Author Topic: Coronavirus  (Read 464255 times)

Dalal.Holdings

  • Hero Member
  • *****
  • Posts: 872
Re: Coronavirus
« Reply #2490 on: March 25, 2020, 03:31:19 PM »
Quote
A refrigerated truck has been stationed outside to hold the bodies of the dead. Over the past 24 hours, New York Cityís public hospital system said in a statement, 13 people at Elmhurst had died

Quote
All of the more than 1,800 intensive care units in the city are expected to be full by Friday, according to a Federal Emergency Management Agency briefing obtained by The New York Times. Patients could stay for weeks, limiting space for newly sickened people.

https://www.nytimes.com/2020/03/25/nyregion/nyc-coronavirus-hospitals.html

FYI.

Destroys the thesis that this has infected millions months ago in the U.S.
« Last Edit: March 25, 2020, 03:33:59 PM by Dalal.Holdings »
Posts are for analytical eyes only; Others need not reply
https://twitter.com/LumeGroup


Liberty

  • Lifetime Member
  • Hero Member
  • *****
  • Posts: 12619
  • twitter.com/libertyRPF
    • twitter.com/libertyRPF
Re: Coronavirus
« Reply #2491 on: March 25, 2020, 03:37:18 PM »
Life revert to normal after that? lol

Well, not totally--some businesses won't survive.  But if we literally get everyone infected in 2 months and all those infections resolved in 3 months, then there really isn't anything to worry about (economically speaking) after that.  I think the faster this happens, the smaller the economic second-order effects, and the more businesses will survive.  Even if bad stuff remains economically, it's much easier to, say, do bridge financing after it's clear the pandemic has run its course and customers have returned to the business.

I'm putting aside the millions of deaths as not mattering that much to the economy, and not having that many second-order effects.

(Also, I'm not suggesting this is what should happen. I'm saying, "if I were a psycho trying to do nothing but maximize economic outcomes and taking nothing else into account, that's what I'd do.")

If you're looking for the least economically damaging, it's the non-stupid one, which is what south-korea and singapore and taiwan has done:

https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56
"Most haystacks don't even have a needle." |  I'm on Twitter  | This podcast episode is a must-listen

elliott

  • Jr. Member
  • **
  • Posts: 85
Re: Coronavirus
« Reply #2492 on: March 25, 2020, 04:13:45 PM »
Given that Trump's business interests have been directly excluded from the bailout/stimulus, does that make him more or less likely to undermine social distancing?

More likely. The optimal outcome for the economy is to get everyone sick over the next 2-3 months, let all the old people die (they don't contribute much to the economy anyway), and then have life revert to normal when everyone has herd immunity.

Richard, what do you make of the points Taleb (and others) make against the case for herd immunity? some body posted an article Taleb co-authored for the guardian a couple of pages back. anyway, one of the several points is, herd immunity relies on, well, immunity, but at this point that has not been proven, ie, you get sick once, you may still get sick again (and transmit the virus).

minten

  • Full Member
  • ***
  • Posts: 122
Re: Coronavirus
« Reply #2493 on: March 25, 2020, 04:20:12 PM »
anyway, one of the several points is, herd immunity relies on, well, immunity, but at this point that has not been proven, ie, you get sick once, you may still get sick again (and transmit the virus).

Not proven, but pretty likely based on experiences with similar viruses.  Btw, they injected COVID-19 on a couple of macaque monkeys, then had them recover and then injected them again. They did develop immunity. That being said, you would think you'd have a large enough number of human subjects you could try it on at this stage.

orthopa

  • Hero Member
  • *****
  • Posts: 1127
Re: Coronavirus
« Reply #2494 on: March 25, 2020, 04:35:21 PM »
https://www.wsj.com/articles/is-the-coronavirus-as-deadly-as-they-say-11585088464?mod=hp_opin_pos_2

"In Iceland, deCode Genetics is working with the government to perform widespread testing. In a sample of nearly 2,000 entirely asymptomatic people, researchers estimated disease prevalence of just over 1%. Icelandís first case was reported on Feb. 28, weeks behind the U.S. Itís plausible that the proportion of the U.S. population that has been infected is double, triple or even 10 times as high as the estimates from Iceland. That also implies a dramatically lower fatality rate."

