COVID-19 reality for us

[jimcav]

In prior threads, I pointed out the models' predictions were NOT tracking the actual data here in the USA. The IMHE model initially had 38k-162k dying, now it has been updated to suggest 100k-240k. Yesterday it predicted 27 dead in CA, we had 30 die. That is off by 10% for my state--the potential growth rate that carries forward is alarming, and the prediction is/was already alarming. I still believe the R0 is underestimated because the rate of asymptomatic spread is underestimated and the model assumes people are practicing the isolation, hygiene, and distancing required. CA has been pretty good on SIP and messaging, yet I still see people ignoring the edicts on spacing--passing on sidewalk without stepping into yards or streets, construction where workers are closer (than 6'), people not adhering to it in grocery isles, etc. Please, until testing is widespread and it PROVES SARS-CoV-2 is not near you, we should all act as if it is. While I'm looking at data for my area and the USA, this applies anywhere that there isn't wide testing. Because I have a mother-in-law in her 80s who I love dearly, and a younger family member at very high risk, I am grateful I have enough knowledge and experience to read through data and papers to give them advice in advance of official guidance. But it is just so scary and sad to see this unfold, and I almost wish I didn't know and understand what is coming. Please be careful, deliberate, and help others do the same. If you aren't literally on the front lines or directly supporting those, it is what me must do. I almost typed "all we can do", but that sounds like it is a limited thing, but it isn't. It is the necessary and sufficient thing to make a real difference. Please, let us all make the model OVERESTIMATE.

[tuxbailey]

I was mowing lawn in my backyard on Monday evening. Our community is right next to a popular state park with a lot of hiking trails. Some guy with 3 kids in tow came to ask for directions to the main road because his wife dropped them off and he got lost.

He got close to 3 ft and I was apprehensive. I didn't say "6 ft" because I was caught by surprise. I think a lot of people are not self ware enough that they are too close to others.

At least it was open air environment and hopefully that mitigated any potential issues. But I was definitely worried that a stranger got too close.

[AngryScientist]

I think this piece from the Times article drives the point home:


https://www.nytimes.com/2020/04/01/u...rus-trump.html

Under the best-case scenario presented on Tuesday, Mr. Trump will see more Americans die from the coronavirus in the weeks and months to come than Presidents Harry S. Truman, Dwight D. Eisenhower, John F. Kennedy, Lyndon B. Johnson and Richard M. Nixon saw die in the Korean and Vietnam Wars combined.

The lowest estimate would claim nearly as many Americans as World War I under President Woodrow Wilson and 14 times as many Americans as Iraq and Afghanistan together under Presidents George W. Bush and Barack Obama.

[AngryScientist]

Also, we were going to start a new thread for this topic this morning, so this works, but please be reminded to keep it civil and not overly partisan political.

thanks.

[oldpotatoe]

I'll add this and it makes ZERO difference if you or a loved one is infected BUT..
'assuming' 'about' 200,000 deaths, means 'about', 10 million infected which means you will be one of 'about' 3% of the population infected. 3%, 97% not infected....Also means of those infected, 9.8 million will recover. Just looking for some decent numbers..Even if they mean not much..

These 'as many died as in Korea or VN', does little IMHO..except make it seem even more pessimistic than it 'should be.

YUP, do your part, stay at home..BUT still butt-nuggets around here..

[tuxbailey]

I think for the near future, regardless when the peak happens, social distancing, face mask wearing, and elevated hygiene practice will become the norm (until the vaccine is available.)

[Cantdog]

Originally Posted by jimcav

In prior threads, I pointed out the models' predictions were NOT tracking the actual data here in the USA. The IMHE model initially had 38k-162k dying, now it has been updated to suggest 100k-240k. Yesterday it predicted 27 dead in CA, we had 30 die. That is off by 10% for my state--the potential growth rate that carries forward is alarming, and the prediction is/was already alarming. I still believe the R0 is underestimated because the rate of asymptomatic spread is underestimated and the model assumes people are practicing the isolation, hygiene, and distancing required. CA has been pretty good on SIP and messaging, yet I still see people ignoring the edicts on spacing--passing on sidewalk without stepping into yards or streets, construction where workers are closer (than 6'), people not adhering to it in grocery isles, etc. Please, until testing is widespread and it PROVES SARS-CoV-2 is not near you, we should all act as if it is. While I'm looking at data for my area and the USA, this applies anywhere that there isn't wide testing. Because I have a mother-in-law in her 80s who I love dearly, and a younger family member at very high risk, I am grateful I have enough knowledge and experience to read through data and papers to give them advice in advance of official guidance. But it is just so scary and sad to see this unfold, and I almost wish I didn't know and understand what is coming. Please be careful, deliberate, and help others do the same. If you aren't literally on the front lines or directly supporting those, it is what me must do. I almost typed "all we can do", but that sounds like it is a limited thing, but it isn't. It is the necessary and sufficient thing to make a real difference. Please, let us all make the model OVERESTIMATE.

Could not agree more. I'm a researcher/clinician in MA and my sister is practicing in NYC so unfortunately we are dealing with this first hand. It is not a matter of if you will be personally impacted by this in terms of family/friends who become ill or die, but when.

Yes, it is hard to know if we are 'overreacting' or if the measures taken, with widespread financial impacts are too much or not. Yes, social distancing + the financials of this will have widespread mental health impacts and long term health impacts, maybe some positive, but many likely negative. But without large scale national testing, it is next to impossible to 'overreact'. Currently, despite working in a high functioning, well funded academic healthcare system access to testing remains limited.

I feel thankful that my patients have been really attentive and taken my advice seriously. But many still initially voiced a dismissive attitude based on their choice of preferred cable news channel. I feel like I've burned through just about all of the 'therapeutic alliance' points built up over the years during March to get folks to stay home, complete ACP, talk through medication stocking, transition to virtual appointments, etc.

Stay home, if only to make my job a bit easier, please.

[Blue Jays]

Thoughtful and solid post, @jimcav. I begin each day thinking about what I can contribute to help.

[AngryScientist]

Originally Posted by yinzerniner

So honest question

just stop.


use your best judgement to discuss the issues at hand here and dont wade into partisan political discussion. this is not the place for that.

if you think it might be out of line, just dont post it.

[jimcav]

Originally Posted by oldpotatoe

'assuming' 'about' 200,000 deaths, means 'about', 10 million infected which means you will be one of 'about' 3% of the population infected. 3%, 97% not infected....Also means of those infected, 9.8 million will recover. Just looking for some decent numbers..Even if they mean not much..

These 'as many died as in Korea or VN', does little IMHO..except make it seem even more pessimistic than it 'should be.

YUP, do your part, stay at home..BUT still butt-nuggets around here..

Well, if you assume a 2% fatality rate, that is of those ill-enough to seek care. The number infected will FAR exceed the number who become ill from that infection. WITHOUT widespread testing that is estimated at 4:1 (mild or asymptomatic infection to actually ill). So if 2% CFR (not of total cases, but of the ill-enough to seek care), then 200k dying means that is 50 million infected. I hope we beat 2%, but in other areas with similar growth curves, CFR has been 4+%. Let's limit it as much as we can.

[zap]

jimcav, thank you for your posts.

Thank you to the Paceline mods as well for all the "hall" monitoring.

Myself and my wife, some weeks ago we (non healthcare professionals-looking at test rates, etc.) figured that infection rates could be as high as 10x higher than what has been reported.

We are older but not at high risk....no underlying conditions. Still, I had pneumonia some years ago and it was not fun.....don't care to go through that again for as long as possible. We have been close to self isolating (occasional trips to stores) for over two weeks and right know it looks like we have two months to go.

It now appears that wearing even the most basic face mask is the way to go when venturing out to stores. This has been mandated in several central European countries as well as Austria. With so many people not showing signs of infections but still possibly spreading C19, having everyone wear masks appears to be a good way to further slow the spread.

[oldpotatoe]

Originally Posted by jimcav

Well, if you assume a 2% fatality rate, that is of those ill-enough to seek care. The number infected will FAR exceed the number who become ill from that infection. WITHOUT widespread testing that is estimated at 4:1 (mild or asymptomatic infection to actually ill). So if 2% CFR (not of total cases, but of the ill-enough to seek care), then 200k dying means that is 50 million infected. I hope we beat 2%, but in other areas with similar growth curves, CFR has been 4+%. Let's limit it as much as we can.

Assuming a lot..just looking for some better 'feeling' info is all. Lots we don't know, of course, like a firm number of those who have gotten infected and have recovered....since many get sick, stayed at home, and then get better.

My point for this layman, who is looking for some 'better' news..MOST won't get sick, and MOST that do, still recover. NOT saying that 'happy days are here again', and we should jump into that hot tub with 20 of our closest friends but...just looking for 'better' news..Like the guy always said in Blade Runner, 'have a better one'...
https://getyarn.io/yarn-clip/4c5dfec...8-1f78e26b0be8

[AngryScientist]

redir -

i JUST warned people about not doing exactly what you just did.

infraction given.

[redir]

Originally Posted by Gummee

...and here we go with the partisan politics...

I'm out and about working on people's bikes nearly every day. So far, the impact is significantly less than I've been told it would be.

M

I don't see it much in my small town yet but that's because local officials have taken it seriously. The University has closed down and the Governor has ordered people to stay home unless absolutely necessary. But just becasue you or I don't see it doesn't mean it's not there. The problem is that nobody believes in experts anymore. For your own safety, and for those who you might one day infect, I'd suggest that you at least listen to them.

[Gummee]

Originally Posted by redir

I don't see it much in my small town yet but that's because local officials have taken it seriously. The University has closed down and the Governor has ordered people to stay home unless absolutely necessary. But just becasue you or I don't see it doesn't mean it's not there. The problem is that nobody believes in experts anymore. For your own safety, and for those who you might one day infect, I'd suggest that you at least listen to them.

Oh, I'm listening. I'm just not seeing what they're predicting firsthand.

M