Keegan99 said:

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A comparison to H3N2 seems relevant.

That killed 100,000+ Americans in 1968-1969.

Most of them were elderly, and that was in a country with a population 60% of today and a median age 10+ years younger.

An equivalent flu today would kill 250k+ easily.

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That was the one called the Hong King Flu, right? I remember reading there was also an influenza pandemic in the late 50's that was pretty bad, and I think that was called the Asian Flu here. So many seem to come out of Asia!

Is it relevant to you because of the death toll? Over what time frame did it kill 100k? 2 years?

I think as the doctors in here have said before nearly all respiratory illnesses have the most impact on the elderly. I think the Spanish flu in 1918 was a bit unique in the number of people aged20-40 that were killed.

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Is it relevant to you because of the death toll? Over what time frame did it kill 100k? 2 years?

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Yeah, the Hong Kong flu pandemic was a 2-season event.

The 100,000 is also an estimate made years later. The healthcare world is already estimating we're well over 100,000 Covid-19 deaths.

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Most of them were elderly, and that was in a country with a population 60% of today and a median age 10+ years younger.

An equivalent flu today would kill 250k+ easily.

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We have a little over twice as many people aged 65 or older today as we did in 1968, so it probably doesn't extrapolate quite that high.

And the bulk is in the 65-70 range, so the younger side of old, as it were. All those school kids in 1968 that skewed the average age down.

The average American 70 year old is going into this pandemic with better health, or better managed health, than they did in 1968.

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From Dr. Coates - More positive news...

For the people still living in fear of Covid-19.
You don't have to here is the latest estimates of mortality rates from the CDC which is not far off of the numbers I gave you the other night. Basically if you are under 50 it is less than the flu and over 50 greater than the flu.

Per CDC, symptomatic case fatality rates by age:
0-49 yrs: 0.02% - 0.1%
50-64: 0.1% - 0.6%
65+: 0.6% - 3.2%
All ages: 0.2% - 1%

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How do those compare by age? Is Coates making an apples to apples comparison here?

TXAggie2011 said:

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Most of them were elderly, and that was in a country with a population 60% of today and a median age 10+ years younger.

An equivalent flu today would kill 250k+ easily.

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We have a little over twice as many people aged 65 or older today as we did in 1968, so it probably doesn't extrapolate quite that high.

And the bulk is in the 65-70 range, so the younger side of old, as it were. All those school kids in 1968 that skewed the average age down.

The average American 70 year old is going into this pandemic with better health, or better managed health, than they did in 1968.

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We have five times as many Americans aged 85+ today as in 1970.

That's a significant number for a disease with a median fatality age above 80.

My Dad got the Hong Kong flu.. Said it was the worst he has ever felt. He graduated from A&M and came down with it the following Monday on his way to work. By the time he got back home he could barely stand, said it was scary as hell.

Oddly until this past January it was the only time that he knows of that he had the flu.

HotardAg07 said:

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TXAggie2011 said:

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Quote:

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From Dr. Coates - More positive news...

For the people still living in fear of Covid-19.
You don't have to here is the latest estimates of mortality rates from the CDC which is not far off of the numbers I gave you the other night. Basically if you are under 50 it is less than the flu and over 50 greater than the flu.

Per CDC, symptomatic case fatality rates by age:
0-49 yrs: 0.02% - 0.1%
50-64: 0.1% - 0.6%
65+: 0.6% - 3.2%
All ages: 0.2% - 1%

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How do those compare by age? Is Coates making an apples to apples comparison here?

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Hes not, I already looked this up. At a younger age you have a lower ifr with covid than all people who get the flu, but you still have a higher ifr than other people the same age who get the flu. The flu has an age dependency as well and the highest rates are also disproportionately in the highest age groups. I would post all my sourcing from the CDC but I'm on my phone and candidly it wouldn't change anybody's mind about anything because the only data that matters here is the data that confirms your prior beliefs.

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Flu is pretty significant in kids < 1 especially preemies- while COVID seems to be almost harmless in that same age group.

Otherwise I agree wtih you hehe.

Knucklesammich said:

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My Dad got the Hong Kong flu.. Said it was the worst he has ever felt. He graduated from A&M and came down with it the following Monday on his way to work. By the time he got back home he could barely stand, said it was scary as hell.

Oddly until this past January it was the only time that he knows of that he had the flu.

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My uncle got the Hong Kong Flu. He was probably 10 or so. Had to be hospitalized but lived and is fine. Lived in rural north east Texas, just for reference.

Keegan99 said:

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TXAggie2011 said:

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Quote:

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Most of them were elderly, and that was in a country with a population 60% of today and a median age 10+ years younger.

An equivalent flu today would kill 250k+ easily.

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We have a little over twice as many people aged 65 or older today as we did in 1968, so it probably doesn't extrapolate quite that high.

