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COVID-19 #13 or: How I Learned to Stop Worrying and Love the Disease


Mr. Chatywin et al.

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10 hours ago, Ran said:

A little update on Sweden. First, today they released some information regarding a sampling of people in week 17 (specifically form April 21 to April 24th) across the country, and found 0.9% returned as having active infections.  The subsection for Stockholm County, a quarter of the tests, showed 2.3% active infection at that time. During week 14, testing in Stockholm showed 2.5% with active infections.

This survey will be repeated every few weeks to show development over time.

Next week they will present results of antibody testing from, I think. week 17 as well,  but that'll capture the picture of the situation 2-3 weeks earlier as I understand it.

In a different vein, Joakim Rocklöv -- one of the more trenchant critics of FHM's approach for a time, and still a bit skeptical but he has recently distanced himself from a group of much more outspoken detractors who repeatedly shot their credibility to shreds with bad modelling and decidedly uncivil language (calling FHM's modellers 'untalented') -- has revised a paper that in its earlier version from early April painted a very negative picture of the situation in Sweden, and presently he finds that Sweden's efforts were largely successful to its stated goals (he doesn'tcome out and say it but he essentially indicates that their 'simple' models were more correct than his own), and were much more effective in reducing R than he gave it credit for. However, he also proposes that with a 10% improvement in effective infectious period (from an average of 3.3 days to 3 days -- this is more a mathematical construct than representing actual infectiousness for any one individual) that he thinks deaths could be nearly halved by September 1st and some 1.5 million fewer people would be infected. The paper lays out all the math for those interested in epidemiological models.

 

I'm starting to think that,  at least in the Northern Hemisphere, the best idea is to have huge chunks of the population infected before the next winter (of course trying to put protections for the vulnerable). If immunity is a thing of course. Immunological defences are typically higher in summer and people naturally don't go into close quarters, reducing the number of infections to a more manageable level.

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https://the-journal.com/articles/176080

Doctors Without Borders deploying to Navajo Nation in New Mexico.

By the way, this story is location-sited as from Farmington New Mexico, outside the rez (like Grants is) which story does not include the information that the 'white' residents of Farmington are militantly demanding reopening, despite the governor's call not to.

https://www.nytimes.com/2020/05/12/us/politics/farmington-nm-jobs-coronavirus-reopening.html

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15 minutes ago, DireWolfSpirit said:

Get outdoors where there is superior air circulation and sunshine. It's your healthiest course imo.

Biologist: Avoid these places to protect against Covid-19

https://www.cnn.com/videos/health/2020/05/13/coronavirus-covid-19-enclosed-spaces-spread-new-day-vpx.cnn

The healthiest course from a virus point of view is staying at home all the time to avoid contact with other people completly. This is only a privilege the rich and the office worker caste have in most places of course. Might not be healthy from a mental health and exercise point of view though.

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14 hours ago, rotting sea cow said:

Apparently they are not going to individually test everyone. Internet wisdom suggest they are going to make chunks of people, mix the samples and test them together. If tests come back negative these groups are fine. If tests come back positive, test them again individually.  That way they need far less tests than the population and can be done much faster. The idea is to do everything within a week or two.

It does seem like a sensible approach if the expectation is that only a very small proportion of the tests are going to be positive.

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19 hours ago, rotting sea cow said:

Apparently they are not going to individually test everyone. Internet wisdom suggest they are going to make chunks of people, mix the samples and test them together. If tests come back negative these groups are fine. If tests come back positive, test them again individually.  That way they need far less tests than the population and can be done much faster. The idea is to do everything within a week or two.

BTW. It is suggested that Germany and Russia are doing exactly that, which explain the huge number of testing they are doing.

 

Yeah the more I personally play around with the qPCR testing protocol the less a fan of this approach I am. It invalidates a control, and it's also going to reduce the sensitivity of the test several fold and so increase the false negative rate (which already seems to be abnormally high for this virus). I've been playing with the detection limit a little for our wastewater project, and seems to be around ~250 virions per sample, which is pretty in line with what others are publishing. So if you're ending up with a 5-10 fold reduction simply due to not putting as much of each sample into the assay it isn't great. OTOH I guess if you're doing it on a population basis on people who wouldn't otherwise be tested it's a decent idea.

