11 ms·

Honest question: yesterday the US saw the most cases in a day since this started. If that doesnt constitute a spike then what does? Or is the planning more ab

Honest question: yesterday the US saw the most cases in a day since this started. If that doesnt constitute a spike then what does? Or is the planning more about anticipated levels 6 weeks from now as compared to now.

protomyth 6y ago
Those are national stats, and we are very rural. Plus, we have a whole set of problems that can make it worse if certain events happen. Add to that we've been under a travel ban for months which requires people to self quarantine at home for 14 days if they leave the state or go to certain cities. And yes, figuring out what is going to happen 6 weeks out is a problem.
staplers 6y ago
At this point we have seen cases dramatically spike, yet deaths have not. I think if/when we see deaths start spiking, then the decision to force closures will start happening.
- latchkey 6y ago
  Simpson's Paradox. https://www.youtube.com/watch?v=ebEkn-BiW5k https://www.youtube.com/watch?v=ebEkn-BiW5k
dwaltrip 6y ago
What you say is true, but you can’t directly compare the numbers of confirmed cases today to the numbers from 3 months ago. We are currently testing 600-700k people each day. At the beginning of April we were only testing less than a quarter of that, around 125-150k people per day. There has certainly been community spread. But the average age of a confirmed case has also dropped enormously.
vxNsr 6y ago
> yesterday the US saw the most cases in a day since this started. More positive tested cases. They also tested more people yesterday alone than they did in any given week in April(the previous spike) while seeing a similar number of cases. The truth that no one wanted to talk about 2 months ago is that we can't reopen fully until we get a vaccine or natural herd immunity. a vaccine is likely still 6-10 months off from mass production, so if we wanna open up normally in anyway we need to go for natural herd immunity. Or we can just stay 50% open, that works for countries where people respect the government (like most of the EU) but here in the US everyone thinks they know better, so there's no way to to enforce something like that.
- efdee 6y ago
  It hasn't been shown yet that achieving natural herd immunity is even an option. Even in countries where they have been very lax on measures there hasn't been enough build-up for HI and it also seems that the antibodies go away quite quickly.
  - ggreer 6y ago
    Herd immunity would require that over half of the population get the disease.[1] (Probably closer to 70% based on the virus's R0.) With an IFR of 0.5%, that would mean around 0.25-0.35% of the population has to die before we get herd immunity. No country has come close to that many deaths yet, so we shouldn't expect any of them to have herd immunity. 1. See figure 2 in this paper for a graph of the relationship between R0 and herd immunity thresholds: https://academic.oup.com/cid/article-pdf/52/7/911/847338/cir007.pdf https://academic.oup.com/cid/article-pdf/52/7/911/847338/cir...
    - ShroudedNight 6y ago
      > Herd immunity would require that over half of the population get the disease. Doesn't this also assume that those people remain inoculated to further viral infections after being infected the first time? From my limited understanding, that is not a given for SARS-CoV-2.
      - ggreer 6y ago
        Correct. This is an optimistic scenario for herd immunity. It assumes low mortality (probably true), no permanent damage to those who survive (unclear, but probably untrue), and immunity lasting a couple years (long enough to remain immune until a vaccine is available).
- briandear 6y ago
  > a vaccine is likely still 6-10 months off from mass production What vaccine?
akiselev 6y ago
The new cases aren't evenly distributed. California just saw over 11,800 new cases yesterday but New York saw a few over 500 new cases - despite having a record of 11,400 in one day at its peak two months ago. Some regions have it under control and can begin to reopen slowly. However, I think it's pretty clear that those regions have it under control only because they've shut almost everything down. The second schools begin reopening and pupils start criss crossing the country, it'll bring the "second wave."
- vondur 6y ago
  Well, from what I read here in Orange County CA, the state forced the county to count people who have tested positive with Antibody tests to now be counted as a positive COVID-19 test, even if the tests were done long ago.
  - akiselev 6y ago
    You should check your sources [1]. Every single time someone has claimed that a federal or state government has "forced" someone to inflate COVID numbers, it's been blatant nonsense. [1] https://www.latimes.com/california/story/2020-07-02/error-led-to-overcount-of-coronavirus-testing-in-orange-county https://www.latimes.com/california/story/2020-07-02/error-le...
    - ryandrake 6y ago
      Not calling GP out specifically, but generally asking someone hell-bent on re-opening to check their sources or facts is pointless. They will just go out and find another rationalization. This isn't just about this school--it's happening all across (at least) the USA. We should be coming up with objective, measurable milestones that support re-opening, tracking towards them, reviewing periodically and then making a decision to re-open based on whether the criteria were met. Instead, people are simply starting with a foregone conclusion of "We must re-open!" and fishing for any nugget that might justify this pre-ordained decision. So far in this thread we've already seen: 1. The cases are not uniformly distributed, therefore it's OK to re-open in areas that currently seem good! [many variants of this one] 2. Cases are spiking but deaths are not up, we should ignore the non-fatal consequences of the disease and re-open! 3. Cases only look like they are up because testing is up, therefore the numbers are in question, so re-open! 4. Governments are conspiring to inflate case numbers, therefore the numbers are in question, so re-open! We are already starting to see the disastrous effects of prematurely re-opening, but the public just won't accept any story that doesn't end with "...and we re-opened everything as soon as we could!"
eanzenberg 6y ago
Yesterday (and the day prior) had the lowest corona deaths since late March.
- claudeganon 6y ago
  Deaths are a lagging indicator. 2-4 weeks behind case counts.
  - eanzenberg 6y ago
    Cases started increasing above norm 4 weeks ago.
    - deleted 6y ago
      [deleted]
  - karlakush 6y ago
    Not true. Deaths only lag cases by 5-10 days. For example, in Italy daily new cases peaked on March 21st and daily deaths peaked on March 27th.
    - elihu 6y ago
