Coronavirus Thread

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RonJohn

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Since economic decline (coming, no matter what) and "re-opening" the economy (sorta) have been a subject here, how about a paper that looks at the data and models the consequences of different re-opening scenarios? See:

https://www.aei.org/wp-content/uploads/2020/03/Scherbina-determining-the-optimal-duration-WP_1.pdf

Scherbina (great name, btw) has run models that use different infection rates. We won't be able to actually determine that due to a lack of widespread testing, but we can kinda do it by hospitalization rates. Assuming that every COVID-19 infection leads to one more (R = 1), that means 30 - 34 weeks shutdown and so on down to R=.5 for seven or eight weeks. In short, we aren't there yet. This paper does a good cost/benefit analysis too, especially in estimating the costs associated with re-opening too soon.

This isn't definitive by any means; we won't see research about that until way after this whole business is over. It's probably as good a benchmark as we'll get for now, however.

I am using my phone and haven't read the paper. How does he arrive at what the Ro rates are for different levels of mitigation? The current rate is lower than what the theoretical predictions were. How much would it increase of we open non contact business, like storage facilities? How much would it increase of we open non essential retail locations with the same distancing and capacity requirements? How much would it increase if we open more businesses but require everyone in public to wear a mask?

As I said I haven't read the paper, but you description sounds like it makes assumptions based on infection rates. To use such calculations and cost/benefit analysis in relation to different levels of opening things up, you would need to have projections for what the infection rates would be for those different levels of opening.
 

Deleted member 2897

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I don't think it's a personal attack on me.

The idea of chuckling about how the Government is stepping in to prevent massive business failures and even higher unemployment without expecting some bumps along the way seems a little misplaced.

I'm not trying to rally around gov't intervention, but there are a lot of people working really hard in the private sector to distribute (banks) or receive (small businesses) these funds in order to save jobs.

If you want to chuckle about something, I'll post some ridiculous TikToks that will make you shake your head.

Okay. I still think that's a bit misplaced of a reaction. Remember, I said a chuckle and a sigh. This is all predictable. It happens every time. We rush to get something out, and it ends up being way more complicated than anybody thought and it doesn't work well. We couldn't manage Cash for Clunkers right. Remember the 'shovel ready jobs'? Its all these projects that had already been on states' books to do, they just didn't have the funding yet. So the federal government gave them the money...and voila - nothing much happened.

My wife is a nurse in elective surgery. Her hours went from 40 to about like 10. We don't need the money, so its not that big a deal, and she's actually fine not being exposed to the virus anyway. But unemployment now with the law covers reduced hours. So she filed for it and it was confirmed...can't remember how long ago, maybe 1-2 weeks. They said they still have some sort of certification something or other to be done before its official. The website shows its still not finalized. And this is someone who was in fact able to get through the process and complete it quite awhile ago. Its just crazy.
 

Milwaukee

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People have to have something to do and keep their minds off things.
54BA324C-941A-4E0B-AD18-C31A3BC4EEFA.gif
 

Milwaukee

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Some of us call that the Milwaukee diet.

As in, "Hey bro, you on that Milwaukee diet?"

cke.gif


"Yup."

Don’t forget the Xanax, vodka, and the occasional pinch of Copenhagen and welcome to my life amirite. It’s amazing my heart hasn’t exploded. Must mean I’m a champion.
 

Techster

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The biggest government that faces that choice in the US.

We have allowed China to become our manufacturer and become dependent on the,. We could move that back to the USA, but the costs would be higher to the consumer. Wal-Mart would not be very attractive anymore.

Personally, I favor that approach, for national security reasons, not as much as economic reasons. But this pandemic has shown us China's true stripes. I believe it is worth the price.

The biggest issue we face is the corporate bottom line. I was listening to an NPR podcast, a CEO discussed the difference between doing what was right morally (manufacturing and keeping jobs in the US) versus doing what was right for shareholders (maximizing profits even if it means moving production offshore). Keep in mind, this all precipitated because of the shortages we're seeing with medical supplies. Ultimately, he said his duty is to the shareholders. What we'll find is 10 out of 10 times, CEO will always choose the maximizing profits over doing what is right morally.

