We are now isolating ourselves, at least the non-MAGA portion of the population. The numbers of cases of Covid-19 – and deaths – are mounting. What can we expect? What happens next?
Lots of us are wondering what comes next in the SARS-CoV-2 pandemic. We already have an indication in New York City. At the same time, many states and countries are instituting lockdown measures that should decrease the numbers of sick and dead. I’ll use the Imperial College paper to discuss what is likely to come next.
A few words first about the Imperial College model, and models in general.
Neil Ferguson, one of the modeling team, testified to Parliament that he was becoming “reasonably confident” that the UK would be able to handle the peak of the epidemic in two or three weeks, with a death toll unlikely to exceed 20,000. This is being spun among those who want to send the US back to work as an indication that the model is wrong. IT IS NOT. What Ferguson is saying is that the UK is now taking measures to change the worst-case modeling scenario. THAT’S THE PURPOSE OF MODELING – to work out possibilities and recommend a path forward.
The Imperial College paper modeled the spread of the virus uncontrolled, and then investigated the effect of social distancing measures. The conclusion was that all the measures studied were required to suppress the growth of COVID-19 cases and avoid overloading the hospital system. I summarized that part of it in my earlier post.
Because the SARS-CoV-2 virus is new to the human race, nobody had immunity to it when it was first introduced. It can spread with no barriers to every human on the planet. As people are infected and recover, they become immune to the virus and cannot become ill from it again. It’s not clear how long that immunity lasts, but if it is even for a few months, it will slow down the spread of the virus.
Social distancing measures also slow down the spread of the virus, but they don’t confer immunity, leaving enough of the population susceptible to the virus that, when the distancing measures are lifted, the virus can spread again. The more successful the distancing measures are, the fewer people will become immune, and thus, the larger the secondary peak. The secondary peak can be controlled by reimposing distancing measures. A target might be set, and a series of secondary peaks at levels that will not break the hospital system would result (Figure 4 of the Imperial College paper).
As a modeling projection goes further into the future, its results become less reliable. This is partly because of uncertainties in the parameters, but it is also because we are taking measures to control the spread of the disease. Distancing helps. If we can make testing general for both the virus itself and for immunity to it, that will change things significantly.
There are several things we don’t know that make a difference in how things will play out. We have some idea about them, but as we learn more, the model predictions may change.
How long do people spread the virus?
How many people are infected by the virus and never show any symptoms but become immune? This is important because the more people become immune this way, the lower the peaks in the model and the faster they die out. When enough people are immune, the virus cannot propagate. That’s herd immunity. We don’t know what percent of the population must be immune to establish herd immunity.
What kind of immunity do people develop after having the virus? How long does it last. Is it a strong immunity, or do some people remain susceptible to reinfection?
Does the virus becomes less infective during the summer? If it does, infections could decrease but peak again in the fall and winter. Or the virus could weaken to cause a less dangerous disease. That’s not unknown in pandemics.
The single biggest factor in filling in what we don’t know now is testing. Test people with symptoms. Test people without symptoms. Test adults. Test children. Test people near the people with symptoms. Test medical workers, them especially. Tracking cases to determine who should be quarantined.
A new test promises results within five minutes. That is a test for the virus itself. We also need serology tests, to determine if people are immune to the virus.
Testing will give individuals and their medical support more information about their next actions. It will also provide information about the course of the disease and information that can be used in modeling.
We are buying time with the measures we are taking now. We can’t shut down the economy for long, and Trump and his admirers are already pressing to open things up again. Some of them are ignoring distancing now.
The answer, eventually, will be a vaccine. Several groups are working on vaccines, and one clinical trial is in progress. Eighteen months is commonly cited as the time period, but it could take longer. We don’t know.
Cross-posted to Nuclear Diner
trollhattan
Thanks Cheryl. As the pandemic unfolds and more data are gathered, it’s hard to keep up with just the changes in the “what we know” lists.
The Abbott Labs 5 to 15 minute virus test, if it can be produced and distributed quicky, can radically alter the landscape, as can the supposed in-home antibody test.
NotMax
Ideally, two rounds of testing, 14 days apart.
And tracking.
dmsilev
Here’s a mordant thought. In normal years, roughly 4 million Americans die. That’s from all causes, cancer, car accidents, Florida Man incidents, everything. That’s about 12,000 or so people a day. Within the next couple of days, COVID-19 will be accounting for about 1/10th of the daily death rate in the country. In about a week and a half, if the curve doesn’t flatten, it will be equalling all other causes of death combined.
Cheryl Rofer
@NotMax: Testing everyone, all the time. Testing people again as necessary.
And, yes, tracking. I think I’ll add that in, because it’s important. I was focusing on the models and individuals.
