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


Gordo

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This just posted by Josh Mitteldorf a few hours ago - his Aging Matters blog well known to long-time members of CRSociety

https://joshmitteldorf.scienceblog.com/2020/04/15/overreaction/

I have no opinion yet on the piece yet as I have not read as of the time of this posting ( earmarked for this afternoon) and I do not want to read too much into the title of the commentary without diving into the details and arguments presented.

I generally vet  commentaries before posting which is a great general rule of thumb,  but given the author’s place in the “life extension” space ( he takes a controversial genetic and species genetically programmed perspective on aging but regardless how you feel about this, Josh regularly takes deep dives into geroscience ), it is interesting to get his perspective.  

All the more so and timeliness of this heads up post with our  upcoming CR Society meeting this Saturday......a little fun controversy amidst serious deliberation and debate can be a good thing!

Edited by Mechanism
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Sibiriak, your video post was beyond words.  A scary segment at multiple levels.  At the same time, understandable that we are witnessing this at all levels: we are talking lives, jobs, freedom, social responsibility and core issues at the heart of our greatest needs and most deeply held values.....

With so much at stake, and rather than  sound bites and simple yes/no policy , we need a careful and nuanced science-grounded approach appropriately balancing the high stakes at all sides of this. 

Edited by Mechanism
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1 hour ago, Mechanism said:

https://joshmitteldorf.scienceblog.com/2020/04/15/overreaction/

I have no opinion yet on the piece yet as I have not read as of the time of this posting ( earmarked for this afternoon) and I do not want to read too much into the title of the commentary without diving into the details and arguments presented.

Josh's post was dated April 15th.  It contains the following statement:

Quote

The good news is that daily deaths from the virus have peaked worldwide, and begun their decline.

and then poses a question which he attempts to answer:

Quote

Does it make sense to continue with policies of economic shutdown and social isolation now that COVID is declining?

Unfortunately on the 15th the US set a new high for daily deaths of 2407 beating the previous high of 2035.  On the 16th the US broke that high with 2482 deaths and the world also set a new high of 7,959 well in excess of the previous high of 7,385.  So the above declarative statement made with no hedging is clearly wrong the day after it was made.  At this moment I consider the article largely rubbish although I hope it eventually turns out to be close to correct.  But it is too early to say much of anything definitively.   We lack good data on the percent of the population infected in hard hit areas or how many will ultimately be infected.  In much of the world there are extremely few counted deaths so far.  Either the virus has only begun to spread in those places or we are grossly under counting deaths.  So far all of the hard hit places are ones that have been able to implement measures such as social distancing and lock downs.  We don't yet know how bad it may get in places with less capacity to slow the spread.   It ain't over till the fat lady sings.

Edited by Todd Allen
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1 hour ago, Todd Allen said:

Unfortunately on the 15th the US set a new high for daily deaths of 2407 beating the previous high of 2035.  On the 16th the US broke that high with 2482 deaths....

This appears related to the "new guidelines" which now count probable cases and deaths in addition to confirmed ones.

As expected, those who imposed the lock-down must justify their position and a low death toll can be problematic for them. So, if the established way of counting doesn't get them scary enough numbers, they are finding new ways to count and pad the numbers. The same happened in Italy, and it's happening in the UK.

A number of hospital reports have noted the sharp drop in hospital and emergency visits for stuff like heart attacks and strokes. The consequences appear likely to result in increases in at-home deaths and elderly facilities deaths, many of which are now added to the official Covid-19 fatalities. As this is largely politically driven, I expect it to result in political fights over counting methods, with the media playing its part in it.

Where Have All the Heart Attacks Gone?

"The hospitals are eerily quiet, except for Covid-19.

I have heard this sentiment from fellow doctors across the United States and in many other countries. We are all asking: Where are all the patients with heart attacks and stroke? They are missing from our hospitals.

Yale New Haven Hospital, where I work, has almost 300 people stricken with Covid-19, and the numbers keep rising — and yet we are not yet at capacity because of a marked decline in our usual types of patients. In more normal times, we never have so many empty beds."

