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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

#461
post #403

Earlier quoted context omitted.

Hey, I'm in broad agreement with you, but, a nit ... > 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. Here in the SF Bay Area we pretty effectively blunted the first wave with public health controls, which meant health care was not stres…

So, that's definitely a good point to raise. I agree and should have been more clear. I think there should not be a second wave because I think we need to resume more or less normal society and let people naturally get exposed (since voluntary self exposure will not ever be tenable in the US I fear). But given the way that California aggressively locked down early into this, I agree that we have been sloping down and…

In San Diego people under 30 are close to 20% of total confirmed and over 5% of hospitalized cases. About 7% of confirmed are hospitalized for this age group. Our positive test ratio is under 7%. Tests are constrained by policy but not dramatically so. https://www.sandiegocounty.gov/content/sdc/hhsa/programs/phs...

Another data point is the US military. I believe they test much more widely due to their living conditions. So far the cfr is about 0.4%.

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

#462
They're trying to measure infection rates by analysing people who are more likely to go outside, and more likely to be infected. There's no adjustment for this confounder at all that I can see. Quick example:

Suppose there's a 10% chance of getting infected every time someone goes outside. Suppose there's a million people of which half are type-A people who go outside once this month, and half are type-B people who go outside 10 times a month.

The type-A person will have a 10% infection rate. The type-B person will have a 65% chance to be infected after a month. The average infection rate is around 42%. Yet if you randomly select someone outside, odds are 10 to 1 that it'll be a type-B person, and you'll get a far higher average of 60%, which isn't indicative of the average person, only of the average person who goes outside.

Second, the article then compares the infection rate to the mortality rate. But the mortality rate does not include excess deaths. These are quite a bit higher for NYC, about 30% or so it seems than the official figures. But even this may be undercounting (or potentially, overcounting) the impact of the corona disease itself. Other deaths might be much lower (e.g. traffic, murder) or higher (e.g. untreated cancer).

Then there's the lag-effect. There's 150 thousand confirmed infected, 15 thousand dead. But the vast majority of confirmed cases are still active, not recovered. They're confirmed because tens of thousands were hospitalised. Of the incubated people, 80% do not come out alive. There's lots of people fighting for their lives right now. Once those cases resolve, many will not have made it. And that's just hospitalised people. Then there's lots of cases who just got infected, and will be developing symptoms in 1-2 weeks.

The way exponentials work is that lag is way more important. In the first weeks NY doubled every 2 days. That means if you have 10 thousand today infected today, in 10 days that's 320 thousand. That's when people start to get symptoms, and 10 days later people start dying from the symptoms. That means your infection count can go into the hundreds of thousands or even millions before seeing any death. But you can't conclude mortality figures from that, at all.

In short, the 21% and the 0.5% conclusions are extremely premature and should not be reported like this. It's good to report the measurements, in context, but you can't draw the conclusions about the population or disease from it.

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

#463

Earlier quoted context omitted.

So, that's definitely a good point to raise. I agree and should have been more clear. I think there should not be a second wave because I think we need to resume more or less normal society and let people naturally get exposed (since voluntary self exposure will not ever be tenable in the US I fear). But given the way that California aggressively locked down early into this, I agree that we have been sloping down and…

In San Diego people under 30 are close to 20% of total confirmed and over 5% of hospitalized cases. About 7% of confirmed are hospitalized for this age group. Our positive test ratio is under 7%. Tests are constrained by policy but not dramatically so. https://www.sandiegocounty.gov/content/sdc/hhsa/programs/phs... Another data point is the US military. I believe they test much more widely due to their living conditi…

> In San Diego people under 30 are close to 20% of total confirmed and over 5% of hospitalized cases.

People under 30 are over half the population in San Diego, so you've just said there's 1/10th as many of them in the hospital as we'd expect if the total risk were equal.

The serology data tells us that an even greater portion of cases in the young are missed-- they are probably actually half the number of infections in San Diego, but a much smaller proportion of hospitalized cases.

The current data implies something close to what he said: about a 1 in 500 to 1 in 1000 chance of hospitalization for people under age 35.

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

#464

Earlier quoted context omitted.

So, that's definitely a good point to raise. I agree and should have been more clear. I think there should not be a second wave because I think we need to resume more or less normal society and let people naturally get exposed (since voluntary self exposure will not ever be tenable in the US I fear). But given the way that California aggressively locked down early into this, I agree that we have been sloping down and…

In San Diego people under 30 are close to 20% of total confirmed and over 5% of hospitalized cases. About 7% of confirmed are hospitalized for this age group. Our positive test ratio is under 7%. Tests are constrained by policy but not dramatically so. https://www.sandiegocounty.gov/content/sdc/hhsa/programs/phs... Another data point is the US military. I believe they test much more widely due to their living conditi…

Young people interact with more individuals, and engage in more behavior that exchanges microbes such as unprotected sex, protected sex, sharing pipes/vapes, sharing utensils, etc.

We should expect that the proportion of people with Covid should be heavily biased towards the young for that reason, as it is for any disease that does not have a biased transmission.

