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Open letter from Italy to the international scientific community

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Re: Open letter from Italy to the international scientific community

#681

Post by trashtester »

alexandercrohde wrote: post #148
trashtester wrote: post #74

Earlier quoted context omitted.

As a physicist, you are familiar with formulas similar to this: N_obs = p_detect * 2^( n_days / T_double ) N_obs : The number of observed cases p_detect : The fraction of actual cases that are detected (assumed to be constant) n_days : number of days T_double : The number of days it takes for the number of real cases to double If you examine the formula, the p_detect constant is almost insignificant. If T_double = 2,…

The point is that the mortality rate estimates are going to be totally out of whack without accurate measurements. As well as estimates of the currently infected. This matters a lot . The first number is obviously important. The second matters so Italy can plan for whether things have peaked yet, or how many weeks out until it does.

The mortality does matter a lot if we plan to let everyone become exposed. However, if we do that, we must expect 15% of the people that are currently having enough symptoms to be diagnosed in Italy to perish. Even if only 20% of the infected are diagnosed there now, that is up 14 million people in Italy (if everyone gets it), out of which 2-3 million would die.

Or, if applied to the US, 10 million.

Alternatively, we can shut down the virus in the same manners that China, South Korea or Singapore have been doing, and keep it supressed until we develop efficient treatment.

Unfortunately, that means shutting down all affected regions really hard, and maintain a high level of supression for maybe 2 years.

However, if we are going to do so anyway, both the human and economic costs will be lower the earlier we begin.

If we allow exponential growth to continue with a doubling time of only a few days (even if we can move it from 2-3 days to 6 days), the time until this move is forced is very limited.

Re: Open letter from Italy to the international scientific community

#682

Post by kps »

contravariant wrote: post #345
dfox wrote: post #251

Earlier quoted context omitted.

I have one issue with or maybe just question about this graph. Why it starts with 100 detected cases? It seems like arbitrary round number, but it also seems to be the smallest arbitrary-looking number that makes SK overlap other countries. Why is that? Why is the initial slow spread in SK irrelevant? What caused it to be initially slower than in other countries?

This doesn't really matter, you're just doing that to make it easier to compare. Shifting South Korea so it doesn't overlap the other countries is possible but not terribly useful. They do seem to be missing Denmark though, which should stick out somewhere top-left of Norway.

Denmark is now in today's version. https://twitter.com/jburnmurdoch/status/1238913530973339648/...

Re: Open letter from Italy to the international scientific community

#683

Post by zhte415 »

gvjddbnvdrbv wrote: post #664
zhte415 wrote: post #593

Earlier quoted context omitted.

It was a nowcast. It's intended to be out of date after a while. And provide an estimation at the time. I don't understand how it is dangerous, could you explain that?... earlier action would have been better.

You are claiming that a study published in January supercedes a study in February. Given that people are making difficult choices right now that will impact the course of the epidemic we should be very careful sharing outdated information that could lead to people becoming infected. China's numbers are a minimum. Many people are saying online they are a maximum. I.e. claiming that there are lots of hidden mild infect…

> You are claiming that a study published in January supercedes a study in February.

No, I am no. I am saying the study supercedes numbers reported by authorities. The point of the study was to scatter information on very opaque reporting.

> China's numbers are a minimum. Many people are saying online they are a maximum. I.e. claiming that there are lots of hidden mild infections when there are not.

That doesn't parse.

Re: Open letter from Italy to the international scientific community

#684

Post by kps »

bsaul wrote: post #25
mensetmanusman wrote: post #2

As a physicist, it still feels odd to me they are talking about statistics with such confidence here. It seems only SK has earned that right and has tested enough people to get reliable statistics. If you only measure the sick in the hospital...

As someone who's dealing with analytics data regularely, thank you ! i absolutely don't understand how can someone give any ratio about this disease knowing how only the most severe cases got tested ( except in SK), and that the symptoms are almost undistinguisable from the flu.

Because differences in testing methodology are a constant factor, which doesn't mean shit to an exponential function.

