Semi-OT: Coronavirus (COVID-19) Discussion Thread III (Info. Post 1)

[basketballRob]

Yes, but it also depends how you calculate the fatality rate.

If you sample a large and diverse population, give all of them a test for Covid, and use that large number of tested individuals as your base, the mortality rate would be lower than what's being reported. In most cases, the Covid test is being given discrimiately to people who show the right combination of symptoms. The excuse for this is that our ability to administer tests is limited and we need to prioritize who we give the test to.

If we use the numbers from the 2018/19 flu season (above) and calculate the mortality rate for the common flu as the number of deaths divided only by the number of cases requiring hospitalization, we would see a mortality rate for the flu of 6.97%.

I'm not saying that Covid-19 isn't serious, and I'm not saying the common flu has the same mortality rate. However, I'm saying the national response of shutting down businesses and asking people to isolate themselves is disproportionate in many areas of the country where the infection rate is very low.

Some of my thoughts:
1. I agree that if we knew the number of actual cases (as opposed to confirmed), the mortality rate would be significantly lower.

2. The mortality rate I mention in #1 assumes that all seriously sick patients are able to get proper medical care. The problem in Italy is that there are far too many seriously sick patients, so the mortality rate is alarmingly high there right now.

3. Being cautious is good, being overcautious is not necessarily bad but of course restricts economic and social activity, being careless is the worst case scenario (where we end up with an overloaded medical system and high mortality rate.)

4. So much is still unknown due to lack of knowledge and lack of testing in this country. Testing alone doesn't solve the problem, but it gives us more data to make the best, safest, smartest strategy possible.

Right now the number of confirmed cases is skyrocketing, because testing is finally increasing. It doesn't mean that spread rate is super high (it may be, but we don't know because of lack of data), but it does mean there are probably a lot more cases we are going to confirm over the next few days and weeks.

The number of confirmed cases in New York is skyrocketing. New York is an absolute nightmare for a pandemic. Nevermind how people depend on using taxi cabs, subways and elevators. The large apartment complexes with central air are tantamount to the Princess cruise ships.

However, the number of confirmed cases in 30-35 other states are not skyrocketing. Not even close.

I agree that it's best to err on the side of caution, and we absolutely need more time to gather data. However, assuming the data doesn't change dramatically, the economic cost of isolating people en masse is going to vastly outweigh the benefit in most states.

NY is just testing more than other places, it's everywhere

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[OkcSinceSGA]

Read on Twitter

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[Raptorzzs]

The USA number skyrocketed today, again likely because we’re starting to test more and more people and confirming more cases. We have no idea yet what the real number of infected are, how fast we’re spreading it right now, etc.

That chart comparing our timeline with Italy? That comparison is probably over, we’re racing ahead going forward. It’s going to make it very hard to draw any sort of predictions for the USA based on Italy’s numbers.

Might make sense to combine UK, France, Germany, Spain, Italy to compare. I think that's still lower than our population.

Yeah, the whole of Europe is a more appropriate comparison to what's coming to the US considering the population and freedom of movement.

[Catchall]

The fatality rate is much higher than the flu at 3%

https://www.marketwatch.com/story/coronavirus-vs-the-flu-its-just-like-other-viruses-and-we-should-go-about-our-normal-business-right-wrong-heres-why-2020-03-09

Yes, but it also depends how you calculate the fatality rate.

If you sample a large and diverse population, give all of them a test for Covid, and use that large number of tested individuals as your base, the mortality rate would be lower than what's being reported. In most cases, the Covid test is being given discrimiately to people who show the right combination of symptoms. The excuse for this is that our ability to administer tests is limited and we need to prioritize who we give the test to.

If we use the numbers from the 2018/19 flu season (above) and calculate the mortality rate for the common flu as the number of deaths divided only by the number of cases requiring hospitalization, we would see a mortality rate for the flu of 6.97%.

I'm not saying that Covid-19 isn't serious, and I'm not saying the common flu has the same mortality rate. However, I'm saying the national response of shutting down businesses and asking people to isolate themselves is disproportionate in many areas of the country where the infection rate is very low.

If we did nothing models say that 2.2 million americans will die, more than all the wars.

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The model projected that half or more of the U.S. population would get infected. The model then projected mortality rates by age group. The model projected different outcomes--low, medium, high, etc.

However, it might have been based on limited data from China, no?

[rugbyrugger23]

He's done a terrible job in terms of preparing for and responding to the virus. Keep denying that all you want.

