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5th Study: CFR Way Lower than Previously Reported

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Yet another study, this one out of Germany, confirms what was reported in Palo Alto, Los Angeles, Boston and New York. This one arrives at an infection rate of 15% (10X the previously thought number) and a CFR of .37%.

One wonders how orthomyxo will spin this (either “don’t believe it” or “it is what I have always been saying” is my guess).

Ipca Laboratories, the market leader for anti-malarial drug hydroxychloroquine in India, was one of only three top-20 drugmakers to post sales growth in April, when overall medicine sales slumped 11.2% year-on-year to ?10,211 crore, data from market research firm AIOCD-AWACS showed. The Mumbai-based drug-maker’s strong sales growth was likely on account of high demand for hydroxychloroquine, touted as a potential treatment for covid-19, even as all other segments witnessed a decline due to falling demand during the nationwide lockdown. High demand for hydroxychloroquine also reflected in an 11% jump in sales of anti-malarial drugs. However, sales at another hydroxychloroquine maker, Zydus Cadila, declined 11.6%. Almost all other segments, barring anti-diabetic and cardiac care drugs, showed a decline of up to 35%. Sales of anti-diabetic and cardiac care drugs were up 6% each on account of panic buying in the first half of the month. https://www.livemint.com/companies/news/hcq-maker-ipca-labs-biggest-gainer-in-april-despite-sales-slump-in-drug-industry-11588948371024.html rhampton7
As the virus began burning through southeast Michigan in March and April, the 14-hospital McLaren system added hydroxychloroquine to its treatment for COVID-19 patients, and a few doctors said there might be “some benefit in some patients,” said Dr. Dennis Cunningham, medical director of infection control at McLaren Health Care. But by this week? “I have to say that doctors are moving away from using it. It’s just not effective,” he said Wednesday. At Detroit Medical Center, Dr. Teena Chopra said doctors believe the drug may be helping keep some COVID inpatients off ventilators. “We haven't seen any harm,” said Chopra, who oversees DMC’s infection prevention efforts. “And we've been able to take patients, use this [drug] and delayed the need for ventilation in some category of our patients.” Beaumont Health doctors, like those at Ascension healthcare system, have been less impressed. “I don't think [it] is hurting anything, but we don't feel that it's been helpful,” said Heidi Pillen, director of pharmacy for medication use policy at Beaumont. Michigan Medicine also has stopped using hydroxychloroquine to treat COVID, unless the patient is enrolled in a clinical trial. That’s because of side effects ranging from vomiting to heart and liver problems, said Dr. Vineet Chopra, Michigan Medicine’s Chief of Hospital Medicine. https://amp.freep.com/amp/3093146001 rhampton7
Hydroxychloroquine Market to Reach USD 2.3 Billion by 2027; Driven by the Increasing Number of Covid-19 Cases, says Fortune Business Insights™ Key Companies Covered in the Hydroxychloroquine Market Research Report are Sanofi, Zydus Cadia, Ipca Laboratories Ltd, Sandoz International GmbH, Mylan N.V., Teva Pharmaceutical Industries Ltd, Bayer AG and other key market players. https://www.globenewswire.com/news-release/2020/05/04/2026540/0/en/Hydroxychloroquine-Market-to-Reach-USD-2-339-1-Million-by-2027-Driven-by-the-Increasing-Number-of-Covid-19-Cases-says-Fortune-Business-Insights.html rhampton7
India accounts for 70 percent of global production of hydroxychloroquine, which is also used to treat lupus and rheumatoid arthritis. To meet the growing demand, Ipca Laboratories, one of four key makers of hydroxychloroquine, is increasing output by a third to 130 million tablets a month in May -- despite having only 40 percent of its 18,000 workers on deck. Zydus Cadila, another major producer, said it would boost production tenfold to about 150 million tablets a month in May. India exports about $20 billion of pharmaceuticals a year and increased production of hydroxychloroquine has come at the cost of making other drugs commonly used to combat diseases ranging from tuberculosis to cancer. https://news.yahoo.com/india-boosts-output-anti-malarial-drug-hyped-trump-023032411.html rhampton7