SFBayAreaGal
I used to work for a bio-tech firm. The clinical trials I worked on usually took around 18 months
dmsilev
@SFBayAreaGal: If you cut every corner that reasonably or plausibly could be cut, etc., how much faster could things get? A year?
That’s of course putting aside the time needed to produce a few hundred million doses of a vaccine even after one is developed tested and approved.
Cheryl Rofer
@SFBayAreaGal: Yes. And not all recent vaccines have been successful. There’s no way to know until you do the clinical trials.
NotMax
@Cheryl Rofer
Three T’s.
Testing, Tracking, Treatment.
Cheryl Rofer
@NotMax: Treatment is important to keep people alive, not so much for the spread of the epidemic. We need to develop it, but it’s not my focus in this post.
NotMax
@Cheryl Rofer
Catchy slogan, though.
Beats the hell out of Duck and Cover.
;)
trollhattan
@dmsilev:
Interesting point. And one unintended positive consequence should be a plunge in vehicle-related death and injury, something akin to the observed jump in air quality in metro areas.
Martin
I’m concerned with the difficulty nations with very good public health responses and tracking are having. Hong Kong went back into lockdown this week after hitting their highest daily new infection count. China had to completely close their borders. Singapore is struggling to keep their cases in check. Japan is about to tip.
I’m trusting that US/Italy style lockdowns are bending the infection rate into contraction, but I’m worried that these western approaches are so porous and uncoordinated that we won’t be able to truly get in front of this until we develop some new society-wide mechanisms. This may necessitate the equivalent of a national EHR, a national ID, etc.
Given the complete lack of a federal response, initiating 50 state level quarantines and letting 50 solutions blossom might be our best option long term.
But I don’t think this will look like a gaussian function. I think we have already determined that a slow fatality burn is acceptable and will ping-pong continuously from open/closed every few weeks because of quarantine fatigue and a lack of end-stage strategies.
I think we may have a significant degree of herd immunity before the vaccine arrives. NYC is already just shy of 1% of the population confirmed, suggesting the real number is 5%-10%.
Trumps quarantine stunt and his rating tweet has really undermined my optimism today.
Jehrler
Good news on the serological front. Big med distributor says will have 200,000+ tests by March 31 and ramping up from there in April. 15 minute result, blood prick, no need for instruments. http://investor.henryschein.com/news-releases/news-release-details/henry-schein-announces-availability-coronavirus-2019-covid-19
NotMax
@dmsilev
Florida Man will need to up his game.
//
Martin
@Cheryl Rofer: I think they will cut corners on the trials. Maybe not much in the US, but probably in some other countries.
I have no idea how we manufacture 300 million doses with a president who has time and again failed to grasp that manufacturing needs to ramp, and you need to start ordering equipment now for a vaccine that will go into production even in 12 months. And vaccines are hard to make, and don’t scale well.
germy
Elizabelle
Interesting article in the The Atlantic yesterday. (Not paywalled, cuz coronavirus-related.) Another reason for testing, testing, testing. Find the donors.
America Needs Plasma From COVID-19 Survivors Now
“People who have recovered from the disease have antibodies that might help those still suffering from it.”
[very recently] …. the Food and Drug Administration began allowing doctors to use plasma, the yellow fluid in which blood cells are suspended, as a Hail Mary to treat very ill COVID-19 patients. The idea of using plasma from survivors, also known as convalescent-plasma therapy, dates back to the late 19th century. Doctors have transfused the blood of recovered patients into those still sick with the 1918 flu, measles, polio, chickenpox, SARS, and Ebola—to varying degrees of success. Given the dearth of treatments for COVID-19, convalescent plasma has gained new prominence. The blood of survivors, the thinking goes, contains proteins called antibodies that can neutralize the coronavirus. Early data from very small numbers of COVID-19 patients in China show some promise. But the first hurdle is finding the recovered patients who can give plasma.
The way to do this at scale is a national network that connects donors, patients, and their doctors. Such an effort began in late February, when Arturo Casadevall, an immunologist at Johns Hopkins, published an op-ed in The Wall Street Journal suggesting the use of convalescent plasma for COVID-19. He started connecting interested doctors, virologists, immunologists, and blood-banking experts, who all came together to launch the National COVID-19 Convalescent Plasma Project.
The movement has gained traction. This week, New York announced that it would be the first state to try convalescent-plasma therapy, and the New York Blood Center, a major blood bank, began collecting plasma from people who have recovered from COVID-19.
…. A single plasma donation from a COVID-19 survivor could go to multiple patients.
And: NY has a potentially rich source of recovered donors, many from the Orthodox Jewish community which was locked down in New Rochelle.
