COVID-19 Megathread 5: The Trumps catch COVID-19

[Fmr. Gov. NickG]

Haven't really researched it tbh, but is there any actual proof that the virus is significantly reduced in warm weather? I mean, the thing is spreading just fine in Brazil, Ecuador and Peru for instance.

Yes, just look at South Africa and Australia, and to an extent India. Also, look at how well several southern states are doing (Florida, Texas, Georgia, Alabama) compared to their governor's loose strategies.

Does anyone have "US minus New York" numbers? It seems like New York being through the worst of it is accounting for most or all of the decline in new cases.

It’s not just New York, things in NJ, LA, and MI are looking positive. That being said, smaller states are seeing substantial case growth and need to be monitored.
(This is why we should have had an actual quarantine of the NYC metro)

Testing is surging, cases p/d are probably going to continue to increase while the testing surges, the actual amount of cases p/d is declining almost everywhere. The only acceptable metric is percent of positives, which is declining everywhere.

Is India really a success story?  It seems like infections there are just starting to explode, despite the country implementing a pretty strict lockdown relatively early.

[Fmr. Gov. NickG]

In vaccine news Oxford is so far they're reporting those who got the actual vaccine in their study are doing fine and none showed any bad effects So far 4 Vaccine candidates are doing well one from Pfizer, Oxford, Moderna and Sinovac Biotech.

Though I don't expect a vaccine to be distributed before years end

But Oxford isn’t doing human challenge trials, right?  They just need to wait to see if people in the trials get infected naturally.  I wonder if any of the potential human challenge trials will get useable results sooner.

[Fmr. Gov. NickG]

Spain just completed a nationwide seroprevalence test, testing 90,000 people over the course of more than two weeks.

They found that 5% of their population had been infected.  

This would be about nine times the number of confirmed cases, which seems very plausible to me given that Spain has tested significantly more people per capita than any other large country.

https://www.nytimes.com/reuters/2020/05/13/world/europe/13reuters-health-coronavirus-spain-study.html

[Fmr. Gov. NickG]

I really like most of the approach that Gov. Cuomo has taken of phased reopening based on metrics defined clearly and in advance.  Decisions to either lift or extend restrictions should not be made ad hoc.  More importantly, the metrics are focused on health care and testing capacity rather than, say, the number of new cases (a metric with severe moral hazard problems).  I really wish we saw this in more states.  

My one disappointment with the NY program is that I wish they would prioritize school reopening ahead of stuff like entertainment and retail.  I understand that people are hypervigilient about their kids, but this is really the most essential part of our society that still appears to be nowhere close to reopoening.

I also appreciate that Gov. Cuomo was way in front on serological tests, and also seemed open to the possibility of immunity certificates until that dumb notice from the WHO.  Has information coming from the WHO been helpful in any way during this pandemic other than to spread paranoia?

[Fmr. Gov. NickG]

How is opening a school either any more risky or any less essential than opening a pork processing plant?

[Fmr. Gov. NickG]

https://twitter.com/bopanc/status/1260957885057695748

Who cares? Life has risks. Do you make a graph for every other possible illness you might get before leaving your house? This remains all so ridiculous.

I mean if you want to live in a world of delusion be my guest I have no sympathy for people like you if you get it






Anyways in some good news
https://www.biorxiv.org/content/10.1101/2020.05.13.093195v1?fbclid=IwAR1Xb79A0cGjORE2nwKTEvBb7y4-NBuD5oRf2wKWZfAhoCJ8_T73QSQfskw


The ChAdOx-CoV2 vaccine candidate so far doesnt appear to cause ADE and prevents SARS pneumonia in rhesus macaques and they believe they could possibly go into trials with health care workers and general Phase III trials next month

I still haven’t heard anything real about getting the human challenge trials moving that will accelerate the testing of these potential vaccines.  This seems like such a no-brainer to me.  I signed up to potentially participate on the 1 Day Sooner website, and strongly encourage other healthy people to do so demonstrate the willingness and demand for this.

[Fmr. Gov. NickG]

https://twitter.com/bopanc/status/1260957885057695748

Who cares? Life has risks. Do you make a graph for every other possible illness you might get before leaving your house? This remains all so ridiculous.

