Just a reminder. COVID is a nasty nasty virus as it has just enough lag on median phase changes that we simple, slightly evolved East African Plains Apes have challenges in intuitively getting cause and effect.
Let’s imagine that someone was not infected in the last minutes of the Trump Presidency but was infected sometime in the first few hours of the Biden administration.
We have a few scenarios and option trees. Let’s go with a simple one where the person is not part of a screening testing program and is not being quickly contact traced.
Day 0 (January 20) — infected
Day 2 (January 22) — infected and infectious and feeling fine.
Day 3 (January 23) — infected, infectious and feeling a bit off
Day 4 (January 24) — infected, infectious, feeling off and goes to get a test
Day 6 (January 26) — infected, infectious and the test comes back positive and the person enters isolation after talking with their primary care provider.
This is a 6 day lag between the actual infection moment and the confirmation of infection.
Day 11 (January 31) — infected, not infectious and feeling like crap.
Day 13 (February 2) PCP tells their patient to go to the hospital (7 day lag between identification and hospitalization; 13 day lag between infection and hospitalization)
Day 19 (February 8) — Patient has consistently low blood oxygen saturation even while proned and coagulation problems. Patient is moved to ICU 6 days after they are admitted to the hospital.
Day 23 (February 12) — Patient dies.
That is not a particularly unusual hypothetical timeline. Some people will be tested and get their results earlier or later. Others will never be tested as they felt fine and were minimally symptomatic. Some people will be admitted to the hospital and be out in a day or two. Others will be admitted straight to the ICU. There is a lot of variance.
But there are, on average, notable lags between infection, identification, hospitalization and death.
Anything we do today will show up in next week’s infection counts and next months mortality data.
On The Road – Lapassionara – Paris, Paris
Scamp Dog
Do you read Brad Delong’s blog? That’s where I’ve run across the term “East African Plains Ape”, and it does strike me as a useful concept, too.
evodevo
Thanks for this David…Ima puttin’ this up on my Book of Faces page right now…I’m STILL at this late date having to argue with conservative idiots about various facets of the pandemic…the Trump prion will be infecting these people for many years, I fear.
Cheryl Rofer
I had a conversation with a friend last night. He understands the delays built in by the nature of the virus, but he was having a hard time with the idea that things will be dreadful at least to the end of February.
And I don’t look forward to the media blaming Biden for the deaths, which will start in a week or two.
Ramalama
I’m waiting for the shoe to drop. I caught the ‘Rona. I am no longer contagious. Besides the waiting to see if this thing would kill me, I had nothing, really. I had it easy.
I am still hyper sensitive to any change in my body that’s making me think I’ve turned into a hypochondriac. “Mars bars for breakfast? Virus.”
“Wanting to listen to more ABBA? Virus.”
“Needing to take a pee? Virus.”
“Not wanting to work? Virus.”
Seems like the way I got infected might have been just in passing, so my contact was minimal. So it’s possible that the most serious offense to me was facing life like I just turned 30 in the middle of a Logan’s Run episode. And then I woke up. Or I escaped (and landed in the middle of an episode of Seinfeld).
Platonicspoof
And without the ideal of easy access (phone apps) and still protected universal tracking, there are five or more days which the infectious person would have to recall from memory where they went and when, in order to alert others.
Or, as I’ve started to do on my “To Do” calendar, since I rarely go out, record where and when I go to the store, etc.
lowtechcyclist
Speaking of lag times, I know that the Covid vaccinations take some time to fully protect the person who’s been vaccinated. But it isn’t really clear at what point you’re about as protected as you’re going to get.
Say, for instance, a workplace has had all its workers teleworking, but wants to start letting people return to their desks after they’ve gotten both vaccinations. Would having the second shot be sufficient, or would they want to require employees to wait a certain length of time after the second shot before returning?
(Do not need answer fast.)
Platonicspoof
@lowtechcyclist:
I keep reminding myself that a 95% effective vaccine means there could be about one in 20 people, very generally, who could be unprotected and a carrier, especially in places like the U.S.
So my unprofessional opinion is that the second shot will never be “sufficient”, there must also, at the very least, be frequent workplace testing until the virus is much less rampant.
Ken
@lowtechcyclist: For the Moderna vaccine, the trial arms start diverging at about 14 days, the time of the second shot. Still wouldn’t hurt to wait another couple of weeks after that.
