“Only Realistic Option” Says Foreign Affairs
Herd Immunity Is the Only Realistic Option.. The Question Is How to Get There Safely say Foreign Affairs authors Nils Karlson, Charlotta Stern, and Daniel B. Klein.
Their articles is entitled Sweden’s Coronavirus Strategy Will Soon Be the World’s
Swedish authorities have not officially declared a goal of reaching herd immunity, which most scientists believe is achieved when more than 60 percent of the population has had the virus. But augmenting immunity is no doubt part of the government’s broader strategy—or at least a likely consequence of keeping schools, restaurants, and most businesses open. Anders Tegnell, the chief epidemiologist at Sweden’s Public Health Agency, has projected that the city of Stockholm could reach herd immunity as early as this month.
In the United States, which has by far the highest absolute number of reported COVID-19 deaths, several states are easing restrictions at the urging of President Donald Trump, who despite bashing the Swedish model, is pushing the country toward something very similar.
Lockdowns are simply not sustainable for the amount of time that it will likely take to develop a vaccine. Letting up will reduce economic, social, and political pressures. It may also allow populations to build an immunity that will end up being the least bad way of fighting COVID-19 in the long run.
Sweden is a special country characterized by high levels of trust—not just between people but between people and government institutions. Swedes were primed to take voluntary recommendations seriously in a way that citizens of other nations may not be.
Uniquely Sweden
“The Swedish experience cannot be extrapolated to support a swift reopening elsewhere,” Goldman Sachs said in a note. “Its population density is about half that of Italy, and Sweden has a high proportion of single-occupancy households, and a relatively low proportion of multi-generational households.”
Open Questions
Discover asks Is Herd Immunity Our Best Weapon Against COVID-19?
One of the big open questions right now is whether recovered coronavirus patients are immune from contracting the disease a second time. “We don’t know yet if having the virus protects you from getting it again,” says Jared Baeten, a professor of medicine and global health at the University of Washington. The World Health Organization has emphasized that we do not know if people who recover from COVID-19 are capable of getting sick again with the virus. “Individual immunity is not yet proven, much less herd immunity,” Baeten says.
When a vaccine does become available, we will only be able to achieve herd immunity if the vast majority of people get vaccinated, Baeten says. Dudley agrees: “The vaccine is our best hope to improve herd immunity [and boost] the number of people that can resist the infection when they’re exposed,” she says.
Sweden Revises Covid Strategy After Deaths of Elderly Spiral
Sweden’s death rate is about 32 per 100,000, compared with 24 in the U.S. and roughly 9 in neighboring Denmark., but most of Sweden’s deaths are in nursing homes.
Bloomberg reports Sweden Revises Covid Strategy After Deaths of Elderly Spiral
Sweden will adjust a key corner of its strategy for dealing with Covid-19, after the death rate at care homes spiraled out of control.
Earlier this month, Sweden said prosecutors had started an investigation into the high death rate at a care home. Half of those over 70 years old who have died from Covid-19 in Sweden lived in nursing homes, according to national statistics at the end of April. As of Monday, the country had registered 3,256 Covid-19 related deaths.
Denmark is now in the second phase of reopening its economy. What’s more, recent data even suggest its infection rate is falling, and its death rate so far is less than a third Sweden’s.
Economically Speaking
Sweden kept more of its economy open but Sweden unlikely to feel economic benefit of no-lockdown approach says the Financial Times.
The European Commission forecasts that Sweden’s GDP will fall by 6.1 per cent this year.
The Riksbank, the country’s central bank, has an even gloomier outlook, estimating that GDP will contract by 7-10 per cent, with unemployment peaking at between 9 and 10.4 per cent. These are disastrous figures for the Scandinavian country.
“It is too early to say that we would do better than others. In the end, we think Sweden will end up more or less the same,” said Christina Nyman, a former deputy head of monetary policy at the Riksbank who is now chief economist at lender Handelsbanken.
Supply Chain
Sweden is dependent on the rest of Europe for parts, and global supply chains are in disarray.
And while Sweden did not officially close, store traffic is way down. In addition, Sweden has few multi-generation homes and less population density than neighboring countries.
Debate Still Rages
All things considered, Sweden did not do as brilliantly as widely acclaimed.
Yet, the debate still rages.
Dangerous Misconceptions
Johns Hopkins calls Early Herd Immunity against COVID-19 A Dangerous Misconception
We have listened with concern to voices erroneously suggesting that herd immunity may “soon slow the spread”1 of COVID-19. For example, Rush Limbaugh recently claimed that “herd immunity has occurred in California.” As infectious disease epidemiologists, we wish to state clearly that herd immunity against COVID-19 will not be achieved at a population level in 2020, barring a public health catastrophe.
Although more than 2.5 million confirmed cases of COVID-19 have been reported worldwide, studies suggest that (as of early April 2020) no more than 2-4% of any country’s population has been infected with SARS-CoV-2 (the coronavirus that causes COVID-19). Even in hotspots like New York City that have been hit hardest by the pandemic, initial studies suggest that perhaps 15-21% of people have been exposed so far. In getting to that level of exposure, more than 17,500 of the 8.4 million people in New York City (about 1 in every 500 New Yorkers) have died, with the overall death rate in the city suggesting deaths may be undercounted and mortality may be even higher.
Some have entertained the idea of “controlled voluntary infection,” akin to the “chickenpox parties” of the 1980s. However, COVID-19 is 100 times more lethal than the chickenpox. Someone who goes to a “coronavirus party” to get infected would not only be substantially increasing their own chance of dying in the next month, they would also be putting their families and friends at risk.
To reach herd immunity for COVID-19, likely 70% or more of the population would need to be immune. Without a vaccine, over 200 million Americans would have to get infected before we reach this threshold. Put another way, even if the current pace of the COVID-19 pandemic continues in the United States – with over 25,000 confirmed cases a day – it will be well into 2021 before we reach herd immunity. If current daily death rates continue, over half a million Americans would be dead from COVID-19 by that time.
Things That Are Clear
- Social distancing works. This is debated but there is no debate. Without human interaction, the virus would not spread.
- Anyone who gets their Covid-19 advice from Rush Limbaugh is truly a sorry case.
Legitimate Debate
- There is a legitimate debate about what it will take to reach herd immunity, assuming it works as believed.
- Meanwhile, there is an ongoing debate about the economic costs of the shutdown, how fast there may a vaccine, what measures are “reasonable”, etc.
Unfortunately, the spread of truly ridiculous ideas drowns out the legitimate debate over what needs to happen and how fast.
I do not know, but nor do the experts.
Closing Permanently
It’s easy for the scientists who have a job to make recommendations about how fast things should proceed, but what do we do with the millions of small businesses owners who are wiped out.
For discussion, please see Closing Permanently “Thank You From the Bottom of Our Hearts”
Mish
Mish & all others quoting generalised data – you pointedly ignore the age skew of the deaths, in every article you post, and talk as if the death rate applies to the whole general population. It does not. Older people die at much, much higher rates, while deaths of healthy people below 50 are negligible. Saying the death rate is 2.5% (to pick a number for example) is not the same as saying that a healthy person below 50 years of age has a 2.5% chance of dying of this virus. That is nonsense and a very poor basis for any policy response.
I found this explanation for the lower death rate in Scandanavian countries. Apparently they all routinely supplement their food with Vitamin D since sunlight is so scarce there in winter, and they would otherwise be deficient. As a result of the supplementation, they tend to have higher levels of Vitamin D.
WildBull, you’re not insinuating that the virus was created and released by our health care and pension systems as a way of reducing their “unfunded liabilities”?
Very interesting. If not true in this instance, a possible case study for future outbreaks.
As for Rush Limbaugh, while he is no epidemiologist, when have any of them been right so far? Limbaugh does not make this stuff up, he gets it from doctors and scientists who are being ignored by the mainstream media. I trust Limbaugh more than Mish. Sorry Mish, but the fear pours out of your writings these days.
One overlooked low risk strategy being used in India & Turkey is the ‘prophylactic’ use of hydroxychloroquine–India in particular has a long history with this drug, & one of the lowest death rates in the ‘top 50 nations’. Anecdotally, lupus patients taking one 200 mg pill daily don’t get the virus–in India, the dose is 2 pills weekly, & in Turkey, the dose is one pill every 3 weeks. The possibility of cardiac arrhythmias from this drug is overblown at best, & non-existent at these low doses. As a physician, I offer my high-risk patients this sensible way to contribute to ‘herd immunity’ without infection. And yes, studies are underway….But there is no downside to implementing this strategy at present.
If studies are indeed underway, and they are done honestly, rather than with a predetermined goal of discouraging use of anything other than some high cost medication like Remdesivir, which did not show very good study results anyway, that would be very good news.
With 30% unemployment, rampant bankruptcy, poverty, stress and despair, how many more per 100,000 will die?
Quite a few people now say that the virus was released from the lab in Wuhan. Isn’t it interesting that it mostly kills people with symptoms of “metabolic syndrome” which is the cluster of chronic illnesses associated with obesity and inactivity. Theses illnesses also pose the greatest long term cost to the health care system. Odd coincidence.
Read something the other day that posited a possible connection between the virus and sugar, which might be why people with diabetes are more prone to getting sick.
“We don’t know yet if having the virus protects you from getting it again,”
“When a vaccine does become available, we will only be able to achieve herd immunity if the vast majority of people get vaccinated”
If having the virus might not protect from getting it again, it would seem that the same would apply to a vaccine.
The whole Sweden discussion is a red herring. You can’t compare Sweden directly the US because there are different demographics, and different policies. Instead, you can compare them directly with other Scandanavian countries which have the same demographics and different policies, or you can compare them with countries like Brazil, which have the same policies, but different demographics. Even then, you can’t complete the comparison until it’s all over. Will Denmark and Norway eventually catch up with Sweden, when a second wave hits this Fall?
Intelligent post.
It is possible to develop a vaccine that does not depend on using dead/attenuated virus particles to spur immune response.
I will believe it when I see it. But anything is possible, one can argue.
Modern medicine is still very limited in its capacity to invent new treatments since PCN.
But can you make people TAKE the vaccine?
Yes, but the protection is not better than actually getting it. Not even veterinarian Corona viruses (less stringent trials) have ever succeeded against a Corona virus.
“The best immunity comes from actually being infected. If this does not protect you, neither will any vaccine. So that part of the discussion is completely bogus.”
Flu vaccines annually, protect better than once having had the flu in 1964…..
Flu vaccines work poorly in the elderly because their immune systems, like many things, are shyte.
Influenza viruses are different all the time. Influenza viruses also mutate much faster than do Corona viruses. Vaccines only work on single variants or closely related ones.
That may well be true. But that doesn’t automatically imply that immunizing a population against a pathogen by way of a vaccination program, somehow works less good, than by having all of them infected.
Just the fact that the possible risks from getting a vaccine, while never a hard zero, is so much less than from contracting a potentially deadly disease, means you can safely structure booster shots etc. to where you obtain much more reliable “herd immunity” from vaccination programs, than from letting the disease itself tear through the population.
I think that they will try.
Cuomo is finding out that a significant number of infections come from individuals that had already sheltered in place.
A bunch of polls and studies tell us that infection rates are far higher than we realise or report.
New evidence, indicates that the virus may have manifested as far back as November 2019 in the USA but likely earlier. X-Rays and blood samples are being reviewed and retested as I type.
Data from the cruise ships as well as the war ship Theodore Roosevelt is very informative and is backed up by polls and tests that have been conducted in the past few weeks across the USA like the test on the waste water plant in Massachusetts. All indicate that the virus is far more pervasive than thought.
Arithmetically speaking, if the virus has already propagated through the population as it is likely it has, blanket lock downs may turn out to be futile.
Expensive and futile.
Expensive not only materially but also in human lives.
It just means lockdown is impractical and has never worked as planned.
Social distance is just an empty slogan.
There seems to be a lot of confusion about Sweden, largely because people conflate herd immunity and infectivity (the R0). Whilst the two are connected they are actually very different things. We have no idea yet whether recovering from COVID grants any immunity to catching & spreading it again. We do know though that behavioral changes have a massive impact on how COVID spreads (hygeine, social distancing, masks, etc). Right now all we know for certain about Sweden is that it has declining numbers of new infections. That means Sweden has an R0 < 1.
An R0 < 1 might mean that Sweden has had a high number of undetected infections/recoveries which is helping to slow the spread (i.e. Herd Immunity). However, Sweden has performed quite a high level of tests, and has not had a high number of deaths overall, so it seems somewhat unlikely that the infection has spread widely or that herd immunity is having much effect there yet. I doubt that even 5% of the population in Sweden has had this yet?
We do know that Sweden has preferential demographics (younger/healthier population, Vitamin E supplements, non-nuclear families, low population density, societal compliance, etc) and that whilst it hasn’t gone for full lockdown it has made substantial changes to how its people behave – bans on large gatherings, social distancing, reduced mobility, etc. It strikes me that the main thing that Sweden has actually done is make sensible and proportionate changes to drive R0 down to below 1.
The simple and concrete fact is that if every country could sustain an R0 below 1 this thing would die out over time, and no new clusters would ever gain traction. That is what Sweden teaches us.
Correct. We also know that other Scandanavian countries have seen unusually low death rates. Thus, we also know that following the Swedish model leads to about 5x more deaths than they saw in Iceland, Denmark, and Norway. Five times higher deaths when you start from a very low level may be acceptable. Would it also lead to a 5x higher death rate if used in US, where the base death rate is already high? Why are deaths so high in Brazil that they are just digging mass graves? Is the US more like Brazil, or more like Sweden?
If Covid 19 is as infectious as they say, we can flatten out the curve, but the area under the curve will be the same, unless we developed a cure.
Otherwise, summer month will eradicate the disease.
Why is no one talking about the actual strategy – manage the virus? Who thinks the strategy was to shutdown forever? We only shut down temporarily because of the CDC’s inability to test. Write about the best strategy – beat the virus – which has worked in China, Taiwan, South Korea, Hong Kong, New Zealand, Australia, and Singapore among other places. California has a “manage the virus” strategy and only shutdown temporarily because of the CDC’s inability to test. In mid-March we only had results on about 1,000 tests per day for a population of 40 million. Now we have daily results on more than 40,000 and growing. Check out the Covid 19 tracking project for daily testing. Newsom has hired more than 20,000 contact tracers and will roll out new technology. He is very popular in CA now. People want leaders who take action and produce measurable results. I can’t stress enough how important it is to frame the debate appropriately. We don’t have to make a crude choice between doing nothing or locking down forever.
I appreciate your clear attempt to write a balanced article. There is a lot we don’t know, that the ‘experts’ don’t know, so lots of room for debate. I don’t agree with you on some of this, but it is neither interesting nor productive to read only articles that agree with one’s own position. Great to have a forum where lots of different views can be discussed freely, from conspiracy ideas to unconventional medical theories to economic analysis.
if we accept some of the numbers in this article that NYC has 15% infected, and that results in 1 in 500 deaths and that we need 70% infected to get herd immunity then for the US we’d be looking at about 3 million deaths. It would really suck if we killed off appoximately 7% of our 65+ population and it turns out you can still get the virus again. not to mention long term health effects which are not understood
As the FT (and you) said, Sweden’s economics also depends on other countries. However, economics is not only about GDP. In the link at the end of this article “Closing Permanently ‘Thank You From the Bottom of Our Hearts’”, it is a story a hair studio was forced to close permanently. The FT article, on the hand, also tells a story about a small shop: “Mickes, unlike most record shops in Europe, is still open for business. The compact store in southern Stockholm, crammed with thousands of vinyl LPs, last week enjoyed a steady stream of customers taking advantage of Sweden’s no-lockdown approach to coronavirus.” I suspect that small businesses are more likely to survive had countries took Sweden’s approach.
What would happen to those records, if Sweden was locked down for two months, like Wuhan?
Once lockdown is over, assuming tastes remain the same, people would go back to wanting to buy records, wouldn’t they? And the records would still be there.
Whether “the economy” gets poorer from lockdown, depends on how many resources the lockdown prevents from being produced, MINUS the number of resources lockdown prevents from being consumed. In addition to a delta arising from consumer preference changes, which leaves pre lockdown resource allocation currently suboptimal.
Many things do decay as they sit there. But most assets of an industrial economy, don’t decay as fast as food pre refrigeration. Real economies are much more resilient than that, by now.
Leaving the very likely possibility that the main “hit” to the economy from the pandemic, is not “lockdowns”, but rather preference changes resulting in pre-pandemic organization of productive means now being very far from optimal. If noone wants to sit close together in restaurants, on cruise ships nor on airplanes, then, yes, there’s an economic “hit.” But not from “lockdowns.” Instead, the “hit” is just a free market’s way of telling participants that different things are valued now, so they should busy themselves supplying what is now wanted, rather than what was wanted before. So you have change, but not in any a priori positive nor negative way. Just change, that’s all.
Stop focusing on deaths. 50% of those hospitalized are not old. These people leave in poor shape. Even those deemed not sick enough to be hospitalized have been found to have lung damage.
Please put your comments in some type of perspective. The flu increases stroke risk. Swine flu causes kidney damage. EBV causes cancer. Shutdown?
Covid-19 is a coronavirus, related to Sars and Mers, among others. I do not believe that there has ever been a vaccine developed for any related coronaviruses. Why would we assume that Covid-19 would be any different? If so, herd immunity — meaning, we’re all gonna get it and either live or die — is the only option left.
Yes, coronavirii are a cause of the common cold. Saw a figure of 25-30%. So while there are very big $ to be made from a vaccine, an effective treatment might be the best bet. If folk can get it and mostly just get flu symptoms, then life can move on. In many countries, such as the US it is now too widespread to control, so time for Plan B
There was a vaccine developed for SARS. It was successful in Phase 1 and 2 trials, but by the time it was ready for Phase 3, SARS was no longer a problem, so no one was willing to pay for the Phase 3 trial. It is technically correct that there was no approved vaccine for SARS, but there is every reason to believe that if SARS would have continued to be a problem, one would be available.
Of course Sweden’s economy will just as hard hit as everyone else’s. If the rest of the world is imploding economically, there’s no way Sweden can avoid getting swept up in that.
You (and Johns Hopkins) missed a significant point – we do not yet know the extent of the population that has been infected. We only know the portion who had symptoms severe enough to require medical care. Much of the discussion is based on erroneous data, namely a false % of people infected.
But some have blind faith in experts who need to feel important.
C’mon now! If someone with a bunch of letters pinned to their name says something, it must be correct,no?
The studies I remember from the west coast (San Diego, I think) suggested that the number of infected was 50-80x larger than those counted. However, even with that type of multiplier, the percent infected in that test area was only 5-10%. Far below herd immunity levels.
It is counterproductive to resort to disinformation and lies to attempt to drive home a point. “Some have entertained the idea of “controlled voluntary infection,” akin to the “chickenpox parties” of the 1980s. However, COVID-19 is 100 times more lethal than the chickenpox. Someone who goes to a “coronavirus party” to get infected would not only be substantially increasing their own chance of dying in the next month, they would also be putting their families and friends at risk.” Unless you are a 75 year-old partygoer with diabetes and emphysema, you are not going to increase your risk of dying by going to such an imaginary party. Why even use such a ridiculous line of argument?
The NYC data as well as data from Sweden and other countries illustrates the low risk of death from COVID-19 in younger healthy people without comorbidities. Even if you are 75 years old without a comorbidity, the risk is very low.
There is no guarantee that there will be an effective vaccine.
““We don’t know yet if having the virus protects you from getting it again,” says Jared Baeten, a professor of medicine and global health at the University of Washington.” How many times have you had the flu?
COVID-19 is a risk for old sick people, that is irrefutable. They have no immunity to the virus. By preventing the future old sick people from developing immunity to the virus, we are condemning them to similar risk.
So if I went to a Covid party and got infected, my elderly father who lives with me would have no risk? How about all of his elderly friends?
Yes, your elderly father would have significant risk if he were obese, had type 2 diabetes, or chronic health problems including respiratory disease like emphysema. But when did we get into the situation where we will shut down the economy to try to protect every life? You father under the above scenarios would also be at risk of dying from the flu, from the swine flu, and from other bacterial and viral diseases, even from wood smoke from your neighbor’s fireplace. Shall we shut down the economy to protect him from every possible threat?
So why is it impossible to not reasonably open up and still be safe? I went to an outdoor restaurant yesterday. It was fairly windy and I sat up-wind from everyone else. My buddy and I sat across the table from each other with a cross-wind between us. The menu and utensils were all paper/plastic and disposable. All seating was at least 6 feet apart.
The waitresses wore masks and disposable gloves. The beer was served in plastic cups. The shrimp platter was properly cooked and served hot. Tables were wiped down with Clorox wipes as soon as you got up to leave. There was a hand-sanitizer dispenser on the wall on the way out.
I wear a mask into every store I go into. If the hired help doesn’t wear a mask, I simply don’t go in. They’re the people most likely to catch this. And if management doesn’t care about them, they’re certainly not going to care about you. I expect to get COVID on my hands from anything I touch. So I minimize touching, and use hand-sanitizer as soon as I get back to my car. I wipe down anything I buy when I get home, and thoroughly wash my hands.
This whole process adds 10 minutes to my day. Not a big deal at all. I don’t have to outrun the bear, I just have to outrun you.
How do you eat/drink with a mask on? Do you think that if you had the virus or someone else near you had the virus that the times where you don’t have you mouth/nose covered could provide entry/exit points for the virus?
Do you read?
Your points were answered in the original post.
australia has been successful at reducing the pandemic and have common sense strategy to release from lockdown.
Herd immunity may end up being the best we can do, but that will result in far more sickness and death. We’re not remotely out of the woods yet, plus we’ll probably have another outbreak this autumn.
It’s going to be a bumpy ride for a while if our strategy is to allow everyone to catch the virus and let the chips fall where they may.
Bumpy ride it is then. The process of dying starts on the moment of birth. Let’s make living worthwhile….out there.
Lots of people are pinning hopes on a vaccine to save us. But we know that the flu vaccines yearly success ranges from 10-60%. And we also know that large numbers of people in the USA (not just the rabid anti-vaxxer’s) refuse to get flu shots each year. That isn’t going to change with a CV19 vaccine. To wit:
Fastcompany
05-09-20
An alarming number of Americans say they will not get a COVID-19 vaccine when it becomes available
As Big Pharma races to develop a COVID-19 vaccine that could save millions of lives globally, nearly 1 in 5 Americans are saying they won’t get vaccinated if and when it arrives.
I’ll wait a year or two. Sometimes things go wrong. If no one is growing antlers in 2022, I’ll get a shot.
Can we all agree to ignore anyone who talks about Sweden’s population density?
It’ll save a lot of time and energy – at no-cost.
“We don’t know yet if having the virus protects you from getting it again,” says Jared Baeten
That is a very, very telling statement. Exactly how is it possible that “we don’t know”? Presumably there have been quite a number of people who have had Covid19 and have survived. And no one has kept track of whether they get it again?
Now, whether immunity lasts for long, or whether the virus is mutating away from natural immunity? Those are other questions. But, if you don’t get immunity, don’t count on a vaccine real soon now.
The antibody question is an important one for sure. This is why I wish China gave honest data, since their longer timeline would show what reinfection rates the rest of the world can expect in coming months.
Individual immunity post infection which lasts 3 seconds, isn’t all that useful for building herd immunity.
And while there may have been a few patients who recovered more than 3 seconds ago, there are precious few who recovered more than 3 months ago. Which is also a bit short, wrt effective “herd immunity.”
I believe Swedens’ strategy fits the best for most of America. Not places like New York/New Jersey, for obvious reasons. America cannot replicate China/Asian countries strategies, due to hipaa. Also, a good number of americans will not self quaratine, even if instructed to do so.
3 articles on Sweden, and you can see Mish is softening on their strategy. Sweden has failed their elderly, but has offered opportunities to their working class youth in the worst pandemic in 100 years.
The c19 lockdown occurred because of a modelled death rate at Spanish Flu levels (like 2-5% of the population). Random antibody testing is suggesting true death rate of 0.2% with the risk concentrated amongst the very old and sick.
Meanwhile, yet again, the Gen Z and Millenials taking the hit for the Baby Boomers and our economy is in danger of a major meltdown. Fed balance sheet going exponential, national debt up what $4 trillion in FY2020. We are dead, economically as a nation if we don’t reopen and soon.
Models? Did someone say models? How about an analysis of the original model?
Code Review of Ferguson’s Model
by Sue Denim (not the author’s real name)
5 May 2020
Imperial finally released a derivative of Ferguson’s code. I figured I’d do a review of it and send you some of the things I noticed. I don’t know your background so apologies if some of this is pitched at the wrong level.
The boomers aren’t even in the high risk group. My mother is, and she is the Silent Generation. I’m not even eligible for SS yet. And the Viral death rate In this county is 0.003%. Yeah, we panicked for nothing.
How much thinner will the herd be to achieve herd immunity?
What’s a few hundred thousand more dead one way or another? Most of them have diseases that have crippled them and left them hanging onto their lives by a thread. 3 million people die in the USA annually. That’s every single freaking year! andno one seems to get very excited about it.
Genomic analysis has one Korean guy bar-hopping and infecting 50 others in a single evening, and potentially exposing 7200 others. Something this infectious and deadly, to the sick and elderly, is utterly incompatible with a “business as usual” economic environment.
Millions of people won’t have to be told to stay home if a half dozen such episodes break out here. We need reliable, accurate testing with quick results, an antiviral cocktail on or near symptom onset that works, and isolation-til-further-notice for the vulnerable. Everybody else needs to get back to work, wearing masks, etc. while there’s still an economy to go back to.
I don’t need no stinkin’ mask!
When I am forced to wear one, I pull it down below my nose,as so many others I see do also or if I think I can get away with it w/o a major confrontation with store employees, I drop it below my chin.
I know this is a new virus but the experts haven’t been right about very much so there’s not much reason to believe anything they say.
Face masks don’t work?
The Who has been a complete failure, maybe intentionally?
The natural vs lab created debate is over
The mortality rate is much lower than any of them predicted
End the lockdown, give the people good honest advice and get on with the show. This virus is here for the duration and the “experts” have almost always been wrong.
How many of the deaths can be laid squarely at the door of the politicians and their lackeys in the medical administration bureaucracy who have restricted HCQ+zinc+azithromyacin as treatment?
My friend in Colorado with covid was treated with that regimen, and cleared up in two days.
Wait a minute… in your prior posts you’re claiming there are no deaths, now your hawking a snake oil cure? Go home, Jared. You’re drunk.
HCQ trials abandoned in several countries due to side effects and no improvement of death rates. Zinc sure can’t hurt, unless in the form of a slab of metal. And the 3rd one is an anti-biotic ??
The story on HCQ is simple. If given early, when the virus is replicating, it helps tremendously. If given late, by the time the patient is hospitalized, and the patient’s heart is damaged, it makes things worse because it can have mild effects on the heart, which would be a problem in an already damaged heart situation. In the US, the only studies have involved patients who were given HCQ late, so as you would expect, it didn’t help. The most telling study, though, was a study from Italy. They looked at 65,000 patients who were already taking HCQ for lupus or arthritis. If they had fared the same as the average people in Italy, you would have expected about 430 cases of Covid19, and about 35 deaths. Instead they found only 20 cases, and not one of those needed hospitalization, much less died. Now that’s a truly remarkable difference!
There is no question that HCQ works, but only if given at the first exposure, or at least, very early, while symptoms are mild. By the time a patient is presenting at the hospital, the virus has already replicated, and it’s time to move on to anti-inflammatories, anti-oxidants, and anti-coagulants.
Here’s an analogy. Say you have a dam, and it starts to leak, will some leak patch help? Well, if you get there early, yes. But if you wait, the leak will grow and grow, and then burst. Leak patch will no longer help. Instead you need to use sandbags and other things downstream to minimize the damage until the dam is reconstructed.
“The story on HCQ is simple. If given early, when the virus is replicating, it helps tremendously. ”
If it was that simple, everyone prophylactically taking a subtoxic swig of the stuff every other day, would end the pandemic…..
“How many of the deaths can be laid squarely at the door of the politicians and their lackeys in the medical administration bureaucracy who have restricted HCQ+zinc+azithromyacin as treatment?”
Eh…, a good bit fewer than the number saved by not partying it up, with whatever weirdo toxic concoction some dude may feel compelled to imbibe, for fun, profit, naivete and superstition…?
So the data that is being used is pretty bad all around. From tests being contaminated to not working to false positives/negatives to goats and fruit testing positive.
The data on deaths varies by country as they are counting them differently. In the USA death “WITH” covid-19 is being counted as death “FROM” covid-19.
So some are suggesting to look for excess deaths which is a good idea. If we are in a true pandemic then we should see more deaths than usual.
“https://gis.cdc.gov/grasp/fluview/mortality.html“
Click New York state and then go through weeks 1 to 16 and then get the “Total Deaths” from the bottom right. First 4 months is 39,005
The yearly data on deaths for New York state are here and 2014-17 average about 120,000 a year
“https://www.cdc.gov/nchs/pressroom/states/newyork/newyork.htm“
So we expect approximately 40,000 deaths in 1/3rd of the year and we have 39,005. Now this doesn’t take seasonal variations, late reporting or other factors into account but it will be interesting at the end of the year to see.
As of now there are no excess deaths in the state of New York. I chose it because it is the worst hit and if excess deaths were going to show up you think it would be there.
Excellent points, TRM.
Has a death count .CSV file for each state by week for 2019/2020.
Yeah, NY has 4 weeks starting late March that peak at a bit more than double the previous year’s norm.
NJ has a triple week peak around the same time.
WA has nothing unusual.
CA is a bit high, similar to early 2019.
LA has an April bump of sorts, if you look closely.
And, the old folks home, FL? Magnifying glass shows a rise. FL is the hero of the USA states, with their demographics, eh?
Given the 80/20 nature of disease-spread, it doesn’t seem overly surprising that the Taiwans of the world have handled this thing’s first round extremely well. Stop super-spreaders. Period. And, perhaps, keep tottering people away from others?
TRM the fluview website has data from prior years for their dataset, so I’m not sure why you’d need to try to find a secondary source, and even the briefest of scrolling through that prior year data says a) the two websites must have different cohorts because the fluview website has around 2k deaths per month last year which is maybe 100k for the year window, and b) there were clearly excess deaths in NY State in April 2020, as Felix_Mish points out in his first line, so hopefully there’s a lesson here about trying to compare two random websites and calling it significant without applying some skepticism to your own conclusions.
“Herd Immunity Is the Only Realistic Option.”
Yup! Pragmatically speaking, given the economic catastrophe, this is the only option. Even if you know that it takes 1 year to eradicate Covid 19, do you mean to say the lockdown should be in place till then. Can we AFFORD the economic destruction?
“Sweden is dependent on the rest of Europe for parts, and global supply chains are in disarray.”
This is the other problem. One country being open in an interconnected world will only help the local businesses like restaurants, bars etc. – they will also be hit due to “social distancing” but their revenues will not be zero.
Presently the course we are on implies the cure is worse than the disease. The world simply cannot afford a lockdwn given its interconnectedness.
At 10x current infection rate with herd immunity@60 % that’s 250k cases everyday for the next 2.1 years.
The IFR would shoot up like a rocket as hospitals filled up. That doesn’t scream spend baby spend.
Hope for a vaccine is the only plan. It’s also the only play.
Another facet to this discussion, and knowing data on infections is erratic , is that the US has higher total infected rate than Sweden per million
Or that Sweden has levelled off at around 500 infected per day per 10 million, and Spain with large restrictions has gone down to a steady near 400 infected per day per 10 million , even as it starts to relax restrictions.
Qatar is taking off and apart from Andorra and San Marino has highest infected rate, but as they are small countries more extensive testing might make them stand out.
Then there is also no way to know if countries that managed to almost eliminate infections won’t have new surges.
That is really just to say there are so many ways to look at all of this.
I agree. It is very inconsistent how aggressively various places have been testing. In some areas they have 40% positive tests, meaning that they are only testing people who almost certainly have it. In my state, I’ve been told I am eligible to be tested, even though I have no symptoms, and no known exposure. In some countries the death rate is running at over 10% of known infections, but in my state, hospitalizations are running at 5% of infections, and deaths at 1%. Now, with less aggressive testing, we could report 1/10 the cases, a 50% hospitalization rate, and 10% deaths.
So, the problem is, how can you compare one area to another, and the answer is that you really can’t. In the end we will need antibody tests before we can do any real comparisons.
This is from Spain just now, so no critical review of the data as of yet
Wuhan is planning a full-population test of 10+ million people in the next two weeks. That may yield some insights into how the pandemic behaves in a high-density large urban area.
Another, less intentional, “experiment” is what is currently unfolding in Singapore. They have high infection rates in what is some of the most dense packed populations on earth, their dormitories. IOW, about worst-case as far as exposure to contagion is concerned.
Yet, at the same time, the population is about best case: Young, healthy workers self selected for a level of healthiness which enables them to do hard labor, with minimal sick days in tropical heat in a dense city with more travel to/from every virus carrying place anywhere. Even when housed in conditions maximally exposing them to any contagious disease.
So far, death rates, or even bad-outcome-rates, among them, remain remarkably low. While Singapore have managed to shield it’s older population very effectively. Which does give some credence to the notion that letting young people partying it up and “keeping the economy running,” while cordoning off the vulnerable, may be a viable strategy elsewhere as well. At least as long as Singapore grade levels of execution can be maintained.
It will take month or two, to see if the remarkably low rates of serious complications persist. But if it does, it does provide at least a glimmer of hope.
If lock-downs, and their unavoidable, cosmic scale economic devastation, were destined to work, New York’s new cases should have collapsed to near-nothing many weeks ago; They didn’t. Cuomo is right; We absolutely must understand why we paid this enormous price for so little. Since we’re obviously guessing, my guess is it’s the air being shared in high density dwelling arrangements. Whatever the reason, it absolutely must be understood and dealt with or no plan will work short of herd immunity with hundreds of thousands more dead.
That would require people to accept scientific outcomes that ran counter to their beliefs. Instead, we’ll shriek and pelt each other with poop, as we always have.
breathing other folks exhalations obviously bad. and enclosed spaces with other folk bad. but I expect it spreads fastest on surfaces. if you are out in the city, shop, office how many things do you touch, every day, that someone else has touched. same as flu or colds, they last a long time on non-porous surfaces such as steel
The idea of ‘herd immunity’ is nebulous. I suspect that a second wave of ‘wu-flu’ (thanks Psalm 876!) will need to be endured before we see any evidence of natural immunity (from prior exposure) in the broader community. Test the thesis, so to speak. I think that it is probable, viz. the Spanish Flu.
Spanish Flu was orders of magnitude more deadly. Not comparable to C19.
The Spanish flu was a joke compared to this.
Without modern medicine the IFR would be nuts. Just think of all the people that would die without oxygen from this thing. Then the amount that would die without antibiotics.
This thing would probably have a 5-15% IFR without modern medicine.
The Spanish flu would be much easier to treat with modern medicine.
Well there would be no Novel Coronavirust without modern medicine either. 🙂
We actually have data on NYC daily fatalities to compare. Covid peaked around 577 deaths per day, 1918 Flu and Pneumonia combined, around 800.
But the 1918 flu deaths were not limited to the elderly in retirement homes. Not comparable.
Even statistical data on the virus is anecdotal at this point in time, because we do not know on reinfection or reactivation, we do not know on length of immunity or to different strains, we do not know on sequelae. Anyone who doesn’t acknowledge that we are in the dark on these is just not thinking. That means we cannot talk of herd immunity, to suggest pursuing it without further knowledge verges on criminal.
However, there are other facets regarding actions taken or to take that do count. Freedom of economy or economic choices , slowing infection rate, protecting most vulnerable, protecting individual rights or freedom, maintaining social stability and structure (even if by non action), moderation of political directions.
So when we talk of Sweden vs US, those are some of what I see as in play, not herd immunity vs. protection from the virus. I wish Sweden fortune and if they eventually show us all also that herd immunity is possible so much the better , though I would not base my own actions on that – and I expect most Swedes all the same would rather be part of the 40% who did not need to catch the virus rather than the 60% who did in that case.
You should take your line of thought to its conclusion. Let’s say 1% of the population died from this in the last 3 months. With reinfection/mutation, it will only take 3 months * 99 for the entire Sweden population to disappear. This assumes zero births however.
Sorry you are utterly wrong. If you get it and don’t die (like over 99% of the people), that means you won’t die from C19. So over 342348234 months, you’ll die from something else. 🙂
If there isn’t some degree of individual immunity after recovery, we are firetrucked.
I’ll flip one of the questions: Are there any other known infections that don’t have some immunity post-recovery?
Common cold is one. The immunity is very short (days/weeks).
Flu immunity also doesn’t last very long. People can get the flu up to three times each Flu season.
Common colds don’t make healthy people with healthy immune systems particularly sick. That indicates that the immune system is perfectly capable of dealing with them. Which suggests that any scheme classifying people as having “no immunity” against them, could stand some improvement.
The same can generally be said of flus. The flu mutates enough to put sufficient pressure on immune responses to be noticeable every so often, but is rarely able to overrun healthy ones.
If there was “no immunity” against flus and colds, severely immunosupressed patients would fare just as well as healthy individuals when infected by them.
Of course, it’s the same story wrt Sars-Cov2: It’s a “new” virus, so immune response is “uncalibrated,” hence less efficient than against previously encountered and defeated pathogens. But it’s not zero, in healthy individuals. The immune system is already primed, to some extent, to respond to even a novel Coronavirus. It’s just not very efficient at it yet.
As a general rule, life is rarely completely either/or. Rather it’s gradations.
It’s extremely unlikely that an adaptive immune system, does not incorporate “any” learnings at all, from contact with a new-to-it pathogen. If you kept reinfecting the same healthy guy with the same dose of an exact clone of the same virus every two weeks, it would be very surprising to see no adpation at all over time.
At the same time, being resource constrained, it would also be counterproductive for the immune system to maintain peak-of-infection levels of highly specific antibodies for decades on end, against a pathogen encountered only once-in-a-lifetime. So it’s really more of a question of how immunity is increased with each exposure, and how the decline curves look after each of them, rather than No immunity vs Completely immune.
People get common cold and flu repeatedly because the viruses mutate. Small mutations still mean it’s a slightly different attacker and the immune system has to develop newer antibodies for the new mutated virus. This is also how a person’s immune system gets strengthened. By exposure to a variety of pathogens the immune system can quickly develop new antibodies for slightly mutated varieties by – guess what? random mutations in it’s own antibodies. i.e. new antibodies.
HIV. It’s different but it answers your question.
We just don’t know yet. We should keep at least some immunity. By definition the second time you get it, it’s no longer novel. So there is that.
TechLover is correct. Catching the Flu doesn’t give you immunity which is why you’re supposed to get a vaccine shot every single year.
Herpes Simplex, Shingles.
The upper respiratory tract is – as far as the body is concerned – part of the external immune system. This is why doctors no longer prescribe antibiotics for bacterial infections of the upper respiratory tract unless you’ve had it for a while and/or the infection finds its way into the “internal” system. They simply aren’t very effective.
There are supposed to be a handful of people who had the disease and got it again. My guess: false positives: they didn’t have it the first time….
It seems if there was little or no immunity you’d have many thousands of people getting reinfected, but I haven’t heard anything to that effect. Does anyone have better information?
Every healthy person will have an immune response. That’s why so many are asymptomatic, their immunity crushed the virus before it had a chance to develop symptoms. Generally, the longer it takes for your immunity to mount a response, the stronger the symptoms will be, but also the longer-lasting the incurred immunity (unless you are immune-suppressed). If we could not mount an immune response against COVID then a)we would all die upon catching it, and b)a vaccine would be pointless, as vaccines merely pre-activate an immune response from the body.
Social distancing works? Governor Cuomo has indicated that 66% of infections were found in folks quarantining at home. That runs counter to your first given, by any definition of ‘working’. In my state we have found that most infections were in planes and large gatherings, but not at even heavily travelled businesses, like Costco. Would you reconsider point 1?
“Americans quarantining at home” simply means they stay at home other than going to groceries, restaurants, parks, etc. It’s also unclear how many of those people live with an essential worker or two.
People calling for reopening also talk about protecting vulnerable people. Well in that case, please suggest options on how to do this? I mean if people who are trained to deal with vulnerable people can’t do it (see all those deaths in nursing homes), what makes these people think that they can do a better job?
Still don’t think this is a lockdown/no lockdown issue. Everyone should just suck it up and wear a mask in public. The more successful Asian countries are doing it, and the number of deaths are way lower than ours and those countries have a lot of old people.
But of course Americans are so dumb, they can only think of TWO options: all open or all closed. No compromise.
The first part of your response restates the proposed lack of certainty about the cause of the 66% of recent infections in the stay at home population. My request is that Mish rethink the accuracy of stating point 1 as something we know.
Mish is like Trump. He almost never backs off on a point he is invested in.
Mish is nothing like Trump. For starters, he’s smart and actually looks at facts. I wish I could say the same for the all of his readers.
Home? Like a REST home?
Social distancing AKA contact limiting works. There is no debate. If you limit your contact with other people your chances of getting a virus infection decrease.
And the 66%? People lie. People in the city live in apartments with contact with others. People have to leave the house on occasion to get staples. Perception is not reality.
There is only one way to make social distancing work and that is to weld people into their homes like was done in China. Otherwise, most people will continue to do like they want.
We don’t even know if it worked in China. Didn’t they just lock Harbin down again, and aren’t they about to test EVERY Wuhan resident (11M people) due to another outbreak?
Folks are not talking about the permanent maiming that afflicts the infected. If you have been hospitalized because of the Wu-Flu you are permanently barred from military service in the USA. I wonder why?