The long term end of the COVID-19 pandemic is that most of the world acquires herd immunity. We can do it through either large fractions of the population getting infected and a significant fraction of the infected population recovering or through vaccination or through a bit of both. The differences in approaches will be measured by time and body bags.
One of the optimistic scenarios for COVID-19 is an asymptomatic hypothesis. This hypothesis contends that there is a large pool of individuals who are immune to COVID-19 because they had a very mild or asymptomatic infection over the winter. These people would now be immune to COVID and can be released from physical distancing and resume critical medical and economic activity. The more optimistic variants of this optimistic scenario would have continual and widespread asymptomatic infection continue even as we have physically distanced over the past three weeks. If this family of scenarios is close to reality, we would have widespread herd immunity fairly quickly without needing to wait for a vaccine.
The test for these scenarios would be widespread serological testing. Serological testing looks for antibodies in the blood of an individual. Antibodies are what recognize and attack a pathogen and they thus serve as a good history book of diseases that an individual’s immune system has mobilized against in the past. If someone was aysmptomatic while infected, a serological test would reveal that they had actually been infected.
Serology testing is not widespread nor common at this time. However, one of the Colorado ski resort counties, San Miguel County where Telluride is located, has done serological testing on about 1,000 residents. There is no huge reservoir of individuals who have recovered from asymptomatic infections:
COVID-19 in San Miguel County, only eight, or about one percent have come back positive. Another 23 have either indeterminate or borderline results, which means the person may have been exposed to the virus, but their immune system hasn’t yet produced enough antibodies to register a positive on the test…
San Miguel County was the first place to embark on testing for all. Anyone could get a COVID-19 blood serum test, healthy or not. So far, they have tested about 12 percent of the county’s 8,000 residents.
This is very valuable information. It is telling us that there is unlikely to be a large, natural and pain free herd immunity that has been developed over the past few months. It precludes a pathway which means resources and attention can be more effectively and efficiently focused on other pathways that hold more promise.
OzarkHillbilly
Welp, there goes the trump admins strategy.
satby
Well, isn’t Telluride kind of an atypical community though? Not that I think there’s been a lot of herd immunity developed, just that a small, somewhat remote and insular community may not be the best example.
@OzarkHillbilly: it was Boris Johnson’s strategy in the UK too.
WereBear
If you were talking about a crossroads in Arkansas, possibly. But this is a place with a lot of outside contacts and “people not from here” in the population, so I don’t think so.
Sloane Ranger
@OzarkHillbilly: Bah! We need to get America back to work. We’re losing money hand over fist here. I’m down to my last billion!
Look at the figures. It’s mainly killing the “Others”, know what I mean?
Sure a few thousand real ‘Muricans might die and more get seriously ill but that’s a small price to pay for saving my stock portfolio.
Snark.
Baud
@Sloane Ranger:
I distrust Trump’s judgement as much as anybody, but don’t underestimate the antsiness of people to earn income again and just to get out of the house.
Ohio Mom
About twelve years ago, I had a volunteer gig as an autism mom educator at the local children’s hospital, and they wanted proof I’d had measles, mumps and rubella or the MMR vaccine.
Which I didn’t have. I knew I’d had measles and rubella, and family lore was that I’d had a subclinical case of mumps; while my siblings had mumps one early December, I continued to appear healthy. A big family Christmas break trip to Florida was cancelled because everyone was waiting around for me to get sick.
I never showed any symptoms and no one could believe I escaped the mumps, so the subclinical story was created.
The point of this too long story is, forty-plus years later, I went for a blood test and learned my immune system was still faithfully producing measles and rubella antibodies, which is amazing if you think about it. There were no signs of mumps antibodies so I had the MMR vaccine.
One thing recounting this story just now has given me is an appreciation of how chaotic elementary school teaching must have been back then.
Teachers must have had to do a lot of treading water while childhood diseases ran their course: for instance, you couldn’t introduce long division to a class missing a good number of its students and move on to the next math skill, you’d have to keep teaching long division while all your students took turns being sick.
Sloane Ranger
@Baud: I don’t. I have a great work pension that is more than adequate for my needs and I want my life back to what it was before.
That’s why firm, decisive leadership based on medical and scientific advice is required. Not decisions based solely on financial issues or on what Trump and his advisers think will be best for his chances of re-election.
snoey
@satby: Techbro couldn’t have picked a less useful population to survey, but he had a place there so he was going to be a local hero.
Baud
@Sloane Ranger:
But her emails.
Robert Sneddon
The British government placed advanced orders for 17.5 million serologic tests for COVID-19 antibodies several weeks ago. The tests will come from a number of bio and pharma companies which are developing “pregnancy test stick” style tests, simple to use with quick results and they can be self-administered or done at a GP clinic without having to send blood samples to a lab for processing. Putting those orders out there ensures anyone developing such tests will find a market for them, encouraging investment in time and effort into such work.
