COVID COVID-19 Coronavirus Containment Efforts

[DennisN]

Worrying news reports about Brazil :

• Brazilian city health systems on verge of collapse (The Guardian live update, 25 april 2020)
• Brazil threatens to become COVID-19 hotspot with health system on verge of collapse (ABC News, 25 april 2020)

Cases of the new Coronavirus are overwhelming hospitals, morgues and cemeteries across Brazil as Latin Americas largest nation veers closer to becoming one of the world’s pandemic hot spots.
[...]

[...]
Medical officials in Rio de Janeiro and at least four other major cities have warned that their hospital systems are on the verge of collapse, or already too overwhelmed to take any more patients.
[...]

 

[mfb]

The claim that Belgium overestimates its deaths is very questionable, given that their excess deaths are twice the COVID-19 deaths. What is the cause of death of all these other people? Here is the article again.
I can't tell how reliable the baseline curves are (here is a comment by V50), but the increase is clearly much larger than the official COVID-19 deaths.

I just read Trump's latest about not participating in the WHO world vaccine initiative:
https://thehill.com/changing-americ...18-world-leaders-kick-off-initiative-to-fight

Meanwhile he was suggesting bleach injections...

After the Wuhan lockdown started many countries were interested in flying their people out. What options did China have? Say no, keeping foreigners in the country against their will? As far as I understand these people were quarantined on arrival. But it was too late already.

 

[Vanadium 50]

I have been doing a lot of posts in our local paper

Perhaps you could use that position to initiate a discussion on goals. Is the goal

1. To flatten the curve?
2. To extinguish the disease in humanity now?
3. To save every life, no matter the cost?

I don't think the goals have been articulated clearly. As late as yesterday, I was seeing PSA's saying that the goal was flattening, but as Russ keeps reminding me, that's all changed and the goal is actually extinction.

It seems to be that the cost a society is willing to pay depends on the goals' benefits and probability of success, so a discussion of that would be beneficial in a democratic society.

 

[bhobba]

I don't think the goals have been articulated clearly.

That one is being discussed endlessly. Let's just say it's far from clear what the goal is, except Australia is in a good position to decide it's next step. Our lockdown must be relaxed slowly and carefully, that's all that nearly everyone (not all though) agrees on. I am a believer in the tracing app the government wants to deploy, but there is fierce debate about it.

Thanks
Bill

 

[bhobba]

Meanwhile he was suggesting bleach injections...

I gave up trying to figure him out long ago. So has a very seasoned and successful ex politician here in Australia, called Graham Richardson. He just notes, somehow, and even he does not know how, it seems to work for him. He confounds even the experts.

Thanks
Bill

 

[mfb]

Perhaps you could use that position to initiate a discussion on goals. Is the goal

1. To flatten the curve?
2. To extinguish the disease in humanity now?
3. To save every life, no matter the cost?

A couple of island countries are on a good way to local extinction, I expect them to aim at that if they don't depend too much on tourism.
Australia is down to 10-20 new cases per day after 6700 total cases.
New Zealand is down to 5 new cases per day after 1500 total cases.
Iceland found zero new cases on Thursday and a single new case on Friday (1800 total cases). Overall they tested 13% of their population now.
Malta is down to 1-2 new cases per day (450 total cases).
Not a country, but Hawaii's new cases are very low as well (600 total cases). They might depend too much on tourism to keep that up, however.

Keeping the case count low is an option you didn't list.

Interesting things found on the way: Puerto Rico reduced its total number of cases (double counting error).

 

[StevieTNZ]

New Zealand is down to 5 new cases per day after 1500 total cases.

Today it is reported we have nine new cases, although that is pretty good.

 

[mfb]

I took the average over the last days. The exact range doesn't matter: 39 cases in 7 days, 30 cases in 6 days, 25 in 5 days, 22 cases in 4 days are all consistent with "5 per day". In two weeks this might be 0-1 cases per day if the trend continues, and maybe 0 per day in three weeks? Iceland could reach that point in 1-2 weeks already.

 

[StevieTNZ]

In two weeks this might be 0-1 cases per day if the trend continues, and maybe 0 per day in three weeks?

I hope so! I'm sick of this lockdown.

 

[bhobba]

Today it is reported we have nine new cases, although that is pretty good.

It does vary in both Aus and NZ - the main thing is to keep R0 less than 1. I think NZ is like Aus at about .5 - at that level it will go away - eventually. It is now being considered lifting travel restrictions between Australia and NZ and sporting competitions returning eg cricket. But that's a bit down the track.

Queensland is now lifting restrictions, but I will do a separate post about that.

