Taking it to the Streets - Covid-19 #12

[The Anti-Targ]

I had a nightmare last night. In real life our region has been free from active cases for about a week. In my nightmare I was diagnosed with the infection becoming the first person to start the epidemic off again in our region, and because I had been so complacent about us having no active cases for a week I had been lax with social distancing. The pandemic isn't just dominating my waking life, it's assaulting me in my sleep too. But maybe it was also my subconscious tell me I still need to be cautious even though the infection appears to be gone from here.

[Jeor]

28 minutes ago, The Anti-Targ said:

In my nightmare I was diagnosed with the infection becoming the first person to start the epidemic off again in our region, and because I had been so complacent about us having no active cases for a week I had been lax with social distancing.

I don't think Australia or NZ are going to fully eradicate the virus so I doubt it would be one person who started it all over again...if that's any comfort!

I'd be interested if Australia and New Zealand let each other inside to form a two-country bubble. We already have reciprocity for all sorts of things (residency etc) and no need for visas, so if the virus is similarly low in both of our countries that might be one way to let airlines operate again and help both countries and their tourist industries.

EDIT: Obviously not right now, but maybe later in the year, especially if both countries close their borders to everything else.

[Fragile Bird]

Those numbers from anti-body testing in California were from Santa Clara County, the ones that suggest numbers of infections could be 58x higher.

The NYT is reporting that autopsies being done in Santa Clara show two people who died, Feb. 6 and Feb. 17, died of Covid-19, THREE WEEKS before the first reported US death on Feb. 26 in Washington state. Neither victim had any travel history, meaning the Coronavirus had already spread through the community.

eta: Feb. 26th was the day the CDC confirmed the first official case, Feb. 29th was the day of the 'first' death.

[Fez]

31 minutes ago, Fragile Bird said:

Those numbers from anti-body testing in California were from Santa Clara County, the ones that suggest numbers of infections could be 58x higher.

The NYT is reporting that autopsies being done in Santa Clara show two people who died, Feb. 6 and Feb. 17, died of Covid-19, THREE WEEKS before the first reported US death on Feb. 26 in Washington state. Neither victim had any travel history, meaning the Coronavirus had already spread through the community.

It's interesting data points, especially the earlier deaths (the anti-body testing could be a result of selection bias in who was getting tested; it would be great if that weren't the case though). 

The theory that makes the most sense to me is that California is dealing with a different strain of the virus than New York; and New York's mutated into something deadlier. Otherwise, I'm just not sure why California had so much less spread than New York; especially with the extra lead time indicated by these earlier deaths.

[Mexal]

3 minutes ago, Fez said:

It's interesting data points, especially the earlier deaths (the anti-body testing could be a result of selection bias in who was getting tested; it would be great if that weren't the case though). 

The theory that makes the most sense to me is that California is dealing with a different strain of the virus than New York; and New York's mutated into something deadlier. Otherwise, I'm just not sure why California had so much less spread than New York; especially with the extra lead time indicated by these earlier deaths.

From what I understand, different strains have different viral loads so this is definitely possible. The strain in NY was predominantly from Europe, whereas the strain in California was from China. It'll be really interesting to see the analysis when this is all over.

[Mr. Chatywin et al.]

3 minutes ago, Fez said:

The theory that makes the most sense to me is that California is dealing with a different strain of the virus than New York; and New York's mutated into something deadlier. Otherwise, I'm just not sure why California had so much less spread than New York; especially with the extra lead time indicated by these earlier deaths.

I thought I read this virus isn't mutating much. Has that changed?

Also, Cali is no where near as dense as NYC.

[Rippounet]

Well that was quick...

https://www.lemonde.fr/planete/article/2020/04/22/coronavirus-une-proportion-reduite-de-fumeurs-parmi-les-malades_6037365_3244.html

There's a study from Assistance publique-Hôpitaux de Paris (AP-HP) on Covid-19 and Nicotine. It's apparently available on a site called Qeios.

Out of 11,000 patients, only 8,5% smoked, against 25,4% for the country.

[ljkeane]

23 minutes ago, Fez said:

The theory that makes the most sense to me is that California is dealing with a different strain of the virus than New York; and New York's mutated into something deadlier. Otherwise, I'm just not sure why California had so much less spread than New York; especially with the extra lead time indicated by these earlier deaths.

