COVID-19 Coronavirus Containment Efforts

[bhobba]

I just want to point out that we are suffering financially due to the pandemic even though we have a more relaxed policy. And we are also quite dependent on the economies of other countries.

After listening to the retired Swedish epidemiologist, I do not think cost was the factor - simply, in his view, the futility of some measures and how hard it would be on the population. By futility he meant what happens when you get rid of the measures - it would come roaring back and you have to do it again. He dismissed entirely the idea we will get a vaccine. As I am writing this I am listening to a news story that now is the real test for Australia - we are gradually easing measures, and the debate is will there be a second wave?

If you want my view, should a second wave come (not just clusters appearing here and there) it's lockdown until we get the vaccine which now looks reasonable by the end of the year, beginning next year.

Thanks
Bill

 

[Vanadium 50]

@bhobba, you asked about churches a few days ago. Been busy.

The legal situation with churches is very complicated in the US. There is the 1st Amendment, which says "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof", and the 14th which extends federal protections to the states. There were a number of cases and laws in the 1990's, many triggered by Native Americans who ritually used peyote, intended to provide clarity. This worked about as well as you would expect if you pit put a couple hundred lawyers together and said to them "provide clarity!"

Insofar as there are guiding themes, the government cannot regulate religions per se, but they can regulate everyone, which can include religions. Any impact on religion must serve a compelling state interest, and achieve that interest with the least restrictive means possible. So, for example, the government can require that houses of worship follow building codes, but these building codes cannot prohibit minarets.

So can a US state ban religious gatherings? I am not a lawyer, but it seems like there would be several hurdles that would need to be overcome.

1. The whole question of how long an emergency lasts, especially without legislative re-authorization, is not settled. Likewise what powers governors have during the emergency. The first order of business will be to determine if the government can act at all.
2. The next question will be whether the compelling state interest can be satisfied by a strong recommendation rather than a legal edict.
   1. I believe the burden would be on the state to show that a mandatory vs. a voluntary ban would substantially (and likely measurably) reduce the spread of the disease. I don't believe "it stands to reason" or "every bit helps" would pass legal muster.
3. I believe that keeping Costco open and closing churches will not be easy to defend. "We did a cost-benefit analysis and..." won't pass strict scrutiny, nor will "religion is just unnecessary organized superstition". What might is a rule that X people or Y people per square foot are allowed in both Costco and churches.
4. The arbitrary nature of what is "essential" makes the "this applies to everyone" argument difficult to defend. Why are ice cream trucks essential but vegetable seeds not?
5. Banning parking lot services looks particularly troublesome, since schools are having parking lot graduation ceremonies. The argument that the safety depends on the content of the ceremony will get no traction.

Governments are almost sure to have more success trying to achieve their aims voluntarily.

 

[anorlunda]

So can a US state ban religious gatherings? I am not a lawyer, but it seems like there would be several hurdles that would need to be overcome.

That's a pretty good summary. I would add to that.

In addition to needing a compelling government interest, they are required to accomplish it by the least restrictive means. Thus lawyers can argue in court that a voluntary rather than mandatory lockdown would fulfill the compelling interest.

And the specific words in the laws matter. One state law authorized quarantine up to the incubation period of the disease. It should have said contagious period. Words matter.

 

[DennisN]

After listening to the retired Swedish epidemiologist, I do not think cost was the factor - simply, in his view, the futility of some measures and how hard it would be on the population. By futility he meant what happens when you get rid of the measures - it would come roaring back and you have to do it again.

Yes, I saw the entire interview too, and I got the same impression. I remember he also questioned if it would be possible to have long "forced" lockdowns in democratic societies, i.e. if the people would allow it or grow tired of it after some time. It was a very interesting interview.

 

[bhobba]

Should we expect a reversal in the trend toward high density living to be a consequence of this pandemic?

I think so. But I also think it would have eventually happened anyway - a big driver IMHO would have been self driving cars. That is going to be a very very disruptive technology. Even if you live an hour away you can relax while driving to and from work with no super high parking costs.

