This year we kill it: Corona Virus Thread Mark II

[warty goblin]

It's not a rigorous statistical analysis by any means, but when it comes to the effectiveness of shutting business and banning personal gatherings, I find Minnesota's case and death curves very interesting.

By the end of October/early November it was pretty clear that we were in pretty much textbook exponential growth*. On the 10th of November, the governor issued an order that slightly restricted bars and restaurants, then followed this up with a much stricter order on the 18th which closed restaurants and bars for indoor dining, and banned all meetings between people from different households. At that point we were reporting about 7k cases a weekday, and roughly half that on the weekends. Now because this was right before Thanksgiving, and the reporting apparatus more or less shuts down for holidays, the data are pretty garbage for the next week or so, but by late November/early December cases had dropped considerably. The 30th is back up to 7k, but right after that the case count/day just starts to plummet. At that point the so-called 'dial-back' had been in effect for about two weeks, which at least to me looks an awful lot like the fact nobody was going anywhere or seeing anyone was effectively interrupting chains of transmission.

The death curve paints a similar picture, although it's a lot noisier, the delay between the order on the 18th and the peak is longer, and the overall decrease in the rate has been much smaller than the decrease in cases. But it looks like the death rate peeks about the week of December 12th or 18th, i.e. 3 - 4 weeks after the 'dial-back' order. This is apparently about what one expects, based on the lag between infection and death; by the time of the order most of the people who died in the next 3 or 4 weeks were probably already infected and not preventable deaths anymore.

It's of course possible that this isn't a result of the order, but it seems to me that a pretty solid alternative hypothesis is necessary. The changes in the curve's trajectory are pretty consistent with what's known of the progression of the disease, and certainly something acted as a brake in late November and early December.


*Like so textbook you could look at the plots, smooth out the weekend bumps, and notice that the daily and cumulative curves were making exactly the same shape.

[Forum Explorer]

The lack of a national level distribution plan is really evident, isn't it? How is the rollout going in non-U.S. countries?

Slow but steady here. Which is fine, because we're likely gearing up to the point where we are using vaccine faster than we can get it.

I suspect the devil is in the details. The Stanford paper talks about subtracting the effect of lrNPIs and the general course of the virus but they use two hand-picked countries to create that baseline: South Korea and Sweden.

They say in the case of SK that they did not implement mrNPIs but instead relied on extensive contact tracing and testing. But since the countries they're subtracting SK from didn't use as extensive contact tracing and testing, any sort of advantage from that would be attributed against mrNPIs.

On the other hand, they may be using Sweden and SK to bracket the extremes since it looks like they do pairwise comparisons.

Will look in more detail later.

Sweden is a bad example these days anyways. At first they were fine and comparable to South Korea, but now they've got 7 times the cases with a fifth of the population and a death per million rate that is over 100 times greater than South Korea's.

[snowblizz]

The lack of a national level distribution plan is really evident, isn't it? How is the rollout going in non-U.S. countries?

The rollout is as far as I know going fine. We just aren't getting enough doses in Finland, and I think that's a concern in other European countries. The EU has secured supplies as a collective but not getting what was promised. Though eg I hear in the Netherlands there is an issue with storage as they were expecting another vaccine type requiring less stringent storage needs.

Am sure you are all just pouring them out and mishandling them over there in the US or something...

[comicshorse]

Vaccinations seem to be going Ok in the UK. The government have set a target of 2 million vaccinations a week and though we haven't got there yet we hit 1.2 million vaccinations for the week ending 10th of January. So hopefully gearing up to it

[Justanotherhero]

The lack of a national level distribution plan is really evident, isn't it? How is the rollout going in non-U.S. countries?

The rollout is as far as I know going fine. We just aren't getting enough doses in Finland, and I think that's a concern in other European countries. The EU has secured supplies as a collective but not getting what was promised.

I can pretty much second the Finland perspective for Germany. People are complaining the government should have bought independently from the EU, I personally disagree with that assessment. We are one market and the EU approach was the right one.