---

But let's see where we get. Even with the padded mortality numbers, the combined US flu and Covid-19 death toll is unlikely to end up much higher than the 61,000 deaths from the 2017-2018 flu season. Italy's combined flu and Covid-19 death toll is still lower than the upper estimate for the 2017-2018 flu season deaths, even with their padded numbers. 

The real proof of where we really are will emerge only when we have sufficient serologic tests data to show what percent of the population has already been infected. I wonder how that will be span.

Of note, now that Denmark is ending their lock-down by sending kids to school (which is the recommendation Prof. Wittkowski makes in the video above), the UK and US news coverage is suddenly silent on Sweden and is no longer predicting dire consequences and urging a lock-down. It'd be very interesting to see how antibodies and immunity are distributed among the Swedish and Danish populations, as one refused to lock-down, while the other imposed a lock down.

Edited by Ron Put
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On 4/14/2020 at 10:57 AM, Gordo said:

And yet here we sit near epic all time high [stock market] valuations as a whole.  I know many believe it is not a good idea to time the market, just ride everything out, there is no way to consistently beat the averages...  I don't know, we'll see what happens, should be interesting to watch. I think  some of these high yield bonds  may be better investments than stocks.

Gordo,

First off, I'm not an economist or investment professional, so take what I say with a grain of salt.

I agree the stock market seems out of whack with the reality on the ground and time will tell how it shakes out. But it seems to me that the Fed's printing money and giving it to (mostly big) corporations make the stock market a better long-term investment than bonds, as long as one has the cash reserves to survive what could be a rough couple years.

It sucks for the vast majority of Americans, but it seems like one more example of Picketty's rule that capital almost invariably outperforms labor in an economy, especially since capital has captured government, at least in the US:

Capital (which by Piketty’s definition is pretty much the same thing as wealth) has tended over time to grow faster than the overall economy. Income from capital is invariably much less evenly distributed than labor income. Together these amount to a powerful force for increasing inequality.

Which reminds me of what Jim Cramer, the host of the investment show Mad Money recently said:

“There’s a seething anger sweeping this country and it’s directed point-blank at Wall Street,” he said on “Mad Money” after the closing bell marked the end of another market advance. “This relentless rally seems unfair, it seems senseless and it seems heartless.”
Cramer said he understands why the screenshot might have struck a nerve:

         Screenshot_20200416-134731_Chrome.jpg

“I agree it’s messed up, but the contrast between a roaring stock market and an obliterated job market does tell you a lot about what’s happening at this moment,” he explained. “The stock market’s made up of big, huge companies, not the small- to medium-sized businesses that are the backbone of our economy. You don’t have to like it — I know I don’t — but it’s the big dogs with pristine balance sheets and gigantic scale that can survive this lockdown.”

It's possible we'll have a (hopefully bloodless) revolution in the US to upend the social order where the rich get richer. But I don't think it likely with Biden as the presumptive Democratic nominee, the Fed willing to print an unlimited amount of new money and the federal government willing to send out checks to everyone to (hopefully) keep them from starving or revolting.

It is certainly true the Fed may lose the fight this time, given the magnitude of the economic disruption caused by the virus and the resulting lockdown. But unless/until there is a revolution that overturns the advantage that capital has over labor it seems likely that stocks will continue to be the best investment, at least for those with a long time horizon.

--Dean

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1 hour ago, Dean Pomerleau said:

....

“There’s a seething anger sweeping this country and it’s directed point-blank at Wall Street,” he said on “Mad Money” after the closing bell marked the end of another market advance. “This relentless rally seems unfair, it seems senseless and it seems heartless.” ...

Yeah, this will be another wedge used by those populists who imposed the lock-downs and destroyed their economies: Deflect the popular anger to "Wall Street" instead of asking why those "leaders" caused the economic collapse.

Massive political blunders, including wars, always have losers and winners, even if in some cases the losers vastly outnumber the winners. Thus it's easy to come up with a strategy to blame "The Corporations" for the failures of the political "leaders" and ignore the fact that much of "Wall Street" is actually your own pension fund. Also ignore the fact that they cheered the "free money" bidding war between the Democrats and Trump.