Hancock, the Secretary of Health more recently threw cold water on the assorted claims, publicity puff pieces and breathless articles in the press about this company or that who were about to release such a test — the government had received beta versions of some of the test units being developed and validated them, with discouraging results. As many as three out of four test results were wrong for one product line, something that absolutely bars use of these tests to provide essential herd immunity data to determine when the lockdowns can be eased or lifted. The UK government has, as yet, not proceeded with requesting delivery of any of the tests coming on to the market for this reason.
Wag
@snoey:
I disagree. Mountain resort towns like Telluride are a maelstrom of possible infections from all over the world. I practiced medicine in Vail for many years. At any given time during the ski season, the Vail Valley would have 20,000 visitors from many countries and from across the nation. When Beaver Creek hosted the FIS World Championships in 2015, there were competitors in the Valley from 60 different nations. Add to that the workers, both documented and undocumented, working as ski instructors, housekeepers, cooks, dishwashers, salespeople, and all the other jobs that support the ski industry, and you have a community that is far from “insular”. The same dynamics, on a smaller scale, happen in Telluride, as well.
snoey
@Wag: It’s not that it’s not isolated, it’s that we don’t know what the imported case load was so we have no denominator to measure the spread, and it’s so small that 1 or 2 additional spreaders can badly skew the results.
Chris T.
@Ohio Mom: There are diseases that, if you get them, you produce antibodies for life. Supposedly pertussis (whooping cough) is one.
I am of an age where we all got pertussis vaccinations. Apparently the ones we got back then, however, were actually only good for ~30 years. I went on a trip, about 30 years after the vaccination, through non-vaccination-country (parts of WA/ID/MT) and within a week or so came down with a terrible cough that caused vomiting and bronchial scarring and so on and went on for three months: almost certainly whooping cough, though they did not test me for it.
Hey, at least I didn’t break ribs. (That’s common too.) Only the very young whoop, and only the very young regularly die from it. For adults it’s a “mere” 3 month nuisance where you can’t sleep and barf a lot and/or break ribs and so on.
Apparently the modern vaccine lasts longer…
PsiFighter37
Beginning to seriously wonder if I should bite the bullet on my (mostly) nonrefundable hotel reservation in North Italy for mid-August (the plane ticket could be re-used within the next 2 years). I thought things would be better by then, but given the timelines being talked about for social distancing, I’m really not sure.
Lacuna Synechdoche
David Anderson @ Top:
But they won’t be. Maybe at the state level, depending on the state, but not at the federal level.
The typical Trumpian response to that information will be: That’s a nasty conclusion, you’re a terrible analyst, I’m a very stable genius and I say herd immunity will develop and we’ll all be fine. You don’t know anything about diseases or reality.
Which he’ll say right up until the day he dies from CoVid-19.
We’ve all seen how conservatives react to climate change. What makes us think their reaction to pandemic disease will be any different?
Sigh, I don’t know. Maybe I’ve just got learned helplessness from watching too many decades of this shit show play out in various manifestations over and over again.
VOR
@Ohio Mom: My mother had Scarlet Fever as a child, which left her with life-long heart issues. Nobody even thinks about that disease now.
My brother got Chicken Pox at the age of 19. He missed about two weeks of college, one week of which he spent with a 104+ fever. He wasn’t hospitalized but it was a near thing. There was a concern the fever may have left him sterile, which turns out not to be the case.
Apparently as a child, I had a very brief case of chicken pox, so brief my mother wasn’t sure I had actually had it. So I avoided my brother when he was ill. Later, as an adult I went to a birthday party for my wife’s step-sister’s child where I was in close contact while my son played with the girl. At the end of the party, the girl’s mother casually told us she currently had Chicken Pox. And yet she held the party anyways, thought nothing of exposing adults and other children. Getting Chicken Pox as an adult did not appeal to me so I went to my local clinic to have the serological test for chicken pox antibodies. Turns out I did have the antibodies, which was a major relief.
WereBear
@Lacuna Synechdoche:
I think you are right. We all have it.
Anyone familiar with the abuse paradigm is now seeing it played out on a federal level.
We are all helpless children whose fate is held in the fist of a deranged human with ultimate power over us.
We really must push for a long-range solution or we will merely get rid of one “bad parent” and receive another.
Sloane Ranger
@Baud: :-)
Sloane Ranger
@PsiFighter37: BC (before coronavirus) I had booked a holiday in Provence due to start on 20 April. This has been cancelled for obvious reasons. The company contacted me and I have re-booked for October. I have serious doubts that that will take place either. The company told me if it had to be cancelled, I could go in 2021. They definitely don’t want to give me back my money.
