is true it is a bad form of America First.

[John Camp]

Here's another interesting set of graphics on how lowering the peak works.

https://www.washingtonpost.com/graphics/2020/world/corona-simulator/?itid=hp_hp-top-table-main_virus-simulator520pm%3Ahomepage%2Fstory-ans

[chez]

Slowing down the spread, as in the slogan "flatten the curve", is a core strategy now that containment has largely failed: spreading the case load over a longer time period so that at any given time the demand for intensive care beds and respirators does not exceed capacity, or does not exceed it by as much. Italy is already hitting capacity limits and having to send other patients (including for example chemotherapy patients) home more quickly than is preferred.

P. S. I expect that in a year or a bit more, most of us will have either had COVID-19 and recovered, or will receive a vaccination. (Dare I speculate on how anti-vax science-denialists will react when faced by a 1%–4% death rate?)

That's exactly right...the isolation is not to prevent people from getting the virus...it's to prevent people from getting the virus all at once and flooding our ability to support the one's that are in serious shape.

[Alan Klein]

 

Slowing down the spread, as in the slogan "flatten the curve", is a core strategy now that containment has largely failed: spreading the case load over a longer time period so that at any given time the demand for intensive care beds and respirators does not exceed capacity, or does not exceed it by as much. Italy is already hitting capacity limits and having to send other patients (including for example chemotherapy patients) home more quickly than is preferred.

P. S. I expect that in a year or a bit more, most of us will have either had COVID-19 and recovered, or will receive a vaccination. (Dare I speculate on how anti-vax science-denialists will react when faced by a 1%–4% death rate?)

I don't take the flu shot any more as I feel I got it a few years ago right after I took it.  The shot was 40% effective last year.  A half a million people died from flu in the world last year, 50,000 in the US.  Even if they develop a vaccine, we don't know how effective it will be.  Covid might turn out less deadly than the regular flu.  There's just too many unknowns at this time.  It's all speculation.   

What does spreading out the infection rate mean?  Do we shut down the world for one week, two weeks, or 6 months?  Frankly, I'm afraid these are all just feel-good measures.  It's like a box of chocolates.  You never know what you're going to get until you get it.

[BJL]

Lots of data and analysis here, such as on the importance of social isolation. (I think it is trustworthy, though I prefer more clearly authoritative sources like the CDC or secondary sources with thorough citation of such.)
https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca

Chart 18 says that about 14% of cases need hospitalization and almost 5% need intensive care. With the estimate that about half or more of us will eventually be infected, this suggests 5–10 million intensive care cases total, and I am then guessing on the order of a million needing respirators. We can only handle a small fraction of that many at one time.

[chez]

I don't take the flu shot any more as I feel I got it a few years ago right after I took it.  The shot was 40% effective last year.  A half a million people died from flu in the world last year, 50,000 in the US.  Even if they develop a vaccine, we don't know how effective it will be.  Covid might turn out less deadly than the regular flu.  There's just too many unknowns at this time.  It's all speculation.   

What does spreading out the infection rate mean?  Do we shut down the world for one week, two weeks, or 6 months?  Frankly, I'm afraid these are all just feel-good measures.  It's like a box of chocolates.  You never know what you're going to get until you get it.

There are actual mathematical models that show the effect of spreading out the infections and their affects on a limited system. It's not hocus pocus but actually has some math behind it... I listened to a program the other day on the CBC which had a modelling specialist and it was very eye opening how much affect delaying getting infected has on the outcome.

[Alan Klein]

Here's another interesting set of graphics on how lowering the peak works.

https://www.washingtonpost.com/graphics/2020/world/corona-simulator/?itid=hp_hp-top-table-main_virus-simulator520pm%3Ahomepage%2Fstory-ans

That's interesting graphic John.  The problem as I see it is how long do you shut down society to extend the rate of infections so you can handle cases?  Even in there graph where China isolated groups, some infection gets out to the rest of the population.  So it's going to spread no matter what.  Will shutting down society for 6 months be acceptable? 

[Alan Klein]

There are actual mathematical models that show the effect of spreading out the infections and their affects on a limited system. It's not hocus pocus but actually has some math behind it... I listened to a program the other day on the CBC which had a modelling specialist and it was very eye opening how much affect delaying getting infected has on the outcome.

I'm not doubting your point.  The questions are how long do we have to shut down society and is the time frame realistic and acceptable?

[BJL]

Covid might turn out less deadly than the regular flu.

There is plenty of evidence available that COVID-19 is far deadlier than the typical seasonal flu! By a factor of 10 to 30, as you should be able to find in some of the medical sources shared in this thread. For example, see the first graph in https://www.kevinmd.com/blog/2020/03/a-covid-19-coronavirus-update-from-concerned-physicians.html which has it broken down by age group.

Factor in the lack of a vaccine for now (expected in one to two years?) so that there will likely be more infections this year than in a flu season, and it is almost certainly going to cause a far higher death toll over the next year or so, before settling in as a "community disease" that we can manage reasonably well.

[BJL]

The problem as I see it is how long do you shut down society to extend the rate of infections so you can handle cases?  Even in there graph where China isolated groups, some infection gets out to the rest of the population.  So it's going to spread no matter what.  Will shutting down society for 6 months be acceptable?

That is an important question indeed. Evidence from places like Hubei province in China (the one where Wuhan is, with the provincial population about as big as Italy) suggests that two to four weeks could be enough: it seems to be quite well controlled there by now, and stuff is reopening. Cynically, forcing everyone to take their annual vacation at the right time (as a boring "staycation") might be enough!

[Alan Klein]

There is plenty of evidence available that COVID-19 is far deadlier than the typical seasonal flu! By a factor of 10 to 30, as you should be able to find in some of the medical sources shared in this thread. For example, see the first graph in https://www.kevinmd.com/blog/2020/03/a-covid-19-coronavirus-update-from-concerned-physicians.html which has it broken down by age group.

Factor in the lack of a vaccine for now (expected in one to two years?) so that there will likely be more infections this year than in a flu season, and it is almost certainly going to cause a far higher death toll over the next year or so, before settling in as a "community disease" that we can manage reasonably well.

If I'm reading the article correctly, it will take 3 months for the virus to spread through the entire US population.  So to slow it down so you have enough hospital beds, you isolate the community.  Well, how long do you want to spread it out? 6 months. A year?  Of, so let's shut down the US for 6 months or a year.  Is that the recommendation?  IF so, how do you do that? No ones' going to shop, go to the doctors, got to school go to work. stop eating, etc.  We're kidding ourselves.