Covid-19 #18: Everything Old is New Again!

[Mudguard]

2 hours ago, rotting sea cow said:

Ok, This is around the news. Here is just one article.

Coronavirus: WHO estimates 10% of global population infected with COVID-19

https://www.dw.com/en/coronavirus-who-estimates-10-of-global-population-infected-with-covid-19/a-55162783

I've no idea how they are calculating these numbers. 10% means ~750 millions of people.

The current death toll just surpassed 1 million, so even with vastly undercounting the IFR would be around 0.2%, hardly more dangerous than the Flu. It would also speak of a large fraction of asymptomatic individuals.

Something smell fishy here. Is this disease really dangerous? Or just too contagious?

 

It's just a really rough estimate that could easily be off by a factor of 2 or more.  I wouldn't put any stock in the precise number, but the general sentiment that the vast majority of people remain at risk is probably correct. 

There had been some speculation earlier that certain hard hit areas like Stockholm and New York City might be close to herd immunity due to persistent low rates of new cases, but the recent uptick in cases in these areas as measures have been relaxed seems to now suggest otherwise.  

This disease spreads so quickly that you really can't go back to normal unless you completely eliminate community spread first, and even then you have to remain vigilant for imported cases.

[Heartofice]

https://www.theguardian.com/world/2020/oct/06/scientists-call-for-herd-immunity-covid-strategy-for-young
 

This article is pretty disingenuous with its headlining, as Herd Immunity is not a strategy, and saying it is really doesn’t help debate. 
 

It also states that half the UK population have a health risk for Covid, which is quite vague and certainly doesn’t mean they are in the vulnerable category. Bloody guardian. 
 

Anyway, it’s interesting that at this stage there is still debate as to what should be done, as this is basically the strategy that was called for at the beginning of the outbreak, before the UK reverted to lockdowns in a panic.

[Werthead]

7 hours ago, rotting sea cow said:

Ok, This is around the news. Here is just one article.

Coronavirus: WHO estimates 10% of global population infected with COVID-19

https://www.dw.com/en/coronavirus-who-estimates-10-of-global-population-infected-with-covid-19/a-55162783

I've no idea how they are calculating these numbers. 10% means ~750 millions of people.

The current death toll just surpassed 1 million, so even with vastly undercounting the IFR would be around 0.2%, hardly more dangerous than the Flu. It would also speak of a large fraction of asymptomatic individuals.

Something smell fishy here. Is this disease really dangerous? Or just too contagious?

I can believe they meant that 10% has been exposed to it, but that doesn't necessarily mean infected. It seems to be a rather vague, guessworky figure and isn't helping the WHO's flaky reputation on reporting the issue.

Confirmed cases as of today are 35.5 million infected with 1.04 million dead. I'm not sure how they're calculating that they've only recorded 1 in 21 cases and for every confirmed case there have been 20 that are undiagnosed. The figure they seem to have been using as a very rough average is much lower than that, at around three to five. I've seen some suggestions it might be higher, with a corresponding drop in mortality, but nowhere near that much higher.

Quote

It also states that half the UK population have a health risk for Covid, which is quite vague and certainly doesn’t mean they are in the vulnerable category. Bloody guardian. 

They don't say that. They're quoting Gregg Gonsalves who said that half of the American population has an underlying health risk for COVID. Obesity is a key risk factor and 36.5% of Americans are obese, with another 32.5% being overweight. 35% of the population is aged over 45, when risk factors for COVID grow significantly. So that appears to be accurate. British figures are somewhat different, but combined the figures could still add up to more than 50% here as well, but it'd be maybe stretching the definition of "some health risk".

[Werthead]

23 minutes ago, Chataya de Fleury said:

How did smallpox never achieve “herd immunity”? I’m wondering if like Ebola, it was too deadly to carry far...but the smallpox vector was solely human, it had no animal reservoir.

Wasn’t smallpox the Plague of Justinian and then after wiping a lot of people out just kept on popping up every so often until it was eradicated in 1980?

Smallpox became infectious only after the initial rash appeared, so diagnosis before the onset of the infectious cycle was possible. Transmission also required prolonged exposure at close quarters to another infected person, or their bedding or clothing. Smallpox also had no asymptomatic state, you either had it and had all the signs and were infectious, or you didn't.

This made it relatively easy to contain viral outbreaks and prevent onward transmission. This is why smallpox outbreaks tended to be small and not result in pandemics as such, at least not once the virus had become better understood.

