MODERATOR NOTE: Let’s please maintain respect and stay on topic. Several,posts deleted.
“Between March 1 and May 9, the nation recorded an estimated 101,600 excess deaths, or deaths beyond the number that would normally be expected for that time of year, according to an analysis conducted for The Washington Post by a research team led by the Yale School of Public Health.”
“It’s clear that the burden is quite a bit higher than reported totals,” said Daniel Weinberger, the Yale professor of epidemiology who led the analysis.
17k per mile in SF vs an average of 40k mile in greater NYC is not even close to comparable.
https://en.m.wikipedia.org/wiki/List_of_United_States_cities_by_population_density
This also doesn’t take into consideration that the virus was likely in the USA in December (according to what I have heard) and that there are many deaths that happened from them to March which were listed as ‘pneumonia’ and not Covid. I think the important number to see is % of those who get noticeably sick who get hospitalized and % who die and also % of those who get hospitalized who die. all three of these things are shockingly high in my opinion.
Thank you for your calm, intelligent posts calling things like you see them. I really appreciate them. I can say there are a percent I’m not sure I understand in what you post. I should listen to more of TWIV, I guess! I listened to some and it is very good and think you are very right that most of us here should listen to that and actually learn what we are talking about. Easy to have opinions when one is pretty uneducated on a topic.
I remember there was a young man in Brooklyn who came back from Japan and had classic Covid symptoms. He could not get tested because at the time, despite having a lot of Covid in Japan, that was not a country of concern on the CDC list. CDC rules prevented him from being tested. He tried and tried to get tested. The CDC then added Japan to the list but he couldn’t get tested even then because he wasn’t hospitalized. I think also of California where they knew they had Covid but were being prevented from testing by the CDC. Finally they broke the rules and tested anyway and found it was there. Had they not broken the rules how much worse would things have gotten before the idiotic rules preventing testing would have changed and how much more silent spread would have happened, uncounted deaths, etc.
I don’t know that I would call people illiterate, but on this particular topic, yes, I think there are opinions that count as pretty close to illiterate if they come from partisan news sources with a partisan political goal and predetermined ‘facts’ rather than a search through sources written by experts or informed by experts. There are so many beliefs that would be seen immediately as false by experts being touted as possible or even as true that is scares me for the future of the country. If we turn from science and math, the future is very dim. We are done with being world-leaders in innovation if we do that. We are being left in the dust if we do that (I think we have been left in the dust). I don’t want that for America. I want us to have innovation, a great future, not to be backward, science doubting. I am not trying to be insulting to anyone. History shows turning from science doesn’t turn out well. There are many great examples. Turning from science during a pandemic is irresponsible and will result in many more deaths and a more horribly hit economy.
Plus the stories like this don’t seem to get as much press. People cleaning up Minneapolis. Lots of masks there.
@OneMoreToGo’s calculations on the seroprevalence and the infection fatality rate in Florida counties are perfectly correct. I would have multiplied the numbers in a different order, but the calculations compute the number correctly, assuming you believe the data is right.
There’s some question as to the accuracy of the tests used. Some antibody tests report too many positives, which will make the seroprevalence appear too high and the infection fatality rate appear too low.
Sure, but during that same time "millions of people [were coming] into [SF, LA and Seattle (especially from China, including Wuhan)] and brought the virus. And there was NO testing… "
Exactly. Arguably, CA has the first known case of COVID.
IMO, density (and local response) is the elephant in the room.
Does anybody still remember that San Francisco declared its state of emergency before its first confirmed case?
Regarding wiping down surfaces, I hope we don’t throw the baby out with the bathwater on that one. I have followed that more because I’m immune deficient. We are still being told to be very careful with things we bring into our homes. Letting things sit in a decontamination pile and/or washing/wiping down what we can is still recommended (but not contaminating food with dangerous chemicals in the process).
When I read the updated recommendations for the general population, I’m not seeing them say you can’t get Covid from surfaces. In fact, I’m seeing that you can from things like doorknobs and other ‘high touch surfaces’. But now the focus has shifted more to ‘wash your hands a lot’ rather than ‘be careful what you touch.’ I would rather feel things in my home likely don’t have the virus so I can relax and not worry if I touch my face in my own house or if I have washed my hands every 20 minutes or whatever by ensuring things that come into my home likely are clean from the virus.
I read that it is unlikely but not impossible that a person could get Covid from the mail, from packages, from boxes of cereal. I think it is very possible that if another non-masked shopped sneezes on a box of cereal and then I come get that box and I then touch my nose, I could get sick. I think it isn’t a bad thing to just be careful as long as it isn’t impacting one’s mental health. I do think that concerns about people developing OCD or having OCD becoming debilitating are important to keep in mind and balance. I have a friend who is on disability from OCD and know it is a horrible thing.
However, I think people are hearing a message that isn’t there if they think there isn’t any risk from surfaces. There certainly is, especially high touch ones that could be sneezed on.
I can also say since getting diagnosed as immune deficient, I have been extremely careful about touching my face. I’m aware of when my hands have touched something that could have germs on it and I don’t touch my face or things I will eat or anything without washing my hands. This cut down on how much I get sick by an enormous amount. So, from just a one person case study, I believe surfaces are a transmitter of much illness even in the case where illnesses are also airborne like this one.
I also think the stubborn focus on 6 feet is concerning when there are studies showing this thing travels more than 6 feet pretty easily, esp in enclosed spaces, where it can hang in the air. The whole idea of if you are in and out of a place fast you won’t get a big viral load seems to ignore this in my opinion. I believe in the idea of the viral load and think that being fast in and out of a store is a good thing, but I dont’ think that makes it impossible to get sick in any indoor space. If one is unlucky, one will take in a breath that contains a big viral load from someone who just couched or sneezed or stood talking for a long while in that area. I think masks are very important for this reason.
I’m curious what you feel San Francisco did right that NY did wrong. I think that some of what happened certainly was caused by not acting sooner in NY. I think also that some of what happened that went well in SF was that they were lucky and also that they don’t have as much use of mass transit as NYC does. I don’t think the two are comparable for that reason.
I wonder what you are seeing in this regard.
At least some of these deaths can be attributed to the response to COVID, rather than to the disease itself.
In any event I would be inclined to accept the numbers, as they are in accordance with the estimates of a number of prominent scientists (including Micheal Levitt at Stanford): approximately a 15% burden of excess death for a relatively short period of time (estimated at 4-6 weeks). Lesser excess burden for a few weeks before and a few after. This is consistent with numbers in Europe as well.
Sure, all death is regrettable, but we have not repealed the laws of nature. This is relatively mild in the history of viral pandemics over the past, say, 2000 generations.
The New York area was seeded by a lot of infected travelers returning from Italy and France at the same time. Then New York had at least one superspreading event, that lawyer in New Rochelle.
The San Francisco Bay Area was seeded early by a few travelers from China, but it looks like the infection chains mostly died out.
The state of Washington got unlucky early. There were infected travelers from China, and one infection chain got into an elder facility and exploded.
The more initial infections, the more likely that one of them explodes with a superspreader. The New York metro area evidently had a lot of initial infections at the same time, because it’s populous and has a lot of business links to Europe, and there were no bans on European travelers and no monitoring at airports. New York couldn’t do testing surveillance because there were no tests, and airport monitoring is a federal matter, not a state matter.
New York made mistakes, but a lot of the initial epidemic was beyond their control.
There is no question that serology testing is imperfect, and generalizations from samples will exhibit both Type I and Type II statistical errors.
Nevertheless, these are the best data we have so far.
Rather than focus on the technical aspects of the test, the real issue with all these tests is sample bias.
Are people who felt sick at some point in the past more likely to get tested (the Florida program is voluntary)?
Do tests show a systematic skew by cognitive ability (are more intelligent people more or less likely to be tested, and is disease acquisition statistically correlated with intelligence)? SES skew? Race and/or culture skew?
Are younger people less likely to be tested, especially if asymptomatic? Children? The very elderly who feel fine (no doubt many 80+ year olds are also aymptomatic)?
The list of potential biases is enormous, and statistics seeks to minimize or at least test for them, but when you are talking of sample sizes this small relative to population, regrettably the only answer is that we need more data.
The German Gangelt study sought to avoid much of this by testing 90% of the population. At that level of testing, sample bias is practically nonexistent. The virologists calculated an IFR of 0.24-0.26%, exactly in accordance with the preliminary estimate from our CDC.
Last, it should be noted that IFR embeds an exogenous variable: the quality of health care received. On this front, it is not difficult for me to imagine that the standard of care in many NYC hospitals was lower than that of Florida or California hospitals, if for no other reason that clearly the system was stressed in NYC and not elsewhere.
Different standards of care are also likely reflected in the apparent differences in observed fatality rates in Germany versus Italy and Spain.
@“Cardinal Fang” I wonder what you think are the main causes of what makes the virus spread more in one place than another. I’d love to read your thoughts on this.
Thanks!
Thank you for posting this. And I see that is only staring March 1. I wonder if we look back to December what we would find as we know the virus was in the country much earlier than previously thought and that deaths from it were listed as pneumonia as we were not testing at the time. (Source = Robert Redfield, Director CDC in his testimony before Congress in March).
The first things that the First Amendment refer to that Congress shall make no law on involve religion.
“Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.”
https://www.archives.gov/founding-docs/bill-of-rights-transcript
Not all parts of NY area are densely populated. Essex county, NJ, has a density of 6k per sq mile and over 1600 deaths, five times as many as SF.
The state of Indiana did random sampling using state records, and got an IFR of 0.58%.
The German Gangelt study produced an IFR with a point estimate of 0.36%. @OneMoreToGo2021, your claimed “0.24-0.26%” wasn’t even in their confidence interval of [0.29%; 0.45%].
https://www.medrxiv.org/content/10.1101/2020.05.04.20090076v1
I too believe that in many NYC hospitals, and some in New Jersey as well, the standard of care was worse than in SF hospitals, because the New York hospitals were overwhelmed. Indeed, a doctor at UCSF Hospital, who went to Queens Presbyterian to help out, described a situation in Queens where staffing on his covid ward, because of the exigent circumstances, was smaller and less qualified than the staffing at his home hospital.
I think a lot who live there work in NYC so still don’t think this is an equivalent situation. These people might have been much more likely to be on crowded public transportation.