Taking it to the Streets - Covid-19 #12

[JoannaL]

we have now the first numbers for overall mortality in Germany (there was a very interesting article in this thread a while back for other countries) its only for Northrhine-Westphalia, but since this is the most populated state, and one of those worst hit by corona, I think this numbers may be representativ for the whole country:

https://www.it.nrw/keine-erhoehte-sterblichkeit-im-maerz-2020-nordrhein-westfalen-99420

So 18800 people died in this state in March, last year it was 19100. You do not see any statistical relevant rise (on the figure you do see the bad flu season of 2018 though, there were more deads then)

Not only does it seem that there is no undercounting, but also it seems that the number of Covid-19 deads are not statistical relevant at all.

 

[Mr. Chatywin et al.]

8 minutes ago, Derfel Cadarn said:

I saw an older couple walk to the supermarket entrance with face masks dangling round their necks. Plus plenty of couples where one wears a mask but the other isn’t.

I wouldn’t be surprised to see someone remove their mask in order to cough.

You have to to sneeze, otherwise the thing is just disgusting. 

[Filippa Eilhart]

@JoannaL interestingly, I just saw a news item on a Polish life-ticker (no link) saying there is a 30% increase in the number of deaths in France compared to previous years. 93K compared to an average of 71K between 1 March and 17 April.

[Fez]

In less great news out of Germany though,

Germany's caseload may low enough that even being stuck at R0 of 1.0 is manageable for them. But if even in Germany the R0 started going up immediately after restrictions were first loosened, it bodes poorly for us other countries that aren't in as good shape as Germany.

[JoannaL]

5 minutes ago, Filippa Eilhart said:

@JoannaL interestingly, I just saw a news item on a Polish life-ticker (no link) saying there is a 30% increase in the number of deaths in France compared to previous years. 93K compared to an average of 71K between 1 March and 17 April.

Interesting, I also saw the numbers here somewhere for the UK which also showed a distinct rise.

It must be that our outbreak is far less severe than  in other countries. This leads back to the prevention paradoxon. If our outbreak is not statistical relevant than the lock-down is an overreaction - but if we havent had a lock-down, perhaps we had other numbers?

[Jeor]

7 minutes ago, Fez said:

In less great news out of Germany though,

Germany's caseload may low enough that even being stuck at R0 of 1.0 is manageable for them. But if even in Germany the R0 started going up immediately after restrictions were first loosened, it bodes poorly for us other countries that aren't in as good shape as Germany.

From what I've read, Germany's health system seems one of the most advanced and well-equipped in Europe so they can probably handle a small spike. But once R0 starts going north of 1.0, the situation may spiral out of control. Even a rate of 1.1 or 1.2 is enough to really compound the spread, as Merkel herself said.

I'm surprised we're getting data this early, to be honest. I expected that we wouldn't see a spike in infections from reopenings until 10-14 days after the reopenings, given the lengthy incubation time.

The US is going to be a walking time bomb with so many restrictions being relaxed across many states, it is clearly way too early and I think in two weeks' time we're going to see the ramifications of that. Sadly I think they're going to be on pace for well over 100K deaths at this rate.

[Rippounet]

On 4/24/2020 at 11:57 PM, A Horse Named Stranger said:

People are offending Mayonaise. Isn't that like declaring cultural war on France?
Sorry, Rippounet, I am also not a huge Mayonaise fan.

Meh... I don't like the stuff much myself (only in sandwiches, and like most people I prefer actual meals), and I don't think I know anyone who really likes it either. GF says it's generally eaten with seafood (which I hardly eat).

12 minutes ago, Filippa Eilhart said:

@JoannaL interestingly, I just saw a news item on a Polish life-ticker (no link) saying there is a 30% increase in the number of deaths in France compared to previous years. 93K compared to an average of 71K between 1 March and 17 April.

I saw something similar, and not just for France but for a bunch of European countries.

BTW apparently our PM wants to make masks mandatory in public transportation.
Also there's a weird story about how France is butting heads with Google and Apple over the development of an ap' to trace Covid-19. France wanted a "centralized" ap' which apprently is a problem for i-phones and Apple doesn't want to implement any changes to its IP?? Not sure I get it, but it seems to also be about who gets to keep user data.

