9 ms·

Can anyone explain how the virus is twice as infectious as we thought, but we're consistently lowering our death projections everyday?

unsrsly 7y ago
The R is a function of human behavior, so sheltering in place lowers it (ideally below 1) which also reduces deaths in the future.
- williamstein 7y ago
  E.g., from the article: "Dr Feigl-Ding explains that R0 is the “R reproductive number at time 0 before countermeasures”. He points out that this is not the R(effective) at current time under mitigation measures such as distancing and testing, tracing and quarantine, which are expected to slash chains of transmission."
  - fspeech 7y ago
    R0 is also culture dependent but before countermeasures are applied.
  - unsrsly 7y ago
    Thanks for adding that. Interestingly, Eric Feigl-Ding is a bit like Nicholas Christakis in that he is not an expert in infectious diseases, however he has positioned himself as an expert on COVID19. This seems to have annoyed some of the real experts like Marc Lipsitch. However, Feigl-Ding probably does deserve some credit for sounding the alarm relatively early on COVID19.
    - empath75 7y ago
      The real experts were all saying ‘it’s too early to say for sure’ and he was saying, yes, but the worst case scenario is really bad and everyone should know that.
- makomk 7y ago
  Higher R0 should reduce the effectiveness of measures like social distancing, shelter-in-place, etc too though - those work by reducing the number of people each infected person interacts with, but if those interactions are more likely to spread the disease than previously estimated the eventual R you end up with is going to be higher than expected too.
  - jkhdigital 7y ago
    Exactly, like HIV started with a high R0 but its transmission mechanism is pretty easy to get a handle on--don't have unprotected sex or donate blood. Once this information is widely known, BAM, low R0. SARS-CoV-2 is quite a different beast, and reducing the R0 might be a hell of a lot more difficult.
    - nradov 7y ago
      There is no HIV risk in donating blood. The risk was in receiving blood transfusions, before blood banks started doing HIV testing.
tunesmith 7y ago
Wouldn't it mean that physical distancing was even more effective than we thought?
jboggan 7y ago
Because the IHME model is based on taking China's data at 100% face value and applying it to the US. It over-predicts in the short term and under-predicts in the medium to long term. They keep revising the overall number down to line up with an epidemic peak in 3-4 days in the US, which is ridiculous.
- btilly 7y ago
  The reason why the epidemic peak is estimated so soon is that New York has the bulk of the cases and they began bringing new cases under control before most of the rest of the nation. Dig into state by state numbers and most states are after that with lower peaks. See https://covid19.healthdata.org/united-states-of-america https://covid19.healthdata.org/united-states-of-america and then https://covid19.healthdata.org/united-states-of-america/new-york https://covid19.healthdata.org/united-states-of-america/new-... to verify.
  - fyp 7y ago
    Does anyone else think NY called their peak prematurely? It seems like there's some periodicity in the data and there's always a slight two day drop every 7 days. This makes sense since many people are still working mon-fri in the city. This is for NYC specifically (last few days of data are incomplete): https://www1.nyc.gov/site/doh/covid/covid-19-data.page https://www1.nyc.gov/site/doh/covid/covid-19-data.page I wouldn't be surprised if NY continued surging in the coming days.
    - deleted 7y ago
      [deleted]
    - a9h74j 7y ago
      Also, I wonder, could there be any effect of a population decrease from an exodus from NYC?
  - marvin 7y ago
    So the assumption here is that New York will be the last big outbreak in the US.
FPGAhacker 7y ago
Taking your post at face value, I would say we know it’s twice as infectious due to more testing and/or better data. So we know that more people have been infected. We didn’t discover a bunch of dead people that were infected. So the denominator increased relative to the numerator. Not stating this as fact.
- jkhdigital 7y ago
  The preprint of this article was published on Feb 7th: https://www.medrxiv.org/content/10.1101/2020.02.07.20021154v1.full.pdf https://www.medrxiv.org/content/10.1101/2020.02.07.20021154v... The authors of this study are almost certainly not the only ones who "knew" it was twice as infectious based only on the data available back in early February, before anyone outside of China was testing at all.
lindenksv85 7y ago
Being highly infectious is one thing but a virus’s deadliness is another. Something can have a really high infectiousness rate but not be very deadly, like common cold. The infectiousness they are citing her is the infectiousness that exists under normal conditions. So if you social distance, you can lower the infectiousness. Projected death rates are going down because distancing is working and we are lowering the virus’s infectiousness.
- xienze 7y ago
  > because distancing is working Really? Because all I’ve been hearing for weeks is nonstop complaining about how the US started social distancing measures way too late, how no one is taking it seriously, etc.
  - tunesmith 7y ago
    That's not a counterpoint, though. That can all be true at the same time as it being true that the situation could be a heck of a lot worse right now.
jariel 7y ago
"but we're consistently lowering our death projections every day?" 'The first casualty if war is the Truth'. Whatever the government tells you during a time of crisis is a form of propaganda, 'for your own good' so to speak. Even if individuals are intelligent, crowds are not. Whatever they say is very calculated and controlled, as if to achieve a specific outcome. So imagine a very cynical view of political messaging in normal times, but now tilt that towards a more truly civic situation wherein maybe it doesn't seem quite so cynical because, well, there is actually a crisis. The 'numbers' projected a few weeks ago will have been constrained by a) what people could handle without panicking, b) what kind of numbers might get them to actually behave properly, c) what will save every political leaders skin (i.e. give bad news then everything after that seems like good news), d) how much we can bend reality without hurting their own credibility by being perceived as lying. It's extremely hard and politically risky to 'shut down a country' and get millions of individual actors to 'buy-in' to behave as we want especially if it means annoyance or personal hardship. Political leaders are used to acting in a very populist way, and basically right now they are doing the extreme opposite. Every day, politicians have to act against their best populist instincts. It's hard to overstate what a sensitive time this is, it could go sour very quickly. So take everything with a grain of salt, knowing that whatever is being said is calculated and 'all projections' are filtered somewhat. Ostensibly 'for our own good'. I think there are often more qualified numbers published out there, but you have to go right to the source, if available. Edit: the 'masks' PR and policy is probably the best example of that. In reality, there's not much harm, and likely a little bit of good that can come from masks. But the strategy was to get PPE to the front-line health workers who have a greater need and were in a real crisis, so, the public messaging was 'no masks'. But the 'truth' of masks started to creep to the fore, more were asking questions, moreover, the PPE situation started to stabilize a little bit and 'poof' all of a sudden 'masks are good'. Now they are telling us? The Canadian Chief Medical Officer literally did a 180 on that, sounding a lot like Donald Trump in his total about turns. The communications strategy early on was fairly clear and it made sense, but it's a little uncomfortable to see your so-called leaders only make decisions 'after everyone else' so as to avoid taking and risky or blame (Canada wouldn't budget on it until most other countries did first). If you read the fairly confident communications about masks from several weeks ago and compare them to the messaging now - you see a problem that very only makes sense in the context of "purposeful misdirection for the 'public good' ". Masks did not 'get safer' and nor did our understanding of them change. What changed was who ostensibly needed them the most.
nullc 7y ago
> Can anyone explain how the virus is twice as infectious as we thought, but we're consistently lowering our death projections everyday? This article is talking about R0-- a measure of contagion without considering interventions like increasing mask wearing, quarantines, or physical distancing. The higher the R0 the harder we have to work to push the effective R below 1, as is required to stop the spread... and the wider and faster the spread will be if we don't mitigate it.
guscost 7y ago
One explanation is that >50% of people have already caught it.

