Covid blood testing in Telluride, expert projections + more
I posted a link to a story last week saying that Telluride Colorado (San Miguel County) is doing some of the first wide scale blood antibody testing. Early results are in, they’ve tested about 1000 of 8000 residents.
‘Of the almost 1,000 people tested for COVID-19 in San Miguel County, eight have come back positive and another 23 have either indeterminate or borderline results.” (About 1% to 3%, but unclear if testing is being done randomly or there is an attempt to focus on those who are likely to have been exposed first)
In other news, linked is the weekly survey of experts being done at U-Mass that 538 has been highlighting. Myself and others have posted earlier iterations (I haven’t seen this one yet.When there is this widespread disagreement amongst experts, you can see why some of the debates here seem like they are based on completely different sets of facts One tidbit:
“They believe there were between 289,000 and 12.8 million infections, with 1.1 million being the consensus estimate, implying that the experts think that only about 12 percent of all infections have been reported. This is in line with what they’ve reported for the past three weeks, when the share of reported infections has ranged between 9 percent and 12 percent.”
Also from 538, an interesting piece explaining some of the challenges with modeling Coronavirus.
‘So, imagine a simple mathematical model to predict coronavirus outcomes. It’s relatively easy to put together — the sort of thing people on our staff do while buzzed on a socially isolated conference call after work. The number of people who will die is a function of how many people could become infected, how the virus spreads and how many people the virus is capable of killing.
See? Easy. But then you start trying to fill in the blanks. That’s when you discover that there isn’t a single number to plug into … anything. Every variable is dependent on a number of choices and knowledge gaps. And if every individual piece of a model is wobbly, then the model is going to have as much trouble standing on its own as a data journalist who has spent too long on a conference call while socially isolated after work.”
https://fivethirtyeight.com/features/why-its-so-freaking-hard-to-make-a-good-covid-19-model/
Finally - a few quick thoughts about exponential growth.
5 doubles of 1 get you to 32. 10 doublings get you to 1024. 15 doublings to about 32,000. Doesn’t seem to bad does it? But 20 doubles gets you to over 1 million. And from there, things really take off.
Unfortunately that is in large part because nobody knows. I had a conversation with my cardiologist about my level of risk. Walked through my thinking - he responded, that makes sense but there just isn’t data to really know at this point.
This question is directed for all the smart people out there who know statistics, and have a background infectious diseases...
Can we really believe the numbers out of China, and how they've completely stopped the spread of the virus, and their death rate? If not, why are we even including them in cases around the world?
Seems like a question better answered by reporters or people knowledgeable about the inner workings of the Chinese government than statisticians. I believe China has openly said they're not counting cases that are asymptomatic.
I'd have to imagine there's a good deal of underreporting because not only have new cases been low but they've almost completely stopped, as you say. Having said that, lockdowns do work and no one was more severe in regards to travel restrictions than China. They're quite good at controlling the populace. So I do think they have things under control.
You don't really need to be a statistician or have a background in infectious diseases to know that China is lying about their numbers. There is enough testimonial evidence to know that China has been greatly under reporting their cases and deaths. Also, it's logical that a country with 5x the population of the US with higher population density is going to have more cases and deaths
The way you know China is lying is because of the nature of the data they've reported. There is no way to have the outbreak of a disease like this literally stop in its tracks within a couple of days. It doesn't take a statistician, scientist, or expert in infectious disease to grasp the magnitude of their bullshit.
It didn't stop it in its tracks though. It took about 2 weeks for things to start tailing off, which is basically what we've seen in other countries as well.
You're right (I was exaggerating by saying "a couple of days"). But the change in slope over that two weeks just didn't make any sense. Almost no new cases were being reported anywhere in China after weeks of exponential growth, where the cases were doubling in less than 4 days. There wasn't a period where it was about 5 days, then 6, etc. Obviously, they were using quarantine facilities, etc., but that still doesn't make sense, because they were separating entire families from their communities. It stands to reason that if you're putting sick people together with a fairly large number of those who hadn't yet been infected, then those cases would have been easy to spot in the data; but they're not there in anything like the expected numbers.
Like many other have said, you don’t need to be a statistician to know China’s numbers are completely false. It would not shock me at all if they have over a million dead from C19. We will never truly know.
