Best theory I've seen is that widespread exposure to 2003 SARS confers a higher degree of protection in the population. Only thing that is really consistent across all of those countries. Lots of different policies (SK? Lots of testing and tracing! Japan? Almost no testing and tracing!), but comparable outcomes.
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Last: 2 yr ago by AggieUSMC
It's absolutely due to their early response. Cultures with high levels of conformity, most of whom were already used to wearing masks due to living in heavily polluted urban areas and/or due to experience dealing with bird flu, etc.Complete Idiot said:Why is Asia so different? Never really established, they got a hold of it early enough where man did have some control? It's a weird anomaly to me.Keegan99 said:
There's a seasonality and latitude component. Los Angeles, Phoenix, Houston, Jacksonville. All on I-10.
All with remarkably concurrent curves.
While not fully understood, the effect of latitude on seasonality of viruses was observed by Hope-Simpson decades ago.
The singular conceit through all of this is the belief that mankind has some great control. I do believe we can make it worse (see: NY and NJ) and perhaps slow it a bit, but we can't really shut it down once it's established in a community. The virus is going to do its thing.
Funny that warm latitudes are somehow getting equated with virus prevalence. This thing was supposed to be dead when things warmed up in April...
Well, that was one prediction I had that hasn't proven true - this coronavirus was highly seasonal like other known coronaviruses and would therefore dissipate in June. I had seen a study that all other known coronaviruses peak Dec - Mar in America, and largely go away after May. This one seems different, maybe just because it is novel and therefore doesn't follow the patterns of established viruses. Or maybe it's just different enough genetically.
If the 20% herd immunity holds, it probably points to things like natural immunity, acquired immunity from other viruses, natural resistance to acquiring it, asymptomatic ability to fight the virus or some factor a person has that reduces the spread. I believe that the mitigation (e.g. masks) people are doing is suppressing the spread as well.
Here is what Hope Simpson observed.
Great, so December and January are gonna be worse than spring / summer.
The 2002-2004 SARS outbreak is thought to have infected fewer than 9000 people. So, it seems unlikely to me that there is widespread cross-immunity from that. I do think that the scary nature of that outbreak (~10% mortality) helped many governments in East Asia take public health very seriously. It's true that South Korea's approach to contact tracing is quite different from Japan's "cluster-busting" strategy. But I think that just means there are multiple successful ways to control this epidemic - as long as you have decent government w/ good public health infrastructure.
wrt the idea that 20% might be close to the herd immunity threshold: I'd love that to be the case (one of my kids is moving to NYC very soon). But it seems hard to square with very high seroprevalence in some parts of Lombardy, or this new estimate of 71% seroprevalence in Iquitos, Peru (
wrt the idea that 20% might be close to the herd immunity threshold: I'd love that to be the case (one of my kids is moving to NYC very soon). But it seems hard to square with very high seroprevalence in some parts of Lombardy, or this new estimate of 71% seroprevalence in Iquitos, Peru (
). Epidemiologists expect some "overshoot" of the herd immunity threshold in conditions of fast spread, but 71% seems very high if the threshold is in the 20% range.
It's certainly not out of the realm of possibility that Covid could behave completely oppositely from the seasonality of other coronaviruses and the flu, but that's a really bold leap at this juncture.Keegan99 said:
Virus gonna virus.
There are states further north that are seeing a second wave (e.g. Wisconsin, Iowa) and also ones that still haven't yet confirmed a first peak... they've been a slow ramp upward (Ohio, Tennessee).
There are countries in the south (Australia, New Zealand) that are done with it. While it's true they had the luxury of geographic isolation, they also committed early to stopping Covid. Just like East Asian countries above and below the equator did.
This is about attitude, not latitude.
I mean some flu strains that end up in the flu shot today are still quite deadly. H3N2 being one of them. AFAIK they occasionally put in what is known as the Hong Kong flu in the shot every so often.Complete Idiot said:Cyp0111 said:
You mean the one that was more than 100 years ago and previous ones that did not have near the level of global interconnects.
Well, there have been many pandemics. Late 50's, late 60'a, 2009 - they did all end. However , each is unique of course and while likely to end at some point there are no guarantees - and can be painful to get there.
One pandemic has been going on almost 40 years - HIV/AIDS, so not every other pandemic has ended.
It is entirely plausible COV19 is with us for 40 years as well. Although not in the same way as HIV, obviously.
For good news, the state that got hit the hardest is looking reasonably good.
The latest day had only 18 deaths. The peak day was 1025.
