[HN Gopher] In 4 US state prisons, 3,300 inmates test positive, ...
___________________________________________________________________
In 4 US state prisons, 3,300 inmates test positive, 96% without
symptoms
Author : throwaway888abc
Score : 290 points
Date : 2020-04-25 19:58 UTC (3 hours ago)
(HTM) web link (www.reuters.com)
(TXT) w3m dump (www.reuters.com)
| ilamont wrote:
| 96% are without symptoms _yet_.
|
| There was a nursing home in Massachusetts which had 51 out of 98
| residents testing positive but asymptomatic in early April. While
| this sounded encouraging in the sense no one was critically ill
| because of coronavirus, a few weeks later 19 had died and about
| 30 more had tested positive.
|
| Let's wait a month until there is a clearer picture about the
| impact of the virus on a particular population of people.
|
| https://www.boston.com/news/local-news/2020/04/04/coronaviru...
|
| https://www.wcvb.com/article/85-of-patients-at-wilmington-ma...
| [deleted]
| RangerScience wrote:
| ...Let's also ask if the tests have a high false positive rate?
| bumby wrote:
| Dr. David Katz was just in Bill Maher's show indicating the
| test has a high false _negative_ rate
| kfrzcode wrote:
| Is it indicated how long ago these inmates were tested? Seems
| like that's a key component in this mystery and I can't find
| it.
| sharken wrote:
| In Marion Correctional Institution, Ohio it could look like
| the tests were conducted in mid-april according to https://dr
| c.ohio.gov/Portals/0/DRC%20COVID-19%20Information%....
|
| But as of 25-04-2020 at least 4 inmates have died to Corona
| virus according to https://eu.marionstar.com/story/news/local
| /2020/04/24/corona.... There are 2,564 inmates
| (https://drc.ohio.gov/mci).
| JPKab wrote:
| Did you see the NYC antibody sample that showed that
| approximately 21 percent of citizens had antibodies? It seems
| like a nursing home is a pretty bad representation of a
| population.
| jpster wrote:
| I am not sure how reliable these studies are, given this
| reporting:
|
| https://www.nytimes.com/2020/04/24/health/coronavirus-
| antibo...
| bashtoni wrote:
| It didn't show that - there's a good analysis at
| https://towardsdatascience.com/were-21-of-new-york-city-
| resi...
| pbourke wrote:
| I don't buy any inference drawn from that study that is in
| the realm of "20% of the population of NYC was exposed to
| SARS-CoV-2 and developed immunity"
|
| I think that will be the primary message that people will get
| from that study.
| SpicyLemonZest wrote:
| Is there any evidence that _would_ convince you 20% of NYC
| was exposed and developed immunity?
| CydeWeys wrote:
| How about an actually randomly sampled test, for
| starters?
| ta1771 wrote:
| Antibodies for __which of the 8+ strains?
| prussian wrote:
| Am I the only one who is still confused by what they're
| finding in these antibody tests? Are they looking for
| antibodies that attach to specific features unique to SARS-
| CoV-2? Because I'm pretty sure even HCoV-NL63 enter lung
| cells through ACE2 as well. How can they tell antibodies for
| these viruses apart? Also aren't antibodies effectively
| developed in a sort of random process?
| lend000 wrote:
| I am also curious about this. As I understand it, an immune
| individual could have any mathematical subset of antibodies
| from the base set, which is the collection of all proteins
| that can bind to something on the surface of a COVID-19
| virion. Furthermore, I would think these base sets can
| change slightly for different mutations of the virus.
|
| Perhaps humans tend to have enough random antibody
| generation that they are likely to start mass producing
| most of the protein shapes that are able to bind to the
| virus? And as another commenter pointed out, there are not
| that many options to bind to.
| vikramkr wrote:
| Look up VDJ recombination[0] for a sense of how
| antibodies are generated. Ling story short, yeah its
| pretty random in a really clever process that generates
| enormous variability. There are also only so many
| features to bind on the covid virus protein, which are
| what we test, but there are a lot of antibodies that our
| body can make against them
| SN76477 wrote:
| I am confused as can be about all of it now. First it was
| stay locked in, then heard immunity, now they say heard
| immunity may not happen.
| 13415 wrote:
| If you're confused by this, you may need to check your
| news sources. Experts have been explaining all of this
| for months. First, people need to stay locked in and keep
| distance in order to slow down the spreading so health
| care systems don't get overwhelmed. Second, the disease
| itself can only be stopped once herd immunity is reached.
| Ideally, herd immunity is achieved by vaccination, once
| there is one. Until then, social distancing is needed to
| limit the number of deaths and keep the health system
| working. Third, it is not yet clear whether long-lasting
| immunity can be achieved at all. It's very likely, but
| there is not yet enough data. Immunity may last from 2
| months to 2 years or longer. We don't know yet for sure.
| sndean wrote:
| > Are they looking for antibodies that attach to specific
| features unique to SARS-CoV-2?
|
| They're all slightly different, but yes they're looking for
| antibodies against specific parts of SARS-CoV-2, like the N
| protein [0][1]. I think the N protein ones are most common.
| I just did a BLASTp against SARS-CoV's N protein and
| there's maybe ~90% homology? So I would hope they're using
| a site that's different between the two. Or, there's an
| assumption that most people have not been previously
| exposed to SARS-CoV or others with similar N proteins.
|
| > Also aren't antibodies effectively developed in a sort of
| random process?
|
| Yeah, but there's only so many prominent features to a
| virus that you can make antibodies against.
|
| [0] https://www.abcam.com/novel-coronavirus-igg-antibody-
| detecti... [1] https://www.ncbi.nlm.nih.gov/protein/QHW0604
| 6.1?report=fasta
| AJ007 wrote:
| 8,399,000 people in NYC, 21 percent of that is 1,763,790. 1%
| of that is 17,000.
|
| So far as of Saturday at 6:49pm EST 16,919 have officially
| died in NYC.
|
| I think the anti-body test in this case is fairly close and
| the death rate is probably 1% more or less depending on the
| demographic distribution. Obviously there are a number of
| people in NYC who will die over the next month even if all
| new infections where halted right now.
|
| The serology tests are just wrong when only a small number of
| people in the sample were infected, which is what we've seen
| from the stuff in CA so far.
| CydeWeys wrote:
| You're using the death count for the entire state, not just
| NYC. The blood antibody test positive % for the overall
| state is 13, not 21. And the population is around 19.5
| million.
| hristov wrote:
| I am not sure that these antibody tests mean what people
| generally think they mean. For example, there seem to be
| multiple events where people get sick even after it has been
| established that they have antibodies.
|
| Furthermore, people in environments with a lot of virus
| (i.e., cruise ships, hospitals, or just northern italian
| towns where the virus has run amok, tend to get sick and die
| at much higher rate than those antibody tests would suggest.
|
| There may be a mechanism for multiple infection which makes
| multiple exposure more dangerous even if you have antibodies.
| ilamont wrote:
| I agree, but so is a group of male inmates (many of them
| older) compared to the general population. Until more testing
| on this group is done in a few weeks and symptoms emerge, we
| won't have a clear picture on how many are truly
| asymptomatic.
| sandworm101 wrote:
| Fine non-Covid point:
|
| >>> The United States has more people behind bars than any other
| nation, a total incarcerated population of nearly 2.3 million as
| of 2017 -- nearly half of which is in state prisons. Smaller
| numbers are locked in federal prisons and local jails, which
| typically hold people for relatively short periods as they await
| trial.
|
| That isn't correct. "Local Jails" hold two general populations:
| people serving less than a year (generally non-felony
| convictions) and people awaiting legal process. The infamous
| Rikers Island in NY is technically a "local jail". People
| regularly stay in these facilities for YEARS. The AVERAGE stay at
| Rikers is 6+ months. (Total stay, not time between appearances.)
|
| The distinction between "jail" and "prison" in the US is
| academic. For purposes of disease, and certainly from the
| perspective of inmates, both are prisons where large populations
| are locked up in confined quarters for years at a time.
| IAmEveryone wrote:
| Plugging the 96% into New York numbers results in 155,000 / 4 *
| 100 = 3,875,000 infected people in NYC, or about half the
| population.
|
| This is assuming that tests in NYC currently include every
| infected and symptomatic person. Considering the official advice
| for people with mild symptoms is to stay home (and not seek a
| test), that assumption is ... optimistic.
|
| It also wouldn't fit with the anti-body tests that have been done
| in NYC that showed figures closer to 15-20%.
|
| So I'd expect about 1/2 to 2/3 of these 96% to develop symptoms
| within the next week.
|
| The other possibility is the prison population not being
| representative of the general population. That's probably true in
| terms of fatality rates, because they are younger. I'm not
| entirely sure if that age imbalance is just as strong for _any_
| symptoms as it is for risk of hospitalisation and death.
| sergiotapia wrote:
| >"It adds to the understanding that we have a severe undercount
| of cases in the U.S.," said Dr. Leana Wen,
|
| There it is! Now can we get back to normal. Of those 4% with
| symptoms, what tiny percentage need advanced hospitalization? Of
| that tiny percentage, what tinier percentage still, die?
| Munky-Necan wrote:
| The cruise ships were a great Petri dish and so far it is
| believed that asymptomatic patients comprise 15-20%, but more
| research is needed.
|
| https://www.niid.go.jp/niid/en/2019-ncov-e/9417-covid-dp-fe-...