It's a more complicated question than it seems. The Party did what it always does: come out of the gate lying and obscuring because no problems are supposed to be acknowledged. But once it was obvious things were getting out of control, they flipped around and started doing things that no other country in the world had going for them:
1. If you've ever been to a big city in China, almost everyone in the cities already wears masks because the air quality is so poor. It's just what you do even when there isn't an epidemic. But once this became a thing, it kicked to 100%. It's amazing how much social pressure and policing of this there is.
2. They locked down entire cities. That is not a stay-at-home. That is a whole-city quarantine, a "no one gets into or out of this city for a few weeks." No one else in the world did that or could do that.
3. They have unlimited human resources for contact tracing. Huge teams of govt personnel tracked every contact from known positive people through cellular data and quarantined all their contacts. No other country has the kind of manpower resources to do that level of tracing, not even S Korea or Germany, the two Gold Medal countries in the Coronavirus Olympics.
4. Chinese research has been invaluable. Almost all the hard data for first couple of months has been coming out of Chinese research labs because they had the ability to run studies and access to the most patients.
5. Tech companies are reopening factories and stores all over China. I would rely on their data more than any government. Things indicate they are slowly getting back to business, though fears of a second wave persist.
That's a lot to think about. I do think their total case number is way low and death toll is artificially low, but as far as control of spread currently, I think they probably do have it under control because of Nos. 1-3 above.
Yes, they probably have things "under control" using draconian methods. But their numbers make zero sense based on worldwide experience and they've proven to be extremely dishonest in their handling of this outbreak. Why should anybody trust their data now?
China is definitely lying about its numbers. They initially suppressed information about Covid-19 and lied about it - even about human to human transmission. They didn't allow WHO and other international health authorities adequate access to Wuhan. They've kicked out foreign reporters. People in Wuhan have also been spreading rumors that the data is false. MillIons of cell phone accounts apparently disappeared. A mathematical analysis indicated the data did not follow a natural trend and appeared fabricated. How wrong are the numbers? Who knows? I would not be surprised if hundreds of thousands died there - China is 4 times the size of this country after all. They likely used draconian methods to control the virus (per reports) but even so, their numbers make no sense given worldwide experience thus far.
Any model based on Chinese data is not reliable. I foolishly relied on the Chinese data initially and had an overly optimistic outlook. Unfortunately, many in power also didn't adequately question the numbers. We need more testing and data, including population studies, to understand the mortality and overall picture.
and no one got hurt in Tiananmen Square.
On a different COVID topic I checked the Health Weather map today and while the general trend is downward, apparently there is an increasing 7-day trend in some new areas (Kentucky, Tennessee and West Virginia). There are a few counties that are red (the highest level of increase). We’ll see if this is a reliable predictor of virus hotspots.
Michigan meanwhile is solidly in the “decreasing” category on the map so hopefully our surge in cases/deaths still reflects the time before restrictions set in.
I've noticed that, too. It's troubling, but not surprising. If GA's governor is representative of the rest of them in the region, they're not exactly big on math and science.
Many times I think I learn more on this site than I can other places. This is much appreciated. Serious question here. If (and that's a big if) people are practicing proper social distancing, isn't it a good thing that 10 x's more have it or have had it than realize they have it? Doesn't that help build more herd immunity without more people being sick?
I realize if people are not practice good social distancing than these carriers could be spreading the virus more. A big reason why we need more testing.
I'm just asking because most articles I read on the subject make it sound like a bad thing that 10x's more people have it than realize. I tend to think it could possibly be a good thing.
It cuts both ways. On one hand, yes that means more people will be immune and can go about their lives (which will help economic recovery) assuming there is a way to confirm they had it (antibody testing). On the other hand, it means there are more people walking around spreading the virus (even by accident like at a grocery store or pharmacy). If EVERYBODY self isolates really well, as long as these cases are mild then I would think more people having had it and fully recovered (Not taking up hospital resources) would be better once we start opening things back up.
On another note it’s not just asymptomatic people that aren’t being counted, there are many people that are pretty sure they have it/have had it but are at lower risk so there’s no reason to use a test on them (just make sure the take care of themselves and isolate). I’ve talked to many people in MI, which is doing a relatively decent job with testing, that have called their physician and been told something like “yeah, you most likely have Covid, just drink fluids and get rest and self isolate until symptoms are gone for X days. If you experienced any ABC symptoms call again and we’ll get you in”. These people are not counted as cases in any of the official stats.
