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Preliminary test results suggest 21% of NYC residents have Covid antibodies

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Re: Preliminary test results suggest 21% of NYC residents have Covid antibodies

#381

Earlier quoted context omitted.

> Being summer, the virus will not be that contagious. I think that is still scientifically debatable, good overview: https://www.newscientist.com/article/2239380-will-the-spread... Certainly it is still transmissible in hot countries.

Thanks for the link. It's a good read. That said, science is enamored with significance levels, p-values, etc. Most people just do that because that's what they've learned, and think that's how it should be done. They don't think it comes from Bayesian inference, where you put a very low prior probability of a drug being useful (because the very vast majority of chemicals we could put in our bodies are either harmful…

It will increase, because vastly more people will have already been exposed. The seasonal variation in the cold exists for many reasons, including SCHOOL is open, and people tend to congregate in enclosed spaces more. None of these things are relevant to COVID

Re: Preliminary test results suggest 21% of NYC residents have Covid antibodies

#382
post #334

Earlier quoted context omitted.

The death rate of 0.5% falls right in the range of what modelers have been using, by the way. Not exactly very positive news.

Right. Really this study is just confirming (with higher error bars than we'd like) what we already strongly suspected. Note that as others are pointing out, that 0.5% isn't really extrapolated correctly. The tested case deaths are looking like they're only 70% of the total or so. Also using a current death count with contemporary infection counts is a mismatch, because it forgets that ~35% of the people currently in…

Except this data is also lagging by three weeks, depending on what antibodies are being checked. Some deaths today have come from infections in April, so the net effect could be a wash.

And where are you getting a 35% death rate for "ever hospitalized"? It's realistically somewhere around 15%-20%, though with major age skew. (https://www.thelancet.com/journals/laninf/article/PIIS1473-3...)

Re: Preliminary test results suggest 21% of NYC residents have Covid antibodies

#383
post #357
post #163

Earlier quoted context omitted.

0.6% this is the estimated ifr. comparing it to the cfr of flu is not right, which is about ten times less than the flu ifr - or about 60 times less than this figure. your conclusion is upheld, but even moreso

According to the CDC, the estimated prevalence of symptomatic flu last year was 45 million illnesses and 61,000 deaths. For NY, assuming it’s evenly distributed, that would translate into 13.8% of 20 million = 2.8m symptomatic flu cases and 3,753 deaths. COVID appears to be significantly more prevalent (roughly twice as prevalent in just 3 months as flu gets all year despite incredible efforts), and roughly 2-3x as f…

According to the CDC web site, those numbers are 35.5M flu cases and 34,200 deaths (https://www.cdc.gov/flu/about/burden/2018-2019.html), giving an IFR of more like 0.1%. Which would put COVID-19 at more like 5-6x more fatal than the flu. Combine that with the virtually complete lack of natural and vaccinated resistance compared to the flu, and it's clear that the potential fatality totals for COVID-19, absent drastic action, would be much, much higher than for the seasonal flu.

Re: Preliminary test results suggest 21% of NYC residents have Covid antibodies

#384
0.5% IFR is still very high, I wonder what the antibody detection threshold is - i.e. is it possible that a lot more people have been exposed but don't have detectable antibody levels ? Would it qualify as infection in the sense that they are not susceptible for covid19 in the near term ?

Re: Preliminary test results suggest 21% of NYC residents have Covid antibodies

#385
post #360

Earlier quoted context omitted.

>There are many more infections than we know about and the CFR is not anywhere close to the actual IFR. That is the optimistic takeaway. The pessimistic takeaway is that even the hardest hit areas are nowhere near herd immunity levels and that we are either going to be isolating until a vaccine is created or we can expect to see a lot more death once nonessential people are forced back to work.

I don't think this a binary outcome. Getting closer to herd immunity also makes things better. Take NYC. Now 1 out of 5 people you see can't infect you (assuming having antibodies means immunity). The closer we get, the better it is. Having 21% "immune" leads to far different outcomes than .1%.

> The closer we get, the better it is. Having 21% "immune" leads to far different outcomes than .1%.

It depends on how long the immunity lasts. If it's permanent, this is indeed great. If it lasts only a few months, this 21% won't make any difference for another wave of infections this fall.

Re: Preliminary test results suggest 21% of NYC residents have Covid antibodies

#386
post #360

Earlier quoted context omitted.

