Without good testing, then deaths is our only sound metric. And given the progression of Covid-19, it looks like deaths trail acquisition of the disease by 2-3 weeks. Everything else metric-wise (CFR, IFR, total cases, total recovered, on and on) is garbage, which means that models are garbage, and any experiment that anyone runs on opening the economy has to wait 2-3 weeks before we even begin to see the results of the experiment.
At this point, it seems to me that the priority should be on good tests, including antibody tests. Get those rolled out to health care workers, then to other critical workers like grocery store workers. PPE for folks like this is a close second.
Figuring out a way to keep people from hard-hit areas like New York from infecting less-hit areas like Wyoming is also pretty important as we start to look toward taking our foot off the economyâs brake. At this point, it looks like Wyomingites donât have much to fear from each other, but have quite a lot to fear from New Yorkers.
Something that has surprised me is that my state, California, has had substantially fewer deaths per million than New York and even some interior states even though California has many major urban areas and close connections to China. Perhaps our very early shutdown helped, or the fact that many people and business were already social distancing weeks ahead of the official shutdown, but I wonder if there are other factors coming into play. It would be useful to find out what these are.
My expectation is that we will move to a middle-of-the-road solution. People will return to work, but they will maintain more distance, and many will still work from home. Smaller gatherings will be allowed, especially with distancing measures, but Disneyland will remain closed and there wonât be any professional conventions. Restaurants may reopen, but they wonât get as much patronage as before. Schools and colleges will stay closed until fall.
Iâve concluded that the U.S. simply doesnât have the institutional capability to aggressively test, trace, and quarantine, so for the next year or so there will always be the danger of cases exploding again. We will have more testing than before, but not enough, so any time it looks like cases start rapidly rising again in some region, that region will be shut down again. I would not be surprised to several cycles shutdown and opening occur until a vaccine is developed or most of the population will have been infected at one time or another.
Most areas of Wyoming probably wonât have an explosion of cases, but they shouldnât think it canât happen to them. All it takes is for a Wyoming native to visit family in New York, develop an extremely mild form of the disease after returning home, then go to a local business roundtable meeting and infect thirty others (this sort of thing seems to have happened), who then go on to each infect several of their own family members, all before anyone has any idea what is happening. And now a town in Wyoming has many more people in serious distress than the local hospital can handle.
If only they emulated earlier parts of his speech:
And what have we to oppose to them? Shall we try argument? Sir, we have been trying that for the last ten years. [âŚ] Sir, we have done everything that could be done to avert the storm which is now coming on. We have petitioned; we have remonstrated; we have supplicated; we have prostrated ourselves before the throne, and have implored its interposition to arrest the tyrannical hands of the ministry and Parliament.
Ten years. Weâre tempted to go nuclear after less than ten weeks.
King George didnât ruin the economy throwing millions out of work either and destroying small mom and pop businesses which wonât be back. Perhaps a bit more patience was warranted back in the 1700âs.
Thatâs exactly what Iâm saying they should avoid. Itâs not the Wyomingite they need to worry about per se, itâs the New Yorker. Anyone who has been to NY/NJ/CT/Detroit/New Orleans needs to be quarantined for two weeks before seeing other Wyomingites.
With good testing, you could just test people as they move around and skip the quarantine for the uninfected. But like you, Iâm unconvinced that we have the capacity to develop and roll out that level of testing.
One thing I donât think the âmuh Libertyâ crowd understands, is that during a pandemic, authorities have to govern to the lowest common denominator. Are you, Mr. Fiscally and Socially Conservative MAGA Hat Wearing Guy, capable of proper social distancing while working, recreating, shopping, etc? Probably (though Iâm beginning to wonderâŚ)
If the country was made up entirely of people like yourself, then things would be vastly different (in many regards.) The truth is, there is a large segment of the countryâs population who are utterly incapable of even the most basic functions. Take my wonderful home state of Michigan for instance. All those people storming the Capitol yesterday were most certainly from the West side of the state. They completely forget about the East side of the state, which not coincidentally, is being overwhelmed by huge numbers of infection and death. Until that long awaited wall is built separating us, the state must be governed as a whole.
Iâm rapidly arriving at the belief that thereâs no way out of this situation without either a huge number of deaths or a huge economic disruption, or, most likely, some combination of both. There is a massive Covid sandwich, and pretty much everyone is going to have to take a bite.
I donât think those all happened yesterday, John. There were a lot of extra deaths reported in NY from over the course of the last few weeks. So really, all the previous days should be somewhat higher and that number should be quite a bit lower.
Iâm seeing 2,174 and 2,288 the two sites Iâve been watching.
Well, happily, as far as I can tell, itâs fake news combined with an odd choice to make the âdayâ go from 8pm-8pm.
Johns Hopkins University only updates daily at 8pm, according to their dashboard, but you can see numbers updated mostly live (complete with source links for that dayâs data for each state) here: United States COVID - Coronavirus Statistics - Worldometer
And itâs worth noting that they say JHU is using their data.
Another site compiling their own data (a bit slower than the previous one, but still updated frequently throughout the day) is here: https://coronavirus.1point3acres.com
Both of them show a huge jump to over 6000 deaths on the 14th.