[Zorral]

1 hour ago, Chataya de Fleury said:

How did smallpox never achieve “herd immunity”? I’m wondering if like Ebola, it was too deadly to carry far...but the smallpox vector was solely human, it had no animal reservoir.

Wasn’t smallpox the Plague of Justinian and then after wiping a lot of people out just kept on popping up every so often until it was eradicated in 1980?

https://www.infoplease.com/math-science/health/diseases/epidemics-of-the-past-smallpox-12000-years-of-terror

Many historical / forensic epidemiologists think the plague of Justinian's time was exactly that -- the Bubonic plague, at least the pneumonic type.  "Justinian's Flea is a good study.

https://goinggentleintothatgoodnight.com/2018/04/10/book-review-justinians-flea-plague-empire-and-the-birth-of-europe-by-william-rosen/

They didn't call that century the Dark Ages for nothing. There is less record keeping in the 6th century than the one before and the ones after -- because there were so many pandemics, and thus famines, as well migrations of conquest and desperation.

[Mudguard]

11 hours ago, Werthead said:

I can believe they meant that 10% has been exposed to it, but that doesn't necessarily mean infected. It seems to be a rather vague, guessworky figure and isn't helping the WHO's flaky reputation on reporting the issue.

Confirmed cases as of today are 35.5 million infected with 1.04 million dead. I'm not sure how they're calculating that they've only recorded 1 in 21 cases and for every confirmed case there have been 20 that are undiagnosed. The figure they seem to have been using as a very rough average is much lower than that, at around three to five. I've seen some suggestions it might be higher, with a corresponding drop in mortality, but nowhere near that much higher.

They don't say that. They're quoting Gregg Gonsalves who said that half of the American population has an underlying health risk for COVID. Obesity is a key risk factor and 36.5% of Americans are obese, with another 32.5% being overweight. 35% of the population is aged over 45, when risk factors for COVID grow significantly. So that appears to be accurate. British figures are somewhat different, but combined the figures could still add up to more than 50% here as well, but it'd be maybe stretching the definition of "some health risk".

The 20 or 10 times the number of confirmed cases is based on antibody surveillance studies, but there's still large uncertainties around these results.

[SpaceChampion]

Neanderthal Genes Linked To Severe Coronovirus Reactions

[Castellan]

I gather Trump shot some ghastly thing out his nose while talking to press - I suppose it was his brain.

That man is sick. He is getting poor treatment because no-one has forced him to stay in hospital instead of charging around on steroids.

 

 

 

 

[Kalbear]

12 hours ago, SpaceChampion said:

Neanderthal Genes Linked To Severe Coronovirus Reactions

I think this is interesting and also complete bullshit. This fails to explain well why in the US AA populations are 5 times more likely to suffer serious problems than white people are, with all other factors basically removed. And  the AA population should as a rule have significantly less neanderthal than the population of the US at large.

[Castellan]

2 hours ago, Chataya de Fleury said:

Link to serious news source? Pics or it didn’t happen?

None of the above. Sorry to raise your hopes, its just people dwelling on that video of him ranting about drugs (latest video on his twitter feed, he is standing outside under some trees and near a garden bed) and think they have identified a nasal snort happening and then also pondering what's wrong with his eye. My husband wandered into my study laughing about it and I passed in to you on mindlessly. 

[Castellan]

1 hour ago, Kalibear said:

I think this is interesting and also complete bullshit. This fails to explain well why in the US AA populations are 5 times more likely to suffer serious problems than white people are, with all other factors basically removed. And  the AA population should as a rule have significantly less neanderthal than the population of the US at large.

Within the article they have a long quote from someone who is not part of the team studying Neanderthal genetics

"There really isn't anything medically or biologically special about the fact that this variant arose in Neanderthals," Dr. Jeffrey Barret, a geneticist at Britain's Sanger Institute who was not involved in the study, told CNN.

 

"Humans have a great deal of genetic diversity, some of which arose in our pre-human ancestors, some in Neanderthals, some during the time when all ancient humans lived in Africa, and some more recently."

Barret said this particular stretch of DNA explains only a small percentage of the differences in illness severity among coronavirus patients.

 

 

I think the Neanderthal genetics team are just trying to make some mileage out of COVID.

