The Next Pandemic: SARS-CoV-2/COVID-19

[Magox]

34 minutes ago, Hapless Bills Fan said:

 

If we don't generally #testtraceisolate, then unless we achieve close to 100% public mask wearing, the chances of keeping the disease burden from overwhelming hospitals again seem slim.

 

Or what is your notion on how one achieves that latter?

 

I think the large number of asymptomatic infected people arise in specific circumstances - places where large numbers of people are regularly forced into close contact such as meat packing plants, prisons, cruise ships etc. 

 

The whole point of "flatten the curve" from an epidemiologist viewpoint (and I am not an epidemiologist though I have worked with same on occasion) is to buy time to increase testing and put together a contact-tracing mechanism, while lowering the # cases to the point where #testtraceisolate is feasible.  After Wuhan, China appears able to have done this.  Singapore seems to have done this - ID'd an outbreak and contained.  S. Korea seems to have done this with several surges. Several European nations will be giving their try.

 

It's the same disease here, are you saying we are somehow less capable, more deficient and more sociologically challenged than democracies such as S. Korea, Taiwan etc?

 

That may be a rhetorical question fair warning I'm not likely to hang here.

 

From an epidemiological viewpoint, reopening should occur when the number of cases have subsided and testing/contact tracing capabilities have been built to the point where #testtraceisolate is possible.

 

There are some rather large differences between South Korea/Taiwan and the United States.

 

Before I get into them this is what I said earlier:

 

—————

If we had been starting off with a much lower baseline to work off, like near 0 then maybe we could employ this strategy as an effective tool to mitigate it.  But we aren't, and most likely by the end of summer, we will still have more than quite a few infections. 

 

—————-

 

Taiwan has/had less than 500 confirmed cases in total.  We get 500 confirmed cases in a half hour.   
 

South Korea has/had less than 11k confirmed cases in total, we get that in about 10 hours.

 

If you look at my quote I made the case that contact tracing could work if you are working off of a low baseline,  we definitely would not be.  We have about 25k confirmed cases a day, which means we realistically have anywhere from 150k to as high as 400k actual new cases daily due to the asymptomatic cases.   That’s each and every day just piling on top of one another.   So when I said the toothpaste is out the tube, it means it’s too late for that.  There is no way you can contact trace something that is outside the realm of control.  Unless somehow we can get those cases to below maybe like 1000-2000 confirmed cases daily and even then I am still highly skeptical.

 

Taiwan and South Korea went through MERS and SARS and already have a playbook for this.  Secondly their populace is willing to give up freedoms and allow cell phone tracking and basically just listen to what their government tells them to do.

 

Im not here to debate what people should be doing according to health officials believe but what they won’t do.  And that is allow their lives to be completely upended for an extended period of time.  Many won’t wear masks like they do in Taiwan/SK, many are skeptical of what the government tells them to do unlike Taiwan/SK.   In short compliance Of recommendations or dictates will not be followed by many here in the US as it would be in SK/Taiwan.

 

It truly is an apples and oranges comparison.

[Hapless Bills Fan]

I think you all guys need a little "sexy cyborg" in here

 

Personally I think if our leaders give a clear and unambiguous message, people will do the right thing.  We saw that in the huge mobilization efforts around the World Wars.  We saw behavior change around seatbelts when massive public service campaigns were joined to legal penalties.  It's silly to say just many "won't wear masks"  - of course, when they see our President and VP/Task Force Leader not wearing masks, and when Missouri Governor says "it's a personal choice, I chose to not wear a mask", OF COURSE people won't wear masks.  But we could do the experiment.

I leave you with Better Hand Washing, courtesy of Naomi Wu

 

[Justice]

On 5/1/2020 at 7:09 PM, ~Kostabi~ said:

Robs House this is for you.  This will clear up any questions in regards to my views on the coronavirus.

