Lunch at the Labs

Coronavirus, Covid-19

Various links related to the Coronavirus pandemic with some contrarian views. But note that what is known about Covid-19 is often uncertain so information can become outdated.

• COVID-19 Superspreader Events in 28 Countries: Critical Patterns and Lessons

  When do COVID-19 SSEs happen? Based on the list I've assembled, the short answer is: Wherever and whenever people are up in each other's faces, laughing, shouting, cheering, sobbing, singing, greeting, and praying. You don't have to be a 19th-century German bacteriologist or MIT expert in mucosalivary ballistics to understand what this tells us about the most likely mode of transmission.

  It's worth scanning all the myriad forms of common human activity that aren't represented among these listed SSEs: watching movies in a theater, being on a train or bus, attending theater, opera, or symphony (these latter activities may seem like rarified examples, but they are important once you take stock of all those wealthy infectees who got sick in March, and consider that New York City is a major COVID-19 hot spot). These are activities where people often find themselves surrounded by strangers in densely packed rooms-as with all those above-described SSEs-but, crucially, where attendees also are expected to sit still and talk in hushed tones.

  In a similar vein, The Subway is Probably not Why New York is a Disaster Zone.

• Swedish expert: why lockdowns are the wrong policy

  Video of interview with Professor Johan Giesecke epidemiologists, advisor to the Swedish Government.

  Summary:

  • UK policy on lockdown and other European countries are not evidence-based
  • The correct policy is to protect the old and the frail only
  • This will eventually lead to herd immunity as a "by-product"
  • The initial UK response, before the "180 degree U-turn", was better
  • The Imperial College paper was "not very good" and he has never seen an unpublished paper have so much policy impact
  • The paper was very much too pessimistic
  • Any such models are a dubious basis for public policy anyway
  • The flattening of the curve is due to the most vulnerable dying first as much as the lockdown
  • The results will eventually be similar for all countries
  • Covid-19 is a "mild disease" and similar to the flu, and it was the novelty of the disease that scared people.
  • The actual fatality rate of Covid-19 is the region of 0.1%
  • At least 50% of the population of both the UK and Sweden will be shown to have already had the disease when mass antibody testing becomes available
• "Living Days Stolen" ... A Smarter Way To Measure COVID-19 Deaths

  COVID-19's damage has been awful. But from a public policy perspective, it should be judged by the number of living days it has robbed from human beings, not by raw deaths tallied up without the context of demographics. Using the living days stolen scale is the only fair way to assess COVID-19's damage as policy makers and citizens begin the hard task of weighing the health and economic tradeoffs of COVID-19.

• Some doctors moving away from ventilators for virus patients

  But 80% or more of coronavirus patients placed on the machines in New York City have died, state and city officials say.
  ...
  But increasingly, physicians are trying other measures first. One is having patients lie in different positions - including on their stomachs - to allow different parts of the lung to aerate better. Another is giving patients more oxygen through nose tubes or other devices. Some doctors are experimenting with adding nitric oxide to the mix, to help improve blood flow and oxygen to the least damaged parts of the lungs.

  Also see New analysis recommends less reliance on ventilators to treat coronavirus patients.

• Influential Covid-19 model uses flawed methods and shouldn't guide U.S. policies, critics say

  The chief reason the IHME projections worry some experts, Etzioni said, is that "the fact that they overshot will be used to suggest that the government response prevented an even greater catastrophe, when in fact the predictions were shaky in the first place." IHME initially projected 38,000 to 162,000 U.S. deaths. The White House combined those estimates with others to warn of 100,000 to 240,000 potential deaths.

  That could produce misplaced confidence in the effectiveness of the social distancing policies, which in turn could produce complacency about what might be needed to keep the epidemic from blowing up again.
  Believing, for instance, that measures well short of what China imposed in and around Wuhan prevented a four-fold higher death toll could be disastrous.
  

  ... The death curves in cities outside the U.S. are assumed to describe the U.S., too, with no attempt to judge whether countermeasures -lockdowns and other social-distancing strategies - in the U.S. are and will be as effective as elsewhere, especially Wuhan.

  Also see related, After Repeated Failures, It's Time To Permanently Dump Epidemic Models.

• Conservative Pundits Weren't the Only Ones to Get the Pandemic Wrong

  Media figures on both sides of the aisle failed to appreciate the extent of the threat until it was too late. Liberals shouldn't pretend otherwise.

• Age is not the only risk for severe coronavirus disease

  Older people remain most at risk of dying as the new coronavirus continues its rampage around the globe, but they're far from the only ones vulnerable. One of many mysteries: Men seem to be faring worse than women.

  And as cases skyrocket in the U.S. and Europe, it's becoming more clear that how healthy you were before the pandemic began plays a key role in how you fare regardless of how old you are.

  The majority of people who get COVID-19 have mild or moderate symptoms. But "majority" doesn't mean "all," and that raises an important question: Who should worry most that they'll be among the seriously ill? While it will be months before scientists have enough data to say for sure who is most at risk and why, preliminary numbers from early cases around the world are starting to offer hints.

• The Science Behind Coronavirus Testing, and Where the U.S. Went Wrong

  The U.S. was completely unprepared for a public health emergency of this scale. South Korea revamped its emergency preparedness plans after the MERS outbreak of 2015, recognizing that early detection and isolation were effective to mitigate an outbreak, and putting resources and procedures into place which could be mobilized quickly.
  ...
  The CDC updates the number of tests performed at CDC and public health labs daily. Though the U.S. has now performed several hundred thousand tests, it still lags behind South Korea having tested six time less individuals per capita as of March 24th, despite having detected the virus on the same day.

• Coronavirus: The Hammer and the Dance

  As the title indicates, Pueyo and his collaborators are suggesting an approach that combines initial aggressive action followed by a longer period of efficient vigilance. First comes the Hammer - we use aggressive measures for weeks, giving our healthcare system time to ramp up & scientists time to research the hell out of this thing and for the world's testing capability to get up to speed.
  ...
  And then we Dance. If you hammer the coronavirus, within a few weeks you've controlled it and you're in much better shape to address it. Now comes the longer-term effort to keep this virus contained until there's a vaccine.