And the bulk is in the 65-70 range, so the younger side of old, as it were. All those school kids in 1968 that skewed the average age down.

The average American 70 year old is going into this pandemic with better health, or better managed health, than they did in 1968.

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We have five times as many Americans aged 85+ today as in 1970.

That's a significant number for a disease with a median fatality age above 80.

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Yep. Glad you looked that up. We may be in better health now in our over 70+ population, but there are far less. H3N2s numbers would likely go up if it circulated now with 5x the elderly population. I wonder how many 70-84 more there were, too? Probably even more than 5x that amount.

From http://www.nationalreview.com/corner/swedens-covid-death-rate-now-ten-times-higher-than-norways/:

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There have now been ten times as many COVID-19 deaths in Sweden than Norway on a per capita basis.

According to the Worldometers website, 435 out of every one million Swedes have died from the virus, while the virus has killed 44 out of every million Norwegians.

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Particularly troublesome is this:

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Swedish government officials said lockdowns could do little to save lives over the long term and that their more lax approach would let their society reach herd immunity more quickly and lessen the economic pain the country would endure. "About 30 percent of people in Stockholm have reached a level of immunity," Karin Ulrika Olofsdotter, the Swedish ambassador to the United States, told NPR on April 26. "We could reach herd immunity in the capital as early as next month."

But a recent study found that just 7.3 percent of Stockholm residents tested positive for coronavirus antibodies at the end of April. "I think herd immunity is a long way off, if we ever reach it," Bjorn Olsen, professor of infectious medicine at Uppsala University, told Reuters.

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eric76 said:

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From http://www.nationalreview.com/corner/swedens-covid-death-rate-now-ten-times-higher-than-norways/:

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There have now been ten times as many COVID-19 deaths in Sweden than Norway on a per capita basis.

According to the Worldometers website, 435 out of every one million Swedes have died from the virus, while the virus has killed 44 out of every million Norwegians.

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Particularly troublesome is this:

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Swedish government officials said lockdowns could do little to save lives over the long term and that their more lax approach would let their society reach herd immunity more quickly and lessen the economic pain the country would endure. "About 30 percent of people in Stockholm have reached a level of immunity," Karin Ulrika Olofsdotter, the Swedish ambassador to the United States, told NPR on April 26. "We could reach herd immunity in the capital as early as next month."

But a recent study found that just 7.3 percent of Stockholm residents tested positive for coronavirus antibodies at the end of April. "I think herd immunity is a long way off, if we ever reach it," Bjorn Olsen, professor of infectious medicine at Uppsala University, told Reuters.

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I don't understand why the earlier result was 30% and the later result was coming in at 7.3. Possibly one test was identifying IgM and the other was identifying IgG. Maybe the first test had a high false positive.

But, if we think about timelines...
Disease timeline...
Day 0 exposure
After about a week symptoms develop
Antibodies ramp up about 2 weeks after symptoms and top out about 3 weeks after onset.


So, if a positive antibody test is late April, you are actually looking back to early April for exposure. Sweden had fewer than 500 deaths as of April 7 and less than 200 on April 1.

Should we really be surprised that only 7.3% of Stockholm was infected in early April as the disease was just starting to take off?

By April 21, they had over 1500 deaths. with a rough tripling from Apr 7 to Apr 21, you could assume 3x exposure two weeks later. That may show up as 21% antibodies in mid May.

They crossed 3000 deaths 2 weeks later... another doubling to 40% antibodies by late May?

2 more weeks and they cross 4000 deaths, another 1000 deaths and maybe another 15% infected. Do you see 55% antibodies in mid June?

BiochemAg97 said:

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eric76 said:

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From http://www.nationalreview.com/corner/swedens-covid-death-rate-now-ten-times-higher-than-norways/:

Quote:

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There have now been ten times as many COVID-19 deaths in Sweden than Norway on a per capita basis.

According to the Worldometers website, 435 out of every one million Swedes have died from the virus, while the virus has killed 44 out of every million Norwegians.

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Particularly troublesome is this:

Quote:

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Swedish government officials said lockdowns could do little to save lives over the long term and that their more lax approach would let their society reach herd immunity more quickly and lessen the economic pain the country would endure. "About 30 percent of people in Stockholm have reached a level of immunity," Karin Ulrika Olofsdotter, the Swedish ambassador to the United States, told NPR on April 26. "We could reach herd immunity in the capital as early as next month."

But a recent study found that just 7.3 percent of Stockholm residents tested positive for coronavirus antibodies at the end of April. "I think herd immunity is a long way off, if we ever reach it," Bjorn Olsen, professor of infectious medicine at Uppsala University, told Reuters.

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I don't understand why the earlier result was 30% and the later result was coming in at 7.3. Possibly one test was identifying IgM and the other was identifying IgG. Maybe the first test had a high false positive.

