2019 - nCoV (novel coronavirus originating in Wuhan, China)

[BC]

But Italy still has new infections. It had 1150 yesterday. In fact it is currently trending up. Perhaps lock down slowed the infections or perhaps it didn't

I wonder if this takes Italy off of BC's list of nations that don't need a vaccine. 

Indeed numbers of infections are up for reasons mentioned prior, but positivity remains low.  Again, the main difference is that Italy and other countries are working with low infection numbers after successful effective mitigation and not high numbers with less effective mitigation.  If Italy has 1500 infections daily multiply by 5.5  = 8250 as comparable number adjusted for US population.  Pre-weekend 7 day average for the US was 40,000 approximately 5 times higher and also a higher positivity rate.  Since beginning of July, average daily deaths for the US has hovered around 1000.  For the same time period Italy 10 deaths per day.  This represents a world of difference.

Yes, I am still confident that Italy, if necessary, could maintain very low deaths for the longer term even without a vaccine.  I can't say the same for the US with confidence.

[BillyB]

Out of curiosity I crunched the numbers.  Blue 731 vs Red 463 deaths per million based the 2016 state results.

There's a couple of flaws in there. Red vs Blue needs to be based on who's governor, not based off the 2016 Presidential map. Some states that did bad with COVID are ran by Democratic governors although they voted for Trump. The cities within those states did much worse than the suburbs. Also you need to base it on who's running those states in 2020, not 2016.

http://www.worldometers.info/coronavirus/country/us/

In an unrelated story I know a Chinese guy who has family living in smaller towns in China. He talks to them occasionally. They told him that the government dug huge holes in the ground to mass bury people. Cameras and media weren't allowed to record what was happening. Although China has the biggest population, they are now 39th in the world for total infections.

[BC]

There's a couple of flaws in there. Red vs Blue needs to be based on who's governor, not based off the 2016 Presidential map.

Waat? you don't like the EC system anymore?

There is no flaw. Red and Blue states were mentioned and that's what I did.

If you want to do it by governor, go right ahead.  Hey, maybe mayor of the biggest city in each state?  Dead is dead, we don't need to haggle over 'em.

Have fun.

[Gator]

Out of curiosity I crunched the numbers.  Blue 731 vs Red 463 deaths per million based the 2016 state results. 

Admirable effort, compiling deaths by state and factoring populations.     Thanks. 

My eyeball guess was about 60-40, and yes the red percentage seems to be increasing.  BillyB made some valid comments about mayors, governors, etc.  My state of Florida is red (barely) and majority of deaths occur in blue cities. 

 
Lets make it simple and divide up the homework.  The WH came out with reopening guidelines, once revised.

Can you help out and show me that states followed these guidelines and are doing so today?  ohh.. wait.. seems someone has already done it. [ ]

If you believe Trump has urged states to follow the guidelines do a google search for terms like Trump urges states reopen etc and you'll get many news reports like this one from 26 May

President Donald Trump on Tuesday urged states to open up from coronavirus lockdowns “ASAP,” as he celebrated strong gains for U.S. stocks.

Keyword:  Federalism.

If State Governors and mayors were subordinate to the President, Trump would order them to curb the violent protests that have waged for over 100 days.  Being the President, is Trump responsible for the creation of sanctuary cities and states? 

Why in the world would Trump push states to open in total disregard of his own life saving guidelines? 

Trump listened to scientists, all scientists, not just epidemiologists,  but economists, psychologists, education....He synthesized a decision balancing all considerations.  And that is his job, to make tradeoffs.

BC,  US citizens certainly had ample information to make mitigation decisions, which I contend was the greatest determinant  of outcomes.   

As I stated before, in countries that were most successful,  politics followed science.   

 
Again, you focus on numbers of deaths and current levels of infections.  Are the death numbers properly weighted in the tradeoffs involving the economy and mental health?  Also, do those countries have federal governments similar to the US, compounded by severe political division?

[BC]

Admirable effort, compiling deaths by state and factoring populations.     Thanks.

Copying and pasting worldometer.com tables into excel is not that awfully difficult. From there it's simple worksheet stuff to crunch the numbers.

My eyeball guess was about 60-40, and yes the red percentage seems to be increasing.  BillyB made some valid comments about mayors, governors, etc.  My state of Florida is red (barely) and the majority of deaths occur in blue cities. 

