Stayin' Alive - Covid-19 #10

[Castellan]

sounds like it would take a long time to develop treatments too:

https://www.smh.com.au/national/read-about-a-new-covid-19-treatment-study-it-probably-won-t-work-20200406-p54hjs.html

 

[Zorral]

    . . . . There is a classic sfnal scenario about what this all means, especially for our now present and future. There were many variations which were in movies, tv, print entetainment and / or warning  between about the 1930's and whenever lock step in grey 1984-Brave New Worlds and other variations were no longer anyone feared because the commiesocialist baddies had been so beaten. But here again is the variation of what was so inspired by certain people's ideas of what it was like in China and Asia then.

Quote

Wuhan emerged from its 76-day lockdown.
Eleven million residents have been given the liberty to move around the city and mainland country again, provided their government-issued “health code” shines green. People are assigned a green, orange or red code, according to their risk of having the coronavirus, and must scan a green QR code before they can enter stores or restaurants, or take public transportation — an electronic passport for daily life. (Anna Fifield and Lyric Li)

Everything feels very strange at the moment. I mean, wot the hell. I mean this is what They Said FDR, Obama, etc, were going to do to us, but it was, as we knew, what They wanted to do to us.

I mean, this is the sfnal template, not the cozy disaster in which the nice people who matter and have relatives who are Super Competents in the military and sciences and they put it all back together even better than before (though they caused it in the first place) and ride in on USA helicopters with vast supplies and ferry their family members and their new community of other super competents back to where civilization has been reinstituted, along with elections.  And even out there at rich country relatives house, summer home, they manage to do well, and certainly well enough and are from the gitgo the defacto leaders of this improvised disaster community -- and everybody else is just, I dunno? collateral damage?

 

[Aemon Stark]

3 hours ago, Fragile Bird said:

Thanks for that, @Aemon Stark!  Btw, how goes the battle in your neck of the woods?

I am wondering if this paper in the Lancet is what the story was referring too.  The story was written for the lay person, the summary to this paper is not.

https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3544826

There's a bit over 200 cases in NL now, mostly not hospitalized, and our area has so far been largely spared. For now. 

I think the lipid thing is interesting, because there is retrospective data in the dialysis population regarding outcomes and lipid levels. But it's very hard to know what that means; they tend to be high risk at baseline for infectious and vascular complications, among other things. 

There's still much we don't know about this virus. 

[The Anti-Targ]

53 minutes ago, Aemon Stark said:

There's a bit over 200 cases in NL now, mostly not hospitalized, and our area has so far been largely spared. For now. 

I think the lipid thing is interesting, because there is retrospective data in the dialysis population regarding outcomes and lipid levels. But it's very hard to know what that means; they tend to be high risk at baseline for infectious and vascular complications, among other things. 

There's still much we don't know about this virus. 

If you are talking about the Netherlands I think you mean 20,000 not 200.

[Meera of Tarth]

12 hours ago, Toth said:

Day 23 of the lockdown. I... I'm afraid my body starts to dissolve into a heap of pain. While I am a big couch potato, this amount of sitting at the laptop that I am doing right now is truly ridiculous. Because I have started to fight with constant neck pain and headaches I have started to pick up jogging again yesterday. After a small jog and a shower my pain is like blown away, but over the course of the day and into the night till the next morning it slowly returns. This happened yesterday and this happened today, with me already having my headache back. This... this is super frustrating... I guess I have to look for stuff I can do inside to work on my fitness, but here I have to deal with my usual anxiety attacks that prevent me from doing any exercise for fear of getting seen. Gah...

I am feeling the effects as well..Never ever had so much work every day just for academical issues......but here we can't go jogging as you know.

Well....I have never thought people actually wants or doesn't want to see you go jogging...so don't worry for that. You are just self-conscious. It's not real. And I bet now it would be the least of their priorities...

However training inside should be more admisable now probably.

[Wall Flower]

4 hours ago, Ran said:

Every country except a relative handful will attempt to control the virus at a level that does not overload the health care system but is otherwise as loose as is possible. Rather than going full lockdown every time things get past test-and-trace, I think most countries will accept that there's a certain amount of spread that will have be tolerated that extends beyond what testing and tracing regimens are simply capable of. That's my view of where this is going.

 

Especially in the US. And not even through Trump's incompetence or malfeasance, but because the United States is a place where you aren't even obligated to provide identification to authorities in most states. The idea that we're going to able to pervasively track and identify carriers within state boundaries, much less across them, in the time it takes this thing to spread a few times is fantastical.

