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A preprint from April 12:

Title: Incidence, clinical outcomes, and transmission dynamics of hospitalized 2019 coronavirus disease among 9,596,321 individuals residing in California and Washington, United States: a prospective cohort

Lewnard, Liu, Jackson, Schmidt, Jewell, Flores, Jentz, Northrup, Mahmud, Reingold, Petersen, Jewell, Young, Bellows

ABSTRACT

Methods: We assessed incidence, duration of hospitalization, and clinical outcomes of acute COVID-19 inpatient admissions in a prospectively-followed cohort of 9,596,321 individuals enrolled in comprehensive, integrated healthcare delivery plans from Kaiser Permanente in California and Washington state. We also estimated the effective reproductive number (RE) describing transmission in the study populations.

Re is much the same as R0 unless you are getting toward herd immunity.

Results: Data covered 1277 hospitalized patients with laboratory- or clinically-confirmed COVID-19 diagnosis by April 9, 2020. Cumulative incidence of first COVID-19 acute inpatient admission was 10.6-12.4 per 100,000 cohort members across the study regions. Mean censoring-adjusted duration of hospitalization was 10.7 days (2.5-97.5%iles: 0.8-30.1) among survivors and 13.7 days (2.5-97.5%iles:
1.7-34.6) among non-survivors. Among all hospitalized confirmed cases,censoring-adjusted probabilities of ICU admission and mortality were 41.9% (95% confidence interval: 34.1-51.4%) and 17.8% (14.3-22.2%), respectively, and higher among men than women. We estimated RE was 1.43 (1.17-1.73), 2.09 (1.63-2.69), and 1.47 (0.07-2.59) in Northern California, Southern California, and Washington, respectively, for infections acquired March 1, 2020. RE declined to 0.98 (0.76-1.27), 0.89 (0.74-1.06), and 0.92 (0.05-1.55) respectively, for infections acquired March 20, 2020.

Conclusions: We identify high probability of ICU admission, long durations of stay, and considerable mortality risk among hospitalized COVID-19 cases in the western United States. Reductions in RE have occurred in conjunction with implementation of non-pharmaceutical interventions.

Funding: Kaiser Permamente

… Social distancing recommendations for vulnerable populations were issued in San Francisco on March 6, 2020, and large gatherings were banned in Washington on March 11. Large-scale stay-at-home orders were implemented March 17 for the six counties of the San Francisco Bay area, and statewide in California and Washington on March 19 and March 24, respectively….

To inform the epidemiology of COVID-19 in these regions, we analyzed healthcare data covering all hospitalized COVID-19 cases within the cohort of 9,596,321 individuals receiving comprehensive, integrated care from Kaiser Permanente (KP) healthcare systems in Northern California (KPNC), Southern California (KPSC), and Washington state (KPWA).

METHODS
Study design
The KPNC, KPSC, and KPWA systems deliver fully integrated healthcare to diverse membership cohorts generally resembling the commercially-insured populations of the surrounding geographic areas. We analyzed clinical and administrative data captured from all KP members who had been hospitalized within these KP care delivery systems with COVID-19 laboratory or clinical diagnoses at any recorded healthcare encounter by April 9, 2020.

Available data for patients included dates of COVID-19 clinical encounters, patient age, sex, dates of hospitalization, total duration of hospital stay, duration of ICU stay, ultimate clinical disposition (for completed hospitalizations only), and COVID-19 diagnostic tests performed in any setting as well as test results. …

Ethics approval
Retrospective reviews of de-identified administrative data for this study were considered exempt, nonhuman subjects research by the KPNC, KPSC, and KPWA institutional review boards.

Role of the funding source
The funder of the study played no role in study design, data collection, data analysis, data interpretation, or the writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.

RESULTS
Patients
In total, 1277 members were hospitalized with confirmed COVID-19 diagnoses as of April 9, 2020, with 539, 664, and 74 belonging to the KPNC, KPSC, and KPWA cohorts, respectively (Table 1). The median age of cases across all three cohorts was 60 years

Same as in the UK: 60 year old median age for hospitalizations (not deaths).

, with a range of 1-103 years and 50% of patients between 47-72 years of age. Four (0.3%) patients were under 20 years of age, 505 (39.5%) were ages 65 years or older, and 157 (12.2%) were ages 80 years or older; 725 (56.8%) were male. Laboratory confirmation of COVID-19 diagnosis was available for 1171 (91.7%) hospitalized patients as of April 9, 2020.

Hospitalizations were complete for 817 (64.0%) individuals

36% were still in the hospital.

, among whom disposition data were complete for 772. Among all patents with completed hospitalizations and outcomes recorded, 119 (15.4%) were deceased by April 9, 2020. Data on ICU admission were available for 617 individuals (only those in the KPNC and KPSC cohorts), among whom 158 were admitted to ICU.

Incidence of COVID-19 hospitalization
For the period ending April 9, 2020, we estimated the cumulative incidence of COVID-19 hospitalization within the KPNC, KPSC, and KPWA cohorts to be 12.4, 14.6, and 10.6 per 100,000 individuals (Figure 1). Incidence increased with age, reaching 61.0, 55.2, and 37.4 hospitalizations per 100,000 individuals ages ≥80 years in each of the three regions, respectively.

… we estimated 41.9% (34.1-51.4%) probability of ICU admission and 17.8% (14.3-22.2%) probability of death. Risk of death generally increased with age, while risk of ICU admission and death each tended to be higher among male than female patients (Figure 3). Risk of ICU admission appeared to increase with age among men only, with estimates ranging from 44.6% (26.4-76.0%) at ages 20-29 years to 70.7% (48.2-100.0%) at ages 70-79 years.

Transmission dynamics
… Our estimates of RE indicated that individuals acquiring infection on March 1, 2020 were expected to cause an average of 1.43 (1.17-1.73), 2.09 (1.63-2.69), and 1.47 (0.07-2.59) secondary cases in Northern California, Southern California, and Washington state, respectively. Those acquiring infection on March 20, were expected to cause 0.98 (0.76-1.27), 0.89 (0.74-1.06), and 0.92 (0.05-1.55) secondary infections in the same settings.

So R0 was slightly under 1.0 by March 20 on the West Coast. Is this in line with other numbers? Deaths in California keep going up, so I don’t know.

We estimated a mean interval of 13.5 days (4.8-27.9) between infection and hospitalization for cases that would ultimately be hospitalized (Table S3). Accounting for the ratio of total infections to hospitalized cases, and for censoring of infections not yet hospitalized, we estimated the cumulative incidence of infection within the KPNC, KPSC, KPWA cohorts was 2.2 (1.7-3.1), 3.0 (2.3-4.1), and 1.6 (1.2-2.2) per 1000 individuals as of April 3, 2020.

DISCUSSION
… It should be noted that our daily RE(t) estimates describe transmission resulting from infections acquired each day t, rather than those transmitting on each day t. Because most individuals begin transmitting >4 days after acquiring infection, declines in RE values are expected to precede dates of implementation of interventions that would affect transmission during individuals’ infectious periods. Individuals may have also taken precautionary measures to limit risk of acquiring or transmitting infection prior to implementation of stay-at-home orders.

… Within these regions, individuals receiving healthcare from KP
health plans may be wealthier than those without commercial insurance. Economic security and employment type may impact individuals’ ability to comply with stay-at-home orders, meaning our estimates of transmission dynamics may not describe circumstances for other populations, including socioeconomically vulnerable groups. Despite this limitation, our use of data on hospitalized cases in a prospectively-followed cohort, receiving care within a unified healthcare delivery system, overcomes inconsistencies affecting RE estimates from syndromic surveillance of milder COVID-19 cases across care providers and jurisdictions.30
The considerable length of stay among hospitalized cases in our study indicates that unmitigated transmission of SARS-CoV-2 poses a threat to US hospital capacity, consistent with observations in Italy and other high-resource settings3 as well as recent experience in New York. Our estimates of cumulative
infections suggest the western United States remains far from reaching a herd immunity threshold.

 
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  1. Good thing we have Top Men working on this.

    • Replies: @Father O'Hara
    I am surprised nobody has so far commented on this stupid savage who somehow got to be a leader of our healthcare system,no doubt at a very high salary.
    You can't tell me they couldnt see what a nutcase she is.
    I bet she have great nails!
    , @James N. Kennett
    Anyone genuinely working on vaccines for the virus would not have time right now to be a prolific tweeter.
    , @Anonymous
    Her tweets are private now.

    You can still see her twitter page though.

    "Virology. Vaccinology. Vagina-ology. Vino-ology."

    It is good to know that we have top vagina-ologists on the case. Also, I hope she waits until after work to get into the vino-ology.

    However, from an intersectional point of view, I can understand it. The vinology leads to virology issues with the vaginaology, and she is working on vaccineology to prevent this in the future. Like HPV shots.

    This reminds me that when AIDS was a new thing, all these people who are now draconian quarantine lockdown proponents told us that it was absolutely unAmerican and impossible to separate HIV and AIDS patients from their many victims. What changed?

    https://www.twitter.com/KizzyPhD
  2. What will the total number of deaths in this country be from xovid? Divide that into three trillion dollars and lmk the result.

  3. Interesting that Re was so low before (presumably) social distancing began.

  4. What useful treatment are most of them receiving in hospital? Or is their long stay just an alliance between panicking patients wanting to luxuriously use their health insurance for anxiety control and hospitals raking it in for mere bedspace?

    Meanwhile, calls to suicide hotlines have gone up eightfold…

    • Replies: @danand

    "What useful treatment are most of them receiving in hospital?"
     
    UK, the couple of people I know who were hospitalized at Silicon Valley Kaiser facilities were treated with the Hydroxychloroquine /Zpack "cocktail". They survived. Excerpt from an earlier post covering local news clip on another Kaiser patient:

    "Now at Kaiser Fremont, doctors say Tomei has responded to hydroxychloroquine treatments, so they want to send her back to Gateway."
     
    Video of news-clip, ~3 min long; "hydroxychloroquine" reference within first few seconds:

    https://abc7news.com/video/embed/?pid=6103855

    An aside, a SARS-CoV-2 infected butcher who worked in a grocery store a couple blocks from me died yesterday. Have not heard, yet, of other employees being infected.
    , @ic1000
    > What useful treatment are most of them receiving in hospital?

    The complaints last month about Didier Raoult and hydroxycholoroquine/azithromycin was that his trials were observational -- not randomized, not placebo-controlled.

    The complaint yesterday about U. Chicago and remdesivir was the same.

    Valid points, although performing an acceptably perfect RCT in the midst of pandemic mayhem could be challenging.

    I haven't heard anybody propose a head-to-head randomized trial of hydroxycholoroquine/azithromycin versus remdesivir. Why not? Both approaches show promise. The exact types of patients that each may benefit is still very unclear. Patients would be very likely to be willing to enroll in such a trial -- nobody risks getting an ineffective "placebo".
  5. “Deaths in California keep going up, so I don’t know.”

    As opposed to what? People being resurrected?

    • LOL: Daniel Williams
  6. This paper belongs to the category of “Steve asks, and he receives” –i.e., a pretty sophisticated demographic study of a population based on a subset of cases.

    If these results are an accurate reflection of what has happened/is happening in the population here’s your mitigating strategy: everybody over 60 stays home for some period of time, everybody else can go about their business.

    Here’s a couple sentences that really popped out for me:

    The 11-day average duration of stay for hospitalized patients is consistent with observations in China.However, we estimated a 14-day average duration of stay among non-survivors, whereas non-survivors had a shorter length of hospitalization in China (7.5 days) than survivors. This difference may reflect, among other factors, alternative approaches to extending end-of-life care in the two settings.

    What a lovely piece of judicious rhetoric! Who says STEM folks can’t be skilled writers?

    Translation? In China, some ICU cases got off the machines and were place in the hallway to meet their fate.

    Cue the Monty Python bit in the Holy Grail, sort of: “Bring out your dead.”

    • Replies: @anon
    We do that too here; it is called hospice/palliative care. Common in case of cancer. In some places, they go one step further and call it by the alliterative phrase death with dignity.
    , @JimB

    In China, some ICU cases got off the machines and were place in the hallway to meet their fate.

    Cue the Monty Python bit in the Holy Grail, sort of: “Bring out your dead.”
     
    "I'm not dead, yet."

    https://www.breitbart.com/asia/2020/04/07/report-wuhan-funeral-homes-burned-people-alive/
    , @Daniel Williams

    In China, some ICU cases got off the machines and were place in the hallway to meet their fate.
     
    According to Breitbart, the Chinese hastened some of them along that journey by burning them alive!

    https://www.breitbart.com/asia/2020/04/07/report-wuhan-funeral-homes-burned-people-alive/

    If it were any other government, I’d think this story was hysterical nonsense ...
  7. Anonymous[634] • Disclaimer says:

    “… a prospectively-followed cohort”

    >hyphenated adverb in the literal abstract.

    Into the trash.

    • Replies: @Keypusher
    Did you consciously aim at coming across as a pompous idiot, or did it just work out that way?
  8. Deaths in California keep going up

    Short of Jesus returning, deaths have no choice but to go up. Death rates are the thing to look at.

    Maybe, best of all, weekly modified total death rate by which I mean total weekly deaths less those that can be unambiguously classified as not COVID-related – car crashes, stabbings, shootings, and anything else that clearly belongs in a different bucket.

    Perhaps if you could get modified total death rates of people aged 60 or over that would be even better.

  9. Let’s keep healthy people isolated longer, so we don’t get herd immunity!

    • Agree: Kyle, Hippopotamusdrome
    • Replies: @danand

    "Let’s keep healthy people isolated longer, so we don’t get herd immunity!"
     
    Herd immunity will not happen until many people you know, or you, are dead. Even if it were possible, immunity may last only one "flu" season, or until next mutation. 100% testing, or near, is the only "safe" way to "re-open the economy". By safe I mean a place where most people feel it's OK for them to resume their pre SARS-CoV-2 lifestyle. Even if one doesn't feel at risk for death, getting "deathly Ill" will cause more than a little pause. Hesitant to even say resume because given the shock, seems near impossible the US will see another + $20 Trillion GDP print any year soon.

    Even going with about the most expensive currently available testing regime, performed via the Abbott ID NOW™ 15 minute routine, would not the “cost” be roughly 1/10 the lower end of what many figure to be the eventual cost for the US's “economic bailout”.

    Test "everyone" in the US:

    $10,000 Abbott ID NOW™ (part #NAT-024), 1 per 100 persons. I know it's overkill, but things break, and the're the relatively cheap part of the equation; make them ubiquitous, the machines could be located at every local library (12K), school (150K), McDonald's (14K), gas station (170K), etc... across the USA = $33,500,000,000 ($34B)

    $98 single use test kits - 335,000,000 persons in the USofA times 6 tests each. (1 test administered every week, for 6 weeks, for every person). Total test kit cost for 6 weeks would be $196,980,000,000 ($200B)

    $100 (estimated) - administration/labor cost of a single test. 6 tests times 335M people would run $201,000,000,000 ($200B)‬

    Everyone in USA 15 minute tested 6 consecutive weeks to effectively extinguish Covic-19 at a cost of $450 Billion, roughly half what Austin Powers would ask.

    The economy could be opened right now, with initial/1st week test round; as that would catch a majority of the infected right off the bat.

    After 6 consecutive weeks of testing, even given an individual test was only ~80% accurate and that not all infected would quarantine, the USA would be Covid-19 extinguished. At least until the next possible wave(s) comes in: Covid-21, Covid-22, Covid-23...

    BTW - China is still locked down province by province. There is extremely limited travel between them. (A distant associate who lives just outside Shanghai has been "stuck" in Wuhan province year to date.)
  10. On this herd immunity thing, what percentage of the population actually ends up getting the flu (Ron, babe, I am not saying this thing is the flu, I am asking for a comparison) in a major flu epidemic?

    I had heard that the R_0 (I finally learned that this is the factor of “spread”) of flu is actually rather low. But is the percentage getting the flu consistent with this R_0 value, taking into account effectiveness or lack therof of whatever flu vaccine in use, or is some other factor — warmer weather, some people being resistant to it even if they are not “pos” to that flu strain, mild or asymptomatic cases to recognized as flu?

    • Replies: @anon
    On this herd immunity thing, what percentage of the population actually ends up getting the flu

    Not a reasonable question, because each flu is a mutation of a previous one, so there are always older people around who survived the previous one. The 1918 flu was apparently close enough to something from the 1890's (25 or so years previous) that there were 40 year old people who were immune. Some percentage of the population had therefore "already gotten" it a generation earlier.

    SARS-COV-2 is not like anything previous. We dunno what percentage will get it. We dunno if everyone who gets it becomes immune. We dunno how long immunity lasts.

    The whole world is like some bunch of isolated islanders who just got visited for the first time by a boatload of Europeans, we have a surprise package and it's still not clear what's in it

    It's probabilities, and the Confidence Intervals are way too wide even now to make any sort of accurate predictions. The uncertainty is huge problem, and that's why this Kaiser study has value.
  11. A third of the 200 people on the street randomly tested for CV antibodies had them in Chelsea, Mass.

    https://www.bostonglobe.com/2020/04/17/business/nearly-third-200-blood-samples-taken-chelsea-show-exposure-coronavirus/

    None who tested positive had severe symptoms, and half had had 1 symptom in the past month, which sounds completely normal late March in a cold climate.

    The biggest winner from the Wuhan Depression:

    Cancel your prime membership!

    • Replies: @ic1000
    In this comment (editing window just closed), I estimate that a 0.1% IFR implies that +/- one-third of New Yorkers (the city) would have been SARS-CoV-2 infected on March 20th, and reckoned that was unlikely.

    You linked to an article in today's Boston Globe, Nearly a third of 200 blood samples taken in Chelsea show exposure to coronavirus. Paraphrasing the first three paragraphs,


    200 semi-randomly-chosen residents of the most-affected neighborhood of Boston were tested for antibodies on April 14th and 15th, and the test came back positive for 64 (32%). Participants were generally healthy, though half had experienced at least one symptom of COVID-19 in the past four weeks. The rate of Chelsea residents confirmed positive by PCR is 1,900/100,000 or about 2%.
     
    In terms of rate of confirmed cases, Massachusetts on 4/15 is where New York State was on 3/25. That's not the apples-to-apples comparison, which would be hotspot-to-hotspot, i.e. NYC to Boston (or to Chelsea).

    Still, this suggests that an IFR in the range of ~0.2% to 0.5% is more plausible than I'd thought, in terms of the implied very high rates of infection in NYC around March 20th.

    , @e
    This is immature of me, but I still feel the need to say it: Jeff Bezos is physically ugly.
    , @Meretricious
    That's not a random population sample.
    , @Kyle
    Don’t you mean cancel your woman’s prime membership?
    , @Brutusale
    Chelsea, more of a suburb of Santa Domingo than of Boston, has the highest CV rate in Massachusetts.

    It's also the leading city in MA for population density and percentage of people still working. It's surprising that it was only a third.

    , @Bill P
    The Santa Clara study implies that around seven to ten percent of the people in my county have already been infected, maybe more. The infection seems to be petering out with 29 dead so far out of 200,000 residents, almost all in nursing homes.

    So we're looking at typical flu numbers here.

    With ten percent of the population having already caught the virus, this suggests that the horse left the barn well before the economic nuclear strike was inflicted upon us by our dear leaders. Also, there's no avoiding this nasty cold. It will eventually get the susceptible one way or another, so we're all just delaying the inevitable with this lockdown, which young people are wisely ignoring in any event.

    I think we're all going to have to admit that we got duped by crude CCP propaganda intended to portray China as heroically defeating a menace to humanity by locking up their people in response to another nasty virus from one of their filthy farms. What is really unbelievable is how many Westerners praised them for this transparent charade.

    I really hate to admit it, but THE SWEDES WERE RIGHT! So was Lukashenko...

    Joke's on us.
    , @AnotherDad


    None who tested positive had severe symptoms, and half had had 1 symptom in the past month, which sounds completely normal late March in a cold climate.
     
    Actually Lot it's yet another rebuke of the "it's just the flu, bro" deniers:

    Chelsea:
    -- 40,000 people
    -- 39 deaths so far
    So they are already at 0.1% IFR ... even if entire population was infected.

    But this "quasi random" sampling suggests only about 1/3. So they are at 0.3%. And no doubt some more of the currently infected will die as well. So expect this to tick up a bit.

    Pretty much the same result as the study in hard hit Gangelt where they found 16% infected and a 0.37% IFR.

    Contra deniers, everyone has not yet been "infected" or "exposed". The reaction has pushed down transmission--of everything else too, as we've seen flu cases drop. Where a lot of people have been exposed, we get a lot of dead people, several times the normal monthly rate, greater than any recent flu season peaks.

    The data keep pointing in the same direction they have from the beginning:
    -- at least half asymptomatic or very mild cases, most of the rest "bad flu"
    -- < 1% real IFR -- probably will converge 0.3-0.7% for American age distribution
    (not the ridiculous numbers the hysterics get by dividing deaths by "cases"--many more infected are out there)
    -- 10-50X more lethal as "the flu"
    -- kills primarily the old and sick; very low mortality for young and healthy--only issue is mega-dose and cytokine storm;
    -- definitely *not* anything like the Spanish Flu which scythed through young men in armies
    -- not any sort of "threat to civilization" mostly just an "early harvest" of us old guys

    ~~

    The other thing of note with Chelsea:

    A rebuke to the "global cosmopolitans" who--as part of stripping Americans of our birthright--want to pack us in like sardines.
    https://www.amazon.in/One-Billion-Americans-Thinking-Bigger/dp/0593190211

    Turns out the countryside or even American style suburbia is much more robust.

    Dense crowded cities turn out to be susceptible to epidemic disease--now who could possibly have imagined that?
  12. 36% were still in the hospital.

    My god, treat them with Remdisivir ASAP.

  13. Mountain of COVID Stats Set to Surpass Entire History of Major League Baseball.
    “It’s going exponential,” says one beleaguered statistician.”It’s a war zone in here, logarithmically speaking.”

  14. OFF TOPIC:

    Chile’s celebrated author Luis Sepulveda, who died Thursday aged 70 from COVID-19, was a committed writer exiled by the Pinochet dictatorship for his political activities.

    Best-known for his 1992 novel, The Old Man Who Read Love Stories, Sepulveda was particularly successful in Europe, where he had been based since the 1980s.

    His works, appreciated for their simple humour and depictions of life in South America, have been translated in some 50 countries and range from novels, chronicles and novellas to children’s stories.

    • Replies: @Stan
    Nobody cares.
    , @but an humble craftsman
    At least I care.
  15. From the study:

    “…we did not conduct a detailed review of medical records. As such, we do not address presenting characteristics of hospitalized patients…”

    So guess the comorbidities present? That’s just a tad bit important in making a public policy decision, isn’t it?

  16. Some personal good news regarding The Virus.

    My 81-year-old aunt was sick with COVID-19 (tested positive). I was pretty worried because she is not that healthy, she is overweight and sedentary. She spent about two weeks in bed and said it was really tough but she has recovered and has been fever free for over a week. She never had to go to the hospital. It is hard to remember with all the bad news, but, even though their percentages are worse than for younger people, the old folks can survive without trips to the ICU and ventilators.

    • Thanks: epebble, Tor597
    • Replies: @Alice
    Actually, it seems like the ventilators will killing them.

    ER docs are not scientists. They aren't diagnosticians, and they don't even take the advice of their fellow specialists who often say things like "it's not necessary to hospitalize for these issues.". They sure aren't House, MD.

    They do the things they do that keep you from dying in their ER. so they intervene-- they give you an IV. Why? in case you need fluids. (huh? what?) Your oxygen dropping? they ventilate you. (huh? what?)

    but since the issue was oxygen uptake in hemoglobin, it was the wrong treatment...
    , @Hail

    My 81-year-old aunt was sick with COVID-19 (tested positive) [...] she has recovered and has been fever free for over a week
     
    That is good to hear.

    It turns out this kind of good news really is the norm and not the exception. (What I don't understand is why the good news never gets out...)

    The chance that someone over age 80 dies from the virus has now been proposed to be as low as 3%, meaning 97% of the 80+ group survive contact with the virus. Many of the 97% will get symptoms, as your aunt did, but will survive. The 3% deaths will be drawn heavily from the very ill, people always at risk. The 3% estimate has been proposed by the Centre for Evidence-Based Medicine (CEBM) at Oxford in a just-released study.

    They also find the number for those over age 70 without serious pre-existing health conditions to be very solidly below 1% deaths. As for the all-population fatality rate, study after study by qualified experts now points to the 0.1%-fatality range, possibly lower. In other words, the embarrassing possibility keeps presenting itself that the Wuhan coronavirus is not even unambiguously the worst flu strain seen in the past five or ten years in most places.

    We are left to pick up the pieces. Was this the Hoax of the Twenty-First Century? If the 0.1% estimates that keep coming out are right, how long will this charade last?

    Here is the wording from the CEBM study:


    In those without pre-existing health conditions, and over 70, the data suggests the IFR will likely not exceed 1%.

    Mortality in children seems to be near zero (unlike flu) which is also reassuring and will act to drive down the IFR significantly.

    It is now essential to understand whether individuals are dying with or from the disease. Understanding this issue is critical. If, for instance, 80% of those over 80 die with the disease then the CFR would be near 3% in this age group
     

    https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/
    , @Mike_from_SGV
    Great news, blessings to your extended family.
    , @PiltdownMan
    That's reassuring to hear, and wonderful news in your family. Best wishes to your aunt, and all in your family.
  17. Lot of data/information, little knowledge/wisdom.

    Covid = a riddle, wrapped in a mystery, inside an enigma

    • Replies: @Colin Wright
    '...Covid = a riddle, wrapped in a mystery, inside an enigma'

    How about: 'remarkably little, wrapped inside hysteria, wrapped inside media sensationalism'?

    I'd say it's all been about enough, wouldn't you?
  18. Anon[319] • Disclaimer says:

    OT South Florida Sun Sentinel, 04/18/20 – Tua Tagovailoa had lowest Wonderlic score among 2020 QB prospects

    https://www.sun-sentinel.com/sports/miami-dolphins/fl-sp-tua-tagovailoa-wonderlic-20200418-swoxmkth4zaplktnpxhw27khwq-story.html

    The Athletic’s Bob McGinn reports that ex-Alabama star quarterback Tua Tagovailoa scored a woeful 13 on the Wonderlic test, administered by the NFL to draft prospects before the draft.

    Among the other first-round prospects, McGinn reported that LSU’s Jake Burrow scored a 34, Utah State’s Jordan Love got a 27 and Oregon’s Justin Herbert had a 25. The highest reported score among the 2020 quarterback draft prospects was a 40 by Iowa’s Nate Stanley.

    Current Dolphins starting quarterback Ryan Fitzpatrick’s 48 (number of correct answers out of 50 questions) is reportedly tied for the third-best all-time (Fitzpatrick’s fellow Harvard alum Pat McInally, a Bengals punter from 1976-85, owns the lone perfect score).

    Quarterbacks have brushed off a low Wonderlic to star in the league. Dolphins Hall of Famer Dan Marino’s score in 1983 was widely reported to be a 16, and Ravens defending NFL Most Valuable Player Lamar Jackson was reported to have the same score as Tagovailoa two years ago.

    • Replies: @Reg Cæsar

    Tua Tagovailoa had lowest Wonderlic score among 2020 QB prospects
     
    At least he got through his tweens without knocking up his middle-school teacher. (As far as we know.)



    https://i.dailymail.co.uk/1s/2018/11/15/18/6238250-6394407-image-a-1_1542308304121.jpg

    https://www.biography.com/news/mary-kay-letourneau-vili-fualaau-wedding-anniversary-scandal
    , @Federalist

    LSU’s Jake Burrow scored a 34,
     
    Joe Burrow. Not Jake.
    , @anon
    Is intelligence (which I guess Wonderlic is supposed to more or less be a measure of) so prized that it's always better to have a high score? Or would it be cooler to score really bad yet still go on to a stellar career?

    And then be able to brag "I'm as dumb as a rock, but I'm still one of the most envied people in the country'.

    , @Aeronerauk
    I get the impression Marino, knowing his own value, just didn't take the test all that seriously.
  19. Table S3 (final page in PDF) is interesting, but rather cryptic unless you are fluent in probability distributions (more than I am). I took some time to understand it and thought it was worthwhile to pass this along. First, the entries I find most informative.

    Table S3: Parameters obtained from other studies.

    Parameters | Distribution | Source
    Time from infection to shedding | Weibull(κ = 5.983, λ = 1.455) | refs.13,19–21
    Time from shedding to symptoms | Weibull(κ = 0.294, λ = 0.14) | refs.13–16
    Time from symptoms onset to hospitalization | Gamma(κ = 5.078, θ = 0.765) | ref.17
    Time shedding onset to clearance | Exp(1/9) | ref.6

    They are using three different probability distributions. Weibull, Gamma, and Exponential. I will include Wikipedia links if anyone wants more detail, but will focus on looking at visualizations and some summary statistics (using Wolfram Alpha) for the particular distribution parameters from the table. I recommend clicking through to the Wolfram Alpha link to get more of a feel for the distributions but will give a brief description as well. Units are unspecified, but I assume days.

    Weibull distribution
    https://en.wikipedia.org/wiki/Weibull_distribution

    Time from infection to shedding | Weibull(κ = 5.983, λ = 1.455)
    https://www.wolframalpha.com/input/?i=weibull+shape%3D5.983%2C+scale%3D1.455
    mean 1.35, SD 0.26, some left skew, roughly speaking 1-1.75 days

    Time from shedding to symptoms | Weibull(κ = 0.294, λ = 0.14)
    https://www.wolframalpha.com/input/?i=weibull+shape%3D0.294%2C+scale%3D0.14
    This one seems bizarre enough (and, in combination with above, far enough from the 5 day infection-symptoms estimate I have seen) that I wonder if I have made a mistake.
    mean 1.42, SD 8.0, median 0.04 (!), incredibly right skewed

    Gamma distribution
    https://en.wikipedia.org/wiki/Gamma_distribution

    Time from symptoms onset to hospitalization | Gamma(κ = 5.078, θ = 0.765)
    https://www.wolframalpha.com/input/?i=gamma+shape%3D5.078%2C+scale%3D0.765
    mean 3.88, SD 1.72, some right skew, roughly speaking 1.5-7 days

    Exponential distribution
    https://en.wikipedia.org/wiki/Exponential_distribution

    Time shedding onset to clearance | Exp(1/9)
    https://www.wolframalpha.com/input/?i=exponential+distribution+rate+1%2F9
    mean 9, SD 9, the exponential decline is heavily right skewed

    References from table for anyone who wants to dig deeper. 6, 13-17, 19-21

    6. Ferguson NM, Laydon D, Nedjati-Gilani G, et al. Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand. Imperial College, London 2020. DOI:10.25561/77482.
    https://spiral.imperial.ac.uk:8443/handle/10044/1/77482

    13. Tindale L, Coombe M, Stockdale JE, et al. Transmission interval estimates suggest presymptomatic spread of COVID-19. medRxiv 2020. DOI:10.1101/2020.03.03.20029983.
    https://www.medrxiv.org/content/10.1101/2020.03.03.20029983v1

    14. Backer JA, Klinkenberg D, Wallinga J. Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20-28 January 2020. Euro Surveill 2020.
    DOI:10.2807/1560-7917.ES.2020.25.5.2000062.
    https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.5.2000062

    15. Lauer SA, Grantz KH, Bi Q, et al. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: Estimation and application. Ann Intern Med 2020.
    DOI:10.7326/M20-0504.
    https://annals.org/aim/fullarticle/2762808/incubation-period-coronavirus-disease-2019-covid-19-from-publicly-reported

    16. Linton NM, Kobayashi T, Yang Y, et al. Incubation period and other epidemiological characteristics of 2019 novel coronavirus infections with right truncation: a Statistical analysis of publicly available case data. J Clin Med 2020. DOI:10.3390/jcm9020538.
    https://www.mdpi.com/2077-0383/9/2/538

    17. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020. DOI:10.1001/jama.2020.1585.
    https://jamanetwork.com/journals/jama/fullarticle/2761044

    19. Du Z, Xu X, Wu Y, Wang L, Cowling BJ, Meyers LA. Serial Interval of COVID-19 among Publicly Reported Confirmed Cases. Emerg Infect Dis J 2020; 26. DOI:10.3201/eid2606.200357.
    https://wwwnc.cdc.gov/eid/article/26/6/20-0357_article

    20. Nishiura H, Linton NM, Akhmetzhanov AR. Serial interval of novel coronavirus (COVID-19) infections. Int J Infect Dis 2020. DOI:10.1016/j.ijid.2020.02.060.
    https://www.sciencedirect.com/science/article/pii/S1201971220301193

    21. Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronaviruinfected pneumonia. N Engl J Med 2020. DOI:10.1056/nejmoa2001316.
    https://www.nejm.org/doi/full/10.1056/NEJMoa2001316

    A notable thing I see in these references is multiple mentions of pre-symptomatic transmission.

    P.S. I would appreciate it if someone more probability distribution literate could double check this. I would not recommend anyone rely on these numbers until that has happened.

    • Thanks: YetAnotherAnon
  20. anon[154] • Disclaimer says:
    @Inquiring Mind
    On this herd immunity thing, what percentage of the population actually ends up getting the flu (Ron, babe, I am not saying this thing is the flu, I am asking for a comparison) in a major flu epidemic?

    I had heard that the R_0 (I finally learned that this is the factor of "spread") of flu is actually rather low. But is the percentage getting the flu consistent with this R_0 value, taking into account effectiveness or lack therof of whatever flu vaccine in use, or is some other factor -- warmer weather, some people being resistant to it even if they are not "pos" to that flu strain, mild or asymptomatic cases to recognized as flu?

    On this herd immunity thing, what percentage of the population actually ends up getting the flu

    Not a reasonable question, because each flu is a mutation of a previous one, so there are always older people around who survived the previous one. The 1918 flu was apparently close enough to something from the 1890’s (25 or so years previous) that there were 40 year old people who were immune. Some percentage of the population had therefore “already gotten” it a generation earlier.

    SARS-COV-2 is not like anything previous. We dunno what percentage will get it. We dunno if everyone who gets it becomes immune. We dunno how long immunity lasts.

    The whole world is like some bunch of isolated islanders who just got visited for the first time by a boatload of Europeans, we have a surprise package and it’s still not clear what’s in it

    It’s probabilities, and the Confidence Intervals are way too wide even now to make any sort of accurate predictions. The uncertainty is huge problem, and that’s why this Kaiser study has value.

  21. @Anon
    OT South Florida Sun Sentinel, 04/18/20 - Tua Tagovailoa had lowest Wonderlic score among 2020 QB prospects

    https://www.sun-sentinel.com/sports/miami-dolphins/fl-sp-tua-tagovailoa-wonderlic-20200418-swoxmkth4zaplktnpxhw27khwq-story.html

    The Athletic’s Bob McGinn reports that ex-Alabama star quarterback Tua Tagovailoa scored a woeful 13 on the Wonderlic test, administered by the NFL to draft prospects before the draft.

    Among the other first-round prospects, McGinn reported that LSU’s Jake Burrow scored a 34, Utah State’s Jordan Love got a 27 and Oregon’s Justin Herbert had a 25. The highest reported score among the 2020 quarterback draft prospects was a 40 by Iowa’s Nate Stanley.

    Current Dolphins starting quarterback Ryan Fitzpatrick’s 48 (number of correct answers out of 50 questions) is reportedly tied for the third-best all-time (Fitzpatrick’s fellow Harvard alum Pat McInally, a Bengals punter from 1976-85, owns the lone perfect score).

    Quarterbacks have brushed off a low Wonderlic to star in the league. Dolphins Hall of Famer Dan Marino’s score in 1983 was widely reported to be a 16, and Ravens defending NFL Most Valuable Player Lamar Jackson was reported to have the same score as Tagovailoa two years ago.
     

    Tua Tagovailoa had lowest Wonderlic score among 2020 QB prospects

    At least he got through his tweens without knocking up his middle-school teacher. (As far as we know.)

    https://www.biography.com/news/mary-kay-letourneau-vili-fualaau-wedding-anniversary-scandal

    • Replies: @prosa123
    The daughters certainly worked out well.
    , @YetAnotherAnon
    I thought she was looking a bit thicker round the waist - I forgot she already had four kids before meeting her 12 year old Mr Right.

    I wonder how her ex felt about two of his daughters attending their mother's second wedding.
    , @AnotherDad
    I guess--tautology--the girls are the big winners here as they are alive, and life is good.

    Among the principals the big winner is the ex-husband Steve. He was lucky his BPD wife blew up their marriage in an illegal fashion.

    I know a few guys where the wife blew up the marriage and they got kicked out of the house, but pay the mortgage, fork over a huge chunk of their paycheck and then get dicked around on seeing their kids. That's normal American "justice". (Surprised there isn't more homicide. Only because we white guys are so tame.) A default of joint custody is a much needed reform.

    Steve on the other hand, was able to dump the BPD wife, keep his kids and remarry and have more kids with presumably a younger and saner gal. Winner!

    The kid has wasted his youth hanging out with the old bag. But he's got a couple daughters in the deal. And he's still young and they've split now, so he can go on and find a younger more-compatible woman to have a life with.

    Her mad desire for POC love ... well i guess she'll have cats.

    This thing has Whiskey written all over it.
  22. Anon[397] • Disclaimer says:

    “Conclusions: We identify high probability of ICU admission, long durations of stay, and considerable mortality risk among hospitalized COVID-19 cases in the western United States.”

    This needs to be qualified. A new virus always hits the most vulnerable hardest. Because of this effect, the most vulnerable pile massively into hospitals early on.

    But this is not the way things will be in the latter stages. In the latter stages, the most vulnerable will be either dead or recovered, and the virus will be struggling to make headway among the healthier population that’s leftover. Death rates will drop, as will hospitalization rates.

    It’s a mistake to say that the virus will cause X amount of hospitalizations and deaths in a population only judging from your initial wave, because that initial wave will skew the overall statistics.

  23. This looks like the largest and best snapshot of infection and disease, so far. Thanks for posting, Steve.

    There’s been a lot of discussion of using recorded deaths and an assumed Infection Fatality Rate (IFR) to get an estimate of the percentage of people who were infected, at the time the people who died had gotten infected. Given the delay in getting testing in the US underway, this strikes me as sensible.

    This paper says that for the Kaiser Permanente cohort, “We estimated a mean interval of 13.5 days… between infection and hospitalization for cases that would ultimately be hospitalized…” And, “Mean censoring-adjusted duration of hospitalization was… 13.7 days… among non-survivors.”

    So that’s an average of 27 days (nearly 4 weeks) between infection and death. Much longer than the 2 week frame some people have been using.

    Below the fold, I do some arithmetic with these figures to back-project the infection rate in hotspot New York City on March 20, 2020. tl;dr — An IFR of much less than 0.5% doesn’t make much sense. An IFR of 0.1% implies that one-third of NYC residents were already infected by then. Herd immunity would have been achieved weeks ago.

    [MORE]

    From 91-COVID, the JHU 7-day trailing average for NY state is 1,323 deaths on April 17. The number of confirmed new cases for March 20 (28 days prior) was 2,945. Probably better to take 7-day average centered on March 20, which was 2,845.

