The herd immunity theory...

[Jean in Newcastle]

22 minutes ago, fifiruth said:

The average being above 20% is indeed too high.

I’m saying slowly keep opening up, as in keep an eye on the situation and stop if it looks to be too much. They could increase the number of people inside by 5 every two weeks, for instance. That would give people hope but still be very conservative in its approach. Opening up wide open all at once is too risky, but flat out not moving at all is increasing frustration, anger, non-compliance, and despair.

Every single state that I know of in the US has opened up at least some.  The careful states are doing the slowly opening up approach.  They are keeping an eye on the situation.  And they are stopping if it looks to be too much. 

[kbutton]

A local school district is doing their own contact tracing, and they've kept cases in the single digits, I believe, even though the entire county is out partying.

I wonder if they are successful largely because they know what their students are doing all day, every day. 

Districts north and south of them have many more cases. I think one of those districts is similar-sized, and the other one is bigger.

[Not_a_Number]

2 minutes ago, fifiruth said:

I suppose that I am somewhere in the middle of the extremes in my thinking.

Ironically, Wisconsin will probably reach immunity faster than most of the country. Will they be “done” in a few months per the GBD? We won’t know until then. 

Maybe. I don't think NY has reached herd immunity, and it has 10 times the death rate of Wisconsin. It'll take Wisconsin quite a while to catch up with NYC... and then do that a few more times, and it'll be done! 

 

2 minutes ago, fifiruth said:

In the meantime, the level of sickness is awful and no one wants to see that happening to any of our communities. Hopefully, they are recovering.

Yeah 😞 .

[Bootsie]

24 minutes ago, Not_a_Number said:

So 40% of all people are reached, or they provide contacts? It'd be good to see the numbers. 

NY also rolled out a tracking app, so we'll see if that helps or not. I would guess that the rapid tests are helping a lot, because contact tracing someone from a few weeks ago and someone who got sick yesterday is a very different proposition. I know Cuomo's e-mails tend to explain where the clusters are, which is why I'm assuming contact tracing is working relatively well -- they find clusters, they isolate people, the positivity goes down again. 

We don't have any dashboard of contact tracing to be able to see the actual numbers, so any information comes through media reports which don't always quote the statistics correctly.  The most recent reports for my county said "getting information from 47%" but I do not know if that is real contacts.  

The county tried to hire 270 more contact tracers (which would have cost more than $20,000,000) but it was voted down.  The local medical school professors are saying to be effective, you need to reach 80% of contacts quickly.  There was little hope of the additional contact tracers being able to really do that, so it was seen as spending $20,000,000 with very little return.  

[Not_a_Number]

1 minute ago, Bootsie said:

The local medical school professors are saying to be effective, you need to reach 80% of contacts quickly.  There was little hope of the additional contact tracers being able to really do that, so it was seen as spending $20,000,000 with very little return.  

Hmmmmm. I would think that any time you speed up the contact tracing, or manage to do more detective work to figure out where spread is happening, you get something for your money. But if the main issue is the speed of the testing, then I would think that working on faster testing would be the first thing to do. 

[Bootsie]

3 minutes ago, Not_a_Number said:

Hmmmmm. I would think that any time you speed up the contact tracing, or manage to do more detective work to figure out where spread is happening, you get something for your money. But if the main issue is the speed of the testing, then I would think that working on faster testing would be the first thing to do. 

But where would the $20,000,000 for contact tracing for ONE county come from?  Could that $20,000,000 be more effectively spent on something else?  And if the main problem is that people don't answer their phones or don't give information when contacted, no number of contact tracers will solve that problem.  

[Corraleno]

16 minutes ago, fifiruth said:

I suppose that I am somewhere in the middle of the extremes in my thinking.

Ironically, Wisconsin will probably reach immunity faster than most of the country. Will they be “done” in a few months per the GBD? We won’t know until then. 

Let's do the math on this: 
population of Wisconsin = 5.8 million
65% of population needed for herd immunity = ~3.8 million
IFR of 1% (because hospital overwhelm is only going to get worse) = 38,000 dead residents of Wisconsin
Current number of Wisconsin residents killed by CV = 1550
So Wisconsin "only" needs another 36,450 deaths to reach herd immunity

Do you think that can happen in 3 months? Do you think that would really boost the economy as opposed to scaring the shit out of everyone? 

Edited October 15, 2020 by Corraleno

[Not_a_Number]

2 minutes ago, Bootsie said:

But where would the $20,000,000 for contact tracing for ONE county come from?  Could that $20,000,000 be more effectively spent on something else?  And if the main problem is that people don't answer their phones or don't give information when contacted, no number of contact tracers will solve that problem.  

Yeah, I agree that it's a huge problem. That's a problem that's probably hard to fix. 

[Bootsie]

2 minutes ago, Not_a_Number said:

Yeah, I agree that it's a huge problem. That's a problem that's probably hard to fix. 

So, it sounds to me like we have circled back around to what really is a plan and what are the costs involved with it.  Unfortunately, I do not see a good model.  When I really look, I am not seeing a place in the US that has had great success with contact tracing.  Unless we have a way to overcome the barriers that have kept it form working like we wished it would have, I don't see how putting our hope in contact tracing as a plan is going to be very successful.  

