I'm also in CO and had COVID-19 like symptoms about a month ago (fever and GI issues without any other major symptoms for a week progressing into a dry cough/heavy breathing -- completely unlike any other flu I've had). I never got tested due to lack of test kits here in CO at the time and because my symptoms stayed manageable I never saw a health care provider beyond a virtual meeting to get a rescue inhaler.
At the point when my fever started getting more severe is about the same time people were going absolutely crazy buying everything up - my girlfriend couldn't even find a thermometer or medicine to keep my fever down. Luckily I had a friend who overnighted a bunch of supplies to me.
It's really scary to realize there is a possibility that you could die, alone, in a hospital, unable to have family visit. The lowest my blood oxygen got was 89% -- I'm fortunate that if I had CVD19 I seem to have got the "light" version of it and never reached the respiratory distress that would put me in the hospital.
I strongly suspect that the reported infections in CO are off by a lot - it wouldn't surprise me to find out it is/was off by an order of magnitude.
Which would in fact be good news in a certain way, because either it's as deadly as reported and nowhere near as contagious as your last paragraph suggests, or its far more contagious and widespread but thus nowhere near as deadly as is being seen from case fatality rates derived from known cases. I'm not stating anything new with this really, but your case is likely one of many, many others in which a person felt mysterious illness symptoms for days or weeks and never was registered as a positive case through any testing procedure. This is not to even mention all possible asymptomatic cases. I'm sure many COVID-ralted deaths are also under-reported bit I strongly doubt the level of inaccuracy is nearly the same as that of cases being under-reported.
The problem with this interpretation is that whatever the combination of deadly/contagious the virus is, we already have direct evidence that when it spreads without any containment it causes unacceptably extreme amounts of sickness and death. So exactly where the virus ends up on the grid of mortality/contagiousness doesn't seem to be all that important because it is well beyond the frontier of being problematic.
Hopefully in the next few days/weeks we'll get very concrete data on exactly what percentage of people are/were asymptomatic cases, but my guess is it will not be some crazy high number because if so we'd have likely already figured that out by now.
If we go with the highest realistic-seeming estimates of contagiousness and (and thus lowest of deadliness), then we can say that what NY and Italy saw was something close to worst-case. One reasoned estimate had 20% of Italians -- and almost 40% of Northern Italians -- infected in a six-week period.
If that estimate is correct, then even if Italy completely unlocked tomorrow, and held mass hug-ins and cough-ins at every gathering place, it still would probably only get back to as bad as it was 3 weeks ago, and probably only stay there for a month or so.
That would be incredibly tragic, but not world endingly so.
On the other hand, if you take the maximal estimate the other way, and say that Italy and NY at the peak were detecting 1/3-1/2 of their cases (it kinda can't be more than that), then there is the potential for outbreaks 5x as bad and 10x as long unless they stay socially distant until there is a vaccine in widepsread use -- and even so, hundreds of thousands more will inevitably die along the way.
Myself, I think the evidence points to higher contagiousness than this, but the difference does actually matter, even if that still outs us beyond the "threshold of ignorability"
Sweden didn't take no measures. Sweden took flexible measures[1]. Social distancing, allowing anyone who felt sick to stay home, encouraging people to work from home (and 50% Swedes apparently can do that[2]).
The problem is that when American employers grant to no sick leave to employees and are brutally against ever doing so, applying the flexible Swedish model to the US would be extremely hard. The model involves mutual trust and responsibility between the state, employers and employees and there's very little trust there in most other countries.
All I know is that the streets are just as crowded, people are still going out and businesses are still open. There are plenty of news reports showing that.
There is no known method of stopping the spread of this disease. Even if you flatten the curve, without a vaccine, the area under the curve remains the same.
The area under the infection curve does, but not the area under the death curve. The entire point of flattening the curve is to avoid doctors having to ration care due to overwhelming demand.
Fwiw, I'm also in the camp that cases are an order of magnitude off and there is significantly more immunity in the population than we think. However that's a hunch and with out widespread antibody testing it would be irresponsible for anyone to act on such a hunch.
However that's a hunch and with out widespread antibody testing it would be irresponsible for anyone to act on such a hunch.
