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

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

That cases now seem to be trending upwards across virtually all of the south and southwest is troubling. No doubt this is to some degree due to increased testing, since tests have been increasing (and were higher today), but I think Аverroës' and peenie_weenie's point about air conditioning in the south/southwest likely has a lot to do with it. It seems like (and I have seen from personal experience) huge #s of people think that "the pandemic is over" and have stopped taking the virus seriously and are not taking basic precautions (including but not limited to not wearing masks) that could slow/stop spread like it has been slowed down/stopped in numerous other countries. And we are now starting to pay the price for that. The protests will likely only make this worse, regardless of how just the cause of the protests may be.

It is interesting/good that while cases appear to be going back up again, deaths still seem to be trending down a bit. However, there are too reasons why we should not only look at the death figures to get a good idea of whether/to what degree a second wave/resurgence is starting -

1) Deaths are a lagging indicator, so we should expect to see an uptrend in cases before an uptrend in deaths, if we are having a 2nd wave.
2) Doctors may have gotten a bit better at treating the virus, and maybe (hopefully?) the death rate may have gone down a bit gradually. It would be nice to have evidence/data indicating this were the case. Though if this were the case, that would mean the death data going down was not indicating that the virus was under any more control.

Because of those 2 interpretive problems with death data and the problem of figuring out how much of any increase in cases is due to increased testing, the most reliable data would seem to be hospitalizations. But this is the type of data that is inconsistently reported by different states and across time, unfortunately. So we just hear occasionally that hospitalizations have gone up or down in some states, but this data is not on sources like worldometer.

At the moment it looks to me like we are probably on the same general course as Iran, where they opened up too early and had a second wave/resurgence before their 1st wave really declined.

If indeed there is a 2nd wave, this will cause more long-term damage to the economy than we would have had if we had properly taken steps to actually beat back/contain the virus in the first place to the same sort of degree that countries like South Korea and Germany have done. So it seems to me that as a result of our incompetent half-assed response, we remain on track for a worst of all worlds outcome. More deaths, and also more economic damage.

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

Interestingly, this sounds exactly like...

TRUMP

https://twitter.com/spwells/status/1271586947383701505

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

Well, Florida is reporting +2,581 cases on Worldometer, compared to its previous high yesterday of 1,902. And what is worse, it is a weekend, cases are usually lower on weekends, right? That is quite a large increase and a very worrying uptrend. Alabama also reported its highest case # so far today.

We will have to wait and see what the other states report later in the day, if the other southern/southwestern states show a similar trend, that will mean serious problems going forward. With each passing day at the moment, we are looking more like Iran.

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

Statistics and news reports don't generally report details of who in particular is being newly infected. However, of the anecdotal news reports I have seen around in Texas, most of them recently seem to be reports of retail employees who have gotten infected from recently re-opened businesses. This primarily has been restaurant employees near me, but also to some degree retail workers in stores. This has generally been announced by the restaurant/store in question and in quite a few cases the restaurants/stores have now re-closed because of the employee infections.

I am just wondering, in other areas have other posters seen similar reports? Insofar as details about who is being infected are getting reported in your area, are you hearing about employees in restaurants/retail getting infected? And are stores/restaurants re-closing in response to this?

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

Why do all these stories keep using new cases as their central metric?  If you are trying to argue that the virus is an escalating problem, demonstrate it through stats on hospitalizations or deaths.  

A growth in cases without an associated increase in serious health consequences is a good thing, as it just indicates that testing has improved, treatment has improved, the immunity rate had increased, or all of the above.

Ideally we would all do exactly that, look at hospitalizations and deaths rather than simply looking at cases. You are quite right that case #s can be confounded by testing.

But unfortunately, is the data for hospitalizations and deaths are both problematic.

Hospitalizations are problematic as a data point because they are not generally reported across the board by all states, and are not reported consistently/reliably. If hospitalizations were consistently reported, this would likely be the best metric and the one we should focus on more so than cases. However, in southern/southwestern states that do report that data it has seemed to be generally trending up along with their cases.

Deaths are also a problematic indicator for two reasons - first, they are a lagging indicator, generally they are roughly 2-3 weeks behind. And secondly, the quality of care is likely getting better over time, hopefully reducing the fatality rate as the medical system and doctors gain experience with things like plasma therapy, appropriate use of ventilators, and as more studies are completed showing the effectiveness or counterproductiveness of various experimental drugs etc.

