OT (not really): COVID-19 Discussion Thread
With sports currently shut down, there is little to talk about other than the current pandemic. There have been a few threads on this, but nothing today and nothing currently on the page 1 of the board.
With life drastically altered, I, for one, miss so many of the mundane aspects of life, one of which is my discussions / arguments / laughs with the community on this board. Hence, this topic.
Here are a few questions / comments to get the discussion started, but feel free to chime in with your own:
1. When do you think that we will resume primarily normal activities in this country. By that, I don't mean 100% normal, but open bars and restaurants, most kids back in school, resumption of sports and open offices?
The decision is not so clear. On the one hand, we want to protect people from this scourge. On the other, locking down the world is going to have devastating real life financial consequences (not just the markets, but real people losing real jobs that won't come back for quite some time) if this goes on for more than a week or so. My prediction is that on or around April 1, the Fed government will announce that the 15 days to stop the spread did enough to slow the disease that the medical resources can deal with this disease. The reality is that almost all of the fatalities have been in a very defined group of people - older people or those with compromised immune systems. I can see a lifting of many of the shutdowns, but with advisories and restrictions left in place for such people. I can also see more localized shutdowns remaining in place in hot spots such as NY and Cali.
2. If the country is open for business by May, why would the NCAA not consider hosting "March Madness" then. Yes, it would require a massive amount of logistical work, but (a) the athletes who worked so hard deserve the opportunity to play; and (b) it would be a huge positive for the country's morale and for the economy (which is very needed). In my view, hosting the Tourney in May or June is the right, and patriotic, thing to do.
Its going to be awhile.
Not going to say my company name, but the West Coast company that I work for just told us that we have to work from home until the end of April. So thats likely going to be the reality for the rest of the nation soon.
That can’t be allowed. There’s just no way that’s a feasible option nationwide. For individual companies maybe. But there is no way the economy can survive a shutdown that lasts that long.
Lol man, economy is already fucked. Start thinking May, which aligns with what we last heard from CDC.
The sooner we get back out there the better, economically speaking. The only hope is that officials, and people in general, realize that keeping everyone indoors is not a long term solution. We have to learn that fast and come up with a way to get back to work sooner rather than later. MASSIVE unemployment (think 20% or higher) will be a very real thing if we dont.
Who said you have to stay indoors?
The economy is fucked regardless. Once the lockdowns and isolation in China and SK cease, you’ll see a spike in cases just due to sheer interaction.
The economy will then tank again due to that.
It’s inevitable.
Yep. The outbreaks will not stop until there is a vaccine, which is probably 18 months out still. Unless there is a miracle, our economy is fucked for the next year at least.
Yes.
There's a lot of uncertainty right now. Even if this social distancing works as intended and deaths peak no higher than the low thousands, there's a chance it will spread again after we start going back to normal. All it takes is one idiot who doesn't quarantine. Past pandemics have had waves.
After you get past whether this social distancing will actually work as intended in the US (and there's a big fat question mark there, I still see a disturbing number of people out and about pretending everything is normal), you gotta wonder what happens the next time we're faced with the prospect of having to social distance ourselves.
People are out and about because life doesn’t just cease to exist because of a pandemic. This might come as a surprise to you, but people still have to work at most places. People still have to get gas so they can drive to work. People still have to go to the store for food and supplies. What else are these people “out and about” doing? Everything else has been shut down ffs. Also where are you seeing these people “out and about”? Are you “out and about” to see them? Smdh
Everything was shut down because people can't follow the fucking rules.
PLENTY of people still think this is "just the flu" and an overreaction. Trust me, I'm apparently friends with all of them on Facebook.
I've seen it first hand, too. Some are over-cautious, probably, but too many do not give a rats-ass. Saturday we went to brunch and there were only a few people in there and they were screaming about what bullshit this all was and hanging all over each other and the waitress they knew.
Plus look at all the people partying in Florida, right now.
