Disclaimer: I'm Irish, working in tech but my hobby that gets me more of a social life is involvement with an Irish political party.
The new variant accounted for 10-25% of these new cases over the period of that spike. The spike happened two weeks after Christmas when lock-down restrictions were lifted, as planned in October, so people could have a respite after 9 months of all this. Did the government misjudge just how much people would socially interact? You bet.
But to claim that this event is a sign of things to come is to willfully ignore what Irish medical professionals (NPHET) are saying about what the root cause has been and fully buy into the government politicians attempts to cover their butts by blaming the new strain and not their own operational strategy.
Also note that it is coming up to three weeks since Christmas and new infections today is half of what it was last week already and dropping.
Also Irish. +1 on your assessment here. The virulent strain narrative was peddled by the Irish government who went against medical advice and tried to deflect blame. The evidence doesn’t support the narrative.
I think the COVID-fatigue angle is quite interesting though. As critical as I am of the government they were under a lot of pressure from the populous to provide some sort of respite.
It was going badly before Christmas, compared to earlier, and the break of Christmas/St Stephens made a gap in the testing, and then it slammed upwards over the next week, overwhelming the IT and health professionals dealing with turning positive swab numbers into confirmed cases.
By NYE, there were 9k tests in limbo that weren't in the stats.
At the point where the daily positives get over 2k, that's with a different test population. They're no longer testing contacts of people with COVID, they're testing people with symptoms. The positive rate went from 8% -> 40% in that time.
Anecdotally, I had no 1st order contacts with Covid (i.e., I know them well, rather than my sister's friend sort of thing), and over Christmas that went to more like 5 in three separate clusters.
Actually the new strain is already responsible for 45% of infections in Ireland (as per yesterday's NPHET briefing) while it was 10% at the beginning of the year IIRC
So yeah it's not the whole story, but it is an important part of it.
Also worth mentioning that due to low infection rates beforehand, the Irish population is more primed to be hit with bigger spike.
Infection has more chance to spread as only few people are immune. Other EU countries that already had large numbers of their people immune after recovering from covid.
And yeah, it was a perfect storm of badluck. Covid fatigue, xmas break, people from UK returning (with no oversight, spreading new strain) and of course Christmas dinner with uncles and aunts from each county :D
What everyone seems to be assuming is that this new strain will cause a constant increase in the reproduction number R of ~50% in every situation. I haven't really seen any discussion of if and why that is actually a good extrapolation to make.
So for example in a specific situation, with a specific type of intermingling of a population in which the R value was, say, 1.2, we think the new strain caused that to increase to an R value of 1.8. How does it necessarily follow that taking intervention measures that bring the R value of the base strains down to, say, 0.8 would bring the R value of the new strain to exactly 1.2?
There are just so many factors involved, it doesn't seem like this could possibly be knowable right now. So there may be some hope that things like getting everyone N95 masks and requiring their use, and closing down indoor activities, which are good measures to control the current strains anyway, could also bring down the reproduction number of the new strain below 1 as well.
However, this is all a purely academic exercise anyway. Even in places that are being "aggressive" in countering the virus like San Francisco, we have done exactly nothing to react to new information in the past 1.5 months. Our "lockdown", which is entirely optional and has no teeth, is clearly not working, but we have neither removed it or strengthened it. The health department has exactly zero plans regarding the vaccine. It feels like we've just given up altogether, and we're praying that the private market saves us by somehow distributing the vaccines effectively. And on top of all that, we've handicapped the private market by making it illegal to distribute the vaccine to the vast majority of the population, even the elderly and vulnerable groups!
This is really poorly reasoned. To take a couple examples:
> Using data from flu monitoring programs in prior years, the CDC models project that 70 MILLION Americans have already gotten sick with symptomatic Covid, but decided to just write it off as a bad cold and never got tested. I am not making this up.
Why is this hard to believe? Covid testing, especially depending on where you live, can be difficult to obtain. If you have a cough and a loss of sense of smell but nothing debilitating, getting a Covid test just satisfies your curiosity, because you're going to be isolating anyway.
> I mean, take that Re up to 3.0 (the high end of the current Ireland estimate), and a single Covid case will result in 5.2 BILLION total cases over a 100-day period, about 60% of the entire human population on the planet. Obviously our social behaviors around the disease would change dramatically well before we got to that point.
"Social behaviors" are not what slows down Rt when you get to 60% of the entire human population infected; the number of targets gradually diminishes, slowing the spread.
>> ...the CDC models project that 70 MILLION Americans have already gotten sick with symptomatic Covid, but decided to just write it off as a bad cold and never got tested...
> Why is this hard to believe?
I don't agree with the article more broadly, but it does make the point that 70 million prior infections isn't consistent with hospitalization numbers over the summer vs now. The only way I can reconcile those numbers is by adding two assumptions: first, that severity depends on initial viral dose; second, various social and weather patterns associated with summer drive lower initial viral doses. I don't think these are implausible assumptions--in fact, I'd guess they're true--but I would need significantly more evidence to make me think they account for many tens of millions of missed COVID cases.
In November my daughter came down with a slight fever and runny nose. We didn't think it was COVID, but of course wanted to make sure. It was much more difficult than I thought it would be to get tested. Many places wouldn't test a child under 10. Once we finally found a location to test the soonest they had an appointment was 24 hours later. It took several days to get the negative result as well and I had to call them twice to get the results. I'm sure many people wouldn't go through the effort.
