Coronavirus Sars-CoV-2/Covid-19 Megathread

[Sheilbh]

The City Mapper tracker is kind of incredible to see this sort of shift:
https://citymapper.com/cmi/london
https://citymapper.com/cmi/barcelona

[alfred russel]

On the one hand, you dispute the % of deaths as being fabricated by the media, or at best, being distortionned because many, many, many, many people have experienced only mild symptoms and have not been tested (and we know that isn't true, it's simply a matter of time before most people feeling sick get tested and join the official stats, but let it pass for now).

But then, you come and say that the virus has 16.3% chance of killing elderly people, based on the same stats you dispute.  That is strange...

I have never said the % of deaths is fabricated by the media. I believe, after reading actual scientists, talking to doctors I know, and a friend working at the CDC in public health, that those death rates published in the media derived from dividing the number of confirmed deaths by the number of confirmed cases is likely a poor estimate of the number of actual deaths divided by the number infected in the community. The reason being that more serious cases are more likely to be confirmed than less serious.

I don't think that 0.8% of the population are going to die from coronavirus, which is what would be the implications in the thought experiment.

In any case.

Let say you are 75 years old.  You are an healthy 75 years old, and you want to live.
Or you are like Merry, younger, much, much younger, generally healthy, but slightly overweight and with minor health problems that do not bother you so much in your daily activities.

You want to live.

Someone, somewhere, decides that these two categories of people will die shortly anyway, they are currently a burden to society and their life expectancy is obviously lower than an active 30 something.

That person somewhere takes matters into in his own hands.  He uses his God given right to own an assault rifle, load himself with cartridges everywhere he can, and goes on a rampage killing approximately 0,8% of the population, mostly the elderly and the not 100% healthy.  Anyone overweights he croses his dead.  Anyone with grey hair he crosses his dead.

Do we hail him as a hero?

Should cops refrain from acting to stop him, given his targets?

If he were to get arrested, detained and put to trial, should the jurors accept his defense that he only hastened the death of people who would have died anyway?

And would you feel grateful to have been killed rather than living the remaining of your life partially dependant on others?

Society has to make those decisions. There is risk versus reward. I am abiding by the decisions.

The CDC estimates that the flu kills between 12,000 and 61,000 americans annually. The global toll may exceed 500k. We could just generally live like this and probably save many of those lives. As a society we've decided that the cost of those people dying is not worth the cost to society for preventing the spread of influenza. Someone with a loved one or at high risk themselves of dying of influenza may object strongly that we don't try harder to stop it, but such is life.

[The Minsky Moment]

Til Lindemanmn (Rammstein) is in intensive care, but he's no longer critical.  At least that is positive.

. . .

Not old, not fat, not cripple, not diseased, yet infected and in intensive care.

Everyone knows people like that worship the Devil.  God protects the true believers. 

[The Minsky Moment]

The CDC estimates that the flu kills between 12,000 and 61,000 americans annually. The global toll may exceed 500k. We could just generally live like this and probably save many of those lives. As a society we've decided that the cost of those people dying is not worth the cost to society for preventing the spread of influenza. Someone with a loved one or at high risk themselves of dying of influenza may object strongly that we don't try harder to stop it, but such is life.

Are we really still having this discussion?  Where is the evidence that COVID-19 mortality rates are on par with seasonal flu? 

[celedhring]

Moreover, the fact there's no vaccines or immunity (even with seasonal mutations, we do retain a degree of immunity that inhibits the spread of seasonal flu), makes it that Covid has the potential to spread to the whole population in one go. That's a gigantic pile of dead even with 1% mortality.

[Valmy]

I mean I am no medical expert so I am not really able to counter the expert claims of AF and his...wait...what is his career again? He is some sort of medical specialist right?

[Legbiter]

Christ, 919 deaths in Italy today. By far the highest daily toll. 

It will plateau and fall very soon. The virus can only infect those in the same household now because of control measures. I dunno, if the Italians and Spaniards are commonly living with their parents and grandparents then that could explain the spike. Celed was very prudent for instance to resist his mom's request to spend quarantine with the family, difficult though it was.

[The Minsky Moment]

Excerpt from: https://ourworldindata.org/covid-mortality-risk

When there are people who have the disease but are not diagnosed, the CFR will overestimate the true risk of death. With COVID-19, we think there are many undiagnosed people.

As we saw above, in our discussion on the difference between total and confirmed cases (here), we do not know the number of total cases. Not everyone is tested for COVID-19, so the total number of cases is higher than the number of confirmed cases.

