COVID COVID-19 Coronavirus Containment Efforts

[OmCheeto]

...

If you use an overall fatality rate of 0.64% (*), then this implies a huge number of unrecorded cases in most countries. I cannot comment on this, other than to say that anyone who claims such a low fatality rate has a lot of apparently contradictory data to explain. This has been raised several times in the previous posts. To repeat the one example of South Korea, who recorded 11,600 cases and 273 deaths (2.3%). Which implies that S Korean identified only one case in four - and yet effectively stamped it out.

...

Some of us are of the opinion that simply wearing masks is the biggest factor in the spread of the disease.

If 80% of Americans Wore Masks, COVID-19 Infections Would Plummet, New Study Says [Vanity Fair, 8 May, 2020]​

As long as a population follows simple rules, the disease loses.

Here's some data I graphed about a week ago:

[ref: Singapore, Malaysia]

From the Vanity Fair article; “One reason is that nearly everyone there[Japan] is wearing a mask,”
I'm guessing South Koreans probably all wear masks.

It would be interesting to find data for other countries.
I saw a video last week from New York City where one unmasked customer was bullied out of the grocery store by the masked customers.

 

[OmCheeto]

...
I'm guessing South Koreans probably all wear masks.
...

Ha!
According to Statista, 19% of South Koreans were wearing masks BEFORE the outbreak.
70% wore them after the outbreak, and 11% didn't wear them ever.

 

[atyy]

Some of us are of the opinion that simply wearing masks is the biggest factor in the spread of the disease.

If 80% of Americans Wore Masks, COVID-19 Infections Would Plummet, New Study Says [Vanity Fair, 8 May, 2020]

It seems the Japanese also did social distancing and contact tracing, not just mask wearing.
https://www.ft.com/content/7a4ce8b5-20a3-40ab-abaf-1de213a66403

New Zealand has also had a successful response so far, and mask wearing in the community is not currently recommended for healthy people.
https://www.health.govt.nz/our-work...eral-public/covid-19-use-face-masks-community

 

[mfb]

Here is a larger metastudy:
Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis
Not surprisingly, they find that all three help.
Caveat: It's not a randomized study for obvious reasons, it's just from observations. The overall conclusion is probably right but the numbers could be quite different.

13 days without new case in New Zealand. Still one active case.

 

[Astronuc]

Anders Tegnell, Sweden's state epidemiologist, told Swedish radio station Sveriges Radio on Wednesday that while the country would have implemented tougher restrictions, they would still likely not have been as strict as in many countries.

"If we were to encounter the same illness with the same knowledge that we have today, I think our response would land somewhere in between what Sweden did and what the rest of the world has done," Tegnell said, according to Bloomberg.

"Clearly, there is potential for improvement in what we have done in Sweden," he added.

https://news.yahoo.com/architect-swedens-no-lockdown-plan-132103531.html

STOCKHOLM — The debate over Sweden’s controversial no-lockdown Coronavirus strategy flared again after its architect, state epidemiologist Anders Tegnell, appeared to suggest the country's approach had been flawed.

https://www.politico.eu/article/swedens-dr-no-lockdown-denies-tactical-retreat/

However, at his daily press briefing in Stockholm, Tegnell pushed back against the idea that he was changing tack and reiterated his view that Sweden’s overall strategy had been correct.

“We continue to believe the strategy is good but then there are always improvements we can make,” he told reporters.

In hindsight, there is always room for improvement, but ideally, it helps one develop some foresight.

 

[bob012345]

Sweden again. They're wailing and gnashing their teeth over this data but it amounts to a little worse than The Netherlands without the severe disruptions to economic and social life which itself may have led to hundreds of untimely deaths. Also the list of countries included are misleading. Why not include Belgium (824)? Or France (445)? Then, there is discussion that the deaths may be more to do with differences in the health care system and policy differences in treatment.

