Covid-19 #14 - Are We Done Yet?

[williamjm]

6 hours ago, rotting sea cow said:

You might be on something.

There are (admittedly sketchy) reports that air conditioning might aerosolize  the virus and thus increase its infectivity.

I wonder if in hot weather having air conditioning might encourage people to gather indoors whereas countries where air conditioning is less common might see more people gathering outside? It does seem to be commonly suggested that there's much more risk of transmission indoors than outdoors.

[Luzifer's right hand]

16 minutes ago, williamjm said:

I wonder if in hot weather having air conditioning might encourage people to gather indoors whereas countries where air conditioning is less common might see more people gathering outside? It does seem to be commonly suggested that there's much more risk of transmission indoors than outdoors.

I just saw something about a 2nd wave in Isreal because of school reopenings and one of the interviewed docs said that the combination of AC inside and low mask discipline outside(entrance areas and courtyards) because of the hot weather might be part of the problem. Most interviewed people seemed to agree that reopening schools at all before the fall was a bad idea. One school had 120 positive tests but only 10 had mild symptoms. Severe cases involve the kids families not the kids themselves.

[Raja]

Not great. I think data on testing is easier to fudge ( something the UK is also doing ) than mortality, especially excess mortality, but Florida not even releasing care home deaths is not good.

[rotting sea cow]

6 hours ago, Fury Resurrected said:

I wasn’t disputing that they have missed the mark here. But, I do think the western world deferring to them is part of the problem.

Western developed countries have no excuse. We all agree here. They have the resources, including intelligence reports and the political clout to pursue independent policy.  

6 hours ago, Fury Resurrected said:

In taking all their training modules, one of the first things they say is that you should follow the advice of your local governments first- which really underscores that WHO is primarily there for countries that can’t mount their own response and for data collection. The modules recommend hand sanitizer OVER hand washing, which is completely the opposite of the CDC, which was weird to me until I took the sanitation module. That made it super clear by the things they assumed I needed to know like digging placenta pits and the sharps disposal with cement and fire (and there were worse methods shown in case there was no cement available)- that they stress hand sanitizer because they are trying to speak to places that don’t necessarily have running water. And if you don’t have running water you probably can’t wear a clean mask every day. And if you can’t wear a clean mask, wearing a dirty mask may be worse than not masking at all. This is why anyone privileged enough to read this on the internet probably needs to be listening to their local authorities instead of the WHO- which is exactly what WHO advises

Still disagree with you, sorry. You might be right on these particular points, but WHO statements have created at the very least confusion. I don't come from a developed country, mind you, so I know on the ground how things are. I have also done voluntary work and one of the things I learned is that clear easy to understand message are fundamental.

Furthermore, if their mission was to protect the most vulnerable countries they should have advised the border closure which could have slowed down the spread of the disease for several key months.

Finally, in my home country, it was just found that the Health Ministry has been doctoring disease fatalities. The Minister was sacked, but it became clear that the WHO was aware of the true figures (and not the citizens) and was compelled into silence via "incentives".

With that the last bit of confidence on the WHO faded away.

[Seli]

19 hours ago, Rippounet said:

What I don't get is why the epidemy is slowing down throughout Europe. We don't seem to be seeing any "second waves" after the end of lockdowns, even though the percentage of people initially infected is quite low (around 6% for France I believe?).

If it's not heat, why is the virus disappearing?

Surely, social distancing isn't that effective?

It makes sense to me it is, together with the lockdowns.

The big thing those do is of course locking people into relatively small social circles, containing spread. And of course preventing people who otherwise rarely meet from mingling for long times.

[Zorral]

The Governor is threatening to prohibit NYC and the Hamptons to fully reopen because everyone is pretty much ignoring the rules and regs in place at the moment, which prohibit the serving and consuming of food and drink on premises.  Even our beloved local was doing this -- and there was no space whatsoever between the seated diners, and nobody was wearing masks. This is the end of our relationship with them.  

This, after all the deaths and sicknesses, when the curve is almost flat (only 23 deaths yesterday, compared with nearly 800 a month ago), thank to the incredible sacrifices, even deaths, of so many, from the health care professionals and assistants, to the supermarket workers, delivery people and so on.  It's just incredibly disrespectful, just for starters.

