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

[Sbane]

https://www.yourbasin.com/news/ector-county-swat-team-raids-local-bar-for-protesting-to-reopen/

Texas shows how to deal with protesters.

[Fmr. Gov. NickG]

Looking at the CDC demographic breakdown of covid deaths makes me think the difference in death rate by gender has actually been significantly undercovered.

It would appear that men are at least twice as likely to die from the virus as women, once we adjust for age.

Men account for about 56% of covid deaths overall.  But the only reason that the gender breakdown is that close is that the death rate is so high among those 80 years or older, and there are far more women who are 80+ than men.

Among people under 65, men account for 70% of US covid deaths.

[Meclazine for Israel]

France
SNIP
France 1 May - Active Cases
Predicted peak of Active Cases: 59,955 – April 11
Recoveries added to curve – 77,000

France on it's way down the curve.

Is France testing anyone who isn't showing up at a hospital in respiratory distress?

Their death to case ratio is up to 15% and creeping upward.

Of course, that wouldn't make your curves invalid since new cases would be recorded on a consistent basis.

If a country with increased testing is reporting asymptomatic individuals, they are essentially reporting cases that have recovered as soon as the individual recovers from the pain of having a swab crammed up their nostril, and don't have to run the three weeks before they walk out of the hospital or their body is carried out.

On the right track. France, Italy and Spain all have very high rates due to more testing centred around sick people entering hospital. If you only test people who are ill with symptoms, the measured death rate will appear higher.

But when the testing is spread out into the community, then we have a much lower rate. USA, Germany and Australia show examples of lower rates because of increased testing in the community of people with few symptoms.

If France is only diagnosing 20% of cases, then the total case count would be 852,000.

That would decrease the death rate to 3.0%

Keep in mind that even in Australia, we have had 664,756 tests conducted and recorded 1.0% of people as positive.

Now even such a low number is still skewed towards sick people and symptomatic people.

Let's say 6,650 people have tested positive, and 80% of cases were never tested. That makes 33,250 cases in Australia.

So the percentage of the population with Corona-virus is 0.13%

And if the death rate is 0.3% of those infected, then the overall chance of an Australian dying from the disease is 0.0004%.

So in terms of risk, Australia is in a good position to re-open with this analysis.

[○∙◄☻¥tπ[╪AV┼cVê└]

https://twitter.com/JonIsAwesomest/status/1257736569370247169

This isn't the kind of "new Pearl Harbor" that PNAC wanted to start war with Iraq.

[Smeulders]

If the task force is disbanded, I don't think we'll ever be free of this pandemic. Not until we have a vaccine, which might never happen; we've never created a vaccine for a coronavirus.

We would have to learn to live with it, although I think it's impractical to expect social distancing, masks, and all the rest to continue indefinitely. Our society eventually acclimatized itself to HIV/AIDS, to give an example of what the path forward might look like if there is no vaccine.

HIV/AIDS is much easier to prevent transmission of. If this coronavirus is truly with us forever, we're looking at an eventual herd immunity scenario as the only realistic ending. Of course that probably means 1-2 million deaths.

We are only looking at 1-2 million deaths if we achieve herd immunity through a random spread throughout the population.  If we had targeted infections among the young and healthy, we could achieve herd immunity much more quickly with likely under 100,000 deaths.

I am going to start by saying that I am not against targeted infection on principle. We do not live in a perfect world where we can think about healthcare without thinking about trade-offs.  In my job I actually (on occasion) work on allocation of scarce resources in healthcare.  That said, I have serious reservations about the targeted infections "plan".

The idea of targeted infections sounds appealing at first. The plan in two sentences: People are going to get infected anyway, let's achieve herd immunity at minimum cost to get this over with. We achieve minimum cost by making sure that people least (less) likely get severely ill get infected. In two sentences this sounds sensible, but a lot falls apart when you get into more detail.

