Just curious, anyone have a plan, or preps for global pandemic?

[Sibiriak]

Key U.S. coronavirus death projection revised down to 60,000

Quote

 

In New York City, the outbreak’s epicenter, Mayor Bill de Blasio said mitigation efforts such as ordering all non-essential workers to remain at home “actually are starting to yield some progress,” but he warned against relaxing any restrictions too soon.

“Double down, double down, because this is finally some evidence that these strategies can work,” de Blasio told CNN.

 

 

[Thomas G]

2 hours ago, Gordo said:

That's right, Thomas you misinterpreted that article.  Having an elevated ALT before you get COVID-19 probably doesn't predict a higher risk of COVID-19 severity.  If you got COVID-19, and then your ALT shot up, that is essentially a sign that the disease is screwing with your organs and you may be headed for trouble.

This is from people who have tested positive for COVID-19 and are in the early stages of the progression of the illness. We have no way of knowing if the higher ATL numbers are a result of the infection and its impact on the liver, or if these people had higher ATL levels before they got sick and for some reason because of that they are having more severe cases. We just don't know. But given that I have higher ATL levels anyway, it seems like a potential concern.

2 hours ago, Gordo said:

 Perhaps more importantly, you might want to try to figure out why your ALT is elevated.  Note that some CR Society members have seen elevated ALT in the past related to supplements or foods they had been taking/eating.  If you are taking anything you might consider "suspect", you might try eliminating that, and getting another blood test in 3-6 months to see if your ALT has gone back down.  Certain medications can also elevate ALT.

I'm at the early stages of researching all of this and haven't had the time to look to closely at it. I am a minimalist on supplements. I do eat maybe an excessive amount of dark green leafies. I also eat a lot of turmeric. Those are the only suspicions I have at the moment. I need to learn a lot more.

Here is another fun AI related COVID-19 research project. They are training a neural network to listen to people's voices and coughs to see if they can start to identify who is sick and who isn't. I tried it myself but the results were not very user friendly in terms of what it actually means. Just a horizontal bar without any numbers or explanatory text. Still an interesting project and one I wouldn't be surprised might work if they give it enough time.

https://gizmodo.com/researchers-built-an-app-that-aims-to-detect-covid-19-b-1842613139

[Sibiriak]

Pastor who criticized coronavirus ‘mass hysteria’ dies from illness

 

----------------------------------------------------------------------------------------------

Speculation that the actual number of Covid-19 deaths in Spain is much higher than official figures.

Quote

Recently released data from judicial authorities in Madrid, for example, suggest that 6,600 more people than usual died in the last two weeks of March, compared to the official tally of 3,500 Covid-19 deaths in the region.

When pressed, Spain’s health minister argued that Spain’s criteria ranks among the most stringent in Europe. “Everyone who tests positive and dies is counted as having died due to the coronavirus,” Illa told reporters.

His explanation suggests that those who have died in elderly care homes and private residences – the vast majority of whom were not tested for the virus – are not included in the data. 

Spain’s justice ministry has responded by requesting judicial authorities to urgently send all records of burials and cremations that have taken place since emergency measures were imposed in mid-March, according to broadcaster Cadena Ser.

The confusion over the official figures comes as the Spanish government seeks to gauge the spread of the virus across the country. In the coming days, the health ministry said it would begin mass testing on more than 62,000 randomly chosen people.

After hard-hit regions such as Madrid and Catalonia instructed people with mild symptoms to self-isolate rather than seek testing, health officials in Spain have estimated that as many 90% of the country’s cases may have gone undetected.

Edited April 8, 2020 by Sibiriak

[Ron Put]

12 hours ago, Sibiriak said:

Perhaps Ron Put ought to take up the fight against Gates's  vast influence, rather than obsessing over  some  statement  made by Tedros Adhanom Ghebreyesus back on March 3  which virtually no one puts any stock into today.    Note also:  the Bill & Melinda Gates Foundation has donated HUNDREDS of millions of dollars  to the evil WHO!

2 hours ago, Sibiriak said:

Pastor who criticized coronavirus ‘mass hysteria’ dies from illness

----------------------------------------------------------------------------------------------

Speculation that the actual number of Covid-19 deaths in Spain is much higher than official figures.

Hm, those statements by WHO, that you think "no one puts any stock into," are the whole basis for WHO's recommendation that the world follow the China lock-down model. They ARE the reason why much of the world has shut down. Given the dire consequences as a result of the shutdown, methinks we should all care if it was all a lie.

I disagree with some of what the Gates foundation is doing, but it is their money and in a liberal democracy they can do what they wish, as long as it's not illegal. Perhaps you should stop obsessing with their "vast influence" over how they spend their own money and focus more on the "peace-loving" oligarchy where you apparently live?

Also, speaking of obsession, I notice a trend of choice doom and gloom anecdotal and speculation posts in the vein of the above, all obsessing with the West....

-----------------------

5 hours ago, Gordo said:

New twist on SARS-CoV-2, there had been reports from China about people who had recovered, tested negative, then got reinfected....

Yep, it's another Covid-19 aspect which puts it close to influenza, which has a relatively high reinfection rate.

Which means it's very likely that this coronavirus will join the other four corona viruses which have become endemic to the world's human population and reappear seasonally.

