COVID-19

[ubkev]

2 hours ago, Eleven said:

What country do you think this is?

I heard this in the garage attendant's voice from Ferris Bueller's Day Off.

[Eleven]

23 minutes ago, ubkev said:

I heard this in the garage attendant's voice from Ferris Bueller's Day Off.

That's how I heard it when I was writing it.

30 minutes ago, Taro T said:

The current hotbeds fortunately MIGHT be reaching / have reached the peaks of their infections.

Let's hope so.  A Floridian died from COVID every eight minutes yesterday.

[shrader]

11 hours ago, North Buffalo said:

Yes and No... No given your point... yes because you would have thought they understood how NY got it under control and followed suit.  Even NY needs to be careful not to drop the ball...

When all is said and done, I’d suspect that as a whole, most states will wind up with a similar proportion of their population with documented covid. Well... except Florida because they’re Florida. So if that happens, is one approach really any better than the other? If anything, the earlier cases in NY could be worse since they didn’t have the knowledge of how to treat yet at that point. 
 

It’ll vary a bit from state to state thanks to thinks like population density, but I fully understand spect similar rates. 

[LGR4GM]

48 minutes ago, Taro T said:

NY definitely improved their handling of the virus in May.  That likely had a large impact in reducing deaths.  It also very likely had an impact on slowing the spread of the virus.  But the question is whether NYC had approached the "herd immunity" threshold by then and the follow on is was that a larger factor in getting the disease under control?

Initially experts expected we'd need to see at least 70% of the population exposed and maybe even 80%+ to reach herd immunity effectiveness thresholds.  But there are indications that "burnout" of the virus spread may come with as little as 20-30% exposure.  (Which would be great news if that's actually the case.)  If the herd immunity effect can be realized at only 20% exposure, then that could be what helped so much here downstate.

Interestingly, since the end of May, we've seen similar behaviors in Los Angeles and in NYC.  (Both in behaviors that would be expected to limit transmission & those that at a minimum wouldn't be expected to limit transmission.)  One didn't really see a 1st wave in March/April & 1 did.  The one that didn't is getting hit hard now and the other isn't getting hit hard.

The current hotbeds fortunately MIGHT be reaching / have reached the peaks of their infections.  If they have, and absolutely we should hope they have, then there may be something to that 20-30% threshold.  We should know if they've peaked within the next 2 - 3 weeks.

IF they are at their peaks AND NYC doesn't get that dreaded 2nd wave (desperately hoping they don't, btw) we'll likely see other areas that haven't been hit hard yet have their own 1st waves.  (And unfortunately that includes much of upstate NY.)  But that would be OK most likely as our medical professionals know so much more about this & how to protect the most vulnerable than they did in March when NYC hot hit hard.  It also would have an upside as we'd know that we can have a lot of society opened back up & understand what the signs would be that particular areas need to buckle down for 6 or so weeks.

Unfortunately there seems to be no seasonality to this (good call on that Weave) but if herd immunity is more readily obtained than 1st feared that would/will be huge.  Hoping the worst is behind us.

I saw that and am highly skeptical of that number. 

[kas23]

5 hours ago, Weave said:

Interesting report in the Wall Street Journal today.  The usual influenza wave in the southern hemisphere doesn't appear to be taking shape.  Assumption is that all of the protective measures for COVID is resulting in the influenza virus not getting an opportunity to get  foothold.  Could be good news for later this year in the US.  If we stay diligent with masks and distancing maybe there isn't an influenza outbreak this season to compound COVID.

 

I'd link it but it is paywalled.

That and also there has probably been a much greater urgency in getting every possible person immunized against the flu. We are about to see this here in the next couple months...but then again, people in the US may think getting a flu shot is restricting their freedom. 

[nfreeman]

16 minutes ago, shrader said:

When all is said and done, I’d suspect that as a whole, most states will wind up with a similar proportion of their population with documented covid. Well... except Florida because they’re Florida. So if that happens, is one approach really any better than the other? If anything, the earlier cases in NY could be worse since they didn’t have the knowledge of how to treat yet at that point. 
 

It’ll vary a bit from state to state thanks to thinks like population density, but I fully understand spect similar rates. 

This jibes with a number of articles I've read recently -- i.e. the theory is that the spread of the virus can be slowed via masks, social distancing, etc., but not prevented from reaching its "natural" level, so pretty much all regions will end up with a similar infection rate.  NYC, the theory goes, due to population density and several mistakes early in the process, suffered both a higher infection rate and a higher fatality rate than anywhere else in the US, but the other regions will get to the same infection rate (but probably not the same fatality rate) eventually.

