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  #51  
Old April 4th, 2020, 10:11 PM
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Testing for infection (in the US anyway) is skewed heavily towards patients who come to the hospital for treatment. We have anecdotes and self-volunteered information for people who caught Coronavirus but never stayed in a hospital. We have almost no idea about people who got "a nasty flu bug" and recovered but never considered that their illness might have been Coronavirus.

Besides the day-to-day treating the sick, we need a major effort to manufacture enough test kits to get _everybody_ tested, to learn the true scope and scale of the problem. Then we can take informed action accordingly.
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  #52  
Old April 4th, 2020, 11:58 PM
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Well, yes and no.

Yes, the original sin of the US public health response to Covid-19 (if we set aside lack of preparation) is our lack of testing at scale. It meant that we have had no effective response to the contagion other than physcial distancing of asymptomatics and isolating the sick. If we had fast, effective testing earlier, we could have tried to contain SARS-2 virus (e.g. done aggressive contact tracing and testing) but it really seems too late for that now as too many people in too many places are carriers and we still don't have adequate testing. (100K tests per day isn't very good for a nation of 330M).

But there is an important "no" part too. We do have reasonable estimates about how pervasive the disease is because we have very good (though not perfect) estimates of who has died from Covid-19. We can relying on data from nations that have had better testing regimes (eg. South Korea and Germany) to estimate the fatality rate of the disease. Back calculating our infection rate from the known fatalities and fatality rates isn't that hard. It won't be perfect, but it gives you a good idea of the infection rate.

So I pay attention to the San Francisco area (because it's where I'm from) and New York City (because it's the epicenter of the US outbreak.) It's not hard too see from fatalities that the SF area has an infection rate around 0.4%. That is almost an order of magnitude higher than the confirmed cases (0.05% of the local population) because our testing is so limited and so slow, but the body count tells an undeniable story of the prevalence of the disease here. Similarly, New York City has an infection rate of around 7% of the population based on the fatality experience, regardless of their confirmed cases of 0.75% of the population. (It is no surprise that the NY Times is reporting that 1 in 6 NYPD are out sick or quarantined when you realize that 1 in 14 New Yorkers are infected in the first place.)
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  #53  
Old April 5th, 2020, 06:24 AM
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Bill Gates has been publicly warning the electorate, and privately the administration(s), for years, about the dangers of a pandemic.

This was not just some New Age hippy prophesying in the desert.

History demonstrated that it was inevitable, the question was probability, which was affected by human behaviour.

I believe almost all pandemics originate in China, and usually due to the close interaction between animals and humans in unsanitary settings.
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  #54  
Old April 5th, 2020, 11:04 AM
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Quote:
Originally Posted by Condottiere View Post
I believe almost all pandemics originate in China, and usually due to the close interaction between animals and humans in unsanitary settings.
Well, H1N1 2009 flu pandemic originated in California or Mexico, and the origin of the 1918 one (also H1N1 flu) is not clear...
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  #55  
Old April 7th, 2020, 05:46 PM
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Quote:
Originally Posted by vegas View Post
But there is an important "no" part too. We do have reasonable estimates about how pervasive the disease is because we have very good (though not perfect) estimates of who has died from Covid-19. We can relying on data from nations that have had better testing regimes (eg. South Korea and Germany) to estimate the fatality rate of the disease. Back calculating our infection rate from the known fatalities and fatality rates isn't that hard. It won't be perfect, but it gives you a good idea of the infection rate.

So I pay attention to the San Francisco area (because it's where I'm from) and New York City (because it's the epicenter of the US outbreak.) It's not hard too see from fatalities that the SF area has an infection rate around 0.4%. That is almost an order of magnitude higher than the confirmed cases (0.05% of the local population) because our testing is so limited and so slow, but the body count tells an undeniable story of the prevalence of the disease here. Similarly, New York City has an infection rate of around 7% of the population based on the fatality experience, regardless of their confirmed cases of 0.75% of the population. (It is no surprise that the NY Times is reporting that 1 in 6 NYPD are out sick or quarantined when you realize that 1 in 14 New Yorkers are infected in the first place.)
I don't think anybody has accurate infection scope data. Infection and mortality rate "estimates" are a guess on top of extrapolations. It would help to put things in a wider perspective. Even the common cold has ~5% fatality for age 80+, which is the category of a large percentage of CV deaths. Based on that, CV is only 3 times as bad as common cold.

The Bay area has a normal death rate of 129/day. With 100 deaths as of April 6, a 34 day period from the first California death, that's 3/day. The slope of the curve at present is about 8.5/day. During flu season the Bay area has about 6/day as a ratio of the state population (can't find county breakdown on that, or peak rate). Both figures share common data that could be double-counted, statistically speaking, because pneumonia mortality is most often counted for whatever disease initially presented in the case. Many pneumonia deaths aren't tested for flu and an autopsy isn't called for. CDC simply counts them as one category.

If people tracked and watched daily data on any communicable disease they'd get paranoid. We really don't need to test everyone.