I don't know. How many people travel back and forth between New York and California on a regular basis? I'd guess there's probably a decent number of people in California who caught the virus via New York. I think the theory is generally that the outbreak in New York largely came via Europe and you're seeing a lot of variation between particularly bad outbreaks in Northern Italy and, relatively speaking, milder ones in places like Germany. I think environmental factors like population density and the effectiveness of social distancing efforts are likely to be far more important.

[Fragile Bird]

29 minutes ago, Fez said:

It's interesting data points, especially the earlier deaths (the anti-body testing could be a result of selection bias in who was getting tested; it would be great if that weren't the case though). 

The theory that makes the most sense to me is that California is dealing with a different strain of the virus than New York; and New York's mutated into something deadlier. Otherwise, I'm just not sure why California had so much less spread than New York; especially with the extra lead time indicated by these earlier deaths.

I said very early on to my family that Italy must have been unlucky and got a worse strain of the virus than elsewhere. The guess is that Chinese tourists brought it, and it may very well be that the strain they just happened to bring was a deadlier variety.

I keep seeing there are 8 strains at the moment. The first three were labeled A, B and C (the others could continue the lettering, idk) and strain C is what Europe got.

[Fez]

6 minutes ago, ljkeane said:

I don't know. How many people travel back and forth between New York and California on a regular basis? I'd guess there's probably a decent number of people in California who caught the virus via New York. I think the theory is generally that the outbreak in New York largely came via Europe and you're seeing a lot of variation between particularly bad outbreaks in Northern Italy and, relatively speaking, milder ones in places like Germany. I think environmental factors like population density and the effectiveness of social distancing efforts are likely to be far more important.

But that's the thing, there was no social distancing, even in California, that early in February. San Francisco locked down on February 26, that's three weeks after this new first death. And my understanding is that the tech companies were only a couple days ahead of that. There was plenty of time for the virus to spread. And Santa Clara's only like 50 miles from downtown San Francisco, which is plenty dense as far as cities go (not as much as NYC, but way more than New Orleans, another hard-hit city). San Francisco even has one of the more used local rail systems in the country (though again, nothing like NYC itself).

Unless temperature/humidity play a major role in transmission (though then why are Houston and New Orleans getting hit), I don't see a good explanation for why San Francisco had so little issue with the virus. Unless its a different strain.

[ljkeane]

7 minutes ago, Fez said:

But that's the thing, there was no social distancing, even in California, that early in February. San Francisco locked down on February 26, that's three weeks after this new first death. And my understanding is that the tech companies were only a couple days ahead of that. There was plenty of time for the virus to spread. And Santa Clara's only like 50 miles from downtown San Francisco, which is plenty dense as far as cities go (not as much as NYC, but way more than New Orleans, another hard-hit city). San Francisco even has one of the more used local rail systems in the country (though again, nothing like NYC itself).

Unless temperature/humidity play a major role in transmission (though then why are Houston and New Orleans getting hit), I don't see a good explanation for why San Francisco had so little issue with the virus. Unless its a different strain.

I mean we're speculating wildly at this point but San Francisco's a major city so obviously it's not uncrowded but my experience was that it's a lot less crowded than New York. I'd assume it's generally a lot warmer than New York in February/March too, temperature might not factor directly into how infectious the virus is but if people are spending more time outside rather than packed indoors in bars and restaurants etc that might help. I think New Orleans had Mardi Gras like normal which probably didn't help on that front. Maybe it's just luck and early cases didn't infect a lot of other people for whatever reason.

[Paxter]

6 hours ago, Jeor said:

I don't think Australia or NZ are going to fully eradicate the virus so I doubt it would be one person who started it all over again...if that's any comfort!

I'd be interested if Australia and New Zealand let each other inside to form a two-country bubble. We already have reciprocity for all sorts of things (residency etc) and no need for visas, so if the virus is similarly low in both of our countries that might be one way to let airlines operate again and help both countries and their tourist industries.

EDIT: Obviously not right now, but maybe later in the year, especially if both countries close their borders to everything else.

I don't see this as likely, particularly if Ardern stays on as PM (election slated for Sept). Aus/NZ relations are historically strong, but there has been a noticeable souring in recent years. 

[rotting sea cow]

2 hours ago, Fragile Bird said:

Those numbers from anti-body testing in California were from Santa Clara County, the ones that suggest numbers of infections could be 58x higher.

