[pescetom]

Today's statistics in Italy: positive 85388 (+3%), dead 14681 (+6%), no longer infected 19578 (+8%). Intensive care 4053 (+0%). Fatality rate 14.7%.
These percentages are now in some statistical equivalent of lockdown, except for the ever climbing fatality rate.

[pilowsky]

Here is a short video from a former student of mine it has subtitles in Farsi. It provides an excellent explanation of why COVID-19 is much much worse than influenza and why social distancing is our ONLY protection.
https://www.facebook...05863549497747/
Remember that the data are only as useful as the numerator AND the denominator AND the quality of the tests. None of these is currently reliable. What we know is that that it is worse than it seems.

[FelicityR]

FelicityR, on 2020-April-02, 09:46, said:

The European Medicine Agency warned on Wednesday that neither chloroquine nor hydroxychloroquine should be used to treat COVID-19 cases, except for clinical trials or in the event of a "national emergency."

Here's an interesting article I found online this morning whilst reading up on the virus.

https://www.dailymai...-available.html

Whilst just over a third (37%) is hardly a shining endorsement, the statistics may be distorted because some countries and physicians haven't been using the drug as the primary medicine to combat covid-19. There are obviously many other factors to take into consideration beyond this, but it does seem that recovery from the illness could be dependent on where you live in the world.

[johnu]

FelicityR, on 2020-April-04, 02:31, said:

Here's an interesting article I found online this morning whilst reading up on the virus.

https://www.dailymai...-available.html

Whilst just over a third (37%) is hardly a shining endorsement, the statistics may be distorted because some countries and physicians haven't been using the drug as the primary medicine to combat covid-19. There are obviously many other factors to take into consideration beyond this, but it does seem that recovery from the illness could be dependent on where you live in the world.

There are a couple of other drugs undergoing trials in China and Japan, remdesivir, and the newest anti-flu drug, Favipiravir that may have more promise (or maybe not ) And there are several studies for immunotherapy treatments that may hold some promise. So far, there are only anecdotal success stories.

One major problem in the US is that it is a huge problem to get tested for COVID-19 right now in almost the entire country, and most of these treatments requires that they be started early. But you won't get any treatment unless you have tested positive, and you usually can't get tested at all unless you are already showing somewhat advanced symptoms. So right now it's a big Catch-22.

Of course, the other problem is that even if these treatments are effective, production of the drugs needs to be massively expanded over current levels which can't be done overnight.

[FelicityR]

johnu, on 2020-April-04, 04:32, said:

There are a couple of other drugs undergoing trials in China and Japan, remdesivir, and the newest anti-flu drug, Favipiravir that may have more promise (or maybe not ) And there are several studies for immunotherapy treatments that may hold some promise. So far, there are only anecdotal success stories.

One major problem in the US is that it is a huge problem to get tested for COVID-19 right now in almost the entire country, and most of these treatments requires that they be started early. But you won't get any treatment unless you have tested positive, and you usually can't get tested at all unless you are already showing somewhat advanced symptoms. So right now it's a big Catch-22.

Of course, the other problem is that even if these treatments are effective, production of the drugs needs to be massively expanded over current levels which can't be done overnight.

Yes, John, it's a race against time to develop drugs, and a race against time to be tested and treated with any drug being used to treat covid-19. Testing in the UK has been sub-standard, and even if tests are completed it takes more than a few days for the results to appear, and that can make the difference between being just symptomatic, to being sick and at an advanced stage where any treatment is effectively palliative, except in the rare cases where recovery is virtually a miracle. Just to give you an idea of what's happening pharmaceutically with covid-19 therapies, the following gives you an idea of how pharma/biotech companies have responded.

https://www.clinical...-mers-cov-drugs

[y66]

From Bill Gates via WaPo (March 31):

Quote

There’s no question the United States missed the opportunity to get ahead of the novel coronavirus. But the window for making important decisions hasn’t closed. The choices we and our leaders make now will have an enormous impact on how soon case numbers start to go down, how long the economy remains shut down and how many Americans will have to bury a loved one because of covid-19.

Through my work with the Gates Foundation, I’ve spoken with experts and leaders in Washington and across the country. It’s become clear to me that we must take three steps.