But: still in early stages. Donors have to be matched for blood type, etc.
And: tests will focus on those with milder cases of COVID-19. It’s thought plasma is less useful once the disease is destroying major organs.
But a glimmer of hope. Trust science.
rikyrah
Thread
JoyceH
@rikyrah: The story that was the last straw for me was the one about Azar trying to warn Trump what was coming. After a lot of effort, he finally got onto Trump’s calendar and went to the White House to talk to Trump in person and really emphasize to him the seriousness of the situation. But after he’d talked for just a few minutes, Trump changed the subject. Wanted to talk about whether he should ban the sale of flavored vapes. Wouldn’t it be lovely to have a president who had a longer attention span than a gnat’s?
smintheus
I think Fauci’s estimate of 100,000 deaths in the US is too rosy for the upper limit of what is plausible. In fact I think it’s far too rosy. If half the population gets it, then we could count ourselves as lucky if there aren’t more than a million deaths … especially given the underlying condition we all have, named “Trump”.
germy
(NYTimes)
WereBear
For me it was when I learned the Pandemic Response team had been dismissed years ago.
They had no clue.
smintheus
@rikyrah: Have we finally seen Trump’s Katrina? My guess is the US media won’t even touch this story.
WereBear
@smintheus: every single day a red state keeps screwing around and not taking it seriously, doesn’t close businesses, makes people keep working, allows churches to stay open… I know they won’t be on the rosy end of the modeling.
The Florida governor doesn’t even understand how this virus works.
Cheryl Rofer
@Martin:
I agree. My big worry is that the vaccines won’t do what we want them to. I’ve been following vaccine development via Science magazine, and there have been big surprises in the wrong direction a number of times over the past few years.
Oh man, THIS multiplied by 100 for test kits, ventilators, face masks, PPE, potential treatments, and probably more I haven’t thought of. Logistics should have been a part of the planning all along, but none of that crew in Washington understands that you actually have to acquire material and process it to make things.
Kent
Some perspective:
Total number of US combat deaths in all American wars from 1776 to the present day: 666,441
Total US non-combat war deaths from all American wars (mostly disease epidemics during the Civil War): 673,929
https://en.wikipedia.org/wiki/United_States_military_casualties_of_war
JoyceH
@smintheus: I don’t know – so far today I’ve seen this go from Twitter to the blogs. I think it will be in the media pretty soon. Because it’s not a matter of opinion, there’s the State Department press release about it as large as life. And when I first saw something about sending our PPE to China, it was a real jolt. I don’t think I’m the only person who will have that reaction.
smintheus
@WereBear: The fundigelicals will want to make a show of curing it away by laying on of hands.
Cheryl Rofer
@Elizabelle: This is one possible treatment, which may or may not work. I hate, hate, hate the journalists who publish this stuff like it’s THE ANSWER.
It’s the kind of treatment that has worked for other diseases, but it needs testing and may not work out. Keep that in mind every time one of these articles surfaces.
Chetan Murthy
Regarding vaccines, I think we need to be cautious in our expectations. I remember reading about some SARS-CoV-1 (for first SARS virus) vaccines that caused lung pathology in rats when they were exposed to the SARS virus itself. It’s tricky to do this work, and we can’t expect that they’ll get it right in 18mo.
Our only hope right now is testing/tracing/quarantine.
Cheryl Rofer
@germy: Got a link?
Chyron HR
@rikyrah:
“It wasn’t a donation, they paid me for it!” – Donald John Trump, probably
randy khan
The more I read about countries with relatively flat curves, the more I am inclined to think that testing is the key.
smintheus
@JoyceH: I hope for our sake you’re right. But I watch Trump daily on TV commiting high crimes, extorting Democratic governors and proudly declaring that he’ll refuse them federal aid, and I look in vain for the journalists who are demanding to know why he isn’t being impeached.
Another Scott
Yeah, what a loooser.
(sigh)
Cheers,
Scott.
smintheus
@Chetan Murthy: Plus even if the vaccine is good and free of danger, there will a lot of slow adopters. My parents said they thought looooonnnngggg and hard before deciding to have my oldest brother vaccinated for polio during the first year when it was released.
The Moar You Know
Sadly, at the moment there is zero proof of this assertion. I hope it’s true. I pray it is true. But there is not one bit of evidence to show that is, in fact, true.
There is evidence to prove that the human immune system produces antibodies after an infection with SARS-2, but that is not remotely the same thing as proof of immunity.
cain
I was imagining what would happen if Obama was in charge and tried to do a 50 state federal response. All the red state will use that as an excuse to repudiate him and tell their people to do whatever their want. If he were to bring in the army it would be that shit show that happened just for doing mock exercise.. spark a complete civil war with asshats out with guns..
