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On Topic Discussion 2019 Coronavirus (COVID-19/SARS-CoV-2)

I can't thank you enough for the detailed information you've shared with us.
Many times a day I have to remind myself that my age puts me in a high-risk group and this virus event may be with us for months to come.

There's a lot of information that we're being bombarded with (and a lot of threads about coronavirus on JUB).

Right now, voices that in March were saying, "It's all just the media trying to scare you" are the same voices that are today saying, "Oh that wasn't so bad, let's all go back to work".

This thread is a good place to retrace what really happened- For example:
  • On 17-March, the global count was 182,986 cases and 7,158 deaths. In the US, there were 4,661 cases and 85 deaths.
  • Yesterday, the global count was 2,081,969 cases, 138,487 deaths. The US had 639,733 cases and 31,002.
That's a 1,037% increase in cases and a 1,834% increase in deaths in one month worldwide.

You can also read a story talking about how South Dakota has no stay-at-home order and then see that now they have the highest increase in cases of all the States- running 12% to 18% per day for several days.

On the upside, on 17-March, the US cases were increasing 25% from day to day. Yesterday, the US cases were increasing 5% now that most of us are at home and avoiding contact with other people. What we're doing is working.
 
When will they find a cure/vaccine?

Life is so miserable when you are stuck at home, and you have to wear a mask when going out.

I don't know how long this is going to last.
 
17-Apr-2020:

Global COVID-19 Mortality/Morbidity
- Cases reported: 2,172,031 (up from 2,081,969) - *‬*90,062 new cases yesterday
- Deaths: 146,201 (up from 138,487) - **‬7,714 people died yesterday

US COVID-19 Mortality/Morbidity
- Cases reported in the US - 671,425 cases (up from 639,733 yesterday, ‬**31,692 new cases)
- Deaths reported in the US - 33,286 deaths, **2,284 new deaths yesterday, 30% of the world's new deaths were in the US
Note: the US has begun implementing the new CDC policy that a positive SARS-CoV-2 test is not required to count the death as COVID-related. This will cause death counts to be unusually high until the counts are adjusted for past deaths that had not been counted previously.

NY state and NYC COVID-19 Mortality/Morbidity (as of 11AM yesterday)
- Cases reported in NY state - 223,691 (up from 213,779 / +9,912)
- Cases reported in NYC - 117,565 (down from 118,302 / ‬-737[sup]a‬[/sup]) , hospitalized - 30,903
- Deaths reported in NYC - 11,477‬[SUP]a[/SUP] (up from 10,899 / +578), confirmed 7,563, suspected 3,914
- Persons tested in NY state - 550,579 (526,012 tested prior day, 24,567 new tests) 41% positive
Note: [sup]a[/sup]NY started implementation of the CDC policy on Tuesday. Death numbers will be skewed until corrections from the past 6 weeks are reflected in totals.

