For WHOm the Bell Tolls - Covid-19 #11

[Mladen]

What do I hear about a congressman who said that China should pay for the respirators? Have no idea who he is, but I do hope there will be some serious investigation into Chinese possibly hiding valuable information during epidemic in Wuhan in December and January.

[Clueless Northman]

NYC subway system indeed is crowded, wagons are packed, and the stations are usually tiny and easily crowded as well - they're a century old and never were designed to deal with so many people.

 

5 hours ago, Jeor said:

I think we all expect that there would be a high number of asymptomatic cases out there that we don't know about, but those numbers are crazy. Herd immunity might be a lot closer than we think.

That being said, I don't think we can reach too many conclusions until there's an easy, cheap antibody test that everyone can take pretty easily that will give us a much better indication of the population spread.

Besides what Werthead said, there's also the problem that we don't know how immune asymptomatic people would truly be. Even among people with some degree of illness, antibodies can be found in low levels. Basically, too early to tell, so better be safe and don't plan on getting a natural herd immunity.

[Mr. Chatywin et al.]

11 minutes ago, Risto said:

What do I hear about a congressman who said that China should pay for the respirators? Have no idea who he is, but I do hope there will be some serious investigation into Chinese possibly hiding valuable information during epidemic in Wuhan in December and January.

Good luck with that. 

[Paxter]

The effect of some of the Euro lockdown is interesting. They seem to have done a great job at moving from rapid growth to stabilization, but nothing is really happening beyond stabilization. Italy's 7-day rolling average of daily fatalities is pretty much flat for the past two weeks. 

I'd still call that (qualified) success, but it's obviously not what we saw in China, with fatalities falling sharply around 30-40 days after the general outbreak. 

[Altherion]

3 hours ago, Kalbear said:

Ah, here we go - here's that map I mentioned.

https://abcnews.go.com/Health/nyc-map-shows-neighborhoods-hit-hardest-coronavirus/story?id=69918823

"Some of the hardest-hit neighborhoods include Elmhurst and Kew Gardens Hills in Queens, the South Bronx, and East New York in Brooklyn."

That is emphatically NOT about subway ridership. 

How do you think poor people get to work in NYC? Granted, in some of those areas it's more about buses than subways, but there is little difference between a crowded bus and a crowded train car. In fact, the buses are now somewhat worse because the area near the driver is cordoned off so there is even less space to spread out (but on the bright side, they're temporarily free to use).

[Fez]

14 minutes ago, Paxter said:

The effect of some of the Euro lockdown is interesting. They seem to have done a great job at moving from rapid growth to stabilization, but nothing is really happening beyond stabilization. Italy's 7-day rolling average of daily fatalities is pretty much flat for the past two weeks. 

I'd still call that (qualified) success, but it's obviously not what we saw in China, with fatalities falling sharply around 30-40 days after the general outbreak. 

I think its clear we shouldn't be looking at China's data at all. The revision of a 50% increase in Wuhan's death total announced today is the only the start of the changes that would be needed before its remotely trustworthy.

I mean, they still claim that not a single member of the military became infected, despite them having a frontline role in Wuhan. It's laughable.

[williamjm]

6 hours ago, JoannaL said:

so all over the world, remdesivir is tested. but now first results are public by a chicago hospital. They look very promising. (Unfortunately again just a prepublication, and so on ... so not 100% sure results)

https://www.statnews.com/2020/04/16/early-peek-at-data-on-gilead-coronavirus-drug-suggests-patients-are-responding-to-treatment/

It's always difficult to know whether to pay any attention to this sort of unofficial report, but it sounds like the official results should be coming in later this month, hopefully they'll show some improvement.

While at that website I saw another story criticising the site we were discussing in one of the earlier threads that was estimating death tolls. I remember last week it was predicting abrupt declines in the Italian and Spanish numbers but the decline seems to be much more gradual.

https://www.statnews.com/2020/04/17/influential-covid-19-model-uses-flawed-methods-shouldnt-guide-policies-critics-say/

6 hours ago, Fragile Bird said:

Argh, yes of course! I was thinking of Taiwan, population 23.8 M.

Speaking of Taiwan, they've reported no new cases for two days in a row.

