COVID COVID-19 Coronavirus Containment Efforts

[russ_watters]

We can control it with strict rules and public cooperation, but as has been seen in Australia that now looks like it may be breaking down as people tire of it. The vaccine may be the only hope.

That's the situation in the US as well, except with a much worse baseline.

That's due to privacy concern.

RE google and Apple. I should have added: they're not using for COVID. They of course use it where they can make money from it.

 

[russ_watters]

In Aus it is thought the app is not doing much good over and above normal tracing methods. There seem to be a number of reasons, one of which is many phones go into an idle mode while not being used and the app is then not working.

Well, from what I'm seeing it isn't using the Google/Apple api, but has similar features/limitations:
1. It's voluntary to use and report positive test results.
2. It uses bluetooth instead of gps.

Using bluetooth instead of gps makes them not very effective, but making them voluntary drops that usefulness by an order of magnitude.
[edit]
But it does look like it has one major difference to improve performance: government control over/access to the information, to supplement manual contact tracing.
https://www.gizmodo.com.au/2020/07/covidsafe-apple-google-api-exposure-notification-system/

 

[russ_watters]

Well, the thing is we know that the traditional contact tracing does work, and we are not sure whether a GPS app works without the traditional contact tracing.

I wouldn't intend for such an app to replace people entirely. One of its functions would be (is, for those who have it) to augment traditional contact tracing. Yes, we know traditional contact tracing works, but for COVID it has severe limitations of both speed and scale, both of which are ideal problems for digital contact tracing to solve. Ultimately, it has to lead to a county health department official showing up at your door with a nasal swab and a lecture about staying home (at least).

In all cases, it is essential for the public to trust the government. Trust seems already to be at such low levels in the US, maybe it's better to spend it on the traditional methods (which we know works), rather than squandering what little is left of the trust on an untested method that many are suspicious of (and which may not work without the traditional methods).

I hear you, and if trust were the only issue I'd agree. There's also effectiveness, cost, scale, and features. I'm not naive though; I don't expect the US will create a nationwide digital contact tracing app, at least for the next 6 months.

But incidentally, can GPS alone really contact tracing? Does it work well enough indoors to tell whether people are less than 2 meters apart?
https://www.gps.gov/systems/gps/performance/accuracy/
" For example, GPS-enabled smartphones are typically accurate to within a 4.9 m (16 ft.) radius under open sky (view source at ION.org). However, their accuracy worsens near buildings, bridges, and trees. "

Indoors GPS accuracy depends on the building. But yes, it can't do any better for larger buildings than tell you that you were in the same building as an infected person. In densely populated cities with large infection numbers that would be a problem. In suburban or rural areas, it wouldn't be. I haven't tried to calculate it yet, but I'd bet only one infected person goes to my grocery store per week.

 

[bhobba]

I heard a claim on the news last night that the AZ vaccine might be ready by September. Seems like hype at the moment.

2 billion doses by September:
https://nairametrics.com/2020/07/15...e-new-frontrunner-to-produce-2-billion-doses/

This is a CEPI vaccine, and they are, as per Bill Gates's requirement who set it up, committed to an equitable distribution of it.

I did a post previously in the thread that with 4 vats they think they can produce 1 billion doses a month. Should it be effective, and this is true, scaling it to inoculate the world quickly is not out of the question. We just need the will and let the logistic experts do their thing.

This could be one of the greatest triumphs humanity has ever accomplished. The Oxford team could easily win the Nobel. But for me the real hero is Bill Gates, yet all I ever hear is silly conspiracy theories not worthy of a man who has spent billions of his own money on this. As a businessman his practices were sometimes questionable, but never forget he did the toughest freshman math course in the world:
https://en.wikipedia.org/wiki/Math_55

He is a first class scientific intellect.

Thanks
Bill

 

[Vanadium 50]

but your issue is more with treating COVID as an emergency than it is with the specific emergency response measure.

That's fair. However, I think it also factors into people's decisions that emergencies tend never to go away. The last national emergency to end was 2012-2015. The terror alert level put in place in 2001. It was never below "elevated" and went to "high" six times.

The threshold for national emergency is also quite low - the last public health emergency was 2009-2010 (H1N1 flu) which killed 3,433 people in the US. That's 1/10 the number killed in automobile accidents in that time.

