Coronavirus Numbers

[Guest]

Nothing but full protective gear (Hazmat) will protect virtually 100% (or 95%) but a mask of decent sort will also protect you, maybe only 80%, but that's a whole lot better than zero. Washing hands/hand sanitizer helps a bunch too.

 

I agree on the hand washing/sanitizing, but on what basis do you make the claim that a mask protects the wearer from Covid-19?

[JulianLondon]

 

Stephen Fry

 

We’ve been doing our best to collate the most credible science from around the world to paint a picture of how things might develop with this pandemic. Bear in mind, NO ONE knows for sure. This is all new. But we hope this film sheds some responsible light

 

[+ tassojunior]

I agree on the hand washing/sanitizing, but on what basis do you make the claim that a mask protects the wearer from Covid-19?

The same basis that the CDC and many cities require masks; Most infection is into the nose or throat. Any mask of any sort is going to be a lot better than none both for stopping your infection and your spread. Edited April 23, 2020 by tassojunior

[Guest]

The same basis that the CDC and many cities require masks; Most infection is into the nose or throat. Any mask of any sort is going to be a lot better than none both for stopping your infection and your spread.

That's obviously a completely non-responsive answer. My question was "on what basis do you make the claim that a mask protects the wearer from Covid-19?". Do you know of any reputable scientific studies that show that wearing a mask without other protective gear provides protection? Or at least know of a statement by a reputable medical organization or authoritative medical leader (not Donald Trump) that states that this is the case? There's obviously a good reason that Covid-19 has spread like wildfire in meat packing plants, even though the workers have been wearing face masks. That's because the workers are working on a production line, and the infection is spread by droplets (and obviously they can't change gloves every time a new slab of meat goes through). Yes, the face masks will reduce the number of droplets an infected worker will get onto the production line. But if one of those droplets gets through, everyone down the line is potentially exposed, and the masks and dirty gloves don't help.

 

https://www.usatoday.com/in-depth/news/investigations/2020/04/22/meat-packing-plants-covid-may-force-choice-worker-health-food/2995232001/

[Populist Fury]

Unless you are in full protective gear, which you are able to change in between each person you see, I would not buy masks with the thought that it's protecting YOU from getting Covid-19. The idea behind the masks is that it will limit droplet spread to decrease your ability to transmit it to others. Just about anything you put in front of your face (as long as it's not a mask with one of those one-way valves) will do.

 

 

I'm in favor of the Sweden herd immunity approach + I probably already had the virus pass through me back in Feb.

 

The masks are for someone else who needs a new one every day, & to have a few extra dozen available @ home in case anyone else I know needs some. Ended up ordering 2 large batches of N95 & KF94 respirators from an Amazon-like China site, from sellers with a US stock. The Korean style is a better design ?

 

I agree with Tasso that these masks are much more protective for the wearer than some poorly-made cloth mask made out of an old sock or something else. They also make people feel safer when they go outside regardless of the actual science.

[Guest]

I'm in favor of the Sweden herd immunity approach... They also make people feel safer when they go outside regardless of the actual science.

 

Well, as long as long as hospitalizations, especially in the ICU, drop considerably, and if it seems that Covid-19 becomes much less virulent in the warm weather (as is the case with other known coronaviruses), then it might be a good idea to open things up during the hot months, with the idea of avoiding a more serious surge/total deaths in the Fall and Winter. Sweden's mortality from Covid is 2 to 5 times its neighbors' (Norway, Denmark, Finland), but their hospitals haven't been overwhelmed, so the extra people who died may have just died sooner rather than later.

And who cares about science and facts as long as you feel better? People were so thrilled when Donald Trump said hydroxychloroquine was a "game changer." When the issue was examined scientifically, however, those taking hydroychloroquine died at double the rate of those who didn't take it. If people are wearing masks to "feel better" rather than to protect others (its real purpose), then maybe good feelings are what's important, regardless of the facts.

https://thehill.com/policy/healthcare/493931-largest-analysis-of-hydroxychloroquine-use-finds-no-benefit-increased

"The analysis examined 97 patients treated with hydroxychloroquine alone, 113 treated with a combination of hydroxychloroquine and azithromycin, and the rest with neither drug. According to the analysis, about 28 percent of patients who were given hydroxychloroquine plus the usual care died, versus 11 percent of those getting routine care alone."