 

744 pages and this is where we’re still at. All we

needed was this one post lol 

[Magox]

21 minutes ago, Hapless Bills Fan said:

I think you all guys need a little "sexy cyborg" in here

 

Personally I think if our leaders give a clear and unambiguous message, people will do the right thing.  We saw that in the huge mobilization efforts around the World Wars.  We saw behavior change around seatbelts when massive public service campaigns were joined to legal penalties.  It's silly to say just many "won't wear masks"  - of course, when they see our President and VP/Task Force Leader not wearing masks, and when Missouri Governor says "it's a personal choice, I chose to not wear a mask", OF COURSE people won't wear masks.  But we could do the experiment.

I leave you with Better Hand Washing, courtesy of Naomi Wu

 

 

You know who else thinks it’s silly to wear masks?

 

https://m.youtube.com/watch?v=PRa6t_e7dgI

 

[Hapless Bills Fan]

1 hour ago, snafu said:

 

You’ve been a boon to this community, and I mean that. I’ve learned a helluva lot from you.

I was being pretty lazy in my response to Doc Brown. To answer your question, I’ve seen recent reports from Cuomo that say that up to 21% of NYC residents showed antibodies, and over 13% statewide. That was at least a week ago. The numbers must be a bit higher now, and it is my opinion (based on reports) that there’s a significant multiplier (7x, 10x, 15x, 20x ??) higher than those results which will push the number closer to herd immunity than the estimates you are stating.

 

Couple that with what Cuomo said today (yesterday) stating that up to 66% of hospitalized New Yorkers were infected at home, while not working, and I’ve got a problem believing that this policy should remain in place as is for much longer. The hardest hit part of the country so far (by far) has been NYC. Reports indicate that the hospitals are well below capacity.   If other parts of the country are now “hot” then deal with them S. Korea style. Isn’t it much easier to do that in less densely populated areas?

 

You can can go to any of my posts on this subject and see that I’ve advocated regional opening where possible, and more testing and tracing.  I believe that as long as people are diligent and honest, they will be able to self monitor and report their illness to their health care professionals and family and friends more quickly than government-appointed tracers, and the contacts can be tested and monitored as needed.  I believe that the development of quick and easy (saliva based) testing makes it much more possible to let people get back to work to a reasonable extent.   I believe (without any overt proof) that researchers every day are gaining a better understanding of treatment protocols.  I believe that PPE is being replenished so that the inevitable spike can be met with more preparedness than we had at the outset of this mess.

 

Maybe I’m the eternal optimist. I also balance my optimism with knowledge that people are going to continue to get sick and die whether we open or remain shut in. I just believe that the shutdown of our society (not just the economy) is only prolonging our necessary march toward true herd immunity.

 

I realize that my post may be thin on facts, charts, numbers and heavy on what I glean from news reports.  It is how I see things. Thanks for asking, I mean that.

 

Hi, thanks for the kind word.  I think one needs to distinguish between surveillance and clinically-driven testing here.

 

The RT-PCR testing, especially in the NYC area, has been driven by ill people.  It needs a multiplier. 

 

Antibody testing done by selecting random people or at random locations is surveillance testing.  It should not need a multiplier, if it's truly random.

The 14% overall statewide is the result of averaging 3-4% upstate numbers with 21% NYC numbers.  Something like (3% of 7M Upstate + 21% of 14M people living in NYC)/21M total = 14%.  3%, 14%, and 21% are all well short of 50-60% herd immunity.   NYC is on a "cases double every 2 months" trajectory right now, so that number won't have changed much in a week or so.

 

Let's cross check another way.  Most epidemiologists I follow feel that unless there is a large excess of negative tests - something like 95% negative tests - we aren't close to catching most covid-19 cases.  This is especially true of an outbreak area like NYC where the testing was limited to very ill people for a while, and it's still only running about 60% negative/40% positive.  The estimate is that the case numbers should be multiplied 10x. 

 

Currently NYC has about 430k cases.  10x would mean actually 4.3M cases.  21% of Population 14M by antibody testing would mean ~3M cases.  Not that far off for a rule of thumb.

Now let's look at Tompkins County, NY which currently has 97% negatives on its RT-PCR testing and may be closer to catching all the cases.  3% covid-19 positive by RT-PCR and 3-4% having had the disease by antibody testing pretty close match.   I don't think they're anywhere near herd immunity either.