Thanks
Bill

 

[bhobba]

The lifting of restrictions is now starting. Queenslanders will be allowed to go on picnics, bushwalks, go shopping more freely and take a leisurely drive or go boating from next weekend. Three new cases of Coronavirus were recorded overnight, taking the state’s total to 1030 cases. There have been 98,000 tests conducted in Queensland alone and it's going to increase markedly using the new tracing app. If enough people do not take it up then restrictions will be greater. I think we are eventually heading towards the Taiwan model.

What do I think is the objective? I do not think anyone really knows, but my objective would be to slowly lift restrictions ensuring R0 remains reasonably under 1 - say not greater than .8. That way it will smoulder on at a very low level or even be eradicated until the vaccine comes. It's what I would do.

Thanks
Bill

 

[bhobba]

Here is some early, and perhaps surprising research, due to economic, hygiene and behavioural changes, on what life in Australia will be like when the virus is well under control.

A push towards suburban living with big backyards instead of compact high density living.

Overconsumption “will feel obnoxious” and loyalty will return as employees seek financial security.

Workers who felt trapped in insecure jobs will be desperate and motivated to upskill.

Restaurants buffets are likely to be scrapped, as will plastic menus, communal cutlery and the ubiquitous pub food “buzzer”, according to the hospitality industry. There goes my trips to Sizzler's, at least as I know it.

Cinemas have revealed moviegoers will sit in a chequered pattern – instead of side-by-side – to enforce social distancing when they first reopen.

Public hugs and handshakes are predicted to be socially unacceptable for at least three years.

Homeowners will be more likely to have adult children and elderly parents living with them admit the economic downturn, leaving houses packed to the rafters.

Gardening, boardgames, baking and DIY will increase and there will be no more running up the credit cards to buy “keeping up with Joneses” superficial items.

Children will thrive as they enjoy more time with their parents and kids are learning resilience — a vital life skill psychologists say has been missing in recent times.

One so called 'social expert' said many of us will look back on this pandemic and realize that it has changed our lives for the better. The new normal will not look anything like our old normal but in many ways that’s a good thing,

Interesting to see exactly what does eventuate.

Thanks
Bill

 

[Vanadium 50]

Here is some early, and perhaps surprising research, due to economic, hygiene and behavioural changes, on what life in Australia will be like when the virus is well under control.

I suspect any sort of societal changes will depend more on the response to the next pandemic than this one. Shutting down society for 3 months every century is a different thing than doing it every decade. (The last WHO-declared pandemic was H1N1 in 2009-2010)

 

[WWGD]

NYT suggesting there is an undercount by comp

LA Times reports, "Autopsies reveal first confirmed U.S. Coronavirus deaths occurred in Bay Area in February," which is repeated by other media, e.g., Yahoo, Washington Post, NBC, . . . .Santa Clara County press release - https://www.sccgov.org/sites/covid19/Pages/press-release-04-21-20-early.aspx The victims were tested posthumously, and the results returned 75 days and 64 days, respectively, after death! Date of autopsy (specimen collection) is not mentioned.

Clearly early detection (and testing) is necessary.

"The County of Santa Clara is reporting a total of 1,922 cases and 83 deaths." on April 20.
https://www.sccgov.org/sites/covid19/Pages/press-release-04-20-2020-dashboard-cases-reporting-process-update.aspx

"Santa Clara County has so far reported 88 coronavirus-related deaths, including five new deaths reported Tuesday. The county now has 1,948 confirmed cases."
https://www.mercurynews.com/2020/04...s-in-bay-area-occurred-in-february-not-march/

Also, I read a brief headline that the government of Wuhan had revised their number up by the end of last week.

Belgian prime minister and others are claiming Belgium's poor performance is the result of a liberal attribution to Covid of several deaths. It seems he's being asked to tighten the rules used to attribute a death to Covid19.

 

[Ygggdrasil]

Belgian prime minister and others are claiming Belgium's poor performance is the result of a liberal attribution to Covid of several deaths. It seems he's being asked to tighten the rules used to attribute a death to Covid19.

As mentioned previously in this thread by @mfb, analysis of the number of excess deaths in Belgium suggests that deaths are being undercounted to a similar extent as in other regions.

 

[mfb]

One caveat: That analysis ends April 5. Maybe things changed in the three weeks since then. It would need a pretty strong change, however, and actual deaths peaking before hospitalizations - an odd behavior.

 

[Astronuc]

It does vary in both Aus and NZ - the main thing is to keep R0 less than 1. I think NZ is like Aus at about .5 - at that level it will go away - eventually. It is now being considered lifting travel restrictions between Australia and NZ and sporting competitions returning eg cricket. But that's a bit down the track.

Queensland is now lifting restrictions, but I will do a separate post about that.

Thanks
Bill

According to a NY Times article, Australia and New Zealand are aiming to eliminate the virus.
https://www.nytimes.com/2020/04/24/world/australia/new-zealand-coronavirus.html?
The two countries, led by ideological opposites, are converging on an extraordinary goal: eliminating the virus. Their nonpolitical approach is restoring trust in democracy.

