A couple of things have become clear in the past week or so. Asymptomatic carriers ARE a major vector. They were thought to be fairly safe until they started showing Sx. This is not true.
"Dutch researchers estimate that the “the proportion of pre-symptomatic transmission was 48% (95%CI 32-67%) for Singapore and 62% (95%CI 50-76%) for Tianjin, China.”Link
Testing is still a problem. The difficulty in isolating healthcare workers from thousands of potential positive cases is enormous. Drive through testing seems to be the best answer so far.
Are those old Fotomat booths still around?
Too soon to say. Look at the same graph of new cases, to the tendency between March 1 and March 6, or between March 11 and March 13. The tendency between March 14 and March 17 might be the beginning of the flattening-out of the curve, or a statistical artifact that is following by a jump upwards in new cases, like previous “flattenings”.
I think the data from Hubei (chart 7 here) are pretty unambiguous in that regard: after lockdown, the actual new cases start immediately to recede, although of course, one only notices that in the detected cases after a time lag roughly of the order of the incubation period, due to those that have already been infected, but not tested yet/are showing no symptoms.
Yeah it was immediately after the lockdown. Like within 2 days it went flat.
Which is sort of weird, given that the median incubation period is 5 to 6 days.
Naive to what was done when my impulse would be to look at what was changing beginning more like the 6 days before a flattening of the new case curve, and to look for the impact of a specific change 6 days after a particular intervention.
In fact what was happening 5 to 6 before before was broad acceptance in the region of social distancing less severe in nature as cases started to explode.
The timing is more consistent with the hypothesis that the curve can be flattened with social distancing short of those measures extremely severe, and that perhaps the lockdown contributed to actually driving the curve down, at least while such suppressive measures remain in place, but that the curve can be flattened without lockdown.
It is of note that China locked down Hubei and a total of about 60 million people. The remainder of their over 1,400,000,000 population with COVID-19 in their communities were not locked down but practiced less severe social distancing measure. And it did not spread there.
Put together it is pretty convincing that severe measures that come with great harm are not required to flatten the curve. Less harmful social distancing can be effective.
The next part of the experiment they are doing on behalf of the world is what happens as restrictions are eased, which they began to do last week. If it is true that only a fraction of a percent of the Chinese population has been infected, so no effective herd immunity exists, then they will rebound a beginning within a few weeks of release of restrictions.
The story in China very likely is not done yet. Stay tuned.
One thing that has to be considered with any plan is how well the people will follow it. I would suspect that the Chinese people will follow government restrictions better than Americans will. You can see that right now if you go to the store. People are not maintaining distance, they are coughing, touching their face, talking close to other people, etc. Even at the checkout the cashiers are still chatting with customers, which provides a great opportunity for virus transmission. We can’t even get people to stop buying toilet paper. American society and its people are such that a plan that works will likely need to be very strict since otherwise it won’t be followed.
Incubation period is the period between infection and symptoms, isn’t it? If they are testing people without symptoms (which I believe they are), then they would detect infections before symptoms appear.
Actually, that seems pretty consistent with what you’d expect. Incubation period has been between 2-14 days, so two days after lockdown, you get those that would have been newly infected and shown symptoms after two days less than the exponential increase, three days later the (higher) number of people that would’ve shown symptoms after three days, and so on, leading to an extended plateau, followed by a decline, which is what we see, at least within normal statistical variation.
Testing everyone regularly seems like it would be the fastest way to get life back to normal. If everyone could take a daily/weekly test, the infected could quickly self-isolate and drastically slow the spread. I’m sure getting that kind of testing available would be expensive, but it might be a bargain compared to the worldwide economic downturn.
This seems like as good a time as any to ask: how does the test actually work? I understand the swabbing portion, but what about the actual test. I remember reading something that suggested it was pretty labor intensive (and took a day or so), but I don’t know. I mean, would it even be possible to ramp up testing that much?
I’m guessing some kind of breakthrough will be needed similar to the at-home pregnancy tests. Or maybe you leave the test in a special box at your mailbox and the postal service picks it up for daily testing. Ireland recently announced they have a 15 minute test. Hopefully things keep progressing in that direction.
This administration will move heaven and earth to use tax money to send $1000 checks to americans before the election. It’s not their money anyway, and it’s a transactional thing that tormp understands.
According to the map and chart at New York Times, yesterday was the worst day so far for new reported cases. Today already looks primed to easily overtake it.
[ul]
[li]Compliance with the national home quarantine remains high, though there have of course been isolated exceptions. Police fined a guesthouse and a hairdresser for illegally opening for business today, and have had to break up occasional gatherings of more than five people, including beggars.[/li]
[li]Though state schools and day care centres officially remain open in order to care for children of essential workers, most families are opting to keep their children at home. School and day care attendance is down to 1% to 2% in some states.[/li]
[li]People are being urged not to visit their doctors except in cases of extreme urgency. Practices and clinics are now offering telemedicine services, where diagnoses and treatment plans are issued by phone. (Of course, if the doctor determines an in-person visit is necessary for further diagnosis or treatment, they will invite the patient to attend.) I myself had to visit my general practitioner today. There was only one other person in the waiting room, which is normally filled to capacity. The receptionists have barricaded themselves behind a wall of chairs in order to enforce distance with patients, and refuse to touch health cards. (You have to read your number out to them.)[/li]
[li]Vienna has enlisted the city’s tailors to mass-produce face masks. It’s estimated that each tailor can produce up to 1000 masks per day. Meanwhile, supermarkets are hurriedly erecting protective plexiglass booths for their cashiers.[/li]
[li]The unemployment rate continues to skyrocket. So far this week 48,969 people have registered with the government as unemployed. Some 40% of these people had been employed in the hospitality and food service industries, and about 10% in construction. The UN estimates that worldwide 25 million people could lose their jobs as a result of the pandemic.[/li]
[li]The government, which had already a few days ago passed a €4 billion aid package to prop up businesses, today approved yet another economic aid package, this time for €38 billion.[/li]
[li]Hungary temporarily reopened its borders with Austria to allow Romanians and Bulgarians to return home overland. This has caused a traffic jam backing up 45 km from the border. The Red Cross has been called in to provide drinking water and care to the trapped motorists.[/li]
[li]Austria has already closed its land border with Germany, and is now going to close its water and air borders as well.[/li][/ul]
So the US and Canada are closing their border. Can anybody explain why (other than to look like they are doing something)? The infection rates of the two countries look about the same so it doesn’t seem to really be an issue of isolating the infected from the uninfected.