The real answer is to ask your doctor, and/or read the documentation they give you when you get the vaccine.
Ceci n est pas mon nym
I highly recommend the 200-page National Strategy for the Covid-19 Response and Pandemic Preparedness for all you want to know about what’s going to be happening over the next few months.
In the briefing where Biden announced this plan, he also warned that it’s going to be getting worse for awhile, and that we’ll likely hit 500K deaths.
I don’t know how he’s going to combat mask-aversion. My wife just read me a depressing account of a road trip (from the NYT I think) where virtually everyone had “masks required” signs and virtually everybody ignored them.
Danton
I tested positive on December 13 and immediately isolated myself. Fortunately, no one else in the family has tested positive across three tests. I never developed a fever, congestion, aches and pains, loss of taste, etc. I have a compromised immune system, so I was quite worried I’d wind up in an ICU. What did develop was unusual fatigue for about five or six days, and even now there are days when I need to take a nap in the middle of the afternoon.
I work remotely and get groceries at a store with a strict mask policy (I love this store and its employees). And I have a pretty good idea how I got infected. A maskless couple came into the store. I was unaware of them until they began an argument with the manager and a couple of employees right behind me. When this started, I automatically turned around while the couple were screaming at the employees (eventually, one of the meat department guys, who is BIG, go into a shoving match with the guy and then the cops arrived).
What now concerns me is what might happen to my health in the near and distant future. The fatigue is steadily diminishing, but will some other problem emerge in time? I don’t know. I keep playing it safe: mask, frequent hand washing, social distancing, avoiding groups of people. It’s the responsible thing to do.
Searcher
Do you have any insight or knowledge into the false negative rates of COVID tests?
bcw
Just heard a talk by Joe DeRisi who runs the biohub lab that switched over to do COVID testing and does about half of all testing for CA. They set up street units in the Mission district of SF (high pop density, middlish class, fairly Hispanic, about half contractors and other can’t work-from-home types. Test everyone for free. They found 90% of sick were in the can’t work from home group. Also viral loads were highest in first week so fast testing is really important. Also viral loads (meaning likelihood of infecting other people) were the same whether symptomatic or not and the same over all age groups. Found the 15minute tests catch all but the low level people unlikely to infect others. Made a big point that these fast tests have to become common. Said the longer the time that many people are sick, the greater the risk that vaccine resistance could occur. Need to track people who get vaccinated and watch for changes so the fast adaptability of mRNA vaccines could be used to keep vaccine effective.
bcw
@Searcher:
False negatives are dominated by group that has been infected too recently to be detected.
lowtechcyclist
@Danton:
And the unfortunate truth is, no one knows yet. We’ll know when you and everyone else who survived Covid in the past year has lived a few decades after having had it.
The couple diagonally across the street from me both got a mild case of Covid a couple months back. I saw him earlier this week; he seems to be doing well, and he says she is as well. But they’re in the same situation: only time will tell what the long term effects will be.
It’s weird, the not knowing. I know a woman fairly well who’s just enough older than me (I’m in my late 60s) that she got polio as a child. We know what the long term of that looks like. But we won’t know the same about Covid until there is a long term.
Danton
@lowtechcyclist:
Thanks. Keep your fingers crossed for the thousands of people in a similar situation.
Ramalama
@Danton:
When Obama first came into office as Prez, he made a tour of several US universities and then released a yuge mass of funding for science research. I was working at a venerable institution across the Charles River, Boston, at the time, and I scrambled to push paperwork along for all of these projects that had previously been denied funding, not because the projects were not good; there was just no more money (thanks a lot, W).
So Obama gets elected, and then the profs I work for start getting phone calls and emails from NIH, NSF, etc, saying “Remember your proposal X… well, can you resubmit it in 2-3 days? There might be some money for this…”
And a shite ton of proposals were suddenly funded. Proposals that had met the criteria of the reviewers, mind you.
I’m really really hoping that the Moon shot this time around will be massive research into the causes and effects of Covid-19.
I live in the woods in remote Canada. I wear a mask all the time, even while walking my dog up old ski hills, with nary a Quebecer nearby. I’m not sure how I got it. But it’s a nefarious fcker. Hoping science can kick some serious arse here.