Covid-19 News

Quote from Shane D.

This new Washington Post article puts it into perspective:

Yes, let up put things in perspective. Good idea. Imagine the situation is reversed. Adults seldom seldom get seriously ill, but 20% of patients under 18 die. No one would say: "Let the adults go back to work. Let them crowd in hallways without mask. There is practically no chance they will get seriously ill or die. Only about 100 people over 18 have died. So what if 200,000 children are dead?"

Those Georgia high school kids crowded into hallways without masks may not have been risking their own lives, but they were risking the lives of their teachers, parents and grandparents.

Quote from JedRothwell

Yes, let up put things in perspective. Good idea. Imagine the situation is reversed. Adults seldom seldom get seriously ill, but 20% of patients under 18 die. No one would say: "Let the adults go back to work. Let them crowd in hallways without mask. There is practically no chance they will get seriously ill or die. Only about 100 people over 18 have died. So what if 200,000 children are dead?"

Those Georgia high school kids crowded into hallways without masks may not have been risking their own lives, but they were risking the lives of their teachers, parents and grandparents.

Don’t the teachers not wear masks, social distance, wash their hands etc?

Quote from Roseland67

Don’t the teachers not wear masks, social distance, wash their hands etc?

If many people in the room are infected, these steps are not enough. You have to wear full medical PPE. Even that is dangerous, as you see from the numbers of doctors and nurses who have been infected. If the students are not wearing masks, and they are crowded, it is certain many will soon be infected.

Quote from Shane D.

These kids are either back in school now, or will be soon. Do you really think it is practical to expect them to wear a mask, and social distance all day long...in classrooms, hallways, cafeterias?

Yes, it is practical, and it is essential. Students in Japan, Italy and elsewhere all wear masks. Without them, another 150,000 people are likely to die before the end of the year. As many as died in WWI. If this was 1917, and we could magically save all those lives by wearing masks, do you think anyone would object?

Quote from Shane D.

And if so, how long do you think this can go on?

Until a vaccine is deployed. Or, until 1 or 2 million people die and we reach herd immunity.

Quote from Shane D.

IMO, we can pretend these rules will be largely obeyed by rambunctious students, full of energy and raging hormones, or we can be practical,

Do you think that kids in Japan and Italy are not rambunctious, full of energy and raging hormones? I went to school in Japan. I assure they are.

American 18-year-old kids in 1918 and 1941 went off to fight the Germans. That was far more difficult than wearing a mask. Infinitely more difficult. But they did it, because they had to, and because they were patriotic and they loved their country. They did it to save the adults and smaller children. You should not doubt for one second that today's generation of high school kids would also risk their lives if they were called upon to do so. Asking them to wear masks is trivial in comparison.

When hundreds of thousands of lives are at stake, people will act with discipline. They will sacrifice. Teen-age kids will, as readily as anyone else. You need to call upon them to do it. Tell them -- truthfully -- that this is the challenge of their generation. This is their chance to save lives. If they fail, and kill off their parents and grandparents, they will regret it for the rest of their lives.

An article in the Lancet and a CDC study shows that about 10% of the U.S. population has been infected with COVID-19. See:

https://www.nytimes.com/2020/0…ld/covid-coronavirus.html

So, to reach 70% herd immunity, roughly 7 * 200,000 people will die. 1.4 million. Fewer, if effective therapies are deployed.

The official stats show roughly 2% of people have been infected:

https://www.worldometers.info/coronavirus/#countries

7*200,000

Not that many. Care has improved (don't ventilate glassy lungs), and more attention is being paid to elder care situations (though half the deaths in my county were in one skilled nursing home).

On the other hand, total infections are 5-10? Times tested numbers.

Wonderful interview

Rep Louie Gohmert .. Socrates.. he gave lots of good advice .. but they made him drink poison.

But the USA is not Athenian Greece or Novichokracy

The greatness of USA is in its diversity.. not in its conformity .

TM28:55

Dr Smith, When doctors /administrators were threatening you what was their basis for threatening you ?

