Dealing with Lockdown

[vegas]

bad flu nothing more.

I was in the "it's a bad flu" camp until late-February. There was no reason to believe the numbers coming out of the PRC or that they would be representative even if they were reliable for the rest of the world.

But since then the rest of the world x-PRC has observed increasingly bad fatality rates. South Korea in particular can be our canary in the coal mine, with their early exposure and high level of testing. The progression of the disease there makes it clear this is no flu. I'm not going to repeat what I posted upthread, but the across many dimensions (e.g. fatality rate, fatality rate for 50 year olds, hospitalization/ICU rate for prime working aged, contagiousness) covid-19 is significantly worse than flu.

All that written, I don't think people outside a high risk group should be afraid of this. It is not a zombie apocalypse, and society is not going to collapse from covid-19. The infection fatality rate could well be below the 2.0% the RoK is reporting (the reported fatality rate went up 0.1% since I last posted in this thread) because asymptomatic and mild cases go under-reported. Nevertheless, the observed mortality and morbidity rates are too much to ignore from a public health perspective.

 

[flykiller]

Philippines has threatened to shoot violators

(laugh) and what's this I hear about putin having lions released on the streets of moscow to encourage quarantine?

the observed mortality and morbidity rates are too much to ignore

saw a headline the other day to the effect that there were more suicides in tennessee this month than covid19 fatalities in the u.s. so far. if we're going by numbers then this whole thing is worse than fake and the hysterical over-response is going to kill ten times more people than this flu ever will. 10 million applying for unemployment this month? $2 trilllion in spending with more on the way? this ain't got nothing to do with the flu and it makes you wonder what is going on here.

somebody pointed out that you can say "covid19" to the tune of "come on eileen". maybe I'll put it to lyrics or something ....

 

[flykiller]

(laugh)

line outside of a gun shop in san francisco ...

(laugh) guess they know what 30% unemployment means ....

 

[vegas]

Fake news: there's a Trader Joe's on the next block.

 

[vegas]

The math of pandemic if you do nothing is that the percentage of the people that get infected is = 1 - (1/Ro)
Where Ro is the number of people the marginal initial person infects

Ro for covid is unknown but estimated at 2.5 to 6. So do nothing and we are looking at 60 to 85% of the population getting this illness while we have no known treatment.

If the fatality rate is 2% or a quarter of that, its an overwhelming number of people in the hospital/ICU/morgue.

Not even Chairman Xi and the PRC could choose to swallow hard and take that on.

 

[Carlobrand]

What is going on here is we have a disease for which we don't have a vaccination, that tends to be most dangerous to the elderly and medically vulnerable, and that is transmitted by infected persons who have no idea that they are infected. That last part is the scary part: the guy who goes to his job at the nursing home without so much as a scratchy throat could end up being the vector that triggers the death of a quarter of the nursing home's inhabitants. We're going through all this because ending up with 60,000 people dead and folk saying it was all an overreaction is a better result than ending up with a million dead and folk saying we could have prevented those deaths.

My mother, my wife, and my daughter are among the populations considered most likely to experience a lethal response to the disease. Despite this mess, the economy's fundamentals are solid and are likely to remain solid if we do what is necessary to see businesses and the displaced employees through this, so recovery should be fairly quick. Not meaning to get political here but, from where I sit, when a president and a party whose top priorities were the economy are now willing to accept economic disruption to control the disease, it means something. Both sides agree that we need to be doing this, for all that they might argue about details - and that's the part that really scares me because it means the ones who are least inclined to overreact still feel these measures are needed.

 

[Straybow]

It is wrong to suggest that "everyone else went about business as usual." Schools were closed. Large gatherings banned. Teleworking encouraged. Buildings required masks and temperature checks to enter. Physical distancing may have been voluntary, but it was still highly promoted and followed. It was and is anything but "business as usual" in Korea.

The first of these stats is highly misleading, and the second is wrong. Yes, the peak outbreak stabilized after about 3 weeks, but South Korea hasn't been able to relax their procedures and haven't been able to drive the pace of infection down. They are 48 days into their public health response.

Korea's fatality rate experience with covid-19 has continued to increase, and today it stands at 1.9%.

True enough, I haven't been following SK fatality rate in the last couple of weeks. It is business as usual when you're allowed to open your doors to the public and do ordinary transactions. Wear a mask, check your temperature before entering a shop, anything of that sort is a trivial inconvenience compared to being barred from doing even that much.


I think that we didn't need to do anything more than that here in USA where our population density is far lower than Asian cities. Follow good hygiene, test the sick, treat those with CV.

 

[McPerth]

bad flu nothing more.

I also thought this...

I even made my predictions for Spain, back in early March (based on known nubers to the date): 50-80000 ill people with 2500-3500 fatalities, with its peack at the beginings of April...

Now, Spain has had over 150000 cases, with more than 15000 deaths, and it's not yet over. ICU beds have been more than tripled, and even so the collapse was near (yes, I was fully wrong in numbers, not so much in the timings).

