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A Third Solution

paulbuchheit.blogspot.com

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Re: A Third Solution

#171

Post by triyambakam »

roywiggins wrote: post #19
triyambakam wrote: post #3

The article begins by stating that this is not like the flu, yet we know people die from complications or directly from the flu every year. And further, we're seeing more and more evidence of huge numbers of the population with antibodies, i.e. already infected and immune. We also have seen the damage that using ventilators have had due to misunderstanding how this virus starves the body of oxygen (through the blood,…

It's not the flu because the infection fatality rate is almost certainly a lot higher, we have no vaccine, and no reliable treatments. Seasonal flu has (semi-reliable) vaccines and antivirals and is almost definitely significantly less deadly. Look at the excess death statistics. There's no question that it's deadlier than seasonal flu, because the seasonal flu doesn't kill a 9/11s worth of New Yorkers above the usua…

Is it actually excess deaths? So many deaths are being counted as covid-19 that it looks more like we have the same amount of total deaths by all causes and any other year

Re: A Third Solution

#172

Post by maxerickson »

not_a_moth wrote: post #160

A fourth way: We throw as many resources as we can at sampling undiagnosed populations, like the recent NYC study that suggests 20% of the city (10% of the state) has antibodies already. We could get real confidence that it's safe enough to return to normal, acceping that COVID is a new disease that's just going to be around, the 5th coronavirus that we deal with seasonally.

The arithmetic on that is ~1 million early deaths in the US.

The screening in the article would cost billions of dollars.

If it worked, we could then reuse the infrastructure to kill the flu. And then start on the colds.

Re: A Third Solution

#173

Post by predxionbio »

vikramkr wrote: post #127

Really interesting read and sounds like it could be a game changer for testing - I know in NY we've been clamoring for increased testing for a while to help us reopen. I've got two questions I'm curious about: 0) Sensitivity/specificity: Any data yet on what the sensitivity and specificity of this form of test for SARS-COV-2 will be? And, is work in characterizing all of that far enough along that we can expect to se…

0) From a clinical perspective this is data we are generating on an on going basis. Analytically this is a largely a function of the characteristics of the affinity, specificity of the capture molecule used to capture the target (viral particle). As you point out EUA gives opportunities to launch sooner... But it's still critical to validate technogies both internally and externally probably to a greater extent than the de minimus EUA reqs

1) great question. Our approach is novel which allows us to tap into new supply chains that are inherently more scalable (think semi-conductor Fab) but the trade off is execution risk.

Re: A Third Solution

#174

Post by arcticbull »

jhayward wrote: post #158
arcticbull wrote: post #149

Earlier quoted context omitted.

Again, as always, Sweden seems to be doing it just fine.

Sweden isn’t proof of anything, please stop using it as though it is. Your claim is that the vulnerable can be “holed up” while everyone else goes about their happy business. There is no such thing, and I challenge you to provide the details and success as measured by per-demographic death rates of any proof you may have.

The crux of the issue is this: Neither I nor the Swedes believe that you can keep this disease at bay by hiding indoors for a few months and then opening back up well in advance of a vaccine which appears to be the entire world's game plan. I think it's fair to say there won't be a vaccine for 12-18 months, and we're not as a society prepared to stay indoors for that long.

Not to mention even with complete lockdowns around the US we're somehow seeing 38,000 new cases per day. This is not winning. With an R0 of 2-5 a single new infected person post lockdown lifting is going to set the wildfire ablaze again. As China is showing us, if you lock down then re-open, you're just going to start playing whack-a-mole with rolling city-level lockdowns.

Even if we were to stay inside for months, the case the Swedes are making is that deaths are higher now than in locked down countries, but unlike locked down countries, the Swedes will have developed herd immunity in a few months, and will never be affected again.

This makes the temporary delta in death rates not a success for locked-down countries but rather a temporary deferral.

Sweden is proof of something, but it's not clear yet what. Somehow, their new case load is pretty flat, just like the US. [1]

[1] https://aatishb.com/covidtrends/?location=Canada&location=Sw...

Re: A Third Solution

#175

Post by chockablock »

centimeter wrote: post #37
rguzman wrote: post #20

Earlier quoted context omitted.

the CFR is only as low as 0.5-1% when there is adequate medical care and the population is otherwise healthy. in NYC the CFR for the 18-45 cohort is ~5%[1]. [1]: https://www.worldometers.info/coronavirus/coronavirus-age-se...