Thanks
Bill

 

[Vanadium 50]

It certainly is rejected by me now. The consequences are now clearly and obviously absurd.

Why do you say that?

If one works backwards and takes the number of deaths in LA and Santa Clara counties and infers the number infected using results from the New York (city and atate), Heidelberg and Miami-Dade studies, one gets 230-550K infected in LA county and 15-33K in Santa Clara county. The corresponding "obviously absurd" numbers are 210-442K and 14-35K. To me it looks like they are seeing more or less what everyone else is seeing.

Wrong, sure. Maybe it's wrong. Obviously absurd? I'm not seeing it.

 

[Vanadium 50]

While the Santa Clara study was flawed, there are other reasons not to rule out a death rate near 0.3%. One should of course also not rule out higher death rates near 1% (rough calculation with NYC antibody testing suggests about 0.8%).

I agree. I suspect that if you looked at non-nursing home cases, the numbers will get closer together.

 

[bhobba]

Obviously absurd? I'm not seeing it.

Good point - one must always be carefull with language. There may be other explanations for extrapolating things to other situations such as MFB mentioned.

Thanks
Bill

 

[mfb]

China Wants to Use Its Coronavirus App to Track How Much Its Citizens Sleep, Drink, and Smoke
It's not difficult to see why people are skeptical about tracking apps, especially mandatory ones.

 

[bhobba]

Nice video from Peter Doherty:


Strange though, we have some people doubting that social distancing is of any value at all - they say it has been debunked. I find it very very hard to believe, but it is being said by a few commentators - not scientists though.

Thanks
Bill

 

[Vanadium 50]

In addition to needing a compelling government interest, they are required to accomplish it by the least restrictive means.

I just read the sixth circuit injunction Roberts v. Neace, and that phrase figures prominently. Two other points are made:

1. "The Governor has offered no good reason for refusing to trust the congregants who promise to use care in worship in just the same way it trusts accountants, lawyers, and laundromat workers to do the same...aren’t the two groups of people often the same people—going to work on one day and going to worship on another?" (p.6)
2. Governor DeWine said it was "not Christian" to hold church services during the crisis. That has the State determining what a given denomination can and cannot believe. That, obviously, was a mistake.

One thing i learned is that the list of what is "essential" is 4 pages long.

 

[Vanadium 50]

we have some people doubting that social distancing is of any value at all

In some places, I would agree. In a NY nursing home, where essentially everyone has been infected, what's the point? And in isolated parts of the world where you need to drive for miles and miles to find a case, again, what's the point?

 

[bob012345]

Nice video from Peter Doherty:


Strange though, we have some people doubting that social distancing is of any value at all - they say it has been debunked. I find it very very hard to believe, but it is being said by a few commentators - not scientists though.

Thanks
Bill

He states that "we need to vaccinate everyone in the world". Is that really reasonable? At some point well before that, the virus would have few places to go.

 

[bob012345]

In some places, I would agree. In a NY nursing home, where essentially everyone has been infected, what's the point? And in isolated parts of the world where you need to drive for miles and miles to find a case, again, what's the point?

Maybe because how sick a person gets may be related to how much virus exposure they have. I heard somewhere that medical workers who get sick get really sick. Otherwise, you could just let Covid positive but asymptomatic health care workers keep treating other Covid patients.

 

[Rive]

"we need to vaccinate everyone in the world". Is that really reasonable?

If the immunity (by the vaccine) lasts long enough, then maybe.

 

[anorlunda]

[Moderator: 29 posts relating to elevators and airflow were moved to a new thread.]
https://www.physicsforums.com/threads/elevators-and-airflow.989692/

 

[atyy]

Correction by Trevor Bedford on an earlier speculation of his that I posted earlier in this thread.

"Based on data that's emerged in the intervening months, I no longer believe that a direct WA1 introduction is a likely hypothesis for the origin of the Washington State outbreak. ...

Thus, I believe I was wrong in the original assessment of a WA1 introduction, but correct in asserting significant community spread in Washington State on Feb 29 ...

I'm sorry to have created confusion here. Although I do think that my original actions were warranted given available evidence at the time."