 

[rotting sea cow]

1 hour ago, Kalibear said:

I think this is interesting and also complete bullshit. This fails to explain well why in the US AA populations are 5 times more likely to suffer serious problems than white people are, with all other factors basically removed. And  the AA population should as a rule have significantly less neanderthal than the population of the US at large.

Because there are other confounding factors. It isn't a single one. The black population in US tends to be poorer with less access to health services, living in cramped spaces. I also think to remember that obesity is also more prevalent in the American Black population.

Also, IIRC the genetics of the whole think are complicated, apparently that particular gene is more prevalent in Asian populations than European ones. The gene comes from the Neanderthals, but they are extincted long ago, Sapiens have mixed themselves a lot since then.

[Heartofice]

Yeah my first thought was if this was true about the Neanderthal gene then it would be white and Asian people dying in greater numbers. But that isn’t the case almost anywhere.

Its unlikely that you can pin those numbers on any one thing. There might have been something in Vitamin D protection but even then there are a ton of other factors, such as living conditions, obesity, diet, lifestyle, population density, viral load etc.

[rotting sea cow]

The Swedish might have gotten the things right

Read carefully.

Quote

Covid-19: Modelling the pandemic

When the covid-19 pandemic hit, the reaction of researchers around the world was “How can I help?” The consequence was thousands of well meaning, but unreviewed preprint papers, and hundreds of suggestions cluttering the inboxes of the government’s scientific advisors.  

There had to be a better way. The Royal Society sent an appeal to the computer modelling community to help epidemiologists. “Rapid Assistance to Modelling the Pandemic” or RAMP—an acronym which seemed snappy in March—was set up. Soon dozens of coders were seconded to the leading modelling groups, contributing to the signal, not the noise. We rethought how to do peer review in a crisis. Firstly triage, we crowdsourced reviews of the preprints, then a rapid filtering to an expert review panel, and onwards to the UK government advisory committees SPI-M and SAGE.  

With rapid turnaround required by policymakers, even the best groups are in danger of slip ups, so another RAMP task was replication of influential work. We looked at the code for the modelling done by Neil Ferguson from Imperial College London.  His group’s blandly-titled “Report 9” predicted half a million deaths from covid-19 if nothing was done, and is generally regarded as “The Science” behind the lockdown. Reading it, carefully, we noticed something surprising—while all the proposed measures slowed the epidemic, school closures increased the total number of deaths. Our first thought was that it was a mistake, but after a little work on the code, we replicated the result. The basic reason for this counter-intuitive result is that an intervention that substantially suppresses the first-wave of the epidemic leads to a stronger second wave once the interventions are lifted.

So, why was this advice ignored? Perhaps because the result only holds if there’s no successful vaccination programme for a couple of years. But more likely, the natural impulse of anyone faced with a result that goes against their preconceived ideas is denial—and scientists are no different in this respect. The UK had planned for a flu epidemic, and schools are a hotbed for influenza transmission. So, even though the low infectivity and morbidity for young people was understood by March, it may have been difficult to accept how different influenza and covid-19 really were, and there may have been some nervousness about trying anything counter-intuitive based on a model.  Moreover, failing to suppress the pandemic in the short term, based on a prediction of saving lives in the long term would be politically brave: especially when the identities of those saved could never be known.

While school closures are an interesting case, the general lesson from the model is simple. The effective interventions are those which focus strongly on protecting the vulnerable. Broader measures across all of society turn out to be counterproductive in the long term, even if compliance on the most effective features is uncompromised. In practice, the failure to focus on protecting care homes meant that the first wave was, disastrously, to concentrate the pandemic on the most vulnerable.

Scientific predictions are often published to great fanfare, with retrospective analysis seldom attracting as much attention. Report 9 appeared in March, we completed our study in June, and a lot has happened since. Infections went down steadily during lockdown, as predicted, and at the time of writing are rising again, just as predicted. With hindsight, the Imperial model has proved remarkably accurate. It turned out that the experts really are expert.

https://blogs.bmj.com/bmj/2020/10/07/covid-19-modelling-the-pandemic/

 

[Ormond]

5 hours ago, Heartofice said:

Its unlikely that you can pin those numbers on any one thing. There might have been something in Vitamin D protection but even then there are a ton of other factors, such as living conditions, obesity, diet, lifestyle, population density, viral load etc.

Of course you cannot pin the numbers on any one thing. There will be scores if not hundreds of different factors involved.

