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Estimating unobserved SARS-CoV-2 infections in the United States

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Re: Estimating unobserved SARS-CoV-2 infections in the United States

#51

Post by makomk »

zaroth wrote: post #21
SpicyLemonZest wrote: post #7

Earlier quoted context omitted.

California wasn't hit very hard early. In terms of total reported cases, they're only just now starting to catch up with New York (21 per thousand for the state vs 17 per thousand for California) - and as we catch up we've had a pretty sharp improvement from the peak in July. The theory is that California flattened the curve in the original sense, delaying the peak in order to ensure it's moderately lower and protect…

I’m sure overall prevalence in CA has a ways to go to catch up to NY (NY “cases” is a massive undercount compared to CA’s moderate undercount) but they’ll get there soon enough. The takeaway to me is that unless you are willing to exert extremely strict border controls, localized quarantines and hard lockdowns of hotspots, and pervasive test & trace, indefinitely, then you wont keep Rt below 1 without the benefit of…

That might be part of the problem; if it turns out that everyone is in the same boat and will hit the same endpoints, then it's not going to be possible to politicize it, and there is an impending presidential election in the United States where the challenger and a lot of the press are relying on the idea that the US could've done massively better if not for the current incumbent to try and unseat him.

Re: Estimating unobserved SARS-CoV-2 infections in the United States

#52

Post by millettjon »

kspacewalk2 wrote: post #46
jliptzin wrote: post #39

Earlier quoted context omitted.

I know for a fact deaths are dramatically under reported (at least in FL) because I have relatives that died of COVID and the nursing homes put congestive heart failure and respiratory failure as cause of death and not COVID. After receiving positive COVID test results...

It's much less clear cut than that. In fact death with COVID ≠ death from COVID every single time, even for elderly people.

The parent is giving an example where it is clear cut.

Re: Estimating unobserved SARS-CoV-2 infections in the United States

#53

Post by netsharc »

kspacewalk2 wrote: post #46
jliptzin wrote: post #39

Earlier quoted context omitted.

I know for a fact deaths are dramatically under reported (at least in FL) because I have relatives that died of COVID and the nursing homes put congestive heart failure and respiratory failure as cause of death and not COVID. After receiving positive COVID test results...

It's much less clear cut than that. In fact death with COVID ≠ death from COVID every single time, even for elderly people.

"Your honor, the man didn't die because I pushed him down the stairs, he died because he hit his head against a wall at the bottom of those stairs.".

Re: Estimating unobserved SARS-CoV-2 infections in the United States

#54

Post by tripletao »

0xFFC wrote: post #45
jandrewrogers wrote: post #14

Earlier quoted context omitted.

A substantial percentage of infections are believed to not show up in seroprevalence studies. One of the major areas of research right now is determining how large this population is.

> A substantial percentage of infections are believed to not show up in seroprevalence studies What is the reason behind this?

The thresholds for antibody tests were established using known true negative samples (e.g., blood banked before the pandemic) and known true positive samples (e.g., patients who tested positive by PCR). But patients with worse symptoms are over-represented among people who tested positive by PCR (since they're more likely to seek a test), and patients with worse symptoms will generally have higher levels of antibodies in the blood. So if anything, the sensitivity of the test is probably an overestimate, which would make the number infected an underestimate.

I've seen a few papers testing asymptomatic patients (identified by contact tracing or other mass testing), with mixed results. NYC uses an in-house test for which I don't believe any paper exists, so I don't think we can say anything there. The IFR from NYC's serology is higher than most other estimates, which could imply under-ascertainment but could also be real (e.g., because they forced nursing homes to accept positive patients, because they were doing early intubation that we now know is harmful, etc.).

Re: Estimating unobserved SARS-CoV-2 infections in the United States

#55

Post by m0zg »

netsharc wrote: post #53
kspacewalk2 wrote: post #46

Earlier quoted context omitted.

It's much less clear cut than that. In fact death with COVID ≠ death from COVID every single time, even for elderly people.

"Your honor, the man didn't die because I pushed him down the stairs, he died because he hit his head against a wall at the bottom of those stairs.".

In the US if he tested positive for COVID after death, he would have been recorded as a COVID death. Not even joking.

Re: Estimating unobserved SARS-CoV-2 infections in the United States

#56

Post by nxpnsv »

throwawaysea wrote: post #30
nxpnsv wrote: post #24

Earlier quoted context omitted.

Get an IgG antibody test if you want to know, should still be visible there

It isn’t a fully reliable test though. There are both false positives and false negatives.

Sure, but if you had symptoms AND test positive, it is quite likely (above 95%) the result is correct.

Re: Estimating unobserved SARS-CoV-2 infections in the United States

#57

Post by Jabbles »

tomarr wrote: post #50
kspacewalk2 wrote: post #46

Earlier quoted context omitted.

It's much less clear cut than that. In fact death with COVID ≠ death from COVID every single time, even for elderly people.

Well sure, and that is a perfectly valid comment at the micro level. However, we can relatively clearly see that the COVID-linked death reporting is under-reported from mortality baselines. Therefore it's highly likely that for a given death it is more likely to be incorrectly categorise as non-COVID when COVID was responsible, than to be incorrectly designated COVID.

For contrast the UK overcounted its COVID deaths

https://www.washingtonpost.com/world/britain-says-it-overcou...

Re: Estimating unobserved SARS-CoV-2 infections in the United States

#58

Post by joshuamorton »

m0zg wrote: post #55
netsharc wrote: post #53

Earlier quoted context omitted.

"Your honor, the man didn't die because I pushed him down the stairs, he died because he hit his head against a wall at the bottom of those stairs.".

In the US if he tested positive for COVID after death, he would have been recorded as a COVID death. Not even joking.

Clearly not, given the grandparent.

Re: Estimating unobserved SARS-CoV-2 infections in the United States

#59

Post by sushshshsh »

DoofusOfDeath wrote: post #29
sushshshsh wrote: post #3

Earlier quoted context omitted.

I don't know a single person in NY who wasn't coughing for a week at some point between january and march.

Is it possible that your NY social network at the time was part of a fairly insular clique? That might explain why your sample is (potentially) not representative of the overall city or state.

I have friends all over NYC and Long Island and Jersey City, plus colleagues, their friends and family, etc etc. Collectively we know thousands of people.

The CDC officially became aware of coronavirus on Jan 1, and the first documented case in the USA was Jan 20. Now, we could have all had the flu, but really the flu doesn't have such a horrible deep chest cough like we all had in my opinion.

Given that some people say coronavirus was circulating as early as November 2019, I think we all had something more than the seasonal flu. By march 2020, the only people I knes who were sick were in nursing homes.

Re: Estimating unobserved SARS-CoV-2 infections in the United States

#60

Post by segmondy »

dehrmann wrote: post #31

I've been looking at the infection rates in the US falling over the past few weeks, and I'm wondering if it's because we achieved herd immunity for the current r0, people changed their behavior when they saw cases rising, or fewer people are getting tested because with the lag in processing time, a positive result isn't actionable.

You're looking at garbage data. The data has never been accurate or consistent.
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