No, positivity increase/decrease doesn't seem to correlate with when there is an outbreak in a care facility. We had no care facility outbreaks from the start of reporting mid-April through the last week of May, with 928 cases and one death (not specified from where) from 4/14-5/26. The first week of June we had our first two facility outbreaks, which added four deaths over that week and the next (not specified from where). The second week of June through the first week of August we had no new facility outbreaks (case numbers more than doubled from 6/9 to 7/14 then started to decline). Our death count went up by three that whole time (it's not specified if those were in a care facility or not) and our cases went up by 1702. The last three weeks of August, as case numbers were steadily declining, 7 facilities reported outbreaks and our deaths went up by 7 (again not specified from where). Oddly enough, our case numbers through September were at the lowest point (between 69 and 41 per week) since this all started, probably due to the wildfires keeping people at home, and we still had 2 outbreaks in the third week, and then none until 5 were reported this week. The county only started to specify care facility case and death numbers the last week of August, and since then, all the deaths have been from there.

I'm not going to give my exact location (for reasons you probably understand). Our death count remains the same until an outbreak happens in a care facility, and then they tick up. On the bright side, our % positive rate for people over 65 was cut in half after the first few months.

Either proving or disproving this should be a priority right now as it would add valuable data to inform a strategy moving forward. Scientists/doctors on both sides are speaking on conjecture. There are other viruses that offer cross-reactive protection to differing strains within the same virus family, so I don't think it is off-base to say that it is likely the case for coronaviruses.

I have been looking at my county's numbers and have found that the positivity rate in long term care facilities is a better predictor of the death rate, which isn't surprising/alarming considering most all-cause deaths occur in long-term care facilities and most patients in places like that don't have a very prolonged longevity. https://www.ucsf.edu/news/2010/08/98172/social-support-key-nursing-home-length-stay-death “One quarter of all deaths in the United States occur in nursing homes, and that figure is expected to rise to 40 percent by the year 2020,” says Smith. "The average age of participants when they moved to a nursing home was about 83. The average length of stay before death was 13.7 months, while the median was five months. Fifty-three percent of nursing home residents in the study died within six months."

I have not read through any of the responses, but I wanted to drop these two here in case they haven't been linked yet; there are many other articles and papers on the subject. More evidence of some level of protective immunity has come to light since the beginning of the year, so if we need ~70% of the population to have immunity and ~50% already has immunity, we only need ~20% to reach herd immunity. If the people already infected is a factor of ~17-20 of the positive rate, that changes the game significantly. Waiting for a vaccine that may or may not come to fruition should be Plan B. Plan A should be to get to herd immunity while insulating the most vulnerable, which could be done in several months. Other novel coronaviruses have faded out within 2 years, so postulating anything different doesn't make logical sense. https://www.nih.gov/news-events/nih-research-matters/immune-cells-common-cold-may-recognize-sars-cov-2 From the article (emphasis mine): The researchers generated T cell lines from the memory cells that recognized SARS-CoV-2 fragments. They then tested them for cross-reactivity against a peptide pool from other coronaviruses. They found that of the SARS-CoV-2 and “common cold” coronavirus fragments that were most similar (at least 67% genetic similarity) 57% showed cross-reactivity by memory T cells. We have now proven that, in some people, pre-existing T cell memory against common cold coronaviruses can cross-recognize SARS-CoV-2, down to the exact molecular structures,” Weiskopf says. “This could help explain why some people show milder symptoms of disease while others get severely sick.” “It still remains to be addressed whether this immune memory reactivity influences clinical outcomes and translates into some degrees of protection from more severe disease,” adds Sette. “Having a strong T cell response, or a better T cell response may give you the opportunity to mount a much quicker and stronger response." Notably, these findings contrast with those from antibodies, which haven’t shown significant cross-reactivity between common cold coronaviruses and SARS-CoV-2. https://directorsblog.nih.gov/2020/07/28/immune-t-cells-may-offer-lasting-protection-against-covid-19/ From the article (emphasis mine): Next, they looked at blood samples from 23 people who’d survived SARS. Their studies showed that those individuals still had lasting memory T cells today, 17 years after the outbreak. Those memory T cells, acquired in response to SARS-CoV-1, also recognized parts of SARS-CoV-2. Finally, Bertoletti’s team looked for such T cells in blood samples from 37 healthy individuals with no history of either COVID-19 or SARS. To their surprise, more than half had T cells that recognize one or more of the SARS-CoV-2 proteins under study here. It’s still not clear if this acquired immunity stems from previous infection with coronaviruses that cause the common cold or perhaps from exposure to other as-yet unknown coronaviruses.

