COVID-19 Megathread 4: Grandma Got Run Over by the Dow Jones

[Vaccinated Russian Bear]

What the CDC and most of the public health establishment was saying up until yesterday was that there is no reason to wear a mask unless you are sick.  That would imply that if you aren't sick then you can't spread the virus.

They were only saying that because there was (is) a huge shortage of proper masks (both N95s and surgical masks) and they made a judgment that it was better (not good, but less bad) to lie and tell people that they didn't need masks and that masks don't do anything in the hopes that it would make it easier to get more masks into the hands of health care providers. And also, it was easier to communicate than it was to spell out the differences between different types of masks and the varying effectiveness of them in different settings, which doesn't fit so easily into a simple soundbite and which people would have a hard time understanding. Moreover, at the time they said that you didn't need to wear a mask or be particularly worried on the individual level, that *was* true. On an individual level, current risk *was* low (and in most parts of the country, current individual risk is quite low even now!

This was a bad judgment IMO, but it is not hard to see why they made it. It is not that they didn't know that asymptomatic or pre-symptomatic people could spread the virus.

I don't believe, they knew, but lied. You can't cover up lies like that. I believe that they really underestimated the transmission rate of pre/a symptotical cases. As far as I know WHO and ECDC made similar assumptions and gave similar recommendations as CDC.

[Penn_Quaker_Girl]

I though the safety trials had already been completed for Remdesivir from its Ebola testing days and they were primarily testing for efficacy now?

That's what I thought too. I thought they also said the efficacy for this drug was fantastic.

Sorry, Bandit, I should've been more specific to Remdesivir (I was referring to drugs currently being tested as potential breakthroughs in general).  

From what I've read, Remdesivir's efficacy has definitely been promising, but we really won't conclusively know until China's trials yield their results:

the World Health Organization labeled it as “the most promising” antiviral during the early days of the outbreak. But its effectiveness won’t be known until a slate of clinical trials reads out, with the first expected from China in the coming weeks.

And there are concerns about sample size and the bottleneck-effect of dozens-and-dozens of clinical tests needing a limited number of participants:

However, there have been concerns about whether those trial findings will be conclusive. As the virus was quickly contained in China, there simply may not be enough patients there—especially severely sick ones—for the remdesivir trial. Plus, hundreds of clinical trials are fighting for participants, including tests of other promising antivirals such as chloroquine, Fujifilm’s flu drug Avigan and AbbVie’s HIV combo Kaletra, as well as for meds that aim to manage potentially life-threatening complications, including Roche’s IL-6 inhibitor Actemra.

.

Source:  https://www.fiercepharma.com/pharma/gilead-ceo-pledges-affordable-remdesivir-as-promising-covid-19-drug-expects-clinical-data

(On a side note, Avigan is a pretty interesting drug, but I'll leave that for another time )

It's a gigantic tangle and one that doesn't just fall on the FDA.  It's the coordination of those who peer-review these clinical trials, drug companies, government agencies, etc. etc.  

[Southern Senator North Carolina Yankee]

We cannot sustain these lock downs for eternity.

The thing is you have to have a set understanding or process for these phases to occur. Right now we are locking down but things have to be proceeding in the back ground on long term, medium term and short term time frames.

What can we do in the period of 30 days to 60 days that can bolster our position relative to the virus?

1. Rapid and antibody testing (They exist, they need to be mass produced)
2. Mass Production of supplies, ventilators and so forth.
3. Therapies

We need to be of a mind to say, okay by June 1st what can we do to make us able to remove the shelter in place orders and move to a secondary phase, and what does that phase look like. I think officials should have been talking about this from the beginning that way people know what we are aiming for step by step and would be more likely to cooperate and less willing to resist out of the "OMG OMG 18 month shut down third world impoverished country".

