COVID-19 Coronavirus Containment Efforts

[bhobba]

Since this is a thread about reactions, one might ask if reactions intended to address the first peak are optimal to address the second. (I note in passing that the original objective of "flatten the curve" seems to have been achieved, which makes the question "so why are there still cases now" somewhat puzzling. That was the policy's intent, at least originally)

We need to learn what countries/places that did well got right. As I said before we need to get the basics right ie voluntary mask wearing, social distancing and hand washing, but strongly recommended. Do not interfere with doctors right to prescribe medication they have been using for years off label - we must trust our health professionals. Make sure all the bureaucrats are trained properly and there is proper coordination. And finally rather than lockdowns, border closures etc have a very good 'participatory' tracing system like Taiwan, and quarantine with proper support and checking. Plus ensuring we look after the elderly and vulnerable as a priority.

Thanks
Bill

 

[Gary_T2018]

My 2 cents, and I know this will upset a lot of people: If you really want to control the spread, mandatory N95 masks + mandatory quarantine + forced travel logging.

This is how it is done in China and Korea. This is how partially it was done in New Zealand.

This is not going to be possible in most western liberal democracies because it would be viewed as a fundamental infringement on human rights. The idea of a liberal democracy is to have hedgers, checks and balances so the "winner takes all" situation doesn't happen.

 

[Vanadium 50]

We need to learn what countries/places that did well got right.

Well...

This is the data from New York State, said to be a success story that we all should strive to emulate:

The success is that they avoided a second bump (dashed lines are national), but at a cost of making the first bump 5x larger.

(Further, there are only a few states with two bumps. Most of the "second bump" are in places experiencing their first wave, only later. Louisiana is an example of a state with two bumps. Alabama one with one. To a good degree, the 2nd bump are not drawn from the same population as the first)

 

[jack action]

We need to learn what countries/places that did well got right.

Does anyone knows how much is in control of human behavior and how much is due to variables outside of human control?

Is it possible that some regions are just "lucky" and the Coronavirus is just easier to get rid of, and/or some are "unlucky" and it spreads much much faster, maybe even more virulent? Are we able to identify and take these environmental effects into considerations?

 

[Vanadium 50]

Is it possible that some regions are just "lucky"

This is not too far away from "Corona is punishment from the gods. We must do what our priests ask in order to redeem favor with them!".

Presumably the time of onset is related to the time of first infection, and the rate of spread and number of new infections is related to the number of people the infected interact with and the probability these interactions result in new infections. When integrating this over millions of people, the effect of an individual's "luck" is minimal.

 

[mfb]

This is the data from New York State, said to be a success story that we all should strive to emulate:

Said by whom?

When integrating this over millions of people, the effect of an individual's "luck" is minimal.

Environmental effects are not individual events, they can consistently impact the distribution. A population that lives very spread out for example would make that region "lucky" in the context of the question asked.
If different strains have slightly different spreading speed then the local distribution can have a long-lasting impact, too.

 

[Vanadium 50]

Said by whom?

The governor of the state in question.
Valerie Jarrett.
The Washington Post's Jennifer Rubin.
ABC News.
Harvard Global Health Institute.

A population that lives very spread out for example would make that region "lucky" in the context of the question asked.

I wouldn't call this luck. I would say you have deterministic factors like population density, and you have random factors that affect individuals, but statistically they average out.

 

[jack action]

but statistically they average out.

Even from region to region? What about environmental factor such as temperature, humidity and the like? Could there be groups that are more resistant or resilient than others? Got any sources for the effect of those deterministic factors?

 

[Vanadium 50]

What about environmental factor such as temperature, humidity and the like?

Sure, but to have a big effect would imply that most transmission is outdoors. I don't think that's the case.

Could there be groups that are more resistant or resilient than others?

We know Covid hits African-Americans harderl https://www.cdc.gov/coronavirus/201.../hospitalization-death-by-race-ethnicity.html

Got any sources for the effect of those deterministic factors?

Upthread I showed some correlations with population density.

I would call none of these factors "luck".

