I like in KC, KS, USA. So back in early late November early December, I had something that was exactly like Covid19 symptoms: lasted 2.5 weeks, mild fever, fatigue, persistent cough, upper respiratory problems. The doctor said it was likely viral and they couldn't give me anything. Unfortunately, I don't know if there's a way to test how old my antibodies are IF this was in fact was Sars-Cov-2.
I think the bigger question is, let's say it did arrive much earlier that we think, does that mean the virus grows at a much smaller rate than current models?
It could also be a different strain that was spreading before it mutated into the more deadly and viral version. The virus spread is weird we can get a super spreader that can spread to 60-70 people like the church in Korea. At the same time I know personally of a family of 8 where 1 person got it had it for almost a week before getting tested positive and then sent to quarantine none of the other family members was infected.
Given the correlation between cases and deaths, isn't one of the big arguments against the early community spread theory that we would have seen death rates increase earlier on than they actually did?
No, because the mortality rate is very, very low outside nursing homes. And cause of death in the early days won't be listed as corona, since it was an unknown disease.
The Wuhan "first patient" was admitted Dec. 6, but nobody believes he was "patient zero". Since he likely contracted it Dec. 1, that means there were others with corona in Nov. or before. (Chinese people I've talked to invariably mention Oct. as when they started to hear chatter about corona.)
I have been beating this drum for a while. I feel like I'm shouting aliens. The CFR for sixty plus is staggering. Below sixty? Still crappy, but not shut down the world. Below twenty? We wouldn't even notice.
The problem is not whether this is more or less scary than the flu (or anything else), it is both. With no solutions aimed at buffering nursing homes/elderly.
Am I just insane? This narrative seems completely absent in all of the coverage.
What narrative... that COVID-19 is most deadly for those over 60? That's literally the only fact that most people know about it. If you think that has been absent in all the coverage, I have no idea what coverage you have been paying attention to.
It is and it isn't. This thread is predicated on an IFR that is a flat 5 or so percent on the population.
We all acknowledge that it is deadly. Because it is. And you are right that this is in all the data. But the narrative is still holistic. We are locking down everyone to try and kill the virus.
Yes, it could work. But so could strict access to most nursing homes. Wouldn't be cheap, but could have even been more effective. Reasoning that we could reach herd immunity style buffer between the populations.
(Note that I flat reject just letting people die. I am not saying to abandon the older at risk crowd. I'm saying take pointed measures to explicitly protect them.)
This was more or less the original UK strategy: isolate the elderly and go full-bore for herd immunity. They scrapped that plan after they updated the model to account for ventilator shortages.
There is lots of commentary on that strategy if you want to go back and read it. Even if you were gonna do this, you’d have to figure out how to isolate high-risk populations as thoroughly as possible, to the point of locking caretakers in with them and whatnot. If you lock everyone down, you have a lot more latitude to half-ass things as long as you keep R below 1. Isolating high-risk populations and deliberately pursuing herd immunity means operating consistently under the assumption that virtually everyone else will, as opposed to may, be contagious.
That was reported as full on no shut down. Just crap reporting?
Note that I am still proposing an expensive solution. But asking if the barrier between the populations could be setup stronger. Such that the death and hospitalization load would have been what we have had, minus most of the elder population.
Edit: you edited on me. Yes, I am proposing that offering strict access to this crowd could have been done cheaper and more effective than what we have done.
The problem with isolating high risk populations is that you have to go round them all up and temporarily house them in quarantined facilities. And since the elderly are sometimes infamous for their unwillingness to be rounded up and forced to leave their homes, you have to either force them anyway or just abandon them to their fate. And that’s without touching the massive logistics of such an effort. (Not rounding them up would be even harder.)
Honestly, if you were gonna try and do that, I think geographical isolation would be a better option. Compartmentalize your state/region/country into separate zones, block all non-essential travel between zones, regularly test essential travelers, and change the lockdown status of each zone based on local conditions.
What will end up happening is occasional breaches between zones where a zone might go from green to red. But it gets us in a position where most people are mostly unrestricted most of the time. It also makes it possible to eradicate the virus without actually infecting most of the population, which is nice. Logistically you’d, at most, just set up checkpoints on roadways and inside airports and train stations to enforce the travel restrictions.
Over time you could even allow travel between green zones.
No worries on the edit. Meant that more to explain if I seemed to ignore party of your post.
I think you could have gotten pretty good volunteer isolation. As simple as getting grocery stores to deliver to elderly. As expensive as renting the Ritz for a month. Still expensive, but cheap compared to what we have landed in.
In Australia we basically did both: shutdown everything, and shutdown all access to nursing homes.
It has been disastrous (comparatively). We had a couple of asymptomatic carriers infect some aged care facilities and now nearly 20% of the deaths country wide are from those incidents. And that's with the second best testing regime in the world though March/April (after South Korea).
We'd have been better closing the aged care faculties and moving people in with relatives. That's not very practical, but the COVID deaths would almost certainly have been less.
I'm not sure how that would have been better. You are basically calling to mix them in with the whole population, do you would expect them to get more exposure, right? Why do you think it would have been less?
In Australia (where we have been lucky and controlled the virus) there would almost certainly have been less deaths if they were in the general population.
Here there has been very limited community transmission, and aged care facilities have turned out to be transmission clusters (not just death clusters). I guess shared facilities, lots of people in limited space etc.
And it's proved very hard to keep it out of facilities despite the best testing in the world. So here in Australia, (with different transmission dynamics to most places) they have been more likely to be exposed in aged care homes than elsewhere. This observation is made with the benefit of hindsight though.
Counter-factuals are hard, but in the proposed model where all old people are quarantined and the rest of the population is left to be infected the Australian experience indicates that the quarantine for aged care facilities wouldn't have been effective enough.
I can see how they may become transmission corridors. My thought is they could also be treatment clusters. Don't just quarantine them in place, per se. Take over nearby hotels and spread them out, if needed. On contamination, have all supplies ready and onsite.
Note, I explicitly don't think this would be cheap. Such that I am not sure it is tenable without hindsight.
That said, I can see your point. With my firework shop metaphor, you are basically proposing to disperse the inventory such that one misfire will not ignite all of them.
I think I just have a hard time believing we will contain this with all of the other data we have seen. My gut is it is as likely that there is some yet unknown factor for the places that have seen better numbers.
You might find this article (on Sweden) interesting:
About half of Sweden’s deaths have been in nursing homes, which prohibit visitors. Tegnell said health officials had thought it would be easier to keep the disease away from them..... "“We really thought our elderly homes would be much better at keeping this disease outside of them then they have actually been,” he told Noah."
But my suggestion isn't just to prohibit visitors. It is to basically isolate all living staff. Cleaners, caretakers, all. If need, rent out hotels nearby to spread them out.
Note. Not cheap. At all.
For the at home rate, we need the question of would that have simply shifted if we sent them home?
Edit. Realized I didn't say it directly. I do find these interesting. Thanks!
> In summary none of the patients who are put on ventilators survive.
That's simply not true. A very high percentage of them die (because you only put very sick people on ventilators), but to suggest that they all die is just absurd.
There are millions of people in high risk groups outside of nursing homes. How do you propose protecting them?
There are also millions of people in low risk groups who care for people in nursing homes and other high risk populations. How do you propose keeping them from infecting those they are caring for?
The thread is also predicated on a very high base reproduction number. A high R0 means a very large percentage of the population needs to be immunity before "herd immunity" is a thing (on the order of 80-90%). Even with a very low IFR, that is hundreds of thousands dead.
We haven't dodged that bullet in our current strategy. And the more data we get, the more it looks like we haven't protected them, honestly.
I'll note some of the first cases in WA included a high school student that had not been traveling. I cannot square that, how contagious this is, and the idea that it wasn't widely in that school.
I think herd immunity is silly at the holistic level. At a cohort level, though, it could work reasonable. Consider, at this point we could start rotations of health workers that have the antibodies.
I have said it before, but I will stress again I am just a random internet poster. Much of why I am posting this is to get challenged on it.
New York seems to have a reasonable plan. Hospitalization rate is under control, careful planning is going into how to reopen the state in a tiered way, etc.
What are they doing to keep it out of the rest of their long term care facilities? Note that they have over a million people over sixty. And if you redo their numbers assuming the CFR is roughly known in the different age brackets, things could get much much worse. (That is, the CFR in WA is in very low numbers holistically. For the sixty plus? It is over 15%!!)
So, unless they have something protecting them, just reopening slowly didn't really have a mechanism to protect them.
Now, they could go for herd immunity in care workers. Rotate in those with antibodies, and you are simulations how we protect the elderly from the flu.
But just slowly reopening? What is the mechanism that is expecting a change?
It's going to be interesting to see how the mix of competence and luck plays out over the next nine months.
Evil dictator idea. App on peoples smartphones that collects the number of unique close contacts and rebroadcasts that. So then people get warned that someones a risk.
But how are we going to effectively isolate people? More, if it is in a young community, do we care?
That is, we do not have data showing this is deadly for pretty much why identifiable group, other than elderly. Such that no matter where a flare up is, we need to isolate the elderly.
My fireworks quip was that if a spark gets in there, the whole thing blows. But, large parts of the city could likely take a flare up and not notice. That is, the whole city is not a firework store. Right?
This is absolutely insane. My ex was telling me today, "well we could have a vaccine in 18 months" and I am so getting sick of this bullshit big-pharma narrative.
Safe vaccines take 5~10 years to develop. A vaccine in <2 years seems like a disaster waiting to happen. Vaccines for SARS1 were very difficult to make and some caused reinfections worse or incomplete protection[0].
We still don't have safe vaccines for HIV or Herpes. I feel like people talking about vaccines in 18 months are being totally unrealistic and irresponsible.
Yes, pretty much. It's more likely we'll find a drug or surgery to prevent people from dying (if feels like we're literally throwing every compound that's already FDA approved at it in the massive amounts of emergency clinical trials).
But there's no telling if or when one of those drugs will pan out (and it would certainly be before a vaccine). There is no talk of reconstruction now, which really needs to happen.
To provide some context: the Oxford people have been testing their viral vector (a non-human adeno-associated virus which expresses, in this case, the spike protein of SARS-CoV-2) for malaria in the past (which failed) and for MERS (which was being trialed), so they're building on previous experience.
You're not insane, but you need to take into account that the CFR would be higher if the healthcare system were overwhelmed with patients. Also reducing death is not the only target, we are reasonably sure that many patients will have long-lasting damage to their lungs.
There is of course some trade off between number of deaths avoided and amount of money we should be prepared to throw at the problem. Where on this spectrum are you?
My specific point is that people need to stop looking at a single IFR/CFR stat. It does no good. We look to be getting safer numbers there by simply increasing testing. (Of note, NYC has a strict lower bound on its numbers with how many in its population has died. But, do note they have more people over sixty than most cities do people. Such that most places will not be comparable.)
And that is the problem. The virus has not gotten safer as we get more data. Our understanding is just not focusing on helping the elderly. We seem to be taking a crap shot that everyone can stay home and we can out sit the virus.
I would wager we could have setup hotels and strict access controls on supplies into and out of at risk communities cheaper than what we have done. Certainly if you count on all of the job loss.
> you need to take into account that the CFR would be higher if the healthcare system were overwhelmed with patients
This is the narrative we keep getting fed over and over again, but it doesn't seem to be working out. There are a lot of people who were afraid to go to doctors for minor issues, a lot of important surgeries canceled for being elective, etc. On top of that, 80% of people who need a ventilator who are older or have other health issues, will die on them[0]. For the younger patients, it's almost a coin toss.
Some hospital systems are overwhelmed, but some are totally empty. Treating a region as large as the US as one unified geographical region, even with our unrestricted travel, didn't seem sound.
The devastation to peoples jobs, lives, savings, homes .. everything ... we keep saying Lives > Economy, but unless our leaders address how to deal with reconstruction (no one seems to be talking about this), there could be a lot of consequences worse than covid down the line.
The numbers show that this is <1% fatal and probably <0.1% but all it takes is one story of some 30 year old dying on the news and everybody loses their minds.
Granted, I was very scared myself before we had numbers, but I don’t know how many people are willing to actually take a look at them now that this has become sort of political. It’s like how a school shooting will get a lot of coverage, but nobody talks about how way more people are shooting themselves in the head. Emotions over facts.
That is a lower limit on the IFR in NYC. They also have more people over sixty two than city of Seattle has people. So, much more dense, with about 13% of the population an at risk group.
Sure. Per yesterday's paper, there have been 15185 cases and 834 deaths in WA. That would be a CFR of about 5%.
Now, it says the cases are 33% above sixty, and the deaths are 91% above sixty. So that would be a CFR of 758/5011, 15%.
Contrast with below sixty. Which comes to a CFR of about .7%.