People DIED so you didn't have to deal with dead bodies on the streets and now you just throw all that in their faces.

https://www.nydailynews.com/coronavirus/ny-coronavirus-reopening-complaints-andrew-cuomo-20200614-3sfxpsocrzfgxdgsj5pcjs3jiy-story.html

https://gothamist.com/news/coronavirus-updates-june-14-2020

Quote

 

1:45 p.m.: Governor Andrew Cuomo put Manhattan and the Hamptons on blast for getting the most complaints for businesses not following reopening rules, and then warned of localized rollbacks of the reopening should the COVID-19 infection rate spike.

"This is a question of violating the law. Not just feel guilty. You're violating the law, alright?" Cuomo said during a press briefing on Sunday in Albany. "This is a very serious situation, and I want to make sure that everybody knows the consequences here. A bar or restaurant that is violating these rules can lose their liquor license."

Cuomo said there have been 25,000 complaints statewide about businesses, particularly bars and restaurants, being out of compliance with the phased reopening plan. In Manhattan's East Village, revelers were seen drinking in close proximity to others, many without masks, on Saturday.

"We have never received more complaints in a shorter period of time," Cuomo said.

Large gatherings with little social distancing or mask-wearing is likely to spur an increase in an uptick of coronavirus spread, Cuomo warned. Without proper enforcement by local governments, there's a possibility the state would intervene and "repause" localized areas.

State Liquor Authority officials were inspecting bars and restaurants for violations. Cuomo also reminded New Yorkers they weren't allowed to drink on the street due to open container laws and that not wearing a mask is currently a legal violation.

As the widespread protests against police violence and systemic racism continue, Cuomo said local police need to wear masks too—NYPD officers assigned to demonstrations and other locations have been frequently observed without face coverings.

"Police department: Your job is to enforce the law. Why don't you follow the law?" Cuomo said.

 

 

[Iskaral Pust]

I was always worried about quarantine fatigue.  It’s one thing to stay isolated in March and April while people are highly anxious, but then summer arrives and people are already feeling stir crazy, and the threat seems to have receded.  

I think the best plan now is for people to maintain social distancing as best as they’re willing — some will expose themselves to greater risk, but not so many as to overwhelm the health system; especially because people with comorbidities will more cautious — and keep shut the super-spreader venues, e.g. keeping offices closed also keeps density much lower on public transport and city sidewalks, keep churches, theaters, stadia, schools, etc closed.  This is going to be with us for a while.  We just need to manage it until a vaccine is developed.

[Guest]

53 minutes ago, Triskele said:

This is all quite discouraging. 

I absolutely understand quarantine fatigue, but it now feels like there are going to be some new spikes in certain places where leaderships are going to have to seriously consider more draconian lockdowns than before (Houston maybe).

Another wild factor to throw into the mix:  more emerging evidence that the virus causes long term damage even to people with milder cases.

If this is true it seriously changes things, if you ask me.  It greatly weakens the "let's just rush to heard immunity" line as it also greatly weakens the "can I just go ahead and get this thing so that I can get immune and move on" line.  That doesn't sound so great if it means radiology scan showing a gravelly lungs or endothelial blood vessel damage causing god knows what down the road.

 

 

 

 

I agree with this.

I get quarantine fatigue, but I don't get throwing all caution to the wind. Despite my hatred of it, I've been dying to hit the gym for months, injury notwithstanding. And I've been dying to eat out, but there are ways to mitigate risk that it doesn't seem anyone is interested in employing.

My fucking Senator was on tv today bragging about how people here aren't wearing masks. That's why our cases are spiking moron!

[Werthead]

23 hours ago, Rippounet said:

What I don't get is why the epidemy is slowing down throughout Europe. We don't seem to be seeing any "second waves" after the end of lockdowns, even though the percentage of people initially infected is quite low (around 6% for France I believe?).

If it's not heat, why is the virus disappearing?

Surely, social distancing isn't that effective?

Quite a big story here this week that it's now believed that asymptomatic infected do not transmit the virus, almost at all, and if they do, anyone they infect is likely to be asymptomatic as well and highly unlikely to be infectious.

