This Thread Blows - C19 and beyond

[Mahnken]

Isn't herd immunity only effective when 98% of the population is immune? That's not possible without a ton of death.

 

[Norm]

I'd like your serious thoughts on the later portion of how this virus is controlled.

Personally I don't think we can have that conversation yet because we haven't been able to keep the people providing care safe. To me that's the primary thing right now. If I am ruling the world I would approach that first. So.

Step 1: Lock Everything/Everyone Down

There is no longer essential anything, other than food & medicine as well as services. Basically, stop the tide now. For now, rather. These road crews of 12 people are essential? Construction projects? I mean come on already.

Step 2: Fix the Hospitals

I alluded to this yesterday. The governor may not know what is best for me and/or you on a personal level but the government does have the ability to start redirecting resources as-needed. Our current situation sees far too many people in the hospital system getting sick, and this in turn is going to cause more of the virus to spread. If 300 people are really out from Newark, then 350 are actually positive, which means that each of those 350 people are likely going home and infecting a family member. Or all of them. We need to address that problem, or steady-state it, first.

An example would be to figure out a system of infection distribution that does not tax 1 hospital too much. Or you need to make 1 system the epicenter and staff it with doctors & nurses that have gotten it and gotten through it. These are "shit on the wall" ideas. But this is not my job. That's what the governor is supposed to do. This is what the state and country should be mobilizing for.

The aim there is to steady-state how much the hospital system can take in a given day/week.

Step 3: Do the Math

Of every 1000 people, figure out what the rate of transmission is, how many the hospitals can take, etc. I will phone a friend, @jmanic, for this one. Tell me how many people can we safely "let out" and not blow up the healthcare system again.

Step 4: The Draft System

Since we are in fantasy land, we now institute a draft system to figure out how we let people back into the wild. At this point I don't know if I would bother even writing this out. But you know where I'm going with this. If we can handle allowing X people a day, you figure out how you distribute that number. There are 12 problems with this plan and it will never happen. So why bother writing more than this?

Alternate #1: Hope for a Vaccine

Sure.

I have a saying: You can hope in 1 hand and shit in another and see which fills up first.

Alternate #2: Accept this New Reality

It is what it is, and we're just going to have to let it play out. I know this sounds crude & crass but if you look at the way we're approaching this objectively, this is what we're doing. By "we" I mean humanity. The whole world is just letting it run its course. Sure South Korea got in front of it, but they're still going up every day in total cases and like you say, +1 person is all it takes to rekindle the whole damn thing.

The Problem Statement

As far as I can tell, when you boil it down, a huge item to address is this: How do we move forward without saying, "Sorry old people, at least 25% of you guys are going to die in the next 6 months because of this."?

I do not know how to approach that specific conundrum. Without a vaccine, the elderly are, to put it frankly, fucked. That's a pretty shitty plan really.

 

[68nova200]

Why not just tell old people and those with pre-existing conditions to stay home. Then let the rest of us healthy people out and function normally? We boost herd immunity. and maybe the hospitals get slightly taxed... since 95% of cases are mild I think we just need to all get it and hope we don't die in a car crash on the way to work (statistically more deadly). I'm using the worldmeters site for that 95% mild case number... If the powerball had a 95% win rate there wouldn't be a person in the world that doesn't buy a ticket...

 

[jmanic]

Step 3: Do the Math

Of every 1000 people, figure out what the rate of transmission is, how many the hospitals can take, etc. I will phone a friend, @jmanic, for this one. Tell me how many people can we safely "let out" and not blow up the healthcare system again.

So in a vacuum, the math would work like this:
when we have a solid breakdown of the levels of disease- % asymptomatic, % mild, % severe (with % that require the most care- vents),
the last being the ones that will really dictate what the system can withstand.
Work backward from the number of beds and vents you have and that would give you the number you could release and not overwhelm the system.
If the data are rich enough, you could also do adjusted numbers based on say age, sex, ethnicity, if we know the breakdown by these factors related to severity.
So that can get you a ballpark of how many people we can let out, but I'm sure this is oversimplified,
and you'd need to account for modeling of transmission, unless we start having corona exposure parties to control that.
You'd probably aim lower than that, just to make sure you don't overwhelm the system.