The guy in the video was using the term Gompertz curve, which was new to me; I was aware of Farr's curve. It looks like Gompertz curve is not exponential. Maybe because India is so densely populated with less than ideal living conditions still in some places, the curve was sharper? I speculate it's because, like what was said upthread, that the medically fragile people are removed from the pool first and then what's mostly left is a population that can handle the illness, so herd immunity is reached?

In the video I posted, it explained why southern places (or maybe it was, more specifically, places close the the equator) get not only different shaped virus curves but also different timing as to when in the year viruses tend to hit the hardest. Places like the U.S. that are so spread out tend to get one sharper spike in the north and then a smaller, flatter spike in the south later in the year. Hence, we don't really get a "second wave," it's just the same virus moving to a different location. I am paraphrasing and not using scientific language like the video did, but hopefully I got the point across 🙂.

We haven't had "so few cases" near me, just few deaths. People are only wearing face coverings in stores. People are still having parties at their houses with no face coverings. They are still eating in restaurants with no face coverings. Life didn't really slow down here except for the last part of March. I think the low deaths might be because the population here is relativity active/healthy and there are low minority and aging populations, but that is just me speculating. I *am* saying that we should be looking at excess deaths, not just covid deaths. From my post: "Excess deaths, looked at over a number of years or decades, are very telling and shape a more complete picture."

Nature does what nature does. In some respects, she's a cruel mistress. It is really pretty here now with the leaves changing and falling, so she's not cruel in all respects :).

https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6936a5-H.pdf

I have not down played this, nor have I made it into a giant. It is a virus. People are dying. It dies out in one place and moves onto another. I'm outside of Seattle so we have had cases, to include a spike in the summer, which stayed pretty high for 6-8 weeks. We are at the start of another one right now even though we have been fairly restricted since March, 100% masking in public since July 7, and no in-person school since mid-March. My county is still under 20 deaths recorded with covid out of a total population of 300,000. I understand that a person's experiences can color their perceptions. Being in the ICU, you are going to see the worst of the worst. I have family members and close friends in the medical field in different parts of the U.S.; they are not seeing what you are seeing. My husband manages 100s of people; he is not seeing what you are seeing. What we are seeing are hospitals with few to no covid patients, and people testing positive via PCR are having no symptoms or mild symptoms for a few days. You are seeing deaths of people with covid. My dental hygienist's son has been a paramedic for 14 years and is changing professions because of the increase in suicides he's been called to since March. There has got to be a middle ground where we can look at the big picture, not just positive cases/deaths from this one virus. Also, it seems that lockdowns, face coverings, and a vaccine with some amount of efficacy, even if it doesn't prevent asymptomatic spread, are what is being focused on. Unless one concentrates on human interest stories, people with healthy immune systems are clearing this easier. If "an ounce of prevention is worth a pound of cure," why are we not emphasizing health improvements since people with diabetes and obesity are having a higher rate of complications if they get covid? It is another layer of protection we could add right now, keeping more people out of your ICU. You may want to skip this part because it is about the video I posted. It does go on to show how deaths fluctuate from year to year, having relatively high numbers after a year with relatively low numbers; it's cyclic. The countries that had more excess deaths last year are showing less excess deaths this year. The countries with a negative number of excess deaths last year are showing a higher number of excess deaths this year. Excess deaths, looked at over a number of years or decades, are very telling and shape a more complete picture. Another thing it looked at was cases v. deaths. Most deaths happened in the spring even though case numbers have been rising.

Any of these? https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6936a5-H.pdf https://jamanetwork.com/journals/jama/fullarticle/2768532 https://www.cdc.gov/mmwr/volumes/69/wr/mm6928e2.htm?s_cid=mm6928e2_w

Has anyone else watched this? I was introduced to EuroMOMO and the dry tinder metaphor. This week, I am going to use EuroMOMO and see when each country implemented mandatory lockdown/mask policies.