It seems to me a better metric is not deaths per million but cases per million. That measures the spread while deaths measures the way they handle the disease. Even though Sweden tops this list below, it is ranked #20 in the world.

Total cases per million goes as;

Sweden 4149
Holland 2740
Germany 2203
Denmark 2040
Finland 1247
Estonia 1425
Norway 1567
Poland 662
Iceland 5295
Lithuania 619
Latvia 573

 

[Ygggdrasil]

Overheard: "Almost all COVID-19 patients are no longer contagious by the 11th day of illness. Korea and Singapore are changing their guidelines for clearing people from quarantine and are going for time-based clearance rather than test-based clearance. For context, RT-PCR can remain positive for up to 8 weeks, but people are no longer contagious by the 2nd week. This will allow us to record recoveries much faster (you used to have to have 2 negative RT-PCRs for clearance) and free up hospital and isolation beds.

Can you confirm this? Especially the highlighted bit.

I don't know anything about the policies of Korea and Singapore, but the the scientific claim that COVID-19 patients are no longer contagious by the 11th day of illness despite still testing positive for the virus, these claims are supported by this non-peer reviewed study that studied the infectiousness of COVID-19 patients over time:

People who contract the novel coronavirus emit high amounts of virus very early on in their infection, according to a new study from Germany that helps to explain the rapid and efficient way in which the virus has spread around the world.

At the same time, the study suggests that while people with mild infections can still test positive by throat swabs for days and even weeks after their illness, those who are only mildly sick are likely not still infectious by about 10 days after they start to experience symptoms.

Link to the scientific paper: https://www.medrxiv.org/content/10.1101/2020.03.05.20030502v1
Link to a popular press summary: https://www.statnews.com/2020/03/09...-likely-not-infectious-after-recovery-begins/

 

[kyphysics]

https://www.theatlantic.com/health/...-coronavirus-longterm-symptoms-months/612679/
COVID-19 Can Last for Several Months
The disease’s “long-haulers” have endured relentless waves of debilitating symptoms—and disbelief from doctors and friends.

For vonny leclerc, day one was March 16.
Hours after British Prime Minister Boris Johnson instated stringent social-distancing measures to halt the SARS-CoV-2 coronavirus, LeClerc, a Glasgow-based journalist, arrived home feeling shivery and flushed. Over the next few days, she developed a cough, chest pain, aching joints, and a prickling sensation on her skin. After a week of bed rest, she started improving. But on day 12, every old symptom returned, amplified and with reinforcements: She spiked an intermittent fever, lost her sense of taste and smell, and struggled to breathe.

When I spoke with LeClerc on day 66, she was still experiencing waves of symptoms. “Before this, I was a fit, healthy 32-year-old,” she said. “Now I’ve been reduced to not being able to stand up in the shower without feeling fatigued. I’ve tried going to the supermarket and I’m in bed for days afterwards. It’s like nothing I’ve ever experienced before.” Despite her best efforts, LeClerc has not been able to get a test, but “every doctor I’ve spoken to says there’s no shadow of a doubt that this has been COVID,” she said. Today is day 80.

 

[mfb]

Also the list of countries included are misleading. Why not include Belgium (824)? Or France (445)?

Because it's a list of neighbors, with a bit of liberty in the definition for oceans, but Belgium and France are definitely not neighbors.

It seems to me a better metric is not deaths per million but cases per million.

I agree. But recorded cases per million is a really poor metric, especially if a country decides to stop large-scale testing, like Sweden did.

14 days without new case in New Zealand.

 

[bhobba]

14 days without new case in New Zealand.

Australia is lifting restrictions. Tons are screaming - lift them entirely - we have beaten it. Not so fast - we are in fact tetering as the growth factor (r0 is 1 right now) shows:
https://www.abc.net.au/news/2020-04...ustralia-growth-factor-covid-19/12132478?nw=0

We need to lift restrictions slowly and be prepared to clamp them on again. I try to explain this in forums out here, but to no avail. Personally I think we are lifting them too fast.