Both nations are now reporting just a handful of new infections each day, down from hundreds in March, and they are converging toward an extraordinary goal: completely eliminating the virus from their island nations.

it may end up being a mirage or temporary triumph in Australia and New Zealand. Elimination means reducing infections to zero in a geographic area with continued measures to control any new outbreak, and that may require extended travel bans. Other places that seemed to be keeping the virus at bay, such as China, Hong Kong and Singapore, have seen it rebound, usually with infections imported from overseas.

 

[Vanadium 50]

A couple of island countries are on a good way to local extinction, I expect them to aim at that if they don't depend too much on tourism.

Kosrae, a state of the FSM, has as far as I know zero cases. However, their connection to the rest of the world is primarily by air, and there haven't been flights in or out for about a month. It looks like to get people or cargo on or off takes a 350 mile boat trip to Pohnpei and a charter to or from Port Morseby. (Which has Covid cases)

 

[Vanadium 50]

Atty, what are you skeptical of? That Kosrae has zero cases?

 

[Astronuc]

BBC reports: Coronavirus: Australians download COVIDSafe contact tracing app
https://www.bbc.com/news/world-australia-52433340

More than a million Australians have downloaded a Coronavirus contact tracing app within hours of it being released by the government.

The COVIDSafe smartphone app uses a Bluetooth wireless signal to exchange a "digital handshake" with another user when they come within 1.5m (4.9ft).

The app then logs this contact and encrypts it.

Are folks ready for this?And in the UK, the 'good outcome' that never was
https://www.bbc.com/news/stories-52419218

 

[Vanadium 50]

It is likely still too early to judge the success/failure of Sweden's policy by looking at death data. Data over the next few weeks, however, will likely be informative.

With an additional 9 days, Sweden's rate (number of deaths in that 9 days divided by total deaths) over those 9 days vs the total is 20.4% and Denmark's is 23.2%.

 

[atyy]

It’s Not Too Late to Go on Offense Against the Coronavirus
By Jim Yong Kim
April 20, 2020
https://www.newyorker.com/science/m...late-to-go-on-offense-against-the-coronavirus

 

[Ygggdrasil]

With an additional 9 days, Sweden's rate (number of deaths in that 9 days divided by total deaths) over those 9 days vs the total is 20.4% and Denmark's is 23.2%.

Examining the actual trend in numbers does not look so favorable for Sweden:

(data from https://opendata.ecdc.europa.eu/covid19/casedistribution/csv, a seven day moving average of daily death counts is plotted)

Whereas deaths/day seems to be fairly flat for Germany and Denmark, deaths/day has continued to rise for Sweden. There may be signs of deaths/day leveling off in recent days, though deaths/day data is very noisy for Sweden, so I would want to observe the same trend for a few more day to be confident in saying whether or not deaths/day has leveled off in Sweden.

 

[bhobba]

According to a NY Times article, Australia and New Zealand are aiming to eliminate the virus.

It hasn't been stated as the aim, but certainly what we are doing may have that outcome. It may be the official aim, but has not been told to the public. What has been reported is the government is now focussing on keeping R0 less than 1. If sustained for long enough it will of course be eliminated.

Thanks
Bill

 

[StevieTNZ]

One new case, with four probable, confirmed today for NZ. And a slight revision with previous numbers as some cases ger clarified and get recategorised. https://www.stuff.co.nz/national/he...-3-with-1-million-kiwis-expected-back-at-work

With particular note of the following:

He was then asked for a response to US President Donald Trump's comments about injecting bleach to kill off the virus. Bloomfield initially chose not to comment.
Ardern said there was no suggestion any advice has been given to New Zealanders to take this action, with Bloomfield adding that "under no circumstances" should people do this.

as well as

Prime Minister Jacinda Ardern says she is confident there is no undetected community transmission as the country prepares to move out of a weeks-long nationwide lockdown at midnight.

 

[bhobba]

BBC reports: Coronavirus: Australians download COVIDSafe contact tracing app
https://www.bbc.com/news/world-australia-52433340

I tried downloading it on my Huawei Android phone last night from the App Store. It took a bit of mucking around to find it - but when I did I got the very informative message - your device is not compatible with this version. Yet I have the latest version of the Android operating system according to my phone. Go figure.

Thanks
Bill

 

[wukunlin]

I tried downloading it on my Huawei Android phone last night from the App Store. It took a bit of mucking around to find it - but when I did I got the very informative message - your device is not compatible with this version. Yet I have the latest version of the Android operating system according to my phone. Go figure.

Thanks
Bill

Could it have something to do with newer Huawei phones not having access to Google services?