Look at the worldwide numbers and past U.S. epidemics. You’d be hard pressed to find another leader who reacted as strongly, and closed borders as rapidly saving millions like the Trump admin. The response to H1N1 from Obama/Biden was exponentially worse. But keep watching CNN I guess...

https://www.rollingstone.com/politics/politics-news/trump-coronavirus-timeline-dismissed-969381/

March 4th: In an interview with Sean Hannity, Trump calls the WHO’s estimate of the global death rate “false,” describes the coronavirus as “very mild,” and suggests that those infected can get better by “sitting around” and “going to work.”

March 7th: “No, I’m not concerned at all,” Trump said from Mar-a-Lago. “No, I’m not. No, we’ve done a great job.”

March 9th: Trump bashes Democrats for sounding the alarm “far beyond what the facts would warrant” before implying that the common flu is far worse

I can see this thread evolved into Trump blaming again.

Even those who don’t like the man personally (like myself) or care for a lot he does on the surface, it is so obvious he has a large percentage of those who wouldn’t agree with any action he made/makes or said/says. And we all see you for what it is. We would rather not read that here. Go find an outlet (not here) and move on with your lives. Not healthy.

[spacemonkey]

In addition to this, quoting from some of my earlier posts:

On N95 vs Surgical:

Between September 23, 2008, and December 8, 2008, 478 nurses were assessed for eligibility and 446 nurses were enrolled and randomly assigned the intervention; 225 were allocated to receive surgical masks and 221 to N95 respirators. Influenza infection occurred in 50 nurses (23.6%) in the surgical mask group and in 48 (22.9%) in the N95 respirator group (absolute risk difference, −0.73%; 95% CI, −8.8% to 7.3%; P = .86), the lower confidence limit being inside the noninferiority limit of −9%.

https://jamanetwork.com/journals/jama/fullarticle/184819

When worn consistently:

In an adjusted analysis of compliant subjects, masks as a group had protective efficacy in excess of 80% against clinical influenza-like illness. The efficacy against proven viral infection and between P2 masks (57%) and surgical masks (33%) was non-significant.

https://www.ijidonline.com/article/S1201-9712(08)01008-4/fulltext

Masks, in the grand scheme of things, may be less important than maintaining proper hand hygiene and not chewing your nails after you've touched a public restroom doorknob.

But there are other effects: Normalizing masks means that those who are infected and know they are, and for whatever reason have to leave home, do not feel a stigma for wearing a mask and are more likely to do so, thereby preventing spread.

As it is, you are still ridiculed and/or ostracized for wearing a mask in public in much of the West, encouraging you not to do so.

And on efficacy of surgical masks:

Masks have been shown to be effective as reducing influenza-like illness spread from parents to children: https://www.ncbi.nlm.nih.gov/pubmed/19193267

We conducted a prospective cluster-randomized trial comparing surgical masks, non-fit-tested P2 masks, and no masks in prevention of influenza-like illness (ILI) in households
...
We found that adherence to mask use significantly reduced the risk for ILI-associated infection

The major hurdle with masks is adherence, as noted in that study.

Part of the reason why masks are being discouraged in many countries is because they are being taken away from medical frontline staff, who absolutely do need them - as shown in the first linked study of efficacy of N95 vs Surgical in trained individuals (nurses).

However, the messaging has unfortunately been warped into / conflated with "masks are not effective for the general public", which is likely completely incorrect:

The major talking points against using a mask to prevent infection (rather than spread) for the average Joe generally are:

1. People may touch their face more and fiddle with the mask
2. People don't know how to properly fit them
3. People don't know how to properly remove them

There is some truth to all of these claims, but if the world wasn't experiencing a severe mask shortage, would we really be discouraging the use of masks?

A lot of the problem surrounding this pandemic is the mixed messaging that is going on, whether in terms of warped / distorted messaging, or willfully incorrect / misinformative messaging.

It is pretty clear that in some cities with strict mask-adherence protocols (in concert with social distancing and proper hand hygeine), such as Hong Kong, Singapore, Taiwan, Korea, and Japan, the spread has been limited / slowed effectively, despite their relative proximity and links with the source of the virus, Mainland China.

Ultimately, in those places where medical frontline staff are experiencing a shortage of masks, we can only come to the conclusion that the government and healthcare systems in place failed to prepare for an emergency pandemic by stocking enough. I would hesitate to blame the general public for buying masks which, unfortunately, has been some of the messaging.