There has been a lot of sensational broadcasting and media throughout this process and not all of it is Trump's fault. The hand wringing and screaming over Jared Kushner's presence comes to mind, and while his worming of his way into most everything is something to be concerned about, the fact remains that even Cuomo praised his assistance at one point and while his background and such is concerning if not criminal, I don't think it warrants headlines like "Kushner is going to kill us all".

Another example that is Trump's fault is the whole uproar over him not wearing a mask. It took a long time in yesterday's briefing to state the obvious, the recommendation is to wear a mask to prevent spread by asymptomatic cases, but Trump was just tested again using the rapid test and came back negative. Rather than saying that upfront, he made some point about the resolute desk and meeting people and basically coming down to the optics of the matter.

[It’s so Joever]

When are we going to be willing to have a conversation about whether we have massively overreacted without people saying that anyone who doesn't repeat the #StayAtHomeFor18Months #FlattenTheCurve mantra is wanting people to die?

https://twitter.com/ClayTravis/status/1246491967841882112

Hopefully soon.  I'm a 63 year old in an essential occupation.  I have come to believe that this is an overreaction that has arisen out of good and bad motives.

The medical and scientific "experts" (and I'm not denying their expertise) have, indeed, been repeatedly wrong about this issue, and that includes the now Iconic Dr. Fauci.  John Kerry was for the Iraq war before he was against it and Anthony Fauci thought this would be a minor deal before it came the Bubonic Plague Lite.

https://www.usatoday.com/story/news/health/2020/02/17/nih-disease-official-anthony-fauci-risk-of-coronavirus-in-u-s-is-minuscule-skip-mask-and-wash-hands/4787209002/

If that testing shows the virus has slipped into the country in places federal officials don't know about, "we've got a problem," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told USA TODAY's Editorial Board Monday.

Short of that, Fauci says skip the masks unless you are contagious, don't worry about catching anything from Chinese products and certainly don't avoid Chinese people or restaurants.

That was February 19, 2020.  Here's what he said April 2:

https://www.yahoo.com/huffpost/fauci-national-lockdown-stay-at-home-orders-152802623.html

As more U.S. states issue stay-at-home orders and the federal government recommends a 30-day period of social distancing, Dr. Anthony Fauci on Thursday suggested the need for a national lockdown, while acknowledging he does not have the authority to order one.

Fauci has lectured Americans about how people will die and how we need to stay at home longer, or "people will die".  And I get that.  I get it about "lowering the curve".  But will people not die if we tank the economy and they cannot maintain basic necessities?  Tucker Carlson stated last night in pondering the issue that we can go on like this long enough to where we become a poorer nation going forward.  Is he wrong?  Is that an outcome that can happen.  Carlson also suggested that poorer nations are less healthy than richer nations.  Is he wrong?

Our system of government is not an "expertocracy".  There's a place for experts, and Fauci is indeed that, but it's easy for him to talk how others need to hang in there because he's not losing his job and he's got the means to ride out whatever comes.  The same can't be said for millions of Americans' their entire future can be altered for the worse, and permanently so, if they have to do without doing business for 3-4 months (or even longer).  Business "experts" predict all sorts of 1929 scenarios should this go on for 5-6 months; are they to just be blown off?

There does become a point where the cure is worse than the disease.  That needs to be honestly discussed.  I'm not convinced that locking down America to the extreme degree we have is a solution that is smaller than the problem.  Perhaps it IS necessary.  But I'm not willing to blindly listen to "experts" uncritically.  It was the foreign policy Anthony Faucis that advised LBJ prior to the Gulf of Tonkin resolution all the way up through the Tet Offensive.  

So America is now somehow special from literally every other country that has gone under lockdown?
We have the most cases in this country because of people like you, who fail to understand that a complete collapse of the healthcare system and millions of deaths as a result (not just from Covid, but from the hospital collapse) will also hurt the economy. We had months before to prevent this outcome, and you people called us “alarmists”, told us to stop panicking over every little thing, compared it to the flu, etc. Your actions have consequences and it’s too late to prevent any harm to the economy. The smart thing to do would be to go under a strict lockdown for two weeks nationally, and then to ease restrictions based on infection rates in certain states. Of course, you would still cry about the economy and “muh big government” no matter what. We get it, you think science is an imprecise guessing game and Fauci doesn’t know what he is doing. We get it, your amazing internet biology knowledge triumphs over decades of public work and experience in fighting epidemics.

