Coronavirus 2019

[Oghier]

@triggercut

a nasty feedback loop.

… that has far too much runtime. The idea of sitting home and playing videogames for a month or two sounds great as an idea. As a reality, I already hate it.

[Oghier]

@charmtrap

C’mon God. If you’re out there, give us a sign.

An incapacitated Trump would leave Pence in charge. Maybe that’s slightly better. Pence doesn’t believe in science, but Trump doesn’t believe in reality.

It’s not much better, though. I worry that Pence’s solution might be focused on prayer and welcoming the end times.

[SlyFrog]

Significant other is going nuts because she wants to go to the gym. She lifts weights (just to keep toned, it’s not like she’s a professional power lifter or anything) and really enjoys it. I’d say it is nearly a necessity for her mental health - it’s pretty much her “thing,” and I don’t really know how to replicate it. It’s still fucking cold outside even if she did run outside, and while you can run, there’s not that much that can replicate barbells, kettle balls, and plates if you’re an active gym user.

[Mellified]

Apple is closing all their stores for two weeks starting Monday. They called me because my wife’s laptop was in for a repair.

[LeeAbe]

House bill isn’t that great supposedly (NY Times business writer):

Binyamin Appelbaum (BCAppelbaum)

Binyamin Appelbaum (BCAppelbaum)

[LeeAbe]

And they are paying all all employees during that time.

[Oghier]

@SlyFrog

Significant other is going nuts because she wants to go to the gym. She lifts weights (just to keep toned, it’s not like she’s a professional power lifter or anything) and really enjoys its. I’d say it is nearly a necessity for her mental health - it’s pretty much her “thing,” and I don’t really know how to replicate it.

Yoga mat and https://www.reddit.com/r/bodyweightfitness/

[dionisus1122]

YouTube yoga and strength building routines

[MikeJ]

I just bought a fairly significant set of adjustable barbell weights for a similar reason.

[KevinC]

@LeeAbe

House bill isn’t that great supposedly (NY Time business writer):

Fucking hell. At least Google is making a national website to help process COVID-19 care, amirite?

[DarthMasta]

Doesn’t replicate a gym, but it’s pretty fun, Nintendo Switch Adventure…

[Teiman]

flattening the curve enough to save everyone may not be possible

“Flattening the Curve” is a deadly delusion

[kedaha]

@Juan_Raigada

You must have a very dire opinion of our public health specialists if you think they make such basic mistakes. That reported cases lag is obvious and the relevant experts do know much more than you or me about exponential growth and epidemics. Heck, the government clearly said we’ll be looking at 10k cases by Wednesday next week at the latest, so it’s not that they don’t acknowledge it either.

In general, you take into account the delay and the exponential growth to take measures so you avoid overburdening the system. The problem was that last Monday cases jumped far faster than the usual. We went from an stable 25% increase day-over-day to a 90% increase in a single day. That moved the needle and we shifted to catch-up, but still the measures are mostly in place in a reasonable timeframe (probably two days later than ideal or so due to said spike).

Some numbers: ICU units in Madrid (hardest hit region, also were I live), are at 28% occupancy by coronavirus cases. Since we will have some surge capacity in the coming days we might be able to avoid total saturation (it’s going to be tight, but you can move patients to other regions if needed, nationally only 5% of ICU units are used for coronavirus cases as of today), specially if the measures start showing signs of stopping the growth (which is why looking at Italy is so important). Take into account the two days we are off due to last Monday’s spike and we would have been in a good position measure-wise without that spike.

I’m not seeing any ‘stable’ increases at all. Spain did not take any responsible measures in a reasonable timeframe, nor did Italy, Germany, Norway France or the UK. Ironically, Italy took the most timely measures of those countries but even then left it far too late.

Estimates at mortality rate are around 1-2% based on the studies I’ve read. Italy is up to 1,441 deaths. It takes between 1-2 weeks from infection to death on average (again, based on the few studies I’ve read). Italy - particularly the north - has an above average health service so you would assume the lower end of mortality. That puts Italy at ~ 75-150,000 infections 1-2 weeks ago when a) schools/unis were still open and sporting events still taking place & b) back when the lockdown was only affecting 61,000 people total.

