24,911,727 total cases
841,331 dead
17,299,916 recovered
In the US:
6,096,235 total cases
185,901 dead
3,375,838 recovered
Yesterday’s numbers for comparison:
Pretty sure you are mistaken.
IF there is no vaccine before it happens and X% of the population end up infected (and if such leads to herd immunity), then a germ being much more contagious means you get to X% faster. The number of people who end up in the hospital or dead over the course is the true IFR*X%*population size, smaller the smaller true IFR is.
Yes, unless @Tfletch1 misstated what he meant. For a given number of serious cases & fatalities so far, it is unequivocally good news if we discover that a much larger proportion of the population that we thought has already been infected asymptomatically.
This is going to get very complicated very soon I think.
There are some number of individuals out there getting re-infected. Some will be asymptomatic to mild infections. Few of them will be identified. Some will have more significant symptoms. More of them will be identified.
Knowing the true rate of re-infections will be very hard unless a large population is followed with regular testing prospectively. Given that some number can have more significant disease on re-infection there will be a selection bias to them being identified.
Ooof.
Meanwhile yeah even one case like this, in which the re-infection was worse than the primary infection, gets me worried about many things. It raises the possibility that some unknown number of people might actually experience antibody disease enhancement, possibly related to antibody levels alone, possibly related to other items intrinsic to them as unique individuals.
Knowing if that IS the case, and how frequently it happens, is going to be critical, and, unlike having asymptomatic to mild re-infections, has huge implications for vaccine development.
Not panic level but worrisome.
TENS OF THOUSANDS protest pandemic restrictions in Berlin.
Nothing good can come of this.
Yes, I hear what you’re saying. But the plan for humanity is to achieve herd immunity through vaccination, not through infection. So the most critical thing is the average immune response to optimal vaccination, not the immune response to infection under highly variable circumstances. I would be far more worried if the preliminary data suggested anything other than a good average response to vaccination. Of course, what’s lacking at this stage is data on the longer term response to vaccination, but this will be monitored rigorously in carefully controlled studies. If vaccination does not work in 10% of the population, that’s not a huge problem if it works for the other 90%. Nor is it that big a deal if we need to revaccinate annually - we already live with that routine process for 'flu.
Yes. It has similar implications for “herd immunity” achieved by natural infection. It’s potentially extremely bad news.
For me at least even figuring out what the implications for both might be (and big emphasis on that “might”) are difficult, partly because it depends on the numbers.
Let’s play with some hypotheticals, if nothing else as a thought exercise. @Riemann I could use your help here in particular.
Let’s say that natural disease protects from reinfection for an average of two to three years for say 95% of people, with some variation about the mean, and that most of them get mild to asymptomatic disease on reinfection when immunity fades years later. Of the remaining 5% the majority get mild or asymptomatic reinfections, possibly with less transmissibility, but maybe 1 per thousand of all those infected experiences antibody dependent enhancement (ADE), or some other mechanism of enhancement, such that a second infection is worse, such as seems to have happened in this case - initial infection relatively mild with sore throat, cough, headache, nausea, and diarrhea; reinfection more severe with more significant pulmonary impact inclusive of hypoxia. For the sake of the hypothetical assume all reinfections are as contagious as they would have been if they had been primary infections.
Let’s further say that immunization leads to similar results.
So far there are 25 million confirmed infections, and many would estimate that the true number is at least ten times that. Go with 250M as the true infection number. 5% of that is 12.5M people at risk of reinfection in the short term and the one per thousand at risk of enhanced disease upon reinfection is 25,000 at risk of experiencing enhanced disease (some number of whom who may not have known they had a first infection and experience this as infection one). One identified possible case of enhanced disease being seen so far is not inconsistent with that.
With those sorts of numbers, one in twenty prone to reinfection, there is still no problem with either reaching herd immunity, at least from severe disease, for the wide ranges bandied about as required to achieve it, either by infection, or preferably by immunization (presuming a large number of at risk individuals get the possible vaccine and keep up getting it at whatever intervals are required to keep protection).
The one per thousand chance of making the disease worse if you get infected though may rationally be a good trade off for a reduction of getting infected by 95%, and from severe disease even more often, but explaining that to the portion of the public that will be skeptical, especially young adults currently at relatively lower risk of severe disease, will not be easy. And not sure how the FDA would respond to a one per thousand chance of ADE in the approval process even if the best guess is that natural infection has identical numbers.
Even going down to 85% experiencing good medium term protection allows for herd immunity from severe infection … it just raises the number of those needing to have gotten infected or immunized some.
A big deal is knowing how often (if it does at all) any possible ADE happens in both arms. A 30K vaccine trial, of whom maybe 10% (?) experience infections during the trial period, might not show any tendency to ADE, and certainly won’t be enough to pin it down. And again it would take a huge prospective study to pin it down for reinfection after natural disease, one that I doubt will be done. Unless I’m missing some way to reliably deduce it.
Once again … ooof.
Things escalated, apparently (same link, story was updated):
IIRC, one of the banners loved by the extremist right in Germany is the confederate rag because that is not outlawed like the Nazi banner is. I cannot find any good photos (evidently, I rot at Internet image searches) of the event. Did they happen to be bearing that stupid rag also?
Unfortunately, a disease being more contagious is like moving the goal posts. Herd immunity depends on the effective reproduction number. If the coronavirus is more contagious than we thought, the Ro will be a higher number and the % immune required for herd immunity will be higher. If Ro is only 2, we’d reach herd immunity at 50%. However, if it’s really 5 or 6, then we’ll need over 80% of the population immune.
