New Coronavirus threat

[Todjaeger]

Disgraceful that anyone would try to mislead the public on this for their own financial gain.

As an Aussie looking at the US from the outside in, I am bewildered by the extent to which some Americans view quarantine/isolation measures as a fundamental violation of their rights/civil liberties. The feeling here is more that it is a short term sacrifice for a long term objective, not a form of tyranny. By all accounts it seems to be working too... knock on wood of course *taps head* ;-)

I wish I had some sort of logical or rational explanation for why things are the way they are currently in the US. Unfortunately I do not.

I have some ideas, however that would involve socio-political discussion which very much frowned upon here on DT, and with good reason.

 

[Boagrius]

I wish I had some sort of logical or rational explanation for why things are the way they are currently in the US. Unfortunately I do not.

I have some ideas, however that would involve socio-political discussion which very much frowned upon here on DT, and with good reason.

Fair enough. Not my intention to derail things either. Hopefully the outlook brightens over there soon and the response is guided by the best science available.

 

[ngatimozart]

Fair enough. Not my intention to derail things either. Hopefully the outlook brightens over there soon and the response is guided by the best science available.

Probably a result of their rebellion against their legal Monarch and liege Lord. They've never been the same since.

 

[cdxbow]

I wish I had some sort of logical or rational explanation for why things are the way they are currently in the US. Unfortunately I do not.

I have some ideas, however that would involve socio-political discussion which very much frowned upon here on DT, and with good reason.

If you want it without 'socio-political discussion', and starting off with understanding the USA being in the best position of any country in the world to cope well with a crisis like this in terms of resources eg bed stock, ventilators, epidemiologists, intensivists, leader in the biotech industry, had pre-prepared plans etc.

Denial - when to 'break the glass' is often a difficult one for organisations, this pandemic was the time to do it. The administration started with denial
Totally confused and conflicting messaging by the authorities
Very delayed response - there is more than a month that was lost with little preparation
Unwillingness to listen to experts
Disorganised response
Testing issues ( eg delayed, insufficient)
Supply problems
Federal-state warfare, competition between states for resources, crazy stuff in a crisis.
Media spreading misinformation & disinformation = 'it's just a flu', Hydroxychloroquine etc
Crisis plans were lost, not used or forgotten
Heavily politicised

You couldn't do worse unless you tried. People in the future will look at this and shake their heads, and say 'what happened in the USA". They'll use it to teach what not to do in a crisis. Then they'll compare it Taiwan, Singapore, Oz and NZ. I hope have managed to avoid taboo 'socio-political discussion'.

 

[John Fedup]

An article published by Fintan O’Toole on April 25 in the Irish Times is not far off the mark wrt the sad state of affairs in the US.

 

[Milne Bay]

An article published by Fintan O’Toole on April 25 in the Irish Times is not far off the mark wrt the sad state of affairs in the US.

The Irish Times is a subscription service.
If you don't want to subscribe, but wish to get the gist of Fintan O'Toole's article, you can hear it read (badly) on Youtube here:

Pity indeed.
MB

 

[ASSAIL]

If you want it without 'socio-political discussion', and starting off with understanding the USA being in the best position of any country in the world to cope well with a crisis like this in terms of resources eg bed stock, ventilators, epidemiologists, intensivists, leader in the biotech industry, had pre-prepared plans etc.

Denial - when to 'break the glass' is often a difficult one for organisations, this pandemic was the time to do it. The administration started with denial
Totally confused and conflicting messaging by the authorities
Very delayed response - there is more than a month that was lost with little preparation
Unwillingness to listen to experts
Disorganised response
Testing issues ( eg delayed, insufficient)
Supply problems
Federal-state warfare, competition between states for resources, crazy stuff in a crisis.
Media spreading misinformation & disinformation = 'it's just a flu', Hydroxychloroquine etc
Crisis plans were lost, not used or forgotten
Heavily politicised

You couldn't do worse unless you tried. People in the future will look at this and shake their heads, and say 'what happened in the USA". They'll use it to teach what not to do in a crisis. Then they'll compare it Taiwan, Singapore, Oz and NZ. I hope have managed to avoid taboo 'socio-political discussion'.

There needs to be a greater perspective than just looking at the raw numbers of casualties in the US.

Veteran commentator Paul Kelly wrote some interesting analysis of the numbers in today’s “Australian” which unfortunately I can’t link.
Australia and NZ suffer a casualty rate of 4 deaths per million with Australia just marginally more successful.
In comparison; the US rate is 46 x worse, Britain is 96 x worse, France x92 and Canada x 20.
These are all comparable countries with sophisticated health systems and he states that “basically the European and US experience is defined by a slow response to the virus and economic restrictions which were imposed too late and which needed to be more severe”.

it’s too easy to come down hard on the US because of the large numbers, continual media saturation and frustration at complex divisions of power and responsibilities but a comparison of numbers shows that so far the US is ahead of some.

