COVID-19 Coronavirus Containment Efforts

[BillTre]

A NY Times interview with a mathematician who studies virus spread.
He details how the stats should be done and provides some interesting rules of thumb and back of the envelope, such as:

One signal to watch out for is if the first case in an area is a death or a severe case, because that suggests you had a lot of community transmission already. As a back of the envelope calculation, suppose the fatality rate for cases is about 1 percent, which is plausible. If you’ve got a death, then that person probably became ill about three weeks ago. That means you probably had about 100 cases three weeks ago, in reality. In that subsequent three weeks, that number could well have doubled, then doubled, then doubled again. So you’re currently looking at 500 cases, maybe a thousand cases.

 

[Jarvis323]

What would Issac Newton think about viruses, and illnesses based on his research.

Probably nothing interesting. It took over 200 years since Isaac Newton before science recognized the existence of germs. Newton probably accredited illness to acts of god, demons, or the occult or something like that.

It's actually kind of an eye opening story how germ theory started. The first scientist to challenge the dogma was Ignaz Semmelweis in the mid 1800's who promoted hand washing as a means to prevent infection. For that, the mainstream scientific community shunned him, and drove him into a mental institution. They weren't going to take this radical, crazy, paranoid, blasphemous idea that invisible things are floating around infecting people.

I use this story to remind myself not to take mainstream scientific views for granted. The fact is, it's made up of the same species that not long ago held that hand washing and germs were pseudo-scientific crack-pottery.

https://www.mentalfloss.com/article...got-one-19th-century-doctor-institutionalized

 

[anorlunda]

To put things in perspective, this is how Covid-19 compares with other viruses in terms of transmission.

The factor is called R0 (basic reproduction number). Estimates from the 1918 Spanish Flu were R0=2 to 3.

Several sources say we have no reliable number yet on COVID19, but the following is from the CDC.

Reproduction Number and Attack Rates
The number of secondary cases resulting from a single initial case (reproduction number, R0) (Appendix reference 74) ranges widely for MERS-CoV, e.g., from 8.1 in the South Korea outbreak, compared with an overall R0 of 0.45 in Saudi Arabia (Appendix reference 74). Superspreading events, which generally describe a single MERS-CoV case epidemiologically linked to >5 subsequent cases, have been frequently described, particularly in healthcare-associated outbreaks (Appendix references 55,56). R0 estimates, however, can vary depending on numerous biologic, sociobehavioral, and environmental factors, and must be interpreted with caution (Appendix reference 75). Most studies estimating R0 across multiple areas, or at the end stage of an outbreak, result in estimates of R0<1, consistent with the knowledge that the virus does not continue to circulate in humans and that outbreaks are eventually contained. A wide range in published attack rates (the proportion of exposed persons who are infected) has also been reported (Appendix reference 74).

WHO says:

Human-to-human transmission is occurring and a preliminary R0 estimate of 1.4-2.5 was presented.

Wikipedia says: R0=2.2 to 3.9

To interpret the significance of R0, consider starting with one case, then secondary, then tertiary, ..., up to N stages away. Starting from one person, and N generations of infection, the number of people infected will be R0^N.

The extremes from that are all over the map, so until we know better all outcomes are possible, from almost nothing, to everyone on the planet getting it. That's not very helpful. The CDC source above says that they expect the final estimate will show R0<1. That's reassuring, but it is also obvious that R0>1 today.

Here are some numbers to put it in perspective. With N=20, and with the low to high estimates for R0, we get:

0.94²⁰~0.3
1.4²⁰~800
2.5²⁰~10⁸
3.9²⁰~10¹²
8.1²⁰~10¹⁸

 

[jedishrfu]

ArsTechnica has an FAQ article (see below) that they say will be updated at 3 pm EST every day with the very latest in COVID-19 information:

https://arstechnica.com/science/202...ive-ars-technica-guide-to-the-coronavirus/#h1

 

[Rive]

...For that, the mainstream scientific community shunned him, and drove him into a mental institution.