Rollout is simply based on age and profession as far as I can tell.
I could register now to get the vaccine I decided against it because I think other people need it more right now.

[Grey_Wolf_c]

Do we know why our body 'remembers' for some diseases and not others?

OK, I remembered to ask my microbiologist friend while we were doing our weekly online game. Disclaimer first: this has been filtered through my non-medical brain, so take it as what it is: hearsay and simplification. All errors are mine, pinches of salt, etc.

Essentially, the "memory" is stored in the memory cells, like the video showed. Their skin is a sort of duplicate of the pathogen, and is used as a pattern to create antibodies. However, like any cell it dies relatively quickly (I believe he mentioned about 21 days), and thus have to keep duplicating to retain the pattern. These duplication slowly degrade the pattern until it isn't good enough to actually train the antibodies. How long the degradation takes depends on how good the pattern was to start with, and that is dependent on the disease. So with syphilis, the pattern last longer than human lives, while for, say, polio, you need boosters every few years if you are going to a risk area.

Funnily enough, the flu pattern is actually very long lived - what makes it need a new vaccine every year is that the flu virus changes. But occasionally, out of random chance, a flu season will repeat a pattern from decades earlier, and a bunch of old people are still immune to it - those are good years, too, since of course old people are more vulnerable, so starting off with a bunch of them already immune is great.

Grey Wolf

[sihnfahl]

Well, finally got around to evaluating the last news release from the EMA:

"This included internal/confidential email correspondence dating from November, relating to evaluation processes for COVID-19 vaccines. Some of the correspondence has been manipulated by the perpetrators prior to publication in a way which could undermine trust in vaccines. "

Unfortunately, the page is just a bland 'well, just FYI...' without showing the major differing points between the actual and manipulated sections.

Or any points, really. Just a generic 'well, they made process look bad when it really wasn't'....

[Rogar Demonblud]

They probably didn't expect anyone to bother reading that far who wouldn't already know exactly what they're talking about.

[pendell]

Well, let's have some good news and some bad new.

First, from Israel: Indications are that Pfizer prevents transmission , so that's definitely hopeful IF it proves out. One study does not a scientific consensus make.

On the bad news side Moderna lot 41L20A is being pulled due to an unusually large number of allergic reactions. I don't know why that particular lot would have more problems than any other Moderna vaccine. If anyone knows, I'm listening.

Respectfully,

Brian P.

[sihnfahl]

I don't know why that particular lot would have more problems than any other Moderna vaccine. If anyone knows, I'm listening.

Lot contamination, perhaps, or incomplete reaction, leaving behind some precursors that have bad results?

[NichG]

Well, let's have some good news and some bad new.

First, from Israel: Indications are that Pfizer prevents transmission , so that's definitely hopeful IF it proves out. One study does not a scientific consensus make.

On the bad news side Moderna lot 41L20A is being pulled due to an unusually large number of allergic reactions. I don't know why that particular lot would have more problems than any other Moderna vaccine. If anyone knows, I'm listening.

Respectfully,

Brian P.

We'll have good data on prevention of transmission in 2-3 weeks if the effective reproduction number in Israel drops precariously. Much bigger N than any kind of controlled study They're already at, what, 30% of the population with the first shot?

[Grey_Wolf_c]

On the bad news side Moderna lot 41L20A is being pulled due to an unusually large number of allergic reactions. I don't know why that particular lot would have more problems than any other Moderna vaccine. If anyone knows, I'm listening.

Given how localised the problem is, it seems likely it is either a bad lot, like sihnfahl suggests, or poor handling on the ground. Not necessarily another instance of deliberate spoilage like the [unprintable] pharmacist, but e.g. lack of training of the local technicians leading to contamination of the samples.

GW

[sihnfahl]

We'll have good data on prevention of transmission in 2-3 weeks if the effective reproduction number in Israel drops precariously. Much bigger N than any kind of controlled study They're already at, what, 30% of the population with the first shot?

Population 9 million, a little over 2 million with first, half million with second.