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

Why do all these stories keep using new cases as their central metric?  If you are trying to argue that the virus is an escalating problem, demonstrate it through stats on hospitalizations or deaths.

They keep using new cases but not the percent positive rate, which is way, way down from April.

I am absolutely convinced the media wants more lockdowns and other authoritarian measures, and I think they want it because the major media companies have investments in China, and the Chinese government wants us locked down. I now believe the Chinese government is influencing stories published in the Western media. There's just no other explanation for it.

It's completely contrary to science to use the wrong metric for a pandemic, yet it continues.

The positive rate is another useful indicator, yes, and it avoids some of the problem of case # just looking at testing. And indeed, it is generally down by a lot from earlier.

However, on a national level it seems to have flatlined at this point at about 5%, and possibly may be at the very beginning of trending back up despite increased testing. Which direction the positivity rate goes from here is something we should watch closely - whether it starts to trend back up, remains stable at 5%, or decreases.



And what is also worrisome is that the positivity rate remains high and has apparently been trending *upwards* in key states of concern in the south/southwest. Most worrisome is Arizona, which has an 18.1% positivity rate which has been increasing. But other southern/southwestern states seem to be potentially on that same sort of track.





It should be noted also though that the positivity rate is not without problems - most notably data does not always consistently distinguish overall tests from *people* tested (for people who are tested multiple times, looking at you Florida) and there have also been inconsistencies in whether/how antibody tests have been included.

The overall national #s are potentially a bit misleading to look at, because it is quite clear that things have been getting better in New York (and to a lesser degree in the North/Midwest generally). The problem is with the South/Southwest.

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

Here are some other good graphs regarding the positivity rate. While has trended down and then stabilized at about 5% nationally, it seems to be increasing in Florida and recently also in TX, with California relatively stable but also recently possibly up-trending.

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

Insert Everything is fine meme.

https://twitter.com/WPLGLocal10/status/1272185530529308672

And to think Sundays are usually a lower-reporting day.

Alabama reported its all-time high # of cases today of +1,014 despite it being a Sunday, and despite the 3 previous days also being all-time highs at the time.

There are other states with lower #s than yesterday and overall I think we are on track for less cases than Saturday, but it seems like the #s for today overall may end up being pretty high for a Sunday. Hopefully we don't start exceeding 30k cases again nationwide over the next week or two on weekdays.

--- edit --- and also the same thing for South Carolina, 4 days in a row of new record highs for both SC and AL, and Texas is once again reporting record hospitalizations. As more data comes in the trend in the south/southwest seems to be getting more clear and more clearly bad.

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

Well, it took 159 years, but it has finally happened. The South is rising again.

Not rising in rebellion though, but in COVID-19 cases.

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

Deaths are also a problematic indicator for two reasons - first, they are a lagging indicator, generally they are roughly 2-3 weeks behind. And secondly, the quality of care is likely getting better over time, hopefully reducing the fatality rate as the medical system and doctors gain experience with things like plasma therapy, appropriate use of ventilators, and as more studies are completed showing the effectiveness or counterproductiveness of various experimental drugs etc.

I don’t understand why improved treatment would be considered problematic.  If the virus is something that can be consistently treated sucessfully, it is nowhere near as concerning if more people are being infected.  

It would be like hearing about an increase in chlamydia rates.  A hundred years ago, this might call for significant public policy intervention.  Today, this would basically just call for more testing rather than a fundamental change in the way we live our daily lives.  

That’s not to say we are there yet, but if fatalities have fallen 60% while cases have remained constant (as seems to be true over the last 2 months), it suggests we are making real progress toward this.

It is obviously good if treatment becomes more effective and the fatality rate therefore trends down - indeed, I said exactly that ("hopefully reducing the fatality rate").

But for purposes of using death data to project the course of the epidemic, if the fatality rate is decreasing, you need to take that into account. If the fatality rate is declining, then even if the number of actual/true infections remains constant (or is slightly increasing below a certain threshold), then death data will show a downward trend (like we have generally observed so far).

However, if you then conclude that the fact that deaths are declining means that the epidemic is being brought under control, that conclusion would not be correct because infections would still be spreading and causing various suffering/problems short of death. In addition, unless the fatality rate dropped all the way to zero due to better treatment, then if actual true infections continued to grow, eventually the actual raw # of deaths could begin to increase simply because greater absolute #s of people would be infected at any particular time, even if any individual case had a lower individual probability of death. That would be especially the case if it got to the point where medical capacity was exceeded (and there are now a number of states reportedly getting close to full in their ICUs), at which point the fatality rate may start increasing again (in addition to the raw underlying # of serious cases increasing).

