13 ms·

I believe US could see rolling series of “Ireland events” over next 2 months

jdmoreira 6y ago
So many reasoning flaws. The spike happened after Christmas as New Years. There are other possible explanations not being factored as well... People have been home A LOT this past year and are probably in worse shape then ever and some people probably lack more vitamin d then ever before. The weather is colder in the northern hemisphere now, contributing to low air humidity and benefiting viruses.
captain_price7 6y ago
> Using data from flu monitoring programs in prior years, the CDC models project that 70 MILLION Americans have already gotten sick with symptomatic Covid, but decided to just write it off as a bad cold and never got tested. I am not making this up. In Bangladesh, a well-regarded study found that 45% of people in Dhaka, one of the most densely populated regions in the world, had antibodies. This study was conducted between April 18 and July 5. I'm sure the number is much higher now. And most people around me seem to agree with this- our total deaths so far is 1/50 of USA, despite having 1/2 population. Even if we multiply our total deaths by 5 to account for maybe government cover-up, our death rate/infection rate still seems too low. Widespread immunity appears to be the only explanation for this disparity. [1] https://bdnews24.com/bangladesh/2020/10/12/45-percent-of-dhaka-residents-carry-covid-19-antibodies-study https://bdnews24.com/bangladesh/2020/10/12/45-percent-of-dha...
- nradov 6y ago
  A similar study in part of India found an antibody seroprevalence rate of 57% and a corresponding IFR under 0.1%. https://www.cnbctv18.com/healthcare/57-sero-prevalence-in-slums-16-in-non-slums-in-mumbai-says-survey-of-3-wards-6475141.htm https://www.cnbctv18.com/healthcare/57-sero-prevalence-in-sl... There could be other explanations beyond widespread existing immunity. For example could diet be a factor?
  - BillyTheKing 6y ago
    the most likely explanation is just age-distribution. The vast majority of our covid-fatalities are older than 70, most are 80 or older. To make things worse, many of them live in retirement homes which turn into death traps once the virus entered. That's all fairly unique to Western societies and is definitely one explanation for vastly different IFRs.
    - umanwizard 6y ago
      As an Indian acquaintance explained to me bluntly: if you were going to die of Covid, in that part of the world you've probably already died of something else.
alkonaut 6y ago
> More than three times the number of known Covid cases? Wouldn't detecting 1/3 and missing 2/3 be pretty expected, especially since a lot of the cases were early on? Count backwards from the estimated IFR of e.g. 0.2..1.0% and you get a number of million infections from the ~400k dead. You need to go pretty low in that IFR to get to 1/3 of the population though.
bjornsing 6y ago
> More than three times the number of known Covid cases? C’mon, man. Actual cases being three times the number of known cases sounds reasonable to me. I protested when the Swedish CDC (Folkhälsomyndigheten) claimed it was 1000x, then 100x and finally 75x. But 3x sounds very reasonable to me, perhaps even a bit low.
drcross 6y ago
I'm Irish in Ireland, I've been following the matter closely. Ireland had one of the strictest lockdowns in most of Europe since March, no pubs, nightclubs, limited restaurants, churches, limited sports, 5km travel restrictions were on and off. We masked up early and our national broadcaster was constantly warning everyone non-stop. Schools were open however. We were the poster boy for lockdown success up until at least November. Other nations were commenting on our achievements. You can see what has happened since. The WHO warns that lockdown should only be treated as a last resort, to truly flatten the curve and no more. We ignored that. It's my sincere opinion that we've tried to push back a virus through our lockdown measures and social distancing that eventually cannot be controlled. Holding back a virus is like holding back a damn, eventually something will burst and typically at the wrong time. If we had listened to the WHO by not locking down, gaining natural immunity during the summer (when coronaviruses aren't as prevalent) we wouldn't be in the mess that we are in now. The median age of death of this virus is 82. Please conceptualise this. Less than 20 people under the age of 44 died from covid in 2020. With our current technology dying is a part of life that cannot be avoided. The people who are dying from covid at the moment are people who were going to die this year, remember, people have to die, most of them have already made peace with this idea. If we didn't try so hard to prevent these aged people from dying we wouldn't have our resources stretched thin which is compounding the death rate further. I'm sorry to be the person to tell you this but we all have to die, we shouldn't be stopping the living from enjoying their days on earth. Lockdowns are hurting the young and middle age to a drastic degree. You may not care because you work from home and are still guaranteed a paycheck. It's easy to virtue signal that you want to save everyone from the comfort of your keyboard. You aren't impacted by business closures but if you had any shed of humanity you would disagree to these lockdowns because they are causing more harm than good.
- salmon30salmon 6y ago
  Thank you. I honestly believe that there is a non-trivial percentage of the population that _likes_ the COVID world and wants to keep it going as long as possible. Some may like working remotely, others may like the wider acceptance of meal and grocery delivery, others may prefer the reduction in greenhouse gases. That is the only way I can rationalize the insistence of lockdowns here on HN and elsewhere. Either that or COVID is another social issue that is being exploited by nefarious actors to divide western nations. Or both.
godmode2019 6y ago
A point not many people are raising is its winter in the northern hemisphere, so naturally the R0 will increase. Why this new strain is so prevalent? My personal opinion is since schools opened up they have acted as the main vector. Going undetected for an extended period, I read children are 'being hit the hardest' ie their is a lot more asymptomatic children. The latter point is just conjecture but the note on winter I do think has merit. Overtime the virus will be less deadly to all age groups and likely become another common cold virus. I read a article in hn the other day talking about how all cold virus might have started as pandemics. Based in history pandemics last 18 months. Two winters and one summer. But that is during natural spread rather than nation wide lockdown. While I'm ranting, I believe masks were always a vector to get people the smallest viral dose. Have you seen anyone with a mask, they touch it every few seconds and even reuse it. I remember back 12months ago I was panning on wearing different clothes inside from outside, having a buffer area in my house and having a mask cycle were they spend 3 days in the suns UV. I don't think the virus will get as much news, a important catalyst is when their is government mandate of the pcr cycle number. If they reduce it they can stimulate low infection numbers. In my personal opinion mass testing was the biggest mistake, after it hit large community spread they should have only tested in hospitals for research purposes and held all data at a national security level for 10 years. People are just not mentally able to deal with such situation, look at social media for an example their is so much pure rage in the world. Even in my county NZ the anger on social media is shocking. Its the same logic that you should not tell people about aliens (in movies) because people as a group can not take the stress. We on HN are a bad sample, we are probably more likely to be logical. Where most people would have strong emotions. I read this title as "Ireland events" as social unrest. I know this is not the subject, but its equally vaild, given what we have witnessed over the last year.
- scarmig 6y ago
  One seasonal question that I'm pondering: It's currently summer in South Africa, but death rate is spiking there, more than during its winter. This surprises and concerns me. What's the explanation? Thankfully, other obvious Southern Hemisphere countries aren't seeing a big spike right now.
f430 6y ago
> An “Ireland Event” outbreak, with draconian shutdowns, an unemployment shock and small business bankruptcies, would be massively deflationary. Close your positions or reduce it today. Do it now. Don't wait until the shit hits the fan. Sell, reduce or hedge. You've been warned.
theandrewbailey 6y ago
On the first graph, that last label makes me distrust the entire article.
- bichiliad 6y ago
  Can you clarify which graph and which label? The first graph I see is the number of new cases in Ireland over the past year, and I don't see any labels that seem suspicious.
  - brundolf 6y ago
    The final label on the x-axis says January 2, 2020 instead of 2021. I assume the GP was being partly facetious
