Author Topic: The optimistic take on Covid-19  (Read 8241 times)

investmd

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Re: The optimistic take on Covid-19
« Reply #10 on: March 25, 2020, 11:19:50 PM »
I thought this was a good article:
https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/

I'm aware of previous work by Ioannidis and it is high quality. While he hits the mark in saying we are making decisions without data, this article is off side in that he offers no proposed solution. We can see a tsunami coming off shore. The only tool we have to possibly prevent a disaster is social distancing. This article https://www.statnews.com/2020/03/18/we-know-enough-now-to-act-decisively-against-covid-19/ offers a friendly response to Ioannidis' and conclude with "no choice but to buy time with social distancing"


investmd

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Re: The optimistic take on Covid-19
« Reply #11 on: March 25, 2020, 11:31:37 PM »
The problem isn't the mortality rate, it's the virulence - how many people get infected and how fast. If current doubling time in your part of the world is 4-5 days (number of cases double every 4 to 5 days), in approx 6 weeks there will be roughly 1024x more cases (10 doubling times) . So if your region has 500 cases now, in 6 weeks it will be 500,000. Some people will die. Some young people will die too. However, the point is that the hospital system will be overrun. That means people who need usual life saving type treatments (heart attacks, strokes, cancer therapy....) won't be able to be accommodated. Article on the math of pandemic - by using simple math and data available in the news the author concluded on March 12 that social distancing was mandatory to flatten the curve: https://medium.com/@Jason_Scott_Warner/the-sober-math-everyone-must-understand-about-the-pandemic-2b0145881993


investmd

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Re: The optimistic take on Covid-19
« Reply #12 on: March 25, 2020, 11:33:00 PM »
I was on a conf call today with a surgeon from Brooklyn who said their one hospital has 180 Covid patients admitted with 90 of them on a ventilator in the ICU - their previous capacity for ventilated patients was 60 prior to emergency expansion. Means that other sick people just won't get care.

There's 2 things people can do: provide emergency services (healthcare, fire, police, stock grocery stores so that people can eat) or do your part to help society by "bending the curve" and be strict in social distancing. If one can change the doubling time from 5 days to 7 days or 10 days or longer, it will prevent the entire healthcare system from being overrun.

Currently most hospitals in N. America are not doing elective surgeries - keeping the beds open for the oncoming onslaught - which has arrived in NYC already.

Aurelius

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Re: The optimistic take on Covid-19
« Reply #13 on: March 26, 2020, 07:57:10 AM »
https://www.cloverpop.com/blog/we-need-a-covid-19-testing-moonshot
Quote
In the whole world, there are only two places that can reasonably claim to be taking a scientific approach to those aspects of this virus at this point: Iceland and the Faeroe Islands. Both have tested about 3% of their populations (that’s about 6X better than South Korea, 12X better than Italy, and 100X better than the US). Iceland is trying to test a representative population, although their testing is still skewed towards ill and exposed people. The Danes of the Faeroe Islands are tracing almost 100% of cases.

Because they have relatively low numbers of hospitalizations and deaths, the information they are uncovering has been hidden in the press. However, their information is currently the most accurate information out there about the spread of infection. Here is what they’ve learned:

Their reported rates of infection in their general populations are about 2X higher than Italy and 10X higher than the rest of the world (about 2,000 infections per million people vs about 200 infections per million or less). This is true even though they’ve tested relatively few people and their samples were still skewed to the sick or exposed.
Their rates of hospitalization per case (2.5% in Iceland) and death per case (0.15% for both combined) are about 10X lower than the rest of the world.
In the Faeroe Islands, scientists doing almost complete contact tracing have found some evidence that one strain of the virus is far more contagious.

This might explain alot:
Quote
What if we had only the information above, and none of the other terrible true-but-skewed information flooding the news about doctors and nurses facing impossible decisions, PPE shortages and piled up coffins? What could explain what we were seeing?

