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Covid-19 at a homeless shelter in Boston: Implications for universal testing

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Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#131

Post by zzzzzzzza »

usaar333 wrote: post #127
zzzzzzzza wrote: post #118

Earlier quoted context omitted.

https://www.reddit.com/r/medicine/comments/fyf0yh/megathread... you mean this serological study? And taiwan is at 1.5% CFR as well? And still 60 or so unresolved diamond princess cases with ~7 in critical condition?

Yes, I agree it is preliminary and not too much should be drawn off it. Every country is missing large numbers of cases, so CFR doesn't mean much - randomized testing is what is needed. Imperial College's paper (linked above which gives a 0.7% population IFR) uses Diamond Princess as an input. The relative risk ratio they give for someone age 70 (mean age on Diamond Princess) is something like 4.5x (IFR ~3%), so you'…

69 is the mean age of the passengers, the crew was like less than or equal 39 (about 2/3 passengers 1/3 crew I think)

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#132

Post by marvin »

usaar333 wrote: post #75
MiguelVieira wrote: post #55

Earlier quoted context omitted.

Likewise, South Korea reports a fatality rate of about 2% https://www.worldometers.info/coronavirus/country/south-kore... Since they have coronavirus relatively under control and have been doing extensive testing and contact tracing for months, it's plausible that they've caught most cases. It's wishful thinking to believe the infection fatality rate is an order of magnitude lower.

It is not plausible they caught most cases. Here's the result of randomized testing in Iceland, which also has the virus under control and has done even more testing per capita ( https://www.nejm.org/doi/full/10.1056/NEJMoa2006100?query=fe... ) Randomized testing was still finding 0.6% of the population (outside those otherwise quarantined already) actively infected. This means even in Iceland, less than half of infe…

That's a much more reasonable interpretation of the available data, although there are still plenty of unknowns here, as sibling comments are pointing out. My interpretations the last week are converging on the same ballpark figures.

I'd just like to point out that this is still a far cry from the wishful thinking a lot of people are putting forth, claiming an IFR of These interpretations seem less likely to be true today than they did two weeks ago, and even then they were making assumptions on the optimistic side.

An IFR of 0.5% and a hospitalization rate in the high single digits is still a big frickin problem for society, when the disease has a reproduction number greater than 2 (and in the absence of countermeasures, more likely in the region 2-5).

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#133

Post by analog31 »

I certainly don't have a better read on the numbers than anybody else. But I think that the rising number of reported cases and deaths is going to make it harder and harder to think that there is a huge hidden pool of asymptomatic or immune people in the population.

For instance as of today, the number of unreported to reported cases in the US can't be more than about 500.

The time period when the disease could have been prevalent in the US can't have been very long, because at its present level it kills about 15000 per week -- a number that could not have gone unnoticed even a month ago.

Eventually, the curves of hopes, reported data, and reality will all have to intersect, I just don't know where or when.

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#134

Post by perl4ever »

_euac wrote: post #128
wutbrodo wrote: post #119

Earlier quoted context omitted.

> The Diamond Princess likely had a very atypical (older) population than the general population though. This would dovetail with the fact that places like sub-Saharan Africa and India haven't been hit very hard yet; they also happen to be _very_ young compared to Western countries.

I don't know if people are aware of this, but there's an increasing suspicion that countries still using the BCG vaccine for tuberculosis might be seeing [1]way lower infection rates. If that's the case, it'd explain why developed countries are bearing the brunt of the pandemic. A very interesting example of similarly developed countries with comparable (but not equal) populations and population density, but differen…

"there's an increasing suspicion that countries still using the BCG vaccine for tuberculosis might be seeing [1]way lower infection rates"

Obvious to me, perhaps dumb, question - if countries that were slower to change vaccination regimes have some advantage, then wouldn't we see older people in the countries that did change also at an advantage? Yet all reporting seems to be that older people are harder hit.

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#135

Post by usaar333 »

zzzzzzzza wrote: post #131
usaar333 wrote: post #127

Earlier quoted context omitted.

Yes, I agree it is preliminary and not too much should be drawn off it. Every country is missing large numbers of cases, so CFR doesn't mean much - randomized testing is what is needed. Imperial College's paper (linked above which gives a 0.7% population IFR) uses Diamond Princess as an input. The relative risk ratio they give for someone age 70 (mean age on Diamond Princess) is something like 4.5x (IFR ~3%), so you'…

69 is the mean age of the passengers, the crew was like less than or equal 39 (about 2/3 passengers 1/3 crew I think)

hence why I divided by the passenger, not total, count

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#136

Post by kevingadd »

stetrain wrote: post #78
bgorman wrote: post #29

Earlier quoted context omitted.