So that's how you'd get an idea of how many could be released to the wild,
but doesn't get to Steve's question of how TF do you roll that in practice?
Regionally? By job category? Hunger Games lottery?
Assuming you want to have a controlled burn, it would have to be at least by region.

I dunno, there's some lessons from the 1918 flu, where similar things were implemented,
most notably the spikes that happened in places that rolled back restrictions too quickly.

 

[Patrick]

@Santapez
I was talking to the wife about this the other day.

Herd immunity is 60-70% (source:memory)
we are a long way from there.
at some point, we'll all need to be tested for antibodies, to see just how far away this is.

I don't think there is a robust economy while this is out there.

Somewhere i saw the death by age at 0.2% for 20-60. rising a bit at 50+ (and theories it is under-reported)
Who is choosing the 1/500 route?
That is assuming the healthcare system can save the people that can be saved, and doesn't collapse under the weight.
At that point, other diseases or accidents, that wouldn't usually be fatal, are now a problem. A heart attack victim
can't get a stent, bleed-outs from cuts, gangrene from a broken bone. Not to mention the issues with managing the dead,
and what that means (mass burials, or cremation - i'm sure it could be done more efficiently than 1-at-a-time.)
Pick you adjusted death rate 5%? (around 2% are requiring critical care right now - they all die, then the higher rate with the 60+ crowd)
that is 6M to 15M people.

Just looking at the math - if we were to open the doors and say have at it. Make like life is ok. and went back to this doubling
every 3-4 days (say 2x/wk for easy math). the whole country has it in about 6 weeks. .5,2,8,32,128,300+ - it will blow through
herd immunity cause all the active cases are not immune - resolved takes 3 weeks(again memory) -
how many are so mild they just keep working - and they don't have anyone to care for, and keep the spread going?
If we are going this way, we should have covid parties to compress the timeframe.

What does the rest of the world think if this isn't a global policy?

^^^so that is going to be high, cause sigmoid curve, but we don't know the factors to draw the curve - so assuming the worst,
cause we are creating the worst situation. if everyone with C19 can spread it for 3 weeks, then 32M/64M people will infect everybody that
doesn't hide...

Then what is critical? Keep the lights on, water flowing, food available (this might solve the obesity problem), garbage collected.
F recycling. saw karen went nuts when somerset paused it for a few days.

There is a sharp change in the graph when a packaged treatment (cure?) is available, and is very efficient - like 99.99% and a week of time.
And,of course, if there is a vaccine -

Another concern is social stigma (i'm reading Erewhon) - do you get an immunity card? How about an arm band?
Are the people who "sacrificed" their loved ones going to be the same? Questions of why did i survive, and my kid die?
Did we do everything we could? - because we were worried about the economy? Or quality of life for a couple months, or even a year?



i don't need to go to the mall, movies, or the park. the town is delivering meals to anyone that asks.
i don't care what my portfolio looks like, or if it needs to be raided to meet other commitments.
I support the cessation of collection activity on debt while people are asked not to work - we'll figure it out later.
so basic needs met for everyone, shelter, food, relief of the worry about $$.
it isn't a normal time, gotta adapt.

on the flip side.
we now have a gun. ammo, extra gasoline, and a generator.
I leave the outside lights on all night (LED of course)

the spice rack is organized, and i wrote what everything is on the lids, cause it is below waist level.
Find something to do - and make it a multi-day project. Cause we all got multiple days.

My kid is 17, and just got his license (feb). He almost has a GF. He has been working hard for 3 months leading into track season.
Doing well in school, looking at colleges...
all just stopped. He'd been saving forever for a car. "Chicks dig cars and athletes." He was finally there.
Hopefully the long term effect of this is a net positive for appreciating that everyone is in this thing together.
Now a member of Generation C19. (my name for it)

I really feel for the kids in an urban environment.

