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OT: Tracking Current Developments in Coronavirus Science and Public Health

A thread for people interested in keeping each other posted in the current state of affairs with regards to the COVID-19 pandemic. This is for sharing fact-based science and public health from reliable sources.

Use the other rant thread for debate and ranting. This thread is aimed sharing information from reliable expert sources and discussing the implications.

To start, U of W epidemiologist Carl Bergstrom posted some interesting thoughts about a model of the epidemic recently put online that is far more optimistic than what most epidemiologists have put out there:

https://threadreaderapp.com/thread/1244815009303023616.html

The TLDR: he thinks the projections in the study being discussed are the range of a best-case scenario and that many are reading the study not realizing that the projections are best-case.

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Comments

  • An article on statnews outlining a couple of models of what needs to happen to enable resuming a more normal life:

    https://www.statnews.com/2020/03/29/two-new-road-maps-lay-out-possible-paths-to-end-coronavirus-lockdowns/

  • Yes I wish the media would lose its ideological blinkers over this one, because it could potentially be effective. Let's hope so anyway.

    One thing that I've only just recently discovered though, is that one of Dr Raoult's patients in the initial well-publicised study did in fact die, so out of a group of only 26 people that is somewhat disheartening. Nonetheless everyone should approach this topic with an open mind, rather than jump to conclusions derived from ideological bias.

  • Interesting Twitter thread, on the possibility that the virus isn't attacking the lungs so much as attacking haemoglobin cells and preventing them from doing their job (it's worth reading the whole thread):

  • Indispensable U of Washington day by day metrics for US state by state. This data makes it very very clear...

    http://covid19.healthdata.org/

  • @LinearLineman said:
    Indispensable U of Washington day by day metrics for US state by state. This data makes it very very clear...

    http://covid19.healthdata.org/

    See the article/thread that I posted up top. It is important for understanding and interpreting the IHME site that you just linked to. That site isn't doing any modeling of the epidemic. It is using curve fitting techniques to map the results in Wuhan to some data points in the U.S., and it is based on a best-case scenario.

    So, when you see the site, realize that the data projections are based on what happens if every state does a Wuhan-style lockdown.

    As bad as this looks, since many places are not locked down, epidemiologists think that barring some effective drug interventions that things will be significantly worse.

  • edited April 1

    @espiegel123, my understanding was that they remodel every day according to whether lockdowns have been put in place or not. I understand it may be an underestimate, but it still is scary as shit. Unfortunately, the great unwashed (wow, that has new meaning!) will never see it.

  • @LinearLineman said:
    @espiegel123, my understanding was that they remodel every day according to whether lockdowns have been put in place or not.

    Did you read the thread that I pointed you to? If not, please do. The IMHE authors have confirmed what Bergstrom says -- 1) they are not modeling anything (in the sense of true computer modeling/simulation) their predictions are based on adapting the data from Wuhan, 2) their analysis is based on an assumption of aggressive social distancing.

    Per the IMHE FAQ:

    The model includes the effects of social distancing measures implemented at the “first administrative level” (in the US this generally means the state level) and assumes continued social distancing until at least the end of May 2020. We classified social distancing measures using the New Zealand Government alert system Level 4 and then assume that locations that have instituted fewer than three of these measures will enact the remaining measures within seven days. We also assume that implementation and adherence to these measures is complete. With each model update, the assumption of full implementation of social distancing measures is reset; any delay will be reflected in the number of deaths and burden on hospital systems that the model estimates.

    What does this mean?

    The IMHE site is useful for getting an idea of the range of outcomes even with strong social distancing. But it isn't a sophisticated modeling of the epidemic.

    But, because it isn't actually modeling the epidemic, it can't really deal with the implications of states that are not locked down or have mild social distancing, etc.

    It is worth reading their FAQ. The prime reason for the site is to help hospital administrators understand their needs -- even in the best case. So that they can start figuring out how many hospital beds they need, how much ICU capacity they need, etc.

    It is pretty daunting if you realize that the site's data is based on states having take action that some (like Florida) still haven't taken.

  • @LinearLineman said:
    @espiegel123, I get it now.