The thing you are missing is world governments want to milk this crisis, not act objectively. There is simply no other explanation.

Milk it by tanking GDP? I'm sure that will do well for government revenue this year. I'm sure Trump was just itching to shut down international travel, recommend reduced productivity, and mail everyone checks. He just needed a good excuse.

Sending out checks is pretty popular with voters, which is why he's insisting on having his personal signature on them in an election year.

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#137

Post by sjg007 »

casefields wrote: post #114
sjg007 wrote: post #19

Earlier quoted context omitted.

It's probably low prevalence in the population based on our understanding of when covid-19 first appeared. The UK has some randomized seriological surveillance and it's about 13% prevalence. That matches with the pregnancy study of 15% prevalence (which may be enriched due to hospital visits).

There's already a change in the public narrative. New signs suggest coronavirus was in California far earlier than anyone knew: https://www.latimes.com/california/story/2020-04-11/bay-area... Whoops.

That's not inconsistent with the Seattle timeline. But for sure genetic analysis of the viruses would reveal the source.

"Stanford’s virology lab, looking retroactively at some 2,800 patient samples collected since January, did not find the first COVID-19 cases until late February — from two patients who were tested Feb. 21 and Feb. 23"

Again not inconsistent with the Seattle timeline.

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#138

Post by IAmEveryone »

MikeAmelung wrote: post #84
IAmEveryone wrote: post #64

Earlier quoted context omitted.

> Imagine if 10+% of the population already had COVID and where immune, we'd be much closer to heard immunity than we currently think. We’d be about 1/7 the way there. Meaning we’d see another 6x current deaths to get through this. That’s not even close to acceptable. And the 10% aren’t realistic, anyway. At least nationally. Assuming nationwide rates of 10%, then scaling up by death numbers, would put infection rate…

Why would the rest of the country have the exact same percentage of infected as New York City, the only place in the country where most people don't own cars, and almost everyone takes cramped public transportation. NYC clearly has a MUCH higher infection rate than anywhere else in the country.

> Why would the rest of the country have the exact same percentage of infected as New York City?

I didn't say that. In fact, I said the exact opposite: to get to 10% nationwide while explaining the rather large per capita differences in deaths, you'd need either negative infection rates in some places (say, Alaska), or >100% infection rates in hotspots. Neither is possible.

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#139

Post by halliburton »

notJim wrote: post #109
cgb223 wrote: post #52

Earlier quoted context omitted.

> In the US, we're now doing significant amounts of testing, but we're still primarily testing only those with severe symptoms Its not a significant amount of testing if we're only testing those with severe symptoms Here in SF at least there are scores of people I know who all were sick with a "weird flu" at some point from February to now who would all kill for a test to show that they have COVID immunity. These are…

> These are people who could potentially go back into society Do we know this for sure? I've read that we're seeing re-infections of people who previously had it, but it wasn't clear exactly what was happening.

we don't. he is (perhaps unknowingly) spreading disinformation, but that's really very normal behavior.

the hardest thing about this is finding real information and then accepting it.

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#140

Post by makomk »

cgb223 wrote: post #52
jlmorton wrote: post #14

Earlier quoted context omitted.

We already have lots of data that says this is not true. For instance, on the Diamond Princess, widespread testing of a confined group initially found many asymptomatic infections, but the majority of those turned out to be pre-symptomatic, not asymptomatic. Longer term follow-up found ~25% of infections were asymptomatic. In the US, we're now doing significant amounts of testing, but we're still primarily testing on…

> In the US, we're now doing significant amounts of testing, but we're still primarily testing only those with severe symptoms Its not a significant amount of testing if we're only testing those with severe symptoms Here in SF at least there are scores of people I know who all were sick with a "weird flu" at some point from February to now who would all kill for a test to show that they have COVID immunity. These are…

The US is doing a significant amount of testing compared to what's available almost anywhere else on the planet. I think Germany is still beating them, but they're basically the only large country that is at this point. Journalists here in the UK have actually been pointing to the US as one of the examples that proves we're the ones failing at testing for a while now.
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