    Taking 1,323 deaths on 4/17 and walking back 28 days to 3/20 —

    IFR of 2% means 66,000 actual new infections that day. (~4% of cases were detected)
    IFR of 0.5% means 260,000 actual new infections that day (~1% of cases were detected)
    IFR of 0.1% means 1.3 million actual new infections that day (~0.2% of cases were detected)

    Infections take 2 to 3 weeks to resolve (my estimate). Hopkins says there were 8,310 confirmed cases on 3/20, which was 15 days after crossing the threshold of 20 confirmed cases on 3/5. So essentially all of the SARS-CoV-2 infections that had occurred were active on 3/20.

    On 3/20, there were 2,845 new cases confirmed (7-day average). 2845/8310 = 34%. Thus, in the midst of rapid exponential growth, 34% of the people who were infected on midnight of 3/20 are projected to have gotten infected within the past 24 hours. In other words, the total number of infected at midnight of 3/20 should be about three times the number of people who became infected on that day.

    IFR of 2% means 190,000 actual current NYS infections on that day
    IFR of 0.5% means 780,000 actual NYS infections
    IFR of 0.1% means 3.9 million actual NYS infections

    The population of NY state is 19.4 million. NYC’s population is 8.6 million. Assuming that about 3/4 of the NYS infections of 3/20 were in NYC (my estimate):

    IFR of 2% means 142,000 actual current NYC infections on that day (1.7% of the city)
    IFR of 0.5% means 570,000 actual NYC infections (6.6% of the city)
    IFR of 0.1% means 2.8 million actual NYC infections (33% of the city)

    If IFR was 0.1%, herd immunity should have been achieved by early April, with 60% to 80% of the population infected or recovered (or dead). Herd immunity alone would explain why the NYC curve has flattened since then, to the extent it has.

    But, then what explains the similar flattening of the curve in almost every other jurisdiction, at lower rates of infection that preclude herd immunity as an explanation?

    An IFR of under 0.5% in the NYC setting looks unlikely, to me.

    • Replies: @Kratoklastes
    Your estimates will change if you re-do everything with
     • age-relevant transition probabilities (i.e., old sick people are outright more susceptible; develop symptoms quicker; and have disease progression that hits harder, earlier); and
     • the assumption that more than half of all 'confirmed' infections in the young (the largest cohort of 'confirmed' infections) are asymptomatic, and almost none of the young die from covid19.

    Given the CF(w)R for people over 75 is of the order of 30% on a 'same date' basis (i.e., using 'cases today' as the denominator for 'deaths today')‚ if lag structure is set up as age-agnostic numbers suggest, the system runs into problems.

    Take the April 17 deaths for NYC.

    There were 287 deaths of people aged 75 and over (NY's data still apparently still requires a positive lab test - at least that's what's shown at the top of each day's NYC Daily Death Summary for April 15 2020.

    Go back 27 days and fetch the 'confirmed cases' data for NYC for March 21st: there were only 390 cases in the 65+ group (until March 21, NYC was ending the relevant age cohorts at 65).

    But this was notionally the day these fogies got infected... they wouldn't show symptoms until incubation was finished.

    Five days later on the 26th (assuming that 75+ people start to show symptoms at the median incubation period) there were only 302 new confirmed cases among the 75+ group - so we're 15 deaths to the good... we can have <100% mortality and a 22-day look-back. In fact, the last week's worth of deaths is only 73% of the total cases up to March 26th.

    If you do this consistently - that the deaths have to come from new cases 22 days ago - it paints a terrible picture: a tad under ¾ of infected in the age group, 75+ die.

    What's missing? All of the 75+ cases since March 26th.

    Using the 22-day-lookback, results in a gigantic - and still-growing - pool of old infected waiting to die. That's not observed.

    Currently it would be all 75+ cases after March 26th. 12,868.

    So 73% of them will cark it over the next 22 days. That's 9,429 old people - which is almost 2.3 times the current cumulative total number of deaths in that age group.

    That's the thing that shows that the cases-wide dynamics are a bad choice.

    It's also why your proposed 'go back 22 days; count all cases; divide by assumed IFR' isn't a good idea.

    .

    This is why the putative "death-date-to-infection-date-matching" idea is a really bad idea if age-agnostic parameters are used - it biases the look-back period upwards (and therefore, for a given IFR, it overstates 'undiscovered' cases).

    I've used "75+" people as a cohort as if it doesn't have a natural internal partition - but of course it does... 75+ers with chronic illness - who die even faster than 75+ without. NYC's data doesn't have case comorbidity data; it has death

    Given that CFR has such a distinct age-cohort pattern, and is so strongly influenced by key relevant chronic illness, it would be weird to assume that susceptibility (and other transmission probabilities) aren't also different.

    .

    The thing is best modelled with age-group-specific dynamics - where the older age groups (and particularly the chronically-ill older people) take less than a week from symptoms to death or recovery. There's still a very high IFR in their age cohort, but correspondingly much much lower than 0.5 for the other age cohorts.

    I've spent a couple of days doing a half-assed search of the literature, and this seriously seems to be something that has had almost no real attention - I guess because this is the first real pandemic where the death-by-age is so tilted towards one end of the age distribution.

    If I was 15 years younger I would be eagerly writing up something with a view to submitting it to an open journal.

    As it is I'll do a half-assed writeup and stick it on a blog - there's no incentive to do more, because covid19's about to be dropped from media coverage.

    PandemicTV is pretty much done for 2020, and the next few weeks will be politicians doing victory laps and crowing that they saved humanity... and in 3 months there might be a 3 paragraph story in some inside page, discussing a recent inexplicable spike in suicides.
  24. Our estimates of cumulative 
infections suggest the western United States remains far from reaching a herd immunity threshold.

    Damn. So is Kaiser saying this contagion emergency is likely to be

    [MORE]

    Permanente

    • Replies: @Captain Tripps
    That opening scene from CSI: Miami with David Caruso/Horatio Caine was always a hoot... :-)
  25. @Reg Cæsar

    Tua Tagovailoa had lowest Wonderlic score among 2020 QB prospects
     
    At least he got through his tweens without knocking up his middle-school teacher. (As far as we know.)



    https://i.dailymail.co.uk/1s/2018/11/15/18/6238250-6394407-image-a-1_1542308304121.jpg

    https://www.biography.com/news/mary-kay-letourneau-vili-fualaau-wedding-anniversary-scandal

    The daughters certainly worked out well.

    • Replies: @Reg Cæsar

    The daughters certainly worked out well.
     
    Grandpa ran on George Wallace's party line in 1972. He outpolled McGovern in parts of Idaho:


    https://en.m.wikipedia.org/wiki/John_G._Schmitz


    East of the Rockies, his best performance was in the Florida Parishes of Louisiana.

  26. @Lot
    A third of the 200 people on the street randomly tested for CV antibodies had them in Chelsea, Mass.

    https://www.bostonglobe.com/2020/04/17/business/nearly-third-200-blood-samples-taken-chelsea-show-exposure-coronavirus/

    None who tested positive had severe symptoms, and half had had 1 symptom in the past month, which sounds completely normal late March in a cold climate.

    The biggest winner from the Wuhan Depression:

    https://thenypost.files.wordpress.com/2019/03/jeff-bezos-amazon.jpg

    Cancel your prime membership!

    In this comment (editing window just closed), I estimate that a 0.1% IFR implies that +/- one-third of New Yorkers (the city) would have been SARS-CoV-2 infected on March 20th, and reckoned that was unlikely.

    You linked to an article in today’s Boston Globe, Nearly a third of 200 blood samples taken in Chelsea show exposure to coronavirus. Paraphrasing the first three paragraphs,

    200 semi-randomly-chosen residents of the most-affected neighborhood of Boston were tested for antibodies on April 14th and 15th, and the test came back positive for 64 (32%). Participants were generally healthy, though half had experienced at least one symptom of COVID-19 in the past four weeks. The rate of Chelsea residents confirmed positive by PCR is 1,900/100,000 or about 2%.

    In terms of rate of confirmed cases, Massachusetts on 4/15 is where New York State was on 3/25. That’s not the apples-to-apples comparison, which would be hotspot-to-hotspot, i.e. NYC to Boston (or to Chelsea).

    Still, this suggests that an IFR in the range of ~0.2% to 0.5% is more plausible than I’d thought, in terms of the implied very high rates of infection in NYC around March 20th.

  27. @Lot
    A third of the 200 people on the street randomly tested for CV antibodies had them in Chelsea, Mass.

    https://www.bostonglobe.com/2020/04/17/business/nearly-third-200-blood-samples-taken-chelsea-show-exposure-coronavirus/

    None who tested positive had severe symptoms, and half had had 1 symptom in the past month, which sounds completely normal late March in a cold climate.

    The biggest winner from the Wuhan Depression:

    https://thenypost.files.wordpress.com/2019/03/jeff-bezos-amazon.jpg

    Cancel your prime membership!

    This is immature of me, but I still feel the need to say it: Jeff Bezos is physically ugly.

    • Replies: @PiltdownMan

    This is immature of me, but I still feel the need to say it: Jeff Bezos is physically ugly.
     
    https://images.financialexpress.com/2017/07/amazon-ceo-main.jpg
    , @Carol
    Yes. Be looks like that Applewhite freak.

    Bring back hair plugs!
  28. @Lot
    A third of the 200 people on the street randomly tested for CV antibodies had them in Chelsea, Mass.

    https://www.bostonglobe.com/2020/04/17/business/nearly-third-200-blood-samples-taken-chelsea-show-exposure-coronavirus/

    None who tested positive had severe symptoms, and half had had 1 symptom in the past month, which sounds completely normal late March in a cold climate.

    The biggest winner from the Wuhan Depression:

    https://thenypost.files.wordpress.com/2019/03/jeff-bezos-amazon.jpg

    Cancel your prime membership!

    That’s not a random population sample.

  29. Anon[397] • Disclaimer says:

    There’s been an interesting trend in my own state. Looking at the statistics, there was an initial spread throughout the state that was caused by Covid-19 being brought in by travelers returning from airports, and a lot of our counties around the state had a few cases of Covid-19 pop up. Today, 17 of those infected counties no longer have any. Those who were sick have recovered, and the virus has died out in those places. The only places where the virus is increasing is in the places where the big cities are, and in those places it’s being continually churned along by our minority population.

    There’s a false narrative being pushed by the SJW left that blacks are getting Covid-19 because they tend to work service jobs. Well, who doesn’t work a service job nowadays? The US economy moved from a farming base to a manufacturing base to a middle-class service job economy during the 20th century. Most whites work a service job, too. Many whites have jobs that deal with customers or clients. Even those whites who don’t have service jobs still work inside offices close to co-workers in open floor plans with no walls. The white death rate shouldn’t be any different from the black rate, but it is. The idea that blacks have higher death rates because of service jobs just doesn’t cut it.

    • Agree: Jay Fink
    • Replies: @Kratoklastes

    the virus has died out in those places
     
    It'll be interesting if there's ever wide-scale random testing in your neck of the woods.

    That might never happen though - in all likelihood the antibody test will have fallen into disrepute by that stage. It's giving numbers for asymptomatic undetected cases, that make the entire media-political circus look ridiculous - and certainly nowhere near a good reason for stopping the world economy. But we all knew that, soo...
  30. Important result:

    13.5 days between infection and hospitalization
    10.7 days duration of hospitalization among survivors
    13.7 days duration of hospitalization among non-survivors
    _______________

    The effects of countermeasures will be observable in the death rates after 27 days.

  31. Anonymous[380] • Disclaimer says:

    Too bad Kaiser didn’t flood the zone with HCQ+ZPAC mid march when Didier Raoult’s first study hit.

    The extended hospital stays referenced in this article could’ve been avoided.

    HIT THE ‘RONA HARD AND EARLY WITH THE “TRUMP PILLS”

    …then 99.9% will not need a damn ventilator.

  32. @kpkinsunnyphiladelphia
    This paper belongs to the category of "Steve asks, and he receives" --i.e., a pretty sophisticated demographic study of a population based on a subset of cases.

    If these results are an accurate reflection of what has happened/is happening in the population here's your mitigating strategy: everybody over 60 stays home for some period of time, everybody else can go about their business.

    Here's a couple sentences that really popped out for me:

    The 11-day average duration of stay for hospitalized patients is consistent with observations in China.However, we estimated a 14-day average duration of stay among non-survivors, whereas non-survivors had a shorter length of hospitalization in China (7.5 days) than survivors. This difference may reflect, among other factors, alternative approaches to extending end-of-life care in the two settings.
     
    What a lovely piece of judicious rhetoric! Who says STEM folks can't be skilled writers?

    Translation? In China, some ICU cases got off the machines and were place in the hallway to meet their fate.

    Cue the Monty Python bit in the Holy Grail, sort of: "Bring out your dead."

    We do that too here; it is called hospice/palliative care. Common in case of cancer. In some places, they go one step further and call it by the alliterative phrase death with dignity.

    • Replies: @Kratoklastes
    Palliative care? (Cue 'Hospital TV show aimed at housewives'...

    Palliative care? I didn't become the most gifted telegenic ex-Special Forces lady-doctor in Yankistan, just to let deathly-ill people die. Not on my watch. Let's roll. Get some. Oo-rah. Send it. Let's roll - oh, I said that already. We got this.

    To patient: FIGHT, damn, you! FIGHT! GOD DAMN IT... she's coding. Prep 2-by vasopressin and epinephrine - STAT!! (Pick up paddles)... CHARGING 300... CLEAR

    (familiar "Thump-wheeeeee"; patient bucks)
    (repeat "Charging... clear..." 5 or 6 times)

    Patient (groggy): mmm... ugh...
    Patient (now awake): Thanks doc. Now I better go get them terrrrrrists and stop that dirty bomb attack with weaponised covid19.

    (Patient yanks IV leads from arm and dashes out the door)

    Dr: Well, I guess that's what you would expect from a selfless maverick ex-Marine who follows his own rules.


     
  33. @Lot
    A third of the 200 people on the street randomly tested for CV antibodies had them in Chelsea, Mass.

    https://www.bostonglobe.com/2020/04/17/business/nearly-third-200-blood-samples-taken-chelsea-show-exposure-coronavirus/

    None who tested positive had severe symptoms, and half had had 1 symptom in the past month, which sounds completely normal late March in a cold climate.

    The biggest winner from the Wuhan Depression:

    https://thenypost.files.wordpress.com/2019/03/jeff-bezos-amazon.jpg

    Cancel your prime membership!

    Don’t you mean cancel your woman’s prime membership?

    • Agree: Mr McKenna
  34. Anonymous[276] • Disclaimer says:

    The war is over, Steve.

    You and Greg lost.

    This isnt a threat and never was. Sorry you wanted millions of deaths but its just not happening.

    • Agree: Je Suis Omar Mateen
    • Troll: James N. Kennett
  35. O/T, but of interest:

    https://www.washingtonpost.com/investigations/contamination-at-cdc-lab-delayed-rollout-of-coronavirus-tests/2020/04/18/fd7d3824-7139-11ea-aa80-c2470c6b2034_story.html

    What an unanticipated surprise.

    If it were practical, it would be a good thing for the CDC to be the recipient of something like the Red Team tests that they use in the military, units of which who are tested through simulated attacks by the Red Team to assess readiness, and quick responses to threats. When Go Time came, the CDC didn’t present the appearance of a well-oiled machine, or of an organization who had the faintest glimmering of OODA loops and adaptability on the fly. Sad.

  36. @kpkinsunnyphiladelphia
    This paper belongs to the category of "Steve asks, and he receives" --i.e., a pretty sophisticated demographic study of a population based on a subset of cases.

    If these results are an accurate reflection of what has happened/is happening in the population here's your mitigating strategy: everybody over 60 stays home for some period of time, everybody else can go about their business.

    Here's a couple sentences that really popped out for me:

    The 11-day average duration of stay for hospitalized patients is consistent with observations in China.However, we estimated a 14-day average duration of stay among non-survivors, whereas non-survivors had a shorter length of hospitalization in China (7.5 days) than survivors. This difference may reflect, among other factors, alternative approaches to extending end-of-life care in the two settings.
     
    What a lovely piece of judicious rhetoric! Who says STEM folks can't be skilled writers?

    Translation? In China, some ICU cases got off the machines and were place in the hallway to meet their fate.

    Cue the Monty Python bit in the Holy Grail, sort of: "Bring out your dead."

    In China, some ICU cases got off the machines and were place in the hallway to meet their fate.

    Cue the Monty Python bit in the Holy Grail, sort of: “Bring out your dead.”

    “I’m not dead, yet.”

    https://www.breitbart.com/asia/2020/04/07/report-wuhan-funeral-homes-burned-people-alive/

  37. anon[371] • Disclaimer says:

    ALOS or average length of hospital stays is around 4.7 days.

    The defining characteristic of concern over this is the visible chaos this creates in hospital care. Overcrowded ER’s, running out of supplies esp PPE, Overcrowding of ICU’s, physician testimonials, etc.

    Note that it seems to have been the Chinese experience in their hospitals that led to a massive Chinese lockdown.

    Patients remaining 2x longer than the average stay reduces spare capacity in half.

    Regardless, simply working backwards, the critical statistic seems to be the IHR or infectious hospitalization rate. If such a thing exists.

  38. @Lot
    A third of the 200 people on the street randomly tested for CV antibodies had them in Chelsea, Mass.

    https://www.bostonglobe.com/2020/04/17/business/nearly-third-200-blood-samples-taken-chelsea-show-exposure-coronavirus/

    None who tested positive had severe symptoms, and half had had 1 symptom in the past month, which sounds completely normal late March in a cold climate.

    The biggest winner from the Wuhan Depression:

    https://thenypost.files.wordpress.com/2019/03/jeff-bezos-amazon.jpg

    Cancel your prime membership!

    Chelsea, more of a suburb of Santa Domingo than of Boston, has the highest CV rate in Massachusetts.

    It’s also the leading city in MA for population density and percentage of people still working. It’s surprising that it was only a third.

  39. @UK
    What useful treatment are most of them receiving in hospital? Or is their long stay just an alliance between panicking patients wanting to luxuriously use their health insurance for anxiety control and hospitals raking it in for mere bedspace?

    Meanwhile, calls to suicide hotlines have gone up eightfold...

    “What useful treatment are most of them receiving in hospital?”

    UK, the couple of people I know who were hospitalized at Silicon Valley Kaiser facilities were treated with the Hydroxychloroquine /Zpack “cocktail”. They survived. Excerpt from an earlier post covering local news clip on another Kaiser patient:

    “Now at Kaiser Fremont, doctors say Tomei has responded to hydroxychloroquine treatments, so they want to send her back to Gateway.”

    Video of news-clip, ~3 min long; “hydroxychloroquine” reference within first few seconds:

    https://abc7news.com/video/embed/?pid=6103855

    An aside, a SARS-CoV-2 infected butcher who worked in a grocery store a couple blocks from me died yesterday. Have not heard, yet, of other employees being infected.

  40. “…Liu…Jewell…Mahmud…Reingold…Jewell…”

    Trustworthy people we can rely on, I’m sure.

  41. @UK
    What useful treatment are most of them receiving in hospital? Or is their long stay just an alliance between panicking patients wanting to luxuriously use their health insurance for anxiety control and hospitals raking it in for mere bedspace?

    Meanwhile, calls to suicide hotlines have gone up eightfold...

    > What useful treatment are most of them receiving in hospital?

    The complaints last month about Didier Raoult and hydroxycholoroquine/azithromycin was that his trials were observational — not randomized, not placebo-controlled.

    The complaint yesterday about U. Chicago and remdesivir was the same.

    Valid points, although performing an acceptably perfect RCT in the midst of pandemic mayhem could be challenging.

    I haven’t heard anybody propose a head-to-head randomized trial of hydroxycholoroquine/azithromycin versus remdesivir. Why not? Both approaches show promise. The exact types of patients that each may benefit is still very unclear. Patients would be very likely to be willing to enroll in such a trial — nobody risks getting an ineffective “placebo”.

  42. @Thatgirl
    Some personal good news regarding The Virus.

    My 81-year-old aunt was sick with COVID-19 (tested positive). I was pretty worried because she is not that healthy, she is overweight and sedentary. She spent about two weeks in bed and said it was really tough but she has recovered and has been fever free for over a week. She never had to go to the hospital. It is hard to remember with all the bad news, but, even though their percentages are worse than for younger people, the old folks can survive without trips to the ICU and ventilators.

    Actually, it seems like the ventilators will killing them.

    ER docs are not scientists. They aren’t diagnosticians, and they don’t even take the advice of their fellow specialists who often say things like “it’s not necessary to hospitalize for these issues.”. They sure aren’t House, MD.

    They do the things they do that keep you from dying in their ER. so they intervene– they give you an IV. Why? in case you need fluids. (huh? what?) Your oxygen dropping? they ventilate you. (huh? what?)

    but since the issue was oxygen uptake in hemoglobin, it was the wrong treatment…

    • Replies: @botazefa

    but since the issue was oxygen uptake in hemoglobin, it was the wrong treatment…
     
    I've see lots of comments here that imply SARS Cov2 is harming red blood cells, like you seem to imply. From what I understand as a Respiratory Therapist the Covid-19 can cause diffuse interstitial pneumonia- at least that is the proximal cause of death in all the cases. It's been hypothesized that SARS-Cov2 attacks the blood/gas membrane in the alveolus through ACE receptors. This is the pathway of previous SARS apparently. The destruction of the lung/blood membrane results in poor oxygen transfer from lung to blood.


    You can treat this with supplemental oxygen, positive pressure ventilation, or ECMO. The prognosis in such cases is *never* very good, regardless what caused the problem initially.

    Others have been arguing here that artificial ventilation is causing deaths. They point to stories about people avoiding ventilators by laying on their stomachs and receiving supplemental oxygen. That may be a decent early intervention but when someone starts exhausting of breathing because it is so hard and their CO2 is rising, the only treatment is the vent.

    In summary: Hypoxia in Covid-19 can be explained by causes not related to anemia and ventilators aren't causing premature deaths.

    Generally speaking, ICU's in the US handle respiratory failure very well because of all the smoking induced diseases they regularly deal with.
  43. @Reg Cæsar

    Tua Tagovailoa had lowest Wonderlic score among 2020 QB prospects
     
    At least he got through his tweens without knocking up his middle-school teacher. (As far as we know.)



    https://i.dailymail.co.uk/1s/2018/11/15/18/6238250-6394407-image-a-1_1542308304121.jpg

    https://www.biography.com/news/mary-kay-letourneau-vili-fualaau-wedding-anniversary-scandal

    I thought she was looking a bit thicker round the waist – I forgot she already had four kids before meeting her 12 year old Mr Right.

    I wonder how her ex felt about two of his daughters attending their mother’s second wedding.

  44. @Lot
    A third of the 200 people on the street randomly tested for CV antibodies had them in Chelsea, Mass.

    https://www.bostonglobe.com/2020/04/17/business/nearly-third-200-blood-samples-taken-chelsea-show-exposure-coronavirus/

    None who tested positive had severe symptoms, and half had had 1 symptom in the past month, which sounds completely normal late March in a cold climate.

    The biggest winner from the Wuhan Depression:

    https://thenypost.files.wordpress.com/2019/03/jeff-bezos-amazon.jpg

    Cancel your prime membership!

    The Santa Clara study implies that around seven to ten percent of the people in my county have already been infected, maybe more. The infection seems to be petering out with 29 dead so far out of 200,000 residents, almost all in nursing homes.

    So we’re looking at typical flu numbers here.

    With ten percent of the population having already caught the virus, this suggests that the horse left the barn well before the economic nuclear strike was inflicted upon us by our dear leaders. Also, there’s no avoiding this nasty cold. It will eventually get the susceptible one way or another, so we’re all just delaying the inevitable with this lockdown, which young people are wisely ignoring in any event.

    I think we’re all going to have to admit that we got duped by crude CCP propaganda intended to portray China as heroically defeating a menace to humanity by locking up their people in response to another nasty virus from one of their filthy farms. What is really unbelievable is how many Westerners praised them for this transparent charade.

    I really hate to admit it, but THE SWEDES WERE RIGHT! So was Lukashenko…

    Joke’s on us.

    • Replies: @Hail

    I really hate to admit it, but THE SWEDES WERE RIGHT! So was Lukashenko…

    Joke’s on us.
     
    "I'd like to congratulate the entire world on making Sweden look like a sane country. They could not have done this without your help." -- Lars Porsena

    Let it be remembered that 2020 was the year Sweden defied all odds and emerged, at least for a time, as the Great White Hope.
  45. @prosa123
    The daughters certainly worked out well.

    The daughters certainly worked out well.

    Grandpa ran on George Wallace’s party line in 1972. He outpolled McGovern in parts of Idaho:

    https://en.m.wikipedia.org/wiki/John_G._Schmitz

    East of the Rockies, his best performance was in the Florida Parishes of Louisiana.

    • Replies: @Bill P
    Poor Vili got stuck with Mary Kay because he couldn't afford the child support as a teenager. Our crazy laws will actually force a 12yo boy to pay child support to a 40yo woman who seduced him. Whenever you hear a feminist psychopath blabbering about the patriarchy think of that.

    BTW plenty of Samoan women are way more attractive than washed up Mary Kay. She trapped the boy and made him a laughing stock to his own people. If anyone exercised "white privilege," it was that criminal woman.
    , @AnotherDad

    https://en.m.wikipedia.org/wiki/John_G._Schmitz
     
    LOL. I'd never read this bit of trivia before. I'm sure it "explains it" somehow.
    , @captflee
    Given the alternatives presented to me, McGovern and Nixon, I feel pretty good having cast my first ever vote for the AIP. Had no idea MKL was his offspring.
  46. One monkey wrench we don’t need at the moment:

    Every deportation flight from the U.S. is an ‘alarm bell’ as Central American countries brace for coronavirus

    Will the Ninth Circuit label deportation as “cruel and unusual”? Will a UN resolution condemn it as biological warfare?

    • Replies: @Inverness
    Funny how the courts can consider sending people to their homes "cruel and unusual punishment" but have no problem with whites systematically gang-raped by blacks in prisons every day of the year.
    , @Louis Renault
    Do like Andy Jackson and ignore the court. They can send the 9th Circuit police out to enforce their order.
  47. Could Steve be sued out of business because his basement closet isn’t ADA-compliant? An e-mail touting this service– and touting touting it to others– just came in: https://getadacomply.com

    Could they come after commenters as well? It’s 25 steps up to our apartment, and no elevator. We can’t afford to rent a cherry-picker.

    • Replies: @Alice
    I once founded a non profit corp with myself and one other employee. She and I consulted, and to keep costs down, when not at a customer site, we worked in coffershops. I used to carry one of those MINIMUM WAGE IS poster and the state OSHA phone number poster in my briefcase and unfurl them while we sat sipping. I was joking with her because I trusted my employee, but I was sure I could be sued for violating the law and not posting the posters at our workplace.
  48. @Reg Cæsar
    One monkey wrench we don't need at the moment:

    Every deportation flight from the U.S. is an 'alarm bell' as Central American countries brace for coronavirus

    Will the Ninth Circuit label deportation as "cruel and unusual"? Will a UN resolution condemn it as biological warfare?

    Funny how the courts can consider sending people to their homes “cruel and unusual punishment” but have no problem with whites systematically gang-raped by blacks in prisons every day of the year.

  49. @Reg Cæsar
    One monkey wrench we don't need at the moment:

    Every deportation flight from the U.S. is an 'alarm bell' as Central American countries brace for coronavirus

    Will the Ninth Circuit label deportation as "cruel and unusual"? Will a UN resolution condemn it as biological warfare?

    Do like Andy Jackson and ignore the court. They can send the 9th Circuit police out to enforce their order.

  50. @Anon
    OT South Florida Sun Sentinel, 04/18/20 - Tua Tagovailoa had lowest Wonderlic score among 2020 QB prospects

    https://www.sun-sentinel.com/sports/miami-dolphins/fl-sp-tua-tagovailoa-wonderlic-20200418-swoxmkth4zaplktnpxhw27khwq-story.html

    The Athletic’s Bob McGinn reports that ex-Alabama star quarterback Tua Tagovailoa scored a woeful 13 on the Wonderlic test, administered by the NFL to draft prospects before the draft.

    Among the other first-round prospects, McGinn reported that LSU’s Jake Burrow scored a 34, Utah State’s Jordan Love got a 27 and Oregon’s Justin Herbert had a 25. The highest reported score among the 2020 quarterback draft prospects was a 40 by Iowa’s Nate Stanley.

    Current Dolphins starting quarterback Ryan Fitzpatrick’s 48 (number of correct answers out of 50 questions) is reportedly tied for the third-best all-time (Fitzpatrick’s fellow Harvard alum Pat McInally, a Bengals punter from 1976-85, owns the lone perfect score).

    Quarterbacks have brushed off a low Wonderlic to star in the league. Dolphins Hall of Famer Dan Marino’s score in 1983 was widely reported to be a 16, and Ravens defending NFL Most Valuable Player Lamar Jackson was reported to have the same score as Tagovailoa two years ago.
     

    LSU’s Jake Burrow scored a 34,

    Joe Burrow. Not Jake.

  51. @Reg Cæsar

    The daughters certainly worked out well.
     
    Grandpa ran on George Wallace's party line in 1972. He outpolled McGovern in parts of Idaho:


    https://en.m.wikipedia.org/wiki/John_G._Schmitz


    East of the Rockies, his best performance was in the Florida Parishes of Louisiana.

    Poor Vili got stuck with Mary Kay because he couldn’t afford the child support as a teenager. Our crazy laws will actually force a 12yo boy to pay child support to a 40yo woman who seduced him. Whenever you hear a feminist psychopath blabbering about the patriarchy think of that.

    BTW plenty of Samoan women are way more attractive than washed up Mary Kay. She trapped the boy and made him a laughing stock to his own people. If anyone exercised “white privilege,” it was that criminal woman.

  52. @kpkinsunnyphiladelphia
    This paper belongs to the category of "Steve asks, and he receives" --i.e., a pretty sophisticated demographic study of a population based on a subset of cases.

    If these results are an accurate reflection of what has happened/is happening in the population here's your mitigating strategy: everybody over 60 stays home for some period of time, everybody else can go about their business.

    Here's a couple sentences that really popped out for me:

    The 11-day average duration of stay for hospitalized patients is consistent with observations in China.However, we estimated a 14-day average duration of stay among non-survivors, whereas non-survivors had a shorter length of hospitalization in China (7.5 days) than survivors. This difference may reflect, among other factors, alternative approaches to extending end-of-life care in the two settings.
     
    What a lovely piece of judicious rhetoric! Who says STEM folks can't be skilled writers?

    Translation? In China, some ICU cases got off the machines and were place in the hallway to meet their fate.

    Cue the Monty Python bit in the Holy Grail, sort of: "Bring out your dead."

    In China, some ICU cases got off the machines and were place in the hallway to meet their fate.

    According to Breitbart, the Chinese hastened some of them along that journey by burning them alive!

    https://www.breitbart.com/asia/2020/04/07/report-wuhan-funeral-homes-burned-people-alive/

    If it were any other government, I’d think this story was hysterical nonsense …

    • Replies: @obwandiyag
    It is hysterical nonsense. You are another deluded China Did It troll.
  53. @Bill P
    The Santa Clara study implies that around seven to ten percent of the people in my county have already been infected, maybe more. The infection seems to be petering out with 29 dead so far out of 200,000 residents, almost all in nursing homes.

    So we're looking at typical flu numbers here.

    With ten percent of the population having already caught the virus, this suggests that the horse left the barn well before the economic nuclear strike was inflicted upon us by our dear leaders. Also, there's no avoiding this nasty cold. It will eventually get the susceptible one way or another, so we're all just delaying the inevitable with this lockdown, which young people are wisely ignoring in any event.

    I think we're all going to have to admit that we got duped by crude CCP propaganda intended to portray China as heroically defeating a menace to humanity by locking up their people in response to another nasty virus from one of their filthy farms. What is really unbelievable is how many Westerners praised them for this transparent charade.

    I really hate to admit it, but THE SWEDES WERE RIGHT! So was Lukashenko...

    Joke's on us.

    I really hate to admit it, but THE SWEDES WERE RIGHT! So was Lukashenko…

    Joke’s on us.

    “I’d like to congratulate the entire world on making Sweden look like a sane country. They could not have done this without your help.” — Lars Porsena

    Let it be remembered that 2020 was the year Sweden defied all odds and emerged, at least for a time, as the Great White Hope.

  54. Exhibit #197 on why NOT to create a Panic and why not to fan the flames of Panic based on thin- and highly-questionable data:

    In Canada, 31 people died in a nursing home after „almost all nursing staff had left the facility in a hurry for fear of the corona virus spreading. Health authorities found the people in the home in Dorval near Montreal only days later – many of the survivors were dehydrated, malnourished and apathetic.“

    Similar tragedies were already reported from northern Italy, where Eastern European nurses left the country in a hurry when panic broke out and lockdown measures were announced.

    Another case of the ‘cure’ being worse than the disease here, in all kinds of ways.

    It turns out that when you fan the flames of a Virus Apocalypse Panic, bad things happen. It’s a stunning finding. We need to get our best minds on this puzzle and study this shock finding.

    Alternatively, we could have crushed the Panic early and listened to the experts like Wodarg, Ioannidis, and Wittkowski (the latter is now providing running CoronaCommentary, reposted for your convenience and reference here at iSteve).

    • Replies: @Jenner Ickham Errican

    Exhibit #197 on why NOT to create a Panic
     
    Your SWPRS quote is about not “Panic” in those cases, it’s an immigration story:

    Italy, where Eastern European nurses left the country in a hurry
     

    In Canada, 31 people died in a nursing home after almost all nursing staff had left the facility in a hurry for fear of the corona virus spreading.

     

    Montreal Gazette:

    Samir Emilie Chowieri, president of Katasa Groupe in charge of the Herron
     
    CBC:

    Court documents reveal owner of CHSLD Herron's lengthy criminal past

    The Montreal residents were already doomed, panic or no panic, due both to management and staff criminality.

    I’d like to know the demographic backgrounds of the vanished nursing home employees “Katasa” hired. Any Montreal iStevers with info?
  55. Zooming out a bit, this study (1200 out of 9.6m ever hospitalized w/ an avg stay ~10 days) reminds me of how much time we’re wasting out here in California with empty hospitals and idle doctors week after expensive week.

    Hospital capacity w/ surge: ~ 125,000 (1)

    hospitalized with Covid-19: 3,200 (2) (and basically flat for a week)

    homeless put up in hotels: 4,211 (of 15,000 rooms already secured) (3)

    We have more homeless people put up on hotels than we do hospitalized Covid-19 patients.

    Shutdown for almost a month now.

    This is not how flattening the curve is supposed to work.

    We’re not building herd immunity while protecting the health system from overload.

    We’re not extinguishing the virus (which is probably impossible anyway, but in any case we’re not doing it).

    We’re just sitting here in limbo with our thumbs up our butts burning truckloads of cash.

    Before this I assumed epidemiologists were serious people who could make tough tradeoffs etc, but their performance had been just pathetic:
    – they lied about how it’s spread (aerosols)
    – they lied about masks
    – their mickey-mouse models have been so sensitive to unknown parameters that they’ve been useless. There’s a guy here who derisevely calls it eight grade math. I bristled at that a few times, but seriously… all we got is “OMG exponentials grow really fast!”
    – they don’t have any insight into how to actually mitigate transmission. 4 months into this all they can say is “uhhh….. everyone stay home and wash your hands.” Seriously, how useless are these people?!

    (e.g if they had said, “no, don’t cut subway service because that make things worse…” that would’ve been a marginally insightful contribution that an outsider would take 10 minutes to think about. But they didn’t even do that)

    [MORE]

    1)

    The state has aggressively planned for a surge in hospitalizations in the coming weeks and aims to add 50,000 beds to our existing hospital capacity of nearly 75,000 beds. At least 60 percent of those additional beds, or 30,000, will come from within existing hospitals, and the state will secure the remaining beds, up to 20,000.

    (https://www.gov.ca.gov/2020/04/06/governor-newsom-announces-progress-in-expanding-hospital-capacity-to-fight-coming-surge-in-covid-19-cases/)

    2) https://www.eastbaytimes.com/2020/04/18/coronavirus-california-passes-1000-deaths-and-29000-cases-but-growth-slowing-after-deadliest-day/

    3) https://sanfrancisco.cbslocal.com/2020/04/18/coronavirus-california-struggles-covid-spread-homeless/

    • Replies: @Alice
    This times 100. I think it's another case of cargo cult expertise. I had also assumed epidemiology was serious, but it's just another instance of what Michael Chrichton called Murray Gell-Mann Amnesia. (see: https://web.archive.org/web/20160303012224/http://larvatus.com/michael-crichton-why-speculate )
    We are serious people, and assume others are.

    But none of these people are serious. Not the idiots who just put patients on ventilators because that's what you do when patients get pneumonia, isn't it, not the health depts that found 1 case of covid they couldn't account for, so they abandoned all contact tracing, not the hospitals that went to having 9% of capacity to wait for the nonexistent wave without realizing they'd be bankrupt in a month, not the CDC who said no masks, yes masks, no masks, and said keep the achools open, no wait, close them, not the NC governor who made an executive order keeping all people under house arrest, but didn't order staff in nursing homes to wear masks for another 2 weeks, and of xourse the best of all, the supposed 2M dead down to 60k.


    Apparently epidemiologist is the name for people who aren't the researchers figuring out differential diagnosis, aren't the people figuring out transmission, and aren't the people figuring out treatment, and therefore just make really cool models after they apparently wait for other people to tell them the relevant facts. Beyond that they just tell us to wash our hands or maybe they do the contact tracing questionnaire.

    This is sickeningly like Chrichton's other great talk, Aliens Cause Global Warming.

    https://wattsupwiththat.com/2010/07/09/aliens-cause-global-warming-a-caltech-lecture-by-michael-crichton/
    , @Intelligent Dasein
    The only silver lining to this whole coronavirus panic is that it seems to be the high water mark of clown world. The omnipotent incompetence that characterized globalism final has a few cracks in the armor.
    , @Polynikes
    Correct. Everyone needs to remember that “flatten the curve” wasn’t about saving people from the virus. That was never claimed nor could it be. It was about keeping hospitals from overflowing and thus losing people who couldn’t get treatment.

    Hospitals never overflowed, and most never came close.
    , @Kaz
    What's going on in Italy and Spain?

    Are there healthcare systems that bad compared to ours?
    , @Hail

    This is not how flattening the curve is supposed to work.

    We’re not building herd immunity while protecting the health system from overload.

    We’re not extinguishing the virus (which is probably impossible anyway, but in any case we’re not doing it).

    We’re just sitting here in limbo with our thumbs up our butts burning truckloads of cash.
     

    I hate to be the one to tell you this, vhrm, but I will:

    You are in the Twilight Zone.

    The Corona Twilight Zone.

    https://www.youtube.com/watch?v=Gdo3BP3m42I


    Kramer: So what are you saying, that we're wrong? Oh, everybody's wrong but you.

    Jerry: You know, this is like that Twilight Zone, where the guy wakes up, and he's the same but everybody else if different!

    Kramer: Which one?

    Jerry: They were all like that.
     

  56. Anonymous[326] • Disclaimer says:

    Sailer is completely insane wanting to re-open the economy. A voice of sense:

    Tucker Carlson is such a moron. Arguing that the coronavirus is not a big deal because the flu killed twice as much last year as this coronavirus. Key word here is “year”. Coronavirus has killed in 6 weeks as much as the flu took 6 months to kill *despite the quarantine and lockdown* . Now imagine how bad it will be if we end the quarantine. Literally 20% of the entire NYPD is on leave due to sickness caused by COVID-19, and several cops have already died. We would have the same situation with the population at large if we re-opened the economy.

