Coronavirus/COVID-19, Thread 2

[Slax]

I'm a visual person so this chart was better than a million words for me. They've estimated the 2020 total corona deaths at 150,000, broke those estimates down by age based on current trends, then showed how those deaths compare to 2016 causes of death.



Explanations and other interesting stuff on the page:

https://freopp.org/estimating-the-risk-of-death-from-covid-19-vs-influenza-or-pneumonia-by-age-630aea3ae5a9

Really puts things in perspective. I happen to think the estimate of 150k deaths is low but even if you doubled it to 300k I, at 30 years of age, am 12 times more likely to die from an unintentional injury than covid.

An important piece of context to this table is that most likely only a few percent of Americans have ever been infected with COVID-19, in large part due to drastic changes to our society and economy that suppressed the potential for large outbreaks. Compare that with the state of New York, where serology tests indicate that roughly 14% of residents have been infected with COVID-19. There have been nearly 23k confirmed deaths (and thousands more probable deaths) in the two months of the outbreak in New York. By contrast, in the entire year of 2017, 44k New Yorkers died of heart disease, 35k of cancer, and 4.5k of flu and pneumonia.

Keeping that in mind, the forward-looking conclusion "COVID-19 is less risky to me as a 30-year-old than unintentional injury" is only true if you remain very unlikely to get infected going forward. The current estimates I'm seeing for case fatality rate of COVID-19 in that 25-34 range is somewhere around 0.2%. If about a quarter of the 45 million Americans in that 25-34 demographic were infected with COVID-19, we would expect about as many 25-34 year olds to die from COVID-19 as from unintentional injuries. If 100% of them were infected, we would expect twice as many of them to die from COVID-19 as from all other causes of death combined.

What Roy is doing here is basically saying, "if you assume a constant of 150k deaths, COVID-19 isn't that risky, so it's OK for us to do things that may increase the spread of COVID-19," which is logically incoherent. As it happens, I don't expect 25% of Americans to become infected with COVID-19, but I expect that to be the case because we will continue to take at least some suppressive measures that hurt the economy, at least to some extent. And I say that even as someone who agrees with the conclusion that we need to try to get adults back to work, and kids back into schools and daycares.

[claycarver]

Compare that with the state of New York, where serology tests indicate that roughly 14% of residents have been infected with COVID-19.

That 14% New York estimate was reported April 23rd. I've been looking for more recent stats but they're hard to come by. There's also a real wide range of estimates for heard immunity. 65% I've been reading recently, but who knows?

Not knowing what percentage of people are currently infected and not having a good sense of the upper end of anticipated infections makes this such a crapshoot.

The current estimates I'm seeing for case fatality rate of COVID-19 in that 25-34 range is somewhere around 0.2%.

I'm seeing that the infection fatality rates as low as .02 to .04%...which would be more helpful than the case fatality rate when trying to estimate the risk of death compared to other causes of death.

[Slax]

Compare that with the state of New York, where serology tests indicate that roughly 14% of residents have been infected with COVID-19.

That 14% New York estimate was reported April 23rd. I've been looking for more recent stats but the estimates are super hard to come by. There's also a real wide range of estimates for heard immunity. 65% I've been reading recently, but who knows?

Not knowing what percentage of people are currently infected and not having a good sense of the upper end of anticipated infections makes this such a crapshoot.

The number plausibly may have gone up by a few percent since April 23, but probably not enough to make a huge difference. April 23 was long after the peak of the COVID crisis in New York. I don't necessarily trust the serology tests to get a great estimate, but between the New York and Spain studies, it seems pretty clear at least that most people haven't been infected even in the places that had the worst outbreaks, and that therefore it's not the case that COVID-19 isn't dangerous. As far as herd immunity goes, I don't think anywhere would be close to herd immunity if the virus is diffusing in a random way, but an interesting question is what happens if a lot of the people who are most likely to become infected and spread a virus to other people ("superspreaders" who come in contact with lots of people on a regular basis) become infected, recover, and are then immune. I think it's plausible to imagine that in a place like New York City where a substantial percentage of the population (I think it was about 20%?) was measured as having COVID-19 antibodies, a lot of that immunity could be clustered in people who are most likely to spread the virus, and so you could actually have at least some protective effect that reduces the present day R value, reducing the likelihood of a second wave. Pure speculation on my part, would be interesting to hear an epidemiologist weigh in.