 

[Santapez]

My kid is 17, and just got his license (feb). He almost has a GF. He has been working hard for 3 months leading into track season.
Doing well in school, looking at colleges...
all just stopped. He'd been saving forever for a car. "Chicks dig cars and athletes." He was finally there.
Hopefully the long term effect of this is a net positive for appreciating that everyone is in this thing together.
Now a member of Generation C19. (my name for it)

I really feel for the kids in an urban environment.

I thought this was @jmanic posting and when I got to this point and was like WTF, THERE'S SOME SHIT HERE HE'S BEEN HIDING FROM US.

 

[68nova200]

That all makes sense but it seems that you are using the assumption that 100% will be infected. That's simply not the case. Lets use NYC as an example. 3.5 weeks ago it was nearly life as normal. Subways, taxis, buses, all in use with no sanitizing efforts. 5 million people use mass transit daily in NYC. Explain why there aren't 5 million cases in the city now? There are only 74000 cases in NYC by my calculations, that's only a 1.5% infection rate.

 

[Santa]

The world is never going to be same. I hope you all understand this. What we are doing to flatten the curve might be necessary who knows but it is destroying us at the same time. We won’t recover from this devastation.

 

[Santapez]

I dunno, there's some lessons from the 1918 flu, where similar things were implemented,
most notably the spikes that happened in places that rolled back restrictions too quickly.

Yes, would want to roll back restrictions in a place where we think we're past that curve and at a plateau or decline. Probably a first-in-first-out situation (who got it bad at first) will be realisticly how it will unfold, but needs to be based on #s, not just what region got it bad at first.

I just don't know how you can open up pretty much ANYTHING without rationing. If you open up restaurants and say 1/4 or 1/3 seating, you'll have a mob outside. Probably would need to institute some sort of other rule like you can go to restaurants on alternating days based on the letter of the name of your street you live on or something.

 

[Santapez]

The world is never going to be same. I hope you all understand this. What we are doing to flatten the curve might be necessary who knows but it is destroying us at the same time. We won’t recover from this devastation.

That's a little drastic.

Spanish Flu
War of 1812
Civil War
Spanish Flu
WWI
WWII
Cold War
Civil unrest in the '60s, president being shot, his assassin being shot live on TV, MLK & the president's brother being shot. A war we lose, a president involve in a cover-up.
The cancellation of Firefly
Terrorists bombing our landmarks and getting us into a war in the middle east we're still involved in.
Trump

We'll be OK.

 

[Santa]

Everything posted here is opinion so I gave mine. Don’t think it’s drastic. I’m out have fun y’all

 

[Santapez]

Everything posted here is opinion so I gave mine. Don’t think it’s drastic. I’m out have fun y’all

Don't think I'm saying you're an idiot or your opinion isn't valid just because my opinion is different.

 

[Patrick]

That all makes sense but it seems that you are using the assumption that 100% will be infected. That's simply not the case. Lets use NYC as an example. 3.5 weeks ago it was nearly life as normal. Subways, taxis, buses, all in use with no sanitizing efforts. 5 million people use mass transit daily in NYC. Explain why there aren't 5 million cases in the city now? There are only 74000 cases in NYC by my calculations, that's only a 1.5% infection rate.

this is the fallacy of small numbers - and the same reasoning was used when it was only a few 100 people.
if it is more contagious than the flu, more virulent than the flu, there is a vaccine + some natural immunity for the flu (in many cases)
then why wouldn't it keep spreading at the early rate? the flu spreads at a predictable rate.

it is not a "there is only this many now" problem.
we are doing everything we can, and at the current rate, totals in NY/NJ will double again in 10 days.
Nationally it will double in 6-7.

taken another way - the flu killed 80,000 people, mostly very young or very old, in 2018 in a season -
of the 60M that got it.
this has killed 12,500 in 6 weeks - doing everything we can to slow it.
using the flu, i'll make a lower bound calculation that 60M would get this if not mitigated - 3M will require hospitalization (your number 5%),
1% die directly (current observed rate). 600,000 people. How many more from overwhelming the healthcare system?
and the collateral death - because emergency care is not available.

 

[JimN]

We'll be OK.

