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Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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10 minutes ago, Skipper said:

A little off topic, and I'm not saying this is a bad thing, but exactly how can state govts (i.e., California) unilaterally mandate that insurance not charge for coronavirus testing.  Is California basically telling the insurance company they are eating the costs?  How does that work?

If you offer healthcare in the great state of CA this coverage is mandatory...   ezpz

just like

If you sell cars in the great state of CA these pollution measures are mandatory

 

 

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5 minutes ago, Liquor and Poker said:

I don’t think anyone honest can really say the number of confirmed cases is relevant to much of anything without widespread testing.  

Well as a denominator it can be instructive.   #confirmed deaths / #confirmed cases gives some indication of the mortality rate in severe cases (since currently those are the only ones being tested)

 

So while you shouldn't bet on it being accurate you can make decisions based on the results over time.   If you had 1000 confirmed and 0 deaths no one would care, but if that number changed to say 10/1000 that does tell you something...  

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10 minutes ago, Loco said:

Well as a denominator it can be instructive.   #confirmed deaths / #confirmed cases gives some indication of the mortality rate in severe cases (since currently those are the only ones being tested)

 

So while you shouldn't bet on it being accurate you can make decisions based on the results over time.   If you had 1000 confirmed and 0 deaths no one would care, but if that number changed to say 10/1000 that does tell you something...  

I guess strictly for a ratio of confirmed positives resulting in death.  But without wide testing neither of those numbers tells you anything about prevalence, except maybe informally. 

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5 hours ago, closetojumping said:

Ha. The jokes on you, sir. I've been prepping for this moment for most of my adult life. I have a bunch of little kids, so I'm pretty, prettay sure that I'm immune. Beyond that, one of my brothers is a doctor and has already loaded me up on various needs for when the apocalypse comes. Beyond beyond that, as a Surly 1%er, naturally I own a medical treatment company and we stocked all the way the fuck up on zinc, vitamin c, a bunch of other medical shit, and 3 months of inventory worth of lactated ringers. The hype around this thing is going to be a boon. Also also also, we've immediately started ratcheting up pricing in order to profiteer all over the face of this thing. You're welcome.

 

Lactated ringers? WTF are those, part of a HuCow fetish?

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43 minutes ago, closetojumping said:

 

So you don't know what a growth factor is, then. Got it. We're talking about two different things. 

https://www.worldometers.info/coronavirus/coronavirus-cases/#cases-growth-factor

I didn't key on a formal definition of "growth factor" per your link as distinct from a positive sloped line indicating an increased rate of infection and the translated meaning of differences in slope.  But even looking at your link, and "growth factor" graph, the average GF of the last 3 days is 1.20, which your link states "could signal exponential growth."  What you're showing me is that we really aren't far apart on this. And I'm sure as hell not being hysterical, dude, whatever satisfaction you're trying to get.

We need more time and data, but if I had to bet, the 'outside of China curve' will look worse over the next 3 weeks than 'the China curve' in Jan/Feb mainly because we're not doing military grade isolation and quarantine by the 10's of millions.  Protective factors for us relate to not having average city sizes of 11M, having generally well stocked stores for supplies and infrastructure to support better hygiene and social distancing.  I'm not throwing in any towels here.  And I could go full fucking CR right now, but won't.

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https://reason.com/2020/03/06/trump-says-the-covid-19-death-rate-will-be-a-fraction-of-1-percent-is-he-right/

Quote

President Donald Trump opined this week that the U.S. death rate from COVID-19 would turn out to be "a fraction of 1 percent." At least one authority—University of Pennsylvania vaccine expert Paul A. Offit—agrees. "I think he's right," he told FactCheck.org, adding that there has been a "wild overreaction" to the disease largely because it is new. "We're more the victim of fear than the virus," he said.

Are Trump and Offit right?

