patrick.net

I doubt this curve will flatten by 9000 people (the 0.0003 cited above). The steepness of our death rate and the lack of flattening are far worse than China at this point, three weeks past the 20-death mark.



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nginx/1.6.2

Heraclitusstudent says

Reality says

Social-distancing and shutting down the economy were supposed to "flatten the curve," not reducing the total number of infections/exposures.

BS You flatten it until a vaccine.
If your assumption is 70% of people will get it anyway, then the toll will be close to 2 millions regardless of everything.

Utter nonsense! Read up what "flatten the curve" means. It doesn't affect the total infection/exposure count, but only the speed at which infections/exposure take place, hoping to limit it to the hospital capacity. What the hospital-worshipers failed to take into account is that hospital intensive care only cures less than 10% of cases that require that kind of intensive care, so fitting the hospital capacity is a meaningless goal except for maximizing medical bills on the population!

When a virus has natural R0=3, then 66%-70% of the people will have to be infected/exposed to the virus before herd immunity is sufficient to stop the virus. That's just basic math / medical knowledge. Exposing 66-70% of the US population to the virus doesn't mean 2 million dead because the actual case fatality rate is much much lower than what they had thought initially. The original 2mil number came from 1% fatality assumption (66-70% of 300+mil is about 200+mil, and 1% of that is 2+mil). The fact that most people exposed to it are non-symptomatic and there already being a large immune population (Diamond Princess showing only 20-30% positive instead of 100% positive after mingling for weeks if there were no existing immunity) is indicating that the actual fatality rate is 0.1% or lower.

The countries with success in flattening the curve (and not initiating steep death rates from the outset) are all east Asian: China, Japan, Korea, Singapore, Taiwan, Hong Kong.

In contrast to the West, they have widespread use of 1) masks, 2) testing, 3) medication (HCQ for one), 4) selective quarantine of the positive cases -- not economic destruction via mass quarantine. China's mass quarantine lasted 3 weeks, then the economy restarted. Ours has no end in sight.

CDC is asleep at the wheel here with their OCD handwashing / social avoidance campaign, and nothing else from the above list.

Reality says

Utter nonsense! Read up what "flatten the curve" means. It doesn't affect the total infection/exposure count, but only the speed at which infections/exposure take place, hoping to limit it to the hospital capacity.

Thank you Reality.

What you've just done is teach our resident faux intellectual, the concept of integral calculus.

In other words, when one adds all the incremental volumes under a rate curve, one gets a summation, or an integration, which is the total no of cases. The longer the 'curve' stays flat, the longer it takes for the larger population to get exposed to the virus and thus, spares the medical centers from reaching critical mass of patients, both Corona related and non-related, where they can't deliver healthcare to the masses.

Reality says

Utter nonsense! Read up what "flatten the curve" means. It doesn't affect the total infection/exposure count, but only the speed at which infections/exposure take place, hoping to limit it to the hospital capcity.

Yes, that's all we're doing at this point. It's a virus. It doesn't go away. Even with a vaccine, it's not going to be 100% effective. 2M won't die. As more of the sick and elderly die, there's less opportunity for the virus to kill.

People put waaaayyyy too much faith in who they think are "educated" and "know" what they're talking about.

Reality says

When a virus has natural R0=3, then 66%-70% of the people will have to be infected/exposed to the virus before herd immunity is sufficient to stop the virus.

South Korea has stopped the increase in COVID cases without "herd immunity." We know this because their mass testing yielded relatively few positive cases: 338,000 tested and 9600 positive. 133 of those died.

www.youtube.com/embed/gAk7aX5hksU&feature=youtu.be

goofus says

South Korea has stopped the increase in COVID cases without "herd immunity." We know this because their mass testing yielded relatively few positive cases: 338,000 tested and 9600 positive. 133 of those died.

Another medical ignoramus. How does testing stop spreading? It's a virus for crying out loud. 338k is less than 1% of SK population. Did they kill all the 9600 people who tested positive? Did they kill the remaining 50+ million South Koreans waiting to be tested?

