Thread: Potential Good News On the COVID Front

Originally Posted by elanjacobs

We already know that the flu numbers here are waaaaay down on previous years, although my totally uneducated opinion is that's probably more to do with people having less contact with others in general than vaccine availability (obviously it's a combination of both, although I have no idea how you'd be able to accurately measure them independently).

I think you could measure the number of doses of the annual flu vaccine administered in 2020 compared to 2019 -- my impression, based on vaguely remembered reports on the ABC news, is that significantly more (perhaps as many as 2 million more) flu vaccine doses were administered in 2020 compared to 2019. This should give a measure of the overall herd immunity add to which would be increased hand hygiene and social distancing.
However, I'll let the etymologists play with the figures.

Small update here, as the officials argue about who is right regarding who is now protected against the virus and for how long.

Our second wave after opening everything including bars and such is winding down, and the tail end of that is deaths (the pattern is predictable - open for two weeks, cases start to rise. Wait and watch a week or two longer, cases accelerate more. Close things back down in critical situations - schools, public concerts, bars, etc - griping, cases continue to increase due to lag in incubation or slow testing results. Horror stories follow in the news to keep everyone tuned in, and then as with the initial go around, a nursing home or three gets inundated and drives up the counts - and this is a very bad thing, not just "oh well, they were all on the back side of the hill".

My county is a little more than 1.2MM people. 291 documented deaths so far in both outbreaks (about 50/50, but more cases in the second outbreak and lower death rate). At first, that seems like a lot - it is a lot - if it were a train wreck, but then it comes to mind how vulnerable diabetic, aged, infirm, cancer patients, folks with heart disease are, etc, and there must be more than a hundred thousand of those folks here. Diagnosed cases are 10k. The death count suggests they are under by about a factor of 6.

College kicked around the idea of going back to school, but that's been put on ice - they will start their semesters online. Public schools in my state have their choice of what they'll do, but all that open will likely shut as soon as there's any outbreak. In the suburbs here (there are some areas of the state where the case count is a couple total for the whole county, but not in my populous area), our schools are a little bit more progressive and they've changed their mind to online school through the fall, but it will be involved online and teachers will be teaching and kids will be on video conference for half the day at least with enough work to keep them busy most of the other half. That is a good thing under this roof as the kids quickly learned that when it was pass/fail submissions of worksheets, they could do the day's worksheets in 2 hours and have the rest of the day off. My kids are young, so you could see the things they were making progress on slow down a lot.

The BIG difference here now, and one the news finds uninteresting is that testing is widespread. You go to the dr. with anything that looks remotely similar to flu, cold, diarrhea...anything at all, you're sent to get a covid test. There is no question now of who you were exposed to and whether you were a high enough priority.

My comment of things on the ground - I work with 25 people, figure they have spouses and kids. Our circle of pool and friends is a couple of hundred people more with only a fraction of them close to us. I don't know anyone yet who has gotten covid and tested positive. It looks like we'll all get it at some point, and the vaccines thus far may have poor effective rates and sketchy side effect trial statistics (common here to test vaccines against a control instead of nothing and report effects above the control - if that's the meningitis vaccine, that's a problem as that one is associated with a lot of complications).

Very early on, I observed that the nursing homes, etc, with high concentration of virus had terrible outcomes. Even the staff had high hospitalization rates (50% in the NW US in washington state) and in other areas that continued to operate (like meat packing factories) huge numbers of people tested positive but were asymptomatic, even though they had physical characteristics (high obesity rates in low wage jobs, etc) that should've made the situation worse. I joked with someone if this was going to go on forever, i'd like just a tiny amount to put in the tip of my nose and we'll see how it goes from there. At least it would take about 6 days before it would get to my lungs.

This is turning out to be no joke, and supports wearing moderately ineffective masks. While certain partially effective masks aren't good at preventing people from getting covid, the data is coming in to suggest that they lower the initial load received and the number of folks who are asymptomatic is far higher as a %.