Coronavirus cases/deaths in active countries (preference to countries with JUB members):
  • Spain - 184,948 (up from 182,816 / 1.2%) - 19,315 deaths
  • Italy - 168,941 cases (up 165,155 / 2.3%) - 22,170 deaths
  • France - 147,113 cases (down from 134,598 / 9.3%) - 17,942 deaths
  • UK - 104,155 cases (up from 99,516 / 4.7%) - 13,759 deaths
  • Turkey - 74,193 cases (up from 69,392 / 6.9%) - 1,643 deaths
  • Russia - 32,008 (up from 27,938 cases / 14.6%) - 273 deaths
  • Canada - 30,973 cases (up from 28,379 / 9.1%) - 1,231 deaths
  • Brazil - 30,891 (up from 29,015 cases / 6.5%) - 1,952 deaths
  • Netherlands - 29,383 cases (up from 29,381 ) - 3,327 deaths
  • India - 13,495 (up from 12,456 / 6.5%) - 448 deaths
  • Ireland - 13,271 (up from 12,547 / 5.8%) - 486 deaths
  • Japan - 9,231 (down from 8,626 / 7.0%) - 190 deaths
  • Mexico - 6,297 (up from 5,847 / 7.7%) - 486 deaths
Coronavirus cases/deaths in recovering countries:
  • Germany - 138,221 cases (up from 132,210 / 2.6%) - 4,098 deaths / 81,800 recovered
  • China - 83,760 (up from 83,355 / 0.4%) - 4,636 deaths / 77,551 recovered
  • Iran - 79,494 cases (up from 76,389 / 1.9%) - 4,958 deaths / 54,064 recovered
  • Switzerland - 27,078 cases (up from 26,023 / 2.5%) - 1,288 deaths / 15,900 recovered
  • South Korea - 10,635 cases (up from 10,591 / 0.2%) - 230 deaths / 7,829 recovered
  • Australia - 6,522 cases (up from 6,462 / 0.9%) - 3,808 deaths / 3,808 recovered
  • New Zealand - 1,409 (up from 1,401 / 0.6%) - 11 deaths / 816 recovered
Individual States with high case counts:
  • New York - 223,691 (up from 214,832 / 4.1%) - 14,832 deaths
  • New Jersey - 75,317 (up from 71,030 / 6.0%) - 3,518 deaths
  • Massachusetts - 32,181 (up from 29,918 / 7.6%) - 1,245 deaths
  • Michigan - 29,263 (up from 28,059 / 4.3%) - 2,093 deaths
  • California - 28,157 (up from 27,098 / 3.9%) - 973 deaths
  • Pennsylvania - 28,314 (up from 26,804 / 5.6%) - 848 deaths
  • Illinois - 25,733 (up from 24,593 / 4.6%) - 1,073 deaths
  • Florida - 23,340 (up from 22,519 / 3.6%) - 668 deaths
  • Louisiana - 22,532 cases (up from 21,951 / 2.6%) - 1,156 deaths
  • Texas - 17,263 (up from 16,289 / 6.0%) - 429 deaths
  • Georgia - 16,368 (up from 15,267 / 7.2%) - 617 deaths
  • Connecticut - 15,884 (up from 14,755 / 7.7%) - 971 deaths
  • Washington - 11,285 (up from 10,971 / 2.9%) - 587 deaths
  • Maryland - 10,784 (up from 10,032 / 7.5%) - 294 deaths
  • Colorado - 8,675 (up from 8,280 / 4.8%) - 372 deaths
  • Tennessee - 6,263 (up from 6,288 / -0.4%) - 141 deaths
  • Mississippi - 3,624 (up from 3,360 / 7.9%) - 129 deaths
  • South Dakota - 1,311 (up from 1,168 / 12.2%) - 7 deaths
Canadian Province Stats:
  • Alberta - 2,158 (up from 1,996 / 8.1%) - 50 deaths
  • British Columbia - 1,575 (up from 1,561 / 0.9%) - 77 deaths
  • Manitoba - 250 (up from 246 / 1.6%) - 5 deaths
  • New Brunswick - 117 (unchanged from 117) - 0 deaths
  • Newfoundland/Labrador - 252 (up from 247 / 2.0%) - 3 deaths
  • Northwest Territories - 5 (unchanged from 5) - 0 deaths
  • Nova Scotia - 579 (up from 549 / 5.5%) - 3 deaths
  • Ontario - 9,828 (up from 8,447/ 16.3%) - 459 deaths
  • Quebec - 15,587 (up from 14,860 / 4.9%) - 630 deaths
  • Prince Edward Island - 26 (up from 25 ) - 0 deaths
  • Saskatchewan - 305 (up from 304 / 0.3%) - 4 deaths
  • Yukon - 8 (unchanged from 8) - 0 deaths
There were also 13 Canadians on the Grand Princess, one of whom died.
 
Whereas the pandemic is indeed costly in human life, in addition to any economic impact, it should always be kept in perspective.

The WHO estimates that the flu annually kills between 300,000 and 600,000 souls. So far, this virus is at half the low end estimate of that and rising. We'll see if it even hits the 600,000 mark, which would put it only in line with our annual global deaths from influenza.

The US only sees about 60,000 deaths from influenza annually. We are at half that number and rising.

Assuming that the actual infection rate is at least 15% (see the reference to pregnant women in this thread's linked article), then the US has at least 50 million cases already, so the deaths are far below 1 in 1000. We should take some comfort in that when compared to the estimated 10% fatality rate in the 1918 pandemic.