The study about the Neanderthal genes is probably not "bull" at all. The scientists who did the research were careful to point out, as was quoted above, that this explains only a small percentage of the variance in severity of Covid-19. It's the headline writers who are primarily at fault for giving the false impression this might be a big factor. 

[Zorral]

Yes, protecting the vulnerable while keeping the economy open depends entirely on protecting the vulnerable, and Sweden did not do that, nor has any other nation, and all for the same reasons: greed, selfishness and making profit.  So in the end the economy crashes, whether open or not.

With the Great Mortality in Europe, the economic fall-out continued for two centuries, for large portions of the economy for nearly two centuries from the successive waves  (so much for herd immunity). Many previously wealth generating sectors simply disappeared, as we are seeing presently, probably, in the arts and performance sectors.

Quote

 

....Yet among the nearly 6,000 people whose deaths have been linked to the coronavirus in Sweden, 2,694, or more than 45 percent, had been among the country’s most vulnerable citizens — those living in nursing homes.

That tragedy is in part the story of how Sweden has, over decades, gradually yet relentlessly downgraded its famously generous social safety net.

Since a financial crisis in the early 1990s, Sweden has slashed taxes and diminished government services. It has handed responsibility for the care of older people — mostly living at home — to strapped municipal governments, while opening up nursing homes to for-profit businesses. They have delivered cost savings by relying on part-time and temporary workers, who typically lack formal training in medicine and elder care.

This is how the nursing staff at the Sabbatsbergsbyn nursing home in the center of Stockholm found itself grappling with an impossible situation....

 

https://www.nytimes.com/2020/10/08/business/coronavirus-sweden-social-welfare.html?

[Mudguard]

7 hours ago, rotting sea cow said:

The Swedish might have gotten the things right

Read carefully.

https://blogs.bmj.com/bmj/2020/10/07/covid-19-modelling-the-pandemic/

 

I wouldn't say that Sweden got things right, particularly not in the beginning when they suffered large numbers of deaths in their elderly population.  Compare their numbers with their neighbor Norway.  You can argue that letting SARS-Cov-2 spread like wildfire in the beginning when it wasn't well understood resulted in thousands of unnecessary deaths.

Now that we know much more about the virus and disease, including who is most at risk and how to best treat these people, and now that there are several treatments that help, we are seeing much lower rates of deaths in the second waves that are sweeping across Europe.  Slowly opening up things now, while carefully monitoring everything, is a much more reasonable approach than just going for herd immunity right at the beginning when we had little understanding of the virus.

I don't put much stock into these coronavirus models.  They have been often way off, and there are so many versions that it's not surprising that you can later cherry pick one that matches up OK with current numbers.  We've had models predicting millions of deaths in the US, which predictably has allowed Trump to argue that he's saved millions of lives.  We also had models that concluded that case numbers would drop to zero in the summer.  Both model conclusions were idiotic on their face because they were based on completely unrealistic assumptions.  For example, the first model assumed that the US would do absolutely nothing, which was wrong from the start because private businesses and citizens were taking it upon themselves to social distance and wear masks, despite zero guidance from the government.  

Personally, I like the approach taken by countries like South Korea, New Zealand, Taiwan, etc., all of which have kept the disease in check from the beginning and have both low cases numbers and low deaths.  It was possible at the beginning for each country to do the same thing, but do to poor choices and a lack of will, here we are.

[Zorral]

As the NYT report linked to just above concludes about Sweden, it was a failure, not a success.

https://www.nytimes.com/2020/10/08/business/coronavirus-sweden-social-welfare.html?

Quote

Sweden is supposed to be immune to such dangers. Yet this country of only 10 million people has been ravaged by the coronavirus, with per capita death rates nearly as high as the United States, Britain and Spain, according to World Health Organization data

.

[williamjm]

5 hours ago, Zorral said:

Yes, protecting the vulnerable while keeping the economy open depends entirely on protecting the vulnerable, and Sweden did not do that, nor has any other nation, and all for the same reasons: greed, selfishness and making profit.  So in the end the economy crashes, whether open or not.

I was reading an article earlier commenting on the herd immunity strategy which pointed out that it's easy to suggest 'protecting the most vulnerable parts of society' but really hard to actually implement that, the Swedes themselves admitted they failed to do that.

[The Anti-Targ]

I don't think anyone can credibly claim that Sweden got it right with the death rate is saw. But also anyone claiming Sweden officially or unofficially was aiming for a straight herd immunity ASAP approach is also wrong. It took measures to control spread, just not lockdown measures.