For me to support this policy, I would want a higher threshold, a well-defined time period before a sunset, and scientific evidence about whether or not it's helping. It would sure help to have clearer guiding principles on what is and is not allowed.

 

[atyy]

2 billion doses by September:
https://nairametrics.com/2020/07/15...e-new-frontrunner-to-produce-2-billion-doses/

CanSino uses a similar technology as the Oxford vaccine - expressing a SARS-CoV-2 protein in an adenovirus. I wonder how they are doing. Like the Oxford team, they recently published their results in the Lancet.
CanSino: https://doi.org/10.1016/S0140-6736(20)31605-6
Oxford: https://doi.org/10.1016/S0140-6736(20)31604-4

 

[atyy]

This could be one of the greatest triumphs humanity has ever accomplished. The Oxford team could easily win the Nobel. But for me the real hero is Bill Gates, yet all I ever hear is silly conspiracy theories not worthy of a man who has spent billions of his own money on this. As a businessman his practices were sometimes questionable, but never forget he did the toughest freshman math course in the world:
https://en.wikipedia.org/wiki/Math_55

https://www.quora.com/How-gifted-wa...hat-he-successfully-passed-Math-55-at-Harvard
"Two years later, I called to tell him our paper had been accepted to a fine math journal. He sounded eminently disinterested. He had moved to Albuquerque, New Mexico to run a small company writing code for microprocessors, of all things. I remember thinking: "Such a brilliant kid. What a waste."

 

[mfb]

It's all hands on deck for our Covid containment efforts, trying everything that might help regardless of firm evidence that it will help -- except that. No, we can't even consider that.

• Who says it was not considered? I'm sure every country considered it. And nearly all decided it won't help enough to implement it, or the legal obstacles are too big, implementation will take too long to be helpful, or something else makes it unsuitable. How can you come to so fundamentally different conclusions than nearly every government?
• There are plenty of things that are not tried because they would cause more harm than benefit.

(2) I don't see why it should be considered likely to be permanent.

How many of the laws introduced after 9/11 were removed later? How many similar laws do you know that were removed? We still can't bring liquids through airport security, and in the US you still have to remove the shoes there.

(3) Whether governments or individuals, clearly competence has been a problem in the pandemic response. But this problem is independent of the issue of improving contact tracing.

It's not an independent problem. You need to demonstrate that the government could actually reduce the spread with all that information. That needs a big team of competent people.

(4) I'm not following/understanding this example at all.

I can't see how this could be unclear, but if you don't see any issue with that scenario it's clear why you keep dismissing privacy concerns.

 

[Vanadium 50]

We still can't bring liquids through airport security

That's because liquids are the most dangerous phase of matter. Or something.

 

[Astronuc]

We still can't bring liquids through airport security, and in the US you still have to remove the shoes there.

We can as long as the volume is less than 3 fl oz, 90ml ( or perhaps 3.5 fl oz, 100 ml). Small tubes of toothpaste are fine.

 

[mfb]

Yes, and it needs to be separate in a clear bag and so on, total volume is restricted as well. It's silly and doesn't improve security, but it's a rule that is supposed to increase the security, so it's likely to stay.

 

[bhobba]

https://www.quora.com/How-gifted-wa...hat-he-successfully-passed-Math-55-at-Harvard
"Two years later, I called to tell him our paper had been accepted to a fine math journal. He sounded eminently disinterested. He had moved to Albuquerque, New Mexico to run a small company writing code for microprocessors, of all things. I remember thinking: "Such a brilliant kid. What a waste."

The issue was while he was exceptional at math, he was not the very best - there were a few better. He could not stand that, although he maintained an interest in the area all his life. So he switched to computer science (which was part of applied math back then) where nobody could touch him. It's pure vs applied math - the stuff of many punny jokes like - is it pure or puerile math - I keep forgetting. It's his nature - he had to be the best. I was watching a documentary on him. He is a voracious reader. They went through the current books he was reading - one struck me - Quantum Mechanics and Algorithms. He obviously has wide interests.

I just love the what a waste comment - in his younger days his programming feats were stories of legend.