OzarkHillbilly
@VOR: My ex got chicken pox when 4 mos pregnant with my youngest. As best I recall, the docs didn’t think it would have much affect on him at his stage of development but had no idea if he would be born infectious or what, so they put us in isolation after his birth. He had the antibodies at birth but 6 mos later they were gone and he ended up getting them later anyway.
Butch
I was under the impression that we still don’t know for sure whether contracting and surviving Covid makes you immune. Am I wrong?
Ohio Mom
Chris T@13: There is something of a mini baby boom in my extended family and as a result I have learned that today’s new parents want evidence visitors have had a recent TDAP for just that reason.
I wonder if we know why our immune systems keep chugging out antibodies for some viruses and not for others.
OzarkHillbilly
@Butch: I have read of 2 cases of a “2nd” infection with covid, but in both cases it was uncertain that they had ever truly recovered or if the disease had just entered a dormant stage for a bit.
Amir Khalid
@Sloane Ranger:
If you did want a refund, how willingly would they give you back your money? I imagine they are not seeing many new holiday bookings, and need to hang on to their £££.
Hildebrand
@Baud: Even today, this very morning, two of my right wing relations posted anti-Hillary memes involving prosecuting her for her emails. Unreal.
Lacuna Synechdoche
We know people develop anti-bodies to fight off the disease and survive it. That means they must develop immunity at least long enough to live through the illness (aka the immune reaction) and kill off most of the virus.
How long we retain the ability to kill off the virus afterwards is up for debate, since, at best, no one has been immune to it for more than 4 or 5 months.
We also think that maybe the virus reactivates in some people after they’ve “recovered” but we don’t know if it makes them sick again or not. We suspect, but don’t know, that maybe they never fully recovered.
But we do know that recovery gives you some immunity – otherwise, you wouldn’t recover and the fatality rate would be 100%. We just don’t the limits or length of that immunity yet, or how effective that immunity will continue to be against mutated strains of the same virus.
Lacuna Synechdoche
@OzarkHillbilly:
Yep, and there seem to be a lot of cases of people, who ultimately died, appearing to improve for a few days before finally succumbing to the disease.
WereBear
@Lacuna Synechdoche:
The “cytokine storm” which was a feature of the 1918 Pandemic.
Which, it turns out, started in Kansas.
Lacuna Synechdoche
@WereBear:
Yes, exactly.
Chris T.
That sort of thing cannot go on forever.
When something cannot go on forever, it doesn’t. Exactly how it stops … that’s the real question. Historically, there are only two options: guillotines (or equivalent), or trials (or equivalent). To those who think they are Masters Of The Universe right now, I say: choose wisely.
RSA
From the article:
Greatest health system in the world, or so I’m told.
PsiFighter37
@Sloane Ranger: That’s great flexibility to have. Unfortunately, I am going up into the Dolomites (Italian Alps), and as a non-skier, I would have no interest in going later than I do, as it will start to get cold / snow by mid-fall.
I will probably just end up hanging on and seeing what happens. The good part is that the Dolomites don’t get much foreign traffic outside of Germany, and the area we are staying is not densely populated at all. Unfortunately, everything at this point, until (if?!) there is a vaccine is something of a calculated risk.
J.
@Ohio Mom: Thank you for sharing. It’s a good story.
@David Anderson: Why isn’t serology testing made a priority? (I know: the Trump Administration.) But seriously, in lieu of a vaccine, serology testing would seem to make a lot of sense and could help at least some people/businesses/industries get back to work safely.
WereBear
@Chris T.:
My entire adult life has been a slow slide into suck, courtesy of Republicans. Lots of stored rage there.
I knew food was a tipping point when the Bastille was stormed. Found this:
If this administration keeps screwing around — and of course they will — people without money will be people without food.
different-church-lady
So I see “#TrumpBurialPits” is trending on Twitter…
evodevo
@OzarkHillbilly: That’s ’cause he got them from mom…a newborn gets almost any antibody that mom has in her circulation – passive immunity, from either milk or across the placenta. That’s why colostrum is so important. A lot of mammals protect their young this way. However it usually fades in humans somewhere between 6mos and 1 yr.
Zzyzx
Here’s a link for a study in Germany that showed a much higher percentage of people with antibodies: https://twitter.com/nachristakis/status/1248228331352461312?s=21. This, at least, is the right question to be asking, so I’m glad we’re getting the data one way or another.
I hope we can analyze it relatively clear headed instead of through wishful thinking or fears.
David Anderson
@J.: The first priority has been point of care diagnostic testing as that immediately informs both clinical and public health measures. Serology testing informs public health and public policy matters. And right now, if a resource has to be devoted to one last test development, there probably is more value to allocate that resource to diagnostic testing.
