COVID19 Factors We Should Consider/Current Events COVID19 Factors We Should Consider/Current Events - Page 21

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Thread: COVID19 Factors We Should Consider/Current Events

  1. #201
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    • texas starting strength seminar september 2020
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    Excellent post, just adding one consideration
    Quote Originally Posted by lazygun37 View Post
    the number of people infected by this virus doubles every ~5 days. Take the current number of cases and work out on a piece of paper how many you'll have in 1 month, 2 months or 3 months. .
    many regions in europe currently have a doubling time of just over 3 days. so iwork out on a piece of paper how many you'll have in 1 week, 2 weeks.... no need to look at months

    Some calculations estimate that if china would have locked down 3 weeks earlier 95% less people would have been infected. 3 weeks later and there would have been 18 times more

  2. #202
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    Hi,
    Enter here to see how the USA was doing with the COVID-19 theme. I live in Spain and here things are getting serious. There are many infected cases and deaths. Do not compare it to the flu because it is not a flu. It is severe pneumonia. Here the government has taken very restrictive measures for the circulation of people. He has forbidden to leave the house if it is not to buy basic foods, he has closed borders. There are young people and children admitted in serious condition due to the virus. In Spain we already have more than 11,000 infected and almost 500 dead. The data in Italy is much worse.
    That said, seeing the evolution in Italy, Spain, Iran, etc. the data from China is not credible to anyone. Surely they have lied about the number of infected and dead. After all, China is not a very transparent country.

    Greetings.

  3. #203
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    Quote Originally Posted by lazygun37 View Post
    I really wish that everybody who thinks this is all one big over-reaction would carefully read the modelling paper I linked to above. Have any of you? It's this analysis, I believe, that has led both UK and US governments to adjust course in the last couple of days.

    For anybody who really tries to digest what is being said there, it is brutal reading.

    I also wish people would stop citing small current numbers as if they were evidence for this whole thing being overblown. It is in the nature of exponential growth that we find it hard to wrap our heads around it. In the exponential growth phase, the number of people infected by this virus doubles every ~5 days. Take the current number of cases and work out on a piece of paper how many you'll have in 1 month, 2 months or 3 months. And remember that nobody has any true immunity against this yet. Even if you optimistically assume that some significant fraction of the population never become symptomatic, the numbers are likely to be overwhelming. And asymptomatic people may still be carriers.
    Yeah, I read through the paper. Not a super detailed look, but I went through it. My problem is that (as I posted earlier) none of these models include confidence intervals. That's akin to a weatherman saying, "the hurricane will make landfall at 8:27 pm this Thursday at the corner of Atlantic and Ocean Ave.". That means even the most cursory check of the models shows them to be wrong. WHO data from 3/11 shows 118,319 cases. Five days later it was 167,515 (not even close to doubling).

    Quote Originally Posted by lazygun37 View Post
    The detailed modelling is particularly scary in what it suggests about the only options we currently have on the table:
    The detailed modeling is not actually that detailed, and it's based off of a lot of assumptions with no data to back them up. For instance:
    -Per-capita contacts within schools were assumed to be double those elsewhere in order to reproduce the attack rates in children observed in past influenza pandemics
    -We assume that symptomatic individuals are 50% more infectious than asymptomatic individuals
    -Individual infectiousness is assumed to be variable, described by a gamma distribution with mean 1 and shape parameter alpha=0.25.
    -Infection was assumed to be seeded in each country at an exponentially growing rate (with a doubling time of 5 days) from early January 2020

    The last one is especially egregious, as it does not appear to be supported by the actual data. The first one is in direct contradiction to the widely publicized fact that this strain does not seem to affect children nearly as much as others. Fauci and others have said as much many times.

    Quote Originally Posted by lazygun37 View Post
    It is absolutely worth remembering that even though many or most of us will probably get this, the vast majority of us will recover. But that doesn't mean everything will be just fine.
    Why do you suppose only 17% of the passengers of the Diamond Princess were infected? Given that most authorities say that the situation was mishandled and the quarantine made everything worse?
    Quote Originally Posted by lazygun37 View Post
    Finally, I think people are fundamentally misunderstanding the main point of limiting social interactions. It's not primarily about stopping *you* from getting infected. It's about (a) stopping all of us from infecting vulnerable populations we come into contact with, and (b) preventing the health care system from being brought to its knees. It's obviously tempting to say "but I'm sure that I personally am not a carrier". But that's non-sense from a public health perspective: some small fraction of the people who say this -- and this includes you and me -- are going to be wrong.
    But I'm not saying that. I'm saying that last year 150 people died in the US from Tylenol. Over 100 a day die on average from traffic fatalities. In China, over 5000 die every day from ischemic heart disease. As many as 55,000 have died in the US this season from the "regular" flu (which we already have vaccines and partial immunity to). There are certain risks to being a human in the year 2020. The mitigation should match the probability and severity of the potential hazard. Declaring pseudo-martial law does not seem to be commensurate with the level of risk involved.