[+ WilliamM]

Well, as long as long as hospitalizations, especially in the ICU, drop considerably, and if it seems that Covid-19 becomes much less virulent in the warm weather (as is the case with other known coronaviruses), then it might be a good idea to open things up during the hot months, with the idea of avoiding a more serious surge/total deaths in the Fall and Winter. Sweden's mortality from Covid is 2 to 5 times its neighbors' (Norway, Denmark, Finland), but their hospitals haven't been overwhelmed, so the extra people who died may have just died sooner rather than later.

And who cares about science and facts as long as you feel better? People were so thrilled when Donald Trump said hydroxychloroquine was a "game changer." When the issue was examined scientifically, however, those taking hydroychloroquine died at double the rate of those who didn't take it. If people are wearing masks to "feel better" rather than to protect others (its real purpose), then maybe good feelings are what's important, regardless of the facts.

https://thehill.com/policy/healthcare/493931-largest-analysis-of-hydroxychloroquine-use-finds-no-benefit-increased

"The analysis examined 97 patients treated with hydroxychloroquine alone, 113 treated with a combination of hydroxychloroquine and azithromycin, and the rest with neither drug. According to the analysis, about 28 percent of patients who were given hydroxychloroquine plus the usual care died, versus 11 percent of those getting routine care alone."

 

Are you suggesting it is fine if old people die sooner rather than later in Sweden if they have serious under lying conditions? You a good guy and an excellent doctor ?.

[+ sniper]

Well, as long as long as hospitalizations, especially in the ICU, drop considerably, and if it seems that Covid-19 becomes much less virulent in the warm weather (as is the case with other known coronaviruses), then it might be a good idea to open things up during the hot months, with the idea of avoiding a more serious surge/total deaths in the Fall and Winter. Sweden's mortality from Covid is 2 to 5 times its neighbors' (Norway, Denmark, Finland), but their hospitals haven't been overwhelmed, so the extra people who died may have just died sooner rather than later.

I wonder if Sweden simply chose not to ventilate a lot of older people given that most don't survive? That would be a way to significantly reduce the burden on hospitals as patients would die in a matter of days rather than lingering for weeks causing a backup.

[+ tassojunior]

That's obviously a completely non-responsive answer. My question was "on what basis do you make the claim that a mask protects the wearer from Covid-19?". Do you know of any reputable scientific studies that show that wearing a mask without other protective gear provides protection? Or at least know of a statement by a reputable medical organization or authoritative medical leader (not Donald Trump) that states that this is the case? There's obviously a good reason that Covid-19 has spread like wildfire in meat packing plants, even though the workers have been wearing face masks. That's because the workers are working on a production line, and the infection is spread by droplets (and obviously they can't change gloves every time a new slab of meat goes through). Yes, the face masks will reduce the number of droplets an infected worker will get onto the production line. But if one of those droplets gets through, everyone down

 

I also don't know of any studies that show that cotton clothing generally prevents or decreases sunburn to the covered skin but it's common sense.

[+ bigjoey]

Chinese games exposed. Changing definitions change the numerical results:

https://www.newsweek.com/coronavirus-china-latest-cases-february-four-times-official-figure-new-study-1499745

[+ Charlie]

The temperature in Palm Springs at the moment (6pmPDT) is 100 F. I hope that discourages the virus from visiting if restrictions are loosened.

...if it seems that Covid-19 becomes much less virulent in the warm weather (as is the case with other known coronaviruses), then it might be a good idea to open things up during the hot months, with the idea of avoiding a more serious surge/total deaths in the Fall and Winter. "

[Guest]

I also don't know of any studies that show that cotton clothing generally prevents or decreases sunburn to the covered skin but it's common sense.

Well, unfortunately it looks as though you lack a great deal of common sense, since the rapid spread of Covid-19 in meat packing plants, where everyone is wearing face masks, plainly disproved the idea that they provide any significant protection to the wearer (let alone the "80%" you claimed). And, yes, studies have been done to demonstrate the relative protection factors of various clothing. Who even needs facts and science, when you've got the "common sense" of people like TJ and Donald Trump?

http://i2.wp.com/twistedmalemag.com/wp-content/uploads/2019/11/DSC_4642-01.jpeg?resize=800,1202

https://www.mdedge.com/dermatology/article/87059/aesthetic-dermatology/uv-radiation-transmittance-regular-clothing-versus

Edited April 24, 2020 by Unicorn

[Guest]

Are you suggesting it is fine if old people die sooner rather than later in Sweden if they have serious under lying conditions? You a good guy and an excellent doctor ?.