"Everything" isn't shut down. You can still go to a restaurant, bar, movie, etc. Social distancing only works if most people actually do it. I know people still have to work and get groceries, you think I'm that fucking dumb? But one might expect that less people would be out and about if most everyone were actually following the CDC recommendations (namely stay home if you can). I literally can't go to work right now (only essential employees - everyone else has to telework - I work at a university). I've been home all week. I've gone out of my house literally twice since last Friday - once to take my dog for a walk at a park, another to get groceries. Both times I was astounded at how many people were driving around, like nothing had changed. I don't think everyone is taking this near as seriously as they should be. A lot of people are, but not everyone.
Or maybe, I dunno, we find a treatment while we work on a vaccine, begin importing mass amounts of ventilators, masks and gloves while we work on bringing back the capability of doing this ourselves (which is the real problem 50 years in the making) and in a few weeks we lift quarantines while keeping the most vulnerable of our population safe.
Or maybe, I dunno, we find a treatment
Yes, I mentioned that in my comment when I said, "unless there is a miracle"
begin importing mass amounts of ventilators, masks and gloves
Import them from what country? Every country in the world wants these things. Ventilators take a long time to manufacture due to supply chain constraints. Healthcare workers are going without masks and gloves or being asked to reuse them. This is with those mask/glove manufacturers working at 110% capacity and world demand growing every day.
while we work on bringing back the capability of doing this ourselves (which is the real problem 50 years in the making) and in a few weeks we lift quarantines
Riiiiight. We're going to accomplish all these things in a few weeks? I wish I lived in your fantasy land and not in the reality everyone else is living in.
Scientific advancement is not a miracle, it's actually happening right now.
We are already seeing rapid advancement in testing and test kit production as well as advances in the tests themselves.
Factories here are going to begin producing the things we need.
All of this stuff is already beginning to happen and yet people are still acting like nothing is going on and everywhere is Northern Italy.
You can't reason with these people Scooter. They've not had to cope with something this fear-inducing. 9/11 was 19 years ago! Most on this board are in their 20's I would guess. They don't yet know resiliency. But they will soon enough. The old saying...it's darkest before the dawn. Gonna get darker yet, but the light will come. Stay safe.
Hard to say one way or the other because we don't have a good baseline of infections....for all we know the true infection rate is MUCH higher already (which I believe) and the death rate is therefore not as bad as we fear.
I don't know, if we don't get people back to work in 15-30 days, no amount of gov't intervention will save us from a depression. It's not realistic to lose two months of GDP without EVERYTHING going to shit.
Agreed.
At the risk of sounding horrible, from what I've read (caveat emptor) this is a bad virus; but isn't dangerous to most of the population. Fatalities start rising when you hit fifty and dramatically when you hit 60 and beyond.
I also have read that once you get it, for this strain at least, you can't relapse. It's also slow to mutate.
If the above remains true it might be better to do a targeted quarantine/isolation and let the rest of the economy back to work.
Allow those 60 and over, or with other comorbidities, to have some legal protection that allows them to stay home without being fired. Be very careful about nursing homes and rehab facilities. But let the rest get sick and recover.
Well they are now finding that a third of those that get it will have up to 30% reduction in lung function that is permanent. Even people 30-50 years old with no prior health problems are seeing this same issue. Go ahead, but I don’t want to chance it.
Do you have a source? I’m not being a dick I’m honestly wondering. I have been looking at the CDC website this afternoon and did a google search for long term health affects but haven’t found anything. I’d love to see more data. I know Things are developing and I could well be missing something.
March 19th, 2020 at 10:29 PM ^
NO. This virus has been around for a couple months. How could anyone say it's permanent damage? No doctors are saying that. But yes, it is true that some people have lingering effects, and who knows, it could be permanent. But we just don't know yet.
At the risk of sounding horrible, from what I've read (caveat emptor) this is a bad virus; but isn't dangerous to most of the population.