    Here is an interesting letter from that I think provides some good insights about the IMHE projections:

    https://talkingpointsmemo.com/edblog/more-on-the-ihme-study

  • Thanks Buddy, I have been holding back on this information.. But.. I must release...

    Alexander Hamilton’s West Indian Cure..

    Bless..

  • Has anybody seen anything discussing why the UK's total deaths per total cases is so high? Is the UK still not testing widely and so the total cases are vastly under-reported?

    Per https://www.worldometers.info/coronavirus/#countries the UK has almost half as many deaths as in the U.S. for for but like 1/8 the number of cases.

  • @espiegel123 said:
    Has anybody seen anything discussing why the UK's total deaths per total cases is so high? Is the UK still not testing widely and so the total cases are vastly under-reported?

    Per https://www.worldometers.info/coronavirus/#countries the UK has almost half as many deaths as in the U.S. for for but like 1/8 the number of cases.

    Very little testing

  • The US is underreporting deaths. I suspect it will be like Katrina, we'll never know the true number.

  • @cian said:
    The US is underreporting deaths. I suspect it will be like Katrina, we'll never know the true number.

    From what I've been reading this is typical even when people are trying to record death attributions accurately.

    I posted articles about a week back that touched on why death statistics for an epidemic will often be lower while the epidemic is going on than they should be. The articles explain that -- even when people are working in good faith -- an accurate estimate can't be done till after the fact. I don't know that there is evidence that there is much in the way of intentional under-reporting in the U.S. for this epidemic.

    If the pattern of past epidemics is true, it sounds like the "excess deaths" due to coronavirus stats are likely to be anywhere from 2 to 10 times what we are seeing now. A couple of regions in Italy are doing some analysis that indicates they think the excess deaths rate is about 4 times what the initial reports have been.

  • Isolating the root issue to making normal blood chemistry to malfunction is huge.
    Hopefully the CISPR genetic techniques can be implemented to protect the blood cells from
    spreading the virus rapidly so anti-bodies can develop to keep more people out of the ICU.

    People who survive the infection will have these positive anti-bodies in their blood plasma.
    Maybe they can shift the critical shortage away from ventilators to injections of serums.

    The research resources of the planet are focused on this. Hopefully this can help break the stranglehold Big Pharma has over genetically engineered drugs in the public interest.

  • I'm looking for clues to progress on a useful "vaccine". Everything we are doing is just trying delay exposure to allow for more people to get ICU access if needed but ideally we need to learn how to have remedial responses to new viruses. I guess there's safety in numbers with the lab resources of the world focusing on the problem.

    Everything I read is 18 months to have wide spread access to a vaccine.

    Of course the human body does it's own research on the problem and creates mutations and maybe the human race will engineer a fix in a shorter time but we may have to accelerate the distribution of the fixes.

  • @McD said:
    I'm looking for clues to progress on a useful "vaccine". Everything we are doing is just trying delay exposure to allow for more people to get ICU access if needed but ideally we need to learn how to have remedial responses to new viruses. I guess there's safety in numbers with the lab resources of the world focusing on the problem.

    Everything I read is 18 months to have wide spread access to a vaccine.

    Of course the human body does it's own research on the problem and creates mutations and maybe the human race will engineer a fix in a shorter time but we may have to accelerate the distribution of the fixes.

    From what I have read, one of the issues with developing a vaccine is that there isn't a lot that you can do to short-cut the human trials and manufacturing at scale. And, there is a lot of variance in the effectiveness of vaccines -- so, until an actual vaccine is tested we won't know if it is highly effective (like the measles vaccine), so-so (like the recently retired Shingles vaccine that was only about 50% effective).

    One of the reasons that one doesn't want a massive outbreak is that the larger the initial outbreak, the more mutations that will happen -- and the likelihood goes up that new strains will come into existence for which the vaccine isn't effective. So, besides keeping mortality down, it sounds like there are other reasons to try to limit the scale of the pandemic while a vaccine is sought.

    Hopefully, the antibody treatments will prove effective and buy us some time until a vaccine is available.

