Stanford study estimates 48,000+ infected in Santa Clara County - Printable Version
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RE: Stanford study estimates 48,000+ infected in Santa Clara County - OutsiderFan - 04-20-2020
I ask again, what evidence do we have that there is such thing as immunity with Covid-19? To me, it's an assumption not backed by anything other than previous experiences with other viruses.
And there are so many other questions around what the virus does long-term and what second exposures do to people. I continue to be concerned about reports of T-cell loss. There is suspicion that even if people are infected with the virus and have no symptoms that it can destroy T-cells. One researcher called it and I quote:
Quote:These findings show that we have a super potent virus that is evolving and behaving like an airborne HIV ‘cousin’!
https://www.thailandmedical.news/news/covid-19-alert-new-study-shows-sars-cov-2-coronavirus-targets-and-destroys-t-cells,-similarly-as-what-hiv-does
The implications of this are staggering. So yes, what difference does it make if someone has had the virus and their immune system is wrecked as a result?
RE: Stanford study estimates 48,000+ infected in Santa Clara County - BostonCard - 04-20-2020
Here's the original article:
https://www.nature.com/articles/s41423-020-0424-9
Quote:These results suggest that SARS-CoV-2 may enter MT-2 cells at 6 h post infection, but does not replicate, and then the viral RNA degrade.
Thus, this is nothing like HIV, which not only replicates in lymphocytes, but, as a retrovirus, incorporates its genome into the host cell DNA.
BC
RE: Stanford study estimates 48,000+ infected in Santa Clara County - burger - 04-20-2020
A new serology study from Los Angeles county gave roughly the same results as the Stanford test: http://publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm?prid=2328 They estimate ~400,000 infected in LA county.
I haven't been able to find a final report, but people on the internet (reliable, I know) are saying it's the same test they used at Stanford, so that's still a problem. The sampling was better than Stanford but there is still going to be quite a bit of self-selection until you literally force people to take the test (China probably has a leg up over the US in this department).
Anyway, I'll withhold final judgment until I see a report.
RE: Stanford study estimates 48,000+ infected in Santa Clara County - 2006alum - 04-20-2020
(04-20-2020, 02:12 PM)burger Wrote: A new serology study from Los Angeles county gave roughly the same results as the Stanford test: http://publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm?prid=2328 They estimate ~400,000 infected in LA county.
I haven't been able to find a final report, but people on the internet (reliable, I know) are saying it's the same test they used at Stanford, so that's still a problem. The sampling was better than Stanford but there is still going to be quite a bit of self-selection until you literally force people to take the test (China probably has a leg up over the US in this department).
Anyway, I'll withhold final judgment until I see a report.
Indeed. I'm pretty frustrated that the recruitment techniques/scripts are "proprietary" (so the public doesn't get to see them), they have not released the raw data, and they used Chinese-made tests that were never validated in China and were later banned for export from China, per NBC news:
Quote:But some COVID-19 antibody tests, including those being used by public health departments in Denver and Los Angeles and provided to urgent care centers in Maryland and North Carolina, were supplied by Chinese manufacturers that are not approved by China's Center for Medical Device Evaluation, a unit of the National Medical Product Administration, or NMPA, the country's equivalent of the U.S. Food and Drug Administration, NBC News has found.
Two U.S. companies — Premier Biotech of Minneapolis and Aytu Bioscience of Colorado — have been distributing the tests from unapproved Chinese manufacturers, according to health officials, FDA filings and a spokesman for one of the Chinese manufacturers. Many of the unapproved tests appear to have been shipped to the U.S. after the FDA relaxed its guidelines for tests in mid-March and before the Chinese government banned their export just over two weeks later.
From USC Q&A about the Study:
Quote:How people were selected for this study?
Participants for the USC-L.A. County study were recruited by the market services firm LRW Group using a large proprietary database that ensures factors such as age, race and sex are part of the random selection. For the first testing that took place on April 10 and 11, USC and the L.A. County Department of Public Health identified six sites for drive-thru testing. Our plan moving forward is to test a different group of 1,000 randomly selected people every several weeks.
How reliable are the antibody tests?
Premier Biotech, the manufacturer of the test that USC and L.A. County are using, tested blood from COVID-19-positive patients with a 90 to 95% accuracy rate. The company also tested 371 COVID-19-negative patients, with only two false positives. We also validated these tests in a small sample at a lab at Stanford University. When we do our analysis, we will also adjust for false positives and false negatives.