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23 minutes ago, Triskele said:

 

Do you have a sort blanket report on just what it feels like in terms of the national mood?

Polling has been supportive of the government and health authority -- over 70% last I checked. This has to do with the high public trust most Swedes have, and the way things have been carried out -- the health and social agencies and their experts have been front-and-center every day, and there's been a lot of transparency and data put out by various agencies.

(In fact, at this moment Linda is filling out a survey about how she feels the government has been handling things. Swedes are quite good about filling out these sorts of surveys.)

For the most part, life feels fairly normal for most people. Two of the most commonly repeated questions at the press conferences right now are: when can elderly people see and hug their grand and great-grandchildren, and when can top level football teams start up playing again. 

 

 

 

 

 

 

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1 minute ago, Triskele said:

That was a great response, and I really appreciate it.  Button won't allow me to do a "thanks" cause too many but thanks. 

Oh, the other big question is "when can we travel over the summer". They've been fairly clear that they don't think casual international travel can be expected this year, and presently they recommend taking no unnecessary journeys more than an hour or two from where you reside, at least through July 15th (which is when the current travel recommendations come to an end, but no doubt they will be extended or revised by that time).

There's a big jump in people looking at used boats, presumably because they're thinking of boating for the summer rather than vacationing as they might normally do.

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Just now, Triskele said:

Hi Ran - Still being very interested in Sweden being the canary in the coal mine or not, i'm struggling to follow the thrust of this post.  

Is the upshot that Swedes are mainly going as normal but only really contemplating stuff in terms of summering?  I fear I could be way off base.  Any clarity appreciated.  

Basically, summer is ... kind of big for Swedes, for reasons of long dark winters and wet and chill springs. Summer vacation is holy. Lots and lots of Swedes have summer cottages or homes in various rural parts of the country (e.g. Linda and I summer at her mother's family farm about a dozen hours northeast of where we live). Lots of Swedes go abroad. Rather than feeling stress about the economy, despite the fact that most everyone feels the pinch on various sectors as global supply and demand chains were disrupted, the most immediate concern is something as jejune as vacationing or hanging out with friends and family.

In other words, there's not a sense of imminent collapse or disaster looming. Everything feels orderly and being taken care of in a reasonable manner. Or to put in a particularly Swedish way, everything is lagom.

 

 

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Around here Sweden is used as a bad example as they are approaching 5 times our deaths per million people. Most people seem to want to take the Swedish approach though. 

I don't really believe the official numbers of Austria I admit and I think they are keeping them as low as possible with statistical tricks.

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9 minutes ago, Luzifer's right hand said:

Around here Sweden is used as a bad example as they are approaching 5 times our deaths per million people. Most people seem to want to take the Swedish approach though. 

The big problem is deaths from elderly homes and those receiving home assistance. Just over 75%. If these had been sheltered better in the two most affected regions, deaths would be a lot, lot lower. The hope is that the rest of Sweden, with more time ahead of it, will do better, and so far that seems to be working okay. The region of Skåne, which is Sweden's 3rd most populous and 2nd most densely populated and features our third largest city, has numbers much more comparable to the other Nordic countries despite having the same approach as Stockholm.

 

9 minutes ago, Luzifer's right hand said:

I don't really believe the official numbers of Austria I admit and I think they are keeping them as low as possible with statistical tricks.

I see FT says that as of May 12th Austria has approximately 1100 excess dead over baseline, while reporting about 620 dead from covid-19... Could be missing a few hundred, but not a lot more I expect. By way of comparison, as of the 12th Sweden had 3,000 excess dead, while reporting 3400 dead from Covid-19, and Belgium has 8,000 excess dead while reporting 8900 covid-19 deaths. But Sweden and Belgium rate as among the most accurate.