unsrsly 7y ago

The R is a function of human behavior, so sheltering in place lowers it (ideally below 1) which also reduces deaths in the future.

williamstein 7y ago
E.g., from the article: "Dr Feigl-Ding explains that R0 is the “R reproductive number at time 0 before countermeasures”. He points out that this is not the R(effective) at current time under mitigation measures such as distancing and testing, tracing and quarantine, which are expected to slash chains of transmission."
- fspeech 7y ago
  R0 is also culture dependent but before countermeasures are applied.
- unsrsly 7y ago
  Thanks for adding that. Interestingly, Eric Feigl-Ding is a bit like Nicholas Christakis in that he is not an expert in infectious diseases, however he has positioned himself as an expert on COVID19. This seems to have annoyed some of the real experts like Marc Lipsitch. However, Feigl-Ding probably does deserve some credit for sounding the alarm relatively early on COVID19.
  - empath75 7y ago
    The real experts were all saying ‘it’s too early to say for sure’ and he was saying, yes, but the worst case scenario is really bad and everyone should know that.
makomk 7y ago
Higher R0 should reduce the effectiveness of measures like social distancing, shelter-in-place, etc too though - those work by reducing the number of people each infected person interacts with, but if those interactions are more likely to spread the disease than previously estimated the eventual R you end up with is going to be higher than expected too.
- jkhdigital 7y ago
  Exactly, like HIV started with a high R0 but its transmission mechanism is pretty easy to get a handle on--don't have unprotected sex or donate blood. Once this information is widely known, BAM, low R0. SARS-CoV-2 is quite a different beast, and reducing the R0 might be a hell of a lot more difficult.
  - nradov 7y ago
    There is no HIV risk in donating blood. The risk was in receiving blood transfusions, before blood banks started doing HIV testing.

tunesmith 7y ago

Wouldn't it mean that physical distancing was even more effective than we thought?

jboggan 7y ago

Because the IHME model is based on taking China's data at 100% face value and applying it to the US. It over-predicts in the short term and under-predicts in the medium to long term. They keep revising the overall number down to line up with an epidemic peak in 3-4 days in the US, which is ridiculous.

