[Archived] Bogleheads community discussion - Coronavirus

US Local Chapters, Wiki, and general Bogleheads community discussion, news, events, and announcements.
Locked
User avatar
Sandtrap
Posts: 10552
Joined: Sat Nov 26, 2016 6:32 pm
Location: Hawaii No Ka Oi , N. Arizona

Re: Bogleheads community discussion - Coronavirus explained by an immunologist at Johns Hopkins

Post by Sandtrap » Wed Mar 25, 2020 5:58 pm

UPDATE: Snopes has a fact check and the quote below regarding the Virus is inaccurate.


For convenience, here's an excerpt:
Feeling confused as to why Coronavirus is a bigger deal than Seasonal flu? Here it is in a nutshell. I hope this helps. Feel free to share this to others who don’t understand...
It has to do with RNA sequencing.... I.e. genetics.
Seasonal flu is an “all human virus”. The DNA/RNA chains that make up the virus are recognized by the human immune system. This means that your body has some immunity to it before it comes around each year... you get immunity two ways...through exposure to a virus, or by getting a flu shot.
Novel viruses, come from animals.... the WHO tracks novel viruses in animals, (sometimes for years watching for mutations). Usually these viruses only transfer from animal to animal (pigs in the case of H1N1) (birds in the case of the Spanish flu). But once, one of these animal viruses mutates, and starts to transfer from animals to humans... then it’s a problem, Why? Because we have no natural or acquired immunity.. the RNA sequencing of the genes inside the virus isn’t human, and the human immune system doesn’t recognize it so, we can’t fight it off.
Now.... sometimes, the mutation only allows transfer from animal to human, for years it’s only transmission is from an infected animal to a human before it finally mutates so that it can now transfer human to human... once that happens..we have a new contagion phase. And depending on the fashion of this new mutation, thats what decides how contagious, or how deadly it’s gonna be..
H1N1 was deadly....but it did not mutate in a way that was as deadly as the Spanish flu. It’s RNA was slower to mutate and it attacked its host differently, too.
Fast forward.
Now, here comes this Coronavirus... it existed in animals only, for nobody knows how long...but one day, at an animal market, in Wuhan China, in December 2019, it mutated and made the jump from animal to people. At first, only animals could give it to a person... But here is the scary part.... in just TWO WEEKS it mutated again and gained the ability to jump from human to human. Scientists call this quick ability, “slippery”
This Coronavirus, not being in any form a “human” virus (whereas we would all have some natural or acquired immunity). Took off like a rocket. And this was because, Humans have no known immunity...doctors have no known medicines for it.
And it just so happens that this particular mutated animal virus, changed itself in such a way the way that it causes great damage to human lungs..
That’s why Coronavirus is different from seasonal flu, or H1N1 or any other type of influenza.... this one is slippery. And it’s a lung eater...And, it’s already mutated AGAIN, so that we now have two strains to deal with, strain s, and strain L....which makes it twice as hard to develop a vaccine.
We really have no tools in our shed, with this. History has shown that fast and immediate closings of public places has helped in the past pandemics. Philadelphia and Baltimore were reluctant to close events in 1918 and they were the hardest hit in the US during the Spanish Flu.
Factoid: Henry VIII stayed in his room and allowed no one near him, till the Black Plague passed...(honestly...I understand him so much better now). Just like us, he had no tools in his shed, except social isolation...
And let me end by saying....right now it’s hitting older folks harder... but this genome is so slippery...if it mutates again (and it will). Who is to say, what it will do next."
"Snopes" flagged the above quote as inaccurate.
Last edited by Sandtrap on Wed Mar 25, 2020 7:48 pm, edited 4 times in total.
Wiki Bogleheads Wiki: Everything You Need to Know

rkhusky
Posts: 9220
Joined: Thu Aug 18, 2011 8:09 pm

Re: Bogleheads community discussion - Coronavirus

Post by rkhusky » Wed Mar 25, 2020 6:00 pm

Fitting exponential curves to the US data from the site below, the doubling period for testing is about 2.3 days, but it appears that testing has dropping some in the last 3 or 4 days.
The doubling period for confirmed infections is also about 2.3 days and also appears to have dropped in the last couple of days.
The doubling period for hospitalizations is about 2.4 days and the doubling period for deaths is about 2.6 days.
About 15% of tests have come back positive.

https://docs.google.com/spreadsheets/u/ ... j5/pubhtml#
Last edited by rkhusky on Wed Mar 25, 2020 6:03 pm, edited 1 time in total.

JBTX
Posts: 6152
Joined: Wed Jul 26, 2017 12:46 pm

Re: Bogleheads community discussion - Coronavirus

Post by JBTX » Wed Mar 25, 2020 6:02 pm

folkher0 wrote:
Tue Mar 24, 2020 8:42 pm
So...

I’ve read several posts in this thread with the them of “this is no big deal” or that we are overreacting.

I’m a doctor in New York. I work at a large tertiary care hospital. In the last 4 days the COVID census is up to about 20% of our beds. 2/3 these are ICU patients. Staff are being pulled from totally unrelated specialties to care for these patients. All other clinical programs are mothballed. Unless you are dying, you probably cannot get care from a specialist. Non Intensivists are taking crash courses on ventilator management. If you come down with this virus you may very well be cared for by a gynecologist.

This is unprecedented. We have never seen anything remotely like this. We have been at this for about a week and we are at capacity. Despite what you may read, young people get very ill too. They may not be dying at the same rate as older folk, but a week on the ventilator will scar you for life and take 6 months to recover from.

This is just the beginning. We anticipate this to worsen over the next 2-4 weeks. Doctors and nurses are getting sick.

Every doctor I know with half a brain is scared out of their whits.

Listen to me.
This is not the flu.

Please stay home no matter what the president says.
Thanks for your valuable perspective.

KyleAAA
Posts: 8264
Joined: Wed Jul 01, 2009 5:35 pm
Contact:

Re: Bogleheads community discussion - Coronavirus explained by an immunologist at Johns Hopkins

Post by KyleAAA » Wed Mar 25, 2020 6:09 pm

Sandtrap wrote:
Wed Mar 25, 2020 5:58 pm
Here's a recent missive from an immunologist at Johns Hopkins that explains a little about the Corona-Virus. I found it helpful as it explains it a bit more simply and gives the implications of its nature.

Link to an article and within it links to follow ups:
https://www.newsweek.com/coronavirus-di ... ay-1492912
Johns Hopkins Medical Center Corona FAQ
https://www.hopkinsmedicine.org/health/ ... -questions

For convenience, here's an excerpt:
Feeling confused as to why Coronavirus is a bigger deal than Seasonal flu? Here it is in a nutshell. I hope this helps. Feel free to share this to others who don’t understand...
It has to do with RNA sequencing.... I.e. genetics.
Seasonal flu is an “all human virus”. The DNA/RNA chains that make up the virus are recognized by the human immune system. This means that your body has some immunity to it before it comes around each year... you get immunity two ways...through exposure to a virus, or by getting a flu shot.
Novel viruses, come from animals.... the WHO tracks novel viruses in animals, (sometimes for years watching for mutations). Usually these viruses only transfer from animal to animal (pigs in the case of H1N1) (birds in the case of the Spanish flu). But once, one of these animal viruses mutates, and starts to transfer from animals to humans... then it’s a problem, Why? Because we have no natural or acquired immunity.. the RNA sequencing of the genes inside the virus isn’t human, and the human immune system doesn’t recognize it so, we can’t fight it off.
Now.... sometimes, the mutation only allows transfer from animal to human, for years it’s only transmission is from an infected animal to a human before it finally mutates so that it can now transfer human to human... once that happens..we have a new contagion phase. And depending on the fashion of this new mutation, thats what decides how contagious, or how deadly it’s gonna be..
H1N1 was deadly....but it did not mutate in a way that was as deadly as the Spanish flu. It’s RNA was slower to mutate and it attacked its host differently, too.
Fast forward.
Now, here comes this Coronavirus... it existed in animals only, for nobody knows how long...but one day, at an animal market, in Wuhan China, in December 2019, it mutated and made the jump from animal to people. At first, only animals could give it to a person... But here is the scary part.... in just TWO WEEKS it mutated again and gained the ability to jump from human to human. Scientists call this quick ability, “slippery”
This Coronavirus, not being in any form a “human” virus (whereas we would all have some natural or acquired immunity). Took off like a rocket. And this was because, Humans have no known immunity...doctors have no known medicines for it.
And it just so happens that this particular mutated animal virus, changed itself in such a way the way that it causes great damage to human lungs..
That’s why Coronavirus is different from seasonal flu, or H1N1 or any other type of influenza.... this one is slippery. And it’s a lung eater...And, it’s already mutated AGAIN, so that we now have two strains to deal with, strain s, and strain L....which makes it twice as hard to develop a vaccine.
We really have no tools in our shed, with this. History has shown that fast and immediate closings of public places has helped in the past pandemics. Philadelphia and Baltimore were reluctant to close events in 1918 and they were the hardest hit in the US during the Spanish Flu.
Factoid: Henry VIII stayed in his room and allowed no one near him, till the Black Plague passed...(honestly...I understand him so much better now). Just like us, he had no tools in his shed, except social isolation...
And let me end by saying....right now it’s hitting older folks harder... but this genome is so slippery...if it mutates again (and it will). Who is to say, what it will do next."
Be smart folks... acting like you’re unafraid is so not sexy right now. Gosh, I've seen this amongst seniors as well. Why? (de Nile?)
Stay home folks... and share this useful info with others.
It would appear as though that quotation is inaccurate according to Snopes
https://www.snopes.com/news/2020/03/23/ ... sonal-flu/

KlangFool
Posts: 16078
Joined: Sat Oct 11, 2008 12:35 pm

Re: Bogleheads community discussion - Coronavirus

Post by KlangFool » Wed Mar 25, 2020 6:27 pm

folkher0 wrote:
Wed Mar 25, 2020 5:31 pm
KlangFool wrote:
Wed Mar 25, 2020 1:56 pm
framus wrote:
Wed Mar 25, 2020 1:49 pm


A significant help in opening up the shutdown would be a test that would enable determination that a person had developed immunity to the pathogen. This would enable these folks to re-engage in commerce and not be contamination vectors. Mario Cuomo has articulated how such an approach could be established.
frames,

In another word, more and better testing. In contrast to the "no testing and assume everyone will be infected" approach. Aka, just send everyone back to work and hope for the best.