From the week ending April 17 to the week ending April 24, demand for hydroxychloroquine plunged 62% among hospitals placing orders for the decades-old malaria drug. The number of tablets sought fell to 198,500 from 462,850 during that stretch, according to Vizient, a group purchasing organization that negotiates contracts for medicines on behalf of about 3,000 hospitals and health care facilities in the U.S. At the same time, supplies appear to be stabilizing, most likely due to donations from several large manufacturers — including Bayer, Teva Pharmaceutical and Novartis — that agreed to provide millions of tablets to the U.S. Strategic National Stockpile after the Food and Drug Administration issued an emergency use authorization for hospitals. Lupus and rheumatoid arthritis patients have become collateral damage. For weeks, many were unable to obtain their usual prescriptions, causing concerns about their health. Some also were alarmed after hearing a drumbeat of warnings about side effects risks, according to Kenneth Farber, president of Lupus Research Alliance, an advocacy group that is sponsoring an observational study to assess the incidence of Covid-19 among lupus patients who are already taking hydroxychloroquine for their condition. Over the past several days, however, he indicated that the shortage has abated most everywhere and lupus patients say they are finding it easier to obtain hydroxychloroquine. He attributed the change to increased production and reservations among some physicians to increasingly prescribe the tablet for Covid-19. But he worries hoarding may return if studies indicate the drug is useful for the coronavirus. https://www.statnews.com/pharmalot/2020/04/28/covid19-coronavirus-hydroxycholoroquine-lupus-trump/ rhampton7
I think what’s happened is there’s been a lot of promotion of this drug as a cure-all by politicians and by the media. And, parenthetically, at the same time there’s been a lot of unnecessary vilification of the drugs,” Gellad says. “The reality is, there’s a ton of uncertainty … My guess is the FDA wanted to pull back on the idea that the government was promoting the use of this drug, not pushing this therapy but being very responsible, using it in clinical trials.” The FDA wanted to remind primary care physicians that while they were allowed to prescribe these drugs off-label, they had real side effects—and that some people who don’t have Covid-19 infections really need them for other reasons. “ Yet the fights over hydroxychloroquine continue, on the internet and in real life. If the drug works, some partisans argue, it’s wrong to delay its widespread use by waiting for results; if it doesn’t, it’s wrong to even try it on people. “The social media perspective is: About half of people think it’s an unethical trial because it clearly works, and the other half thinks it's clearly dangerous and we shouldn’t do it,” Boulware says. “We’re just trying to get the answer. Having a solid study design and having the actual answer is really important for both the country and the world, and that’s our goal.” Meanwhile, though, it’s important to remember that nobody actually knows that answer. The Silicon Valley adherents insisting that the problem with the negative results thus far is that researchers tested the wrong kind of people, or used the wrong dose, or didn’t use zinc—they don’t have the data that can say whether any of that is true. The people saying that hydroxychloroquine is clearly unsafe, or that it can’t possibly work? They don’t have that data, either. Nobody does. The studies aren’t finished. “It’s going to be May 1, and we still don’t know if it works. It’s a giant failure,” Gellad says. “We should have had an answer. All you need is a randomized controlled placebo trial with 1,000 patients, and we’d know.” https://www.wired.com/story/the-info-war-over-chloroquine-has-slowed-covid-19-science/ Published in late April rhampton7
Rhampton7 @46 Conspiracy theory - a prediction: If the underlying political and financial motivations to "debunk" HCQ and AZT treatment are strong enough, then the study protocol will conveniently make sure that the conditions cause failure of the therapy. Such as, waiting too long in the course of the disease before treatment, unnecessarily and harmfully using intubation, and/or maybe using a wrong dosage. We'll see. doubter
Maybe New York doctors should talk to doctors in Houston who are having success with a treatment that includes HCQ. https://bit.ly/2SKgJcY
“I was really looking for a study that showed that people who were treated with it were less likely to get intubated,” said Dr. Luke O’Donnell, attending physician at NYU Langone. “And I think more and more data is showing that there is minimal to no difference.”