I was surprised the difference was not more.  Yes, one can divvy up down to the county and city if that is somehow momentarily comforting but I don't find it very useful.  Each 'cut' of the pie is less relevant to the whole.  The virus crisis is a national problem and we should start viewing it that way.  Maybe try looking at a current 'snapshot' of recent data to get a better picture of what is going on now.  NY and other NE states seem to be handling it very well nowadays and the virus is 'moving on' as you noted.  No city, county or state is immune and I believe in the end any differences will be very minimal.

Keyword:  Federalism.

If State Governors and mayors were subordinate to the President, Trump would order them to curb the violent protests that have waged for over 100 days.  Being the President, is Trump responsible for the creation of sanctuary cities and states? 

Yes, I do understand the concept.  That is why leadership is so important in 'setting the tone' and getting states on-board with the program.

Trump listened to scientists, all scientists, not just epidemiologists,  but economists, psychologists, education....He synthesized a decision balancing all considerations.  And that is his job, to make tradeoffs.

As long as tradeoffs are genuinely in the interest of the nation I have no objection.  His many statements and actions that conflict even with WH guidelines does not lead me to believe it is so.

BC,  US citizens certainly had ample information to make mitigation decisions, which I contend was the greatest determinant  of outcomes.   

As long as my mitigation or lack thereof does not endanger others, that's fine.  It is obviously not the case with this crisis.  I wear a mask to help keep you from getting sick. Only works if we all are willing to participate.

Again, you focus on numbers of deaths and current levels of infections.  Are the death numbers properly weighted in the tradeoffs involving the economy and mental health?  Also, do those countries have federal governments similar to the US, compounded by severe political division?

Many countries have stark divisions, Italy, Belgium, Spain even Germany still to some waning extent, just to name a few. As for the side effects of mitigation, it's probably too early to assess that with any authority, but I do believe EU will do better than other places due to the higher social net and resources that minimize mental and physical stressors along with a higher level of access to mental health resources.  Many like those here in the south of Italy also benefit from family structures that are more geared towards supporting one another, where 'chipping in' to fill a pot for all is more usual than unusual.  Affordable broadband Internet has helped a lot as well with fixed and mobile access a fraction of the cost in the US.

[Gator]

Yes, I do understand the concept.  That is why leadership is so important in 'setting the tone' and getting states on-board with the program.

How can one be a leader when half the nation has mutinied?  Its worse than herding cats.  The cats are doing sneak attacks rather than joining the family, purposefully not using the litter box,  making a mess and saying the dog did it, killing wild birds, etc.  All the while the media says they are not only justified, they are adorable. 

As long as tradeoffs are genuinely in the interest of the nation I have no objection.  His many statements and actions that conflict even with WH guidelines does not lead me to believe it is so.

I admit Trump focuses on the economy and security, yet IMO does not ignore the rest. Yesterday, for example, he granted millions to ehance Florida's environmental protection programs.
 

As long as my mitigation or lack thereof does not endanger others, that's fine.  It is obviously not the case with this crisis.  I wear a mask to help keep you from getting sick. Only works if we all are willing to participate.

As we should.  The President does not have the authority to order and enforce individual mitigation measures.  How many municipalities do that? 

Some of the lack of compliance is subscribing to different opinions.  Some of it is being a social animal.  Some of it is residing in low infection areas.  Some of it is the "home of the brave and the land of the free."  Some of it is pure mix of stupidity and egotism.   

Sadly, people have died, and the numbers are indeed more than a bad flu season, yet IMO not a significant uptick in mortality (even less when factoring comorbidity). 

Many countries have stark divisions, Italy, Belgium, Spain even Germany still to some waning extent, just to name a few.

 

Is the degree of division in these nations the worst in 150 years?

[Gator]

PAUSING OF OXFORD-ASTRAZENECA VACCINE TRIAL

The Phase 3 clinical trial was paused to do a more comprehensive analysis of data before injecting more volunteers with the trail vaccine. 

From what I can decipher, of the 10,000 volunteers injected one patient developed a case of transverse myelitis.  This is a rare form of spinal cord inflammation caused by  infections, immune system disorders, and other factors.  The condition has been reported in some of the millions and millions of COVID infections. 