This is without some kind of intervention like masks, quarantines, surveillance, etc. I was hopeful that interventions would drive this thing down enough to eliminate it from the population but second waves popped up in other countries fairly quickly. I think they’re going to look like scenario 1 in this figure. The US might end up looking like scenario 2 with the giant wave happening in the fall due to schools being open.
(https://www.cidrap.umn.edu/sites/default/files/public/downloads/cidrap-covid19-viewpoint-part1_0.pdf)
25,170,157 total cases
846,787 dead
17,509,856 recovered
In the US:
6,139,078 total cases
186,855 dead
3,408,799 recovered
Yesterday’s numbers for comparison:
I know I’m a couple of days late in responding to this conversation arc, but it seems to me that we have always encouraged overstating the risks as part of a robust disaster response.
What percentage of people living in a hurricane strike zone actually get killed by the hurricane? I bet it’s a pretty damn small number. Probably a double digit number, if that.
So why don’t we alter our public response? Evacuations are costly and disruptive. Maybe we should change our disaster response model.
Let’s make sure everyone knows that the last bigly hyped hurricane only killed twelve people out of the several hundred thousand in the affected area. Then let’s just encourage people to not alter their routine during the storm, and call them scaredy-cats and laugh at them if they do.
Conservatives have slammed the very concept of public health as unconstitutional and they are currently the party in power. As they’ve said many times, everyone is responsible for keeping themselves safe and if they’re scared they can stay home while the rest of us go out.
So everyone has to do their own cost -benefit analysis. And most of us are going to err on the side of caution. Because, as it turns out, the benefit of dining in a restaurant as opposed to serving a well-presented take-out meal at home or an in person yoga class as opposed to an on-line class is very small indeed, at least to me. So it doesn’t take much of a risk to offset the benefits since, at least to me, the benefits are negligible.
And if I’m now going to hear “It’s not about you, it’s about all of us. If we don’t start taking more risks we can’t save the economy boo hoo hoo” I’m going to respond with a hearty “Screw You”. You rejected the “we’re all in this together” concept when I was trying to protect my health - I’m not going to embrace it to protect your wealth”
There was some meeting in NH about opening schools and a woman’s argument was “well odds are at most only 2 kids in the district will die” and a school board member replied with some drivel, when of course the answer to that particular argument should have been, “we’ll put all the names in a drum and you can pick out the two, Jennifer.”
Or, “let’s just choose YOUR two right now and everyone else will be safe.”
Thing is we DON’t tell people in a predicted hurricane landing zone that they are at much greater risk than they are at, or encourage them to think something false. To the degree that the media does that they lose their credibility. Well to some degree that is baked in by now. Expert bodies overstating risks, even just encouraging misunderstanding of risks, and losing their credibility would be a horrible price to pay in the future.
Evacuation responses for potential disasters during a storm are in fact not so costly (not much business going on during a hurricane hunkered in place or evacuated, it’s the cost of gas and hotels) and the costs of having to mount rescue responses for those who did not evacuate very high.
Exactly. Just like the fact that business activity is going to be depressed in a pandemic because people will self-quarantine regardless of what the government allows, and the costs of treating people in an ICU are much higher than if they were to not get infected in the first place.
It’s pretty much exactly analogous.
Just like we don’t tell people to not worry about the hurricane that’s about ready to hit their area, we shouldn’t be telling people to not worry about the pandemic.
So let me see if I understand what you are saying … officials and the media should intentionally mislead segments of the public into believing that risks are significantly larger than they are, in order to get more to self-quarantine and otherwise socially distance, which won’t have any negative impact because they are self-quarantining and otherwise socially distancing?
If truth gets in the way of promoting a desired public action, well screw that inconveniece? Lie. There’s no consequences to that moving forward. None at all.
I don’t think so
No, I’m not saying that. There is nothing to be gained from misleading the public.
I’m saying that just like officials and the media warn people of an impending hurricane and that they should take steps to protect themselves, officials should also warn the public of the dangers of the pandemic and how to protect themselves and their community.
With that said, just like officials do not say that the absolute risk to an individual is low in a hurricane (if you consider the number of people typically killed compared to the population at risk), and that therefore the public has no need to prepare and protect themselves, officials should also not make a point of saying that the absolute risk to a given individual is low due to the pandemic, and that they therefore do not need to take any precautions.*
For one thing, unlike in a hurricane, people’s actions in a pandemic affect others. A 20-year old may not have much risk of a bad outcome in an absolute sense if he gets infected, but his 75-year relative does if he exposes her to the virus.
*Note that I have no issue with the first part of this. There’s nothing inherently wrong with telling someone their absolute risk is low in an abstract sense, especially if they are anxious about this. The part I’m focusing on is the second part. There’s also nothing wrong with telling everyone to take precautions, such as wearing a mask and to socially distance to protect themselves and others, even if one’s individual risk of a bad outcome is relatively low.
I don’t know how you got this out of my post.
Well the context was my response to @Ann_Hedonia’s position that overstating the risk was part of a robust response.
Now I read “overstating” as intentionally presenting false information in order to mislead, which means lying to them to get them to do what you think they should do.
The argument clearly made to my read is that it is good if people are misled into thinking their risk is greater than it is if it results in behaviors you want to see, that you think serve the greater good.
We can make the argument for the actions of public good without intentionally overstating or misleading. And making overstated claims, falsely presenting risks, costs you in your ability to be believed, and get action, in the future.