COVID COVID-19 Coronavirus Containment Efforts

[Astronuc]

I believe 'probable' cases are treated separately, but it's not clear how uniform and consistent the reporting is across 50 states and the 3000+ counties.

From - https://news.yahoo.com/texas-erases-covid-cases-fans-091650711.html

“The case data on our website reflect confirmed cases, and cases identified by antigen testing are considered probable cases under the national case definition,” said Chris Van Deusen, a spokesman for the Texas Department of State Health Services.

Under that definition, the CDC only considers cases “confirmed” if they are diagnosed using a molecular, often called PCR, test. Cases that are detected using antigen tests are classified as “probable.” If someone is diagnosed with an antigen test, Texas will not count their case among the state total.

The removed cases were from Bexar County, which includes San Antonio. The city’s mayor said Thursday that San Antonio was one of three cities in Texas that tracks antigen tests—and that the tests help local health officials “see the full picture” of COVID-19 in the area.

Article with map of states with and without mandatory wearing of face (nose and mouth) covering/masking.
https://finance.yahoo.com/news/coro...-that-america-needs-to-regroup-164519833.html

Coronavirus Testing Basics
https://www.fda.gov/consumers/consumer-updates/coronavirus-testing-basics

https://www.centerforhealthsecurity.org/resources/COVID-19/COVID-19-fact-sheets/200410-RT-PCR.pdf

 

[etotheipi]

Something published today: https://www.thelancet.com/lancet/article/s0140-6736(20)31604-4

Interpretation: ChAdOx1 nCoV-19 showed an acceptable safety profile, and homologous boosting increased antibody responses. These results, together with the induction of both humoral and cellular immune responses, support large-scale evaluation of this candidate vaccine in an ongoing phase 3 programme

 

[mfb]

500 people, 2-3 months since they got the vaccine, antibodies look good, no one got seriously ill but mild to moderate side effects 2-3 days after vaccination are pretty common (figure 1 B). These side effects can make it more difficult to distribute the vaccine - most people will know someone who had them.

 

[russ_watters]

Sure - analyse it through that paradigm if you like. Ultimately in a democracy the people decide.

Yes, and that's what has me upset. In most developed countries in the world, "we" have chosen to allow thousands to hundreds of thousands of deaths because of concern over a vague/undefined privacy risk. I find that despicable.

For example people are now saying, including even me, fine and arrest those just exercising their privacy to protect the rest of us. An example is those refusing to take Covid tests. That is their legal right, but the push now is, not to take away that privacy, but to fine and force them into lockdown in a hotel at their own expense. Actually the government through biosecurity legislation can force them to take the test, but do not want to go that far - yet.

Ironically, many if not most of the legal mechanisms are already in place, but are only used on a case by case basis, not wholesale. We have had examples of forced quarantines, subpoenas for contact tracing, and mandatory affirmative proof of infection status.

It's not clear the apps work without traditional contact tracing and quarantine of confirmed cases and close contacts.
[snip]
(which one may need to anyway, even if there is an app).

I don't understand -- they are at least logically equivalent, so what would be the difference that would require traditional contact tracing? What would traditional contact tracing do that the app couldn't?

Also, doesn't South Korea provide clear-cut evidence that this method works?

If traditional contact tracing is in place, then it may be possible that the app need not be compulsory. Thus for example, it appears that the contact tracing for some of the early cases in the US was very well done.

From what I've seen, the lag time of traditional contact tracing makes it basically pointless for COVID. One of the early cases in PA was quickly identified and traced, and all the contact tracing accomplished was following the tree of infection after it had already spread:
https://www.inquirer.com/health/cor...-international-travel-infection-20200428.html

Another approach is to scale that up considerably

The scale problem seems intractable to me. A few months ago people had talked about returning to contact tracing and scaling-up to hundreds of thousands of tracers in the US, but it hasn't happened.

 

[mfb]

Also, doesn't South Korea provide clear-cut evidence that this method works?

It provides evidence that this method works in South Korea and with years of preparations.

