How many people have already had COVID-19?
That is the trillion-dollar question, isn’t it? And we don’t know the answer, although the US is starting to try to find out.
In line with that, take a look at this news from Chicago:
A phlebotomist working at Roseland Community Hospital said Thursday that 30% to 50% of patients tested for the coronavirus have antibodies while only around 10% to 20% of those tested have the active virus.
Sumaya Owaynat, a phlebotomy technician, said she tests between 400 and 600 patients on an average day in the parking lot at Roseland Community Hospital. Drive-thru testing is from 9 a.m. to noon and 1 to 4 p.m. each day. However, the hospital has a limited number of tests they can give per day.
Owaynat said the number of patients coming through the testing center who appear to have already had coronavirus and gotten over it is far greater than those who currently have the disease.
There are several things there that make me wary, though. The first is that I didn’t think that drive-through centers were testing for antibodies; ordinarily it’s just for the disease. The second is that this is not a random group of people without symptoms. I believe that patients have to be approved by doctors in order to qualify for testing, even drive-through testing.
But also in the article is this extremely interesting – and more seemingly more valid – news:
A recent study of 1,000 people in the Heinsberg District of Bonn, Germany found that 15% of the population had contracted the virus, many unknowingly and without symptoms.
Of those, only 0.37% died from COVID-19, a figure much lower than those previously cited.
Germany is one of the western European countries that has been doing a fair job containing COVID, and so (at least to me) a 15% infection rate at this point is rather high and in a sense rather promising. The more people who are infected and survive without problems, the better it is for the group as a whole because over time the virus should find it harder and harder to spread. On the other hand, it does mean that in the shorter term it will be harder to protect especially vulnerable groups, because for now the illness is so easily spread.
There are a lot of smart medical practitioners each using their own experience informed by local data to crack this problem. So I’m hoping for a number of approaches sooner, rather than later, to help reduce the devastation caused by Covid-19.
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And now, somewhat off topic, my personal Northeastern Illinois shopping report from this morning…
We went back to boomer hours at our local grocery store.
Fruits & veggies were at normal levels. As we walked and down the aisles – might as well get some exercise – almost everything was stocked … but maybe only at 90%.
Our favorite brand of olive oil was entirely sold out, but others were available.
The bread and bakery area was fully stocked.
The fish and meat counter looked pretty well stocked.
We have been using a local butcher since … well … forever. Higher prices but they’ll do the major slicing for us. And they are taking long-time customer orders at priority.
Paper goods were plentiful but customer limits were in place. Soaps and detergents were the same. They actually had some Aloe-Vera gel.
But absolutely NO Isopropyl Alcohol. I asked 🙁
Dairy was ok except, again, some brands were entirely missing. Small containers of yogurt were available but no larger sizes at all. ( what does someone do with a half gallon of yogurt anyway? )
About 90% of us customers had on face masks. We were in the 1/3 with cloth ones. We did wonder how the others had surgical style masks to use? Maybe their PCP got those for them?
All the employees had on surgical style masks and were wearing blue plastic gloves. Plexiglass barriers around the cash registers.
The ‘returns’ desk had huge signs saying absolutely no returns until further notice. Good policy that.
We suburbanites are still in good shape grocery wise.
It’s odd that the number of positive tests compared to the total varies so wildly.
In Washington state the number is 9%, while in New York its 40% and 57% positive in New Jersey. The countrywide number is 19%.
I think at this point they are still only testing people that have some symptoms.
As to the number of asymptomatic cases, it seems that’s just a wild guess. Places that have tried to quantify those who have the virus without symptoms varies from 5% to 80%.
https://www.cebm.net/covid-19/covid-19-what-proportion-are-asymptomatic/
Just to add to the confusion, I’ve been estimating the number of recovered cases since Mar 1. Assuming a two week recovery and that 97% never need hospitalization which is a number that continues to seem to be justified by the 2.5% serious case rate, I estimate by today there should have been almost 80,000 recoveries. That’s based on the number of active cases from two weeks ago. Worldommeters lists recoveries at 27,000. Are they undercounting by almost a factor of 3?? If so, there are a lot of people out there who are now immune. Open up the damn country!!
One has to careful with medical science information that might be filtered through technically illiterate journalists.
From Neo’s (chicagowire) link:
“Abbott Labs in particular, which developed a five-minute testing kit, is stepping up efforts to roll out more antibody testing kits.”
Are they saying the 5 min. test is an antibody test? Because it isn’t. The 5-minute test is specifically this:
“Abbott ID NOW is a rapid, instrument-based system for the qualitative detection of infectious diseases using isothermal nucleic acid amplification technology.”
So it does something similar to PCR thermal cycling DNA amplification, without the thermal cycler, which is the part that slows things down. But it is about DNA and not antibodies.
