COVID COVID-19 Coronavirus Containment Efforts

[mfb]

The global official death toll (sum of the official numbers) exceeded 100,000. The real value is probably quite a bit higher. The US death toll reached Italy's number.
1.7 million confirmed cases, rising at 100,000 per day.

A report that some mutations in humans might provide some resistance against the disease:
https://www.researchgate.net/publication/340461531_Structural_Variations_in_Human_ACE2_may_Influence_its_Binding_with_SARS-CoV-2_Spike_Protein

Most ACE2 variants showed similar binding affinity for SARS‐CoV‐2 spike protein as observed in the complex structure of wild type ACE2 and SARS‐CoV‐2 spike protein. However, ACE2 alleles, rs73635825 (S19P) and rs143936283 (E329G) showed noticeable variations in their intermolecular interactions with the viral spike protein. In summary, our data provide structural basis of potential resistance against SARS‐CoV‐2 infection driven by ACE2 allelic variants.

 

[bhobba]

New Zealand and Australia both report falling numbers of new cases. It is possible to stop this virus early on if the countries act fast enough.

The government in Aus put in our current restrictions about mid March, which are somewhere between level 2-3, but are being tweaked all the time so now we probably are at level 3. When this was bought in all commentators, including me at the time, thought we would be at level 4 (ie total lockdown) in a few days. It didn't happen. It is now thought we imposed them just in a nick of time. We still have people ignoring it, but the police are increasingly clamping down hard on violations - so much so quite a few people say they sometimes are silly eg someone fishing in a tinny away from anyone. I think over time we will get better at when to strongly enforce the rules, and when to be more lenient. But in general experts are optimistic here in Aus:
https://www.abc.net.au/news/2020-04...ns-on-the-cusp-of-slowing-paul-kelly/12141050

Thanks
Bill

 

[kyphysics]

https://www.bloomberg.com/news/arti...uld-be-ready-in-six-months-times?srnd=premium
Coronavirus Vaccine Could Be Ready in Six Months: Times

A vaccine against the Coronavirus could be ready by September, according to a scientist leading one of Britain’s most advanced teams.

Sarah Gilbert, professor of vaccinology at Oxford University, told The Times on Saturday that she is “80% confident” the vaccine would work, and could be ready by September. Experts have warned the public that vaccines typically take years to develop, and one for the Coronavirus could take between 12 to 18 months at best.

In the case of the Oxford team, however, “it’s not just a hunch, and as every week goes by we have more data to look at,” Gilbert told the London newspaper.

Thoughts from the crew here?

 

[Astronuc]

https://www.bloomberg.com/news/arti...uld-be-ready-in-six-months-times?srnd=premium
Coronavirus Vaccine Could Be Ready in Six Months: Times
Thoughts from the crew here?

http://www.ox.ac.uk/news/2020-02-07-oxford-team-begin-novel-coronavirus-vaccine-research

The Jenner Institute at the University of Oxford has agreed a contract with Italian manufacturer Advent Srl to produce the first batch of a novel Coronavirus vaccine for clinical testing.

The vaccine ‘seed stock’ is currently being produced at the University’s Clinical Biomanufacturing Facility, and will be transferred to Advent who will initially produce 1,000 doses for the first clinical trials of the vaccine, ChAdOx1 nCoV-19.

More importantly,

The vaccines are produced using a safe version of an adenovirus; another virus that can cause a common cold-like illness. The adenovirus has been modified so that it cannot reproduce within the body, and the genetic code to provide instructions for making the Coronavirus Spike protein . . .

The body then forms antibodies to the Spike protein.

 

[bhobba]

Thoughts from the crew here?

We are in uncharted waters here. The testing of the Oxford vaccine is being done here in Aus at the CSIRO's Geelong facility. Interestingly UQ's vaccine testing is being done in Holland. Everyone involved in this is doing everything they can to shorten it. We hear that it will take 12 to 18 months and even that is unprecedented. Well not quite - the Swine Flu Vaccine was developed from 14 May 2009 to November 2009. What is unprecedented is a vaccine in such a short period of time we do not yet have a vaccine for the type of pandemic virus - in this case the Coronovirus. We have been developing vaccines against the Flu for yonks. So we will have to take the 80% estimate as an informed 'guess' from someone on the front lines. The UQ vaccine is timelined for 18 months since it was started in January - but have stated they have consistently beaten their timelines and are hopeful it will be available in mass quantities end of the year - a bit after the Oxford effort. My guess is these people are working around the clock, they are true heroes, and are obviously enthused about what they are doing - they must be to maintain morale. There could be some 'overexubrance' going on. That said it's still encouraging.

