Coronavirus Sars-CoV-2/Covid-19 Megathread

[Gups]

UK numbers today are good (as in there wasn't the usual up-tick after the weekend), but I don't believe because they still seem suspciously low given the numbers of daily fatalities we were seeing last week. I suppose it makes sense that there might be more of a lag after a bank holiday weekend than a normal weekend? But normally we've been seeing a big up-tick a couple of working day's after the weekend so I thought we'd see the same here.

Or maybe the numbers peaked last week not this week - and are now plateauing at about 750 deaths a day? That doesn't seem likely (but I think last week wound have been days 14-21 since full lockdown which is I think how long it took for a peak in other countries like Spain?). Hopefully that was the peak last week.

It's impossible to make any sense of the numbers. Of the 651 hospital deaths in England announced today:

- 113 occurred on 14 April
- 277 occurred on 13 April
- 103 occurred on 12 April

151 of the deaths took place between 1-11 April, and the remaining seven deaths occurred in March, with the earliest new death taking place on 23 March

[Sheilbh]

It's impossible to make any sense of the numbers. Of the 651 hospital deaths in England announced today:

- 113 occurred on 14 April
- 277 occurred on 13 April
- 103 occurred on 12 April

151 of the deaths took place between 1-11 April, and the remaining seven deaths occurred in March, with the earliest new death taking place on 23 March

Yeah but presumably it does give some sort of indication of a trend because even though it's only reported after they've notified next of kin etc, they will have done that more in the last 24 hours if there's more deaths. I could be wrong but I also thought that might be why there's a lag on weekends - they find it more difficult to get in touch with people on a weekend than on a weekday.

[mongers]

Whilst I think our version of the lockdown is being very well observed by the huge majority of the population*, I fear it isn't quite strict enough and so the 'plateau' might linger for a long time.

Might we have to introduce some 'chinese measures' or some of what they've done in Italy and France? 



* not my next door neighbours, who I think were away for a while, turned up for two/three days over the easter weekend and have now gone again. Not sure if a teacher counts as essential workers, but as they're rather wealthy they deserve a break.

[celedhring]

UK numbers today are good (as in there wasn't the usual up-tick after the weekend), but I don't believe because they still seem suspciously low given the numbers of daily fatalities we were seeing last week. I suppose it makes sense that there might be more of a lag after a bank holiday weekend than a normal weekend? But normally we've been seeing a big up-tick a couple of working day's after the weekend so I thought we'd see the same here.

Or maybe the numbers peaked last week not this week - and are now plateauing at about 750 deaths a day? That doesn't seem likely (but I think last week wound have been days 14-21 since full lockdown which is I think how long it took for a peak in other countries like Spain?). Hopefully that was the peak last week.

Yeah, we peaked during days 18-19.

[Sheilbh]

Whilst I think our version of the lockdown is being very well observed by the huge majority of the population*, I fear it isn't quite strict enough and so the 'plateau' might linger for a long time.

Might we have to introduce some 'chinese measures' or some of what they've done in Italy and France? 

I often think about that Chinese doctor who was sent to Italy and did a press conference with the Italian medics. The Italians were talking about their lockdown starting to have an effect etc etc and then the press asked the Chinese doctor who said this wasn't a real lockdown yet

In terms of compliance the FT did a piece on this this morning, we are generally very compliant but obviously a little less locked down than France/Spain/Italy but more than the US/Germany/Sweden:


The only area where there was a reasonably big difference is parks (but the same pattern holds: we're less locked down than the Med countries, but more than the US/Germany/Sweden). The bit I'm not sure about and haven't seen any information on is workplaces because we are open (as is France) for lots of non-essential business. But it would be interesting to see how much we are not in those workplaces compared to other countries. I'm not sure how much this affects the plateaus though - because it seems the rate is falling quite quickly in Spain but lingering in Italy and Germany, France is somewhere in between. I'm not sure what's driving it.

* not my next door neighbours, who I think were away for a while, turned up for two/three days over the easter weekend and have now gone again. Not sure if a teacher counts as essential workers, but as they're rather wealthy they deserve a break.

From teacher friends I think it depends because some of them are still working for the key worker schools that are still running - so in fact they may have been working more because they might not have had an Easter holiday?

[Zanza]

Just read an article that India has "dozens of millions" more unemployed from the lockdown. There is no help at all from the government. This creates a lot of unrest as people are literally starving. I doubt that's sustainable much longer.

[Sheilbh]

Also presumably their lockdowns will often be in multi-generational households which may not be in very large physical properties. I understand that in Wuhan specifically there was a very large number of cases of intra-household transmission.

A friend who works the UN has said that where he is the guidance is basically lockdown, but the situation is thousands in refugee camps who don't have the space for that to be feasible. He's complained that the WHO guidance for the country is, in his non-expert view, absolutely useless for a developing country.

I hope there is something to the heat/humidity point that slows transmissions and that there'll be treatments soon and it hit the developed world first (also the higher risk factors are less likely to be present). Because otherwise I worry that our waves will just be a drop compared to what will happen in the developing world.