- DaiPlusPlus 6y ago
  What "last label" are you referring to?
- _nothing 6y ago
  What about it? The fact that it says January 2 while the caption says it's through January 7? I'm assuming that's just because the labels are generated at 11 day increments and Jan 7 isn't 11 days away from the 2nd.
  - kissickas 6y ago
    It says 2020 instead of 2021.
    - _nothing 6y ago
      Ah, that's definitely strange. A bug in the graphing software, maybe?
      - the_local_host 6y ago
        I think it's more likely that there were one or more manual steps in generating the graph, and someone just kept going with 2020 instead of typing 2021. The author should explain what went wrong there if this reaches their attention.
Atlantium 6y ago
When I read the headline I thought this article might be about domestic terrorism in the US. When I clicked on the article I saw it it was in fact about COVID-19. This is how I test my assumptions.
- Eric_WVGG 6y ago
  Huh. I guessed “potato famine”
- jedimastert 6y ago
  I was just thinking about a comment about how the current situation could lead to a US "Troubles"
- brundolf 6y ago
  I thought the exact same thing- "The Ireland Event" being the Catholic-Protestant conflict in the latter part of the 20th century
  - Accujack 6y ago
    I was hoping it involved Guinness myself, or better yet Smithwick's. I'd be okay with multiple events like that.
    - f430 6y ago
      I love your humour during these times, also thought by "Ireland Event" he was talking about "The Troubles" coming to America and clicked but I guess we have different stereotypical images of Irish folks.
  - bklaasen 6y ago
    We euphemistically call that "The Troubles".
  - hervature 6y ago
    I thought it was about potatoes
majormajor 6y ago
That graph looks a lot like what California already did in December. I'm not sure where to find Re numbers to compare with his discussed ones for Ireland. ANOTHER huge spike on top of the one that only now is starting to slow would be pretty terrible, or maybe we just saw the same thing already (new strains have been identified here, and behavior seems like it deteriorated before the holidays before getting improved after the spike). I think it's fairly incomplete to make predictions about the US like the linked article (let alone speculation about government motivations) without discussing or comparing the current US numbers much at all. The author acknowledges that it would be a spread-out-over-time-regionally thing, but looks at aggregate country-level US data that is going to make it hard to see. The political speculation seems a bit out of left field: in the US I did hear a lot about "the winter will be tough" "it will be worse if people travel after getting fatigued with restrictions" "we can't let our guard down even though numbers are improving now". And we've heard a lot about "we need to keep an eye on new strains and such and may have to make further adjustments." Not this head-in-the-sand posture the author is describing.
Fordec 6y ago
Disclaimer: I'm Irish, working in tech but my hobby that gets me more of a social life is involvement with an Irish political party. The new variant accounted for 10-25% of these new cases over the period of that spike. The spike happened two weeks after Christmas when lock-down restrictions were lifted, as planned in October, so people could have a respite after 9 months of all this. Did the government misjudge just how much people would socially interact? You bet. But to claim that this event is a sign of things to come is to willfully ignore what Irish medical professionals (NPHET) are saying about what the root cause has been and fully buy into the government politicians attempts to cover their butts by blaming the new strain and not their own operational strategy. Also note that it is coming up to three weeks since Christmas and new infections today is half of what it was last week already and dropping.
- randompwd 6y ago
  Also let's not forget the porous border with Northern Ireland, which is suffering from London's stupid rules.
- deleted 6y ago
  [deleted]
- cactus2093 6y ago
  What everyone seems to be assuming is that this new strain will cause a constant increase in the reproduction number R of ~50% in every situation. I haven't really seen any discussion of if and why that is actually a good extrapolation to make. So for example in a specific situation, with a specific type of intermingling of a population in which the R value was, say, 1.2, we think the new strain caused that to increase to an R value of 1.8. How does it necessarily follow that taking intervention measures that bring the R value of the base strains down to, say, 0.8 would bring the R value of the new strain to exactly 1.2? There are just so many factors involved, it doesn't seem like this could possibly be knowable right now. So there may be some hope that things like getting everyone N95 masks and requiring their use, and closing down indoor activities, which are good measures to control the current strains anyway, could also bring down the reproduction number of the new strain below 1 as well. However, this is all a purely academic exercise anyway. Even in places that are being "aggressive" in countering the virus like San Francisco, we have done exactly nothing to react to new information in the past 1.5 months. Our "lockdown", which is entirely optional and has no teeth, is clearly not working, but we have neither removed it or strengthened it. The health department has exactly zero plans regarding the vaccine. It feels like we've just given up altogether, and we're praying that the private market saves us by somehow distributing the vaccines effectively. And on top of all that, we've handicapped the private market by making it illegal to distribute the vaccine to the vast majority of the population, even the elderly and vulnerable groups!
tgb 6y ago
So the main complaint is that the US Govt model has 70 million symptomatic-but-undiagnosed cases in the US compared to 23 diagnosed cases and the author claims this is wildly wrong. If those numbers were correct, we'd have diagnosed 23% of cases. Do we really thing we've done much better than that? I'm not certain. I'd be a little surprised if it were over 50%, but that's purely based off intuition. The other point the author kind of brings up: the current Alabama numbers are roughly in line with the "Ireland event" already. So a "rolling series" of these events is kind of what we already have happening, isn't it? That doesn't diminish the toll of the situation or the mistakes in the responses from the authorities.
- avs733 6y ago
  Information on US COVID-19 seroprevlance surveys can be found on the CDC website [0]. There are also a number of more locally sampled sero surveys going on concurrently right now by state/city/county public health departments. 'Sero' surveys are a commonly used tool in infectitious disease research to understand the difference between identified and total case numbers. They have tons of pros and cons (see [1] for some examples). There are also different types [2] They aren't exact, but the goal with this type of research isn't perfect accuracy, that is impossible, it's better information than we currently have. The prevalence number that you get from a sero survey is hugely important to accurately estimating the effectiveness of medical tests. However, getting that data into a model of test accuracy isn't necessarily easy. [3] This is an example of a COVID sero survey from Santa Clara County last April [4]. Over two days they collected around 3500 samples over two days. There results summary is basically this: The raw prevalence of antibodies to SARS-CoV-2 in our sample was 1.5%. Weighted for population demographics of Santa Clara County, the prevalence was 2.8%. Using those prevalence numbers, the unweighted estimate of case numbers was 23,000. Using the weighted prevalence number, the estimate was 54,000. In early April, there were approximately 1,000 confirmed cases in Santa Clara County. From my epidemiologist friends, they think 50% diagnosed cases is if anything a massive overestimate of the diagnostic rate and something like 1 in 4 diagnosed cases is probably accurate (this is hearsay that I can't cite from people in the field). The problem is that the 23,000-54,000 people who 'had' (air quotes) COVID last April may or may not be immune at this point. The numbers may be high or low ...either way they are BAD Not even getting into what this means about vaccine policy...just talking about what the data and numbers are here. I'm still trying to process what the original post means/is trying to say honestly. [0] https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/geographic-seroprevalence-surveys.html https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/geog... [1] https://www.who.int/immunization/monitoring_surveillance/burden/laboratory/Serosurvey_Manual_chapter_1.pdf https://www.who.int/immunization/monitoring_surveillance/bur... [2] https://www.cdc.gov/coronavirus/2019-ncov/covid-data/seroprevalence-types.html https://www.cdc.gov/coronavirus/2019-ncov/covid-data/seropre... [3] https://academic.oup.com/aje/article/190/1/109/5893084?login=true https://academic.oup.com/aje/article/190/1/109/5893084?login... [4] https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v2 https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v...