But, if we think about timelines...
Disease timeline...
Day 0 exposure
After about a week symptoms develop
Antibodies ramp up about 2 weeks after symptoms and top out about 3 weeks after onset.


So, if a positive antibody test is late April, you are actually looking back to early April for exposure. Sweden had fewer than 500 deaths as of April 7 and less than 200 on April 1.

Should we really be surprised that only 7.3% of Stockholm was infected in early April as the disease was just starting to take off?

By April 21, they had over 1500 deaths. with a rough tripling from Apr 7 to Apr 21, you could assume 3x exposure two weeks later. That may show up as 21% antibodies in mid May.

They crossed 3000 deaths 2 weeks later... another doubling to 40% antibodies by late May?

2 more weeks and they cross 4000 deaths, another 1000 deaths and maybe another 15% infected. Do you see 55% antibodies in mid June?

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I think that the 30% figure is an estimate of how many people have or have had covid-19. If that is the case, then it would seem that antibodies aren't being produced in a many cases

That would probably be the first time in history for a cold like virus to not generate some immunity, so not likely.

I am going with, the numbers change a few more times. Plus have to get each country to count deaths the same which isn't gonna happen. The lock downs have to get justified so the numbers will reflect what they want.

Have Sweden's hospitals overwhelmed?

If not then they did the right thing. The goal was to flatten the curve to prevent that.

KidDoc said:

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DadHammer said:

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That would probably be the first time in history for a cold like virus to not generate some immunity, so not likely.

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Where do you get this assumption? It is more often the opposite where people have been shown to not develop long term immunity to common respiratory viruses like flu, rsv, corona, rhino.

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You just said long term, I said some kind of immunity. I read read many articles on the topic.

Irwin M. Fletcher said:

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terradactylexpress said:

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Dadhammer has ignored everything and anything that doesn't match his personal opinions which he takes as fact

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Totally agree, he is the definition of someone that only uses confirmation bias data. Not saying he is always wrong but he doesn't want to hear anything that doest fit with what he already believes.

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That could be somewhat true, but as of today no one has posted any evidence that Sweden was incorrect.

Posting that not all people will be 100% immune after infection is just not correct.

Most people will have some immunity to the virus and most history suggests this to be true. Can it change over time? Of course it can. Will the change be better or worse? Know body knows.

KidDoc said:

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DadHammer said:

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That would probably be the first time in history for a cold like virus to not generate some immunity, so not likely.

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Where do you get this assumption? It is more often the opposite where people have been shown to not develop long term immunity to common respiratory viruses like flu, rsv, corona, rhino.

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Dr. Coates has already posted the study that proves a degree of immunity is achieved with corona virus. Will it last forever? Probably not but it doesn't have to either.

KidDoc said:

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DadHammer said:

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That would probably be the first time in history for a cold like virus to not generate some immunity, so not likely.

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Where do you get this assumption? It is more often the opposite where people have been shown to not develop long term immunity to common respiratory viruses like flu, rsv, corona, rhino.

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Kid

Read this article. People were shown to have some immunity to the SARS covid virus for years.

https://www.foxnews.com/media/new-study-revealing-covid-19-mutations-weakening

I hear you Fitch and good points.

But most viruses I have read about give you some immunity after infection. If not, the flue shot would never work and there would be way fewer vaccines. Even if the immunity just makes the infection way less symptomatic it's a win. The run with doom and gloom crowd when basic facts from history, and current facts about this virus, point in a much more positive light get under my skin.

BiochemAg97 said:

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KidDoc said:

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DadHammer said:

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KidDoc said:

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DadHammer said:

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That would probably be the first time in history for a cold like virus to not generate some immunity, so not likely.

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Where do you get this assumption? It is more often the opposite where people have been shown to not develop long term immunity to common respiratory viruses like flu, rsv, corona, rhino.

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Kid

Read this article. People were shown to have some immunity to the SARS covid virus for years.

https://www.foxnews.com/media/new-study-revealing-covid-19-mutations-weakening

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That article is about mutations decreasing the lethality of the virus which is common and great news. It is highly probable that COVID cases get at least short term immunity but it is not an established fact and there is no way to tell how long it lasts at this point. Therefore it would be horribly irresponsible to make public policy on conjecture and hope at this point in time.

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Seems like all we have done lately... only more of conjecture and less of hope. I would suggest it is way more logical to assume, absent evidence to the contrary, that the immune system works for this virus and people develop antibodies that confer immunity for some period of time rather than to make policy decisions assuming the immune system does not work and therefor people will just get sick from the virus over and over again.

The last paragraph of the article is significant to the current discussion.