 

[ngatimozart]

NOT AIMED AT ANYONE IN PARTICULAR.

I REALISE WHEN DISCUSSING THE USA IT IS DIFFICULT TO SEPARATE THE POLITICS FROM THE CURRENT SITUATION. HOWEVER AS EVERYONE IS AWARE WE HAVE A RULE ABOUT POLITICS. SOME RECENT POSTS HAVE EITHER SKATED VERY CLOSE TO OR BREACHED THE RULE. PLEASE STAY AWAY FROM POLITICS AND IF IN DOUBT DON'T POST.

 

[Projectman]

People picking on usa should take a look at the performance of uk with nearly 28000 dead and steadily climbing.
Uk's example is more striking as trump has given a mixed performance, he did stop direct flights from China quite early , but then decided to put the onus on states rather than taking a leadership role.
Uk's PM initially preached herd immunity, shook hands in hospitals and got serious only after he himself contracted the virus.
Since the PM has been in office for only a few months in uk , the failure is totally of the much heralded NHS. It seems this centrally controlled agency had no one advising the government on lockdowns or PPE procurement. And unfortunately the media was willing participants, putting out feel good stories while hundreds were dying daily in hospitals and old age homes. The deaths in old age homes due to negligence is a crime by any standards. Treating them as low priority patients and letting them die is not what a democratic government does.
Difference between the 2 countries is stark . While usa was upfront about the problems and fatalities, uk even till now is more concerned with preserving its image. Not the behavior of a old democracy ,more befitting a country like china.

 

[John Fedup]

Old age home deaths are not unique to the UK. A large portion of deaths in the provinces of Ontario and Quebec weee in these facilities. In Quebec some of these deaths were criminal. That being said, the residents were the most vulnerable. The support workers are minimally paid. Worse, some of them worked at several different facilities thus spreading the virus. Like many other institutions, old age homes lacked.

US statistics compared to Europe aren’t useful at this point. Geography is a factor IMO that can give misleading performance. For example, comparing NY state to the UK might be better. Although Canada seems to be twice as good as the US, Quebec numbers compared to NY state are similar. NZ realistically is one of the few countries that could actually make use of their geographical location to beat COVID. Unlike North America or Europe, you can’t walk or swim to NZ. Even small boats are a real challenge.

 

[Todjaeger]

There needs to be a greater perspective than just looking at the raw numbers of casualties in the US.

Veteran commentator Paul Kelly wrote some interesting analysis of the numbers in today’s “Australian” which unfortunately I can’t link.
Australia and NZ suffer a casualty rate of 4 deaths per million with Australia just marginally more successful.
In comparison; the US rate is 46 x worse, Britain is 96 x worse, France x92 and Canada x 20.
These are all comparable countries with sophisticated health systems and he states that “basically the European and US experience is defined by a slow response to the virus and economic restrictions which were imposed too late and which needed to be more severe”.

it’s too easy to come down hard on the US because of the large numbers, continual media saturation and frustration at complex divisions of power and responsibilities but a comparison of numbers shows that so far the US is ahead of some.

I agree that more than just the raw numbers of fatalities need to be looked at, so I look at several numbers and compare their relationships to each other. With what I look at, the US really does not look all that good.

While the # of confirmed cases is pretty scary, the general consensus is that the actual # infected is significantly higher. I would not be surprised if the actual# was 5x higher than the confirmed number, and some US projections have estimated the actual # being more like 50x higher though these have yet to be peer-reviewed and have some potential issues.

When I look at the total deaths #, I compare that to the # recovered and the # of confirmed active cases, as that can give an idea of how many of the currently known cases might not survive, or might require more medical intervention. The importance of those numbers and their relationship is that while the # of US deaths as of 2 May, 2020 11:44 GMT/Zulu time stands at 65,782, with 161,666 having recovered (or about 5 recover for every 2 deaths), the US still has over 900,000 known active cases. If that CFR for the known active cases continues unchanged for the currently known cases, that means the US would see an additional 260k+ deaths.

I also tend to look at the number and rates for COVID-19 testing as that can give an idea on how well (or poorly) the # confirmed cases might be compared to the as yet unknown # of actual cases.