JPKab 6y ago
"that 70 MILLION Americans have already gotten sick with symptomatic Covid, but decided to just write it off as a bad cold and never got tested. I am not making this up." Based on quantity of people with antibodies in NYC, Italy, etc who never knew they had it other than symptoms they thought were a cold, there's nothing surprising about a number of 70 million.
- majormajor 6y ago
  "Symptomatic" in that sentence feels strange too. Why would we not be counting the asymptomatic cases for these purposes? 381K fatalities against 70M assumed cases is a fatality rate of about half a percent. It would doubtless tick up a bit higher if nobody got sick anymore starting today as hospitalizations are at very high numbers compared to the past, in the US, so those cases have more deaths to come. https://www.webmd.com/lung/news/20200901/what-changing-death-rates-tell-us-about-covid https://www.webmd.com/lung/news/20200901/what-changing-death... here the CDC projection is stated as about 0.6% which is consistent with that. So their numbers would be internally consistent, at least. It's obviously hard to be fully sure of what that true rate is, but I'm not seeing a TON of people thinking it's over 1%.
HALtheWise 6y ago
The article spends a long time complaining about the high "unreported infection" numbers used by CDC models, but doesn't actually address the biggest piece of evidence, which is seroprevalence surveys. For example, https://www.cidrap.umn.edu/news-perspective/2021/01/study-us-covid-cases-deaths-far-higher-reported https://www.cidrap.umn.edu/news-perspective/2021/01/study-us... claims 15% of US residents had COVID antibodies in mid-November, and if you want to claim a number that disagrees with that, you at least need to address the evidence.
- boffinism 6y ago
  To be fair, the study you linked suggests 45m have had COVID, and the CDC model assumes 100m have had Covid, of whom 70m were symptomatic. So it actually appears to undermine CDC and support the article.
  - ricardobeat 6y ago
    It's from mid November. Since then, at a near 200k/day rate, another 10M+ diagnosed cases have been recorded. In other words: that article extrapolates from the CDC report of 10 million cases in November, and that is now sitting at around 23M. If anything, the estimate should be way above 70M.
    - bpodgursky 6y ago
      Also, antibodies often don't linger more than a few months, and the immunity is handled by memory cells instead. So that 15% is just a window.
protoman3000 6y ago
Assuming all it takes is a strict 3 week shutdown, why can’t we have that? Or is the assumption wrong? Why weren’t we able to produce enough stock for 3 weeks of total halt?
- netsharc 6y ago
  A 3 week shutdown is politically not feasible, a high percentage of people would just ignore it, with plenty of them yelling and screaming on Parl... Twitter. Somehow it's easier to do in a police state like China. Or maybe a country where there's still a high degree of solidarity (don't quote me, I'm not an expert on exactly why) like New Zealand.
  - umanwizard 6y ago
    Neither China nor New Zealand was ever completely shut down. The closest thing was Wuhan - but that is only one tiny part of China.
- syshum 6y ago
  Most supply chains today are measured in days not weeks The average Grocery will run out of stock in 2-4 days (most being closer to 2 days) The supply chain network is not setup for allow for a 3 week shutdown, nor can it be easily adapted to allow for it. Most people, espically in urban centers, would not have enough supplies to last more than a couple of days as well. Given that most people also can not budget for a $100 emergency they would be hard pressed to walk into a store and buy 3 weeks of food even if we could stock the stores to supply it (which we can not) That is with out getting into the needs of Power, Water, Gas, Sewer, Public Safety, etc etc etc you can not shut down a nation for 3 weeks, it is simply not possible
- anewaccount2021 6y ago
  There is nothing about the severity of covid that merits shutting down the entire economy. A full shutdown of the entire economy (i.e. you can't get food or water if you need them) would only be warranted in the case of an existential threat.
- 6y ago
aresant 6y ago
I instantly read this title and assumed given the current political environment he was predicting an armed, IRA like insurrection in the US Phew he was just talking about the once in a lifetime pandemic shit show. Time for a break from the internet today.
- selimthegrim 6y ago
  Well we are already at the Armalite and the ballot box stage
jdminhbg 6y ago
This is really poorly reasoned. To take a couple examples: > Using data from flu monitoring programs in prior years, the CDC models project that 70 MILLION Americans have already gotten sick with symptomatic Covid, but decided to just write it off as a bad cold and never got tested. I am not making this up. Why is this hard to believe? Covid testing, especially depending on where you live, can be difficult to obtain. If you have a cough and a loss of sense of smell but nothing debilitating, getting a Covid test just satisfies your curiosity, because you're going to be isolating anyway. > I mean, take that Re up to 3.0 (the high end of the current Ireland estimate), and a single Covid case will result in 5.2 BILLION total cases over a 100-day period, about 60% of the entire human population on the planet. Obviously our social behaviors around the disease would change dramatically well before we got to that point. "Social behaviors" are not what slows down Rt when you get to 60% of the entire human population infected; the number of targets gradually diminishes, slowing the spread.
- scarmig 6y ago
  >> ...the CDC models project that 70 MILLION Americans have already gotten sick with symptomatic Covid, but decided to just write it off as a bad cold and never got tested... > Why is this hard to believe? I don't agree with the article more broadly, but it does make the point that 70 million prior infections isn't consistent with hospitalization numbers over the summer vs now. The only way I can reconcile those numbers is by adding two assumptions: first, that severity depends on initial viral dose; second, various social and weather patterns associated with summer drive lower initial viral doses. I don't think these are implausible assumptions--in fact, I'd guess they're true--but I would need significantly more evidence to make me think they account for many tens of millions of missed COVID cases.
  - nradov 6y ago
    There is really no reliable evidence that symptom severity is correlated with initial viral dose. It's a plausible hypothesis but remains unproven.
  - 8note 6y ago
    There's another assumption you can add - that some people are more susceptible than others. A good portion of hospitalizations and deaths have been the elderly via nursing homes. If those have become safer, it'd make sense that we can have more cases without heavily increasing hospitalizations
DanBC 6y ago
Nice article, but it's flawed because it doesn't mention the cause of the spike is partly the backlog in testing over Christmas. Ireland have recently cleared that backlog, which contributed to the spike.
- stefan_ 6y ago
  A backlog in testing? If you are gonna take more than like two days to process a test, why are you even testing?
  - azundo 6y ago
    Might also be people with mild symptoms delaying to go get a test because they're on break, not necessarily the labs being backed up.
  - DanBC 6y ago
    You test a population to see how prevalent covid-19 is, how it's spreading, whether your containment efforts are working, what variants are spreading. You test an individual to help you decide on appropriate healthcare. It's really important that people who test negative still behave as if they might have covid and might spread covid.
kaczordon 6y ago
I feel like everyone continues to assume COVID-19 infection has an exponential curve but it's been shown by Nobel prize winner Michael Levitt that it actually follows a Gompertz function more accurately. Not only that but the WHO recently released a statement saying that PCR testing for COVID-19 is not suitable as it detects many forms of respiratory problems including the common cold. I feel like the author of this article is simplifying a complex topic. [1] https://youtu.be/Uw2ZTaiN97k https://youtu.be/Uw2ZTaiN97k [2] https://www.who.int/news/item/14-12-2020-who-information-notice-for-ivd-users https://www.who.int/news/item/14-12-2020-who-information-not...
- aidenn0 6y ago
  All apparent exponential growth is actually sigmoid growth. It's just that the difference doesn't matter until you are on the right-hand side of the curve. The author of TFA clearly understands this because if 70M people have undaignosed covid, that shifts us to the right of the curve.
