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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

#81

Post by w0utert »

Retric wrote: post #20
gnulinux wrote: post #8

Earlier quoted context omitted.

It seems to indicate this disease infected a lot more than what we see, and maybe mortality rate is lower than what we currently assume. Maybe it's around 0.1% to 0.5%. So is it possible this disease appeared in China way before December, maybe a few months back. Then in December it reached a saturation point (i.e. infected hundreds of thousands of people, so deaths started to get noticed by respiratory specialists).…

No for several reasons. The Dimond Princess had over 100 crew of young healthy adults test positive and only 25% where asymptotic long term. Additionally South Korea has a massive effort into contact traction which demonstrated just how rapidly the disease spread. Their mortality numbers looked to be about 0.6% early on, but eventually hit 2% a month after the peak with people spending weeks in critical condition. On…

>> Their mortality numbers looked to be about 0.6% early on, but eventually hit 2% a month after the peak with people spending weeks in critical condition.

I see this repeated often but this is a misrepresentation of the statistics. Case fatality rate (CFR) is not the same as mortality rate. The CFR is the ratio between deaths and confirmed cases, mortality rate is the ratio between deaths and total number of people infected. The former number is 2% in South Korea now, the latter can not be measured directly without testing 100% of the population continually during the entire timespan of the outbreak, but it is (practically speaking) by definition significantly lower than 2%, unless there is a huge number of unaccounted Covid-19 deaths, which is very unlikely.

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

#82

Post by bb2018 »

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.

Do you have a link to that? I'd love to know more about why this would be the case.

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

#83

Post by usaar333 »

credit_guy wrote: post #21
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…

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…

15% of pregnant woman in NYC that delivered had active Covid infections (https://www.nejm.org/doi/full/10.1056/NEJMc2009316) detectable by PCR. It's highly unlikely under 20% of the population was infected. I'd bet closer to the 30% in fact.

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

#84

Post by MikeAmelung »

IAmEveryone wrote: post #64
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…

> 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.

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

#85

Post by riazrizvi »

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…

Well we need to measure if people have it and if people have had it. The have it test is currently $3000 a pop, and the had it test is hitting accuracy road blocks [1].

[1] https://www.wsj.com/articles/health-authorities-roll-out-new...

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

#86

Post by usaar333 »

sauwan wrote: post #48
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…

The Diamond Princess likely had a very atypical (older) population than the general population though. The CDC is currently estimating an R0 of 5.7, which has likely been repressed by shelter in place orders. But even if it was only 4 before any interventions, there's still a chance there there are closer to 20M cases in the US rather than the 660,000 now. My point is just that there's still a lot we don't know, and…

5.7 in Wuhan. That could be true for NYC as well, but is far less likely to be true in the rest of the lower density country. That said I agree with you that infections are likely in the 10M range.

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

#87

Post by cgb223 »

beamatronic wrote: post #66
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…

Go do the Stanford drive-through blood antibody tests. It takes five minutes it’s free and they do it for everybody.

Do you need any kind of doctors order for that or health insurance?

Like how does it work? Would love to go do that

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

#88

Post by dh37 »

w0utert wrote: post #81
Retric wrote: post #20

Earlier quoted context omitted.

No for several reasons. The Dimond Princess had over 100 crew of young healthy adults test positive and only 25% where asymptotic long term. Additionally South Korea has a massive effort into contact traction which demonstrated just how rapidly the disease spread. Their mortality numbers looked to be about 0.6% early on, but eventually hit 2% a month after the peak with people spending weeks in critical condition. On…

>> Their mortality numbers looked to be about 0.6% early on, but eventually hit 2% a month after the peak with people spending weeks in critical condition. I see this repeated often but this is a misrepresentation of the statistics. Case fatality rate (CFR) is not the same as mortality rate. The CFR is the ratio between deaths and confirmed cases, mortality rate is the ratio between deaths and total number of people…

Agreed, although a nitpick: I think what you call "mortality rate" is called "infection mortality rate". (Totally agree with your important point that IFR < CFR.)

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

#90

Post by redis_mlc »

gnulinux wrote: post #8
easytiger wrote: post #5

Earlier quoted context omitted.

Yup. And for far longer.

It seems to indicate this disease infected a lot more than what we see, and maybe mortality rate is lower than what we currently assume. Maybe it's around 0.1% to 0.5%. So is it possible this disease appeared in China way before December, maybe a few months back. Then in December it reached a saturation point (i.e. infected hundreds of thousands of people, so deaths started to get noticed by respiratory specialists).…

Hospital Patient Zero has been traced back to Dec. 1.

Given that most ill people don't get lung complications, that likely means Nov. was the real patient zero. This is close to 100% certain. It should be verified by looking at Chinese sites.

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