I firmly believe, and Australia has shown its possible, if we hold the course we can control the outbreak until we get the vaccine. It is now estimated here, in Aus, only 2.2% of the population will eventually get it - I have posted where some expert thinks we could even wipe it out by getting R0 less than 1 - personally I think that is over optimistic. That's better than the Flu - and we have a vaccine for that - which varies from 3%-11% of the population. So keep the faith - we know how to control this thing - the math is well known - and we will triumph.

Thanks
Bill

 

[mfb]

I don't know what causes the difference but the trends in Australia and NZ look much better than in Europe. Yes, many countries have a downwards trend, but it's a really slow trend. At this rate the healthcare system can handle it but it means we need very long lockdowns unless something else reduces the spread. That will come with many other problems.

The US consistently reports ~30,000 new cases per day now (graph). At 20% positive tests they are still missing many cases. New Jersey has 58,000 positive tests and 62,000 negative tests... New York has 180,000 positive and 260,000 negative tests (tables by state)).

 

[Astronuc]

New signs suggest Coronavirus was in California far earlier than anyone knew
https://www.latimes.com/california/...rus-deaths-signs-of-earlier-spread-california
LA Times reports that it appears that SARS-Cov-2 was circulating in San Francisco area well before March, possibly since December. Two people returning from Wuhan to Santa Clara County tested positive a week before federal approval of emergency testing for the disease on February 4. In this thread, the death on March 4 of a passenger from the Grand Princess (man developed symptoms during period February 11-21 on the cruise) was reported as the first death in California (Placer County), and a second death (70-year old man found deceased at home) occurred on March 6, but that was not publicly announced. A woman who died on March 9 of COVID-19 had become ill by February 20. This woman lived off the same main road about 4 miles as the second from the second fatality.

Stanford's virology laboratory had been looking at 2800 samples collected since January and is finding positive indications of coronavirus.

http://med.stanford.edu/news/all-ne...d-samples-to-track-early-spread-of-virus.html

CNN reported on Why New York appears to be hit so hard by coronavirus
https://www.cnn.com/2020/04/11/opinions/new-york-hit-hard-coronavirus-sepkowitz/index.html

The state's total of 181,026 cases, as of April 11, is higher than Spain's (161,852 cases) and Italy's (152,271), countries with populations many times larger than New York. Of the 20,389 deaths in the United States, 8,627, or 42%, have occurred in New York. Its mortality rate is 4.7%, compared with 3.4% in the rest of the country, and New York City and its suburban counties — Nassau, Suffolk, Westchester and Rockland — are responsible for 93% of the statewide case count. Furthermore, in New York City, the Covid-19 death rate is about 6% higher than most countries.

Mortality rate is based on reported positive cases. Deaths and positive cases are under-reported. CNN reports, "A caution on numbers: Counting cases and mortality rates is difficult because most counting is done by county or borough or parish rather than city, and city of residence may differ from city of diagnosis or death. Even so, New York City is off the charts." Same problem applies to NY state and other states.

Population density explanation may explain some of the difference, but not all of it. New York's densest borough is Manhattan, while relatively sprawling Queens sits at fourth out of five. But Queens has more than twice the cases and twice the rate of cases as Manhattan.

 

[bhobba]

I don't know what causes the difference

My guess, and it's just that, is two factors. Going hard ASAP. We went hard just in a nick of time. And testing and tracing constantly. The US, Italy etc did not go hard enough initially, but seem to be levelling off now - deaths are a lagging indicator. I think they will bring it under control eventually, test and trace very vigorously like we do, then it's just a matter of time until the vaccine - it's coming. In Australia we get 1500-3000 deaths each year from the flu - and we have a vaccine for that - we have about 50-60 so far from the Coronavirus. So when under control, like here, and I believe other countries will eventually be able to do the same, it's not the apocalypse some have predicted. The apocalypse is in the economy, but resisting lifting the restrictions too early, must, and I emphasize must, be resisted. Regardless how bad we get hit economically we can recover. Still some do not seem to get it. Just as an example this Easter people were not allowed to travel except for essential purposes - getting a flu shot, buying food etc. Going to your holiday house over Easter is obviously not essential travel. Yet some are complaining - they have no right to do that to them (in fact they do - the number of armchair constitutional lawyers posting is amazing) and get this one - we want a rebate on our rates since we can't visit them. You have to wonder at their priorities - you really do.

Thanks
Bill

 

[kyphysics]

I don't know what causes the difference but the trends in Australia and NZ look much better than in Europe.

The US consistently reports ~30,000 new cases per day now (graph). At 20% positive tests they are still missing many cases. New Jersey has 58,000 positive tests and 62,000 negative tests... New York has 180,000 positive and 260,000 negative tests (tables by state)).

Could the Australia and NZ difference be attributed to the weather theory: heat, humidity, and sunshine make for lower survival rates of the virus outside of hosts? I know the science is up for debate right now. But, with Australia and NZ having been in summer/warmer weather, maybe that was a difference? Plus, I had read much of Australia's outbreak came from foreign travelers (meaning perhaps people were coming back with it from colder climates).