[Catchall]

Some of my thoughts:
1. I agree that if we knew the number of actual cases (as opposed to confirmed), the mortality rate would be significantly lower.

2. The mortality rate I mention in #1 assumes that all seriously sick patients are able to get proper medical care. The problem in Italy is that there are far too many seriously sick patients, so the mortality rate is alarmingly high there right now.

3. Being cautious is good, being overcautious is not necessarily bad but of course restricts economic and social activity, being careless is the worst case scenario (where we end up with an overloaded medical system and high mortality rate.)

4. So much is still unknown due to lack of knowledge and lack of testing in this country. Testing alone doesn't solve the problem, but it gives us more data to make the best, safest, smartest strategy possible.

Right now the number of confirmed cases is skyrocketing, because testing is finally increasing. It doesn't mean that spread rate is super high (it may be, but we don't know because of lack of data), but it does mean there are probably a lot more cases we are going to confirm over the next few days and weeks.

The number of confirmed cases in New York is skyrocketing. New York is an absolute nightmare for a pandemic. Nevermind how people depend on using taxi cabs, subways and elevators. The large apartment complexes with central air are tantamount to the Princess cruise ships.

However, the number of confirmed cases in 30-35 other states are not skyrocketing. Not even close.

I agree that it's best to err on the side of caution, and we absolutely need more time to gather data. However, assuming the data doesn't change dramatically, the economic cost of isolating people en masse is going to vastly outweigh the benefit in most states.

NY is just testing more than other places, it's everywhere

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In NY, 22% of people who have been tested are positive.
In many states, only 3% - 7% of people who have been tested are positive.
NY is a different kettle of fish.

You can say it's everywhere, but in reality it's at least 70% concentrated in NY, Seattle and Calif, and that concentration is likely to go up.

[Nuntius]

Here's a very interesting article about the way that the NBA is handling Covid-19 -> https://www.espn.com/nba/story/_/id/28925716/how-nba-moved-quickly-coronavirus-testing

Overall, I really have to commend the NBA on the way they've handled this. They've been monitoring the situation for a while (ever since mid-January), they've been listening to expert advice and following health protocols, they've been communicating with the teams on a consistent basis and they took immediate and decisive action the moment a player tested positive. They never tried to underplay the situation either. In simply terms, they acted responsibly. I realize that there is a big difference between running a league and running a country but I really wish that more governments had acted in a similar fashion. Unfortunately, they didn't as most Western governments were either slow to react or tried to underplay it.

[basketballRob]

Yes, but it also depends how you calculate the fatality rate.

If you sample a large and diverse population, give all of them a test for Covid, and use that large number of tested individuals as your base, the mortality rate would be lower than what's being reported. In most cases, the Covid test is being given discrimiately to people who show the right combination of symptoms. The excuse for this is that our ability to administer tests is limited and we need to prioritize who we give the test to.

If we use the numbers from the 2018/19 flu season (above) and calculate the mortality rate for the common flu as the number of deaths divided only by the number of cases requiring hospitalization, we would see a mortality rate for the flu of 6.97%.

I'm not saying that Covid-19 isn't serious, and I'm not saying the common flu has the same mortality rate. However, I'm saying the national response of shutting down businesses and asking people to isolate themselves is disproportionate in many areas of the country where the infection rate is very low.

If we did nothing models say that 2.2 million americans will die, more than all the wars.

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The model projected that half or more of the U.S. population would get infected. The model then projected mortality rates by age group. The model projected different outcomes--low, medium, high, etc.

However, it might have been based on limited data from China, no?

https://mobile-reuters-com.cdn.ampproject.org/v/s/mobile.reuters.com/article/amp/idUSKBN2141EP?amp_js_v=a3&amp_gsa=1&usqp=mq331AQFKAGwASA%3D#aoh=15846880117548&referrer=https%3A%2F%2Fwww.google.com&amp_tf=From%20%251%24s&ampshare=https%3A%2F%2Fwww.reuters.com%2Farticle%2Fus-health-coronavirus-britain-research-idUSKBN2141EP

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[Catchall]

If we did nothing models say that 2.2 million americans will die, more than all the wars.

Sent from my SM-G950U using RealGM mobile app

The model projected that half or more of the U.S. population would get infected. The model then projected mortality rates by age group. The model projected different outcomes--low, medium, high, etc.

