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Coronavirus Coronavirus

04-17-2020 , 04:11 PM
Quote:
Originally Posted by despacito

We can use our prevalence estimates to approximate the infection fatality rate from COVID-19 in Santa Clara County. As of April 10, 2020, 50 people have died of COVID-19 in the County, with an average increase of 6% daily in the number of deaths. If our estimates of 48,000-81,000 infections represent the cumulative total on April 1, and we project deaths to April 22 (a 3 week lag from time of infection to death22), we estimate about 100 deaths in the county. A hundred deaths out of 48,000-81,000 infections corresponds to an infection fatality rate of 0.12-0.2%. If antibodies take longer than 3 days to appear, if the average duration from case identification to death is less than 3 weeks, or if the epidemic wave has peaked and growth in deaths is less than 6% daily, then the infection fatality rate would be lower. These straightforward estimations of infection fatality rate fail to account for age structure and changing treatment approaches to COVID-19. Nevertheless, our prevalence estimates can be used to update existing fatality rates given the large upwards revision of under-ascertainment.
Kelhus100, they do account for the lag time from infection to death, as you can see above. To provide a counterpoint though (in addition to what you mention of the potentially undercounted COVID-19 deaths), in New York state right now (not just the city but the entire state), they're already at 853 deaths per million. In less than eight days, I expect they'll be at 1200 per million, which obviously is 0.12%, and the low end of the range that the study above estimates. For that IFR to be accurate, it would mean every person in New York state has had the virus.
04-17-2020 , 04:24 PM
Trump/supporters starting to push hard for easing lockdown. Americans are pretty weak at civil unrest but we may be reaching a boiling point soon.
04-17-2020 , 04:26 PM
Quote:
Originally Posted by Best Buddy
Disaster. We need more people immune ASAP. Effing virus kills enough people to cause terror and spreads rapidly without causing widespread immunity. Who INVENTED this?
I know CRAZY right??!?!

Its the same entity that invented Polio, ALS, CANCER, the measles, Mumps, Smallpox, Herpes, Hepititis, and even the common cold!!!

Why is no one reporting on this?!?!
04-17-2020 , 04:29 PM
Quote:
The world’s biggest trial of drugs to treat Covid-19 patients has been set up in the UK at unprecedented speed, and hopes to have some answers within weeks.

The Recovery trial has recruited over 5,000 patients in 165 NHS hospitals around the UK in a month, ahead of similar trials in the US and Europe, which have a few hundred.

“This is by far the largest trial in the world,” said Peter Horby, professor of emerging infectious diseases and global health at Oxford University, who is leading it. He has previously led Ebola drug trials in west Africa and the Democratic Republic of the Congo (DRC).

The Recovery team expects to be the first to have definitive data. “We’re guessing some time in June we may get the results,” said Prof Horby. “If it is really clear that there are benefits, an answer will be available quicker.” But he warned that in the case of Covid-19, there would be no “magic bullet”
https://www.theguardian.com/world/20...al-covid-19-uk
04-17-2020 , 04:31 PM
Quote:
Originally Posted by m_reed05
And pushing the blame for testing inadequacies to states. What a leader!

"Trump says "Nobody told me about the pandemic *I* warned you about. If the economy is bad, it's the governors' fault, but if you don't get sick, credit me. I have all the authority and none of the responsibility." - Kasparov
04-17-2020 , 05:13 PM
Quote:
Originally Posted by somigosaden
Kelhus100, they do account for the lag time from infection to death, as you can see above. To provide a counterpoint though (in addition to what you mention of the potentially undercounted COVID-19 deaths), in New York state right now (not just the city but the entire state), they're already at 853 deaths per million. In less than eight days, I expect they'll be at 1200 per million, which obviously is 0.12%, and the low end of the range that the study above estimates. For that IFR to be accurate, it would mean every person in New York state has had the virus.
Fair enough. Even if you double the amount of COVID deaths to account for probably undercounting and take the high end of the range you are probably looking at an IFR < 0.5%.

So, say a real IFR of 0.5% for New York State (slightly higher due to greater prevalence of morbidities). So with ~20 million persons this would mean if 25% of the population was infected now, you have 5 million infections and 25,000 deaths from these infections. It certainly seems reasonable New York State will have ~25,000 deaths by April 24th.

So maybe that is it.