Speculative question based on speculative/inconclusive science. Still, it's an area I'd like to hear more of if possibly relevant. We won't know until summer here in the U.S. But, lab studies have shown that heat does seem to affect the virus.

 

[kyphysics]

"The seasonality of flu and other respiratory viruses has been known for hundreds of years, if not thousands," says Akiko Iwasaki, a professor of immunobiology at the Yale University School of Medicine. "During the winter months, we tend to have a surge in the cases of respiratory infection, including the influenza viruses."

There are a number of factors that contribute to why the flu arrives in the winter, but Iwasaki says the primary factor is the relative humidity of the air. In winter, the drop in the amount of water vapor in the cold, dry air makes it easier for viruses to become airborne.

We can only hope!

This makes what Iwasaki calls the "perfect setting" for respiratory viruses to transmit.

"When you cough or sneeze or even talk, you're generating these droplets that are coming out of your mouth," she says. "And some of them, if you're infected, will contain virus particles. In very arid conditions, those particles lose the water vapor and they become airborne." This allows the virus to persist in the air for a long time, much longer than in summer.

Of course, she's talking about traditional cold and flu viruses that have been studied for years.

The question is whether the new Coronavirus will also behave this way.

Iwasaki thinks so.

There's some debate in the article - it's worth looking at.

 

[bhobba]

Could the Australia and NZ difference be attributed to the weather theory: heat, humidity, and sunshine make for lower survival rates of the virus outside of hosts?

We have the case of Greenland:
https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Greenland

My guess is in the worst hit countries the virus was circulating longer than originally thought and the response was not vigorous when it was found to be circulating. In Aus the first case was in January and we took action virtually immediately. All along we have taken early and hard action. Plus constant and full tracing. Here in Aus when we trace we find only something like 1% have it, but in other countries it was something like 9% indicating it had been spreading longer and/or the tracing was not as though.

Yes summer will help, but I do not think its the major cause.

Thanks
Bill

 

[chemisttree]

I’d like to be optimistic about a vaccine but we don’t have a single vaccine for any of the coronaviruses that humans get. Perhaps we should put our money on zinc and hydroxychloroquine?

 

[bhobba]

I’d like to be optimistic about a vaccine but we don’t have a single vaccine for any of the coronaviruses that humans get. Perhaps we should put our money on zinc and hydroxychloroquine?

Maybe, we will have to see.

Thanks
Bill

 

[wukunlin]

Could the Australia and NZ difference be attributed to the weather theory: heat, humidity, and sunshine make for lower survival rates of the virus outside of hosts? I know the science is up for debate right now. But, with Australia and NZ having been in summer/warmer weather, maybe that was a difference? Plus, I had read much of Australia's outbreak came from foreign travelers (meaning perhaps people were coming back with it from colder climates).

With regards to NZ, the summers of Auckalnd in my experience is barely hotter than the winters of Taiwan and Southern China, so I'm still skeptical about the weather theory. I think NZ closing its borders rather swiftly and implemented quarantines contributed to the mitigation of the virus the most, together with being quite isolated from the rest of the world and having a low population density.

 

[kyphysics]

We have the case of Greenland:
https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Greenland

My guess is in the worst hit countries the virus was circulating longer than originally thought and the response was not vigorous when it was found to be circulating. In Aus the first case was in January and we took action virtually immediately. All along we have taken early and hard action. Plus constant and full tracing. Here in Aus when we trace we find only something like 1% have it, but in other countries it was something like 9% indicating it had been spreading longer and/or the tracing was not as though.

Yes summer will help, but I do not think its the major cause.

Thanks
Bill

Greenland is interesting. It's population is 56,000-ish. If I'm not mistaken, the geography and physical layout of cities is spread out. It's much easier to coordinate a program of action, presumably, for a smaller sized population than with a larger one. And if there are natural geographic or city-scape features that promote distance between humans, then presumably that helps slow/prevent the spread as well.

Just a guess.

I would't think to completely invalidate the weather theory based on Greenland. It seems weather is just one factor. Geography and city-scape spacing...population size...earlier preventative measures (testing and tracing) all probably have a big impact too (if not more possibly?).

 

[mfb]

I’d like to be optimistic about a vaccine but we don’t have a single vaccine for any of the coronaviruses that humans get. Perhaps we should put our money on zinc and hydroxychloroquine?

There was no need for a vaccine for any Coronavirus so far. 4 of them just cause a common cold. SARS was stopped before vaccine development progressed much, MERS never evolved to spread well among humans.
Zinc and hydroxychloroquine and many others are attempts to treat the disease, and they are not very promising so far. That's very different from a vaccine.

My guess, and it's just that, is two factors. Going hard ASAP. We went hard just in a nick of time. And testing and tracing constantly. The US, Italy etc did not go hard enough initially, but seem to be levelling off now - deaths are a lagging indicator. I think they will bring it under control eventually, test and trace very vigorously like we do, then it's just a matter of time until the vaccine - it's coming.