For these reasons, in principle one would think that hospitalizations would be the best metric to look at rather than fatalities or tests/positivity rate, but the problem with that is the data for hospitalizations is very incomplete/not consistently reported.

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

I don't understand why you are appealing to science when you appear not to understand very much of it.

I know more about science than the guy who came up with that model that said America would have 2.2 million deaths by now.

I do my homework on this.

You clearly don't know more about science than him, because if you did know more about science than him you would know that Ferguson/Imperial and the Ferguson/Imperial model did not say that America would have 2.2 million deaths by now.

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

+3,909 new cases in Texas alone today on Worldometer, and they have not even finished updating for the day...

The previous high was 2,437 on June 10, which at the time seemed like a shockingly high # and an aberration.

Similarly, there are record highs for other states in the South/Southwest like Florida, Arizona, and Nevada, and other southern/southwestern states that are not at their all-time highs (today) are close to them and it seems like only a matter of time before they exceed them and make new highs in a few days, or maybe in a week. There is noise and fluctuation in the trend, but the general direction seems clear across states. Up, up, and away.

The virus is a test of societies and nations, and USA has failed the test. Essentially every other developed 1st world nation has more or less managed to bring the virus more or less under control, except for the USA. Those of posters/readers us in the US well and truly live in a failed state.

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

+3,909 new cases in Texas alone today on Worldometer, and they have not even finished updating for the day...

There's a note underneath the chart that says this includes 1,500 old cases from state prisons.

It is up to +4,412 now (reminder, the previous  was 2,437) and STILL not done reporting for the day, so even if you want to declare prisoners un-persons, still looks like record highs. As for prisoners, unfortunately they still need treatment and take up limited medical capacity, and the virus can be (and no doubt has been) spread from prisoners to staff and visitors, and from there to the general population.

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

Looks like another horrible day in terms of the national trend of overall cases. While cases continue to trend down in the North/Midwest, they continue to trend up across the South/Southwest/West. Another record # of cases for California, and if you want to not count the big batch of prisoners that was reported yesterday, then the Texas cases today are higher than yesterday also.

At this rate, we will probably start exceeding 30k cases a day once again next week, and if policy changes of some sort are not made, and made immediately, we appear on a date with destiny to exceed our previous national record of 39k cases in a single day (and perhaps at this point that is unavoidable even if policy were suddenly changed). The only question is what day that will occur. Could it be as early as late June? August? I doubt we can push it back into September.

Over the last two days it also has started to look more clearly like the positivity rate has broken its downtrend and is also starting to increase on a nationwide level, and it is no longer possible to make an argument that it is still down-trending at this point:

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

Yet another record day for Florida, 3207 new cases reported... Previous high (only 2 days ago) was 2783, which at the time seemed like a shocking increase.

And in other news, Texas yet again reports new record high COVID-19 hospitalizations.



The hits just keep on coming.

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

Cases nationwide are steady while deaths continue to decrease every week.  No one thought we were going to eradicate the virus.  The idea behind the lockdown was to mimimize the strain on the health care system until we had better testing and treatment.  We now have better testing and treatment.  

We need to manage hotspots where the health care system is close to capacity.  But beyond that, I don’t see how it’s a mistake to continue to open up.  The steady flow of new infections we are seeing, coupled with fewer and fewer deaths, seem like the very definition of “flattening the curve”.  And it’s the way we eventually get to herd immunity with the lowest cost to life and ecconomic hardship (besides deliberately infecting younger people, which seems impossible now).

It was a mistake to not get the virus under control to a similar degree as essentially every other developed country (South Korea, Australia, the entirety of Western Europe, etc) and without having adequate public health measures such as testing/contact tracing in place before opening up, because it means that cases are now rising again. Granted, Americans are perhaps so incredibly stupid that this may not ever have been possible in the Failed States of America, at least not with leaders such as Trump attempting to sabotage the process by discouraging sensible low-cost precautions like mask wearing.

The economic response could have been much better managed. There is no reason whatsoever why, for example, FSA unemployment should be so high (it is not in western Europe or elsewhere because they had more sensible employment/social safety net policies to deal with the economic effects of lockdown). There is absolutely 0 reason why anyone in the USA should not have enough to eat, or be at risk of losing their housing etc. The fact that some are is purely and entirely a policy failure, and is in no way necessitated by the pandemic itself. Both the health damage and the economic damage in the Failed States is unique among developed countries in its extent and both the health and the fact that both are as bad as they are is an entirely self-inflicted wound.