  • @espiegel123 said:
    From what I have read, one of the issues with developing a vaccine is that there isn't a lot that you can do to short-cut the human trials and manufacturing at scale. And, there is a lot of variance in the effectiveness of vaccines -- so, until an actual vaccine is tested we won't know if it is highly effective (like the measles vaccine), so-so (like the recently retired Shingles vaccine that was only about 50% effective).

    50% less transmission sounds great vs "stay home" for 18 months.

    One of the reasons that one doesn't want a massive outbreak is that the larger the initial outbreak, the more mutations that will happen -- and the likelihood goes up that new strains will come into existence for which the vaccine isn't effective. So, besides keeping mortality down, it sounds like there are other reasons to try to limit the scale of the pandemic while a vaccine is sought.

    That's a good point. Mutations could be positive and negative. Survive Covid-19 but not Covid-19-v2.0?

    Hopefully, the antibody treatments will prove effective and buy us some time until a vaccine is available.

    Yes. Ventilators just give those at risk improved odds. But an antibody treatment would reduce the need for ICU facilities.

    The virus will wipe to small businesses but the medical bills will wipe out the financial stability of millions of people/families financially. No one can know the final costs of all these actions.

  • @espiegel123 said:

    @McD said:
    I'm looking for clues to progress on a useful "vaccine". Everything we are doing is just trying delay exposure to allow for more people to get ICU access if needed but ideally we need to learn how to have remedial responses to new viruses. I guess there's safety in numbers with the lab resources of the world focusing on the problem.

    Everything I read is 18 months to have wide spread access to a vaccine.

    Of course the human body does it's own research on the problem and creates mutations and maybe the human race will engineer a fix in a shorter time but we may have to accelerate the distribution of the fixes.

    From what I have read, one of the issues with developing a vaccine is that there isn't a lot that you can do to short-cut the human trials and manufacturing at scale. And, there is a lot of variance in the effectiveness of vaccines -- so, until an actual vaccine is tested we won't know if it is highly effective (like the measles vaccine), so-so (like the recently retired Shingles vaccine that was only about 50% effective).

    One of the reasons that one doesn't want a massive outbreak is that the larger the initial outbreak, the more mutations that will happen -- and the likelihood goes up that new strains will come into existence for which the vaccine isn't effective. So, besides keeping mortality down, it sounds like there are other reasons to try to limit the scale of the pandemic while a vaccine is sought.

    Hopefully, the antibody treatments will prove effective and buy us some time until a vaccine is available.

    It could be that there’ll never be a viable vaccine, there’s no logical reason why we’ll actually find one just by trying hard and hoping we will, it might elude us.

    The higher chance of mutation of SARS-CoV-2 the higher also is the chance of a less virulent (or even completely hopeless at being a virus) strain that simply doesn’t cause the amount of harm that these ones do – so with no mutation, it causes as much harm as it does, but with some mutation, some of the result will be less harmful and some about the same (unlikely to be considerably more harmful unless we’re really unlucky).

  • @u0421793 said:

    @espiegel123 said:

    @McD said:
    I'm looking for clues to progress on a useful "vaccine". Everything we are doing is just trying delay exposure to allow for more people to get ICU access if needed but ideally we need to learn how to have remedial responses to new viruses. I guess there's safety in numbers with the lab resources of the world focusing on the problem.

    Everything I read is 18 months to have wide spread access to a vaccine.

    Of course the human body does it's own research on the problem and creates mutations and maybe the human race will engineer a fix in a shorter time but we may have to accelerate the distribution of the fixes.

    From what I have read, one of the issues with developing a vaccine is that there isn't a lot that you can do to short-cut the human trials and manufacturing at scale. And, there is a lot of variance in the effectiveness of vaccines -- so, until an actual vaccine is tested we won't know if it is highly effective (like the measles vaccine), so-so (like the recently retired Shingles vaccine that was only about 50% effective).

    One of the reasons that one doesn't want a massive outbreak is that the larger the initial outbreak, the more mutations that will happen -- and the likelihood goes up that new strains will come into existence for which the vaccine isn't effective. So, besides keeping mortality down, it sounds like there are other reasons to try to limit the scale of the pandemic while a vaccine is sought.

