Covid Discussion

[LTownZag]

I'm essentially paraphrasing epidemiologists who are far more knowledgable than me. Using my own Spokane County as an example, we have had less than 10 new cases a day for quite awhile and our own health commissioner believes we are ready to do it.

Sonuvazag,

neither of those links lead to any description of how the USA or a given internal part of the contiguous USA could test/trace/isolate. Did you mean to link to one?

As I said, I'd prefer that kind of course, if it were possible. Do you have any reasons to suggest it is possible? (again, over a 12-36 month time horizon, and not for an island nation)

The USA is down there in the bottom right (30tests per1000 people). Y axis is tests per thousand people.

We aren't (and currently can't) test anywhere close to enough people to effectively test/trace/isolate. Even if we had the political and social willingness to trace and be traced, and to isolate and be forcefully isolated, we lack the physical capacity to sufficiently test, and aren't trending toward having it.

[willandi]

You are assuming that I find death in any family acceptable. You are also assuming lockdown isn’t causing deaths and misery that may outpace the virus in the long run.

If everybody had quarantined and masked it may have bent the curve more but it wouldn’t have stopped the eventual spread of the virus. It is going to run it’s course and it’s arrogant to think we can stop it unless herd immunity is achieved.

One more thing you are assuming. I don’t go about willy nilly without disinfecting things and not taking reasonable precautions designed to protect others like my mother and neighbors that are in higher risk categories.

I am not assuming anything. I am responding to your words.

[Markburn1]

I am not assuming anything. I am responding to your words.

Grow up!

Hmmm. No sense of humor. Haha.

[willandi]

Hmmm. No sense of humor. Haha.

Well, I did delete the grow up before you posted this, or at the same time.

[sonuvazag]

Sonuvazag,

neither of those links lead to any description of how the USA or a given internal part of the contiguous USA could test/trace/isolate. Did you mean to link to one?

As I said, I'd prefer that kind of course, if it were possible. Do you have any reasons to suggest it is possible? (again, over a 12-36 month time horizon, and not for an island nation)

The USA is down there in the bottom right (30tests per1000 people). Y axis is tests per thousand people.

We aren't (and currently can't) test anywhere close to enough people to effectively test/trace/isolate. Even if we had the political and social willingness to trace and be traced, and to isolate and be forcefully isolated, we lack the physical capacity to sufficiently test, and aren't trending toward having it.

Test trace and isolate is what we will be doing in Spokane County and throughout Washington state so I'm not sure why you're convinced it can't or won't be done. As the second link I provided explains our new daily infections are low enough and our testing capacity is high enough for the undertaking. This, again, is me paraphrasing my county's health officer. Do you disagree with his assessment. If so, why?

Crucially, Lutz’s request is founded on his belief that the district has created a way to test enough people that when we find the sick ones, we can trace the path of the disease through their contacts and isolate them. He outlines this plan in his letter to the governor, along with the statistics showing that Spokane’s cases, hospitalizations and deaths have been consistently below the rest of the state.

Too many people have seen our low case counts as the only factor in reopening. But in a time without a vaccine, it’s the test-trace-isolate regimen that is the most important consideration. It is the obvious, absolute requirement for a responsible reopening, and Lutz waited until he had it before getting on board.

In an interview last week, Lutz talked about this strategy as a way of “boxing in” the virus, to allow things to begin to reopen responsibly. This is vital because reopening will all but certainly lead to more COVID-19 cases. If the county can test-trace-isolate, it can shut the cases down before they spread, Lutz said.

He likened it to opening a door very cautiously, while remaining poised to slam it shut if need be.

[Markburn1]

Well, I did delete the grow up before you posted this, or at the same time.

Peace, Brother.

We disagree how this mess should be handled. That’s all.

I don’t wish ill health for anybody.

The goal is to get back to living with a minimum amount of tragedy in the interim. I think it can be done without destroying our way of life.

[LTownZag]

Test trace and isolate is what we will be doing in Spokane County and throughout Washington state so I'm not sure why you're convinced it can't or won't be done. As the second link I provided explains our new daily infections are low enough and our testing capacity is high enough for the undertaking. This, again, is me paraphrasing my county's health officer. Do you disagree with his assessment. If so, why?

I disagree with his expectation that over the course of the next 6 months Spokane or any major city or entire state (maybe except AK, Hawaii, perhaps Vermont or Maine?) will have sufficient tests (not to mention willing test-takers and isolation enforcers) to trace and isolate infected people and their contacts.

