Wuhan Killer Sneeze (thanks Tea)

The IFR is probably lower than 0.5% and the possibility of its actually being significantly lower - given the historical tendency for fatality rates to be downgraded over time in other epidemics (https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/) - should be taken into account, especially when there are decisions made that entail having people die now for certain to save people from dying in the future perhaps; the government went all-out in clearing the decks and that turned out to be an error (because the reasonable worst case turned out to be less likely than the actual case!)

I don't think 100% susceptibility should be the default view - not only is it pretty much unprecedented but it was already apparent that people of different ages were differently susceptible to a great degree. It was also known that COVID kills off many who are already teetering on the edge due to other ailments, which subgroup is limited in number. This difference in susceptibility influences the shape of the graph, with the demise of the most susceptible creating a steep increase in deaths at the start (given sufficient transmission), after which the downward trend begins to take shape.

The models skirt/ignore the susceptibility issue by referring to the 'susceptible' population rather than the general population. If they paid heed to the susceptibility unknown, the range of possible outcomes would be so huge as to be useless...they may as well use their experience, logic and intuition to make a reasoned assessment rather than run a glorified computer game (heaven forbid).

I do agree that early and thus brief lockdowns are probably ok. My main bone of contention is with the UK-lockdown, which I think has been net-negative (and was done for this particular government's political benefit as much as anyone else's - but that's another story).

That would be great news...everyone back to school?!

HMGovt said:

It's over.
History's biggest nothing burger

Asymptomatic spread of coronavirus is 'very rare,' WHO says

Government responses should focus on detecting and isolating infected people with symptoms, said the WHO's Dr. Maria Van Kerkhove.

www.cnbc.com

Click to expand...

To be honest, it would have to be a very strong argument to convince me that measures intended to reduce the rate at which people come into close contact with each other could possibly fail to reduce the spread of an infectious disease, reduce the total number of infections and reduce the number of deaths or other serious health outcomes. To me it's as straightforward as the idea that reducing traffic speed in a blackspot known for accidents caused by people driving too fast is going to reduce the accident rate. Like, how could it possibly not?

And there is an obvious precedent for all of this, of course: https://www.nationalgeographic.com/...-curve-1918-spanish-flu-pandemic-coronavirus/

Social distancing: fine; banning mass gatherings: fine (although SAGE isn't especially convinced); hand-washing: fine (the most effective measure)...but the costs of a prolonged lockdown are horrendous - it's like reducing speed by building a brick wall across the road (which bricks you've taken out of the middle of the city's only bridge).

Furthermore, I don't buy that lockdown has been the cause of London's cases dwindling to 20ish a day and prevalence sinking to 1/1000 - it just doesn't make sense, as hundreds of thousands have still been going to work and/or otherwise mixing (and there would have been spikes post-VE day etc); I think the virus got pretty much everywhere pre-lockdown and then just exhausted the bulk of susceptible people.

This Spanish flu reference class-of-one thing has not been especially helpful, I might add (and there is a weird disconnect between its use and the fixation on the meagre five-year average when it comes to fatalities).

Mr. Tea said:

To me it's as straightforward as the idea that reducing traffic speed in a blackspot known for accidents caused by people driving too fast is going to reduce the accident rate. Like, how could it possibly not?

Click to expand...

mixed_biscuits said:

That would be great news...everyone back to school?!

Click to expand...

Agreed, this would be amazing, but it seems that they are differentiating between asymptomatic (20%) and pre symptomatic, at least thats the best guess.

mixed_biscuits said:

That would be great news...everyone back to school?!

Click to expand...

It seems UK is the only country in the world who hasn't got the news that is not a disease that targets children, neither are they a vector of transmission. In my country kids has been to school since mid-April. Sweden was right about the school from the very beginning.

droid said:

Agreed, this would be amazing, but it seems that they are differentiating between asymptomatic (20%) and pre symptomatic, at least thats the best guess.

Click to expand...

