Coronavirus: How dangerous a threat?

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Infants do exhibit bad cases of COVID at higher rates than other children. One thing that may be protective is that they may get other viral infections like RSV, which may boost some bystander innate defenses to COVID. And as Koronin notes, some passive immunity is provided from the mother before and after birth and who likely would be infected if the infant gets COVID. There will be a lot of interest in how COVID might influence the development of asthma and other lung allergies down the road. Little kids look vulnerable, but they can actually withstand some really bad health scares. All their organs are fresh off the assembly line and they can withstand scary high fevers. Older people... not so much. They just can't handle the sickness as well in addition to having poorer immune systems on average.

I always hear that the margins on the liquor is higher than the food, so keeping the bars closed is a big hit on the pocketbook too. I have no desire to go into a restaurant at the moment, but I have used an online delivery service (DD) to support the local non-chain places that I hope to visit in the future. It is no contact delivery. I make my own drinks, but was really running low on wine, so I did visit a local winery last weekend that was doing outdoor seating. Good social distancing and masks were required except when you were seated at your table.
Idaho liquor stores remained open the entire time because they generate a big chunk of change for state revenue. I've always heard the same that beverages (beer, wine, booze, soda) have solid margins.
 
I posted that in the movie thread last month because we were discussing Sean. I didn't post it here because at the time we had someone who would have replied: "You just can't stop posting politics...sad". Even though politics isn't the message.

I liked this interview especially because he avoided talking politics almost entirely. The interviewer gave him several chances to do so with some of the questions, but Penn was not interested in blaming anyone. Even when he was asked about Biden vs. Trump, he just said he thought the country needed younger leaders, in fact, he's in favor of lowering the minimum age (35) to be President.

He did insist that the U.S. could test everyone once or twice a week, which would be almost 50-100 million tests a day. I don't know if that's possible, certainly it would take some time to get there.

There are still a large number of people that are reticent about returning to normal.

This is a major flaw in the argument that lockdowns don't work. The assumption is that when a lockdown is lifted, the area will go from 0% of people returning to their normal life, to 100%. That's not what happens.

That said, here's a nice little study showing the effect of stay-at-home orders. The authors compared Iowa, one of the few states not to have such orders, with Illinois. They looked at case rates in Iowa counties on the border with Illinois, vs. rates in Illinois counties right across the border. So you have similar rural populations in the same general area. The rates were very similar preceding the stay-at-home order in Illinois, at which point the Iowa cases greatly exceeded those in Illinois. The testing rate in Illinois was higher than in Iowa, so that should not have been a factor in the higher rate in Iowa.

The estimates indicate excess cases in the border Iowa counties by as many as 217 cases after 1 month without a stay-at-home order. This estimate of excess cases represents 30.4% of the 716 total cases in those Iowa counties by that date.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229521/
 
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Here's a very interesting new revelation that's sure to create more confusion & skepticism:

I think they mean that someone who never develops symptoms rarely infects others. Because there is quite a bit of evidence that transmission can occur by presymptomatics. And in practice, a presymptomatic person is much like an asymptomatic, because infection can occur before testing and contact tracing.
 
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Indirect evidence, but intriguing nevertheless:


Satellite imagery showing spikes in vehicles outside major hospitals in Wuhan last winter suggest the coronavirus may have been present and spreading in the city months before authorities acknowledged the disease.

Researchers from Harvard Medical School, Boston University of Public Health and Boston Children’s Hospital analysed satellite imagery of the parking lots of major hospitals in Wuhan between 9 Jan 2018 and 30 April, 2020, as well as internet search trends.

According to the study, which is still under peer review, vehicle counts extracted from the high-resolution images of Wuhan hospital parking lots showed a “steep increase” starting in August 2019 and peaking in December 2019. Between September and October, five of the six hospitals analysed saw their highest daily volume of cars.

Search query terms for “diarrhoea” and “cough” show a large increase about 3 weeks before the spike in confirmed Covid-19 cases in late 2019, the study said.

The authors said that while they cannot confirm if the increased vehicle volume was directly related to the new virus, the evidence “supports other recent work showing that emergence happened before identification at the Huanan Seafood market,” in late December when Chinese officials reported a cluster at the market in central Wuhan.

“These findings also corroborate the hypothesis that the virus emerged naturally in southern China and was potentially already circulating at the time of the Wuhan cluster,” the report said.

“Something was happening in October,” John S Brownstein of Boston Children’s Hospital told ABC News. “Clearly, there was some level of social disruption taking place well before what was previously identified as the start of the novel coronavirus pandemic.”
 
