COVID-19 Coronavirus Containment Efforts

[atyy]

*Now for the next steps and the flaw in the individual response: as we all know, the incubation period can be up to two weeks. Baseball's plan does not include quarantining exposed players for more than the time it takes to do two tests in just over 24 hours. Presumably if nobody on the Phillies tests positive today (from tests Sunday and yesterday?), the Phillies will be playing the Yankees tonight, and continue their schedule (I'm not sure what happens with the Marlins). But it is nigh on impossible that anyone in the Phillies organization (this includes team and stadium staff, by the way) exposed this weekend to test positive today as a result. Logic dictates that they all be quarantined for 14 days, but that would destroy the season, so they aren't going to do it.

But would a Phillies player have come within 2 meters of a Marlins player for more than say 5 minutes? Also, presumably they were outdoors, so that would reduce the risk of transmission. My guess is the Marlins had no safe distancing in the locker room.

Forgive me, I've had the game explained to me multiple times over many years, and have understood it for brief periods in my life (about 1 day after each explanation). Till this day, it looks to me like a game in which nothing ever happens

 

[bhobba]

Realize that I am of the mind that the economic closures and coming business failures will be far more detrimental in long term life and health effects than Covid19. Making lots of people poor/broke will cause problems we will have to resolve in the future. Getting statistics on drug OD's, suicides, child abuse, crime, etc. hidden in this situation, will be very difficult to get in the current environment. Of course, we will have to wait for all the dust to settle to see what happened, if the data is available.

You are not the only one who thinks this. I was watching a discussion panel on this very issue, and a professor of Economics was adamant on this point. What we are doing will have long term economic effects greater than the pandemic and we need a better way. Very good argument.

The counter-argument - not so much an argument against a new approach - but rather the idea of having the least amount of restrictions is not the way to go either as Sweden shows:
https://www.nytimes.com/2020/07/07/business/sweden-economy-coronavirus.html

My personal view is we should do what Taiwan did. It has a pretty normal life and virtually no transmission. But there are privacy issues with its approach. We did have a win here in Aus on that in that we were going to have a protest with thousands attending. Last time it happened a link was proven between it and the bad outbreak we now have in Victoria. This time the police was ready. Even though current laws forbid it they went to the trouble of getting a court order outlawing it. Here is what happened:
https://www.news.com.au/national/nsw-act/news/black-lives-matter-sydney-protest-live-updates/live-coverage/0a37f0de48135e874e976aab1f05ec83

So choose your poison - there is no easy answers.

It is interesting the Aboriginal killed in custody that was a big issue with the protesters was because, they stated, he died simply because he wanted a biscuit and they would not give him one. The police claim he was diabetic and his blood sugar was dangerously high - he easily could have died if the police let him eat the biscuit. They want a Royal Commission into it. I personally would give them that Royal Commission so the public can be sure the police acted properly, and things are not always as simple as they seem on the surface.

Thanks
Bill

 

[Buzz Bloom]

warning: do not use methanol

Why not?

 

[Astronuc]

Why not?

Methanol is toxic (and can be absorbed through the skin), so do no use methanol in any form!

Ingestion of methanol may result in blindness, nerve damage, damage or failure of organs, e.g., kidney, and in extreme cases death. Formic acid is directly toxic to the retina, and may lead to blindness.
https://www.sciencedirect.com/topics/medicine-and-dentistry/methanol-poisoning

Alcohol dehydrogenase oxidizes methanol to formaldehyde, and aldehyde dehydrogenase subsequently oxidizes formaldehyde to formic acid.
https://www.ncbi.nlm.nih.gov/books/NBK482121/

Effects depend on the quantity of methanol ingested.

 

[russ_watters]

And if the CDCs 0.26% holds, 100% were infected. They're done!
However, it's not that simple. New York imported some of their sick. People outside NYC went to hospitals inside NYC and died there.

Current story in USA Today:

What went wrong during the Northeast's first COVID-19 spike and is the region ready for another?

... New York and New Jersey have gone on to have the most Coronavirus deaths in the nation ...

Infection rates in the Northeast have fallen to record lows in recent weeks even as they have soared to record highs in more than 30 other states, mostly in the South and West.

Now the question is: How well prepared are Northeast states for another spike of COVID-19?

https://www.usatoday.com/story/news...t-region-second-coronavirus-spike/5526854002/

I think this is a swing and a miss on the premise (but they need something to write about...).

Starting in mid-April, New York's test positivity rate dropped smoothly and exponentially to the 1-2% range by the beginning of June and hasn't budged since. New Jersey's curve wasn't smooth due to awful early testing rates, but it also dropped below 2% by the second week of June and also hasn't budged.

Both states have largely re-opened (NYC just went to "phase 4" on July 20, which isn't quite normal), but I don't believe that New York and New Jersey have uniquely excelled at personal mitigation efforts since April while other states such as PA have experienced a resurgence as they re-opened. Whether it's 25% or nearly everyone who has been exposed, it seems pretty clear to me that NY and NJ have achieved herd immunity, and COVID is basically finished with them.