Cuomo and Newsom are looking for a federal bailout for their decision to lock down their states, , just like Italy, is looking to the EU. The problem is, the only one the US feds can ask to bail us out is, uhm..., China.

Edited by Ron Put
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It's all well and good to play the "blame game", whoever ends up blamed (everyone). But there are also stark realities - wealth inequality is at pretty extreme levels. That's a fact. This reality - regardless of the blame game - is a destabilizing factor. If the wealth concentration is skewed to the point where very large majorities lose any stake in the game, you have a recipe for revolt - people will opt out of an arrangement that seems to condemn them to endless precarity whilst vastly privileging a very few. Regardless of why that happened and where the "blame" lies, it's unsustainable.

If you are not going to distribute the wealth in such a way that substantial numbers of people feel like they have a stake and therefore a buy-in into the system they can then support, then you need to find a way to channel that "revolt" away from wealth-redistribution - you could do it through identifying a scapegoat to blame (Jews, immigrants, filthy foreigners, gays, generally "the other") instituting fascism, another way is through war (strong way of re-directing attention, imposing an emergency, getting rid of excess population etc.), and another way is through repression (frank dictatorship). 

The underpinning of any economic system is an ideology. That works as long as it allows enough people to support the system. So an ideology of pulling yourself by your bootstraps, the self-made man, the job creators, the feckless poor, the undeserving, the irresponsible have-nots, the lazy, the hard working, the American dream etc. - all that powered the protestant work ethic behind the U.S. economic development. If now it looks like absurd amounts of wealth are flowing to the tiny top and the vast bottom are losing out, that idealogy starts losing adherents. People simply won't believe that all those millions upon millions upon millions at the bottom of the economic pile are all "lazy, feckless, undeserving" and responsible for their own fate - not when jobs are either not available, or when available do not pay a living wage. And conversely they don't believe that everyone (or at least the majority) on the top of the economic pile got there through their own efforts, when the surest way to economic security is through inherited wealth, connections and social capital (statistical fact). Additional barriers of race and gender emphasize the lack of legitimacy to the ideology based on such manifestly unjust outcomes. 

Now, once the ideology loses credibility, you are left with people demanding a re-negotiation of an arrangement that keeps them trapped in a hopeless situation. Socioeconomic mobility in the U.S. has declined dramatically since the 70's and 80's as inequality has increased, which means that people are increasingly unable to fulfill the American dream, pull themselves by their bootstraps and self-make. These are statistical facts. And these facts undermine the prevailing ideology, and when people lose faith that their position is the result their own efforts and in fact are trapped due to no fault of their own - well, they revolt.

How will that revolt be handled? I outlined the usual means of handling it if wealth-redistribution is NOT on the table - in the case of the U.S., it might be some version of modern fascism, not necessarily majoritarian (see popular vote totals in elections Repubs vs Demos), and with strong racial and xenophobic overtones. Xenophobia and racial hatred is a very useful tool in the U.S. due to the large undocumented population ("internal enemy") and so can get some buy-in especially amongst the working poor (and not only among the whites!) - increasing racial division is also very useful. Blaming gays is losing appeal, though the trans community is still a useful target of re-directing hatred, but that's small potatoes. External "enemies" that have some plausible talking points - China is a much better target than Mexico (not enough people bought the notion that Mexico is at the bottom of all our problems), because China is a legitimate economic rival - increase the tensions and re-direct attention to external "enemies" (rather than rivals). Is it gonna be enough to keep the (uneasy) peace? There will certainly be a good deal of repression too, what with expanded security apparatus and decreased legal protections. The gamble here is that this will be enough to keep the peace without re-distributing wealth in any serious way.

FDR dealt with a similar problem through elements of wealth re-distribution, but this seems less likely (at least in the current political climate).

Strong, sudden shocks tend to crystalize for people the ideological underpinnings of the economic systems - people start asking questions, is it really a good idea that your health insurance is tied to your employer who can go bankrupt at any moment, is it really OK for you to die because you don't have the money for medical care or medication (insulin etc.), is it OK that wealth flows so strongly to the top, that you earn so little that you are a paycheck away from ruin etc.

