OT: Coronavirus 2, the No Politics Version

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ORIGINAL: Canoerebel

We've all been there (or will get there). Each nation (and, here, each state, city and county) has to decide when it's prudent to ease restrictions and what's economically necessary. Tough balancing act. It seems like Erik is satisfied that this has to happen now in UK. It seems like John is satisfied that NY has done about as well as it could. And you know I'm pleased with the response by Georgia and my local county.

Seems like we're all glad we live where we live and wouldn't want others from far away deciding how we should do things.

Well, the balancing act has to be based on something tangible. The prevalence of the disease can't be completely ignored in order to prioritise the economy, or you get what happened to the UK in the first wave. At the same time there is a moment where the case load reaches a more maneageable point and you can more safely open risky parts of the economy, which is imperative in order to get people working and stave off the other negative effects of lockdowns.

I'm not at all happy with the response so far from the UK government, and I'm very happy with how many other places have dealt with this. South Korea, Germany, Taiwan, etc.

The point of the my rambling post is that opening and restrictions should be balanced with the actuality of known case numbers and hospital inputs (as well as predicted asymptomatic cases) in each regional area, knowing what we know about how outbreaks spiral upward and asymptomatic cases abound.

Many states in the US and some countries in the rest of the world aren't using the now established best practices to fight this disease. John Dillworth was pointing this out.

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ORIGINAL: JohnDillworth

ORIGINAL: Canoerebel

We've all been there (or will get there). Each nation (and, here, each state, city and county) has to decide when it's prudent to ease restrictions and what's economically necessary. Tough balancing act. It seems like Erik is satisfied that this has to happen now in UK. It seems like John is satisfied that NY has done about as well as it could. And you know I'm pleased with the response by Georgia and my local county.

Seems like we're all glad we live where we live and wouldn't want others from far away deciding how we should do things.

.

I guess that is the distinction. While things have quieted down in my little village by the sea I am concerned for the entire country in particular, and the world in general. We are fighting thousands of little battles instead of one great war if we let "Each nation (and, here, each state, city and county)" decide what is best for themselves. I submit that a unified, national, response would be be a better way to attack a global pandemic that have every county do their own thing.

Regional approaches are actually quite effective if they look at what is working elsewhere. With a novel disease it makes a lot of sense that each country is doing something different. Where decisions have gone wrong it has usually been not acting on current understandings early enough.

If there was a WHO directed worldwide response, and each country adhered rigidly to that I think we wouldn't also get the extreme success stories of SK and Germany, which have their own methods that have been matched with available resources and cultural abilities and constraints.

Some of what happened early on everywhere could have been avoided if all just locked down before the crisis was established, and some countries actually did that. They're actually doing very well now. Humans respond better to tragedy though, and it was really only after news from Italy that most began to take this seriously to some degree.

[JohnDillworth]

ORIGINAL: obvert

ORIGINAL: JohnDillworth

ORIGINAL: Canoerebel

We've all been there (or will get there). Each nation (and, here, each state, city and county) has to decide when it's prudent to ease restrictions and what's economically necessary. Tough balancing act. It seems like Erik is satisfied that this has to happen now in UK. It seems like John is satisfied that NY has done about as well as it could. And you know I'm pleased with the response by Georgia and my local county.

Seems like we're all glad we live where we live and wouldn't want others from far away deciding how we should do things.

.

I guess that is the distinction. While things have quieted down in my little village by the sea I am concerned for the entire country in particular, and the world in general. We are fighting thousands of little battles instead of one great war if we let "Each nation (and, here, each state, city and county)" decide what is best for themselves. I submit that a unified, national, response would be be a better way to attack a global pandemic that have every county do their own thing.

Regional approaches are actually quite effective if they look at what is working elsewhere. With a novel disease it makes a lot of sense that each country is doing something different. Where decisions have gone wrong it has usually been not acting on current understandings early enough.