Paul Romer, whom Yglesias mentioned in the embedded tweet, is talking about the US building up the ability to take and process 100 million tests per week to combat a virus that will not be stomped out. It's absurd. The flu season in 2017-2018 may have killed 61,000 Americans, according to the CDC, and it's just something we accept and approach from the perspective of reasonable mitigation.

COVID-19 will also be the subject of reasonable mitigation as we keep seeing these outbreaks, especially if the vaccines people talk about are a pipe dream. I thought vaccination was time consuming but relatively easy, but reading more about it, we have basically never created a coronavirus vaccine before. Not even for SARS. It'd make more sense to try variolation techniques than to hold out hope for a vaccine that may never come and, in any case, may be all rather moot ~12 - 18 months out if most of the world has gone through infection anyways.

There was an interesting interview with one of the teams here in Australia working on the development of a vaccine. They had been involved in initial research into the development of a vaccine against SARS and MERS but that development didn't proceed because both those outbreaks were successfully contained, not because they didn't believe that a vaccine wasn't possible. Obviously, the development of a vaccine is consuming of both funding and time.

[The Anti-Targ]

Very early to come to a solid conclusion, but 2 weeks to the day that our lockdown started we see a precipitous drop in daily cases from 50 new cases yesterday to 29 new cases today. I'm predicting this significant drop will continue and keep dropping now that the 2 week incubation period of pre-lockdown exposure has ended and we start to see the true benefit of the lock down. I expect if we collectively keep up the discipline we should be down below 10 cases per day by the end of the next 2 weeks.

The question now is how do we button off without getting a rebound in daily cases.

[S John]

3 hours ago, Zorral said:

    . . . . There is a classic sfnal scenario about what this all means, especially for our now present and future. There were many variations which were in movies, tv, print entetainment and / or warning  between about the 1930's and whenever lock step in grey 1984-Brave New Worlds and other variations were no longer anyone feared because the commiesocialist baddies had been so beaten. But here again is the variation of what was so inspired by certain people's ideas of what it was like in China and Asia then.

Everything feels very strange at the moment. I mean, wot the hell. I mean this is what They Said FDR, Obama, etc, were going to do to us, but it was, as we knew, what They wanted to do to us.

I mean, this is the sfnal template, not the cozy disaster in which the nice people who matter and have relatives who are Super Competents in the military and sciences and they put it all back together even better than before (though they caused it in the first place) and ride in on USA helicopters with vast supplies and ferry their family members and their new community of other super competents back to where civilization has been reinstituted, along with elections.  And even out there at rich country relatives house, summer home, they manage to do well, and certainly well enough and are from the gitgo the defacto leaders of this improvised disaster community -- and everybody else is just, I dunno? collateral damage?

 

The Chinese government is pretty fucked up.  There’s plenty out there about the shit they’ve done in Xinjiang, and IMO (and there’s available evidence for this opinion), they are gearing up to go country-wide on the tech based surveillance system they’ve been honing in Xinjiang against the Uyghur's.  China is legitimately on the brink of becoming a highly functioning sci-fi style surveillance state dystopia...  and they’d love to export that system.  

I cannot stand Trump and I have a lot of problems with the way he goes about it, but a tough stance on Xi’s China is not unwarranted.  America has a myriad of problems but if it’s between us (or, say, the West in general) leading the way into the future vs. China, I don’t think that’s a hard call at all.  I have no problem being friendly with China and trading with them, but we really should ensure that we do not depend on them for anything critical.  And we should serve as a check on their ambitions.  

Trump kind of approaches China from a somewhat bizarre trade deficit perspective, but it’s really a national security issue.  China is the big reason why Trump alienating our actual allies with his boorishness makes me so squeamish.  A global community in an era increasingly driven by technology with a dominant China (at least with their current government) is seriously scary. 

[Luzifer's right hand]

A co-worker of an aunt of mine who had a very mild case and no symptoms for 10 days was tested again 16 days after her first positive test and was positive again. This was only done because her doctor made it happen. Other positive co-workers of her with less mild symptoms returned to work 2-4 days after being symptom free without undergoing a test.

For the last two days on my way home from work I walked past a construction site where people work and in hand with each other without any protective equipment. The police drove by one of those times without doing anything. 

At work people ignore the rules all the time unless you are aggressive about protecting yourself and don't shy away from confrontation. 

Most things I, famliy or friends experinced in the last few weeks don't match the narrative my goverment and classic media are telling at all. I dunno if you can call it anything else but propaganda at this point. Message control is what our chancellor calls this I belive(classic media in Austria is controlled by a handful of companies). 