How will this be handled? I guess we'll have to wait and see.

Edited by TomBAvoider
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3 hours ago, Ron Put said:

This appears related to the "new guidelines" which now count probable cases and deaths in addition to confirmed ones.

...

But let's see where we get. Even with the padded mortality numbers, the combined US flu and Covid-19 death toll is unlikely to end up much higher than the 61,000 deaths from the 2017-2018 flu season.


The flu statistics you cite are not a count of confirmed cases.  Usually they aren't even probable flu but rather probable "flu like illnesses and deaths".   Can you explain how including probable cases and deaths pads covid-19 numbers but doesn't pad flu numbers?

Considering we are currently approaching 35,000 covid-19 deaths and we have yet to see a peak and have little reason to believe this will be a Gaussian distribution with roughly as many deaths on each side of the peak to still be estimating a total in the ballpark of 60,000 smells like a crack pipe dream.  Consider that in New York they have had 8 times as many deaths per million than we have seen in the country as a whole.  If the rest of the nation merely catches up with where New York is today we will be in excess of 250,000 deaths.  And they are still dying of this at a fast rate in New York.

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On a slightly reassuring note for us skinny folks, a new accepted journal article [1] found that in people under 60, obesity doubled the risk of ending up in the ICU if you get Covid-19. 

--Dean

----

[1] Clinical Infectious Diseases

https://doi.org/10.1093/cid/ciaa415

Published: 09 April 2020 

Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission 

Jennifer Lighter, MD, Michael Phillips, MD, Sarah Hochman, MD, Stephanie Sterling, MD, Diane Johnson, MD, Fritz Francois, MD, Anna Stachel, MPH

... We performed a retrospective analysis of BMI stratified by age in Covid-19-positive
symptomatic patients who presented to a large academic hospital system in New York City. Patients presented to the ED with signs of respiratory distress were admitted to the hospital....

Of the 3,615 patients who tested positive for Covid-19, 775 (21%) had a body mass index (BMI) 30-34, and 595 (16% of the total cohort) had a BMI >35. There were 1,853 (51%) patients discharged from the ED, 1,331 (37%) were admitted to the hospital in acute care and 431 (12%) were either directly admitted or transferred to the ICU during admission. During analysis we found significant difference in admission and ICU care only in patients <60 years of age with varying BMIs (Table 1).

Patients aged <60 years with a BMI between 30-34 were 2.0 (95% 1.6-2.6, p<0.0001) and 1.8 (95% CI 1.2-2.7, p=0.006) times more likely to be admitted to acute and critical care, respectively, compared to individuals with a BMI <30 (Table 1). Likewise, patients with a BMI >35 and aged <60 years were 2.2 (95% CI 1.7-2.9, p<.0001) and 3.6 (95% CI 2.5-5.3, p=<.0001) times more likely to be admitted to acute and critical care compared to patients in the same age category who had BMI <30.

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Why is there such a wide disparity between both the number of cases, and the number of deaths and infection and mortality rates between New York and California? BBC has an article:

Coronavirus: How California kept ahead of the curve

"

The University of Washington's Institute for Health Metrics and Evaluation projected in March that more than 6,000 people in California would die of coronavirus. This week, the institute revised their forecast - projecting that California will reach its peak on 17 April - with 1,783 deaths.

California has only tested 212,900 people - and not all of the tests have been processed - so the number of confirmed cases will likely be considerably higher. But the death rate is much lower than many expected.

Graphic that shows how New York State has many more confirmed cases and deaths, per 100,000 people, compared to California

So why is California faring so much better than many predicted?

The state acted early

California was the first place in the United States to issue shelter in place orders. Gov Newsom ordered California to shelter in place on 19 March - three days before New York.

The statewide order followed similar ones issued on 16 March by several Bay Area counties and cities - including San Francisco.

Residents were urged to stay home and only go to essential businesses, like grocery stores and pharmacies, when necessary.