[Zanza]

Germany will start with removing some of the restrictions, but I find the proposals pretty non-sensical. E.g. they will allow shops below 800 square meters to open. But when you should keep distance, shouldn't the shops be larger not smaller?

[Syt]

Germany will start with removing some of the restrictions, but I find the proposals pretty non-sensical. E.g. they will allow shops below 800 square meters to open. But when you should keep distance, shouldn't the shops be larger not smaller?

In Austria we opened shops up till 400 square meter. The idea is to limit the number of people inside. I find it unlikely that this can be properly policed or monitored, though.

[alfred russel]

Also presumably their lockdowns will often be in multi-generational households which may not be in very large physical properties. I understand that in Wuhan specifically there was a very large number of cases of intra-household transmission.

A friend who works the UN has said that where he is the guidance is basically lockdown, but the situation is thousands in refugee camps who don't have the space for that to be feasible. He's complained that the WHO guidance for the country is, in his non-expert view, absolutely useless for a developing country.

I hope there is something to the heat/humidity point that slows transmissions and that there'll be treatments soon and it hit the developed world first (also the higher risk factors are less likely to be present). Because otherwise I worry that our waves will just be a drop compared to what will happen in the developing world.

Something I find interesting is watching interview footage of really old people from the early era of film in the early 20th century. For example, I saw a video of the first female senator from Georgia talking about her early memories of watching the Cherokee Indians being removed and starting their walk on the trail of tears. It is a connection with what seems the distant past...

In any event, something I've noticed is that the old people in their 90s are in remarkably good health compared to the people in their 90s I'm used to encountering. It could be just who was getting interviewed, but I think more of it is that the very frail elderly we encounter would have died in the era before modern medicine and climate control.

I've read that something like 1/3 of the French deaths are in old age homes, and obviously the elderly are where the mortality is concentrating. In the developing world, with younger populations, lower life expectancy, less obesity, etc., I wonder if it will really be so bad.

[Valmy]

In the developing world, with younger populations, lower life expectancy, less obesity, etc., I wonder if it will really be so bad.

https://worldpopulationreview.com/countries/most-obese-countries/

Lot of developing countries on that list .

I don't think the developing world is as radically different today than it was decades ago, particularly in Latin America.

But I guess we will find out.

[Iormlund]

Anecdotal information from Spain is that Latinoamericans are especially vulnerable.

[Sheilbh]

So this is interesting - China's released data that also shows a large number of aymptomatic cases:

China's Data on Symptom-Free Cases Shows Most Never Get Sick
Bloomberg News
15 April 2020, 11:01 BST Updated on 15 April 2020, 13:56 BST

China for the first time publicized a breakdown of people testing positive for the novel coronavirus without outward signs of being sick, revealing that those among them who remain symptom-free throughout infection are in the majority.

Among 6,764 people who tested positive for infection without showing symptoms, only one fifth of them -- 1,297 -- have so far developed symptoms and been re-classified as confirmed cases, China's National Health Commission spokesman Mi Feng said at a briefing in Beijing Wednesday.

Some 1,023 are still being monitored in medical quarantine to see if they develop symptoms. The rest -- 4,444 -- have been discharged from medical observation after recovering from the virus.

The phenomenon of asymptomatic transmission is a puzzling feature of the virus that's allowed the pandemic to spread wider and faster than previous outbreaks. While researchers earlier thought that most patients ultimately end up developing symptoms, the indication from China's data that a sizable group remains symptom-free throughout infection underscores the challenge of containing the widening pandemic.

Researchers are still struggling to understand asymptomatic cases: there's a possibility that patients who appear to be symptom-free are actually just manifesting symptoms that doctors don't know yet to look for. For months, a fever and dry cough were understood to be the disease's main markers, and it's only recently emerged that a loss of smell and taste is also a sign of infection. China has not disclosed the range of symptoms it looks for.

China continues to detect asymptomatic infections even after new confirmed cases dropped to zero for the first time in March. The virus, which emerged from the central Chinese city of Wuhan last December, has officially sickened some 82,000 and killed over 3,000 in the country.

Ten provinces and cities in China, including Wuhan, are conducting surveys so researchers can learn more about asymptomatic cases and antibodies in people with coronavirus infections, the Hubei Daily has reported. The survey in Wuhan will cover 11,000 people randomly selected from 100 neighborhoods.

The number of asymptomatic infections is likely higher than the 6,764 China has detected. These cases were found through efforts to test the contacts of confirmed patients. Otherwise, those who show no signs of being sick have no reason to seek out testing on their own.

Once found, asymptomatic patients are placed under isolated quarantine for monitoring and discharged only when they no longer tested positive for the virus. Those who develop symptoms during the two-week quarantine period will be re-classified as confirmed cases under China's counting method and treated in hospital.

— With assistance by Sharon Chen, and Dong Lyu
(Updates with report on nation's surveys of asymptomatic people in 7th paragraph.)

That number of around 80% I think matches the small Italian town that tested everyone and isn't far off the NYC hospital either. So maybe there are a lot more asymptomatic cases than people thought

[Razgovory]

Well, I get direct deposit for Social Security disability and I haven't seen any cash come my way today.

[PDH]

I got my sweet, sweet Trumpvirus money.  I spend it all on yeast.