South Korea has not stopped the transmission. There is a large number of new cases in Seoul in today's news. What South Korea did accomplish was slowing down the wild-fire hospital spread by forcing all doctors and nurses to wash their hands between patients.

Reality says

goofus says

South Korea has stopped the increase in COVID cases without "herd immunity." We know this because their mass testing yielded relatively few positive cases: 338,000 tested and 9600 positive. 133 of those died.

Another medical ignoramus. How does testing stop spreading? It's a virus for crying out loud. 338k is less than 1% of SK population. Did they kill all the 9600 people who tested positive? Did they kill the remaining 50+ million South Koreans waiting to be tested?

Give me a break. The pomposity. Testing stops spreading because they selectively quarantine those with positive results. Two weeks in-home, with a phone app tracking location. Authorities force them to remain in place, keeping track of (patient-reported) symptoms twice daily, followed by a doctor's visit afterward with tests for COVID antibodies. Those without antibodies are not considered cured.

You think South Korea never initiated the steep death climb because of doctors "hand washing"? You've got to be kidding me. This isn't the middle ages...

goofus says

I doubt this curve will flatten by 9000 people (the 0.0003 cited above). The steepness of our death rate and the lack of flattening are far worse than China at this point, three weeks past the 20-death mark.



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nginx/1.6.2

You are drawing a log chart to mislead.

What is not shown in your log chart is another even faster rising exponential curve of people who have been exposed and survived and therefore immune.

All those exponential curves eventually have to level out to a Gaussian curve due to the large immune population. That's how all contagious disease plot over time.

The longer lock-down takes place, the more weeks it will take before the Gassian curve can flatten

So long as the lock-down is targeted at the rest of the economy instead of targeted at the hospitals, the lock-down policy is actually artificially selecting for the most deadly strains of the virus: the patients suffering from the more deadly strains get to the hospital and can communicate to others (and to medical personnel who then can bring it out to others outside the hospitals), whereas the more benign strains that land on the rest of the population are impeded from spreading. Such a policy will lead to more deaths than not having any intervention at all, where the more deadly strains would have died with the dead people leaving the more benign varieties to survive!

goofus says

a virus has natural R0=3,

Reality doesn't understand that R0=3 is for a given environment, and its value depends heavily on the environment.
There is no such thing as a 'natural R0'.

goofus says

Give me a break. The pomposity. Testing stops spreading because they selectively quarantine those with positive results. Two weeks in-home, with a phone app tracking location. Authorities force them to remain in place, keeping track of (patient-reported) symptoms twice daily, followed by a doctor's visit afterward with tests for COVID antibodies. Those without antibodies are not considered cured.

LOL! You are indeed a medical ignoramus! Those with antibodies would be highly prized because they'd be immune and can care for the sick just like TB facilities/colonies were run a century ago. There isn't a proper Covid-19 antibody test authorized yet. All the widespread tests are testing for antigens. The antigen tests range from 30%-80% in accuracy. You are out of your mind if you think those tests can really lock all infected into quarantine. Even at 80% accuracy, if you get 9600 positives, you are missing close to 2000 via false-negatives. What about the other 99+% (50+ million) of the population that have not yet been tested?

Heraclitusstudent says

a virus has natural R0=3,

Reality doesn't understand that R0=3 is for a given environment, and its value depends heavily on the environment.
There is no such thing as a 'natural R0'.

Stop projecting your own ignorance. "Natural R0" means in the absence of lock-downs. Why is that important? Because you can't lock-down forever. At some point, the lock-down will have to be lifted. If at that point the population doesn't have 66-70% immunity, the virus will spread along the exponential curve (really the left side of a Gaussian curve) until 66-70% immunity is reached, just as if the lock-down had never taken place.

To the extent that the hospitals are left not locked-down whereas the rest of the economy is locked-down, the delay during lock-down would only give the most deadly strains of the virus a Darwinian advantage, effectively artificially select, and to have an initial advantage in numerical percentage when the lock-down is lifted.

