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Posted: **Thu Mar 26, 2020 10:00 am**

Tracking the curve. Just to toot my own horn a bit if you look at the beginning of this thread I was the most pessimistic about were this was going. As I said, this doubles every 3 days. I started a spreadsheet in the beginning of March. While we are not tracking exactly to those numbers we are pretty darn close. This is an exponential rate of 31% growth per day: Now clearly we can not sustain this rate. We will run out of people. I created this snapshot before we did any significant testing. So we should see the curve level off. Yet, we have not seen the curve level off. It needs to start soon. So, I ask you, Is the country open by Easter, or are we over a million cases by Easter?

Posted: **Thu Mar 26, 2020 10:08 am**

John, good luck in dealing with it there.

Question: Is your spreadsheet projection for the USA or some other geographical entity?

Posted: **Thu Mar 26, 2020 10:13 am**

I think the Easter time-frame was "aspirational". You are going to need the National Guard and Homeland Security to get some of the patients out. Just shut down whatever the road to Philadelphia is and start sending them.

Posted: **Thu Mar 26, 2020 10:14 am**

USA but the spreadsheet could be used anywhere. For some reason I can't attach it here. If you DM me your email I'll be happy to send it. It's interesting to play with the rate. Even if you raise and lower it just a bit the numbers swing wildly. Exponents are scary things. Once the rate I am showing is too high that is a good thing. hasn't happened yet but it should nudge soon as testing is catching up and the big population centers got hit first. Anywhere that is a port of especially a large air hub got, or will get crushed. That is why Atlanta is feeling it now

Posted: **Thu Mar 26, 2020 10:19 am**

Since testing has been increasing so rapidly over the past week or so, will that drive the chart's numbers in ways not necessarily tied to the extent of the outbreak?

Would a chart of mortality be more accurate, assuming tallying of deaths remains consistent?**

**Yesterday's long discussion in here covered some countries whose counting seems wonky compared to others.

Posted: **Thu Mar 26, 2020 10:22 am**

https://www.tn.gov/health/cedep/ncov/re ... sites.html

"Locations will be added daily. Tennesseans should first call their usual source of care. If an assessment cannot be done in that location, individuals should call the assessment sites prior to going onsite. Most locations do a phone assessment to determine if an in-person assessment or test is needed. Most individuals, particularly those with mild or no symptoms do NOT need a test.

Posted: **Thu Mar 26, 2020 10:26 am**

I only started to track it this way because the I can compare against a good and accurate number. My comparisons are assuming the Johns Hopkins numbers are correct so that is what I compare my numbers against. Ah, so speaking of plagues numbers, Johns Hopkins and Dan there must be a book. Dan likes books. Here is what I believe the best single book on the 1918 Flu The Great Influenza: The Story of the Deadliest Pandemic in History by John M. Barry. Johns Hopkins was all over that too.

Posted: **Thu Mar 26, 2020 10:28 am**

New York (and possibly the Seattle area, parts of California and maybe the New Orleans area?) are the first to deal with full-blown, mature outbreaks. New York may serve as an important indicator for the rest of the nation, as it has some disadvantages, such as population density and earlier onset before drastic countermeasures were imposed. As Italy goes, so goes the rest of the world (hopefully mostly better or much better). As NY goes, so goes the USA (hopefully mostly better or much better). Pulling for Italy and NY.

Posted: **Thu Mar 26, 2020 10:28 am**

ORIGINAL: Cap Mandrake

The Covid 19 genotype maps to bat and pangolin hybridization of the species-specific Cornavirus viral genome.

Somebody in Wuhan thought it was a good idea to eat one of these.

Crikey! There is a documentary on Netflix about smuggling pangolins. I fell asleep part way through, I hope it's not a 'how to'!!!

Posted: **Thu Mar 26, 2020 10:28 am**

ORIGINAL: Chickenboy

I guess that's my point. Little is known about typical 'clearance' of the virus relative to production of detectable antibodies. Is it possible that someone that is seropositive has a titer that is insufficient to protect against future challenges? Yes. Is it possible that someone that thinks they're antibody negative has only started with the disease and therefore hasn't had time to produce a detectable serologic response (this takes several days)? Yes. Is it possible that someone that is antibody positive could be shedding virus? Yes.

*Maybe* paired samples-RT-PCR and simultaneous antibody screening could provide a more useful picture. Antibody positive and simultaneous virus negative is a greater margin of safety IMO.

We run into this from time to time with animal disease outbreaks. Serosurveillance is nice for planned, routine screens of a population for diseases that one should not find antibody (or to quality check vaccination strategies when a titer *is* expected). But there is an inherent delay between the introduction of a pathogen (e.g., avian influenza) and production of detectable antibodies. Depending on the test and the disease, this could be 48-96 hours or more.

Performing antibody serosurveillance as a quasi-realtime diagnostic tool in a rapidly evolving disease outbreak is usually selecting the wrong tool for the task. Unless there was considerable (2+ days) delay in getting antigen testing results back, there are better choices.

Rapid antigen (read: virus) detection kits can be used as a proxy for virus isolation or PCR in a pinch. But antibody detection tests require too many assumptions about temporal exposure to be proactive in a timely fashion, IMO.

Lots of folks / companies trying to dump test kits or treatments or cures on a panicked public. I question the rationale of this antibody detection implementation without deeper thought about whether some better choices may exist.