The implications of this are that we get to see what it looks like to let COVID run wild and then get back to normal quickly, and compare that to, say, Pennsylvania, which I expect will be in a state of partial shutdown for the next 6 months.

 

[Vanadium 50]

The counter-argument - not so much an argument against a new approach - but rather the idea of having the least amount of restrictions is not the way to go either as Sweden shows:
https://www.nytimes.com/2020/07/07/business/sweden-economy-coronavirus.html

I think the NYT's...um...slant is showing there.

I've shown data before that Sweden's profile looks pretty much like everybody else's. Yes, their total deaths per capita is higher than Denmark's, but not as high as Belgium's. Or Peru. They sit between Italy and Chile. But more importantly, the shape of the curve deaths vs. time looks like pretty much every other European country. That says after a country is infected, things are more or less ballistic.

I know that's unpopular, but look at the curves. At most, Sweden has a 10% late tail, and some of this - perhaps all - is from areas (like Gavelborg) that peaked after Stockholm.

 

[russ_watters]

But would a Phillies player have come within 2 meters of a Marlins player for more than say 5 minutes? Also, presumably they were outdoors, so that would reduce the risk of transmission.

Probably not/probably correct. I think the transmission risk during the games is probably low, but we'll see. Stadium staff that interacted more with the players would be at higher risk, but bluntly they are easier to replace than players.

My guess is the Marlins had no safe distancing in the locker room.

Or bus or plane. Social distancing is all but inherently impossible when traveling.

 

[Vanadium 50]

The implications of this are that we get to see what it looks like to let COVID run wild and then get back to normal quickly, and compare that to, say, Pennsylvania, which I expect will be in a state of partial shutdown for the next 6 months.

You forgot "while sneering at the rubes in flyover country and making them quarantine." Do they really think New Yorkers are at risk from Alaskans? The death rate per capita is 50x lower in Alaska. Cases in NYC are 2.7% of the population. The case rate - and Alaska has tested a larger fraction of its population than NYS - is 6x smaller. Alaskans who visit New York are more likely to get infected than the other way round.

Yes, they got the case rate down, by having the...um...foresight to infect their nursing homes right away. And that did open up more beds for important people, although I am sure that was just an unintended consequence. Still, maybe this would make a good Star Trek episode: a governor makes a decision costing thousands of lives, and ends up becoming an actor in a traveling Shakespeare company.

 

[russ_watters]

You forgot "while sneering at the rubes in flyover country and making them quarantine."

Nope, I didn't forget, I was just saving the next level analysis for a separate post in hopes I could get people to at least agree to the premise first. There's still an awful lot that people don't want to see/believe about the pandemic, and it isn't just over there to your right.

Contrary to many popular predictions, New York tells us that in general to let COVID run wild:
1. Doesn't overwhelm the medical system and cause a large number of additional/unnecessary deaths.
2. Doesn't itself cause calamitous economic or social consequences.

Ideally the US - and everyone else - would have successfully implemented a mitigation strategy that kept deaths and economic impacts to a minimum, but that hasn't happened, especially in the US. New York and New Jersey had a crappy spring, but moving forward they get to...move forward while most of the rest of the country is choosing a path where:
1. We inflict an economic and social calamity on ourselves for probably at least a year.
2. Most people get exposed anyway.

 

[mfb]

I've shown data before that Sweden's profile looks pretty much like everybody else's.

Their tail of deaths looks much longer than e.g. in Belgium and Germany.
7-day average, excluding the last days as Belgium and Sweden report "deaths on that day" which needs a few days until it's complete. Normalized to have the same area. Norway, Finland and Denmark have so few deaths that it's hard to interpret a shape into them. Someone should update the Wikipedia tables I used for the plot.

Contrary to many popular predictions, New York tells us that in general to let COVID run wild:
1. Doesn't overwhelm the medical system and cause a large number of additional/unnecessary deaths.
2. Doesn't itself cause calamitous economic or social consequences.

New York did not "let it run wild". It just suppressed it weaker than other places.

I don't think we can conclude that they have heard immunity now. The behavior of people in New York certainly changed as reaction to hospitals at their limits, bodies stacked in refrigerator trucks and so on.

 

[PeroK]

Their tail of deaths looks much longer than e.g. in Belgium and Germany.
7-day average, excluding the last days as Belgium and Sweden report "deaths on that day" which needs a few days until it's complete. Normalized to have the same area. Norway, Finland and Denmark have so few deaths that it's hard to interpret a shape into them. Someone should update the Wikipedia tables I used for the plot.

In any case, the UK has more deaths per day now than the rest of Western Europe put together. This is despite having a low case rate for the past five weeks. It's about 65 deaths per day at the moment - and is expected to stay around that for a few weeks to come.

The rest of Western Europe has about 50 deaths per day total. And all of Eastern Europe (except Russia) about the same as the UK.

 

[russ_watters]

New York did not "let it run wild". It just suppressed it weaker than other places.