I mean if you want to live in a world of delusion be my guest I have no sympathy for people like you if you get it






Anyways in some good news
https://www.biorxiv.org/content/10.1101/2020.05.13.093195v1?fbclid=IwAR1Xb79A0cGjORE2nwKTEvBb7y4-NBuD5oRf2wKWZfAhoCJ8_T73QSQfskw


The ChAdOx-CoV2 vaccine candidate so far doesnt appear to cause ADE and prevents SARS pneumonia in rhesus macaques and they believe they could possibly go into trials with health care workers and general Phase III trials next month

I still haven’t heard anything real about getting the human challenge trials moving that will accelerate the testing of these potential vaccines.  This seems like such a no-brainer to me.  I signed up to potentially participate on the 1 Day Sooner website, and strongly encourage other healthy people to do so demonstrate the willingness and demand for this.

They already said they arent doing challenge trials

If so, this is completely absurd and orders of magnitude worse than any of the dozens of horrible decisions Trump has made over the past few months.

[Fmr. Gov. NickG]

This is how virus-truthers feel across the country. They are scared to acknowledge the truth so they stay buried under the sand in with fictitious beliefs that everything is normal and always will be. Basically a form of denial to cope with tough situations.
It’s truly an enviable way of thinking, to be able to be so willfully ignorant for your own happiness.

Their chief:

https://twitter.com/RadioFreeTom/status/1261036307972833281

I mean, this is actually true.  If you do more testing you will invariably identify more cases.  Didn't we all agree on this several weeks ago?

Great. So I guess if the police stopped doing rape kits that would solve the rape and sexual assault problem.

The only way you get from the observation that testing capacity has a deterministic impact on new case counts to what you just said is by either 1) being illiterate or 2) operating in extremely bad faith. 

Is Trump articulate or even inspiring confidence with his remarks?  An emphatic no.  But he's just repeating a pretty compelling, standard argument that's been evoked ad naseum by scientists, doctors, and commentators on both the left and right. 

It is a factual statement that if you do more testing, you will find more cases.
But what exactly is the argument?
This statement could be used in support of the argument that finding more cases is a good thing.  But it sounds like Trump wants to use to support an argument in favor of less testing.  Which is absurd.  You want/i] to find more cases, not fewer, and testing is the essential way to do that.

[Fmr. Gov. NickG]

Latest U.S. vs. Europe case & death graphs.

Today was the first day in which the 7-day average of deaths was declining faster week-over-week in America than in the big five European countries (American deaths declined 23.7% this week compared to the previous week, while European deaths declined 21.5% over the same period).

[Fmr. Gov. NickG]

I don't see how anyone can listen to Trump's remarks and walk away thinking he wants to do less testing; it's even pretty obvious he's taking a jab at the media when he says "they don't wanna write that".  "That" being when you do more tests you identify more cases.

I've seen MSNBC report many times now that if you do more tests you find more cases.

20,000 cases is still 20,000 cases even if you can make an argument (unproven) that there are fewer new infections now than the last time a week ago when 20,000 cases were found.

If the test positivity rate is dramatically lower, tha would suggest there are fewer new infections.  Nevertheless, given that we might still only be finding 10% or less of actual infections (and thus there may be 200,000-300,000 new people infected everyday), the absolute number of “cases” has become pretty irrelevant.

[Fmr. Gov. NickG]

France has "neutralized" the virus? They're still reporting a few hundred new cases a day (with a terrible and very limited testing regime so they are inevitably missing more cases than most countries) and an average of close to a hundred deaths a day. That's not neutralized.

Yeah. France reported 351 deaths today, which is a similar per capita number to the US.  Their reporting throughout had been really inconsistent, so perhaps they swings are tricking whatever measure is being used in the map.  If you average everything out, they going strongly in the right direction, but still slightly behind Spain.

[Fmr. Gov. NickG]

https://www.politico.com/news/2020/05/14/trump-pence-coronavirus-258299

White House press secretary Kayleigh McEnany revealed Thursday there is no procedure in place to facilitate House Speaker Nancy Pelosi’s ascension to the presidency should President Donald Trump and Vice President Mike Pence become incapacitated by the coronavirus.

After one of Trump's personal valets, Pence's press secretary and Stephen Miller's wife all tested positive last week...we probably should be think about a President Pelosi, a President Grassley, or more realistically (as both Pelosi and Grassley are both 80+) a President Pompeo (he's 56, and relatively healthy).

Shouldn't our President be trying to keep possible successors (Biden doesn't count, as he might lose in November) aware of what is going on so that if something happens effective continuity of government is maintained?

Besides being morbid, this is exceptionally silly.  Even among those age 80+, the IFR of the virus is only around 10%. 