Fwiw, as long as people continue with physical distancing and mask wearing, I don't necessarily think we need to reach herd immunity to be safe; we just need to implement good testing, contact tracing, and quarantine, like a handful of other countries have proved is possible. Some states are trying to do this, but I really think this would work a lot better if we had a coordinated national strategy and proper funding for it, because state governments don't really have all the right resources for it.

[threrf23]

The number plausibly may have gone up by a few percent since April 23, but probably not enough to make a huge difference. April 23 was long after the peak of the COVID crisis in New York. I don't necessarily trust the serology tests to get a great estimate, but between the New York and Spain studies, it seems pretty clear at least that most people haven't been infected even in the places that had the worst outbreaks, and that therefore it's not the case that COVID-19 isn't dangerous. As far as herd immunity goes, I don't think anywhere would be close to herd immunity if the virus is diffusing in a random way, but an interesting question is what happens if a lot of the people who are most likely to become infected and spread a virus to other people ("superspreaders" who come in contact with lots of people on a regular basis) become infected, recover, and are then immune. I think it's plausible to imagine that in a place like New York City where a substantial percentage of the population (I think it was about 20%?) was measured as having COVID-19 antibodies, a lot of that immunity could be clustered in people who are most likely to spread the virus, and so you could actually have at least some protective effect that reduces the present day R value, reducing the likelihood of a second wave. Pure speculation on my part, would be interesting to hear an epidemiologist weigh in.

It was said that just under 20% of NYC residents had antibodies (appr. when it was reported a little bit more than two weeks ago. Because of the exponential nature of viral spread, it could feasibly be above 40% already.

Deaths per capita is probably a better indication, though. NYC currently shows about 21,000 confirmed or "probable" deaths, plus I would estimate at least another 2-3k unidentified probable cases, plus of those in the hospital currently, trends suggest another 2k deaths or so over the next two weeks. So let's go with 26k confirmed/probable/expected deaths.

Mortality rate in general IMO is probably around 0.5, but in NYC everything is double (higher viral loads, overwhelmed hospitals, apathetic leaders), so let's go with 1%. 26k deaths = 2.6 million progressed cases. 2.6 mil cases / 8.4 mil population = 31% with antibodies. But if we count new cases and add 1k expected deaths, the number is probably closer to 35% - a little more than half way to possible herd immunity.

In Sweden btw, antibody testing from late April has been revealed to indicate that only about 5% of the population had been infected, 7.3% in Stockholm. The numbers are surely higher by now, but they still have a long way to go.

Fwiw, as long as people continue with physical distancing and mask wearing, I don't necessarily think we need to reach herd immunity to be safe; we just need to implement good testing, contact tracing, and quarantine, like a handful of other countries have proved is possible. Some states are trying to do this, but I really think this would work a lot better if we had a coordinated national strategy and proper funding for it, because state governments don't really have all the right resources for it.

I very much agree. Although I question the exact importance of masks (< n95). They don't necessarily protect the wearer, because if the virus ends up on the front of the mask, it can still be breathed in. They effect effective air quality, may contain chemicals; when I have worn I am constantly trying to adjust to feel comfortable, and depending on fit by breath deflects up towards my eyes and dries them out (or otherwise causes strain). This South Korean study suggests that the masks we wear are not likely to prevent spread in the event we cough and someone is in close range.

I don't doubt that masks are much more likely to help than hurt; but it feels to me like counting on masks to prevent transmission is like counting on hydroxychloroquine to cure the virus. Even the CDC has merely recommended masks to be worn either in areas that have been hit particularly hard, or where social distancing cannot be maintained. In most places I don't think they should be mandatory (where symptoms are not present), some cannot safely wear masks (i.e. due to asthma) and are falsely made out to be arrogant ****, others who wear masks or simply see others wearing masks likely have a false sense of security.

[Slax]

It was said that just under 20% of NYC residents had antibodies (appr. when it was reported a little bit more than two weeks ago. Because of the exponential nature of viral spread, it could feasibly be above 40% already.

