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Who Pays the Coronaman? - Covid #8


Tywin Manderly

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We have 408 cases (+65 since yesterday). And I finished up the first bottle of Matusalem of today. This morning I was feeling especially awful about the world and I was telling my mother that I thought the dinosaurs were better off with their meteorite, then again, they didn’t have booze, so I hereby retract that opinion. 

I also let go of attempting to make sense of this situation. The news are completely unreliable and nobody really has any idea what the correct course of action is.

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19 hours ago, Ran said:

They are not wrong, exactly. The WHO's standard focus on systematic mass testing really is motivated by the question of resources available to care for people who are not accurately or certainly diagnosed (or diagnosed early) but present a burden to the health care system when ill. Countries that have the capacity to care for many ill people really don't have to test as widely so long as their capacity is not outstripped by cases.

The issue, of course, is the uncertainty about the rate and spread of the illness. But part of the problem is that the current testing regimen is potentially too broad in its findings -- it detects the RNA of the disease but that can be present in people who have already had it in the past but are no longer ill. This is the theory behind how some countries (Sweden, for example) are approaching it, that the tactics used by, for example, South Korea and Germany are a sledge hammer rather than a razor because the testing is too unspecific. 

We'll see how it plays out over the next couple of weeks, especially as antibody testing begins to ramp up.

 

The WHO's recommendation is a containment strategy that is designed to minimize the numbers of people that get infected.  It only works when the number of infected is low.  When the number of infected is high, you do not have the resources to perform enough tests or to do the contract tracing, which is very labor and resource intensive.  Many countries have way too many cases to use this approach right now.

The viral RNA is only detectable when the patient is shedding the virus, which is during infection and for a short period of time after you've recovered while your body sheds dead virus.  You shouldn't be able to detect viral RNA after all the dead virus has been cleared by the body.  I think this can take up to a week or two, but I'm not sure.  There is probably quite a bit of variability that depends on things like the severity of the infection (severe infection means more virus to clear which takes longer).

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On 3/28/2020 at 11:15 AM, Maithanet said:

Continuing my series, Here's an update on the number of coronavirus test results by day in the US.

3/23 - 54k

3/24 - 64k

3/25 - 74k

3/26 - 97k

3/27 - 107k 

3/28 - 109k

However, I was looking more carefully at this dataset, and it is pretty disheartening.  The biggest caveat is that the 109k includes all the negatives for Maryland and Missouri in the past two weeks, which accounts for 21k negative tests that day.  Take those out and the number goes down to 88k.  But there were several states that didn't give an update (CT), states that updated the positive cases but not the total cases (AL, AZ, DE, HI, ME, MS, OH) or inexplicably that updated only NEGATIVE cases (WTF are you doing Michigan?)  Anyways, I remain incredibly frustrated both that testing is going up so slowly AND that states are not prioritizing keeping the public informed. 

Because of this, you get people making inferences from bad data like this:

Which sounds encouraging, but is almost total crap, because on 3/27 we the only state that didn't update positive cases was SC, whereas on 3/28 it was CT and MI (two states with exploding numbers of cases).  Those states have both updated since then, and together would put the 3/28 total over 20k.  Which destroys the whole thesis that positive cases are "leveling off".  AT BEST they're increasing a bit less quickly.  And even that might be a function of fewer tests (because of the MO/MD problem above), rather than actually fewer cases.

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6 minutes ago, Maithanet said:

"snip"

Which sounds encouraging, but is almost total crap, because on 3/27 we the only state that didn't update positive cases was SC, whereas on 3/28 it was CT and MI (two states with exploding numbers of cases).  Those states have both updated since then, and together would put the 3/28 total over 20k.  Which destroys the whole thesis that positive cases are "leveling off".  AT BEST they're increasing a bit less quickly.  And even that might be a function of fewer tests (because of the MO/MD problem above), rather than actually fewer cases.

Every time I see some blowhard comment on a NYT article that "China's numbers can't be trusted" I point out the US numbers can't be trusted. Oh, the fury that causes!

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23 minutes ago, Fragile Bird said:

Every time I see some blowhard comment on a NYT article that "China's numbers can't be trusted" I point out the US numbers can't be trusted. Oh, the fury that causes!

