Pandemic threat? Anyone else concerned?

Frankenscript

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This was always and still is a balancing act between health of the individual and health of the country. I don’t know the answer, and there is no playbook. I’m damn glad I didn’t have to make the call and am fortunate to be close enough to retirement age with next to no debt to be able to ride it out better than some, not as well as others.
I agree with you on this more than anything else, ever...
 

sebastiantombs

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OK, so based on the numbers today, ~6 million infections and ~191 thousand deaths, that results in a death rate of ~3%. Now, if we extrapolate your "window", let's say just 10x the total infections, that means a death rate of ~.3%. Numbers can't lie. The big problem comes from the sheer numbers of people that need hospitalization if it's allowed to spread unchecked in any way. Of course the models have been wrong, again and again, so there is no way to be 100% certain.

It is hard not to be cynical when the goalposts move constantly and the specifics of "lock downs" are administered in arbitrary and capricious manners all over the place at the whim of politicians who haven't got a clue in the first place.
 

Jessie.slimer

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My my, sebastiantombs, aren't we cynical today? :)

Actually guys, this is something that is important to study and various initiatives are doing just that. Here is one of them, based in Indiana, which I've posted here before but will refresh your memories and highlight it for those that didn't see it before:


The initiative will collect data on active infections of randomly selected participants via PCR (which notably often remains positive for a week or more after being actively infectious) as well as data on past infection via antibody tests (which are getting better over time).

The study was designed to work in four waves. Data is available for the first wave, with sampling dates in late April, at the height of the first wave. You can dig through the data and reports, but here's the TL/DR for you. Based on the random sampling, in late April just shy of 3% of the Indiana population age >12 were considered to have had had COVID-19 infections, which was about 10x the number of documented cases in the state at that time. Of these infections, about 44% were asymptomatic. Overall IFR (infection death rate) of about 0.6%, which is ~6 times seasonal flu IFR for the whole population. Hopefully the next wave of data will be available soon; I think they did sampling again over the summer. Other studies I've heard of were in this 10x infections-to-cases ballpark.

OK, so, early on, when testing was hard to come by, 10X as many people had had infections as were documented as cases. So, you can use that as a high water mark. Tests are much easier to come by now (though, getting results in a useful time frame still often eludes us...) so it makes sense that as testing became more available, the ratio of infections to cases would have come down significantly, since pretty much anyone who gets a sniffle now is tested before they can return to work/school etc.. Of course since >40% of infections are asymptomatic, a lot of these people won't have reason to get tested. So the current minimum ratio between infections and cases is probably no lower than 6x. Let's split the difference and say as a rule of thumb, since the beginning of this thing, there have been 8x as many infections as cases.

Total cases in the US, per Worldometers today, is just shy of 6.6M. So, using our 8x multiplier, that suggests a ballpark of 53M Americans who had infections out of 331M. About 16%. Disagree with my figures or assumptions? How about a window "more than 10%, less than 20%" of Americans have been infected. For sure, the reality is somewhere in there.

Let's just say "less than 20%" for purposes of discussion. This is way too low to offer any significant herd immunity, but some sectors will break that trend: groups that were hard hit early on now have a fair amount of people with some degree of immunity working there... Critical point: meatpacking is working at good capacity and the bacon supply is plentiful. Repeat: bacon is plentiful.

However, natural immunity from coronavirus infections is believed to be fleeting. Sure, for a few months you're good. And after that you might get a less severe case due to lingering antibody protection, as long as you don't have a major risk factor going on (old, fat, cancer, heart disease). But this natural immunity tends to be much less powerful than vaccine-derived protection.

So we have been going on with this disease for 8 months and have less than a fifth of us infected. And the earliest infection are likely much less immune now than they were months ago... they could get it again, or at least will be vulnerable again soon enough. So Jessie is right, the virus is still there.

But getting infected isn't inevitable by any means. Mask up, minimize gatherings, work appropriately --like we're doing in Indiana for the most part--, minimize school density, and we can make it another 3-6 months to a vaccine. The only way we get to the other side is the vaccine. There are a bunch of them in the works, some using new technology and some with more tried and true methods, and I'm confident one or more of them will be ready for deployment in Q1 2021.

