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http://www.publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm?prid=2328

USC-LA County Study: Early Results of Antibody Testing Suggest Number of COVID-19 Infections Far Exceeds Number of Confirmed Cases in Los Angeles County

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Los Angeles (April 20, 2020) - USC and the Los Angeles County Department of Public Health (Public Health) today released preliminary results from a collaborative scientific study that suggests infections from the new coronavirus are far more widespread - and the fatality rate much lower - in L.A. County than previously thought.

The results are from the first round of an ongoing study by USC researchers and Public Health officials. They will be conducting antibody testing over time on a series of representative samples of adults to determine the scope and spread of the pandemic across the county.

Based on results of the first round of testing, the research team estimates that approximately 4.1% of the county's adult population has antibody to the virus. Adjusting this estimate for statistical margin of error implies about 2.8% to 5.6% of the county's adult population has antibody to the virus- which translates to approximately 221,000 to 442,000 adults in the county who have had the infection. That estimate is 28 to 55 times higher than the 7,994 confirmed cases of COVID-19 reported to the county by the time of the study in early April. The number of COVID-related deaths in the county has now surpassed 600.

"We haven't known the true extent of COVID-19 infections in our community because we have only tested people with symptoms, and the availability of tests has been limited," said lead investigator Neeraj Sood, a USC professor of public policy at USC Price School for Public Policy and senior fellow at USC Schaeffer Center for Health Policy and Economics. "The estimates also suggest that we might have to recalibrate disease prediction models and rethink public health strategies."

The results have important implications for public health efforts to control the local epidemic.

"These results indicate that many persons may have been unknowingly infected and at risk of transmitting the virus to others," said Dr. Barbara Ferrer, director of the L.A. County Department of Public Health. "These findings underscore the importance of expanded polymerase chain reaction (PCR) testing to diagnose those with infection so they can be isolated and quarantined, while also maintaining the broad social distancing interventions."

The antibody test is helpful for identifying past infection, but a PCR test is required to diagnose current infection.

"Though the results indicate a lower risk of death among those with infection than was previously thought, the number of COVID-related deaths each day continues to mount, highlighting the need for continued vigorous prevention and control efforts," said Dr. Paul Simon, chief science officer at L.A. County Department of Public Health and co-lead on the study.

The study's results have not yet been peer reviewed by other scientists. The researchers plan to test new groups of participants every few weeks in coming months to gauge the pandemic's trajectory in the region.

About the study With help from medical students from the Keck School of Medicine of USC, USC researchers and Public Health officials conducted drive-through antibody testing April 10th and 11th at six sites. Participants were recruited via a proprietary database that is representative of the county population. The database is maintained by LRW Group, a market research firm.

The researchers used a rapid antibody test for the study. The FDA allows such tests for public health surveillance to gain greater clarity on actual infection rates. The test's accuracy was further assessed at a lab at Stanford University, using blood samples that were positive and negative for COVID-19.

In addition to Sood and Simon, other authors and institutions contributing to the study include Peggy Ebner of the Keck School; Daniel Eichner of the Sports Medicine Research & Testing Laboratory; Jeffrey Reynolds of LRW Group; Eran Bendavid and Jay Bhattacharya of Stanford University School of Medicine.

The study was supported with funding from USC Schwarzenegger Institute, USC Lusk Center, USC President's Office, Jedel Foundation, LRW Group, Soap Box Sample, and several individual donors.

 

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50 minutes ago, dcar00 said:

Oh I agree they did the work.  I didn't misunderstand anything.  The 2.2M number was bullshit based on using default values, getting an R0 of 2.4(adjusted for what they felt was a problem with natural historical parameters, again an estimate based on other estimates) and 81% of gen pop infected(really?) and an approx .9x% IFR.  I believe the China number was .66% in the report you referenced.  why didn't they use that?

The report had no basis in reality and was bunk from the get go.

(1) You literally just said the opposite?