As someone who used to live in Telluride for the better part of a decade (humble brag), I can tell you although they have a small doctors' office, the medical establishment there is world class. I recall my doctor being an expert in HACE and HAPE, because Telluride sits at such high elevation. He had climbed Everest multiple times and communicated that the doctors' office in Telluride, although small was amongst the best equipped in the nation. Obviously, this makes sense that they are leading testing on something like this since the population is so small and the $$$ is there. Kudos to them.
I believe the company doing this is also HQ'ed in the area...
China has already done this testing exercise and they say that 64% of the people that tested positive for the antibody never exhibited symptoms. There was an article about it in Bloomberg yesterday.
I know a lot the posts on this site are coming from people in Metro Detroit, which has been hit unusually hard, but you all realize this has been a nothingburger in most of the country right? I live in South Carolina and the hospitals are at 54% utilization. Bon Secours, the hospital company, started laying people off last week. I'm very concerned that people have lost all sense of rationality on this issue and we're going to have a really hard time getting back to any kind of normalcy. At this point, the overreaction is going to effect this country negatively for years and years, and it didn't have to be this way.
This post is so Hanitty from 3 weeks ago
I +1’d you bc you linked an interesting article I hadn’t read. That said, there are two things about your post I don’t agree with:
1) different parts of the country will be impacted at different times, and some more or less than others overall. Calling it a nothing-burger when >1000 Americans died yesterday is a bit much. Many experts think it’s staring to flare up in the south next.
2) over the coming months and years we will learn more about this virus and be able to critically analyze the response to it. It may come to pass that information arises that suggests what we’re doing now to the economy was unnecessary or even ineffective in terms of fighting the virus. In my opinion that doesn’t indicate an ‘overreaction’ when the decisions being made are made at a time when we don’t know shit. Note that while I am following guidelines, I do not agree with everything we’re doing and also have been extremely disappointed in forward looking planning at the federal, state and local levels which indicate a lack o strategy that seems to persist even now.
@Mitch Cumstein - In the US, in an average year, we lose 275,000 people a month (9,000+/day) and people don't normally bat an eye. Saying 1,000 people died yesterday is, statistically speaking, a blip. This is especially true when you consider hoe badly this skews to the older populations.
In Spain - EDIT: median age of death is 80.
In Italy - EDIT: median age of death is 79.
In Colorado - 80% of deaths are aged 70+ with most being over 80
In NYC - 70% of deaths are aged 65 or older
To be technically correct, the 79 and 80 #s for Spain and Italy are the median - not the average.
But, even the median for Colorado and NYC are 70+. American numbers are trending the same way.
As America discusses how to move forward during this crisis, those facts and a discussion about "incremental deaths" should be a part of the conversation. I know that's painful for many to talk about, but an honest discussion brings every fact forward.
+1 - I edited my comment.
Are you implying this may save social security?
You understand the concept of exponential growth?
1,000 people dying of this one single cause per day (365,000 per year) would be really bad, especially knowing that covid-19 patients are causing emergency rooms to get slammed and will cause death rates from other medical causes to likely increase, too. But that's not the worst of it.
On March 16, there were 18 deaths from covid-19 in the U.S.
On March 19, there were 56.
On March 22, there were 113.
On March 28, there were 525.
On April 1, there were 1,019.
If it just stopped there, that would already be bad, but it's not likely to. We're likely to enter the stage of multiple thousands per day. If we had not begin social distancing three weeks ago, we'd be there now.
I've heard of it, yes.....the issue for me with the data (one of them anyway) is we still don't know if these numbers are correct because who knows when this hit and how many deaths in January from "pneumonia" would have been for covid 19 so the growth rates are likely off.
The other issue with this data is that a lot of the covid 19 deaths are being tagged as covid even though there could have been other issues at play: https://www.nola.com/news/coronavirus/article_8f833ac2-6fb7-11ea-8f9f-e34730a5ec7c.html
There were reports this was a big issue in europe as well which is throwing off the numbers.
You should play around with some data and see if you can come up with a realistic scenario where there were lots of people infected in January. As I noted in the OP, the number of cases up to 15 doubles is small, but then it starts to take off very quickly.