The reason why companies choose to do business in China is because labor is so cheap, and the government helps pretty much all strategic industries with favorable tax rates and subsidies. China is playing the long game, and they are willing to finance influence on the backs of their citizens. The world is playing right into China's hands because everyone wants everything for cheap. The world also wants access to China's market of over a billion people...so it becomes a double attraction of potential customers and cheap manufacturing costs. They are uniquely positioned, along with India, to capitalize on the labor and consumer side.

There's is an interesting battle of ideology going on right now. The US has turned inward in terms of trying to influence the world, while China is aggressively expanding outward to influence the world with their new found money.

The real answer to the question is whether the United States can influence the rest of the world to make strategic decisions in terms of turning away from China for manufacturing...especially for strategic and important products. Even though China seems central to everything right now, the United States is still the leading world economic power. There are other places that offer, or can offer (with tax incentives and subsidies) and equivalent manufacturing option to China. Southeast Asia, Africa, and India are several options that have been looked into. The bottom line, pun withstanding, is whether the global marketplace is willing to go there.

Turning back to the Coronavirus, I think what we're seeing first hand and in real time is the need for the Federal government to find a way to protect our essential sources in times like this. If the government takes this seriously, the one thing this highlights is how fragile the United States is to becoming dependant on another nation. This is a REAL shot to our pride...if we don't take this seriously, imagine what happens if there was a world war with China. The thought of what could happen should chill our leaders who think strategically for possible war time.
 
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The biggest issue we face is the corporate bottom line. I was listening to an NPR podcast, a CEO discussed the difference between doing what was right morally (manufacturing and keeping jobs in the US) versus doing what was right for shareholders (maximizing profits even if it means moving production offshore). Keep in mind, this all precipitated because of the shortages we're seeing with medical supplies. Ultimately, he said his duty is to the shareholders. What we'll find is 10 out of 10 times, CEO will always choose the maximizing profits over doing what is right morally.

The reason why companies choose to do business in China is because labor is so cheap, and the government helps pretty much all strategic industries with favorable tax rates and subsidies. China is playing the long game, and they are willing to finance influence on the backs of their citizens. The world is playing right into China's hands because everyone wants everything for cheap. The world also wants access to China's market of over a billion people...so it becomes a double attraction of potential customers and cheap manufacturing costs. They are uniquely positioned, along with India, to capitalize on the labor and consumer side.

There's is an interesting battle of ideology going on right now. The US has turned inward in terms of trying to influence the world, while China is aggressively expanding outward to influence the world with their new found money.

The real answer to the question is whether the United States can influence the rest of the world to make strategic decisions in terms of turning away from China for manufacturing...especially for strategic and important products. Even though China seems central to everything right now, the United States is still the leading world economic power. There are other places that offer, or can offer (with tax incentives and subsidies) and equivalent manufacturing option to China. Southeast Asia, Africa, and India are several options that have been looked into. The bottom line, pun withstanding, is whether the global marketplace is willing to go there.

Turning back to the Coronavirus, I think what we're seeing first hand and in real time is the need for the Federal government to find a way to protect our essential sources in times like this. If the government takes this seriously, the one thing this highlights is how fragile the United States is to becoming dependant on another nation. This is a REAL shot to our pride...if we don't take this seriously, imagine what happens if there was a world war with China. The thought of what could happen should chill our leaders who think strategically for possible war time.
And those "leaders" extend well beyond the executive branch of the government.
 

gtchem05

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New early study from Los Alamos on R0 rate for COVID19.
Study says unmitigated transmission rate (R0) of 5.7.

https://wwwnc.cdc.gov/eid/article/26/7/20-0282_article
active surveillance, contact tracing, quarantine, and early strong social distancing efforts are needed to stop transmission of the virus.

Thanks for sharing this! I'm not an epidemiologist, but this looks like about as good of a study as could done given the circumstances. Based on what we've seen about how contagious this thing is, I think Ro calculated in this study is probably more accurate than the previous estimate in the 2.5-3 range. If the Ro for COVID-19 is truly 5.7 (95% confidence interval was 3.8-8.9 in this study), then the disease requires immunity from 82% of the population to achieve herd immunity rather than ~60%. I don't think this absolutely necessitates a vaccine to achieve herd immunity, but it makes obtaining an effective vaccine even more valuable. It also means that projected curves, like the one I'm attaching below, may be steeper but shorter in duration than previously thought.
 