[Not_a_Number]

Just now, Bootsie said:

So, it sounds to me like we have circled back around to what really is a plan and what are the costs involved with it.  Unfortunately, I do not see a good model.  When I really look, I am not seeing a place in the US that has had great success with contact tracing.  Unless we have a way to overcome the barriers that have kept it form working like we wished it would have, I don't see how putting our hope in contact tracing as a plan is going to be very successful.  

But I didn't say that. I said that first you should figure out where the biggest hold up is. Is it people not picking up the phone? Is it inability to figure out where spread is happening? Is it speed of testing? Some of those might be easier to rectify than others. As I said, I've seen contact tracing get positivities back down in New York state, so it doesn't look like it's doing nothing here. 

[Bootsie]

1 minute ago, Not_a_Number said:

But I didn't say that. I said that first you should figure out where the biggest hold up is. Is it people not picking up the phone? Is it inability to figure out where spread is happening? Is it speed of testing? Some of those might be easier to rectify than others. As I said, I've seen contact tracing get positivities back down in New York state, so it doesn't look like it's doing nothing here. 

Has it really been contact tracing getting positives down?  Or, is there simply a correlation between those two things occurring?  Has contact tracing really changed that significantly in NY?  (Not being there I really do not know.)

This https://forward.ny.gov/percentage-positive-results-region-dashboard shows the 7-day rolling average positivity rate for NY holding steady at 1% since early June.  When did the more effective contact tracing occur?

[Not_a_Number]

1 minute ago, Bootsie said:

Has it really been contact tracing getting positives down?  Or, is there simply a correlation between those two things occurring?  Has contact tracing really changed that significantly in NY?  (Not being there I really do not know.)

I don't know, I suppose. The positivity in a region would go up, they would report that they found the source of the cluster, it would go down again. Could it be random flukes? I suppose it could. But I have no idea how to answer questions like this, because we're getting into infinite nitpicking land again, and I just don't have the energy. 

 

1 minute ago, Bootsie said:

This https://forward.ny.gov/percentage-positive-results-region-dashboard shows the 7-day rolling average positivity rate for NY holding steady at 1% since early June.  When did the more effective contact tracing occur?

Can't say I remember, sorry, and I'm not super interested in digging up exact dates for specific clusters in specific regions unless there's some chance the information will change your mind. 

[Frances]

1 hour ago, fifiruth said:

It seems as though too many people are living in the past....March and April. We are now seven months into this, and the dynamics are different. It’s the same virus, yes, but the situation is different. 

As a local head of a seven-hospital system in our area said a couple of weeks ago...they usually only have 9-10 patients, and sometimes none, spread out over the seven hospitals. He said that they know better what to do now, and have some medicines and protocols which have enabled the vast majority to recover. He also said that they use a similar protocol as the one the pres. received, all except that it’s convalescent plasma instead of Regeneron.   

As it is now, some state gov. are in a total holding pattern and are refusing to slowly but surely KEEP moving forward with ever increasing openness. Flat out refusal, and even threatening more restrictions.  As NOW has recently said, governments need to stop using lockdowns as their primary stategy.

 

Because every state is in such a different place in terms of mandates, cases, and hospitalizations, I’m not sure talking generally about what every state should be doing makes sense. Although cases are slowly rising again in my state, we’ve never really had a major surge and things have slowly opened up, and construction, food processing, and manufacturing were never really shut down. But with the exception of some rural areas, masking compliance has been pretty good, especially after the mandates.
 

Contrast that with my mom’s state where lockdown and masking have been fought every step of the way in court cases. She is hospitalized (not Covid related)in a hotspot city in a state with surging cases and the hospital is so over capacity that I’m just extremely grateful my brother has been able to be with her all day every day because the chaos surrounding her care is unending. And this is a hospital, based on much prior experience, where my parents always had exemplary care. So what are they supposed to be opening up while cases are surging, hospitals are filling, and people, including the majority of one political party leadership, are still activity fighting masking?

Edited October 15, 2020 by Frances

[hopeallgoeswell]

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.

[Pen]

@Jean in Newcastle

I am getting logged out in midst of trying to post — I tried copying a reply to you a quote from you with “let it rip” phrase in reply to a quote from me that might have seemed to

you to advocate “let it rip” though that was not my intent at all.

My reply may or may not have already posted during website difficulties. Apologies if it’s a double post.

 

———-

I’m not in favor of “let it rip” and am hopeful that we will have a good vaccine by this time in 2021–which will still be amazingly fast,  but I think it possible. Or maybe it is better to keep targeting on a closer date like promise of a sun day through rainy season, or of rain in fire season to keep hope alive and so people maybe do try to keep on using precautions if it is only for a sense of not too long still to go.  

I do not particularly want to get Covid either.  I cannot think of any virus that I want to get. 

And I have tended to be distressed by the tendency of people in my society to go to school, work, etc sick and expose others to whatever they have.

I hope that this virus will change some of that behavior long term. 

 

But things have changed since spring. Personally, for example, I have what I believe are good masks now.  My vitamin D levels were good at last check and probably still are good. I have cleaning supplies I did not have b.c. (Before Covid.) etc

In spring, family members in health care didn’t have suitable sufficient PPE, some younger ones were worried about their elementary school age children being left orphans.  And more. The situation was very bad.

