We're #1 !!!

[BostonCard]

But the bottom line is that I don't think any nation has come up with a solution that balances out the various factors of economic distress and public health concern in a fully rational manner. There is an act-of-God quality to the Covid phenomenon that is often overlooked when we get down to 'mere politics'.

Taiwan (0.3 deaths/million people), South Korea (9), Germany (121), Canada (262), Australia (35), New Zealand (5; you may think New Zealand was too heavy handed, but its people resoundingly endorsed government policy in the last election), Uruguay (15, a big exception in South America, despite being sandwiched between hard hit Brazil and Argentina).  All of these countries are democracies that have had less than half the per-capita mortality than the US (coming up on 700/million).  The other Nordic countries (Denmark, Norway, Finland) have all had about the same economic hit as Sweden, but managed to have much lower mortality.

Generally, there has been not a trade-off between limiting the virus and hurting the economy.  Rather, the relationship has been the opposite, where the countries that have been impacted by the virus most heavily have also seen the greatest economic hit.  Early and decisive action generally controls the virus, which allows the economy to re-open.  Late and incompetent action allows the virus to fester and the pandemic to rage out of control, which scares the population or forces the government to put in restrictions.

The fundamental problem is that viral spread is exponential, so you can't say "I'm willing to accept X new cases (X new deaths) a day in exchange for opening the country up by X amount." because as you open up the country and R-effective increases above 1, the number of cases will keep rising exponentially and you will have to close down again.  The best you can do is to do what you need to keep R-effective at just under 1 and slowly drive the number of cases down.  What really needs to happen is that you drive the number of cases down to a level where you can effectively track and trace, as is done in Taiwan and South Korea (and to a lesser extent Germany), and rely on test/track/trace to keep R-effective under 1 while opening up the wider economy.  But alas, Mark Meadows has as much as acknowledged that we've given up.

BC

[Goose]

But the bottom line is that I don't think any nation has come up with a solution that balances out the various factors of economic distress and public health concern in a fully rational manner. There is an act-of-God quality to the Covid phenomenon that is often overlooked when we get down to 'mere politics'.

I would argue that Taiwan has come up with a rational solution that works pretty well both economically and public health wise. They did get on the disease early and did install mandatory quarantine for people entering the country early on. That was smart, but one could argue they had the benefit of previous epidemics to guide them, which Europe and the USA did not. They are fortunate to be an island nation with very heavily guarded borders, so they actually can control arrivals, which the USA arguable cannot and certainly does not.

The "plan" of the lockdowns was to get the disease level down to "manageable" levels and then to use contact tracing and testing to control the disease. We would have pretty much a "normal" situation, except anyone who got COVID-19 and all their contacts would isolate/quarantine. That was rational. That was allegedly the "plan". That could have worked. Unfortunately, we did not have and did not develop an adequate system of contact tracing and associated testing. Even in situations where contact tracing is "pretty good", the jurisdictions involved are unwilling to enforce the isolation/quarantine  requirements. Given that, the plan can't work. The politicians gave up on that plan early on, but never really came up with an alternative other than hold on for a vaccine and pray we aren't beyond hope by that time.

Europe is basically in the same situation. Places like Italy drove their case count way down. They have somewhat more will to enforce contact tracing requirements, but not enough. There are both political and practical constraints to what can be done. All of Western Europe, as well as the USA, have significant "underground" societies that basically operate outside of government control. These groups don't participate in contact tracing. Given that, there will always be enough disease remaining that controlling it by contact tracing will be problematic. This is not the case in Taiwan (or Korea and Japan for that matter), and that is why it can work for them.

[Mick]

We've broken 80,000 new cases the last two days.

I can't believe the https://www.worldometers.info/coronavirus/ site is that far off.  They show 69,841 and 63,510 new American infections the last two days.

[OutsiderFan]

We've broken 80,000 new cases the last two days.

I can't believe the https://www.worldometers.info/coronavirus/ site is that far off.  They show 69,841 and 63,510 new American infections the last two days.

Today was 70k. Sunday was 63k.  Saturday and Friday were both 80k+.

[BostonCard]

We've broken 80,000 new cases the last two days.

I can't believe the https://www.worldometers.info/coronavirus/ site is that far off.  They show 69,841 and 63,510 new American infections the last two days.

Remember that there is a temporal trend to these numbers.  Cases trough on Sundays, and then rises throughout the week, peaking on Friday. If you look at the worldometer data for Friday and Saturday, they are both above 80K.  A week ago, cases were at 58K.

BC

[M T]

Kinda makes you wonder about the derivative of R, and then, the second derivative.  It isn't just whether R is above or below 1, but how fast it swings high.   If it slowly climbed from below 1 to above 1, society would have time to react.  But, if it jumps (hypothetically speaking, as I didn't look for computed R numbers) from 0.9 to 1.5 in a week, you can get these jumps from 58K to 80K.

To me, R is a number derived from what happens, not as some intrinsic number that drives the infections.  So, the derivative of R is also just a number computed from what happens, rather than being a driver.