 

[bhobba]

Here in Aus we are also, at the moment, having an online Q&A with the Education Minister on opening schools. He claims the advice is it's perfectly safe to do so with minimal disruptions to school operations other than hand washing, better cleaning etc. Not so sure about that:
https://www.sciencedirect.com/science/article/pii/S235246422030095X
'Policy makers need to be aware of the equivocal evidence when considering school closures for COVID-19, and that combinations of social distancing measures should be considered. Other less disruptive social distancing interventions in schools require further consideration if restrictive social distancing policies are implemented for long periods.'

Personally I believe it should be a staged reopening with carefull monitoring explaining because of the R0 this virus has it could explode quickly if we are not carefull. The post was deleted

Added later:
The minister used the same paper as reason to open all schools - go figure. Hopefully by open he means what I think - a slow stage opening with carefull monitoring and an immediate clamp if it shows an increase in cases.

Thanks
Bill

 

[bhobba]

Could it have something to do with newer Huawei phones not having access to Google services?

Maybe - who knows. Google maps works fine though. I will see if I can report it to someone in authority.

Thanks
Bill

 

[morrobay]

Reuters: In four U. S. State prisons nearly 3,300 inmates test positive for Coronavirus -- 96% without symptoms. And in this topic 53/55 were asymptomatic from the Philippines. It is becoming very evident that those at high risk are a subset with a collection of certain cofactors , all of which are so far unknown. These numbers above imply that the morbidly for this flu is probably much less than accepted now. I would like to see more investigation in identifying all the cofactors, in addition to the obvious ones.

 

[bhobba]

These numbers above imply that the morbidly for this flu is probably much less than accepted now.

That's why it is now thought to be about the same as the Flu at about .1% death rate. But remember the Flu's R0 is about 1.3 while Coronovirus is about 2.3 (could even be 3). That means it literally explodes if it takes hold, and we are less likely to know if it has due to the high proportion of asymptomatic or extremely mild cases. We will know more once the antibody tests are more widely in use. But to me that's the real danger - not the death rate. If it takes hold in Australia 24k people will die compared to 1.5-3k for the flu because as yet no vaccine and how quickly it spreads. It's a terrible question to ask, little alone answer, but is 24k lives worth the estimated $150 Billion the Australian government is spending trying to prevent that? That's over $6 million per life. My answer is of course - how could you think otherwise - but I must admit it's my view - others may have a different opinion eg its inevitable everyone will get it eventually so all we are doing is delaying it. But maybe, just maybe, we can buy time enough to get the vaccine.

Thanks
Bill

 

[bhobba]

According to a NY Times article, Australia and New Zealand are aiming to eliminate the virus.
https://www.nytimes.com/2020/04/24/world/australia/new-zealand-coronavirus.html?
The two countries, led by ideological opposites, are converging on an extraordinary goal: eliminating the virus. Their nonpolitical approach is restoring trust in democracy.

But both countries with a strong, almost fanatical commitment, to freedom and democracy, and in Australia's case an unshakeable commitment to the US - not so much NZ though, they keep a greater distance from the US. We also have a deep bond with NZ - so much so they are welcome to become an Australian state any time they wish. Australia will always, and I mean always, come to the aid of the US, as indicated by invoking immediately the Ansus treaty on 9/11, even though technically it only applies to the Pacific region. No Australian would have expected otherwise. Australia even has a regular TV program about the close bond between Australia and the US.

What is the culture in Australia? It has changed over my lifetime. When young my father taught me the values best expressed by the following article in the Spectator magazine, and a speech by an early prime minister:
https://www.spectator.com.au/2018/04/never-forget-we-fought-for-freedom/

He was so committed to it, that only on very few occasions did I see him cry, but when explaining this stuff to me he would sometimes be in tears - it meant so much to him. We have now changed, we are much more multicultural, but IMHO the following now best expresses our national identity:


That now, like my father did when explaining what that ancient prime minister of Australia said, nearly brings me to tears.

You love freedom and democracy - you too are Australian. The difference is we have more trust in our experts like the Nobel Prize winner Professor Peter Doherty, whose endorsement of the tracing app I have no doubt helped in its the strong uptake. He is also working on the front lines fighting the virus at the Doherty institute named after him:
https://www.doherty.edu.au/news-eve...ht/pustules-poxes-and-world-immunisation-week

Thanks
Bill

 

[mfb]

Reuters: In four U. S. State prisons nearly 3,300 inmates test positive for Coronavirus -- 96% without symptoms. And in this topic 53/55 were asymptomatic from the Philippines. It is becoming very evident that those at high risk are a subset with a collection of certain cofactors , all of which are so far unknown. These numbers above imply that the morbidly for this flu is probably much less than accepted now. I would like to see more investigation in identifying all the cofactors, in addition to the obvious ones.

Asymptomatic at the time of the test. We'll see how many develop symptoms later:

Some people diagnosed as asymptomatic when tested for the coronavirus, however, may go on to develop symptoms later, according to researchers.

Prison inmates are not representative either.

This virus is not a flu. It's a completely different type of virus, so please don't call it a flu.

-------

I found this article about Hokkaido, which had a local outbreak early in the pandemic (cases started to accumulate late February). It declared a state of emergency and added restrictions, cases went down after two weeks, it ended most restrictions, cases went up again after two to three weeks. Here, I made a graph based on Wikipedia's table:

 

[atyy]

Quick note on "asymptomatic" - it is a subjective definition. It is fine for the definition to be subjective, because that has practical importance. For example, if one has a policy that limits testing or self-isolation to symptomatic individuals, and one requires the individuals to self-identify, then the extent to which people are unable to self-identify as symptomatic will make the policy less effective.

In this definition, "asymptomatic" does not mean they do not have a cough, nor that their chest x-rays are normal. For example, https://www.nejm.org/doi/full/10.1056/NEJMoa2008457 which finds 50% of positive individuals in their sample are asymptomatic, defines "Asymptomatic residents were those who had no symptoms or only stable chronic symptoms (e.g., chronic cough without worsening). Presymptomatic residents were those who were asymptomatic at the time of testing but developed symptoms within 7 days after testing. Residents who did not develop symptoms in the 7 days after testing remained classified as asymptomatic."

 

[kadiot]

Is there an evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection?

 

[atyy]

Is there an evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection?

Not directly at the moment, but it is reasonable to expect that they will have some level of protection for some amount of time. The WHO has clarified its earlier statement that led some to think otherwise.


The main concern about the earlier statement remains important: that many immunity tests are not reliable. Many immunity tests have a false positive rate that may mislead people who have not had the disease to neglect precautions, increase their risk of infection and transmitting it to others.
https://www.evaluate.com/vantage/ar...-19-antibody-tests-face-very-specific-problem
https://www.statnews.com/2020/04/24...to-be-released-heres-how-to-kick-their-tires/

 

[DennisN]

Examining the actual trend in numbers does not look so favorable for Sweden:

In Swedish news today:

Largest number of deaths in Sweden at Easter since 2000

The largest number of deaths since 2000 was registered during the Easter week this year. This is seen in statistics from Statistiska Centralbyrån (SCB). The reason is the pandemic which continues to increase the number of deaths in Stockholm Country and six other counties.

(my translation to English)

Graph showing deaths in Sweden:
(blue graph is deaths this year, red graph is average deaths 2015-2019)

(Graph words translation to English:
avlidna: deceased
genomsnitt: average
vecka: week
källa: source)

Source: Högsta antalet döda i Sverige under 2000-talet vid påsk (DN, 27 April 2020, Swedish only)

Unemployment is now at 8,1%, which is a 0,1% increase since last week.

(my translation to English)
Source: Arbetslösheten ökar men varslen fortsätter tappa fart (DN, 27 April 2020, Swedish only)

 

[kadiot]

In Swedish news today:(my translation to English)

Graph showing deaths in Sweden:
(blue graph is deaths this year, red graph is average deaths 2015-2019)

View attachment 261546
(Graph words translation to English:
avlidna: deceased
genomsnitt: average
vecka: week
källa: source)

Source: Högsta antalet döda i Sverige under 2000-talet vid påsk (DN, 27 April 2020, Swedish only)(my translation to English)
Source: Arbetslösheten ökar men varslen fortsätter tappa fart (DN, 27 April 2020, Swedish only)

I'm afraid about Sweden for exposing its population to a disease. I understand the economic side of it. However, we know too little about this virus to understand how many hundreds of thousands or millions of people will needlessly die. Maintaining social distancing and wearing masks doesn't hurt. In the Philippines where large segments of the population live with their parents and grandparents, opening schools and letting young people get infected will bring deaths to multigenerational households. The ONLY safe way to achieve herd immunity is with a vaccine. The ONLY way to get there while we wait with reduced casualties is to continue practicing interventions that bring the R0 down - social distancing, work from home if able, wear a mask, wash your hands. I hope Sweden is going well.

https://www.usatoday.com/story/news...not-fully-stop-spread-coronavirus/5156368002/

 

[Vanadium 50]

Examining the actual trend in numbers does not look so favorable for Sweden:

Thanks! This is much, much better than typing numbers from Wikipedia!

Here is a different way of looking at this.

Sweden is blue, Denmark is red (naturally). This is the 7-day running average divided by the total for cases (dotted) and deaths (solid). I have been focused on the mortality numbers because the case numbers are dependent on reporting methodology. You can see this in Denmark, where the line undertakes a huge change in slope on April 10th. I like this ratio because it divides out how hard hit a country is.

What we see is that the two countries are on similar paths in early April, and then they start diverging, with, yes, Denmark doing better than Sweden. Since early April is when mortality peaked, it makes a huge difference whether that is included in your metric or not.

How much better is Denmark doing? If Sweden were able to go on the Danish curve, they would have been able to save around 100 lives, which is 4 or 5%.

 

[Astronuc]

WGBH (Boston), April 10, 2020 - Coming Soon: Tracking The Spread Of COVID-19 With Smartphones
https://www.wgbh.org/news/local-new...cking-the-spread-of-covid-19-with-smartphones

Researchers at Boston University and MIT are collaborating on a smartphone app that will alert people if they’ve been near someone who has tested positive for the Coronavirus or come down with the disease, while protecting the privacy of everyone involved.

The Baker administration has launched a more traditional approach to what's known as contact tracing with its COVID-19 Community Tracing Collaborative. But a manual survey — asking an infected person who they have been in contact with and trying to track those people down — has its limitations. That person may not remember or even know everyone they've been in contact with.

Seems similar to the Australian approach.

 

[DennisN]

An article today about a US/British reporter (James Longman, CBC) visiting Sweden, some quotes:

Sky-high death rates and a "life-threatening experiment". This has been reported in foreign media about Sweden's corona strategy.

A picture that journalist James Longman, 34, from the American television giant ABC wanted to nuance during his trip to Stockholm.

But he was not convinced that Sweden had chosen the right path.

[...]

The picture I had before I came here was that life is as usual here, while the death toll shoots up. That's how foreign media have reported on Sweden, says James Longman when Aftonbladet meets him in Stockholm.

The picture of Sweden is changing

But while the closures are being extended around the world, he says he sees a shift in both public opinion and media reporting in the United States regarding Sweden's strategy. This is despite the fact that President Donald Trump has repeatedly pointed out Sweden as a terrible example.

- I would not be surprised if Trump too starts talking positively about Sweden's strategy soon, says James Longman.

He says that critics of the US shutdowns and quarantine have begun to highlight Sweden as an example of success.

Many Americans now want the United States to go the same route as Sweden to deal with the pandemic.

- Americans are bored. They don't want to quarantine anymore. So they have a simplified picture of: "Look, we can do what Sweden does!". But we are trying to explain to them why Sweden can handle the virus in a way that is not possible in the US.

"You look at the whole"

He emphasizes Swedish welfare, that the number of people with underlying illnesses is fewer and that the inequalities are smaller in society. Factors that he believes allow Sweden to handle the crisis without having to shut down the entire country.

[...]

In his report to millions of American viewers, James Longman has tried to explain that Sweden is in a "voluntary shutdown". But after a few days in the Swedish capital, he is not convinced that we have chosen the right path. In cafes, restaurants and in parks he has seen people crowding and not keeping distance from each other.

- The idea of a voluntary shutdown is nice in theory, but seems to be difficult for people in practice. It seems stressful for individual business owners to understand what is right or wrong. We have talked to cafe owners who thought it would be easier if the government just told them to shut down, because now they do not understand the recommendations.

- In the United States, there is a kind of relief that someone tells you what to do. In Sweden, it seems tough for people to make all the decisions themselves, says James Longman.

He points out that no one yet knows the outcome of how the pandemic is handled in different countries.

[...]

(Google translation to English with some translation corrections by me)

Source: Amerikanska journalisten: ”Verkar svårt för svenskarna att förstå strategin” (AB, 27 April 2020, Swedish only)

Google translation of the article to English: here.

Inspections and closing of restaurants in Stockholm:

On Saturday, SVT News reported that eleven of the 32 pubs that the city of Stockholm inspected during Friday night were given a warning that they did not comply with the new rules on social distancing.

On Saturday, new inspections were also carried out in Stockholm. A total of 25 inspections were carried out, of which an additional ten locations received a note.

On Sunday evening Smittskydd Stockholm said that it has now decided to close five restaurants for infection protection reasons.

(my translation to English)

EDIT: The first article and the CBC reporter mentions some things which make direct comparisons of Sweden and US difficult. If I remember correctly I've before only said that the US is much bigger and has a much larger population than Sweden.

Another difficulty making comparisons is that there are differences how the countries are governmentally organized, and it is also my understanding that the organization of healthcare is quite different.

When it comes to Sweden, I think it is best to compare Sweden with the other Scandinavian countries, Denmark and Norway, and also Finland. I think this group of countries have more in common with each other.

 

[Vanadium 50]

While writing my last post, I saw this on Wikipedia. This is the number of deaths per day in Sweden:

Why is it symmetric? Why should it be? All the "flatten the curve" PSAs also show a symmetric curve.

 

[peanut]

Not directly at the moment, but it is reasonable to expect that they will have some level of protection for some amount of time. The WHO has clarified its earlier statement that led some to think otherwise.


The main concern about the earlier statement remains important: that many immunity tests are not reliable. Many immunity tests have a false positive rate that may mislead people who have not had the disease to neglect precautions, increase their risk of infection and transmitting it to others.
https://www.evaluate.com/vantage/ar...-19-antibody-tests-face-very-specific-problem
https://www.statnews.com/2020/04/24...to-be-released-heres-how-to-kick-their-tires/

Immunity to a pathogen through natural infection is a multi-step process that usually takes place over 1-2 weeks. The body responds to a viral infection immediately with a non-specific innate response: macrophages, neutrophils, dendritic cells slow the progress of the virus. This non-specific response is followed by an adaptive response i.e. body makes antibodies that specifically bind to the virus. These antibodies are proteins called immunoglobulins. The body also makes T-cells that recognize & eliminate other cells infected with the virus. This MAY clear the virus from the body; if response is strong enough, it MAY prevent progression to severe illness / re-infection by the SAME virus. This is often measured by the presence of antibodies in blood. For COVID-19, most studies show that people who have recovered from infection have SARSCoV2 antibodies. However, some have VERY LOW levels of neutralizing antibodies in the blood suggesting that cellular immunity may also be critical for COVID-19 recovery. Laboratory tests that detect antibodies to SARS-CoV-2 in people, including rapid immunodiagnostic tests, need further validation to determine their ACCURACY and RELIABILITY. Inaccurate immunodiagnostic tests may FALSELY categorize people in two ways. Tests may 1) falsely label people who have been infected as negative or 2) falsely label people who haven't been infected as positive. Both have serious consequences. Tests also need to distinguish between past SARS-CoV-2 infections from infection with other human coronaviruses: SARSCoV, MERS and other 'common cold' coronaviruses.

 

[DennisN]

I'm afraid about Sweden for exposing its population to a disease. I understand the economic side of it.

I don't know how much of the strategy is due to economics. I haven't seen much discussion of that in Swedish news when it comes to the disease strategy. Actually I personally haven't seen any such discussion at all in the Swedish news, but that's of course not saying there hasn't been any . Furthermore, we are quite dependent on the success of the economies of other countries, so our economy will suffer (and is suffering) regardless of our strategy. What I have seen discussed, though, is financial support to businesses.

Maintaining social distancing and wearing masks doesn't hurt.

I agree.

In the Philippines where large segments of the population live with their parents and grandparents, opening schools and letting young people get infected will bring deaths to multigenerational households.

I understand. That part of culture is VERY different in Sweden. We don't have large segments of the population living with parents and grandparents. We usually live separately. Seniors/elders usually live in their own homes, with eldercare/healthcare visiting them or they live in nursing homes.

I hope Sweden is going well.

Thank you, and I wish you and your country the same.

 

[Ygggdrasil]

While writing my last post, I saw this on Wikipedia. This is the number of deaths per day in Sweden:

View attachment 261554
Why is it symmetric? Why should it be? All the "flatten the curve" PSAs also show a symmetric curve.

There seems to be some fairly big discrepancies between the data reported by the Swedish FOHM (black, https://www.folkhalsomyndigheten.se...la-utbrott/covid-19/bekraftade-fall-i-sverige) and the ECDC (red, https://opendata.ecdc.europa.eu/covid19/casedistribution/csv):

Wikipedia apparently uses data from the FOHM while my previous plots were based on data downloaded from the ECDC. The FOHM data suggests deaths/day are decreasing, while the trend is not so clear with the ECDC data.

My guess might be that Sweden's reporting of deaths could be delayed, so the ECDC data may be recording deaths as they are reported while the Swedish FOHM may go back to attribute the deaths to the date of death. If reporting is delayed, then it is unclear whether the recent decrease in deaths in the black curve represents a real decrease or a lack of reporting.

(Maybe someone who can speak Swedish can look through the FOHM site for more information about the time delay between when someone dies and when the death is recorded in the FOHM data).

 

[Ygggdrasil]

Reuters: In four U. S. State prisons nearly 3,300 inmates test positive for Coronavirus -- 96% without symptoms. And in this topic 53/55 were asymptomatic from the Philippines. It is becoming very evident that those at high risk are a subset with a collection of certain cofactors , all of which are so far unknown. These numbers above imply that the morbidly for this flu is probably much less than accepted now. I would like to see more investigation in identifying all the cofactors, in addition to the obvious ones.

Here's a link to the Reuters piece cited: https://www.reuters.com/article/us-...coronavirus-96-without-symptoms-idUSKCN2270RX

Presumably the prisons are removing sympotmatic prisoners who test positive, so there is somewhat of a selection for positive, asymptomatic individuals in the prisons.

Here's a nice summary from Scripps, which I posted earlier in another thread, collecting data from a variety of studies that tested a large population for the virus, summarizing the number of positive but asymptomatic individuals found:

In the studies that we have summarized in the table, the range of infection rates is wide: from 0.76% for residents of Iceland to 36% for residents of a Boston homeless shelter. It is striking, however, that the proportion of individuals who test positive for SARS-CoV-2, but who have no symptoms of COVID-19, remains consistently high: from approximately 31% to 88%, with a mean of 56%. Because of various limitations in the summarized studies, this likely overstates the overall population mean, which some observers have suggested is around 40%.

It should be noted that the summarized studies are essentially convenience samples. They do not purport to depict anything more than the circumscribed populations from which data were collected. Large, well-designed studies with representative samples are desperately needed to accurately assess the prevalence of those who are infected with SARS-CoV-2, yet are asymptomatic for COVID-19—and to determine their impact on the pandemic.

https://www.scripps.edu/science-and...te/about/news/sarc-cov-2-infection/index.html

In some of these cases, it is possible that the positive tests could be pre-symptomatic individuals (because the average incubation for the virus is ~5 days from initial infection with the virus to showing symptoms, many individuals who test positive and are asymptomatic may later show symptoms).

Hopefully, as more serological testing is done, we will get better ideas about the true number of infections and improve our estimates of the mortality rate.

 

[DennisN]

(Maybe someone who can speak Swedish can look through the FOHM site for more information about the time delay between when someone dies and when the death is recorded in the FOHM data).

I do. I let Google Translate do a translation to English of the FOHM page you linked to:

Latest updates on the outbreak of Coronavirus disease (covid-19). The page is updated daily with number of cases at. 14:00 or when the statistics are compiled.

Information about data sources

The number of cases reported in the statistics is based on laboratory-confirmed cases reported in accordance with the Infection Protection Act according to the reporting date. Data on the number of intensive care providers is obtained from the Swedish Intensive Care Register's special reporting module SIRI. The number of reported cases is constantly changing as people seek care and are examined for the virus. There is some delay in reporting and adjustments of data on new cases and deceased cases, so the numbers for recent days (especially during holidays) should be interpreted with caution. The statistics are compiled daily with notifications received until 11.30 the same day. The current and previous day's number is incomplete and will be complete only the following day.

The statistics of deceased persons are based on data reported so far to the Public Health Agency, and there can be differences compared to the regional reporting. The statistics show the number of people with confirmed Covid-19 who have died, regardless of the cause of death. The time series with the number of deceased per day contains only those cases where the date of the death is known, therefore the total number of deceased can differ from the number reported in the time series.

Laboratory-confirmed cases are an indicator for monitoring developments. Initially, people who were living in areas with known spread of Covid-19 were sampled. But since mid-March, people with symptoms consistent with Covid-19 infection who are in need of inpatient hospital care, healthcare personnel and elderly care, and people who are being tested in sentinel testing are primarily being tested. This means that people with mild symptoms are not asked to contact the healthcare and therefore do not end up in the statistics of reported cases. When using data, specify the source Public Health Authority.

(my bolding and with some translation corrections by me)

 

[bhobba]

I don't know how much of the strategy is due to economics.

I saw an interview with one of the Swedish epidemiologists responsible for their policy. It's based on the thinking everyone will get it anyway so spending a fortune and disrupting people's lives is not going to change long term outcomes. Australia has a different belief - we believe we can beat this - it will cost and likely 'destroy' the economy - I did another post that it's possibly over $6 million per life saved - but our ethos is it will not beat us. Our culture is we help out mates, and we have the symbol of the battler - it's striving against even overwhelming odds that's the true measure - winning is important, but to strive is heroic. Its part of Australian slang - you drongo - failing or being a bit stupid - but striving anyway. It's used as a mild form of insult meaning "idiot" or "stupid fellow", but you still tried. This usage derives from an Australian racehorse of the same name (apparently after the spangled drongo, Dicrurus bracteatus) in the 1920s that never won despite many places. The word drongo has been frequently used towards mates and can be used in a casual or serious tone.

As the NY Times article Astonunc posted said: 'what Australia and New Zealand have already accomplished is a remarkable cause for hope.' We will see if our hope is justified.

Thanks
Bill

 

[kadiot]

Check out these data-driven AI-projected COVID-19 end dates for the world and various countries courtesy of the Singapore University of Technology and Design (SUTD).

Of course these are just projections. Interesting nonetheless.

https://ddi.sutd.edu.sg/

 

[anorlunda]

An island could conceivably make the virus extinct on the island. But it would also have to ban all travel to the island until a vaccine is ubiquitous.

I was shocked to go to the store today (in Florida) and see that compliance with face masks dropped from nearly 100% 10 days ago to 10% today. In addition, more businesses are threatening to defy the guidelines. Also we again see pictures of big crowds on the beaches. Government's ability to enforce the guidelines is extremely thin. Success depends on voluntary compliance, and I think that is highly fluid and changing day by day.