COVID COVID-19 Coronavirus Containment Efforts

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Containment efforts for the COVID-19 Coronavirus are facing significant challenges, with experts suggesting that it may no longer be feasible to prevent its global spread. The virus has a mortality rate of approximately 2-3%, which could lead to a substantial increase in deaths if it becomes as widespread as the flu. Current data indicates around 6,000 cases, with low mortality rates in areas with good healthcare. Vaccine development is underway, but it is unlikely to be ready in time for the current outbreak, highlighting the urgency of the situation. As the outbreak evolves, the healthcare system may face considerable strain, underscoring the need for continued monitoring and response efforts.
  • #4,021
Here is the whole pandemic, from The Atlantic's Covid Tracking Project. The Atlantic has their own slant ("Georgia's Experiment in Human Sacrifice") but for now, let's take their collected data at face value.

1600036676759.png


My reading from this is that the two peaks are different. Deaths per hospitalization is down a factor of two, hospitalizations per case is also down by a factor of two, and while the number of cases is up a factor of two, the number of tests you need to give to get a positive case is also up by a factor of 2.

My conclusion is that the second peak is different from the first. The simplest explanation that fits the data is that the people in the second peak are less sick than the people in the first. A "case" is either someone who presents symptoms or has a positive test. It would appear that the mix of those two is likely to be the same in both peaks.

Since this is a thread about reactions, one might ask if reactions intended to address the first peak are optimal to address the second. (I note in passing that the original objective of "flatten the curve" seems to have been achieved, which makes the question "so why are there still cases now" somewhat puzzling. That was the policy's intent, at least originally)
 
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  • #4,022
Vanadium 50 said:
Can you summarize it so we don't have to sit through a 38 minute video?

Sure. He is looking at a few things. First the shape of the case curve, and he finds them all similar in Europe and North America. It rises sharply in the beginning, reaches a peak, then tapers off to a small amount. He then looks at the shape in South America and Southern USA - it has the same sort of shape but has a second hump to it at the end, or in some cases rises slowly, then is constant for some time, then slowly tapers off - this due to no actual 'winter'. Why that is he calls the dry tinder theory. He looks at how bad the flu season was the year before and hypothesises in countries where it was weak, and not many older people died, they were 'fodder' for when the virus hit and we saw a bad spike. If it was a normal or worse season then the spike when it did hit was not as big or even smaller. Although he did not examine Australia our aged deaths are in fact 1000 down on last year at this time - and that is even with how horrid we managed our aged care homes. Last year was a bad flu season so that is consistent with his view. He also compared it in some countries to the Spanish Flu, and showed it had a much bigger spike in deaths - while Covid is bad the Spanish Flu was much worse - at least for the countries he looked at. He then looked more closely at Sweden. They took very few forced precautions, although we have no idea the amount of voluntary precautions people took. That is generally thought to be the reason for the high death rate - however Sweden had a very good flu season last year (ie not many dying) and his hypothesis is it was the dry tinder effect. Why Sweden now has a sharp fall off, as if heard immunity had been reached, when in fact not as many people were infected for heard immunity to be achieved, he attributes to t-cell immunity from previous exposure to coronavirus's that cause the common cold. Basically he thinks the pandemic is over except in a few countries where, while not quite over, soon will be. He also found no real evidence, when his tinder hypotheses was taken into account, for the effectiveness of stringent lockdowns, and other draconian measures. He also hypothesised in some countries that had a second wave it was from over-testing - people immune still had fragments of the virus in their nasal passages. As evidence he cites the death rate per case found plummeting.

That's his view. I do not agree with it for a few reasons. First, to me by not examining Australia, Japan, Korea, Singapore, Taiwan, other Asian Countries, and Africa he IMHO is cherry picking results. Nor is he looking at what happened in very successful Taiwan where throughout the pandemic things have been close to normal. They did not do draconian lockdowns etc but simply implemented the basics very well. Excellent tracing and quarantine is the key. Social distancing and mask wearing, while strongly encouraged, were nonetheless optional - still most did it anyway. Mandatory temperature taking on entering any building. When someone is quarantined they are randomly rung 3 or 4 times a day not just to check they are there, but to ensure everything is fine - do they need food, drugs, how is the quality of food they are getting if it is a hotel, how are the staff and other guests etc. Contrast that to Melbourne Australia where people were banging on walls, running naked in corridors, begging to be let out, and offering money and/or sex to guards, who had received no relevant training except for an hour or so on diversity. It was overseen by a number of government departments each with their own priories eg one department did a video congratulating staff for getting dates to 'guests' at the end of Ramadan. Basically a total stuff-up and responsible, with nearly 100% certainty (as found by an independent enquiry) for the entire second wave here in Australia that we are now experiencing. There were also tracing issues. Some states were doing tracing brilliantly like NSW, and others very good like Queensland where I am. But Victoria was a basket case as far as tracing went and that has only now been rectified to some extent by sending people to NSW to learn how they did it recently. Of course at the start of the pandemic every state should have got together, decided on best practice tracing and implemented a coordinated approach. That alone would have avoided border closures and other draconian measures politicians are still arguing about. Plus the horrid individual cases that occurred:
https://www.theguardian.com/austral...-wont-be-bullied-by-pm-over-border-exemptions