6 hours ago, Tywin et al. said:

Perhaps, but they're also testing at higher rates compared to other places. I still remain in the camp that places all over the country, and the world. are vastly under-reporting. I keep going back to the places I've traveled to in the developing world and wonder how their numbers are not exploding.

I read a story earlier about a city in Ecuador where the official death count from coronavirus was 400+ but the number of extra deaths compared to the same period last year was about 6000. There have been stories for a while now that there was a particularly bad problem in Ecuador so it may be worse than other South American countries but it does show how the official figures can be massive underestimates.

[Werthead]

The WHO is concerned about the antibody levels in people who've had the virus, which are not universally, conclusively high enough to suggest that building herd immunity is even possible.

Still early days but that is a concerning conclusion.

[Paxter]

2 minutes ago, Fez said:

I think its clear we shouldn't be looking at China's data at all. The revision of a 50% increase in Wuhan's death total announced today is the only the start of the changes that would be needed before its remotely trustworthy.

I mean, they still claim that not a single member of the military became infected, despite them having a frontline role in Wuhan. It's laughable.

Fair point. I guess I was proceeding on the basis that, even if China's figures are severely under-counted in aggregate, there may be some truth to the downward trend we saw in fatalities/day.

I'm also not really bothering to look at Brazil or Russia's stats so far. (Or Iran's, obviously). 

[Fez]

3 minutes ago, Werthead said:

The WHO is concerned about the antibody levels in people who've had the virus, which are not universally, conclusively high enough to suggest that building herd immunity is even possible.

Still early days but that is a concerning conclusion.

This reminds me of that joke-y NEJM article from years ago pointing out that there was no evidence that parachutes save the lives of skydivers; because there'd never been a peer-reviewed study of it.

I think its incredibly reckless of the WHO to say there's this when there's also no evidence yet that antibodies aren't high enough to confer immunity. And it is important for states and countries to be getting ready for the future; eventually things are going to be reopening to some degree. 

Even the preliminary study I linked to a few days ago was that only a percentage of people seemingly had antibody levels too low for immunity (interestingly it was generally the asymptomatic people who had that issue), for the vast majority of people the antibodies were in line with what would be expected to confer immunity. Now we don't know for sure that it does yet, but consider that in nearly all cases viral antibodies do give immunity for at least a couple years, I'd be pretty surprised if there was no protection now.

[Fragile Bird]

China was selling military equipment to Ecuador, although their biggest partners are Brazil, Chile, Venezuela, Argentina and Mexico.

I woud think any country that gets a lot of aid from China must be seeing outbreaks. Peru, Chile and Ecuador are the three countries with the most cases after Brazil.

[Werthead]

3 minutes ago, Fez said:

I think its incredibly reckless of the WHO to say there's this when there's also no evidence yet that antibodies aren't high enough to confer immunity. And it is important for states and countries to be getting ready for the future; eventually things are going to be reopening to some degree. 

Even the preliminary study I linked to a few days ago was that only a percentage of people seemingly had antibody levels too low for immunity (interestingly it was generally the asymptomatic people who had that issue), for the vast majority of people the antibodies were in line with what would be expected to confer immunity. Now we don't know for sure that it does yet, but consider that in nearly all cases viral antibodies do give immunity for at least a couple years, I'd be pretty surprised if there was no protection now.

There has been a strong narrative in the last couple of days from the "let's reopen everything now" brigade that asymptomatic people would also be immune to the virus and thus would already be building towards herd immunity (they're the same people who've been seizing on these dubious reports that up to 78% of patients are asymptomatic). The WHO report I think was mostly in response to this assumption, which seems to be incredibly dangerous.

[williamjm]

13 minutes ago, Fez said:

This reminds me of that joke-y NEJM article from years ago pointing out that there was no evidence that parachutes save the lives of skydivers; because there'd never been a peer-reviewed study of it.

I think its incredibly reckless of the WHO to say there's this when there's also no evidence yet that antibodies aren't high enough to confer immunity. And it is important for states and countries to be getting ready for the future; eventually things are going to be reopening to some degree. 

Even the preliminary study I linked to a few days ago was that only a percentage of people seemingly had antibody levels too low for immunity (interestingly it was generally the asymptomatic people who had that issue), for the vast majority of people the antibodies were in line with what would be expected to confer immunity. Now we don't know for sure that it does yet, but consider that in nearly all cases viral antibodies do give immunity for at least a couple years, I'd be pretty surprised if there was no protection now.