Recovered: As of today, 3.8M out of the 6.6M cases. Recovered is hard to measure as it's not always tracked, unlike deaths. However, something like 5-10% of COVID cases (cases, not infections) lead to lasting damage and problems (lung issues, clotting, heart issues). This is the great unremarked thing that's going on now. Lots of my doctor friends are strongly concerned about whether these impacts will be just for months, or permanent.
While I do appreciate your work on this, and have no doubt you are intelligent and well meaning (so please don't take it otherwise), all of this data you quoted is based on assumptions. How do you know how many people were tested/not tested? Can you link me to that statistic? A lot of assumptions are being built on shaky ground here. How can a reliable graph be made without known accurate data?

I have not been tested. My local family has not. I have been asking the hundreds of people I come in contact with, and short of a few, none of them have been either. How many here have been tested? See what I mean about making assumptions based on unknown data? Maybe 75% of these people have had it and are now immune, but were never tested because they had no symptoms, fought through it, or the test was simply not available to them.

How do you know that people do not build up immunity after recovering from the virus?

Also, how do you know that vaccine treatment is more reliable or longer lasting than herd immunity when a vaccine does not even exist?

It's nice to root for a speedy vaccine (I am too), but putting the world on lockdown waiting is just crazy. What is the fastest time to market for a vaccine to date? 4 years? Do we have vaccines for any other coronaviruses?

I, too, am glad I don't make the rules.
 

Frankenscript

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OK, so based on the numbers today, ~6 million infections and ~191 thousand deaths, that results in a death rate of ~3%. Now, if we extrapolate your "window", let's say just 10x the total infections, that means a death rate of ~.3%. Numbers can't lie. The big problem comes from the sheer numbers of people that need hospitalization if it's allowed to spread unchecked in any way. Of course the models have been wrong, again and again, so there is no way to be 100% certain.

It is hard not to be cynical when the goalposts move constantly and the specifics of "lock downs" are administered in arbitrary and capricious manners all over the place at the whim of politicians who haven't got a clue in the first place.
Six million CASES not infections.. will reply more later, about to donate blood.

Sent from my ONEPLUS A6013 using Tapatalk
 

sebastiantombs

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If a "case" is not someone who has been infected with CCP Virus, exactly what is it? Some "magic number" used to describe how many have showed symptoms, at least, or tested "positive" using one form of test or another, is what it would seem to imply which translates to people who are infected, at least to me. I guess the subtlety of medical nomenclature is lost on me, along with everyone else.
 

Armed&Overclocked

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If a "case" is not someone who has been infected with CCP Virus, exactly what is it? Some "magic number" used to describe how many have showed symptoms, at least, or tested "positive" using one form of test or another, is what it would seem to imply which translates to people who are infected, at least to me. I guess the subtlety of medical nomenclature is lost on me, along with everyone else.
my guess is cases = positive tests. but that's a guess based on what i've read from his other post(s)
 

sebastiantombs

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Given the overall "accuracy" of the tests in the first place any number can be somewhat to very questionable depending on which specific test is used not to mention the lab that analyzes for results.

I have been trying not to post in this thread because the whole thing is a circular argument although it's more of a spiral due to the moving goalposts. I think I'll just stop paying any attention to it at all.
 

Frankenscript

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OK, so based on the numbers today, ~6 million infections and ~191 thousand deaths, that results in a death rate of ~3%. Now, if we extrapolate your "window", let's say just 10x the total infections, that means a death rate of ~.3%. Numbers can't lie. The big problem comes from the sheer numbers of people that need hospitalization if it's allowed to spread unchecked in any way. Of course the models have been wrong, again and again, so there is no way to be 100% certain.

It is hard not to be cynical when the goalposts move constantly and the specifics of "lock downs" are administered in arbitrary and capricious manners all over the place at the whim of politicians who haven't got a clue in the first place.
If a "case" is not someone who has been infected with CCP Virus, exactly what is it? Some "magic number" used to describe how many have showed symptoms, at least, or tested "positive" using one form of test or another, is what it would seem to imply which translates to people who are infected, at least to me. I guess the subtlety of medical nomenclature is lost on me, along with everyone else.
Hi @sebastiantombs ,

The "infection versus case" thing is easy to get tripped up on. Let me clarify.

