40 minutes ago, Alan_A said:

Lots of unanswered questions, but it seems the projections aren't fully baked.

Interesting, I suspect this model might have no mitigation parameters in place if it turns out to be credible. I would hope that officials would take some kind of action before it ever reached 200,000 cases a day. However it does serve to remind folks how fast these things can get out of control.

Thanks for the post.

Martin

10 minutes ago, MartinRex007 said:

Thanks for the post.

Trying to stick to good journalistic practice - update the coverage and issue corrections and new/better information becomes available.

Least we can do... 😎

13 minutes ago, MartinRex007 said:

Interesting, I suspect this model might have no mitigation parameters in place if it turns out to be credible.

I guess that would put it in the same category as the high end of the Imperial College model - projecting the "do nothing" scenario as the extreme end of the range.

 

3 hours ago, KevinAu said:

Well then, the government better get their act together so that there are enough tests and masks. The people better get their act together and stop refusing to mask up or stay home when directed. We are indeed running out of time.

If you really cared for the economy, you should have been arguing for a hard close of everything for 3 weeks, everywhere, all at once, back in march, strictly enforced. Then we would have had all of this shutdown nonsense behind us weeks ago. If you want to reopen the economy, you should be arguing that everybody has to wear masks.

All I see are people wanting things both ways. They want to reopen the economy and they don’t want to wear masks or wait for the testing to be adequate. If you do this without the masks and without the testing, we will be right back where we started and that will destroy the economy even more.

If you really cared you'd see it my way.  Nope, sorry, it's not, as Alan pointed out above, a binary choice...your way or certain doom.

All I see are people weighing the risks vs the costs and trying to find a way through that poses the least reasonable risk.

FWIW, I went out today to do the registration on one of my vehicles (at an automated kiosk), and I'd say that 90% of the people I saw out in the shopping center were masked-up...including yours truly.  As far as testing...once again, can't test people any faster than you can make the tests.  I know you subscribe to the "where's a will there's a way" philosophy, but there are real constraints that prevent our just doing a left-hand extraction and ponying-up half a billion test kits made out of good wishes and fairy dust.  To me, that means for a while we will have to navigate through a period of increased risk before the testing ramps up to the levels we want, not that the sky will fall if we choose a compromise course of action.

2 hours ago, n4gix said:

Here in Indiana the majority of deaths fall to the age range of 40-59 totaling 47.5%.

80+ only accounts for 10.4% of total cases...

More disturbing is my county's mortality rate of 4.67%. The state's mortality rate is 5.68%.

Since I am wholly dependent on the VA for my health care, having to risk VA hospitalization should I contract Covid-19 frankly is terrifying...

...considering the reported state of outcomes in various VA facilities!

I'm seeing a lot different numbers on the in.gov site...that site shows 47.4% of the deaths in the 80+ yo cohort, and 36.5% of all the deaths statewide occurring among residents of long-term care facilities.  Also, the CFR (case fatality rate) is the percentage of confirmed cases that result in death.  Given that there is understood to be a large incidence of asymptomatic or mild cases that never result in a doctor/hospital visit and/or testing, the actual fatality rate is expected to be much lower.  Now, that said, the CFR for the 70-79 yo cohort is still a whopping 16.6%, so I wouldn't suggest that you take up employment as a Walmart greeter or school bus driver any time soon.  OTOH, in the 20-49 yo cohort, the case fatality rate is 0.3%.  And I'm sure that 0.3% group is overwhelmingly populated with people with severe co-morbidities.  A healthy 30-something faces a much lower level of risk when trying to balance cost-vs-risk when deciding what activities he/she can/should engage in.

 

2 hours ago, w6kd said:

There are plenty of examples in nature of animals that maim or kill their own for dominance in their group, to defend against others encroaching on their territory, to take food from others etc.

Which is exactly why I put "generally" in there, since there are always exceptions.

2 hours ago, w6kd said:

When I refer to base animal instinct, I'm not referring to people pushing each other over a package of TP in the grocery store...no, think a group of armed men kicking down your door and taking what they need to feed themselves or their families.

It's kind of the same thing for me. From my perspective, It seems clear that some believe that for their own (in this case financial) survival, others should either be sacrificed, or should be willing to sacrifice themselves.

We already know who those others are likely to be however. We know which categories/communities are the most affected, and we know that those with the least insurance and other protections are likely to bear a disproportionate amount of the negative impact from reopening too early.

It's another of those 800 pound gorillas in the room that many avoid looking squarely in the face. It's not as overt as armed gunmen kicking in the door, but it might be just as deadly to the intended sacrifices.

