Coronavirus: How dangerous a threat?

[Rollthedice]

"Immunity passports" in the context of COVID-19

Scientific Brief

www.who.int

Seems about right. The amount of stupidity on a global scale is staggering. You don't need to be an epidemiologist or Dr. Feelgood to maybe cross your mind that since this is a virus related to the common cold virus it's actually more likely that you will not get a lasting immunity. All the geniuses promoting "herd immunity" must think fast of some other sci-fi strategies.

 

[aphronesis]

Yeah, that’s a nice dream. I might gamble on it, but don’t want to infect anyone. Not clear many leaders want to bank on that one now.

 

[Rollthedice]

Another disturbing thing, the extermination of people in care homes. How on earth nobody thought to protect our fellow vulnerable humans who live in an environment with a high contamination risk. Test everybody (especially the personnel) use masks, lock the doors, disinfect, throw the food and water over the fence if it's necessary, rinse and repeat from the first minute the virus runs free through the country. Was it so hard for the geniuses and advisors to figure it out? Now they are counting the bodies.

 

[Chris Gadsden]

Another disturbing thing, the extermination of people in care homes. How on earth nobody thought to protect our fellow vulnerable humans who live in an environment with a high contamination risk. Test everybody (especially the personnel) use masks, lock the doors, disinfect, throw the food and water over the fence if it's necessary, rinse and repeat from the first minute the virus runs free through the country. Was it so hard for the geniuses and advisors to figure it out? Now they are counting the bodies.

God’s waiting room. Most of those places are horrendous in the best of times. When I think of things worse than death, being placed in a skilled nursing facility is something that crosses my mind.

In the greater context you are right of course.

 

[aphronesis]

And some/many in the city are not especially skilled. Mostly reliant on Medicare/Medicaid with up to 4 people in a room and a good percentage of workers coming from equally crowded conditions.

The one at the heart of the Seattle area outbreak isn’t highly regarded either.

New York refused to send nursing home’s COVID-19 patients to nearly empty USNS Comfort

New York health officials were warned in writing that a Brooklyn nursing home where 55 patients have died of coronavirus was overwhelmed — weeks before it began topping the state’s official list of…

www.google.com

 

[Unchained]

In Europe, the total number of excess deaths is still lower than the heavy 2018 flu season. In several countries, it is higher, obviously, but still - I sometimes think we are losing some perspective here.

I try and square this personally at least once or twice per day.
First I ask what are they talking about? I am not a nurse,don't work in a hospital..not a doctor. So w that, with 10's of 1000's of medical care providers, EMT and ambulance drivers saying that they have never seen anything like it..
Where is the perspective..? They are setting a reference for me,that I hold in high regard given a world wide similarity to the level of death and devastation.
so how do we..Joe Public square up the Covid-19- Seasonal flu comparison? I am going to sit out most of the deep detailed analysis, and instead depend on a reference point of people in the business.
Cycling has given me a good place to start. Early in my cycling experience and straight through to today..ask a question about a location or route for someplace 25-40 miles away and the non cyclist you are talking to will breath heavy using personal reference points to make riding there difficult to impossible..but from an insider's view it's a turn around point for a coffee and pastry..hardly unimaginable.
1 reference point I use for Covid-19 is STD's, Tuberculosis,Polio ,Mumps,Measels or other highly contagious conditions. I want to hope that the person next to me ,preparing my food or caring for me or my family..I don't want to be in a subway,bus or plane w people who have these ailments..can be tested
And flu included..I know that is not possible,but I still strive for the goal..
in many places there are criminal repercussions for engaging with the public once your disease status is known to you.
I watched a nurse named KP Mendoza last night on PBS Newshour..it broke me..https://m.youtube.com/watch?v=zjnuUQF4In4

Interview is @ 18:15 in..