[JoannaL]

4 minutes ago, Jeor said:

From what I've read, Germany's health system seems one of the most advanced and well-equipped in Europe so they can probably handle a small spike. But once R0 starts going north of 1.0, the situation may spiral out of control. Even a rate of 1.1 or 1.2 is enough to really compound the spread, as Merkel herself said.

I'm surprised we're getting data this early, to be honest. I expected that we wouldn't see a spike in infections from reopenings until 10-14 days after the reopenings, given the lengthy incubation time.

 

I think what we are seeing here is the Easter holidays not the cautious reopenings which were later.

[Starkess]

1 hour ago, Jeor said:

I'm surprised we're getting data this early, to be honest. I expected that we wouldn't see a spike in infections from reopenings until 10-14 days after the reopenings, given the lengthy incubation time.

My understanding is that the 14 days is the upper end of the range, but the average incubation time is ~5 days, so you'd start seeing effects sooner than 10-14 days.

[Luzifer's right hand]

1 hour ago, JoannaL said:

we have now the first numbers for overall mortality in Germany (there was a very interesting article in this thread a while back for other countries) its only for Northrhine-Westphalia, but since this is the most populated state, and one of those worst hit by corona, I think this numbers may be representativ for the whole country:

https://www.it.nrw/keine-erhoehte-sterblichkeit-im-maerz-2020-nordrhein-westfalen-99420

So 18800 people died in this state in March, last year it was 19100. You do not see any statistical relevant rise (on the figure you do see the bad flu season of 2018 though, there were more deads then)

Not only does it seem that there is no undercounting, but also it seems that the number of Covid-19 deads are not statistical relevant at all.

 

That is good news. 

Although the numbers for March 2019 or only preliminary and not final according to that site.

[Jon AS]

2 hours ago, Rippounet said:

Also there's a weird story about how France is butting heads with Google and Apple over the development of an ap' to trace Covid-19. France wanted a "centralized" ap' which apprently is a problem for i-phones and Apple doesn't want to implement any changes to its IP?? Not sure I get it, but it seems to also be about who gets to keep user data.

A centralised, server-based solution would be a nightmare from the perspective of privacy and data security*. The German government was also pushing for a centralised app, despite various experts warning against it, but gave up on it in the face of Apple and Google adamantly refusing to change their stance on the issue. I guess for once the duopoly of the mobile-OS-market has had a benificial side effect?

I'm personally not convinced that a tracking app is going to be all that useful. It'll have to err on the side of caution and bluetooth actually has quite a respectable range, which probably means that many, many people would be sent into prophylactic quarantine despite not having been truly exposed to any infected people.

 

*Germany's RKI already had a major fuck-up in this respect with an app that allows users to donate data from their fitness-tracking apps for research purposes during the Corona crisis.

[Mudguard]

6 hours ago, ljkeane said:

It depends what you mean by 20% efficiency. Most of the experts quoted in articles about making your own masks seem to be saying, yes, it's theoretically possible to catch the virus by breathing in droplets or whatever suspended in the air but you're far, far more likely to catch it by touching something, then touching your face. The concern with home made face masks is you might reduce your risk of the very unlikely event of breathing in enough of the virus to be infected but if you end up touching your face a lot to adjust the mask you're increasing the far more likely risk of infecting yourself via transfer from surfaces.

 

The main purpose in having the general public wear masks is not to protect the individual wearer from infection, although it's great if it helps even a little.  The main purpose is to reduce the amount of droplets that are expelled by infected individuals.  If everyone wears a mask or facial covering, there should be a lot less droplets that are expelled into the environment, which should make the air in enclosed spaces more safe and surfaces more safe.  

[williamjm]

2 hours ago, Starkess said:

My understanding is that the 14 days is the upper end of the range, but the average incubation time is ~5 days, so you'd start seeing effects sooner than 10-14 days.

I was just reading an article on this story which says that their measurement is reflecting what R0 would have been a few days ago:

https://www.theguardian.com/world/2020/apr/28/germans-urged-to-stay-home-amid-covid-19-infection-rate-fears

For its own estimate of the reproduction number, the attempts to take into account the time lag by ignoring data from the last three days and back-dating known cases to their likely day of infection around a week earlier.

The reproduction number announced on Tuesday can therefore only give an indication of the pandemic’s development at a point about a week and a half ago, when a relaxation of social distancing measures had been announced by Angela Merkel but not yet come into effect.