[Taro T]

55 minutes ago, LGR4GM said:

I saw that and am highly skeptical of that number. 

Nothing wrong with skepticism.  Like had said upthread, we should know in ~2-3 weeks if there might be some merit to the lowered "herd immunity threshold."  If the 3 states & SoCal that are all getting hit hard now are seeing an ebb to their new cases, there could be some serious merit to that theory.

Spain is another area that might provide a case worth watching.  Madrid was hit hard early.  Barcelona's getting hit now.  How they both fare over the next month will be interesting.  

[LGR4GM]

3 minutes ago, Taro T said:

Nothing wrong with skepticism.  Like had said upthread, we should know in ~2-3 weeks if there might be some merit to the lowered "herd immunity threshold."  If the 3 states & SoCal that are all getting hit hard now are seeing an ebb to their new cases, there could be some serious merit to that theory.

Spain is another area that might provide a case worth watching.  Madrid was hit hard early.  Barcelona's getting hit now.  How they both fare over the next month will be interesting.  

I just don't think it is as simple as 20% gives you heard immunity. I think it far more likely that the 20% who would be infected because they do dumb things or are more susceptible are. A 20% infection rate for a disease is high but that hitting it doesn't mean heard immunity. Basically I think the concept of heard immunity is being misrepresented or was in the report I saw on the 20% rate. This was the article I saw on it and I get what the science and modeling shows but I think again the concept is being used incorrectly. Herd immunity really means that there are so many people that can't get sick from a disease that it doesn't spread. I just don't see how a 20% rate accomplishes that unless it corresponds to a 50% asymptomatic rate as well which would in essence get us up into that 70-90% area we like. Again, I could be wrong I am just skeptical of that modeling for now. 

https://www.theatlantic.com/health/archive/2020/07/herd-immunity-coronavirus/614035/

[Stoner]

1 hour ago, nfreeman said:

This jibes with a number of articles I've read recently -- i.e. the theory is that the spread of the virus can be slowed via masks, social distancing, etc., but not prevented from reaching its "natural" level, so pretty much all regions will end up with a similar infection rate.  NYC, the theory goes, due to population density and several mistakes early in the process, suffered both a higher infection rate and a higher fatality rate than anywhere else in the US, but the other regions will get to the same infection rate (but probably not the same fatality rate) eventually.

We can't discuss government response to the virus. You've disguised it, but you're talking about mistakes the Cuomo administration made, right?

34 minutes ago, LGR4GM said:

I just don't think it is as simple as 20% gives you heard immunity. I think it far more likely that the 20% who would be infected because they do dumb things or are more susceptible are. A 20% infection rate for a disease is high but that hitting it doesn't mean heard immunity. Basically I think the concept of heard immunity is being misrepresented or was in the report I saw on the 20% rate. This was the article I saw on it and I get what the science and modeling shows but I think again the concept is being used incorrectly. Herd immunity really means that there are so many people that can't get sick from a disease that it doesn't spread. I just don't see how a 20% rate accomplishes that unless it corresponds to a 50% asymptomatic rate as well which would in essence get us up into that 70-90% area we like. Again, I could be wrong I am just skeptical of that modeling for now. 

https://www.theatlantic.com/health/archive/2020/07/herd-immunity-coronavirus/614035/

But it's not 50% of the population that had Covid asymptomatically. That's an estimate of the number of people who had Covid who were asymptomatic.

[LGR4GM]

9 minutes ago, PASabreFan said:

We can't discuss government response to the virus. You've disguised it, but you're talking about mistakes the Cuomo administration made, right?

But it's not 50% of the population that had Covid asymptomatically. That's an estimate of the number of people who had Covid who were asymptomatic.

Right that is my issue. Let me expand because I am not being clear. I am saying we would need a higher asymptomatic infection rate to get to herd immunity. We would need there to be like 50% of the population to have had covid asymptomatically. I am just skeptical of the 20% number 

Edited July 24, 2020 by LGR4GM

[Stoner]

4 minutes ago, LGR4GM said:

Right that is my issue. 

Got it.

20% is a pipe dream nationally. The CDC fairly recently estimated something around 20 million cases when accounting for those not tested. That's only about six percent of the U.S. (I understand Taro's theory is NYC centric.)

And there's the question of what immunity means if you've had Covid 19. A couple months of protection, a year?

[LGR4GM]

Just now, PASabreFan said:

Got it.

20% is a pipe dream nationally. The CDC fairly recently estimated something around 20 million cases when accounting for those not tested. That's only about six percent of the U.S. (I understand Taro's theory is NYC centric.)

And there's the question of what immunity means if you've had Covid 19. A couple months of protection, a year?