And whenever there are cases of the disease that are not counted, then the probability of dying from the disease is lower than the reported case fatality rate. Remember our imaginary scenario with 10 deaths and 100 cases. The CFR in that example is 10% – but if there are 500 real cases, then the real risk (the IFR) is just 2%.

Or in one sentence. If the number of total cases is higher than the number of confirmed cases, then the ratio between deaths and total cases is smaller than the ratio between deaths and confirmed cases.  . . .  Importantly, this means that the number of tests carried out affects the CFR – you can only confirm a case by testing a patient. So when we compare the CFR between different countries, the differences do not only reflect rates of mortality, but also differences in the scale of testing efforts.

When some people are currently sick and will die of the disease, but have not died yet, the CFR will underestimate the true risk of death. With COVID-19, many of those who are currently sick and will die have not yet died.
...
With the COVID-19 outbreak, it can take between two to eight weeks for people to go from first symptoms to death, according to data from early cases (we discuss this here).12

That means that some people who are now counted as confirmed cases and who will die are not yet included in the number of deaths. This means the CFR right now is an underestimate of what it will be when the disease has run its course.
...
This is a common source for misinterpretation of a rising CFR in the earlier stages of an outbreak.13

This is what happened during the SARS-CoV outbreak in 2003: the CFR was initially reported to be 3-5% during the early stages of the outbreak, but had risen to around 10% by the end.14,15

This is not just a problem for statisticians: it had real negative consequences for our understanding of the outbreak. The low numbers that were published initially resulted in an underestimate of the severity of the outbreak. And the rise of the CFR over time gave the wrong impression that SARS was becoming more deadly over time. These errors made it harder to come up with the right response.

tl/dr - reported mortality rates have two sources of error - under-reporting of infection due to limits on testing and tracking and under-reporting of deaths due to lag time between infection and death.  Error 1 causes mortality rates to seem higher than true rates, error 2 causes them to seem lower.

[alfred russel]

And the virus remains on surfaces for days at a time, so someone coming along and climbing after a COVID-positive climber risks getting it. Ergo, spreading the virus. That's unlikely to happen while camping.

But then, we're also talking about Tennessee, a Republican state. That the state parks are even still open is problematic to me. But I suppose ARs are going to AR, so fuck it. Let's torch the world. To hell with the high risk folks like me.

There is a significant diversity in outdoor climbing spots. There is a place (already shut down) two hours from Atlanta where they built a road right up to the climbing area to facilitate the filming of a movie. That place becomes a zoo as people can just drive up and climb.

Lots of areas are not like that though. I've been climbing in places you have to hike 5 or 6 hours to get to the climbing area (not in the southeast, where access is easier). But in the area we are going tomorrow, it involves a significant hike and the area is massive. I regularly never see anyone. Yes it is theoretically possible that someone will climb the same route and put their hand in the same place, and spread the disease.

You know what seems more likely? Lets say we take your counsel and stay in Atlanta. We go to Piedmont Park, which is where the entire city is going right now and is a zoo. We keep our social distancing, but at some point of course we will touch a park bench or railing.

If you are worried about disease transmission to Oregon, the path of Atlanta --> rural Tennessee --> Oregon seems less likely than just Atlanta --> Oregon in any event.

Lets take something that I don't think any of us give a shit about so all the emotion is out of it: launching boats in south florida. In some counties they are shutting down the boat ramps, and in at least one case they shut them down because party boats with more than 10 people were being launched.

At least to me, there is a serious element of "this is serious, nobody can have any fun!" If people are launching party boats, target those boaters. In any event, I bet the parties will move from the boat to the swimming pools/houses. The people that want to go fishing or skiing (which seem like great ways to socially isolate) are now screwed.

[The Larch]

I don't know if you can really 3D print a ventilator. Maybe some ancillary parts like tubing. But it'd be like 3D printing a car. This is a $30,000 piece of technology which a high amount of precision required. If your machine breaks or has a bug, the patient stops getting oxygen to their brain and dies.

No idea how they do it. I know it's been certified by local hospitals.

This is the thing:

I remembered that there were local news around here about a similar group of companies producing another version of a makeshift ventilator, and searching for the news there seem to be a number of similar initiatives all over the country.