- selimthegrim 6y ago
  There is a lot of pushback on Levitt's predictions that keep moving the goalposts. Let's just say his Nobel Prize wasn't in curve fitting. https://liorpachter.wordpress.com/2020/09/21/the-lethal-nonsense-of-michael-levitt/ https://liorpachter.wordpress.com/2020/09/21/the-lethal-nons...
- avs733 6y ago
  I wouldn't trust a PhD in literature to tell me about epidemiology, I'm disinclined to trust a chemist either.
- krona 6y ago
  Isn't it trivially true to say it's impossible for any natural process to sustain exponential growth for a sustained duration of time?
- thesimon 6y ago
  >Not only that but the WHO recently released a statement saying that PCR testing for COVID-19 is not suitable as it detects many forms of respiratory problems including the common cold. From what I read in the WHO link, they are mostly saying that users should read the manual and check the cycle treshold to make sure no false negative results are seen.
umanwizard 6y ago
The author’s argument for why it’s implausible that a lot of people don’t get tested is literally “c’mon, man.” That not satisfying to me. I was sick for a few days over the summer. Was it a mild case of Covid? I don’t know, or care. Why should I get tested when that information will change literally nothing about my life?
- aidenn0 6y ago
  1. It's not literally "c'mon man" it's "look at these graphs, then 'c'mon, man'." 2. They stipulate that lots of people didn't get tested, but believe it to be an order of magnitude less than the CDC estimates.
  - kansface 6y ago
    I have no trouble believing the 3x rate given that I believe I had Covid in April and was steadfastly refused a test, and later in November, after traveling, was refused testing once more. There still isn't sufficient testing capacity for everyone who wants one, and even then, not everyone who is sick wants a test.
    - aidenn0 6y ago
      FWIW, every single person I know who I know who "believe they had covid in April" who later got an antibody test tested negative.
  - djrogers 6y ago
    > 2. They stipulate that lots of people didn't get tested, but believe it to be an order of magnitude less than the CDC estimates. That would imply that we've verified 23M out of a total of only 30M infections. Given how much of a hassle it is to get tested (even more so 3-4 months ago), it would be utterly shocking if we've tested ~75% of those infected.
- lern_too_spel 6y ago
  The author's argument only relies on people being more likely to getting tested for Covid-19 than for the flu, not on them always testing, so your anecdote does not work as a refutation.
rindalir 6y ago
One technical point that I disagree with is his characterization of exponential spread. He is mentally modeling it like every person is the root of their own tree in a societal forest. While the number of infected nodes in an SIR model on a network does grow exponentially in early stages, at some point the growth slows as many of your contacts have already been infected. This may not happen until some constant fraction of the graph has been infected, however. Of course as we all have heard the equilibrium state is "herd immunity" when the infection dies out or remains contained to small components, but even before this I believe the growth rate slows. I should know more about this considering it is what i wrote my doctoral thesis on, but i've made room for other things.
sub7 6y ago
The vaccine to senior citizens is a game changer here. If successful, it'll cut deaths by over 90% at which point safety protocols can be drastically loosened.
Animats 6y ago
A big problem is that nobody seems to be monitoring Covid antibodies in a large-scale, consistent way. Here's the CDC's "COVID-19 Serology Surveillance Strategy" [1] They have a few tools. One is a blood donor test, where donated blood is tested for antibodies. Another is random sampling of blood tests taken for other medical reasons. Those establish bounds - blood donors are healthier than average, and people getting blood tests for medical reasons are less healthy than average. The results, though, are very spotty. The most recent US data published seems to be from September 2020.[2] "In this repeated, cross-sectional study of 177 919 residual clinical specimens, the estimated percentage of persons in a jurisdiction with detectable SARS-CoV-2 antibodies ranged from fewer than 1% to 23%. Over 4 sampling periods in 42 of 49 jurisdictions with calculated estimates, fewer than 10% of people had detectable SARS-CoV-2 antibodies. ... Samples were obtained during 4 collection periods: July 27 to August 13, August 10 to August 27, August 24 to September 10, and September 7 to September 24, 2020."[3] Those are from anonymous random blood samples taken from people who had a lab test for something else. For blood donors, there's this data.[3] "Data from the American Red Cross, which is providing serosurveillance data as part of the MASS study, indicated that 8.4 percent of U.S. blood donors it tested in a week in late November carried antibodies to Covid-19 in their blood." So that's the US situation from November. Those set upper and lower bounds on how many people in the US have had Covid-19. Those are actuals, not estimates. One would expect this would be tracked and updated weekly, but if it is, the data isn't widely available. The main thing one can conclude from this is that it's nowhere near "herd immunity". That would require 7x-10x as many people showing antibodies. The CDC's estimates based on a flu-based estimate of how many people need medical attention per infection seem inconsistent with that actual data. As for the "Ireland event", here it is on the Financial Times graph with other countries.[4] From 5 cases per 100K to 130 cases per 100K. For comparison, California is now around 105 cases per 100K. [1] https://www.cdc.gov/coronavirus/2019-ncov/covid-data/serology-surveillance/index.html https://www.cdc.gov/coronavirus/2019-ncov/covid-data/serolog... [2] https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2773576 https://jamanetwork.com/journals/jamainternalmedicine/fullar... [3] https://www.medscape.com/viewarticle/944035#vp_2 https://www.medscape.com/viewarticle/944035#vp_2 [4] https://ig.ft.com/coronavirus-chart/?areas=eur&areas=usa&areas=gbr&areas=irl&areasRegional=usny&areasRegional=usnj&areasRegional=usia&areasRegional=usca&areasRegional=usnd&areasRegional=ussd&cumulative=0&logScale=0&per100K=1&startDate=2020-09-01&values=cases https://ig.ft.com/coronavirus-chart/?areas=eur&areas=usa&are...
dmoo 6y ago
Current data from Ireland https://covid19ireland-geohive.hub.arcgis.com/ https://covid19ireland-geohive.hub.arcgis.com/
raphlinus 6y ago
I think the central claim of this article is something of a mainstream concern. For example, here's a blog by Tom Frieden, who is in my opinion one of the more credible voices: https://www.tomfriedenpublichealth.net/tom-frieden-blog#january-11-humanity-vs-the-virus-the-virus-is-winning https://www.tomfriedenpublichealth.net/tom-frieden-blog#janu... . Other virologists and epidemiologists who I follow on Twitter are saying similar things.
JimBlackwood 6y ago
This is just a terrible article. It’s just a lot of “I think” “There’s a non-trivial chance” “I expect” “I predict” without any sources to back anything up. If you’re going to disagree with the CDC model, at least show why they’re wrong or why your reasoning is correct. Same goes for the Ireland situation, if you’re so obsessed with it; put them in context. For instance, name how Ireland eased their lockdown for Christmas [1], how 45% of new cases are due to the UK-variant [2]. Given that, what could happen, based on data, that a similar event can happen in the US? Don’t just show a chart and say “I predict that there is a non-trivial chance that the same thing will happen in the US.” If anyone went to the comments to see if this article is worth your time; I predict there’s a non-trivial chance you will find that it is not worth your time. Furthermore, I expect you’ll also not find the website worth 200$/year. The website looks pretty though. [1] https://www.bbc.com/news/world-europe-55364744 https://www.bbc.com/news/world-europe-55364744 [2] https://www.irishpost.com/news/taoiseach-uk-variant-account-for-almost-half-of-all-covid-19-cases-in-ireland-201302 https://www.irishpost.com/news/taoiseach-uk-variant-account-...
breck 6y ago
There's a phenomena happening for hundreds of thousands of years called "winter". Every single one of these "winters" we see an exponential rise in respiratory illnesses like the flu or COVID-19. https://www.cdc.gov/mmwr/preview/mmwrhtml/figures/m6223a5f1.gif https://www.cdc.gov/mmwr/preview/mmwrhtml/figures/m6223a5f1.... If things *didn't* go up >10x, it would be news.
Balgair 6y ago
Oh Jesus, I read the title and thought it was about 'The Troubles' coming to the US over the insurrection. Which I thought would be really bad. But then it was about covid-19, and, well ... that actually may be worse in terms of casualties. Good Lord.