The critical question is whether it was caused by the volunteer patient's immune response to the trial vaccine or by something else.  The question must be answered before proceeding and will involve a lengthy process, such as examining whether it was overlooked in other trail inoculations.   

Oxford vaccine uses an  adenovirus vector platform to deliver the gene material prompting a spike protein expression.  Some of the other vaccines underdevelopment use a similar program, and this could cause some of them to also pause their trails.  There are other vaccines using alternative platforms, such as the "down and dirty" one associated with the Russian and Chinese vaccines. 

What this shows is the value of clinical trails before mass usage on the general population.  Are you listening Russia? 

It also shows the safety precautions taken by he FDA and other organizations to protect the public, and explains why the development of a viral vaccine normally takes years. 

Overall this is a lengthy setback for one and maybe more of the vaccines now under development. 

__________________________________________________________________________ ______

BOTTOMLINE:  Would you take a vaccine that is maybe only 60% effective and has a 1-in-10,000 chance of causing a spinal cord inflammation condition requiring 1-2 years of recovery?

[BC]

How can one be a leader when half the nation has mutinied?  Its worse than herding cats.

You follow your own playbook. Consistent messaging is key.  From His playbook:



How many 'deviations' to these guidelines have you observed by our self-appointed spokesperson?

http://www.cdc.gov/eis/field-epi-manual/chapters/Communicating-Investigation.html

The President does not have the authority to order and enforce individual mitigation measures.

Lead by example. Build trust.  Has Trump been a good example for mitigation measures?  Has Trump been a good trust builder or breaker?

Some of the lack of compliance is subscribing to different opinions.  Some of it is being a social animal.  Some of it is residing in low infection areas.  Some of it is the "home of the brave and the land of the free."  Some of it is pure mix of stupidity and egotism.

 

It's the job of a leader to set simple but effective goals that make sense to all citizens and residents.  He rallied many states to be inconsistent with his own published plan.  Is that effective leadership?  The same effort would have been much more effective promoting his plan and rallying folks to observe and comply.

Sadly, people have died, and the numbers are indeed more than a bad flu season, yet IMO not a significant uptick in mortality (even less when factoring comorbidity).

 

Flu season hasn't even hit yet.  Fortunately, the same mitigation measures should work well against both viruses.  Now ask yourself what you expect results will look like based on past performance.
 

Is the degree of division in these nations the worst in 150 years?

Divisions are always present and I'd say they are the worst in 150 years, still very 'tame' compared to Trump's USA.  In the face of a common enemy, many of these divisions were set aside with only a few outliers.  Building trust, setting goals, following a plan and adjusting when needed, along with good, clear messaging.  All are key to the continuing effort.

[BC]

BOTTOMLINE:  Would you take a vaccine that is maybe only 60% effective and has a 1-in-10,000 chance of causing a spinal cord inflammation condition requiring 1-2 years of recovery?

Having the luxury of doing so, I would patiently wait until other trials have been completed, presenting a wider range of choice.

I do hope it is proven unrelated, but since such reactions can be caused by viral infection, pausing to investigate and exclude is prudent.

I suspect somewhere down the road scientists may find that combining multiple vaccines may prove to be the best way to improve efficacy.  60% would be a bummer having to continue mitigation and containment measures.

[BillyB]

Do we know what the illness is? It is said to be transverse myelitis, although AstraZeneca has not confirmed that. That is inflammation of the sheath containing the nerves of the spinal cord. It can be treated by steroids to reduce the inflammation but the condition can be permanent.

The above is from the article below. If the illness is determined to create permanent harm to people, the vaccine may be scrapped. The good news is they are taking safety seriously.

http://www.msn.com/en-us/health/medical/oxford-covid-vaccine-trial-suspension-what-happens-next/ar-BB18RiUU?ocid=spartan-ntp-feeds

[Gator]

How many 'deviations' to these guidelines have you observed by our self-appointed spokesperson?

Woiuld require a detailed qualitative analysis that boils down to touchy-feely considerations, something you probably relish.    I prefer a Gestalt analysis. 

Lead by example. Build trust.  Has Trump been a good example for mitigation measures?  Has Trump been a good trust builder or breaker?