The correction posted points to this very interesting paper. It points out that the erroneous hypothesis from Bedford that the WA1 case seeded the Washington state outbreak obscured the effectiveness of the early contact tracing efforts - they were in fact successful (also points out early contact tracing in Germany was successful). They say that is ironic that the erroneous hypothesis nonetheless did lead state officials to take early actions promoting social distancing, which may have been beneficial.
https://www.biorxiv.org/content/10.1101/2020.05.21.109322v1
The emergence of SARS-CoV-2 in Europe and the US
Michael Worobey, Jonathan Pekar, Brendan B. Larsen, Martha I. Nelson, Verity Hill, Jeffrey B. Joy, Andrew Rambaut, Marc A. Suchard, Joel O. Wertheim, Philippe Lemey
"Our finding that the virus associated with the first known transmission network in the US did not enter the country until mid-February is sobering, since it demonstrates that the window of opportunity to block sustained transmission of the virus stretched all the way until that point. It is clear that early interventions can have outsized effects on the course of an outbreak, and the precise impact of the slow rollout of diagnostic tests in the US on the early stages of the pandemic is likely to be explored and debated for years to come, including the initially narrow criteria for who could be tested."
@chemisttree raised these concerns very early in this thread.

 

[mfb]

Despite concerns about the reproduction rate in Germany after more things opened again: The rate of new cases is still falling.

30-40 deaths per day, or ~1% of all deaths. That's a very manageable level, and the number of active cases is still going down.

https://de.wikipedia.org/api/rest_v1/page/graph/png/COVID-19-Pandemie_in_Deutschland/0/a85c5c4ef62066a22e2dfca0beed613578731df9.png - most of the time they are below 1.

 

[bob012345]

Here is an interesting idea. The idea is to reduce the potential spread of virus through social interaction by anti-viral mouthwash use. If you must socially engage people, killing most potential viruses inside your mouth first may help mitigate spreading for a short time. Of course this assumes you don't know you are infected but are just willing to take precautions similar to and in addition to wearing masks and distancing in public. Perhaps an anti-viral Lozenge could also be designed for continuous action during a necessary social interaction.

https://academic.oup.com/function/advance-article/doi/10.1093/function/zqaa002/5836301

 

[bhobba]

He states that "we need to vaccinate everyone in the world". Is that really reasonable? At some point well before that, the virus would have few places to go.

I think the better question is, is it necessary. If the vaccine is highly effective then only a certain percentage needs to be vaccinated and herd immunity will help us out. If not then it may be necessary to vaccinate as many as possible. I was recently reading an interesting article on the resurgence of Whooping Cough:
https://www.sciencedaily.com/releases/2015/06/150624071018.htm

Certainly when I was young you never heard of Whooping Cough. But recently we are seeing outbreaks of clusters. I thought it was the rise of anti-vaxers. But the above made me think again.

Thanks
Bill

 

[OmCheeto]

I think the better question is, is it necessary. If the vaccine is highly effective then only a certain percentage needs to be vaccinated and herd immunity will help us out. If not then it may be necessary to vaccinate as many as possible. I was recently reading an interesting article on the resurgence of Whooping Cough:
https://www.sciencedaily.com/releases/2015/06/150624071018.htm

Certainly when I was young you never heard of Whooping Cough. But recently we are seeing outbreaks of clusters. I thought it was the rise of anti-vaxers. But the above made me think again.

Thanks
Bill

I and a couple of my co-workers contracted Whooping Cough back in 2002. There were several interesting things about it that I noticed.

1. Everyone over 45 contracted it, while no one under 45 did. This led me to the conclusion that vaccines might lose their potency after time.
2. My two co-workers refused to acknowledge they had it, even though they had the classic symptoms. When I played the audio of a child's cough, mean as junkyard dog grandma said; "That's exactly what my grand-baby sounds like when he coughs.". This was my dollar store version of "contact tracing": We all caught it from grandma, who caught it from her grandson.
3. When I went to the doctor to get tested, I was told I didn't have it, as I had none of the symptoms, and therefore didn't warrant a test.