 

It is not the same situation now. They have the PPE needed, their patients are not often dying of covid, and instead now are apparently dying of things like heart problems or cancers that perhaps needed surgery sooner but that got blocked as “elective”.   So Some sense of medical priorities have changed. There is some sense that lockdown went too far for too long in some regards. 

 

One of my main extended family parts with doctors has already been personally visited by Covid 19 and it passed through their home without major problems (unless something rears  its head as a future sequelae). CV19 also came close to some of my in their 80’s family. Some of these recent semi close encounters has led to a different view in a personal way now than  in Spring.

And it is not the same situation with regard to minor children of my family in health care either. It substantially shifted from fear that the children would be left orphans to a significant need for the children to have school and other things open because the parents need to work. (Kids Going to day camp while parents worked is how they got it in their family.) 

I have a cousin who is a geriatric specialist in a city that was hard hit who I have not spoken to recently, but my last impression second hand was that she also thought the situation is  better than it was in Spring as there is relatively better understanding of how to keep people in NHs and similar situations more safe from getting it in first place, and also more understanding of what can be done to help if they do get it. It went from thinking a whole generation was going to die to realizing that even some quite old seniors could survive this with relatively mild cases.  

[Not_a_Number]

Just now, hopeallgoeswell said:

ore 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.

First of all, we aren't sure that everyone with these T-cells is actually fine. 

Secondly, here's an interesting point Andrew Gelman made on his blog (he's a stats guy at Columbia): if it is TRUE that 50% of people are actually immune already, then COVID is actually much more contagious than we think, and we need more than 70% of the population to be infected. More like 80-90%. 

[Ausmumof3]

20 minutes ago, Bootsie said:

Has it really been contact tracing getting positives down?  Or, is there simply a correlation between those two things occurring?  Has contact tracing really changed that significantly in NY?  (Not being there I really do not know.)

This https://forward.ny.gov/percentage-positive-results-region-dashboard shows the 7-day rolling average positivity rate for NY holding steady at 1% since early June.  When did the more effective contact tracing occur?

I realise Aus is not the US but apparently one difference between vic and nsw here is that nsw had fairly strong already establish contact tracing systems in place whereas Vic didn’t.

[Frances]

3 hours ago, Pen said:

@Not_a_Number I saw our posts crossed.

probably your answer to her is same as to me

 

If you have a specific place you think we should copy please let me know. 

 

The only countries I see really “in control” other than China which had earlier warning and a police state approach— right now are small and often also islands.  And not even UK which is relatively small and islands is managing well like AU and NZ and Taiwan and Singapore.  Additionally if the Neanderthal gene hypothesis as to worse cases is correct, some of the countries with “control” also have populations less susceptible to severe illness from SARS2 virus. 

 

I have been following this attentively for months.

I have studied what I can about other approaches. 

I do not think what we both wish were possible is actually possible at this point. And increasingly when I have studied dispersal from China, I do not think that for USA it ever was. 

Sadly.

And at this point I do not even think in general that it is the “United States” fault, neither leadership nor populace.   Because we had ____ (many!) International flights per day from China, other parts of Asia and Europe I think we already had a major spread here before we even knew there was a novel coronavirus spreading in China. 

So you don’t think any lives could have been saved or still could be saved with better leadership and compliance from the general public? If from the very beginning there had been a strong and consistent message from the very top that we are all in this together and it is patriotic to protect others by following the guidelines? Sure, there were things we couldn’t control or know at the beginning, but I firmly believe we could have done better and still could do better, both in terms of leadership and individual responsibility.

[Not_a_Number]

6 minutes ago, Pen said:

It went from thinking a whole generation was going to die to realizing that even some quite old seniors could survive this with relatively mild cases.  

I don't know who was thinking this back in the spring. It never looked quite that bad. If you're going to start out with hyperbole, then yes, things are better than we thought. A 20% death rate for 80 and up still means 80% survive... 

[Frances]

14 minutes ago, Pen said:

@Jean in Newcastle

I am getting logged out in midst of trying to post — I tried copying a reply to you a quote from you with “let it rip” phrase in reply to a quote from me that might have seemed to

you to advocate “let it rip” though that was not my intent at all.

My reply may or may not have already posted during website difficulties. Apologies if it’s a double post.

 

———-

I’m not in favor of “let it rip” and am hopeful that we will have a good vaccine by this time in 2021–which will still be amazingly fast,  but I think it possible. Or maybe it is better to keep targeting on a closer date like promise of a sun day through rainy season, or of rain in fire season to keep hope alive and so people maybe do try to keep on using precautions if it is only for a sense of not too long still to go.  

I do not particularly want to get Covid either.  I cannot think of any virus that I want to get. 

And I have tended to be distressed by the tendency of people in my society to go to school, work, etc sick and expose others to whatever they have.

I hope that this virus will change some of that behavior long term. 

 

But things have changed since spring. Personally, for example, I have what I believe are good masks now.  My vitamin D levels were good at last check and probably still are good. I have cleaning supplies I did not have b.c. (Before Covid.) etc

In spring, family members in health care didn’t have suitable sufficient PPE, some younger ones were worried about their elementary school age children being left orphans.  And more. The situation was very bad.