Wow, it is gratifying to see someone able to say this. Absolutely, with some luck there are a bunch of limiting factors (both that there's are harmless infections, that ) that are going to keep the epidemic from reaching the potential it seems to have "on paper". But these are unknown, these are the major unknowns and acting like we can just guestimate them and be safe is supremely irresponsible since if get it wrong, an order of magnitude more people die. A flu season? Ten flu season? A hundred flu season? Do you really want to roll those dice? To a fair extent, we already are but it's not comforting.
There's never ever going to be enough antibody kits for everyone in the world. Same with the PCR test, its impossible to make so many. The only discussion is going to be about the definition of "wide-spread". Whats yours?
> Even if you flatten the curve, without a vaccine, the area under the curve remains the same.
Not necessarily. The higher the social distancing at the peak, the lower the percentage of infection needed for herd immunity to kick in. Ergo, in effect, lower number of cases. If you drop your R0 by half, your her immunity percentage necessary halves as well!
No, even in your hypothetical case, the disease still continues to infect when you lift the social distancing and the economy re-opens. That is not herd immunity.
It's really too early to say one way or the other because spread of the virus started a different times in different countries. Plus we have to factor in the long term excess deaths that will be caused by lockdown measures. Poverty kills (even in Scandinavia).
Sad as it may seem, you cannot avoid those deaths. Stopping the spread of this disease is impossible. Even if you flatten the curve, the virus will continue to infect just as many, just slowly.
>and Sweden's tactics don't seem to be working that well.
Their healthcare isn't being overwhelmed and that is the only thing that matters in any country at this moment.
There is one problem with what you say about its spread at levels that saturate healthcare systems and cause extreme amounts of sickness and death: They may not be the case so much because the virus is particularly deadly or even much deadlier than the flu -which may indeed be the case: that it's only part of an order of magnitude deadlier than H1N1, we don't know yet until we get more concrete infection rate surveys- but there are reasoned arguments supporting this idea.
Instead it saturates in such ugly ways because it's so contagious (as the comment below this mentions). Thus, highly contagious + entirely virgin population of susceptible people (of all types: asymptomatic, lightly symptomatic, moderately, severely, mortally) will inevitably result in very high infection rates and thus an initial saturation that's also high even if hospital-worthy cases are a small percentage of total known and unknown cases.
This saturation may or may not be capable of getting worse than what we've seen so far in NYC, Northern Italy, Spain and Iran to a lesser extent, but though we don't yet know this for sure, if it is the case, the virus being allowed to spread far and fast will likely cause these bad but possibly tolerable saturations to happen quickly only once, and then simply cease as enough people become immune or at least resistant, and healthcare systems steadily adapt.. So far, it seems that Italy and Spain might actually be close to as bad as it gets even with widespread infection of the population, since credible estimates are presupposing at least 2 million cases in total in Italy at this point, for example. Even in New York there are signs of slowdown already. Again, if that is in fact the worst case scenario in any given region, its cost, as tragic as it is, might be worth weighing against the possibly more catastrophic cost of prolonged quarantine and its resulting economic and social consequences.
We could possibly be delaying an inevitable event with only briefly heavy localized consequences and moderate general clinical consequences by artificially creating a much worse long term problem that kills too, albeit more indirectly and among a wider demographic through missed clinical care appointments of other kinds, depressive suicides, economic ruin, substance abuse and other general population harm factors we can only start guessing at so far.
I believe there have been several random studies and very educated estimates that came from these that show that the mortality rate is about 0.5% or even lower, which might put it close to the same order of magnitude as the flu. However, crucially, it is much much more contagious than the flu. With an R0 of 2 or more (some estimate up to 6) the difference after a few days, because of exponential growth, is as much as a thousandfold more infections.
My thought is that the mortality rate is rather low, especially for those that are healthy, but there's a ton of people that have it. More than 1% of New York State is now infected with Coronavirus. That's crazy.
I have a proble with a single number mortality rate gor this virus, because mortality differs by the two or three orders of magnitude depending on the age. Not an infant and younger than 2 (or even 30)—almost zero chances to die (Italy's data).
Over 70/80? It's 30-40%.
> Which would in fact be good news in a certain way
This holds for the calculus of personal risk ("I'm sick, will I die?"), but not public risk nor policymaking.