Also another question but I think we just lost the CDC. Their school reopening guidelines just changed. 

[Taro T]

45 minutes ago, LGR4GM said:

I just don't think it is as simple as 20% gives you heard immunity. I think it far more likely that the 20% who would be infected because they do dumb things or are more susceptible are. A 20% infection rate for a disease is high but that hitting it doesn't mean heard immunity. Basically I think the concept of heard immunity is being misrepresented or was in the report I saw on the 20% rate. This was the article I saw on it and I get what the science and modeling shows but I think again the concept is being used incorrectly. Herd immunity really means that there are so many people that can't get sick from a disease that it doesn't spread. I just don't see how a 20% rate accomplishes that unless it corresponds to a 50% asymptomatic rate as well which would in essence get us up into that 70-90% area we like. Again, I could be wrong I am just skeptical of that modeling for now. 

https://www.theatlantic.com/health/archive/2020/07/herd-immunity-coronavirus/614035/

It comes down to whether there is a %age of the population that has enough of a preexisting immunity (or more accurately enough of an ability to fight it off) to COVID from either being extremely lucky in the genetic lottery (not very likely) or from a lifetime of fighting off other corona viruses (possible) that they aren't particularly susceptible to COVID and in particular can keep it from multiplying in their own bodies to refrain from "shedding" through their exhaling (or other means of shedding it) so much of it that others get infected by it to a degree they can't fight off.

Knowing that not all members of a household that has a single case of COVID end up getting it, there is some degree of immunity "naturally" for a segment of the population.  How big that segment is is the $1B question.  In March we expected that %age to be in the teens or even single digits.  Turns out, that worst case early fear might have been off fairly significantly.  If the natural rate of possessing a predisposition to not getting infected is at or above 50% of the population, then reaching the level where 70-80% of the population won't spread the disease except in extreme circumstances can be approached with only 20-30% of the population being exposed.  (Realizing the group that includes the predisposition to not catch the virus will overlap somewhat with the group that is initially exposed to the virus.)

Like mentioned upthread: 1 skepticism is good (don't take any of these numbers without seeing some evidence to back them up); and

2. we should be seeing evidence of a 20-30% herd immunity threshold within ~3 weeks if that might truly be the target we need to reach.  AZ's hospitalizations have been declining for ~1 week.  If, in a week or 2, FL, TX, & SoCal follow (as IMHO is what we'll likely see), then hopefully the experts are looking at those exposures in those regions and seeing if there is a commonality.

[LGR4GM]

7 minutes ago, Taro T said:

It comes down to whether there is a %age of the population that has enough of a preexisting immunity (or more accurately enough of an ability to fight it off) to COVID from either being extremely lucky in the genetic lottery (not very likely) or from a lifetime of fighting off other corona viruses (possible) that they aren't particularly susceptible to COVID and in particular can keep it from multiplying in their own bodies to refrain from "shedding" through their exhaling (or other means of shedding it) so much of it that others get infected by it to a degree they can't fight off.

Knowing that not all members of a household that has a single case of COVID end up getting it, there is some degree of immunity "naturally" for a segment of the population.  How big that segment is is the $1B question.  In March we expected that %age to be in the teens or even single digits.  Turns out, that worst case early fear might have been off fairly significantly.  If the natural rate of possessing a predisposition to not getting infected is at or above 50% of the population, then reaching the level where 70-80% of the population won't spread the disease except in extreme circumstances can be approached with only 20-30% of the population being exposed.  (Realizing the group that includes the predisposition to not catch the virus will overlap somewhat with the group that is initially exposed to the virus.)

Like mentioned upthread: 1 skepticism is good (don't take any of these numbers without seeing some evidence to back them up); and

2. we should be seeing evidence of a 20-30% herd immunity threshold within ~3 weeks if that might truly be the target we need to reach.  AZ's hospitalizations have been declining for ~1 week.  If, in a week or 2, FL, TX, & SoCal follow (as IMHO is what we'll likely see), then hopefully the experts are looking at those exposures in those regions and seeing if there is a commonality.

First sentence is definitely something to think about. 

[Taro T]

16 minutes ago, PASabreFan said:

Got it.

20% is a pipe dream nationally. The CDC fairly recently estimated something around 20 million cases when accounting for those not tested. That's only about six percent of the U.S. (I understand Taro's theory is NYC centric.)

And there's the question of what immunity means if you've had Covid 19. A couple months of protection, a year?

At present, 20% nationally is a ways off.  NYC, Detroit, NE, northern Joisey, & a few others likely reached that in May.  The urban hubs in the SW & South are likely reaching that now.  What'll be the next places to get there - likely smaller cities in those regions and bigger cities in the mid-West.