Reality says

You are drawing a log chart to mislead.

What is not shown in your log chart is another even faster rising exponential curve of people who have been exposed and survived and therefore immune.

All those exponential curves eventually have to level out to a Gaussian curve due to the large immune population. That's how all contagious disease plot over time.

I've not plotted a log-log plot, which forces a line. This is a log vs time plot, which would exaggerate any positive or negative shift in the rate of change of deaths. We should be seeing a slight inflection downward in the US if even the rate of increase were leveling and we're not (even Italy and Spain, both with parabolic increases in death on a straight plot, have evident downturns on their log vs time plots).

Reality says

LOL! You are indeed a medical ignoramus! Those with antibodies would be highly prized because they'd be immune and can care for the sick just like TB facilities/colonies were run a century ago. There isn't a proper Covid-19 antibody test authorized yet. All the widespread tests are testing for antigens. The antigen tests range from 30%-80% in accuracy. You are out of your mind if you think those tests can really lock all infected into quarantine. Even at 80% accuracy, if you get 9600 p...

"LOL"! OMG.

Look, those without antibodies are not considered cured because this is the group known to relapse. Those with antibodies are medically useful (and their antibodies, through blood samples, are indeed being used to treat COVID patients). You know so very little for one so enthusiastic.

goofus says

I've not plotted a log-log plot, which forces a line. This is a log vs time plot, which would exaggerate any positive or negative shift in the rate of change of deaths. We should be seeing a slight inflection downward in the US if even the rate of increase were leveling and we're not (even Italy and Spain, both with parabolic increases in death on a straight plot, have evident downturns on their log vs time plots).

I never accused you drawing a log-log chart. It was the log-linear chart that you drew that was misleading: exaggerating the early part of what will eventually be a Gaussian curve.

As to why we are not seeing the inflection point yet, you can blame that on the lock-down: lock-down would of course spread the Gaussian curve wider . . . which is exactly what "flatten the curve" was designed / claimed to do.

goofus says

"LOL"! OMG.

Look, those without antibodies are not considered cured because this is the group known to relapse. Those with antibodies are medically useful (and their antibodies are indeed being used to treat COVID patients). You know so very little for one so enthusiastic.

You are once again wrong, and showing your ignorance on the basic medical facts. Those so-called "relapse" is actually indicative that there might be different viruses running around. You can get flu last year, and get flu this year, not due to "relapse" but due to different types of flu infected you.

Reality says

goofus says

"LOL"! OMG.

Look, those without antibodies are not considered cured because this is the group known to relapse. Those with antibodies are medically useful (and their antibodies are indeed being used to treat COVID patients). You know so very little for one so enthusiastic.

You are once again wrong, and showing your ignorance on the basic medical facts. Those so-called "relapse" is actually indicative that there might be different viruses running around. You can get flu last year, and get flu this year, not due to "relapse" but due to different types of flu infected you.

OK, Reality. We'll just agree to disagree on "reality." This has been in the popular press for more than a month:

https://www.usatoday.com/story/news/nation/2020/02/19/coronavirus-after-2000-deaths-can-you-get-virus-again/4804905002/

"The number of confirmed cases in the coronavirus outbreak racing across China and seeping around the globe rolled past 75,700 Wednesday, and though more than 2,100 people have died, many thousands more have recovered.

With no end to the outbreak in sight, health officials grapple with the issue of reinfection – whether people can "catch" the virus again.

Li QinGyuan, director of pneumonia prevention and treatment at China Japan Friendship Hospital in Beijing, said a protective antibody is generated in those who are infected.

"However, in certain individuals, the antibody cannot last that long," Li said. "For many patients who have been cured, there is a likelihood of relapse."

goofus says

You are once again wrong, and showing your ignorance on the basic medical facts. Those so-called "relapse" is actually indicative that there might be different viruses running around. You can get flu last year, and get flu this year, not due to "relapse" but due to different types of flu infected you.

