Cont: The One Covid-19 Science and Medicine Thread Part 2

[Orphia Nay]

The Times on Britain's leading epidemiologist:

a report titled Contingency Planning for a Possible Influenza Pandemic. It was dated 2006, towards the end of King’s term, and published by the UK Cabinet Office.

This document considers a range of measures for a possible pandemic. Employers, it says, should be prepared for a large number of absences during the two to three-week peak. The country should be prepared to have 350,000 deaths in the first wave, but, “Key messages from the government during a pandemic will be that people who are well should carry on with normal, essential activities as far as possible, at the same time taking personal responsibility for self-protection.”

Some measures to “reduce social mixing” may be necessary. These include closing large events. But the overall aim should be, it summarises, to minimise disruption as much as possible, while the virus passes through society.

Fourteen years after that document – the considered thoughts of the government at the time – King is explaining to me the correct response in the early stage of a pandemic. “You have to understand exponential growth. As soon as you know that the curve is going up and cases are doubling every two to three days, as soon as you know that, surely you would go into lockdown at that point?”

Put like this, it does sound sensible. But, I say, if I might refer him to the UK’s 2006 pandemic plan, produced in the tenure of one D King, the advice seems to be a little different. In fact, it feels a little bit – how should I put this? – a little bit like herd immunity.

King barely misses a beat. “You’re right. But on the other hand, what we also did very clearly say, I believe – and maybe my memory is a bit faulty here – is you have to get ahead of the epidemic. In other words, look at the people coming into your countries, and test and trace is absolutely key to any epidemic.”

https://www.thetimes.co.uk/article/...-covid-19-and-what-we-should-do-now-nvhdxf7p9

 

[Samson]

I think there is a credibility gap.
Eradication is essential.
Rolfe is describing Scotland's endeavours that will probably work, New Zealand has succeeded.
Always aim high dear worldlings.

 

[marting]

Way too small/limited to be considered more than anecdotal evidence.

While not a large sample size, 1 positive out of 123 kids between the age of 5 and 9 that were in a Covid-19 household is statistically significant (95%) at the 5% transmission level. The problem is more likely the Elisa test used which was only validated for adults. Given the much higher China study level you linked to, this seems a likely source of error.

CDC COVID 19: Information for Pediatric Healthcare Providers

 

[WhatRoughBeast]

All the statistics sites list "deaths reported that day." "Reported" means reaching the final stage of the information being received and listed by the relevant state agency and then getting passed on to whomever's posting the graphs. The weekly patterns relate mostly to which hospital departments and public health departments and intermediate state agencies are closed on weekend days, meaning not many of them reach the final tally point on Sun. or Mon.

While that is a perfectly reasonable explanation, I have my doubts.

Let's say deaths are running 1,000 per day. 40% of agencies don't report on weekends. Then, come Monday and Tuesday, there will be an additional 800 deaths which have to be added to the correct totals, and this would (as far as I can figure it) produce a fairly massive overshoot in the Wednesday / Thursday totals. But there is nothing which looks statistically significant in the other five days' totals.

 

[Trebuchet]

So, (rule of), is what the USA is now seeing the "second wave" or still the first one? I'm thinking still the first, since it's striking in a lot of places that didn't have it so much in the Spring.

 

[The Atheist]

So, (rule of), is what the USA is now seeing the "second wave" or still the first one? I'm thinking still the first, since it's striking in a lot of places that didn't have it so much in the Spring.

Definitely still the first wave, as Fauci has stated on numerous occasions.

And still with a very long way to go.

 

[Skeptic Ginger]

Because teachers are not at any increased risk of being infected.

This article in Nature looks like a good summary of the current science:

How do children spread the coronavirus? The science still isn’t clear

It is almost 2 months old so there might be better research by now. I'm not buying the assertion teachers in Sweden aren't getting COVID 19 without some actual research.

But whether kids play a minor role in the spread of COVID 19, I'll keep an open mind.

 

[Skeptic Ginger]

And as I said, 80% of cases are mild.

There's no question about that.

You wouldn't want to expose thousands of kids to the virus, however, without concern for the small number that do experience life threatening disease. There's no way to know if your kid will be the one that is the exception.

 

[Aridas]

So, (rule of), is what the USA is now seeing the "second wave" or still the first one? I'm thinking still the first, since it's striking in a lot of places that didn't have it so much in the Spring.

Generally speaking, I would call it the first wave. Some places in the US are at risk for a second wave - New York City, for example, but for most of the US, it's first wave. For there to be a second wave, it's pretty much necessary for the first wave to have significantly gone down, and plateaus don't really count.

 

[Skeptic Ginger]

While not a large sample size, 1 positive out of 123 kids between the age of 5 and 9 that were in a Covid-19 household is statistically significant (95%) at the 5% transmission level. The problem is more likely the Elisa test used which was only validated for adults. Given the much higher China study level you linked to, this seems a likely source of error.

I'm not going to argue with you. Unless the research is repeatable, it's not very meaningful. You don't know, was the antibody test reliable, was the population protected because of some other means.

See my post with the Nature article link. There's a good discussion of the wide range of results and possibilities with regard to the role of children in the spread of COVID 19.

You know the common saying, extraordinary claims require at least more than a minimal level of evidence. It would indeed be extraordinary if it turned out kids were not a major spreader of this virus.

Possible, but you need more evidence than one single small study.

 

[Skeptic Ginger]

So, (rule of), is what the USA is now seeing the "second wave" or still the first one? I'm thinking still the first, since it's striking in a lot of places that didn't have it so much in the Spring.