However, it might have been based on limited data from China, no?

https://mobile-reuters-com.cdn.ampproject.org/v/s/mobile.reuters.com/article/amp/idUSKBN2141EP?amp_js_v=a3&amp_gsa=1&usqp=mq331AQFKAGwASA%3D#aoh=15846880117548&referrer=https%3A%2F%2Fwww.google.com&amp_tf=From%20%251%24s&ampshare=https%3A%2F%2Fwww.reuters.com%2Farticle%2Fus-health-coronavirus-britain-research-idUSKBN2141EP

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Okay, it's based on Italy.

[shangrila]

Experts admit by "flattening the curve" they still expect the same number of infected, they just want it to peak less violently to avoid overwhelming the system. I'd think it would do both? I assume while quarantined many will shed virus and lessen how much is going around? Or are we all going to eventually get it?

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So flattening the curve is designed to spread out the cases as much as possible to, as you say, not overwhelm the health care system. And yes, it's probable that this will work. Reports suggest that people with severe symptoms (i.e. the ones requiring hospitalisation) take roughly 3-6 weeks to recover. So if you spread out the cases ideally you just swap out people that have recovered with new people that need those hospital beds.

[shangrila]

Regarding California, how is everyone going to eat if they lock down the entire state? What happens when people run out of food? Are supermarkets, gas stations and pharmacies excluded?

If it's anything like Australia then yes, those stores will remain open as they'll be classified as essential.

[shangrila]

I'm so glad the mayor of LA is talking right now. THERE ARE NO SHORTAGES OF FOOD AND SUPPLIES. STOP HOARDING

Take the word of an Australian supermarket worker; you need product limits and even then you have to watch for people coming in 2-3 times a day.

[SimonFish]

It is pretty clear that in some cities with strict mask-adherence protocols (in concert with social distancing and proper hand hygeine), such as Hong Kong, Singapore, Taiwan, Korea, and Japan, the spread has been limited / slowed effectively, despite their relative proximity and links with the source of the virus, Mainland China.

All of your points are spot on.

I personally live in Hong Kong. One thing I would like to add is that, prior to this week, the number of infection cases is rather steady (less than 10 cases per day). However, since early this week, many students who study abroad in western countries (mostly in the UK) came back, and the number of cases have since then rocketed (we had twenty something cases yesterday, and thirty cases this morning alone).

[parapooper]

Look at the worldwide numbers and past U.S. epidemics. You’d be hard pressed to find another leader who reacted as strongly, and closed borders as rapidly saving millions like the Trump admin. The response to H1N1 from Obama/Biden was exponentially worse. But keep watching CNN I guess...

https://www.rollingstone.com/politics/politics-news/trump-coronavirus-timeline-dismissed-969381/

March 4th: In an interview with Sean Hannity, Trump calls the WHO’s estimate of the global death rate “false,” describes the coronavirus as “very mild,” and suggests that those infected can get better by “sitting around” and “going to work.”

March 7th: “No, I’m not concerned at all,” Trump said from Mar-a-Lago. “No, I’m not. No, we’ve done a great job.”

March 9th: Trump bashes Democrats for sounding the alarm “far beyond what the facts would warrant” before implying that the common flu is far worse

I can see this thread evolved into Trump blaming again.

Even those who don’t like the man personally (like myself) or care for a lot he does on the surface, it is so obvious he has a large percentage of those who wouldn’t agree with any action he made/makes or said/says. And we all see you for what it is. We would rather not read that here. Go find an outlet (not here) and move on with your lives. Not healthy.

I posted some facts and quotes in response to someone painting Trump as some sort of hero with unmatched foresight in all of this.
How is that worse than your whiny post that contributes absolutely nothing?

[rugbyrugger23]

https://www.rollingstone.com/politics/politics-news/trump-coronavirus-timeline-dismissed-969381/

March 4th: In an interview with Sean Hannity, Trump calls the WHO’s estimate of the global death rate “false,” describes the coronavirus as “very mild,” and suggests that those infected can get better by “sitting around” and “going to work.”

March 7th: “No, I’m not concerned at all,” Trump said from Mar-a-Lago. “No, I’m not. No, we’ve done a great job.”

March 9th: Trump bashes Democrats for sounding the alarm “far beyond what the facts would warrant” before implying that the common flu is far worse

I can see this thread evolved into Trump blaming again.