| ivanhoe wrote:
| I've read that asymptomatic carriers are though to be less
| infectious than those with symptoms because of the lower
| concentration of virus in the saliva. Also, many virologists
| mentioned in recent texts that the initial concentration of the
| virus you receive can affect how sick you'll get - the more
| viruses you're exposed to, the faster they can invade the body
| and the more severe it will get.
|
| Can those two facts be combined into a theory that asymptomatic
| carriers are more likely to produce more mild and asymptomatic
| cases?
|
| Don't know if it makes any sense (probably not), but it would
| certainly explain how in some closed environments there's a
| prevalence for mild cases, while in others there's a plenty of
| very sick people, regardless of the age.
| frereubu wrote:
| Where did you read that? Superficially that might make sense -
| less virus particles == less obvious symptoms - but there are a
| wide variety of virus responses that show virulence and
| infectiousness aren't necessarily correlated.
|
| If anyone wants to read more about this I can't recommend
| highly enough the book _Spillover_ by David Quammen, which was
| published in 2012, and covers zoonotic (animal-to-human
| transmission) viruses, including SARS. Reading the section on
| SARS made the hairs on the back of my neck stand up. It 's
| uncannily similar to what's happening with Covid-19, and
| explains a lot of the background involved in these kinds of
| viruses.
| throwaway7614 wrote:
| https://www.newscientist.com/article/2238819-does-a-high-
| vir...
| ketzo wrote:
| I actually do remember reading that this was true
| specifically in the case of COVID -- that more exposure so
| far seems to correlate with a worse infection.
|
| Sadly, I have no idea where I read this. But... I know I did!
| Recently! Maybe NYT?
| ScottBurson wrote:
| Yeah, I saw it too. The hypothesis, as I recall, is that
| the more virions inhaled, the more likely some of them will
| get deep in the lungs where they can do the most damage.
| phkahler wrote:
| I read something like that too. I came away thinking that
| ingestion might be a better way to get it than
| inhalation. I think you really need to keep it out of the
| lungs and nervous system. But that's all my impression
| from who knows where.
| snowmaker wrote:
| This is the article you meant:
| https://www.nytimes.com/2020/04/01/opinion/coronavirus-
| viral...
| alkonaut wrote:
| A crude mathematical model from Swedish authorities on the
| Stockholm outbreak used two parameters: 1: the fraction of
| undetected cases (assumed to be mild or asymptomatic) and 2:
| the relative infectiousness of that group compared to the
| "detected" group.
|
| The larger the undetected group is, the lower their relative
| infectiousness has to be in order to fit the observations.
| The best fit I believe was 1/25 detected and 11%
| infectiousness of the undetected group.
| netcan wrote:
| Bucheight
| belltaco wrote:
| https://www.cebm.net/covid-19/sars-cov-2-viral-load-and-
| the-...
| frereubu wrote:
| Thanks - that's the kind of thing I was looking for, but
| this line stuck out to me: "However, the evidence of the
| relationship is limited by the poor quality of many of the
| studies, the retrospective nature of the studies, small
| sample sizes and the potential problem with selection
| bias." The book I mention gives me enough reason to doubt
| that what we know about Covid-19 at this point is anything
| like the whole story.
| toshk wrote:
| These were exactly the assumptions of the RIVM in the
| Netherlands end Februari and March causing it to completely
| spiral out of control.
| johnchristopher wrote:
| > Rijksinstituut voor Volksgezondheid en Milieu
|
| > Netherlands National Institute for Public Health and the
| Environment
|
| > The Netherlands National Institute for Public Health and
| the Environment, is a Dutch research institute that is an
| independent agency of the Dutch Ministry of Health, Welfare
| and Sport. RIVM performs tasks to promote public health and a
| safe living environment by conducting research and collecting
| knowledge worldwide.
| Peter-Jan wrote:
| > causing it to completely spiral out of control.
|
| I live in the Netherlands and I think you could say that we
| actually have it quite under control (relatively speaking of
| course). We never reached peak ICU capacity and the ICU
| occupancy has been steadily declining for more than two weeks
| now[1]. Our schools for children between the ages of 4 and 12
| are scheduled to partially open again on the 11th of may[2].
|
| [1] https://nos.nl/artikel/2331720-coronacijfers-
| van-25-april-ri...
|
| [2] https://nos.nl/artikel/2331460-kabinet-wil-basisscholen-
| voor...
| ck2 wrote:
| how do you ever make antibodies if you are perpetually
| asymptomatic though?
|
| do you carry it forever? does it attack eventually?
|
| what happens if you are an asymptomatic carrier and get a vax?
| venning wrote:
| "Typhoid Mary" was an asymptomatic carrier of typhoid fever
| for at least 38 years.
|
| https://en.wikipedia.org/wiki/Mary_Mallon
| [deleted]
| darkwater wrote:
| AFAIK asymptomatic means you show no symptoms but your body
| fights and creates antibodies just the same. Disclaimer: I'm
| not a doctor.
| sandworm101 wrote:
| >> Also, many virologists mentioned in recent texts that the
| initial concentration of the virus you receive can affect how
| sick you'll get - the more viruses you're exposed to, the
| faster they can invade the body and the more severe it will
| get.
|
| That is basic infections 101. When you are exposed to any
| dangerous virus a race starts between the virus and your immune
| system. If the virus starts out only infecting a handful of
| cells, your immune system has a head start in developing
| antibodies before symptomatic infection sets in. (This is also
| a basic principle behind many vaccines.) But if you are hit
| will a massive viral load that instantly infects every cell in
| your lungs, the immune system is fighting uphill from day one.
| A massive initial viral exposure can also trigger an excessive
| immune response, for instance dangerously high fever. Such an
| immune response can be as deadly as the virus. Much covid
| research is going into not defeating the virus directly but
| regulating/slowing the immune response to the patient survives
| their own immune response.
|
| This principal explains why healthcare workers are suffering
| so. They are exposed to constant massive doses of virus,
| possibly from multiple patients carrying slight different
| versions of the virus. So they get sicker than people who are
| exposed in the general community.
| throwaway7614 wrote:
| Sleep deprivation and extreme stress could be factors that
| affect healthcare workers (1)
|
| https://theconversation.com/coronavirus-does-the-amount-
| of-v...
| jbritton wrote:
| I have been wondering about the effect of the degree of initial
| infection. I kind of assume the virus grows exponentially
| inside the body and would dwarf the initial constant. If a low
| initial dose affects the severity of the disease, I think that
| would be incredibly useful to know. I also wish there was info
| on percentage of infection via fomites vs inhalation.
| mgummelt wrote:
| > I kind of assume the virus grows exponentially inside the
| body and would dwarf the initial constant.
|
| Perhaps a more mild initial growth stage gives the immune
| system more time to respond.
| vanniv wrote:
| Early on, there was some discussion of the possibility that
| folks whose initial exposure is via the eyes would have a
| more mild illness than if the exposure was via nostrils or
| inhalation, because the immune system would have time to
| begin work while the virus was multiplying more slowly in
| tissue less suited to it.
|
| I haven't heard anything in weeks studying anything like
| this, though, so I don't know where we ended up, if, indeed
| anybody knows anything at all.
| tarsinge wrote:
| Not expert but I think if the initial constant can be several
| orders of magnitude different (I guess a few when airborne vs
| billions in a droplet) then it can impact the delay of the
| infection and give time for the immune response.
| BurningFrog wrote:
| Yeah, as I understand it, typically the "dose" of the initial
| infection is important for how bad the symptoms will be.
|
| The virus will grow exponentially, but so will the immune
| response, so starting conditions are important.
|
| This is a basis for the old pre vaccine "variolation"
| strategy of getting immunity. Some radical thinkers argue for
| it as a Covid remedy.
| fermienrico wrote:
| I think it's the opposite. The initial conditions have a
| profound effect on the exponential nature of the growth. Half
| the dose could mean that your immune system can suppress it.
| There is probably critical rate at which both growth rates
| match.
| vikramkr wrote:
| Most infectious diseases are dose dependent in their effects
| actually, which can be a bit counterintuitive. I dont know of
| any data for covid yet, but heres a paper on influenza,
| another viral disease:
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342672/
| FabHK wrote:
| Would be nice if they had specified what test (PCR from throat
| swap, from sputum, from stool; antibody test; ...).
| eblah wrote:
| Does anyone know if there's been any studies on those who have
| taken no medications at all in past X days vs those that take any
| (either OTC or otherwise) and those with and without symptoms?
|
| I ask because I'd assume drug use would be lower in prisons, and
| among those in poorer countries. I'm just wondering if a
| particular set of drugs could accelerate/make this worse?
|
| That said, I'm not sure this is even possible to obtain metrics
| on, it'd just be interesting to see if there's any type of
| correlation to rule out. I realize there's been conflicting
| studies on whether certain heart meds may accelerate, but I've
| not been able to find anything about any drugs use whatsoever.
| colmvp wrote:
| As a Canadian, I'm shaking my head at our officials who said "we
| do know that asymptomatic people are not the key driver of
| epidemics" as a response to concerns back in January of the
| potential for the virus to grow in our country via incoming
| travelers who came from hot spots and were not screened or forced
| to isolate if they expressed no symptoms.
|
| Now our long term care facilities are being overrun with cases
| potentially because we waited until deaths piled up before
| testing asymptomatic caretakers for the virus.
| hn_check wrote:
| A test is a snapshot of time. A person could pass a test and be
| shedding viruses two days later. A person could shed viruses,
| get over it, and pass a test.