 

-------------------------

4 hours ago, Sibiriak said:

Key U.S. coronavirus death projection revised down to 60,000

So, even if as high as that, which I am strongly doubting, this will be a bad flu. Looking at Sweden, Belarus and Brazil, and some US states, there is no evidence that a complete lock-downs are significantly better at preventing the spread of Covid-19 than prudent distancing, which all of us do in the case of the flu. Despite of the media onslaught which is lighting a fire under local politicians to force lock downs.

So, there is no evidence that the most dramatic (probably ever) politically-motivated peace time disruption of the world economy was justified. Yet, here we are, with much worse to come.

[Sibiriak]

1 hour ago, Ron Put said:

Hm, those statements by WHO, that you think "no one puts any stock into [today],"

Who puts an stock into those March 3rd statements of Tedros today?  Who believes that Covid -19 is " not nearly as contagious as the flu "?   Quote  some key figures who believe that today. 

Which of the influential models determining various countries' policies are based on such an assumption?   Neil Ferguson's model ( Imperial College London ) which played a pivotal role in getting the UK government to abandon their previous "herd immunity" strategy?  The London School of Hygiene and Tropical Medicine's models ?  The Institute for Health Metrics and Evaluation (IHME) ) models (Seattle)?   The University of Washington models?   The Robert Koch Institute's models (Germany) ?  The Pierre Louis Institute of Epidemiology and Public Health's models (France)?  Etc.   I haven't seen any evidence that any country is basing  their policies on that statement Tedros made on March 3rd which you've mentioned in at least a half  dozen posts.

 

Quote

They ARE the reason why much of the world has shut down

According to you.  But assertion is not evidence.

Edited April 8, 2020 by Sibiriak

[Dean Pomerleau]

A fascinating article in Nature about analyzing sewage to get a better handle on how widespread coronavirus is, especially given the lack of widespread community testing.

Here is a highlight:

More than a dozen research groups worldwide have started analysing wastewater for the new coronavirus as a way to estimate the total number of infections in a community, given that most people will not be tested. The method could also be used to detect the coronavirus if it returns to communities, say scientists. So far, researchers have found traces of the virus in the Netherlands, the United States and Sweden.

Analysing wastewater — used water that goes through the drainage system to a treatment facility — is one way that researchers can track infectious diseases that are excreted in urine or faeces, such as SARS-CoV-2.

One treatment plant can capture wastewater from more than one million people, says Gertjan Medema, a microbiologist at KWR Water Research Institute in Nieuwegein, the Netherlands. Monitoring influent at this scale could provide better estimates for how widespread the coronavirus is than testing, because wastewater surveillance can account for those who have not been tested and have only mild or no symptoms, says Medema, who has detected SARS-CoV-2 genetic material — viral RNA — in several treatment plants in the Netherlands. “Health authorities are only seeing the tip of the iceberg.”

--Dean

[TomBAvoider]

Continuing with anecdotal reports :)

I know many folks are experiencing economic hardships, so I don't want to play that down. However, it seems to me, tons and tons of people are still quite flush judging by the pricing side of the economy. A great deal of products are not experiencing downward pricing pressure, but rather the opposite. I look across Amazon, and in general prices seem to be higher, sometimes sharply higher. Supermarkets are constantly short as people keep buying out stuff. A key characteristic of a depression is a collapse in demand. So far, there has not been a sharp collapse in demand - at least some sector demand. This is in keeping with government fiscal and monetary stimulus to keep the demand side strong, hoping for a strong V-shaped recovery rather than a prolonged recession. We'll have to see how this turns out. A V-shaped recovery is probably overly optimistic, but maybe a U shape can be managed.

So, we have a ways to go before we see a slackening of demand and consequent price moderation. So far, from what I can see, prices are rising! All anecdotes of course, we'll have to see what the numbers are once we get government reports. By the way, I read about how fuel prices have collapsed due to oil hitting insane lows, but again, it's all regional - in CA fuel prices have hardly dropped despite the low oil prices and much less driving. It'll all take time to shake out. It's still early in this process.

[Todd Allen]

2 hours ago, Ron Put said:

Looking at Sweden, Belarus and Brazil, and some US states, there is no evidence that a complete lock-downs are significantly better at preventing the spread of Covid-19 than prudent distancing

I see compelling evidence of effectiveness from places using containment strategies such as Singapore, Taiwan, Hong Kong, South Korea and China.

[Ron Put]

4 hours ago, Sibiriak said:

Who puts an stock into those March 3rd statements of Tedros today?  Who believes that Covid -19 is " not nearly as contagious as the flu "?   Quote  some key figures who believe that today. ...

What part of "Covid-19 is CONTAINABLE because it is NOT AS CONTAGIOUS like the flu" is giving you trouble? This was the main reason why WHO called for all countries to implement lock-downs.

Here is an example:

"WHO Director-General Tedros Adhanom expressed the concern in a press briefing on Thursday, saying that some countries were laxed in the war against the virus.

"Despite our frequent warnings, we are deeply concerned that some countries are not approaching this threat with the level of political commitment needed to control it," he said. "Let me be clear: describing this as a pandemic does not mean that countries should give up. The idea that countries should shift from containment to mitigation is wrong and dangerous. On the contrary, we have to double down.""

