Covid-19 discussion and humor thread [Was: CDC says don't touch your face to avoid Covid19...Vets to the rescue!

[Hapless Bills Fan]

[Augie]

4 minutes ago, Hapless Bills Fan said:

 

I'm pretty sure I’ve seen that brave man at Hammer’s lot! 

 

 

Drinking thru sunrise may have influenced that notion? 

[ExiledInIllinois]

Silent Sub-Epidemic? YIKES!

 

https://www.msn.com/en-us/news/us/patients-with-heart-attacks-strokes-and-even-appendicitis-vanish-from-hospitals/ar-BB12SZBY

 

"... “Everybody is frightened to come to the ER,” Puskas said.

 

Some doctors worry that illness and mortality from unaddressed health issues may rival the carnage produced by the virus in regions less affected by covid-19. And some expect they will soon see patients who have dangerously delayed seeking care as ongoing symptoms force them to overcome their fear. ..."

2 hours ago, Augie said:

 

I'm pretty sure I’ve seen that brave man at Hammer’s lot! 

 

 

Drinking thru sunrise may have influenced that notion? 

Or... Working out back pain spread out in the back bed of an imported pick-up truck...

?

Ain't no shame in it... ?

 

[Sundancer]

10 hours ago, Limeaid said:

 

Sorry Sunduncer but only thing I will not do is allow tracing even if it means I leave phone home which I often do anyways.  Already posted a picture of me with my mask and mask/face shield.

 

And you sound like one of the excuse makers for companies who say "Oops, sorry we forgot about that the app copied your ssn, dob and password to our protected server which was hacked by a teenager and sold on black market.  Here is a coupon."    For one application M$ had you needed to have a M$ email account so I created one in hotmail and each item I included false information.  Less than a month later I get calls on the phone number (office mate's phone who had left) asking for this fictitious person.  There never was such a person so only way they got info was from M$.   Tracking can be used for very bad things and until the government whose laymakers get campaign donations (turned into pocket funds when they retire) I am not allowing any tracking I can prevent.

 

I put my goal about getting out of this without more deaths and more shutdowns way above someone knowing that I go to PetSmart once a month or my Youp### preferences.

 

And since I assume there's already a ton out there about me, taking on a little more to get out of this mess seems worth it. 

Edited April 20, 2020 by Sundancer

[Hapless Bills Fan]

On 4/19/2020 at 6:22 AM, Sundancer said:

OK thank you, this makes good sense. Given the availability of these antibody tests now, it seems we will shortly have a lot more data, and a lot more data about "man on the street" prevalence and also how symptomatic this is. But these glimpses seem to show good and bad news: The bad is that the disease can be asymptomatic for lots of people, maybe way more than we know (and if it's transmissible while asymptomatic like we think it is, that's bad), and the good being that it may be asymptomatic and have less complications/fatalities than we thought. Neither is an argument for changing current distancing policy since we've already seen how this overwhelms healthcare systems.

 

So just looping back here....several of my favorite epidemiologists are disputing the Santa Clara study's methodology.

Here's the preprint of the study  https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1.full.pdf
 

To do them justice, the authors acknowledge the criticism, but that's not what's making it into the news.

 

I'll try to extract the salient points of the twitter discussion.
1) All antibody tests have false positives.  The test used claims a specificity (false positive rate) of 99.5% during its validation tests.  In real world real use, it's very very likely to be lower specificity, that's just how real world works, stuff never works as well as it did in the lab.  But just taking that specificity at face value, when they say "The unadjusted prevalence of antibodies to SARS-CoV-2 in Santa Clara County was 1.5%", their 50 positives could actually be 33 positives or 1%.

The authors make a statement about range of 98-99.9% specificity, it's not clear how they got that range, but if the specificity is 98%, that would actually mean in a sample of 3,330 people, 66 false positives would be expected - a number larger than the 50 positive results they got!  Their samples could be 100% false positives, given the specificity range they report!  Ooops!  To avoid dealing with that, it appears the authors tried to simultaneously correct for demographics and the impact of false positives.  But the result is that none of their corrected prevalence estimates are below the 1.5% unadjusted prevalence rate they give.  Their lowest in their confidence intervals is 1.8% - HIGHER than the actual % of positives.  How can that be? 

 

Back when I was a bench scientist, we put error bars on our test data, THEN did any corrections for sample bias - this is the time-tested procedure I was taught, so "I smell smoke".  Fundamentally, the more massaged data becomes, the less anyone should trust it.  Several scientists I respect are on twitter making this point in more or less dramatic fashion - my personal fave is the guy who dramatically reports hearing "loud sobbing from beneath Bayes gravestone" LOL.   Less dramatic:
 

 

 

https://twitter.com/jjcherian/statu

s/1251273320940666881?s=20

2) Questions about the confidence interval on the test's specificity aside, the sample was very non-representative.