 

It is not the same situation now. They have the PPE needed, their patients are not often dying of covid, and instead now are apparently dying of things like heart problems or cancers that perhaps needed surgery sooner but that got blocked as “elective”.   So Some sense of medical priorities have changed. There is some sense that lockdown went too far for too long in some regards. 

 

One of my main extended family parts with doctors has already been personally visited by Covid 19 and it passed through their home without major problems (unless something rears  its head as a future sequelae). CV19 also came close to some of my in their 80’s family. Some of these recent semi close encounters has led to a different view in a personal way now than  in Spring.

And it is not the same situation with regard to minor children of my family in health care either. It substantially shifted from fear that the children would be left orphans to a significant need for the children to have school and other things open because the parents need to work. (Kids Going to day camp while parents worked is how they got it in their family.) 

I have a cousin who is a geriatric specialist in a city that was hard hit who I have not spoken to recently, but my last impression second hand was that she also thought the situation is  better than it was in Spring as there is relatively better understanding of how to keep people in NHs and similar situations more safe from getting it in first place, and also more understanding of what can be done to help if they do get it. It went from thinking a whole generation was going to die to realizing that even some quite old seniors could survive this with relatively mild cases.  

So it sounds like your main desires at this point are opening schools and nursing homes? As far as I know, all health systems here are fully running. Some people might still be waiting for elective procedures due to continuing back log from the relatively brief suspension of electives. Even the people I know who are going out the very least are still seeing doctors, dentists, orthodontists, physical therapists, eye doctors, etc. for regular appointments.

[Not_a_Number]

Just now, Frances said:

So it sounds like your main desires at this point are opening schools and nursing homes? As far as I know, all health systems here are fully running. Some people might still be waiting for elective procedures due to continuing back log from the relatively brief suspension of electives. Even the people I know who are going out the very least are still seeing doctors, dentists, orthodontists, physical therapists, eye doctors, etc. for regular appointments.

Yeah, we have been. I did decide to delay the longer term dental work, though, because I didn't want to be in the middle of something that can't be delayed for a month... if NY stays under control, though, I may revise. But I got my teeth cleaned and so did my kids and everyone has been going to the doctor. 

[TCB]

2 hours ago, Not_a_Number said:

Well, the story people are spreading right now (with no support that I can see) is that treatments have improved, and things are better. 

I'll believe it when I see it. And given that I would LIKE it to be true, I really will believe it when I see it. 

Not my experience about better treatments really. Avoiding intubation if at all humanly possible seems to help some. We also seem to have sicker patients this time round - but that’s just my experience, don’t know if it means anything.

[Bootsie]

39 minutes ago, Not_a_Number said:

I don't know, I suppose. The positivity in a region would go up, they would report that they found the source of the cluster, it would go down again. Could it be random flukes? I suppose it could. But I have no idea how to answer questions like this, because we're getting into infinite nitpicking land again, and I just don't have the energy. 

 

Can't say I remember, sorry, and I'm not super interested in digging up exact dates for specific clusters in specific regions unless there's some chance the information will change your mind. 

I am less optimistic that it is finding the source of a cluster that is causing the positivity rate to fall.  I cluster will be associated with a rising positivity rate.  Those people have been infected. by the time the cluster has been identified. After the cluster has been identified the positivity rate goes down because the cluster was what was causing the positivity rate to rise.

The NY site shows the state rolling average positivity rate at 1% consistently since June 8--if there is no change in a variable, there is no change in a variable.  If there is no deviation in a variable, then how does one show cause and effect?  Call that what you would like, but I don't see how that is nitpicking.  

 

[Not_a_Number]

1 minute ago, Bootsie said:

 Call that what you would like, but I don't see how that is nitpicking.  

I've never changed your mind on anything. Frankly, it never feels like anything I say is interesting or useful to you. That's fine, but it makes conversations boring. 

[Jean in Newcastle]

37 minutes ago, Pen said:

@Jean in Newcastle

I am getting logged out in midst of trying to post — I tried copying a reply to you a quote from you with “let it rip” phrase in reply to a quote from me that might have seemed to

you to advocate “let it rip” though that was not my intent at all.

My reply may or may not have already posted during website difficulties. Apologies if it’s a double post.

 

———-

I’m not in favor of “let it rip” and am hopeful that we will have a good vaccine by this time in 2021–which will still be amazingly fast,  but I think it possible. Or maybe it is better to keep targeting on a closer date like promise of a sun day through rainy season, or of rain in fire season to keep hope alive and so people maybe do try to keep on using precautions if it is only for a sense of not too long still to go.  

I do not particularly want to get Covid either.  I cannot think of any virus that I want to get. 

And I have tended to be distressed by the tendency of people in my society to go to school, work, etc sick and expose others to whatever they have.

I hope that this virus will change some of that behavior long term. 

 

But things have changed since spring. Personally, for example, I have what I believe are good masks now.  My vitamin D levels were good at last check and probably still are good. I have cleaning supplies I did not have b.c. (Before Covid.) etc

In spring, family members in health care didn’t have suitable sufficient PPE, some younger ones were worried about their elementary school age children being left orphans.  And more. The situation was very bad.

 

It is not the same situation now. They have the PPE needed, their patients are not often dying of covid, and instead now are apparently dying of things like heart problems or cancers that perhaps needed surgery sooner but that got blocked as “elective”.   So Some sense of medical priorities have changed. There is some sense that lockdown went too far for too long in some regards. 

