COVID19 Factors We Should Consider/Current Events

[Gerald Boggs]

Busted! My local food store has not been practicing social distancing and maybe 1 out of 8 were wearing a mask as of Friday morning. Today, everyone was masked, although still not social distancing. Word came down from higher that masks were mandatory.

On a different note, I think I understand why folks are so freaked out by the deaths in nursing homes. It's the suddenness of it. Normally, the decline and death of a loved one is a slow gradual process. You have time to accept what's happening and are able to spend the last moments by their side. That's how it was for me and my mom. Now, from time of positive infection to death is often a few days and people aren't allowed to be there. That's hard way to die and a hard thing to experience as child.

However, and not to be callous, but what should not be overlooked by us collectively, is many of those that have died, where going to die, maybe not this month but certainly this year. From a CDC page:

“Over 4 million Americans are admitted to or reside in nursing homes and skilled nursing facilities each year and nearly one million persons reside in assisted living facilities. Data about infections in LTCFs are limited, but it has been estimated in the medical literature that:
1 to 3 million serious infections occur every year in these facilities.
Infections include urinary tract infection, diarrheal diseases, antibiotic-resistant staph infections and many others.
Infections are a major cause of hospitalization and death; as many as 380,000 people die of the infections in LTCFs every year.”

My point? We need to keep perspective and not let our fears overwhelm our sense. Here in Virginia, except for the larger population centers, the virus is like watching the wars. It's something happening somewhere else to someone else, but we're all stuck with the same lockdown and from my perspective, that makes no sense.

If you're interested, here's the information the masses are being given: Coronavirus: in Virigina: Data show evidence of flattening the curve

[Mark Rippetoe]

YouTube

Full press conference from that CA doc....

This is excellent. And it's important to note the behavior of the media in this briefing. They are the source of this panic, because they do not actually understand any of this material. And they do not take notes: notice how many times Erickson had to present the same data to these idiots.

[Robert Santana]

most people simply aren't ready or willing to go back to business as usual, even if you let them. And an economy with no customers isn't an economy.

Which is precisely why the government does not need to participate in closures. Losses are inevitable and ensuring a total loss through mandated closures is unnecessary and has no guarantee of saving anymore lives than what the market will clearly do on its own in response to a pandemic.

[lazygun37]

I believe this latest YouTube expert and his press conference happy ER doctor sidekick divided total deaths by total population to arrive at an absolute mortality of .03% and not an IFR of .03%...

Well, that would be even more insane. But nope: 50,000/330 million = 0.015%. Shows one thing though -- they're apparently assuming the number can't go higher than about 100,000 for whatever reason. I guess because they think at least 30% of people are already infected right now or something. But that's not even true in NYC based on actual antibody testing.

Where do you work? What are your credentials?

Why are you so obsessed with where I live and what I do? Are you planning to come round for tea?

If I was arguing with you about libertarian vs socialist politics, perhaps I could understand this. But I'm not -- you only think I am. I'm arguing about numbers with you. The ones you cite are almost invariably wrong or misunderstood. And every single time I point this out I explicitly lay out my reasoning and sources. And I'm sorry -- maths is maths. It's not opinion. Which is, of course, why you never even try to argue the facts with me. I completely understand that you would much prefer to dismiss what I say on the basis of who I am -- despite the fact that this is precisely the sort of bullshit you constantly complain about in the context of strength training, health and just about anything else. So forgive me for not indulging you.

2.9 million people died in the US last year. No, it does not qualify.

Thanks, finally a clear answer. But in case *I* wasn't clear. I wasn't talking about 5000 deaths in total (obviously -- there are already have more than 10x that in the US). I was talking about 5000 deaths per 1 million cases. Which is how you get an estimate of ~1M deaths in total for an unsuppressed outbreak. But I guess that's still less than 2.9 million and therefore fine.

It doesn't matter, since it's tailing off already.

I think we actually have common ground in hoping that's true. If so, why do you think that is?

How about you answer questions for a while. You have lots of problems with posing as an expert behind a user name, and ignoring all the arguments but your own.

I'm happy to answer any substantive question about my reasoning, where my numbers come from, etc etc. And I have no idea why you say I "pose as an expert". I've stated explicitly multiple times in this thread that I'm no epidemiologist. What I've said is that I happen to know quite a bit of stats. You ought to be able to judge for yourself if that's true or not. As for "ignoring all arguments but my own": that's also untrue, of course. The problem is your argument is always about diseases statistics until somebody points out you're wrong, at which point it was never about diseases statistics in the first place and all about economics, politics and social issues. But even with that, it's pretty ironic that you accuse me of this in a response to a post that explicitly deals with the economic and social argument you say is so important to you.

Which is precisely why the government does not need to participate in closures. Losses are inevitable and ensuring a total loss through mandated closures is unnecessary and has no guarantee of saving anymore lives than what the market will clearly do on its own in response to a pandemic.

The goal of mandated closures is obviously to slow -- or ideally suppress -- the spread of an outbreak. They can help with this in two related ways: (i) if applied before the numbers are obvious, they can stop them becoming overwhelming; (ii) they deal with the small fraction of idiots who might not take precautions even once the numbers are obvious.

I hope we can agree that a highly infectious disease can be transmitted pretty effectively even if the fraction of idiots is pretty small. Moreover, I would expect the free market to respond precisely once the numbers are obvious -- which is way too late for outbreaks that initially grow exponentially. So in the free-market scenario you envision, how do you prevent the initial explosive growth and how do you stop a small fraction of idiots from making life miserable for everybody else for far longer than necessary?

[lazygun37]

Where are your numbers coming from? Show me yours first and I’ll show you mine...

Deal.