South Korea didn't do any of this. They isolated positive test patients, and the most vulnerable elderly and their caretakers self-quarantined. Everyone else went about their business as normal (of course, masks are a bit more normal there than here). They knocked it down from 800-ish cases per day to less than 100 cases/day in three weeks. Their fatality rate is listed as 0.9% of positive cases.
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  #56  
Old April 7th, 2020, 09:30 PM
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Quote:
Originally Posted by McPerth View Post
Well, H1N1 2009 flu pandemic originated in California or Mexico, and the origin of the 1918 one (also H1N1 flu) is not clear...
There is a book on Project Gutenberg written by a physician regarding the 1918 flu pandemic. http://www.gutenberg.org/files/61607...-h/61607-h.htm

Regarding the 1918 pandemic, he twice places the initial appearance in Spain once in Southwestern Spain, and once in Southeastern Spain, Barcelona to be specific. However, he notes the appearance of the flu in Hawaii in June of 1918, prior to the appearances in Spain. This may indicate an Asian source for it. He also comments on the successful use of Quinine in treating the flu. This is interesting as to the use of Chloroquine in current treatment.

Note: This book has been downloaded quite a lot in the last 30 days.
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  #57  
Old April 7th, 2020, 10:21 PM
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You are thinking about this correctly, Stray, but some of your data you are assuming isn't right.

It certainly is true that everything about the covid-19 pandemic is an estimate at this point. If past epidemics are any indication, it will take years to figure out a "true" rates of infection with SARS-2 or the covid-19 fatality rate. But that reality doesn't mean we are completely in the dark. Public health professionals are used to dealing with high degrees of uncertainty.

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It would help to put things in a wider perspective. Even the common cold has ~5% fatality for age 80+, which is the category of a large percentage of CV deaths. Based on that, CV is only 3 times as bad as common cold.
Regardless of fatality rates for the age 80+ cohort (and I don't think your common cold fatality rate is correct, btw), widen the lens again and look at a few more cohorts and it is clear covid-19 is far more consequential. Boris Johnson (age 55) would not be in the ICU right now if he had a common cold. Cold and flu do not put 20% of infected working age adults (20-65) in the hospital like covid-19. Cold and flu don't kill 0.5-1% of people in their 50s. This is a far more serious disease than cold or flu for the working age set.

And while there are certainly cases of over-counting (from people who have SARS-2 infections and die, but not from covid-19) and under-counting (from people who die of covid-19 but are never identified), it is a safe bet given the limited nature of testing that under-counting fatalities dominates.

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South Korea didn't do any of this. They isolated positive test patients, and the most vulnerable elderly and their caretakers self-quarantined. Everyone else went about their business as normal (of course, masks are a bit more normal there than here).
This is bit is wrong and misleading. Misleading because South Korea has options that most other countries don't. They have far greater per capita testing capacity. That makes isolation and contact tracing possible. They also have and use surveillance and tracking technology as well as public health resources that simply do not exist at the same scale in the US (for one example).

It is wrong to suggest that "everyone else went about business as usual." Schools were closed. Large gatherings banned. Teleworking encouraged. Buildings required masks and temperature checks to enter. Physical distancing may have been voluntary, but it was still highly promoted and followed. It was and is anything but "business as usual" in Korea.

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They knocked it down from 800-ish cases per day to less than 100 cases/day in three weeks. Their fatality rate is listed as 0.9% of positive cases.
The first of these stats is highly misleading, and the second is wrong. Yes, the peak outbreak stabilized after about 3 weeks, but South Korea hasn't been able to relax their procedures and haven't been able to drive the pace of infection down. They are 48 days into their public health response.

Korea's fatality rate experience with covid-19 has continued to increase, and today it stands at 1.9%.
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  #58  
Old April 8th, 2020, 06:22 AM
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Quote:
Originally Posted by timerover51 View Post
There is a book on Project Gutenberg written by a physician regarding the 1918 flu pandemic. http://www.gutenberg.org/files/61607...-h/61607-h.htm

Regarding the 1918 pandemic, he twice places the initial appearance in Spain once in Southwestern Spain, and once in Southeastern Spain, Barcelona to be specific. However, he notes the appearance of the flu in Hawaii in June of 1918, prior to the appearances in Spain. This may indicate an Asian source for it. He also comments on the successful use of Quinine in treating the flu. This is interesting as to the use of Chloroquine in current treatment.

Note: This book has been downloaded quite a lot in the last 30 days.
Well, while not denying the possibility, Barcelona was not among the places I've ever read as its origin... In fact, most I've read about it talk about unkown origin, the name of Spanish Influeza given due to Spain, being not under war censorship, was the first to report it.

In any case, from this same book:

Quote:
Origin in south eastern Spain, Barcelona, a seaport; April, 1918, where a German submarine is said to have carried it; originally acquired by this boat at the Baltic port or ports of Danzig or Stettin.
So, it seems it was imported to Barcelona from the Baltic, hinting it was not the origin...

In any case, after just skim reading the book, I saw some inconsistencies or wrong info, as the same fact Barcelona is in Sout east Spain (just look at a map, you'll see it's east/north east), or the fact in Spanish flu is called catarro (this Word is used for a common cold, while flu is gripe is Spanish).

I hope the rest of the book is better documented...
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  #59  
Old April 8th, 2020, 11:12 PM
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Korea's fatality rate experience with covid-19 has continued to increase, and today it stands at 1.9%
that's about what the cruise ship diamond princess's rate is turning out to be, and they had no internal quarantine and an (presumably) elderly population. bad flu nothing more.
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  #60  
Old April 9th, 2020, 04:45 AM
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Taiwan, Hong Kong and South Korea had a bad experience with SARS, learnt their lessons, and took appropriate precautions to ensure they can minimize fallout when another pandemic hit them.

Singapore tends to be foresighted, the Philippines has threatened to shoot violators, while the Japanese have been strongly advised to follow guidelines; so have the North Koreans, though I suspect they probably still will get shot.

Indochina, don't know what's going on there.
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