People need to stop repeating this idea. It's very misleading. Read this article :
This post isn’t in any way meant to be flippant, or in anyway undercut the seriousness of the virus to young people. It can put you in the hospital and do long-lasting damage. It should be taken seriously, and all people need to social distance and practice perfect hygiene. That said, the numbers in that article (and others I’ve seen like it) are likely very misleading.
1) due to the limited availability of testing is the US, less severe cases are typically not being tested. So any stat around “this % of people in this age bucket Test positive are hospitalized” probably is higher than reality.
2) I believe that the “fun fact” in this article (and I’ve seen similar for France) that X% (a big number around 50) of hospitalizations are people under age Y is extremely misleading. 1st, there are more people under age Y than above it. That’s like saying people under the age of 100 are at high risk bc we’ve seen that 99%+ of people hospitalized are under 100. Number of people in a bucket being hospitalized will always be a function of the total size of the bucket. 2nd, these stats are highly skewed by behavioral patterns (which I acknowledge is one of the purposes of the article you link) where after this outbreak accelerated we see a general trend of younger people continue to gather in groups and older people isolate. These behaviors likely have as much if not more to do with the hospitalization trends than the inherent rate and intensity of infection as a function of age.
+100. GREAT post. Thinking about the numbers in a holistic sense, as opposed to just an isolation.
I think everyone recognizes that a lot of mild/asymptomatic cases aren't identified (by design, right now). But the fact remains that for a young adult, COVID-19 puts you at greater risk of becoming seriously ill than pretty much any other contagious disease out there. People need to be aware of that.
And of course there is the concern that you could spread it to a person in the risk categories.
The point isn't to be terrified and hide under your bed, but to understand that your age doesn't make you bulletproof. Your thought shouldn't be "I'm going to be fine, but others won't" but rather "I've got to take precaution, too."
Well put. I think it was a problem with the messaging - the word got out that elderly and people with immune system problems were most at risk so young healthy people took that to mean it wouldn't affect them, 'I don't need to worry'. And that's how you get these 20 year old jabronis on the beach in Florida saying 'if I get it, I get it, no big deal'. 1) Getting sick sucks, no matter what it is 2) You don't know how it will affect you individually if you do get it 3) You could be a carrier and not be sick - please take the precautions and don't spread it around. Basically, be smart and not selfish.
I've been thinking about the virus this way, please indulge this clunky, backwards metaphor for a second: Let's say there's a new lottery ticket/game out there that gives you between a 0.6 and 3.5% chance of winning the jackpot. If you win - you get either a good sum of money or an absolute life-changing jackpot. Also, if you win, members of your family, especially your grandma have increased odds of winning. Now would you buy that ticket? Sure, it's not a bad bet because those odds are actually pretty good and significantly higher than your usual old lottery ticket. Except in this lotto, the jackpot is death and you should do what you can to stay the fuck away from it.
But the fact remains that for a young adult, COVID-19 puts you at greater risk of becoming seriously ill than pretty much any other contagious disease out there.
Source?
I can think of a few that I'd be more worried about. HIV and HPV should be obvious. Polio, if it gets back out. Measles, since we've lost herd immunity. Ebola.
Yes....the key word for me was "confirmed cases". When the only people you are testing are those sick enough to require medical attention, you have a big "adverse selection" problem. There are likely 100,000s of cases showing no symptoms and having no problems walking around. This has been in the air since November, I guarantee people you know are walking around with it with no clue or just an annoyingly persistent cold.
EDIT: from the article itself after they provided an UPDATE:
"UPDATE: This story has been updated to clarify the study sample included in the CDC's survey. The number of confirmed cases is almost certainly well below the number of actual cases, meaning the percentage of young Americans who contract the coronavirus and require hospitalization is likely much lower. A previous version of this story was unclear about the difference between confirmed cases and actual case numbers."
Within your own article:
"The true percentage of young people who require hospitalization is likely much less, because many remain asymptomatic."
"Between 2 percent and 4 percent of confirmed cases among people that young are admitted to intensive care units. The fatality rate is low, only 0.1 percent to 0.2 percent."