    • Troll: Je Suis Omar Mateen
    • Replies: @newrouter
    >Sailer is completely insane wanting to re-open the economy.<

    I feel your: fear, panic, delusion, pain.
    , @Daniel Williams
    Everyone but you is insane or a moron, right?
    , @Reg Cæsar
    The left has been saying for decades, "Do what Sweden does! Do what Sweden does!"

    Now Donald Trump is doing, or proposing doing, what Sweden is doing. And everybody wants his head.
  57. @Reg Cæsar
    Could Steve be sued out of business because his basement closet isn't ADA-compliant? An e-mail touting this service-- and touting touting it to others-- just came in: https://getadacomply.com

    Could they come after commenters as well? It's 25 steps up to our apartment, and no elevator. We can't afford to rent a cherry-picker.

    I once founded a non profit corp with myself and one other employee. She and I consulted, and to keep costs down, when not at a customer site, we worked in coffershops. I used to carry one of those MINIMUM WAGE IS poster and the state OSHA phone number poster in my briefcase and unfurl them while we sat sipping. I was joking with her because I trusted my employee, but I was sure I could be sued for violating the law and not posting the posters at our workplace.

  58. Hail says: • Website
    @Thatgirl
    Some personal good news regarding The Virus.

    My 81-year-old aunt was sick with COVID-19 (tested positive). I was pretty worried because she is not that healthy, she is overweight and sedentary. She spent about two weeks in bed and said it was really tough but she has recovered and has been fever free for over a week. She never had to go to the hospital. It is hard to remember with all the bad news, but, even though their percentages are worse than for younger people, the old folks can survive without trips to the ICU and ventilators.

    My 81-year-old aunt was sick with COVID-19 (tested positive) […] she has recovered and has been fever free for over a week

    That is good to hear.

    It turns out this kind of good news really is the norm and not the exception. (What I don’t understand is why the good news never gets out…)

    The chance that someone over age 80 dies from the virus has now been proposed to be as low as 3%, meaning 97% of the 80+ group survive contact with the virus. Many of the 97% will get symptoms, as your aunt did, but will survive. The 3% deaths will be drawn heavily from the very ill, people always at risk. The 3% estimate has been proposed by the Centre for Evidence-Based Medicine (CEBM) at Oxford in a just-released study.

    They also find the number for those over age 70 without serious pre-existing health conditions to be very solidly below 1% deaths. As for the all-population fatality rate, study after study by qualified experts now points to the 0.1%-fatality range, possibly lower. In other words, the embarrassing possibility keeps presenting itself that the Wuhan coronavirus is not even unambiguously the worst flu strain seen in the past five or ten years in most places.

    We are left to pick up the pieces. Was this the Hoax of the Twenty-First Century? If the 0.1% estimates that keep coming out are right, how long will this charade last?

    Here is the wording from the CEBM study:

    In those without pre-existing health conditions, and over 70, the data suggests the IFR will likely not exceed 1%.

    Mortality in children seems to be near zero (unlike flu) which is also reassuring and will act to drive down the IFR significantly.

    It is now essential to understand whether individuals are dying with or from the disease. Understanding this issue is critical. If, for instance, 80% of those over 80 die with the disease then the CFR would be near 3% in this age group

    https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/

    • Replies: @Alice
    Honestly, I don't think it was a hoax, but we punked ourselves, and then the politicians saw opportunity for graft. The media being teenage brats trying to get back at Daddy Trump while being too stupid to understand 8th grade math didn't help.

    But bigger, the same kind of full throated mass delusion that makes Trans Pronouns a thing made this a thing. Everyone must be on board.

    Reading Mackay's book had been quite helpful. Beyond that, we are, as a people, afraid of death more than we fear anything else. The background radiation atheism that means you really think THIS IS ALL THERE IS will do that, as well as the cult of health as the solution to it. These people are more afraid of dying than of not living in the first place.

  59. @vhrm
    Zooming out a bit, this study (1200 out of 9.6m ever hospitalized w/ an avg stay ~10 days) reminds me of how much time we're wasting out here in California with empty hospitals and idle doctors week after expensive week.

    Hospital capacity w/ surge: ~ 125,000 (1)

    hospitalized with Covid-19: 3,200 (2) (and basically flat for a week)

    homeless put up in hotels: 4,211 (of 15,000 rooms already secured) (3)

    We have more homeless people put up on hotels than we do hospitalized Covid-19 patients.

    Shutdown for almost a month now.

    This is not how flattening the curve is supposed to work.

    We're not building herd immunity while protecting the health system from overload.

    We're not extinguishing the virus (which is probably impossible anyway, but in any case we're not doing it).

    We're just sitting here in limbo with our thumbs up our butts burning truckloads of cash.

    Before this I assumed epidemiologists were serious people who could make tough tradeoffs etc, but their performance had been just pathetic:
    - they lied about how it's spread (aerosols)
    - they lied about masks
    - their mickey-mouse models have been so sensitive to unknown parameters that they've been useless. There's a guy here who derisevely calls it eight grade math. I bristled at that a few times, but seriously... all we got is "OMG exponentials grow really fast!"
    - they don't have any insight into how to actually mitigate transmission. 4 months into this all they can say is "uhhh..... everyone stay home and wash your hands." Seriously, how useless are these people?!

    (e.g if they had said, "no, don't cut subway service because that make things worse..." that would've been a marginally insightful contribution that an outsider would take 10 minutes to think about. But they didn't even do that)



    1)

    The state has aggressively planned for a surge in hospitalizations in the coming weeks and aims to add 50,000 beds to our existing hospital capacity of nearly 75,000 beds. At least 60 percent of those additional beds, or 30,000, will come from within existing hospitals, and the state will secure the remaining beds, up to 20,000.
     
    (https://www.gov.ca.gov/2020/04/06/governor-newsom-announces-progress-in-expanding-hospital-capacity-to-fight-coming-surge-in-covid-19-cases/)

    2) https://www.eastbaytimes.com/2020/04/18/coronavirus-california-passes-1000-deaths-and-29000-cases-but-growth-slowing-after-deadliest-day/

    3) https://sanfrancisco.cbslocal.com/2020/04/18/coronavirus-california-struggles-covid-spread-homeless/

    This times 100. I think it’s another case of cargo cult expertise. I had also assumed epidemiology was serious, but it’s just another instance of what Michael Chrichton called Murray Gell-Mann Amnesia. (see: https://web.archive.org/web/20160303012224/http://larvatus.com/michael-crichton-why-speculate )
    We are serious people, and assume others are.

    But none of these people are serious. Not the idiots who just put patients on ventilators because that’s what you do when patients get pneumonia, isn’t it, not the health depts that found 1 case of covid they couldn’t account for, so they abandoned all contact tracing, not the hospitals that went to having 9% of capacity to wait for the nonexistent wave without realizing they’d be bankrupt in a month, not the CDC who said no masks, yes masks, no masks, and said keep the achools open, no wait, close them, not the NC governor who made an executive order keeping all people under house arrest, but didn’t order staff in nursing homes to wear masks for another 2 weeks, and of xourse the best of all, the supposed 2M dead down to 60k.

    Apparently epidemiologist is the name for people who aren’t the researchers figuring out differential diagnosis, aren’t the people figuring out transmission, and aren’t the people figuring out treatment, and therefore just make really cool models after they apparently wait for other people to tell them the relevant facts. Beyond that they just tell us to wash our hands or maybe they do the contact tracing questionnaire.

    This is sickeningly like Chrichton’s other great talk, Aliens Cause Global Warming.

    https://wattsupwiththat.com/2010/07/09/aliens-cause-global-warming-a-caltech-lecture-by-michael-crichton/

  60. @Hail

    My 81-year-old aunt was sick with COVID-19 (tested positive) [...] she has recovered and has been fever free for over a week
     
    That is good to hear.

    It turns out this kind of good news really is the norm and not the exception. (What I don't understand is why the good news never gets out...)

    The chance that someone over age 80 dies from the virus has now been proposed to be as low as 3%, meaning 97% of the 80+ group survive contact with the virus. Many of the 97% will get symptoms, as your aunt did, but will survive. The 3% deaths will be drawn heavily from the very ill, people always at risk. The 3% estimate has been proposed by the Centre for Evidence-Based Medicine (CEBM) at Oxford in a just-released study.

    They also find the number for those over age 70 without serious pre-existing health conditions to be very solidly below 1% deaths. As for the all-population fatality rate, study after study by qualified experts now points to the 0.1%-fatality range, possibly lower. In other words, the embarrassing possibility keeps presenting itself that the Wuhan coronavirus is not even unambiguously the worst flu strain seen in the past five or ten years in most places.

    We are left to pick up the pieces. Was this the Hoax of the Twenty-First Century? If the 0.1% estimates that keep coming out are right, how long will this charade last?

    Here is the wording from the CEBM study:


    In those without pre-existing health conditions, and over 70, the data suggests the IFR will likely not exceed 1%.

    Mortality in children seems to be near zero (unlike flu) which is also reassuring and will act to drive down the IFR significantly.

    It is now essential to understand whether individuals are dying with or from the disease. Understanding this issue is critical. If, for instance, 80% of those over 80 die with the disease then the CFR would be near 3% in this age group
     

    https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/

    Honestly, I don’t think it was a hoax, but we punked ourselves, and then the politicians saw opportunity for graft. The media being teenage brats trying to get back at Daddy Trump while being too stupid to understand 8th grade math didn’t help.

    But bigger, the same kind of full throated mass delusion that makes Trans Pronouns a thing made this a thing. Everyone must be on board.

    Reading Mackay’s book had been quite helpful. Beyond that, we are, as a people, afraid of death more than we fear anything else. The background radiation atheism that means you really think THIS IS ALL THERE IS will do that, as well as the cult of health as the solution to it. These people are more afraid of dying than of not living in the first place.

    • Agree: Hail
  61. The New York Times had a library of health articles about the epidemic of uncontrolled Type 2 Diabetes, HBP and obesity among the Black, Puerto Rican and Dominican population in the city back a few years ago which they made available to nonsubscribers. It’s a multigenerational problem with fathers and sons getting kidney disease, losing eyesight, and having feet and legs amputated. The amazing thing was that in addition to being unable to change their diet or lifestyle they were not taking their medications. One of the proposed solutions was using community groups to hire people to knock on doors to remind them to take their meds. Medicaid and Obamacare are free or highly subsidized for the low or moderate-income. The developing narrative is that systemic racism and lack of healthcare are responsible. We need to know who is actually succumbing to the virus.

    • Replies: @botazefa

    . The developing narrative is that systemic racism and lack of healthcare are responsible.
     
    Blacks have less lung volume than whites. That's an anatomical fact no physician would dispute. Not sure how that would increase Covid-19 morbidity in blacks though.
  62. @vhrm
    Zooming out a bit, this study (1200 out of 9.6m ever hospitalized w/ an avg stay ~10 days) reminds me of how much time we're wasting out here in California with empty hospitals and idle doctors week after expensive week.

    Hospital capacity w/ surge: ~ 125,000 (1)

    hospitalized with Covid-19: 3,200 (2) (and basically flat for a week)

    homeless put up in hotels: 4,211 (of 15,000 rooms already secured) (3)

    We have more homeless people put up on hotels than we do hospitalized Covid-19 patients.

    Shutdown for almost a month now.

    This is not how flattening the curve is supposed to work.

    We're not building herd immunity while protecting the health system from overload.

    We're not extinguishing the virus (which is probably impossible anyway, but in any case we're not doing it).

    We're just sitting here in limbo with our thumbs up our butts burning truckloads of cash.

    Before this I assumed epidemiologists were serious people who could make tough tradeoffs etc, but their performance had been just pathetic:
    - they lied about how it's spread (aerosols)
    - they lied about masks
    - their mickey-mouse models have been so sensitive to unknown parameters that they've been useless. There's a guy here who derisevely calls it eight grade math. I bristled at that a few times, but seriously... all we got is "OMG exponentials grow really fast!"
    - they don't have any insight into how to actually mitigate transmission. 4 months into this all they can say is "uhhh..... everyone stay home and wash your hands." Seriously, how useless are these people?!

    (e.g if they had said, "no, don't cut subway service because that make things worse..." that would've been a marginally insightful contribution that an outsider would take 10 minutes to think about. But they didn't even do that)



    1)

    The state has aggressively planned for a surge in hospitalizations in the coming weeks and aims to add 50,000 beds to our existing hospital capacity of nearly 75,000 beds. At least 60 percent of those additional beds, or 30,000, will come from within existing hospitals, and the state will secure the remaining beds, up to 20,000.
     
    (https://www.gov.ca.gov/2020/04/06/governor-newsom-announces-progress-in-expanding-hospital-capacity-to-fight-coming-surge-in-covid-19-cases/)

    2) https://www.eastbaytimes.com/2020/04/18/coronavirus-california-passes-1000-deaths-and-29000-cases-but-growth-slowing-after-deadliest-day/

    3) https://sanfrancisco.cbslocal.com/2020/04/18/coronavirus-california-struggles-covid-spread-homeless/

    The only silver lining to this whole coronavirus panic is that it seems to be the high water mark of clown world. The omnipotent incompetence that characterized globalism final has a few cracks in the armor.

  63. Leftists have decided to blame anti-lockdown protests on (Guess who? You’ll never be able to tell) the Russians. Propagandists gotta propagandize. I wonder that they’re not embarrassing their own side by now. Liberalism isn’t a mental disorder, it’s a cult.

    • Replies: @eD
    I've also seen comments on left wing blogs where the protesters were called racists.
  64. Anon[846] • Disclaimer says:

    De Blasio is now encouraging people to take cell phone pictures of anyone not social distancing and text the shots to ‘law enforcement.’ Judging from the comments, New Yorkers do not like this.

    You learn a lot about a person’s character by how they act under times of stress. Has anyone seen De Blasio’s popularity ratings lately?

    • Replies: @Mehen


    De Blasio is now encouraging people to take cell phone pictures of anyone not social distancing and text the shots to ‘law enforcement.’ Judging from the comments, New Yorkers do not like this.

     


    How do you report places that aren’t enforcing social distancing? It’s simple: just snap a photo and text it to 311-692. #AskMyMayor pic.twitter.com/WQdCcVf1Rl— Mayor Bill de Blasio (@NYCMayor) April 18, 2020
     
    As a few Twitteratti have commented regarding this development:

    "Sure would be a shame if a bunch of people texted dick pics to this number"
  65. @Anonymous
    Sailer is completely insane wanting to re-open the economy. A voice of sense: https://youtu.be/_8NkuVId2Lw

    Tucker Carlson is such a moron. Arguing that the coronavirus is not a big deal because the flu killed twice as much last year as this coronavirus. Key word here is "year". Coronavirus has killed in 6 weeks as much as the flu took 6 months to kill *despite the quarantine and lockdown* . Now imagine how bad it will be if we end the quarantine. Literally 20% of the entire NYPD is on leave due to sickness caused by COVID-19, and several cops have already died. We would have the same situation with the population at large if we re-opened the economy.

    >Sailer is completely insane wanting to re-open the economy.<

    I feel your: fear, panic, delusion, pain.

    • Replies: @Anonymous
    Ok. So why don't you go outside without a mask, and rub your figners on all surfaces and stick them inside your nose, since there is no cause for concern? Your sarcasm is completely idiotic considering the seriousness of this.
  66. anon[227] • Disclaimer says:
    @Anon
    OT South Florida Sun Sentinel, 04/18/20 - Tua Tagovailoa had lowest Wonderlic score among 2020 QB prospects

    https://www.sun-sentinel.com/sports/miami-dolphins/fl-sp-tua-tagovailoa-wonderlic-20200418-swoxmkth4zaplktnpxhw27khwq-story.html

    The Athletic’s Bob McGinn reports that ex-Alabama star quarterback Tua Tagovailoa scored a woeful 13 on the Wonderlic test, administered by the NFL to draft prospects before the draft.

    Among the other first-round prospects, McGinn reported that LSU’s Jake Burrow scored a 34, Utah State’s Jordan Love got a 27 and Oregon’s Justin Herbert had a 25. The highest reported score among the 2020 quarterback draft prospects was a 40 by Iowa’s Nate Stanley.

    Current Dolphins starting quarterback Ryan Fitzpatrick’s 48 (number of correct answers out of 50 questions) is reportedly tied for the third-best all-time (Fitzpatrick’s fellow Harvard alum Pat McInally, a Bengals punter from 1976-85, owns the lone perfect score).

    Quarterbacks have brushed off a low Wonderlic to star in the league. Dolphins Hall of Famer Dan Marino’s score in 1983 was widely reported to be a 16, and Ravens defending NFL Most Valuable Player Lamar Jackson was reported to have the same score as Tagovailoa two years ago.
     

    Is intelligence (which I guess Wonderlic is supposed to more or less be a measure of) so prized that it’s always better to have a high score? Or would it be cooler to score really bad yet still go on to a stellar career?

    And then be able to brag “I’m as dumb as a rock, but I’m still one of the most envied people in the country’.

  67. @Redneck farmer
    Let's keep healthy people isolated longer, so we don't get herd immunity!

    “Let’s keep healthy people isolated longer, so we don’t get herd immunity!”

    Herd immunity will not happen until many people you know, or you, are dead. Even if it were possible, immunity may last only one “flu” season, or until next mutation. 100% testing, or near, is the only “safe” way to “re-open the economy”. By safe I mean a place where most people feel it’s OK for them to resume their pre SARS-CoV-2 lifestyle. Even if one doesn’t feel at risk for death, getting “deathly Ill” will cause more than a little pause. Hesitant to even say resume because given the shock, seems near impossible the US will see another + $20 Trillion GDP print any year soon.

    Even going with about the most expensive currently available testing regime, performed via the Abbott ID NOW™ 15 minute routine, would not the “cost” be roughly 1/10 the lower end of what many figure to be the eventual cost for the US’s “economic bailout”.

    Test “everyone” in the US:

    $10,000 Abbott ID NOW™ (part #NAT-024), 1 per 100 persons. I know it’s overkill, but things break, and the’re the relatively cheap part of the equation; make them ubiquitous, the machines could be located at every local library (12K), school (150K), McDonald’s (14K), gas station (170K), etc… across the USA = $33,500,000,000 ($34B)

    $98 single use test kits – 335,000,000 persons in the USofA times 6 tests each. (1 test administered every week, for 6 weeks, for every person). Total test kit cost for 6 weeks would be $196,980,000,000 ($200B)

    $100 (estimated) – administration/labor cost of a single test. 6 tests times 335M people would run $201,000,000,000 ($200B)‬

    Everyone in USA 15 minute tested 6 consecutive weeks to effectively extinguish Covic-19 at a cost of $450 Billion, roughly half what Austin Powers would ask.

    The economy could be opened right now, with initial/1st week test round; as that would catch a majority of the infected right off the bat.

    After 6 consecutive weeks of testing, even given an individual test was only ~80% accurate and that not all infected would quarantine, the USA would be Covid-19 extinguished. At least until the next possible wave(s) comes in: Covid-21, Covid-22, Covid-23…

    BTW – China is still locked down province by province. There is extremely limited travel between them. (A distant associate who lives just outside Shanghai has been “stuck” in Wuhan province year to date.)

    • Disagree: Polynikes
    • Replies: @Sean

    By safe I mean a place where most people feel it’s OK for them to resume their pre SARS-CoV-2 lifestyle
     
    Coughing in public will never be OK again.

    USA would be Covid-19 extinguished
     
    Maybe but after the all the infrastructure and protection and laws and enforcement (it would have to be compulsory and enforced) had 'succeeded' it's as likely as not that COVID-19 would come back a few months later. Influenza disappears in the summer then roars back in the annual season. Dubious that an attempt to beat COVID-19 finally by an expensive universal testing and compulsory quarantining program would be the best use of resources and public willingness to cooperate, unless it was more or less guaranteed to work.

    There are going to be permanent changes in how close people stand to each other when talking, wearing masks on public transport, and social habits like going to crowded bars and restaurants. Some up to the individual, some mandated by law. Going out for a drink or meal is going to become a lot more expensive and many businesses less profitable as packing people in like sheep is forbidden.


    At least until the next possible wave(s) comes in: Covid-21, Covid-22, Covid-23…
     
    Given there have been three coronavirus diseases appearing out of nowhere in the last 20 years, with the last being much worse that the ones before, that there will be another still nastier one along shortly is hardly far fetched. The reorganization of society to have procedures in place to cope with a low lasting COVID-19 becoming endemic, and a possibly much nastier epidemic that the current COVID-19 one, would now seem prudent.
    , @newrouter
    >Test “everyone” in the US:<

    I feel your: fear, panic, delusion, pain and stupidity.
    , @PiltdownMan

    $10,000 Abbott ID NOW™ ...
     
    The cost per unit that you use in your example reflects the asking price computed on a much smaller number for total unit production. The marginal cost of each of those tests is definitely less than in your example, quite possibly by an order of magnitude (or more in the case of the fancy Abbott machine.)

    The total cost of such a plan would likely be significantly less than that figure of $450 billion. The problem, of course, is ramping up production rapidly to that scale, and raw materials supply/sorucing problems, not least because, if it is feasible, every other country that can afford such a program will want to do the same.
    , @Travis
    masks are more important than testing. The vast majority of those with CV will never bother getting tested, since they have mild symptoms and are being told to stay home and not seek treatment.

    Priority #1 -We need to produce more masks , so American who seeks a mask can obtain one.

    Priority #2 is testing people for antibodies. This is more important at this stage of the outbreak than testing for the CV virus.

    Priority #3 is producing enough hydrochloroquine to treat the sick and allow doctors to subscribe HCQ to patients. Currently this treatment is still banned by the governor of New York. And HCQ is unavailable at most pharmacies today, due to shortages.
  68. @Hail
    Exhibit #197 on why NOT to create a Panic and why not to fan the flames of Panic based on thin- and highly-questionable data:

    In Canada, 31 people died in a nursing home after „almost all nursing staff had left the facility in a hurry for fear of the corona virus spreading. Health authorities found the people in the home in Dorval near Montreal only days later – many of the survivors were dehydrated, malnourished and apathetic.“

    Similar tragedies were already reported from northern Italy, where Eastern European nurses left the country in a hurry when panic broke out and lockdown measures were announced.
     

    Another case of the 'cure' being worse than the disease here, in all kinds of ways.

    It turns out that when you fan the flames of a Virus Apocalypse Panic, bad things happen. It's a stunning finding. We need to get our best minds on this puzzle and study this shock finding.

    Alternatively, we could have crushed the Panic early and listened to the experts like Wodarg, Ioannidis, and Wittkowski (the latter is now providing running CoronaCommentary, reposted for your convenience and reference here at iSteve).

    Exhibit #197 on why NOT to create a Panic

    Your SWPRS quote is about not “Panic” in those cases, it’s an immigration story:

    Italy, where Eastern European nurses left the country in a hurry

    In Canada, 31 people died in a nursing home after almost all nursing staff had left the facility in a hurry for fear of the corona virus spreading.

    Montreal Gazette:

    Samir Emilie Chowieri, president of Katasa Groupe in charge of the Herron

    CBC:

    Court documents reveal owner of CHSLD Herron’s lengthy criminal past

    The Montreal residents were already doomed, panic or no panic, due both to management and staff criminality.

    I’d like to know the demographic backgrounds of the vanished nursing home employees “Katasa” hired. Any Montreal iStevers with info?

    • Thanks: Hail
  69. Apologies if this posts twice:

    This comment is directed to Steve Sailer and Ron Unz:

    I was a Corona-Believer from mid January to about early March. In other words, I had hopped on that train early on. In early March I was really freaking out, considering some of the evidence that this virus was bioengineered in some fashion. Around March 15 I started reading all the Corona-Skeptics and eventually went down that rabbit-hole.

    But up to that point I had been researching and spending tons of money on mitigation strategies.

    To that end I had amassed a large quantity of nutraceuticals in order to strengthen my immune system in preparation for the Apocalypse.

    I have been taking most of the following for weeks now, but I am beginning to lay off the practice of swallowing 20 pills a day because I now believe this virus has been overhyped.

    I won’t bother getting into the scientific evidence supporting the ingestion of the following nutraceuticals because I had so little time to prepare. But I do have a background in pharmacology for mental disorders as well as having a history in “supplements” for nootropic effects and body-recomposition effects. In other words, do your own research. The following is just a guide.

    The primary things Steve and Ron should be taking, which have the most scientific research:

    Vitamin D3 (4000-5000 IU) — some say this should be augmented with Vitamin K2 for atherosclertoic reasons

    Vitamin C — in moderate doses as a prophylactic, in high doses during sickness (the liposomal form is the ideal)

    Zinc — try to stay away from cheap forms of Zinc like Zinc gluconate, and go for ionic forms of Zinc like Zinc sulfate or Zinc acetate

    Those are the big three.

    But there are many others, in the event you are shitting your pants.

    Omega-3 fish oil — reduces inflammation

    Olive leaf extract

    Black elderberry (keep in mind there is some evidence this should only be used as a prophylactic and not used during the infection period because it might enhance so-called “cytokine storms”)

    Quercetin — which shows similar Zinc ionophor features as the fabled Hydroxychloroquine

    Curcumin

    Chaga mushroom extract

    Oregano Oil

    Selenium

    Glutathione

    N-acetyl-Cysteine

    Probiotics (remember that 80% of your immune system is dependent on your gut flora)

    ECGC (Green Tea extract)

    Garlic extract

    The amino acid L-Lysine seems to have anti-viral properties

    Grape seed extract

    Alpha-lipoic acid

    For the brave among you:

    Nebulized colloidal silver

    AHCC

    I am confident that if you have such a battery behind you, you will not need to be hospitalized by this virus.

    I happen to have a well-stocked medicine cabinet at this point so if Steve and Ron are still concerned, I am willing to share some of my stash with them.

    • Disagree: Jack Armstrong
    • Thanks: Mark G.
    • Replies: @Lot
    There’s some evidence taking zinc above what you’d get in a normal diet is dangerous. Eating silver will turn your skin a deathly shade of blue permanently, as the Blue Libertarian found out.

    http://www.cbsnews.com/images/2002/10/03/image524282x.jpg

    The unregulated supplement industry funds the “studies” of these things, and nobody has the incentive to spend a lot of money debunking them.
  70. @danand

    "Let’s keep healthy people isolated longer, so we don’t get herd immunity!"
     
    Herd immunity will not happen until many people you know, or you, are dead. Even if it were possible, immunity may last only one "flu" season, or until next mutation. 100% testing, or near, is the only "safe" way to "re-open the economy". By safe I mean a place where most people feel it's OK for them to resume their pre SARS-CoV-2 lifestyle. Even if one doesn't feel at risk for death, getting "deathly Ill" will cause more than a little pause. Hesitant to even say resume because given the shock, seems near impossible the US will see another + $20 Trillion GDP print any year soon.

    Even going with about the most expensive currently available testing regime, performed via the Abbott ID NOW™ 15 minute routine, would not the “cost” be roughly 1/10 the lower end of what many figure to be the eventual cost for the US's “economic bailout”.

    Test "everyone" in the US:

    $10,000 Abbott ID NOW™ (part #NAT-024), 1 per 100 persons. I know it's overkill, but things break, and the're the relatively cheap part of the equation; make them ubiquitous, the machines could be located at every local library (12K), school (150K), McDonald's (14K), gas station (170K), etc... across the USA = $33,500,000,000 ($34B)

    $98 single use test kits - 335,000,000 persons in the USofA times 6 tests each. (1 test administered every week, for 6 weeks, for every person). Total test kit cost for 6 weeks would be $196,980,000,000 ($200B)

    $100 (estimated) - administration/labor cost of a single test. 6 tests times 335M people would run $201,000,000,000 ($200B)‬

    Everyone in USA 15 minute tested 6 consecutive weeks to effectively extinguish Covic-19 at a cost of $450 Billion, roughly half what Austin Powers would ask.

    The economy could be opened right now, with initial/1st week test round; as that would catch a majority of the infected right off the bat.

    After 6 consecutive weeks of testing, even given an individual test was only ~80% accurate and that not all infected would quarantine, the USA would be Covid-19 extinguished. At least until the next possible wave(s) comes in: Covid-21, Covid-22, Covid-23...

    BTW - China is still locked down province by province. There is extremely limited travel between them. (A distant associate who lives just outside Shanghai has been "stuck" in Wuhan province year to date.)

    By safe I mean a place where most people feel it’s OK for them to resume their pre SARS-CoV-2 lifestyle

    Coughing in public will never be OK again.

    USA would be Covid-19 extinguished

    Maybe but after the all the infrastructure and protection and laws and enforcement (it would have to be compulsory and enforced) had ‘succeeded’ it’s as likely as not that COVID-19 would come back a few months later. Influenza disappears in the summer then roars back in the annual season. Dubious that an attempt to beat COVID-19 finally by an expensive universal testing and compulsory quarantining program would be the best use of resources and public willingness to cooperate, unless it was more or less guaranteed to work.

    There are going to be permanent changes in how close people stand to each other when talking, wearing masks on public transport, and social habits like going to crowded bars and restaurants. Some up to the individual, some mandated by law. Going out for a drink or meal is going to become a lot more expensive and many businesses less profitable as packing people in like sheep is forbidden.

    At least until the next possible wave(s) comes in: Covid-21, Covid-22, Covid-23…

    Given there have been three coronavirus diseases appearing out of nowhere in the last 20 years, with the last being much worse that the ones before, that there will be another still nastier one along shortly is hardly far fetched. The reorganization of society to have procedures in place to cope with a low lasting COVID-19 becoming endemic, and a possibly much nastier epidemic that the current COVID-19 one, would now seem prudent.

    • Replies: @Mr McKenna

    Given there have been three coronavirus diseases appearing out of nowhere in the last 20 years, with the last being much worse that the ones before, that there will be another still nastier one along shortly is hardly far fetched. The reorganization of society to have procedures in place to cope with a low lasting COVID-19 becoming endemic, and a possibly much nastier epidemic that the current COVID-19 one, would now seem prudent.
     
    There's also the option of bringing worldwide public pressure to bear upon China to end some of its barbaric practices with respect to the provision of exotic meats (and other products) to its preposterously large population.

    Not saying it would be an eternal, universal cure, but it would represent real progress. Because these diseases do not in fact 'appear out of nowhere' and while China isn't the only offender, it's by some margin the worst.

  71. @vhrm
    Zooming out a bit, this study (1200 out of 9.6m ever hospitalized w/ an avg stay ~10 days) reminds me of how much time we're wasting out here in California with empty hospitals and idle doctors week after expensive week.

    Hospital capacity w/ surge: ~ 125,000 (1)

    hospitalized with Covid-19: 3,200 (2) (and basically flat for a week)

    homeless put up in hotels: 4,211 (of 15,000 rooms already secured) (3)

    We have more homeless people put up on hotels than we do hospitalized Covid-19 patients.

    Shutdown for almost a month now.

    This is not how flattening the curve is supposed to work.

    We're not building herd immunity while protecting the health system from overload.

    We're not extinguishing the virus (which is probably impossible anyway, but in any case we're not doing it).

    We're just sitting here in limbo with our thumbs up our butts burning truckloads of cash.

    Before this I assumed epidemiologists were serious people who could make tough tradeoffs etc, but their performance had been just pathetic:
    - they lied about how it's spread (aerosols)
    - they lied about masks
    - their mickey-mouse models have been so sensitive to unknown parameters that they've been useless. There's a guy here who derisevely calls it eight grade math. I bristled at that a few times, but seriously... all we got is "OMG exponentials grow really fast!"
    - they don't have any insight into how to actually mitigate transmission. 4 months into this all they can say is "uhhh..... everyone stay home and wash your hands." Seriously, how useless are these people?!

    (e.g if they had said, "no, don't cut subway service because that make things worse..." that would've been a marginally insightful contribution that an outsider would take 10 minutes to think about. But they didn't even do that)



    1)

    The state has aggressively planned for a surge in hospitalizations in the coming weeks and aims to add 50,000 beds to our existing hospital capacity of nearly 75,000 beds. At least 60 percent of those additional beds, or 30,000, will come from within existing hospitals, and the state will secure the remaining beds, up to 20,000.
     
    (https://www.gov.ca.gov/2020/04/06/governor-newsom-announces-progress-in-expanding-hospital-capacity-to-fight-coming-surge-in-covid-19-cases/)

    2) https://www.eastbaytimes.com/2020/04/18/coronavirus-california-passes-1000-deaths-and-29000-cases-but-growth-slowing-after-deadliest-day/

    3) https://sanfrancisco.cbslocal.com/2020/04/18/coronavirus-california-struggles-covid-spread-homeless/

    Correct. Everyone needs to remember that “flatten the curve” wasn’t about saving people from the virus. That was never claimed nor could it be. It was about keeping hospitals from overflowing and thus losing people who couldn’t get treatment.

    Hospitals never overflowed, and most never came close.

    • Agree: Alice
    • Replies: @Justvisiting

    Hospitals never overflowed, and most never came close.
     
    You may turn out to be correct, but the Gods tend to be very unkind to those who celebrate before the game is over.
    , @utu
    "Everyone needs to remember that “flatten the curve” wasn’t about saving people from the virus. " - Nonsense. The area under the flattened curve is smaller than under the curve of the unconstrained epidemic running at its natural R0. When the concept of herd immunity was introduced to the general public the curves used to illustrate it mislead many people as the areas under both curves appeared to be equal. It is unfortunate that Knut Wittkowski, who got a significant following among the skeptic-hoaxer-just-a-flu crowd by providing them with cogent talking points to their liking perpetuates the same mistake. Wittkowski knows better, yet he does not rectify this error. For the skeptic-hoaxer-just-a-flu crowd the belief that the countermeasure won't change the ultimate death count is their most powerful argument. They know that this argument has a better chance of getting traction than "who cares if old people die" argument to which they are naturally inclined.
  72. @danand

    "Let’s keep healthy people isolated longer, so we don’t get herd immunity!"
     
    Herd immunity will not happen until many people you know, or you, are dead. Even if it were possible, immunity may last only one "flu" season, or until next mutation. 100% testing, or near, is the only "safe" way to "re-open the economy". By safe I mean a place where most people feel it's OK for them to resume their pre SARS-CoV-2 lifestyle. Even if one doesn't feel at risk for death, getting "deathly Ill" will cause more than a little pause. Hesitant to even say resume because given the shock, seems near impossible the US will see another + $20 Trillion GDP print any year soon.

    Even going with about the most expensive currently available testing regime, performed via the Abbott ID NOW™ 15 minute routine, would not the “cost” be roughly 1/10 the lower end of what many figure to be the eventual cost for the US's “economic bailout”.

    Test "everyone" in the US:

    $10,000 Abbott ID NOW™ (part #NAT-024), 1 per 100 persons. I know it's overkill, but things break, and the're the relatively cheap part of the equation; make them ubiquitous, the machines could be located at every local library (12K), school (150K), McDonald's (14K), gas station (170K), etc... across the USA = $33,500,000,000 ($34B)

    $98 single use test kits - 335,000,000 persons in the USofA times 6 tests each. (1 test administered every week, for 6 weeks, for every person). Total test kit cost for 6 weeks would be $196,980,000,000 ($200B)

    $100 (estimated) - administration/labor cost of a single test. 6 tests times 335M people would run $201,000,000,000 ($200B)‬

    Everyone in USA 15 minute tested 6 consecutive weeks to effectively extinguish Covic-19 at a cost of $450 Billion, roughly half what Austin Powers would ask.

    The economy could be opened right now, with initial/1st week test round; as that would catch a majority of the infected right off the bat.

    After 6 consecutive weeks of testing, even given an individual test was only ~80% accurate and that not all infected would quarantine, the USA would be Covid-19 extinguished. At least until the next possible wave(s) comes in: Covid-21, Covid-22, Covid-23...

    BTW - China is still locked down province by province. There is extremely limited travel between them. (A distant associate who lives just outside Shanghai has been "stuck" in Wuhan province year to date.)

    >Test “everyone” in the US:<

    I feel your: fear, panic, delusion, pain and stupidity.

    • Replies: @danand

    “I feel your: fear, panic, delusion, pain and stupidity.”
     
    Newrouter, no doubt there is some truth in your statement; delusion(al) most applicable.

    In any event, I’m really only interested in returning to, as close to possible, what was pre-pandemic. It very well could be that the world overreacted, but it has, and that’s where we are now. The restrictions could all be lifted, and the US/world economies “reopened” tomorrow, but unfortunately without clarity, “full level” participation simply will not return. There would be significant disruption; likely disruption most would not find positive. Certainly employment, at least in a lot of jobs that were, would not resume. It would be a brave new world (perhaps not so brave).

    100% repeated weekly testing over a short period would be a relatively cheap and easy “fix”, compared with the alternative. That alternative being, even with repeated stimulus until exhaustion, I suspect, long term economic malaise at best.

    But if the world were to stop economically spinning, at least Greta Thunberg could find peace.
  73. @Daniel Williams

    In China, some ICU cases got off the machines and were place in the hallway to meet their fate.
     
    According to Breitbart, the Chinese hastened some of them along that journey by burning them alive!

    https://www.breitbart.com/asia/2020/04/07/report-wuhan-funeral-homes-burned-people-alive/

    If it were any other government, I’d think this story was hysterical nonsense ...

    It is hysterical nonsense. You are another deluded China Did It troll.

    • Replies: @Daniel Williams

    You are another deluded China Did It troll.
     
    You’re just judging me based on my wild, colorful hair and the jewel in my belly.
    , @Lot
    The CCP would never do something like that!

    https://www.nytimes.com/1993/01/06/world/a-tale-of-red-guards-and-cannibals.html
  74. @Anon
    Leftists have decided to blame anti-lockdown protests on (Guess who? You'll never be able to tell) the Russians. Propagandists gotta propagandize. I wonder that they're not embarrassing their own side by now. Liberalism isn't a mental disorder, it's a cult.

    https://twitter.com/BarbMcQuade/status/1251530112488607746

    I’ve also seen comments on left wing blogs where the protesters were called racists.

  75. @Polynikes
    Correct. Everyone needs to remember that “flatten the curve” wasn’t about saving people from the virus. That was never claimed nor could it be. It was about keeping hospitals from overflowing and thus losing people who couldn’t get treatment.

    Hospitals never overflowed, and most never came close.

    Hospitals never overflowed, and most never came close.

    You may turn out to be correct, but the Gods tend to be very unkind to those who celebrate before the game is over.

    • Agree: Morris Applebaum IV
    • Replies: @Polynikes
    I'm not celebrating, nor feel a need to. There just aren't any winners here--not by the people affected by the virus or the much larger people affected by the resulting political and economic fallout. The lack of any concern or consideration of the latter has been my focus the majority of the time. Seeing how the gods haven't seen fit to save that latter group in-spite of guys like DeBlasio's hubris, I doubt my minor indiscretion of having a good laugh at the ineptitude of the UWash's models will severely alter our cosmic fate.
  76. @obwandiyag
    It is hysterical nonsense. You are another deluded China Did It troll.

    You are another deluded China Did It troll.

    You’re just judging me based on my wild, colorful hair and the jewel in my belly.

  77. @Anonymous
    Sailer is completely insane wanting to re-open the economy. A voice of sense: https://youtu.be/_8NkuVId2Lw

    Tucker Carlson is such a moron. Arguing that the coronavirus is not a big deal because the flu killed twice as much last year as this coronavirus. Key word here is "year". Coronavirus has killed in 6 weeks as much as the flu took 6 months to kill *despite the quarantine and lockdown* . Now imagine how bad it will be if we end the quarantine. Literally 20% of the entire NYPD is on leave due to sickness caused by COVID-19, and several cops have already died. We would have the same situation with the population at large if we re-opened the economy.