 

[mfb]

We know Covid hits African-Americans harderl https://www.cdc.gov/coronavirus/201.../hospitalization-death-by-race-ethnicity.html

More often at least - but if they go to a hospital, they are less likely to die. The cases vs. hospitalization rate could come from a difference in testing.

 

[russ_watters]

More often at least - but if they go to a hospital, they are less likely to die. The cases vs. hospitalization rate could come from a difference in testing.

Good chance; in the US the cities are higher black proportion than the national average and the suburbs lower. That can lead to differences in the spread of the virus, but it also definitely shows up in the testing patterns. In my area of PA, for example, my county (9% black) adjacent to Philadelphia (44% black) had a 20% peak positivity rate vs 10% in Philadelphia, but Philadelphia had 50% more cases per 100,000. Clearly that tells us that testing was more concentrated in the city and more cases were missed in the suburbs.

...though watching/reading the news you'd get the impression that the situation was reversed.

 

[mfb]

Moderna Shares the Blueprint for Its Coronavirus Vaccine Trial
The irony of vaccine trials: To test the efficacy they need people to get sick (in the control group at least). The more wide-spread the disease is the faster we might get an approved vaccine. If it's 60% efficient as they hope then they need 150 cases spread over both groups (15,000 per group, later a bit more). If it is more efficient then smaller samples can be sufficient.
The first analysis is scheduled for November, followed by one that's probably end of December; a final one might come in May. Each time the study gets more sensitive.
Good chance to have a proven efficacy, a good safety record and enough doses for large-scale vaccination mid 2021.

 

[OmCheeto]

I posted something to this effect on my Facebook page way back on June 25th.

Study the role of hubris in nations’ COVID-19 response

I probably came to the conclusion that hubris was a big factor, as by that time, New York City was the world leader in Covid deaths, and a blurb in the Urban Dictionary said; "When I was in the Bronx I got mugged, shot, raped, and murdered in a New York Minute."
Along with everything I've ever seen about NYC characterizing the populous as "tough".

In any event, I'm guessing there's some hubris involved with the following graph.

 

[mfb]

Sorry, could not resist:

 

[Vanadium 50]

In any event, I'm guessing there's some hubris involved with the following graph.

How exactly? That the US is below most nations tsk tsking at it? True, but not crazy when you account for a) population density, and b) the fact that the US is big enough to have both early and late outbreaks.

If you split the US into NY, NJ, CT, MA and everybody else, you get a very different story - one line is flat and well above Belgium, and the other line has the same slope (it has to, since the upper line is fairly flat) but is translated lower.

 

[mfb]

Shouldn't it have a higher slope? Roughly the same rate of deaths but a smaller population in the denominator.

 

[Vanadium 50]

I guess so, but it's only about one eighth the population.

 

[bhobba]

Sorry, could not resist:

Well - what do you expect when your country is headed by someone with a doctorate in Quantum Chemistry. It makes perfect sense. Australia has 34 deaths per million and we are headed by a guy with a degree in economic geography so I suppose out goes that theory. We would be way better if it wasn't for the bungling of some of our public servants whose butt covering is a wonder to behold - they have it down to a fine art form:
https://www.abc.net.au/news/2020-09...tel-quarantine-a-quagmire-no-answers/12678624

Now if only it can somehow be morphed into taking positive action against this virus - but somehow I think it may remain one of those things forever just beyond our grasp.

Thanks
Bill

 

[mfb]

Experts Think The Economy Would Be Stronger If COVID-19 Lockdowns Had Been More Aggressive

Out of those surveyed, 74 percent of economists said the U.S. would be in a better economic position now if lockdowns had been more aggressive at the beginning of the crisis.

Asked what should be shut down first, most said indoor dining followed by gyms.

 

[russ_watters]

Today, the state of Pennsylvania released a digital contact tracing app, base on the Apple/Google platform:
https://www.pa.gov/covid/covid-alert-pa/

In case anyone is unware, today is September 22.

 

[vela]

Today, the state of Pennsylvania released a digital contact tracing app, base on the Apple/Google platform:
https://www.pa.gov/covid/covid-alert-pa/

To be precise, it's an exposure notification app, not a contact tracing app. Traditional contact tracing is still required.

