outbreak! (ebola, sars, coronavirus, etc)

iirc the fraction of positive tests has fallen in NYS at the same time as the rate of testing has plateaued, which is difficult to explain without assuming the spread has slowed.

on a national scale, though, i suppose the improvements in new york are being offset by growth in new regions. given that NY and NJ represent so much of the national caseload, i was hoping that continuing improvement there would lead to an overall decline soon. i guess i'm anxious to get to the other side of the curve.

some of the projections for overall deaths seemed to feature an assumption that the distribution would be normal. but it could very well be heavy on the post-peak side, even before you start to consider the effects of various states and cities opening up prematurely. on the other hand, maybe those dumb unforced errors will be offset by advances in treatment.

https://i.imgur.com/y2CNC6q.png

I don't really look at testing/cases. The U.S. is not doing enough testing for those numbers to be meaningful imo. I look at hospitalizations and deaths. I would say we are plateauing in NYC, but it's still a high, unmanageable plateau, in terms of the strain on the hospitals. I think as the East Coast recovers a bit, the Midwest will be hit harder.

This is the most infuriatingly Japanese response to the corona virus - only white masks are acceptable attire in some schools and businesses

https://mainichi.jp/english/articles/20200420/p2a/00m/0na/014000c

is that because it's easier to verify that a white mask is clean (whatever that means) or is it a 'uniform' thing? maybe I should click the link.

A little of A and a lot of B

Looking at Karl's graph, there appears to be a fairly stable ratio between the number of tests and the number of positives. On days when tests rise, the positive results rise in tandem. On days with fewer tests, the positives dip right along in the same ratio.

To me this is not reassuring; it suggests that, if twice as many tests had been done on any day, it might have discover twice as many cases that day. Or not. The only way to break that pattern of constant ratio of tests-done-to-positive-results would be to conduct so many tests that the number of positive results stalled out, no matter how many additional tests were done. We are not there and it would help immensely if we achieved that state.

Agreed. We're gonna need... so much more testing.

@Karl, I'd either do a rolling average (3, maybe even 7?) because the reporting is so wonky over the weekend, you end up with almost a sawtooth pattern.

But more importantly, today is tracking to be the worst day yet so all that chatter about post-peak, etc. seems way premature... :-(

(also what is your source for these numbers?)

covidtracking.com

here's an updated version with rolling 3-day averages for both new tests and cases

https://i.imgur.com/54G6MUt.png

This piece is proposing a four day week to counter the economic impact of covid.

https://amp.ft.com/content/5c208540-831c-11ea-b6e9-a94cffd1d9bf

gimme

A four-day fortnight!

The Trump administration promised that by March 28th – nearly a month ago – there would be over 27 million coronavirus tests conducted in the U.S. It’s April 21st and we haven’t reached 5 million.

Where are the tests? https://t.co/eOi8O03XYJ

— Sheldon Whitehouse (@SenWhitehouse) April 21, 2020

“There’s a possibility that the assault of the virus on our nation next winter will actually be even more difficult than the one we just went through,” CDC Director Robert Redfield said in an interview with The Washington Post. “And when I’ve said this to others, they kind of put their head back, they don’t understand what I mean.”

“We’re going to have the flu epidemic and the coronavirus epidemic at the same time,” he said. Having two simultaneous respiratory outbreaks would put unimaginable strain on the health-care system, he said.

https://www.washingtonpost.com/health/2020/04/21/coronavirus-secondwave-cdcdirector/

^ Which is why we need a really strong planning effort all through the summer and fall to put all the necessary testing and supplies in place, along with contingency plans for extra beds and keeping health workers safe. Lead time is the main advantage we'll have then that we didn't have at the outset. But Trump squandered our brief lead time in January and February, and there's no indication he'll do better with his second chance.

So if one of these anitviral treatments work, are we good to go?

Do doctors often use antiviral medicine originally developed to fight HIV on other viruses? Seems like generally people just wait them out.

Antivirals won't stop anyone from getting or spreading the disease, but at least there would be a way to treat those who become ill with it. How effective a treatment they may be is the question, but most antivirals require swift intervention at an early stage of the progression to be much good.

Effective antiviral treatment isn’t really a “good to go” scenario I don’t think. Drugs may be expensive, difficult to manufacture, may be in short supply once an existing antiviral is shown to be effective, and it’ll still be highly preferable for people to not get sick in the first place.

