Corona Virus

[Ken]

April 21 (Reuters) - U.S. coronavirus deaths topped 45,000 on Tuesday doubling in a little over a week and rising by a near-record amount in a single day, according to a Reuters tally.

Doesn't really seem like it is slowing down.

That's the wrong statistic. Deaths are indicative of transmission from 2 weeks ago (which, of note, was right around the peak in new cases). If you are looking for "slowing down", you want to look at the new cases on a daily basis, which does appear to be slowing down finally.

[Gregg]

That's the wrong statistic. Deaths are indicative of transmission from 2 weeks ago (which, of note, was right around the peak in new cases). If you are looking for "slowing down", you want to look at the new cases on a daily basis, which does appear to be slowing down finally.

Good point. Thank you.

[Sour Masher]

April 21 (Reuters) - U.S. coronavirus deaths topped 45,000 on Tuesday doubling in a little over a week and rising by a near-record amount in a single day, according to a Reuters tally.

Doesn't really seem like it is slowing down.

As Ken said, new cases is the thing to look at to give us hope. Also, I think it is important for us to keep in mind that it is so much slower than it would be without the measures we have put in place. Because I think some of the folks who want to open up early see these numbers and ask, why are we even bothering? The answer is that is we hadn't done what we've done, these numbers would be 5-10 times worse by now.

I fear that the pressure to open up things will win out pretty soon--maybe too soon--because a lot of folks will say, well, it isn't quite as bad as the doomsday folks were saying it could be. But it isn't as bad, yet, precisely because of the measures we have taken! I fear a second wave of this is inevitable as we make the call to open things back up, especially if we are not really careful.

[DMT]

From an infectious diseases expert.

https://amp.cnn.com/cnn/2020/04/21/opinions/bergen-osterholm-interview-two-opinion/index.html

I've come to the point of concluding, let's throw out all the models. They're not helpful because they're causing some to believe the administration is overinflating the numbers of potential cases and deaths. Meanwhile, others conclude the model used by the White House is intentionally underreporting the numbers and they think the administration is trying to downplay this pandemic. It seems that nobody trusts anybody.

There are 320 million people in the United States. If half of them get infected in the next 6 to 18 months, that's 160 million people. The 50% rate of infection over the course of the pandemic is at the low end of my colleagues' consensus on what we can expect to see given the infectiousness of this virus.

Based on what we know from Asia, from the European Union and from the United States, about 80% of these cases will have asymptomatic, mild or moderate illness but won't need professional medical care. About 20% of infected people will seek medical care. That's 32 million people.

Of those, about half will be hospitalized. That's 16 million people. Of those who are hospitalized, about half will actually require some form of critical care. That's 8 million people. About 0.5 to 1% of the total number of 160 million infected people will die. So you have the possibility of at least 800,000 deaths in the US over the next 18 months. This is the number of deaths I'm expecting.

If you don't like the numbers I just used, go ahead and change them however you want. Just provide your justification. We have a long way to go with this pandemic. We just need to make people understand that this is going to be bad until we get a safe, effective and widely available vaccine. It's a sad commentary about our state of affairs that the number of people who die from Covid-19 in the US ranks as one of the top daily causes of death -- on some days it's been ranked higher than heart disease, cancer and accidents. Six weeks ago, it wasn't even in the top 60 causes of deaths.

[Sour Masher]

From an infectious diseases expert.

https://amp.cnn.com/cnn/2020/04/21/o...ion/index.html

His take is a pessimistic one. The whole point of what we are doing is to stop those numbers from becoming a reality. If he really thinks we will get to 800k deaths, it is a compelling case to open things back up just a soon as the trials for that new drug show results and we have enough testing in place. That is basically what he is saying we should do, but in saying that, it seems to be a self-fulling prophesy to this higher death toll. I still believe there are measures we can continue to take that keeps the death count lower than that, even as we open things back up. He may be right that we won't do them, though. He doesn't seem to think we can; he says it would destroy our economy and our country, but I think there is a middle path that is more cautious than the one he says is a middle path. I wouldn't call a path that leads to herd immunity before we get a vaccine (that is what over 160 million infections would likely lead to) is any kind of middle path. We should be able to slow this thing enough so that we get a vaccine well before the majority of people get this thing, or what's the point of it all, really?

[DMT]

Except none of this is true if we keep social distancing, which the author really should have made clear, or what is the point of us doing any of this? This is a good reminder of what would have happened if we did nothing, for sure, and I think we need that reminder. But if half of us will get this and 800k will die despite us doing all of this, then there is no point in doing any of it. The whole point of the tremendous hit we are taking economically is to reduce the number of people who get this from 160 million to a small fraction of that, to hold down the numbers until we can get a vaccine.