That marginal allocation decision is changing as diagnostic testing has been ramping up. Soon, bigger picture data that is informed by serology testing will be worth the last marginal resource.
evodevo
@Hildebrand: Yep. A right wing nutjob Facebook acquaintance brings that up at every opportunity…
Frankensteinbeck
@Lacuna Synechdoche: and @Butch:
I’ll add that it would be downright bizarre for the body not to develop somewhere between years and a lifetime of immunity. That’s how the human immune system works, with damned few exceptions. We haven’t had a chance to find out for sure, but there is no evidence beyond a handful of anecdotes that this isn’t true. It would be very, very, VERY obvious by now if we did not develop at least a few months of immunity.
@J.:
You answered your own question. Everyone knows it needs to be done, Trump won’t let it be done. The most common theory is that he thinks accurate numbers will make him look bad.
Ohio Mom
There are some viruses we end up in an uneasy truce with — I’m thinking of the various types of herpes, where a person can have periodic outbreaks their whole life.
There is one spot on my lower lip that starts to tingle and I know a cold sore is on its way. Then I slather on the OTC Abreva, and sometimes it works well and sometimes it doesn’t.
And then there is the chicken pox virus that can trigger Shingles decades later.
So Gulp and Welp if the COVID-19 ends up being in this category (I am assuming this category has a scientific name we may all be learning soon).
schrodingers_cat
@Baud: Garbage Times has still not given up on trying to normalize the Orange One.
evodevo
@PsiFighter37: Great place. We were there a couple years ago and enjoyed it tremendously..
Zzyzx
As a result, I liked this article. It presented the case but also pointed out the biases in those making it and talked about it not being as much of a game changer as we’d want.
https://apple.news/AnZUJLV5gSeSxCGzYKJTg-g
Amir Khalid
@Zzyzx:
I saw that study mentioned in this video that was posted today, but there are commenters mentioning that the paper is only a pre-print and not yet peer-reviewed. Plus some commenters are noting that its conclusions are in some dispute.
Zzyzx
@Amir Khalid: well I’m sticking with my current theory: we don’t know enough yet about anything to make solid predictions. We should know more in the next few weeks. But models are only as good as the data we give them and we’ve had really crappy data.
scav
@evodevo: Could be dust or damage to the neural ruts, could be an unbalanced arm to cause terminal skipping like that.
Immanentize
@Hildebrand: I wonder what joy they receive for that thought? Is it like imagining eternal damnation for the guy who bullied you on high school? Or that girl who wouldn’t go to see a band with you that you knew she loved in college?
Immanentize
@Ohio Mom: Like David St. Hubbins in Spinal Tap?
Meanwhile, I have read very different reports of lasting immunity — some say that in people who might have had mild cases, there is little evidence of immunity, while perhaps those who had serious cases have some significant immunity. There was just a Colorado serology test of a whole small city that had a number of reported cases and they found very little or weak herd immunity. Yikes!
Immanentize
@Zzyzx: sadly, by “we” you cannot mean the US because our data is such puro crap. The real info. Will have to come from elsewhere (like Germany and countries that see me outbreaks like Japan). Let Sigh.
BobS
I’ve thought for awhile now that once antibody testing becomes available and widespread, first responders and hospital workers need to go to the front of the line, followed by other essential municipal workers like public transit, garbage pick-up, child care, etc.
Does this sound right, Mr.Anderson?
zzyzx
I mean if I had said 2-3 weeks ago, “With a solid set of social distancing in most places, but one that falls well short of what China did and with some areas still holding out, the US is likely to see 40k deaths by the end of April with numbers trending off their peak,” I think I would have been told that that was ridiculously optimistic and no model is showing anything close to those results. Now that seems like a likely path.
I mean we’re not out of the woods and I’m expecting other waves, and 30-40k deaths is still a ton, but at some point it has to become obvious that the March model runs were way too pessimistic and we were giving way too much credence to them based on the garbage data we were inputting.
I still think social distancing saved us from a far worse fate than what we’ll end up in, and I still think we’re in this for a while to come (depending on what data comes out), but it’s becoming harder to not see the earlier models as being off in assumptions. I’m going where the data sends me, and I’m feeling more tentatively optimistic these days than I was a few weeks ago. I hope May doesn’t send me back into a pit of despair.
Immanentize
@zzyzx: But what is your death data? If it is anything published as “reported deaths from Covid” it is way too optimistic. And States are actively suppressing death by Covid data.
zzyzx
@Immanentize: depends on which state you’re talking about. Outside of Iceland, which is the one place that’s really doing widespread testing, NY, MA, WA, LA, UT, and RI are all testing at per capita rates along the lines of Europe. We started late but we’re getting there… assuming worldometers data is accurate of course.