 

[gregrowlerson]

The Belgian government yesterday announced their exit strategy. One of the measures is that schools will not open for everybody yet - first (05/18) the most important grades, and even there only with half classes. Another thing is that they will further ramp up testing, up to 25-30.000 test per day, in emergency situations 45.000/day. That's a lot for a country of 11 million. We happen to have a large number of pharmaceutical companies here and university labs, so I'm guessing that makes it easier then.

Something I'm hearing very little about: the lack of huge outbreaks in Africa and India. Huge clusters of people, but the number of reported cases is (relatively) extremely low: lack of testing, climate factor or genetics? In India, a couple hundred thousand people die each year of tuberculosis, which barely raises eyebrows. Now, a hundreds of millions of people with little or no savings are locked down for a disease that is totally dwarfed by other causes of death in India. India also has a young population, so from my perspective, the lockdown is only there to protect the elites, and does more bad than good for most of the rest.

Really great point about India here. Different countries should treat covid 19 and lockdowns differently.

 

[movingtarget]

Another disturbing thing, the extermination of people in care homes. How on earth nobody thought to protect our fellow vulnerable humans who live in an environment with a high contamination risk. Test everybody (especially the personnel) use masks, lock the doors, disinfect, throw the food and water over the fence if it's necessary, rinse and repeat from the first minute the virus runs free through the country. Was it so hard for the geniuses and advisors to figure it out? Now they are counting the bodies.

Once it gets into a nursing home it's very hard to stop. It's not only equipment issues it's staff ignoring their own symptoms especially if they are only mild, and continuing to go to work as has happened in Australia at one or two places. Low paid staff wanting to continue working..........who would have thought !

 

[Merckx index]

Are you still working out in the pool? I understand that if you drink pool chemicals it will kill C19...and you. I hope that your recovery is still going well!

Thanks. Yes, though the pool is only open three days a week now, and i hear in Manila all pools have been closed. You in the U.S. think you have it bad with your lockdowns, we not only have that, but all liquor sales have been banned. Can't even drown our sorrows in a beer or glass of wine.

How reliable are the antibody tests?

For the past few weeks, more than 50 scientists have been working diligently to do something that the Food and Drug Administration mostly has not: Verifying that 14 coronavirus antibody tests now on the market actually deliver accurate results.

In the new research, researchers found that only one of the tests never delivered a so-called false positive — that is, it never mistakenly signaled antibodies in people who did not have them.

Two other tests did not deliver false-positive results 99 percent of the time.

But the converse was not true. Even these three tests detected antibodies in infected people only 90 percent of the time, at best…

Four of the tests produced false-positive rates ranging from 11 percent to 16 percent; many of the rest hovered around 5 percent.

In all, the investigators analyzed 10 rapid tests that deliver a yes-no signal for antibodies, and two tests using a lab technique known as Elisa that indicate the amount of antibodies present and are generally considered to be more reliable.

Each test was evaluated with the same set of blood samples: from 80 people known to be infected with the coronavirus, at different points after infection; 108 samples donated before the pandemic; and 52 samples from people who were positive for other viral infections but had tested negative for SARS-CoV-2.

Tests made by Sure Biotech and Wondfo Biotech, along with an in-house Elisa test, produced the fewest false positives.

The Sure Biotech and Wondfo tests are LFA. I don't know what test the CA antibody studies employed, but it was LFA.

A test made by Bioperfectus detected antibodies in 100 percent of the infected samples, but only after three weeks of infection. None of the tests did better than 80 percent until that time period, which was longer than expected [/quote]

So a lot of recently infected people would be missed. Given the problems with false positives, though, you might want to err on the false negative side. At least then you can estimate a minimum prevalence.

https://www.nytimes.com/2020/04/24/health/coronavirus-antibody-tests.html

This is just what I feared. People with symptoms of a heart attack or imminent heart attack are afraid to be treated:

A recent paper by cardiologists at nine large medical centers estimated a 38 percent reduction since March 1 in the number of patients with serious heart attacks coming in to have urgently needed procedures to open their arteries.

https://www.nytimes.com/2020/04/25/...text=storyline_updates_national#link-2a972101

 

[del1962]

Part of problem for care homes is new residents often arrive straight from hospitals, the most likely place yo pick it up

On another note

A look at Sweden

 

[Koronin]

Thanks. Yes, though the pool is only open three days a week now, and i hear in Manila all pools have been closed. You in the U.S. think you have it bad with your lockdowns, we not only have that, but all liquor sales have been banned. Can't even drown our sorrows in a beer or glass of wine.