    Everyone but you is insane or a moron, right?

    • Replies: @Anonymous
    Based on the delusional responses here about how this is just a tiny flu and that we should end quarantine: yes, everyone here appears to be either insane or a moron.
  78. @Polynikes
    Correct. Everyone needs to remember that “flatten the curve” wasn’t about saving people from the virus. That was never claimed nor could it be. It was about keeping hospitals from overflowing and thus losing people who couldn’t get treatment.

    Hospitals never overflowed, and most never came close.

    “Everyone needs to remember that “flatten the curve” wasn’t about saving people from the virus. ” – Nonsense. The area under the flattened curve is smaller than under the curve of the unconstrained epidemic running at its natural R0. When the concept of herd immunity was introduced to the general public the curves used to illustrate it mislead many people as the areas under both curves appeared to be equal. It is unfortunate that Knut Wittkowski, who got a significant following among the skeptic-hoaxer-just-a-flu crowd by providing them with cogent talking points to their liking perpetuates the same mistake. Wittkowski knows better, yet he does not rectify this error. For the skeptic-hoaxer-just-a-flu crowd the belief that the countermeasure won’t change the ultimate death count is their most powerful argument. They know that this argument has a better chance of getting traction than “who cares if old people die” argument to which they are naturally inclined.

    • Replies: @Mr. Anon

    .............who got a significant following among the skeptic-hoaxer-just-a-flu crowd by providing them with cogent talking points to their liking perpetuates the same mistake.
     
    Hoaxer? You're conflating a whole range of opions with "hoaxer". By the way, aren't you a 911 "truther"? Are you not a "Moon hoaxer"? Now all of a sudden here you are calling out people who deviate from the official line - the narrative profferred by the powers-that-be - with your own little dismissive perjorative.

    I haven't noticed many people here (perhaps not anyone here) calling the coronavirus a hoax. I haven't seen too many people dismiss it as "just the flu". I have seen people say, in effect, this is probably equivalent to the Hong Kong Flu or the Asian Flu. And the World didn't shut itself down and plunge itself into depression for those.
    , @Mr McKenna
    We keep seeing bizarre stories like this one.

    Broadway star Nick Cordero to have leg amputated in COVID-19 complication

    Broadway star Nick Cordero, who recently starred in a new production of “Rock of Ages” in Hollywood, is set to have his leg amputated after suffering complications linked to COVID-19.

    The Canadian actor, who has a 10-month-old son with former dancer Amanda Kloots, is due to have his right leg amputated Saturday due to blood clotting in the limb following an infection from the novel coronavirus, Kloots shared on Instagram Saturday.

    https://www.latimes.com/entertainment-arts/business/story/2020-04-18/broadway-star-nick-cordero-to-have-leg-amputated-in-covid-19-complication
     

    What do you (or anyone) make of them? Meaningless noise? Or just a result of being bedridden for so long?
    , @Alice
    well, no slide ever shown by the CDC had a smaller area under the curve. Neither did the imperial College model.

    Re: we really think "who cares if old people die": the lockdown isn't saving the old people in my state. Are you sure it is in your state? there's an assumption "think of how much worse without lockdown", but it's a non sequitur.

    The old people dying are in nursing homes. They were already under de facto lockdown before the virus was sequenced. most nursing homes in my state had closed off visitors by March 1. March 13 began the voluntary lockdown, and my state's involuntary one came March 27. So why are they dying? How is the movie theatre and swingset and little league field being closed affecting killing or saving great granny?

    The evidence is mounting that infection is largely nosocomial and intrafamilial. You get it in close quarters, and the lockdowns made more close quarters, not fewer. Mass transit in NYC metro is of course also close quarters for long stretches of timez and NY never closed subways.

    And in my state, they've done nothing to save the nursing home folks The governor didn't even require nursing home staff to wear masks til April 13, literally a month after CDC social distancing and 2 weeks after STAY AT HOME order in my state closed all gathering over 10 people, and closed every state park, beach, and playground.

    So you may believe the numbers if dead would skyrocket if lockdown removed, but it asserts facts not in evidence.
    , @Polynikes

    Nonsense.
     
    It's not nonsense. Take a quick refresher in recent history and look again at the charts used and rationale given. That's exactly what was sold to the public--mass infections creating the need for mass hospitalizations leading to the collapse of the hospital system resulting in excess deaths.

    When the concept of herd immunity was introduced to the general public the curves used to illustrate it mislead many people as the areas under both curves appeared to be equal.
     
    Maybe you're British? Herd immunity was not a selling point to lock-downs, or any strategy absent vaccines, in America. As little as a week ago Fauci was still talking about targeted lock-downs throughout the fall until a vaccine was found. You wouldn't need vaccines if the population acquired herd immunity by letting the infection spread.


    So, what I wrote is exactly ("precisely" as you Brits might say) right. If you think the lock-downs provided some benefit, feel free to discuss. I don't doubt that they have had some marginal effect. Then we can get into the discussion on whether it was worth it or not. But the original rationale, in America, was 100's of thousands of people not being able to get medical treatment and then dying unnecessarily. (Remember the ventilators?). Never happened.
  79. @Jack Armstrong
    OFF TOPIC:

    Chile’s celebrated author Luis Sepulveda, who died Thursday aged 70 from COVID-19, was a committed writer exiled by the Pinochet dictatorship for his political activities.

    Best-known for his 1992 novel, The Old Man Who Read Love Stories, Sepulveda was particularly successful in Europe, where he had been based since the 1980s.

    His works, appreciated for their simple humour and depictions of life in South America, have been translated in some 50 countries and range from novels, chronicles and novellas to children’s stories.
     

    Nobody cares.

    • Thanks: Jack Armstrong
  80. Anonymous[326] • Disclaimer says:
    @newrouter
    >Sailer is completely insane wanting to re-open the economy.<

    I feel your: fear, panic, delusion, pain.

    Ok. So why don’t you go outside without a mask, and rub your figners on all surfaces and stick them inside your nose, since there is no cause for concern? Your sarcasm is completely idiotic considering the seriousness of this.

    • Replies: @Kratoklastes

    So why don’t you go outside without a mask, and rub your figners on all surfaces and stick them inside your nose, since there is no cause for concern?
     
    OK Doomer.


    Also...

    Is that your idea of how to behave in the normal 'Non-Chicken-Little' course of events?

    If that's the case, you and I part ways after "go outside without a mask".

    Going outside without a mask is what I do now. It's what I have done all my life. It's what I will continue to do.

    That's because I'm numerate, and I'm not an 80 year old with chronic lung or heart disease.

    Even my irrational fear of dying ironically doesn't give the corona nothingburger enough excess risk to worry about - coz I'm not famous either.
  81. @danand

    "Let’s keep healthy people isolated longer, so we don’t get herd immunity!"
     
    Herd immunity will not happen until many people you know, or you, are dead. Even if it were possible, immunity may last only one "flu" season, or until next mutation. 100% testing, or near, is the only "safe" way to "re-open the economy". By safe I mean a place where most people feel it's OK for them to resume their pre SARS-CoV-2 lifestyle. Even if one doesn't feel at risk for death, getting "deathly Ill" will cause more than a little pause. Hesitant to even say resume because given the shock, seems near impossible the US will see another + $20 Trillion GDP print any year soon.

    Even going with about the most expensive currently available testing regime, performed via the Abbott ID NOW™ 15 minute routine, would not the “cost” be roughly 1/10 the lower end of what many figure to be the eventual cost for the US's “economic bailout”.

    Test "everyone" in the US:

    $10,000 Abbott ID NOW™ (part #NAT-024), 1 per 100 persons. I know it's overkill, but things break, and the're the relatively cheap part of the equation; make them ubiquitous, the machines could be located at every local library (12K), school (150K), McDonald's (14K), gas station (170K), etc... across the USA = $33,500,000,000 ($34B)

    $98 single use test kits - 335,000,000 persons in the USofA times 6 tests each. (1 test administered every week, for 6 weeks, for every person). Total test kit cost for 6 weeks would be $196,980,000,000 ($200B)

    $100 (estimated) - administration/labor cost of a single test. 6 tests times 335M people would run $201,000,000,000 ($200B)‬

    Everyone in USA 15 minute tested 6 consecutive weeks to effectively extinguish Covic-19 at a cost of $450 Billion, roughly half what Austin Powers would ask.

    The economy could be opened right now, with initial/1st week test round; as that would catch a majority of the infected right off the bat.

    After 6 consecutive weeks of testing, even given an individual test was only ~80% accurate and that not all infected would quarantine, the USA would be Covid-19 extinguished. At least until the next possible wave(s) comes in: Covid-21, Covid-22, Covid-23...

    BTW - China is still locked down province by province. There is extremely limited travel between them. (A distant associate who lives just outside Shanghai has been "stuck" in Wuhan province year to date.)

    $10,000 Abbott ID NOW™ …

    The cost per unit that you use in your example reflects the asking price computed on a much smaller number for total unit production. The marginal cost of each of those tests is definitely less than in your example, quite possibly by an order of magnitude (or more in the case of the fancy Abbott machine.)

    The total cost of such a plan would likely be significantly less than that figure of $450 billion. The problem, of course, is ramping up production rapidly to that scale, and raw materials supply/sorucing problems, not least because, if it is feasible, every other country that can afford such a program will want to do the same.

    • Replies: @danand
    PiltdownMan, agree with everything you said, valid points. The machines would certainly been less expensive at megaunit quantities, but they are the “cheap” piece. Not sure how much buffer there is with the test kits. Still seems a bargain for virtual elimination of this virus; and preparedness for those in the future.

    Lockdowns/restrictions could be unwound right quick; and the vast majority would gain the confidence to return to their normally scheduled lives.

    https://flic.kr/p/2iRrR7k

    https://flic.kr/p/2iRns4R
  82. Anonymous[326] • Disclaimer says:
    @Daniel Williams
    Everyone but you is insane or a moron, right?

    Based on the delusional responses here about how this is just a tiny flu and that we should end quarantine: yes, everyone here appears to be either insane or a moron.

    • Replies: @Mr McKenna
    We have a frequent contributor here like you--her name is Alden. Since she has found a couple of people here who say things she doesn't like, she's on an endless rampage against "The Men of Unz" who (according to her) represent 100% of the readership and cause pretty much all of the evil in the world. Perhaps you two should meet some time. You could get a room by the hour, that sort of thing.
  83. @vhrm
    Zooming out a bit, this study (1200 out of 9.6m ever hospitalized w/ an avg stay ~10 days) reminds me of how much time we're wasting out here in California with empty hospitals and idle doctors week after expensive week.

    Hospital capacity w/ surge: ~ 125,000 (1)

    hospitalized with Covid-19: 3,200 (2) (and basically flat for a week)

    homeless put up in hotels: 4,211 (of 15,000 rooms already secured) (3)

    We have more homeless people put up on hotels than we do hospitalized Covid-19 patients.

    Shutdown for almost a month now.

    This is not how flattening the curve is supposed to work.

    We're not building herd immunity while protecting the health system from overload.

    We're not extinguishing the virus (which is probably impossible anyway, but in any case we're not doing it).

    We're just sitting here in limbo with our thumbs up our butts burning truckloads of cash.

    Before this I assumed epidemiologists were serious people who could make tough tradeoffs etc, but their performance had been just pathetic:
    - they lied about how it's spread (aerosols)
    - they lied about masks
    - their mickey-mouse models have been so sensitive to unknown parameters that they've been useless. There's a guy here who derisevely calls it eight grade math. I bristled at that a few times, but seriously... all we got is "OMG exponentials grow really fast!"
    - they don't have any insight into how to actually mitigate transmission. 4 months into this all they can say is "uhhh..... everyone stay home and wash your hands." Seriously, how useless are these people?!

    (e.g if they had said, "no, don't cut subway service because that make things worse..." that would've been a marginally insightful contribution that an outsider would take 10 minutes to think about. But they didn't even do that)



    1)

    The state has aggressively planned for a surge in hospitalizations in the coming weeks and aims to add 50,000 beds to our existing hospital capacity of nearly 75,000 beds. At least 60 percent of those additional beds, or 30,000, will come from within existing hospitals, and the state will secure the remaining beds, up to 20,000.
     
    (https://www.gov.ca.gov/2020/04/06/governor-newsom-announces-progress-in-expanding-hospital-capacity-to-fight-coming-surge-in-covid-19-cases/)

    2) https://www.eastbaytimes.com/2020/04/18/coronavirus-california-passes-1000-deaths-and-29000-cases-but-growth-slowing-after-deadliest-day/

    3) https://sanfrancisco.cbslocal.com/2020/04/18/coronavirus-california-struggles-covid-spread-homeless/

    What’s going on in Italy and Spain?

    Are there healthcare systems that bad compared to ours?

    • Replies: @PiltdownMan
    This may offer some clues. Or not, as the case may be.

    https://www.unz.com/isteve/what-is-australia-doing-right/#comment-3842412
    , @Thatgirl
    Maybe their healthcare systems have, instead, been THAT good - i.e. they have kept a very aged population alive with numerous comorbidities. If Italy hadn’t had so many old and sick people it would not have had so many people die from Coronavirus.
  84. @Mehen
    Apologies if this posts twice:

    This comment is directed to Steve Sailer and Ron Unz:

    I was a Corona-Believer from mid January to about early March. In other words, I had hopped on that train early on. In early March I was really freaking out, considering some of the evidence that this virus was bioengineered in some fashion. Around March 15 I started reading all the Corona-Skeptics and eventually went down that rabbit-hole.

    But up to that point I had been researching and spending tons of money on mitigation strategies.

    To that end I had amassed a large quantity of nutraceuticals in order to strengthen my immune system in preparation for the Apocalypse.

    I have been taking most of the following for weeks now, but I am beginning to lay off the practice of swallowing 20 pills a day because I now believe this virus has been overhyped.

    I won't bother getting into the scientific evidence supporting the ingestion of the following nutraceuticals because I had so little time to prepare. But I do have a background in pharmacology for mental disorders as well as having a history in "supplements" for nootropic effects and body-recomposition effects. In other words, do your own research. The following is just a guide.

    The primary things Steve and Ron should be taking, which have the most scientific research:

    Vitamin D3 (4000-5000 IU) -- some say this should be augmented with Vitamin K2 for atherosclertoic reasons

    Vitamin C -- in moderate doses as a prophylactic, in high doses during sickness (the liposomal form is the ideal)

    Zinc -- try to stay away from cheap forms of Zinc like Zinc gluconate, and go for ionic forms of Zinc like Zinc sulfate or Zinc acetate

    Those are the big three.

    But there are many others, in the event you are shitting your pants.

    Omega-3 fish oil -- reduces inflammation

    Olive leaf extract

    Black elderberry (keep in mind there is some evidence this should only be used as a prophylactic and not used during the infection period because it might enhance so-called "cytokine storms")

    Quercetin -- which shows similar Zinc ionophor features as the fabled Hydroxychloroquine

    Curcumin

    Chaga mushroom extract

    Oregano Oil

    Selenium

    Glutathione

    N-acetyl-Cysteine

    Probiotics (remember that 80% of your immune system is dependent on your gut flora)

    ECGC (Green Tea extract)

    Garlic extract

    The amino acid L-Lysine seems to have anti-viral properties

    Grape seed extract

    Alpha-lipoic acid

    For the brave among you:

    Nebulized colloidal silver

    AHCC


    I am confident that if you have such a battery behind you, you will not need to be hospitalized by this virus.

    I happen to have a well-stocked medicine cabinet at this point so if Steve and Ron are still concerned, I am willing to share some of my stash with them.

    There’s some evidence taking zinc above what you’d get in a normal diet is dangerous. Eating silver will turn your skin a deathly shade of blue permanently, as the Blue Libertarian found out.

    The unregulated supplement industry funds the “studies” of these things, and nobody has the incentive to spend a lot of money debunking them.

    • Replies: @Mr. Anon
    I have read that colloidal silver might be a good topical anti-biotic for treating wounds (then again so are bacitracin and neosporin). But ingesting it is probably crazy. I know people who think that silver is a cure-all - it's a monomania with some people.
    , @PiltdownMan

    Eating silver will turn your skin a deathly shade of blue permanently,
     
    Libertarian Stan Jones got off relatively lightly.

    https://i.imgur.com/ZMVBenC.jpg

    , @Mehen

    Eating silver will turn your skin a deathly shade of blue permanently, as the Blue Libertarian found out.
     
    So I've heard. But from my brief perusal it seems this is the only known negative effect of ingesting colloidal silver, and even then probably only in those who ingest large amounts. This is why I specified *nebulized* CS as this specifically targets the point of infection (lungs), thereby requiring only tiny dosages, both factors which avoid high systemic levels. Of course this is all speculative.

    There’s some evidence taking zinc above what you’d get in a normal diet is dangerous.
     
    That's possible. What did you have in mind? I know that there are qualified medical professionals prescribing Covid-19 patients Zinc in the 200mg+ range which is a bit higher than the normal 50mg limit. But your comment reminds me that excessive zinc intake can deplete copper levels, is this what you had in mind? In which case popping a copper supplement every few days should be enough to offset that.

    The unregulated supplement industry funds the “studies” of these things, and nobody has the incentive to spend a lot of money debunking them.

     

    There is probably an element of truth to this, but it is equally true that those who have the money and clout to fund the expensive studies demonstrating the efficacy of nutraceuticals have no incentive to do so because these are natural substances which cannot be patented, so why bother?

    If you look at the board of organizations like the Life Extension Foundation, they are virtually all qualified MD's and researchers, not exactly homeopaths. I guess it once again boils down to "why are your experts more valid than my experts"?

    It may reassure you to learn that some of the aforementioned nutraceuticals have been included in the Covid-19 Management protocol devised by a Dr. Marik, Chief of Pulmonary and Critical Care at the Eastern Virginia medical school:

    https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf

    That document reminds me of a couple of other items I forgot to include in my original list:

    - Melatonin

    - Magnesium

    ...which I also have in my pantry.

    I'll draw your attention to one thing he says:


    It is important to stress that there is no known drug/treatment that has been proven unequivocally to improve the outcome of COVID-19. This, however, does not mean we should adopt a nihilist approach and limit treatment to “supportive care”. Furthermore, it is likely that there will not be a single “magic bullet” to cure COVID-19. Rather, we should be using multiple drugs/interventions that have synergistic and overlapping biological effects that are safe, cheap and “readily” available.
     
    If any readers are interested in the scientific rationale for including these nutraceuticals in a Covid-19 regimen, the following two articles go into some depth. I believe I discovered these two links in the comments here at UR, in fact:

    https://www.sciencedirect.com/science/article/pii/S0033062020300372

    https://www.paulcraigroberts.org/wp-content/uploads/2020/02/0418-Blaylock.pdf

  85. @obwandiyag
    It is hysterical nonsense. You are another deluded China Did It troll.
  86. @ic1000
    This looks like the largest and best snapshot of infection and disease, so far. Thanks for posting, Steve.

    There's been a lot of discussion of using recorded deaths and an assumed Infection Fatality Rate (IFR) to get an estimate of the percentage of people who were infected, at the time the people who died had gotten infected. Given the delay in getting testing in the US underway, this strikes me as sensible.

    This paper says that for the Kaiser Permanente cohort, "We estimated a mean interval of 13.5 days... between infection and hospitalization for cases that would ultimately be hospitalized..." And, "Mean censoring-adjusted duration of hospitalization was... 13.7 days... among non-survivors."

    So that's an average of 27 days (nearly 4 weeks) between infection and death. Much longer than the 2 week frame some people have been using.

    Below the fold, I do some arithmetic with these figures to back-project the infection rate in hotspot New York City on March 20, 2020. tl;dr -- An IFR of much less than 0.5% doesn't make much sense. An IFR of 0.1% implies that one-third of NYC residents were already infected by then. Herd immunity would have been achieved weeks ago.

    From 91-COVID, the JHU 7-day trailing average for NY state is 1,323 deaths on April 17. The number of confirmed new cases for March 20 (28 days prior) was 2,945. Probably better to take 7-day average centered on March 20, which was 2,845.

    Taking 1,323 deaths on 4/17 and walking back 28 days to 3/20 --

    IFR of 2% means 66,000 actual new infections that day. (~4% of cases were detected)
    IFR of 0.5% means 260,000 actual new infections that day (~1% of cases were detected)
    IFR of 0.1% means 1.3 million actual new infections that day (~0.2% of cases were detected)

    Infections take 2 to 3 weeks to resolve (my estimate). Hopkins says there were 8,310 confirmed cases on 3/20, which was 15 days after crossing the threshold of 20 confirmed cases on 3/5. So essentially all of the SARS-CoV-2 infections that had occurred were active on 3/20.

    On 3/20, there were 2,845 new cases confirmed (7-day average). 2845/8310 = 34%. Thus, in the midst of rapid exponential growth, 34% of the people who were infected on midnight of 3/20 are projected to have gotten infected within the past 24 hours. In other words, the total number of infected at midnight of 3/20 should be about three times the number of people who became infected on that day.

    IFR of 2% means 190,000 actual current NYS infections on that day
    IFR of 0.5% means 780,000 actual NYS infections
    IFR of 0.1% means 3.9 million actual NYS infections

    The population of NY state is 19.4 million. NYC's population is 8.6 million. Assuming that about 3/4 of the NYS infections of 3/20 were in NYC (my estimate):

    IFR of 2% means 142,000 actual current NYC infections on that day (1.7% of the city)
    IFR of 0.5% means 570,000 actual NYC infections (6.6% of the city)
    IFR of 0.1% means 2.8 million actual NYC infections (33% of the city)

    If IFR was 0.1%, herd immunity should have been achieved by early April, with 60% to 80% of the population infected or recovered (or dead). Herd immunity alone would explain why the NYC curve has flattened since then, to the extent it has.

    But, then what explains the similar flattening of the curve in almost every other jurisdiction, at lower rates of infection that preclude herd immunity as an explanation?

    An IFR of under 0.5% in the NYC setting looks unlikely, to me.

    Your estimates will change if you re-do everything with
     • age-relevant transition probabilities (i.e., old sick people are outright more susceptible; develop symptoms quicker; and have disease progression that hits harder, earlier); and
     • the assumption that more than half of all ‘confirmed’ infections in the young (the largest cohort of ‘confirmed’ infections) are asymptomatic, and almost none of the young die from covid19.

    Given the CF(w)R for people over 75 is of the order of 30% on a ‘same date’ basis (i.e., using ‘cases today’ as the denominator for ‘deaths today’)‚ if lag structure is set up as age-agnostic numbers suggest, the system runs into problems.

    Take the April 17 deaths for NYC.

    There were 287 deaths of people aged 75 and over (NY’s data still apparently still requires a positive lab test – at least that’s what’s shown at the top of each day’s NYC Daily Death Summary for April 15 2020.

    Go back 27 days and fetch the ‘confirmed cases’ data for NYC for March 21st: there were only 390 cases in the 65+ group (until March 21, NYC was ending the relevant age cohorts at 65).

    But this was notionally the day these fogies got infected… they wouldn’t show symptoms until incubation was finished.

    Five days later on the 26th (assuming that 75+ people start to show symptoms at the median incubation period) there were only 302 new confirmed cases among the 75+ group – so we’re 15 deaths to the good… we can have <100% mortality and a 22-day look-back. In fact, the last week’s worth of deaths is only 73% of the total cases up to March 26th.

    If you do this consistently – that the deaths have to come from new cases 22 days ago – it paints a terrible picture: a tad under ¾ of infected in the age group, 75+ die.

    What’s missing? All of the 75+ cases since March 26th.

    Using the 22-day-lookback, results in a gigantic – and still-growing – pool of old infected waiting to die. That’s not observed.

    Currently it would be all 75+ cases after March 26th. 12,868.

    So 73% of them will cark it over the next 22 days. That’s 9,429 old people – which is almost 2.3 times the current cumulative total number of deaths in that age group.

    That’s the thing that shows that the cases-wide dynamics are a bad choice.

    It’s also why your proposed ‘go back 22 days; count all cases; divide by assumed IFR‘ isn’t a good idea.

    .

    This is why the putative “death-date-to-infection-date-matching” idea is a really bad idea if age-agnostic parameters are used – it biases the look-back period upwards (and therefore, for a given IFR, it overstates ‘undiscovered’ cases).

    I’ve used “75+” people as a cohort as if it doesn’t have a natural internal partition – but of course it does75+ers with chronic illness – who die even faster than 75+ without. NYC’s data doesn’t have case comorbidity data; it has death

    Given that CFR has such a distinct age-cohort pattern, and is so strongly influenced by key relevant chronic illness, it would be weird to assume that susceptibility (and other transmission probabilities) aren’t also different.

    .

    The thing is best modelled with age-group-specific dynamics – where the older age groups (and particularly the chronically-ill older people) take less than a week from symptoms to death or recovery. There’s still a very high IFR in their age cohort, but correspondingly much much lower than 0.5 for the other age cohorts.

    I’ve spent a couple of days doing a half-assed search of the literature, and this seriously seems to be something that has had almost no real attention – I guess because this is the first real pandemic where the death-by-age is so tilted towards one end of the age distribution.

    If I was 15 years younger I would be eagerly writing up something with a view to submitting it to an open journal.

    As it is I’ll do a half-assed writeup and stick it on a blog – there’s no incentive to do more, because covid19’s about to be dropped from media coverage.

    PandemicTV is pretty much done for 2020, and the next few weeks will be politicians doing victory laps and crowing that they saved humanity… and in 3 months there might be a 3 paragraph story in some inside page, discussing a recent inexplicable spike in suicides.

    • Thanks: ic1000
    • Replies: @Whitey Whiteman III
    I've learned to stop worrying and love the germ.
    , @Je Suis Omar Mateen
    "PandemicTV is pretty much done for 2020, and the next few weeks will be politicians doing victory laps and crowing that they saved humanity…"

    TV is unwatchable now, especially the sanctimonious ads of heroic TP manufacturers and heroic car dealerships and heroic pizza slingers all vowing NO ICKY HUMAN EVER touched the merch before it was delivered to your diseased, fragile little fingers. It's worse than after 9/11.

    The weeks-long onanastic public self-stroking by Democratic governors, the President, Dr. Poochy and Dr. Scarfy will be nauseating to anyone rocking an IQ supra 95. Summer can't get here soon enough.
    , @res

    This is why the putative “death-date-to-infection-date-matching” idea is a really bad idea if age-agnostic parameters are used – it biases the look-back period upwards (and therefore, for a given IFR, it overstates ‘undiscovered’ cases).

    I’ve used “75+” people as a cohort as if it doesn’t have a natural internal partition – but of course it does… 75+ers with chronic illness – who die even faster than 75+ without. NYC’s data doesn’t have case comorbidity data; it has death

    Given that CFR has such a distinct age-cohort pattern, and is so strongly influenced by key relevant chronic illness, it would be weird to assume that susceptibility (and other transmission probabilities) aren’t also different.

    .

    The thing is best modelled with age-group-specific dynamics – where the older age groups (and particularly the chronically-ill older people) take less than a week from symptoms to death or recovery. There’s still a very high IFR in their age cohort, but correspondingly much much lower than 0.5 for the other age cohorts.
     
    That makes sense. The question is: how big a difference does it make? I don't think anyone is arguing for an IFR above 0.5% below age 50. Where that changes between ages 50 and 75 is hard to say right now (I would guess somewhere between 60 and 70).

    So how would you correct “death-date-to-infection-date-matching” to yield more accurate numbers? If you have actually run the numbers, how much does that change the estimated population wide IFR? 10%? 2x?

    The issue here is we need a way to estimate IFR so we can judge the need for countermeasures vs. letting it rip. Don't let the perfect be the enemy of the good.

    Ideally we would have age specific information for both IFR and the expected impact of various countermeasures. The one thing I think Sweden is doing very right is focusing their countermeasure attention on the old.

    It seems clear that we (should) want to establish herd immunity among the relatively low risk population (younger with minimal preexisting conditions) while protecting the higher risk population with countermeasures during that period.

    The problem is that with that approach some younger people will die. And any deaths seem to be politically unacceptable right now.
    , @AnotherDad
    Kratoklastes, that's a solid critique of using these "average time to death" estimates. (As in ic1000s spitballing.)

    When there are rising infections then the deaths on any given day are actually dominated by the old and weak dying from more recent infections.

    However, your close:

    PandemicTV is pretty much done for 2020, and the next few weeks will be politicians doing victory laps and crowing that they saved humanity… and in 3 months there might be a 3 paragraph story in some inside page, discussing a recent inexplicable spike in suicides.
     
    I don't buy. Yeah politicians will crow and pretend they saved the world--they are after all politicians-- ... but first the world has to actually be saved.

    The plain fact here is that most Americans have not been infected--and probably never exposed.

    Summer weather--heat, humidity, sunshine--will be a huge help--as it is with the flu. But 95% of Americans are Corona-Chan virgins. If/when people just "business as usual"--the "just the flu" folks advocate, then this will at least sizzle along all summer and definitely kick back up again in the fall, when we enter the normal flu season.

    Over-reaction and--i'd argue--wrong steps, ok. Cost benefit, agreed. But people who don't think this is a real bug--one which
    a) basically no one has any pre-existing immunity from prior exposure and so easily spreads through the population and
    b) kills a bunch of people--though fortunately mostly old/sick, ergo minimal lost years
    ... are simply data-averse loons.

    It isn't going away--in three months or three years--until there's herd immunity or a vaccine.
    , @ic1000
    K., you have convinced me that the exercise I tried isn't the way to extract useful information on past SARS-CoV-2 prevalence and thus IFR. There are too many unconstrained variables.

    If this is worth doing at all, the analyst has to work from primary data. E.g. the mean (and distribution) of the time from infection to death could be reliably estimated, for the chosen definition of "the elderly" (>65? 70? 80?).
  87. @Anonymous
    Sailer is completely insane wanting to re-open the economy. A voice of sense: https://youtu.be/_8NkuVId2Lw

    Tucker Carlson is such a moron. Arguing that the coronavirus is not a big deal because the flu killed twice as much last year as this coronavirus. Key word here is "year". Coronavirus has killed in 6 weeks as much as the flu took 6 months to kill *despite the quarantine and lockdown* . Now imagine how bad it will be if we end the quarantine. Literally 20% of the entire NYPD is on leave due to sickness caused by COVID-19, and several cops have already died. We would have the same situation with the population at large if we re-opened the economy.

    The left has been saying for decades, “Do what Sweden does! Do what Sweden does!”

    Now Donald Trump is doing, or proposing doing, what Sweden is doing. And everybody wants his head.

    • Replies: @danand

    “The left has been saying for decades, “Do what Sweden does! Do what Sweden does!””
     
    Reg Cæsar, that’s a great observation. Does the left ever say Do what Wyoming does?

    https://flic.kr/p/2iRWiYz


    https://flic.kr/p/2iRYhBt
    https://flic.kr/p/2iRYhCa
    https://flic.kr/p/2iRYkgX
    , @res
    The only "principle" that seems to matter to the left in 2020 is proving (believing) "Orange Man Bad." That this is preventing effective action is unforgivable.
  88. @Thatgirl
    Some personal good news regarding The Virus.

    My 81-year-old aunt was sick with COVID-19 (tested positive). I was pretty worried because she is not that healthy, she is overweight and sedentary. She spent about two weeks in bed and said it was really tough but she has recovered and has been fever free for over a week. She never had to go to the hospital. It is hard to remember with all the bad news, but, even though their percentages are worse than for younger people, the old folks can survive without trips to the ICU and ventilators.

    Great news, blessings to your extended family.

    • Replies: @Thatgirl
    Thank you!
  89. @Sean

    By safe I mean a place where most people feel it’s OK for them to resume their pre SARS-CoV-2 lifestyle
     
    Coughing in public will never be OK again.

    USA would be Covid-19 extinguished
     
    Maybe but after the all the infrastructure and protection and laws and enforcement (it would have to be compulsory and enforced) had 'succeeded' it's as likely as not that COVID-19 would come back a few months later. Influenza disappears in the summer then roars back in the annual season. Dubious that an attempt to beat COVID-19 finally by an expensive universal testing and compulsory quarantining program would be the best use of resources and public willingness to cooperate, unless it was more or less guaranteed to work.

    There are going to be permanent changes in how close people stand to each other when talking, wearing masks on public transport, and social habits like going to crowded bars and restaurants. Some up to the individual, some mandated by law. Going out for a drink or meal is going to become a lot more expensive and many businesses less profitable as packing people in like sheep is forbidden.


    At least until the next possible wave(s) comes in: Covid-21, Covid-22, Covid-23…
     
    Given there have been three coronavirus diseases appearing out of nowhere in the last 20 years, with the last being much worse that the ones before, that there will be another still nastier one along shortly is hardly far fetched. The reorganization of society to have procedures in place to cope with a low lasting COVID-19 becoming endemic, and a possibly much nastier epidemic that the current COVID-19 one, would now seem prudent.

    Given there have been three coronavirus diseases appearing out of nowhere in the last 20 years, with the last being much worse that the ones before, that there will be another still nastier one along shortly is hardly far fetched. The reorganization of society to have procedures in place to cope with a low lasting COVID-19 becoming endemic, and a possibly much nastier epidemic that the current COVID-19 one, would now seem prudent.

    There’s also the option of bringing worldwide public pressure to bear upon China to end some of its barbaric practices with respect to the provision of exotic meats (and other products) to its preposterously large population.

    Not saying it would be an eternal, universal cure, but it would represent real progress. Because these diseases do not in fact ‘appear out of nowhere’ and while China isn’t the only offender, it’s by some margin the worst.

    • Agree: Sean, Meretricious
  90. @Kaz
    What's going on in Italy and Spain?

    Are there healthcare systems that bad compared to ours?

    This may offer some clues. Or not, as the case may be.

    https://www.unz.com/isteve/what-is-australia-doing-right/#comment-3842412

  91. @Thatgirl
    Some personal good news regarding The Virus.

    My 81-year-old aunt was sick with COVID-19 (tested positive). I was pretty worried because she is not that healthy, she is overweight and sedentary. She spent about two weeks in bed and said it was really tough but she has recovered and has been fever free for over a week. She never had to go to the hospital. It is hard to remember with all the bad news, but, even though their percentages are worse than for younger people, the old folks can survive without trips to the ICU and ventilators.

    That’s reassuring to hear, and wonderful news in your family. Best wishes to your aunt, and all in your family.

    • Replies: @Thatgirl
    Thank you. I’m sharing the story because I felt like there was no hope when I first heard her diagnosis. I wanted others to know it is not a death sentence even for the elderly.
  92. @Anonymous
    Based on the delusional responses here about how this is just a tiny flu and that we should end quarantine: yes, everyone here appears to be either insane or a moron.

    We have a frequent contributor here like you–her name is Alden. Since she has found a couple of people here who say things she doesn’t like, she’s on an endless rampage against “The Men of Unz” who (according to her) represent 100% of the readership and cause pretty much all of the evil in the world. Perhaps you two should meet some time. You could get a room by the hour, that sort of thing.

    • Replies: @Pericles
    Lol, ever since she mentioned she had during her working life imprisoned hundreds if not thousands of negros, I've thought Alden is alright.
  93. @utu
    "Everyone needs to remember that “flatten the curve” wasn’t about saving people from the virus. " - Nonsense. The area under the flattened curve is smaller than under the curve of the unconstrained epidemic running at its natural R0. When the concept of herd immunity was introduced to the general public the curves used to illustrate it mislead many people as the areas under both curves appeared to be equal. It is unfortunate that Knut Wittkowski, who got a significant following among the skeptic-hoaxer-just-a-flu crowd by providing them with cogent talking points to their liking perpetuates the same mistake. Wittkowski knows better, yet he does not rectify this error. For the skeptic-hoaxer-just-a-flu crowd the belief that the countermeasure won't change the ultimate death count is their most powerful argument. They know that this argument has a better chance of getting traction than "who cares if old people die" argument to which they are naturally inclined.

    ………….who got a significant following among the skeptic-hoaxer-just-a-flu crowd by providing them with cogent talking points to their liking perpetuates the same mistake.

    Hoaxer? You’re conflating a whole range of opions with “hoaxer”. By the way, aren’t you a 911 “truther”? Are you not a “Moon hoaxer”? Now all of a sudden here you are calling out people who deviate from the official line – the narrative profferred by the powers-that-be – with your own little dismissive perjorative.

    I haven’t noticed many people here (perhaps not anyone here) calling the coronavirus a hoax. I haven’t seen too many people dismiss it as “just the flu”. I have seen people say, in effect, this is probably equivalent to the Hong Kong Flu or the Asian Flu. And the World didn’t shut itself down and plunge itself into depression for those.

    • Replies: @utu
    You are right. I should avoid using triggering terms. W/o them perhaps you would concentrate on what my comment was about instead you just got triggered.
    , @Meretricious
    Is he really a moon-landing hoaxer?

    I really need to keep track better.

    Is there a master list somewhere?
    , @Hail

    I haven’t seen too many people dismiss it as “just the flu”
     
    It's unclear what people understand that term to mean. It sounds like it started as a Twitter troll term, and has been used in the US far more by supporters of the Panic for the past ca. five weeks, in the era of the media waving corona-bodies at us nonstop and creating their own self-reinforcing CoronaNarrative.

    But 'the flu' is, and always has been, potentially very serious for the weakest, say, 1% or somesuch among us (and for a few flukes among the other 99%). If a fifth of those at risk get it in a year, one tenth of those might die (total: 0.02% flu deaths), even with treatment, who otherwise wouldn't die in the near-term. Sometimes more, sometimes less. Maybe this time it's "more." Incidentally, these are still very low numbers in historical terms; see here.


    Maybe this time it's "more."
     
    What we have always wanted to know is data on how much worse this strain is than other flu strains. Not partial data, not somebody's worst-case-scenario projections; not Scary Big Contextless Numbers.

    The concept of the Null Hypothesis is our friend here. Austrian researchers have now found they cannot reject the null hypothesis that corona-positive deaths are any different than corona-negative deaths, in other words the people dying are of such advanced age and health condition to begin with that one's chances of dying may be the same. If that finding is valud, it is not a sure bet at all that coronavirus is a major threat. At least that applies to Austria, which has a sample of hundreds of corona-positive deaths.

    "Just the Flu" is not as unreasonable as it sounds.

  94. @e
    This is immature of me, but I still feel the need to say it: Jeff Bezos is physically ugly.

    This is immature of me, but I still feel the need to say it: Jeff Bezos is physically ugly.

  95. @utu
    "Everyone needs to remember that “flatten the curve” wasn’t about saving people from the virus. " - Nonsense. The area under the flattened curve is smaller than under the curve of the unconstrained epidemic running at its natural R0. When the concept of herd immunity was introduced to the general public the curves used to illustrate it mislead many people as the areas under both curves appeared to be equal. It is unfortunate that Knut Wittkowski, who got a significant following among the skeptic-hoaxer-just-a-flu crowd by providing them with cogent talking points to their liking perpetuates the same mistake. Wittkowski knows better, yet he does not rectify this error. For the skeptic-hoaxer-just-a-flu crowd the belief that the countermeasure won't change the ultimate death count is their most powerful argument. They know that this argument has a better chance of getting traction than "who cares if old people die" argument to which they are naturally inclined.

    We keep seeing bizarre stories like this one.

    Broadway star Nick Cordero to have leg amputated in COVID-19 complication

    Broadway star Nick Cordero, who recently starred in a new production of “Rock of Ages” in Hollywood, is set to have his leg amputated after suffering complications linked to COVID-19.