KlangFool
Klangfool,

I want to thank you for many of your posts. You are one of the reasons we rent our house and haven’t bought. The economic scenario we are entering is echoed in many of your posts.

In regards to testing: it’s just not good enough yet. It’s been reported that the negative predictive value of the tests we use (PCR of nasal swabs) has a negative predictive value of about 60%. That means a patient WHO HAS THE DISEASE will test negative about 40% of the time.

it’s just just good enough, fast enough or widely enough available to reliably rule out COVID at the population level.

When you remind yourself that 14 days ago we had no test at all in the US, it’s remarkable how far we’ve come.

When you remind yourself that WHO already had a test available and South Korea was able to screen tens of thousands of people before the first test was done in the US, you begin to understand how far behind the curve we are.
folkher0,

And, other countries solved the problem by testing multiple times over multiple periods. And, they speeded up the testing time and they do local testing. This is the common practice in any field when you have an unreliable test. It is not rocket science.

KlangFool

palanzo
Posts: 631
Joined: Thu Oct 10, 2019 4:28 pm

Re: Bogleheads community discussion - Coronavirus

Post by palanzo » Wed Mar 25, 2020 6:28 pm

folkher0 wrote:
Tue Mar 24, 2020 8:42 pm
So...

I’ve read several posts in this thread with the them of “this is no big deal” or that we are overreacting.

I’m a doctor in New York. I work at a large tertiary care hospital. In the last 4 days the COVID census is up to about 20% of our beds. 2/3 these are ICU patients. Staff are being pulled from totally unrelated specialties to care for these patients. All other clinical programs are mothballed. Unless you are dying, you probably cannot get care from a specialist. Non Intensivists are taking crash courses on ventilator management. If you come down with this virus you may very well be cared for by a gynecologist.

This is unprecedented. We have never seen anything remotely like this. We have been at this for about a week and we are at capacity. Despite what you may read, young people get very ill too. They may not be dying at the same rate as older folk, but a week on the ventilator will scar you for life and take 6 months to recover from.

This is just the beginning. We anticipate this to worsen over the next 2-4 weeks. Doctors and nurses are getting sick.

Every doctor I know with half a brain is scared out of their whits.

Listen to me.
This is not the flu.

Please stay home no matter what the president says.
Hopefully they are only scared out of their wits.

folkher0
Posts: 332
Joined: Fri Dec 09, 2016 2:48 pm

Re: Bogleheads community discussion - Coronavirus

Post by folkher0 » Wed Mar 25, 2020 6:42 pm

KlangFool wrote:
Wed Mar 25, 2020 6:27 pm
folkher0 wrote:
Wed Mar 25, 2020 5:31 pm
KlangFool wrote:
Wed Mar 25, 2020 1:56 pm
framus wrote:
Wed Mar 25, 2020 1:49 pm


A significant help in opening up the shutdown would be a test that would enable determination that a person had developed immunity to the pathogen. This would enable these folks to re-engage in commerce and not be contamination vectors. Mario Cuomo has articulated how such an approach could be established.
frames,

In another word, more and better testing. In contrast to the "no testing and assume everyone will be infected" approach. Aka, just send everyone back to work and hope for the best.

KlangFool
Klangfool,

I want to thank you for many of your posts. You are one of the reasons we rent our house and haven’t bought. The economic scenario we are entering is echoed in many of your posts.

In regards to testing: it’s just not good enough yet. It’s been reported that the negative predictive value of the tests we use (PCR of nasal swabs) has a negative predictive value of about 60%. That means a patient WHO HAS THE DISEASE will test negative about 40% of the time.

it’s just just good enough, fast enough or widely enough available to reliably rule out COVID at the population level.

When you remind yourself that 14 days ago we had no test at all in the US, it’s remarkable how far we’ve come.

When you remind yourself that WHO already had a test available and South Korea was able to screen tens of thousands of people before the first test was done in the US, you begin to understand how far behind the curve we are.
folkher0,

And, other countries solved the problem by testing multiple times over multiple periods. And, they speeded up the testing time and they do local testing. This is the common practice in any field when you have an unreliable test. It is not rocket science.

KlangFool
I agree. Do you think we will start testing fast enough and broadly enough in the US? With what federal guidance.

New York has tested far more broadly than any other state. Iit has not yet changed the course of disease here.

SteadyOne
Posts: 171
Joined: Fri Mar 22, 2019 5:26 pm

Re: Bogleheads community discussion - Coronavirus

Post by SteadyOne » Wed Mar 25, 2020 6:44 pm

palanzo wrote:
Wed Mar 25, 2020 6:28 pm
folkher0 wrote:
Tue Mar 24, 2020 8:42 pm
So...

I’ve read several posts in this thread with the them of “this is no big deal” or that we are overreacting.

I’m a doctor in New York. I work at a large tertiary care hospital. In the last 4 days the COVID census is up to about 20% of our beds. 2/3 these are ICU patients. Staff are being pulled from totally unrelated specialties to care for these patients. All other clinical programs are mothballed. Unless you are dying, you probably cannot get care from a specialist. Non Intensivists are taking crash courses on ventilator management. If you come down with this virus you may very well be cared for by a gynecologist.

This is unprecedented. We have never seen anything remotely like this. We have been at this for about a week and we are at capacity. Despite what you may read, young people get very ill too. They may not be dying at the same rate as older folk, but a week on the ventilator will scar you for life and take 6 months to recover from.

This is just the beginning. We anticipate this to worsen over the next 2-4 weeks. Doctors and nurses are getting sick.

Every doctor I know with half a brain is scared out of their whits.

Listen to me.
This is not the flu.

Please stay home no matter what the president says.
Hopefully they are only scared out of their wits.
Kinsa temperature maps show that social distancing started to work in the US. They collect data from about 1 million thermometers across the country. “We are seeing increasing evidence that social distancing policies enacted at the state level are causing decreases in viral transmission“

https://www.kinsahealth.co/social-dista ... f-illness/
“Every de­duc­tion is al­lowed as a mat­ter of leg­isla­tive grace.” US Federal Court

JBTX
Posts: 6152
Joined: Wed Jul 26, 2017 12:46 pm

Re: Bogleheads community discussion - Coronavirus

Post by JBTX » Wed Mar 25, 2020 6:55 pm

It was argued here that based on Germany the real death rate was "only" 0.4% based on more widespread and extensive testing. But consider seasonal flu is about 0.1%. So that is 4 times as high.

It has been estimated that half or more would likely get it if we did nothing about it. There are quite a few anecdotes of high rates of infection in close quarters. 0.4% on 200 million is 800,000 deaths. On 100 million is 400,000 deaths. And those are on top of all the usual causes like flu. This is a key point. They aren't instead of the flu. They are on top of it. And the number who get very sick and hospitalized is far higher. Add all those millions of critical cases on top of a medical system that doesn't have a lot of headroom. This is how you get to what folkhero is describing.

Hopefully they won't be nearly that high, but probably because as feckless as our efforts have been they are better than nothing. And maybe if we are lucky the warm weather will at least slow the infection rate down, but then that leaves next fall and winter.

User avatar
Sandtrap
Posts: 10552
Joined: Sat Nov 26, 2016 6:32 pm
Location: Hawaii No Ka Oi , N. Arizona

Re: Bogleheads community discussion - Coronavirus explained by an immunologist at Johns Hopkins

Post by Sandtrap » Wed Mar 25, 2020 6:59 pm

KyleAAA wrote:
Wed Mar 25, 2020 6:09 pm
Sandtrap wrote:
Wed Mar 25, 2020 5:58 pm
Here's a recent missive from an immunologist at Johns Hopkins that explains a little about the Corona-Virus. I found it helpful as it explains it a bit more simply and gives the implications of its nature.

