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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

#71

Post by gnulinux »

gowld wrote: post #40
irishcoffee wrote: post #33

Earlier quoted context omitted.

Occams Razor would suggest that they may not have caught the virus on the boat then but perhaps after, no?

Why? 23 days for the longest time to succumb isn't surprisingly long. small exposure, healthy person / lucky genes, good medical treatment, but not quite healthy/lucky/good enough.

Well the longest possible according to this data would be 54 days. We don't know the identity of patients who died, could be one of the people who tested positive on Feb 1 (or sometime in early Feb).

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

#72

Post by marcosdumay »

kens wrote: post #34

Regarding the title "Covid+", it seems that most people (even on the news) don't care about the difference between SARS-CoV-2 (the virus) and COVID-19 (the disease). Is this distinction being abandoned? (I'm not trying to be pedantic here; I'm just curious about the common usage.)

Nobody ever cared. The names are confusing (the virus is named after the disease, and the disease after the virus), and the virus name obtuse. The obvious consequence is that nobody ever used the virus name, and never will.

The best you can hope for is for people to call it the "COVID19 virus".

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

#73

Post by arcticfox »

dajohnson89 wrote: post #32
credit_guy wrote: post #21

Earlier quoted context omitted.

My bet is that it's much more than 10%. In NYC I think it's at least 20%-30% by now. Obviously, I don't have any more data than what you can find online, but anecdotally, I think one of my sons had it; he most likely got it from his piano teacher who exhibited all the Covid symptoms (fever, dry cough, loss of smell), but was never tested. I think at least myself and my wife got this from him as well; likely his two s…

brooklyn resident here. fwiw (not much), it feels like easily 1/3 of the local people i know got some mild fever symptoms in the same 3-week timespan.

As a counterpoint, I saw a lot of people supporting the idea (with similar anecdotes) that there was a huge outbreak in California in December before we were even testing for COVID at all. Which was empirically demonstrated to be untrue by the later Seattle Flu Study testing of the viral genome.

That said, it's a whole lot more likely that you're right than the December-California-epidemic folks, just saying that that type of anecdotal evidence is fairly easy to come by in the winter.

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

#74

Post by ska »

irishcoffee wrote: post #33
gnulinux wrote: post #16

Earlier quoted context omitted.

A Diamond Princess ex-passenger died as late as March 24. The first patient was tested positive on February 1, and the ship was quarantined on Feb 4, and everyone left the ship on March 1. It doesn't seem unlikely you can die from this virus a month (or even two months?) after testing positive. Or maybe I'm missing something?

Occams Razor would suggest that they may not have caught the virus on the boat then but perhaps after, no?

Given current information, Occam's razor cuts the other way. Unless perhaps that person had another known significant contact.

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

#75

Post by usaar333 »

MiguelVieira wrote: post #55
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…

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 infections were being caught.

Iceland's CFR right now is 0.74% using deaths/recovered (or if you use an ultimate 20% hospitalization fatality rate, around 0.87%). If they missed half of infections, you get an IFR down to under 0.5%, though I'll admit they are doing better by keeping their most vulnerable population from being infected. (note the low infection rate for people 70+ at https://www.covid.is/data).

So no, not an order of magnitude lower, but 3x lower (0.7%) is looking pretty reasonable. Imperial College's latest estimate is 0.66% for China (https://www.medrxiv.org/content/10.1101/2020.03.09.20033357v...).

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

#76

Post by IAmEveryone »

autokad wrote: post #39
raphlinus wrote: post #18

Earlier quoted context omitted.

No. We know from genomic analysis [1] that "The common ancestor of circulating viruses appears to have emerged in Wuhan, China, in late Nov or early Dec 2019." It's fun to speculate about other possibilities, but I personally like to stick to what the science tells us. [1]: https://twitter.com/nextstrain/status/1248707010750640128

well, google coronavirus searches in China, specifically Hubei province, spiked in September of 2019. Science is a term being twisted out of its original context. if people keep doing that, its going to be a pejorative.

Even if I were inclined to believe such statements without a link, this doesn’t make any sense.

For Google searches to spike, information about the disease would need to be public knowledge. And at that point, you wouldn’t need Google search traffic to prove anything.

Also: Google is blocked in China, isn’t it?

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

#77

Post by arcticfox »

jandrese wrote: post #11
drtillberg wrote: post #7

Earlier quoted context omitted.

The Boston Globe this morning ran an op-ed advocating testing a random sample of residents to get a better sense of community-wide infection rates.[1] It's amazing that this needed to be stated in a major market newspaper four weeks after most business and school was stopped due to the virus. Goverent is doing some interesting things, random sampling apparently isn't one of them, for reasons it's hard to understand.…

Everybody knows this, but the US healthcare system was so unprepared for this that there simply weren't (aren't) enough test kits around to do a proper study. Even people who have the symptoms struggle to find a place that will test them in some cities.

I like Step 0 of Paul Romer's proposal: "Stop testing people with symptoms. Presume positive and isolate."

https://twitter.com/paulmromer/status/1248712889705410560

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

#78

Post by stetrain »

bgorman wrote: post #29
smallgovt wrote: post #17

Earlier quoted context omitted.

> We need more studies to gather data on these asymptomatic cases if we want to reopen the economy soon. I don't understand what's so hard about measuring population infection rate. Assuming the population infection rate is between 1-10%, we would only need to do around ~500 randomized tests to achieve a 95% confidence interval of +/- 1%. For example, let's say we tested 500 random NYC residents for COVID and found t…

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.

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

#79

Post by pm_me_ur_fullz »

sjg007 wrote: post #24
pm_me_ur_fullz wrote: post #9

Earlier quoted context omitted.

I really don't understand why people immediately want to discredit the idea that US patient zero was not the first in US. Or that this virus was around earlier and that there are limitations in contact tracing capabilities. This seems to have the toughest aspect of gaining consensus. Need antibody tests now, and ones that work reliably.

Because it's not true.

Why is that the most preposterous hypothesis that doesn't warrant any review?

We have no reliable antibody tests, and then won't give the unreliable ones people because they are so rare. So where does the confidence come from that we can rule out this possibility?

What if this is already the "second wave". Something with lower symptoms wouldn't have warranted checking for a new strain, complications and deaths would fit into the normal distribution of last fall's flu season with no outlier spikes. We would then be deep into the second wave and can't even test most for people currently exposed to it, much less having already been exposed. This is enough not to dismiss the hypothesis.

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

#80

Post by dr_dshiv »

smallgovt wrote: post #17
jcp2fa wrote: post #6

> Cough (7.5%), shortness of breath (1.4%), and fever (0.7%) were all uncommon among COVID-positive individuals It seems the more important point here is that the majority of the COVID-positive individuals were asymptomatic, putting another datapoint towards the conclusion that there are orders of magnitude more people that have this disease than have tested positive. We need more studies to gather data on these asym…

> We need more studies to gather data on these asymptomatic cases if we want to reopen the economy soon. I don't understand what's so hard about measuring population infection rate. Assuming the population infection rate is between 1-10%, we would only need to do around ~500 randomized tests to achieve a 95% confidence interval of +/- 1%. For example, let's say we tested 500 random NYC residents for COVID and found t…

Amen. The whole scenario seems like a bad statistics lesson.

Happy to change my mind -- but there simply hasn't been any effort to use population testing in this way -- which is one of the only useful forms of testing. Otherwise, why test people in the hospital? It doesn't change treatment. Finding asymptomatics is actually useful -- and random sampling seems critical for understanding whether we are simply fucked or actually fubar'd.

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