Just for the log: the most likely reason for his mental breakdown is suspected to be an illness - progressing late stage syphilis, what was kind of common at that time for his profession. This is suspected to be behind the really provoking, negative and obsessed tone of his later publications, what led to negative response.

Yup, kind of trolling.

While the theory was not accepted, the practice actually was: not by all, but by many.

I don't know what's the moral of this sad story.

 

[Jarvis323]

ArsTechnica has an FAQ article (see below) that they say will be updated at 3 pm EST every day with the very latest in COVID-19 information:

https://arstechnica.com/science/202...ive-ars-technica-guide-to-the-coronavirus/#h1

For balance,

When an official makes a statement such as "There is no need for public panic," it indicates a limited understanding of how people behave during disasters. Moreover, it reflects a fundamental distrust in the tendency of the public to generally do the right things when given the right information.

https://www.crainsdetroit.com/other-voices/commentary-stop-telling-us-not-panic-about-covid-19

 

[Jarvis323]

This is suspected to be behind the really provoking, negative and obsessed tone of his later publications, what led to negative response.

But it would seem perfectly normal for him to have such a negative tone, because this is after his ground breaking ideas had been ridiculed, gotten him kicked out the university, and shunned from the medical community. Meanwhile they were continuing to cause thousands of preventable deaths by ignoring him. I would expect most people in that situation would have a really provoking, negative and obsessed tone.

Anyway I guess this is getting off topic. Sorry.

 

[bhobba]

ArsTechnica has an FAQ article (see below) that they say will be updated at 3 pm EST every day with the very latest in COVID-19 information:

Nice. I think the key point to take away is its coming - like it or not. It's entirely up to us how bad it is. I think what happened in Italy is because they did not act fast enough. We will see what happens now they have finally acted, and acted hard. I think China did the same, but its difficult to really know because of the secrecy they had in the early stages. My suspicion is some infected people got into Italy before containment measures were taken in China, which is how Italy's troubles started. Here in Australia the government has not acted hard - yet - I just prey they time it right. And while 'amusing' the toilet paper debacle does not give me confidence. Unfortunately my gut feeling is people really are that 'dumb' in which case acting 'hard' may require more than just voluntary compliance.

A reporter decided to check out the measures they have put in place such as fever clinics. It was hopeless. Nobody really knew what what they were doing. Everyone was told to leave at least a seat between them and other people. But most didn't and nobody in authority stopped it. Another suspected they had it, had the test done, was promised the results reasonably quickly, but had to follow it up himself. He was sent on a goose-chase from person to person for days before he found out the results well after they should have been available. A lot of issues need fixing.

One show I watched lamented at students shying away from science and hence may not really understand the necessity for this.

Thanks
Bill

 

[Jarvis323]

Here is a good source on crisis communication. They also point out the myth of public panic tendencies.

What about Panic? Contrary to what you may see in the movies, people seldom act completely irrationally during a crisis. During an emergency, people absorb and act on information differently from nonemergency situations. This is due, in part, to the fight-or-flight mechanism.The natural drive to take some action in response to a threat is sometime described as the fight-or-flight response. Emergencies create threats to our health and safety that can create severe anxiety, stress, and the need to do something. Adrenaline, a primary stress hormone, is activated in threatening situations. This hormone produces several responses, including increased heart rate, narrowed blood vessels, and expanded air passages. In general, these responses enhance people’s physical capacity to respond to a threatening situation. One response is to flee the threat. If fleeing is not an option or is exhausted as a strategy, a fight response is activated. You cannot predict whether someone will choose fight-or-flight in a given situation.These rational reactions to a crisis, particularly when at the extreme ends of fight-or-flight, are often described erroneously as “panic” by the media. Response officials may be concerned that people will collectively “panic” by disregarding official instructions and creating chaos, particularly in public places. This is also unlikely to occur. If response officials describe survival behaviors as “panic,” they will alienate their audience. Almost no one believes he or she is panicking because people understand the rational thought process behind their actions, even if that rationality is hidden to spectators. Instead, officials should acknowledge people’s desire to take protective steps, redirect them to actions they can take, and explain why the unwanted behavior is potentially harmful to them or the community. Officials can appeal to people’s sense of community to help them resist unwanted actions focused on individual protection.In addition, a lack of information or conflicting information from authorities is likely to create heightened anxiety and emotional distress. If you start hedging or hiding the bad news, you increase the risk of a confused, angry, and uncooperative public.

