COVID-19 Coronavirus: general discussion

[Lothor]

This one is on target: Individual preventive social distancing during an epidemic may have negative population-level outcomes


"However, the aim of our paper is to show, in a theoretical context, that rational individual-level preventive measures can have counterintuitive consequences for the population-level. Public health interventions that aim at changing individual behaviour through social distancing could have adverse consequences, for example, school closures could reduce social contacts between children in the school classes but may (partly) be replaced by social contacts outside of school. But similarly, these measures could be beneficial for the population. As our results show, it is not necessarily straightforward what effects such behaviour may have at the population level, where much may depend on the disease and population under consideration. "

Maybe. I think it's a strange assumption to make in the model that people search for new contacts to maintain an existing number of contacts when they isolate themselves, and if they do these contacts may be made online (a guy quarantined in Wuhan turned up on a Facebook group I'm a member of precisely because he was feeling lonely and fed up). Who knows? As the paper says, because of the complexity of the situation, a partial reduction in the number of contacts may have a counterintuitive effect of worsening the situation but I don't think it makes it not worth trying, particularly with people feeling better with some action than no action from leaders.

 

[Mark of Zorro]

I think it's a strange assumption to make in the model that people search for new contacts to maintain an existing number of contacts

I cannot prove it, but I doubt its just an assumption. I would bet there was some piece of research behind that, or yes indeed, it would be a very strange assumption.

 

[TGI-ECT]

I have to apologize for this, but you put a smile on my face and I just can't help myself.

. . . truncated before the quote . . . Old people have to die eventually. _ and after _

You see, I am still feeling guilty about my point made in another thread about using 'very' to modify 'often' and then I saw your words posted, Mark of Zorro, and the first thing that jumped into my brain was that non-old people do not have to die. I am officially declaring myself to be non-old and that will be a status I will work on maintaining forever and so I will be heading to that State of Florida where I think that Spanish explorer fella was looking for that special fountain because the secret is finally out what he was really looking for. And now I completely understand the reason for the name Mark of Zorro. I feel like that Columbo fella. Or Sherlock Holmes. Wisdom at last. With forever attached.

 

[Mark of Zorro]

Ancient people say I am middle aged, or even still young. I say I am old. I could die tomorrow of natural causes. It would only be a small surprise.

 

[Lothor]

I found this an interesting article, which argues that the real number of infected people is likely to be a lot higher than currently being reported because of the relatively limited amount of testing being done in Japan compared with other badly affected countries.

Limited virus testing in Japan masks true scale of infection

Japan is becoming a center of concern as the coronavirus spreads globally, with the country’s official infection tally suspected to be the tip of the iceberg of a much wider outbreak.

www.japantimes.co.jp

 

[Mark of Zorro]

the real number of infected people is likely to be a lot higher than currently being reported

And why in the world should all that money be spent to test people who have mild symptoms of.....something?

If this was the plague I would understand. But this is a bad cold. And just like any cold we will never know how many had it. Nor should we worry so much.

 

[Lothor]

And why in the world should all that money be spent to test people who have mild symptoms of.....something?

To help avoid the mass transmission of a virus that kills about 2% of the people it infects.

 

[SomeCallMeChris]

a virus that kills about 2% of the people it infects.

Dr. Fauci et. al's editorial is widely accepted in the medical community. It is not, of course, in and of itself a study but it is a commentary from experts in the field on how to understand the real implications of the raw data that we have.

"If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968)"

https://www.nejm.org/doi/full/10.1056/NEJMe2002387?query=recirc_curatedRelated_article

 

[TGI-ECT]

There has been something about the responses we have been seeing from the medical professionals that has been bugging me for about a week or so. Maybe longer, but other matters in life don't allow me to stay too focused on this particular area of human trouble.

I finally figured out the important question to help me inch toward understanding what might it be that is bugging me about what I see and hear and read from the Top Dog Docs. Has anyone read or heard any doctor explain whether our systems gain any advantage to being infected and then recovering?

I am no doctor, for sure. Just basic first aid taught when I was active duty and having to use some of that a few times. My reason for explaining that is because I do not know the right vocabulary to use. That business of I catch a bad something, but after I recover I am then safe from that something if it hits me again. An immune type thing, yes?

Well, has anyone heard any medical Top Dog explain about our systems becoming immune to this Covid-19? Or would that idea be completely absurd for this particular nasty bug?