"The epidemic started in China sometime in November or December. The first confirmed U.S. cases included a person who traveled from Wuhan on Jan. 15, and it is likely that the virus entered before that: Tens of thousands of people traveled from Wuhan to the U.S. in December. Existing evidence suggests that the virus is highly transmissible and that the number of infections doubles roughly every three days. An epidemic seed on Jan. 1 implies that by March 9 about six million people in the U.S. would have been infected. As of March 23, according to the Centers for Disease Control and Prevention, there were 499 Covid-19 deaths in the U.S. If our surmise of six million cases is accurate, thatís a mortality rate of 0.01%, assuming a two week lag between infection and death. This is one-tenth of the flu mortality rate of 0.1%. Such a low death rate would be cause for optimism."

"This does not make Covid-19 a nonissue. The daily reports from Italy and across the U.S. show real struggles and overwhelmed health systems. But a 20,000- or 40,000-death epidemic is a far less severe problem than one that kills two million. Given the enormous consequences of decisions around Covid-19 response, getting clear data to guide decisions now is critical. We donít know the true infection rate in the U.S. Antibody testing of representative samples to measure disease prevalence (including the recovered) is crucial. Nearly every day a new lab gets approval for antibody testing, so population testing using this technology is now feasible."

"If weíre right about the limited scale of the epidemic, then measures focused on older populations and hospitals are sensible. Elective procedures will need to be rescheduled. Hospital resources will need to be reallocated to care for critically ill patients. Triage will need to improve. And policy makers will need to focus on reducing risks for older adults and people with underlying medical conditions. A universal quarantine may not be worth the costs it imposes on the economy, community and individual mental and physical health. We should undertake immediate steps to evaluate the empirical basis of the current lockdowns."

Granted this is an opinion piece but this has been my position all along. Will be interesting to see what the end result of this. Glad to see this was published in WSJ.

orthopa

  • Hero Member
  • *****
  • Posts: 1127
Re: Coronavirus
« Reply #2495 on: March 25, 2020, 05:00:04 PM »
I guess I will know for sure if I was wrong if/when the healthcare system collapses. I could get lucky as my predictions above (not too bad for 2 weeks ago huh?) were before the nationwide stay home theme and ramp up in healthcare preparedness across the country. I believe a lot of our back and forth at the time was about Washington state? and the deaths there? They are at 110 so I guess it remains to be seen if that continues to exponentially increase with time. NYC will be the test as that is where the healthcare system could break and wasnt even close at the time of our discussions.

FWIW I still think there is no doubt millions had been infected then, and even more so now. Dont forget the asymptomatic rate is 86% per Chinese data. For now its a point that is a waste of time to argue as until further means for testing comes out we will never know. What will really tell us for sure will be serologic testing which I hope for the economy's sake happens very soon as that would be a means for every group to tell if they have been infected and are immune. That could be a very quick send away lab and could be done on all asymptomatic people and in any doctors office, ER, etc.

FWIW the healthcare system is holding up good(NYC to be determined still), and has been since we talked. Its been ~2 weeks since we went back and forth and we are up to 698 deaths. Since that time ~26k give or take have died from heart disease so heart disease may still be the winner this year. Will have to see. And yes they are real living people so them dying counts too, even though it doesn't "spread". And yes those people that live have life long lung and heart issues, CHF, etc. I didn't know we had such empathetic people on the board!

I do find it very interesting how much everyone who is not medical trained does seem to care about people dying, ICU beds, ethical hard decisions, medicine etc as this what those in the medical field deal with every day. My hope is once this is over there is just as much passionate discussion about diabetes, HTN, heart disease etc. With the amount of outpouring and compassion I can certainly envision many on the board spending time at nursing homes, cardiac rehab facilities, and community health centers going forward. That will be great as opposed to a passing interest due to self preservation.

Thanks for your honest response--I really do appreciate it when people are willing to act with intellectual honesty.  So much of that is missing in the world today.

That said, your 86% asymptomatic rate isn't credible. The most credible number I've read is ~30% (though at this point, I'd be delighted if it were 86%. Asymptomatic people are bad early in a pandemic, and good when it's out of control.)

In any case, we'll have to keep watching New York to see when they get overloaded.  New York's normal capacity is about 60K hospital beds and 3000 ICU beds.  So, I'll assume that if we go over, say, 70k simultaneous hospitalized COVID-19 patients or 3300 simultaneous COVID-19 ICU patients, that means that you'll have recognized that "this isn't a big deal, there are already hundreds of thousands if not millions infected and there's been no problems" analysis was incorrect.

It's nice to have goal posts planted firmly in the ground, and clearly if COVID-19 patients alone--without even taking into account people in the hospital for other reasons--exceed hospital capacity, then it was a pretty big deal.

All that said, I'm pretty surprised that you don't understand why people would care much more about an epidemic than heart disease deaths.

