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Dean Pomerleau

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About Dean Pomerleau

  • Birthday 11/12/1964

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  1. Hang in there Matt, and best wishes for your mom. Apologies if this website has already been posted in this thread, but I don't remember it. I've been frustrated by lack of data on the number of tests being conducted in the US and especially data broken down by state. Are the states with few reported cases just not testing very much? This website is a treasure trove for such data: http://coronavirusapi.com/ It shows that across the US about 18% of tests are coming back positive. But there is a HUGE range. Below is the most interesting table from that website, showing the data broken down by state. I've highlighted New York (NY) and my state of Pennsylvania (PA). As you can see, both states have tested about the same fraction of their population (2000-3000 tests per million citizens). But in NY they are seeing 90% of their tests return positive, while PA is only seeing 10% of their tests return positive, which is below the national average of around ~18%. But some states are much lower still, such as Minnesota (MN) where they've also tested ~3000 people per million citizens and are only seeing 2.7% of tests coming back positive. This clearly suggests two things: a) some state (like NY) are only testing very sick people who are very likely to have the virus and b) the percent of the population who has the virus does indeed appear to vary quite widely between states. In other words, the low # of cases in some states isn't just that those states aren't testing very much, they really haven't been hit hard by the virus yet. --Dean
  2. From that article: In Iran, the number of newly confirmed COVID-19 cases per day remained relatively flat last week, going from 1,053 last Monday to 1,028 on Sunday. Although that's still a lot of new cases, Levitt said, the pattern suggests the outbreak there "is past the halfway mark." Today is three days since that article was published, and Iran is now running at 3,000 new cases per day. So much for "relatively flat" and "past the halfway mark." Given that, I'm not sure his optimistic predictions should be given much credence. --Dean
  3. Here is an detailed model that projects both hospital beds needed and deaths per day by US state and US overall, assuming pretty strict social distancing measures are implemented and remain in place. Here are two of the graphs for New York, projecting a peak of daily deaths in 11 days (Apr. 8th) with ~550 deaths per day. They project the death rate will drop pretty quickly, with around 10K total deaths in NY between now and August. Here are the same graphs for the whole US, with a projected peak in 17 days (Apr. 14th) with a peak daily death rate of ~2300 and ~81K total deaths between now and August. The authors suggest several limitations of their study, most of which seem to me to suggest they are being optimistic about their assumptions. For example, they are assuming all states will quickly implement 3 out of 4 social distancing measures that Wuhan took pretty quickly (school closures, non-essential business closures including bars and restaurants, stay-at-home order and travel restrictions including public transport closures) and 3-out-of-4 will be enough to get Wuhan-like squashing of the spread (which seems pretty dubious to me, given the very strict travel restrictions Wuhan implemented). Interestingly, the time between Wuhan's strict lock down and the peak death rate was 27 days. --Dean
  4. In the beginning, people were not following the restrictions much, until the police started fining. Now you can see very few people around, even walking dogs must be done within a narrow radius from the residence. But of course, someone manages to escape, although the probability of being caught now is substantial. Last but not least: if you are caught on the move and you are confirmed with symptoms of the Covid-19, you can be charged with a procured epidemic, which may result in a few years of incarceration... Wow, Mccoy. Thanks for the update. That's a pretty serious lockdown. It seems like it may be working though. Italy's rate of new cases and deaths appears to be leveling out. At 600-700 deaths per day it is obviously tragic (especially in the hardest hit area), but not unfathomably so. The US has ~5x the population of Italy, so the equivalent here would be 3000-3500 deaths per day. If we could keep the mortality rate at that level in a few weeks I think we should count ourselves pretty lucky, given the slow rollout of testing and social distancing measures, and the very slim chance that we could impose the kind of travel restrictions you are experiencing now in Italy in order to slow the spread of the virus. I fear instead we could see a peak death rate of 5000-10,000 per day here in a month's time. We're at 250 deaths per day now. That's up from ~25 per day a week ago, suggesting a doubling time of less than 2 days. If that keeps up, or even slows down to "only" a 3-4 day doubling time as a result of efforts at social distancing, we'll get to those sorts of daily mortality numbers in much less than a month. Let's hope it doesn't come to that. --Dean
  5. Mccoy, Over on the greens thread, you wrote: How much is travel restricted in Italy, particularly to/from the Lombardy region? If there are travel restrictions, are people following them and how are they enforced? Did I hear someone say Bitcoin? 🙂 --Dean
  6. Dean Pomerleau

    Getting your greens during Coronavirus

    That seems almost inevitable without any travel restrictions. What would you do if you were a New Yorker who feels fine at the moment and have some place to escape to? I think the biggest risk in the US is that we'll see each new hotspot city send out a diaspora of new cases to other part of the country, setting off a chain reaction of major outbreaks in metropolitan areas over the next six months and preventing us from getting back to any semblance of normalcy. Trump's idea of getting everything fired up by Easter (2.5 weeks) would be laughable if it weren't so tragic, encouraging people to think the worst is behind us and social distancing will soon be unnecessary. --Dean
  7. Dean Pomerleau

