Miscellaneous And Off Topic Subjects

[iam416]

Estimated deaths: 4.953 million (worst case with shelter in place states)

Yep. I mean, if we're talking worst case then we're talking 50-60% infection rate. That's roughly 160M. And you're talking a CFR that is pushed up by lack of medical capacity. So maybe 3-4% instead of 1-2%. That's right around 5-6M. In terms of terms of sheer numbers, that's staggering. In terms of "odds" -- it's 98.5% chance you'll surive without regard to age group.

[Jeff Buchanan]

Look, I get the fatalism, the negativity. With people's personal world's crashing before their own eyes, with the press absolutely full of negativity, where people's moods are is not to be unexpected. But we are letting negativity and fear drive us. There are other viewpoints and they aren't that hard to find ...... assuming of course you want to find them as a potential path out of your own personal BPONE.

3/26/20: AS Fauci et al. COVID-19: Navigating the uncharted. The New England Journal of Medicine, 2020 DOI: 10.1056/NEJMp2002387

On the basis of a case definition requiring a diagnosis of pneumonia, the currently reported case fatality rate is approximately 2%.⁴ In another article in the Journal, Guan et al.⁵ report mortality of 1.4% among 1099 patients with laboratory-confirmed Covid-19; these patients had a wide spectrum of disease severity. If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.²

https://www.nejm.org/doi/full/10.1056/NEJMe2002387

Experts need to get an accurate handle on the death rate before they know the extent of the pandemic. The problem is, answering this question is complicated as the rate is all over the place and swings dramatically from country to country.

https://www.psychologytoday.com/us/blog/its-catching/202003/covid-19-the-severity-hinges-question

[AlabamAlum]

It'll be interesting to see how this plays out globally, but I don't think anyone is getting out from under this tidal wave. It's inevitable. My best hope is that infections are significantly underreported and, thus, mortality rates are significantly lower. I'd be stunned -- I mean, floored -- if the CFR was any lower than 1%. And, as AA noted, with a 30% infection rate and even just a 1% CFR, you're looking at 0.3% of the population dying. When you're talking 7.75B, that's a lot. That's 40M. And I expect it to be 40-50M --and I expect that number to be hit by this summer.

[AlabamAlum]

[iam416]

No one alive will be happier to be wrong.

Yeah. I have never wanted to be wrong so badly.

[Dr. Strangelove]

I finally found more explanation for why there is such a breakout in Albany, GA. On Feb. 28 there was a funeral held for a school custodian who had died from a heart attack. Guy had a huge family, lots of relatives, some who flew in from Louisiana and Florida. They're traced dozens of cases back to that day. The pastor who delivered the poor guy's eulogy, and pretty much shook everyone's hand that was there. died himself this past week.

[iam416]

Good day in Ohio. 17.5% growth in cases.

Experts need to get an accurate handle on the death rate before they know the extent of the pandemic.

Totally agree. And that's really my best (and only) hope -- as I said -- significant underreporting of cases. If that's the case then things may not be so bad. But, if we're dealing with a high R0 -- and we are -- then 50% infection is certainly conceivable. Let's say it's a little lower -- let's say in the US we have 150M infections. There's almost no realistic CFR that makes that anything other than a tragedy -- even 0.5% is still 750,000 dead. The case numbers are going to be SO big -- and on that I think we completely agree -- that unless the CFR gets down below 0.5 we're going to have a really bad situation. If it's above 1% we have a catastrophe.

[AlabamAlum]

Just a WAG, but I think the CFR will be right at what the Imperial College model predicted: 0.9%. Which will be ugly.

[Dr. Strangelove]

Good day in Ohio. 17.5% growth in cases.



Totally agree. And that's really my best (and only) hope -- as I said -- significant underreporting of cases. If that's the case then things may not be so bad. But, if we're dealing with a high R0 -- and we are -- then 50% infection is certainly conceivable. Let's say it's a little lower -- let's say in the US we have 150M infections. There's almost no realistic CFR that makes that anything other than a tragedy -- even 0.5% is still 750,000 dead. The case numbers are going to be SO big -- and on that I think we completely agree -- that unless the CFR gets down below 0.5 we're going to have a really bad situation. If it's above 1% we have a catastrophe.

That's definitely good news. Hopefully it keeps up. We're almost exactly 2 weeks after DeWine shut down restaurants & bars.

Most of what I've heard is that 10% is bad but a level hospitals can keep up with.