IFR = 0.5% with estimated 25% of NY state population infected now accounting for 25,000 deaths (with lag)

-I saw a NY hospital did a study on expectant mothers coming in and found 15% had COVID-19 at time of deliver, so throw in an extra 10% for never diagnosed recovered infections and story checks out.
04-17-2020 , 05:15 PM
Lots of problems with the Stanford study:

https://twitter.com/MidwestHedgie/st...02396501524481

One of the consequences of finance being so lucrative over the last generation is that you have smart finance guys correcting the folks who do this as their day job...
04-17-2020 , 05:20 PM
The one problem I am having with the narrative that the virus is much more prevalent and less deadly than expected is the continued aggressive Chinese response. They have had more time than us to work out the particulars and they have the benefit of being privy to their real numbers.

Would they really take such extreme measures for a disease that was only 2x as deadly as the flu, concentrated mostly in the extreme elderly? Doesn't add up.

But if it was 20% as deadly as the flu, then their continued aggressive response makes more sense.
04-17-2020 , 05:38 PM
Quote:
Originally Posted by harriedseldon
Lots of problems with the Stanford study:

https://twitter.com/MidwestHedgie/st...02396501524481

One of the consequences of finance being so lucrative over the last generation is that you have smart finance guys correcting the folks who do this as their day job...
04-17-2020 , 05:43 PM
-In fairness to the Stanford study, if you doubled the amount of deaths due to undercounting (which isn't actually that unreasonable given what we know you the undercounting going on) their upper bound IFR would be around the same place as the Gangelt study.

(I didn't look at the actual study, but I assume the publication isn't giving us bogus numbers. I tend to be very skeptical when media starts telling us what numbers mean, but for the most part I give them the benefit of the doubt for giving us the right numbers.)
https://spectator.us/covid-antibody-...nfection-rate/

"Data from coronavirus deaths in Gangelt suggests an infection mortality rate of 0.37 percent, significantly below the 0.9 percent which Imperial College has estimated, or the 0.66 percent found in a revised study last week."
04-17-2020 , 05:59 PM
--To give some perspective, if the IFR is really <0.5 it appears this disease is about as deadly as measles, and probably less infectious, even with no behavioral PPE.

--Given that measles obviously sucked, but the world got by just fine coping with it for a couple hundred years pre vaccine, this definitely gives some perspective. Of course you could view it as a positive testament to how we currently value human life that we are making such a big deal over potentially Measles 2.0.
04-17-2020 , 06:50 PM
I don't know the rationale for why Stanford would assume false negatives > false positives, if indeed that is the case. I'm assuming it is not a baseless assertion solely to skew their numbers to fit a narrative. Regarding the sample of only 3,000 out of 2M in Santa Clara county, that alone is not evidence of selection bias, but more likely reflects the urgency to get data to health authorities. The LA County health chief (Ferrer) although not commenting on the specific numbers when asked about this study, understood there is a vast under-count of those exposed. I understand Stanford is conducting additional studies as well. So there will be plenty of time to counter their claims if the evidence points to such.

Also, the Stanford numbers align fairly well with the recent sewage analysis study done in MA, that is about 10-80x under-count of CV infections. In NY there have been 550K tests performed, with 222K positives. The under-count in NY is likely on the lower end of that range because 2.8% have already been tested for infection, highest of any state. (with 40% positive, behind only NJ) If the 2 studies above pan out we can assume that a pretty big number of people in NYC have been exposed to CV, maybe upwards of 30%. Although the possibility of reinfection exists, if we assume 25% exposure that would put a theoretical limit of 3x the current # of deaths going forward, probably less due to herd immunity.

LA County released a stat, 87% of all CV reported deaths have come from those with serious underlying health issues. It seems logical to assume that those who would die first in a pandemic would be those most vulnerable, and that IFR should go down over time.

Although I don't have any hard numbers comparing deaths from nursing-assisted facilities with the general public, it should be straightforward to infer:
-nursing-assisted facilities are comprised primarily of elderly and those with serious underlying conditions;
-nursing-assisted facilities do not represent a lifestyle of the general public;
-nursing-assisted facilities would be the earliest to suffer.

All of this seems to imply, that without any effective treatment or vaccine:
-prevalence of exposure at 2.5-5% nationwide;
-IFR of 0.25-0.5% to date (some areas higher, some lower), trending down over time as those yet to be exposed represent demos that have a lower IFR;
-an implied IFR of 0.03-0.06% for those without serious underlying conditions;
-a cap on projected total deaths nationwide somewhere around 15-30x current totals.

The real problem is lack of an existing vaccine. Even flu vaccines at 50% efficacy do an effective job at reducing R-0. I can imagine that without these vaccines the most severe flu seasons in recent years could have been just as bad as CV.
04-17-2020 , 07:01 PM
Even if it's 0.5 for the entire population - and this was estimated months ago already - it is the wrong way to look at it.