Let's start with why "getting this over with" is not necessarily a good thing. Slowing down infections means we may achieve herd immunity through vaccines instead of infections.  Second, slowing down infections means we have time may find better treatment options, so people infected have better survival chances. Third, even if we we manage to only get healthier people ill, we are still risking severe peaks in hospitals, further reducing survival chances. Not just for Covid, but also for other things requiring hospitalisation. Fourth, the more people still infected when herd immunity is reached, the higher the "overshoot" (people who are infected after R < 1 is reached).

By trying to fast-forward to the end of the pandemic, we get more people infected at worse chances of survival.

Next is the "targeted" infections thing. People are very confident that we can sufficiently control the spread of this disease. I fail to see where this confidence comes from. Problem 1: who is vulnerable?  That is a question I haven't seen a good answer to yet. You can read that in 2 ways. a) at how much risk should someone be before they get quarantined under the plan? b) Are we confident we have enough information about underlying conditions to accurately assess the risk of people? (What factors determine risk, and can we identify them in individuals or populations?) Problem 3: Is the "safe" population even big enough to achieve herd immunity?

Problem 2: Setting up a good quarantine. It's easy to say we should separate vulnerable from low-risk. It's another to do so. Let's take retirement homes, how would this work? We have an at risk population that requires constant care from people in the "low risk" category. How do we separate them? We can't, so we would need to quarantine the complete staff of retirement homes. What if they have families? What if they need to care for children? Are they thrown in quarantine as well? A full quarantine of retirement homes will put their staff in impossible positions. Quarantining everyone that comes into contact with at risk people lowers the odd you have enough infected for herd immunity.

Retirement homes are an easy case. The physical infrastructure is there already, there is a professional staff. What happens to vulnerable people living at home? My grandmother (80+) still lives at home, alone. She still has some freedom. As infection is mostly suppressed in the general population, she can go to neighbourhood shops with a very (very) low chance of getting infected. My father can visit her (with 2 chairs set far apart in her garden), because we know he has a very low chance of being ill. Does she have to sacrifice all of her freedom so younger people get more? How many months should she go without seeing anyone?

As far as I can tell "managed infection plans" are more wishful thinking than actual plans. I haven't seen anyone try to actually model what the costs and benefits of it would be, nor have I seen any plan on how to organise it. Get me a good plan, and I may support it. Right now it looks more like a way to argue against lockdowns.

[GeorgiaModerate]

A new Georgia hot spot is emerging in Gainesville, a northeastern exurb of Atlanta:

https://www.ajc.com/news/northeast-georgia-new-covid-hot-spot-emerges/ZgbPAH5CHeVQdDGy0KiJUN/

Poultry processing is a major industry in the area, although it's not clear whether the outbreak is tied to the poultry plants; the above article says it's not, but I've seen another that said there is a high number of cases reported in them.

[pbrower2a]

Truth be told, I feel that mask laws would be good in theory, but the American politicians are too afraid to enforce them. We saw how many who broke the stay-at-home orders in front of the police weren’t arrested, and I highly doubt people who don’t wear masks would be arrested considering the precedent. Honestly, this crisis has really revealed just how truly eroded our society has become.
Modern American “culture” is a blight on our country.

Businesses can. I am surprised that they don't turn people away for not wearing masks.

[💥💥 brandon bro (he/him/his)]

Looking at the CDC demographic breakdown of covid deaths makes me think the difference in death rate by gender has actually been significantly undercovered.

It would appear that men are at least twice as likely to die from the virus as women, once we adjust for age.

Men account for about 56% of covid deaths overall.  But the only reason that the gender breakdown is that close is that the death rate is so high among those 80 years or older, and there are far more women who are 80+ than men.

Among people under 65, men account for 70% of US covid deaths.

It's been covered in some places, but you are right, it's not covered nearly as much as racial disparities.

The most compelling reason for this is that there's strong evidence that women typically have more active and effective immune systems than men. But there's also the possibility of men waiting longer to seek treatment and men having higher comorbidities (immune-related or otherwise).  I don't know if there's any reason to suspect there are differences in behavior which cause men to get infected mor often.

[GeorgiaModerate]

https://twitter.com/BahmanKalbasi/status/1258037663770259456

[JA]

Open States, Lots of Guns. America Is Paying a Heavy Price for Freedom.

The coronavirus scenario I can’t stop thinking about is the one where we simply get used to all the dying.

I first saw it on Twitter. “Someone poke holes in this scenario,” a tweet from Eric Nelson, the editorial director of Broadside Books, read. “We keep losing 1,000 to 2,000 a day to coronavirus. People get used to it. We get less vigilant as it very slowly spreads. By December we’re close to normal, but still losing 1,500 a day, and as we tick past 300,000 dead, most people aren’t concerned.”

[...]

There’s also a national precedent for Mr. Nelson’s hypothetical: America’s response to gun violence and school shootings.

As a country, we seem resigned to preventable firearm deaths. Each year, 36,000 Americans are killed by guns — roughly 100 per day, most from suicide, according to data from the Giffords Law Center. Similarly, the Everytown for Gun Safety Support Fund calculatesthat there have been 583 “incidents of gunfire” on school grounds since 2013. In the first eight months of 2019, there were at least 38 mass shootings, The Times reported. Last August, 53 Americans died in mass shootings — at work, at bars, while shopping with their children.

[...]

For Dr. Megan Ranney, an emergency physician and Brown University professor who works on gun violence prevention, the dynamics of the lockdown protesters are familiar.

“This group has moved the reopening debate from a conversation about health and science to a conversation about liberty,” Dr. Ranney told me. “They’ve redefined the debate so it’s no longer about weighing risks and benefits and instead it’s this politicized narrative. It’s like taking a nuanced conversation about gun injury and turning it into an argument about gun rights. It shuts the conversation down.”

[...]

As in the gun control debate, public opinion, public health and the public good seem poised to lose out to a select set of personal freedoms. But it’s a child’s two-dimensional view of freedom — one where any suggestion of collective duty and responsibility for others become the chains of tyranny.

This idea of freedom is also an excuse to serve one’s self before others and a shield to hide from responsibility. In the gun rights fight, that freedom manifests in firearms falling into unstable hands. During a pandemic, that freedom manifests in rejections of masks, despite evidence to suggest they protect both the wearers and the people around them. It manifests in a rejection of public health by those who don’t believe their actions affect others.

Now that I think about it, it does seem that the most fanatical pro-2nd Amendment folks are often also the most rabidly opposed to the lockdowns. The same people who offer up nothing but "thoughts and prayers" to the victims of our near daily gun violence, including regular school mass shootings, are offering nothing more than "thoughts and prayers" to the victims of Covid-19 and their families. In fact, just like with gun violence, they are just going through the motion of the words, but not actually feeling empathy with those suffering. All that matters is that their overprivileged, self-centered lifestyle isn't affected by the problems that primarily plague disadvantaged communities (which is the case with both gun violence and covid-19).

[lfromnj]

Looking at the CDC demographic breakdown of covid deaths makes me think the difference in death rate by gender has actually been significantly undercovered.

It would appear that men are at least twice as likely to die from the virus as women, once we adjust for age.

Men account for about 56% of covid deaths overall.  But the only reason that the gender breakdown is that close is that the death rate is so high among those 80 years or older, and there are far more women who are 80+ than men.

Among people under 65, men account for 70% of US covid deaths.

https://www.theatlantic.com/international/archive/2020/03/feminism-womens-rights-coronavirus-covid19/608302/
Don't worry the real gender gap is being covered and the real victims are being covered!

[Fmr. Gov. NickG]

If the task force is disbanded, I don't think we'll ever be free of this pandemic. Not until we have a vaccine, which might never happen; we've never created a vaccine for a coronavirus.

We would have to learn to live with it, although I think it's impractical to expect social distancing, masks, and all the rest to continue indefinitely. Our society eventually acclimatized itself to HIV/AIDS, to give an example of what the path forward might look like if there is no vaccine.

HIV/AIDS is much easier to prevent transmission of. If this coronavirus is truly with us forever, we're looking at an eventual herd immunity scenario as the only realistic ending. Of course that probably means 1-2 million deaths.

We are only looking at 1-2 million deaths if we achieve herd immunity through a random spread throughout the population.  If we had targeted infections among the young and healthy, we could achieve herd immunity much more quickly with likely under 100,000 deaths.

I am going to start by saying that I am not against targeted infection on principle. We do not live in a perfect world where we can think about healthcare without thinking about trade-offs.  In my job I actually (on occasion) work on allocation of scarce resources in healthcare.  That said, I have serious reservations about the targeted infections "plan".

The idea of targeted infections sounds appealing at first. The plan in two sentences: People are going to get infected anyway, let's achieve herd immunity at minimum cost to get this over with. We achieve minimum cost by making sure that people least (less) likely get severely ill get infected. In two sentences this sounds sensible, but a lot falls apart when you get into more detail.

Let's start with why "getting this over with" is not necessarily a good thing. Slowing down infections means we may achieve herd immunity through vaccines instead of infections.  Second, slowing down infections means we have time may find better treatment options, so people infected have better survival chances. Third, even if we we manage to only get healthier people ill, we are still risking severe peaks in hospitals, further reducing survival chances. Not just for Covid, but also for other things requiring hospitalisation. Fourth, the more people still infected when herd immunity is reached, the higher the "overshoot" (people who are infected after R < 1 is reached).

By trying to fast-forward to the end of the pandemic, we get more people infected at worse chances of survival.

Next is the "targeted" infections thing. People are very confident that we can sufficiently control the spread of this disease. I fail to see where this confidence comes from. Problem 1: who is vulnerable?  That is a question I haven't seen a good answer to yet. You can read that in 2 ways. a) at how much risk should someone be before they get quarantined under the plan? b) Are we confident we have enough information about underlying conditions to accurately assess the risk of people? (What factors determine risk, and can we identify them in individuals or populations?) Problem 3: Is the "safe" population even big enough to achieve herd immunity?

Problem 2: Setting up a good quarantine. It's easy to say we should separate vulnerable from low-risk. It's another to do so. Let's take retirement homes, how would this work? We have an at risk population that requires constant care from people in the "low risk" category. How do we separate them? We can't, so we would need to quarantine the complete staff of retirement homes. What if they have families? What if they need to care for children? Are they thrown in quarantine as well? A full quarantine of retirement homes will put their staff in impossible positions. Quarantining everyone that comes into contact with at risk people lowers the odd you have enough infected for herd immunity.

Retirement homes are an easy case. The physical infrastructure is there already, there is a professional staff. What happens to vulnerable people living at home? My grandmother (80+) still lives at home, alone. She still has some freedom. As infection is mostly suppressed in the general population, she can go to neighbourhood shops with a very (very) low chance of getting infected. My father can visit her (with 2 chairs set far apart in her garden), because we know he has a very low chance of being ill. Does she have to sacrifice all of her freedom so younger people get more? How many months should she go without seeing anyone?

As far as I can tell "managed infection plans" are more wishful thinking than actual plans. I haven't seen anyone try to actually model what the costs and benefits of it would be, nor have I seen any plan on how to organise it. Get me a good plan, and I may support it. Right now it looks more like a way to argue against lockdowns.

These are all very good points.  And it is true that I don’t know of anyone with any substantial influence who has tried to put together an actual plan for targeted infections.

That said, I’m don’t feel like you can call what we are doing now a “actual plan”.  We just shut things down across the board in a panic and haven’t done a lot to develop a contingency for what should have happened when things didn’t go according to the very flawed and hastily assembled models. 

It seems like people for some reason believe the only choices are (a) just keep doing what we are doing, which isn’t working and was never the result of a plan in the first place; or (b) gradually go back to the pre-virus status quo, which wouldn’t even claim to make the virus situation any better.

[GeorgiaModerate]

https://twitter.com/StevenTDennis/status/1258087314561142785

[Darthpi – Anti-Florida Activist]

A new Georgia hot spot is emerging in Gainesville, a northeastern exurb of Atlanta:

https://www.ajc.com/news/northeast-georgia-new-covid-hot-spot-emerges/ZgbPAH5CHeVQdDGy0KiJUN/

Poultry processing is a major industry in the area, although it's not clear whether the outbreak is tied to the poultry plants; the above article says it's not, but I've seen another that said there is a high number of cases reported in them.

I have friends who live very close to there. Luckily they have been able to work from home this whole time, but still, worrisome.

[Fmr. Gov. NickG]

https://twitter.com/StevenTDennis/status/1258087314561142785

This poll question is so unhelpful as a way to frame the policy debate.
For people who are saying restaurants are “safe”, are they saying this because they think they are unlikely to get the virus if they go to a restaurant, or they think they are likely to get the virus, but that getting the virus is not unsafe for them?

[Calthrina950]

https://twitter.com/StevenTDennis/status/1258087314561142785

None of this is surprising to me. Republican areas are generally pushing to lift restrictions more quickly and more broadly than Democratic areas, and Republican voters have, as previous polls shown, adhered less to social distancing guidelines than their Democratic counterparts. Here in El Paso County, for example, the Board of Commissioners is pushing for dine-in restaurants to reopen, although the County Health Department is recommending against doing so.

[Crumpets]

In a kind of sick way, part of living in a decentralized democracy is going to be that, in a time like this, you're going to have some areas that just accept a higher level of casualties in exchange for the economic benefit than other areas. I think ironically some conservative communities are using a similar logic when it comes to COVID as liberals did with terrorism post-9/11 (i.e. yeah it's a problem and we should work to fix it, but I'm not going to live my life in constant fear of possibly being killed by a terrorist/COVID).

[Fmr. Gov. NickG]

This poll question is so unhelpful as a way to frame the policy debate.
For people who are saying restaurants are “safe”, are they saying this because they think they are unlikely to get the virus if they go to a restaurant, or they think they are likely to get the virus, but that getting the virus is not unsafe for them?

"Would you go to X?" is the formulation that I've seen in other polls and IIRC the numbers are lower across the board among Republicans.

I assume you mean the numbers are higher across the board for Republican than Democrats.
I’m not denying that at all.
It’s just that in terms of public policy framing, it seems much more important to understand -why- people would describe this as “safe” (or be willing to go to).  I’ve seen very little polling on what exactly people understand and believe about the virus and its consequences.

[Calthrina950]

If the task force is disbanded, I don't think we'll ever be free of this pandemic. Not until we have a vaccine, which might never happen; we've never created a vaccine for a coronavirus.

We would have to learn to live with it, although I think it's impractical to expect social distancing, masks, and all the rest to continue indefinitely. Our society eventually acclimatized itself to HIV/AIDS, to give an example of what the path forward might look like if there is no vaccine.

HIV/AIDS is much easier to prevent transmission of. If this coronavirus is truly with us forever, we're looking at an eventual herd immunity scenario as the only realistic ending. Of course that probably means 1-2 million deaths.

True, but as I've said, we're not going to be able to continue today's measures indefinitely. Do you think people are going to tolerate putting up with social distancing on a permanent basis? And I'm aware of the arguments that have been made about herd immunity.

Building upon this, here's an article I've found outlining what "living with coronavirus" would look like without a vaccine: https://www.cnn.com/2020/05/03/health/coronavirus-vaccine-never-developed-intl/index.html/.

[#TheShadowyAbyss]

Until we get a vaccine or a very strong treatment that will reduce the risk of mortality to a very low level socially distancing in masks in public are going to be a thing. This is kind of why I'm hoping that the Oxford vaccine ends up working because it works so we can get a vaccine by September life can start to go back to normal around election time and for the holidays.

 but until either one of those two things happen we just have to accept we're going to live in a new reality

[Tintrlvr]

Until we get a vaccine or a very strong treatment that will reduce the risk of mortality to a very low level socially distancing in masks in public are going to be a thing. This is kind of why I'm hoping that the Oxford vaccine ends up working because it works so we can get a vaccine by September life can start to go back to normal around election time and for the holidays.

 but until either one of those two things happen we just have to accept we're going to live in a new reality

Depends what you mean by "social distancing". Shutting down, for example, crowded concert venues might continue indefinitely, but the types of general shutdowns we have now are not going to last much longer anywhere, certainly not until September let alone later.