Thanks
Bill

 

[Ygggdrasil]

The threshold for national emergency is also quite low - the last public health emergency was 2009-2010 (H1N1 flu) which killed 3,433 people in the US. That's 1/10 the number killed in automobile accidents in that time.

For me to support this policy, I would want a higher threshold, a well-defined time period before a sunset, and scientific evidence about whether or not it's helping. It would sure help to have clearer guiding principles on what is and is not allowed.

Infectious diseases are much easier to stop and contain when the outbreaks are small. If the threshold is too high, then by the time you declare an emergency, there isn't really anything public health officials can do short of a shutdown to contain an outbreak of a new disease. Besides, I'm sure very few were actually affected by the government declaring a public health emergency in 2009-2010 (do you remember any effects on your life from that time?). As far as I can tell (e.g. skimming this report), the emergency declaration mostly helped the federal government to mobilize resources to states and allowed relaxation of certain regulations (e.g. emergency authorization to expedite approval of testing for the new strain of virus). The threshold would certainly be higher for the implementation of more intrusive measures.

That the pandemic resulted in relatively few deaths is almost beside the point. Given what we've seen with COVID-19, it's hard to argue that newly emerging respiratory viruses don't pose major health and economic dangers to the country.

 

[Vanadium 50]

My point is that the threshold for declaring an emergency is not high. It sounds like you are agreeing, saying it shouldn't be.

 

[Ygggdrasil]

My point is that the threshold for declaring an emergency is not high. It sounds like you are agreeing, saying it shouldn't be.

I think your post confuses a few things (admittedly, my post also confuses and conflates some of the same points as well). Let me try to clarify:

Your original post was made in the context of a discussion of digital contact tracing and (more generally) trade offs between public health and individual privacy. However, the example you cite (declaration of an emergency for the 2009-2010 H1N1 influenza pandemic) is not a good example because, as far as I can tell, the emergency declaration did implement any invasive measures that invaded the privacy of citizens. I don't see how this threshold is relevant to your discussion.

Given that we are in a pandemic with >140k deaths (and counting) and have not implemented any mandatory digital surveillance, it is pretty clear that the US has a very high threshold for the invasion of personal privacy vs public health.

In general, I do agree that broad, mandatory digital surveilance of citizens should require a high threshold, be supported by scientific evidence, and have well defined limits of duration and scope.

 

[Vanadium 50]

The example was used to counter the "it's only for emergencies" argument. It shows that the threshold for declaring an emergency is low.

 

[OmCheeto]

This sounds like good news:

NYT, July 22, 2020​

​

Covid-19 Patients No Longer Need Tests to End Isolation​

​

Under new guidelines from the C.D.C., recovering Coronavirus patients should be free to resume normal activity after 10 days, if they have no fever or other symptoms.​

 

[nsaspook]

https://www.nature.com/articles/s41586-020-2550-z_reference.pdf

SARS-CoV-2-specific T cell immunity in cases of COVID-19 and SARS, and uninfected controls

 

[mfb]

In the US California now has more confirmed cases than New York (at twice the population, however). Florida will follow this weekend, Texas early next week.
Current hospitalizations went from a minimum of 28,000 in late June to 60,000 (source), the same as during the first peak in April. Caveat: Florida decided to include more cases in between, that's an increase of ~5000 or so from a changed reporting method. But the numbers are still going up...

New Zealand is below 1 case per day again, they might have stopped the outbreak that was started by visitors.

Iceland's statistics are strange. I guess they keep adding people with antibodies (i.e. past infections) to the total - they just have 5-10 active cases but add ~5 cases per day. COVID-19 doesn't go away that fast.

 

[bhobba]

Given that we are in a pandemic with >140k deaths (and counting) and have not implemented any mandatory digital surveillance, it is pretty clear that the US has a very high threshold for the invasion of personal privacy vs public health.

I am not quite sure of that.

