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

[Fmr. Gov. NickG]

2nd highest number of cases today.

Deaths are down some though.

The new case numbers are not very important.  Since we are only identifying a small fraction of actual infections, this is mostly a function of testing, and we had a record number of new tests today.

Deaths are a much more important stat, especially deaths outside of New York, since the decline in NYC can be attributed to progress toward herd immunity.

We are not trying to get herd immunity through infections! I am not sure why you keep repeating this line. Any effort to accomplish herd immunity would be hugely destructive even if we could somehow limit infection just to people we suspect are more resilient. We are trying to stall transmission until there's a vaccine so we don't overwhelm hospitals. That's it.

The decline in New-York-City-area deaths, which you are attributing to herd immunity, also just so happens to coincide with a massive and successful lockdown. Are you saying that's a coincidence? What do you think the true death rate of this disease actually is?

New York City has had a similar lockdown to almost every other major metropolitan area in the country.  And yet they are seeing steep declines in cases and deaths while other cities are seeing continued increases.

I think over the past two weeks we have established a much better understanding of the true death rate of the virus through the serology studies.  The consensus estimate is around 0.6%.

(Also, the post of mine you quoted doesn’t say anything about trying to accomplish herd immunity through infection, so I’m not sure why you say I keep repeating it.)

[emailking]

What does "the true death rate" mean?

[Fmr. Gov. NickG]

What does "the true death rate" mean?

I mean the IFR for a representative cross section of the population.
Obviously is it much lower for younger people and much higher for older people or people with certain health conditions.

[emailking]

That sounds subjective.

[Fmr. Gov. NickG]

That sounds subjective.

How do you mean?  We have estimates for total infections based on serology, and estimates for number of deaths, and you just divide one by the other.  You can critique the method for deriving either number, but I wouldn’t describe that as “subjective”, merely inaccurate.  And a lot of studies seems to be converging on the same estimate using different methodologies, so the estimate should be pretty robust to a flaw in the data of any one study.

[emailking]

You said the IFR for a representative cross section of the population. The rate is going to be highly dependent on what that is, but who determines it? It's not handed to us. People are going to disagree.

Do you assume everyone in the sample gets infected and no one else? Because survival rate might be dependent on whether there's room for them at the hospital.

Does the sample include people who don't get infected? Because then you have the issue that people who are more vulnerable are tending to isolate more, and thus less likely to get infected.

Back in part 1 someone (I think Beet or Meclazine) suggested the total number of people who ever die divided by total number ever infected. That's objective (if you can decide on both numbers) but it doesn't exist while the disease is ongoing.

[Meclazine for Israel]

What does "the true death rate" mean?

You can calculate deaths/cases as an apparent Mortality Rate:

https://www.worldometers.info/coronavirus/

The Netherlands ~ 10%.
Italy ~ 14%

But is that the "True Death Rate"?

No.

You need to divide that number above by your a- or non-symptomatic case rate.

Only a certain proportion of people are being tested, so the number of cases out there is higher than what is reported. These people are not sick enough to enter the medical system.

So if 1 in 4 people get sick enough to be tested, divide the apparent Mortality Rate number by about 4 to get the "True Death Rate".

That means that only 1 in 4 people infected are testing positive because that 25% are presenting with symptoms.

However, 3 in 4 people are asymptomatic or non-symptomatic but still carrying the virus briefly before developing antibodies. They are not being tested.

When calculating the mortality rate, these people are not being included in the denominator.

From German research, it looks like 4 is about right.

Italy has an extremely high apparent Mortality Rate because they tested people who were very sick already coming to hospital.

So each country has a different mortality rate according to health policies, testing regime and social density and interactivity for example.

The "True Death Rate" in Germany and Australia appears to be around 0.3%

When Nick talks about a factor of under-reported cases of 10 (only 10% being reported), in Italy, he would be correct. It could be as high as 20 (only 5 % being reported).

Without serological testing, we will not know this final piece in the puzzle, because that is the true number we need to open up society based on an accurate risk assessment.