-An infection is just that: somewhere in the real world someone actually got infected with the virus. Maybe they get symptoms, maybe not. Maybe they get tested, maybe not. For this reason, it can be difficult to know how many infections there are, because most of them for COVID-19 at least are unreported.

-A case is a diagnosis of the disease. Cases can be thought of as primarily falling into three categories:
a) Most cases result from someone with symptoms who got tested and it was positive and there was a diagnosis of COVID. This is the biggest bucket now, so many months in.
b) someone with symptoms didn't get tested but was diagnosed anyway. This was common early on when tests were hard to come by. The symptoms of severe COVID-19 are pretty clear so when things were going to hell in March and tests were essentially unobtainium in many places, and wouldn't impact treatment anyway, plenty of people were diagnosed based on their symptoms.
c) A relatively very small number of people were tested for some reason other than symptoms and were positive, and thus diagnosed with the disease. So if a white house aid who feels fine is routinely tested once a week, and they come down with a positive test, and that leads to a diagnosis, that's a case.

So if you look at CFR "case fatality rate" that's the number of deaths divided by the number of diagnosed cases. For the US so far, just about 3%. Earlier on, it was around 6% but treatment has improved and the average age/health of people getting covid has trended in a favorable direction, so a smaller percentage of CASES (mostly, sick people getting tested) are dying now versus in April.

But what really matters is the infection death rate. "If I get infected by the virus, what are my chances?" We know for the typical influenza the IFR --infection fatality rate--is about 0.1%. We know this because of many years of data that include cases (sick people getting diagnosed) and random screens to show the prevalence of infection even when symptoms are not reported. I've participated in an influenza screening twice in my life (wasn't sick, but guy shows up at work taking voluntary samples of blood for influenza screening). So every year there is data about flu, cases and infections, and from cases come a few deaths, and we figure out the IFR for flu. About 0.1%.

To understand COVID-19 infection, studies like the one I referenced earlier are looking at populations of people and doing random COVID-19 screening to see who has either an active infection or traces of a prior infection. This gives us insight into how many infections there have been versus cases. Early on data from several places showed probably only around ~10% of infections turned into cases. In the late April sample, when CFR was around 6%, IFR was around 0.6%. It's believed now fewer infections escape detection now (hence my discussion above). CFR should come down over time as we identify a larger portion of total infections and turn them into cases; IFR will vary with the the population of people getting sick.
 

sebastiantombs

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So cases and diagnosis have no relationship to each other. Testing positive is not a case, but being diagnosed is. So how do they diagnose...with a test of course. All the typical "let's split the hair so thin it can't be seen anymore" bullshit. Pointless discussion of pointless, meaningless, statistics compiled by equally pointless and meaningless people and promulgated further by the same.

End of rant.
 

Frankenscript

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While I do appreciate your work on this, and have no doubt you are intelligent and well meaning (so please don't take it otherwise), all of this data you quoted is based on assumptions. How do you know how many people were tested/not tested? Can you link me to that statistic? A lot of assumptions are being built on shaky ground here. How can a reliable graph be made without known accurate data?

I have not been tested. My local family has not. I have been asking the hundreds of people I come in contact with, and short of a few, none of them have been either. How many here have been tested? See what I mean about making assumptions based on unknown data? Maybe 75% of these people have had it and are now immune, but were never tested because they had no symptoms, fought through it, or the test was simply not available to them.

How do you know that people do not build up immunity after recovering from the virus?

Also, how do you know that vaccine treatment is more reliable or longer lasting than herd immunity when a vaccine does not even exist?

It's nice to root for a speedy vaccine (I am too), but putting the world on lockdown waiting is just crazy. What is the fastest time to market for a vaccine to date? 4 years? Do we have vaccines for any other coronaviruses?

I, too, am glad I don't make the rules.
Hi Jessie, don't worry, I know you're not trying to insult me on this stuff.