One of the meat packing factories here had an asymptomatic rate close to or above 90%, and the speculation is that the folks are working side by side in a large area, they continued to work and couldn't avoid all exposure, but the volume of the area and their use of marginal masks made them all start with low doses.

One hopes there's not a snafu where they just had false positives.

Originally Posted by D.W.

One hopes there's not a snafu where they just had false positives.

Must admit that I'm more worried about false negatives.
I understand that the false positive rate is <2%, but that the false negative rate can be as high as 30%.

Very concerning if true

David

I wondered how you are going over there in the land of the free. There are many reasons why people go quiet on the Forum, but inevitably we tend to think the worst: Still, I am hoping that is not true.

In many ways I can relate to your experience of this virus and by that I mean the way in which we are exposed to it. I too live in a small community and it is probably much smaller than yours as the town is around 1400 population: Not much more than a hamlet really. There are no cases of Covid 19 in the immediate vicinity and even in the nearest major town, Toowoomba ( we call it a city and it is the largest inland city in Australia at around the 100,000 mark) there were about three cases early on and a small controversy when a single person entered the state from overseas on a diplomatic passport and then did a runner before his quarantine period had expired. He did give himself up.

Consequently, the chance of exposure in our region seems slight. However, this is where the greatest risk lies to my mind. We become casual (more than normal) and relax our guard. Then somebody comes into our environment carrying the virus, quite likely unknowingly, and within a short period of time you have an escalation of cases ripping through the community.

So what is the problem with that? For many there is no problem. They may show mild symptoms or even no symptoms. Unfortunately that doesn't apply to everybody. People at risk are those with underlying health issues and the elderly as typically they will be more likely to have health problems. So, if we do not isolate, that leaves us deciding how many people we are prepared to let die from the virus. What is the acceptable number? What degree of liability do we accept? This is perhaps the variable around the world. The argument for this path to happen is that they were going to die anyway. True, we all are: Eventually. The case against is that very few people wish to die prematurely and in particular from something that is preventable. Preventable by contact rather than cure. Around 20% of infected people have serious issues stemming from the illness and a further high proportion require hospitalisation and intensive care. For some unfortunate individuals the virus sparks a raft of other issues that continue well past the life of the original infection. Some survivors report that it is a particularly nasty and invidious condition and quite unlike the common all garden flu varieties.

One of the issues that makes this virus so contentious is the different ways it has manifested itself and the consequences of how it is treated in different parts of the world. I have put together a table below to illustrate that just because a country is one of the so-called developed nations, it does not automatically mean it has handled the outbreak well. There is this juxtaposition of economy versus health. Also bear in mind that although I have taken my figures (now about two or three days out of date on 22 Aug 2020) from information displayed by Johns Hopkins on their website, they can only rely on data supplied to them. Some countries may not have the facilities for testing extensively, some may not have comprehensive reporting facilities and some may, for their own reasons, be clouding the information (A euphemism .)

I have chosen countries from your region, our region and some others. I have not cherry picked, but I have selected, but not to support any agenda. We can always find information to support our position if we wish and I am sure (I think you mentioned your profession is an actuary) you know of the saying " there are lies, damned lies and statistics!" However that was not my intention. Just a broad spread was intended. I hope my percentage figures are correct. I appreciate I could have set up an Excel spread sheet which would have done the hard yards for me, but it would have taken me longer to get my head around that and I would have suffered more hair loss as well. So I did the manual thing.