Many experts disagreed, but were then attacked by the press:

This will not be contained': Experts cast doubt that spread of COVID-19 can be stopped

"But some medical experts believe that the containment stage has long since passed, that the spread of the COVID-19 is inevitable, and that living with the coronavirus could become a reality. COVID-19 is the respiratory illness caused by the new coronavirus.

"This will not be contained, this has not been contained," said Isaac Bogoch, an infectious disease physician at Toronto General Hospital....

Some have suggested the virus will run its course throughout the world and burn itself out, while others believe that the novel coronavirus will integrate itself into the seasonal viruses that come around every winter, causing clusters of COVID-19.

"This is going to become like some of the other coronaviruses that we have. There are four of them that cause disease every year. This is likely to become the fifth coronavirus at that capacity,"  Adalja said.

"This isn't unprecedented. And the vast majority of cases are going to be mild," he said. "This isn't something that's going to be cataclysmic."

In the UK, the Oxford study which said the same thing was mocked by Ferguson and by the press. In the US, political opportunists like Cuomo and Newsom in the US used it to declare that Trump failed as a leader, because he did not impose a lock-down. Then they implemented their own lock downs, hailed as "true leaders" by the US media. In Italy and some other parts of Europe, it was the Right which used the WHO praise of the China model to push for a local lock-downs.

Again, this was a political, not a medical crisis. I hate defending Trump, but he was right on this. Being an opportunist and a populist himself, he changed course, one-upped the Democrats and his poll numbers started raising. He is likely to get reelected, and we all deserve our leaders (this goes for Sibiriak, too).

 

___

2 hours ago, Todd Allen said:

I see compelling evidence of effectiveness from places using containment strategies such as Singapore, Taiwan, Hong Kong, South Korea and China.

4 hours ago, TomBAvoider said:

So far, from what I can see, prices are rising! All anecdotes of course, we'll have to see what the numbers are once we get government reports.

I am certain that you personally see all kinds of things.... Is this why Covid is in virtually every country in the world, just like the flu?

Here is an example of a government report:

French economy shrinks to WW2 levels, no end in sight for Covid-19 lockdown

___

4 hours ago, Dean Pomerleau said:

A fascinating article in Nature about analyzing sewage to get a better handle on how widespread coronavirus is, especially given the lack of widespread community testing....

This is interesting indeed, as it is how the Netherlands discovered the Covid-19 infection was present, before they had any actual cases. All kinds of live viruses are routinely found in the sewage systems around the world, having survived treatment. While it sounds scary, I am not aware of any cases of an infection spreading this way.

On the other hand, it is the reason why social media spread the rumors that nobody should go on the beach, because the water spray/vapor will infect them. 

Edited April 9, 2020 by Ron Put

[BrianA]

Tom, regarding short term pricing trends or empty shelves being indicative of economic okay-ness, I would disagree. These issues are being driven by significant supply chain disruptions, along with certain areas of the economy such as food having traditionally operated in a very bifurcated manner. By that I mean when it comes to food in the US, there are separate manufacturing facilities and distributors for the retail grocery side of things and the restaurant/institutional side. This is why you're seeing some shortages and crowds at the retail groceries currently - a lot of restaurants and institutions like schools are closed, so almost all food is having to be produced and distributed via the retail chain, leading to some problems. If you look at the restaurant food distributors like Sysco or US Foods they are on the other hand suffering significant economic damage, not to mention smaller restaurant food distributors and producers who may go out of business completely.

 

As for prices at Amazon, there currently is a large reduction in competition on many products that are "non-essential" as Amazon was forced by overwhelming demand to disallow sellers from sending in those products to the Amazon warehouses. Other issues are lack of ability to obtain new inventory due to other kinds of supply chain disruptions going on. Worldwide air cargo capacity has been sharply reduced and prices for it increased drastically, so getting fresh inventory from China or other locations is currently either more expensive and/or slower than usual.

 

Basically you're seeing various types of shortages and lack of competition in the supply chain, not necessarily increasing consumer demand overall.

[TomBAvoider]

Good points, Brian. But at the same time, people are hoarding, which indicates demand is not depression-era dead; this might be because it's still early, and we'll have to wait until the full effects hit.

[Gordo]

1 hour ago, TomBAvoider said:

Good points, Brian. But at the same time, people are hoarding, which indicates demand is not depression-era dead; this might be because it's still early, and we'll have to wait until the full effects hit.

Yea demand for survival supplies (food, guns, ammo) is through the roof - not sure that supports your apparent argument though. With skyrocketing unemployment I would not expect demand for non-essentials to be very strong. Wait until luxury car sales numbers come out, or all auto sales for that matter, how about new and existing home sales? Analysts are expected the worst drop in GDP in our country's history. The gas price in California and some other states is largely taxes. How about actual national data though?

You do touch on one thing I’m concerned about - people are starting to hoard food, even farmers are now panic buying feed for livestock, and this is causing problems. If it escalates, life is going to get even more interesting. I drove by two grocery stores today that had totally packed parking lots. I’ve seen videos I won’t post links to of food hoarding in China. This type of thing can easily spread. Even though it’s irrational, the rumor mill causes people to do things they wouldn’t otherwise do. Then in a twisted sense it becomes rational - “maybe I better secure as many bags of rice and canned food as I can before it’s all gone due to all those irrational people buying up all the supplies”.