Not weaker, later. If such measures are accurate, cell phone data indicated NYC had one of the better shutdowns, with well over a 90% reduction in mobility. But by the time they shut down, infections had likely already peaked. The measured peak occurred on April 3, but the shutdown (statewide) occurred on March 23. That 11 day gap is likely fully consumed by incubation time, symptom appearance, test delay, testing ramp, and results lag. In other words, the number of people infected per day almost certainly peaked before the shutdown.

[edit] By contrast, PA shut down on March 21 and our peak occurred on April 19. That's 19 extra days of nearly uncontained exponential growth. PA's bumpy and slow back-side of the curve is explainable by less than perfect controls, as expected.

I don't think we can conclude that they have heard immunity now. The behavior of people in New York certainly changed as reaction to hospitals at their limits, bodies stacked in refrigerator trucks and so on.

Changed from before the pandemic, yes, but it has also clearly changed from what it was during the shutdown. That's what "reopening" is. But I don't think NYC is so cloistered and unified, and the culture so malleable that it could change from what even nearby neighbors are like. I watched the news every day in March and April and saw the reports of conditions in NYC, but my adjacent state is seeing an increase in cases/positives. The governor of New York agrees:

"The only question is how far up our rate goes," Cuomo said in an interview with WAMC radio on Friday[July 10]. "You can't have it all across the country and not come back."

https://abc7ny.com/reopen-new-york-ny-covid-19-coronavirus/6312873/

But who knows, maybe they're now more like Norwegians than Pennsylvanians.

 

[Astronuc]

Not weaker, later.

New York implemented stay-at-home on March 22 effective 8 pm.
https://www.physicsforums.com/threads/covid-19-coronavirus-containment-efforts.983707/post-6316586

The first death due to COVID-19 in Dutchess County was March 20. The first positive COVID cases was on March 11. Folks should have been observing social distancing (2m) and wearing masks (or face cover) by then. Currently, in that county, the cumulative COVID-19 cases are 4447 confirmed, 4082 recovered, 212 active cases, 153 deaths. https://dcny.maps.arcgis.com/apps/opsdashboard/index.html#/8905f4428f3148d0bffd50a2f3e4db11 Dutchess County was 7th in terms of case load outside of NY City, then Erie County (Buffalo) blew past them. Erie County now has more than 8400 cases, and 620 deaths (including 593 county residents).

Masks were in short supply during March and April.

From my personal observation, about two-thirds of persons did not wear masks, until it was mandated, and then it was maybe 5-10% did not wear masks.

I had traveled to NY at the end of Feb, so I was paying attention to the spread of coronavirus. It was that weekend when I heard about the first case. By March 5, there were 8 cases in Westchester County (all related to the first case, and all in one extended family), two in NY City, and 1 on Long Island.
https://www.pix11.com/news/coronavi...ases-of-covid-19-in-westchester-officials-say

https://forward.ny.gov/early-warning-monitoring-dashboard

 

[russ_watters]

New York implemented stay-at-home on March 22 effective 8 pm.
https://www.physicsforums.com/threads/covid-19-coronavirus-containment-efforts.983707/post-6316586

The first death due to COVID-19 in Dutchess County was March 20. The first positive COVID cases was on March 11. Folks should have been observing social distancing (2m) and wearing masks (or face cover) by then.

I added a comparison to PA for context. Based on the timing of the peak, the shutdown was 19 days later in New York than PA. The first confirmed case in New York was announced on March 1 and and the first death announced on March 14. But testing was practically nonexistent in New York until starting to ramp up around March 17 (1,700 tests that day; 17,000 a week later), so these "first" dates are largely meaningless. It's likely the true first case occurred in January and it circulated - and killed - undetected for more than a six weeks before showing up on radar.
https://www.nbcnewyork.com/news/loc...-infections-before-first-case-report/2386680/

A technical note on the stay-at-home order timings: PA's order went into effect on March 19, also at 8:00 pm. I count that as March 20 because the day is effectively over already. A large number of people (myself included) had a normal workday on March 19, before going home. That said, I still went to the office on March 20, to pick up some needed items to work from home.

 

[Vanadium 50]

cell phone data indicated NYC had one of the better shutdowns, with well over a 90% reduction in mobility.

But still, two-thirds of the new cases were from people already sheltering in place.

Manhattan has a nighttime density of 66000 people per square mile (daytime is probably at least 2-3 times larger). That means in a 100 foot radius, there are 24 other people. Compare that to Keweenaw County, Michigan, where to get 24 people you need to go out 1.4 miles.

Put another way, for Manhattan, 90% is demonstrably nowhere near enough. Foregoing a trip to the Hamptons makes little difference.

 

[russ_watters]

Foregoing a trip to the Hamptons makes little difference.

Agreed. Also, going to stay with your parents in Pennsylvania so you don't have to quarantine in a 400 square foot apartment probably doesn't show up in those stats, and it isn't great for Pennsylvania.