    The Canadian actor, who has a 10-month-old son with former dancer Amanda Kloots, is due to have his right leg amputated Saturday due to blood clotting in the limb following an infection from the novel coronavirus, Kloots shared on Instagram Saturday.

    https://www.latimes.com/entertainment-arts/business/story/2020-04-18/broadway-star-nick-cordero-to-have-leg-amputated-in-covid-19-complication

    What do you (or anyone) make of them? Meaningless noise? Or just a result of being bedridden for so long?

    • Replies: @vhrm
    One of the recent Medcram videos mentioned that ACE-2 plays a role in preventing blood clots and that Sars-cov-2 prevents it from working right.

    Sounds good to me, though i won't pretend to have known any of this before watching that video.

    Similar thought via a different source:

    COVID-19 enters human cells by attaching to a protein on the cell surface called ACE-2. The pattern of COVID-19 pneumonia on CT scan matches the distribution of ACE-2 in the lungs. ACE-2 is actually an enzyme with strong beneficial effects. When corona virus binds to ACE-2, the protein loses its enzyme activity. In the words of one scientist, COVID-19 produces “ACE-2 exhaustion”. Some scientists believe that ACE-2 exhaustion is responsible for the severity of pneumonia and for catastrophic effects like heart failure, blood clots, and circulatory collapse. Blood vessels are the leading source of ACE-2 in the body, and its depletion has a profound impact on their function. In the brain, ACE-2 has significant neuroprotective effects. I believe that all the clinical manifestations of COVID-19, even the abnormal scarring that occurs (fibrosis), can be traced to ACE-2 destruction by the virus.

    Laboratory studies have shown that restoring ACE-2 dramatically reduces the severity of pneumonia in animals with many types of lung injury, infectious or toxic, including those infected with SARS CoV-1, a close relative of SARS-CoV-2. The resilience of ACE-2 may explain the diversity of responses to corona virus infection. ACE-2 activity is highest in young animals and decreases with age. Conditions associated with death from COVID-19 infection (advanced age, diabetes, high blood pressure, heart disease, kidney disease) are all associated with diminished baseline ACE-2 activity. Men appear to have a greater need for ACE-2 than women. The second phase of COVID-19, the progression from a minor viral illness to severe pneumonia, blood clotting and circulatory problems, may reflect ACE-2 exhaustion, occurring several days after the initial symptoms.
     
    ( from https://drgalland.com/coronavirus-protection-protocol/ )

    But the blood clots definitely seems to be a recognized finding the past few weeks:
    https://www.statnews.com/2020/04/16/blood-clots-coronavirus-tpa/
  96. @Lot
    There’s some evidence taking zinc above what you’d get in a normal diet is dangerous. Eating silver will turn your skin a deathly shade of blue permanently, as the Blue Libertarian found out.

    http://www.cbsnews.com/images/2002/10/03/image524282x.jpg

    The unregulated supplement industry funds the “studies” of these things, and nobody has the incentive to spend a lot of money debunking them.

    I have read that colloidal silver might be a good topical anti-biotic for treating wounds (then again so are bacitracin and neosporin). But ingesting it is probably crazy. I know people who think that silver is a cure-all – it’s a monomania with some people.

  97. @Jack Armstrong
    OFF TOPIC:

    Chile’s celebrated author Luis Sepulveda, who died Thursday aged 70 from COVID-19, was a committed writer exiled by the Pinochet dictatorship for his political activities.

    Best-known for his 1992 novel, The Old Man Who Read Love Stories, Sepulveda was particularly successful in Europe, where he had been based since the 1980s.

    His works, appreciated for their simple humour and depictions of life in South America, have been translated in some 50 countries and range from novels, chronicles and novellas to children’s stories.
     

    At least I care.

  98. Why are these people so dead keen not to present age-cohort data for ICU admission, deaths, release from hospital and so forth?

    I mean it’s starting to get really obvious.

    There’s an actual effort being made to give the impression that
     • fatal outcome (%);
     • discharge (%); and
     • ICU Admission (%)
      are the same whether the person is a 25 year old athlete or an 85 year old diabetic with emphysema.

    They do us the courtesy of endorsing some parameters from a fitted Beta distribution for each age cohort, which purports to determine Pr(Hospitalised|Positive). Those are in Table S3, and are taken from Verity et al, which mostly uses data from February (although it’s been revised since) and is a pretty good bit of work (I love the IFR column of Table 1 of Verity et al).

    If you parameterise a Beta distribution using the parameters listed in Table S3, and ‘back-solve’ for the number of infections that would result in the hospitalisations listed in Table 1, and you’re sanguine about how you do a confidence interval… you get a table that looks like this ->

    When I say ‘sanguine about how you do a confidence interval‘: the way it’s done in the table above is just calculating μ and σ for a Beta distribution, and forming a symmetric CI for the mean (i.e., μ±2σ), then dividing the number of hospitalisations by the ends of the CI.

    I know that’s slightly cheeky, but it’s good enough for present purposes (ie., to get a thumbnail sketch of uncertainty on case numbers). Besides, it won’t be far from the analytical CI.

    Think of it as “the CI you get when you want a very good estimate but can’t be arsed doing it perfectly“.

    If you actually do it properly, you’ll get an asymmetric CI, but all that will do is move the lower bound up a bit, and the upper bound up about twice as much… which suits me.

    .

    Also… the apparent Dog That Did Not Bark is a multi-part thing which might have a perfectly plausible explanation.

    Kaiser Mesa Verde has 9-million-some clients, and 1200-some went to hospital and mad an insruance claim.

    Presumably, there’s some other subset that made a claim for a covid-adjacent visit (or test) that didn’t require hospitalisation.

    Maybe that other set of clients felt like absolute shit, had a cough and what not, visited a doc, got tested, signed the insurance forms… and everyone agreed it might well be covid19, but it wasn’t severe enough to require hospitalisation.

    Maybe some subset of those people requested a test; maybe some of those tests came back positive.

    .

    Maybe that’s not how the Kaiser system works: maybe nobody ticks a box marked “insurance” until the patient’s on a gurney with their ass hanging out the back of a gown.

    That sounds unlikely: after all, if you had paid all those premiums to Keyser Söze-nente and felt bad enough to go see a doctor, you would claim that visit, right?

    Where’s the data on those guys? By age cohort.

    • Replies: @res

    Those are in Table S3, and are taken from Verity et al, which mostly uses data from February (although it’s been revised since) and is a pretty good bit of work (I love the IFR column of Table 1 of Verity et al).
     
    That is a useful table. A simplified version of Table 1 is what worldmeters uses at
    https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/

    If I understand correctly, the revision was fairly trivial. They did not update the data or anything.
    https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30309-1/fulltext

    Can you infer age based fatality data for the Kaiser study from the detailed age based hospitalization data in Figure 1 (and Table 1) and fatality data in Figure 3B? Say by scaling the Table 1 admissions proportions to population proportions in each age bucket?
  99. @Anonymous
    Ok. So why don't you go outside without a mask, and rub your figners on all surfaces and stick them inside your nose, since there is no cause for concern? Your sarcasm is completely idiotic considering the seriousness of this.

    So why don’t you go outside without a mask, and rub your figners on all surfaces and stick them inside your nose, since there is no cause for concern?

    OK Doomer.

    Also…

    Is that your idea of how to behave in the normal ‘Non-Chicken-Little’ course of events?

    If that’s the case, you and I part ways after “go outside without a mask”.

    Going outside without a mask is what I do now. It’s what I have done all my life. It’s what I will continue to do.

    That’s because I’m numerate, and I’m not an 80 year old with chronic lung or heart disease.

    Even my irrational fear of dying ironically doesn’t give the corona nothingburger enough excess risk to worry about – coz I’m not famous either.

    • Replies: @utu
    Nobody cares what is your level of fear of dying or how numerate you are or how old you are (btw, you are 55, aren't you?). You should wear a mask so you do reduce chances of infecting others, so you do not cause discomfort and anxiety in others.
  100. @Reg Cæsar
    The left has been saying for decades, "Do what Sweden does! Do what Sweden does!"

    Now Donald Trump is doing, or proposing doing, what Sweden is doing. And everybody wants his head.

    “The left has been saying for decades, “Do what Sweden does! Do what Sweden does!””

    Reg Cæsar, that’s a great observation. Does the left ever say Do what Wyoming does?

    F5CC9D29-67CB-4C8A-9406-2D67B22D81AF

    9D6969A4-2A26-4794-8C10-7CD9C88D9567
    CB2799F9-14E2-4C7C-9243-780A5512DDBA
    2387B73A-590E-4913-880D-C9CBA012DECB

  101. @Mr. Anon

    .............who got a significant following among the skeptic-hoaxer-just-a-flu crowd by providing them with cogent talking points to their liking perpetuates the same mistake.
     
    Hoaxer? You're conflating a whole range of opions with "hoaxer". By the way, aren't you a 911 "truther"? Are you not a "Moon hoaxer"? Now all of a sudden here you are calling out people who deviate from the official line - the narrative profferred by the powers-that-be - with your own little dismissive perjorative.

    I haven't noticed many people here (perhaps not anyone here) calling the coronavirus a hoax. I haven't seen too many people dismiss it as "just the flu". I have seen people say, in effect, this is probably equivalent to the Hong Kong Flu or the Asian Flu. And the World didn't shut itself down and plunge itself into depression for those.

    You are right. I should avoid using triggering terms. W/o them perhaps you would concentrate on what my comment was about instead you just got triggered.

    • Replies: @Mr. Anon
    No, I didn't get triggered. I noticed that which you did not notice yourself, and I simply disagreed with you.
  102. @Kratoklastes

    So why don’t you go outside without a mask, and rub your figners on all surfaces and stick them inside your nose, since there is no cause for concern?
     
    OK Doomer.


    Also...

    Is that your idea of how to behave in the normal 'Non-Chicken-Little' course of events?

    If that's the case, you and I part ways after "go outside without a mask".

    Going outside without a mask is what I do now. It's what I have done all my life. It's what I will continue to do.

    That's because I'm numerate, and I'm not an 80 year old with chronic lung or heart disease.

    Even my irrational fear of dying ironically doesn't give the corona nothingburger enough excess risk to worry about - coz I'm not famous either.

    Nobody cares what is your level of fear of dying or how numerate you are or how old you are (btw, you are 55, aren’t you?). You should wear a mask so you do reduce chances of infecting others, so you do not cause discomfort and anxiety in others.

    • Replies: @Steve Sailer
    Wearing a mask in the near future is like not wearing a mask in the recent past: something you ought to do for other people.
    , @BenKenobi
    And what if I want to cause discomfort and anxiety in others? Specifically the mush-brains doing the Jeb! "please clap" routine every evening at 7pm?
  103. @utu
    Nobody cares what is your level of fear of dying or how numerate you are or how old you are (btw, you are 55, aren't you?). You should wear a mask so you do reduce chances of infecting others, so you do not cause discomfort and anxiety in others.

    Wearing a mask in the near future is like not wearing a mask in the recent past: something you ought to do for other people.

    • Agree: utu
  104. From the NY Times:

    Federal officials acknowledged on Saturday that sloppy laboratory practices at the Centers for Disease Control and Prevention caused contamination that rendered the nation’s first coronavirus tests ineffective.

    Two of the three C.D.C. laboratories in Atlanta that created the coronavirus test kits violated their own manufacturing standards, resulting in the agency sending tests that did not work properly to nearly all of the 100 state and local public health labs, according to the Food and Drug Administration.

    “C.D.C. did not manufacture its test consistent with its own protocol,” Stephanie Caccomo, a spokeswoman for the F.D.A., said in a statement on Saturday.

    Problems ranged from researchers entering and exiting the coronavirus laboratories without changing their coats, to test ingredients being assembled in the same room where researchers were working on positive coronavirus samples, the F.D.A. said. Those practices made the tests sent to public health labs unusable because they were contaminated with the coronavirus, and produced some inconclusive results.

    https://www.nytimes.com/2020/04/18/us/coronavirus-live-news.html?action=click&module=Spotlight&pgtype=Homepage#link-43b7ba3b

    I find myself wondering how many of those involved in this episode were hired to give voice to the otherwise neglected insights of underrepresented populations in science.

  105. @newrouter
    >Test “everyone” in the US:<

    I feel your: fear, panic, delusion, pain and stupidity.

    “I feel your: fear, panic, delusion, pain and stupidity.”

    Newrouter, no doubt there is some truth in your statement; delusion(al) most applicable.

    In any event, I’m really only interested in returning to, as close to possible, what was pre-pandemic. It very well could be that the world overreacted, but it has, and that’s where we are now. The restrictions could all be lifted, and the US/world economies “reopened” tomorrow, but unfortunately without clarity, “full level” participation simply will not return. There would be significant disruption; likely disruption most would not find positive. Certainly employment, at least in a lot of jobs that were, would not resume. It would be a brave new world (perhaps not so brave).

    100% repeated weekly testing over a short period would be a relatively cheap and easy “fix”, compared with the alternative. That alternative being, even with repeated stimulus until exhaustion, I suspect, long term economic malaise at best.

    But if the world were to stop economically spinning, at least Greta Thunberg could find peace.

  106. @Mr McKenna
    We keep seeing bizarre stories like this one.

    Broadway star Nick Cordero to have leg amputated in COVID-19 complication

    Broadway star Nick Cordero, who recently starred in a new production of “Rock of Ages” in Hollywood, is set to have his leg amputated after suffering complications linked to COVID-19.

    The Canadian actor, who has a 10-month-old son with former dancer Amanda Kloots, is due to have his right leg amputated Saturday due to blood clotting in the limb following an infection from the novel coronavirus, Kloots shared on Instagram Saturday.

    https://www.latimes.com/entertainment-arts/business/story/2020-04-18/broadway-star-nick-cordero-to-have-leg-amputated-in-covid-19-complication
     

    What do you (or anyone) make of them? Meaningless noise? Or just a result of being bedridden for so long?

    One of the recent Medcram videos mentioned that ACE-2 plays a role in preventing blood clots and that Sars-cov-2 prevents it from working right.

    Sounds good to me, though i won’t pretend to have known any of this before watching that video.

    Similar thought via a different source:

    COVID-19 enters human cells by attaching to a protein on the cell surface called ACE-2. The pattern of COVID-19 pneumonia on CT scan matches the distribution of ACE-2 in the lungs. ACE-2 is actually an enzyme with strong beneficial effects. When corona virus binds to ACE-2, the protein loses its enzyme activity. In the words of one scientist, COVID-19 produces “ACE-2 exhaustion”. Some scientists believe that ACE-2 exhaustion is responsible for the severity of pneumonia and for catastrophic effects like heart failure, blood clots, and circulatory collapse. Blood vessels are the leading source of ACE-2 in the body, and its depletion has a profound impact on their function. In the brain, ACE-2 has significant neuroprotective effects. I believe that all the clinical manifestations of COVID-19, even the abnormal scarring that occurs (fibrosis), can be traced to ACE-2 destruction by the virus.

    Laboratory studies have shown that restoring ACE-2 dramatically reduces the severity of pneumonia in animals with many types of lung injury, infectious or toxic, including those infected with SARS CoV-1, a close relative of SARS-CoV-2. The resilience of ACE-2 may explain the diversity of responses to corona virus infection. ACE-2 activity is highest in young animals and decreases with age. Conditions associated with death from COVID-19 infection (advanced age, diabetes, high blood pressure, heart disease, kidney disease) are all associated with diminished baseline ACE-2 activity. Men appear to have a greater need for ACE-2 than women. The second phase of COVID-19, the progression from a minor viral illness to severe pneumonia, blood clotting and circulatory problems, may reflect ACE-2 exhaustion, occurring several days after the initial symptoms.

    ( from https://drgalland.com/coronavirus-protection-protocol/ )

    But the blood clots definitely seems to be a recognized finding the past few weeks:
    https://www.statnews.com/2020/04/16/blood-clots-coronavirus-tpa/

    • Replies: @Meretricious
    Yeah the neurological damage stories are among the scariest.

    Seems like these angles are good reasons people shouldn't be quite so complacent.

  107. @Anonymous
    Good thing we have Top Men working on this.

    https://youtu.be/hGmkl0MYzxA

    I am surprised nobody has so far commented on this stupid savage who somehow got to be a leader of our healthcare system,no doubt at a very high salary.
    You can’t tell me they couldnt see what a nutcase she is.
    I bet she have great nails!

  108. @vhrm
    One of the recent Medcram videos mentioned that ACE-2 plays a role in preventing blood clots and that Sars-cov-2 prevents it from working right.

    Sounds good to me, though i won't pretend to have known any of this before watching that video.

    Similar thought via a different source:

    COVID-19 enters human cells by attaching to a protein on the cell surface called ACE-2. The pattern of COVID-19 pneumonia on CT scan matches the distribution of ACE-2 in the lungs. ACE-2 is actually an enzyme with strong beneficial effects. When corona virus binds to ACE-2, the protein loses its enzyme activity. In the words of one scientist, COVID-19 produces “ACE-2 exhaustion”. Some scientists believe that ACE-2 exhaustion is responsible for the severity of pneumonia and for catastrophic effects like heart failure, blood clots, and circulatory collapse. Blood vessels are the leading source of ACE-2 in the body, and its depletion has a profound impact on their function. In the brain, ACE-2 has significant neuroprotective effects. I believe that all the clinical manifestations of COVID-19, even the abnormal scarring that occurs (fibrosis), can be traced to ACE-2 destruction by the virus.

    Laboratory studies have shown that restoring ACE-2 dramatically reduces the severity of pneumonia in animals with many types of lung injury, infectious or toxic, including those infected with SARS CoV-1, a close relative of SARS-CoV-2. The resilience of ACE-2 may explain the diversity of responses to corona virus infection. ACE-2 activity is highest in young animals and decreases with age. Conditions associated with death from COVID-19 infection (advanced age, diabetes, high blood pressure, heart disease, kidney disease) are all associated with diminished baseline ACE-2 activity. Men appear to have a greater need for ACE-2 than women. The second phase of COVID-19, the progression from a minor viral illness to severe pneumonia, blood clotting and circulatory problems, may reflect ACE-2 exhaustion, occurring several days after the initial symptoms.
     
    ( from https://drgalland.com/coronavirus-protection-protocol/ )

    But the blood clots definitely seems to be a recognized finding the past few weeks:
    https://www.statnews.com/2020/04/16/blood-clots-coronavirus-tpa/

    Yeah the neurological damage stories are among the scariest.

    Seems like these angles are good reasons people shouldn’t be quite so complacent.

  109. @Kratoklastes
    Your estimates will change if you re-do everything with
     • age-relevant transition probabilities (i.e., old sick people are outright more susceptible; develop symptoms quicker; and have disease progression that hits harder, earlier); and
     • the assumption that more than half of all 'confirmed' infections in the young (the largest cohort of 'confirmed' infections) are asymptomatic, and almost none of the young die from covid19.

    Given the CF(w)R for people over 75 is of the order of 30% on a 'same date' basis (i.e., using 'cases today' as the denominator for 'deaths today')‚ if lag structure is set up as age-agnostic numbers suggest, the system runs into problems.

    Take the April 17 deaths for NYC.

    There were 287 deaths of people aged 75 and over (NY's data still apparently still requires a positive lab test - at least that's what's shown at the top of each day's NYC Daily Death Summary for April 15 2020.

    Go back 27 days and fetch the 'confirmed cases' data for NYC for March 21st: there were only 390 cases in the 65+ group (until March 21, NYC was ending the relevant age cohorts at 65).

    But this was notionally the day these fogies got infected... they wouldn't show symptoms until incubation was finished.

    Five days later on the 26th (assuming that 75+ people start to show symptoms at the median incubation period) there were only 302 new confirmed cases among the 75+ group - so we're 15 deaths to the good... we can have <100% mortality and a 22-day look-back. In fact, the last week's worth of deaths is only 73% of the total cases up to March 26th.

    If you do this consistently - that the deaths have to come from new cases 22 days ago - it paints a terrible picture: a tad under ¾ of infected in the age group, 75+ die.

    What's missing? All of the 75+ cases since March 26th.

    Using the 22-day-lookback, results in a gigantic - and still-growing - pool of old infected waiting to die. That's not observed.

    Currently it would be all 75+ cases after March 26th. 12,868.

    So 73% of them will cark it over the next 22 days. That's 9,429 old people - which is almost 2.3 times the current cumulative total number of deaths in that age group.

    That's the thing that shows that the cases-wide dynamics are a bad choice.

    It's also why your proposed 'go back 22 days; count all cases; divide by assumed IFR' isn't a good idea.

    .

    This is why the putative "death-date-to-infection-date-matching" idea is a really bad idea if age-agnostic parameters are used - it biases the look-back period upwards (and therefore, for a given IFR, it overstates 'undiscovered' cases).

    I've used "75+" people as a cohort as if it doesn't have a natural internal partition - but of course it does... 75+ers with chronic illness - who die even faster than 75+ without. NYC's data doesn't have case comorbidity data; it has death

    Given that CFR has such a distinct age-cohort pattern, and is so strongly influenced by key relevant chronic illness, it would be weird to assume that susceptibility (and other transmission probabilities) aren't also different.

    .

    The thing is best modelled with age-group-specific dynamics - where the older age groups (and particularly the chronically-ill older people) take less than a week from symptoms to death or recovery. There's still a very high IFR in their age cohort, but correspondingly much much lower than 0.5 for the other age cohorts.

    I've spent a couple of days doing a half-assed search of the literature, and this seriously seems to be something that has had almost no real attention - I guess because this is the first real pandemic where the death-by-age is so tilted towards one end of the age distribution.

    If I was 15 years younger I would be eagerly writing up something with a view to submitting it to an open journal.

    As it is I'll do a half-assed writeup and stick it on a blog - there's no incentive to do more, because covid19's about to be dropped from media coverage.

    PandemicTV is pretty much done for 2020, and the next few weeks will be politicians doing victory laps and crowing that they saved humanity... and in 3 months there might be a 3 paragraph story in some inside page, discussing a recent inexplicable spike in suicides.

    I’ve learned to stop worrying and love the germ.

  110. @Mr. Anon

    .............who got a significant following among the skeptic-hoaxer-just-a-flu crowd by providing them with cogent talking points to their liking perpetuates the same mistake.
     
    Hoaxer? You're conflating a whole range of opions with "hoaxer". By the way, aren't you a 911 "truther"? Are you not a "Moon hoaxer"? Now all of a sudden here you are calling out people who deviate from the official line - the narrative profferred by the powers-that-be - with your own little dismissive perjorative.

    I haven't noticed many people here (perhaps not anyone here) calling the coronavirus a hoax. I haven't seen too many people dismiss it as "just the flu". I have seen people say, in effect, this is probably equivalent to the Hong Kong Flu or the Asian Flu. And the World didn't shut itself down and plunge itself into depression for those.

    Is he really a moon-landing hoaxer?

    I really need to keep track better.

    Is there a master list somewhere?

  111. @Lot
    There’s some evidence taking zinc above what you’d get in a normal diet is dangerous. Eating silver will turn your skin a deathly shade of blue permanently, as the Blue Libertarian found out.

    http://www.cbsnews.com/images/2002/10/03/image524282x.jpg

    The unregulated supplement industry funds the “studies” of these things, and nobody has the incentive to spend a lot of money debunking them.

    Eating silver will turn your skin a deathly shade of blue permanently,

    Libertarian Stan Jones got off relatively lightly.

    • Replies: @Mr. Anon

    Libertarian Stan Jones got off relatively lightly.
     
    Cue the speech from Braveheart:

    "...........they'll never take our FREEDOM!!!!"


    https://i.pinimg.com/originals/02/f3/dc/02f3dcd3e83315432c146034235efafa.jpg

    , @Hippopotamusdrome
    http://resources2.news.com.au/images/2008/06/12/va1237313220190/Papa-Smurf-6088583.jpg
  112. @utu
    "Everyone needs to remember that “flatten the curve” wasn’t about saving people from the virus. " - Nonsense. The area under the flattened curve is smaller than under the curve of the unconstrained epidemic running at its natural R0. When the concept of herd immunity was introduced to the general public the curves used to illustrate it mislead many people as the areas under both curves appeared to be equal. It is unfortunate that Knut Wittkowski, who got a significant following among the skeptic-hoaxer-just-a-flu crowd by providing them with cogent talking points to their liking perpetuates the same mistake. Wittkowski knows better, yet he does not rectify this error. For the skeptic-hoaxer-just-a-flu crowd the belief that the countermeasure won't change the ultimate death count is their most powerful argument. They know that this argument has a better chance of getting traction than "who cares if old people die" argument to which they are naturally inclined.

    well, no slide ever shown by the CDC had a smaller area under the curve. Neither did the imperial College model.

    Re: we really think “who cares if old people die”: the lockdown isn’t saving the old people in my state. Are you sure it is in your state? there’s an assumption “think of how much worse without lockdown”, but it’s a non sequitur.

    The old people dying are in nursing homes. They were already under de facto lockdown before the virus was sequenced. most nursing homes in my state had closed off visitors by March 1. March 13 began the voluntary lockdown, and my state’s involuntary one came March 27. So why are they dying? How is the movie theatre and swingset and little league field being closed affecting killing or saving great granny?

    The evidence is mounting that infection is largely nosocomial and intrafamilial. You get it in close quarters, and the lockdowns made more close quarters, not fewer. Mass transit in NYC metro is of course also close quarters for long stretches of timez and NY never closed subways.

    And in my state, they’ve done nothing to save the nursing home folks The governor didn’t even require nursing home staff to wear masks til April 13, literally a month after CDC social distancing and 2 weeks after STAY AT HOME order in my state closed all gathering over 10 people, and closed every state park, beach, and playground.

    So you may believe the numbers if dead would skyrocket if lockdown removed, but it asserts facts not in evidence.

    • Replies: @Big Dick Bandit
    the 'close quarters' thing is likely true, but everything we know about some of the superspreader events (like Georgia, and South Korea) indicates that church services, funeral gatherings, and restaurants are still very fertile ground--not just hospitals and nursing homes.
    , @utu
    "no slide ever shown by the CDC had a smaller area under the curve. Neither did the imperial College model." - It was an unfortunate mistake. Those who prepared the slides did not realize that some people would take them literary not just an illustration of the concept and then draw a false conclusion that flattening the curve does not change the total number of deaths.
  113. @Mr McKenna
    We have a frequent contributor here like you--her name is Alden. Since she has found a couple of people here who say things she doesn't like, she's on an endless rampage against "The Men of Unz" who (according to her) represent 100% of the readership and cause pretty much all of the evil in the world. Perhaps you two should meet some time. You could get a room by the hour, that sort of thing.

    Lol, ever since she mentioned she had during her working life imprisoned hundreds if not thousands of negros, I’ve thought Alden is alright.

  114. @Lot
    A third of the 200 people on the street randomly tested for CV antibodies had them in Chelsea, Mass.

    https://www.bostonglobe.com/2020/04/17/business/nearly-third-200-blood-samples-taken-chelsea-show-exposure-coronavirus/

    None who tested positive had severe symptoms, and half had had 1 symptom in the past month, which sounds completely normal late March in a cold climate.

    The biggest winner from the Wuhan Depression:

    https://thenypost.files.wordpress.com/2019/03/jeff-bezos-amazon.jpg

    Cancel your prime membership!

    None who tested positive had severe symptoms, and half had had 1 symptom in the past month, which sounds completely normal late March in a cold climate.

    Actually Lot it’s yet another rebuke of the “it’s just the flu, bro” deniers:

    Chelsea:
    — 40,000 people
    — 39 deaths so far
    So they are already at 0.1% IFR … even if entire population was infected.

    But this “quasi random” sampling suggests only about 1/3. So they are at 0.3%. And no doubt some more of the currently infected will die as well. So expect this to tick up a bit.

    Pretty much the same result as the study in hard hit Gangelt where they found 16% infected and a 0.37% IFR.

    Contra deniers, everyone has not yet been “infected” or “exposed”. The reaction has pushed down transmission–of everything else too, as we’ve seen flu cases drop. Where a lot of people have been exposed, we get a lot of dead people, several times the normal monthly rate, greater than any recent flu season peaks.

    The data keep pointing in the same direction they have from the beginning:
    — at least half asymptomatic or very mild cases, most of the rest “bad flu”
    — < 1% real IFR — probably will converge 0.3-0.7% for American age distribution
    (not the ridiculous numbers the hysterics get by dividing deaths by "cases"–many more infected are out there)
    — 10-50X more lethal as "the flu"
    — kills primarily the old and sick; very low mortality for young and healthy–only issue is mega-dose and cytokine storm;
    — definitely *not* anything like the Spanish Flu which scythed through young men in armies
    — not any sort of "threat to civilization" mostly just an "early harvest" of us old guys

    ~~

    The other thing of note with Chelsea:

    A rebuke to the "global cosmopolitans" who–as part of stripping Americans of our birthright–want to pack us in like sardines.

    Turns out the countryside or even American style suburbia is much more robust.

    Dense crowded cities turn out to be susceptible to epidemic disease–now who could possibly have imagined that?

    • Agree: Lot
    • Thanks: Big Dick Bandit
    • Replies: @Big Dick Bandit
    this sounds about right to me.

    given Italy and New York, it's clear that this isn't "just the flu"; however, if the Boston/Santa Clara findings are even *remotely* credible (they've been impugned quite a bit, but like, even in the REALM of accurate) then the 'true' Fatality Rate clearly isn't quite as bad as it seemed was possible either.

    if this settles at a .7% IFR (or something close), will people think that lockdowns were worth it? were they?

    i don't know. i've been of the mind that distancing was necessary because this thing clearly isn't just the flu, and clearly is very contagious....at .7% or whatever, and primarily concentrated on the olds, it feels like maybe a strategy of turtling up all the 65+ and letting everybody else do their thing within some reason would have been better.

    could be wrong.
    , @Bill P
    It's probably going to end up a little higher than seasonal influenza, but not much. The infection fatality rate drops over time because the most vulnerable die early. So when Gangelt reaches 50% infected, the death rate will end up being something like 0.2%.

    That's where Chelsea will end up, too. If one third have already been infected, then they've almost reached herd immunity and there should be very few additional deaths.
  115. @Anon
    OT South Florida Sun Sentinel, 04/18/20 - Tua Tagovailoa had lowest Wonderlic score among 2020 QB prospects

    https://www.sun-sentinel.com/sports/miami-dolphins/fl-sp-tua-tagovailoa-wonderlic-20200418-swoxmkth4zaplktnpxhw27khwq-story.html

    The Athletic’s Bob McGinn reports that ex-Alabama star quarterback Tua Tagovailoa scored a woeful 13 on the Wonderlic test, administered by the NFL to draft prospects before the draft.

    Among the other first-round prospects, McGinn reported that LSU’s Jake Burrow scored a 34, Utah State’s Jordan Love got a 27 and Oregon’s Justin Herbert had a 25. The highest reported score among the 2020 quarterback draft prospects was a 40 by Iowa’s Nate Stanley.

    Current Dolphins starting quarterback Ryan Fitzpatrick’s 48 (number of correct answers out of 50 questions) is reportedly tied for the third-best all-time (Fitzpatrick’s fellow Harvard alum Pat McInally, a Bengals punter from 1976-85, owns the lone perfect score).

    Quarterbacks have brushed off a low Wonderlic to star in the league. Dolphins Hall of Famer Dan Marino’s score in 1983 was widely reported to be a 16, and Ravens defending NFL Most Valuable Player Lamar Jackson was reported to have the same score as Tagovailoa two years ago.
     

    I get the impression Marino, knowing his own value, just didn’t take the test all that seriously.

  116. @Alice
    Actually, it seems like the ventilators will killing them.

    ER docs are not scientists. They aren't diagnosticians, and they don't even take the advice of their fellow specialists who often say things like "it's not necessary to hospitalize for these issues.". They sure aren't House, MD.

    They do the things they do that keep you from dying in their ER. so they intervene-- they give you an IV. Why? in case you need fluids. (huh? what?) Your oxygen dropping? they ventilate you. (huh? what?)

    but since the issue was oxygen uptake in hemoglobin, it was the wrong treatment...

    but since the issue was oxygen uptake in hemoglobin, it was the wrong treatment…

    I’ve see lots of comments here that imply SARS Cov2 is harming red blood cells, like you seem to imply. From what I understand as a Respiratory Therapist the Covid-19 can cause diffuse interstitial pneumonia- at least that is the proximal cause of death in all the cases. It’s been hypothesized that SARS-Cov2 attacks the blood/gas membrane in the alveolus through ACE receptors. This is the pathway of previous SARS apparently. The destruction of the lung/blood membrane results in poor oxygen transfer from lung to blood.

    [MORE]

    You can treat this with supplemental oxygen, positive pressure ventilation, or ECMO. The prognosis in such cases is *never* very good, regardless what caused the problem initially.

    Others have been arguing here that artificial ventilation is causing deaths. They point to stories about people avoiding ventilators by laying on their stomachs and receiving supplemental oxygen. That may be a decent early intervention but when someone starts exhausting of breathing because it is so hard and their CO2 is rising, the only treatment is the vent.

    In summary: Hypoxia in Covid-19 can be explained by causes not related to anemia and ventilators aren’t causing premature deaths.

    Generally speaking, ICU’s in the US handle respiratory failure very well because of all the smoking induced diseases they regularly deal with.

  117. @danand

    "Let’s keep healthy people isolated longer, so we don’t get herd immunity!"
     
    Herd immunity will not happen until many people you know, or you, are dead. Even if it were possible, immunity may last only one "flu" season, or until next mutation. 100% testing, or near, is the only "safe" way to "re-open the economy". By safe I mean a place where most people feel it's OK for them to resume their pre SARS-CoV-2 lifestyle. Even if one doesn't feel at risk for death, getting "deathly Ill" will cause more than a little pause. Hesitant to even say resume because given the shock, seems near impossible the US will see another + $20 Trillion GDP print any year soon.

    Even going with about the most expensive currently available testing regime, performed via the Abbott ID NOW™ 15 minute routine, would not the “cost” be roughly 1/10 the lower end of what many figure to be the eventual cost for the US's “economic bailout”.

    Test "everyone" in the US:

    $10,000 Abbott ID NOW™ (part #NAT-024), 1 per 100 persons. I know it's overkill, but things break, and the're the relatively cheap part of the equation; make them ubiquitous, the machines could be located at every local library (12K), school (150K), McDonald's (14K), gas station (170K), etc... across the USA = $33,500,000,000 ($34B)

    $98 single use test kits - 335,000,000 persons in the USofA times 6 tests each. (1 test administered every week, for 6 weeks, for every person). Total test kit cost for 6 weeks would be $196,980,000,000 ($200B)

    $100 (estimated) - administration/labor cost of a single test. 6 tests times 335M people would run $201,000,000,000 ($200B)‬

    Everyone in USA 15 minute tested 6 consecutive weeks to effectively extinguish Covic-19 at a cost of $450 Billion, roughly half what Austin Powers would ask.

    The economy could be opened right now, with initial/1st week test round; as that would catch a majority of the infected right off the bat.

    After 6 consecutive weeks of testing, even given an individual test was only ~80% accurate and that not all infected would quarantine, the USA would be Covid-19 extinguished. At least until the next possible wave(s) comes in: Covid-21, Covid-22, Covid-23...

    BTW - China is still locked down province by province. There is extremely limited travel between them. (A distant associate who lives just outside Shanghai has been "stuck" in Wuhan province year to date.)

    masks are more important than testing. The vast majority of those with CV will never bother getting tested, since they have mild symptoms and are being told to stay home and not seek treatment.

    Priority #1 -We need to produce more masks , so American who seeks a mask can obtain one.

    Priority #2 is testing people for antibodies. This is more important at this stage of the outbreak than testing for the CV virus.

    Priority #3 is producing enough hydrochloroquine to treat the sick and allow doctors to subscribe HCQ to patients. Currently this treatment is still banned by the governor of New York. And HCQ is unavailable at most pharmacies today, due to shortages.

  118. @AnotherDad


    None who tested positive had severe symptoms, and half had had 1 symptom in the past month, which sounds completely normal late March in a cold climate.
     
    Actually Lot it's yet another rebuke of the "it's just the flu, bro" deniers:

    Chelsea:
    -- 40,000 people
    -- 39 deaths so far
    So they are already at 0.1% IFR ... even if entire population was infected.

    But this "quasi random" sampling suggests only about 1/3. So they are at 0.3%. And no doubt some more of the currently infected will die as well. So expect this to tick up a bit.

    Pretty much the same result as the study in hard hit Gangelt where they found 16% infected and a 0.37% IFR.

    Contra deniers, everyone has not yet been "infected" or "exposed". The reaction has pushed down transmission--of everything else too, as we've seen flu cases drop. Where a lot of people have been exposed, we get a lot of dead people, several times the normal monthly rate, greater than any recent flu season peaks.

    The data keep pointing in the same direction they have from the beginning:
    -- at least half asymptomatic or very mild cases, most of the rest "bad flu"
    -- < 1% real IFR -- probably will converge 0.3-0.7% for American age distribution
    (not the ridiculous numbers the hysterics get by dividing deaths by "cases"--many more infected are out there)
    -- 10-50X more lethal as "the flu"
    -- kills primarily the old and sick; very low mortality for young and healthy--only issue is mega-dose and cytokine storm;
    -- definitely *not* anything like the Spanish Flu which scythed through young men in armies
    -- not any sort of "threat to civilization" mostly just an "early harvest" of us old guys

    ~~

    The other thing of note with Chelsea:

    A rebuke to the "global cosmopolitans" who--as part of stripping Americans of our birthright--want to pack us in like sardines.
    https://www.amazon.in/One-Billion-Americans-Thinking-Bigger/dp/0593190211

    Turns out the countryside or even American style suburbia is much more robust.

    Dense crowded cities turn out to be susceptible to epidemic disease--now who could possibly have imagined that?

    this sounds about right to me.

    given Italy and New York, it’s clear that this isn’t “just the flu”; however, if the Boston/Santa Clara findings are even *remotely* credible (they’ve been impugned quite a bit, but like, even in the REALM of accurate) then the ‘true’ Fatality Rate clearly isn’t quite as bad as it seemed was possible either.

    if this settles at a .7% IFR (or something close), will people think that lockdowns were worth it? were they?

    i don’t know. i’ve been of the mind that distancing was necessary because this thing clearly isn’t just the flu, and clearly is very contagious….at .7% or whatever, and primarily concentrated on the olds, it feels like maybe a strategy of turtling up all the 65+ and letting everybody else do their thing within some reason would have been better.

    could be wrong.

  119. @Boomer
    The New York Times had a library of health articles about the epidemic of uncontrolled Type 2 Diabetes, HBP and obesity among the Black, Puerto Rican and Dominican population in the city back a few years ago which they made available to nonsubscribers. It's a multigenerational problem with fathers and sons getting kidney disease, losing eyesight, and having feet and legs amputated. The amazing thing was that in addition to being unable to change their diet or lifestyle they were not taking their medications. One of the proposed solutions was using community groups to hire people to knock on doors to remind them to take their meds. Medicaid and Obamacare are free or highly subsidized for the low or moderate-income. The developing narrative is that systemic racism and lack of healthcare are responsible. We need to know who is actually succumbing to the virus.

    . The developing narrative is that systemic racism and lack of healthcare are responsible.

    Blacks have less lung volume than whites. That’s an anatomical fact no physician would dispute. Not sure how that would increase Covid-19 morbidity in blacks though.

  120. @Reg Cæsar

    The daughters certainly worked out well.
     