#3 is what had me laughing when I heard no one could initially get tested for Corona virus. Some things never change.

It's possible my experience with Pertussis has skewed my reaction, and therefore actions, to the way I'm dealing with Covid.

 

[vela]

3. When I went to the doctor to get tested, I was told I didn't have it, as I had none of the symptoms, and therefore didn't warrant a test.

If you didn't have symptoms, how did you know you had it?

 

[OmCheeto]

If you didn't have symptoms, how did you know you had it?

The medical practitioner said I had no symptoms. He was incorrect. I had all the symptoms.

Unfortunately, my printer was not working, so I couldn't print out: "A printout for your doctor".

I think it's changed a bit in the past 18 years. But the gist is the same; "It is very difficult to diagnose because it does not make people ill and the severe coughing only happens every few hours."

I didn't cough once during my visit, hence, I didn't have a cough.

 

[mfb]

Simpson's paradox in Covid-19 case fatality rates: a mediation analysis of age-related causal effects
Italy had a lower case fatality rate both in the 0-69 and the 70+ age group than China, but a higher overall case fatality rate - because they had more cases among older people (and they generally have more older people than China).
Here is a video discussing it

No new cases in New Zealand for a whole week, only 1 known active case.
Iceland has 1-2 per week (3 in the last 14 days, only one active case), Hawaii has an average below 1 per day (10 in the last 14 days, 26 active cases).

 

[atyy]

‘Got my fingers crossed.’ As ITER fusion project marks milestone, chief ponders pandemic impact
https://www.sciencemag.org/news/202...roject-marks-milestone-chief-ponders-pandemic

 

[sophiecentaur]

I think this must be a simple piece of Maths and, if it is, then the situation is pretty scary.
R₀ can be looked upon as the number of other people an infected person will pass on the infection to. (It can be related to individual viruses but my worry still applies.)
If R₀ is greater than 0.5, in a population and the restrictions are lifted, just-like-that and with no extra technical help or some alternative restrictions then it's very likely that we (UK) will all, on average, have contact with at least twice as many other individuals. It seems to me that will imply R₀ will double to more than unity which will cause rapid growth in infection numbers. Will it be treated as a bit of bad luck and will the population be blamed, as usual?

It amazes me that nobody much (in UK at least) seems to have set up a vast (government backed) retail industry for 'fashionable PPE' which could be worn when away from home and allow the wearer to still look stylish and stay safer. (In my case, probably more stylish than usual.) Quite recently a flourishing industry for Outdoor Wear was developed. Where's the Corvid equivalent? And it wouldn't just be snake oil if it could be hot washable. The only sign of any level of PPE supplies seems to have been overpriced pretty face masks, produced by 'cottage industries' on a very casual basis.
When you think how fast the UK industry managed to produce arms at the beginning of WW2 - Spitfire Fighters came off the production line faster than the Enemy could shoot them down. Where is the equivalent effort to produce vast amounts of suitable equipment to help the public?

My son and family moved house this week and the 'movers' (a very well known name) were not using any form of PPE. Hard to credit.

 

[Vanadium 50]

I think this must be a simple piece of Maths

Why do you say that? We can't tell what R is now, much less how it will change in the future. The only thing simple is "it will be no smaller than it would be if we stayed locked down". Beyond that, it's anyone's guess.

 

[atyy]

My son and family moved house this week and the 'movers' (a very well known name) were not using any form of PPE. Hard to credit.

If they had no symptoms (not even mild ones), kept 1.5 m apart (or whatever the recommended safe distance is in the UK), and the house was well ventilated (eg. windows open), then they could still be operating safely.

 

[BillTre]

Saw this today on my Linked In feed:

A lot of biological research involves repeating something many times to find a rare but important result.

 

[bob012345]

‘Got my fingers crossed.’ As ITER fusion project marks milestone, chief ponders pandemic impact
https://www.sciencemag.org/news/202...roject-marks-milestone-chief-ponders-pandemic

That the ITER chief is worried about pandemic delays is a hoot. The project has already been severely compromised, delayed and financially overextended as to make any Covid related setbacks comparatively insignificant.