It's almost like less populated and less densely populated areas aren't hit as hard
Also, the 64% of people who didn't exhibit symptoms number doesn't really matter. It means that those people are more likely to spread it. And if you want to think the numbers in Italy, China, Spain, New York, Detroit, etc. are all no big deal, then I guess you're ok with 100,000 people dying
I promise to stop posting the same stuff at some point, but in the 2017-8 flu season 80,000 people died and nobody cared. Proportional to the population, 200,000 people could die in this country and it'd be no worse than the flu seasons of 1957 and 1968. Epidemiologists on the one hand admit that they don't understand it (why has Metro Detroit been hit so hard when DFW hasn't? Why is NYC so bad and there's almost nothing happening in DC?) and then on the other hand say we need to hide in our houses indefinitely until they say otherwise. Humanity has wiped out one virus ever as far as we know, and that was smallpox after generations of worldwide vaccinations. Maybe we'll get a vaccine for this in a year, maybe we won't. Good luck getting your $2 trillion back, convincing housewives to send their kids back to school in the fall (even when they're in virtually zero danger from this), repairing a now broken economy and repairing hundred of thousands of strained marriages.
but in the 2017-8 flu season 80,000 people died and nobody cared.
It was 61,000. Covid is likely to breeze past that number before April is over. That is with this massive social distancing.
Moreover, in that year, there were 710,000 hospitalizations for influenza. Covid is going to send far, far more people than that to the hospital - again, with all the social distancing in place.
And if we didn't do anything? We are talking a seven-figure death toll and eight- or nine-figure hospitalization total. How would the economy look with going on? Think people would just chill and go to the movies while all that was happening?
And when it does NOT breeze past 61,000 in the US before April is over then what?
https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm
Worldwide again the CDC estimated 1.4 billion got the Swine flu in a year and up to 500k + died in a year. We are at (right now) 1.6 million WORLDWIDE with this new virus and 96k dead.
The H1N1 virus that caused that pandemic is now a regular human flu virus and continues to circulate seasonally worldwide. Life goes on .... normally even.
From April 12, 2009 to April 10, 2010, CDC estimated there were 60.8 million cases (range: 43.3-89.3 million), 274,304 hospitalizations (range: 195,086-402,719), and 12,469 deaths (range: 8868-18,306) in the United States due to the H1N1 virus.
Additionally, CDC estimated that 151,700 to 575,400 people worldwide died from the H1N1 virus infection during the first year the virus circulated.
No one knows how this will really all play out. It's bad fur sure, but is it THAT bad? I guess but it's not off the charts bad to me. I doubt it will breeze past 61k deaths in the US in April though.
I'll give you a +1 for this comment: "humanity has wiped out one virus ever as far as we know, and that was after generations of worldwide vaccinations."
Society needs to quickly come to terms with the following, which is basically a fact: "we will not eradicate Coronavirus today, tomorrow, this month, this year, or this decade. It is now a part of human society, and will be for a generation."
I think there are some folks, including some current public policy makers, who honestly think "let's lockdown for April and then we'll eliminate it to zero!!!"
That's impossible.
Risk management HAS to be a part of the discussion, and sooner rather than later.
We also have essentially eradicated polio. So we have at least a couple of wins.
Exactly. It's fine for everyone now to think we'll hide for a month or two and it will go away. It won't. I'm just looking six weeks into the future when we all need to react to this like adults. 200,000 might die. Maybe 300,000. They will be mostly elderly people who've lived good lives. Start coming to grips with that and rationalizing it in the overall scheme of things. It's not that big of a deal.
Am I ok with people dying, no. But it's a fact of life and 100,000 may sound like a lot but it's less than 50% of any normal months death rate in the US (275,000). Now, look deeper into the deaths and realize the vast majority are 70+....does that change the equation at all for you? The median age of death in Italy and Spain is 80.
Is it worth sending 20,000,000 people into unemployment or bankruptcy and destroying the economic future of our kids to try to extend the lives of 80 year olds another 3 years?
I guess it is.....
1 out of 6 NYC police is either out sick with symptoms or in quarantine. Ww’ve only seen the tip of what happens when Covid-19 runs unchecked. Do you really think that the numbers we are seeing in southeast Michigan and New York City wouldn’t be worse without pretty extreme measures? Do you really think that wouldn’t in and of itself have a huge economic impact? Do you really think the rest of the country that hasn’t been hard hit is somehow immune?