    Grandpa ran on George Wallace's party line in 1972. He outpolled McGovern in parts of Idaho:


    https://en.m.wikipedia.org/wiki/John_G._Schmitz


    East of the Rockies, his best performance was in the Florida Parishes of Louisiana.

    https://en.m.wikipedia.org/wiki/John_G._Schmitz

    LOL. I’d never read this bit of trivia before. I’m sure it “explains it” somehow.

    • Replies: @Reg Cæsar
    Schmitz is a good argument for policing your own side as well as the other.
  121. @PiltdownMan
    That's reassuring to hear, and wonderful news in your family. Best wishes to your aunt, and all in your family.

    Thank you. I’m sharing the story because I felt like there was no hope when I first heard her diagnosis. I wanted others to know it is not a death sentence even for the elderly.

  122. @Mike_from_SGV
    Great news, blessings to your extended family.

    Thank you!

  123. @Kaz
    What's going on in Italy and Spain?

    Are there healthcare systems that bad compared to ours?

    Maybe their healthcare systems have, instead, been THAT good – i.e. they have kept a very aged population alive with numerous comorbidities. If Italy hadn’t had so many old and sick people it would not have had so many people die from Coronavirus.

  124. Hail says: • Website
    @Mr. Anon

    .............who got a significant following among the skeptic-hoaxer-just-a-flu crowd by providing them with cogent talking points to their liking perpetuates the same mistake.
     
    Hoaxer? You're conflating a whole range of opions with "hoaxer". By the way, aren't you a 911 "truther"? Are you not a "Moon hoaxer"? Now all of a sudden here you are calling out people who deviate from the official line - the narrative profferred by the powers-that-be - with your own little dismissive perjorative.

    I haven't noticed many people here (perhaps not anyone here) calling the coronavirus a hoax. I haven't seen too many people dismiss it as "just the flu". I have seen people say, in effect, this is probably equivalent to the Hong Kong Flu or the Asian Flu. And the World didn't shut itself down and plunge itself into depression for those.

    I haven’t seen too many people dismiss it as “just the flu”

    It’s unclear what people understand that term to mean. It sounds like it started as a Twitter troll term, and has been used in the US far more by supporters of the Panic for the past ca. five weeks, in the era of the media waving corona-bodies at us nonstop and creating their own self-reinforcing CoronaNarrative.

    But ‘the flu’ is, and always has been, potentially very serious for the weakest, say, 1% or somesuch among us (and for a few flukes among the other 99%). If a fifth of those at risk get it in a year, one tenth of those might die (total: 0.02% flu deaths), even with treatment, who otherwise wouldn’t die in the near-term. Sometimes more, sometimes less. Maybe this time it’s “more.” Incidentally, these are still very low numbers in historical terms; see here.

    Maybe this time it’s “more.”

    What we have always wanted to know is data on how much worse this strain is than other flu strains. Not partial data, not somebody’s worst-case-scenario projections; not Scary Big Contextless Numbers.

    The concept of the Null Hypothesis is our friend here. Austrian researchers have now found they cannot reject the null hypothesis that corona-positive deaths are any different than corona-negative deaths, in other words the people dying are of such advanced age and health condition to begin with that one’s chances of dying may be the same. If that finding is valud, it is not a sure bet at all that coronavirus is a major threat. At least that applies to Austria, which has a sample of hundreds of corona-positive deaths.

    “Just the Flu” is not as unreasonable as it sounds.

    • Replies: @AnotherDad

    The concept of the Null Hypothesis is our friend here. Austrian researchers have now found they cannot reject the null hypothesis that corona-positive deaths are any different than corona-negative deaths,
     
    From your comment:

    Hail:


    They were unable to reject the null-hypothesis that a given corona-positive person’s risk of death is the same as the corona-negative risk of death.
     
    Austrian Medical Stats guys:

    “The risk of dying from COVID19 is basically proportionate to the risk of normal death risk for one’s respective age group,”
     
    Hail, "proportionate to" and "same as" are not remotely the same thing.

    It's very clear for at least a couple months now (for me, others probably earlier) that the risk profile for those dying from covid-19 is pretty similar to the risk profile of dying period. It's actually *more* skewed toward the old and sick. (Ordinary death does happen to kids and is basically non-existent here.)

    That's all those guys are saying. "Hey it's the same profile of people" They state explicitly that as a result it's pretty hard to say how many years of life are lost.

    That is not remotely the same as the risk does not exist or is zero. Basically this appears to be on the order of maybe 4 months to a year's harvest of "harvestable" people. But it could have been 1 month--i.e. "really bad flu year" or ten years--mayhem!--in the same proportion.
  125. @utu
    "Everyone needs to remember that “flatten the curve” wasn’t about saving people from the virus. " - Nonsense. The area under the flattened curve is smaller than under the curve of the unconstrained epidemic running at its natural R0. When the concept of herd immunity was introduced to the general public the curves used to illustrate it mislead many people as the areas under both curves appeared to be equal. It is unfortunate that Knut Wittkowski, who got a significant following among the skeptic-hoaxer-just-a-flu crowd by providing them with cogent talking points to their liking perpetuates the same mistake. Wittkowski knows better, yet he does not rectify this error. For the skeptic-hoaxer-just-a-flu crowd the belief that the countermeasure won't change the ultimate death count is their most powerful argument. They know that this argument has a better chance of getting traction than "who cares if old people die" argument to which they are naturally inclined.

    Nonsense.

    It’s not nonsense. Take a quick refresher in recent history and look again at the charts used and rationale given. That’s exactly what was sold to the public–mass infections creating the need for mass hospitalizations leading to the collapse of the hospital system resulting in excess deaths.

    When the concept of herd immunity was introduced to the general public the curves used to illustrate it mislead many people as the areas under both curves appeared to be equal.

    Maybe you’re British? Herd immunity was not a selling point to lock-downs, or any strategy absent vaccines, in America. As little as a week ago Fauci was still talking about targeted lock-downs throughout the fall until a vaccine was found. You wouldn’t need vaccines if the population acquired herd immunity by letting the infection spread.

    So, what I wrote is exactly (“precisely” as you Brits might say) right. If you think the lock-downs provided some benefit, feel free to discuss. I don’t doubt that they have had some marginal effect. Then we can get into the discussion on whether it was worth it or not. But the original rationale, in America, was 100’s of thousands of people not being able to get medical treatment and then dying unnecessarily. (Remember the ventilators?). Never happened.

    • Replies: @utu
    The area under the flattened curve is smaller than under the curve of the unconstrained epidemic running at its natural R0. That it was not apparent in the slides used to illustrate the concept of the flattening the curve when it was being introduced to the general public was very unfortunate as many people, like yourself, took what was just a conceptual illustration literary and drew a false conclusion that flattening the curve does not reduce the total number of deaths and the only reason it being done was to reduce the excess deaths due to the medical system overload.
  126. @utu
    Nobody cares what is your level of fear of dying or how numerate you are or how old you are (btw, you are 55, aren't you?). You should wear a mask so you do reduce chances of infecting others, so you do not cause discomfort and anxiety in others.

    And what if I want to cause discomfort and anxiety in others? Specifically the mush-brains doing the Jeb! “please clap” routine every evening at 7pm?

  127. @Justvisiting

    Hospitals never overflowed, and most never came close.
     
    You may turn out to be correct, but the Gods tend to be very unkind to those who celebrate before the game is over.

    I’m not celebrating, nor feel a need to. There just aren’t any winners here–not by the people affected by the virus or the much larger people affected by the resulting political and economic fallout. The lack of any concern or consideration of the latter has been my focus the majority of the time. Seeing how the gods haven’t seen fit to save that latter group in-spite of guys like DeBlasio’s hubris, I doubt my minor indiscretion of having a good laugh at the ineptitude of the UWash’s models will severely alter our cosmic fate.

  128. @Kratoklastes
    Your estimates will change if you re-do everything with
     • age-relevant transition probabilities (i.e., old sick people are outright more susceptible; develop symptoms quicker; and have disease progression that hits harder, earlier); and
     • the assumption that more than half of all 'confirmed' infections in the young (the largest cohort of 'confirmed' infections) are asymptomatic, and almost none of the young die from covid19.

    Given the CF(w)R for people over 75 is of the order of 30% on a 'same date' basis (i.e., using 'cases today' as the denominator for 'deaths today')‚ if lag structure is set up as age-agnostic numbers suggest, the system runs into problems.

    Take the April 17 deaths for NYC.

    There were 287 deaths of people aged 75 and over (NY's data still apparently still requires a positive lab test - at least that's what's shown at the top of each day's NYC Daily Death Summary for April 15 2020.

    Go back 27 days and fetch the 'confirmed cases' data for NYC for March 21st: there were only 390 cases in the 65+ group (until March 21, NYC was ending the relevant age cohorts at 65).

    But this was notionally the day these fogies got infected... they wouldn't show symptoms until incubation was finished.

    Five days later on the 26th (assuming that 75+ people start to show symptoms at the median incubation period) there were only 302 new confirmed cases among the 75+ group - so we're 15 deaths to the good... we can have <100% mortality and a 22-day look-back. In fact, the last week's worth of deaths is only 73% of the total cases up to March 26th.

    If you do this consistently - that the deaths have to come from new cases 22 days ago - it paints a terrible picture: a tad under ¾ of infected in the age group, 75+ die.

    What's missing? All of the 75+ cases since March 26th.

    Using the 22-day-lookback, results in a gigantic - and still-growing - pool of old infected waiting to die. That's not observed.

    Currently it would be all 75+ cases after March 26th. 12,868.

    So 73% of them will cark it over the next 22 days. That's 9,429 old people - which is almost 2.3 times the current cumulative total number of deaths in that age group.

    That's the thing that shows that the cases-wide dynamics are a bad choice.

    It's also why your proposed 'go back 22 days; count all cases; divide by assumed IFR' isn't a good idea.

    .

    This is why the putative "death-date-to-infection-date-matching" idea is a really bad idea if age-agnostic parameters are used - it biases the look-back period upwards (and therefore, for a given IFR, it overstates 'undiscovered' cases).

    I've used "75+" people as a cohort as if it doesn't have a natural internal partition - but of course it does... 75+ers with chronic illness - who die even faster than 75+ without. NYC's data doesn't have case comorbidity data; it has death

    Given that CFR has such a distinct age-cohort pattern, and is so strongly influenced by key relevant chronic illness, it would be weird to assume that susceptibility (and other transmission probabilities) aren't also different.

    .

    The thing is best modelled with age-group-specific dynamics - where the older age groups (and particularly the chronically-ill older people) take less than a week from symptoms to death or recovery. There's still a very high IFR in their age cohort, but correspondingly much much lower than 0.5 for the other age cohorts.

    I've spent a couple of days doing a half-assed search of the literature, and this seriously seems to be something that has had almost no real attention - I guess because this is the first real pandemic where the death-by-age is so tilted towards one end of the age distribution.

    If I was 15 years younger I would be eagerly writing up something with a view to submitting it to an open journal.

    As it is I'll do a half-assed writeup and stick it on a blog - there's no incentive to do more, because covid19's about to be dropped from media coverage.

    PandemicTV is pretty much done for 2020, and the next few weeks will be politicians doing victory laps and crowing that they saved humanity... and in 3 months there might be a 3 paragraph story in some inside page, discussing a recent inexplicable spike in suicides.

    “PandemicTV is pretty much done for 2020, and the next few weeks will be politicians doing victory laps and crowing that they saved humanity…”

    TV is unwatchable now, especially the sanctimonious ads of heroic TP manufacturers and heroic car dealerships and heroic pizza slingers all vowing NO ICKY HUMAN EVER touched the merch before it was delivered to your diseased, fragile little fingers. It’s worse than after 9/11.

    The weeks-long onanastic public self-stroking by Democratic governors, the President, Dr. Poochy and Dr. Scarfy will be nauseating to anyone rocking an IQ supra 95. Summer can’t get here soon enough.

  129. Treating Covid like cancer wasn’t a good idea. With cancer, it’s ideal to try to kill it as much as possible. With Covid, it’s pragmatic to learn to live with it.

    Doing national chemo on a flu-virus isn’t sensible.

  130. @Kratoklastes
    Your estimates will change if you re-do everything with
     • age-relevant transition probabilities (i.e., old sick people are outright more susceptible; develop symptoms quicker; and have disease progression that hits harder, earlier); and
     • the assumption that more than half of all 'confirmed' infections in the young (the largest cohort of 'confirmed' infections) are asymptomatic, and almost none of the young die from covid19.

    Given the CF(w)R for people over 75 is of the order of 30% on a 'same date' basis (i.e., using 'cases today' as the denominator for 'deaths today')‚ if lag structure is set up as age-agnostic numbers suggest, the system runs into problems.

    Take the April 17 deaths for NYC.

    There were 287 deaths of people aged 75 and over (NY's data still apparently still requires a positive lab test - at least that's what's shown at the top of each day's NYC Daily Death Summary for April 15 2020.

    Go back 27 days and fetch the 'confirmed cases' data for NYC for March 21st: there were only 390 cases in the 65+ group (until March 21, NYC was ending the relevant age cohorts at 65).

    But this was notionally the day these fogies got infected... they wouldn't show symptoms until incubation was finished.

    Five days later on the 26th (assuming that 75+ people start to show symptoms at the median incubation period) there were only 302 new confirmed cases among the 75+ group - so we're 15 deaths to the good... we can have <100% mortality and a 22-day look-back. In fact, the last week's worth of deaths is only 73% of the total cases up to March 26th.

    If you do this consistently - that the deaths have to come from new cases 22 days ago - it paints a terrible picture: a tad under ¾ of infected in the age group, 75+ die.

    What's missing? All of the 75+ cases since March 26th.

    Using the 22-day-lookback, results in a gigantic - and still-growing - pool of old infected waiting to die. That's not observed.

    Currently it would be all 75+ cases after March 26th. 12,868.

    So 73% of them will cark it over the next 22 days. That's 9,429 old people - which is almost 2.3 times the current cumulative total number of deaths in that age group.

    That's the thing that shows that the cases-wide dynamics are a bad choice.

    It's also why your proposed 'go back 22 days; count all cases; divide by assumed IFR' isn't a good idea.

    .

    This is why the putative "death-date-to-infection-date-matching" idea is a really bad idea if age-agnostic parameters are used - it biases the look-back period upwards (and therefore, for a given IFR, it overstates 'undiscovered' cases).

    I've used "75+" people as a cohort as if it doesn't have a natural internal partition - but of course it does... 75+ers with chronic illness - who die even faster than 75+ without. NYC's data doesn't have case comorbidity data; it has death

    Given that CFR has such a distinct age-cohort pattern, and is so strongly influenced by key relevant chronic illness, it would be weird to assume that susceptibility (and other transmission probabilities) aren't also different.

    .

    The thing is best modelled with age-group-specific dynamics - where the older age groups (and particularly the chronically-ill older people) take less than a week from symptoms to death or recovery. There's still a very high IFR in their age cohort, but correspondingly much much lower than 0.5 for the other age cohorts.

    I've spent a couple of days doing a half-assed search of the literature, and this seriously seems to be something that has had almost no real attention - I guess because this is the first real pandemic where the death-by-age is so tilted towards one end of the age distribution.

    If I was 15 years younger I would be eagerly writing up something with a view to submitting it to an open journal.

    As it is I'll do a half-assed writeup and stick it on a blog - there's no incentive to do more, because covid19's about to be dropped from media coverage.

    PandemicTV is pretty much done for 2020, and the next few weeks will be politicians doing victory laps and crowing that they saved humanity... and in 3 months there might be a 3 paragraph story in some inside page, discussing a recent inexplicable spike in suicides.

    This is why the putative “death-date-to-infection-date-matching” idea is a really bad idea if age-agnostic parameters are used – it biases the look-back period upwards (and therefore, for a given IFR, it overstates ‘undiscovered’ cases).

    I’ve used “75+” people as a cohort as if it doesn’t have a natural internal partition – but of course it does… 75+ers with chronic illness – who die even faster than 75+ without. NYC’s data doesn’t have case comorbidity data; it has death

    Given that CFR has such a distinct age-cohort pattern, and is so strongly influenced by key relevant chronic illness, it would be weird to assume that susceptibility (and other transmission probabilities) aren’t also different.

    .

    The thing is best modelled with age-group-specific dynamics – where the older age groups (and particularly the chronically-ill older people) take less than a week from symptoms to death or recovery. There’s still a very high IFR in their age cohort, but correspondingly much much lower than 0.5 for the other age cohorts.

    That makes sense. The question is: how big a difference does it make? I don’t think anyone is arguing for an IFR above 0.5% below age 50. Where that changes between ages 50 and 75 is hard to say right now (I would guess somewhere between 60 and 70).

    So how would you correct “death-date-to-infection-date-matching” to yield more accurate numbers? If you have actually run the numbers, how much does that change the estimated population wide IFR? 10%? 2x?

    The issue here is we need a way to estimate IFR so we can judge the need for countermeasures vs. letting it rip. Don’t let the perfect be the enemy of the good.

    Ideally we would have age specific information for both IFR and the expected impact of various countermeasures. The one thing I think Sweden is doing very right is focusing their countermeasure attention on the old.

    It seems clear that we (should) want to establish herd immunity among the relatively low risk population (younger with minimal preexisting conditions) while protecting the higher risk population with countermeasures during that period.

    The problem is that with that approach some younger people will die. And any deaths seem to be politically unacceptable right now.

  131. @Reg Cæsar

    The daughters certainly worked out well.
     
    Grandpa ran on George Wallace's party line in 1972. He outpolled McGovern in parts of Idaho:


    https://en.m.wikipedia.org/wiki/John_G._Schmitz


    East of the Rockies, his best performance was in the Florida Parishes of Louisiana.

    Given the alternatives presented to me, McGovern and Nixon, I feel pretty good having cast my first ever vote for the AIP. Had no idea MKL was his offspring.

  132. @Reg Cæsar
    The left has been saying for decades, "Do what Sweden does! Do what Sweden does!"

    Now Donald Trump is doing, or proposing doing, what Sweden is doing. And everybody wants his head.

    The only “principle” that seems to matter to the left in 2020 is proving (believing) “Orange Man Bad.” That this is preventing effective action is unforgivable.

  133. @Kratoklastes
    Why are these people so dead keen not to present age-cohort data for ICU admission, deaths, release from hospital and so forth?

    I mean it's starting to get really obvious.

    There's an actual effort being made to give the impression that
     • fatal outcome (%);
     • discharge (%); and
     • ICU Admission (%)
      are the same whether the person is a 25 year old athlete or an 85 year old diabetic with emphysema.

    They do us the courtesy of endorsing some parameters from a fitted Beta distribution for each age cohort, which purports to determine Pr(Hospitalised|Positive). Those are in Table S3, and are taken from Verity et al, which mostly uses data from February (although it's been revised since) and is a pretty good bit of work (I love the IFR column of Table 1 of Verity et al).

    If you parameterise a Beta distribution using the parameters listed in Table S3, and 'back-solve' for the number of infections that would result in the hospitalisations listed in Table 1, and you're sanguine about how you do a confidence interval... you get a table that looks like this ->

    https://www.dropbox.com/s/prntthyx8u4gcmk/Lewnard_Table_01.png?dl=1

    When I say 'sanguine about how you do a confidence interval': the way it's done in the table above is just calculating μ and σ for a Beta distribution, and forming a symmetric CI for the mean (i.e., μ±2σ), then dividing the number of hospitalisations by the ends of the CI.

    I know that's slightly cheeky, but it's good enough for present purposes (ie., to get a thumbnail sketch of uncertainty on case numbers). Besides, it won't be far from the analytical CI.

    Think of it as "the CI you get when you want a very good estimate but can't be arsed doing it perfectly".

    If you actually do it properly, you'll get an asymmetric CI, but all that will do is move the lower bound up a bit, and the upper bound up about twice as much... which suits me.

    .

    Also... the apparent Dog That Did Not Bark is a multi-part thing which might have a perfectly plausible explanation.

    Kaiser Mesa Verde has 9-million-some clients, and 1200-some went to hospital and mad an insruance claim.

    Presumably, there's some other subset that made a claim for a covid-adjacent visit (or test) that didn't require hospitalisation.

    Maybe that other set of clients felt like absolute shit, had a cough and what not, visited a doc, got tested, signed the insurance forms... and everyone agreed it might well be covid19, but it wasn't severe enough to require hospitalisation.

    Maybe some subset of those people requested a test; maybe some of those tests came back positive.

    .

    Maybe that's not how the Kaiser system works: maybe nobody ticks a box marked "insurance" until the patient's on a gurney with their ass hanging out the back of a gown.

    That sounds unlikely: after all, if you had paid all those premiums to Keyser Söze-nente and felt bad enough to go see a doctor, you would claim that visit, right?

    Where's the data on those guys? By age cohort.

    Those are in Table S3, and are taken from Verity et al, which mostly uses data from February (although it’s been revised since) and is a pretty good bit of work (I love the IFR column of Table 1 of Verity et al).

    That is a useful table. A simplified version of Table 1 is what worldmeters uses at
    https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/

    If I understand correctly, the revision was fairly trivial. They did not update the data or anything.
    https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30309-1/fulltext

    Can you infer age based fatality data for the Kaiser study from the detailed age based hospitalization data in Figure 1 (and Table 1) and fatality data in Figure 3B? Say by scaling the Table 1 admissions proportions to population proportions in each age bucket?

  134. @Reg Cæsar

    Tua Tagovailoa had lowest Wonderlic score among 2020 QB prospects
     
    At least he got through his tweens without knocking up his middle-school teacher. (As far as we know.)



    https://i.dailymail.co.uk/1s/2018/11/15/18/6238250-6394407-image-a-1_1542308304121.jpg

    https://www.biography.com/news/mary-kay-letourneau-vili-fualaau-wedding-anniversary-scandal

    I guess–tautology–the girls are the big winners here as they are alive, and life is good.

    Among the principals the big winner is the ex-husband Steve. He was lucky his BPD wife blew up their marriage in an illegal fashion.

    I know a few guys where the wife blew up the marriage and they got kicked out of the house, but pay the mortgage, fork over a huge chunk of their paycheck and then get dicked around on seeing their kids. That’s normal American “justice”. (Surprised there isn’t more homicide. Only because we white guys are so tame.) A default of joint custody is a much needed reform.

    Steve on the other hand, was able to dump the BPD wife, keep his kids and remarry and have more kids with presumably a younger and saner gal. Winner!

    The kid has wasted his youth hanging out with the old bag. But he’s got a couple daughters in the deal. And he’s still young and they’ve split now, so he can go on and find a younger more-compatible woman to have a life with.

    Her mad desire for POC love … well i guess she’ll have cats.

    This thing has Whiskey written all over it.

    • Replies: @Reg Cæsar

    And he’s still young and they’ve split now, so he can go on and find a younger more-compatible woman to have a life with.
     
    I'd read that their divorce was a mere formality because her criminal record compromised his application for a marijuana merchant's license.

    This thing has Whiskey written all over it.
     
    And Margaret Mead.

    I know a few guys where the wife blew up the marriage and they got kicked out of the house, but pay the mortgage, fork over a huge chunk of their paycheck and then get dicked around on seeing their kids.
     
    The men's rights movement has been an ongoing failure because it focuses on rights. Men are the adults in the room, and adults are about duties, not rights. Men would prevail more often were they to concentrate on their duties, and how wife-initiated divorce is a threat to performing those duties.

    Steve LeTourneau came out on top because that was in the best interest of his children. John Schmitz would have lost everything had his wife divorced him. He wrecked his wife's career as well as his own.

    Note that the one "right-wing" issue that has been successful in recent decades has been in the area of guns, particularly concealed carry. That's because despite the NRA and others yammering about their rights and "self"-defense, the word militia refers to a duty. That pistol in your pocket is a means of civic defense.
  135. @utu
    You are right. I should avoid using triggering terms. W/o them perhaps you would concentrate on what my comment was about instead you just got triggered.

    No, I didn’t get triggered. I noticed that which you did not notice yourself, and I simply disagreed with you.

    • Replies: @utu
    "I simply disagreed with you." - Disagree about pejorative labels that I used but do you agree with me that "The area under the flattened curve is smaller than under the curve of the unconstrained epidemic running at its natural R0."? You haven't addressed my comment yet.
  136. @e
    This is immature of me, but I still feel the need to say it: Jeff Bezos is physically ugly.

    Yes. Be looks like that Applewhite freak.

    Bring back hair plugs!

  137. @AnotherDad

    https://en.m.wikipedia.org/wiki/John_G._Schmitz
     
    LOL. I'd never read this bit of trivia before. I'm sure it "explains it" somehow.

    Schmitz is a good argument for policing your own side as well as the other.

  138. @Kratoklastes
    Your estimates will change if you re-do everything with
     • age-relevant transition probabilities (i.e., old sick people are outright more susceptible; develop symptoms quicker; and have disease progression that hits harder, earlier); and
     • the assumption that more than half of all 'confirmed' infections in the young (the largest cohort of 'confirmed' infections) are asymptomatic, and almost none of the young die from covid19.

    Given the CF(w)R for people over 75 is of the order of 30% on a 'same date' basis (i.e., using 'cases today' as the denominator for 'deaths today')‚ if lag structure is set up as age-agnostic numbers suggest, the system runs into problems.

    Take the April 17 deaths for NYC.

    There were 287 deaths of people aged 75 and over (NY's data still apparently still requires a positive lab test - at least that's what's shown at the top of each day's NYC Daily Death Summary for April 15 2020.

    Go back 27 days and fetch the 'confirmed cases' data for NYC for March 21st: there were only 390 cases in the 65+ group (until March 21, NYC was ending the relevant age cohorts at 65).

    But this was notionally the day these fogies got infected... they wouldn't show symptoms until incubation was finished.

    Five days later on the 26th (assuming that 75+ people start to show symptoms at the median incubation period) there were only 302 new confirmed cases among the 75+ group - so we're 15 deaths to the good... we can have <100% mortality and a 22-day look-back. In fact, the last week's worth of deaths is only 73% of the total cases up to March 26th.

    If you do this consistently - that the deaths have to come from new cases 22 days ago - it paints a terrible picture: a tad under ¾ of infected in the age group, 75+ die.

    What's missing? All of the 75+ cases since March 26th.

    Using the 22-day-lookback, results in a gigantic - and still-growing - pool of old infected waiting to die. That's not observed.

    Currently it would be all 75+ cases after March 26th. 12,868.

    So 73% of them will cark it over the next 22 days. That's 9,429 old people - which is almost 2.3 times the current cumulative total number of deaths in that age group.

    That's the thing that shows that the cases-wide dynamics are a bad choice.

    It's also why your proposed 'go back 22 days; count all cases; divide by assumed IFR' isn't a good idea.

    .

    This is why the putative "death-date-to-infection-date-matching" idea is a really bad idea if age-agnostic parameters are used - it biases the look-back period upwards (and therefore, for a given IFR, it overstates 'undiscovered' cases).

    I've used "75+" people as a cohort as if it doesn't have a natural internal partition - but of course it does... 75+ers with chronic illness - who die even faster than 75+ without. NYC's data doesn't have case comorbidity data; it has death

    Given that CFR has such a distinct age-cohort pattern, and is so strongly influenced by key relevant chronic illness, it would be weird to assume that susceptibility (and other transmission probabilities) aren't also different.

    .

    The thing is best modelled with age-group-specific dynamics - where the older age groups (and particularly the chronically-ill older people) take less than a week from symptoms to death or recovery. There's still a very high IFR in their age cohort, but correspondingly much much lower than 0.5 for the other age cohorts.

    I've spent a couple of days doing a half-assed search of the literature, and this seriously seems to be something that has had almost no real attention - I guess because this is the first real pandemic where the death-by-age is so tilted towards one end of the age distribution.

    If I was 15 years younger I would be eagerly writing up something with a view to submitting it to an open journal.

    As it is I'll do a half-assed writeup and stick it on a blog - there's no incentive to do more, because covid19's about to be dropped from media coverage.

    PandemicTV is pretty much done for 2020, and the next few weeks will be politicians doing victory laps and crowing that they saved humanity... and in 3 months there might be a 3 paragraph story in some inside page, discussing a recent inexplicable spike in suicides.

    Kratoklastes, that’s a solid critique of using these “average time to death” estimates. (As in ic1000s spitballing.)

    When there are rising infections then the deaths on any given day are actually dominated by the old and weak dying from more recent infections.

    However, your close:

    PandemicTV is pretty much done for 2020, and the next few weeks will be politicians doing victory laps and crowing that they saved humanity… and in 3 months there might be a 3 paragraph story in some inside page, discussing a recent inexplicable spike in suicides.

    I don’t buy. Yeah politicians will crow and pretend they saved the world–they are after all politicians– … but first the world has to actually be saved.

    The plain fact here is that most Americans have not been infected–and probably never exposed.

    Summer weather–heat, humidity, sunshine–will be a huge help–as it is with the flu. But 95% of Americans are Corona-Chan virgins. If/when people just “business as usual”–the “just the flu” folks advocate, then this will at least sizzle along all summer and definitely kick back up again in the fall, when we enter the normal flu season.

    Over-reaction and–i’d argue–wrong steps, ok. Cost benefit, agreed. But people who don’t think this is a real bug–one which
    a) basically no one has any pre-existing immunity from prior exposure and so easily spreads through the population and
    b) kills a bunch of people–though fortunately mostly old/sick, ergo minimal lost years
    … are simply data-averse loons.

    It isn’t going away–in three months or three years–until there’s herd immunity or a vaccine.

    • Agree: ic1000, TomSchmidt
    • Replies: @Kratoklastes
    Oh, don't get me wrong - I'm not saying that this specific coronavirus family will actually go away.

    I'm just saying that once the victory laps are done, deaths from covid19 will not get large-scale media coverage in any subsequent Northern Hemisphere flu season.

    In subsequent US flu seasons, the only covid19 deaths recorded will be genuine deaths-from; nobody will be under pressure to record the death of every massively-ill old person as 'covid19' and there will be no federal grants to hospitals for each near-death person that they attach to a ventilator.

    The other thing to bear in mind is that as testing becomes less selective, evidence is rapidly accumulating that the 'confirmed case' counts are massive underestimates of total infections - at least an order of magnitude - and as a result even age-cohort IFRs are massively overstated.

    This is consistent with my position right from the start: if this thing started with an R[0] of 2.5 and was spreading unchecked for 3 months, a very very large proportion of the population would already have been exposed. (This was my major beef with an unconstrained SEIR model that used age-agnostic parameters).

    A couple of recent examples that reinforce the 'Ruh roh - maybe a shitload of people have got/had it' case...

     • One third of people tested for antibodies in Boston, tested positive. All were asymptomatic (this was a free rapid-test). Sample size was only 200, though, and the serological tests are much less accurate than PCR (although PCR has its own problems in 'real live' conditions.

     • 397 people in a Boston homeless shelter were PCR-tested. 146 returned positive tests - not one of them was symptomatic. None even had a fever (a fever of 100.4°F was previously used as the trigger for a test).

    "The homeless" isn't an obvious answer to "identify a healthy subpopulation" - although people in crisis accommodation skew young.

    The acknowledged asymp rate keeps climbing, but is often based on small samples. The BMJ (BMJ 2020;369:m1375) claims that there is data from China that has 80% of cases asymptomatic, but that was one day's test results.

    According to that BMJ story, China has found 43,000 asymps through contact tracing of existing 'confirmed cases' (some of whom were asymps themselves). That still hasn't been published anywhere, but let's hope there's an age breakdown.

    So hitherto-undiscovered asymps raised the Chinese case count by more than 50% since April 1, and can still be guaranteed to have missed a bunch of people. Once they've done contact tracing on everyone, they need to turn around and test downstream from all the newly-discovered asymps - i.e., their contacts after their presumed infection date.

    There's a lot of uncertainty in all these numbers though: serological 'antibody' tests are extremely error-prone, because the FDA standards for test approval have been gutted and rely on unrealistic 'contrived' test samples.

    In other words, serological tests are the "Affirmative Action hires" of the covid19 testing world. Everyone just has to shut up and believe that they're adequate, knowing that they ain't.
    , @Polynikes

    But people who don’t think this is a real bug
     
    Have we slipped back to this strawman now?

    If/when people just “business as usual”–the “just the flu” folks advocate, then this will at least sizzle along all summer and definitely kick back up again in the fall, when we enter the normal flu season.
     
    Of course this will happen. But there’s little choice unless you want to stay in some quasi-authoritarian state until Bill Gates delivers his vaccine.

    BTW, the regular flu is mutating. And starting next fall it is going to kill 30-50,000 Americans. What should we do about that?
  139. @AnotherDad
    I guess--tautology--the girls are the big winners here as they are alive, and life is good.

    Among the principals the big winner is the ex-husband Steve. He was lucky his BPD wife blew up their marriage in an illegal fashion.

    I know a few guys where the wife blew up the marriage and they got kicked out of the house, but pay the mortgage, fork over a huge chunk of their paycheck and then get dicked around on seeing their kids. That's normal American "justice". (Surprised there isn't more homicide. Only because we white guys are so tame.) A default of joint custody is a much needed reform.

    Steve on the other hand, was able to dump the BPD wife, keep his kids and remarry and have more kids with presumably a younger and saner gal. Winner!

    The kid has wasted his youth hanging out with the old bag. But he's got a couple daughters in the deal. And he's still young and they've split now, so he can go on and find a younger more-compatible woman to have a life with.

    Her mad desire for POC love ... well i guess she'll have cats.

    This thing has Whiskey written all over it.

    And he’s still young and they’ve split now, so he can go on and find a younger more-compatible woman to have a life with.

    I’d read that their divorce was a mere formality because her criminal record compromised his application for a marijuana merchant’s license.

    This thing has Whiskey written all over it.

    And Margaret Mead.

    I know a few guys where the wife blew up the marriage and they got kicked out of the house, but pay the mortgage, fork over a huge chunk of their paycheck and then get dicked around on seeing their kids.

    The men’s rights movement has been an ongoing failure because it focuses on rights. Men are the adults in the room, and adults are about duties, not rights. Men would prevail more often were they to concentrate on their duties, and how wife-initiated divorce is a threat to performing those duties.

    Steve LeTourneau came out on top because that was in the best interest of his children. John Schmitz would have lost everything had his wife divorced him. He wrecked his wife’s career as well as his own.

    Note that the one “right-wing” issue that has been successful in recent decades has been in the area of guns, particularly concealed carry. That’s because despite the NRA and others yammering about their rights and “self”-defense, the word militia refers to a duty. That pistol in your pocket is a means of civic defense.

    • Replies: @vhrm

    The men’s rights movement has been an ongoing failure because it focuses on rights. Men are the adults in the room, and adults are about duties, not rights. Men would prevail more often were they to concentrate on their duties, and how wife-initiated divorce is a threat to performing those duties.
     
    What duties did you have in mind?
    Perpetuating the patriarchy? Indoctrinating their offspring with their toxic masculinity?

    In the current family court system the primary duty of men is the duty to provide money for the woman to spend however she sees fit.

    The secondary duty of men is to STFU and do what they're told.
    At the whim of the woman and the court that means either providing childcare as instructed or not even looking at the kids, as instructed. Any deviations from doing what he's told means more money or jail.
  140. OT: I found this preprint article on the CDC website that claims a much higher R0 for SARS-Cov-2:

    High Contagiousness and Rapid Spread of Severe Acute Respiratory Syndrome Coronavirus 2

    We found R0 is likely to be 5.7 given our current state of knowledge, with a broad 95% CI (3.8–8.9). Among many factors, the lack of awareness of this new pathogen and the Lunar New Year travel and gathering in early and mid-January 2020 might or might not play a role in the high R0. A recent study based on structural analysis of the virus particles suggests SARS-CoV-2 has a much higher affinity to the receptor needed for cell entry than the 2003 SARS virus (21), providing a molecular basis for the high infectiousness of SARS-CoV-2.

  141. @Alice
    well, no slide ever shown by the CDC had a smaller area under the curve. Neither did the imperial College model.

    Re: we really think "who cares if old people die": the lockdown isn't saving the old people in my state. Are you sure it is in your state? there's an assumption "think of how much worse without lockdown", but it's a non sequitur.

    The old people dying are in nursing homes. They were already under de facto lockdown before the virus was sequenced. most nursing homes in my state had closed off visitors by March 1. March 13 began the voluntary lockdown, and my state's involuntary one came March 27. So why are they dying? How is the movie theatre and swingset and little league field being closed affecting killing or saving great granny?

    The evidence is mounting that infection is largely nosocomial and intrafamilial. You get it in close quarters, and the lockdowns made more close quarters, not fewer. Mass transit in NYC metro is of course also close quarters for long stretches of timez and NY never closed subways.

    And in my state, they've done nothing to save the nursing home folks The governor didn't even require nursing home staff to wear masks til April 13, literally a month after CDC social distancing and 2 weeks after STAY AT HOME order in my state closed all gathering over 10 people, and closed every state park, beach, and playground.

    So you may believe the numbers if dead would skyrocket if lockdown removed, but it asserts facts not in evidence.

    the ‘close quarters’ thing is likely true, but everything we know about some of the superspreader events (like Georgia, and South Korea) indicates that church services, funeral gatherings, and restaurants are still very fertile ground–not just hospitals and nursing homes.

  142. It’s summertime, and the livin’ is easy…

    Sunlight destroys virus quickly, new govt. tests find…

    Wheel ’em outside!

    • Replies: @Kratoklastes
    It must be wonderful to be a (female) cheerleader: youth, athleticism, attention, and no expectation that you do anything except be bewilderingly optimistic.

    It must be a bit like being a labrador or a golden retriever.

    It's basically 'high dose' blue-pill (although all teenagers are assholes, so in their own group they're probably as neurotic as the rest of us).

    I guess their shit tends to go south once they get crow's feet, and the guy who married them for their looks starts banging a waitress 5 years younger.

    Still: ~35 years of empty-headed bliss - life's almost half over before there's any pressure to be displeased about how the world works.
  143. @PiltdownMan

    Eating silver will turn your skin a deathly shade of blue permanently,
     
    Libertarian Stan Jones got off relatively lightly.

    https://i.imgur.com/ZMVBenC.jpg

    Libertarian Stan Jones got off relatively lightly.

    Cue the speech from Braveheart:

    “………..they’ll never take our FREEDOM!!!!”

  144. @Reg Cæsar

    And he’s still young and they’ve split now, so he can go on and find a younger more-compatible woman to have a life with.
     
    I'd read that their divorce was a mere formality because her criminal record compromised his application for a marijuana merchant's license.

    This thing has Whiskey written all over it.
     
    And Margaret Mead.

    I know a few guys where the wife blew up the marriage and they got kicked out of the house, but pay the mortgage, fork over a huge chunk of their paycheck and then get dicked around on seeing their kids.
     
    The men's rights movement has been an ongoing failure because it focuses on rights. Men are the adults in the room, and adults are about duties, not rights. Men would prevail more often were they to concentrate on their duties, and how wife-initiated divorce is a threat to performing those duties.

    Steve LeTourneau came out on top because that was in the best interest of his children. John Schmitz would have lost everything had his wife divorced him. He wrecked his wife's career as well as his own.

    Note that the one "right-wing" issue that has been successful in recent decades has been in the area of guns, particularly concealed carry. That's because despite the NRA and others yammering about their rights and "self"-defense, the word militia refers to a duty. That pistol in your pocket is a means of civic defense.

    The men’s rights movement has been an ongoing failure because it focuses on rights. Men are the adults in the room, and adults are about duties, not rights. Men would prevail more often were they to concentrate on their duties, and how wife-initiated divorce is a threat to performing those duties.

    What duties did you have in mind?
    Perpetuating the patriarchy? Indoctrinating their offspring with their toxic masculinity?