How reliable are the antibody tests?











The Sure Biotech test is ELISA, while Wondfo is LFA. I don't know what test the CA antibody studies employed, but it was LFA, suggesting it probably had a significant false positive rate.

A test made by Bioperfectus detected antibodies in 100 percent of the infected samples, but only after three weeks of infection. None of the tests did better than 80 percent until that time period, which was longer than expected

So a lot of recently infected people would be missed. Given the problems with false positives, though, you might want to err on the false negative side. At least then you can estimate a minimum prevalence.

https://www.nytimes.com/2020/04/24/health/coronavirus-antibody-tests.html

This is just what I feared. People with symptoms of a heart attack or imminent heart attack are afraid to be treated:



https://www.nytimes.com/2020/04/25/...text=storyline_updates_national#link-2a972101
[/QUOTE]


I would much prefer having a higher false negative than false positives. However, I want a test that is over 90% accurate before I even want it if I'm paying for it. I certainly don't like the false positives.

 

[Merckx index]

I would much prefer having a higher false negative than false positives. However, I want a test that is over 90% accurate before I even want it if I'm paying for it. I certainly don't like the false positives.

Yes, there are really two different purposes for an antibody test. For individuals, you definitely don't want a test that has false positives, because you might be one, and wrongly conclude that you had the virus and recovered.

For population studies, false positives might be tolerated if the rate is well known and low compared to the true positives. But based on what the virus tests tell us, this is unlikely to be the case, at least right now. If the virus continues to spread, the situation could change.

 

[yaco]

Once it gets into a nursing home it's very hard to stop. It's not only equipment issues it's staff ignoring their own symptoms especially if they are only mild, and continuing to go to work as has happened in Australia at one or two places. Low paid staff wanting to continue working..........who would have thought !

The problem is Government's throughout the world have parrotted their care for elderly people by imposing the strictest restrictions on this cohort of people - Yet the number one way to protect residents of aged care homes is by testing the workers, yet health authorities won't follow this simple practice - Following Government's rhetoric, then logically, aged care workers are the number one group to be tested - After all, these places banned visitors ,so the virus could only come from one place .

 

[Jagartrott]

I try and square this personally at least once or twice per day.
First I ask what are they talking about? I am not a nurse,don't work in a hospital..not a doctor. So w that, with 10's of 1000's of medical care providers, EMT and ambulance drivers saying that they have never seen anything like it..
Where is the perspective..? They are setting a reference for me,that I hold in high regard given a world wide similarity to the level of death and devastation.
so how do we..Joe Public square up the Covid-19- Seasonal flu comparison? I am going to sit out most of the deep detailed analysis, and instead depend on a reference point of people in the business.
Cycling has given me a good place to start. Early in my cycling experience and straight through to today..ask a question about a location or route for someplace 25-40 miles away and the non cyclist you are talking to will breath heavy using personal reference points to make riding there difficult to impossible..but from an insider's view it's a turn around point for a coffee and pastry..hardly unimaginable.
1 reference point I use for Covid-19 is STD's, Tuberculosis,Polio ,Mumps,Measels or other highly contagious conditions. I want to hope that the person next to me ,preparing my food or caring for me or my family..I don't want to be in a subway,bus or plane w people who have these ailments..can be tested
And flu included..I know that is not possible,but I still strive for the goal..
in many places there are criminal repercussions for engaging with the public once your disease status is known to you.
I watched a nurse named KP Mendoza last night on PBS Newshour..it broke me..https://m.youtube.com/watch?v=zjnuUQF4In4

Interview is @ 18:15 in..