If there was a WHO directed worldwide response, and each country adhered rigidly to that I think we wouldn't also get the extreme success stories of SK and Germany, which have their own methods that have been matched with available resources and cultural abilities and constraints.

Some of what happened early on everywhere could have been avoided if all just locked down before the crisis was established, and some countries actually did that. They're actually doing very well now. Humans respond better to tragedy though, and it was really only after news from Italy that most began to take this seriously to some degree.

look at what is working elsewhere.

Well that is kind of the key now isn't it? Look around, emulate what was successful. I submit New York and Western Europe (not you Sweden!) were successful in flattening the curve. Many parts of the United States, have not been successful and continue to not be successful. Yet they continue to do what has not worked and they are getting the same unsuccessful results. Step 1 is admitting you have a problem.

[BBfanboy]

The recent outbreaks in Germany show a determination to trap and crush the epidemic there. A meat processing plant suddenly showed 1500 cases out of 7000 workers and Merkel sent in the army to lock down the plant and enforce a quarantine of workers and their families and the immediate shops in the area where workers families would have contacted the local population. Heavy handed but necessary. The soldiers were required because many of the workers are itinerants who do not speak German so they were not understanding what was happening with the lockdown and violated the quarantine at first. They also were very poor and had no savings to buy groceries. I think the Germans have addressed those problems now.

The other outbreak was in a tall apartment building which was isolated with an enforced quarantine for entry/exit. I presume testing on the spot would play a role in letting people out of the building.

So there will be hot spots but the government needs to be strong-willed about containing them even at political cost.

[Sammy5IsAlive]

ORIGINAL: JohnDillworth

ORIGINAL: obvert

ORIGINAL: JohnDillworth

.

I guess that is the distinction. While things have quieted down in my little village by the sea I am concerned for the entire country in particular, and the world in general. We are fighting thousands of little battles instead of one great war if we let "Each nation (and, here, each state, city and county)" decide what is best for themselves. I submit that a unified, national, response would be be a better way to attack a global pandemic that have every county do their own thing.

Regional approaches are actually quite effective if they look at what is working elsewhere. With a novel disease it makes a lot of sense that each country is doing something different. Where decisions have gone wrong it has usually been not acting on current understandings early enough.

If there was a WHO directed worldwide response, and each country adhered rigidly to that I think we wouldn't also get the extreme success stories of SK and Germany, which have their own methods that have been matched with available resources and cultural abilities and constraints.

Some of what happened early on everywhere could have been avoided if all just locked down before the crisis was established, and some countries actually did that. They're actually doing very well now. Humans respond better to tragedy though, and it was really only after news from Italy that most began to take this seriously to some degree.

look at what is working elsewhere.

Well that is kind of the key now isn't it? Look around, emulate what was successful. I submit New York and Western Europe (not you Sweden!) were successful in flattening the curve. Many parts of the United States, have not been successful and continue to not be successful. Yet they continue to do what has not worked and they are getting the same unsuccessful results. Step 1 is admitting you have a problem.

I think that is a bit of a weird way to look at it? NYC/Italy/Spain/UK all show a big drop in cases precisely because things got so bad in the first places. There are plenty of extenuating circumstances that we can discuss but that does not represent success.

Other states in the US locked down much earlier comparatively. But they can't remain in that situation for ever waiting for a vaccine.

Where I probably agree with you more is at least from a UK perspective there has been very little reflection on what has worked well elsewhere. We've had 2 months at least to look at things and try and replicate those approaches but no we find ourselves basically crossing our fingers and hoping for the best.

[RangerJoe]

ORIGINAL: JohnDillworth

ORIGINAL: Canoerebel

Wait....

New York set the standard on how to handle this? [&:] [X(]

I'd rather follow the lead of Arkansas. [:)]

New York went from worst to pretty much first. Arkansas has a much higher R-T value as of yesterday. New York has flattened the curve, Arkansas has not. Not really following your logic. New York and Western Europe got absolutely crushed and now are in much better shape than the rest of the United States, particularly the South. So why not follow that model? I understand I might have to go to Georgia for an "essential tattoo" but other than that I think New York is doing a heck of a lot better than Dixie

I think that is because so many vulnerable people in New York have already died.