So many reasoning flaws. The spike happened after Christmas as New Years. There are other possible explanations not being factored as well... People have been home A LOT this past year and are probably in worse shape then ever and some people probably lack more vitamin d then ever before. The weather is colder in the northern hemisphere now, contributing to low air humidity and benefiting viruses.

captain_price7 6y ago

> Using data from flu monitoring programs in prior years, the CDC models project that 70 MILLION Americans have already gotten sick with symptomatic Covid, but decided to just write it off as a bad cold and never got tested. I am not making this up. In Bangladesh, a well-regarded study found that 45% of people in Dhaka, one of the most densely populated regions in the world, had antibodies. This study was conducted between April 18 and July 5. I'm sure the number is much higher now. And most people around me seem to agree with this- our total deaths so far is 1/50 of USA, despite having 1/2 population. Even if we multiply our total deaths by 5 to account for maybe government cover-up, our death rate/infection rate still seems too low. Widespread immunity appears to be the only explanation for this disparity. [1] https://bdnews24.com/bangladesh/2020/10/12/45-percent-of-dhaka-residents-carry-covid-19-antibodies-study https://bdnews24.com/bangladesh/2020/10/12/45-percent-of-dha...

nradov 6y ago
A similar study in part of India found an antibody seroprevalence rate of 57% and a corresponding IFR under 0.1%. https://www.cnbctv18.com/healthcare/57-sero-prevalence-in-slums-16-in-non-slums-in-mumbai-says-survey-of-3-wards-6475141.htm https://www.cnbctv18.com/healthcare/57-sero-prevalence-in-sl... There could be other explanations beyond widespread existing immunity. For example could diet be a factor?
- BillyTheKing 6y ago
  the most likely explanation is just age-distribution. The vast majority of our covid-fatalities are older than 70, most are 80 or older. To make things worse, many of them live in retirement homes which turn into death traps once the virus entered. That's all fairly unique to Western societies and is definitely one explanation for vastly different IFRs.
  - umanwizard 6y ago
    As an Indian acquaintance explained to me bluntly: if you were going to die of Covid, in that part of the world you've probably already died of something else.

alkonaut 6y ago

> More than three times the number of known Covid cases? Wouldn't detecting 1/3 and missing 2/3 be pretty expected, especially since a lot of the cases were early on? Count backwards from the estimated IFR of e.g. 0.2..1.0% and you get a number of million infections from the ~400k dead. You need to go pretty low in that IFR to get to 1/3 of the population though.

bjornsing 6y ago

> More than three times the number of known Covid cases? C’mon, man. Actual cases being three times the number of known cases sounds reasonable to me. I protested when the Swedish CDC (Folkhälsomyndigheten) claimed it was 1000x, then 100x and finally 75x. But 3x sounds very reasonable to me, perhaps even a bit low.

drcross 6y ago

I'm Irish in Ireland, I've been following the matter closely. Ireland had one of the strictest lockdowns in most of Europe since March, no pubs, nightclubs, limited restaurants, churches, limited sports, 5km travel restrictions were on and off. We masked up early and our national broadcaster was constantly warning everyone non-stop. Schools were open however. We were the poster boy for lockdown success up until at least November. Other nations were commenting on our achievements. You can see what has happened since. The WHO warns that lockdown should only be treated as a last resort, to truly flatten the curve and no more. We ignored that. It's my sincere opinion that we've tried to push back a virus through our lockdown measures and social distancing that eventually cannot be controlled. Holding back a virus is like holding back a damn, eventually something will burst and typically at the wrong time. If we had listened to the WHO by not locking down, gaining natural immunity during the summer (when coronaviruses aren't as prevalent) we wouldn't be in the mess that we are in now. The median age of death of this virus is 82. Please conceptualise this. Less than 20 people under the age of 44 died from covid in 2020. With our current technology dying is a part of life that cannot be avoided. The people who are dying from covid at the moment are people who were going to die this year, remember, people have to die, most of them have already made peace with this idea. If we didn't try so hard to prevent these aged people from dying we wouldn't have our resources stretched thin which is compounding the death rate further. I'm sorry to be the person to tell you this but we all have to die, we shouldn't be stopping the living from enjoying their days on earth. Lockdowns are hurting the young and middle age to a drastic degree. You may not care because you work from home and are still guaranteed a paycheck. It's easy to virtue signal that you want to save everyone from the comfort of your keyboard. You aren't impacted by business closures but if you had any shed of humanity you would disagree to these lockdowns because they are causing more harm than good.

salmon30salmon 6y ago
Thank you. I honestly believe that there is a non-trivial percentage of the population that _likes_ the COVID world and wants to keep it going as long as possible. Some may like working remotely, others may like the wider acceptance of meal and grocery delivery, others may prefer the reduction in greenhouse gases. That is the only way I can rationalize the insistence of lockdowns here on HN and elsewhere. Either that or COVID is another social issue that is being exploited by nefarious actors to divide western nations. Or both.

godmode2019 6y ago

A point not many people are raising is its winter in the northern hemisphere, so naturally the R0 will increase. Why this new strain is so prevalent? My personal opinion is since schools opened up they have acted as the main vector. Going undetected for an extended period, I read children are 'being hit the hardest' ie their is a lot more asymptomatic children. The latter point is just conjecture but the note on winter I do think has merit. Overtime the virus will be less deadly to all age groups and likely become another common cold virus. I read a article in hn the other day talking about how all cold virus might have started as pandemics. Based in history pandemics last 18 months. Two winters and one summer. But that is during natural spread rather than nation wide lockdown. While I'm ranting, I believe masks were always a vector to get people the smallest viral dose. Have you seen anyone with a mask, they touch it every few seconds and even reuse it. I remember back 12months ago I was panning on wearing different clothes inside from outside, having a buffer area in my house and having a mask cycle were they spend 3 days in the suns UV. I don't think the virus will get as much news, a important catalyst is when their is government mandate of the pcr cycle number. If they reduce it they can stimulate low infection numbers. In my personal opinion mass testing was the biggest mistake, after it hit large community spread they should have only tested in hospitals for research purposes and held all data at a national security level for 10 years. People are just not mentally able to deal with such situation, look at social media for an example their is so much pure rage in the world. Even in my county NZ the anger on social media is shocking. Its the same logic that you should not tell people about aliens (in movies) because people as a group can not take the stress. We on HN are a bad sample, we are probably more likely to be logical. Where most people would have strong emotions. I read this title as "Ireland events" as social unrest. I know this is not the subject, but its equally vaild, given what we have witnessed over the last year.

scarmig 6y ago
One seasonal question that I'm pondering: It's currently summer in South Africa, but death rate is spiking there, more than during its winter. This surprises and concerns me. What's the explanation? Thankfully, other obvious Southern Hemisphere countries aren't seeing a big spike right now.

f430 6y ago

> An “Ireland Event” outbreak, with draconian shutdowns, an unemployment shock and small business bankruptcies, would be massively deflationary. Close your positions or reduce it today. Do it now. Don't wait until the shit hits the fan. Sell, reduce or hedge. You've been warned.

theandrewbailey 6y ago

On the first graph, that last label makes me distrust the entire article.

bichiliad 6y ago
Can you clarify which graph and which label? The first graph I see is the number of new cases in Ireland over the past year, and I don't see any labels that seem suspicious.
- brundolf 6y ago
  The final label on the x-axis says January 2, 2020 instead of 2021. I assume the GP was being partly facetious
DaiPlusPlus 6y ago
What "last label" are you referring to?
_nothing 6y ago
What about it? The fact that it says January 2 while the caption says it's through January 7? I'm assuming that's just because the labels are generated at 11 day increments and Jan 7 isn't 11 days away from the 2nd.
- kissickas 6y ago
  It says 2020 instead of 2021.
  - _nothing 6y ago
    Ah, that's definitely strange. A bug in the graphing software, maybe?
    - the_local_host 6y ago
      I think it's more likely that there were one or more manual steps in generating the graph, and someone just kept going with 2020 instead of typing 2021. The author should explain what went wrong there if this reaches their attention.

Atlantium 6y ago

When I read the headline I thought this article might be about domestic terrorism in the US. When I clicked on the article I saw it it was in fact about COVID-19. This is how I test my assumptions.

Eric_WVGG 6y ago
Huh. I guessed “potato famine”
jedimastert 6y ago
I was just thinking about a comment about how the current situation could lead to a US "Troubles"
brundolf 6y ago
I thought the exact same thing- "The Ireland Event" being the Catholic-Protestant conflict in the latter part of the 20th century
- Accujack 6y ago
  I was hoping it involved Guinness myself, or better yet Smithwick's. I'd be okay with multiple events like that.
  - f430 6y ago
    I love your humour during these times, also thought by "Ireland Event" he was talking about "The Troubles" coming to America and clicked but I guess we have different stereotypical images of Irish folks.
- bklaasen 6y ago
  We euphemistically call that "The Troubles".
- hervature 6y ago
  I thought it was about potatoes

majormajor 6y ago

That graph looks a lot like what California already did in December. I'm not sure where to find Re numbers to compare with his discussed ones for Ireland. ANOTHER huge spike on top of the one that only now is starting to slow would be pretty terrible, or maybe we just saw the same thing already (new strains have been identified here, and behavior seems like it deteriorated before the holidays before getting improved after the spike). I think it's fairly incomplete to make predictions about the US like the linked article (let alone speculation about government motivations) without discussing or comparing the current US numbers much at all. The author acknowledges that it would be a spread-out-over-time-regionally thing, but looks at aggregate country-level US data that is going to make it hard to see. The political speculation seems a bit out of left field: in the US I did hear a lot about "the winter will be tough" "it will be worse if people travel after getting fatigued with restrictions" "we can't let our guard down even though numbers are improving now". And we've heard a lot about "we need to keep an eye on new strains and such and may have to make further adjustments." Not this head-in-the-sand posture the author is describing.

Fordec 6y ago

Disclaimer: I'm Irish, working in tech but my hobby that gets me more of a social life is involvement with an Irish political party. The new variant accounted for 10-25% of these new cases over the period of that spike. The spike happened two weeks after Christmas when lock-down restrictions were lifted, as planned in October, so people could have a respite after 9 months of all this. Did the government misjudge just how much people would socially interact? You bet. But to claim that this event is a sign of things to come is to willfully ignore what Irish medical professionals (NPHET) are saying about what the root cause has been and fully buy into the government politicians attempts to cover their butts by blaming the new strain and not their own operational strategy. Also note that it is coming up to three weeks since Christmas and new infections today is half of what it was last week already and dropping.

randompwd 6y ago
Also let's not forget the porous border with Northern Ireland, which is suffering from London's stupid rules.
deleted 6y ago
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cactus2093 6y ago
What everyone seems to be assuming is that this new strain will cause a constant increase in the reproduction number R of ~50% in every situation. I haven't really seen any discussion of if and why that is actually a good extrapolation to make. So for example in a specific situation, with a specific type of intermingling of a population in which the R value was, say, 1.2, we think the new strain caused that to increase to an R value of 1.8. How does it necessarily follow that taking intervention measures that bring the R value of the base strains down to, say, 0.8 would bring the R value of the new strain to exactly 1.2? There are just so many factors involved, it doesn't seem like this could possibly be knowable right now. So there may be some hope that things like getting everyone N95 masks and requiring their use, and closing down indoor activities, which are good measures to control the current strains anyway, could also bring down the reproduction number of the new strain below 1 as well. However, this is all a purely academic exercise anyway. Even in places that are being "aggressive" in countering the virus like San Francisco, we have done exactly nothing to react to new information in the past 1.5 months. Our "lockdown", which is entirely optional and has no teeth, is clearly not working, but we have neither removed it or strengthened it. The health department has exactly zero plans regarding the vaccine. It feels like we've just given up altogether, and we're praying that the private market saves us by somehow distributing the vaccines effectively. And on top of all that, we've handicapped the private market by making it illegal to distribute the vaccine to the vast majority of the population, even the elderly and vulnerable groups!

tgb 6y ago

So the main complaint is that the US Govt model has 70 million symptomatic-but-undiagnosed cases in the US compared to 23 diagnosed cases and the author claims this is wildly wrong. If those numbers were correct, we'd have diagnosed 23% of cases. Do we really thing we've done much better than that? I'm not certain. I'd be a little surprised if it were over 50%, but that's purely based off intuition. The other point the author kind of brings up: the current Alabama numbers are roughly in line with the "Ireland event" already. So a "rolling series" of these events is kind of what we already have happening, isn't it? That doesn't diminish the toll of the situation or the mistakes in the responses from the authorities.

avs733 6y ago
Information on US COVID-19 seroprevlance surveys can be found on the CDC website [0]. There are also a number of more locally sampled sero surveys going on concurrently right now by state/city/county public health departments. 'Sero' surveys are a commonly used tool in infectitious disease research to understand the difference between identified and total case numbers. They have tons of pros and cons (see [1] for some examples). There are also different types [2] They aren't exact, but the goal with this type of research isn't perfect accuracy, that is impossible, it's better information than we currently have. The prevalence number that you get from a sero survey is hugely important to accurately estimating the effectiveness of medical tests. However, getting that data into a model of test accuracy isn't necessarily easy. [3] This is an example of a COVID sero survey from Santa Clara County last April [4]. Over two days they collected around 3500 samples over two days. There results summary is basically this: The raw prevalence of antibodies to SARS-CoV-2 in our sample was 1.5%. Weighted for population demographics of Santa Clara County, the prevalence was 2.8%. Using those prevalence numbers, the unweighted estimate of case numbers was 23,000. Using the weighted prevalence number, the estimate was 54,000. In early April, there were approximately 1,000 confirmed cases in Santa Clara County. From my epidemiologist friends, they think 50% diagnosed cases is if anything a massive overestimate of the diagnostic rate and something like 1 in 4 diagnosed cases is probably accurate (this is hearsay that I can't cite from people in the field). The problem is that the 23,000-54,000 people who 'had' (air quotes) COVID last April may or may not be immune at this point. The numbers may be high or low ...either way they are BAD Not even getting into what this means about vaccine policy...just talking about what the data and numbers are here. I'm still trying to process what the original post means/is trying to say honestly. [0] https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/geographic-seroprevalence-surveys.html https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/geog... [1] https://www.who.int/immunization/monitoring_surveillance/burden/laboratory/Serosurvey_Manual_chapter_1.pdf https://www.who.int/immunization/monitoring_surveillance/bur... [2] https://www.cdc.gov/coronavirus/2019-ncov/covid-data/seroprevalence-types.html https://www.cdc.gov/coronavirus/2019-ncov/covid-data/seropre... [3] https://academic.oup.com/aje/article/190/1/109/5893084?login=true https://academic.oup.com/aje/article/190/1/109/5893084?login... [4] https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v2 https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v...