btilly 7y ago
The reason why the epidemic peak is estimated so soon is that New York has the bulk of the cases and they began bringing new cases under control before most of the rest of the nation. Dig into state by state numbers and most states are after that with lower peaks. See https://covid19.healthdata.org/united-states-of-america https://covid19.healthdata.org/united-states-of-america and then https://covid19.healthdata.org/united-states-of-america/new-york https://covid19.healthdata.org/united-states-of-america/new-... to verify.
- fyp 7y ago
  Does anyone else think NY called their peak prematurely? It seems like there's some periodicity in the data and there's always a slight two day drop every 7 days. This makes sense since many people are still working mon-fri in the city. This is for NYC specifically (last few days of data are incomplete): https://www1.nyc.gov/site/doh/covid/covid-19-data.page https://www1.nyc.gov/site/doh/covid/covid-19-data.page I wouldn't be surprised if NY continued surging in the coming days.
  - deleted 7y ago
    [deleted]
  - a9h74j 7y ago
    Also, I wonder, could there be any effect of a population decrease from an exodus from NYC?
- marvin 7y ago
  So the assumption here is that New York will be the last big outbreak in the US.

FPGAhacker 7y ago

Taking your post at face value, I would say we know it’s twice as infectious due to more testing and/or better data. So we know that more people have been infected. We didn’t discover a bunch of dead people that were infected. So the denominator increased relative to the numerator. Not stating this as fact.

jkhdigital 7y ago
The preprint of this article was published on Feb 7th: https://www.medrxiv.org/content/10.1101/2020.02.07.20021154v1.full.pdf https://www.medrxiv.org/content/10.1101/2020.02.07.20021154v... The authors of this study are almost certainly not the only ones who "knew" it was twice as infectious based only on the data available back in early February, before anyone outside of China was testing at all.

lindenksv85 7y ago

Being highly infectious is one thing but a virus’s deadliness is another. Something can have a really high infectiousness rate but not be very deadly, like common cold. The infectiousness they are citing her is the infectiousness that exists under normal conditions. So if you social distance, you can lower the infectiousness. Projected death rates are going down because distancing is working and we are lowering the virus’s infectiousness.

xienze 7y ago
> because distancing is working Really? Because all I’ve been hearing for weeks is nonstop complaining about how the US started social distancing measures way too late, how no one is taking it seriously, etc.
- tunesmith 7y ago
  That's not a counterpoint, though. That can all be true at the same time as it being true that the situation could be a heck of a lot worse right now.

jariel 7y ago

"but we're consistently lowering our death projections every day?" 'The first casualty if war is the Truth'. Whatever the government tells you during a time of crisis is a form of propaganda, 'for your own good' so to speak. Even if individuals are intelligent, crowds are not. Whatever they say is very calculated and controlled, as if to achieve a specific outcome. So imagine a very cynical view of political messaging in normal times, but now tilt that towards a more truly civic situation wherein maybe it doesn't seem quite so cynical because, well, there is actually a crisis. The 'numbers' projected a few weeks ago will have been constrained by a) what people could handle without panicking, b) what kind of numbers might get them to actually behave properly, c) what will save every political leaders skin (i.e. give bad news then everything after that seems like good news), d) how much we can bend reality without hurting their own credibility by being perceived as lying. It's extremely hard and politically risky to 'shut down a country' and get millions of individual actors to 'buy-in' to behave as we want especially if it means annoyance or personal hardship. Political leaders are used to acting in a very populist way, and basically right now they are doing the extreme opposite. Every day, politicians have to act against their best populist instincts. It's hard to overstate what a sensitive time this is, it could go sour very quickly. So take everything with a grain of salt, knowing that whatever is being said is calculated and 'all projections' are filtered somewhat. Ostensibly 'for our own good'. I think there are often more qualified numbers published out there, but you have to go right to the source, if available. Edit: the 'masks' PR and policy is probably the best example of that. In reality, there's not much harm, and likely a little bit of good that can come from masks. But the strategy was to get PPE to the front-line health workers who have a greater need and were in a real crisis, so, the public messaging was 'no masks'. But the 'truth' of masks started to creep to the fore, more were asking questions, moreover, the PPE situation started to stabilize a little bit and 'poof' all of a sudden 'masks are good'. Now they are telling us? The Canadian Chief Medical Officer literally did a 180 on that, sounding a lot like Donald Trump in his total about turns. The communications strategy early on was fairly clear and it made sense, but it's a little uncomfortable to see your so-called leaders only make decisions 'after everyone else' so as to avoid taking and risky or blame (Canada wouldn't budget on it until most other countries did first). If you read the fairly confident communications about masks from several weeks ago and compare them to the messaging now - you see a problem that very only makes sense in the context of "purposeful misdirection for the 'public good' ". Masks did not 'get safer' and nor did our understanding of them change. What changed was who ostensibly needed them the most.

nullc 7y ago

> Can anyone explain how the virus is twice as infectious as we thought, but we're consistently lowering our death projections everyday? This article is talking about R0-- a measure of contagion without considering interventions like increasing mask wearing, quarantines, or physical distancing. The higher the R0 the harder we have to work to push the effective R below 1, as is required to stop the spread... and the wider and faster the spread will be if we don't mitigate it.

guscost 7y ago

One explanation is that >50% of people have already caught it.