    Getting your greens during Coronavirus

    Shezian, You could check if there is a CSA program in your area that you could join in order to get your produce directly from a local farmer rather than the supermarket. http://www.csanetworkausnz.org/ --Dean
  8. Popular Science has an article with some nice ways of visualizing the scale of the outbreak in different countries which I haven't seen before: https://www.popsci.com/story/health/misleading-covid-coronavirus-graphs-charts/ Here is one I found interesting showing the number of confirmed cases scaled by a country's population. China is the top row and the US is the light green row six down from the top. I strongly suspect the US row is so light partly because of the lack of testing: Speaking of a lack of testing biasing US data, here is another graph from the PopSci article showing rate of testing by US state vs. number of confirmed cases. As you can see, most states with very low confirmed cases also have done very few tests, leaving us in the dark about just how free from the disease they are: --Dean
  9. Here is a nice, frequently updated log-scale graph of deaths by country. It helpfully shows the point at which various countries instituted stay at home policies, and how long it is taking for the curve to start bending down subsequently. https://www.ft.com/coronavirus-latest Here is the the graph as it stands today. Thankfully Italy appears to be flattening out. --Dean
  10. Ron, Read your own post and my highlight of it more carefully. I'll repeat it here: 1.9M / 108K = 18x, which I said called "nearly 20x". Regarding all this being "worst case scenario", from this NYT article: In the absence of public projections from the C.D.C., outside experts have stepped in to fill the void, especially in health care. Hospital leaders have called for more guidance from the federal government as to what might lie in store in the coming weeks. Even severe flu seasons stress the nation’s hospitals to the point of setting up tents in parking lots and keeping people for days in emergency rooms. Coronavirus is likely to cause five to 10 times that burden of disease, said Dr. James Lawler, an infectious diseases specialist and public health expert at the University of Nebraska Medical Center. Hospitals “need to start working now,” he said, “to get prepared to take care of a heck of a lot of people.” Dr. Lawler recently presented his own “best guess” projections to American hospital and health system executives at a private webinar convened by the American Hospital Association. He estimated that some 96 million people in the United States would be infected. Five out of every hundred would need hospitalization, which would mean close to five million hospital admissions, nearly two million of those patients requiring intensive care and about half of those needing the support of ventilators. This is not a "worst case scenario" - this the "best guess" projection of a top infectious disease public health professional. He's saying it will be 5 to 10x the burden of a severe flu season and two million patients will require admission to intensive care. We only have ~100K intensive care beds, with most of them already occupied (and likely to remain so) by people who don't have coronavirus. So again, your apparent confidence that it won't get that bad seems wildly optimistic to me, given what credible experts are saying. I agree it might not get that bad if we suddenly become really serious about extreme social distancing, travel restrictions, quarantining, contact tracing, etc. But it doesn't seem like we are moving very fast in that direction, even in those places (like NY) where widespread testing has shown the magnitude of the problem. --Dean
  11. With all the talk about chloroquine, it looks like supplies are being tapped out already: https://www.businessinsider.com/chloroquine-hydroxychloroquine-shortage-coronavirus-treatment-lupus-arthritis-2020-3 Demand for malaria pills has skyrocketed on hopes that the drug can treat COVID-19, the disease caused by the new coronavirus. Demand has ramped up so much that the drugs chloroquine and hydroxychloroquine are now in shortage, according to a pharmacy group that tracks supplies of medicines. --Dean
  12. Hi Sthira, I haven't been on absolute calorie restriction for many years as you probably already know. But I am relatively CRed and so far I have not increased my calorie intake and am maintaining my BMI around 19.5. I feel that is a reasonable compromise between maintaining a hypervigilant immune system with CR and being robust enough to weather a serious illness. YMMV. --Dean
  13. Ron, You quote credible sources projecting we'll need nearly 20x more ICU beds than the total number we have in this country, to say nothing of the fact that the vast majority of those existing beds are already occupied by very sick (non-coronavirus) patients and the geographic distribution of those beds is very unlikely to match up with the location where they are needed. And yet you keep calling out people for scaremongering. I agree panic is to be avoided, but I don't get why you seem to be continually downplay the seriousness of the situation when the evidence strongly suggests that US hospitals are on track to become overwhelmed with gravely ill patients like they were in Wuhan and are now in parts of Italy and Spain. --Dean
  14. Nice article arguing with numbers that the best way to proceed is a tight lock down for a few weeks (like Hubei and current Italy) followed by relaxation of restrictions just enough to keep the R value below 1. https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56 --Dean
  15. Ron, Can you elaborate on why/how the complexity of blood groups would undermine the credibility of this finding on blood type association with covid-19 risk? Because to me it sounds analogous to the specious argument that high LDL shouldn't be interpreted as a risk factor for heart disease because you might have "large fluffy" LDL particles. While having large fluffy LDL particles may indeed be harmless (or less harmful than small dense particles), the fact remains that overall, high LDL cholesterol is associated with greater CVD risk. In the present case, the study may have other faults (esp. since it hasn't been peer reviewed yet), but simply saying "blood groups are significantly more complex than this" does not seem to me to undermine in any way the high level association between covid-19 susceptibility and certain blood groups (i.e. O-type being beneficial, A-type being detrimental). --Dean