If true, that means between a third and half of people infected with COVID-19 are effectively incapable of spreading the disease and the virus dead-ends through them, which massively disrupts the modelling.

Of course, those people are also much less likely to develop antibodies, so they're still vulnerable in a second wave, but there you go.

The WHO has stressed caution over the story, which was based on a moderate sample number, but further testing could confirm or deny that. It would certainly explain the way numbers seem to be falling even in areas where mitigation measures have been lukewarm to non-existent (such as the UK and Sweden).

Another story also suggests that infected people wearing even fairly modest masks may be incredibly more effective than first thought. 2 infected hairdressers in Missouri practiced vigorous mask measures in their business and none - 0% - of the 140 customers they treated in the infectious stage and none of their coworkers were infected. That's a single story, so again caution must be expressed over, but given how ripe transmission should be in a hairdressers, it seems interesting.

What does seem universally agreed on now is that reducing the R number can be achieved through a set of moderate measures - masks, social distancing where possible, the most vulnerable groups remaining in lockdown, washing hands - almost as effectively as enforcing a lockdown. The problem is that the success of this is highly dependent on the government enforcing rules and the population's willingness to go along with them. If they take their eye off the ball, you can get a big spike developing very quickly (as we're seeing now in Beijing).

[Zorral]

"We opened too early."

Well, duh.

https://www.washingtonpost.com/nation/2020/06/14/coronavirus-live-updates-us/#link-KT6MGYEG55BUTMT36Q5T2TGIRM

Quote

 

Hospitalizations related to the virus are up more than 10 percent since Memorial Day in at least 10 states — more than 120 percent in Arkansas, nearly 75 percent in Arizona.

Infectious-disease experts are worried about the trends they’re seeing, as some places in the United States experience their biggest tallies yet of coronavirus cases requiring serious medical care and as more than half of states hit seven-day averages of new cases that are higher than a week ago.

[....]“And so it’s not just the cases, it’s the fact that, at this point, hospitals are at risk of getting overwhelmed,” she said. “And that is basically signaling to me that the states are already behind, and they should consider potentially whether they should be rolling back, at least not progressing with further reopening.”[....]

 

 

[Altherion]

2 hours ago, Triskele said:

Another wild factor to throw into the mix:  more emerging evidence that the virus causes long term damage even to people with milder cases.

Link? It's pretty well established that people who are hospitalized and placed in a respirator are likely to end up with lung damage, but this is the first I've heard of mild cases causing long term harm.

[Zorral]

Just google instead of waiting.

This long term damage has been reported for many weeks now that there are people recovered from relatively mild cases (and even that so-called mild infection sounds utterly dreadful, judging by people we know who were ill with it, never hospitalized, and recovered).  This includes the young and the previously healthy.  Sometimes one feels fine, and the damage shows up a few weeks later.  Been written about in the NY Times and the WaPo and other news sites a lot. 

People seem to not bother reading these reports, even when pre-digested in newspapers.

Which is probably why there are so many idiots running around saying about 20% of New York has been infected so now we have herd immunity.  Idiots.  Herd immunity has to be at least 70% infected.

[Rippounet]

12 minutes ago, Zorral said:

Just google instead of waiting.

This long term damage has been reported for many weeks now that there are people recovered from relatively mild cases (and even that so-called mild infection sounds utterly dreadful, judging by people we know who were ill with it, never hospitalized, and recovered).  This includes the young and the previously healthy.  Sometimes one feels fine, and the damage shows up a few weeks later.

Careful, I think you're confusing the "long form" of the virus and "long-term damage."

People with mild cases can keep experiencing symptoms for months, that is well-established. However, it is not clear whether this is due to long-term damage or not. In some cases it is or will be (obviously), but at this point it seems likely that many people just need a long time to recover.
We still do not know whether a long recovery is synonymous with long-term damage. Maybe, maybe not.

[Altherion]

9 minutes ago, Triskele said:

Here's one pretty good piece on it (Atlantic's free clicks COVID section).  