And that is a great lead in to antibody testing:

https://www.theatlantic.com/health/archive/2020/05/coronavirus-antibody-test-immunity/611005/

[Torrain]

The US's Food and Drug Administration (FDA) has authorised emergency use of the Ebola drug remdesivir for treating the coronavirus.

The authorisation means the anti-viral drug can now be used on people who are hospitalised with severe Covid-19.

A recent clinical trial showed the drug helped shorten the recovery time for people who were seriously ill.

However, it did not significantly improve survival rates.

www.bbc.com/news/amp/world-us-canada-52511270

[Smeulders]

2nd highest number of cases today.

Deaths are down some though.

The new case numbers are not very important.  Since we are only identifying a small fraction of actual infections, this is mostly a function of testing, and we had a record number of new tests today.

Deaths are a much more important stat, especially deaths outside of New York, since the decline in NYC can be attributed to progress toward herd immunity.

We are not trying to get herd immunity through infections! I am not sure why you keep repeating this line. Any effort to accomplish herd immunity would be hugely destructive even if we could somehow limit infection just to people we suspect are more resilient. We are trying to stall transmission until there's a vaccine so we don't overwhelm hospitals. That's it.

The decline in New-York-City-area deaths, which you are attributing to herd immunity, also just so happens to coincide with a massive and successful lockdown. Are you saying that's a coincidence? What do you think the true death rate of this disease actually is?

New York City has had a similar lockdown to almost every other major metropolitan area in the country.  And yet they are seeing steep declines in cases and deaths while other cities are seeing continued increases.

I think over the past two weeks we have established a much better understanding of the true death rate of the virus through the serology studies.  The consensus estimate is around 0.6%.

(Also, the post of mine you quoted doesn’t say anything about trying to accomplish herd immunity through infection, so I’m not sure why you say I keep repeating it.)

Some days ago you made a similar point, that lockdowns don't work and progress in NYC is due to the large number of immune people slowing down spread. I asked you the following questions then, in a post you either missed or ignored. Given that you're still beating on the same drum, I'm just going to copy paste that post. I hope you think about the answers this time.

Let me get this straight. You are doubting that keeping people away from one another reduces the transmission of the virus? What mechanism of transmission do you think the virus has, that apparently doesn't need physical access to new hosts?

You are right that immunity does reduce transmission. But again I am curious by what mechanism 25% immune managed to reduce transmission by more than 50%.

Your herd immunity, not distancing hypothesis also fails to account completely for the mass of other countries that managed to push R below 1 without the massive rate of infected NY has.

[jamestroll]

I see nothing but bad about to happen to us! Nothing but bad! It will all be ing bad.

We are prematurely opening and now we will head into a great depression.

Why are we celebrating reopenings??

[Absentee Voting Ghost of Ruin]

https://twitter.com/KHayhoe/status/1242817345069998080

[Meclazine for Israel]

Tucker Carlson talks about Sweden and the WHO.

He said they were the only Western country not to place people in lockdown:

https://www.facebook.com/TuckerCarlsonTonight/videos/255471012495949/

Tucker is a little bit hysterical, but the interesting part is that Sweden might become a model for what Phase 2 and 3 relaxations look like.

[jamestroll]

I am going to decide I will just relax about the easing of restrictions. Most people are voluntarily practicing social distancing. Airlines are requiring masks. Gyms and restaurants will be spaced out. Even my place of work has a smart plan in place for business returning.

And if there is a second wave in the fall after a slow down in summer we will be much better prepared to deal with it hopefully and most vulnerable people know to be extra cautious. It is not like nursing homes will allow outside visitors for the foreseeable futre.

And if there is a spike in the south later this month it is likely governors would immediately tighten restrictions again.

We can be individually smart and slowly reopen the economy again.

[Brittain33]

I am going to decide I will just relax about the easing of restrictions.

[Fmr. Gov. NickG]

Some days ago you made a similar point, that lockdowns don't work and progress in NYC is due to the large number of immune people slowing down spread. I asked you the following questions then, in a post you either missed or ignored. Given that you're still beating on the same drum, I'm just going to copy paste that post. I hope you think about the answers this time.

