Coronavirus: How dangerous a threat?

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Big announcement that Pfizer is not going to hit their interim analysis point by having 32 total events before November. The optimistic take is that the relative slowness might indicate that the vaccine arm is doing really well. But it is all blinded, so nobody should know if there is protection or not until they hit 32 and can look at how those numbers distribute between the groups.

ETA. There was a path where surging diagnostics could've given the country a theoretical exit strategy to COVID. But this slides shows that it was never even attempted. Vaccines or bust....

View: https://twitter.com/ScottGottliebMD/status/1321099893298089996

Vaccines should not have been prioritized over treatments. We need treatments to get to vaccines. UGH
 
Remember that in lots of places the question asked here..how dangerous is the Corona Virus?
Has an answer..so far it's dangerous to 1 of every 1620 Americans..you die..straight forward..
when we hit @320-330'it will be
One of every 1000 Americans is killed by Covid-19.
Straight forward
 
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Remember that in lots of places the question asked here..how dangerous is the Corona Virus?
Has an answer..so far it's dangerous to 1 of every 1620 Americans..you die..straight forward..
when we hit @320-330'it will be
One of every 1000 Americans is killed by Covid-19.
Straight forward
I get your point but there's also tons of potentially long-term issues that many covid survivors are experiencing, and not just in "long covid" cases.

This is one of the most frustrating things for me, incidentally. Since the very beginning we had decent mortality estimates for this virus across different age groups, but it's hard to find hard data on how many infections lead to observable sequelae.
 
Probably less than 10% of all infections, but even that figure is mind boggling. The best data will not be available for some time though as people learn whether long term symptoms end up being permanent disability. For instance, Inflammation of the lung, brain, and heart will eventually resolve, but it is anybody's guess whether scarring and fibrosis will be permanent.
Many researchers are now launching follow-up studies of people who had been infected with SARS-CoV-2, the virus that causes COVID-19. Several of these focus on damage to specific organs or systems; others plan to track a range of effects. In the United Kingdom, the Post-Hospitalisation COVID-19 Study (PHOSP-COVID) aims to follow 10,000 patients for a year, analysing clinical factors such as blood tests and scans, and collecting data on biomarkers. A similar study of hundreds of people over 2 years launched in the United States at the end of July.
 
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It is a little more complicated. Wild polio has been eradicated, but vaccine induced polio is still lingering because they use a live attenuated vaccine that can revert to virulence on rare occasions. That is not same vaccine that the developed world gets. Can you imagine how frothy anti-vaxxers would be if people were getting polio from their vaccine?
Joe F** Rogan strikes again. Really normal discussion with noted medical expert Alex Jones about vaccines and the types of stories that you can expect to hear more of as the COVID-19 vaccines near the end of the clinical trials. I am not going to post the clip but you can find it at the following handle --> @nathanTbernard
 
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I think you're missing the point. Gupta didn't say masks were ineffective. She said they should be limited to those at risk. If she believed masks are ineffective, why would she recommend that? At the same time, her recommendation, again, is backwards. It's the people less at risk who need to be wearing them.

Good grief, look at the opening question in that Bhattacharya interview you posted. The woman points out that some public official tested positive despite wearing a mask. Making a statement like this is basically spreading false information, implying that a mask is supposed to protect a wearer, rather than others. What really matters is that most people at that event did not wear masks--video confirms that.

And no, I wouldn't be emphasizing Gupta's authority. Again and again, I have made my points by citing studies, regardless of who published them. I've never singled out anyone as someone who ought to be listened to, I rarely mention any names at all. I simply show studies.



It depends on what you call effective against viruses. There are dozens and dozens of studies showing that masks do block viral particles/aerosols. The evidence is beyond debate.

What anti-mask advocates are arguing is that there is no compelling evidence that masks reduce transmission rates or disease incidence. But these are very difficult studies to run, because the goal is not to show that masks reduce disease for the wearer--an individual effect, the kind that most health scientists are accustomed to demonstrating (and most of the studies Rancourt cites are of this kind)--but for others in contact with the wearer, a social effect. Citing situations where many people wearing masks hasn't reduced case levels doesn't necessarily prove anything, because there are too many other factors that can't be controlled.