IFR: The NYC antibody study Rip used to love suggests an IFR of 0.6%, but I thought that was a bit harsh. Similar studies from Iceland and Germany that have already been discussed gave estimates of about 0.4%. I believe I've cited every one of these studies in this thread. So 0.5% seems pretty fair.

Herd immunity threshold: This can be estimated based on R0, the reproduction number (i.e. the average number of people an infected person infects). Herd immunity is expected roughly when the fraction of the population that is immune reaches (R0-1)/R0. For COVID-19, I'd taken R0 = 2.5 as an estimate to get the 60% number I used. The Imperial College model assumed R0 = 2.4 as a baseline, for example. However, if anything, the latest estimates seem to come in higher -- e.g. Early Release - High Contagiousness and Rapid Spread of Severe Acute Respiratory Syndrome Coronavirus 2 - Volume 26, Number 7—July 2020 - Emerging Infectious Diseases journal - CDC suggests R0 ~ 3. For higher R0, that threshold goes up -- e.g. for R0 = 3, the threshold is 67%.

Your turn.

[wiigelec]

The Attack Rate of the COVID-19 in a Year by Daihai He, Daozhou Gao, Zian Zhuang, Peihua Cao, Yijun Lou, Lin Yang :: SSRN

[Mark Rippetoe]

UT model: 64% chance Texas and 99% chance U.S. has already seen peak COVID-19 deaths | KXAN.com

[lazygun37]

UT model: 64% chance Texas and 99% chance U.S. has already seen peak COVID-19 deaths | KXAN.com

“The researchers found clear evidence that the timing and extent of people’s distancing behavior differ across states—and that these differences matter in terms of ‘flattening the curve,'” said a release from UT about this modeling on Friday. “In Texas, for example, many large cities issued stay-at-home orders that began to curtail mobility many days before a statewide policy was enacted.”

"The numbers can only reflect confirmed COVID-19 deaths and the models assume that people will continue social distancing to the same extent they have been."

"This UT model was only designed to forecast a single wave of COVID-19 and can’t predict the possibility or characteristics of a possible second wave of the virus."

The Attack Rate of the COVID-19 in a Year by Daihai He, Daozhou Gao, Zian Zhuang, Peihua Cao, Yijun Lou, Lin Yang :: SSRN

Interesting. This is pretty far from a peer-reviewed paper, and I'm surprised to see a reliance on Chinese sources. But OK. So these guys think the attack rate is lower (around 20%) and the IFR much higher (around 2%). If I plug those numbers in, I get 330 million x 0.02 x 0.2 = 1.3 million deaths predicted. I'd consider this pretty far from a solid source, but even if we did -- how exactly does this support your argument?

[Mark Rippetoe]

But even with that, it's pretty ironic that you accuse me of this in a response to a post that explicitly deals with the economic and social argument you say is so important to you.

This is your version of dealing with the economic and social argument:

And yes, I know the libertarian take here is to just take the government out of it and let people decide what they want to do. But, judging from many recent posts in this thread, there seems to be a realization that this wouldn't really be a solution -- because most people simply aren't ready or willing to go back to business as usual, even if you let them. And an economy with no customers isn't an economy.

So what I wish we'd talk about more in this thread is what realistic alternatives we actually have. What does -- or should -- "re-opening the economy" look like?

Here are some random thoughts and questions I have in this vein. If nothing else, perhaps this will at least convince some people here that not everybody who disagrees with you is a fascist:

• The default at the moment seems to be to assume we'll have sufficient testing and contact tracing in place "soon" to prevent most large scale outbreaks. I can sort of believe the testing side of this -- we're not there right now, but it seems at least plausible that we could get there. But I'm always surprised that there is so little discussion of contact tracing. Traditional shoe-leather contact tracing is *hugely* demanding -- how many tracers do we actually have or can train, and how many cases could we realistically track this way?
• As was briefly discussed earlier in this thread -- if shoe-leather contact tracing is unrealistic, could/should things like phone apps be used? Could the privacy concerns be dealt with somehow, e.g. via strict laws with massive penalties for data breaches/misuses?
• Finally, there *is*, of course, a way to reduce the IFR and still achieve herd immunity. If you could quarantine old people and people with serious co-morbidities, and if you could also make sure that the rest of us mostly get infected, you'd probably get to sth like the 60% infected threshold with an IFR < 0.1%, say. But how could you actually achieve this? This virus is pretty damn infectious, so how do you effectively quarantine old and sick people? And are younger and healthier people really going to be so keen to get infected for the greater good? I mean their odds of not dying are good, but the disease is still pretty nasty, and some *will* die, of course. So, individually, everybody is better off if everybody else got themselves infected. (The pay-off matrix here is that of a Prisoner's Dilemma, actually.)
• Last, but not least -- do we actually know that infection gives long-lasting immunity against COVID-19? If not, that's obviously the nightmare scenario. I suspect it would change the cost-benefit calculus of almost all interventions.

Every single time you post, without exception, you demonstrate conclusively that you neither know about nor care what the rest of society is dealing with as a result of your "knowing quite a bit about stats." You may even be that great fool Anthony Fauci. You and he and your media are directly responsible for this economic bloodbath, the extent of which you will never grasp. At this point it doesn't matter if 1 million die, or 5 million, because the survivors will have nothing left. And they may justly demand a reckoning.

[Sean Berry]

The X-axis is time.

The total number of humans infected was never the point. It was to avoid "crashing" the over-burdened health care system. Pretty clear that the hospitals are not being flooded by sick folks, and the piles of bodies are not piling up in the makeshift morgues, much less in the streets. Hopefully, the planned-demic is over.

Incidentally, the take-home from the UT article was, to me, the inclusion of "mask-wearing" as an official "healthy activity."


sb