COVID-19 Megathread 3: Third time's a charm

[Bandit3 the Worker]

https://twitter.com/Atul_Gawande/status/1243880264163524610

That's not what the U.S. is doing. I haven't fled my area to a place with fewer restrictions.

[Okay, maybe Mike Johnson is a competent parliamentarian.]

That's not what the U.S. is doing.

No, the US is doing something significantly more half-assed.

[brucejoel99]

https://twitter.com/Atul_Gawande/status/1243880264163524610

That's not what the U.S. is doing. I haven't fled my area to a place with fewer restrictions.

The U.S. is literally "follow[ing] the spread rather than prevent[ing] it.

[💥💥 brandon bro (he/him/his)]

For what it's worth, the number of new U.S. cases on Worldometer dropped today, and is less than what it was even 2 days ago.

Even using a 2-day rolling total, it's dropped for the first time since at least March 3, maybe earlier.

Less testing today.

https://twitter.com/Noahpinion/status/1244388003780235264

[Fmr. Gov. NickG]

For what it's worth, the number of new U.S. cases on Worldometer dropped today, and is less than what it was even 2 days ago.

Even using a 2-day rolling total, it's dropped for the first time since at least March 3, maybe earlier.

I think a lot of places (US and other countries) just tend to do less testing on Sundays.  I wouldn’t get too optimistic until we see cases and deaths drop week-over-week.

[Meclazine for Israel]

For what it's worth, the number of new U.S. cases on Worldometer dropped today, and is less than what it was even 2 days ago.

Even using a 2-day rolling total, it's dropped for the first time since at least March 3, maybe earlier.

Less testing today.

https://twitter.com/Noahpinion/status/1244388003780235264

The Corona-virus testing regime is usually only in response to patients presenting with the basic symptoms of the virus. Random COVID-19 spot testing is rare and has been conducted in Iceland and Norway.

The UK and Australia have now introduced antibody testing.

What will be interesting from this testing will be the number of people who:

(a) Develop immunity through normal infection; (visibly sick through to recovered)
(b) Develop immunity through normal infection without displaying symptoms; (asymptomatic)
(c) Develop immunity through coming into contact with Corona-virus but not becoming infected.

The ratio of (b) to (a) is thought to be about 6:1 from modelling in China.

The ratio of people in the (c) category to the other categories is impossible to determine as they will never test positive to the virus.

An anti-body test may highlight that groups of people (maybe children) are developing immunity without getting infected at all.

Complete unknown at the moment, but I am looking for numbers on this topic from previous pandemics.

China are also taking plasma from healed patients and injecting the plasma into sick patients to measure pre-existing antibody response.

This is a known form of treatment that was used by the US Military in the Korean War in the 1950's to fight viral infections in soldiers.

[Dr. Arch]

The updated numbers for COVID-19 in the U.S. are in for 3/29 per: https://www.worldometers.info/coronavirus/country/us/

I'll be keeping track of these updates daily and updating at the end of the day, whenever all states finish reporting for that day. The percentages represent the daily increase from the last report.

3/26:

• Cases: 85,390
• Deaths: ±1,200

3/27:

• Cases: 103,798 (+18,408 | ↑21.56%)
• Deaths: 1,693 (+493 | ↑41.03%)

3/28 (Yesterday):

• Cases: 123,428 (+19,630 | ↑18.91%)
• Deaths: 2,211 (+518 | ↑30.60%)

3/29 (Today):

• Cases: 142,178 (+18,750 | ↑15.20%)
• Deaths: 2,484 (+273 | ↑12.35%)

[Meclazine for Israel]

Forgive me for circling back, but I'm a bit confused about the projection model on this site posted earlier: https://covid19.healthdata.org/projections.

If my math is right, with total American deaths coming in at around 81,000, a death rate of 1% means we will only see ~8 million Americans get infected with this virus. How is that possible in a country as populous as the United States? Either the death rate is wrong and there is a ridiculous proportion of asymptomatic cases, or the virus will come back with just as much force as before... right?

You're corrrect.

Any model showing less than 250,000 deaths need to explain why the following isn't true:

- AT LEAST 0.5% of infected Americans will die (probably more)
- AT LEAST 25% of all Americans will eventually get COVID-19 (probably more)
- If herd immunity doesn't materialize, simply containing the virus is a stopgap

All three are true... no?

Punch in the US population on a calculator, multiplied by 0.25 infected, multiplied by 0.005 death rate, and keep in mind I'm using conservative numbers here. I'd be glad to be wrong about this, but nobody has shown me why I'm wrong as of yet. I'm open-minded to changing my mind here.

Just to get some clarity on using scientific data-sets with modeling and making a useful interpretation. You are making final statements on numbers with limited information and no presented technique for getting to those numbers.