1.The first rationale was that they're going to run out of HCQ

and actually that led to the CMO hanging up on me when i said i don't believe you

2.then they said well you're going to kill people

they said well it's unsafe they said that's going to change EKG's

and i said well it hasn't yet ...ask dave dillabesh

and when i dropped his name because they respect Dave.. they know who Dave is

so they backed off but i knew my neck was out there and it was very scary

to be working as hard as i was working and trying to save patients

and also realizing that if anything untoward happened to my patients

that was unexpected that they were going to come after me

3.they did ask me to show up for a meeting with the CMO

and the CMO and said there was a patient complaint

they want to talk to me about some you know whatever something else i said

well i don't have any patient complaint please send it to me

i'm still waiting that was two or three months ago!!!!!

Quote from Alan Fletcher

7*200,000

Not that many. Care has improved (don't ventilate glassy lungs),

Unfortunately, good care is not reaching many patients in the U.S., because of the inequality and inefficiency of our health care system.

Quote from Alan Fletcher

On the other hand, total infections are 5-10? Times tested numbers.

5 times, according to these latest numbers from different studies. Previous estimates of ~10 were exaggerated.

It varies a great deal from one location to another. Overall, it is about 9%, or 4.5 times tested numbers.

Quote from Shane D.

The NYT's must have missed that the definition of "herd immunity" has evolved to include T-cell resistance, and cross immunity.

You mean the CDC experts and the people at Stanford U. missed the definition. Not the NYT.

I expect they know what they are talking about.

https://www.thelancet.com/jour…-6736(20)32009-2/fulltext

word search.. herd.. authors are saying only seroconversion is immunity? or immune response

"

We confirm that as in other studies from COVID-19 hotspots,1
a minority of the population has evidence of exposure and immune response, and a vast majority,

including people at high risk for mortality (ie, the population on dialysis), remain vulnerable.

In fact, even if the seroprevalence estimates derived from the US dialysis population overestimated true seroprevalence in the overall US adult population, our data nonetheless support that fewer than 10% of the US population has seroconverted as of July, 2020,

and herd immunity remains out of reach, as has been the conclusion from large international surveys from the UK
and Spain,1

The poor coronavirus, even after apparently sweeping through a city like New York, has only got ten percent of the population to make antibodies. Surely it can do better than that! It's almost like most of the population doesn't even have to get to the stage of making antibodies in order to fight the virus off.

But ssshhhhh, don't tell the experts that, they rather like the idea that the 'vast majority' of people in even hard hit populations still remain 'vulnerable' because they have not seroconverted. We'll have to stick them all with needles and shove antigens and adjuvants into their bodies to make them seroconvert, dammit! Convert, you seronegative heathen!

And there's Fauci, protesting that Rand Paul says New York's numbers are way down because of herd immunity. Instead, Fauci credits the mighty actions of New York for bringing the virus under control! I wonder who Fauci credits for Sweden's recent low numbers.

Quote from Mark U

Convert, you seronegative heathen!

I pray I already have heretical Tcells..

Quote from RobertBryant

word search.. herd.. authors are saying only seroconversion is immunity? or immune response

"

We confirm that as in other studies from COVID-19 hotspots,1
a minority of the population has evidence of exposure and immune response, and a vast majority,

including people at high risk for mortality (ie, the population on dialysis), remain vulnerable.

In fact, even if the seroprevalence estimates derived from the US dialysis population overestimated true seroprevalence in the overall US adult population, our data nonetheless support that fewer than 10% of the US population has seroconverted as of July, 2020,

and herd immunity remains out of reach, as has been the conclusion from large international surveys from the UK
and Spain,1

Display More

OK, at least we have a scientific question that remains open, rather than rehash of known data.

(1) Seroconversion rate in the US is 9% or so from a sentinel population of dialysis patients. That, interestingly, is 50% higher than the UK's 6.2%, when my previous view had been that UK infection rates were about the same as the US. However, dialysis patients are a selected population that have characteristics (journeys to dialysis machines in hospitals) that will skew their likelihood of being infected so we cannot from this say much with confidence about the overall seropositivity rates in the US, which we might expect to be much lower. We have good data for UK overall seropositivity at 6.5% or so from random sample testing. The paper referenced is not drawing conclusions about overall rates, but about relative rates from different groups:

During the first wave of the COVID-19 pandemic, fewer than 10% of the US adult population formed antibodies against SARS-CoV-2, and fewer than 10% of those with antibodies were diagnosed. Public health efforts to limit SARS-CoV-2 spread need to especially target racial and ethnic minority and densely populated communities.