I guess I understand why a mostly investor/business crowd (this board) cares more about a pandemic as its an immediate known threat to ones life and when driven by fear even more so. I guess my point again tho is that people die every day in medicine. We run codes when the pt arrives with no pulse, sometimes they die. We see strokes paralyze people. We see people on dialysis who are dying right in front of your eyes. We see non compliant cardiac/DM patients who are taking years off their lives and dont care even though they know it.

This happens every day, all day, all across the world. This will likely be a flash in the pan looking at the big picture many years from now. The other diseases I have mentioned wont. And almost everyone on this board/parents loved ones will die of CA/MI/DM etc and surely right now care much more about Covid19. Does that many any sense? Dont be worried about what is going to kill you and how to change that but what your AFRAID might kill you?

My point regarding time spent with those dying wasn't necessarily a jab but is true. If we really cared that much about people dying we would be spending time in nursing homes, rehab facilities, dialysis centers etc. That obviously wont happen. Many non medical people have become very interested in deaths and treatment of the ill. Thats great but IMO is mostly due to a the natural flight or flight response we all have to an immediate know threat right in front of our face 24hrs a day.

I have read on twitter many people abhorred by the fact that the economy may open and people may die. That being said I cant believe how many people on waiting lists for lung/heart/kidney etc transplants die never getting an organ. You just don't hear about it everyday and we each have the power to control that directly, but few will. You can go down this rabbit hole quick but I think I made my point.


minten

  • Full Member
  • ***
  • Posts: 122
Re: Coronavirus
« Reply #2496 on: March 25, 2020, 05:07:42 PM »
I guess I understand why a mostly investor/business crowd (this board) cares more about a pandemic as its an immediate known threat to ones life and when driven by fear even more so. I guess my point again tho is that people die every day in medicine. We run codes when the pt arrives with no pulse, sometimes they die. We see strokes paralyze people. We see people on dialysis who are dying right in front of your eyes. We see non compliant cardiac/DM patients who are taking years off their lives and dont care even though they know it.

This happens every day, all day, all across the world. This will likely be a flash in the pan looking at the big picture many years from now. The other diseases I have mentioned wont. And almost everyone on this board/parents loved ones will die of CA/MI/DM etc and surely right now care much more about Covid19. Does that many any sense? Dont be worried about what is going to kill you and how to change that but what your AFRAID might kill you?

My point regarding time spent with those dying wasn't necessarily a jab but is true. If we really cared that much about people dying we would be spending time in nursing homes, rehab facilities, dialysis centers etc. That obviously wont happen. Many non medical people have become very interested in deaths and treatment of the ill. Thats great but IMO is mostly due to a the natural flight or flight response we all have to an immediate know threat right in front of our face 24hrs a day.

I have read on twitter many people abhorred by the fact that the economy may open and people may die. That being said I cant believe how many people on waiting lists for lung/heart/kidney etc transplants die never getting an organ. You just don't hear about it everyday and we each have the power to control that directly, but few will. You can go down this rabbit hole quick but I think I made my point.

Your post makes a lot of sense.

I'm surprised about the large number of ER-doctors etc that go on cam these last few weeks, visibly very emotional, about the COVID-situation and patients that they've lost. Really makes me wonder why this gets to them (which it obviously does), while their day-to-day job normally can't be that much different.

Liberty

  • Lifetime Member
  • Hero Member
  • *****
  • Posts: 12619
  • twitter.com/libertyRPF
    • twitter.com/libertyRPF
"Most haystacks don't even have a needle." |  I'm on Twitter  | This podcast episode is a must-listen

KCLarkin

  • Hero Member
  • *****
  • Posts: 1826
Re: Coronavirus
« Reply #2498 on: March 25, 2020, 05:19:00 PM »
Granted this is an opinion piece but this has been my position all along. Will be interesting to see what the end result of this. Glad to see this was published in WSJ.

Yes, your opinion is that, let's say, 6 million were infected as of March 9th. If the infection rate doubles every 3 days, there should be 200 million infected. And by Friday, every single person in the US will be infected.

The problem is that no evidence supports this opinion.

LC

  • Hero Member
  • *****
  • Posts: 4598
Re: Coronavirus
« Reply #2499 on: March 25, 2020, 05:22:02 PM »
Given the lack of reliable data, we really have just guesses as to when the virus first entered the US, how many were (and are) infected, how many died from the virus and were not tested, etc. etc. etc.

The point is, the only real way to determine (generally) the severity will be this year's morality and hospital utilization compared to the prior few years.
"Lethargy bordering on sloth remains the cornerstone of our investment style."
----------------------------------------------------------------------------------------
brk.b | goog | irm | lyv | net | nlsn | pm | t | tfsl | v | wfc | xom