It's not feasible that the total number of infected people in New York City doubled since late April when the serology study happened. Even lagging indicators like hospitalizations and deaths were already in decline for New York City by early April. If the same number of people were infected in late April and early May as were infected in March and most of April, we would have seen a much longer plateau of hospitalizations and deaths.

[threrf23]

According to the CDC's newly released "current best estimates,"

35% of all cases are asymptomatic and don't involve a fatality rate, and the mortality rate for the 65% of symptomatic cases is 0.4%; 1.3% for seniors (65+), and 0.05% amongst those under 50.

If true, we would see just below 600k deaths if 70% of the country's population became infected, and we would expect to see just over 15,000 deaths in NYC if 70% of NYC's population was infected.

It's maybe not true. Gotta be a typo somewhere. 0.4% makes sense if it is the mortality rate across all ages and cases, IMO.

Read on Twitter

Read on Twitter

[threrf23]

Read on Twitter

[KGboss]

So the season may start back up in a week with training camps?

Sent from my SM-G950U using Tapatalk

[Parliament10]

So the season may start back up in a week with training camps?

Sent from my SM-G950U using Tapatalk

Adam Silver is supposed to give the word around June 1st, which way things are going to go.

[Captain_Caveman]

It was said that just under 20% of NYC residents had antibodies (appr. when it was reported a little bit more than two weeks ago. Because of the exponential nature of viral spread, it could feasibly be above 40% already.

It's not feasible that the total number of infected people in New York City doubled since late April when the serology study happened. Even lagging indicators like hospitalizations and deaths were already in decline for New York City by early April. If the same number of people were infected in late April and early May as were infected in March and most of April, we would have seen a much longer plateau of hospitalizations and deaths.

Hat tip for your solid, informed, accurate, and reasonable posts in these threads.

[ConstableGeneva]

I encourage you to read this encouraging article (hopefully not a puff piece lol)...

Read on Twitter

[claycarver]

According to the CDC's newly released "current best estimates,"

35% of all cases are asymptomatic and don't involve a fatality rate, and the mortality rate for the 65% of symptomatic cases is 0.4%; 1.3% for seniors (65+), and 0.05% amongst those under 50.

If true, we would see just below 600k deaths if 70% of the country's population became infected, and we would expect to see just over 15,000 deaths in NYC if 70% of NYC's population was infected.

It's maybe not true. Gotta be a typo somewhere. 0.4% makes sense if it is the mortality rate across all ages and cases, IMO.

The mortality rate differs a lot between countries and between states. We can't just project New York city's mortality rate on the entire country, but I don't know how to break out the factors...population density, age, international travelers, time from infection to treatment...willingness of the population to seek treatment, reducing the known symptomatic pool of patients. I don't know what else could be involved. Still, I wouldn't want to point to NYC alone as a reason to dismiss the estimated 0,4% national rate.

On a side note, in my county, 205 of 277 all deaths deaths, 74%, are from nursing homes.

The median age of death is higher than the American life expectancy. Our response should be as targeted as the disease.

[jmr07019]

I got censored on facebook for sharing this



The censorship on facebook and youtube is out of control. What I shared is an obvious joke and we should be allowed to make jokes. Facebook said I was spreading misinformation Jokes aside people should be allowed to express opinions that differ from the prevailing wisdom. Many doctor's have had videos taken down off of youtube because they don't agree with the powers that be. It would be one thing if the people in charge were honest and knew what they were doing but they're not and they don't. The WHO saying this can't be transmitted from one human to another, the CDC flip flopping on masks and whether the virus can survive on surfaces. The "experts" are just guessing like the rest of us. It might be a slightly more informed guess but their track record stinks. Let people talk. Stop censorship.

[threrf23]

The mortality rate seems to seems to differ a lot in some countries and between states. I'm guessing that we can't just impose New York city's mortality rate on the entire country, but I don't know how to break out the factors...population density, age, international travelers, time from infection to treatment...willingness of the population to seek treatment, reducing the known symptomatic pool of patients. I don't know what else could be involved. Still, I wouldn't want to point to NYC alone as a reason to dismiss the estimated 0,4% national rate.

On a side note, in my county, 205 of 277 all deaths deaths, 74%, are from nursing homes.

The median age of death is higher than the American life expectancy. Our response should be as targeted as the disease.