It says nothing of whether or not the young people in the article had any pre-existing conditions.
In short, people are taking exceptions and trying to make them the rule despite all evidence to the contrary.
Being hospitalized and going to the ICU are two separate things. Up to a fifth of young adults that are confirmed cases are hospitalized, and within that group, 10-20% require going to the ICU.
When you're sent to the ICU you're in really bad shape, but being "just" hospitalized (without going into ICU) isn't awesome either. That happened to me a few years back.
People (of all ages) just need to take precaution.
Yes, we need to take precaution.
No, we don't need to freak everyone out by trying to pretend that the relatively few cases of young people having serious reactions to the virus are the norm. What do you think that does to people with anxiety? With kids? We can ask people to be cautious without overstating reality.
I think many of you are missing the point. Many people look at the mortality numbers and say that almost no one under 60 who gets dies, ergo it is not serious for people under 60. What this points out is that there are other key parameters that suggest the health risks for people under 6o are greater than you’d think if you focused on mortality alone.
while this doesn’t tell us how many people who are under 60 who get this will have more serious health impacts, it clearly shows that of the people who have been identified as having serious health impacts, a nontrivial number of them are under 60.
in an ideal world this data would be presented in age based quantiles. There is no doubt that you would see a higher number if hospitalizations and ICU admissions in the higher quintiles, but it would not be nonzero for the middle quintiles even though it appears that way when you focus solely on mortality.
Because we would be focusing solely on the subset if people with significant impacts (which we have a much better grasp of), such an analysis is not flawed because you don’t know how many people in a given quintile have a mild case.
20 percent of hospitalizations due to serious complications from the virus are victims between the ages of 20-50, according to the CDC. It's wrong to say it's not a serious threat to younger people.
I also have read that once you get it, for this strain at least, you can't relapse. It's also slow to mutate.
For fuck's sake, man, no poster on this board seems as dedicated to spreading bad or misleading scientific information.
A second infection with the identical strain of virus is unlikely for any virus, at least for a while, because of the presence of residual activated lymphocytes (including specific CD8 "killer" T-cells, antibody-secreting B-cells specific to some antigen on the viral surface, non-specific "natural killer" NK cells, and later, "memory" lymphocytes that can trigger a much more robust immune response the second time around).
However, multiple infections with coronaviruses have been reported in the literature back as far as 1990. Here's a blurb:
In general, immunity to local coronavirus infection appears to be fairly short-lived, and reinfection can occur with the same strain of virus.
Fundamental Virology, Fields and Knipe Eds. (1996) at 553, citing Callow et al., The time course of the immune response to experimental coronavirus infection of man. Epidemiol Infect 1990;105:435-446.
The good news from the Callow et al. article is that even though reinfection occurred (the study measured infectivity 1 year after the original infection with a rhinovirus), the subjects did not become sick despite the infection with homologous virus. But there have already been reports out of Japan of the same patients getting sick twice, though we'll need much more data globally to determine how many "reinfections" were actually failures of accurate testing.
We're not likely to get reinfected because usually the course of the epidemic will have moved on by the time the short-term immune response begins to weaken, and chances of a second exposure become statistically very unlikely.
Second, while all RNA viruses have a high mutation rate, coronaviruses as a family are particularly quick to mutate because of their replication mechanism.
From the same text as above:
A unique feature of coronavirus genetics is the high frequency of RNA recombination. While the nonsegmented genomes of most other viruses exhibit very low or undetectable recombination frequencies, the recombination frequency for the entire coronavirus genome has been calculated to be as high as 25%. [this is compared to typical recombination rates of 1% or less in other virus families]
So coronaviruses would be expected to mutate all the time, but those mutants aren't going to take hold in the population unless there is a selection pressure that advantages them. Right now, with no vaccines and no therapies, there is zero pressure to select for a particular mutant strain over the strain that is running wild already.
You need to catch up on the numbers.
Not horrible, just horribly wrong information.
I think May is even super optimistic.