 

Edited April 9, 2020 by Gordo

[TomBAvoider]

Yeah, I am speculating and it's all gut feel and anecdotal - which I'm very aware of! - so we have to wait for government data to come out (not that it's necessarily super accurate). The breakdowns in supply chains have all sorts of weird effects. Farmers are throwing out milk, literally dumping into the ground, because they can't sell it all - meanwhile, where I'm at, there are milk shortages and the stores are only selling limited quantities per person. What puts a big kink into all of this is the fact that a huge amount of agricultural products were going into the restaurant and other kinds of supply businesses or organizations (like schools with their lunches and milk programs etc.) which have now been shut down - so the producers can't get rid of their stock and don't have the distribution system to switch it all to supermarkets. It's just a mess. One of the weaknesses of mature systems is that an infrastructure built on JIT (Just In Time) doesn't have the flexibility to deal with dramatic spikes in demand or supply - the flexibility is along fractions of a percentage point, so if the disruption is on the order of several percentage points, the whole system breaks down.

It will take time for it all to shake out. Meanwhile, speaking of hoarding - the authorities are telling us that we should avoid going out AT ALL this week, including trying not to even go to the grocery store. No problem for us (my wife and me), as we're set for at least 6 weeks, but this is some kind of BS - because all you're doing is bunching up the demand even worse. And who wants to bet that next week it won't be BUT THIS week you really should not go out even to the grocery store, and so on for the rest of April and into May depending on the area. I'm sorry, but this just encourages hoarding. I even had this discussion with my wife - sure, we are fine for several weeks, but do we really want to exhaust everything down to the last reserve and then have to go out and battle it out with the hungry hordes? It might make more sense to re-supply when we still have some small reserves so that something unexpected doesn't leave us high and dry. And speaking of "rationality" - when you go out and re-supply "bigly" so that you won't have to come back too often exposing yourself to the virus (and others), people will look at you weird as you are a "hoarder". But what's the alternative - buy a little and constantly keep running back and forth to the store causing crowding and potentially spreading germs? So this rationality business is not so straightforward - there may be a case made for "hoarding". But really there is no happy solution here, there has to be some kind of balance between supply and demand, and I guess a price equilibrium will be reached. Maybe it'll come down to ration cards like during WWII :)...

[BrianA]

Here's some interesting news that air pollution may significantly affect C19 death rates. Combine with a map of Europe's annual pm 2.5 pollution exposure, and you can see why North Italy might fare a lot worse?

 

Harvard study finds small increase in long-term exposure to PM2.5 leads to a large increase in COVID-19 death rate

https://www.greencarcongress.com/2020/04/20200408-harvard.html

 

 

PM2.5 annual mean in 2016

https://www.eea.europa.eu/data-and-maps/figures/pm2-5-annual-mean-in-1

[Sibiriak]

High Contagiousness and Rapid Spread of Severe Acute Respiratory Syndrome Coronavirus 2 [CDC    Emerg Infect Dis. 2020 Jul]  

 

Quote

Abstract

Severe acute respiratory syndrome coronavirus 2 is the causative agent of the 2019 novel coronavirus disease pandemic. Initial estimates of the early dynamics of the outbreak in Wuhan, China, suggested a doubling time of the number of infected persons of 6–7 days and a basic reproductive number (R₀) of 2.2–2.7. We collected extensive individual case reports across China and estimated key epidemiologic parameters, including the incubation period. We then designed 2 mathematical modeling approaches to infer the outbreak dynamics in Wuhan by using high-resolution domestic travel and infection data.

Results show that the doubling time early in the epidemic in Wuhan was 2.3–3.3 days. Assuming a serial interval of 6–9 days, we calculated a median R₀ value of 5.7 (95% CI 3.8–8.9).

We further show that active surveillance, contact tracing, quarantine, and early strong social distancing efforts are needed to stop transmission of the virus.

 

Quote

Discussion

In this study, we estimated several basic epidemiologic parameters, including the incubation period (4.2 days), a time dependent duration from symptom onset to hospitalization (changing from 5.5 days in early January to 1.5 days in late January outside Hubei Province), and the time from symptom onset to death (16.1 days). By using 2 distinct approaches, we estimated the growth rate of the early outbreak in Wuhan to be 0.21–0.30 per day (a doubling time of 2.3–3.3 days), suggesting a much faster rate of spread than initially measured. This finding would have important implications for forecasting epidemic trajectories and the effect on healthcare systems as well as for evaluating the effectiveness of intervention strategies.

We found R₀ is likely to be 5.7 given our current state of knowledge, with a broad 95% CI (3.8–8.9). Among many factors, the lack of awareness of this new pathogen and the Lunar New Year travel and gathering in early and mid-January 2020 might or might not play a role in the high R₀. A recent study based on structural analysis of the virus particles suggests SARS-CoV-2 has a much higher affinity to the receptor needed for cell entry than the 2003 SARS virus (21), providing a molecular basis for the high infectiousness of SARS-CoV-2.