Date 22/8/20	Cases	Deaths	Population	Deaths as % of cases	Cases as % of Pop	Deaths as % of Pop
Worldwide	22,998,346	800,000	7,806,682,000	3.47%	.29%	.01%
United States	5,624,721	175,416	331,002,000	3.12%	1.6%	.05%
United Kingdom	325,271	41,491	67,886,000	12,75%	.48%	.06%
Canada	126,318	9110	37,742,000	7.21%	.33%	.02%
Brazil	3,532,330	113,358	212,559,000	3,12%	1.66%	.05%
Mexico	549,734	59,610	128,932,000	10.8%	.42%	.05%
Russia	949,531	16,268	145,934,000	1.72%	.65%	.011%
France	271,960	30,508	65,274,000	11.2%	.42%	.05%
Saudi Africa	603,338	12,843	59,308,000	2.13%	1.02%	.02%
Saudi Arabia	305,186	3,580	34,814,000	1.17%	.88%	.01%
India	2,975,701	55,794	1,380,004,000	1.88%	.216%	.004%
Sweden	86,068	5,810	10,099,000	6.75%	.85%	.06%
Australia	24,602	485	25,500,000	2.13%	.09%	.002%
Norway	10,275	264	5,421,000	2.57%	.19%	.005%

Sweden is a good example of why the "herd" immunity is not an option and, as the figures show, that path was disastrous for them. It is a little difficult to understand the high proportion of deaths in the like of France and the UK, the latter of which has a fairly good National Health system. I would be interested to hear from others as to why the figures are there. One possibility is that many cases went unreported in the early days of the virus so that would have distorted the percentages.

I have heard the POTUS say that America is doing very well. He must be looking at some figures to which the general population has no access. Australia has done well, but we have a natural advantage of distance and a small population plus we have at various times locked down. The state of Victoria is at a high level and New South Wales is at a lower level. Here in Queensland we don't let any of those sickly types in ad they are stopped at the border or have to quarantine for two weeks in a hotel at their expense. Our politicians followed the best course of action, albeit reluctantly, from a health point of view, but had to be kicked and shamed into action.

Without any wish to be disrespectful, countries such as India may not be able to accurately record data and they would not be alone. It would be easy to imagine the pandemic to run completely out of hand in such countries. Having said that, life is really rugged in some of those countries and to survive you have to be tough. Perhaps they have more resilience (not really immunity) than we effete Western types.

Anyway, some food for thought. I hope everybody on the Forum is Covid-19 free even if you are suffering from the restrictions.

Regards
Paul

Meanwhile, NZ has been taken to task following POTUS description of the "massive" re-emergence of the virus.
Someone overseas calling themselves 'No Lockdown' tweeted a description of NZ's condition as a "hellhole".
The link shows some of the responses.
https://www.odt.co.nz/news/national/kiwis-counter-hellhole-claims​


Pete

no real change here. the levels of new cases are down some (School starts this week, though!! most schools still remote). I still don't know anyone who has gotten covid and tested positive - our family friends all came back negative. About 5% of symptomatic patients come back positive, the rest here have cold and flu or something else (food poisoning, etc).

What people are doing here is getting more back to normal except for outright dangerous stuff. No bars fully open, etc, but restaurants open to low capacity and most have adapted by greatly increasing outdoor seating. I go back into the office from time to time, but none of us would feel comfortable if everyone was there all in one day. Client meetings are mostly remote except for the few that have been on a golf course (that's not my role) where you're out in the open air.

As far as the herd immunity - it depends on your lens. I'm getting to the point thinking as a spatial thinker that it doesn't look like this virus is going to do anything but become part of society everywhere. I doubt the vaccines at this point will be that effective, and it sounds like there's bad side effect potential. The meningitis vaccine here is a good lesson - if you get meningitis, that's bad, you have a good chance of dying. So few people got it that the cost to society of the vaccine has probably been higher. but it satisfies the "we must do something" crowd.

If this covid is like other colds, etc, we're going to start seeing examples of people who get it a second time in the next year or so, and I'd imagine if they get two different strains so that it can be identified, they won't have much reaction to the second one. But like anything else, if they get it a 10th time when they're old, they may die from it (or from pneumonia).

My point is, if you're living somewhere that there's been no exposure to the virus, you're going to be in for a rough ride in the future in all likelihood. Efficacy of trial vaccines has been poor and honest disclosure of side effects, etc, has been muted because nobody wants to hear right now that nothing good is coming along.