https://emergency.cdc.gov/cerc/ppt/CERC_Psychology_of_a_Crisis.pdf

 

[StatGuy2000]

Higher rates of certain medical conditions in men could certainly contribute to the differences in immune responses between the sexes. However, the NYT piece also notes higher rates of autoimmune disease in women ("Nearly 80 percent of those with autoimmune diseases are women, Dr. Clayton noted."), which could suggest some underlying biological differences between immunity in men and women.

It is well documented that women have higher rates of various autoimmune diseases. The article you link to suggests a possible mechanism, where preceding infections could stimulate pro-inflammatory cytokines fro mast cells during the innate immune response, and how sex hormones may amplify this effect.

At the same time, I'm curious if the lower mortality rates for COVID-19 in women compared to men could be explained primarily through such a mechanism. I would be especially curious as to how this would compare with SARS or MERS.

 

[Jarvis323]

One thing that is interesting is the disparity between mortality rates in different countries. In Germany, with 1,565 cases, the mortality (based on deaths/total cases) is only about 0.13%, and critical cases (based on critical case/active cases) 0.58%. In Italy, mortality is 6.2% (48X higher) and critical cases 10.3% (17.7X higher).

Maybe Germany just has more accurate statistics due to widespread testing? If it is true, it might suggest the mortality rate is nearer to that of the flu. But I am wondering how those rates are calculated for the flu since most people don't get tested for the flu. It could also be that Germany's COVID-19 testing is outpacing normal flu testing. Is it possible that the mortality rate of the flu is exaggerated as well?

Even if the true rate is 0.13% or lower, Italy is still struggling pretty hard to handle the additional strain on the hospitals.

 

[DennisN]

Here in Sweden we now have got new directives.
The community spread threat level has been increased to the highest, since there have been indications of some community spread of the virus.

Because of this our national health recommendations has been updated, and those who are feeling ill with cold- or flulike symptoms are recommended to stay at home and don't go to work, school or social gatherings.

Source:
http://www.dn.se/nyheter/sverige/risken-for-smittspridning-hojs-till-hogsta-nivan/
(only in Swedish, sorry)

Furthermore, in my city, those who are employed in healthcare or work at the university have been advised to cancel all travels and public meetings that are not absolutely necessary.

In Sweden we now have 325 confirmed cases (and no known deaths), but worth noting is also that we have a pretty small population, about 10 million.

Personally I have sent advice and guidelines to my old parents, the same guidelines I wrote about previously in this thread, gathered from the WHO advice.

 

[OmCheeto]

This seems like suspicious maths to me:

vs

I suppose if gamma = 1, there's no problem.

 

[chirhone]

"China stopped the coronavirus. Your country won't"



What happens if my or your country won't be able to stop it? Does it mean continuous exposure like the common colds?

 

[atyy]

What would Issac Newton think about viruses, and illnesses based on his research.

Not really, what you are asking, but much of Newton's groundbreaking work was done in a period when the university had closed because of the plague, and he had to work from home.
https://www.bbc.co.uk/teach/isaac-Newton-the-man-who-discovered-gravity/zh8792p

Many companies are now introducing work from home where possible to help with the social distancing measures to prevent COVID-19 spread.
https://www.channelnewsasia.com/new...om-home-flexible-best-practices-tips-12421586
https://www.theverge.com/2020/3/8/21170547/tim-cook-remote-iphone-apple-global-coronavirus
https://www.theverge.com/2020/3/10/...ican-employees-work-from-home-sick-leave-fund
https://techcrunch.com/2020/03/09/b...ff-work-from-home-to-reduce-coronavirus-risk/

 

[kadiot]

Iran just released 70,000 inmates on FURLOUGH because of the relentless spread of the corona virus ...

Wow! I wonder how they will summon them back when the medical crisis is over...

Like... do they have LOCATOR CHIPS in their bodies?

