TO PLAY or NOT TO PLAY... COVID-19

BWGophers wrote:

bird04 wrote:

BWGophers wrote:Just some back of the envelope numbers based on the data released from NY State today:

H1N1 - From CDC - ~60.8 Million US infections, 12,469 US deaths in 12 months, Mortality Rate for those infected = 12,469/60.8 Million = 0.02%

COVID-19 - From NY Antibody Study, estimating ~2.7 Million NY Infections, ~15,000 NY deaths in 2 Months, Mortality Rate for those infected = 15,000/2.7 Million = 0.55%

In other words, COVID-19 mortality rate is somewhere in the neighborhood of 27.5 TIMES more deadly than H1N1, for a similar infection rate (~15%).

Maybe just stop everything in NYC/New Jersey? Cuz those are very non-representative numbers for the rest of the country...easy to cherry pick statistical subgroups within a nationwide sample to get frightening numbers.

I would refer you to the latest vis a vis the relationship between prevalence (the denominator) and mortality (the numerator)...turns out in the Stanford study and, subsequently, the UCLA study, the number of people who have had COVID is under reported by a factor of 50-80 times. If such is the case, and it appears so as the studies definitely were powered correctly by appearance, then the mortality comes in right at the H1N1 numbers. My memory fails me at times as I get older, but I don't remember the nationwide shutdown at the time of bird flu...

So what's the difference and, if there is a difference that we cannot ascertain, the question becomes...do we open up the rest of the country, and if so, how about allowing those at minuscule risk (i.e. healthy young athletes, not the elderly with co-morbidities) back to normalcy. I say yes, as you can tell from the tone of this post. But I would also say that the stats and science back me up on this.

Some reading...

https://www.sciencemag.org/news/2020/04/antibody-surveys-suggesting-vast-undercount-coronavirus-infections-may-be-unreliable

There's also a good article from The Hill on this topic. And plenty more. We as a society are odd about these type things, maybe for good reason...the old precautionary principle, for instance. But any principle taken too far can be harmful in a world of multivariate and competing and equally legitimate interests and facts. A bad flu season kills 80,000 but we rightfully don't shut society down for this relatively low risk, albeit tragic in every instance, annual disease. Nor should we now, at this point, for this one, now that we have some data that says it is much, much more like the annual flu than the Black Death or Andromeda Strain. And awaiting the re-opening of society for the time when we have a vaccine is not policy. It is wishful thinking. Sometimes vaccines are developed right along the Gann charts plotted in the pharmaceutical companies that make them. Other times, it's like the AIDS vaccine....30 years and waiting. So, no, policy cannot be grounded on that.

You are correct.  So I went and ran the numbers.  The Stanford study estimates that Santa Clara county infections are somewhere between 50-80x greater than what is being reported.  Per the Johns Hopkins web site, Santa Clara county currently has 1987 reported cases with 95 reported deaths.  So, using the 50-80x range, that puts the mortality rate at 0.06% on the low side, 0.10% on the high side.  So, somewhere between 3-5 times the mortality rate (0.02%) of H1N1.  Definitely not as severe as the NY data, but definitely not in the same arena as H1N1.

So, can you tell me where DFW fits in this curve?  Do we have a total infection rate close to NY (~15%)?  If so, that'd be great, because with a combined population of 6.6 million in Dallas/Tarrant/Denton/Collin Counties, that means 990,000 have been infected with 150 total deaths so far, or a mortality rate of 0.015%, which is on par with H1N1.  Or, do we have a total infection rate close to LA or Santa Clara counties (~4%), that would mean 264,000 infections in DFW with 150 deaths so far, or a mortality rate = 0.056% or ~3x the mortality rate of H1N1.  Not great, but not NY.  However, what if our current infection rate in DFW is actually less than LA or Santa Clara, say 1% or ~66,000 of us currently have the virus (this is about 10x the total # of current reported cases in the 4 counties), that means the mortality rate in DFW is closer to .22% or 11x H1N1.

Can anyone tell us what the actual infection rate is in DFW?  Can anyone tell us what the infection rate would then become if we relaxed social distancing?

I would argue to you that the answer is currently NO on both cases, so we currently CAN'T say whether COVID is just another bad flu season, or if it's the Black Death or Andromeda Strain.  

So...  back to the original point I made in this thread yesterday...  since we CAN'T say with any level of certainty yet what the true extent and severity of COVID is, because we don't have the testing in place to generate the proper data, I think the general public, businesses, schools, sport entities, etc. are going to be VERY hesitant to open things back up, no matter Trump, Abbott, Patrick, Jenkins, etc. say.

So, to keep total deaths down and not overwhelm our medical ecosystem, you need to be sure you can:
1) Keep down the infection rate via vaccine, and/or expansive/comprehensive testing with rapid isolation and contact tracing, and/or social distancing
and/or
2) Have expansive/comprehensive testing to generate more accurate data to confirm that the true mortality rate is much lower than current data supports
and/or
3) Reduce the mortality rate by having an effective treatment for those that do get infected

I'm all for any and all of these things ASAP. However, until we get at least one of them, I don't think you'll see things open up, no matter our what our elected leaders tell us.