I think they mean that someone who never develops symptoms rarely infects others. Because there is quite a bit of evidence that transmission can occur by presymptomatics. And in practice, a presymptomatic person is much like an asymptomatic, because infection can occur before testing and contact tracing.
Not having an expert contextualize what the WHO stated at that press conference is the root of the problem with that article. Characterizing her statements with a two word 'very rare' in the headline is the cherry on top. I agree that this was the main takeaway from her comments. And based on the clustering effect, it is estimated that 70% of people do not transmit the virus to anybody else.

On the banner for the linked article is this headline. Same author....LOL. Much of the mainstream news coverage about COVID is dispensable garbage.
WHO scrambles to clarify comments on asymptomatic coronavirus spread, says much is still unknown
 
WHO may be basing its conclusions on studies done in China. The Chinese recently tested everyone, or nearly everyone, in Wuhan

The Chinese city of Wuhan, where the coronavirus was first detected late last year, has tested nearly 10 million people in an unprecedented 19-day campaign to check an entire city.

It identified just 300 positive cases, all of whom had no symptoms. The city found no infections among 1,174 close contacts of the people who tested positive, suggesting they were not spreading it easily to others.

In less than three weeks, the Chinese tested about half as many people as the U.S. has tested since the pandemic began. The total cost was just $125 million, or about $12.50 per test. To put that in perspective, the $2 trillion stimulus package could have paid for testing for everyone in America every day for more than a year. Just 10%, or $200 billion, of that money would have been enough to test everyone daily for a month and a half.

https://edition.cnn.com/2020/05/26/asia/coronavirus-wuhan-testing-intl-hnk/index.html

I see that WHO has not only backtracked on its original statement, but said that they indeed were referring only to asymptomatics, not presymptomatics:

Another distinction Van Kerkhove made in clarifying Tuesday is that she was referring to truly asymptomatic people, and not people who are presymptomatic, meaning they do not have symptoms at the moment but will later.

Presymptomatic people and those with mild illness that someone might not even notice can transmit the virus, meaning that someone should not assume the absence of symptoms means they are not infectious.

"People who are not showing symptoms can still spread the disease; it's just that they're likely pre-symptomatic rather than truly asymptomatic," tweeted Jeremy Konyndyk, senior policy fellow at the Center for Global Development. "Keep wearing those masks. Keep distancing."

https://thehill.com/homenews/corona...y-widely-criticized-statement-on-asymptomatic
 
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So medical workers were 45 times more likely to be infected than employees who worked in sales. No surprise there. And family members of employees were almost ten times more like to be infected than the employees. That's certainly a surprise.

The overall rate of 0.43% is about 7.5 times the rate of confirmed cases in Tokyo, which is roughly in the range other antibody studies have found, though this was not a random sample. The 0.73% rate for family members looks like a better estimate of Tokyo as a whole.
 
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I don't know how representative the people tested are of the general population, however I can tell you that it's extremely hard to get tested here (I'm in Japan), and for sure there are many cases who most likely have (/have had) it, but not confirmed so not counted. I guess that's the same elsewhere as well. The state of emergency was lifted 2 weeks ago, so lets see if cases start rising again as many people are not taking notice of physical distancing at all. (there is some for sure, but other areas and people ignoring it).
 
There was an article here in the newspaper, where specialists said "Japan did so many things wrong, and still it's turning out OK - how is that possible?" It's very strange: slow response, low amount of testing, face masks distributed by the government not up to standard, low amounts of hospital beds, etc. Have they been incredibly lucky, was it the hindlying culture (no handshakes etc.), was it something genetic,...?
 
here was an article here in the newspaper, where specialists said "Japan did so many things wrong, and still it's turning out OK - how is that possible?" It's very strange: slow response, low amount of testing, face masks distributed by the government not up to standard, low amounts of hospital beds, etc. Have they been incredibly lucky, was it the hindlying culture (no handshakes etc.), was it something genetic,...?

To all that, you can add that Tokyo has one of the highest population densities in the world, and generally, that correlates strongly with virus transmission. So what's going on? Being an island helps, it's easier to bar or reduce the influx of foreign visitors. The customs may help a little. Mostly, I think Orientals find it easier to do things with the collective in mind. So many Asian countries have done well in the pandemic. Even if the government hasn't set down a lot of strict rules, I think the corporate culture in Japan has probably greatly encouraged people to social distance.
 
There was an article here in the newspaper, where specialists said "Japan did so many things wrong, and still it's turning out OK - how is that possible?" It's very strange: slow response, low amount of testing, face masks distributed by the government not up to standard, low amounts of hospital beds, etc. Have they been incredibly lucky, was it the hindlying culture (no handshakes etc.), was it something genetic,...?

I hear so many different accounts as to what is happening in Japan, I don't know what to believe. Two things I read about Japan recently:
  • they focused on the super-spreading very early. Instead of closing everything they mostly closed spaces like gyms.
  • instead of laws and acts that enforce closing of shops and so on, they"asked" to close, so that the state does not have to pay compensation, but only support. But because of that lots of people are telling others, who don't do everything to avoid the corona-spreading (like, open their shops), they should, and there are even many bullying events.