I'm not sure what your point is exactly. This is a new disease, so obviously the symptoms are partly 'never seen'. Yet, from a numbers perspective, it isn't very spectacular. I'm an ecologist. Ask any biologist: would you be concerned about disease X that kills 0.5% of a population of species Y, especially the sick and the elderly? Of course they wouldn't. Obviously, we want to lower the impact, yes. We do not want the sick and elderly to die early - this is compassionate. Yet, at the same time we cannot lose perspective of a number of very unclear side-effects. The India thought above is on example, pushing tens of millions into hungers and (more) despair. Also, I read that the UN fears that malaria deaths could double this year because prevention actions are hampered because of covid-19. That would mean about 350.000-400.000 additional malaria deaths. Which is double the current covid-19 death count globally. The same goes for a number of other diseases. That is part of keeping things into perspective, and it seems that the perspective is focused a lot on the one in first world countries.

 

[jmdirt]

I got a message that my post had been sent to limbo. I don't remember posting anything against the rules, or even controversial since this thread opened back up, but sorry to ya'll and the mods for whatever it was.

EDIT: I just went to my profile and scrolled through my recent posts, the one missing was about the Idaho protests (I think), but I don't remember exactly what I typed. None the less, like I said, sorry for whatever it was.

 

[Merckx index]

Yet another study showing that a very large fraction of virus positives were asymptomatic. A multi-state study reported that of more than 3000 prison inmates testing positive, 96% were asymptomatic. I still suspect that many of them will develop symptoms later on.

Also of concern is the high proportion of positives. In one prison, nearly 90% of the inmates tested were positive; in the other three prisons in this study, about 40% of those tested were positive. Since most of them were asymptomatic, the testers clearly weren't targeting individuals likely to be positive.

In addition to the states participating in this study--Ohio, Arkansas, NC and Virginia--other states are testing prisoner populations:

Tennessee said a majority of its positive cases didn’t show symptoms. In Michigan, state authorities said “a good number” of the 620 prisoners who tested positive for the coronavirus were asymptomatic. California’s state prison system would not release counts of asymptomatic prisoners.

In the case of Michigan, about half the prisoners in the Lakeland facility reporting have other conditions. Nine prisoners in this prison have died from C19, and so far, about 66% of those tested are positive.

The article goes on to point out that most testing at prisons targets only inmates with symptoms, so they are almost certainly undercounting the total positives. Maybe somewhat like Wuhan in late December, prison officials don't want to release large numbers of positives.

In Michigan's Lakeland, at least, test results usually are available within twenty-four hours. This quick turnaround time is necessary, because pending the results, the prisoners have to be quarantined, and negative ones can be returned to the prison population--at least to the population that has tested negative. But this quick procedure also means that many positives might not have enough time to develop symptoms.

Does this matter? Asymptomatic vs. presymptomatic? In terms of spreading the virus silently, probably not much. Since studies are now confirming that presymptomatics can infect others--and the huge % of positives in prisons is further validation of that--they are, from the point of view of spreading, just like asymptomatics, except that they will be identified eventually--so the silent period may not last as long.

But the distinction does matter in terms of determining mortality rates. If most positives with no symptoms are in fact presymptomatic, then to the extent that people with symptoms are eventually tested, the number of cases more accurately reflects the pool which leads to deaths.

https://www.reuters.com/article/us-...coronavirus-96-without-symptoms-idUSKCN2270RX

 

[jmdirt]

I found this interesting:
https://www.cbsnews.com/news/artifi...g-coronavirus-pandemic-60-minutes-2020-04-26/

The other two segments of show show weren't bad either IMO.