Wonder if we can do the same with our inmates... uhmmm...

 

[mfb]

This seems like suspicious maths to me:

View attachment 258505

vs

View attachment 258506

I suppose if gamma = 1, there's no problem.

The problem is the inconsistent use of $\gamma$. In "Basic reproduction number" gamma is the time someone is infectious, in "Compartmental models in epidemiology" it's the inverse of time.
Edit: Mentioned it on the talk pages of these articles.

@Jarvis323: Germany has a lot of new cases right now, many of them will die over time. Italy has more older cases and it had the disease hit some hospitals and retirement homes, that drives up the case fatality rate.

 

[DennisN]

I saw a very interesting report from Italy on BBC News, regarding the countermeasures against the virus spread, the impact and also a short interview with a doctor in one of the worst hit regions:

"We are facing a war now here."

which echoes the words of Dr Richard Hatchett in a previous video I posted in this thread.

Coronavirus - Italy in lockdown - BBC News (Mar 10, 2020)

 

[DennisN]

And here is a very interesting and informative interview with Giacomo Grasselli:

Giacomo Grasselli - a senior Italian government health official who is coordinating the network of intensive care units in Lombardy - explains the “critical” situation in Italy, brought about by the Covid-19 outbreak.

I am quoting one of the things he said:

Hopefully in other countries it's not behaving like this, but what is very, very, very important for every country [...] is that everyone must understand if you're not very careful in controlling the spread of the disease, this disease will overwhelm your system no matter how efficient, good or modern it is.

Sobering words indeed.
Source: Interview time at 5m 35s.

The entire interview is here:
Coronavirus ‘worse than a bomb’ on Italy, says doctor coordinating response (Channel 4 News, Mar 10, 2020)

 

[nsaspook]

https://www.medrxiv.org/content/10.1101/2020.03.03.20029843v2

Background: The COVID-19 outbreak containment strategies in China based on non-pharmaceutical interventions (NPIs) appear to be effective.
...
Without NPIs, the number of COVID-19 cases would likely have shown a 67-fold increase (IQR: 44 - 94), with the effectiveness of different interventions varying. The early detection and isolation of cases was estimated to prevent more infections than travel restrictions and contact reductions, but integrated NPIs would achieve the strongest and most rapid effect. If NPIs could have been conducted one week, two weeks, or three weeks earlier in China, cases could have been reduced by 66%, 86%, and 95%, respectively, together with significantly reducing the number of affected areas. However, if NPIs were conducted one week, two weeks, or three weeks later, the number of cases could have shown a 3-fold, 7-fold, and 18-fold increase across China, respectively. Results also suggest that the social distancing intervention should be continued for the next few months in China to prevent case numbers increasing again after travel restrictions were lifted on February 17, 2020. Conclusion: The NPIs deployed in China appear to be effectively containing the COVID-19 outbreak, but the efficacy of the different interventions varied, with the early case detection and contact reduction being the most effective. Moreover, deploying the NPIs early is also important to prevent further spread. Early and integrated NPI strategies should be prepared, adopted and adjusted to minimize health, social and economic impacts in affected regions around the World.

 

[Mary Conrads Sanburn]

10 MARCH 2020
Coronavirus latest: global infections pass 100,000
Updates on the respiratory illness that has infected tens of thousands of people and killed several thousand.

• 
  

Officials spray antiseptic solution in Seoul.Credit: Chung Sung-Jun/Getty
Here’s the latest news on the outbreak.

