Preliminary test results suggest 21% of NYC residents have Covid antibodies • Hacker News Board

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

#661

Post by zaroth » Fri, Apr 24, 2020, 8:52 PM UTC

vannevar wrote: post #645

zaroth wrote: post #638

Earlier quoted context omitted.

I actually agree with everything you said, but I still haven’t found the basis for the tremendously costly actions taken. As we can see, NYC did not particularly flatten their curve, and they did not see excess deaths due to lack of available care. They already hit the endpoint prevalence that you would see with the flu in a very bad year. It’s not clear how much further SARS-CoV-2 would go naturally — the S curve do…

NYC did not particularly flatten their curve, and they did not see excess deaths due to lack of available care. I'm pretty sure all the family members of the people who died would regard their loved ones as "excess deaths". Your technocratic language ascribes no value to the lives lost, in which case of course the actions seem excessive. For people who don't value the lives of others, it would be hard to understand a…

So the most charitable interpretation of my comment is to convince yourself I’m a sociopath?

Excess deaths is a term of art to describe a number of deaths over a baseline. It can be used in general, or specifically, as I was using it, to describe the repercussions of an overloaded health care system. Here, for example, is a Sky News story from today using the term in its headline. [1]

I think you owe me an apology, but I won’t hold my breathe.

“Flattening the curve” is absolutely not intended to buy time to develop a cure or vaccine. The timeline over which the economic devastation of flattening the curve can be sustained is measured in weeks not 12-18 months.

The purpose of flattening the curve is to be sure there are the necessary number of hospital beds and ICU beds to provide effective treatment. If effective treatment can not be provided it leads to “excess deaths”.

Bad projections based on a 10% hospitalization rate and based on assumptions that ICU ventilators wouldn’t kill 80% of patients, have led to disastrously bad public policy which is causing untold suffering throughout the country. This suffering, which many people seem to be blind to, is notably self-imposed rather than natural, and through logical and reasonable interpretation of factual data we can stop this suffering.

This is very much unlike the suffering caused by people who are dying from COVID, for which unfortunately we have no effective cure or treatment, and for which it is not reasonable to assume we will develop one in the timeline of this current pandemic.

This is the key takeaway from “flattening the curve”. It cannot and will not decrease the total number of people who are ultimately exposed at this stage of the pandemic. Once the health system capacity is high enough to handle the number of cases coming in with effective care, continuing social distancing causes extraordinary damage without any benefit.

Since effective care at this point has proven to be both simple and extremely scalable (non-invasive ventilation, antibiotics, and frequent repositioning) the resource curves for effective care are extremely larger than projected, back when they were based on availability of ventilators.

Simply put, the data has changed, and it’s time to update the policy. It’s extremely incompassionate to do otherwise.

[1] - https://news.sky.com/story/amp/coronavirus-englands-excess-d...

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

#662

Post by athrowaway3z » Fri, Apr 24, 2020, 9:08 PM UTC

newacct583 wrote: post #355

athrowaway3z wrote: post #297

Earlier quoted context omitted.

What? All of these numbers are inline with what experts have been saying and modeling for more than a month. We will be dealing with this for at least another year. We will cycle through policy to loosen up and close back down a little. In the best case for NYC they are 1/4th of the way to herd immunity in numbers. With the drop in transmissions, this might be 1/8th of the way in terms of time. There will be more dea…

Herd immunity doesn't mean 100% exposure. It means a high enough incidence of antibodies such that the effective R0 goes lower than one, meaning that new outbreaks tend to shrink over time and not grow. With most endemic viruses, antibody incidence is somewhere around 30-50% I believe, but I haven't seen any modelling for what covid is expected to do specifically.

If there are a high number of asymptomatic/mild cases that are to infectious to others this means it will have to be more. i've seen numbers between 70% and 80%. Thats why i took 1/4th to mean 80%

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

#663

Post by __blockcipher__ » Fri, Apr 24, 2020, 11:57 PM UTC

nodamage wrote: post #481

__blockcipher__ wrote: post #387

Earlier quoted context omitted.

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 mo…

> 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. Can you share the specific numbers you used to reach this conclusions? The reason I ask is because I'm seeing a lot of people in this thread comparing: 1) Overall influenza fatality rates to age stratified Covid fatality rat…

Following up here:

I came across https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-.... It's not clear if it's referring to CFR or IFR but I imagine it must be CFR given how high some of the numbers are (500 deaths per 1000 in some cases).

I agree that finding properly stratified data that is comparing IFR and not just symptomatic CFR is quite tricky.

At a minimum though, if we assume the chart I linked is CFR and compare to the Covid 5-20% CFRs we've seen, we still get that order of magnitude difference for the very, very young. But like I said in my previous comment here, I don't think the statement for all under 30's holds. It'd have to be https://bmcmedicine.biomedcentral.com/track/pdf/10.1186/1741... is helpful, I still haven't proven anything)

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

#664

Post by kurthr » Sat, Apr 25, 2020, 1:24 AM UTC

kurthr wrote: post #596

TheBlight wrote: post #348

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…

Nope, because they're all designed to skew higher. People who are out shopping, people who will go out of their way on a weekend to be tested, healthcare workers... all of them are likely skewed high. One might as well conclude (with as much evidence) that the purpose of the tests is to show higher infection rates. Still, nobody doubts that we're under testing by a factor of 3-5x to catch a majority of cases. What's…

In support of my statement, it is now noted that the lead professor's wife sent out misleading emails to find people who wanted to return to work, if they tested positive. The professor says he knew nothing of it and because they are wealthy they would skew low rather than high.