As it is, with cases rising we are going to start getting more economic damage, because remember that the economic damage started well before lockdowns were imposed - the economic damage resulted primarily from voluntary changes in behavior across the world. Leading economic indicators such as restaurant reservations are already starting to trend back down in states where virus cases are now surging. It is true there is a short term trade-off between lockdowns and economic activity, but if you go in the direction of opening up the economy too early, that trade-off disappears (and at some point reverses) as the surging virus at a certain point causes many people to once again change their behavior and go into self-lockdown mode or self semi-lockdown mode.

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

And yet another record day for Arizona also... 2,519 more new cases, the previous high was was 2,392, also 2 days ago.

The more the Failed States of America's Government dawdles, the worse things will get.

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

I don't think anyone is arguing that Trump's response was "effective" or "good". Most people on here have been harshly critical of his response, and I myself have expressed my concerns regarding it.

Yeah, my point in this was not really to single out Trump, my mention of him was just a side swipe. In any case personally I would say that Trump is a symptom of our problems, not the cause.

However, do you believe that this country should go back under lockdown? What benefit will we derive now by shutting down all activity again, closing businesses, and restricting movement? Given the outburst of anger and emotion which we saw during the recent riots/protests (which I attribute partly to the response to the shutdowns), I would shutter to think about what we would face if we were to resume with such rigorous policies.

This is a legitimate and good question which demands a serious answer. My answer would be that in the ideal case, if Americans were capable of doing so, yes we should go into a STRICT nationwide lockdown. However, you phrase it as "go back under lockdown." But this is not a question of returning to lockdown, but having an actual lockdown in the first place, because only a very small part of the country ever had anything like a European-style lockdown, much less an Asian-style one. If EVERYONE actually SERIOUSLY locked down, didn't go ANYWHERE unnecessarily for about a month, and 100% of people wore masks then that would be sufficient to temporarily drop R far below 1, so that the virus would basically for that month or so only spread within households and not between them. In households where there was one infection, other household-members would be infected, and after that the virus would largely die out. We know that this is possible because literally every other developed 1st world country other than the Failed States of America has done it. There is the possible exception of the Dis-United Kingdom, which still has fairly high #s, which nonetheless has done significantly better than the Failed States. Note that the reason the Dis-United Kingdom has done 2nd-worst among developed nations is their cultural similarity to the FSA. There is also the exception of Sweden, but that is only because they never tried, not because they are not capable.

However, in the realistic case, Americans seem to be incapable of locking down to the degree necessary to actually bring the virus under control. In the USA, we only ever brought down R on a nationwide level to about 1, never really under it (at least not significantly so). Given that a large # of Americans are idiots and are incapable of actually making a short term sacrifice for our collective long-term benefit, it is not worth making a short term sacrifice. This fundamentally seems to stem from our instant gratification culture and historically unprecedented sense of entitlement. In the USA, everything is about me, me, me and now, now, now. We as a society are utterly incapable of collective action that carries a short-term cost but which brings a long-term benefit that exceeds the short-term cost. This is why we are the Failed States. So I would say no, there is no reason to have another lockdown if it is a half-assed, uncoordinated, incompetent and dysfunctional lockdown, which is what it would be.

So my answer is that there is nothing we can do. We are simply collectively too short sighted and selfish as a society. This is why we are condemned to a bad health outcome, which will worsen our economic outcome as compared to taking the steps to get to a better health outcome. This is why we are doomed to the worst of both worlds - both a health and an economic disaster.

I also will say that it is impossible to expect for this virus to be completely eliminated. Just recently, New Zealand has had three new cases of coronavirus, in a country that has almost completely closed itself off from the outside world. I certainly think that we need to continue with the precautions that we have taken (i.e. limits on large gatherings, mask wearing, sanitary practices), but businesses and individuals cannot and should not be subjected to the same kinds of lockdowns that were in place before. In California, in Colorado, in Texas, and in other states, the authorities recognize that such a move would have costs far outweighing the benefits.

It is likely true that the virus cannot be entirely eliminated from the world (at least not prior to a vaccine). I would say, though, that this is primarily because it is effectively impossible to eliminate from the 3rd world/developing countries, and if it could not be eliminated in those countries, it would keep periodically spreading to developed nations. Every other developed has dramatically brought down case numbers other than the USA. If the world consisted only of countries with a level of development similar to Europe and the developed East Asian/Oceania countries with competent governments, then in theory I would say it appears to actually be theoretically possible to eliminate the virus from the globe (which is definitely more than I thought possible a few months ago, and speaks to the competence and capability of non-American developed nations).