A few days ago, Dr. Birx was talking about getting their test kits utilizing the Abbott M2000 machine fully ramped up. The M2000 is a big and clumsy looking machine that can produce DNA results in 15 minutes. But I think that it can be loaded up with a large number of samples that can be processed in parallel. Birx described it as high throughput.
Dr. Birx also talked yesterday about community “surveillance” using serology antibody tests. So I guess that is where they plan to focus their random testing.
physicsguy,
At this point I have no clue what it will take to open the country. I’ve never been one to go all doom and gloom but this entire thing is pushing me that way. Maybe it’s the loss of any sense of control of our lives. Damn depressing.
The lack of more accurate numbers made me suspicious. Ranges like 30% to 50% say “WAG”, not “counted”. I also didn’t recall any report that the tests could detect antibodies rather than RNA, although newer tests may be able to do that. I definitely put the report in the “needs information” bin. The technician may have been making a conjecture based on other evidence. Who knows? Newspaper reports are gossip and generally useless if you want actual information.
@ Brian E
My guess is that some places are restricting testing to people with symptoms because they lack the facilities to do more. Utah has tested more than 1% of its population and the positive rate is about 5%. The high percentage of people tested in Utah may be because reports from private laboratories are used along with reports from the state laboratories.
Like I said, it should already have hit USA airports before Jan 2020. Why are human rumor mills so slow.
At this point I have no clue what it will take to open the country. I’ve never been one to go all doom and gloom but this entire thing is pushing me that way. Maybe it’s the loss of any sense of control of our lives. Damn depressing.
As the angels of scripture kept saying… Y: Fear not humans.
My @50 yr daughter was unequivocally and heavily exposed to CoV-19 because her 20 yr son got all the classical symptoms and was tested at his university and sent home and her husband and other son then got the same thing after exposure to the infected son and all three were really intensely coughing and feverish and the illnesses lasted like 2 weeks. She was exhausted taking care of all these guys. About 21 days after she was first exposed she got this terrible headache and lost all of her smell. We all thought oh no! These lasted only about a half day. Then she got over all symptoms and has felt fine and healthy and chipper for the last 3 weeks.
The only thing she did that may have helped her was to take lots if vit C, and daily doses of zinc, selenium and arginine. This was because I had read in the Am. J. of Clinical Nutrition about 20 years ago that these micronutrients might help boost immunity and I had told her this. I am a retired clinical chemist.
So, who knows? Just an anecdote. But pretty safe to try if you are desperate.
Tuvea:
Very happy to hear that most people are wearing face masks. This is such a total no-brainer and it’s been driving me nuts that people in the west have had such a ridiculous mental block about this.
I live in a very densely populated place (Hong Kong) and there have been so far just 4 deaths from Covid-19 here. Taiwan has had all of 6 deaths.
From Day 1, masks went on and people got serious about their own personal hygiene.
There is this perception in the West that East Asians are all obedient conformists and therefore more easily obey some hive-directive to mask up. I don’t think this is correct. But they are certainly *pragmatists* when it comes to things like survival; they don’t have this Western urge to show how smart they are by taking contrarian positions on anything and everything. Kind of nuts how everyone goes around LARPing Socrates. A city state can afford to tolerate perhaps *one* Socrates per generation — and even *one* was arguably too much for Athens eventually.
In the bad-news / good-news aisle, Number-3-Son is furloughed from his retail job, but his wife — a pro/am quilter — started making face masks and selling them on her Etsy platform – she can’t keep up with the orders.
He is going to start helping with the work, and may even learn to sew (which I’m sure he can do, just never had to before).
As Scott Adams would say: what’s your skill stack?
https://personalexcellence.co/blog/talent-stack/
Morning update: So yesterday Trump and Cuomo stated the peak is near, or has passed. I don’t know what those two are smoking, but the numbers paint a completely different picture. Active cases still adding about 30,000 per day; serious cases took another 10% jump from the previous day. Any “peaking” (to use the new term) keeps getting pushed out at least another week. Their models still working wonderfully.
I’m glad Trump is talking about opening the country up, but how long will that “commission” take to form and get started, then work through all the crap? I’m guessing at least two months….sigh….
And now the governor of Michigan has declared de facto marshal law, arresting people for just being out period. The old Soviet Union has nothing on us.
Worldommeters lists recoveries at 27,000. Are they undercounting by almost a factor of 3??
If Worldometers is anything like Covidtracking.com, which has a similar number, they are just adding up the reported recoveries from the states. But lots of states don’t report that number, so they get zeros. That includes a lot of large states (CA, IL, PA). I’m actually trying to figure out what a better estimate would be.
physicsguy, have you run any curves excluding the NY Metro area? I realize you are in the hot spot (NY/NJ/CT). Nationwide, there are hot spots and then all the rest, and some of the rest are going down the right-hand side of that sigmoid curve.
physicsguy: cases are growing with testing, but hospitalizations and deaths are flattening out.