San Francisco street banners say it is "ahead of the curve"Image copyrightGETTY IMAGES Image captionStreet banners in San Francisco boast that the city is "ahead of the curve" on dealing with Covid-19

But can a day or two really make that much difference? "Oh yes," said Dr Neha Nanda, the medical director of infection prevention and antimicrobial stewardship at Keck Medicine, University of Southern California.

"Even being one day ahead can have a huge impact," she told the BBC. "The morbidity we will be able to avert, the mortality we will be able to avert - it's huge."

 

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5 hours ago, TomBAvoider said:

... How will that revolt be handled? I outlined the usual means of handling it if wealth-redistribution is NOT on the table - in the case of the U.S., it might be some version of modern fascism, not necessarily majoritarian (see popular vote totals in elections Repubs vs Demos), and with strong racial and xenophobic overtones. Xenophobia and racial hatred is a very useful tool in the U.S. due to the large undocumented population ...

FDR dealt with a similar problem through elements of wealth re-distribution, but this seems less likely (at least in the current political climate)....

I am not even sure what exactly you are arguing, so I wasn't even going to respond, but here we go.... The closest the US has ever had to an authoritarian government is in fact the reign of FDR, for whom the US constitution was a mere inconvenience. He wanted to serve four terms and stacked the Supreme Court so that can can effectively rule by decree. FDR disliked Churchill (who thought FDR was an idiot), had a great admiration for Stalin and felt that the US should be ideologically closer to the USSR than to an "empire" like Britain. Also, it is grossly simplistic and inaccurate to say that FDR "dealt" with the economic problems at the time, at least not successfully. The US economy did not show significant growth until the country engaged in WWII and even though the economy started growing during the war time, it was largely due to government procurements directly to fight the war, which is not how you build a sustainable economy. The reality is that the US economy returned to real growth only at the time of FDR's death in 1945, after government spending dried up and private investment increased dramatically. Don't have time to look now, but here is some of the data based on a quick search:

What Really Ended the Great Depression?

This is not the forum to debate this, but statements like "xenophobia and racial hatred is a very useful tool in the U.S" are just nonsense -- enforcing national immigration laws is hardly xenophobia, and compared to places like the EU, Australia or much of Asia, the US has practically open borders. But race and class baiting has been on the rise for a while, so I expect it to be duly amplified now.

____

5 hours ago, Todd Allen said:

The flu statistics you cite are not a count of confirmed cases.  Usually they aren't even probable flu but rather probable "flu like illnesses and deaths".   Can you explain how including probable cases and deaths pads covid-19 numbers but doesn't pad flu numbers?

"Flu-like illnesses and deaths" include a bunch of respiratory disease causing viruses, including influenza and the four corona-viruses which have become endemic in the last two decades and circulate every season, just like Covid-19 is likely to circulate in the future. While the CDC uses modeling, it appears to be a lot more stringent than the way New York is currently counting Covid-19 cases, which likely lump anything from influenza cases (the flu season is not quite over) to heart attack and stroke deaths, which have markedly dropped because of reluctance of those experiencing symptoms to go to the emergency room, because of Covid-19. The numbers in NY just do not make sense right now, so we'll have to wait and see how it shakes out.

___

2 hours ago, TomBAvoider said:

Why is there such a wide disparity between both the number of cases, and the number of deaths and infection and mortality rates between New York and California? BBC has an article:


This BBC story is half baked and provides no useful information, other than taking up enormous space on the forum page.
 

___

4 hours ago, Dean Pomerleau said:

Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission 

Obesity is also a major risk factor for the flu. I don't know if the thinner among us should rejoice much though, since the flu kills the overly thin, too.

On the other hand, you are likely right, as one can have body fat of 9% because they have a terminal illness, or because they are a body builder.... Obesity is just obesity.

Edited by Ron Put
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Indeed this is not a forum to debate such topics, but some of this is a bit comical:

The closest the US has ever had to an authoritarian government is in fact the reign of FDR, for whom the US constitution was a mere inconvenience. He wanted to serve four terms and stacked the Supreme Court so that can can effectively rule by decree. FDR disliked Churchill (who thought FDR was an idiot), had a great admiration for Stalin and felt that the US should be ideologically closer to the USSR than to an "empire" like Britain.

