Coronavirus - worldwide spread and control

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Long article in the New Yorker (also available as audio):

How Does the Coronavirus Behave Inside a Patient?
We’ve counted the viral spread across peoples; now we need to count it within people:
https://www.newyorker.com/magazine/2020/04/06/how-does-the-coronavirus-behave-inside-a-patient
But three questions deserve particular attention, because their answers could change the way we isolate, treat, and manage patients. First, what can we learn about the “dose-response curve” for the initial infection—that is, can we quantify the increase in the risk of infection as people are exposed to higher doses of the virus? Second, is there a relationship between that initial “dose” of virus and the severity of the disease—that is, does more exposure result in graver illness? And, third, are there quantitative measures of how the virus behaves in infected patients (e.g., the peak of your body’s viral load, the patterns of its rise and fall) that predict the severity of their illness and how infectious they are to others? So far, in the early phases of the covid-19 pandemic, we have been measuring the spread of the virus across people. As the pace of the pandemic escalates, we also need to start measuring the virus within people.
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As the virus continues to cyclone across the world, we will begin to find quantitative answers to these questions of how exposure intensity and subsequent viral loads relate to the clinical course of covid-19. We will supplement the bird’s-eye view with the worm’s-eye view. How will these insights change the way we manage patients, hospitals, and populations?
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To win the Kampf against covid-19, it’s essential to trace the course of the virus as it moves through populations. But it’s equally essential to measure its course within a single patient. The one becomes the many. Count both; both count.
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Sly Saint said:
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I wonder if she's trolling on purpose..I've never heard of her until she shared her Covid diagnosis and I learned that she's SW's partner.

That use of the word "fatigue" was provocing and of course pwME - or with "false illness believe" - jumped on it and now she can tell everyone that with the right attitude you recover and go back to baking or whatever.

I'm scared by how psychiatrists already are putting their claws on this trying to gain significance. I wish they would stay in their line with really supporting people's mental health when needed - not using mental health as an excuse for poor medical outcomes and political mismanagement (speaking in general)
 
Adrian said:
Is she the same person who was saying we don't need to follow the WHO advice because we have an advanced public health care system? Saying "the clue for the who is in its title it is a world health organization and it is addressing all countries across the world with entirely different health infrastructures and particularly public health infrastructures. We have an extremely well developed public heath system in this country and in fact our health teams train others abroad ..... and so although we some contact testing in high risk areas like prisons and care homes that is not an appropriate mechanism as we go forward ...."

In other words she believes Britain is in someway special and doesn't need to follow WHO advice and do testing.


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This is British Exceptionalism at its absolute worst.

As @Sasha has asked about, if there is no one at the “top” pushing for eradication and testing, how will things ever change? It’s very worrying and frustrating.
 
Leila said:
I wonder if she's trolling on purpose..I've never heard of her until she shared her Covid diagnosis and I learned that she's SW's partner.

That use of the word "fatigue" was provocing and of course pwME - or with "false illness believe" - jumped on it and now she can tell everyone that with the right attitude you recover and go back to baking or whatever.

I'm scared by how psychiatrists already are putting their claws on this trying to gain significance. I wish they would stay in their line with really supporting people's mental health when needed - not using mental health as an excuse for poor medical outcomes and political mismanagement (speaking in general)
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I'm not really concerned. We were slowly but effectively erased from reality because almost nobody in medicine cared about us and were willing to fling the hot potato to someone who demanded it. Even the biggest ME outbreaks were rather small all things considered. Technically it seems SARS was the truly the biggest one but it flew completely under the radar. Somehow. Frankly that's weird but then everything is with us.

This time it's massive. If they try to get some limelight here their private bits will be very exposed by the incompetence of their ideas. In full HD at high FPS for that extra hairy glory. I'm sure many of them are delusional enough to have convinced themselves that they have any clue what they're doing but this is such an explosive event, very different thing than the shadowy work they needed to do with us, where they controlled the proceedings and could exclude anything they didn't like from being written down in the first place.