      Doesn't that depend a great deal on testing capability? If testing is quick and widely available, then I'd expect the lag to be larger as people get diagnosed earlier.
    - perl4ever 6y ago
      This assumes the death rate is independent of, say, health care system capacity. Didn't they have an issue with that in Italy?
  - eanzenberg 6y ago
    I’m not sure why a child-comment got killed: >>> Not true. Deaths only lag cases by 5-10 days. For example, in Italy daily new cases peaked on March 21st and daily deaths peaked on March 27th. This is correct. People are expecting a step function of deaths exactly 4 weeks from the peak of cases? This is not statistical. Peak of deaths lag peak of cases closer to 1-5 days. If case growth is a matter of true rise of infections we would see modest increase of deaths about 2-3 weeks ago (cases started growing 4 weeks ago). We’ve only seen deaths drop on a exponential decay trend.
dragonwriter 6y ago
> Honest question: yesterday the US saw the most cases in a day since this started. If that doesnt constitute a spike then what does? A spike would be an isolated short-term jump, this is just continuous increase in cases. Of course, from a “should we open things” perspective, that’s worse than a spike, not better.
nostromo 6y ago
More testing = more cases. Actual deaths are down and have been trending down for months. https://i.imgur.com/83sw5pd.png https://i.imgur.com/83sw5pd.png https://www.worldometers.info/coronavirus/country/us/ https://www.worldometers.info/coronavirus/country/us/ I have no idea why this isn't front page news.
- sgustard 6y ago
  More young people going out = more cases. Those people infecting their parents and grandparents may lead to more deaths in due time. And it has been news. https://www.nytimes.com/2020/07/03/health/coronavirus-mortality-testing.html https://www.nytimes.com/2020/07/03/health/coronavirus-mortal...
  - nostromo 6y ago
    "just wait two weeks!" People have been saying this for months now, and it hasn't been true at any point. Daily deaths have been falling as cases rise.
    - eanzenberg 6y ago
      They will continue to say “just wait two weeks!” two weeks from now.
    - freehunter 6y ago
      That’s a particular challenge with this virus: it takes a long time between being exposed and actually suffering from the disease. Which makes it really easy to dismiss the impact because the side saying “it’s a big deal” has to wait two weeks or more while the side saying “it’s not a big deal” gets to claim victory for two weeks before being proved right or wrong. The fact is we don’t know a lot about how this virus operates or why it does what it does. What we do know is that there are fates much worse than death that come from this disease (reduced lung/heart/organ function, long hospital stays with very expensive bills at the end, etc). We know it spreads quickly and we know it’s spreading uncontrolled right now. We know at least 130,000 people in the US have died and many more will be permanently injured. We know the countries who handled the response right, because they are opening back up. We know the countries who handled it poorly because their cases are still going up. All of the things we don’t know are problems and we need to keep learning. All the things we DO know tell us this is bad and it’s going to get worse before it gets better unless people start taking it seriously. Unfortunately many people are taking the opposite approach and claiming victory based on the unknown factors we still don’t know answers to.
AlexCoventry 6y ago
The prevalence varies from state to state, and Massachusetts is doing pretty well, right now. https://91-divoc.com/pages/covid-visualization/?chart=states-normalized&highlight=Massachusetts&show=us-states&y=both&scale=linear&data=cases-daily-7&data-source=jhu&xaxis=right#states-normalized https://91-divoc.com/pages/covid-visualization/?chart=states... Presumably students coming from high-prevalence areas will be forced to quarantine for the first two weeks, and high-frequency testing and contact tracing will be mandatory. It might be manageable.
CivBase 6y ago
Honest question: if there is really an increase in cases across the US, shouldn't we see an increase in positive test result rates (# confirmed / # tested)? The positive test result rate continues to decrease across the United States, albeit more slowly as of late. I really do mean this as an honest question.
- hansvm 6y ago
  Not necessarily. (1) It's important to make sure the numbers you're using are directly comparable -- e.g., if #confirmed is the count of unique individuals who are confirmed to have the virus and #tested is the number of tests administered rather than the number of people who have been tested then you won't get the expected results. (2) There can be confounding variables like choosing to test people with milder symptoms. (3) False positive/negative rates can be a factor (though they shouldn't be in a halfway decent test). If your false negative rate is x and your false positive rate is greater than 1-x then your positive test result rate will fall as your true positive rate rises. (4) Etc. The problem is that the numbers you're measuring (reported test results) aren't the numbers you care about (true infection rates). They might align, and they will mostly align with good tests and unbiased data that are correctly and honestly reported, but they don't have to. Caveat: I haven't been closely following covid news and have no idea how much any of those potential discrepancies might apply IRL.
- jfim 6y ago
  It varies by state, see for example https://www.axios.com/coronavirus-cases-testing-growth-62d6256b-33e2-491d-b94e-91110a74bc85.html https://www.axios.com/coronavirus-cases-testing-growth-62d62... Looking at only the US numbers hides some of the picture. For example, there's this chart from about a month ago showing that only looking at US numbers without breaking them down can be misleading: https://www.axios.com/us-coronavirus-new-cases-second-wave-new-york-b6eda2dc-ef39-4b61-9385-d02a2fd3c494.html https://www.axios.com/us-coronavirus-new-cases-second-wave-n...
- JohnBooty 6y ago
  The significance of positive test rate rates is extremely dependent upon the slectiveness & availability of testing, which has trended higher but has varied in extreme ways. Initially, only the sickest patients, most obviously suffering from COVID-19, were eligible for testing. We would of course expect positive test rates to be sky-high during this time, as we were only testing those whom we were pretty certain were infected and were suffering life-threatening symptoms. Now, tests are more widely available. Testing is no longer tightly constrained to the most obvious suspected cases. So, with a wider swatch of the population being eligible for testing, we would probably expect the % of positive test rates to fall even as the number of infected goes up.