| hazeii wrote:
| There's asymptomatic and presymptomatic (a very rapid spread
| could give lots of positive results before symptoms appear).
| tempestn wrote:
| Agreed 100%. Here in BC, public health wasn't even saying,
| "It's not known whether asymptomatic carriers can spread the
| virus," but actually, "Evidence suggests asymptomatic carriers
| _can not_ spread the virus. " Something that as far as I can
| tell was never actually true. This was reported in public
| briefings, was repeated by public health nurses on the call-in
| lines, and was distributed as the government's official
| position to daycare workers, presumably among others. Really
| mind-boggling to me. I can only assume somewhere along the line
| lack of evidence got confused for evidence of lack, and just
| kept getting parroted from there.
| uvesten wrote:
| Exactly like in Sweden. Our ministry of health has _almost_
| given up the claim that asymptomatic carriers don't spread
| the virus by now, so... Progress!
| antonvs wrote:
| > "Evidence suggests asymptomatic carriers can not spread the
| virus."
|
| I don't understand this. How would that even work? If you're
| infected, what would stop you from shedding virus like anyone
| else? Is there a precedent for this, for respiratory viruses?
| hilbertseries wrote:
| Both SARS and MERS were not particularly contagious during
| the incubation phase.
| microcolonel wrote:
| Ultimately this has exposed that WHO is a malicious institution
| which actively undermines the public health for Tedros
| Adhanom's personal relationship to the cause of the CCP and of
| fascism more generally.
|
| Each of our government's dangerously false statements has come
| from the WHO, and trusting them has been the primary mistake
| made in assessing this threat.
|
| "no evidence of Human-to-human spread" when they had evidence,
| "no evidence of asymptomatic spread" when we all had evidence,
| "no evidence of aerosol spread" when there was evidence in
| public view: The WHO been there at every step to cast doubt on
| the seriousness of this threat, and to discourage us from
| considering and addressing the avenues of spread.
| pfarrell wrote:
| I can't believe this is not a new account. Blanket
| propagandistic statements are not the conversation we have in
| Hacker News comments.
| sharken wrote:
| Calling WHO a malicious institution is a bit too much, but
| let's just say that their track record is far from stellar,
| some examples:
|
| In the 2017/2018 flu season the WHO recommended a trivalent
| vaccine for the common flu (https://www.who.int/influenza/v
| accines/virus/recommendations...)
|
| It turned out that another type B variant was the dominant
| one that year (https://en.ssi.dk/surveillance-and-
| preparedness/surveillance...) which caused a total of 1,644
| deaths in Denmark, which is almost four times the current
| death toll for Corona virus in Denmark.
|
| Another example: On the 3rd of march the general secretary
| of the WHO issued this statement:
| https://www.who.int/dg/speeches/detail/who-director-
| general-...
|
| It says for example this: "Evidence from China is that only
| 1% of reported cases do not have symptoms, and most of
| those cases develop symptoms within 2 days."
|
| And yet here we are with a 96% asymptomatic rate being
| reported in a prison.
|
| I would rather that the WHO delayed their news flow,
| instead of reporting too soon on what they think. Oh, and
| probably they should trust the Chinese regime less than
| they do.
| aguyfromnb wrote:
| > _Blanket propagandistic statements_
|
| Blanket implies "all". Are the OP's following statements
| incorrect?:
|
| "no evidence of Human-to-human spread" when they had
| evidence, "no evidence of asymptomatic spread" when we all
| had evidence, "no evidence of aerosol spread" when there
| was evidence in public view
|
| Taiwan warned the WHO with respect to human-to-human
| transmission. Is this in dispute?
|
| https://www3.nhk.or.jp/nhkworld/en/news/20200412_01/
|
| > _not the conversation we have in Hacker News comments._
|
| These are precisely the sorts of conversations people
| should be having.
| sharken wrote:
| > These are precisely the sorts of conversations people
| should be having.
|
| Indeed.
| prox wrote:
| Its the same story in Wuhan, probably quite a few asymptomatic
| carriers until the death toll start rising because of the
| exponential growth and came on the radar.
| robocat wrote:
| If the virus moves fast through a population (like we might
| expect in a crowded prison) then all the population in one
| provision will have a single strain.
|
| However, this is 4 prisons: do staff or inmates move between
| prisons more often than say every week?
|
| It is possible (although unlikely) the virus strain is less
| spdangerous.
| aazaa wrote:
| No mention of what kind of test was performed. And this article
| is not alone - most don't bother.
|
| The kind of test matters. A qPCR tests the presence of an active
| infection. Antibody test determines past exposure.
|
| Each has different expectations for symptoms, communicability,
| and prognosis.
|
| It's not a lot to ask - just report the kind of test that was
| done, and do so with in the first two paragraphs. Then let me
| draw my own conclusions about what the study means.
|
| That's a minimum. Ideally, an article would mention the exact
| brand of test that was performed. If heterogeneous testing
| methods were used, report that as well.
| shawnz wrote:
| If it were an antibody test then I don't think it would be
| correct to say that they "tested positive for coronavirus", and
| also it wouldn't make sense to talk about their symptomaticity
| alexbanks wrote:
| Before the deluge of "But wait two weeks" comments, I just want
| to ask at what point we accept that the potentially of totally
| asymptomatic cases is insanely high, far higher than anyone
| thought?
| FabHK wrote:
| It's not like this is the first population that has been nearly
| exhaustively tested. There was the cruise ship, there was the
| navy ship, etc. Those have shown between <20% (among the
| elderly cruise ship demographic) to 60% (among healthy
| soldiers) asymptomatic.
|
| This certainly adds another data point, but I wouldn't throw
| conventional wisdom out the window yet.
| alkonaut wrote:
| > at what point
|
| When at least one large studied group has an outcome
| (symptomatic recovered, asymptomatic recovered, or dead). So
| for this group I guess a few more weeks.
| taeric wrote:
| I also want to add that this doesn't make the virus less
| deadly. It just gives it a very population varied IFR. It
| appears far more deadly for some populations. Near harmless for
| others. But no clear way to confine it to the harmless crowd.
| vmception wrote:
| > But no clear way to confine it to the harmless crowd.
|
| That won't be what the public policy decisions will be based
| around if the asymptomatic and already exposed rate is so
| high.
|
| We don't know enough to make that decision yet, but testing
| more broadly was the first step.
|
| Remaining steps:
|
| - Do they get sick in two weeks?
|
| - Skip testing for current sickness, and test for antibodies
| instead.
|
| - Get a better antibody test that is more accurate
|
| - Understand how well antibodies work, and for how long
|
| and _then_ we can make decisions, even if they are as simple
| as "this is a systemwide over the air update, some people
| will get bricked"
|
| it's becoming clear that we might end up with a society where
| the average BMI is under 24.9 simply due to the lower oxygen
| and resource requirements to support those body systems.
| taeric wrote:
| Not sure I follow. I confess I'm biased in thinking we
| could have locked down nursing homes and shaved a large
| chunk of deaths. Catch is, we should have done that in
| January.
| SpicyLemonZest wrote:
| Like with the death rate, I expect we'll seamlessly transition
| from "this isn't proof, in 2 weeks you'll see" to "this isn't
| news, everyone always believed that so it doesn't imply any
| changes in strategy".
| wegs wrote:
| Well, it isn't proof. It is evidence, though. And in two
| weeks, we will have a lot more evidence.
|
| A lot of this is like Russian Roulette -- there's a huge
| amount about this virus which we don't know, and it could be
| super-bad or not-that-bad. It could also be there are bad and
| not-so-bad strains. Or it could be bad down-the-line.
|
| Until we do have proof, I'm advocating being conservative. In
| 2 weeks, we'll know if people are turning up in ERs or in
| morgues. In a few months, we'll know about lung damage,
| immune system damage, strokes, or a lot of the other
| potential consequences. In a year, we'll know about vaccine
| and long-term immunity.
|
| I think the key problem here is failure to understand risk
| management. I can believe one think, but act another way just
| in case I'm wrong. Or I can be unsure. And so on. That nuance
| is lost in the right/wrong discussions.
| Zach_the_Lizard wrote:
| > A lot of this is like Russian Roulette -- there's a huge
| amount about this virus which we don't know, and it could
| be super-bad or not-that-bad.
|
| I think at this point we know enough to say:
|
| 1) For most of the population, the virus is not that
| serious
|
| 2) For a subset of the population the virus is seriously
| deadly. For example, ~20% of NY state coronavirus deaths
| were from nursing homes, ~37% are 80 or older. By contrast,
| there were 2 people under the age of 10 at the time of this
| post. [0]
|
| > I think the key problem here is failure to understand
| risk management
|
| I think another key problem is a failure to be frank about
| the cost-benefit of our actions. I have had to make
| stronger cases about changing the color of a button or
| optimizing a backend call than I've seen presented by
| authorities who are shutting down or reopening or anywhere
| in between.
|
| [0] https://covid19tracker.health.ny.gov/views/NYS-
| COVID19-Track...
| edmundsauto wrote:
| On 1), what do you consider "not that serious"? IE, what
| are your metrics of choice, and what are the acceptable
| values?
|
| Regarding the cost-benefit discussion, my perspective is
| that people only want to discuss the downsides from a
| reduced economy. Second order effects include reduced
| vehicle deaths, reduced deaths from pollution, etc. IE,
| my discussions has felt agenda driven because it
| considers first order effects only.