    Hopefully, the antibody treatments will prove effective and buy us some time until a vaccine is available.

    It could be that there’ll never be a viable vaccine, there’s no logical reason why we’ll actually find one just by trying hard and hoping we will, it might elude us.

    The higher chance of mutation of SARS-CoV-2 the higher also is the chance of a less virulent (or even completely hopeless at being a virus) strain that simply doesn’t cause the amount of harm that these ones do – so with no mutation, it causes as much harm as it does, but with some mutation, some of the result will be less harmful and some about the same (unlikely to be considerably more harmful unless we’re really unlucky).

    There is no compelling reason for a less virulent version of the virus to dominate the current virus. One of the things that makes this virus so nasty is that people transmit the virus without even knowing they are ill -- and many people don't realize that they have been ill.

    I keep seeing people state that "viruses tend to mutate to weaker versions over time" but that often isn't true. The flu has not generally mutated into significantly less deadly disease.

    @McD: a 50% effective vaccine won't let things get back to normal if you are in any of the risk groups (that is a lot of people). We will be really screwed if there is a highly transmissible disease that has a 1% lethality rate for which we don't have effective treatment and a vaccine that is only 50% effective. True that it would be better than nothing -- but it'll suck and we will need to revamp our healthcare system. Because our healthcare system gets overloaded in bad flu years and the flu vaccine is generally quite a bit better than 50% effective and the flu seems to be less lethal.

  • @McD said:

    Isolating the root issue to making normal blood chemistry to malfunction is huge.
    Hopefully the CISPR genetic techniques can be implemented to protect the blood cells from
    spreading the virus rapidly so anti-bodies can develop to keep more people out of the ICU.

    People who survive the infection will have these positive anti-bodies in their blood plasma.
    Maybe they can shift the critical shortage away from ventilators to injections of serums.

    The research resources of the planet are focused on this. Hopefully this can help break the stranglehold Big Pharma has over genetically engineered drugs in the public interest.

    Thank you very much @richardyot for posting this!

    So from this we can conclude that the real cure is to be found in nature:

    Pau D’ Arco has been shown to help increase the production of red blood cells which carry the body’s oxygen supply and removes carbon dioxide from the blood stream. Scientists isolated an active chemical found in the bark, and termed it lapachol. Some researchers have theorized that other ingredients in the bark besides lapachol may have therapeutic benefits. Researchers have isolated over 20 active compounds in Pau D’ Arco. Research has shown Pau D’ Arco to have anti-bacterial, anti-viral and antifungal properties, helping destroy bacteria, viruses, fungi and some parasites by increasing the supply of oxygen to the cells. Pau D’ Arco has also been shown to influence the activity of the immune system. In small dosages, it can support immune system activity and in large doses may suppress some unhealthy immune responses.

    Pau D' Arco is also known as Ipe Roxo.
    I just bought a bag a few days ago completely unrelated to Covid-19 since I'm into herbs from all over world. ;) This is the best stuff I've tried in ages. Real medicine! :)

    There's tons of science based info out there on Pau D' Arco (Lapachol) and I hope we can spread the facts to as many people as possible. Even malaria can be treated using lapachol.

    Pic of the bag I bought:

  • @richardyot said:
    Another interesting Twitter thread:

    He’s the author of a very influential book (well, influential to me)
    https://www.amazon.co.uk/Linked-Science-Networks-Albert-Laszlo-Barabasi/dp/0738206679 (The only kindle book I ever bought)

  • An thread worth reading about why one should be wary of reading too much into the latest hydrochloroquine study:

    https://threadreaderapp.com/thread/1246051564307038211.html

    This is not to say that it might not turn out to be beneficial...but there is not much evidence for it yet. Hopefully, we’ll-designed studies will have some results to share before long.

  • Some thoughts from epidemiologist Carl Bergstrom about wearing masks even homemade ones

    https://threadreaderapp.com/thread/1246013181551493120.html

    Something mentioned in passing here was mentioned in something I read about mask-wearing in Japan: besides whatever health benefit there is, they reinforce to others the message that social distancing is what keeps us safe.

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