My only pointed policy opinion about this at this point is that everyone who can plausibly work from home should continue doing so until they are vaccinated.

If there was a drug treatment that was effective, inexpensive, and easy-to-manufacture, there is no way that we would all keep this lockdown going, and that would be a good thing!

Not to the same degree, but filling office buildings with people from a vast commute radius who don’t really need to work from the office shouldn’t resume (1) ever but (2) at all prematurely.

I’m down with that, to some extent, but I think in-person work is valuable too.

If there was a drug treatment that was effective, inexpensive, and easy-to-manufacture, there is no way that we would all keep this lockdown going, and that would be a good thing!

If Ivermectin turns out to be an effective treatment, it's apparently cheap and easy-to-manufacture. It's what heartworm medicine for pets is!

ivermectin will not be the answer. I really wish the media would stop reporting these preprints because none of them have any idea how to interpret them

yeah, while I agree with you in principle silby, there are mental health benefits to getting out of your house and seeing co-workers in person (some of them anyway)

If everybody went to the office 2 days a week instead of 5 the environmental benefits alone would be *checks note* immense

yeah i'd sign up for that for sure

Dying with stupidity pic.twitter.com/cyssMCk9KN

— TheIainDuncanSmiths (@TheIDSmiths) April 21, 2020

the freedom to be a complete numpt can often have consequences it seems!

https://apple.news/AqiSfdCQbRHSq13u6U8nDKA

A person who died at home in Santa Clara County on Feb. 6 was infected with the coronavirus at the time of death, a stunning discovery that makes that individual the first recorded COVID-19 fatality in the United States, according to autopsy results released by public health officials late Tuesday.

People typically die of COVID-19 about a month after they are infected with the coronavirus, suggesting that the person who died Feb. 6 likely was infected in early January. At that time, the virus had been reported only in China — the U.S. Centers for Disease Control and Prevention had not yet issued any advisories to Americans about the potential threat.

Thread on immunity and vaccine potential – it comes across as too pessimistic (as he says himself) but the thing that has me thinking is a) how seriously long getting to vaccine might take, and b) how if it's only 50% effective we're going to be living with serious but hopefully localised outbreaks more-or-less forever, basically

If you’re hoping a vaccine is going to be a knight in shining armor saving the day, you may be in for a disappointment. SARSCOV2 is a highly contagious virus. A vaccine will need to induce durable high level immunity, but coronaviruses often don’t induce that kind of immunity 1/

— David States (@statesdj) April 21, 2020

Just because she was infected with the virus at the time of death doesn't actually mean that she died from it? Difficult to know without more information about the patient but it doesn't necessarily mean it was circulating a month prior to her death.

People typically die of COVID-19 about a month after they are infected with the coronavirus

yep and this is patently untrue - you could die within days after showing symptoms (anywhere between 4-14 days) if you have a weak immune system or have underlying conditions. so the person may have contracted in January but you wouldn't be able to say when exactly.

even january is, i think, quite a bit earlier than they were thinking we had anyone infected in the US? and it almost certainly should indicate that more people were infected at that time.

about this morning's news:

WASHINGTON — The alarming messages came fast and furious in mid-March, popping up on the cellphone screens and social media feeds of millions of Americans grappling with the onset of the coronavirus pandemic.

Spread the word, the messages said: The Trump administration was about to lock down the entire country.

“They will announce this as soon as they have troops in place to help prevent looters and rioters,” warned one of the messages, which cited a source in the Department of Homeland Security. “He said he got the call last night and was told to pack and be prepared for the call today with his dispatch orders.”

did anyone here from the U.S. receive any text message like that, or hear of anyone else that did? i didn't.

sorry, forgot to include this snip as well:

Since that wave of panic, United States intelligence agencies have assessed that Chinese operatives helped push the messages across platforms, according to six American officials, who spoke on the condition of anonymity to publicly discuss intelligence matters. The amplification techniques are alarming to officials because the disinformation showed up as texts on many Americans’ cellphones, a tactic that several of the officials said they had not seen before.

yeah, I don’t think the bullet point here is early january, just january and california — the emphasis has been on february cases in washington. january and california is a whole new epidemiological exploration

Nope. I got a two local ones from the City of Chicago, but I never saw a single national one.