  4. #204
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    Playing a devil's advocate line:
    1. I'm almost certain to get covid-19
    2. Once infected and (hopefully) recovered I gain immunity and can no longer act as a carrier
    3. The medical facilities are available now but may not be available later as the outbreak becomes rampant
    4. My personal risk is therefore mitigated by choosing to be infected now.
    5. My contribution to peak infection is minimised by choosing to be infected and self isolating now.

    Is this just version of the 'herd immunity' reasoning?

  5. #205
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    Here's an interesting article with a completely different perspective:

    Has Cornavirus Been Here All Along? - Justin Hart - Medium

  6. #206
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    Interesting. I can say, anecdotally, that there have been a couple of waves of a particularly nasty respiratory crud here in Minnesota in the last 3 months--not flu, but might as well have been. Lots of missed school, plus about half of my 75 person office was either out or working sick. My family got it, although the kids fared the worst.

    There has not been an uptick in unexplained viral pneumonias though, which was what tipped off the Chinese that they were dealing with something unusual. In our case, my youngest had a negative chest xray.

  7. #207
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    This video will provide a healthy dose of skepticism re covid19


    [English] Credible insights into the Coronavirus by Dr. Wolfgang Wodarg


  8. #208
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    I promised myself not to get drawn into an endless forum discussion, so please forgive that I'll respond only this once in detail. And I do that not because I expect to be able to change *your* mind, but just to make sure that others reading this thread don't think these are are valid rebuttals. They really are not.

    I also want to say up front that it is really not my intent to come across as a dick here, nor to personally attack you in any way. And I also want to apologize for two lengthy posts in a row.

    Quote Originally Posted by Rob Waskis View Post
    Yeah, I read through the paper. Not a super detailed look, but I went through it. My problem is that (as I posted earlier) none of these models include confidence intervals. That's akin to a weatherman saying, "the hurricane will make landfall at 8:27 pm this Thursday at the corner of Atlantic and Ocean Ave.".
    I'm really sorry, but this is just wrong. Confidence intervals of the sort you are describing are routinely used in cases where *random statistical errors* dominate the uncertainties. For example, if you find 100 new cases in 1 day, there is an unavoidable and completely random uncertainty on the true rate being 100 per day of +/- 10 per day (at 68% confidence). But for things like what is being modelled here, it is *always* going to be the *systematic errors* that dominate the true uncertainties. They are exactly the sort of things you criticize later, i.e. the types of assumptions the modeller has to make about all manner of things. And the only way to assess *those* uncertainties is to run grids of models covering a range of different assumptions. Which is precisely what they did in this report. Hence phrases in my post about "the most optimistic mitigation scenario". To be clear, the uncertainties in this sort of modelling are always going to be big. But analysis like this one do the best possible job of exploring and accounting for them.

    Quote Originally Posted by Rob Waskis View Post
    That means even the most cursory check of the models shows them to be wrong. WHO data from 3/11 shows 118,319 cases. Five days later it was 167,515 (not even close to doubling).
    Again, I'm really not trying to be a jerk, but this is just a serious misunderstanding of the data. As I made explicitly clear in my post, the 5-day (approximately) doubling time applies only in the exponential growth phase. By using global numbers you are mixing up China, for example, with the rest of the world. Now China alone contributed around 80,000 of the cases you mention, and the case load in China was basically completely flat over this period. And that's because they are *not* in the exponential growth phase anymore. As I said in my post, they *have* taken the drastic steps that are needed to make suppression work, at least for now, i.e. at least for the short term. So subtract China's number off and look at the rest of the world. Then, going by your own numbers, you've got about 40,000 cases on 3/11, moving up to about 90,000 five days later. Which is more than doubling.

    This is precisely why I think it's dangerous for all of us to think we know better than those stupid experts. (And to be clear, I'm not an expert in epidemiology -- I just happen to do a lot of modelling and statistics in my area of research also.)

    Quote Originally Posted by Rob Waskis View Post
    The detailed modeling is not actually that detailed, and it's based off of a lot of assumptions with no data to back them up. For instance:
    -Per-capita contacts within schools were assumed to be double those elsewhere in order to reproduce the attack rates in children observed in past influenza pandemics
    -We assume that symptomatic individuals are 50% more infectious than asymptomatic individuals
    -Individual infectiousness is assumed to be variable, described by a gamma distribution with mean 1 and shape parameter alpha=0.25.
    -Infection was assumed to be seeded in each country at an exponentially growing rate (with a doubling time of 5 days) from early January 2020

    The last one is especially egregious, as it does not appear to be supported by the actual data. The first one is in direct contradiction to the widely publicized fact that this strain does not seem to affect children nearly as much as others. Fauci and others have said as much many times.
    Hopefully you'll at least agree that your point about the "especially egregious" last point is just factually wrong. And I'm not going to argue with you about the other things, because that is *precisely* the sort of thing that I'm pretty sure they know more about than you or me. And, again, they did explore a wide range of different models. So I guess the question is really to you: whatever quibble you have about whatever detailed assumption, do you have a clear and compelling reason to think it would completely invalidate their conclusions?