The Worldometers note on the 14th says the following:
30720 new cases and 6185 new deaths in the United StatesNew York City today has reported 3,778 additional deaths that have occurred since March 11 and have been classified as âprobable,â defined as follows: âdecedent [âŚ] had no known positive laboratory test for SARS-CoV-2 (COVID-19) but the death certificate lists as a cause of death âCOVID-19â or an equivalent" [source]. We will add these to the New York State total as soon as it is determined whether the historical distribution can be obtained.
The historical distribution is evidently not available, and this is clearly the cause of the overly high number for the next âdayâ in the JHU data. If you remove that day (as you must since its data is including additional deaths from many other days), then the highest deaths in a day (by date, rather than measured from 8pm to 8pm) is 2618 or 2796 depending on your source. And those numbers may also be slightly inflated by historical data adjustments. You can read more about it here: Changes in US Data following new CDC guidelines on "Case" and "Death" definition (April 14, 2020) - Worldometer
As I mentioned previously, even if the government ended the shutdown, that doesnât mean the economy would go back to normal. One reason would be the threat of lawsuits. Here we see an example, though it looks like it wonât get far due to special laws governing this particular situation.
Good grief. It does not at all seem to me that weâve reached the âsue everyone in sightâ phase of this particular pandemic, but weâre already weeks into the âscore points against your political opponentsâ phase, so maybe itâs about time we got to the lawsuits.
It would be nice if people could wait for the ground to settle a bit on the mass graves before starting this nonsense.
All the protesters I heard (including the organizers) said they were supportive of the initial shutdown, but were protesting arbitrary restrictions of the extended lock down. Once the ruckus got started, Iâm sure there were many who were not so temperate. But itâs important not to characterize the whole based on the worst.
âHugeâ is a relative term in need of some context. Itâs true that Michigan is #3 in the nation in terms of cases and deaths and virtually all of those are from the metro-Detroit area. But even so, Beaumont hospital in Detroit, which was designated a COVID-only hospital, has shut down and put all staff on unemployment because they have zero patients. Without downplaying the seriousness of those affected, âhuge numbers,â means a medical system running at something like 25%-35% capacity.
There is no reason that the whole state must have one uniform set of restrictions. Supposedly we have counties for a reason. Thereâs no reason whyâat this pointârestrictions could not be lifted on a county-by-county basis. And there is no reason that, two weeks ago, counties with few cases could have allowed landscapers to go back to work (with reasonable restrictions for social distancing) while the counties around metro-Detroit remained in a tighter lock down.
Yesterday there were about 2400 deaths in the US attributed to corona virus. Today, short of a miracle, we will pass 60,000 deaths, which was the lowest revision from the model initially predicting 100,000 deaths. That model has been twice revised up in the last week, and now predicts 74,000 deaths by August.
It is also worth noting that this model was originally assuming that social distancing would continue through May, which isnât happening in some states. They are attempting to model those changes in an update soon, but itâs still anybodyâs guess what will happen in the states that lift restrictions.
It has been 10 days since the last comment in this thread. Any new thoughts? Iâm still not sure what I think, but Iâm growing more suspicious that the general shut down needs to end. Replacing it with something more dependent on local context may be in order.
But are we really going to say that the economic devastation was justified by the empty hospitals?
Well itâs been a month and deaths are now 78,000âŚif youâre thinking yeah but that isnât 100,000 on the low endâŚIâm thinking you are putting you own understanding to the test. You probably would have never predicted this many deaths in one month.
Agreed. This virus is not affecting everyone everywhere equally. I think measures need to be proportionate to the actual impacts in a community. However, we still have the problem of mobility. People move, and that is how this virus came to the US to begin with. It may be that some major city centers need to be completely quarantined in order to allow the rest of the nation to pick up and start living again. I think that would be politically disastrous and very risky, epidemiologically.
As Iâve said before this isnât about the people who arenât effected by this virus but the people who contract it from the seemingly healthy carriers. I just got word that the group homes that I normally inspect are only now starting to have the outbreak. Well behind the rest of the country. But theyâve been on lock down for quite some time. Well itâs the seemingly healthy staff and visitors that introduce it and then it spreads like a wildfire.
One last thing about predicting these numbers. As I said this virus has widely varying effects. For instance the infection rates currently in New York (1.7%), New Jersey (1.5%) and Massachusetts (1%) are exponentially greater than any other nationâs infection rates that weâve observed (on average about 0.23%).
But thankfully, the fatality rates in those states are considerably less. New York, New Jersey and Massachusetts are hovering around 6% of cases die. While on average 8% die, something like 13-19% of contracted cases die in the most infected countries. This leads me to believe one of two things, either we are testing so many more people than those other nations are, and are thereby gaining a more accurate picture of the actual fatality rates as a percentage of cases, or there are health and demographic factors that makes us more susceptible to spread, but less susceptible to death.
But we wonât know any of those answers till we can run regression analysis on multiple data sets over extended periods of time. The answers we need, we wonât actually get until we donât need them so much.