I think it may be dependant, at rock bottom, on the publics knowledge of, and faith in, basic science. Except for this forum, programs I watch (of course not the epidemiological experts they sometimes interview - although on occasion you wonder - but that is another story) and discussions I have about it elsewhere, show appallingly low knowledge of the simple concept of r0. I have heard some, and they include the occasional MD who should know better, say if we had not discovered this virus we would simply say - we are having a rather bad flu season this year. The flu has an r0 of about 1.2, Covid 2.5. The death rate of flu is about .2% - Covid, about .5% to 1%. We also have a vaccine for the flu, but let us say we got the strains totally wrong this year so the vaccine is ineffective. A bit of simple math shows for the flu it's a slow exponential increase, for Covid it's an explosive exponential increase - I think greater than the Spanish Flu which I believe was 2.2. It's death rate was however higher - 2% or so. It can easily rumble on at a low level then explode - which is what we have seen in many places. If people understood that then they would be prepared, IMHO, to undertake measures like Taiwan, that while invasive as far as privacy goes, especially when implemented early, will allow life to be relatively normal, until the ultimate answer, the vaccine, is available. Here in Aus where I am, we too are concerned about privacy, but nearly 70% of people in Queensland believe we should shut Queensland's borders from the rest of Australia because of the bad outbreak in Victoria, and the developing outbreak in Sydney, a very invasive measure with huge economic ramifications, because they have seen what happens when it gets out of control. It is strange as far as priorities go - they will get upset (or politicians at least believe they will) if we use GPS data kept by Google and others to contact trace making border closures not necessary - we can see where people have been and/or are going - so make sure they do the right thing. Yet are prepared to accept border closures. Just my view of course - because people here in Aus are opting out of taking science and math at school in droves we will never know if it is lack of understanding or fear of loss of privacy.

Thanks
Bill

 

[atyy]

https://www.sciencemag.org/news/202...st-center-covid-19-origin-theories-speaks-out
I think the additional information released in the interview with Shi Zhengli rules out quite definitively the possibility that SARS-CoV-2 came from mishandling of viral samples at the Wuhan Institute of Virology. It was already unlikely, but there were some exotic scenarios discussed eg. in https://doi.org/10.1038/s41591-020-0820-9. I think the additional information supplied here rules out the exotic scenarios.

 

[bhobba]

I think the additional information supplied here rules out the exotic scenarios.

I think so too. But an immunologist working on a vaccine here in Aus, Nikolai Petrovsky, thinks it has aspects that suggest something funny is going on about how it originated (some parts are suggested in Atty's linked article):

https://arxiv.org/pdf/2005.06199.pdf
'Notably, this approach surprisingly revealed that the binding energy between SARS-CoV-2 spike protein and ACE2 was highest for humans out of all species tested, suggesting that SARS-CoV-2 spike protein is uniquely evolved to bind and infect cells expressing human ACE2. This finding is particularly surprising as, typically, a virus would be expected to have highest affinity for the receptor in its original host species, e.g. bat, with a lower initial binding affinity for the receptor of any new host, e.g. humans. However, in this case, the affinity of SARS-CoV-2 is higher for humans than for the putative original host species, bats, or for any potential intermediary host species.'

Personally, while strange, I still think it is just blind luck. Sometimes low probability things do happen naturally.

Thanks
Bill

 

[PeroK]

'Notably, this approach surprisingly revealed that the binding energy between SARS-CoV-2 spike protein and ACE2 was highest for humans out of all species tested, suggesting that SARS-CoV-2 spike protein is uniquely evolved to bind and infect cells expressing human ACE2. This finding is particularly surprising as, typically, a virus would be expected to have highest affinity for the receptor in its original host species, e.g. bat, with a lower initial binding affinity for the receptor of any new host, e.g. humans. However, in this case, the affinity of SARS-CoV-2 is higher for humans than for the putative original host species, bats, or for any potential intermediary host species.'

Personally, while strange, I still think it is just blind luck. Sometimes low probability things do happen naturally.

Thanks
Bill

COVID-19 has done its damage because it is highly infectious. If it had a low infection rate in humans, we might never have noticed it.

There's a strong correlation between a virus that (by chance) is highly infectious to humans and a virus that causes a global pandemic.

 

[bhobba]

COVID-19 has done its damage because it is highly infectious.

Of course. It was the first thing my Rheumatologist said to me when I asked him it's implications in my case. As I said in a previous post - it's the r0.

Thanks
Bill

 

[bhobba]

New Zealand is below 1 case per day again, they might have stopped the outbreak that was started by visitors.