FDR "wanted to serve four terms", because there was nothing in the constitution that he was ignoring in that regard - the two term limit wasn't passed until after his death (hardly surprising the Republicans were heavily lobbying for it, given the success FDR had). So there was nothing unconstitutional or dictatorial about FDR's 4 terms - far from a result of FDR's authoritarian and constitution-defying, those terms were the result of wide victories in elections, or, you know, a characteristic of democratic governance, chosen by the citizenry. He did attempt to "stack of the Supreme Court" - because again, there is nothing in the constitution specifying 9 SC Justices, a fact that Republicans have widely argued when they denied Obama's pick and were quite willing to block any Demo picks however long it took and however few Justices were left alive - so much for "the constitution". And after FDR was unsuccessful in such stacking, he didn't resort to authoritarian measures, but lived with that democratic outcome. FDR - the closest we came to an authoritarian government, LOL, especially LOL in seeing his very "democratic" opposition during that time

I don't think there was any personal animus from FDR toward Churchill, although if you read through the history of that time, it's really not surprising that FDR was not keen on Churchill's schemes of trying to use U.S. military might to re-establish the British Empire, indeed he'd be quite a chump had he agreed to do Churchill's bidding. 

As to the Depression and how FDR dealt with it - an even bigger LOL. There is no doubt whatsoever, that FDR arrested the spiral of deflation and economic destruction that was so well characterized by Keynes - in fact, his only fault was in cutting short the stimulus measures which led to stagnation in further recovery until the spending of WWII. 

The Heritage Foundation link is of course from a Heritage Foundation perspective. I was actually surprised by several statements in that article which were eminently reasonable (unproductive military spending among other absolutely correct statements) and quite true, although of course the ultimate conclusion is a big LOL and springs forth in a deus ex machina fashion:

"In sum, it wasn’t government spending, but the shrinkage of government, that finally ended the Great Depression."

Comedy gold. It's as if the author thinks he possesses the "Men In Black" device that obliterates any memory of recent history, like, you know, the one just before the Great Depression, LOL. Only with such a memory-wiping can he hope to make his case. Because all that golden "little government spending in the economy" was what prevailed before the Great Depression, and far from "ending" the Great Depression, it led to the Great Depression as Keynes patiently explained. What was responsible for the recovery after WWII was not the magic of "little government in the economy", but the fact that the U.S. was the only large economy in the world that was relatively intact after WWII, while the rest of the world was an open market for our enterprise. By the way, all that government spending (very much against Heritage Foundation ideology), is what brought prosperity to continental Europe and Japan... in contradistinction to the austerity post WWI - as again, demonstrated by Keynes. Massive spending by governments in Europe was crucial to the post WWII economic miracle - it wasn't just scrappy ole private enterprises that picked themselves by their bootstraps, it was government funds administered in massive amounts with the Marshall Plan (again, contrast with the opposite approch after WWI - which led to economic calamity). 

By the way, the New Deal programs that the Heritage Foundation decries with such piteous bleeting are a foundation of the great middle class formation that followed WWII, rural infrastructure and recovery, national park infrastructure, highways and transportation networks, Social Security (opposed tooth and nail by the Republicans and their ideological heirs in the Heritage Foundation) and so on. It's especially ironic how they crowed that FDR did not manage to institute a National Health Insurance program - boy, has that ever been a boon... not. Meanwhile, those dopes the Canadians and the Brits managed to pass theirs during that time, and when they look over the utter disaster that our healthcare industry is, they thank their lucky stars they managed to get it done. Meanwhile, the American public has been the loser in this - too bad FDR did not succeed here, to our eternal detriment.

enforcing national immigration laws is hardly xenophobia, and compared to places like the EU, Australia or much of Asia, the US has practically open borders.

True enough. But it doesn't address the issues I raised... which I'll *briefly* raise in a separate post.