OK, Reality. We'll just agree to disagree on "reality."

There's nothing to disagree. It's the basics of human immunology.

Reality says

That's nothing to disagree. It's the basics of human immunology.

Once again, with prejudice:

https://www.usatoday.com/story/news/nation/2020/02/19/coronavirus-after-2000-deaths-can-you-get-virus-again/4804905002/
With no end to the outbreak in sight, health officials grapple with the issue of reinfection – whether people can "catch" the virus again.

Li QinGyuan, director of pneumonia prevention and treatment at China Japan Friendship Hospital in Beijing, said a protective antibody is generated in those who are infected.

"However, in certain individuals, the antibody cannot last that long," Li said. "For many patients who have been cured, there is a likelihood of relapse."

goofus says

Reality says

That's nothing to disagree. It's the basics of human immunology.

Once again, with prejudice:

https://www.usatoday.com/story/news/nation/2020/02/19/coronavirus-after-2000-deaths-can-you-get-virus-again/4804905002/
With no end to the outbreak in sight, health officials grapple with the issue of reinfection – whether people can "catch" the virus again.

Li QinGyuan, director of pneumonia prevention and treatment at China Japan Friendship Hospital in Beijing, said a protective antibody is generated in those who are infected.

"However, in certain individuals, the antibody cannot last that long," Li said. "For many patients who have been cured, there is a likelihood of relapse."

They are trying to cover up the fact that multiple different viruses escaped from their lab and/or their tests suck. Any first-year student in immunology would know that immunity wouldn't drop within weeks / days. The "replapse" was either due to the shitty tests (30% accuracy) they have indicating false negatives earlier or the patients being infected with a different virus. The "director" was obviously a communist party member paid to lie.

If in fact it escaped from a lab and has an HIV-like insertion (retracted Indian paper from January), then perhaps it responds in atypical ways. One cannot say at this point, particularly not a "first year immunology student" (c.f. --?)

goofus says

If in fact it escaped from a lab and has an HIV-like insertion (retracted Indian paper from January), then perhaps it responds in atypical ways. One cannot say at this point, particularly not a "first year immunology student" (c.f. --?)

HIV replicates very slowly and spreads only through blood on blood contact. Maybe it has or has not a very small component of it, but it's overall a totally different virus.

mell says

HIV replicates very slowly and spreads only through blood on blood contact. Maybe it has or has not a very small component of it, but it's overall a totally different virus.

Agreed, Mell. But COVID nonetheless responds to anti-retroviral medications (along with anti-malarial, anti-Ebola, and a few others). It's a strange bird.

goofus says

If in fact it escaped from a lab and has an HIV-like insertion (retracted Indian paper from January), then perhaps it responds in atypical ways. One cannot say at this point, particularly not a "first year immunology student" (c.f. --?)

A virus is a virus, regardless whether it is natural or man-made. Nobody is alleging the Covid-19 virus destroys the human immune system (especially T-cells) itself like the HIV does . . . if it does, then a vaccine would be quite impossible, even after 40 years!

ThreeBays says

There's so much misinformation here I don't know where to start.

The models Fauci is referring to are known. The 100k to 200k number is only through the end of August while assuming continued social distancing. Following that, they will have to either continue distancing or have a very successful testing and containment strategy for a year until vaccines are approved, or else it'll be another round on the 100k roller coaster.

LOL! Are you not aware that the flu/cold/respiratory infectious disease season is in the winter / low-UV months? Are you not aware that Corona Virus is an RNA virus prone to mutation? Why don't we just lock all those who want and enjoy lock-downs into basements and never let them see any UV . . . they will all die of respiratory infectious disease as they wish.

Reality says

ThreeBays says

There's so much misinformation here I don't know where to start.

The models Fauci is referring to are known. The 100k to 200k number is only through the end of August while assuming continued social distancing. Following that, they will have to either continue distancing or have a very successful testing and containment strategy for a year until vaccines are approved, or else it'll be another round on the 100k roller coaster.