That's the point, BIRD! No one can trust the numbers. 

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12 minutes ago, Tywin et al. said:

That's the point, BIRD! No one can trust the numbers. 

Yep. It’s in a very cynic way almost funny. Stalin was right (one death a tragedy etc). For example, in Italy, France (and likely the UK) only those that died in hospital are statistically counted. Those that died at home or nursing home don’t go into the statistic. IRRC @fez posted an interesting hard data empirical analysis. 

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1 hour ago, Maithanet said:

3/28 - 109k

However, I was looking more carefully at this dataset, and it is pretty disheartening.  The biggest caveat is that the 109k includes all the negatives for Maryland and Missouri in the past two weeks, which accounts for 21k negative tests that day.  Take those out and the number goes down to 88k.  But there were several states that didn't give an update (CT), states that updated the positive cases but not the total cases (AL, AZ, DE, HI, ME, MS, OH) or inexplicably that updated only NEGATIVE cases (WTF are you doing Michigan?)  Anyways, I remain incredibly frustrated both that testing is going up so slowly AND that states are not prioritizing keeping the public informed. 

Because of this, you get people making inferences from bad data like this:

Which sounds encouraging, but is almost total crap, because on 3/27 we the only state that didn't update positive cases was SC, whereas on 3/28 it was CT and MI (two states with exploding numbers of cases).  Those states have both updated since then, and together would put the 3/28 total over 20k.  Which destroys the whole thesis that positive cases are "leveling off".  AT BEST they're increasing a bit less quickly.  And even that might be a function of fewer tests (because of the MO/MD problem above), rather than actually fewer cases.

Yes, what we need to also know is how large is the backlog of tests waiting to be tested.  I still read that turnaround time is generally five or more days.  Senator Rand's test took 6 days to process.  This means there's still a huge backlog of samples to be tested, and that testing capacity is still not enough to meet demand yet, which will only get worse as the number of infected increases.

I think our number of infected numbers are counted when the results come in.  It would be more useful if it was counted based on when the sample was collected, along with showing the numbers of samples from that day which are still awaiting results.  It would be much easier to determine whether the infection rate was actually leveling off if it was presented this way.  Right now with the way the data is presented, it's impossible to tell.

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41 minutes ago, Arakan said:

Yep. It’s in a very cynic way almost funny. Stalin was right (one death a tragedy etc). For example, in Italy, France (and likely the UK) only those that died in hospital are statistically counted. Those that died at home or nursing home don’t go into the statistic. IRRC @fez posted an interesting hard data empirical analysis. 

Interesting if true. And just that line of thought in and of itself shows what I'm saying. Who knows if your info is good either? This fucker moves to quickly, and we have far from the best people in charge in many places. 

Also, it's cynical, but your English is far better than my German. Only took one semester in college. I had an A going into the last couple of weeks of the year, but dropped it to get into a program heading to Argentina. It didn't help that most of the audio exercises where street conversations, because you could only hear two-thirds of the dialogue and Germans make up words on the fly! 

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The numbers however that can be trusted: the number of shipments / trucks with massive amounts of medical supplies of every kind to Florida, three so far, another coming -- with little to nothing to New York, New Jersey, Maine, Michigan, Connecticut.  New Jersey received a one-day supply shipment. Once. 

Florida news is trumpeting headlines that all their medical supplies have been diverted to New York. This cannot be ... trusted . . . .

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11 minutes ago, Tywin et al. said:

Interesting if true. And just that line of thought in and of itself shows what I'm saying. Who knows if your info is good either? This fucker moves to quickly, and we have far from the best people in charge in many places. 

Also, it's cynical, but your English is far better than my German. Only took one semester in college. I had an A going into the last couple of weeks of the year, but dropped it to get into a program heading to Argentina. It didn't help that most of the audio exercises where street conversations, because you could only hear two-thirds of the dialogue and Germans make up words on the fly! 

The official wording by the UK authorities, from today (those cheeky smartasses hahaha, noooooo we don’t lie like those commie Chinese or those Allahu Akbar Iranians...you just have to read carefully). 

