The Shape of the Covid19 Curve

[happyhoix]

Apr 2, 2020 9:40:44 GMT -5 pulmonarymd said:

Apr 2, 2020 9:34:14 GMT -5 happyhoix said:

how long, do you think, before they have an antibody test? That would enable all the people already exposed to go back to work at least. 

Depends on a number of factors. That should be easier than a vaccine. Sure it is being worked on. Biggest impediment will be how you ast it is too automate. If it cannot be easily done by a machine, it becomes very labor intensive. Capacity stays low and turnaround time is longer, so will take longer to screen people

Yes I saw something on one of the plethora of news shows about how someone is working on this. And yes it would need to be a quick and easy instrument test that all the local clinics could run in-house so that people could go, get tested, and get some kind of official document that they're free to go work around other people. 

That would be a start at relaunching the economy, anyway. Hope they get it soon. 

[wwtpgirl66]

Apr 2, 2020 8:32:35 GMT -5 deminmaine said:

Down heah in Northern MA (York County ME) myself wwtpgirl66 !  We too are an essential workplace, although I scratch my head at that.  That is the national guideline though, not the state, and we do hospital and some defense related work, so, yeah, I get it kind of.  We have two people out with what are hopefully just allergy coughs, but gotta be safe.  Everyone else are following protocol, but we are putting ourselves and other people at risk by being out and about, buying gas, all that stuff.

Midcoast area is pretty.  Love the Blues Festival and its setting, but haven't been in a few years.

The Blues Festival is held in the city I live in as well as the Maine Lobster Festival

[lynnerself]

This site has been updated again today. There is also an interesting look at how the predictions have matched reality in the last week.

www.healthdata.org/covid/updates

[thyme4change]

So, make sure I'm doing this correctly

covid19.healthdata.org/projections

This says the peak in mid-late April is projected to have 263k people sick, but it could be as low as 140k and as high as 450k?

Deaths are projected at 2600 on the day of the peak, but could be twice that, or half that?

Right?

[tallguy]

Apr 1, 2020 18:27:47 GMT -5 happyhoix said:

Apr 1, 2020 2:46:22 GMT -5 djAdvocate said:

here is why the curve will end up over 93k:

As of Monday afternoon, Nevada, North Dakota, South Dakota, Nebraska, Iowa and Arkansas have no mandatory shelter-in-place directives at the city or state level.

here is another reason why:

Utah, Wyoming, Alaska, Texas, Oklahoma, Missouri, Tennessee, Mississippi, Alabama, Georgia, Florida, South Carolina, Pennsylvania and Maine have partial lockdown orders; individual cities have declared shelter-in-place mandates but the state as a whole has not.

until that happens, the actuals will very likely run ahead of the projections.

Kemp finally issued a stay at home order for the state of GA until April 13th. And he closed all the K-12 schools to the end of the school year. A little late for Atlanta. 

He actually said yesterday that he didn't know that people could spread the virus if they weren't showing symptoms?  Really?  That has been common knowledge for what, months?  No wonder Georgia is still kind of backwards.

‘We Didn’t Know That Until the Last 24 Hours’: Georgia Gov. Says He Just Found Out People without Symptoms Can Spread Coronavirus

[djAdvocate]

April 13th is a month too soon.

[djAdvocate]

Apr 2, 2020 11:19:50 GMT -5 thyme4change said:

So, make sure I'm doing this correctly

covid19.healthdata.org/projections

This says the peak in mid-late April is projected to have 263k people sick, but it could be as low as 140k and as high as 450k?

Deaths are projected at 2600 on the day of the peak, but could be twice that, or half that?

Right?

yes, and I think that is conservative. we are already above the low number.  we will be approaching the high number within a week.

NOTE: this is below my earlier estimate of reaching 500k TOMORROW.  there is no way that will happen.  our daily growth rate has fallen from 30% to 15%.  and, as I mentioned before, I will lift a glass to that.  a little hope is starting to emerge.

the active caseload in the US will pass 250k tomorrow, though.

[haapai]

Apr 2, 2020 14:25:31 GMT -5 djAdvocate said:

Apr 2, 2020 11:19:50 GMT -5 thyme4change said:

So, make sure I'm doing this correctly

covid19.healthdata.org/projections

This says the peak in mid-late April is projected to have 263k people sick, but it could be as low as 140k and as high as 450k?

Deaths are projected at 2600 on the day of the peak, but could be twice that, or half that?

Right?

yes, and I think that is conservative. we are already above the low number.  we will be approaching the high number within a week.

NOTE: this is below my earlier estimate of reaching 500k TOMORROW.  there is no way that will happen.  our daily growth rate has fallen from 30% to 15%.  and, as I mentioned before, I will lift a glass to that.  a little hope is starting to emerge.

the active caseload in the US will pass 250k tomorrow, though.