10 March 03:30 GMT — Call for more funding
At least US$8 billion is needed to address the most pressing threats posed by the novel coronavirus, says the Global Preparedness Monitoring Board (GPMB), an independent group co-convened by the World Health Organization and the World Bank Group to combat public health emergencies.
The money is needed in addition to the tens of billions of dollars already pledged from the International Monetary Fund, the World Bank Group and individual governments.
The GPMB released a report on 9 March calling on advanced economies, such as the members of the Group of Seven and the Group of 20, and financial institutions to provide money to address five priority areas. These include strengthening weak healthcare systems; supporting the World Health Organization’s efforts to help vulnerable countries; developing diagnostics, therapeutics and vaccines; strengthening regional surveillance; and ensuring sufficient protective equipment is available for health workers.
9 March 04:00 GMT — Global cases pass 100,000
The number of known global cases of COVID-19 passed 100,000 over the weekend. On 8 March, the World Health Organization reported 105,586 confirmed cases across more than 100 countries and territories. Although the outbreak has been slowing in China, where it originated, the country still accounts for almost 80% of confirmed cases.
6 March 11:30 GMT — US Congress approves US$8.3 billion for Coronavirus response
The United States Congress has passed an emergency spending bill that will allocate US$8.3 billion for the country’s Coronavirus response. The House of Representatives passed the bill in a near-unanimous vote on Wednesday afternoon; the Senate followed suit on Thursday.

[ . . . ]

###
https://www.nature.com/articles/d41586-020-00154-w#correction-0

 

[chemisttree]

Mask vs. Beard:
View attachment 258493

Masks will not work well if the mask-face seal is compromised by facial hair.
I like the names for the different hair styles.

There is no easy way to test fitment of the respirators either. At least with a rubber mask it is easy to test for a positive seal. I’ve never liked fabric respirators.

 

[DennisN]

I recommend getting your personal moisturizer, since frequent hand-washing leads to dry and cracked skin.

Thanks for the advice! I have now noticed that effect on my hands.

 

[chemisttree]

Here in Australia the government has not acted hard - yet - I just prey they time it right. And while 'amusing' the toilet paper debacle does not give me confidence. Unfortunately my gut feeling is people really are that 'dumb' ...

And that happens for something insignificant. Imagine some more desperate for something truly important. And then imagine you are in the US and those guys have guns...

I really doubt it will come to that though.

 

[bhobba]

I really doubt it will come to that though.

So do I.

Some people on twitter were concerned China says it will have an emergency vaccine in April sometime:
https://nypost.com/2020/03/10/coronavirus-vaccine-could-be-ready-by-april-chinese-officials-say/

They were all worried they were going to be forcibly vaccinated. They didn't seem to understand the word emergency. Highly doubtful one would be released to the public that had not been tested as safe which is going to take a least a year the experts say. Its simply as it said - for emergency use only.

I doubt its any further along the development cycle than others like the UQ one or Modernia. China IMHO is just trying to grab headlines.

A question. During the discussion a lot of people complained they had trouble with the swine flu vaccine. Yet here in Aus I am not aware of anyone that had trouble - I certainly didn't and my immune system has a superhighway through it from taking Biologics (at the moment Cosentyx - its not too bad - only, if I recall correctly, a 5 times increase in the risk of colds or the flu, which is why you must get the flu shot each year - others are evidently much worse). Did some US people get a bad batch or something?

Thanks
Bill

 

[chemisttree]

So do I.

Some people on twitter were concerned China says it will have an emergency vaccine in April sometime:
https://nypost.com/2020/03/10/coronavirus-vaccine-could-be-ready-by-april-chinese-officials-say/

They were all worried they were going to be forcibly vaccinated. They didn't seem to understand the word emergency. Highly doubtful one would be released to the public that had not been tested as safe which is going to take a least a year the experts say. Its simply as it said - for emergency use only.

I doubt its any further along the development cycle than others like the UQ one or Modernia. China IMHO is just trying to grab headlines.

A question. During the discussion a lot of people complained they had trouble with the swine flu vaccine. Yet here in Aus I am not aware of anyone that had trouble - I certainly didn't and my immune system has a superhighway through it from taking Biologics (at the moment Cosentyx - its not too bad - only, if I recall correctly, a 5 times increase in the risk of colds or the flu, which is why you must get the flu shot each year - others are evidently much worse). Did some US people get a bad batch or something?

Thanks
Bill

Nobody I knew had a bad reaction either. Some people always have a reaction to the flu shot. I guess they must complain a lot. I certainly don’t complain about a sore arm from 10 years ago! Of course I never got Guillain–Barré syndrome either.

Shingle vaccine is another story though! Side effects from those are brutal!