 

[Ygggdrasil]

Both states have largely re-opened (NYC just went to "phase 4" on July 20, which isn't quite normal), but I don't believe that New York and New Jersey have uniquely excelled at personal mitigation efforts since April while other states such as PA have experienced a resurgence as they re-opened. Whether it's 25% or nearly everyone who has been exposed, it seems pretty clear to me that NY and NJ have achieved herd immunity, and COVID is basically finished with them.

Most data available for New York City suggests that the city has not achieved herd immunity.

A study published in JAMA Internal Medicine by CDC researchers measured a seroprevalence rate of only 6.9% in New York City from samples collected in late March.

A non-peer reviewed pre-print that sampled patients at a New York City hospital measured a seroprevalence rate of 19% from samples collected in late April.

A New York Times article from early July reports data from CityMD clinics measuring a 26% seroprevalence rate overall (from tests done late April-late June), though some communities (such as the aptly named neighborhood of Corona in Queens), showed seroprevalence rates as high as 68% which is in the range expected to confer herd immunity.

Having some amount of people with antibodies to SARS-CoV-2 (and presumably immunity), is likely protective to some extent even if it is not at the rate needed for herd immunity. Likely, the immunity is enough to protect against outbreaks with some level of social distancing (especially if the immunity is concentrated among people like essential workers who are not able to social distance), but immunity is not high enough to allow a complete relaxation of social distancing measures.

It is also worth noting that while the behavior of the disease in New York City and other areas in the Northeast seems like the exception in the US, it is more broadly consistent with the case curves seen in other developed nations. Most of the nations observed a significant spike in cases in March-April, followed by a decline as a result of social distancing measures that has been able to persist despite limited re-opening and lifting of lockdowns. While other developed nations have experienced some localized outbreaks during re-opening, most other developed countries have been able to avoid exponential growth of new cases and keep them at a low level like New York City.

Data from the 1918 influenza pandemic, suggests that cities in the US with stronger responses to the pandemic (i.e. more aggressive government interventions to shutdown the spread of the disease) had stronger economic recoveries after the pandemic was over. The US's failure to contain the disease as well as other developed nations will leave the US in an economically disadvantaged position compared to our main economic competitors in the years to come.

 

[jim mcnamara]

@davenn @bhobba
Histogram of Australian Covid confirmed positive tests from March to July 27. From JHU dashboard.
What happened? Things looked fine, so I stopped checking. A newsfeed about the Victoria PM response and continuing dialog on the new problem, led me to check. Yikes.

 

[russ_watters]

A study published in JAMA Internal Medicine by CDC researchers measured a seroprevalence rate of only 6.9% in New York City from samples collected in late March.

March? It isn't clear to me where the samples came from or how they could hope for a representative sample of the population. If a person was in the midst of a moderately sever case of Covid and locked themselves in their home for 2 weeks to isolate and recuperate, were they sampled? I'd really like to see some current studies of this (I did look but didn't find any).

Most data available for New York City suggests that the city has not achieved herd immunity.

...some communities (such as the aptly named neighborhood of Corona in Queens), showed seroprevalence rates as high as 68% which is in the range expected to confer herd immunity...

Likely, the immunity is enough to protect against outbreaks with some level of social distancing (especially if the immunity is concentrated among people like essential workers who are not able to social distance), but immunity is not high enough to allow a complete relaxation of social distancing measures.

In other words, the herd immunity threshold varies based on on the amount of interaction/mitigation effort in a community. Presumably the 60% threshold I've seen for herd immunity is with exactly zero mitigation efforts. The smoothness of the data says to me that whatever the mitigation vs herd immunity threshold is, the reopening hasn't been enough to even make the needle nudge away from herd immunity at the current mitigation level.

I'm ok with being wrong here. I've suggested what most other people consider an unacceptably draconian mitigation effort to try and stop the disease. Evidently New York doesn't need it. They appear to have a magic bullet and I'd really like to know what it is so people can voluntarily implement it elsewhere.

Data from the 1918 influenza pandemic, suggests that cities in the US with stronger responses to the pandemic (i.e. more aggressive government interventions to shutdown the spread of the disease) had stronger economic recoveries after the pandemic was over.

I'll be interested to read the actual paper (I found it - I'll read it). I'm interested to learn if they separately considered aggressiveness, duration and timing, and what they found of these different response attributes. A brief summary with a scatter plot shows what to me looks like an extremely poor curve fit between employment and death rate. It's nearly vertical in one place and nearly horizontal in another. Not a strong opening line.

The US's failure to contain the disease as well as other developed nations will leave the US in an economically disadvantaged position compared to our main economic competitors in the years to come.

In what way/why/based on what? I actually agree with you on the what, but not the why: The why, to me, is not the failure to contain itself, but the long duration of the containment effort.

Surely it must be logical/obvious that shutting down hard for 2 months is less impactful than shutting down partway for a year? E.G., a restaurant that totally closes for 2 months loses less money than a restaurant that is open at half capacity for a year, right?

Statistical analysis showing correlation is nice, but I'm looking for logical cause and effect to make predictions here. Otherwise, vaguely analyzed data from 100 years ago under a totally different economic situation with a virus that was 10 times as deadly with a medical system that was barely out of the dark ages doesn't seem that compelling to me.