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Just now, Ran said:

The big problem is deaths from elderly homes and those receiving home assistance. Just over 75%. If these had been sheltered better in the two most affected regions, deaths would be a lot, lot lower. The hope is that the rest of Sweden, with more time ahead of it, will do better, and so far that seems to be working okay. The region of Skåne, which is Sweden's 3rd most populous and 2nd most densely populated and features our third largest city, has numbers much more comparable to the other Nordic countries despite having the same approach as Stockholm.

 

I see FT says that as of May 12th Austria has approximately 1100 excess dead over baseline, while reporting about 620 dead from covid-19... Could be missing a few hundred, but not a lot more I expect. By way of comparison, as of the 12th Sweden had 3,000 excess dead, while reporting 3400 dead from Covid-19, and Belgium has 8,000 excess dead while reporting 8900 covid-19 deaths. But Sweden and Belgium rate as among the most accurate.

I'm not saying that our approach is not working pretty well. Excess death numbers look better than in most countries but our goverment refuses to comment on them at all. The fact that the last goverment collapsed last year prevented massive health care system cuts which is a plus and after some early problems things worked out rather well.

Our economy has been hit harder than the Swedish and the German though. Tourism is the main problem although Italy and Spain will suffer much more because of that.

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On 5/12/2020 at 7:12 PM, karaddin said:

If I'm following it right it would mean that if they're doing 20k tests for active virus and 80k for antibodies they are reporting their total tests as 100k even though 80% of those tests can't identify active cases. So their active infections number will be artificially suppressed while their recovered number would look higher.

Well, shit. The Atlantic now has confirmation that at least Virginia is actually doing this.https://www.theatlantic.com/health/archive/2020/05/covid-19-tests-combine-virginia/611620/

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That said, Virginia’s decision to mix the results of two different kinds of tests marks a new low in data standards.

The state is reporting viral tests and antibody tests in the same figure, even though the two types of test answer different questions about the pandemic and reveal different types of information. By combining these two types of test, the state is able to portray itself as having a more robust infrastructure for tracking and containing the coronavirus than it actually does. It can represent gains in testing that do not exist in reality, says Ashish Jha, the K.T. Li Professor of Global Health at Harvard.

“It is terrible. It messes up everything,” Jha told us. He said that combining the test results, as Virginia has done, produces information that is impossible to interpret.

The two tests have little in common. Viral tests help officials do the basic blocking and tackling necessary to contain an outbreak. If someone tests positive on a viral test, they are still infectious, so they can be told to self-isolate in order to protect the susceptible population. Public-health workers can trace their contacts to find others who may be infected with the coronavirus but who are not yet experiencing symptoms. Viral tests can also be used to monitor people who work in high-risk environments—such as a meatpacking plant—to diagnose a contagious person before they spread the disease.

Antibody tests, on the other hand, allow for something closer to post-game analysis. They help officials understand the true number of people in a state or city who have been exposed to the coronavirus. But they do so on a lag: Individuals who test positive on an antibody test are likely no longer infectious, and were infected by the coronavirus at least a week earlier.

In other words, combining positive and negative results from the two tests in the same statistic, as Virginia has done, makes no sense.

But commonwealth officials say they have no choice. Other states are mixing their results, claimed Clark Mercer, the chief of staff to Governor Ralph Northam, at a press conference this week.

“You can’t win” by keeping viral and antibody findings separate in public data, he said, adding that combining the two tests’ results was the only way to improve Virginia’s position in a list of states ranked by the number of tests they had conducted per capita. “If another state is including serological tests, and they’re ranked above Virginia, and we are not, and we’re getting criticized for that, [then], hey, you can’t win either way. Now we are including them, and our ranking will be better, and we’re being criticized,” he said.

Although The Atlantic hasn't been able to confirm yet that other states are also combining results the way Virginia is, they do note that...

Quote

 

The scope of the test-mixing problem is not yet clear. No other state aside from Virginia has admitted to counting antibody tests in their overall totals. We do know, however, that large numbers of antibody tests are being completed in the U.S. but not reported to the public by most states. As test numbers have shot up, Quest Diagnostics—one of the two largest commercial laboratories in the country—reported doing only 200,000 PCR tests from May 4 to May 11, which is 180,000 fewer diagnostic tests than in the preceding week. In fact, from May 4 to May 11, the company did almost 100,000 more antibody tests than PCR ones. LabCorp, the other major commercial reference laboratory, has not released similar data, but it has stated that its diagnostic- and antibody-test capacity are about equal.

