Slitherine

quote:

ORIGINAL: Orm

I find it funny that Sweden both manage to get criticism for to harsh measures, and to lax measures.

quote:

ORIGINAL: geofflambert

Not knowing is a problem. Not testing is not an answer to that problem. Random testing could at least provide us with scientific wild-ass guesses but we're not even doing that. The testing we are doing is ad hoc and incomplete. New York recently added thousands of deaths as being "likely" related to the coronavirus. "Flattening the curve" buys us time, but only if we actually do something with that time, like produce more tests by a factor of 1,000 or more. Just waiting until everyone eventually is infected and the survivors may or may not be immune before we start the world turning again is not an answer. If you're telling me that we just can't test everyone, you're telling me we didn't vaccinate virtually everyone against smallpox or that we really didn't almost eliminate polio. When we go to our doctors our medical record is checked to make sure our vaccinations are up-top-date. We regularly get tested for things like colon polyps and prostate problems. This will all get to be routine eventually. The problem we have to fix is getting to where it's routine sooner, way sooner than we're going at the current pace. We need to get to the place where any doctor anywhere can order tests and get them in a timely fashion from LabCorp or wherever. Diagnosis ---> treatment. Modellers are trying to model what is actually happening. Critics are checking that modelling against invalid data. What's the use in that?

quote:

ORIGINAL: Cap Mandrake

quote:

ORIGINAL: Alfred


When this period is calmly assessed in the future, I think you will find a timeline which shows that all the Western governments relied very much on the WHO advice that there was no evidence existed for human to human transmission. Without that particular transmission mechanism, the very costly to society steps since implemented could not be justified.

There is a vert strong argument to be made that the reason why countries like Taiwan and South Korea have done comparatively better than the West is because at no stage did they pay any attention to what WHO said. Having directly experienced the earlier pandemics which originated in China, immediately they heard of the situation in Wuhan, they activated their pandemic plans which had been developed in response to those earlier pandemics.

Alfred

Agreed. The January 14 pronouncement by the WHO that there was "no clear case for human to human transmission" is the worst scientific advice of the 21st century (so far). The only question in my mind is, was it simply scientific caution or was the WHO leadership coddling China? The evidence for the latter is very strong. There were several cases of severe pneumonia among doctors and nurses in Wuhan IN LATE DECEMBER. They had cared for the same type of patients AND they had no connection to the Wuhan wet market. This should have set off alarm bells in the WHO but it seems the Chicoms were not being totally honest. I'm shocked I tell you! Even so, the locals had ALL figured it out.

The Taiwanese clearly have not the slightest concern about hurting Beijing's feelings. They have extensive business with PRC (Foxcom for example) but they have a tripwire mentality regarding potential epidemics or a Chicom attack. They also had already identified the WHO head as a Beijing call girl well before COVID.

In order for containment to work...there needed to be a total, universal ban on flights from China by early January. The thermometer check at the airport thing was complete bullshit.

quote:

ORIGINAL: Alfred


Cap Mandrake,

I think you will find this recent report

https://henryjacksonsociety.org/wp-content/uploads/2020/04/Coronavirus-Compensation.pdf

very illuminating. It provides a detailed timeline of all the actions taken by the Chinese authorities to cover up their culpability and the gullibility of the WHO. Also detailed is how the UK's special committee (Nervtag) tasked with providing advice to the Chief Medical Officer and ultimately to the UK Department of Health and Social Care was misled to provide poor advice throughout January 2020. Quite a different perspective from the salacious charges made against the UK government by the Sunday Times.

The study concludes that China was in clear breach of its legal responsibilities under the 2005 International Health Regulations.

Alfred

quote:


2 January 41 new cases confirmed on this date at one Wuhan hospital were
reported to include 27 patients who had been to the Huanan Market,
while the rest had not.

quote:

ORIGINAL: Alfred

It provides a detailed timeline of all the actions taken by the Chinese authorities to cover up their culpability and the gullibility of the WHO.

quote:

ORIGINAL: Cap Mandrake

quote:

ORIGINAL: Alfred


Cap Mandrake,

I think you will find this recent report

https://henryjacksonsociety.org/wp-content/uploads/2020/04/Coronavirus-Compensation.pdf

very illuminating. It provides a detailed timeline of all the actions taken by the Chinese authorities to cover up their culpability and the gullibility of the WHO. Also detailed is how the UK's special committee (Nervtag) tasked with providing advice to the Chief Medical Officer and ultimately to the UK Department of Health and Social Care was misled to provide poor advice throughout January 2020. Quite a different perspective from the salacious charges made against the UK government by the Sunday Times.

