COVID COVID-19 Coronavirus Containment Efforts

[kadiot]

What a sad discovery.

Apparently for younger people, CORONAVIRUS might present as a stroke instead of a simple respiratory problem

https://edition.cnn.com/2020/04/22/...T23:00:21&utm_source=fbCNNi&utm_medium=social

 

[kadiot]

Wow! Oil producers now have to pay someone US$37/ barrel to take oil from their hands because of extreme lowering of demand brought on by the medical crisis ...

US is filing up its strategic reserves as its own shale producers are declaring bankcruptcies...

Going forward, will the oil industry recover or will the renewables overtake fossil fuel?

 

[chemisttree]

Going forward, will the oil industry recover or will the renewables overtake fossil fuel?

No way renewables will ever replace oil when it is priced so low. The first to die will be the renewables most likely.

 

[mfb]

Wow! Oil producers now have to pay someone US$37/ barrel to take oil from their hands because of extreme lowering of demand brought on by the medical crisis ...

In one place, for one type of contract.
Let's not forget the context here.

Going forward, will the oil industry recover or will the renewables overtake fossil fuel?

They still have the oil underground for the time when demand goes up again.

 

[kadiot]

No way renewables will ever replace oil when it is priced so low. The first to die will be the renewables most likely.

I agree with your point. Super cheap oil will give renewables a run for their money! How long this oil bonanza will last may be coincident with the Corvid. But then, there is the politics between Russia and OPEC with KSA as lead... uhmmm

 

[kadiot]

The contact tracing app which South Korea used so successfully and which the UK is now adopting is raising serious privacy issues...

However, some quarters have pointed out that identifying a Corvid positive in the same space where you are, may redound more to everyone’s interests...

Further, this cannot be compared to identifying HIV positive individuals because of the tremendous social opprobrium of those who are HIV infected...

 

[Tendex]

Analyzing what practical measures could have maybe helped at the beginning, with an eye on what would be the best actions before possible new similar situations, we all know (taking seriously China's reports) how effective the internal lock-down in China was, but international airplane travel from China, including Wuhan, was continued if I'm not mistaken, all through the months of January and most of February which is the time window where the virus seems to have spread worldwide and especially in Europe, including up to 6 regular flights per week from Wuhan to Paris and similar frequencies to Rome and London. Would it have been practical to halt the epidemic spread interrupting those international flights from China to the rest of the world? Could China have done it? I'm centering in what China could have done more than what the destiny countries could have done as I think it would have been more difficult for each country to lock entrance to people from China if that measure was not taken by most countries in a coordinated way, otherwise each country would have had to lock entrance from any other country which is not practical except maybe for North Corea and such.

 

[hmmm27]

Last week, the news stat's were : cases/deaths/recovered, with "deaths" being about 15% of "recovered". Now it's cases/deaths, and readers have to dig a bit for "recovered" : makes for a slightly less ominous bit of basic math, I suppose.

 

[Vanadium 50]

Any reason for the periodicity?

I'm sure there's some reason.

Some places show a clear weekend effect.

These people argue (in https://arxiv.org/abs/2004.07208 ) that it's real and comes out of their model.

 

[TeethWhitener]

I'm sure there's some reason.

Some places show a clear weekend effect.

These people argue (in https://arxiv.org/abs/2004.07208 ) that it's real and comes out of their model.

Interesting. I just hopped back on to say that the periodicity (at least on the Wikipedia plots) also appears in deaths, which one might expect to be reported in a more timely fashion than new positive cases. I’ll take a look at the preprint.

 

[mfb]

Some countries have published recent total death numbers, so people looked at the excess mortality. It's higher than the reported COVID-19 deaths in most cases: Tracking Covid-19 excess deaths across countries
Caveat: Deaths from people less likely to go to a hospital (or unable to go there, in some cases) with other diseases show up in excess mortality but don't count as COVID-19 deaths, so we don't expect an exact match.

Lombardy peaked at three times the normal death rate. 1/3 expected for other reasons, 1/3 attributed to COVID-19, 1/3 linked to COVID-19 but not counted in its death toll.

 

[peanut]

Is it true that the lining of blood vessels are another target of Covid-19?