First things first. You are applying a linear model to a non-linear system. So any predicted numbers based on the parameters presented are simply a guess. Only when the pandemic is finished will those numbers be available. But during the pandemic, the system is changing in a non-linear fashion.

When presented with a large volume of data, the only thing to keep in mind is setting up the correct mathematical modeling regime for the scientific situation. Predictability of future events in time or space or readings of a physical parameter are made available through the study of physical, chemical and and biological systems.

My main work is involved in modelling physical and chemical systems. And these same mathematical modelling techniques lend themselves nicely to biological ones.

So what are we actually dealing with here?

We need to change our paradigm to the mathemetical system that is currently in play.

Here is a simulation using mathematical analysis to give you a clue about the actual non-linearity of this pandemic.

3Blue1Brown

SIR Modelling

https://www.youtube.com/watch?v=gxAaO2rsdIs

This video clearly illustrates why Japan and Singapore are so effective at containing the virus. Social distancing is not the only parameter to consider.

Contact tracing and isolation of specifically identified infected patients early with strong isolation procedures is far more effective.

Having an asymptomatic category of people makes this virus particularly hard to contain.

[Absentee Voting Ghost of Ruin]

Donald Trump now claims over one hundred thousand dead Americans will be a "very good job".

“If we can hold that down, as we're saying to 100,000 [deaths], it's a horrible number, maybe even less, but to 100,000, so we have between 100,000 and 200,000, we all together have done a very good job,” said Trump, who predicted that the peak number of deaths will occur in two weeks.

https://twitter.com/JuddLegum/status/1244394427805769728

[○∙◄☻¥tπ[╪AV┼cVê└]

That's not what the U.S. is doing.

No, the US is doing something significantly more half-assed.

Our political leaders saw that half-assed didn't work, so went with quarter-assed.

[Koharu]

Just found out that a couple I went to church with when I was growing up had COVID, and it seems like they got it via community spread as early as mid-February in rural Minnesota. Interestingly, the county they live/work in is one of the random high-rate counties that seems weirdly high compared to its neighbors on that green colored map posted earlier.

The wife has underlying health issues and got it from her husband and had very bad reaction to it, and was hospitalized for several days. She went to the ER on March 15, though her symptoms started March 11. The husband also tested positive, but his symptoms had been just fatigue and a headache, and had happened 2-3 weeks before March 17, meaning community spread in late February for sure. Which explains why Martin county has such a high number of cases relative to its population, but I'm really curious how it got to the community in the first place.

[T'Chenka]

Just to get some clarity on using scientific data-sets with modeling and making a useful interpretation. You are making final statements on numbers with limited information and no presented technique for getting to those numbers.

First things first. You are applying a linear model to a non-linear system. So any predicted numbers based on the parameters presented are simply a guess. Only when the pandemic is finished will those numbers be available. But during the pandemic, the system is changing in a non-linear fashion.

When presented with a large volume of data, the only thing to keep in mind is setting up the correct mathematical modeling regime for the scientific situation. Predictability of future events in time or space or readings of a physical parameter are made available through the study of physical, chemical and and biological systems.

My main work is involved in modelling physical and chemical systems. And these same mathematical modelling techniques lend themselves nicely to biological ones.

So what are we actually dealing with here?

We need to change our paradigm to the mathemetical system that is currently in play.

Here is a simulation using mathematical analysis to give you a clue about the actual non-linearity of this pandemic.

3Blue1Brown

SIR Modelling

https://www.youtube.com/watch?v=gxAaO2rsdIs

This video clearly illustrates why Japan and Singapore are so effective at containing the virus. Social distancing is not the only parameter to consider.

Contact tracing and isolation of specifically identified infected patients early with strong isolation procedures is far more effective.

Having an asymptomatic category of people makes this virus particularly hard to contain.

Good post and good video, but I think there's a flaw in your argument here.

This comes back to my third point: we need a vaccine or herd immunity in the long run to avoid the deaths I'm talking about. All.the really really good scenarios where you basically eliminate the virus from a community / country are great, but if there isn't a high number of immune people (Removed / grey in that Youtube video) and a low-ish number of people who have never been infected, the virus will get back into your country one way or another and start up all over again from the beginning. The only way to avoid this is to keep your borders totally closed (but open businesses again) or develop and mass produce a vaccine. You can't just kill the virus and wait for every other country to kill it too, because a few countries will struggle to do so and you'll have to wait a lomg long time.

Again, hoping I'm wrong.

[Meclazine for Israel]

There is no argument, and hence no flaw.

I am just explaining one methodology of non-linear system analysis that scientists employ when dealing with large active time-dependent datasets that are involved with pandemic analysis.

There are different modeling approaches which can be employed for this pandemic, and one may work better than another. It's not as simple as saying this modeling approach is the best.

