• Isaac
    10.3k
    Doing absolutely nothing will mean your ICUs are overloaded in week 18 assuming they all have ventilators. The next week you run out of enough beds to take care of hospitalised infected. Somewhere in week 22 you will have over 40% infected and herd immunity will slow the spread. I don't know how much, so I haven't taken it into account for the two weeks thereafter (so you should ignore those). By week 22 almost 2,9 million US citizens will have died (actually, that number is probably delayed by a couple of weeks).Benkei

    Your estimate is based on a misunderstanding of the statistics. 0.6% is not a target. It doesn't act as some kind of quota the virus is trying to fill. It's a summary of the frequencies which have been observed so far, all of which reflect the combined action of underlying (hidden) variables. So, to take one such variable - d-dimer greater than 1 μg/ml. It increases the risk of mortality 18 fold. Once the cohort of people with comorbidities likely to lead to such a score has been exhausted, remaining cohorts then have 1/18th of the relative chance of dying in that variable alone. Age, organ condition and hypertension are all documented factors raising relative risk way above statistical significance. As these cohorts become exhausted the fatality rate will drop dramatically (as you can see with the example I gave, the effect on risk is not small).

    You cannot accurately predict the death rate using a snapshot of the fatality rate at a given moment in time and simply extrapolate unless you use a very short timescale. You have to estimate the variables leading to death (as the experts are now doing) and produce a multi-variate model based on a declining cohort.
  • ztaziz
    91
    The Virus is already statistically showing that it does not spread in this way;

    Proof 1. There are about 8 people in my town hospital with corona, that's less than one percent.

    Proof 2. We goto the shops and stand in line every day, if corona was at that shop, we would know.
    Proof 2b. Someone has to come to the shop with corona, and touch stuff or be near to someone.

    If people are weaponizing it, it may be a problem.

    As for working, I think, there's no chance of a sharp enough to be called sharp increase.

    And it will do nothing to the economy, imagine a week with stock troubles. We are theives and we will continue to with such power.
  • unenlightened
    9.2k
    Before infection reaches 40%, herd immunity plays a very limited role.Benkei

    There is no certainty that immunity will ever reach that modest figure.

    "Right now, we have no evidence that the use of a serological test can show that an individual has immunity or is protected from reinfection."

    She added: "These antibody tests will be able to measure that level of seroprevalence - that level of antibodies but that does not mean that somebody with antibodies means that they are immune."

    I wonder if anyone is modelling a scenario where herd immunity doesn't happen, and vaccines don't work.

    You cannot accurately predict the death rate using a snapshot of the fatality rate at a given moment in time and simply extrapolate unless you use a very short timescale.Isaac

    A short timescale? It looks to me as though that timescale is about up to the point where herd immunity might become a factor. Cohorts will not be exhausted as long as the virus is spreading geographically to new populations. Is that right?
  • Streetlight
    9.1k
    https://nypost.com/2020/04/21/de-blasios-social-distancing-tip-line-flooded-with-obscenities/

    "Mayor Bill de Blasio’s critics let him know how they really felt about him ordering New Yorkers to snitch on each other for violating social-distancing rules — by flooding his new tip line with crank complaints including “dick pics” and people flipping the bird, The Post has learned."

    Glory to the people.
  • Benkei
    7.7k
    I got it from here : https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext

    I'd say it's the best estimate we have so far.
  • Benkei
    7.7k
    Correction on the below. I thought the estimated death rate was .6% but it's .66%. Plus I was an order of magnitude off. We're talking about 637,000 deaths from covid-19 directly in week 22.

    I'm sure there's still plenty that can be perfected in that EXCEL (after all, it's just a quick doodle) but it does give you a feeling of what we're talking about. Doing absolutely nothing will mean your ICUs are overloaded in week 18 assuming they all have ventilators. The next week you run out of enough beds to take care of hospitalised infected. Somewhere in week 22 you will have over 40% infected and herd immunity will slow the spread. I don't know how much, so I haven't taken it into account for the two weeks thereafter (so you should ignore those). By week 22 almost 2,9 million US citizens will have died (actually, that number is probably delayed by a couple of weeks).Benkei
  • Isaac
    10.3k
    It looks to me as though that timescale is about up to the point where herd immunity might become a factor. Cohorts will not be exhausted as long as the virus is spreading geographically to new populations. Is that right?unenlightened

    Cohorts are technically exhausted the moment one person dies, the cohort {most likely to die from condition x} is fully exhausted as soon as someone dies from condition x. Depends on the specificity of the cohort. The effect is that the make-up of (and therefore the risk distribution within) a cohort will change depending on the variables it is exposed to.