In Ireland, the seasonal flu killed 97 people in the 18/19 moderate season and 255 in the 17/18 severe season. The season is 8 months.
Covid already killed 531 in 7 weeks.
04-17-2020 , 07:06 PM
Projections have been all over the place. I read the other day CA is projected at 800K+ deaths.

And those flu viruses had vaccines. My basic point is that CV is a bad flu without a vaccine.

Last edited by PokerHero77; 04-17-2020 at 07:12 PM.
04-17-2020 , 08:24 PM
PokerHero, you are spouting crap.

A bad flu that still pushes Europe to the cap of its hospital capacity after living 4-5 weeks under quarantine/lockdown. And without anyone realizing what was going on until it was too late.

A bad flu that is breaking excess death records since the start that excess death is being monitored across varios countries in Europe... by 100% and more.

Even if your assumptions are right all of those fly out of the window once hospitals are overloaded, equipment is gone, and doctors are gone and people start dying because they can't get treatment.

How many <50 year people does the flu put in a coma every year for 2-3 weeks? There are thousands of those in the world at the moment.
04-17-2020 , 08:29 PM
Quote:
Originally Posted by bbfg
PokerHero, you are spouting crap.

A bad flu that still pushes Europe to the cap of its hospital capacity after living 4-5 weeks under quarantine/lockdown. And without anyone realizing what was going on until it was too late.

A bad flu that is breaking excess death records since the start that excess death is being monitored across varios countries in Europe... by 100% and more.

Even if your assumptions are right all of those fly out of the window once hospitals are overloaded, equipment is gone, and doctors are gone and people start dying because they can't get treatment.

How many <50 year people does the flu put in a coma every year for 2-3 weeks? There are thousands of those in the world at the moment.
I dont think you get his point. A bad flu season with no vaccines would cause all those scenarios. A measles outbreak with no vaccine would cause all those scenarios.

The point is that pre vaccines, diseases like this were just **** that people had to live with, and they did. Life used to be a lot harder and life expectancy a lot lower because of it. Diseases taking out the weak is probably one of the main reasons there weren't a lot of 50+ year olds around back then.

The fact this is such a big deal is a testament to how much modern technology and medicine has improved the human condition. I don't think Pokerhero is minimizing the disease. I think the point is this is what people had to deal with before vaccines and other technological/medicl advancements in the 20th century.
04-17-2020 , 08:55 PM
Quote:
Originally Posted by Kelhus100
I dont think you get his point. A bad flu season with no vaccines would cause all those scenarios. A measles outbreak with no vaccine would cause all those scenarios.

The point is that pre vaccines, diseases like this were just **** that people had to live with, and they did. Life used to be a lot harder and life expectancy a lot lower because of it. Diseases taking out the weak is probably one of the main reasons there weren't a lot of 50+ year olds around back then.

The fact this is such a big deal is a testament to how much modern technology and medicine has improved the human condition.
If his point is to say "yeah this sucks but in the past this was like normal", what's the point of that? Coronavirus is no biggie, it just means we'll revert back to life standards of 100 years ago? And we just have to accept that and go back to normal and keep consuming so we can go back to business as usual and markets can recover? And just go to the movies etc and accept that everytime we go see a movie there's 2-5 people in the cinema that will die from watching the movie? Same with everything else in our lifes?

I'd also like you to point me to a data point that could be seen as proof that the hospitalization rate of corona is anywhere near the worst flu epidemic in modern history , same for mortality rate.

Spoiler alert: it's not.

It's like saying "yeah this is basicly just the worst flu ever x5-25, no biggie".
04-17-2020 , 08:59 PM
Also is it correct that Trump just doubled down on "60.000 to 65.000 corona deaths in USA" today? It's going to break 65.000 before May 1st most likely.
04-17-2020 , 09:16 PM
Human life has been around about 200,000 years.

I guarantee there has been a **** ton of novel diseases and pandemics worse than this during that time. History didn't start 50 years ago.

This is life. The western world has had a nice long nap the last 100 years or so with respect to new deadly diseases, and now nap time is over.
04-17-2020 , 09:35 PM
What would CV look like to the “no biggy” crowd if no measures were taken and it was left to grow exponentially through the world?

Would they still be saying its no biggy?

Probably, unless they or someone close to them died waiting in a line outside of a hospital....
04-17-2020 , 09:41 PM
Quote:
Originally Posted by WorldBoFree
What would CV look like to the “no biggy” crowd if no measures were taken and it was left to grow exponentially through the world?

Would they still be saying its no biggy?

Probably, unless they or someone close to them died waiting in a line outside of a hospital....