What’s up with France by the way? They’re testing far fewer per capita than even we are.
Now
zzyzx
@Immanentize: It’s possible, but we’re not seeing the complete universal overwhelming of hospitals (knock on wood) that Italy saw. The data is garbage all around, but if it’s off by that much, it can’t be hidden.
Matt McIrvin
@zzyzx: Many of the states have really stepped up in the absence of federal leadership. It doesn’t feel great to me because I’m living in a hard-hit East Coast hot spot–I was hoping Mass. had flattened the curve successfully but there was another big, grim jump up in new cases yesterday; it looks like we’re going to have to turn the screws tighter.
John S.
@VOR: My son had scarlet fever about 8 years ago when he was 4. When they came back with the diagnosis, my wife and I were like “that’s still a thing?!” Amazing how these diseases make their way around.
Matt McIrvin
@zzyzx: We’re seeing overwhelmed hospitals and mass graves in New York City. That’s the worst case right now. It doesn’t look like everywhere will be New York, but some places might be.
Zzyzx
@Matt McIrvin: I’m not saying things are good and we need to reopen the country. I’m saying that – if this is indeed the peak – that it’s far less bad than the best case scenarios of mid March. I was expecting Seattle to be like New York is.
Omnes Omnibus
@John S.: The bubonic plague is still bouncing around the world. The military still inoculates for it. Also too, don’t pet the prairie dogs.
Le Comte de Monte Cristo, fka Edmund Dantes
@different-church-lady:
“Trump Burial Pits are coming in ahead of schedule and under budget. One of the bulldozer guys – and these are big, strong guys, unemotional guys who don’t cry about anything – came to me in tears and said ‘Sir, these pits are the greatest, most magnificent pits. How do you do these things so well?’. Anything saying that they’re sloppy and not deep enough is fake news, and is part of a plot by Nancy Pelosi and the Democrat party to put me in another witch hunt.”
sdhays
@zzyzx: The recent surge in non-hospital deaths in NYC suggests that part of the reason we’re not seeing the hospitals completely overwhelmed there is that a lot of people who should have been in the hospital are staying home, for whatever reason. That’s a really troubling development.
Le Comte de Monte Cristo, fka Edmund Dantes
On another humorous note, I just called SBA. The Trumptard who answered to was a dullard with a speech impediment who said that I just have to be patient that it doesn’t move as fast as the law required, he didn’t know why the law required such fast movement, and that he personally didn’t agree with closing the country. I pointed out my situation, and then he said he could get me toward a loan officer faster, and then transferred me to a dead line.
Assholes. The guillotines can’t come fast enough.
dmsilev
LA County is starting community serological testing today.
They’re looking to do 1000 tests; article doesn’t say over what timespan, but presumably just a few days.
PenAndKey
@Ohio Mom: you’re thinking of retroviruses. They persist because they reverse transcribe (hence “retro”) into your DNA. When they’re in that form they’re technically now part of your genome and they’re dormant as a provirus. Herpes is part of that group. The virus that causes COVID-19, however, isn’t. It’s a positive sense single-stranded rna virus with a lipid envelope. It also appears to have a fairly stable genome, so once people fight it off there’s no reason to suspect those people won’t have at least a few years of immunity. Our immune system is very good at remembering positive sense rna viruses.
Le Comte de Monte Cristo, fka Edmund Dantes
@Immanentize:
Let’s flip the calendar back an eternity to March 6, 2020.
U.S. The Trump administration’s decision to forgo a World Health Organization test and create its own had fateful consequences, experts say
We still don’t know why this decision was made, and who profited from it.
MomSense
@sdhays:
I talked to my dad last night. He’s 80, has had major heart surgery and a lung condition. He told me that if he gets it, he will stay home and die rather than go to the hospital. I can understand that decision.
We had a surprise snow storm. Well we knew we were getting snow, just not as much. It was super heavy snow and took a lot of trees down including in my neighborhood. Made me feel for the pandemic sufferers of the past. Dark house, no cell coverage so no phone, and no tv or music distractions is a lonely experience. You just sit with all the worry. We made the best of it, but it was a strange feeling to be so disconnected.
BobS
@Matt McIrvin: https://www.yahoo.com/news/gavin-newsom-declares-california-nation-160012325.html
Brachiator
@Zzyzx:
Less bad in terms of deaths? I guess. But don’t we need to look at deaths and required hospitalizations, at least, to measure some of the impact?
And do we have any reliable explanations as to why some regions were not as hard hit as others, assuming that the regions compared took similar steps to reduce infection?