(2) IFR for different countries would vary based on demographics (in particular, age distributions). It isn't a one size fit all number. The report covers further modification they did: "The age-stratified proportion of infections that require hospitalisation and the infection fatality ratio (IFR) were obtained from an analysis of a subset of cases from China12 . These estimates were corrected for non-uniform attack rates by age and when applied to the GB population result in an IFR of 0.9% with 4.4% of infections hospitalised" 

Their original work assumed "that the attack rate is uniform across age-groups (i.e. all ages are equally susceptible)." Basically, to simplify things, they assumed that all ages would be equally likely to be exposed. For their US/UK work they went a step further (although I can't find the details on the precise changes) and adjusted for age-based exposure chances. I believe basically they concluded that older people were less likely to be exposed in China, but died at a higher rate once exposed. Therefore, their original IFR estimates, which were based on reported confirmed cases and deaths in China, over-estimated the amount of total cases (including unconfirmed cases) in older populations. I may be misunderstanding though as it isn't laid out in detail.   

At any rate, those corrections were only a minor portion of the overall IFR change. Most of it just came due to the different age-distributions in the US and UK compared to China.  Although all the variables aren't spelled out in the report, I pulled US demographic age ranges and applied the adjusted and original IFRs, and weighted them to give an overall IFR number. It changes, but only by .14%. So, you can see the primary source of variation from .66% China number the ~1% UK number was the different age distributions and not the slight revision to the IFR number for each age bracket. 

Age Population AdjustIFR       China IFR      Weighted IFR   Weighted China IFR
<5 19,810,000 0.002% 0.002% 0.000122% 0.000098%
5-9 19,200,000 0.002% 0.002% 0.000118% 0.000095%
10-14 20,880,000 0.006% 0.007% 0.000386% 0.000450%
15-19 21,090,000 0.006% 0.007% 0.000390% 0.000455%
20-24 21,850,000 0.030% 0.031% 0.002020% 0.002087%
25-29 23,560,000 0.030% 0.031% 0.002178% 0.002250%
30-34 22,130,000 0.080% 0.084% 0.005455% 0.005728%
35-39 21,560,000 0.080% 0.084% 0.005315% 0.005580%
40-44 19,720,000 0.150% 0.160% 0.009114% 0.009722%
45-49 20,740,000 0.150% 0.160% 0.009586% 0.010225%
50-54 20,890,000 0.600% 0.600% 0.038621% 0.038621%
55-59 21,940,000 0.600% 0.600% 0.040562% 0.040562%
60-64 20,330,000 2.200% 1.900% 0.137814% 0.119021%
65-69 17,080,000 2.200% 1.900% 0.115782% 0.099994%
70-74 13,400,000 5.100% 4.300% 0.210575% 0.177544%
75-79 7,680,000 5.100% 4.300% 0.120688% 0.101756%
80 and above 12,680,000 9.300% 7.800% 0.363357% 0.304751%
           
Totals 324,540,000     1.062083% 0.918939%

 

Edited by Dahobbs
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18 minutes ago, Dahobbs said:

(1) You literally just said the opposite?

(2) IFR for different countries would very based on demographics (in particular, age distributions). It isn't a one size fit all number. The report covers further modification they did: "The age-stratified proportion of infections that require hospitalisation and the infection fatality ratio (IFR) were obtained from an analysis of a subset of cases from China12 . These estimates were corrected for non-uniform attack rates by age and when applied to the GB population result in an IFR of 0.9% with 4.4% of infections hospitalised" 

Their original work assumed "that the attack rate is uniform across age-groups (i.e. all ages are equally susceptible)." Basically, to simplify things, they assumed that all ages would be equally likely to be exposed. For their US/UK work they went a step further (although I can't find the details on the precise changes) and adjusted for age-based exposure chances. I believe basically they concluded that older people were less likely to be exposed in China, but died at a higher rate once exposed. Therefore, their original IFR estimates, which were based on reported confirmed cases and deaths in China, over-estimated the amount of total cases (including unconfirmed cases) in older populations. I may be misunderstanding though as it isn't laid out in detail.   