The hospitals in NYC during the peak were ugly.  Even cities that weren't so utterly overwhelmed but had an outbreak such as New Orleans and Atlanta were struggling.  If we push towards "herd immunity" without controlling that, it will be uglier.  I hear people won't wear masks, won't maintain social distance in nice weather, won't stay shut down.  What will we do?  Guess we'll find out.

Other countries are doing this much better.  Maybe we should stop making excuses for why we can't do as well and show that America actually is still great.

14 minutes ago, Magox said:

You know who else thinks it’s silly to wear masks?

 

https://m.youtube.com/watch?v=PRa6t_e7dgI

 

 

That's March 8, when Fauci was speaking from the data available at the time - when the number of asymptomatic carriers and the length of the presymptomatic transmission period were not known.  I discussed that in a response to Figster on the OTW discussion thread.

 

Advice changes as more is learned, so what is the point of waving around something 2 months old?  That's pleistocene in pandemic terms.

 

[Motorin']

13 minutes ago, Magox said:

 

You know who else thinks it’s silly to wear masks?

 

https://m.youtube.com/watch?v=PRa6t_e7dgI

 

Did you actually listen to what he said? 

 

He said people people who are infected need to wear masks. This was also over a mo the ago, and he was trying to stop people from buying up all of the medical masks. 

 

I'll stop wearing a mask in public when I can get a test and know I'm not infected. 

[Magox]

19 minutes ago, Motorin' said:

Did you actually listen to what he said? 

 

He said people people who are infected need to wear masks. This was also over a mo the ago, and he was trying to stop people from buying up all of the medical masks. 

 

I'll stop wearing a mask in public when I can get a test and know I'm not infected. 

 

The question is did you?

 

and no, that is not what he was saying.  He was saying that at this stage of the game it’s silly to wear a mask. You can visually see him scoffing at the idea of wearing a mask. He thinks it’s silly and he made that visibly and audibly clear on a couple occasions.    What he said was unless you are infected or someone in the medical field then those are who should be wearing it.  He even goes on to say “if it makes you feel better”.  
 

It was only until the interviewer at the very end after Fauci made it very clear that the benefits for people who don’t have the virus that it’s silly and not effective to wear masks that the interviewer said “to preserve masks” and Fauci agreed.

 

you can try to spin it all you like, The bottom line is that Fauci thinks it’s silly for people who don’t have the virus to wear a mask and he explains why citing three reasons.

 

Listen to it again.  

[snafu]

26 minutes ago, Hapless Bills Fan said:

The hospitals in NYC during the peak were ugly.  Even cities that weren't so utterly overwhelmed but had an outbreak such as New Orleans and Atlanta were struggling.  If we push towards "herd immunity" without controlling that, it will be uglier.  I hear people won't wear masks, won't maintain social distance in nice weather, won't stay shut down.  What will we do?  Guess we'll find out.

 

We shall find out. 

I just want to clarify that I don’t advocate for an “all stops out” opening.  I think it is too early for that.  There’s a balance, for sure. It should be found quickly.  There’s enough talk about planning.  Eventually the do-ing needs to start.  Sooner than later.  And the people in Tompkins County can get the S. Korea track and trace — that’s a good example for that control to prevent overwhelming. This should have been started anywhere outside of the Northeast Corridor and other large city hotspots at least a month ago. But here we are.  

 

[Magox]

43 minutes ago, Hapless Bills Fan said:

 

Hi, thanks for the kind word.  I think one needs to distinguish between surveillance and clinically-driven testing here.

 

The RT-PCR testing, especially in the NYC area, has been driven by ill people.  It needs a multiplier. 

 

Antibody testing done by selecting random people or at random locations is surveillance testing.  It should not need a multiplier, if it's truly random.

The 14% overall statewide is the result of averaging 3-4% upstate numbers with 21% NYC numbers.  Something like (3% of 7M Upstate + 21% of 14M people living in NYC)/21M total = 14%.  3%, 14%, and 21% are all well short of 50-60% herd immunity.   NYC is on a "cases double every 2 months" trajectory right now, so that number won't have changed much in a week or so.