It's going down faster because it's on a lower level overall so there is more effort per case? That would be very useful for Europe. We'll see.

Globally there are about 60 million deaths per year, or 160,000 per day.
By confirmed deaths COVID-19 killed 7000 per day in the last days, or 4% of all deaths. The actual number will be higher due to some dead people who don't get tested and governments that under-report numbers. If this rate would be sustained over the whole year it would be one of the leading causes of deaths (graphs of other causes).
As comparison: Road accidents are responsible for ~2% of all global deaths.

 

[chemisttree]

There was no need for a vaccine for any Coronavirus so far. 4 of them just cause a common cold. SARS was stopped before vaccine development progressed much, MERS never evolved to spread well among humans.
Zinc and hydroxychloroquine and many others are attempts to treat the disease, and they are not very promising so far.

Perhaps you could adjust your thinking?




$20 per patient to treat sounds very promising to me.

 

[peanut]

Experimental drug remdesivir showed promise in an early analysis (not a randomized control trial); clinical improvement observed in 36 out of 53 (68%).

All received remdesivir for up to 10 days on a compassionate use basis, a program that allows people to use unapproved medicines when no other treatment options are available. Over 18 days, 68% of the patients improved, with 17 of the 30 patients on mechanical ventilation being able to get off the breathing device. Almost half of the patients studied were ultimately discharged, while 13% died.

Several large scale clinical trials are underway to evaluate the benefit of remdesivir for COVID19. One conducted in China could report results end April / early May. Another, sponsored by the US National Institutes of Health, has enrolled patients rapidly as the virus spread throughout the country.

Remdesivir, a broad-spectrum antiviral, is viewed by researchers and doctors as one of the most promising agents against SARSCoV2, the Coronavirus that causes COVID-19, to enter human trials to date. In lab studies conducted prior to the outbreak on numerous compounds, researchers found the drug had potent activity against a wide variety of coronaviruses similar to the new coronavirus.

 

[kyphysics]

False Negatives Raise Doctors' Doubts About Coronavirus Tests
A surprising number of patients have obvious symptoms but still test negative, say doctors

https://www.bloomberg.com/news/arti...est-results-raise-doctors-doubts?srnd=premium

False-negative results from Coronavirus tests are becoming an increasing concern, say doctors trying to diagnose patients and get a grip on the outbreak, as a surprising number of people show up with obvious symptoms only to be told by the tests that they don’t have the disease.

While still more research is necessary to determine the true prevalence of such false-negative results, experts agree that the problem is significant. False negatives not only impede the diagnosis of disease in individual patients and an accurate understanding of the extent of its proliferation, but also risk patients who think they aren't ill further spreading the virus.

This is interesting. Not sure how to take it.

On the one hand, it's disturbing that testing can potentially lead to lots of false negatives. On the other hand, if it's true that many actual carriers test negative (how many? - no one may know), then perhaps the real fatality rate is lower? And, additionally, perhaps many more people have immunity than we think?

I really hope we can get immunity test out soon. Perhaps many more people have already been infected than we know and have survived with immunity.

Thoughts?

 

[peanut]

False Negatives Raise Doctors' Doubts About Coronavirus Tests
A surprising number of patients have obvious symptoms but still test negative, say doctors

https://www.bloomberg.com/news/arti...est-results-raise-doctors-doubts?srnd=premium
This is interesting. Not sure how to take it.

On the one hand, it's disturbing that testing can potentially lead to lots of false negatives. On the other hand, if it's true that many actual carriers test negative (how many? - no one may know), then perhaps the real fatality rate is lower? And, additionally, perhaps many more people have immunity than we think?

I really hope we can get immunity test out soon. Perhaps many more people have already been infected than we know and have survived with immunity.

Thoughts?

WHO has specifically warned about the improper use and interpretation of tests, particularly lateral flow IgM/IgG assays (these are the blood tests that look like pregnancy tests and require a drop of blood). The only thing WORSE than NO TEST is a BAD TEST, which will give people a false sense of security and may increase their risk of contracting disease.

 

[Vanadium 50]

New signs suggest Coronavirus was in California far earlier than anyone knew

Certainly the California experience is different from the rest of the county. However, when the first case was has become extremely politicized for reasons I don't entirely understand.

New York's densest borough is Manhattan, while relatively sprawling Queens sits at fourth out of five. But Queens has more than twice the cases and twice the rate of cases as Manhattan.

New York reports where the hospitalization or death occurred, not the place of residence. This explains why Rockland and Westchester counties are apparently being hit the hardest. They have a slightly high fraction of hospitals than NYC, but you know what they have a lot of? Nursing homes.