(2)

Roseland and others are asking why therefore not let it spread amongst the young and shield the old?

You would not from that get herd immunity, because a lot of the cross-household contact - social indoors - startifies by age - young party with young, old with old.

As Jed pointed out, more immediately, the young people who have the virus go home, hug their parents and grandparents, and hey presto you have a high infection rate amongst the old which then spreads. To fix that you need to lock up anyone older than 60, no hugs, rooms separte from those younger. Oh, that will not work for those in cramped economically deprived housing, and would be difficult in other many other ways for those able to afford comfortable isolation.

I'm still willing to consider the "lock up the oldies" solution, as one preferable to the great economic damage of not doing so. As long as its full cost is taken into account. Just as we should take into account the costs of locking up the economy we should also take into account the costs of letting the virus run free and trying to lock up those most at risk to reduce the death toll.

One additional complication. As shown from the seropositivity paper (and obvious to all) those who are in densely populated communities (and colored, though since that correlates with dense population I'm not sure that is causative rather than associational) are going to be disproportionately affected, less able to lock down the elderly. Be careful that in making wise decisions for the whole country you are considering how it affects everyone, not just those like yourself.

(2) Then there is the argument about T-cell immunity. this is actually an argument for vaccination by variolation. A time-honoured technique. The idea is that those who get just the right dose, not too large, not too small, will fight off the infection quickly, using only T-cells, and in the process tune their immune system to fight the virus better without full-blown anti-body-triggered response.

There are two parts to this argument:

(1) some people get (helpful) cross-immunity anyway from previous coronavirus infections.

(2) those who do not will become immune from mild exposure "variolation".

This is all true, and nowhere do we have evidence to say that it is sufficient to stop the disease. Look to the UK and Europe for information here where after a big lockdown was eased (and at, in the UK, 6.5% seroprevalence or so) we are now getting exponential increase in infection rates again.

We can only get a definitive answer by letting infections continue and seeing how high the infection rate can go before it hits some T-cell immunity barrier. In fact the variolated part of the population can still catch COVID properly, and will then become seropositive. the hope is that they are less likely to get severe COVID and take harm from this.

These arguments are very uncertain. We just don't know. It is possible that variolation will mean severe COVID rates are much lower in later phases of the epidemic. It is possible that the effect of variolation on overall severe COVID is relatively low. It is also possible that good socila distancing, mask wearing, etc, will increase the beneficial population effect of variolation.

Jed, I hope, will admit that he does not know how large this effect might be: except from evidence of deaths and "long COVID" disability already seen.

RB and others, I hope, will admit that they do not know how large this effect might be. Evidence of some existing cross-immunity (at say 80%) does not help to answer the question, because cross-immunity is no guarantee you will not seroconvert in the future catching the disease in a milder form. The death rates we already have, as percentage of those seroconverted, take such partial immunity into account. Cross-immunity may be the reason for the observed lowish mortality when compared to say SARS, in which case you cannot count it again to say that it will limit seroconversion to only 20% of the population.

Imagining that this (real) effect, variolation, can somehow reduce death rates a lot as percentage of seroconversion, by making a larger percentage of cases mild, is an exercise in extreme optimism. There is no evidence for it and some (the innate cross-immunity) against. Expecting some help from additional variolated immunity given by a population living with the virus for some time and getting small amounts of it is reasonable. Expecting a lot of help from that is folly. The main risk indicator is clearly age, and those who are older will have more cross-immunity - but maybe also less capable innate immune systems.

I think uncertainty on both sides should be acknowledged, and the average case (mortality reduces as fraction of seropositivity to maybe 50% of its initial value, with better treatment, assuming hospitals are not over-run, terminal seropositivity is at least 50% and probably > 60%) acknowledged. Then the difficult political question is how do you cope with that uncertainty.

The US would be a good place to gather data with evidence from different States with different startegies. The problem is that no state I know has been brave (foolhardy) enough yet to allow seropositive rates to climb very high.

THH

Quote from Mark U

The poor coronavirus, even after apparently sweeping through a city like New York, has only got ten percent of the population to make antibodies. Surely it can do better than that! It's almost like most of the population doesn't even have to get to the stage of making antibodies in order to fight the virus off.