Other numbers which tend to be harder to come by are the rate of hospital bed utilization, as well as the burn rates for PPE, though these numbers tend to not be available publicly. One thing I have noted in the US, is that most of the states which are re-opening earliest, tend to also be states have among the lowest per capita testing rates. This tends to reinforce the impression I have formed that many of these states are making decisions based upon ideology rather than facts, because the facts themselves are known to be unreliable due to under testing.

 

[ngatimozart]

Agree with @John Fedup that old age home deaths are not just a UK problem. We have 20 COVID-19 related deaths here in NZ and 12 of them came from 1 old age home, with IIRC, another 3 or 4 from another old age home in a different city. All had underlying health conditions.

With regard to the current situation in the US, we also have to take into account the legislative landscape across the country with legislative and political tensions between the states and the federal govt, at a bureaucratic level and at the political leadership level. It is a system uniquely US and any conflicts that normally exist between the two, have been significantly exacerbated by the dysfunctional political climate that has existed in the Congress for the last decade.

Hence it does make for some difficulties to obtain a nationwide picture of the situation when each state is more or less independently doing its own thing. That means that because of the apparent uncoordinated approach, the virus will expand its presence regardless of attempts by individual states to restrict it, unless they close their borders and actively police them. But that comes at a price and would invoke howls of protest from Washington, interest groups, and political activists. So would state governments be willing to go that far and take the flak, especially in election year?

There are other countries as well that are heading down the dark path. Brazil is one unfortunately, with Bolsonaro, the President saying "So what" when asked about Brazil's rising COVID-19 death toll 'So what?': Bolsonaro shrugs off Brazil's rising coronavirus death toll. He's attracted a fair amount of criticism from home and abroad for his views, and IMHO in the end he has to live with his decisions both good and bad, however one would expect a bit more empathy and political nous from a national leader during an emergency crisis. Well I have never equated pollies with brains and intelligence.

 

[cdxbow]

…...One thing I have noted in the US, is that most of the states which are re-opening earliest, tend to also be states have among the lowest per capita testing rates. This tends to reinforce the impression I have formed that many of these states are making decisions based upon ideology rather than facts, because the facts themselves are known to be unreliable due to under testing.

Yes, they are the states with lowest testing which makes the decision to reopen early even more difficult to understand. Having a vigorous testing regimen and contract tracing in place before you open is essential and I suspect these states don't. If it goes bad we will see it in the figures within about 3 weeks.

Overall CFR will be less than 1% when it's all done and dusted and all the asymptomatic and mild symptoms ones are included.

The UK has done terribly for 2 utterly inexplicable decisions. The first was the herd immunity nonsense mention by Projectman. To depend on that, early in he outbreak, when you don't even know if an individual develops effective, lasting immunity, is just fantasy. I see some in the UK are asking to see the deliberations of their SAGE committee and the government to see where it came from and how it was derived. The second big UK failing was the refusal to do wide spread community testing and contact testing. I cannot understand that one, either. Restricting contacts and tracing them quickly are a key to a good response. The poor response of the USA is a result of more complex and systemic failings however one commonality in both countries were the leadership were slow to get onboard.

Every country had the same warning period from China, some used it usefully. The main thing was to move fast early on with some form of social distancing and travel restrictions, it probably didn't matter what you did, as long as you did something early to reduce transmission and get the R0 < 1.

Everyone needs to remember that for every death there is probably going to be at least an equal number people left with severe and chronic illness. Covid 19 has caused people to have thrombo-embolic events, even young people, who have lost legs, had pulmonary emboli and strokes. It cause encephalitis, many of whom will be impaired lifelong, and the commonest long term complication will be people whose lungs are left permanently impaired after the pneumonia and ARDS.

So the burden of disease is not just the people acutely ill with Covid19 currently, there are going to be hundreds of thousands debilitated for the rest of their lives and the best way to reduce this is preventing spread. I have yet to see any economic modelling of the disease include this, or it mentioned by the people who want to open early. There seems to be a terrible and incorrect attitude of some, so what, it only kills old folks.

 

[Todjaeger]

Yes, they are the states with lowest testing which makes the decision to reopen early even more difficult to understand. Having a vigorous testing regimen and contract tracing in place before you open is essential and I suspect these states don't. If it goes bad we will see it in the figures within about 3 weeks.

I can confirm that at least one of those states, which also happens to be in the bottom three in terms of testing per capita, does not have either a vigorous testing regimen, or extensive contact tracing system in place.

Curiously, this specific state is also claiming that only ~20% of the total confirmed tests are still active.