Until we have more precise IFR numbers, my simplistic "model" is just to divide the current death count by 0.005, which suggests around 78 million have had an infectious exposure in the US so far. The CDC number doesn't feel surprising.
Unfortunately a large number of those infections (far more than recorded cases) happened last spring, so millions of people could be losing their immunity if they've managed to avoid substantial re-exposures since then.
Agreed. Some people just don't care about testing.
I am friends with a doctor who tested positive. They went into quarantine with their whole family, assuming they would all get it one way or another, and didn't bother with further testing. I suspect this is the case for a lot of people.
> Covid test just satisfies your curiosity, because you're going to be isolating anyway
This might be your personal bubble speaking. I have two non-tech friends (EMT and a labourer) who contracted Covid and both of their workplaces required a positive Covid test if they wanted to take two weeks off for quarantine.
The whole thing comes off as a rant supported by gut feelings about his own questionable figures and quickly dismissing contradictory sources as political.
Author does not provide sources or analysis as to why he trusts his figures and remains skeptical of others.
That's the core of what the article is about; it's hard to believe based on comparing testing and hospitalization numbers.
> "Social behaviors" are not what slows down Rt ... the number of targets gradually diminishes
Those aren't mutually exclusive, and it is possible to change social behaviors fast enough that it happens before you reach a threshold where you get significant slowing due to reduction in available "targets".
>"Social behaviors" are not what slows down Rt when you get to 60% of the entire human population infected; the number of targets gradually diminishes, slowing the spread.
Or the virus mutates, and off you go on another round. We have a couple of corona viruses that are already endemic in the human population, what makes you think this one will just die out naturally?
The author makes the point that the assumption behind that number is that people test for Covid-19 at the same rate as they would test for the flu. I know of very few people who have tested for flu but many who have tested for Covid-19.
I'm Irish in Ireland, I've been following the matter closely.
Ireland had one of the strictest lockdowns in most of Europe since March, no pubs, nightclubs, limited restaurants, churches, limited sports, 5km travel restrictions were on and off. We masked up early and our national broadcaster was constantly warning everyone non-stop. Schools were open however.
We were the poster boy for lockdown success up until at least November. Other nations were commenting on our achievements. You can see what has happened since.
The WHO warns that lockdown should only be treated as a last resort, to truly flatten the curve and no more. We ignored that.
It's my sincere opinion that we've tried to push back a virus through our lockdown measures and social distancing that eventually cannot be controlled.
Holding back a virus is like holding back a damn, eventually something will burst and typically at the wrong time.
If we had listened to the WHO by not locking down, gaining natural immunity during the summer (when coronaviruses aren't as prevalent) we wouldn't be in the mess that we are in now.
The median age of death of this virus is 82. Please conceptualise this. Less than 20 people under the age of 44 died from covid in 2020. With our current technology dying is a part of life that cannot be avoided. The people who are dying from covid at the moment are people who were going to die this year, remember, people have to die, most of them have already made peace with this idea.
If we didn't try so hard to prevent these aged people from dying we wouldn't have our resources stretched thin which is compounding the death rate further.
I'm sorry to be the person to tell you this but we all have to die, we shouldn't be stopping the living from enjoying their days on earth. Lockdowns are hurting the young and middle age to a drastic degree. You may not care because you work from home and are still guaranteed a paycheck. It's easy to virtue signal that you want to save everyone from the comfort of your keyboard. You aren't impacted by business closures but if you had any shed of humanity you would disagree to these lockdowns because they are causing more harm than good.
Thank you. I honestly believe that there is a non-trivial percentage of the population that _likes_ the COVID world and wants to keep it going as long as possible. Some may like working remotely, others may like the wider acceptance of meal and grocery delivery, others may prefer the reduction in greenhouse gases. That is the only way I can rationalize the insistence of lockdowns here on HN and elsewhere.
Either that or COVID is another social issue that is being exploited by nefarious actors to divide western nations.
> The WHO warns that lockdown should only be treated as a last resort, to truly flatten the curve and no more. We ignored that.
Countries that have eliminated the virus have ignored this for good results. Some like us here in Melbourne have used lockdowns to eliminate the virus, others like New Zealand have used them as a first resort to contain outbreaks. Because we eliminated it we're now back to (mostly) normal, we don't have young people sacrificing anything, we have kids in school, we have large sporting events and it's not coming at the cost of everyone's lives. Despite WHO advice most countries that eliminated it have also kept borders mostly shut.
Ireland is a tragedy because the were so close to elimination but never took those final steps to eliminate it and keep it out. The worlds tragedy is that they gave up on elimination, it would have been much cheaper and less impactful than rolling lockdowns.
Just imagine if they had used all the propaganda to promote exercise and healthy eating to the population while handing out free bottles of vitamin d3 instead of the opposite (stay inside, don't sunbathe, don't exercise, eat poorly due to depression and economic hardship)
1. holding the damn until the vaccine gets deployed
2. What are your concerns if any about the long term illnesses and organ damage in younger covid afflicted patients.
I agree with your points except for those two key considerations.
Because of this, I am for continuing lockdowns and distancing until the vaccine and refuse to potentially subject myself to life long debilitation when waiting 3 more months would offer significantly more protection.
The article spends a long time complaining about the high "unreported infection" numbers used by CDC models, but doesn't actually address the biggest piece of evidence, which is seroprevalence surveys. For example, https://www.cidrap.umn.edu/news-perspective/2021/01/study-us... claims 15% of US residents had COVID antibodies in mid-November, and if you want to claim a number that disagrees with that, you at least need to address the evidence.
> Using data from flu monitoring programs in prior years, the CDC models project that 70 MILLION Americans have already gotten sick with symptomatic Covid, but decided to just write it off as a bad cold and never got tested. I am not making this up.
In Bangladesh, a well-regarded study found that 45% of people in Dhaka, one of the most densely populated regions in the world, had antibodies. This study was conducted between April 18 and July 5. I'm sure the number is much higher now. And most people around me seem to agree with this- our total deaths so far is 1/50 of USA, despite having 1/2 population. Even if we multiply our total deaths by 5 to account for maybe government cover-up, our death rate/infection rate still seems too low. Widespread immunity appears to be the only explanation for this disparity.
It’s just a lot of “I think” “There’s a non-trivial chance” “I expect” “I predict” without any sources to back anything up.
If you’re going to disagree with the CDC model, at least show why they’re wrong or why your reasoning is correct.
Same goes for the Ireland situation, if you’re so obsessed with it; put them in context. For instance, name how Ireland eased their lockdown for Christmas [1], how 45% of new cases are due to the UK-variant [2]. Given that, what could happen, based on data, that a similar event can happen in the US? Don’t just show a chart and say “I predict that there is a non-trivial chance that the same thing will happen in the US.”
If anyone went to the comments to see if this article is worth your time; I predict there’s a non-trivial chance you will find that it is not worth your time. Furthermore, I expect you’ll also not find the website worth 200$/year.
So the main complaint is that the US Govt model has 70 million symptomatic-but-undiagnosed cases in the US compared to 23 diagnosed cases and the author claims this is wildly wrong. If those numbers were correct, we'd have diagnosed 23% of cases. Do we really thing we've done much better than that? I'm not certain. I'd be a little surprised if it were over 50%, but that's purely based off intuition.
The other point the author kind of brings up: the current Alabama numbers are roughly in line with the "Ireland event" already. So a "rolling series" of these events is kind of what we already have happening, isn't it? That doesn't diminish the toll of the situation or the mistakes in the responses from the authorities.
I'm usually a flag-carrier for epsilon theory here and elsewhere, but I think this is the closest approximation to reality.
What's happen(ed)ing in Ireland is Bad capital B. But that just puts into context USA's reality for the last ~3 months or so. We have been living an ongoing Ireland event since people gave up in the Fall.
Information on US COVID-19 seroprevlance surveys can be found on the CDC website [0]. There are also a number of more locally sampled sero surveys going on concurrently right now by state/city/county public health departments. 'Sero' surveys are a commonly used tool in infectitious disease research to understand the difference between identified and total case numbers. They have tons of pros and cons (see [1] for some examples). There are also different types [2]
They aren't exact, but the goal with this type of research isn't perfect accuracy, that is impossible, it's better information than we currently have. The prevalence number that you get from a sero survey is hugely important to accurately estimating the effectiveness of medical tests. However, getting that data into a model of test accuracy isn't necessarily easy. [3]
This is an example of a COVID sero survey from Santa Clara County last April [4]. Over two days they collected around 3500 samples over two days. There results summary is basically this:
The raw prevalence of antibodies to SARS-CoV-2 in our sample was 1.5%. Weighted for population demographics of Santa Clara County, the prevalence was 2.8%. Using those prevalence numbers, the unweighted estimate of case numbers was 23,000. Using the weighted prevalence number, the estimate was 54,000. In early April, there were approximately 1,000 confirmed cases in Santa Clara County.
From my epidemiologist friends, they think 50% diagnosed cases is if anything a massive overestimate of the diagnostic rate and something like 1 in 4 diagnosed cases is probably accurate (this is hearsay that I can't cite from people in the field). The problem is that the 23,000-54,000 people who 'had' (air quotes) COVID last April may or may not be immune at this point. The numbers may be high or low ...either way they are BAD
Not even getting into what this means about vaccine policy...just talking about what the data and numbers are here. I'm still trying to process what the original post means/is trying to say honestly.
I feel like everyone continues to assume COVID-19 infection has an exponential curve but it's been shown by Nobel prize winner Michael Levitt that it actually follows a Gompertz function more accurately. Not only that but the WHO recently released a statement saying that PCR testing for COVID-19 is not suitable as it detects many forms of respiratory problems including the common cold.
I feel like the author of this article is simplifying a complex topic.
A big problem is that nobody seems to be monitoring Covid antibodies in a large-scale, consistent way. Here's the CDC's "COVID-19 Serology Surveillance Strategy" [1] They have a few tools. One is a blood donor test, where donated blood is tested for antibodies. Another is random sampling of blood tests taken for other medical reasons. Those establish bounds - blood donors are healthier than average, and people getting blood tests for medical reasons are less healthy than average.
The results, though, are very spotty. The most recent US data published seems to be from September 2020.[2] "In this repeated, cross-sectional study of 177 919 residual clinical specimens, the estimated percentage of persons in a jurisdiction with detectable SARS-CoV-2 antibodies ranged from fewer than 1% to 23%. Over 4 sampling periods in 42 of 49 jurisdictions with calculated estimates, fewer than 10% of people had detectable SARS-CoV-2 antibodies. ... Samples were obtained during 4 collection periods: July 27 to August 13, August 10 to August 27, August 24 to September 10, and September 7 to September 24, 2020."[3] Those are from anonymous random blood samples taken from people who had a lab test for something else.
For blood donors, there's this data.[3] "Data from the American Red Cross, which is providing serosurveillance data as part of the MASS study, indicated that 8.4 percent of U.S. blood donors it tested in a week in late November carried antibodies to Covid-19 in their blood."
So that's the US situation from November. Those set upper and lower bounds on how many people in the US have had Covid-19. Those are actuals, not estimates. One would expect this would be tracked and updated weekly, but if it is, the data isn't widely available. The main thing one can conclude from this is that it's nowhere near "herd immunity". That would require 7x-10x as many people showing antibodies.
The CDC's estimates based on a flu-based estimate of how many people need medical attention per infection seem inconsistent with that actual data.
As for the "Ireland event", here it is on the Financial Times graph with other countries.[4] From 5 cases per 100K to 130 cases per 100K. For comparison, California is now around 105 cases per 100K.
That graph looks a lot like what California already did in December.
I'm not sure where to find Re numbers to compare with his discussed ones for Ireland. ANOTHER huge spike on top of the one that only now is starting to slow would be pretty terrible, or maybe we just saw the same thing already (new strains have been identified here, and behavior seems like it deteriorated before the holidays before getting improved after the spike).
I think it's fairly incomplete to make predictions about the US like the linked article (let alone speculation about government motivations) without discussing or comparing the current US numbers much at all. The author acknowledges that it would be a spread-out-over-time-regionally thing, but looks at aggregate country-level US data that is going to make it hard to see. The political speculation seems a bit out of left field: in the US I did hear a lot about "the winter will be tough" "it will be worse if people travel after getting fatigued with restrictions" "we can't let our guard down even though numbers are improving now". And we've heard a lot about "we need to keep an eye on new strains and such and may have to make further adjustments." Not this head-in-the-sand posture the author is describing.
Assuming all it takes is a strict 3 week shutdown, why can’t we have that? Or is the assumption wrong? Why weren’t we able to produce enough stock for 3 weeks of total halt?
Most supply chains today are measured in days not weeks
The average Grocery will run out of stock in 2-4 days (most being closer to 2 days)
The supply chain network is not setup for allow for a 3 week shutdown, nor can it be easily adapted to allow for it.
Most people, espically in urban centers, would not have enough supplies to last more than a couple of days as well.
Given that most people also can not budget for a $100 emergency they would be hard pressed to walk into a store and buy 3 weeks of food even if we could stock the stores to supply it (which we can not)
That is with out getting into the needs of Power, Water, Gas, Sewer, Public Safety, etc etc etc
you can not shut down a nation for 3 weeks, it is simply not possible
A 3 week shutdown is politically not feasible, a high percentage of people would just ignore it, with plenty of them yelling and screaming on Parl... Twitter.
Somehow it's easier to do in a police state like China. Or maybe a country where there's still a high degree of solidarity (don't quote me, I'm not an expert on exactly why) like New Zealand.
There is nothing about the severity of covid that merits shutting down the entire economy.
A full shutdown of the entire economy (i.e. you can't get food or water if you need them) would only be warranted in the case of an existential threat.
The author’s argument for why it’s implausible that a lot of people don’t get tested is literally “c’mon, man.” That not satisfying to me.
I was sick for a few days over the summer. Was it a mild case of Covid? I don’t know, or care. Why should I get tested when that information will change literally nothing about my life?
A point not many people are raising is its winter in the northern hemisphere, so naturally the R0 will increase. Why this new strain is so prevalent? My personal opinion is since schools opened up they have acted as the main vector. Going undetected for an extended period, I read children are 'being hit the hardest' ie their is a lot more asymptomatic children. The latter point is just conjecture but the note on winter I do think has merit.
Overtime the virus will be less deadly to all age groups and likely become another common cold virus. I read a article in hn the other day talking about how all cold virus might have started as pandemics.
Based in history pandemics last 18 months. Two winters and one summer. But that is during natural spread rather than nation wide lockdown.
While I'm ranting, I believe masks were always a vector to get people the smallest viral dose. Have you seen anyone with a mask, they touch it every few seconds and even reuse it. I remember back 12months ago I was panning on wearing different clothes inside from outside, having a buffer area in my house and having a mask cycle were they spend 3 days in the suns UV.
I don't think the virus will get as much news, a important catalyst is when their is government mandate of the pcr cycle number. If they reduce it they can stimulate low infection numbers.
In my personal opinion mass testing was the biggest mistake, after it hit large community spread they should have only tested in hospitals for research purposes and held all data at a national security level for 10 years.
People are just not mentally able to deal with such situation, look at social media for an example their is so much pure rage in the world. Even in my county NZ the anger on social media is shocking. Its the same logic that you should not tell people about aliens (in movies) because people as a group can not take the stress.
We on HN are a bad sample, we are probably more likely to be logical. Where most people would have strong emotions.
I read this title as "Ireland events" as social unrest. I know this is not the subject, but its equally vaild, given what we have witnessed over the last year.
I think the central claim of this article is something of a mainstream concern. For example, here's a blog by Tom Frieden, who is in my opinion one of the more credible voices: https://www.tomfriedenpublichealth.net/tom-frieden-blog#janu... . Other virologists and epidemiologists who I follow on Twitter are saying similar things.
> More than three times the number of known Covid cases?
Wouldn't detecting 1/3 and missing 2/3 be pretty expected, especially since a lot of the cases were early on? Count backwards from the estimated IFR of e.g. 0.2..1.0% and you get a number of million infections from the ~400k dead. You need to go pretty low in that IFR to get to 1/3 of the population though.
"that 70 MILLION Americans have already gotten sick with symptomatic Covid, but decided to just write it off as a bad cold and never got tested. I am not making this up."
Based on quantity of people with antibodies in NYC, Italy, etc who never knew they had it other than symptoms they thought were a cold, there's nothing surprising about a number of 70 million.
One technical point that I disagree with is his characterization of exponential spread. He is mentally modeling it like every person is the root of their own tree in a societal forest. While the number of infected nodes in an SIR model on a network does grow exponentially in early stages, at some point the growth slows as many of your contacts have already been infected. This may not happen until some constant fraction of the graph has been infected, however. Of course as we all have heard the equilibrium state is "herd immunity" when the infection dies out or remains contained to small components, but even before this I believe the growth rate slows. I should know more about this considering it is what i wrote my doctoral thesis on, but i've made room for other things.
Oh Jesus, I read the title and thought it was about 'The Troubles' coming to the US over the insurrection. Which I thought would be really bad. But then it was about covid-19, and, well ... that actually may be worse in terms of casualties. Good Lord.
[+] [-] Fordec|5 years ago|reply
The new variant accounted for 10-25% of these new cases over the period of that spike. The spike happened two weeks after Christmas when lock-down restrictions were lifted, as planned in October, so people could have a respite after 9 months of all this. Did the government misjudge just how much people would socially interact? You bet.
But to claim that this event is a sign of things to come is to willfully ignore what Irish medical professionals (NPHET) are saying about what the root cause has been and fully buy into the government politicians attempts to cover their butts by blaming the new strain and not their own operational strategy.
Also note that it is coming up to three weeks since Christmas and new infections today is half of what it was last week already and dropping.
[+] [-] lynchdt|5 years ago|reply
I think the COVID-fatigue angle is quite interesting though. As critical as I am of the government they were under a lot of pressure from the populous to provide some sort of respite.
[+] [-] wiredfool|5 years ago|reply
It was going badly before Christmas, compared to earlier, and the break of Christmas/St Stephens made a gap in the testing, and then it slammed upwards over the next week, overwhelming the IT and health professionals dealing with turning positive swab numbers into confirmed cases.
By NYE, there were 9k tests in limbo that weren't in the stats.
At the point where the daily positives get over 2k, that's with a different test population. They're no longer testing contacts of people with COVID, they're testing people with symptoms. The positive rate went from 8% -> 40% in that time.
Anecdotally, I had no 1st order contacts with Covid (i.e., I know them well, rather than my sister's friend sort of thing), and over Christmas that went to more like 5 in three separate clusters.
[+] [-] raverbashing|5 years ago|reply
So yeah it's not the whole story, but it is an important part of it.
[+] [-] randompwd|5 years ago|reply
[+] [-] me_me_me|5 years ago|reply
Infection has more chance to spread as only few people are immune. Other EU countries that already had large numbers of their people immune after recovering from covid.
And yeah, it was a perfect storm of badluck. Covid fatigue, xmas break, people from UK returning (with no oversight, spreading new strain) and of course Christmas dinner with uncles and aunts from each county :D
[+] [-] unknown|5 years ago|reply
[deleted]
[+] [-] cactus2093|5 years ago|reply
So for example in a specific situation, with a specific type of intermingling of a population in which the R value was, say, 1.2, we think the new strain caused that to increase to an R value of 1.8. How does it necessarily follow that taking intervention measures that bring the R value of the base strains down to, say, 0.8 would bring the R value of the new strain to exactly 1.2?
There are just so many factors involved, it doesn't seem like this could possibly be knowable right now. So there may be some hope that things like getting everyone N95 masks and requiring their use, and closing down indoor activities, which are good measures to control the current strains anyway, could also bring down the reproduction number of the new strain below 1 as well.
However, this is all a purely academic exercise anyway. Even in places that are being "aggressive" in countering the virus like San Francisco, we have done exactly nothing to react to new information in the past 1.5 months. Our "lockdown", which is entirely optional and has no teeth, is clearly not working, but we have neither removed it or strengthened it. The health department has exactly zero plans regarding the vaccine. It feels like we've just given up altogether, and we're praying that the private market saves us by somehow distributing the vaccines effectively. And on top of all that, we've handicapped the private market by making it illegal to distribute the vaccine to the vast majority of the population, even the elderly and vulnerable groups!
[+] [-] jdminhbg|5 years ago|reply
> Using data from flu monitoring programs in prior years, the CDC models project that 70 MILLION Americans have already gotten sick with symptomatic Covid, but decided to just write it off as a bad cold and never got tested. I am not making this up.
Why is this hard to believe? Covid testing, especially depending on where you live, can be difficult to obtain. If you have a cough and a loss of sense of smell but nothing debilitating, getting a Covid test just satisfies your curiosity, because you're going to be isolating anyway.
> I mean, take that Re up to 3.0 (the high end of the current Ireland estimate), and a single Covid case will result in 5.2 BILLION total cases over a 100-day period, about 60% of the entire human population on the planet. Obviously our social behaviors around the disease would change dramatically well before we got to that point.
"Social behaviors" are not what slows down Rt when you get to 60% of the entire human population infected; the number of targets gradually diminishes, slowing the spread.
[+] [-] scarmig|5 years ago|reply
> Why is this hard to believe?
I don't agree with the article more broadly, but it does make the point that 70 million prior infections isn't consistent with hospitalization numbers over the summer vs now. The only way I can reconcile those numbers is by adding two assumptions: first, that severity depends on initial viral dose; second, various social and weather patterns associated with summer drive lower initial viral doses. I don't think these are implausible assumptions--in fact, I'd guess they're true--but I would need significantly more evidence to make me think they account for many tens of millions of missed COVID cases.
[+] [-] volker48|5 years ago|reply
[+] [-] mcbits|5 years ago|reply
Unfortunately a large number of those infections (far more than recorded cases) happened last spring, so millions of people could be losing their immunity if they've managed to avoid substantial re-exposures since then.
[+] [-] s1artibartfast|5 years ago|reply
I am friends with a doctor who tested positive. They went into quarantine with their whole family, assuming they would all get it one way or another, and didn't bother with further testing. I suspect this is the case for a lot of people.
[+] [-] Permit|5 years ago|reply
This might be your personal bubble speaking. I have two non-tech friends (EMT and a labourer) who contracted Covid and both of their workplaces required a positive Covid test if they wanted to take two weeks off for quarantine.
[+] [-] the-dude|5 years ago|reply
Ehhh, people might be avoiding the test ... to avoid having to isolate. I am making this shit up, but I wouldn't be surprised.
[+] [-] chapium|5 years ago|reply
Author does not provide sources or analysis as to why he trusts his figures and remains skeptical of others.
[+] [-] agf|5 years ago|reply
That's the core of what the article is about; it's hard to believe based on comparing testing and hospitalization numbers.
> "Social behaviors" are not what slows down Rt ... the number of targets gradually diminishes
Those aren't mutually exclusive, and it is possible to change social behaviors fast enough that it happens before you reach a threshold where you get significant slowing due to reduction in available "targets".
[+] [-] soperj|5 years ago|reply
Or the virus mutates, and off you go on another round. We have a couple of corona viruses that are already endemic in the human population, what makes you think this one will just die out naturally?
[+] [-] lern_too_spel|5 years ago|reply
[+] [-] drcross|5 years ago|reply
Ireland had one of the strictest lockdowns in most of Europe since March, no pubs, nightclubs, limited restaurants, churches, limited sports, 5km travel restrictions were on and off. We masked up early and our national broadcaster was constantly warning everyone non-stop. Schools were open however.
We were the poster boy for lockdown success up until at least November. Other nations were commenting on our achievements. You can see what has happened since.
The WHO warns that lockdown should only be treated as a last resort, to truly flatten the curve and no more. We ignored that.
It's my sincere opinion that we've tried to push back a virus through our lockdown measures and social distancing that eventually cannot be controlled.
Holding back a virus is like holding back a damn, eventually something will burst and typically at the wrong time.
If we had listened to the WHO by not locking down, gaining natural immunity during the summer (when coronaviruses aren't as prevalent) we wouldn't be in the mess that we are in now.
The median age of death of this virus is 82. Please conceptualise this. Less than 20 people under the age of 44 died from covid in 2020. With our current technology dying is a part of life that cannot be avoided. The people who are dying from covid at the moment are people who were going to die this year, remember, people have to die, most of them have already made peace with this idea.
If we didn't try so hard to prevent these aged people from dying we wouldn't have our resources stretched thin which is compounding the death rate further.
I'm sorry to be the person to tell you this but we all have to die, we shouldn't be stopping the living from enjoying their days on earth. Lockdowns are hurting the young and middle age to a drastic degree. You may not care because you work from home and are still guaranteed a paycheck. It's easy to virtue signal that you want to save everyone from the comfort of your keyboard. You aren't impacted by business closures but if you had any shed of humanity you would disagree to these lockdowns because they are causing more harm than good.
[+] [-] salmon30salmon|5 years ago|reply
Either that or COVID is another social issue that is being exploited by nefarious actors to divide western nations.
Or both.
[+] [-] flukus|5 years ago|reply
Countries that have eliminated the virus have ignored this for good results. Some like us here in Melbourne have used lockdowns to eliminate the virus, others like New Zealand have used them as a first resort to contain outbreaks. Because we eliminated it we're now back to (mostly) normal, we don't have young people sacrificing anything, we have kids in school, we have large sporting events and it's not coming at the cost of everyone's lives. Despite WHO advice most countries that eliminated it have also kept borders mostly shut.
Ireland is a tragedy because the were so close to elimination but never took those final steps to eliminate it and keep it out. The worlds tragedy is that they gave up on elimination, it would have been much cheaper and less impactful than rolling lockdowns.
[+] [-] DSingularity|5 years ago|reply
[+] [-] 1experience|5 years ago|reply
1) this is Sweden 2020 death rate compared to other Scandinavian countries (no lockdown, no masks) https://preview.redd.it/jujfoejeqwa61.png?width=1024&auto=we...
2) these are some of the effects caused by lockdowns worldwide https://outline.com/JKgfuv
[+] [-] scsilver|5 years ago|reply
1. holding the damn until the vaccine gets deployed 2. What are your concerns if any about the long term illnesses and organ damage in younger covid afflicted patients.
I agree with your points except for those two key considerations.
Because of this, I am for continuing lockdowns and distancing until the vaccine and refuse to potentially subject myself to life long debilitation when waiting 3 more months would offer significantly more protection.
[+] [-] unknown|5 years ago|reply
[deleted]
[+] [-] HALtheWise|5 years ago|reply
[+] [-] aresant|5 years ago|reply
Phew he was just talking about the once in a lifetime pandemic shit show.
Time for a break from the internet today.
[+] [-] captain_price7|5 years ago|reply
In Bangladesh, a well-regarded study found that 45% of people in Dhaka, one of the most densely populated regions in the world, had antibodies. This study was conducted between April 18 and July 5. I'm sure the number is much higher now. And most people around me seem to agree with this- our total deaths so far is 1/50 of USA, despite having 1/2 population. Even if we multiply our total deaths by 5 to account for maybe government cover-up, our death rate/infection rate still seems too low. Widespread immunity appears to be the only explanation for this disparity.
[1] https://bdnews24.com/bangladesh/2020/10/12/45-percent-of-dha...
[+] [-] nradov|5 years ago|reply
https://www.cnbctv18.com/healthcare/57-sero-prevalence-in-sl...
There could be other explanations beyond widespread existing immunity. For example could diet be a factor?
[+] [-] JimBlackwood|5 years ago|reply
It’s just a lot of “I think” “There’s a non-trivial chance” “I expect” “I predict” without any sources to back anything up.
If you’re going to disagree with the CDC model, at least show why they’re wrong or why your reasoning is correct.
Same goes for the Ireland situation, if you’re so obsessed with it; put them in context. For instance, name how Ireland eased their lockdown for Christmas [1], how 45% of new cases are due to the UK-variant [2]. Given that, what could happen, based on data, that a similar event can happen in the US? Don’t just show a chart and say “I predict that there is a non-trivial chance that the same thing will happen in the US.”
If anyone went to the comments to see if this article is worth your time; I predict there’s a non-trivial chance you will find that it is not worth your time. Furthermore, I expect you’ll also not find the website worth 200$/year.
The website looks pretty though.
[1] https://www.bbc.com/news/world-europe-55364744
[2] https://www.irishpost.com/news/taoiseach-uk-variant-account-...
[+] [-] tgb|5 years ago|reply
The other point the author kind of brings up: the current Alabama numbers are roughly in line with the "Ireland event" already. So a "rolling series" of these events is kind of what we already have happening, isn't it? That doesn't diminish the toll of the situation or the mistakes in the responses from the authorities.
[+] [-] second--shift|5 years ago|reply
What's happen(ed)ing in Ireland is Bad capital B. But that just puts into context USA's reality for the last ~3 months or so. We have been living an ongoing Ireland event since people gave up in the Fall.
[+] [-] avs733|5 years ago|reply
They aren't exact, but the goal with this type of research isn't perfect accuracy, that is impossible, it's better information than we currently have. The prevalence number that you get from a sero survey is hugely important to accurately estimating the effectiveness of medical tests. However, getting that data into a model of test accuracy isn't necessarily easy. [3]
This is an example of a COVID sero survey from Santa Clara County last April [4]. Over two days they collected around 3500 samples over two days. There results summary is basically this:
The raw prevalence of antibodies to SARS-CoV-2 in our sample was 1.5%. Weighted for population demographics of Santa Clara County, the prevalence was 2.8%. Using those prevalence numbers, the unweighted estimate of case numbers was 23,000. Using the weighted prevalence number, the estimate was 54,000. In early April, there were approximately 1,000 confirmed cases in Santa Clara County.
From my epidemiologist friends, they think 50% diagnosed cases is if anything a massive overestimate of the diagnostic rate and something like 1 in 4 diagnosed cases is probably accurate (this is hearsay that I can't cite from people in the field). The problem is that the 23,000-54,000 people who 'had' (air quotes) COVID last April may or may not be immune at this point. The numbers may be high or low ...either way they are BAD
Not even getting into what this means about vaccine policy...just talking about what the data and numbers are here. I'm still trying to process what the original post means/is trying to say honestly.
[0] https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/geog...
[1] https://www.who.int/immunization/monitoring_surveillance/bur...
[2] https://www.cdc.gov/coronavirus/2019-ncov/covid-data/seropre...
[3] https://academic.oup.com/aje/article/190/1/109/5893084?login...
[4] https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v...
[+] [-] kaczordon|5 years ago|reply
I feel like the author of this article is simplifying a complex topic.
[1] https://youtu.be/Uw2ZTaiN97k [2] https://www.who.int/news/item/14-12-2020-who-information-not...
[+] [-] Animats|5 years ago|reply
The results, though, are very spotty. The most recent US data published seems to be from September 2020.[2] "In this repeated, cross-sectional study of 177 919 residual clinical specimens, the estimated percentage of persons in a jurisdiction with detectable SARS-CoV-2 antibodies ranged from fewer than 1% to 23%. Over 4 sampling periods in 42 of 49 jurisdictions with calculated estimates, fewer than 10% of people had detectable SARS-CoV-2 antibodies. ... Samples were obtained during 4 collection periods: July 27 to August 13, August 10 to August 27, August 24 to September 10, and September 7 to September 24, 2020."[3] Those are from anonymous random blood samples taken from people who had a lab test for something else.
For blood donors, there's this data.[3] "Data from the American Red Cross, which is providing serosurveillance data as part of the MASS study, indicated that 8.4 percent of U.S. blood donors it tested in a week in late November carried antibodies to Covid-19 in their blood."
So that's the US situation from November. Those set upper and lower bounds on how many people in the US have had Covid-19. Those are actuals, not estimates. One would expect this would be tracked and updated weekly, but if it is, the data isn't widely available. The main thing one can conclude from this is that it's nowhere near "herd immunity". That would require 7x-10x as many people showing antibodies.
The CDC's estimates based on a flu-based estimate of how many people need medical attention per infection seem inconsistent with that actual data.
As for the "Ireland event", here it is on the Financial Times graph with other countries.[4] From 5 cases per 100K to 130 cases per 100K. For comparison, California is now around 105 cases per 100K.
[1] https://www.cdc.gov/coronavirus/2019-ncov/covid-data/serolog...
[2] https://jamanetwork.com/journals/jamainternalmedicine/fullar...
[3] https://www.medscape.com/viewarticle/944035#vp_2
[4] https://ig.ft.com/coronavirus-chart/?areas=eur&areas=usa&are...
[+] [-] majormajor|5 years ago|reply
I'm not sure where to find Re numbers to compare with his discussed ones for Ireland. ANOTHER huge spike on top of the one that only now is starting to slow would be pretty terrible, or maybe we just saw the same thing already (new strains have been identified here, and behavior seems like it deteriorated before the holidays before getting improved after the spike).
I think it's fairly incomplete to make predictions about the US like the linked article (let alone speculation about government motivations) without discussing or comparing the current US numbers much at all. The author acknowledges that it would be a spread-out-over-time-regionally thing, but looks at aggregate country-level US data that is going to make it hard to see. The political speculation seems a bit out of left field: in the US I did hear a lot about "the winter will be tough" "it will be worse if people travel after getting fatigued with restrictions" "we can't let our guard down even though numbers are improving now". And we've heard a lot about "we need to keep an eye on new strains and such and may have to make further adjustments." Not this head-in-the-sand posture the author is describing.
[+] [-] jdmoreira|5 years ago|reply
The spike happened after Christmas as New Years.
There are other possible explanations not being factored as well...
People have been home A LOT this past year and are probably in worse shape then ever and some people probably lack more vitamin d then ever before.
The weather is colder in the northern hemisphere now, contributing to low air humidity and benefiting viruses.
[+] [-] protoman3000|5 years ago|reply
[+] [-] syshum|5 years ago|reply
The average Grocery will run out of stock in 2-4 days (most being closer to 2 days)
The supply chain network is not setup for allow for a 3 week shutdown, nor can it be easily adapted to allow for it.
Most people, espically in urban centers, would not have enough supplies to last more than a couple of days as well.
Given that most people also can not budget for a $100 emergency they would be hard pressed to walk into a store and buy 3 weeks of food even if we could stock the stores to supply it (which we can not)
That is with out getting into the needs of Power, Water, Gas, Sewer, Public Safety, etc etc etc
you can not shut down a nation for 3 weeks, it is simply not possible
[+] [-] umanwizard|5 years ago|reply
[+] [-] netsharc|5 years ago|reply
Somehow it's easier to do in a police state like China. Or maybe a country where there's still a high degree of solidarity (don't quote me, I'm not an expert on exactly why) like New Zealand.
[+] [-] anewaccount2021|5 years ago|reply
A full shutdown of the entire economy (i.e. you can't get food or water if you need them) would only be warranted in the case of an existential threat.
[+] [-] umanwizard|5 years ago|reply
I was sick for a few days over the summer. Was it a mild case of Covid? I don’t know, or care. Why should I get tested when that information will change literally nothing about my life?
[+] [-] godmode2019|5 years ago|reply
Overtime the virus will be less deadly to all age groups and likely become another common cold virus. I read a article in hn the other day talking about how all cold virus might have started as pandemics.
Based in history pandemics last 18 months. Two winters and one summer. But that is during natural spread rather than nation wide lockdown.
While I'm ranting, I believe masks were always a vector to get people the smallest viral dose. Have you seen anyone with a mask, they touch it every few seconds and even reuse it. I remember back 12months ago I was panning on wearing different clothes inside from outside, having a buffer area in my house and having a mask cycle were they spend 3 days in the suns UV.
I don't think the virus will get as much news, a important catalyst is when their is government mandate of the pcr cycle number. If they reduce it they can stimulate low infection numbers.
In my personal opinion mass testing was the biggest mistake, after it hit large community spread they should have only tested in hospitals for research purposes and held all data at a national security level for 10 years.
People are just not mentally able to deal with such situation, look at social media for an example their is so much pure rage in the world. Even in my county NZ the anger on social media is shocking. Its the same logic that you should not tell people about aliens (in movies) because people as a group can not take the stress.
We on HN are a bad sample, we are probably more likely to be logical. Where most people would have strong emotions.
I read this title as "Ireland events" as social unrest. I know this is not the subject, but its equally vaild, given what we have witnessed over the last year.
[+] [-] raphlinus|5 years ago|reply
[+] [-] alkonaut|5 years ago|reply
Wouldn't detecting 1/3 and missing 2/3 be pretty expected, especially since a lot of the cases were early on? Count backwards from the estimated IFR of e.g. 0.2..1.0% and you get a number of million infections from the ~400k dead. You need to go pretty low in that IFR to get to 1/3 of the population though.
[+] [-] JPKab|5 years ago|reply
Based on quantity of people with antibodies in NYC, Italy, etc who never knew they had it other than symptoms they thought were a cold, there's nothing surprising about a number of 70 million.
[+] [-] rindalir|5 years ago|reply
[+] [-] Balgair|5 years ago|reply