Here's what their sample looked like:

They then tried to correct for the non-random nature of their sample by demographic adjustment.  But there is an additional potential bias they don't address,  as virologist Peter Kolchinksky explains:

 

 

 

A lower sampling of people from certain demographics - let's say male Hispanics 40 - 50 yrs old - naturally places more weight on both self-selection and the impact of any false positives in that demographic when extrapolated. 

 

But the authors didn't attempt to address sampling bias that perhaps people who actually had symptoms were significantly more likely to desire testing and drive out to have blood drawn. (I think that's very likely - I know I'm far more interested to see my daughter, who was sick, be tested than to be tested myself)
 

3) Now the study gets out into the wild and people want to use the 50-85x more infections than positive test and apply that broadly, for example in calculating the actual lethality rate.  Here is where it gets into very very murky waters indeed, for the reasons given above.  Kolchinsky points out that looked at differently, the data could just as well support a lethality rate of 1% vs. 0.19% (adjusting for false positives, whether the sample is non-random in that untested people with symptoms may be more likely to seek antibody testing etc etc).

 

 

 

I think the data are very interesting, but I would be much more comfortable taking the 1.5%, adjusting for the measured test false positive rate to 0.99% seroprevalence, and working from that. 

 

My bottom line: I think this is an interesting study and shows pretty clearly that the seroprevelance in Santa Clara county is in the <5% range, most probably 1-3% range.  Not 20%, not 30%, not 50%.  1-3%, less than <5%.

 

To use it further to extrapolate a death rate - I think that's kind of bunk, and the fact that there are a bunch of epidemiologists and virologists on twitter yelling illustrates that.  There are too many uncertainties (including the authors doubling the actual number of deaths to account for seriously ill people who may die, but are still alive.  I dunno about you but I want to actually die before you count my body) for that to be meaningful.

 

 

[Sundancer]

That's great stuff.

 

The takeaways from the Santa Clara study and the two data points in Boston and Iceland is this: We need to do some true random studies but also get much better antibody tests if we can. That will give us better measures of prevalence and morbidity. The other takeaway is that the quick antibody test is critical for reopening. 

[Bad Things]

In case anyone is interested on how things are going outside of the US.

(This is about NZ's successful response.)

 

https://www.bbc.com/news/world-asia-52344299

 

 

[BillsFan4]

 

 

[Saxum]

3 hours ago, Bad Things said:

In case anyone is interested on how things are going outside of the US.

(This is about NZ's successful response.)

 

https://www.bbc.com/news/world-asia-52344299

 

 

 

It is a lot easier for small, mostly homogeneous (or a lot more than US) to find rules that work.

While the virus has spread in US demonstrating the connectivity of the virus the US is much more difficult for the US since it has so many different areas of country which do not usually agree with each other. Remember the bloodiest war we have ever fought was a civil war.  Add this being an election year (no I do not advocate as one person on radio did suspend elections until virus is cured) it makes it even worse. 

[Bad Things]

4 minutes ago, Limeaid said:

 

It is a lot easier for small, mostly homogeneous (or a lot more than US) to find rules that work.

While the virus has spread in US demonstrating the connectivity of the virus the US is much more difficult for the US since it has so many different areas of country which do not usually agree with each other. Remember the bloodiest war we have ever fought was a civil war.  Add this being an election year (no I do not advocate as one person on radio did suspend elections until virus is cured) it makes it even worse. 

Understood.

I was never suggesting that our situations were similar.  Still though...

[Saxum]

17 minutes ago, Bad Things said:

Understood.

I was never suggesting that our situations were similar.  Still though...

 

Not saying you were and I commend that you have isolated the virus.

From what I have read the US is dealing with more than 1 strain of virus so even our virus is not homogeneous!

[Hapless Bills Fan]

1 hour ago, Limeaid said:

 

Not saying you were and I commend that you have isolated the virus.

From what I have read the US is dealing with more than 1 strain of virus so even our virus is not homogeneous!

 

I'd be happy to comment if you link what you've read, but that's a "negative" as far as I know on the multiple strains.

There are literally thousands of known mutations - all over the world as in the US - but none yet rising to the level of "different strains".

 

This calls itself "opinion" but quotes extensively from genomic epidemiologist/virologist Trevor Bedford and molecular biologist Peter Thielen:

https://www.nytimes.com/interactive/2020/04/16/opinion/coronavirus-mutations-vaccine-covid.html
Scientists know that SARS-CoV-2 is mutating.

Among the thousands of samples of the long strand of RNA that makes up the coronavirus, 11 mutations have become fairly common. But as far as we know, it’s the same virus infecting people all over the world, meaning that only one “strain” of the virus exists, said Peter Thielen, a molecular biologist with the Johns Hopkins Applied Physics Laboratory.