[BostonCard]

To me, the issue on lockdowns is how long lasting the effect. If it is relatively temporary, only a palliative (as the European experience seems to show), what ultimately is the point? My own belief is that we are going to see more and more refined measures of social distancing, rather than an out-and-out lockdown.



As to China, sorry, but there is a credibility gap here. I'm not inclined to believe any posturing of that nation unless independently verified.



Masking and social distancing is so incontestably effective it is hard to see the point of resistance. Trump bears a heavy burden of responsibility for undercutting this. 



But the bottom line is that I don't think any nation has come up with a solution that balances out the various factors of economic distress and public health concern in a fully rational manner. There is an act-of-God quality to the Covid phenomenon that is often overlooked when we get down to 'mere politics'.

I wish I could find the quote, but I heard a lockdown referred to as a policy failure.  It's your last option when the virus is raging out of control, the hospitals are full and people are dying at home because the ambulances are too overwhelmed to even take them to the hospital, as was the case in Italy and Spain and New York early in the pandemic.  Otherwise, in the face of rising case counts and increasing hospitalization rates, you do what you can to slow it down; you shut down high risk activities, limit not quite as high risk activities, and implore the population to do their part to do their part to limit the spread.

The other thing is that you are playing for time.  At the beginning of the pandemic, when vaccine development seemed like it was 18 months away at best, that would have been a hard lockdown to sustain.  But even with delays (and Fauci suggesting the data may not be available until January), you are still in a position where if you can hold the virus at bay for another few months, you can start vaccinating the most vulnerable, which should further drive down mortality.

BC

[chrisk]

In both China and the US, lockdowns were relatively early options. In China, the lockdowns were more limited geographically but much, much tighter than the US lockdowns.

Regardless of official Chinese posturing, you can find many average Chinese who are happy with their government's performance (particularly if they weren't among those tightly locked down). They don't have much respect for the failure of the US (judging from videos circulating on Social media sent from China to the US). Many Americans have friends and family in China posting videos of their big dinner parties in Shanghai, etc.

[fullmetal]

I would argue that Taiwan has come up with a rational solution that works pretty well both economically and public health wise. They did get on the disease early and did install mandatory quarantine for people entering the country early on. That was smart, but one could argue they had the benefit of previous epidemics to guide them, which Europe and the USA did not. They are fortunate to be an island nation with very heavily guarded borders, so they actually can control arrivals, which the USA arguable cannot and certainly does not.

"They had the benefit of previous epidemics to guide them..."  What like SARS and MERS were secrets?  Their govt response is a matter of public record.  We had the benefit of Taiwan's experience to guide us!  But we threw away that playbook on day one of this administration.  Remember this administration refusing to meaningfully attend the passdown meeting with the prior administration regarding pandemics?

"They are fortunate to be an island nation with very heavily guarded borders, so they actually can control arrivals..."  I'm betting money that most of the inbound covid cases entering the United States did not do so over a land border.  Controlled borders was not the issue.  Viral introduction happened through airports, and the US (specifically TSA/CBP) failed to show any kind of leadership in the smallest of gestures -- no temperature checking, no mask requirements, etc.  Federal entities with airport and travel oversight did not control those borders (even the China travel ban wasn't actually a ban; over 400k travelers from China still entered the US despite this "ban").

[teejers1]

In both China and the US, lockdowns were relatively early options.  In China, the lockdowns were more limited geographically but much, much tighter than the US lockdowns.

Regardless of official Chinese posturing, you can find many average Chinese who are happy with their government's performance (particularly if they weren't among those tightly locked down).  They don't have much respect for the failure of the US (judging from videos circulating on Social media sent from China to the US).  Many Americans have friends and family in China posting videos of their big dinner parties in Shanghai, etc.

China is a great country.
I'm sure we all wish we could be like China, be governed like the population in China, and have family dinners like they do in Shanghai.

[oldalum]

China is a great country.
I'm sure we all wish we could be like China, be governed like the population in China, and have family dinners like they do in Shanghai.

Or we could all just order takeout from a local Chinese restaurant.  :)

[BostonCard]

The 88,000 number is bad, but the real concerning aspect is that hospitals are starting to become strained.  Over/under on breaking 100,000 cases by election day?

BC

[lex24]

The 88,000 number is bad, but the real concerning aspect is that hospitals are starting to become strained.  Over/under on breaking 100,000 cases by election day?

BC

Not interested in the prediction  game. Good news in Ca.  Deaths hit low last week.  And the dire prediction on hospitization rates soaring in October did not come to pass.

Course, no one wants to hear good news on this board. Not at least till Biden wins. Which I find interesting - cause I doubt there is one person that reads (or at least posts) on this site that will be voting for Trump. .

[Farm93]

The 88,000 number is bad, but the real concerning aspect is that hospitals are starting to become strained.  Over/under on breaking 100,000 cases by election day?

BC

88,000 places the USA above "Original" Stanford Stadium's one time capacity of ~86,000.   So that passing that is noteworthy to me.