BuzzFeed News: A Stanford Professor’s Wife Recruited People For His Coronavirus Study By Claiming It Would Reveal If They Could “Return To Work Without Fear”. https://www.buzzfeednews.com/article/stephaniemlee/stanford-...

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

#665

Post by Gibbon1 » Sat, Apr 25, 2020, 1:46 AM UTC

mlyle wrote: post #654

Gibbon1 wrote: post #361

Earlier quoted context omitted.

This weekend San Francisco plans to do a hard test of about 6000 people in a couple of square blocks of the Mission district. They are going door to door to encourage people to get tested. Still biased but probably better than anything so far.

Yup.. though it's unclear how much we'll clear the test sensitivity hurdle by.

I wonder about that. They are trying to test a neighborhood they think is most effected. One wonders if it's possible to follow up and retest positives to exclude false one.

Suspect the Bay Area is moving towards what Korea is doing. Intense testing and contact tracing.

Friend who works at a biomedical corp says scuttlebutt is they're separating their workforce into groups based on critical need and how well they can work remotely. Workers like him not expected to return to work onsite until next year.

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

#666

Post by mlyle » Sat, Apr 25, 2020, 2:12 AM UTC

Gibbon1 wrote: post #665

mlyle wrote: post #654

Earlier quoted context omitted.

Yup.. though it's unclear how much we'll clear the test sensitivity hurdle by.

I wonder about that. They are trying to test a neighborhood they think is most effected. One wonders if it's possible to follow up and retest positives to exclude false one. Suspect the Bay Area is moving towards what Korea is doing. Intense testing and contact tracing. Friend who works at a biomedical corp says scuttlebutt is they're separating their workforce into groups based on critical need and how well they can…

Retesting positives won't work because we don't know whether it's independent. If there's some rare common cold coronavirus antibodies that some of the population has, that set off the test, they'll still have them later.

Not sure how well having the Bay Area do one thing, and large chunks of the rest of the country dash to herd immunity is going to work.

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

#667

Post by mlthoughts2018 » Sat, Apr 25, 2020, 2:43 AM UTC

mlyle wrote: post #646

mlthoughts2018 wrote: post #631

Earlier quoted context omitted.

> “ since the majority of people have no choice but to grocery shop in person” This is deeply flawed. I live in NYC and have been making donations to have food delivered to elderly people since this started. Just the other day, de Blasio announced that taxi and rideshare drivers would be paid by the city to deliver food - and city agencies would be serving as overflow dispatchers and tech support for it. Many, many p…

> and in most cases the test specificity is on par with the incidence rate itself, ????? We can't exclude that specificity may be 97% (it's unlikely, based on our data, but it's at the edge of the confidence interval), which is unfortunately on par with the studies returning 2-4% positives... but can't exactly explain a return of 21%. Subtract off 4% worst-case false positives from 21%, and where are you? Since you w…

From the same Gelman article:

> First off, 3% does not sound implausible. If they said 30%, I’d be skeptical, given how everyone’s been hiding out for awhile, but 3%, sure, maybe so.

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

#668

Post by Gibbon1 » Sat, Apr 25, 2020, 4:37 AM UTC

mlyle wrote: post #666

Gibbon1 wrote: post #665

Earlier quoted context omitted.

I wonder about that. They are trying to test a neighborhood they think is most effected. One wonders if it's possible to follow up and retest positives to exclude false one. Suspect the Bay Area is moving towards what Korea is doing. Intense testing and contact tracing. Friend who works at a biomedical corp says scuttlebutt is they're separating their workforce into groups based on critical need and how well they can…

Retesting positives won't work because we don't know whether it's independent. If there's some rare common cold coronavirus antibodies that some of the population has, that set off the test, they'll still have them later. Not sure how well having the Bay Area do one thing, and large chunks of the rest of the country dash to herd immunity is going to work.

I think team herd immunity is going to have a rough time of it.

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

#669

Post by [deleted] » Sat, Apr 25, 2020, 5:14 AM UTC

greendave wrote: post #294

Retric wrote: post #137

Earlier quoted context omitted.

Flu is generally well under 0.1% of those infected on average. If you’re comparing them you want to either include or exclude asymptotic people from both populations. “Symptomatic Illnesses” https://www.cdc.gov/flu/about/burden/index.html As to NYC deaths, many people currently infected will die in the future. You can make various estimates to account for this but a reasonable first approximation is to double current…

As an asymptotic* person, I resent your hyperbola. (Sorry, couldn't resist).

[deleted]

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

#670

Post by keenmaster » Sat, Apr 25, 2020, 6:06 AM UTC

varenc wrote: post #459

CydeWeys wrote: post #433

Earlier quoted context omitted.

The study is dramatically over-sampling exactly the people who have the most potential exposure to COVID-19, and dramatically over-sampling the people who don't. This could easily be way off. It's not testing the people who aren't home at all, and it has a low chance of only testing the people who leave home rarely, only when strictly necessary. It's mainly finding the people who leave home a lot.

I think the overwhelming majority of people are visiting grocery stores to buy food. (Or have someone in their household doing it) If the studied presume this then it makes more sense.

At any given point of time, a disproportionate number of shoppers in a store are super-shoppers - people that shop more often than the average person and for longer periods of time. Those people are also more likely to have caught Coronavirus before. Without even getting into online ordering, false positives, etc...this phenomenon alone may confound the test results.