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

[emailking]

You could have a constant number of new cases each day, and that percentage increase would be going down.

Due to consistent sub-exponential growth, we have an increase in case numbers whilst having a drop in case % growth.

Case % growth is therefore not a useful indicator under these circumstances.

What would be the preferred metric?

I like seeing your metrics actually. I think some people are reading in to them more than they should, but the numbers are what they are.

[Storr]

I did not have "oral sex caused the corona virus" on my galaxy brain takes bingo card.

"We never had this kind of thing when I was coming up." So the flu didn't exist when Pat Robertson was growing up? Got it.

[Del Tachi]

I don’t think we can convincingly say the worst is over until we see week-over-week decline. 

This Sunday the US had 1165 coronavirus deaths. 
Last Sunday the US had 363 deaths. 

So we definitely aren’t there yet.

Deaths are always a lagging indicator though (its the last thing to happen to people who got COVID 2-4 weeks ago)

Do we have any good, granular data on new COVID-19 hospital admits?  This indicator should lead deaths, while not being influenced by the availability of testing.

[💥💥 brandon bro (he/him/his)]

You could have a constant number of new cases each day, and that percentage increase would be going down.

Due to consistent sub-exponential growth, we have an increase in case numbers whilst having a drop in case % growth.

Case % growth is therefore not a useful indicator under these circumstances.

What would be the preferred metric?

I like seeing your metrics actually. I think some people are reading in to them more than they should, but the numbers are what they are.

Probably the best way to do this is to calculate the percentage change from the previous day's new cases. E.g., if you get 20000 cases yesterday and 21000 cases today, you'd have a 5% increase in cases.

If x_{t} is the number of cases on day t, then you'd want something like

100 * [(x_{t} / x_{t-1}) - 1]

This would be vulnerable to noise in fluctuations from day to day; you could use a moving average if you wanted to get sophisticated.

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

I just think it's premature to say that the worst is over or that we're on track for the new cases peak being moved earlier on the basis of one day, especially when we know that mutatis mutandis Sundays have less reporting of cases.

[It’s so Joever]

I highly doubt the worst is over. I think our peak as a country will be April 22nd, give or take a few days. It’s important to remember that just a week ago, plenty of people were still going about as normal, and a lot of people (just check this forum) seem to want to break the rules. It could peak in ten days, but I have my doubts. I think that’s a bit too soon.

[100% pro-life no matter what]

The Murray model has finally updated...and it looks good for America but bad for the "doom and gloomers".  The peak is now expected to come by mid-April, but the bigger news is that the death projections were revised down to 81K and that widespread hospital bed shortages are no longer expected.  The curves also look like things will be pretty much back to normal by May 1.

[💥💥 brandon bro (he/him/his)]

Short but fascinating thread for people who want to know some basics of how the virus works:

https://twitter.com/PeterKolchinsky/status/1246975275021348865

Interestingly there's a good explanation in here for why there are so many asymptomatic patients: SARS-2 infects the throat rather than the lungs, which doesn't elicit the same physical response.

https://twitter.com/PeterKolchinsky/status/1246975283346931713

[TJ in Oregon]

The Murray model has finally updated...and it looks good for America but bad for the "doom and gloomers".  The peak is now expected to come by mid-April, but the bigger news is that the death projections were revised down to 81K and that widespread hospital bed shortages are no longer expected.  The curves also look like things will be pretty much back to normal by May 1.

If we're not peaking until mid-April how are we going to be pretty much back to normal by May 1? Everywhere else this has hit is showing a positively-skewed normal distribution of active cases, so if it took us from March 11-April 15th or so to get to the peak, it will take even longer to get back down to March 11 levels after the peak. If it peaks April 15th, that would put us returning to normal, oh, probably sometime in June.

[True Federalist (진정한 연방 주의자)]

https://www.bbc.com/news/world-us-canada-52177586

Tiger at Bronx zoo tests positive for coronavirus.

I wonder about lions and bears as well, oh my!

[brucejoel99]

https://www.bbc.com/news/world-us-canada-52177586

Tiger at Bronx zoo tests positive for coronavirus.

