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50% – 75% of cases of Covid-19 are asymptomatic

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Re: 50% – 75% of cases of Covid-19 are asymptomatic

#421

Post by sudosteph »

jhayward wrote: post #315
sudosteph wrote: post #254

Earlier quoted context omitted.

I've actually been really surprised by how well he has handled this so far too. The nation-wide lockdown plus direct cash stimulus are exactly the measures I had hoped to see. Pandemics may be one of the rare situations where having authoritarian leadership can actually benefit the populace. Though I guess we have a while before it plays out completely. I have doubts about whether any non-populist president would hav…

> I've actually been really surprised by how well he has handled this so far too No one who knows how national pandemic response works agrees with you. They know that trying to suppress testing, and criminal lack of executive management of the testing capacity was a known and must-be-fixed quantity 6 weeks ago. They know that hundreds of millions of PPE supplies should have been ordered under federal pandemic authori…

Thanks for chiming in with those examples. I suppose "well" is much too strong of a word then. I guess I just have very little faith that others would do a decent job either.

Since you seem knowledgeable, I guess my question is: While large scale testing seems a reasonable thing to do on it's face - since we already know this thing spreads like wildfire - isn't the best play to just have everyone self-quarantine regardless of health status? Why spend resources on mass testing and preparing for mass-scale treatment when it seems that a total lock-down could nip the transmission in the bud? If you're a non-severe case they tell you that you're supposed to stay away from people if you test positive. So if you're doing that already - what's the difference? Especially considering the logistics of performing large scale testing to identify non-critical cases could expose the people performing the tests if they mess up on their safety protocols. And then there's the issue of false-positives and false-negatives.

I guess I just don't see the benefit of mass testing everybody when we have the option of just shutting down everything now.

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#422

Post by jhayward »

sudosteph wrote: post #421
jhayward wrote: post #315

Earlier quoted context omitted.

> I've actually been really surprised by how well he has handled this so far too No one who knows how national pandemic response works agrees with you. They know that trying to suppress testing, and criminal lack of executive management of the testing capacity was a known and must-be-fixed quantity 6 weeks ago. They know that hundreds of millions of PPE supplies should have been ordered under federal pandemic authori…

Thanks for chiming in with those examples. I suppose "well" is much too strong of a word then. I guess I just have very little faith that others would do a decent job either. Since you seem knowledgeable, I guess my question is: While large scale testing seems a reasonable thing to do on it's face - since we already know this thing spreads like wildfire - isn't the best play to just have everyone self-quarantine rega…

> Why spend resources on mass testing and preparing for mass-scale treatment

This is a good question, I hear it a lot. So here's an inarticulate stab at an answer.

[TLDR: After quarantine the population is still at risk and the virus will start its exponential growth again, just a few weeks down the line]

No matter how effective your mass quarantine may be, we will never "nip transmission in the bud". This thing is endemic and may well be chronic.

The purpose today of mass quarantine is just to slow down the exponential growth of the epidemic. It's only worth doing if you have something to stop the growth from starting again at the end since shutting down the economy isn't sustainable and is enormously damaging even in the short term.

What's that something? Wide-spread, universal testing. Rapid follow-up on positive tests to trace contacts and isolate them. This way you cut down the number of people each person can infect so that the growth rate is less than 1.

You have to keep this regime going until a sufficiently large proportion (in this case, 60%-70%) is immune either because they have recovered from infection or they have been vaccinated.

So, barring getting really lucky with some kind of seasonal disappearance of the virus, we will have to maintain this surveillance-tracing-isolation three legged stool until a vaccine is available.

If we had done this from the beginning we would not now have to be shutting down and destroying the economy to prevent a worst-case disaster, which is estimated that it would peak at about 40,000+ deaths per day in the US, sometime in late May, if left unchecked.

If we had done wide-scale test-trace-isolate from the beginning we could just be going about our business, albiet with this new factor in our lives. Since the criminals bungled, and are still bungling the response, we instead will have many many deaths and serious illnesses w/lifetime consequences and unprecedented economic damage.

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#423

Post by Jedd »

bart_spoon wrote: post #279
Jedd wrote: post #121

Earlier quoted context omitted.

This doesn't add up either -- immunity per individual is expected to last 'only a few months', opening the door to multiple infections per year per person.

There's no indication how long the immunity is expected to last. It's just as likely that immunity, even if temporary, can last for a year or more, as is the case with the flu or some other viruses.

On HN this morning -- news that someone in Japan is already on their second infection of this virus.

So there's our first data point.

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#424

Post by neuronic »

rv-de wrote: post #417
neuronic wrote: post #355

Earlier quoted context omitted.

Hey, here with you. I have chest tightness (and sometimes a stabby pain) and it feels like I cannot breathe as well. Going on for almost two weeks now - no other symptoms at all. I called in with a physician and they said likely not covid, just muscular stuff. I also have allergies and thing begin to bloom... So I am confused and worried, lots of anxiety. But it could just be allergies or something muscular from work…

I'm also not 100% convinced that it isn't something psychosomatic. The whole situation is very tense and that reflects physically. The fact that even in Germany testing isn't an option doesn't help. I stay mostly home and and it seems that the situation is improving. I hope you'll also soon feel better!

Thank you, today it seemed better until afternoon... now its back to tight chest and all. It might very well be psychosomatic but I dont dare to go out to a physician these days.

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#425

Post by takeda »

sveng wrote: post #346
learnstats2 wrote: post #323

Earlier quoted context omitted.

current advice is: DON'T take NSAIDs (e.g. ibuprofen), which may cause complications due to interaction with immune system. do take paracetamol

aka Tylenol (acetaminophen) in the USA. Consult your doctor. Not sure what this means for children, but this directive against NSAIDs is a really important development in treatment protocols for COVID-19.