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The Economist will now be regularly tracking excess mortality from Covid-19 having determined that official daily  death tolls  are systematically understating the true number of people killed by the virus.

https://threadreaderapp.com/thread/1250815341044924425.html

https://twitter.com/J_CD_T/status/1250815341044924425

 

Edited by Sibiriak
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1 hour ago, Sibiriak said:

The Economist will now be regularly tracking excess mortality from Covid-19 having determined that official daily  death tolls  are systematically understating the true number of people killed by the virus.

https://threadreaderapp.com/thread/1250815341044924425.html

https://twitter.com/J_CD_T/status/1250815341044924425

 

Yes, amidst all the garbage data thrown upon us, that appears one of the best and unbiased indicators. The best presentation of excess mortality (in relation to the historical average for the same month) would be in a time series, as in the plot posted previously by Dean. That's most eloquent. the spikes are the anomalies. In NYC, the largest, overwhelming  anomaly is Covid19. The second-largest is  9/11.  

image.png.4223b3905910223c552b98764447bff1.png

Edited by mccoy
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The truncated historical series for Lombardy clearly shows that deaths attributed to COVID19 are but a fraction of the excess deaths (red + yellow), measured as number of deaths above the expected trend (dotted line). Edit: one drawback of this indicator is maybe the time elapsed since the official every-death count. Data are available every month or week. It remains a useful objective benchmark though.image.png.534803a1f89e9c451806b65cc18dec5d.png

 

 

Edited by mccoy
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Medical Xpress has an article   High glucose levels may explain why some flu patients have more severe symptoms

https://medicalxpress.com/news/2020-04-high-glucose-flu-patients-severe.html

They found that those patients with higher glucose levels were more likely to undergo a cytokine storm. They suggest their findings explain why patients with diabetes are more likely to experience cytokine storms and to have worse outcomes with flu (and possibly COVID-19) infections.

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On 4/16/2020 at 9:08 AM, Mechanism said:

This just posted by Josh Mitteldorf a few hours ago - his Aging Matters blog well known to long-time members of CRSociety

https://joshmitteldorf.scienceblog.com/2020/04/15/overreaction/

I have no opinion yet on the piece yet as I have not read as of the time of this posting 

 

Just read it.  Setting aside the arguments about economic damage and the best way to deal with this pandemic...

I'm not sure why he wrote:

Quote

Saturation / herd immunitymost people have already been exposed and have built up immunity

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If claims that non-symptomatic carriers can be contagious are credible, then surely a majority of people have been exposed by now, enough that our immune systems have generated the first few antibody-producing B cells, 

Sorry but this is complete nonsense.  Even in New York City where some random testing has been done, only 15% are showing antibodies (study cited in prior post by myself), and that's in the worst hit city in the country.  We are NO WHERE NEAR "most people having immunity".

Then he goes on to include a video of Knut Wittkowski predicting there should only be 10,000 total US deaths with NO MITIGATION efforts at all, it will just come and go in 4 weeks and we are done.  And yet, we now have 35,000 deaths (US) right now, with lockdowns, social distancing, masks, school closures, and lots of mitigation efforts.  I'm not sure he is "winning" this argument (even if grand total deaths at the end of the year pretty much match a bad flu season).  But I guess we still have Sweden to look to right? Ironically, Josh's article includes the following chart (with NO commentary about this specific situation as if he completely missed it!):

covid-and-temperature-1.png

Either way I still think at some point soon politicians will be forced ton throw in the towel and go back to business as usual.  You've probably all seen the protests in Michigan already.  Same thing will happen in Pennsylvania on Monday.  PA Governor just declared (yesterday) that everyone must wear masks in shops now, even went as far as to say this will be enforced with fines.

Edited by Gordo
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20 minutes ago, Gordo said:

 

Just read it.  Setting aside the arguments about economic damage and the best way to deal with this pandemic...

I'm not sure why he wrote:

Sorry but this is complete nonsense.  Even in New York City where some random testing has been done, only 15% are showing antibodies (study cited in prior post by myself), and that's in the worst hit city in the country.  We are NO WHERE NEAR "most people having immunity".

