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

[Skill and Chance]

https://mobile.twitter.com/ndrew_lawrence/status/1252400233662693377?ref_src=tws...

Patrick went on: "There are more important things than living, and that's saving this country for my children and my grandchildren and saving this country for all of us.

"I don't want to die, nobody wants to die but man we have got to take some risk and get back in the game and get this country back up and running," he told the Tucker Carlson Tonight host.

Isn't he also the one who said we may have to sacrifice a bunch of old people so young people can live

Yes.  Fortunately the Governor of Texas has been ignoring him and going more gradually than other Southern states. 

[Skill and Chance]

https://twitter.com/LindseyGrahamSC/status/1252643727811756034

This is interesting.  Georgia seems like the libertarian version of Michigan in terms of handling this.  Nail salons and movie theaters are on a totally different level from parks and beaches.

[Skill and Chance]

https://www.nbcnews.com/news/world/u-n-warns-hunger-pandemic-amid-threats-coronavirus-economic-downturn-n1189326

Can we stop pretending that we will be all locked down for years and that it will be worth it past June?

I know most people on this forum come from households earning millions a year but...

Almost all of this article is about problems that will be much more prominent in the global south than the United States...

The areas in the US experiencing the most poverty and what is historically some of the worst health care in the country are experiencing some of the heaviest case loads and fatalities (reservations, urban centers, factories and processing plants staffed by immigrants and blue collar workers). In addition to having more comorbidities, people in these communities typically work manual or service jobs deemed essential. In other words, being "incentivized" to continue to participate in the labor force is making these people more sick than the white collar workers who can stay at home. Notably, the (astroturfed) "liberate" movements and TV pundits talking about reopening the economy don't have any representation from these communities.

Containing the virus versus keeping people fed is of course a false choice in the United States. This is why the social safety net exists. Just give people money. We already do this in several forms; just temporarily scale it up for a few months.

As the economy continues to deteriorate people from all sectors will begin to be laid off due to lack of demand.

And we are doing everything atrociously right now. Georgia, Tennessee and Texas are opening up prematurely which will only cause the spread of the virus to accelerate. We just are not ready yet.

We can't say we will temporarily scale up safety nets for a few months when it will be years with the way we are operating this entire crisis. We are putting ourselves in a box in which we will have to wait for a vaccine.

The Georgia plan is insane and needs to be distinguished from what is happening in Tennessee and Texas.  The later both have less of a problem to begin with and are moving 2 weeks later than Georgia and allowing stricter measures to continue in urban counties.

[Skill and Chance]

New CDC update on COVID-19 released yesterday.  The hospitalization rate is highest among adults 65 or older, but is comparable to what is seen during a high severity flu season.  For children (aged 0-17), hospitalization rates are much lower than a typical flu season.  Nationally, hospitalizations for respiratory illness are only above baseline in the Northeast. 

Hospitalizations are a key indicator, because they lead deaths/ICU admissions while not being influenced by the availability of testing (i.e., severe cases progress to the hospital regardless of when/if testing is performed). 

This all great to see, but it's not comparable to a typical flu season.  This is what we are seeing after 6 weeks of closed schools and large gathering bans and a variable but shorter period of non-essential business closures in most states.  We do not do any of this in a typical flu season.

[Skill and Chance]

I would agree with this. Individual businesses should have the right to decide whether or not they will require customers to wear masks while on their premises, but government should not, at least to the extent of fining, jailing, or otherwise penalizing people for not wearing them.

Does government have the right to tell you to cover your genitals in public, including in stores? It's for hygiene right? Because, so is this.

There is a difference between indecent exposure and mask wearing.

I'm OK with an enforceable mask law, but I prefer just encouraging private businesses to provide them to employees and throw out customers who aren't wearing them.  Make it part of the safe harbor guidelines for legal liability.

[Skill and Chance]

Social distancing assumes that, at some point or another, you will eventually come into contact with a high enough concentration of the virus to get infected.  The only thing that varies is the timing. 

No I don't think that's right. Suppose a kid is asymptomatic and visits his grandma. If they try to stay 6 feet apart she'll probably get a smaller load than if they hug and kiss when they meet/leave. This affects her mortality. After that, if she survives she's immune. It doesn't matter how many other infected people she comes into contact with at that point.

Not to nitpick, but that is what social distancing assumes because the "flatten the curve" models are unspecified in regards to viral loads/divergent infectivity.   

Even so, viruses are not poisons - within the body they are self-replicating.  While the initial "dose" of virus someone receives may affect their disease's progression (their innate immune response could be overwhelmed, thus making their later acquired immune response less effective), higher viral loads are themselves a result of severe cases more so than a cause.  Asymptomatic children are not going to be carrying enough virus to seriously impede the innate immune response of an (even older) adult; if grandma gets sick this way and dies, her immune system was already operating at severe disadvantage.   