Now seems Spain has passed the worst (though the hospital increased needs are expected to keep for 3-4 weeks more at least), after over 4 weeks of people confined at home under Alarm State (and it's expected to keep this, at least partially, for at least 4 more weeks).

US is just begining. I hope you better luck than Spain, as othrwise, if population is an indicative, you can expect over 5 times Spanish numbers...

I can only advise you to learn from others' errors

 

[Condottiere]

Going by my currently domiciled statistics, detected infection has reached a tad under point three percent of the population, with about one in thirty fatalities attributed to Human Malware.

 

[vegas]

It is business as usual when you're allowed to open your doors to the public and do ordinary transactions.

As a parent, I categorically assure you it is not business as usual when the schools are closed.

I think that we didn't need to do anything more than that here in USA

That would be true if we had had the rest of the package of public health resources - testing, contact tracing, surveillance, etc. - that Korea has. We didn't, still don't, and now we have much too large of a problem for that to be a live option for us.

Testing is the easiest to look at public health resource because it is easily quantified, though it is not the only resource that matters. The RoK was running 20k tests per day back in February. On a per capita basis, that would be the same as the US running 130K per day. It is now April and the US has NEVER ON ANY DAY run that many tests. The US first cracked 100K on March 16th but it has not been sustained; we have only hit that number 9 more more days since. And that is just the raw number of tests, ignoring some of the miserable test cycle times we have suffered in the US.

When you can't test well enough, track/trace/isolate isn't a live strategy. And once the contagion gets loose, it takes too much resources to even attempt such a thing. The RoK has 10K identified SARS-2 infections, while the US has 470K. So we have a 47 times more identified infections yet our population is only 6 times theirs. This is an outbreak beyond even the capabilities of the RoK to manage now.

The horse is out of the barn on this one.

 

[flykiller]

the economy's fundamentals are solid

sure, that's why they printed up $2 trillion in new debt to hold it up and are talking $2 trillion more 'cause the first $2 trillion won't be enough - and it's all supposed to be paid back. and all that's normalcy-bias presumption before massive business failures and unemployment have taken hold. oh yeah we're doing just peachy. might want to buy a pallet of rice ....

Spain has had over 150000 cases, with more than 15000 deaths

I predict 3 million deaths in the u.s.

'course we get 3 million deaths each year anyway, but this time they'll be accompanied by .3 unemployment. it's not going to be an improvement.

 

[Straybow]

As a parent, I categorically assure you it is not business as usual when the schools are closed.

That would be true if we had had the rest of the package of public health resources - testing, contact tracing, surveillance, etc. - that Korea has. We didn't, still don't, and now we have much too large of a problem for that to be a live option for us.

Testing is the easiest to look at public health resource because it is easily quantified, though it is not the only resource that matters. The RoK was running 20k tests per day back in February...

When you can't test well enough, track/trace/isolate isn't a live strategy... This is an outbreak beyond even the capabilities of the RoK to manage now.

The horse is out of the barn on this one.

Well, the horse was out of the barn sometime around November when the ChiComs decided to hide what was going on. Basically, SK got lucky that it didn't get a foothold somewhere outside Seoul first. Everyone else is dealing with multiple outbreaks.

Yes, I'm a parent also (6 & 10). I'm talking business, not home life management. Businesses operating at half normal staffing hours can often sustain far more than half the business volume for a time before neglected tasks catch up to them. Businesses can operate with half normal manpower at more than half normal staff hours fairly easily.

We are not falling behind on testing. Everyone on Earth except SK was slow to start. Latest figures I have (https://ourworldindata.org/covid-testing) says 2.36M US test (with a degree of uncertainty) compared to 494k for SK, which is near proportional to population (7.2/1k vs 9.6/1k). Test per day peaked at 0.35/1k in SK but now averages around 0.2/1k. Test per day in the US passed 0.29/1k Mar 26 (I would say 0.30, but it dropped to 0.29 a couple days later) and passed 0.35/1k on Apr 2.

Testing positive doesn't mean sick, or contagious, or even likely to become either. There isn't enough data on that. The tests sample mucus in the upper nasal passage, which is the place designed to catch invasive critters. Things in the mucus are potentially being expelled before successful colonization. Then there are false positives and confusion over recovered patients testing positive (including one 39yo Chinese man who was declared recovered and then died 5 days later).

The exception to that is when testing is primarily done on people who report as being sick. That's most of the testing for the US. Also, lower respiratory samples that return positive are generally established cases that are more likely to become severe.

The real metric should be hospitalizations. That tells us it isn't asymptomatic, or a brief cold-like case, or a simple flu-like case. Nobody is publishing much of that, as far as I can tell, except studies based on data from China. Two weeks ago NY hospitalizations were declining. We have the NY doctor who was testing the malaria drug based regimen reporting no severe cases among 699 patients in the test group. My understanding is that not severe means not hospitalized.