JPKab 6y ago

"that 70 MILLION Americans have already gotten sick with symptomatic Covid, but decided to just write it off as a bad cold and never got tested. I am not making this up." Based on quantity of people with antibodies in NYC, Italy, etc who never knew they had it other than symptoms they thought were a cold, there's nothing surprising about a number of 70 million.

majormajor 6y ago
"Symptomatic" in that sentence feels strange too. Why would we not be counting the asymptomatic cases for these purposes? 381K fatalities against 70M assumed cases is a fatality rate of about half a percent. It would doubtless tick up a bit higher if nobody got sick anymore starting today as hospitalizations are at very high numbers compared to the past, in the US, so those cases have more deaths to come. https://www.webmd.com/lung/news/20200901/what-changing-death-rates-tell-us-about-covid https://www.webmd.com/lung/news/20200901/what-changing-death... here the CDC projection is stated as about 0.6% which is consistent with that. So their numbers would be internally consistent, at least. It's obviously hard to be fully sure of what that true rate is, but I'm not seeing a TON of people thinking it's over 1%.

HALtheWise 6y ago

The article spends a long time complaining about the high "unreported infection" numbers used by CDC models, but doesn't actually address the biggest piece of evidence, which is seroprevalence surveys. For example, https://www.cidrap.umn.edu/news-perspective/2021/01/study-us-covid-cases-deaths-far-higher-reported https://www.cidrap.umn.edu/news-perspective/2021/01/study-us... claims 15% of US residents had COVID antibodies in mid-November, and if you want to claim a number that disagrees with that, you at least need to address the evidence.

boffinism 6y ago
To be fair, the study you linked suggests 45m have had COVID, and the CDC model assumes 100m have had Covid, of whom 70m were symptomatic. So it actually appears to undermine CDC and support the article.
- ricardobeat 6y ago
  It's from mid November. Since then, at a near 200k/day rate, another 10M+ diagnosed cases have been recorded. In other words: that article extrapolates from the CDC report of 10 million cases in November, and that is now sitting at around 23M. If anything, the estimate should be way above 70M.
  - bpodgursky 6y ago
    Also, antibodies often don't linger more than a few months, and the immunity is handled by memory cells instead. So that 15% is just a window.

protoman3000 6y ago

Assuming all it takes is a strict 3 week shutdown, why can’t we have that? Or is the assumption wrong? Why weren’t we able to produce enough stock for 3 weeks of total halt?

netsharc 6y ago
A 3 week shutdown is politically not feasible, a high percentage of people would just ignore it, with plenty of them yelling and screaming on Parl... Twitter. Somehow it's easier to do in a police state like China. Or maybe a country where there's still a high degree of solidarity (don't quote me, I'm not an expert on exactly why) like New Zealand.
- umanwizard 6y ago
  Neither China nor New Zealand was ever completely shut down. The closest thing was Wuhan - but that is only one tiny part of China.
syshum 6y ago
Most supply chains today are measured in days not weeks The average Grocery will run out of stock in 2-4 days (most being closer to 2 days) The supply chain network is not setup for allow for a 3 week shutdown, nor can it be easily adapted to allow for it. Most people, espically in urban centers, would not have enough supplies to last more than a couple of days as well. Given that most people also can not budget for a $100 emergency they would be hard pressed to walk into a store and buy 3 weeks of food even if we could stock the stores to supply it (which we can not) That is with out getting into the needs of Power, Water, Gas, Sewer, Public Safety, etc etc etc you can not shut down a nation for 3 weeks, it is simply not possible
anewaccount2021 6y ago
There is nothing about the severity of covid that merits shutting down the entire economy. A full shutdown of the entire economy (i.e. you can't get food or water if you need them) would only be warranted in the case of an existential threat.
6y ago

aresant 6y ago

I instantly read this title and assumed given the current political environment he was predicting an armed, IRA like insurrection in the US Phew he was just talking about the once in a lifetime pandemic shit show. Time for a break from the internet today.

selimthegrim 6y ago
Well we are already at the Armalite and the ballot box stage

jdminhbg 6y ago

This is really poorly reasoned. To take a couple examples: > Using data from flu monitoring programs in prior years, the CDC models project that 70 MILLION Americans have already gotten sick with symptomatic Covid, but decided to just write it off as a bad cold and never got tested. I am not making this up. Why is this hard to believe? Covid testing, especially depending on where you live, can be difficult to obtain. If you have a cough and a loss of sense of smell but nothing debilitating, getting a Covid test just satisfies your curiosity, because you're going to be isolating anyway. > I mean, take that Re up to 3.0 (the high end of the current Ireland estimate), and a single Covid case will result in 5.2 BILLION total cases over a 100-day period, about 60% of the entire human population on the planet. Obviously our social behaviors around the disease would change dramatically well before we got to that point. "Social behaviors" are not what slows down Rt when you get to 60% of the entire human population infected; the number of targets gradually diminishes, slowing the spread.

scarmig 6y ago
>> ...the CDC models project that 70 MILLION Americans have already gotten sick with symptomatic Covid, but decided to just write it off as a bad cold and never got tested... > Why is this hard to believe? I don't agree with the article more broadly, but it does make the point that 70 million prior infections isn't consistent with hospitalization numbers over the summer vs now. The only way I can reconcile those numbers is by adding two assumptions: first, that severity depends on initial viral dose; second, various social and weather patterns associated with summer drive lower initial viral doses. I don't think these are implausible assumptions--in fact, I'd guess they're true--but I would need significantly more evidence to make me think they account for many tens of millions of missed COVID cases.
- nradov 6y ago
  There is really no reliable evidence that symptom severity is correlated with initial viral dose. It's a plausible hypothesis but remains unproven.
- 8note 6y ago
  There's another assumption you can add - that some people are more susceptible than others. A good portion of hospitalizations and deaths have been the elderly via nursing homes. If those have become safer, it'd make sense that we can have more cases without heavily increasing hospitalizations

DanBC 6y ago

Nice article, but it's flawed because it doesn't mention the cause of the spike is partly the backlog in testing over Christmas. Ireland have recently cleared that backlog, which contributed to the spike.

stefan_ 6y ago
A backlog in testing? If you are gonna take more than like two days to process a test, why are you even testing?
- azundo 6y ago
  Might also be people with mild symptoms delaying to go get a test because they're on break, not necessarily the labs being backed up.
- DanBC 6y ago
  You test a population to see how prevalent covid-19 is, how it's spreading, whether your containment efforts are working, what variants are spreading. You test an individual to help you decide on appropriate healthcare. It's really important that people who test negative still behave as if they might have covid and might spread covid.

kaczordon 6y ago

I feel like everyone continues to assume COVID-19 infection has an exponential curve but it's been shown by Nobel prize winner Michael Levitt that it actually follows a Gompertz function more accurately. Not only that but the WHO recently released a statement saying that PCR testing for COVID-19 is not suitable as it detects many forms of respiratory problems including the common cold. I feel like the author of this article is simplifying a complex topic. [1] https://youtu.be/Uw2ZTaiN97k https://youtu.be/Uw2ZTaiN97k [2] https://www.who.int/news/item/14-12-2020-who-information-notice-for-ivd-users https://www.who.int/news/item/14-12-2020-who-information-not...

aidenn0 6y ago
All apparent exponential growth is actually sigmoid growth. It's just that the difference doesn't matter until you are on the right-hand side of the curve. The author of TFA clearly understands this because if 70M people have undaignosed covid, that shifts us to the right of the curve.
selimthegrim 6y ago
There is a lot of pushback on Levitt's predictions that keep moving the goalposts. Let's just say his Nobel Prize wasn't in curve fitting. https://liorpachter.wordpress.com/2020/09/21/the-lethal-nonsense-of-michael-levitt/ https://liorpachter.wordpress.com/2020/09/21/the-lethal-nons...
avs733 6y ago
I wouldn't trust a PhD in literature to tell me about epidemiology, I'm disinclined to trust a chemist either.
krona 6y ago
Isn't it trivially true to say it's impossible for any natural process to sustain exponential growth for a sustained duration of time?
thesimon 6y ago
>Not only that but the WHO recently released a statement saying that PCR testing for COVID-19 is not suitable as it detects many forms of respiratory problems including the common cold. From what I read in the WHO link, they are mostly saying that users should read the manual and check the cycle treshold to make sure no false negative results are seen.