Confirmed novel coronavirus cases in the U.S. number around 250 so far, and 14 people have died of the COVID-19 respiratory disease caused by the virus. Crudely, these data would yield a truly frightening mortality rate of more than 5 percent. In contrast, the Centers for Disease Control and Prevention estimate that the current death rate from this season's influenza epidemic is between 0.05 and 0.10 percent. The global case fatality rate for the most severe pandemic in recent history, the Spanish flu epidemic in 1918, was between 3 and 6 percent; the rate was around 2.4 percent in the United States.

 

So are we facing an epidemic comparable to 1918 or something more like a severe flu season? "Globally, about 3.4 percent of reported COVID-19 cases have died. By comparison, seasonal flu generally kills far fewer than 1 percent of those infected," declared World Health Organization Director-General Tedros Adhanom Ghebreyesus earlier this week. According to the latest data, more than 100,000 cases of COVID-19 around the world have been confirmed, resulting in 3,408 deaths so far. Simple math yields the 3.4 percent death rate cited by Dr. Tedros.

If that's the right figure, then we're headed toward Spanish flu death rates. But before dousing yourself continually with Purell, note that the critical caveat is "reported" COVID-19 cases. Most experts believe the number of unreported cases is large. So far it appears that at least 80 percent of infected people exhibit mild or even no symptoms, and thus are unlikely to have come in contact with medical surveillance systems.

The fact that the U.S. lags in testing for the virus means that public health officials do not have a good idea of just how many Americans are already infected. That makes it difficult to estimate the disease's real mortality rate. In contrast, South Korea has been more aggressive, testing more than 140,000 people for the virus. Doctors there have confirmed more than 6,000 cases, yielding a fatality rate of 0.6 percent.

Interestingly, if the estimate that as many as 1,500 cases are currently undetected in Washington state, the 14 deaths (8 of whom were residents of the Life Care nursing home) reported there yields a case-fatality rate of just over 0.9 percent. Aboard the once quarantined Diamond Princess cruise ship, 707 passengers contracted the illness and so far 6 have died, yielding a death rate of 0.85 percent. That rate is unlikely to be representative, since COVID-19 is much riskier for older people and the ages of cruise passengers skew older.

A new report by researchers in Hong Kong estimate a symptomatic case-fatality rate of 1.4 percent. This is considerably lower than the WHO's 3.4 percent death rate. And again, it does not account for infected folks whose symptoms are mild or absent.

A preliminary modeling study by European researchers estimated that the undetected rate of coronavirus infection could be 20 times higher than the number of confirmed cases. If this is so, they write, that yields "a much lower mortality rate, which according to our computations is of the order of 0.15%." That would make the death rate for a coronavirus epidemic similar to that of a severe flu season.

One caution: A higher percentage of the population would be vulnerable to coronavirus infection, since flu epidemics are blunted by the fact that millions of us get our annual vaccinations. There will be no vaccine against this virus for at least 12 months.

"The best estimates now of the overall mortality rate for COVID-19 is somewhere between 0.1 percent and 1 percent," said Brett Giroir, an assistant secretary at the Department of Health and Human Services, at a press conference yesterday. The good news is that as more testing data comes in, the lower the mortality rate for COVID-19 falls.

 

Disclosure: As I report this, I am self-isolated with a bad cold which could well be caused by one of the four human coronavirus strains that are thought to be responsible for about 15 percent of adult common colds.

 

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https://www.theatlantic.com/health/archive/2020/03/how-many-americans-have-been-tested-coronavirus/607597/?fbclid=IwAR3xCptI-_223gC3WY3RR0vEvJqipY_mZ0IqnIflJ4-QbANIkqmfQJzk1oo

 

Quote

It’s one of the most urgent questions in the United States right now: How many people have actually been tested for the coronavirus?

This number would give a sense of how widespread the disease is, and how forceful a response to it the United States is mustering. But for days, the Centers for Disease Control and Prevention has refused to publish such a count, despite public anxiety and criticism from Congress. On Monday, Stephen Hahn, the commissioner of the Food and Drug Administration, estimated that “by the end of this week, close to a million tests will be able to be performed” in the United States. On Wednesday, Vice President Mike Pence promised that “roughly 1.5 million tests” would be available this week.