To take just one example, mask mandates are usually put into place when cases are rising, which in turn frequently result when economies open up and people stop taking simple precautions. The result is that masks are being worn under conditions that promote transmission more than when the masks were not being worn. In fact, many people feel that if they wear a mask, they can go out in public more than they would otherwise, and pay less attention to social distancing.

With regards to Rancourt in particular, yes, I responded to that, but I later looked more closely into his claims, and didn't post on that, as I recall. The fundamental flaw in Rancourt's argument is his assumption that a single air-borne particle can result in infection, and even the best masks will not block every single particle. What is his evidence for that? He cites a single source that argues--not on the basis of evidence, but on theory--that the size of certain air-borne particles are large enough to contain several thousand viruses, and that this is a large enough number to ensure infection. Even this cited author admits this is purely a theoretical calculation, that a sphere of a certain radius could contain several thousand viruses, if they were all packed together.

But that isn't how viral transmission works. This is how a physicist like Rancourt thinks it works, but it isn't how virologists and epidemiologists know how it works. The newly replicated viruses in an infected person don't have a program that enables them to pack themselves tightly into a compact sphere. The actual events involve particles getting into saliva, and it's droplets or aerosols of saliva that transmit the virus. Thus the key factor is, what is the concentration of virus in saliva, and how many individual viruses in an aerosol does that indicate? If you use the actual data on viral concentrations in saliva, it turns out that most aerosol particles will contain no virus at all. An air-borne particle has to be fairly large before it has a significant probability of carrying virus, and even then, probably only a few dozen at most, which are likely not enough to cause infection. Much larger particles can contain larger numbers of virus, but then these particles quickly settle to the ground because of their size.



https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275719/

So Rancourt is incorrect that a single air-borne particle is even likely, let alone certain, to transmit the virus. It almost always takes many particles, and this is why masks can be effective. If they block a significant proportion of exhaled particles, they reduce the likelihood of infection of other people.

some studies of viral concentration in saliva:

https://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(20)30196-1.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7107974/
https://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(20)30196-1.pdf
https://pubmed.ncbi.nlm.nih.gov/32235945/

studies of droplet size:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7126899/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382806/
J Aerosol Sci. 40(2): 122–133

Here's a table I constructed from the data of multiple studies:

Particle size (um)Virions in ave. load (7 x 106)Virions in peak load (7 x 108)Infectious dose (peak particles)Settling time (100 cm)
1< 0.1.0110,000 or more6 hr
2< 0.10.37100 - 10001.5 hr
5< 0.15.610 – 10015 min.
100.46461 – 105 min.

The particle size is after dehydration, which takes place in milliseconds after saliva is exhaled into the air. Dehydration results in a reduction of the particle’s diameter to roughly 20% of its original value, which means less than 1% of its original volume. I have shown estimates (number of viruses per particle) for average viral loads (column 2) in infected people, about 7 million per cc, and the highest loads recorded (column 3), about 100 times more concentrated. Even for the latter, the average number of viruses per particle of 10 um--the largest that might remain suspended in the air for several minutes--is only about 50. One or a very small number of these particles might be capable of infecting someone. But this is an extreme case, involving unusually high viral loads--and even for individuals like these, these levels would only occur in a narrow window of time. And other studies, shown in the list above, show that particles this size are not among the most numerous typically exhaled.
Your summary rebuttal is all fine & dandy, but as I said at the end of my post; anedoctally, masks haven't had any effect in stopping the spread here in the Denver-Metro area.

To reiterate: The governor implemented a state-wide mask mandate back in July that's been renewed on a monthly basis. Compliance has been surprisingly high and very seldom do I see anyone not wearing a mask. The state has been in masks for almost four straight months now. However, starting about 3 weeks ago, cases have exploded to levels exceeding the highest numbers back in the spring when no one was wearing masks!

And as anticipated, a dreaded "Safer-At-Home - Level 3 High Risk" action plan was implemented with the mayor's & governor's finger nervously on the "Stay-at-Home" lockdown button. In level 3, non-critical retail & restaurants are capped at 25% capacity, large gatherings are banned, houses of worship are restricted to 50 people and gyms/fitness centers are restricted to 25% capacity or 25 people, which ever is smaller. The irony of this is not one Covid case has been traced to any gyms/fitness centers in the entire city area!