 

[Vanadium 50]

Some countries have published recent total death numbers, so people looked at the excess mortality

You see the same effect (from the same source, EuroMOMO) in 2017, 2018 and 2019 flu seasons. Some of this depends on how the accounting is done: if someone catches the flu and goes out to see his doctor and is killed in a car crash, it is not recorded as flu, even though if he hadn't got the flu he'd still be alive.

EuroMOMO seems to have an obsession with z-scores, which I don't understand. They also have a sinusoidal "normal range" which is exceeded every winter they report. Seems like an odd definition of normal: if it were me, I'd find a different periodic function, one where about half the years were below normal and half above normal rather than everything above normal.

 

[Astronuc]

In mid-February, a month before New York City schools were closed, New York City and San Francisco already had more than 600 people with unidentified infections, and Seattle, Chicago and Boston already had more than 100 people, the findings estimate. By March 1, as New York confirmed its first case, the numbers there may already have surpassed 10,000.

https://www.nytimes.com/2020/04/23/us/coronavirus-early-outbreaks-cities.html

Some critics believe the number of unknown infections may be overestimated.

The virus moved under the radar swiftly in February and March, doctors and researchers said, because few cities or states had adequate surveillance systems in place. And testing, if it was being done at all, was haphazard. Emergency rooms were busy preparing for the predicted onslaught and likely missed some of early virus-related deaths, and didn’t have time or tools to verify infections on the fly, experts said.

It was mid-March before teams at N.Y.U. and Mount Sinai began taking samples for testing in New York.

 

[russ_watters]

In iOS you can disable it.

Yes, but it is on by default and not many people do disable it. We're talking about opposite sides of the same coin here. For the same feature:
-If you allow an optional opt-in, most people won't.
-If you allow an optional opt-out, most people won't.

But again, the key feature here isn't the location tracking because that's already basically ubiquitous. Nothing at all new has to happen for it. The key feature is government access to and dissemination of private, legally protected medical records to/from private companies and at some level, to the general public.

That's part of "measures that would be very, very unpopular in western countries" I mentioned.

In the quote I said "to the federal government": actually, it's both and the key information as I said above has to come from the government. They could in principle do this without providing location data to the government, but they can't do it without receiving medical data from the government.

...unless Google and Apple figure out for themselves who has Coronavirus and who doesn't (or at least who is sick and who isn't). I suspect they could do that with a scary level of accuracy via location tracking alone.

 

[russ_watters]

Any reason for the periodicity? It shows up in US data as well. It seems to peak in the Thursday-Friday range.

Analysis date as far as I understand, and fewer tests analyzed at the weekend. Plus some reporting lag, so tests from one day can appear in the statistics of the next day. More discussion here and details in its German source.

In my area, the peak-trough pattern was clear before the peak, but the timing is not consistent and does not align with weekends. I'm guessing some testing or reporting happens in batches, which aren't necessarily scheduled according to the work-week.

Since the peak, which was just before Easter here, the data has gotten very chaotic for some reason. I expected it to regain some consistency after an initial Easter testing lull, but it hasn't. So it is very hard to tell what the case decrease rate is.

 

[russ_watters]

Analyzing what practical measures could have maybe helped at the beginning, with an eye on what would be the best actions before possible new similar situations, we all know (taking seriously China's reports) how effective the internal lock-down in China was, but international airplane travel from China, including Wuhan, was continued if I'm not mistaken, all through the months of January and most of February which is the time window where the virus seems to have spread worldwide and especially in Europe, including up to 6 regular flights per week from Wuhan to Paris and similar frequencies to Rome and London. Would it have been practical to halt the epidemic spread interrupting those international flights from China to the rest of the world? Could China have done it?

Of course China could have done it, but why protect others from them?

In the US we instituted a travel ban from China on February 2, which I think was reasonably early, but Europe didn't (not sure when they did their own) and we didn't implement one from Europe until March 14, which was way too late since as you said, the virus was already widespread in several countries such as Italy. A significant fraction of the East Coast outbreak has origins from Europe.

 

[DennisN]

An article on Reuters today about the race for a vaccine:

LONDON/ROME (Reuters) - Scientists in Britain began clinical trials of a potential COVID-19 vaccine on Thursday as other vaccine developers across Europe also stepped up work on experimental shots against the disease caused by the new coronavirus.