I wonder about lions and bears as well, oh my!

Great. Just great. Now, we have to stay 6 feet away from tigers too.

[#TheShadowyAbyss]

https://www.bbc.com/news/world-us-canada-52177586

Tiger at Bronx zoo tests positive for coronavirus.

I wonder about lions and bears as well, oh my!

Great. Just great. Now, we have to stay 6 feet away from tigers too.

Wait, you mean to tell me I can just go up to a tiger and play with it?

[emailking]

Anthropomorphizing the virus bothers me. (Trump is doing it too, although maybe he actually believes it.) The virus doesn't know it exists. It's not evil, or an enemy, and it doesn't learn anything. Its mutation is random chance. We don't talk this way about opioids, for example. They're doing a lot of harm too.

[Meclazine for Israel]

https://www.bbc.com/news/world-us-canada-52177586

Tiger at Bronx zoo tests positive for coronavirus.

I wonder about lions and bears as well, oh my!

Great. Just great. Now, we have to stay 6 feet away from tigers too.

Wait, you mean to tell me I can just go up to a tiger and play with it?

[jimrtex]

Surprised this hasn't been talked about yet in the thread, but Walmart an Target are rolling out new social distancing measures tomorrow limiting stores to 20% capacity.

https://twitter.com/NPR/status/1246277075100749824
Cities and counties are also starting to implement similar guidelines, like these new ones in Terrebone Parish, Louisiana (pop. 115k) that, among other things:

• All retail stores, including grocery stores and pharmacies, limited to 20% of fire marshal capacity
• Retail stores only open from 6AM to 8PM
• Shopping trips should only be made for "essential" items
• Only one person per family should go to the store at a time, if possible
• A 10PM to 5AM curfew is already in effect

I just don't understand the calculus here.  It's just a constant escalation of restrictions.  You can always find a way to be more aggressive in social distancing, but after a certain point the marginal costs exceed the marginal benefits.  Unfortunately, the sensationalist media and #FlattenTheCurve cultists will have these sorts of restrictions as their main raison d'etre by the middle of next week.

Panic buying is already a *major, major problem (and so far is actually a bigger problem than anything we've seen on the healthcare side).  Now the police are going to start enforcing a 20% limit?  What's the logical outcome here?  A bunch of people waiting several hours in line to buy groceries, contributing only to further panic and more runs on the supermarkets (which will lead to even longer lines in the best case scenario, violence in the worst).

Not to sound too alarmist here - but this is the *truly worrying stuff, not ICU/ventilator shortages.  The role of government in this situation should be to step-in and make sure essential retail operations remain open and accessible to all Americans.  If that means making people assume a bit more risk when they go out shopping, its a risk that's actually worth it in this case. 

What is fire marshal capacity for a Walmart (SuperCenter)?

With large numbers, it is harder to enforce social distancing in checkout lines. Competitors may also have complained that Walmart was getting an "essential retail" dispensation based on selling groceries, while bored customers were browsing the clothing aisles or buying bedspreads.

Walmart could organize a car queue to regulate customers coming in.

Depends on the square footage of the store. I have heard numbers of 5, 10, and 20 per thousand square footage of store.

I drove by my local Walmart - hoping to see if there was a posted occupancy limit. The parking lot was close to full. Perhaps not pre-Christmas full, but close to it. People may have heard about limited access and made a run on the store.

[○∙◄☻¥tπ[╪AV┼cVê└]

I don’t think we can convincingly say the worst is over until we see week-over-week decline.  

This Sunday the US had 1165 coronavirus deaths.  
Last Sunday the US had 363 deaths.  

So we definitely aren’t there yet.

We're hopefully near the peak number of new cases. New deaths will lag.

[Devout Centrist]

Again:

Quarantining the population will flatten the curve...but it doesn't change the area under the curve. The same number of people will get infected over a longer timespan.

[Southern Senator North Carolina Yankee]

Again:

Quarantining the population will flatten the curve...but it doesn't change the area under the curve. The same number of people will get infected over a longer timespan.