 

[atyy]

Saw this today on my Linked In feed:

Wow, I'm impressed but a little skeptical - did he really save all the 96 well plates he used?

I met a patch clamper who saved all the "pipettes" he'd used, but doesn't one usually just wash the plates and reuse them?

 

[PeroK]

I think this must be a simple piece of Maths and, if it is, then the situation is pretty scary.
R₀ can be looked upon as the number of other people an infected person will pass on the infection to. (It can be related to individual viruses but my worry still applies.)
If R₀ is greater than 0.5, in a population and the restrictions are lifted, just-like-that and with no extra technical help or some alternative restrictions then it's very likely that we (UK) will all, on average, have contact with at least twice as many other individuals. It seems to me that will imply R₀ will double to more than unity which will cause rapid growth in infection numbers. Will it be treated as a bit of bad luck and will the population be blamed, as usual?

Like all such data analysis it depends ultimately on the distribution: who is currently carrying the virus and how are they passing it on? It could be that currently almost all new infections are caused by a) people doing essential jobs - or otherwise not working from home; or b) people flagrantly breaking the rules. It could be that your average family in lockdown, who has no personal contact with people who are at work, have a very low risk of becoming infected and represent a very low percentage of the new cases.

Under this assumption, an opening up of social activities to those people may make little or no difference.

On the other and, if a significant percentage of new infections come from the large number of people having brief contact with others - shopping or passing in the street etc. - then any easing of the restrictions will push the R number up significantly.

My view, for what it's worth, is that the UK government(s) are working with a very broad brush of measures. That we have little or no idea how many people have been infected is, in my view, missing possibly the most vital piece if information. Without knowing the true infection rate - not just the number who get sick - we are effectively in the dark.

 

[sophiecentaur]

We get regular updates on the R factor in UK and we don’t need to know the value of a variable to make algebraic calculations. I have not read of it being steadily below 0.5 in any case.
As for operating “safely”, I don’t know of a method of carrying a fridge yet behind 1.5m apart. Then there is the puffing and blowing and touching (Shared touch) items with ungloved hands. The male half of the UK public, especially the young and old, have no culture of hand washing and I really doubt that it’s done by some sectors at all often. all those sloppy men, returning to high risk employment will soon change R unless it’s made the most important factor in Staff Training about Health and Safety. That must involve ‘dressing up’ to look the part (Village People made hard hats and gloves acceptable amongst the manual operatives all over the world).
But my main point is not about specifics. It’s Bayesian statistics. Change one probability and you need to respond with another change to maintain even just the same result.)
hopefully our “world beating” track and trace System will put those sloppy guys back home PDQ. And it is mostly guys who don’t wash hands.

 

[BillTre]

Wow, I'm impressed but a little skeptical - did he really save all the 96 well plates he used?

I met a patch clamper who saved all the "pipettes" he'd used, but doesn't one usually just wash the plates and reuse them?

My guess is he accumulated used plates from the lab after his project to make the picture based on the numbers he had.
In my experience used plates are not reused but pitched. It would be hard to clean them well.

Out of curiosity, I counted the number of plates in one of his stacks: ~130
8 stacks -> 1040 plates
96 wells/plate -> 99840 wells, almost 100,000.
That's a lot, but probably not all the wells were used.

He could have been using a robot to deal with some of the use of the plates.

I have been in fly labs where gallon jars of dead flies in alcohol were accumulated.
That would be millions of dead flies.

 

[kyphysics]

Big question for me is colleges (and the towns they exist in).

Colleges cannot social distance easily. Dorms are packed. Lecture halls are packed. Young people WANT to be around each other. College students also cannot just stop attending school. They are too old to be under parental control and support, yet too young and unqualified to work and live on their own.

They have to go back to school. So, what happens in these colleges and college towns? Fall/winter is also when a second wave could hit if following the trend of the 1918 Spanish flu. This could be an even more virulent strain.
Is mass infection inevitable from a return to school this fall?