First, we need a consistent nationwide approach to shutting down. Despite urging from public health experts, some states and counties haven’t shut down completely. In some states, beaches are still open; in others, restaurants still serve sit-down meals.

This is a recipe for disaster. Because people can travel freely across state lines, so can the virus. The country’s leaders need to be clear: Shutdown anywhere means shutdown everywhere. Until the case numbers start to go down across America — which could take 10 weeks or more — no one can continue business as usual or relax the shutdown. Any confusion about this point will only extend the economic pain, raise the odds that the virus will return, and cause more deaths.

Second, the federal government needs to step up on testing. Far more tests should be made available. We should also aggregate the results so we can quickly identify potential volunteers for clinical trials and know with confidence when it’s time to return to normal. There are good examples to follow: New York state recently expanded its capacity to up to more than 20,000 tests per day.

There’s also been some progress on more efficient testing methods, such as the self-swab developed by the Seattle Coronavirus Assessment Network, which allows patients to take a sample themselves without possibly exposing a health worker. I hope this and other innovations in testing are scaled up across the country soon.

Even so, demand for tests will probably exceed the supply for some time, and right now, there’s little rhyme or reason to who gets the few that are available. As a result, we don’t have a good handle on how many cases there are or where the virus is likely headed next, and it will be hard to know if it rebounds later. And because of the backlog of samples, it can take seven days for results to arrive when we need them within 24 hours.

This is why the country needs clear priorities for who is tested. First on the list should be people in essential roles such as health-care workers and first responders, followed by highly symptomatic people who are most at risk of becoming seriously ill and those who are likely to have been exposed.

The same goes for masks and ventilators. Forcing 50 governors to compete for lifesaving equipment — and hospitals to pay exorbitant prices for it — only makes matters worse.

Finally, we need a data-based approach to developing treatments and a vaccine. Scientists are working full speed on both; in the meantime, leaders can help by not stoking rumors or panic buying. Long before the drug hydroxychloroquine was approved as an emergency treatment for covid-19, people started hoarding it, making it hard to find for lupus patients who need it to survive.

We should stick with the process that works: Run rapid trials involving various candidates and inform the public when the results are in. Once we have a safe and effective treatment, we’ll need to ensure that the first doses go to the people who need them most.

To bring the disease to an end, we’ll need a safe and effective vaccine. If we do everything right, we could have one in less than 18 months — about the fastest a vaccine has ever been developed. But creating a vaccine is only half the battle. To protect Americans and people around the world, we’ll need to manufacture billions of doses. (Without a vaccine, developing countries are at even greater risk than wealthy ones, because it’s even harder for them to do physical distancing and shutdowns.)

We can start now by building the facilities where these vaccines will be made. Because many of the top candidates are made using unique equipment, we’ll have to build facilities for each of them, knowing that some won’t get used. Private companies can’t take that kind of risk, but the federal government can. It’s a great sign that the administration made deals this week with at least two companies to prepare for vaccine manufacturing. I hope more deals will follow.

In 2015, I urged world leaders in a TED talk to prepare for a pandemic the same way they prepare for war — by running simulations to find the cracks in the system. As we’ve seen this year, we have a long way to go. But I still believe that if we make the right decisions now, informed by science, data and the experience of medical professionals, we can save lives and get the country back to work.

Good idea to start building vaccine factories now. Would like to know what else can be done concurrently vs sequentially and to compress time cycles. 18 months sounds realistic. What are the major obstacles to cutting that in half besides high risk human testing?

[Winstonm]

y66, on 2020-April-04, 08:49, said:

From Bill Gates via WaPo (March 31):


Good idea to start building vaccine factories now. Would like to know what else can be done concurrently vs sequentially and to compress time cycles. 18 months sounds realistic. What are the major obstacles to cutting that in half besides high risk human testing?

This advice flies in the face of libertarians and market-driven conservatives because it shows that only governments are capable of handling the cost of preparing for black swan events.

[y66]

From Michael Lewis at Bloomberg:

Quote

My father now knows nine people who have been killed by the coronavirus. He’s 83 and entirely sound of mind and body. He rides his bike many miles every morning around Audubon Park in New Orleans and is as fun to talk to as he was when he was 40. His only response to the news that he and my mother would be confined to the house I grew up in was to call the liquor store and order seven cases of wine.