Summary of the Imperial College of London's report/simulation on US cases says we should be looking at 18 months of varyling levels of shutdowns and outbreaks unless we get some sort of miracle cure or vaccine. If we don't do this, millions could die.
I think we should all prepare for this lasting much longer than the general consensus of a couple weeks or a month. This is going to be a fight.
6.8.0I'm sorry, but this is nothing but fearmongering. It denies all reality. Think about what they are saying:
4 million people will die in three months.
If you factored in the population difference, do you know how many people died of the Spanish flu over 3 years? 2.24 million.
So this paper says that almost double the people will die in roughly 1/12 the time of the worst pandemic in 100 years.
The truth is, we have zero idea of how many people are actually infected and what the real CFR happens to be.
The situation is Italy is also distorting what is happening as well: You have one of the oldest populations in the world, high levels of smoking in an area with bad air quality that has direct flights coming in and out of the epicenter of the crisis in China where people great each other by kissing with high population density....I mean its basically the worst of all worst case scenarios. Its the nursing home in Washington on steroids.
You need to reach out to the Imperial College of London and the US Government to give them your expertise. It's cool we have epidemiologists and infectious disease experts like you right here in this forum that know more than the experts handling this problem.
Not only did you not read the report correctly regarding the 4 million figure, but you're making false equivalencies with the current virus and the Spanish/Kansas flu. Bravo. It takes effort to actually become this ignorant.
Oh my bad dude. You're right. You want to know why? I was going off a summary from one of your fellow DPCs (trying not to get banned here!).
Here, let's go through the expert analysis:
They state "comparable lethality to the Spanish flu". Wait, what? How do you figure? How do you know? What evidence is there that this is true? Spanish flu is generally considered to have a 2.5% to 10% CFR. We have zero idea what the CFR is for this. For instance, CFR of swine flu was initially .56% in 2009. It was downgraded to .02% in 2019.
"81% of the population will become infected in the United States". Huh? Why? What are we basing this on? Spanish flu is estimated to have an R0 between 1.8 and 3 from what I have seen. It infected 27% of the population. COVID-19 is between 1.4 and 3.9. They use 2.4 but somehow come up with triple the infected population.
"2.2 million US deaths" Okay, so you're right, its not double the Spanish flu in 3 months, its just the Spanish flu in...6 months! And double the Spanish flu when we factor in all the residual deaths! Nope, not fearmongering at all! Nope, 69720 deaths a day at the peak is totally rational. Yes, you read that right: 69720 deaths a day. More people than were killed during the entire Asian flu in 1957 in a single day! Okay, let's be fair, factoring in population increase, two days!
They are also basing this off of the "UK, China and Italy". Why? Why only those three populations? Why China? Are we trusting that data? Why not Germany? Why not Austria? Why not Sweden? Why not France? Why not Spain? Why not Japan? Why not South Korea? Why not the United States? Why not the Diamond Princess?
You're using two extreme outliers: China, which we cannot trust and Italy, which is a perfect storm situation taking place almost exclusively in a single region.
Oh, by the way: according to these guys stopping massing gatherings would have "little effect". So the experts are totally fine with Coachella, NBA games, concerts, etc.! Someone call Adam Silver and let him know its fine to open up the arenas!
As I said, this is pure, unadulterated fear-mongering.
March 19th, 2020 at 10:40 PM ^
Those are worst-case scenario numbers though, assuming a fairly high mortality rate and people taking no precautions.
The whole "the economy is already fucked" is such a stupid answer. Honestly. That's like saying "dude, you already have cancer, so no need to go to the doctor."
Yes, the economy took a massive hit. Now we need to figure out how massive the hit is going to be and start to dig out. It is far better to dig out of a 4-week hit than an 8-week hit. I'm not advocating taking this lightly. But, we need to balance the harm from the disease against the economic harm from simply shutting down the world. We can do that by applying the concepts of proportionality and trade-off.