Many will have PVF and likely ME, many will have mild cases, many of those will be people who huffed the BPS paint and will be faced with the reality that what they'd been told all along is a bunch of made-up BS that qualifies as a proper scam, as well as a human rights disaster but hey, small detail.

I get a mental image of someone who somehow convinced themselves they are an invincible superhero jumping on the tracks to stop the incoming freight train. It won't leave much to examine after the fact. We are easy pray, generally hated by most medical professionals, and still it took decades to pull it off. Not this time. The emperor really wants to give his big speech, entirely oblivious to the fact that inviting the cameras to capture the moment is how you destroy the myth of the magical expensive clothes.
 
This video is interesting if you like watching simulation models and the impact different measures have on the epidemic spread.
He simulates various things like 100%compliance with social distancing versus 90% and 50% compliance.
Also the effect of isolation with the exception of people going to a central location like a supermarket.

 
Coronavirus - decision making under radical uncertainty :

Over 60 countries in the world have now ordered a lockdown in their fight against the pandemic. It will help the health systems cope and prevents governments from being blamed later. Those who die from the negative effects of the lockdown will remain largely unaccounted for. Remember the suicide rate that soared in Greece after the austerity programme was imposed by creditors? There is a short-term bias for politicians, while the long-term costs are largely unaccounted for.
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https://www.eurointelligence.com/public.html

Some fair points.
 
Estimating the number of infections and the impact of non-pharmaceutical interventions on COVID-19 in 11 European countries

Following the emergence of a novel coronavirus (SARS-CoV-2) and its spread outsideof China, Europe is now experiencinglarge epidemics. In response, many European countries have implemented unprecedented non-pharmaceutical interventions including case isolation, the closure of schools and universities, banning of mass gatherings and/or public events, and most recently,widescale social distancing including local and national lockdowns. In this report, we use a semi-mechanistic Bayesian hierarchical model to attempt to infer the impact of these interventions across11 European countries.Our methods assume that changes in the reproductive number –a measure of transmission -are an immediate response to these interventions being implemented rather than broader gradual changes in behaviour. Our model estimates these changes by calculating backwards from the deaths observed over time to estimate transmission that occurred several weeks prior, allowing for the time lag between infection and death.
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https://www.imperial.ac.uk/media/im...urope-estimates-and-NPI-impact-30-03-2020.pdf
 
Most media and commentary I'm seeing keeps talking about getting through the peak and we'll be through this in 6-8 weeks. After the peak things will reopen and the economy will recover. How accurate is this? How do countries that are on lockdown re-open? The whole thing starte in some places with 1 or 2 infections. I get that there will be smaller numbers with contact tracing and social distancing, but how optimisitic are people and governments being? Sort of a general question for anyone.
 
dreampop said:
Most media and commentary I'm seeing keeps talking about getting through the peak and we'll be through this in 6-8 weeks. After the peak things will reopen and the economy will recover. How accurate is this?
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I think the 6-8 weeks may be perfectly realistic. Once the out of home spread mechanism is blocked we just have to wait for relatives to get infected and recover or not - that should take no more than month or so.

What seems to me, as to you, implausible is that any sort of return to normal economic activity could begin for many months because clearing out the last few cases will take a long time and if they are not cleared out the problem will flare up exactly the same within a month or so. Rather few people have been infected as a percentage of the population so there will be no slowing from 'herd immunity' for years.

What may be more realistic is that certain types of business currently shut down may be able to start up again. I am personally waiting for solicitors and council officers to sort out a house purchase. That might get back on track. I also want to buy in some wire mesh fencing for the garden and the timber merchant might be able to one up again. But anything that requires commuting or international travel is going to be hugely problematic. I suspect we will gradually get to know a very different sort of lifestyle with even more emphasis on internet communication. I think that different lifestyle may last five years at least.

I don't think a new runway or high speed train is going to be needed for a while.
 
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