Not necessarily, the virus can only spread through contact or proximity with another affected individual or surface contamination. Therefore quarantining can reduce both the rate of spread and also the total number of people infected.

[Mad Deadly Worldwide Communist Gangster Computer God]

Again:

Quarantining the population will flatten the curve...but it doesn't change the area under the curve. The same number of people will get infected over a longer timespan.

Not necessarily, the virus can only spread through contact or proximity with another affected individual or surface contamination. Therefore quarantining can reduce both the rate of spread and also the total number of people infected.

Fauci believes the virus will be seasonal and won't be completely eradicated.  If we don't get a vaccine developed soon, the curve will bend upwards again in the years to come.

This is why it's more important than ever to squash the anti-vaxxer movement and educate people, but I'm not sure how that's possible when even in the midst of a pandemic, advice from medical experts falls on deaf ears.

[Devout Centrist]

Again:

Quarantining the population will flatten the curve...but it doesn't change the area under the curve. The same number of people will get infected over a longer timespan.

Not necessarily, the virus can only spread through contact or proximity with another affected individual or surface contamination. Therefore quarantining can reduce both the rate of spread and also the total number of people infected.

Perhaps, if the rate of reproduction can be held below 1.0; we have no guarantee something like that will happen this time. Many of these stay at home orders have big exceptions. In addition, we have a large working class population that must continue to work outside during this pandemic. If they lack reliable protective gear (and most do), they risk acquiring and spreading the disease.

[Southern Senator North Carolina Yankee]

Again:

Quarantining the population will flatten the curve...but it doesn't change the area under the curve. The same number of people will get infected over a longer timespan.

Not necessarily, the virus can only spread through contact or proximity with another affected individual or surface contamination. Therefore quarantining can reduce both the rate of spread and also the total number of people infected.

Fauci believes the virus will be seasonal and won't be completely eradicated.  If we don't get a vaccine developed soon, the curve will bend upwards again in the years to come.

This is why it's more important than ever to squash the anti-vaxxer movement and educate people, but I'm not sure how that's possible when even in the midst of a pandemic, advice from medical experts falls on deaf ears.

I agree with seasonality, but I will note that is not at odds with what I said would happen with this curve and this particular spike.

Again:

Quarantining the population will flatten the curve...but it doesn't change the area under the curve. The same number of people will get infected over a longer timespan.

Not necessarily, the virus can only spread through contact or proximity with another affected individual or surface contamination. Therefore quarantining can reduce both the rate of spread and also the total number of people infected.

Perhaps, if the rate of reproduction can be held below 1.0; we have no guarantee something like that will happen this time. Many of these stay at home orders have big exceptions. In addition, we have a large working class population that must continue to work outside during this pandemic. If they lack reliable protective gear (and most do), they risk acquiring and spreading the disease.

Yes, I am well aware of this problem, I am one of those people working during this situation in a very exposed position.

I think the big disconnect here is that you see the only end points here being 1. Herd Immunity - in which case yea bending the curve makes that take eons or 2. Vaccines - which of course take months and possibly more than a year.

It doesn't help that there is a constant stream of negative and sensationalized press, which creates a feedback loop of distrust and pessimism.

Some examples of this:
1. The story about Trump playing favorites with aid b/c of early request denials. Maine is not likely to be a hot spot. You know who is a hot spot, New York and where do a lot of New Yorkers travel to, Florida. There is a legitimate reason to prioritize limited resources to a place like New York or those places peripherally related to New York like New Jersey, Florida, Connecticut etc, beyond just favoritism. That said, does it play a part in Trump's narcissitic mind, probably so.

2. The mask controversy. At the latest press briefing Fauci was asked why doesn't he (Fauci) wear a mask and his response was the same as Trump's, "I just got tested and came back negative". The mask doesn't protect you from the virus, it protects everyone else from getting your asymptomatic transmission.