As of 5pm on 28 March, of those hospitalised in the UK, 1,228 have sadly died.

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8 minutes ago, Arakan said:

The official wording by the UK authorities, from today (those cheeky smartasses hahaha, noooooo we don’t lie like those commie Chinese or those Allahu Akbar Iranians...you just have to read carefully). 

As of 5pm on 28 March, of those hospitalised in the UK, 1,228 have sadly died.

Again, if verifiable, what a joke. 

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So took the dog out for a two mile run/walk. It didn't help that it was cold and a little rainy, but man, I used the word eerie just a couple of weeks ago and this was starkly different. I saw next to no one. Two other dog walkers. A couple walking together. A dad with a few kids in the park. Maybe five cars. And that was it in a fairly busy area. Good! 

I live right next to a major highway and different hospital though, and am hearing an unusual amount of sirens from my window. 

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Apparently Southeast Michigan, Detroit area, is "burning" - i.e., media-speak for an overwhelming number of C19 cases.  They better get a handle on things fast.

From the Detroit Free Press: "How widespread the virus really is, and how many people have contracted it, but don't have confirmation through testing, remains unknown. Access to tests and testing supplies remain very limited in Michigan, which has conducted 15,282 coronavirus tests on a population of nearly 10 million since late February in the state's Department of Health and Human Services labs, hospitals and commercial labs.

What we do know is that the official coronavirus case count is currently doubling about every three days in Michigan. At this rate, Michigan could reach 10,000 cases on Wednesday, and surpass 25,000 on Sunday, if the growth rate doesn't slow, and the state is able to test enough people accurately to assess the caseload. "Southeast Michigan is burning right now," said Dr. Teena Chopra, medical director of infection prevention and hospital epidemiology at DMC Harper University Hospital and a professor at Wayne State University. The surge has begun.

Saturday morning, the state ranked seventh nationally in the number of confirmed cases per capita, behind New York, New Jersey, Louisiana, Washington, Massachusetts and the District of Columbia. Dr. Teena Chopra, medical director of infection prevention and hospital epidemiology at DMC Harper University Hospital, DETROIT MEDICAL CENTER

All indications suggest Detroit is a new hotspot for a fast-spreading coronavirus that was first discovered in December in China and spread like wildfire around the world. The United States now has more confirmed cases than anywhere else globally - more than 120,000 - and more than 2,000 deaths. Wayne County, with Detroit as the county seat, is in the top counties nationally for COVID-19 cases. The infection rate in Detroit is 205 per 100,000 residents, compared to 132 per 100,000 in Wayne County and 47 per 100,000 in the state."

 

Trump better not count on Michigan this election.

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19 minutes ago, Fragile Bird said:

Dr. Fauci was on CNN this morning and he said the US should brace itself for 100,000 to 200,000 deaths. I thought I misheard him, but they are re-running the interview. That's pretty damn chilling.

That is actually a relatively „soft“ outcome given the circumstances. It would mean the infection can be limited to roughly 10% of the population until a viable vaccine or viable anti virals are found. 

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22 hours ago, davos said:



So, at least around here, people are taking this pretty seriously.   Its not enough, though.  With so many people still having to work, its going to continue spreading.  Hopefully it will flatten the curve enough, but I doubt it.  As far as I can find out, the hospitals have not yet been overwhelmed.  But that could change quickly.  I fear what is going to happen in Milwaukee, with its higher population density and large areas of deep poverty.  

 

Hard to say exactly what it's like in Milwaukee right now.  I'm just outside of it (though Milwaukee city lines are screwy that sometimes if you look our place up on a map, it's listed as Milwaukee and not Tosa...so weird).

I'm seeing lots of people walking dogs, biking, etc. around here, bit in the city itself?  My corner of that is just the Marquette area, and I've not been there a lot in the last week or so.  Parents have been moving their students out of dorms, but that's been quick and efficient.  

We'll see what next week is like though, as we've got just enough people living on campus that we're still "essential" in that we have to feed them.  But we're only using salaried managers to do that coverage.  They've allowed work from home, but that's a little tricky when you work in food service...but what I've seen of the campus itself and adjoining area has been very quiet...

 

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