Oh, dear. It looks as though someone doesn't understand why everyone's been doing what they've been doing. The goal of these shelter-in-place orders is to "flatten the curve" so as not to overwhelm the healthcare system all at once (and, to be more blunt, the mortuary system). The total number of people under the curve is the same. The idea is to avoid a rapid spike.

[JulianLondon]

[MEDIA=twitter]1253603765200080896[/MEDIA]

[samhexum]

I've seen 2 headlines now about people dying of Covid-19 in 2020 whose siblings had died of the Spanish flu in 1918. Weird!

[+ honcho]

I've seen 2 headlines now about people dying of Covid-19 in 2020 whose siblings had died of the Spanish flu in 1918. Weird!

 

Local news (CBS, bay area) today reported a case of a 107 year old woman who survived the 1918 pandemic, caught corona virus and

recovered! (She was in the hospital for 3 weeks, but pulled through).

[+ bigjoey]

If this testing results hold true to the general population, this means both the infection rate and the death rate figures we have so far are almost meaningless. The death rate of those infected drops dramatically.

https://www.reuters.com/article/us-health-coronavirus-prisons-testing-in/in-four-u-s-state-prisons-nearly-3300-inmates-test-positive-for-coronavirus-96-without-symptoms-idUSKCN2270RX?feedType=mktg&feedName=topNews&WT.mc_id=Partner-Google

 

What puzzles me is what factors does a person who tests positive have that the virus causes no symptoms (and I assume no health problems, at least in the short run)? What factors are in play for the people whose symptoms are just mild like a cold or even the flu? What factors are in play for those who end up requiring hospitalization? I am starting to wonder if there is a genetic component to the Covid Virus.

[LivingnLA]

If this testing results hold true to the general population, this means both the infection rate and the death rate figures we have so far are almost meaningless. The death rate of those infected drops dramatically.

https://www.reuters.com/article/us-health-coronavirus-prisons-testing-in/in-four-u-s-state-prisons-nearly-3300-inmates-test-positive-for-coronavirus-96-without-symptoms-idUSKCN2270RX?feedType=mktg&feedName=topNews&WT.mc_id=Partner-Google

 

What puzzles me is what factors does a person who tests positive have that the virus causes no symptoms (and I assume no health problems, at least in the short run)? What factors are in play for the people whose symptoms are just mild like a cold or even the flu? What factors are in play for those who end up requiring hospitalization? I am starting to wonder if there is a genetic component to the Covid Virus.

 

Genetic diversity creates subtle difference and variance throughout human tissues. Add in environmental and nutritional factors and there's even more variance, which may be part of what's going on in the USA. For example, we have terrible obesity rates which cost us over a hundred billion every year in excess healthcare and lost productivity. Obesity appears to be a significant factor for COVID-19. This is probably connected to inflammation.

 

Stroke rates are higher in some, which is probably related to the unusual rapid clotting that seems to happen in some infected people.

 

https://www.npr.org/sections/health-shots/2020/04/07/828091467/why-some-covid-19-patients-crash-the-bodys-immune-system-might-be-to-blame

Now doctors and researchers are increasingly convinced that, in some cases at least, the cause is the body's own immune system overreacting to the virus. The problem, known broadly as a "cytokine storm," can happen when the immune system triggers a runaway response that causes more damage to its own cells than to the invader it's trying to fight.

 

https://www.theatlantic.com/health/archive/2020/04/coronavirus-immune-response/610228/

This degree of uncertainty has less to do with the virus itself than how our bodies respond to it. As Murphy puts it, when doctors see this sort of variation in disease severity, “that’s not the virus; that’s the host.” Since the beginning of the pandemic, people around the world have heard the message that older and chronically ill people are most likely to die from COVID-19. But that is far from a complete picture of who is at risk of life-threatening disease. Understanding exactly how and why some people get so sick while others feel almost nothing will be the key to treatment.