protomyth 6y ago

Those are national stats, and we are very rural. Plus, we have a whole set of problems that can make it worse if certain events happen. Add to that we've been under a travel ban for months which requires people to self quarantine at home for 14 days if they leave the state or go to certain cities. And yes, figuring out what is going to happen 6 weeks out is a problem.

staplers 6y ago

At this point we have seen cases dramatically spike, yet deaths have not. I think if/when we see deaths start spiking, then the decision to force closures will start happening.

latchkey 6y ago
Simpson's Paradox. https://www.youtube.com/watch?v=ebEkn-BiW5k https://www.youtube.com/watch?v=ebEkn-BiW5k

dwaltrip 6y ago

What you say is true, but you can’t directly compare the numbers of confirmed cases today to the numbers from 3 months ago. We are currently testing 600-700k people each day. At the beginning of April we were only testing less than a quarter of that, around 125-150k people per day. There has certainly been community spread. But the average age of a confirmed case has also dropped enormously.

vxNsr 6y ago

> yesterday the US saw the most cases in a day since this started. More positive tested cases. They also tested more people yesterday alone than they did in any given week in April(the previous spike) while seeing a similar number of cases. The truth that no one wanted to talk about 2 months ago is that we can't reopen fully until we get a vaccine or natural herd immunity. a vaccine is likely still 6-10 months off from mass production, so if we wanna open up normally in anyway we need to go for natural herd immunity. Or we can just stay 50% open, that works for countries where people respect the government (like most of the EU) but here in the US everyone thinks they know better, so there's no way to to enforce something like that.