Even so, if someone lives in Queens and works in Manhattan, where should the case be charged? Indeed, what exactly is population? The daytime population of Manhattan is 4 million, even though only 1.6M people live there.

Illinois has statistics based on ZIP code of residence. I aggregated by county (I am too cheap to buy the demographics by ZIP code) and in some cases city. Roughly, each order of magnitude in population is a factor of 1500 cases per million. It appears to be somewhat non-linear with a trend above the curve for the largest cities.

One very interesting feature is that nearby population density matters. Aurora, Naperville and Rockford are comparably sized. Aurora and Naperville are close enough for people to commute to Chicago, and they have a case rate per million about 950. Rockford really is not, and it's at 350.

 

[bhobba]

Interestingly, just watching 60 minutes now, the new worry is people are basically doing the right thing, but will over time get sick of it so it may not remain controlled. This worries a lot of people, especially the police. The feeling is we need the vaccine end of this year, early next year. There were interviews with a number of vaccine experts and they are optimistic. But if it does not happen things can get bad, really bad. Another is the dumb situation with water here in Aus - we have tons of it actually in many key growing areas, but can't touch it. It's tied very much up with politics and not suitable for discussion here. The only thing I want to mention is if we need the water to prevent food shortages the situation will become quite interesting.

Thanks
Bill

 

[chemisttree]

Is a potential food shortage due to not growing enough locally or not having enough workers available to process and distribute it?

 

[bhobba]

Is a potential food shortage due to not growing enough locally or not having enough workers available to process and distribute it?

Simply, for political reasons, we have tons of water passing by many fertile growing areas that the growers are not allowed to use. Allow them to use it, and everything else is in place to grow a lot more food locally that is now imported. But the imports are drying up due to Coronovirus.

Thanks
Bill

 

[Keith_McClary]

when the first case was has become extremely politicized for reasons I don't entirely understand

I guess it's like wildfires, they blame whosever utility pole blew down and sparked it. (Rather than thinking: "Hey, we're living in a tinderbox that will inevitably go up in flames.")

 

[dlgoff]

TOPEKA, Kan. (WIBW/AP) --- The Legislative Coordinating Council voted to overturn Gov. Laura Kelly’s newest executive order restricting the size of religious gatherings.

Update:
BELLE PLAINE, Kan. — UPDATE, 9:17 p.m. | The Kansas Supreme Court "invalidated" a legislative panel's decision to overturn Gov. Laura Kelly's order that banned religoius and funeral services of more than 10 people.

 

[DennisN]

Yes, many countries have a downwards trend, but it's a really slow trend. At this rate the healthcare system can handle it but it means we need very long lockdowns unless something else reduces the spread. That will come with many other problems.

(my bolding)

I think we could be heading for that scenario, i.e. long lockdowns (but I'm not making any prediction ).

I read the entire article in a previous post by @Mary Conrads Sanburn in this thread, and I remember a particular part in the article, quote:

I’ve heard that the peak may not be until June or later. Do you agree with these estimates?

Nicholas Jewell: Yes, unchecked and without any steps to mitigate it, the models tend to show that the peak would be around June. Then there’s the ironic fact of trying to flatten the curve in that, while that’s a very good thing to do, it will make the epidemic last longer and will push the peak out. But probably not more than by a month or two.

Source: https://alumni.berkeley.edu/california-magazine/just-in/2020-03-27/dos-and-donts-health-experts-answer-your-covid-questions (California Magazine, UC Berkeley)

Edit: On a second thought, maybe you meant longer lockdowns than this, @mfb , I don't know.

 

[peanut]

Is a potential food shortage due to not growing enough locally or not having enough workers available to process and distribute it?

Both the above factors and this is exacerbated by disruptions to the global and local supply chains. Case in point, in my country we have adequate supply of fish, but do we have enough tin, tomato sauce, oil, labels and cartons to bring the canned sardines to the grocery shelves? Are workers, managers, delivery trucks and drivers coming to office for their tasks? Remember without a label, canned sardines won't make it to grocery shelves. The entire ecology of fishing, canning, warehousing, marketing, distribution, accounting and collection must be complete. Food security will be a huge problem as much as public health safety. Ergo, any and all sources to ensure this basic requirements must be tapped ASAP.

 

[chemisttree]

Yes, which is why I don’t think we can afford as much as a two month lockdown. That is too long for people to be out of work. People in Italy are already organizing raids on grocery stores in Italy. It could get very ugly in the US with such an armed population.

 

[DennisN]

Interestingly, just watching 60 minutes now, the new worry is people are basically doing the right thing, but will over time get sick of it so it may not remain controlled. This worries a lot of people, especially the police.

This worries me too. And the danger of a growing complacency/overconfidence.

 

[Ygggdrasil]

Is a potential food shortage due to not growing enough locally or not having enough workers available to process and distribute it?