 

Here's an article about how immune parameters can possibly be used to predict infection outcomes.

We propose that these immune parameters should be characterized in larger cohorts of people with COVID-19 with different disease severities to determine whether they could be used to predict disease outcome and evaluate new interventions that might minimize severity and/or to inform protective vaccine candidates. Furthermore, our study indicates that robust multi-factorial immune responses can be elicited to the newly emerged virus SARS-CoV-2 and, similar to the avian H7N9 disease8, early adaptive immune responses might correlate with better clinical outcomes.

[+ stevenkesslar]

If this testing results hold true to the general population, this means both the infection rate and the death rate figures we have so far are almost meaningless. The death rate of those infected drops dramatically.

https://www.reuters.com/article/us-health-coronavirus-prisons-testing-in/in-four-u-s-state-prisons-nearly-3300-inmates-test-positive-for-coronavirus-96-without-symptoms-idUSKCN2270RX?feedType=mktg&feedName=topNews&WT.mc_id=Partner-Google

 

What puzzles me is what factors does a person who tests positive have that the virus causes no symptoms (and I assume no health problems, at least in the short run)? What factors are in play for the people whose symptoms are just mild like a cold or even the flu? What factors are in play for those who end up requiring hospitalization? I am starting to wonder if there is a genetic component to the Covid Virus.

 

I actually think the numbers are getting clearer and clearer with these antibody tests.

 

If I had to guess, The Lancet studied that estimated a death rate of 0.66 % - if everybody in the whole world could be tested at once - is in the ballpark of correct. That said, if you include the CA and NY antibody studies, it could be anywhere from 0.2 % to 1 %. In other words, COVID-19 could be two to ten times more deadly than the flu.

 

I think we know for a fact that this is more deadly than the flu. The flu does not kill 22,000 New Yorkers in less than a few months. The flu does not lead to refrigerated trucks being turned into morgues. So the question now is: how much more deadly is it, and how do we protect the people it is deadly to?

 

I put this post in the politics section although 99 % of it is apolitical test data. All the data does hold together, and creates a relatively sensible hypothesis, at least, of what is going on.

 

So if you take the NY data, which is the most extensive, we know that 2 % of all NYC residents have confirmed cases. And the antibody tests suggests a 20 % infection rate. In NY state, we know that 1.44 % of state residents have confirmed cases (287,000 out of 19.5 million people). The antibody tests suggest a 14 % infection rate. So in both cases it works out to about a 10 to one ratio between confirmed cases and actual cases.

 

We've known all along that these high death rates - 7.56 % in New York right now - are so high because the people being tested are only the sickest subset of victims. So right on the face of it, you can divide 7.56 % by 10 and get a hypothetical 0.756 % death rate. That's in line with what The Lancet and Fauci have been saying all along.

 

You can get to similar results by taking these presumed infection rates, based on the antibody tests, and work back to a presumed death rate.

 

So in NYC there's a presumed infection rate of 21 %, which would be 1.76 million New York City residents out of 8.4 million. There are 16,388 reported deaths as of yesterday. That's a 0.93 % death rate.

 

In NY State there's a presumed infection rate of 14 %, which would be 2.73 million state residents out of 19.5 million. There are 20,861 deaths as of yesterday. That's a 0.76 % death rate.

 

The CA data from LA County and Santa Clara County suggest a somewhat more optimistic picture - perhaps a death rate as low as 0.2 %, and perhaps anywhere from 20 to 50 actual cases for every confirmed case.

 

LA's antibody tests suggested an actual infection rate of 4 % of the population. That would be 400,000 infected of a 10 million population. There are 797 deaths. That's a 0.2 % death rate. In their findings, Santa Clara County estimated a 0.2 % death rate.

 

There's three good reasons I can think of for why CA would suggest a 0.2 % death rate, and NYC would suggest anywhere from 0.6 % to up to 1 %.

 

First, testing errors. We really have no clue whether these tests measure anything valid. The more studies that come out, the more likely it is that they do paint a picture of a disease that does not kill MOST people, and that has many asymptomatic infections. We knew that already. But false positives can make a difference, especially when you are talking about tests that measure numbers like 4 %, rather than 50 %, testing positive for something.