[Which Tyler]

5 hours ago, The Anti-Targ said:

Very early to come to a solid conclusion, but 2 weeks to the day that our lockdown started we see a precipitous drop in daily cases from 50 new cases yesterday to 29 new cases today. I'm predicting this significant drop will continue and keep dropping now that the 2 week incubation period of pre-lockdown exposure has ended and we start to see the true benefit of the lock down. I expect if we collectively keep up the discipline we should be down below 10 cases per day by the end of the next 2 weeks.

The question now is how do we button off without getting a rebound in daily cases.

The "If I were in charge" - it would be a staged release of lockdown. Each stage being 3 weeks apart (longer if necessary).

1. Anyone who has had symptoms (whether tested or not) is released from lockdown (but hygeine requirements and social distancing still practiced) - this would show a surge in new infections, but should be small and manageable (certainly well below healthcare capacity); with testing and contact tracing. Maybe include something like the South Korean app using bluetooth data as a prerequisite for release.

2. Allow a new category of "sub-essential workers" to be released - so that other occupations can return to work - especially those who cannot work from home; but require strict hygeine guidelines for them - again, this would show a surge in new infections again, which should be manageable with test and contact tracing. This would need to be tracked very carefully to ensure that any surge is kept small.

3. Allow other workers to be released - and again, strict hygeine, track and trace measures.

4. Lockdown is released (barring vulnerable people), but national borders are still secured - track and trace.

5. Gradually ease off on the hygeine and social distancing measures -track and trace.

6. Vaccine found and distributed OR herd immunity otherwise gained.

7. Gradually re-open national borders, initially to countries with successful vaccine programs &/ herd immunity also reached. This is the time to release the vulnerable popultion.

 

But the situation will be fluid, and the government would need to publicise both the plan, and the fact that it's not a linear process, and that they may need to tighten things up again based on the data on the ground - especially if a surge is bigger or faster than expected. You need to be well into the downside of any slope before triggering the next phase - so 3 weeks minimum (preferably more), as the data is always going to be 2 weeks behind what's happening, and you need a good 3-4 days worth of results to know you're looking at a trend, not a fluke.

The bigger the population, and the larger the land border - the tougher it's all going to be.

[BigFatCoward]

4 minutes ago, Which Tyler said:

The "If I were in charge" - it would be a staged release of lockdown. Each stage being 3 weeks apart (longer if necessary).

1. Anyone who has had symptoms (whether tested or not) is released from lockdown (but hygeine requirements and social distancing still practiced) - this would show a surge in new infections, but should be small and manageable (certainly well below healthcare capacity); with testing and contact tracing. Maybe include something like the South Korean app using bluetooth data as a prerequisite for release.

2. Allow a new category of "sub-essential workers" to be released - so that other occupations can return to work - especially those who cannot work from home; but require strict hygeine guidelines for them - again, this would show a surge in new infections again, which should be manageable with test and contact tracing. This would need to be tracked very carefully to ensure that any surge is kept small.

3. Allow other workers to be released - and again, strict hygeine, track and trace measures.

4. Lockdown is released, but national borders are still secured - track and trace.

5. Gradually ease off on the hygeine and social distancing measures -track and trace.

6. Vaccine found and distributed OR herd immunity otherwise gained.

7. Gradually re-open national borders, initially to countries with successful vaccine programs &/ herd immunity also reached.

 

But the situation will be fluid, and the government would need to publicise both the plan, and the fact that it's not a linear process, and that they may need to tighten things up again based on the data on the ground - especially if a surge is bigger or faster than expected. You need to be well into the downside of any slope before triggering the next phase - so 3 weeks minimum (preferably more), as the data is always going to be 2 weeks behind what's happening, and you need a good 3-4 days worth of results to know you're looking at a trend, not a fluke.

The bigger the population, and the larger the land border - the tougher it's all going to be.

I agree that something like this is needed, however how do you control arseholes at stage one?  Every ignorant fuck will just be 'i've had symptoms, let me out'. 

[Which Tyler]

34 minutes ago, BigFatCoward said:

I agree that something like this is needed, however how do you control arseholes at stage one?  Every ignorant fuck will just be 'i've had symptoms, let me out'. 

Ultimately - you can't (excepting authoritarian dictatorships I guess).
You could go further, and keep stage 1 to those who tested positively (or who sought medical help); but then, we'd be releasing such a small number it wouldn't make much difference on a national level; all it would serve is a test as to whether exposure actually grants immunity or not (a worthwile test). Ultimately each phase needs to release enough people to make it worthwhile - economically, and as a test of where the infection rate goes. The track and trace is where it's really at (give police the power, or a simple-enough tool, to check that anyone they want to talk to, has the relevant app, and bluetooth enabled)

If a cheap, easy and reliable anti-body test is developed, then great; go with that; but otherwise, you're left "on your honour" - and hope there aren't too many selfish arseholes as a percentage of the population (where, of course, you'll have unavoidable observer bias). If there are too many arseholes - the everyone's grounded again, and back to stage 0 (or only those who've tested positive).