Link to an article and within it links to follow ups:
https://www.newsweek.com/coronavirus-di ... ay-1492912
Johns Hopkins Medical Center Corona FAQ
https://www.hopkinsmedicine.org/health/ ... -questions

For convenience, here's an excerpt:
Feeling confused as to why Coronavirus is a bigger deal than Seasonal flu? Here it is in a nutshell. I hope this helps. Feel free to share this to others who don’t understand...
It has to do with RNA sequencing.... I.e. genetics.
Seasonal flu is an “all human virus”. The DNA/RNA chains that make up the virus are recognized by the human immune system. This means that your body has some immunity to it before it comes around each year... you get immunity two ways...through exposure to a virus, or by getting a flu shot.
Novel viruses, come from animals.... the WHO tracks novel viruses in animals, (sometimes for years watching for mutations). Usually these viruses only transfer from animal to animal (pigs in the case of H1N1) (birds in the case of the Spanish flu). But once, one of these animal viruses mutates, and starts to transfer from animals to humans... then it’s a problem, Why? Because we have no natural or acquired immunity.. the RNA sequencing of the genes inside the virus isn’t human, and the human immune system doesn’t recognize it so, we can’t fight it off.
Now.... sometimes, the mutation only allows transfer from animal to human, for years it’s only transmission is from an infected animal to a human before it finally mutates so that it can now transfer human to human... once that happens..we have a new contagion phase. And depending on the fashion of this new mutation, thats what decides how contagious, or how deadly it’s gonna be..
H1N1 was deadly....but it did not mutate in a way that was as deadly as the Spanish flu. It’s RNA was slower to mutate and it attacked its host differently, too.
Fast forward.
Now, here comes this Coronavirus... it existed in animals only, for nobody knows how long...but one day, at an animal market, in Wuhan China, in December 2019, it mutated and made the jump from animal to people. At first, only animals could give it to a person... But here is the scary part.... in just TWO WEEKS it mutated again and gained the ability to jump from human to human. Scientists call this quick ability, “slippery”
This Coronavirus, not being in any form a “human” virus (whereas we would all have some natural or acquired immunity). Took off like a rocket. And this was because, Humans have no known immunity...doctors have no known medicines for it.
And it just so happens that this particular mutated animal virus, changed itself in such a way the way that it causes great damage to human lungs..
That’s why Coronavirus is different from seasonal flu, or H1N1 or any other type of influenza.... this one is slippery. And it’s a lung eater...And, it’s already mutated AGAIN, so that we now have two strains to deal with, strain s, and strain L....which makes it twice as hard to develop a vaccine.
We really have no tools in our shed, with this. History has shown that fast and immediate closings of public places has helped in the past pandemics. Philadelphia and Baltimore were reluctant to close events in 1918 and they were the hardest hit in the US during the Spanish Flu.
Factoid: Henry VIII stayed in his room and allowed no one near him, till the Black Plague passed...(honestly...I understand him so much better now). Just like us, he had no tools in his shed, except social isolation...
And let me end by saying....right now it’s hitting older folks harder... but this genome is so slippery...if it mutates again (and it will). Who is to say, what it will do next."
Be smart folks... acting like you’re unafraid is so not sexy right now. Gosh, I've seen this amongst seniors as well. Why? (de Nile?)
Stay home folks... and share this useful info with others.
It would appear as though that quotation is inaccurate according to Snopes
https://www.snopes.com/news/2020/03/23/ ... sonal-flu/
Wow~
Good catch!
I'm going to correct the post and pass on to others as well!
thanks!
j :happy
Wiki Bogleheads Wiki: Everything You Need to Know

folkher0
Posts: 332
Joined: Fri Dec 09, 2016 2:48 pm

Re: Bogleheads community discussion - Coronavirus

Post by folkher0 » Wed Mar 25, 2020 7:03 pm

palanzo wrote:
Wed Mar 25, 2020 6:28 pm
folkher0 wrote:
Tue Mar 24, 2020 8:42 pm
So...

I’ve read several posts in this thread with the them of “this is no big deal” or that we are overreacting.

I’m a doctor in New York. I work at a large tertiary care hospital. In the last 4 days the COVID census is up to about 20% of our beds. 2/3 these are ICU patients. Staff are being pulled from totally unrelated specialties to care for these patients. All other clinical programs are mothballed. Unless you are dying, you probably cannot get care from a specialist. Non Intensivists are taking crash courses on ventilator management. If you come down with this virus you may very well be cared for by a gynecologist.

This is unprecedented. We have never seen anything remotely like this. We have been at this for about a week and we are at capacity. Despite what you may read, young people get very ill too. They may not be dying at the same rate as older folk, but a week on the ventilator will scar you for life and take 6 months to recover from.

This is just the beginning. We anticipate this to worsen over the next 2-4 weeks. Doctors and nurses are getting sick.

Every doctor I know with half a brain is scared out of their whits.

Listen to me.
This is not the flu.

Please stay home no matter what the president says.
Hopefully they are only scared out of their wits.

Apparently I am too frightened to spellcheck. ;)

folkher0
Posts: 332
Joined: Fri Dec 09, 2016 2:48 pm

Re: Bogleheads community discussion - Coronavirus

Post by folkher0 » Wed Mar 25, 2020 7:08 pm

JBTX wrote:
Wed Mar 25, 2020 6:55 pm
It was argued here that based on Germany the real death rate was "only" 0.4% based on more widespread and extensive testing. But consider seasonal flu is about 0.1%. So that is 4 times as high.

It has been estimated that half or more would likely get it if we did nothing about it. There are quite a few anecdotes of high rates of infection in close quarters. 0.4% on 200 million is 800,000 deaths. On 100 million is 400,000 deaths. And those are on top of all the usual causes like flu. This is a key point. They aren't instead of the flu. They are on top of it. And the number who get very sick and hospitalized is far higher. Add all those millions of critical cases on top of a medical system that doesn't have a lot of headroom. This is how you get to what folkhero is describing.

Hopefully they won't be nearly that high, but probably because as feckless as our efforts have been they are better than nothing. And maybe if we are lucky the warm weather will at least slow the infection rate down, but then that leaves next fall and winter.
It’s not just the death rate. Deaths from the flu are relatively normally distributed around a peak date. The health care capacity can account for and accommodate flu admissions. It’s like a river that will predictably ebb and flow in a season.

There is no natural immunity to this virus. It spreads so fast that all the cases are coming at the same time. There is simply no capacity in our systems to accommodate. It’s like an avalanche or an earthquake. All of a sudden. All at once.

KlangFool
Posts: 16078
Joined: Sat Oct 11, 2008 12:35 pm

Re: Bogleheads community discussion - Coronavirus

Post by KlangFool » Wed Mar 25, 2020 7:18 pm

folkher0 wrote:
Wed Mar 25, 2020 6:42 pm
KlangFool wrote:
Wed Mar 25, 2020 6:27 pm
folkher0 wrote:
Wed Mar 25, 2020 5:31 pm
KlangFool wrote:
Wed Mar 25, 2020 1:56 pm
framus wrote:
Wed Mar 25, 2020 1:49 pm


A significant help in opening up the shutdown would be a test that would enable determination that a person had developed immunity to the pathogen. This would enable these folks to re-engage in commerce and not be contamination vectors. Mario Cuomo has articulated how such an approach could be established.
frames,

In another word, more and better testing. In contrast to the "no testing and assume everyone will be infected" approach. Aka, just send everyone back to work and hope for the best.

KlangFool
Klangfool,

I want to thank you for many of your posts. You are one of the reasons we rent our house and haven’t bought. The economic scenario we are entering is echoed in many of your posts.

In regards to testing: it’s just not good enough yet. It’s been reported that the negative predictive value of the tests we use (PCR of nasal swabs) has a negative predictive value of about 60%. That means a patient WHO HAS THE DISEASE will test negative about 40% of the time.

it’s just just good enough, fast enough or widely enough available to reliably rule out COVID at the population level.

When you remind yourself that 14 days ago we had no test at all in the US, it’s remarkable how far we’ve come.

When you remind yourself that WHO already had a test available and South Korea was able to screen tens of thousands of people before the first test was done in the US, you begin to understand how far behind the curve we are.
folkher0,

And, other countries solved the problem by testing multiple times over multiple periods. And, they speeded up the testing time and they do local testing. This is the common practice in any field when you have an unreliable test. It is not rocket science.

KlangFool
I agree. Do you think we will start testing fast enough and broadly enough in the US? With what federal guidance.

New York has tested far more broadly than any other state. Iit has not yet changed the course of disease here.
folkher0,

Westchester's new case count had dropped. But, this is still too early to tell.

https://www.youtube.com/watch?v=4CJQaFmiqYM
<<NY Gov. Cuomo Gives Update On Coronavirus Pandemic | NBC News (Live Stream Recording)>>

Start at 26:00

<< I agree. Do you think we will start testing fast enough and broadly enough in the US? With what federal guidance.>>

New York had done more tests than anyone else. If it is proven to be working, it would change other's minds.

KlangFool

SteadyOne
Posts: 171
Joined: Fri Mar 22, 2019 5:26 pm

Re: Bogleheads community discussion - Coronavirus

Post by SteadyOne » Wed Mar 25, 2020 7:20 pm

JBTX wrote:
Wed Mar 25, 2020 6:55 pm
It was argued here that based on Germany the real death rate was "only" 0.4% based on more widespread and extensive testing. But consider seasonal flu is about 0.1%. So that is 4 times as high.