A team at Britain’s Oxford University dosed the first volunteers in a trial of their vaccine - called “ChAdOx1 nCoV-19” - while Italy’s ReiThera, Germany’s Leukocare and Belgium’s Univercells said they were working together on another potential shot and aimed to start trials in a few months.

...

As many as 100 potential COVID-19 candidate vaccines are now under development by biotech and research teams around the world, and at least five of these are in preliminary testing in people in what are known as Phase 1 clinical trials.

Source: European firms step up COVID-19 vaccines work, UK team starts human trials (Reuters, April 23, 2020)

 

[Vanadium 50]

So, while the data are valuable, they are by no means definitive and should be taken in context with other seroprevalence studies underway in other areas of the world.

There is now a released study from USC (Google the PI "Neeraj Sood" to find popular press descriptions of the study - I failed to find the preprint of the scientific article) that gets an antibody rate of 2.8 to 5.6%. The first (Santa Clara County) study came up with 2.58 to 5.70%.

 

[kadiot]

An article on Reuters today about the race for a vaccine:Source: European firms step up COVID-19 vaccines work, UK team starts human trials (Reuters, April 23, 2020)

Yuhoo! Another step closer to a vaccine for COVID19 virus SARSCoV2's other cousin, MERS (Middle East Respiratory Syndrome) coronavirus.

 

[Jarvis323]

Any reason for the periodicity? It shows up in US data as well. It seems to peak in the Thursday-Friday range.

At least one source (for deaths) is that they periodically tally up deaths of people who died outside of hospitals. That was the cause of a recent increase in NYC deaths a few days ago (actually the number of new deaths went down).

 

[anorlunda]

This sounds ominous.

ERs seeing less heart attack, stroke patients during COVID-19

If people die of other diseases because they fear doctors and hospitals, do the statistics count that as a COVID-19 death? Perhaps it should be recorded as cause of death --journalism.

Also, regarding phone apps for virus tracking. I did not read all the posts here about tracking versus privacy. But I did read that the proposed Google+Apple app does not use your actual location. It requires enough proximity to sense the bluetooth ID of another nearby phone. Only proximity is relevant, not location. Of course proximity can have privacy implications too.

I also read that about 20% of smart phones still in use do not have the hardware needed to scan for nearby bluetooth while using low power. Those phones will not be able to use the app. That reduces the effectiveness of the app.

 

[ChemAir]

I suspect they could do that with a scary level of accuracy via location tracking alone.

While I'd agree this is likely true for those with the most modern devices that are fully connected, I don't believe enough people (of all ages) in the country have smartphones that are current enough to be effective at managing this.

3 thoughts (without solutions)--I'll probably have others, but these come to mind:

1) I operate my phone with GPS/wifi/bluetooth disabled. I find ads based on location intrusive and unhelpful, unless I am asking for information. People like me will not have close enough tracking, especially if you work in different facilities like I do, where cameras (and phones with them) are prohibited, and left in vehicles or offices in the workday. Based on my phone use, contact tracking will be useless for me.

2) As resistant to tracking by the government the average person is, criminals don't intend to have a trackable smartphone. States have released detainees for many crimes, many of whom have no such cell phone. Most will find it a little more than offensive if they are arrested for not having a cell phone (that they pay for) while detainees are being released for the detainees' safety, while not having a registered cell phone, and they'll have a point.

Thought 2 is mostly there to state that the general public would not appreciate no-trial imprisonment, or it's equivalent (ankle bracelet), while current detainees are given free reign following arrest for cause, without the same consideration.

3) A large number of cellphones are not in the names of the people that carry them. Many are business owned, and tracking a phone number that gets transferred between people over years will be problematic. Likewise, phone numbers for children in the name of the parent will be difficult to parse.

The logical answer for anyone not wanting this intrusion is to stop paying their cell phone bill, which could torpedo this idea. I guess the government could try to either issue us all cell phones, or force us to pay bills for phones we would have to carry lest we be arrested, but I suspect that won't go very well, even if the government could afford it.

On the other hand, if you wanted to use your phone to help yourself mitigate risk, that is certainly possible, but could only made fully effective if everyone did it.

 

[OmCheeto]

The articles states that Rhode Island has the highest per capita testing rate of the 50 states. I have not independently verified.
...

This is true.

But it's somewhat trivial, so I'd rather not discuss it further.