I do need to add an extra stage though - to release the vulnerable from isolation - actually, that's probably at the same time as border re-open, as you don't want it until herd immunity is acheived (via vaccine or exposure).

 

The key is to learn from the South Korean model; and to release the population in sections, not totality to keep it manageable - first the least vulnerable, then the most "important" members of society. Yes, antibody testing would be great - but who knows how long before that's realistcally possible. IMO you CAN keep lockdown in place for several months. You can't when measuring time frames in years. There comes a point when the cost of lockdown simply outweighs the benefits.

 

Having said that, of course, there comes a point where risk of COVID19 is less than the risk of miscellaneous health problems caused by isolation (predominantly mental, cardiac & musculoskeletal - 2 of which can be deadly in and of themselves, and the 3rd feeds straight back into the first 2) - that judgement requires way more information than I could ever come up with as a suggestion.

[Heartofice]

I think it’s not possible till there is a reliable anti body test , and then bracelets or something to prove you are ‘clean’

BFC is right, there will be enormous numbers of arseholes who don’t really care and will just pretend they are already immune, especially if it’s summer. I think we both share the same cynical view of humanity, or at least your average Brit 

[RhaenysBee]

Well well. 

appears that I was wrong on Monday. We do have a daily increase of 80ish new cases now. People just won’t stay the F home. We have about 10 new deaths per day as well, which brings us to a solid 40% mortality rate of closed cases. 

also, a smart friend of mine suggested that we might after all have a lockdown from tomorrow on, as in retrospect our government’s response can be broken down into two-week phases. Now the two weeks of partial lockdown is up and city residents‘ lack of abiding of the rules made sure that we didn’t see the positive impact the restrictions were supposed to bring. We will have announcements later today but I feel like there will be some very difficult decision-making this afternoon. Also, I have to run out an quickly buy hair dye while I still can. 

[Ran]

10 hours ago, Mudguard said:

Currently, there are about 1.5 million confirmed cases, so if you assume that we only detect 20% of the cases, that would mean there's currently about 7.5 million cases.

This is probably a very generous assumption.  Imperial College's modelling suggests the number is much higher. In fact, there's the first results (Reddit thread because it provides a translation of the key facts) of antibody reporting in Denmark  is useful because it uses March 28th breakpoint that Imperial College did. At that time, there were 917 detected cases. Imperial College estimated that with  1.1% (95% credible level) of the population was infected at that point with a range from .40 to 3.1%. Denmark's antibody test suggests to them that on March 28th 3.5% were actually infected.

So more people were infected then even the most extreme of the estimate. The most extreme of the Italy and Spain estimates based on their models were 26% and 41% respectively, so... yeah. We've likely detected substantially less than anyone thinks.

Also saw the NY Times believes that NYC has had cases as far back as mid-February.

[Hereward]

8 hours ago, The Anti-Targ said:

If you are talking about the Netherlands I think you mean 20,000 not 200.

Newfoundland and Labrador I believe.

[Clueless Northman]

39 minutes ago, Ran said:

Also saw the NY Times believes that NYC has had cases as far back as mid-February.

Makes sense, since it was running wild across Northern Italy since late January - and the first cases in the East Coast definitely came from Europe.

[Chaircat Meow]

In the UK we think the first cases may have been mid-January as people came back from Alpine ski resorts. can't find link to the story at the moment.

Oddly enough half of my office, including me, had moderate to bad flu in early-mid February and we are in central London (I lived in London's COVID-19 hotspot at the time, Southwark.) No one really thought it was Corona but it might have been as flu never seemed to hit so many people so hard in previous years. As most people are under-40 it may have been able to spread around the office without causing a serious case. On the other hand, may just have been the usual. 

[Rippounet]

So 11,000 deceased in France.
Since I've been following the numbers these last few days it seems we're not far from 1,000/day.

There's a rumor that "patient zero" in France was aboard a specially chartered plane (a military A340 to be specific) bringing back VIPs (business people, diplomats...) from Wuhan on January 31.
Having checked, it seems to be bullshit. The people were all quarantined and under medical surveillance, and on January 31 France had already 6 cases of Covid-19.

 

[JoannaL]

Today a study was pulished which may help determine the number of infected without symptoms. In a county with a major outbreak (1500 infected, 44 dead),  600 randomly selected persons were examined (antibody-testing). They found in  2 % active cases of a coronavirus infection  and in 15% of all persons antibodies. Which means the mortality rate is substaintely lower than expected previously ( something like 0,37 %)