Keep perspective. Obsession doesn't equate to loss.

The Spanish Flu killed an estimated 50 million souls with a world population less 1/3 of ours. And society rebounded quickly in the 1920's after that much greater loss. And remember that the Spanish Flu didn't take the elderly and weakened; it targeted the healthy and those between 20 and 40, so that would have a much greater impact on a society. And no, that doesn't mean we write off old people, only that younger members of society have more active roles in it by many standards.

That doesn't minimize our present pandemic, but it is perspective, and many people seem to be losing perspective in an age of CNN, and supposed news that does little more than obsess and dramatize in order to attract viewers.
 
We don't have a vaccine yet for this, though. Without social distancing and stay at home restrictions, it would be a lot worse. For 15-20% of victims, the virus causes severe or critical breathing difficulties. Organ damage is even being seen in people recovered. When it hits hard, it is nastier than the flu. Don't be a Dr. Phil or William Bennett, either.
 
When evaluating NYC's statistics, the metropolitan area includes 20,000,000 people. They are standing at just over 10,000 deaths. That is just about 1/1000 of the infection rate if the 15% estimate is ever validated.

Of course, there is the possibility that even more than 15% is infected, which would make the fatality rate even lower. Few believe less are infected, as the lack of testing only gives rise to the belief that it is hugely underreported.
 
We don't have a vaccine yet for this, though. Without social distancing and stay at home restrictions, it would be a lot worse. For 15-20% of victims, the virus causes severe or critical breathing difficulties. Organ damage is even being seen in people recovered. When it hits hard, it is nastier than the flu. Don't be a Dr. Phil or William Bennett, either.

I am a skeptic on the belief of social distancing, not that we shouldn't be trying it, but that there are SOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO many stupid people in this world.

Every single time I made a grocery run, the clerks were congregating within one foot of one another, including their managers, and on two or three separate occasions, I saw them hug people who were most obviously customers, not their housemates. Every single time there were doltish customers who closed in when unnecessary, or blocked aisles or similar. I kept moving away.

It just seems very like a lot of people are claiming they are keeping the distance while not at all, which means the infection rate is already much much higher than people are assuming. And we'll likely not ever all be allowed to be tested to ever know the real numbders. And, since it has become a political football, we'll never get trustworthy data on a national scale.
 
...The WHO estimates that the flu annually kills between 300,000 and 600,000 souls.
Keep in mind that a flu season is 13-16 weeks. The 2018 flu epidemic in the US was the worst in a decade- 34,200 died. About 490,600 ended up in the hospital.

With COVID-19, we've had about 30,000 people die in 4 weeks.

We're still in the process of revising the death count upward because we missed quite a few deaths- take a look at today's stats above for NYC deaths - confirmed 7,563 plus suspected 3,914 - which is an indicator that we might see a final count of 40,000+ deaths once the numbers are revised.

Assuming that the actual infection rate is at least 15% (see the reference to pregnant women in this thread's linked article), then the US has at least 50 million cases already, so the deaths are far below 1 in 1000. We should take some comfort in that when compared to the estimated 10% fatality rate in the 1918 pandemic.
That 15% is from a NYC sampling where we know we have a worst case scenario because of the dependence upon mass transit and the density of the population.

The epidemiologists are expecting to see something like 5% of the population that will get infected nationwide. That's 16 million people. If you assume a 4% mortality, that's 660,000 dead. If you assume that 15% of the infected will end up in a hospital, that's 2.5 millions people. If you assume that 5% will require a ventilator, that's 825,000 people.



We don't have a vaccine yet for this, though. Without social distancing and stay at home restrictions, it would be a lot worse. For 15-20% of victims, the virus causes severe or critical breathing difficulties. Organ damage is even being seen in people recovered. When it hits hard, it is nastier than the flu. Don't be a Dr. Phil or William Bennett, either.

A few of my healthcare associates have gotten sick. Their experience varied from a mild cold that lasted 7-10 days to several who had a severe flu-like experience that took 4-6 weeks to get through. One colleague spent 3 days in the ICU. When you extrapolate that to a population of 16 million people who could get sick with this in the US, that's a lot of lost productivity.