 

But the number of tests performed across the country has fallen far short of those projections, despite extraordinarily high demand, The Atlantic has found.

Read: You’re likely to get the coronavirus

“The CDC got this right with H1N1 and Zika, and produced huge quantities of test kits that went around the country,” Thomas Frieden, the director of the CDC from 2009 to 2017, told us. “I don’t know what went wrong this time.”

Through interviews with dozens of public-health officials and a survey of local data from across the country, The Atlantic could only verify that 1,895 people have been tested for the coronavirus in the United States, about 10 percent of whom have tested positive. And while the American capacity to test for the coronavirus has ramped up significantly over the past few days, local officials can still test only several thousand people a day, not the tens or hundreds of thousands indicated by the White House’s promises.

 

To arrive at our estimate, we contacted the public-health departments of all 50 states and the District of Columbia. We gathered data on websites, and we corresponded with dozens of state officials. All 50 states and D.C. have made some information available, though the quality and timeliness of the data varied widely. Some states have only committed to releasing their numbers once or three times a week. Most are focused on the number of confirmed cases; only a few have publicized the number of people they are capable of testing.

Read: The official coronavirus numbers are wrong, and everyone knows it

The Atlantic’s numbers reflect the best available portrait of the country’s testing capacity as of early this morning. These numbers provide an accurate baseline, but they are incomplete. Scattered on state websites, the data available are not useful to citizens or political leaders. State-based tallies lack the reliability of the CDC’s traditional—but now abandoned—method of reporting. Several states—including New Jersey, Texas, and Louisiana—have not shared the number of coronavirus tests they have conducted overall, meaning their number of positive results lacks crucial context.

 

The net effect of these choices is that the country’s true capacity for testing has not been made clear to its residents. This level of obfuscation is unexpected in the United States, which has long been a global leader in public-health transparency.

The figures we gathered suggest that the American response to the coronavirus and the disease it causes, COVID-19, has been shockingly sluggish, especially compared with that of other developed countries. The CDC confirmed eight days ago that the virus was in community transmission in the United States—that it was infecting Americans who had neither traveled abroad nor were in contact with others who had. In South Korea, more than 66,650 people were tested within a week of its first case of community transmission, and it quickly became able to test 10,000 people a day. The United Kingdom, which has only 115 positive cases, has so far tested 18,083 people for the virus.

Normally, the job of gathering these types of data in the U.S. would be left to epidemiologists at the CDC. The agency regularly collects and publishes positive and negative test results for several pathogens, including multiple types of the seasonal flu. But earlier this week, the agency announced that it would stop publishing negative results for the coronavirus, an extraordinary step that essentially keeps Americans from knowing how many people have been tested overall.

 

Read: What you can do right now about the coronavirus

“With more and more testing done at states, these numbers would not be representative of the testing being done nationally,” Nancy Messonnier, the chief CDC official for respiratory diseases, said at the time. “States are reporting results quickly, and in the event of a discrepancy between CDC and state case counts, the state case counts should always be considered more up to date.”

 
 

Then, last night, the CDC resumed reporting the number of tests that the agency itself has completed, but did not include testing by state public-health departments or other laboratories. Asked to respond to our own tally and reporting, the CDC directed us to Messonnier’s statement from Tuesday.

Our reporting found that disorder has followed the CDC’s decision not to publish state data. Messonnier’s statement itself implies that, as highly populous states like California increase their own testing, the number of people the CDC reports as having been tested and the actual number of people tested will become ever more divergent. The federal tally of positive cases is now also badly out of date: While the CDC is reporting 99 positive cases of the coronavirus in the United States, our data, and separate data from Johns Hopkins University, show that the true number is well above 200, including those on the Diamond Princess cruise ship.

 

The White House declined to comment.

The haphazard debut of the tests—and the ensuing absence of widespread data about the epidemic—has hamstrung doctors, politicians, and public-health officials as they try to act prudently during the most important week for the epidemic in the United States so far.

Our reporting found that the capacity to test for the coronavirus varies dramatically—and sometimes dangerously—from state to state.

California claims the highest testing capacity of any state, and has tested the most individuals so far. As of yesterday afternoon, it had tested 516 people, with 53 positive cases, a spokesperson for the Department of Health told us. The department now has the capacity to test 6,000 people every day, and it expects that capacity to expand to 7,400 people a day starting today, the spokesperson said.

Washington State, the site of the country’s largest outbreak thus far, can test roughly 1,000 people a day. The state health department’s laboratory can test 100 people a day; the rest of the testing is being done at the University of Washington’s Virology Lab. Officials have found 70 positive cases in Washington so far, though a genetic study has estimated that there may be hundreds of untested people who have COVID-19 in the greater Seattle area.

 

Read: The problem with telling sick workers to stay home

Oregon, situated between the California and Washington hot spots, can test only about 40 people a day. Texas has 16 positive cases, according to media reports, but the health department’s website still lists only three cases. The Texas Tribune has reported that the state can test approximately 30 people a day.

Other states can test even fewer. Hawaii can test fewer than 20 people a day, though it could double that number in an emergency, an official told us. Iowa has supplies to test about 500 patients a day. Arkansas, though not near a current known outbreak, is able to test only four or five patients a day.

 
 

On the East Coast, testing capacity varies significantly. New York State has 22 positive cases, including several cases of community transmission in Manhattan and Brooklyn. It can test 100 to 200 people a day. Neighboring New Jersey and Connecticut have not shared any information about how many tests they have run, or about their daily testing capacity.

 

Pennsylvania can test only about a dozen people a day, and Delaware can test about 50 people, our survey found. An official in Massachusetts, where two of 20 tests have come back positive, said that she did not know the Bay State’s daily capacity, but that its health department “currently [has] an adequate supply of test kits.”

Read: The gig economy has never been tested by a pandemic

These data come with an important caveat. Currently, most labs require two specimens to test one person. Single-specimen testing capability is being developed, but right now the top-line number of available tests should be cut in half. In other words, “1.5 million tests” should be able to test roughly 750,000 people. Some states, such as Colorado, told us how many specimens they could test a day (160), not how many patients (about 80). Other states shared the number of patients they could test, but not the number of specimens. In this story, we’ve standardized these numbers by dividing any specimen figure by two to give an estimate of the number of patients who can be tested.

 

Our reporting found that three factors determine the number of people who are tested for the coronavirus.

The first factor is the availability of tests. Until recently, very few physical tests were available, because of a mistake that the CDC made with a crucial component. The White House has pushed for and highlighted a massive increase in available tests, to perhaps 1 million in the next week. But labs have to be trained on how to set up and execute the relatively complex procedure.

The second factor is that the CDC sets the parameters for state and local public-health staff regarding who should be tested. The agency’s guidelines were very strict for weeks, focusing on returning international travelers. Even as they have been loosened in the past few days, there are persistent reports that people—including a sick nurse who had cared for a coronavirus patient—have not been able to get tested.

Finally, the more people who contract the illness, the greater the demand for testing. Some weeks ago, the number of cases in the United States was probably much, much smaller than today. The upshot is that there is likely to be an explosion of Americans tested for the coronavirus in the next week, led by California and Washington, each of which has a substantial number of cases and has shown signs that the virus is spreading.

 

Read: The coronavirus is a truly modern epidemic

 
 

Even in an emergency, laboratories cannot be spun up immediately. The University of Washington, which appears to have the country’s largest testing capacity outside of California—it can test up to 1,000 people a day—has been working on its own coronavirus test for several weeks.

A week ago, the FDA eased some regulations on the types of coronavirus tests that can be used. This means that testing capacity will increase, but not overnight.

It has not always been so challenging to get estimates of the number of Americans tested. Throughout February, the CDC published a regular tally of Americans who had been tested for the pathogen. Last Saturday, several days after the country’s first case of community transmission was confirmed, that figure was 472.

Then the agency stopped updating the tally. It did not publish new numbers of how many Americans had been tested for the virus on Sunday or Monday, as public criticism of the sluggish response to the disease began to mount. On Tuesday, it announced that it would stop publishing the figure altogether.