Thanks
Bill

 

[Bystander]

but Belgium and France are definitely not neighbors.

Say again?

 

[wukunlin]

Say again?

I think he means they are not neighbors of Sweden

 

[mfb]

Say again?

... of Sweden. It was a list of neighbors of Sweden, and Belgium and France don't belong in that list because they are not neighbors [of Sweden].

 

[atyy]

I don't know anything about the policies of Korea and Singapore, but the the scientific claim that COVID-19 patients are no longer contagious by the 11th day of illness despite still testing positive for the virus, these claims are supported by this non-peer reviewed study that studied the infectiousness of COVID-19 patients over time:

Link to the scientific paper: https://www.medrxiv.org/content/10.1101/2020.03.05.20030502v1
Link to a popular press summary: https://www.statnews.com/2020/03/09...-likely-not-infectious-after-recovery-begins/

It's since been published in Nature
https://www.nature.com/articles/s41586-020-2196-x

The current Singapore policy is to use 21 days and clinically well, even if the patient tests positive by PCR.
https://www.moh.gov.sg/news-highlights/details/revised-discharge-criteria-for-covid-19-patients
" ... This is corroborated by local research. The recent position statement on the period of infectivity by the National Centre for Infectious Diseases and the Chapter of Infectious Disease Physicians, Academy of Medicine, Singapore, noted that viable COVID-19 virus was not found after the second week of illness despite the persistence of PCR detection of RNA. Local and international clinical observations therefore support the discharge of well patients after Day 14 from the onset of illness. ..."

 

[Vanadium 50]

It seems to me a better metric is not deaths per million but cases per million.

That would be true if there were 100% testing. But without it, the number of cases is strongly dependent on the number of tests.

 

[Vanadium 50]

If you align them by onset of the pandemic (let's say 0.2 of the peak) you get completely different conclusions.

Not for Sweden and Norway. They are on the same upward trend.

Funny how Norway is the perfect comparison to Sweden, except when it isn't.

 

[Vanadium 50]

It's much too easy to criticize new work.

New York screwed up big time. They acted late (when the shelter-in-place order was given they had 20,000 cases) and they put policies in place to make the situation in nursing homes worse, not better. (By that time we had known the impact on the elderly for some time).

 

[bob012345]

That would be true if there were 100% testing. But without it, the number of cases is strongly dependent on the number of tests.

I suspect that the number of actual cases tracks the number of reported cases fairly consistently in European countries. If so, using reported cases is still a better benchmark than deaths.

 

[Vanadium 50]

Well, you'd be wrong. See https://ourworldindata.org/coronavi...testing-compared-to-the-scale-of-the-outbreak For example, croatia and Portugal are more than an order of magnitude apart.

 

[PeroK]

... of Sweden. It was a list of neighbors of Sweden, and Belgium and France don't belong in that list because they are not neighbors [of Sweden].

The European Union has a population of 445 million. You are only prepared to compare Sweden with three countries with a combined population of 16 million. Excluding 96% of the data is fundamentally unscientific and designed only to support an a priori conclusion.

If you really believe what you say you must be prepared to absolutely condemn Spain in comparison with its neighbor Portugal: 580 deaths per million against 144. That's appalling. What was the Spanish government doing to lose so many people?

 

[bob012345]

Well, you'd be wrong. See https://ourworldindata.org/coronavi...testing-compared-to-the-scale-of-the-outbreak For example, croatia and Portugal are more than an order of magnitude apart.

Well, I'm wrong about a lot of things but this chart is daily tests vs. daily confirmed cases. I'm not sure what this has to do with my point?

 

[Vanadium 50]

That's just the first plot. Scroll down and you will see "How many tests are performed each day" and "
total tests performed relative to the size of population".

 

[bob012345]

That's just the first plot. Scroll down and you will see "How many tests are performed each day" and "
total tests performed relative to the size of population".