Unfortunately I also do not have any difficulty understanding why the decisions to reopen the state was made. IMO it was made in large measure due to the comparatively low numbers of confirmed cases, which gave the decision makers room to argue that the state has not really be impacted by the virus. That is a rather rich argument to make when one is aware that testing has been rather limited. To give a measure of comparison, NY state has been testing roughly 1 in 20 people, while some of the states getting ready to open so soon are only testing about 1 in 100 people, and then citing low #'s of confirmed cases to justify why the state can reopen.

 

[John Fedup]

This article has some interesting information about bats and Coronaviruses and how these viruses can in exist in bats. The suggestion that stress promotes viral release to inflict other species is interesting.

"Super Immunity" of Bats May Explain How They Carry Coronavirus

Scientists have uncovered how bats can carry the Middle East Respiratory Syndrome (MERS) coronavirus without getting sick—research that could shed light on how coronaviruses make the jump to humans and other animals.

www.technologynetworks.com

 

[Todjaeger]

I can confirm that at least one of those states, which also happens to be in the bottom three in terms of testing per capita, does not have either a vigorous testing regimen, or extensive contact tracing system in place.

Curiously, this specific state is also claiming that only ~20% of the total confirmed tests are still active.

Unfortunately I also do not have any difficulty understanding why the decisions to reopen the state was made. IMO it was made in large measure due to the comparatively low numbers of confirmed cases, which gave the decision makers room to argue that the state has not really be impacted by the virus. That is a rather rich argument to make when one is aware that testing has been rather limited. To give a measure of comparison, NY state has been testing roughly 1 in 20 people, while some of the states getting ready to open so soon are only testing about 1 in 100 people, and then citing low #'s of confirmed cases to justify why the state can reopen.

As an update to this, there are now personnel trained and tasked with conducting contact tracing, and apparently the restrictions on who is eligible to be tested for COVID-19 have now been relaxed in this state. However, I have also confirmed that my suspicions on the claimed rate of recovered cases is also incorrect though what the accurate number is I do not know.

While testing in the US is finally (FINALLY!) starting to get where it should have been much sooner, I suspect that many states are going to see the numbers cases climbing by the end of next week as many restrictions are being lifted. While an increase would be expected due to a greater availability in testing, I suspect some of the increase will be due to less containment.

 

[swerve]

...
I also tend to look at the number and rates for COVID-19 testing as that can give an idea on how well (or poorly) the # confirmed cases might be compared to the as yet unknown # of actual cases.

... One thing I have noted in the US, is that most of the states which are re-opening earliest, tend to also be states have among the lowest per capita testing rates. This tends to reinforce the impression I have formed that many of these states are making decisions based upon ideology rather than facts, because the facts themselves are known to be unreliable due to under testing.

The Economist has published some figures on excess deaths, & presumed undercounting of CoViD-19 deaths. Last update was 28th April. Tracking covid-19 excess deaths across countries

It's noticeable that there's huge variation between countries in the discrepancy between recorded CoViD-19 deaths & excess deaths, but in general it looks as if there's considerable undercounting. This is not surprising: it's normal in epidemics. Seasonal flu figures, for example are estimated using various sources & the accepted figures are much higher than recorded deaths, & that's not at all controversial. Everyone thinks it's reasonable.

As for the USA, the official numbers for New York state appear to be pretty good. They're also by far the highest in the country. I think only New Jersey is anywhere near.

I don't think anyone imagines that Texas, for example, has anywhere near New York's death rate, but it's very likely that the Texas numbers are a lot further from reality than those in NY. Not that Texas is likely to be the worst in that respect. Consider W. Virginia, where the first recorded case damn near died trying to get tested, let alone treated, while the state governor was proudly proclaiming that there were no cases in his state.

Meanwhile, I see many people ignoring such things as excess deaths & claiming that any possible mistakes in the attribution of any deaths to CoViD-19 prove that the numbers are fraudulent & enormously exaggerated.

 

[Todjaeger]

The Economist has published some figures on excess deaths, & presumed undercounting of CoViD-19 deaths. Last update was 28th April. Tracking covid-19 excess deaths across countries

It's noticeable that there's huge variation between countries in the discrepancy between recorded CoViD-19 deaths & excess deaths, but in general it looks as if there's considerable undercounting. This is not surprising: it's normal in epidemics. Seasonal flu figures, for example are estimated using various sources & the accepted figures are much higher than recorded deaths, & that's not at all controversial. Everyone thinks it's reasonable.

As for the USA, the official numbers for New York state appear to be pretty good. They're also by far the highest in the country. I think only New Jersey is anywhere near.

I don't think anyone imagines that Texas, for example, has anywhere near New York's death rate, but it's very likely that the Texas numbers are a lot further from reality than those in NY. Not that Texas is likely to be the worst in that respect. Consider W. Virginia, where the first recorded case damn near died trying to get tested, let alone treated, while the state governor was proudly proclaiming that there were no cases in his state.