Something else, folks; this thing has got to be a bigger worry for the medical folks, and the insurance companies behind them, than the common cold. There is just way too much Top Dog Doc focus on this particular bug for us to be able to pull up numbers for this and that and just compare it to the common cold. Something has the docs spooked. And that will mean the insurance companies, and it is there at that level of economics where we should pay attention. When the insurance companies get spooked people should pay attention. And they are definitely spooked.

 

[SomeCallMeChris]

Well, has anyone heard any medical Top Dog explain about our systems becoming immune to this Covid-19? Or would that idea be completely absurd for this particular nasty bug?

It has been mentioned in passing that people who have recovered are now immune. There's no reason for it not to work that way, it's just that to become immune that way you have to first be sick.

this thing has got to be a bigger worry for the medical folks, and the insurance companies behind them, than the common cold. There is just way too much Top Dog Doc focus on this particular bug for us to be able to pull up numbers for this and that and just compare it to the common cold. Something has the docs spooked.

It is as contagious as the common cold (it really isn't different from any other coronavirus in that respect) and at least as lethal as the ordinary flu. The ordinary flu is something we are used to, but is by no means a minor issue.

We don't really have hard numbers right now, but supposing COVID-19 infected twice as many people as a seasonal flu with twice the mortality rate, that's already a serious issue with 4 times the deaths of a normal flu season.

The point of the article was not that it's not serious; the point was that it's probably not whole orders of magnitude more serious than the flu and nowhere near as serious as SARS and MERS.

The financial impact of COVID-19 is still not really known, but various medical stocks are shooting up or down depending on whether people think they will get a financial benefit or financial harm from the virus. Markets in general are down dramatically anyway, but whether they are down enough to represent the actual financial impact of the virus is a matter of debate. In any case, it's not a secret that it will have a financial impact in general and on the business of medicine in particular, just a matter of debate as to what that impact will be.

 

[Mark of Zorro]

To help avoid the mass transmission of a virus that kills about 2% of the people it infects.

Please tell me your percentage threshold to start testing people with mild cold symptoms. Then perhaps we can start working on an estimate of how many diseases we have to start testing for and how much all this is going to cost us in terms of money, time and fear.

 

[Mark of Zorro]

Well, has anyone heard any medical Top Dog explain about our systems becoming immune to this Covid-19? Or would that idea be completely absurd for this particular nasty bug?

Development of antibodies does not make a person 100 percent immune. A handful of people getting re-infected is most likely because they have a poor immune system or some other special factor, like garbage for nutrition...or heavy exposure to people currently infected.

Hell, I don't even much trust medical science to even keep up with Covid-19 on the fly. I mean how much mutation is enough that they can detect before they start labeling it as a different strain? At what point do your antibodies no longer fight a new mutation? I cannot answer those questions. But I am sure the medical community will have plenty of 20/20 hindsight on the issue 5 years from now.

And please note, the press, that lying, self-righteous, money grubbing, attention seeking body ruled by rich leeches and peopled by muck-rakers, will take .001 percent and make it seem like 50 percent for the shock value, clicks and sales it will garner. If you are not reading a news article and perpetually asking yourself "what could they be exaggerating here?" then you will get lost.....and wind up lost in precisely the place they wanted you lost....and most people do.

 

[SomeCallMeChris]

I mean how much mutation is enough that they can detect before they start labeling it as a different strain? At what point do your antibodies no longer fight a new mutation?

This is actually all very heavily studied already. Remember that coronavirus is responsible for much of the common cold as well as SARS and MERS. It's true that it is very likely to mutate... it's hard to find articles right now because of the news cycle dominating the search results, but as I recall, it's roughly 2-4 years before a strain fades away. Part of that is herd immunity (enough people have become immune that the old strain has trouble propogating) and part of it is mutation rate. Mutations are constant in cold and flu viruses, which is a significant part of why we haven't just eliminated them like we did with smallpox. Also, of course - partly because of the mutation rate - there are a *lot* of strains out there.

Anyway, the COVID-19 virus will certainly mutate, but then it won't be the COVID-19 virus anymore - it will be another coronavirus (more accurately, many coronaviruses; every time the virus duplicates, in every infected person, everywhere in the world, there is a small chance of a mutation, some of which will result in viable new strains).
The new viruses may not cause pneumonia anymore. If one or more does, we'll have to deal with that then... but chances are good that any strain different enough to fool our immune systems has also mutated back into just being a cold.

Some of the difficulties in creating a vaccine for the virus are discussed here, as is the risk of mutation, but it doesn't directly address all the concerns we're discussing here.

