"Many people think COVID-19 kills 1% of patients, and the rest get away with some flulike symptoms. But the story gets more complicated. Many people will be left with chronic kidney and heart problems. Even their neural system is disrupted. There will be hundreds of thousands of people worldwide, possibly more, who will need treatments such as renal dialysis for the rest of their lives."
There have also been reports of people in China with significantly reduced lung capacity even months after recovery. Still so many scary questions about the long-term effects of this virus, possibly the biggest ones being about the post-recovery immunity. How long does the immunity last and how encompassing is it?
There is so much we donot know about the long-term effects. It shocks me to Silicon Valley icons like Elon Musk, Paul Graham, and Justin Kan pushing to reopen and spreading conspiracy theories over building tools to understand the long term effects.
There is some research [0] that immunity to SARS ”v1.0” lasts around 1-3 years for those who had it. It would seem reasonable that Immunity against Covid19 lasts about the same period of time.
We are now at about 6 months into people being infected en masse. So hopefully in about another 6 months people in Wuhan and elsewhere wont start getting sick again!
China is a big place. Imagine any possible negative health complications, we can safely assume that at least one person in China has developed it. The question is, what fraction of people have developed these complications? We don't even know what fraction of people developed the disease, or what fraction outright died...
It would be good to hear plausible scenarios of how people still catch it despite of masks and social distancing. There is something to learn from each story. And I see a distinct lack of focus on anecdotal stories of how people think they caught it. How the fuck are people catching this disease?
I find the Korean call center paper pretty interesting [1]. In early March, this building had 97 infections: 89 on one half of one floor, 5 on the other half of the floor, and 3 on other floors. The two halves of the floor were separated by doors but shared the elevators, bathrooms, etc. It seems clear from this that almost all of the infections were from being in a shared space with someone infected. (There's a nice diagram of the infections [2].)
The other thing I got from the article is that South Korea is on a whole different level of testing than the US. When infection was detected, they tested everyone who was in the building or had visited: 1143 people tested with results in 12-24 hours. Everyone positive was isolated and everyone negative was quarantined and re-tested for 14 days. They also texted 16,628 people who had been near the building for more than 5 minutes (from cell data), telling them to avoid contact with others and get tested. This level of testing and tracing got South Korea (51 million people) to the point that it is now averaging just 10 new cases per day.
1. Many people don’t have masks. Cloth masks aren’t as effective as N95s anyway and we don’t have nearly enough N95s. New York serology survey shows FEWER health care workers have caught the virus than general population - because only health care workers have access to and training in how to use N95s, face shields, gowns and goggles.
2. Many people are still working in industries where they aren’t social distancing, e.g. all the meat packing plant outbreaks where sick employees were ordered to continue working in close proximity to their coworkers and nearly every employee in the plant got infected.
3. Positive cases are being sent home to quarantine in the same residence as their uninfected family members, who then catch the virus. Some other countries are either quarantining sick cases in the hospital, in hotels, or in monitored quarantine sites, but we haven’t been doing that in most cases and so we send home a positive case and they then infect everyone else in their home. This is worst in nursing homes but is happening in multigenerational households and other households as well. https://www.nydailynews.com/coronavirus/ny-coronavirus-cuomo...
> It would be good to hear plausible scenarios of how people still catch it despite of masks and social distancing.
One of the issues is that not everyone is wearing masks or properly social distancing. If you have any opportunity to go out and safely observe from a distance any groups, you'll notice a sizable fraction not wearing masks and many not properly distancing themselves.
All it takes is some percentage of those who are not mask wearing or distancing also being asymptomatic spreaders to keep the spread going.
You're assuming people are following protocol. Humans undergo lapses in judgement multiple times a day and are just as forgetful. Just the other day, I found myself having scratched my face under the mask while at the supermarket, something I only realised after the fact.
Many people don't realise how much contact spread can occur in just half an hour as well, as seen [0]. This was modelling the spread inside of a dining hall of a cruise ship, but you can imagine similar behaviour in other public spaces.
Most people out there have “essential” jobs and can’t work from home. How could they not still catch it? All it takes is one eye rub, forgetting to sanitize your hands before you eat, etc.
At my local grocery store, they carefully arrange hard cheeses like Parmesan so that the price tag is hidden from view. If you comparison shop, that means you'll be touching several packets before making your final selection. And when you bring it home, it's coming along with the fingerprints of perhaps a half-dozen other customers. If it's shrink-wrapped plastic, you can wash it (do you?) -- if it's wrapped in clingfilm, you can't wash it without harming the cheese, so you need to somehow remove it from its packaging without carrying over the contamination. That's just a piece of cheese.
One of the difficulties in disease modeling is how very many transmission vectors that aren't accounted for.
People are still going to grocery stores, pharmacies. Lots of people break quarantine and visit others. In some areas stores and places of worship are still open. And we don’t isolate people outside the home, so people spread to family/roommates.
Further, the virus can take 5-14 days to show symptoms, and people don’t go for a test immediately. So confirmed cases lag actual infections.
I expect mostly poor hygiene when it comes to touching contaminated things and faces. I basically can't go out in public without seeing someone with their mask pulled down to talk/eat/smoke. You should be sanitizing your hands every single time you don or doff a mask.
I think that you are considerably underestimating how small and numerous viruses are, and how difficult one like this is to stop once it's spreading in a community. They've evolved for billions of years to do exactly this, and they are very good at it.
a) masks and social distancing only reduce the risk of transmission substantially, they do not eliminate it. Especially in the case of essential workers and stuff like grocery shopping
b) not everyone is socially distancing to the same degree.
There's so much conflicting information out there right now that I'm not even listening to it. I'm wearing masks and avoiding people, because my wife has bad lungs and I have a 6 month old. Until there's more facts that are rock solid, all anyone is doing is speculating. The real issue here is lack of consistency and leadership from the top levels of government (USA here). If we had a consistent message from the experts and politicians together, then there would be less speculation, less fighting over lockdowns, less misinformation, and less grasping at straws guessing what the virus is doing. Instead, we (Americans in aggregate) have lost trust in both the experts and politicians, which is resulting in major issues. The deadliness of the virus isn't the major issue, it's the infighting that's preventing us from fixing it that's the issue now and will result in more dead.
When you walk around outside, are you also carrying an umbrella? Because cloth masks aren't that effective at protecting the wearer and I don't see how else you can prevent someone else from getting close to you.
The German hospital Universitätsklinikum Hamburg Eppendorf (UKE) performed more than 190 autopsies of patients who died with COVID-19. In a study (where they covered the first 12 cases) they found an unusually high number of of thromboembolic events. Therfore they are now recommending a prophylactic heparin treatment (a commonly uses blood thinner to prevent thrombosis), even for ambulantory care.
I think the overall reason for that effect might be that CO2 can still be transported out properly (which is what your body uses to measure how much breath it's got) but not enough O2 in, which you don't notice happening at all other than oxygen deprivation symptoms.
The Samsung Health app on their Galaxy phones has a Stress Tracker that measures your blood oxygen saturation. You put your finger on the sensor and it shines light to measure your pulse and O2.
> That’s why I get so annoyed by the many commentators on the sidelines who, without much insight, criticize the scientists and policymakers trying hard to get the epidemic under control. That’s very unfair.
Do viral epidemiologists have much insight about the effects of economic depression, combined with all-but-unprecedented fear and social isolation, on public health? Do they have any at all? This comes across as incredibly arrogant, and just as unfair.
There's a huge difference between criticizing the people/science and criticizing the decision. We collectively need to have a real conversation about the pros/cons/risks of reopening parts of society. However, we're stuck in this rut of just calling the science bad (it's not) in order to avoid talking about the harsh reality of increased death rate.
In Slovenia we did random sample testing. Out of this we concluded that 3% of population had covid-19. This is 60000 people of which ~100 people die. This gives death rate around 0.17. Majority were people in elderly homes with many other diseases.
NYC has population fatality ratio of 0.17% to 0.23%. 8.4 million people and 14,753 confirmed COVID-19 deaths [0]. They have also 5,178 probable COVID-19 deaths. In other words, around 1 person per 500 overall died due COVID-19. Serology tests shows that only one in 5 people had the disease [1]. So the population fatality rate could still go up to 1 in 200. Imagine a wedding party, then imagine one person dead and 5 hospitalized, that's how bad it can get. There are very similar statistics in Bergamo, Italy and on board of Diamond Princess. Well, Diamond Process has infection fatality rate of 1.8% - 13 people out of 712 infected died.
“Let’s be clear: Without a coronavirus vaccine, we will never be able to live normally again. The only real exit strategy from this crisis is a vaccine that can be rolled out worldwide.”
Worldwide? It is fair to expect this will take years.
In the mean time what does normalcy look like? Sweden?
Yes, unless something important changes. Many places have published their pre-vaccine plan, and the restrictions have been pretty similar to what Sweden has.
Here in new Zealand we are embarked on a total eradication path. Just yesterday a friend was espousing that even if we succeed, sooner or later we'll have to join Sweden anyway (unless a vaccine arrives) as the only alternative is to keep our borders entirely shut. Personally I don't have a problem with that, as I have several elderly relatives, but it's amazing to contemplate the decisions that await us all in these strange times.
With the death rate is so slow for large portions of the population, the vaccine will have basically no margin for error. How do you convince parents to vaccinate kids for a disease that has say a .001% fatality rate for those under 17 unless the vaccine is even safer?
[+] [-] jobu|5 years ago|reply
There have also been reports of people in China with significantly reduced lung capacity even months after recovery. Still so many scary questions about the long-term effects of this virus, possibly the biggest ones being about the post-recovery immunity. How long does the immunity last and how encompassing is it?
[+] [-] SpicyLemonZest|5 years ago|reply
[+] [-] pl0x|5 years ago|reply
[+] [-] rixrax|5 years ago|reply
We are now at about 6 months into people being infected en masse. So hopefully in about another 6 months people in Wuhan and elsewhere wont start getting sick again!
[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851497/
[+] [-] ashtonkem|5 years ago|reply
The question about why some viral infections confer lifelong immunity while others don’t is still an open question, I believe.
[+] [-] pacala|5 years ago|reply
[+] [-] fermienrico|5 years ago|reply
It would be good to hear plausible scenarios of how people still catch it despite of masks and social distancing. There is something to learn from each story. And I see a distinct lack of focus on anecdotal stories of how people think they caught it. How the fuck are people catching this disease?
[+] [-] kens|5 years ago|reply
The other thing I got from the article is that South Korea is on a whole different level of testing than the US. When infection was detected, they tested everyone who was in the building or had visited: 1143 people tested with results in 12-24 hours. Everyone positive was isolated and everyone negative was quarantined and re-tested for 14 days. They also texted 16,628 people who had been near the building for more than 5 minutes (from cell data), telling them to avoid contact with others and get tested. This level of testing and tracing got South Korea (51 million people) to the point that it is now averaging just 10 new cases per day.
[1] https://wwwnc.cdc.gov/eid/article/26/8/20-1274_article [2] https://wwwnc.cdc.gov/eid/article/26/8/20-1274-f2
[+] [-] javagram|5 years ago|reply
2. Many people are still working in industries where they aren’t social distancing, e.g. all the meat packing plant outbreaks where sick employees were ordered to continue working in close proximity to their coworkers and nearly every employee in the plant got infected.
3. Positive cases are being sent home to quarantine in the same residence as their uninfected family members, who then catch the virus. Some other countries are either quarantining sick cases in the hospital, in hotels, or in monitored quarantine sites, but we haven’t been doing that in most cases and so we send home a positive case and they then infect everyone else in their home. This is worst in nursing homes but is happening in multigenerational households and other households as well. https://www.nydailynews.com/coronavirus/ny-coronavirus-cuomo...
[+] [-] pwg|5 years ago|reply
One of the issues is that not everyone is wearing masks or properly social distancing. If you have any opportunity to go out and safely observe from a distance any groups, you'll notice a sizable fraction not wearing masks and many not properly distancing themselves.
All it takes is some percentage of those who are not mask wearing or distancing also being asymptomatic spreaders to keep the spread going.
[+] [-] kerakaali|5 years ago|reply
Many people don't realise how much contact spread can occur in just half an hour as well, as seen [0]. This was modelling the spread inside of a dining hall of a cruise ship, but you can imagine similar behaviour in other public spaces.
[0] https://youtu.be/9cZTfUAYrF8
[+] [-] mdturnerphys|5 years ago|reply
[+] [-] jeremiahhs|5 years ago|reply
This is one https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article Image https://i.insider.com/5ea01ef938bf2357b9756173?width=750&for...
As we are two months into this, we really should be getting regular updates on infection events.
[+] [-] AuryGlenz|5 years ago|reply
[+] [-] klyrs|5 years ago|reply
One of the difficulties in disease modeling is how very many transmission vectors that aren't accounted for.
[+] [-] graeme|5 years ago|reply
Further, the virus can take 5-14 days to show symptoms, and people don’t go for a test immediately. So confirmed cases lag actual infections.
[+] [-] Marsymars|5 years ago|reply
[+] [-] guscost|5 years ago|reply
[+] [-] rcxdude|5 years ago|reply
b) not everyone is socially distancing to the same degree.
[+] [-] battery_cowboy|5 years ago|reply
[+] [-] afarrell|5 years ago|reply
[+] [-] jansan|5 years ago|reply
Here is the study: https://annals.org/aim/fullarticle/2765934/autopsy-findings-...
And for those who speak German, here is their press conference: https://www.youtube.com/watch?v=VvH3mG-v0Ms
[+] [-] novaRom|5 years ago|reply
[+] [-] amelius|5 years ago|reply
I've read about this pitfall before. It might be an idea to have a blood oxygen saturation meter at home to keep an eye on this.
[+] [-] zaarn|5 years ago|reply
[+] [-] amalter|5 years ago|reply
It’s never my favorite source, but in the US there are a number of Chinese companies with US shipping on EBay.
I purchased 7 devices from “ConTec” at ~$26/each. All arrived and at least my unit read the same as a retail unit from Walgreens.
Not trying to shill, there are a number of other sources with thousands of positive reviews.
[+] [-] Noumenon72|5 years ago|reply
[+] [-] dharma1|5 years ago|reply
[+] [-] beamatronic|5 years ago|reply
[+] [-] guscost|5 years ago|reply
Do viral epidemiologists have much insight about the effects of economic depression, combined with all-but-unprecedented fear and social isolation, on public health? Do they have any at all? This comes across as incredibly arrogant, and just as unfair.
[+] [-] Caligatio|5 years ago|reply
[+] [-] balb0a|5 years ago|reply
[+] [-] Isinlor|5 years ago|reply
[0] https://www1.nyc.gov/site/doh/covid/covid-19-data.page [1] https://www.nytimes.com/2020/04/23/nyregion/coronavirus-anti...
[+] [-] vkou|5 years ago|reply
[+] [-] op00to|5 years ago|reply
[+] [-] chvid|5 years ago|reply
Worldwide? It is fair to expect this will take years.
In the mean time what does normalcy look like? Sweden?
[+] [-] SpicyLemonZest|5 years ago|reply
[+] [-] beachy|5 years ago|reply
[+] [-] rustybelt|5 years ago|reply
[+] [-] 2Xheadpalm|5 years ago|reply
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[+] [-] unknown|5 years ago|reply
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