Re: Open letter from Italy to the international scientific community

#685

Post by trashtester »

jrandm wrote: post #179
trashtester wrote: post #74

Earlier quoted context omitted.

As a physicist, you are familiar with formulas similar to this: N_obs = p_detect * 2^( n_days / T_double ) N_obs : The number of observed cases p_detect : The fraction of actual cases that are detected (assumed to be constant) n_days : number of days T_double : The number of days it takes for the number of real cases to double If you examine the formula, the p_detect constant is almost insignificant. If T_double = 2,…

I believe you're focusing on the days aspect of that equation without considering what a lower T_double/p_detect could mean relative to hospitalizations. If the real number of cases is doubling significantly faster than those detected -- say due to not testing them because their symptoms are mild enough to be missed entirely or to not seek treatment -- the calculations around things like mortality rate and severity o…

If the number of real cases double every N days, the number of people needing hospitalization is also likely to double every N days. If not, it probably means that the infection rate spread at different rates in high risk vs low risk part of the population, but unless those populations are strongly segregated from each other, that is unlikely.

This could go in both directions. In both cases, though it would require that the high-risk subpopulation is primarily infected by each other (or staff) instead of being infected from the general population. If high-risk individuals are primarily infected by low-risk individuals, the doubling time for each group should be the same.

Note that such an effect could go in both directions. The high risk subpopulation could get it at a higher rate the rest if we let the infection spread like wildfire in hospitals and elderly housing centers, or it could spread at a lower rate if the risk patients are kept isolated.

Re: Open letter from Italy to the international scientific community

#686

Post by gvjddbnvdrbv »

zhte415 wrote: post #683
gvjddbnvdrbv wrote: post #664

Earlier quoted context omitted.

You are claiming that a study published in January supercedes a study in February. Given that people are making difficult choices right now that will impact the course of the epidemic we should be very careful sharing outdated information that could lead to people becoming infected. China's numbers are a minimum. Many people are saying online they are a maximum. I.e. claiming that there are lots of hidden mild infect…

> You are claiming that a study published in January supercedes a study in February. No, I am no. I am saying the study supercedes numbers reported by authorities. The point of the study was to scatter information on very opaque reporting. > China's numbers are a minimum. Many people are saying online they are a maximum. I.e. claiming that there are lots of hidden mild infections when there are not. That doesn't pars…

A lot of people are claiming that China's death rate was under 1%. That is one of the reasons everyone is delaying action.

Re: Open letter from Italy to the international scientific community

#687

Post by cknoxrun »

jfkebwjsbx wrote: post #638
cknoxrun wrote: post #104

Earlier quoted context omitted.

They can work from home. But I'm learning from this thread, that being in a rather northern location where no one in the entire city has started working from home is not the norm. Again, it was only yesterday that the government gave any official guidance on travel or gatherings of people.

If your government gave no official guidance at all, then you would do nothing. If other companies did nothing, then you would do nothing. Interesting. Entrepreneurs are usually way more forward thinking.

Perhaps the difference is cultural. In my country we place a lot of confidence in the government and public health care system. We have been tested more in our province of <4 million than the entire US (x2). Additionally, we do not live in constant state of fear, we are comfortable, perhaps to our detriment in this situation, I fully admit.

Re: Open letter from Italy to the international scientific community

#688

Post by cknoxrun »

mft_ wrote: post #580
cknoxrun wrote: post #104

Earlier quoted context omitted.

They can work from home. But I'm learning from this thread, that being in a rather northern location where no one in the entire city has started working from home is not the norm. Again, it was only yesterday that the government gave any official guidance on travel or gatherings of people.

For so many reasons, selfish and not, you should target being ‘ahead of the curve’. Your government is not the oracle here. Later, you’ll be happy you acted earlier than others. Move your employees to WFH now. Ensure you all have the infrastructure at home to support being as effective as possible.