|
| If we're going to compare apples-to-apples, I'm willing
| to have that conversation. If the conversation is limited
| to "people die during recessions", it's a pretty clear
| signal that agenda is driving and would not be a
| productive use of my time.
| alexbanks wrote:
| It seems kind of ridiculous to cite "reduced deaths from
| pollution" as an upside while people are also being
| forced into confinement, no?
| sharken wrote:
| We are quite a lot of people that fear the operation will
| be successful but the patient is dead with the Corona
| actions being taken. Case in point, 26.5 million
| americans have sought unemployment benefits
| (https://vastuullisuusuutiset.fi/en/weben/women-bear-
| brunt-of...).
|
| The deaths in New York are quite telling for who is at
| risk, see
| https://www.statista.com/statistics/1109867/coronavirus-
| deat....
|
| Over 90% of the dead so far are old with comorbidites
| such as Hypertension and Diabetes, see
| https://www.bloomberg.com/news/articles/2020-03-25/most-
| nyc-....
|
| So i agree that "not serious" is an accurate statement.
| AnthonyMouse wrote:
| > Before the deluge of "But wait two weeks" comments, I just
| want to ask at what point we accept that the potentially of
| totally asymptomatic cases is insanely high, far higher than
| anyone thought?
|
| Presumably in two weeks, when we know whether more of these
| thousands of people go on to develop symptoms or not.
|
| Is anybody following up on stories like this? Do we have any
| from two weeks ago?
| onlyrealcuzzo wrote:
| The asymptomatic rate being that high and that many people
| being infected implies three things.
|
| 1) that the asymptomatic rate for this Coronavirus is much
| higher than other Coronaviruses.
|
| 2) but at the same time, it's more deadly than most
| Coronaviruses.
|
| 3) and it's also the R0 is much higher than other
| Coronaviruses.
|
| Isn't it more likely there's a testing issue? This seems a
| lot like a person that runs a SQL query that overturns all
| established data at a business, and instead of first assuming
| that their query is wrong, they instead assume everyone at
| the business is wrong.
|
| I'm not saying the tests are inaccurate. I'm saying when you
| get highly conflicting data that has critical implications,
| you shouldn't jump to conclusions. And you should prepare for
| the worst case, not assume the best.
| whiddershins wrote:
| If the asymptomatic rate is higher, then it is less dealt,
| no?
| robocat wrote:
| > the R0 is much higher than other Coronaviruses
|
| R0 depends on the population you measure. In a high
| contact, crowded place, the R0 could be very high. In a
| population staying at home, the R0 could be very low.
| jacobolus wrote:
| > _Is anybody following up on stories like this?_
|
| The best follow-up we have is from the cruise ship, where at
| the time of testing more than half of those who tested
| positive were asymptomatic, but ultimately something like 80%
| of the confirmed infected ended up with symptoms.
| wk_end wrote:
| Just curious - do you have any sources for this? I've heard
| it a few times and just looked it up - I found a paper [1]
| from March 12 that used "statistical modelling" to predict
| ~20% asymptomatic after a delay, but several articles 1-2
| weeks _after_ 12th indicating that they were still seeing
| ~50% (e.g. [2]). I think all the articles with that 50%
| number were based on the same test, but couldn 't find
| anything suggesting that there were follow-ups to confirm
| the 20% prediction.
|
| [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078829/
|
| [2] https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e3.htm
| jacobolus wrote:
| You might be right that that statistical estimate from a
| month ago was the source of the 20% number. I also can't
| find any good follow-up sources.
|
| I probably saw that factoid hyped up in multiple media
| stories which misconstrued the original paper.
|
| If anyone knows of more reliable recent sources about
| this, it would be great to clear it up.
| tyingq wrote:
| There's also the nuance of US state prison care quality. _"
| Without symptoms"_ could just mean _" not obviously gasping for
| air"_.
| lostlogin wrote:
| Amnesty International campaign against this and are currently
| calling for the release of ICE detainees. Judging by a skim
| of their releases even those obviously gasping for air don't
| necessarily get the care they need. It's a truely massive
| system which in itself is part of the problem, though the
| exceptionally low bar for the care of prisoners is Amnesty's
| primary angle.
|
| https://www.amnesty.org/en/latest/news/2020/04/usa-
| covid19-p...
| code_duck wrote:
| Sure, in New Mexico there are routinely lawsuits against the
| state and county's for completely ignoring inmates'
| communicated medical needs (or worse).
|
| https://www.santafenewmexican.com/news/local_news/what-
| happe...
| londons_explore wrote:
| "Not dead yet"
| DoreenMichele wrote:
| "Just their usual whining because that's what prisoners do.
| These are not the symptoms you are looking for. Move
| along."
| [deleted]
| Pfhreak wrote:
| This is absolutely my reading. That someone is not really
| observing or listening to prisoner symptoms with much care
| either because of distrust between the prisoner and the
| medical technicians or because prisoners receive such poor
| care.
| sroussey wrote:
| It's always high on these antibody tests, low on tests approved
| by the FDA.
| cjlars wrote:
| I'll venture a guess that by Wednesday the news cycle will be
| deep in the implications of very high asymptomatic case
| count... Assuming we don't start seeing contradicting evidence.
| vanniv wrote:
| Nah, that has too much risk of admitting that eternal house
| arrest isn't a good solution, so we can be certain that won't
| be the media narrative.
| code_duck wrote:
| I'm confused about this version of events that some are
| supporting. In your view, why does the media have a motive
| to engage in a secret conspiracy to not present any
| solutions other than an endless shutdown? How would that
| benefit 'The media'?
| SpicyLemonZest wrote:
| It's not a secret! Many media outlets and government
| officials have been very explicit about it: shutdowns are
| the only option for us, it's irresponsible to demand a
| date when they'll end, and it's very offensive to ask
| whether they're worth the cost.
|
| I do share your confusion about why the media would say
| such things, but they are.
| axguscbklp wrote:
| The media is not monolithic, but a large subset of it is
| fervently against Trump, against Trump supporters, and
| against Republicans in general. The worse the pandemic
| and shutdown get, the more this subset of the media can
| use it to bash Trump, Trump supporters, and Republicans.
| Generally speaking, the worse the economy gets, the less
| likely that the incumbent president will be re-elected. I
| don't think that this media slant is the result of a
| conspiracy, though, at least not for the most part. I'd
| guess that probably most of the slant comes from
| subconscious bias, not conscious intent.
|
| I'm against Trump too, for various reasons - for example,
| I don't like his authoritarian mindset, his stance on
| torture, his stance on surveillance, and his foreign
| policy towards Iran - but I'm not a fan of the constant
| hysterics of the anti-Trump media either. Some of those
| people would claim that Trump was somehow being deceitful
| and evil even if he just said that 2 + 2 = 4.
|
| There are, I'm sure, other sources of media bias on this
| matter as well, but this is the one that immediately
| comes to my mind.
| vanniv wrote:
| I don't really have enough karma to be able to waste
| responding, but I'll make an exception for you, since you
| asked more politely than most.
|
| First, there's not much secrecy involved. It isn't a
| secret at all that, Hollywood, the American mainstream
| media, and the political left are all on the same side.
| It's been obvious for 30 years now.
|
| What we are currently living through is a left-
| authoritarian consolidation of power. Like other similar
| consolidations in the 20th century.
|
| That is why, within 24 hours of the first house-arrest
| orders, propaganda about how our old lives of freedom are
| gone forever because they were "irresponsible", and how
| we must all get used to "the new normal" began.
|
| Dr. Fauci says that physical human contact is a thing of
| the past ("nobody will ever shake hands ever again"),
| governors, especially those of "blue states" have all
| acted to either make their house-arrest orders indefinite
| (like in CA) or to declare that they will continue for
| multiple years (as VA announced yesterday, for example).
|
| Enforcement is gradually increased everywhere, and
| citizens are increasingly encouraged to snitch.
|
| Political protests are banned. Even organizing them
| online is being locked down, with states pressuring
| Facebook and Google into deleting people's accounts if
| they even mention the existence of a protest.
|
| The thing is, it takes time to take a society used to
| freedom and fully consolidate it.
|
| The house arrest orders are the start -- now, when the
| government eventually let's people out of their houses,
| but only on conditions (like wearing a tacking wristband,
| showing your papers to any government official, having to
| have "a legitimate purpose"), people will be so desperate
| to leave home that they'll agree.
|
| With "contact tracing" apps and "mandatory isolation",
| the government will be able to declare any person they
| need to silence as "contaminated", and they go back to
| imprisonment, with no recourse, no due process, no burden
| of proof. Even better, having communicated with a
| "contaminated" person automatically adds you to the list
| of the unpersoned.
|
| The economic disruption has already made 1 in 4 Americans
| dependent upon government handouts to survive. Every
| week, another 4-5% join them. An authoritarian government
| needs it's people to be dependent for survival, in order
| to ensure cooperation.
|
| Meanwhile, the food supply is being turned off. We
| already have a third of our food production offline, and
| are most of the way toward driving all independent
| farmers and ranchers into bankruptcy. We are pretty much
| guaranteed to have widespread hunger by the fall. This
| will leave the way for a government takeover of food
| production.
|
| But, in order for the consolidation to work, they have to
| keep us all imprisoned willingly until they finish
| consolidating enough power to make it permanent, or we
| will all just go back to our lives as free people, the
| economy will recover, and people won't be dependent upon
| the would-be dictators for their continued survival.