[Jeff Buchanan]

Believe me, COVID-19 is presenting the world with a huge shit-sandwich. I believe it. I have no intention here of minimizing the challenge. But, the human race is incredibly adaptable and possesses the intelligence to problem solve, apply technology and get the world through this. I'd like more people to stop looking at worst case scenarios ..... it depresses me. We'll each to his own.

I saw a on-line video that many of you have probably seen early last week. It's narrated by a family practice physician that works in MI. He demonstrates how to bring carry out food and groceries safely back to your home creating and using a sterile field - something every well trained medical professional understands. It's not hard and you can google how to do this or watch the video if you haven't seen it. Sure you can do this but is it over-kill?

Here's what needs to happen for any container or piece of produce to become contaminated with the COVID-19 virus:

A person who is actively shedding virus has to transfer it from his nasal passages or oropharynx by expelling droplets in a cough or sneeze to the surface in question. I'll get to the transfer of virus from an infected person's hands/fingers below. Note that the likelihood of the virus living in the form of airborne droplets or from droplets contaminating any particular surface varies and not insignificantly. The numbers you have been hearing about these time frames are anecdotal and are so because health officials and the public are asking for hard answers and there are none of those in good science without well designed and controlled studies. Take them for what they are worth - something but they are not definitive.

Next, you have to transfer sufficient numbers of virulent virus (note that not all COVID-19 viruses are equal - if you want to read a layman's explanation of this, read the Phylogenetics, Taxonomy and Structural Biology section of COVID-19 at WIKI). The probability of that transfer occurring successfully to groceries, containers of your take-out food or the food inside those containers is low.

Next, the virus has to transfer from the groceries or take-out food containers in sufficient amount to remain competent on your hands and fingers. Low probability.

Next, you have to transfer from your fingers or hands sufficient live virus to contaminate the mucosal tissues of your nose or mouth such that you will introduce active virus capable of replicating within your body. Have you been warned to wash your hands and not touch your face? Again, low probability of this step successfully occurring if you are following the most basic preventative hygiene measures.

Can this happen? Sure, but look at all the successful steps, all of those steps with low probability of occurrence, that have to happen for you to become infected from bringing groceries or take-out food into your home.

Here's the point. Everyone looks at worst case and then generalizes it to the notion that the worst case, even though it is a case with a low probability of occurring, is assured. It's not. Personally, I think creating a sterile field when you are bringing your groceries or take-out food into your home is over-kill because of the probability of a bad outcome for you and your family. For me, I'd estimate not undertaking this task is slightly more risky than me driving on I95 South from Fort Lauderdale to Miami. It's risky but it's not going to stop me from making that trip.

[Dr. Strangelove]

The President's ratings for his Pandemic Update press conferences are in! They're AWESOME! And he couldn't be more thrilled. AMERICA!

[Dr. Strangelove]

And I know I know I know...don't want to start a fight over Trump

He's a parody of himself at this point.

[iam416]

[iam416]

[Jeff Buchanan]

The CFR for COVID-19 isn't reliable - not even remotely close - yet everyone is getting their panties in a wad over the implications of the numbers of confirmed COVID-19 cases being reported as it relates to predicting how many people on the planet are going to die. Calculating how many people are going to die based on the CFR, right now, is a fools' errand bound to create hopelessness. We MIGHT know the actual CFR of SarsCOV-2 at some point in the future.

I'm not going to make a long post explaining how important understanding CFR, it's limitations as a predictive tool and the multitude of death stats people are throwing around .... the net result producing fear and panic.

I've linked to this before. It takes a lot of time to wade through and digest all the information at this web site that is updated daily. We seem to be focused here on the CFR and it's implications. Go to the link below and scroll down until you get to this section: What do we know about the risk of dying from COVID-19?

The answer to that question, a very important one, is a resounding, "we don't," and won't until the outbreak of COVID-19 has passed. We also don't reliably know how many people will die, how many people will require hospitalization, how many people will require ventilators? You might say, so, plan on worst case. The numbers are so staggering when you do that one has to step back and reassess given the knowledge that, at this point, CFR simply isn't reliable enough to accurately inform appropriate responses. We should be doing the best we can with who is sick, what's available now to take care of them, including innovative ways to do that, and what's in the pipeline. When I look at it from that perspective, if I look at it locally (and I'm in FL - a hot-spot, now), we're doing well and hopeful that it will stay that way.

https://ourworldindata.org/coronavirus#the-growth-rate-of-covid-19-deaths