That's why Australia does not want to go for an eradication strategy despite many epidemiologists saying that's what we should do. Just one slip up after its eradicated and it's back again. We are trying for a strong suppression strategy that nearly led to eradication, but one 'slip up' and it was all undone. Still it looks highly likely once the Victorian and now Sydney outbreak is under control we will have travel between Aus and NZ. After that Japan and other countries are being looked at.

Thanks
Bill

 

[Astronuc]

COVID-19 has done its damage because it is highly infectious. If it had a low infection rate in humans, we might never have noticed it.

There's a strong correlation between a virus that (by chance) is highly infectious to humans and a virus that causes a global pandemic.

That is the subject of a set of Wall Street Journal articles. The latest:
How Deadly Is Covid-19? Researchers Are Getting Closer to an Answer, Research suggests the new Coronavirus kills about five to 10 people for every 1,000 that it infects, though rate varies based on age and access to health care
July 21 (updated) https://www.wsj.com/articles/how-de...s-are-getting-closer-to-an-answer-11595323801
(subscription required)

July 24 - U.S. records 1,000 Coronavirus deaths for fourth day, some progress seen
https://www.reuters.com/article/us-...r-fourth-day-some-progress-seen-idUSKCN24Q0R3

At least 1,019 fatalities due to COVID-19 were confirmed nationwide on Friday, following 1,140 on Thursday, 1,135 on Wednesday and 1,141 on Tuesday. Total cases across the United States rose by at least 68,800 on Friday to over 4 million.

The numbers have been driven in large part by a surge in infections in Arizona, California, Florida, Texas and California.

https://graphics.reuters.com/HEALTH-CORONAVIRUS-USA/0100B5K8423/index.html

According to Business Insider, Florida has surpassed New York in total cases.
Florida reports 414,511 (up from 402312 yesterday) confirmed COVID-19 cases, while NY reports 411,501 (up from 410450 yesterday). ncov2019.live has NY with 439089, which may include probable cases (~29000).
Florida - https://experience.arcgis.com/experience/96dd742462124fa0b38ddedb9b25e429
New York - https://covid19tracker.health.ny.gov/views/NYS-COVID19-Tracker/NYSDOHCOVID-19Tracker-Map/

https://covidtracking.com/data/state/florida
https://covidtracking.com/data/state/new-york

https://ncov2019.live/data/unitedstates

 

[berkeman]

Research suggests the new Coronavirus kills about five to 10 people for every 1,000 that it infects

Doesn't that seem low? My local EMS Dashboard has Santa Clara County at 2% total right now, and I'm pretty sure I've seen overall US numbers more like 5%.

https://www.sccgov.org/sites/covid19/Pages/dashboard.aspx

 

[Astronuc]

Doesn't that seem low? My local EMS Dashboard has Santa Clara County at 2% total right now, and I'm pretty sure I've seen overall US numbers more like 5%.

https://www.sccgov.org/sites/covid19/Pages/dashboard.aspx

It depends on the model and denominator. The mortality rate based on confirmed cases is 2 to 6%, however, if the denominator includes expected cases, which some believe is 4 to 10 times the confirmed cases, then the number drops. Some early estimates indicated that 80% of those infected may not know they are or were infected. Most of the time, folks got tested if they presented symptoms, or were exposed. The nationwide (US) average is about 3.4%, while individual states vary from less than 1% to over 6%. NY State mortality rate is about 6.1% of confirmed cases, while Wa state is about 3% according the numbers I've been tracking. Of course, there may be deaths related to COVID-19 not counted, others who were counted by didn't have COVID-19 and folks who were infected who have not been tested.

 

[berkeman]

It depends on the model and denominator. The mortality rate based on confirmed cases is 2 to 6%, however, if the denominator includes expected cases, which some believe is 4 to 10 times the confirmed cases, then the number drops.

Thanks Astro. In a way that is encouraging...

 

[atyy]

Thanks Astro. In a way that is encouraging...

It shouldn't be considered as changing the picture much. Terminology varies, but basically, the infection fatality rate (IFR) has been distinguished from the raw case fatality ratio, with the IFR estimated from 0.3% to 1% since early in the outbreak.
https://www.who.int/docs/default-so...ation-reports/20200219-sitrep-30-covid-19.pdf
https://www.who.int/docs/default-so...ation-reports/20200220-sitrep-31-covid-19.pdf
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext