Coronavirus (Sports-Related and General)

Lawman 2020-04-23 15:49:56 UTC #723

This sums most of the answers to most of the CV-19 related questions.

Austinfan 2020-04-23 16:27:51 UTC #724

Which is why the precautionary principle counseled lockdowns.

It may turn out that the infected mortality rate (IMR) is much lower than thought, say only 0.1%, and it's just a "bad flu" with no herd immunity, killing 160K instead of 60K (2017-18).
Unlikely since we're at 45K WITH a lockdown, but possible.

However if the IMR is 0.5%, and 160M are infected, we're talking 800K dead.
This would imply that 8 or 9 out of 10 cases go undetected (rate of death for confirm cases is between 4-5%).

When there are so many unknowns, prepare for the worst and hope for the best.

schillingfan 2020-04-23 17:10:12 UTC #725

I heard her interview with Anderson Cooper. Her position was that it was up to the casinos to figure out how to social distance, and said she had offered to be a test study. She was not too bright.

Lawman 2020-04-23 17:40:57 UTC #726

OTOH, New York's data - admittedly a small sample size of around 3,000 people - of anti-body testing would seem to indicate that approximately 2.7 Million people in the state has CV. Cuomo closed NY assuming that close to 1 million cases will lead to ~130K in the hospital and ~30K in the ICU all at once. Those numbers never materialized and, indeed, NY is sending the USNS Comfort back to Virginia. It was never really needed.

If the data percentage extrapolation is true, and NY really had closer to 2.7MM then 1MM, then NY needs to begin opening up.

I'm inclined to allow houses of worship to open up this weekend with caps at the lesser number of fifty people or 50% capacity as an experiment. Allows for fairly easy contact tracing and identifying who was present. Unlike say, shopping malls, where people are going from store to store and it's a bunch of strangers, synagogues, churches, and mosques are easier to identify who was there.

Austinfan 2020-04-23 18:13:22 UTC #727

Don't have the testing capacity yet, you not only have to be able to test everyone immediately, you have to get the test results back in "real time" so you can isolate the infected.

This is why the Great Oragatun has been such a disaster, a crash program to expand testing should have been implemented a month ago or longer, testing has always been the key until a vaccine is developed.

Test - Trace - Isolate.

I don't trust the antibody studies right now, it's been know for a while that the IMR is a fraction of the CMR, by a factor of 5-10 (CMR of 4-5%, IMR of 0.4 to 1.0%). There are two issues with the antibody studies, one is how accurate are the tests for COVID, and how representative are the samples.

And of course the $64K question, do antibodies correlate with immunity or maybe just a mild infection that doesn't grant immunity (the severity of infection, and the extent of immunity, may be related to viral load).

Lawman 2020-04-23 18:29:32 UTC #728

Not that I disagree, but I also don't think you can remain on lockdown of this scale while waiting for both more tests to be available at the capacity we need and better tests to be developed.

julio 2020-04-23 18:53:46 UTC #729

The frustrating thing is that we could have managed a broad lock-down until truly widespread testing was available - if we had focused nationally on crash-building testing capacity, we'd be there. But we couldn't do that... No, we had to pretend testing wasn't urgent, and pretend that the private sector (LabCorp, Quest) could handle it. Now it's six weeks later, and the orange orangutan is still ditzing around; the commercial test labs have huge backlogs; and we cannot begin to do mass testing.

All because millions of partisan Republicans, coupled with disaffected rural white folks, misogynists and racists, decided that an incompetent B-level TV personality would make an acceptable President of the United States...and that includes some who will read this comment. If you're in that category... you own this mess, too.

bkox 2020-04-23 18:54:44 UTC #730

Here is the problem... it only takes one person to potentially kill many.

A nursing home here in town has had 11 deaths. One person brought it into the facility.

I'm in a different rehab/nursing home...but lets say gov Pritzker says churches can be open this sunday. My cna goes to church. Gets exposed to corona. Comes to work on monday and unknowingly spreads it here. Suddenly we have a dozen deaths.

The rally about opening up has been well just keep the vulnerable people isolated. But that becomes much harder when the ppl that care for them will be around exponentially more people

Lawman 2020-04-23 19:48:59 UTC #731

I am innocent.

Lawman 2020-04-23 20:01:13 UTC #732

But, we didn't and we don't. And, from an economic point of view, we cannot continue to lockdown until we have the widespread testing in place. Which is not to say we should open up willy-nilly either. But, some/most small businesses should be able to manage with social distancing. Masks/face coverings should be worn by everyone going out in public. Ensure hospitals have enough capacity to handle a spike in cases that will inevitably rise when opening up happens. Actually, this last sentence is probably the key.

andyb 2020-04-23 20:27:11 UTC #733

This statement misuses the implied data. I would not be shocked if NY had 2.7 million cases. It is likely a bit lower, but let's assume that is true. That means we got over 20,000 deaths from something affecting 13.9% of the population. We need to get to 50%-75% to get herd immunity. So should we be OK with another 40,000-75,000 deaths to get there.

Then we should ask the question of WHO is that 2.7 million. Most likely it skews younger and healthier because they often have to do these day to day service jobs. And then tend to be the ones out running and picking up food. Not exclusively, but there is every reason to believe that younger people are more likely to have contracted the virus as older people stay home. That means the mortality rate you calculate for the 2.7 MM would be much lower than the mortality rate of the whole population.

There are lots of amateur data scientists who take this data and then create whatever thesis they want. It is now becoming pretty obvious that many more people have the virus than have tested positive. It is also true that we would easily run the risk of 500,000 deaths in a year if we relaxed things too soon. We could already be on a path for 200,000 extra deaths (we are missing maybe a third in our count now, and then many other deaths are occurring because people with other ailments are not getting to the doctor).

No single study out there tells the whole story. It is pretty bad though. The one "good" think the higher virus estimates might show is that we might have a path towards herd immunity protecting us somewhat against a second season in the Fall. If we had a serology test that worked and a third of the population had some immunity, then a partial shutdown might be feasible.

Lawman 2020-04-23 20:31:19 UTC #734

Right. So that means that any move to opening up will still require older and immunocompromised to remain on lockdown.

julio 2020-04-23 20:45:49 UTC #735

This is certainly a critical condition - necessary, but we may disagree about suffiicient.

The thing is, even if there's adequate hospital space, enough ventilators... people will die. People who get ill enough to require ventilators will die at a high rate. Yes, in NYC, the death rate was increased by the insufficiency of beds and incubators - but nationally and worldwide, if the patient gets to the point of needing ventilation, the survival rate is not good.

So... Perhaps we say, open sole proprietorships - if the proprietor wants to take the risks, and his customers do too, maybe that's OK.

But businesses with employees? Employees who will be pressured to come to work, to take the risks, whether they want to, or not? In a society that is indifferent to the economic pressure that these people will be under (e.g., take the risk, or lose your home, or don't eat, etc.)? Do we want to go there? Do we want greedy business owners essentially extorting their employees to come to work, at risk of being infected?

White collar workers, who will likely be able to work remotely, from their self-isolation, will be fine. Businesses that employ only such workers, and who are enlightened enough to allow them to work remotely (essentially ALL the time)... sure, they can open.

But restaurants? Restaurants owned by corporations (e.g, not chef-owned 4-star places) that pressure wait staff to come work for $2.10/hour, and risk a deadly infection? It's bad enough that we allow such establishments to exist in the absence of COVID-19, so that the rest of us can enjoy an inexpensive restaurant meal and provide a measly tip. But in a COVID-19 environment?

Casual air travel? Only if you're an idiot, or have a death wish or something.

We've seen what has been happening in more essential food processing plants - the meat-packing hotspots. Can these places really re-tool to provide enough space to protect their workers? Even if they could, will they (given that retooling costs money, and we're leaving this to "the market")?

I have two sons who work in shipping/logistics - they're still working, and the facility has made efforts to protect them - gloves, masks, temperature checks, enforced distancing. But they're still at risk; they interact with delivery drivers, and complete distancing is impossible. But it's an essential business (it is, given the range of things they ship). They define it as an acceptable risk - but to provide entertainment?

