Coronavirus Sars-CoV-2/Covid-19 Megathread

[Malthus]

I'm not sure I understand the controversy.

Seems plain as day to me that those jurisdictions who shut down quickly and comprehensively did better than those that did not. They are in a position where they can start to reopen without a whole lot of illnesses and deaths, while those that gambled on such measures being bad for the economy lost big - got illnesses and deaths plus economic damage to boot.

Your understanding is wrong in the US context. In the US overall, there have been 439.8 deaths per million residents.

States like Georgia (299.1), Florida (236.3), and Texas (144.2) are all doing better than that average.

Weren't you earlier in this thing telling me that Florida was doing better than Ontario?

Now, it looks like it's out of control there. It just seems whatever strategy they are using is not working. On Sunday, they allegedly reported 12k new cases in one day. Ontario has around 200 (and a total of 37k so far). Florida has had 360k cases so far and is ramping up, not down.

The local governor appears to be in full political damage control mode, which certainly makes it appear that he's well aware the situation there is screwed up: https://www.google.ca/amp/s/beta.cp24.com/world/2020/7/17/1_5028764.html

The primary difference appears to have been the attitude of the politicians at the top. Ontario's premier is as right-wing as they come (pre-pandemic he was sometimes considered a Trump mini-me). However, for whatever reason, he refused to politicize his pandemic response and, after some damaging hesitation, took sweeping shutdown measures. This has proved relatively successful and has resulted in a corresponding popularity bump for him (in that many who could not stand him have had, grudgingly, to admit he was right on this one). Fortunately, the same was largely true of provincial authorities across Canada, with BC doing the best/fastest job, and Quebec hit hardest for reasons that are not entirely clear.

Point is this: the main damage in the US was caused by governments politicizing their response (starting with the President), and failing to take, or maintain, adequate measures. That this has led to disastrous results is not exactly a secret, and the worst is likely yet to come.

The lesson is that you have to act fast and sternly to clamp a lid on a pandemic, and letting politics get in the way of epidemiology is a bad thing. Bad for the population, bad for the economy, and (I suppose most importantly to them) bad for the politicians who fail to act, because while a few may be pissed off at the restrictions, the many will not easily forgive incompetence that directly impacts their lives.

[HisMajestyBOB]

No Malthus, as long as Florida and Georgia stay under the total deaths that occurred in NYC, then everything is fine and Florida and Georgia's strategy are perfect.

The policy isn't to minimize unnecessary deaths, it's to do nothing and find evidence to claim that is the best strategy.

[Malthus]

You also have a few large midwestern states and other smaller eastern states that had big death numbers.  From April.

Right now Florida is 25 out of 50 in terms of state death rates and rising fast, Georgia is in the top half. 

But even that is an apples to oranges comparison - comparing death spikes from four months ago to current conditions.

The past is the past but policy can still impact the present.  And in the present, Florida is a COVID horror show.

If we are evaluating public policy responses, it only makes sense to look at cumulative numbers. Otherwise someone might get the impression that NY has had a better response than Florida. Also--antibody testing in NYC indicates that enough of the population has been infected to materially retard the spread of the disease at this point.

If you think Florida is a horror show based on 90 deaths yesterday, I think you should remember what a real horror show looks like. If New York never has another Covid death, and Florida continues with 90 / day, Florida will match the New York death total on May 23, 2021. Of course as Florida has a higher population, it will still trail in the per capita death count.

That's a big assumption - that there will be no growth in the death rate.  Given that the number of cases in Florida is increasing, it's not a very comforting assumption to make.

The whole problem with pandemics is the terrifying potential for growth. Hence the expression "flatten the curve" as a goal.

[alfred russel]

I'm not sure I understand the controversy.

Seems plain as day to me that those jurisdictions who shut down quickly and comprehensively did better than those that did not. They are in a position where they can start to reopen without a whole lot of illnesses and deaths, while those that gambled on such measures being bad for the economy lost big - got illnesses and deaths plus economic damage to boot.

Your understanding is wrong in the US context. In the US overall, there have been 439.8 deaths per million residents.

States like Georgia (299.1), Florida (236.3), and Texas (144.2) are all doing better than that average.

Weren't you earlier in this thing telling me that Florida was doing better than Ontario?

Now, it looks like it's out of control there. It just seems whatever strategy they are using is not working. On Sunday, they allegedly reported 12k new cases in one day. Ontario has around 200 (and a total of 37k so far). Florida has had 360k cases so far and is ramping up, not down.