Did the New York study show severity and when the drug was administered? jerry
The study, published in the leading cancer journal Annals of Oncology, suggests that androgen-deprivation therapies (ADT) may protect men from Covid-19 infection. The researchers found that out of 4,532 men infected with Covid-19, 9.5 per cent (430) had cancer and 2.6 per cent (118) had prostate cancer. Male cancer patients had a nearly twofold higher risk of Covid-19 infection out of the whole male population, and developed more severe disease. However, when they looked at all prostate cancer patients, they found that only four out of 5,273 men on ADT developed Covid-19 infection and none of them died. This compared to 37,161 men with prostate cancer who were not receiving ADT, of whom 114 developed Covid-19 and 18 died. Among 79,661 patients with other types of cancer, 312 developed Covid-19 and 57 died. rhampton7
So NYC is not using zinc in conjunction with HCQ. What is wrong with these alleged medical professionals? ET
Today, researchers at The Lundquist Institute began a randomized, double-blind, placebo-controlled clinical trial designed to find out whether hydroxychloroquine and azithromycin reduce hospitalization and/or death in individuals suffering from COVID-19, the disease caused by the novel coronavirus, SARS-CoV-2. This trial, sponsored by the National Institutes for Health, will include 2,000 adults with symptomatic SARS-CoV-2 infections. Under the direction of Dr. Eric Daar, The Lundquist Institute will be one of 25 to 30 sites nationwide, each looking to enroll about 100 patients over the next six weeks. During the trial, patients will receive seven days of treatment with drugs or placebo, with a follow-up appointment at 20 days. A randomized selection of participants will receive oral doses of hydroxychloroquine or placebo twice daily for seven days, as well as a daily dose of azithromycin or placebo for five days. This combination of medications has been used to treat a few COVID-19 patients and is advocated by some in the medical and political communities, but its efficacy, as well as its safety, is unproven at this point, which is why this trial is required. The initial endpoint of the study would be to evaluate the levels of hospitalization and/or death within 20 days following enrollment in the study. https://finance.yahoo.com/news/nih-sponsored-covid-19-clinical-140000628.html rhampton7
Hospitals in NYC Have Abandoned Hydroxychloroquine “We know now it probably doesn’t help much," said Dr. Thomas McGinn, Deputy Physician-In-Chief at Northwell Health. "We’re not recommending it as a baseline therapy anymore. It is only in a treatment protocol in a study that we’re recommending it." “As of last week, we stopped using hydroxychloroquine as a routine medication in our hospital based upon the cumulative experience in our hands and in others, and recommendations by the FDA that it should not be used outside of clinical trials,” said Dr. Charles Powell, chief of the Division of Pulmonary, Critical Care and Sleep Medicine at the Mount Sinai Health System and CEO of the Mount Sinai-National Jewish Health Respiratory Institute. “I was really looking for a study that showed that people who were treated with it were less likely to get intubated,” said Dr. Luke O’Donnell, attending physician at NYU Langone. “And I think more and more data is showing that there is minimal to no difference.” https://www.ny1.com/nyc/all-boroughs/news/2020/05/07/hospitals-in-nyc-abandon-hydroxychloroquine-treatment-touted-by-trump- rhampton7
No, I don’t agree. Why would anyone try to be so confusing?
Because it is not confusing and it communicates. A disinfectant is preventing infection or rendering something from creating an infection. That is essentially what a disinfectant does. There may be other methods of preventing something from creating an infection than by killing it. jerry
If someone made a spray that prevented germs from being infectious even if it didn’t kill them I bet they would say it is like a disinfectant. Such a spray would prevent infection or dis-infect. Don’t you agree?