This is incorrect. Paracetamol, Tylenol etc are brand names for acetaminophen which is not NSAID. Ibuprofen, Naproxen, Aspirin are NSAIDs.

https://en.wikipedia.org/wiki/Nonsteroidal_anti-inflammatory...

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#426

Post by woodandsteel »

groby_b wrote: post #389
mynegation wrote: post #358

Earlier quoted context omitted.

The cost as in “COGS + markup” may be low but the opportunity cost (cost of not doing a test when it is more important) might be higher when the supply of tests and lab time is limited. While it is absolutely important to ramp up both, it is a different story.

^^^^^^^ This, right here. The entire world is struggling to get enough testing supplies. Testing somebody who's experiencing mild symptoms takes away from testing cases that are much more important - because part of what is happening right now is that everybody with a light fever is all "I GOT THE COVIDS" and wants a test. Fact of the matter: We don't have enough tests, worldwide. We can't produce them fast enough. W…

Yes, but it is also true that the number of available tests is increasing rapidly, and also is partly in response to government demand.

If the the available number increased to the level where everyone with symptoms could be tested, would you favor doing so? and do you think that governments should push til enough tests are available to do that?

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#427

Post by woodandsteel »

dustinmoris wrote: post #333
netsharc wrote: post #292

Earlier quoted context omitted.

Isn't it the case that most countries in the world don't have enough tests, it seems only South Korea does. I live in Switzerland and they are also restricting tests to higher risk groups, and people with worse conditions (which is a bit grim, how dead do I need to be before I can get a test?) Either it's due to Olympics, or just logistics. Will the Olympics even happen if Japan is declared "OK" but many guest nation…

It's not really about how bad your symptoms get before you can get tested. It's about WHERE you are. Coronavirus is a virus after all, just like the flu, there is no medication. You can only treat the symptoms, but not the virus itself (as opposed to a bacterial infection where you can attack the bacteria with antibiotics). So with these undeniable facts it's fairly simple, if your symptoms are so mild that you can c…

If you know you have the covid virus, then you know you have a disease that is far more dangerous than the standard flu, and so you need to take much more stringent measures to prevent others from being infected. You also need to have to health dept trace out all the people you may have infected already.

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#428

Post by Engineering-MD »

nicoburns wrote: post #387
12elephant wrote: post #293

Earlier quoted context omitted.

What no one is talking about is how much social distancing/isolation is needed to avoid hospital saturation. I ran the numbers for Canada, and it looks like we'd need isolation measures for 2+ years. I don't see how that's a feasible solution long-term.

The numbers I ran for the UK put it at 12 years: No. People in UK: ~66,000,000 Est. proportion of people who will get sick: 80% Est. proportion of sick people who require intensive care: 5% (in Italy it's 10%) So that's 60,000,000 0.8 0.05 = 2,640,000 Number of ICU beds in the UK: ~4100 (90% occupied, but let's ignore that for now) Length of time ICU required: at least 1 week (probably longer, but let's ignore that t…

I did a similar calculation but came back more optimistically (although still on scale of a year to two).

You only need count over 18s as very few cases in this group. It is believed by the UK experts to have a lower fatality rate of 1% and likely lower admission rate due to asymptomatic infections (estimates at 16-75%). Ventilator capacity can increase with stopping surgery and CPAP/other measures can be used in some cases. Treatments developed later should improve efficiency of treatment. Extra ventilators should be manufactured and help ease burden. I think 80% is too high, likely more 60% given an R0 of 2-3. Finally, the chronically unwel elderly are unlikely to benefit from ITU care significantly and would never qualify. With these exceptions it gets down to 1-2 years depending on assumptions.

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#429

Post by dmix »

neuronic wrote: post #355
rv-de wrote: post #157

Earlier quoted context omitted.

Same here, persistent mild chest pressure. My girlfriend as well as myself are experiencing it. But it's so subtle that you start to question it at times. But especially when lying in bed it becomes quite annoying or frightening if I think too much about it.

Hey, here with you. I have chest tightness (and sometimes a stabby pain) and it feels like I cannot breathe as well. Going on for almost two weeks now - no other symptoms at all. I called in with a physician and they said likely not covid, just muscular stuff. I also have allergies and thing begin to bloom... So I am confused and worried, lots of anxiety. But it could just be allergies or something muscular from work…

That sounds like anxiety to me. I used to get that in my early 20s with those exact symptoms. That was before I learn to recognize my anxiety. Breathing tools were the best solution, at different times I've needed anti-anxiety medication.

Chest tightness and panicked breathing, followed by heart palpitations with no other primary symptoms (fever, cough, etc).

This is a very stressful time, especially for high-information consumers. I wouldn't be surprised if there are thousands of people right now mistaking anxiety for COVID symptoms. Over analyzing your health can lead to some crazy self-driven outcomes too.

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#430

Post by annamargot »

surfsvammel wrote: post #343

I have shortness of breath, cannot go up the stairs in our house without having to stop and rest. 37 years old and otherwise quite healthy. Have underlying autoimmune disease, and am on immunomod. Coughing and light fever. I’ve had this for 5 days. When I called the hospital they told me to come in and get tested, but when I came to the hospital they did not test me. The doctor told me, it wouldn’t make a difference…

It would sure be nice to know whether you’ve had it though.

If I thought I’d already recovered from a mild COVID-19 - assuming I’d then have immunity for a decent chunk of time - I might think I could now move from the sidelines and into the fight and help others.

But if I was wrong and I never did actually have it, then I’d be making things worse.

Widespread testing could obv illuminate much.

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