We probably have sufficient tests for all cases now, on that I likely agree.
But Spokane is a hub of commerce, education, and transportation for a huge area and has a population that is completely unexposed to a novel highly infection respiratory disease. It doesn't have natural borders or barriers to entry and can't realistically be locked-down in the sense that Israel, or Wuhan, or Singapore has been.


I just found this:

( testandtrace.com ) I appreciate that they quantify their baseline for preparedness (Less than 3% of tests being positive, and having a staff of 5-15 trained contact tracer per daily positive case).

[willandi]

[sonuvazag]

We probably have sufficient tests for all cases now, on that I likely agree.
But Spokane is a hub of commerce, education, and transportation for a huge area and has a population that is completely unexposed to a novel highly infection respiratory disease. It doesn't have natural borders or barriers to entry and can't realistically be locked-down in the sense that Israel, or Wuhan, or Singapore has been.

Everything you said about Spokane was true over the last two months when our restrictions were able to cause a peak and recession in our number of daily infections. It's strongly suggested by Bob Lutz that he's ready to move us back into a more restrictive scenario as necessary. But if we have capacity to test trace and isolate at the moment, I just don't understand why we wouldn't do it.

Sure, there's a theoretical timeline that's long enough where, without the emergence a treatment or vaccine, it will eventually be moot, but it's pretty likely that after two months less than 1% of the county's population has been infected so far. With that in mind, it would be pretty outrageous in my opinion not to try and buy some more time for an effective treatment or vaccine.

[Markburn1]

https://spectator.us/lives-vs-lives-...cost-lockdown/

Something to consider

[Markburn1]

Another. A balanced approach.

https://okstatefe.blogspot.com/2020/...defeating.html

Agree with most of this. Not all.

[LTownZag]

Everything you said about Spokane was true over the last two months when our restrictions were able to cause a peak and recession in our number of daily infections. It's strongly suggested by Bob Lutz that he's ready to move us back into a more restrictive scenario as necessary. But if we have capacity to test trace and isolate at the moment, I just don't understand why we wouldn't do it.

Sure, there's a theoretical timeline that's long enough where, without the emergence a treatment or vaccine, it will eventually be moot, but it's pretty likely that after two months less than 1% of the county's population has been infected so far. With that in mind, it would be pretty outrageous in my opinion not to try and buy some more time for an effective treatment or vaccine.

1. It's definitely not "pretty likely" that 1% of the US has been infected. 4-5% is what the large scale studies are showing for antibodies. If only 1% have been infected (3.3 million) then the infected fatality rate would be over 3%. It's not that deadly.

2. What the Spokane area could have done in March or April, isn't likely to be what they will be able to do in 6 or 10 months. I hope so, but i fear and predict not.

[willandi]

https://www.healthline.com/health/r-...r#covid-19-r-0

"For example, in 1918 there was a worldwide outbreak of the swine flu that killed 50 million people. According to a review article published in BMC Medicine, the R0 value of the 1918 pandemic was estimated to be between 1.4 and 2.8.

But when the swine flu, or H1N1 virus, came back in 2009, its R0 value was between 1.4 and 1.6, report researchers in the journal Science. The existence of vaccines and antiviral drugs made the 2009 outbreak much less deadly.


COVID-19 R0
The R0 for COVID-19 is a median of 5.7, according to a study published online in Emerging Infectious Diseases. That’s about double an earlier R0 estimate of 2.2 to 2.7

The 5.7 means that one person with COVID-19 can potentially transmit the coronavirus to 5 to 6 people, rather than the 2 to 3 researchers originally thought."

[sonuvazag]

1. It's definitely not "pretty likely" that 1% of the US has been infected. 4-5% is what the large scale studies are showing for antibodies. If only 1% have been infected (3.3 million) then the infected fatality rate would be over 3%. It's not that deadly.

2. What the Spokane area could have done in March or April, isn't likely to be what they will be able to do in 6 or 10 months. I hope so, but i fear and predict not.

The United States has regional differences in the percentage infected.

You said earlier that you believe 14,850,000 Americans have been infected. That's approximately 10x the number of confirmed cases. I'll use that multiplier.

There have been 394 confirmed cases in Spokane County and we have a low % of positive tests so it's likely we are, if anything, very good at detecting infections. If I multiply 394 by 10 I get 3,940, which is less than 1% of the 500,000 total county population.