The NYT is reporting that autopsies being done in Santa Clara show two people who died, Feb. 6 and Feb. 17, died of Covid-19, THREE WEEKS before the first reported US death on Feb. 26 in Washington state. Neither victim had any travel history, meaning the Coronavirus had already spread through the community.

eta: Feb. 26th was the day the CDC confirmed the first official case, Feb. 29th was the day of the 'first' death.

Yes, it's all over the internet and users are providing their own experiences with cases that *might* be COVID19. Everybody I know agrees that this winter the viruses have been weird, but if cases were so widespread as such early dates, we should have seen that in the hospitalizations. I don't know how to explain it. 

 

 

 

[Martell Spy]

Quote

People wrote grievances requesting that masks be mandated for anybody coming into our home, and they received only vague and evasive responses. I used to think the DOC staff was indifferent toward the well-being of prisoners. Being aware of the “us versus them” mentality that they’re taught in training, I only blamed the ones who seemed smart enough to know better. After being incarcerated during a pandemic, however, I’m convinced they hate us. The guards in MCC seemed genuinely angry at our insistence that they stop trying to murder us by not wearing masks. Their attitudes and tones whenever the topic arose made it clear they were having their own discussions, and it seemed they were set on resisting the notion that we should be protected from them.

I’m In Prison During A Pandemic, And It’s Tense. I Worry It May Soon Turn Deadly.
“I used to think DOC staff were indifferent toward the well-being of prisoners ... after being incarcerated during a pandemic, however, I’m convinced they hate us.”

https://www.huffpost.com/entry/life-in-prison-during-covid-19_n_5e9db301c5b63c5b58723156

[Jeor]

26 minutes ago, Paxter said:

I don't see this as likely, particularly if Ardern stays on as PM (election slated for Sept). Aus/NZ relations are historically strong, but there has been a noticeable souring in recent years. 

I agree relations have not been great, but the potential morale booster of travel to another country - and the hope that gives to hotels, airlines and other tourism-based industries is worth looking into.

I expect both Australia and NZ are likely to keep their more or less international ban (enforced isolation for 14 days) for a long time - possibly through to the end of 2021 and the northern hemisphere winter.

[Ormond]

About the lack of a "lockdown" in Nebraska.

I really don't like our governor Pete Ricketts and don't completely trust him, but I do wonder how much that's a matter of semantics. We don't have a statewide stay at home ORDER in Nebraska, but the state government certainly has said that people should stay home even though it's a "request" instead of an "order." All of the schools are closed here for the rest of the school year, we have the order for restaurants to only do take-out, the hair and nail salons have been legally closed, all lodging and camping in the state parks are banned, and we even have an official ban of gatherings of more than ten people. The only legal ban Ricketts put in place which he has so far announced a relaxation in is that of elective surgery in hospitals, and that's not a total relaxation because it only applies to hospitals able to show they have 30% of their overall beds available, 30% of their ICU beds, and 30% of their ventilators. 

 http://netnebraska.org/article/news/1217092/hospitals-prepare-elective-surgeries-may

States which have stay at home "orders" of course exempt "essential" workers, including workers in food processing plants, which are a main hot spot in Nebraska as in other states in our part of the country. People in Omaha seem to be following stay at home guidelines pretty well at the moment. Infections aren't rising at a big clip in Omaha yet and Lincoln is doing even better -- it's Grand Island, where the total population of the county is only 60,000, which is the big hot spot in the state, with 50% more diagnosed cases that Douglas County (Omaha) and an infection rate like that of Louisiana. 

I'd prefer a shelter at home "order" but since Nebraska is one of the states in the top ten for what psychologists and sociologists call "social capital", I'm sure we actually do get a higher rate of compliance with a "request" here than would be the case in other parts of the country.  Ricketts claims that the individual orders about schools, salons, restaurants, etc. that he's put in place add up to few significant differences from states where they have shelter in place "orders" when you take the "essential" exceptions into account. I hope he's right and doesn't pull a Georgia next week. 

 

[Ran]

@Ormond

That seems a fairly even-handed way of dong things, and I hope it works out. I suspect there'll be some attention paid to it in Sweden down the road, as the recommendation rather than order aspect of it is more in line with our own approach.

[Mudguard]

So there is some reporting now that Sweden has retracted yesterday's report that claimed that 1/3 of Stockholm could be infected by May 1st.  The article provides a link to what is supposedly Sweden's Public Health Agency's twitter account, but I'm not familiar enough with them to determine whether it's legitimate.  I think it is, but not completely sure.  I'm having a hard time confirming this story.  The general press hasn't picked up on this yet.