I'm curious what the original comments were in full because journalists have a tendency to summarise things poorly. I couldn't find the source with a quick search (I didn't try too hard), but I did find some more detailed comments from the same WHO doctor from earlier this week.

(The last paragraph in the quote below was meant to be my comment on it but I think the eccentricities of the board's quoting system have struck again and I can't move it out of there)

https://www.npr.org/sections/coronavirus-live-updates/2020/04/13/833534116/who-says-covid-19-immunity-is-an-unknown-disease-10-times-deadlier-than-2009-flu?t=1587156319318

Quote

While noting that the study out of Shanghai has not been peer-reviewed, Van Kerkhove said the findings suggest different immunity levels for different patients.

The study "found some individual had strong antibody response," Van Herkhove said, adding, "Whether that antibody response actually means immunity is a separate question."

Researchers in that project, she added, "found some patients who had no detectable antibody response. And they found some individuals who had a very high response."

"Right now, we don't have a full picture of what immunity looks like," Van Herkhove said. "And until we do, we can't give a complete answer."

It sounds like at that time she was basing the comments on what seems to be the same study you linked to in the previous thread. The statement in the quote on BBC News that "She said initial evidence did not suggest large numbers of people were developing antibodies after having the virus" seems more negative, I don't know whether new information has come in in the last couple of days.

[Kalbear]

29 minutes ago, Altherion said:

How do you think poor people get to work in NYC? Granted, in some of those areas it's more about buses than subways, but there is little difference between a crowded bus and a crowded train car. In fact, the buses are now somewhat worse because the area near the driver is cordoned off so there is even less space to spread out (but on the bright side, they're temporarily free to use).

I think a lot of them go to work by bus, but the more important thing is that they have to go to work, period. Manhattan - which is significantly more dense and has lots of rapid transit - benefitted greatly because most people could either work from home or could afford to not work. 

[Mudguard]

48 minutes ago, Paxter said:

The effect of some of the Euro lockdown is interesting. They seem to have done a great job at moving from rapid growth to stabilization, but nothing is really happening beyond stabilization. Italy's 7-day rolling average of daily fatalities is pretty much flat for the past two weeks. 

I'd still call that (qualified) success, but it's obviously not what we saw in China, with fatalities falling sharply around 30-40 days after the general outbreak. 

I think we are seeing something similar in the NYC area, where it's more of a plateau than any type of significant drop, at least so far, and counter to the prediction of the models, which have shown themselves to be largely unreliable.

This shouldn't be too surprising since the rest of the world for the most part isn't imposing all the measures that China did during it's lockdown.  Our mask usage, although it's changing, is still very much a work in progress.  I think the WHO is still recommending that there is no need if you are healthy to wear a mask in public, even though there is overwhelming evidence to support wearing masks (i.e., large percentage of asymptomatic or pre-symptomatic people combined with droplet transmission).  Our lockdowns are much looser, in general.  For example, I think only one person per household was allowed to leave to get food and supplies in China.  Measuring peoples temperature before entry into supermarkets is also something that is rarely done in the US, at least where I live.  Placing infected into camps to isolate the sick from the healthy.  Massive amounts of contact tracing.  

We have been implementing some these things on a rolling basis, and you'll only see an effect after 3-4 weeks, so that's part of the reason why we are just seeing a plateau instead of a drop.  We have many people more concerned with privacy issues rather than supporting the development and usage of improved contact tracing tools.  This disease is clearly extremely infectious and will require extraordinary measures to stamp it out, or at least reduce it to very low levels.  If you are unwilling to tolerate these extraordinary measures, you have to accepting living with the presence of the disease in your community, at least until an effective vaccine is developed.  Like it or not, we may be more like Sweden than we think in our approach, where we are going to have to manage a steady number of cases.

[Mr. Chatywin et al.]

1 hour ago, williamjm said:

I read a story earlier about a city in Ecuador where the official death count from coronavirus was 400+ but the number of extra deaths compared to the same period last year was about 6000. There have been stories for a while now that there was a particularly bad problem in Ecuador so it may be worse than other South American countries but it does show how the official figures can be massive underestimates.

