Coronavirus Thread

[gthxxxx]

Yes. The whole point of statistical manipulation is to try to get to precise estimations of error in estimations of parameters. If you have a universe of data, then there's no point in trying to sample; you already have the actual parameters, at least for the population of interest. That's why the new databases that cover entire populations are so important.

Now, of course, this is a sub-set of available data. There are a lot of questions that could benefit from a random sample for estimation purposes. However, this is not as necessary as it once was. Big Data really is that; for many questions I think (and I'm not the only one) that we are close to getting the data to estimate parameters accurately.

That doesn't mean we won't need sophisticated sampling schemes for many others, however. It'll depend on what we are collecting. And, of course, this only applies to countries with good national statistical services.

Skimming through the recent pages of this thread, there's a lot of conclusions being drawn from data sample sets that are either almost certainly not representative of the target population in the conclusion or it's sampled in a way that would give no confidence to the conclusion; or both. Also, this observation is not limited to forum members but can be expanded to multiple "expert" articles whose authors may be authoritative in medicine but would fail an introductory college statistics course. Oftentimes, it seems like they're just forced to say something for the sake of saying something. I'm not sure how big data can help here given how little data there is available.

 

[GoldZ]

Hello fellow swarmers!
I have a request. I wrote an opinion article on COVID-19 and what I think needs to happen at this point. I would love it if you would consider reading it and offering your thoughts and criticisms. I’m hoping it strikes a reasonable balance between what seems like a dichotomy of opinions on how the country should operate. Thank you!

Also, of note, I did not mention in this article some of the things I have posted previously about influenza death rates because I thought it would be beyond the scope of the article. I still stand by my previous posts on this issue, though.

Good job of summarizing chem, it's appreciated. What is it that you see as different about our current phased return to work plan, versus the approach you outlined? Seems it's all based on testing, otherwise it's risky beyond reason. Considerably expanded testing may tell us whether we have to be callous or cautious. The speed and accuracy of testing tells us the answers to some very difficult decisions.
Sacrificing 10% to save 90% (the callous approach that some advocate), is akin to surrender imo, at least when it comes to this disease. We can and likely will, do much better.
Thanks again, Z

 

[GTNavyNuke]

Yes. The whole point of statistical manipulation is to try to get to precise estimations of error in estimations of parameters. If you have a universe of data, then there's no point in trying to sample; you already have the actual parameters, at least for the population of interest. That's why the new databases that cover entire populations are so important.

Now, of course, this is a sub-set of available data. There are a lot of questions that could benefit from a random sample for estimation purposes. However, this is not as necessary as it once was. Big Data really is that; for many questions I think (and I'm not the only one) that we are close to getting the data to estimate parameters accurately.

That doesn't mean we won't need sophisticated sampling schemes for many others, however. It'll depend on what we are collecting. And, of course, this only applies to countries with good national statistical services.

One thing I'm really looking forward to seeing (statistically only of course), is how many of the CVN71 sailors test positive in the coming days / weeks. It will be reassuring if there is not an increase in positive results. That would help confirm the validity of the tests to pick up low threshold viral loads.

The problem with the full dataset idea is that it is static and a snapshot in time. But without question, that full dataset over a period of time is about 10000% better than what we have right now at 150,000 test a day out of a population of 330,000,000.

I know everyone wants answers now, but each one of these corona's seems different (tic) and it'll take a while to figure out. Hopefully the virus doesn't mutate too fast. https://www.webmd.com/lung/coronavirus-strains#1

 

[MWBATL]

There was a story in the Washington Post on 4/19 about how so many patients with other types of emergency medical problems are delaying going to the ER (or not going at all) because they are afraid of catching the china coronavirus.(I can't link it because I am not a subscriber.) Somewhat anecdotal, but it describes how many other types of medical problems are being delayed by this fear...there are significant reductions (apparently) in the number of people showing up at the ER for heart attacks, strokes and appendicitis. This is the unstated impact that the "panic porn" media coverage that Bill Maher complained about last week is having on the public. It could also explain some of the increase in the totals of stay at home deaths that have apparently also increased during this time period. I guess we should not assume that all those stay at home deaths are coronavirus deaths, per se.