How contagious SARS-CoV-2 is in other countries remains to be seen. Given the rapid rate of spread as seen in current outbreaks in Europe, we need to be aware of the difficulty of controlling SARS-CoV-2 once it establishes sustained human-to-human transmission in a new population (20).

Our results suggest that a combination of control measures, including early and active surveillance, quarantine, and especially strong social distancing efforts, are needed to slow down or stop the spread of the virus. If these measures are not implemented early and strongly, the virus has the potential to spread rapidly and infect a large fraction of the population, overwhelming healthcare systems.

Fortunately, the decline in newly confirmed cases in China and South Korea in March 2020 and the stably low incidences in Taiwan, Hong Kong, and Singapore strongly suggest that the spread of the virus can be contained with early and appropriate measures.

 

Forbes article on that study:

The COVID-19 Coronavirus Disease May Be Twice As Contagious As We Thought

 

Quote

The new study, published in the Emerging Infectious Diseases journal, shifts the R0 for COVID-19 from about 2.2 to about 5.7. With the lower number, only 55% of a population needs to be immune from COVID-19 to stop its spread through herd immunity. Herd immunity refers to enough of a population being immune to a disease that the disease cannot travel through it. 

But if more people get infected from a single person with COVID-19, then more people need to be protected from the disease to stop it from continuing to spread. With an R0 of 5.7, approximately 82% of the population needs to be immune to reach herd immunity and stop the disease from spreading easily through the population, the researchers concluded. The new calculations also estimate the incubation period—the time from being exposed to the virus and developing symptoms—to be an average of 4.2 days, which is in line with most other estimates (though symptoms can still take up to 14 days to show up). 

Because people can be contagious before realizing they are infected, identifying and isolating patients, plus following up with people they interacted with, will only work to contain COVID-19 if only a small number of people with the disease aren’t aware they’re infected.  Because people can be contagious before realizing they are infected, identifying and isolating patients, plus following up with people they interacted with, will only work to contain COVID-19 if only a small number of people with the disease aren’t aware they’re infected. 

[...] The new R0 applies specifically to data collected in China. “How contagious SARS-CoV-2 is in other countries remains to be seen,” the authors wrote. “Given the rapid rate of spread as seen in current outbreaks in Europe, we need to be aware of the difficulty of controlling SARS-CoV-2 once it establishes sustained human-to-human transmission in a new population.”  That much is now obvious to people following the news on COVID-19’s spread. The authors recommend the same strategies to control the disease that you’ve likely been hearing about.   “Our results suggest that a combination of control measures, including early and active surveillance, quarantine, and especially strong social distancing efforts, are needed to slow down or stop the spread of the virus,” the authors wrote. “If these measures are not implemented early and strongly, the virus has the potential to spread rapidly and infect a large fraction of the population, overwhelming healthcare systems.”

 

Edited April 9, 2020 by Sibiriak

[Gordo]

BREATHE EASY - NHS doctor shares breathing technique that JK Rowling claims helped her recover from coronavirus

[Dean Pomerleau]

[Edit: Sorry - I noticed Siberiak already commented on this news a few posts above, which I missed. I think my marked-up diagram makes the post worth keeping it around.]

The US CDC is out with a new paper [1] that estimates the R₀ for covid-19. R₀ is average number of people infected by each sick person absent any measures to slow transmission.

They come up with an estimate for R₀ of 5.7 (95% CI 3.8-8.9). This is much higher than the initial estimate for R₀ of ~2-2.5.

Here is approximately where the new estimate puts covid-19, although the fatality rate will likely be somewhat lower than the single dot I've drawn when/if we are able to get a final handle on the number of asymptomatic people infected:

Given this higher R₀, the authors emphasize the importance of social distancing measures to slow the spread. They also address the implication of this higher R₀ for "herd immunity", saying it will take a much higher fraction of the population (>82%) to be immune (via prior infection or vaccine) in order to make the disease disappear:

For example, the threshold for combined vaccine efficacy and herd immunity needed for disease extinction is calculated as 1 – 1/R0. At R0 = 2.2, this threshold is only 55%. But at R0 = 5.7, this threshold rises to 82% (i.e., >82% of the population has to be immune, through either vaccination or prior infection, to achieve herd immunity to stop transmission).

--Dean

--------------

[1] Emerg Infect Dis. 2020 Jul [date cited].

High contagiousness and rapid spread of severe acute respiratory syndrome coronavirus 2.

Full text: https://doi.org/10.3201/eid2607.200282

Sanche S, Lin YT, Xu C, Romero-Severson E, Hengartner N, Ke R.

Abstract

Severe acute respiratory syndrome coronavirus 2 is the causative agent of the 2019 novel coronavirus disease pandemic. Initial estimates of the early dynamics of the outbreak in Wuhan, China, suggested a doubling time of the number of infected persons of 6–7 days and a basic reproductive number (R0) of 2.2–2.7. We collected extensive individual case reports across China and estimated key epidemiologic parameters, including the incubation period. We then designed 2 mathematical modeling approaches to infer the outbreak dynamics in Wuhan by using high-resolution domestic travel and infection data. Results show that the doubling time early in the epidemic in Wuhan was 2.3–3.3 days. Assuming a serial interval of 6–9 days, we calculated a median R0 value of 5.7 (95% CI 3.8–8.9). We further show that active surveillance, contact tracing, quarantine, and early strong social distancing efforts are needed to stop transmission of the virus.