We're really in a difficult situation. In epidemiology, they always try to get in early with prevention by preventing people from an illness from getting established in a population. When prevention fails, we end up in mitigation- basically trying to stop an established illness from getting worse and continuing to multiply.

In the US, the time for prevention was January and early February. We blew that. So, now we are in mitigation looking at a virus that is firmly established in all 50 states, Guam and Puerto Rico. In States like California and Ohio that were aggressive with mitigation, the cases are increasing 3-5% per day. States that were slow to put in mitigation like Florida and Louisiana, the rates were 15-30% until they put in mitigation. That critical misstep in prevention resulted in a $2 trillion spending package and millions of unemployed people.

What is worrisome is that if the US blows mitigation and we see rates return to 15-30% increases daily, then we're back to more spending packages and more unemployed people.

It's not going to be an easy road until there's a vaccine or an effective way to lessen the course of the illness so that we don't have millions of people who are sick for 2 to 6 weeks... assuming they don't end up in the hospital or in the morgue.
 
The lower numbers of people expected to be infected(5% of the population now over fears of 40-70% infected) are they due to lower virulence than expected, or precisely because of the keeping people home as much as possible/social distancing/ mask-wearing?
 
The lower numbers of people expected to be infected(5% of the population now over fears of 40-70% infected) are they due to lower virulence than expected, or precisely because of the keeping people home as much as possible/social distancing/ mask-wearing?

That 5% number came from Harvard's Department of Epidemiology. They were estimating what we will find once we start mass antibody testing to see who has already been infected. Their projects were based upon current data with social distancing. If we stop mitigation, the models say that about 20-40% of the population could be infected with the longer the disease circulates, the higher the number will continue to climb.

Concept of "herd immunity" is based upon the R[sub]0[/sub] which is a measure of how contagious a disease is- the point at which a population has immunity to a disease such that the disease no longer spreads in the community.

A disease like measles has a high R[sub]0[/sub]: 1 person with measles can pass the disease to 10-18 people. To get to her immunity on a high R[sub]0[/sub] disease, you have to have immunity in >90% of the population. That's why the MMR is so aggressively pushed- we need to have as many people with immunity in the population as possible.

SARS-CoV-2 is estimated to have an R[sub]0[/sub] of between 2 to 5 which means that you need >50% of the population to be immune before you can hope to eliminate the disease from the population. If we're projecting a best case of 5% and a worst case of 20-40%, we're not going to get to herd immunity anytime soon. That's why Fauci keeps saying we're going to be in this situation until we have a vaccine and it's why he keeps emphasizing that COVID-19 will continue to flare up periodically until we have the vaccine available.
 
17-Apr-2020:

Global COVID-19 Mortality/Morbidity
- Cases reported: 2,172,031 (up from 2,081,969) - *‬*90,062 new cases yesterday
- Deaths: 146,201 (up from 138,487) - **‬7,714 people died yesterday

A few observations about today's statistics.

For a couple of weeks, China has been reporting 82,000 cases and adding about 50-900 new cases per day. On their death counts, they reported about 3,300 deaths total with <10 new deaths daily. Yesterday, China reported 358 new cases and 1,290 new deaths. There have been reports coming out of Wuhan that the government had ordered thousands of funeral urns for ashes- far more than the number of reported deaths. We may see the Chinese increase their cases and deaths over the next few weeks.

There were some outliers in the numbers today.
  • Canada's case numbers have jumped this week. This seems to be because Ontario has started testing a lot more people. On April 10th, Canada reported 1,475 cases. Yesterday, they reported 2,594 cases. This seems to be associated with 1,381 new cases in Ontario and 727 new cases in Quebec that were added yesterday, probably because the increased testing is picking up cases that might have been missed before they increased their testing rate.
  • Russia has a problem. In March, they bragged that they had their cases under control. In a week, they've gone from 11,917 cases to 32,008 cases in a week.
  • Brazil is still in denial. They're undertesting. Even with their inadequate testing program, they've gone from 18,176 to 30,891 cases in a week. If this gets into the slums around Rio, it's going to be a disaster.
  • France has been canvassing retirement homes this week. They added 12,515 new cases overnight- mostly cases from their long term care facilities that were not included earlier.
  • Japan had claimed that they had their cases under control after the big increases in China back in January and February. The Japanese have been lax on social distancing in March and April. Japan's cases went from 5,530 to 9,231 in a week.
 