I don't know what you think of that, dusty?
 
I hear so many different accounts as to what is happening in Japan, I don't know what to believe. Two things I read about Japan recently:
  • they focused on the super-spreading very early. Instead of closing everything they mostly closed spaces like gyms.
  • instead of laws and acts that enforce closing of shops and so on, they"asked" to close, so that the state does not have to pay compensation, but only support. But because of that lots of people are telling others, who don't do everything to avoid the corona-spreading (like, open their shops), they should, and there are even many bullying events.

I don't know what you think of that, dusty?

Sorry I couldn't figure out how to add more than one quote to my reply, but I'm replying also to Merckx and Jagartrott.


It's a mystery to me too!

For sure they closed places early - schools were closed in I think late Feb (possibly early March, I don't remember the exact date, I was out of the country for a few weeks then), and also events with large numbers of people were canned, or should I say ‘strongly requested’ to be cancelled around that time too.

Instead of the focus on the term physical distancing (that came in a lot later - i.e. - with tape on the floor of shops, etc) - they heavily promoted focus on avoiding overlap of what they call the 3Cs:
1 - Closed spaces with poor ventilation
2 - Crowded places with many people
3 - Close contact settings (such as close-range conversations)
Here’s an English version of the kind of posters they had around the place:


And yes, they also followed the tact of tracking clusters, which seemed to work early on, but at some point (in March?) they couldn’t trace some of the cases and cases were rising.

In early April the prime minister declared a national emergency and many places closed. And yes - being shamed goes a long way in Japan. Big companies will comply with these kinds of requests.
Because of the Japanese constitution (probably due to WWII) the government isn’t legally allowed to enforce lockdown, all they can do is “strongly request” that we stay home, etc. The big companies all complied, others didn’t. I know of people who thought the whole thing was all overblown and it was biz as usual for them. All my own live work shut down except some studio jobs (I’m in the music industry). They found some clusters tracked from live house (music bar/club) venues, so these were also ‘strongly requested’ to close.

They were late in closing down borders, so it’s still strange to me - flights still coming and going from China though a lot less, and probably none from Wuhan! Tourist areas and major travel hubs became very quiet while other areas were still pretty busy until the emergency declared. And they let at least 60 people off that cruise ship without even testing them!

Cases were rising in March - esp in Tokyo - and the weather was starting to warm up, but it wasn’t until the Olympics were finally off the table in late March, also coinciding with Tokyo’s cherry blossom season, that the Tokyo Governor ‘strongly requested’ we didn’t have our usual cherry blossom parties when the cherries started blooming, some of the more popular areas where giant groups of people love to sit under the trees and eat and drink for hours were even blocked off…

Then during the golden week holiday at the end of April / beginning of May the requested we didn’t travel to rural areas (in case the virus was spread to areas with smaller hospital infrastructures).

We all felt the government only paid mild lip service to distancing until the Olympics were gone - and we felt it was going to become the next UK or Italy, because there were still many people ignoring the request. But it didn’t happen.

For sure Japan is a mask wearing culture - many people have allergies as well this time of the year so normally wear masks then as well.

The national emergency was lifted 2 weeks ago, I was reading that they’re recommending people in the ‘water trade’ - i.e. hostess bars, host bars, etc get tested frequently as they recently found another cluster coming from one of these.

Some of the live music has returned - but the big hotels haven’t resumed music yet - well they don’t have many international guests due to no tourism, but others will open soon (with local customers).

One of the other reasons many businesses stayed open was simply because they couldn’t afford to close. We’re still waiting for gvt money to arrive. Some businesses and freelancers like myself who can prove loss of income are able to apply for grants, a different grant for bigger business chains have had so many hoops to jump thru that some have given up. It’s kind of crazy at the moment. I don’t think I’ll have much work at all for months, though I should be able to pick up a bit here and there.

But for sure it’s just been extremely difficult to get tested - many hoops to jump through in general, so for sure that affects the numbers, same with deaths, though there hasn’t been a massive spike in deaths compared to previous years - so the death toll - though likely higher than the official one, doesn’t seem to be like some of the tragically effected other countries.

Since we’re only been ‘open’ for a few weeks it remains to be seen if we get a spike in new cases in the coming weeks/month. Personally I’m still mainly hanging around my little area where I can walk to the park and see water every day, and just shopping locally. Many people in the park are wearing masks. I don’t wear a mask outside because (assuming I had the virus without realizing)I don’t believe it’s dangerous in wide open spaces when you’re not close to people. But I do wear my mask when shopping, etc. I’ve heard that in town there are people not wearing masks, but most people I see in my area are wearing them (except kids).