[Penn_Quaker_Girl]

Remdesivir has shown promise and I'm definitely interested to see its potential, but the FDA approval process is slow and deliberate.  By approving a drug or treatment, the FDA is basically saying "we have conclusively determined that this item's benefits outweigh its risks."  And with something novel like COVID-19, they need to do more thorough testing before upping its status from compassionate use designation.  

There's no time left. People are dying RIGHT NOW.

I know, I know.  But ethically, medical providers can't just say "let's try it! If it works it works.  If it doesn't, it doesn't" -- especially with a novel drug such as remdesivir.  The "doesn't work" side of the coin isn't restricted to simply not having any effect at all.  It could mean adverse and dangerous side effects.  It could mean unexpected interactions with other drugs.  

The unknown is a major factor in the administration of novel medications.  Politics and money aside (though, hey, it's drug companies, so those are always considerations), that's why testing is so important and so deliberate.  

I never got the fact why it isn't possible for a patient to say let me try it, I accept every possible risk...

This is getting into law and pharma industry (which is far outside of my wheelhouse), but there is something called the "Right To Try". 

So I'll let Dr. FDA explain:

The Right to Try Act permits/allows eligible patients to have access to eligible investigational drugs.

An eligible patient is a patient who has:

1.  Been diagnosed with a life-threatening disease or condition

2.  Exhausted approved treatment options and is unable to participate in a clinical trial involving the eligible investigational drug (this must be certified by a physician who is in good standing with their licensing organization or board and who will not be compensated directly by the manufacturer for certifying)

3.  And has provided, or their legally authorized representative has provided, written informed consent regarding the eligible investigational drug to the treating physician

An eligible investigational drug is an investigational drug:

1.  For which a Phase 1 clinical trial has been completed

2.  That has not been approved or licensed by the FDA for any use

3.  For which an application has been filed with the FDA or is under investigation in a clinical trial that is intended to form the primary basis of a claim of effectiveness in support of FDA approval and is the subject of an active investigational new drug application submitted to the FDA

4.  Whose active development or production is ongoing, and that has not been discontinued by the manufacturer or placed on clinical hold by the FDA

https://www.fda.gov/patients/learn-about-expanded-access-and-other-treatment-options/right-try

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

Castiglione d'Adda was one of the earliest and hardest hit towns in Northern Italy.  There was a report that 70% of people who showed up to donate blood last week had antibodies, so that town may have herd immunity now if that is verified.  But, crucially, they have already lost about 2% of their total 2017 population to coronavirus.  Many other people there are still very sick and at risk of dying from it.  That's what any jurisdiction that goes for herd immunity is risking.

It there more data about Castiglione? In Kirkland's nursing home ~50% died. With other words, if a nursing homes with 100 people in Castiglione would get infected, it'd be enough to get 2% of whole population. 5k town can become anecdotal evidence. Italy has also 4-6 times less ventilators per capita then US I think.

The bad news is that recent news show that Western World keep failing protecting places like nursing homes, so we can, indeed, follow Castiglione...

That I don't know.

If it turns out to be Italy's version of The Villages, that would be somewhat reassuring.  If it's a college town, that would be terrifying. 

https://www.citypopulation.de/en/italy/lombardia/lodi/098014__castiglione_dadda/

Age Groups (E 2019)
0-17 years   648
18-64 years   2,910
65+ years   1,088

Age Distribution (E 2019)
0-9 years   325
10-19 years   421
20-29 years   476
30-39 years   486
40-49 years   708
50-59 years   820
60-69 years   602
70-79 years   477
80+ years   331


That comes out to 23.4% age 65+ in Castiglione d'Adda.