But ssshhhhh, don't tell the experts that, they rather like the idea that the 'vast majority' of people in even hard hit populations still remain 'vulnerable' because they have not seroconverted. We'll have to stick them all with needles and shove antigens and adjuvants into their bodies to make them seroconvert, dammit! Convert, you seronegative heathen!

And there's Fauci, protesting that Rand Paul says New York's numbers are way down because of herd immunity. Instead, Fauci credits the mighty actions of New York for bringing the virus under control! I wonder who Fauci credits for Sweden's recent low numbers.

Mark U - do you remember that time, with cases climbing inexorably, until the US locked down tighter than anywhere else has done? Just possibly the virus gave up because of that lockdown, combined with a high infection rate amongst essential workers who, given lockdown, were spreading the disease, and clustering effects that will eventually saturate?

Looking at the dynamics of infection rates is very interesting, and not simple. Do you remember that very important paper (published in PNAS - Proceedings of the national Academy of Science of the USA) that predicted linear rise in infection in many situations due to clustering effects? That explains the lack of exponential rise during later phases of the initial epidemic in many countries.

Have a look at seroprevalence rates from patients receiving routine medical blood tests (noting that this is a selected population and those without health insurance, more likely to be infected, will be less represented):

https://www.cdc.gov/coronaviru…mmercial-lab-surveys.html

Here is a more informative illustration of NYC data:

https://covid.cdc.gov/covid-da…tml#serology-surveillance

And here is analysis of the results:

https://www.cdc.gov/coronaviru…rpreting-serology-results

https://jamanetwork.com/journa…ntent=tfl&utm_term=072120

NYC is up at 20%. And rates seem to be going down, which shows there are effects here beyond just the population seropositivity change. The infection rate now is very low - low enough that strong track and trace together with some social distancing can keep it low, though this will inevitably get more challenging during winder when people tend to be indoors with windows shut.

I applaud your wish to explain all the facts. I would hope you keep your mind open to all of the evidence, and be curious, rather than thinking you know the answer on such limited evidence.

Quote from Shane D.

"When it comes to fatalities, the data is consistent. The CDC last week reported 121 deaths among people under the age of 21 through July 31. Its website, which divides age categories differently, lists just 34 deaths among children 0 to 4 and 58 deaths among children and adolescents aged 5 to 17. The American Academy of Pediatrics lists 105 deaths through Sept. 10."

Here we have no deaths with age <40 years. Would be interesting to work out the differences between UK/USA and the central Europe states.

Quote from JedRothwell

You are missing the point. When children get the disease, they are likely to spread it to adults, teachers, parents, elderly people and so on. That is very dangerous, even if the kids themselves are not likely to get seriously ill. Furthermore, many young people suffer from serious problems even if they survive. Some problems may be lifelong.

No this is highly unlikely as some studies do show here as they have no symptoms and do not cough. Could be different in USA/UK with many obese and addicted children.

Quote from JedRothwell

An article in the Lancet and a CDC study shows that about 10% of the U.S. population has been infected with COVID-19. See:

This picture is seen world wide. Only people that had no strong cross immunity develop enough antibodies to be seen in the standard test. Do also not worry about news that tell antibodies do decline over time. This only indicates you have a good T-Cell immune response that will curb the production up again.

But one thing is clear. Antibodies act immediately and protect you with a high degree from all symptoms. T-cell need some time and after a high does might be a bit to slow.

This is exactly what we see here in central Europe. We overall are close to herd immunity but not due to antibodies. So we have heavily fluctuating infection numbers as e.g. 10 super spreaders are enough to raise the numbers by 50..100%. Or in France where groups drink together 500..1000%!

And as I already said about a month ago. Now dozens of expert believe that masks may help to produce immunity due to low aerosol doses.

Last: Do not believe any expert as in fact there are none: It's all (-most all) new knowledge and you have to gather enough information yourself. E.g. I just read - German doctors heavily prescribe HCQ!

Quote from RobertBryant

I pray I already have heretical Tcells..

Your T cells are hereby absolved of any sin, real or imagined.

May heretical cells and people continue to live long and prosper in New Zealand

https://en.wikipedia.org/wiki/Lloyd_Geering

The evidence just keeps mounting that vitamn D is the key to turning this around yet no alerts. Fucci admitting in a interview he himself takes it to protect imune system function but no word to the world. This is becoming criminal

https://www.webmd.com/lung/new…her-odds-for-severe-covid