You've said earlier that you would raise a glass if the case count was under 500K.  Do you still feel comfortable doing that? 

I'm trying to get a handle on the under-testing and failing quite badly.  In order for our case count to remain even close to as accurate as it has been, we need to expand our testing at the same rate that the disease is expanding,  I don't see that happening, and I have difficulty raising a glass to the resulting data which may be horrifically constrained and inaccurate. 

I'm sorry that you put yourself into a position where you promised to celebrate something that means so little. 

[djAdvocate]

Apr 2, 2020 15:27:39 GMT -5 haapai said:

Apr 2, 2020 14:25:31 GMT -5 djAdvocate said:

yes, and I think that is conservative. we are already above the low number.  we will be approaching the high number within a week.

NOTE: this is below my earlier estimate of reaching 500k TOMORROW.  there is no way that will happen.  our daily growth rate has fallen from 30% to 15%.  and, as I mentioned before, I will lift a glass to that.  a little hope is starting to emerge.

the active caseload in the US will pass 250k tomorrow, though.

You've said earlier that you would raise a glass if the case count was under 500K.  Do you still feel comfortable doing that? 

I'm trying to get a handle on the under-testing and failing quite badly.  In order for our case count to remain even close to as accurate as it has been, we need to expand our testing at the same rate that the disease is expanding,  I don't see that happening, and I have difficulty raising a glass to the resulting data which may be horrifically constrained and inaccurate. 

I'm sorry that you put yourself into a position where you promised to celebrate something that means so little. 

i think the fact that 80-90% of the nation sheltering in place and taking this seriously is something to celebrate.

i think that having 300k active cases rather than 500k is something to celebrate.

what this means is that, in the intermediate term, far more people will survive this thing.

and yeah, our response has been pitiful.  and yes, we are probably going to pass Spain and Italy sometime soon in terms of infection rates.  and yes, our hospitals will be overrun, and they will be sending people home to die.  all of that was predictable a month ago.  the only difference is HOW MANY.

if am choosing between a limited response and losing half a million, and NO response (which is what Trump was basically saying 2 weeks ago) and losing 1M, i am taking the half million, and a triple shot of Mezcal.

[teen persuasion]

Apr 2, 2020 10:55:48 GMT -5 lynnerself said:

This site has been updated again today. There is also an interesting look at how the predictions have matched reality in the last week.

www.healthdata.org/covid/updates

Wow, NY's curve got taller.  Yikes!  But it also looks like they expect it to be all over (in NY) about May 1?

I'm wondering how it plays out outside of NYC, though.  We've got fewer cases, but I think we are a bit behind them on the timeline.  Does Cuomo open things in the state back up when NYC is done, or wait for the rest of the state to catch up, or what?

[djAdvocate]

the place that projects peaks is updating TOMORROW:

Please check back on Saturday, April 4 for our next update.

so, I am going to raise my glass to being WRONG about how bad this would be tonight.
we are going to end up at around 280k cases -vs- my worst case scenario of 500k.

I have another doomsday projection for the coming week: that we are at 1M cases by next Friday, and pass both Spain and Italy in death totals. I would LOVE it if I am wrong (again).

[djAdvocate]

Apr 3, 2020 10:25:53 GMT -5 teen persuasion said:

Apr 2, 2020 10:55:48 GMT -5 lynnerself said:

This site has been updated again today. There is also an interesting look at how the predictions have matched reality in the last week.

www.healthdata.org/covid/updates

Wow, NY's curve got taller.  Yikes!  But it also looks like they expect it to be all over (in NY) about May 1?

I'm wondering how it plays out outside of NYC, though.  We've got fewer cases, but I think we are a bit behind them on the timeline.  Does Cuomo open things in the state back up when NYC is done, or wait for the rest of the state to catch up, or what?

did you check out Washington?  they are doing amazingly well.

#modelofwhat2do

[pulmonarymd]

Apr 3, 2020 15:58:59 GMT -5 djAdvocate said:

the place that projects peaks is updating TOMORROW:

Please check back on Saturday, April 4 for our next update.

so, I am going to raise my glass to being WRONG about how bad this would be tonight.
we are going to end up at around 280k cases -vs- my worst case scenario of 500k.

I have another doomsday projection for the coming week: that we are at 1M cases by next Friday, and pass both Spain and Italy in death totals. I would LOVE it if I am wrong (again).