My guess is that eventually this hits everywhere in the US (unless we get lucky with a vaccine) & the rest of the world as well.  We've seen a lot of regions get hit hard by the virus & then it subsides with the virus essentially moving on to new addresses but not going back to the old ones (yet).  (Not saying that will happen that way but expect it to follow that pattern.)  Except for possibly New Orleans, no place has yet seen a second wave.  Desperately hope that trend continues & am expecting that as well.

Be ready to keep the vulnerable protected while we brace for the flood.  Until there's a vaccine, that's about all the laymen can do.  That, and assume when you're out in public that someone you walk past or talk to is "vulnerable," so take precautions to not be the one that kills them.

[Taro T]

4 minutes ago, LGR4GM said:

First sentence is definitely something to think about. 

Again, we'll have some reasonable indicators as to whether that's the case or not & whether it is enough or not by mid-August (or late August at the latest) and what we find there will go a long way towards understanding how we need to prepare & react to this.

[SwampD]

5 hours ago, nfreeman said:

This jibes with a number of articles I've read recently -- i.e. the theory is that the spread of the virus can be slowed via masks, social distancing, etc., but not prevented from reaching its "natural" level, so pretty much all regions will end up with a similar infection rate.  NYC, the theory goes, due to population density and several mistakes early in the process, suffered both a higher infection rate and a higher fatality rate than anywhere else in the US, but the other regions will get to the same infection rate (but probably not the same fatality rate) eventually.

Making a decision based on the limited information available at the time, only to find out later that it was incorrect based on newer information, is not makIng a mistake.

It’s called learning.

Some still haven’t learned that masks work.

[Taro T]

16 minutes ago, SwampD said:

Making a decision based on the limited information available at the time, only to find out later that it was incorrect based on newer information, is not makIng a mistake.

It’s called learning.

Some still haven’t learned that masks work.

Hoping this isn't considered political; if it is, please just delete it, n.

Cutting down on the # of trains running & inadequately cleaning those that were running was a mistake.  Other decisions throughout the country & in Europe, though later proven to be incorrect, at least make sense on a certain level given the info available when they were made.  That one still remains a head scratcher.

[kas23]

Here in Maryland, we closed our schools statewide on 3/12. NYC closed theirs on 3/16. I would classify that as a mistake that didn’t take any kind of special insight. 
 

NY is going to reopen schools if Covid test positivity results are less than 5% on a 14 day average. Maryland’s 7-day positivity rate is 4.69%. The 14 day rate is lower. That would qualify for reopening schools if we were in NY, but it’s been decided to go virtual for the 1st half of the year. Interestingly, our positivity rate of 4.69% earned us a travel ban to NY. 

[biodork]

5 hours ago, LGR4GM said:

I just don't think it is as simple as 20% gives you heard immunity. I think it far more likely that the 20% who would be infected because they do dumb things or are more susceptible are. A 20% infection rate for a disease is high but that hitting it doesn't mean heard immunity. Basically I think the concept of heard immunity is being misrepresented or was in the report I saw on the 20% rate. This was the article I saw on it and I get what the science and modeling shows but I think again the concept is being used incorrectly. Herd immunity really means that there are so many people that can't get sick from a disease that it doesn't spread. I just don't see how a 20% rate accomplishes that unless it corresponds to a 50% asymptomatic rate as well which would in essence get us up into that 70-90% area we like. Again, I could be wrong I am just skeptical of that modeling for now. 

https://www.theatlantic.com/health/archive/2020/07/herd-immunity-coronavirus/614035/

Right you are; best estimates now based on ease of transmission suggest closer to 60% would be required for herd immunity:

https://www.sciencefocus.com/news/coronavirus-can-herd-immunity-protect-us-from-covid-19/

This is a long read, but an interesting post-mortem on how the initial messaging and response to COVID cases was done well and poorly in Seattle vs NYC:

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

 

[nfreeman]

3 hours ago, SwampD said:

Making a decision based on the limited information available at the time, only to find out later that it was incorrect based on newer information, is not makIng a mistake.

It’s called learning.

Some still haven’t learned that masks work.

 

3 hours ago, Taro T said:

Hoping this isn't considered political; if it is, please just delete it, n.

Cutting down on the # of trains running & inadequately cleaning those that were running was a mistake.  Other decisions throughout the country & in Europe, though later proven to be incorrect, at least make sense on a certain level given the info available when they were made.  That one still remains a head scratcher.

 

2 hours ago, kas23 said:

Here in Maryland, we closed our schools statewide on 3/12. NYC closed theirs on 3/16. I would classify that as a mistake that didn’t take any kind of special insight. 
 