I imagine a similar situation when a Dem president is in charge next year.
germy
@Cheryl Rofer: yes:
https://www.nytimes.com/2020/03/28/us/coronavirus-data-privacy.html?action=click&module=Spotlight&pgtype=Homepage
cain
@Martin:
He will do what he is doing now, tell people it’s coming, or are already coming. He will lie his way.. but he won’t be around when this comes out anyways.
Eunicecycle
The governor of Ohio has just announced that Battelle Institute in Columbus has come up with a way to treat PPE so it can be reused. They will be capable of treating up to 80,000 pieces a day. It is now waiting for FDA approval which is supposed to be fast-tracked. I’m sure others will come up with similar processes. I know it isn’t enough but it could help.
Raoul
In between testing an vaccine is also treatment. Ventilators, obviously, to hopefully reduce mortality. But might we also be able to quickly develop pharmaceutical (and other?) interventions?
No, I’m not hucking a Rudy-Donny do this off-lable use of a drug thing. But if trials show efficacies, just being able to shift some percent more ppl to home recuperating would help.
And from stories of ‘mild’ sufferers, shortening and or lessening severity would be very welcome while we all wait the agonizing vaccine development period.
Another Scott
Thanks again, Cheryl.
Perhaps this is a silly question, but I hope someone can answer it for me.
CDC:
(Emphasis added.)
Does “asymptomatic” mean that none of those symptoms are present? (The list of symptoms is hugely broad.) What’s he difference between “asymptomatic” and “sub-clinical”? (I assume sub-clinical means they couldn’t detect it above whatever the detection limit is?)
Thanks.
Cheers,
Scott.
Cheryl Rofer
@germy: Thanks!
Kelly
@dmsilev:
2018 us deaths CDC 2,839,205
https://www.cdc.gov/nchs/products/databriefs/db355.htm
So we’re closer to that milestone
Cheryl Rofer
@The Moar You Know: There actually is supporting evidence, which is getting stronger. I don’t have a link at my fingertips, but it’s pretty clear that there is some immunity. Not clear whether everyone gets it or how long it lasts, though.
cain
@Another Scott:
I noticed that I have one of the symptoms which is chest pains. I also been traveling and exposed to a lot of people because of conferences.
I couldn’t get a test because it was reserved for people who have real symptoms. But the nurse said that I should absolutely be tested to see if I am a carrier. Instead, I am staying away from people and isolating myself.
Raoul
@dmsilev: One of the ideas being put forward was to start making vaccine in quantity once it shows promise of results, but before safety and duration of immunity testing is complete, as I think that’s the longish part.
Could be for more than one vaccine, possibly. It would have to be publicly funded, with the understanding of destroying the damn (huge) batch if the trial ultimately fails. But it would speed distribution if the trials succeed.
Others here may have a knowledge base to say if that’s a good, bad or neutral idea.
Cheryl Rofer
@Another Scott: “Asymptomatic,” as I understand it, means none of those symptoms. Not sure about “subclinical.”
Martin
@Cheryl Rofer: When we recognized that China was in some shit and we sent them our reserves (a decision I support by the way – China was in some shit) we should have had a national effort on production and procurement that day. Even if you thought the US wouldn’t be affected, it was a national strategic advantage to fill the void of China’s shut down manufacturing. And if you did need it, you now had your own supply.
There was no reason to not do, and yet we didn’t do it. Fuck, even if you want to do evil and trade medical supplies for tariff concessions, you do it.
Cheryl Rofer
@Martin: I’m seeing people on Twitter asking what Trump got for that donation of supplies, since he is not a man whose altruism runneth over.
And I totally agree it was the right thing to do. The mistake was, as you say, not ramping up production the same day.
Buckeye
@Eunicecycle:
DeWine had to call Trump after the FDA initially refused the larger amount:
This conversation came just hours after Governor Mike DeWine and Lt. Governor Jon Husted expressed “deep disappointment” in the FDA’s decision to limit the use of new technology to sterilize desperately-needed surgical masks in Ohio.
According to the governor, the FDA has authorized Columbus-based company Battelle to sterilize 10,000 surgical masks in Ohio each day.
However, the company has the ability to sterilize up to 160,000 masks per day in Ohio alone.
The Governor’s Office says this prevents Batelle from being able to send its “groundbreaking technology” to other areas impacted by the coronavirus, such as New York.