Whatever the "true" severity of this disease is, it's known, experimentally, to be high enough to overwhelm regional hospital capacity. That means that it has to be controlled, because if it isn't then a lot of people will be sick without care, and thus a lot more people will die.
It's true that we don't know the "pessimal peak" of case load. Maybe we'd be looking at a doomsday scenario of only 4M people dead globally, and not the 40M the measured fatality rate would indicate. But... who cares? We won't get that high, because we had to lock down even for the "good news" 4M number.
The U.S. has about 600k cases. One order of magnitude more is 6M cases. That's still very far from broadly spreading. It's worrying about the viability of the herd immunity theory (too few people had it), and opening the country soon (a few weeks of exponential case increases would overload hospital capacity, even after stemming the case growth through sheltering-- putting us back to square one). It feels, 1-2 months into this, we have no good options.
At least in Europe the results of quarantine are starting to show results, Italy, Spain and Germany and all seeing a drop in new daily cases and deaths. Spain will allow factories and businesses that can't work remotely to reopen today, although there are concerns it may be too early. Other European countries that imposed quarantine 'ahead of the curve' are not facing any issues in terms of hospital capacity.
That still doesn't explain how opening businesses can avoid infecting many more people. Now certainly but even when infection rates get considerably lower.
A scan of recent news seems to indicate Spain doesn't have anything like a testing program in place.
A look at Italy, Spain, France and Germany seems to indicate the epidemic has plateaued, not stopped and it's plateaued at a fairly high level.
You know if we start to open/close in cycles in theory it's possible that a manageable equilibrium of cases can be achieved while we work out a prophylactic or cure. Capacity everywhere for supplies is ramping up and I imagine once that happens masks will be commonplace and perhaps the stigma around masks will die once a couple hundred thousand Americans do.
I'm in BC, Canada. People are talking about our lockdown going too well. The hospitals are not overwealmed like those in New York. Infections are under control, mainly contained to care homes. But you don't get to herd immunity if the virus does not spread. Vaccines are a year or more away. Holding the lockdown that long would devastate a generation. The government isn't saying it but people are deciding to head out on their own. Outside of urban centers, this Easter weekend looked almost normal.
I was at the grocery store today. Maybe 1 in 10 people had some form of mask. Tomorrow I go to work, where we aren't using masks either. We never did. I have some homemade masks but have never felt the need. There is virus in our area but it just isn't spreading at nearly the predicted rate given our relaxed "lockdown".
You can't enter my grocery store without a face covering. I didn't see anyone strictly enforcing it, but there was a >80% compliance rate, based off what I saw.
In Germany you cannot enter most groceries stores without a shopping cart. It did not used to be that way, they made shopping carts mandatory to stop covid.
If I had a blood oxygen of 89% I would have gone to the emergency room immediately. That's 80 year old smoker with emphysema levels. If you were previously healthy that is far more serious than the "light" covid-19 that many people get, assuming the reading was accurate.
That's what my friend said, too, but it didn't linger there for long and I felt comfortable enough with my breathing that I didn't feel it warranted going to the hospital.
As my symptoms got better it gradually improved and the last time I did a reading it was at 99%, which I think is where I normally am (it's not something I measured before this though).
I only suggest that it was the "light" version because it seems like the advanced cases develop into pneumonia and I definitely didn't have pneumonia. The breathing problems felt no worse than a bad cold to me.
I have asthma and bad allergies, so it could just be that I'm somewhat used to sub-par breathing in general. I also know of some breathing exercises that always seem to help.
Anybody living in CO has already self-selected for being able to adapt to lower oxygen levels, maybe you were at less risk of getting really bad than the average for the US.
I have mild breathing issues during winters, which affects my sleep and I used to wake up with a headache. The fingertip SpO2 meter helps quantify the problem, so it was a good buy. According to my readings, headaches were bad when my readings were 92 or lower. Also helped when my son was having bouts of bronchiolitis when he was younger.
It's only about $50 and batteries last long, so I'd totally recommend it if you have breathing ailments. Maybe even otherwise.
Oximeter. They're cheap, you can grab one on Amazon for $40. My friend who mailed me the medicine supplies (who is married to a doctor) insisted I have it and that I measure it regularly.