100,000 is a big round number, but we are also close to exceeding the 107,601 of the Big House in Michigan.   So that would mean something in the BigTen country.

To your odds - 
Friday is likely the last potential day BEFORE election day.   
Saturday, Sunday and Monday each have a weekend effect for different reasons.
Tuesday seems to serve as a catch-up day.

Friday is too soon for 100K.
Given Tuesday likely will have some cases from multiple prior days it is possible, but if that happens it will not be covered on that night.

Really wish it didn't seem inevitable, but Europe was on this path already.   The cases exploded and then when it was really clear cases were out of control and hospitals were filling up the governments decided to take more decisive steps.  We have a bigger base set of cases, we have fewer citizens trying to reduce the spread, and we have a national government that is not exactly working diligently to reinforce best practices for pandemic mitigation. 

Even if decisive steps in the USA were taken tomorrow by citizens and the government the new cases we will see next week are already in the incubation phase.   So we will hit 100,000 new cases and my guess is we will hit that number late NEXT week on Worldometers.

[BostonCard]

Not interested in the prediction  game. Good news in Ca.  Deaths hit low last week.  And the dire prediction on hospitization rates soaring in October did not come to pass.


Course, no one wants to hear good news on this board. Not at least till Biden wins. Which I find interesting - cause I doubt there is one person that reads (or at least posts) on this site that will be voting for Trump. .

Here's some good news:

https://www.fiercebiotech.com/biotech/re...-2-3-trial

Regeneron’s anti-SARS-CoV-2 antibody cocktail has significantly reduced medical visits in ambulatory COVID-19 patients. The phase 2/3 clinical trial linked REGN-COV2 to a 57% decline in medical visits associated with COVID-19 in the 29 days after treatment.

The downside is that this is an IV antibody cocktail, but you could imagine a case where high risk patients who have been exposed get the cocktail as prophylaxis.  Cutting the hospitalization rate by over half is real progress.

BC

[OutsiderFan]

France has posted single day rates of infection that would be over 150,000 in the U.S., so I fully expect such numbers to happen in the next month. Johns Hopkins site is now predicting 12 million infected 30 days from today. That requires 3M new infections which would be 100k new infections per day for 30 days. Seems doable.

[Goose]

Regeneron’s anti-SARS-CoV-2 antibody cocktail has significantly reduced medical visits in ambulatory COVID-19 patients. The phase 2/3 clinical trial linked REGN-COV2 to a 57% decline in medical visits associated with COVID-19 in the 29 days after treatment.

The downside is that this is an IV antibody cocktail, but you could imagine a case where high risk patients who have been exposed get the cocktail as prophylaxis.  Cutting the hospitalization rate by over half is real progress.



BC

Indeed a cut of over 50% is real progress. It may be that with dosage/formulation tweaks and the like they can do even better. Let's hope so, because it looks like the USA ( and the rest of the Western world) is really going to need it.

[Mick]

In both China and the US, lockdowns were relatively early options.  In China, the lockdowns were more limited geographically but much, much tighter than the US lockdowns.

Regardless of official Chinese posturing, you can find many average Chinese who are happy with their government's performance (particularly if they weren't among those tightly locked down).  They don't have much respect for the failure of the US (judging from videos circulating on Social media sent from China to the US).  Many Americans have friends and family in China posting videos of their big dinner parties in Shanghai, etc.

China is a great country.
I'm sure we all wish we could be like China, be governed like the population in China, and have family dinners like they do in Shanghai.

Agreed.  Not sure what my favorite part of China is.  Might be the persistent IP theft.  Or the Uigher enslavement/jailing.  Could be the severe pollution-- I fondly remember the "mist" in the Beijing Olympics.  The incessant cybercrime and spying.  The eradication of human rights.  So much to admire.

[teejers1]

The 88,000 number is bad, but the real concerning aspect is that hospitals are starting to become strained.  Over/under on breaking 100,000 cases by election day?

BC

You know hospital capacity is my bugaboo, so I took interest in your descriptor "starting to become strained" and what that means.  Nothing in the link you posted, which I think was just a tweet.

But the Utah reports were bad on that front, as is El Paso.  We may see other locales with similar capacity issues, though it's possible we will not.  In all events, that should be the driver, and I agree that as you approach real capacity constraints (not theoretical ones), then it's time to pull back/tighten the restrictions.

Meanwhile, SCC remains ridiculously well positioned on the hospital front, as it has throughout all the "surges" and case "explosions."

https://www.sccgov.org/sites/covid19/Pag...x#capacity

(And I say ridiculous because our "Dear Bureaucrat" seems to think those numbers are meaningless).

[oldalum]

Not sure what my favorite part of China is.  Might be the persistent IP theft.  Or the Uigher enslavement/jailing.  Could be the severe pollution-- I fondly remember the "mist" in the Beijing Olympics.  The incessant cybercrime and spying.  The eradication of human rights.  So much to admire.

That's just recent stuff. Let's not leave out Tibet.