Constant rate of change is what characterizes the peak, which is about half way to the end. Things will be complicated because there are a lot of interacting regions that got started at different times. It looks like there is a line of infections slowly moving west, I wonder if it will stop of the continental divide 🙂
I hear more people talking about “wave 2.” I still don’t think the majority of Americans understand it yet, but it does seem like word is spreading. Unfortunately, most of the people I interact with believe the virus will somehow disappear if we continue the lockdown for some, proper number of weeks that the experts will dictate to us. They act like stopping all human interaction is a cure. “Take two aspirin.” “Shelter in place for 8.74 weeks.”
8 weeks. 12. 18 months. COVID-19 is very patient.
The U.S.A. is so large and diverse; culturally, socially, economically and, likely most important, geographically.
Each state, and even communities within each state, should come up with strategies that are optimal for their circumstances. It’s hard to believe we won’t see some communities restricting/controlling their borders.
Thanks (?) physicsguy!
Projected death toll dramatically lowered after anti-malaria drug approved
Americans for Limited Government President Rick Manning today issued the following statement reacting to the IHME’s death toll projections being lowered to 60,415 from 81,766:
“Projections on the number of cases of COVID-19 are far less important than the actual deaths from the China-originated virus. Now, the most influential projection of future deaths from the disease has lowered that guess again. Just one week ago on April 1, the death projection was 93,651, it was lowered on April 4 to 81,766 and just one week into April the projection is now at 60,415.
“While the public health care bureaucrats will attribute the precipitous drop in the all-important death projections to social distancing, the model assumed that social distancing would be implemented in its projections.
“What has significantly changed in the past week was President Trump’s successfully convincing the Food and Drug Administration to allow the anti-malaria drug, hydroxychloroquine and other antivirals to be prescribed to treat the disease on March 31. While correlation does not necessarily mean causation, it is significant that doctors across the nation have been given the go-ahead to use this treatment and many are reporting success that should not be discounted. Those governors who are restricting the use of this medicine need to reevaluate that political decision in order to help save as many of the lives of their constituents as possible.
https://getliberty.org/2020/04/projected-death-toll-dramatically-lowered-after-anti-malaria-drug-approved/
Meet the former NYT reporter who is challenging the coronavirus narrative
As daily life across America is upended by the coronavirus crisis — with mass business closures plunging the economy into freefall — one former New York Times reporter is sounding the alarm about what he believes are flawed models dictating the aggressive strategy.
Alex Berenson has been analyzing the data on the crisis on a daily basis for weeks and has come to the conclusion that the strategy of shutting down entire sectors of the economy is based on modeling that doesn’t line up with the realities of the virus.
“The response we have taken has caused enormous societal devastation, I don’t think that’s too strong a word,” he told Fox News in an interview Thursday.
Berenson is a former reporter who worked for the Times from 1999 to 2010 primarily covering the pharmaceutical industry. He recently came to prominence again with a book, “Tell Your Children The Truth About Marijuana, Mental Illness, and Violence,” which challenged prevailing narratives on marijuana.
In the face of a broadening consensus on both the left and the libertarian right that sees marijuana as mostly healthy and even a positive in some circumstances, Berenson argued that the evidence instead shows a link between the drug and serious mental illness and an epidemic of violence.
Now he’s turned to challenging the narratives on the response to the coronavirus. What Berenson is promoting isn’t coronavirus denialism, or conspiracy theories about plots to curb liberties. Instead what Berenson is claiming is simple: the models guiding the response were wrong and that it is becoming clearer by the day.
“In February I was worried about the virus. By mid-March I was more scared about the economy. But now I’m starting to get genuinely nervous,” he tweeted this week. “This isn’t complicated. The models don’t work. The hospitals are empty. WHY ARE WE STILL TALKING ABOUT INDEFINITE LOCKDOWNS?”
VERY long for neo
https://www.foxnews.com/politics/ex-nyt-reporter-challenging-the-coronavirus-narrative
“I went to Yale and I worked for the New York Times, the people on the left hold themselves out as being science-driven, as being smarter, they think they’re smarter but they won’t look at facts that won’t meet their narratives,” he said.
He voiced frustration that these arguments have been ignored by a lot of mainstream outlets.
“That is frustrating for me … but everyone needs to hear this counterargument, whether or not it’s right, you need to hear it because the damage we are doing to ourselves right now is so enormous.”
Soap-opera science
Here’s a remarkable story that no-one in the media or social media has picked up on (although you can bet that everyone in the field knows).
So we have two epidemiological teams, one at Imperial, and one at Oxford, with differing ideas about Covid-19.