Let me get this straight. You are doubting that keeping people away from one another reduces the transmission of the virus? What mechanism of transmission do you think the virus has, that apparently doesn't need physical access to new hosts?

You are right that immunity does reduce transmission. But again I am curious by what mechanism 25% immune managed to reduce transmission by more than 50%.

Your herd immunity, not distancing hypothesis also fails to account completely for the mass of other countries that managed to push R below 1 without the massive rate of infected NY has.

Ah, OK, I must have missed that.
It is very plausible that a 25% infection rate might reduce transmission by 50%, depending on how fast the transmission is.  It’s basically the same logic behind how a less than 100% infection rate can reduce the virus to 0.

Let’s say the virus has a baseline R0 of 2 (each person infects 2 new people).  If 25% of the population is infected, the virus has an R0 of 1.5 (since 25% of the new people who would have been infected can no longer be infect).

With no one immune (R0=2), a single infected person infects 2 people.  In the next round, those 2 people infect 4 people.  In the next round, those 4 people infect 8 people.  So over 3 infection cycles, 14 new people have been infected for every 1 person infected at the start.

Now with 25% immune (R0=1.5), a since infected person infects 1.5 people.  Those 1.5 people infect 2.25 in the next round, and those 2.25 people infect 3.375 people in the third round.  Some each infected person infects 7.125 people (compared with 14 people when no one is immune).

If you imagine a 5-day infection cycle, a 25% immunity will reduce transmission by 50% about every 15 days.

Obviously these numbers will change if you alter the length of the infection cycle, but I do find a 50% reduction over some time period given 25% immunity to be totally believable.

[💥💥 brandon bro (he/him/his)]

I've posted it before but it's worth reminding that several serological tests have large false positive rates (some exceeding and several close to 10%). Everybody who reads and cites serological studies should check and refer to the test accuracy and be very cautious when reporting and interpreting results.

[Beet]

Conservatives rejecting remdesivir, still promoting hydroxychloroquine
https://www.politico.com/news/2020/05/02/donald-trump-coronavirus-remdesivir-229765

[100% pro-life no matter what]

I went out to eat for the first time since March today and wanted to share some observations.  For context, I live in a well-off suburban county that is even redder than my already very red state.

I got to the restaurant at 11, right as they were opening for lunch.  There were probably 2 or 3 other parties who were also arriving at the same time.  I could see employees finishing up sanitizing tables and menus as I was walking in.  It is a really nice day- bright sunshine, temperatures in the 80s, and a warm breeze- so I decided to sit on the outdoor patio, but I could still see into the main restaurant.  They had the bar seating roped off, and there was a sign on the bathrooms saying to not have more than 3 people in them at once for social distancing.  There were also hand sanitizing stations everywhere.  By the time I had finished eating and left, they had reached the 50% capacity limit in the front room, which was more desirable due to having floor-to-ceiling windows that they opened, as well as having all of the appropriately spaced outdoor tables occupied, so they had to send new diners to the darker and fully indoors back room.  The servers were all wearing masks and gloves, but obviously none of the diners were wearing them, as you couldn't eat with them on.

Then, I drove into Downtown Franklin and parked in the garage to walk around for a little bit.  I saw pretty decent crowds walking around, but slightly less than an average Saturday.  There, maybe a little over half of the restaurants and most of the stores had resumed in-person service.  A couple stores had signs on their doors asking people to wear masks if they came in, but that was the minority.  Of all the people I saw walking downtown, I only saw 2 wearing masks.  The restaurants that had reopened looked like they were doing pretty well, and at least one appeared to have hit the 50% capacity limit and had a line out the door.

The most surprising thing I saw was on my drive home.  I saw what appeared to be a food truck festival going on.  I just drove by and didn't stop, but I assume that there must have been some precautions being taken.  Plus, sunlight kills this virus pretty quickly from what I have heard.  All in all, having returned home yesterday after quarantining with my parents, I was a little surprised at just how much normal life has come back here.  While I'm sure that some people are choosing to stay home (and all the crowds I saw were mostly young-ish looking), it certainly looks to me like there is a lot of appetite to return to normal life, at least here.

