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ru848789

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About ru848789

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  1. Good find - we all know they've been lying since day one - I've been assuming the real #s are 10X the reported numbers, at least for Wuhan...
  2. Another interesting analysis, also showing a number of things many have been discussing. Bottom line is the virus is spreading rapidly across the country and NY is just out in front and other states/cities are going to catch up when/if they start testing more. We're nowhere near through this yet, as most experts have been saying - and it's also why folks like Gov Cuomo and many other governors now are screaming for more Federal help on PPE/Ventilators and other supplies. Lack of testing masking true case rates and making death rates appear worse than they truly are (Italy/Spain); also NY is likely the only state showing "true" case rate increases, since it's the only state doing very aggressive testing. As the article said. "There is a real threat of many more NY-style scenarios unfolding in other U.S. major metro areas, especially since only some of these states have state-wide lockdown orders in place." By looking at death counts and backing out what that "should have" correlated to in terms of cases, the first graph below was created. It shows how South Korea has tested enough to actually have a likely 77% of actual cases tested and that the "U.S. is in the middle of the pack with ~15% of cases reported (82K on 3/26). If this analysis is accurate, this means U.S. has AT LEAST 500,000 cases as of today, or approximately 0.2% of population." The "true" mortalilty rate (outside of factors like population age, cultural practices like multigenerational families, and hospitals being overwhelmed and not being able to treat everyone) is likely around 1.3%, as that’s what SK has migrated towards and we know they’ve done the most testing per capita. The US case rate increases are the worst in the world right now, although the graphs in the link aren't on a per capita basis, so that could be deceiving. Cool social distancing map keyed to cell phones (just like traffic). https://www.linkedin.com/pulse/covid-19-update-march-26-2020-dmitry-shashkov/?trackingId=ac1U1SfKCvjIX2PAfar9zw%3D%3D
  3. Great stuff, thanks! Curious if the "immune" descriptor for recovered patients is simply supposition based on expected antibody protection we see in all (most?) viral infections or is there actually some data somewhere on re-exposure (maybe from health care workers who recover and are exposed)? I know I saw the macaque data showing absolute proof that the monkeys after infection and recovery do not become reinfected upon re-exposure, due to the antibodies developed. I'm just dying to see any inkling of data on any success with the blood plasma-antibody approach they're starting up in NY on Monday supposedly (I've heard they did some of this in China but haven't seen the results). They're also looking for volunteers who recovered and have antibodies for donation...I wonder if we should post a separate pinned thread on this... https://newyork.cbslocal.com/2020/03/26/coronavirus-antibodies-treatment/ https://thetablet.org/mount-sinai-volunteers-covid19-test/
  4. NY Times article that just came out. Haven't had time to digest it, but the message is that NYC Metro and other US cities are on trajectories worse than Wuhan and Lombardy, at least with regard to cases per 1000 people and that "flattening the curve" when comparing where each city was with similar numbers of infections (to try to normalize the data), is likely not working as well as it worked in those locations. That would not be good. Two caveats however. I have never believed the Wuhan data – they’ve been lying about the outbreak from day 1 and there’s no way they only had 0.05% infected and they just said that they haven’t been counting asymptomatic people who tested positive, which could be 30-40% of all positives, based on data from many locations (including the Diamond Princess, the "gold standard" of data). Secondly, I’m confused by their case growth for NYC metro, which is the 20MM people in NY/NJ/PA/CT. There should be no way the growth rates overall there (which the graph shows as 30-40% growth the past few days) are greater than in NYC proper (9MM), which they are, as NYC proper is seeing 15-20% day over day growth the past few days and NYC is the most densely populated area in the country and in theory should have the greatest growth rate all else being equal (more “collisions” and subways and crowds and such). I’m not saying it’s wrong or the message is wrong, but that bothers me. https://www.nytimes.com/interactive/2020/03/27/upshot/coronavirus-new-york-comparison.html?action=click&module=Spotlight&pgtype=Homepage
  5. Nice find. No doubt it has been a bipartisan effort to cut infrastructure and inventory of medical supplies/beds/ventilators etc. to the bone, as that's what profit driven free markets demand, as inventory, in particular, is the enemy of profitability (I've done a lot of supply chain work on this). Having said that, once this pandemic hit, the lack of a federal response on these national issues has been inexplicable and is now becoming disturbing. Doing this stuff state-by-state is just nuts - we need the Feds and the states working together to bring the resources to where they're needed most and then moving them where they're needed next, all while, in parallel, we get manufacturing capacity going for everyone, since we clearly can't rely on China and others for much of this stuff.