Steeplejack
Murdoch/GOP ratfucking begins! “Democrats want to drop Joe Biden for Andrew Cuomo, poll finds.”
I was all set to go on a rant about one of my hobbyhorses—the Green Lantern syndrome where a public figure does one thing right and suddenly everyone thinks he or she is the solution to all of our problems. Everybody is forgetting that Andrew Cuomo was a major-league asshole in many ways before he became America’s coronavirus darling. Anybody remember when “America’s mayor,” Rudy Giuliani, was on the fast track to the presidency after 9/11, despite his actually atrocious record as mayor? Rhetorical question.
But wait: the poll results were “shared exclusively with the Post” (Murdoch paper) and the poll was “commissioned by the conservative pro-market Club for Growth, which generally supports Republican candidates.”
Hmm, makes you think. ?
WaterGirl
@PenAndKey: Thank you for all that information!
Matt McIrvin
@BobS: I think he also recently referred to the Disney company as a nation-state, so it’s a phrase he likes to toss around a lot…
Matt McIrvin
@Steeplejack: Murdoch’s media have been pushing the “Andrew Cuomo is a threat to Biden” angle hard for while now. Any positive buzz a Democrat gets is bad news for the Democrats.
joel hanes
@zzyzx:
the March model runs were way too pessimistic
I saw an interview with a very prominent epidemiologist who said “In a pandemic, overreaction is the correct reaction”.
In the absence of good data, sing worst-case models to inform your response is the right course, unless the cost of being wrong is small. In this case, had the models _not_ turned out to be pessimistic, the cost would have been hundreds of thousands of lives.
joel hanes
@Immanentize:
States are actively suppressing death by Covid data
I think so too. Particularly Florida, but probably also Texas and Georgia and Alabama.
Kelly
But the worldwide crisis was supposed to have lots of explosions and require guns. Are you telling me it really requires patience, discipline and community effort?
joel hanes
@Zzyzx:
Seattle had better leadership at several levels of government, and locked down earlier. Ditto the Bay Area in California.
joel hanes
@Kelly:
the worldwide crisis was supposed to have lots of explosions and require guns
https://www.designmom.com/lets-talk-about-protecting-our-families/
MomSense
@Immanentize:
I think red states are trying to suppress the data, but all the blue states are frustrated they don’t have enough testing to get accurate accounting and better information about this virus.
I think the Federal government headed by the trump family is actively suppressing the data.
joel hanes
@Zzyzx:
Thanks for that link; it’s an excellent article.
Barbara
@satby: I think Colorado probably has a number of things going for it, including a younger than average age in the ski communities and Denver. And I personally wonder whether they just have better lung function given the altitude. I have been skiing there and the altitude really kicked my butt until I bought and used supplemental oxygen canisters, which they sell all over the place. Athletes train in Colorado for a reason. This is pure speculation on my part but it wouldn’t surprise me.
Kelly
@joel hanes: I ran across that excellent essay a few days ago. Inspired my snark. ;-)
trollhattan
@John S.:
A friend went to the hospital several years ago, sick as hell with a relentless high fever. The doc examining him said “I’ll be right back” and returned with several interns in tow.
“Who can give me a diagnosis for this patient?”
Crickets
“He has scarlet fever, and I wanted you to see what it looks like in case you ever encounter it.”
Talk about feeling special. IIRC it’s a bacterial infection controlled by antibiotics, the trick is a correct diagnosis in time to prevent permanent damage.
I worked with somebody who got bubonic plague, but that’s another story.
Barbara
@Wag: Just following up on what you said, we have been to Vail and other Colorado ski areas multiple times. Most people are from the U.S., especially the southwest (Texas, for instance), but we have met people there from Mexico, Brazil, the Netherlands, and France, and have heard people speaking (to our ears) Chinese, Japanese, Russian, Italian and Spanish and other languages we didn’t recognize. We sat next to a guy on the lift who added two days to a business trip from the Netherlands to SF just so he could ski in Vail.
Barbara
@trollhattan: One of my nephews had a persistent ear infection when he was about 6. When his fever started spiking yet again, dangerously high, on a weekend, they went to an ER, where people were flummoxed. An older doctor came to see him and told everyone to look closely, because my nephew had mastoid infection — something that used to be common and could become more common again with antibiotic resistance. I have read of people having difficulty diagnosing HIB, which they almost never see anymore because of vaccination against it, but anti-vaxxers will often present without identifying their kids as not having been vaccinated. Such a story comprised the first chapter of Seth Mnookin’s book on vaccination.
Ben Cisco
@Steeplejack: Begun, the rodent copulation has.