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

It doesn’t seem like many people are harshly criticizing California’s response.  And despite locking down very early, they are following the same path as Texas and Florida.

Compare and contrast the curve of California's case #s with the case #s of any western European country or developed East Asian/Oceania country.

Clearly all of those other countries have brought the virus under control to a far greater degree than California, so we should definitely be harshly critical of California's response.

Granted, the fault for the failure of California to control the pandemic is undoubtedly partially that California could not close its borders to other Failed States such as neighboring Arizona, where the virus was left to run rampant to a greater degree, and then the virus was imported into California from those states, but it is pretty clear that California never locked down to the same degree and with the same efficicacy as literally all non-American developed countries other than Sweden and perhaps the Disunited Kingdom. True, it is possible that the state government of California may have wished to do so, but it is clear that large numbers of human Californians never did so. And governments do not lock-down. People do (or, in the case of the Failed States, don't).

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

Today provided more leading evidence that the positivity rate is not only no longer declining, but has started to enter back into an uptrend. It is still theoretically possible this might be an abberation, but it becomes more likely with each additional day of these sorts of results:



Here is hoping we don't break once again above 30k cases on Friday (I was hoping that we would delay that benchmark at least until next week). We got way too close to it for comfort on Thursday, and with the positivity rate seem to have stabilized and now starting to change direction, if test numbers (which have been below the peak the past few days) go back up on Friday, that may be enough to already push us above the 30k marker. Then the next stop is to exceed the old high and start hitting 40k per day.

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

If we're going to head for herd immunity anyway (or close to it), I am truly starting to think a strategy of "intentionally infect all the young and healthy people" would have been what was best for two reasons.  First (and most importantly), we would be choosing who gets it.  Based on the CDC's estimate of a 0.26% fatality rate and assuming 50% as the herd immunity threshold, a non-targeted herd immunity strategy would result in about 430K deaths.  However, their estimate is a 0.025% fatality rate in those under 50.  Hitting herd immunity with engineering the infections to be in the young would have only resulted in about 41K deaths.  Now, it probably would have been a little more because we wouldn't have been perfect in stopping older individuals from getting sick.

The second reason is that we could have gotten this whole crisis over with in a matter of a few weeks to maybe a month.  Things truly would have likely been 100% normal by Easter Sunday if we had gone down that path.

If you want to be deliberately infected, I wholeheartedly endorse you deliberately infecting yourself.

As for the fatality rate, the best estimates generally range between .5% and 1% for populations overall (obviously age variation among populations changes this, as well as other factors such as whether medical capacity at any point gets overwhelmed and whether newer treatments lower the fatality rate over time, and whether you account for un-reported/excess deaths, and various other such factors). Given that various localities have had well more than .26% of their total populations dying, .26% isn't particularly plausible unless you are talking about special circumstances such as a population that skews young, has significantly fewer pre-existing risk conditions, or a group of patients that has all been provided with the best available treatments (probably remdisivir/plasma at this point) and highest quality care, etc.

https://www.nature.com/articles/d41586-020-01738-2

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

If we're going to head for herd immunity anyway (or close to it), I am truly starting to think a strategy of "intentionally infect all the young and healthy people" would have been what was best for two reasons.  First (and most importantly), we would be choosing who gets it.  Based on the CDC's estimate of a 0.26% fatality rate and assuming 50% as the herd immunity threshold, a non-targeted herd immunity strategy would result in about 430K deaths.  However, their estimate is a 0.025% fatality rate in those under 50.  Hitting herd immunity with engineering the infections to be in the young would have only resulted in about 41K deaths.  Now, it probably would have been a little more because we wouldn't have been perfect in stopping older individuals from getting sick.

The second reason is that we could have gotten this whole crisis over with in a matter of a few weeks to maybe a month.  Things truly would have likely been 100% normal by Easter Sunday if we had gone down that path.

This is more or less what I’ve been saying for at least two months.
 
I don’t think we should be infecting anyone without their consent.  But we should be providing immunity certificates to those who have recovered, and offering an option for young and healthy people to get a certificate through a low-dose, medically-monitored, quarantined, deliberate infection.  And we should only be fully “opening up” the country for those who already have immunity certificates until we have reached herd immunity levels.