[Fmr. Gov. NickG]

A graph to put the recent drop in US deaths into perspective:

[Fmr. Gov. NickG]

It now seems pretty apparent that for children, covid-19 is less lethal than chickenpox.  The CDC reports that 8 children age 1-14 have died from covid (out of the first ~60,000 US deaths), compared to 50-100 children who died every year from chickenpox prior to the adoption of a vaccine (and thousands who were hospitalized).  

And yet, parents deliberately exposed their children to chickenpox for generations because they wanted them to acquire immunity and we knew that it was much more dangerous to get it as an adult.  Isn’t the exact same thing true of covid, and to an even greater extent given that covid is actually much more lethal to adults than chickenpox?

The smart thing would be to set up summer camps where kids will be exposed to coronavirus, and they can acquire immunity away from the threat of infecting adults, and then come back to school in the fall with complete safety.   The camps could be staffed by people who have immunuty already, and if you excluded children who were already immunocompromised, you’d probably have less than 100 deaths across the entire country.   Schools could reopen immediately and completely, and an entire generation of people could participate fully in society without fear of infecting themselves or others.

[Fmr. Gov. NickG]

WHO says there's 'no evidence' recovered coronavirus patients won't get reinfected

This WHO statement from weeks ago has been thoroughly discredited, as has every other early panicked headline about reinfection.

Every real shred of evidence (including the Science article posted in this thread earlier today) overwhelmingly supports practically universal immunity.

As of course, does the basic fact that we have 4.5 million confirmed infections and zero confirmed examples of reinfection; imagine what we’d say if a vaccine trial revealed zero infections among the first 4.5 million trials.

[Fmr. Gov. NickG]

A serologic study of four Boston zip codes found that 9.9% of asymptomatic people tested had coronavirus antibodies, and 2.6% tested as currently infected with the virus.

For comparison, 1.6% of Boston residents were previously confirmed covid cases.

Boston Mayor Walsh mentioned this was actually a slightly lower number than he expected; he guessed that 15-20% of Bostonians would have antibodies in a larger sample.

https://www.bostonherald.com/2020/05/15/coronavirus-in-boston-10-of-bostonians-have-covid-antibodies/

[Fmr. Gov. NickG]

WHO says there's 'no evidence' recovered coronavirus patients won't get reinfected

This WHO statement from weeks ago has been thoroughly discredited, as has every other early panicked headline about reinfection.

Every real shred of evidence (including the Science article posted in this thread earlier today) overwhelmingly supports practically universal immunity.

As of course, does the basic fact that we have 4.5 million confirmed infections and zero confirmed examples of reinfection; imagine what we’d say if a vaccine trial revealed zero infections among the first 4.5 million trials.

5 USS Roosevelt Sailors Test Positive For COVID-19, Again

The U.S. Navy says five sailors from the USS Theodore Roosevelt who had apparently recovered from the coronavirus and had received negative test results have now tested positive for a second time.

In a statement, the Navy said the sailors had "met rigorous recovery criteria, exceeding CDC guidelines," including testing negative for the virus at least twice, but have now retested positive. The statement said the sailors had been monitoring their health and adhered to social-distancing protocols while on board the Roosevelt, which has been docked in Guam following an outbreak infecting hundreds of crew members.

You were saying? (When you weren't ignoring the potential threat to children from the suggestion in your own earlier post.)

There's no evidence at all in that article of a second independent reinfection.  It sounds like the same scenario as all those early instances in Korea that people initially panicked over, but were then definitively debunked.

[Fmr. Gov. NickG]

For people doubting immunity given what we know so far, I have a question: How are you ever going to trust any vaccine trial?

Given our accelerated trial protocols and procedures, any vaccine that appears effective is going to be approved based on far less direct and indirect evidence than the accumulated evidence we already have for immunity.

[Fmr. Gov. NickG]

I thought this article in Vox today was especially interesting.  it describes the failure of the very early and strict lockdowns in California to suppress the spread of the virus and death toll in that state.

https://www.vox.com/future-perfect/2020/5/16/21254748/california-coronavirus-cases-lockdown

The most important part IMO is the last section, where is discusses why lockdowns appear to be succeeding in New York and New Jersey (and I would say, by extension, Italy and Spain) where they have failed in California and several other states:

A more discouraging explanation is that, since something like 15 percent of people in those states have now been exposed to the coronavirus, it’s easier to reduce transmission. A similarly strict stay-home order to California’s will do more to reduce transmission in a state where many people have already been infected. That interpretation would suggest that states can only get out of limbo at a horrific human price: New York has lost more than 25,000 people to the virus, and tens of thousands of others may suffer long-lasting effects.

Overall, this paints a scary picture; lockdowns alone, no matter how long they last, won’t save us.