"Three, four years after the SARS crisis, we saw that people had, if you will, antibodies to them, the epidemic had fizzled and we even had studies showing five, six, seven years later people still had antibodies against the SARS so I think that's actually good news," he continued.

That suggests antibodies to the virus persist for years. Maybe you need a 3 year booster to you vaccine or maybe 5 or 10.

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The mRNA vaccine is fascinating to me and would likely give long term immunity. It is super promising for multiple other infections as well. Just an amazing vaccine concept and hopefully it will work out. The days of injecting dead or weakened virus to promote a (usually temporary) response are likely in the past. The majority of "new" vaccines(HPV, PCV, MCV) are all conjugate technology not like the traditional vaccines.

Working paper from Sweden shows a shorter lockdown has less welfare costs (which makes intuitive sense).

https://project.nek.lu.se/publications/workpap/papers/wp20_9.pdf?fbclid=IwAR0E0uCbdJUQiRPeb60XOOTeBe6VIOpsL-tQ36k56IixEd9gdfPjh8c1zmM

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We find that stricter and longer stay-at-home policies are disproportionately more costly than more lenient ones. Isolation for 2 weeks but being allowed to leave home for 14 hours per week carries a cost of only $30per week, while isolation for 6 weeks and only being allowed to leave home for 2 hours per week carries a cost of $228per week. This indicates that strict stay-at-home policies are likely to be cost-effective only if they slow the spread of the disease much more than more lenient ones do.

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Higher costs and, in Sweden, the elderly bare a disproportionate share:

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We find that older people face much higher costs of staying home than the rest of the population,even after accounting for socioeconomic characteristics.This finding suggests that pandemic policies targeting the elderly may have more nuanced welfare implications than previously thought.

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Interesting that the elderly have higher costs given that their benefit is greater on a QALY basis. If we were to translate this finding to the US and what are the welfare costs across race and socioeconomic status?

tysker said:

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Working paper from Sweden shows a shorter lockdown has less welfare costs (which makes intuitive sense).

https://project.nek.lu.se/publications/workpap/papers/wp20_9.pdf?fbclid=IwAR0E0uCbdJUQiRPeb60XOOTeBe6VIOpsL-tQ36k56IixEd9gdfPjh8c1zmM

Quote:

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We find that stricter and longer stay-at-home policies are disproportionately more costly than more lenient ones. Isolation for 2 weeks but being allowed to leave home for 14 hours per week carries a cost of only $30per week, while isolation for 6 weeks and only being allowed to leave home for 2 hours per week carries a cost of $228per week. This indicates that strict stay-at-home policies are likely to be cost-effective only if they slow the spread of the disease much more than more lenient ones do.

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Higher costs and, in Sweden, the elderly bare a disproportionate share:

Quote:

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We find that older people face much higher costs of staying home than the rest of the population,even after accounting for socioeconomic characteristics.This finding suggests that pandemic policies targeting the elderly may have more nuanced welfare implications than previously thought.

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Interesting that the elderly have higher costs given that their benefit is greater on a QALY basis. If we were to translate this finding to the US and what are the welfare costs across race and socioeconomic status?

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One other factor that would probably be relevant is their much higher tax burden, which I would think (hope?) results in better overall public services.

tysker said:

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Working paper from Sweden shows a shorter lockdown has less welfare costs (which makes intuitive sense).

https://project.nek.lu.se/publications/workpap/papers/wp20_9.pdf?fbclid=IwAR0E0uCbdJUQiRPeb60XOOTeBe6VIOpsL-tQ36k56IixEd9gdfPjh8c1zmM

Quote:

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We find that stricter and longer stay-at-home policies are disproportionately more costly than more lenient ones. Isolation for 2 weeks but being allowed to leave home for 14 hours per week carries a cost of only $30per week, while isolation for 6 weeks and only being allowed to leave home for 2 hours per week carries a cost of $228per week. This indicates that strict stay-at-home policies are likely to be cost-effective only if they slow the spread of the disease much more than more lenient ones do.

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Higher costs and, in Sweden, the elderly bare a disproportionate share:

Quote:

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We find that older people face much higher costs of staying home than the rest of the population,even after accounting for socioeconomic characteristics.This finding suggests that pandemic policies targeting the elderly may have more nuanced welfare implications than previously thought.

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Interesting that the elderly have higher costs given that their benefit is greater on a QALY basis. If we were to translate this finding to the US and what are the welfare costs across race and socioeconomic status?

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Given the study (survey, would you accept $x to participate under this voluntary policy), it isn't exactly a cost for the elderly as much as a measure of willingness to participate.

That's what welfare is in choice theory and behavioral economics

eta: welfare being the cost at which individuals are willing to participate (or not). Longer+stronger lockdowns => more costly welfare (seems intuitive) and in Sweden the elderly cost more (also intuitive). I'm curious as to what US-centric results would look like.