Then he goes on to include a video of Knut Wittkowski predicting there should only be 10,000 total US deaths with NO MITIGATION efforts at all.  And yet, we now have 35,000 deaths (US) right now, with lockdowns, social distancing, masks, school closures, and lots of mitigation efforts.  I'm not sure he is "winning" this argument (even if grand total deaths at the end of the year pretty much match a bad flu season).  But I guess we still have Sweden to look to right?

Here is a nytimes article just out https://www.nytimes.com/2020/04/17/us/coronavirus-death-rate.html?referringSource=articleShare

As Mark Twain liked to say “ Lies, damn lies and statistics”

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I agree Gordo, I thought the same thing.  

The 15% you cite was from an essentially 100% sample of pregnant woman and the highest reliable source reported Covid percentage that we have seen domestically to date - and from NYC which has been among the hardest hit.

From the New England Journal of Medicine (the highest impact U.S. clinical journal):

https://www.nejm.org/doi/full/10.1056/NEJMc2009316

We have a long way to go before herd immunity is achieved.

I have the same issues with the Knut Wittkowski video.  This is in distinction with Dr John Ioannidis who in my estimation has been consistently balanced, nuanced, and data-responsive.

 

Edited by Mechanism
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We still don't know whether people who have already been infected with COVID-19 actually gain immunity or how long it lasts, but the new estimates for R0 show that each infected person could transmit the virus to as many as 5.7 other people.

There is a formula to determine how many people need to be exposed and gain immunity in order for herd immunity to become protective to the rest of the population. An R0 of 5.7 means roughly 82% of the population would need to become immune. That seems like a lot to me, so many that the costs seem just too high to justify the potential benefits.

But if the R0 really is 5.7, that also seems like it is going to be very difficult to prevent the gradual and pervasive spread. So far maybe as many as 15% of us have already developed antibodies, with most of us blissfully unaware we were ever exposed but also unaware that we were a deadly risk to our neighbors and may have unwittingly lead to enormous suffering and death by being a link in the chain to other people coming down with the illness. I'd be curious to see if that 15% number changes and how quickly it changes. If there are some more completely random testing in another month, will we be at 20%? 30%? Higher? At a certain point the costs are ones we've already borne, and the benefits of increased herd immunity start to outweigh the future costs. But I feel very uncomfortable trying to weight these things against each other from an ethical standpoint.

There is still so much that is unknown. If the virus mutates quickly enough, all of our antibodies could become ineffective and it will just reinfect the herd leading to another wave of suffering and death. And it is also possible that the immunity we gain only lasts for a relatively short period. Maybe we gain some limited immunity for three months, after which we become vulnerable again.

With all of the unknowns out there, the scariest thing to me is how many people seem eager to roll the dice on herd immunity. It seems downright sociopathic. I wouldn't have thought that so many people would jump so quickly to this option as their great hope.

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from worldometer:

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alert China: Hubei Province issued today a "Notice on the Correction of the Number of New Coronary Pneumonia Cases Diagnosed and the Number of Diagnosed Deaths in Wuhan" in which it reported 1,290 additional deaths that had not been previously counted and reported, bringing the total number of deaths in Wuhan from 2,579 to 3,869, an increase of 50%, as the result of a revision by the Wuhan New Coronary Pneumonia Epidemic Prevention and Control. As part of this revision, 325 additional cases in Wuhan were also added. Separately, China's National Health Commission (NHC) reported 26 new cases (and no deaths) in its daily report [source] [source] [source]

Looks like China and The Economist are conspiring to scare the crap out of us.

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UK

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Prof Anthony Costello, professor of global health and sustainable development at [ University College London] Institute for Global Health says [the UK] could see 40,000 deaths by the time this wave of coronavirus is over.

But even with those numbers only 10 to 15% of the population might have had the illness, and developed immunity. 

He says that is why it is crucial to keep the spread of the disease down until a vaccine is ready.

[...]Costello also suggested offering incentives to 10% of the population to stay socially isolated in order to get the economy going again.  "We have to get the economy going and if it means locking down 10% of our population, even giving them incentives to stay in quarantine and with digital apps to help monitor their symptoms and give them support, that’s the way to really keep this going until we get a vaccine and safe herd immunity."

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