[Conradine]

The overwhelming majority of those died due Covid ( or rather with the Covid ) are people over 80 years, or suffering from multiple pre-existing pathologies, or recovering after major operations. The kind of people who easily die due a cold or the common flu.

There has been - very occasionally - younger and healtier victims indeed, but even a viral flue can occasionally kill an otherwise healthy person.

[NichG]

In the US last year, 190000 people of age 75+ died of Covid. 130000 people younger than 75 died of Covid. That may be a majority of older people but not an overwhelming one. There are far fewer people in that age group, so even if the IFR is much higher for them the absolute number of deaths isn't higher by the same amount. https://www.cdc.gov/nchs/nvss/vsrr/c...ekly/index.htm

The bigger issue is though not whether you personally will die, but whether you will be responsible for someone else's death. You might have a 0.01% chance of being killed by Covid, but if you don't take measures against doing so then you're likely to directly cause 2 to 3 cases on average (R0 ~ 2.5). With measures, it's about 1 case (Re ~ 1.1). So the decision to not take measures has about a 1.4% chance of you being personally responsible for a death you could have prevented if you do happen to get Covid, or about 1-2 years reduction of human life expectancy from people collectively making that choice.

If you think Covid is no big deal, would you be willing to be liable for the medical expenses from Covid of anyone you infect? How about their life insurance?

[warty goblin]

The overwhelming majority of those died due Covid ( or rather with the Covid ) are people over 80 years, or suffering from multiple pre-existing pathologies, or recovering after major operations. The kind of people who easily die due a cold or the common flu.

There has been - very occasionally - younger and healtier victims indeed, but even a viral flue can occasionally kill an otherwise healthy person.

Let's examine that claim.

The CDC estimates for flu burden of disease in the 2018 - 2019 season (the last season without covid messing up the numbers) resulted in 34,000 deaths. 2017 - 2018 was a bad year for the flu, and we hit about 61,000 deaths. That's pretty much the covid body count for November and December 2020, respectively. So yes, covid is most deadly to older people, particularly those with comorbidities, just like the flu. If covid did not exist, would some of the people it has killed have died of other things this year, including the flu? Of course. But most of covid's victims would have survived. And those that did not would not have needed to die alone in a covid ward, drugged into unconsciousness with a tube down their throat. Their families could have been there to say goodbye. They could have had a funeral.

And it's not like covid is only killing people days away from death. This paper estimates that each covid death costs, on average, about 13 years of life. This is less than accidents, but more than cancer and heart disease (usually the two biggest killers in the US). Since that's calculated based on age data without directly accounting for comorbidities, it is probably an overestimate. Even if it's a sixfold overestimate though, that's still more than two years per person. As of today the Washington Post is reporting a 7 day average death rate of 3,000/day. At 13 years per death, that means in the last week we lost nearly 400,000 years of human life. At the crazy lowball of two years, that's 42,000 years lost. 42,000 years of memories that never happened, grandparents who never got to see their grandchildren, grandchildren who won't have any memories of a grandparent. All that gone, in a week.

Your claim is factually incorrect. I find it morally horrendous as well.

[Conradine]

Covid isn't a big deal because it only kills old people is wrong - factually and morally utterly wrong

I never said that and I don't think that.

What I mean is that the death of very ill and / or very old people is an inevitable fact.
Over a certain timespan the death rate of human beings is 100%.

Also, it's not the first pandemic of recent history. Even the periodic appearance of pandemics is an inevitability and a constant.


About insurances I don't know, I'm not american.

I find it morally horrendous as well.

I said Covid kills mostly people at death's doorstep. This is an observation, not a moral statement. I didn't said it's a good or a bad thing or else.

So the decision to not take measures has about a 1.4% chance of you being personally responsible for a death you could have prevented if you do happen to get Covid, or about 1-2 years reduction of human life expectancy from people collectively making that choice

But the decision to impose measures caused a sharp rise in teenager and young adults suicides, at least in my country.

https://www.maurizioblondet.it/boom-...-del-covid-19/

[warty goblin]

I never said that and I don't think that.