Ecuador is a SA country I admittedly know nothing about. But I still keep wondering how they could get accurate numbers from the slums, and my understanding is what I saw in Argentina, Paraguay and Uruguay is pretty common throughout the continent. 

[Clueless Northman]

1 hour ago, Paxter said:

The effect of some of the Euro lockdown is interesting. They seem to have done a great job at moving from rapid growth to stabilization, but nothing is really happening beyond stabilization. Italy's 7-day rolling average of daily fatalities is pretty much flat for the past two weeks. 

What is clear in Italy and Spain is that Easter happened. Thankfully, it doesn't look like it turned into the catastrophe it could've been, but the recent peak definitely shows that some people went outside more and/or gathered. I mean, in many places in Spain, the Holy Week is the biggest week of the year. You still could see a downward spiral until a few days ago, so I will assume they basically wasted a week (or possibly 10 days) of effort and lockdown and it will go down soon enough. But as Mudguard said, we don't have measures as extreme as in Wuhan, so the decrease will be slower than in China.

Frankly, the general outlook of China's figures are quite realistic and fatality rate isn't that different from Europe. The key difference is that they never bothered to include non-hospital deaths until today, when Western countries noticed the issue and are growingly trying to include the higher figures to their official tallies.

 

55 minutes ago, Fragile Bird said:

China was selling military equipment to Ecuador, although their biggest partners are Brazil, Chile, Venezuela, Argentina and Mexico.

A lot of Ecuadorians migrated to Spain, and they (as well as Peru) provide a fair share of their hospital staff. And obviously some of them go back to the home country from time to time.

 

1 hour ago, williamjm said:

While at that website I saw another story criticising the site we were discussing in one of the earlier threads that was estimating death tolls. I remember last week it was predicting abrupt declines in the Italian and Spanish numbers but the decline seems to be much more gradual.

https://www.statnews.com/2020/04/17/influential-covid-19-model-uses-flawed-methods-shouldnt-guide-policies-critics-say/

I wouldn't give much weight to that article. They're commenting about various estimates for US casualties with ranges from 30K to 160K. This is pointless: the US is already at 36K officially, and the peak for daily cases hasn't even been hit. This means that yo can pretty much triple the death figure. Unless there's truly a miracle drug around that's massively used in the next weeks, I'm sorry to suspect the US deaths will indeed hit the 100.000 mark. And I don't even want to speculate about an early lifting of measures.

[Mladen]

3 hours ago, Tywin et al. said:

Good luck with that. 

Yeah... Unfortunately, you are right, but one can dream  

[Mr. Chatywin et al.]

Also, more reports on the news about supply lines. So much is just getting thrown away, and of course, plants have outbreaks. 

Fellow carnivores, we might have to make some changes soon. And the frozen chicken strips one roomie bought sucked! It's okay to buy those little dinosaur nuggets, right? I know how they're made, but all my friends with 5 year olds say they are good.

[Zorral]

10 hours ago, Jeor said:

New York might have had a particularly tough time given the enormous population density.

A cursory search suggests that the other big American cities like LA and Chicago have less than half the population density that NYC does.

New York is having a particularly tough time because chiefbloodonhishands is at war with the city and state, along with a lot of other states and cities who don't happen to be blue.  Nebraska, FLORIDA, North Dakota and South Dakota have received the most federal help with supplies and money of any of the states.  New York has received the least, way down there along with California, Michigan, Illinois,.  If you don't kiss the ring you get no ventilators, masks, gloves, TESTS and TEST REAGENTS, no hospital beds (the naval hospital ships isn't taking patients of covid-19 at all, and for anybody else to get on that ship they first have to go to a city hospital and get certified (unless, you know, a celebrity or a buddy of romper), no PPE, NYC has gotten NOTHING from the feds -- while being vilified in the media of places like Florida and etc. for stealing everybody else's supplies.

He's also urging his cadres of confederate/trump/AK-47 flag wavers to attacked the governors and states of the people who are locked down -- see Michigan and Ohio.  Those by the way are organized by Betsy DeVos's people, she who is supposed to be running Education, whose brother Erik Prince, owns fully armed mercenary army and airforce -- Tromper's private army, IOW.

This isn't massive failure of the presidency, this is intentional coup by fortuitous bio weapon attack, that keeps everybody inside while they do what they do.