He approached the pandemic as a leader focused on getting us through the pandemic without causing panic.  Panic would have been worse than the added deaths.  Trump is not as a medical doctor; doctors dwell on worse cases including death as a way to prepare the family.  Besides, even you must acknowledge how our scientific understanding has changed, so who knew with certainty what the eventual outcomes would be. We still don't know.   Yes, in so doing he admitted to "playing it down."
 

It's the job of a leader to set simple but effective goals that make sense to all citizens and residents. 

Did Trump's style influence me into not exercising care?  Not the least bit.  Did it influence you?  Individual choices trumped everything. 
 

Flu season hasn't even hit yet.  Fortunately, the same mitigation measures should work well against both viruses.  Now ask yourself what you expect results will look like based on past performance.

This fall will see an increase in COVID infections. 
 

In the face of a common enemy, many of these divisions were set aside with only a few outliers.

Maybe in Europe, but not the case here.  After the failed Russian collusion investigation, and the failed impeachment, the Democrats soon stopped working across the aisle have to turn the pandemic into another opportunity to slam Trump.  Never waste a crisis to spin it to tear apart the country. 

[BC]

I prefer a Gestalt analysis.

Not sure it would add up

He approached the pandemic as a leader focused on getting us through the pandemic without causing panic.  Panic would have been worse than the added deaths.  Trump is not as a medical doctor; doctors dwell on worse cases including death as a way to prepare the family.  Besides, even you must acknowledge how our scientific understanding has changed, so who knew with certainty what the eventual outcomes would be. We still don't know.   Yes, in so doing he admitted to "playing it down."

I see you saw the 'preview' of "Rage" as well
 

  Individual choices trumped everything.

Maybe something like 'little head' and 'big head' thinking we talk about here.
 

This fall will see an increase in COVID infections. 

I reckon so as well, along with many, many deaths.
   

Maybe in Europe, but not the case here.  After the failed Russian collusion investigation, and the failed impeachment, the Democrats soon stopped working across the aisle have to turn the pandemic into another opportunity to slam Trump.  Never waste a crisis to spin it to tear apart the country.

Yep, those damned dems caused Trump to ignore the danger he was informed of, play it down, not follow the game plan and encourage others to do so as well.  We should tar and feather them all!

[BillyB]

Back in March, the White House said we will have just over 200,000 deaths by the 1st of October. It was a prediction that will come true.

http://www.cbsnews.com/news/coronavirus-white-house-model-prediction-200000-deaths-october/

Dr.Birx said if we do things almost perfectly, we'd have anywhere between 100k-200k deaths. We will be just over the 200k mark come October so we will have done a great job just missing the almost perfect mark. They also predicted up to 2.2 million deaths if we did nothing.

http://www.cnbc.com/2020/03/30/white-house-coronavirus-expert-predicts-up-to-200000-us-coronavirus-deaths.html

[BC]

We will be just over the 200k mark come October so we will have done a great job just missing the almost perfect mark. They also predicted up to 2.2 million deaths if we did nothing.

Birx's 'Perfectly' means absolutely nothing in today's context.  Something akin to saying everyone in the class will get an A+ on the first day of school.

It is actually quite shoddy performance when comparing ourselves to other countries.

[BillyB]

BC, there's a lot of factors involved in evaluating the health of the nation. You've always debated as if Coronavirus is the only thing we need to worry about. A good economy will translate to better lives for all living citizens. America remains healthy enough to take care of its citizens and still loan other nations to take care of their problems.

After the first wave of the Coronavirus, Italy is already borrowing billions. After the pandemic ends, you will be paying back with interest. America will collect interest from the nations we loaned money to. After WWII, those paying back their debt helped us rise to Superpower status and made the dollar the world currency. Life improved here for all. I suspect we'll get another boost after the pandemic because we are not sacrificing our economy as much as you think we should. Italy has their way of doing things, America has it's way of doing things. It'll take few years before we see who handled the pandemic better.

http://ec.europa.eu/commission/presscorner/detail/en/IP_20_1478

[BC]

It'll take few years before we see who handled the pandemic better.

Be sure to tell that to McEnemy will ya?

[BC]

After the first wave of the Coronavirus, Italy is already borrowing billions. After the pandemic ends, you will be paying back with interest. America will collect interest from the nations we loaned money to.