People on social media are still saying “ but the flu kills 40,000 people a year “ blah blah.
04-17-2020 , 09:55 PM
Quote:
Originally Posted by Shuffle
So all of these Dunning-Kruger morons who are out protesting, lead by their spiritual leader Trump, exactly what I've been expecting. Compared to say, South Korea, too many Americans are just plain too stupid and undisciplined to follow social distancing practices for any appreciable amount of time.

Consider the virus risk will be out there unabated for at least 1-2 years minimum, and I'm definitely willing to bet against stupid people that the curve will not flatten for any meaningful amount of time.
But the million dollar question is how long is it going to take the market to actually reflect this?

Also, FWIW, its not just the Trump crowd who are refusing to lockdown and social distance. That is just what the media chooses to emphasize for their own political ends.
04-17-2020 , 10:03 PM
Quote:
Originally Posted by Shuffle

Consider the virus risk will be out there unabated for at least 1-2 years minimum, and I'm definitely willing to bet against stupid people that the curve will not flatten for any meaningful amount of time.
I dont think the general population can hold the line. There's a lot of people can do 4-6 weeks, but eventually enough people say **** it and it starts rolling again
04-17-2020 , 10:54 PM
Here's a response to the Stanford study by a guy who knows what he is talking about.

https://medium.com/@balajis/peer-rev...a-1f6382258c25

There's a lot of conflicting data right now, but I think things will come into focus in the next two weeks as the results of more surveys come in.

Here's an interview with the guy who led the study.

https://ricochet.com/748453/uk-the-f...medium=twitter

Last edited by jsb235; 04-17-2020 at 10:59 PM.
04-17-2020 , 11:22 PM
Quote:
Originally Posted by bbfg
If his point is to say "yeah this sucks but in the past this was like normal", what's the point of that? Coronavirus is no biggie, it just means we'll revert back to life standards of 100 years ago? And we just have to accept that and go back to normal and keep consuming so we can go back to business as usual and markets can recover? And just go to the movies etc and accept that everytime we go see a movie there's 2-5 people in the cinema that will die from watching the movie? Same with everything else in our lifes?

I'd also like you to point me to a data point that could be seen as proof that the hospitalization rate of corona is anywhere near the worst flu epidemic in modern history , same for mortality rate.

Spoiler alert: it's not.

It's like saying "yeah this is basicly just the worst flu ever x5-25, no biggie".
You seem to desperately want to put words in my mouth. When did I ever say "no biggie"? 0.25-0.5% is a pretty big number all things considered.

Of course we don't want to live in an era of <50 year life expectancy, we spend a s***load of money on health care to to live longer. (I heard US spends 50% of GDP on health care) Science has given us the polio vaccine, measles vaccine, smallpox vaccine, malaria drugs, along with improved sanitation to reduce yellow fever, cholera, diarrhea, and so on.

In each of those cases, there was a price to pay: The initial outbreak prior to delivering on a vaccine or effective treatment. That is the situation we are now in with the novel coronavirus. I am figuratively holding my breath that an effective vaccine can be delivered in record time, 12-18 months. I've heard experts who know about vaccines and that time frame is optimistic at best.

The vaccine needs to be effective yet safe. Testing needs to be done right. They need to get the dosages right. They then need to mass produce the vaccine in very high quantities. All of these (esp. the latter) take time, are all very difficult, and no step is assured. The vaccine Fauci is pushing from Moderna uses Messenger RNA, and is probably the quickest path but unfortunately due to its methods poses a risk of actually increasing infection thru antibody enhancement.

Antivirals could play a role, and evidence looks promising. But to try and wait several months for this virus to play out until effective antivirals or a vaccine are developed will simply not work. The shutdown was probably a wise step to figure out where we stand, and what needs to be done going forward to get life back to normalcy as quickly as possible. We have many advantages over 1918. We can perform serology tests to assure those with antibodies can function in society with a reasonable risk of not getting CV. We can take body temperatures very efficiently for those going to crowded areas such as restaurants or sporting events, to further reduce R-0. We can advise those in high risk groups to avoid large gatherings. We can isolate outbreaks and perform mitigation in those areas quickly. Personal hygiene is better.

We also can conduct business in lieu of people. There really is no material reason IMO why the NBA could not resume play next week. Same with MLB. The players want to play, the unions want the players to make money, and the fans want games. Viable plans have been developed, and we could probably ramp up very quickly. Schools should be reopened as well.

Basically, there is no free lunch. Shutdowns going on for months on end will effectively destroy our society beyond the point of recovery. And if the vaccine takes longer, nothing would be gained but a time shift of herd immunity. The most logical step going forward is to resume society balanced with effective mitigation steps which almost everyone can live with. If/when effective treatments and/or vaccines become available, we will be at a point where many will likely benefit (including future generations), and society will not be sacrificed.

      
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