  6. I lean this way, too, but the data are not crystal clear. They've supposedly seen this in China, but the Chinese tests are known to be inaccurate and outside of China it's been just a few supposed cases. We really need antibody tests to clear this up. I'm also very encouraged by the macaque study where reinfection did not occur (and antibodies were shown from the original infection. I've also seen that the Chinese are not including asymptomatic positive tests in their case rate, which is about half of all positives in many cases (Diamond Princess) - not clear to me if this is only a new thing or not - if not, then the Chinese cases would almost double (I've never believed their numbers anyway). https://www.newscientist.com/article/mg24532754-600-can-you-catch-the-coronavirus-twice-we-dont-know-yet/ https://www.npr.org/sections/goatsandsoda/2020/03/27/822407626/mystery-in-wuhan-recovered-coronavirus-patients-test-negative-then-positive
  7. We'll very likely be over 1000 deaths per day in 3-5 days; let's just hope we don't jump to Italy rates, which would be 3000-5000 per day (we have 5-6X their population and they're around 600-900 deaths per day). I don't think we'll go over 1500/day, given they're older, culturally more affectionate and have far more elderly living with family (in China ~80% of transmissions were in the household) and I'm hoping our interventions, which were earlier, are enough to prevent overwhelming our hospitals, unlike in Italy. We'll see.
  8. Same thing that every other country that has done a decent job with the virus has done, although like South Korea, their mortality rate will rise from their current 0.7% (was 0.2% in my note below from Monday on Germany) to at least 1.3% eventually,, like South Korea's (which was 0.5-0.6% for quite awhile) did, because they're early in the outbreak and deaths take 3-5 weeks from infection. The time lag is also why ours will likely be at least 2.5% in a week or two (it's risen from 1.3% to 1.6% in the last couple of days). But even 1.3% or even 2.5% will be way way better than Italy, Spain, France and others for the simple reason below in italics, combined with demographics and cultural differences in Italy especially (very old population, very affectionate, and high % of elderly live with their family) and their rates went up when hospitals were overwhelmed with the peak. This isn't that hard, but we didn't do it and are paying the price in case rates skyrocketing, but have at least avoided very high mortality rates so far. The biggest reason for the difference, infectious disease experts say, is Germany’s work in the early days of its outbreak to track, test and contain infection clusters. That means Germany has a truer picture of the size of its outbreak than places that test only the obviously symptomatic, most seriously ill or highest-risk patients https://www.washingtonpost.com/world/europe/germany-coronavirus-death-rate/2020/03/24/76ce18e4-6d05-11ea-a156-0048b62cdb51_story.html
  9. Excellent analysis from the U of Washington and not just because it's very aligned with my thinking, lol. Their range is 38-162K deaths, depending on how effective interventions are and my range (post linked below from yesterday) was about 35-170K deaths (flu is 35K in an average year) depending on how effective our interventions are - and I think we can even beat that low end of the range (~35K deaths, comparable to the flu) with very, very good interventions. I also was saying our range of serious hospitalizations is about 4X deaths or 150-650K. Finally, with better data now, people seem to be acknowledging that the 1-3MM death scenarios with 50% infection rates of the overall population are not realistic with even modest interventions, let alone what we've been doing. It's not that those estimates were "wrong" it's more that they had some flawed assumptions of how many would get infected and didn't include interventions, but these doomsday scenarios were at least effective in raising awareness of how bad things could theoretically get if we did nothing, treating it like the flu. No matter what, though, even after we see the peak and decline over the next 6 weeks, we'll still need to be vigilant to hotspots and stamp them out, like China and South Korea continue to do with 50-100 new cases per day, meaning we're still going to need testing, tracing, quarantining and some level of social distancing (I'd say just wear masks) even after any "relaxation" in our interventions. At least until we have viable treatments (antibody therapy or drugs or eventually a vaccine). I
  10. screen grab or do you see the slides somewhere - I've looked but can't find the slides...
  11. Deaths always lag new cases, since deaths take 3+ weeks from first symptoms. It's why the US death rate will almost certainly increase from current levels of a few hundred per day to close to or over 1000 per day, which is horrible, but nowhere near Italy's rate of 600-900 per day (which translates to 3500-5500 per day in the US, based on population).
