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

[Fmr. Gov. NickG]

I've updated my cumulative graphs of cases and deaths in the big five Western European countries, based on a five-day weighted average. 

I've also added a line for the US for purpose of comparison. (America has almost the exact same population as these five nations combined.)  The US has now surpassed them in daily new cases, but still only has about 1/3 the number of daily new deaths.

[Fmr. Gov. NickG]

France just added 18,000 new cases to their total, which is now completely throwing off the daily numbers.

[Fmr. Gov. NickG]

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.

[Fmr. Gov. NickG]

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

Just a dose of reality from that article:

The vaccine, which was tested on mice by researchers at the University of Pittsburgh School of Medicine, generated the antibodies in quantities thought to be enough to “neutralise” the virus within two weeks of injection.

The study’s authors are now set to apply to the US Food and Drug Administration for investigational new drug approval ahead of phase one human clinical trials planned to start in the next few months.

[Fmr. Gov. NickG]

I’m pretty worried that we aren’t going to be willing to end lockdowns until the data suggests almost zero new deaths on a daily basis.  

The medical professionals keep reminding us that there is a 2-3 week lag in the data.  And we need to keep that in mind not just in interpreting the data at the start of the lockdown, but also near the end.  

If we get to a point where the trends suggests we will reach an acceptable number of new cases/deaths in 2-3 weeks, we need to end the lockdowns right then and not 2-3 weeks later.

[Fmr. Gov. NickG]

Yet another day in a row where the percentage increase in new cases was less than the day before (and testing is up again).  It wouldn't surprise me we're approaching the peak of new cases in the next couple days (the peak of active cases and deaths would follow a couple weeks behind), and we can start on the downward part of this curve by next week.

Bottom line is that I am confident that most business will reopen on May 1st.

The more cases that have piled up, the harder it is to get a percentage increase. Yeah I guess this is better than daily percentage increases. But the number of cases is still accelerating. We're not peaking.

That is actually true.

On an exponential growth curve like the USA is experiencing in graphic clarity, every day will actually see a decrease in percentage of new cases whilst seeing an acceleration in the number of actual new cases.

Why?

Dividing the new cases into a larger and larger base of existing infections makes no sense to get a percentage. It will just fall slowly like every exponential curve would. It's a symptom of the maths, not a reflection of the reality of what is actually happening.

It is a bit like this:

Growth of new cases in the USA was from Louisiana and Michigan.

But dividing that by the number of existing cases in New York is meaningless.

Hence percentage increases are doubly deceiving when analysing exponential growth data.

The only thing you can conclude is that those countries with the highest percentage increase in New Cases are most like in week 1 of the growth curve.

If the percentage growth is decreasing, then by definition you are not seeing exponential growth.  An exponential growth curve displays a constant percentage increase at all points.

[Fmr. Gov. NickG]

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.

[Fmr. Gov. NickG]

I think it is now reasonable to conclude that the -exponential- growth period of the virus, or at least the first wave of it, is now over.  It may still be growing, but it definitely seems like the rate of that growth, at least expressed as a percentage, is slowing.

[Fmr. Gov. NickG]

Updated cumulative European new case and death graphs (all figures are five-day weighted averages).

[Fmr. Gov. NickG]

IHME updated their model and now it includes EU as well. They project 152,000 will die in EU (first wave) of which 66,000 in UK. Obviously, a lot of assumptions, high uncertainty and so on.

https://covid19.healthdata.org/
http://www.healthdata.org/covid/updates
http://www.healthdata.org/news-release/new-covid-19-forecasts-europe-italy-spain-have-passed-peak-their-epidemics-uk-early-its

So England, who has about 6,000 deaths so far, will ultimately see 10x as many, but Italy, who has seen 17,000 deaths, will only see about 3,000 more?  I know those two countries are still on different sides of the curve, but at least one of those number is waaaay off (and most likely, both are very wrong).

[Fmr. Gov. NickG]

The numbers of reported new cases and deaths appear to be the worst on Tuesdays across the board.  It's the flipside of the numbers going down every Sunday.  

We should be comparing week-to-week rather than day-to-day.

Week-to-week, new deaths have about doubled in the US this week, while new cases have risen about 50%.  Meanwhile, week-to-week new deaths and cases have fallen 20-25% in Italy and Spain.