 

Concepts like testing sensitivity and specificity are above my pay grade. But I tend to think NY would be the most accurate. We can compare a hypothesis based on antibody tests to actual cases and actual mass death. So if the question is: how will this likely play out in the entire US, or world, if let it, I think what happened in NY tells us what we could expect.

 

To simplify, I'd go with Dr. Fauci and a 1 % death rate. Anybody over 50 is potentially in trouble. Anybody over 65 is in big trouble. Anybody over 75 better have a will or trust written up. Meaning your chance of getting really sick, or being in a hospital, or dying is serious.

 

A second reason could be that NYC in particular did experience a relatively complete hospital meltdown. They think 5000 people died of COVID-19 at home, because they were very sick and the hospitals were full. So that right there could potentially double or triple the NY death rate. I think we know now from both 1918 and 2020 that quality of care is a big factor in whether people live or die. It is the whole concept behind "flatten the curve". So you could take NY and CA actual death rates as proof that "flatten the curve" saves many, many lives.

 

A third reason is that if only 4 % of your population is infected, it is probably easier to shelter the vulnerable people. Mainly, they can stay inside. Or you can keep people out of nursing homes. I did check, and the age distribution of cases in NY and CA is very similar. Roughly 1 in 4 cases in both states were seniors. So if that's true, that would not explain the difference between a 0.2 versus 1 % death rate.

 

The timing of cases could be a factor. The number of cases in LA is going way up, in part due to the added testing. Since death lags with COVID-19, the LA death rate may twice as high a month from now.

 

I think one huge problem with the "herd slaughter" concept is that no one who advocates it has come within a million miles of explaining how you bubble wrap 30 % of your population for a year or two. If the idea is that 70 % get infected, the first question is: which 70 %? Some of that 70 % is Black women with diabetes, or young men with heart or lung conditions. But even if you magically solve that problem, who actually works in nursing homes? Who goes into the homes of seniors to clean, or repair things? We can't even get testing and tracing ramped up to what we need to prevent people from getting infected. So now we are suddenly going to reorganize our entire society to protect the 30 % or so that is most vulnerable? Give me a fucking break.

 

One final piece of data. If you look at what is happening on Navy ships, it is very anecdotal. But I think the little we do know confirms the picture I painted above. On the Roosevelt there were about 800 cases. I think 7 ended up being in a hospital, or about 1 %. One sailor died, which would give you a death rate of about 0.1 %. There are two broad data sets that suggest that for adults under 50 or so, the hospitalization rate is 10 to 15 % of all cases. One is a CDC study of about 2500 US patients published in March, and the other is all the NYC data. So, again, it seems like in the real life experiment where we tested 100 % of a young population on a ship, you can divide by about 10. The 10 % hospitalization rate in the CDC study and in real life in NYC probably reflects a small segment of the sickest population of young adults. The 1 % hospitalization rate FOR YOUNG ADULTS is likely more accurate.

 

These numbers may sound low. But they are way higher than flu hospitalization and death rates for young adults. So even if they are that low, our economy is still fucked. We'd have mass death all over the US, like in NYC. And 1 % of all young adults in hospitals is a big number - millions of hospitalizations. And by the way, how do you like the idea of 20 % or 50 % of your workforce out of work sick? In NYC, at one point 20 % of the NYPD was out sick. And a bunch of cops died. So the economic problem is not just all the fear caused, that keeps a huge chunk of people from wanting to go shop or eat in a restaurant. The other huge problem is if we just let this rip through our economy unchecked, you would have 20 % of the workforce sick, all at once. How does an employer manage that?

 

Anybody who is still advocating herd slaughter hasn't thought it through. You can't have 20 % of a workforce that is sick, and another 30 % of vulnerable adults that is bubble wrapped for a year or more. I think pretty much the whole world is moving in the direction of test, trace, treat.

 

Here's the number of actual deaths in a bunch of countries that seem to have gotten a handle on test, trace, treat:

 

Australia - 80 deaths

Austria - 536 deaths

Hong Kong - 4 deaths

New Zealand - 18 deaths

South Korea - 240 deaths

Taiwan - 6 deaths

Thailand - 51 deaths

 

Combined, those nations have over half the population of the US. They all used some variation of a prompt lock down to flatten the number of cases, and then a move to test, trace, and treat to keep it low. It is early days in terms of whether they can sustain this. But it is working so far. It does create an environment where people can shop and eat and work, albeit with a new and enforced set of restrictions to keep the number of new cases a day in the single or double digits. Meanwhile, the US has had 30,000 new cases a day for three weeks running.