Two states do report viral and antibody tests separately. In Colorado, 30 percent of tests completed so far in May were for antibodies. In Arizona, 23 percent of the total number of the tests ever done in the state have been serological. In both states, antibody tests started to be conducted en masse around April 26.

This timeline matches up disturbingly well with the improvement of the national picture, which saw a sudden jump at the end of April from an average of about 150,000 tests per day to 200,000, 250,000, and now 300,000 tests per day. The White House has celebrated the improvements in testing, noting in a press conference this week that the United States does more tests per day than any other country. “We have met the moment and we have prevailed,” President Trump said.

 

So there's a good chance the test positivity rates in many US states (and at minimum, in Virginia) are completely unusable. 

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58 minutes ago, Fez said:

But commonwealth officials say they have no choice. Other states are mixing their results, claimed Clark Mercer, the chief of staff to Governor Ralph Northam, at a press conference this week.

“You can’t win” by keeping viral and antibody findings separate in public data, he said, adding that combining the two tests’ results was the only way to improve Virginia’s position in a list of states ranked by the number of tests they had conducted per capita. “If another state is including serological tests, and they’re ranked above Virginia, and we are not, and we’re getting criticized for that, [then], hey, you can’t win either way. Now we are including them, and our ranking will be better, and we’re being criticized,” he said.

From that Atlantic article Fez posted, I guess the quote function attributes it to whoever posted the quote but anyway - wtf is Clark Mercer talking about?  

It seems like what he’s saying is that if we do not inappropriately mix the two types of testing in Virginia’s reporting that it makes the governor’s office look less good?  Is he taking a page out of the Trump administration book of governance and saying the quiet part out loud?  

I do not know how to interpret that statement any other way than that they know the numbers are misleading but they are doing it anyway so Virginia can maintain or improve its position on a national ranking....  that matters how?!  

Why is that more important than being clear about the the actual situation?  I think citizens deserve at least that much.  Are democrats not supposed to be the party of science and facts?  Maybe I’m misinterpreting Mercer’s statement, but it seems like that is a really piss poor excuse for implementing a piss poor practice.

I recently returned to Virginia from Texas and was hoping for at least a slightly less embarrassing state government (though admittedly my expectations were pretty low for Governor ‘Coonman’).

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Droplets from normal conversation linger for about 9 minutes, according to this experiment -- which to me, calling it an experiment does not mean it is a study, much less a wide-ranging, multi-faceted one:

https://www.washingtonpost.com/health/experiment-shows-human-speech-generates-droplets-that-linger-in-the-air-for-more-than-8-minutes/2020/05/13/7f293ba2-9557-11ea-82b4-c8db161ff6e5_story.html

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[....]

This new study did not involve the coronavirus or any other virus, but instead looked at how people generate respiratory droplets when they speak. The experiment did not look at large droplets but instead focused on small droplets that can linger in the air much longer. These droplets still could potentially contain enough virus particles to represent an infectious dose, the authors said.

Louder speech produces more droplets, they note. The paper estimates that one minute of “loud speaking” generates “at least 1,000 virion-containing droplet nuclei that remain airborne” for more than eight minutes.

[....]