It has been estimated that half or more would likely get it if we did nothing about it. There are quite a few anecdotes of high rates of infection in close quarters. 0.4% on 200 million is 800,000 deaths. On 100 million is 400,000 deaths. And those are on top of all the usual causes like flu. This is a key point. They aren't instead of the flu. They are on top of it. And the number who get very sick and hospitalized is far higher. Add all those millions of critical cases on top of a medical system that doesn't have a lot of headroom. This is how you get to what folkhero is describing.

Hopefully they won't be nearly that high, but probably because as feckless as our efforts have been they are better than nothing. And maybe if we are lucky the warm weather will at least slow the infection rate down, but then that leaves next fall and winter.
Flu numbers will be lower this year because of social distancing
“Every de­duc­tion is al­lowed as a mat­ter of leg­isla­tive grace.” US Federal Court

Cash is King
Posts: 200
Joined: Sun Dec 10, 2017 9:04 am

Re: Bogleheads community discussion - Coronavirus explained by an immunologist at Johns Hopkins

Post by Cash is King » Wed Mar 25, 2020 7:36 pm

Sandtrap wrote:
Wed Mar 25, 2020 6:59 pm
KyleAAA wrote:
Wed Mar 25, 2020 6:09 pm
Sandtrap wrote:
Wed Mar 25, 2020 5:58 pm
Here's a recent missive from an immunologist at Johns Hopkins that explains a little about the Corona-Virus. I found it helpful as it explains it a bit more simply and gives the implications of its nature.

Link to an article and within it links to follow ups:
https://www.newsweek.com/coronavirus-di ... ay-1492912
Johns Hopkins Medical Center Corona FAQ
https://www.hopkinsmedicine.org/health/ ... -questions

For convenience, here's an excerpt:
Feeling confused as to why Coronavirus is a bigger deal than Seasonal flu? Here it is in a nutshell. I hope this helps. Feel free to share this to others who don’t understand...
It has to do with RNA sequencing.... I.e. genetics.
Seasonal flu is an “all human virus”. The DNA/RNA chains that make up the virus are recognized by the human immune system. This means that your body has some immunity to it before it comes around each year... you get immunity two ways...through exposure to a virus, or by getting a flu shot.
Novel viruses, come from animals.... the WHO tracks novel viruses in animals, (sometimes for years watching for mutations). Usually these viruses only transfer from animal to animal (pigs in the case of H1N1) (birds in the case of the Spanish flu). But once, one of these animal viruses mutates, and starts to transfer from animals to humans... then it’s a problem, Why? Because we have no natural or acquired immunity.. the RNA sequencing of the genes inside the virus isn’t human, and the human immune system doesn’t recognize it so, we can’t fight it off.
Now.... sometimes, the mutation only allows transfer from animal to human, for years it’s only transmission is from an infected animal to a human before it finally mutates so that it can now transfer human to human... once that happens..we have a new contagion phase. And depending on the fashion of this new mutation, thats what decides how contagious, or how deadly it’s gonna be..
H1N1 was deadly....but it did not mutate in a way that was as deadly as the Spanish flu. It’s RNA was slower to mutate and it attacked its host differently, too.
Fast forward.
Now, here comes this Coronavirus... it existed in animals only, for nobody knows how long...but one day, at an animal market, in Wuhan China, in December 2019, it mutated and made the jump from animal to people. At first, only animals could give it to a person... But here is the scary part.... in just TWO WEEKS it mutated again and gained the ability to jump from human to human. Scientists call this quick ability, “slippery”
This Coronavirus, not being in any form a “human” virus (whereas we would all have some natural or acquired immunity). Took off like a rocket. And this was because, Humans have no known immunity...doctors have no known medicines for it.
And it just so happens that this particular mutated animal virus, changed itself in such a way the way that it causes great damage to human lungs..
That’s why Coronavirus is different from seasonal flu, or H1N1 or any other type of influenza.... this one is slippery. And it’s a lung eater...And, it’s already mutated AGAIN, so that we now have two strains to deal with, strain s, and strain L....which makes it twice as hard to develop a vaccine.
We really have no tools in our shed, with this. History has shown that fast and immediate closings of public places has helped in the past pandemics. Philadelphia and Baltimore were reluctant to close events in 1918 and they were the hardest hit in the US during the Spanish Flu.
Factoid: Henry VIII stayed in his room and allowed no one near him, till the Black Plague passed...(honestly...I understand him so much better now). Just like us, he had no tools in his shed, except social isolation...
And let me end by saying....right now it’s hitting older folks harder... but this genome is so slippery...if it mutates again (and it will). Who is to say, what it will do next."
Be smart folks... acting like you’re unafraid is so not sexy right now. Gosh, I've seen this amongst seniors as well. Why? (de Nile?)
Stay home folks... and share this useful info with others.
It would appear as though that quotation is inaccurate according to Snopes
https://www.snopes.com/news/2020/03/23/ ... sonal-flu/
Wow~
Good catch!
I'm going to correct the post and pass on to others as well!
thanks!
j :happy
Sandtrap,
I would suggest you do some more research on Snopes before heaping praise for the good catch. FWIW, Snopes is known to flag stuff inaccurate when it's not.

beth65
Posts: 165
Joined: Mon May 08, 2017 1:51 pm

Re: Bogleheads community discussion - Coronavirus

Post by beth65 » Wed Mar 25, 2020 7:42 pm

One would also hope that the only silver lining that comes from Covid-19 is that there is better awareness and practice of hygiene. According to the CDC site, the primary mode of transportation is airborne droplets that fall onto surfaces. Are there really that many people, even at the height of awareness of this pandemic and the general public anxiety, that are still coughing or sneezing directly into the air, or right into their hands and then touching other objects?

I have read the study that the average person touches their face 22.4 times an hour, but how many people are transferring their mucus and saliva onto objects either directly or indirectly?

I had a conversation with a male coworker a few weeks ago about how so few guys wash their hands after going to the bathroom, even in a highly-educated, white collar work environment. If this epidemic gets people to wash their hands and sneeze and cough into their elbows, that might actually be a huge win for hygiene.

ThankYouJack
Posts: 3317
Joined: Wed Oct 08, 2014 7:27 pm

Re: Bogleheads community discussion - Coronavirus

Post by ThankYouJack » Wed Mar 25, 2020 7:47 pm

ThankYouJack wrote:
Wed Mar 25, 2020 12:55 pm
Tigermoose wrote:
Wed Mar 25, 2020 12:06 pm

My family is isolating as well. My concern is for the vast majority of this country that will suffer under unemployment and a depression if we side too heavily with the medical community in making a decision for the well being of the country. They are one side of this argument. Being concerned about deaths due to the coronavirus is admirable, but what about all the death and suffering that comes with a great depression or major recession? Based on the past data, I do think the experts' models are flawed and they lack enough valid data to be close to reasonable.
Are you saying that deaths increase with a depression or major recession? I've read the opposite
Here's one article saying the mortality rate falls during a recession - https://fortune.com/2019/01/25/economic ... ity-rates/

If overall deaths actually increased during a recession I bet the POTUS would be stating it. Instead he only mentioned suicides increasing which may be misleading.

folkher0 wrote:
Wed Mar 25, 2020 7:08 pm


It’s not just the death rate. Deaths from the flu are relatively normally distributed around a peak date. The health care capacity can account for and accommodate flu admissions. It’s like a river that will predictably ebb and flow in a season.

There is no natural immunity to this virus. It spreads so fast that all the cases are coming at the same time. There is simply no capacity in our systems to accommodate. It’s like an avalanche or an earthquake. All of a sudden. All at once.
I heard one analogy that it's like a hurricane combined with terrorist attack. Thank you for all you're doing and also posting here to help inform

Irenaeus
Posts: 100
Joined: Wed Sep 21, 2011 2:06 pm

Re: Bogleheads community discussion - Coronavirus

Post by Irenaeus » Wed Mar 25, 2020 7:50 pm

Barkingsparrow wrote:
Wed Mar 25, 2020 2:13 pm
folkher0 wrote:
Wed Mar 25, 2020 2:02 pm

FWIW I have tried these drugs in my patients. They haven’t worked. We are giving it because we have no other treatments

It’s a little naive to think a 50 year old malaria/lupus drug and a zpac are gonna get us out of this. No matter what the president says.

There are clinical trials ongoing of various agents. No one will know for months if they actually help or hurt.

And no I don’t have any plaquenil or azithromycin and would never horde any.

This story, if true, says more about the morale of health care providers than it does about the efficacy of these meds.
My wife is on plaquenil as she has an auto-immune condition. Fortunately, she was able to renew a 90-day prescription in early March before the president came out with his dangerous anecdotes. However, one of her support group members has said she is unable to refill, and I'm seeing the same situation for other Lupus/Sjogren patients around the country.
I am grateful for my good health and take no medications regularly. I did, however, receive what was to have been the first of two shots of Shingrix (zoster vaccine) to vaccinate against shingles, an illness which my mother suffered briefly. I received the first shot circa September 2019. The second shot was to have been administered 2-6 months after the first, yet the medication for the second shot has not been available, according to my several visits or calls to a few pharmacies over several months now in New York City where I live. Further, I was told that there's been a run on syringes due to the pandemic. Now I'm unsure if it is the vaccine that is still unavailable or the lack of syringes preventing its injection. Anyway, there was a supply problem with medications before the outbreak of COVID-19.