I remember my Mom always complaining that the flu shots gave you all the symptoms of the flu and so she didn’t like them. Thank god there wasn’t an internet back then! Oh, the humanity!

 

[Rive]

link

The person and the story seems to be valid, as far as I could check. If anybody has the revoked study (link or saved copy) then please share it somehow.

 

[Bystander]

..., and now the s**t hits the fan;
https://www.google.com/search?q=cor...ome..69i57.28295j0j7&sourceid=chrome&ie=UTF-8

 

[kadiot]

At the time Italy had found 900 cases they had 20 deaths. Germany has found 1200 cases, but only two deaths (both from today). I don't think Germans live that much healthier. Okay, Italy had a couple of older patients early on, but it's still a big difference. Most likely it's a better test coverage.Then you do that. It's a travel restriction (and a ban of events with large crowds), not a restriction on any movement.
Here is BBC's article

Maybe they're more susceptible. Many old people. And maybe because they 'beso' and hug.

 

[kadiot]

..., and now the s**t hits the fan;
https://www.google.com/search?q=cor...ome..69i57.28295j0j7&sourceid=chrome&ie=UTF-8

I think Americans are fond of law suits...not that much in my country. Unless someone started the trend. That would be unprecedented...lawyers would love it!

 

[kadiot]

It’s so bad in N Italy. overwhelmed ICUs, shortage of beds, staff, ventilators pushing the death toll higher... patients are being treated in operating rooms, hospital corridors, or recovery rooms. This is what to come elsewhere

https://www.vice.com/en_us/article/...jPpwX5eaNoQHj2APv88B3pZjeOI5HJNfF4sIW9PcHnQoQ

 

[DennisN]

Just now I read that we have the first confirmed death in Sweden due to the coronavirus. It was an elderly man with underlying health problems, and he was treated at intensive care at a hospital in the capital Stockholm. This news is so recent that it is not yet reflected in the international statistics.

Edit: I've now found a news agency source¹ for this info (only in Swedish, sorry):
http://www.dn.se/sthlm/en-person-i-stockholm-dod-i-nya-coronaviruset/

¹And thereby I also in a small way promote the importance of mentioning sources , and checking sources, which I think is particularly important in a time like this. We are dealing with a brand new virus, and regardless of this we also live in a time when the spread of disinformation, intentional or unintentional, is sadly not uncommon.

 

[kyphysics]

Pro-Tip 1: Costo has LOTS of rubbing alcohol.

NONE at: Walmart, grocery stores, and Target. . .

Pro-Tip 2: Dollar Tree has hand sanitizers

None at: ...

 

[bhobba]

Maybe Germany just has more accurate statistics due to widespread testing? If it is true, it might suggest the mortality rate is nearer to that of the flu.

.
That's my understanding. What I have been reading (eg in South Korea it has a death rate of about 0.5%) when more testing is done (eg in Aus we are setting up drive though testing stations, fever clinics etc like a number of other countries) you get more accurate results. The flu is 0.1% but we have the vaccine and while worse for older people the flu seems to have a lower death rate in that age group, again possibly due to the vaccine. It's hard to tell, but the feeling I get is its about the same as the flu if we didn't have a vaccine for those under 60. It's more deadly over 60, but, as mentioned before, that may also be because we do not have the vaccine.

On a positive note I just looked at the website of the local medical clinic I go to, and they look like they are doing the right thing:
https://www.redlandsclinic.com.au/

I didn't expect anything else from them really - the senior doctor there is very good. The previous senior doctor was one of the most famous in Australia - he had a column in the Australian Medical Associations Journal advising on the more difficult cases and educating on often difficult to recognize diseases like Polymyalgia Rheumatica.

Thanks
Bill

 

[chemisttree]

Pro-Tip 1: Costo has LOTS of rubbing alcohol.

NONE at: Walmart, grocery stores, and Target. . .

Pro-Tip 2: Dollar Tree has hand sanitizers

None at: ...

Where are you? In San Antonio sanitizer and wipes are in short supply but IPA alcohol is still available at Wal Mart. I imagine on the west coast and New York the situation is different.