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Deleted member 2897

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Thanks for sharing this! I'm not an epidemiologist, but this looks like about as good of a study as could done given the circumstances. Based on what we've seen about how contagious this thing is, I think Ro calculated in this study is probably more accurate than the previous estimate in the 2.5-3 range. If the Ro for COVID-19 is truly 5.7 (95% confidence interval was 3.8-8.9 in this study), then the disease requires immunity from 82% of the population to achieve herd immunity rather than ~60%. I don't think this absolutely necessitates a vaccine to achieve herd immunity, but it makes obtaining an effective vaccine even more valuable. It also means that projected curves, like the one I'm attaching below, may be steeper but shorter in duration than previously thought.

Yep, we got some thinkin to do. Because when its that contagious, if you flatten the curve and take your foot off the gas, it will come right back. The flattening could last for several months. The world can't live like this for that long, and they won't put up with it.
 

gtchem05

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Yep, we got some thinkin to do. Because when its that contagious, if you flatten the curve and take your foot off the gas, it will come right back. The flattening could last for several months. The world can't live like this for that long, and they won't put up with it.
It's going to need to be more region/community specific. There are areas of the country that are trying to 'flatten the line' as it were, which is neither effective nor necessary while there are others that still need intense mitigation. We want to see linear, rather than exponential, growth of cases. As access to testing improves including immunity testing, we will get better at this, but we will need to stop some of the 'they did it so that means we have to do it too' sort of decision making.
 

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It's going to need to be more region/community specific. There are areas of the country that are trying to 'flatten the line' as it were, which is neither effective nor necessary while there are others that still need intense mitigation. We want to see linear, rather than exponential, growth of cases. As access to testing improves including immunity testing, we will get better at this, but we will need to stop some of the 'they did it so that means we have to do it too' sort of decision making.

My county (Charleston) was averaging 10-15% new cases day after day until about 2 days ago. The last 2 days, new cases have been about 4%, 4%. We have about 500,000 people in our county and barely added 10 new cases per day lately. That’s peanuts small.
 

gtchem05

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ole Miss has cancelled all in person camps, conferences and classes through Aug 1.


The State of Arkansas cancelled all college summer camps and in person classes yesterday.

They're using reverse psychology. The other 48 states are always trying to avoid doing what Arkansas and Mississippi do. Ergo, the rest of the country won't cancel things prematurely like AR and MS are doing. They're smarter than they look!



P.S. My apologies to anyone with ties to Mississippi or Arkansas who might find this offensive. Just joking around! Everyone knows it's Alabama we should all be making fun of.
P.P.S. Sorry to Alabama too!
 

takethepoints

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I am using my phone and haven't read the paper. How does he arrive at what the Ro rates are for different levels of mitigation? The current rate is lower than what the theoretical predictions were. How much would it increase of we open non contact business, like storage facilities? How much would it increase of we open non essential retail locations with the same distancing and capacity requirements? How much would it increase if we open more businesses but require everyone in public to wear a mask?

As I said I haven't read the paper, but you description sounds like it makes assumptions based on infection rates. To use such calculations and cost/benefit analysis in relation to different levels of opening things up, you would need to have projections for what the infection rates would be for those different levels of opening.
It's a she, btw.

She does all that in the paper. What she doesn't do is model out different strategies to contain infection. She looks at different infection rates, but mitigation strategies aren't varied. I haven't read the paper through so I'm not sure how to answer all your questions. What I have read seems a through job, however.

What I want us to do is be very, very careful about allowing more businesses to open while the virus is still out there in force. Choosing a date certain for reducing restrictions is a really bad idea; we have to let the disease's progress dictate that. I don't think that will lead to major problems since I doubt that the businesses most effected will recover fully until the population has been vaccinated.
 

takethepoints

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They're using reverse psychology. The other 48 states are always trying to avoid doing what Arkansas and Mississippi do. Ergo, the rest of the country won't cancel things prematurely like AR and MS are doing. They're smarter than they look!