Also, Spain has been mentioned - I can comment on that. I have two sister-in-laws in Espana; one in Madrid and the other in Barcelona (both restaurants owners). They tell me mask compliance has been high over the past months and now Spain has declared a national emergency with a 11:00 pm - 6:00 am curfew for possibly over the next 6 months!

More anecdotal evidence that masks aren't working:

View: https://mobile.twitter.com/yinonw/status/1321177364366123008?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1321177371475542017%7Ctwgr%5Eshare_3%2Ccontainerclick_1&ref_url=https%3A%2F%2Fcdn.embedly.com%2Fwidgets%2Fmedia.html%3Ftype%3Dtext2Fhtmlkey%3Dcb7145f1731b4c328f8e4d2201854ceaschema%3Dtwitterurl%3Dhttps3A%2F%2Ftwitter.com%2Fyinonw%2Fstatus%2F1321177371475542017%2Fphoto%2F1image%3D
 
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To reiterate: The governor implemented a state-wide mask mandate back in July that's been renewed on a monthly basis. Compliance has been surprisingly high and very seldom do I see anyone not wearing a mask. The state has been in masks for almost four straight months now. However, starting about 3 weeks ago, cases have exploded to levels exceeding the highest numbers back in the spring when no one was wearing masks!
You simply can't compare raw case numbers from March/April with those from September/October. As an example, Spain detected ~250,000 cases during the first wave between February and June, with an official figure of ~28,000 deaths. Since then, detected cases have risen to 1,116,738, while the official figure has risen to ~35,000 deaths. My understanding is that this is exactly the same in pretty much every country.
 
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Remember that in lots of places the question asked here..how dangerous is the Corona Virus?
Has an answer..so far it's dangerous to 1 of every 1620 Americans..you die..straight forward..
when we hit @320-330'it will be
One of every 1000 Americans is killed by Covid-19.
Straight forward
The issue at hand with this though is that some people see that as "I won't be one of the few who gets it", so they are careless. I am doing everything within my power to not become one of the few. Also as hortha typed, my biggest worry is surviving with long-term health issues.
 
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College football going great in Wisconsin. Starting QB is confirmed out with COVID-19 for 3 weeks and the backup is getting confirmatory PCR tested after his antigen test was also positive. Their game in doubt for Saturday as they near the 5% tripwire that forces cancelation. Great 'success' story brewing after 1 week and the outbreaks are just picking up steam. I am glad that no one has died yet.

One for Nomad. It should also be pointed out that mask quality is not the best in many places. Like with the lack of diagnostic funding, we also didn't surge funding for high quality masks to people. They should be thought of as one leg in a vaccine prevention plan, not the be all end all. Most places that have mask mandates are because the virus outbreak was out of control, so you have the causation vs association argument regarding the lines on the graph that Nomad posted.

View: https://twitter.com/TopherSpiro/status/1321178200769265676
 
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"Kaiser Study: Severe Obesity Boosts Risk of Death of COVID-19 Death, Especially for the Young."


"Severe obesity puts those with coronavirus disease 2019 (COVID-19) at particularly high risk of death, more so than related risk factors such as diabetes or hypertension, according to a study of patient records that researchers from Kaiser Permanente."

"We present findings that can inform decisions much earlier in the triage process, including in the ambulatory setting,” they wrote. “Our finding that severe obesity, particularly among younger patients, eclipses the mortality risk posed by other obesity-related conditions, such as history of myocardial infarction, diabetes, hypertension, or hyperlipidemia, suggests a significant pathophysiologic link between excess adiposity and severe COVID-19 illness.”


"Not only does being severely obese make it harder to breathe, but the adipose tissue fuels mechanisms that act like magnets for SARS-CoV-2, the virus that causes the COVID-19."

“Fat deposited in skeletal muscle may be sought after by top-end steakhouses but, in vivo, it compromises muscle metabolic efficiency, nutrient uptake, and performance,” Kass wrote. “It requires more muscle force to displace the diaphragm downward when a substantial fat mass lies below it. Abdominal obesity also makes it more difficult to breathe in a prone position that is favored to improve ventilation in patients with COVID-19.”