I would classify this in the "unintended consequences of coronavirus" section.

 

[Deleted member 2897]

There was a story in the Washington Post on 4/19 about how so many patients with other types of emergency medical problems are delaying going to the ER (or not going at all) because they are afraid of catching the china coronavirus.(I can't link it because I am not a subscriber.) Somewhat anecdotal, but it describes how many other types of medical problems are being delayed by this fear...there are significant reductions (apparently) in the number of people showing up at the ER for heart attacks, strokes and appendicitis. This is the unstated impact that the "panic porn" media coverage that Bill Maher complained about last week is having on the public. It could also explain some of the increase in the totals of stay at home deaths that have apparently also increased during this time period. I guess we should not assume that all those stay at home deaths are coronavirus deaths, per se.

I would classify this in the "unintended consequences of coronavirus" section.

All kinds of anything even remotely considered elective are shut down. Hospitals are hemorrhaging money right now. Thousands and thousands and thousands of nurses, doctors, and other healthcare employees have been laid off. A long and brutal list here:
https://www.beckershospitalreview.c...loughing-workers-in-response-to-covid-19.html

Especially older people are steering clear of visiting any doctors offices and hospitals if they can avoid it. The downside of that obviously is that when they do finally show up they are in significantly worse condition than normal.

 

[Supersizethatorder-mutt]

All kinds of anything even remotely considered elective are shut down

Except abortions, of course. They are apparently considered essential. WOW!!!
Now to be fair, very few abortions are done in hospitals, but the fact remains that murdering babies is apparently essential for some in this country.

 

[GTRX7]

I find it interesting how little discussion I’ve seen about the economy in this thread. Where are studies on the potential impact this is having on it? How in the hell do we gauge success without that metric. If we save a 100k lives here, but trigger a depression, I think we would have failed.

I am not an economist and don't necessarily vouch for the conclusions of this article one way or the other, but you asked for a discussion of the potential balance between health and economic impact. Here is one article discussing that calculation:
https://www.marketwatch.com/story/are-we-overreacting-to-the-coronavirus-lets-do-the-math-2020-04-19

 

[gtchem05]

Good job of summarizing chem, it's appreciated. What is it that you see as different about our current phased return to work plan, versus the approach you outlined? Seems it's all based on testing, otherwise it's risky beyond reason. Considerably expanded testing may tell us whether we have to be callous or cautious. The speed and accuracy of testing tells us the answers to some very difficult decisions.
Sacrificing 10% to save 90% (the callous approach that some advocate), is akin to surrender imo, at least when it comes to this disease. We can and likely will, do much better.
Thanks again, Z

Thanks for reading! I’m starting to realize the article needs to be more direct on this part, but basically I’m saying the young and healthy need to go back to life as usual (essentially trying to catch the virus) with the exception of socially distancing from those who are older and those with severe chronic disease. It won’t take long for people in the young healthy group to become immune at which point they won’t need to social distance at all. Probably seems pretty crazy, but hopefully the article explains why this makes sense. By the way, I’m not advocating for civil disobedience here, I’m saying this is what our leaders need to be telling us to do. Until then, we need to follow the current rules.

 

[potatohead]

Thanks for reading! I’m starting to realize the article needs to be more direct on this part, but basically I’m saying the young and healthy need to go back to life as usual (essentially trying to catch the virus) with the exception of socially distancing from those who are older and those with severe chronic disease. It won’t take long for people in the young healthy group to become immune at which point they won’t need to social distance at all. Probably seems pretty crazy, but hopefully the article explains why this makes sense. By the way, I’m not advocating for civil disobedience here, I’m saying this is what our leaders need to be telling us to do. Until then, we need to follow the current rules.

I'm sorry, I didn't read your article. I want to but I'm not a huge fan of downloading .pdf from unknown sources. That being said, and based on your comment, it sounds like what you're suggesting is precisely what the Dutch implemented. Its not crazy, but its success is predicated on a population adhering to the guidelines laid out. I imagine this population would need to be quite unified in the approach and strictly adhere to the guidelines. Neither of these assumptions would be safe bets here in America based on the politicization of this virus.