^^^ This is what I see as THE problem for relaxing social distancing and shelter in place orders.

We have no idea how many people are actually infected and until we have testing widely available we won't and can't know and if the orange man and his cohorts get their way this will all erupt again and again and again.

I have concluded that the people who are not wearing masks in public are either uniformed that they could be making other people sick or they are sociopaths and just don't have the mental capacity to care.

I think maybe stopping people who are not wearing a mask before they enter a public building to let them know the facts about the spread of the disease might help. Too many people listen to 'facts' and now calls to 'liberate' from the orange horror and some preachers when clearly the only people qualified to give accurate information are informed medical professionals.
 
The trouble is, no one knows the truth in the data.

One model predicts X, and another Y. California defied the odds so far.

We don't have any controlled study to speak to the efficacy of masks.

And cities pretty much defy studies anyway.

You'd suspect the pregnant women might be uber conscientious simply because mothers tend to be during their term. So the 15% number could be well shy of the actual infection rate.

As has been said before, we're likely not to learn what percentage is infected -- ever.

Even now, we are only testing a few hundred thousand per day at most, and the need is in the millions. Millions.
 
^^^ I think maybe stopping people who are not wearing a mask before they enter a public building to let them know the facts about the spread of the disease might help. Too many people listen to 'facts' and now calls to 'liberate' from the orange horror and some preachers when clearly the only people qualified to give accurate information are informed medical professionals.
Peer pressure works.

In the US, we're once again in the "Two Americas" paradigm. People in urban areas are acutely aware of the risks and what the rules are. People in the rural areas haven't registered their risks completely. We're also watching two different news narratives that can be divided into Fox vs Reality.

I've spent part of the past few weeks in an urban setting and part of the time in a rural area. I can see the fear in people's eyes in the urban area. When I am out in the rural area, there's fewer people out but those who are out seem to be oblivious to what is happening in the cities.

The trouble is, no one knows the truth in the data.
The experts know. We have models that have told us where this is going. What we lack is testing data that helps us adjust those models to get to predicted numbers for different populations- particularly in the US where we have those Two Americas.

There was an interview on CNBC with an epidemiologist in Iceland who was talking about who Iceland had contained their epidemic (their first cases were in early March). His comment was that the epidemiologists in Iceland knew exactly what to do because the US epidemiologists had taught the world what needed to be done in epidemics but for some reason, the US wasn't doing what they taught everyone else to do.

For reference, Iceland's growth curve is less than 1% per day. The US is running 5-7% per day.
 
A few observations about today's statistics.

For a couple of weeks, China has been reporting 82,000 cases and adding about 50-900 new cases per day. On their death counts, they reported about 3,300 deaths total with <10 new deaths daily. Yesterday, China reported 358 new cases and 1,290 new deaths. There have been reports coming out of Wuhan that the government had ordered thousands of funeral urns for ashes- far more than the number of reported deaths. We may see the Chinese increase their cases and deaths over the next few weeks.

There were some outliers in the numbers today.
  • Canada's case numbers have jumped this week. This seems to be because Ontario has started testing a lot more people. On April 10th, Canada reported 1,475 cases. Yesterday, they reported 2,594 cases. This seems to be associated with 1,381 new cases in Ontario and 727 new cases in Quebec that were added yesterday, probably because the increased testing is picking up cases that might have been missed before they increased their testing rate.
  • Russia has a problem. In March, they bragged that they had their cases under control. In a week, they've gone from 11,917 cases to 32,008 cases in a week.
  • Brazil is still in denial. They're undertesting. Even with their inadequate testing program, they've gone from 18,176 to 30,891 cases in a week. If this gets into the slums around Rio, it's going to be a disaster.
  • France has been canvassing retirement homes this week. They added 12,515 new cases overnight- mostly cases from their long term care facilities that were not included earlier.
  • Japan had claimed that they had their cases under control after the big increases in China back in January and February. The Japanese have been lax on social distancing in March and April. Japan's cases went from 5,530 to 9,231 in a week.

We were expecting very high numbers this week in Ontario, not just from testing but based on probable outcomes of infection before more stringent lockdown protocols as well as the ramping up of testing all residents in nursing homes.
 