The Imperial team, led by Prof. Neil Ferguson, is the team whose study has led to the UK shutdown (Ferguson is a current member of SAGE, the UK government’s Scientific Advisory Group for Emergencies). They’re the current big guns in this world, and have been for years, ever since the 2001 foot and mouth epidemic when they were led by Professor Roy Anderson, and Ferguson was his protege.
Then there’s the Oxford team, led by Sunetra Gupta. They recently brought out a study [HD: text now below] trashing the Imperial’s study, and claiming that half the country may already have had the virus.
“I am surprised that there has been such unqualified acceptance of the Imperial model,” said Prof Gupta.
There was an immediate attempt to trash the Oxford study in the media (clearly orchestrated by Imperial), for example, here.
https://hectordrummond.com/2020/03/30/soap-opera-science/
the other important stuff is that the virus is racist (not really, black folk live in cities more than others).. and they wonder if this is all bad for feminism… (who cares, when i lose my home i am going to add myself to the 80% stat of men that succeed vs women that try… )
Kate: yes, I have one column that subtracts the NY cases from the US. All it does is lower the total, not the trajectory.
Jimmy: Yes, cases are growing with testing. However, “serious cases” are rising, now at about 10% per day. I have to assume “serious cases” means hospitalization. Until that shows a decrease I don’t believe the claim that hospitalizations are decreasing. Also, from the stats I’ve analyzed, about 18% of those serious cases seem to result in death. So again, until those serious cases start to decrease, the death toll will continue to climb.
Chuck: “Constant rate of change is what characterizes the peak,”
I have to disagree. Constant rate of change is a linear function and will keep growing; it’s definitely not a peak. A linear function will reach infinity, just not as fast as a power or exponential function. We need to see a decrease in new active cases each day to declare getting close to peak, and then finally, zero new cases at the peak.
Thanks, physicsguy. My physics guy, sitting next to me, has just surveyed data from a couple of dozen individual states. He’s looking at daily new cases (date of test), which is significantly different from date reported, by four to six days. Those curves are going down, with some exceptions driven by large metropolitan areas.
My interpretation: We don’t have a national trend, we have localized trends. (Husband: “It’s a non-uniform distribution.”) The next few days will show whether these localized trends continue to improve.
I was trying for the past several days to come up with an explanation as to why the impact of the virus appears to be less on the west coast than the east, other than issues of density. Dr. Siegel now advises that the seriology indicates that the virus entering the country from China is a different mutation that then one entering from Europe. Perhaps that might also explain the greater incidence of death in the east, if that ultimately proves the case.
I didn’t say it would continue forever, I said it marked the peak. Sigmoid curves are approximately linear in the middle, which means constant rate of change. The question is how long that linear portion continues. The models are pretty simple, https://ihmeuw-msca.github.io/CurveFit/methods/.
stu,
That would be incredible, if it turns out to be true. There is so much we do not yet understand.
physicsguy,
Only a sample size of 1, so take it for what it’s worth, but my 82 year old mother living in the Chicago area has been ill for over 3 weeks; a few COVID-esque symptoms. We finally convinced her to go to an urgent care (she is a very tough person who always plays down her own aches and pains), where they tested her for Influenza A and sent her home. They called later and told her the test was negative and told her what to watch for, COVID-wise. So far, so good. My dad is keeping a close eye on her.
The point being, even an 82 year old woman who has some of the symptoms and is not really getting better on her own (she’s also not getting worse) was not tested in Chicago. If my mother’s experience is common in Chicago, then people are mostly only showing as positive cases when they are in serious condition because they are only admitting folks who present with serious conditions, and that’s when they are tested. Different states, even different areas within states appear to have more tests, so testing varies.
Rufus,
I have never taken worldometers as being accurate, but maybe reasonable? Also, it’s not good to change data sources once started. I also know that in NH there is very limited testing. Even so, the active cases continues to climb abut 30,000 per day and serious cases (about 3% of the active cases) also climbing. First indication I would think is serious cases going down. Active cases could continue to climb just due to testing. I was hopeful earlier this week when serious cases starting leveling for 3 days, but then surged again.
physicsguy:
NH? According to this chart, NH seems to have a rather middle-of-the-road amount of testing per million inhabitants, compared to the other states.
The numbers are not accurate at all…
thats the problem…
no standard definition of categories, nor would anyone take the time
meanwhile, the admins that put numbers in, find inflating them helps (themselves)
Artfldgr on April 11, 2020 at 3:24 pm said:
The numbers are not accurate at all…
thats the problem…
no standard definition of categories, nor would anyone take the time
meanwhile, the admins that put numbers in, find inflating them helps (themselves)
* * *
The stories I’m seeing support the first charge – even to conflating current cases with cumulative ones.
The second charge ….well…
https://www.thegatewaypundit.com/2020/04/wth-massachusetts-padding-coronavirus-numbers-get-cash/