[Dean Pomerleau]

Being gluttons for punishment, my wife and I watched the 2011 movie Contagion last night. The disease and the social upheaval were more severe than covid-19. The virus in the movie had an R₀ of ~4 which now appears to be in line with or even a bit below covid-19 (see above), but it had a much higher fatality rate of ~20-25%.

If you are fascinated by this stuff and don't mind it hitting pretty close to home, I recommend it. It is available to rent on Amazon Prime for $3.99.

***** Spoiler Alert *********

 

 

 

 

 

Many aspects of the movie were pretty true to life, which we wouldn't have appreciated if we weren't living through it. It even had what turned out to be an ineffective "treatment" hyped by a charlatan pretending to be a medical expert 🙂. There was an amusing cameo appearance by a much younger Dr. Sanjay Gupta from CNN.

One thing that I thought was interesting that we might eventually see come to pass - in the movie, people that were immune either via having been infected and recovered or (eventually) having received the vaccine are given special bracelets to wear in order to be able to move about freely. People who hadn't been either infected and recovered or vaccinated had to remain in their homes until it was there turn to get the vaccine.

The other thing that was realistic was the virus' origin - a bat transferred it to a pig which transfered it to the first human when it was slaughtered. The efforts by the CDC and WHO to trace back the origin of the disease was also really interesting.

--Dean

[Gordo]

I watched "Contagion" several weeks ago 😉

Today my state's governor announced all private and public schools would be closed to students (online learning only) for the rest of the academic year.

I see growing dissent...

 

Meet the former NYT reporter who is challenging the coronavirus narrative

As daily life across America is upended by the coronavirus crisis -- with mass business closures plunging the economy into freefall -- one former New York Times reporter is sounding the alarm about what he believes are flawed models dictating the aggressive strategy.

Alex Berenson has been analyzing the data on the crisis on a daily basis for weeks and has come to the conclusion that the strategy of shutting down entire sectors of the economy is based on modeling that doesn't line up with the realities of the virus.

Berenson is a former reporter who worked for the Times from 1999 to 2010 primarily covering the pharmaceutical industry. He recently came to prominence again with a book, "Tell Your Children The Truth About Marijuana, Mental Illness, and Violence," which challenged prevailing narratives on marijuana.

In the face of a broadening consensus on both the left and the libertarian right that sees marijuana as mostly healthy and even a positive in some circumstances, Berenson argued that the evidence instead shows a link between the drug and serious mental illness and an epidemic of violence.

Now he's turned to challenging the narratives on the response to the coronavirus. What Berenson is promoting isn't coronavirus denialism, or conspiracy theories about plots to curb liberties. Instead what Berenson is claiming is simple: the models guiding the response were wrong and that it is becoming clearer by the day.

"In February I was worried about the virus. By mid-March I was more scared about the economy. But now I'm starting to get genuinely nervous," he tweeted this week. "This isn't complicated. The models don't work. The hospitals are empty. WHY ARE WE STILL TALKING ABOUT INDEFINITE LOCKDOWNS?"

Hospitals, of course, are not empty in places like hard-hit New York City, and tales are widespread of overburdened doctors and emergency rooms. Berenson acknowledged as much in the interview Thursday.

Concerns that this virus is significantly more contagious and deadly than any ordinary flu strain are what's driving the current government approach, in America and around the world. Perhaps due in part to more testing, America reports the highest number of cases in the world right now, with more than 430,000 cases and nearly 15,000 deaths. Symptoms vary widely, with some patients reporting only minor discomfort yet others dealing with crushing physical pain and struggling to breathe, forced to go on ventilators.

But Berenson is taking a broader look. He initially challenged the model put forward by the Imperial College in London, when one of the authors of the models appeared to significantly walk back projections that the U.K. would see 500,000 people killed by the disease to closer to 20,000 -- although the author later said that the 500,000 prediction was without social distancing measures, and 20,000 was with them in place. That model is being used to advise the U.K. government on its strategy for the virus.

"That was March 22 or 23, and ever since then I've been paying incredibly close attention to the modeling and trying to figure out whether it lines up with what we're seeing in reality -- and the answer is it hasn't lined up at all," he said.

Recently he's been focusing on discrepancies within the University of Washington's Institute for Health Metrics and Evaluation (IHME) model. That model has come under renewed scrutiny as it has revised its metrics multiple times. It once predicted more than 90,000 deaths by August but recently issued a new estimate that has the figure closer to 60,000. Government officials say it's a model that's moving with what the country is doing.

"We believe that our health care delivery system in the United States is quite extraordinary," Dr. Deborah Birx said at a White House press briefing on Wednesday. "I know many of you are watching the Act Now model and the IHME model— and they have consistently decreased the number, the mortality from over almost 90,000 or 86,000, down to 81,000 and now down to 61,000. That is modeled on what America is doing. That's what's happening."

Dr. Anthony Fauci said that the indicators are that social distancing efforts are working: "Because remember, what you do with data will always outstrip a model. You redo your models, depending upon your data, and our data is telling us that mitigation is working."