EDIT:
The little wrist device that warns you if you are too close to someone else, and who you have been close to, etc, in the GM/Ford segment is one way to help those factories move to the new normal.

 

[djpbaltimore]

The prison populations need to be studied longitudinally. Not only symptoms, but whether they seroconvert. That was my same question about the Iceland positives. Percentages that high do make me wonder about the possibility of artefacts from sample collection or the PCR reaction. Are these positives without symptoms really infected?

 

[Merckx index]

Are these positives without symptoms really infected?

Well, that's an interesting take. The problem with PCR, at least with this virus, is supposed to be more false negatives than positives--difficulty in getting samples. But that Iceland study does bother me, because it's hard to imagine selection bias being that great, particularly with the group that was initially chosen randomly. The prison populations I still think would show more positives with symptoms over time, though there might be other contributing factors.

Correction: In my original discussion of the Iceland study, I used 270 as the number of confirmed, active cases. That was the current number at the time i was posting, and i assumed it hadn't changed much since the testing, since cases have grown slowly in that country. But i now see that the active cases have risen to. a peak, then fallen, and the period of study in fact coincides with the growth to peak. When the study was begun, there were 134 active cases, which we could correct to 235 including the asymptomatics. At the conclusion of the study, the number was 982, or corrected to 1722.

The latter figure is much closer to the projected number based on 0.8%, of 2912. The discrepancy might be due to sample bias. In fact, the projected number for the randomly chosen group was 2072, which is fairly close to the corrected number of active cases of 1722. But those comparisons are based on the number of active cases at the end of the study. The number of active cases grew by 7.3 fold during the study, all while, according to the authors, the 0.8% value was constant.

Maybe part of the discrepancy could be due to the official testing taking longer. So that cases reported on any one day might reflect tests that had been carried out several days, or even a week earlier. In fact, the delay could be even longer, because many of the active cases would reflect individuals who were still recovering from an infection several weeks before. In principle, the same should apply to the study's pariticipants--except that anyone who had already tested positive before would presumably not volunteer to be tested again. So the positives in the study would represent recently infected individuals, ahead of the official curve.

This still doesn't explain the flattening of the curve, though. I can think of a possible explanation, but it requires more consideration.

 

[Oldermanish]

I got a message that my post had been sent to limbo. I don't remember posting anything against the rules, or even controversial since this thread opened back up, but sorry to ya'll and the mods for whatever it was.

EDIT: I just went to my profile and scrolled through my recent posts, the one missing was about the Idaho protests (I think), but I don't remember exactly what I typed. None the less, like I said, sorry for whatever it was.

I think the discussion went to the orchestration of "events" by agenda-driven groups. That inevitably strayed into the political sphere but was relevant in my mind.

 

[Oldermanish]

On a testing note that is unsettling to the lay dork (ME), hoping for some space from the quarantine confines: Most anti-body tests will always be difficult to rely on based on individuals AB levels and how virulent an exposure the individual endured. That they may have missed the first C19 bus may mean the next, bigger one could get them if they aren't vigilant with protection protocols. That's a daunting prospect for production and factory businesses seeking a clear, predictable class of production labor that aren't carriers or potential infectees...again. It would play to a very conservative reliance on a full work force. It's almost like playing college football with many backup and redshirt employees while the management (engineers, finance, office) plays the game from the skybox of Home. Boeing is ramping up and I'm sure most of the engineers, marketing and finance folks aren't going to the office soon. I'll check and report.
PS-how will this affect international production alliances? Companies that invested heavily in China got doubly hit in shut down plants and disappearing markets.

 

[Merckx index]

Here are some countries that have reached and passed the peak of active cases, IOW, the rate of recoveries is now greater than the rate of new cases, and there is a declining number of people with confirmed positives. There are several more countries that have appeared to peak. The number of days from the beginning of the cases (I arbitrarily took 10 cases as the start) to the peak is shown:

Iceland (34)
S. Korea (40)
Germany (40)
Iran (44)
Israel (43)
Austria (34)
Denmark (41)
New Zealand (22)
Hong Kong (69)

A lot of evidence suggests that Iran, which was the earlier epicenter of the pandemic in the mid-East, may be under-reporting its cases.