bird04 wrote:All valid points of view. I would add that externalities will soon come into play with regard to overall death rate, or what the actuarials would refer to as "excess deaths", secondary to low unemployment, crime, depression, increased drug/alcohol use, domestic violence...on the other hand, people driving less! So a very complex issue. Agree that we need easy and cheap home testing with a relatively high sensitivity and specificity rate...these are soon to be available and, indeed, to some extent are available under a physician's guidance...once this comes about, it would satisfy Gophers call for clarity with regard to prevalence at any locality...important data to have for herd immunity levels (the gold standard goal is 2/3 "immune")...this is likely to be achieved in some degree by late summer....which brings us to the point of this thread--to play or not to play in the COVID era---I bet we play by fall.
Another factor not mentioned above is TREATMENT...it is, in my opinion, more likely that we soon find some therapeutics that have some efficacy towards treating either the virus itself or ameliorating the effects of the disease to significantly lower the actual mortality. This, too, would be a game changer. If we got the mortality down to about the number of people who die in motor vehicle accidents each year, due to therapeutics, then I would be hard put to listen to those who want to shut everything down until metaphysical certitude regarding this disease is achieved. After all, we have to drive to the soccer fields and Dick's!

BWGophers wrote:
So, to keep total deaths down and not overwhelm our medical ecosystem, you need to be sure you can:
1) Keep down the infection rate via vaccine, and/or expansive/comprehensive testing with rapid isolation and contact tracing, and/or social distancing
and/or
2) Have expansive/comprehensive testing to generate more accurate data to confirm that the true mortality rate is much lower than current data supports
and/or
3) Reduce the mortality rate by having an effective treatment for those that do get infected

I'm all for any and all of these things ASAP. However, until we get at least one of them, I don't think you'll see things open up, no matter our what our elected leaders tell us.

BWGophers wrote:

bird04 wrote:All valid points of view. I would add that externalities will soon come into play with regard to overall death rate, or what the actuarials would refer to as "excess deaths", secondary to low unemployment, crime, depression, increased drug/alcohol use, domestic violence...on the other hand, people driving less! So a very complex issue. Agree that we need easy and cheap home testing with a relatively high sensitivity and specificity rate...these are soon to be available and, indeed, to some extent are available under a physician's guidance...once this comes about, it would satisfy Gophers call for clarity with regard to prevalence at any locality...important data to have for herd immunity levels (the gold standard goal is 2/3 "immune")...this is likely to be achieved in some degree by late summer....which brings us to the point of this thread--to play or not to play in the COVID era---I bet we play by fall.
Another factor not mentioned above is TREATMENT...it is, in my opinion, more likely that we soon find some therapeutics that have some efficacy towards treating either the virus itself or ameliorating the effects of the disease to significantly lower the actual mortality. This, too, would be a game changer. If we got the mortality down to about the number of people who die in motor vehicle accidents each year, due to therapeutics, then I would be hard put to listen to those who want to shut everything down until metaphysical certitude regarding this disease is achieved. After all, we have to drive to the soccer fields and Dick's!

BWGophers wrote:
So, to keep total deaths down and not overwhelm our medical ecosystem, you need to be sure you can:
1) Keep down the infection rate via vaccine, and/or expansive/comprehensive testing with rapid isolation and contact tracing, and/or social distancing
and/or
2) Have expansive/comprehensive testing to generate more accurate data to confirm that the true mortality rate is much lower than current data supports
and/or
3) Reduce the mortality rate by having an effective treatment for those that do get infected

I'm all for any and all of these things ASAP. However, until we get at least one of them, I don't think you'll see things open up, no matter our what our elected leaders tell us.

An effective treatment would absolutely be a game changer, and IMO, would be more important and impactful than anything else on my list outside of a vaccine.  

...and I completely agree with your points about the externalities spawning from this, and the increasing negative impact on society the longer everything is shut down.  If you go through all of my posts, I think you will see that I'm not advocating for keeping things shut down, nor am I advocating for opening things back up.  I'm just stating that until we have more sound data-based evidence that tells us that we can better estimate the infection and mortality rates, and drive one or both of those rates down to a level that doesn't risk multiple Wuhan's, or Italy's, or NYC's from happening across the country, I just don't think you'll see people willing to return to businesses, schools, contact sports, etc., that will put non-family members in close contact with one another.

Foxysoccermom wrote: Those soccer coaches don’t have a problem gettin close contact with me...I might just be the antibody they’re looking for.

9iner wrote:This thread is the exact representation of the back and forth that we have in society.    It comes down to the realist and the doomsday data pushers.  I look at the data and realize it’s just like business, I can make any spreadsheet look good in my favor and support my argument...but the reality is we are not living now.   I go back to my original post, we sheltered in place to not overwhelm the hospitals so they can provide care.  That did not happen at 99% of the places so it should be pretty simple now, take precaution and get back to living or you can choose to stay inside and away from everyone.  This is a soccer board and I want my kids to play again soon but my overall opinion is about the big picture in general.  Personally, I believe the mental health of this will have a bigger impact than the virus itself.   A lot of people’s self worth is tied to the ability to provide for their family.  Now 26 million are w/o a job in the last 5 weeks, where is the line drawn?  What will the data show about increased suicide, depression, divorces, addition etc.  Do we not care about that or are we just wanting are vaccine.  Funny thing is fewer than half of Americas get a flu shot so what makes you think people will get this one? What I’ve come to realize is people are in denial of the evolution of life.  Somehow they forgot that when you are given life the other side of that is death which you can’t control .   Again I’m all for not overwhelming the healthcare system and I’ll gladly continue to wear a mask or whatever else is necessary to get us back to some sense of living.  Part of that living is eventually watching the kids play again sooner rather than later.  We are all on this earth to LIVE not merely survive.  #LFG