It is also worth noting that while the behavior of the disease in New York City and other areas in the Northeast seems like the exception in the US, it is more broadly consistent with the case curves seen in other developed nations. Most of the nations observed a significant spike in cases in March-April, followed by a decline as a result of social distancing measures that has been able to persist despite limited re-opening and lifting of lockdowns. While other developed nations have experienced some localized outbreaks during re-opening, most other developed countries have been able to avoid exponential growth of new cases and keep them at a low level like New York City.

That seems like a little bit of a bait-and-switch. Can you name a country that had a massive outbreak and had absolutely no measurable increase by now? Yeah, I know that's a tough and specific criteria, but New York is an exceptional case. They went from an exceptionally poor level of containment to an exceptionally good level of containment in the span of a few weeks and have maintained exceptionality through today. I don't know of a country that had such an exceptional and durable about-face, with the possible exception of China itself.

 

[davenn]

@davenn @bhobba
Histogram of Australian Covid confirmed positive tests from March to July 27. From JHU dashboard.
What happened? Things looked fine, so I stopped checking. A newsfeed about the Victoria PM response and continuing dialog on the new problem, led me to check. Yikes.

View attachment 267018

This is what is happening ...

Victoria is the state to the south of me ... and at the moment they are in deep doodoo down that way.

Sadly, here in NSW ( New South Wales) we have also had a bunch of idiots that have no respect for other people
and we have had a bit of a rise in numbers and if not jumped on really quickly, we will end up in Victoria's predicament

 

[bhobba]

Histogram of Australian Covid confirmed positive tests from March to July 27. From JHU dashboard. What happened?

The Victorian government botched hotel quarantine for overseas arrivals. The security guards literally slept with those in quarantine, in return for 'favours' such as being allowed outside for shopping etc. Why didn't they use the police? Evidently the police union privately rang the premier and said - we are not baby sitters. Why didn't they use the army? That would make the state government look as though they could not handle it. So they hired incompetent private guards with a vacuum between their ears. The security company the government hired subcontracted it out, and creamed money off the top in doing that, it is thought maybe a number of times ie the subcontracted organisation also subcontracted it out. The guards they eventually got were - how to put it - less than the cream of the crop. The guards of course claim they were not trained - right - sexual favours in return for being allowed to break quarantine is a training issue . You need no training, or even an education above primary school, to know what lockdown quarantine means. It was politics overriding sound judgement. But what do you expect from politicians - they will of course give political solutions to problems. I will not give my personal opinion of the incompetent stupidity involved at many levels, as it makes me so angry, and this is a family friendly forum.

The irony is it's so bad now they had to call in the Army anyway - even elite SAS style medical teams usually sent by Australia to overseas hot spots:
https://www.abc.net.au/news/2020-07...ausmat-arrives-amid-aged-care-crisis/12505478

Thanks
Bill

 

[russ_watters]

Let me back up a bit and relay my understanding of the concept of herd immunity and its application. Perhaps some will think I'm over-extending it. Here's a paper discussing it as pertains to COVID:
https://science.sciencemag.org/content/early/2020/06/22/science.abc6810

The basic (the article calls it "classic") herd immunity threshold is simply the fraction of people who need to be immune to get the reproduction rate down to/below 1: h_C = 1 – 1/R₀

I've seen 60% cited as a threshold based on a reproduction rate of 2.5: 1-1/2.5=60%

But this assumes a homogeneous society with zero mitigation effort of any kind. And society is of course not homogeneous and mitigation efforts aren't zero (government mandated or otherwise), nor are they consistent. The article addresses demographics and predicts 43% based on the level of social interaction for different groups.

Looking at the trend data*, Pennsylvania had a noticeable plateau at the end of May/early June before resuming its decreasing trend. Why? Probably because a week earlier, Memorial Day Weekend vastly increased the number of social interactions and vastly increased R.

PA's positivity rate bottomed-out on June 18 and started rising again. Why? Because between May 29 and June 26, all but one county entered the "green" phase of re-opening (in groups, roughly weekly). So this tells us that at some point we reached a threshold of social interaction where R went above 1 again. Zooming in; my county was one of the worst-hit and went green with that last batch on June 26. There's a fair amount of noise in the data at this level, but our positivity rate started increasing 10 days later, on June 5. We've since rolled-back on the reopening.

New York City moved to Phase 4 on July 20, 10 days ago, and was in the final batch in New York State. Nothing until now has moved the needle, so we'll see if this does.

Of course "green" or "phase 4" isn't a total return to normal. Restaurants are still only 50% capacity indoors and professional sports are still without fans. The "herd" is much thinner now than in normal times, and it follows that the associated green/4th phase herd immunity threshold is much lower. And even if we get off the "phases" altogether, I don't think life will go back to normal until a vaccine is approved. I don't think I'm going to a restaurant until then. So we may never get a true test of the "classic" herd immunity threshold.