[JohnDillworth]

Speaking of Arkansas.........New York State just hung a quarantine on them because they are a hot spot

https://www.ky3.com/content/news/NY-NJ-Conn-to-quarantine-visitors-from-worse-off-states-including-Arkansas-571464421.html

[USSAmerica]

ORIGINAL: Canoerebel

The situation in the US is interesting and counterintuitive. Something has to give, soon.

1. The 7-day rolling average continues its long decline. That's good.
2. The 7-day rolling average of new cases is increasing, as the improving situation in NY and vicinity is more than countered by increases elsewhere. That's not good.
3. With cases rising, how can mortality be dropping? If it's the lag period, then mortality will soon increase. The gradual decline in new cases ended about two weeks ago, so rising mortality should kick in soon, if there's a correlation (as you'd expect).
4. Cases have been rising in Georgia since about May 25, but mortality continues to decline steadily. If there is a lag in Georgia, it's nearing a month. That's long enough to begin to strain credibility.
5. Could the new cases be more often asymptomatic or mild, so that not as many are hospitalized or dying? Maybe. In my county, we've had a steady increase in new cases over the past month or more, but the number of hospitalizations is holding steady at seven. Ditto total mortality at 15 (no new deaths since late May).

But maybe this county and state are outliers, the data flattering only to deceive. We should know soon - local, state and nationwide.

Dan, I think part of the disparity can be explained by the high concentration of cases in the NYC area and others that overwhelmed their medical systems back in April. I believe that many of those deaths could have been avoided if the capacity to treat them properly was available. Despite the widespread rising case numbers now, they are just that... widespread.

Using NC as an example, we have had record numbers of COVID-19 hospitalizations for the last week or more, with the numbers still slowly climbing. Despite that, we are still at no more than 10% of the ICU bed capacity in the state. Everyone who needs medical care has it available, for now and likely for a long time, in NC.

So, I think the 7 day moving average of Daily Deaths is decreasing toward something resembling the actual mortality rate of the virus from it's inflated earlier peak.

[sPzAbt653]

Local Radio here in Baltimore opened this morning reporting that spikes all across the country are attributed to the Memorial Day activities.

There has been talk for many years that it would take a world wide problem to unite all countries. It's a laughable premise, how could anyone make such a silly statement? We've had global issues for eternity and still no unity. One of my favorite films, Arrival [2016] with the great actress Amy Adams the great actor Forest Whitaker, covers it a bit.

What did happen in Sweden? I never followed it.

[JohnDillworth]

ORIGINAL: USSAmerica

ORIGINAL: Canoerebel

The situation in the US is interesting and counterintuitive. Something has to give, soon.

1. The 7-day rolling average continues its long decline. That's good.
2. The 7-day rolling average of new cases is increasing, as the improving situation in NY and vicinity is more than countered by increases elsewhere. That's not good.
3. With cases rising, how can mortality be dropping? If it's the lag period, then mortality will soon increase. The gradual decline in new cases ended about two weeks ago, so rising mortality should kick in soon, if there's a correlation (as you'd expect).
4. Cases have been rising in Georgia since about May 25, but mortality continues to decline steadily. If there is a lag in Georgia, it's nearing a month. That's long enough to begin to strain credibility.
5. Could the new cases be more often asymptomatic or mild, so that not as many are hospitalized or dying? Maybe. In my county, we've had a steady increase in new cases over the past month or more, but the number of hospitalizations is holding steady at seven. Ditto total mortality at 15 (no new deaths since late May).

But maybe this county and state are outliers, the data flattering only to deceive. We should know soon - local, state and nationwide.

Dan, I think part of the disparity can be explained by the high concentration of cases in the NYC area and others that overwhelmed their medical systems back in April. I believe that many of those deaths could have been avoided if the capacity to treat them properly was available. Despite the widespread rising case numbers now, they are just that... widespread.