But now he finds himself watching the annihilation of what is left of his generation. Many of his old high school classmates and business associates and tennis partners live in the Lambeth House, the retirement community of choice for the New Orleans gentry. It’s a peculiar group, with its own customs and language, maybe the only American subculture to use “cocktail” as a verb. Up until a month ago, the few hundred New Orleanians living at Lambeth House cocktailed together nightly, without any idea of the risks they were running. On March 10, the first resident tested positive for Covid-19. At least 52 others now have it, and 13 have died, nine of whom my father knew.

Without more tests it’s hard to say how many people are likely to catch the virus — or how many will die. It seems amazingly well-designed to leap from person to person. People can walk around with it for days and even weeks, carrying the infection wherever they go, without knowing they have it. Young people are especially likely to remain oblivious to their infection, but if an 80-year-old man can feel well enough to cocktail and still be ill enough to give the virus to another 80-year-old man, who can’t?

The surprise, if anything, might be that the virus hasn’t spread more rapidly. “Why don’t even more people have it?” asked Richard Danzig, a national security and bioterrorism expert who served as secretary of the Navy under President Bill Clinton. “Early reports stated that only about 10% of family members of people who fall ill are infected. Possibly the numbers are wrong, but we need to focus on why so many people who are exposed don’t get sick.” The Lambeth House in New Orleans is a case in point. Even now there are a couple of hundred ancients still living there, virus free. How did it miss them?

One possibility — Danzig offered this up the other day at a virtual gathering of pandemic experts — is that the virus has a special need to be projected. “Shorter exposure in some contexts like church events seems to have more impact than prolonged exposure to infected family members at home even when no or few precautions were taken pre-symptomatically,” Danzig wrote to his fellow experts. “I am wondering if singing is the important characteristic of church events (the New Rochelle synagogue, et al), making them a major vector of transmission.”

Another possibility is that a lot more people than we know — even 80-year-old people — have had the virus but never got sick enough to get themselves tested. That’s what’s so interesting about the simple, one-page letter written last week by two British doctors. Claire Hopkins and Nirmal Kumar, among the country’s most prominent ear, nose and throat specialists, had both noticed the same odd symptom in their coronavirus patients: a loss of the sense of smell. “Anosmia,” it is called, but I suppose they have to call it something.

The inability to smell was the first symptom many patients noticed; in some cases, it was the only symptom the patients noticed. “In the past it was once in a blue moon that we saw patients who had lost their sense of smell,” Kumar told me. “Now we are seeing it 10 times as often. It’s one of the things that happens with this virus.” The British doctors compared notes with doctors from other countries and gathered what data they could. They concluded that roughly 80% of the people who lost their sense of smell would test positive for the coronavirus, and that somewhere between 30% and 60% of those who had tested positive for the virus had also lost their sense of smell.

Those numbers might turn out to be a bit off — maybe even way off. They are a heroic guess, given how little testing has been done. But it’s precisely the scarcity of tests that makes the observation so intriguing, as it offers the possibility of a crude alternative to a test. Lose your sense of smell and you know to isolate yourself, even if you feel great.

It offers two other things as well: a way to glimpse the virus as it moves through various populations, and a tool for managing the risk. Oddly, hardly anyone who read the doctors’ letter had this thought — or, at any rate, hardly anyone who got in touch with the doctors. “We’ve had more than a thousand responses,” Kumar said. “But almost no one really seeing it as a risk management tool.” The exception was a former Wall Street guy, an Englishman named Peter Hancock.

Hancock had spent much of his career at JPMorgan, where, in the late 1990s, he had served as the bank’s chief risk officer. After the financial crisis he’d been tapped to run the giant risk management mess that was AIG. When he read the letter written by the British doctors, he thought, “Here might be a free way to get a signal, out of all the noise.”

Like everyone else, Hancock has been sitting at home, trying to make sense of what’s going on. To a person who had spent his career managing risk, it was especially troubling how little data there was about the virus. Everywhere he looked, people seemed to be treating the absence of people who tested positive as the absence of the disease. “The governor of West Virginia was on TV saying there are no cases in his state at the same time some poor West Virginia woman was driving her sick husband around, looking for someone to test him,” he pointed out. (The man tested positive.)