 

[GoldZ]

Thanks for reading! I’m starting to realize the article needs to be more direct on this part, but basically I’m saying the young and healthy need to go back to life as usual (essentially trying to catch the virus) with the exception of socially distancing from those who are older and those with severe chronic disease. It won’t take long for people in the young healthy group to become immune at which point they won’t need to social distance at all. Probably seems pretty crazy, but hopefully the article explains why this makes sense. By the way, I’m not advocating for civil disobedience here, I’m saying this is what our leaders need to be telling us to do. Until then, we need to follow the current rules.

Thanks for reply, but chem, going back to work and trying to catch the virus without accurate and widespread testing in place, seems to be a recipe for disaster for a small percentage of young people and a large number of elderly people who depend on the support of the young.

 

[GoldZ]

I'm sorry, I didn't read your article. I want to but I'm not a huge fan of downloading .pdf from unknown sources. That being said, and based on your comment, it sounds like what you're suggesting is precisely what the Dutch implemented. Its not crazy, but its success is predicated on a population adhering to the guidelines laid out. I imagine this population would need to be quite unified in the approach and strictly adhere to the guidelines. Neither of these assumptions would be safe bets here in America based on the politicization of this virus.

Isn't Sweden regretting it about now? Maybe not Dutch, but how are the Dutch as far as testing is concerned ?

 

[Deleted member 2897]

Isn't Sweden regretting it about now? Maybe not Dutch, but how are the Dutch as far as testing is concerned ?

The Netherlands has about 10%-15% fewer positive cases as we do per capita (with the usual caveats of test volumes). Their deaths are almost twice that of ours.

 

[takethepoints]

Skimming through the recent pages of this thread, there's a lot of conclusions being drawn from data sample sets that are either almost certainly not representative of the target population in the conclusion or it's sampled in a way that would give no confidence to the conclusion; or both. Also, this observation is not limited to forum members but can be expanded to multiple "expert" articles whose authors may be authoritative in medicine but would fail an introductory college statistics course. Oftentimes, it seems like they're just forced to say something for the sake of saying something. I'm not sure how big data can help here given how little data there is available.

No argument there. We haven't really started the process of collecting the data we'll need to get the actual scope of the virus. When the house is on fire, all you are interested in is putting out the fire; you can find out if it was arson later. And, no doubt, many people can't keep their mouths shut when they don't know much. A common human failing, that.

But the business about failing a college statistics course involves, I think, a misunderstanding of how stats are used in sciences. The stuff in math department stats courses aren't what most sciences use; the techniques are tied to what the the basic knowledge and SOPs used in the science in question. Sometimes those can be compatible with the mathematical version of stats, sometimes not so much. For instance, there's a raging (as such things go) controversy going on right now in both statistics and other fields about whether to use standard Neyman-Pearson hypothesis testing at all. And if you aren't doing hypothesis testing, then using random samples becomes less important. (Btw, I don't support this.) So, to an extent, I think how much faith you put in randomness as opposed to representativeness depends on what you are looking at and how.

 

[takethepoints]

The problem with the full dataset idea is that it is static and a snapshot in time. But without question, that full dataset over a period of time is about 10000% better than what we have right now at 150,000 test a day out of a population of 330,000,000.

Depends on the data. One thing national stats services have gotten a lot better at is whole population time series data. We've had to come up with whole new fields ("data science") to come up with ways to handle that.

 

[potatohead]

Isn't Sweden regretting it about now? Maybe not Dutch, but how are the Dutch as far as testing is concerned ?

They're all regretting that approach now, and they're also catching allot of flack from their neighbors about the approach due to open borders in Europe. Really not too different than what we'll see here in the States which is why a strong, organized Federal response was so important. If Georgia behaves but Florida continues to screw around, what can Georgia possibly do with interstate travel that reinfects its population? This will be cyclical (infection, reinfect, open, close), at least until a vaccine is developed (year + away). Herd immunity works, its effectiveness is demonstrated by the near eradication of many viruses due to lack of successful hosts, but I just don't see how it would work with Covid-19 without a tremendous loss of life. It relies way too heavily on variables that have to do with human nature, and I find that a very poor bet 9/10 times.

Recent study on reinfection rate https://www.biorxiv.org/content/10.1101/2020.03.13.990226v1

 

[RamblinRed]

Fixed a typo. Here’s an updated version.