Without seeing the underlying dataset, it's really hard to determine whether they have similar issues with their confidence intervals including the possibility that all the positive are false positives. It's also odd that the reports show that 6% of men vs. 2% of women tested positive, and 7% of African Americans vs. 2.5% of Latinos. That is a suspiciously wide variation.
RE: Stanford study estimates 48,000+ infected in Santa Clara County - BostonCard - 04-20-2020
Was just going to post the LA count results. If 440,000 Los Angelinos have been infected and there have been 600 deaths, the lower bound of the death rate is 0.13%. If it's more like 220,000 then you are looking at a fatality rate of 0.27%. The caveat is that not all infected people have died yet.
BC
RE: Stanford study estimates 48,000+ infected in Santa Clara County - burger - 04-20-2020
These folks have a calculator that lets you estimate prevalence for a serology test with known sensitivity and specificity. https://larremorelab.github.io/covid-calculator1
When I put in the numbers for the Stanford study, I got 1.1%, which is 60% below what they reported and more in line with earlier studies.
Caveat: this is new and, like everything else lately, based on a preprint, which I haven't looked at yet.
Also, it's from Harvard. I fear the ultimate takeaway from all of this will be "believe what Harvard says, not Stanford."
RE: Stanford study estimates 48,000+ infected in Santa Clara County - Snorlax94 - 04-20-2020
To what extent are these seroprevalence studies (Stanford, USC, Chelsea) capturing a representative sample by age?
While the multiplier may end up being 15x, 30x, 50x the confirmed cases, I don’t think you can divide the cfr by the same multiplier across all age groups.
I could imagine tons of people under 50 have been getting infected without symptoms.
My guess is that the ifr will plummet for people under 60, and remain disturbingly high for older people. It’s weird that young people are sacrificing relatively more (missing school when their risk is relatively low) and yet many of the protesters seem to be over 60.
RE: Stanford study estimates 48,000+ infected in Santa Clara County - BostonCard - 04-20-2020
(04-20-2020, 05:35 PM)Snorlax94 Wrote: To what extent are these seroprevalence studies (Stanford, USC, Chelsea) capturing a representative sample by age?
While the multiplier may end up being 15x, 30x, 50x the confirmed cases, I don’t think you can divide the cfr by the same multiplier across all age groups.
I could imagine tons of people under 50 have been getting infected without symptoms.
My guess is that the ifr will plummet for people under 60, and remain disturbingly high for older people. It’s weird that young people are sacrificing relatively more (missing school when their risk is relatively low) and yet many of the protesters seem to be over 60.
From what I saw in the methodology of the Stanford paper, they adjust for demographics to reflect the makeup of Santa Clara county.
BC
RE: Stanford study estimates 48,000+ infected in Santa Clara County - OutsiderFan - 04-20-2020
After taking some time to learn about this Stanford study, I literally cringed when learning about it. IOW, burger is right. Stanford should be embarrassed to be associated with this study.
First of all, when Stanford announced it had developed its own antibody test, I assumed it was solid and reliable. Turns out they didn’t use their own test for all of this study. They bought other kits from a Minnesota lab that bought its kits from China. So the test kits used in the study can’t be verified for accuracy by Stanford. Worse, Denmark researchers concluded the test Stanford used was the least accurate of all 9 they tested.
In the paper it says if the tests aren’t at least 98% accurate, their conclusions about IFR aren’t reliable and go down to less than 1% of population infected. The Denmark analysis found the tests only 87% accurate!
How the hell can any university, let alone Stanford roll out research results with such unreliable testing regimes, let alone claim such broad conclusions about infection rate from it? And we know the sample itself can’t be considered random because they advertised people to come get tests on Facebook FFS. Those people who came for the test absolutely were going to have reason to have thunk they were exposed.
Again, when it sunk in just how bad this was, my perception of Stanford went down a notch. It’s really unfortunate that this one terribly conceived study is going to hurt the Stanford brand, but it absolutely will, because it’s visibility and stakes are so damn high.
RE: Stanford study estimates 48,000+ infected in Santa Clara County - BostonCard - 04-20-2020
Stanford did test the performance of the tests, and did the analysis with both the manufacturers specifications and its own numbers. I think my beef is that it is hard to be sure of the specificity when they only tested 300 patients without disease; it produces a 95% confidence interval of about 1%, which might not seem like much, but is the difference between the results they claim and pretty much all the positive tests being false positives.