If I'm over-extending the term "herd immunity", so be it. I'll re-phrase without using the term: I think that the primary reason for New York and some surrounding states' spectacular case curves vs most of the rest of the country is that the reproduction rate is being strongly suppressed by the fraction of people with immunity.

*I primarily use this data for state level:
https://coronavirus.jhu.edu/testing/individual-states/pennsylvania
I don't know of any good sources for county-level data and I have collected my own, from daily cumulative tallys.

 

[bhobba]

I am very positive towards using a vaccine when tested enough to ensure at least good safety, but this is WOW:
https://www.sciencemag.org/news/202...an-have-covid-19-vaccine-ready-use-next-month

Thanks
Bill

 

[Astronuc]

Florida reported a record increase in new COVID-19 deaths for a third day in a row, with 252 fatalities in the last 24 hours. Florida reports 6,457 deaths since yesterday.

Arizona also reported a record increase with 172 fatalities on Thursday, bringing that state's death toll to 3,626, up from 3,454 yesterday.

Texas will overtake New York in confirmed cases soon, if not already.

 

[Astronuc]

Manhattan has a nighttime density of 66000 people per square mile (daytime is probably at least 2-3 times larger). That means in a 100 foot radius, there are 24 other people.

Does the area account for multi-story buildings? That would make a huge difference.

We do have a rough guide, though, based on the committed aficionados at SkyscraperPage.com, which has a reliable database of buildings over 10 stories in major cities, the Big Apple included.

SkyscraperPage has 6,080 buildings that are higher than 10 stories in its New York dataset. Add in buildings under construction — which include the skyline-defining 104-story One World Trade Center — and you have 6,176 buildings. This set of buildings has an average of 18.7 floors and a median of 16 floors, according to my analysis of the site’s data.

So, among buildings over 10 stories, New York has a whopping 115,523 floors. The tallest 2,000 buildings contain half of all the floors. The tallest 10 percent of buildings contain more than a fifth of the floors (22 percent)

https://fivethirtyeight.com/feature...f-stories-in-nyc-skyscrapers-might-floor-you/

If we take the reference number of 10 stories, then 25 people/10 floors = 2.5 persons per 100 foot radius, which is a reasonable separation.

Nevertheless, cities, large, small and in between, do offer a great probability of social interaction. Large cities (with high population densities) have mass transit (buses, subways, light rail, commuter trains), entrances and lobbies of buildings, more crowded stores, so there are many more opportunities to contact strangers. I think we see patterns in the various states, e.g., Florida, Texas, Washington, Idaho, and others, that the cases of COVID-19 and deaths seem to be concentrated in major metropolitan areas and small cities.

 

[mfb]

I'm ok with being wrong here. I've suggested what most other people consider an unacceptably draconian mitigation effort to try and stop the disease. Evidently New York doesn't need it. They appear to have a magic bullet and I'd really like to know what it is so people can voluntarily implement it elsewhere.

That magic bullet killed 0.1% of NYC's population (~23,000 deaths out of ~20 million), in absolute numbers it surpassed the Spanish Flu there.

As mentioned, New York is similar to the pattern we have in many European countries. An outbreak starts, people start avoiding crowded places, followed by a lockdown or similar measures, this gets the outbreak under control, afterwards restrictions are loosened while people behave well enough to keep the reproduction rate around 1 even with relaxed restrictions. Italy, Germany, France, the Netherlands and many smaller countries: They all follow this pattern. The UK generally follows that pattern as well, but with more deaths. Spain is an exception, it sees a rise in cases again now.

 

[Ygggdrasil]

March? It isn't clear to me where the samples came from or how they could hope for a representative sample of the population. If a person was in the midst of a moderately sever case of Covid and locked themselves in their home for 2 weeks to isolate and recuperate, were they sampled? I'd really like to see some current studies of this (I did look but didn't find any).

My post cites a New York Times article reporting seroprevalence data from testing done in late April through late June, which is probably the most recent available. The number reported there (~26%) is in the same ballpark of another non-peer reviewed seroprevalence study of New York City (~20%) that I linked to in my post. I agree that the numbers from the CDC study seem low.

In other words, the herd immunity threshold varies based on on the amount of interaction/mitigation effort in a community. Presumably the 60% threshold I've seen for herd immunity is with exactly zero mitigation efforts. The smoothness of the data says to me that whatever the mitigation vs herd immunity threshold is, the reopening hasn't been enough to even make the needle nudge away from herd immunity at the current mitigation level.

I'm ok with being wrong here. I've suggested what most other people consider an unacceptably draconian mitigation effort to try and stop the disease. Evidently New York doesn't need it. They appear to have a magic bullet and I'd really like to know what it is so people can voluntarily implement it elsewhere.

Yes, as you correctly note in your later post, there is a mathematical relationship between the R_o of a communicable disease, and the herd immunity threshold. If social distancing lowers R_o, then the level of immunity required to prevent exponential growth of the disease is lower.

I think that the primary reason for New York and some surrounding states' spectacular case curves vs most of the rest of the country is that the reproduction rate is being strongly suppressed by the fraction of people with immunity.