|
| The next 3-6 months are critical to breaking the back of
| the capitalist system and soften everyone up to accept
| the new freedomless world. It will take that long to
| drive enough people to poverty, hunger, and desperation
| for them to be willing to go to the authoritarians and
| beg to be ruled.
|
| This isn't a secret, and it isn't really new. It's more
| or less how every current left-authoritarian state was
| formed -- only with more technology and fewer guns.
| edmundsauto wrote:
| It's interesting to see the effect of a strong
| confirmation bias at play. I appreciate you taking the
| time to respond, and would challenge you to think through
| your perceptions if you started from a different
| assumption.
|
| Narratives drive how we see the world. In concrete,
| objective, measurable terms -- what do you mean by a
| "left-authoritarian consolidation of power"? From my
| perspective, the right is the one really good at
| consolidating and protecting their power, while the left
| is a little ADD about what they care about. (And are thus
| less effective at being in charge, even if more Americans
| profess those beliefs.)
| jakeogh wrote:
| https://news.ycombinator.com/item?id=16352498
| Terretta wrote:
| Note that until this past week, officially, the symptoms had to
| be the first three defined by CDC, not the eight or so CDC have
| expanded now: fever, cough, shortness of breath, chills,
| repeated shaking, muscle pain, headache, sore throat and new
| loss of taste or smell, could all appear between two and 14
| days after exposure.
|
| In the field it appears many/most of the less severe cases
| don't exhibit the initial set they had defined, so patients
| experienced illness written off as not COVID-19.
|
| From what I've heard from the field, a careful patient history
| finds there was typically a bout of unusual "but it can't be
| COVID" illness with a set of the expanded set of symptoms in
| almost every "asymptomatic" patient.
|
| It's further speculated these variations may have to do with
| level of exposure and path of infection, along with the earlier
| noted lung health and comorbidities.
| FrojoS wrote:
| Very interesting point. If this is how symptomatic was
| defined, yours should be the top comment of the thread.
| ouid wrote:
| You have to account for events like the Diamond Princess, if
| you want to run with that story.
| marcell wrote:
| I've been tracking the antibody study results in a spreadsheet,
| and they are suggesting a 10-20x undercount of cases in the
| official "confirmed" numbers. You can see the data I've collected
| here:
| https://docs.google.com/spreadsheets/d/16onEUBWIV5IqN1RCvTla...
| joe_the_user wrote:
| Your sheet is interesting. Looking at it, the IFR varies from
| 1.66% down to .11% and the 0.11% is for the Santa Clara, which
| many considered rather suspect.
|
| The 1.66%, otoh, seems reasonably in line or at least
| compatible with what's been observed in Korea and elsewhere.
|
| Given age is going to skew things a good deal, it seems like a
| picture is emerging but not that new a picture. An IFR of even
| 1% is pretty bad, especially given these statistics show how
| infectious this virus is.
| gst wrote:
| The numbers that are quoted for Austria (which has the listed
| IFR of 1.66% in the document) weren't obtained via antibody
| tests, but via PCR tests. Here's a better source than the one
| linked in the document: https://www.sora.at/uploads/media/Aus
| tria_COVID-19_Prevalenc...
|
| Most of those tests were done on April 4th and 5th which was
| 3 weeks after Austria started relatively strict lockdown
| measures, which also impacts that number, as this will result
| in the test to find an even lower number of positive people.
| newacct583 wrote:
| > An IFR of even 1% is pretty bad
|
| To be clear: it would be the most dangerous general epidemic
| disease since the advent of vaccination, and by a significant
| amount. You need to go back to measles and polio to find
| general population outbreaks that were more lethal.
| bb2018 wrote:
| I think antibody tests will soon become more useful for
| tracking disease progression in a population than the viral
| tests. The collection methods may skew things but they still
| are much more close to a random sample than the viral tests
| which have lots of issues with test shortages and people unable
| to get tested (or not wanting to go to the hospital with mild
| symptoms).
| garmaine wrote:
| They have huge false positive rates though.
| ptrincr wrote:
| Not sure why you are being downvoted:
|
| https://www.oxfordbiosystems.com/COVID-19-Rapid-test
|
| "In order to test the detection sensitivity and specificity
| of the COVID-19 IgG-IgM combined antibody test, blood
| samples were collected from COVID-19 patients from multiple
| hospitals and Chinese CDC laboratories. The tests were done
| separately at each site. A total of 525 cases were tested:
| 397 (positive) clinically confirmed (including PCR test)
| SARS-CoV-2-infected patients and 128 non- SARS-
| CoV-2-infected patients (128 negative). The testing results
| of vein blood without viral inactivation were summarized in
| the Table 1. Of the 397 blood samples from SARS-
| CoV-2-infected patients, 352 tested positive, resulting in
| a sensitivity of 88.66%. Twelve of the blood samples from
| the 128 non-SARS-CoV-2 infection patients tested positive,
| generating a specificity of 90.63%."
|
| That gives us 62% false positive ratio according to (where
| a study finds the prevalence to be 6% of subjects using the
| test):
|
| http://vassarstats.net/clin2.html
|
| In some cases we have research being carried out with such
| low positive results that they can entirely be accounted
| for by the low specificity. So for example if you took
| samples from 100 people, based on 90% specificity, even if
| everyone had never had corona, 10 could be found positive.
|
| Credit to this post:
|
| https://old.reddit.com/r/COVID19/comments/g7f373/second_rou
| n...
|
| However it should be noted the article in question for this
| submission does not mention the type of test used.
| raverbashing wrote:
| I wonder what's the process through which false positives
| happen in this case. Previous infection by milder
| Coronaviruses?
|
| Edit: I'm looking at the reddit post but I have a lot of
| reservations with the "prevalence 0.06", unless we'll use
| the test to test absolutely everybody and not only people
| who are suspect. Has that calculator been validated as
| well?
|
| If the test was 12 false positives in 128 negatives, how
| come they can claim the false positive rate is 60%?
| FrojoS wrote:
| Yes. That's one possible explanation. Interestingly quite
| a lot of people might be somewhat immune to the new
| Corona virus due to anti bodies from previous Corona cold
| infections. More than 30% showed such antibodies in a
| recent study.
| https://www.finanzen.net/nachricht/aktien/drosten-
| hinweis-au... (Sorry that the only source I have ready
| right now)
| nodamage wrote:
| 60% is the probability that a particular positive test
| result is actually a false positive. It's not the overall
| the false positive rate.
| ptrincr wrote:
| Apologies for the way this was linked to. The 6% is from
| this study:
|
| https://www.miamidade.gov/releases/2020-04-24-sample-
| testing...
|
| "Our data from this week and last tell a very similar
| story. In both weeks, 6% of participants tested positive
| for COVID-19 antibodies, which equates to 165,000 Miami-
| Dade County residents"
|
| That is what the commentator is referring to in the
| linked post.
|
| So if you plug their own figures into the calculator:
|
| Sensitivity .8866 Specificity .9063
|
| and a Prevalence of .06 based on the study, you get the
| 62% false positive rate.
|
| As the prevalence increases, as with the NYC study which
| found the positive rate to be 21% (prevalence), the false
| positive rate decreases, down to 28% of the NYC study.
| [deleted]
| [deleted]
| timr wrote:
| There are many different tests, from different
| manufacturers. Some of the tests have higher false-positive
| rates than others. Some have higher false-negative rates.
| Even a survey with an imperfect test can be designed to
| yield reliable data.
| taeric wrote:
| Do we know the rates already?
| amluto wrote:
| There's preliminary data:
| https://covidtestingproject.org/
| [deleted]
| danielfoster wrote:
| And false negatives.
| brm wrote:
| Only until the point that they don't. Unfortunately that
| requires a lot more people to have had covid...
| buboard wrote:
| i don't understand the value of this multiplier. Case
| statistics are not an official census, it's incidental ,
| depending on the criteria with which each region makes tests.
| Case numbers are unimportant, it's the total infections and
| consequent deaths that matter
| SpicyLemonZest wrote:
| You're probably right that they _shouldn 't_ be, but case
| statistics are regularly treated as an official census. I've
| seen many news articles in the vein that suchandsuch country
| is handling it better or worse because of their case numbers,
| or statistics like CFR that are computed from official case
| numbers.
| buboard wrote:
| while the absolute value doesn't matter, its time course is
| mostly representative , because countries rarely change
| strategies wrt testing.
| SpicyLemonZest wrote:
| That just doesn't seem true. In the US testing strategies
| are rapidly changing, since health officials indicate
| this will be essential to safely removing restrictions.
| skybrian wrote:
| I wonder which tests they used? A recent study is finding that
| some antibody tests are much better than others when it comes
| to false positives:
|
| https://tildes.net/~health.coronavirus/o6a/coronavirus_antib...
| marcell wrote:
| I know that the California studies used the same test kit. It
| had 2 false positives out of 371 samples of pre-covid19
| cases, and has a 10-20% false negative rate. Because the case
| numbers are so small, the false positives can skew things
| quite a bit. I took the midpoints of their 95% confidence
| intervals in the spreadsheet.
|
| I don't know what tests the other studies used.
| DanBC wrote:
| What numbers are you using for sensitivity and specificity?
| marcell wrote:
| It depends on the study, I've been using their reported
| confidence intervals. The two California studies (Santa Clara
| and Los Angeles) used the same kit, which has 2 false
| positives of 371 tests, and 10-20% false negative rate.