P.S. My apologies to anyone with ties to Mississippi or Arkansas who might find this offensive. Just joking around! Everyone knows it's Alabama we should all be making fun of.
P.P.S. Sorry to Alabama too!
No need to apologize. They deserve it.
 

RonJohn

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It's a she, btw.

She does all that in the paper. What she doesn't do is model out different strategies to contain infection. She looks at different infection rates, but mitigation strategies aren't varied. I haven't read the paper through so I'm not sure how to answer all your questions. What I have read seems a through job, however.

What I want us to do is be very, very careful about allowing more businesses to open while the virus is still out there in force. Choosing a date certain for reducing restrictions is a really bad idea; we have to let the disease's progress dictate that. I don't think that will lead to major problems since I doubt that the businesses most effected will recover fully until the population has been vaccinated.

No disrespect meant with my incorrect gender designation.

I still haven't read the paper, so it might be addressed. Basically what I am saying is that listing economic risk/benefit from an R0 is OK, but by itself that doesn't answer questions about what can/can't open. You would have to answer what the infection rate would be with certain things open with certain restrictions to define what the infection rate would be to use in the economic risk/benefit analysis.

I haven't heard anyone say that we will pick a date and everything will be exactly like it was last year. Every thing I have heard from doctors and from economists is that it will be a slow drawback on restrictions. There are some thing, as I stated before, like non-contact storage facilities that had absolutely no medical reason to be closed in the first place. We should have been looking at situations like that since the restrictions were first put into place and allowing businesses that pose very little to no risk to open.

Large scale mitigation has never been used before to control a pandemic. It appears that doctors have been extremely surprised about how well it has worked. I don't see why we can't have some non-essential businesses open up with the same capacity limitations and distancing requirements as essential businesses. If the infection rates can decline rapidly with grocery stores open, it is likely that board game stores using the same methods could open and still keep infection rates low. If a bakery can operate without infecting all of the employees, then a baseball bat factory can probably operate with the same methods and not infect all of their employees.

It will be more difficult to get nail salons, massage studios, nightclubs, etc open. Such businesses that require or encourage close personal contact will probably have to wait until there is some method to mediate infection, herd immunity, a vaccine, or a break if the virus turns out to be seasonal.
 

Deleted member 2897

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My county (Charleston) was averaging 10-15% new cases day after day until about 2 days ago. The last 2 days, new cases have been about 4%, 4%. We have about 500,000 people in our county and barely added 10 new cases per day lately. That’s peanuts small.

BTW, we’re at 1 total death still. We’re running a 0.3% mortality rate.
 

GT_EE78

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> no big surprise that a french study of patients who had to be admitted to ICU showed over 75% to be obese.
> If i understand the results, BMI>35 versus BMI <25 was 7.36 times more likely to require a ventilator
First published:09 April 2020

https://doi.org/10.1002/oby.22831

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1002/oby.22831

Abstract

Objective

The Covid-19 pandemic is rapidly spreading worldwide, notably in Europe and North America, where obesity is highly prevalent. The relation between obesity and severe acute respiratory syndrome coronavirus (SARS-CoV-2) has not been fully documented.

Methods

In this retrospective cohort study we analyzed the relationship between clinical characteristics, including body mass index (BMI), and the requirement for invasive mechanical ventilation (IMV) in 124 consecutive patients admitted in intensive care for SARS-CoV-2, in a single French center.

Results

Obesity (BMI > 30 kg/m2) and severe obesity (BMI > 35 kg/m2) were present in 47.6% and 28.2% of cases, respectively. Overall, 85 patients (68.6%) required IMV. The proportion of patients who required IMV increased with BMI categories (p < 0.01, Chi square test for trend), and it was greatest in patients with BMI > 35 kg/m2 (85.7%). In multivariate logistic regression, the need for IMV was significantly associated with male sex (p < 0.05) and BMI (p < 0.05), independent of age, diabetes, and hypertension. The odds ratio for IMV in patients with BMI > 35 kg/m2 vs patients with BMI < 25 kg/m2 was 7.36 (1.63-33.14; p=0.02)

Conclusion

The present study showed a high frequency of obesity among patients admitted in intensive care for SARS-CoV-2. Disease severity increased with BMI. Obesity is a risk factor for SARS-CoV-2 severity requiring increased attention to preventive measures in susceptible individuals.
 
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