Meanwhile, I see many people ignoring such things as excess deaths & claiming that any possible mistakes in the attribution of any deaths to CoViD-19 prove that the numbers are fraudulent & enormously exaggerated.

It will probably take several years, once the current pandemic is largely over, before accurate totals are available. To give an example the last complete US seasonal flu data from the CDC is for the 2016-2017 flu season. The data for the 2017-2018 and 2018-2019 flu seasons are preliminary.

My take on much of the disputes people have with the numbers and projections are an uncomfortable mix of ignorance and ideology, coupled with an unhealthy dose of wishful thinking and self-deception.

 

[ngatimozart]

An interesting comparison at how the 37 OECD countries are doing with the COVID-19 virus. David Farrar is a Kiwi centre right blogger who's main business is a polling company. Therefore he's qualified in the use of statistics, which makes the info in his article more accurate in its calculation. However his calculations, analysis and conclusions are only as good as the original data.

Of interest in his article is that generally, at present, the US is doing better than the UK and the likes of Spain and Italy. I say at present because I think that there is a lag between the infection waves in Europe and the US. It also shows that both Australia and NZ are doing well and are consistently near the top of the list of those countries that are doing well. I would have to qualify that by saying that both our nations, being island nations, have advantages over nations with land borders.

How OECD countries are doing with Covid-19 | Kiwiblog

I thought it would be interesting to look at how the 37 OECD countries have all done with Covid-19. As they are all fully developed economies, it is a reasonable set to compare between. The first compare is tests done per million residents, where higher is of course better. So Iceland by far has...

www.kiwiblog.co.nz

On the NZ front, NZ is moving to Alert Level 2 at 2359 NZST 13 May 2020. Level 2 announcement. This gives the population more freedom and means that malls etc., will be open and domestic travel restrictions lifted. There will be queues outside hairdressers as multitudes will turn up to be styled, shorn and / or have lockdown mistakes / horrors rectified. Pubs and clubs will reopen 21st May.

 

[Todjaeger]

An interesting comparison at how the 37 OECD countries are doing with the COVID-19 virus. David Farrar is a Kiwi centre right blogger who's main business is a polling company. Therefore he's qualified in the use of statistics, which makes the info in his article more accurate in its calculation. However his calculations, analysis and conclusions are only as good as the original data.

Of interest in his article is that generally, at present, the US is doing better than the UK and the likes of Spain and Italy. I say at present because I think that there is a lag between the infection waves in Europe and the US. It also shows that both Australia and NZ are doing well and are consistently near the top of the list of those countries that are doing well. I would have to qualify that by saying that both our nations, being island nations, have advantages over nations with land borders.

How OECD countries are doing with Covid-19 | Kiwiblog

I thought it would be interesting to look at how the 37 OECD countries have all done with Covid-19. As they are all fully developed economies, it is a reasonable set to compare between. The first compare is tests done per million residents, where higher is of course better. So Iceland by far has...

www.kiwiblog.co.nz

On the NZ front, NZ is moving to Alert Level 2 at 2359 NZST 13 May 2020. Level 2 announcement. This gives the population more freedom and means that malls etc., will be open and domestic travel restrictions lifted. There will be queues outside hairdressers as multitudes will turn up to be styled, shorn and / or have lockdown mistakes / horrors rectified. Pubs and clubs will reopen 21st May.

I looked at the blog, and while interesting, I do not find much of significance. Part of that is that none of the relationships listed in the data provided showed the number of recovered confirmed cases and/or still active confirmed cases. Looking at what the currently reported numbers seem to be, the UK does seem to be in a worse situation per capita than the US, because there have only been ~1,000 recovered confirmed cases, vs. ~32,000 deaths and ~191,000 still active cases, which in turn works out to ~85% of confirmed UK cases still being active. OTOH while the US has had ~81,000 deaths, there have also been ~262,000 recoveries of confirmed cases, with ~1,040,000 still active cases which is about 75% of the total.

That ratio between recoveries and deaths is what I find particularly concerning, since the UK numbers at present roughly work out to one out of every 33 confirmed cases surviving...

An interesting thing I came across is that there might have been/bee different strains which mutated as they came out of China, with a 'European' strain being essentially worse than a strain which went around and across the Pacific. Where this gets interesting if confirmed is that it seems like the strain which impacted the US West Coast states like California and Washington was the 'Pacific' strain, while the hard hit East Coast, especially areas around NYC, had the 'European' strain. If this divergence is accurate, that could make vaccine development even more problematic.