    Quote Originally Posted by Rob Waskis View Post
    Why do you suppose only 17% of the passengers of the Diamond Princess were infected? Given that most authorities say that the situation was mishandled and the quarantine made everything worse?
    First, this number is highly misleading as an estimate of the fraction of the population that's susceptible to the virus. I didn't do a thorough literature search, but I quickly found a peer-reviewed article looking in detail on the outbreak on this ship. Their modelling shows that the interventions that were taken appear to have prevented the infection rate from reaching about 80% by Feb 19. The following is from the abstract: "On 3 February, 2020, an outbreak of COVID-19 on cruise ship Diamond Princess was reported with 10 initial cases, following an index case on board around 21-25 January. By 4 February, public health measures such as removal and isolation of ill passengers and quarantine of non-ill passengers were implemented. By 20 February, 619 of 3,700 passengers and crew (17%) were tested positive. ... The basic reproduction rate was initially 4 times higher on-board compared to the in the epicentre in Wuhan, but the countermeasures lowered it substantially. ... [W]e estimated that without any interventions within the time period of 21 January to 19 February, 2920 out of the 3700 (79%) would have been infected. Isolation and quarantine therefore prevented 2307 cases. ... [A]n early evacuation of all passengers on 3 February would have been associated with 76 infected persons in their incubation time." [Rocklöv, Sjödin & Wilder-Smith 2020, Journal of Travel Medicine]

    Second, remember that in the most optimistic mitigation scenario in the paper, hospitals were overwhelmed by a factor 8 at peak. So even if you reduced that peak by a significant factor (which would be great!), you would *still* overwhelm the health services. And again that's in the most *optimistic* mitigation model. Would that be OK?

    Quote Originally Posted by Rob Waskis View Post
    But I'm not saying that. I'm saying that last year 150 people died in the US from Tylenol. Over 100 a day die on average from traffic fatalities. In China, over 5000 die every day from ischemic heart disease. As many as 55,000 have died in the US this season from the "regular" flu (which we already have vaccines and partial immunity to). There are certain risks to being a human in the year 2020. The mitigation should match the probability and severity of the potential hazard. Declaring pseudo-martial law does not seem to be commensurate with the level of risk involved.
    I completely agree with every word of that, except for your last sentence. The entire point of modelling efforts like this is to try to help assess the risk. And what it suggests is that you are severely underestimating the risk.

  9. #209
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    Quote Originally Posted by Mark Le Comte View Post
    Playing a devil's advocate line:
    1. I'm almost certain to get covid-19
    2. Once infected and (hopefully) recovered I gain immunity and can no longer act as a carrier
    3. The medical facilities are available now but may not be available later as the outbreak becomes rampant
    4. My personal risk is therefore mitigated by choosing to be infected now.
    5. My contribution to peak infection is minimised by choosing to be infected and self isolating now.

    Is this just version of the 'herd immunity' reasoning?
    Go ahead and try it, I guess?

    (Slightly) more seriously: this is like a game theory scenario. IF you really believe you're certain to get it (i.e. suppression + vaccine will fail), and IF you are willing to bet your life that you'll be in the population that recovers (but remember that a non-negligible fraction of young, healthy people seem to fall seriously ill or even die), and IF you are confident that nobody else is making the same calculation right now (because then the health services will be overwhelmed sooner than you think), then yes, I suppose you might calculate that it's in your personal interest to infect yourself. "Well, do you [believe all that]?"

    It's certainly not a bet I'd be willing to take. But, even in this scenario, I'm not so sure this would be the right thing to do ethically, because you would make yourself part of a population whose behaviour would be hard to predict. And predictability is pretty critical from the public health perspective, I suspect. [To put it more annoyingly: it seems to me that the Golden Rule / Categorical Imperative applies here -- if you don't think everybody else should do it, then probably you shouldn't do it either.]

    Finally, I don't believe your decision wold be especially relevant or helpful to herd immunity. That requires ~60% of the population to have become immune. And since your strategy could never be applied to anything but a small fraction of the population, I don't think it could ever significantly speed up reaching that threshold.

    Quote Originally Posted by Mark Le Comte View Post
    Playing a devil's advocate line:
    1. I'm almost certain to get covid-19
    Just a final point, since I realized that this premise may have come from me writing previously that "many or most of us will probably get this". I shouldn't have said this -- that's assuming suppression for the long-term (long enough to get a vaccine working), is unlikely to happen. Hopefully that's not the case!

    What I should have said is "many or most of us MIGHT get this". My point there was really just that, even in the worst case scenarios, the average young and healthy person can, of course, expect to recover.

  10. #210
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