No, I don't agree. Why would anyone try to be so confusing? Bob O'H
No, Jerry. It’s nothing like a disinfectant, and if you read the title of the article, you’d realise that it doesn’t kill the virus
Oh. I read it and knew exactly how it works. Couldn’t help being a little sarcastic though with a somewhat gratuitous comment. If someone made a spray that prevented germs from being infectious even if it didn’t kill them I bet they would say it is like a disinfectant. Such a spray would prevent infection or dis-infect. Don’t you agree? Let’s just say it’s a pro-life disinfectant. By the way I describe the effect of zinc is like birth control till the killers arrive from the immune system to finish the job. jerry
No, Jerry. It's nothing like a disinfectant, and if you read the title of the article, you'd realise that it doesn't kill the virus - it blocks infection (so it acts more like a contraceptive than a poison). Bob O'H
Jerry, let's hope! KF kairosfocus
RH7, many diseases take damaging effect by throwing the immune system out of kilter. In the case of Covid-19, cytokine storm is an all too familiar outcome that is a killer. BTW, things as familiar as asthma or hay fever or allergic shock or auto-immune diseases are similar. The go out of control happens as things reach a point where there is in effect an out of control reaction. So, damping down that over-reaction is in fact a feature not a bug, just as inhalers etc bring allergic reactions under control. Other plausible mechanisms for HCQ cocktails include providing open gateways for Zn to enter the cell, suppressing viral replication. Of course, that is suppressing cell systems also. That, again is a feature: drugs are poisons in small doses. The immune reaction, under control, is defending the body from potentially destructive invaders but if it goes out of control it can have damaging or deadly effects. KF kairosfocus
A new way to attack the virus. https://www.nature.com/articles/s41467-020-16256-y
The emergence of the novel human coronavirus SARS-CoV-2 in Wuhan, China has caused a worldwide epidemic of respiratory disease (COVID-19). Vaccines and targeted therapeutics for treatment of this disease are currently lacking. Here we report a human monoclonal antibody that neutralizes SARS-CoV-2 (and SARS-CoV) in cell culture. This cross-neutralizing antibody targets a communal epitope on these viruses and may offer potential for prevention and treatment of COVID-19.
Antibodies like this can be made in the lab instead of purified from people’s blood and could conceivably be used as a treatment for disease, but this has not yet been demonstrated.
Maybe it is like a disinfectant that kills the virus but you put it into the body either linterveneously or by a pill or liquid. jerry
Increasing number of cases is not alarming in itself. Increasing number of cases not treated is what is alarming. The sad thing is we have the ability to treat every case with a potential cure but for political reasons we don’t do it. So the fact that certain states are increasing in number of cases is not worrisome but that they will not be treated is the real travesty of this virus. Some states political leaders have made the insane conclusion that because the number of cases is diminishing that the lockdown should continue since it is obviously working. jerry
In addition to keeping an eye on the tragic, and climbing, numbers of total coronavirus cases and deaths across the U.S., it's important to watch how those trends are playing out over time at the state level. Our chart compares each state's seven-day average of new cases from Monday and the seven-day average from a week prior, April 27. Comparing the averages of two dates helps smooth out a lot of the noise in how states sometimes inconsistently conduct and report tests. By this metric, Minnesota, Nebraska and Puerto Rico have the most worrisome trends, while Arkansas and Wyoming have the most positive trends. Twelve states are moving in the right direction. But more than a third of the nation still has growing numbers of cases. And that includes states such as Texas and Virginia, where Republican and Democratic governors are beginning to unveil re-opening plans. https://www.axios.com/coronavirus-caseloads-states-b24899a3-286e-4ea9-bd71-0e88ed645e68.html rhampton7
Some day RHampton will start reporting optimistic reports and not just doom and gloom. What about all those reports of people recovering and the lack of any side effects? Why does the CDC recommend HCQ as a prophylactic if it affects the immune system negatively? Are we to ignore a solution that may save a million because a couple thousand may not be saved? Why hasn't the NR writer heard about Zelenko? And if he has why wasn't he mentioned? jerry