I didn't get that. Social distancing slows the spread, yes, but there are going to be multiple waves. And, we can only hope there will be a vaccine, certainly no guarantee. They still haven't found a vaccine for HIV, though they have developed ways to prevent and manage so it's not a death sentence.

[Sour Masher]

I didn't get that. Social distancing slows the spread, yes, but there are going to be multiple waves. And, we can only hope there will be a vaccine, certainly no guarantee. They still haven't found a vaccine for HIV, though they have developed ways to prevent and manage so it's not a death sentence.

Yeah, I posted that before reading it all. I revised my claim. I don't agree with his argument, his "middle path." If it leads to over half of us being infected in the next year, it doesn't do enough. Simply accepting this rate of infection seems to be serving his underlying argument that we need to give up on what we are doing now to open things up but be careful so as to keep the infection rate a bit slower. He is playing the centrist/reasonable one card, but it is an argument that, by his own admission will lead to over 160 million infected and 800k dead. he is really just arguing to open things up here, because we have no hope to stop most people from getting this. I think other countries are showing us this is not inevitable. We don't have to accept that most of us are going to get this before we get a vaccine.

HIV is a different type of disease. We will be able to get to a vaccine for this. It may mutate after that, but then we will just develop a new vaccine, like we do for the seasonal flu.

[DMT]

Yeah, I posted that before reading it all. I revised my claim. I don't agree with his argument, his "middle path." If it leads to over half of us being infected in the next year, it doesn't do enough. Simply accepting this rate of infection seems to be serving his underlying argument that we need to give up on what we are doing now to open things up but be careful so as to keep the infection rate a bit slower. He is playing the centrist/reasonable one card, but it is an argument that, by his own admission will lead to over 160 million infected and 800k dead. he is really just arguing to open things up here, because we have no hope to stop most people from getting this. I think other countries are showing us this is not inevitable. We don't have to accept that most of us are going to get this before we get a vaccine.

HIV is a different type of disease. We will be able to get to a vaccine for this. It may mutate after that, but then we will just develop a new vaccine, like we do for the seasonal flu.

It's already mutating. And he said doing nothing would result in millions of deaths so I didn't get the sense he's pushing for opening everything up. It's just a sober realization that this is way worse than most people are acknowledging, led by fuckhead. We're going to be at 100K deaths very soon, predicting 800K over the next eighteen months seems about right IMO.

[Sour Masher]

I mean, his take was basically my initial take about a month ago. But I've come around, looking at some other countries, and our own efforts to slow this thing, that it is possible we can keep numbers down enough to the time we get a vaccine that half this country getting infected and 800k dead are not inevitable numbers. What he is arguing for is basically choosing economic well being over additional shut downs. Maybe that is the right move, but it is hard for me to accept a path that leads to that many dead when evidence suggests we absolutely can get that number much lower. But maybe the economic hit we take by saving more lives is too great.

[Sour Masher]

It's already mutating. And he said doing nothing would result in millions of deaths so I didn't get the sense he's pushing for opening everything up. It's just a sober realization that this is way worse than most people are acknowledging, led by fuckhead. We're going to be at 100K deaths very soon, predicting 800K over the next eighteen months seems about right IMO.

I just looked it up and saw the new data that shows the extend of the mutations. Well, shit. That sucks. That makes it more likely that we are looking at a vaccine similar to our annual flu vaccine, one that only protects us from about half the mutations, and we need to get annual shots. My understanding is that is the worst case, though. This isn't like HIV. But that is still really depressing. But it also means say goodbye to herd immunity for this. Damn. If this is true, I guess say hello to COVID-19 being our new reality, just like with colds and flus. I hope the mortality rate falls to their levels as we adapt to this new pathogen.

[Sour Masher]

I just looked it up and saw the new data that shows the extend of the mutations. Well, shit. That sucks. That makes it more likely that we are looking at a vaccine similar to our annual flu vaccine, one that only protects us from about half the mutations, and we need to get annual shots. My understanding is that is the worst case, though. This isn't like HIV. But that is still really depressing. But it also means say goodbye to herd immunity for this. Damn. If this is true, I guess say hello to COVID-19 being our new reality, just like with colds and flus. I hope the mortality rate falls to their levels as we adapt to this new pathogen.

I still hold out hope for a better outcome based on S. Korea and other countries. I know it would be hard, but we need to accept the tracking that S. Korea is doing, even if that freaks us out from a privacy standpoint.