The article (from Forbes, which has a high degree of variability in the quality of their articles) also states that the Swedish blood bank study that found 11 out of 100 blood donors were infected has also been retracted.  I did some googling on this, and another article claimed that that author has now stated that the blood donors could have included infected people that were donating blood for plasma treatment, but they couldn't be sure because all the samples were de-identified (a normal practice to protect privacy).  They plan to redo the study.

I wonder if the Swedish model that predicted 1/3 of Stockholm infected by May 1 was relying on the blood bank data, and that the two retractions are tied together.  If so, this could very well be a case of garbage in equals garbage out.  The problem right now is that the retractions, if true, have so far been completely overshadowed by the claim that Stockholm will reach herd immunity in May, and many people are using this to push their arguments to end the lockdowns, argue that the disease is no worse than the flu, etc.  Swedish authorities should provide a clarification as soon as possible.  Are they still standing by their claim that 1/3 of Stockholm will be infected by May 1st?

[Ran]

@Mudguard

They'll be releasing a corrected version of that paper tomorrow. Anders Tegnell tried to explain what the problem was, and it seemed to do with a variable that wasn't updated and led to them then trying to fit something to the data or ... something. I'm not a mathematician, and even less so in Swedish. That said, from what he indicated, they believed the corrected model will still give a largely similar result -- it predicted that Stockholm's peak was April 15th, and he seemed to indicate that it would end up pretty close to that (many think that the Scenario 1, with 99 undiagnosed for every 1 diagnosed, is what the correct result should have been; in which case that one estimated that peak was 3 days later, on April 18th). I guess that would push 1/3rd infection a little further as well.

Also, the model has nothing to do with Karolinska's own study -- it was not based on antibody tests but instead on PCR tests showing 2.5% of Stockholm's population had active SARS-CoV-2 infection between the 27th of March and the 3rd of April; so far as I know, there has been no criticism of the methodology of that study, and even the critics of FHM have used it in their arguments.

Tegnell noted that not only that, but this new model is not the one that has been used to make any past decisions, it was just to help guide decisions and analysis going forward. As some have noted, so far the model results they released back in late March (which were probably just a fairly standard SEIR model) have been pretty spot on for hospitalization usage in Stockholm, claiming a peak usage of 250 ICU beds there when so far I don't think we've gotten higher than 220 or 230. Note that one thing that seemed to be the case in March was that FHM used an R0 of ~2.4 or 2.5, if I remember right, so that's one of the variables. This seems to conflict with some of the theories out there, and some of the studies that claimed higher R values at certain points (I think there is one from China that guessed the rate was much higher in the early part of spread there.) I'm not sure where FHM sees the spread now, but I think they haven't really changed their mind based on the evidence they have.

[Mudguard]

22 minutes ago, Ran said:

@Mudguard

They'll be releasing a corrected version of that paper tomorrow. Anders Tegnell tried to explain what the problem was, and it seemed to do with a variable that wasn't updated and led to them then trying to fit something to the data or ... something. I'm not a mathematician, and even less so in Swedish. That said, from what he indicated, they believed the corrected model will still give a largely similar result -- it predicted that Stockholm's peak was April 15th, and he seemed to indicate that it would end up pretty close to that (many think that the Scenario 1, with 99 undiagnosed for every 1 diagnosed, is what the correct result should have been; in which case that one estimated that peak was 3 days later, on April 18th).

Also, the model has nothing to do with Karolinska's own study -- it was not based on antibody tests but rather on PCR tests showin 2.5% of Stockholm's population had active SARS-CoV-2 infection between the 27th of March and the 3rd of April. Tegnell noted that not only that, but this new model is not the one that has been used to make any past decisions, it was just to help guide decisions and analysis going forward. As some have noted, so far the model results they released back in late March have been pretty spot on for hospitalization usage in Stockholm, claiming a peak usage of 250 ICU beds there when so far I don't think we've gotten higher than 220 or 230.

Thanks for the update.  I think in the US, the Swedish approach is going to get a lot of traction very soon as justification for ending the lockdowns, so it is crucial that their data is accurate.

For the bolded sentence, has this 2.5% active infection study been published?  Did they collect swab samples from a large random sample of Stockholm's population and then run PCR tests?  If so, that would be probably be fairly accurate, but I'm surprised such a study hasn't received more press.