“The FDA’s decision to severely limit the use of this life-saving technology is nothing short of reckless,” said Governor DeWine. “Battelle’s innovative technology has the capability to protect healthcare professionals and first responders in Ohio and across the country, but in this time of crisis, the FDA has decided not to support those who are risking their lives to save others. This is a matter of life and death. I am not only disappointed by this development, but I’m also stunned that the FDA would decline to do all it can to protect this country’s frontline workers in this serious time of need.”
https://www.wdtn.com/news/ohio/trump-working-with-ohio-gov-to-get-fda-approval-on-expansion-of-mask-sterilization-technology/
I’ve detested DeWine for decades, but he’s actually done a pretty good job with this.
NotMax
@Martin
This. Sending in time of immediate need and not initiating restocking was, if not criminal, a reasonable facsimile thereto.
Elizabelle
@The Moar You Know: How is Mrs. Moar doing? Hope she is feeling much better.
Chetan Murthy
@Buckeye: WTF? Why is the FDA dragging their feet on this? And on so many other things? Is there something going on there that hasn’t been widely-reported?
If the choice is between re-sterilized PPE and fucking masks made from t-shirts ……
japa21
@Martin: Since you are here, I have a question.
There is a lot of reporting that Chicago will become a major hot spot in a couple weeks. The Corps of Engineers is turning McCormick place into a Covid only hospital. Yet Illinois has been on a major lockdown for just over a week and Chicago has even been closing walking trails and the beaches.
Are they figuring 3 weeks post start of lockdown?
Goku (aka Amerikan Baka)
@Buckeye:
Still has to blame “the FDA” and not, y’know, Trump who’s ultimately in charge of the FDA and if he’d been following this closely or been notified, could have intervened sooner or prevented this entirely
But DeWine had a good call with Trump! He’ll get right on fixing this! Just like he invoked the DPA and one of the Navy hospital ships was in New York Harbor two weeks ago
Mary G
This, as the kids say.
As somebody with a ridiculous number of possible comorbidities, the main reason I go into a WASF funk every four or five days is that I realize I won’t be able to go out for many, many months. Possibly even more than two years, if it turns out to be reinfective.
The way this is being handled in America, with Twitler and friends slow-walking testing because it’s required to be provided for free, so they have to figure out a way to make money off it, is making that uncertainty last much longer than it would if the DPA had been invoked when the first case popped up here.
If a portion of the $2 trillion we ended up spending had been dedicated to fast tracking tests, restocking the medical supply reserve, and research into all the factors Cheryl lists in January, we would be making progress into finding at least tentative answers to all the questions.
Now every time I see Twitler preening in front of a hospital ship, Gavin Newsom talking about receiving 172 broken ventilators, or Dr. Brix lavishing praise on the moron’s intellectual capacity, I want to scream.
joel hanes
@JoyceH:
But after [Azar had] talked for just a few minutes, Trump changed the subject.
Of course he did. Nothing Azar was saying mentioned anything that might make Trump “look good”, improve his “ratings”, or make him money, so Trump had no interest.
He was interested in talking about flavored vapes because it had occurred to him that banning them might make him “look good”.
trollhattan
@WereBear:
Working title for my history of the Trump administration.
Goku (aka Amerikan Baka)
@trollhattan:
I prefer, Trump Lied, People Died myself
Eunicecycle
@Buckeye: Yes I am not a fan either, but he has listened to Dr. Acton and made decisions based on science. He felt that the FDA would approve the process today or tomorrow at the latest.
Enhanced Voting Techniques
Speaking of MAGA land…
https://www.sfchronicle.com/bayarea/article/Coronavirus-live-updates-news-bay-area-15151165.php
WereBear
@trollhattan: Got me thinking:
Six Crises… a day!
Team of Morons
Profiles in Incompetence
Martin
@japa21: Probably.
It’s not really that these places are ‘becoming hotspots’. They either were hotspots and we didn’t recognize it, or they they are merely trying to raise the alarm that a lot of those people who got infected a week+ ago are about to descend on hospitals.
Semantics, but a lot of people see the rising cases and think things are getting out of hand, but really, they were out of hand and the lockdown got them in hand, and no you gotta wait to reap those benefits.
trollhattan
Local retro rock station playing The Mothers’ “Trouble Every Day.” Wow, does that ever fit in 2020, even before considering it was released 1966.
Another Scott
(Commenting on reports that “nearly a dozen” Liberty U students have symptoms consistent with COVID-19.)
NobodyEverybody could have predicted.Cheers,
Scott.
Goku (aka Amerikan Baka)
@Martin:
I think a lot red state governors are going to look really bad in a week or so. The Alabama governor who has refused to issue a stay-at-home order is in a high-risk category herself
WereBear
@Enhanced Voting Techniques: Lemmings! Racing for the cliff!
I am just all out of tolerance, I swear.