It seems like the only solution, once we have passed the point of individual contact tracing, is a combination of social distancing restriction AND partial herd immunity.  

The evidence seems to show this doesn't need to be the complete herd immunity of 60-70% that many have suggested, if this factor is able to work in conjunction with social distancing.  It appears that a 10%-20% infection rate may be sufficient to dramatically slow the virus.  The focus now needs to be on how to efficiently achieve this infection rate while minimizing death and serious health consequences.  We can't just wait for hundreds of thousands more people to die with so little to show for it.

[Fmr. Gov. NickG]

I thought this article in Vox today was especially interesting.  it describes the failure of the very early and strict lockdowns in California to suppress the spread of the virus and death toll in that state.

https://www.vox.com/future-perfect/2020/5/16/21254748/california-coronavirus-cases-lockdown

The most important part IMO is the last section, where is discusses why lockdowns appear to be succeeding in New York and New Jersey (and I would say, by extension, Italy and Spain) where they have failed in California and several other states:

A more discouraging explanation is that, since something like 15 percent of people in those states have now been exposed to the coronavirus, it’s easier to reduce transmission. A similarly strict stay-home order to California’s will do more to reduce transmission in a state where many people have already been infected. That interpretation would suggest that states can only get out of limbo at a horrific human price: New York has lost more than 25,000 people to the virus, and tens of thousands of others may suffer long-lasting effects.

Overall, this paints a scary picture; lockdowns alone, no matter how long they last, won’t save us.

It seems like the only solution, once we have passed the point of individual contact tracing, is a combination of social distancing restriction AND partial herd immunity.  

The evidence seems to show this doesn't need to be the complete herd immunity of 60-70% that many have suggested, if this factor is able to work in conjunction with social distancing.  It appears that a 10%-20% infection rate may be sufficient to dramatically slow the virus.  The focus now needs to be on how to efficiently achieve this infection rate while minimizing death and serious health consequences.  We can't just wait for hundreds of thousands more people to die with so little to show for it.

This wouldn’t explain why New Zealand and Australia and Greece and a few other countries were strict lockdowns resulted in fast containment. Hell, this even seemed to work well in Montana.

I said “once you have past the point of individual contact tracing”.  It is true that several countries with very few cases have seemingly been able to eradicate the virus.  But that was never going to be possible in Califonia.  We also just don’t know if a lot of place just haven’t seen a surge in cases yet.  India locked their nation down early and was seemingly able to delay the spread for several weeks, but now cases and deaths there are exploding.

[Fmr. Gov. NickG]

The Vox article above indicates that California has had only about 50% compliance with stay-at-home orders.  There is no way curves will be "crushed" by mitigation procedures that have that have such a low compliance rate.  Lockdowns can only be effective when people observe them.

Anyway, there is still so much we do not know about CoV-19.  We don't know how to vaccinate against it or really treat it systematically.  We don't know how long immunity acquired through exposure lasts.  We don't know much about its mutation rate and patterns.  We still are not doing nearly enough initial testing or contact tracing, our serological tests are still not very accurate, and what immunity rates may presently exist are still quite low.  When most people are still as vulnerable as they are, and when we still know so little about this thing, opening things up to precipitously is like going for a walk during a firestorm.

Just to be clear, I am -not- in favor of “opening things up”.

[Fmr. Gov. NickG]

On one brighter note, it looks like Spain just saw their first day with under 100 deaths in over 2 months.

[Fmr. Gov. NickG]

Ugh, New York is reporting 190 deaths today compared to just 41 last Sunday.  California reporting 53 today compared to 26 last Sunday.  We are already nearing the nationwide death totals from last Sunday, and Illinois, Massachusetts, and Michigan all have yet to report anything.  Perhaps any optimism about a longer term decline was premature.

[Fmr. Gov. NickG]

Latest US vs. European case and death graphs.   

Today was setting up to be the best day in two months for the European totals, likely reducing the cumulative 7-day average below 1000 for for the first time since March 23.  But then France dropped 483 new deaths onto the total, resulting in the biggest jump in the 7-day average in over a month.  Apparently only 54 of those deaths are from hospitals, the rest are accumulated nursing home deaths, but this will hurt the drop in averages all for the next several days. 

[Fmr. Gov. NickG]

I still think it is reasonable to say that covid is at most approximately the same threat to children as chicken pox prior to the development of a vaccine.  About 50 children died each year from chicken pox (death rate around 1 in 60,000), and several thousand were hospitalized.  But it was still seen as important to expose your child to the disease early because it was much more lethal in adults.