Using NC as an example, we have had record numbers of COVID-19 hospitalizations for the last week or more, with the numbers still slowly climbing. Despite that, we are still at no more than 10% of the ICU bed capacity in the state. Everyone who needs medical care has it available, for now and likely for a long time, in NC.

So, I think the 7 day moving average of Daily Deaths is decreasing toward something resembling the actual mortality rate of the virus from it's inflated earlier peak.

At no time were New York hospitals overwhelmed. At no time was a bed or treatment unavailable. No one in New York did not get a bed if they needed one. No one in New York was denied a ventilator. New York got killed because we thought we had a couple more weeks only to learn the virus was already here for a month plus density. There is not other place in the country as dense as NYC, particularly the neighborhoods that got hit hardest.

[JohnDillworth]

ORIGINAL: sPzAbt653

Local Radio here in Baltimore opened this morning reporting that spikes all across the country are attributed to the Memorial Day activities.

There has been talk for many years that it would take a world wide problem to unite all countries. It's a laughable premise, how could anyone make such a silly statement? We've had global issues for eternity and still no unity. One of my favorite films, Arrival [2016] with the great actress Amy Adams the great actor Forest Whitaker, covers it a bit.

What did happen in Sweden? I never followed it.

I suspect that is partially true but if Memorial Day is the entire cause then we should be expecting one hell of a spike in a couple of weeks because of the protests. No sign of anything so far but the critical mass of gestation seems to be longer than previously thought.

Arrival was a fantastic film. It took about 24 hours after seeing it before I completely comprehended the story I had been told. A masterpeice

[BBfanboy]

ORIGINAL: JohnDillworth
At no time were New York hospitals overwhelmed. At no time was a bed or treatment unavailable. No one in New York did not get a bed if they needed one. No one in New York was denied a ventilator. New York got killed because we thought we had a couple more weeks only to learn the virus was already here for a month plus density. There is not other place in the country as dense as NYC, particularly the neighborhoods that got hit hardest.

When NY got hit, testing was nearly non-existent because few were available and what was available was terribly inaccurate. Thus it was hard to get a handle on what was happening. We also had little info in the symptoms, the speed of transmission, the gestation period and arc of the infection in people at various ages. So NY was the experimental lab for North America and had to sort out the cacophony of info/disinfo coming from other places in the world that had it already. Then there was the shortage of PPE and the need to come up with temporary fixes to handle it. (Did that mask sterilizer truck ever get put to use?)

I think NY handled it well considering the obstacles it had. Many of those obstacles have been reduced or removed for current responses so I am less inclined to rationalize their spikes as "beyond their control". BTW, that applies in Canada as well - some areas have done better than others.

[Canoerebel]

Very good news today. IHME has taken a hard look at the data and concluded that rising cases don't much correlate to an increase in mortality.

IHME's projections dropped US mortality by 10%, to about 179k. Georgia dropped a whopping 40%, from 10k to 6k. Many other states also dropped, but not all of them.

These drops assume that the protocols as they are now remain in place. If additional countermeasures are instituted, mortality will drop even further. All this is a major change. It would be fascinating to know what thinking went into such a major change in outlook.

Apparently, a great deal of the rising cases are indeed asymptomatic or young folks that aren't in danger of expiring.

Many of the states that eased countermeasures early on are still doing well, despite rising positives. States like Tennessee, North Carolina, Colorado, Arkansas, and Maine are doing very well. Montana is a standout. [:)]

[Sammy5IsAlive]

ORIGINAL: Canoerebel

Very good news today. IHME has taken a hard look at the data and concluded that rising cases don't much correlate to an increase in mortality.

IHME's projections dropped US mortality by 10%, to about 179k. Georgia dropped a whopping 40%, from 10k to 6k. Many other states also dropped, but not all of them.

These drops assume that the current protocols remain in place. If additional countermeasures are instituted, mortality will drop even further.