Kelly
Former FDA commissioner Scott Gottlieb links to a site that tracks people on the Fort Lauderdale beach spring break back to their homes. TLDR folks left Ft L and scattered from Texas to the Great Lakes to Maine
https://twitter.com/ScottGottliebMD/status/1244335110163439617
WereBear
I am sure, she’s sure, she will get a ventilator if she needs one.
danielx
Boredom baking.
Cheryl Rofer
@The Moar You Know: Here’s a link on immunity.
cain
@Chetan Murthy:
Yes, quid pro quo – gotta kiss the president’s ass if you want the FDA or any of the other fedral govt departments to do anything for you. Favors, that kind of thing.
Robert Sneddon
@Buckeye: “Refreshing” contaminated PPE that’s manufactured to be disposable after a single use is problematic. If I was running the FDA (and I’m not but still…) I’d be extremely leery of this kind of process, especially if it was ramped up from lab-bench demonstration to production without a lot of inspection and verification being integrated into the process.
Worst case, contaminated PPE slips through the process and gets sent out to hospitals where it infects health workers and patients using it because they were in a hurry.
NotMax
@WereBear
The Gang That Couldn’t Govern Straight
Feckless Ignorami
Me! Me! Me!: A Phillipic
:)
cain
@Goku (aka Amerikan Baka):
All that is fine, I never had a fever, no shortness of breaths.. just sore muscles. (it is not heart related)
Goku (aka Amerikan Baka)
@WereBear:
Doesn’t guarantee she’ll survive, though. You can have the best medical equipment and staff in the world and it won’t make a lick of difference if you’re body is too weak or other complications set in
cain
@Enhanced Voting Techniques:
The hubris of church goers.. they think God is gonna protect them.
Elizabelle
@WereBear:
A Confederacy of Trumps
Gone with the Whinge
ziggy
Does anyone know what proportion of the population would need to be infected and recover, in order to have herd immunity? I suppose it is different for every virus. As infectious and widespread as this is, I suspect that the US will have herd immunity before a vaccine is available. We are, like Martin said, going to have to accept some level of deaths, some level of infections. I can’t see how we get the economy back without widespread testing ability , to determine who is safe to interact with people.
So we will be dealing with this for quite a while, one way or another, unless it mysteriously dies out. Ugh.
I’m hopeful that there is little virus spread with asymptotic illness, as some studies have shown. It does seem like the hotspots are around people who are very ill, such as in nursing homes. If there is widespread asymptomatic illness, we might get to herd immunity levels faster and with less pain and suffering.
WereBear
@NotMax: Oh, then we can jump to movies:
The Worst Man
Three Months in May
Mr. Snit Goes to Washington
Goku (aka Amerikan Baka)
@cain:
Good! Hope you get well
The Thin Black Duke
@WereBear: As comedian Ron White said, “You can’t fix stupid.”
Bill Arnold
@dmsilev:
Also note that the US is not the only player. There are players, e.g. China, that are pretty good at cutting corners and doing things recklessly quickly by US standards[1]. If they succeed, we all win.
[1] US standards are great, IMO. But maybe should be loosened for pandemic response.
WereBear
@Elizabelle: Love it :)
Barbara
@Buckeye: American health care providers throw most things away after a single use. Device manufacturers try to get their products approved as single use only — and there are serious risks of cross-contamination. But the luxury of being able to throw things away means that there has been very little research in how best to sterilize for reuse. This is one very small possible silver lining in an otherwise abominable situation.
NotMax
@WereBear
No Good, the Bad and the Ugly.
That’s Strife.
The Worst Years of Our Lives.
F*ck Soup.
:)
ziggy
@ziggy: looks like herd immunity levels are around 85%! That’s really high, higher than I would have thought. Hopefully there is a much lower level that can keep the disease in check along with heavy testing and case monitoring.
Elizabelle
@NotMax: This is fun. Sadly, no end to what we can come up with.
Kay (not the front-pager)
I’m having a little trouble suppressing tears at the moment, looking at that chart and realizing that with the with the successive waves of quarantining I may never see my son in Boston again. He and his wife were supposed to come down this Christmas. It’s pretty obvious that’s not going to happen. But what are the odds all of us will survive to when we can get together in person again? I hope I’m just having a melancholy Sunday but…
Barbara
@ziggy: The only benchmark I know of is measles, which requires 90% immunity to protect the rest of the herd. Chicken pox is pretty high too. My guess is somewhere between 60 and 70 percent.
Another Scott
@Robert Sneddon: Good points.
Also, as we all know, rubber and elastic loses its elasticity over time – especially in things meant to be disposable.
(Though I’m sure Battelle has thought about these issues. More is here. The system uses H2O2 vapor.)
Cheers,
Scott.
JPL
@Kay (not the front-pager): I’m right there with you but thinking about my grandson. We’re all in this together, and I have to believe we will get through this.