The study concludes that China was in clear breach of its legal responsibilities under the 2005 International Health Regulations.

Alfred

Excellent resource! Great find.

quote:


2 January 41 new cases confirmed on this date at one Wuhan hospital were
reported to include 27 patients who had been to the Huanan Market,
while the rest had not.

That is even more compelling evidence of H2H than the case of the wife of an early victim and the healthcare workers. The authors are too kind. It seems obvious "mendacity" from the CCP by the first week of Jan.

The economic costs? Much, much higher than $4T. It's staggering. Maybe 10x higher than that.

quote:

ORIGINAL: obvert

quote:

ORIGINAL: Alfred

quote:

ORIGINAL: Chickenboy

quote:

ORIGINAL: RangerJoe

quote:

ORIGINAL: Canoerebel

Any thoughts as to why Germany's doing so well? Is it a demographic thing, a countermeasures thing, a medicine thing, a reporting thing (or more than one)?

A few weeks ago, there was news that Austria and Denmark would be easing countermeasures, starting a few days ago. I haven't seen any updates, so don't know if they postponed that action or proceeded. It'll be interesting to see how that turns out.

Culturally, the Germans are much more reserved and not into hugging acquaintances.

Meh. It's not like the Swiss are known for their ostentatious or salacious interpersonal behavior either. They're not Belgians, for goodness sake . I think it's something different than just cultural mannerisms for the German difference from the rest of continental Europe.

There are several factors in play.

1. The high number of tests allows the denominator to be larger and therefore the death rate automatically is lower.

2. Testing allows contact tracing. I don't know if Germany is specifically doing this on the quiet but in Australia testing is being used specifically for this purpose. A positive test here results in a telephone contact to every person who has been exposed to the positive testee and a determinati9on is made whether they too have to be tested. This allows for COVID-19 clusters to be identified earlier and quarantined/treated. It slows down the spread rate amongst the rest of the community.

3. There is much we don't know about this corona virus. Some experts suggest ethnicity is a factor. Certainly population density does seem to be relevant for ease of transmission. Although Germany has a population of about 84 million (about a third more than the UK, France, Italy) it is more widely dispersed. There is nothing in size comparable to London or Paris. This lower density would be particularly relevant if the virus had already arrived in Germany (and elsewhere) well before people became aware of its significance.

4. Germany is not rushing to use ventilators. It is very easy for hysterical politicians and journalists to demand more and more ventilators without admitting they are not a panacea. Firstly the recovery rate of those put onto ventilators is not good. Secondly, prolonged reliance on ventilators can easily damage the lungs permanently. Thirdly, you need trained staff to monitor and manage ventilators, who are ipso facto, not available for other tasks. Not to mention the wear and tear on such staff.

5. One can't dismiss the likelihood that Germany is using a different metric to record its statistics compared to that used by the UK, France, Italy etc. Every country is using different metrics which is the fundamental reason why all these case and death graphs provide no meaningful country on country comparison. The fact that a graph is put up by John Hopkins or anyone else, no matter how "prestigious" that institution is held to be, does not change the fact they are merely repeating whatever data is officially released by a country. There is no adjustment of data to apply a common metric. This is why China has such a low death number compared to Western countries.

Alfred

Just commented to answer this as well.

To your point #3 there has been a correlation between severe cases and blood types in Wuhan. This was discussed probably a month ago. Seems to have been lost in the shuffle for most though as in the UK and US there seems to be a more severe response in ethnic minority populations (here labelled BAME) and in the US black and brown minorities. There are also significantly different health profiles due to systematic historically related poverty of these populations, especially in the US, but not as much in the UK where these populations are also experiencing high proportional losses in health professionals especially.

I would doubt that population density is as much a factor considering the early Italian outbreak was in smaller towns and cities, but individual behavioural distance could certainly be a factor, and has been mentioned in some of the articles I've read. Germans do not move as close to speak, do not often use the kiss as a greeting, and have been in a more cold weather climate during early stages of this outbreak than Southern Europeans.

To your point #2, yes, they did not only contact tracing but islolation of contacts with monitoring, especially early. They also closed some factories where outbreaks occurred.