One explanation is that this new coronavirus is at least 10X more contagious and at least 10X less deadly than we think it is. The CDC data could be showing that younger people are being less careful than older people, so they’re getting sick sooner. The Italy and China data could be showing that the disease runs its course in a few weeks, since a highly contagious disease is impossible to truly contain.

Given that information, the pandemic could be summarized this way: A highly contagious virus with a 1-3% hospitalization rate and 0.1-0.3% death rate.

In other words, it could be like the entire flu season getting piled into a few weeks everywhere it hits.

Jurgis

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Re: The optimistic take on Covid-19
« Reply #14 on: March 26, 2020, 08:03:49 AM »
This might explain alot:
Quote
What if we had only the information above, and none of the other terrible true-but-skewed information flooding the news about doctors and nurses facing impossible decisions, PPE shortages and piled up coffins? What could explain what we were seeing?

One explanation is that this new coronavirus is at least 10X more contagious and at least 10X less deadly than we think it is. The CDC data could be showing that younger people are being less careful than older people, so they’re getting sick sooner. The Italy and China data could be showing that the disease runs its course in a few weeks, since a highly contagious disease is impossible to truly contain.

Given that information, the pandemic could be summarized this way: A highly contagious virus with a 1-3% hospitalization rate and 0.1-0.3% death rate.

In other words, it could be like the entire flu season getting piled into a few weeks everywhere it hits.

Quote
The Italy and China data could be showing that the disease runs its course in a few weeks, since a highly contagious disease is impossible to truly contain

This contradicts China data. If disease is highly contagious and impossible to contain, then there should be the same amount of deaths in all provinces rather than being superconcentrated in Wuhan.
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krazeenyc

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Re: The optimistic take on Covid-19
« Reply #15 on: March 26, 2020, 08:17:50 AM »
This might explain alot:
Quote
What if we had only the information above, and none of the other terrible true-but-skewed information flooding the news about doctors and nurses facing impossible decisions, PPE shortages and piled up coffins? What could explain what we were seeing?

One explanation is that this new coronavirus is at least 10X more contagious and at least 10X less deadly than we think it is. The CDC data could be showing that younger people are being less careful than older people, so they’re getting sick sooner. The Italy and China data could be showing that the disease runs its course in a few weeks, since a highly contagious disease is impossible to truly contain.

Given that information, the pandemic could be summarized this way: A highly contagious virus with a 1-3% hospitalization rate and 0.1-0.3% death rate.

In other words, it could be like the entire flu season getting piled into a few weeks everywhere it hits.

Quote
The Italy and China data could be showing that the disease runs its course in a few weeks, since a highly contagious disease is impossible to truly contain

This contradicts China data. If disease is highly contagious and impossible to contain, then there should be the same amount of deaths in all provinces rather than being superconcentrated in Wuhan.

https://youtu.be/YfsdJGj3-jM

Not so contagious it is impossible to contain, but watch the video above to see the kind of actions China has taken to contain it. are we going to do that here in the United States (or something even remotely similar?) -- should we?  Just because they were able to get it under control with their actions, doesn't mean we will with ours.

LongHaul

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Re: The optimistic take on Covid-19
« Reply #16 on: March 26, 2020, 08:23:39 AM »
I like this thread.  Thanks for doing a great writeup.  I think the death rate for <60 is quite small perhaps 20-30 bps.  Tons of cases are not being testing as people with no to few symptoms are not tested. Germany has low rates of death for younger people.

The amount of brainpower on this problem is incredible.  Man vs Covid essentially.  Man will win in the long run.

Also - everyone should wearing masks.   No downside - if you have 1 or make 1 and wear it. 
Lower chance of infecting others and protects yourself.  Western cultures need a culture shift immediately.
Masks should be worn - even homemade ones.
https://medium.com/@matthiassamwald/promoting-simple-do-it-yourself-masks-an-urgent-intervention-for-covid-19-mitigation-14da4100f429

However - I think it is best to think in probabilities about this.  chance of 2 month recover vs. 12 months. 
The models I have seen seem to indicate 4-8 months (or longer) for this to die down, unless severe lockdowns.  Very fluid though.