But Berenson argues that those models have social distancing and other measures baked into them. As for further proof, he says that outside of places like New York there has not been a national health crisis that was predicted -- nor are there signs that the level of lockdown in various states has made a difference.

"Aside from New York, nationally there's been no health system crisis. In fact, to be truly correct there has been a health system crisis, but the crisis is that the hospitals are empty," he said. "This is true in Florida where the lockdown was late, this is true in South Carolina where the lockdown was early, it's true in Oklahoma where there is no statewide lockdown. There doesn't seem to be any correlation between the lockdown and whether or not the epidemic has spread wide and fast."

He has also argued, in lengthy Twitter threads, that the drop in cases seen in various states has come before lockdowns would have had an impact -- since it takes a few weeks for social distancing measures to take effect due to the window between infection and symptoms.

Berenson blames the models for a response that has effectively shut down large sectors of the economy and is causing significant financial harm to Americans. On Thursday it was announced that the number of Americans seeking unemployment benefits swelled to 6.6 million last week, surging for the third consecutive week. Congress has sought to alleviate the pain by boosting those jobless benefits.

His is a view that has seen some sympathy from President Trump, who has spoken about the "cure being worse than the problem" and has indicated that he is keen to end the strict measures as soon as is possible -- saying Wednesday he wants to re-open the economy with a "big bang."

Berenson says the correct response in the initial days of the crisis would not have been to do nothing, but instead to adopt a more measured and targeted approach.

"There was incredible pressure to do something ... so these lockdowns all cascaded, every governor tried to outdo the next. And no one stopped and said 'OK what about Japan, they don't seem to have a terrible epidemic, they wear masks, maybe we should wear masks," he said.

He said other measures such as protecting individuals particularly at risk, and even things such as banning large gatherings such as concerts and sporting events could have been appropriate. But now he fears it may be too late for officials to say they overreacted.

"Now we're in a bad spot because there's clearly a dangerous political dynamic right now -- the economy is in freefall, a lot of people are hurting. If we acknowledge what is clearly happening ... the people who made these decisions, I think there's going to be a lot of anger at them, so they don't want to acknowledge it, so they say 'oh it's the lockdown that saved us,'" he says.

Berenson is not a known partisan. His Twitter feed and other works contain few references to specific politicians, and there's no indication that he's in this to bash or defend Trump or either political party. But he noted that, like with his conclusions on marijuana, there has been a distinct lack of interest from the left.

"I went to Yale and I worked for the New York Times, the people on the left hold themselves out as being science-driven, as being smarter, they think they're smarter but they won't look at facts that won't meet their narratives," he said.

He voiced frustration that these arguments have been ignored by a lot of mainstream outlets.

"That is frustrating for me ... but everyone needs to hear this counterargument, whether or not it's right, you need to hear it because the damage we are doing to ourselves right now is so enormous."

[Dean Pomerleau]

Here is a really good video discussing the Covid-19 blood type susceptibility paper. For the first 10 minutes it talks about the basics of ABO blood types and following that it talks about why different blood types might have different susceptibility to covid-19. 

I'll try to summarize. People with O-type blood have anti-A (and anti-B) antibodies, meaning if they receive A- (or B-) type blood via a transfusion, their anti-A (or anti-B) antibodies will attach to the A (or B) antigens on the surface of the transfused red blood cells causing the cells to clump (i.e. coagulate) in their veins - obviously a very bad thing. That's why O-type people must receive O-type blood and can die if they receive A or B type blood.

Previous in-vitro studies of the original SARS virus (SARS-cov1) showed that anti-A antibodies (which O-type people carry) also attach to the spike protein on the surface of the virus, tagging it for the immune system to destroy. So the authors thought it was worth looking at the prevalence of covid-19 among different blood groups to see if a similar thing might be happening in vivo among O-type individuals.  Sure enough, the authors found infections occurred at a lower rate in O-type people relative to their proportion in the population. They therefore speculate that the anti-A antibodies in the bloodstream of O-type people might be tagging the virus for the immune system to eliminate, thereby conferring some degree of protection from the virus among O-type individuals. 

But the video's creator remains skeptical, both because of potential confounders and because B-type people (who also have the anti-A antibodies in their bloodstream) didn't seem to be protected from the virus. So the jury is still out on the blood-type issue for covid-19. But it was interesting to learn how certain blood types might conceivably be protective, and what different blood types really mean in terms of antigens and antibodies.

--Dean

 

 

[Sibiriak]

Quote

But Berenson argues that those models have social distancing and other measures baked into them.

Really?   There is a whole range of social distancing measures.  Which degree is "baked in"?   Maximum social distancing?  Minimum social distancing?  Which measures?  How are they "baked in"?  Evidence?

Quote

WHY ARE WE STILL TALKING ABOUT INDEFINITE LOCKDOWNS?

Isn't that a bit of a straw man?   Who's talking about indefinite lockdowns? Most discussion is about limited lockdowns and many variations on how to ease out of them,  and how to find a balanced approach. (Even the disgraced and discredited China-puppet Tedros Adhanom Ghebreyesus said " all countries must strike a fine balance between protecting health, preventing economic and social disruption, and respecting human rights. "

Edited April 9, 2020 by Sibiriak

[TomBAvoider]

I first saw Berenson on the Joe Rogan podcast:

I was not overy impressed insofar as he didn't write a book to examine the issue dispassionately, instead it was a book that - as admitted by himeself - was making a case and so emphasized the evidence of one side and suppressed the other.