Consensus is you mostly transmit the virus 1-2 days before symptoms and 0-1 day after. It should be noted that the median number of individuals you will infect is 0, but some spread A LOT. That is why this does not spread like influenza (also very different as kids hardly infect anyone), but through sudden bursts of superspreading events. That also explains the heteregonity and localized character of the infections.

If the Swedes are right that immunity sets in at 20-30% they had it right. The jury is also still out whether there are cross-immunity and T-cell immunity. The antibody tests until now has not able to detect that. Latest news is that Bergamo has 50% immunity(!). London probably quite a lot as well.

The jury's still out, but I fear that Sweden's got it tight this time. As a Dane that is very hard to admit.
And the UK definitely got everything wrong. That SAGE and the Imperial College team didn't recommend banning or reducing big events was a very bad decision in hindsight.

Not sure I understand this POV. Sweden has by far the worst death per million rate in Scandinavia and one of the worst in the world. They have taken just as bad an economic hit as everybody else and are still only at an infection rate of around 7.5%. Essentially they killed a lot of people unecessarily for little or no advantage. Even the architects of their policy are saying it was a mistake.

The epidemiologist who led Sweden's controversial COVID-19 response, which did not involve a strict lockdown, now says that the country should have done more to stop the spread of the virus, according to news reports.

"If we were to run into the same disease, knowing exactly what we know about it today, I think we would end up doing something in between what Sweden did and what the rest of the world has done," Anders Tegnell, the state epidemiologist of the Public Health Agency of Sweden, told Swedish Radio on June 3, according to Reuters.

Click to expand...

chava said:

It seems UK is the only country in the world who hasn't got the news that is not a disease that targets children, neither are they a vector of transmission. In my country kids has been to school since mid-April. Sweden was right about the school from the very beginning.

Click to expand...

This may be right but Id like to see some new data. AFAIK, the jury is still out. Speaking as a parent I can say with certainty that children are absolute germ machines. If there's a virus in their school, they'll catch it and pass it on.

Based on contact surveys, which ask subjects how many people they typically meet during school or workdays and on the weekend, the team found that children have approximately three times as many contacts as adults. Although they were only one-third as likely to be infected, keeping children at home helped curb the outbreak in China, the team concludes in a paper published online by Science on 29 April. Reopening schools will likely accelerate transmission, Ajelli cautions.

Should schools reopen? Kids’ role in pandemic still a mystery

Hints that children don’t spread coronavirus efficiently prompt debate

www.sciencemag.org

Click to expand...

Fukuyama, if anyone still cares what he thinks... I don't think he's saying anything particularly controversial here though -- sounds about right.

HMGovt said:

It's over.
History's biggest nothing burger

Asymptomatic spread of coronavirus is 'very rare,' WHO says

Government responses should focus on detecting and isolating infected people with symptoms, said the WHO's Dr. Maria Van Kerkhove.

www.cnbc.com

Click to expand...

looks like that beefy burger is back on the grill...

The W.H.O. walked back an earlier assertion that asymptomatic transmission is ‘very rare.’

It makes you wonder why you bother reading any news at all.

https://experience.arcgis.com/experience/09f821667ce64bf7be6f9f87457ed9aa - Sweden's health authority site

Another reason why universal lockdown is pointless if the virus is already at large: the people who are at anything more than negligible risk would be in their own separate ecosystems anyway - in shielding/in lockdown (and over-70s who are healthy have an IFR of only 1% anyway)

Cases and deaths, respectively (62 deaths for those <50 yrs old, whether with or of*):

* "Statistiken visar antalet personer med bekräftad covid-19 som avlidit, oavsett dödsorsak." = "
The statistics show the number of people with confirmed covid-19 who have died, regardless of the cause of death."

droid said:

Not sure I understand this POV. Sweden has by far the worst death per million rate in Scandinavia and one of the worst in the world. They have taken just as bad an economic hit as everybody else and are still only at an infection rate of around 7.5%. Essentially they killed a lot of people unecessarily for little or no advantage. Even the architects of their policy are saying it was a mistake.