I wouldn't be surprised if Sweden ends up better off than most places in the end. Nobody here is happy about the death levels, but it appears that all of the societies with some spread so far have about the same overall death rate as a % of population. This is not a surprise. Their diagnosed cases and % death as a % of diagnosed cases are pretty meaningless because there's no reason to believe anything is going on there when the total death rate as a % of the population is the same - except that more testing is done in some places than others.

The other truth that's becoming apparent here (and has been) is that the vulnerable population is almost entirely responsible for the death counts (word that differently if you'd like, but what I mean is that the scary stories of marathon runners being felled like trees left and right just really isn't what's happened. My pdoc said they haven't seen much severity except in vulnerable patients, and the deaths that have occurred in their practice, they've happened either in very old or already very ill patients. Unfortunately, there are a lot of people with heart disease or advanced age who have serious issues and don't know that they're that serious. ).

I'd put the odds on it being that those who went first will have a higher death count. But once we've got herd immunity, we will be reading stories about other societies continuing to be locked down or having waves of infections.

Thanks David. Good to hear you are alive and kicking.

This article I received on herd immunity may be of interest. It relates specifically to Australia, but with some variation dependent on medical facilities I think it would be similarly applicable almost anywhere:

One of the more sincere questions I get asked by people grappling with the CoVID-19 pandemic is: “if the mortality rate is so low, why don’t we just aim for herd immunity. Surely that would be better than locking us all down?”
Herd immunity is the concept that if enough people are immune to a particular disease, either through naturally acquired immunity or vaccination, that the spread of the disease in the community is arrested, hence protecting vulnerable individuals like the elderly, babies, pregnant women and those with chronic health conditions.
The percentage of people that need to be immune to a disease in order to establish herd immunity in the community varies depending on the disease reproductive number. For CoVID-19 the percentage estimated to achieve herd immunity would be 60% of the population.
The current case mortality rate of CoVID in Australia is around 1.7%. Worldwide case mortality is double this at 3.6%. But for the sake of simplicity let’s use the Australian case mortality rate.
If 60% of the community needs to catch COVID-19 to achieve herd immunity, that means that 14.4 million Australians need to be infected. No problem.
But.....
1.7% will die of the disease. That’s 244,800 dead Australians.
But hey, 98.3% will survive, right?
But international figures show 14% of patients require hospitalisation due to extreme symptoms and complications. That’s 1.96 million Australians that will need admission to hospital.
We only have 62,000 beds available Australia-wide. So what happens to the 1.9 million Australians who need beds but can’t get the medical care to pull through?
But forget them...what’s important is that the really sick Australians get a bed, right?
International figures show that 2% of infected patients require intensive care support. That would mean that 280,000 Australians will require ICU admission.
We have 2378 ICU beds. What happens to the 276,000 critically unwell patients that cannot get an ICU bed?
Aiming for herd immunity in Australia would hence result in:
14.4 million infected Australians.
1.9 million severely infected Australians unable to get a hospital bed.
276,000 critically infected Australians unable to get an ICU bed.
Oh, and the 244,800 Australians that are going to die because ‘it’s only a 1.7% mortality rate’.
But, hey, at least we’ll establish herd immunity, right?
Except for that fact that all evidence points to waning immunity following infection, with antibodies waning after 3 months.
Herd immunity is not an option. Stay home, and stay sensible.
EDIT:
From Elaine Stevenson, Australian Infectious Disease Epidemiologist, who contacted me and is aghast by the Swedish approach:
“Herd immunity is a concept which only applies to vaccine preventable diseases as a measure of program efficacy.
It does not apply to the situation that we are currently in vis a vis COVID-19
We do not have enough follow up on the virus to be anything other than extremely cautious”.
- Sara Hassan

The bold type is my emphasis. Also note the suspicion (for the moment) that immunity wanes rapidly, although this has yet to be proven. The caveat, of course, is that this is one view.

Regards
Paul

Those numbers are a bit off. It appears that the actual death rate is somewhere around 0.5% or a little less (it will probably turn out to be less).

That's still A LOT of people.