 

One of my main extended family parts with doctors has already been personally visited by Covid 19 and it passed through their home without major problems (unless something rears  its head as a future sequelae). CV19 also came close to some of my in their 80’s family. Some of these recent semi close encounters has led to a different view in a personal way now than  in Spring.

And it is not the same situation with regard to minor children of my family in health care either. It substantially shifted from fear that the children would be left orphans to a significant need for the children to have school and other things open because the parents need to work. (Kids Going to day camp while parents worked is how they got it in their family.) 

I have a cousin who is a geriatric specialist in a city that was hard hit who I have not spoken to recently, but my last impression second hand was that she also thought the situation is  better than it was in Spring as there is relatively better understanding of how to keep people in NHs and similar situations more safe from getting it in first place, and also more understanding of what can be done to help if they do get it. It went from thinking a whole generation was going to die to realizing that even some quite old seniors could survive this with relatively mild cases.  

Forgive me if I am dense but I have no idea what your post has to do with what I had posted. My post wasn’t referring to anything you had said. I understand that we are 7 months into this (though different areas of the country are in different positions as far as spread, infection rate, hospitalization etc). 
 

Absolutely no elective procedures are blocked in my area. In fact I have friends who have been receiving all sorts of medical care for non COVID related problems for the past 7 months...

There are all sorts of solutions to childcare and schooling in my neighborhood.  There are creative solutions to visits with the elderly available.  The state is doing its best but can’t change the nature of the virus.   (Your area of course may be different.). 

[Bootsie]

1 minute ago, Not_a_Number said:

I've never changed your mind on anything. Frankly, it never feels like anything I say is interesting or useful to you. That's fine, but it makes conversations boring. 

I'm sorry if a conversation is boring to you if I raise questions regarding how you can attribute cause and effect to a variable that has no standard deviation.  And, making comments like this definitely will not change my mind regarding needing some variation in a variable to even begin to show cause and effect.  

I am genuinely interested in learning if there are some places that have good, effective contact tracing (or anything else) that is really reducing cases that could be adopted other places.  And, no, just saying Place X is doing it without any indication of WHAT they are doing differently, HOW it is working, and any indication that it IS indeed working is not going to change my mind.  

 

[Not_a_Number]

4 minutes ago, Bootsie said:

I'm sorry if a conversation is boring to you if I raise questions regarding how you can attribute cause and effect to a variable that has no standard deviation.  And, making comments like this definitely will not change my mind regarding needing some variation in a variable to even begin to show cause and effect.  

Nope, that's not what's making it boring. 

 

Quote

I am genuinely interested in learning if there are some places that have good, effective contact tracing (or anything else) that is really reducing cases that could be adopted other places.  And, no, just saying Place X is doing it without any indication of WHAT they are doing differently, HOW it is working, and any indication that it IS indeed working is not going to change my mind.  

Oh, sure, that's reasonable. But whenever I provide evidence, we go down a long deep rabbit hole of why my evidence is insufficient. I don't think it has once been sufficient. As is, I've given at least a few things that NY is doing differently, which you haven't in any way engaged with.

So, I'm sorry, but I'm not going to dig up more evidence that you can then shoot down unless you provide me with evidence (hah) that you are actually able to change your mind based on anything at all I say.

Edited October 15, 2020 by Not_a_Number

[Corraleno]

50 minutes ago, hopeallgoeswell said:

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.

Those articles do NOT say that "50% of the population already has immunity." They say that some people, in a small sample of people who have not had CV19, have t-cells that seem to recognize certain pieces of the CV19 virus and that, hypothetically, this might possibly account for some of the differences in the severity of the illness. Not that people who have this response will never get the disease, but that they may not get it as severely as those who do not have this response. But even that is just conjecture, and not remotely proven. 

The claim that 50% of Americans are already immune, which is being promoted by Scott Altas and the Hoover Institute and various RW bloggers and media personalities as support for the "herd immunity" approach, is not accepted by the mainstream scientific community and has been widely criticized.

[MercyA]

4 hours ago, fifiruth said:

On the website for the Barrington document, it’s very easy to sign in/on. The fake names were added, I suspect, to undermine the credibility of the statement. 

Read the document, and/or watch the interview, and then judge the assertions on their own merit. 

Or as a protest. 

Yes, I didn't realize initially that it was an "add your signature" type of document and I was mightily confused as to how people could be so foolish as to promote it. And that is saying a lot during these times. 😉 

Your second point is a fair one, fifiruth. 

[MercyA]

It is a true honor to be on this forum. Seriously, you guys are so thoughtful and informed and smart.

Shout out to @Corraleno, @Not_a_Number, and @Spy Carfor exceptional Truth Speaking. And lots more of you, too. I don't remember usernames especially well and I am scanning quickly!

[hopeallgoeswell]

1 minute ago, Corraleno said:

Those articles do NOT say that "50% of the population already has immunity." They say that some people, in a small sample of people who have not had CV19, have t-cells that seem to recognize certain pieces of the CV19 virus and that, hypothetically, this might possibly account for some of the differences in the severity of the illness. Not that people who have this response will never get the disease, but that they may not get it as severely as those who do not have this response. But even that is just conjecture, and not remotely proven. 