3. I think you said earlier that domestic production of supplies and equipment had "stalled" to use your phrase? I have not seen any indications of this but perhaps you can link me to an article. It takes time to ramp up production of something. We compare it to world war two but remember they had weeks and months to transition factories, we have days and maybe weeks in some cases. Remember that a lot of these factories also need to not only ramp up production but alter it so that they are social distancing while producing these materials. Same goes for the whole supply chain and then it must be remembered for ventilators a lot of those supplies are sourced over seas and you cannot use DPA on a foreign company to my knowledge. The best you could do is retrofit another factor to produce that component, which takes yet more time, especially if it is complex, high tech and/or requires sterile production conditions.


At a certain point, I get the feeling that large segments of the media are more concerned with restating for the one millionth time that Trump's an A@$hole at the expense of covering this whole thing responsibly. A lot of questions seem like they are trying to hold Trump to a standard that we all know he is never going to meet and I think most voters realize that by now hence the Biden leads, so for the time being I really don't think it is helpful to the situation at all.

What we should be discussing is what levels of supplies, ventilators and tests we will need after we blunt this curve to achieve a specific, attainable objective. Is that people who are recovered return to work? Is that everyone return to work but has to maintain 6 ft and wear a mask? These scenarios need to be discussed and should be given more top coverage then whether or not Trump is going to wear a mask or Jared Kushner giving a high school debate class speech on national television.

[T'Chenka]

I hope people in this thread are keeping in mind that once we peak and ride the pandemic to the bottom/end, nations are not going to be open their borders without a second slightly smaller wave starting the whole thing up all over again in autumn. A third wave is also possible by winter. You need to either administer millions of vaccines, keep outsiders out of your country or have over 50% of your citizens get the virus and survive and develop immunity. I don't see this being taken into consideration in 75%+ of speculative posts.

[Southern Senator North Carolina Yankee]

I hope people in this thread are keeping in mind that once we peak and ride the pandemic to the bottom/end, nations are not going to be open their borders without a second slightly smaller wave starting the whole thing up all over again in autumn. A third wave is also possible by winter. You need to either administer millions of vaccines, keep outsiders out of your country or have over 50% of your citizens get the virus and survive and develop immunity. I don't see this being taken into consideration in 75%+ of speculative posts.

On the contrary, I see a lot of posters operating on the vaccine, herd immunity, or economic doomsday paradigm.

There are more factors at work here than just vaccines and herd immunity.

[Torrain]

https://www.bbc.com/news/world-us-canada-52177586

Tiger at Bronx zoo tests positive for coronavirus.

I wonder about lions and bears as well, oh my!

I've seen a lot of people online moaning about using limited testing resources on animals.

But this is actually a fairly important thing to keep an eye on. We already knew this virus had zoonotic potential (ability to spread from animals to humans), but we need to be aware of any further host species.

If SARS-CoV-2 can establish infections in cats, dogs, or widespread vermin (rats etc), then there is the potential that the virus will establish a reservoir of infection within the animal population.

That could make elimination a lot harder, and make animal and pet isolation/culling a helpful step in some hard-hit areas (particularly in the developing world, which is still to feel the full brunt of this outbreak).

[Penn_Quaker_Girl]

https://www.bbc.com/news/world-us-canada-52177586

Tiger at Bronx zoo tests positive for coronavirus.

I wonder about lions and bears as well, oh my!

I've seen a lot of people online moaning about using limited testing resources on animals.

But this is actually a fairly important thing to keep an eye on. We already knew this virus had zoonotic potential (ability to spread from animals to humans), but we need to be aware of any further host species.

If SARS-CoV-2 can establish infections in cats, dogs, or widespread vermin (rats etc), then there is the potential that the virus will establish a reservoir of infection within the animal population.

That could make elimination a lot harder, and make animal and pet isolation/culling a helpful step in some hard-hit areas (particularly in the developing world, which is still to feel the full brunt of this outbreak).

Sorry Torrain, just a little tiny annoying nitpicky add-on: "zoonosis" also refers to diseases that can be transmitted from human-to-animal (though this is sometimes called reverse zoonosis).  

Human-to-animal diseases are much more uncommon than animal-to-human, but a notable example is the rabies virus.  

In terms of the word, itself, I had a professor who would go nuts if you pronounced it as it's spelled.  He would constantly remind us that it's "zoh-uh-noe-sees" and not "zoo-oh-noe-sees."