Even those who don’t like the man personally (like myself) or care for a lot he does on the surface, it is so obvious he has a large percentage of those who wouldn’t agree with any action he made/makes or said/says. And we all see you for what it is. We would rather not read that here. Go find an outlet (not here) and move on with your lives. Not healthy.

I posted some facts and quotes in response to someone painting Trump as some sort of hero with unmatched foresight in all of this.
How is that worse than your whiny post that contributes absolutely nothing?

How is it whiny? It is the fact. Political talk should be warned and banned and not taken place in this thread.

Also fact, that Trump will have believers on both side. So why air either side here in non appropriate place?

[parapooper]

I can see this thread evolved into Trump blaming again.

Even those who don’t like the man personally (like myself) or care for a lot he does on the surface, it is so obvious he has a large percentage of those who wouldn’t agree with any action he made/makes or said/says. And we all see you for what it is. We would rather not read that here. Go find an outlet (not here) and move on with your lives. Not healthy.

I posted some facts and quotes in response to someone painting Trump as some sort of hero with unmatched foresight in all of this.
How is that worse than your whiny post that contributes absolutely nothing?

How is it whiny? It is the fact. Political talk should be warned and banned and not taken place in this thread.

Also fact, that Trump will have believers on both side. So why air either side here in non appropriate place?

Again, I was only posting facts and quotes correcting someone spreading nonsense - even assuming your whining about people daring to voice their opinions in a discussion forum is valid - why direct it at me instead of people actually voicing political opinions?

[bwgood77]

Just came across this while reading responses to the above tweet. I don't know if this theory means anything, but looks bad in Florida if it does. I was pretty surprised to see AZ look like that too.

Read on Twitter

This is fascinating, it's been a long time since I've heard of a 'smart' device/appliance/thing that actually provided significant value over the old, dumb version.

It would be wonderful if we could send one of these thermometers to every household in America. At the very least, it would identify potential hot spots that could then be given early investigation/attention which could help slow or stop new outbreaks.

I didn't click on the original source in that article initially, but it's this https://www.nytimes.com/2020/03/18/health/coronavirus-fever-thermometers.html and it looks like this is getting updated starting today... https://healthweather.us/ a little more widespread (higher temperatures registered) than the picture in the tweet.

[mcmurphy]

Low carb works too. Good job. This isn't going to make any sense but I find it hard but simple. Really, logically, it's just giving up soda, rice, chips, pasta mostly. But once you slip up, it's easy to say screw it I messed up anyway and go off the rails completely.

My secret is cheat day. It do it at most once a week (unless on vacation). That way it's not like I'm never eating pizza again... but if I want it I have to wait until Saturday

OT but honestly I don't know how you all do it. My people are bread people. I'm not a confrontational person by nature, but if I cut carbs for a prolonged time, I feel like killing people. Not sure if it's genetics or what, but it does not work for me. You shouldn't be miserable with all the beautiful food combinations in the world, and that's the effect low carbs have on me. Mediterranean balance all the way. But whatever works for each person.

I just think giving up, for instance, Italian food, would never ever work. Ever. I'd rather work out more and enjoy the food. Not that you all don't, but as I sit enjoying a glass of Chianti and thinking of a new recipe for tomorrow, balancing out joyful experiences while socially distancing - it's one of the pleasures one can take full advantage of at home and create positive associations. But if that means some new Keto recipes for you gents, so be it. Cheers!

everything ok, Pop?

[G R E Y]

My secret is cheat day. It do it at most once a week (unless on vacation). That way it's not like I'm never eating pizza again... but if I want it I have to wait until Saturday

OT but honestly I don't know how you all do it. My people are bread people. I'm not a confrontational person by nature, but if I cut carbs for a prolonged time, I feel like killing people. Not sure if it's genetics or what, but it does not work for me. You shouldn't be miserable with all the beautiful food combinations in the world, and that's the effect low carbs have on me. Mediterranean balance all the way. But whatever works for each person.

I just think giving up, for instance, Italian food, would never ever work. Ever. I'd rather work out more and enjoy the food. Not that you all don't, but as I sit enjoying a glass of Chianti and thinking of a new recipe for tomorrow, balancing out joyful experiences while socially distancing - it's one of the pleasures one can take full advantage of at home and create positive associations. But if that means some new Keto recipes for you gents, so be it. Cheers!

everything ok, Pop?

lol all good here, thanks! And nobody better cough in Pop's general direction either. I have a can of whoop ass at the ready.