[Fmr. Gov. NickG]

Too bad you'll never see an article like this in a "mainstream" paper. This is the Socialist Alternative response to that Imperial College report that demanded lockdowns...

https://www.socialistalternative.org/2020/04/07/the-imperial-college-coronavirus-study-a-socialist-response

Oh for gods sake, we go through this argument every week.
That would have been a great strategy back in February, just like banning flights to and from Europe would have been effective in February. We now have 300,000+ confirmed Covid-19 cases with likely millions of unreported ones (based on death rates) and that doesn’t even take into account the 7.10 day incubation period. You know, many “alarmists” were calling for your approach back in February, when it actually would have done something. There is so much spread now, it is practically impossible to trace every case and contact.

No one is arguing the effectiveness of isolating contacts and mass testing as a way to prevent a major pandemic from going out of control. Well guess what, the pandemic has been out of control for weeks, and you know it. More importantly, we don’t have the testing capacity. Do you really think healthcare workers are sitting on 1,000,000 tests and not doing anything? Sure, let’s increase testing capacity, but let’s realize we won’t be South Korea tomorrow and honestly may never be due to the vastly different circumstances.


As for the effectiveness of lockdowns?
News Flash, Italy and Spain didn’t see new case numbers per day drop by doing nothing.

It would have been much better if implemented in February.  But we’d be still be able to target quarantines much more effectively if everyone could get tested today.

But two month later, we’ve still never gotten any straight answer from the government about testing capacity.  Trump has been lying and evading this question every single day.  And for some reason we let him get away with it.

[Fmr. Gov. NickG]

Seems like really discouraging numbers out of Italy, with new cases and death up again.  I realize they still down from their actual peak, but how have they not made more progress after being under national lockdown for a full month?  Maybe the deaths will still lag by a month, but how can they still be getting so many new infections?

[Fmr. Gov. NickG]

Is there anyone here who still maintains that the US is on an Italy-type disease trajectory?  Or can we all reasonably agree that the United States looks like it will be one of the "success stories" of the global pandemic?  If so, can we talk about what factors have influenced the U.S. emerging relatively unscathed from this?  Better testing, more docs/ventilators, lower population density, younger demographics, warm weather, etc.

South Korea was relatively unscathed.  The US may not come out of this quite as badly as Italy (or several other major European countries), but we will be much closer to Italy than Korea or several other Asian countries (or other places that did significant early testing like Iceland).  And that is clearly or failure.

I don’t know why we aren’t talking more about what Iran is doing.  It seems like they stopped the growth of the virus several weeks ago, and have consistently been seeing only about 100 deaths per day for the past month.  They were the earliest Western country to see a big outbreak, and everyone was very concerned about their high death rate.  But the US will pass Iran in deaths per capita today.

[Fmr. Gov. NickG]

https://twitter.com/ScottGottliebMD/status/1248035366914994181

Very confusing graph for an even more confusing model.  So on April 2, the model predicted that infections in Georgia would peak on April 5, and then on April 5 they changed the peak to April 25??  I don’t really see how that can be trusted at all.

[Fmr. Gov. NickG]

All the scientific studies I’ve been seeing over the past week or so seem to be suggesting that the virus is much more contagious than earlier believed, but also likely much less fatal.

As this evidence mounts, doesn’t this point more and more to the best solution being a controlled effort toward herd immunity, implementing severe but selective social distancing restrictions on the most vulnerable populations, or where is appears the health care system may be overwhelmed?

[Fmr. Gov. NickG]

I feel like if the virus is as contagious as it now appears, it won't really matter how long we keep the lockdown going; we're not going to be able to eradicate to a sufficient degree that it won't just pop back up as soon as the lockdown ends.  If this is true, a universal lockdown really has no benefit, because most people are going to get the virus.  It's would be much better to enforce selective social distancing to control when people get the virus rather than if.  We can protect the most vulnerable until we reach herd immunity.

[Fmr. Gov. NickG]

I feel like if the virus is as contagious as it now appears, it won't really matter how long we keep the lockdown going; we're not going to be able to eradicate to a sufficient degree that it won't just pop back up as soon as the lockdown ends.  If this is true, a universal lockdown really has no benefit, because most people are going to get the virus.  It's would be much better to enforce selective social distancing to control when people get the virus rather than if.  We can protect the most vulnerable until we reach herd immunity.