[GwynnInTheHall]

If this indeed goes far into 2021-22 Biden better have a great plan in place to execute day one. And he should be prepared for the place to be trashed because trump isn't doing anything to help a transition.

[chancellor]

It's already mutating. And he said doing nothing would result in millions of deaths so I didn't get the sense he's pushing for opening everything up. It's just a sober realization that this is way worse than most people are acknowledging, led by fuckhead. We're going to be at 100K deaths very soon, predicting 800K over the next eighteen months seems about right IMO.

Hmmm....maybe. Behavior of this virus clearly isn't following norms, and the data we have is extremely jumbled. No one, for example, has been able to explain Honolulu's incredibly low infection and mortality rate. One would think given the high exposure to high risk areas (direct flights from Shanghai, for example, did not end until early Feb.) would have created at least some level of a hot spot.

Beyond a doubt, increased socialization leads to greater first wave infections and deaths. Sweden has taken the tack of allowing for a high level of socialization (much looser than most states in the US); Norway and Finland have taken the tack of severely limiting socialization. Sweden is tracking about 1.8x Norway and Finland for infections and almost the same for deaths on a per capita basis from what I've read. But impact on second/third/fourth wave? Clearly, Sweden's national medical authorities believe that creating a higher level of immunity is critical to future success, while their neighbors disagree. I'd posit that a responsible individual would want to see that data before postulating what the future trends will hold.

[rhd]

I've said this several times before and I'm saying it again because it seems just as valid now as it did before. This pandemic seems to parallel the one in 1918. The mortality rate for the 1918 one is estimated to have been about 2.5%. We don't know what the real mortality rate of CV-19 is and wont for a while but 2.5% seems very realistic. The world rate given by the # of deaths divided by the # of reported cases is 6.96% and the US rate given by this is 5.53%. The "real" rate has been estimated to be as low as 0.5%-1.0% but if that's true I think all that means is there are a ton of mild asymptomatic cases that haven't been reported and why should we be concerned about the mild cases that required little or no special medical care? 2.5% mortality seems very realistic, maybe even conservative. The R-naught (# of new cases caused by existing cases) for the 1918 flu is estimated to be 1.8. I've seen an estimate of 2.0 for CV-19, altho we won't really know this either until later, but this rate also is similar to 1918 flu. The # of the world's population that was infected by the 1918 flu was estimated to be about 28% and that was w/o implementing the preventative tactics that we're using today. I don't know why people are saying that 50%, 60% or even 70% of the world will become infected w CV-19. 30% seems to be the realistic max to me. Rt now, only about 0.25% of the US has been reported infected and only 0.034% of the world. What it means is we'll have to keep practicing social distancing, restricted travel, preventative facewear and good hygiene for an extended period. Which could be up to 2 years (that was about how long the 1918 pandemic lasted). The total deaths from the 1918 flu was estimated to be 500,000-675,000 in the US and 17 mil-to 100 mil in the world, altho 50 mil is the figure I've seen most often. I've said before that a realistic estimate for the US death total is 500,000-1 mil and that still seems realistic altho I'm more optimistic it will be at the lower end of that range now. I would say from 20 mil-50 mil deaths for the world, altho we may never get reliable figures from some countries.

A key factor will be what happens when the world starts opening up again. You cant trust info from places like China, so it will be interesting to see what happens in the western democracies when they open up again. That's the wild card in this whole thing.

[nots]

Hmmm....maybe. Behavior of this virus clearly isn't following norms, and the data we have is extremely jumbled. No one, for example, has been able to explain Honolulu's incredibly low infection and mortality rate. One would think given the high exposure to high risk areas (direct flights from Shanghai, for example, did not end until early Feb.) would have created at least some level of a hot spot.

Beyond a doubt, increased socialization leads to greater first wave infections and deaths. Sweden has taken the tack of allowing for a high level of socialization (much looser than most states in the US); Norway and Finland have taken the tack of severely limiting socialization. Sweden is tracking about 1.8x Norway and Finland for infections and almost the same for deaths on a per capita basis from what I've read. But impact on second/third/fourth wave? Clearly, Sweden's national medical authorities believe that creating a higher level of immunity is critical to future success, while their neighbors disagree. I'd posit that a responsible individual would want to see that data before postulating what the future trends will hold.

Just a follow up: it’s been 3 days since Oahu had a recorded case and the entire state has had less than 100 hospitalizations collectively. Given they are a crossroads for traffic coming from both NA and Asia, this makes little sense.