We knew Italy was the epicentre for transmission of covid-19 in Europe when most countries only had a handful of reported cases. No action at the time was taken to screen travellers, promote self-quarantine on all travellers from Italy or those in contact with them, or more advanced means to target those most at-risk of being infected (e.g. https://www.businessinsider.com/coronavirus-taiwan-case-study-rapid-response-containment-2020-3?r=US&IR=T )

I’m meant to be flying to Lisbon on Thursday 🙄

[Juan_Raigada]

@kedaha

Estimates at mortality rate are around 1-2% based on the studies I’ve read. Italy is up to 1,441 deaths. It takes between 1-2 weeks from infection to death on average (again, based on the few studies I’ve read). Italy - particularly the north - has an above average health service so you would assume the lower end of mortality. That puts Italy at ~ 75-150,000 infections 1-2 weeks ago when a) schools/unis were still open and sporting events still taking place & b) back when the lockdown was only affecting 61,000 people total.

1-2% mortality is at non.saturated health system levels (it’s more like 2-3% in an average European population pyramid). It jumps to 5% to 10% in saturated conditions, heavily dependent on age of population. It is not clear standard of care helps much except having access to a ventilator, so how good a health system is matters only mostly in reach at this point.

Italy’s healthcare is saturated in Lombardy and their population is really old. The virus first hit elderly housing. Thus that’s why you see a higher death rate than expected. You can’t assume 75k infections 1-2 weeks ago from mortality itself. The cases lag the average 5-6 days of symptom onset, but that’s all.

Again, there are very few asymptomatic cases, so as long as the government treats symptomatic cases as cases (for example, Madrid is doing that) the numbers do probably reflect a somewhat close image of the situation at the moment (you can’t detect people in the incubation period). One week ago there where probably about 20-30k cases between symptomatic and pre-symptomatic, because that’s what we have now.

If you compare Italy’s death rate by age to China’s (via the WHO report) you won’t see major differences. It’s just that Italy has many more older people and thus higher overall mortality.

[kedaha]

From The Lancet:

The maximum incubation period is assumed to be up to 14 days, whereas the median time from onset of symptoms to intensive care unit (ICU) admission is around 10 days. Recently, WHO reported that the time between symptom onset and death ranged from about 2 weeks to 8 weeks.

I’ve also seen no studies that suggest a 5-10% mortality rate based on ‘saturated conditions’ - the two primary reasons argued for an apparent declining mortality rate in China are 1) only the most severe cases being admitted (and tested) at the beginning & 2) healthcare professionals unfamiliarity with the new virus

As the Director General of the World Health Organization (WHO), Tedros Adhanom, explained in his briefing “Most people will have mild disease and get better without needing any special care.” Several studies have found that about 80% of all the COVID-19 cases have relatively minor symptoms which end without severe illness and therefore remain unreported.

followed by

other countries include more non‐​severe cases than China does, notably by testing incoming travelers who arrive with a cough and fever. Even after casting a slightly wider net, however, the number of confirmed cases probably captures only about 30% of the actual number.

It’s also a bit disappointing to see you peddling the now thoroughly debunked “very few cases are asymptomatic” argument. The first known transmission of Covid-19 in Europe was an asymptomatic carrier in Germany - https://www.scientificamerican.com/article/study-reports-first-case-of-coronavirus-spread-by-asymptomatic-person/

Or how about this:

Our estimated asymptomatic proportion is at 17.9% (95%CrI: 15.5–20.2%), which overlaps with a recently derived estimate of 33.3% (95% confidence interval: 8.3–58.3%) from data of Japanese citizens evacuated from Wuhan.

From here: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.10.2000180

[magnet]

What all these diagrams have in common:

1. They have no numbers on the axes. They don’t give you an idea how many cases it takes to overwhelm the medical system, and over how many days the epidemic will play out.