User avatar
baconavocado
Posts: 437
Joined: Fri Oct 13, 2017 3:03 pm

Re: Bogleheads community discussion - Coronavirus

Post by baconavocado » Wed Mar 25, 2020 8:00 pm

beth65 wrote:
Wed Mar 25, 2020 7:42 pm
I had a conversation with a male coworker a few weeks ago about how so few guys wash their hands after going to the bathroom, even in a highly-educated, white collar work environment. If this epidemic gets people to wash their hands and sneeze and cough into their elbows, that might actually be a huge win for hygiene.
A female coworker once told me that she didn't like to wash her hands much because she thought it dried her skin and made her hands look older.

webbie90
Posts: 69
Joined: Mon Mar 23, 2020 10:52 pm

Re: Bogleheads community discussion - Coronavirus

Post by webbie90 » Wed Mar 25, 2020 8:30 pm

folkher0 wrote:
Wed Mar 25, 2020 7:08 pm

It’s not just the death rate. Deaths from the flu are relatively normally distributed around a peak date. The health care capacity can account for and accommodate flu admissions. It’s like a river that will predictably ebb and flow in a season.

There is no natural immunity to this virus. It spreads so fast that all the cases are coming at the same time. There is simply no capacity in our systems to accommodate. It’s like an avalanche or an earthquake. All of a sudden. All at once.
From tonight's NYT about the situation unfolding in New York:

"...Patients came in faster than the hospital could add beds; earlier this week, 60 coronavirus patients had been admitted but were still in the emergency room. One man waited almost 60 hours for a bed last week, a doctor said."

"All of the more than 1,800 intensive care beds in the city are expected to be full by Friday, according to a Federal Emergency Management Agency briefing obtained by The New York Times. Patients could stay for weeks, limiting space for newly sickened people."

madbrain
Posts: 5513
Joined: Thu Jun 09, 2011 5:06 pm
Location: San Jose, California

Re: Bogleheads community discussion - Coronavirus

Post by madbrain » Wed Mar 25, 2020 8:33 pm

Turbo29 wrote:
Mon Mar 23, 2020 11:17 am
Maximum unemployment in my state is $240/wk; ~$1000/mo. That won't even pay rent or mortgage for most people.
Wouldn't even pay for COBRA.

JBTX
Posts: 6152
Joined: Wed Jul 26, 2017 12:46 pm

Re: Bogleheads community discussion - Coronavirus

Post by JBTX » Wed Mar 25, 2020 8:45 pm

folkher0 wrote:
Wed Mar 25, 2020 7:08 pm
JBTX wrote:
Wed Mar 25, 2020 6:55 pm
It was argued here that based on Germany the real death rate was "only" 0.4% based on more widespread and extensive testing. But consider seasonal flu is about 0.1%. So that is 4 times as high.

It has been estimated that half or more would likely get it if we did nothing about it. There are quite a few anecdotes of high rates of infection in close quarters. 0.4% on 200 million is 800,000 deaths. On 100 million is 400,000 deaths. And those are on top of all the usual causes like flu. This is a key point. They aren't instead of the flu. They are on top of it. And the number who get very sick and hospitalized is far higher. Add all those millions of critical cases on top of a medical system that doesn't have a lot of headroom. This is how you get to what folkhero is describing.

Hopefully they won't be nearly that high, but probably because as feckless as our efforts have been they are better than nothing. And maybe if we are lucky the warm weather will at least slow the infection rate down, but then that leaves next fall and winter.
It’s not just the death rate. Deaths from the flu are relatively normally distributed around a peak date. The health care capacity can account for and accommodate flu admissions. It’s like a river that will predictably ebb and flow in a season.

There is no natural immunity to this virus. It spreads so fast that all the cases are coming at the same time. There is simply no capacity in our systems to accommodate. It’s like an avalanche or an earthquake. All of a sudden. All at once.

As I posted some number of pages ago daughters BF almost surely has it but they didn't test him at ER and they told them many that were admitted and sick and even in ICU had not gotten results back. A few hours later they sent him home. Didn't tell him or daughter or anybody to quarantine. My only conclusion is when people are that cavalier about things they are overwhelmed and are fighting the biggest fires. If someone can walk in and out of the ER they have bigger fish to fry.

The debate about just going about business as usual is a typical hypothetical counter factual not based on reality. Fact is it had been worse, and at some point people will react a demand action anyway, and at that point it is harder to manage.

JBTX
Posts: 6152
Joined: Wed Jul 26, 2017 12:46 pm

Re: Bogleheads community discussion - Coronavirus

Post by JBTX » Wed Mar 25, 2020 8:48 pm

baconavocado wrote:
Wed Mar 25, 2020 8:00 pm
beth65 wrote:
Wed Mar 25, 2020 7:42 pm
I had a conversation with a male coworker a few weeks ago about how so few guys wash their hands after going to the bathroom, even in a highly-educated, white collar work environment. If this epidemic gets people to wash their hands and sneeze and cough into their elbows, that might actually be a huge win for hygiene.
A female coworker once told me that she didn't like to wash her hands much because she thought it dried her skin and made her hands look older.

Had an employee that said the same thing. Don't think she realized other employees knew it and didn't like office bring your dish events because of this. Fine with me because I hated those anyway.

User avatar
F150HD
Posts: 2990
Joined: Fri Sep 18, 2015 7:49 pm

Re: Bogleheads community discussion - Coronavirus

Post by F150HD » Wed Mar 25, 2020 8:49 pm

walking thru a Target store tonight....suddenly over the loudspeaker a girls voice says "remember customers to stay 6 feet apart at all times".

I felt the page was unnecessary and generated tension in the store among customers.

Why not let the few customers in the store (and there were few) have some degree of normalcy while they shop.

madbrain
Posts: 5513
Joined: Thu Jun 09, 2011 5:06 pm
Location: San Jose, California

Re: Bogleheads community discussion - Coronavirus

Post by madbrain » Wed Mar 25, 2020 8:57 pm

wshang wrote:
Mon Mar 23, 2020 9:40 pm
Just like CCR5 in HIV, it very well could be that discover certain groups are largely untouched, but when infected, could serve as a firebreak or a source of herd immunity for the vulnerable.
The CCR5 delta 32 genetic mutation doesn't prevent all HIV infection. It took 3 decades before it was identified. Individuals with the mutation can still contract HIV through another receptor, CXCR4. Also, only 1% of the world's population is estimated to have this mutation. And it is present mostly in people of European descent, which may not be evenly distributed geographically around the world.

I'm no expert, but these sort of odds don't seem like they would do much to hamper Covid-19 if a similar protection genetic mutation existed. Genetic testing can be relatively expensive, and is controversial, so these individuals might be hard to identify.

User avatar
knpstr
Posts: 2810
Joined: Thu Nov 20, 2014 8:57 pm
Location: Michigan

Re: Bogleheads community discussion - Coronavirus

Post by knpstr » Wed Mar 25, 2020 9:00 pm

F150HD wrote:
Wed Mar 25, 2020 8:49 pm
walking thru a Target store tonight....suddenly over the loudspeaker a girls voice says "remember customers to stay 6 feet apart at all times".

I felt the page was unnecessary and generated tension in the store among customers.

Why not let the few customers in the store (and there were few) have some degree of normalcy while they shop.
I'm sure it is from corporate to parrot it out every X minutes for "good faith" liability reasons.
Very little is needed to make a happy life; it is all within yourself, in your way of thinking. -Marcus Aurelius

JBTX
Posts: 6152
Joined: Wed Jul 26, 2017 12:46 pm

Re: Bogleheads community discussion - Coronavirus

Post by JBTX » Wed Mar 25, 2020 9:01 pm

F150HD wrote:
Wed Mar 25, 2020 8:49 pm
walking thru a Target store tonight....suddenly over the loudspeaker a girls voice says "remember customers to stay 6 feet apart at all times".

I felt the page was unnecessary and generated tension in the store among customers.

Why not let the few customers in the store (and there were few) have some degree of normalcy while they shop.
Because some people take it more seriously than others. It isn't fair to the one who wants to keep six feet when another who doesn't care invades it. In aisles with people and shopping carts you may not have a chance to move. Personally I'm not too worried about it, but just saying.

Went inside a grocery store for the first time in months. Seems all of the pickup slots are either full or canceled because they never know what they may have in stock a day or two ahead.

SteadyOne
Posts: 171
Joined: Fri Mar 22, 2019 5:26 pm

Re: Bogleheads community discussion - Coronavirus

Post by SteadyOne » Wed Mar 25, 2020 9:01 pm

folkher0 wrote:
Wed Mar 25, 2020 7:08 pm
JBTX wrote:
Wed Mar 25, 2020 6:55 pm
It was argued here that based on Germany the real death rate was "only" 0.4% based on more widespread and extensive testing. But consider seasonal flu is about 0.1%. So that is 4 times as high.