The potential for serious arrhythmias from hydroxychloroquine treatment of COVID-19 patients received further documentation from a pair of studies released on May 1, casting further doubt on whether the uncertain benefit from this or related drugs to infected patients is worth the clear risks the agents pose. A report from 90 confirmed COVID-19 patients treated with hydroxychloroquine at one Boston hospital during March–April 2020 identified a significantly prolonged, corrected QT (QTc) interval of at least 500 msec in 18 patients (20%), which included 10 patients whose QTc rose by at least 60 msec above baseline, and a total of 21 patients (23%) having a notable prolongation (JAMA Cardiol. 2020 May 4. doi: 10.1001/jamacardio.2020.1834). This series included one patient who developed torsades de pointes following treatment with hydroxychloroquine and azithromycin, "which to our knowledge has yet to be reported elsewhere in the literature," the report said. https://www.medscape.com/viewarticle/929973 rhampton7
Chloroquine and hydroxychloroquine actually slow down parts of a patient’s immune system by “interfere with lysosomal activity and autophagy, interact with membrane stability and alter signalling pathways and transcriptional activity, which can result in inhibition of cytokine production and modulation of certain co-stimulatory molecules” — which is a jargon-heavy way of saying it makes your immune system’s cells not work as well together. People might wonder why anyone would want to take a drug that weakens their immune system. The coronavirus identified as SARS-CoV-2 can generate a “cytokine storm” — when the body’s immune system kicks into overdrive and starts attacking healthy cells in important organs. Dr. Randy Cron, an expert on cytokine storms at the University of Alabama at Birmingham, told the New York Times last month that in about 15 percent of coronavirus patients, the body’s defense mechanism of cytokines fight off the invading virus, but then attack multiple organs including the lungs and liver, and may eventually lead to death. As the patient’s body fights its own lungs, fluid gets into the lungs, and the patient dies of acute respiratory distress syndrome. From this, you can get a sense of how and why hydroxychloroquine might be effective in some circumstances and not others. It’s also easy to see why we would only want people taking this drug under a doctor’s recommendation and possibly supervision — take the drug too early, and you suppress the body’s immune system just when it needs that system functioning well to fight off the invading virus. Take the drug too late, and the damage to the vital organs can’t be overcome. https://www.nationalreview.com/the-morning-jolt/why-hydroxychloroquine-works-for-some-coronavirus-patients-but-not-others/ rhampton7
With effective treatment the death rate is .03% or a normal flu season. Compare nursing home in Texas with other nursing homes that became infected. This will indicate more accurate rate. So elderly do not have to be sacrificed or quarantined. See https://bit.ly/2A523i5 It is the callousness of the press and politicians that are causing people to die unnecessarily. Look at these death curves and know that in late March, the cure was known but mocked (see link just above and follow other links). What would the curve look like it there had been widespread implementation of the treatment. See https://bit.ly/2Wa9f59 for liberals criticizing liberals on anti Trump bias. Maybe they do not want to die in a good cause? I doubt anyone does but that does not prevent the incredibly cynical rhetoric. jerry
Bob O'H,
It looks like it’s been smoothed, so they’ve removed the noisiness.
Yes, I just meant that the curve has almost no concavity from mid-March onward. I don't know how it was smoothed, but I would guess that significant concavity would not be all but erased by this process. daveS
BO'H: the linearity shows up at global levels too, see OWID on deaths https://ourworldindata.org/grapher/total-daily-covid-deaths and I don't think that is particularly smoothed other than by the fat lines stuff. The OWID global total cases with regional banding is effectively linear at both levels https://ourworldindata.org/grapher/total-covid-cases-region On dynamics of curves, there is a plateau in daily cases and deaths, pointing to an underlying bell-like impulse that is a cumulative impact of onward driving factors. The question is, what is creating that plateau in daily cases and deaths. I would not expect a point of inflexion to be prolonged in a strange equipoise. Obviously, there is not a running down of further vulnerable population to induce the usual type of saturation but something is restraining exponential explosive growth and as numbers of the active infected rise it has to have a stronger and stronger constraining effect to keep growth down to linear. Candidates? E.g. could part of it be northern summer coming with more actinic radiation and formation of vitamin D? Is it a linear growth in testing capability so the proxy confirmed cases is masking the actual incidence pattern? Or, what? KF kairosfocus
A simple graph from Bloomberg. I’d have a hard time drawing it any straighter with a ruler.