3 hours ago, w6kd said:

If personal safety has become the only driver of modern human behavior, then we're doomed anyway.

I don't think worrying about personal safety is even slightly any less honorable than worrying about financial safety.

3 hours ago, w6kd said:

The day is fast approaching that government is not going to be able to pay a third or more of the population to stay home, and at that point those people will be forced to make some uncomfortable choices.

Probably true. I would just note that America is not exactly a stranger to such spending during wartime, (which the president says this is) having already spent almost 8 trillion around the world since 2001 with surprisingly little fanfare. I suspect that if we as a culture had responded more coherently to this crisis, instead of devolving almost immediately into wrangling at cross-purposes with ourselves, we might already have traversed far enough along the curve that many of these concerns would loom far less threateningly.

3 hours ago, w6kd said:

It seems that some of the folks here think that economics don't matter...that economic collapse doesn't have a price in lives.  I think we're going to see that idea refuted in real terms in six months or so when large parts of northeastern Africa are in the grips of an epic famine due to drought and locust pestilence, and with the rest of the world's nations struggling to take care of their own, the help needed to keep millions from starving there will not be coming. 

Speaking for myself, I think that economies matter very much. But on a ship in trouble on the high seas, my personal choice is to toss the chests of gold overboard before looking in grandmas direction. Now, maybe I need that chest of gold to pay for grandmas healthcare once we reach land, but.....

• I don't think we have even remotely reached that crossroads yet, except as a talking point
• I would just have to cross that bridge when I came to it. In the meanwhile, for me, its people first.

4 hours ago, w6kd said:

I think we're going to see that idea refuted in real terms in six months or so when large parts of northeastern Africa are in the grips of an epic famine due to drought and locust pestilence, and with the rest of the world's nations struggling to take care of their own, the help needed to keep millions from starving there will not be coming. 

Its would be interesting indeed if we were (already) after just a few months prepared to sacrifice some of our own citizens in a quite calculated fashion to corona, while simultaneously being concerned about famine in Africa.

But even if that was the case, we've already been slashing aid worldwide to the point that other countries further along in their recovery will likely be more than capable of taking up our slack. Especially China, which has been aggressively expanding its interests there even as we have lessened ours.

Like a lot of this, I guess we'll have to see.

1 hour ago, Alan_A said:

More on that projection of 200,000 cases per day - it was developed by an epidemiologist at Johns Hopkins to model a variety of reopening scenarios.  The modeling wasn't finished, and he doesn't know how it got turned into a presentation deck.

This is from a Washington Post story that just went up - might be behind a paywall, so here's an excerpt:

 

Further comments make it sound as though the variability is based on a range of re-opening scenarios. The article goes on to discuss other models.

Lots of unanswered questions, but it seems the projections aren't fully baked.

A lesson here (note to self) on the dangers of going with a single report.

The local model here (British Columbia) shows a variety of scenarios, depending on the speed of returning to our "normal social / economic interaction".. Indeed the model also shows that if we were to return to 100% of previous behavior, the numbers would spiral out of control within a month..  So that seems entirely consistent with this reporting.

51 minutes ago, w6kd said:

A healthy 30-something faces a much lower level of risk when trying to balance cost-vs-risk when deciding what activities he/she can/should engage in.

Agreed, with the caveat that there are more possible outcomes than just death or recovery.  Recovery covers a wide spectrum, from "mild flu" to "could barely crawl from the bed to the door to get the food tray" to "has to learn to walk again, and life will never be the same." I know several people who've been infected (probably - symptoms are there but none were tested) and while thankfully no one got as sick as the most extreme cases, they still covered a pretty wide range.  As with the economic recovery scenarios, there are many different ways the non-fatal version of the illness can play out.

20 minutes ago, Bert Pieke said:

Indeed the model also shows that if we were to return to 100% of previous behavior, the numbers would spiral out of control within a month

It looks like there are several teams trying to model different outcomes based on behavior, levels of contact, restrictions, etc.  The CDC presentation seems to be one more of them... or at least, we know that now...

And... in what seems to be the theme of the day... here's another sharp upward revision.  IHME has just released a major update to its model, effectively doubling the projected number of US deaths to 134,475 by August 4. The estimated range is from 95,092 to 242,890 deaths by the end of August.

Here are the updated projections.

And here - in contrast to the CDC presentation we were talking about before - is an extensive explanation of what's changed in their model. Both the data and the modeling system itself have changed to account for more data from more sources, improved reporting, and a wider range of factors including temperature, population density and mobility.  The earlier model focused on social distancing policies and transmission rates.  The new model incorporates those additional variables and includes state-level projections. 