The reaction by the Japanese government is essentially non-existent (school closure, okay, and non-mandatory suggestions), but Japan got the outbreak much better under control than the US. What does that tell us? Certainly not "what works in a completely different culture must work here, too".

I have mentioned that before (e.g. in the context of Sweden): Comparisons work better the more similar the countries are.

 

[Astronuc]

The Department of Homeland Security (DHS) Science and Technology Directorate (S&T) has established the Probabilistic Analysis for National Threats Hazards and Risks (PANTHR) program to strengthen customer engagement within the homeland security enterprise by aligning chemical, biological, radiological, and nuclear (CBRN) hazard awareness and characterization activities to provide timely, accurate, and defensible decision support tools and knowledge to stakeholders. So naturally, they are studying the SARS-CoV-2 virus.

ANTHR is working on characterizing the virus responsible for the COVID-19 pandemic. The work being done will provide insight regarding how long the virus can survive on surfaces, the potential for those contaminated surfaces to infect additional individuals, and the ability of various disinfection technologies to clean these surfaces to prevent further infection/transmission.

https://www.dhs.gov/science-and-technology/panthr

DHS staff have developed two calculators to predict the viability of the virus in air and on surfaces.

Estimated Airborne Decay of SARS-CoV-2 (virus that causes COVID-19)
under a range of temperatures, relative humidity, and UV index
https://www.dhs.gov/science-and-technology/sars-airborne-calculator

Estimated Surface Decay of SARS-CoV-2 (virus that causes COVID-19)
on surfaces under a range of temperatures and relative humidity
https://www.dhs.gov/science-and-technology/sars-calculator

Airborne SARS-CoV-2 Is Rapidly Inactivated by Simulated Sunlight
https://academic.oup.com/jid/article/doi/10.1093/infdis/jiaa334/5856149

 

[russ_watters]

It provides evidence that this method works in South Korea and with years of preparations.

I'm not sure the "years of preparations" has been that big of a contributing factor. The needed legal mechanisms and the apps themselves are really simple.

The reaction by the Japanese government is essentially non-existent (school closure, okay, and non-mandatory suggestions), but Japan got the outbreak much better under control than the US. What does that tell us? Certainly not "what works in a completely different culture must work here, too".

I have mentioned that before (e.g. in the context of Sweden): Comparisons work better the more similar the countries are.

You're trying to play opposite sides of a coin here, but you're making the mirror of mistake you're accusing me of: "what works in a completely different culture won't work here because of the culture." Reality is more nuanced than the simplistic categorizations you are making here -- and for Sweden. It's really important to try to identify what factors matter about countries that make them similar or different, and not choose arbitrary or irrelevant ones, or ignore relevant ones.

If Japan and South Korea succeeded more because they have a strong culture of compliance (certainly likely a contributing factor), it makes the need for compulsory measures is greater in countries with a higher propensity toward freedom/individualism, because there's greater "room" for such measures to make a difference.

E.G., the difference between Japan and South Korea's deaths is 25%. If, as you say, they are highly comparable societies, then that difference may be explainable by the difference in approach. So one would expect the worst-case impact of such measures here to be a 25% reduction in deaths in other societies. In the US, that would be 38,000 lives saved and counting.

But what really blows my mind here is that even in the face of many thousands of deaths, people aren't even interested in trying.

 

[BillTre]

Here is a map of the proportion of people wearing masks, based on interviews, as described in this NY Times article.

Here is a map of average daily corona virus cases in the last 7 days, from the NY Times, here.

 

[mfb]

I'm not sure the "years of preparations" has been that big of a contributing factor.

I'm not sure either. That means South Korea's success doesn't imply that this would have to work elsewhere. I haven't seen a convincing argument that this infrastructure - legal and technical - could be set up in a short time. No country managed to do so.

You're trying to play opposite sides of a coin here, but you're making the mirror of mistake you're accusing me of: "what works in a completely different culture won't work here because of the culture."

I don't say that. I said that using South Korea as evidence that this must be very helpful is problematic. Maybe it would be very helpful. I don't know - and I don't claim I would.

So one would expect the worst-case impact of such measures here to be a 25% reduction in deaths in other societies.