 

Sorry, but this is not politics. This is tragedy. Anybody who is a patriot should be deeply embarrassed by the mass death and the mass stupidity.

Edited April 26, 2020 by stevenkesslar

[LivingnLA]

Well written @stevenkesslar and you haven't even touched on all the people who survive but have serious tissue damages. Reduced lung function. Heart damage. Stroke. Damaged colons, kidneys, or liver. It isn't just about the people who will die and many will be in their 20s, 30s, and 40s because obesity is a significant comorbidity.

 

https://www.latimes.com/science/story/2020-04-10/coronavirus-infection-can-do-lasting-damage-to-the-heart-liver

https://www.sciencemag.org/news/2020/04/survivors-severe-covid-19-beating-virus-just-beginning

 

https://www.nature.com/articles/s41574-020-0364-6

In conclusion, to better estimate the risk of complications in patients with COVID-19, in addition to evaluation of standard hospital parameters (such as the Sequential Organ Failure Assessment, d-dimer and pro-inflammatory markers), the measurement of anthropometrics and metabolic parameters is crucial. These parameters include BMI, waist and hip circumferences and levels of glucose and insulin. The latter two parameters can be used for the estimation of insulin resistance, for example by calculation of the HOMA-IR. Knowledge about insulin resistance is important, because it is among the strongest determinants of impaired metabolic health, cardiac dysfunction and CVD-related mortality5. Such measurements might be useful both in a primary care setting and in a hospital setting to assess the risk of a complicated course of disease in patients with a positive SARS-CoV-2 test (Fig. 1).

Edited April 25, 2020 by LivingnLA

[+ stevenkesslar]

Well written @stevenkesslar

 

Thanks. Funny you say that. I thought I was being verbose.

 

As an aside, I have always hated Twitter. The last several years have given me reason to despise Twitter. Twitter is great, as long as you mostly don't give a shit about facts, thoughts, arguments, or details.

 

Maybe what I am about to say in unfair to hospitals. But I think what you pointed to is another reason why herd slaughter is a horrible idea. It just doesn't make sense to combine a stressed out or collapsed medical system with a brand new disease that nobody understands. Even when people survive, there are going to be many permanent bad outcomes.

 

My point is not that hospitals are to blame. It's that are at the front end of a learning curve. And this is one where it's simply better not to even toss the coin and see what happens.

 

The good news is that with AIDS it took years of poisoning people with overdoses to realize that if we use less of this drug and combine it what that drug it works better. And AIDS of course was a death sentence in a way COVID-19 is not. But the bad news in that is it changes the ethics. You could, in effect, use Gay men who were dying anyway as guinea pigs. Because even bad treatment might let them live a bit longer. The same does not apply with COVID-19. That right there has to put even more stress on doctors and nurses that know that, unlike with better known diseases, they are at least partially flying blind.

 

Nick Cordero's wife says he is 'recovering well' after doctors inserted temporary pacemaker

 

 

That's the human face for your point.

 

And I get that the same thing perhaps could have happened if he had the flu. Or if he got hit by a car while crossing the street after leaving a Broadway theater. Part of the fear factor is that everybody is looking at things under a microscope, even though we usually just live the risk. But as you are suggesting, I think that's because the risk is actually way higher.

 

For survivors of severe COVID-19, beating the virus is just the beginning

Hospital practices that keep patients as lucid and mobile as possible, even in the throes of their illness, could improve their long-term odds. But many intensive care unit doctors say the pandemic’s strain on hospitals and the infectious nature of the virus are making it hard to stick to some of those practices.

 

I read a story about a German doctor who specifically said, after being diagnosed with COVID-19, that there was a particular hospital he wanted to be treated in. And it was because they don't use ventilators, or only use them as a last resort if they know you are about to die. This doctor was not ventilated, although he was on an oxygen mask I think. He said for a few days he thought he was going to die, and kind of wanted to die. It was very difficult for him to breathe. But his point is that the ventilators can screw your lungs up, as well. One statistic, which I think exaggerated the point, was that over 80 % of people on ventilators die. One of the earliest reports from China in the NEJM suggested it was at least over 50 % on ventilators die. Again, the issue is not that hospitals should not use ventilators. It's that this disease is so deadly that once you get to an ICU bed, the number of good options starts to rapidly decline.