By comparison, in Italy as a whole, "In 2020, 23.1 percent of the Italian inhabitants were estimated to be aged 65 years and older."

https://www.statista.com/statistics/569201/population-distribution-by-age-group-in-italy/

So looks like it is fairly representative in terms of age of Italy as a whole.

[GP270watch]

What can we do in the period of 30 days to 60 days that can bolster our position relative to the virus?

1. Rapid and antibody testing (They exist, they need to be mass produced)
2. Mass Production of supplies, ventilators and so forth.
3. Therapies

 Everything you want done takes massive government coordination with the public and private sector, organization and a huge labor force(that you also have to protect form getting sick), and competence to plan and direct all these actions. Good luck with that from this administration.

 Red avatars were also calling for some of these measures weeks ago.

 

 

[GeorgiaModerate]

https://twitter.com/EllenBarryNYT/status/1246531849528184832

[Vaccinated Russian Bear]

Castiglione d'Adda was one of the earliest and hardest hit towns in Northern Italy.  There was a report that 70% of people who showed up to donate blood last week had antibodies, so that town may have herd immunity now if that is verified.  But, crucially, they have already lost about 2% of their total 2017 population to coronavirus.  Many other people there are still very sick and at risk of dying from it.  That's what any jurisdiction that goes for herd immunity is risking.

It there more data about Castiglione? In Kirkland's nursing home ~50% died. With other words, if a nursing homes with 100 people in Castiglione would get infected, it'd be enough to get 2% of whole population. 5k town can become anecdotal evidence. Italy has also 4-6 times less ventilators per capita then US I think.

The bad news is that recent news show that Western World keep failing protecting places like nursing homes, so we can, indeed, follow Castiglione...

That I don't know.

If it turns out to be Italy's version of The Villages, that would be somewhat reassuring.  If it's a college town, that would be terrifying. 

https://www.citypopulation.de/en/italy/lombardia/lodi/098014__castiglione_dadda/


That comes out to 23.4% age 65+ in Castiglione d'Adda.

By comparison, in Italy as a whole, "In 2020, 23.1 percent of the Italian inhabitants were estimated to be aged 65 years and older."

https://www.statista.com/statistics/569201/population-distribution-by-age-group-in-italy/

So looks like it is fairly representative in terms of age of Italy as a whole.

I wasn't talking about demographics of town, but demographics of first deaths. One thing if it happened in "regular" basis, the opposite is that outbreak happened in unprepared nursing homes or hospitals. As I said in Kirkland 50% died.

[Penn_Quaker_Girl]

Anybody have any insight into that gargantuan spike in France's daily cases yesterday?

I seem to recall reading it had something to do with a dump of data from nursing homes, but I haven't been able to find follow-up on that. 

[Vaccinated Russian Bear]

What can we do in the period of 30 days to 60 days that can bolster our position relative to the virus?

1. Rapid and antibody testing (They exist, they need to be mass produced)
2. Mass Production of supplies, ventilators and so forth.
3. Therapies

 Everything you want done takes massive government coordination with the public and private sector, organization and a huge labor force(that you also have to protect form getting sick), and competence to plan and direct all these actions. Good luck with that from this administration.

 Red avatars were also calling for some of these measures weeks ago.

It already happens. I think it is fairly likely that US will be one of few nations that will succeed in testing/vaccine/ventilators. Thanks to Big Farma and Tobacco! You don't think so?
https://www.bloomberg.com/news/articles/2020-03-27/abbott-launches-5-minute-covid-19-test-for-use-almost-anywhere
Abbott Launches 5-Minute Virus Test for Use Almost Anywhere

Abbott Laboratories is unveiling a coronavirus test that can tell if someone is infected in as little as five minutes, and is so small and portable it can be used in almost any health-care setting.