At any rate, those corrections were only a minor portion of the overall IFR change. Most of it just came due to the different age-distributions in the US and UK compared to China.  Although all the variables aren't spelled out in the report, I pulled US demographic age ranges and applied the adjusted and original IFRs, and weighted them to give an overall IFR number. It changes, but only by .14%. So, you can see the primary source of variation from .66% China number the ~1% UK number was the different age distributions and not the slight revision to the IFR number for each age bracket. 

Age Population AdjustIFR       China IFR      Weighted IFR   Weighted China IFR
<5 19,810,000 0.002% 0.002% 0.000122% 0.000098%
5-9 19,200,000 0.002% 0.002% 0.000118% 0.000095%
10-14 20,880,000 0.006% 0.007% 0.000386% 0.000450%
15-19 21,090,000 0.006% 0.007% 0.000390% 0.000455%
20-24 21,850,000 0.030% 0.031% 0.002020% 0.002087%
25-29 23,560,000 0.030% 0.031% 0.002178% 0.002250%
30-34 22,130,000 0.080% 0.084% 0.005455% 0.005728%
35-39 21,560,000 0.080% 0.084% 0.005315% 0.005580%
40-44 19,720,000 0.150% 0.160% 0.009114% 0.009722%
45-49 20,740,000 0.150% 0.160% 0.009586% 0.010225%
50-54 20,890,000 0.600% 0.600% 0.038621% 0.038621%
55-59 21,940,000 0.600% 0.600% 0.040562% 0.040562%
60-64 20,330,000 2.200% 1.900% 0.137814% 0.119021%
65-69 17,080,000 2.200% 1.900% 0.115782% 0.099994%
70-74 13,400,000 5.100% 4.300% 0.210575% 0.177544%
75-79 7,680,000 5.100% 4.300% 0.120688% 0.101756%
80 and above 12,680,000 9.300% 7.800% 0.363357% 0.304751%
           
Totals 324,540,000     1.062083% 0.918939%

 

they did the work to put out a report/paper.  I'm highly skeptical of the way they get to 2.2M and 500K and I believe I see some reasons in their analysis.   they lead with it in the paper.  media reports it in headlines(not Imperial Colleges issue) and some articles explain how they get to the 2.2M but some don't(again not Imp College's issue)

you aren't skeptical and that's fair.

Edited by dcar00
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5 minutes ago, South Austin said:

On a side note, I'm really getting close to putting the 1/8" setting on my clippers and shearing my entire head.  I don't see a proper haircut anytime in my near future.

I'm doing the opposite.  I'm embracing my 1970s shagginess.  Figure I'll have a full Barbarino in another month or so....

YDfsP-1455125060-1736-list_items-john_tr

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On a side note, I'm really getting close to putting the 1/8" setting on my clippers and shearing my entire head.  I don't see a proper haircut anytime in my near future.


I buzzed my 10 year old this weekend. He looks like a lightbulb. He loves it.
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Just now, Brisketexan said:

I'm doing the opposite.  I'm embracing my 1970s shagginess.  Figure I'll have a full Barbarino in another month or so....

YDfsP-1455125060-1736-list_items-john_tr

Same. Letting it go wild. Hat usage has also increased exponentially. 

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1 hour ago, bullzak said:

All the reopening talk begs the question of how flat the curve has to be to reopen. I am sure the medical experts would say no new cases but I dont think that is realistic when you have a potential depression on your hands. 

The fact that Texas and Florida seem to have so few problems suggest that maybe warm weather is going to be a factor. 

I think we are going to be pretty much opened up in the next 60 days all over the country no matter what. 

We are going to reopen with some degree of risk. How much is the question. 

 

 

The virus has a lipid shell, it won't start deactivating until 135F.

Weather was beautiful, if not rainy all last month.  So I take it that TX & GA demonstrated success by shutting down.

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54 minutes ago, Buzzrock said:

Well, this will be interesting. This will fall somewhere in between a perfect decision and disaster for Georgia. We will see where.

Fuck, I hope the 'heat/humidity is a huge help' line of thinking is true and you guys have very few issues.  I'll take any hope for being able to live our fucking lives again.  

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As I am a non-medical person, and I can’t remember seeing this discussed anywhere, is there any correlation between exposure time and illness and severity and such? E.g. passing an infected person in a store aisle vs. sitting at an adjacent table in a restaurant vs. next to them at church or a ballgame or flying? 

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6 minutes ago, MNLonghornFUKM said:

Georgia’s an interesting state to see how it goes. Large metro... was hit early but recovere..I’d assume herd immunity is probably large. They probably want to know if patrons can come to the masters

Fulton county was hit pretty good.  A couple of hotter spots in the Southwest part of the state 

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7 hours ago, Foosters said:

Yeah, I just drove to work after my 14 day quarantine ended. The freeways are, again, totally empty.  Maybe Iceman has seen some statistics that back up his argument, but my experience is that there are far fewer people out and about every day.

In Austin:

I-35 about 60-70% normal depending on direction, notably less rush hour traffic.

mopac and 360 are down considerably. 

620 isn't skipping a beat, busy as summer with school out. 

City obviously using this time to do some major road projects on 2222 and SW parkway

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1 hour ago, Brisketexan said:

I'm doing the opposite.  I'm embracing my 1970s shagginess.  Figure I'll have a full Barbarino in another month or so....

YDfsP-1455125060-1736-list_items-john_tr

Yep, I am not cutting it. Am letting my daughter dye it with orange streaks since, well why the fuck not. She won't get another chance! 

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6 hours ago, aggie08 said:

Yeah, but still...

 

I saw two members of the same family grocery shopping together. TWO!!  Shelter in place my ass!  If that's still happening near me, just imagine what it's like everywhere else...

Let's be fair, aggy needs a tard guard when they go in public.  Exceptions must be made for the greater good.

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That makes 3 in the US I think, and they add up to at least 15% of our production.

JBS SA, the world’s top meat company, will shutter its pork processing facility in Minnesota following an outbreak of coronavirus, adding to concerns that slaughterhouse logjams will tighten meat supplies for consumers.
The Worthington, Minnesota, facility will wind down operations over two days to ensure existing product in the facility can be used to support food supply, JBS said Monday. The move comes after seven workers tested positive for the virus and officials from the Minnesota Department of Health said Friday the number will likely rise. No date was given for a reopening. The closure means more that a 10% of U.S. hog slaughtering capacity is down.

https://www.bloomberg.com/news/articles/2020-04-20/jbs-shuts-down-minnesota-pork-plant-as-virus-roils-meatpackers

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28 minutes ago, InkaUtexas said:

Yep, I am not cutting it. Am letting my daughter dye it with orange streaks since, well why the fuck not. She won't get another chance! 

My hair is pretty long now so I decided to use the clippers and give myself an undercut while leaving the top long. I've been channeling Arthur Shelby "By order of the Peaky Blinders" for the past couple of days.

 

 

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7 minutes ago, F250 said:

My hair is pretty long now so I decided to use the clippers and give myself an undercut while leaving the top long. I've been channeling Arthur Shelby "By order of the Peaky Blinders" for the past couple of days.

I did the same.  I look like a retard because I have a natural curl, but my youngest son's is dark and straight.  He looks like Jean-Baptiste Zorg.

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1 hour ago, Treefidy said:

In Austin:

I-35 about 60-70% normal depending on direction, notably less rush hour traffic.

mopac and 360 are down considerably. 

620 isn't skipping a beat, busy as summer with school out. 

City obviously using this time to do some major road projects on 2222 and SW parkway

You really think the city organized or reorganized to increase major roadwork during this time once they realized traffic would be lower? That's a serious question. I have no idea, but it seems like a lot to put all that together. Maybe it's not, I dunno. It'd be great if they could to keep those people working. 

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