Here is a newer article on this I just found.
https://www.reuters.com/article/us-health-coronavirus-germany-defences-i/pass-the-salt-the-minute-details-that-helped-germany-build-virus-defences-idUSKCN21R1DB

quote:

ORIGINAL: Chickenboy

quote:

ORIGINAL: geofflambert

Not knowing is a problem. Not testing is not an answer to that problem. Random testing could at least provide us with scientific wild-ass guesses but we're not even doing that. The testing we are doing is ad hoc and incomplete. New York recently added thousands of deaths as being "likely" related to the coronavirus. "Flattening the curve" buys us time, but only if we actually do something with that time, like produce more tests by a factor of 1,000 or more. Just waiting until everyone eventually is infected and the survivors may or may not be immune before we start the world turning again is not an answer. If you're telling me that we just can't test everyone, you're telling me we didn't vaccinate virtually everyone against smallpox or that we really didn't almost eliminate polio. When we go to our doctors our medical record is checked to make sure our vaccinations are up-top-date. We regularly get tested for things like colon polyps and prostate problems. This will all get to be routine eventually. The problem we have to fix is getting to where it's routine sooner, way sooner than we're going at the current pace. We need to get to the place where any doctor anywhere can order tests and get them in a timely fashion from LabCorp or wherever. Diagnosis ---> treatment. Modellers are trying to model what is actually happening. Critics are checking that modelling against invalid data. What's the use in that?

Demanding 'more testing!' for the virus (e.g., PCR testing) from the general populace doesn't matter for stemming the epidemic curve. And (with the exception of the triage example above) it hardly matters for the clinical patient outcome.

All that aside, I do think extrapolation of 'attack rate' data can help clarify a population's probable prevalance or at least get closer to ground truth. But that sort of testing isn't being done anywhere that I can think of. But that's another post for later.

quote:

ORIGINAL: Orm

I find it funny that Sweden both manage to get criticism for to harsh measures, and to lax measures.

quote:

ORIGINAL: obvert

quote:

ORIGINAL: Chickenboy

quote:

ORIGINAL: geofflambert

Not knowing is a problem. Not testing is not an answer to that problem. Random testing could at least provide us with scientific wild-ass guesses but we're not even doing that. The testing we are doing is ad hoc and incomplete. New York recently added thousands of deaths as being "likely" related to the coronavirus. "Flattening the curve" buys us time, but only if we actually do something with that time, like produce more tests by a factor of 1,000 or more. Just waiting until everyone eventually is infected and the survivors may or may not be immune before we start the world turning again is not an answer. If you're telling me that we just can't test everyone, you're telling me we didn't vaccinate virtually everyone against smallpox or that we really didn't almost eliminate polio. When we go to our doctors our medical record is checked to make sure our vaccinations are up-top-date. We regularly get tested for things like colon polyps and prostate problems. This will all get to be routine eventually. The problem we have to fix is getting to where it's routine sooner, way sooner than we're going at the current pace. We need to get to the place where any doctor anywhere can order tests and get them in a timely fashion from LabCorp or wherever. Diagnosis ---> treatment. Modellers are trying to model what is actually happening. Critics are checking that modelling against invalid data. What's the use in that?

Demanding 'more testing!' for the virus (e.g., PCR testing) from the general populace doesn't matter for stemming the epidemic curve. And (with the exception of the triage example above) it hardly matters for the clinical patient outcome.

All that aside, I do think extrapolation of 'attack rate' data can help clarify a population's probable prevalance or at least get closer to ground truth. But that sort of testing isn't being done anywhere that I can think of. But that's another post for later.

Here is why testing is important. Asymptomatic carriers.

We make predictions about virtually everything using incomplete data. A sample size that is representative enough of a general population to "see" the infection rate on that population can help determine policy around measures to open up the economies of all of these countries. If we don't know more about actual infection rates (Ro if possible but this may not be possible to determine accurately) then we can't take useful measures.Contact tracing once cases reduce will also be needed to slow or shut down new outbreaks.

Right now countries are flattening the curve and beginning to open some parts of their cultures and workplaces.

Should all people be required to wear masks? Which masks? Only surgical? Or more?

Should all people going to work stagger travel times and work hours so that there are less in the office at any one time and less traveling at any one time?

Should restaurants and bars be allowed to reopen with some modification of existing seating or would this be both transmission ineffective and economically difficult (fewer patrons)?

Should schools open as normal or stage weeks for different ages to reduce numbers in the building?

Should all healthcare workers be tested regularly, like each week, to protect them from developing a severe infection?

I can't see any reason why extensive testing would not be an essential part of opening up any country or region after the case curve has lessened to the point reopening is being considered.

quote:

ORIGINAL: Alfred

quote:

ORIGINAL: Cap Mandrake

quote:

ORIGINAL: Alfred


When this period is calmly assessed in the future, I think you will find a timeline which shows that all the Western governments relied very much on the WHO advice that there was no evidence existed for human to human transmission. Without that particular transmission mechanism, the very costly to society steps since implemented could not be justified.