It looks like it's been smoothed, so they've removed the noisiness. Bob O'H
DS, per OWID US, Canada, UK have plateaus, Germany and Spain show turnover humps. Maybe, we should be asking, what is saturating -- flattening! -- rate curves, pointing to another level of driving impulse that creates its own sigmoid. Then, what can drive it down. KF kairosfocus
DS, it's not just the US but the global, too. At least I see a welcome bit of wobble. A steady net driving force at a plateau just does not sit right. That is tempting me to think cases per day is the v result of accumulation of a bell like impulse leading to a plateau, but what could that be that surges and falls to effectively nil and then leaves a steady daily number of cases in its wake apart from noise. Like, saturation postponed. KF kairosfocus
In a major testing effort led by UC San Francisco in the Mission District, 2.1% of the 4,160 people tested for COVID-19 were positive. Of those who tested positive, 90% have been leaving their homes for work. Ninety-five percent of positive individuals were of Latinx heritage. From April 25 to 28, free, voluntary COVID-19 testing was offered to every resident in a 16-block area running from Cesar Chavez to 23rd Street and South Van Ness to Harrison Street. This is the second most dense area of the city and a little over half of the residents living here were tested. Researchers conducted two types of tests to identify those individuals who are currently infected and those who previously had the virus. The diagnostic test for active COVID-19 was implemented by collecting samples with nasal swabs while the antibody test was done with a finger-prick to collect a blood sample. Results were available within 72 hours. https://www.sfgate.com/news/editorspicks/article/90-of-people-who-tested-positive-for-COVID-19-in-15247476.php rhampton7
PaV @23 " This also means that NO vaccine will be necessary." Throwing the elderly under the bus. So they must be eminently expendable in your view. doubter
PaV, What percentage do you believe have already been infected? These studies are saying about 20% in NYC, and up to ~4% in Silicon Valley. daveS
Somewhere along the line, based on the data from the Diamond Princess cruise ship, I calculated a preliminary CFR of around 0.33%. How about that? I believe that there is a good chance that the final CFR will be below even the 0.1% of flu viruses. Why would I say that? Because there's tons of asymptomatic cases. Actually, we may never catch up with them. Here's the real problem of SARS-CoV2: it's not that it's "highly contagious," it's that it's NOT "contagious" enough! What do I mean? We've seen SARS viruses before. They are "deadly"! When you get them, you die. Ergo, you're so sick that you wind up "isolated" in an ICU ward. Ergo, you CAN'T infect anybody else. And, therefore, the virus can't spread. This SARS virus is not nearly as deadly, but very, very nasty. (Although it appears that if a proper treatment protocol is used, the death rate is substantically lowered: i.e., HCQ + Z-pak + Zn, among other indications and possible regimens) Yet, a very large portion of people simply do not get sick from it, or, if they do get sick, they show no symptoms. That is, they feel a little "under the weather," and not much more. So, they go to work, they go to hockey games and basketball games, and they live a normal life, yet, the whole time they are infecting people whose immune systems are not so robust as theirs to this viscious virus. So, it spreads everywhere. But, again, not because it's so highly contagious, but simply because there are so many asymptomatics spreading it. Here's the flip side to this "spread": if there are so many asymptomatics, this means that loads of people have already been exposed to this virus--much more than we now know. If this is the correct view, then, contra the "illustrious" Dr. Fauci (il carotto), there will likely be but a minor spike come November. This also means that NO vaccine will be necessary. What a shame! How much money could have been made by some Big Farma company with the patent! PaV
A simple graph from Bloomberg. I'd have a hard time drawing it any straighter with a ruler. daveS
DS, I hear you but such should be far more noisy, I don't know if our snapshots are too coarse to catch that. Of course a v slow curve can look linear. y = kx +c just does not look right to me, with the balance of forces. KF kairosfocus
KF, I'm noticing cases where the virus seems to finally be arriving in rural areas and spreading quickly, even as more densely populated areas are well past their peaks. This lag in peaks perhaps could also account for the current quasi-linear growth. daveS