If I go with just under twenty, the paper doesn't give me enough data to calculate. They are 4% of the cases, but don't even get listed in the deaths breakdown.
Under forty, the rate is about 1.5%.
And note that more testing can drive down these numbers. But it's unlikely to do so for the elderly.
That doesn't address the the question. We have seen a significant increase in deaths that correlates with our best understanding of when widespread community spread started. If it was "actually" circulating earlier than that, why did the deaths lag significantly?
I think the theory is "there are few enough we didn't notice."
There's other weird effects going on -- some countries that look really really similar have vastly different experiences with the virus. (Canonical example is DR and Haiti, although the situation is dynamic enough no-one knows if that'll last.)
My takeaway from the difficulty in measuring this thing is that there is pretty high variance in transmission. Some carriers spread it REALLY well. Some carriers spread it poorly. With a lot of variance it matters a ton to figure out what is the deal with high-transmission situations. My take so far is we have some clues but no certainty. (Seems to spread in public transit and healthcare environments more rapidly, but slower than you'd expect in schools and prisons.)
It'd clearly be a gigantic win in terms of intervention policy to understand this better, and we simply cannot do that without extensive contact tracing so we know what's going on. They're doing a pretty good job of this in China, HK, Taiwan, South Korea. As nearly as I can tell we're doing a dismally poor job in the US and Europe.
You read papers that have diagrams of restaurant tables and bus seating charts from China. In the US it's hard to get stats on aggregate nursing home vs non-nursing home fatality rates. Maybe it takes some time for these papers to come out, but I don't see evidence that high-quality pre-pub contact tracing data is being relied on to develop policy responses.
> The Wuhan "first patient" was admitted Dec. 6, but nobody believes he was "patient zero". Since he likely contracted it Dec. 1, that means there were others with corona in Nov. or before. (Chinese people I've talked to invariably mention Oct. as when they started to hear chatter about corona.)
I think you're confusing Covid with pneumonic plague: https://www.nytimes.com/2019/11/13/world/asia/plague-china-p.... There's apparently evidence based on mutation rates that COVID-19 can't be older than late October, and it wouldn't have been detected until mid-late November, which matches official timelines.
In the US, Massachusetts, with 6.5M total population has been hit fairly hard (outside of NY/NJ). Today's MA DoH numbers [0] show that of the 4090 deaths to date, the average age of the dead is 82 and just about 60% of them were in long term care homes. If you look towards the end of the report, it lists LTC facility after LTC facility with >30% residents infected, it's quite tragic really.
FWIW, in MA the average age of hospitalized C19 patients is 69, average age of positive tested is 53 -- Interestingly over the last 2 weeks the average ages for deaths and hospitalizations has been creeping up and the average age for a positive test creeping down. In all, 1% of the MA population has tested positive (out of 4.67% the total pop. tested).
Are the spikes in prior year Q4 from the flu? And if so was this year’s flu much more mild? It seems prior to coronavirus the number of excess deaths was quite low compared to past years.
Yes and no. At the start of an epidemic the excess mortality is not yet measurable, its within the variation of normal deaths, and the "official" numbers of corona deaths (people who die after having been tested positive) are not yet observed because there is no testing.
CDC estimates the basic reproduction number to be 6, German Robert-Koch-Institut IIRC around 3. Maybe the presence of earlier, undetected cases have lead to an overestimation of R0.
I've run into a number of southern KC suburbanites who are all convinced they had it. One had attended a thing in Vegas in Jan and came back with bad con-crud. Two houses down the whole family is certain they all had it. I'm super skeptical, because the pattern we've seen in "real" hotspots like NY just don't play out the same. It is feasible that it's really only truly devastating to dense populations, but until we have any kind of reliable testing on the infection and recovered side, the only # we can use is the death rate over normal. And that view seems to point in the direction of people not actually having it until after Feb. But here we are, having exhausted 2 months of our collective patience and not demonstrably further along in our ability to measure this thing.
The other reason to be skeptical is simply by looking at the positive test rate of jurisdictions with high levels of testing. I was also ill in February and then again in March, but the rate of positive tests for COVID-19 in my area has never made it above low single-digits, so just by the numbers, it's pretty unlikely I had it.
My wife and I were just talking about this the other day. We both got really sick in January. We had a few of the symptoms that could be just a regular flu. My wife had one symptom that stood out the most was while she was sick, she lost her sense of taste. Not just lessened, but gone.
> I think the bigger question is, let's say it did arrive much earlier that we think, does that mean the virus grows at a much smaller rate than current models?
This absolutely makes sense to me and would explain a lot of weirdness in the statistics. Less infectious, with a longer incubation period and circulating among the population for longer.
> grows at a much smaller rate than current models?
I think that local data, mortality in just one care center, does not seem to fit with slow spread. Many people have died in a short period of time in just one care center. But, as any small sample of data, could be just an anomaly and not a trend.
I guess that right now all options are open and as data gets cleared and accumulated we will know more. With more testing it would be easier to be sure who is infected, who has been infected and how the pandemic is behaving.
I have a friend in Philly who swears he had it around the holidays in December. Said he had a flu that wiped him out for a few days - said he had never had anything like it. After SARS-CoV-2 blew up and symptoms were being discovered, he swears that it's what he had.
FWIW SARS-CoV-1 specific antibodies last approximately 3 years or so [1]. The antibody test all have a very high specificity (all I've seen have been 98%+, but I'm going off of memory and not any specific cited information), so you'll for sure know you had it.
As I've mentioned before, both Wuhan and Shanghai have busy international airports. So it's nice that France has a confirmed corona diagnosis in late Dec., but it looks like corona was widely circulating outside China by Dec. 10.
On the one hand, I think quite a lot of people will have stories about Corona-like symptoms in late 2019, early 2020 before the real 'outbreak'. I wouldn't be surprised if a mild version of the virus had spread throught he world earlier than the current pandemic, but at the same time I think we should wait for more evidence. One case in France is just that - one case.
I had such stories. I got the sickest I've been in years back in the first week of Feb. Fever, chills, dry cough...I was in bed for a week.
Then again had some light respiratory stuff in early March. I live alone, isolation was already starting in some places, and I'm fortunate enough to work somewhere that WFH is easy.
I had plenty of "I might have already had it!" type conversations.
So I got my antibody test last week at my primary care physician. Negative. Was just a bad flu, I guess.
There's evidence that some subset of younger, healthier people may not produce measurable IgG antibodies. There was an initial study in China and additional preliminary work in Germany and Mayo Clinic.
"""
[Elitza Theel's] team has found that it's mostly the sickest patients — those who've been hospitalized — who produce IgG antibodies. And it appears that a small percentage of patients with milder cases of the disease aren't making the robust IgG antibodies.
"This is very preliminary," Theel warned. "But there might be a differential immune response between very sick individuals and individuals who have a more mild course of disease."
"""
Their definition of "mild" means that you didn't require hospital care. So if you're under ~30 and otherwise healthy, you may be one of the people who beat the infection by some other mechanism. Or you just had influenza. It's impossible to know for sure right now.
My wife had something similar at about that time. I'm curious. Did yours turn into pneumonia within 48 hours? Did you have severe trouble breathing? She's getting the antibody test this week. She had also just been to a meeting with international (especially French) people the week before.
Same for me back in early February. When you think about it, how many people just ride out flu-like symptoms, and how many doctors order official test to confirm influenza? It’s possible this virus was in stealth mode all over the place for awhile last year.
Most likely yes, I've had really severely bad flu twice in my life, it happens. Conversely my wife is a Nurse and she contracted Cov-19, confirmed by a test in early April, but fortunately it was a mild case, recovered ok and she's fine now just with a mild cough.
On the other hand, if I remember rightly some researchers tested a whole bunch of people who thought they had Corona-like symptoms in that time period using antibody tests, and didn't find a single case.
There is actually a plenty of "cousin" coronaviruses around, they are just not that dangerous. 15% of all common colds are caused by them. it might actually explain why some poorer countries appear to have lesser incidence of Covid - people catch cold there more often than in the first world. These "nicer" viruses might provide some immunity (not epidemiologist though).
Some virologists suggest that the common cold corona viruses that are endemic, might have been deadly when novel, and caused similar pandemics, but mutated to something less dangerous over time.
I've wondered that too. What if in human pre-history (10,000+ years ago) modern rhinoviruses and coronaviruses that cause common colds, were once terribly deadly. We could just be the descendants of survivors who evolved immune systems that were able to deal with these viruses?
One of the techniques of trying to make vaccines is to attenuate it by exposing to to different hosts; so that it will mutate into a form that's less harmful to humans; kinda the opposite of what probably happened here, where a virus that was not deadly to either bats or pangolins but caused havoc when it got to us.
SARS-2 isn't particularly dangerous for children. Most of them don't even have symptoms. Maybe all of our cold-causing coronaviruses are deadly when they present for the first time to an adult but since we all get them as children, our immune systems are better prepared.
It need not even be pre-historical. Until indoor plumbing, germ theory, and modern medicine in general, infectious diseases were one of the few remaining modes of natural selection that humanity couldn't control. The usual solutions to nature's challenges like increasing density to allow for specialization and economies of scale or trading with neighbors just made the problem worse. Given how many people died due to the introduction of diseases to the Americas and the black plague in Europe, infectious diseases have definitely been a powerful driver of our evolution in the common era, let alone 10,000+ years ago.
It's not that they mutate specifically to less dangerous versions; rather the subtle variations that don't kill their host before spreading persist while the ones that are rapidly fatal quickly disappear when containment measures are put in place.
Which makes this one bad as it's infectious for a long time before there are symptoms or it kills the host - hence the panic.
My anec-story is from ~Nov 1. BA resident. Sickest in my life. At the ER with 106F (did not know it even went there) fever and bad cough. Complete delirium. Flu result came back negative. No sepsis either. Released with anti-pneumonia antibiotics. Fever > 105F persisted for at least 6-7 days. Coughing that was bad enough to cause spasm. Took a second round of antibiotics (21 days total) to get over the pneumonia. The doc remarked about my chest x-ray ("whoa what is that?!!") but could not give a good explanation.
can you get tested for the antibodies, that's much earlier than other infections (Nov 1). Of course you could have gotten it in a later infection that wasn't so noteworthy.
When I came back from a California trip to my hometown in Mexico, I got something nasty with the typical symptoms: fever, shortness of breath, dry cough, etc etc. I went to the ER and got x-ray and blood samples.
When my doctor arrived, he was all cool. Then he asked me a bunch of questions and went to see the x-ray and blood work result in the labs. After taking some time, when he came back, he had a face mask and a can of Lysol. He said he had been delayed filling an epidemiological report.
NYC resident. I had two back-to-back sinus/chest infections in Late December/Early Jan. Worst illnesses I've had in years. Spent almost a month at home. I was healthy for all of four or five days in between.
Coincidentally, I got sick after several of my coworkers/close friends returned from trips to China.
For my anecdote, I got sick for the first time in years with a cold, right around the new year. This happened after we went out to eat at a restaurant in Portland. Our food was late, and someone came and told us that some kitchen workers had called in sick. We ended up waiting almost 2 hours for our food. After eating, my girlfriend and I felt sick within a day. It was fairly miserable and lasted about 10 days.
Then a month later, after my roommate returned from a trip to Vancouver, BC, we both became ill. This time it lasted about a week.
Next, about a month and a half later I was feeling unwell for weeks with very different symptoms. I went to urgent care. This turned out to be an episode of diabetic ketoacidosis, and I was diagnosed with adult onset type 1 diabetes.
Pneumonia deaths had an unexpected surge in Italy October 2019.
A lot of people in this thread an to be clutching at the assumption it couldn't possibly have been anywhere else before it was detected. One case in France not spreading is fairly lucky if it's true.
Not so much "clutching at the assumption" as saying "that sounds very unlikely given the genetic tracing we have so far showing the path of the virus".
No they aren't from what I understand. Virtually no one dying from covid19 was considered out of the ordinary for many countries, even well after it was established in Asia.
I've posted this a couple of times, and while based mostly on my own anecdotal experience and basic research (I am not an epidemiologist), it still seems to fit the pattern of evidence gradually coming out.
There were a spike in bacterial pneumonia cases in regional Australian hospitals in the middle of summer prior to the known outbreak. I know of 1/2 dozen people (including myself) who caught some highly contagious non-flu virus and had varying symptoms. One person developed pneumonia but tested negative for both the flu and SARS-CoV-2 at the time - which was how I heard about the spike in hospitalisations.
My pet theory is that someone infected with the milder version was co-infected with the bat originated virus in Wuhan resulting in a highly contagious version that can cause COVID-19.
Whether they worked in the lab or got it from the market is a matter of debate. I'm thinking lab as the market didn't have bats and patient zero didn't go to the market, while the lab did have bats at some point. There was a serious effort to hide the evidence which makes it all the more suspicious.