 

Our reporting has found that the CDC has not made good on Messonnier’s assurance that state numbers would be available and up to date. Many states are not reporting their results quickly: In our survey, we found that in some states, the most recently available numbers were days old.

Since the CDC’s pullback, it has become extremely difficult to track the nation’s growing capacity to test for the coronavirus.

There are material reasons for this. At first, the CDC did all the testing, so its results were easy to report. But as the outbreak grew, state public-health laboratories were brought into action. Each of them can do only so many tests, however, so university research laboratories have now joined the effort. Soon—no one is quite sure precisely when—private laboratories such as LabCorp and Quest Diagnostics will begin testing people too.

The more entities involved, the more complex the data-gathering effort grows. State public-health departments should be tracking tests from university labs and eventually private labs, but in this time of crisis, they may not have the capacity to gather those data. For example, a Washington public-health official told us that the state could test up to 100 people, but as noted, the University of Washington has far higher throughput. That suggests a positive implication of our reporting: more capacity nationwide than our, or any, data reflect.

 

Read: Here’s who should be avoiding crowds right now

As more laboratories join in the effort, quality control will become more difficult. While each lab must have the FDA’s permission to operate, under an Emergency Use Authorization, a new FDA policy allows labs to immediately begin testing people, and requires that they submit their paperwork to the agency within the next 15 days.

 
 

These types of measures are necessary because the United States’ response to the coronavirus is far behind the spread of the disease within its borders. Testing is the first and most important tool in understanding the epidemiology of a disease outbreak. In the United States, a series of failures has combined with the decentralized nature of our health-care system to handicap the nation’s ability to see the severity of the outbreak in hard numbers.

Today, more than a week after the country’s first case of community transmission, the most significant finding about the coronavirus’s spread in the United States has come from an independent genetic study, not from field data collected by the government. And no state or city has banned large gatherings or implemented the type of aggressive “social distancing” policies employed to battle the virus in Italy, Hong Kong, and other affluent places.

If the true extent of the outbreak were known through testing, the American situation would look worse. But health-care officials and providers would be better positioned to combat the virus. Hard decisions require data. For now, state and local governments don’t have the information they need.

It's what a lot of us have been saying.  We're behind the 8 ball in testing, either through our own gross incompetence or for other more nefarious reasons (i.e. not wanting the true infected numbers out there scaring the market and stalling the economy).  White House is making claims that it is unlikely to be able to achieve (e.g. 1 million tests available w/in a week).

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I'm not saying SXSW shouldn't be canceled but I don't think the average austinte understands the damage it would do to the local economy. Lots of businesses are going to be looking for ways to balance the books after falling way short of revenue this quarter.  

 

Meeting is about to start. The entire city council is behind the podium which looks like bad news.

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Have to think this is going to be a small domino that makes the general public panic ramp up a notch. And I'm guessing with this precedent you'll see massive changes or cancellations for sporting events like March Madness, all of it. No one wanted to be the first major event to jump into the cold water, but I'm guessing now you'll see a trail of similar reactions across the country. 

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1 minute ago, SydneyCarton said:

No one wanted to be the first major event to jump into the cold water, but I'm guessing now you'll see a trail of similar reactions across the country. 

A Trail of Fears, if you will.

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Just now, Updawg said:
2 minutes ago, StruggleBus said:
If the masters gets cancelled we should nuke China. Close your wet markets, fuck heads. 

I'm with you on that. If we have to quarantine can we still have sporting events go on without spectators.

Italy is doing that for soccer games.  

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So we're still sending millions of Texans out of state to pick up the virus and bring it back to Texas during Spring Break, right?  

Damn shame about SXSW because the most susceptible population for coronavirus is totally the target demographic of the festival proper.  

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4 minutes ago, MissingInAction said:

Also , can you imagine the drink specials going on to get people into the bars?

Who were the fuckheads who got rid of 5 for 1s or whatever they use to have at Abels?

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  • hayden_horn changed the title to Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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