... By March 1, as New York confirmed its first case, the numbers there may already have surpassed 10,000.

https://www.nytimes.com/2020/04/23/us/coronavirus-early-outbreaks-cities.html

...

Yay!

Feb 19, 2020

In my simulation, nearly 10,000 people were infected by the time the first person died. I find that difficult to believe.

[ref]

Though, I'm guessing my 10,000 was more luck than science.
It's been two months, and I still don't fully understand the model.

Anyone else watch the Frontline Coronavirus Pandemic show on Tuesday?
I found the interview with a Dr. Riedo the most interesting
[transcript]

18:45 Francis Riedo, MD, Evergreen Health, Medical Director of Infection Control​

​

Remember, this was flu season and we’d already had a peak of influenza B in December, and now we were going through the peak of influenza A. And so, the unit was full of individuals with severe respiratory infections.​

​

In the meantime, in the background, we’re watching these events unfold with increasing alarm, not only in Wuhan, but now spreading across the globe and wondering when our turn was coming.​

...​

My initial honest response was skepticism. I thought, the odds of both tests in two randomly selected individuals being positive, with no history of travel, no history of exposure to anybody, was fairly astronomical.​

​

This was a huge shift. Incident command was activated, and we made a quick decision to test nine additional people that night. Eight of those nine were positive.​

​

​

 

[Ygggdrasil]

There is now a released study from USC (Google the PI "Neeraj Sood" to find popular press descriptions of the study - I failed to find the preprint of the scientific article) that gets an antibody rate of 2.8 to 5.6%. The first (Santa Clara County) study came up with 2.58 to 5.70%.

Apparently, the paper describing the methods has not yet been released (even though they thought it appropriate to release the results by press release), which is an odd decision. However, a version of the paper was somehow leaked. Notably, the Stanford and USC studies share many authors (e.g. the first author of the USC study, Dr Sood, is also an author on the Stanford study, the first author of the Stanford study is an author on the USC study, and the two studies have the same senior author), so it is possible that they would share similar methodological flaws.

Here's a popular press article dicussing the two reports along with some of the criticism: https://www.buzzfeednews.com/articl...ntibody-test-santa-clara-los-angeles-stanford

I am not necessarily saying that their estimates are wrong, just that there are some valid criticisms of the methods and analyses used by the studies, so they should be take with a grain of salt.

 

[DennisN]

BBC reports about uncertainties regarding the potential treatment drug remdesivir:

Hopes dashed as Coronavirus drug remdesivir fails first trial (BBC, 24 april 2020)

A couple of quotes:

There had been widespread hope that remdesivir could treat Covid-19.

But a Chinese trial showed that the drug had not been successful, according to draft documents accidentally published by the World Health Organization.

The drug did not improve patients' condition or reduce the pathogen's presence in the bloodstream, it said.

The US firm behind the drug, Gilead Sciences, said the document had mischaracterised the study.

[...]

Gilead has disputed the WHO post.

"We believe the post included inappropriate characterisations of the study," a spokesman for Gilead said, adding that it was terminated early due to low enrolment and was therefore not statistically meaningful.

"As such, the study results are inconclusive, though trends in the data suggest a potential benefit for remdesivir, particularly among patients treated early in disease," he said.

This does not spell the end of the road for the drug, however, and several continuing trials will soon provide a clearer picture on the drug's use.

EDIT:

And a new BBC article about the brand new vaccine trial in UK:

Coronavirus: First patients injected in UK vaccine trial (BBC, 24 april 2020)

The first human trial in Europe of a Coronavirus vaccine has begun in Oxford.
Two volunteers were injected, the first of more than 800 people recruited for the study.
Half will receive the Covid-19 vaccine, and half a control vaccine which protects against meningitis but not coronavirus.
The design of the trial means volunteers will not know which vaccine they are getting, though doctors will.
[...]

 

[Vanadium 50]

Thanks for hunting that down. I am more than a little irritated by this. I have always held that "if it isn't published (or at least available as a preprint), it doesn't exist". If the authors aren't willing for this to stand up for peer review, it shouldn't influence public policy.

However, I think BuzzFeed's criticisms are largely unfair.