 

Cordero himself has been on dialysis, pace makers, etc. They are obviously throwing everything they can at him. And he is missing a leg. His Broadway career, if not his life, is over.

 

This is not meant as a dig at doctors, or nurses, or hospitals. The exact opposite. They are putting their own lives at risk to fight a disease nobody really understands. We have let our caregivers down, by not making sure they have the protective equipment they deserve. If they save Cordero's life, that is a victory. But he will have lifelong medical problems. Meanwhile, the hospitals in the middle of this are being crushed financially, as well.

 

In 1918, given what we knew about viruses (pretty much nothing) we didn't have much choice. Even then, we could reduce the death rate by twofold or threefold by taking measures to prevent the spread. The results so far in those countries above strongly suggest that we are now able to actually stop this thing from spreading, if we choose to.

Edited April 26, 2020 by stevenkesslar

[+ sniper]

We don't know that everybody is using the same tests now, frankly, and because they're being fast tracked many have unknown false-positive and false-negative rates.

[+ stevenkesslar]

If this testing results hold true to the general population, this means both the infection rate and the death rate figures we have so far are almost meaningless. The death rate of those infected drops dramatically.

https://www.reuters.com/article/us-...mktg&feedName=topNews&WT.mc_id=Partner-Google

 

This just adds more verbosity to the posts above. So if you are not interested in facts or details or analysis, stop reading and go read Twitter, please.

 

One thing that is clear, and understandable, is that most reporters don't think like epidemiologists. Nor do most people. Now all of a sudden we have to pretend we are experts, when we are in fact largely ignorant, just because we don''t want to get sick.

 

It's hard to make sense of what is actually going on in these prisons, based on the data we know. That one article mostly fuels two ideas: 1) Lots of people get this disease and show no symptoms; 2) Maybe this isn't as deadly as we think.

 

The first statement is true. The models from China and South Korea suggested that maybe 25 % or 30 % of people were asymptomatic through the course of their infection. It could be way higher than that. The Reuters article is mostly NOT helpful because it only offers a snapshot. I think we know that if you tested 1000 people 24 to 48 hours after they were infected, almost none would test positive or show symptoms. Several days later most would test positive, and many would start to show symptoms. Weeks later some would be in hospitals, and some would die. So the article doesn't shine any light on the question of whether COVID-19 is as deadly as people think.

 

Here's a few more articles that do:

 

DRC Confirms Positive COVID-19 Test Result of Correctional Staff Member at Marion Correctional Institution

March 29, 2020

 

As far as I can tell, that was the first death associated with Marion. It makes sense that it could be a staff member, since someone had to bring the virus in from outside.

 

Let me suggest that everyone think of Marion and Ohio prisons this way. Think of them as Amazon fulfillment centers, or cinemas, or factories, or meat packing plants, or shopping malls. These are all places where many people congregate together, in enclosed spaces. Some of them, like Amazon fulfillment centers and factories and meat packing plants, are "essential" work places that we can't shut down. So the best way to think of this issue is a workforce issue, I think. Somehow, we have to have the ability to work. Yet, somehow, this disease makes it so that when people come together to work, you get fear and sickness and hospitalization and death. That's not the kind of work environment people want.

 

17 Ohio prisoners now dead of coronavirus; 4 at Marion Correctional

April 24, 2020

 

So now we have another snapshot, close to a month after the first death. So at Marion, we know the disease has had plenty of time to progress through various phases, ending in death for the unlucky ones. This article only tells us about cases and deaths. We don't know how many people developed symptoms, how many are in hospitals, etc.

 

And here is the most complete picture we have, from the State of Ohio:

 

COVID-19 Inmate Testing | UPDATED: 4/25/2020

 

We still know almost nothing about how many people are symptomatic, or hospitalized. What we do know from this chart is that, if allowed, the disease will likely spread like wildfire. We can hope that in other Ohio prisons, isolation of those that tested positive will stop the spread.