Cermet
@Goku (aka Amerikan Baka): That is utterly wrong and is not true. Don’t post false information. That post needs to be deleted.
Goku (aka Amerikan Baka)
@Cermet:
It is? Do you have a source that says so? If it is false, I apologize and would like it deleted as well
Goku (aka Amerikan Baka)
One dangerous coronavirus ‘self-check test’ is circulating on social media. Here’s why you should avoid it.
Well, I won’t be giving that advice out anymore
ziggy
The thing I’m seeing about the models at that they are just a snapshot in time. There are only good for a very short period, long enough to do just a bit of planning and policy, then they need to be run again with new data inputs (as soon as they are available). So a model that was made even a couple of days ago is no good in this fast moving situation. The best models need to be revamped with new inputs as quickly as we can get them, like weather models. And like weather models, we need to learn from the mistakes that were made, the deviations from the model.
Cheryl Rofer
@ziggy: Herd immunity is related to R0, but I haven’t seen a simple relation. R0 for measles is 15, and herd immunity requires 95% immunized. If R0 for covid is 3, it’s going to be less than 95%, but I saw a curve last night that is pretty steep. I’d say 85 – 90%.
L85NJGT
@Cheryl Rofer:
subclinical:
Cheryl Rofer
@Cermet:
@Goku (aka Amerikan Baka):
I deleted it.
Cheryl Rofer
@ziggy: Models are a help to evaluating situations. They aren’t primarily predictive, although everyone always wants to know the future, so that’s how people tend to think of them. They do need to be updated, but they are often robust to changes in the inputs, so it’s not quite as frantic as your comment sounds.
Cheryl Rofer
@L85NJGT: Thanks. That’s useful.
ziggy
@Cheryl Rofer: I just don’t see how we are going to get through this without a lot of people getting Covid at some point. We can’t shut society down completely forever. Hopefully we can keep the most vulnerable safe. I hate to even write that, but that’s what I see unless something happens to slow transmission.
West of the Rockies
@Goku (aka Amerikan Baka):
Some very stupid people in red states will die. They will take some innocent people with them (people who DO appreciate science, who are trying to flatten the curve). I would think that intelligent people in red states are effectively protecting themselves, despite the Republican intransigence.
JPL
I was surprised that he was holding a briefing in the Rose Garden, because of the rain. Apparently he put down plywood. The tv was on mute, but that’s what it looked like.
WhatsMyNym
We are finally testing over 6,000 a day in Washington state. Positives are still less than 10% of the total tested, that is with very targeted criteria to be tested.
Bill Arnold
@Cheryl Rofer:
Thanks for that link. It references a rhesus macaque study – I hate (the ethics of) rhesus macaque studies but the N=4 experiment is moderately convincing.
Reinfection could not occur in SARS-CoV-2 infected rhesus macaques (March 14, 2020)
ziggy
@Kay (not the front-pager): I don’t know how old you are, or your son, but do remember that the vast majority of people do survive covid, and chances are very good that they will have immunity for quite some time. There may be treatments that are found to improve survivability quite a bit. Keep yourself safe, I’m sure you’ll find a way to meet up again before too long.
The Thin Black Duke
John Prine is in the hospital. Critical condition. I think we can guess what put him there. Damn it.
Enhanced Voting Techniques
Keep in mind at this rate Louisiana will pass New York in deaths in a week.
I suspect herd immunity won’t kick in until the majority of mega church growers have gotten ill and recovered.
James E Powell
I see on the twitter that Maria Mercader, a CBS news exec, died from coronavirus. I wonder if that’s close enough to home to shake the press/media loose from their fluffy coverage of Trump and his hired hands.
Sloane Ranger
Ironically the last talk our Social History group had before we went virtual was from a member who had been a nurse during the 1960’s. She said that when she started every ward had a side room with an autoclave and one of her jobs as a first year trainee was to sterilize all the medical instruments used. She said they had to do this several times a day, it was hard work and they were so grateful when single use items were introduced.
Perhaps, in retrospect, becoming totally reliant on single use was a mistake and we need to re-think our position on this.
Kay (not the front-pager)
@ziggy: I’ll be 70 this summer. I’ve got a couple of “pre-existing conditions” as they like to call them. I think the biggest one is, I’ll be 70 this summer.
My husband turned three quarters of a century just over a week ago, and I wonder if he’ll see another birthday. That’s not something I would have contemplated even 3 months ago. He’s extremely healthy outside of a couple of age-related, well-managed conditions that used to seem negligible. But they are the top 2 pre-existing conditions always mentioned as high risk. So our mortality, and regrets about hugs not given, are very real in a way that I wasn’t expecting quite yet.
trollhattan
@The Thin Black Duke:
I’m horrified at the thought of losing John Prine. He’s a cancer survivor and no doubt very threatened by this virus.
trollhattan
Turns out Vlad did not chase the virus back across the border riding his bear after it.