Regarding your questions, if you are interested please review the publications at the IU/Fairbanks link I posted earlier.The study has been very transparent about their sampling methodology. Here is a full paper on it, analyzing the April data:


In short, >4600 people were randomly selected and tested for current or past infections. RAndom selection isn't perfect, but they made a solid attempt to get a representative sample. The tests aren't perfect but margin of error is small for the purpose used here. For example, PCR can still show positive even weeks after the infection is over, but that doesn't matter in this study because the question asked here is "how many of these people EVER had COVID-19?"

The result that infections outnumber cases by 10:1 is similar to results from tests done in San Francisco in the same time frame and I believe one in Boston. The Indiana study was hailed as being the first big study to randomly pick people across a whole state, not just in a city. Remember, this was a random screen... these people did not seek the test due to symptoms.

That's a point in time in April. Another wave has already tested but results are not released yet.

You asked a question I don't understand, maybe you can clarify:

Jessie said: "Maybe 75% of these people have had it and are now immune, but were never tested because they had no symptoms, fought through it, or the test was simply not available to them."

This is very unlikely, but I may misunderstand your question. Remember, lots of people from all walks of life get tested every day, mostly because they feel sick, right, and go to CVS, Walgreens, Hospital and get a test? And most states have a positivity rate <10% of these sick people. It's very unlikely that your local bubble (for lack of better word) that haven't been obviously sick and haven't been tested, are somehow all the result of asymptomatic spread and are asymptomatic themselves. Less than 50% of folks that get the infection are asymptomatic; lots of data shows this.

People certainly get some protection from going through the COVID-19 illness. What's questionable is how long the immunity will last, and how much protection it confers. Lots of studies are looking at this so we WILL have answers.

The vaccines are being tested now, and with 30,000 volunteers (approximately half the vaccine, half placebo), a safety and efficacy profile will build up for each vaccine tested. After all the data is collected and analyzed, it will be very clear if any of the vaccines work. I think most of them will work, actually, but I will wait until the safety review is done before I get in line. Early results from several vaccines show very strong immune response developed (by measuring anti-covid antibodies), far higher than in seen in people who recovered from the disease. Historically, this is a harbinger of an effective vaccine that lasts a long time.

This will be the first coronavirus-disease vaccine deployed. Vaccines against SARS were made and got through some phases of testing but weren't needed since the disease was contained.
 

Frankenscript

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So cases and diagnosis have no relationship to each other. Testing positive is not a case, but being diagnosed is. So how do they diagnose...with a test of course. All the typical "let's split the hair so thin it can't be seen anymore" bullshit. Pointless discussion of pointless, meaningless, statistics compiled by equally pointless and meaningless people and promulgated further by the same.

End of rant.
No, that's not what I said. Cases are diagnoses. Testing positive becomes a case when it leads to a diagnosis, which is most of the time. So, most positive tests lead to diagnoses; there are exceptions. Just because statistics aren't perfect doesn't mean they aren't valid and meaningful.

Let me make an analogy. I run a budget at my company; I'm responsible for managing spending for a department as one of my "and other duties as assigned" jobs. That's easy right? Spend some money, tally up the bills, square it with finance at the end of the month, right? All the numbers add up, right? WRONG! The numbers rarely add up perfectly. Invoices don't exactly match purchase orders, some projects get mis-assigned to the wrong budget by the originator, some invoices never arrive, and some payments go into a black hole for reasons I can't explain. They pop out 4 or 6 or 12 months later. But, 97+% of the dollars line up just fine, and that's enough for me to manage the budget.

It's the same way with testing and case counts and so on... medicine is complex. But as long as you don't split hairs, the numbers work fine. There will always be edge cases.
 

Arjun

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Billy says End of 202, Way to go Billy...

 

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Arjun

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bigredfish

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This has been proposed by many scientists since March. Some dont want to believe it and I think the Govt knows this beyond doubt and doesnt want it to start a war.

Why the MSM buries it I'm not sure. I suppose its because Trump mentioned it and he cant be allowed to be right about anything. Doesn't fit the agenda.
 

Arjun

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This has been proposed by many scientists since March. Some dont want to believe it and I think the Govt knows this beyond doubt and doesnt want it to start a war.

Why the MSM buries it I'm not sure.
Illegal animal trafficking. The UN is “UN”inspiring
 
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