Fair Economist
@John S.: Scarlet fever is a strange case. Up through the middle of the 19th century it was a dread disease with high mortality. In the early 20th century mortality fell off sharply until it became no more dangerous than other cases of strep throat – very rarely fatal, occasionally causing heart trouble through an autoimmune reaction. Nobody knows why. Speculations include Streptococcus evolving to be less lethal in response to medical treatment and nutrition improvement (though it is not very lethal in the 3rd world either). Medical treatment explains part of the improvement but even untreated cases are almost never fatal anymore.
Beowulf888
Turns out that there are NO real experts claiming that this is a real scenario: “One of the optimistic scenarios for COVID-19 is an asymptomatic hypothesis. This hypothesis contends that there is a large pool of individuals who are immune to COVID-19 because they had a very mild or asymptomatic infection over the winter.”
This hypothesis started with the Rush Limbaugh show when Limbaugh had a guy named Victor Davis Hanson on his show last week. Hanson is a military historian and fellow at the Hoover Institution, a right-wing think tank located at Stanford University. He’s not a public health expert, just a rightwing ideologue spouting bullshit.
After Limbaugh’s show, a reporter from a TV station in Salinas CA put together a news story based on it. She quoted Hanson extensively in the report, and either Hanson misrepresented himself to her — or she assumed — that he was involved a actual study being conducted by researchers at Stanford Medicine to test to people in California for antibodies to the virus. She also misrepresented what the study is looking at — i.e. that the virus has been circulating in California since the fall. It’s not investigating that at all. Here’s a link to the study (it doesn’t make any claims that the virus has been circulation in CA since the fall, nor about CA acquiring herd immunity): https://www.kron4.com/wp-content/uploads/sites/11/2020/04/covid19-study.pdf
The story was reprinted by SF Gate, which is associated with the San Francisco Chronicle. This creates the impression that it’s coming from a reputable source. (Both SF Gate and the Salinas TV station are owned by Hearst Communications.) Limbaugh subsequently cited the San Francisco Chronicle as the source to validate his theory.
Fair Economist
@zzyzx: I am going to hold off cheering until at least ONE state has a sustained drop in new cases. Several states, notably on the West Coast, are doing far better than expected but even there diagnoses and deaths continue to increase. The data still indicates we are on a mitigation path (even if a good one), not a suppression one.
Brachiator
@Matt McIrvin:
I live in Southern California, so I am also a nation-state.
ziggy
Exactly, the numbers of new cases are not dropping precipitously yet. There is plenty of reservoir to crank up high numbers of hospital cases if we let up even a bit at this point. I’m hopeful that some kind of asymptomatic herd immunity, combined with a seasonal slowdown, will bring things down enough that the economy can be brought back somewhat, but it’s not showing up yet.
It will be interesting to see what the results of the SCAN test in Seattle show. If any area has had the opportunity to develop immunity, it would be the Seattle area, with the early exposure and community spread of the virus. ETA–doesn’t sound like they are doing antibody testing yet.
Zzyzx
I’m not partying. I’m more like pleasantly surprised right now.
King County is kind of confusing me. We’ve been in the same range of 150-250 cases and 8-15 new deaths every day for weeks now. To be honest, if we stay shut down until late June and build herd immunity that way, I’m fine.
dimmsdale
My two “without-fail” YouTube stops every day are Cuomo’s daily briefing and Chris Martenson’s “Peak Prosperity” YouTube channel. Martinson is a PhD pathologist and reviews the stats and data on a daily basis, and possible economic implications; his entry yesterday included a citation about fifty South Korean patients who had had the disease, then RE-acquired it. During the course of his data review he asks a lot of interesting questions: Did these folks develop neutralizing antibodies when ill that were insufficient to deal with a second onset (which might mean vaccines may not work, or not work for everyone), or does the virus go dormant only to re-emerge later? Most of his conclusions are temporary and based on the notion of “We just don’t know yet, there’s insufficient data,” but listening to him tease out variable alternatives makes me think we may well be dealing with this thing through December at least. (That includes waiting for the Red State idiots to flounce around without masks or social distancing, get hit good and hard with exponential growth of cases, overwhelmed ICUs and the like, have the Feds swoop in with all that equipment and PPE they’ve been stealing off airport runways from states that already ordered it (and caching someplace, we don’t know where), and hope that the red state case load tapers off somehow so that the rest of us can re-open with a margin of safety.)
ziggy
But I am not! I also live in the PNW, but I’m a landscaper, and this is the season that I make hay. I have plenty of work booked (TG!), but I’m getting further and further behind. If things go on like this much longer, we are going to be really hurting financially, and the small business loan program has been completely unworkable so far.