| nodamage wrote:
| It's worth noting that is the manufacturer claim but has
| not held up to independent validation.
|
| Specifically, the Premier Biotech/Hangzhou Biotest Biotech
| test was validated by a Chinese provincial CDC and found 4
| false positives out of 150. [1]
|
| It was also validated by the COVID-19 Testing project and
| found 3 false positives out of 108. [2]
|
| The Biomedomics test used in the Miami Dade study was also
| validated by the COVID-19 Testing Project and found 14
| false positives out of 107. [2]
|
| Hence I would recommend taking the results of the
| California and Florida studies with a huge grain of salt as
| the prevalence rates they found were within the false
| positive rates of the tests used.
|
| [1] https://imgcdn.mckesson.com/CumulusWeb/Click_and_learn/
| COVID...
|
| [2] https://covidtestingproject.org/
| jMyles wrote:
| Here's a similar spreadsheet, with less detail but more
| studies:
|
| https://www.reddit.com/r/LockdownSkepticism/comments/g6eqtt/...
|
| It may be helpful to you.
|
| Thank you for tracking these metrics.
| cies wrote:
| I did similar calculations, and found the institutions in
| charge give us very unreliable data. The term "corona case" is
| very, very, ambiguous and cannot the understood as such without
| a detailed explanation on how the counting was done.
|
| Thanks for sharing.
|
| I found the peek in all-case mortality also very interesting,
| because that way counting is much more unambiguous: dead is
| dead.
|
| They showed a clear diversion from the "average" in recent
| weeks, but... they did not show the stdev for the averages.
| Finally I found a chart that shows that "outliers" are not
| uncommon.
|
| https://imgur.com/IPNiXRe
| marcell wrote:
| Yea, I agree that the case counts are very different between
| regions. I think the more interesting column is the IFR
| estimate based on the antibody study results, since dead is
| dead as you say.
|
| It is interesting though that the median undercount is
| converging to ~10-20x. Perhaps the protocols across regions
| are similar enough that the confirmed case counts are
| somewhat comparable.
| rjtavares wrote:
| Outliers such as this one are not uncommon in the winter.
| They are in April. According to that chart there isn't a
| single point outside of winter months as high as this year.
| cies wrote:
| Maybe because its new and hit late winter?
| FrojoS wrote:
| Is this for the US? Do you have a link for the source?
| cies wrote:
| the chart is from ft.com, the news paper
| bobongo wrote:
| > because that way counting is much more unambiguous: dead is
| dead
|
| Unrealistically low death stats coming from Turkey compared
| to cases easily refute that argument.
|
| Dead is dead, unless the state finds a way to claim that it
| was not a COVID19 dead.
| gaius_baltar wrote:
| > Dead is dead, unless the state finds a way to claim that
| it was not a COVID19 dead.
|
| It's just a matter of demanding tests to declare as a COVID
| death and do not providing enough tests.
|
| Brazil, for example, has an artificially low count of cases
| due to the lack of tests and a similarly low number of
| deaths. However, cases of death by "pneumonia", generic
| types of SARS and "unexplained respiratory diseases"
| skyrocketed:
| https://oglobo.globo.com/sociedade/coronavirus/alem-da-
| covid...
| lostlogin wrote:
| This has occurred in many countries and will presumably
| be part of way the final impact is finally measured. http
| s://www.nytimes.com/interactive/2020/04/21/world/coronav.
| ..
| snovv_crash wrote:
| Or the other way around, someone who dies in a car crash
| but tests positive could count as a COVID death.
| asveikau wrote:
| I would add that it doesn't have to be a malicious
| government purposefully undercounting. It's very easy to
| undercount or misdiagnose even with competent and well
| meaning people. Specifically every pneumonia death, heart
| attack, stroke is a potential undercount, and people aren't
| "bad people" or evil for making the wrong conclusion about
| the ultimate cause, especially when testing is less
| available and frequent than it should be. Also I have heard
| that there are a significant number of people dying of
| COVID19 in their homes and that those are more likely to be
| undercounted vs. a death in a hospital.
| krisoft wrote:
| No. Not unless. You misunderstand what all cause mortality
| means. The state can count COVID19 deaths as all bungee-
| jumping related the number still shows up in the total
| death rate. If you know what is the usual statistic you can
| show if there is an effect.
|
| This is what "dead is dead" mean. One can argue what should
| count as a COVID19 case, and how exactly we are counting.
| There is a lot less argument over who is dead and who is
| not.
| cies wrote:
| I said "dead is dead" in relation to all cause (not "only
| covid") mortality figures.
| [deleted]
| kortex wrote:
| Maybe we can institute a work-recovery program where inmates can
| do high-exposure work (once they are truly recovered). give them
| experience and a feeling of duty and purpose.
|
| Nah, they'll probably just keep using em for slave labor.
| BurningFrog wrote:
| Two questions:
|
| 1. How good is this test? Maybe people have no symptoms because
| the test is wrong?
|
| 2. Is there some reason prisoners would deny having symptoms even
| if the did?
| OrgNet wrote:
| I wish I could get an anti-body test done because I had flu-like
| symptoms before any tests were available
| adamnemecek wrote:
| No, they will develop symptoms. Test again in two weeks.
| DoreenMichele wrote:
| I'm in a high risk category with an incurable respiratory
| condition. I'm convinced I've already had it and I'm mostly
| recovered now.
|
| I was mostly asymptomatic. The biggest thing going on was that
| I was very tired, which was also something easily explained by
| other things going on, so I was basically already on the mend
| before I concluded I must have had it.
|
| I believe we are barking up the wrong tree. We are looking for
| respiratory distress because it leads to low oxygen levels. I
| think we need to be looking more at what it does to the blood.
| Fortunately, some doctors are looking in that direction, but I
| think not enough, probably.
|
| My symptoms were similar to anemia. It's easily missed because
| you mostly lack energy.
|
| Again, there can be lots of reasons a person has low energy. It
| can be quite hard to say "Clearly, this symptom is indicative
| of Coronavirus."
|
| So I suspect a lot of people will never be overtly symptomatic
| in the ways the world is looking for with its huge focus on
| lung issues.
| [deleted]
| nradov wrote:
| Doctors are already seeing blood clots in many COVID-19
| patients. Strokes, heart attacks, and pulmonary embolisms
| appear to be much more common than with other forms of viral
| pneumonia. Some hospitals have incorporated blood thinners
| into their treatment protocols.
| DoreenMichele wrote:
| Yeah, I'm aware. For example:
| https://news.ycombinator.com/item?id=22883260
|
| I also had an interesting discussion with someone who is
| apparently some kind of medical researcher about zinc and
| blood stuff. This was very helpful to me and my sons in
| trying to recover our energy levels, which also firms up my
| suspicions that a. we had the infection and b. my mental
| models are less wrong than some of what is out there.
| jwlake wrote:
| One of the super-interesting things here, is that apparently
| everyone was in the specific window where they test positive for
| the virus. This implies the population was recently infected, had
| not been previously infected, and it spread almost completely
| within a tight window.
|
| This implies a shocking high R(effective) for that population. In
| 2 weeks we'll have super interesting data one way of the other on
| the CFR.
| Retric wrote:
| Covid-19 fatalities takes up to 2 months after infection.
| hartator wrote:
| Median of 10 days though.
| Retric wrote:
| Numbers I have seen where median 5.1 days from exposure to
| first symptoms and a median of 8 days from first symptoms
| to death in Italy. So, a median of ~2 weeks from exposure
| to death. https://hub.jhu.edu/2020/03/09/coronavirus-
| incubation-period... https://www.lastampa.it/esteri/la-
| stampa-in-english/2020/03/...
|
| However, early estimates are going to be biased without the
| slowest fatalities. Further, that's also population
| specific.
| MrPatan wrote:
| Exactly! What are the chances of that, compared to a gross
| error in the testing, like someone processing the samples was
| infected and not very careful?
| lettergram wrote:
| People can test positive and are most contagious before they show
| symptoms. As opposed to influenza where people with symptoms are
| most contagious. The delay in the onset of symptoms is why this
| is a very difficult virus to contain.
|
| Further, the accuracy of our tests is questionable and hopefully
| improving.
|
| Finally, viral shedding has been seen up to 35+ days since
| symptom onset. Meaning if they showed symptoms a month ago, they
| may still test positive.
|
| https://www.aarp.org/health/conditions-treatments/info-2020/...
| jessaustin wrote:
| Our prisons do not reduce crime. All of these people should have
| been released months ago.
|
| [EDIT:] Apparently these propositions are not self-evident to all
| HN downvoters. They follow directly from several other
| propositions that really should be obvious. USA imprisons vastly
| higher percentages of its population than other nations. Yet it
| still has higher crime than those other nations. QED.
|
| [EDIT:] 'thendrill you appear to be hellbanned.
| thendrill wrote:
| You have to keep in mind that the majority of HN are Pc-babies
| working in IT.
|
| Basically nerds and useful idiots with hi iq...
| pcdoodle wrote:
| Hope they didn't give them the batch that arstechnica reported
| contaminated.
| kgin wrote:
| Alone, this doesn't show anything. But following this population
| for 3 weeks should tell us a alot.
| nodesocket wrote:
| Isn't this a bit of promising news, means herd immunity is
| probably much deeper and larger than we are currently aware.
| esoterica wrote:
| NYC shows that you will end up with probably 0.3% or more of
| the population dead before you get herd immunity. 0.3% of the
| entire US population is 1 million people.