efdee 6y ago
It hasn't been shown yet that achieving natural herd immunity is even an option. Even in countries where they have been very lax on measures there hasn't been enough build-up for HI and it also seems that the antibodies go away quite quickly.
- ggreer 6y ago
  Herd immunity would require that over half of the population get the disease.[1] (Probably closer to 70% based on the virus's R0.) With an IFR of 0.5%, that would mean around 0.25-0.35% of the population has to die before we get herd immunity. No country has come close to that many deaths yet, so we shouldn't expect any of them to have herd immunity. 1. See figure 2 in this paper for a graph of the relationship between R0 and herd immunity thresholds: https://academic.oup.com/cid/article-pdf/52/7/911/847338/cir007.pdf https://academic.oup.com/cid/article-pdf/52/7/911/847338/cir...
  - ShroudedNight 6y ago
    > Herd immunity would require that over half of the population get the disease. Doesn't this also assume that those people remain inoculated to further viral infections after being infected the first time? From my limited understanding, that is not a given for SARS-CoV-2.
    - ggreer 6y ago
      Correct. This is an optimistic scenario for herd immunity. It assumes low mortality (probably true), no permanent damage to those who survive (unclear, but probably untrue), and immunity lasting a couple years (long enough to remain immune until a vaccine is available).
briandear 6y ago
> a vaccine is likely still 6-10 months off from mass production What vaccine?

akiselev 6y ago

The new cases aren't evenly distributed. California just saw over 11,800 new cases yesterday but New York saw a few over 500 new cases - despite having a record of 11,400 in one day at its peak two months ago. Some regions have it under control and can begin to reopen slowly. However, I think it's pretty clear that those regions have it under control only because they've shut almost everything down. The second schools begin reopening and pupils start criss crossing the country, it'll bring the "second wave."

vondur 6y ago
Well, from what I read here in Orange County CA, the state forced the county to count people who have tested positive with Antibody tests to now be counted as a positive COVID-19 test, even if the tests were done long ago.
- akiselev 6y ago
  You should check your sources [1]. Every single time someone has claimed that a federal or state government has "forced" someone to inflate COVID numbers, it's been blatant nonsense. [1] https://www.latimes.com/california/story/2020-07-02/error-led-to-overcount-of-coronavirus-testing-in-orange-county https://www.latimes.com/california/story/2020-07-02/error-le...
  - ryandrake 6y ago
    Not calling GP out specifically, but generally asking someone hell-bent on re-opening to check their sources or facts is pointless. They will just go out and find another rationalization. This isn't just about this school--it's happening all across (at least) the USA. We should be coming up with objective, measurable milestones that support re-opening, tracking towards them, reviewing periodically and then making a decision to re-open based on whether the criteria were met. Instead, people are simply starting with a foregone conclusion of "We must re-open!" and fishing for any nugget that might justify this pre-ordained decision. So far in this thread we've already seen: 1. The cases are not uniformly distributed, therefore it's OK to re-open in areas that currently seem good! [many variants of this one] 2. Cases are spiking but deaths are not up, we should ignore the non-fatal consequences of the disease and re-open! 3. Cases only look like they are up because testing is up, therefore the numbers are in question, so re-open! 4. Governments are conspiring to inflate case numbers, therefore the numbers are in question, so re-open! We are already starting to see the disastrous effects of prematurely re-opening, but the public just won't accept any story that doesn't end with "...and we re-opened everything as soon as we could!"

eanzenberg 6y ago

Yesterday (and the day prior) had the lowest corona deaths since late March.

claudeganon 6y ago
Deaths are a lagging indicator. 2-4 weeks behind case counts.
- eanzenberg 6y ago
  Cases started increasing above norm 4 weeks ago.
  - deleted 6y ago
    [deleted]
- karlakush 6y ago
  Not true. Deaths only lag cases by 5-10 days. For example, in Italy daily new cases peaked on March 21st and daily deaths peaked on March 27th.
  - elihu 6y ago
    Doesn't that depend a great deal on testing capability? If testing is quick and widely available, then I'd expect the lag to be larger as people get diagnosed earlier.
  - perl4ever 6y ago
    This assumes the death rate is independent of, say, health care system capacity. Didn't they have an issue with that in Italy?
- eanzenberg 6y ago
  I’m not sure why a child-comment got killed: >>> Not true. Deaths only lag cases by 5-10 days. For example, in Italy daily new cases peaked on March 21st and daily deaths peaked on March 27th. This is correct. People are expecting a step function of deaths exactly 4 weeks from the peak of cases? This is not statistical. Peak of deaths lag peak of cases closer to 1-5 days. If case growth is a matter of true rise of infections we would see modest increase of deaths about 2-3 weeks ago (cases started growing 4 weeks ago). We’ve only seen deaths drop on a exponential decay trend.

dragonwriter 6y ago

> Honest question: yesterday the US saw the most cases in a day since this started. If that doesnt constitute a spike then what does? A spike would be an isolated short-term jump, this is just continuous increase in cases. Of course, from a “should we open things” perspective, that’s worse than a spike, not better.