It has been estimated that half or more would likely get it if we did nothing about it. There are quite a few anecdotes of high rates of infection in close quarters. 0.4% on 200 million is 800,000 deaths. On 100 million is 400,000 deaths. And those are on top of all the usual causes like flu. This is a key point. They aren't instead of the flu. They are on top of it. And the number who get very sick and hospitalized is far higher. Add all those millions of critical cases on top of a medical system that doesn't have a lot of headroom. This is how you get to what folkhero is describing.

Hopefully they won't be nearly that high, but probably because as feckless as our efforts have been they are better than nothing. And maybe if we are lucky the warm weather will at least slow the infection rate down, but then that leaves next fall and winter.
It’s not just the death rate. Deaths from the flu are relatively normally distributed around a peak date. The health care capacity can account for and accommodate flu admissions. It’s like a river that will predictably ebb and flow in a season.

There is no natural immunity to this virus. It spreads so fast that all the cases are coming at the same time. There is simply no capacity in our systems to accommodate. It’s like an avalanche or an earthquake. All of a sudden. All at once.
If there is no immunity to this virus, then everyone who gets this infection will die. But only few do.
“Every de­duc­tion is al­lowed as a mat­ter of leg­isla­tive grace.” US Federal Court

User avatar
canadianbacon
Posts: 118
Joined: Sun Nov 10, 2019 10:04 pm

Re: Bogleheads community discussion - Coronavirus

Post by canadianbacon » Wed Mar 25, 2020 9:08 pm

I see some discussion about false negative rates on Covid tests. I read on Twitter today that a model had found that a test with up to an 80% false negative rate can still be effective in slowing the growth, provided you isolate every positive. From what I've read, while it's possible for the test to miss the virus, if it comes back positive, you definitely have it... the failures are only in one direction. Being able to test frequently, and act on the results, is how we keep this thing under control once lockdowns end.
Bulls make money, bears make money, pigs get slaughtered.

User avatar
F150HD
Posts: 2990
Joined: Fri Sep 18, 2015 7:49 pm

Re: Bogleheads community discussion - Coronavirus

Post by F150HD » Wed Mar 25, 2020 9:12 pm

knpstr wrote:
Wed Mar 25, 2020 9:00 pm
F150HD wrote:
Wed Mar 25, 2020 8:49 pm
walking thru a Target store tonight....suddenly over the loudspeaker a girls voice says "remember customers to stay 6 feet apart at all times".

I felt the page was unnecessary and generated tension in the store among customers.

Why not let the few customers in the store (and there were few) have some degree of normalcy while they shop.
I'm sure it is from corporate to parrot it out every X minutes for "good faith" liability reasons.
+1

beth65
Posts: 165
Joined: Mon May 08, 2017 1:51 pm

Re: Bogleheads community discussion - Coronavirus

Post by beth65 » Wed Mar 25, 2020 9:21 pm

baconavocado wrote:
Wed Mar 25, 2020 8:00 pm
beth65 wrote:
Wed Mar 25, 2020 7:42 pm
I had a conversation with a male coworker a few weeks ago about how so few guys wash their hands after going to the bathroom, even in a highly-educated, white collar work environment. If this epidemic gets people to wash their hands and sneeze and cough into their elbows, that might actually be a huge win for hygiene.
A female coworker once told me that she didn't like to wash her hands much because she thought it dried her skin and made her hands look older.
I wasn’t intending to male bash. There are some gross females out there, too, but it was all over social media last week that there were lines in the men’s room to wash their hands for the first time, and that made me think of the conversation with my coworker. Most women at least wash hands when another woman is in the restroom, maybe due to social pressure. Who knows what they do alone.

User avatar
wshang
Posts: 1219
Joined: Sun Feb 03, 2008 11:40 am

Re: Bogleheads community discussion - Coronavirus

Post by wshang » Wed Mar 25, 2020 9:33 pm

SteadyOne wrote:
Wed Mar 25, 2020 9:01 pm
folkher0 wrote:
Wed Mar 25, 2020 7:08 pm
JBTX wrote:
Wed Mar 25, 2020 6:55 pm
It was argued here that based on Germany the real death rate was "only" 0.4% based on more widespread and extensive testing. But consider seasonal flu is about 0.1%. So that is 4 times as high.
There is no natural immunity to this virus.
If there is no immunity to this virus, then everyone who gets this infection will die. But only few do.
I'm glad you didn't "there is no immunity to this virus" because the SARS coronavirus as well as the winter NL63 coronavirus use the same docking protein to bind to cells without which there would be no infection. We have many types of immunity.

There are many cases of Nairobi prostitutes repeated exposed to HIV who are resistant because their immunity relies upon the defensive CD8+ T-cell which lie right beneath the cervical and vaginal mucosal surfaces. These women show no evidence of CCR5 nor evidence of infection. The same situation plausibly exists for Covid-19.
https://www.ncbi.nlm.nih.gov/pubmed/27287409
https://www.ncbi.nlm.nih.gov/pubmed/15972696
Madbrain wrote: The CCR5 delta 32 genetic mutation doesn't prevent all HIV infection. I'm no expert, but these sort of odds don't seem like they would do much to hamper Covid-19 if a similar protection genetic mutation existed.
The odds are even better than the prevalence of CCR5. What makes for a Covid-19 target rich environment, is an abnormal abundance of Covid-19 viral binding sites resulting from the diseases of high blood pressure and Type 2 diabetes. Our medications in truth do little for the underlying causes of these diseases. So, speaking momentarily in a fatalistic fashion, we are hearing Darwin's voice from beyond the grave having tried to defeat it with biotechnology all these decades. (I apologize and don't at all mean this callously for all who are suffering and worried. Nature is nature.) We are among the toughest, most adaptable species.

KlangFool
Posts: 16078
Joined: Sat Oct 11, 2008 12:35 pm

Re: Bogleheads community discussion - Coronavirus

Post by KlangFool » Wed Mar 25, 2020 9:42 pm

https://www.youtube.com/watch?v=4CJQaFmiqYM
<<NY Gov. Cuomo Gives Update On Coronavirus Pandemic | NBC News (Live Stream Recording)>>
3/25/2020 Broadcast.

06:20 Density control plan may be working. Hospitalization doubling slows down from every 2 days to every 4.7 days.

14:40 Surge Healthcare Force: 40,000 Responses to date

26:21 Westchester new cases slow to 800 cases. (997 new cases on 3/24/2020)

27:31 Current hospitalization. 30,811 cases, 3,805 (12%) Hospitalized, 888 ICU patients (3% of positive)

3/24/2020 25,665 cases 3,234 hospitalized 756 ICU beds
3/25/2020 30,811 cases,3,805 Hospitalized, 888 ICU patients

KlangFool
Last edited by KlangFool on Wed Mar 25, 2020 9:53 pm, edited 3 times in total.

Spirit Rider
Posts: 12906
Joined: Fri Mar 02, 2007 2:39 pm

Re: Bogleheads community discussion - Coronavirus

Post by Spirit Rider » Wed Mar 25, 2020 10:02 pm

Here are the CDC nationwide confirmed case numbers and daily rate of increase over the last week.

2020-03-19 ​​ 12,018(+49%)
2020-03-20 ​​ 17,439(+45%)
2020-03-21 ​​ 23,710(+36%)
2020-03-22 ​​ 32,341(+36%)
2020-03-23 ​​ 42,749(+32%)
2020-03-24 ​​ 52,685(+23%)
2020-03-25 ​​ 64,661(+23%)

A week a trend does not make, but it appears there may be a deceleration in the rate of new confirmed cases nationwide. People are focusing on the number of new confirmed cases, but the rate of increase is a better measure of the spread of the virus than the number.

Of course, even if the number of new cases starts to level off, the number of deaths are likely to increase. Also, there are likely to be hot spots with accelerating confirmed cases.

quantAndHold
Posts: 4490
Joined: Thu Sep 17, 2015 10:39 pm

Re: Bogleheads community discussion - Coronavirus

Post by quantAndHold » Wed Mar 25, 2020 10:03 pm

SteadyOne wrote:
Wed Mar 25, 2020 7:20 pm
JBTX wrote:
Wed Mar 25, 2020 6:55 pm
It was argued here that based on Germany the real death rate was "only" 0.4% based on more widespread and extensive testing. But consider seasonal flu is about 0.1%. So that is 4 times as high.

It has been estimated that half or more would likely get it if we did nothing about it. There are quite a few anecdotes of high rates of infection in close quarters. 0.4% on 200 million is 800,000 deaths. On 100 million is 400,000 deaths. And those are on top of all the usual causes like flu. This is a key point. They aren't instead of the flu. They are on top of it. And the number who get very sick and hospitalized is far higher. Add all those millions of critical cases on top of a medical system that doesn't have a lot of headroom. This is how you get to what folkhero is describing.

Hopefully they won't be nearly that high, but probably because as feckless as our efforts have been they are better than nothing. And maybe if we are lucky the warm weather will at least slow the infection rate down, but then that leaves next fall and winter.
Flu numbers will be lower this year because of social distancing
The flu season is already over in most (if not all) of the US.
Yes, I’m really that pedantic.

madbrain
Posts: 5513
Joined: Thu Jun 09, 2011 5:06 pm
Location: San Jose, California

Re: Bogleheads community discussion - Coronavirus

Post by madbrain » Wed Mar 25, 2020 10:29 pm

Spirit Rider wrote:
Wed Mar 25, 2020 10:02 pm
Here are the CDC nationwide confirmed case numbers and daily rate of increase over the last week.