IMO, this is one of the main high-risk groups that needs to be locked down and kept out of the public so the rest of us healthy people can get on with our lives without these tyrannical restrictions & lockdown orders. I don't feel a bit sorry for these people - obesity is a preventable condition. It's a choice they've made in life that comes with severe health consequences. Being obese stresses the immune system where they're susceptible to complications from a wide-variety of viral & bacterial infections.

Some people have discipline in their life and excercise & eat healthy while others don't. There are winners & losers when it comes to the decision people make in taking personal responsibility of their health.
 
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College football going great in Wisconsin. Starting QB is confirmed out with COVID-19 for 3 weeks and the backup is getting confirmatory PCR tested after his antigen test was also positive. Their game in doubt for Saturday as they near the 5% tripwire that forces cancelation. Great 'success' story brewing after 1 week and the outbreaks are just picking up steam. I am glad that no one has died yet.
Yeah...how stupid is that - 3 weeks out for an asymptomatic case. That's the Big 10 - the same conference that back in August emphatically stated they would not play football this year under any circumstances. Lol. I guarantee you, though, if it was Justin Fields of OSU (projected #1 or #2 overall pick in the NFL draft) they would find a way for him to play. It's because of Justin Fields the Big 10 did a 180 (when ACC declared they would play which included National Champion Clemson with Trevor Lawrence - the other #1 or #2 OA pick). It's politics and $$$ that is dictating this FBS season...no surprises there.

And not only has no one died, but all cases have been asymptomatic or very mild with both players & coaches. Even the old buck 68 yr Nick Saban of Bama was asymptomatic:


Another middle-aged coach is asymptomatic:


"Less than 24 hours later, Mullen announced that he was also among the positive cases. He said that everyone affected so far has been asymptomatic or experienced only mild symptoms"
 
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Personally, I don't think Saban was ever infected. But that is just my speculation. Just as I posted my last comment it was announced that 6 players and 6 staff have tested positive for Wisconsin, including the Coach Paul Chryst. Their game has been canceled and they can't practice for 7 days after hitting the tripwire. It is so hard to believe that they had an outbreak just a few days after celebrating homecoming in the middle of a pandemic. Shocking..... You can go back all the way to the summer and this was my fear about the whole debacle. Paul is a standup guy, but he is in his mid 50s and pretty portly. And this is only after 1 week of football. 1 week! The Big Ten delaying the start to coincide with fall weather is one of the biggest head scratchers in the whole pandemic. What did they seriously expect?

Good lord..... I guess Clemson is pioneering this strategy by the numbers. I hope they tell the virus not to infect the coaches. I read one from Clemson was self isolating from his wife (who was a cancer survivor) for the duration of the season to prevent from bringing the virus home. Whether this is profoundly depressing or uplifting depends on the POV.

ETA: The moral of the story is that daily antigen tests are not sufficient to block an outbreak. We saw that in the White House and now we are seeing that in the locker rooms of Wisconsin. It is not designed to pick up pre-symptomatic individuals. And we know that they can be spreaders of COVID. It is a step up from temperature checks, but still well short of what is needed.
 
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I get your point but there's also tons of potentially long-term issues that many covid survivors are experiencing, and not just in "long covid" cases.

This is one of the most frustrating things for me, incidentally. Since the very beginning we had decent mortality estimates for this virus across different age groups, but it's hard to find hard data on how many infections lead to observable sequelae.

Probably less than 10% of all infections, but even that figure is mind boggling. The best data will not be available for some time though as people learn whether long term symptoms end up being permanent disability. For instance, Inflammation of the lung, brain, and heart will eventually resolve, but it is anybody's guess whether scarring and fibrosis will be permanent.

Does anyone have validated numbers for long-term issues that many covid survivors are experiencing? I read reports in our media but they never state proportion. I am suspicious because the media do have a tendency to sensationalize.

I had pneumonia a few years ago so I know about scarring of the lungs but with covid anyone with that severity of symptoms would likely be admitted to hospital and end up listed as serious. So I am wondering if we are only talking about a very small percentage of Covid cases?

According to the data I can find, about 1% of Covid active cases are listed as serious or critical. I assume it is only those who get serious or critical symptoms who are at risk from long term problems like Inflammation of the lung, brain, and heart ?

Currently less than 0.6% of US Covid active cases are listed as serious.
Globally about 0.75% of active cases are listed as serious.