I took my dd to the dentist yesterday and was chatting with the hygienist. She said her son is a paramedic but has started taking classes so he can do something in the finance industry because he is burnt out. After 14 years, he can't handle the increase in suicides that have been happening this year. I'm not going to say the age of the last one her son got a call to because it's heartbreaking. I looked at our county statistics. From 2011-2018, mean average for suicides was 47 and median average was 45 in a population of approximately 255,000-290,000. We've had 17 covid deaths. I keep thinking we are not doing a very good job of thinking about second and third-order effects, but we won't know the extent until we get clear excess death counts for the next year or two, which is not helpful now.

Do you have any studies for that? It would be helpful if I could see it :). I found these: https://wwwnc.cdc.gov/eid/article/26/6/20-0495_article and https://www.nature.com/articles/438293a At any rate, hopefully we come a bit closer to understanding why SSE happen.

But isn't it like that with pathogens? Put 100 people in a room with a person infected with *something* communicable. Lather, rinse, repeat with the same infected person and a different set of 100 people. The same number of people aren't going to get it in each group, and of those who get it, a different number will be asymptomatic as opposed to symptomatic. I think there is evidence emerging of cross reactive T cell immunity, like https://www.nature.com/articles/s41586-020-2598-9, and a case being made for adequate vitamin D and zinc levels, which, if I am remembering correctly, @Pen and some other members have already posted links. So, I guess it's random in the sense that we haven't been able to study this specific virus from every angle yet, but it is still just a virus and the human immune system hasn't changed.

🙌 💯

I am wondering why the current president's party (past, present, future "current") should have much sway in the outcome of the court. If the justices are supposed to be impartial/apolitical and make decisions based on the Constitution, it shouldn't matter how many justices are nominated by a president. It seems like politics would come into play through the Senate because they confirm the justice and, more pointedly, the Senate Judiciary Committee because they seem like gate-keepers for the confirmation process.

It was extremely terrifying. I know most new parents like to sit and watch their baby sleep, but I was hyper-vigilant, especially for the first few days after every round of vaccines. I agree that extremism leads to extreme polarization, but I would have to say that doctors' dismissals of parents' observations and concerns (much like my experience upthread) led to what is labeled as the "anti-vax" movement. After almost 20 years of researching this via various medical avenues and history books, I get a little salty when the topic comes up, so this might get long-winded. Are vaccines tested against an inert placebo? Are they tested concomitantly (CDC schedule)? Are they tested longitudinally? Are they tested to see if they offer protection against spreading the illness to others? Are they tested to see how long protection from the vaccine lasts? The adverse reactions captured in testing for most vaccines are limited to little things like fever, headaches, and swelling at the injection site for the next few days and the SAE that are captured for the next 1-6 months are always stated with the caveat of "it isn't known if the vaccine caused them or not." In my experience, when people take an unbiased look into how vaccines get produced, tested, and green-lit for mass distribution (most of the time by mandates), they are generally confused and appalled. Most of who the media would label as "anti-vax" parents are not against vaccines, they just want better testing and more transparency. Most of the "pro-vax" doctors don't want to be dismissive, but they are taught that vaccines are safe and effective and can [very rarely] cause anaphylactic shock, which is fixed with an EpiPen. I am glad production of the covid vaccines are bring the concerns "anti-vaxxers" have had to light and are actually giving them credence.