There was evidence of a human-specific immune response mutation which could indicate it was neither manufactured or required an intermediary host.
What I think we have to be careful of is that the milder version doesn't provide immunity for the more dangerous one.
Anecdote: Metro NYC area. First week of March something weird ripped through my household. Wife lost all sense of taste and smell - complained she couldn't taste my cooking - and had a pretty bad cold. Kids and wife got weird pink eye at the same time with pink rings around their eyes. I was very lethargic during the same period of time and when I would lay down would get waves of chills through my body.
No clue if it was COVID-19, but it was strange. And we're ground zero for it (I work in Manhattan and used to commute every day on public transit).
This is almost exactly what happened in my household. I am also in the NYC metro area. Kids had very mild symptoms, wife lost her sense of smell and I had fever/chills for a few days. I tested positive for covid but thankfully it appears to have been a relatively mild case.
I had the "flu", which started out different than any other sickness I've ever had. Started with a dry cough out of nowhere, and no sore throat/stuffiness, and then the horrible fever set in with an awful cough.
> I wouldn't be surprised if a mild version of the virus had spread throught he world earlier than the current pandemic
or another seasonal infection that is normally benign is going around.
Sars-Cov-2 debilitates linings of the lungs and other organs and the immune system and blood cell oxygen transport efficiency all at once
But if nothing takes advantage of that then nothing happens, and you heal before something does happen.
With HIV we studied it in reverse: we saw people were dying of benign illnesses and then discovered they had been infected with this other virus for a decade. This first exposure to HIV presents itself as a flu/fever until it is sufficiently surpressed by the immune system and takes a decade of iterative mutations to bypass the immune system.
With COVID19 a similar result happens within a week, but we aren't really looking at which bacteria or viruses could have been benign that may also be present.
Not that complicated, just no bandwidth to figure it out yet.
But if you follow this rabbit hole, it could easily suggest that in late fall 2019 there were just few people that had Sars-Cov-2 and they either statistically were not getting exposed to the opportunistic infections, or a seasonal benign opportunistic infection was not running in conjunction that season.
This notion has been vehemently rejected by people over the past month, but it looks like people might be a little more open to it. Maybe the right people will begin to entertain the hypothesis.
Does anyone know if there is currently a source, or if there would be a way to calculate in retrospect, outbreaks in nursing homes? There are hundreds of nursing homes where a sizable portion of the community died in a couple of weeks which is very abnormal.
The only reason I'm confused about stories like the one above or the few about Covid-19 in California in January is that wouldn't we see such data inevitably?
A lot of people have stories about getting the worst sickness of their life in February which I understand but am also skeptical of (with bias probably 10% of the population gets a self-described worst flu of their life every year and Bayesian thinking would suggest almost none of these were Covid). However, it seems like nursing home data would be concrete.
I have a private list of every nursing home / retirement center in the United States. I can not share this, but if someone can propose a way to mesh this with other data, looking for a specific finding I could try it.
One of the standout locations of virus activity for me, and just due to sheer lack of it, is Vegas. It makes no sense how a global city like Vegas who had multiple large scale events during the January/February even into early March time frame, and tons of visitors especially for the Chinese new year...215 reported deaths so far. That number although sad is still remarkably low. In a region of 2.2 million with a not great reputation for health and hospitals to only have a death rate of .01% seems amazing with how NY, and countries like France, Spain and Italy have fared.
Studies like this and I'm sure the many to come make me really wish we had better contact tracing from the get go and hopefully in years to come there can be some better implementations
Look at a map of NO pollution and overlay covid outcomes. It isn't nearly as bad if you have high vitamin D (Vegas) and low NO pollution (mountains only on one side = good).
Is there a study that actually convincingly showed this? Both pollution and infectious disease spread are clearly correlated with population density, so the fact that you see more covid deaths in places with a lot of pollution doesn't mean much unless you statistically control for other effects.
Yes: "an increase of 1 µg/m3 in PM2.5 is associated with an 8% increase in the COVID-19 death rate (95% confidence interval [CI]: 2%, 15%)."
https://projects.iq.harvard.edu/covid-pm
India has hecka pollution and they have low deaths. We can discount their government's ability to register deaths but they can't hide bodies and right now there aren't massive amounts of bodies coming out.
outside of the strip las vegas is pretty sprawled out with a suburban feel. I don't think the virus really is easily transmitted in that environment. indoors isn't that claustrophobic either outside of nightclubs. casinos have a pretty good amount of space. not like a nyc subway.
No. At least not if another anecdote is of any value. The Grand Rapids metro area of Michigan (February and March are quite cold, April and May starts warming) is about 2.2 million as well and there are less than 100 deaths[1]. This is despite being only about 130 miles west of Detroit where infections rage.
[1] counting Kent county and all adjacent counties.
I think so. Graphing death rate by latitude shows tropics and southern latitudes (summer during cov2 outbreak) have substantially lower death rates than up north. My best guess is sun and heat is the cause.
Most people stay in Vegas only for a short time, the casino floors are constantly being cleaned, slot machines are constantly cleaned and inspected, cards and dice are constantly discarded and rotated.
Sure no masks and what may appear crowded is not really that, high ceilings, powerful HVAC heat exchange systems which bring air from the outside and overall low population density in the urban areas make Vegas seem actually a pretty safe place compared to say packed motels during Gra or Spring Break.
P.S. on an anecdotal note about 6-7 years ago after BH USA I’ve personally witnessed a person that was all sweaty and coughing like they are about to die being escorted by security of the floor after about 15-20min of being around the tables.
While I don’t have any sources on to confirm this policy, it really wouldn’t surprise me if casino security monitors people who seem to be ill if nothing else than to avoid the optics of having medics on the casino floor.
I remember being delighted at how 'spacious' walking around Vegas felt the first time I went. Malls were wide and walking through shopping areas never felt cramped like it often does here in Australia. I was really surprised; it didn't feel at all like I was expecting it to.
> No universal healthcare so billing data is available
In many universal healthcare systems there is still clear divison between healthcare providers (doctors and hospitals) and payers (public health insurance), so billing data are also available.
It seems like the US is committing the biggest lie right now by not testing for covid19. Before that one can remember the administration lying about weapons of mass destructing to get in a war. Need more?
A little tin-foily, but I went to Vegas with my family in late December. About 2 weeks after we got back, my dad had a severe case of the flu (so far as we know) and so did my cousin's girlfriend. They were both showing symptoms similar to Covid-19, but because testing was not available then, it's hard to say for sure. And it was flu season then.
My kids in Idaho (that had visited Southern Utah not too far from Vegas) and all the symptoms of COVID-19 back in November. I guess quite a few people did. They were tested for flu and it came back negative, but breathing was hard. Guess we’ll never know.
Hopefully with the roll out of reliable antibody tests we can get the answers to these "mysterious flus" that lot of people anecdotally have. For me at least it would mentally comforting to know if the "flu" that I contracted after traveling to NOLA for Mardi Gras was in fact SARS-CoV-2.
SARS-CoV-2 is the virus. covid-19 is the disease caused by SARS-CoV-2. There are a few permutations of case, dashes etc.
My wife presented with symptoms quite similar to covid-19 to A&E (UK: A&E ~= ER) after a cruise we went on in late November. She has never smoked but she did get quite breathless and shook it off after about a week. As you say, there are a lot of anecdotes.
A decent antibody test would be nice but at the moment we don't know enough about how the bloody thing works. Even if you have detectable antibodies after an infection, does that mean you have any immunity to another infection and if so, for how long?
My money is on this thing turning into another 'flu after about five years. It will stop killing large numbers of people and evolve into a sort of status quo, just like the seasonal 'flus. It will still be a killer but not quite so aggressive as it is now. It is not as aggressive a killer as Ebola but it spreads far easier. Evolution will ensure that it will find a "happy" medium where it can carry on spreading but we don't still feel the need to eradicate it because we can live with the consequences of the adjusted version.
My language in the above para is a bit off but the sentiment is the same. We happily jump into cars every day (not so much now) and kill ourselves and others in pretty large numbers across the world but that is judged an acceptable risk. covid-19 will simply become another one eventually. For now, it is a right old shit show and we do not understand the enemy at all well. We do not know how to live with it.
"Evolution", evolution takes multiple generations, we won't "evolve" to deal with that anytime soon. There's no reason it will be less of a killer for people that get infected. What we can do is as you say, for now, learn to live with it, and hope for a vaccine.
They mean the virus itself. Viruses that are too lethal can't spread as effectively because they cripple the host and are easily detected. This creates selective pressure for viruses which mutate to be less lethal to spread more widely. If the less lethal virus confers immunity to the more lethal version then the lethal version is likely to die off, or at least become less prominent.
This is not a message that any politician can ever espouse. It is sadly the way of things.
I suspect that the next novel coronavirus will meet with quite a lot of resistance. It seems we screwed the pooch/jumped the shark/fucked up ... with SARS which was our last warning apart from Bird flu (H5N1) and the other horrendous epidemics and pandemics across the years.
It's a bit embarrassing to have several world class virus killer orgs here in the UK and yet we are only deploying them properly fairly recently. You Yanks can stop sniggering at the back - you've screwed up in the same way we have. It is of course not that simple and we are all unprepared for this. It will be different next time and there will be a next time. All countries are changing visibly with their response to this thing. It is remarkable and quite humbling. Keep your eyes peeled and your brain on point and observe. We will never see the like again in our lifetimes (I hope)
My take away is that we need to get all our govts onboard with real risk assessment.
That's a bullshit line by incompetent politicians who deliberately dismantled the very systems that were put in place to deal with this.
As for warnings: By end of December, the epi community knew something was up. By mid January, there was a pretty loud clamor that we need to address this.By end of January, Covid was a regular occurrence in the intelligence briefing for the president, and the warnings weren't exactly ambiguous. By mid February, anybody who was paying actual attention was preparing one way or another.
As for warning the general public: Bill Gates did a whole song and dance on a TED stage. We had SARS, and Mers, and swine flu.
So, no, we are not "all unprepared". Many closed their eyes and pretended wishing extra-hard makes science go away.
And yes, there's a good chance we'll see another one in our lifetime. As we encroach more and more on animal habitats, it's pretty inevitable. (That, too, is a thing people have been warning about for decades)
Well put. A lot of people miss this fact. Also, the US/UK trying to pin the blame for their own incompetence on China suggests that reality attachment in these places, at the government level at any rate, is seriously sub-optimal.
In the US, the Trump administration’s bungling incompetence handling of the outbreak is truly staggering. Wildly contradictory statements from moment to the next, no coordinated pandemic plan, “hijacking” PPE shipments enroute from China and Malaysia to the countries that had bought, and paid for, them...this is rogue/failed state level stuff.
Other western countries also messed up big time. In Canada, France, the UK and Spain people in longterm care homes were abandoned and left wallowing in their own filth as COVID-19 burned through these facilities like wildfire, killing scores of elderly inpatients, many of whom were left to suffer and die alone.
It’s striking how some of the most “advanced” countries utterly failed to prepare for and manage a very foreseeable pandemic.
Then again, is it really that surprising that this happened in places where health care systems have been chronically underfunded for decades as permanent homeless camps have become normalized and the middle-class economy replaced by low-wage precarity and easy credit?
It’s like after four decades of “there is no such thing as society” governance the health and well-being of people, of the public, in these places has become an afterthought.
The scramble to blame other countries or pretend that “there is nothing we could have done to prepare for this” is theatre designed to deflect attention from the fact that dictatorships, like China, and places with authoritarian governments, like Singapore and South Korea, care more for the health of their citizens than many of the western liberal democracies, where austerity and massive neglect of public services and infrastructure have become the norm.
Like the market crash of 2008, the coronavirus outbreak of 2020 is showing that the social and economic system underpinning the west is seriously broken and can’t handle even the slightest amount of stress.
It needs to be replaced with an arrangement that reins in the ability of the avaricious banker and CEO class to dictate how the economy should be run. The health and well-being of all people in society needs to come first or these places will degrade even further.
Almost 100% agree, except for the part tying this to form of governance. Democracies can handle this well (see NZ), and authoritarian places definitely fail (see Singapore now, and I'd argue Brazil and US are more authoritarian than democratic, too)
It does highlight that highly individualistic societies struggle more than places that put a higher value on collective wellbeing.
Does lethality after the contagious period matter? Doesn't seem that there would be any selective pressure if the host (and its extant, too lethal viruses) perishes...
No, it wouldn't. I'm not an expert in epidemiology, so take what I'm about to say as speculation.
My understanding is that viruses typically cause symptoms because they cause the virus to spread, things like coughing spread the virus. If a virus induces too strong of a reaction then the host dies or can't function while they have it and it doesn't spread.
It's probably unlikely for a virus to develop an infectious period where the symptoms are mild but strong enough to spread and then shift phases to become lethal, as a virus has no coordination between itself.