The claim that 50% of Americans are already immune, which is being promoted by Scott Altas and the Hoover Institute and various RW bloggers and media personalities as support for the "herd immunity" approach, is not accepted by the mainstream scientific community and has been widely criticized.

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.

[Not_a_Number]

1 minute ago, hopeallgoeswell said:

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.

If I'm understanding T-cells correctly, they are a LATER defense, right? So even if you're assuming that people in this 50% aren't going to get as sick, there's no reason to assume they can't get infected and spread it? That means we aren't nearly as close to herd immunity as all that. We can't just add those on. 

[Bootsie]

2 minutes ago, Not_a_Number said:

Nope, that's not what's making it boring. 

 

Oh, sure, that's reasonable. But whenever I provide evidence, we go down a long deep rabbit hole of why my evidence is insufficient. I don't think it has once been sufficient. As is, I've given at least a few things that NY is doing differently, which you haven't in any way engaged with.

So, I'm sorry, but I'm not going to dig up more evidence that you can then shoot down unless you provide me with evidence (hah) that you are actually able to change your mind based on anything at all I say.

I suppose I am dense because I have not read anything specific that NY is doing differently.  I have read that they are doing contact tracing, that they have rolled out an app, and that they have identified clusters.  How would one engage with that?  I have asked for specifics, what does it look like ?  How is it different?  What could others do?  What is the evidence that it is having an impact?

The evidence that you provided about the success showed that New York was getting contact information for less than 50% of the cases.  The positivity rate you pointed to has a 0 standard deviation.  Yes, I will draw conclusions from that evidence--New York is getting contact information at the same rate a lot of other states are reporting.  And, I will also conclude that with a variable with zero standard deviation, I cannot reasonably conclude anything about correlation (much less causation).  If there is evidence that suggests another conclusion is reasonable, I would consider that evidence. 

[Not_a_Number]

Well, @Bootsie, this information is in the public domain 🙂 . Feel free to look at it and make up your mind. 

[Corraleno]

5 minutes ago, hopeallgoeswell said:

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.

Even if it is "likely" that having this sort of response might decrease the severity of the illness in some people, that is nowhere near saying that "half the population is already immune."  There is no evidence for that claim, and the people who are making it are purposely distorting scientific data to support a political and economic agenda that flies in the face of the recommendations of the vast majority of epidemiologists and public health officials.

[Jean in Newcastle]

31 minutes ago, Jean in Newcastle said:

Forgive me if I am dense but I have no idea what your post has to do with what I had posted. My post wasn’t referring to anything you had said. I understand that we are 7 months into this (though different areas of the country are in different positions as far as spread, infection rate, hospitalization etc). 
 

Absolutely no elective procedures are blocked in my area. In fact I have friends who have been receiving all sorts of medical care for non COVID related problems for the past 7 months...

There are all sorts of solutions to childcare and schooling in my neighborhood.  There are creative solutions to visits with the elderly available.  The state is doing its best but can’t change the nature of the virus.   (Your area of course may be different.). 

Quoting myself to correct one point. I did quote you and responded specifically to the hospital overrun comment. The rest was not in response to you specifically. 

[Ausmumof3]

30 minutes ago, hopeallgoeswell said:

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.

The other concern is that it may actually make an infection worse due to immune system overreaction.  I would assume studies are being done on this.

There have been some examples with ships etc where almost the entire ship has become infected making it unlikely that 50pc are immune though that may differ with location.

[AmandaVT]

1 hour ago, Bootsie said:

I'm sorry if a conversation is boring to you if I raise questions regarding how you can attribute cause and effect to a variable that has no standard deviation.  And, making comments like this definitely will not change my mind regarding needing some variation in a variable to even begin to show cause and effect.  

I am genuinely interested in learning if there are some places that have good, effective contact tracing (or anything else) that is really reducing cases that could be adopted other places.  And, no, just saying Place X is doing it without any indication of WHAT they are doing differently, HOW it is working, and any indication that it IS indeed working is not going to change my mind.  

 

In VT, we have a really robust contact tracing program. I'm not sure it's lowering our rate, but it's keeping it low, if that makes sense. If a small outbreak happens, they've been able to contain it and we haven't had to go back to a statewide lockdown. The health commissioner has also been very forthcoming about small outbreaks and what was done to contain them, which is keeping people feeling relatively safe. 

https://vtdigger.org/2020/10/05/surge-in-covid-19-cases-in-addison-county-linked-to-apple-orchard-workers/

This was last week - there were about 25 cases connected to an apple orchard. The orchard was immediately closed down, all workers were tested and extra testing sites were made available to people in the area. Contact tracing was done. As far as I know, there have been no other cases connected. 

https://vtdigger.org/2020/10/13/a-cluster-of-12-covid-19-cases-connected-to-montpelier-hockey-leagues/

This is from this week and is about 10 min from my house. I know people that are connected to this ice rink and talked to one today. They've been calling everyone that went to the hockey game, practice at the rink, have kids who practice at the rink, or are connected in any way. Then they determined who was considered a close contact to the affected people. Contact tracers called everyone and asked them to quarantine. There was a case at the school as well that is connected. Every parent in the district got a text that said: "There has been a case in our district, our contact tracers are working to identify close contacts. Pick up the phone if they call you. If you don't get a call, you do not need to take further action." The school moved to remote learning for a couple of days.