BC
RE: Stanford study estimates 48,000+ infected in Santa Clara County - OutsiderFan - 04-20-2020
(04-20-2020, 08:52 PM)BostonCard Wrote: Stanford did test the performance of the tests, and did the analysis with both the manufacturers specifications and its own numbers. I think my beef is that it is hard to be sure of the specificity when they only tested 300 patients without disease; it produces a 95% confidence interval of about 1%, which might not seem like much, but is the difference between the results they claim and pretty much all the positive tests being false positives.
BC
It’s worse. The researchers have flapped their gums in the WSJ editorial pages, claiming the seriousness of Covid-19 is overstated. They wrote these editorials not disclosing they were involved in the research. It looks like they may have designed a study to get the result they wanted.
Stanford should launch an investigation into what is going on here. Did some big monied interest with an agenda enrich these guys to run PR stunts that downplay the virus in some scheme to end shutdowns? I sure as heck wouldn’t rule it out.
One more note on antibodies that I didn’t see until tonight.
Dr. Fauci today said it is true that antibodies do develop that create immunity against other viruses, but there is no evidence to demonstrate antibodies create immunity against this particular virus.
No evidence.
RE: Stanford study estimates 48,000+ infected in Santa Clara County - teejers1 - 04-20-2020
(04-20-2020, 09:15 PM)OutsiderFan Wrote: One more note on antibodies that I didn’t see until tonight.
Dr. Fauci today said it is true that antibodies do develop that create immunity against other viruses, but there is no evidence to demonstrate antibodies create immunity against this particular virus.
No evidence.
You have repeatedly come back to this point about "no guarantee that getting Covid 19 will lead to any form of immunity." Other than a possible "I told you so" down the road, what is the point of this argument?
Is it that we should never leave shut down until there is a vaccine available?
Is it that we can never know what a "second wave" will look like? Or that they will all be NYC Redux because everyone will get it again?
Do you think the US is anywhere near "herd immunity" numbers now, which is where this all comes into play?
I'm just curious what the ultimate point you're trying to make about this notion is. And I'm not saying you're wrong; I'd like to think you are, based on what I've read about past viruses - but am more curious about the ultimate conclusion you're attempting to draw from repeatedly making this point, if any.
RE: Stanford study estimates 48,000+ infected in Santa Clara County - magnus - 04-20-2020
(04-20-2020, 09:38 PM)teejers1 Wrote:(04-20-2020, 09:15 PM)OutsiderFan Wrote: Dr. Fauci today said it is true that antibodies do develop that create immunity against other viruses, but there is no evidence to demonstrate antibodies create immunity against this particular virus.
You have repeatedly come back to this point about "no guarantee that getting Covid 19 will lead to any form of immunity." Other than a possible "I told you so" down the road, what is the point of this argument?
Is it that we should never leave shut down until there is a vaccine available?
Then again, there is no guarantee that a vaccine can be found. But like other people have mentioned, we have to try.
RE: Stanford study estimates 48,000+ infected in Santa Clara County - Goose - 04-20-2020
(04-20-2020, 09:38 PM)teejers1 Wrote: You have repeatedly come back to this point about "no guarantee that getting Covid 19 will lead to any form of immunity." Other than a possible "I told you so" down the road, what is the point of this argument?
Is it that we should never leave shut down until there is a vaccine available?
Is it that we can never know what a "second wave" will look like? Or that they will all be NYC Redux because everyone will get it again?
Do you think the US is anywhere near "herd immunity" numbers now, which is where this all comes into play?
I'm just curious what the ultimate point you're trying to make about this notion is. And I'm not saying you're wrong; I'd like to think you are, based on what I've read about past viruses - but am more curious about the ultimate conclusion you're attempting to draw from repeatedly making this point, if any.
If getting the disease does not generate any immunity, there will be no vaccine and there will be no herd immunity in the classic sense. You can cross those off the list. If that happens, we will have people getting the disease over and over again. It will for sure kill lots of people essentially forever. Not probable, but it could happen, at least in theory.
RE: Stanford study estimates 48,000+ infected in Santa Clara County - oldalum - 04-20-2020
As I've commented before (probably in vain), "no evidence" does not mean "no immunity." It just means what it says, at this point we have no evidence--either way (those supposed case reports are not evidence). I cannot conceive of a way this early for there to be any evidence, so it should be no surprise that we have no evidence. It doesn't mean anything more than that.