What I mean is that the death of very ill and / or very old people is an inevitable fact.
Over a certain timespan the death rate of human beings is 100%.

Fair enough, you didn't say that.

You did however say it's not worse than the flu (factually incorrect), and that the overwhelming majority of people who die from it are old and suffering from multiple comorbidities (also factually incorrect). And yes, everybody's gonna die eventually. Most of us consider dying immediately to be a substantially different condition than dying a decade from now; which is why we try to treat conditions like heart disease and cancer and covid, all of which on average appear to cost a decade or more of life.

Now if your claim was thank heaven covid doesn't kill off 10 year olds with the propensity it does 90 year olds, I don't think anybody would disagree with that. But minimizing the severity of a disease currently scything through 3,000 people a day isn't exactly a great look.

[Conradine]

Most of us consider dying immediately to be a substantially different condition than dying a decade from now

In my country the average lifespan is 80.8 years. It would be good if it was 90 but it isn't. If I must do the math this means a loss of less than a year that, although tragic, is overshaded by the damage the quarantine is doing to economy.
Entrepreneurs are committing suicide in Italy. Countless business are failing. I fear for the future.

[NichG]

But the decision to impose measures caused a sharp rise in teenager and young adults suicides, at least in my country.

https://www.maurizioblondet.it/boom-...-del-covid-19/

Italy had ~35000 Covid deaths (with interventions). I can't find the 2020 numbers but the total number of suicides in 2017 were about 4000, and estimates I've been finding suggest ~100 Covid-related suicides in Italy in 2020 though I can't find official statistics.

So on the balance of lives, treating it casually is still going to be taking responsibility for some deaths even just in terms of people a person directly infects. If you're willing to say 'you know, my way of life probably does cause others to die or have shortened lives but there is some level of that which I'm okay with' that's a different discussion than 'Covid is no big deal'.

I'm not saying this to imply that there is only one choice here. But I'm strongly pushing the idea that, if you want to justify making one choice versus the other, not to try to talk down the cost of the choice you favor. If the numbers come out and say that the average cost incurred by society by someone eating at indoor dining establishments and going to bars throughout Covid comes to $15000, and you say 'fine, tax me on it, use the money to help people struggling with Covid, and let me get on with things' then so be it, its coherent. But I think its important to at least face that calculation first.

[Justanotherhero]

In my country the average lifespan is 80.8 years. It would be good if it was 90 but it isn't. If I must do the math this means a loss of less than a year that, although tragic, is overshaded by the damage the quarantine is doing to economy.
Entrepreneurs are committing suicide in Italy. Countless business are failing. I fear for the future.

With my limited understanding of italian culture:
I believe that Covid measures have different impacts on different countries. Traveling though northern europe I would say that imposing social distancing is barely noticeable among strangers because northern europeans in general do not get that close to each other. I believe Italy and other parts of southern europe are suffering more because the measures don't just affect transportation. Covid measures impact culture severely.
And I believe it is ok to say that this has to be considered.

So on the balance of lives, treating it casually is still going to be taking responsibility for some deaths even just in terms of people a person directly infects. If you're willing to say 'you know, my way of life probably does cause others to die or have shortened lives but there is some level of that which I'm okay with' that's a different discussion than 'Covid is no big deal'.

I'm not saying this to imply that there is only one choice here. But I'm strongly pushing the idea that, if you want to justify making one choice versus the other, not to try to talk down the cost of the choice you favor. If the numbers come out and say that the average cost incurred by society by someone eating at indoor dining establishments and going to bars throughout Covid comes to $15000, and you say 'fine, tax me on it, use the money to help people struggling with Covid, and let me get on with things' then so be it, its coherent. But I think its important to at least face that calculation first.

Again I have not lived long enough in italy to say this with absolute certainty but I did spend some time in the States:

In that I must disagree italy has like many european countries a National Health Service so if a person is infected the costs of treating them are carried by all. So no italian is taking responsibility for another italians death because they already decided to pay to attempt to keep each other alive. The decision to be taxed on it has already been made in favor of paying those taxes.