I think typically viruses are either in an asymptomatic phase, where they're less likely to spread and don't cause symptoms (because they haven't replicated much), and a symptomatic phase where spreading is more likely but obvious the person has it.
As a last bit, my understanding is that "novel" viruses, such as this novel coronavirus, are particularly concerning when they cross over from a non human host and become infectious because they haven't developed to have mild symptoms that are amenable to spreading well, and so can be more deadly than viruses that evolved alongside or within the human population.
The evolutionary pressure you're talking about isn't a given.
The Influenza causing the Spanish flu became deadlier in the second wave, it then evolved to be milder in the third wave, however, still more dangerous than in the first wave.
The evolutionary pressure is for reproduction, and if other factors facilitate reproduction, like a large window during which the infected are asymptomatic but contagious, or maybe airborne transmission, then the virus can very well be deadly.
It appears SARS-Cov-2 is very well adapted given how contagious it is. Personally I fear a more dangerous second wave in autumn or next year.
It seems to me a long enough contagious incubation period makes the severity of the illness moot from an adaptability standpoint. What's the selective pressure against killing for a virus that spreads easily for days to weeks before it makes someone ill and then takes days to weeks more yet to kill?
[It gets on my tits when people downvote a reasoned opinion - jeromegv is having a chat with me and a lot of other people. He is not being rude or offensive, just having a chat and espousing an opinion]
I didn't mean we will evolve. The virus will be doing the evolving. We live for years, this virus "lives" for days.
We already know that SARS-COV-1 IGG antibodies last ~3 years [1]. FWIW antibodies doesn't prevent you from getting sick- there's plenty of studies for the influenza vaccine that show it helps with severity of disease as well in some individuals [2]. I would much rather have a "really bad cold" again then get full COVID-19. Bigger questions around viral shedding after having immunity, but I would almost certainly imagine much less.
> We already know that SARS-COV-1 IGG antibodies last ~3 years
As far as I'm aware, this does not tell us that it'll be the same for SARS-CoV-2. Maybe it makes it more likely, but that's not the same as knowing for sure.
There's loads of reports like yours from LA too, if you get tested for antibodies I would not be surprised if you tested positive. You might well have been an asymptomatic carrier.
With all respect, that's terrible analysis. The epidemiology is really clear that the start of the US epidemics was around January. It's not impossible that there were people with the disease early, but we know with absolute certainty that this number was very, very small. Because if it weren't, we'd see it in incontrovertible evidence like the death curves, and we don't.
People who were sick in December (I mean, be real: a lot of people were sick in December!) are overwhelmingly more likely to have had the flu than a disease that even in Wuhan was at just a few thousand cases at most.
1) flu symptoms aren't the same as covid19 symptoms
2) most tests come back negative, despite generally being limited to people with symptoms
3) other coronaviruses have similar symptoms.
It's really very unlikely that any of you had covid 19 in Las Vegas in late December.
> It's really very unlikely that any of you had covid 19 in Las Vegas in late December.
I think this needs to be repeated more often. Everyone who had a sniffle in the last 6 months thinks they had COVID-19. There are always a lot of different diseases going around in the winter.
That's why they don't think they had it, but are wondering if they could have. You are reading things into other peoples statements and dismissing them because of your own mistake.
Because it wasn't going around Las Vegas? Which we know because people haven't been tested for it? And so he shouldn't get tested to see if what he had was covid?
No, he shouldn't. What would be the point? We don't even know if having had it grants future immunity.
But beyond that, this trend I've seen of people thinking they had it because they had the sniffles is dangerous if it makes them think they're now somehow safe.
If we learn that people who've had it have resistance then we should all get tested, capacity allowing.
Having had a cold at some point is almost irrelevant, because it seems that most carriers are asymptomatic, and that most people with mild covid19-like symptoms don't actually have it. The predictive value really isn't that high.
There were a lot of nasty viruses going around that are easily mistaken for Covid-19. I've had two viruses this winter that lasted a very long time. Most likely neither were Covid-19, even though one lasted a very long time and made me very sick.
I live in Vegas, I'm pretty sure it swept through a few months ago. Before people were testing for it. We had deaths from people testing negative for the Flu and everyone I knew got sick in about a 2 week period (we are <40).
Calling Vegas a "global city" is a bit of a stretch. It's more like a weird theme park surrounded by a whole lot of suburban sprawl. NYC is something like 17x more dense.
Maybe in terms of average density but that's not what matters. In Vegas, the vast majority of people are packed near the strip and density there is much higher than the average for the metro area.
Look ragona not everything is about new York and now matter how much you (personally) shave your head and wear black clothes all day, it still won't be about NYC.
However, fuel your brain with these bits: if lots of transmissions happened in Vegas then they likely counted against another states numbers when those folks went home.
I guess what happens in Vegas doesn't stay in Vegas.
Wait, I actually DO shave my head and wear black clothes all day. Maybe I should visit NYC, I've... actually never been. And yeah, I really wonder how many transmissions were marked in other locations but picked up in Vegas.
I was there in January for Lunar New Year. I came down with something mild there and was super worried it was Covid-19, even though it was barely on any american's radar back then.
I play a lot of table games, and casino chips are pretty disgusting in the best of time. I Immediately washed my hands every time I left the table.
Any smart casino employee is very careful about not touching their faces and washing their hands thoroughly after each shift, with all the shared surfaces that they work with. I would guess that their immune systems are already primed from their average exposure levels. Maybe it's the dryness?
I was in Vegas end of January(actually heard about Kobe's helicopter crash there). I remember it was a blip on the radar at the time, but people were still thinking that it was localized to China. While they do keep casinos pretty clean, there is still just a lot of hand to machine contact and not to mention higher than average smoking(raising your dirty hand to your mouth). It is a pretty phenomenally low number. I wonder, though if its low because of the transient nature of people in Vegas. They could have gone to vegas and gotten sick long after returning home.
Yes, CES is the biggest consumer electronics trade show in the world, and it was held in early January. Lots of Asian companies presented there, or were there to make deals. It was Jan 7-10 this year, just before travel restrictions went into effect.
Many big BIG international conventions take place in Vegas. If there's an industry for it, they probably have a convention in Vegas. It makes sense for Vegas the city to incentivise cheap flights/hotels, which makes it more appealing for business groups to meet there. And of course come spend money in the casinos and restaurants after a hard days work of conferencing! I know a few people that went to Vegas just to party for a long weekend etc. But the vast majority of people I know that went to Vegas, went "for work". Also yes, CES is a big deal.
> It makes no sense how a global city like Vegas who had multiple large scale events during the January/February even into early March time frame, and tons of visitors especially for the Chinese new year...215 reported deaths so far. That number although sad is still remarkably low.
Perhaps a lot of those visitors left the area before symptoms developed.
Right, 7-14 day incubation period. I'm sure there are people who decide to spend 2+ weeks in Vegas but mostly what I hear about are long weekends, or a two day stop as part of a bigger holiday.
But, if it became endemic in Vegas it would start to infect locals. The blackjack dealer and the waitress and the floor manager are still there after you come home.
The low number of infections in Vegas could be due to the weather. Vegas has a pretty warm and dry climate. It's possible the virus does not transmit as easily in this type of weather. Would be interesting to know to know if anyone is studying the effects, if any, climate has on the transmission of the virus.
Agree with you, that has been true. There could be something unique about this one though maybe. Instead of transmission it could be it just thrives better in one climate vs. another. It’s also very possible that climate isn’t playing or is having a very limited role as well.
I have a theory: From reading a bunch of case studies, it seems that the main route of transmission is microdroplets hanging in the air. A huge majority of transmission comes from being near someone for an extended period of time (30 min or so) indoors.
Since smoking is allowed in most casinos, they have extremely powerful ventilation and air filtration systems, so that their non-smoking customers aren't excessively bothered. If you've been in a Vegas casino and seen someone smoking, you notice that the smoke almost instantly gets sucked into the ceiling. This may dramatically reduce transmission in casinos or other venues that allow smoking.
The initial 15 min rule (for whether you might get infected from close proximity to someone infected) was based on the idea that offices cycle their volume of air every 10 minutes, but casinos that allowing smoking may cycle their air more often.
This was often cited as a reason why everyone on a flight won't catch it, just those in nearby rows.
Vegas also doesn't have a subway system, which was cited as why it spread so rapidly in NY.
Many places that are doing well (esp in Asia) have more extensive subway systems than NYC. However the people there might be more hygienic, or maybe the operators are cleaning more often.
I've seen it plausibly argued that in e.g. Japan, they have a culture of not talking on your phone on the subway, and this substantially reduces transmission.
I think one thing is NY is testing like crazy. They're actually trying to find out just how many people are infected.
Some countries are still trying to avoid testing. Many Japanese hospitals are turning people away from testing unless they have severe symptoms lasting several days, so naturally, numbers look tiny. And let's be frank, China's numbers just shouldn't be believed.
Japan's population is lower than the USA. You're comparing absolute numbers when what you want is per million.
The US doesn't have high quality national excess death data, apparently. That's surprising. Part of the distorted response to this outbreak is because most countries only seem to publish relatively recent excess death data - often only a few years. But when longer term data is examined it shows that there have been plenty of flu seasons with similar death rates. That's why people keep comparing it to the flu.
At a national level the peak in the USA was at 20,000 excess deaths. In 2017 the peak was at about 7,000
Well, not really. If you look at the longer term data for a hard-hit country like the UK, where there are a lot of lockdown-created excess deaths due to excessively underloading the hospitals:
You can see that this outbreak had at the end of April an almost identical number of excess deaths so far this year to 2017, 1999 (which was worse), 1998, 1996 and 1995.
It seems flu care might have got better over time, or perhaps vaccinations had the impact. But so far the impact on COVID on the UK is not much different to disease outbreaks throughout the 1990s.
The UK stats will go up and it'll be worse than any other outbreak for sure, because at this point the population is in a state of fear and avoiding hospitals - even if they don't want to, critical treatments for other diseases have been cancelled to free up space for a surge that never came.
>[...] look at the longer term data for a hard-hit country like the UK, where there are a lot of lockdown-created excess deaths due to excessively underloading the hospitals
What a rubbish site.
Its first argument is that deaths are not worse than 2018, so its not bad. Even though you can see that number of deaths quickly surpasses 2018 in 2-3 weeks and rises a lot higher faster, while it started a lot lower.
It's third argument is even more ridiculous. "Look at this graph showing a strong correlation between lockdown stringency and infection cases, stringent lockdowns increase infections!" is akin to saying people should stop using umbrellas because they increase rain.
(Also that graph is useless because the number of cases is not normalized inhabitants per inhabitants, so its x axis is bad)
According to worldometers stats, NY is at 40 tests per death, while the US average is at 100 tests per death. Spain and Italy are in the vicinity of 75 and even Belgium (hardest hit nation state in Europe) is still managing 55. New York is definitely not "testing like crazy", they are hardly keeping up. Portugal for example is at more than 400 tests/death, Czechia at 1000. Testing like crazy is what Singapore or Australia are doing.
You cannot compare situations in the US to situations in Asia since the populations are so different. In Asian countries people wear masks regularly... in the US the Vice President considered it too emasculating even for a HOSPITAL visit. There are plenty of good things about Americans but some of their worst qualities are a perfect match for disease transmission.
The NYC subway seems to have a pretty unique local microclimate though. I don't know if it's just the lack of regenerative braking or if the close proximity to the iconic steam heating network is also playing a role in this, but compared to most other subway networks, the MTA feels like a living history museum - even if you close your eyes, block your ears and only take in the air. The influence of air heat and moisture on virus spread is quite complicated (evaporation ends some droplet classes, condensation ends others) so it's quite possible that some subway systems are much worse spreaders than others.
> Vegas also doesn't have a subway system, which was cited as why it spread so rapidly in NY.
There's no real evidence to support the thesis that the MTA was a primary vector of spread in NYC. Granular data of infection rate by neighborhood is spotty, but the data that does exist doesn't show any clear trends towards increased infection rates nearer subway lines. And the borough with the highest infection rate is the borough with the least transit ridership, and the borough with the lowest infection rate is that with the highest transit ridership...
I think it’s pretty clear that having a large portion of the city spend an hour a day packed together with 80 or so other people is going to increase transmission from a droplet spread disease.
As opposed to people living packed together in dense apartment blocks? Or working in crowded office blocks? Or spending leisure time in crowded recreational facilities? Or shopping in crowded stories? Or eating in crowded restaurants?
Yes, subways are crowded, but so is everything else in NYC. As for why NYC is doing much worse than other comparably dense cities worldwide, my thesis is that it's a failure at all levels of civic participation (federal, state, local, and even residential and commercial proprietors) to be proactive in counteracting the spread of coronavirus.
Just a quick YouTube search. I’m a life long long New Yorker, I can promise you that’s not the busiest. I can try to find you some video of the 7 line, it’s like that all the way from Grand Central to Main Street Flushing during rush hour.
The thing about the subway is that we all try to hold onto a pole or bar, total vectors for the spread. It’s not just an obvious case of being near each other, we’re forced to touch the same surfaces so we don’t collide every 30 seconds.
The case study covers infections in a 19-story mixed commercial-residential building. First case was reported on March 9, 2020. The office seating diagram provided in the article shows extended (10 min or 1hr not sure), very close proximity spacing physically is the main reason for the spread.
Note that this was a call center so people were sitting and talking without masks on for extended periods.
* On March 9, one day after the first cases were reported, the entire building was closed. Testing was performed almost immediately on 1,143 people (workers, residents and a few visitors) with rapid results available to those affected and the team working to control the situation.
The testing showed that 97 people (8.5% of those occupying the building) were infected. Most of the cases were women in their 30s and almost all (94 of the 97) worked on the 11th floor of the building, in the call center.*
I counted colored seats in the diagram and found 84 people in the call center got infected.
I think NYC got hit particularly hard because of subway cars. Enclosed in nearly airtight space for 10 - 30 minutes at a time.
More people in a single apartment will definitely increase spread. I'm not sure small apartments per se make any difference unless the ventilation is interconnected. I'm not sure how common that is.
I agree that everything is more crowded in NYC, but the only thing I can think of more crowded than a subway car is a nightclub. Estimating from ridership numbers, the average New Yorker rides the subway 15-30 minutes per day. The ceilings aren't even that high, just the number of people per unit volume is incredible.
One of the case studies I saw showed it spreading on a long distance bus between people sitting four rows away from each other.
Rush hour cars have 200+ people in them and essentially no air circulation. Generally you're just inches away from people if you aren't outright touching.
The idea that a subway system like New York's (or even more, London's) is NOT a major vehicle of disease transmission is an extraordinary claim that requires evidence more extraordinary than this.
Living in proximity to a subway line doesn't necessarily mean you spend more time on the subway than people who live further away, nor does it mean that you use the subway more. Subway commuters who can't afford to live close to a subway line probably live further from their workplaces, too, which would mean they spend more time on the subway and have more transfers between lines. Those people may then carry germs back to their neighborhoods.
The subway is a shared space with poor air quality and many hard surfaces that are touched by many people every hour.
The blog post you are "citing" tries to draw conclusions by zip code in a map that is not granular enough to support the claims. You yourself acknowledge this so I'm not sure why you use that blog post as evidence.
Also, Jeff Harris (the MIT professor who wrote the paper with which the blogger disagrees) is a doctor as well as being an economist. That doesn't mean he is infallible, but I wouldn't be so quick to dismiss his thoughts.
Agreed, boroughs with high transit ridership are going to be the big hubs, but very few of the people going through those hubs live in the immediate vicinity of the hub, and the people who do live in that vicinity may not have a lot of direct contact with those commuters. The whole problem with transmission through subway transit is that the people using that transit scatter to all and every corner of the region and beyond. They don't stay concentrated in the immediate vicinity of the transit system.
I use an inner city transit system every day on my usual commute, but the transit system hub I access it from is about 15 miles away from where I live. I use a bus and then a regional train network to get to it, then go into the underground.
Well, the primary reason you'd expect a higher than average rate in Nevada is Casinos. Without that, Vegas would have an average rate - plus, is Casinos are the main social outlet, those who don't go to Casinos might not go anywhere and be less likely to get the virus.
My Vegas-resident brother-in-law loved counting cards and betting on unpopular baseball teams, both of which involved entering casinos. Perhaps data is better than our two anecdotes?
Google mobility reports[1] show workplaces down 55% and retail and recreation down 47% for Clark County, Nevada (where Las Vegas is), and both dropped very quickly from March 13.
I mean, HVAC systems are supposed to remain usable for 20+ years, it's not really something you can throw on a production line in a matter of days. Most likely, someone already is working on such a system.
They already exist, i saw a video on hvac systems used in a moroccan pop-up hospital, air coming in or leaving the building goes through filtration and then through a désinfection machine. They didn't explain the method used though.
Hospitals have had such systems for decades: Negative pressure rooms make sure that the bad air goes out through an exhaust that you can clean or at least keep well away from people. Some cars have HEPA filters, and airplanes often have more sophisticated systems than that.
I heard a crazy theory from some foreign tourists visiting Vegas many years ago.
The story I heard is that Vegas hotels/casinos mix in small amount of certain gas/chemical in the circulating air that makes people not want to sleep, which makes people gamble more and spend more money.
Some crazy theories people have...
So I can see (as a non-expert) that the well ventilated casinos is the reason for low infection rate in Vegas.
NYC on the other hand has had the extremely highly infection rate because EVERYONE has to take subway and pretty sure there's not much air circulation in the subway cars...
Either way, I think not spending too much time indoors is the key to avoid covid-19. Unfortunately most all indoor space has recirculated, air-conditioned, stale air.
Edit:
I personally think businesses that can leave windows open for fresh air will have lower chance of spreading Covid-19 than ones with barely functioning AC system with little air circulation.
It’s probable that very few of the people who got sick in Vegas stayed in Vegas; a huge percentage of the people in Vegas on a regular day are short term vacationers.
I know a bunch of people who went to RSA in Vegas that got a mysterious flu that was extremely similar to Covid. Given the Vegas mayor's recent publicity it wouldn't surprise me that Vegas was fudging the numbers.
Most people who work in customer facing roles in Vegas are already extremely paranoid and careful about hygiene. Gloves, constant cleaning of commonly touched surfaces, etc. Being a low level casino/hotel employee teaches you very quickly that humans are just sentient germ dispersal machines.
Also, people with the flu probably wait to get home to seek care, so Vegas may only be able to account for its own population, and any severe cases that couldn't travel home first.
Funny that you mention Vegas: I actually think I got it there (in the airport) on the 21st of February. I went to California for a meeting on that week, and took a flight back to Mexico City, with a 6 hour airport scale in Las Vegas.
My flight was delayed, so I was in the airpot for about 8 hours. I decided to walk a lot during my time at the airport (I do that when I have long flights), so I walked about 20,000 steps in total back and forth in the waiting hall.
About one week later (beginning of March), I started with symptoms and since then it has been a nightmare from which I still haven't completely recovered.
Really it makes great sense to me. The casinos are a world of their own. Hardly any Las Vegas natives go there. Honestly, given my brief time spent with someone actually from Las Vegas, I'd say the invisible wall between the Strip and the rest of the city is probably as good a deterrent as many international borders.
Also, there's a chance your stats are being thrown off by the fact that Las Vegas the city doesn't have very many world-class casinos. All the popular areas are actually in unincorporated Clark county, in an unincorporated community known as Paradise, NV. Make sure you include those.
The most important information: Some old samples analyzed for SARS-CoV-2 in April, finding one positive who spent two nights in hospital from Dec 27, after admitted as emergency:
"taken from a 42 years old. ... One of his child presented with ILI prior to the onset of his symptoms. His medical history consisted in asthma, type II diabetes mellitus. He presented to the emergency ward on December 27 2019 with hemoptysis, cough, headache and fever, evolving for 4 days" ... "evolution was favorable until discharge on December 29,2019."
One obvious question: if this was already spreading in France by late December 2019, what about all the countries with even more travel to and from China, such as South Korea, Taiwan, Singapore, etc?
Which is apparently after it was spreading within the community in France. Taiwan has substantially more travellers from China than France, as well as direct flights from Wuhan. Based on everything we know so far, the 31st of December was probably too late.
This seems like an important result, but one that we might need to approach with measured confidence.
Of 14 samples, from 124 patients in Dec/Jan, one tested positive for COV by PCR. How well can we bound our uncertainty about false positive in such circumstances?
I don't think we have any statistical tests that will give us any kind of certainty with a 1/14 result.
At best you could assume it fits the expected value (maximum likelihood) of a binomial distribution[0], which gives us a 35% chance that the next sample of 14 such people would have no cases at all.
You're not quite thinking in the right direction. No matter the statistical model a 1/14 result, is absolute evidence against there being no infections at all.
The problem lies with the test itself, which might have an unknown false positive rate. Although in this case we're basically looking at what I understand to be the gold standard in RNA/DNA evidence, combined with matching symptoms.
Also apparently they had 2 separate teams testing the samples using different methodology, so we've got at least a decent amount of confidence that something is going on with that sample, although it doesn't rule out systematic bias.
Yes. It's possible (I can't put a number on how likely) that the sample was mishandled and contamination introduced. Depending at what stage this occurred, this could affect all future tests of the sample. Ideally they are able to follow up with serological tests against the specific patient. While a positive carries no information (might have gotten COVID in the intervening time), a negative would point to some sort of sample contamination.
This isn't a knock against their skill or their competence. Sometimes shit just happens. Certainly if this is true, I'd be very interested in how this changes the nature of our models of the virus.
If it is possible to sequence the sample they would be able to confirm that it came from a very early branch of the genetic tree, rather than one introduced at a much later stage.
Yeah, but for IRB reasons, you may not be able to contact the patient. IMHO I would prefer this (potentially) imperfect short communication being out in the scientific world now than a more perfect communication requiring several more months.
If this turns out to be a false positive from contamination, how many man-month do you estimate will be wasted on making models that don't describe reality before the error is caught?
Certainly a possibility, but I would think that it would very unlikely to contaminate the source sample (usually they're frozen in -80 fridge), and if you have a contaminated work station, then the rest of the samples would likely be return false-positive as well.
The paper provides strong evidence that the test is not a false positive. They show an amplification plot where you can easily see the positive sample and negative sample along with the patient sample. The patient sample starts ramping up after cycle 30 of the PCR amplification process.
They support the COVID-19 diagnosis by looking at the patient's lung CT scan, which "revealed bilateral ground glass opacity in inferior lobes."
"Each cycle of PCR includes steps for template denaturation, primer annealing and primer extension. The initial step denatures the target DNA by heating it to 94°C or higher for 15 seconds to 2 minutes. In the denaturation process, the two intertwined strands of DNA separate from one another, producing the necessary single-stranded DNA template for replication by the thermostable DNA polymerase. In the next step of a cycle, the temperature is reduced to approximately 40–60°C. At this temperature, the oligonucleotide primers can form stable associations (anneal) with the denatured target DNA and serve as primers for the DNA polymerase. This step lasts approximately 15–60 seconds. Finally, the synthesis of new DNA begins as the reaction temperature is raised to the optimum for the DNA polymerase. For most thermostable DNA polymerases, this temperature is in the range of 70–74°C. The extension step lasts approximately 1–2 minutes. The next cycle begins with a return to 94°C for denaturation."
Seems plausible. Wuhan is a very large city by any measure. Every large city of that scale must be exchanging people with all the other large cities, it's simply probability. You also have to figure that there's more virus than we can find, ie each patient found in Wuhan represents a fraction of infection cases. So chances are someone from Wuhan got it and spread it by flying to some other large city.
Estimates for the most recent common ancestor point to mid January for France [0]. Of course these numbers could be wrong. But I suspect the level of surveillance of genomes allows for bioinformaticians to keep a close eye on what the virus is doing in a big picture evolution sense. They do note that while most samples are of `A2` strain virus (only meaningful at genotype level, not at phenotype) there were some samples from different genotype branches. Maybe their analysis finds the date for a later introduction of the virus which is different from the potential cryptic transmission occuring in late Dec?
Note that their "slow molecular clock" estimate gives a most recent common ancestor around the end of December. They reject this because it "finds a root which seems very early given the data". It's also, of course, possible that this particular cluster died out entirely, got genetically bottlenecked, or only ended up causing a small proportion of cases just through random chance.
They talk about potential false negative, but should have talked about potential false positive from sample cross contamination, because this isolated case seems in contradiction from everything we know about the french contamination history, a researcher that follow closely the phylogeny of the virus seems very dubious about that one. Now we need a sequence of the genome and serological test of the patient, the family and co-workers.
Also this is not the first hospital to do that in France, IHU Méditerannée Infection, from Raoult and Chloroquine fame did that at the beginning of the epidemic in China, they tested 2500 samples from several month ago and found absolutely nothing.
French contamination history? I'm sure the French have modern microbiology and virology techniques...
That said, I do agree that a seismological test of the patient would be more definitive, but sometimes you cannot contact the patient due to privacy concerns/ IRB rules. I don't know how French hospitals deal with patient data, but if it's anything like America, you are highly unlikely to be able to do those sort of things without additional approval.
I suspect they propose to detonate lots of small explosions at regular time intervals and at regular spacings on the surface of the patient, and then measure the responses using seismographs attached elsewhere to the patient, like what the oil companies do to produce maps of subsurface geology.