 

[BlueRoads]

Here are some countries that have reached and passed the peak of active cases, IOW, the rate of recoveries is now greater than the rate of new cases, and there is a declining number of people with confirmed positives. There are several more countries that have appeared to peak. The number of days from the beginning of the cases (I arbitrarily took 10 cases as the start) to the peak is shown:

Iceland (34)
S. Korea (40)
Germany (40)
Iran (44)
Israel (43)
Austria (34)
Denmark (41)
New Zealand (22)
Hong Kong (69)

A lot of evidence suggests that Iran, which was the earlier epicenter of the pandemic in the mid-East, may be under-reporting its cases.

These numbers unfortunately tell so little. I tried to find out which countries did how much testing. I know they are from now on testing way more people in Germany, want to test even those with any symptoms of a cold (which they absolutely didn't before), but I don't know if that actually happens.
Well, a tendency can probably be deduced, but if the criteria and numbers change constantly and are different in each country anyway, and we are not really told about them, how can we "work" with these numbers?

 

[djpbaltimore]

Well, that's an interesting take. The problem with PCR, at least with this virus, is supposed to be more false negatives than positives--difficulty in getting samples.

The people who have toggled between positive and negative is something that bothers me. PCR is something that is perfect for detecting minute quantities of nucleic acids as evidenced by the swabbing of the cruiseship for viral RNA. What is the threshold for this decision? So, it is not really a false positive in the traditional sense that I am thinking about. I just question whether signs of viral RNA in a swab always means active infection. If you cohabit with a person shedding virus and you breath some into your nose and it gets controlled by your localized innate immune response (no adaptive response), is that something that might be detected as a positive? Is there an empirical difference between viral exposure and viral infection? AFAIK, there has been no close-contact testing of people here in the USA to even generate data on that.

There was plenty of professional condemnation about the WHO's announcement that there is 'no evidence' that COVID-19 generates immunity. But some of what they say is worth considering. I think people are being a little to cavalier about giving the 'all clear' based on testing. If you had a limited infection, I wouldn't count on having robust immunity even if you tested positive by PCR. The best immunity will likely be in the people who had serious illness. If you don't test positive for IgG, I would consider yourself to still be susceptible and act accordingly.

One last thing about the prison data. If it spreads that fast in places of that nature, I don't see how schools are back in session in September.

 

[jmdirt]

On a testing note that is unsettling to the lay dork (ME), hoping for some space from the quarantine confines: Most anti-body tests will always be difficult to rely on based on individuals AB levels and how virulent an exposure the individual endured. That they may have missed the first C19 bus may mean the next, bigger one could get them if they aren't vigilant with protection protocols. That's a daunting prospect for production and factory businesses seeking a clear, predictable class of production labor that aren't carriers or potential infectees...again. It would play to a very conservative reliance on a full work force. It's almost like playing college football with many backup and redshirt employees while the management (engineers, finance, office) plays the game from the skybox of Home. Boeing is ramping up and I'm sure most of the engineers, marketing and finance folks aren't going to the office soon. I'll check and report.
PS-how will this affect international production alliances? Companies that invested heavily in China got doubly hit in shut down plants and disappearing markets.

If you get a chance, check out the wrist device that (Ford) auto workers will be wearing:
https://www.cbsnews.com/news/ford-general-motors-coronavirus-ventilators-medical-supplies/
Devices like this will become SOP I think.

I agree with you that 'things' will have to be different in many/most jobs. I also wonder about schools. My neighborhood elementary school has ~600 kids (in a building built for ~450). Even if kids end up not being as vulnerable as others, they are going home to 1,200 parents (really more because of split families), and visiting 2,400 grandparents, etc...