Most indications I've seen is that the young are not harmed much by covid, but can still get infected just as easily, thus why we see:

"X% of hospitalizations are young people" as opposed to the statement that people actually interpret it as: "X% of young people infected with covid are hospitalized".

Does that make sense?

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

#465
post #454
post #447

Earlier quoted context omitted.

You mind sharing the source on those numbers because the total deaths is somewhat meaningless without the number of infections which I imagine is much higher for the flu? Even those absolute numbers show total deaths being just over 25% higher for COVID-19 than the flu.

Table 2: https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm The statement you differed with is "The third option is, when you take into account that it's approximately as bad as the flu for folks under 40," You're ignoring data in order to make a wishy-washy statement that it must be much worse for people under 40 based on anecdotes you hear. I don't agree flu infections were higher for those 2 months, either. Dist…

First off, all those numbers are once again absolute deaths and not related to case numbers so my prior complaint still stands. If you look at the first chart, you will see that COVID-19 deaths didn't start becoming a problem until March. Distancing practices were not widespread until mid-March. Meanwhile flu deaths weren't dramatically cut until the most recent timeframe. So taking into consideration both the first chart and the second chart that breaks out the numbers by age range, there seems to be an implication that COVID-19 deaths are much higher for young people in recent weeks. Therefore the absolute numbers would look totally different if March 1st was the starting point. I really don't see anything here that demonstrates the flu is as dangerous as COVID-19 for young people.

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

#466
post #438

Earlier quoted context omitted.

The CFR will be much higher than the IFR. For example, approximate flu IFR is 0.05%.

In comparing the COVID-19 IFR to the flu IFR, it is important to remember that flu vaccines are widely available and limit the spread of influenza. For example, CDC retrospectives for 2018-9 estimate that 35M Americans[1] got influenza over the flu season, or less than 12%. By contrast, the current COVID-19 infection rate in New York (from these data) is already higher than 12%. So COVID-19 has the potential to infec…

It's actually important to point out, the CDC is very explicit that they are estimating flu illnesses, in their own words "an estimated 34 million people had symptomatic influenza illness"

Many people are attempting to extrapolate asymptomatic COVID to estimate an infection fatality rate and then making comparisons to CDC flu data for symptomatic illness, which is completely wrong. Actual flu sero studies suggest a large fraction of the population gets flu every year[1] and IFR is more like 0.02->0.05%, so even taking NYC numbers at face value COVID looks 10-50x more fatal than flu.

[1] https://journals.plos.org/plosbiology/article?id=10.1371/jou...

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

#467
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…

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…

Since false positives can be low single digit percentages, anything outside the NYC data is pretty meaningless, and a bunch of meaningless data is still meaningless.

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

#468

Earlier quoted context omitted.

It is very positive in that we can be more confident that our assumptions are close to reality. 0.5%*330M still equals 1.65M deaths, or (very roughly) 5M ICU beds. Spread out over 52 weeks, that's a lot of ventilators and ICU beds and PPE, but it is a target. A very big juicy target that we can and should aim directly at, and HIT.

It's more or less epidemiologically impossible that you will see an attack rate of 100% (as you just assumed). Once attack rate reaches >40~60%, the reproduction number drops below 1 because there just aren't enough uninfected hosts.

It will probably be significantly higher than 60%, since COVID-19's R0 without lockdown seems to be pretty high. The CDC has estimated it at 5.7 [0]. Herd immunity threshold = 1 - 1/R0, so the threshold would be 82.4%.

[0] https://wwwnc.cdc.gov/eid/article/26/7/20-0282_article?deliv...

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

#469
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.

It is very positive in that we can be more confident that our assumptions are close to reality. 0.5%*330M still equals 1.65M deaths, or (very roughly) 5M ICU beds. Spread out over 52 weeks, that's a lot of ventilators and ICU beds and PPE, but it is a target. A very big juicy target that we can and should aim directly at, and HIT.

So having killed 1.6 million in the US alone and run ICU at 100% for a year, you’re just going to hope people remain immune and the virus doesn’t mutate having passed through billions of people worldwide?

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

#470
post #404

Earlier quoted context omitted.

You can't have it both ways. If IFR is low, then that means R0 is way higher than we thought, which also means isolating only the vulnerable will not work. The fact is, the number of deaths is too high in NYC to be able to cherry-pick your way to an argument that supports your view. Either R0 is really high, and we need to shutdown to prevent it from infecting the entire population in a very short time span, or the I…

> If IFR is low, then that means R0 is way higher than we thought, which also means isolating only the vulnerable will not work. No. If you miss a constant percentage of cases, you get the same shape of exponential curve. That is, a virus with an R0 of 2 and 1 case doubling to 2 and 2 cases doubling to 4.... looks the same when you miss 99% of infections and see 1 of 100 infections doubling to 2 of 200 doubling to 4…

> If you miss a constant percentage of cases

We are talking about 1 serological study at a single point in time. We have no idea what percentage of cases we were missing before or after that point.

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