I am with everyone here who is saying that politics have slowly been creeping into medical treatments/products/policies. I think people would be surprised if they took a peek at actual vaccine inserts (not the CDC handout) and looked under section 6 to see what is there and what isn't there. The SAE for vaccines can vary, some only being 30 days. I am very happy that vaccine safety and efficacy is front, center, and fairly transparent right now. It might lead to safer and more effective vaccines...hopefully. We won't be getting the vaccine until all the research is published and we talk with our doctor about it. Back story if you are so inclined to read: I am not "anti-vax." When my first dd was born, she was 4 weeks early. When she was 4 hours old, she was given a hep B vaccine (even though I tested negative for it and she was not going into a daycare setting) and taken to get her first bath. After almost 24 hours of being up and a natural labor, I was tired. I closed my eyes to rest and opened them 45 minutes later in a panic. When I called the nurses' station, she said there was a little problem; dd was ok, but they couldn't bring her back until a doctor was there to speak with me and my husband. When he came in, he said, "Your daughter had a little bout of apnea and we had to resuscitate her after she started turning blue. She'll need to be on a heart and lung monitor for the first few months just so we can keep an eye on her." I knew nothing of the anti-vax movement and was raised by a physician's assistant who was big on "just go with what the docs say," but the first thing I said was, "Could it have been the vaccine?" His response was to chuckle and say, "Oh, no. Vaccines are completely safe and effective. She probably just got mad and held her breath." Chuckle, chuckle. Um, ok. I was always told when kids pitched a fit and held their breath, they automatically started breathing again. But I was 20, and a mere college student; what did I know? He should have told me, "That specific vaccine is noted to cause episodes of apnea in premature babies. There is a small possibility it could have been the vaccine; let's report it to VAERS." It wasn't until I started to get into my higher level stats classes that I became interested about the ins and outs of vaccine research, having a baby who was deep in the throws of several multi-dose vaccines every few months and piling up more and more signs of inflammation. When I asked the doctor a few very specific things, he poo-pooed me away with an air of "They're perfectly safe. I'm the doctor." He never answered one question over the next few visits, so I dug into it myself and changed doctors. Thankfully, we have someone now who believes in informed consent and keeps up-to-date with published research. To say that vaccines are safe and effective, with completely air-tight, unquestionable science, is a bit alarming; we don't do that with any other medical procedure/product. Here is just one interesting study my doctor has given me: https://digital.ahrq.gov/sites/default/files/docs/publication/r18hs017045-lazarus-final-report-2011.pdf Editing to add: I tend to mentally shy away from this, but I wanted to add that if my dd had stayed with us instead of going with the nurse for her bath, I don't think she would be alive right now. The doctor probably would have said it was SIDS.

I may be off, but isn't ACIP in charge of recommending vaccines? And the CDC is responsible for putting it on the schedule and making the information sheet given out by doctors to patients? The executive administration can say whatever they like, but the government medical organizations are the ones who are ultimately in charge of the data and certification.

This. I am not an emotional person and find it difficult to read others' feelings. It used to get me into hot water when I was a kid. I have, thankfully, come up with coping skills so as to not be a heartless robot. Since I am a visual person, my main avenue for accomplishing this is facial features. Masks remove most of my data points. Plus, I am a bit hard of hearing and rely on people's mouths to help...which I didn't even realize until people started wearing masks and I kept having to ask people to repeat themselves.

From March-end of June, I was not wearing a face covering and neither were roughly half the people who live in my town. The last week of June, my governor issued a proclamation mandating face coverings: any material as long as it covered your mouth and nose. The week after that, businesses were to be issued a $1000 fine for allowing someone in without a face covering on, valid medical note or not. No face covering=No entrance. You could, however, put on a face covering, walk into a restaurant, be seated 20 seconds later, take off your face covering, and eat a leisurely meal with all of the other people who were not wearing a face covering. So, no, I have not been in a store or other public place since July 7 except for the local coffee shop because I can go through the drive thru, grab a coffee, park, walk in while I sip my coffee, and sit my butt in a chair with the other people who also have no face coverings on. As far as I can tell from waiting on grocery pick up at several different stores a few times a week, compliance has stayed at 100%. I have been keeping an eye on my county's numbers since the beginning. The numbers from March-beginning of July were in the single digits most weeks, a few had numbers in the teens. I thought it was odd because I live so close to Seattle, people only really stayed home for the last two weeks of March, and face coverings were only being used by about 50% of people. A week after the mandate, numbers doubled for the next three weeks and stayed that high until the beginning of September. I started looking at other states. CA is nearby, issued a strict face covering mandate mid-June, and their state's curves looked similar to my county's curves. One would think if the community face covering mandate worked, numbers would at least plateau or maybe even go down? The more I looked into it, the more befuddled I got. Finally, I stumbled onto some literature of randomized, controlled studies that concluded community-wide face coverings don't reduce cases of ILIs in any statistically significant way, saying something similar to what The WHO put out and what the CDC's stance has been up until a few months ago. No, I'm not worried. We've been seriously ill maybe one time each over the past 10-20 years and it's always been during a move or time of high stress when we weren't keeping up with supporting our immune system. There is a strong focus in our house on keeping as healthy as possible, pandemic or not, because there are always pathogens around us. We don't regularly see anyone high risk. I would have to decline and then we could figure out something fun that both of us were comfortable with! Thank you for being civil :). I have been on the education boards for about a decade and have only starting perusing the chat board recently. I never knew they could get so, um, interesting. The way I look at it is if you (general you) are going to say, "Listen to the doctors/epidemiologists/virologists/etc," then you can't only listen to the experts in front of the cameras who are saying, "This is a deadly, deadly virus! Wear a mask until we can make a vaccine and distribute It to everyone!" There are epidemiologists out there from respectable institutions giving different projections. There are doctors who are treating their patients with protocols that are working. There are virologists who are saying that this isn't some totally alien virus that we know nothing about. Science should be open and debatable. When differing opinions have the fallacy book thrown at them, I start to asking some questions. I know my viewpoint of wear-an-effective-mask-that-protects-you-if-you-need-it-and-don't-if-you-don't isn't a popular one on this forum, but everyone I know irl, to include people in medical professions, are in the same boat as me. I know that others are in a different spot, and that patience and understanding is needed all around.