The local governor appears to be in full political damage control mode, which certainly makes it appear that he's well aware the situation there is screwed up: https://www.google.ca/amp/s/beta.cp24.com/world/2020/7/17/1_5028764.html

The primary difference appears to have been the attitude of the politicians at the top. Ontario's premier is as right-wing as they come (pre-pandemic he was sometimes considered a Trump mini-me). However, for whatever reason, he refused to politicize his pandemic response and, after some damaging hesitation, took sweeping shutdown measures. This has proved relatively successful and has resulted in a corresponding popularity bump for him (in that many who could not stand him have had, grudgingly, to admit he was right on this one). Fortunately, the same was largely true of provincial authorities across Canada, with BC doing the best/fastest job, and Quebec hit hardest for reasons that are not entirely clear.

Point is this: the main damage in the US was caused by governments politicizing their response (starting with the President), and failing to take, or maintain, adequate measures. That this has led to disastrous results is not exactly a secret, and the worst is likely yet to come.

The lesson is that you have to act fast and sternly to clamp a lid on a pandemic, and letting politics get in the way of epidemiology is a bad thing. Bad for the population, bad for the economy, and (I suppose most importantly to them) bad for the politicians who fail to act, because while a few may be pissed off at the restrictions, the many will not easily forgive incompetence that directly impacts their lives.

Florida is still doing in line with Canada overall. Canada has 239.0 deaths / million, while Florida has 236.6. Obviously Florida is trending worse at the moment, we will see where things land when all is said and done.

[alfred russel]

No Malthus, as long as Florida and Georgia stay under the total deaths that occurred in NYC, then everything is fine and Florida and Georgia's strategy are perfect.

The policy isn't to minimize unnecessary deaths, it's to do nothing and find evidence to claim that is the best strategy.

You are a piece of shit.

[HisMajestyBOB]

No Malthus, as long as Florida and Georgia stay under the total deaths that occurred in NYC, then everything is fine and Florida and Georgia's strategy are perfect.

The policy isn't to minimize unnecessary deaths, it's to do nothing and find evidence to claim that is the best strategy.

You are a piece of shit.

You're either blind or disingenuous.

[Sheilbh]

I mean I've said before but I think there is something distinctive that we don't understand yet about New York. It's had the worst outbreak in the developed. It's not metros, it's not density - we've seen outbreaks in European and East Asian cities with those factors that have been contained or, awful as they were, nowhere near as bad as New York. It may just be that it was circulating for so much longer and being under-detected (possibly issues around accessibility to healthcare?), because the antibody studies have a larger rate of infection in New York than Spain, Italy or the UK. And as I say I just don't see the value of comparing yourself to the worst outbreak in the developed world as your measure of success.

So you know the US is now at 440 per million - that's approach France which is one of Europe's bad outbreaks. The difference is France's figure has plateaued while the US is increasing. But Georgia, Florida and Texas are now all way past the "successful" European countries like Germany and getting worse.

But even if you do just look at NY v Florida I think timing matters. We know so much more about how this disease spreads and how to treat it now than we did in late February/early March. Similarly I think while second waves are inevitable in the autumn and winter it would be a huge policy failure if we see anything like the same death or infection rates.

[Malthus]

Florida is still doing in line with Canada overall. Canada has 239.0 deaths / million, while Florida has 236.6. Obviously Florida is trending worse at the moment, we will see where things land when all is said and done.

Again, as you note, the problem is one of trajectory. A glance at the graphs for the two jurisdictions demonstrates that. Florida is ramping up, while Canada has more or less ramped down.

Now Canada could still screw it up for sure, with a second wave, but that seems less likely (or at least less likely to get as bad) unless we abandon all our protective measures. In contrast, it is a near certainty that things will get worse in Florida. The graph is trending sharply upwards and unless something changes (stern measures are taken, or a vaccine produced) that will inevitably produce higher rates of deaths per population.

[alfred russel]

But even if you do just look at NY v Florida I think timing matters. We know so much more about how this disease spreads and how to treat it now than we did in late February/early March. Similarly I think while second waves are inevitable in the autumn and winter it would be a huge policy failure if we see anything like the same death or infection rates.

In terms of death, the US excluding NY/NJ is still worse than Florida. Which is remarkable considering the national criticism the Florida response has had and the significantly older population in Florida.

[Zanza]

What I find interesting is that death rates continue to decline across the Western world despite rising case numbers. Will be interesting to eventually learn the cause for that - virus mutation, existing large-scale immunity, better clinical treatment? 

[alfred russel]

No Malthus, as long as Florida and Georgia stay under the total deaths that occurred in NYC, then everything is fine and Florida and Georgia's strategy are perfect.