This is the one from my region (looks like a barista coffee maker, tbh):



Many others followed the see-through approach (although I guess that it's for the model they show around):







Some even seem to be employing modified diving masks:

[DGuller]

Excerpt from: https://ourworldindata.org/covid-mortality-risk

When there are people who have the disease but are not diagnosed, the CFR will overestimate the true risk of death. With COVID-19, we think there are many undiagnosed people.

As we saw above, in our discussion on the difference between total and confirmed cases (here), we do not know the number of total cases. Not everyone is tested for COVID-19, so the total number of cases is higher than the number of confirmed cases.

And whenever there are cases of the disease that are not counted, then the probability of dying from the disease is lower than the reported case fatality rate. Remember our imaginary scenario with 10 deaths and 100 cases. The CFR in that example is 10% – but if there are 500 real cases, then the real risk (the IFR) is just 2%.

Or in one sentence. If the number of total cases is higher than the number of confirmed cases, then the ratio between deaths and total cases is smaller than the ratio between deaths and confirmed cases.  . . .  Importantly, this means that the number of tests carried out affects the CFR – you can only confirm a case by testing a patient. So when we compare the CFR between different countries, the differences do not only reflect rates of mortality, but also differences in the scale of testing efforts.

When some people are currently sick and will die of the disease, but have not died yet, the CFR will underestimate the true risk of death. With COVID-19, many of those who are currently sick and will die have not yet died.
...
With the COVID-19 outbreak, it can take between two to eight weeks for people to go from first symptoms to death, according to data from early cases (we discuss this here).12

That means that some people who are now counted as confirmed cases and who will die are not yet included in the number of deaths. This means the CFR right now is an underestimate of what it will be when the disease has run its course.
...
This is a common source for misinterpretation of a rising CFR in the earlier stages of an outbreak.13

This is what happened during the SARS-CoV outbreak in 2003: the CFR was initially reported to be 3-5% during the early stages of the outbreak, but had risen to around 10% by the end.14,15

This is not just a problem for statisticians: it had real negative consequences for our understanding of the outbreak. The low numbers that were published initially resulted in an underestimate of the severity of the outbreak. And the rise of the CFR over time gave the wrong impression that SARS was becoming more deadly over time. These errors made it harder to come up with the right response.

tl/dr - reported mortality rates have two sources of error - under-reporting of infection due to limits on testing and tracking and under-reporting of deaths due to lag time between infection and death.  Error 1 causes mortality rates to seem higher than true rates, error 2 causes them to seem lower.

Maybe I've been an actuary for too long, but this seems like a very fundamental failure to do the math correctly.  Mortality should be calculated by length of time since diagnosis, otherwise you're asking to be needlessly misled by shifts in the average duration of illness among the population.

[alfred russel]

I mean I am no medical expert so I am not really able to counter the expert claims of AF and his...wait...what is his career again? He is some sort of medical specialist right?

Want to make a bet that in the final analysis at the end of 2020, the estimated death rate of an American infected with covid 19 is less than 1%? The CDC will be the source. I'll carry it in my sig.

[Valmy]

I mean I am no medical expert so I am not really able to counter the expert claims of AF and his...wait...what is his career again? He is some sort of medical specialist right?

Want to make a bet that in the final analysis at the end of 2020, the estimated death rate of an American infected with covid 19 is less than 1%? The CDC will be the source. I'll carry it in my sig.

I just said I am no medical expert and don't know shit. Now you want me to put money down based on my non-existant expertise?

Nah dude I am not an idiot...unlike some people...

[alfred russel]

The CDC estimates that the flu kills between 12,000 and 61,000 americans annually. The global toll may exceed 500k. We could just generally live like this and probably save many of those lives. As a society we've decided that the cost of those people dying is not worth the cost to society for preventing the spread of influenza. Someone with a loved one or at high risk themselves of dying of influenza may object strongly that we don't try harder to stop it, but such is life.

Are we really still having this discussion?  Where is the evidence that COVID-19 mortality rates are on par with seasonal flu?

MM--go fuck yourself if you think I in any way implied that COVID-19 mortality rates are on par with seasonal flu.

[The Minsky Moment]

I mean I am no medical expert so I am not really able to counter the expert claims of AF and his...wait...what is his career again? He is some sort of medical specialist right?

Want to make a bet that in the final analysis at the end of 2020, the estimated death rate of an American infected with covid 19 is less than 1%? The CDC will be the source. I'll carry it in my sig.

What ifis half that - 0.5%?
Still far, far more deadly than seasonal flu.
So why are we still talking about seasonal flu?