We are not wearing masks and will continue our trend after this has run its course...not seasonally...not while I zoom through the store...not when I have people over to my house...not while I watch a sports game outside...not for any other pathogens transmitted through aerosols and/or droplets. If the IFR of a pathogen were much higher than the current ones in circulation, we probably wouldn't leave our house since masks/vaccines only protect to a certain extent. If anyone in my family was immunocompromised, even before this, we most definitely would have been wearing N95 masks everywhere and requiring them for others who were around us. I don't care if others want to do wear what ever face covering they find best fits their risk profile and don't think they should be ostracized for doing so. We have never been the type to go-go-go everywhere and don't come into contact with many people other than in passing, and we homeschool, so when the rare occurrence comes around that someone is feeling even a bit under the weather, we all stay home and isolate. On a tangential note: I do wish that the topic of overall health and immunity got just as much airtime as masks and vaccines.

We've never taken a flu shot and have never gotten the flu. As per our doctor, we keep our vitamin D levels in the optimal range and keep our immune function high in many other ways. Also, it's usually well under 50% effective, the vaccine does not prevent spreading influenza to others if you do happen to get sick, getting vaccinated every year might lessen overall vaccine effectiveness, and it has an extremely high payout in the Vaccine Injury Compensation Program (over $1,000,000,000). I don't think it should be mandated, either, but that's a whole other can of worms. https://www.cdc.gov/flu/vaccines-work/past-seasons-estimates.html "We identified seven influenza-positive patients who had been vaccinated: two symptomatic household contacts and five index patients. We were surprised to observe that both the proportion of positive samples as well as the viral load among vaccinated cases was similar compared to that among non-vaccinated cases. The only study known to us where these questions have been studied [35] reported similar results. Also this finding may have important implications for the parameterisation of modelling studies. Caution should be taken to avoid misinterpretation, though. It does not mean that the vaccine is not effective. Of 67 vaccinated household contacts only two (3%) contracted influenza. Similarly, in the cited publication by Couch et al., vaccine efficacy for symptomatic illness was 93% and for any shedding 70%, but the probability of being asymptomatic among those who shed was 86% (6/7) in vaccinated and 45% (5/11) in non-vaccinated." https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0051653 "Self-reported vaccination for the current season was associated with a trend (P < 0.10) toward higher viral shedding in fine-aerosol samples; vaccination with both the current and previous year’s seasonal vaccines, however, was significantly associated with greater fine-aerosol shedding in unadjusted and adjusted models (P < 0.01). In adjusted models, we observed 6.3 (95% CI 1.9–21.5) times more aerosol shedding among cases with vaccination in the current and previous season compared with having no vaccination in those two seasons. Vaccination was not associated with coarse-aerosol or NP shedding (P > 0.10). The association of vaccination and shedding was significant for influenza A (P = 0.03) but not for influenza B (P = 0.83) infections (Table S4)." https://www.pnas.org/content/115/5/1081 "Our analysis did not suggest any evidence of vaccine interference when we considered previous-season vaccination. However, the analysis using 5 years of historical vaccination data suggested a significant difference in current-season VE among frequent vaccinees compared with nonvaccinees." https://academic.oup.com/cid/article/59/10/1375/2895694