    In the current family court system the primary duty of men is the duty to provide money for the woman to spend however she sees fit.

    The secondary duty of men is to STFU and do what they’re told.
    At the whim of the woman and the court that means either providing childcare as instructed or not even looking at the kids, as instructed. Any deviations from doing what he’s told means more money or jail.

    • Replies: @Reg Cæsar

    What duties did you have in mind?
     
    Start with tucking them into bed every night and leading them in prayers.

    This was posted a month ago and is about to reach two million views-- not bad for a TED Talk in a peripheral gambling haven:


    https://m.youtube.com/watch?v=RlSwsE22nX0
  145. how will we ever know if the fear of the hospitals being overwhelmed was valid or not?

    seems like all the talk of Fatality Rates is kind of a mirage, because there’s two rates: the ‘normal hospital’ rate (likely very low, especially for non-olds) and the ‘overrun hospital’ rate (probably way high)

    the rationale for distancing was that we had to flatten the curve, otherwise the hospitals would get overrun and the fatality rate would skyrocket–how will we ever know if that tipping point was a real threat or not?

    without knowing that for certain, we’ll never know whether the lockdowns were worth it.

    • Replies: @Steve Sailer
    "seems like all the talk of Fatality Rates is kind of a mirage, because there’s two rates: the ‘normal hospital’ rate (likely very low, especially for non-olds) and the ‘overrun hospital’ rate (probably way high)"

    Right.

    Here's a question: There are basically 5 levels of treatment for infected people:

    1. Stay home, don't see a doctor.
    2. See a doctor, go back home.
    3. Hospitalization.
    4. ICU.
    5. Ventilator.

    How have the treatments changed in effectiveness over time versus expectations? My guess is that ventilators have proven less effective than was hoped. However, Hospitalization and ICU (Boris Johnson got both, but not a ventilator) may have improved: the discovery of "proning" with non-intrusive oxygen treatment may have improved recovery rates. Has hydroxychloroquine helped levels 2 and 3? My impression is that it doesn't do much good for Level 5, but might work well for less severe levels.

    , @Polynikes
    The numbers are conclusive. Outside of a couple hospitals in NYC/NJ, the hospitals are largely empty. Over a hundred hospitals have closed (most just temporarily). Many more have laid off nurses and doctors.

    There was no overrun. The UWash study was as off on hospital beds and ICU beds as it was on deaths.
    , @vhrm

    the rationale for distancing was that we had to flatten the curve, otherwise the hospitals would get overrun and the fatality rate would skyrocket–how will we ever know if that tipping point was a real threat or not?

    without knowing that for certain, we’ll never know whether the lockdowns were worth it.
     
    Hospitals being overrun was (is) a real threat. It happened a lot in Wuhan it happened somewhat in Italy.

    BUT just because it's a threat it doesn't mean that the lockdown was justified. There are many responses: preparing surge capacity at hospitals is a response.
    Banning large events is another.
    Suggesting that people stay home is another.
    Suggesting that people wear masks is yet another.

    Forcing stores and businesses to close and forcing people to stay home is pretty far out there. (though, to be fair, it could be worse. They could have roadblocks on highways and the national guard in the streets. They could require permits to buy gas. They could have the States take over the whole economy and dictate all production, sales and consumption).


    So, imo (and that of most the anti-doomers) SOME responses were warranted to deal with this real threat, but the "lockdown" part of the response was not necessary,
    - especially not necessary at the time (could have waited to see how numbers developed)
    - no longer necessary now when obviously the feared outcomes haven't materialized and hospitals aren't overrun anywhere. (not even in all of NYC though a few hospitals were at capacity there for a few days)
    - not worth the cost by a longshot
    -etc.

    (the details and different flavors of belief are strewn across these comment threads)
  146. So we’re just agreeing to ignore population antibody studies and going right back to focusing on the worst of the worst of the worst of the worst of the worst cases (deaths out of ICU admit out of hospitalizations out of severe symptoms out of symptomatic cases!)?

    The fact that it’s now established that overall fatality rates are LESS than the flu is a minor detail to be discussed independently and infrequently?

    Absolutely maddening to see even official unpersons still essentially playing along with the narrative on this. Anyone with a megaphone of any size should be shouting about the actual fatality rate nonstop. The public failure to understand this new information is unimaginably costly.

  147. @AnotherDad


    None who tested positive had severe symptoms, and half had had 1 symptom in the past month, which sounds completely normal late March in a cold climate.
     
    Actually Lot it's yet another rebuke of the "it's just the flu, bro" deniers:

    Chelsea:
    -- 40,000 people
    -- 39 deaths so far
    So they are already at 0.1% IFR ... even if entire population was infected.

    But this "quasi random" sampling suggests only about 1/3. So they are at 0.3%. And no doubt some more of the currently infected will die as well. So expect this to tick up a bit.

    Pretty much the same result as the study in hard hit Gangelt where they found 16% infected and a 0.37% IFR.

    Contra deniers, everyone has not yet been "infected" or "exposed". The reaction has pushed down transmission--of everything else too, as we've seen flu cases drop. Where a lot of people have been exposed, we get a lot of dead people, several times the normal monthly rate, greater than any recent flu season peaks.

    The data keep pointing in the same direction they have from the beginning:
    -- at least half asymptomatic or very mild cases, most of the rest "bad flu"
    -- < 1% real IFR -- probably will converge 0.3-0.7% for American age distribution
    (not the ridiculous numbers the hysterics get by dividing deaths by "cases"--many more infected are out there)
    -- 10-50X more lethal as "the flu"
    -- kills primarily the old and sick; very low mortality for young and healthy--only issue is mega-dose and cytokine storm;
    -- definitely *not* anything like the Spanish Flu which scythed through young men in armies
    -- not any sort of "threat to civilization" mostly just an "early harvest" of us old guys

    ~~

    The other thing of note with Chelsea:

    A rebuke to the "global cosmopolitans" who--as part of stripping Americans of our birthright--want to pack us in like sardines.
    https://www.amazon.in/One-Billion-Americans-Thinking-Bigger/dp/0593190211

    Turns out the countryside or even American style suburbia is much more robust.

    Dense crowded cities turn out to be susceptible to epidemic disease--now who could possibly have imagined that?

    It’s probably going to end up a little higher than seasonal influenza, but not much. The infection fatality rate drops over time because the most vulnerable die early. So when Gangelt reaches 50% infected, the death rate will end up being something like 0.2%.

    That’s where Chelsea will end up, too. If one third have already been infected, then they’ve almost reached herd immunity and there should be very few additional deaths.

    • Replies: @AnotherDad


    It’s probably going to end up a little higher than seasonal influenza, but not much. The infection fatality rate drops over time because the most vulnerable die early. So when Gangelt reaches 50% infected, the death rate will end up being something like 0.2%.
     
    "It’s probably going to end up a little higher than seasonal influenza,"

    This is just wrong. And frankly ridiculous at this point. Unless you mean ... "because we locked down and knocked the wind out of its sails and a vaccine will come later this year."

    Anyplace where it's had a good run, its death rate has zoomed past any influenza during my entire life--57, 68, 04, 09, etc.


    "The infection fatality rate drops over time because the most vulnerable die early."

    Maybe. The most vulnerable will--on average--likely catch it with "lighter" exposure. The converse is that younger more socially active people are actually more likely to be exposed sooner. They just don't die. The infected right now--not "cases" but the larger number of actually infected--actually skews younger than the population. (For instance i think it's much more likely my kids have had it--or will get it in the next few months--than me. They are much more socially active.)

    But right now we are nowhere near having even a significant fraction of American's exposed. A reasonable guess would be something like the Santa Clara numbers--a few percent.

    If when it gets to Bergamo levels of infection then most people are exposed and you'll have the big cull. But elderly people don't just leap up and die from the damn thing because it's out there ... they have to have someone expose them to it.
  148. @vhrm

    The men’s rights movement has been an ongoing failure because it focuses on rights. Men are the adults in the room, and adults are about duties, not rights. Men would prevail more often were they to concentrate on their duties, and how wife-initiated divorce is a threat to performing those duties.
     
    What duties did you have in mind?
    Perpetuating the patriarchy? Indoctrinating their offspring with their toxic masculinity?

    In the current family court system the primary duty of men is the duty to provide money for the woman to spend however she sees fit.

    The secondary duty of men is to STFU and do what they're told.
    At the whim of the woman and the court that means either providing childcare as instructed or not even looking at the kids, as instructed. Any deviations from doing what he's told means more money or jail.

    What duties did you have in mind?

    Start with tucking them into bed every night and leading them in prayers.

    This was posted a month ago and is about to reach two million views– not bad for a TED Talk in a peripheral gambling haven:

  149. @Hail

    I haven’t seen too many people dismiss it as “just the flu”
     
    It's unclear what people understand that term to mean. It sounds like it started as a Twitter troll term, and has been used in the US far more by supporters of the Panic for the past ca. five weeks, in the era of the media waving corona-bodies at us nonstop and creating their own self-reinforcing CoronaNarrative.

    But 'the flu' is, and always has been, potentially very serious for the weakest, say, 1% or somesuch among us (and for a few flukes among the other 99%). If a fifth of those at risk get it in a year, one tenth of those might die (total: 0.02% flu deaths), even with treatment, who otherwise wouldn't die in the near-term. Sometimes more, sometimes less. Maybe this time it's "more." Incidentally, these are still very low numbers in historical terms; see here.


    Maybe this time it's "more."
     
    What we have always wanted to know is data on how much worse this strain is than other flu strains. Not partial data, not somebody's worst-case-scenario projections; not Scary Big Contextless Numbers.

    The concept of the Null Hypothesis is our friend here. Austrian researchers have now found they cannot reject the null hypothesis that corona-positive deaths are any different than corona-negative deaths, in other words the people dying are of such advanced age and health condition to begin with that one's chances of dying may be the same. If that finding is valud, it is not a sure bet at all that coronavirus is a major threat. At least that applies to Austria, which has a sample of hundreds of corona-positive deaths.

    "Just the Flu" is not as unreasonable as it sounds.

    The concept of the Null Hypothesis is our friend here. Austrian researchers have now found they cannot reject the null hypothesis that corona-positive deaths are any different than corona-negative deaths,

    From your comment:

    Hail:

    They were unable to reject the null-hypothesis that a given corona-positive person’s risk of death is the same as the corona-negative risk of death.

    Austrian Medical Stats guys:

    “The risk of dying from COVID19 is basically proportionate to the risk of normal death risk for one’s respective age group,”

    Hail, “proportionate to” and “same as” are not remotely the same thing.

    It’s very clear for at least a couple months now (for me, others probably earlier) that the risk profile for those dying from covid-19 is pretty similar to the risk profile of dying period. It’s actually *more* skewed toward the old and sick. (Ordinary death does happen to kids and is basically non-existent here.)

    That’s all those guys are saying. “Hey it’s the same profile of people” They state explicitly that as a result it’s pretty hard to say how many years of life are lost.

    That is not remotely the same as the risk does not exist or is zero. Basically this appears to be on the order of maybe 4 months to a year’s harvest of “harvestable” people. But it could have been 1 month–i.e. “really bad flu year” or ten years–mayhem!–in the same proportion.

  150. @Bill P
    It's probably going to end up a little higher than seasonal influenza, but not much. The infection fatality rate drops over time because the most vulnerable die early. So when Gangelt reaches 50% infected, the death rate will end up being something like 0.2%.

    That's where Chelsea will end up, too. If one third have already been infected, then they've almost reached herd immunity and there should be very few additional deaths.

    It’s probably going to end up a little higher than seasonal influenza, but not much. The infection fatality rate drops over time because the most vulnerable die early. So when Gangelt reaches 50% infected, the death rate will end up being something like 0.2%.

    “It’s probably going to end up a little higher than seasonal influenza,”

    This is just wrong. And frankly ridiculous at this point. Unless you mean … “because we locked down and knocked the wind out of its sails and a vaccine will come later this year.”

    Anyplace where it’s had a good run, its death rate has zoomed past any influenza during my entire life–57, 68, 04, 09, etc.

    “The infection fatality rate drops over time because the most vulnerable die early.”

    Maybe. The most vulnerable will–on average–likely catch it with “lighter” exposure. The converse is that younger more socially active people are actually more likely to be exposed sooner. They just don’t die. The infected right now–not “cases” but the larger number of actually infected–actually skews younger than the population. (For instance i think it’s much more likely my kids have had it–or will get it in the next few months–than me. They are much more socially active.)

    But right now we are nowhere near having even a significant fraction of American’s exposed. A reasonable guess would be something like the Santa Clara numbers–a few percent.

    If when it gets to Bergamo levels of infection then most people are exposed and you’ll have the big cull. But elderly people don’t just leap up and die from the damn thing because it’s out there … they have to have someone expose them to it.

    • Replies: @Bill P
    You're in Washington state, right? I'd be willing to bet you we've already had hundreds of thousands of infections.

    I'm in Whatcom county, and we have nearly thirty dead and close to 300 confirmed infected so far. Social distancing is a joke here -- nobody's really practicing it. Neither the old farmers from Lynden nor the young students at Western are wearing masks at the stores, in the parks, wherever. Yet the virus has been here for at least six weeks, but probably a month longer. Based on these antibody studies coming out, we've probably had at least 20,000 infections already out of 200,000 people.

    And even if this lockdown has had some effect, it will be short-lived. It's already over. People are out and about, traffic is nearly back to normal, and furloughed people are most definitely congregating and socially interacting. If the virus comes back with a vengeance, then maybe I'll grant your point, but I don't see that happening given the current situation. Ultimately, I think Whatcom county is going to end up with up to half of the population infected and around 50-100 counted as dead from this virus. Maybe 200 if we're unlucky, but I doubt it, because I think this already went through here in February and they didn't count those deaths as coronavirus.

    It might be different in Seattle, where you have more social comorbidities, but I doubt it. There are tons of illegal immigrants from Hubei here in Washington, so we've had this infection from the beginning. Hell, the ladies running the nail salon in the local strip mall are from Hubei even up here in B-ham. We have now had this virus in WA for at least three months. One month only of half-assed lockdown, before which the disease was doubling every three days. So before lockdown 60 days of unmitigated spread. What's 2 to the 20th power? It's over a million, which is just about what the antibody studies are suggesting for WA.

    So there you have it: the reason the deaths are strangely low on the west coast is that it spread here early and killed off many of the vulnerable before they had the opportunity to classify them as coronavirus deaths, and we're not going to have another high peak because a lot of people have already cleared the infection and are now immune.
    , @Polynikes

    Anyplace where it’s had a good run
     
    That's cherry picking the data. Look at the CDC's website on regular flu years. There's always a couple states hit really hard--often in the NE. If you just used that data, the regular flu would have a IFR many multiples of what it is for the whole country.

    You take things as a whole. Yes, NYC has been hit particularly hard. Other places, that haven't had lockdowns, have not. If anything there's an argument to be made that the strict lockdowns have had a negative impact.
  151. @Alice
    well, no slide ever shown by the CDC had a smaller area under the curve. Neither did the imperial College model.

    Re: we really think "who cares if old people die": the lockdown isn't saving the old people in my state. Are you sure it is in your state? there's an assumption "think of how much worse without lockdown", but it's a non sequitur.

    The old people dying are in nursing homes. They were already under de facto lockdown before the virus was sequenced. most nursing homes in my state had closed off visitors by March 1. March 13 began the voluntary lockdown, and my state's involuntary one came March 27. So why are they dying? How is the movie theatre and swingset and little league field being closed affecting killing or saving great granny?

    The evidence is mounting that infection is largely nosocomial and intrafamilial. You get it in close quarters, and the lockdowns made more close quarters, not fewer. Mass transit in NYC metro is of course also close quarters for long stretches of timez and NY never closed subways.

    And in my state, they've done nothing to save the nursing home folks The governor didn't even require nursing home staff to wear masks til April 13, literally a month after CDC social distancing and 2 weeks after STAY AT HOME order in my state closed all gathering over 10 people, and closed every state park, beach, and playground.

    So you may believe the numbers if dead would skyrocket if lockdown removed, but it asserts facts not in evidence.

    “no slide ever shown by the CDC had a smaller area under the curve. Neither did the imperial College model.” – It was an unfortunate mistake. Those who prepared the slides did not realize that some people would take them literary not just an illustration of the concept and then draw a false conclusion that flattening the curve does not change the total number of deaths.

  152. @vhrm
    Zooming out a bit, this study (1200 out of 9.6m ever hospitalized w/ an avg stay ~10 days) reminds me of how much time we're wasting out here in California with empty hospitals and idle doctors week after expensive week.

    Hospital capacity w/ surge: ~ 125,000 (1)

    hospitalized with Covid-19: 3,200 (2) (and basically flat for a week)

    homeless put up in hotels: 4,211 (of 15,000 rooms already secured) (3)

    We have more homeless people put up on hotels than we do hospitalized Covid-19 patients.

    Shutdown for almost a month now.

    This is not how flattening the curve is supposed to work.

    We're not building herd immunity while protecting the health system from overload.

    We're not extinguishing the virus (which is probably impossible anyway, but in any case we're not doing it).

    We're just sitting here in limbo with our thumbs up our butts burning truckloads of cash.

    Before this I assumed epidemiologists were serious people who could make tough tradeoffs etc, but their performance had been just pathetic:
    - they lied about how it's spread (aerosols)
    - they lied about masks
    - their mickey-mouse models have been so sensitive to unknown parameters that they've been useless. There's a guy here who derisevely calls it eight grade math. I bristled at that a few times, but seriously... all we got is "OMG exponentials grow really fast!"
    - they don't have any insight into how to actually mitigate transmission. 4 months into this all they can say is "uhhh..... everyone stay home and wash your hands." Seriously, how useless are these people?!

    (e.g if they had said, "no, don't cut subway service because that make things worse..." that would've been a marginally insightful contribution that an outsider would take 10 minutes to think about. But they didn't even do that)



    1)

    The state has aggressively planned for a surge in hospitalizations in the coming weeks and aims to add 50,000 beds to our existing hospital capacity of nearly 75,000 beds. At least 60 percent of those additional beds, or 30,000, will come from within existing hospitals, and the state will secure the remaining beds, up to 20,000.
     
    (https://www.gov.ca.gov/2020/04/06/governor-newsom-announces-progress-in-expanding-hospital-capacity-to-fight-coming-surge-in-covid-19-cases/)

    2) https://www.eastbaytimes.com/2020/04/18/coronavirus-california-passes-1000-deaths-and-29000-cases-but-growth-slowing-after-deadliest-day/

    3) https://sanfrancisco.cbslocal.com/2020/04/18/coronavirus-california-struggles-covid-spread-homeless/

    This is not how flattening the curve is supposed to work.

    We’re not building herd immunity while protecting the health system from overload.

    We’re not extinguishing the virus (which is probably impossible anyway, but in any case we’re not doing it).

    We’re just sitting here in limbo with our thumbs up our butts burning truckloads of cash.

    I hate to be the one to tell you this, vhrm, but I will:

    You are in the Twilight Zone.

    The Corona Twilight Zone.

    Kramer: So what are you saying, that we‘re wrong? Oh, everybody’s wrong but you.

    Jerry: You know, this is like that Twilight Zone, where the guy wakes up, and he’s the same but everybody else if different!

    Kramer: Which one?

    Jerry: They were all like that.

    • Thanks: vhrm
    • LOL: Polynikes
    • Replies: @Mr. Anon
    Yet more proof that Seinfeld was the greatest sitcom of all time, and was actually a much better guide to human behavior than the ernestly middlebrow Twilight Zone.
  153. @AnotherDad
    Kratoklastes, that's a solid critique of using these "average time to death" estimates. (As in ic1000s spitballing.)

    When there are rising infections then the deaths on any given day are actually dominated by the old and weak dying from more recent infections.

    However, your close:

    PandemicTV is pretty much done for 2020, and the next few weeks will be politicians doing victory laps and crowing that they saved humanity… and in 3 months there might be a 3 paragraph story in some inside page, discussing a recent inexplicable spike in suicides.
     
    I don't buy. Yeah politicians will crow and pretend they saved the world--they are after all politicians-- ... but first the world has to actually be saved.

    The plain fact here is that most Americans have not been infected--and probably never exposed.

    Summer weather--heat, humidity, sunshine--will be a huge help--as it is with the flu. But 95% of Americans are Corona-Chan virgins. If/when people just "business as usual"--the "just the flu" folks advocate, then this will at least sizzle along all summer and definitely kick back up again in the fall, when we enter the normal flu season.

    Over-reaction and--i'd argue--wrong steps, ok. Cost benefit, agreed. But people who don't think this is a real bug--one which
    a) basically no one has any pre-existing immunity from prior exposure and so easily spreads through the population and
    b) kills a bunch of people--though fortunately mostly old/sick, ergo minimal lost years
    ... are simply data-averse loons.

    It isn't going away--in three months or three years--until there's herd immunity or a vaccine.

    Oh, don’t get me wrong – I’m not saying that this specific coronavirus family will actually go away.

    I’m just saying that once the victory laps are done, deaths from covid19 will not get large-scale media coverage in any subsequent Northern Hemisphere flu season.

    In subsequent US flu seasons, the only covid19 deaths recorded will be genuine deaths-from; nobody will be under pressure to record the death of every massively-ill old person as ‘covid19’ and there will be no federal grants to hospitals for each near-death person that they attach to a ventilator.

    The other thing to bear in mind is that as testing becomes less selective, evidence is rapidly accumulating that the ‘confirmed case’ counts are massive underestimates of total infections – at least an order of magnitude – and as a result even age-cohort IFRs are massively overstated.

    This is consistent with my position right from the start: if this thing started with an R[0] of 2.5 and was spreading unchecked for 3 months, a very very large proportion of the population would already have been exposed. (This was my major beef with an unconstrained SEIR model that used age-agnostic parameters).

    A couple of recent examples that reinforce the ‘Ruh roh – maybe a shitload of people have got/had it‘ case…

     • One third of people tested for antibodies in Boston, tested positive. All were asymptomatic (this was a free rapid-test). Sample size was only 200, though, and the serological tests are much less accurate than PCR (although PCR has its own problems in ‘real live’ conditions.

     • 397 people in a Boston homeless shelter were PCR-tested. 146 returned positive tests – not one of them was symptomatic. None even had a fever (a fever of 100.4°F was previously used as the trigger for a test).

    The homeless” isn’t an obvious answer to “identify a healthy subpopulation” – although people in crisis accommodation skew young.

    The acknowledged asymp rate keeps climbing, but is often based on small samples. The BMJ (BMJ 2020;369:m1375) claims that there is data from China that has 80% of cases asymptomatic, but that was one day’s test results.

    According to that BMJ story, China has found 43,000 asymps through contact tracing of existing ‘confirmed cases’ (some of whom were asymps themselves). That still hasn’t been published anywhere, but let’s hope there’s an age breakdown.

    So hitherto-undiscovered asymps raised the Chinese case count by more than 50% since April 1, and can still be guaranteed to have missed a bunch of people. Once they’ve done contact tracing on everyone, they need to turn around and test downstream from all the newly-discovered asymps – i.e., their contacts after their presumed infection date.

    There’s a lot of uncertainty in all these numbers though: serological ‘antibody’ tests are extremely error-prone, because the FDA standards for test approval have been gutted and rely on unrealistic ‘contrived’ test samples.

    In other words, serological tests are the “Affirmative Action hires” of the covid19 testing world. Everyone just has to shut up and believe that they’re adequate, knowing that they ain’t.

    • Replies: @TomSchmidt
    The numbers in NYC are hopefully much higher. If all we have is serological, then we need to go with that. Cum grano salis.
  154. @Reg Cæsar
    It's summertime, and the livin' is easy...


    Sunlight destroys virus quickly, new govt. tests find...


    Wheel 'em outside!


    https://theplaidzebra.com/wp-content/uploads/2014/08/Teams-Tow-Hospital-Beds-To-Win-Golden-Bedpan_3-768x509.jpg

    It must be wonderful to be a (female) cheerleader: youth, athleticism, attention, and no expectation that you do anything except be bewilderingly optimistic.

    It must be a bit like being a labrador or a golden retriever.

    It’s basically ‘high dose’ blue-pill (although all teenagers are assholes, so in their own group they’re probably as neurotic as the rest of us).

    I guess their shit tends to go south once they get crow’s feet, and the guy who married them for their looks starts banging a waitress 5 years younger.

    Still: ~35 years of empty-headed bliss – life’s almost half over before there’s any pressure to be displeased about how the world works.

  155. @Anon
    There's been an interesting trend in my own state. Looking at the statistics, there was an initial spread throughout the state that was caused by Covid-19 being brought in by travelers returning from airports, and a lot of our counties around the state had a few cases of Covid-19 pop up. Today, 17 of those infected counties no longer have any. Those who were sick have recovered, and the virus has died out in those places. The only places where the virus is increasing is in the places where the big cities are, and in those places it's being continually churned along by our minority population.

    There's a false narrative being pushed by the SJW left that blacks are getting Covid-19 because they tend to work service jobs. Well, who doesn't work a service job nowadays? The US economy moved from a farming base to a manufacturing base to a middle-class service job economy during the 20th century. Most whites work a service job, too. Many whites have jobs that deal with customers or clients. Even those whites who don't have service jobs still work inside offices close to co-workers in open floor plans with no walls. The white death rate shouldn't be any different from the black rate, but it is. The idea that blacks have higher death rates because of service jobs just doesn't cut it.

    the virus has died out in those places

    It’ll be interesting if there’s ever wide-scale random testing in your neck of the woods.

    That might never happen though – in all likelihood the antibody test will have fallen into disrepute by that stage. It’s giving numbers for asymptomatic undetected cases, that make the entire media-political circus look ridiculous – and certainly nowhere near a good reason for stopping the world economy. But we all knew that, soo…

  156. @Big Dick Bandit
    how will we ever know if the fear of the hospitals being overwhelmed was valid or not?

    seems like all the talk of Fatality Rates is kind of a mirage, because there's two rates: the 'normal hospital' rate (likely very low, especially for non-olds) and the 'overrun hospital' rate (probably way high)

    the rationale for distancing was that we had to flatten the curve, otherwise the hospitals would get overrun and the fatality rate would skyrocket--how will we ever know if that tipping point was a real threat or not?

    without knowing that for certain, we'll never know whether the lockdowns were worth it.

    “seems like all the talk of Fatality Rates is kind of a mirage, because there’s two rates: the ‘normal hospital’ rate (likely very low, especially for non-olds) and the ‘overrun hospital’ rate (probably way high)”

    Right.

    Here’s a question: There are basically 5 levels of treatment for infected people:

    1. Stay home, don’t see a doctor.
    2. See a doctor, go back home.
    3. Hospitalization.
    4. ICU.
    5. Ventilator.

    How have the treatments changed in effectiveness over time versus expectations? My guess is that ventilators have proven less effective than was hoped. However, Hospitalization and ICU (Boris Johnson got both, but not a ventilator) may have improved: the discovery of “proning” with non-intrusive oxygen treatment may have improved recovery rates. Has hydroxychloroquine helped levels 2 and 3? My impression is that it doesn’t do much good for Level 5, but might work well for less severe levels.

    • Replies: @Mehen

    How have the treatments changed in effectiveness over time versus expectations? My guess is that ventilators have proven less effective than was hoped. However, Hospitalization and ICU (Boris Johnson got both, but not a ventilator) may have improved: the discovery of “proning” with non-intrusive oxygen treatment may have improved recovery rates. Has hydroxychloroquine helped levels 2 and 3? My impression is that it doesn’t do much good for Level 5, but might work well for less severe levels.
     
    Yes, this relates to the politicization of the HCQ controversy which is absolutely maddening.

    As I mentioned previously, I was on top of this story from the beginning (due in part to Zero Hedge's hysteria) and was aware almost immediately when reports from China indicated their experience with HCQ was very promising. In fact, I was one of those people who purchased the parent molecule -- Chloriquine Phosphate -- from an acquarium store "just in case" (which, by the way, IS the same as the molecule in prescription form, despite what the lying press has told you).

    Very shortly after that it became common knowledge -- at least on Reddit and other fora -- that the best application of the drug was early, before the symptoms had progressed to breathing difficulties, or at the very least at the first sign of breathing difficulties. Lots of people knew it didn't do much once the conditions became severe.

    Yet, many of the recent studies touted as demonstrating HCQ's ineffectiveness either used LARGE dosages that were not even comparable to the dosages used by RA patients who have taken it for years, OR, their study administered the drug only to those with already advanced and severe symptoms!

    Now, I will give them the benefit of the doubt that they only had critical cases to work with, but it does strike me as odd that I, a nobody with an internet connection, seemed to know something these scientists didn't.

    Similarly, about a week or so ago I read of a proposed study by University of Washington (I think, sorry, can't find the link right now), where they were going to test HCQ's effectiveness using a control group. Now, as I'm sure the brainiacs here know, in a medical setting, the control group is given a placebo, usually a sugar pill or somesuch. It turns out that in this particular study, their placebo was to be a Vitamin C pill -- Vitamin C which the Chinese have also used extensively in mitigating their patients' symptoms.

    I'm not saying the study is outright fraud, but you don't have to be a genius to appreciate the implications...

  157. @Polynikes

    Nonsense.
     
    It's not nonsense. Take a quick refresher in recent history and look again at the charts used and rationale given. That's exactly what was sold to the public--mass infections creating the need for mass hospitalizations leading to the collapse of the hospital system resulting in excess deaths.

    When the concept of herd immunity was introduced to the general public the curves used to illustrate it mislead many people as the areas under both curves appeared to be equal.
     
    Maybe you're British? Herd immunity was not a selling point to lock-downs, or any strategy absent vaccines, in America. As little as a week ago Fauci was still talking about targeted lock-downs throughout the fall until a vaccine was found. You wouldn't need vaccines if the population acquired herd immunity by letting the infection spread.


    So, what I wrote is exactly ("precisely" as you Brits might say) right. If you think the lock-downs provided some benefit, feel free to discuss. I don't doubt that they have had some marginal effect. Then we can get into the discussion on whether it was worth it or not. But the original rationale, in America, was 100's of thousands of people not being able to get medical treatment and then dying unnecessarily. (Remember the ventilators?). Never happened.

    The area under the flattened curve is smaller than under the curve of the unconstrained epidemic running at its natural R0. That it was not apparent in the slides used to illustrate the concept of the flattening the curve when it was being introduced to the general public was very unfortunate as many people, like yourself, took what was just a conceptual illustration literary and drew a false conclusion that flattening the curve does not reduce the total number of deaths and the only reason it being done was to reduce the excess deaths due to the medical system overload.

    • Replies: @Kratoklastes
    Add suicides from the flattened economy to the entirely-hypothetical 'flattened' curve.

    And then note that the vast bulk of the deaths from covid19 imposed no significant loss of healthy lifespan, whereas each suicide costs society almost half a healthy lifespan.

    .

    Then, let's recall also that both the flattened and unflattened curves rest on two preposterous assumptions.

    ① that using age-agnostic probabilities of symptoms, hospitalisation and progress to critical illness is a sound idea (it isn't);
    ② that the process being observed began with a single case - namely, the first case with enough symptoms to require a medical visit.

    Consider ①: it matters - significantly - how infections are distributed by age group; how quickly each age group develops symptoms; when in the course of the illness each age cohort requires hospitalisation (and at what rate); how long they stay in hospital; and whether they require an ICU bed (or if you want to kill the fuck out of them, a ventilator).

    NONE of those things is accurately summarised by either the 'unflattened' or 'flattened' version of that fucking 'curve' cartoon.

    Now consider ②.
    That, as far as the 'curve' is concerned, the very first case in the entire US happened on January 19th, and was a 35 year old otherwise-healthy male with no comorbidities who had experienced moderate symptoms for 4 days after returning from China.

    The day before January 18 2020, everything was at zero - because reasons.

    So we know that this 'Patient Zero: Washington' was incubating until January 15th - the day he returned from China on a plane with a bunch of other people.

    So he was in the peak shedding period when he flew back - literally in the sweet-spot (40hrs prior to the onset of symptoms.

    His symptoms had been mild but had worsened on the night of the 18th. He went to the hospital on Jan 19th.

    He had no known contact with sick people in China (i.e., he probably caught it from an asymp), and did not visit the now-famous Hunan market.

    About a million people entered the US between December and from places that had active spread of the disease: China, Italy, Iran.

    Some of those are likely to have been asymps (like ~50% of cases) or oligosymps who thought they had a cold (~30% of cases). They had just had a long flight; felt shit; it's winter; diagnosis: jet-lag and a bad cold.

    Most of the people they infected would also have had no or few symptoms.

    But this one guy (according to the model): he was the only case as of January 19th.

    I deny it. (As R. G. Ingersoll would say).

    Americans love to say short pithy things - "Get some"; "We got this"; "Let's roll" - that sort of juvenile shit.

    My favourite one of those is 'Do the Math'.

    In a model where only 1 in 4 people (age-agnostic) develop symptoms that require medical attention, and only half of those require admission to hospital, what is the likelihood that the very first case on US soil was an otherwise-healthy 35 yo male non-smoker who needed hospitalisation?

    Let's build a population that has an exactly average probability of producing this one guy from its first draw.



    In the latest NYC data, only 10% of cases in the 19-44 age group require hospitalisation.

    So let's do that: assume that 10% of positives in that age group who present with symptoms, require hospitalisation.

    That starts our 'representative batch' on January 19th with not 1 moderately-severe symptomatic 35 year old, but10 - nine of whom are undetected on the day.

    Now we need to double that to conservatively add 'mild' and 'moderate' 19-44 year olds: the people who get it but never feel bad enough to go to the doctor.

    So now we have N[35, 0] = 20.

    Double that (to add for asymps). N[35, 0] = 40

    So on day Zero, being generous it would require a sample that included 40 infected 35 year olds, to be expected to generate 1 hospitalisation from that age range.

    To expand that up to the total case numbers - note that 19-44 year olds are ~37% of all cases.

    So 40/0.37 gives (roughly) 109 infected people (call it 100, and let's ignore gender because that only makes it worse).

    So 100 people of various ages would be a representative 'Batch Zero' that included a hospitalised 35-year old with severe symptoms.

    There would be a 50-odd people who never knew they had it; another 30-odd people who felt bleh in Washington State in winter; and about 30 who really felt awful and were thinking really hard about seeking a doctor - but they didn't go to the doc on January 19th and so missed out on being the starting point for a cartoon curve.
    , @Polynikes
    It’s not about taking them literally. I’m not even talking about the graphs as much as the actual data provided. None of it happened.

    If you want to revise history and make a case that was never made to make yourself feel better or less wrong, go ahead. I’m all ears.
  158. @Mr. Anon
    No, I didn't get triggered. I noticed that which you did not notice yourself, and I simply disagreed with you.

    “I simply disagreed with you.” – Disagree about pejorative labels that I used but do you agree with me that “The area under the flattened curve is smaller than under the curve of the unconstrained epidemic running at its natural R0.”? You haven’t addressed my comment yet.

    • Replies: @Mr. Anon
    I don't know what the area under two different notional curves is. I haven't calculated it. What I do know is that the World's population can't remain in hiding indefinitely, or even until a vaccine is discovered for a corona virus, when no vaccine has ever been developed for any corona virus. This lockdown is foolish, short-sighted and - I suspect - driven by agendas that have nothing to do with public health. I stand by that view. Based on your commenting history at this site, I am surprised that you are not at least a little suspicious about what is behind all this. Do you imagine that the deep state has all of a sudden started leveling with people?

    By the way, my comments were not meant as an insult to you. We disagree on any number of things, but I don't think you are a stupid or frivolous man.
  159. @AnotherDad


    It’s probably going to end up a little higher than seasonal influenza, but not much. The infection fatality rate drops over time because the most vulnerable die early. So when Gangelt reaches 50% infected, the death rate will end up being something like 0.2%.
     
    "It’s probably going to end up a little higher than seasonal influenza,"

    This is just wrong. And frankly ridiculous at this point. Unless you mean ... "because we locked down and knocked the wind out of its sails and a vaccine will come later this year."

    Anyplace where it's had a good run, its death rate has zoomed past any influenza during my entire life--57, 68, 04, 09, etc.


    "The infection fatality rate drops over time because the most vulnerable die early."

    Maybe. The most vulnerable will--on average--likely catch it with "lighter" exposure. The converse is that younger more socially active people are actually more likely to be exposed sooner. They just don't die. The infected right now--not "cases" but the larger number of actually infected--actually skews younger than the population. (For instance i think it's much more likely my kids have had it--or will get it in the next few months--than me. They are much more socially active.)

    But right now we are nowhere near having even a significant fraction of American's exposed. A reasonable guess would be something like the Santa Clara numbers--a few percent.

    If when it gets to Bergamo levels of infection then most people are exposed and you'll have the big cull. But elderly people don't just leap up and die from the damn thing because it's out there ... they have to have someone expose them to it.

    You’re in Washington state, right? I’d be willing to bet you we’ve already had hundreds of thousands of infections.

    I’m in Whatcom county, and we have nearly thirty dead and close to 300 confirmed infected so far. Social distancing is a joke here — nobody’s really practicing it. Neither the old farmers from Lynden nor the young students at Western are wearing masks at the stores, in the parks, wherever. Yet the virus has been here for at least six weeks, but probably a month longer. Based on these antibody studies coming out, we’ve probably had at least 20,000 infections already out of 200,000 people.

    And even if this lockdown has had some effect, it will be short-lived. It’s already over. People are out and about, traffic is nearly back to normal, and furloughed people are most definitely congregating and socially interacting. If the virus comes back with a vengeance, then maybe I’ll grant your point, but I don’t see that happening given the current situation. Ultimately, I think Whatcom county is going to end up with up to half of the population infected and around 50-100 counted as dead from this virus. Maybe 200 if we’re unlucky, but I doubt it, because I think this already went through here in February and they didn’t count those deaths as coronavirus.

    It might be different in Seattle, where you have more social comorbidities, but I doubt it. There are tons of illegal immigrants from Hubei here in Washington, so we’ve had this infection from the beginning. Hell, the ladies running the nail salon in the local strip mall are from Hubei even up here in B-ham. We have now had this virus in WA for at least three months. One month only of half-assed lockdown, before which the disease was doubling every three days. So before lockdown 60 days of unmitigated spread. What’s 2 to the 20th power? It’s over a million, which is just about what the antibody studies are suggesting for WA.

    So there you have it: the reason the deaths are strangely low on the west coast is that it spread here early and killed off many of the vulnerable before they had the opportunity to classify them as coronavirus deaths, and we’re not going to have another high peak because a lot of people have already cleared the infection and are now immune.

    • Agree: Hail
  160. @Big Dick Bandit
    how will we ever know if the fear of the hospitals being overwhelmed was valid or not?

    seems like all the talk of Fatality Rates is kind of a mirage, because there's two rates: the 'normal hospital' rate (likely very low, especially for non-olds) and the 'overrun hospital' rate (probably way high)

    the rationale for distancing was that we had to flatten the curve, otherwise the hospitals would get overrun and the fatality rate would skyrocket--how will we ever know if that tipping point was a real threat or not?

    without knowing that for certain, we'll never know whether the lockdowns were worth it.

    The numbers are conclusive. Outside of a couple hospitals in NYC/NJ, the hospitals are largely empty. Over a hundred hospitals have closed (most just temporarily). Many more have laid off nurses and doctors.

    There was no overrun. The UWash study was as off on hospital beds and ICU beds as it was on deaths.