The medical-device maker plans to supply 50,000 tests a day starting April 1, said John Frels, vice president of research and development at Abbott Diagnostics. The molecular test looks for fragments of the coronavirus genome, which can quickly be detected when present at high levels. A thorough search to definitively rule out an infection can take up to 13 minutes, he said.

https://www.ft.com/content/15834a3a-9efb-48ba-a426-45919ee37b45
US companies launch rapid antibody test
Point-of-care examination set to detect evidence of virus in as little as 15 minutes

Two US companies have launched a rapid antibody test for the coronavirus, which can be used to detect if a person’s immune system has Covid-19 or has recovered from it.

BD, a large medical technology company, and BioMedomics, a North Carolina-based clinical diagnostics company, announced a new point-of-care test that can detect evidence of past or present exposure to the virus in as little as 15 minutes.

The so-called serological tests are important because they could be used to assess who may be immune and can therefore be allowed to leave lockdown to return to normal life — or to help others, in the case of healthcare workers.

Public health officials can also use them to track the spread of the disease. But they are less accurate for diagnosis and cannot detect the disease in the earlier stages. 

https://www.ft.com/content/e3737752-6147-4c0e-82f2-e7df9eb9f6f8
BAT joins race to develop Covid-19 vaccine
Cigarette maker’s biotech unit tests potential antigen in genetically engineered tobacco plants

British American Tobacco, the maker of Lucky Strike and Camel cigarettes, has entered the fray of companies trying to develop a vaccine against Covid-19 — by growing a potential antigen in genetically engineered tobacco plants. 

The tobacco group on Wednesday said its US biotech subsidiary Kentucky BioProcessing was using “proprietary, fast-growing tobacco plant technology” in pre-clinical testing on animals, making it one of dozens of companies and public sector organisations worldwide racing to develop a vaccine.

BAT hopes to produce up to 3m doses a week from June to begin clinical testing. 

Ford Motor and GE promise to produce 50k ventilators by June.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

I wasn't talking about demographics of town, but demographics of first deaths. One thing if it happened in "regular" basis, the opposite is that outbreak happened in unprepared nursing homes or hospitals. As I said in Kirkland 50% died.

Kirkland Washingon has 90,000 people. 50% of the population there did not die. 50% of the confirmed cases there died, I would assume that is what you mean.

But Skill and Chance said that 2% of the entire *population* in Castiglione died.

2% of the population of Kirkland WA dying would be 1,800 deaths.

Which (God forbid) would be entirely consistent with 50% of the people in a single nursing home dying.

[Vaccinated Russian Bear]

https://twitter.com/NateSilver538/status/1246509718249656320
Nate Silver agrees with me RE: misleading stats


"differences aren't actually that big and may largely be explained by other variables (e.g. urbanization)."


538 posted an article (which I didn't read yet) about case counts

https://fivethirtyeight.com/features/coronavirus-case-counts-are-meaningless/
Coronavirus Case Counts Are Meaningless*
*Unless you know something about testing. And even then, it gets complicated.

[Grassroots]

Do we know when things will be back to normal? (meaning: large gatherings, multiple people shopping, non-essential businessis open, no National Gaurd at state boarders, not having to wear masks, etc)?

Businesses/Schools open: mid-late may.
Large gatherings: Late June

[Vaccinated Russian Bear]

I wasn't talking about demographics of town, but demographics of first deaths. One thing if it happened in "regular" basis, the opposite is that outbreak happened in unprepared nursing homes or hospitals. As I said in Kirkland 50% died.

Kirkland Washingon has 90,000 people. 50% of the population there did not die. 50% of the confirmed cases there died, I would assume that is what you mean.

But Skill and Chance said that 2% of the entire *population* in Castiglione died.

2% of the population of Kirkland WA dying would be 1,800 deaths.

Which (God forbid) would be entirely consistent with 50% of the people in a single nursing home dying.

I mean 50% died in Kirkland nursing home. The one that was hit first.

[Crucial Waukesha]

Anybody have any insight into that gargantuan spike in France's daily cases yesterday?