[Markburn1]

Currently checking for bruises on my head and dents in the wall.

I’ll leave you DOOMSDAY prophets alone for awhile.

Haha.

[sonuvazag]

Currently checking for bruises on my head and dents in the wall.

I’ll leave you DOOMSDAY prophets alone for awhile.

Haha.

I read your links and I agree that as we move forward and loosen restrictions, special attention should be given to protecting the most vulnerable. In all conversations on this board I have acknowledged that there is a real cost to restricting the economy.

That I believe the restrictions have helped many US communites bend the curve back substantially and that test, trace, and isolate should be a part of the path forward seem to be our biggest points of contention.

From what I can tell, you don't think the virus is as deadly overall as I do. I believe you've compared it to the seasonal flu many times. Because we operate on different premises about the deadliness of the virus, it makes sense that we have different opinions about how it should be managed.

I don't this is a question of who has the moral high ground here. It's a very difficult problem and there's a lot of noise in the data. It's hard, in my opinion, to be sure about any of it.

[Markburn1]

I read your links and I agree that as we move forward and loosen restrictions, special attention should be given to protecting the most vulnerable. In all conversations on this board I have acknowledged that there is a real cost to restricting the economy.

That I believe the restrictions have helped many US communites bend the curve back substantially and that test, trace, and isolate should be a part of the path forward seem to be our biggest points of contention.

From what I can tell, you don't think the virus is as deadly overall as I do. I believe you've compared it to the seasonal flu many times. Because we operate on different premises about the deadliness of the virus, it makes sense that we have different opinions about how it should be managed.

I don't this is a question of who has the moral high ground here. It's a very difficult problem and there's a lot of noise in the data. It's hard, in my opinion, to be sure about any of it.

Appreciate the response. The only thing I would point out is that I’ve never compared it to the flu that I can remember.

I am going to bow out for awhile on this thread.

[sonuvazag]

Appreciate the response. The only thing I would point out is that I’ve never compared it to the flu that I can remember.

I am going to bow out for awhile on this thread.

Fair enough. Sorry to mix you up with those that were arguing it was just another flu. My only correction is that I am not a prophet of doom. I still believe an effective public health response from this point forward can save A LOT of lives, even accounting for the other costs of economic restrictions.

[ZagaZags]

I like this guy.

[Markburn1]

https://dph.georgia.gov/covid-19-daily-status-report

We were told that Georgia, by reopening too soon, was going to be a disaster of monumental proportions.

There is a chart on this State of Georgia site that shows data concerning covid-19.

It appears that fears were completely overblown. Granted, it's early in the process of reopening but the numbers would indicate that cases, hospitalizations and deaths are all diminishing. I've looked all over trying to find alternative sources that confirm the supposition of disastrous infection rates and deaths. I can't find any.

Do you believe the data?

This should be celebrated shouldn't it? At least cautiously celebrated?

[LTownZag]

https://dph.georgia.gov/covid-19-daily-status-report

We were told that Georgia, by reopening too soon, was going to be a disaster of monumental proportions.

There is a chart on this State of Georgia site that shows data concerning covid-19.

It appears that fears were completely overblown. Granted, it's early in the process of reopening but the numbers would indicate that cases, hospitalizations and deaths are all diminishing. I've looked all over trying to find alternative sources that confirm the supposition of disastrous infection rates and deaths. I can't find any.

Do you believe the data?

This should be celebrated shouldn't it? At least cautiously celebrated?

I think it absolutely should be celebrated. There has been an incredible variety of outcomes (differences from place to place) and we know some of the reasons, but the degree or difference has been shocking.

Why north Italy but not Rome?

Why Madrid but Lisbon?

Why NYC (area) but not Dallas, Houston, or south Florida?

It seems increasingly evidenced that being outside or in large areas with airflow isn't nearly as dangerous a transmission route as close confinement on public transport, shared housing, conferences, religious gatherings, indoor exercise classes, etc.

The daily movements and crowd groupings in Georgia in the past 3 weeks have likely been very different from what they were 3 months ago, and both of those likely very different from NYC are in March. If all federal/state/local lockdown rules were removed today at noon, people and businesses will still act in ways that lower disease spread rate vs 8 weeks ago.

Rudy Gobert getting COVID and the prime time televised Jazz NBA game getting cancelled post-warmups might have done more for overall public health and perception of the seriousness of the threat than many of the subsequent government dictates.