If anyone wants to know why you can't go head long into herd immunity, the only thing that keeps the death rate even that low is the ability to treat people in hospitals, on ventilators, etc. If the hospital system gets overwhelmed, all bets are off and the death rate goes up.

Herd immunity if attempted has to be with limited opening and management of the capacity in hospitals.

Personally, I think it'll turn out to be an OK long term option. But that's just a guess. I'm glad I'm not in charge.


And no worries about what the president says. Nobody listens to him. When biden is president, nobody will listen to him either. We haven't had an easy listening president since early reagan and if you could stand the lip biting, slick willie. The rest of the guys are smooth with no substance, or not smooth at all (and also often with no substance).

A friend's 33 y.o. daughter who lives in London caught COVID in March. Six months down the track she still feels unwell and has just started regaining her sense of smell and taste.

We learned that the U.K. is only reporting cases which require admission to hospital. That would explain their high death rate.

mick

I was looking at the link BushMiller provided. I saw this: New Cases of COVID-19 In World Countries - Johns Hopkins Coronavirus Resource Center

The graph below shows an obvious decline in cases.

Without being rude, the USA has made a mess of it WRT people going out, partying, rioting, working and socialising.... Nobody wearing masks, etc....so WHY is it that it has not spread like it first did?

What has changed? It went up like a rocket, then sideways, a bit more up, now its dropping.

Lets assume the stats are right. That there are no fibs.

Why isn't this thing maintaining it geometric growth?

1 2 4 8 16 32 ..... noooo, its flapping around at 1... 1... 1.2... 1.3 .... 1... 1... (I just made this up)

Is it running out of steam? Has the virus changed?

Obviously all the "vulnerable people" have not been wiped out. I read that many ICU's in the USA are empty after being initially flooded.

What is going on?

Screenshot_2020-08-26 New Cases of COVID-19 In World Countries - Johns Hopkins Coronavirus Resou.png

WP

Interesting comment on the apparent slowing of the virus. Percentages rely heavily on accurate information. Look at Glider's post immediately before yours. The UK's attitude provides a gross distortion on the figures. Which other countries are doing the same thing? Or something similar. I did make the caveat that we need to be mindful of how and what is reported before getting overexcited on an aspect.

One of the peculiarities of this virus is that it has behaved differently to other pandemics that have preceded it. It is uncharted territory, but after eight months we should be getting some sort of handle as to how best to deal with it. If I was sceptical on anything it is the prospect of a satisfactory vaccine in the near future.

Regards
Paul

We should remember that the USA is not a homogeneous place. My daughter is in Colorado, where everyone wears masks if they go into a shop and they practice social distancing pretty well. The city where she is is also a very techy place and a high percentage of people can work from home. Its all quite different to more crowded places, like NYC. Also, each state has a governor who makes a lot of the rules, and may or may not be relatively sane. We have 8 states & territories to wrangle; they have 50.

Originally Posted by woodPixel

What has changed? It went up like a rocket, then sideways, a bit more up, now its dropping.

Lets assume the stats are right. That there are no fibs.

Why isn't this thing maintaining it geometric growth?

Is it running out of steam? Has the virus changed?

What is going on?

Screenshot_2020-08-26 New Cases of COVID-19 In World Countries - Johns Hopkins Coronavirus Resou.png

It's difficult to track the actions of 50 states' governors and their public health authorities, but I'm led to believe that border closures (mostly soft), lockdowns, public distancing and surgical masks have all been employed in varying degrees. Exponential growth hasn't continued for these reasons.

I use public transport a few times a week. My best guess is 50% of all commuters wear masks in Sydney.

I'm coming to the conclusion that people are not necessarily ignoring the safety recommendations, they are following the habits of a lifetime. The "new normal" will take time to become normal.

mick

Originally Posted by D.W.

If anyone wants to know why you can't go head long into herd immunity, the only thing that keeps the death rate even that low is the ability to treat people in hospitals, on ventilators, etc. If the hospital system gets overwhelmed, all bets are off and the death rate goes up.

No, not wondering. We had that analysis back in Feb/March.