Hancock was troubled not just by the dearth of testing but also by its distribution: the only people getting tested were the people who turned up at hospitals with coughs and fevers, the people who very likely had the disease. Those weren’t the people who were going to wander around, infecting other people. To get a picture of the disease in the population — and to find the people who were going to wander around infecting other people — you wanted to test lots of people randomly. That didn’t seem like it was going to happen anytime soon.

Then he read the letter from the British doctors — and called them up. Yes, they agreed, wholeheartedly, it might make a lot of sense to use this odd symptom to track the disease as it moved around the world. If enough people who suddenly found themselves without a sense of smell self-reported their condition, you might well create an early warning signal that told you where the virus was heading, and how fast. “The missing piece is population-wide infection rates,” Hancock said.

His background in risk management was relevant here. He saw an analogy to pandemic risk in his early days at the Wall Street bank. “Those were the days when risk was being quantified in all sorts of new ways,” he said. The bank’s traders organized their risks into buckets — there was one bucket for credit risk, for example, and another bucket for market risk. But there were all sorts of risks that didn’t fit neatly into any particular bucket. Hancock watched a rival firm lose $300 million in a day on its equity derivatives portfolio after an obscure court ruling involving corporate dividend withholding tax. He asked: How would you ever uncover such a risk? His answer was to crowd-source the problem.

And so he created a program — which exists to this day — in which everyone in the bank was encouraged to alert the traders to risk. “There were two rules,” Hancock said. “Your note had to be two sentences or less. And your boss was not allowed to edit it.” The general idea was to make it simple and painless for everyone in the bank to share their thoughts. These thoughts often wound up improving the bank’s risk management. Even though the people who supplied them usually knew nothing about risk management.

So why not do a similar sort of thing with the virus? Encourage everyone in the world with access to the internet to report whether they can or cannot smell. Make it easy for them to do so. Find widely admired people with big social-media followings to make short videos on the subject — at the bottom of which there’d be a simple button that allows anyone watching to report their sense of smell. Go viral with the virus. Before long you’d have a pile of data that smart analysts could use to map it, and evaluate its risks. The results might not be perfect, but they were far better than what we have now in any rich country and far better than what they might ever have in countries with fewer resources.

I love this idea. Hancock is well on his way to building an organization to make it happen — the website is sniffoutcovid.org. He is in the market for both widely admired people and data scientists. Here’s to hoping he finds them before my father calls me to say that he can no longer smell his Burgundy.

[pescetom]

Today's statistics in Italy: positive 88274 (+3%), dead 15362 (+5%), no longer infected 20996 (+7%). Intensive care 3994 (-0%). Fatality rate 15.1%.
For the first time, a drop in the number under intensive care, although just 59, and occupancy was at least 100%.
Medical friends say the hospitals are not under the same pressure as a week ago.

[y66]

Noah Smith @noahopinion Apr 4 said:

Hell yeah #TestAndTrace!!!!!

WGBH News @wgbhnews Apr 3 said:

Gov. Charlie Baker said that Massachusetts’ newly-announced test-and-trace initiative will be the first such statewide effort in the country. It’s an approach that has worked elsewhere across the globe:
https://wgbh.org/new...navirus-in-mass

[y66]

Larry Brilliant MD, MPH @larrybrilliant Epidemiologist, Ending Pandemics, wrote “Sometimes Brilliant.” Fmr head Prof, U Mich; WHO smallpox, TED Prize. TIME100. Co-found Seva & The Well said:

I marvel at how clear the #Economist makes foolish politicians seem. Today they did this interview of me. I swear I am not 1/10th as clear as their editing makes me seem. If U R interested, here is a good summary of what I believe about #COVID19 pandemic.

https://amp.economis...ercome-covid-19

[cherdano]

Turns out Bill Gates isn't waiting for the federal government:

https://www.business...onavirus-2020-4

That's really the best news on coronavirus in a long while. Gates wouldn't be doing this unless he is convinced there is a good chance some of them will work. And I am sure he has thought a lot about that.

Moreover, Gates putting serious money behind this might also give hope that developing countries will get access to the vaccines.

[barmar]

cherdano, on 2020-April-04, 19:00, said:

Moreover, Gates putting serious money behind this might also give hope that developing countries will get access to the vaccines.