CFR is a terrible metric - you should be using IFR. CFR is of course going to be much higher than the IFR, probably orders of magnitude higher. IFR data hasn't been available until recently because you need A) randomized sampling and B) antibody tests, which have only just been rolled out. The most up-to-date IFR data suggests that "0.5%" is actually an astoundingly high over estimate for any reasonable metric of "nu…

> astoundingly high overestimate for any reasonable metric

12k deaths in NYC gives a pretty hard lower bound on IFR of 0.14%.

The IFR will end up higher than 0.5% if incidence in city is any lower than 27%, which seems very reasonably likely.

Re: A Third Solution

#176

Post by roywiggins »

triyambakam wrote: post #171
roywiggins wrote: post #19

Earlier quoted context omitted.

It's not the flu because the infection fatality rate is almost certainly a lot higher, we have no vaccine, and no reliable treatments. Seasonal flu has (semi-reliable) vaccines and antivirals and is almost definitely significantly less deadly. Look at the excess death statistics. There's no question that it's deadlier than seasonal flu, because the seasonal flu doesn't kill a 9/11s worth of New Yorkers above the usua…

Is it actually excess deaths? So many deaths are being counted as covid-19 that it looks more like we have the same amount of total deaths by all causes and any other year

Sure looks that way to me. The spike is larger than 9/11.

https://www.nytimes.com/interactive/2020/04/10/upshot/corona...

Re: A Third Solution

#177

Post by js8 »

SpicyLemonZest wrote: post #86
buboard wrote: post #73

This assumes that "economic activity will restart". Humans won't participate in dangerous activities. They may test the waters e.g. by ggoing to gyms, but as soon as a single case is found they 'll be scared back into their homes. It will happen even more so as the disease spreads and people learn about the death of someone they know. This will happen regardless of how much testing. If you 're doing contact tracing r…

If humans were so extremely risk averse that a single case is unacceptable, wouldn't we have naturally isolated ourselves without requiring lockdown orders?

No, because while many humans are risk averse, we also live in certain cultural circumstances that prevent us to make that decision unilaterally.

For example, I cannot just tell my boss, I am working from home, even though in my case there is no problem. Even if he allows, the company policy might not. (Although I am lucky I live in a sane country and we have that policy now.)

Or in Czechia, now everyone wears a mask (since it is mandatory). It became a norm in like 2 days, one day almost nobody had them (and people felt that wearing them makes you look sick), the next day they became mandatory in public transport, and the day after everybody had them.

There are other examples like that, where the peer pressure plays an important role (in preventing humans to make rational decisions).

Re: A Third Solution

#178

Post by mkolodny »

pb wrote: post #143
adpirz wrote: post #138

Earlier quoted context omitted.

Assuming everything goes to plan, how will these be staffed and manufactured at scale?

It's a fully automated solution, like an airport kiosk or a subway turnstile. Maybe I need to make that more clear?

People hop over subway turnstiles all the time. It would have to be more secure than that to make me feel safe once I'm inside.

You could have security guards with masks at every entrance. But if even one person with COVID-19 gets past security, you could start an outbreak.

Re: A Third Solution

#179

Post by OldHand2018 »

vikramkr wrote: post #46
pb wrote: post #22

Earlier quoted context omitted.

I have not found any mainstream sources that advocate screening everyone every day (which is very different from simply doing "more testing"). Would love some pointers if I'm wrong.

I think governor Cuomo was saying he'd love to test every day if he could, but just doesn't have the capacity. Edit: as a side note he put out a call for companies that can help with testing saying that NY state might be willing to invest to bring things to scale. I believe he already wanted FDA approved tests but there's an opportunity there to work directly with a government to implement this sort of thing. IIRC, m…

Gov Cuomo should call up Gov Pritzger. Illinois recognized the challenge of testing supplies and asked the state universities to solve the problem. They have. Illinois is reporting a lot more positive cases in the past week because they keep increasing the number of daily tests. I believe that today was well over 12000 tests in Illinois. Anyone who feels like getting tested is now allowed to get a test.

Re: A Third Solution

#180

Post by _y5hn »

vikramkr wrote: post #127

Really interesting read and sounds like it could be a game changer for testing - I know in NY we've been clamoring for increased testing for a while to help us reopen. I've got two questions I'm curious about: 0) Sensitivity/specificity: Any data yet on what the sensitivity and specificity of this form of test for SARS-COV-2 will be? And, is work in characterizing all of that far enough along that we can expect to se…

Tests are R&D in Norway that could test entire population in 2-3 weeks. It's developed to scale, so may improve. It's coming and soon, though there will be a ramp-up.
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