But Taiwan's 'partnership' approach is best of all:
https://www.bloomberg.com/opinion/a...-the-best-model-for-coronavirus-data-tracking

IMHO the lessons we should be learning is do the basics right and the rest will follow. But there can be no slip ups, and everything, down to the last detail, must be meticulously planned. To be blunt our public service here in Aus is simply not up to it, and to add insult to injury they all got a 2% pay rise. I do not know about other countries but I suspect it was similar to Aus - the bureaucrats and associated bureaucracy were simply not up to it.

Bottom line - IMHO the 'science' of the video is of dubious value due to cherry picking and not examining how countries that did really well accomplished it.

Also I must mention, although not as yet passing appropriate trials, much more use should be made of treatments we know are safe, and perfectly legal as off-label prescriptions, because we really have nothing to loose. Those treatments are as a prophylactic (from Dr Zev Zelenco whose protocol has been adopted by a number of countries) Querectin 500mg, Vitamin C 500mg, Zinc 25mg daily - all very safe and readily available OTC. He also recommends a HCQ protocol which GP's have prescribed for years here in Aus, and know when and when not to prescribe it. But after speaking to my Rheumatologist, even though it is only used for 5 days in normal doses of 400mg, I am not convinced of its total safety eg the contraindication if you have psoriasis. However, Ivermectin is very safe, and as is now slowly being prescribed in Aus by GP's under Professor Borody's supervision. He will only give out his protocol to doctors, but it is probably similar to Dr Zev's Ivermectin protocol - two 6 mg doses day one (that is all he uses and I checked its the normal dose for a 60kg person), and all days for 5 days, 50mg Zinc and 200mq Doxycycline. The 50 mg Zinc is the only concern as long term use of more than 40mg a day interferes with copper - but for 5 days is fine. Thats it.

Thanks
Bill
 
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  • #4,023
Vanadium 50 said:
Since this is a thread about reactions, one might ask if reactions intended to address the first peak are optimal to address the second.
There are too many conflicting opinions (even conflicting professional opinions) about reactions in general. But: maybe that second peak is different because of the reactions for the first one?
 
  • #4,024
Rive said:
But: maybe that second peak is different because of the reactions for the first one?

You mean maybe the past influences the future? Can't argue much with that. But that;s not very specific.
 
  • #4,025
Vanadium 50 said:
But that;s not very specific.
I guess any really specific answer would belong to a state/country: county: city, depending on the local response for the first wave/sight of the virus.

I feel quire helpless about this. Especially since for some countries the actual response is quite different than the enforced/required/kindly requested response (what brings us into the bottomless mud of the debate around the 'sweden model', for example).
 
  • #4,026
Vanadium 50 said:
Since this is a thread about reactions, one might ask if reactions intended to address the first peak are optimal to address the second. (I note in passing that the original objective of "flatten the curve" seems to have been achieved, which makes the question "so why are there still cases now" somewhat puzzling. That was the policy's intent, at least originally)

We need to learn what countries/places that did well got right. As I said before we need to get the basics right ie voluntary mask wearing, social distancing and hand washing, but strongly recommended. Do not interfere with doctors right to prescribe medication they have been using for years off label - we must trust our health professionals. Make sure all the bureaucrats are trained properly and there is proper coordination. And finally rather than lockdowns, border closures etc have a very good 'participatory' tracing system like Taiwan, and quarantine with proper support and checking. Plus ensuring we look after the elderly and vulnerable as a priority.

Thanks
Bill
 
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  • #4,027
My 2 cents, and I know this will upset a lot of people: If you really want to control the spread, mandatory N95 masks + mandatory quarantine + forced travel logging.

This is how it is done in China and Korea. This is how partially it was done in New Zealand.