#1. The scientists sought media attention before having supporting data. That's certainly a fair criticism of the scientists, but not of the science. Oh, and when you say "Notably, the Stanford and USC studies share many authors (e.g. the first author of the USC study, Dr Sood, is also an author on the Stanford county study, the first author of the Stanford study is an author on the USC study, and the two studies have the same senior author) , so it is possible that they would share similar methodological flaws.", it contradicts the BuzzFeed article you linked to, which says both teams share a member.

#2. The antibody test’s accuracy rates may be shakier than presented. Sure. But there's no evidence that this is the case or that the correction was done incorrectly. Any number in any paper can be wrong, and a good paper - which we do not have - will give enough information for people to judge for themselves. Further the criticism that no amount of testing will ever give perfect certainty is as old as statistics itself.

However, just for giggles I looked at the numbers they have provided.

They say 2 false positives in 371 tests, which they correct for.. That works out to a 95% CL that the truth is less than 6.3. That means they are 95% confident that the false positive rate is less than 1.7%. If I take the following sentence in KCET's report literally - "Preliminary results of the study found that of 863 people randomly selected for testing, 4.1% had antibodies in their system, indicating they had been infected at some point with the virus ", i.e. that the 4.1% is raw, it would be corrected down to 3.6% but at 95% CL could be as low (95% CL) as 2.4%: i.e. the true number could be as small as 2/3 of their central value.

Their central value is 331,000 and their quoted lower limit is 221.000. Their quoted lower bound (which is presumably a 68% number) is 221,000. So I don't see evidence of a problem, although one could always come up later.

#3: The Santa Clara County study picked and sorted participants in questionable ways.

If true, that wouldn't say anything about the Los Angeles study.

BuzzFeed's fourth, unnumbered, objection is that this would be viewed positively by the political right. I would respond to that by saying we should know the truth, no matter who benefits and who does not.

 

[Astronuc]

The Houston Livestock Show and Rodeo is the city’s largest event, attracting 2.5 million people and generating nearly $400 million. But officials pushed forward with the 20-day event until there was a positive COVID-19 case from community spread.
https://www.propublica.org/article/...ton-rodeo-and-proceeded-with-the-event-anyway

“It is my belief that you should use your authority to basically shut down the Houston Rodeo or at least those components of it that will take place in a closed arena,” attorney Seth Chandler, the former director of the University of Houston’s Health Law & Policy Institute, wrote to Dr. David Persse, the head of the city’s Health Department, before opening day.

Ultimately, on March 11, after eight days, the rodeo shut down. A police officer from a neighboring county who attended a pre-rodeo barbecue tested positive for COVID-19 — evidence that it was now spreading in the community. The health department is now confident the officer caught the virus at the rodeo.

So far, at least 18 people who attended the rodeo and live in four counties surrounding Houston have tested positive for the coronavirus, though it is unclear if they all contracted it at the event.

While testing remains problematic across the United States, Texas ranks among the worst in the country.

Back in January and February:

Rodeo organizers and city Health Department officials had tracked the spread of the Coronavirus since January and more closely as opening day approached, knowing it would impact the efforts of 35,000 volunteers, 135 full-time staff and the millions of dollars in educational grants and scholarships given to participants.

In his weekly update to the mayor on Feb. 27, Persse wrote about community spread in California and Washington State. “As predicted, the U.S. strategy of ‘containment’ appears to begin to fail. We should expect to have community spread in Texas shortly.”

The show went on, and some attendees became ill.

 

[russ_watters]

In iOS you can disable it. One of the reasons I use iOS.

While I'd agree this is likely true for those with the most modern devices that are fully connected, I don't believe enough people (of all ages) in the country have smartphones that are current enough to be effective at managing this...

1) I operate my phone with GPS/wifi/bluetooth disabled.

Google tells me that cell phone market penetration in the US among adults as of 2019 was 96%, with 99% from ages 18-49, gradually decreasing to 91% from 65+. Presumably it drops little for teenagers and then gradually decreases to zero among younger kids. All cell phones, whether smartphones or not, have location tracking and for almost all by GPS.
https://www.pewresearch.org/internet/fact-sheet/mobile/

And of course, that's just cell phones. It doesn't include tablets, laptops, smart watches/fitness bands, baby LoJacks, cars, game systems, cameras, ets.