I have thought the same thing. However, the critical assumption there is that immunity is long-lasting, which may well be the case, but is not actually known. A recent study of people in Wuhan found that antibodies may not appear to be long-lasting. Antibodies are not exactly the same thing as immunity, but the degree of immunity over time remains unknown and given that patients no longer have antibodies, one wonders also even if they retain some immunity, how strong/reliable is that and exactly for how long?

If it turns out that immunity only lasts for, say half a year and decreases in strength over time, then deliberate mass infection (or any sort of herd immunity strategy more broadly) would turn out to be a very bad idea.

You May Have Antibodies After Coronavirus Infection. But Not for Long.

It’s a question that has haunted scientists since the pandemic began: Does everyone infected with the virus produce antibodies — and if so, how long do they last?

Not very long, suggests a new study published Thursday in Nature Medicine. Antibodies — protective proteins made in response to an infection — may last only two to three months, especially in people who never showed symptoms while they were infected.

The conclusion does not necessarily mean that these people can be infected a second time, several experts cautioned. Even low levels of powerful neutralizing antibodies may still be protective, as are the immune system’s T cells and B cells.

But the results offer a strong note of caution against the idea of “immunity certificates” for people who have recovered from the illness, the authors suggested.

Antibodies to other coronaviruses, including those that cause SARS and MERS, are thought to last about a year. Scientists had hoped that antibodies to the new virus might last at least as long.

Several studies have now shown that most people who are visibly ill with Covid-19 develop antibodies to the virus, although it has been unclear how long those antibodies last. The new study is the first to characterize the immune response in asymptomatic people.

...

The conclusion does not necessarily mean that these people can be infected a second time, several experts cautioned. Even low levels of powerful neutralizing antibodies may still be protective, as are the immune system’s T cells and B cells.

But the results offer a strong note of caution against the idea of “immunity certificates” for people who have recovered from the illness, the authors suggested.

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

So far today Arizona, Florida, and Nevada have all reported new record numbers. Other states have reported higher #s so far than yesterday also (but a few have also reported lower ones). Overall if the #s reported so far today are fairly representative, I think we will probably bust out and exceed 30k cases again already today. If these case #s keep going up on this trend, eventually the deaths are also going to catch up and start going up as well, even given that a higher proportion of cases are from young people and better semi-effective treatments like convalescent plasma and remdesivir are being used more.

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

eventually the deaths are also going to catch up and start going up as well

Maybe if people keep repeating this mantra enough times without evidence it will turn out to be true.

Cases in California have been steadily increasing almost every week since the middle of March.  But deaths peaked on April 23, and it is now almost two months later.  How much of a lag do you actually expect?

It is a mathematical fact that if cases keep increasing without limit, then unless the death rate falls to 0 (i.e. with a vaccine or completely effective treatment), eventually the raw number of deaths will rise.

This is simply non-debatable math. If you disagree with that, it is not that your opinion is wrong, it is that you are innumerate.

At the hypothetical extreme, what would you say would happen to deaths if cases rose to an infinite number per day? What if they rose to 1 million per day? 100,000 per day? At a certain point, deaths will rise. You can debate what the threshold is at which they will start rising, and how long the time lag is, but you cannot debate that at some threshold and at some time lag deaths will rise if the # of cases per day continues to rise indefinitely.

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

Another day, another 33k (new cases).

The positivity rate also ticked very slightly up again today.

I’ll gladly take a 30% rise in cases (with a 0.5% bump in positivity rate) in exchange for a 20% drop in deaths, which is what today’s numbers look like week-over-week.

That's a bad trade (if we could hypothetically make such a trade) and a bad way to look at it. Hypothetically, we would be better off and it would likely mean fewer deaths in the long run if we instead had a 20% drop in cases and a 30% rise in deaths than vice versa.

Increasing cases (unless the increase is purely attributable to testing) imply that the virus is still spreading and R is > 1. As long as R > 1, more and more people will be infected, and the number of true new cases per day will rise exponentially at some rate that is higher the more R is above 1, but which is exponential even if R is only slightly above 1. As long as R remains > 1, that implies the virus will keep spreading amongst the population until herd immunity is achieved, which means as long as the death rate is > 0, you will get more deaths over time as a greater and greater share of the population becomes infected.

By contrast, if new cases were decreasing by 20%, then as long as we were not simply testing less, that would imply R < 1. Which would mean that the virus was disappearing, and there would be fewer deaths in the long run because the virus would wither away.