LOL! Are you not aware that the flu/cold/respiratory disease season is in the winter months? Are you not aware that Corona Virus is an RNA virus prone to mutation? Why don't we just lock all those who want and enjoy lock-down into basements and never let them see any UV . . . they will all die of respiratory disease as they wish.

The issue right now is that it's on top of cold and flu season. If you'd take away all the cold and flus for this season the system would be able to handle it, but on top of it, many counties/states run out of hospital beds, workers and equipment.

Muh, area under the curve!

The extreme measures—now known as social distancing, which is being called for by global health agencies to mitigate the spread of the novel coronavirus—kept per capita flu-related deaths in St. Louis to less than half of those in Philadelphia.

ThreeBays says

Reality says

LOL! Are you not aware that the flu/cold/respiratory infectious disease season is in the winter / low-UV months? Are you not aware that Corona Virus is an RNA virus prone to mutation? Why don't we just lock all those who want and enjoy lock-downs into basements and never let them see any UV . . . they will all die of respiratory infectious disease as they wish.

Yeah, it's an RNA virus prone to mutation which makes herd immunity an unreliable strategy. We might get 60% ill from it, and not stop it. Like with the flu, Coronavirus will likely require annual vaccination.

Or it will go the way of the many other known CVs causing colds/flus, seasonal and with a death rate of maybe anywhere between 0.01%-0.25% eventually. We don't know how many have it or had it as many are totally asymptomatic. Those usually don't infect many either, but they can infect some.

mell says

The issue right now is that it's on top of cold and flu season. If you'd take away all the cold and flus for this season the system would be able to handle it, but on top of it, many counties/states run out of hospital beds, workers and equipment.

It's not clear whether Covid-19 is "on top of" or "part of" cold and flu. Italy, the most severe case among countries that we have relatively reliable data, is a country of 60+ million population; that translates to about 600k deaths a year, or close to 2000 per day, and due to the heavy toll of flu and cold it was common for Italy to see 3000+ deaths per day in winter months in years past. At this point, the highest daily Covid-19 death count in Italy has been 900+ deaths, and Italian number is already leveled and turning down, not exactly higher than what the usual cold and flu caused in years past. What is the total death count? Until we see 300+% normal winter daily death count, this Covid-19 thing is little more than a reclassification exercise (considering that CDC claims annual flu death is 20mil to 80 mill, a 300% variation). So far, the only 1mil+ pop statistical unit in the world that has shown 300+% normal winter daily death count is Wuhan; the same has not happened in any other country or city/metro with 1mil+ pop sampling size.

.

Heraclitusstudent says

Reality doesn't understand

Reality says

LOL! You are indeed a medical ignoramus!

Please, keep it about points instead of about people.

Reality says

mell says

The issue right now is that it's on top of cold and flu season. If you'd take away all the cold and flus for this season the system would be able to handle it, but on top of it, many counties/states run out of hospital beds, workers and equipment.

It's not clear whether Covid-19 is "on top of" or "part of" cold and flu. Italy, the most severe case among countries that we have relatively reliable data, is a country of 60+ million population; that translates to about 600k deaths a year, or close to 2000 per day, and due to the heavy toll of flu and cold it was common for Italy to see 3000+ deaths per day in winter months in years past. At this point, the highest daily Covid-19 death count in Italy has been 900+ deaths, and Italian number is already leveled and turning down, not exactly higher than what the usual cold and flu caused in years past. What is the total death count? Until we ...

Right, it's not entirely clear which virus/illness occupies the most hospital beds, but that doesn't matter for the outcome of overloaded hospitals. If in fact CV is that contagious the social distancing makes sense, the total lockdowns are too drastic but can be easily "justified" with the hospital overload (no matter which microbe is more responsible).

EBGuy says

The extreme measures—now known as social distancing, which is being called for by global health agencies to mitigate the spread of the novel coronavirus—kept per capita flu-related deaths in St. Louis to less than half of those in Philadelphia.