Later on in the article there's some scepticism about the results:

Statistician Thomas Hotz, of Ilmenau University, said the model used by the RKI had a tendency to “smoothen out” the number of new infections by the method in which it tried to correct for the reporting delay. Hotz said his own model did not indicate a sudden rise of new infections, and that he believed the reproduction number was likely to stay below one in the next few days.

4 hours ago, JoannaL said:

I think what we are seeing here is the Easter holidays not the cautious reopenings which were later.

If the increase in R0 is genuine then that does seem plausible.

[Zorral]

Just saw the governor announced as of today  it's 31% .

https://gothamist.com/news/coronavirus-updates-april-28

Quote

 

2:20 p.m. An average of 31 percent of New York City residents have tested positive for coronavirus over the last 14 days, according to data presented by Governor Andrew Cuomo on Tuesday.

Along with Long Island, which had the same testing percentage, New York City had the highest percentage of positive tests in the state. The mid-Hudson area, which includes Westchester County, had the second highest proportion of positive tests, at 28 percent.

 

 

[Kalbear]

If accurate, that's remarkable and a very good sign for life going forward. As horrible as this has been this might mean that the mortality and high severity rate is far less horrible than we thought. 

It also means that the spread is far greater than we thought. 

[Fury Resurrected]

It’s good news and bad news. Whatever the mortality rate we still have almost 60k dead Americans already. One guy one time fails in an attempt to bomb a plane with his shoes (Harming nobody) and we all take our shoes off at the airport forever. 60,000 dead in three months and we can’t even decide everyone needs healthcare

[Zorral]

It's going to be gruesome here.

https://gothamist.com/news/some-conservatives-and-conspiracists-say-its-time-reopen-nyc

Quote

 

As measures to stop the spread of COVID-19 have stretched into their second month, thousands of protesters have converged on state capitols in recent weeks to demand an end to stay-at-home orders. The emerging anti-lockdown movement, egged on by President Trump and quietly propped up by influential right-wing groups, has so far steered clear New York City.

But as hospitalization rates decline across the five boroughs, a small subset of newly-galvanized New Yorkers — ranging from elected officials to fringe conspiracists — are now calling to ease restrictions inside the epicenter of the country's coronavirus pandemic.

Much of that advocacy is happening through an online Facebook group known as REOPEN NY, a petri dish of misinformation and distortions that has garnered more than 11,000 followers in just two weeks. Following last Wednesday's "Operation Gridlock" protest in Albany, the group is now promoting a statewide day of action on May 1st, including a rally outside City Hall.

"Of course upstate people are more on board, but there are people in the city starting to get involved," said Bradford Solomon, a Sunnyside, Queens resident who hosts a YouTube channel devoted to "debunking" the pandemic, and is helping to organize the Manhattan protest. "New York has gotten most of the propaganda about how bad it is, so you’ve got people scared to speak up."

Like several of REOPEN NY's administrators, Solomon believes the virus is a government ploy to push harmful vaccines on Americans — a conspiracy theory with no basis in reality. Claims that the media is exaggerating the death toll of the virus, or that hospitals are wrongly diagnosing patients to turn a profit, are frequently shared on the page, whose members must agree to support a statewide lifting of lockdown restrictions by May 1st.

A Siena College poll released on Monday found eighty-seven percent of New Yorkers support keeping schools and nonessential businesses closed through at least May 15th, the expiration date of Governor Andrew Cuomo's current PAUSE order. Emphasizing that New York City and its suburbs will require more time, the governor has laid out a plan to regionally "un-pause" parts of the state in mid-May, depending on the rate of cases. Still, the push to reopen the city sooner has taken hold among some establishment conservatives as well.

"We flattened the curve a week ago, so why are businesses still closed? Put your big boy pants on and go back to work," Nachman Mostofsky, a district leader in South Brooklyn and an executive committee member of the Kings County Conservative Party, told Gothamist on Monday. "We’re freaking New Yorkers. We can figure this out."

Mostofsky, who previously served as director of government relations for the National Council of Young Israel, said he's had conversations with people "very high up in [the Trump] administration," all of whom support reopening. "New York is run by progressive, nanny state lunatics who don’t understand how the economy works," he said.

Defying guidance from health officials, President Trump has openly encouraged his base to protest stay-at-home orders imposed in certain states. Behind the scenes, influential conservative groups, some of them connected to the White House, have worked to cultivate those demonstrations.