    • Replies: @prosa123
    Not far from me, about 60 miles east of NYC, the Army Corps of Engineers built a massive field hospital on a university campus in record time. It has the capacity to hold at least 300 patients. The current patient count: a goose egg.
    A couple of weeks ago the Navy hospital ship USNS Comfort arrived in Manhattan with great fanfare. Its departure from Norfolk a day or two earlier was the only time within the past two months that Trump has left the White House. The ship can accommodate 1,000 patients, as of two days ago it had 79 patients. The field hospital at the Javits Convention Center is similarly underutilized.
    Also, to note something mentioned here, golf courses in New York State are now allowed to be open, with certain restrictions as to social distancing. Marinas can open too.
  161. @Lot
    There’s some evidence taking zinc above what you’d get in a normal diet is dangerous. Eating silver will turn your skin a deathly shade of blue permanently, as the Blue Libertarian found out.

    http://www.cbsnews.com/images/2002/10/03/image524282x.jpg

    The unregulated supplement industry funds the “studies” of these things, and nobody has the incentive to spend a lot of money debunking them.

    Eating silver will turn your skin a deathly shade of blue permanently, as the Blue Libertarian found out.

    So I’ve heard. But from my brief perusal it seems this is the only known negative effect of ingesting colloidal silver, and even then probably only in those who ingest large amounts. This is why I specified *nebulized* CS as this specifically targets the point of infection (lungs), thereby requiring only tiny dosages, both factors which avoid high systemic levels. Of course this is all speculative.

    There’s some evidence taking zinc above what you’d get in a normal diet is dangerous.

    That’s possible. What did you have in mind? I know that there are qualified medical professionals prescribing Covid-19 patients Zinc in the 200mg+ range which is a bit higher than the normal 50mg limit. But your comment reminds me that excessive zinc intake can deplete copper levels, is this what you had in mind? In which case popping a copper supplement every few days should be enough to offset that.

    The unregulated supplement industry funds the “studies” of these things, and nobody has the incentive to spend a lot of money debunking them.

    There is probably an element of truth to this, but it is equally true that those who have the money and clout to fund the expensive studies demonstrating the efficacy of nutraceuticals have no incentive to do so because these are natural substances which cannot be patented, so why bother?

    If you look at the board of organizations like the Life Extension Foundation, they are virtually all qualified MD’s and researchers, not exactly homeopaths. I guess it once again boils down to “why are your experts more valid than my experts”?

    It may reassure you to learn that some of the aforementioned nutraceuticals have been included in the Covid-19 Management protocol devised by a Dr. Marik, Chief of Pulmonary and Critical Care at the Eastern Virginia medical school:

    https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf

    That document reminds me of a couple of other items I forgot to include in my original list:

    – Melatonin

    – Magnesium

    …which I also have in my pantry.

    I’ll draw your attention to one thing he says:

    It is important to stress that there is no known drug/treatment that has been proven unequivocally to improve the outcome of COVID-19. This, however, does not mean we should adopt a nihilist approach and limit treatment to “supportive care”. Furthermore, it is likely that there will not be a single “magic bullet” to cure COVID-19. Rather, we should be using multiple drugs/interventions that have synergistic and overlapping biological effects that are safe, cheap and “readily” available.

    If any readers are interested in the scientific rationale for including these nutraceuticals in a Covid-19 regimen, the following two articles go into some depth. I believe I discovered these two links in the comments here at UR, in fact:

    https://www.sciencedirect.com/science/article/pii/S0033062020300372

    https://www.paulcraigroberts.org/wp-content/uploads/2020/02/0418-Blaylock.pdf

  162. @AnotherDad


    It’s probably going to end up a little higher than seasonal influenza, but not much. The infection fatality rate drops over time because the most vulnerable die early. So when Gangelt reaches 50% infected, the death rate will end up being something like 0.2%.
     
    "It’s probably going to end up a little higher than seasonal influenza,"

    This is just wrong. And frankly ridiculous at this point. Unless you mean ... "because we locked down and knocked the wind out of its sails and a vaccine will come later this year."

    Anyplace where it's had a good run, its death rate has zoomed past any influenza during my entire life--57, 68, 04, 09, etc.


    "The infection fatality rate drops over time because the most vulnerable die early."

    Maybe. The most vulnerable will--on average--likely catch it with "lighter" exposure. The converse is that younger more socially active people are actually more likely to be exposed sooner. They just don't die. The infected right now--not "cases" but the larger number of actually infected--actually skews younger than the population. (For instance i think it's much more likely my kids have had it--or will get it in the next few months--than me. They are much more socially active.)

    But right now we are nowhere near having even a significant fraction of American's exposed. A reasonable guess would be something like the Santa Clara numbers--a few percent.

    If when it gets to Bergamo levels of infection then most people are exposed and you'll have the big cull. But elderly people don't just leap up and die from the damn thing because it's out there ... they have to have someone expose them to it.

    Anyplace where it’s had a good run

    That’s cherry picking the data. Look at the CDC’s website on regular flu years. There’s always a couple states hit really hard–often in the NE. If you just used that data, the regular flu would have a IFR many multiples of what it is for the whole country.

    You take things as a whole. Yes, NYC has been hit particularly hard. Other places, that haven’t had lockdowns, have not. If anything there’s an argument to be made that the strict lockdowns have had a negative impact.

    • Replies: @utu
    " If anything there’s an argument to be made that the strict lockdowns have had a negative impact." - If somebody forwarded such an argument, it would be a disclosure of his idiocy. One good thing about this covid thing is that a cognitive reaction to it is a pretty accurate litmus test for the soundness of mind. It is being said that the world will be different after covid. Perhaps it will be better because all kinds of idiots are being outed. They are coming out form their closets on their own.
  163. @Anonymous
    Good thing we have Top Men working on this.

    https://youtu.be/hGmkl0MYzxA

    Anyone genuinely working on vaccines for the virus would not have time right now to be a prolific tweeter.

  164. @Anon
    De Blasio is now encouraging people to take cell phone pictures of anyone not social distancing and text the shots to 'law enforcement.' Judging from the comments, New Yorkers do not like this.

    https://twitter.com/NYCMayor/status/1251496378372632577

    You learn a lot about a person's character by how they act under times of stress. Has anyone seen De Blasio's popularity ratings lately?

    De Blasio is now encouraging people to take cell phone pictures of anyone not social distancing and text the shots to ‘law enforcement.’ Judging from the comments, New Yorkers do not like this.

    How do you report places that aren’t enforcing social distancing? It’s simple: just snap a photo and text it to 311-692. #AskMyMayor pic.twitter.com/WQdCcVf1Rl— Mayor Bill de Blasio (@NYCMayor) April 18, 2020

    As a few Twitteratti have commented regarding this development:

    “Sure would be a shame if a bunch of people texted dick pics to this number”

    • Replies: @anon
    Der Furor discovers someone has gone to the grocery store without a mask.

    https://thumbs.gfycat.com/PleasantFantasticHog-size_restricted.gif
  165. Anonymous[553] • Disclaimer says:
    @Anonymous
    Good thing we have Top Men working on this.

    https://youtu.be/hGmkl0MYzxA

    Her tweets are private now.

    You can still see her twitter page though.

    “Virology. Vaccinology. Vagina-ology. Vino-ology.”

    It is good to know that we have top vagina-ologists on the case. Also, I hope she waits until after work to get into the vino-ology.

    However, from an intersectional point of view, I can understand it. The vinology leads to virology issues with the vaginaology, and she is working on vaccineology to prevent this in the future. Like HPV shots.

    This reminds me that when AIDS was a new thing, all these people who are now draconian quarantine lockdown proponents told us that it was absolutely unAmerican and impossible to separate HIV and AIDS patients from their many victims. What changed?

  166. @utu
    "I simply disagreed with you." - Disagree about pejorative labels that I used but do you agree with me that "The area under the flattened curve is smaller than under the curve of the unconstrained epidemic running at its natural R0."? You haven't addressed my comment yet.

    I don’t know what the area under two different notional curves is. I haven’t calculated it. What I do know is that the World’s population can’t remain in hiding indefinitely, or even until a vaccine is discovered for a corona virus, when no vaccine has ever been developed for any corona virus. This lockdown is foolish, short-sighted and – I suspect – driven by agendas that have nothing to do with public health. I stand by that view. Based on your commenting history at this site, I am surprised that you are not at least a little suspicious about what is behind all this. Do you imagine that the deep state has all of a sudden started leveling with people?

    By the way, my comments were not meant as an insult to you. We disagree on any number of things, but I don’t think you are a stupid or frivolous man.

  167. @Hail

    This is not how flattening the curve is supposed to work.

    We’re not building herd immunity while protecting the health system from overload.

    We’re not extinguishing the virus (which is probably impossible anyway, but in any case we’re not doing it).

    We’re just sitting here in limbo with our thumbs up our butts burning truckloads of cash.
     

    I hate to be the one to tell you this, vhrm, but I will:

    You are in the Twilight Zone.

    The Corona Twilight Zone.

    https://www.youtube.com/watch?v=Gdo3BP3m42I


    Kramer: So what are you saying, that we're wrong? Oh, everybody's wrong but you.

    Jerry: You know, this is like that Twilight Zone, where the guy wakes up, and he's the same but everybody else if different!

    Kramer: Which one?

    Jerry: They were all like that.
     

    Yet more proof that Seinfeld was the greatest sitcom of all time, and was actually a much better guide to human behavior than the ernestly middlebrow Twilight Zone.

  168. @Polynikes

    Anyplace where it’s had a good run
     
    That's cherry picking the data. Look at the CDC's website on regular flu years. There's always a couple states hit really hard--often in the NE. If you just used that data, the regular flu would have a IFR many multiples of what it is for the whole country.

    You take things as a whole. Yes, NYC has been hit particularly hard. Other places, that haven't had lockdowns, have not. If anything there's an argument to be made that the strict lockdowns have had a negative impact.

    ” If anything there’s an argument to be made that the strict lockdowns have had a negative impact.” – If somebody forwarded such an argument, it would be a disclosure of his idiocy. One good thing about this covid thing is that a cognitive reaction to it is a pretty accurate litmus test for the soundness of mind. It is being said that the world will be different after covid. Perhaps it will be better because all kinds of idiots are being outed. They are coming out form their closets on their own.

    • Replies: @Anon
    Yep, this whole Corona Virus thing sure is separating the men from the boys, the faithful from the faithless, and those of sound mind from the easily suggestible. Communicable diseases have been with us since as long as humans have been around. Why weren't these histrionic scared little babies like Utu going crazy before? Because the mass media hadn't told them to yet. Now these weak little bug men like Utu want to control us and tell us that we have to be scared like them and hide under our beds. That's a bridge too far.
  169. @Polynikes
    The numbers are conclusive. Outside of a couple hospitals in NYC/NJ, the hospitals are largely empty. Over a hundred hospitals have closed (most just temporarily). Many more have laid off nurses and doctors.

    There was no overrun. The UWash study was as off on hospital beds and ICU beds as it was on deaths.

    Not far from me, about 60 miles east of NYC, the Army Corps of Engineers built a massive field hospital on a university campus in record time. It has the capacity to hold at least 300 patients. The current patient count: a goose egg.
    A couple of weeks ago the Navy hospital ship USNS Comfort arrived in Manhattan with great fanfare. Its departure from Norfolk a day or two earlier was the only time within the past two months that Trump has left the White House. The ship can accommodate 1,000 patients, as of two days ago it had 79 patients. The field hospital at the Javits Convention Center is similarly underutilized.
    Also, to note something mentioned here, golf courses in New York State are now allowed to be open, with certain restrictions as to social distancing. Marinas can open too.

  170. @anon
    We do that too here; it is called hospice/palliative care. Common in case of cancer. In some places, they go one step further and call it by the alliterative phrase death with dignity.

    Palliative care? (Cue ‘Hospital TV show aimed at housewives’…

    Palliative care? I didn’t become the most gifted telegenic ex-Special Forces lady-doctor in Yankistan, just to let deathly-ill people die. Not on my watch. Let’s roll. Get some. Oo-rah. Send it. Let’s roll – oh, I said that already. We got this.

    To patient: FIGHT, damn, you! FIGHT! GOD DAMN IT... she’s coding. Prep 2-by vasopressin and epinephrine – STAT!! (Pick up paddles)… CHARGING 300… CLEAR

    (familiar “Thump-wheeeeee”; patient bucks)
    (repeat “Charging… clear…” 5 or 6 times)

    Patient (groggy): mmm… ugh…
    Patient (now awake): Thanks doc. Now I better go get them terrrrrrists and stop that dirty bomb attack with weaponised covid19.

    (Patient yanks IV leads from arm and dashes out the door)

    Dr: Well, I guess that’s what you would expect from a selfless maverick ex-Marine who follows his own rules.

  171. @Big Dick Bandit
    how will we ever know if the fear of the hospitals being overwhelmed was valid or not?

    seems like all the talk of Fatality Rates is kind of a mirage, because there's two rates: the 'normal hospital' rate (likely very low, especially for non-olds) and the 'overrun hospital' rate (probably way high)

    the rationale for distancing was that we had to flatten the curve, otherwise the hospitals would get overrun and the fatality rate would skyrocket--how will we ever know if that tipping point was a real threat or not?

    without knowing that for certain, we'll never know whether the lockdowns were worth it.

    the rationale for distancing was that we had to flatten the curve, otherwise the hospitals would get overrun and the fatality rate would skyrocket–how will we ever know if that tipping point was a real threat or not?

    without knowing that for certain, we’ll never know whether the lockdowns were worth it.

    Hospitals being overrun was (is) a real threat. It happened a lot in Wuhan it happened somewhat in Italy.

    BUT just because it’s a threat it doesn’t mean that the lockdown was justified. There are many responses: preparing surge capacity at hospitals is a response.
    Banning large events is another.
    Suggesting that people stay home is another.
    Suggesting that people wear masks is yet another.

    Forcing stores and businesses to close and forcing people to stay home is pretty far out there. (though, to be fair, it could be worse. They could have roadblocks on highways and the national guard in the streets. They could require permits to buy gas. They could have the States take over the whole economy and dictate all production, sales and consumption).

    So, imo (and that of most the anti-doomers) SOME responses were warranted to deal with this real threat, but the “lockdown” part of the response was not necessary,
    – especially not necessary at the time (could have waited to see how numbers developed)
    – no longer necessary now when obviously the feared outcomes haven’t materialized and hospitals aren’t overrun anywhere. (not even in all of NYC though a few hospitals were at capacity there for a few days)
    – not worth the cost by a longshot
    -etc.

    (the details and different flavors of belief are strewn across these comment threads)

    • Agree: Polynikes, res
    • Replies: @Mehen

    BUT just because it’s a threat it doesn’t mean that the lockdown was justified. There are many responses: preparing surge capacity at hospitals is a response.
    Banning large events is another.
    Suggesting that people stay home is another.
    Suggesting that people wear masks is yet another.
     
    I read a great comment somewhere that I wish I could find now. Basically it stressed the importance of appreciating the law of diminishing returns in this situation, and divvied up the various measures into deciles, much as you have done here. Take away point was that by the time you got to the final decile ("total lockdown") you have probably done the best you can within reason, and that final 10% probably doesn't add as much utility, especially compared to the cost.
  172. @Steve Sailer
    "seems like all the talk of Fatality Rates is kind of a mirage, because there’s two rates: the ‘normal hospital’ rate (likely very low, especially for non-olds) and the ‘overrun hospital’ rate (probably way high)"

    Right.

    Here's a question: There are basically 5 levels of treatment for infected people:

    1. Stay home, don't see a doctor.
    2. See a doctor, go back home.
    3. Hospitalization.
    4. ICU.
    5. Ventilator.

    How have the treatments changed in effectiveness over time versus expectations? My guess is that ventilators have proven less effective than was hoped. However, Hospitalization and ICU (Boris Johnson got both, but not a ventilator) may have improved: the discovery of "proning" with non-intrusive oxygen treatment may have improved recovery rates. Has hydroxychloroquine helped levels 2 and 3? My impression is that it doesn't do much good for Level 5, but might work well for less severe levels.

    How have the treatments changed in effectiveness over time versus expectations? My guess is that ventilators have proven less effective than was hoped. However, Hospitalization and ICU (Boris Johnson got both, but not a ventilator) may have improved: the discovery of “proning” with non-intrusive oxygen treatment may have improved recovery rates. Has hydroxychloroquine helped levels 2 and 3? My impression is that it doesn’t do much good for Level 5, but might work well for less severe levels.

    Yes, this relates to the politicization of the HCQ controversy which is absolutely maddening.

    As I mentioned previously, I was on top of this story from the beginning (due in part to Zero Hedge’s hysteria) and was aware almost immediately when reports from China indicated their experience with HCQ was very promising. In fact, I was one of those people who purchased the parent molecule — Chloriquine Phosphate — from an acquarium store “just in case” (which, by the way, IS the same as the molecule in prescription form, despite what the lying press has told you).

    Very shortly after that it became common knowledge — at least on Reddit and other fora — that the best application of the drug was early, before the symptoms had progressed to breathing difficulties, or at the very least at the first sign of breathing difficulties. Lots of people knew it didn’t do much once the conditions became severe.

    Yet, many of the recent studies touted as demonstrating HCQ’s ineffectiveness either used LARGE dosages that were not even comparable to the dosages used by RA patients who have taken it for years, OR, their study administered the drug only to those with already advanced and severe symptoms!

    Now, I will give them the benefit of the doubt that they only had critical cases to work with, but it does strike me as odd that I, a nobody with an internet connection, seemed to know something these scientists didn’t.

    Similarly, about a week or so ago I read of a proposed study by University of Washington (I think, sorry, can’t find the link right now), where they were going to test HCQ’s effectiveness using a control group. Now, as I’m sure the brainiacs here know, in a medical setting, the control group is given a placebo, usually a sugar pill or somesuch. It turns out that in this particular study, their placebo was to be a Vitamin C pill — Vitamin C which the Chinese have also used extensively in mitigating their patients’ symptoms.

    I’m not saying the study is outright fraud, but you don’t have to be a genius to appreciate the implications…

  173. @PiltdownMan

    $10,000 Abbott ID NOW™ ...
     
    The cost per unit that you use in your example reflects the asking price computed on a much smaller number for total unit production. The marginal cost of each of those tests is definitely less than in your example, quite possibly by an order of magnitude (or more in the case of the fancy Abbott machine.)

    The total cost of such a plan would likely be significantly less than that figure of $450 billion. The problem, of course, is ramping up production rapidly to that scale, and raw materials supply/sorucing problems, not least because, if it is feasible, every other country that can afford such a program will want to do the same.

    PiltdownMan, agree with everything you said, valid points. The machines would certainly been less expensive at megaunit quantities, but they are the “cheap” piece. Not sure how much buffer there is with the test kits. Still seems a bargain for virtual elimination of this virus; and preparedness for those in the future.

    Lockdowns/restrictions could be unwound right quick; and the vast majority would gain the confidence to return to their normally scheduled lives.

    D1620DA4-F090-4CBD-951F-4B470F175B78

    72E27CD2-2DC2-4613-B6BF-B1D3EE086E2C

  174. @anon
    Lot of data/information, little knowledge/wisdom.

    Covid = a riddle, wrapped in a mystery, inside an enigma

    ‘…Covid = a riddle, wrapped in a mystery, inside an enigma’

    How about: ‘remarkably little, wrapped inside hysteria, wrapped inside media sensationalism’?

    I’d say it’s all been about enough, wouldn’t you?

  175. @Mehen


    De Blasio is now encouraging people to take cell phone pictures of anyone not social distancing and text the shots to ‘law enforcement.’ Judging from the comments, New Yorkers do not like this.

     


    How do you report places that aren’t enforcing social distancing? It’s simple: just snap a photo and text it to 311-692. #AskMyMayor pic.twitter.com/WQdCcVf1Rl— Mayor Bill de Blasio (@NYCMayor) April 18, 2020
     
    As a few Twitteratti have commented regarding this development:

    "Sure would be a shame if a bunch of people texted dick pics to this number"

    Der Furor discovers someone has gone to the grocery store without a mask.

  176. @vhrm

    the rationale for distancing was that we had to flatten the curve, otherwise the hospitals would get overrun and the fatality rate would skyrocket–how will we ever know if that tipping point was a real threat or not?

    without knowing that for certain, we’ll never know whether the lockdowns were worth it.
     
    Hospitals being overrun was (is) a real threat. It happened a lot in Wuhan it happened somewhat in Italy.

    BUT just because it's a threat it doesn't mean that the lockdown was justified. There are many responses: preparing surge capacity at hospitals is a response.
    Banning large events is another.
    Suggesting that people stay home is another.
    Suggesting that people wear masks is yet another.

    Forcing stores and businesses to close and forcing people to stay home is pretty far out there. (though, to be fair, it could be worse. They could have roadblocks on highways and the national guard in the streets. They could require permits to buy gas. They could have the States take over the whole economy and dictate all production, sales and consumption).


    So, imo (and that of most the anti-doomers) SOME responses were warranted to deal with this real threat, but the "lockdown" part of the response was not necessary,
    - especially not necessary at the time (could have waited to see how numbers developed)
    - no longer necessary now when obviously the feared outcomes haven't materialized and hospitals aren't overrun anywhere. (not even in all of NYC though a few hospitals were at capacity there for a few days)
    - not worth the cost by a longshot
    -etc.

    (the details and different flavors of belief are strewn across these comment threads)

    BUT just because it’s a threat it doesn’t mean that the lockdown was justified. There are many responses: preparing surge capacity at hospitals is a response.
    Banning large events is another.
    Suggesting that people stay home is another.
    Suggesting that people wear masks is yet another.

    I read a great comment somewhere that I wish I could find now. Basically it stressed the importance of appreciating the law of diminishing returns in this situation, and divvied up the various measures into deciles, much as you have done here. Take away point was that by the time you got to the final decile (“total lockdown”) you have probably done the best you can within reason, and that final 10% probably doesn’t add as much utility, especially compared to the cost.

    • Replies: @vhrm
    That would be interesting. I haven't seen anything on the expected effectiveness of different interventions, how they might interact, how much they cost, etc.
  177. @utu
    The area under the flattened curve is smaller than under the curve of the unconstrained epidemic running at its natural R0. That it was not apparent in the slides used to illustrate the concept of the flattening the curve when it was being introduced to the general public was very unfortunate as many people, like yourself, took what was just a conceptual illustration literary and drew a false conclusion that flattening the curve does not reduce the total number of deaths and the only reason it being done was to reduce the excess deaths due to the medical system overload.

    Add suicides from the flattened economy to the entirely-hypothetical ‘flattened’ curve.

    And then note that the vast bulk of the deaths from covid19 imposed no significant loss of healthy lifespan, whereas each suicide costs society almost half a healthy lifespan.

    .

    Then, let’s recall also that both the flattened and unflattened curves rest on two preposterous assumptions.

    ① that using age-agnostic probabilities of symptoms, hospitalisation and progress to critical illness is a sound idea (it isn’t);
    ② that the process being observed began with a single case – namely, the first case with enough symptoms to require a medical visit.

    Consider ①: it matters – significantly – how infections are distributed by age group; how quickly each age group develops symptoms; when in the course of the illness each age cohort requires hospitalisation (and at what rate); how long they stay in hospital; and whether they require an ICU bed (or if you want to kill the fuck out of them, a ventilator).

    NONE of those things is accurately summarised by either the ‘unflattened’ or ‘flattened’ version of that fucking ‘curve’ cartoon.

    Now consider ②.
    That, as far as the ‘curve’ is concerned, the very first case in the entire US happened on January 19th, and was a 35 year old otherwise-healthy male with no comorbidities who had experienced moderate symptoms for 4 days after returning from China.

    The day before January 18 2020, everything was at zero – because reasons.

    So we know that this ‘Patient Zero: Washington‘ was incubating until January 15th – the day he returned from China on a plane with a bunch of other people.

    So he was in the peak shedding period when he flew back – literally in the sweet-spot (40hrs prior to the onset of symptoms.

    His symptoms had been mild but had worsened on the night of the 18th. He went to the hospital on Jan 19th.

    He had no known contact with sick people in China (i.e., he probably caught it from an asymp), and did not visit the now-famous Hunan market.

    About a million people entered the US between December and from places that had active spread of the disease: China, Italy, Iran.

    Some of those are likely to have been asymps (like ~50% of cases) or oligosymps who thought they had a cold (~30% of cases). They had just had a long flight; felt shit; it’s winter; diagnosis: jet-lag and a bad cold.

    Most of the people they infected would also have had no or few symptoms.

    But this one guy (according to the model): he was the only case as of January 19th.

    I deny it. (As R. G. Ingersoll would say).

    Americans love to say short pithy things – “Get some“; “We got this“; “Let’s roll” – that sort of juvenile shit.

    My favourite one of those is ‘Do the Math‘.

    In a model where only 1 in 4 people (age-agnostic) develop symptoms that require medical attention, and only half of those require admission to hospital, what is the likelihood that the very first case on US soil was an otherwise-healthy 35 yo male non-smoker who needed hospitalisation?

    Let’s build a population that has an exactly average probability of producing this one guy from its first draw.

    [MORE]

    In the latest NYC data, only 10% of cases in the 19-44 age group require hospitalisation.

    So let’s do that: assume that 10% of positives in that age group who present with symptoms, require hospitalisation.

    That starts our ‘representative batch’ on January 19th with not 1 moderately-severe symptomatic 35 year old, but10 – nine of whom are undetected on the day.

    Now we need to double that to conservatively add ‘mild’ and ‘moderate’ 19-44 year olds: the people who get it but never feel bad enough to go to the doctor.

    So now we have N[35, 0] = 20.

    Double that (to add for asymps). N[35, 0] = 40

    So on day Zero, being generous it would require a sample that included 40 infected 35 year olds, to be expected to generate 1 hospitalisation from that age range.

    To expand that up to the total case numbers – note that 19-44 year olds are ~37% of all cases.

    So 40/0.37 gives (roughly) 109 infected people (call it 100, and let’s ignore gender because that only makes it worse).

    So 100 people of various ages would be a representative ‘Batch Zero‘ that included a hospitalised 35-year old with severe symptoms.

    There would be a 50-odd people who never knew they had it; another 30-odd people who felt bleh in Washington State in winter; and about 30 who really felt awful and were thinking really hard about seeking a doctor – but they didn’t go to the doc on January 19th and so missed out on being the starting point for a cartoon curve.

  178. “Then, let’s recall also that both the flattened and unflattened curves rest on two preposterous assumptions and blah blah blah” – No assumptions are made about IFR or CFR whether age or not age dependent when developing the model of how the infection is spreading under different countermeasure scenario.

  179. @Mehen

    BUT just because it’s a threat it doesn’t mean that the lockdown was justified. There are many responses: preparing surge capacity at hospitals is a response.
    Banning large events is another.
    Suggesting that people stay home is another.
    Suggesting that people wear masks is yet another.
     
    I read a great comment somewhere that I wish I could find now. Basically it stressed the importance of appreciating the law of diminishing returns in this situation, and divvied up the various measures into deciles, much as you have done here. Take away point was that by the time you got to the final decile ("total lockdown") you have probably done the best you can within reason, and that final 10% probably doesn't add as much utility, especially compared to the cost.

    That would be interesting. I haven’t seen anything on the expected effectiveness of different interventions, how they might interact, how much they cost, etc.

  180. @PiltdownMan

    Eating silver will turn your skin a deathly shade of blue permanently,
     
    Libertarian Stan Jones got off relatively lightly.

    https://i.imgur.com/ZMVBenC.jpg

  181. @Jenner Ickham Errican

    Our estimates of cumulative 
infections suggest the western United States remains far from reaching a herd immunity threshold.
     
    Damn. So is Kaiser saying this contagion emergency is likely to be


    Permanente

    https://pbs.twimg.com/profile_images/449000561799884802/8pMZUmYl_400x400.jpeg

    https://i.imgur.com/eu1sXjB.png

    That opening scene from CSI: Miami with David Caruso/Horatio Caine was always a hoot… 🙂

  182. @Anonymous
    "... a prospectively-followed cohort"

    >hyphenated adverb in the literal abstract.

    Into the trash.

    Did you consciously aim at coming across as a pompous idiot, or did it just work out that way?

  183. @utu
    The area under the flattened curve is smaller than under the curve of the unconstrained epidemic running at its natural R0. That it was not apparent in the slides used to illustrate the concept of the flattening the curve when it was being introduced to the general public was very unfortunate as many people, like yourself, took what was just a conceptual illustration literary and drew a false conclusion that flattening the curve does not reduce the total number of deaths and the only reason it being done was to reduce the excess deaths due to the medical system overload.

    It’s not about taking them literally. I’m not even talking about the graphs as much as the actual data provided. None of it happened.

    If you want to revise history and make a case that was never made to make yourself feel better or less wrong, go ahead. I’m all ears.

    • Replies: @utu
    "..as much as the actual data provided. None of it happened." - We went into the lockdown to lower the number of fatalities. You can't argue that the low number of fatalities now confirms your belief that we did not need the lockdown in the first place, so the lockdown should be lifted. Do you want evidence that lockdowns work? Look at Sweden, it has 7 times higher death rate than its neighbor Finland with similar population density, culture and economic development.
  184. @AnotherDad
    Kratoklastes, that's a solid critique of using these "average time to death" estimates. (As in ic1000s spitballing.)

    When there are rising infections then the deaths on any given day are actually dominated by the old and weak dying from more recent infections.

    However, your close:

    PandemicTV is pretty much done for 2020, and the next few weeks will be politicians doing victory laps and crowing that they saved humanity… and in 3 months there might be a 3 paragraph story in some inside page, discussing a recent inexplicable spike in suicides.
     
    I don't buy. Yeah politicians will crow and pretend they saved the world--they are after all politicians-- ... but first the world has to actually be saved.

    The plain fact here is that most Americans have not been infected--and probably never exposed.

    Summer weather--heat, humidity, sunshine--will be a huge help--as it is with the flu. But 95% of Americans are Corona-Chan virgins. If/when people just "business as usual"--the "just the flu" folks advocate, then this will at least sizzle along all summer and definitely kick back up again in the fall, when we enter the normal flu season.

    Over-reaction and--i'd argue--wrong steps, ok. Cost benefit, agreed. But people who don't think this is a real bug--one which
    a) basically no one has any pre-existing immunity from prior exposure and so easily spreads through the population and
    b) kills a bunch of people--though fortunately mostly old/sick, ergo minimal lost years
    ... are simply data-averse loons.

    It isn't going away--in three months or three years--until there's herd immunity or a vaccine.

    But people who don’t think this is a real bug

    Have we slipped back to this strawman now?

    If/when people just “business as usual”–the “just the flu” folks advocate, then this will at least sizzle along all summer and definitely kick back up again in the fall, when we enter the normal flu season.

    Of course this will happen. But there’s little choice unless you want to stay in some quasi-authoritarian state until Bill Gates delivers his vaccine.

    BTW, the regular flu is mutating. And starting next fall it is going to kill 30-50,000 Americans. What should we do about that?

    • Agree: Hail, TomSchmidt
  185. @Polynikes
    It’s not about taking them literally. I’m not even talking about the graphs as much as the actual data provided. None of it happened.

    If you want to revise history and make a case that was never made to make yourself feel better or less wrong, go ahead. I’m all ears.

    “..as much as the actual data provided. None of it happened.” – We went into the lockdown to lower the number of fatalities. You can’t argue that the low number of fatalities now confirms your belief that we did not need the lockdown in the first place, so the lockdown should be lifted. Do you want evidence that lockdowns work? Look at Sweden, it has 7 times higher death rate than its neighbor Finland with similar population density, culture and economic development.

  186. @Kratoklastes
    Your estimates will change if you re-do everything with
     • age-relevant transition probabilities (i.e., old sick people are outright more susceptible; develop symptoms quicker; and have disease progression that hits harder, earlier); and
     • the assumption that more than half of all 'confirmed' infections in the young (the largest cohort of 'confirmed' infections) are asymptomatic, and almost none of the young die from covid19.

    Given the CF(w)R for people over 75 is of the order of 30% on a 'same date' basis (i.e., using 'cases today' as the denominator for 'deaths today')‚ if lag structure is set up as age-agnostic numbers suggest, the system runs into problems.

    Take the April 17 deaths for NYC.

    There were 287 deaths of people aged 75 and over (NY's data still apparently still requires a positive lab test - at least that's what's shown at the top of each day's NYC Daily Death Summary for April 15 2020.

    Go back 27 days and fetch the 'confirmed cases' data for NYC for March 21st: there were only 390 cases in the 65+ group (until March 21, NYC was ending the relevant age cohorts at 65).

    But this was notionally the day these fogies got infected... they wouldn't show symptoms until incubation was finished.

    Five days later on the 26th (assuming that 75+ people start to show symptoms at the median incubation period) there were only 302 new confirmed cases among the 75+ group - so we're 15 deaths to the good... we can have <100% mortality and a 22-day look-back. In fact, the last week's worth of deaths is only 73% of the total cases up to March 26th.

    If you do this consistently - that the deaths have to come from new cases 22 days ago - it paints a terrible picture: a tad under ¾ of infected in the age group, 75+ die.

    What's missing? All of the 75+ cases since March 26th.

    Using the 22-day-lookback, results in a gigantic - and still-growing - pool of old infected waiting to die. That's not observed.

    Currently it would be all 75+ cases after March 26th. 12,868.

    So 73% of them will cark it over the next 22 days. That's 9,429 old people - which is almost 2.3 times the current cumulative total number of deaths in that age group.

    That's the thing that shows that the cases-wide dynamics are a bad choice.

    It's also why your proposed 'go back 22 days; count all cases; divide by assumed IFR' isn't a good idea.

    .

    This is why the putative "death-date-to-infection-date-matching" idea is a really bad idea if age-agnostic parameters are used - it biases the look-back period upwards (and therefore, for a given IFR, it overstates 'undiscovered' cases).

    I've used "75+" people as a cohort as if it doesn't have a natural internal partition - but of course it does... 75+ers with chronic illness - who die even faster than 75+ without. NYC's data doesn't have case comorbidity data; it has death

    Given that CFR has such a distinct age-cohort pattern, and is so strongly influenced by key relevant chronic illness, it would be weird to assume that susceptibility (and other transmission probabilities) aren't also different.

    .

    The thing is best modelled with age-group-specific dynamics - where the older age groups (and particularly the chronically-ill older people) take less than a week from symptoms to death or recovery. There's still a very high IFR in their age cohort, but correspondingly much much lower than 0.5 for the other age cohorts.

    I've spent a couple of days doing a half-assed search of the literature, and this seriously seems to be something that has had almost no real attention - I guess because this is the first real pandemic where the death-by-age is so tilted towards one end of the age distribution.

    If I was 15 years younger I would be eagerly writing up something with a view to submitting it to an open journal.

    As it is I'll do a half-assed writeup and stick it on a blog - there's no incentive to do more, because covid19's about to be dropped from media coverage.

    PandemicTV is pretty much done for 2020, and the next few weeks will be politicians doing victory laps and crowing that they saved humanity... and in 3 months there might be a 3 paragraph story in some inside page, discussing a recent inexplicable spike in suicides.

    K., you have convinced me that the exercise I tried isn’t the way to extract useful information on past SARS-CoV-2 prevalence and thus IFR. There are too many unconstrained variables.

    If this is worth doing at all, the analyst has to work from primary data. E.g. the mean (and distribution) of the time from infection to death could be reliably estimated, for the chosen definition of “the elderly” (>65? 70? 80?).

  187. The Oxford Covid-19 Evidence Service on IFR (dated 3/17/20, updated 4/15/20):

    We could make a simple estimation of the IFR as 0.36%, based on halving the lowest boundary of the CFR prediction interval. However, the considerable uncertainty over how many people have the disease, the proportion asymptomatic (and the demographics of those affected) means this IFR is likely an overestimate…

    Taking account of historical experience, trends in the data, increased number of infections in the population at largest, and potential impact of misclassification of deaths gives a presumed estimate for the COVID-19 IFR somewhere between 0.1% and 0.36%.

    Unrelated, they offer their view on Hydroxychloroquine (April 14) here. Verdict: ineffective.

  188. @Kratoklastes
    Oh, don't get me wrong - I'm not saying that this specific coronavirus family will actually go away.

    I'm just saying that once the victory laps are done, deaths from covid19 will not get large-scale media coverage in any subsequent Northern Hemisphere flu season.

    In subsequent US flu seasons, the only covid19 deaths recorded will be genuine deaths-from; nobody will be under pressure to record the death of every massively-ill old person as 'covid19' and there will be no federal grants to hospitals for each near-death person that they attach to a ventilator.

    The other thing to bear in mind is that as testing becomes less selective, evidence is rapidly accumulating that the 'confirmed case' counts are massive underestimates of total infections - at least an order of magnitude - and as a result even age-cohort IFRs are massively overstated.

    This is consistent with my position right from the start: if this thing started with an R[0] of 2.5 and was spreading unchecked for 3 months, a very very large proportion of the population would already have been exposed. (This was my major beef with an unconstrained SEIR model that used age-agnostic parameters).

    A couple of recent examples that reinforce the 'Ruh roh - maybe a shitload of people have got/had it' case...

     • One third of people tested for antibodies in Boston, tested positive. All were asymptomatic (this was a free rapid-test). Sample size was only 200, though, and the serological tests are much less accurate than PCR (although PCR has its own problems in 'real live' conditions.

     • 397 people in a Boston homeless shelter were PCR-tested. 146 returned positive tests - not one of them was symptomatic. None even had a fever (a fever of 100.4°F was previously used as the trigger for a test).

    "The homeless" isn't an obvious answer to "identify a healthy subpopulation" - although people in crisis accommodation skew young.

    The acknowledged asymp rate keeps climbing, but is often based on small samples. The BMJ (BMJ 2020;369:m1375) claims that there is data from China that has 80% of cases asymptomatic, but that was one day's test results.

    According to that BMJ story, China has found 43,000 asymps through contact tracing of existing 'confirmed cases' (some of whom were asymps themselves). That still hasn't been published anywhere, but let's hope there's an age breakdown.

    So hitherto-undiscovered asymps raised the Chinese case count by more than 50% since April 1, and can still be guaranteed to have missed a bunch of people. Once they've done contact tracing on everyone, they need to turn around and test downstream from all the newly-discovered asymps - i.e., their contacts after their presumed infection date.

    There's a lot of uncertainty in all these numbers though: serological 'antibody' tests are extremely error-prone, because the FDA standards for test approval have been gutted and rely on unrealistic 'contrived' test samples.

    In other words, serological tests are the "Affirmative Action hires" of the covid19 testing world. Everyone just has to shut up and believe that they're adequate, knowing that they ain't.

    The numbers in NYC are hopefully much higher. If all we have is serological, then we need to go with that. Cum grano salis.

  189. Anon[368] • Disclaimer says:
    @utu
    " If anything there’s an argument to be made that the strict lockdowns have had a negative impact." - If somebody forwarded such an argument, it would be a disclosure of his idiocy. One good thing about this covid thing is that a cognitive reaction to it is a pretty accurate litmus test for the soundness of mind. It is being said that the world will be different after covid. Perhaps it will be better because all kinds of idiots are being outed. They are coming out form their closets on their own.

    Yep, this whole Corona Virus thing sure is separating the men from the boys, the faithful from the faithless, and those of sound mind from the easily suggestible. Communicable diseases have been with us since as long as humans have been around. Why weren’t these histrionic scared little babies like Utu going crazy before? Because the mass media hadn’t told them to yet. Now these weak little bug men like Utu want to control us and tell us that we have to be scared like them and hide under our beds. That’s a bridge too far.

    • Disagree: Peter Frost

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