Is the Trump administration talking about encouraging people to go on cruises, too?

andyb 2020-04-23 20:55:30 UTC #736

Yes, but when. Opening up now means potentially 500,000 deaths even if older people generally stay home. This is still much deadlier than the flu (which also affects older people disproportionately).

You don't just open it up. You need new infections and hospitalizations trending downwards to a small enough number to do contact tracing. We still need that until you get herd immunity.

Lawman 2020-04-23 21:08:49 UTC #737

I think small businesses can open and I think outdoor areas can be open - dry cleaners, clothing stores, gyms (if you can manage capacity), movie theaters (again, if you can manage capacity), outdoor zoos (again, capacity needs to be managed). Indoor malls, sporting venues, theme parks, should remain closed. I'd continue restricting air travel as I don't think I'd want inter-regional travel.

Houses of worship with capacity limited. Libraries with capacity limited. Up here in NY a lot of parks and playgrounds are closed. That may be fine for now, but if camps are closed then they need to be opened up or what are you going to do with kids all summer long? My mother volunteers in the Philadelphia PS system and used to work in DHS with abused kids. She's seen the worst. She is so fearful that schools and camps being closed will lead to a huge spike in child abuse.

Restaurants.....not yet. Maybe in a second wave of openings depending on how it goes with the first wave. I think open up construction (in NY it's mostly not essential and thus closed) and allow construction to begin. Will allow that industry to begin working again.

schillingfan 2020-04-23 21:37:30 UTC #738

I can stay home except doctor visits and lab tests, but I live with my daughter. She’s a public defender, essential employee who goes in to work once or twice a week, but the courthouse is not open to the public and almost everything involving criminal cases involves inmates for which they use videoconferencing.

I think this will continue through May, so her exposure through work is low and she only goes to the grocery store once a week. Luzerne County will be among the last to open and the Courts are under the Pennsylvania Supreme Court and not the Governor. The Supremes have said to make your own decisions. Luzerne is very hard hit, so I think we will be among the last and the County Court will follow the Governor. But it has to open, you can’t have teleconference jury trials. She covers Hazleton, which has half of the County’s Covid19 cases. She has to meet and talk to her defendants and be next to them in Court.

So, yeah, I can isolate, but I can’t isolate from people I live with

Austinfan 2020-04-23 22:11:36 UTC #739

One thing about the antibody testing, even the best tests have a 5% false positive rate, the worst something like 30%.
So 14% is probably more like 9-10% in NYC. So if total infected is 5 to 6 times confirmed, they still have a mortality rate close to 1% of infections.

Even a 0.5% infected mortality rate, spread over half the population, is 800,000K.

While the 0-20 group has almost zero mortality, 20-50 is probably going to be 0.05% to .10%, so if 60M get infected in this group, we're still talking 30 to 60K dead, and 300-600K hospitalized for an extended (1 to 2 week period).

So it's not just us old fogies who are at risk.

BostonRoss 2020-04-23 22:22:11 UTC #740

These businesses, at least the ones who have work on their plates, are still open; so there's nothing to allow. They were not subject to the closure orders.

Lawman 2020-04-24 02:41:59 UTC #741

All I'm saying is this.

New York went into lockdown on the models indicating that, at the apex, they would have ~1 million cases, with 130,000 requiring hospitalization and 30,000 people in ICU's. If NY now has somewhere in the neighborhood of 2.5 million people infected, that would 350,000 hospitalizations and 81,000 ICU cases.

NY required only 5.000 ICUs.

Additionally, while that antibody testing indicated that around 21% of the NY State may be infected, there was also a study of pregnant women across two hospitals that turned up a 15% infection rate. So, I think the state infection percentage is probably in the 15% - 25% range.

zambonir 2020-04-24 04:59:52 UTC #742

Won't be much in the way of summer camps or swimming in NYC, not for safety reasons, but because there's no money (and as we very starkly saw today, the Senate won't be helping)