So yes, a mystery. It could still come back to bite us later in the year once the weather cools down again. At the same time I’m grateful that - apart from not being able to work - that I’ve been able to get outdoors, and basically do what I’d normally do if I wasn’t working.

This article talks about some of the possible reasons that I mentioned:

Del mentioned diet with a question mark. Who knows? Perhaps something about diet does come into this - I have no idea. But there are Japanese that eat really badly too - lots of fried food etc, still the size of the meals are just smaller than in the west. But then what about China - and their diet? Of course it’s different to Japanese diet, but there are lots of similarities, and look at what happened in Wuhan.
 
Some anecdotal evidence that masks possibly do some good.

View: https://twitter.com/zeynep/status/1270455405324402688


I wonder if some of the worst trending places right now are because mask use is waning. Or maybe that people are packing inside for the AC. I am talking mainly about AZ and Texas.


It does appear spread isn't as fast outside and that mask usage does help to some extent. The companies (I work as a vendor) I work for are all requiring mask usage while working. Gloves are optional although they would prefer we use gloves. However, this is a big issue for using gloves. Part of what I do is put large sticker ads on the floor of some grocery stores, also put coupons on product (which are stickers). You can't do that with gloves on.
 
Yeah, that is the worst. Whenever I have to dispense autoclave tape with my gloves on, it is always a disaster. Based on current knowledge, gloves should be the least important of the protective elements. Fomites seem to be less contagious than water droplets and (possibly) aerosols, especially if you wash or sanitize your hands regularly.
In all scenarios the study looked at, routine face mask use by 50% or more of the population reduced COVID-19 spread to an R of less than 1.0, flattening future disease waves and allowing for less stringent lockdowns.
The bewildering part is that I don't know if we can get to 50% mask wearing here in the USA. The quote is from a Reuters article, the paper is linked below.

https://royalsocietypublishing.org/doi/10.1098/rspa.2020.0376
 
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It just makes sense that masks would cut down on the amount of virus that a mask-wearer puts into the air, regardless if there is any protection for that person from incoming virus. I also notice that so far--though it may be too early--all the protests in the U.S. haven't seemed to result in much of a spike in cases. Being outdoors helps, too. One study in China reported only a single infection resulting from outdoor contact, out of more than 700 cases. When pro sports resume in America, I'd bet there will be more problems with spreading in the NBA than in the NFL.

Trump visited a swab factory in Maine the other day, and as usual, he was the only person in the group not wearing a mask. It was reported that after he left, all the swabs that were present while he was there were destroyed, as a precaution.
 
It just makes sense that masks would cut down on the amount of virus that a mask-wearer puts into the air, regardless if there is any protection for that person from incoming virus. I also notice that so far--though it may be too early--all the protests in the U.S. haven't seemed to result in much of a spike in cases. Being outdoors helps, too. One study in China reported only a single infection resulting from outdoor contact, out of more than 700 cases. When pro sports resume in America, I'd bet there will be more problems with spreading in the NBA than in the NFL.

Trump visited a swab factory in Maine the other day, and as usual, he was the only person in the group not wearing a mask. It was reported that after he left, all the swabs that were present while he was there were destroyed, as a precaution.


Interestingly enough NASCAR is in process of finalizing plans to start allowing small numbers of fans back into tracks. It will be grandstands only, thus no one in the infield. Tonight in Martinsville no fans. This coming weekend in Florida (Miami) will be around 1,000 fans. However, they are all first responders/heath care workers. The next race that is going to allow fans is Talladega is going to allow 5,000 fans grandstands only, social distancing of 6 ft and facial coverings required. So yet again NASCAR is going to be the guinea pig.

 
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And they're banning confederate flags. Finally.

That's going to be interesting as I'm not sure how they are going to enforce it. The campgrounds outside the tracks they have zero control over and they aren't going to search motorhomes of people going into the infield. People don't have them in the actual grand stands. So the interesting thing is going to be how to deal with people flying that flag on their own motor homes and campers in the infield. People who live right outside many of the tracks allow fans to pay and set up campers, tents and motor homes in their front yards. There are campgrounds right outside some tracks that aren't owned by the track.
 
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I don't want to get into the specifics of protests too much, but it is a good experiment to detect the degree that outdoor gatherings have on transmission while people are mostly masked. There was a report of a National guardsmen testing positive, but many of them were not masked. And of course, the people protesting are still a relatively small number of people compared to the population of the USA. The aggregate behavior of the entire population might have more of a substantial effect.

Starting tomorrow evening in MD, indoor dining is starting in restaurants at decreased capacity and malls and indoor fitness centers are reopening. Masks and social distancing are still in effect. The question is how much of that behavior persists once things are re-opened. So far, most of the country has been dipping the toe in the water carefully. These changes are a lot more substantial and bring about a lot more risk of transmission.
 
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