Apparently, a great deal of the rising cases are indeed asymptomatic or young folks that aren't in danger of expiring.

Many of the states that eased countermeasures early on are still doing well, despite rising positives. States like Tennessee, North Carolina, Colorado, Arkansas, and Maine are doing very well. Montana is a standout. [:)]

A revision downwards is always good news and should be celebrated as such.

I would urge some caution though - we have been here before a couple of months ago with their model. IIRC there was a point where their projection got down to c.60k deaths by August and there were suggestions that the downward trend might continue to bring the 'real' numbers even below that. In hindsight it is apparent that those projections were a long way off the mark. The US is at 125k deaths in June.

The mask issue is worthy of comment also - they seem to be modelling 30-35k deaths saved nationwide if the public wear masks.

At the moment they haven't released the commentary to the update - it's only then that you can get into the nuts and bolts of their projections.

But I'll repeat once more - whilst we should always treat 'good news' (and 'bad news') critically it is always better to have good news with a margin of error than bad news with a margin of error

[Canoerebel]

Yeah, IHME has been all over the place. Some here have noted that can be an attribute. I'm more inclined to view it as not so good.

But you'd think with this much more time under their belts, they'd be working awfully carefully. To lower mortality projections in the face of increasing case numbers and the caterwauling of the press is a major step to take.

Moreover, it holds true with the trend in data coming in, especially from the states that eased measures early on. Georgia did so two months ago but is experiencing a steady decline in mortality. That's very encouraging but hard to register on the public radar given what's coming from the press.

[Sammy5IsAlive]

ORIGINAL: Canoerebel

Yeah, IHME has been all over the place. Some here have noted that can be an attribute. I'm more inclined to view it as not so good.

But you'd think with this much more time under their belts, they'd be working awfully carefully. To lower mortality projections in the face of increasing case numbers and the caterwauling of the press is a major step to take.

Moreover, it holds true with the trend in data coming in, especially from the states that eased measures early on. Georgia did so two months ago but is experiencing a steady decline in mortality. That's very encouraging but hard to register on the public radar given what's coming from the press.

Out of interest is anybody else publishing 'real time' (in the loosest sense) projections in the way that IHME are doing?

[CaptBeefheart]

A personal update from Korea as life returns to normal: The Canadian Chamber of Commerce held a networking event last night at the Four Seasons Hotel in town. It was supposed to be a rooftop event, but since it was raining, it went indoors. Maybe 100 people were there, including the Canadian ambassador. Since people were drinking beer or wine, the masks were generally off. Some people even tried to shake my hand, although I begged off stating my wife works in a hospital (and thus absolutely can't be getting Covid). Fist bumps work for me. As usual for this kind of event, people exchanged business cards. I hit up the hand sanitizer several times during the festivities.

The American Chamber had a ball at the Hyatt on June 12 attended by 400 people. I didn't attend, since I've got better things to spend $400 on, like 10 Matrix games. Anyway, if there was any kind of an outbreak from that event, I think we'd have heard about it by now.

A European embassy is thinking of hosting a trade event in Seoul in September. I hope they go through with it. The problem is will any business people come from the home country if they have to quarantine for two weeks. The answer is undoubtedly "no." The embassy guy I talked to yesterday said they are going to see if they can work out some sort of quarantine exemption with the Korean government. He also told me diplomats and their spouses and dependents are exempt from the quarantine. He had to take a Covid test upon arrival here in Korea but was free to go home even before the results were known. At some point I think business people will have to get similar exemptions. As the embassy guy said, he has companies back home interested in doing business in Korea, but that won't happen until they have face-to-face meetings, eat some BBQ and drink soju (Korean firewater) with potential business partners. Zoom can only do so much.

Cheers,
CB

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One of the issues with this virus is the potential for long term complications. I just spoke to a parent of one of the kids in nursery and he had Covid early on (which it might have been good to know earlier, since our children were in constant close contact during that time). He is fine, but a work colleague who he might have contracted it from ha had severe complications. He has had inflammation of the heart.