There’s got to be a way to get there without destroying more of the economy…
Zzyzx
@ziggy: ping me in a few weeks and I might hire you guys if all of my summer tour plans get axed. I let my yard go and that needs to be fixed.
joel hanes
@Fair Economist:
Scarlet fever
Pathogens that frequently kill their victims before or during their reproductive years will, all other things being equal, tend to evolve to be less fatal.
ziggy
@Zzyzx: appreciate the thought, and I’d love to work in Seattle again, but I actually have work booked through the end of my season (November), that I can’t get to now. If this continues beyond May 4th, I’m considering putting together an online consulting/designing service.
Zzyzx
@ziggy: oh you meant it that way. Ok
Good luck!
Kirk Spencer
@ziggy: my pessimist model still stands .
I see a minimum of 50% of the population getting this, and up to 90%. I’ve go a handwaved estimation that half those who get it are asymptomatic, either no symptoms or so mild it goes unreported. Of the remainder a minimum of 1/1000 will die either directly or consequential to it.
That gives a floor of 82500 dead in the US.
Raise the percentage dying to the current US of 1.5% and you get just under 1.25 million dead. That’s keeping enough social distance to avoid swamping any more medical systems, but sustaining our current known death rate of known cases.
Note this is end of sequence, not end of month or maybe even end of year. The grinding death toll is going to be normal, but not yet
My opinion, of course.
Brachiator
@dimmsdale:
I will take a look at the Martenson channel. Thanks for the info.
ziggy
@Kirk Spencer: Unfortunately I agree with the premise that a large proportion of the population will eventually get it. And that we will become numb to the grinding death toll. Even South Korea is still swatting out fires. But I’m hopeful that the mortality rate can be kept much lower:
–if there is a large percentage of asymptomatic/mildly symptomatic such as has been seen in Iceland with widespread testing.
–protecting the population most vulnerable to mortality with continued quarantines and policies. Just keeping it out of nursing homes and assisted living facilities would be a tremendous boost. Instantaneous testing could be a big help with that.
–developing new treatment protocols and finding drugs that are more effective, to keep people from getting to the point that they need assisted breathing.
–many people will hopefully give up some of the practices, such as smoking cigarettes and pot, and I think vaping, that make them more likely to develop serious complications.
Brachiator
@ziggy:
Human beings are social by nature. This is now a vulnerability. We may have to rethink how we deal with places where people congregate voluntarily, and where people congregate when they have no choice.
The former includes all public venues such as theaters, sports stadiums (or is it stadia), buses and trains, etc.
Among the latter are prisons and nursing homes and other assisted living facilities. The sometimes unhealthy environment of nursing homes is a sad almost open secret that people don’t talk about. The problems existed before, but the pandemic made them more tragically manifest.
It’s going to take money and political will to address these issues.
Great point. It will be interesting to see what happens here. Any new treatments might also help with pneumonia, asthma, etc.
There are some new studies that de-emphasize the fact that in China many more men smoke than women as a large factor in virus fatalities. Vaping and pot smoking? Makes sense to some degree, but there needs to me more investigation here.
I wonder what the smoking habits are in Iran, where there have also been a large number of cases and fatalities.
J R in WV
@MomSense:
My wife spent weeks on a vent in MICU 10 years ago. Survived Septic Shock when the odds were 70/30 against her. Since we have traveled to Europe twice and Baja California Sud to hug whales. She is 71, a little frail, and completely unwilling to trek to the ER again for any uncurable condition.
Many times she has said “They are going to have to carry me out of home on a slab!” So I am going to do whatever I can do that will keep her safe at home… I know this might not be possible, but there you go.
Will be wearing a mask and gloves next time I go to the store, even if the good mask I have will make me look like a martian invader. It is an industrial mask with two giant lavender filter packs on either side, N-100 for particulate material, also was good for gas and fumes back when I bought it, probably not so much anymore, but the N-100 is what counts in today’s hazardous world.
otmar
David, this may be of interest to you.
Austria did a statistically valid study to see how many cases are undetected.
Steeplejack (phone)
@otmar:
Damn it, that whole story, and presumably the study, hinges on “acutely infected” rather than just (merely?) infected, but nowhere does it define “acutely infected.”
glc
@Butch: Or to put it another way –
This is a working hypothesis:
And one which is likely to be resolved or very much clarified quite soon.
ColoradoGuy
A good complement to Martenson’s YouTube channel is MedCram, by a pulmonary specialist in Southern California. Martenson can sometimes tilt towards the worst-case scenarios, while the MedCram channel is focused on detailed methods on how to decrease the percentage of infected people who end up in hospital. The 1918 methods of hydrotherapy, which strongly stimulate the “innate immune system”, look promising. As the host of MedCram mentions, prior to the 1950’s, a diagnosis of pneumonia was close to a death sentence, so there were many methods to prevent it developing. These methods are now useful in keeping from advancing to the more severed forms of the disease.