  12. Notes from today's presser by Cuomo. FYI, I've been doing these because there's no question NY and NYC are on the front lines of the biggest and earliest major wave of this epidemic, so what happens here will be very informative for what is likely to happen in many other locations (especially more densely populated cities) and what can hopefully be done to reduce transmission and the peak, as well as how to prepare the hospitals for potential peaks, among other things. Today's was fom the Javits Center, which has been retrofitted to be a 1000 bed hospital in 1 week by the Feds/Army Corps of Engineers/National Guard, along with 3 other 1000-bed sites (he said they did such a great job he’s asking for 4 more) Testing: 138K total tested in NY/57K in NYC; 16K tested in NYyesterday/7K in NYC Positive Cases: 45K total/7300 new; 25K total/4K new in NYC Deaths: 519 total in NY, was 385 day before (134 yesterday) – will keep increasing, as deaths take 3+ weeks from symptoms and most new cases have been in the past week Hospitalizations: 45K positive tests, 6480 are hospitalized and 1583 in ICU (+290 vs. yesterday) and 2045 discharged to date Model apex (in ~21 days) planned for: need 140K beds and had 53K but up to 93K now (all hospitals have increased beds by 50-100% via creativity and suspending hospital regs) Model apex: need 40K ICU beds with ventilators and have 10K now; ventilator splitting approved The hospitalization doubling rate slowed from every 2 days to every 4 days over past 9 days, so rate of increase is slowing (so interventions are working), but cases still going up. My comment: assuming interventions are working, as I think they are, the modeled peak numbers will be significantly greater than what we actually see. However, I completely understand preparing for the modeled apex, since time is so short and if the interventions don't work well, the modeled numbers would make overwhelming the hospitals a given. Stockpile of PPE/supplies probably good for a week or two, not enough for peak Schools will likely go beyond 4/1 closing date to 4/15 and the 180-day waiver will extend Support level is inspring: 10K medical staff volunteering in last few days – now up to 62K volunteers; 10K mental health volunteers Made a very nice speech to the Feds/ACE/National Guard folks in attendance thanking them profusely and promising that together they were all going to go out and “kick the coronavirus’s ass.” Said 10 years from now, people will look back on this and despite the heartache and losses, people will be proud of what they accomplished, saving lives. One more editorial comment. This better be a wakeup call to the world and the US, as we've been ignoring pandemic threats for decades (on both sides of the political aisle) and the next one could be just as contagious as this one with a 10% fatality rate, like SARS or even a 30% rate like MERS and it will be a real tragedy if we don't prepare for that possibility in the future by putting all of the infrastructure in place to support aggressive testing, quarantining, tracing of contacts, social distancing, establishing a mask culture, etc., as well as preparing our health care systems with regard to hospital capacity, hospital supplies (PPE, masks, gloves, ventilators, etc.), and funding more research on viruses, transmissions, and development of better/faster antibody treatment/diagnostic technologies and vaccine technologies. https://www.governor.ny.gov/keywords/health
  13. As I said to all my chem E friends in particular, if a "Y" is all it took to double/quadruple ventilator capacity, we can all have a big chuckle. Had an exchange with a friend on this a few days ago and we figured that it must be harder than just putting in a "Y" lol. I assumed one would need parallel pressure/flow controllers on each branch to ensure each patient got the correct pressure and flow rate of oxygen and we started geeking out on designing something (this is the kind of stuff we do every day in our eng'g R&D labs), but this just looks like a Y. Maybe they plan to put people with similar needs on the same pair of lines from one ventilator. Think those can be ordered in the thousands from Fisher. https://www.prismahealth.org/vesper/?fbclid=IwAR2QAInln4nm-5qaXw1sPyeMA3driRtx_cUJvL-a2ziwKkBE7t7zrHRWeT8
  14. SK has had 50-150 new cases per day for about 2 weeks vs. 500-750 per day during their peak. Seems like it's still percolating, which makes sense since only about 0.02% of their population has tested positive for the virus, meaning likely lots of targets still available. This is why we need that antibody test STAT in order to get a handle on what % of the 99.9+% of people were infected but never had symptoms, but have antibodies. In fact, I'd daresay that opening back up to normal life will be very difficult to do until we can do mass antibody testing - I know I'm going to be very reluctant to go back out into that world without that test. I can stay in the house for a long time, lol...
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