| MikeAmelung wrote:
| How many of those overlap with the 3 million people that are
| going to die in the US this year anyway?
| DanBC wrote:
| WHO says we can't assume previous infection means future
| immunity.
|
| https://www.who.int/news-room/commentaries/detail/immunity-p...
| SpicyLemonZest wrote:
| The WHO says that we can't assume someone is 100% guaranteed
| to be immune when they have antibodies. That's true, and it's
| an important flaw in the idea of immunity passports that
| they're tackling - you couldn't send people with immunity
| passports into quarantined nursing homes or allow them to
| attend potential superspreading events.
|
| Herd immunity doesn't require perfect immunity or a 100%
| guarantee of it. No reasonable expert doubts that herd
| immunity is possible, although some argue it's too costly.
| TallGuyShort wrote:
| You _can_ be reinfected. It sounds like there 's already some
| evidence suggesting that reinfection is at least
| significantly less likely than initial infection.
| nodesocket wrote:
| Not sure why I am getting downvoted, I guess covid-19 shaming
| is a thing. From what I've read people who appear to get it
| again is actually just a relapse of the original
| infection[1].
|
| [1] https://thehill.com/changing-america/well-
| being/prevention-c...
| cm2187 wrote:
| I must say that for a community of rather technical people
| when not scientists and engineers, hackernews has a
| surprisingly high level of FUD-pushers and doomers on that
| topic. I put that on account of anxiety.
| [deleted]
| badfrog wrote:
| The key part of that press release is:
|
| > As of 24 April 2020, no study has evaluated whether the
| presence of antibodies to SARS-CoV-2 confers immunity to
| subsequent infection by this virus in humans.
|
| The most likely thing is that it does mean immunity, but the
| WHO isn't going to say that without clear evidence.
| drstewart wrote:
| That doesn't mean it doesn't, it just means it isn't
| scientifically proven yet.
| theferalrobot wrote:
| No-one is assuming - we are weighing evidence and there is
| far more evidence that it does provide at least some immunity
| than none - it seems oddly disingenuous of WHO to make
| statements like this because they know how it will be
| interpreted.
| azakai wrote:
| It doesn't appear to mention what type of test was done. Were
| they checking for current active infection, or for antibodies
| which would indicate if the person has ever been infected? (if
| the latter, they may have had symptoms back then)
| ImaCake wrote:
| I am not willing to even consider these results until more
| details about testing are revealed. There has already been so
| much misinformation about testing and results that I am
| incredibly skeptical of any results now.
| JoeAltmaier wrote:
| Lets not get too excited about this. Whatever the numbers, that's
| interesting and worth recording for planning. But whatever they
| are, they result in "way too many deaths". This is still a very
| dangerous and rapidly-spreading virus.
| partiallypro wrote:
| I think the hope is that we could be closer to herd immunity
| than we think.
| the8472 wrote:
| Any herd immunity scenario is conditionnal on immunity is
| long-lasting, which is far from certain considering related
| viruses are recurring seasonally or in single-digit year
| intervals.
|
| Don't bet the farm on it.
| nradov wrote:
| Even if infection doesn't confer permanent total immunity,
| subsequent reinfections are likely to be less severe as the
| immune system is primed to respond. So herd immunity is
| still a viable strategy.
| FrojoS wrote:
| Maybe, but this particular virus is believed to not mutate
| much.
| k2enemy wrote:
| Where is the cutoff between "way too many deaths" and not too
| many deaths? I don't mean to be glib, but it is an important
| question that needs to be weighed against destroying all of our
| economic institutions.
| tempestn wrote:
| Yeah, one leap I often see made is, say a study shows "only" a
| 0.5% case fatality rate, about 5x as bad as an average flu.
| It's natural from there to then think letting it run unchecked
| would only be about 5x as bad as a flu. Very bad, certainly,
| but perhaps manageable. But that ignores the fact that there is
| a flu vaccine, and even without one the natural rate of spread
| of the flu is lower than this virus. So without measures, many
| more people would be infected and so it would be much worse
| than 5x an average flu, even if the CFR is indeed 0.5% (for
| example).
|
| Of course, that doesn't mean these numbers aren't useful for
| planning and determining what degree of intervention is
| warranted, as you say.
|
| Edit: could one of those down-voting explain? If I'm making a
| mistake here I'd like to understand it.
| kensai wrote:
| Ioannidis was right all along.
| 8note wrote:
| From what I can tell, this makes a strong suggestion that were
| much further through infecting the whole population than we
| think.
|
| Anyone with some bayesian ideas on by how much?
| crazygringo wrote:
| Every article I see about people testing asymptomatic is followed
| by comments insisting they were asymptomatic _when tested_ , with
| no idea of whether they _stayed_ asymptomatic or whether
| virtually all of them had symptoms a few days later, thus
| basically invalid.
|
| But this _doesn 't seem like a hard problem to solve, folks_. Is
| nobody bothering to _follow up_ with the asymptomatic people a
| week later? Just take their mobile phone number, and text them en
| masse with a quick Y /N question as to whether or not they got
| sick?
|
| This stuff _baffles_ me. This is literally a matter of life-and-
| death, and yet the most basic questions seem to be unanswered.
| (Or are these follow-up surveys being done but the media just
| refuses to report them because it now feels like week-old news? I
| 'd love to know.)
| nradov wrote:
| The USS Theodore Roosevelt situation was discussed here several
| days ago. At this time about 60% of the crew who tested
| positive are still asymptomatic. Enough time has passed that we
| can be confident they aren't just presymptomatic. Numbers are
| pretty solid since they were all quarantined and tracked.
| Infection fatality rate was about 0.1%, however that's probably
| not representative of the general population.
| edmundsauto wrote:
| Also, how should we weight the validity of the data, given
| the political leadership issues surrounding this situation.
| vosper wrote:
| > Just take their mobile phone number, and text them en masse
| with a quick Y/N question as to whether or not they got sick?
|
| I've been wondering why this isn't just being done for everyone
| in the country, every few days?
|
| "The main symptoms of COVID-19 are X, Y, Z. If you think you
| may have COVID-19 please respond "Yes" to this text message.
| This is free. Your response is private and used to understand
| the spread of COVID-19 in our country. Please visit
| http://some.link for more information"
|
| If someone responds "yes" you could follow up with some more
| questions, if that was useful. And then text them a few days
| later to see if they're feeling better or worse, or maybe ask
| them to describe how they feel.
|
| There are lots of problems with this idea: people lying or not
| taking it seriously; people not responding; not everyone has a
| cellphone; some people will be worried about privacy, etc
| etc...
|
| But surely there'd be something useful to learn from it? And it
| seems like it should be easy to do, really, if you got the
| mobile providers on board (or just order them to help).
| alexis_fr wrote:
| Do you even need to be an official to do that? Perhaps a
| newspaper could do it, to accurate news.
| jariel wrote:
| It's truly disorienting.
|
| We need good data, badly, and we have an entire world as our
| Petree dish and yet can't seem to get it.
|
| You'd think the CDC would be sending out questionnaires, forms,
| coordinating such tests, giving guidelines, collating results
| etc..
|
| Literally the worst economic shock maybe ever and we can't
| count marbles to save ourselves.
| lukevdp wrote:
| Yes, one study when the diamond princess was tested it was
| originally 50% asymptomatic and then later on that had gone
| down to under 20%
| graeme wrote:
| A lot of the asymptomatic cases had pneumonia in their lungs
| too. They were however still able to expel CO2 and so did't
| feel shortness of breath.
| randyrand wrote:
| Do states have an legal obligation to prevent the spread of
| disease in prisons? It seems like prison does not provide enough
| space to stop people from dying from diseases.
|
| I wonder if you can sue.
| vrtx0 wrote:
| I posted the following comment on a very similar Reuters article
| about asymptomatic rates on an aircraft carrier 8 days ago (on a
| Friday):
|
| - - IMHO, this article is intentionally misleading. The
| incubation period is currently estimated to be 2-14 days (mean is
| 5.6 days per CDC, similar per WHO). The article doesn't mention
| any dates or time frames, but does mention: "Roughly 60 percent
| of the over 600 sailors who tested positive so far have not shown
| symptoms of COVID-19" -- note how "so far" is ambiguous in that
| sentence. It also states, "The Navy's testing of the entire
| 4,800-member crew of the aircraft carrier - which is about 94%
| complete...", which seems to indicate nowhere near enough time
| has elapsed to draw any sort of conclusion. This paper [1] found
| that testing of all pregnancy patients in a hospital yielded 34%
| asymptomatic cases. That number drops to 8% "shortly after
| discharge", and could be lower than 8% (Again, no timeframe is
| stated). [1]
| https://www.sciencedirect.com/science/article/pii/S258993332... -
| -
|
| If you just s/navy/prisons/ and s/[navy figures]/[prison figures]
| (and forgive my oversimplification of RegEx captures), I think
| that comment works just as well here.
|
| At the risk of sounding paranoid, does this seem like a campaign
| of misinformation by omission? Or perhaps I'm being overly
| critical?
|
| The key issue I take with both articles is that they speculate _a
| lot_ , but gloss over the fact that no timeframes are provided to
| determine what percentage could actually be asymptomatic and
| never develop symptoms vs. simply being pre-symptomatic at the
| time of testing.