The difference was more likely due to difference in population density and Asprin prescription rates. St. Louis was a more frontier city, whereas Philadelphia was much more built-up.

What was remarkable about that chart is that St.Louis had a 2nd peak much higher than the 1st peak due to "social distancing." It's indicative that the lock-down period artificially selected a more deadly strain of the virus for the 2nd outbreak!

Reality says

not having any antibiotic effective against the virus

Um, antibiotics are only effective against bacteria not viruses, so no virus has an antibiotic effective against it.

astronut97 says

Um, antibiotics are only effective against bacteria not viruses, so no virus has an antibiotic effective against it.

Doesn't matter. All the antibiotics have probably been hoarded up already.

mell says

Right, it's not entirely clear which virus/illness occupies the most hospital beds, but that doesn't matter for the outcome of overloaded hospitals. If in fact CV is that contagious the social distancing makes sense, the total lockdowns are too drastic but can be easily "justified" with the hospital overload (no matter which microbe is more responsible).

That is assuming hospital is helpful instead of being of negative value! The only tools that hospitals have (and people can't have at home) are the ventilator and intubation; the survival rate of those are less than 10%! Whereas even in normal years, 100,000 people in the US die of contagious diseases that they pick up from hospitals every year (according to CDC).

The unusually high rate of deaths rate in Wuhan contrasting with everywhere else (including other parts of China) may well be due to the large number of people flocking to the hospitals at the beginning: the hospitals were packed to the walls, with the hallways literally filled along with dead bodies! I was shocked looking at those Youtube videos, and couldn't believe how stupid those people were: sitting next to dead bodies and not realizing the hospital was a contagious disease trap! After three days, those hospitals emptied out, as the lemming crowds figured out it was dangerous to go to a hospital when there is highly contagious disease around. Everywhere else in the world (including other parts of China) had learned that lesson watching Wuhan in those three days.

If there is one place that needs to be locked down, it's the hospitals!

If people can't go to hospital, that might actually be an advantage! Also, when the general society is locked down whereas the hospitals are not locked down, that gives the most deadly strains of virus a big Darwinian advantage in spreading! Making it especially dangerous when the lock-down is lifted . . . just as shown in the St. Louis chart during the 1918-1919 "Spanish Flu"

astronut97 says

Reality says

not having any antibiotic effective against the virus

Um, antibiotics are only effective against bacteria not viruses, so no virus has an antibiotic effective against it.

Actually, the weird thing about azithromycin is that it seems to have some anti-viral effects even though it was designed to work against bacteria.

Booger says

Doesn't matter. All the antibiotics have probably been hoarded up already.

What part of "antibiotics are only effective against bacteria" did you not understand?

ThreeBays says

Here's a 300+% increase during one week.

www.youtube.com/embed/ZCr3ns1yL3Q

Bergamo is a city of 120k, with likely only one burner topping out at 25 bodies to burn per day; the sampling size was way too small. Bergamo is way out in the far ex-burbs of Milan at the foothill and facing water, could be a retirement community.. The same thing is not happening in the nearest metro Milan, pop about 5mil. The very fact that the Lamestream Media can't put forth a bigger sampling size than the tiny town/city with 25 burning capacity is indicative that the same sort of thing is not happening any large metro area other than Wuhan.

They sure tried arranging a whole bunch of caskets for pictures. Obviously people wouldn't randomly put a bunch of caskets on the floor disorganized, and filling them with dead bodies . . . as the bodies would rot! Those pics of disorganized caskets were obvious set up for photo-ops.

That too, but there was also mention of specifically anti-viral activity in a scientific paper.

ThreeBays says

The only tools that hospitals have are the ventilator and intubation; the survival rate of those are less than 10%!

False, the survival is around 50%.

Where are you getting that? The study published in TheLancet with sampling size of 190+ is indicating survival rate of 3-5%! for ventilators and intubation.

Oxygen therapy can be done at home, and likely done much safer at home when there is a contagious disease running rampant in the hospitals