2. They suggest that currently, the medical system can deal with a large fraction (like maybe 2/3, 1/2 or 1/3) of the cases, but if we implement some mitigation measures, we can get the infections per day down to a level we can deal with.

3. They mean to tell you that we can get away without severe lockdowns as we are currently observing them in China and Italy. Instead, we let the infection burn through the entire population, until we have herd immunity (at 40% to 70%), and just space out the infections over a longer timespan.

Here is that damn graph again, but finally with some numerical estimates.

Dampening the infection rate of COVID-19 to a level that is compatible with our medical system means that we would have to spread the epidemic over more than a decade

[Teiman]

We are fucked.

[Juan_Raigada]

Dude,

1- Median incubation period is 5.5 days.

2- This is from March 10th, from the head of an Italian Public Health Group. You can find many opinions like this. We might not have a study, but when people die without being to the ICU due to lack of beds, you have to admit there’s an influence in the mortality rate.

Lethality in Italy is higher than China because we are only doing swab tests on patients with symptoms, while we have estimated that asymptomatic cases might be around 15,000 at the moment. We are just scratching the surface of the virus diagnostics here. Also, the 6.1 percent lethality rate registered in Lombardy, shows that the healthcare system no longer holds. More people are dying because the system is saturated.

3- From the same WHO report where the 80% mild cases number comes from

Asymptomatic infection
has been reported, but the majority of the relatively rare cases who are asymptomatic on the date of identification/report went on to develop disease. The proportion of truly asymptomatic infections is unclear but appears to be relatively rare and does not appear to be a major driver of transmission

[Juan_Raigada]

@kedaha

Our estimated asymptomatic proportion is at 17.9% (95%CrI: 15.5–20.2%), which overlaps with a recently derived estimate of 33.3% (95% confidence interval: 8.3–58.3%) from data of Japanese citizens evacuated from Wuhan.

From here: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.10.2000180

Yes, I linked that paper several post above you. That’s the highest estimate we have, and it’s an statistical study. Probably the upper estimate of asymptomatic cases. china reported 1%, Italy is reporting 7%.

The real number could be between 10 and 20%. Which is way too low to justify your crazy math of 75k-150k infected in Italy a week ago.

[kedaha]

You’re assuming that as soon as the incubation period is over, those numbers are being captured by testing. There is no evidence of this.

The WHO said up until recently that there was “No evidence of asymptomatic transmission” - unsurprisingly, their information is lagging too.

The Lombardy quote is arguing that because the death rate appears so high, the healthcare system must be saturated. That’s an irrational argument and a common fallacy.

You are peddling out of date information that’s countered by actual empirical studies on the ground, apparently because people in your family are Doctors and you want to believe that your country’s response is a good one 🙄 Do you not think a Europe-wide flu pandemic is the wrong time to get caught up in nationalist pride and maybe not to peddle bad information online as result?

You’re now arguing that “only asymptomatic patients aren’t getting tested and counted” which is so deluded as to be frightening. Real world evidence suggests that the vast majority of infections in China were never tested and never counted - but you’re arguing the opposite is true in Europe.

The mind genuinely boggles.

My crazy math is the way actual epidemiologists & statisticians try to approximate infections early on, e.g.

Experts say that they compare various lines of evidence. One estimate begins with the number of deaths in an area. Farrar calls this a “guesstimate” because each of the variables researchers are using right now are subject to change, introducing uncertainty at each step in the calculation. However, it goes something like this: Data from China suggest that about three weeks passes between when a person feels sick and dies from COVID-19. And if you assume a case fatality rate of roughly 1%, a back-of-the-envelope calculation suggests that each death represents about 100 cases in the first week. Right now, he adds, you can expect the epidemic to double each week if those cases aren’t identified and isolated — bringing the estimate to 400 at the time of death. Because the error bars on each of these variables are large, epidemiologists check their figures against further information.

Should I be apologetic for having up-to-date information and using the same sort of reasoning that epidemiologists use?