nostromo 6y ago

More testing = more cases. Actual deaths are down and have been trending down for months. https://i.imgur.com/83sw5pd.png https://i.imgur.com/83sw5pd.png https://www.worldometers.info/coronavirus/country/us/ https://www.worldometers.info/coronavirus/country/us/ I have no idea why this isn't front page news.

sgustard 6y ago
More young people going out = more cases. Those people infecting their parents and grandparents may lead to more deaths in due time. And it has been news. https://www.nytimes.com/2020/07/03/health/coronavirus-mortality-testing.html https://www.nytimes.com/2020/07/03/health/coronavirus-mortal...
- nostromo 6y ago
  "just wait two weeks!" People have been saying this for months now, and it hasn't been true at any point. Daily deaths have been falling as cases rise.
  - eanzenberg 6y ago
    They will continue to say “just wait two weeks!” two weeks from now.
  - freehunter 6y ago
    That’s a particular challenge with this virus: it takes a long time between being exposed and actually suffering from the disease. Which makes it really easy to dismiss the impact because the side saying “it’s a big deal” has to wait two weeks or more while the side saying “it’s not a big deal” gets to claim victory for two weeks before being proved right or wrong. The fact is we don’t know a lot about how this virus operates or why it does what it does. What we do know is that there are fates much worse than death that come from this disease (reduced lung/heart/organ function, long hospital stays with very expensive bills at the end, etc). We know it spreads quickly and we know it’s spreading uncontrolled right now. We know at least 130,000 people in the US have died and many more will be permanently injured. We know the countries who handled the response right, because they are opening back up. We know the countries who handled it poorly because their cases are still going up. All of the things we don’t know are problems and we need to keep learning. All the things we DO know tell us this is bad and it’s going to get worse before it gets better unless people start taking it seriously. Unfortunately many people are taking the opposite approach and claiming victory based on the unknown factors we still don’t know answers to.

AlexCoventry 6y ago

The prevalence varies from state to state, and Massachusetts is doing pretty well, right now. https://91-divoc.com/pages/covid-visualization/?chart=states-normalized&highlight=Massachusetts&show=us-states&y=both&scale=linear&data=cases-daily-7&data-source=jhu&xaxis=right#states-normalized https://91-divoc.com/pages/covid-visualization/?chart=states... Presumably students coming from high-prevalence areas will be forced to quarantine for the first two weeks, and high-frequency testing and contact tracing will be mandatory. It might be manageable.

CivBase 6y ago

Honest question: if there is really an increase in cases across the US, shouldn't we see an increase in positive test result rates (# confirmed / # tested)? The positive test result rate continues to decrease across the United States, albeit more slowly as of late. I really do mean this as an honest question.

hansvm 6y ago
Not necessarily. (1) It's important to make sure the numbers you're using are directly comparable -- e.g., if #confirmed is the count of unique individuals who are confirmed to have the virus and #tested is the number of tests administered rather than the number of people who have been tested then you won't get the expected results. (2) There can be confounding variables like choosing to test people with milder symptoms. (3) False positive/negative rates can be a factor (though they shouldn't be in a halfway decent test). If your false negative rate is x and your false positive rate is greater than 1-x then your positive test result rate will fall as your true positive rate rises. (4) Etc. The problem is that the numbers you're measuring (reported test results) aren't the numbers you care about (true infection rates). They might align, and they will mostly align with good tests and unbiased data that are correctly and honestly reported, but they don't have to. Caveat: I haven't been closely following covid news and have no idea how much any of those potential discrepancies might apply IRL.
jfim 6y ago
It varies by state, see for example https://www.axios.com/coronavirus-cases-testing-growth-62d6256b-33e2-491d-b94e-91110a74bc85.html https://www.axios.com/coronavirus-cases-testing-growth-62d62... Looking at only the US numbers hides some of the picture. For example, there's this chart from about a month ago showing that only looking at US numbers without breaking them down can be misleading: https://www.axios.com/us-coronavirus-new-cases-second-wave-new-york-b6eda2dc-ef39-4b61-9385-d02a2fd3c494.html https://www.axios.com/us-coronavirus-new-cases-second-wave-n...
JohnBooty 6y ago
The significance of positive test rate rates is extremely dependent upon the slectiveness & availability of testing, which has trended higher but has varied in extreme ways. Initially, only the sickest patients, most obviously suffering from COVID-19, were eligible for testing. We would of course expect positive test rates to be sky-high during this time, as we were only testing those whom we were pretty certain were infected and were suffering life-threatening symptoms. Now, tests are more widely available. Testing is no longer tightly constrained to the most obvious suspected cases. So, with a wider swatch of the population being eligible for testing, we would probably expect the % of positive test rates to fall even as the number of infected goes up.