Coronavirus

[AWvsCBsteeeerike3]

Nuance is important in these conversations.

It's frustrating that more isn't absolutely known 6 months into this pandemic but I'd tend to agree with AD (if I understand correctly) that it's important to give medical professionals a voice even if we aren't dealing in absolutes at the moment.

That said, nuance is not exactly well received nor well communicated given the current atmosphere. Within hours of the WHO announcement yesterday, there were headlines abound that read "Asymptomatic spread of virus is 'very rare,' WHO says". For a society that just reads headlines and takes them as gospel, yeah, that's a dangerous headline.

Similarly, people will very much cling onto any bit of information that fits their world view and run with it. And, I'd tend to agree with Zeus that people will be able to run with this information in dangerous directions.

This entire situation has really highlighted how inept our lines of communication are in America. People can watch different news outlets and come to completely different conclusions because the news can be so divisive and leading. People are too stupid to try to understand a full picture and news organizations have no incentive to portray the full picture anyway.

[Arthur Dent]

That said, nuance is not exactly well received nor well communicated given the current atmosphere. Within hours of the WHO announcement yesterday, there were headlines abound that read "Asymptomatic spread of virus is 'very rare,' WHO says".

The truly irresponsible party here is not a WHO official trying to answer a question to the best of her knowledge, but the media and political actors who run with a single statement in this manner.

But I don’t know that the broad public is actually all that responsive to single headlines either. For all the focus on jerks, people overwhelmingly seem to be trying to do their part, even when painful, and generally support the need for public health measures even while being doused by irresponsible media and politicians.

[heyzeus]

I disagree, AD. I think what the WHO released, saying asymptomatic spread was "rare," was a disservice to the public on its face, and the only uncertainty was introduced by the WHO itself. Four studies have already showed that the disease is spread by asymptomatic carriers. The correct conclusion that WHO could have (but didn't) publicize is that contact tracing is not effective at demonstrating asymptomatic spread, which is unsurprising given that we're talking about exposure to people who themselves don't know they have COVID.

[mikechamp]

(sigh....)

13 high school students test positive for coronavirus after unsanctioned prom

At least 13 students from Foster High School and George Ranch High School have tested positive for COVID-19 after reportedly attending a prom event in Katy on May 28. The event was not sanctioned by the schools, and the group then spent the weekend at a beach house in Galveston, according to the Fort Bend Herald.

https://www.yahoo.com/lifestyle/13-high ... 42716.html

[Arthur Dent]

The studies show that asymptomatic spread is possible, and in specific circumstances common. They do not establish it is common in general.

The studies showing asymptomatic spread are based on limited relatively closed spaces, where it is possible to study these things. The most famous example is the Diamond Princess cruise ship. In those cases, asymptomatic spread is relatively common. But do the circumstances on a cruise ship or homeless shelter mirror those in the wider population? To answer that, you'd want to look at things like contact tracing of a big population. This method, of course, carries it's own problems of missed cases, unreported contacts etc.

Let me quote from the Annals of Internal Medicine:

Prevalence of Asymptomatic SARS-CoV-2 Infection

As noted earlier, the data and studies reviewed here are imperfect in many ways. The ideal study of asymptomatic SARS-CoV-2 infection has yet to be done. What might that study look like? Most important, it must include a large, representative sample of the general population, similar to the U.S. serosurvey for which the National Institutes of Health is currently recruiting (31). In contrast to the narrowly defined cohorts here, it will be illuminating to have data that accurately reflect the population at large. In addition, longitudinal data must be collected over a sufficiently long time to distinguish between asymptomatic and presymptomatic cases.

Closed cohorts, such as cruise ships, aircraft carriers, and correctional facilities, offer both advantages and disadvantages. Because the likelihood of viral exposure is so much greater than in other settings, the “treatment” that participants receive may be close to uniform. As a result, we may learn more about the average incidence of asymptomatic infection. But the confined environment—which ensures frequent, overlapping interaction between participants—makes it challenging to accurately trace contacts and elucidate the chain of viral transmission.