The latest day had only 18 deaths. The peak day was 1025.
It's worth noting it's not just the state hit the hardest, the NYC area is the hardest hit area in the world (as measured by deaths per million in population). Of course this is assuming data is reported accurately from all world areas, but Worldometers shows NYC area as the highest deaths per million in the world.
It's hard to understand why.
It's hard to understand why.
Complete Idiot said:
It's worth noting it's not just the state hit the hardest, the NYC area is the hardest hit area in the world (as measured by deaths per million in population). Of course this is assuming data is reported accurately from all world areas, but Worldometers shows NYC area as the highest deaths per million in the world.
It's hard to understand why.
Manhattan is probably a big reason. 2 million people commute in and out 5 days per week.
Certainly thats notable but I don't know if it's unique among the largest cities in the world. NYC isn't even a top 10 largest city at the moment (per wiki anyway).
Maybe its a combination of the population, and transient population as you noted, plus the fact it got in there real bad before the rest of the major cities and before lock downs in the other huge cities. It's probably dumb, but I feel a bit embarrassed a US city has the highest death rate in the world - I thought our practices and health care system would have made that impossible.
Maybe its a combination of the population, and transient population as you noted, plus the fact it got in there real bad before the rest of the major cities and before lock downs in the other huge cities. It's probably dumb, but I feel a bit embarrassed a US city has the highest death rate in the world - I thought our practices and health care system would have made that impossible.
Complete Idiot said:
Certainly thats notable but I don't know if it's unique among the largest cities in the world. NYC isn't even a top 10 largest city at the moment (per wiki anyway).
Maybe its a combination of the population, and transient population as you noted, plus the fact it got in there real bad before the rest of the major cities and before lock downs in the other huge cities. It's probably dumb, but I feel a bit embarrassed a US city has the highest death rate in the world - I thought our practices and health care system would have made that impossible.
We also didn't barricade people into their homes, block roads with dirt so people couldn't leave the city, or restrict people by having only one person going outside for only 1-2 hours a day for the sole purpose of getting groceries.
NYC stats do show 90% of those who passed had a comorbidity, it's possible NYC is just unhealthier than average as well?
Or course people also accused NYC of lying about the numbers as well, so who knows.
Or course people also accused NYC of lying about the numbers as well, so who knows.
Both sides of the equator look similar...check.Keegan99 said:
Here is what Hope Simpson observed.
What is up with the disparity of virus prevalence in the N30+ and S30+ hemispheres? ...seems wrong.
Northern/Southern Hemisphere summers are opposite months?
Could be an artifact of the very analog era when the data was collected and the populace in that range globally.
Complete Idiot said:
NYC stats do show 90% of those who passed had a comorbidity, it's possible NYC is just unhealthier than average as well?
Or course people also accused NYC of lying about the numbers as well, so who knows.
So, I also think NYC's issue was putting sick patients back in nursing homes. Just looking at NYC Health's webpage, the deaths per 100,000 is over 1,500/100K for the age group 76+. The next lowest is the 65-74 age group at 600/100K. Almost 3X as much in the 75+ age group - hard to imagine sending sick patients back into nursing homes didn't play a role in those numbers.
Beat40 said:Complete Idiot said:
NYC stats do show 90% of those who passed had a comorbidity, it's possible NYC is just unhealthier than average as well?
Or course people also accused NYC of lying about the numbers as well, so who knows.
So, I also think NYC's issue was putting sick patients back in nursing homes. Just looking at NYC Health's webpage, the deaths per 100,000 is over 1,500/100K for the age group 76+. The next lowest is the 65-74 age group at 600/100K. Almost 3X as much in the 75+ age group - hard to imagine sending sick patients back into nursing homes didn't play a role in those numbers.
This is alarming. I put Harris side-by-side with Hidalgo county here.
Note the differences in the Y-axis intervals. Much loser cases, much higher death counts. Their % death rate has got to be really really bad and its probably the reason why the cumulative death rate in Texas has been flat at 1.2% for the past week, when it had been dropping daily for over a month.
https://tabexternal.dshs.texas.gov/t/THD/views/COVIDExternalQC/COVIDTrends
Note the differences in the Y-axis intervals. Much loser cases, much higher death counts. Their % death rate has got to be really really bad and its probably the reason why the cumulative death rate in Texas has been flat at 1.2% for the past week, when it had been dropping daily for over a month.
https://tabexternal.dshs.texas.gov/t/THD/views/COVIDExternalQC/COVIDTrends
Australia isn't done with it. They too are in the middle of a second wave.deadbq03 said:It's certainly not out of the realm of possibility that Covid could behave completely oppositely from the seasonality of other coronaviruses and the flu, but that's a really bold leap at this juncture.Keegan99 said:
Virus gonna virus.