North Dakota has developed a pair of apps. One is an exposure notification app. The other is a location logging app, and a user who tests positive can choose to provide this data to contact tracers.

 

[russ_watters]

To be precise, it's an exposure notification app, not a contact tracing app. Traditional contact tracing is still required.

North Dakota has developed a pair of apps. One is an exposure notification app. The other is a location logging app, and a user who tests positive can choose to provide this data to contact tracers.

Yes, you are correct -- the app provides notification, but its ability to assist in contact tracing is thin at best (despite the headline I let dupe me...).

 

[mfb]

It could help contact tracing quite a bit if many people use the app:

The app detects if users are in close contact with another app user, using Bluetooth Low Energy (BLE) technology. It is the same technology that your phone uses to connect to wireless headphones or your car.

It still has the problems discussed a while ago, of course: Can it give a reasonable set of contacts without spamming contact tracers with everyone who visited the same mall at the same time?

 

[morrobay]

Could an exposure notification quantify the virus lode . Then that leads to a commentary in the New England Journal Of Medicine that mask wearing could lower the exposure dose resulting in a less severe mild/asymptomatic infection. Eg that masks allow just enough entry of the virus to prime the immune system.
They support this with some case histories.

 

[vela]

It could help contact tracing quite a bit if many people use the app.

Apparently, many health authorities didn't have the resources and expertise to build and maintain an app, so Apple and Google have developed a simpler system. With iOS 13.7 and later, as long as your local health authority supports it, all you have to do is enable the feature on the phone. I'm not sure how Google is implementing the system on Android.

It still has the problems discussed a while ago, of course: Can it give a reasonable set of contacts without spamming contact tracers with everyone who visited the same mall at the same time?

The phones only exchange tokens if they're in proximity to each other for 15 minutes or more, so just walking by a person who laters reports being infected isn't going to result in a notification.

My iPhone is able to determine when I'm within a few feet of a device as opposed to just being in the same room, which suggests that it should be good about deciding if another phone is close enough to qualify as a possible exposure.

 

[collinsmark]

My iPhone is able to determine when I'm within a few feet of a device as opposed to just being in the same room, which suggests that it should be good about deciding if another phone is close enough to qualify as a possible exposure.

If you* live in an apartment building, as many do, your phone might be within a few feet from your neighbor's phone all night long, even though the phones are not even in the same room. Bluetooth signals can penetrate walls.

*I don't mean "you" in particular, but "you" in general.

 

[russ_watters]

It could help contact tracing quite a bit if many people use the app:

It still has the problems discussed a while ago, of course: Can it give a reasonable set of contacts without spamming contact tracers with everyone who visited the same mall at the same time?

No, the app is completely anonymous and all information is locally stored or encrypted, so it doesn't have the ability to do 3rd party contact tracing. There is no database of people who have come into contact with each other generated by the app/phone company/google, for the local health department to access.

The primary way it would assist in contact tracing is indirect: by telling you that you have been exposed, you then voluntarily contact your local health department. But that information is soooooo limited because you/it doesn't know who you came in contact with.

 

[russ_watters]

Apparently, many health authorities didn't have the resources and expertise to build and maintain an app, so Apple and Google have developed a simpler system. With iOS 13.7 and later, as long as your local health authority supports it, all you have to do is enable the feature on the phone. I'm not sure how Google is implementing the system on Android.

Sorry, but what app are we talking about here? You said North Dakota has two apps. As far as I know, Google/Apple only created one platform (not an app; authorities create/subcontract the app themselves). It would shock me if they also created a true tracking app, because this was a huge controversy.

The platform was pushed to phones several months ago -- I'm on Android and I got it; I assume iPhone users got it at about the same time.

The phones only exchange tokens if they're in proximity to each other for 15 minutes or more, so just walking by a person who laters reports being infected isn't going to result in a notification.

Actually, my app says it will. The tokens are saved, so if one of those contacts later reports an infection, I'll get a notification that I was exposed. I just won't know who it was.

My iPhone is able to determine when I'm within a few feet of a device as opposed to just being in the same room, which suggests that it should be good about deciding if another phone is close enough to qualify as a possible exposure.