An analysis by the Washington Post found that a family of far-right pro-gun activists were behind many of the largest anti-lockdown Facebook groups, including the now-deleted "New Yorkers Against Excessive Quarantine.” Powerful, dark money advocacy groups such as FreedomWorks and Tea Party Patriots have also worked to increase turn out to rallies in parts of the country.

Marc Ambinder, a fellow at the University of California who studies disinformation, stressed that it was important to understand that the backlash to stay-at-home orders reflected real frustrations of citizens worried about their next paycheck — while still acknowledging that protests were not spreading organically.

"It’s growing, it exists, and it’s real," he said. "And there are ideological opportunists using it for specific political ends."

Such opportunists may have been hesitant to target New York City, where the virus has killed at least 17,000 people, more than anywhere else in the United States. Some right-wing activists said they've noticed that reluctance has started to fade.

"There’s a growing sentiment in New York City. Most people are really done with the lockdown," said Evan Freeman, the leader of the Empire State Conservative Network, a media platform and podcast (the group also sells merchandise, including a face mask emblazoned with Cuomo as Star Wars villain Emperor Palpatine.) "Let's get everything going. Let's open it back up."

While Freeman stressed that those calling for a continued lockdown were "out of touch" with the typical worker, polls do not back that up. According to the Siena College survey, nearly 70 percent of New York voters, including half of Republicans, said the state should not open before widespread testing was available. Some conservative officials said they empathized with the desire to lift restrictions — but said the city was not there yet.

"People are hurting financially and they're angry. You can’t give business owners the idea that this is never going to end," said New York City Councilman Joe Borelli, a Republican and rare Trump supporter in the legislative body. But, he added, he'd just spoken to a hospital in Staten Island with more than 100 people on ventilators. "On a normal day they’d have maybe 10. So yeah, it's still too rushed to talk about a full reopening."

 

 

[Ran]

Speaking of testing, I forgot to follow up with the results of the testing of staff at Danderyd Hospital in Stockholm. This is a test from the Royal Institute of Technology in Stockholm  with a private partner, SciLifeLab (who are also involved in a study to use wastewater to monitor levels of infection in communities) which they say has been 100% on positive and negative samples they've thrown at it, because of it checking across so many of the viral proteins rather than just a couple.

In any case, per their report, 20% of the 527 hospital workers tested positive. This was from samples taken a week ago, and so represents infections from ~3 weeks ago (or potentially earlier). Interestingly, they plan to make a long-term study of this particular hospital:

Quote

After the first test, follow-up is done after 3, 6 and 12 months, probably even after 2 and 5 years respectively. This is because the study wants to know how long an individual has antibodies. The follow-up is done regardless of whether the individual had initially formed antibodies or not.

 

[Mudguard]

8 minutes ago, Kalbear said:

If accurate, that's remarkable and a very good sign for life going forward. As horrible as this has been this might mean that the mortality and high severity rate is far less horrible than we thought. 

It also means that the spread is far greater than we thought. 

Possibly good news.  Even if the numbers are roughly accurate, I don't think the tests are measuring how strong the antibody response is, so it's not clear what percentage of that 31% have lasting immunity.  

One way to think about this is to consider how we do many vaccinations with a priming shot followed after some time by a booster shot.  The first priming shot results in a relatively modest immune response with measurable amounts of antibody.  However, the booster shot results in a much stronger immune response with lasting immunity.  If you only get the priming shot, but not the booster, you may not have lasting immunity.

It's not clear yet whether many people were exposed to very small amounts of the virus, and were able to clear it rapidly without generating the high levels of high affinity antibodies that are required to provide immunity.  In particular, it's possible that the asymptomatic infected fall in this category of very mild infection.  I'm sure many people of studying this right now, so hopefully we'll have more answers soon.

[Maithanet]

44 minutes ago, Mudguard said:

Possibly good news.  Even if the numbers are roughly accurate, I don't think the tests are measuring how strong the antibody response is, so it's not clear what percentage of that 31% have lasting immunity. 

Reading that article, I'm fairly sure that the 31% is percentage of positive cases divided by total tests, not the percentage of all New Yorkers who had coronavirus.  The fact that number is going down is good, but it isn't really relevant to the question of herd immunity.