>There are many more infections than we know about and the CFR is not anywhere close to the actual IFR. That is the optimistic takeaway. The pessimistic takeaway is that even the hardest hit areas are nowhere near herd immunity levels and that we are either going to be isolating until a vaccine is created or we can expect to see a lot more death once nonessential people are forced back to work.

I don't think this a binary outcome. Getting closer to herd immunity also makes things better. Take NYC. Now 1 out of 5 people you see can't infect you (assuming having antibodies means immunity). The closer we get, the better it is. Having 21% "immune" leads to far different outcomes than .1%.

I'm no expert here, so someone can correct me if I am wrong. But I believe as long as each infected person spreads it to more than 1 other non-infected person the disease will continue to spread until there is a herd immunity level of infections. That spread rate will decrease as more people have antibodies, but it seems unlikely to get below 1 since even all the stay at home orders haven't been able to get that number much below 1.

Re: Preliminary test results suggest 21% of NYC residents have Covid antibodies

#387
post #360

Earlier quoted context omitted.

Sure all of these studies are potentially flawed but they're all generally pointing in the same direction. There are many more infections than we know about and the CFR is not anywhere close to the actual IFR. NYC is an outlier with a 21% infection estimate but for the rest of NY (outside NYC metro/Westchester/LI) the estimate is 3.6%. Santa Clara estimate was 3%. LA County estimate was 4%. Seems like a trend is deve…

>There are many more infections than we know about and the CFR is not anywhere close to the actual IFR. That is the optimistic takeaway. The pessimistic takeaway is that even the hardest hit areas are nowhere near herd immunity levels and that we are either going to be isolating until a vaccine is created or we can expect to see a lot more death once nonessential people are forced back to work.

At this point people advocating the position you’re advocating for are in a state of denial (this is my opinion, not a matter of fact, obviously). Your assumption is that we can effectively prevent the majority of the nation from exposure via lockdown.

Not only does evidence seem to point against that, but when you do the math on mortality due to suicide and overdose it’s not clear that containment would even save more lives in the long run.

Here’s how you can tell people’s philosophical positions: if they talk about fear of a “second wave” they are Containers, since that implies the initial “wave” will not infect the majority; ie the virus is successfully contained (EDIT: See https://news.ycombinator.com/item?id=22961927 for the caveat here).

Ironically, leaders like Fauci are verbally saying that containment is not the strategy, yet every word that he says and the IMHE model everyone is relying on are all the result of a Containment ideology.

The alternative is what I would call Pareto mitigation. The vulnerable portion of the population self isolates, while the rest of us are _allowed_ to resume working and living more or less normally (still no large gatherings presumably).

I'd like to take this moment to put out a brief PSA that the serological data coming out, while not 100% reliable, is all telling more or less the same story. Let's look at these IFRs (the second link is CFRs but for Italian healthcare workers who presumably are all getting tested so I'm treating it as a de-facto IFR):

https://old.reddit.com/r/COVID19/comments/g4tqvk/dutch_antib...

https://old.reddit.com/r/COVID19/comments/g6nmtf/update_on_i...

(I'm linking to the reddit comments instead of the actual study because they're really nice tables and the links are still there for anyone who wants to double check)

As others have said, for those around age 45 or less, Covid is equally or less dangerous than Influenza. And particular for those under 30 the flu is an order of magnitude more deadly at least.

In the general population overall, Covid is undeniably more deadly than the flu, but only about 3-5x (and I think 3x personally right now).

Recall that the flu is characterized by deaths in the very young and very old, while being less harmful to those "in between", purportedly due to the "cytokine storm" which is a scorched earth reaction of the immune system. Covid is very different, it is extraordinarily deadly to the very old, extraordinarily non-deadly to the very young, and about the same as the flu to those in between.

A disease with such a "spiky" (highly variable) mortality rate based on your risk factors is precisely the kind of disease that is most effectively treated with risk-informed self quarantine rather than a national lockdown.

Unemployment is correlated with a 2-3x higher chance of suicide, of which perhaps half can be explained away by mental health confounds [1]. There's unique factors in play here - rampant social isolation and widespead fearmongering, propagated even by health experts and "trusted" news sources at times - that lead me to believe that the spike in suicide and overdoses will actually be much higher than predicted by just unemployment alone.

We're currently at 50,000 suicides per year in the US as a base rate, it is not unimaginable that we would see at least 50,000 _extra_ suicide deaths attributable to a mixture of lockdown and the general socioemotional environment.