I doubt that anyone with mild symptoms is going to end up with long term problems?
 
as far as I understood from comparing the numbers on worldometer to country updates, serious or critical are those who are basically in ICU

then something like 10x or 15x that number are the people who are in hospital and not in the ICU
 
You simply can't compare raw case numbers from March/April with those from September/October. As an example, Spain detected ~250,000 cases during the first wave between February and June, with an official figure of ~28,000 deaths. Since then, detected cases have risen to 1,116,738, while the official figure has risen to ~35,000 deaths. My understanding is that this is exactly the same in pretty much every country.

Just to add, I've seen estimates that to be able to compare numbers from spring to now one should multiply the spring numbers by between 5 and 7 to account for the increased testing.

Edit: an obviously not forgetting the much stricter restrictions then
 
We talked about it earlier, the US is behind Europe by a couple of weeks. Seems like the strongly increasing infection phase has started in many American states. We're breaking records in almost every EU country at the moment, so I can tell you it's moving incredibly fast. About 4-5 weeks ago, regular Joe's here were wondering if the virus lost its vigour and more of that. Now, we're seeing hospital admissions that are already nearing the late March peak. For a president to keep insisting your country has rounded the corner is pretty incredible. The next months are going to be difficult in many places in the northern hemisphere.
 
as far as I understood from comparing the numbers on worldometer to country updates, serious or critical are those who are basically in ICU

then something like 10x or 15x that number are the people who are in hospital and not in the ICU
Well I doubt that sorry. In Australia there is nothing like this number in hospital from Covid. Our medical centers are also empty. Social distancing also prevents spread of cold and flu.
 
We talked about it earlier, the US is behind Europe by a couple of weeks. Seems like the strongly increasing infection phase has started in many American states. We're breaking records in almost every EU country at the moment, so I can tell you it's moving incredibly fast. About 4-5 weeks ago, regular Joe's here were wondering if the virus lost its vigour and more of that. Now, we're seeing hospital admissions that are already nearing the late March peak. For a president to keep insisting your country has rounded the corner is pretty incredible. The next months are going to be difficult in many places in the northern hemisphere.
According to worldometer cases are skyrocketing not deaths or serious cases'. Covid deaths are about the same ratio as back in July. In US deaths peaked in April. If you have evidence for the bold, please share.

Don't get me wrong, I think the US is a disaster but it is important to get the numbers and sense of proportion right.
 
yeah, 10x or 15x is probably an overestimate although it could be valid for some countries

here are some examples

Spain


17073 hospitalized, 2368 in ICU

UK


9502 hospitalized, 902 in ICU

Italy


14981 hospitalized, 1526 in ICU
 
According to worldometer cases are skyrocketing not deaths or serious cases'. Covid deaths are about the same ratio as back in July. In US deaths peaked in April. If you have evidence for the bold, please share.

Don't get me wrong, I think the US is a disaster but it is important to get the numbers and sense of proportion right.

7 day moving average for deaths is up over 20% through October and that's a lagging indicator

restrictions being added in Europe is precisely because of the bold as capacity is starting to run out
 
yeah, 10x or 15x is probably an overestimate although it could be valid for some countries
I think it is also highly dependent on the ICU capacity, including beds and personnel. In Maryland, we have top tier hospitals with a good amount of capacity and we have been between 3x and 5x.
If your teams win the world series you can celebrate with them even if you have just tested positive!
I don't know which was worse. Sitting right next to his cancer survivor manager for the team picture or kissing his wife on the mouth.
 
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Masks are only required when you lose control of the virus. Look at Australia's stats and understand that only the state of Victoria mandated the use of masks after losing control of quarantine, then poor contact tracing systems. What saves Australia is isolation and the 14 day compulsory quarantine for all returned travelers. All Australian states have strict covid safe regulations including social distancing.

People are accutely aware of the Covid threat though. I frequent a suburb in Sydney with a large Chinese community. When news of the virus is worrying everyone wears masks. But I was there two weeks ago and noticed many were not wearing masks. But I can understand this knowing that in the state of NSW where I reside there is virtually zero community transmission of Covid-19. Virtually all new recorded cases are returned international travelers who are placed into 14 day quarantine.

 
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