A microbiology researcher I know (one who is a former resident of France, no less) informs me that cross-contamination is a real risk, and that when it comes to tests involving PCR the level of paranoia involved to guard against this is not trivial.
It is not. An article from last month put the first case found by contact tracers to the beginning of January, at least two weeks before the first official "imported case". Sad that the full report hasn't been published:
Paywalled: https://www.lemonde.fr/societe/article/2020/04/08/coronaviru...
I would really like to see them confirm this case with antibody testing.
Even with antibody testing, it would still be possible that the sample from December was a false positive, and the patient later contracted CoVID-19 and developed antibodies, but it would increase the certainty a great deal. If the person has antibodies and does not report having had an additional bout of CoVID-19-like symptoms after the initial disease, then this would be much more certain.
I'm sure this they case most everywhere where international travel is widespread. If the virus started spreading in China in November, then it most likely spread to most major international cities in December.
I was in Paris in November and saw nothing, but I was back in late January and I saw Asian people wearing masks in the airport and had the following thoughts:
- Airborne
- 8+ daily flights between Paris and Algiers on one company (8 others)
- It's a matter of days if it's not already in Algiers.
Went back to Algiers. I canceled meetings in Paris for February. Algeria had its first confirmed case on 25 February 2020 - an Italian national coming back from Italy, and no airport measures whatsoever at the time -.
We established work from home for some teammates - who take public transportation - a few days later while we learn more about this as the risk/reward of not doing it was high and we transitioned to exclusively remote for everyone when it hit 17 confirmed cases in the country 4 March.
I looked at putative drug-related adverse event case reports submitted to the US FDA. Interestingly, there are 61 case reports that mention drugs used to treat "corona virus infection." 52 of those cases were filed in 2020.
Oddly, 6 cases involved drugs used to treat "corona virus infection" in 2019 (all submitted in the US). My speculation was that those 6 cases were unrelated to SARS-CoV-2, but you never know.
Well, the current virus is a type of coronavirus, old fashioned SARS and MERS are also caused by coronaviruses. They are so named because they have a crown (corona) shape.
I wouldn’t put much weight on this. They looked at about 15 stored samples (actually 80 depending how you count) and got one positive. As far as I can tell that forms the entire factual evidence. Contamination/false positive works out to be a large concern. Clearly they wanted the result as well.
No, that’s not the only evidence. The patient also presented with the relevant set of symptoms:
“ He presented to the emergency ward on December 27 2019 with hemoptysis, cough, headache and fever, evolving for 4 days. Initial examination was unremarkable and the performed CT scan revealed bilateral ground glass opacity in inferior lobes”
The patient presented with the exact symptoms of the virus, tested negative for other diseases that cause similar symptoms, and had two separate labs report the sample as positive for Covid. I'd say it's far more likely than not that this patient actually did have the virus. December 27th is not even a farfetched date to get the virus given that it was reportedly spreading in China in late November.
> Clearly they wanted the result as well.
Based on what? If anything, I'd say it's clear you don't want the result.
Dec 2017 - 93% of class C cases were infectious diarrhea, influenza, foot and mouth disease.
Dec 2018 - 93% of class C cases were infectious diarrhea, influenza, foot and mouth disease.
Dec 2019 - 98% of class C cases were infectious diarrhea, influenza, foot and mouth disease.
Dec 2017 - 10 deaths were class C
Dec 2018 - 16 deaths were class C
Dec 2019 - 18 deaths were class C
Maybe they've been misclassifying COVID-19 as influenza or this has to do with their misreporting.
> Maybe they've been misclassifying COVID-19 as influenza or this has to do with their misreporting.
We know that most countries have made this mistake, even if their intentions are good.
We know that every authoritarian nation has intentionally misrepresented Covid cases in extreme ways. Russia for example was aggressively lying about their cases, claiming hospitalizations were pneumonia early on and not Covid. Eventually Russia was unable to maintain the lies, which is what happened in China's case as well (the lie gets overwhelmed).
Back in early January The Wall Street Journal caught China lying about Covid deaths, they were putting pneumonia on the death certificates when they knew it was Covid.
No, that's just how flu season works. The numbers in the US are also higher this year, and it normally ranges within a factor of ~4 from year to year depending on the dominant strains in circulation. [0] It's completely implausible that there were a million cases of COVID-19 in December.
I am out of China at the moment, but I can say from Chinese media buzz is that it is now almost certain that China's SARS numbers already passed hundreds by early-mid November.
It appears that by late November, the government first took a notice of the outbreak, and by early December it was already a complete freak out.
How the government knew? China has built a nationwide electronic infectious disease reporting system after the first SARS outbreak with specific intent of spotting SARS recurrence. Hospitals in China are required by law to report anything with a remote semblance of SARS into the system. China also holds nationwide drills for infectious disease specialists annually with SARS comeback in mind.
Any claim that China was caught unprepared are hard to believe.
Given that first reliably confirmed info on Beijing dispatching orders to provincial governments on handling a "disaster" also comes onto first days of December, it seems very, very likely to me that they already knew of it being SARS in December.
I also heard of what I have no ability to confirm, like the talk of huge pileups at HK border crossings in first days of December, and a spike of private jet departures.
SCMP is itself source refer to a third party source. Caixin had a deleted report with about the same message. A few other apparently refer to the same blurry pics with a document saying something about SARS that were going around in Wechat groups in first week of January.
The first "something is going on" signal I remember was an article on aboluowang in the last week of December, where they cite a report of major mobilisation in provincial governments, and preparation for "medical emergency" starting first days of December.
Google doesn't give me any result if I search "?? ??" (Wuhan Pneumonia) prior to December 30. December 30 was definitively the first time it appeared on the news, and when it did, it quickly became the top news in about a week.
Why would media in China be publishing articles including that term before December 30; and what does not seeing those articles say about the parent post?
Do you think Chinese politicians are superhuman who know things before anyone report on them?
Xi Jinping had no problem locking down cities after he learned the severity of it. It's ludicrous to think he knew it in December but somehow decided it was a good idea to wait till it spread to the whole country to do it.
I mean, surely given how embarrassing it has been for PRC, I wouldn't expect ?? to be excited to publish it for the public and the world to see. And yes, in China especially I expect the party to know about bad news, particularly bad news generated at state institutions, before the media is permitted to report on it, and I expect that reporting to be partial if it ever comes.
In fact, I am suspicious of anyone who knows anything about this and claims otherwise.
- He had no problems locking down cities after the severity became known. Is fairly Reasonable to think that in the beginning they thought it was something they could keep quiet and it would go away
- people in China don’t report things that might be negative for fear of consequences, he is creating a situation where he doesn’t get to know things before it’s too late this way
No, number of cases is a bad metric. Deaths is far more accurate. I don't trust their numbers, but if you assume deaths are at least within an order of magnitude, it's clear they did better than any major western country.
Rather than pointing fingers at China we should point at our own governments and ask how with months of warning watching this unfold in China, we were caught completely unprepared and on the back foot? Every single country. It's a truly shameful performance that has cost us big time in deaths and lost economic output.
I don’t trust deaths as well coming from China. There has been some interesting research into sudden changes in number of mobile subscribers in China suggesting it was much, much worse.
Although it has been bad, parts of Europe has not been that bad. Germany, Norway, Denmark and maybe others have had very low numbers of deaths with much less impact on the population than China. Also of course New Zealand have done very well.
Sure we should ask our governments to do more, but this issue is because of China. They create the conditions for Coronaviruses and they are extremely unhelpful in fighting them.
I remember the mobile subscriber numbers, but it doesn't look like any other data points have corroborated that story (no changes in electric bills, other utilites, etc.)
Plus the China numbers match Italy and elsewhere. I doubt their real numbers are that much off from their official released numbers. If they were, we'd see it around the world by now.
In the end, western countries are indeed responsible for their own well being, but China did everything they can to block information from going out.
To know the true severity of the virus, you had to rely on leaked information. Doctors were silenced and journalists arrested, and social media censored.
Taiwan sent their own researchers in December, when only rumors were out. This is what western countries should have done.
> To know the true severity of the virus, you had to rely on leaked information. Doctors were silenced and journalists arrested, and social media censored.
I'm not trying to resort to hyperbole to make my point, but how is this not considered Biological Warfare by the CCP?
I'm being sincere, whether deliberate or by accident they ended up using their citizens as a (possible) vector of infection in Hong Kong--a country they have had ongoing political strife and used overt violence against--while maintaining and withholding information of its infectious nature to the rest of the World, and censoring or outright disappear'ing Citizen journalists or Physicians on the mainland who tried to share that information in the process. Which then overwhelmed Hong Kong's medical system by keeping the borders open, despite local opposition from the medical professionals as well as the Citizenry for reasons only Lam's administration could rationalize, one that risked the lives of the over worked medical professionals who were just trying to cope [4] with the influx of patients.
All while censoring the Internet for possible related incidents for those who tried to research the topic on their own
Even now Xi/CCP are trying to stonewall the investigation [1] and even threatening Australia with a boycott [2] for their calls for the probe.
And now with the findings of the Five Eyes dossier [3], which has to be approached and treated with a healthy level of skepticism, it is coinciding with the events the CCP took and has taken in the past to curtail anything it deems undesirable.
If anything this underscores why a Free Internet, uncesonrable by any Nation-State(s) is a matter of Life or Death and should be taken as serious as any other critical form of infrastructure and move away form its current monetized Panopticon model at all costs. And I'm not just referring to the one behind the Great Firewall, either.
> In early February China and the WHO was criticising countries for imposing travel restrictions
Because the WHO does not generally condone travel restrictions. Based on research on influenza pandemics, the WHO (and much of the epidemiology community) believe that travel restrictions are largely ineffective at stopping highly contagious, airborne diseases like influenza (and now CoVID-19).
Beyond that, the entire framework of international health cooperation is set up to discourage travel restrictions. The International Health Regulations of 2005 state that any travel restrictions must be explicitly justified with scientific evidence, and periodically reviewed, and should be negotiated with the country that is on the receiving end of the restrictions.
> China did everything they can to block information from going out.
Except for issuing an official alert within days of discovering the first cases, releasing the genome, and stating that person-to-person transmission was a possibility. Even if one missed all that, shutting down a province of over 50 million people should have been a massive giveaway.
That is based on China's own numbers. I have been following this since early januari and there are leaked videos of corpses in hospital hallways and body bags stacked like garbage in vans, while officially there were only "hundreds of deaths". No one believed the official numbers at that time.
I think hundreds is a very low estimate. It seems not that it spread from China to Italy and France late last year and that seems unlikely but not impossible if only hundreds Chinese people had the virus.
If you had the correct source you'd know the reporting system about pneumonia of unknown etiology you mentioned was not put into use until mid-January much to the disappointment of the official who boasted about it.
On 10/18/2019 US held a pandemic simulation that happened to focus on coronavirus (the director of Chinese CDC was also involved): "That center's latest pandemic simulation, Event 201, dropped participants right in the midst of an uncontrolled coronavirus outbreak that was spreading like wildfire out of South America to wreak worldwide havoc. As fictional newscasters from "GNN" narrated, the immune-resistant virus (nicknamed CAPS) was crippling trade and travel, sending the global economy into freefall. Social media was rampant with rumors and misinformation, governments were collapsing, and citizens were revolting." https://hub.jhu.edu/2019/11/06/event-201-health-security/
Presumably Chinese government holds such events regularly to test preparedness as well. They could be easily confused with prescience if there is not enough transparency about such things.
A slight variant from that is some academics looked at keywords trending on WeChat search, a bit like google trends, and the earliest was the Chinese term for SARS which started trending on 1 Dec 19.
The term for "Novel Coronavirus" started trending on Dec 11th
So that suggests they noticed people getting sick around the 1st and had identified the virus by the 11th.
Say case zero was on Nov 1 and it doubled every 3 days then there I guess there would be about 1000 infected by Dec 1st and maybe 5 or 10 seriously ill. (guessing it takes 12 days to get seriously ill and maybe 5% of those infected). I think epidemiologists actually estimated it started about Nov 10th.
I was in France in December/January, flied back to SF then to NYC for Real World Crypto 2020. I felt sick after flying back from France, got a really weird flu, similar to H1N1 back then. Flying back from NYC I remember being extremely sick in the plane... I'm convinced this was the coronavirus.
Maybe I was patient 0 for both california and new york :|
I know people in the US who thought they had COVID-19 in late December 2019. Until now the earliest proven cases were in February 2020. Are there any reports earlier than that now?
I work in Times Square, so I'd probably be one of the first to be exposed if anything came to the US early. I had a very weird flu back in late January. It wasn't serious, but I had a cough that wouldn't go away for a week afterwards.
This also just came out. This New Jersey mayor tested positive [1] for coronavirus antibodies. And he says he got sick in November 2019.
Unless, the antibody test gave a false positive, and he did not get the virus. Then, how the hell did an American politician get the virus, before China even noticed it on their radar, and reported it to the W.H.O. in December 2019?