So far, small outbreaks have not turned to big outbreaks. Our schools have moved into Phase III which allows mixing of classes/cohorts, sports to be up and running, and students allowed into gyms and cafeterias at school. Many districts are choosing not to loosen restrictions for a little while longer, including mine. We're all feeling like something isn't going to hold and we'll end up with community spread, but we're just holding our breath and trying to do our best.

[Matryoshka]

2 hours ago, Bootsie said:

I am less optimistic that it is finding the source of a cluster that is causing the positivity rate to fall.  I cluster will be associated with a rising positivity rate.  Those people have been infected. by the time the cluster has been identified. After the cluster has been identified the positivity rate goes down because the cluster was what was causing the positivity rate to rise.

The NY site shows the state rolling average positivity rate at 1% consistently since June 8--if there is no change in a variable, there is no change in a variable.  If there is no deviation in a variable, then how does one show cause and effect?  Call that what you would like, but I don't see how that is nitpicking.  

Well, my thinking is the reason the positivity rate has stayed at 1% in spite of clusters, is that the contact tracing has effectively shut the clusters down.  In absence of that contact tracing, the clusters would have spread the virus, and increased the positivity rate.   The very stability of the positivity rate in spite of clusters shows that the contact tracing is working.

[Matryoshka]

16 minutes ago, AmandaVT said:

So far, small outbreaks have not turned to big outbreaks. 

@Bootsie This.  This is how you know the contact tracing is working.  It doesn't prevent small outbreaks, it prevents them turning into big outbreaks, which then increase the positivity rate -> cases -> deaths.

[Not_a_Number]

1 minute ago, Matryoshka said:

Well, my thinking is the reason the positivity rate has stayed at 1% in spite of clusters, is that the contact tracing has effectively shut the clusters down.  In absence of that contact tracing, the clusters would have spread the virus, and increased the positivity rate.   The very stability of the positivity rate in spite of clusters shows that the contact tracing is working.

I'm very interested in what happens now. There are unambiguous and more serious clusters in some neighborhoods (largely Orthodox neighborhoods, I think.) They've locked those down, in fact. The question is now whether they can control this. 

[Matryoshka]

4 minutes ago, Not_a_Number said:

I'm very interested in what happens now. There are unambiguous and more serious clusters in some neighborhoods (largely Orthodox neighborhoods, I think.) They've locked those down, in fact. The question is now whether they can control this. 

Here I'm guessing the Orthodox Jewish communities are mostly in Brookline, which I haven't heard of as a problem.  Mostly North Shore is problematic, which is diverse in other ways.

[Not_a_Number]

Just now, Matryoshka said:

Here I'm guessing the Orthodox Jewish communities are mostly in Brookline, which I haven't heard of as a problem.  Mostly North Shore is problematic, which is diverse in other ways.

Yeah, this seems to be a specifically NY thing. I would also guess the Orthodox neighborhoods in Boston are in Brookline. But here, it's definitely a lot of Orthodox neighborhoods at the moment. Maybe the holidays did it. 

[Bootsie]

1 hour ago, Matryoshka said:

@Bootsie This.  This is how you know the contact tracing is working.  It doesn't prevent small outbreaks, it prevents them turning into big outbreaks, which then increase the positivity rate -> cases -> deaths.

I am having difficulty with combining this with what we know about the dispersion of the infection rates.  If the dispersion of the infection rate is such that 80% of the people who are infected do not infect anyone else, it isn't really a situation in which a cluster forms where 20 people are infected and each of those people goes and infects one more person.  In that cluster of 20 there may be 3 people who infect a couple of other people and 1 person who infects a larger number.  The odds are not really in the favor of finding that person if you only get contact information from less than 50% of the 20 in the cluster (so let's just say 10) and then you only get in touch with less than half of those people's contacts, and of those you get in touch with 25% are already symptomatic (those percentages are in line with what is being reported by New York, not just hypothetical).   And if you have managed to contact that person, and they aren't symptomatic, the chances that you have contacted them before they have spread to others is also unlikely.  Add into that the "contacts" are often people who know the infected individual, such as family members who have known about the possible infection long before they are contacted by a tracer.  

I understand the theory of contact tracing, but where the rubber meets the road with this particular virus, I am not seeing generalized evidence that it is working greatly.

[Not_a_Number]

2 minutes ago, Bootsie said:

I am having difficulty with combining this with what we know about the dispersion of the infection rates.  If the dispersion of the infection rate is such that 80% of the people who are infected do not infect anyone else, it isn't really a situation in which a cluster forms where 20 people are infected and each of those people goes and infects one more person.  In that cluster of 20 there may be 3 people who infect a couple of other people and 1 person who infects a larger number.  The odds are not really in the favor of finding that person if you only get contact information from less than 50% of the 20 in the cluster (so let's just say 10) and then you only get in touch with less than half of those people's contacts, and of those you get in touch with 25% are already symptomatic (those percentages are in line with what is being reported by New York, not just hypothetical).   And if you have managed to contact that person, and they aren't symptomatic, the chances that you have contacted them before they have spread to others is also unlikely.  Add into that the "contacts" are often people who know the infected individual, such as family members who have known about the possible infection long before they are contacted by a tracer.  