Here’s why the WHO says a coronavirus vaccine is 18 months away

Researchers around the world are working together to control the coronavirus outbreak, now known as COVID-19. This is what’s behind the global effort to develop a vaccine.

theconversation.com

 

[TGI-ECT]

I must ask the management here if it might not be a good idea to have a special thread not for us to post in, but only for links to sites where we can trust that reasonably reliable information can be attained.

I indicate above "reasonably reliable" because I did include in some post a link to two NHK sites --- one in English and the other in Japanese.

The other link I posted was a government page, but at this time I feel an addition of two more sites can be of benefit:

Cabitnet Secretariat
内閣官房
新型コロナウイルス感染症の対応について｜内閣官房新型インフルエンザ等対策室

And I think we should start trying to go beyond the relatively few languages that most government websites allow for in non-Japanese language support to a site that covers a wider range of languages:

新型（しんがた）コロナウイルスについて＜やさしいにほんご＞About the New Coronavirus＜English＞

新型（しんがた）コロナウイルスの　日本語（にほんご）以外（いがい）の　言葉（こと...

www.clair.or.jp

 

[Mark of Zorro]

This is actually all very heavily studied already. Remember that coronavirus is responsible for much of the common cold as well as SARS and MERS. It's true that it is very likely to mutate... it's hard to find articles right now because of the news cycle dominating the search results, but as I recall, it's roughly 2-4 years before a strain fades away. Part of that is herd immunity (enough people have become immune that the old strain has trouble propogating) and part of it is mutation rate. Mutations are constant in cold and flu viruses, which is a significant part of why we haven't just eliminated them like we did with smallpox. Also, of course - partly because of the mutation rate - there are a *lot* of strains out there.

A bunch of claims that did NOTHING to address either of the questions of mine that were quoted. I ask "at what POINT?" and get "roughly 2-4 years". That's not a point. Very heavily studied "ACTUALLY"? Yet no clear answers available to my questions. I don't know, maybe you were TRYING to prove my point? Sounded like you were trying to contradict me.

I will say it once again....on the fly we are not going to get clear information on specific questions and points...such as when EXACTLY Covid-19 has new mutations, when EXACTLY its basically gone or dying out or when EXACTLY a new mutation will evade our antibodies. 5 years from now 20/20 hindsight will kick in and the medical community will tell us a whole bunch.

Anyway, the following should make it abundantly clear that virus mutation rates are as clear as mud and you cannot even narrow it down to "2 to 4 years". In fact, it faster. But of course the question is "At what point has it evolved enough to matter?". We won't get that answer on the fly I think.

Client Challenge

 

[Lothor]

It was on the news this morning that there are now two distinct strains of the virus - it has already mutated.

‘Striking’ coronavirus mutations found in one family, scientists say

More work needed to determine impact of genetic changes on patients, according to researchers.

www.scmp.com

 

[SomeCallMeChris]

I'm not trying to prove anybody's points, I'm just commenting when I think I can help keep the conversation grounded in fact. I was saying that coronaviruses in general are heavily studied, their mutation rates, means of transmission, etc, are all well understood by specialists in the field.

If you don't believe me, I suppose I can start citing random papers on SARS, MERS, and the common cold, but I can't believe that you genuinely don't believe those things have been heavily studied, or that you don't believe they are actually caused by coronaviruses so I'm not sure what the point would be.

specific questions and points...such as when EXACTLY Covid-19 has new mutations, when EXACTLY its basically gone or dying out or when EXACTLY a new mutation will evade our antibodies. 5 years from now 20/20 hindsight will kick in and the medical community will tell us a whole bunch.

These kinds of specifics of course will not be known until after the fact.

Obviously we cannot know when a mutation has formed a viable new strain until after it happens, it's a random, unpredictable act of nature. We can know the statistical chances of these things happening and the rough probable timetable, but we can't know what will happen. You also can't be sure that a virus has been eliminated until you've gone years without an incident (You can still never be 100% sure, but eventually you can be close enough for all intents.) We should, however, know with only a month or so delay what the new case rate looks like, once widespread testing is in place. Collecting, analyzing, and distributing the data will take time of course, but not 5 years. I'm sure there will be papers written studying events in 5 years and even further out, but it's not as if we will be entirely in the dark that whole time.

You seem to be angry at the complexity of nature or at the scientific method itself here, or both. These are difficult problems, and I'm sorry that human capacity to deal with them doesn't meet your approval.

 

[SomeCallMeChris]

there are now two distinct strains of the virus

I think the most important part of that article is this,

Qiu Haibo, a member of the national expert panel advising the government on the fight against the virus, said on Sunday that so far there was no evidence that mutations could cause "repeated infections".