 

Let's cross check another way.  Most epidemiologists I follow feel that unless there is a large excess of negative tests - something like 95% negative tests - we aren't close to catching most covid-19 cases.  This is especially true of an outbreak area like NYC where the testing was limited to very ill people for a while, and it's still only running about 60% negative/40% positive.  The estimate is that the case numbers should be multiplied 10x. 

 

Currently NYC has about 430k cases.  10x would mean actually 4.3M cases.  21% of Population 14M by antibody testing would mean ~3M cases.  Not that far off for a rule of thumb.

Now let's look at Tompkins County, NY which currently has 97% negatives on its RT-PCR testing and may be closer to catching all the cases.  3% covid-19 positive by RT-PCR and 3-4% having had the disease by antibody testing pretty close match.   I don't think they're anywhere near herd immunity either.

The hospitals in NYC during the peak were ugly.  Even cities that weren't so utterly overwhelmed but had an outbreak such as New Orleans and Atlanta were struggling.  If we push towards "herd immunity" without controlling that, it will be uglier.  I hear people won't wear masks, won't maintain social distance in nice weather, won't stay shut down.  What will we do?  Guess we'll find out.

Other countries are doing this much better.  Maybe we should stop making excuses for why we can't do as well and show that America actually is still great.

 

That's March 8, when Fauci was speaking from the data available at the time - when the number of asymptomatic carriers and the length of the presymptomatic transmission period were not known.  I discussed that in a response to Figster on the OTW discussion thread.

 

Advice changes as more is learned, so what is the point of waving around something 2 months old?  That's pleistocene in pandemic terms.

 

 

You misunderstood what he said.

 

He said “when you are in the middle of an outbreak wearing a mask may make people feel better (he even gives the hand quotation sign as to mock the idea) and it may even block a droplet, but it’s not providing the perfect protection that people think that it does”. Then he goes on to cite how there are unintended risks of hands touching the face due to usage of the mask.

 

Then he says once again that masks are for people who have the virus and for medical providers.   He even says that the 85% of people in Asia wearing masks “it’s fine, it’s fine”. Essentially implying what he said earlier which was “if it makes them feel better”.   In other words, from his view it’s not necessary.   
 

 

Edited May 7, 2020 by Magox

[Justice]

18 minutes ago, Magox said:

 

You misunderstood what he said.

 

He said “when you are in the middle of an outbreak wearing a mask may make people feel better (he even gives the hand quotation sign as to mock the idea) and it may even block a droplet, but it’s not providing the perfect protection that people think that it does”. Then he goes on to cite how there are unintended risks of hands touching the face due to usage of the mask.

 

Then he says once again that masks are for people who have the virus and for medical providers.   He even says that the 85% of people in Asia wearing masks “it’s fine, it’s fine”. Essentially implying what he said earlier which was “if it makes them feel better”.   In other words, from his view it’s not necessary.   
 

 

‘It’s not necessary’ and yet he says medical workers need it. Hmm. 

[Q-baby!]

34 minutes ago, Magox said:

 

The question is did you?

 

and no, that is not what he was saying.  He was saying that at this stage of the game it’s silly to wear a mask. You can visually see him scoffing at the idea of wearing a mask. He thinks it’s silly and he made that visibly and audibly clear on a couple occasions.    What he said was unless you are infected or someone in the medical field then those are who should be wearing it.  He even goes on to say “if it makes you feel better”.  
 

It was only until the interviewer at the very end after Fauci made it very clear that the benefits for people who don’t have the virus that it’s silly and not effective to wear masks that the interviewer said “to preserve masks” and Fauci agreed.

 

you can try to spin it all you like, The bottom line is that Fauci thinks it’s silly for people who don’t have the virus to wear a mask and he explains why citing three reasons.

 

Listen to it again.  

If only “everyone who needs a test can get a test” was true, then we would actually know who had the virus and then we would know who should be wearing a mask. 