Many farmers and food producers are reporting having to destroy crops or dairy products due to decreased demand from schools and restraunts:

The closing of restaurants, hotels and schools has left some farmers with no buyers for more than half their crops. And even as retailers see spikes in food sales to Americans who are now eating nearly every meal at home, the increases are not enough to absorb all of the perishable food that was planted weeks ago and intended for schools and businesses.
The amount of waste is staggering. The nation’s largest dairy cooperative, Dairy Farmers of America, estimates that farmers are dumping as many as 3.7 million gallons of milk each day. A single chicken processor is smashing 750,000 unhatched eggs every week.

Many farmers say they have donated part of the surplus to food banks and Meals on Wheels programs, which have been overwhelmed with demand. But there is only so much perishable food that charities with limited numbers of refrigerators and volunteers can absorb.

https://www.nytimes.com/2020/04/11/business/coronavirus-destroying-food.html

FWIW, government officials do not see food shortages as an issue in the US (of course, the credibility of the US government is no so high right now):

In recent days, top U.S. government officials have moved to assure Americans that they won't lack for food, despite the coronavirus.

As he toured a Walmart distribution center, Vice President Pence announced that "America's food supply is strong." The Food and Drug Administration's deputy commissioner for food, Frank Yiannas (a former Walmart executive) told reporters during a teleconference that "there are no widespread or nationwide shortages of food, despite local reports of outages."

"There is no need to hoard," Yiannas said.

In fact, the pandemic has caused entirely different problems: a spike in the number of people who can't afford groceries and a glut of food where it's not needed.

(source: NPR)

 

[Vanadium 50]

Interestingly, just watching 60 minutes now, the new worry is people are basically doing the right thing, but will over time get sick of it so it may not remain controlled.

But how long is "the right time" to do the "right thing"?

(Using US numbers). "The right thing" was decided when it looked like it might save millions of lives. Now it looks like that was at least an order of magnitude too high. Do we keep going if it saves 10,000 lives? (Remember, the potenial number of lives saved drops over time) 1000? Do we lock down the entire country when there is a single sick person - waiting until he recovers or dies?

If we don't start having this discussion now about when and how to end this, the answer by default will be "we'll end this when it feels like the right time to end this."

 

[peanut]

Yes, which is why I don’t think we can afford as much as a two month lockdown. That is too long for people to be out of work. People in Italy are already organizing raids on grocery stores in Italy. It could get very ugly in the US with such an armed population.

In my country farmers are discouraged to plant, growers discouraged to raise, and fishers discouraged to fish. All because they are having difficulty to get raw materials and to sell their harvest. Generally, economy is an integrated ecosystem, you stop one part it may still function with a bit of difficulty, If you stop half of it then it will affect what is left. Can our country afford a two months lock down? The answer is Yes and No. NO because it will kill a good part of the economy, YES because people survive. This may be a start of something good if people manage it correctly.

 

[DennisN]

British Prime Minister Boris Johnson who fell ill with Covid-19 and was taken to intensive care, is now out of the hospital. It seems to have been a quite close call... :

Sources:

• Out of hospital, UK's Johnson says "it could have gone either way" (Reuters, April 12, 2020)
• Boris Johnson says medics saved his life as UK deaths pass 10,000 mark (Reuters, April 12, 2020)

“It is hard to find the words to express my debt to the NHS (National Health Service) for saving my life,” he said in a video message posted on Twitter on Sunday, shortly after it was announced he had been discharged from St Thomas’ hospital in London.

 

[chemisttree]

Any word on what they treated him with? Antivirals like Remdesivir or hydroxychloroquine and azithromycin and zinc?

 

[DennisN]

Any word on what they treated him with? Antivirals like Remdesivir or hydroxychloroquine and azithromycin and zinc?

I haven't heard anything about that. I just read the two articles from Reuters and I did not see any specification about medicines, only that he was given oxygen.

 

[chemisttree]

In my country farmers are discouraged to plant, growers discouraged to raise, and fishers discouraged to fish. All because they are having difficulty to get raw materials and to sell their harvest.

Interesting. Does your country have enough reserves to miss a planting season without it causing a famine? I don’t think international trade will be available when it’s needed most. Tough times all over. Very precarious!

Plant a garden if you can!

 

[chemisttree]

I haven't heard anything about that. I just read the two articles from Reuters and I did not see any specification about medicines, only that he was given oxygen.

So, three days in intensive care and on the third day he rose ... on Easter?

 

[Astronuc]

Another cruise ship stranded with COVID-19 cases on board. Back on March 27.
April 7 - https://www.theguardian.com/world/2...ralian-passengers-from-covid-19-stricken-ship

The Greg Mortimer has been anchored 20km (12 miles) off the coast of Uruguay since 27 March, but authorities in the South American country had until now refused to allow passengers off.