But one thing is clear, using a linear modeling technique of a non-linear system will lead to flawed results, and hence, flawed conclusions.

With scientific analysis of a pandemic, the secret is to model what matters and discover the parameters that can be controlled to bring down the infection rate and control its spread.

Clearly, Japan, South Korea and Singapore employed a strategy that used this data modeling from their SARS epidemic experience to minimise the spread of the infection and maximise containment. In that process, they appear to have discovered some important parameters that need to be controlled to minimise the spread.

That is, contact tracing leading to strict citizen isolation protocols appropriate to the unfolding circumstances.

[T'Chenka]

There is no argument, and hence no flaw.

I am just explaining one methodology of non-linear system analysis that scientists employ when dealing with large active time-dependent datasets that are involved with pandemic analysis.

There are different modeling approaches which can be employed for this pandemic, and one may work better than another. It's not as simple as saying this modeling approach is the best.

But one thing is clear, using a linear modeling technique of a non-linear system will lead to flawed results, and hence, flawed conclusions.

With scientific analysis of a pandemic, the secret is to model what matters and discover the parameters that can be controlled to bring down the infection rate and control its spread.

Clearly, Japan, South Korea and Singapore employed a strategy that used this data modeling from their SARS epidemic experience to minimise the spread of the infection and maximise containment. In that process, they appear to have discovered some important parameters that need to be controlled to minimise the spread.

That is, contact tracing leading to strict citizen isolation protocols appropriate to the unfolding circumstances.

So how are Japan, South Korea and Signapore planning to handle COVID-19 going forward? They "defeated" the virus (or are well on their way) but did not acheive herd immunity. Will they lockdown for 12-18 months until a vaccine is ready? Or will they go back to normal only to lockdown again during a 2nd wave, and then repeat and repeat until a vaccine is available?

[BlueSwan]

The updated numbers for COVID-19 in the U.S. are in for 3/29 per: https://www.worldometers.info/coronavirus/country/us/

I'll be keeping track of these updates daily and updating at the end of the day, whenever all states finish reporting for that day. The percentages represent the daily increase from the last report.

3/26:

• Cases: 85,390
• Deaths: ±1,200

3/27:

• Cases: 103,798 (+18,408 | ↑21.56%)
• Deaths: 1,693 (+493 | ↑41.03%)

3/28 (Yesterday):

• Cases: 123,428 (+19,630 | ↑18.91%)
• Deaths: 2,211 (+518 | ↑30.60%)

3/29 (Today):

• Cases: 142,178 (+18,750 | ↑15.20%)
• Deaths: 2,484 (+273 | ↑12.35%)

Death toll down massively yesterday. Not quite sure what to make of this. Hopefully it is a sign of better things ahead, but honestly, the daily death toll isn't "supposed" to culminate yet, let alone fall.

[Meclazine for Israel]

So how are Japan, South Korea and Signapore planning to handle COVID-19 going forward? They "defeated" the virus (or are well on their way) but did not acheive herd immunity. Will they lockdown for 12-18 months until a vaccine is ready? Or will they go back to normal only to lockdown again during a 2nd wave, and then repeat and repeat until a vaccine is available?

I understand your point about the potential to get another growth spurt in Japan, and a small one happened in Hong Kong, but the Asian societies are much more "collective" than Western cultures in their attitudes towards a pandemic response.

Hence, they will most likely introduce a travel system where people entering Japan or South Korea go into quarantine for 14-28 days against their will at a prescribed location. No exceptions. They also trace people extremely well using existing technology. So if they have community transmission, they can remove potential sources of infection from society quickly.

Their strict social standards with social monitoring and immigration are advantageous under these conditions and are to be admired.

They don't have glowing examples of stupidity like we have had.

Japan and South Korea actually walk the walk, and can therefore effectively protect the uninfected until a vaccine arrives.

In comparison, the application of protocols in Australia has been nothing short of appalling:

https://www.abc.net.au/news/2020-03-23/cruise-passengers-not-tested-for-coronavirus-before-disembarking/12081426

https://www.abc.net.au/news/2020-03-28/coronavirus-covid-19-cruise-ship-doctors-angry-over-quarantine/12099604

https://www.smh.com.au/national/bewildered-and-confused-doctors-on-flight-say-they-were-following-orders-20200329-p54ezz.html

This complete sh**t-show has added between 5-7% of the Corona-virus infections to our national tally.

[T'Chenka]

So how are Japan, South Korea and Signapore planning to handle COVID-19 going forward? They "defeated" the virus (or are well on their way) but did not acheive herd immunity. Will they lockdown for 12-18 months until a vaccine is ready? Or will they go back to normal only to lockdown again during a 2nd wave, and then repeat and repeat until a vaccine is available?