What does this have to do with my original suspicion? I didn't mention testing.

 

[mfb]

The European Union has a population of 445 million. You are only prepared to compare Sweden with three countries with a combined population of 16 million. Excluding 96% of the data is fundamentally unscientific and designed only to support an a priori conclusion.

The list had more than three countries.
Why stop at the EU? Why not take Earth?
Excluding 96% of some larger dataset is perfectly fine and even necessary if these 96% are different.

If you really believe what you say you must be prepared to absolutely condemn Spain in comparison with its neighbor Portugal: 580 deaths per million against 144. That's appalling. What was the Spanish government doing to lose so many people?

Act too late, among other problems. Why is this even a question? Does anyone doubt that Portugal did better than Spain?

I didn't mention testing.

Yes, that's the problem. You compared people tested positive without taking into account how many people were tested. No tests, no confirmed cases, perfect outcome?

 

[Vanadium 50]

What does this have to do with my original suspicion? I didn't mention testing.

Here's what you said.

I suspect that the number of actual cases tracks the number of reported cases fairly consistently in European countries. If so, using reported cases is still a better benchmark than deaths.

The way you get to be a "reported case" is to test positive. That means there is a strong dependency on how many people you test.

Fatalities don't have the same problem. Dead is dead, whether or not you've been tested. They do have the problem that ascribing a single cause is difficult if the patient has multiple conditions, and we know that these are the people for whom Covid is most deadly. But this is perhaps tens of percent, not the order of magnitude of the testing rate.

 

[bob012345]

Here's what you said.
The way you get to be a "reported case" is to test positive. That means there is a strong dependency on how many people you test.

Fatalities don't have the same problem. Dead is dead, whether or not you've been tested. They do have the problem that ascribing a single cause is difficult if the patient has multiple conditions, and we know that these are the people for whom Covid is most deadly. But this is perhaps tens of percent, not the order of magnitude of the testing rate.

Ok, I made an assumption and used a misleading word when I said it 'tracks'. What I meant to communicate was that I believe the number of actual cases correlates to the number of official confirmed cases. Obviously not one-to-one. For a large population size and roughly equivalent social dynamics like European countries I thought that was reasonable but I would not compare Belgium to Belize. Sorry for the confusion.

 

[PeroK]

Fatalities don't have the same problem. Dead is dead, whether or not you've been tested.

It's funny you should say that. The Spanish suddenly went from an average of 179 deaths per day for the week up to 26th May to an average of 1 death per day for the week up to 2nd June. They recorded 280 new deaths on May 26th and no more than 5 on any day since. This is a pattern not shown in any other European country. It's not credible that one day the deaths from COVID-19 would almost suddenly stop.

I found this in the Financial Times, which is also skeptical of the Spanish figures. They quote that 17 deaths were recorded in the regions but never made it to the national figures:

https://www.ft.com/content/77eb7a13-cd26-41dd-9642-616708b43673

 

[bob012345]

It's funny you should say that. The Spanish suddenly went from an average of 179 deaths per day for the week up to 26th May to an average of 1 death per day for the week up to 2nd June. They recorded 280 new deaths on May 26th and no more than 5 on any day since. This is a pattern not shown in any other European country. It's not credible that one day the deaths from COVID-19 would almost suddenly stop.

I found this in the Financial Times, which is also skeptical of the Spanish figures. They quote that 17 deaths were recorded in the regions but never made it to the national figures:

https://www.ft.com/content/77eb7a13-cd26-41dd-9642-616708b43673

Why assume the number of deaths per day are anything other than accounts of the numbers recorded that day, not the actual deaths that day. The accuracy and consistency of reporting systems might vary geographically and temporally.

 

[Evo]

V50 asked to have this thread merged with the Covid-19 containment thread, so I have done so. The posts are now here https://www.physicsforums.com/threads/covid-19-coronavirus-containment-efforts.983707/

 

[Vanadium 50]

Thanks!