On Tuesday, the ship’s operator, Aurora Expeditions, said that of 132 passengers and 85 crew, 128 people had tested positive for Covid-19. Most on board are understood to be Australian, although there are also citizens of New Zealand, the US and the UK.

The ship set out on 15 March from the Argentinian port of Ushuaia, the southernmost city in the world. It was to have undertaken a 16-day cruise to Antarctica and South Georgia, christened “In Shackleton’s Footsteps” after the Irish polar explorer, Ernest Shackleton.

Symptoms of Coronavirus started to appear soon after departure, and the ship diverted to the Uruguayan capital Montevideo. Even the ship’s doctor fell ill with a fever and was left unable to perform his duties.

On April 10, NY Times reported

Uruguay evacuated 112 Australians and New Zealanders Friday from a cruise ship that has been anchored off the South American country’s coast since March 27 with more than half its passengers and crew infected with the new coronavirus. Officials say the evacuees will be flown to Australia early Saturday.

At least six Americans, five British citizens and passengers from other countries, as well 83 crew members, remain aboard the Greg Mortimer, a ship operated by Australia’s Aurora Expeditions, while arrangements for their evacuation are made.

https://www.nytimes.com/aponline/2020/04/10/world/americas/ap-lt-virus-outbreak-uruguay-cruise-ship.html

 

[mfb]

Perhaps you could adjust your thinking?

Yes, but not based on two random Youtube videos. You'll need a study.

$20 per patient to treat sounds very promising to me.

Only if it works.

All received remdesivir for up to 10 days on a compassionate use basis, a program that allows people to use unapproved medicines when no other treatment options are available. Over 18 days, 68% of the patients improved, with 17 of the 30 patients on mechanical ventilation being able to get off the breathing device. Almost half of the patients studied were ultimately discharged, while 13% died.

How does that compare to the control group?

(Using US numbers). "The right thing" was decided when it looked like it might save millions of lives. Now it looks like that was at least an order of magnitude too high. Do we keep going if it saves 10,000 lives? (Remember, the potenial number of lives saved drops over time) 1000? Do we lock down the entire country when there is a single sick person - waiting until he recovers or dies?

How do the impact go down? If you let this spread (R>>1) without a vaccine in reach you still get the worst-case scenario over time.

 

[atyy]

But how long is "the right time" to do the "right thing"?

(Using US numbers). "The right thing" was decided when it looked like it might save millions of lives. Now it looks like that was at least an order of magnitude too high. Do we keep going if it saves 10,000 lives? (Remember, the potenial number of lives saved drops over time) 1000? Do we lock down the entire country when there is a single sick person - waiting until he recovers or dies?

If we don't start having this discussion now about when and how to end this, the answer by default will be "we'll end this when it feels like the right time to end this."

It depends on the country. You can look at China and South Korea for examples that seem to be succeeding. Here in Singapore, we've been open to various degrees most of the time, until last week when it seemed that there might be an increase in the number of cases beyond the reach of contact tracing. The idea is that the latest much stricter measures can start to be relaxed when that threat seems to have passed. Of course there's a long way to fully relaxing all measures. For example, elective medical procedures have been postponed for many months now - eventually they must resume, but only when it seems there is not a threat on supplies for medical emergencies.

The stricter measures buy you time to prepare so that you can reopen. The measures don't work unless people understand them and there is buy-in from society at large. Some of the things that might be done to prepare to relax social distancing are to increase contact tracing capability (maybe the effort by Apple and Google to coordinate the contact tracing apps will help), and build up medical supplies.

 

[russ_watters]

But how long is "the right time" to do the "right thing"?

(Using US numbers). "The right thing" was decided when it looked like it might save millions of lives. Now it looks like that was at least an order of magnitude too high. Do we keep going if it saves 10,000 lives? (Remember, the potential number of lives saved drops over time) 1000? Do we lock down the entire country when there is a single sick person - waiting until he recovers or dies?

If we don't start having this discussion now about when and how to end this, the answer by default will be "we'll end this when it feels like the right time to end this."

My hope is that we end the social distancing when the number of active cases gets low enough and testing available enough that they can be tracked and managed individually like in Korea. But as you suggest, I haven't seen real discussion of such plans*, and my fear is that we'll lift the restrictions when "it feels like the right time" and without a management strategy, and we'll just have another spike.

*Keeping the shutdown too long has negative implications for the economy, but tracking and quarantining individuals is onerous from a liberty standpoint. In some ways I think the general semi-voluntary shutdown is easier than mandatory, forced quarantines for individuals. Are people really going to accept the federal government using our cell phones as ankle bracelets as if we are all criminals on house arrest?

 

[kyphysics]

WHO has specifically warned about the improper use and interpretation of tests, particularly lateral flow IgM/IgG assays (these are the blood tests that look like pregnancy tests and require a drop of blood). The only thing WORSE than NO TEST is a BAD TEST, which will give people a false sense of security and may increase their risk of contracting disease.