I don't follow on this.  If ~15% of the population in the hardest hit parts of Europe has it, how is it so contagious that it's inevitable a supermajority of the population gets it by the end of the year?

It's very true there is a limit to lockdowns.  I agree that we need a prompt transition to intermediate distancing measure that are socially and economically sustainable until universal vaccination in areas where this is under control (sports for TV with empty stadiums, restaurants with tables 6+ ft apart and masked servers, middle seats blocked off on aircraft,  every other pew in churches, etc.).

I’m not sure of the point you are trying to make with the 15% figure.  Are you suggesting this is high or low?  

If you are asking why -only- 15% of the hardest hit places have the virus, it’s obviously because they implemented a lockdown.  It does seem like the lockdowns eventually get the R0 of the virus below 1.  But not sufficiently below 1 that the cases will fall enough for the lockdowns to be lifted in any reasonably amount of time.  And whenever they are lifted, that 15% will again expand rapidly until herd immunity is reached.

[Fmr. Gov. NickG]

Updated cumulative European case & death graphs (5-day weighted averages).  Italy & Spain remain down from their highs of three weeks ago, but I'm seeing very little improvement over the past several days.

[Fmr. Gov. NickG]

The MTA’s COVID19 Response Is Killing NYC Workers

As the Coronavirus crisis worsens, massive numbers of workers who cannot afford to isolate themselves are forced to ride packed NYC subway cars, with untold numbers becoming ill from the overcrowding. This is a result of the massive cuts to the city’s mass transit service, which were made despite the need for social distancing. City transit workers are finally getting some protective gear, but it is far too little too late for the 41 workers who have already died and the more than 1,100 who have contracted the virus. And there is no protective gear supplied to the people who have to keep riding the trains during the pandemic.

As early as March 19, it was publicly announced that 23 MTA workers — who work in the city and in the broader metropolitan area — had tested positive for the Coronavirus. At least three of those workers were stationed at the Fresh Pond Bus Depot in Queens. The workers’ union, TWU local 100, called on the MTA to “arrange for expedited testing of its front-line employees and to consider taking additional aggressive steps to protect them.”  The MTA Chairman and CEO Patrick J. Foyle replied that the employees who had been in direct contact with the three Fresh Pond workers were in quarantine and that workplaces would be “immediately and aggressively disinfected,” assuring the workers that more tests would be made available.

Yet an MTA memo issued the same day posted in a Brooklyn bus depot bluntly stated: “Attn Bus Operators: As per AGM [name redacted], facemasks are not to be issued to you.”

How many more people have to die before realization and change are to be made that the insistence on following the business friendly solution is not one favorable to the public, that there are mechanisms and institutions in place that should not be run to be maximized to the benefit of the few elite of this nation, much less New York.

The MTA is run to the benefit of the few elite in this nation?  when 55% of New York households don't have a car?

I’m saying that the people running it are not looking out for the users of it.

What exactly do you want the MTA to do?

[Fmr. Gov. NickG]

I would fully support opening up the country again on May 1st if we can be assured that everyone can easily get a covid test by then.

Why is this not happening?  Where are the tests?  We have millions of new unemployed people every week.  Why not put them to work producing and distributing tests?

These questions has been asked every day now for more than a month, and the President has been outrageously dishonest in answering it everyday.

[Fmr. Gov. NickG]

Reported new cases and death in Italy today are the highest in a week.  There’s still no evidence of continued decline. 

[Fmr. Gov. NickG]

Why is the administration so obsessed with hydrochloroquine when there are several other possible drugs out there that seem to have shown more promise with fewer side effects?

[Fmr. Gov. NickG]

https://twitter.com/shadihamid/status/1248664536078483462

How is Sweden’s economy holding up relative to the rest of Europe?  And is their health care system close to collapsing?

[Fmr. Gov. NickG]

Updated cumulative European new case and death graphs (showing 5-day weighted averages):




I think it is pretty clear that the lockdowns have stopped the continued growth of the virus in most places.  What is much less clear, and much less encouraging, is whether the lockdowns are effective at steadily and efficiently reducing the virus toward an level where it will be acceptable to open things back up again.  Italy in particular hasn't really seen any continued progress over the last week.