I seem to recall reading it had something to do with a dump of data from nursing homes, but I haven't been able to find follow-up on that. 

Yep, the past 3 days they have added 800, 500 and 600 deaths respectively from a backlog of deaths from nursing homes.

[Penn_Quaker_Girl]

Anybody have any insight into that gargantuan spike in France's daily cases yesterday?

I seem to recall reading it had something to do with a dump of data from nursing homes, but I haven't been able to find follow-up on that. 

Yep, the past 3 days they have added 800, 500 and 600 deaths respectively from a backlog of deaths from nursing homes.

Thank you, my dear.  Welcome to TE btw!

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

This was re-tweeted by Marc Lipsitch (epidemiologist from Harvard for anyone who doesn't know who that is):

https://twitter.com/AndurandPierre/status/1246348944331988993

[GP270watch]

 Trump just shrugged his soldiers very disrespectfully when a reporter asked him about video of Sailors applauding Captain Brett Crozier as he departed the USS THEODORE ROOSEVELT. Pretending to know nothing about the situation but as he talked said he was wrong for writing a letter.

 

[Badger]

When are we going to be willing to have a conversation about whether we have massively overreacted without people saying that anyone who doesn't repeat the #StayAtHomeFor18Months #FlattenTheCurve mantra is wanting people to die?

https://twitter.com/ClayTravis/status/1246491967841882112

Maybe when we have evidence (not self-reported speculation) from actual scientists along the lines of what is listed in the tweet. The 50x number you're quoting is drawn out of thin air. Your confirmation bias is showing.

Mina is also saying that's the upper bound of what he would consider an unsurprising result — if you scroll up two tweets he says it could be 2 million, 4 million, somewhere in that range. Travis is cherry-picking the highest figure he threw out and treating it like he's making a much more specific claim than he is.

I recognize that it's a high estimate, and I don't agree that it's less deadly than influenza.  My argument for weeks has been that it's slightly more deadly than the flu (probably 0.25-0.5% vs. 0.1%), but that it's not deadly enough to justify drastic changes to daily life, except perhaps for the most vulnerable.

Current death rate in the United States is pushing 3%. Far far far deadlier than the common flu. Please do not wrap yourself up in disinformation, or at least at the minimum do not spread it to others. Practice social distancing, not factual distancing.

[T'Chenka]

BREAKING: American man vaccinates entire nation

[GeorgiaModerate]

https://twitter.com/StephenGutowski/status/1246552009785913346

[GeorgiaModerate]

(snip)

Current death rate in the United States is pushing 3%. Far far far deadlier than the common flu. Please do not wrap yourself up in disinformation, or at least at the minimum do not spread it to others. Practice social distancing, not factual distancing.

Best line of the thread.  This should be on T-shirts.

[emailking]

Working at Target I can tell you that we have strict limits on essential items now, panic buying has pretty much been banned. I can tell you this cause I’ve been verbally harassed and berated over the past few weeks upholding them. But guess what? Those customers can get f**ked. Done being polite.

Besides toilet paper and cleaning supplies, what are people trying to hoard?

Why is the Supreme Court cancelling oral arguments?  There is absolutely no legal or practical impediment to holding these remotely. 

We shouldn’t be using the virus as a an excuse to suspend the regular and essential functions of our government, especially those functions that uphold the basis rights of citizens.

The oral arguments are mostly just jockeying between the justices anyway. They've already read the briefs and spend most of the time asking questions. Their minds are usually made up already. Plus, they're looking at options for holding arguments for some of the cases.

[Vaccinated Russian Bear]

(snip)

Current death rate in the United States is pushing 3%. Far far far deadlier than the common flu. Please do not wrap yourself up in disinformation, or at least at the minimum do not spread it to others. Practice social distancing, not factual distancing.

Best line of the thread.  This should be on T-shirts.

If it is 3% in US, what is it in Italy/Spain/France then? 10%?