And who did we borrow trillions from and will that not be paid back with interest?

 

[BC]

I watched the White House press conference today and the WH press secretary said UK, Belgium, and France has around a 10% death rate while America has 3%. If she did case fatality rate, those numbers would be higher but the fact is America's medical system and response has kept our numbers down and it would be lower if certain boneheaded Democratic governors acted faster instead of laughing at Trump's China and Europe travel bans.

What McEnemy does not tell you:

Countries have varying approaches to COVID-19 case definitions. CFR will vary according to how they are defined.

WHO: During the COVID-19 pandemic, broad variations in CFR estimates have been published, which may be misleading. This scientific brief concludes by providing some explanations for these variations, and why making comparisons between countries can be problematic.

IOW she is simply dividing the number of deaths by the number of confirmed cases (positive tests).  This was fine in the beginning as testing was restricted to patients presenting with significant symptoms. Nowadays just about anyone can get a test.  I could throw any CFR number out there and no one could prove me wrong.  The number she is throwing at you is not CFR, it is IFR since the number of infections she uses include also asymptomatic cases that were tested.

Like the case fatality rate, the term infection fatality rate (IFR) also applies to infectious disease outbreaks, but represents the proportion of

deaths among all infected individuals, including all asymptomatic and undiagnosed subjects

. It is closely related to the CFR, but attempts to additionally account for inapparent infections among healthy people

Further, she does a walk around the bush with the next question that was asked:

McEnemy: "The case fatality rate notes that, and that’s a testament to our therapeutics that the President has navigated —"

Question: "But if you look at the per capita rate, the U.S. is still — towards the very top of that."

McEnemy: "The case fatality is the metric that shows how well our response has done with therapeutics, and we are leading the world in having the lowest case fatality rate."

IFR does nothing of this sort. Deaths per capita is the only remaining, comparable value we have left nowadays.

So you see, the WH is still duping folks right and left to follow that mirage...

NB: this post copied from the Trump thread as it is relevant here also.

[BC]

Back in March, the White House said we will have just over 200,000 deaths by the 1st of October. It was a prediction that will come true.

That briefing was at on 30 March.  Trump 'knew' at least at the beginning of February.

In terms of virus spread and effectiveness of mitigation efforts an eternity.  A couple of weeks can halve deaths.

http://www.webmd.com/lung/news/20200521/lockdown-1-week-earlier-would-have-saved-36k-lives#1

During the same time-frame, it was actually a team from China that scolded Italy about lax lockdown measures. They saved many, many lives by insisting that localized lockdowns, lax enforcement would not suffice and only more restrictive measures would work.

http://www.thedailybeast.com/chinese-red-cross-official-tells-italians-they-are-too-lax-on-covid-19-lockdown

As a result, national lockdown measures already in place since the beginning of March were strengthened considerably.

From Wikipedia:

On 20 March, the Ministry of Health ordered tighter regulations on free movement. The new measures banned open-air sports and running, except individually and in close proximity of one's residence. Parks, playgrounds, and public green were closed down. Furthermore, movement across the country was further restricted, by banning "any movement towards a residence different from the main one", including holiday homes, during weekends and holidays.

On 21 March, Conte announced further restrictions within the nationwide lockdown, by halting all non-essential production, industries and businesses in Italy, following the rise in the number of new cases and deaths in the previous days.[251] This measure had also been strongly asked for by multiple institutions, including trade unions, mayors, and regional presidents, as well as medical professionals, but was initially opposed by the industrialists.[252][253][254][255][256][257][excessive citations]

On 24 March, in a live-streamed press conference, Conte announced a new decree approved by the Council of Ministers. The decree imposed higher fines for the violation of the restrictive measures, and regulation of the relationship between government and Parliament during the emergency. It included also the possibility of reducing or suspending public and private transport, and gave the regional governments power to impose additional restrictive regulations in their Regions for a maximum of seven days before being confirmed by national decree.[258][259]

On 1 April, the government extended the period of lockdown until 13 April, with health minister Speranza saying that the restrictive measures had begun to yield the first positive results.[260]

On 8 April, a government's decree closed all Italian ports until 31 July, stating that they do not ensure the necessary requirements for the classification and definition of "safe place", established by the Hamburg Rules on maritime search and rescue."[263]

On 10 April, Conte announced the prolongation of the lockdown until 3 May, as well as the reopening of some businesses like bookshops and forestry

4 May to 15 June phased reopening to include cinemas, bars barber shops etc.

Since June only discotheques were closed again and masks required in all populated public places and crowds.