Mandatory masks are a kind "of course" solution that is really very non-intrusive (much less so than any of the social distancing requirements) and may be in place indefinitely as well. The only reason it wasn't in place earlier was because masks were so difficult to obtain in March/early April.

[Tintrlvr]

This poll question is so unhelpful as a way to frame the policy debate.
For people who are saying restaurants are “safe”, are they saying this because they think they are unlikely to get the virus if they go to a restaurant, or they think they are likely to get the virus, but that getting the virus is not unsafe for them?

"Would you go to X?" is the formulation that I've seen in other polls and IIRC the numbers are lower across the board among Republicans.

I assume you mean the numbers are higher across the board for Republican than Democrats.
I’m not denying that at all.
It’s just that in terms of public policy framing, it seems much more important to understand -why- people would describe this as “safe” (or be willing to go to).  I’ve seen very little polling on what exactly people understand and believe about the virus and its consequences.

Undoubtedly the public has completely wrong and uninformed views about the virus in a wide variety of disparate ways (you'd get a big portion who think "about half" of people who get sick die and another big portion who think "no more than die from the flu" if you prompted both answers, e.g.). That's just par for the course.

[Storr]

Quite the example of incompetence in this ProPublica article about some dude with no experience flying around the country after getting a VA contract to buy N95 masks for VA workers.....and failing miserably.

https://www.propublica.org/article/how-profit-and-incompetence-delayed-n95-masks-while-people-died-at-the-va

"It remains a mystery why the CEO of Federal Government Experts LLC let me observe his frantic effort to find 6 million N95 respirators and the ultimate unraveling of his $34.5 million deal to supply them to the Department of Veterans Affairs hospitals, where 20 VA staff have died of COVID-19 while the agency waits for masks.

It’s also unclear why the VA gave Stewart’s fledgling business — which had no experience selling medical equipment, no supply chain expertise and very little credit — an important contract. Or why the VA agreed to pay nearly $5.75 per mask, a 350% markup from the manufacturer’s list price. In the end, after ProPublica asked questions about the deal this week, the VA quickly terminated it and referred the case to its inspector general for investigation."

[True Federalist (진정한 연방 주의자)]

Until we get a vaccine or a very strong treatment that will reduce the risk of mortality to a very low level socially distancing in masks in public are going to be a thing. This is kind of why I'm hoping that the Oxford vaccine ends up working because it works so we can get a vaccine by September life can start to go back to normal around election time and for the holidays.

 but until either one of those two things happen we just have to accept we're going to live in a new reality

The idea that any vaccine will be widely available before next year is crazy. Even if production started to ramp up while being tested, the logistics involved in vaccinating everyone quickly would prevent that.

[Fmr. Gov. NickG]

This poll question is so unhelpful as a way to frame the policy debate.
For people who are saying restaurants are “safe”, are they saying this because they think they are unlikely to get the virus if they go to a restaurant, or they think they are likely to get the virus, but that getting the virus is not unsafe for them?

"Would you go to X?" is the formulation that I've seen in other polls and IIRC the numbers are lower across the board among Republicans.

I assume you mean the numbers are higher across the board for Republican than Democrats.
I’m not denying that at all.

What I'm saying is that Americans, including Republicans, have been less likely to affirm any personal interest in eating in restaurants, going to movie theaters, and so on than they are to affirm support for allowing others to do those things.

It’s just that in terms of public policy framing, it seems much more important to understand -why- people would describe this as “safe” (or be willing to go to).  I’ve seen very little polling on what exactly people understand and believe about the virus and its consequences.

The Economist/YouGov poll has included a few questions about personal risk every week, although I'm not sure that I've seen any that reflect exactly the distinction in which you're most interested. The number that I remember vividly from today's is that 49% said that the virus either "definitely" or "probably" originated from a lab in China (compared to 28% for "probably" or "definitely" false).

Have you seen any question that is just something like “How likely do you think it is that you will be infected with the virus within the next year?”