There are states further north that are seeing a second wave (e.g. Wisconsin, Iowa) and also ones that still haven't yet confirmed a first peak... they've been a slow ramp upward (Ohio, Tennessee).
There are countries in the south (Australia, New Zealand) that are done with it. While it's true they had the luxury of geographic isolation, they also committed early to stopping Covid. Just like East Asian countries above and below the equator did.
This is about attitude, not latitude.
goodAg80 said:
If the 20% herd immunity holds, it probably points to things like natural immunity, acquired immunity from other viruses, natural resistance to acquiring it, asymptomatic ability to fight the virus or some factor a person has that reduces the spread. I believe that the mitigation (e.g. masks) people are doing is suppressing the spread as well.
Good post
Very similar 12-14 week burn out in most hard hit cities and countries. Houston will see the same big drop off by the end of August, IMO.
I also believe NYC spread it throughout the country. I know of two families myself that split town and went to Georgia and Jacksonville, Fl. . . .
Cepe - its pronounced "Ceep" and stands for my initials - CP.
This is really not that hard to figure out. For any geographical area, you see very few cases at first. Then at some point the virus gets to enough people you see exponential spread, a spike in positive cases, and then a spike in hospitalizations, then a spike in deaths...all lagging the former by about 1-2 weeks. Followed by a peak of these things lagging the former by 1-2 weeks, followed by a gradual tapering off down to almost zero.
It has followed this pattern in literally every circumstance and every geographical region. The only difference is WHEN the virus starts spreading rapidly. This lends credence to the Herd Immunity Threshold ~20%. The virus fizzles out predictably. The biggest variables that alter the height of the peak:
1. Situations like NY where Senior Facilities were literally seeded with positive patients, followed by a very dense population allowing higher-than-normal community spread
2. No two entities reporting the statistics in the same way, both relative to other cities/counties, states/countries, but, in many cases, not even the same way as themselves compared to a week or a month, or three months ago.
Places like Texas, that "locked down" well before the virus really took hold, see rises once things open to some extent. It is inevitable. We can debate whether that was the right thing to do, but I think it is clear we are more capable of handling a spike now than we would have been April 1, for myriad reasons.
Why we don't have leadership that can see this pattern is beyond me.
It has followed this pattern in literally every circumstance and every geographical region. The only difference is WHEN the virus starts spreading rapidly. This lends credence to the Herd Immunity Threshold ~20%. The virus fizzles out predictably. The biggest variables that alter the height of the peak:
1. Situations like NY where Senior Facilities were literally seeded with positive patients, followed by a very dense population allowing higher-than-normal community spread
2. No two entities reporting the statistics in the same way, both relative to other cities/counties, states/countries, but, in many cases, not even the same way as themselves compared to a week or a month, or three months ago.
Places like Texas, that "locked down" well before the virus really took hold, see rises once things open to some extent. It is inevitable. We can debate whether that was the right thing to do, but I think it is clear we are more capable of handling a spike now than we would have been April 1, for myriad reasons.
Why we don't have leadership that can see this pattern is beyond me.
Agree. So what's the solution?RandyAg98 said:
This is really not that hard to figure out. For any geographical area, you see very few cases at first. Then at some point the virus gets to enough people you see exponential spread, a spike in positive cases, and then a spike in hospitalizations, then a spike in deaths...all lagging the former by about 1-2 weeks. Followed by a peak of these things lagging the former by 1-2 weeks, followed by a gradual tapering off down to almost zero.
It has followed this pattern in literally every circumstance and every geographical region. The only difference is WHEN the virus starts spreading rapidly. This lends credence to the Herd Immunity Threshold ~20%. The virus fizzles out predictably. The biggest variables that alter the height of the peak:
1. Situations like NY where Senior Facilities were literally seeded with positive patients, followed by a very dense population allowing higher-than-normal community spread
2. No two entities reporting the statistics in the same way, both relative to other cities/counties, states/countries, but, in many cases, not even the same way as themselves compared to a week or a month, or three months ago.
Places like Texas, that "locked down" well before the virus really took hold, see rises once things open to some extent. It is inevitable. We can debate whether that was the right thing to do, but I think it is clear we are more capable of handling a spike now than we would have been April 1, for myriad reasons.