This timeline also seems to coincide with CDC warnings of strange flu and pneumonia patterns late last year, with people having more difficult symptoms than normal.
If you recall getting very sick late last year in 2019, then you should consider taking a coronavirus antibody test, to confirm whether you got the virus or not.
Initially Chinese people treated it as flu, then they freaked out finding it to be SARS-like, and Hong Kong, Taiwan and Singapore set temperature checks. During the SARS outbreak, Asian countries run totally unprotected for months with only thousands of cases, and actually they were relieved to know that the CFR is much lower. But this time, the virus is much contagious.
Actually many in China suspect that maybe a weak version has been around in SE Asia and China for years (remember that Malay pangolin?).
Interesting to see how people deal with this information given that mainstream media has instilled in us that the moral responsibility of the disease lies in China.
> moral responsibility of the disease lies in China
Is there a another opinion on this? It's where the virus originated (Lab created or from eating a bat or even US military doing it - whatever you are opting to believe) in November 2019 and it took them until late Jan 2020 to say that there's human to human transmission despite their own doctors warning and telling the world earlier than that (and they were silenced)
That is patently false. The CDC head was briefed by the Chinese "around New Year's Day" 2020 (https://www.nytimes.com/2020/03/28/us/testing-coronavirus-pa...). By Jan 7, 2020 the CDC had already setup a task force to deal with the COVID threat. I certainly don't want to defend the Chinese government. I'm sure there are a lot of things they did wrong (on top of all the horrendous human rights abuses they commit on a daily basis), but the whole narrative of blaming China for COVID seems like an obvious ploy to shit blame away from our own incompetent response. The fact of the matter is that we saw this coming in slow motion and comprehensively failed to respond in a way that could have prevented this human tragedy.
Even if they knew, if they had themselves been moral and decided to stop all travel, it would've been fair to say we are all responsible. They did not do that. Sure all the countries are at fault too definitely (me, as an Indian, included) but doesnt take away the fact that Chinese authorities downplayed this and led to the spread. No matter how you put it and the moment it had spread world over, stopped flights to China to stop spread.
Sorry, all governments are to blame here, for sure (these deaths cant be justified) but China and to a large extent WHO are in the blame here too. Majorly.
Seems dubious. Everything we know about the phylogenesis of SARS2 points to the origin being China. All RNA sequences that were published have been shown [1] to be mutations of earlier samples from Wuhan. If we would have had community transmission in France in late December, we would see that being a distinct branch in the genealogy. We don't see that, all RNA we've seen being sequenced in Europe is descended from China.
The detail is his wife worked at a supermarket near the main Paris airport, and had often had travellers (inc. from China) coming in, straight off the plane [0]. So one suggestion is she was caught it and was asymptomatic, and he caught it from her.
What happened to the strain of the virus? The previously known first case in France is this one [1]. If there was community transmission in France for a month, we should see different mutations than the ones in China.
To be clear, the claim is if there was earlier community spread, the current virus in France should look different because of presumed mutation rates, because right now it looks similar to China?
I don’t think the current virus would need to look different. For the other first few cases in France a month later, we are relatively sure that they come from China because their RNA has mutations that have nit been there in December. If there would have been transmission in France in December, we would expect to see a strain if the virus without the mutations that happened in China in January (but potentially with different mutations).
This makes me think that either
1. nobody else in France was infected by the spread that they now found to have happened in December, the strain died
2. the findings are wrong
1 seems pretty unlikely. We’ll know once they hopefully sequence and publish the genome of the virus they found.
The french Institut Pasteur has sent to preprint a genetic study which tends to show that the coronavirus was silently spreading in france in february, as as distinct branch from those in other auropen countries. This was sent to preprint before this other study was made public : https://www.sciencedirect.com/science/article/pii/S092485792... .
In this paper, another team looked back at records of patient showing flu-like symptoms before the supposed start of outbreak in France. They discovered by PCR testing archived samples that one of these french patients was positive to SARS-Cov-2 in late december
As somebody living in Europe I find this data very interesting. We had a super strong flu season, which was incredibly contagious. This is the first year (in a decade) that everybody in my family got it. One kid first, then the other, then wife, then grandparents that were babysitting while wife was down. I'm the only one that didn't get it, but I was on travels during that time. Effects were mild on the kids, while the grandparents needed 14 days to recover. Wife lost sense of taste and smell.
I really want to do a serological test for Covid just to see if we might have gone through it in January, when 0 cases were reported in our vicinity (Slovenia, which is next to Italy).
Anecdata, but two people in my office had really persistent coughs in February, lasting multiple weeks, not days. I wonder if that was the Rona. One of the people that had it thinks it might have been.
I can add one data point to support this (not that it is worth much).
I had the normal story of being sick in January in London with the "worst flu ever" and suspected it might have been COVID. But I recently had a lab-based IgG antibody test and it came back negative.
Everyone else in my family was also negative. Also, friends who have family members who work in the NHS with similar stories of being sick were also negative. No one I know directly has tested positive yet.
I can't speak to the overall accuracy of the test, but the one I took was the private IgG antibody offered through the company 'Qured'.
Another random datapoint. I had covid according to a PCR test and it was pretty much a non event - slight sore throat only. I think unless you get the full can't breath thing it's very hard to tell.
We do not have the data to support or refute the original statement. Mostly because the US has a poor understanding of the uniqueness and context of every person's immune system and how it plays a role in new viruses, reactivating old viruses, depleting nutrition required to successfully fight off multiple strains through the winter season, having multiple pathogens at once and a suppressed immune system, etc. This lack of understanding requires a lot more testing of pathogens, T-cells, mast cells, and signaling (cytokines, etc) from a lot of people. It's usually seen as too costly or invasive. Not that this current pandemic has been costly ;-)
In the US Midwest it was very harsh for flu, conjunctivitis, strep, etc. My children both had coughs, fever, ruptured right ear and one had chicken pox style rash (late December). Doctors never tested my son, my daughter tested negative for flu with multi-day symptoms and then positive for flu A (same test) ~10 days later. So there is/was a definite lack of data. Unfortunately, we do not have the samples to go back in time and apply newer tests. Luckily, France had the foresight to preserve some of the samples.
Disease spread tends to always show a pretty standard shape. It was that observation (Farr's law) that led to epidemiology being born as a field. It grows, it peaks, it enters immediate decline. Importantly the peak doesn't last long - epidemics don't spend 6 months with a stable number of people getting sick at the peak. Look at graphs of COVID deaths and cases and you'll see the standard pattern.
We know now that this virus has left hospitals virtually everywhere without overload, even in places like Sweden. A few other places were hit much harder. But the response in New York (with mobile morgues) wasn't reported anywhere else. It's apparently some kind of invention of New York policymakers during a brief peak rather than a worldwide phenomenon.
A virus can be spreading and growing for a long time before it attracts attention. The evidence keeps mounting that the first reports in Wuhan were not in fact the first cases after COVID had mutated or crossed from animals but merely the first where doctors decided to search for a novel virus after coming under pressure and noticing some novel symptoms. What you saw in New York was a mix of:
1. Conditions at the absolute peak of infection, not at the start.
2. Media hype and fake news.
For (2) I present https://nypost.com/2020/04/01/cbs-admits-to-using-footage-fr... as evidence. CNBC spliced video from an ICU in Italy into reports about New York without telling anyone. Outright deliberate deception is also the tip of an iceberg: there's far more selective reporting, exaggerated anecdotes and so on. On April 6th Vox reported the entire USA was running out of sedatives needed for ventilation:
On the same day Gov Cuomo was saying they had enough ventilators with some in reserve. A few days later he was sending them to other parts of the USA.
Whatever you think you know about the situation in New York you really only have a tiny fragment of the whole picture (and the same for me and everyone else posting here). Our understand of reality lies shattered in pieces on the floor, smashed by speed, poor quality data, poor use of data, and extremely poor journalism. All we can do is work to piece together a narrative of what really happened by examining all the evidence we can get. Repeated anecdotes from many different people about having had a COVID-like illness before it was being discussed much are interesting for that reason.
Actually a personal friend who is a doctor on the frontline in Paris saw mobile morgues back in late March.
So I am capable of personally falsifying your statement:
>But the response in New York (with mobile morgues) wasn't reported anywhere else.
I lack a citation but I'm not really trying to prove anything either. I don't think New York is isolated. Lombardy seems to be stricken pretty hard, and it's hard for us to know what it was truly like in Wuhan.
Speaking for Italy: at least part of the high number of deaths might be traced back to hospital infections (such as a massive outbreak in the hospital of Alzano Lombardo, which initially was kept open after a very brief closure) which of course targeted more vulnerable people.
Also nursing care homes make up a significant part of the deaths: some infected patients from elsewhere were put there under the "promise" of keeping them separate from the others, and you can imagine what happened later.
> Importantly the peak doesn't last long - epidemics don't spend 6 months with a stable number of people getting sick at the peak. Look at graphs of COVID deaths and cases and you'll see the standard pattern.
What's interesting is that many US states have shown virtually linear growth for more than a month, which is an extended "peak", assuming it's a peak. That depends on if enough of the population is exposed before the interventions are relaxed, or else it will just revert to its natural progression and the media will have something exciting to report on again.
> What's interesting is that many US states have shown virtually linear growth for more than a month,
The US data is tricky to interpret because the nation's testing rate has been growing relatively slowly. Over the past week (Covid tracking project data), the US has reported about 242k tests/day; for the week ending April 7 (so 4 weeks ago), that number was 144k tests/day.
In the meantime, an extended peak is consistent with the idea that policy measures in place have reduced the R0, but only to a value close to 1. Suppose stay-at-home orders reduce the number of daily contacts by about 70%, taking the R0 from 2.5 to about 0.8. With an infection period of two weeks, that would only reduce the number of new infections per day by 35% after a month.
> Disease spread tends to always show a pretty standard shape. It was that observation (Farr's law) that led to epidemiology being born as a field. It grows, it peaks, it enters immediate decline.
Only without intervention. With social change, the disease's R0 (with respect to a given society) will differ, altering the shape of the epidemic curve.
We can have great confidence that COVID has not gone through a full, "status quo" epidemic curve anywhere.
Take Italy as an example. That nation has conducted (as of May 2, Wikipedia data) 2.11 million tests to find 210k positive cases. That 10% test positivity rate forms a loose upper bound on the prevalence of nCoV in the entire population -- even if we assume that policymakers erred and many infections are asymptomatic, test-selection criteria should not have caused a worse than average chance of detecting a positive case.
In the meantime, Italy documented 28,710 COVID-related deaths as of that date. If we again make the generous assumption that all COVID-related deaths were detected but the true population prevalence was about 10%, that would give the disease an 0.48% IFR. That's far too high for a rapidly-spreading disease to remain hidden for long.
Simultaneously, we can't say that the supposed 10% infection rate is sufficient for herd immunity. If 10% of the population is infected now when the virus was introduced at the end of December, the R0 of the disease must be well above 2 (with a generously short two-week period between infection and recovery -- shorter than many observations -- we've only had 8 generations.) Herd immunity would then require > 50% immunity in the population.
Instead, the much simpler conclusion is that policy responses have worked, with lockdowns and distancing reducing Italy's R number to somewhere around 0.75 (based on a rough look at the number of new cases per day, divided by the number from two weeks ago).
> All we can do is work to piece together a narrative of what really happened by examining all the evidence we can get.
Yes, but we must examine all that evidence in light of what we know of epidemiology. It's far too easy to cherry-pick data that is comforting or aligns with our political predispositions.
> Repeated anecdotes from many different people about having had a COVID-like illness before it was being discussed much are interesting for that reason.
... but the plural of anecdote is not data. Especially for a disease such as COVID, where the range of attributed symptoms is so wide that just about any commonly-circulating cold or flu could -- by symptoms alone -- be attributed to nCoV.
Also, Lombardia and neighbouring regions are still by by far the worst affected. Southern regions are still relatively unscathed. While it is likely that there might be other factors that contributed to the difference, it is at least plausible that lock down was a contributor.
Italy will slowly get out of lock down soon (while still preventing travel across regions). We will see how it goes.
> The UK, France, Spain, and Italy are all countries that have temporary morgues because of covid-19.
Aside due to the fact that there were high number of cases and the skewed death rate towards the elderly, couldn't also this be due to the fact that (at least in Italy) tests are done only if a patient is hospitalized?
I mean, the evidence is so far scant and anecdotal, but the timeline for treatment (I'm aware only remedisivir has been proven to be effective, but protocols also use other drugs, even if the efficacy is unknown) suggests that the earlier the treatment, the more effective it will be.
If only admitted patients are tested, that usually means a lag from symptom onset, which may ultimately be detrimental.