Good write-up but I disagree with it,
You are seriously underestimating both the health and economic costs of trying to get to natural herd immunity.
Let's use the low end estimate of 62%, (which is likely underestimating how many would need it).
62% of the 328M Americans is over 200,000,000 Americans would have to be infected (you would need children to get infected even though they tend to have mild symptoms)
If you could actually isolate all Americans over 60 and all Americans who would be at high risk that would be over 100M Americans. So the first place this idea falls apart is who is going to take care of 100M isolated Americans? Because anybody that interacted with them would have to be proven not have any COVID19 antibodies in their body to be safe.

Even if you could isolate those individuals and then used 50% of the current estimated death rates for the remaining age ranges from 19-60 that would create a best case scenario of 440K deaths. A moderate level scenario would mean 880K deaths. That is not sicknesses, that is deaths. The hospitalizations for that population would be in the tens of millions.

The economic devastation of this is also seriously understated. As people start getting sick and dying you lose both economic productivity and purchasing.
during the herd immunity phase over 130M Americans would have to miss at least 2 weeks of work, some would die and 10's of millions would get sick enough that they would require more than 2 weeks away. Many would be overloading our health care systems - while 65+ are over 75% of our COVID19 deaths, they are less than 45% of our hospitalizations. Even a decent percentage of young people require hospitalizations (currently a little over 15% of hospitalizations are 18-44), and the 45-64 age even with lower death rates than the 65+ crowd have high hospitalizations rates.
As we are already seeing in processing plants in states all over the US, all it takes is one person and all of a sudden you have hundreds of employees out and you either have to stop or severly curtail production. This also fails to take into account that by isolating all these individuals you are removing a not insignificant portion of your labor force. in 2017 35.7M Americans over 55 are in the labor force. As of 2019 there are 130.6M Americans in the labor force. So a little over 25% of the the workforce is 55+.


The other issue is it simply spreads too fast. if you allow it to run it replicates at a rate that keeps you from being able to maintain business as usual.
In a best case scenario (where the flu has a transmission rate of 1.3 and COVID19 has a transmission rate of 2.6) by the 10th generation 1 person with COVID19 has infected 1000X the number of people as one person with the flu will (14,000 vs 14). Keep in mind we vaccinate over 100M American adults each year- removing 50-80% of them (depending upon how good the vaccination is in a given year) from being potential spreaders and significantly lowering the R0 so it is manageable. We would not have to ability to do that with COVID19.

Most US cities in the 1918 Pandemic that had mitigation measures in place and then discontinued them before the first wave was almost down to zero got overrun with a larger second wave that ended up causing more long term economic damage.

Finally, no infectious disease has ever been brought to herd immunity level through natural herd immunity. Herd immunity to any infectious diseases has only been accomplished through vaccination programs.

So it all sounds great except for a few minor details.

1. Logistically it is impossible to isolate 68.7M Americans, much less the 110M that would likely be required.
2. In order to handle herd immunity, the testing has to exist and be in place.
3. You would first need to understand whether having the virus grants you immunity and if so for how long. Most previous Coronavirus' immunity, if there is any at all, tend to last months to a couple of years at most. So you could go through the whole herd immunity idea and then simply have to redo it in a year or two.
4. Economically natural herd immunity puts too many people out of work and lowers purchasing power too much to sustain.
5. Due to the high transmission rate our health and economic systems would likely be overrun within a couple of months.

https://www.jhsph.edu/covid-19/articles/achieving-herd-immunity-with-covid19.html

 

[dtm1997]

 

[684Bee]

American ingenuity and ability to adapt to this has been so impressive.

 

[dtm1997]

Is this legit? If yes, good luck down there. I'd be real ****ing wary of any of those places tho.

 

[takethepoints]

We didn’t even have 30 confirmed total cased nationwide until March.

FIFY.

In fact, we probably had thousands of cases by then, especially since we let 40K people back from China after we "stopped travel". The initial big outbreak in Washington State was community spread.

Not, mind, that we had much choice about letting US citizens back into the country or anyplace to put them to isolate them for 2 weeks. All that came later. Still … there it is.