> Is this something that people with rescue inhalers also typically have?
I'm not sure. I usually get a rescue inhaler prescribed roughly once a year to help get over a cold. I have light asthma and bad allergies. The breathing here in Denver is definitely more challenging in general as well.
It's a small rural county and they haven't finished processing the tests and it's a couple weeks old at this point and maybe it isn't reliable and so on, but San Miguel County didn't have a lot of people test positive in the 1600 blood tests they have results for.
Professor Victor Davis Hanson is one of America's smartest and most lateral thinkers. If he proposes a theory, it's a good idea to at least think about.
Because of how highly contagious corona virus is, I agree with him. It also matches the Daily Mail article.
I lean towards lockdown as being a rationalization now that we know ventilators don't work with 66% to 90% mortality, and that we (the US) don't have the testing and tracing capabilities to stop a highly contagious disease.
Most people can't separate their personal fear of death with public policy. This seems to go all the way up our political structure.
I have seen those theories that it has already spread <in whatever area> and that is why there aren't the cases now, but I find it difficult to believe from the following reasoning:
1. California has ~40 million people
2. Herd immunity would start at what ~30 million cases?
3. Elsewhere in the world, it seems that there is a ~1% infection fatality rate
So how did California get herd immunity without ~300,000 people who died of pneumonia from an unknown cause piling up in the corridors in a couple of months? I read elsewhere that fatality rate of people on ventilators is about 50%. Assuming that the Californian cohort were treated properly means there would have been ~600,000 people in critical condition and only half of them died. There will be more who went to hospital but weren't considered critical enough for ventilation. Its a rough guestimate but lets say twice as many "non-critical but hospitalized" as "hospitalized and critical" so there were ~1 million people queuing in the hospitals. These figures are pulled out of the air and can be adjusted, but it doesn't really help with the sheer numbers, for example there are ~7000 ICU beds in California, so the 300,000 who might have got better with care wouldn't have had access to it.
It seems obvious that to get to the immunity, you have to go through the eye of a needle.. The basic premise of theories like this seems to be that the fatality rate may be actually negligible and therefore that the whole issue has been overblown. But I have seen video from Wuhan and from Italy and New York that shows images of body bags piled in the corridors. That is not normal and it would surely have been remarked on in California or <whatever area> at the time. Don't forget that Wuhan had ~3000 deaths. Furthermore, California is not an island and for it to have been widespread there that long ago means it would have had to be widespread across the whole USA if not the entire world.
It is tempting I think to believe that <yourself> cannot be affected by <external threat> and obviously, extrapolating from the fact that it never happened before, <yourself> would be entirely correct. Unfortunately history is littered with people who chose to just live their lives like that until the <external threat> came along and wiped them out without blinking. All of us here are the descendants of the lucky ones!
Iceland and a couple European countries did some sample testing studies where they tested a random sample of the population(1-2 %) to see how many people have coronavirus antibodies. Even in Italy in the most affected regions this was only about 10%, on Iceland it was about 1%.
So it's really unlikely large amount of the population anywhere has already had the coronavirus and might be immune without anyone noticing (without you know, all the totally overloaded hospitals and lots of people suddenly dying).
Unsure. I work from home so my exposure to germs is already pretty minimal, however, I did take a trip to SF about two weeks before I showed symptoms. My girlfriend is also a school teacher so she ends up bringing a lot of colds home. She never (and still hasn't) showed any major symptoms other than a small fever that lasted just a day or two a week after we got back from SF (although she could have been an asymptomatic carrier).
At the point when my fever started getting more severe is about the same time people were going absolutely crazy buying everything up - my girlfriend couldn't even find a thermometer or medicine to keep my fever down. Luckily I had a friend who overnighted a bunch of supplies to me.
It's really scary to realize there is a possibility that you could die, alone, in a hospital, unable to have family visit. The lowest my blood oxygen got was 89% -- I'm fortunate that if I had CVD19 I seem to have got the "light" version of it and never reached the respiratory distress that would put me in the hospital.
I strongly suspect that the reported infections in CO are off by a lot - it wouldn't surprise me to find out it is/was off by an order of magnitude.