A lot what you said is just factually incorrect as pointed out by others. Those anecdotes will be interesting when they can point out any differentiation from regular seasonal flu (such as bilateral pneumonia etc)
Excess deaths as of today are maybe 50% higher than usual even at the peak, so there is no way we would able to tell that we had an outbreak from excess deaths that early on.
The only way to know would have been to perform tests, which we did not do.
All the antibody studies so far suggested infection numbers that were massively higher than confirmed cases.
Furthermore the PCR tests used for initial diagnosis have high false negative rates and most people with only mild or no symptoms never got tested in the first place.
It is that high now, it would not have been that high early on, especially considering that mortality is most likely closer to 0.5%.
It simply would not have registered among the usual deaths from viral pneumonia, which has a year over year variance of a similar magnitude.
The actual death numbers are also highly dependent on the age groups affected, in Germany for instance there is no discernible excess mortality because most of the infected are below the age of 65.
I want to believe that a bunch of us already had and got over Covid, I really do. I am in northeastern USA and a lot of people around me had this "unusually bad" flu this year. Coworkers, kids, me and family - took us a month to get over it. But, that would mean the disease was super widespread and we couldn't call that period "early on". Based on anecdata and Bayes it means a lot of people had it already in Feb, as many as during peak flu season.
This is why I believe it's just a bad flu after all - the spread pattern matches the usual seasonal flu/cold; and we would have noticed an elevated mortality.
We'll never know because we won't know how the disease would've spread without all these measures.
If we adjust for years of life lost, as opposed to just lives lost, COVID-19 may be less severe than seasonal H1N1 Influenza, which kills a lot of young people. On the other hand, COVID-19 also seems to be far more infectious.
There are several European countries that right now have no discernible excess mortality despite having hundreds of thousands of confirmed cases and thousands of deaths.
Outside of NY/NJ, the excess mortality in the US is within 20% of the normal rate, no different than the variance expected from a bad/mild flu season.
If you were to transpose those cases back to February, what would you have seen in the death statistics? Nothing suspicious at all. There could have been hundreds of thousands of cases that have gone unnoticed, because there wasn't any testing - and that's assuming a mortality rate of over 2%. If the mortality rate is lower than 0.4%, as some studies suggest, it could've been millions of cases.
You do realize we’ve been waiting it out at home since early march here in CA? The only real reason why no of deaths is not through the roof yet. If you divide number of confirmed (!) covid deaths in nyc by total pop it’s already over 0.2%
Edit: actual calc i did is 13k confirmed deaths in nyc / 70% herd immunity magic number of 8.4 mil
Let's look at Germany from that EUROMOMO map. Despite all the measures, they have had over 150k cases and over 6k deaths (a death rate of over 2%), but it doesn't show up on the graph.
All the deaths that have happened in Germany in the past weeks could've happened months earlier and it wouldn't have shown up either.
This disproves the idea that there couldn't have been any mass infections earlier, because we would've seen that from excess deaths. That's the point I am making. The only way to know would've been through testing, but there wasn't any testing then.
Hypothesis: "If there had been mass spread outside of Asia as soon as January or February, we would have been able to tell because of unusually high excess deaths"
Contradicted by: "There are known cases of mass spread that didn't result in unusually high excess deaths"
Therefore, excess death is an insufficient metric to reveal a mass spread of COVID-19 - it could have been spreading undetected.
Whether there have been any measures to limit the spread is irrelevant to that conclusion.
> "There are known cases of mass spread that didn't result in unusually high excess deaths"
You used Germany as an example.
Here's the situation in Germany:
Since 13 March, the pandemic has been managed in the protection stage as per the RKI plan, with German states mandating school and kindergarten closures, postponing academic semesters and prohibiting visits to nursing homes to protect the elderly. Two days later, borders to five neighbouring countries were closed. By 22 March, all regional governments had announced curfews or restrictions in public spaces. Throughout Germany, domestic travelling is only authorised in groups not exceeding two people unless they are from the same household. Some German states imposed further restrictions authorising people to leave their homes only for certain activities including commuting to workplaces, exercising or purchasing groceries.[10]
Tell me, please, how does this support the idea that mass spread without extreme protective measures (as was the case in January or February) can result in no excess death?
> Tell me, please, how does this support the idea that mass spread without extreme protective measures (as was the case in January or February) can result in no excess death?
I'm not saying it can result in "no excess death", I'm saying if there had been mass spread back then, even on the order of hundreds of thousands of cases, it could've gone unnoticed, because the excess death would've been within the seasonal variance.
If there are really 10x as many actual cases as reported - which is what antibody studies suggest - then the virus has either been spreading much faster than we assumed, or has been spreading for longer than we assumed.
The fact that somebody who died in France in December appears to have been infected with COVID-19 strongly suggests that there has been community spread far earlier than we assumed.
> There are several European countries that right now have no discernible excess mortality
This is because there are lags in the data. You need to wait a few more weeks (and for some countries it'll be months) for the data to come in and be reported.
I don't know the extent to which this is true, but even then, we do know the average deaths in previous years and we do know the actual deaths reported and can get an idea of high how the discrepancy could've been.
In the case of Germany, there would be 12,000 weekly deaths on average, versus about 2000 weekly deaths due to COVID-19 at the peak - that is within the variance caused by the seasonal flu. It would not have been a suspicious rise.
> In the case of Germany, there would be 12,000 weekly deaths on average, versus about 2000 weekly deaths due to COVID-19 at the peak - that is within the variance caused by the seasonal flu. It would not have been a suspicious rise.
If you're comparing covid-19 to flu you must count them using the same method, and you're not doing that here. Here, for covid-19 you're using "deaths after confirmed positive" but for flu you're using "all cause mortality". When you use the same method to count covid-19 and flu deaths you see much higher rates of death for covid-19.
> It's very easy to search for this information. Here's one link...
Your claim is that the lack in excess mortality is solely due to lag. Your link doesn't say anything about the extent of the delay regarding countries like Germany.
> If you're comparing covid-19 to flu you must count them using the same method, and you're not doing that here. Here, for covid-19 you're using "deaths after confirmed positive" but for flu you're using "all cause mortality".
The hypothesis is "If there had been mass spread back then, we would've seen it from excess deaths", which implies all-cause mortality. Of course I'm mentioning Influenza because it causes some of the seasonal variance and some of the same symptoms.
> When you use the same method to count covid-19 and flu deaths you see much higher rates of death for covid-19.
Yes, but that's in hindsight. That's not the way you would have looked at the cases at the time.
There are about 20,000 pneumonia deaths per year in Germany where the cause is never determined[1]. That's over 300 per week average, more in the winter years. Now suppose an old person comes in and dies of pneumonia. There's nothing suspicious about this. Suppose a few more come in this year than the last year. Again, nothing suspicious, some flu seasons are worse than others.
I'm not saying there have been 2000 undetected cases of COVID-19 deaths per week in Germany back in January/February, but there could have easily been 100-200.
This data is very interesting. I wonder whether it will bounce below the historical average after the peak (i.e. people dying 3-6 months earlier due to the pandemic).
I'm not native english speaker and I'm wondering if this is the correct use of the word "hardly". I expect that to mean "not" or "almost not". "hardly hit" would mean "hit very little". Or am I confused?
> Excess deaths as of today are maybe 50% higher than usual even at the peak
They're still higher than usual, and so any 'even at the peak' appeal to curves acknowledges that epidemiologists were probably correct and numbers of cases rose very rapidly from near-negligible levels, before slowing due to social distancing measures. If the disease was widespread much earlier, excess hospitalisations and deaths during that period ought to be much higher than they are now with aggressive social distancing having been place for nearly two months. It's not like France has limited access to healthcare or was more likely to chalk a surge of hospital inpatients with severe respiratory symptoms off as something else in late Feb or early March than in late April, when despite lockdown they were much higher...
> It would have been invisible for a long time, spreading uncontrolled.
Except that if it really was 'spreading uncontrolled' and giving everyone 'the worst flu', as opposed to a handful of isolated cases which became more than a handful shortly after people started to panic about it, there wouldn't still be more vastly people being hospitalised for respiratory symptoms weeks after measures were taken to halt the spread than in late February. There might not have been much community testing going on then, but hospitals were certainly keeping records of who was coming in with respiratory problems; the well-established fact that comparatively few people were is strong evidence against the hypothesis it had already become widespread by then.
COVID-19 isn't giving everyone "the worst flu", certainly not to the extent that it requires a hospital visit. Most confirmed cases report mild symptoms. Without the expectation of having contracted COVID-19, getting a cold - even a relatively bad one - would not cause panic.
You're also more likely to develop pneumonia from Influenza than from COVID-19, especially if you're young. If you presented to a doctor oblivious of COVID-19 (or SARS), they would assume it is Influenza.
Some have low specificity, but others aren't that bad. They haven't been tested to the degree that you would like to, but they have been tested. There is a margin of error of course.
It might sound absurd, but here in Ireland everyone in the office got a strong cold early February, including me and my wife. Also my mum back in north Spain and my brother in the Canary Islands got sick as well. It is very interesting the fact that I have never seen my brother sick in some 30 years and we talk almost every day.
I keep hearing this. I also had the worst cold in 10 years easily, this january. My kids were unaffected but me and the wife had 40 deg fevers and muscle pains for days. The whole family took the seasonal flu vaccine (not sure if it was the correct one this year).
What seems to indicate that it wasn't Covid was that at the same time as all of us had that monster flu in january, the hospitals weren't filling up with people who couldn't breathe.
The hospitals are filling up with cases of viral pneumonia every year, at the beginning there would have been nothing to suggest that this was anything more than a bad flu season.
And by late February and early March when medical professionals were hunting for signs of the novel coronavirus and people were about to start being hospitalised and dying in large numbers, there'd be an enormous amount of hospital inpatients with respiratory symptoms to test. We know this wasn't the case until later...
That's a fallacy. At any point in time, there will be patients showing up with viral pneumonia in the hospitals, with some seasonal variance.
For there to be a discernible difference here, you need a "critical mass" of cases. How many such cases are necessary depends on the incidence of severe cases vs non-severe cases, but we do not know the amount of non-severe cases, because we did not test everyone.
Antibody studies suggest that there are 10x as many cases as reported. If that is true, then there could have been hundreds of thousands of cases that went undetected along with some more severe cases that were labeled as "viral pneumonia".
The different rates of infection in different countries may well have more to do with the amount of testing than the actual infection rate.
I think you're either missing or proving an implicit point.
I'll try to explain my reasoning:
- there are lots of ILI
- COVID-19 is a more severe ILI
- more severe ILI requires more hospital resources
- COVID-19 is an infectious disease, more disease, more infections
- depending on how much more severe COVID-19 is set to be, a conclusion can be drawn whether it was more or less likely that you had COVID-19 versus any other ILI based on increased hospital resource usage.
The important thing here is removing the perceived illness severity (i.e. worst flu ever, etc.) from the calculation, because it's highly subjective, as well of being a sample size of one.
The thing that usually happens is that someone writes that they had the worst flu ever, and soon somebody responds with something that they feel is relevant to the post, e.g. "I also had the worst flu ever", these comments often imply the possibility that their "worst flu" was their "COVID-19", which is exponentially less likely the closer to the start of the pandemic you go.
I'll call this phenomenon COVID-19+1 unless there's already a better name for it. And I won't claim immunity to it.
>it wasn't Covid was that at the same time as all of us had that monster flu in january, the hospitals weren't filling up with people who couldn't breathe.
Maybe there is a second actor there teaming with it
Just to provide a counter point: Noone in my family got the flu this winter. I have one friend who got it (and it was bad) but that's the only one i know of.
How do we reconcile this with the known spread rate and lethality? If it was spreading around late December when lot's of people are traveling, seeing family and drinking over Christmas and New Years then where are the mass casualties?
With a doubling time of 3 days and a morality rate of 1% a single person had it December 31st it would have infected a million people by around the end of February, killed approximately 10,000 and 150,000 would have been hospitalized by it.
I've seen a lot of articles about how it may have been spreading earlier but none seem to account for the exponential growth.
I am was on a mission in south-west France at that time and the local pharmacist told me around February she was convinced Covid was there since November 2019... She saw some of her customers having strong cases flu that would not go...
That area (North side of Paris) is interesting and very important, I think.
First that's where CDG airport is. This is the second largest airport in Europe by passenger traffic and the main gateway into Paris for tourists (not least Chinese tourists).
Second, that's where Paris' Gare du Nord is. This is the largest train station in Europe by traffic, where trains from CDG airport arrive, and the start of high speed trains to London, Brussels, Amsterdam.
So to me it's not surprising that this virus arrived there early.
But it also means that the area should be monitored closely, not only by French authorities, but by British ones, etc. as well because any highly contagious disease that shows up there will be around Europe in no time.
I think the bigger question is, let's say it did arrive much earlier that we think, does that mean the virus grows at a much smaller rate than current models?
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