The carefully unmentioned elephant in the room is the CFR confirmed fatality rate calculated for one specific age group: over 80 years old. This appears to be alarmingly high, about 20% with standard treatment protocol (without hydrochloroquine and using standard ventilator intubation). In this age group, with multiple preexisting conditions, IFR will not be as drastically lower than CFR as it is with the younger age groups. So COVID-19 is proving to be a true grim reaper culling agent of decimation for the elderly. COVID-19 can be dismissed as a catastrophic grim reaper pandemic only by ignoring the elderly. doubter
DS, linear is exactly what we should not be seeing. Dragging a point of inflexion along suggests a decline in onward cases per case in some balance with number of cases. But there the plateau in fresh cases is. I am wondering if changes in testing and ways deaths are attributed means that we are gradually transforming mangoes into guavas? In which case, we are back to the noisy proxy problem. KF kairosfocus
KF, The curves for total cases and total deaths are remarkably linear aren't they? According to worldometers, we'll be hitting 70,000 total deaths in the US very soon, with about 60,000 of those deaths in the last month. daveS
Ortho, I am highly confident that we lack adequate tracking data, we only have crude, noisy proxies. Debating matches between idealised models and dirty proxies is almost pointless. KF kairosfocus
Vivid, All you can do is carefully consider the assumptions of each model and then track both the outcomes and stats associated with those assumptions (like mobility data and current infection rates) to see how well they perform and if disagreement between model and reality of due to assumptions or model failure. It's not possible to predict what will happen without assumptions about the virus and, more importantly, the response to it, so I wish more of these models would include runs of the modern under specific scenarios. Would help both with to compare interventions and to test strength of models. orthomyxo
Vivid, while spiky, the OWID wave of deaths peaked at over 10 k/day and is now heading down, at 3500 today. I am seeing a cluster of countries that have flat lined at low levels. This includes Bahrain, an early adopter of the HCQ cocktail. A significant number of countries have gone down to 1 - 10 cases/day, suggesting we are better at saving lives. The US plateau and global linear growth trends are of concern to me. KF kairosfocus
Ortho I am on record of not being a fan of models however we now have two more predictions by IHME and John Hopkins. The IHME says that we will see 900 deaths per day peaking in August and JH predicts 3000 per day. So we have two models on record going forward how would one go about judging these models if they are wrong going forward without appealing to ad hoc explanations? Vivid vividbleau
Bufallo, You may want to read the giant blue information box at that website. And the text underneath it. And the footnotes to the tables. And the detailed explanation at the bottom of the page. orthomyxo
As I said above, working through a calculation and focusing on the assumptions does move the conversation to more productive areas. The issue is now how many people will be infected, so I'll lay out the logic to get to 65% more carefully. The number is not arbitrary, So called "herd immunity" occurs when the susceptible proportion of a population is the inverse of the reproductive number (R zero). A pretty conservative estimate of R for this virus is 2.2 (it was obviously much higher than this in NYC) . Given that, you'll need the susceptible proportion to be 1/2.2 = 45% of the population (or 55% infected). But herd immunity doesn't stop the virus in its tracks, people infected with the virus will still pass it on (albeit to fewer than one person on average) so you'll "overshoot" the herd immunity threshold. I made a very conservative estimate of 10% overshoot to come up with 65%. So, why can we be sure that less than 65% of the population will become infected? orthomyxo
hmmmmm. United States5 37,308 CDC Covid deaths as of May 1 https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm?fbclid=IwAR0wfA4zAAtfKDpq6BwMN0I5XP7VR21rzO_q2kc5ZNPMVka2u3OywD9LJB8 buffalo
Do you think the epidemic has ended in New York? Did you forget the lockdown enacted there? orthomyxo
I”d like to know why we can be sure something will stop the virus from infecting ~65% of the population.