Daddio7
“We don’t know.”, finally people are admitting that. No one truly knows, it is turning out to be as bad as could be. Now all prevention methods will be tried, to hell with the economy. Funny that some governors pushed back against doing all that could be done because they thought it too much. Will they be right or wrong?
ziggy
@Kay (not the front-pager): You know what to do to stay safe and as healthy as possible. Even 75 year olds have a good chance of kicking the virus. Once there is widespread testing, your family should be able to visit you safely. I don’t have kids, but I have step-step grandkids, and not seeing them is hard, along with my older sisters and brother. But we will get through this, I’m sure of it.
Steeplejack (phone)
@danielx:
Looks good!
catclub
anybody else notice the curve for Spain in Kevin Drum’s Cv-19 graphs by country? It is a lot worse than Italy.
I worry that compared to germany, all those cheek kisses, and grandparents living with extended family, have accelerated the spread in Spain and Italy.
ruemara
Thank you, Cheryl. That really helps me understand the modeling.
Fair Economist
@Cheryl Rofer: To block transmission of an R0 3 virus, at most 1/3 of contacts can be susceptible, so theoretically 67% would have had to have had it. In practice a little less will do as long as people are being careful, as they are now.
debbie
@Buckeye:
Yes, he has. I wouldn’t vote for him at gunpoint, but he has shown remarkable fairness for a GOPer.
CarolPW
@The Thin Black Duke: Oh fuck. Fuck fuck fuck!
debbie
@Robert Sneddon:
It’s better than nothing. No one’s getting the supplies they need.
debbie
Bastard.
Cheryl Rofer
@ziggy: A lot of people will eventually get covid. The point is to keep from overwhelming hospital facilities. The combination of people getting it and becoming immune and, hopefully, a vaccine is what will eventually give us herd immunity.
L85NJGT
@debbie:
All projection, all the time.
finson
I live on Whidbey Island in Washington, fairly close to Coupeville and the hot spot developing there. I am caring for my wife with Alzheimers at home, so this is all fairly intense. We are doing pretty well so far, most of our caregivers are at home on paid leave, we are pretty well supplied with food, and I am wiping down those Amazon packages when they get here. So at least theoretically we are well protected.
However, I keep thinking about the people who cannot just stay home and completely self isolate like we can. Either they are first line responders like medical staff, or they are essential workers continuing to work in order to get us food and shelter, or they are people who not working but absolutely do not have the money to just take an unexpected, un-paid vacation. All of these people are under tremendous stress.
I would like to suggest that those of us who can afford the enforced idleness consider these people to be worthy recipients of whatever aid we can give personally. If in fact the federal government distributes checks to everyone, consider how important that money is to you.
If your reaction to the impending check is along the lines of “oh this is nice, but really, it’s kind of dinky compared to what I just spent on my new whatever” then please, think about donating that check to someone who really needs it. Even though you may not be aware of it, there are plenty of people in your life for whom $500, $1200, or whatever it is could mean that they and their kids could eat this week, or perhaps put gas in the car for another few weeks to get to that high risk job, or perhaps pay for shelter for them or their equally at risk parents, or whatever.
If you need the money, definitely use it without guilt, but if you can pass it along, please do so to a person in need as directly as you can.
Thanks.
bjacques
@debbie: yeah, then torching the hospitals for the insurance. But not on Trump’s watch. No sir, now that the Pentagon has plenty of ammo again.
Sister Rail Gun of Warm Humanitarianism
@Robert Sneddon: Duke has developed a similar setup with aerosolized H2O2. From what they’ve said, the biggest hurdle was finding a way to do it that didn’t distort the masks to the point where they couldn’t be used again.
They’re not prepared to operate on the same scale that Battelle is claiming, but every little bit helps.
Bill Arnold
@debbie:
Obviously projection, but I’m struggling to figure out how and why D.J.Trump is stealing and selling masks. Maybe it’s a metaphor and he’s COVID-19 profiteering in some more abstract way.
J R in WV
@Elizabelle:
I am pretty sure that plasma donors do not have to match recipients as to blood type, because all the fractions of whole blood that react as to blood type have been removed from the plasma.
My brother donated plasma weekly while dad was in treatment for his leukemia, which you can’t do if you donate whole blood, etc, etc…
Will look into this issue…
NotMyRealName
@Cheryl Rofer: Treatment can also keep people out of the hospital and keep hospitalized patients out of the ICU. In that way, it relieves stress on an overwhelmed system.