I understand your point about the potential to get another growth spurt in Japan, and a small one happened in Hong Kong, but the Asian societies are much more "collective" than Western cultures in their attitudes towards a pandemic response.

Hence, they will most likely introduce a travel system where people entering Japan or South Korea go into quarantine for 14-28 days against their will at a prescribed location. No exceptions. They also trace people extremely well using existing technology. So if they have community transmission, they can remove potential sources of infection from society quickly.

Their strict social standards with social monitoring and immigration are advantageous under these conditions and are to be admired.

They don't have glowing examples of stupidity like we have had.

Japan and South Korea actually walk the walk, and can therefore effectively protect the uninfected until a vaccine arrives.

In comparison, the application of protocols in Australia has been nothing short of appalling.

https://www.abc.net.au/news/2020-03-23/cruise-passengers-not-tested-for-coronavirus-before-disembarking/12081426

https://www.abc.net.au/news/2020-03-28/coronavirus-covid-19-cruise-ship-doctors-angry-over-quarantine/12099604

So in that case, if we look at Australia, America, India and Canada, where we do not have a society as well-equipped to deal with this, what should we expect for death tolls? Under your advice, I will not use linear analysis and I wil not ask for or provide hard numbers.

I simply want to know what the endgame is here. The very very end is a vaccine, but before that, the virus must either be eliminated (unlikely due to culture/society) or the countries will likely under wave after wave until a reasonable herd immunity is achieved. OR, do you think it's likely that getting half-way to herd immunity (20-40% roughly?) combined with a tightly closed border after one or two waves could keep this manageable enough to open society back up until the vaccine arrives?

All these different outcomes could result in different death tolls, but our societies not being as "unified" as Asian societies will not help us keep these numbers low.

[Meclazine for Israel]

I simply want to know what the endgame is here. The very very end is a vaccine, but before that, the virus must either be eliminated (unlikely due to culture/society) or the countries will likely under wave after wave until a reasonable herd immunity is achieved. OR, do you think it's likely that getting half-way to herd immunity (20-40% roughly?) combined with a tightly closed border after one or two waves could keep this manageable enough to open society back up until the vaccine arrives?

I don't know, and researching the subject whilst analysing the numbers correctly is the only choice you have.

This is a very slow moving numerical beast, and you just need to read up and focus on the right numbers.

The only thing definite is that no one knows with certainty how this will transpire within the USA.

[T'Chenka]

The only thing definite is that no one knows with certainty how this will transpire within the USA.

I know - with certainty - that the end result would be better with a different President.

[wbrocks67]

For what it's worth, the number of new U.S. cases on Worldometer dropped today, and is less than what it was even 2 days ago.

Even using a 2-day rolling total, it's dropped for the first time since at least March 3, maybe earlier.

Less reporting on the weekends

[wbrocks67]

Cuomo has an 87% approval in NY for the virus

https://twitter.com/NickReisman/status/1244574328949178368

[Torrain]

Cuomo has an 87% approval in NY for the virus

https://twitter.com/NickReisman/status/1244574328949178368

Cuomo's basically got a fourth term as Governor, or his pick of any cabinet position he wants in the next Democratic administration, at this point.

[Penn_Quaker_Girl]

Morning, y'all.  

Feeling noticeably worse than yesterday.  My temperature is up around 1.2*F/-17*C from twelve hours ago, though my body has gone from feeling overheated to feeling cold -- haven't been able to stop shivering all morning.  I've also been sweating profusely. A persistent and non-productive cough woke me up at least three times last night and I'm experiencing pretty moderate muscle soreness.  

No headache or noteworthy GI discomfort; no issues with my sinuses.  No anosmia or dysgeusia, either.  

Vitals look okay other than temp: (102.2*F/38.0*C, BP 92/65, resting pulse 58 bpm).  Borderline hypotension probably because I'm a bit dehydrated from sweating and just not drinking enough water, though I've always been prone to low blood pressure and marginal bradycardia -- thank you dance and soccer.  Breathing isn't producing any crackles or wheezing.  

Still not all that concerned at this point in time.  But, in short: this s*** sucks.  

EDIT: Even though my symptoms are not personally a cause for alarm, I'm about to call the doctor I see when I'm here in PA to (a) get the ball rolling should my symptoms worsen and (b) see if he recommends that I get tested.  

That's something that I'll recommend to anybody reading this who is experiencing symptoms that potentially line up with a positive case.  Even if those symptoms are not severe enough to warrant a visit to the ER or extra medical treatment, don't wait until they reach that point before calling your doctor.  Yes, things are likely chaotic for your PCP right now, but he/she is here to help.  

[GeorgiaModerate]

https://twitter.com/joshtpm/status/1244119212701990913

[Penn_Quaker_Girl]

SNIP!

I'm personally a fan of the royalty-free "Sad Piano Music 1".