There is no magic case where we do very little, a bunch of old people die and there is not a big economic impact.
https://www.nytimes.com/2020/03/20/opinion/coronavirus-pandemic-social-distancing.html
“The data from South Korea, where tracking the coronavirus has been by far the best to date, indicate that as much as 99 percent of active cases in the general population are “mild” and do not require specific medical treatment. The small percentage of cases that do require such services are highly concentrated among those age 60 and older, and further so the older people are. Other things being equal, those over age 70 appear at three times the mortality risk as those age 60 to 69, and those over age 80 at nearly twice the mortality risk of those age 70 to 79.”
This has been widely shared, so you may have seen it, but I think it does a good job of explaining why the current measures are needed: https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56
Basically, if we do nothing, or less than the current measures, we risk exponential growth in the death rate due to the collapse of the healthcare system due to demand. And that has the side effect of killing a bunch of non-COVID patients because they can't get adequate care.
Less densely populated areas are likely just hit later (and maybe without as much of a peak). The transmission will be slower so it might take more time to spread.
I live in South Carolina and the hospitals are at 54% utilization.
There are hospitals in Michigan (not in SE Michigan) that are like that. The hospital ship in New York likewise doesn't have many patients. This is a spinoff effect of the pandemic. A lot of people have decided that going to the ER for trivial, non-emergency reasons is not a good idea right now as they fear getting the virus. There also probably are fewer traffic accidents.
It can change fast though - and many fear an outbreak in the South.
Tick tock South Carolina.
Careful ..... many people on here don't want rational thinking on here and absolutely NO positive thinking or any spins of any kind! Out of the box thinking is very much frowned upon.
It's pretty clear you're confusing what is and what will be. The virus is just now establishing a foothold in the Deep South -- New Orleans is already swamped, Florida soon will be -- and the ripples will extend accordingly. The Deep South generally and the poorest states in particular are especially ill-prepared to handle something like this, because their hospitals are underfunded and their populations disproportionally suffer underlying conditions: obesity, diabetes, heart issues, asthma. Only the most isolated and underpopulated communities nationally will largely mass problems; most everyone else will likely get it, according to the models. Only a hospital in the dumb fucking south would lay off workers now, of all times.
Thanks for the post
I was looking at the numbers closely last night and a couple things stood out to me.
6% of reported cases result in deaths world wide (USA about 4%)
- that's pretty damn high. what is worse, a high of death rate or a much lower death rate because more people are not diagnosed? Let's say the true death rate is 1%, then this means there are 6 million infected.
The world site has a stat for the number tested per million people for each country
- example test rate per county: usa 4%, spain 7.5%, italy 10%, norway 20%, south korea 9%
I'm not questioning your numbers, but I think death rates as whole need to be taken with a grain of salt for now. Almost every country that has been hit really hard by COVID-19 has a really high population of elderly people and also elderly people who smoke or did smoke: Spain, Italy, China,etc. which I think likely impacts death rates a good deal
no worries
There are so many factors in this thing, (age, population density, wealth, use of mass transit, culture)
I don't claim to understand
here is my source which many have posted here I think:
At this point, talking about how old and frail the people are in Italy, Spain, etc. sounds like a rationalization. COVID-19 is now killing a thousand Americans per day and that's probably going to keep increasing.
That's a strange statistic to hang your head on as it provides no base of comparison or detail....9,000 people die every day in the US in a normal year. 150,000 people die every day around the world.
1,000 a day may seem like a big number but it's well within the range of "normal" for any given year.
A few points:
1) 1000 deaths per day from a single cause is awful and it's pretty callous to argue otherwise.
2) This is an undercount anyway - these are deaths in a hospital setting from people that tested positive. We're not conducting tests on every dead body all over.
3) We're not close to the inflection point in the curve either. The death curve is going to get a lot worse than this actually.
4) This is all while we are social distancing. This is not the full brunt of COVID-19. This is COVID-19 with mitigation.
5) That all of this is caused by an infectious disease, as opposed to all of the other leading causes of death (cancer, heart disease, accidents) will have a much larger psychological effect on society, including on consumer activity.
I don't like to see the economy crash either (my 401K has taken a beating), but I don't understand how anyone could think it would be doing OK in the midst of a full COVID outbreak.