A "second wave" would mean after the first wave was pretty much over. The second wave in the 1918 flu was the following year.

This is still the first wave.

 

[JeanTate]

Do we know how many deaths are in the 40% without risk factors? If it's40%, then the definition of risk factors is bogus science. IF it is greater than 40%, then those are actually protective factors. Whatever the math, I don't think those risk factors are very strong. Rather than age or health, I think the big risk factor of catching it is environment. Like meat processing plants, care homes,... But no doubt the frail will have a higher death rate. But 99.4% of us are not going to die form it, only catch it. So let's get practical about living life while not catching it.

Shouldn't there be CDC Epidemiologists making tallies?

Apples and oranges are not the only fruits.

There are those who catch it, get very sick, and recover fully (after a while).

And those who catch it, get very sick, but never fully recover (Covid-19 as a new chronic condition).

Those who catch it, don’t get very sick, but still end up being sick for the rest of their lives.

Etc.

And there’s things that are not fruit; for example, “I caught it in March 2020, got sick, and recovered. But in March 2021, I caught it again, got very sick, and will very likely die”.

 

[JeanTate]

Everyone that becomes symptomatic was pre-symptomatic between the point of exposure and developing symptoms. This is referred to as the incubation period. Asymptomatics refer to people that were infected but have never had symptoms.

I wonder to what extent being “asymptomatic” is poorly understood, or arbitrary.

Some hypotheticals:

- “the screener asked me if I had a fever, headache, and/or dry cough. Over the phone. I said no, even though I had all three. Ten days later, when I truly did feel fine, I had a nasal swab.”

- “the doctor asked me ..., and took my temperature, and a nasal swab.”

- “the screener, a volunteer, asked me ... I did have a temperature and a low grade fever, but I have those all the time because I have [chronic condition].”

- asymptomatics who are false positives.

 

[JeanTate]

Just wondering - in addition to masks, why not full-face motorcycle helmets as an alternative? People could then see your face and you could even install a little filtered fan for some air circulation (with some other minor modifications). Plus, it's great protection for if you fall down!

OK, they're much more expensive, but plenty of people have them already. I've seen people wearing ski or airsoft masks, but those still obscure your mouth and nose.

I have seen a health care worker (a tech, I think) wearing something like just such a helmet.

 

[JeanTate]

The CDC has also come out and stated they believe infections are under-stated by a factor of 10, with 20M Americans having had Covid to date: https://www.npr.org/sections/corona...ave-had-coronavirus-heres-who-s-at-highest-ri

I think we can be fairly confident that the same applies everywhere, giving a likely mortality rate of 0.5% overall.

There’s still, for the US at least*, the puzzle of why African Americans, Hispanics, and Asian Americans (in that order) seem to have a higher IFR. Even when adjusted for age and pre-existing conditions.

*or at least some parts of the US

 

[JeanTate]

I wonder to what extent being “asymptotic” is poorly understood, or arbitrary.

Some hypotheticals:

- “the screener asked me if I had a fever, headache, and/or dry cough. Over the phone. I said no, even though I had all three. Ten days later, when I truly did feel fine, I had a nasal swab.”

- “the doctor asked me ..., and took my temperature, and a nasal swab.”

- “the screener, a volunteer, asked me ... I did have a temperature and a low grade fever, but I have those all the time because I have [chronic condition].”

- asymptomatics who are false positives.

Right on cue ... “How the World Missed Covid-19’s Silent Spread” (NYT earlier today, link to follow). Contains at least one example, though more about pre-symptomatic than asymptomatic.

ETA: link https://www.nytimes.com/2020/06/27/world/europe/coronavirus-spread-asymptomatic.html

 

[Ulf Nereng]

Two milestones have been reached: Over 10 million confirmed cases, and 500 000 dead.

 

[TellyKNeasuss]

There’s still, for the US at least*, the puzzle of why African Americans, Hispanics, and Asian Americans (in that order) seem to have a higher IFR. Even when adjusted for age and pre-existing conditions.

*or at least some parts of the US

Are you sure that Hispanics have a higher IFR than white Americans? They have a slightly higher fatality per million ratio than white Americans but I thought that they had a substantially higher rate of infection.

 

[marting]

I wonder to what extent being “asymptomatic” is poorly understood, or arbitrary.

Some hypotheticals:

- “the screener asked me if I had a fever, headache, and/or dry cough. Over the phone. I said no, even though I had all three. Ten days later, when I truly did feel fine, I had a nasal swab.”

- “the doctor asked me ..., and took my temperature, and a nasal swab.”

- “the screener, a volunteer, asked me ... I did have a temperature and a low grade fever, but I have those all the time because I have [chronic condition].”

- asymptomatics who are false positives.

This is a very good point.

I've looked for studies that explore variations in how people are characterized as symptomatic or not. This really isn't that hard a study to do and might yield better info on Covid-19 effects.

Who doesn't wake up and perhaps cough? Symptoms are quite nebulous and frankly, pretty common. I sneeze about half the time after I eat. And sometimes I'll cough a bit non-productively. But it's just something I've always done as long as I remember.

 

[JeanTate]

Are you sure that Hispanics have a higher IFR than white Americans? They have a slightly higher fatality per million ratio than white Americans but I thought that they had a substantially higher rate of infection.

My bad.

I really shouldn’t rely on memory!

What I remembered was a CDC document, dated 25 June, “COVID-19 in Racial and Ethnic Minority Groups”, as well as something from either NYC or NY state Health (neither of which I can find just now ).

The CDC document is about hospitalizations, and is adjusted for age (but not underlying health conditions).