[LTownZag]

The United States has regional differences in the percentage infected.

You said earlier that you believe 14,850,000 Americans have been infected. That's approximately 10x the number of confirmed cases. I'll use that multiplier.

There have been 394 confirmed cases in Spokane County and we have a low % of positive tests so it's likely we are, if anything, very good at detecting infections. If I multiply 394 by 10 I get 3,940, which is less than 1% of the 500,000 total county population.

We know about 10% of Boston and ~20% of those in NYC have antibodies (signs they were infected).

Other (most) areas of the USA are well below the average of 4%. I wouldn't be surprised if at this point, only 1-2% of people in eastern Washington, Spokane, or the whole PNW outside Seattle metro have antibodies. I tried to look up if widespread randomized antibody tests have been done, and couldn't find any. Please post if you do.

[JPtheBeasta]

Covid Deaths By Age Group:

Data from the CDC website, accessed 5/17/2020 [https://www.cdc.gov/nchs/nvss/vsrr/c...kly/index.htm]

Age Group	Covid Deaths	Population	Percent of All Covid Deaths	Percent of Age Group	Deaths Per 100K Persons
<1	4	3,848,208	0.01%	0.00%	0.10
1-4	2	15,962,067	0.00%	0.00%	0.01
5-14	6	41,075,169	0.01%	0.00%	0.01
15-24	59	42,970,800	0.11%	0.00%	0.14
25-34	388	45,697,774	0.71%	0.00%	0.85
35-44	973	41,277,888	1.77%	0.00%	2.36
45-54	2,772	41,631,699	5.05%	0.01	6.658
55-64	6,725	42,272,636	12.26%	0.02%	15.91
65-74	11,524	30,492,316	21.01%	0.04%	37.79
75-84	14,930	15,394,374	27.21%	0.10%	96.98
85<	17478	6,544,503	31.86%	0.27%	267.06
All	54861	327,167,434	100%	0.02%	16.77

Commentary:
It is safe to assume that athletes are in the low risk category unless a) they have other things wrong with them (sickle cell trait is one that isn't on the list but I would love to see data on, given the weird vascular stuff going on with this disease) or b) they play for BYU, in which case there may be a chance they are 35 or older (zing!). I agree with a comment above that this is more about protecting coaches, ancillary staff, and fans than the players (potentially really nasty illness that you get over, notwithstanding). The table and other data (above and below) is helpful in determining one's risk of death/serious illness, based on age and current health condition.

Other useful things to consider:

• "[F]or 7% of the deaths, COVID-19 was the only cause mentioned. For deaths with conditions or causes in addition to COVID-19, on average, there were 2.5 additional conditions or causes per death." [Same reference as above]

• An oft-cited number is that about 80% of all Covid-19 cases are mild

• 89.3% of all persons who are hospitalized have at least one other underlying condition. That number jumps up to 94.4% for persons over 65.[https://www.cdc.gov/coronavirus/2019...patients.html] If you are a healthy person over 65, despite the data above, your risk seems to still be low.

• In a study of a large NY hospital, 88% of the patients that were admitted (ie seriously ill) had 2 or more comorbidities [https://jamanetwork.com/journals/jam...ticle/2765184]

• 43,932 deaths (80%) are persons over the age of 65. If you look at ages 55 and up, that percentage goes to 92%

[MDABE80]

OLDER GUYS! Drat!...…..let's plan on a season of good competition. Data is mixed but it does look like the number of new cases has been cut in half compared to Early March. There still will be blips though. Big problem is the mixed diagnoses. I have a crew that does janitorial. The owner is Ukrainian and his father passed at age 72 last week. His dad had congestive heart failure and some component of kidney failure. His death certificate read COVID. No blood test to confirm. Lots of this has gone on. Not sure what to make of it. It is now and it'll be difficult to know exactly what disease/diseases are responsible for mortality. My Friends at NIH are thinking 25-50% were coded wrongly or scik elderly had that as a final straw that pushed them over the edge. Troublesome when the data isn't clear. IMHO.

[scrooner]

Data is mixed but it does look like the number of new cases has been cut in half compared to Early March.

Can you clarify this statement? Where is this reduction in new cases taking place? In "early March" in the US, we were seeing less than 1K new cases per day in the US. We are now seeing between 18K and 25K new cases per day.