The mathematical modeling is interesting. Given the incubation period, much of the growth is already baked in because NYC dominates the number. We will hopefully see growth slow down next week based on shelter in place orders in high population areas. If so, we will peak at less than 750,000 in 1 week. If the number is closer to yours, we are in deep shit because it will be exploding elsewhere. Keeping my fingers crossed while dreading the worst

[djAdvocate]

there are AREAS of the country that are doing fairly well.

unfortunately, they are not the urban states.

the urban states are doing terribly, and that should be no surprise to anyone. in urban environments, the opportunity to stay in is much lower. you are more dependent on your surroundings for work and food. you come into contact with MANY more people than you do in the burbs or rural areas.

when I lived in a rural part of town, I would go entire days without encountering anyone. when I moved to the burbs, I would run into a few people a day. in the city, I would run into dozens, if not hundreds, every day.

that is the problem, in a nutshell. even with "shelter in place" the dynamics of those living environments remain in play.

[djAdvocate]

here is something else to keep in mind, and I mean this with all due respect to those in charge.

if we do WELL in this, it is going to last LONGER than if we do poorly. in other words, if we are responsible, and flatten the curve, it will last weeks longer than if we are irresponsible and let it do it's thing. and that is a REALLY TOUGH SELL for government. so they are probably better off not mentioning it.  in terms of the human toll, it is the difference between a raging bonfire and a controlled burn.

I might also say that the economic impacts are far worse by doing the responsible thing. which is probably why Trump hasn't done the most responsible thing.

[pulmonarymd]

Apr 3, 2020 16:21:32 GMT -5 djAdvocate said:

here is something else to keep in mind, and I mean this with all due respect to those in charge.

if we do WELL in this, it is going to last LONGER than if we do poorly. in other words, if we are responsible, and flatten the curve, it will last weeks longer than if we are irresponsible and let it do it's thing. and that is a REALLY TOUGH SELL for government. so they are probably better off not mentioning it.  in terms of the human toll, it is the difference between a raging bonfire and a controlled burn.

I might also say that the economic impacts are far worse by doing the responsible thing. which is probably why Trump hasn't done the most responsible thing.

That is an important point, we are in this for the long haul. What we are doing now is trying to save the medical system and prevent deaths due to a lack of resources. Not doing well so far. But, if we can keep this modestly in check, then we can start to slowly reopen in stages. We also buy time for science to catch up. Being able to do testing to see the extent of infection will be huge, because we can then assess the pool of likely immune individuals. We also can see if we have any effective treatments, and possibly test a vaccine. The acute economic effects are worse, but in the Medium term, we should be better off than if we did nothing. Lots of pain to go around, and the administration should have prepared us for that

[teen persuasion]

Apr 3, 2020 16:00:27 GMT -5 djAdvocate said:

Apr 3, 2020 10:25:53 GMT -5 teen persuasion said:

Wow, NY's curve got taller.  Yikes!  But it also looks like they expect it to be all over (in NY) about May 1?

I'm wondering how it plays out outside of NYC, though.  We've got fewer cases, but I think we are a bit behind them on the timeline.  Does Cuomo open things in the state back up when NYC is done, or wait for the rest of the state to catch up, or what?

did you check out Washington?  they are doing amazingly well.

#modelofwhat2do

That's just it - comparing the two, I'm left wondering how my area will fare.  NYC is swamping the numbers for the state, but Upstate is an entirely different creature.  We might as well be a different state.

Looking at the dates, NYC (or downstate) had its first case confirmed 3/1, and that Westchester guy a day or 2 later, but he was sick back in February, so probably much earlier.  My area had its first cases confirmed 3/14, all travel related from NYC or Italy or out of state.  So we are at least 2 weeks behind NYC, and much less densely populated, quite a bit rural/sparsely populated.  We also shut things down immediately as first cases were confirmed, so relatively earlier in the process than NYC.  Might we have a flatter curve?  Hope so, but watching...


Doesn't help that Cuomo announced he's going to forcibly take ventilators and PPE not currently in use from other regions. Umm, we're right behind you, we'll need them in a matter of days, too. That pronouncement isn't going over well outside NYC.

[djAdvocate]

the shape of the curve in all states is starting to flatten.
the slope is below doubling every 3 days now, in most areas (notable exception = NJ)
th biggest areas of concern are the urban areas, as previously discussed.

that having been said, we are nowhere near the peak. this talk about it being over this week is nonsense.
if everything goes right, we can talk about where the peak is in 2 weeks.

we will add another 30k cases today, in all likelihood. maybe 40k.

we are making very poor progress on flattening the curve so far, but at least it is not accelerating, like it was 11 days ago.

[haapai]

Where are you seeing that graph or getting that info from?  IHME has not updated its projections as promised.

[Gardening Grandma]

Apr 3, 2020 16:00:27 GMT -5 djAdvocate said:

Apr 3, 2020 10:25:53 GMT -5 teen persuasion said:

Wow, NY's curve got taller.  Yikes!  But it also looks like they expect it to be all over (in NY) about May 1?