(xpost)

Karl; I think they mean people in the community
texting each other, not an agency doing it

“cited a source in DHS” is the covid version of “my uncle at nintendo told me about luigi”

yep, i know mh, i was just wondering how widespread they got. because honestly it just sounds like the kind of dumb made-up shit that people send to each other all the time anyway; i'm surprised it could be tracked down

where is all this "hospitals are intentionally inflating the death count" stuff coming from? how does that square with the fact that the federal government is still trying to downplay this as much as possible?

Another group of governors have formed a multi-state pact to figure out when and how to open their states. This is not good news.

Republican governors across the Southeast are teaming up to reopen the region’s economy, even as they lack the testing to know how rapidly the coronavirus is spreading.

One health expert called the political decision a “perfect storm” for the virus to reassert itself.

The newly formed coalition includes Florida, Georgia, South Carolina, Tennessee, Alabama and Mississippi, a part of the country that has underfunded health systems, as well as high rates of obesity, diabetes and other illnesses that amplify the deadliness of the coronavirus.

And unlike their peers in New York, New Jersey and other Northeastern states that have been working cooperatively since last week to restart their economies, the six in the South have lagged on testing and social distancing measures.

“If you put these states together, there is a perfect storm for a massive epidemic peak later on,” said Jill Roberts of the University of South Florida’s College of Public Health. “The Southeast region is not known for having the best health record. Diabetes and heart disease come to mind. I am very concerned about how our states will do it.”

...

As of Tuesday morning, the six states had collectively tested about one-tenth of 1 percent of their total populations. Mississippi, which ranks 15th nationally in testing, had the group’s best testing rate at 1.7 percent of its population. Georgia was the lowest, with a testing rate of less than one one-hundredth of 1 percent, or 42nd in the country, according to the Covid Tracking Project.

By comparison, the coalition of seven states in the Northeast has a collective testing rate twice that of the Southeast, having swabbed more than two-tenths of 1 percent of their collective population.

Five of the seven states included in the Northeastern coalition are in the top 15 nationally in per-capita testing.

Beyond the numbers, the two regions differ culturally and in the political instincts of their leaders. Even as the Northeast looks to band together, its governors are urging caution.

Southern governors, most of whom have built political careers on small-government conservatism, are driving, by contrast, to restart their economies and get people back to work, even as infections mount.

...

Dr. Aileen Marty, a pandemic and infectious disease expert at Florida International University, said gains made through social distancing and other precautions are good signs, but not the signal to loosen efforts that Southern governors think they are.

“They are heavily Republican with social conservatives who are all of a like mind,” Marty said. “They are tempting fate by having the virus out and about among us, but if they don’t do it in a controlled way, we will again be back in situations of overwhelmed hospitals and more people dying.”

i think the idea is that hospitals are calling all deaths by ppl who tested positive for covid-19 covid-19 deaths "even if" they died of some pre-existing condition (that covid-19 maybe didn't exacerbate? idk these ppl aren't that smart) but the truth is that hospitals are undercounting the death count bc loads of ppl who die at home and are never tested have it too (which is why they've had to revise numbers in many places). xp

where is all this "hospitals are intentionally inflating the death count" stuff coming from?

generally the people saying that are buying the federal government's line of bullshit and make arguments that if you were hospitalized with covid-19 then died of organ failure or a heart attack it doesn't count because.. you died of organ failure

Apparently it's just a funny coincidence to these people that death rates are way above average.

if you were hospitalized with covid-19 then died of organ failure or a heart attack it doesn't count because.. you died of organ failure

Ultimately, we all die of cardiac arrest.

unless we get 'sploded

https://www.youtube.com/watch?v=vM3J9jDoaTA

Following the Covid-19 pathology literature it seems it may soon be easier to name organs Covid-19 doesn't attack in critical cases. Lungs, kidneys, heart, liver, central nervous system all are accounted for. DIC associated with Covid-19 and SIRS associated with Covid-19 are bad bad news, all over the body.

And death attribution doesn't really matter in the end. Whether one dies of Covid-19, with Covid-19, or without Covid-19 because medical resources are overwhelmed, or because one fears engaging with the medical system during a pandemic, its all fairly directly attributable to the ongoing pandemic.