I would argue that the world was never the same after all of those events, and @Santa is right that it won't be the same after this event. Most of us will be ok, just like most of us were ok after all those other things you listed. I also just want to clarify that me saying that Dom is right doesn't mean he isn't an idiot though

 

[rick81721]

Sweden will be an interesting case study to follow. They basically said F-it, stay away from others best you can but we aren't shutting down the country:

https://www.businessinsider.com/coronavirus-sweden-no-lockdown-test-thousands-deaths-expected-2020-4

And people need to relax about a vaccine - it will come, sooner rather than later. This isn't rocket science - there are multiple options already in testing. And the approval process will be accelerated as fast as possible. Side note - you can volunteer for vaccine trials - I already threw my hat into the ring via an email to:

vaccines@nih.gov

Finally, biotech is another mature technology, and the US leads. There are antibody treatments under development that could potentially be approved and available this year.

 

[Fat Trout]

doesn't mean he isn't an idiot though

Makes me think of this clip

 

[68nova200]

this is the fallacy of small numbers - and the same reasoning was used when it was only a few 100 people.
if it is more contagious than the flu, more virulent than the flu, there is a vaccine + some natural immunity for the flu (in many cases)
then why wouldn't it keep spreading at the early rate? the flu spreads at a predictable rate.

it is not a "there is only this many now" problem.
we are doing everything we can, and at the current rate, totals in NY/NJ will double again in 10 days.
Nationally it will double in 6-7.

taken another way - the flu killed 80,000 people, mostly very young or very old, in 2018 in a season -
of the 60M that got it.
this has killed 12,500 in 6 weeks - doing everything we can to slow it.
using the flu, i'll make a lower bound calculation that 60M would get this if not mitigated - 3M will require hospitalization (your number 5%),
1% die directly (current observed rate). 600,000 people. How many more from overwhelming the healthcare system?
and the collateral death - because emergency care is not available.

Assuming my 1.5% infection rate in the most densely populated part of the country is accurate. Then only 4.5 million in the USA will contract it if we go about normal business. I think the last time I went to the city I easily walked past about 5000 people in a mile. So let me run some numbers based on that and the number of new cases reported on 3/20 in NYC. 3762 new cases reported on 3/20. Nearly all of those people took mass transit to get tested. Lets say 500 people per case positive interacted in a way that would pass along infection. There should be 1.8 million new cases in the 2 to 14 days after 3/20. Bottom line is that this thing really isn't that infectious and I think my basic calculations prove that pretty effectively.

 

[Magic]

The cancellation of Firefly

Thanks Steve. Getting-over-it meter back at 0%

 

[MMuller]

We're all in this together. Copy/pasted from Surfline.com

We deeply understand the draw to the ocean, especially as a means to relieve stress in trying times. However, as of April 6th, at least 311 million people in at least 41 states, three counties, eight cities, the District of Columbia and Puerto Rico are being urged to stay home.

San Diego Lifeguard Chief James Gartland, in an article published on Surfline on Wednesday April 1, said: “By going out and surfing, you’re putting the lifeguard at risk, you’re putting the firemen at risk if you get injured, you’re putting the police officer who has to come and enforce it at risk. And then if you end up in the hospital, you’re taking a bed away from someone who might need it more than you.”

There are many asymptomatic folks out there who can spread this thing -- even you. Check out coronavirus.gov, follow the guidelines from the Center for Disease Control and please review the latest beach closure information in your area.

We all need to act in the most socially responsible manner possible to bring an end to this once-in-a-generation pandemic.

And for us that means, at least for now, shred at home. Here’s a collection of stories, features and videos to help keep the stoke alive.

 

[Mahnken]

Assuming my 1.5% infection rate in the most densely populated part of the country is accurate. Then only 4.5 million in the USA will contract it if we go about normal business. I think the last time I went to the city I easily walked past about 5000 people in a mile. So let me run some numbers based on that and the number of new cases reported on 3/20 in NYC. 3762 new cases reported on 3/20. Nearly all of those people took mass transit to get tested. Lets say 500 people per case positive interacted in a way that would pass along infection. There should be 1.8 million new cases in the 2 to 14 days after 3/20. Bottom line is that this thing really isn't that infectious and I think my basic calculations prove that pretty effectively.

I could be wrong, but I think your basic calculations are too basic.