We have let everyone know they must start working from home, and we are purchasing proper audio equipment for our employees. This thread acted as a wake-up call. I fully admit we have had our head down. I have been dismissive in the middle of raising a seed round while running a company of 20 employees, with two very active boys at home. I have had no time to stay up to date on the world, and the general lack of action around me made me feel that it was something we had time to get to later. That is no excuse, only an explanation. I do sincerely hope that nothing negative comes out of our actions.

Re: Open letter from Italy to the international scientific community

#689

Post by maremp »

joshstrange wrote: post #226

Chris Martenson likes to say "If the facts scare you, the problem isn't with the facts". (also check out his COVID-19 updates, I think they are very well done! [0]) You may think "it's not here yet". It is. You may think "the numbers are low". They aren't. We are failing miserably in our testing, our numbers are easily off by a factor of 10 (for infections). You might not want to be "weird" and not want to practice s…

> they don't have training, and the hospital itself has no plans in place

I have a difficult time grasping this part. It’s not like it’s something completely new. We encounter virus infections every year during flu season. The SARS outbreak was 18 years ago and MERS was 8 years ago. Did we not learn anything from it?

Sure, it was not as severe as SARS-CoV-2, but we should know how to handle it. I agree we should take precautions to stop spreading. But from seeing what is going on around here in EU, I am thinking that the panic is over-inflated and is doing more harm than good. Maybe it takes panic and fear to scare the majority of people into taking all precautions to stop the virus from spreading?

Re: Open letter from Italy to the international scientific community

#690

Post by joshstrange »

maremp wrote: post #689
joshstrange wrote: post #226

Chris Martenson likes to say "If the facts scare you, the problem isn't with the facts". (also check out his COVID-19 updates, I think they are very well done! [0]) You may think "it's not here yet". It is. You may think "the numbers are low". They aren't. We are failing miserably in our testing, our numbers are easily off by a factor of 10 (for infections). You might not want to be "weird" and not want to practice s…

> they don't have training, and the hospital itself has no plans in place I have a difficult time grasping this part. It’s not like it’s something completely new. We encounter virus infections every year during flu season. The SARS outbreak was 18 years ago and MERS was 8 years ago. Did we not learn anything from it? Sure, it was not as severe as SARS-CoV-2, but we should know how to handle it. I agree we should take…

> The SARS outbreak was 18 years ago and MERS was 8 years ago. Did we not learn anything from it?

> Sure, it was not as severe as SARS-CoV-2, but we should know how to handle it.

The answer appears to be no, we didn't. Remember neither of those really hit here in the US.

CDC SARS FAQ [0]

> How many people contracted SARS in the United States during the 2003 outbreak? How many people died of SARS in the United States?

> In the United States, only eight persons were laboratory-confirmed as SARS cases. There were no SARS-related deaths in the United States. All of the eight persons with laboratory-confirmed SARS had traveled to areas where SARS-CoV transmission was occurring.

CDC MERS FAQ [1]

> Q: Has anyone in the United States gotten infected?

> A: Yes, two patients in the U.S. tested positive for MERS-CoV infection, both in May 2014.

The hospitals (nurses at them) that I've heard from say they don't have the masks on hand and they have received no training for how to deal with something like this on this scale. In fact they are being told things contrary to their training like having them wipe down the disposable shield of a CAPR [2] with bleach to re-use it (they are supposed to be single use).

They have limited (10 in the case of the CAPR shields in one hospital) because it's only required for specific diseases that they see few to no cases of per year. They don't have stockpiles of n95 masks because they could alway just order more if they needed them (same with CAPR). They are having to use the CAPR's temporarily because you need to pass a n95 mask fit test [3] (to insure nothing can get in) but the nurses haven't done that. At one hospital they just so happened (dumb luck) to have someone working that day that knew how to administer it and so they have been rushing to have nurses complete it.

> But from seeing what is going on around here in EU

What do you mean by this?

[0] https://www.cdc.gov/sars/about/faq.html

[1] https://www.cdc.gov/coronavirus/mers/faq.html

[2] http://www.lbs-biotech.com/products/personal-protection/max-...

[3] https://www.osha.gov/video/respiratory_protection/fittesting...

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