NY is going to reopen schools if Covid test positivity results are less than 5% on a 14 day average. Maryland’s 7-day positivity rate is 4.69%. The 14 day rate is lower. That would qualify for reopening schools if we were in NY, but it’s been decided to go virtual for the 1st half of the year. Interestingly, our positivity rate of 4.69% earned us a travel ban to NY. 

@PASabreFan has rightly pointed out that I have said that this thread is not for discussion of government responses to the virus.  While that was not the intent or the gist of my post, I don't think we should go down this road here.  In any case I agree with @SwampD that it's unfair to assign blame for all of the decisions that in retrospect turned out to be bad calls (probably more true in some cases than others but again that's a conversation for a different time and place).

Separately, my wife and I went out to dinner tonight with some friends in a small town in upstate NY, at a now-outside-only nice restaurant, with well-spaced tables in the shade and a nice breeze.  It was our first restaurant meal with friends, and only our 3rd restaurant meal, since early March.  Now that was a F'n Fantastic Friday event.

[Wyldnwoody44]

Just to show how absolutley irrational everyone is in the decision making process in this.... One of my nurses went on a trip last week, her friend has Covid and they shared straws, drinks etc.

When she came home the DOH had her quarantine for the 14 days with in home checks, ok, whatever.... The kicker, even though she had it and was asymptomatic, she was allowed to come to work as a nurse during her "quarantine" 

I think what bothers me the most of all of this is the complete and utter lack of common sense in it all, from the top down to the local hospital policies.

We also have the ability to test IGg and IGm antibodies in the blood which in theory should be more slam dunk than the nasal swabs, they come back quicker, but yet other facilities won't accept transfers without the nasal swabs which take 3-5 days still, so now we have patients sitting in a hospital getting worse because of absolutley silly rules.

My good teacher friend said when they start school, 2 days a week will be in class but the other 3 online.... Why?! Wtf?? That makes less than zero sense.... Freaking pick a path and take it, keep it online or let them go to school, why are we complicating everything? 

Misanthropy would be a positive step up for me at this point. 

Edited July 25, 2020 by Wyldnwoody44

[Curt]

11 minutes ago, Wyldnwoody44 said:

My good teacher friend said when they start school, 2 days a week will be in class but the other 3 online.... Why?! Wtf?? That makes less than zero sense.... Freaking pick a path and take it, keep it online or let them go to school, why are we complicating everything? 

To me, this potentially makes some sense.  They are trying to walk a line between limiting exposure and providing as good an education as possible.  Fewer kids in school less often = less potential exposure.  Some in person instruction = better learning than zero in person instruction.  It’s what most NYS schools are doing I think.  My mother’s school is doing something very similar.

The example you gave with your nurse makes zero sense and is actually insane.

The example you gave with patients’ test results is illogical and an unfortunate/sad result of stupid red tape.

[carpandean]

1 hour ago, Wyldnwoody44 said:

My good teacher friend said when they start school, 2 days a week will be in class but the other 3 online.... Why?! Wtf?? That makes less than zero sense.... Freaking pick a path and take it, keep it online or let them go to school, why are we complicating everything?

53 minutes ago, Curt said:

To me, this potentially makes some sense.  They are trying to walk a line between limiting exposure and providing as good an education as possible.  Fewer kids in school less often = less potential exposure.  Some in person instruction = better learning than zero in person instruction.  It’s what most NYS schools are doing I think.  My mother’s school is doing something very similar.

A key part of these plans is that half the kids will be on one two-day pattern, while the other half will be on a different one.  So, it will look like:

• Monday: Group A in school, Group B online
• Tuesday: Group A online, Group B in school
• Wednesday: Group A and B online, School cleaned heavily
• Thursday: Group A in school, Group B online
• Friday: Group A online, Group B in school

This reduces the maximum number of students on buses, in school, etc, to half.  Plus, it gives a good cleaning in between.

Edited July 25, 2020 by carpandean

[Wyldnwoody44]

1 hour ago, carpandean said:

A key part of these plans is that half the kids will be on one two-day pattern, while the other half will be on a different one.  So, it will look like:

• Monday: Group A in school, Group B online
• Tuesday: Group A online, Group B in school
• Wednesday: Group A and B online, School cleaned heavily
• Thursday: Group A in school, Group B online
• Friday: Group A online, Group B in school

This reduces the maximum number of students on buses, in school, etc, to half.  Plus, it gives a good cleaning in between.

I suppose this makes more sense, I only talked with her briefly so maybe there was more to it than was revealed to me.