Is this true of any antibody test? Is it a well understood percentage of results? Would such a test still be useful for determining who *very likely* has immunity?

Thanks.

Posted: **Thu Mar 26, 2020 10:28 am**

ORIGINAL: obvert

ORIGINAL: Cap Mandrake

The first human-derived isolate is from Dec 3, 2019

This does NOT mean the first human infection was from that date. It took some time for the infection to amplify and come to the attention of doctors in Wuhan. It takes 1 or 2 or 3 doctors talking to each other over lunch. "Man that guy could not take a joke! His O2 sat is 95% and then 8 hrs later he is dead!"

I know it sounds cynical but that's how it is....then the second guys says...."Shit, that sounds like SARS!" because he is a bit older and remembers SARS...and then they all leave their food on the table.

They traced case zero to Nov 17. The first case who presented in a hospital which they diagnosed retroactively. I remember distinctly as that is the day my wife returned from a trip to China. However a geneological study on the virus went back to mid-late-October for its origin.

This was some of what fed the hype of it being a military developed virus, as there was a military games in Wuhan in mid-October. Since also disproven.

As I recall reading they do not believe that person was the first infected ("patient zero"), that was simply as far back as they could find.

Posted: **Thu Mar 26, 2020 10:29 am**

Mortality is a lagging indicator and will actually change in the next months and years. Reported infections is probably the best number for predictive analysis

Posted: **Thu Mar 26, 2020 10:35 am**

ORIGINAL: Cap Mandrake

Wow. That sounds near apocalyptic. What about sending hospitalized patients not yet in respiratory failure to outlying hospitals (50-70 miles away..Philadelphia, Baltimore, CT) via ambulance BEFORE they need a vent?.

They will not have the ventilators either soon enough. The war for containment is lost. We barely understand the exact transmission methods and duration on surfaces. We had a few precious weeks and we didn't use them as well as we should of. That is for another time. Again, we lost the containment war. We are on to the next fight

Posted: **Thu Mar 26, 2020 10:38 am**

We've been monitoring this chart of mortality in Italy for quite awhile. It seemed to plateau a few days back, and the Italian members of this group have expressed some degree of confidence that this is the case.

If so, it also bears on related numbers and trends - the exponential increase period in Italy's deaths lasted about two weeks (roughly beginning 3/8). There should also be a correlation between onset of drastic countermeasures and the flattening of the curve. I can't remember exactly when Italy imposed those, but I think around 3/12 or 3/14?) And Italy's outbreak is fairly clumped geographically. There are concerns whether new bell curves will ensue in the other regions.

There are then interesting possible correlations between Italy and China/South Korea, including the limited geographical extent of the outbreaks, the number of days of exponential increases, the effect of drastic countermeasures (which varied in extent from country to country), etc.

For so many reasons, I'm anxious to see Italy's numbers each day (hoping always that the trend is true and not anomalous or deceiving).

Posted: **Thu Mar 26, 2020 10:39 am**

Mortality lags, but you can allow for the lag in the calculations/interpretations.

Pardon my layman's ignorance, but I have much more confidence in the utility and reliability of mortality numbers.

ORIGINAL: JohnDillworth

Mortality is a lagging indicator and will actually change in the next months and years. Reported infections is probably the best number for predictive analysis

Posted: **Thu Mar 26, 2020 10:43 am**

ORIGINAL: JohnDillworth
Be human to each other.

+1

Posted: **Thu Mar 26, 2020 11:14 am**

Digital Dollars.

Posted: **Thu Mar 26, 2020 11:19 am**

Here's South Korea's situation.

When Korea's numbers were first listed here a few weeks ago, the totals included 51 deaths and 118 recoveries. Since then 80 deaths and 4,000 recoveries. Using those two figures yields a 0.2% mortality rate.**

South Korea's daily new case numbers are down but never to zero. Curiously, the number of daily deaths has remained fairly level - fluctuating greatly from day to day but always around 3 to 8.

If a key is flattening out the curve, Korea seems to have accomplished that. Long term, will that be a benefit (I'd think so) or a detriment (a possibility, but isn't it better to deal with small numbers over time, if possible, so that the system isn't overwhelmed and labs can develop vaccines, etc.?)

**That number typically decreases over time.

Posted: **Thu Mar 26, 2020 11:21 am**

ORIGINAL: JohnDillworth

ORIGINAL: Cap Mandrake

Wow. That sounds near apocalyptic. What about sending hospitalized patients not yet in respiratory failure to outlying hospitals (50-70 miles away..Philadelphia, Baltimore, CT) via ambulance BEFORE they need a vent?.

They will not have the ventilators either soon enough. The war for containment is lost. We barely understand the exact transmission methods and duration on surfaces. We had a few precious weeks and we didn't use them as well as we should of. That is for another time. Again, we lost the containment war. We are on to the next fight

Right. The containment fight was lost in December in Wuhan as Chicom authorities tried to cover it up and the WHO was their willing enabler. Now we are on to the ICU bed fight.

Posted: **Thu Mar 26, 2020 11:30 am**

https://www.businessinsider.com/china-v ... srupted-18

Total Cases: 463,761
0.0059% of Humanity

Deaths: 21,089
0.0003% of Humanity

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