The device doesn't need to know where you are (and for the google/Apple platform I'm aware of it explicitly does not), it just needs to know if you are near another bluetooth enabled phone. Since the range is only 30' and (I think...) they measure signal strength, that is pretty straightforward.

[edit]
Here's a timeline for what I see for N. Dakota:
4/7/2020 - "Care-19" App launched
https://www.health.nd.gov/news/north-dakota-launches-care19-app-combat-covid-19
From the description, it must use GPS (though it doesn't say "GPS") and it has nothing to do with the Google/Apple bluetooth-based platform, since it was launched long before that platform.

5/20/2020 - Apple/Google COVID tracker API released

6/24/2020 - Reference to the "second app" that was under development at the time, that uses the Apple/Google API:
https://www.statnews.com/2020/06/24/digital-contact-tracing-north-dakota/

8/13/2020 - "Care 19 Alert" App released, using the google/apple api:
https://www.kxnet.com/news/state-ne...reduce-spread-of-covid-19-as-students-return/

Looking at the google app store, and the North Dakota website, it appears to me there is only one app and that's the second one -- it appears to me that the google/apple based app replaced the gps based one:
https://www.ndresponse.gov/covid-19-resources/care19

In any case, it does surprise me that any state developed an actual location tracking app and surprises me that it didn't get more press due to the privacy concerns.

 

[mfb]

The phones only exchange tokens if they're in proximity to each other for 15 minutes or more, so just walking by a person who laters reports being infected isn't going to result in a notification.

Well, then it's completely useless for many people, me included. Public transport is the only place where I could get such a notification from - if I'm longer close to other people elsewhere then I know these people or at least can make it easy for contact tracers to find them (and vice versa). With such an app my phone would have a handful of entries from July (couldn't avoid public transport) and nothing else useful since February.

 

[OmCheeto]

Sorry, could not resist:

View attachment 269795

That's actually quite interesting about Germany. Only 1 US state had a flatter slope in that time period.
The slope being deaths per day per million.
You can also manipulate that number to yield the fraction of deaths that are due to Covid.
In Germany, 1 in 340 deaths was due to Covid.
Only Vermont had a better ratio at 1 in 380.
The next best was Maine at 1 in 68.
The other end of the scale isn't quite so good. I actually have trouble believing the numbers are that bad.
2 out of 7 deaths in Mississippi for the last 2 months have been due to Covid.

If you split the US into NY, NJ, CT, MA and everybody else, you get a very different story

If it weren't for maths, I wouldn't be able to tell the difference between the two US slopes.

 

[gmax137]

You can also manipulate that number to yield the fraction of deaths that are due to Covid.

How do you do that?

 

[jack action]

Amazon city of Manaus may have reached 'herd immunity'

 

[mfb]

0.10% of the population died in Manaus. Some parts of NYC had more deaths. It's possible that the official number underestimates the total deaths of course.

 

[russ_watters]

Well, then it's completely useless for many people, me included. Public transport is the only place where I could get such a notification from...

The intended value is that you would respond to the notification by getting yourself tested.

if I'm longer close to other people elsewhere then I know these people or at least can make it easy for contact tracers to find them (and vice versa).

Hopefully your relative would let you know, but if they register their status on the app before letting you know, the app would.

But you're right, without true contact tracing/location tracking the value is extremely limited.

 

[OmCheeto]

How do you do that?

First, you have to figure out what the average, or usual, death rate is. Globally and in the US, it's around 20 deaths per million per day.
If you add Covid deaths to that, and divide by Covid deaths, it yields the ratio.
Of course, the usual death rate varies by location, but it's close enough for my purposes.

An alternative, but dreadfully time consuming procedure:
The CDC has a list of the weekly tally of deaths for all the states from 2017 to the present.
Using Mississippi as an example, you can see that deaths for the time period from 2017 to 2019 are fairly consistent.
2020 showed a marked increase.
Dividing the total deaths by the Covid deaths for the last two weeks in this graph, you get about 3.
So although Mississippi has a death rate of 28 X/M/D, the number came out very close to my 3.5 from my previous post.