umanwizard 6y ago

The author’s argument for why it’s implausible that a lot of people don’t get tested is literally “c’mon, man.” That not satisfying to me. I was sick for a few days over the summer. Was it a mild case of Covid? I don’t know, or care. Why should I get tested when that information will change literally nothing about my life?

aidenn0 6y ago
1. It's not literally "c'mon man" it's "look at these graphs, then 'c'mon, man'." 2. They stipulate that lots of people didn't get tested, but believe it to be an order of magnitude less than the CDC estimates.
- kansface 6y ago
  I have no trouble believing the 3x rate given that I believe I had Covid in April and was steadfastly refused a test, and later in November, after traveling, was refused testing once more. There still isn't sufficient testing capacity for everyone who wants one, and even then, not everyone who is sick wants a test.
  - aidenn0 6y ago
    FWIW, every single person I know who I know who "believe they had covid in April" who later got an antibody test tested negative.
- djrogers 6y ago
  > 2. They stipulate that lots of people didn't get tested, but believe it to be an order of magnitude less than the CDC estimates. That would imply that we've verified 23M out of a total of only 30M infections. Given how much of a hassle it is to get tested (even more so 3-4 months ago), it would be utterly shocking if we've tested ~75% of those infected.
lern_too_spel 6y ago
The author's argument only relies on people being more likely to getting tested for Covid-19 than for the flu, not on them always testing, so your anecdote does not work as a refutation.

rindalir 6y ago

One technical point that I disagree with is his characterization of exponential spread. He is mentally modeling it like every person is the root of their own tree in a societal forest. While the number of infected nodes in an SIR model on a network does grow exponentially in early stages, at some point the growth slows as many of your contacts have already been infected. This may not happen until some constant fraction of the graph has been infected, however. Of course as we all have heard the equilibrium state is "herd immunity" when the infection dies out or remains contained to small components, but even before this I believe the growth rate slows. I should know more about this considering it is what i wrote my doctoral thesis on, but i've made room for other things.

sub7 6y ago

The vaccine to senior citizens is a game changer here. If successful, it'll cut deaths by over 90% at which point safety protocols can be drastically loosened.

Animats 6y ago

A big problem is that nobody seems to be monitoring Covid antibodies in a large-scale, consistent way. Here's the CDC's "COVID-19 Serology Surveillance Strategy" [1] They have a few tools. One is a blood donor test, where donated blood is tested for antibodies. Another is random sampling of blood tests taken for other medical reasons. Those establish bounds - blood donors are healthier than average, and people getting blood tests for medical reasons are less healthy than average. The results, though, are very spotty. The most recent US data published seems to be from September 2020.[2] "In this repeated, cross-sectional study of 177 919 residual clinical specimens, the estimated percentage of persons in a jurisdiction with detectable SARS-CoV-2 antibodies ranged from fewer than 1% to 23%. Over 4 sampling periods in 42 of 49 jurisdictions with calculated estimates, fewer than 10% of people had detectable SARS-CoV-2 antibodies. ... Samples were obtained during 4 collection periods: July 27 to August 13, August 10 to August 27, August 24 to September 10, and September 7 to September 24, 2020."[3] Those are from anonymous random blood samples taken from people who had a lab test for something else. For blood donors, there's this data.[3] "Data from the American Red Cross, which is providing serosurveillance data as part of the MASS study, indicated that 8.4 percent of U.S. blood donors it tested in a week in late November carried antibodies to Covid-19 in their blood." So that's the US situation from November. Those set upper and lower bounds on how many people in the US have had Covid-19. Those are actuals, not estimates. One would expect this would be tracked and updated weekly, but if it is, the data isn't widely available. The main thing one can conclude from this is that it's nowhere near "herd immunity". That would require 7x-10x as many people showing antibodies. The CDC's estimates based on a flu-based estimate of how many people need medical attention per infection seem inconsistent with that actual data. As for the "Ireland event", here it is on the Financial Times graph with other countries.[4] From 5 cases per 100K to 130 cases per 100K. For comparison, California is now around 105 cases per 100K. [1] https://www.cdc.gov/coronavirus/2019-ncov/covid-data/serology-surveillance/index.html https://www.cdc.gov/coronavirus/2019-ncov/covid-data/serolog... [2] https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2773576 https://jamanetwork.com/journals/jamainternalmedicine/fullar... [3] https://www.medscape.com/viewarticle/944035#vp_2 https://www.medscape.com/viewarticle/944035#vp_2 [4] https://ig.ft.com/coronavirus-chart/?areas=eur&areas=usa&areas=gbr&areas=irl&areasRegional=usny&areasRegional=usnj&areasRegional=usia&areasRegional=usca&areasRegional=usnd&areasRegional=ussd&cumulative=0&logScale=0&per100K=1&startDate=2020-09-01&values=cases https://ig.ft.com/coronavirus-chart/?areas=eur&areas=usa&are...

dmoo 6y ago

Current data from Ireland https://covid19ireland-geohive.hub.arcgis.com/ https://covid19ireland-geohive.hub.arcgis.com/

raphlinus 6y ago

I think the central claim of this article is something of a mainstream concern. For example, here's a blog by Tom Frieden, who is in my opinion one of the more credible voices: https://www.tomfriedenpublichealth.net/tom-frieden-blog#january-11-humanity-vs-the-virus-the-virus-is-winning https://www.tomfriedenpublichealth.net/tom-frieden-blog#janu... . Other virologists and epidemiologists who I follow on Twitter are saying similar things.

JimBlackwood 6y ago

This is just a terrible article. It’s just a lot of “I think” “There’s a non-trivial chance” “I expect” “I predict” without any sources to back anything up. If you’re going to disagree with the CDC model, at least show why they’re wrong or why your reasoning is correct. Same goes for the Ireland situation, if you’re so obsessed with it; put them in context. For instance, name how Ireland eased their lockdown for Christmas [1], how 45% of new cases are due to the UK-variant [2]. Given that, what could happen, based on data, that a similar event can happen in the US? Don’t just show a chart and say “I predict that there is a non-trivial chance that the same thing will happen in the US.” If anyone went to the comments to see if this article is worth your time; I predict there’s a non-trivial chance you will find that it is not worth your time. Furthermore, I expect you’ll also not find the website worth 200$/year. The website looks pretty though. [1] https://www.bbc.com/news/world-europe-55364744 https://www.bbc.com/news/world-europe-55364744 [2] https://www.irishpost.com/news/taoiseach-uk-variant-account-for-almost-half-of-all-covid-19-cases-in-ireland-201302 https://www.irishpost.com/news/taoiseach-uk-variant-account-...

breck 6y ago

There's a phenomena happening for hundreds of thousands of years called "winter". Every single one of these "winters" we see an exponential rise in respiratory illnesses like the flu or COVID-19. https://www.cdc.gov/mmwr/preview/mmwrhtml/figures/m6223a5f1.gif https://www.cdc.gov/mmwr/preview/mmwrhtml/figures/m6223a5f1.... If things *didn't* go up >10x, it would be news.

Balgair 6y ago

Oh Jesus, I read the title and thought it was about 'The Troubles' coming to the US over the insurrection. Which I thought would be really bad. But then it was about covid-19, and, well ... that actually may be worse in terms of casualties. Good Lord.