Sorry, but that approach is absurd in every aspect.

 

[atyy]

I don't understand -- they are at least logically equivalent, so what would be the difference that would require traditional contact tracing? What would traditional contact tracing do that the app couldn't?

One problem seems to be that distance is hard to infer using bluetooth. If we quarantine a lot of people who are not close contacts, people will think the system is crying wolf.
Inferring distance from Bluetooth signal strength: a deep dive
Why Bluetooth apps are bad at discovering new cases of COVID-19

My understanding is that in Singapore, where the spread seems to be reasonably well managed, the bluetooth app is not yet compulsory, and traditional contact tracing has been beefed up a lot. We'll probably have to wait 3 to 6 months before they release a paper on how much the app is helping with contact tracing.

I should say that the bluetooth tracing is not the only tech tool in Singapore. Everyone here has an identity card, and one's identity card number must be logged when one enters public places like malls, supermarkets and restaurants. For convenience, the logging can be done by another functionality packaged with the bluetooth app, but they are separate functions. Use of the app is not compulsory. The entry registration is compulsory, and can be done by methods other than using the app.

Here is an example of the public messaging on the bluetooth tracing (TraceTogether) and entry registration systems (SafeEntry): https://nusmedicine.nus.edu.sg/images/resources/newsinfo/Jul2020/newsinfomain_COVIDChronicles75_200718.jpg

 

[atyy]

Also, doesn't South Korea provide clear-cut evidence that this method works?

I think South Korea also has a lot of traditional contact tracing. If I understand you correctly, you think that the US is doing so poorly at traditional contact tracing, that maybe the bluetooth tracing app will help (without the traditional contact tracing). Maybe you are right, but I think South Korea has both, so it isn't a case study on whether the app would be effective without the traditional methods.

 

[bhobba]

Things are getting bad in Victoria Australia.
https://www.couriermail.com.au/news/lawfirm-outbreak-prompts-probe-decision-on-restrictions-looms/news-story/b452755511bfb4c7a33ec5cebae44783?utm_source=CourierMail&utm_medium=Email&utm_campaign=Editorial&utm_content=CM_NEWS-ALERT_CUR_01&net_sub_id=311202432&type=curated&position=1&overallPos=1

It's very sad 9 out of 10 people do not immediately isolate while waiting for Covid test results or are found to have it. Surely they realize how dangerous that is. In a practical sense all that will happen is stronger measures will be taken such as wearing bracelets like they do with house detention. This will tie up police time to implement who could instead be helping wth tracing etc.

Thanks
Bill

 

[bhobba]

Testing everyone in both groups twice in that time span will increase the statistics a lot (and will give another data point on how many cases the US is missing).

I think the initial data suggests a number of vaccines actually work in the sense of reducing the number of people that get Covid. What we do not know is long term effects which makes this whole thing tricky. Even the idea of using stage two trials to try and break up hot spots with small numbers vaccinated has me a bit worried long term. This is going to be a very difficult decision to make morally. Things here in Aus are breaking down to some extent with more people not adhering to rules. If they only show a bit more sense then we can wait longer to deploy the vaccine and get better safety data.

Thanks
Bill

 

[bhobba]

Maybe you are right, but I think South Korea has both, so it isn't a case study on whether the app would be effective without the traditional methods.

In Aus it is thought the app is not doing much good over and above normal tracing methods. There seem to be a number of reasons, one of which is many phones go into an idle mode while not being used and the app is then not working. Also it does not help with cases picked up from surfaces or fine droplets that remain longer in the air and do not fall to the ground quickly.

Thanks
Bill

 

[russ_watters]

One problem seems to be that distance is hard to infer using bluetooth.

I'm not referring to the Google/Apple platform. Yes, it's fundamentally flawed and largely useless. I'm referring to a properly made system that would use GPS; My understanding is South Korea and several other countries use GPS. The irony is that Apple and Google already collect GPS location data, they're just choosing not to use it.

India is also using GPS in a compulsory app, which may explain why a country you'd expect COVID to blast through is instead seeing a slow burn.