|
| If the article were focused on how quickly this virus can spread
| in closed quarters, that would be one thing. But this rather
| lengthy article only has one sentence in the middle that even
| mentions asymptomatic cases eventually developing symptoms:
|
| "Some people diagnosed as asymptomatic when tested for the
| coronavirus, however, may go on to develop symptoms later,
| according to researchers."
|
| Also, this article mentions testing asymptomatic prisoners
| (universal testing), but it doesn't say why these specific
| prisons where chosen first. Perhaps some had at least one
| positive test result? If so, wouldn't the close quarters explain
| most of the relatively high rates of asymptomatic positives
| reported, given the (initially) exponential curve of spread over
| time?
| mkagenius wrote:
| The test seems so freaking flawed to me, if you test isolated ISS
| astronauts, you would get half of them infected. Or probably
| aliens are infected too. Maybe some people who are dead for
| million years are infected as well. No one freaking talks about
| the test being flawed (rtpcr).
| booboolayla wrote:
| You can almost see the pain in 50% of comments here - it's almost
| like their pet disease might not last until November elections!
| w3mmpp wrote:
| > by throwaway888abc
|
| Pretty funny, good enough for reuters but not for HN it seems...
| codecamper wrote:
| I've read there are over 10,000 strains of the virus, some more
| deadly than others!
| https://www.scmp.com/news/china/science/article/3080771/coro...
| stevespang wrote:
| "The United States has more people behind bars than any other
| nation, a total incarcerated population of nearly 2.3 million as
| of 2017 -- nearly half of which is in state prisons. Smaller
| numbers are locked in federal prisons and local jails, which
| typically hold people for relatively short periods as they await
| trial."
|
| More than N.Korea, Myanmar, Communist China, Russia, you name it.
| "LAND OF THE FREE !"
| konschubert wrote:
| One potential cause: We habe hints now (Charite Study) that
| previous infections with other, less harmful corona viruses may
| provide some degree of immunity (unconfirmed).
|
| Maybe one or more these other coronaviruses made rounds in this
| prison earlier this year?
| H8crilA wrote:
| This is actually not such a bad thing. It means that the true
| case rate is much much higher, and thus the true fatality rate is
| much much lower.
| bobongo wrote:
| HN seems to have forgotten what happened in Wuhan, Bergamo, and
| New York in its newfound polemic of "the death rate is just like
| that of the flu" in the comments of the recent headlines.
|
| Either this is actually HN's denial of what's going on, or we are
| witnessing paid shills overwhelming actual users in the number of
| comments and votes.
| srl wrote:
| Paid by who? Your comment would be much more interesting if you
| implied something concrete, instead of the more common (and
| boring) "people who disagree with me must be paid off by ...
| someone".
| empath75 wrote:
| The nature of exponential growth is such that no matter when you
| test, 50% will have gotten it within the last doubling period. If
| it's doubling every three days, half have caught it in the last 3
| days, 75% in the last 6 days, 86% in the last 9 and so on. Given
| the long incubation period it makes sense that the vast majority
| are currently asymptomatic. I think that will be the case at
| every point during exponential growth, even if the ultimates
| fatality rate is quite high.
| Brendinooo wrote:
| I don't know a lot about the antibody tests. Is the novel
| coronavirus novel enough that they know exactly the kind they're
| testing? Is it a specific test for SARS-CoV-2?
| FabHK wrote:
| There are many antibody tests. The one I've read about (from
| the Charite in Berlin) was designed (or found) to also test
| positive for the "original" SARS, and for very closely related
| bat viruses (neither of which should present an issue when
| testing humans today), but not for other corona viruses (such
| as the common cold etc.).
|
| That test has also very carefully been validated, with
| excellent sensitivity (=few false negatives) and specificity
| (=few false positives). Not sure all available tests have gone
| through quite so thorough validation.
| maxerickson wrote:
| The Ohio prison system is probably testing for the presence of
| the SARS-CoV-2 virus, not antibodies. That testing is specific
| to the virus (the type of test can respond to multiple viruses,
| but being specific to the target is one of the design
| criteria).
|
| An antibody test should also generally be well targeted.
| creddit wrote:
| I'd guess smoking rates are very high in prisons. It seems
| smokers (even former) are much better off than non-smokers.
| hkeide wrote:
| That's the opposite of everything I've read
| frereubu wrote:
| I think they're referring to this:
| https://www.theguardian.com/world/2020/apr/22/french-
| study-s...
|
| The idea is that nicotine may lower your chances of
| infection, but once established I imagine that smoking will
| definitely reduce your chances of survival.
| samatman wrote:
| Well, it lowers your chance of being listed as an infected
| person.
|
| Presuming this is true (lots of evidence but still much too
| early to be sure), there's two possibilities: nicotine
| makes a person less likely to be infected, or nicotine
| makes it less likely that the infected will develop any
| symptoms. No symptoms, no test, that's been the rule until
| quite recently.
|
| If it's the latter, it could explain what's going on here.
| I doubt that's the explanation, but it's possible.
| creddit wrote:
| There seems to be a reasonable path to effect regarding
| regulation of ACE2 which is the primary receptor molecule
| for COVID.
|
| https://www.qeios.com/read/article/571
| macromagnon wrote:
| Smoking weakens your heart and lungs (and probably doesn't help
| high blood pressure) so what makes you say that?
| creddit wrote:
| https://www.theguardian.com/world/2020/apr/22/french-
| study-s...
|
| https://www.qeios.com/read/article/571
| MrPatan wrote:
| Does anybody know the false positive rate of the test?
|
| Could this be an artifact of that plus low actual incidence like:
|
| - False positive rate of 10%
|
| - 100 tests
|
| - 1 true positives. All with symptoms
|
| - 9 false positives. All without symptoms (duh!)
|
| Headline: "90% asymptomatic!"
|
| Truth: "Shitty test procedure!"
|
| Yes, yes, I know you know this. Do you think people doing tests
| and writing headlines know this?
|
| What is the false positive rate?
| hutzlibu wrote:
| " Do you think people doing tests know this?"
|
| Probably.
|
| " Do you think people writing headlines know this?"
|
| Maybe, but unlikely that they care, if the result is a flashing
| headline.
| FabHK wrote:
| No, that can't be the case here, because a shockingly large
| proportion of people tested positive according to the article.
| (Thus, either the false positives are negligible, or the test
| employed has a an astronomical false positive rate (bad
| specificity)).
| MrPatan wrote:
| You're right, they get a positive result for almost all the
| population!
|
| Wait, does that pass the smell test? Do prisions become huge
| flu hotspots as well? The Diamond Princess outbreak didn't
| have that kind of numbers... What's more likely at this
| point, the numbers from the article or human error?
|
| My respects to anybody trying to do actual science with this
| kind of data in this kind of situation...
| SpicyLemonZest wrote:
| Not quite _this_ huge, but then again states generally try
| to get them flu vaccines. It 's reasonably common for
| prisons to enact emergency measures to stop the spread of
| the flu.
| samatman wrote:
| Right, it could literally be as dumb as: all the tests were
| processed by one person, and that person is infected with
| covid-19.
|
| Drawing signal out of the noise right now is very, very
| difficult.
| vanniv wrote:
| A cruise ship under quarantine is dramatically more
| socially isolating than a prison.
|
| You would expect spread to be absurdly more efficient in a
| prison. Less physical separation, less hygiene, less
| everything.
| Pfhreak wrote:
| Densely crowded environment where people were unlikely to
| maintain social distancing, poor quality health care,
| probably poor quality sanitation. It seems reasonable to me
| that a prison would fare worse than a cruise ship.
| DoreenMichele wrote:
| It's a prison population. Prisons and nursing homes are both
| seeing shockingly high infection rates because of the nature of
| what they do, which involves confining groups of people in
| close quarters.
|
| People in nursing homes are elderly. Lots are dying.
|
| People in prison aren't uniformly elderly. You are bound to see
| more variation in symptoms.
|
| (Plus, as stated elsewhere, the opinions and experiences of
| known criminals tend to get discounted, so the report of lack
| of symptoms may be more about that than about the general
| resilience of the population. Also also: It's well established
| that if you ignore, dismiss and neglect someone enough, they
| stop complaining because they know it doesn't do any good. Aka
| _learned helplessness._ )
| [deleted]
| cwillu wrote:
| > They started with the Marion Correctional Institution, which
| houses 2,500 prisoners in north central Ohio, many of them
| older with pre-existing health conditions. After testing 2,300
| inmates for the coronavirus, they were shocked. Of the 2,028
| who tested positive, close to 95% had no symptoms.
| cwillu wrote:
| The article almost seems to be making a point of not putting
| all the needed numbers together for any given population that
| they talk about though.
| jfasi wrote:
| This is the relevant response. What the commenter is trying
| to imply is that the authors of this study are so
| staggeringly stupid that they overlooked the possibility of
| false positives when designing this experiment.
|
| In reality, this test would need a false positive rate of
| over eighty percent to explain this kind of asymptomatic
| infection rate.
|
| Also, prisons are useful because due to the close quarters it
| can be taken as a given that a substantial proportion of the
| population is infected, further minimizing the danger of
| these sorts of errors. The choice of population suggests a
| sophisticated experiment design, and the commenter is
| implying that the study authors made a statistics 101-level
| error.
| MrPatan wrote:
| As someone else has said on another comment, it just needs
| the experimenter to be infected and a bit careless, and
| there is your high percentage of positive results.
|
| Plus yeah, to be honest, you dismiss staggering stupidity
| leading to juicy headlines at your own risk.
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