[Roll Roons]

https://www.msn.com/en-ca/news/world/scientists-conclude-people-cannot-get-coronavirus-twice/ar-BB13tm64?ocid=st2

Korean scientists definitively conclude that it's impossible for people to get it twice.

[It’s so Joever]

https://www.msn.com/en-ca/news/world/scientists-conclude-people-cannot-get-coronavirus-twice/ar-BB13tm64?ocid=st2

Korean scientists definitively conclude that it's impossible for people to get it twice.

Yeah that would make sense.
Even the four cold-causing coronaviruses offer a few months of immunity, so this one isn’t likely to be worse.
The real question is how long does immunity last against Covid-19?
SARS and MERS have a few years of immunity, so that could be the case with this virus,
or it could be longer/shorter. I guess we will know in a few years.
Also even if there isn’t permanent full immunity, a second reinfection may also be a lot milder/asymptomatic in nearly everyone.

[It’s so Joever]

Conservatives rejecting remdesivir, still promoting hydroxychloroquine
https://www.politico.com/news/2020/05/02/donald-trump-coronavirus-remdesivir-229765

What a shame.
I never understood why hydroxychloroquine was so hyped when Remdesivir was obviously more promising since early February. I guess Trump supporters sometimes can’t think for themselves.

[Hammy]

Conservatives rejecting remdesivir, still promoting hydroxychloroquine
https://www.politico.com/news/2020/05/02/donald-trump-coronavirus-remdesivir-229765

What a shame.
I never understood why hydroxychloroquine was so hyped when Remdesivir was obviously more promising since early February. I guess Trump supporters sometimes can’t think for themselves.

Trump and his followers don't understand the concept of admitting they're wrong--once they decide to get behind something they dig in and no amount of facts will convince them otherwise.

[It’s so Joever]

Conservatives rejecting remdesivir, still promoting hydroxychloroquine
https://www.politico.com/news/2020/05/02/donald-trump-coronavirus-remdesivir-229765

What a shame.
I never understood why hydroxychloroquine was so hyped when Remdesivir was obviously more promising since early February. I guess Trump supporters sometimes can’t think for themselves.

Trump and his followers don't understand the concept of admitting they're wrong--once they decide to get behind something they dig in and no amount of facts will convince them otherwise.

That’s exactly why we should deny hospital beds and medical treatment to those who were in the reopening protests, at least for now. Even better, let’s just give them as much hydroxychloroquine as they want for free. They can even decide their dosage sizes without extra cost!

[PSOL]

AP: Most states fall short of coronavirus testing thresholds

As more states begin to relax their coronavirus lockdowns, most are falling short of the minimum levels of testing suggested by the federal government and recommended by a variety of public health researchers, an Associated Press analysis has found.

Three months into an unprecedented public health emergency, the White House has largely resisted calls for a coordinated plan to conduct the millions of tests experts say are needed to contain the virus. What federal officials outlined recently isn’t even an official benchmark, and AP’s analysis found that a majority of states are not yet meeting it.

...

Only about 40% of states currently meet even the 2% testing threshold, according to AP’s analysis. The percentage is expected to rise as states increase their testing capabilities. The AP based the monthly testing rate for each state on the average number of new daily tests over the most recent 7 days. The data is from the COVID Tracking Project and includes counts up to April 30th.

[GeorgiaModerate]

Conservatives rejecting remdesivir, still promoting hydroxychloroquine
https://www.politico.com/news/2020/05/02/donald-trump-coronavirus-remdesivir-229765

What a shame.
I never understood why hydroxychloroquine was so hyped when Remdesivir was obviously more promising since early February. I guess Trump supporters sometimes can’t think for themselves.

Trump and his followers don't understand the concept of admitting they're wrong--once they decide to get behind something they dig in and no amount of facts will convince them otherwise.

That’s why the Democrats should engage in as much voter suppression of predominately Trump supporting rural areas as possible, at least in the short term. I hate to say it, but it’s essential for our survival as a country in the long run.

No no no no no!  That "cure" would indeed be worse than the disease.  Don't try to restrict people's right to vote, no matter how good your intentions may be.  That kind of thinking weakens our democracy; fatally, if taken far enough.