If immunity to the mainline strain provides immunity to the mutation then it's not really a change in the threat level and a vaccine to one will probably work against the other. I'm glad they're keeping a close eye on it though, and that they are apparently sharing their findings openly.

 

[Mark of Zorro]

You seem to be angry at the complexity of nature or at the scientific method itself here, or both. These are difficult problems, and I'm sorry that human capacity to deal with them doesn't meet your approval.

No. I am angry about all the utter crap human responses, such as the hysteria and fear mongering, as if the world has never seen flu and cold viruses before.

These kinds of specifics of course will not be known until after the fact.

Much better. We are in agreement about something then.

Collecting, analyzing, and distributing the data will take time of course, but not 5 years.

Yeah, more like 2 years...but still the horse will have bolted and the closing of the barn door will be much too late.

 

[Lothor]

No. I am angry about all the utter crap human responses, such as the hysteria and fear mongering, as if the world has never seen flu and cold viruses before.

The WHO are taking the coronavirus extremely seriously - hysteria and fearmongering so that they can justify their salaries or an appropriate response by medical experts? The latter is more plausible.

 

[Mark of Zorro]

It was on the news this morning that there are now two distinct strains of the virus - it has already mutated.

Yeah...at least once. They cannot actually keep up with any of it. And they never could. But who panicked?

 

[Mark of Zorro]

The WHO are taking the coronavirus extremely seriously - hysteria and fearmongering so that they can justify their salaries or an appropriate response by medical experts? The latter is more plausible.

I don't know how you figured that the latter is more plausible. I suggest you don't know human "leaders" very well.

Also, you left out the desire to feel important regardless of the salary.

And you left out the idea that this is an ongoing experiment/preparation for an actual emergency.

Further I mentioned earlier a comment by Beau of the Fifth column about how a body guard will tell you the worst that can happen and prepare for the worst, never just giving you a straight up conversation about what is most likely. The WHO operates the same way....worst case scenario. They take EVERYTHING seriously whether its warranted in the layman's world or not. And the media just runs with it when they see fit. They are not giving a clear picture of the WHO in general, but only focusing on it now in this manufactured crisis.

 

[Mark of Zorro]

I guess I better be clear about "manufactured crisis". I suppose most people mean a fake crisis. I use it to mean a crisis that is now real, because it was manufactured. But I don't mean Covid 19 is the crisis. I mean the crisis is the human response, which has been manufactured...mostly unintentionally but also with a smattering of intention here and there.

I also mean that the direct effect of Covid 19 has been made worse by the reaction to it, esp. in China and on the Diamond Princess.

 

[Mark of Zorro]

My calculations using WHO numbers for Italy and Iran give the virus a 3.5 and 3.1 percent death rate respectively. That is dividing the known deaths from the virus by the known cases of the virus.

But you still have to keep mind:

1) Every time I see specifics about the dead (which is not often enough) they are almost always old and/or already sick.
2) We don't actually know how many have been infected. Those not showing signs and those will mild symptoms are not being tested.

I will also point out that the WHO worldometer site has given up doing death rate estimates, most likely for reason number two above. They put it at 2 percent earlier.

And I will repeat that I believe most of the dead are people who were already hospitalized or visited hospitals recently. Hospitals are incubators. But if that's true would they tell us that? No. I don't think they would. And that right there is why I have a problem with massive, poorly planned quarantines...that's just making an incubator too. That's how I see the PRC handling of Wuhan. It might have temporarily protected the rest of the country, but it made everything far worse in Wuhan. And for all that, now PRC is complaining other countries are infecting THEM back!

 

[Lothor]

I don't know how you figured that the latter is more plausible. I suggest you don't know human "leaders" very well.

Also, you left out the desire to feel important regardless of the salary.

And you left out the idea that this is an ongoing experiment/preparation for an actual emergency.

Further I mentioned earlier a comment by Beau of the Fifth column about how a body guard will tell you the worst that can happen and prepare for the worst, never just giving you a straight up conversation about what is most likely. The WHO operates the same way....worst case scenario. They take EVERYTHING seriously whether its warranted in the layman's world or not. And the media just runs with it when they see fit. They are not giving a clear picture of the WHO in general, but only focusing on it now in this manufactured crisis.

I think it's a rather dangerous trend to start dismissing the work of experts by claiming "they would say that, just look at human nature". That's exactly one of the arguments used by global-warming deniers, and has led to the rise of leaders such as Trump and Johnson who are completely out of their depth when it comes to understanding the complexity of issues. Indeed, why bother training and employing experts at all if we're going to dismiss them out of hand for having vested interests when they come to a different conclusion to a layperson?