My understanding is that social distancing that is sufficient to make the reproductive rate permanently go below 1 would lead to the virus eventually dying out in the population if sustained long enough and any infected international travelers are quarantined before entry.

However, at our current degree of social distancing, the reproductive rate in most states appears to be 0.8-1.1 depending on how this is influenced by the ramp up of testing.  With an initial reproductive rate of 0.9 and large outbreak to begin with, whatever social distancing conditions led to the 0.9 rate would have to be sustained for a very long time--potentially multiple years--for the virus to die out rather than spreading throughout that population.  If prohibitions on 100+ gatherings alone are sufficient to drive infection reproduction to 0.9, that might be socially sustainable until it's gone in the summer of 2022, but it's clear the current measures in the more restrictive states will not be sustainable that long.  However it's also true that, in practice, we are trying to hold the line until effective outpatient treatments are available and may not ultimately need to drive it to 0, just keep a lid on it until better medicine comes along.  That is more viable. 

[Skill and Chance]

It’s also a reason for us to have a strictly enforced lockdown for a shorter period of time, as opposed to a mild-lockdown which requires months to have an impact and ironically exposes more people to the virus.

Are you saying are mild lockdowns expose more people than if we hadn't done anything?

My bad, no.
I’m saying longer mild lockdowns expose more people and hurt the economy more than shorter but stricter lockdowns.

Strict lockdowns in the international sense are likely to be unconstitutional here (though we likely could do more to formally limit travel between states and cities/coounties- for example, several of the Founding Fathers were denied entry/exit from Philadelphia for several months during the 1790's Yellow Fever outbreak).  It's also unclear to me that a strict lockdown targeting disease eradication can succeed unless your country is an island.  In most wealthy countries that aren't islands, this is about slowing it down enough to buy time until better treatments.  In that sense, we have at least partially succeeded.

At this point the rest of the free world is doing about the same thing we are: starting to open up small businesses while continuing to shut down large gatherings.  That now includes Italy and Spain!  What happened in Georgia with massage parlors, etc. in late April after only ~3 weeks of shutdown was reckless, but states that are opening with capacity restrictions this month are acting well within the international norm.  On some measures, the US stands out as aggressive.  Our rest of the academic year school closures are going to be some of the longest in the wealthy world.

[Skill and Chance]

Montana is allowing schools to reopen. A few districts actually have.

I know, but it's a handful of rural schools.  Every state but MT and WY has called the public school academic year (ID apparently allowed a handful private schools to reopen with precautions).   We are talking about states with < 1% of the US population.

[Skill and Chance]

Welp Tucker just went off on what a “buffoon” Fauci was so good luck y’all who thought he wouldn’t go truther

What a shame.  He was originally the strongest voice on Fox for getting out ahead of the problem and treating it as a crisis.

[Skill and Chance]

Certain Governors and Mayors are really letting their authoritarian instincts show. If states like Colorado and Georgia are able to keep the virus under control while cautiously reopening, no way do these hard lockdowns last for months more without the use of force.

Montana may very well be the best example of reducing this virus while letting things open.

And Montana and Colorado have Democratic Governors. As I've said before, Polis has done a good job of balancing public health with economic considerations, and has certainly had a clearer direction, in terms of how reopening will proceed, than many of his colleagues.

On the one hand, the downside risk in California is particularly severe.  It's easy to imagine SF (2nd highest transit ridership after NYC) or L.A. turning into an NYC/Lombardy situation very quickly if left unattended.   On the other hand, the situation is pretty clearly improving in warm, sunny states and it's quite a stretch to say things will be worse in July.  A better plan may be to open up as much as possible in the summer with a plan in their back pockets to shut down on a moment's notice if things get out of hand with the first cold front in October.  

[Skill and Chance]

Wow, the UK is in a really dark place.

[Skill and Chance]

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

IFR just over 1% for Spain as a whole if that study is accurate.  Matches very closely with the NYC antibody studies. 

[Skill and Chance]

The Wisconsin Supreme Court continues to be the worst:

https://twitter.com/MollyBeck/status/1260691610485964800?s=20

https://twitter.com/MollyBeck/status/1260692925211488256?s=20

Lame duck showing its ugly face here. I wonder if Evers would try again once Karofsky is on the court, especially with Hagedorn writing the dissent.

She doesn't join until August, but given Hagedorn flipped, he would presumably have the court's backing to act aggressively against a fall wave of COVID-19 and push the limits as DeWine did.

[Skill and Chance]

This virus shows up at the perfect time to get Trump re-elected.

Explain?  This seems counterintuitive.  He can still win, but his path clearly seems harder now.