    Geographic spread could affect the rate at which cohorts are exhausted (one localised sub-section of a cohort might become fully exhausted before the disease has spread to the next), it would also affect the rate of increase if the cohorts are not geographically homogeneous, but I don't think either of those factors will affect things on a national scale - maybe though. I'm sure some states/countries have a different age distribution and so fatality rates would rise/fall as the disease reaches those areas.

    I got it from here : https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext

    I'd say it's the best estimate we have so far.
    Benkei

    It's not the quality of the estimate that's the problem, it's extrapolating it to changing cohorts. Image a 100% infectious disease only killed men (but did so every time). At first the CFR for society would be 50% (for every 100 infected 50 died) , but it could not sustain that ratio as within time (depending on R values) there would be twice as many women as men. Killing all infected men would still only yield a societal CFR of 25%.

    Thankfully (because of the lockdowns) we're unlikely to be dealing with total deaths anywhere near big enough for the effect of changing the risk profile within cohorts to be so large, but it is incorrect to use these unadjusted figures to imply such massive numbers as your model does in the case of an uncontrolled spread.

    In expectation terms the uncontrolled spread would kill 90% of the cohort who are at 90% risk, 80% of the cohort at 80% risk... And so on, with those risks being calculated independently (ie from within their cohorts).

    Once it's killed 90% of the 90% risk cohort, it's not going to start killing more in the less at risk group to 'make up the numbers'.
  • Benkei
    7.7k
    If I give you access to the sheet, can you make adjustments to it to reflect this issue? Would be nice if we get a reasonable estimate set up for PF that we can adjust as we get more info.
  • Isaac
    10.3k


    I don't think we'd have the data. What I'd need is the CFR (or better IFR) for a stratified set of cohorts. What we have from the Lancet study is the answer to the question "of everyone who caught this disease and died, how many were 70-80?" (or whatever cohort size). What I'd need is the answer to the question "of all the people who were 70-80 who caught the disease, how many died of it?". I don't think anyone has done that yet.

    Another possibility is to use the RR values for the prognostic factors, if I could find data on the prevelence of those factors (they're so important for loads of conditions, I expect that data is out there). I'll have a look and see what I can find.

    To clarify though, with every country in some form of lockdown these numbers are purely speculative. The r values are going to drop to too low a rate before any major age cohort is exhausted.
  • frank
    15.7k
    The University of Texas model says Georgia has a 94% chance of being past peak deaths.
  • Baden
    16.3k


    In order to maintain the trend they'd have to continue doing what they're doing though. Otherwise the cycle will just restart.

    "Key model assumptions: (1) The observed and projected numbers reflect confirmed COVID-19 deaths only. (2) The model estimates the extent of social distancing using geolocation data from mobile phones and assumes that the extent of social distancing does not change during the period of forecasting. (3) The model is designed to predict deaths resulting from only a single wave of COVID-19 transmission and cannot predict epidemiological dynamics resulting from a possible second wave."
  • frank
    15.7k
    Yes. If the UT model is right, Georgia's health system should be ok if they start easing off restrictions. If things explode after a couple of days, local governments will take over and close back down as needed. They will cue off hospital administrators. That's how a lot of the US went on lockdown originally: at the request of hospitals.
  • unenlightened
    9.2k
    Cohorts are technically exhausted the moment one person dies, tIsaac

    Ok. Then I have no idea what you are talking about. Just ignore me, I was thinking Roman army divisions - not exhausted even by decimation.
  • praxis
    6.5k
    I did, and the blank was filled with: he's lying.
    — praxis

    I’m flattered you spent the time.
    NOS4A2

    Oh it wasn’t me, and I stopped paying my research team when this whole corona thing started.
  • NOS4A2
    9.2k


    Oh it wasn’t me, and I stopped paying my research team when this whole corona thing started.

    All that effort, added a little image too. I guess I have a fan.
  • Hanover
    12.9k
    es. If the UT model is right, Georgia's health system should be ok if they start easing off restrictions. If things explode after a couple of days, local governments will take over and close back down as needed. They will cue off hospital administrators. That's how a lot of the US went on lockdown originally: at the request of hospitals.frank

    The truth is that there's a whole lot of speculating going on and no one knows with any real sense of likelihood what the hell is going to happen. Human behavior is variable enough that we just don't know. We can all take out our calculators and push a bunch of buttons and declare we've got it figured out, but we wouldn't.

    So, it might well be that Kemp is going to be right about this and the Georgia economy will thrive. It's also possible it won't. The question then is one of prudence, as in, do you think putting your life savings on red is the prudent thing to do? There is something I like about optimistic recklessness, and this whole thing is way outside my control, so all I can do is watch the wheel spin and wait with excitement to find out.
  • NOS4A2
    9.2k
    This is interesting and somewhat contrary to what we’ve been told.