Their rationale:

Quote

 

We, collectively, are now entering a new phase of the COVID-19 pandemic. More locations are easing previously implemented social distancing policies, and human mobility patterns are trending upward – even in places where distancing measures remain in place. Testing has scaled up in many parts of the world, but such progress has been uneven and is not keeping pace with the growing demand for lifting business and gathering restrictions. Carefully tracking what is happening today as locations move to “re-open” will provide vital information for potential COVID-19 trajectories in the coming weeks and months.

Today we launch a major update to our COVID-19 estimation framework: a multi-stage hybrid model. This modeling approach involves estimating COVID-19 deaths and infections, as well as viral transmission, in multiple stages. It leverages a hybrid modeling approach through its statistical component (deaths model), a new component quantifying the rates at which individuals move from being susceptible to exposed, then infected, and then recovered (known as SEIR), and the existing microsimulation component that estimates hospitalizations. We have built this modeling platform to allow for regular data updates and to be flexible enough to incorporate new types of covariates as they become available. Last, by relating transmission parameters to predictions of key drivers of COVID-19 epidemic trends – temperature, the percentage of populations living in dense areas, testing per capita, and human mobility – this new modeling approach will allow for a more comprehensive examination of how COVID-19’s toll could unfold in the coming months, taking into account these underlying drivers. This is particularly important as many locations ease or end prior distancing policies without having a clear sense of how these actions could potentially affect COVID-19 trajectories given current trends in testing and mobility, among others. With our new modeling framework, we aim to provide a venue through which different COVID-19 epidemic scenarios and responses can be explored by location.

 

It's a long read but worth your time to understand why the estimates have changed so dramatically.

As so often with these things, I wish the news was better.

 

6 hours ago, birdguy said:

101 pages into this we have all hardened our stances and no minds have been changed.  It's pointless to continue.  I'm going into the lurking mode to see how long the redundancy will continue.

Noel

If you have any friends in Gallup I suggest you talk to them. You may get a new perspective..........Doug

12 minutes ago, W2DR said:

If you have any friends in Gallup I suggest you talk to them. You may get a new perspective..........Doug

Gallup's outbreak is very atypical...it's due to unchecked spread in the nearby Navajo reservation.  The poverty, poor sanitation, unhealthy living, and lack of adherence to mitigation measures on the reservation is something akin to what you'd find in a third-world country like Bangladesh.  The governor had to put up a firewall by closing the roads in and out of town (the PC way of saying to/from the Rez).

The thing about testing is this...just because you test negative today take no comfort. You may well test positive tomorrow, or the day after. The most important thing about a single test is to determine whether, or not, you are asymptomatic and, if so therefore, capable of infecting others.

2 minutes ago, w6kd said:

Gallup's outbreak is very atypical...it's due to unchecked spread in the Navajo reservation next door.  The poverty, unhealthy living, and lack of adherence to mitigation measures on the reservation is something akin to what you'd find in a third-world country like Bangladesh.  The governor had to put up a firewall by closing the roads in and out of town (the PC way of saying to/from the Rez).

South Atlanta is atypical also.But once it's there it's unlikely to be 100% contained. I don't think the fact that the roads are closed gives much comfort to the people in Gallup.

2 minutes ago, W2DR said:

South Atlanta is atypical also.But once it's there it's unlikely to be 100% contained. I don't think the fact that the roads are closed gives much comfort to the people in Gallup.

Well, it will give the locals some room to breathe, as it should mitigate the spread being caused by people migrating back and forth from a nearby uncontrolled hotspot. 

It's like being in rural eastern NJ...the proximity of the teeming masses still packing themselves like cattle into public transportation every day in the NYC hot zone is going to make the risk in your rural population much much higher than a similarly sparsely populated county in western Kansas or northeastern NM.

Since I promised to keep track of Sweden, here's a critical but nuanced take.

This part might be of broader interest:

 

Quote

 

But what about the economy? The choice is not between indefinite shutdown and Russian roulette. A transition needs to occur that balances the risks at play. From that perspective, Sweden is the future. But not because of a herd immunity strategy. Because a more targeted approach to social distancing can be deployed when the timing calls for it, when old-fashioned public health methods can foster a gradual easing of restrictions in a way that can be tweaked as we learn more and develop new tools — treatments, understanding of immunity, testing improvements, and epidemiological data.

The key will be for countries not to let their guard down too soon. They must roll out a testing and contact-tracing infrastructure that will allow them to identify outbreaks early and isolate and quarantine as necessary. In the United States, this is a realistic goal if there’s enough political willpower, fiscal firepower, and coordination. These things — not Sweden’s experience — should guide our next steps.