I am not an economics mayor but I fear Covid will once again fortify a certain distance between economies like the United States that can print money because they are the current world reserve currency and other economies that simply do not have as many options when it comes to economic recovery. As I understand it the european central bank is intervening financially but I don't think it compares to the measures the american president announced.

Edit:
The european central bank announced 1,85 billion Euro in funding.
Source: https://www.ecb.europa.eu/home/searc....de.html#item1

In comparison President Biden announced: 1,9 trillion US Dollars.
Source: https://www.forbes.com/sites/jackkel...recovery-plan/

The italian government approved about 60 billion dollars.
Source:
https://www.reuters.com/article/us-h...-idUSKBN22P2YE

One billion is a thousand millions.

One trillion is a thousand billions, or equivalently a million millions.

Yeah I am pretty sure there is going to be another ECB package.

[Forum Explorer]

In my country the average lifespan is 80.8 years. It would be good if it was 90 but it isn't. If I must do the math this means a loss of less than a year that, although tragic, is overshaded by the damage the quarantine is doing to economy.
Entrepreneurs are committing suicide in Italy. Countless business are failing. I fear for the future.

On the contrary, I read an article some time ago saying that not locking down is doing far more damage to the economy than quarantining is.

To be more specific, it's pointing out that places that did a hard lockdown (like Australia and New Zealand) no longer have to do any sort of lockdown at all. Movie Theaters are open, you can go to a restaurant, museum, concert, whatever. And that's before you look at the bonuses of people not having to take weeks off of work in order when they get sick, and of course the medical cost of treating thousands of people for COVID. Their economy is operating, and in good condition. Sure the tourism industry took a massive hit, but that was pretty much unavoidable.

While places like Canada, which did do lockdowns, but not nearly to the same degree, now has to go back into lockdown in order to get the virus back under control. Same with the UK. If these countries had bit the bullet, kept the rules strict, and the lockdown on until the cases were basically eliminated entirely, we'd have not only saved hundreds of lives, but reduced our time in quarantine by something along the line of 6 to 8 weeks.

[NichG]

Again I have not lived long enough in italy to say this with absolute certainty but I did spend some time in the States:

In that I must disagree italy has like many european countries a National Health Service so if a person is infected the costs of treating them are carried by all. So no italian is taking responsibility for another italians death because they already decided to pay to attempt to keep each other alive. The decision to be taxed on it has already been made in favor of paying those taxes.

It probably doesn't cover 100% of the responsibility for the consequences of one's own actions unless those actions are 100% in alignment with those of every other member of the society. If say 90% are acting carefully and 10% act in a way that puts others at risk, the 10% only pay 10% of the cost of their decision and not 100%. Also, if someone dies, then the cost of that death (rather than the attempt to keep them alive) is borne primarily by that person and their friends and family. The $15k guess I made wasn't based just on the medical care, but also the idea in things like health and safety regulations of putting a particular finite value on how much a company or organization must spend to prevent a preventable death - generally the number that gets quoted there is about $10 million. So if say 10% of people have Covid and you have a 1% increased chance of killing someone because you act one way rather than another if you happen to have Covid, then $10 million becomes $10000.

[Grey_Wolf_c]

The overwhelming majority of those died due Covid ( or rather with the Covid ) are people over 80 years, or suffering from multiple pre-existing pathologies, or recovering after major operations. The kind of people who easily die due a cold or the common flu.

There has been - very occasionally - younger and healtier victims indeed, but even a viral flue can occasionally kill an otherwise healthy person.

So what? It's not a big deal because it only kills old people? That's despicable.

It is also neither "an overwhelming" majority nor, given excess mortality, is the common flu anywhere near the death toll of Covid. Your assertions in this respect continue to be provably false.

GW

[akma]

We'll have good data on prevention of transmission in 2-3 weeks if the effective reproduction number in Israel drops precariously. Much bigger N than any kind of controlled study They're already at, what, 30% of the population with the first shot?