I agree with this. However, it is important to note that the measured levels of seroprevalence in New York City (~20-25%) are not yet in the range expected to provide herd immunity with no social distancing measures (40-60% of the population), so immunity is not yet widespread enough for everything to return to normal. To get there would require a second wave of roughly the same size as the first wave, which is not something we should want to see. I agree with you that things will not be back to normal until a safe and effective vaccine is widely available.

That seems like a little bit of a bait-and-switch. Can you name a country that had a massive outbreak and had absolutely no measurable increase by now? Yeah, I know that's a tough and specific criteria, but New York is an exceptional case. They went from an exceptionally poor level of containment to an exceptionally good level of containment in the span of a few weeks and have maintained exceptionality through today. I don't know of a country that had such an exceptional and durable about-face, with the possible exception of China itself.

Here's a chart showing the 7-day rolling average of the daily new cases per million in the US and some other developed nations (data downloaded from the ECDC):

I included the UK and Canada as good comparisons to the US as well as Spain and Italy, which were some of the hardest hit European nations. Italy and the UK spikes in Coronavirus cases similar to the US in Mar-Apr yet both nations have been able to maintain new Coronavirus cases stable at a fairly low level since mid-late June. Canada, while not as hard hit as the US, has also shown this pattern and has also maintained low case counts throughout the last month or so. This also seemed to be the case for Spain, though it is showing a recent growth in cases (similar to what @jim mcnamara reported about cases in Australia). The US (with only a slight decline in cases throughout May followed by a massive increase in cases in Jun-Jul) is the clear outlier when compared with most developed countries.

Of course, the recent increases in Spain and Australia do present cautionary tails. While most of the developed countries have been able to keep Coronavirus cases low, this may not always be the case going forward (especially as the Northern hemisphere moves into fall and winter). Perhaps some of my thoughts on the economic impacts in the US vs other developed nations may not turn out to be true if other countries suffer "second waves" like the US is currently experiencing and the only difference is the timing of the wave and not the magnitude.

*I primarily use this data for state level:
https://coronavirus.jhu.edu/testing/individual-states/pennsylvania
I don't know of any good sources for county-level data and I have collected my own, from daily cumulative tallys.

The NY Times has compiled some county level data: https://github.com/nytimes/covid-19-data

 

[Astronuc]

That magic bullet killed 0.1% of NYC's population (~23,000 deaths out of ~20 million), in absolute numbers it surpassed the Spanish Flu there.

The current number of cumulative deaths is 25145 as of July 29. The number of deaths is still increasing by about 10 +/- 5 per day, and the number of new cases is running between 500 to 800 per day. It's not clear how many might be repeat tests. NY state is being aggressive about folks traveling from high risk areas out of state as well as in state. NY City is still a hot zone.

 

[bhobba]

From todays Australian (with some minor editing):

Start of Article

'A COVID-19 vaccine has been shown to be safe in phase 1 trials, and has generated an immune response in human subjects. Volunteers were dosed with the vaccine, dubbed Covax-19, this month. While definitive study results are yet to be published, Professor Petrovsky said safety data from the phase 1 trial of the vaccine had been provided to the study’s ethics committee, which had approved further testing in more volunteers, including the elderly, children and cancer patients.

“We have confirmed that the Covax-19 vaccine induces appropriate antibody responses in human subjects,” he said. “We now have preliminary safety data showing there were no significant systemic side-effects in any of the subjects. We also have permission to immunise subjects who have already had COVID-19 to see if we can further boost their immunity and prevent them getting reinfected.”

Professor Petrovsky is offering to dose aged-care residents at risk of contracting COVID-19 with his vaccine. “We’ve made the offer to Victoria,” he said. “Obviously our vaccine is still under testing, it would have to be done within a clinical trial but there’s no reason you couldn’t enrol people in Victorian nursing homes into the trial and give them the vaccine which would hopefully then protect them. We’re certainly very open to talking to the Victorian government about doing that, which would hopefully have a benefit even if it’s within the context of a clinical trial. We know it’s not going to hurt because we now know that the vaccine is completely safe.”

None of the volunteers who were dosed with Covax-19 reported significant side-effects, and no one experienced a fever. This is in contrast to the phase 1 results of two other vaccines that have now progressed to phase 3 testing, from the University of Oxford and the US biotech company Moderna.

Phase 2 trials for Covax-19, set to involve between 400 and 500 volunteers, are slated to begin in September. Negotiations are underway with other countries on plans for phase 3 trials, which would need to enrol up to 50,000 volunteers, predominantly in countries heavily affected by COVID-19. The University of Queensland also has a vaccine candidate, which this month began to be tested on human volunteers in phase 1 trials.