Only one of those common mutations affects the “spike protein,” which enables the virus to infect cells in the throat and lungs. Efforts to produce antibodies that block the spike protein are central to many efforts to develop a vaccine. Since the spike protein has changed little so far, some scientists believe that’s a sign that it can’t alter itself very much and remain infectious.

 

[Hapless Bills Fan]

3 hours ago, BillsFan4 said:

 

 

 

 

 

Kind of hard to obtain a socially distant haircut and style, as well

[Hapless Bills Fan]

 

https://www.theatlantic.com/ideas/archive/2020/04/were-testing-the-wrong-people/610234/

 

I haven't seen this spelled out clearly anywhere else.

 

Basically, the authors point out that if we want to contain a disease that may be spread by asymptomatic people, we need to stop focusing our limited testing resources on testing people who show symptoms that might be covid-19 - it won't change their treatment. 

Instead, we need to focus on testing asymptomatic or mildly symptomatic people whose job places them in contact with the public - first responders, health care workers, aides working with the elderly, and people planning to return to the workplace.

 

I think they've got a valid point.

 

 

[Hapless Bills Fan]

@SDS you were worried about food supply?

 

https://www.bbc.com/news/world-us-canada-52311877

https://www.washingtonpost.com/business/2020/04/20/meat-plant-pork-close/

 

 

[plenzmd1]

@Hapless Bills Fan, care to weigh on on this odious issue? 

 

https://nypost.com/2020/04/20/can-the-coronavirus-be-spread-through-farts/

[Royale with Cheese]

9 hours ago, Hapless Bills Fan said:

 

 

 

Kind of hard to obtain a socially distant haircut and style, as well

I live in Atlanta and this is dumb.

 

Im seeing people talk about it on Facebook and surprisingly, most people are against this and will continue to stay home.  It hasn’t even peaked yet in Georgia and we aren’t going to practice social distancing anymore.

[Lurker]

1 hour ago, plenzmd1 said:

@Hapless Bills Fan, care to weigh on on this odious issue? 

 

https://nypost.com/2020/04/20/can-the-coronavirus-be-spread-through-farts/

 

Just great.   Now I have to wear a mask on my ass as well???

[/dev/null]

1 hour ago, Lurker said:

 

Just great.   Now I have to wear a mask on my ass as well???

 

They're called pants.  People used to wear them before web conferencing was a thing

[BillsFan4]

4 hours ago, Royale with Cheese said:

I live in Atlanta and this is dumb.

 

Im seeing people talk about it on Facebook and surprisingly, most people are against this and will continue to stay home.  It hasn’t even peaked yet in Georgia and we aren’t going to practice social distancing anymore.

I don’t get what this reopening plan is even based on. I don’t see how Georgia meets the federal govt’s gating criteria to move to phase one (though I’m guessing the federal govt. must agree because they haven’t protested georgia’s plan and they said they would if they thought a state was trying to open before it was ready).

 

https://assets.documentcloud.org/documents/6840714/Guidelines.pdf 

(gating criteria)

 

Their covid cases aren’t trending down (I believe they’re actually still trending up),

they aren’t able to do the widespread testing the plan talked about. They don’t have widespread antibody testing. They don’t have any tracing or screening in place that I’m aware of. Do they have those sentinel sites screening asymptomatic people and contact tracing the plan talks about? Do they have the PPE stockpiles it calls for? (I’d be somewhat surprised if they do with the shortages being faced by most of the country, but who knows). How are they going to protect the workers being asked to go back? Do they have some way for these businesses to purchase/acquire n95 masks for their workers (assuming healthcare workers in the state already have an ample supply)? So many questions...

 

 

Also, some of the stuff that’s opening was surprising. How do you social distance while giving a tattoo or cutting hair, or even serving food? A waitress has to bring the food to the table. They have to go into the kitchen w/the cook(s). Plus, customers can’t eat their food with masks on.

While you can maybe social distance in a movie theatre, it’s still shared indoor air space. One sick person coughs during that movie and those airborne virus particles could spread throughout the whole theatre.

 

You could see this coming though. I knew states would start opening back up as soon as that federal plan was released and they said 29 states were about ready to open within the next few days. You know some governors were just itching to reopen.

 

 

It sounds like a number of mayors are fighting the plans to reopen. I’ve read comments from quite a few that are not at all happy. Your mayor in Atlanta blasted this plan. The mayor in savannah is asking businesses to ignore this plan and remain closed. 

 

https://www.politico.com/news/2020/04/21/atlanta-mayor-blindsided-georgia-governor-reopening-state-197937

 

https://www.wsav.com/news/local-news/in-my-mind-this-is-reckless-mayor-van-johnson-reacts-to-governors-decision-to-allow-some-businesses-to-reopen/

 

https://www.wjcl.com/article/watch-live-savannah-mayor-addresses-response-to-coronavirus/32222105

 

whatever ends up happening with this reopening, try to stay safe friend! 

Edited April 21, 2020 by BillsFan4