How about hard data instead of an arbitrary number you pulled out of your ass? NY is the hardest hit, by far, of all US states. According to New York Governor Andrew Cuomo, they "have undertaken the largest, most comprehensive study of New York state to find out what is the infection rate." Certainly Cuomo has no interest in understating the infection rate. The results of the survey varied by area, with the most densely populated zones hit the hardest. The survey showed an overall infection rate in the state of 13.9%. Yeah, that's right folks. Ortho helped himself to an infection rate 4.7X the rate of the hardest hit state in the union and projected that onto the country as a while, including Wyoming and Alaska. We should not be surprised. Yesterday he helped himself to death projections that were 2.4X the upper-bound of the most wildly pessimistic models in his comments to another post. Summary: Ortho is good at telling lies, scaremongering and pulling scary but random numbers out of his ass. So, dear readers, you can believe him if you want to. But I don't know why you would. Barry Arrington
Of course, but makign the estimates this way allows you to talk about the assumptions instead of just throwing your hands up and declaring the result a lie or scaremongering. In this case, Barry thinks only a faer-mongering internet troll (https://uncommondesc.wpengine.com/medicine/what-are-total-deaths-telling-us/#comment-700675) could think ~600,000 might die from this disease in the US. The next day, he parades an estimate of the IFR as being good news, despite the fact it would predict considerably more deaths than the fear-mongering number I implied was possible. Barry claims this is "wrong" without giving a reason. If he thinks this IFR is reasonable (why else be so excited by it?) we are only left with the total number of cases absent suppression as the wrong assumption. If that's the case then I"d like to know why we can be sure something will stop the virus from infecting ~65% of the population. orthomyxo
Orthomyxo: But for now, let’s take it as true. If 65% of the US catch the virus, and the IFR is .004 how many will die? About 850,000. That's IF your assumptions are correct. That's the trouble with models; you base them on assumptions depending on what data you have. The Spanish flu pandemic of 1918-19 has been estimated to have infected about 500 million people, one-third of the world population at the time. The death toll has been estimated to have been between 17 and 50 million people. IF the death toll was 30 million and the world population was 1.5 billon then that's 2% of the world population. Let's hope we aren't even close to that this time around. It's going to take some time for COVID-19 to get to its maximum spread so it's going to take some time to get some good solid numbers. JVL
If 65% of the US catch the virus, and the IFR is .004 how many will die?
Yes, we can all do math. Just like the guys at Imperial who ran the numbers and predicted 2 million deaths. They were wildly wrong. You are wildly wrong. Barry Arrington
OK so just under 1 million in the USA. We can whittle that down by following the guidelines in EVMS CRITICAL CARE COVID-19 MANAGEMENT PROTOCOL, and sequestering the weak. ET
Texas nursing home 88 of 89 recover - https://bit.ly/2KXk7wz Guess what they used? The treatment recommended by Zelenko. Dr. Todaro estimates .03 percent will die if this treatment is used early and often. That is a incredibly low CFR So current no treatment CFR's are much higher than necessary. Who is getting in way of using treatment? 330 million times .0003 is a lot of people, about 90 thousand. A lot less than currently are dying though. As of today it wa 70,000 with the current estimate of 10-15% infected. Most of whom could have been saved. That is about 500-700 thousand with no treatment jerry
sigh. Probably a small blip of people amongst all the other diseases that are killing everybody all over the world https://www.worldometers.info/ Looking at NYC numbers and comparing them to everyone else all over the globe causes me to greatly question their methods AaronS1978
0.4% is a little lower than I would have guessed, given the NYC data. I will have to look at the design, statistics and age structure. But for now, let's take it as true. If 65% of the US catch the virus, and the IFR is .004 how many will die? orthomyxo

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