    Low incidence of daily active tobacco smoking in patients with symptomatic COVID-19

    Conclusions and relevance: Our cross sectional study in both COVID-19 out- and inpatients strongly suggests that daily smokers have a very much lower probability of developing symptomatic or severe SARS-CoV-2 infection as compared to the general population.

    https://www.qeios.com/read/article/574

    Smoke ‘em if you got ‘em.
  • praxis
    6.5k
    I just cross referenced the post where his gran just died and he's been retired for a few years. Something doesn't compute.Punshhh

    Yeah, my gran just died too. She was infected by one of those lockdown protesters. Filthy bastards!
  • NOS4A2
    9.2k


    You ghoulishly mock the death of my grandmother because you have can’t muster any other argument.
  • Isaac
    10.3k


    No luck finding the analysis I'm afraid. Shame because I'd be quite interested (albeit only academically), but to do it from multiple RRs even if I had the prevalence data for those groups would require both the computer and the statistician (I'm not good enough to do my own stats) from work. As I'm now (re)retired, that would be quite a stretch for an idle speculation.

    One way to look at the final figure though is the method I mentioned to boethius using a cohort of {those with underlying conditions serious enough to be listed as a cause of death}. We know Covid-19 mortality comes almost entirely from this group (91-98% in the reports I've read), and those with two or more have at least triple the RR, so they contribute more than their numerical share to the mortality.

    So, once this group is exhausted, CFR will drop to at or below the CFR for the less affected groups (less than 0.1).

    The US death rate is about 2.9 million per year (and almost half of those are accidents or intentional self-harm) , so even if Covid-19 attacked every single one it would be difficult to reach your target without exhausting the group from which almost all fatalities are drawn.
  • Isaac
    10.3k
    I was thinking Roman army divisions - not exhausted even by decimation.unenlightened

    Yeah, this seems a common misconception. That because the fatality rate is 1% it kills 1% of any population it's exposed to, as if the virus itself has a quota to fill. The 1% is a feature of the population, not the virus. It's saying we, as a population, are in a state of risk distribution such that 1% of us will be killed if exposed. Once that 1% has been killed we are no longer the same population, we no longer have the same risk distribution.

    As a (socio-political) aside. It's interesting how little focus there is on the fact that the fatality rate is a measure of the health of our population (and by association, the quality of our healthcare). The same people who are decrying the lamentable state of our healthcare system in its (in)ability to respond to this crisis seem (to me) to be the same people wanting desperately to downplay the relationship between poor health and increased Covid-19 mortality which that same lamentable state is directly responsible for. But maybe I'm reading the wrong people.
  • praxis
    6.5k
    You ghoulishly mock the death of my grandmother because you have can’t muster any other argument.NOS4A2

    Working from your playbook... You're mocking the death of my poor grand?! She died alone! :groan:
  • NOS4A2
    9.2k


    Working from your playbook...I am an introvert to disguise from the public that I’m just another scumbag.
  • praxis
    6.5k
    That doesn’t even make sense, so still your playbook.
  • NOS4A2
    9.2k


    Frightening. State-enforced economic collapse. Capitalism hasn’t failed; it was murdered by the state.
  • frank
    15.7k
    There is something I like about optimistic recklessness, and this whole thing is way outside my control, so all I can do is watch the wheel spin and wait with excitement to find out.Hanover

    I'm the opposite by nature. But staying on lockdown is also dangerous.

    Speaking of which: "Already, 135 million people had been facing acute food shortages, but now with the pandemic, 130 million more could go hungry in 2020, said Arif Husain, chief economist at the World Food Program, a United Nations agency. Altogether, an estimated 265 million people could be pushed to the brink of starvation by year’s end."

    from the NYT
  • Hanover
    12.9k
    I'm the opposite by nature.frank

    Sounds boring. If you're stuck in the spinning swirling crashing death spin, you might as well enjoy the ride. Do you want your last breaths to be spent trembling and clinging to whatever you can hold onto until it too fractures into a million pieces?

    It's the response of the unscarred soul that has never experienced true devastation, so it lives with the illusion that there really is stability to lose. True optimism is forged in trauma, so the most fearful are those who haven't ever felt walked in sufficient darkness, so they live their lives trying to avoid it, which only leads them to something worse. It's that frigid timid place of worry and fret where you hold onto whatever makes you feel stable, despite you're not realizing that whatever it is you hold onto is infinitely more fragile than the divinity impregnated in you. If you'd only step away and stand on your solid feet, you'd realize that is the only thing that won't falter.

    Sort of an interesting post I think?
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