Nursing homes account for a large percentage of deaths everywhere it seems.

In Italy and China, one reason it was said (guessed) to have been so deadly, is because adults in those countries are more likely to live with their parents, than in the US. So you had active, younger, possibly probably asymptomatic folk spreading to their parents. This might not be the case in NYC, but in NYC you have people of all ages living on top of one another.

The virus has mutated and there are are supposedly multiple strains, and it's been said if not concluded that the strain which spread in NYC was deadlier than others. But my personal, non-scientific conjecture is that severity of symptoms maybe relates at least in part to viral load, and that viral load correlates with overall exposure - i.e. transmission might not be a black and white issue and maybe the virus mutates as a result of high viral load.

[Slax]

It was said that just under 20% of NYC residents had antibodies (appr. when it was reported a little bit more than two weeks ago. Because of the exponential nature of viral spread, it could feasibly be above 40% already.

It's not feasible that the total number of infected people in New York City doubled since late April when the serology study happened. Even lagging indicators like hospitalizations and deaths were already in decline for New York City by early April. If the same number of people were infected in late April and early May as were infected in March and most of April, we would have seen a much longer plateau of hospitalizations and deaths.

Hat tip for your solid, informed, accurate, and reasonable posts in these threads.

Thanks man, there has been a ton of great content in this thread. Even most of the stuff I disagree with, I think is generally well informed and interesting. Hat tip to the whole Celtics forum for having smart, educated posters.

[claycarver]

On a side note, in my county, 205 of 277 all deaths deaths, 74%, are from nursing homes.

I've read that up to half the deaths are from nursing homes...but 74%? I know it's just one county and there are going to be differences from one location to another, but this definitely changed the conversation when that information got out. We went from being a county with a covid problem, to a county with a nursing home problem.

[theman]

On a side note, in my county, 205 of 277 all deaths deaths, 74%, are from nursing homes.

I've read that up to half the deaths are from nursing homes...but 74%? I know it's just one county and there are going to be differences from one location to another, but this definitely changed the conversation when that information got out. We went from being a county with a covid problem, to a county with a nursing home problem.

And you have to wonder why Cuomo was forcing nursing homes to take covid patients.

[theman]

I got censored on facebook for sharing this


The censorship on facebook and youtube is out of control. What I shared is an obvious joke and we should be allowed to make jokes. Facebook said I was spreading misinformation Jokes aside people should be allowed to express opinions that differ from the prevailing wisdom. Many doctor's have had videos taken down off of youtube because they don't agree with the powers that be. It would be one thing if the people in charge were honest and knew what they were doing but they're not and they don't. The WHO saying this can't be transmitted from one human to another, the CDC flip flopping on masks and whether the virus can survive on surfaces. The "experts" are just guessing like the rest of us. It might be a slightly more informed guess but their track record stinks. Let people talk. Stop censorship.

On realgm you can make jokes, as long as you are making jokes about the right people. You will be fine.

[Slax]

On a side note, in my county, 205 of 277 all deaths deaths, 74%, are from nursing homes.

I've read that up to half the deaths are from nursing homes...but 74%? I know it's just one county and there are going to be differences from one location to another, but this definitely changed the conversation when that information got out. We went from being a county with a covid problem, to a county with a nursing home problem.

And you have to wonder why Cuomo was forcing nursing homes to take covid patients.

My guess: misguided attempt to avoid a situation where a large population of disabled elderly people was caught between nursing homes that didn't want to risk COVID outbreaks and strained hospitals trying to discharge patients who didn't require critical care to free up beds for those who did, at a point in time when there weren't enough tests to ensure everyone being discharged was testing negative. I think the main mistake was waiting too long to order hospitals not to discharge patients into nursing homes until they tested negative, rather than forcing nursing homes to take back recovered patients. Should have been done by late April after it became known nursing homes were a major source of COVID deaths.

[claycarver]

For anyone interested, this page from the CDC is endlessly fascinating. You can look at total deaths, deaths with covid broken out, etc. You can look at individual states and you can see how a particular state has faired compared to how they were hit during the flu season in 2018 (the only other event captured in the data).

When you look at the spike in New York City and New Jersey specifically...unbelievable.

https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm