CoVid-19 and The 2020 Burning Man Event

[Canoe]

• We are past 250,000 Confirmed (253,926)
• We are past 10,000 Deaths (10,406)
• We are over 150,000 Active (154,450)
• Italy has more Deaths than China (3,405 to 3,255)
• Daily Deaths are continuing and are climbing, yesterday was 1,090 (including China's NHC daily update).
• The U.S. is showing 14,372 cases, and should pass 15,000 sometime today. At 217 Deaths.
  ICUs are filling up, young & old.
  Ventilators are becoming scare, including some sites putting two Pt.s per ventilator, some preparing for four-per (and how to address different Pt. needs with that).
  PPE (Personal Protection Equipment) is becoming scarce for health care personnel. Re-using, using lower level equipment or going without.
  Health care personnel are isolating themselves from their families to protect them.

From Italy,

• To date in Italy there are 300 children with coronavirus but "there are no victims or serious cases".
• citizens will no longer have to go to a general practitioner, but will have a code in the pharmacy to collect the "medications.
• the release of the field hospital situation and the government's announcement to send 300 doctors to the most affected areas.
• The head of state was also reportedly impressed by the images of the column of the army vehicles that yesterday brought to other provinces about seventy coffins that it was not possible to manage in the Orobic cemetery and asked "to embrace all the Bergamo citizens and to hold on. "
• Five other doctors died of the new coronavirus in Lombardy, bringing the tragic toll between white coats to 13 victims, according to Fnomceo. … The list of deaths among doctors is unfortunately continuously updated.

http://www.ansa.it/canale_saluteebeness ... a2c1b.html

[Canoe]

Europe sure takes a huge chunk.
Wuhan, one city, still shows 20%.
Although China was/is the only country that tracked and reported the non-lab-confirmed Mild & Moderate cases as Suspected. And those were tested over time, now down to 104 from its maximum of 29,730.

COVID-19 Global distribution March 20, 2020 part.png

[Sham]

Statement from Burning Man CEO, Marian Goodell:
https://journal.burningman.org/2020/03/ ... yA6bIuxFDQ

Second statement:
https://journal.burningman.org/2020/03/ ... f5bGt7R4Rg

[XPTom]

Scary thing is the pie chart does not account for population size. USA has 5 times more population than Italy. China almost 25 times more. If NYC or California goes in the "Italy mode" we are f'd .

[Canoe]

Scary thing is the pie chart does not account for population size. USA has 5 times more population than Italy. China almost 25 times more. If NYC or California goes in the "Italy mode" we are f'd .

It's interesting to compare the two circumstances.

• Italy was initially doing extensive testing and extensive tracking down of contacts, so people would know if they're infectious and would quarantine, thereby limiting the spread. Their capital didn't like the expense, nor the numbers public (bad image, affect tourism, etc.), so testing was restricted to those with obvious symptoms. This left all of the mild cases, pre-symptomatic and contacts in the dark, and they went about their usual business, unaware they were infected with SARS-CoV-2 and were infecting others.
  By the time the count was so high they couldn't ignore it anymore, it was too late. The infection was thoroughly seeded and active in a large and undetected infected population. Their health care system should have been able to contain things at a CFR of 2.05 or better, closer to 1.0, even 0.7 if they'd detected it early (like they had).
  Italy's Crude Fatality Rate as of yesterday's numbers is 8.6%. With their reported Confirmed population of 47,021 cases, at a CFR of 3.6, they'd be expected to eventually accumulate 1,693 Deaths as that population ran out the course of the disease. Only they have 4,032 Deaths. They already have 238% of the expected eventual accumulated deaths for their infected population size. That number of deaths would be expected at 3.6 CFR for an infected population of 112,000. But deaths lag onset and detection, with most deaths occuring in the third week of the course of the disease. So if we assign current deaths as 60% of the eventual deaths for the current infected population, the infected population would be 186,667 infected, not the ~47K they report. With no increase in the number of people infected, a 3.6 CFR indicates an expected 6,720 deaths.
  A polynomial trend line on the rising Deaths indicates a March 31 projection of over 10,700 deaths.
• The U.S.A. had a huge deficit in testing. Instructions from above wanted reported numbers as low as possible. It took a doctor defying orders to not test, to give an indication that the U.S. had clusters. Once testing was allowed by non-CDC entities, detections took off.
  As of yesterday's numbers, the U.S. with 19,393 Confirmed cases has beat everyone else on the globe, having the steepest slope yet in the rise of Confirmed cases. There are clusters reported widely throughout the U.S.. Testing is still ramping up. Fortunately, that steep rise is likely not the infection rate, but reflects a detection rate, due to the huge delay in testing. Unfortunately, that number illustrates the huge seeding of the infection through the U.S..
  As testing still hasn't caught up, modelling the multiple seeded outbreaks in the U.S. has a wide range. Attached is one graph of several model results.
  But due to an ongoing deficit in testing, it is as yet unknown where the U.S. sits. The various social distancing shutdowns will limit the spread of new infections, allow those already infected and pre-symptomatic to present with the disease, those mild will run through the course of the disease, and clusters will be identified (many? most?).

It is yet unknown where the U.S. sits in regard to where Italy found themselves due to restricted testing.

U.S. infected models to March 16, 2020

US models to Mar 16 2020.jpg

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Confirmed/Active curves aligned from 1000 Confirmed cases.

Covid-19 TOP aligned 2020-03-20 - U.S..png

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Italy's Deaths trend to March 31, 2020

Covid-19 Italy - deaths trend out to mar 31, as of mar 20 2020 condensed c.png

[Token]

Canoe buddy, all the numbers, graphs, and charts - you are looking into the past. Minimum 10 days in the past, probably more.

2-14 day incubation period,
...typically 5-6 days
3-5 days of mild symptoms most are conditioned to ignore.
2-3 days of oh shit I’m sick and getting tested

So all that data on reported cases is for events and state of affairs from 10-14 days in the past which are being correlated to mortality of now.

Try an experiment: time shift the CFR to match the temporal lag of the detection.

Even then it will be quite flawed as we likely do not know how long on average the terminal cases were infirmed.

[Canoe]

Canoe buddy, all the numbers, graphs, and charts - you are looking into the past. Minimum 10 days in the past, probably more. ...
So all that data on reported cases is for events and state of affairs from 10-14 days in the past which are being correlated to mortality of now.
Try an experiment: time shift the CFR to match the temporal lag of the detection.
Even then it will be quite flawed as we likely do not know how long on average the terminal cases were infirmed.

Yes, but that's the apples to apples comparison available from such measurements.
A time shift doesn't work well. I use Deaths represent 60% of CFR expected deaths to approximate that, as the lag is the point. The lag should show that the deaths for a detected population are lagging. Instead, the deaths for Italy are already greater than the eventual expected accumulation for the detected/reported population. Which is why use a CFR to calculate what the detected infected population should be, instead of what has been detected. Which is why for current Deaths of 4,032, if accumulating/lagging, the 3.6 CFR based infected population size that should have been detected is 186,667, instead of the reported 47,021.

Done more properly, one needs the more detailed case data, where they do a case by case for onset and detection, and for contact/exposure were possible.
A simplified example of that is included on their info graphic at the link I gave in a prior post. I haven't check if they've updated it after yesterday's numbers. ...
https://www.epicentro.iss.it/coronaviru ... ianza-dati
They have.
part of the infographic

COVID-19, Italy, Onset graph.png

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This is a few days old, but you can see how the External Confirmed leads the External Deaths.
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Covid-19 deaths - lag.png

[Luigi]

Going to interesting to see how the main sale goes. In today's RGJ news:

https://www.rgj.com/story/life/arts/bur ... 890410001/

[Canoe]

I started graphing the numbers for 2019-nCov on February 2nd.
As the numbers out of China grew, there were times I was shocked, and saddened.
Tonight I updated today's numbers to EOD UTC and went through the spreadsheet updating the ranges of the various graphs.
Then I got Italy's detailed info on hospitalized, ICU & home isolation and entered those.
Then updated Italy's projection to March 31, 2020.
Now I've got tears running down my face.
China's NHC should have their daily update posted and ready for me to run through google translate and finish my graph updates for the day. But I'm going to leave that for tomorrow.

Italy for March 21, 2020, total 53,578 Confirmed:

• 4,825 Deaths
• 6,072 Recovered
• 42,681 Positive
  • 22,116 in home isolation
  • 17,708 hospitalized
  • 2,857 hospitalized in ICU

Crude Fatality Rate = 9.0%
Based on the Deaths, a CFR of 3.6 and allowing for lag, the Confirmed infected population size should be 223,380.
Projected from Deaths to date, a polynomial trendline with an R²=1.00 projecting to March 31, 2020, shows 15,200 Deaths.
I hope their Social Distancing measures start to kick in sometime soon.
.

Covid-19 Italy - deaths trend out to mar 31, as of mar 21 2020 condensed C.png

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And the U.S. numbers jumped over 7,000 today.
Now showing 26,686 Confirmed, 340 Deaths and 176 Recovered.

[666isMONEY]

Wish Arizona would shut everything down to flatten the curve like California and Nevada did.

[Canoe]

March 21, 2020 Polynomial Projection of COVID-19 Deaths to March 31, 2020

• External to China 38,100+
• Global 41,500+

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COVID-19 Deaths Polynomial Projection to March 31, 2020 - March 21, 2020 - inset.png

[XPTom]

Canoe buddy, all the numbers, graphs, and charts - you are looking into the past. Minimum 10 days in the past, probably more.

2-14 day incubation period,
...typically 5-6 days
3-5 days of mild symptoms most are conditioned to ignore.
2-3 days of oh shit I’m sick and getting tested...….

Add another day or two for govt agencies to digest the test info before we get to smell it. When our Liquor Control Board took action on Saturday to close State Stores in the Philly area it is safe to say they knew something late Friday. The spike in the data that drove the decision was Sunday news.

[Canoe]

Let's hope no one tells Trump the U.S. is in third place behind China and Italy...
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COVID-19 Global distribution March 22, 2020.png

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This is not a model. A number of interventions are already underway.
From Deaths to March 22, 2020, a polynomial trendline projection out to April 30, 2020.
Call it 440K External Deaths and 454K Global Deaths.
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Covid-19 deaths trend out to April 30, as of mar 22 2020.png

[666isMONEY]

Canoe: what’s your opinion of Trump’s idea to send young people back to work and advising vulnerable old people to stay indoors?

Just heard Italy hospitals are turning away anyone over 60:

Israeli medical doctor Gai Peleg told Israeli television that in northern Italy the orders are not to allow those over 60 access to respiratory machines.

https://www.jpost.com/International/Isr ... -60-621856

[some seeing eye]

+1 666 for a source using a log scale

[Canoe]

Canoe: what’s your opinion of Trump’s idea to send young people back to work and advising vulnerable old people to stay indoors?

My opinion isn't worth much. You want the experts opinion. I haven't heard theirs on this.
Unfortunately, with Trump he's likely heard part of something and understood less, but he'll speak his mangled understanding of it anyways.

I can see the logic, but I sure wouldn't want the younger people going back to work until there's been enough isolation time:

• for the Mild cases run their course and no longer be contagious,
• for pre-symptomatic cases to develop and present (and ideally run their course through to non-contagious too), and
• for all or a representative number of cases to be counted so public health authorities know where the clusters are, so they can make informed decisions about when & where to relax isolation measures and by how much.

Doing that before numbers are well known seems like a really bad idea. The numbers of Confirmed reported each day strongly suggest the U.S. is still on testing catch-up, where the increase really means a detection rate, not an infection rate.

Just heard Italy hospitals are turning away anyone over 60:

Israeli medical doctor Gai Peleg told Israeli television that in northern Italy the orders are not to allow those over 60 access to respiratory machines.

Not phrased accurately. Not turning away. Respirator priority.
From what I've read, that's been the triage reality in Italy for some weeks, due to duration of use and outcome expectation. An elderly person would tie up a respirator for up to eight weeks, just to give them a chance. For a younger person, they are much more likely to pull through, and more likely to use the machine for one to two weeks, sometimes longer.
To simplify it, for one respirator: give one person a chance at an iffy outcome vs. likely save three to six, maybe more.
It initially caused some outrage in Italy, with PTSD presenting and expected in the staff making or around such decisions.
Back when I last read about that, it was still on a case-by-case basis. That could easily change in a hospital at any given time depending on their case load.
That's why places in Italy went to using 3D-printed parts when they could no longer source 'approved' parts: And why in the U.S. in places they've already been putting multiple people on a respirator: I've seen accounts of four-per and unsubstantiated reports of eight-per.

[Canoe]

+1 666 for a source using a log scale

I've made them, but I don't find them more useful.
Could you explain how/why?
.

Covid-19 TOP aligned log 2020-03-22.png

[Canoe]

Global Distribution of Confirmed, February 18, 2020 to March 23, 2020.
Data End Of Day is EOD UTC, so the U.S. will still be tallying cases until its EOD.
Unlike CSSE and some others, this includes China's Daily Update for March 23, 2020.
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COVID-19 Global Distribution Feb 18 to March 23 2020.png

[Sham]

According to Trump, this should all be behind us and over by Easter--April 12th. This gives everyone plenty of time to prepare for the 2020 burn. Great news from Washington.

[some seeing eye]

^ April 12 should easily be enough time to get the slush fund through...
Srsly, I would imagine the CrowdRX, hospital, and ambulance contracts are obstructed, to say nothing of the thoughts of ESD volunteers.

[Canoe]

According to Trump, this should all be behind us and over by Easter--April 12th. This gives everyone plenty of time to prepare for the 2020 burn. Great news from Washington.

But I thought this was false news, and over in a few days?

1. In Wuhan and places in Hubei, once people had no more food for their pets, rather than let them starve, they started letting their cats and dogs loose so they could at least try and fend for themselves.
2. The U.S. has more privately owned tigers than there are in the wild. And a fair amount of other big cats. What happens when they run out of food for them?

Could sure cut down on the people not sheltering in place.
Just curious...

th_popcorncat.gif

[BBadger]

1. The U.S. has more privately owned tigers than there are in the wild. And a fair amount of other big cats. What happens when they run out of food for them?

I'm sure the plan is that the grandparents foregoing treatment as their duty to the nation stock market could be used as a food source for the privately owned tigers.

Circle of life and all that.

[The Rod]

Already happened in Russia:
"Vladimir Putin has dropped 800 tigers and lions all over the country to push people to stay home. Stay Safe Everyone!!”

[Token]

When Putin postpones the vote to make him dictator of Russia for the next 20 years ...

... you know this is some serious shit!

Hope y’all didn’t already pay for them tickets. It’s gonna be a loooooong ride.

[some seeing eye]

Interactive map of locial distancing by US county derived from mobile phone data:

https://www.unacast.com/covid19/social- ... scoreboard



History:

[Canoe]

Why the U.S. response was delayed.

[Canoe]

Public Health Responses to COVID-19 Outbreaks on Cruise Ships — Worldwide, February–March 2020

• SARS-CoV-2 RNA was identified on a variety of surfaces in cabins of both symptomatic and asymptomatic infected passengers up to 17 days after cabins were vacated on the Diamond Princess but before disinfection procedures had been conducted
• Available statistical models of the Diamond Princess outbreak suggest that 17.9% of infected persons never developed symptoms
• All persons should defer all cruise travel worldwide during the COVID-19 pandemic.

http://dx.doi.org/10.15585/mmwr.mm6912e3

[Canoe]

P.S.
The U.S. now has more Active cases than Italy.

Italy: 74,386 Confirmed, 57,521 Active, 7,503 Deaths.
U.S.: 64,775 Confirmed (detections still behind), 63,472 Active, 910 Deaths.

The ball park in Wuhan for hospital planning, based on observed cases, was 20% will be Severe, 18% of Severe will eventually succumb. That's 3.6%.

Italy's Crude Fatality Rate went up again today. Now at 10.1%.

[Token]

P.S.
The U.S. now has more Active cases than Italy.

Italy: 74,386 Confirmed, 57,521 Active, 7,503 Deaths.
U.S.: 64,775 Confirmed (detections still behind), 63,472 Active, 910 Deaths.

The ball park in Wuhan for hospital planning, based on observed cases, was 20% will be Severe, 18% of Severe will eventually succumb. That's 3.6%.

Italy's Crude Fatality Rate went up again today. Now at 10.1%.

So what you’re saying; in the US 910 died and 393 are cured?

64775 detected - 63472 active - 910 dead = 393

I know, super-silly and morbid math.

[Canoe]

P.S.
The U.S. now has more Active cases than Italy.

Italy: 74,386 Confirmed, 57,521 Active, 7,503 Deaths.
U.S.: 64,775 Confirmed (detections still behind), 63,472 Active, 910 Deaths.

The ball park in Wuhan for hospital planning, based on observed cases, was 20% will be Severe, 18% of Severe will eventually succumb. That's 3.6%.

Italy's Crude Fatality Rate went up again today. Now at 10.1%.

So what you’re saying; in the US 910 died and 393 are cured?

64775 detected - 63472 active - 910 dead = 393

I know, super-silly and morbid math.

Yes.
Recovered/cured
(My bad. I usually work with graphs and numbers all day, so I just throw out what seems important to me, without including it all...)
Of course, it's dynamic so it's changed now... and not done for the day.

65,652, Confirmed

• 64,327 Active
• 1,325 Resolved
  • 931 Deaths
  • 394 Recovered

Of course with less than 3% Resolved, the Resolved Fatality Rate looks ridiculous at 70.2%.
But the bulk of deaths should be lagging by ~19 days, with more Recovered occurring before that. But testing was delayed, so the numbers will look weird until they catch up. If they catch up.
It used to be most fatalities in the third week, if you got past the fourth you'd likely recover, with the course of the disease up to eight weeks. But with improved treatments, treatments approved or not, and anti-bodies concentrated from survivors' plasma available or not, and the U.S. still ramping up, who knows where things will fall...