Peer pressure works.

In the US, we're once again in the "Two Americas" paradigm. People in urban areas are acutely aware of the risks and what the rules are. People in the rural areas haven't registered their risks completely. We're also watching two different news narratives that can be divided into Fox vs Reality.

I've spent part of the past few weeks in an urban setting and part of the time in a rural area. I can see the fear in people's eyes in the urban area. When I am out in the rural area, there's fewer people out but those who are out seem to be oblivious to what is happening in the cities.


The experts know. We have models that have told us where this is going. What we lack is testing data that helps us adjust those models to get to predicted numbers for different populations- particularly in the US where we have those Two Americas.

There was an interview on CNBC with an epidemiologist in Iceland who was talking about who Iceland had contained their epidemic (their first cases were in early March). His comment was that the epidemiologists in Iceland knew exactly what to do because the US epidemiologists had taught the world what needed to be done in epidemics but for some reason, the US wasn't doing what they taught everyone else to do.

For reference, Iceland's growth curve is less than 1% per day. The US is running 5-7% per day.

Not skipping the fact that Iceland's population of around 360,000 people, is scattered over 40,000 sq mi of insular territory dropped halfway to (or from) the North Pole. They did a good job at mending the 2008 economy bombings too.
It would be a perfect element for testing stupidity if, under those conditions, you would allow any sort of epidemic to thrive among the people.
 
Keep in mind that a flu season is 13-16 weeks. The 2018 flu epidemic in the US was the worst in a decade- 34,200 died. About 490,600 ended up in the hospital.

With COVID-19, we've had about 30,000 people die in 4 weeks.

Yet this site isn't political, but it quotes the 2017-2018 influenza death toll at 80,000. It was published in the past and cites the CDC.

https://www.statnews.com/2018/09/26/cdc-us-flu-deaths-winter/

Peer pressure works.

In the US, we're once again in the "Two Americas" paradigm. People in urban areas are acutely aware of the risks and what the rules are. People in the rural areas haven't registered their risks completely. We're also watching two different news narratives that can be divided into Fox vs Reality.

Too simplistic. Plenty of us never ever see Fox or any pro-Trump spin, yet find plenty of independent contradictory estimates. Tonight, on ABC, there was an interview with a scientist who did a study in California and found a much larger infection rate indicated, again shredding implications that there is anywhere near a 4% death rate.

Karabulut said:
The experts know. We have models that have told us where this is going. What we lack is testing data that helps us adjust those models to get to predicted numbers for different populations- particularly in the US where we have those Two Americas.

No. The experts don't know. They are theorizing and revising numbers constantly, and the swings are wide. Being an authority means one knows the topic and has training. It doesn't give them any magical powers to create data that no one has.

I don't support the administration in any way. I've never voted conservatively. I watch PBS constantly and listen to NPR and am fully aware of their biases and prejudices that slant the news as routinely as any conservative outlets.

Presuming "truth" is out there, other than coverage of actual events, is presumptive. Saying it authoritatively doesn't make the total picture more clear.

Trump being a total idiot doesn't make the obverse true either.
 
Yet this site isn't political, but it quotes the 2017-2018 influenza death toll at 80,000. It was published in the past and cites the CDC.

That might have been preliminary estimates that came out of the weekly mortality and morbidity reporting from CDC Fluview. There's often a delay in the final stats.
2017-2018 season burden stats
2018-2019 season burden stats


No. The experts don't know. They are theorizing and revising numbers constantly, and the swings are wide. Being an authority means one knows the topic and has training. It doesn't give them any magical powers to create data that no one has.
But that's what epidemiology is. Extrapolations are made from predictive models. Then data is reviewed retrospectively and finalized. It's why we don't get final numbers from flu season until a year or so after the season.

For SARS-CoV-2, we're missing one important data point for input- large population sample testing for US cases. That data point is being estimated from smaller samples and it is true that smaller samples introduce a bias risk. They're also using comparative samples from countries like Germany, Iceland and South Korea that did large population sampling and contact tracing.

Eventually when we have antibody tests, they'll be able to get larger samples but you're probably not going to get those numbers for a couple of years.
 
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