2020-03-19 ​​ 12,018(+49%)
2020-03-20 ​​ 17,439(+45%)
2020-03-21 ​​ 23,710(+36%)
2020-03-22 ​​ 32,341(+36%)
2020-03-23 ​​ 42,749(+32%)
2020-03-24 ​​ 52,685(+23%)
2020-03-25 ​​ 64,661(+23%)

A week a trend does not make, but it appears there may be a deceleration in the rate of new confirmed cases nationwide. People are focusing on the number of new confirmed cases, but the rate of increase is a better measure of the spread of the virus than the number.

Of course, even if the number of new cases starts to level off, the number of deaths are likely to increase. Also, there are likely to be hot spots with accelerating confirmed cases.
The fatality rate in the US is up 31% for today according to
https://ncov2019.live/data
That's 246 deaths in one day.

We had over 12,000 new cases today vs 5,000 new cases 6 days ago. That is hard to celebrate.
The total US number of cases is going to pass Italy in just 1 to 3 days, and likely will also pass China by the middle of next week.

iceman
Posts: 44
Joined: Mon Jan 04, 2010 2:18 pm

Re: Bogleheads community discussion - Coronavirus

Post by iceman » Wed Mar 25, 2020 10:29 pm

iceman wrote:
Mon Mar 23, 2020 12:53 pm
Total (worldwide) deaths went from 4,981 on March 12th to 10,031 on March 19th, doubling in 7 days. As of yesterday it hit 14,467. I'd expect to be at/over 20k by March 26th, doubling again in 7 days. Left unchecked, that rate of growth would lead to over 1m deaths six weeks from now.
Very unfortunately, worldometers is showing worldwide (cumulative) total of over 21k deaths today. I think we know that this count trails action being taken by 3 if not 4 weeks. I am hopeful that this rate slows down - obviously the biggest driver are areas like N Italy. Things look dicey in Spain at the moment, but unless multiple countries begin to experience conditions like N Italy, then hopefully it slows. If it doesn't, we'd look to be around 40k deaths near end of next week.

Also surreal to see the total cases number climb from 100k to 200k in 12 days and then climb from 200k to 470k in 8 days.

quantAndHold
Posts: 4490
Joined: Thu Sep 17, 2015 10:39 pm

Re: Bogleheads community discussion - Coronavirus

Post by quantAndHold » Wed Mar 25, 2020 10:38 pm

SteadyOne wrote:
Wed Mar 25, 2020 9:01 pm
folkher0 wrote:
Wed Mar 25, 2020 7:08 pm
JBTX wrote:
Wed Mar 25, 2020 6:55 pm
It was argued here that based on Germany the real death rate was "only" 0.4% based on more widespread and extensive testing. But consider seasonal flu is about 0.1%. So that is 4 times as high.

It has been estimated that half or more would likely get it if we did nothing about it. There are quite a few anecdotes of high rates of infection in close quarters. 0.4% on 200 million is 800,000 deaths. On 100 million is 400,000 deaths. And those are on top of all the usual causes like flu. This is a key point. They aren't instead of the flu. They are on top of it. And the number who get very sick and hospitalized is far higher. Add all those millions of critical cases on top of a medical system that doesn't have a lot of headroom. This is how you get to what folkhero is describing.

Hopefully they won't be nearly that high, but probably because as feckless as our efforts have been they are better than nothing. And maybe if we are lucky the warm weather will at least slow the infection rate down, but then that leaves next fall and winter.
It’s not just the death rate. Deaths from the flu are relatively normally distributed around a peak date. The health care capacity can account for and accommodate flu admissions. It’s like a river that will predictably ebb and flow in a season.

There is no natural immunity to this virus. It spreads so fast that all the cases are coming at the same time. There is simply no capacity in our systems to accommodate. It’s like an avalanche or an earthquake. All of a sudden. All at once.
If there is no immunity to this virus, then everyone who gets this infection will die. But only few do.
No. The body has two types of immune responses, primary and secondary. The primary immune response kicks into gear whenever the body is attacked by any foreign organism, virus, bacteria, whatever. It’s slow and clunky, and takes time to fight off the attacking organism. But when the primary immune response successfully fights off the organism, we call that “getting well.”

When we talk about people having immunity, we’re really talking about secondary immunity. Secondary immunity develops after the body’s primary immunity has done its job. Basically, the body remembers the organism it just fought off, and develops antibodies. Secondary immunity is a much faster, stronger response. Someone can get secondary immunity by having had the illness, or from vaccines. If you have secondary immunity, you either won’t get sick, or you will get a much milder form of the illness. In the case of COVID-19, we don’t yet know whether the secondary immunity people develop will be permanent or temporary, and how strong the secondary immune response will be.

Anyway, it’s called a “novel” virus because it’s new. Nobody has the antibodies yet to have secondary immunity. And yes, if your primary immunity can’t fight it off, you die.
Yes, I’m really that pedantic.

webbie90
Posts: 69
Joined: Mon Mar 23, 2020 10:52 pm

Re: Bogleheads community discussion - Coronavirus

Post by webbie90 » Wed Mar 25, 2020 10:38 pm

madbrain wrote:
Wed Mar 25, 2020 10:29 pm
Spirit Rider wrote:
Wed Mar 25, 2020 10:02 pm
Here are the CDC nationwide confirmed case numbers and daily rate of increase over the last week.

2020-03-19 ​​ 12,018(+49%)
2020-03-20 ​​ 17,439(+45%)
2020-03-21 ​​ 23,710(+36%)
2020-03-22 ​​ 32,341(+36%)
2020-03-23 ​​ 42,749(+32%)
2020-03-24 ​​ 52,685(+23%)
2020-03-25 ​​ 64,661(+23%)

A week a trend does not make, but it appears there may be a deceleration in the rate of new confirmed cases nationwide. People are focusing on the number of new confirmed cases, but the rate of increase is a better measure of the spread of the virus than the number.

Of course, even if the number of new cases starts to level off, the number of deaths are likely to increase. Also, there are likely to be hot spots with accelerating confirmed cases.
The fatality rate in the US is up 31% for today according to
https://ncov2019.live/data
That's 246 deaths in one day.

We had over 12,000 new cases today vs 5,000 new cases 6 days ago. That is hard to celebrate.
The total US number of cases is going to pass Italy in just 1 to 3 days, and likely will also pass China by the middle of next week.

It looks to me that by the end of the day tomorrow the US will pass both Italy and China in number of cases.

madbrain
Posts: 5513
Joined: Thu Jun 09, 2011 5:06 pm
Location: San Jose, California

Re: Bogleheads community discussion - Coronavirus

Post by madbrain » Wed Mar 25, 2020 10:43 pm

webbie90 wrote:
Wed Mar 25, 2020 10:38 pm
It looks to me that by the end of the day tomorrow the US will pass both Italy and China in number of cases.
You are right, possibly will pass China tomorrow too, Italy almost surely.

webbie90
Posts: 69
Joined: Mon Mar 23, 2020 10:52 pm

Re: Bogleheads community discussion - Coronavirus

Post by webbie90 » Wed Mar 25, 2020 11:00 pm

madbrain wrote:
Wed Mar 25, 2020 10:43 pm
webbie90 wrote:
Wed Mar 25, 2020 10:38 pm
It looks to me that by the end of the day tomorrow the US will pass both Italy and China in number of cases.
You are right, possibly will pass China tomorrow too, Italy almost surely.
Italy's case numbers have grown 8-fold in the 16 days since they instituted their nationwide lockdown on March 9. An 8-fold increase in the US (only parts of which are currently in lockdown) would put total case numbers at 550,000.

3504PIR
Posts: 968
Joined: Mon Jul 26, 2010 2:46 am

Re: Bogleheads community discussion - Coronavirus

Post by 3504PIR » Wed Mar 25, 2020 11:08 pm

F150HD wrote:
Wed Mar 25, 2020 8:49 pm
walking thru a Target store tonight....suddenly over the loudspeaker a girls voice says "remember customers to stay 6 feet apart at all times".

I felt the page was unnecessary and generated tension in the store among customers.

Why not let the few customers in the store (and there were few) have some degree of normalcy while they shop.
Perhaps there was some crowding in another part of the store, which isn’t likely, but perhaps we are generally morons who are not reacting to a threat we cannot see and need to be reminded?

7eight9
Posts: 955
Joined: Fri May 17, 2019 7:11 pm

Re: Bogleheads community discussion - Coronavirus

Post by 7eight9 » Wed Mar 25, 2020 11:16 pm

beth65 wrote:
Wed Mar 25, 2020 7:42 pm
One would also hope that the only silver lining that comes from Covid-19 is that there is better awareness and practice of hygiene. According to the CDC site, the primary mode of transportation is airborne droplets that fall onto surfaces. Are there really that many people, even at the height of awareness of this pandemic and the general public anxiety, that are still coughing or sneezing directly into the air, or right into their hands and then touching other objects?