Unless Trump blocks them like he's trying to do with 3M.

[hrothgar]

cherdano, on 2020-April-04, 19:00, said:

Turns out Bill Gates isn't waiting for the federal government:

I'm very glad that Gates is funding this effort. At the same time, I am really ticked off that we need to rely on a civic minded billionaire to fund efforts that the federal government should be providing.

What makes me furious is the way that Trump and Kushner are using the powers of the government to grift off the pandemic.

What we are seeing now is a situation in which

1. The federal government is seizing PPE equipment that states have privately contracted for
2. They are then handing this equipment over to a "public / private" partnership being run by friends of Jared
3. Said partnership is then jacking the prices of the items up seven to ten fold and selling the equipment back to the state governments

I am opposed to the death penalty.

But in all seriousness, when this is over, Trump and his brood need to be taken out and publicly executed

[FelicityR]

cherdano, on 2020-April-04, 19:00, said:

Turns out Bill Gates isn't waiting for the federal government:

https://www.business...onavirus-2020-4

That's really the best news on coronavirus in a long while. Gates wouldn't be doing this unless he is convinced there is a good chance some of them will work. And I am sure he has thought a lot about that.

Moreover, Gates putting serious money behind this might also give hope that developing countries will get access to the vaccines.

It's a nobel gesture, as always by Bill Gates, the problem is vaccines take time to develop and test. Another different virus will need another vaccine. A covid-19 vaccine will at least give us the re-assurance that another covid-19 outbreak will not be as disastrous as this one. But I doubt, even if a vaccine could be developed and tested within the next few months, it's unlikely it will have any effect on this outbreak which will have to run its course.

The Ebola vaccine took five years to develop (2019) from the most serious outbreak in 2014 which lasted two years in Africa. Bill Gates helped to fund this, too.

[hrothgar]

FelicityR, on 2020-April-05, 03:57, said:

It's a nobel gesture, as always by Bill Gates, the problem is vaccines take time to develop and test.

Did you actually read the article?
If so, did you understand the key point that was made?

Gates is funding / building SEVEN separate factories to produce vaccines.
In turn this is allowing seven different vaccines to be explored in parallel rather than in serial and will significantly increase the time to develop / test various candidates.

[pescetom]

Today's statistics in Italy: positive 91246 (+3%), dead 15887 (+3%), no longer infected 21815 (+7%). Intensive care 3977 (-0%). Fatality rate 14.8%.
A second tiny drop in the number under intensive care.

[shyams]

pescetom, on 2020-April-03, 11:05, said:

Today's statistics in Italy: positive 85388 (+3%)

pescetom, on 2020-April-04, 11:47, said:

Today's statistics in Italy: positive 88274 (+3%)

pescetom, on 2020-April-05, 11:32, said:

Today's statistics in Italy: positive 91246 (+3%)

In stark contrast, the growth in new positive cases in the UK has been 10%-15% every day for the last 3-4 days. This is despite the lock-down having begun over a week ago. Disheartening.

[barmar]

shyams, on 2020-April-05, 13:08, said:

In stark contrast, the growth in new positive cases in the UK has been 10%-15% every day for the last 3-4 days. This is despite the lock-down having begun over a week ago. Disheartening.

It's hard to compare statistics like these, because each country has different levels of testing.

The numbers always go up significantly as you increase the testing availability. It's not so much the actual number of infected people increasing (although that's part of it), it's that now we know more of the infected.

As an extreme example, suppose everyone is infected, but you only have one test kit and it can only be used once a day. Your infection rate will appear to be 1 new infection/day. If you then get a second test kit, the infection rate will suddenly double to 2/day. But nothing changed regarding who is infected.

[cherdano]

hrothgar, on 2020-April-05, 04:13, said:

Did you actually read the article?
If so, did you understand the key point that was made?

Gates is funding / building SEVEN separate factories to produce vaccines.
In turn this is allowing seven different vaccines to be explored in parallel rather than in serial and will significantly increase the time to develop / test various candidates.

In this case it's you who didn't read the article. Vaccines will be explored in parallel either way. The Gates foundation will build major factories with large capacity to produce each of these vaccines so they can be mass-produced the moment one of them turns out to be safe and effective.