For example, we need to protect older and immuno-suppressed individuals, as well as those with certain underlying conditions. That's because those people are overwhelmingly the most at risk of death, whereas younger and healthier people have virtually no such risk. Do we need to shut down the entire country, which will lead to millions being unemployed, homelessness, suicide, etc., or can we perhaps come up with a more targeted way to protect those individuals (as Ventura County, California just did).
I'm sure you were the guy posting about media hysteria a week ago. Now you're sure it's a 4 week problem so your 401k can recover faster. Look forward to your conclusion next week.
I was not the guy posting about media hysteria a week ago, but the person who was posting that was not far off. COVID-19 is a serious disease. If unchecked, it will certainly kill a number of people (we don't know what that number is - could be 10 or 20 thousand, which would be less than the flu kills annually, or could be hundreds of thousands). At the same time, the reaction of "holy shit, shut down literally the entire world forever, even if it means wiping out people's finances and costing them their businesses and jobs" does seem to me to be a disproportionate reaction. We don't do that during a bad flu season, which can kill 80,000 in a bad year in the US ALONE.
Your problem is your assumption that the economy is just going to go back to normal as soon as the quarantine ends. If we don't have this virus under control and we're hearing daily death tolls like Italy's (multiplied by five for the population difference), that's going to be terrible for the economy. That's going to scare the crap out of a lot of people and they're not going to do all the old things they used to. Fear is really bad for consumer confidence.
Let's say that the restrictions are lifted and 30% of the population is still too scared to go buy anything other than food. Can your company survive a 30% decrease in revenue? Unless you've got massive profit margins, probably not.
What the government should be doing right now is try to find ways to help us ride the quarantine out, rather than prematurely end it and put the population back at elevated risk.
March 20th, 2020 at 10:27 AM ^
I get the sense that we are coming at this problem from opposite sides, but I thought that your post was really good and raised some great counter-points to mine. My responses:
"Your problem is your assumption that the economy is just going to go back to normal as soon as the quarantine ends"
I definitely do not think that. It is going to take months to dig out. But, the longer we keep the entire world shut down, the harder it will be. Use restaurants for example. Many that are closed for 2-3 weeks will be able to sustain the hit and return (some are already done for, unfortunately). But, if those restaurants are down for 2-3 months, a TON more will be gone forever, which results in millions more lost jobs.
"If we don't have this virus under control and we're hearing daily death tolls like Italy's (multiplied by five for the population difference), that's going to be terrible for the economy. That's going to scare the crap out of a lot of people and they're not going to do all the old things they used to. Fear is really bad for consumer confidence"
I agree with you. We definitely need to get this under control otherwise the economy will spiral based upon the fear that you identified. But getting the virus under control and re-opening the country are not mutually exclusive. What I am arguing for is that after another week or so of shut down, we will need to be smart in re-opening the economy. I would 100% keep international travel grounded. I would also consider keeping some of the hot spots (NYC, parts of California and Washington, for example) shut down, and would also keep in place certain social distancing measures for a few more weeks.
"Can your company survive a 30% decrease in revenue? Unless you've got massive profit margins, probably not."
No, most companies cannot sustain that. But all companies cannot sustain a 100% decrease in revenues, which is where we currently are with the world completely shut down. Again, there is already drastic harm to the economies of the world. I am talking about the depth of that harm.
Yes, you're right, the only way to save the economy is to... *checks notes* expose everyone to an easily transmitted and potentially deadly virus.
I’m not saying just walk outside like nothing happened. There are measures that can be put in place. Extra precautions such as the mass distribution of the proper face masks, hand sanitizer and mobile hand wash stations at every business, Mandatory cleaning procedures. Things like that.
If those things were effective enough for life to carry on as normal, that's what we'd be doing right now.
No, not necessarily. Politicians are too scared of getting blamed when the number of infections go up. It wouldn’t matter what the numbers are. If we did those things and the numbers go up, the public says “oh god! You idiot! You said it was safe to go out!” Which it pretty much is ok for most of us to go out with certain provisions in place.