Google also tells me about 90% of people keep location services on on their smartphones. It's probably higher on non-smartphones, and higher still on those other devices, especially those in which people never thought to check if they had a GPS or where location tracking is the primary function.
https://geomarketing.com/overwhelming-number-of-smartphone-users-keep-location-services-open

For the least likely people to have location trackers on them almost all the time - kids and the elderly - they are likely to be either mostly immobile already (the elderly) or paired-up with someone who has a location tracker (kids).

So I think it is safe to say that all but a small single-digit percentage of Americans and other westerners are being tracked. You guys are outliers.

I would hope - expect, even - that Google and Apple are already using that data to predict who has COVID-19 (and has been with the flu, for a decade). It should be relatively easy given how predictable people have become due to mandatory isolation.

Here's the true story of my mandatory isolation, and what I expect Google knows about it, or easily could if they chose to:

Mandatory isolation started for me 5 weeks ago tomorrow. On that Friday, 3/20 I briefly went to work to gather needed materials for isolation, hit-up a grocery store on my way home, and then started my isolation. Since then, I've visited four places outside my home (besides the mailbox), three of them more than once.

Before I had even settled-in to my pattern, by Sunday Google already knew I was sick. I told it so by repeatedly Googling "coronavirus symptoms", "coronavirus vs sinus infection symptoms chart" and other such terms. And by trying, unsuccessfully, to buy an oral thermometer online and at a pharmacy I went to that I rarely visit. Starting in the afternoon, I noticed a just barely perceptable scratchy throat, that gradually got worse. I was worried because I had just visited my parents for brunch (my normal Sunday routine) and to scold my mother that, no, she couldn't play bridge next week and to give my parents some alcohol wipes and hand sanitizer.

By Tuesday, I was moderately sick. Google knew this because I was still spending 9 hours a day using my work laptop in my office (via cell phone GPS and the laptop's Chrome browser) instead of lying in bed or on my couch all day. But I wasn't exercising anymore and was walking slower (according to the phone's accelerometers). And because I called my doctor's office after using Google Maps to find the phone number, even though it is probably stored in my contacts.

I didn't return to the pharmacy, so Google knew the doctor diagnosed the throat-sinus infection as viral and didn't prescribe antibiotics. It knew I didn't drive to a testing site, so the doctor did not suspect COVID-19. It knew from GPS and the phone's accelerometers tracking my movement in my house (or lack thereof) that the infection peaked on Friday, and then rapidly improved on Saturday. By middle of the next week I was exercising again, and settled down into my routine, which I've followed almost exactly for the next 4 weeks.

The key limitation in their capabilities isn't the tracking coverage. It's not even the accuracy. It's the latency. The detection only works once a person is sick enough change their behavior or flag themselves (as I did). I suspect I got my throat-sinus infection at the grocery store two days before symptoms started, but I also suspect Google knows it nearly for certain, because they'd been tracking that very infection's spread. A heads-up would have been nice...

 

[Tendex]

Of course China could have done it, but why protect others from them?

This question, in case it is not just rhetorical/cynical, could lead to a number of intriguing or even frightening answers that I won't pursue here as they would go off-topic and would probably break forum rules .
But since this thread is about containment efforts I think it is relevant to ponder about why China established the largest and strictest lockdown in history according to the WHO and IA, to avoid spreading the epidemics inside China but it didn't include the logical measure of avoiding the virus spreading worlwide by closing all international departures of people from China to other countries. I mean talk about the most effective and efficient containment effort to avoid a pandemia at their disposal and just "forgetting" it, as one can read in the Wuhan lockdown timeline WP article: "23 January, transport in Wuhan, Huanggang and Ezhou severely restricted, including closure of public transit, trains, airports, and major highways. Wuhan airport was not closed for departures completely; flights still left to many destinations."
I haven't seen many people commenting on this. I think that, should a new virus outbreak arise, this should be a must from the first moment, basically because once the virus is globalized, the containment effort is orders of magnitude less effective whatever the measures a country takes, and orders of magnitude more costly.

In the US we instituted a travel ban from China on February 2, which I think was reasonably early, but Europe didn't (not sure when they did their own) and we didn't implement one from Europe until March 14, which was way too late since as you said, the virus was already widespread in several countries such as Italy. A significant fraction of the East Coast outbreak has origins from Europe.

Exactly, this is why I said that either all countries agreed from the start to ban travel from China, which is very difficult or the measure was doomed to be ineffective.