There is a vert strong argument to be made that the reason why countries like Taiwan and South Korea have done comparatively better than the West is because at no stage did they pay any attention to what WHO said. Having directly experienced the earlier pandemics which originated in China, immediately they heard of the situation in Wuhan, they activated their pandemic plans which had been developed in response to those earlier pandemics.

Alfred

Agreed. The January 14 pronouncement by the WHO that there was "no clear case for human to human transmission" is the worst scientific advice of the 21st century (so far). The only question in my mind is, was it simply scientific caution or was the WHO leadership coddling China? The evidence for the latter is very strong. There were several cases of severe pneumonia among doctors and nurses in Wuhan IN LATE DECEMBER. They had cared for the same type of patients AND they had no connection to the Wuhan wet market. This should have set off alarm bells in the WHO but it seems the Chicoms were not being totally honest. I'm shocked I tell you! Even so, the locals had ALL figured it out.

The Taiwanese clearly have not the slightest concern about hurting Beijing's feelings. They have extensive business with PRC (Foxcom for example) but they have a tripwire mentality regarding potential epidemics or a Chicom attack. They also had already identified the WHO head as a Beijing call girl well before COVID.

In order for containment to work...there needed to be a total, universal ban on flights from China by early January. The thermometer check at the airport thing was complete bullshit.

Cap Mandrake,

I think you will find this recent report

https://henryjacksonsociety.org/wp-content/uploads/2020/04/Coronavirus-Compensation.pdf

very illuminating. It provides a detailed timeline of all the actions taken by the Chinese authorities to cover up their culpability and the gullibility of the WHO. Also detailed is how the UK's special committee (Nervtag) tasked with providing advice to the Chief Medical Officer and ultimately to the UK Department of Health and Social Care was misled to provide poor advice throughout January 2020. Quite a different perspective from the salacious charges made against the UK government by the Sunday Times.

The study concludes that China was in clear breach of its legal responsibilities under the 2005 International Health Regulations.

Alfred

quote:

ORIGINAL: obvert

Here is why testing is important. Asymptomatic carriers.

quote:

ORIGINAL: obvert

quote:

ORIGINAL: Orm

I find it funny that Sweden both manage to get criticism for to harsh measures, and to lax measures.

It's interesting that Sweden has been able to keep a good portion of the economy open by trusting the citizens to take advice rather than mandating they do by law. This says a lot about the social responsibility of Swedes, since the result so far has not been far off other countries that are completely locked down.

I'd be interested to know though how much you see on the ground with people not heeding guidelines and engaging in more risky social gathering behaviour?

quote:

ORIGINAL: Chickenboy

quote:

ORIGINAL: obvert

quote:

ORIGINAL: Orm

I find it funny that Sweden both manage to get criticism for to harsh measures, and to lax measures.

It's interesting that Sweden has been able to keep a good portion of the economy open by trusting the citizens to take advice rather than mandating they do by law. This says a lot about the social responsibility of Swedes, since the result so far has not been far off other countries that are completely locked down.

I'd be interested to know though how much you see on the ground with people not heeding guidelines and engaging in more risky social gathering behaviour?

Currently, Sweden's death rate is about 25% higher than the United States at 152/M vs. 121. When compared to Scandinavian neighbors Denmark (61/M), Finland (17/M) and Norway (30/M) it's a real standout too. I've seen some pieces fawning over the "Swedish Model" lately, but I think Sweden will wind up ruing some of their approach before all's said and done.

A good article on this:

https://www.project-syndicate.org/commentary/swedish-coronavirus-no-lockdown-model-proves-lethal-by-hans-bergstrom-2020-04

quote:

ORIGINAL: Cap Mandrake

Chickenboy is right. There are numerous obstacles to testing. When the CDC relinquished exclusive testing in the US and the private and university labs started to step up we set up expensive tents and outdoor heaters and paid a bunch of staff to gown up in face masks, and N-95 masks to collect the specimens...and then we ran out of viral transport media...and then when, after all effort we finally got the specimens to Quest it took 6-7 days to get a result...and then we had only 10% positive after selecting for the sickest appearing patients.

quote:

ORIGINAL: obvert

quote:

ORIGINAL: Cap Mandrake

Chickenboy is right. There are numerous obstacles to testing. When the CDC relinquished exclusive testing in the US and the private and university labs started to step up we set up expensive tents and outdoor heaters and paid a bunch of staff to gown up in face masks, and N-95 masks to collect the specimens...and then we ran out of viral transport media...and then when, after all effort we finally got the specimens to Quest it took 6-7 days to get a result...and then we had only 10% positive after selecting for the sickest appearing patients.

And yet, more tests are what will get the country open again according to this.

https://www.nytimes.com/interactive/2020/04/17/us/coronavirus-testing-states.html?action=click&module=Spotlight&pgtype=Homepage

As some governors consider easing social distancing restrictions, new estimates by researchers at Harvard University suggest that the United States cannot safely reopen unless it conducts more than three times the number of coronavirus tests it is currently administering over the next month.

An average of 146,000 people per day have been tested for the coronavirus nationally so far this month, according to the COVID Tracking Project, which on Friday reported 3.6 million total tests across the country. To reopen the United States by mid-May, the number of daily tests performed between now and then should be 500,000 to 700,000, according to the Harvard estimates.

That level of testing is necessary to identify the majority of people who are infected and isolate them from people who are healthy, according to the researchers. About 20 percent of those tested so far were positive for the virus, a rate that the researchers say is too high.

“If you have a very high positive rate, it means that there are probably a good number of people out there who have the disease who you haven’t tested,” said Ashish Jha, the director of the Harvard Global Health Institute. “You want to drive the positive rate down, because the fundamental element of keeping our economy open is making sure you’re identifying as many infected people as possible and isolating them.”

quote:

ORIGINAL: Chickenboy


... I will be keen to follow the (hopefully) international response(s) in the coming years.

quote:

ORIGINAL: Alfred

quote:

ORIGINAL: Chickenboy

... I will be keen to follow the (hopefully) international response(s) in the coming years.

The Australian Foreign Affairs minister has called for an international inquiry, not run by WHO, into the entire COVID-19 pandemic.

https://www.abc.net.au/news/2020-04-19/payne-calls-for-inquiry-china-handling-of-coronavirus-covid-19/12162968

She made the obvious observation that the inquiry would need all countries to be fully transparent. Further down the article there are some interesting hints about the Australian government's future relationship with WHO.

Already a Chinese academic from Shanghai has strongly criticised the need for an international inquiry on the basis that China has been fully transparent. He kindly reminded Australia that China's relationship with Australia would be adversely affected as we should not be following Trump's direction of misrepresenting China's role.

Personally I have zero faith that anything meaningful will result from this initiative. China will bully/bribe African/Asian leaders into not cooperating. Too many western governments (including Australia's) will be afraid of suffering any economic pain from the inevitable Chinese "punishment". Any remaining countries participating in such an inquiry will find it a pointless exercise when one bears in mind there is already a Chinese law which makes it a criminal offence for any Chinese national to provide information on COVID-19 to foreigners without prior approval. Plus the specimens taken from the early Chinese victims have already, in accordance with a government directive, been destroyed.

IN international diplomatic terms, China is just gong to walk away scott free. that can only change if western governments are prepare to pay the costs associated with having the creation of a new bamboo curtain. I'm not holding my breath on that.

Alfred

quote:

ORIGINAL: Alfred

quote:

ORIGINAL: Chickenboy


... I will be keen to follow the (hopefully) international response(s) in the coming years.

The Australian Foreign Affairs minister has called for an international inquiry, not run by WHO, into the entire COVID-19 pandemic.

https://www.abc.net.au/news/2020-04-19/payne-calls-for-inquiry-china-handling-of-coronavirus-covid-19/12162968

She made the obvious observation that the inquiry would need all countries to be fully transparent. Further down the article there are some interesting hints about the Australian government's future relationship with WHO.

Already a Chinese academic from Shanghai has strongly criticised the need for an international inquiry on the basis that China has been fully transparent. He kindly reminded Australia that China's relationship with Australia would be adversely affected as we should not be following Trump's direction of misrepresenting China's role.

Personally I have zero faith that anything meaningful will result from this initiative. China will bully/bribe African/Asian leaders into not cooperating. Too many western governments (including Australia's) will be afraid of suffering any economic pain from the inevitable Chinese "punishment". Any remaining countries participating in such an inquiry will find it a pointless exercise when one bears in mind there is already a Chinese law which makes it a criminal offence for any Chinese national to provide information on COVID-19 to foreigners without prior approval. Plus the specimens taken from the early Chinese victims have already, in accordance with a government directive, been destroyed.

IN international diplomatic terms, China is just gong to walk away scott free. that can only change if western governments are prepare to pay the costs associated with having the creation of a new bamboo curtain. I'm not holding my breath on that.

Alfred