That said, I don't think there is no value in such "case making" books or approaches, and I do agree very strongly with him in this quote from Gordo's post:

"[...]everyone needs to hear this counterargument, whether or not it's right, you need to hear it because the damage we are doing to ourselves right now is so enormous."

Anyone who is interested in the truth - and we all should be - ought to address legitimate arguments, regardless of what side we fall on. The fact that there isn't much engagement with these arguments is certainly disappointing. YMMV.

[Sibiriak]

On 4/8/2020 at 7:56 PM, Gordo said:

COVID-19 REINFECTION RISK QUESTIONED AFTER LOW LEVELS OF ANTIBODIES FOUND IN RECOVERED PATIENTS

I wonder what, if any, implications this has for the prospects of an effective vaccine?

And what are the implications for the feasibility of a "herd immunity" strategy in the absence of mass vaccination?

Quote

The researchers found that the antibody level in around a third of the patients may be too low to provide protection. "About 30 percent of patients failed to develop high titers [concentrations] of neutralizing antibodies after COVID-19 infection

 

Edited April 9, 2020 by Sibiriak

[Dean Pomerleau]

5 hours ago, Gordo said:

Quoting former NYT reporter:

"Aside from New York, nationally there's been no health system crisis. In fact, to be truly correct there has been a health system crisis, but the crisis is that the hospitals are empty," he said. "This is true in Florida where the lockdown was late, this is true in South Carolina where the lockdown was early, it's true in Oklahoma where there is no statewide lockdown. There doesn't seem to be any correlation between the lockdown and whether or not the epidemic has spread wide and fast."

First of all, I'm all for making plans to intelligently relax the stay-at-home orders, hopefully learning from the experience in China and Italy.

But the above statement seems rather naive to me. First of all, the hospitals in some parts of the country besides NY are under serious stress, including in parts of Louisiana, Chicago and Detroit. Gordo, our own state (Pennsylvania) is seeing the third highest rate of new infections (after NY and NJ). In short, many parts of the US aren't out of the woods yet.

Moreover, making a blanket comparison between lockdown onset date and hospital load is bogus, since it fails to take into account other factors that influence rate of spread, including when the virus started spreading in a particular city/state (relative to the lockdown date), the city/state's population density, ability to test and quarantine suspected cases etc. 

Plus, it think he's just wrong about the effectiveness of stay-at-home orders at stopping the spread, as long as it happens early enough. Two cities in our own state of Pennsylvania (Philadelphia and Pittsburgh) make for a good comparison. They both have about the same population (1.5M vs. 1.2M) and were put on lockdown on the same day (March 23rd). Unfortunately for Philadelphia, its proximity to the NY/NJ hotspot meant it has many more cases than Pittsburgh at the onset of the lockdown. Since then the number of cases and deaths in Philadelphia has risen precipitously and currently stands at 5029 cases and 89 deaths, while Pittsburgh has kept the outbreak much more under control with just 729 cases and 12 deaths so far. 

This illustrates that what counts when it comes to controlling the outbreak in a region is the date of the lockdown relative to how widespread the virus is circulating at the time in that area. Lombardy, New York City and Philadelphia didn't lockdown early enough relative to their case load to stop the spread before it got out of hand and are suffering the consequences.

Note - this is total orthogonal to whether the benefit of a prolonged and ongoing lockdown is worth the cost in terms of social and economic impact.

It is simply to say that lockdowns do work to bring the effective R below 1, stopping the exponential spread of the virus, which now appears to has a very high R₀ (CDC estimated R₀ > 5). The evidence for this is clear as locations around the world, from Wuhan to Lombardy to Seattle to NYC which have seen their rate of new cases and deaths plateau and in some cases drop substantially, very much short of the penetration (~82%) that would be required to stop the virus naturally via herd immunity alone (i.e. without any social isolation).

Lockdown is clearly a very blunt instrument. I think our governor has done pretty well instituting the lockdown progressively in Pennsylvania, starting with the big cities and surrounding counties where the virus was really starting to spread, and then expanding it to more rural counties as they began to experience community spread, and finally to the whole state.

Now is the time to starting thinking about doing the reverse, i.e. loosening restrictions in areas where the virus is under control and/or for professions/activities where social distance can be effectively maintained (e.g. construction work).

--Dean

 

[Dean Pomerleau]

4 hours ago, Gordo said:

Quoting a former NY Times reporter:

"Aside from New York, nationally there's been no health system crisis. In fact, to be truly correct there has been a health system crisis, but the crisis is that the hospitals are empty," he said. "This is true in Florida where the lockdown was late, this is true in South Carolina where the lockdown was early, it's true in Oklahoma where there is no statewide lockdown. There doesn't seem to be any correlation between the lockdown and whether or not the epidemic has spread wide and fast."

He's not even accurate. South Carolina wasn't early. It didn't lock down until two days ago (April 7th).

--Dean