On the basis of the 3 cohorts with representative samples—Iceland and Indiana, with data gathered through random selection of participants, and Vo', with data for nearly all residents—the asymptomatic infection rate may be as high as 40% to 45%. A conservative estimate would be 30% or higher to account for the presymptomatic admixture that has thus far not been adequately quantified. In any case, these high rates are not aligned with current testing programs that have predominantly focused on symptomatic cases. Beyond expanding testing to those without symptoms or known exposure, our inability to recognize carriers might make necessary the broad adoption of preventive strategies, such as masks.

[heyzeus]

GRB: Come for the dick jokes and occasional baseball-related pathos, stay for the passages from the Annals of Internal Medicine.

That does make sense, AD. I'm very curious about 1) Outdoors asymptomatic spread, and 2) asymptomatic spread in primary school settings. Do kids spread to kids, do kids spread to adults? I assume so, but it would be great to have it studied.

[ghostrunner]

Both interesting tweets.

First is just another in a set of examples suggesting that outdoor spread is unlikely. Though i still would say that was premature, but I guess we can learn from it.

The second one is more interesting. Just a data point, as she says.

Separately there also some results from tracing done on that Navy ship suggesting that masks are effective.

[ghostrunner]

Here’s the study on the navy ship. I suppose it’s probably best not to draw too much from any one of these polls/studies, but at least these are some results from everyday circumstances.

I wonder if anyone followed up on that restaurant from Colorado.

[AWvsCBsteeeerike3]

The truly irresponsible party here is not a WHO official trying to answer a question to the best of her knowledge, but the media and political actors who run with a single statement in this manner.

No disagreement there.

But I don’t know that the broad public is actually all that responsive to single headlines either. For all the focus on jerks, people overwhelmingly seem to be trying to do their part, even when painful, and generally support the need for public health measures even while being doused by irresponsible media and politicians.

That's probably true, overall. But there are no shortage of people with their heels dug in. And, they continue to load their argument with half-truths and misleading statements such as this one. And, these are the people that think wearing masks is a sin against manhood, social distancing is an assault on freedom, etc. Maybe your faith in humanity is more than mine, or maybe I'm just exposed to more of these people than you and that shapes my views differently. Regardless, they are numerous around here.

[AWvsCBsteeeerike3]

Looking at the numbers from the Arkansas Dept of Health, which I think has done a good job of recording data overall, they have some information that helps break down the mortality rate.

Overall, as of 6/9/20, there's 161 deaths and 6875 recoveries which is a 2.3% mortality rate. There's no assumptions or ambiguities in that calc, it's a hard fact.

Going further, they break down the deaths by age group, but they don't break down the recoveries by age group. Again, 6/9 numbers are 10071 cases. Going back 2.5 weeks which I'll use for time to die from Covid, that's ~6000 cases. 6K/10K = ~0.6. By taking cases today in each age group and multiplying by 0.6, it gives the approximate number of cases for each age group from 2.5 weeks ago. (It's not perfect, but it turns out to be conservative). Dividing deaths today by those reduced numbers gives the mortality rate for age groups which are as follows:

65+: 15.4% (117/757)
45-64: 2.1% (36/1774)
25-44: 0.3% (8/2286)
0-24: 0% (0/1229)

0-64: 0.83% (44/5289) Back checking this number by taking all non 65+ deaths divided by all recoveries with the assumption all 65+ cases were recoveries (to lower the denominator as much as possible) gives 44/(6875-1262) = 0.78%. Going further and adding the 65+ deaths back into the denominator since we know they didn't recover gives 44/(6875-1262+117)= 0.77%

So, there's that. Obviously that accounts for only 6K recoveries when we know there have been 6875, so that's conservative as the last back check shows. The numbers further don't account for the lack of testing from earlier in the pandemic. So, that leads to conservative estimations as well.

But, as of right now, that's the best I got for Arkansas' mortality rates. And, it should be noted, Arkansas is probably in the worst 10% of all states for [expletive] like obesity, diabetes, hypertension, etc. Basically, all the stuff that increases risk.