The majority of US 'stay at home' orders, a more lax form of lockdown were done much later with the exception of NY and some neighbouring states.  All these states are doing quite well today still.

http://en.wikipedia.org/wiki/COVID-19_pandemic_lockdowns#United_States

Now, reviewing all this, did Italy panic?  Did any other countries really panic faced with the truth?  How can one justify that the US would panic if given truthful and accurate information?

Are we really so weak that our citizens cannot handle the truth?

Something is very, very wrong with those defending Trump's efforts to keep us from knowing what's really happening, facts that would enable folks to make informed choices accordingly and save lives.  His decision is totally indefensible.

[Gator]

Yep, those damned dems caused Trump to ignore the danger he was informed of, play it down, not follow the game plan and encourage others to do so as well. 

Sarcasm noted. 

You would benefit from a chart of time vs the following three:

     1.  Consensus opinions and guidance from health scientists about COVID.
     2.  Remarks/actions made by Trump about COVID
     3.  Remarks/actions  made by Dem leaders such as Cuomo, Biden, Pelosi, et al.

It would show Dem leaders in the early months were playing it down more than Trump.   That later changed when the pandemic became politicized. 

Obama even spoke about staying calm. 

  We should tar and feather them all!

 

I would prefer each side crossing the aisle. 

[Gator]

Are we really so weak that our citizens cannot handle the truth?

What was the truth?  The daily press conferences were showing varying estimates of deaths.  The COVID team was saying tens of thousands, maybe more than a 100,000 would die.

The average person was informed well enough to take mitigation precautions.  My family did.   Why the national run on clorox wipes, isopropyl alcohol, masks, etc.?  Some panicked  and hoarded toilet paper as if everyone would get diarrhea. 
 

Something is very, very wrong with those defending Trump's efforts to keep us from knowing what's really happening, facts that would enable folks to make informed choices accordingly and save lives.  His decision is totally indefensible.

What were the alternatives?  An Italy shutdown would have saved lives and today our economy would be in a deeper hole.   Could an Italy shutdown  be enforced (NYC and NYS  knew the facts and delayed their shutdown)?  Was a shutdown advisable for the entire nation?   

   

[msmob]

Gator,

Please demonstrate your assertion that the Dems 'politicised' the virus and made less of its risks in the earlier days.

Sorry, I think you will have a hard time.

[BillyB]

And who did we borrow trillions from and will that not be paid back with interest?

 

We been through this before. America is owed more than we owe. Don't want to address Italy's borrowing problem?

Precisely how much Italy will get is unclear. Giuseppe Conte, the prime minister, claims it will be €209bn: €81bn in grants and €127bn in loans. But though Italy’s loan entitlement can be calculated, what it actually borrows will depend on factors including the commission’s assessment of Italy’s spending proposals and its government’s willingness to take on yet more debt: extra borrowing to cope with covid-19 has nudged the total to at least 155% of GDP.

http://www.newsday24.com/world/europe/italy-has-to-work-out-what-to-do-with-all-its-new-eu-money/

That briefing was at on 30 March.  Trump 'knew' at least at the beginning of February.

And Trump took action as early as January. If you wanted the honest bad news early, the Democrats could've told you that to help more panic beyond toilet paper shopping.

[BC]

What was the truth?  The daily press conferences were showing varying estimates of deaths.  The COVID team was saying tens of thousands, maybe more than a 100,000 would die.
   

Yes, two months after Trump knew the bug was dangerous.  I'm quite sure you have seen this video, but keep 7 February in mind while watching the dates flash by to absorb the impact of his words in this new context. Think of his 'base' followers that believe every word that comes out of his mouth.



What were citizens and residents to think all the while?  Heck, even other nations listening to the words of the most powerful leader on earth with the best and most vast resources of knowledge and experts at his beck and call.

Inconsistent messaging is deadly.

[BC]

extra borrowing to cope with covid-19 has nudged the total to at least 155% of GDP. [/b]

and what is US debt to GDP ratio? 140% and growing?