This is not going to be possible in most western liberal democracies because it would be viewed as a fundamental infringement on human rights. The idea of a liberal democracy is to have hedgers, checks and balances so the "winner takes all" situation doesn't happen.
 
  • #4,028
bhobba said:
We need to learn what countries/places that did well got right.

Well...

This is the data from New York State, said to be a success story that we all should strive to emulate:

1600096814848.png

The success is that they avoided a second bump (dashed lines are national), but at a cost of making the first bump 5x larger.

(Further, there are only a few states with two bumps. Most of the "second bump" are in places experiencing their first wave, only later. Louisiana is an example of a state with two bumps. Alabama one with one. To a good degree, the 2nd bump are not drawn from the same population as the first)
 
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  • #4,029
bhobba said:
We need to learn what countries/places that did well got right.
Does anyone knows how much is in control of human behavior and how much is due to variables outside of human control?

Is it possible that some regions are just "lucky" and the Coronavirus is just easier to get rid of, and/or some are "unlucky" and it spreads much much faster, maybe even more virulent? Are we able to identify and take these environmental effects into considerations?
 
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  • #4,030
jack action said:
Is it possible that some regions are just "lucky"

This is not too far away from "Corona is punishment from the gods. We must do what our priests ask in order to redeem favor with them!".

Presumably the time of onset is related to the time of first infection, and the rate of spread and number of new infections is related to the number of people the infected interact with and the probability these interactions result in new infections. When integrating this over millions of people, the effect of an individual's "luck" is minimal.
 
  • #4,031
Vanadium 50 said:
This is the data from New York State, said to be a success story that we all should strive to emulate:
Said by whom?
Vanadium 50 said:
When integrating this over millions of people, the effect of an individual's "luck" is minimal.
Environmental effects are not individual events, they can consistently impact the distribution. A population that lives very spread out for example would make that region "lucky" in the context of the question asked.
If different strains have slightly different spreading speed then the local distribution can have a long-lasting impact, too.
 
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  • #4,032
mfb said:
Said by whom?

The governor of the state in question.
Valerie Jarrett.
The Washington Post's Jennifer Rubin.
ABC News.
Harvard Global Health Institute.

mfb said:
A population that lives very spread out for example would make that region "lucky" in the context of the question asked.

I wouldn't call this luck. I would say you have deterministic factors like population density, and you have random factors that affect individuals, but statistically they average out.
 
  • #4,033
Vanadium 50 said:
but statistically they average out.
Even from region to region? What about environmental factor such as temperature, humidity and the like? Could there be groups that are more resistant or resilient than others? Got any sources for the effect of those deterministic factors?
 
  • #4,034
jack action said:
What about environmental factor such as temperature, humidity and the like?

Sure, but to have a big effect would imply that most transmission is outdoors. I don't think that's the case.

jack action said:
Could there be groups that are more resistant or resilient than others?

We know Covid hits African-Americans harderl https://www.cdc.gov/coronavirus/201.../hospitalization-death-by-race-ethnicity.html

jack action said:
Got any sources for the effect of those deterministic factors?

Upthread I showed some correlations with population density.

I would call none of these factors "luck".
 
  • #4,036
mfb said:
More often at least - but if they go to a hospital, they are less likely to die. The cases vs. hospitalization rate could come from a difference in testing.
Good chance; in the US the cities are higher black proportion than the national average and the suburbs lower. That can lead to differences in the spread of the virus, but it also definitely shows up in the testing patterns. In my area of PA, for example, my county (9% black) adjacent to Philadelphia (44% black) had a 20% peak positivity rate vs 10% in Philadelphia, but Philadelphia had 50% more cases per 100,000. Clearly that tells us that testing was more concentrated in the city and more cases were missed in the suburbs.

...though watching/reading the news you'd get the impression that the situation was reversed.
 
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  • #4,037
Moderna Shares the Blueprint for Its Coronavirus Vaccine Trial
The irony of vaccine trials: To test the efficacy they need people to get sick (in the control group at least). The more wide-spread the disease is the faster we might get an approved vaccine. If it's 60% efficient as they hope then they need 150 cases spread over both groups (15,000 per group, later a bit more). If it is more efficient then smaller samples can be sufficient.
The first analysis is scheduled for November, followed by one that's probably end of December; a final one might come in May. Each time the study gets more sensitive.
Good chance to have a proven efficacy, a good safety record and enough doses for large-scale vaccination mid 2021.
 