 

[G. Kashkanun Anderson]

We have the NY doctor who was testing the malaria drug based regimen reporting no severe cases among 699 patients in the test group. My understanding is that not severe means not hospitalized.

Doctor Zelenko is not treating diagnosed COVID-19 patients with his regimen; he is taking people coming in to his office complaining of experiencing ‘shortness of breath’ and giving them the treatment. Or milder symptoms (dry cough, etc.), if they’re older than 60.

Needless to say, there are a lot of reasons a person can have shortness of breath or a dry cough — most of whom, even now, are not related to COVID-19. Doctor Zelenko is generally not bothering to test the people he is treating, so I honestly don’t see how any data he collects can be useful on any other level than as talk show fodder.

 

[vegas]

We are not falling behind on testing... 2.36M US test (with a degree of uncertainty) compared to 494k for SK, which is near proportional to population (7.2/1k vs 9.6/1k). Test per day peaked at 0.35/1k in SK but now averages around 0.2/1k. Test per day in the US passed 0.29/1k Mar 26 (I would say 0.30, but it dropped to 0.29 a couple days later) and passed 0.35/1k on.

The US testing failure is not about falling behind, it's about not having enough testing capacity when the outbreak was small in order to contain it.

It is not relelvent that in April the US has a large cummulative number of tests. What matters is that back in February we could hardly test at all. Now we have a huge outbreak and would require a proprtionally huge test capacity to not have to "do anything more than [South Korea] here in USA."

South Korea isn't testing a lot now because they don't have to any longer (at least for now.) They controlled and shrank their outbreak. The US outbreak is slowing, but is now huge. The South Korea approach isn't feasible until the number of cases is far lower than it is today, our test capacity (not cumulative tests!) is higher, and we put in place the other public health resources necessary to test/trace/isolate. But I'm repeating myself now so I'll stop making that point.

The real metric should be hospitalizations.... Nobody is publishing much of that, as far as I can tell,...

Deaths or hospitalizations are both good, objective measures in the absence of strong testing data. For my own fooling around, I use deaths because it is easily available and aggregated. The experts are aggregating and estimating hospitalization data, it just takes more work because it is more complicated and not as easily aggregated, but the data is definitely out there.

Two weeks ago NY hospitalizations were declining.

That is not true. NYC has had >1000 new hospital admissions every day since 3/24. Maybe it has plateaued, but there were 1,400 new admissions in NYC on Monday.

A few links if you are interested.

NYC covid data including cases, hopitalizations, fatalities
EDIT: I noticed the link was broken, and when I fixed it I say the Monday NYC admissions are now over 1,500, so it is safe to assume the hospitalization data is at least 1 week delayed.

At least around where I live, every county is publishing their covid hospitalization data. Just check out your county public health department.

CDC covid data from mid-Feb to mid-Mar cases, hospitalizations, ICU, fatalities
This one was recently updated for all March data, but I can't lay my hands on the link this moment.

 

[Timerover51]

At least around where I live, every county is publishing their covid hospitalization data. Just check out your county public health department.

And where do you live? All your profile says is in the "U.S.A:". Your comment is meaningless without more information.

Side Note of Firearm Purchases: My local gun shop has been just about cleaned out of its inventory of firearms, and for new weapons, all it has a display models for handguns. If you want one of those, and have a valid Illinois Firearm Owner Identification Card, they will order it, and get you in the buying queue at the manufacturer. For long arms, a few shotguns are left, and some AR clones, along with a fair number of used firearms on consignment. Range and gun safety classes are going full blast. Some types of ammo are in short supply unless you want to order a case of 500 or 1000 rounds. Business has been very brisk. For those without an Illinois FOID card, the wait is pretty long to get one. Buying a firearm in Illinois is not easy.

 

[vegas]

I posted it up thread if you are genuinely interested.

 

[Timerover51]

I posted it up thread if you are genuinely interested.

So you are located in the San Francisco area somewhere.

 

[vegas]

Nobody is publishing much of that, as far as I can tell,

The experts are aggregating and estimating hospitalization data, it just takes more work because it is more complicated and not as easily aggregated, but the data is definitely out there.

And speaking (writing) of the devil, just this weekend Johns Hopkins has started publishing aggregated hospitalization for the US and by state. You can find it here if you want:

Johns Hopkins COVID-19 dashboard

 

[McPerth]

And speaking (writing) of the devil, just this weekend Johns Hopkins has started publishing aggregated hospitalization for the US and by state. You can find it here if you want:

Johns Hopkins COVID-19 dashboard

This seems an adptataion of the WHO COVID-19 dashboard (at least its map is quite similar).

As an aside, if US has made (as this link says) over 2800000 tests and about 2/3 of them are positive, it seems only simptomatic or suspicious people are being tested (as in Spain).

 

[vegas]

I think you got your math messed up. It's about 20% positive rate, 550K/2.8M