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I haven't even gotten to the philosophical battle of "freedom versus security". I am, ideologically, someone who drank the koolaid and really believes in freedom and civil liberties over "security" (which I view as illusory anyway), but _even just viewed through the lens of reducing mortality_, the evidence is stacking up that lockdown is going to do more harm than good.

Is the evidence fully settled? Of course not. But it's shocking to me how many people seem to be operating off of the projected CFR's we had in early February, shouting from the rooftops about "1 in 20" people dying (random recent case in point: https://news.ycombinator.com/reply?id=22952764&goto=threads%...). I don't know whether it's just that a large swath of the population already had clinical anxiety which is further magnified by social isolation and social media and news headlines, or whether something else is at play, but I'm very concerned about the state of discourse in the United States right now, and more broadly, the entire world. In fact, ironically I feel a bit luckier to be in the US than some of these other countries because in the US _every_ issue is partisan, which while entirely irrational means that roughly half the country will be in favor of ending the lockdown at any given time (the position I am advocating for, within reason, insofar as hospitals are not overwhelmed), as opposed to other places where you can get given a $1600 ticket for driving a car by yourself, based off of a superstition that _being outside_ causes Covid as opposed to exposure to infected respiratory droplets...

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EDIT: Lastly I should mention that in a perfect world we could have voluntary variolation; I would love to be able to expose myself to a controlled dose of SARS-CoV-2 and self isolate for several weeks to ensure that I can never pass on Covid to someone else. Unfortunately that would be very hard to make a reality due to the political environment, even though I am advocating for it to be totally voluntary. I was heartened to see this recent paper toying with a variant of that approach: https://www.medrxiv.org/content/10.1101/2020.04.12.20062687v... (I don't agree with an "Immunity Card" for ideological reasons but I'm glad we have a paper attempting to model it out which does show benefit of voluntary self exposure)

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1732539/pdf/v05...

Re: Preliminary test results suggest 21% of NYC residents have Covid antibodies

#388
post #317

> In his press conference today, Governor Cuomo revealed the preliminary results of a first-phase antibody test that surveyed 3,000 New Yorkers over two days in 19 counties at 40 locations that included grocery and big-box stores. The sample suggests that 13.9% of New York State residents have the antibodies, meaning they had the virus at one point and recovered. Of the regions tested–Long Island, NYC, Westchester/Ro…

So if 100% of the USA gets it at 330 M people that amounts to: 1,650,000 deaths. It is unlikely 100% will catch it from a single wave however.

Herd immunity will cap the total %! The second wave will be less contagious where current infection rate is higher.

Re: Preliminary test results suggest 21% of NYC residents have Covid antibodies

#389
post #360

Earlier quoted context omitted.

>There are many more infections than we know about and the CFR is not anywhere close to the actual IFR. That is the optimistic takeaway. The pessimistic takeaway is that even the hardest hit areas are nowhere near herd immunity levels and that we are either going to be isolating until a vaccine is created or we can expect to see a lot more death once nonessential people are forced back to work.

> The pessimistic takeaway is that even the hardest hit areas are nowhere near herd immunity levels and that we are either going to be isolating until a vaccine is created or we can expect to see a lot more death once nonessential people are forced back to work. The third option is, when you take into account that it's approximately as bad as the flu for folks under 40, we let out the young and keep the older folks a…

I have never heard of any healthy person under 40 dying from purely the flu. COVID-19 is certainly less dangerous to the young than the old, but there are plenty examples of it killing young and otherwise healthy people.

Re: Preliminary test results suggest 21% of NYC residents have Covid antibodies

#390

Earlier quoted context omitted.

That doesn't make sense to me. I would think you'd want to get to the point where you've reached the carrying capacity, so that "overshoot" of the equilibrium doesn't result.

See my other reply below. You can't overshoot 100%, and long before we get there herd immunity takes hold, and there's no question of the disease being kept from working its way through -- only a question of managing the rate at which it does. All in all the economic damage of continued shutdown does not make sense at this point (at 21% of the population exposed). We should stop now.

Your comment doesn't address my point. See this Twitter thread, https://twitter.com/CT_Bergstrom/status/1251999295231819778

specifically this comment:

https://twitter.com/CT_Bergstrom/status/1252008040376614912

for a good illustration of what I'm talking about. Keeping the rate of transmission low through the peak can definitely save lives.

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