According to the official Israeli ministery of health telegram channel, in 8:22 AM today (~7.5 hours ago), 2,364,828 got the first vaccine, 691,876 got the second one. According to the Israeli central bureau of statistics, there are 9.279 million Israelies, so a bit more then a quarter of the people.
Apparently my country is the fastest to vaccinate in the world, odd.
I know that after the "vaccination hours" are over, the nurses still vaccinate some people with leftover vaccines or something, I don't remember what I heard exactly but I know someone that got a vaccine that way.

[sihnfahl]

Apparently my country is the fastest to vaccinate in the world, odd.

Not really. If there's something I've learned to respect about Israel is its ability to mobilize in a crisis.

And a general sense of 'We're all in this together'.

That, and I get the feeling they had a distribution plan ready to go before there was even something to distribute in the first place.

[Conradine]

So what? It's not a big deal because it only kills old people? That's despicable.

I didn't said that and I don't think that.
I mean that old and ill people routinely die for a variety of reasons, so they should be considered dead with the Covid ( among other factors ) rather than due Covid.

It is also neither "an overwhelming" majority nor, given excess mortality, is the common flu anywhere near the death toll of Covid. Your assertions in this respect continue to be provably false.

If we consider death toll of Covid people who would probably have died for other reasons in short time, it's obvious that the statistic result distorted / misrepresented.

A silly example which I hope will explain : all those who died on Earth this year breathed oxygen, that means oxygen kills 100% of people?

[Grey_Wolf_c]

I get the feeling they had a distribution plan ready to go before there was even something to distribute in the first place.

It takes three separate characteristics to deploy a vaccine in mass: money, societal infrastructure and will. Plenty of poor countries lack the first - they just don't have the cash to attempt this at country-scale. Plenty of countries lack the second: either they lack the physical infrastructure (although that overlaps with the first group) or, more likely, their government or their people are too fragmented - excessive decentralization, country too big, etc. To a degree, the UE is suffering from this - instead of unified response, each member country is doing its own thing and thus the result is patchy. Finally, the country needs to want to do this - the US being the most prominent counterexample, with significant percentage of the population outright refusing to take the vaccine (40%, I read recently? Take with a large pinch of salt, it was just one survey). When you put all things together, Israel seems to be the only country rich enough, unified enough and not filled with denialists.

(Other countries - such as New Zealand - probably would have been similarly well disposed, but their isolation made their shutdowns effective enough they didn't need to. Israel never stood the chance there, since it is not an Island off the side of the map, when it is included at all. Israel is too much in the way of everywhere else, and too big a player in international relationships, to completely shutdown)

I didn't said that and I don't think that.
I mean that old and ill people routinely die for a variety of reasons, so they should be considered dead with the Covid ( among other factors ) rather than due Covid.

If we consider death toll of Covid people who would probably have died for other reasons in short time, it's obvious that the statistic result distorted / misrepresented.

Excess Death Statistics shows this for the provable falsehood that it is. Far more people have died over the last year that statistically expected. Many would still have been alive had it not been for contracting covid. Therefore, covid is responsible for their deaths.

Grey Wolf

[sihnfahl]

with significant percentage of the population outright refusing to take the vaccine (40%, I read recently? Take with a large pinch of salt, it was just one survey).

It depends on the survey and where.

Forbes quoted Kaiser Foundation as almost 27% against back in December.

USA Today / Suffolk University has it at 18% outright refusal; poll released 3 days ago.

Gallup released one a week ago; while they didn't break it down into yes / not right now / heck no, so it's just a generic yes to a vaccine right now or no ... they had 35% against.

[Conradine]

Statistic is not an exact science and IMO it's easily mispresented if a conflict of interest arise.

Many would still have been alive had it not been for contracting covid. Therefore, covid is responsible for their deaths.

To say that would require exact knowledge of the future and perfect knowledge of causality relations. But I'll not call it "falsehood" because I accept that people may have divergent opinions without being liars or morally despicable. Agree to disagree.