Sweden's lax COVID-19 response caused too many deaths, country's top epidemiologist says

The country should have done more, he says.

www.livescience.com

Click to expand...

Of course they have been hit hard economically, they are just as connected in the global economy as anyone else. They do have better numbers for Q1 though. Remember their policy was never justified because of saving the economy, but because of maintaining social life and stability. Tegnell was saying very early that a lockdown will have severe consequences for the working class/subproletariat/immigrant community which I though was crazy talk back then. Again, he was probably also right.
But Tegnell hasn't admitted anything in term of their policy, if anything he has blamed the nursing homes for not taken precautions.

While initially being completely amazed about his arrogance in the beginning I now admire his stubborness. I can't imagine the pressure he must be under.

Can you point to some actual, tangible benefits of the Swedish approach? As Tea points out, comparisons to their neighbours are appropriate and in deaths per million they now have 4.5 times the number of deaths than Denmark and 10 times the deaths of Norway and new cases are actually increasing.

Thats a lot of extra dead people for no appreciable benefit. I fail to see what's so wonderful about this.

Yeah I'm not seeing what's good there.
Seems that the argument for saying the Swedish approach has worked has two stages
1. Arguing that different countries are so completely unrelated and alien to each other that any comparison of number of deaths or deaths per million or anything those lines is utterly meaningless (the UK are also big fans of this argument now that they come out pretty much at the bottom of any comparison with any other country)
2. Saying that locking down less than other countries carries some intangible and hard to pinpoint advantage which can clearly be compared rigorously between any two countries and by which measure Sweden do better than anyone else.

droid said:

Can you point to some actual, tangible benefits of the Swedish approach? As Tea points out, comparisons to their neighbours are appropriate and in deaths per million they now have 4.5 times the number of deaths than Denmark and 10 times the deaths of Norway and new cases are actually increasing.

Thats a lot of extra dead people for no appreciable benefit. I fail to see what's so wonderful about this.

Click to expand...

I am not defending Swedens strategy I am just just as baffled as anybody else why they are the sole exception in the entire world and I can't understand why the international media aren't are more interested in their approach. Unless you believe Anders Tegnell is the devil himself (some do), you must try to understand their reasoning (which until the Imperial College report was the standard approach for large parts of Northern Europe (UK, Netherlands, Denmark, Belgium)).

Other than severe economical, social and health consequences of lockdown, their approach is basically herd immunity in some form as they believe it kicks in earlier (maybe at 30%). And they don't believe in a working vaccine program in the near future (they had bad experience with the H1N1 vaccine btw).

Hospitalizations seems to be going down in Stockholm now, according to Tegnell because of immunity as they obviously haven't changed behaviour all of a sudden.

Sure, Im not saying you are, but even what you have outlined above doesnt really make sense, or is based on some unknowable assumptions.

Stockholm is at about 7.5% infection rate, way off the 30% they (hope) = herd immunity, but, at best, thats a gamble to begin with. I haven't really seen anything concrete with regard to the negative consequences of lockdown, it seems, at least wrt the Nordics that the effects of lockdown have not been particularly onerous, so I struggle to see the balance there. 10 times the deaths of Norway - for what exactly?

The precautionary principle applies here. you take the course of action that you know will result in the least worst outcome based on the best data you have. From that perspective, it seems to me that the Swedish approach has been proven to be unconscionably reckless, at least so far.

they will legalise weed

According to themselves Stockholm are not at 7%; but who knows. Still why are hospitalizations falling without significant change in behaviour?

There are huge costs to a lockdown, it's obvious. Of course so is doing nothing, but nobody ever expected people to nothing. Why would anybody just go about living normally if people started dying in the streets? People change behaviour lockdown or not.

Nordics in general will handle this better because of several reasons, but poor countries obviously cannot afford lockdown at all so are opening now way before the stats are telling them to.