The policy isn't to minimize unnecessary deaths, it's to do nothing and find evidence to claim that is the best strategy.

You are a piece of shit.

You're either blind or disingenuous.

I'm blind or disingenuous?

Lets go through what was being posted in the very early days:

-I insisted the death rate that was being discussed was much too high and would be less than 1% when all is said and done. If you want me to dredge up statements that had it over that number, are you going to tell those posters they were alarmist or stupid now that it is generally acknowledged to be 0.5%-1%?
-I posted that masks would help stop the spread, way back while the UK was moving against mask sellers for false advertising and the WHO/CDC was not recommending their use.
-I posted that the lockdown here would backfire, as the extreme measures would not materially slow the spread and were unsustainable. Here we are: with positive cases at all time highs and mobility data showing that people are disregarding the virus more than at any point in time. Ie: the worst case scenario. Who here could have seen this coming?

There were a bunch of predictions that the south with its Trumpist governors would have disproportionate suffering. I think that there is one state in the South with deaths above the national average: Louisiana. And guess what? The governor is a democrat. The point isn't that republican governors have solved the mystery of coronavirus, and the solution is to pretend it doesn't exist. Obviously that is absurd. The point is that the dire predictions haven't come to pass, and you can't draw a direct link between state level responses and outcomes.

[alfred russel]

how are the hospitals coping?  Is there a lot of ICUs left available?

Georgia reports 1,862 of 2,812 ventilators are available, with 642 of 2,863 critical care beds available, and 3,987 of 15,097 of general inpatient beds.

So 66% of ventilators are available, 22% of ICU beds, and 26% of regular inpatient beds.

That's horrifying, especially given in two weeks is going to be a hell of a lot worse.

But yes, let's open the country up. Totally worth the risk.

Here is a another prediction from two weeks ago. Daily cases in Georgia are averaging about 3k a day but have stabilized and declined slightly the past few days. That is at a very high level - when lockdown came and went we were around 500.

But right now 60% of ventilators are available, 16% of ICU beds, and 22% of regular inpatient beds. That is worse than it was when Meri made her post, but not a hell of a lot worse. Deaths also haven't spiked--we are around 15 / day versus 40 when this was at the peak.

[DGuller]

What I find interesting is that death rates continue to decline across the Western world despite rising case numbers. Will be interesting to eventually learn the cause for that - virus mutation, existing large-scale immunity, better clinical treatment?

I think a big part of it is that infections numbers are now far less distorted.  Back during the height of the pandemic we had to do a lot of imputations to calculate the death rate, because on the face of it it looked like 5%-10%, but most people believed that the real infection fatality rate was more like 1%.  I think we are now observing nominal statistics converging to what imputed statistics were.

[merithyn]

You also have a few large midwestern states and other smaller eastern states that had big death numbers.  From April.

Right now Florida is 25 out of 50 in terms of state death rates and rising fast, Georgia is in the top half. 

But even that is an apples to oranges comparison - comparing death spikes from four months ago to current conditions.

The past is the past but policy can still impact the present.  And in the present, Florida is a COVID horror show.

If we are evaluating public policy responses, it only makes sense to look at cumulative numbers. Otherwise someone might get the impression that NY has had a better response than Florida. Also--antibody testing in NYC indicates that enough of the population has been infected to materially retard the spread of the disease at this point.

If you think Florida is a horror show based on 90 deaths yesterday, I think you should remember what a real horror show looks like. If New York never has another Covid death, and Florida continues with 90 / day, Florida will match the New York death total on May 23, 2021. Of course as Florida has a higher population, it will still trail in the per capita death count.

Florida (and Georgia) are reaching ICU bed capacity. Don't worry. Those death numbers will start going up.

[alfred russel]

Florida (and Georgia) are reaching ICU bed capacity. Don't worry. Those death numbers will start going up.

I understand. Disaster for the irresponsible states is always just a little further off.

Meanwhile, Gov. Cuomo has developed a policy, probably with his science advisors:

Let's be clear.

Outdoor dining is now permitted statewide.

Outside drinking is not.

https://twitter.com/NYGovCuomo/status/1285602348446945281?s=20

This is transparently bullshit. People see this and think politicians are just on an arbitrary power trip and become prone to ignore everything. Sort of like how public boat ramps were closed in Florida when cases were way lower but are open now when they are at an all time high, or how climbing spots were closed, but now even indoor gyms are open.

Hell, I'm trying to put together a vacation for a weeklong hike on the Appalachian Trail, and there are campsites that are still closed. But no problem if our mayor wants to participate in crowded protests through a major city.