And it really has to die on a worldwide basis because it can easily come back.

Jurgis

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Re: The optimistic take on Covid-19
« Reply #17 on: March 26, 2020, 08:31:52 AM »
This might explain alot:
Quote
What if we had only the information above, and none of the other terrible true-but-skewed information flooding the news about doctors and nurses facing impossible decisions, PPE shortages and piled up coffins? What could explain what we were seeing?

One explanation is that this new coronavirus is at least 10X more contagious and at least 10X less deadly than we think it is. The CDC data could be showing that younger people are being less careful than older people, so they’re getting sick sooner. The Italy and China data could be showing that the disease runs its course in a few weeks, since a highly contagious disease is impossible to truly contain.

Given that information, the pandemic could be summarized this way: A highly contagious virus with a 1-3% hospitalization rate and 0.1-0.3% death rate.

In other words, it could be like the entire flu season getting piled into a few weeks everywhere it hits.

Quote
The Italy and China data could be showing that the disease runs its course in a few weeks, since a highly contagious disease is impossible to truly contain

This contradicts China data. If disease is highly contagious and impossible to contain, then there should be the same amount of deaths in all provinces rather than being superconcentrated in Wuhan.

...
Not so contagious it is impossible to contain
...

That's not what the OP's quote argues.

I agree with you that virus was mostly contained in China. And I disagree with OP's quote and conclusions stemming from it.
« Last Edit: March 26, 2020, 08:34:12 AM by Jurgis »
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"Before you can be rich, you must be poor." - Nef Anyo
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cherzeca

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Re: The optimistic take on Covid-19
« Reply #18 on: March 26, 2020, 09:10:06 AM »
great post Aurelius.  value added.

relying to another post:  "The problem isn't the mortality rate, it's the virulence - how many people get infected and how fast." 

I disagree wholeheartedly.  every flu season we are indifferent to virulence and mortality..I suppose because we offer a predictive vaccine, we believe we are doing enough.  I doubt anyone on this board would have known before covid-19 that there are 10,000-50,000 flu-related deaths in US every year.

yes the facts have changed with a novel virus, but every season we have some novel viruses (hence vaccinated people still get sick), and the development of antibodies by the vast majority of infected by covid-19 is a big plus and necessary to deal with covid-19...which is why all of our focus should be on ring fencing and protecting elderly/immune compromised.  that we only recently barred visitation to nursing homes is batshit crazy.  that is the first thing we should have done

StevieV

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Re: The optimistic take on Covid-19
« Reply #19 on: March 26, 2020, 10:00:55 AM »
I like this thread.  Thanks for doing a great writeup.  I think the death rate for <60 is quite small perhaps 20-30 bps.  Tons of cases are not being testing as people with no to few symptoms are not tested. Germany has low rates of death for younger people.

The amount of brainpower on this problem is incredible.  Man vs Covid essentially.  Man will win in the long run.

Also - everyone should wearing masks.   No downside - if you have 1 or make 1 and wear it. 
Lower chance of infecting others and protects yourself.  Western cultures need a culture shift immediately.
Masks should be worn - even homemade ones.
https://medium.com/@matthiassamwald/promoting-simple-do-it-yourself-masks-an-urgent-intervention-for-covid-19-mitigation-14da4100f429

However - I think it is best to think in probabilities about this.  chance of 2 month recover vs. 12 months. 
The models I have seen seem to indicate 4-8 months (or longer) for this to die down, unless severe lockdowns.  Very fluid though.

And it really has to die on a worldwide basis because it can easily come back.

I've been thinking about masks.  I'd be ramping up mask production as fast as possible.  But, I've never worn one in my life as far as I can recall, and I'd need one or two a day.  Same for the rest of my family.  A billion or more a week in the US.  I figure it would take many multiples of current mask production.  How possible is that?

Regardless, I'd push hard on masks.  Absent a treatment, this will at the least be around in the fall.