I have read the study that the average person touches their face 22.4 times an hour, but how many people are transferring their mucus and saliva onto objects either directly or indirectly?

I had a conversation with a male coworker a few weeks ago about how so few guys wash their hands after going to the bathroom, even in a highly-educated, white collar work environment. If this epidemic gets people to wash their hands and sneeze and cough into their elbows, that might actually be a huge win for hygiene.
This reminds me of one of all time favorite jokes.

A Harvard grad and Yale grad met in the bathroom during halftime of The Game. The Harvard graduate said, "Didn't they teach you to wash your hands at Yale?" The Yale grad responded, "They taught us not to pee on our hands."

:happy
I guess it all could be much worse. | They could be warming up my hearse.

3504PIR
Posts: 968
Joined: Mon Jul 26, 2010 2:46 am

Re: Bogleheads community discussion - Coronavirus

Post by 3504PIR » Wed Mar 25, 2020 11:18 pm

webbie90 wrote:
Wed Mar 25, 2020 10:38 pm
madbrain wrote:
Wed Mar 25, 2020 10:29 pm
Spirit Rider wrote:
Wed Mar 25, 2020 10:02 pm
Here are the CDC nationwide confirmed case numbers and daily rate of increase over the last week.

2020-03-19 ​​ 12,018(+49%)
2020-03-20 ​​ 17,439(+45%)
2020-03-21 ​​ 23,710(+36%)
2020-03-22 ​​ 32,341(+36%)
2020-03-23 ​​ 42,749(+32%)
2020-03-24 ​​ 52,685(+23%)
2020-03-25 ​​ 64,661(+23%)

A week a trend does not make, but it appears there may be a deceleration in the rate of new confirmed cases nationwide. People are focusing on the number of new confirmed cases, but the rate of increase is a better measure of the spread of the virus than the number.

Of course, even if the number of new cases starts to level off, the number of deaths are likely to increase. Also, there are likely to be hot spots with accelerating confirmed cases.
The fatality rate in the US is up 31% for today according to
https://ncov2019.live/data
That's 246 deaths in one day.

We had over 12,000 new cases today vs 5,000 new cases 6 days ago. That is hard to celebrate.
The total US number of cases is going to pass Italy in just 1 to 3 days, and likely will also pass China by the middle of next week.

It looks to me that by the end of the day tomorrow the US will pass both Italy and China in number of cases.
And it will go up. Aside from restaurants being closed, it’s business as usual where I am. I had to go grocery shopping today and have not left the farm in well over a week. It is definitely business as usual here and every day it remains the same is another day of the same. And my comment doesn’t even account for the lack of testing which is another whole discussion. I was mildly surprised at the lack of stay at home, but not shocked. Disappointed more than anything. Business as usual and we will go on, and on. No idea where everyone is driving to, but unless the State government closes more than restaurants and schools, nobody will fear what they cannot see. I got some looks today grocery shopping with latex gloves on, and I was alone wearing them. Fortunately the grocery store was largely empty, which leads me back to where the hell all these folks are going?

madbrain
Posts: 5513
Joined: Thu Jun 09, 2011 5:06 pm
Location: San Jose, California

Re: Bogleheads community discussion - Coronavirus

Post by madbrain » Thu Mar 26, 2020 12:14 am

3504PIR wrote:
Wed Mar 25, 2020 11:18 pm
And it will go up. Aside from restaurants being closed, it’s business as usual where I am. I had to go grocery shopping today and have not left the farm in well over a week. It is definitely business as usual here and every day it remains the same is another day of the same. And my comment doesn’t even account for the lack of testing which is another whole discussion. I was mildly surprised at the lack of stay at home, but not shocked. Disappointed more than anything. Business as usual and we will go on, and on. No idea where everyone is driving to, but unless the State government closes more than restaurants and schools, nobody will fear what they cannot see. I got some looks today grocery shopping with latex gloves on, and I was alone wearing them. Fortunately the grocery store was largely empty, which leads me back to where the hell all these folks are going?
Over here in Silicon Valley, the county has closed everything except "essential" businesses, which includes grocery stores, pharmacies, and healthcare providers. There is also a statewide "safer-at-home" order which is slightly less restrictive. I have been at home for 3 weeks. I'm immuno-compromised and not taking any chances.

3504PIR
Posts: 968
Joined: Mon Jul 26, 2010 2:46 am

Re: Bogleheads community discussion - Coronavirus

Post by 3504PIR » Thu Mar 26, 2020 12:40 am

madbrain wrote:
Thu Mar 26, 2020 12:14 am
3504PIR wrote:
Wed Mar 25, 2020 11:18 pm
And it will go up. Aside from restaurants being closed, it’s business as usual where I am. I had to go grocery shopping today and have not left the farm in well over a week. It is definitely business as usual here and every day it remains the same is another day of the same. And my comment doesn’t even account for the lack of testing which is another whole discussion. I was mildly surprised at the lack of stay at home, but not shocked. Disappointed more than anything. Business as usual and we will go on, and on. No idea where everyone is driving to, but unless the State government closes more than restaurants and schools, nobody will fear what they cannot see. I got some looks today grocery shopping with latex gloves on, and I was alone wearing them. Fortunately the grocery store was largely empty, which leads me back to where the hell all these folks are going?
Over here in Silicon Valley, the county has closed everything except "essential" businesses, which includes grocery stores, pharmacies, and healthcare providers. There is also a statewide "safer-at-home" order which is slightly less restrictive. I have been at home for 3 weeks. I'm immuno-compromised and not taking any chances.
We all should be following California’s lead. Not doing so is only extending this day by day. Half my family lives in SoCal and they were surprised at the order you mention. Smh. Stay safe.

Alex Frakt
Founder
Posts: 11074
Joined: Fri Feb 23, 2007 1:06 pm
Location: Chicago
Contact:

Re: Bogleheads community discussion - Coronavirus

Post by Alex Frakt » Thu Mar 26, 2020 1:53 am

This thread is taking up more moderator time than entirety of the rest of the forum. If this keeps up we will have to lock it. Here's a reminder from the first post on this thread:

You are welcome to share your concerns, but please be cognizant of the Forum Policies. No politics, conspiracy theory (virus origins), or medical advice is permitted. Epidemiology should point to official sources.

MiloMoney
Posts: 49
Joined: Wed Mar 18, 2020 11:37 pm

Re: Bogleheads community discussion - Coronavirus

Post by MiloMoney » Thu Mar 26, 2020 3:48 am

They closed my high school, having do classes online starting in the next couple weeks. Scary stuff.

User avatar
Stinky
Posts: 3966
Joined: Mon Jun 12, 2017 11:38 am
Location: Sweet Home Alabama

Re: Bogleheads community discussion - Coronavirus

Post by Stinky » Thu Mar 26, 2020 5:52 am

Alex Frakt wrote:
Thu Mar 26, 2020 1:53 am
This thread is taking up more moderator time than entirety of the rest of the forum. If this keeps up we will have to lock it. Here's a reminder from the first post on this thread:

You are welcome to share your concerns, but please be cognizant of the Forum Policies. No politics, conspiracy theory (virus origins), or medical advice is permitted. Epidemiology should point to official sources.
Please, folks, let's keep this thread clean and within the BH rules.

I'm really enjoying hearing the various viewpoints from thoughtful folks who post here.

But please, let's keep out the politics and the sniping. It would be a real loss if this thread (and any others like it that pop up) get locked up.

Many folks post in the "thanks to our moderators" threads about how great their work is. This is a chance to pay it back to the moderators.
It's a GREAT day to be alive - Travis Tritt

vested1
Posts: 2071
Joined: Wed Jan 04, 2012 4:20 pm

Re: Bogleheads community discussion - Coronavirus

Post by vested1 » Thu Mar 26, 2020 5:58 am

KlangFool wrote:
Wed Mar 25, 2020 1:56 pm
framus wrote:
Wed Mar 25, 2020 1:49 pm


A significant help in opening up the shutdown would be a test that would enable determination that a person had developed immunity to the pathogen. This would enable these folks to re-engage in commerce and not be contamination vectors. Mario Cuomo has articulated how such an approach could be established.
frames,

In another word, more and better testing. In contrast to the "no testing and assume everyone will be infected" approach. Aka, just send everyone back to work and hope for the best.

KlangFool
The small town of Telluride in Colorado is testing the blood of the entire population of around 8,000 residents for the presence of antibodies to COVID-19. The testing is being paid for by a private partnership of local wealthy philanthropists. The incidence of the disease there is almost non-existent, with no cases initially and only 3 individuals with respiratory symptoms who were suspected of having it. An update in the article linked below says there is now one confirmed case.

The test has been or is scheduled to be given to all residents, and all who currently test negative for antibodies will be retested in 14 days to measure any increase. Individuals who have the antibodies will be considered resistant to the virus after having been exposed to it and will apparently be allowed to resume normal activity.

This test is supposed to be less expensive and take far less time to return results. It should be interesting to watch, and to extrapolate how expanding such a program could have a positive impact on getting people back to work with some degree of confidence. If results are found to be accurate it would also be a valuable tool in determining which individuals are more able to assist in the treatment of the infected.

https://coloradosun.com/2020/03/20/tell ... 9-testing/

Locked