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  • #4,038
I posted something to this effect on my Facebook page way back on June 25th.

Study the role of hubris in nations’ COVID-19 response

I probably came to the conclusion that hubris was a big factor, as by that time, New York City was the world leader in Covid deaths, and a blurb in the Urban Dictionary said; "When I was in the Bronx I got mugged, shot, raped, and murdered in a New York Minute."
Along with everything I've ever seen about NYC characterizing the populous as "tough".

In any event, I'm guessing there's some hubris involved with the following graph.

DPM.Screen Shot 2020-09-20 at 4.58.10 PM.png
 
  • #4,039
Sorry, could not resist:

covid.png
 
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  • #4,040
OmCheeto said:
In any event, I'm guessing there's some hubris involved with the following graph.

How exactly? That the US is below most nations tsk tsking at it? True, but not crazy when you account for a) population density, and b) the fact that the US is big enough to have both early and late outbreaks.

If you split the US into NY, NJ, CT, MA and everybody else, you get a very different story - one line is flat and well above Belgium, and the other line has the same slope (it has to, since the upper line is fairly flat) but is translated lower.
 
  • #4,041
Shouldn't it have a higher slope? Roughly the same rate of deaths but a smaller population in the denominator.
 
  • #4,042
I guess so, but it's only about one eighth the population.
 
  • #4,043
mfb said:
Sorry, could not resist:

Well - what do you expect when your country is headed by someone with a doctorate in Quantum Chemistry. It makes perfect sense. Australia has 34 deaths per million and we are headed by a guy with a degree in economic geography so I suppose out goes that theory. We would be way better if it wasn't for the bungling of some of our public servants whose butt covering is a wonder to behold - they have it down to a fine art form:
https://www.abc.net.au/news/2020-09...tel-quarantine-a-quagmire-no-answers/12678624

Now if only it can somehow be morphed into taking positive action against this virus - but somehow I think it may remain one of those things forever just beyond our grasp.

Thanks
Bill
 
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  • #4,045
Today, the state of Pennsylvania released a digital contact tracing app, base on the Apple/Google platform:
https://www.pa.gov/covid/covid-alert-pa/

In case anyone is unware, today is September 22.
 
  • #4,046
russ_watters said:
Today, the state of Pennsylvania released a digital contact tracing app, base on the Apple/Google platform:
https://www.pa.gov/covid/covid-alert-pa/
To be precise, it's an exposure notification app, not a contact tracing app. Traditional contact tracing is still required.

North Dakota has developed a pair of apps. One is an exposure notification app. The other is a location logging app, and a user who tests positive can choose to provide this data to contact tracers.
 
  • #4,047
vela said:
To be precise, it's an exposure notification app, not a contact tracing app. Traditional contact tracing is still required.

North Dakota has developed a pair of apps. One is an exposure notification app. The other is a location logging app, and a user who tests positive can choose to provide this data to contact tracers.
Yes, you are correct -- the app provides notification, but its ability to assist in contact tracing is thin at best (despite the headline I let dupe me...).
 
  • #4,048
It could help contact tracing quite a bit if many people use the app:
The app detects if users are in close contact with another app user, using Bluetooth Low Energy (BLE) technology. It is the same technology that your phone uses to connect to wireless headphones or your car.
It still has the problems discussed a while ago, of course: Can it give a reasonable set of contacts without spamming contact tracers with everyone who visited the same mall at the same time?
 
  • #4,049
Could an exposure notification quantify the virus lode . Then that leads to a commentary in the New England Journal Of Medicine that mask wearing could lower the exposure dose resulting in a less severe mild/asymptomatic infection. Eg that masks allow just enough entry of the virus to prime the immune system.
They support this with some case histories.
 
  • #4,050
mfb said:
It could help contact tracing quite a bit if many people use the app.
Apparently, many health authorities didn't have the resources and expertise to build and maintain an app, so Apple and Google have developed a simpler system. With iOS 13.7 and later, as long as your local health authority supports it, all you have to do is enable the feature on the phone. I'm not sure how Google is implementing the system on Android.

It still has the problems discussed a while ago, of course: Can it give a reasonable set of contacts without spamming contact tracers with everyone who visited the same mall at the same time?
The phones only exchange tokens if they're in proximity to each other for 15 minutes or more, so just walking by a person who laters reports being infected isn't going to result in a notification.

My iPhone is able to determine when I'm within a few feet of a device as opposed to just being in the same room, which suggests that it should be good about deciding if another phone is close enough to qualify as a possible exposure.
 

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