Covid 19 CRISIS

Dr_Grip

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Addendum: I just went back through parts of this thread - we have come down quite some way in the infection mortality department, with the Brazilian study above putting it at .28%, which is less than a tenth of what was assumed early in the pandemic.
By now this seems not too different to the seasonal flu. The problem with covid, thus, is not so much how deadly it is, but how quickly it spreads in a populace with unprepared immune systems, and that it does not go away in summer - the seasonal flu catches "only" up to 20% of the population per season, while covid running unchecked burns through the populace at a brutal pace. Plus, we have vaccines and treatments against the flu.

Another observation - compared with the scenarios from March/April, even current worst case predictions look rather good.
 
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loose_unit

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I would suggest taking the Brazilian numbers with a grain of salt.

A personal experience was was a member of a family that I know there caught covid, was tested positive, went to hospital got on a ventilator and eventually died. On the death certificate the cause of death was listed as simply unknown.

Edit: However, I decided to do some digging - if you take the estimated actually infected people in New York as somewhere around 25% (Around 2.1m people) with deaths being reported as around 32,500 you get to the death rate of around 0.16%

A significant factor as you mentioned @Dr_Grip is how quickly it spreads - If we can slow down the spread we are able to reduce the death rate because enough ICU beds will be available.
 
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Dr_Grip

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The Brazilian study on death rate is backed up by the "Heinsberg study" about the first cluster in Germany.

The authors were widely criticized back in the day for putting mortality around 0,38%. Again, that was at a point in time when 3,5% were seen as a realistic mortality rate.

EDIT: Also, looking at the New York number - it does not matter how many percent they represent, 35K dead are a tragedy that should be avoided.
 
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RdKetchup

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The province of Quebec is now pretty much officially in the second wave with approximately 500 new cases per day.

We now use colour code to describe the situation, and while the first wave was concentrated in Montreal, we now have 3 regions considered "Orange" (second highest level).

View attachment 3558554View attachment 3558555
More and more regions are now coded 3.

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It's my oldest daughter 10th birthday next week, and we had to cancel our visit to my mom (different city, travel strongly discouraged), and my father and brother-in-law also cancelled the dinners we had planned :(
 

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Dr_Grip

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Elimination is a nice theoretical construct that hinges on all countries locking down at the same time, and sealing their borders to those who can't lock down because they are too poor forever.

It would be splendid if "saving as many lifes as possible no matter the cost" would be the only objective, but sadly, that's and approach 90% or more of the world can't afford.
 

Dr_Grip

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One more thing - maybe one should not be CNN and read the Lancet paper more as lessons learned for the next pandemic.

For covid, changing course does not make a lot of sense right now.

Going in, we had three options:
  • Herd immunity
  • Elimination
  • Manage the spread until treatments and vaccines are available
New Zealand chose elimination. Sweden chose a hybrid path between managing and herd immunity. Most other countries chose a hybrid between managing and almost-elimination, but are now more aligning with the Swedish approach, without saying so.

Changing course now, with some countries (voluntarily or out of ineptitude) approaching herd immunity, while vaccines, even in realistic worst cases, are less than half a year away, would not make any sense at all.
 

loose_unit

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In the end, I feel like the right approach is the half way between elimination and managing - Keep hospital beds open for those that need them, but let things get back to sort-of normal.

The Swedish approach works reasonably well in such a sparsely populated country where outside of main centres the spread is just naturally slower - This would not have worked nearly as well in Germany or most parts of Europe.

Additionally, when the approach was decided by each country at the time, there was no 100% clear evidence that people were actually immune and no way to test for the antibodies very early on.

Changing the approach now based on the new evidence is absolutely fine and I would be disappointed if governments were not doing this.
 

Dr_Grip

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Fully agreed - I should have been more precise: "changing course now towards elimination makes no sense".
 

93Flareside

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Elimination is a nice theoretical construct that hinges on all countries locking down at the same time, and sealing their borders to those who can't lock down because they are too poor forever.
Or the US who can’t decide whether we care for each other or don’t because individualism is the most important thing, it depends on whether we’re at church and listening to what the pastor says or we are going about our lives on a Tuesday. The longer I hear about individualism and listen to people I work or converse with, the more I realize it’s just another word for “fuck you, I only care about myself.”
 

RdKetchup

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Montreal and a few other regions are getting upgraded to Red on Thursday.

INSPQ_daily_20200929.png
regions_colour_20200929.png


This means that for the following 28 days:

- Bars and restaurant have to close their dining room and terrasse (takeout and delivery allowed).
- We cannot invite anybody at home, even outside.

And a bunch of other stuff. But these are the 2 that affect me.

We had my BIL visit last Saturday, so good timing I guess.

I got tested yesterday for COVID, I hope to get the results before leaving for Germany on Thursday.
 

Dr_Grip

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Decidedly mediocre news from the "herd immunity" city in Brazil... after three months, they are experiencing a second wave. It seems like the "functional immunity" scenario most serious experts have been peddling for months becomes true: After you overcame covid once, you are not fully immune from reinfection, but it turns into a benign cold with symtoms so little it might as well count as "asymptomatic" (this is in line with animal testing data from frontrunner vaccines: No viral infection in the lungs, but two to three days of virus in the upper respiratory tract). Which of course means you have all the time in the world to visit grandma in her retirement home, infect her, and kill her off.

Or in other words: Bring on a vaccine for frontline medical workers, the elderly and all the other groups who should rather not go through "full covid" to build this functional immunity. Literally no one needs 100% of the world's population go through this process: If the theory that the late-19th century "Russian flu" in fact was an earlier coronavirus is true, it would take three to four waves and several million dead to acheive this goal. Vaccination sounds a lot more civilized to me.

EDIT: According to an epic twitter thread by Mt. Sinai's Prof. Krammer second or third gen vaccines given orally or as a nasal spray might provide full protection, since it's know from the flu that vaccines given as a shot have great performance in the lungs but not so much in the upper respiratory tract.
 
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gaasc

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So I did an experiment.

Not willingly of course, my elderly person needed some medical procedure done and non-essential medical facilities apparently do not take the scheduled days to go out as defined by the national ID into account for medical appointments. So I had to go out when it was none of our days to leave home (I should point out that the medical procedure would've left him unable to drive himself). Tegucigalpa, as the second hub of infection in the country, has taken it upon itself to go ahead and try to curb the infection by requiring strict checkpoints everywhere and requiring that all stores have temperature and mask checks as well as hand sanitizing stations and places where you verify your ID and you will be denied entry if it is not your day to go out.

Major arteries are also filled with police checkpoints which reduce the road down to one lane in order to pull over and check for IDs. The idea is to ensure as thorough an enforcement as possible and make sure that a country which has no concept of personal space and, little of personal hygiene respects things that are nothing less than alien to them.

Unfortunately, it doesn't work. All of the checkpoints were more chicanes staffed by texting policemen who did not pull over anyone. Informal business on the sidewalk continued unabated and there were lines with maskless people and no social distancing outside most banks and storefronts. This parses with my experience going to stores in which I can notice the staff not even taking a glance at my ID, where the small table to decontaminate is out of everything and you can see staff just not looking at the thermometer or, indeed, pointing them in the correct direction.

I was stopped from going into Pricemart though, but that was because they no longer accept me going with someone else's membership.
 

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We were spared here until very recently. This is a student town and when thousands of students came back from summer leave they immediately started doing what students do best... partying and being shitfaced. City healthcare officials are in an emergency meeting as we speak, figuring out what to do and which restrictions to put in place.
 
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