Why we don't have leadership that can see this pattern is beyond me.
I don't pretend to know all the answers, but, in my opinion...
Open up everything, using social distancing, masks, reasonable occupancy limits, and other precautions until we are well into the downswing (estimated by me to be 3-4 weeks from now in Houston).
School should be able to start, in person (for those who want or need it), for AT LEAST K-5 grades, with all adults practicing social distancing protocols with each other, but teaching kids normally.
Avoid large gatherings in tight quarters until we reach 50% of the peak hospitalizations.
Continue to take every precaution to protect high-risk individuals.
Then get on with life.
Open up everything, using social distancing, masks, reasonable occupancy limits, and other precautions until we are well into the downswing (estimated by me to be 3-4 weeks from now in Houston).
School should be able to start, in person (for those who want or need it), for AT LEAST K-5 grades, with all adults practicing social distancing protocols with each other, but teaching kids normally.
Avoid large gatherings in tight quarters until we reach 50% of the peak hospitalizations.
Continue to take every precaution to protect high-risk individuals.
Then get on with life.
While I do think that 20% infection rate PLUS other mitigation measures (whether government enforced or not) may be enough to have sustained R_t < 1, it is worth noting that there ARE areas that had >20% infection rate.
In Bergamo, Italy -- one of the first hot spots that was late to shut down after experiencing their outbreak, had 57% of their residents get coronavirus.
https://www.reuters.com/article/us-health-coronavirus-italy-antibodies/over-half-of-people-tested-in-italys-bergamo-have-covid-19-antibodies-idUSKBN23F2JV
https://www.medrxiv.org/content/10.1101/2020.04.15.20067074v3
The death rate of the entire population was 0.58%, which means that if 57% of the entire population was infected, then the infection fatality rate is about 1%, which lines up with the calculated IFRs of similar early-breakout locations when treatments were still in their infancy.
That doesn't suggest to me that something like that could happen in the US now, by and large their outbreak happened before people took the virus seriously and they were extremely late to react. They also had the issue of multi generational housing and an older population. They were probably undergoing something close to the true R0 of 2.5 during their outbreak, whereas in the US the places that are "outbreaking" are peaking at R_t of 1.1-1.3.
But, to me it is reasonable evidence that there is not some magical barrier at 20% infection where the virus dies out regardless of what behaviors we pursue. I think we are just seeing that 20% infection of the population, in combination with other behavior changes, testing, tracing, etc. is probably enough to have sustained R_t <1.
In Bergamo, Italy -- one of the first hot spots that was late to shut down after experiencing their outbreak, had 57% of their residents get coronavirus.
https://www.reuters.com/article/us-health-coronavirus-italy-antibodies/over-half-of-people-tested-in-italys-bergamo-have-covid-19-antibodies-idUSKBN23F2JV
https://www.medrxiv.org/content/10.1101/2020.04.15.20067074v3
The death rate of the entire population was 0.58%, which means that if 57% of the entire population was infected, then the infection fatality rate is about 1%, which lines up with the calculated IFRs of similar early-breakout locations when treatments were still in their infancy.
That doesn't suggest to me that something like that could happen in the US now, by and large their outbreak happened before people took the virus seriously and they were extremely late to react. They also had the issue of multi generational housing and an older population. They were probably undergoing something close to the true R0 of 2.5 during their outbreak, whereas in the US the places that are "outbreaking" are peaking at R_t of 1.1-1.3.
But, to me it is reasonable evidence that there is not some magical barrier at 20% infection where the virus dies out regardless of what behaviors we pursue. I think we are just seeing that 20% infection of the population, in combination with other behavior changes, testing, tracing, etc. is probably enough to have sustained R_t <1.
Those more well-versed...is R0 affected by population density, social dynamics, etc. Or is it theoretically a constant for a given pathogen?
I agree with Randy 88- Randy for Governor!RandyAg98 said:
I don't pretend to know all the answers, but, in my opinion...
Open up everything, using social distancing, masks, reasonable occupancy limits, and other precautions until we are well into the downswing (estimated by me to be 3-4 weeks from now in Houston).
School should be able to start, in person (for those who want or need it), for AT LEAST K-5 grades, with all adults practicing social distancing protocols with each other, but teaching kids normally.
Avoid large gatherings in tight quarters until we reach 50% of the peak hospitalizations.
Continue to take every precaution to protect high-risk individuals.
Then get on with life.
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