I'm wondering how it plays out outside of NYC, though.  We've got fewer cases, but I think we are a bit behind them on the timeline.  Does Cuomo open things in the state back up when NYC is done, or wait for the rest of the state to catch up, or what?

did you check out Washington?  they are doing amazingly well.

#modelofwhat2do

Gov Inslee just announced WA is sending 400 ventilators
www.governor.wa.gov/news-media/we%E2%80%99re-together-%E2%80%93-washington-state-send-ventilators

[djAdvocate]

Apr 5, 2020 14:01:49 GMT -5 haapai said:

Where are you seeing that graph or getting that info from?  IHME has not updated its projections as promised.

www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html

[haapai]

paywalled out.  Care to give a synopsis?  I can't be the only one who clicked and then saw everything go blank. 

I was mightily intrigued by what I saw, because I believe that the national and local variation is extreme. 

And I can't help but point out the similarity between the NYT's paywall and a peepshow. 

[djAdvocate]

Apr 5, 2020 17:34:02 GMT -5 haapai said:

paywalled out.  Care to give a synopsis?  I can't be the only one who clicked and then saw everything go blank. 

I was mightily intrigued by what I saw, because I believe that the national and local variation is extreme. 

And I can't help but point out the similarity between the NYT's paywall and a peepshow. 

actually, you can get it at the other site by using the USA link:

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

scroll down to "total cases" and hit "logarithmic".

[oped]

Apr 5, 2020 19:47:49 GMT -5 djAdvocate said:

Apr 5, 2020 17:34:02 GMT -5 haapai said:

paywalled out.  Care to give a synopsis?  I can't be the only one who clicked and then saw everything go blank. 

I was mightily intrigued by what I saw, because I believe that the national and local variation is extreme. 

And I can't help but point out the similarity between the NYT's paywall and a peepshow. 

actually, you can get it at the other site by using the USA link:

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

scroll down to "total cases" and hit "logarithmic".

That scale though...

[djAdvocate]

so, this was a good day, folks.

this is the first day in TWO WEEKS that we had a 24 hour drop in cases.

of course, there might be trailing totals that have not been registered (the clock just reset) but it is coming in at 25k rather than 35k.

if that holds up, it is the first sign in a good while that we are making NATIONAL progress.

I will circle back in a few hours to check it.

[haapai]

Excellent site, very searchable and some very good information regarding the availability of testing and cases and deaths as percentage of population. 

I felt sorry for myself for living in Michigan before poking around on that site.  Now all that I can say is send prayers, personnel, and PPE to Louisiana,  They are in a really bad situation.   If you start measuring any indicator of "bad" and adjust it for population, Louisiana is 50% to 100% worse off than my state as a whole. 

It seems churlish at this point to mention my fears that Michigan's covid-19 testing and reporting of covid-19 deaths may have broken down to the degree that they are not helpful for surveillance or projection purposes.

Louisiana is probably in worse shape.

[oped]

I saw today that normally 20-25 people die at home in NYC and the past week was 200-250... DAILY...  I also read an article on Italy Spain and France and areas where the expected deaths plus covid deaths were only part of the equation and there was also another large group of unexpected un-covid diagnoses deaths... I feel like it will be a long time, if ever, that we have accurate numbers on this.

www.economist.com/graphic-detail/2020/04/03/covid-19s-death-toll-appears-higher-than-official-figures-suggest?fbclid=IwAR1tR_sgflRuNMy0BGjTJl955Bb-1z0ZI-g-bOQ1WW174CVw3vkTErVVxQk

[pulmonarymd]

Apr 5, 2020 20:40:20 GMT -5 djAdvocate said:

so, this was a good day, folks.

this is the first day in TWO WEEKS that we had a 24 hour drop in cases.

of course, there might be trailing totals that have not been registered (the clock just reset) but it is coming in at 25k rather than 35k.

if that holds up, it is the first sign in a good while that we are making NATIONAL progress.

I will circle back in a few hours to check it.

I noticed that too. But since it’s a Sunday, official reporting may lag. Need to see a few days in a row where it is consistently less than predicted. Also need a few more data points to see if curve shifted. Last I saw the deaths appeared to be lower than the covid19.healthdata site predicted, unless a bunch came in after I last looked

[haapai]

Wait. a sec.  I may have read those charts a bit too quickly.  Despite having some otherwise horrific metrics, Louisiana does seem to be testing at much higher degree than my own state. 

[teen persuasion]

Locally, they are suggesting that for every confirmed case there may be 11 or more active cases in the community.

Testing is very low, especially compared to other urban areas in the state, maybe 2k-ish tests for a county of almost 1 million (second largest city in the state). The counties containing the next 3 cities in size from 800k down to 260k had each done 3500+ in tests days ago.

They just can't seem to get their hands on more tests - an order of rapid tests got shipped to NYC, instead of the local hospital system that ordered it.