What the Stanford "study" shows is what can happen when the normal processes of science are short-circuited in an emergency that produces nonstop public/media attention: you get a lot of junk science. When investigators are not rushed, they are more likely to craft better-designed studies. When IRB approval is not rushed or bypassed, problems with methodology are more likely to be noticed. When researchers wait for normal peer review and don't put out press releases or "preprints," the first product to reach the public is likely to be much better.
RE: Stanford study estimates 48,000+ infected in Santa Clara County - Snorlax94 - 04-20-2020
I wouldn’t say there is “no evidence” anti-bodies confer immunity.
https://www.biorxiv.org/content/10.1101/2020.03.13.990226v1
It might not be great evidence, but it is something.
RE: Stanford study estimates 48,000+ infected in Santa Clara County - oldalum - 04-20-2020
thanks, I had written a line about needing an animal model that could be re-challenged, so glad you found that one. But as you implied, it is not yet known if the animal model is analogous to human infection and immune response. It does show that post-infection immunity is possible, but I think we already knew that from other viruses.
RE: Stanford study estimates 48,000+ infected in Santa Clara County - BostonCard - 04-20-2020
The logical test will be if convalescent plasma works to reduce the severity of covid-19, and then, if it can work to prevent infection.
BC
RE: Stanford study estimates 48,000+ infected in Santa Clara County - OutsiderFan - 04-21-2020
My point, t1, is this.
Given the range of possibilities we have evidence to show could be facing society, with some of them being really, really catastrophic, it’s foolish to be making decisions without more known about the disease itself, and its implications for humanity.
There is overwhelming discussion about case growth, deaths, PPE, testing, treatments, and vaccine, but I see virtually zero public discussion focused on what the disease actually does and the aftermath implications of those who get it. Chicken pox stays in the body forever, but we know once we have it, that’s that, and it almost never causes any serious harm to us. Covid-19 may stay with those infected forever, but come back and do damage we don’t know about yet.
Discussions about how to lift NPIs* will be had in a much different light if this variable was factored into the equation. There has been evidence that shows reinfections. There has been evidence particularly younger people exposed to virus don’t develop enough antibodies to fight it, and also evidence exposure to it kills T-cells. It may not kill them on an ongoing basis like AiDS does, but what if reinfection kills more each time the body fights Covid19? We’ll start seeing many more people getting sick and dying in society than it is prepared to handle.
Shouldn’t the eyes of public discussion be much more wide open about how the virus actually works and the implications of spreading it to more of the population, before it is, because we never get a second chance to get our response right? IMO, the body politic should be calling for more research into this, rather than taking the typical human approach of trying to find a vaccine or cure, or assuming there will be one.
The chief medical officer for Japan apparently said yesterday he doesn’t think the Olympics will be held next year either because he still sees Covid-19 ravaging the globe then. We only get one chance to contain spread. I’m of the mind more should be known or discussed about implications before we entertain when and how to deal with the crisis. The last thing I want is to see a worse disaster than we could have had, take 2, because people did not factor in the worst case scenarios in their return to normal impulses, and then hearing them bitching about it later. So many people saying it’s just the flu still, or thinking the biggest concern is economy because they may not know what they don’t know is even possible, and how bad it could be. Maybe some are incapable, but there should be some devil’s advocates gaining currency in public discussion on the issues I’ve raised so that position is represented. I don’t see it.
* The fact the preferred language used has been “opening the economy” instead of “lifting NPIs” (with the public knowing what NPIs means) is itself framing the issue we face as a short-term economic challenge much more than a medical emergency, and that in and of itself is a disservice to us as people trying to grapple with what we should be doing to deal with our new reality.
RE: Stanford study estimates 48,000+ infected in Santa Clara County - Goose - 04-21-2020
(04-21-2020, 04:55 AM)OutsiderFan Wrote: Given the range of possibilities we have evidence to show could be facing society, with some of them being really, really catastrophic, it’s foolish to be making decisions without more known about the disease itself, and its implications for humanity.OF, the obvious problem with waiting until more is known to make a decision IS a decision. We made the decision to "shelter in place" on information that was not perfect. I am pretty sure most all of us think that was a reasonable action. However, it is I think pretty clear that we can't wait two years gathering information in this present state (although you may feel otherwise).
Society often has to make decisions in the presence of great uncertainty. Sometimes there are no risk-free alternatives available. OTOH, many of the decisions humanity has made in the past based on what at the time was regarded as adequate information have had serious unanticipated negative consequences. In the case of COVID-19, I am certain that our nation, and almost all other nations of the world, will be making decisions in the next few months based on much less certainty than they prefer. Deciding to wait in the status quo is such a decision.