 

Again, I would encourage everyone to think of that prison chart as a list of every Amazon fulfillment center in the state, or every Walmart in the state, or every shopping mall in the state. Prisoners have no choice about being in prison. People have a choice about whether to work at Amazon or Walmart, or shop at Walmart or a shopping mall. So if we want to prevent an economy from being able to function, what we very much want to add to the picture is virus, sickness, hospitalization, and death. This is certainly how Gov. DeWine is looking at it. That's not a political statement. That's just a fact.

 

So what we know is we have 17 certain COVID-19 prisoner deaths, plus two other suspected COVID-19 prisoner deaths, plus one staff member death at Marion. I think we also know more of these infected people will eventually die. But let's look at 20 people statewide, and 5 people at Marion. And this is out of a base of 3,845 inmates and 240 staff with confirmed infections, or about 4100 people.

 

Statewide, 20 out of 4100 is obviously just shy of a 0.5 % death rate. At Marion, 5 people (including the staff member) out of 2028 have died, so it is closer to 0.25 %. At Pickaway, it's 12 deaths (including 2 suspected) out of 1563 inmates and 79 staff. That's a 0.73 % death rate - very close to what New York's statewide death rate is, if the antibody tests are correct and 14 % of the state population is infected.

 

There's a lot we don't know. How many prisoners eventually got sick? How sick? How many were hospitalized?

 

But I think we are getting more and more data that suggest that while a 0.2 % death rate might be possible, it's a stretch. 1 % might be too high. But especially if we factor in "herd slaughter", and the idea that we want mass sickness and lots of death, it's quite doable. Add collapsed hospitals, where doctors and nurses also get sick and die because they lack PPE, and you can probably get over a 1 % death rate. Especially if we make sure we have lots of dead bodies in houses that people want to get out of the home because they stink. That could give you a 1 % death rate. And some really high quality stench and fear and sickness and sadness and terror and misery. Oh, yeah, and a whole fucking boatload of death.

 

My point is that this is creating an uproar in the Ohio prison system, where people don't get to choose to be prisoners. Does anyone really think this could work in a meat packing plant, or a Walmart, or a shopping mall, or an Amazon distribution center? Once you add fear and choice, people would not want to work there, eat there, or shop there. And it won't take one-third of the employees getting sick. Once a couple employees get sick, probably the whole place gets shut down.

 

I don't think we have any choice but to focus on test, trace, treat. The experts say millions of tests a day, and maybe something like 300,000 contact tracers. This is where I become a huge fan of Abbott, and corporate America. If Big Pharma can figure out mass production and profitability, please let them do it. The public health contact tracing is, and needs to be, a government function. It's that, or have every shopping mall and factory and Walmart and Amazon fulfillment center in America be like those Ohio prisons.

 

If people take this prison analysis to mean that most people who get infected don't develop symptoms, or don't get very sick, they are just missing the point. Most people don't die from smoking or drunk driving or speeding. That's because we have tons of laws governing those things, and lots of enforcement mechanisms.

 

0.2 % of America is 650,000 dead Americans. 1 % of America is 3.25 million Americans. You can argue about whether we really need 25 % or 50 % or 75 % of Americans infected to complete our fun and interesting herd slaughter experiment. In New York, if we go with the 14 % estimate, we know their terror is basically just getting started, if we go for completely effective herd slaughter. Only about 20,000 New Yorkers have died. Even to get to 60 % herd slaughter, we need 60,000 more dead New Yorkers.

 

Whatever numbers you pick, it is simply going to be mass fear and mass death. If anyone can explain how you run a workforce and an economy with coronavirus numbers like this, please explain.

Edited April 26, 2020 by stevenkesslar

[mike carey]

As an aside, I have always hated Twitter. The last several years have given me reason to despise Twitter. Twitter is great, as long as you mostly don't give a shit about facts, thoughts, arguments, or details.

Twitter runs hot and cold. The bad is the lack of facts you cite and the frequent bitchiness. Also the near impossibility of subtlety or nuance. The good is links to articles that I might not otherwise find, and some of the longer thoughtful threads some people post. The most recent account I follow is John Burn-Murdoch who does a lot of the statistical analysis and graphs for the FT, and tweets in detail most days.

Edited April 26, 2020 by mike carey

[+ Pensant]

The prison systems in many states have become hotspots.