I think South Korea also has a lot of traditional contact tracing. If I understand you correctly, you think that the US is doing so poorly at traditional contact tracing, that maybe the bluetooth tracing app will help (without the traditional contact tracing).

GPS based, but yes, that is my position.

Maybe you are right, but I think South Korea has both, so it isn't a case study on whether the app would be effective without the traditional methods.

Well, it's all layers, right? It's social distancing + masks + quarantines + contact tracing + etc...

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

 

[Vanadium 50]

"we" have chosen to allow thousands to hundreds of thousands of deaths because of concern over a vague/undefined privacy risk.

Let me try and clarify it, then:

(1) The guiding and limiting principles on what actions the government may take in emergencies are least as vague and undefined. If it is "any action is permissible if it saves just one life" that takes us to a place where the government can tell us what to eat (obesity is at least as serious an issue as Covid) and who to marry (wouldn't want genetic problems in the offspring, now would we?)

(2) It would likely be a permanent state of affairs. If you divide the country in two pieces: NY, NJ, MA and CT in one, and the other 46 in the other, the Covid fatality rate in the "other 46" is about the same as a really bad flu season. If it's worth imposing mandatory contact tracking to the Other 46 now, why would we not impose it every year for influenza?

If you're still not convinced, we could probably eliminate STDs. All we need to do is create a national database of everybody and their sexual partners. Think of the suffering we would eliminate!

(3) I for one, and probably others, are skeptical of the competency of governments to act on this information. Ultimately, the premise of contact tracing is that this is an information problem. More information and the problem will be solved. But let's look at the situation in the Four States listed above and nursing homes. The vulnerability of the elderly to Covid was well-established. The fact that individuals had Covid was known. And yet these people were deliberately moved into nursing homes. Around half the deaths in the Four States were in nursing homes.

(4) Keeping a list of people who were at "defund the police" rallies and handing that list to the police - purely for health reasons, you know - makes people uneasy. And while one might say "governments/police are too noble to act on this information", and I might even agree with them, the people who are protesting would not.

I would argue that if you want to bring people around to your way of thinking you should address these points. I would especially focus on the limiting principle.

 

[bhobba]

The irony is that Apple and Google already collect GPS location data, they're just choosing not to use it

That's due to privacy concern. It's the old privacy vs public safety debate. I come down on the side of public safety and would use it - evidently Taiwan does and it is still doing well. But we live in a democracy so it's not my choice to make.

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

Thanks
Bill

 

[Astronuc]

I just read a headline that the US government has placed an order for 300 M doses of a SARS-CoV-2 vaccine. The WSJ reports a 100 M dose order (should it be cleared by regulators).
https://www.wsj.com/articles/pfizer...vaccine-order-from-u-s-government-11595418221

COVID-19 Vaccine Efforts at Pfizer
https://www.pfizer.com/science/coronavirus/vaccine

Some results - https://www.pfizer.com/news/press-r...iontech-announce-early-positive-update-german

Meanwhile, AstraZenaca's vaccine is showing promise.
https://www.astrazeneca.com/media-c...-in-all-participants-in-phase-i-ii-trial.html

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

 

[atyy]

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

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

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

 

[russ_watters]

Let me try and clarify it, then:

(1) The guiding and limiting principles on what actions the government may take in emergencies are least as vague and undefined. If it is "any action is permissible if it saves just one life" that takes us to a place where the government can tell us what to eat (obesity is at least as serious an issue as Covid) and who to marry (wouldn't want genetic problems in the offspring, now would we?)...

(2) It would likely be a permanent state of affairs. If you divide the country in two pieces: NY, NJ, MA and CT in one, and the other 46 in the other, the Covid fatality rate in the "other 46" is about the same as a really bad flu season. If it's worth imposing mandatory contact tracking to the Other 46 now, why would we not impose it every year for influenza?...

(3) I for one, and probably others, are skeptical of the competency of governments to act on this information.

(4) ...

(1) Yes, it's a slippery slope, and we're always on it. Governments make such decisions every day - it's a core issue of governance. Philadelphia has a soda tax(!), and it isn't small. This is something decided case-by-case, with oversight and framing based on our governments' structures. In this case, "we" have decided that it's a health emergency and as such massive restrictions on freedom and massive costs are permissible to save lives. But zero cost in privacy is worth it to save any number of lives, money or freedom. If you're worried about that slope, I don't see why: none of us have ever seen anything like the current government response in our lifetimes. Though we do see several disaster declarations a year for floods/hurricanes. There's usually FEMA-associated conspiracy theories about where those powers could lead, but they've been pretty quiet lately.

(2) I don't see why it should be considered likely to be permanent. Many(most?) countries have passed COVID-specific response laws. Even countries like South Korea that had mechanisms in place for this required explicit authorization to apply it to COVID. Your logic in comparing it to flu(or STDs) doesn't apply because:
a) The decision has been made that this is worse than the flu, and more on par with a hurricane. If we decide it isn't worse than the flu, then no emergency response is warranted at all. This is the same as your #1: it's never happened in our lifetimes, so I see no reason to expect it to be permanent/continuous.
b) Your logic of comparing it to flu doesn't work because the current state of COVID is after/with a shutdown. If we weren't already taking emergency measures, COVID would be much worse in health impact. It's already much worse in financial and freedom impact.

(3) Whether governments or individuals, clearly competence has been a problem in the pandemic response. But this problem is independent of the issue of improving contact tracing. Improving contact tracing can't make it worse, it can only improve it. The guy who tries to go shopping without a mask might still go to the grocery store even if their app buzzes and tells them there's 5 infected people clustered right in front of him at the front door. But would you? I wouldn't. And I'd wager there's not an insignificant number of outspoken people who talk tough on facebook, but would cave if the information was shoved in their face/pocket. [edit] I'll add that I favor coercion be included in this apps, but we haven't even gotten to that yet...

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

I would argue that if you want to bring people around to your way of thinking you should address these points. I would especially focus on the limiting principle.

The limiting principle is that a health emergency like this hasn't happened in our lifetimes before, so there is no reason to expect it to happen again, much less be applied continuously. That's the typical fallacy of slippery slopes: they are an effect without a cause or historical precedent/evidence.

By the way, this is all good discussion, but your issue is more with treating COVID as an emergency than it is with the specific emergency response measure. Since COVID has already been declared an emergency, that's not what is standing in the way of digital contact tracing. What's standing in the way is privacy concerns, and specifically, Apple and Google decided/declared that they'd be creating an ineffective digital contact tracing system in order to prioritize privacy over effectiveness.

 

[russ_watters]

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

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

That's due to privacy concern.

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

 

[russ_watters]

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

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

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

 

[russ_watters]

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

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

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

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

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

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

 

[bhobba]

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

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

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

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

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

He is a first class scientific intellect.

Thanks
Bill

 

[Vanadium 50]

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

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

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

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

 

[atyy]

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

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

 

[atyy]

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

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

 

[mfb]

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

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

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

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

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

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

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

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

 

[Vanadium 50]

We still can't bring liquids through airport security

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

 

[Astronuc]

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

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

 

[mfb]

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

 

[bhobba]

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

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

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

Thanks
Bill

 

[Ygggdrasil]

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

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

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

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

 

[Vanadium 50]

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

 

[Ygggdrasil]

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

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

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

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

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

 

[Vanadium 50]

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

 

[OmCheeto]

This sounds like good news:

NYT, July 22, 2020​

​

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

​

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

 

[nsaspook]

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

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

 

[mfb]

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

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

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

 

[bhobba]

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

I am not quite sure of that.

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

Thanks
Bill

 

[atyy]

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

 

[bhobba]

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

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

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

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

Thanks
Bill

 

[PeroK]

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

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

Thanks
Bill

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

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

 

[bhobba]

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

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

Thanks
Bill

 

[bhobba]

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

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

Thanks
Bill

 

[Astronuc]

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

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

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

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

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

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

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

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

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

https://ncov2019.live/data/unitedstates

 

[berkeman]

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

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

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

 

[Astronuc]

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

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

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

 

[berkeman]

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

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

 

[atyy]

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

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