Although I think that could happen - the false sense of security thing - I also think some people would know that they could STILL get the virus (precisely b/c they didn't have it on their test).

At least, that's how I would take it. The only thing that would make me feel more safe is an immunity test. Then, at least, I know I'd already had it and beaten it once. But, if some doctor said I tested negative, that WOULD NOT make me (personally) feel all safe to go out.

But, yeah, for some ...that could be the case.

 

[atyy]

Although I think that could happen - the false sense of security thing - I also think some people would know that they could STILL get the virus (precisely b/c they didn't have it on their test).

At least, that's how I would take it. The only thing that would make me feel more safe is an immunity test. Then, at least, I know I'd already had it and beaten it once. But, if some doctor said I tested negative, that WOULD NOT make me (personally) feel all safe to go out.

But, yeah, for some ...that could be the case.

The test that @peanut was referring to was (I think) a test related to immunity (but one may not be using it as the sole test on which a decision is made; and one may be using it for diagnosis, rather than to certify immunity). In principle, one could also get a false positive on an immunity test, which would make one think one is immune when one is not. So if one is trying to use it to certify immunity, one would also like to know the false positive and false negative rates.

 

[bhobba]

But how long is "the right time" to do the "right thing"?

Very true, and yes we are having the discussion here in Aus now. We started out hard, and police have been 'over exuberant' (there was a story in the local paper where many fines have been revoked). Now is the time to slowly remove restrictions, wait a couple of weeks to see what happens, then reevaluate. But I would rather, with lives at stake, be over cautious initially, then gradually reduce, waiting for the vaccine (yes I know it is not 100% sure we will even get one - but a number of people working in the area are confident it will be here by years end).

I wrote about the Ruby Princess fiasco in a previous post and mentioned I think 10 people had died - now it has risen to 18. And still nobody has been held to account about letting the people off. They all just keep finger pointing. This is not good enough. Any person with a brain can see you should not do that when you had more than 150 with illness confined to their cabins, with at least 26 tested for flu and found negative. This makes me so mad I can't on this forum say what I really think. This is a case where the opposite happened - not imposing even basic restrictions of simply testing people highly likely to have it before they were let go.

We must find the right balance - but I would rather err on the side of caution than have a Ruby Princess.

Thanks
Bill

 

[bhobba]

Keeping the shutdown too long has negative implications for the economy,

Having a shutdown at all has negative impacts to the economy. Some say the cure is worse than the disease. This is a value judgement, not science. All science can say is here in Aus we have it under control and hence should look at the exit strategy. The priorities that are bought to such a discussion are for each individual to decide.

Thanks
Bill

 

[russ_watters]

Having a shutdown at all has negative impacts to the economy. Some say the cure is worse than the disease. This is a value judgement, not science.

Yes; too long = more negative than we thought we wanted.

All science can say is here in Aus we have it under control and hence should look at the exit strategy.

There I disagree: that's a value judgment too. That's a lot of the problem I have with choices made so far. Most of what people have judged to be logical/obvious choices have in reality been value judgments. But it is only on the backside that people seem to be accepting that value judgments even exist.

The priorities that are bought to such a discussion are for each individual to decide.

And on that, I strongly disagree. This issue requires united solutions. Governments must make the decisions and force them on their citizens. Otherwise we have a situation where smoking is allowed in restaurants, so one person smokes and everyone else has to breathe smoke. But instead of smoke, they breathe COVID-19.

 

[atyy]

There I disagree: that's a value judgment too. That's a lot of the problem I have with choices made so far. Most of what people have judged to be logical/obvious choices have in reality been value judgments. But it is only on the backside that people seem to be accepting that value judgments even exist.

I'm not sure that is universally the case - if by value judgements we mean non-economic judgements. I would be extremely surprised if the actions taken in China and South Korea did not have a large element of economic consideration - bring or keep things under control so that as much of normal daily life - normal economic activity - can go on.

 

[bhobba]

There I disagree: that's a value judgment too. That's a lot of the problem I have with choices made so far. Most of what people have judged to be logical/obvious choices have in reality been value judgments. But it is only on the backside that people see to be accepting that value judgments even exist.

Yes - these things are recursively triky - shades of Godel, Escher, Bach.

on that, I strongly disagree. This issue requires united solutions. Governments must make the decisions and force them on their citizens. Otherwise we have a situation where smoking is allowed in restaurants, so one person smokes and everyone has to breathe smoke. But instead of smoke, they breathe COVID-19.

True - but discussing, then deciding on those solutions, can be a 'free for all' so to speak. That's what democracy is all about. The elected representatives then decide on what is implemented - and at that point you are of course correct.

Thanks
Bill

 

[phinds]

I'm not sure that is universally the case - if by value judgements we mean non-economic judgements.

What makes you think that economic judgements are not value judgements? A few simple ones may not be, but most are.