Mortality is certainly the outcome we most want to avoid, but large amounts of cases in the population may cause long term affects in those who don't die as well. As always, the best case scenario is to limit cases until we know more and there are more effective treatments or vaccines.

https://www.gavi.org/vaccineswork/long- ... s-covid-19

THE LONG-TERM OUTLOOK FOR COVID-19

A striking feature of COVID-19 is how long the symptoms can last. Early in the pandemic, initial medical advice on recovery times for mild COVID-19 had suggested 1-2 weeks. However, many people have seen symptoms last for 8 to 10 weeks or longer, and symptoms can seem to go away only to come racing back. A research group at King’s College London, UK, developed a COVID-19 tracker app for people to record their symptoms daily, and estimated 200,000 have been reporting symptoms for the entire six weeks since the tracker was launched.

Many people had a pattern of symptoms, where their symptoms were heightened initially, nearly disappeared, then returned again with ferocity, along with a very wide range of symptoms.

A key question is what is causing the recurring symptoms – i.e. whether it is reactivation of a persistent infection, reinfection (which seems unlikely based on current data), or whether the person has become infected with another virus or even bacteria as their immune system is still recovering.

Given the multi-organ effect of COVID-19 on the body, survivors may have a variety of long-term effects on their organs, including what some doctors are calling ‘post-COVID lung disease’. Looking at the organs that are affected during infection could give an idea of where the long-term effects on the body are likely to manifest.

As we are still in the throes of the pandemic, and at a relatively early stage of a new disease, it is too early to tell what COVID-19 survivors are likely to experience in a year’s time.

Some researchers are concerned, however, that just as with SARS, many people with the new coronavirus will go on to develop post-viral chronic fatigue syndrome.

[fcooke]

ORIGINAL: Sammy5IsAlive

ORIGINAL: Canoerebel


Seems like we're all glad we live where we live and wouldn't want others from far away deciding how we should do things.

From a UK perspective I'm not sure I'd go that far. A while back our government set out 'alert levels' that were supposed to link the progress of the epidemic with corresponding levels of response in terms of social distancing measures. As far as I am concerned we seem to be racing well ahead of that road map and without the testing and tracing system that we had previously been told would be the cornerstone of being able to open up safely.

But I think the reality is that we are taking the only course of action available - the economy simply cannot afford to continue paying for lock-down. What frustrates me is that there is no transparency - so we are not only opening up prematurely from a public health perspective but also not giving people the appropriate information in terms of the ongoing risks to encourage them to continue to take informal social distancing measures. I don't know what it's like north of the river but in South London everything seems to have broken down. People have been told it is safe to go back to normal and that is precisely what they are doing. Edit - this is actually perhaps harsh on the govt. who have been paying lip service to the importance of maintaining social distancing. I think my issue is more that they know what the fundamental message is that people will be taking and are being reckless to this - see for example this article by a behavioural scientist https://www.theguardian.com/commentisfr ... wn-england

The other point for me is that whilst we are now probably taking the only available course of action economically, as things stand the examples of other countries both elsewhere in Europe and further afield suggest that we didn't have to be in this position in the first place had we reacted quicker.

On both counts it seems to me that the US is in a similar position.

I'm happy to live where I live for lots of other reasons. I'd be much happier if I could add to those reasons a government that had reacted well to this epidemic.

Where exactly south of the river? Lots of good boroughs down there....some still working on improving. Just curious. When I lived in London I was north of the river.

[BBfanboy]

obvert: Many people had a pattern of symptoms, where their symptoms were heightened initially, nearly disappeared, then returned again with ferocity, along with a very wide range of symptoms.

That seems to fit with the research that shows the virus developing new strains quite quickly, probably as the body neutralizes the initial infection. Another reason why I think we will be fighting this beast for a long time. I know vaccines try to target immunity to some key, immutable characteristic of the virus but sometimes the best we can come up with is a vaccine that targets an RNA bit that can mutate.