I understand the theory of contact tracing, but where the rubber meets the road with this particular virus, I am not seeing generalized evidence that it is working greatly.

What they are doing is, I think, figuring out the center of the spread, then quarantining everyone associated with it. That seems to be enough to keep people from spreading it to lots of people. Just because some people can spread it to lots of people doesn't mean that they already did by the time they found the central event/location. 

The sooner you get to these superspreader events, the better. 

[Bootsie]

1 hour ago, AmandaVT said:

In VT, we have a really robust contact tracing program. I'm not sure it's lowering our rate, but it's keeping it low, if that makes sense. If a small outbreak happens, they've been able to contain it and we haven't had to go back to a statewide lockdown. The health commissioner has also been very forthcoming about small outbreaks and what was done to contain them, which is keeping people feeling relatively safe. 

https://vtdigger.org/2020/10/05/surge-in-covid-19-cases-in-addison-county-linked-to-apple-orchard-workers/

This was last week - there were about 25 cases connected to an apple orchard. The orchard was immediately closed down, all workers were tested and extra testing sites were made available to people in the area. Contact tracing was done. As far as I know, there have been no other cases connected. 

https://vtdigger.org/2020/10/13/a-cluster-of-12-covid-19-cases-connected-to-montpelier-hockey-leagues/

This is from this week and is about 10 min from my house. I know people that are connected to this ice rink and talked to one today. They've been calling everyone that went to the hockey game, practice at the rink, have kids who practice at the rink, or are connected in any way. Then they determined who was considered a close contact to the affected people. Contact tracers called everyone and asked them to quarantine. There was a case at the school as well that is connected. Every parent in the district got a text that said: "There has been a case in our district, our contact tracers are working to identify close contacts. Pick up the phone if they call you. If you don't get a call, you do not need to take further action." The school moved to remote learning for a couple of days.

So far, small outbreaks have not turned to big outbreaks. Our schools have moved into Phase III which allows mixing of classes/cohorts, sports to be up and running, and students allowed into gyms and cafeterias at school. Many districts are choosing not to loosen restrictions for a little while longer, including mine. We're all feeling like something isn't going to hold and we'll end up with community spread, but we're just holding our breath and trying to do our best.

The apple orchard case appears to have been workers who had recently entered the US and were all quarantined together.  It is very easy to contact trace among a quarantined group and contain the outbreak to that group.  

In smaller communities, where people tend to know each other, tend to know the other people on sports teams, or at schools, I think it is much easier.  In areas where people live in one municipality and work in another municipality and maybe go to a store in a third municipality, it is more difficult.  When you live in one county and your children go to school in another county, the contact tracing becomes more complicated.  

[Not_a_Number]

1 minute ago, Bootsie said:

When you live in one county and your children go to school in another county, the contact tracing becomes more complicated.  

Yeah, this is obviously trickier in NYC than in other parts of NY. I think the contact tracing has frankly worked better in other parts of NY. 

[Ausmumof3]

6 minutes ago, Bootsie said:

I am having difficulty with combining this with what we know about the dispersion of the infection rates.  If the dispersion of the infection rate is such that 80% of the people who are infected do not infect anyone else, it isn't really a situation in which a cluster forms where 20 people are infected and each of those people goes and infects one more person.  In that cluster of 20 there may be 3 people who infect a couple of other people and 1 person who infects a larger number.  The odds are not really in the favor of finding that person if you only get contact information from less than 50% of the 20 in the cluster (so let's just say 10) and then you only get in touch with less than half of those people's contacts, and of those you get in touch with 25% are already symptomatic (those percentages are in line with what is being reported by New York, not just hypothetical).   And if you have managed to contact that person, and they aren't symptomatic, the chances that you have contacted them before they have spread to others is also unlikely.  Add into that the "contacts" are often people who know the infected individual, such as family members who have known about the possible infection long before they are contacted by a tracer.  

I understand the theory of contact tracing, but where the rubber meets the road with this particular virus, I am not seeing generalized evidence that it is working greatly.

It is definitely working here.  I think the size of the outbreak you guys have is the issue.  The idea is lockdown short and hard to be able to build up contact tracing capacity and testing capacity.  Repeated lockdowns without that are kind of an exercise in futility.

it does seem that in western countries manual contact tracing works better than app based solutions.

[Ausmumof3]

https://www.abc.net.au/radio/programs/coronacast/how-do-contact-tracing-systems-differ-between-nsw-and-victoria/12767442
 

@Bootsie

this was a really interesting episode with a lot about contact tracing down here and how it works.  There is a transcript if you are like me and find it easier to read than listen or watch.  

[Bootsie]

6 minutes ago, Ausmumof3 said:

It is definitely working here.  I think the size of the outbreak you guys have is the issue.  The idea is lockdown short and hard to be able to build up contact tracing capacity and testing capacity.  Repeated lockdowns without that are kind of an exercise in futility.

it does seem that in western countries manual contact tracing works better than app based solutions.

Do you have any idea of how long the average time is between exposure and being contacted there is?  How are contacts being reached?  Do people answer their phone there?

Oh--I see you posted some information about this while I was asking these questions--so you can ignore them for now and I will look at your inf.

 

Edited October 16, 2020 by Bootsie