Professor Petrovsky previously developed a vaccine for swine flu, as well as vaccines for two forms of bird flu. He has a patented vaccine adjuvant known as Advax, which effectively boosts the immune response in human subjects. Both Covax-19 and the University of Queensland candidate are protein sub-unit vaccines that inject small synthesised pieces of the SARS-CoV-2 spike protein into the body to induce an immune response. UQ has partnered with CSL to manufacture millions of doses of the university’s vaccine. Recombinant protein vaccines work by inducing an immune response in the body to invasion by the spike proteins of the SARS-CoV-2 virus that causes COVID-19. These protein spikes surround the surface of the SARS-CoV-2 virus, forming part of the crown or “corona” that gives the virus its name. In Coronavirus infection, the SARS-CoV-2 spikes, called S1 proteins, bind to a receptor molecule on the body’s cells, called ACE2. The virus is then able to invade the cell and replicate extensively. SARS-CoV-2 has a high binding capacity for ACE2, making it highly infectious.

To make a recombinant protein-based vaccine, researchers insert the genetic sequence for the coronavirus’ distinctive spike protein into a cell. The cell then grows this protein. Researchers then purify the protein and turn it into a vaccine. It is the first candidate to clear phase 1 trials in Australia, and one of only a handful that have progressed beyond the first phase of human trials in the world. In Coronavirus infection, the SARS-CoV-2 spikes, called S1 proteins, bind to a receptor molecule on the body’s cells, called ACE2. The virus is then able to invade the cell and replicate extensively. SARS-CoV-2 has a high binding capacity for ACE2, making it highly infectious. To make a recombinant protein-based vaccine, researchers insert the genetic sequence for the coronavirus’ distinctive spike protein into a cell. The cell then grows this protein. Researchers then purify the protein and turn it into a vaccine.'

End of Article

The situation in Aus is getting very bad in Victoria, starting to get bad in NSW, and could get bad where I am in Queensland. We can not keep this up forever. There must be an end game. Professor Petrovsky believes we can be ready to inoculate all Australians in 3-4 months if we start manufacturing now. In the meantime, as part of phase 2 trials we can use it to clamp down on hotspots as they emerge.

The question is - do we do this now. Australia is supposed to be the smart country. The grit and determination we showed in the bushfires at the start of the year may need to be called on one more time to combat an even deadlier enemy. Is Australia up to the challenge?

Thanks
Bill

 

[PeroK]

The situation in Aus is getting very bad in Victoria, starting to get bad in NSW and could get bad where I am in Queensland.

The Australian numbers in a global context are still quite low. Perhaps bad is relative. South Africa has over 10,000 new cases per day. I'd say that's very bad.

 

[mfb]

We know it’s not going to hurt because we now know that the vaccine is completely safe.

Their phase 2 trials will have 400-500 people, presumably the phase 1 trials had fewer, and all of them healthy. They don't know if it is "completely safe". Anyway, good to see more progress.

 

[bhobba]

The Australian numbers in a global context are still quite low. Perhaps bad is relative. South Africa has over 10,000 new cases per day. I'd say that's very bad.

Bad is definitely relative. But we all know basic math on this forum, and the consequences of an r0 of about 2.5 compared to the flu's r0 of about 1.2. The Spanish flu with an r0 of 2.2 was virtually eliminated here when one case quickly sparked a second wave much worse than the first. We must clamp down on this early and hard or we will end up like South Africa. The question is it now time to take a risk and deploy the vaccine? India is very aggressive and will deploy one of their vaccines by at the latest August 16. I think, because Australia is relatively still in a good place, we do not need to be that aggressive, but IMHO the end of the year is realistic, and we can use it now to dampen hotspots in say nursing homes as they emerge,

Thanks
Bill

 

[OCR]

Lol. . . thanks Bill. .

End of Article

For a time there, I thought I was locked into a. . . .

.

 

[bhobba]

Their phase 2 trials will have 400-500 people, presumably the phase 1 trials had fewer, and all of them healthy. They don't know if it is "completely safe". Anyway, good to see more progress.

Yes - there is risk involved. For the UQ vaccine we had thousands of volunteers for the 120 they are using in phase 1 trials. I think we will get thousands of volunteers for challenge phase 2 trials where volunteers are deliberately infected, as well as using it to inoculate known hot spots like nursing homes. If we then deploy the vaccine or wait until phase 3 trials with 50.000 people will depend on the situation at the time. We may even get enough people here in Australia to volunteer to do a challenge phase 3 trial. Do we have the courage and 'true grit'. We will see.

Thanks
Bill

 

[Ygggdrasil]

The Australian numbers in a global context are still quite low. Perhaps bad is relative. South Africa has over 10,000 new cases per day. I'd say that's very bad.

Here's the plot of the 7-day rolling averages of daily new cases for the USA, UK, Australia, Spain, and South Africa:

Indeed, the Australian cases per million are still quite small and the increase is also small compared to the increases seen in the US, South Africa, and Spain. The numbers in South Africa are indeed bad, approaching similar per capita levels of new infections as the US.

The US and South Africa are among the worst large countries (pop > 5M) in terms of cumulative per capita cases over the past two weeks along with Brazil, Israel and Colombia (Kyrgzstan tops this list but this is due to basically one day reporting >10,000 cases, with the rest showing more than an order of magnitude fewer cases):

Note that because testing rates and availability are not the same across all countries, comparing case counts across countries is not a fair apples-to-apples comparison.