[billsfan1959]

6 hours ago, Motorin' said:

As opposed to the walking cliché of right wing, bitter criticism springing from a delusional sense of moral and intellectual superiority? 

Please regale us all some more with your intellectually stunning analysis of the Spanish Flu. It had us all on the edge of our seats.

No, really....

 

11 hours ago, Motorin' said:

A guy who thinks he knows the depths of who I am from a few posts about corona virus is calling me extreme and programmed. Alrighty. 

 

This from a guy who compared another poster to David Koresh (or Koresch, as you like to call him) based "on a few posts about corona virus." Kinda does shed a little light on the depth of who you are....

[\GoBillsInDallas/]

No good deed goes unpunished:

 

https://www.pix11.com/news/coronavirus/health-workers-that-volunteered-to-come-to-ny-during-pandemic-have-to-pay-state-income-tax-cuomo

 

 

 

Edited May 7, 2020 by \GoBillsInDallas/

[billsfan1959]

8 minutes ago, \GoBillsInDallas/ said:

No good deed goes unpunished:

 

https://www.pix11.com/news/coronavirus/health-workers-that-volunteered-to-come-to-ny-during-pandemic-have-to-pay-state-income-tax-cuomo

 

 

It could be worse. while they were in NY, Cuomo could have made them stay in Nursing Homes where he liked to put Covid patients....

[Kemp]

9 minutes ago, billsfan1959 said:

 

It could be worse. while they were in NY, Cuomo could have made them stay in Nursing Homes where he liked to put Covid patients....

 

He claimed he was unaware.

 

Also, some nursing homes said no, while others took them because it meant more money in their pockets.

[billsfan1959]

Just now, Kemp said:

He claimed he was unaware.

 

If it was Trump and that was his response, you would have already written post after post condemning him in your typical, mind numbing, stream of consciousness fashion...

[Kemp]

27 minutes ago, billsfan1959 said:

 

If it was Trump and that was his response, you would have already written post after post condemning him in your typical, mind numbing, stream of consciousness fashion...

 

I didn't say I believe him, which is a stark contrast to how Trump supporters cheerlead him as he goes from one lie to another.

[billsfan1959]

9 minutes ago, Kemp said:

 

I didn't say I believe him, which is a stark contrast to how Trump supporters cheerlead him as he goes from one lie to another.

 

Well, if you don't believe him, then where is your outrage? Putting Covid patients in nursing homes literally killed people.

 

You have been on a crusade of outrage - page after page of posts regarding Trump making positive statements about China in January, making a stupid comment about bleach, and other inconsquential things. And yet, you are strangely silent on this or, for that matter, anything for which you can't find a way to blame Trump.

 

Hypocrisy, thy name is Kemp...

 

Edited May 7, 2020 by billsfan1959

[Reality Check]

I was wrong about Bill Gates. Here is some proof that we can trust him.http://stateofthenation.co/?p=12320

[Kemp]

2 minutes ago, billsfan1959 said:

 

Well, if you don't believe him, then where is your outrage? Putting Covid patients in nursing homes literally killed people.

 

You have been on a crusade of outrage - page after page of posts regarding Trump making positive statements about China in January, making a stupid comment about bleach, and other inconsquential things. And yet, you are strangely silent on this or, for that matter, anything for which you can't find a way to blame Trump.

 

Hypocrisy, thy name is Kemp...

 

 

Pretty funny. I acknowledge he might be lying and it's the only time I'm aware of an accusation against him.

 

Name one time any Trump supporter here has once acknowledged Trump had lied, even though there are multiple confirmed lies by him in regards to the virus.

 

Why aren't you outraged by this?

 

When: Thursday, March 12
The claim: All U.S. citizens arriving from Europe would be subject to medical screening, COVID-19 testing, and quarantine if necessary. “If an American is coming back or anybody is coming back, we’re testing,” Trump said. “We have a tremendous testing setup where people coming in have to be tested … We’re not putting them on planes if it shows positive, but if they do come here, we’re quarantining.”
The truth: Testing is already severely limited in the United States. It is not true that all Americans returning to the country are being tested, nor that anyone is being forced to quarantine, CNN has reported.