Which may contribute to why work places like nursing homes and call centers are such infectious centers.

~~~~~~~~

Beyond this, with the 'mixing' of numbers and the refusal to even want to DO anything to reduce contagion, infection and illness + death, very quickly the US will find itself a pariah country -- particularly as it has been withdrawn from every other kind of health movement for human beings, the environment and the planet -- while having utterly destroyed its own economy, because it didn't know what the eff and then turning around and opening everything that it closed for a far too short time.

Other groups of states and nations who are at the very least trying, will not only refuse to allow people from the US inside their own borders -- will have no need whatsoever to trade with the US either -- particularly since the US is having trade wars with everybody -- maybe even the UK?  I can never quite figure out what's going on there.  But then it's all so insane from the gitgo in both countries, that isn't any surprise.

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For those still making excuses for Trump, here is a success story from Kerala, a state in India with a population of 35 million

https://www.theguardian.com/world/2020/may/14/the-coronavirus-slayer-how-keralas-rock-star-health-minister-helped-save-it-from-covid-19

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On 20 January, KK Shailaja phoned one of her medically trained deputies. She had read online about a dangerous new virus spreading in China. “Will it come to us?” she asked. “Definitely, Madam,” he replied

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Three days after reading about the new virus in China, and before Kerala had its first case of Covid-19, Shailaja held the first meeting of her rapid response team. The next day, 24 January, the team set up a control room and instructed the medical officers in Kerala’s 14 districts to do the same at their level. By the time the first case arrived, on 27 January, via a plane from Wuhan, the state had already adopted the World Health Organization’s protocol of test, trace, isolate and support.

So there are 4 deaths out of 35 million people, although if the lockdown in India is lifted soon, there may be migrant workers returning to the state. For those of you triggered by socialism, I should note she is a member of the Communist Party of India (Marxist), the Marxist part being to distinguish them from the other flavors of communist parties in India.

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1 hour ago, IheartIheartTesla said:

For those still making excuses for Trump, here is a success story from Kerala, a state in India with a population of 35 million

Years of investment in public health, education and development has put Kerala in the position that it is in. In a country that has basically left it's poor completely during the pandemic, Kerala has been far ahead of the curve. Also, experience with the Nipah outbreak in 2018 also helps. They started from a very good baseline, but this is what public health officials taking the threat seriously as early as January 24th looks like.

Things like below are not happening in the majority of states in India that are currently under lockdown ( the Indian lockdown is probably the strictest compared to a lot of other countries) and it's sad, but Kerela has been a source of good news in the complete haphazard lockdown in India.

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But this iron-fist approach was matched by socially valuable outreach policies. Supplies were home-delivered, midday meals from schools were sent to children even when schools were shut, regular and clear communication channels were established to dispel fake news, migrant labourers from other states were well taken care of, and mental health helplines were established across the state. The “break the chain” campaign to limit the Covid-19 spread was particularly successful.

Public health interventions work, and we have plenty of examples that they do, but there needs to be the political will and obviously the know how.

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Yeah, my parents live in Navi Mumbai, and have been under lockdown. They did go to a doctor's office once, and were stopped twice by the police. Sometimes it makes the protests here in Michigan seem so quaint when you see cops with lathis beating offenders or making them do sit ups. Still I understand the need a little bit to make the trade off between the extremes of authoritarian diktats and complete freedom. But it looks like Kerala took the lead in testing and even contact tracing, I believe, so it isnt as if the numbers are hiding cases, like I suspect in the US.

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22 minutes ago, IheartIheartTesla said:

Yeah, my parents live in Navi Mumbai, and have been under lockdown.

Hope your parents are doing okay. I'm in Pune at the moment so not too far from there & will be traveling to Mumbai and then onward to London in the next couple of weeks. I'll have to get a pass from the police here that allows me to travel but I'm nervous about making the journey. The brunt of this is being felt by the poor & daily wage workers whilst our PM is going on the TV and making speeches about how India needs to be self reliant :bang:

Honestly, if the states hadn't taken leadership the way they have and left it to the center, we would be even worse off that we are at the moment. There's a weird parallel here to the US where states are the ones leading the public health efforts.

Unsurprisingly, Maharashtra  & Mumbai is pretty hard hit by it, and we haven't exactly been flattening the curve since all this began, though some parts of the state & country haven't had cases in a couple of weeks.

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Here's hoping things go well for you, Honestly, the 15ish hour flight to London is probably the one that is health-wise the most 'risky', although I do know airlines are taking all the precautions they can.

As for Mumbai, yeah...having lived there for 20 years, it's essentially bodies piled on bodies with about 2 exit points to the mainland. I'm surprised it isnt worse than what it is. My parents did note this app that tracked local cases (on a street basis), and they were cordoning off streets, so it looks like even in a messy congested place like India there were some tools available (although I didnt ask about privacy and content related to that app and whether it was govt. sanctioned)

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