Isn't this what Rippounet addressing above though? This article is about a small fraction of cases in which the infection is not life-threatening, but persists for months. It does point out yet another way in which the disease can be bad, but this is not the same as mild cases causing long-term damage.

[rotting sea cow]

9 hours ago, Zorral said:

Which is probably why there are so many idiots running around saying about 20% of New York has been infected so now we have herd immunity.  Idiots.  Herd immunity has to be at least 70% infected.

First. Classical herd immunity is reached at 1 - 1/R0. Given that the "natural" R0 of COVID-19 is heavily disputed with numbers as low as R=1.6 to as high as R0=6, the herd immunity can be achieved at very different levels.

Second. With the infection dominated by superspreaders events, one can substantially lower the spread by minimizing those events. Even if that doesn't happen, the disease will find bottlenecks and spread will slow.

See for example this: https://arxiv.org/abs/2005.03085

and the Australian strategy for re-opening https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3625655

So, in case of heavely affected countries/regions, I do think that once the most socially "promiscuous" (for lack of a better word) will create a social firewall that will slow the spread substantially. It doesn't mean of course carte-blanche for doing anything.

 

 

 

[rotting sea cow]

8 hours ago, Rippounet said:

Careful, I think you're confusing the "long form" of the virus and "long-term damage."

People with mild cases can keep experiencing symptoms for months, that is well-established. However, it is not clear whether this is due to long-term damage or not. In some cases it is or will be (obviously), but at this point it seems likely that many people just need a long time to recover.
We still do not know whether a long recovery is synonymous with long-term damage. Maybe, maybe not.

There are some fears that the virus can hide itself in the body like the Herpes virus to reappear at the worst moment, which may explain these reports of people sick for months. The question is of course, are they exceptions or just the tip of the iceberg?

We have talked before about the great variety of symptoms observed and it's bewildering. so we cannot exclude anything.

[Zorral]

There can't be anything like herd immunity for hub locations like NYC if / when (as even now) people from everywhere else constantly refresh the population, while not observing any of the safety protocols, particularly that of wearing masks and observing distance.

 

[Zorral]

As one can see, this article was written at least before last week, when the rapid increase in infection and hospitalizations began in the parts of the US that believed itself immune, or unlikely to be much affected, and opened or never shut, and went crazy over Memorial Day weekend.  Now, for instance in Tucson, hospital beds are at capacity.

Quote

Dr. Ashish Jha, director of the Harvard Global Health Institute, and his team also assumed that between 20% and 60% of the population would be infected with COVID-19 over six to 18 months. That was before stay-at-home orders took effect nationwide, which slowed the virus’s spread. Outside of New York City, a far lower percentage of the population has been infected. Granted, we’re not even six months into the pandemic.

In contrast to hospital bed capacity in NYC, the morgues ran out of space, as did other places, to store dead bodies.  This is not the subject of the article, so not addressed, but it is something to think about.  Particularly how much worse it would have been without the enormous effort and sacrifice of everyone who works in the medical system here.  And that it all can be reversed in a few hours by selfish idiots.

One woman reported on WNYC today that she went into a supermarket for the first time in months this weekend, and an idiot gets to checkout, pulls of his mask and announces, "I wanna see if I catch it."

https://www.propublica.org/article/how-americas-hospitals-survived-the-first-wave-of-the-coronavirus

[Fragile Bird]

Some good news - one of our boarders, who works on a cruise ship, has finally touched solid ground after 93 days at sea, mostly off the coast of Florida since Governor Dipshit allowed students from across the US to frolic on beaches, bringing Covid-19 to Florida or carrying it back to their home state, but wouldn't allow people isolated on ships for months to go to the airport and fly home. Her ship crossed the Atlantic and she flew home from Heathrow.

[kairparavel]

https://thehill.com/policy/healthcare/502748-fda-withdraws-emergency-use-authorization-for-hydroxychloroquine

Quote

The Food and Drug Administration (FDA) has withdrawn the emergency use authorization for two controversial coronavirus treatment drugs promoted by President Trump because of serious safety issues.

The agency said recent clinical trial failures mean chloroquine and hydroxychloroquine may not be effective at treating COVID-19 or preventing it in people who have been exposed, and that their potential benefits do not outweigh the risks.